Reproductive Aging and Symptom Experience at Midlife Among Bangladeshi Immigrants, Sedentees, and White London Neighbors

这项研究的目的是更好地了解激素水平在绝经前、绝经期间和绝经后的变化，并检查六组妇女在年龄和绝经时症状体验方面的差异。这包括从孟加拉国东北部锡尔赫特来到伦敦的四组不同年龄的移民：(A)成年(16岁以上)，(B)婴儿(0-2岁)，(C)儿童(3-8岁)，(D)青春期前(9-青春期)，以及(E)仍生活在孟加拉国的Sylheti妇女，和(F)与移民生活在类似伦敦社区的白人妇女。女性的荷尔蒙会随着年龄和更年期状况的变化而变化。PI将从志愿者的血液样本中检测三种不同的荷尔蒙，这三种荷尔蒙可以大致判断女性卵巢中还剩下多少卵子。当女性的卵子用完时，她们就会进入更年期。这些激素被称为卵泡刺激素、抑制素B和抗苗勒氏激素。将估计每一组妇女的平均绝经年龄，并将在组内和组间检查与绝经年龄变化相关的可能因素(例如吸烟和咀嚼槟榔)。更年期症状的频率，特别是潮热和头痛，将通过访谈和问卷调查在所有六组中进行测量。一些女性还将使用电子监测器测量潮热，这种监测器可以佩戴24小时，几乎不会感到不适。为了了解不同的妇女群体如何经历更年期过渡，PIs将特别关注社会压力(例如，婚姻压力和社会孤立)与症状频率之间的关系，以及当地条件如何影响更年期体验。这是第一个将特定激素水平作为发展中国家移民生殖老龄化指标的项目。这也是首次在孟加拉国和国外的孟加拉妇女中使用潮热监测仪的研究。这项研究还建立在Bentley和她的同事之前对孟加拉国年轻女性(18-39岁)生殖功能的研究基础上。这项研究将扩大对环境和发展条件对生殖老龄化体验的影响的认识。它将进一步加强国际合作，并为培养来自美国、英国和孟加拉国的学生做出贡献。这也是一个机会，可以为关于压力和更年期转变的文献做出贡献。此外，专门针对英格兰孟加拉移民社区需求的研究很少，特别是可能对社区工作者有帮助的研究。项目成果可以用非常实际的方式向当地社区和保健提供者通报孟加拉国移民的更年期经历。

The purpose of this study is to better understand how hormone levels vary before, during, and just after menopause, and to examine differences in age and symptom experience at menopause among six groups of women. This includes four groups of migrants who came to London from Sylhet, NE Bangladesh at different ages: (a) as adults (over 16 years), (b) as infants (0-2 years), (c) as children (3-8 years), and (d) as pre-adolescents (9-puberty), as well as (e) Sylheti women still living in Bangladesh, and (f) white women living in similar London neighborhoods as the migrants. Women's hormones change with age and menopausal status. The PIs will be looking at three different hormones from blood samples taken from volunteers that tell roughly how many eggs there are remaining in a woman's ovary. When women run out of eggs, they reach menopause. These hormones are called follicle stimulating hormone, inhibin B and anti-mullerian hormone. Average ages at menopause will be estimated in each group of women, and possible factors associated with variation in menopausal age (e.g., smoking and betel nut chewing) will be examined within and between groups. The frequency of menopausal symptoms, especially hot flashes and headaches, will be measured in all six groups through interviews and questionnaires. Hot flashes will also be measured in some women using an electronic monitor that can be worn with little discomfort for 24 hours. To understand how the different groups of women experience the menopausal transition, the PIs will be looking, in particular, at the relationship between social stress (e.g., marital stress and social isolation) and symptom frequencies, and how local conditions could affect the menopausal experience.This is the first project to look at specific hormone levels as indicators of reproductive aging among migrants from a developing country. It is also the first study to use hot flash monitors among Bangladeshi women in Bangladesh and abroad. This study also builds on the previous work of Bentley and her colleagues on reproductive function among younger Bangladeshi women (aged 18-39).The study will extend knowledge of the effects of environmental and development conditions on the experience of reproductive aging. It will further international cooperation, and contribute to the training of students from the United States, UK, and Bangladesh. It also represents an opportunity to contribute to the literature on the topic of stress and the menopausal transition. In addition, there is very little research that specifically addresses the needs of the Bangladeshi immigrant community in England especially research that might be helpful for community workers. Project results could be used in very practical ways to inform the local community and health providers about the menopausal experiences of Bangladeshi migrants.