598例妇女围绝经期症状调查

目的:了解围绝经期妇女的有关围绝经期症状及相关症状年龄分布。方法:采取随机整群抽样的方法,对598例40~65岁石家庄市妇女进行问卷调查和Greene评分。随机抽取其中的100例对象进行双能X线右前臂远端骨密度检查。结果:绝经平均年龄(48.38±5.36)岁。绝经症状发生率84.1%,45岁后骨密度显著下降,56岁后骨质疏松症发生率逐渐增加。围绝经期妇女所处年龄段不同其症状也不同。46~50岁多见潮热出汗;61~65岁多见肌肉关节痛、复发性生殖泌尿系统感染,差异均有统计学意义(P0.05)。结论:绝经及其相关疾病给妇女生理和心理带来很大困扰,在进行围绝经期妇女的保健治疗中不能忽视这些相关疾病的防治,应根据不同年龄制定防治措施。     

围绝经期症状与激素替代治疗

围绝经期(perimenopausal period)指近绝经时出现与绝经有关的内分泌、生物学和临床特征起至绝经后1年的期间。     

围绝经期血管舒缩症状的非激素治疗

血管舒缩症状(VMS)是围绝经期女性最常见症状,激素替代治疗是有效改善围绝经期症状的治疗方法,但是激素替代治疗并非适合所有女性。目前已探究出多种对VMS有效的非激素治疗方法,但尚缺乏非激素治疗VMS的较大样本的临床资料证据支持。另外,目前对VMS的改善标准也缺少统一的评价指标。神经激肽3受体拮抗剂(MlE-4901)未来有望成为VMS的靶向治疗药物,但仍需更多基础及临床试验证据支持。     

围绝经期心理精神神经症状浅析

随着医学科学的发展和保健、营养状况的改善，许多疾病得到控制，使人类特别是妇女的平均预期寿命可达80岁左右。但自45～55岁，绝经的预兆就开始向妇女袭来。绝经是每个妇女生命进程中必然发生的生理过程。绝经表示卵巢功能衰退，生殖功能终止；卵巢激素缺乏使绝经期妇女的精神心理乃至躯体     

围绝经期睡眠障碍的研究

绝经是女性生理上重要的转折点，在绝经过渡期，因为卵巢功能的减退，约三分之二的妇女可出现一系列因性激素水平变化所引起的症状。流行病学资料提示，围绝经期及绝经期后妇女睡眠障碍的发生率增加，现将有关围绝经期睡眠障碍的研究综述如下。     

围绝经期症状及治疗

绝经是每个妇女生命进程中必然发生的生理过程，绝经表示卵巢功能衰退、生殖功能终止，在这一过程中妇女的性腺轴将发生一系列的变化，临床上可出现一系列症状。     

激素水平与农村围绝经期女性情绪障碍的流行病学探讨

目的:了解江西农村地区围绝经期情绪障碍者体内不同激素水平及变化特点。方法:用多阶段整群随机抽样方法,采用《焦虑自评量表》(self-rating anxiety scale,SAS)、《抑郁自评量表》(self-rating depression scale,SDS)并结合某些临床症状及体征,对靖安和分宜两县40～56岁的妇女进行筛查。内容包括一般情况,焦虑和抑郁的评定,部分女性血中雌二醇(estradiol,E2),促卵泡生成激素(follicle-stimulating hormone,FSH),黄体生成素(luteinizing hormone,LH)等3种激素水平的放射免疫检测。结果:调查围绝经期女性613例,采集有效血样85份,情绪障碍患病率27.89%,其中焦虑患病率24.80%,抑郁患病率14.68%。E2、FSH、LH水平在情绪障碍者与无情绪障碍者之间无明显差异(P0.05);在不同年龄段的情绪障碍者及不同月经周期的情绪障碍者之间有显著差异(P0.05)。处于卵泡期的焦虑者FSH水平比无焦虑者高,月经周期不正常的抑郁者FSH水平高于无抑郁者,且差异均有统计学意义(P0.05)。结论:未发现情绪障碍发生与否同E2水平变化有直接关系,但焦虑和抑郁的发生与FSH水平有统计学上的联系。     

