A prospective population-based study of menopausal symptoms
A prospective population-based study of menopausal symptoms
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DOI：
10.1016/s0029-7844(00)00930-3
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发表时间：
2000-09-01
影响因子：
7.2
通讯作者：
Burger, HG
中科院分区：
文献类型：
--
作者：
Dennerstein, L;Dudley, EC;Burger, HG
目的：确定中年期间患病率和严重程度的变化，并评估其与绝经状态、激素水平和其他因素的关系。方法：在一项基于人群的纵向研究中，对438名澳大利亚出生的女性进行了7年的观察，保留率为89%，其中172人从绝经前进展到围绝经期或绝经后。年度测量包括33项症状清单；心理社会、生活方式和健康相关因素；月经状况；激素使用情况；以及卵泡刺激素和雌二醇(E2)的血液水平。结果：从围绝经期早期到晚期，出现5种或更多症状的女性数量递增(+14%)、潮热(+27%)、盗汗(+17%)和阴道干燥(+17%)(均P<；.05)。乳房酸痛-压痛随着绝经过渡而减少(-21%)。睡眠困难增加了6%。除失眠呈逐渐上升趋势外，围绝经期早期至晚期患病率变化较大。与潮热发生最相关的变量是围绝经期早期症状的数量(P<；.05)、无技能或无职业(P<；.05)、吸烟超过10包年(P<；.01)以及雌二醇值下降(P<；.01)。盗汗发生率随雌二醇水平的变化而增加(P<；0.05)。受教育年限越长，阴道干燥的发生率越低(P<；0.05)。更低的幸福感(P<；.01)、认为有很多兴趣的女性几乎注意不到更年期(P<；.01)和潮热(P<；.01)可以预测睡眠困难。结论：虽然中年女性有高度的症状，但与绝经过渡的荷尔蒙变化有关的症状似乎是血管舒缩症状、阴道干燥和乳房压痛。失眠反映了烦人的潮热和心理社会因素。《妇科杂志》2000年版；96：351-8。(C)2000年由美国妇产科医师学会颁发)。
Objective: To identify symptoms that change in prevalence and severity during midlife and evaluate their relationships to menopausal status, hormonal levels, and other factors.Methods: In a longitudinal, population-based study of 438 Australian-born women observed for 7 years with an 89% retention rate, 172 advanced from premenopause to perimenopause or postmenopause. Annual measures included a 33-item symptom check list; psychosocial, lifestyle, and health-related factors; menstrual status; hormone usage; and blood levels of follicle-stimulating hormone and estradiol (E2).Results: Increasing from early to late perimenopause were the number of women who reported five or more symptoms (+14%), hot flushes (+27%), night sweats (+17%) and vaginal dryness (+17%) (all P < .05). Breast soreness-tenderness decreased with the menopausal transition (-21%). Trouble sleeping increased by +6%. The major change in prevalence was from early to late perimenopause, except for insomnia, which showed a gradual increase. Those variables most related to onset of hot flushes were number of symptoms at early perimenopause (P < .05), having an unskilled or no occupation (P < .05), more than 10 pack-years of smoking (P < .01), and decreased E2 (P < .01). The onset of night sweats increased with the change in E2 (P < .05). The onset of vaginal dryness decreased with more years of education (P < .05). Trouble sleeping was predicted by prior lower well-being (P < .01), belief at baseline that women with many interests hardly notice menopause (P < .01), and hot flushes (P < .01).Conclusion: Although middle-aged women are highly symptomatic, the symptoms that appear to be specifically related to hormonal changes of menopausal transition are vasomotor symptoms, vaginal dryness, and breast tenderness. Insomnia reflected bothersome hot flushes and psychosocial factors. (Obstet Gynecol 2000;96:351-8. (C) 2000 by The American College of Obstetricians and Gynecologists).