初潮年龄对女性绝经年龄及围绝经期综合征影响的横断面研究

目的分析不同月经初潮年龄对女性绝经年龄及围绝经期综合征的影响。方法:采用多阶段整群随机抽样方法,以在甘肃省居住≥1年的40~55岁女性为研究对象,于2016年3—11月期间展开横断面调查。结果 (1)共调查8 500人,最终纳入分析7 236人。初潮年龄≤12岁者461例(6.4%),13~14岁初潮者2 335例(32.3%),15~16岁初潮者2 838例(39.2%),≥17岁初潮者1 602例(22.1%)。(2)共1 673例女性绝经,平均绝经年龄为(47.9±3.3)岁。随着初潮年龄的增加,绝经年龄增加,单因素方差分析显示组间数据差异有统计学意义(F=12.741,P=0.000),多因素Cox回归分析显示,初潮年龄早是绝经年龄提前的危险因素。(3)随着初潮年龄增加,围绝经期综合征发生率增加,并且中、重度围绝经期综合征发生率增加(P=0.000)。(4)多因素logistic回归分析显示,初潮年龄与围绝经期综合征的严重程度发生无相关性。结论月经初潮年龄越早,绝经发生越早;随着初潮年龄增加,围绝经期综合征发生率增加,初潮年龄与围绝经期综合征严重程度无相关性。     

文化程度及生育情况对女性围绝经期症状的影响

目的:探讨围绝经期女性文化程度及生育情况与其发生围绝经期症状的关系。方法:选取2013年1月—2017年12月在浙江地区相关医院妇科门诊就诊的2 917例围绝经期女性,采用问卷方式调查其基本情况、改良Kupperman评分法评估女性围绝经期症状。结果:最终纳入的2 479例研究对象中,有721例(29.08%)已自然绝经,绝经年龄为(49.42±3.57)岁。不同文化程度女性在绝经年龄、分娩次数、流产次数、妊娠次数、腰臀比、感觉异常、情绪波动、抑郁疑心和性生活问题方面比较,差异均有统计学意义(均P0.05)。不同文化程度、分娩次数和妊娠次数间改良Kupperman评分总分的差异均有统计学意义(均P0.05)。结论:文化程度越低,分娩及妊娠次数越多,改良Kupperman评分总分越高,围绝经期症状越严重。不同文化程度及生育情况的围绝经期女性临床处理应个体化。     

更年期门诊妇女绝经综合征与抑郁症状相关性的初步研究

目的探讨更年期门诊妇女绝经综合征与抑郁症状的相关性。方法将2016年7月—2017年2月期间因围绝经期相关症状在中国福利会国际和平妇幼保健院更年期门诊首次就诊的妇女纳入本研究。调查研究对象的一般情况、健康状况,应用Kupperman绝经指数量表(Kupperman menopausal index,KMI)评估围绝经期相关症状,采用患者健康问卷抑郁量表(patient health questionnaire,PHQ-9)对抑郁症状进行量化评分。结果共计调查153名门诊妇女,平均年龄为(47.3±4.3)岁,月经不规则者占77.78%。73.86%的调查对象患有绝经综合征(KMI6),疲乏(70.59%)、情绪波动(63.40%)、失眠(59.48%)、潮热出汗(56.21%)和骨关节痛(52.29%)是最常见的围绝经期症状;35.95%的门诊妇女存在抑郁症状(PHQ-9≥5)。绝经综合征的严重程度、相关症状的共患程度与门诊妇女是否患有抑郁症状显著相关。多因素分析显示,抑郁症与潮热出汗、失眠、情绪波动、眩晕、疲乏、头痛、心悸、性生活等具体症状的严重程度均有统计学联系。结论更年期门诊患者绝经综合征和抑郁症状间存在明显联系。未来应加强对围绝经期妇女心理健康问题的关注,使更多的妇女平稳度过围绝经期。     

