Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and the Royal Women's Hospital, Melbourne, VIC, Australia.
Department of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA.
Lancet. 2024 Mar 9;403(10430):947-957. doi: 10.1016/S0140-6736(23)02799-X. Epub 2024 Mar 5.
Menopause eventually happens to all people with typically functioning ovaries, and almost one billion women worldwide are postmenopausal. Although the biology of typical menopause is ubiquitous, the experience varies substantially. Factors contributing to the experience include not only individual factors, such as the nature and severity of symptoms, but also psychological, social, and contextual considerations, many of which are modifiable. In this first paper in the Lancet Series on menopause, we argue for a new approach that goes beyond the treatment of specific symptoms, to encompass a broad model to support women transitioning this life stage, using the model of empowerment. WHO defines empowerment as an active process of gaining knowledge, confidence, and self-determination to self-manage health and make informed decisions about care. Rather than focusing on menopause as an endocrine deficiency, we propose an empowerment model that recognises factors modifying the experience, in which the patient is an expert in their own condition and the health-care worker supports the patient to become an equal and active partner in managing their own care.
绝经最终会发生在所有卵巢功能正常的人身上,全世界有近 10 亿女性已经绝经。尽管典型的绝经生物学是普遍存在的,但绝经体验却有很大的差异。导致这种体验的因素不仅包括个体因素,如症状的性质和严重程度,还包括心理、社会和环境方面的考虑因素,其中许多因素是可以改变的。在《柳叶刀》绝经系列的第一篇论文中,我们主张采用一种超越特定症状治疗的新方法,采用赋权模式来支持女性过渡这一生命阶段,该模式涵盖了支持女性过渡这一生命阶段的广泛模型,利用赋权模式。世界卫生组织将赋权定义为积极获取知识、信心和自我决定,以自我管理健康并就护理做出明智决策的过程。我们不是将绝经视为内分泌缺乏症,而是提出一个赋权模式,承认影响体验的因素,其中患者是自身状况的专家,医疗保健工作者支持患者成为管理自身护理的平等和积极伙伴。