Global prevalence of vasomotor symptoms in the menopause transition: systematic review and meta-analysis.

OBJECTIVE: Vasomotor symptoms (VMS) are common symptoms experienced during the menopausal transition. Previous reviews have highlighted regional heterogeneity but have not quantitatively pooled prevalence estimates. This study estimated pooled VMS prevalence across five global regions using a systematic review and meta-analysis. METHOD: MEDLINE, PsycINFO, CINAHL and Web of Science were searched from database inception to January 2025. Population-based studies reporting VMS prevalence among perimenopausal or postmenopausal women aged 40-65 years published from 2014 onwards (minimum sample size of 200) were included. Data were extracted using a standardized template. Random-effects meta-analyses determined pooled prevalence estimates, with heterogeneity assessed using I2. RESULTS: Forty-one studies (n = 28,955) were included. Pooled prevalence estimates ranged from 54.29% in Africa to 74.23% in the Americas and Europe. Heterogeneity was high across analyses (I2 > 97%). Prevalence was higher in postmenopausal than perimenopausal women in all regions except South Asia and nearby regions. Pooled prevalence estimates differed between geographical regions, although substantial heterogeneity suggests these differences should be interpreted cautiously. The heterogeneity observed indicates that biological factors alone do not explain variation in VMS, highlighting cultural and methodological influence. CONCLUSION: These findings support culturally sensitive and context-specific approaches to menopause care and management.