不同绝经状态妇女绝经症状与抑郁状态的临床分析

目的:探讨对不同绝经症状妇女的健康保健措施。方法:366例就诊于更年期门诊的妇女按月经状态分成围绝经期组(n=104)、绝经早期组(n=194)、绝经晚期组(n=68),采用改良Kupperman评分法和自评抑郁量表(self-rating depression scale,SDS)对患者进行绝经症状及抑郁症状评分。结果:改良Kupperman评分异常者占46.99%(172/366),Kupperman评分绝经早期组和绝经晚期组比较无显著差异(t=0.393,P>0.05);绝经早期组、绝经晚期组显著高于围绝经期组(t=2.899,P=0.004;t=2.371,P=0.019)。SDS异常者占11.20%,各组间SDS评分无差异。改良Kupperman评分与SDS评分具有相关性(18.58±9.05vs33.60±9.44,Pearson相关系数为0.599,P=0.000)。结论:绝经症状评分绝经妇女高于围绝经妇女,抑郁评分与绝经症状评分存在显著相关性,故需关注妇女的绝经症状,尤其是抑郁症状。     

医护人员围绝经期情况调查

目的了解北京大学人民医院女性医护人员的围绝经期相关情况及自我认知。方法选取于2012年7月在北京大学人民医院行常规体检的女性职工共596位,年龄在40~60岁之间,以问卷形式调查其围绝经期月经状况、围绝经期症状发生程度以及对围绝经期的自我认知。结果①本次收回有效问卷557份。被调查者平均年龄（46.3±3.7）岁,其中已绝经者63人,自然绝经者45人,平均自然绝经年龄（47.7±4.7）岁;手术绝经（切除卵巢者）10人;药物绝经2人。从出现月经紊乱到绝经平均（1.6±1.5）年;②557名职工中,出现围绝经期相关症状者331人,其中对于更年期症状可治疗表示＂完全知道＂者45（13.6%）;对围绝经期症状＂知道一些＂的281人（84.9%）,表示＂完全不了解＂者5人（1.5%）。绝经远期危害中,知道＂骨质疏松＂者291人（52.2%）,知道＂心脑血管疾病＂者170人（30.5%）,知道＂阿尔兹海默症＂者59人（10.6%）,知道＂反复泌尿系感染＂者162人（29.1%）。所有受调查者中正在使用药物治疗围绝经期症状者69人（12.4%）,其中33人使用性激素类药物治疗（5.9%）,39人使用中药类药物治疗（7.0%）,其中3人两者均用（0.5%）;③557例中有围绝经期症状者331人,占59.4%,平均Kupperman绝经指数为11.9分（量表最高63分）。331人中有症状但未绝经者291人,平均绝经指数为11.1分;有症状且已经绝经者40人,绝经指数为16.5分。在有围绝经期症状的人群中,各项症状发生率从19.9%~77.6%不等。大多数发作者症状为轻至中度,重度者仅占0.6%~3.3%。结论女性医护人员围绝经期状况应引起重视。从事医疗行业女性对围绝经期的自我认知优于一般妇女群体,寻求药物治疗控制围绝经期症状的人群比例也高于一般妇女人群,但仍需加强相关知识的宣传和普及。     

经皮雌二醇凝胶对手术绝经妇女凝血功能、血脂及T淋巴细胞凋亡的影响

目的:研究经皮雌二醇凝胶对手术绝经妇女的凝血功能、血脂、T淋巴细胞凋亡的影响。方法:选取手术绝经、自然绝经1～5年内以及生育年龄妇女各15例,采外周静脉血检测,并分离出T淋巴细胞,用流式细胞术检测细胞凋亡率。手术绝经组共有13例使用经皮雌二醇凝胶治疗3个月,用药前后采外周静脉血检测,并采用"改良Kup-perman评分法"和"绝经期生存质量量表"评估围绝经症状和生存质量。结果:手术绝经和自然绝经妇女的血清E2水平显著低于生育年龄组,FSH水平显著高于生育年龄组(P<0.01),T淋巴细胞凋亡率显著高于生育年龄组(P<0.05)。手术绝经组用经皮雌二醇凝胶治疗3个月后,血清E2水平从(8.38±9.49)pg/ml升至(27.23±24.11)pg/ml(P<0.05),改良Kupperman评分从(19.46±6.70)降至(14.46±4.46)、绝经期生存质量量表评分从(37.31±8.92)降至(23.77±9.69)(P均<0.01);活化部分凝血酶时间从用药前(24.85±1.77)s升至(28.31±3.43)s(P<0.05);甘油三酯水平从(2.56±0.90)mmol/L降至(1.78±0.96)mmol/L、低密度脂蛋白水平从(2.99±0.72)mmol/L降至(2.73±0.58)mmol/L(P均<0.05),T淋巴细胞凋亡率从用药前(14.89±2.28)%降至(13.96±2.38)%,但差异无统计学意义(P>0.05)。结论:经皮雌激素治疗(ET)显著升高了手术绝经妇女血清E2水平,显著改善了围绝经期症状和生存质量,并且凝血功能和脂代谢也有一定的改善。经皮ET有降低手术绝经妇女T淋巴细胞凋亡的趋势,提示低剂量ET可能有保护免疫功能的作用。     

