Symptoms associated with menopausal transition and reproductive hormones in midlife women

被引:224
作者
Freeman, Ellen W.
Sammel, Mary D.
Lin, Hui
Gracia, Clarisa R.
Pien, Grace W.
Nelson, Deborah B.
Sheng, Li
机构
[1] Univ Penn, Dept Obstet Gynecol, Ctr Clin Epidemiol & Biostat, Ctr Res Reprod & Womens Hlth, Philadelphia, PA 19104 USA
[2] Univ Penn, Dept Psychiat, Ctr Clin Epidemiol & Biostat, Ctr Res Reprod & Womens Hlth, Philadelphia, PA 19104 USA
[3] Univ Penn, Dept Med, Philadelphia, PA 19104 USA
[4] Temple Univ, Coll Hlth Profess, Philadelphia, PA 19122 USA
[5] Drexel Univ, Dept Math, Philadelphia, PA 19104 USA
关键词
D O I
10.1097/01.AOG.0000270153.59102.40
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: To test the hypothesis that prevalence of women with menopausal symptoms of hot flushes; aches, joint pain, and stiffness; depressed mood; poor sleep; decreased libido; or vaginal dryness increases with progression through the menopausal transition. METHODS: Women in the Penn Ovarian Aging Study were assessed longitudinally for 9 years. Data were obtained from structured interviews, a validated symptom questionnaire, menstrual bleeding dates and early follicular hormone measures (estradiol [E2], follicle-stimulating hormone [FSH], and inhibin b). Menopausal stages were based on menstrual bleeding patterns. Other risk factors included age, race, history of depression, current smoking, body mass index, and perceived stress. Generalized linear regression models for repeated measures were used to estimate associations among the variables with each symptom. RESULTS: The prevalence of hot flushes; aches, joint pain, and stiffness; and depressed mood increased in the menopausal transition. Menopausal stage was associated with hot flushes (P <.001); aches joint pain, and stiffness (P <.001); and depressed mood (P=.002). Within-woman fluctuations of E2 were associated with hot flushes and aches. Poor sleep, decreased libido, and vaginal dryness were not associated with menopausal stages. There was 80% power to detect an absolute difference of 11% for libido and vaginal dryness and 17% for poor sleep in the prevalence of these symptoms in the late menopausal transition compared with premenopausal status. CONCLUSION: The study highlights the role of menopausal stages for some symptoms of midlife women and indicates that stages in the transition to menopause are associated with hot flushes; aches, joint pain, and stiffness; and depressed mood. Fluctuations of E2, decreased levels of inhibin b, and increased FSH levels were associated with these symptoms.
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收藏
页码:230 / 240
页数:11
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