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The purpose of the study was to explore the association of menstrual and reproductive factors with thyroid nodules in Chinese women older than 40?years of age. A questionnaire was completed by 6,571 women aged 40?years or older in a community-based epidemiological investigation of thyroid nodules conducted from June to November 2011 in Nanjing City. Thyroid nodules were measured by ultrasound. The Thyroid Imaging Reporting and Data System score was used to differentiate between benign and possibly malignant nodules. Menopausal age (>55 vs. 40 vs.