文化程度及生育情况对女性围绝经期症状的影响

目的：探讨围绝经期女性文化程度及生育情况与其发生围绝经期症状的关系。方法：选取2013年1月-2017年12月在浙江地区相关医院妇科门诊就诊的2 917例围绝经期女性,采用问卷方式调查其基本情况、改良Kupperman评分法评估女性围绝经期症状。结果：最终纳入的2 479例研究对象中,有721例（29.08%）已自然绝经,绝经年龄为（49.42±3.57）岁。不同文化程度女性在绝经年龄、分娩次数、流产次数、妊娠次数、腰臀比、感觉异常、情绪波动、抑郁疑心和性生活问题方面比较,差异均有统计学意义（均P＜0.05）。不同文化程度、分娩次数和妊娠次数间改良Kupperman评分总分的差异均有统计学意义（均P＜0.05）。结论：文化程度越低,分娩及妊娠次数越多,改良Kupperman评分总分越高,围绝经期症状越严重。不同文化程度及生育情况的围绝经期女性临床处理应个体化。     

成都市1906名中老年妇女对绝经的认知和接受性

目的 :通过对中老年妇女的绝经状况以及对绝经认识的研究 ,为开展健康保健提供依据。方法 :对成都市城区和郊县的 190 6名 4 4岁以上的妇女进行横断面调查 ,以调查表的形式进行调查 ,对结果进行统计学处理和分析。结果 :调查发现该 190 6名妇女的平均绝经年龄为 4 8 0± 3 8岁。常见的围绝经期症状包括潮热盗汗、情绪不稳定、记忆力下降以及泌尿生殖道不适 ,这些症状的发生 ,在年龄 <5 0岁的妇女明显高于年龄 >6 0岁的妇女 (P <0 0 0 5 )。多数已绝经的妇女认为自己的绝经年龄合适 ,绝经不影响其生活。结论 :妇女在围绝经期前后具有许多健康问题 ,迫切需要健康保健宣传和服务 ,使其平安度过围绝经期。     

更年期女性胆固醇水平调查与影响因素分析

目的研究胆固醇代谢与绝经的关联和可能的影响因素。方法对杭州市拱墅区963例40~60岁女性进行横断面调查,收集其月经史及其他临床资料,填写改良Kupperman更年期症状量表(mKMI),检测血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)水平。收集参与者教育程度、婚姻状态、职业状态、收入、居住地等社会人口资料。研究不同绝经状态女性胆固醇水平及高胆固醇血症、LDL-C升高的发生率,并分析年龄、绝经状态、FSH、E_2、社会人口等因素对血清胆固醇的影响。结果963例参与者平均年龄(51.0±5.6)岁,其中绝经前期302例(31.4%),围绝经期197例(20.5%),绝经后期464例(48.2%),绝经后参与者的平均绝经年龄(49.9±3.8)岁。在所有参与者中,绝经前期mKMI总分(6.36±6.43)显著低于围绝经期(10.30±7.88)和绝经后期(10.35±7.97)(P0.001)。绝经前后平均TC、LDL-C水平呈显著上升趋势,FSH、LH水平呈上升趋势,E_2水平呈下降趋势(P0.001)。所有参与者中高胆固醇血症比例为13.3%,LDL-C升高比例为15.0%,从绝经前期过渡到围绝经期、绝经后期的过程中,高胆固醇血症及LDL-C升高的发生率显著上升(P0.001)。Logistic多元回归分析表明FSH≥40IU/L是发生高胆固醇血症和LDL-C升高的危险因素(OR=2.821,95%CI=1.429~5.569,P=0.003;OR=2.587,95%CI=1.356~4.937,P=0.004),调整FSH水平后,年龄、绝经状态、E_2水平、社会人口因素与发生高胆固醇血症和LDL-C升高均无显著关联(P0.05)。结论相比绝经前期,围绝经期和绝经后女性平均TC、LDL-C上升,胆固醇水平升高的发生率增加,FSH水平升高可能是胆固醇代谢紊乱的内在机制,降低FSH水平可作为绝经激素补充治疗的目标和疗效指标。     

