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Abdelmola AO, Mesawa RM, Hakami AM, Ageeli RF, Khawaji OA, Ageeli HM, Alabood ZM, Kariri HDH, Abdelwahab SI. Determinants of knowledge and perception about menopause among Saudi women: A cross-sectional study. Heliyon 2024; 10:e32935. [PMID: 38948045 PMCID: PMC11211883 DOI: 10.1016/j.heliyon.2024.e32935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 07/02/2024] Open
Abstract
Background Healthcare professionals and educators closely monitor the occurrence of climacteric symptoms in women's primes. Knowledge and perception of menopause play a crucial role in improving quality of life. This study aimed to assess the knowledge and perceptions of menopause among Saudi women and identify its predictors. This study is the first of its kind in the southern region of Saudi Arabia. Methods Conducted in accordance with the STROBE guidelines, this cross-sectional study was carried out in the Jazan region from May 2022 to January 2023 and involved 480 Saudi women who provided consent. Data were collected through interviews using a validated questionnaire and random sampling. The questionnaire consisted of four parts: informed consent, demographics, 21 knowledge questions, and ten menopause perception questions. The validity of the content and the internal consistency were evaluated before data collection. Primary healthcare centers were randomly selected from four governorates with a proportional sample size to the population. Descriptive analysis, Pearson correlation, and multivariate logistic regression analyses were performed using IBM-SPSS. Results Among the participants, 64 % were under 40 years old, 80 % had experienced menarche between the ages of 10 and 15, 48 % were employed, approximately half held a bachelor's degree, and they had a good family income. The mean knowledge score of the participants was 48.87 ± 11.72, with a minimum score of 27 and a maximum score of 78. In terms of knowledge categories, 56.3 % of the participants (N = 270) were classified as having low knowledge, while 43.8 % (N = 210) were classified as having high knowledge. Most of the participants had positive perceptions and agreed that menopause is a natural event in women's lives. There was a significant positive correlation between knowledge and perception (R = 0.219, P < 0.01). Variable findings were observed regarding the role of explanatory variables in women's knowledge of menopause between univariate and multivariate models. The results of the multivariate model showed that age (46-50 years, OR = 0.42), having children (OR = 1.09), residence (OR = 0.45-5.73) and family income categories (medium: OR = 3.98, good: OR = 3.78, and excellent: OR = 1.95) had a significant impact on knowledge, highlighting the correlation between demographic factors and knowledge. Conclusions Based on the study findings, we recommend implementing workplace and community-based activities to increase women's awareness of menopause and incorporating it as an integral part of counseling sessions for women in this age group. Therefore, the results of the study will be shared with the relevant authorities responsible for women's health, enabling them to effectively support and educate women.
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Affiliation(s)
- Amani Osman Abdelmola
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Rufaydah Mohammad Mesawa
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Alia'a Mohammed Hakami
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Razan Faiez Ageeli
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Ola Abdo Khawaji
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Halimah Mohammed Ageeli
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Zainab Mohammed Alabood
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
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Aquino CI, Stampini V, Osella E, Troìa L, Rocca C, Guida M, Faggiano F, Remorgida V, Surico D. Menopausal Hormone Therapy, an Ever-Present Topic: A Pilot Survey about Women's Experience and Medical Doctors' Approach. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:774. [PMID: 38792957 PMCID: PMC11122847 DOI: 10.3390/medicina60050774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/18/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Background and Objective: Menopause can be associated with many clinical manifestations: vasomotor symptoms, urogenital problems, and additional psychological disturbances, such as anxiety, mood changes, and sleep alterations. The prolonged lack of hormones also increases the risk of long-term consequences. Hormone Replacement Treatment (HRT) in menopause consists of the administration of estrogen, alone or associated to progesterone, to relieve these uncomfortable disturbances and to prevent the onset of other pathologic conditions. The aim of this study is to examine the prevalence of HRT use in a sample of menopausal women and their experience with menopause and HRT. This study also investigates the knowledge of general practitioners (GPs) and gynecologists about HRT and its prescription. Materials and Methods: We conducted a cross-sectional population survey on 126 women of 50-59 years in an industrial city in the North of Italy, Vercelli (Novara), in Eastern Piedmont. We also presented a questionnaire on the topic to 54 medical doctors (GPs and gynecologists) of the same area. Results: The prevalence of HRT use in our sample was 11.9%. In total, a good percentage of the users affirmed to be satisfied with HRT. Additionally, a minority of women reported being ideally against the use of replacement hormones, were advised against using HRT by doctors, and did not use it because of the fear of side effects. We found a positive association between patient education, health care attitude, and HRT usage. A significant number of women knew about HRT from the media, and most of them were not informed by a health professional. Despite this, the interviewed doctors considered their knowledge about HRT as 'good' and would recommend HRT: only 5.6% would not prescribe it. Conclusions: Our results highlight the need for information about HRT among patients and health professionals, along with the need for more effective communication, evaluation, and suggestion of treatment.
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Affiliation(s)
- Carmen Imma Aquino
- Department of Translational Medicine, University of Piemonte Orientale, Gynecology and Obstetrics, “Maggiore della Carità” Hospital, 28100 Novara, Italy
| | - Viviana Stampini
- Department of Translational Medicine, University of Piemonte Orientale, Gynecology and Obstetrics, “Maggiore della Carità” Hospital, 28100 Novara, Italy
| | - Elena Osella
- Department of Translational Medicine, University of Piemonte Orientale, Gynecology and Obstetrics, “Maggiore della Carità” Hospital, 28100 Novara, Italy
| | - Libera Troìa
- Department of Translational Medicine, University of Piemonte Orientale, Gynecology and Obstetrics, “Maggiore della Carità” Hospital, 28100 Novara, Italy
| | - Clarissa Rocca
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Guida
- Department of Neurosciences and Reproductive Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Fabrizio Faggiano
- Department for Sustainable Development and Ecological Transition, University of Piemonte Orientale, 13100 Vercelli, Italy
| | - Valentino Remorgida
- Department of Translational Medicine, University of Piemonte Orientale, Gynecology and Obstetrics, “Maggiore della Carità” Hospital, 28100 Novara, Italy
| | - Daniela Surico
- Department of Translational Medicine, University of Piemonte Orientale, Gynecology and Obstetrics, “Maggiore della Carità” Hospital, 28100 Novara, Italy
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Tang R, Xie Z, Ruan X, Zhang Z, Ren M, Wu J, Shu K, Shi H, Xie M, Lv S, Yang X, Chen R, Yu Q. Changes in menopausal symptoms comparing oral estradiol versus transdermal estradiol. Climacteric 2024; 27:171-177. [PMID: 37942806 DOI: 10.1080/13697137.2023.2273530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/04/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE This study aimed to compare the efficacy and safety of oral and transdermal estradiol in alleviating menopausal symptoms. METHOD A total of 257 recently menopausal women were randomized into two groups. The t-E2 group received transdermal estradiol (2.5 g per day) (n = 128) and the o-E2V group received oral estradiol valerate (2 mg per day) (n = 129) for 24 weeks; both groups received micronized progesterone (200 mg per day). The primary outcome measure is the change in the modified Kupperman Menopausal Index (KMI) after 24 weeks of treatment. Menopausal symptoms were recorded at screening and at 4, 12 and 24 weeks using both the KMI and the Menopause Rating Scale (MRS). RESULTS Significant amelioration was observed by KMI and MRS scores for both groups after treatment (p < 0.001). The mean KMI scores showed no difference between the two groups. The mean MRS scores were similar between the two groups at baseline and after 4 weeks of treatment. The results showed statistical differences after 12 weeks and 24 weeks of treatment (p = 0.005 and p = 0.011). Both the after-treatment scores minus the baseline scores of KMI and MRS and the incidence of adverse effects showed no difference between the two groups. CONCLUSIONS This study shows that both transdermal and oral estradiol are effective in relieving menopausal symptoms, with little difference in treatment efficacy and safety. CLINICAL TRIAL NUMBER ChiCTR2300073146.