围绝经期症状与激素替代的合理应用

围绝经期(perirnenopausal pedod)指围绝经前后的一段时期，起于卵巢功能开始衰退至绝经后1年的生命时期。     

北京市大兴区围绝经期患者症状及相关因素分析

目的 调查北京市大兴区围绝经期患者的相关症状,并分析其影响因素。方法 选择围绝经期患者293例为研究对象,采用自行设计问卷进行调查。统计各因素对围绝经期症状的影响。结果 不同学历、婚姻状况、怀孕次数、分娩次数、可支配月收入、对围绝经期的了解程度、对围绝经期的了解来源方式等方面对患者进行改良kupperman评分比较,差异均无统计学意义（P>0.05）;在职与否、绝经与否、不同睡眠情况与是否用激素治疗、不同社会支持、压力程度等方面对患者进行改良kupperman评分比较,差异均有统计学意义（P<0.05）。不同满意度患者改良kupperman评分比较,差异均有统计学意义（P<0.05）。结论 围绝经期患者症状受多种因素影响,需加强围绝经期宣教,开展多样化的科普,倡导社会及家庭给予围绝经期患者更多的关爱,提升她们的生活质量。     

女性围绝经期的生理和病理变化

围绝经期是妇女从生育功能旺盛走向衰退的过渡时期，它包括从临床上、内分泌学及生物学上开始出现绝经趋势的迹象，一直持续至最后一次月经后的1年，即绝经过渡期加绝经后1年。此期起点定义模糊，但目前大多学者以闭经3～12个月或频繁出现不规则月经为起点，发生在39～51岁之间，持续时间平均约4年。围绝经期妇女最显著的变化是卵巢功能逐渐衰退，生育能力丧失，最终卵巢内卵泡耗竭，不能分泌雌激素，导致绝经、生殖道的萎缩以及一系列退行性病理改变，如月经紊乱、骨质疏松症、心血管疾病、生殖道肿瘤等。     

Assessment of bone mineral density should be considered earlier in perimenopausal women with vasomotor symptoms

Objective

To investigate the relationship between vasomotor symptoms (hot flashes) and osteopenia or osteoporosis in perimenopausal women.

Method

In this cross-sectional study 79 perimenopausal women aged between 45 and 55 years and seen at the Gynecology or Menopause Outpatient Clinic of Marmara University School of Medicine were allotted to one of 2 groups according to the presence or absence of hot flashes. The groups were then compared for bone mineral density (BMD) of the lumbar vertebrae, as measured by dual energy X-ray absorptiometry.

Results

The mean BMD measurement for vertebrae L2 to L4 was 0.32 ± 0.19 for the group with no hot flashes and  − 0.53 ± 0.21 for the group with hot flashes (P = 0.007). In the former, 6.1% of the women and in the latter, 32.6% of the women had a BMD value less than a 1.5 standard deviation from the mean (P = 0.005).

Conclusion

Women with vasomotor symptoms are more prone to have osteopenia or osteoporosis.     

围绝经期异常子宫出血与子宫内膜病变的危险因素分析

目的 分析围绝经期异常子宫出血与子宫内膜病变的危险因素.方法 回顾性分析100例围绝经期异常子宫出血患者的临床资料,根据临床病理检查结果分为良性组(26例)、病变组(52例)、正常组(22例).采用多因素Logistic回归分析围绝经期异常子宫出血与子宫内膜病变的危险因素.结果 三组患者孕产次数、BMI、子宫内膜厚度、...     

莉芙敏片与替勃龙改善围绝经期症状的效果和安全性比较

增加.结论 莉芙敏片能够有效、安全地改善妇女的围绝经期症状,其疗效与替勃龙相似,不良事件发生率低于替勃龙.     

米非司酮用于围绝经期功能性子宫出血治疗的临床观察

目的探讨米非司酮治疗围绝经期功血的效果。方法将确诊为围绝经期功血的患者16人,口服米非司酮10mg,每日晨空腹服用,连服6个月,于治疗前及治疗过程中用B超监测子宫内膜厚度及血清内分泌六项、肝肾功能等指标。结果患者在服药期间均闭经,雌激素水平降低,无子宫内膜增厚,其他监测指标无明显改变。结论 口服低剂量米非司酮对围绝经期功血疗效肯定,是一种可行的治疗方法。     

