von Mühlen D G, Kritz-Silverstein D, Barrett-Connor E
Department of Family and Preventive Medicine, University of California, San Diego, La Jolla 92093-0607, USA.
Maturitas. 1995 Sep;22(2):71-8. doi: 10.1016/0378-5122(95)00917-a.
This study examines the symptoms after a natural menopause recalled by women aged 50-89 years. We determined the frequency and clustering of symptoms, the effect of age on symptoms, and the relation of symptoms to the use of estrogen therapy in a cross-sectional, community-based study of 589 Caucasian, middle- to upper-middle-class women from Rancho Bernardo, California. At the time of menopause, 55% of the women reported that they felt life was getting better and 57% were more cheerful. The most frequently recalled symptoms were hot flushes (74%), propensity to weight gain (45%), night sweats (35%), tiredness (32%), and insomnia (28%). Irritability was reported by one-fourth, depression by one-fifth. Nearly 11% reported anxiety about looking older. The recalled prevalence of hot flushes, irritability, weepiness and tiredness did not vary by current age, but younger women were significantly more likely than older women to have experienced night sweats, visible flushes, depression, anxiety about looking older and insomnia. Principal components factor analysis yielded four main independent factors: psychological symptoms (21% of the variance), vasomotor symptoms (14%), positive feelings (11%), and negative self-image (8%). The four symptom groupings suggest different causal mechanisms. Forty-two percent reported past, and 27% reported current use of estrogen therapy. Both past and current hormone users were significantly more likely to report menopause symptoms than non-users. Estrogen use was not associated with positive feelings or self-image at the time of menopause. Although three-quarters experienced symptoms, the majority of women reported positive feelings about menopause.
本研究调查了年龄在50 - 89岁的女性回忆起的自然绝经后的症状。在一项基于社区的横断面研究中，我们对来自加利福尼亚州兰乔贝纳多的589名白种人、中上层阶级女性进行了研究，确定了症状的频率和聚类情况、年龄对症状的影响以及症状与雌激素治疗使用之间的关系。在绝经时，55%的女性表示她们觉得生活在变好，57%的人更开朗。最常回忆起的症状是潮热（74%）、体重增加倾向（45%）、盗汗（35%）、疲倦（32%）和失眠（28%）。四分之一的人报告有易怒情绪，五分之一的人报告有抑郁情绪。近11%的人报告担心看起来变老。潮热、易怒、易哭和疲倦的回忆患病率不因当前年龄而异，但年轻女性比年长女性更有可能经历盗汗、明显潮热、抑郁、担心看起来变老和失眠。主成分因子分析产生了四个主要独立因素：心理症状（占方差的21%）、血管舒缩症状（14%）、积极情绪（11%）和负面自我形象（8%）。这四个症状分组表明了不同的因果机制。42%的人报告过去使用过雌激素治疗，27%的人报告目前正在使用。过去和现在使用激素的人比未使用者更有可能报告绝经症状。雌激素的使用与绝经时的积极情绪或自我形象无关。虽然四分之三的人经历了症状，但大多数女性对绝经报告有积极情绪。