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Affiliation(s)
- R Tang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Z Xie
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - X Ruan
- Beijing Obstetrics and Gynaecology Hospital, Capital Medical University, Beijing, China
| | - Z Zhang
- Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, China
| | - M Ren
- Zhongda Hospital affiliated to Southeast University, Nanjing, China
| | - J Wu
- Jiangsu Province Hospital, Jiangsu, China
| | - K Shu
- Jiangxi Maternal and Child Health Hospital, Jiangxi, China
| | - H Shi
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - M Xie
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - S Lv
- The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China
| | - X Yang
- Peking University People's Hospital, Beijing, China
| | - R Chen
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Q Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Bai S, Song D, Chen M, Lai X, Xu J, Dong F. The association between mammographic density and breast cancer risk in Chinese women: a systematic review and meta-analysis. BMC Womens Health 2024; 24:131. [PMID: 38378562 PMCID: PMC10877813 DOI: 10.1186/s12905-024-02960-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
PURPOSE Breast density has consistently been shown to be an independent risk factor for breast cancer in Western populations; however, few studies have evaluated this topic in Chinese women and there is not yet a unified view. This study investigated the association between mammographic density (MD) and breast cancer risk in Chinese women. METHODS The PubMed, Cochrane Library, Embase, and Wanfang databases were systematically searched in June 2023 to include all studies on the association between MD and breast cancer risk in Chinese women. A total of 13,977 breast cancer cases from 14 studies were chosen, including 10 case-control/cross-sectional studies, and 4 case-only studies. For case-control/cross-sectional studies, the odds ratios (ORs) of MD were combined using random effects models, and for case-only studies, relative odds ratios (RORs) were combinations of premenopausal versus postmenopausal breast cancer cases. RESULTS Women with BI-RADS density category II-IV in case-control/cross-sectional studies had a 0.93-fold (95% confidence interval [CI] 0.55, 1.57), 1.08-fold (95% CI 0.40, 2.94), and 1.24-fold (95% CI 0.42, 3.69) higher risk compared to women with the lowest density category. Combined RORs for premenopausal versus postmenopausal women in case-only studies were 3.84 (95% CI 2.92, 5.05), 22.65 (95% CI 7.21, 71.13), and 42.06 (95% CI 4.22, 419.52), respectively, for BI-RADS density category II-IV versus I. CONCLUSIONS For Chinese women, breast cancer risk is weakly associated with MD; however, breast cancer risk is more strongly correlated with mammographic density in premenopausal women than postmenopausal women. Further research on the factors influencing MD in premenopausal women may provide meaningful insights into breast cancer prevention in China.
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Affiliation(s)
- Song Bai
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Di Song
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Ming Chen
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Xiaoshu Lai
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China.
| | - Fajin Dong
- Department of Ultrasound, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, 518020, China.
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Tamlyn Anne R, Downes M, Simoncini T, Yu Q, Ren M, Wang Y, Graziano CM, Kim K. Evaluating the cost utility of estradiol plus dydrogesterone for the treatment of menopausal women in China. J Med Econ 2024; 27:16-26. [PMID: 38037348 DOI: 10.1080/13696998.2023.2289297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/15/2023] [Indexed: 12/02/2023]
Abstract
AIM Evaluate the cost utility of menopausal hormone therapy for women in China. MATERIALS AND METHODS A bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China's Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks. RESULTS According to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of -7,184$ (-47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China. CONCLUSION Contingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.
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Affiliation(s)
| | - Martin Downes
- Centre for Applied Health Economics, Griffith University, Griffith, Australia
| | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Molecular and Cellular Gynaecological Endocrinology Laboratory (MCGEL), University of Pisa, , Pisa, Italy
- European Menopause and Andropause Society, Geneva, Switzerland
| | - Qi Yu
- Centre of Gynaecological Endocrinology and Reproduction, Peking Union Medical College Hospital, Peking, China
- Asia Pacific Menopause Federation, Devon, United Kingdom of Great Britain and Northern Ireland
| | - Mulan Ren
- Department of Obstetrics and Gynaecology, Southeast University School of Medicine, Nanjing, Jiangsu, China
- Reproductive Centre, Zhongda Hospital Southeast University, Nanjing, Jiangsu, China
- Gynaecologic Endocrinologist Training Base of Chinese Medical Doctor Association, Beijing, China
- Menopause Group, Obstetrics and Gynaecology Society of Chinese Medical Association, Beijing, China
- Jiangsu Obstetrics and Gynaecology Quality Control Centre, Nanjing, Jiangsu, China
- Osteoporosis and Bone Mineral Salt Disease, Nanjing Medical Association, Nanjing, China
- Reproductive Medicine, Jiangsu Association of Integrative Medicine, Nanjing, Jiangsu, China
| | - Yaping Wang
- Centre for Reproductive Endocrinology and Infertility, Peking Union Medical College Hospital, Peking, China
| | | | - Kyoo Kim
- Abbott Products Operations AG, Basel-Landschaft, Switzerland
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Tao X, Li T, Gandomkar Z, Brennan PC, Reed WM. Incidence, mortality, survival, and disease burden of breast cancer in China compared to other developed countries. Asia Pac J Clin Oncol 2023; 19:645-654. [PMID: 37026375 DOI: 10.1111/ajco.13958] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 02/20/2023] [Accepted: 03/22/2023] [Indexed: 04/08/2023]
Abstract
Breast cancer was the most diagnosed malignant neoplasm and the second leading cause of cancer mortality among Chinese females in 2020. Increased risk factors and widespread adoption of westernized lifestyles have resulted in an upward trend in the occurrence of breast cancer. Up to date knowledge on the incidence, mortality, survival, and burden of breast cancer is essential for optimized cancer prevention and control. To better understand the status of breast cancer in China, this narrative literature review collected data from multiple sources, including studies obtained from the PubMed database and text references, national annual cancer report, government cancer database, Global Cancer Statistics 2020, and Global Burden of Disease study (2019). This review provides an overview of the incidence, mortality, and survival rates of breast cancer, as well as a summary of disability-adjusted life years associated with breast cancer in China from 1990 to 2019, with comparisons to Japan, South Korea, Australia and the United States.
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Affiliation(s)
- Xuetong Tao
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Tong Li
- The Daffodil Centre, A Joint Venture with Cancer Council NSW, The University of Sydney, Sydney, New South Wales, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ziba Gandomkar
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Patrick C Brennan
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Warren M Reed
- Discipline of Medical Imaging Science, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Pershad A, Morris JM, Shearer K, Pace D, Khanna P. Influencing factors on women's attitudes toward hormone therapy acceptance for menopause treatment: a systematic review. Menopause 2023; 30:1061-1069. [PMID: 37643393 DOI: 10.1097/gme.0000000000002243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
IMPORTANCE There is a paucity of data on recent attitudes and perceptions toward hormone therapy use, especially subsequent reanalysis and follow-up of Women's Health Initiative data. OBJECTIVE The aim of this systematic review was to assess the factors influencing women's attitudes and perceptions toward hormone therapy use for menopausal symptoms. EVIDENCE REVIEW We conducted a comprehensive search of several medical databases including PubMed, Web of Science, Google Scholar, and Scopus. Quality assessment was performed using the Strengthening the Reporting of Observational Studies in Epidemiology Statement for cross-sectional studies. A search was conducted for cross-sectional articles published from January 2012 to March 2023 in English medical databases (PubMed, Web of Science, Scopus, and Google Scholar). Search keywords included "hormone therapy," "acceptance," "menopause," "attitudes," "influence," "factor," "estrogen," "perimenopause," "postmenopause," and "climacteric." Studies evaluating factors that influenced women's attitudes toward hormone therapy were identified. FINDINGS A total of 1,280 articles were initially identified. Twenty-one articles were ultimately included in the review after screening studies based on inclusion and exclusion criteria. The studies were conducted between 2012 and 2023 and included a total of 40,226 participants. The most common positive factor included awareness of the existence and efficacy of hormone therapy. The most common negative factors included concern for general adverse effects and negative perception of hormone therapy from family and friends. The factors assessed in this review on women's attitudes toward hormone therapy acceptance for menopause treatment were categorized into three main themes: (1) demographic factors, (2) environmental/contextual factors, and (3) health care-related factors. CONCLUSIONS AND RELEVANCE Hormone therapy can be a safe and effective tool to improve the quality of life in perimenopausal and postmenopausal women with vasomotor and genitourinary symptoms. However, there are many complex factors that shape women's perceptions of the efficacy, safety, and accessibility of hormone therapy. Healthcare providers should seek to understand these factors to better discuss the benefits and risks with women and assist with decision making based on cultural, personal, and environmental factors.
