Sievert Lynnette Leidy, Espinosa-Hernandez Graciela
Department of Anthropology, University of Massachusetts at Amherst, 01003-9278, USA.
Women Health. 2003;38(2):93-106. doi: 10.1300/J013v38n02_07.
To examine how attitudes toward menopause were associated with symptom frequencies after controlling for menopause status and level of education.
Women aged 28-70 (n = 755) were interviewed from May, 1999 through August, 2000 in the city of Puebla, Mexico. Over 90% of the sample were aged 40-60. Participants were asked to select from a set of dichotomies to describe "how a woman feels during menopause." Symptom frequencies were assessed by a checklist of everyday complaints experienced during the two weeks before interview. Symptom presence or absence was examined in relation to attitudes while controlling for menopause status and level of education using binary logistic regression analyses.
The majority of respondents said that a menopausal woman feels "insecure" and "unattractive" yet "complete," "necessary," and "successful." Pre-menopausal women and respondents who had undergone a hysterectomy were more likely to express negative attitudes. Post-menopausal women and women with fewer years of education were significantly more likely to report symptoms such as hot flashes, joint aches, and nervous tension. A range of negative attitudes were associated with nervous tension, feeling blue, and head aches; however, only a few negative attitudes were significantly predictive of estrogen-related symptoms (e.g., hot flashes).
There is a high value placed on both external appearance and familial responsibility among menopausal women in Puebla, Mexico, and negative characterizations of menopause reflect these values. Negative attitudes were associated with more frequently reported symptoms compared with positive attitudes. The challenge remains to separate factors related to the hormonal changes of menopause from those not associated with hormonal changes to better understand symptom experience.
在控制绝经状态和教育水平后，研究对更年期的态度与症状频率之间的关联。
1999年5月至2000年8月期间，在墨西哥普埃布拉市对755名年龄在28 - 70岁的女性进行了访谈。样本中超过90%的女性年龄在40 - 60岁之间。参与者被要求从一组二分法中选择来描述“女性在更年期的感受”。通过一份在访谈前两周内经历的日常不适清单来评估症状频率。在控制绝经状态和教育水平的同时，使用二元逻辑回归分析来检查症状的有无与态度之间的关系。
大多数受访者表示，更年期女性感觉“不安全”且“缺乏吸引力”，但同时也“完整”、“必要”且“成功”。绝经前女性和接受过子宫切除术的受访者更有可能表达负面态度。绝经后女性和受教育年限较少的女性更有可能报告潮热、关节疼痛和神经紧张等症状。一系列负面态度与神经紧张、情绪低落和头痛有关；然而，只有少数负面态度能显著预测与雌激素相关的症状（如潮热）。
在墨西哥普埃布拉市，更年期女性非常重视外表和家庭责任，对更年期的负面描述反映了这些价值观。与积极态度相比，负面态度与更频繁报告的症状有关。将与更年期激素变化相关的因素与那些与激素变化无关的因素区分开来，以更好地理解症状体验，仍然是一项挑战。
