Division of General Internal Medicine, University of Pittsburgh School of Medicine, 230 McKee Place, Suite 600, Pittsburgh, PA 15213, USA.
Qual Life Res. 2012 Apr;21(3):535-44. doi: 10.1007/s11136-011-9959-7. Epub 2011 Jul 14.
We examine the impact of menopausal status, beyond menopausal symptoms, on health-related quality of life (HRQoL).
Seven hundred thirty-two women aged 40-65, regardless of health condition or menopausal status, were enrolled from single general internal medicine practice. Women completed annual questionnaires including HRQoL, and menopausal status and symptoms.
The physical health composite of the RAND-36 is lower in late peri (45.6, P < .05), early post (45.4, P < .05), and late postmenopausal women (44.6, P < .01), and those who report a hysterectomy (44.2, P < .01) compared to premenopausal women (47.1), with effect sizes of Cohen's d = .12-.23. The mental health composite of the RAND-36 is lower in late peri (44.7, P < .01), early post (44.9, P < .01), and late postmenopausal women (45.0, P < .05) and those who report a hysterectomy (44.2, P < .01) compared to premenopausal women (46.8), with effect sizes of Cohen's d = .15-.20. Findings are comparable adjusted for menopausal symptom frequency and bother.
Over a 5-year follow-up period, we found a negative impact of menopause on some domains of HRQoL, regardless of menopausal symptoms. Clinicians should be aware of this relationship and work to improve HRQoL, rather than expect it to improve spontaneously when menopausal symptoms resolve.
我们研究了绝经状态(超越绝经症状)对健康相关生活质量(HRQoL)的影响。
从单家综合内科诊所招募了 732 名 40-65 岁的女性,无论健康状况或绝经状态如何。女性每年完成包括 HRQoL、绝经状态和症状在内的问卷。
RAND-36 的生理健康综合评分在晚期围绝经期(45.6,P<.05)、早期绝经后(45.4,P<.05)和晚期绝经后(44.6,P<.01)以及接受子宫切除术的女性(44.2,P<.01)较低,与绝经前女性(47.1)相比,效应大小为 Cohen's d=0.12-0.23。RAND-36 的心理健康综合评分在晚期围绝经期(44.7,P<.01)、早期绝经后(44.9,P<.01)和晚期绝经后(45.0,P<.05)以及接受子宫切除术的女性(44.2,P<.01)较低,与绝经前女性(46.8)相比,效应大小为 Cohen's d=0.15-0.20。这些发现与调整绝经症状频率和困扰后的结果相似。
在 5 年的随访期间,我们发现无论绝经症状如何,绝经对某些 HRQoL 领域都有负面影响。临床医生应该意识到这种关系,并努力改善 HRQoL,而不是期望随着绝经症状的缓解而自然改善。