Attitudes toward menopause in relation to symptom experience in Puebla, Mexico

OBJECTIVE: To examine how attitudes toward menopause were associated with symptom frequencies after controlling for menopause status and level of education. METHODS: Women aged 28-70 (n = 755) were interviewed from May, 1999 through August, 2000 in the city of Puebla, Mexico. Over 90% of the sample were aged 40-60. Participants were asked to select from a set of dichotomies to describe "how a woman feels during menopause." Symptom frequencies were assessed by a checklist of everyday complaints experienced during the two weeks before interview. Symptom presence or absence was examined in relation to attitudes while controlling for menopause status and level of education using binary logistic regression analyses. RESULTS: The majority of respondents said that a menopausal woman feels "insecure" and "unattractive" yet "complete," "necessary," and "successful." Pre-menopausal women and respondents who had undergone a hysterectomy were more likely to express negative attitudes. Post-menopausal women and women with fewer years of education were significantly more likely to report symptoms such as hot flashes, joint aches, and nervous tension. A range of negative attitudes were associated with nervous tension, feeling blue, and head aches; however, only a few negative attitudes were significantly predictive of estrogen-related symptoms (e.g., hot flashes). CONCLUSIONS: There is a high value placed on both external appearance and familial responsibility among menopausal women in Puebla, Mexico, and negative characterizations of menopause reflect these values. Negative attitudes were associated with more frequently reported symptoms compared with positive attitudes. The challenge remains to separate factors related to the hormonal changes of menopause from those not associated with hormonal changes to better understand symptom experience.     

佛山市社区妇女围绝经期健康现状及需求的调查

目的:了解佛山市社区围绝经期妇女的健康状况及其保健需求,为构建新型社区卫生服务模式提供决策依据。方法:用整群随机抽样方法,选择佛山市社区308名45~60岁妇女为调查对象,以Greene症状量表和自编问卷形式进行调查。结果:佛山市社区妇女自然绝经年龄平均47.9岁,现患病前4位顺位分别是心血管疾病(20.10%)、骨关节疾病(12.70%)、高脂血症(8.10%)和子宫肌瘤(7.50%),围绝经期综合征的发生率为68.80%。最为痛苦的前4位症状是:烦躁54.20%(115/212),失眠52.36%(111/212),肌肉、骨关节疼痛48.10%(102/212),容易疲劳和乏力46.20%(98/212),有关"绝经的原因、绝经的远期影响、保健措施、骨质疏松的危险因素"等正确回答率均低于23.10%。结论:围绝经期综合征及相关疾病严重地影响围绝经期妇女的身心健康,应提供全方位的保健服务。     

深港两地围绝经期妇女健康状况调查

目的:了解深港两地妇女围绝经期综合征的患病情况及其相关因素。方法:在深圳市罗湖区、香港各随机整群抽取一个社区,采用统一的调查问卷,对40～60岁围绝经期妇女进行调查。结果:在418例被调查者中,出现围绝经期综合征者225例,发生率为53.83%,其中以骨关节痛、失眠、烦躁易怒、潮热出汗、容易疲劳或乏力、性欲下降等症状表现较为突出;血管舒缩症状、骨质疏松症状深圳妇女高于香港妇女(P<0.01),而精神神经症状香港妇女高于深圳妇女(P<0.01);随着绝经的来临和年龄增长,围绝经期症状的发生率呈增高趋势(P<0.01)。结论:围绝经期妇女的健康问题不容忽视,应加强围绝经期妇女的保健工作,缓解症状,改善生活质量。     

