Hill K
Department of Population Dynamics, Johns Hopkins University, Baltimore, Maryland, USA.
Maturitas. 1996 Mar;23(2):113-27. doi: 10.1016/0378-5122(95)00968-x.
Menopause marks a time of dramatic hormonal and often social change for women. Both risk factors and health needs are likely to change as women pass through menopause. This paper examines the demographic characteristics of the world population of menopausal and post-menopausal women, and also examines the implication of menopause for mortality risks. The numbers of women involved are large. Using age 50 as a proxy for menopause, about 25 million women pass through menopause each year, and we estimate that in 1990 there were 467 million post-menopausal women in the world, with an average age of about 60 years. By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion, with 47 million new entrants each year. The mortality implications of menopause are also substantial. Ratios of female to male mortality risks from all causes and from all major cause groups except neoplasms decline to low levels around menopause or shortly thereafter, and then rise again to near unity. This pattern is taken as evidence that the female reproductive period is broadly protective of health, but that this protection disappears after menopause. The main protective effect is through reduced risk of cardiovascular disease mortality, partially offset by increased risks of cancer mortality, particularly of the breast and endometrium.
更年期标志着女性荷尔蒙发生巨大变化，且往往伴随着社会角色的转变。随着女性步入更年期，风险因素和健康需求都可能发生变化。本文研究了全球更年期及绝经后女性人群的人口统计学特征，并探讨了更年期对死亡风险的影响。涉及的女性数量众多。以50岁作为更年期的近似年龄，每年约有2500万女性步入更年期，据我们估计，1990年全球绝经后女性有4.67亿，平均年龄约为60岁。到2030年，预计全球更年期及绝经后女性人口将增至12亿，每年新增4700万。更年期对死亡率的影响也相当大。除肿瘤外，所有原因及所有主要病因组别的女性与男性死亡风险比在更年期前后或之后不久降至较低水平，然后又回升至接近1。这种模式被视为女性生育期对健康具有广泛保护作用的证据，但这种保护在绝经后消失。主要的保护作用是通过降低心血管疾病死亡率实现的，部分被癌症死亡率上升所抵消，尤其是乳腺癌和子宫内膜癌死亡率的上升。