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Affiliation(s)
- Anita Pershad
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
| | | | - Katie Shearer
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
| | - Diane Pace
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
| | - Pallavi Khanna
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
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Kabir MR, Chan K. Menopausal experiences of women of Chinese ethnicity: A meta-ethnography. PLoS One 2023; 18:e0289322. [PMID: 37703245 PMCID: PMC10499211 DOI: 10.1371/journal.pone.0289322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/17/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVE Menopause and the changes it brings to a woman's life necessitate a comprehensive approach to face and experience the transition. This paper aims at synthesizing results from qualitative studies of menopausal experiences among Chinese and other women of similar ethnicity and culture. DESIGN AND METHOD A comprehensive search strategy of multiple databases along with bibliographic hand searches was employed to identify qualitative studies published in English peer-reviewed journals between 2008 and 2022 focused on the menopausal experiences (peri and post-menopause) of Chinese and other women of similar ethnic backgrounds. Twelve studies met the inclusion criteria. The final sample consisted of 238 women aged between 40 to 60 years who had experienced menopausal symptoms. This qualitative systematic literature review adopted Noblit and Hare's seven-stage theoretical meta-ethnographic approach to construct an inductive and interpretive form of synthesis and subsequent analysis. SYNTHESES OF FINDINGS The synthesis of primary data identified four key concepts that entitle women's menopausal experiences: being menopausal, ramifications on well-being, family and social support around menopause, and healthcare throughout menopause. The subsequent second-order interpretation revealed that women accepted the inevitability of the natural aging process in the decline of sexual drive, reinvented relationships with partners, and expressed the significance of a supportive environment in order to successfully navigate the transition. Third-order interpretations sought to establish a link between physiological complications, loss of femininity, patriarchal-dominated societal norms, and a support system that spans the entire menopause experience. Healthcare's contribution has also been deemed to be insufficient due to a lack of information and empathy from health experts. Negligence or reluctance to seek healthcare and skepticism toward hormone replacement therapy (HRT) had also been a source of concern, as they have had the potential to exacerbate medical difficulties and emotional turmoil. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE A comprehensive approach that considers women's physiological and psychological well-being and major attempts to change cultural beliefs and norms about women's sexual health may be effective in aiding menopausal women during their transition. Additionally, appropriate guidelines and management should be in place to enable women to address menopause difficulties effectively with the assistance of healthcare experts and the support of their families and community.
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Affiliation(s)
- Md Ruhul Kabir
- Department of Communication Studies, School of Communication and Film, Hong Kong Baptist University, Hong Kong, Hong Kong
- Department of Food Technology & Nutrition Science, Noakhali Science & Technology University, Noakhali, Bangladesh
| | - Kara Chan
- Department of Communication Studies, School of Communication and Film, Hong Kong Baptist University, Hong Kong, Hong Kong
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Tariq B, Phillips S, Biswakarma R, Talaulikar V, Harper JC. Women's knowledge and attitudes to the menopause: a comparison of women over 40 who were in the perimenopause, post menopause and those not in the peri or post menopause. BMC Womens Health 2023; 23:460. [PMID: 37648988 PMCID: PMC10469514 DOI: 10.1186/s12905-023-02424-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 05/09/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES To evaluate women's knowledge and attitudes towards the menopause by comparing three groups of women: perimenopause, post menopause and those women not in either the peri or post menopause (other). METHODS A 35 question online survey was advertised on social media to evaluate women's attitudes and knowledge of the menopause. Three groups of women were compared: perimenopause, post menopause and those women not in either the peri or post menopause (other). RESULTS Most women were completely uninformed or only had some knowledge of the menopause before the age of 40. Most women thought that the menopause should be taught at school, but over 80% had received no menopause education at school themselves. The most popular sources of menopause information were independent websites and friends. Perimenopausal women were significantly more likely than postmenopausal women to use online resources for menopause information. The perimenopausal and postmenopausal groups had more positive attitudes towards the menopause than the other group. 57.5% of postmenopausal women found the menopause difficult or very difficult. Most women were happy about no longer menstruating, although some expressed sadness regarding fertility loss. CONCLUSIONS Most women had limited knowledge and negative attitudes towards the menopause, leaving them unprepared to cope with the physical and psychological changes associated with this stage of life. Improved menopause education is required to improve quality of life during the menopausal transition and a most positive narrative of life postmenopause.
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Affiliation(s)
- Bisma Tariq
- Institute for Women's Health, University College London, London, UK
| | | | - Rina Biswakarma
- Institute for Education, University College London, London, UK
| | | | - Joyce C Harper
- Institute for Women's Health, University College London, London, UK.
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Li Y, He H, Wang J, Chen Y, Wang C, Li X, Dai A, Liu Y, Xi X, Huang J, Zou M, Fan Y, Zhou M, Yi P, Yu L, Lei X. Effect of multidisciplinary health education based on lifestyle medicine on menopausal syndrome and lifestyle behaviors of menopausal women: A clinical controlled study. Front Public Health 2023; 11:1119352. [PMID: 37006585 PMCID: PMC10060660 DOI: 10.3389/fpubh.2023.1119352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundMenopausal women may experience menopausal syndrome and long-term effects caused by low estrogen levels, such as senile dementia and osteoporosis in the elderly. Most menopausal women may have misconceptions about menopause and low use of pharmacological interventions. These misconceptions may damage the quality of life and miss the critical period for preventing senile diseases. Thus, enhancing the awareness of menopausal women regarding psychosocial and physical changes through health education programs was a way to improve positive attitudes toward menopause and make further treatment options.ObjectivesThis study aimed to evaluate the effect of multidisciplinary health education based on lifestyle medicine on menopausal syndrome and lifestyle behaviors of menopausal women.MethodsThe study was conducted in several hospitals in Chongqing, China. The two groups were from different hospitals with similar medical levels in order to reduce information contamination. It was designed as a clinical controlled trial in which the intervention group (n = 100) and control group (n = 87) were matched for age, age at menarche, menopausal symptoms and drug use status at enrollment. Women in the intervention group received multidisciplinary health education based on lifestyle medicine for 2 months while those in the control group received routine outpatient health guidance. Menopausal syndrome, physical activity and dietary status of participants were assessed before and after the intervention. Paired t-tests and Independent-sample t-tests were adopted for comparison within and between groups, respectively, in the normal variables. Wilcoxon signed-rank tests and Mann-Whitney U tests were adopted for comparison within and between group, respectively, in the abnormal variables. Categorical variables were tested using Pearson's χ2. P-value < 0.05 was statistically significant in statistical tests.ResultsPost intervention testing indicated that menopausal syndrome of participants was significantly improved in the intervention group compared to the control group (P < 0.001). Between-group comparison showed a significant improvement of weekly energy expenditure of total physical activity (P = 0.001) and participation in exercise (P < 0.001) in the intervention group compared to the control group after the intervention. The dietary status of participants was significantly improved in the intervention group compared to the control group (P < 0.001). In the intervention group, the menopausal syndrome of participants improved more in the hormone drug group than in the non-hormone group (P = 0.007), as did the control group (P = 0.02). In the hormone drug group, the physical activity (P = 0.003) and dietary status (P = 0.001) mproved more in the intervention group than in the control group.ConclusionsThe multidisciplinary health education based on lifestyle medicine was effective in improving the menopausal syndrome and healthy lifestyle behaviors of menopausal women. Studies with extended observation period and larger sample size are in need to evaluate the long-term scale-up effects of the multidisciplinary health education.
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Affiliation(s)
- Yangmei Li
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Haiyang He
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
| | - Jiaxi Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yifan Chen
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Chunyuan Wang
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xinyue Li
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Anqi Dai
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Yue Liu
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Xin Xi
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Juan Huang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mi Zou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yao Fan
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
| | - Mingfang Zhou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ping Yi
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lili Yu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Lili Yu
| | - Xun Lei
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing, China
- Collaborative Innovation Center of Social Risks Governance in Health, Chongqing Medical University, Chongqing, China
- Research Center for Public Health Security, Chongqing Medical University, Chongqing, China
- *Correspondence: Xun Lei
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Cheng ES, Velentzis LS, Weber M, Steinberg J, Canfell K, Yu XQ. Female reproductive and hormonal factors and lung cancer mortality among never-smokers: A prospective cohort study of 287 408 Chinese women. Int J Cancer 2023; 152:2528-2540. [PMID: 36916124 DOI: 10.1002/ijc.34508] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/20/2023] [Accepted: 02/23/2023] [Indexed: 03/15/2023]
Abstract
There is growing, but inconsistent evidence suggesting oestrogen may play a key role in lung cancer development, especially among never-smoking women for whom lung cancer risk factors remain largely elusive. Using the China Kadoorie Biobank, a large-scale prospective cohort with 302 510 women aged 30 to 79 years recruited from 10 regions in China during 2004 to 2008, we assessed the risk of lung cancer death among self-reported never-smoking women who were cancer-free at baseline, in relation to age at menarche, age at menopause, time since menopause, prior use of oral contraceptives (OCP), number of livebirths, breastfeeding and age at first livebirth. Women were followed up to December 31, 2016 with linkage to mortality data. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression, adjusting for key confounders including several socio-demographic, environmental and lifestyle factors. Among 287 408 never-smoking women, 814 died from lung cancer with a median follow-up of 10.3 years. Women who had used OCP within 15 years prior to baseline had a significantly higher hazard of lung cancer death compared with never-users: HR = 1.85 (95% CI: 1.14-3.00) and risk increased by 6% with each additional year of use: HR = 1.06 (1.01-1.10). Among parous women, the hazard of lung cancer death increased by 13% with each single livebirth: HR = 1.13 (1.05-1.23); and among post-menopausal women, the risk increased by 2% with each year since menopause: HR = 1.02 (1.01-1.04). These results suggest that reproductive factors which were proxies for lower endogenous oestrogen level, for example, longer duration of OCP use, could play a role in lung cancer development.