潍坊市部分围绝经期妇女相关症状与性生活情况调查

[目的]了解围绝经期妇女相关症状、性生活状况，为今后更有针对性地开展围绝经期预防保健工作提供依据。[方法]对2007年9月至2008年5月就诊于潍坊市某高等学校门诊的180名40～60岁妇女进行调查。[结果]调查的180人中，已绝经的占37．78％。自然绝经者所占比例，40～45岁为14．29％，46～50岁为21．43％，51～55岁为65．91％，56-60岁为90．00％；绝经时年龄为（49±5）岁。调查180人中，已出现更年期症状的占82．22％。更年期症状发生率，40-45岁为66．67％，46-50岁为95．24％，51～55岁为75．00％，56～60岁为70．00％（P〈0．01），出现更年期症状时的年龄为（47±5）岁。出现更年期症状的148例中，64．87％有潮热出汗，66．22％有烦躁易怒，44．60％有阴道干燥，43．92％有疲乏失眠，16．89％有心慌，12．84％有骨关节肌肉痛，18．92％有性欲下降，接受激素治疗的占18．92％。[结论]更年期妇女的相关症状主要是烦躁易怒、潮热出汗、阴道干燥、疲乏失眠、性欲下降。70％以上有性生活。     

The use of complementary and alternative medications by menopausal women in South East Queensland.

This study aimed to identify the prevalence and types of complementary and alternative medications (CAMs) used by women during menopause and explore potential associations between CAM use and menopausal symptoms. Analysis was undertaken with 886 randomly selected menopausal women aged 47-67 years who participated in a postal questionnaire on the menopause experience. The prevalence of CAM use was relatively high (82.5%), with nutrition most commonly cited (67%), followed by phytoestrogens (56%), herbal therapies (41%), and CAM medications (25%). Multivariate analysis adjusted for confounders revealed that women who consumed CAM medications were 17-23% more likely to report anxiety (p = .019) or vasomotor symptoms (p = .013). Women who used herbal therapies (p = .009) or phytoestrogens (p = .030) were 13-16% more likely to experience vasomotor symptoms. Women who used nutrition were 18% more likely to experience anxiety (p = .049). These results highlight the importance for health professionals to incorporate CAMs into their practice to better inform menopausal women of their treatment choices.     

丽水地区农村围绝经期妇女健康状况和保健需求研究

目的:了解丽水地区农村围绝经期妇女的健康现状和保健需求,为改善农村围绝经期妇女健康状况提供帮助,为建立农村围绝经期妇女保健服务模式提供依据。方法:采用多阶段随机组群抽样方法,选取丽水地区农村40～55岁的妇女540人为调查对象,使用统一问卷进行入户现场调查。结果:在540例接受调查的妇女中,月经正常或基本正常306例,月经紊乱119例,绝经115例,自然绝经平均年龄为(49.21±2.18)岁。围绝经期综合征发生率为78.1%,主要症状为骨关节肌肉痛380例,失眠355例,头痛316例,头晕心悸316例,烦躁不安281例,易激动292例。不同年龄组别之间的妇女生存质量状况比较差异均有统计学意义(P<0.01)。只有17.4%妇女了解围绝经期知识,围绝经期激素补充治疗(HT)率2.4%;仅有35.6%的围绝经期妇女1～2年内有过健康体检。结论:丽水地区农村妇女保健意识薄弱,围绝经期综合征发病率高。开展农村妇女围绝经期的全科医疗卫生保健服务,加强围绝经期综合征的综合防治,有利于提高农村妇女的健康水平和生存质量。     

更年期门诊患者的社会人口统计学调查

通过对 1998年 7月～ 2 0 0 0年 7月 5 0 3名在我院更年期门诊就诊的围绝经期、绝经后期妇女进行问卷式社会人口统计学调查 ,并参照其他国家和地区的调查报告进行分析 ,以了解我国的现状及为围绝经期和绝经后期妇女保健工作提供参考。被调查者的年龄为 3 5～ 82岁 (包括外科手术绝经和卵巢早衰绝经者 ) ,平均年龄为 5 1.9± 7岁。4 1.0 %小于 5 0岁 ;3 5 .0 %为 5 0～ 5 4岁 ;12 .0 %为 5 5～ 5 9岁 ;12 .0 %超过 60岁。绝经年限 :5 1%处于绝经过渡期 ;4 9%为绝经后期 ,其中绝经 1～ 5年者为 18% ,6～ 10年者和超过 10年者分别为 16%、15 %。其中有 3 8.8%为手术绝经。教育水平 :5 5 .5 %为大学毕业 ;4 0 .0 %为高中毕业 ,4 .5 %的教育水平相当于或低于小学水平。     

