Mitchell E S, Woods N F, Mariella A
University of Washington, School of Nursing, Seattle 98195-7262, USA.
Menopause. 2000 Sep-Oct;7(5):334-49. doi: 10.1097/00042192-200007050-00008.
As more interest centers on the years surrounding menopause, the inconsistent use of nonspecific terminology to define these years becomes a problem. Our objective was to describe the development of specific criteria that define stages within the menopausal transition and to apply these criteria to classify midlife women into a stage of transition.
A total of 184 midlife women from the Seattle Midlife Women's Health Study taking no hormones and for whom data were available about initial menstrual cycle changes were studied. Questionnaires about menstrual cycle changes and menstrual calendars were mailed yearly. Intra-individual analyses for type and chronology of menstrual cycle changes during midlife for change in flow amount or duration, cycle length change, cycle irregularity, or skipped periods were conducted.
Changes in flow or cycle length most frequently preceded irregularity without skipped periods, which preceded skipped periods. Initial changes began in the early 30s and most frequently between ages 40 and 44. Only 14% had irregularity as the initial change. Three stages of the menopausal transition were identified: early (flow and/or cycle length changes), middle (irregularity without skipping), and late (skipped periods). Age did not differentiate the three stages.
These findings provide evidence for a progression of menstrual cycle events through the menopausal transition, which form the basis for three stages of the transition: early, middle, and late transition. Studies about the entire transition need to include women younger than 45. Both menstrual calendars and questionnaire data are needed to identify these three stages, and precise definitions of irregularity and skipped period are necessary.
随着越来越多的关注集中在围绝经期的几年，使用非特定术语来定义这些年份的不一致性成为一个问题。我们的目的是描述定义绝经过渡阶段的具体标准的制定，并应用这些标准将中年女性分类到过渡阶段。
对来自西雅图中年女性健康研究的184名未服用激素且有初始月经周期变化数据的中年女性进行了研究。关于月经周期变化的问卷和月经日历每年邮寄一次。对中年期间月经周期变化的类型和时间顺序进行个体内分析，以分析经量或经期长度的变化、周期长度变化、周期不规律或经期跳过情况。
经量或周期长度的变化最常先于无经期跳过的不规律情况，而这种不规律情况又先于经期跳过。初始变化始于30岁出头，最常见于40至44岁之间。只有14%的人以不规律作为初始变化。确定了绝经过渡的三个阶段：早期（经量和/或周期长度变化）、中期（无经期跳过的不规律）和晚期（经期跳过）。年龄并不能区分这三个阶段。
这些发现为月经周期事件在绝经过渡过程中的进展提供了证据，这构成了过渡的三个阶段的基础：早期、中期和晚期过渡。关于整个过渡阶段的研究需要纳入45岁以下的女性。需要月经日历和问卷数据来确定这三个阶段，并且需要对不规律和经期跳过进行精确的定义。
