The International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
Front Endocrinol (Lausanne). 2022 Jun 23;13:856044. doi: 10.3389/fendo.2022.856044. eCollection 2022.
Primary ovarian insufficiency (POI) has serious physical and psychological consequences due to estradiol deprivation, leading to increased morbidity and mortality. However, the causes of most POI cases remain unknown. Psychological stress, usually caused by stressful life events, is known to be negatively associated with ovarian function. It is important to explore high-frequency adverse life events among women with POI for future interventions.
Forty-three women (mean age=33·8 years) were recruited who were newly- diagnosed with idiopathic POI (FSH levels >40 IU/L) to participate in semi-structured interviews through convenience sampling. The main questions covered by the topic guide were designed to explore adverse life events prior to POI diagnosis. Interviews were audio recorded, transcribed and analyzed thematically. Data were analyzed from June 2019 to August 2020.
Among the women with POI, mean age at diagnosis of POI was 33·8 years (range from 19 to 39 years), and the average time between the onset of irregular menstruation and POI diagnosis was 2.3 years. These women with POI had a relatively normal menstrual cycle before the diagnosis. A number of stressful life events prior to POI diagnosis were discussed by them as important factors influencing their health. Four core themes emerged: 1) persistent exposure to workplace stress, 2) persistent exposure to family-related adverse life events, 3) sleep problem/disturbance existed in women with POI before diagnosis, and 4) participants' general cognition and concerns about POI.
Persistent exposures to adverse life events related to work stress, family stress and sleep problem existed in women with POI. Our findings are consistent with the hypothesis that adverse life events play a role in the development of POI. Future research should investigate how social environmental factors influence POI disease risks, and whether provision of tailored interventions (i.e. preventing or mitigating impact of adverse life events) aimed at high-risk populations may help prevent new POI cases and improve conditions of women with POI. We gained an in-depth understanding of the experiences of these women 1:1 qualitative method, and find adverse life events are frequent in women with POI prior to the diagnosis.
由于缺乏雌二醇，原发性卵巢功能不全（POI）会导致严重的身心后果，导致发病率和死亡率增加。然而，大多数 POI 病例的原因仍不清楚。心理压力通常是由生活压力事件引起的，已知与卵巢功能呈负相关。重要的是要探索 POI 女性的高频不良生活事件，以便为未来的干预措施提供参考。
通过便利抽样招募了 43 名新诊断为特发性 POI（FSH 水平>40IU/L）的女性进行半结构式访谈。主题指南涵盖的主要问题旨在探讨 POI 诊断前的不良生活事件。访谈进行了录音、转录，并进行了主题分析。数据于 2019 年 6 月至 2020 年 8 月进行分析。
在 POI 女性中，POI 的平均诊断年龄为 33.8 岁（19 岁至 39 岁），从月经不规律到 POI 诊断的平均时间为 2.3 年。这些 POI 女性在诊断前有相对正常的月经周期。她们讨论了一些诊断前的压力生活事件，认为这些事件是影响其健康的重要因素。出现了四个核心主题：1）持续暴露于工作场所压力，2）持续暴露于与家庭相关的不良生活事件，3）POI 诊断前女性存在睡眠问题/障碍，4）参与者对 POI 的一般认知和关注。
POI 女性持续暴露于与工作压力、家庭压力和睡眠问题相关的不良生活事件中。我们的研究结果与不良生活事件在 POI 发展中起作用的假设一致。未来的研究应调查社会环境因素如何影响 POI 的疾病风险，以及针对高危人群提供量身定制的干预措施（即预防或减轻不良生活事件的影响）是否有助于预防新的 POI 病例并改善 POI 女性的状况。我们通过 1:1 定性方法深入了解了这些女性的经历，发现 POI 女性在诊断前经常经历不良生活事件。