Prevalence and clustering of menopausal symptoms in older women by hysterectomy and oophorectomy status

This study examines the association of hysterectomy and oophorectomy with the prevalence and clustering of menopausal symptoms in a large population-based sample of older women. Subjects were 1121 women aged 50-89 from the Rancho Bernardo Study. Information on menopause, hysterectomy, oophorectomy, estrogen use, and other covariates was obtained in 1984-1987. A 1989 mailed survey obtained information on menopausal symptoms. In this sample, 22.1% reported hysterectomy with bilateral oophorectomy, and 25.3% reported hysterectomy with ovarian conservation. Mean time since hysterectomy was 26 (+/-12) years. Overall, 37% reported current estrogen use, and 40% reported past use. The duration of estrogen use was longer for women who had a hysterectomy (p < 0.001). Age-adjusted comparisons indicated that more women who had a hysterectomy, with or without bilateral oophorectomy, reported greater energy after menopause (p = 0.003 and p = 0.001, respectively), and more women with bilateral oophorectomy reported greater interest in sex (p = 0.007) and that life was getting better (p = 0.012) than women with natural menopause. Principal components factor analysis of the symptom data for all women yielded four factors: psychological, vasomotor, positive feelings, and self-image. Analyses performed within each group of women yielded similar factors and loadings. Adjusted comparisons of factor scores indicated that positive feelings were significantly higher in women who had a hysterectomy, with or without bilateral oophorectomy (p < 0.01) than in women with natural menopause. This difference was limited to current estrogen users. Vasomotor symptoms, psychological symptoms, and negative self-image did not differ by hysterectomy or oophorectomy status before or after stratification for estrogen use (p > 0.10). This study found after a hysterectomy, women are more likely to recall positive feelings about their menopause than women with natural menopause. Relief from symptoms leading to hysterectomy and use of replacement estrogen may be partly responsible. Results do not support the thesis that surgical menopause is associated with a sustained increased prevalence of vasomotor, psychological, or other symptoms.     

Is early natural menopause a biologic marker of health and aging?

The relation between age at natural menopause and all-cause mortality was investigated in a sample of 5,287 White women, ages 55 to 100 years, naturally-postmenopausal, Seventh-day Adventists who had completed mailed questionnaires in 1976. The age-adjusted odds ratio of death during 1976-82 in women with natural menopause before age 40 was 1.95 (95% confidence interval = 1.24, 3.07), compared to the reference group of women reporting natural menopause at ages 50 to 54. Corresponding odds ratios of death were 1.39 (95% CI = 1.06, 1.81) for natural menopause at ages 40 to 44, and 1.03 (95% CI = 0.84, 1.25) for natural menopause at ages 45 to 49. Among 3,166 White, 55- to 100-year-old, surgically-postmenopausal, Adventist women, there was no relation between age at surgical menopause and mortality. Logistic regression analyses indicated that findings from this study were apparently not due to confounding by smoking, over- or underweight, reproductive history, or replacement estrogen use.     

