Schneider H P G, Birkhäuser M
a Department of Obstetrics and Gynecology , University of Muenster , Muenster , Germany.
b Department of Obstetrics and Gynecology , University of Berne , Berne , Switzerland.
Climacteric. 2017 Jun;20(3):187-194. doi: 10.1080/13697137.2017.1279599. Epub 2017 Jan 24.
Health-related quality of life (HRQoL) refers to the effects of an individual's physical state on all aspects of psychosocial functioning. For postmenopausal women, HRQoL is the only global criterion that is decisive for their daily well-being. Symptoms experienced during menopause and sociodemographic characteristics affect quality of life in postmenopausal women. In younger, symptomatic, postmenopausal women, HRQoL may be significantly diminished. However, quality of life after menopause is influenced by many additional, non-menopausal factors. In the last decades, more specific symptom lists or other questionnaires have been developed. Such scales would qualify as standardized or disease-specific by fulfilling four criteria: (1) they have been constructed on the basis of a factor analysis; (2) they consist of several subscales, each measuring a different aspect of a specific symptomatology; (3) the scales possess sound psychometric properties; and (4) they have been standardized using adequate populations of women. A variety of instruments currently dominating international practice are here reviewed. Therapeutic approaches that treat climacteric symptoms and all measures ameliorating unfavorable non-hormonal factors could improve HRQoL among postmenopausal women. This includes partnership and sexual counseling as well as psychosocial measures. Menopausal hormone therapy (MHT) may reverse this deterioration of HRQoL if it is due to postmenopausal estrogen deficiency. On the contrary, when MHT is prescribed to asymptomatic younger and older postmenopausal women, no gain in HRQoL can be obtained.
健康相关生活质量（HRQoL）指个体身体状况对心理社会功能各方面的影响。对于绝经后女性而言，健康相关生活质量是决定其日常幸福感的唯一综合标准。绝经期间出现的症状以及社会人口学特征会影响绝经后女性的生活质量。在较年轻、有症状的绝经后女性中，健康相关生活质量可能会显著下降。然而，绝经后的生活质量还受许多其他非绝经因素的影响。在过去几十年里，人们开发出了更具体的症状清单或其他问卷。此类量表若满足以下四个标准，可被视为标准化量表或疾病特异性量表：（1）它们是在因素分析的基础上构建的；（2）它们由几个子量表组成，每个子量表测量特定症状学的不同方面；（3）这些量表具有良好的心理测量特性；（4）它们已在足够数量的女性群体中进行了标准化。本文对目前在国际实践中占主导地位的各种工具进行了综述。治疗更年期症状的治疗方法以及所有改善不利非激素因素的措施都可以提高绝经后女性的健康相关生活质量。这包括伴侣关系和性咨询以及心理社会措施。如果健康相关生活质量的下降是由绝经后雌激素缺乏所致，绝经激素治疗（MHT）可能会逆转这种情况。相反，当对无症状的年轻和老年绝经后女性开处绝经激素治疗时，健康相关生活质量不会得到提高。
