Department of Epidemiology, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China.
Department of Research and Education, Shanghai Center for Women and Children's Health, Shanghai 200062, China.
Int J Environ Res Public Health. 2020 Apr 12;17(8):2640. doi: 10.3390/ijerph17082640.
The aim of the study was to specify prevalence and severity of menopausal symptoms among middle-aged women and to understand the factors associated with women's perimenopausal healthcare-seeking behavior in Shanghai, China. A community-based cross-sectional study was carried out involving 3147 participants aged 40-60 years. A combination of stratified sampling and quota sampling was used. Out of the total 16 districts in Shanghai, 7 were purposefully selected in consideration of covering both central and suburban areas, population distribution, and willingness to participate. Two communities were randomly selected in each of six districts. Four communities were randomly selected in the 7th district considering the relatively low coverage of central population in the sampling frame. Eligible women were recruited continuously according to the house number and invited to participate in the study until 200 participants were recruited in each community. A structured questionnaire was designed to collect information including sociodemographic data, menopausal symptoms, and experiences in seeking perimenopausal healthcare. The severity of menopausal symptoms was assessed with the modified Kupperman menopausal index (mKMI). The mean age of all the participants was 51 years. 33.13% of the participants were premenopausal, 14.52% were perimenopausal, and 52.35% were postmenopausal. The total prevalence of menopausal symptoms was 73.8%, while among the perimenopausal women, the symptoms were the most common (81.70%). The top three reported symptoms were fatigue (38.08%), hot flushes and sweating (33.65%), and joint ache (28.81%). Perimenopausal and postmenopausal participants had a higher score of the mKMI than premenopausal women ( < 0.01). Of the women who had symptoms, 25.97% had sought healthcare. A logistic regression model revealed that employment, menstruation status, and the mKMI were significantly associated with healthcare-seeking behaviors ( < 0.01). We concluded that prevalence of menopausal symptoms was relatively high among middle-aged women, with perimenopausal women showing the highest level. However, only a small percentage of the participants sought healthcare. Carrying out health education may be a measure to improve the healthcare-seeking behavior.
本研究旨在明确上海地区中年女性围绝经期症状的发生率和严重程度，并了解与女性围绝经期保健寻求行为相关的因素。采用基于社区的横断面研究，共纳入 3147 名年龄在 40-60 岁的参与者。采用分层抽样和配额抽样相结合的方法。在上海的 16 个区中，出于考虑覆盖中心区和郊区、人口分布和参与意愿的目的，有 7 个区被有目的地选择。在 6 个区中的每个区随机选择了 2 个社区。在第 7 个区，由于抽样框架中中心区人口覆盖率相对较低，因此随机选择了 4 个社区。根据门牌号连续招募符合条件的女性，并邀请她们参加研究，直到每个社区招募到 200 名参与者。设计了一份结构化问卷，收集包括社会人口学数据、围绝经期症状和围绝经期保健寻求经历等信息。采用改良 Kupperman 绝经指数（mKMI）评估绝经症状的严重程度。所有参与者的平均年龄为 51 岁。33.13%的参与者处于绝经前期，14.52%处于围绝经期，52.35%处于绝经后期。总的围绝经期症状发生率为 73.8%，而在围绝经期女性中，症状最为常见（81.70%）。报告的前三种症状是疲劳（38.08%）、潮热和出汗（33.65%）和关节疼痛（28.81%）。围绝经期和绝经后期参与者的 mKMI 评分高于绝经前期女性（<0.01）。在有症状的女性中，有 25.97%寻求了医疗保健。Logistic 回归模型显示，就业状况、月经状况和 mKMI 与保健寻求行为显著相关（<0.01）。我们得出结论，中年女性围绝经期症状的发生率相对较高，围绝经期女性的症状发生率最高。然而，只有一小部分参与者寻求医疗保健。开展健康教育可能是改善保健寻求行为的一项措施。