更年期妇女骨骼健康状况的流行病学调查

目的：了解上海更年期妇女骨骼健康状况及城乡差异。方法：1996年8月～10月对卢湾区瑞金街道和浦东新区黄楼乡40～60岁的各1000名妇女进行流行病学调查。采用统一问卷，调查一对一当面进行，并有专业人员进行体格检查，调查表格专人审核后输入AST／486计算机运用SPSS软件进行分析。结果：上海市妇女平均绝经年龄为城市49．22岁，农村48．51岁．全市48．82岁。城市妇女饮食结构较合理，但有一半妇女无乳类摄入；农村近一半以素食为主，97％的妇女无乳类摄入。骨骼系统症状（排除肿瘤、炎症、外伤）以腰痛最常见，其次为关节痛。身高下降自40岁开始，50少后一半妇女身高下降。年龄越大，骨骼症状越多，骨折发生率40岁时为2．79％，50岁时7．2％，55岁后16．72％。绝经者症状发生率显著高于未绝经者，骨折发生率是后者的3～4倍；农村地区的骨骼症状发生率显著高于城市，且平均发生年龄较城市早2．6岁；荤菜摄入充分及经常摄入乳类者，骨骼症状发生率轻于以素菜为主，乳类摄入少者，且发生年龄迟，差异有显著意义。结论：骨骼代谢疾病与雌激素水平、饮食结构及乳类摄入密切相关。早期诊断，生长期加强营养和体锻，提高骨量峰值及激素替代疗法是预防骨质疏松的最有效、最重要的措施     

Middle-Aged Women's Experience and Perceptions of Menopause

The purpose of this study was to examine, women's perceptions of menopause, and their relation to physical symptoms, psychological and socio~ultural variables. Physical symptoms and experiences described by women during menopause vary greatly among individuals. Numerous theories have been proposed as to the reason for the variations among women. This study consisted of a survey of 40-60 year old women. Questionnaire items investigated altitudes, physical symptoms, and demographic characteristics, including ethnic and cultural background, educational level, work and career orientation, mother's experiences with menopause, age of menarche, marital status, number of children, and socio-economic status. Relation- ships were examined among the demographic variables, physical symptoms, and attitudes toward menopause.     

更年期知识女性健康促进干预的研究

目的:通过对更年期知识女性进行自身对照的健康促进干预研究,评价干预措施对提高生存质量,探索改善更年期人群健康状况的行为模式。方法:采用分层整群抽样的方法,自贵阳市不同行业中抽取40～60岁大专或中级职称以上的女性679名为研究对象,同时在同单位选择40～60岁大专以下文化程度妇女100例为对照组,采用世界卫生组织生存质量量表(WHO-QOL-BREF)进行健康体检,根据健康体检结果整理出促进健康的干预模式,随机抽取研究组部分自愿参加该研究活动的更年期知识女性共计122名,进行为期1年健康促进干预,1年后用相同的量表复测生存质量及健康检查,两次测定结果进行比较。结果:更年期知识女性生存质量较对照人群低。通过实施健康促进的干预措施:膳食指导、体育锻炼指导、心理咨询、定期的健康教育讲课以及针对干预对象所患疾病的防治等健康促进措施后,更年期知识女性的生存质量得到提高,差异有显著性(P<0.05)。结论:健康行为干预对改善更年期知识女性生存质量是有效的,健康促进干预模式值得深入探讨。     

Gynecology and sexuality in middle-aged women

In Sweden and other Western societies, the number of women above the age of 40 is increasing and health and well-being of middle-aged women is an increasing matter of concern. This study examines menstrual histories, gynecological operations, urinary incontinence, and reproductive functions in a representative sample of middle-aged women, as well as the frequency of climacteric symptoms and how to predict the women at risk for acquiring these symptoms. The sexuality of the mature woman as also explored. Women aged 37 to 66 years were randomly selected from the Census Register in Goteborg, Sweden. The bulk of information was obtained by means of questionnaires. Among the findings are that the median age for natural menopause was 50.9 years. Forty percent of the postmenopausal women reported frequent vasomotor symptoms. The occurrence of climacteric complaints is strongly connected to psychosocial variables. Every tenth woman reported frequent urinary leakage. Fifty-three percent of the women had undergone a D&C and 9% were hysterectomized. The woman around 40 reported few sexual partners (median 3) and her first intercourse occurred at age 18. Extramarital sex was uncommon. The masturbation rate was low and the frequency of homosexuality was extremely low. The majority of women had experienced orgasm.     