盆底功能障碍症状对中老年女性性功能的影响因素调查

目的调查盆底功能障碍症状对中老年女性性功能的影响及相关危险因素。方法对40～65岁扬州市区在本院进行健康体检的292名女性进行面对面问卷调查。采用盆底功能障碍症状量表简版(PFDI-20)评估盆底功能障碍症状,性功能障碍问卷(PISQ-12)评估性功能。采用多因素回归模型分析盆底功能障碍症状及其他危险因素对中老年女性性功能影响。结果 292名女性中,性功能障碍(PISQ-1230分)者占50.7%(148/292)。绝经(OR=2.89,95% CI:1.33～6.27;P=0.008)和泌尿系症状对中老年女性性功能障碍有影响(OR=1.66,95% CI:1.02～2.70;P=0.040)。结论性功能障碍在中老年女性中多见,泌尿系症状和绝经增加中老年女性性功能障碍的发病风险。     

Menopausal symptoms in a hospital-based sample of women in southern Thailand.

OBJECTIVE: To evaluate menopausal symptoms and quality of life in middle-aged women. STUDY DESIGN: Hospital-based, cross-sectional study. METHODS: A survey was conducted among 270 women aged 45-65 years who attended the gynecological and menopause clinic, Songklanagarind Hospital. We used the MENQOL questionnaire as the instrument. RESULTS: The average age at menopause of the postmenopausal women was 48.7 years (range 40-57 years). The prevalences of the classical menopausal symptoms--hot flushes, night sweats, and vaginal dryness--in the women aged 45-65 years were 36.8%, 20.8 and 55.3%, respectively. The three most prevalent symptoms in perimenopause were aching in muscles and joints, experiencing poor memory, and change in sexual desire. Within the four domains (vasomotor, psychological, physical, and sexual symptoms), more suffering was reported in the perimenopausal and postmenopausal subjects than in the premenopausal subjects (p < 0.001). CONCLUSIONS: Peri- and postmenopausal women had a significant decrease in quality of life compared to premenopausal women.     

Menopausal symptoms and associated risk factors among postmenopausal women screened for the metabolic syndrome

Background Although the frequency of menopausal symptoms may vary according to the studied population, in general severe intensity has been related to lower quality of life. Objective To assess the frequency of menopausal symptoms and involved risk factors in an Ecuadorian postmenopausal population. Methods Postmenopausal women that participated in a metabolic syndrome screening program were interviewed with the Menopause-specific quality of life questionnaire (MENQOL) in order to determine the most frequently presenting menopausal symptoms and correlate these symptoms with socio-demographic data and the main results of the screening program. Results Three hundred and twenty-five postmenopausal women (n = 325) were surveyed with the MENQOL. Mean age of participants was 55.9 ± 8.1 years (median: 54 years). The most frequently presenting symptoms were: hot flushes (53.3%), sweating (49.2%), poor memory (80.6%), feeling depressed (67.4%), aching in muscles and joints (84%), drying of their skin (85.5%), avoiding intimacy (76.2%) and change in their sexual desire (76.5%). Multivariate analysis determined that abdominal obesity was a significant risk factor for presenting hot flushes, depression and muscle and joint pain. High triglyceride levels were associated to higher rates of sweating and depression. While women with basal hyperglycemia were associated to dry skin and changes in sexual desire in a higher proportion, those who were older and with more years of menopause onset were related less frequently to vasomotor symptoms. Older age was also significantly associated in a higher rate to dry skin. Conclusion In this postmenopausal Ecuadorian population, the frequency of menopausal symptoms, as assessed with the MENQOL, was found to be relatively similar to other Latin and non-Latin American populations and associated to age, hormonal status and related metabolic conditions.     