围绝经期妇女抑郁症相关因素及预防策略

目的了解围绝经期妇女抑郁症的发病率、发病相关因素及预防策略。方法采用汉密顿抑郁量表、改良围绝经期症状评分表、生活事件量表、改良社会支持评定量表和一般资料调查表,于2007年1月至6月期间对广东地区112名围绝经期妇女进行调查。结果围绝经期妇女抑郁症的发生率为41.07%。经前期综合征、痛经程度、绝经、居住环境、抑郁史、生活事件量表总分、改良社会支持评定量表总分及Kupperman绝经指数是围绝经期妇女发生抑郁症的主要影响因素。结论围绝经期妇女抑郁症的发生率较高,除与性腺功能减退有关外,还与社会、家庭及精神因素有关。针对病因进行预防,可减少围绝经期妇女抑郁症的发生,提高妇女生活质量。     

与妇科泌尿系统症状相关的流行病学调查问卷

问卷调查是临床和科研工作中了解女性泌尿系统症状的重要方法。目前,针对女性下尿路症状及其相关的生活质量调查问卷很多。不同问卷针对的内容不同,有特定的适用范围以及不同的循证医学等级。应用不恰当,或者是未经验证的问卷,就无法获得可靠的结果。文章就常用的妇科泌尿系统症状相关的流行病学调查问卷做一阐述,希望对临床研究有指导作用。     

宫腔镜在围绝经期异常子宫出血诊断中的临床价值

目的 探讨围绝经期异常子宫出血患者采用宫腔镜诊断的临床价值。方法 选取100例围绝经期异常子宫出血患者,患者均实施宫腔镜下活检或分段诊刮术,对刮出组织行病理检查。以病理诊断为金标准,分析宫腔镜检查与病理诊断结果诊断符合率,并分析宫腔镜检查对各疾病诊断的敏感性、特异性,评价其诊断效能。结果 宫腔镜检查与病理诊断结果的符合率为92.00%,Kappa值为0.90,一致性较好。对诊断异常子宫出血类疾病的敏感性、特异性均处于较高水平。结论 围绝经期异常子宫出血患者采用宫腔镜检查具有较高的诊断价值,可及时明确病因,为早期诊断与治疗提供可靠依据。     

Perimenopause: more than hot flushes and night sweats for some Australian women

OBJECTIVE: To identify the most common perimenopausal symptoms experienced by a group of Australian women and explore the extent to which those symptoms were distressing. DESIGN: A quantitative survey. SETTING: All women's health centers listed with the New South Wales Women's Information and Referral Service. PARTICIPANTS: A convenience sample of 200 healthy women, aged 45 to 55 years, drawn from a statewide population of women residing in Australia. MAIN OUTCOME MEASURE: The Women's Health Assessment Scale. RESULTS: Most frequently occurring perimenopausal symptoms included forgetfulness, lack of energy, irritability, and weight gain. The most distressing perimenopausal symptoms included weight gain, heavy bleeding, poor concentration, leaking of urine, and feeling as though life were not worth living. Current use of hormone replacement therapy contributed to the prediction of both symptom occurrence and symptom distress. CONCLUSION: Perimenopause is marked by more than hot flushes and night sweats; cognitive and affective changes are other distressing symptoms. The relationships between hormone replacement therapy use and both symptom occurrence and symptom distress warrant further investigation. In addition, practitioners should address concerns related to urinary incontinence, weight gain, cognitive and affective dysfunction, and general health status.     

Mood, energy, cognition, and physical complaints: a mind/body approach to symptom management during the climacteric

Recent studies suggest that energy and cognitive and physical complaints such as fatigue, disrupted sleep, concentration problems, and pain are more problematic than clinical depression during the climacteric and may contribute to depressed mood. Central nervous system pathways that mediate mood, cognition, and energy are influenced by fluctuations of circulating estrogen during perimenopause. Symptoms are also influenced by other factors, including psychosocial and environmental stresses and supports. Health care for women from perimenopause to postmenopause should include an accurate assessment of energy and cognitive, physical, and emotional symptoms. Multidisciplinary approaches that combine prevention, symptom management, and health promotion are most effective for women. A mind/body program for perimenopause and menopause is presented as an example of a comprehensive treatment approach for assessment and management of perimenopause and menopause. This 10-week group program combined information, self-education, relaxation training, group support, lifestyle modification, and psychological coping skills.