Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Center of Excellence in Maternal and Child Health, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA.
BMC Womens Health. 2024 Sep 4;24(1):487. doi: 10.1186/s12905-024-03329-z.
The transition to menopause is a significant event affecting health, well-being, and quality of life. Menopause typically occurs between the ages of 44-57, accompanied by symptoms such as hot flashes, mood changes, and sleep disturbances. Being postmenopausal also increases the risk of cardiovascular disease, stroke, and osteoporosis. Despite its importance, menopause is under-researched and under-discussed, particularly concerning the impact of chronic psychosocial stress.
A scoping review of qualitative, quantitative, and mixed methods research was conducted to map existing literature on the transition to menopause among populations experiencing chronic psychosocial stress in the United States. The review followed the PRISMA-ScR methodology, systematically searching literature in PubMed and SCOPUS databases using MeSH terms. Studies were included which focused on menopausal symptoms and psychosocial stressors. Data extraction and charting were performed using Covidence software.
Fifteen studies were included, highlighting relationships between socioeconomic status, intimate partner violence, childhood abuse, and racial disparities which influenced menopausal experiences. Lower- income, higher perceived stress, and negative attitudes towards menopause were associated with increased psychological and somatic symptoms and early onset of menopause (prior to age 45). African American women were found to experience earlier onset and more severe vasomotor symptoms compared to their White counterparts. Women veterans used hormone therapy more frequently than the general population, particularly those with mood or anxiety disorders. The review also identified a geographic bias, with most studies conducted in the Northeast, Midwest, and Western regions of the United States.
This review underscores the necessity of considering social, cultural, and environmental factors in understanding menopausal experiences and addressing health disparities. Future research should aim to include diverse populations and adopt longitudinal and qualitative study designs to capture the dynamic nature of menopausal experiences. Policies and interventions directed at improving the well-being of women experiencing menopause in the context of chronic psychosocial stress are warranted.
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绝经是影响健康、幸福感和生活质量的重大事件。绝经通常发生在 44-57 岁之间，伴随热潮、情绪变化和睡眠障碍等症状。绝经后还会增加心血管疾病、中风和骨质疏松症的风险。尽管其重要性，绝经仍未得到充分研究和讨论，特别是关于慢性心理社会压力的影响。
对美国经历慢性心理社会压力的人群绝经过渡的定性、定量和混合方法研究进行了范围综述。该综述遵循 PRISMA-ScR 方法，使用 MeSH 术语在 PubMed 和 SCOPUS 数据库中系统地搜索文献。研究重点关注绝经症状和心理社会压力源。使用 Covidence 软件进行数据提取和图表制作。
纳入了 15 项研究，强调了社会经济地位、亲密伴侣暴力、儿童期虐待和种族差异之间的关系，这些关系影响了绝经经历。低收入、更高的感知压力和对绝经的负面态度与增加心理和躯体症状以及提前绝经（45 岁之前）有关。与白种人相比，非裔美国女性更早出现更严重的血管舒缩症状。女性退伍军人比一般人群更频繁地使用激素治疗，尤其是那些有情绪或焦虑障碍的人。该综述还发现了一个地理偏差，大多数研究在美国东北部、中西部和西部进行。
该综述强调了在理解绝经经历和解决健康差异时考虑社会、文化和环境因素的必要性。未来的研究应旨在包括不同的人群，并采用纵向和定性研究设计，以捕捉绝经经历的动态性质。需要制定针对在慢性心理社会压力背景下经历绝经的女性的政策和干预措施，以提高她们的幸福感。
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