Menopausal symptoms and related factors among Cambodian women

ABSTRACT

This study analyzed the prevalence and severity of menopausal symptoms and associated factors among Cambodian women. A cross-sectional study was performed with 200 women aged 40–60 years in three provinces and one urban area in Cambodia from July 2017 to August 2017. Three symptom categories: somatic, psychological, and urogenital symptoms (totaling 11 symptoms) related to menopause were assessed using the Khmer version of Menopause Rating Scale (MRS). Over one-fifth (21.5%) of the participants were premenopausal; 22.5% were perimenopausal, and 56% were postmenopausal. Somatic and psychological symptoms occurred more frequently than urogenital symptoms in all three statuses. The three most prevalent symptoms for all women were physical and mental exhaustion (88.1%), irritability (85.9%), and sleep problems (82.5%). The average MRS score was 12.22 ± 5.37 (range 0–44). Postmenopausal women had significantly higher rates of menopausal symptoms than pre- and perimenopausal women. Increased severity of menopausal symptoms was associated with less personal income (≤100 US$), higher parity (>4 children), abortion(s), use of calcium supplements, and history of heart disease and rheumatoid arthritis. This study demonstrated a high prevalence of menopausal symptoms among Cambodian women in Cambodia. A multidisciplinary approach is needed to deal with independent factors associated with these symptoms.     

Treatment of menopausal symptoms--review of the current literature

Although the expected mean age of women increased significantly in the 20th century, the time of menopause has not changed (age of 50-51 years). Women's life span in Hungary is 77.2 years, which means, that one third of their lives is lived in menopause. Aging and the consequent lack of estrogen means a more and more serious problem on social level as well. In Hungary there are approximately 1.8 million women above the age of 50. Only an insignificant part of them is treated, which is about 5%, compared to other European countries, where this ratio is between 5 and 25%. Menopause-related symptoms can be divided into the following groups: vasomotor symptoms (sweating, hot flashes, palpitation), decreased psychic and physical functions (fatigue, depression, panic disease, cognitive problems, decreased libido), cardiovascular diseases (ischaemic heart disease), endometrial atrophy, bone and articular alterations (osteoporosis) and urogenital symptoms (vaginal dryness, incontinence, cystitis). The most frequent symptom is hot flashes, which is characteristic of more than 60% of women in menopause. Osteoporosis after the cardiovascular diseases is the second most serious problem on public health level. Approximately 9% of the Hungarian population suffers from osteoporotic problems, which concretely means 600.000 women and 300.000 men. The most frequent fractures are the hip and vertebral fractures. In 1999, 15.100 hip and 51.000 peripheric fractures occurred in Hungary. The above mentioned symptoms, even separately, may decrease the quality of life, therefore their treatment and the knowledge of all of the therapeutic possibilities are essential.     

社区更年期女性自我保健意识现状调查

目的了解社区更年期妇女对更年期症状、更年期保健知识、态度和行为的知晓情况,为开展更年期妇女的保健及健康教育提供参考依据。方法用随机整群抽样的方法,选择200名分别在济南市天桥区、槐荫区及其周边郊区的44—55岁妇女,以问卷形式进行调查,询问有关更年期症状相关了解情况及保健知识。结果平均绝经年龄为45．67岁,以询问法获得的更年期症状发生率51．5％。68．5％的妇女知道有关的更年期保健知识,农村妇女的知晓率明显低于城市妇女,两者差异有显著性（P〈0．05）。在城乡更年期妇女中,有36．3％人去医院就诊,有47．9％人在控制饮食方面较强,48．0％人经常锻炼身体。结论更年期女性缺乏更年期保健知识和保健意识,存在不健康的生活方式。因此,应加强有关更年期保健的健康教育并提高自我保健意识。     