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Affiliation(s)
- Elvin S Cheng
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Louiza S Velentzis
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Marianne Weber
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Xue Qin Yu
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Pompei LM, Bonassi-Machado R, Steiner ML, Pompei IM, de Melo NR, Nappi RE, Fernandes CE. Profile of Brazilian climacteric women: results from the Brazilian Menopause Study. Climacteric 2022; 25:523-529. [PMID: 35801642 DOI: 10.1080/13697137.2022.2088276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aims to understand the epidemiological characteristics of Brazilian menopausal women, and their view on menopause hormone therapy (MHT). METHODS A national cross-sectional study with 1500 women between 45 and 65 years old was carried out through questionnaires. RESULTS The overall median age of participants was 52 [47-56] years, and 55 [52-59] years for the postmenopausal subgroup. Menstrual irregularity started at median age 46 [44-49] years. Median menopause age was 48 [45-51] years with no differences between socioeconomic classes. The prevalence of any climacteric symptoms was 87.9% and hot flashes started at median age 47 [45-50] years. Among women in menopause/menopausal transition, 52.1% received any medical prescription, and MHT was recommended for 22.3%. Among those who started MHT, 45.4% were still using the treatment and the median duration of use was 8 months, but different among socioeconomic classes (24 months for class A against 3 months for class D/E). CONCLUSIONS In this first Brazilian national population-based study on menopause and MHT, it was observed that, in spite of being symptomatic when entering menopause around 48 years of age, only a small part of Brazilian women started MHT and the median duration of treatment was less than 1 year, but the duration was higher for higher socioeconomic class.
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Affiliation(s)
- L M Pompei
- Obstetric and Gynecology Department, Faculdade de Medicina do ABC, Santo André, Brazil
| | - R Bonassi-Machado
- Obstetric and Gynecology Department, Faculdade de Medicina de Jundiaí, Jundiaí, Brazil
| | - M L Steiner
- Obstetric and Gynecology Department, Faculdade de Medicina do ABC, Santo André, Brazil
| | - I M Pompei
- Medicine Student, Faculdade de Medicina de Jundiaí, Jundiaí, Brazil
| | - N R de Melo
- Obstetric and Gynecology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - R E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - C E Fernandes
- Obstetric and Gynecology Department, Faculdade de Medicina do ABC, Santo André, Brazil
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Yu Q, Chae HD, Hsiao SM, Xie J, Blogg M, Sumarsono B, Kim S. Prevalence, severity, and associated factors in women in East Asia with moderate-to-severe vasomotor symptoms associated with menopause. Menopause 2022; 29:553-563. [PMID: 35231007 PMCID: PMC9060817 DOI: 10.1097/gme.0000000000001949] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To understand prevalence, severity, impact, and treatment of vasomotor symptoms associated with menopause, using cross-sectional survey data. METHODS This online, two-part survey was conducted in East Asia among women 40-65 years recruited from established online panels (Edelman, Beijing; Hankook Research, Seoul; Rakuten Insight, Taipei) using stratified sampling. Part I collected demographics/disease characteristics, including menopausal status and vasomotor symptom severity. Women with moderate-to-severe vasomotor symptoms completed Part II, including clinical characteristics, health-related quality of life, and healthcare-seeking behavior. Primary endpoints included vasomotor symptom prevalence and severity and proportions of women eligible and willing to take hormone therapy. Results are presented for each of the three online panels separately and as a pooled total. All analyses are descriptive with no formal hypothesis testing across groups. RESULTS Numbers of peri- versus postmenopausal women completing Part I were Edelman, 1,588 (55.1% vs 44.9%); Hankook Research, 1,000 (43.6% vs 56.4%); Rakuten Insight, 773 (61.7% vs 38.3%). Vasomotor symptom prevalence was =80% in each region; overall moderate-to-severe vasomotor symptom prevalence was 55%; >50% of women were untreated. Most of those treated used non-prescription treatments. Menopausal hormone therapy use was reported by 11.6% of peri- and 7.2% of postmenopausal women. In peri- and postmenopausal women with moderate-to-severe vasomotor symptoms, 8.6% and 3.4%, respectively, were hormone therapy-willing, 19.3% and 16.8% hormone therapy-contraindicated, 25.4% and 23.0% hormone therapy-cautious, and 10.2% and 8.3% hormone therapy-averse. Women experienced significant burden on health-related quality of life and substantial impairment of work productivity and daily activities. CONCLUSIONS Vasomotor symptoms associated with menopause affected =80% of women aged 40 to 65 years. A substantial proportion of women are unsuitable for, or choose not to take, menopausal hormone therapy, resulting in an unmet need for nonhormonal treatment options.
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Affiliation(s)
- Qi Yu
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College
| | - Hee-Dong Chae
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital
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Association between Reproductive Factors and Type 2 Diabetes: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19021019. [PMID: 35055839 PMCID: PMC8775663 DOI: 10.3390/ijerph19021019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/14/2022] [Accepted: 01/15/2022] [Indexed: 12/15/2022]
Abstract
(1) Introduction: The available studies on the association between type 2 diabetes mellitus (T2DM) and menopause report conflicting results. (2) Objective: This study aimed to investigate the association of menopausal status, age at menopause, and length of the reproductive period with T2DM. (3) Methods: This cross-sectional study is part of the ‘China Eastern Cohort Study’, which is a community-based cohort study. Multistage, stratified, clustered sampling was used to recruit the study participants in Shanghai, China. Age at menarche and menopause was recorded, and reproductive period was calculated. Weighted logistic regression was used to calculate the prevalence ratios (PRs) with 95% confidence intervals (CIs) of T2DM. Restricted cubic splines were used to assess the relationship between age at menopause, reproductive period, and T2DM. (4) Results: A total of 20,128 women were included. The prevalence of T2DM was 13.7%. Postmenopausal women exhibited a higher prevalence of T2DM than premenopausal women (p < 0.001) and an unfavorable metabolic profile, including higher body mass index, hypertension, and hyperlipidemia. A higher risk of T2DM was observed in postmenopausal women (PR2.12, 95%CI: 1.79–2.51, p < 0.001) compared with premenopausal women, independently of confounding factors. After adjustment for confounding factors, age at menopause and reproductive period were not significantly associated with T2DM. (5) Conclusions: Postmenopausal status is associated with T2DM, while menopausal age and reproductive period are not associated with T2DM. Menopausal status should be considered during T2DM screening.
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Harper JC, Phillips S, Biswakarma R, Yasmin E, Saridogan E, Radhakrishnan S, C Davies M, Talaulikar V. An online survey of perimenopausal women to determine their attitudes and knowledge of the menopause. WOMEN'S HEALTH 2022; 18:17455057221106890. [PMID: 35758176 PMCID: PMC9244939 DOI: 10.1177/17455057221106890] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Women are not usually taught about the menopause formally, and many general practitioners have relatively little training. The aim of this study was to explore perimenopausal women’s attitudes and knowledge of the menopause. Method: An online survey was designed to evaluate attitudes and knowledge of the menopause in women older than 40 years. The survey was generated with Qualtrics XM® and promoted via social media. In all, 3150 women started the survey. In this study, data from 947 perimenopausal women were analysed. Results: Regarding women’s attitudes to the menopause, 38.8% were accepting of it but more than 30% were dreading it. The women had experienced a number of menopause symptoms including mood swings (68.9%), brain fog (68.3%), and fatigue (66.8%). More than 90% of women had never been taught about the menopause at school, and more than 60% did not feel informed at all about the menopause. School was thought to be the best place for menopause education to start (83.6%). In all, 68.2% of women had only looked for information about the menopause as their symptoms started and they had talked to friends and used a variety of websites to look for information. When asked for their free-text views on the menopause, thematic analysis produced four themes: the overarching knowledge gap, the onset and impact of symptoms, perimenopause: the hidden phenomenon, and managing symptoms: differing schools of thought. Conclusion: Lack of education for women and their general practitioners is causing perimenopausal women to go through this important stage in their lives with a lack of knowledge and appropriate medical care. It is essential that women are taught about the menopause, from school onwards and that we offer health professionals appropriate training starting from the medical school curriculum.
