highly significantp < 0.001
The mean ages were 44.1 ± 5.5 years in PERI, 52.6 ± 3.9 years in early PM, and 57.7 ± 5.4 years in late PM, with highly significant differences among groups (ANOVA F = 142.33, p < 0.001); post hoc analyses confirmed a stepwise increase (PERI < early PM < late PM, all p < 0.001).