Associations between BMI and menopausal symptoms among Danish nurses: A cross-sectional study

Objective: To examine the association between body mass index and the severity of menopausal symptoms among Danish nurses.
Study design: Cross-sectional analysis of the 2024 wave of the Danish Nurse Cohort.
Main outcome measures: Total score on the Menopause Rating Scale dichotomized as no-to-mild (<9) versus moderate-to-severe (≥9), with domain cut-offs applied for somatic, psychological, and urogenital symptoms. Multiple logistic regression models were applied, adjusted for age, smoking, alcohol, physical activity, diet, cohabitation, and age at last menstrual period.
Results: Of 6078 women (mean age 63.5 (standard deviation 9.3) years), 55.8% reported moderate-to-severe symptoms. Each 5-unit increase in body mass index was associated with higher odds of moderate-to-severe symptoms (odds ratio 1.13, 95% confidence interval 1.06–1.20). Domain analyses showed associations for psychological (odds ratio 1.15, 95% confidence interval 1.08–1.23) and somato-vegetative (odds ratio 1.15, 95% confidence interval 1.08–1.22) domains, but not urogenital (odds ratio 0.96, 95% confidence interval 0.91–1.03). Participants with a body mass index of less than 18.5 kg/m2 had lower associated odds (odds ratio 0.53, 95% confidence interval 0.34–0.83) and participants with a body mass index of 30 kg/m2 or more had higher odds (odds ratio 1.24, 95% confidence interval 1.05–1.46) than women with an eutrophic body mass index.
Conclusions: In a large national representative cohort of Danish nurses, higher body mass index was significantly associated with greater severity of menopausal symptoms, particularly psychological and somato-vegetative. These findings highlight the importance of considering weight-related factors when addressing midlife women's health and menopause care.