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Affiliation(s)
- Joyce C Harper
- EGA Institute for Women’s Health, University College London, London, UK
| | - Samantha Phillips
- EGA Institute for Women’s Health, University College London, London, UK
| | - Rina Biswakarma
- Institute of Education, University College London, London, UK
| | - Ephia Yasmin
- Reproductive Medicine Unit, University College Hospital, London, UK
| | - Ertan Saridogan
- Reproductive Medicine Unit, University College Hospital, London, UK
| | | | - Melanie C Davies
- Reproductive Medicine Unit, University College Hospital, London, UK
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Min SH, Yang Q, Min SW, Ledbetter L, Docherty SL, Im EO, Rushton S. Are there differences in symptoms experienced by midlife climacteric women with and without metabolic syndrome? A scoping review. WOMEN'S HEALTH 2022; 18:17455057221083817. [PMID: 35266423 PMCID: PMC8918770 DOI: 10.1177/17455057221083817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction: Midlife climacteric women with metabolic syndrome are at high risk for experiencing a complex array of symptoms. The aim of this scoping review was to identify the prevalence, types, and clustering of symptoms in midlife climacteric women with metabolic syndrome and to compare them to symptoms of midlife climacteric women without metabolic syndrome. Methods: A three-step search method was used according to Joanna Briggs Institute methodology. Eligibility criteria of participants, concept, context, and types of evidence were selected in alignment with the review questions. Seven databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation & Theses, OpenGrey) were searched using search terms with no language or date restrictions. Title and abstract screening, full-text review, data charting, and data synthesis were conducted by two independent researchers based on the eligibility criteria. Results: The search yielded 3813 studies after removing duplicates with 48 full-text papers assessed for eligibility. A total of eight studies were reviewed and analyzed which reported the prevalence and types of symptoms individually or grouped based on each body system. Midlife climacteric women with metabolic syndrome experience a wide prevalence of individual and grouped urogenital, vasomotor, psychological, sleep, and somatic symptoms. Mental exhaustion had the highest prevalence (84.4%) among the individual symptoms, and urogenital symptoms had the highest prevalence (81.3%) among the grouped symptoms. There were mixed findings on symptoms between midlife climacteric women with metabolic syndrome and without metabolic syndrome. No studies focused on symptom clusters. Conclusion: Our findings will serve as a knowledge basis for understanding symptoms experienced by midlife climacteric women with metabolic syndrome. This new knowledge can assist clinicians in effectively assessing and managing their symptoms in clinical settings and inform future development of targeted symptom management interventions.
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Affiliation(s)
- Se Hee Min
- Duke University School of Nursing, Durham, NC, USA
| | - Qing Yang
- Duke University School of Nursing, Durham, NC, USA
| | - Se Won Min
- School of Nursing, University of Washington, Seattle, WA, USA
| | | | | | - Eun-Ok Im
- School of Nursing, Emory University, Atlanta, GA, USA
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Wang L, Zhang R, Yang Y, Sun X, Zhang B, Zhu H, Luo X, Ma X, Zhang X. Severity and factors of menopausal symptoms in middle-aged women in Gansu Province of China: a cross-sectional study. BMC Womens Health 2021; 21:405. [PMID: 34879847 PMCID: PMC8653527 DOI: 10.1186/s12905-021-01531-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the severity and risk factors of menopausal symptoms in the middle-aged women in Gansu Province of China. METHODS In this cross-sectional study, a total of 7319 women (aged 40-55 years) attended the health survey in Gansu Province in China were enrolled. Information on demographics, menopausal status, reproductive history, and history of chronic diseases was collected via a structured questionnaire. Severity of menopausal symptom was evaluated by the Modified Kupperman Menopausal Index. Ordinal logistic regression model was applied to explore its risk factors. RESULTS A total of 7319 participants were included in present study, among them, 3606 (49.27%) had moderate or severe menopausal symptom. Compared with premenopausal women, perimenopausal and postmenopausal women have a higher mKMI score. We observed that older age, higher BMI, non-married status, longer duration of menstruation (≥ 7 days), number of pregnancy (> 3 times), longer duration of breastfeeding (> 12 months), peri- or post-menopausal status, and menopause hormone therapy was positively associated with menopausal symptom score, while higher level of family income, educational and physical activity, and history of gynecological, breast or chronic disease were negatively associated with the score. CONCLUSIONS Numerous factors were associated with the severity of menopausal symptom among the Chinese women. Because it was gradually increased with aging, more attention is warranted to manage the menopausal symptom.
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Affiliation(s)
- LiRong Wang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Rui Zhang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - Ye Yang
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - XiaoYan Sun
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - BaoLi Zhang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - HaiYing Zhu
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - XiaoRong Luo
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, Gansu, China
| | - XiaoLing Ma
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China
| | - XueHong Zhang
- The Reproductive Medicine Special Hospital of the First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo, Lanzhou, Gansu, China.
- The First Hospital of Lanzhou University, Key Laboratory for Reproductive Medicine and Embryo of Gansu Province, No. 1, Donggangxi Rd, Chengguan District, Lanzhou City, 730000, Gansu Province, China.
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Wang X, Wang L, Di J, Zhang X, Zhao G. Prevalence and risk factors for menopausal symptoms in middle-aged Chinese women: a community-based cross-sectional study. Menopause 2021; 28:1271-1278. [PMID: 34469934 PMCID: PMC8547757 DOI: 10.1097/gme.0000000000001850] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine the prevalence and risk factors of menopausal symptoms in middle-aged Chinese women. METHODS A cross-sectional, community-based study recruited 6,745 women aged 40 to 55 years in the eastern, central, and western regions of China during 2018. Menopausal status was categorized into reproductive stage (defined as regular menstruation or subtle changes in menstrual cycle characteristics), menopausal transition (the beginning of a persistent difference of 7 d in the length of consecutive cycles, or the last menstruation having occurred no more than 12 mo), or postmenpause (the end of the 12 mo period of amenorrhea) according to the Stages of Reproductive Aging Workshop classification. Menopausal symptoms were determined by the modified Kupperman Menopausal Index (KMI) questionnaire and considered nonmenopausal symptoms (total KMI score<15) and menopausal symptoms (total KMI score≥15). Demographic, lifestyle, physical, and menopausal characteristics were collected by face-to-face interviews. Logistic regression models were used to identify factors associated with the risk of menopausal symptoms. RESULTS Among all participants, the mean age was 46.9 years, and 15.7% (1,001/6,364) of participants reported experiencing menopausal symptoms. The prevalence of menopausal symptoms was 9.3% (303/3,256), 23.9% (293/1,227), and 21.5% (405/1,881) in the reproductive stage, menopausal transition, and postmenopausal stage, respectively. Overall, the three most prevalent menopausal symptoms were insomnia (44.7%), fatigue (40.4%), and mood swings (37.2%). The multivariable logistic regression model showed that menopausal status, residence, nulliparity, and chronic diseases were associated with the risk of menopausal symptoms (all P < 0.05). Women during menopausal transition (OR = 2.66, 95% CI: 2.21-3.20) or postmenopause (OR = 2.26, 95% CI: 1.82-2.80) had significantly increased risk of menopausal symptoms compared with those in the reproductive stage. CONCLUSIONS Menopausal status, residence, nulliparity, and chronic diseases were associated with menopausal symptoms in middle-aged Chinese women.
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Affiliation(s)
- Xueyin Wang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Linhong Wang
- National Centre for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiangli Di
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaosong Zhang
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
| | - Gengli Zhao
- Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China
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Women's knowledge and awareness on menopause symptoms and its treatment options remains inadequate: a report from the United Arab Emirates. ACTA ACUST UNITED AC 2021; 28:918-927. [PMID: 33973540 DOI: 10.1097/gme.0000000000001783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We aimed to evaluate the awareness, knowledge, and perception of middle-aged women regarding menopause and hormone therapy (HT). METHODS This observational study was conducted on pre-, peri-, post-, and surgically menopausal women (n = 591) from January 2020 until June 2020 in Dubai. A structured questionnaire was developed based on previous literature to assess participants' knowledge and awareness of menopause and HT. The questionnaire was implemented by face-to-face interview. Factors associated with the degree of menopausal knowledge were identified. RESULTS Majority (498, 82%) of participant women had fair to poor overall knowledge on menopause, did not know whom HT is used for (404, 48%), and for whom it is contradicted (455, 77%). Knowledge on menopause and HT was highly associated with better attitudes (P < 0.001 and P < 0.001, respectively).Furthermore, the greater the knowledge on menopause, the better the knowledge of HT (P < 0.001). Education was the primary factor that played a significant role in having better knowledge or attitudes. Nationality showed an association with better attitudes on menopause, with non-Arabs having better attitudes than Arabs and UAE nationals. CONCLUSIONS Community medicine educators and primary healthcare providers need to prepare tailored premenopausal and postmenopausal educational interventional programs for further educating women and preparing them for this phase of their lives.
