Bair Yali A, Gold Ellen B, Zhang Guili, Rasor Niki, Utts Jessica, Upchurch Dawn M, Chyu Laura, Greendale Gail A, Sternfeld Barbara, Adler Shelley R
Planned Parenthood Affiliates of California, Sacramento, CA, USA.
Menopause. 2008 Jan-Feb;15(1):32-43. doi: 10.1097/gme.0b013e31813429d6.
This study examined whether use of complementary and alternative (CAM) therapies during the menopause transition varied by ethnicity.
The Study of Women's Health Across the Nation is a prospective cohort study following a group of 3,302 women from five racial/ethnic groups at seven clinical sites nationwide. Using longitudinal data encompassing 6 years of follow-up, we examined trends in use of five categories of CAM (nutritional, physical, psychological, herbal, and folk) by menopause status and ethnicity. To account for potential secular trends in CAM use or availability, we also evaluated the trends in CAM use over calendar time.
Approximately 80% of all participants had used some form of CAM at some time during the 6-year study period. White and Japanese women had the highest rates of use (60%), followed by Chinese (46%), African American (40%), and Hispanic (20%) women. Overall use of CAM therapy remained relatively stable over the study period. In general, CAM use did not seem to be strongly associated with change in menopause transition status. Use of CAM among white women did not change with transition status. Among Chinese and African American participants, we observed an increase in CAM use as women transitioned to perimenopause and a decrease in use of CAM with transition to postmenopause. Among Hispanic and Japanese women, we observed a decrease in use of CAM in early perimenopause, followed by an increase as women entered late perimenopause and a decrease as they progressed to postmenopause. Patterns of use for the five individual types of CAM varied. White women had relatively stable use of all CAM therapies through the transition. Japanese women decreased use of nutritional and psychological remedies and increased use of physical remedies as they transitioned into late perimenopause. Among African American women, use of psychological remedies increased as they progressed through menopause.
Although CAM use did vary in some ethnic groups in relation to advancing menopause status, there was no evidence of influence of calendar time on CAM use. Patterns of CAM use during menopause are likely to be driven by personal experience, menopausal health, and access to therapies. Women's personal preferences should be taken into consideration by healthcare providers for medical decision making during menopause and throughout the aging process.
本研究调查了绝经过渡期间补充和替代医学（CAM）疗法的使用是否因种族而异。
全国妇女健康研究是一项前瞻性队列研究，跟踪全国七个临床地点的3302名来自五个种族/族裔群体的女性。利用涵盖6年随访的纵向数据，我们研究了按绝经状态和种族划分的五类补充和替代医学（营养、身体、心理、草药和民间）的使用趋势。为了考虑补充和替代医学使用或可及性的潜在长期趋势，我们还评估了补充和替代医学使用随日历时间的趋势。
在为期6年的研究期间，约80%的参与者曾在某个时间使用过某种形式的补充和替代医学。白人和日本女性的使用率最高（60%），其次是中国女性（46%）、非裔美国女性（40%）和西班牙裔女性（20%）。在研究期间，补充和替代医学疗法的总体使用保持相对稳定。一般来说，补充和替代医学的使用似乎与绝经过渡状态的变化没有密切关联。白人女性补充和替代医学的使用情况不会随过渡状态而改变。在中国和非裔美国参与者中，我们观察到随着女性过渡到围绝经期，补充和替代医学的使用增加，而随着过渡到绝经后期，补充和替代医学的使用减少。在西班牙裔和日本女性中，我们观察到在围绝经期早期补充和替代医学的使用减少，随着女性进入围绝经期后期使用增加，而随着进入绝经后期使用减少。五类补充和替代医学各自的使用模式有所不同。白人女性在整个过渡过程中对所有补充和替代医学疗法的使用相对稳定。日本女性在过渡到围绝经期后期时，营养和心理疗法的使用减少，身体疗法的使用增加。在非裔美国女性中，随着她们经历绝经，心理疗法的使用增加。
尽管在某些种族群体中，补充和替代医学的使用确实因绝经状态的进展而有所不同，但没有证据表明日历时间对补充和替代医学的使用有影响。绝经期间补充和替代医学的使用模式可能由个人经历、绝经健康状况和治疗可及性驱动。医疗保健提供者在绝经期间及整个衰老过程中进行医疗决策时，应考虑女性的个人偏好。