武汉市妇女绝经相关因素的调查

目的评估武汉市40~65岁妇女自然绝经过程中绝经相关症状的发生及影响因素。方法选取2014年4~10月武汉市参加年度健康体检、年龄40~65岁的956名妇女为调查对象,采用问卷形式调查妇女的基本信息、月经状况、运动锻炼情况、重要躯体疾病以及围绝经期相关症状,用Greene评分法评估绝经症状,分析绝经症状的发生情况及影响因素。结果月经不规律妇女出现的得分高的前五位绝经相关症状是:感到疲惫或精力不足、失眠、感到头晕或无力、潮热、肌肉或关节酸痛(P0.05);得分高的常见的症候群是:焦虑症状、躯体症状、抑郁症状和血管舒缩症状(P0.05)。绝经后妇女出现的得分高的绝经症状是:失眠、潮热、感到疲倦或精力不足和肌肉关节酸痛(P0.05);常见症候群是血管舒缩症状和性生活问题(P0.05)。躯体疾病对5种绝经症候群均有显著影响(P0.05);40~50岁者较61~65岁者更易有抑郁症状(P0.05);体质量指数增加更易有血管舒缩症状(P0.05)。结论绝经症状在绝经的各个阶段侧重表现不同,慢性躯体疾病是绝经症状的不良影响因素。     

Vasomotor symptoms are not associated with reduced bone mass in postmenopausal women: the Rancho Bernardo Study

The association of menopause-related vasomotor symptoms with later bone mineral density (BMD) at axial and appendicular sites was examined in community-dwelling older women. Subjects were 894 postmenopausal women from the Rancho Bernardo Study who had BMD measured in 1988-1991 and responded to a 1989 mailed survey that included questions about menopause symptoms. Mean age was 73 years (SE +/- 9.5, range 47-97), and mean age at menopause was 47 years (SD +/- 6.8, range 21-62). Vasomotor symptoms were recalled by two thirds (68%) and night sweats by 36% of all women, with no significant differences in symptom frequency by age or type of menopause. Postmenopausal estrogen (PME) had been used by 644 women (72%) for an average duration of 12.3 (+/-11) years. Among women who reported current estrogen use with a duration >3 years, those who experienced vasomotor symptoms had significantly higher BMD at the lumbar spine (p = 0.01), femoral neck (p = 0.05) and midshaft radius (p = 0.05) compared with women who did not experience symptoms. Vasomotor symptoms were not associated with BMD among past or never PME users or among women who reported current PME use for 3 or fewer years. Analyses stratified by age, type of menopause, or when PME use began showed similar results. Women who reported night sweats also had no difference in BMD compared with women without night sweats. In conclusion, vasomotor symptoms are not a marker for low BMD years after menopause in women with access to healthcare. Vasomotor symptoms significantly increased the likelihood of continued use of PME, which was in turn associated with higher BMD levels.     

青岛市围绝经期妇女健康状况调查

目的:了解青岛市围绝经期妇女健康状况,为制订相应的保健措施提供依据。方法:采用整群随机抽样方法,选取青岛市城郊1 600名35~59岁女性作为调查对象,进行围绝经期相关健康状况的流行病学调查。结果:妇女平均绝经年龄为(49.70±3.35)岁,84%绝经前发生月经紊乱。常见的围绝经期症状为情绪波动、潮热出汗、性生活异常、失眠、疲乏,发生率分别为36.75%、34.94%、33.19%、32.38%、31.25%,症状的发生率有年龄差异,且随年龄的增长呈增加趋势。绝经的低骨量发生率为61.70%(29/47),明显高于未绝经的9.90%(10/101)。体重指数(BMI)随年龄而增加,45~59岁BMI均数>24;慢性疾病发生率也随年龄而增加。55~59岁潮热发生率高达64.26%。年龄大、生活压力大、文化水平高、吸烟、绝经、患有慢性疾病等是影响症状的主要因素。性激素周期序贯法治疗围绝经期综合征,Kupperman评分和抑郁自评量表评分明显降低。结论:积极开展健康教育,加强自我保健,规范应用性激素,是提高围绝经期妇女生活质量的重要措施。