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The effects of a new, improved Chinese medicine, Gengnianchun formula granules, on hot flushes, depression, anxiety, and sleep in Chinese peri- and postmenopausal women: a randomized placebo-controlled trial. ACTA ACUST UNITED AC 2021; 27:899-905. [PMID: 32379216 DOI: 10.1097/gme.0000000000001558] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the effectiveness and safety of a new, improved herbal formula of a traditional Chinese medicine, improved Gengnianchun (I-GNC), on hot flushes, depression, anxiety, and sleep in peri- and postmenopausal women in China. METHODS A randomized, single-blind, placebo-controlled trial of peri- and postmenopausal women with Kupperman Index (KMI) scores of 15 or higher was conducted for 12 weeks. Hot flush frequencies, KMI scores, Hamilton depression scale scores, Hamilton anxiety scale scores, and Pittsburgh Sleep Quality Index scores were evaluated. Each outcome was evaluated every 4 weeks. RESULTS Ninety-eight participants completed the study. The I-GNC formula significantly reduced the mean (SD) frequency of hot flushes from 7 (4.554) to 1.2 (1.675) in the I-GNC group and from 6.74 (3.43) to 3.66 (2.635) in the placebo group (P < 0.01). The KMI (P < 0.01), Hamilton depression scale (P < 0.01), and Hamilton anxiety scale (P < 0.01) scores decreased in both groups after treatment, and significant differences were observed between the two groups (P < 0.01); however, no significant difference in the Pittsburgh Sleep Quality Index score was observed. I-GNC had no effect on serum follicle-stimulating hormone or E2 levels. There were no obvious adverse effects. CONCLUSIONS The traditional Chinese medicine herbal formula I-GNC can alleviate the symptoms of menopausal syndrome and improve quality of life among peri- and postmenopausal women. I-GNC is safe and has no notable adverse effects.
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Baquedano L, Espiau A, Fasero M, Ortega S, Ramirez I, Mendoza N. Beliefs, knowledge and the impact of COVID19 on menopause therapies in Spanish women: COMEM-treatment study. BMC Womens Health 2020; 20:277. [PMID: 33371883 PMCID: PMC7768270 DOI: 10.1186/s12905-020-01151-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To study what women think about menopause treatments and assess their knowledge about them. To analyze adherence to treatment during COVID-19 confinement as a secondary objective. METHODS A multi-center cross-sectional observational study was conducted using a survey of 2500 women between January and June 2019. This was administered following a non-probability sampling procedure including women between 35 and 75 years. An extension study was conducted during the coronavirus pandemic, between March and June 2020. RESULTS The responses of 2355 surveyed women were analyzed. Of this sample, 42% knew about menopause hormone therapy (MHT). The most frequently identified indication was the treatment of hot flashes (65.6%). The MHT risks most frequently perceived were weight gain (24.2%) and breast cancer (21.7%); the main reason for rejecting MHT was a lack of information (96.1%). Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care and level of education. During the coronavirus confinement period, 85 women using MHT were located, of which 84.7% continued it. CONCLUSIONS Women hold certain false beliefs about menopause, and their knowledge of the available treatments is somewhat limited. Adherence to MHT during the COVID-19 confinement in Spain has been high.
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Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain.
| | - Andrea Espiau
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Silvia Ortega
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - Isabel Ramirez
- Sexual and Reproductive Health Service, UGC Dr Cayetano Roldan San Fernando Health Centre, Cadiz, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
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22
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Falkingham J, Evandrou M, Qin M, Vlachantoni A. Chinese women's health and wellbeing in middle life: Unpacking the influence of menopause, lifestyle activities and social participation. Maturitas 2020; 143:145-150. [PMID: 33308620 DOI: 10.1016/j.maturitas.2020.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 08/12/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To examine Chinese middle-aged women's health and wellbeing and the associated biosocial correlates. STUDY DESIGN This study used a cross-sectional design, including selected retrospectively collected information on the final menstrual period, drawn from the 2013 wave of the China Health and Retirement Longitudinal Study (CHARLS). Women aged 45 to 59 were selected. MAIN OUTCOME MEASURES Factor analysis of 16 menopausal symptom ratings yielded four different and independent measures of pre-/peri-menopausal and early postmenopausal women's health. These were: negative mood (feel frustrated, sad, lonely, worried, bored, angry, tired and stressed), positive emotions (feel enthusiastic, content and happy), musculoskeletal pain (shoulder/neck pain, knee and other joint pain, and back pain), and sleep and memory problems (trouble sleeping and poor memory). RESULTS Menopausal status was positively associated with sleep and memory problems, whilst the number of years since the final menstrual period was positively associated with musculoskeletal pain. In contrast, lifestyle activities and social participation were linked to positive emotions. The association between selected biosocial factors and negative mood was not significant after controlling for other demographic and social background factors. CONCLUSIONS Musculoskeletal health as well as sleep and memory problems are positively associated with menopausal biological factors amongst Chinese mid-life women. Maintaining active social engagement contributes to positive wellbeing among middle-aged women.
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Affiliation(s)
- Jane Falkingham
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK.
| | - Maria Evandrou
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK; Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK
| | - Min Qin
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK; Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK
| | - Athina Vlachantoni
- ESRC Centre for Population Change, University of Southampton, Southampton, SO17 1BJ, UK; Centre for Research on Ageing, University of Southampton, Southampton, SO17 1BJ, UK
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23
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Alshogran OY, Mahmoud FM, Alkhatatbeh MJ. Knowledge and awareness toward menopause and hormone therapy among premenopausal women in Jordan. Climacteric 2020; 24:171-178. [PMID: 32914657 DOI: 10.1080/13697137.2020.1813099] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Menopause is a natural important transition in women's life. Having adequate knowledge and perception about menopause at a young age is critical for women to cope better with its associated consequences and improve their well-being. OBJECTIVE This study evaluated the awareness, knowledge, and perception of menopause and menopause hormone therapy (MHT) among premenopausal females from Jordan. METHODS A cross-sectional study including females aged 20-40 years (n = 450) was conducted from November 2018 to March 2019 in two hospitals in Irbid, Jordan. A structured questionnaire was developed based on previous literature and using the Green Climacteric Scale to assess participants' knowledge and awareness of signs and symptoms of menopause and MHT. Data were collected by face-to-face interview. Factors associated with the degree of menopausal knowledge were identified. RESULTS The mean ± standard deviation age of participants was 29.1 ± 6.3 years. More than half of participants were knowledgeable about several aspects of menopause. Education to college or more was significantly and positively associated with knowledge about menopause (β = 0.504, p = 0.005). The majority of participants did not know the roles, benefits, and risks of MHT. There was an almost equal distribution for participants' positive (47.6%) and negative (50%) attitudes toward menopause. CONCLUSIONS The findings suggest that premenopausal females in Jordan are knowledgeable about various aspects of menopause. Nevertheless, there is still a need to develop educational programs and implement proper counseling to improve young females' awareness about menopause, particularly its health implications and treatment options.
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Affiliation(s)
- O Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - F Mz Mahmoud
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - M J Alkhatatbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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24
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Smail L, Jassim GA, Sharaf KI. Emirati Women's Knowledge about the Menopause and Menopausal Hormone Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4875. [PMID: 32640704 PMCID: PMC7369704 DOI: 10.3390/ijerph17134875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to investigate the knowledge of Emirati women aged 30-64 about menopause, menopausal hormone therapy (MHT), and their associated health risks, and additionally, to determine the relationships between Emirati women's knowledge about menopause and their sociodemographic and reproductive characteristics. A community-based cross-sectional study was conducted of 497 Emirati women visiting five primary healthcare centers in Dubai. Data were collected using a questionnaire composed of sociodemographic and reproductive characteristics, menopause knowledge scale (MKS), and menopause symptoms knowledge and MHT practice. The mean menopause symptoms knowledge percentage was 41%, with a standard deviation of 21%. There were significant differences in the mean knowledge percentage among categories of education level (p < 0.001) and employment (p = 0.003). No significant differences in the knowledge percentages were found among categories of menopausal status. "Pregnancy cannot occur after menopause" was the statement with the highest knowledge percentage (83.3%), while the lowest knowledge percentages were "risk of cardiovascular diseases increases with menopause'' (23.1%), "MHT increases risk of breast cancer'' (22.1%), and "MHT decreases risk of colon cancer'' (13.9%). The knowledge of Emirati women about menopause, MHT, and related heart diseases was very low; therefore, an education campaign about menopause and MHT risks is needed to improve their knowledge for better coping with the symptoms.
