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对于 60 至 65 岁的女性,中度至重度血管舒缩和性功能症状仍然是个问题。

Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 years.

机构信息

From the Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

出版信息

Menopause. 2018 Nov;25(11):1331-1338. doi: 10.1097/GME.0000000000001237.

Abstract

OBJECTIVE

This study aims to determine the prevalence and severity of menopausal symptoms in older postmenopausal women and, hence, the need for treatment options for women of this age.

METHODS

This is a cross-sectional questionnaire-based study conducted between October 2013 and March 2014 among 2,020 women aged 40 to 65 years and living independently across Australia. The main outcome measures were the prevalence of moderate to severe vasomotor symptoms (VMS), as measured by the Menopause-Specific Quality of Life Questionnaire, and the current use of prescription therapy for menopausal symptoms.

RESULTS

The prevalence of moderate to severe VMS was as follows: 2.8% in premenopausal women, 17.1% in perimenopausal women, 28.5% in postmenopausal women younger than 55 years, 15.1% in postmenopausal women aged 55 to 59 years, and 6.5% in postmenopausal women aged 60 to 65 years. Prescription therapy for menopausal symptoms was used by 135 women: 120 (5.9%) women using hormone therapy and 15 (0.7%) women using nonhormonal medication. The factors positively associated with moderate to severe VMS were smoking (odds ratio, 1.6; 95% CI, 1.1-2.3; P < 0.05) and a body mass index of 25 to 29.9 kg/m (odds ratio, 1.7; 95% CI, 1.1-2.5; P < 0.05); education beyond high school was inversely associated (odds ratio, 0.7; 95% CI, 0.5-0.9; P < 0.05).

CONCLUSIONS

In this large, representative, community-based sample of women, there is a high prevalence of untreated moderate to severe VMS even in women aged 60 to 65 years. The use of vaginal estrogen and nonhormonal prescription therapy with proven efficacy for treatment of menopausal symptoms is strikingly low, suggesting that menopause remains an undertreated condition.

摘要

目的

本研究旨在确定绝经后老年女性的更年期症状的发生率和严重程度,以及为此年龄段女性提供治疗选择的必要性。

方法

这是一项横断面问卷调查研究,于 2013 年 10 月至 2014 年 3 月期间在澳大利亚独立生活的 2020 名 40 至 65 岁女性中进行。主要结局指标为绝经特异性生活质量问卷(Menopause-Specific Quality of Life Questionnaire)评估的中重度血管舒缩症状(vasomotor symptoms,VMS)的发生率,以及当前用于治疗更年期症状的处方疗法。

结果

中重度 VMS 的发生率如下:绝经前女性为 2.8%,围绝经期女性为 17.1%,55 岁以下绝经后女性为 28.5%,55 岁至 59 岁绝经后女性为 15.1%,60 岁至 65 岁绝经后女性为 6.5%。有 135 名女性使用处方治疗更年期症状:120 名(5.9%)女性使用激素治疗,15 名(0.7%)女性使用非激素药物。与中重度 VMS 呈正相关的因素有吸烟(优势比,1.6;95%置信区间,1.1-2.3;P<0.05)和体质指数为 25 至 29.9kg/m²(优势比,1.7;95%置信区间,1.1-2.5;P<0.05);而接受过高中以上教育则与之呈负相关(优势比,0.7;95%置信区间,0.5-0.9;P<0.05)。

结论

在这项基于社区的大型代表性女性样本中,即使是 60 至 65 岁的女性,也存在未经治疗的中重度 VMS 的高发率。对于治疗更年期症状具有明确疗效的阴道雌激素和非激素处方疗法的使用率极低,这表明更年期仍然是一种治疗不足的病症。

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