Taylor Sylvia M, Kinney Ann M, Kline Jennie K
Department of Epidemiology, Joseph L. Mailman School of Public Health, and the Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA.
Menopause. 2004 Jan-Feb;11(1):40-8. doi: 10.1097/01.GME.0000074820.41532.50.
To assess whether menstrual variability predicts time to menopause.
Analyses drew on 326 menstruating women, aged 44 to 56, who were followed until they reached menopause or the study ended. The women provided data on their menstrual characteristics at intake. We evaluated the utility of six definitions of menstrual variability for predicting time to ascertained menopause (final menstrual period + 12 months): (1) more than 90 days since the most recent menstrual period (n = 20); (2) 60 or more days of amenorrhea during the previous year (n = 71); (3) cycle lengths that varied by 19 or more days (n = 106); (4) cycle lengths too variable to report a usual length (n = 29); (5) cycles less regular than they had been at age 40 (n = 107); and (6) change in the duration or heaviness of menstrual flow compared with age 40 (n = 255). In addition, we evaluated hot flashes or night sweats during the previous week (n = 50) and age 50 or more years (n = 60) as predictors.
Definitions 1 to 5 predicted time to menopause; definition 6 did not. Definition 1 had the highest positive predictive value for ascertained menopause within 2 years and within 4 years; definitions 2 and 4 had low to moderate positive predictive values for ascertained menopause within 2 years but good positive predictive values for ascertained menopause within 4 years. For ascertained menopause within 2 years, definition 2 showed the best balance of sensitivity (94%) and specificity (91%).
Simple questions about menstrual variability elicit information that is informative about proximity to menopause.
评估月经周期变化是否能预测绝经时间。
分析纳入了326名年龄在44至56岁之间的月经周期正常的女性，对她们进行随访直至绝经或研究结束。这些女性在入组时提供了月经特征数据。我们评估了六种月经周期变化的定义对于预测确定绝经时间（最后一次月经 + 12个月）的效用：（1）自最近一次月经起超过90天（n = 20）；（2）前一年闭经60天或更长时间（n = 71）；（3）月经周期长度变化19天或更多（n = 106）；（4）月经周期长度变化太大以至于无法报告通常长度（n = 2）；（5）月经周期比40岁时更不规律（n = 1）；以及（6）与40岁时相比月经持续时间或经量的变化（n = 5）。此外，我们评估了前一周出现潮热或盗汗（n = 5）以及年龄50岁及以上（n = 6）作为预测因素。
定义1至5可预测绝经时间；定义6不能。定义1对于2年内和4年内确定绝经的阳性预测值最高；定义2和4对于2年内确定绝经的阳性预测值低至中等，但对于4年内确定绝经的阳性预测值良好。对于2年内确定绝经，定义2显示出最佳的敏感性（94%）和特异性（91%）平衡。
关于月经周期变化的简单问题能得出与绝经临近程度相关的信息。