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Affiliation(s)
- Linda Smail
- Department of Mathematics and Statistics, Zayed University, Dubai 19282, UAE;
| | - Ghufran A. Jassim
- Royal College of Surgeons in Ireland-Medical University of Bahrain, Busaiteen 15503, Bahrain;
| | - Khawla I. Sharaf
- Department of Mathematics and Statistics, Zayed University, Dubai 19282, UAE;
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25
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Lin L, Feng P, Yu Q. Attitude and knowledge for menopause management among health professionals in mainland China. Climacteric 2020; 23:614-621. [PMID: 32543223 DOI: 10.1080/13697137.2020.1775809] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE This study aims to understand the attitude of health-care professionals (HPs) in mainland China toward menopause management (MM) as well as the knowledge they have received regarding MM during training. METHODS An anonymous survey recruited 3709 medical workers nationwide (including physicians, orthopedists, obstetricians and gynecologists, and general practitioners) through online surveys and on-site interviews at professional meetings. RESULTS Of the 3709 questionnaires completed, 3426 questionnaires met the inclusion criteria. Of the participants, 1532 HPs had not received menopause management training (MMT) in nearly 1 year. Among the residents and physician assistants, 103 reported they were not familiar with MM. Satisfyingly, 98.3% of HPs considered it very important or essential to accept MM. Although most interviewees replied some correct menopausal knowledge, nearly half of them could not correctly identify the contraindications for menopause hormone therapy (MHT). Additionally, 73.1% of HPs would advise patients with premature ovarian insufficiency to receive hormone replacement therapy at least until the average age of menopause. CONCLUSION This survey indicated that HPs have some knowledge regarding MM, but a gap remains to master the basic theory of MHT. In order to manage the growing menopausal population in China, creating more in-depth educational MMT programs for HPs is necessary.
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Affiliation(s)
- L Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - P Feng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Q Yu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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26
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Hormone Replacement Therapy: Lebanese Women's Awareness, Perception, and Acceptance. Obstet Gynecol Int 2020; 2020:5240932. [PMID: 32607105 PMCID: PMC7315264 DOI: 10.1155/2020/5240932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 11/30/2022] Open
Abstract
Objectives Hormone replacement therapy (HRT) had been the gold standard for the treatment of menopausal symptoms until the publication of the World Health Initiative (WHI) study. After the WHI study, the use of HRT changed among the physicians and patients all over the world despite newer more reassuring data. This study aimed to investigate the knowledge and attitudes of women towards HRT and the factors affecting it for better counseling. Study design. A clinic-based cross-sectional study using a survey was offered to women aged 40 years and above coming to the women's health center at the American University of Beirut Medical Center (AUBMC) from October 1st, 2017, till March 31st, 2018. The questionnaire included questions about demographics and menopausal symptoms in addition to knowledge and attitudes towards menopause and HRT. Main outcome measures. Our main hypothesis was that women would be aware of HRT as a treatment modality; however, the majority would have a negative attitude towards its usage. Results The response rate was 87.8%. Seventy-three percent of the respondents had already heard about HRT with 57.9% supporting the use of HRT; however, 47.9% did not know when to use it. The significant predictor for having heard about HRT and a positive attitude towards HRT were having HRT prescribed as a part of treatment and employment status, respectively. Conclusions Lebanese women are aware of HRT as a treatment option; however, a lack of both proper information and positive attitude towards HRT use was noted.
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27
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Li S, Yin P, Yin X, Bogachko A, Liang T, Lao L, Xu S. Effect of acupuncture on insomnia in menopausal women: a study protocol for a randomized controlled trial. Trials 2019; 20:308. [PMID: 31146772 PMCID: PMC6543678 DOI: 10.1186/s13063-019-3374-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 04/19/2019] [Indexed: 12/20/2022] Open
Abstract
Background The National Institutes of Health estimates the prevalence of insomnia in menopausal women at 40–50%. Some studies have shown that acupuncture might be effective in treating primary insomnia and insomnia related to depression and stroke. Although there are some programs supporting insomnia during the menopausal transition, there are few randomized controlled trials (RCT) to provide evidence regarding their effectiveness. We design a RCT of suitable sample size to verify the effectiveness of acupuncture in patients with insomnia during the menopausal transition and to form an optimized acupuncture treatment protocol. Method/Design In this randomized, single-site, single-blind, placebo-controlled trial, 84 eligible patients will be recruited and randomly assigned to either the acupuncture group (n = 42) or the sham control group (n = 42) in a 1:1 ratio. Participants will receive a total of 18 treatment sessions for eight consecutive weeks. Treatments will be given three times per week in the first four weeks, twice a week for the next two weeks, and finally once weekly for the final two weeks. Treatment will utilize eight main acupoints (GV20, GV24, GV29, RN6, RN4, SP6, HT7, EX-HN22) and extra two acupoints based on syndrome differentiation. The primary outcome will be assessed using the Pittsburgh Sleep Quality Index (PSQI). The secondary outcomes will be measured by sleep parameters recorded in the Actigraphy (SE, TST, SA), Insomnia Severity Index (ISI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and Menopause Quality of Life (Men-QOL). The primary outcomes will be assessed at baseline, week 4, week 8, and the first and third month after the end of treatment. Discussion If the results confirm that acupuncture is effective and safe for the treatment on insomnia in menopausal women, this positive outcome could provide evidence for clinical application. Trial registration Chinese Clinical Trial Registry, ChiCTR1800018645. Registered on 10 January 2018.
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Affiliation(s)
- Shanshan Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Ping Yin
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Xuan Yin
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Anna Bogachko
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Tingting Liang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Lixing Lao
- School of Chinese Medicine, University of Hong Kong, Hong Kong, China. .,University of Maryland School of Medicine, Baltimore, MD, 21201, USA.
| | - Shifen Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China.
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28
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Demands for perimenopausal health care in women aged 40 to 60 years—a hospital-based cross-sectional study in Shanghai, China. Menopause 2019; 26:189-196. [DOI: 10.1097/gme.0000000000001172] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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29
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Kong F, Wang J, Zhang C, Feng X, Zhang L, Zang H. Assessment of sexual activity and menopausal symptoms in middle-aged Chinese women using the Menopause Rating Scale. Climacteric 2019; 22:370-376. [PMID: 30612483 DOI: 10.1080/13697137.2018.1547702] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- F. Kong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - J. Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - C. Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
- Department of Obstetrics and Gynecology, The Affiliated Zhongshan Hospital of Dalian University, Dalian, P.R. of China
| | - X. Feng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - L. Zhang
- Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
| | - H. Zang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian, P.R. of China
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30
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Sung H, Guo C, Li E, Li J, Pfeiffer RM, Guida JL, Cora R, Hu N, Deng J, Figueroa JD, Sherman ME, Gierach GL, Lu N, Yang XR. The relationship between terminal duct lobular unit features and mammographic density among Chinese breast cancer patients. Int J Cancer 2019; 145:70-77. [PMID: 30561789 DOI: 10.1002/ijc.32077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 11/14/2018] [Accepted: 11/26/2018] [Indexed: 12/15/2022]
Abstract
Extensive mammographic density (MD), a well-established breast cancer risk factor, is a radiological representation of stromal and epithelial breast tissue content. In studies conducted predominantly among Caucasian women, histologic measures of reduced terminal duct lobular unit (TDLU) involution have been correlated with extensive MD, but independently associated with breast cancer risk. We therefore examined associations between TDLU measures and MD among Chinese women, a low-risk population but with high prevalence of dense breasts. Diagnostic pre-treatment digital mammograms were obtained from 144 breast cancer cases at a tertiary hospital in Beijing and scored using the Breast Imaging Reporting and Data System (BI-RADS) density classification. TDLU features were assessed using three standardized measures (count/100 mm2 , span [μm], and acini count/TDLU) in benign tissues. Associations between each of TDLU measures and MD were examined using generalized linear models for TDLU count and span and polytomous logistic regression for acini count with adjustment for potential confounders stratified by age. Among women ≥50 years, 63% had dense breasts; cases with dense breasts (BI-RADS, c-d) had greater TDLU count (21.1 [SE = 2.70] vs. 9.0 [SE = 1.83]; p = 0.0004), longer span (480.6 μm [SE = 24.6] vs. 393.8 μm [SE = 31.8]; p = 0.03), and greater acini count (ORtrend = 16.1; 95%CI = 4.08-63.1; ptrend < 0.0001) compared to those with non-dense breasts (BI-RADS, a-b). Among women <50 years, 91% had dense breasts, precluding our ability to detect associations. Our findings are consistent with previously reported associations between extensive MD and reduced TDLU involution, supporting the hypothesis that breast cancer risk associated with extensive MD may be related to the amount of "at-risk" epithelium.