A quantitative analysis of the menopause experience of Indian women living in Sydney

AIMS: To examine the experience of menopause in Indian women (aged 45-65 years) in Sydney, and the relationship between sociodemographic factors and menopausal symptoms, and also to explore the cultural context. METHODS: Two hundred and three women were interviewed about their menopausal experiences in the preceding week using the 29-item Menopause-Specific Quality of Life questionnaire. RESULTS: The mean age of menopause for Indian women was found to be earlier than in other groups in the published literature, at 48.21 years. While there were higher scores for physical symptoms than for other symptoms, and there were significant differences between perimenopausal women and the others, it was found that the prevalence of classical menopausal symptoms was lower in Indian women than that found in Caucasians. However, physical and several psychological symptoms were found to be more prevalent than the usual vasomotor symptoms. Unemployed women and women with a tertiary level of education were found to experience a significantly higher score for all symptoms in our sample. CONCLUSIONS: Lower scores of menopause symptoms indicate that Indian women have fewer complaints of symptoms and a positive attitude towards menopause. Somatic symptoms are multifactorial in nature and could be because of health problems associated with ageing, midlife crises and cultural influences. Further detailed studies could examine the important relationship between cultural lifestyle factors and climacteric symptoms.     

The experience of menopausal symptoms by Arabic women in Sydney.

AIM: To investigate the menopausal experience of Arabic women living in Sydney and to explore the relationship between the psychosomatic symptoms and various sociodemographic factors. METHOD: A cross-sectional survey was conducted among 197 Arabic women aged 45-65 years. The Menopause-specific Quality of Life (MENQOL) questionnaire was used to collect information on sociodemographic characteristics and menopausal symptoms. RESULTS: The median age at menopause in the present study was 49 years (mean+/-standard deviation, 47.9+/-5.0 years). Out of 29 symptoms, the most frequent symptom reported was 'feeling tired or worn out' (86%), followed by 'aching in muscles and joints' (85%). Sixty-three percent of the subjects reported 'hot flushes' and 54% reported 'vaginal dryness during intercourse'. The least prevalent symptom was 'increased facial hair' (35%). Postmenopausal women suffered more vasomotor and sexual symptoms than pre- and perimenopausal women (p<0.05). Women from the sample who were better educated and had a lower body mass index reported fewer and less severe symptoms. CONCLUSION: Menopause-related symptoms among these Arabic women in Sydney were more prevalent and severe than those reported in many other countries and their quality of life was negatively affected by these symptoms.     

The relationship between women’s attitude towards menopause and menopausal symptoms among postmenopausal women

Abstract

Objectives: The purpose of this study is to assess the symptoms of menopausal women as well as the relationship between women’s attitude towards menopause and menopausal symptoms.

Method: This studied, following a cross-sectional method, included 349 selected postmenopausal women attending health care centers. The data was collected using the attitude toward menopause (ATM) checklist and Menopause-Specific Quality of Life (MENQOL) questionnaires.

Results: The most common menopausal symptoms were physical with joint and muscle pain. The highest mean score belongs to vasomotor symptoms (1.37?±?1.43), followed by psychosocial (1.32?±?1.16), physical (1.22?±?0.96), and sexual (0.91?±?0.94) symptoms. Attitude toward menopause was significantly influenced by sweat nights, poor memory, and sleeplessness. The marital status and educational level of the husband were the only demographic factors affecting the severity of menopausal symptoms.

Conclusion: This study provides deeper insights about the relationship between attitudes towards menopause and menopausal symptoms, which can guide health-care professionals towards providing an optimal package.     

