目的:了解我国东、中、西部地区农村妇女的围绝经期现状,为改善农村围绝经期妇女的健康状况和建立农村围绝经期妇女的保健服务模式提供依据。方法:采用整群随机抽样方法,在东、中、西部地区7个省,选取年龄在40~65岁的农村妇女3 500人为调查对象,使用统一问卷进行入户现场调查,获得3 463份有效问卷。结果:55.0%的调查对象已经绝经,东部、中部、西部地区平均绝经年龄分别为49.6岁、48.3岁、47.7岁,地区间年龄分布有统计学差异(P=0.000)。围绝经期综合征的发生率为60.3%,14.8%的妇女反应较严重,中部地区妇女围绝经期有严重反应的比例高于西部、东部地区,对围绝经期知晓的妇女围绝经症状的发生率及严重程度明显高于不清楚的妇女。进入围绝经期的妇女中有626名妇女放置了宫内节育器避孕,147名(23.5%)妇女绝经后没有取出,其中,中部和西部地区妇女绝经后没有取出宫内节育器发生率明显高于东部地区,分别占32.7%和31.9%,地区间有统计学差异(P=0.000)。结论:农村妇女围绝经期保健意识薄弱,容易忽视围绝经期有关的症状及对绝经后安全取出宫内节育器的必要性没有明确的认识。应将妇幼专干、村医、计生专干的工作有效整合与分工,提升在第一线面对面咨询服务的能力,承担起对农村妇女的健康教育与咨询指导责任。 OBJECTIVE: To understand the status of perimenopausal women in the rural areas in the eastern, central and western regions of our country and provide the basis for improving the health status of rural women in perimenopausal period and establishing the health service model for women in perimenopausal period in rural areas. Methods: In a cluster random sampling method, 3 500 rural women aged 40-65 years were enrolled in 7 provinces in the eastern, central and western regions as the survey subjects, and a total of 3 463 validated households were surveyed using the unified questionnaire Questionnaire. Results: 55.0% of the respondents had been menopausal. The mean menopause ages in eastern, central and western regions were 49.6 years, 48.3 years and 47.7 years, respectively. There was a statistically significant difference in age distribution among regions (P = 0.000). The incidence of perimenopausal syndrome was 60.3%, 14.8% of women reacted more seriously, and the proportion of women in central region who had severe reactions during the menopause was higher than that in the west and east regions. Perimenopausal symptoms were known in perimenopausal women Rate and severity were significantly higher than those who did not know. Among the women who entered peri-menopausal period, 626 women had IUD contraceptives and 147 (23.5%) women did not take it after menopause. Among them, the incidence of post-menopausal women who did not take IUD in central and western regions was significantly higher In the eastern region, they accounted for 32.7% and 31.9%, respectively, with statistical differences between regions (P = 0.000). CONCLUSIONS: Rural women have a low awareness of perimenopausal health care and tend to overlook the symptoms associated with menopause and have no clear understanding of the need for safe removal of an IUD after menopause. Efforts should be made to effectively integrate and divide work of women and children in specialized cadres, village doctors and family planning professionals so as to enhance their ability to meet face-to-face consultation services in the front line and assume responsibility for health education and counseling for rural women.