Martin-Key Nayra A, Funnell Erin L, Tomasik Jakub, Bahn Sabine
Cambridge Centre for Neuropsychiatric Research, Department of Chemical Engineering and Biotechnology, University of Cambridge, Philippa Fawcett Drive, Cambridge, CB3 0AS, UK.
BMC Womens Health. 2025 Aug 4;25(1):384. doi: 10.1186/s12905-025-03929-3.
While there exist safe hormonal and non-hormonal therapeutic interventions for the menopause, their efficacy profiles are not fully characterized. This study sought to use a symptom checklist to examine menopausal symptom relief associated with different treatments.
An online survey study was conducted between December 2023 and February 2024. Convenience sampling was conducted, with participants recruited via social media, email, through relevant foundations and support groups, and by word-of-mouth. Inclusion criteria were: (1) ≥ 18 years, (2) assigned female at birth, (3) strong comprehension of the English language, and (4) must be currently experiencing symptoms of the menopause or menopause transition. 3330 respondents consented to participate in the study and of these, 91.95% (N = 3062) who had completed at least 88% of the survey were included in the analysis. Symptom relief per treatment (transdermal hormone replacement therapy (HRT), oral HRT, vaginal HRT, antidepressants, testosterone, cognitive behavioral therapy (CBT)/other therapy/counseling) was assessed using the symptoms included in the Menopause-Specific Quality of Life (MENQOL) questionnaire, which measures four symptom domains: vasomotor, psychosocial, physical, and sexual.
Data from a total of 3062 respondents were included for analysis (mean age = 51.97, SD = 5.24). Treatment response rates differed significantly across the domains (vasomotor: F(5,2340) = 204.93, p < 0.001, η = 0.31; psychosocial: F(5,2340) = 75.12, p < 0.001, η = 0.14; physical: F(5,2340) = 65.46, p < 0.001, η = 0.12; sexual: F(5,2340) = 89.34, p < 0.001, η = 0.16). Transdermal HRT performed better at reducing vasomotor symptoms relative to all other treatment options. Regarding psychosocial symptoms, CBT/other therapy/counseling outperformed all other treatment options. The use of transdermal HRT and testosterone was associated with greater response rates in physical symptoms relative to other treatments. Finally, vaginal HRT and testosterone were associated with significantly higher response rates in sexual symptoms in comparison to all other treatments.
The findings demonstrate differential response rates to menopausal treatments across symptom domains, underscoring the importance of a comprehensive, multidimensional approach to menopausal symptom management. Utilizing a symptom checklist can facilitate the tailoring of treatment plans for specific symptom profiles and patient needs. The outcomes of this study hold considerable implications for improving and shaping treatment guidelines for the menopause.
虽然存在针对更年期的安全激素和非激素治疗干预措施，但其疗效特征尚未完全明确。本研究旨在使用症状清单来检查与不同治疗相关的更年期症状缓解情况。
在2023年12月至2024年2月期间进行了一项在线调查研究。采用便利抽样，通过社交媒体、电子邮件、相关基金会和支持小组以及口碑招募参与者。纳入标准为：（1）年龄≥18岁，（2）出生时被指定为女性，（3）对英语有较强的理解能力，（4）目前必须正在经历更年期症状或更年期过渡。3330名受访者同意参与研究，其中91.95%（N = 3062）完成了至少88%的调查，这些受访者被纳入分析。使用《更年期特异性生活质量》（MENQOL）问卷中的症状评估每种治疗（经皮激素替代疗法（HRT）、口服HRT、阴道HRT、抗抑郁药、睾酮、认知行为疗法（CBT）/其他疗法/咨询）的症状缓解情况，该问卷测量四个症状领域：血管舒缩、心理社会、身体和性方面。
共纳入3062名受访者的数据进行分析（平均年龄 = 51.97，标准差 = 5.24）。各领域的治疗反应率差异显著（血管舒缩：F(5,2340) = 204.93，p < 0.001，η = 0.31；心理社会：F(5,2340) = 75.12，p < 0.001，η = 0.14；身体：F(5,2340) = 65.46，p < 0.001，η = 0.12；性方面：F(5,2340) = 89.34，p < 0.001，η = 0.16）。与所有其他治疗选择相比，经皮HRT在减轻血管舒缩症状方面表现更好。关于心理社会症状，CBT/其他疗法/咨询的效果优于所有其他治疗选择。与其他治疗相比，经皮HRT和睾酮的使用在身体症状方面的反应率更高。最后，与所有其他治疗相比，阴道HRT和睾酮在性症状方面的反应率显著更高。
研究结果表明，更年期治疗在不同症状领域的反应率存在差异，强调了采用全面、多维度方法管理更年期症状的重要性。使用症状清单有助于根据特定症状特征和患者需求制定个性化的治疗方案。本研究结果对改进和制定更年期治疗指南具有重要意义。
