Gibson-Helm M, Teede H, Vincent A
* Women's Public Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Clayton, Victoria.
Climacteric. 2014 Dec;17(6):666-73. doi: 10.3109/13697137.2014.913284. Epub 2014 Jul 17.
To explore symptoms, understanding of menopausal therapies, medication use and health-related behavior in women with and without premature menopause.
Cross-sectional, questionnaire-based study involving a community-based sample of 77 women in Australia: 23 premenopausal, 25 with premature ovarian failure (POF) and 29 with medically induced premature menopause (MIPM).
The median (interquartile range) age of each group was: premenopausal = 29 (13) years, POF = 36 (8.0) years and MIPM = 38 (4.0) years (p < 0.001). The reported frequency of menopausal symptoms differed across the groups for difficulty sleeping (premenopausal = 26%, POF = 44%, MIPM = 69%, p = 0.01), some depression symptoms (premenopausal = 4.4-22%, POF = 20-25%, MIPM = 38-59%, p < 0.05), hot flushes (premenopausal = 4.4%, POF = 28%, MIPM = 59%, p < 0.001), sweating at night (premenopausal = 4.4%, POF = 20%, MIPM = 52%, p < 0.001) and loss of interest in sex (premenopausal = 17%, POF = 52%, MIPM = 54%, p = 0.02). More women with premature menopause than premenopausal women reported taking prescription medication (premenopausal = 52%, POF = 92%, MIPM = 86%, p = 0.002), perceived that hormone therapy (HT) was associated with increased breast cancer risk (premenopausal = 43%, POF = 56%, MIPM = 79%, p = 0.03) and that HT prevented fractures (premenopausal = 13%, POF = 56%, MIPM = 39%, p = 0.01). Most women reported not knowing risks/benefits of bioidentical hormone therapy (premenopausal = 86%, POF = 56%, MIPM = 75%, p = 0.06). Regarding health-related behavior around prevention and screening, varying rates of bone densitometry (premenopausal = 4.4%, POF = 64%, MIPM = 59%, p < 0.001), blood glucose testing (premenopausal = 39%, POF = 67%, MIPM = 57%, p = 0.16) and cholesterol testing (premenopausal = 22%, POF = 71%, MIPM = 54%, p = 0.003) were reported.
Differences in understanding of menopausal therapies and health-related behavior exist among women with premature menopause of differing etiology and premenopausal women. While perceived understanding of HT was greater than other therapies, targeted education is needed regarding specific risks/benefits of menopausal therapies and regarding preventive health screening after premature menopause.
探讨自然绝经和过早绝经女性的症状、对绝经治疗的认知、药物使用情况及健康相关行为。
基于问卷调查的横断面研究，以澳大利亚77名女性为社区样本，其中23名处于绝经前，25名患有卵巢早衰（POF），29名因医源性因素导致过早绝经（MIPM）。
每组的年龄中位数（四分位间距）分别为：绝经前 = 29（13）岁，POF = 36（8.0）岁，MIPM = 38（4.0）岁（p < 0.001）。各组间报告的绝经症状频率存在差异，包括睡眠困难（绝经前 = 26%，POF = 44%，MIPM = 69%，p = 0.01）、一些抑郁症状（绝经前 = 4.4 - 22%，POF = 20 - 25%，MIPM = 38 - 59%，p < 0.05）、潮热（绝经前 = 4.4%，POF = 28%，MIPM = 59%，p < 0.001）、夜间出汗（绝经前 = 4.4%，POF = 20%，MIPM = 52%，p < 0.001）以及对性失去兴趣（绝经前 = 17%，POF = 52%，MIPM = 54%，p = 0.02）。与绝经前女性相比，过早绝经女性报告服用处方药的比例更高（绝经前 = 52%，POF = 92%，MIPM = 86%，p = 0.002），认为激素疗法（HT）与乳腺癌风险增加相关（绝经前 = 43%，POF = 56%，MIPM = 79%，p = 0.03），且认为HT可预防骨折（绝经前 = 13%，POF = 56%，MIPM = 39%，p = 0.01）。大多数女性报告不了解生物同源激素疗法的风险/益处（绝经前 = 86%，POF = 56%，MIPM = 75%，p = 0.06）。关于预防和筛查方面的健康相关行为，报告的骨密度检测率（绝经前 = 4.4%，POF = 64%，MIPM = 59%，p < 0.001）、血糖检测率（绝经前 = 39%，POF = 67%，MIPM = 57%，p = 0.16）和胆固醇检测率（绝经前 = 22%，POF = 71%，MIPM = 54%，p = 0.003）各不相同。
不同病因的过早绝经女性与绝经前女性在对绝经治疗的认知及健康相关行为方面存在差异。虽然对HT的认知程度高于其他疗法，但仍需要针对绝经治疗的特定风险/益处以及过早绝经后的预防性健康筛查进行有针对性的教育。