Neurovegetative disorders of perimenopausal women treated with docosahexaenoic acid (DHA, 625 mg)

The study evaluated the effect of DHA 625?mg in women who experience menopausal symptoms, on sexuality and quality of life (QoL), and on the auditory brainstem response (ABR). Forty-two perimenopausal women were enrolled. The Kupperman Index (KI) was used to evaluate menopause symptoms. The Short Form-36 (SF-36), Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale (FSDS) were used to assess QoL, sexual function, and sexual distress, respectively. Auditory evoked potentials to measure the ABR. The study had one follow-up at 6 months. The women reported an improvement in the KI total score (p?p?p?=?NS). FSFI and FSDS total scores increased (p?p?p?p?p?相似文献   

Prevalence of menopausal symptoms and quality of life after menopause in women from South India

Objectives: This study was carried out to establish the age at onset of menopause and the prevalence of menopause and menopausal symptoms in South Indian women.
Materials and methods: Three hundred and fifty-two postmenopausal women attending the outpatient clinics of obstetrics and gynaecology department of Dr TMA Pai Hospital, a tertiary care Hospital in South India, were included in the study. The Menopause-Specific Quality of Life (MENQOL) questionnaire was used in the study. Data were presented as percentages for qualitative variable.
Results: The mean age at menopause was 48.7 years. Most frequent menopausal symptoms were aching in muscle and joints, feeling tired, poor memory, lower backache and difficulty in sleeping. The vasomotor and sexual domains were less frequently complained when compared to physical and psychological domains.
Conclusion: The age at onset of menopause in southern Karnataka (India) is 48.7 years which is four years more than the mean menopause age for Indian women. This could be attributed to better socioeconomic and health-care facility in this region.     

The relationship between the duration of menopause and lower urinary tract symptoms in women aged 40 to 59

OBJECTIVE: To evaluate lower urinary tract symptoms in pre- and perimenopausal women. METHOD: Four hundred seventy-one women between 40 and 59 years of age with perimenopausal complaints attending our menopause clinic were evaluated for lower urinary tract symptoms by using the International Prostate Symptom Score questionnaire. The women were categorized by subgroups as being in premenopause, early menopause (1-<5 years' duration) and late menopause (> or = 5 years' duration), and by decade. Statistical evaluations were done by unpaired t test, one-way ANOVA, and simple and multiple regression analyses. RESULTS: The premenopausal women in their forties had more severe lower urinary tract symptoms when compared with early and late menopausal women. In comparisons the nocturia score tended to rise with age. CONCLUSION: Lower urinary tract symptoms appear to be affected by both age and the duration of menopause in women in their forties and fifties, and this observation might be taken into consideration while evaluating this age group for lower urinary tract symptoms.     

Women's perception of sexuality around the menopause: outcomes of a European telephone survey

OBJECTIVE: Women's attitudes and experience towards sexuality around the menopause were investigated in Europe by a telephone survey. In addition, it was qualified to what extent reduced sex drive and vaginal dryness affect personal life, taking into account cultural differences. STUDY DESIGN: A survey on 1,805 post-menopausal women (age range: 50-60 years), experiencing at least one menopausal symptom (hot flushes or sleeplessness) or not menstruating for at least 1 year, was conducted in six European countries (United Kingdom, France, Germany, Italy, The Netherlands, Switzerland) by computer-assisted telephone interviewing. A structured interview analysed menopausal profile, sexuality-related menopausal symptoms, mental well-being and attitudes towards sexuality. RESULTS: Apart from hot flushes or sleeplessness, women particularly experienced sexual symptoms, such as reduced sexual desire and vaginal pain/dryness during the menopausal transition: one third (34%) of the women mentioned experiencing a reduced sex drive whereas one half (53%) of the women noticed that they became less interested in sex in spite of the majority of the sample reporting finding it important to maintain an active sex life (71%). Sex is experienced as an important part of the relationship with a partner, especially for Italian and Swiss women and ageing seems to play a critical role in sexual functioning, particularly for Italian and Dutch women. A general positive attitude toward sex was supported by the evidence that almost half of the study sample reported having sexual contact at least four times a month. Mental and sexual well-being interfered with self-worth and enjoyment of life, as did vaginal discomfort. CONCLUSIONS: These data suggest that European middle-aged women experience the menopause as a process that brings about mood and sexual changes able to impair their personal life. However, cultural values and health beliefs influence perception of sexuality at the time of the menopause and will also influence the need for treatment.