Department of Epidemiology, Graduate School of Public Health University of Pittsburgh, Pittsburgh, PA.
David Geffen School of Medicine at UCLA, Los Angeles, CA.
Menopause. 2019 Oct;26(10):1213-1227. doi: 10.1097/GME.0000000000001424.
Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women.
This review summarizes the central findings of SWAN to date that can inform women and their healthcare providers about the impact of the MT and midlife aging on overall health and well-being.
SWAN characterized changes in reproductive axis and menstrual cycle patterns that informed the development of the reproductive aging staging system Staging of Reproductive Aging Workshop+10; MT-related symptoms and mental health (vasomotor symptoms, sleep complaints, psychological symptoms, cognitive performance, and urogenital and sexual health); and physiological systems and functions (cardiovascular and cardiometabolic health, bone health, physical function performance) that are influenced by the MT. SWAN demonstrated substantial interrelations among these changes and significant racial/ethnic differences in the rate and magnitude of change in multiple health indictors in midlife women. The findings point to midlife as a critical stage for adopting healthy behavior and preventive strategies.
Over the past 23 years, SWAN has advanced our understanding of the impact of the MT and midlife aging on health and well-being in women. SWAN will be instrumental to determine whether MT-related changes during midlife are related to unfavorable health and well-being in early old age.
我们最初对绝经过渡期（MT）的理解是基于寻求治疗的女性的临床样本，而不是基于基于人群的研究。妇女健康全国研究（SWAN）于 1996 年启动，总体目标是定义 MT，描述其在种族和种族多样化的中年女性样本中的生物学和心理社会前因和后果。
本综述总结了迄今为止 SWAN 的主要发现，这些发现可以为女性及其医疗保健提供者提供有关 MT 和中年衰老对整体健康和幸福感的影响的信息。
SWAN 描述了生殖轴和月经周期模式的变化，这些变化为生殖衰老分期系统（生殖衰老分期系统+10）的发展提供了信息；MT 相关症状和心理健康（血管舒缩症状、睡眠问题、心理症状、认知表现以及泌尿生殖和性健康）；以及受 MT 影响的生理系统和功能（心血管和心脏代谢健康、骨骼健康、身体功能表现）。SWAN 表明这些变化之间存在大量相互关系，以及中年女性在多个健康指标的变化速度和幅度上存在显著的种族/民族差异。这些发现表明，中年是采取健康行为和预防策略的关键阶段。
在过去的 23 年中，SWAN 提高了我们对 MT 和中年衰老对女性健康和幸福感的影响的理解。SWAN 将有助于确定中年时期与 MT 相关的变化是否与早期老年的不良健康和幸福感有关。
