Reviewer ’s report  
 
Title: Is menopause still evolving? Evidence from a longitudinal s tudy of multiethnic 
populations and its relevance to women's health  
 
Version: 0 Date: 14 Jan 2020  
 
Reviewer: Antonio Simone Laganà  
 
Reviewer's report:  
I was pleased to review the Manuscript titled "Is menopause still evolving? Evidence from a 
longitudinal study of multi -ethnic populations and its relevance to women's health" (BMWH -D-
19-00957).  
 
The topic of this Manuscript falls within the aims of Inter national Journal of Environmental 
Research and Public Health. The article provides a valuable and methodologically correct data 
analysis, the conclusion is consistent with data discussion and with available evidence 
throughout the text. The topic of this s tudy is novel, so it may be of great interest for the readers.  
 
In general, the Manuscript may benefit from some minor revisions, as suggested below:  
 
- The Authors did not mention the sample size calculation for their study. It is essential to 
specify thi s data in order to guarantee an adequate significance of the results obtained by the 
Authors.  
- What are the actual clinical implications of this study? it is important to report the results 
obtained by the authors in the context of clinical practice and t o adequately highlight what 
contribution this study adds to the literature already existing on the topic and to future study 
perspectives.  
- I appreciated the novelty of the topic and the interesting findings of this study. In this 
regard, it would be inte resting to discuss the use of nutraceuticals (such as isoflavones) in 
menopause and their impact on metabolic parameters, quality of life and sexual function. More 
specifically, I suggest citing these recent studies about the topic that could help to impro ve the 
paper on this specific point: Prz Menopauzalny. 2018 Mar;17(1):32 -38. doi: 
10.5114/pm.2018.73791; Maturitas. 2018 Mar;109:78 -80. doi: 10.1016/j.maturitas.2017.12.015; 
Gynecol Endocrinol. 2017 Dec;33(12):951 -957. doi: 10.1080/09513590.2017.1332588.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are re quired in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
addit ional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financi ally from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating  to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organiz ation that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of th e above, write 'I declare that I have  no competing interests' 
below. If your reply is yes to any, please give details below.  
 
'I declare that I have no competing interests  
 
I agree to the open peer review policy of the journal. I understand that my name will  be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available unde r an Open Access Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editors, which will not be p ublished.  
 
I agree to the open peer review policy of the journal