Øverlie Inger, Moen Mette Haase, Holte Arne, Finset Arnstein
Department of Behavioural Sciences in Medicine, University of Oslo, P.O. Box 1111, Blindern, N-0317 Oslo, Norway.
Maturitas. 2002 Jan 30;41(1):69-77. doi: 10.1016/s0378-5122(01)00256-0.
In this paper, the association of hormones to vasomotor complaints during the menopausal transition is discussed. Fifty-seven regularly menstruating women without history of hormone replacement therapy (HRT) were selected for a longitudinal, prospective study around the menopausal transition. The mean age at the start of the study was 51.3 (+/-2.0) years. At intervals of 12 months all women went through a semi-structured interview and filled in questionnaires. Venous blood samples were collected every 12-month for analyses of estradiol (E2), testosterone, androstendione, dehydroepiandrosterone-sulphate (DHEA-S), follicle stimulating hormone (FSH), thyrotropin (TSH), and luteinizing hormone (LH). Vasomotor complaints were tested using questions about hot flushes and bouts of sweating in terms of occurrence, frequency and degree of distress. Forty-six percent of the subjects reported hot flushes and bouts of sweating before menopause, increasing to 67% during the first year after menopause and 49% in the second year postmenopause. Low levels of estradiol and high levels of FSH were associated with vasomotor complaints before menopause. During menopause high levels of TSH were related to vasomotor complaints. The first year after menopause, women, who at this point achieved hot flushes, were characterised by high levels of E2, but declining and low levels of FSH, but increasing. Postmenopausal, high levels of testosterone and DHEA-S seemed to protect against vasomotor symptoms. Our most important finding was, that among women who achieved hot flushes at the first assessment postmenopause, the high androgen levels was a significant predictor of recovery from hot flushes at the last assessment, 1 year later.
本文讨论了激素与绝经过渡期间血管舒缩症状的关联。选取了57名无激素替代疗法（HRT）史且月经规律的女性，围绕绝经过渡进行纵向、前瞻性研究。研究开始时的平均年龄为51.3（±2.0）岁。所有女性每隔12个月接受一次半结构化访谈并填写问卷。每12个月采集静脉血样，分析雌二醇（E2）、睾酮、雄烯二酮、硫酸脱氢表雄酮（DHEA-S）、促卵泡激素（FSH）、促甲状腺激素（TSH）和促黄体生成素（LH）。通过询问潮热和出汗发作的发生情况、频率及困扰程度来检测血管舒缩症状。46%的受试者在绝经前报告有潮热和出汗发作，绝经后第一年增至67%，绝经后第二年为49%。绝经前，雌二醇水平低和FSH水平高与血管舒缩症状有关。绝经期间，TSH水平高与血管舒缩症状有关。绝经后第一年，出现潮热的女性其特征是E2水平高，但FSH水平下降且较低，但呈上升趋势。绝经后，睾酮和DHEA-S水平高似乎可预防血管舒缩症状。我们最重要的发现是，在绝经后首次评估时出现潮热的女性中，高雄激素水平是1年后最后一次评估时潮热恢复的显著预测指标。
