围绝经期的流行病学调查

Epidemiology of perimenopause

1990年5～12月在北京东城区40～65岁妇女中进行了围绝经期流行病学调查。随机抽样得调查对象5000余名,应答率97.1％。共有5134名妇女进入分析,其中54.4％已绝经。绝经者中自然绝经占93.8％,手术绝经占5.4％。自然绝经平均年龄49岁。既往月经多,曾用甾体避孕药,肥胖及多次妊娠等与绝经晚有关;而吸烟及绝经前生活中发生重大事件可导致提早绝经。更年期症状不如西方妇女严重,与亚洲一些国家的研究结果接近,表明了种族和社会文化的不同对更年期症状的影响。产次、教育水平、绝经年龄、月经状况、哺乳、绝经时婚姻状态,以及生活中重大事件或环境变化等,均可以其特有方式影响更年期症状的轻重、出现早晚和持续时间。

Due to the lack of information aboutthe menopause in China, an epidemiologic survey among perimenopausal women aged 40~65 was conducted in Beijing from May to December 1990. Over 5 000 women were selected by random sampling. An unified questionnaire was copmleted by face to face ynterviews. 5 134 women were included in the analysis. Among them 54. 4% were postmenopausal,10% in 40～49 age group,87. 8% in 50～59 and 99. 3% in 60～65 age group. The menopause in 93. 8% were natural menopause, 5. 4% after hysterectomy and 0. 8% after drug or radiation. The mean age at natural menopause is49(22～61) , not very different from other reports . Premature menopause before 4 0 was 3. 1 % . The incidence of menopausal symptoms varied between 4 6. 6 % ～1 0. 1 % . Irritability , sweating and hot flushing were the most frequent ones,but they were usually mild, only about 20% were severe, and other symptoms were severe in about 10%. Late menopause were related with heavy menstural bleeding , use of oral contraceptives, obesity and multigravida; while early menopause are related with smoking and accidents or happenings during premenopausal period. Only 4 women in this sample used estrogen replacement therapy for more than half a year, 0. 4% of the menopausal women. In this study, menopause following surgery, menopausal symptoms and hormone replacement therapy were all lower than that in western countries but similar to that in eastern countries.