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Affiliation(s)
- Hyuna Sung
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Surveillance and Health Services Research, American Cancer Society, Atlanta, Georgia, USA
| | - Changyuan Guo
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Erni Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ruth M Pfeiffer
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jennifer L Guida
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Renata Cora
- Independent Contractor, CT(ASCP), MB(ASCP), Stamford, Connecticut, USA
| | - Nan Hu
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Joseph Deng
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jonine D Figueroa
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Usher Institute of Population Health Sciences and Informatics, CRUK Edinburgh Centre, The University of Edinburgh, Edinburgh, United Kingdom
| | - Mark E Sherman
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.,Health Sciences Research, Mayo Clinic, Jacksonville, Florida, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Ning Lu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong R Yang
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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31
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Lan D, Jiang C, Du X, He L, Guo X, Zuo S, Xia S, Chang S, Wen S, Wu J, Ruan Y, Long D, Tang R, Yu R, Sang C, Bai R, Liu N, Jiang C, Li S, Dong J, Lip GYH, Chen A, Ma C. Female Sex as a Risk Factor for Ischemic Stroke and Systemic Embolism in Chinese Patients With Atrial Fibrillation: A Report From the China-AF Study. J Am Heart Assoc 2018; 7:e009391. [PMID: 30371338 PMCID: PMC6404890 DOI: 10.1161/jaha.118.009391] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 08/20/2018] [Indexed: 11/16/2022]
Abstract
Background Previous studies have provided conflicting results as to whether women are at higher risk than men for thromboembolism in the setting of atrial fibrillation ( AF ). We investigated whether women with AF were at higher risk of ischemic stroke in the China-AF (China Atrial Fibrillation Registry) Study. Methods and Results A total of 19 515 patients were prospectively enrolled between August 2011 and December 2016 in the China- AF Study. After exclusion of patients receiving anticoagulation or ablation therapy, 6239 patients (2574 women) with results from at least 6 months of follow-up were used for the analysis. Cox proportional hazards models were performed to evaluate whether female sex was an independent risk factor for thromboembolism after multivariate adjustment. The primary outcome was the time to the first occurrence of ischemic stroke or systemic embolism. After a mean follow-up of 2.81±1.46 years, 152 female patients reached the primary outcome, as compared with 172 male patients. Crude incidence rates of thromboembolism between women and men were of borderline statistical significance (2.08 versus 1.68 per 100 patient-years, P=0.058). After multivariable analysis, female sex was not independently associated with an increased thromboembolism risk (hazard ratio 1.09, 95% confidence interval 0.86-1.39). There was no significant difference in thromboembolism risk by sex stratified by age and presence or absence of risk factors ( P for interaction all >0.1). Conclusions Although crude incidence rates of thromboembolism were higher in Chinese female patients with AF compared with male patients, female sex did not emerge as an independent risk factor for thromboembolism on multivariate analysis. Clinical Trial Registration URL : http://www.chictr.org.cn/ . Unique identifier: Chi CTR - OCH -13003729.
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Affiliation(s)
- Di‐Hui Lan
- Department of CardiologyHeart CenterZhu Jiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Chao Jiang
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Xin Du
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
- Heart Health Research CenterBeijingChina
| | - Liu He
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Xue‐Yuan Guo
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Song Zuo
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Shi‐Jun Xia
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - San‐Shuai Chang
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Song‐Nan Wen
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Jia‐Hui Wu
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Yan‐Fei Ruan
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - De‐Yong Long
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Ri‐Bo Tang
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Rong‐Hui Yu
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Cai‐Hua Sang
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Rong Bai
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Nian Liu
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Chen‐Xi Jiang
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Song‐Nan Li
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Jian‐Zeng Dong
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
| | - Gregory Y. H. Lip
- Institute of Cardiovascular SciencesUniversity of BirminghamUnited Kingdom
| | - Ai‐Hua Chen
- Department of CardiologyHeart CenterZhu Jiang HospitalSouthern Medical UniversityGuangzhouChina
| | - Chang‐Sheng Ma
- Department of CardiologyBeijing AnZhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina
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Yang L, Lin L, Kartsonaki C, Guo Y, Chen Y, Bian Z, Xie K, Jin D, Li L, Lv J, Chen Z. Menopause Characteristics, Total Reproductive Years, and Risk of Cardiovascular Disease Among Chinese Women. Circ Cardiovasc Qual Outcomes 2018; 10:CIRCOUTCOMES.117.004235. [PMID: 29117982 PMCID: PMC5704734 DOI: 10.1161/circoutcomes.117.004235] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 10/17/2017] [Indexed: 12/26/2022]
Abstract
Supplemental Digital Content is available in the text. Background— Previous studies, mostly of Western women, have reported inconsistent findings on the association of menopause characteristics (status, age, and time since menopause) and total reproductive years with risk of cardiovascular disease (CVD). Methods and Results— The China Kadoorie Biobank recruited 302 632 women in 2004 to 2008 from 10 regions across China. During 9-year follow-up, 19 393 incident cases of stroke, 18 611 of ischemic heart disease, and 4978 CVD deaths occurred. Cox regression yielded adjusted hazard ratios relating each menopause characteristic and total reproductive years to CVD risk. Among 274 233 women with no prior CVD at baseline, 134 010 were naturally postmenopausal women (mean [SD] age at menopause of 48.6 [4.0] years and total reproductive years 32.7 [4.4]). Compared with premenopausal women, naturally peri- or postmenopausal women were at a higher risk of either fatal or nonfatal CVD. Among women who had had menopause, inverse associations were observed between age at menopause and risks of CVD mortality, incident ischemic heart disease, stroke, and subtypes of stroke, with 1.5% higher risk of CVD death (P<0.001), 0.7% for incident ischemic heart disease (P=0.002), and 0.5% for incident stroke (P=0.02) for every 1 year lower age at menopause. Compared with women who had menopause at age 48 to 50 years, lower age at menopause (ie, <43 years) was associated with 14% higher risk of CVD death and 6% higher risks of both incident ischemic heart disease and stroke. Higher risks of both fatal and nonfatal CVD were also found in women with 5 to 10, 10 to 15, 15 to 20, or >20 years since menopause compared with <5 years since menopause. Total reproductive years were inversely associated with risks of both fatal and nonfatal CVD, with 1.4% lower risk of CVD death per additional reproductive year (P<0.001). Conclusions— Women with younger age at menopause, longer time since menopause, or fewer total reproductive years had a higher risk of CVD.
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Affiliation(s)
- Ling Yang
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.).
| | - Liling Lin
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Christiana Kartsonaki
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Yu Guo
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Yiping Chen
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Zheng Bian
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Kaixu Xie
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Donghui Jin
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Liming Li
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Jun Lv
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
| | - Zhengming Chen
- From the Medical Research Council Population Health Research Unit (L.Y., C.K., Y.C.) and Clinical Trial Service Unit and Epidemiological Studies Unit (L.Y., C.K., Y.C., Z.C.), University of Oxford, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China (L. Lin, L. Li, J.L.); Chinese Academy of Medical Sciences, Beijing (Y.G., Z.B.); NCDs Prevention and Control Department, Tongxiang CDC, China (K.X.); and NCDs Prevention and Control Department, Hunan CDC, Changsha, China (D.J.)
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Huang Y, Chatooah ND, Qi T, Wang G, Ma L, Ying Q, Lan Y, Song Y, Li C, Chu K, Chen P, Xu W, Wan H, Cai Y, Zhou J. Health-related quality of life and its associated factors in Chinese middle-aged women. Climacteric 2018; 21:483-490. [PMID: 29856658 DOI: 10.1080/13697137.2018.1476133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Y. Huang
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - N. D. Chatooah
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - T. Qi
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - G. Wang
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - L. Ma
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Q. Ying
- Zhejiang Cancer Institute, Zhejiang Cancer Hospital, Hangzhou, People’s Republic of China
| | - Y. Lan
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Y. Song
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - C. Li
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - K. Chu
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - P. Chen
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - W. Xu
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - H. Wan
- Maternal and Child Health & Family Planning Service Center, Gongshu District, Hangzhou, People’s Republic of China
| | - Y. Cai
- Maternal and Child Health & Family Planning Service Center, Gongshu District, Hangzhou, People’s Republic of China
| | - J. Zhou
- Department of Gynecology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
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Jiang H, Bai W, Wang W, Wang K, Jia J, Zhang J, Diao H, Qin L. Proteomics in plasma of ovariectomized rats and those exposed to estradiol valerate. J Steroid Biochem Mol Biol 2018; 178:1-12. [PMID: 29054504 DOI: 10.1016/j.jsbmb.2017.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 09/19/2017] [Accepted: 10/12/2017] [Indexed: 01/29/2023]
Abstract
The menopausal period, an inevitable physiological process for women, is frequently associated with physiological and psychological dysfunction attributable to substantial fluctuation and gradual decrease in female hormones induced by ovarian failure, leading to corresponding symptoms and diseases that impact multiple systems in the body to varying degrees. As prior studies have focused primarily on menopausal syndrome-related pathophysiological changes and hormone replacement therapy effects, here we approached menopausal disease incidence risk and pathogenesis through systemic plasma proteomics analysis. Female Sprague-Dawley rats were randomly divided into sham, ovariectomized, and estrogen treatment after ovariectomy groups (n=9 per group). Tandem Mass Tag quantitative proteomics analysis of their plasma identified over 900 proteins by MS. Between group fold change of >1.2 and p<0.05 (Student's t-test) identified 121 (including 36 up-regulated and 85 down-regulated), 117 (69 up-regulated and 48 down-regulated), and 109 (41 up-regulated and 68 down-regulated) differentially expressed proteins between groups, respectively. Of these, 5 (GHR, LIFR, apoA IV, RTN, and Lin28b) were verified by parallel reaction monitoring to be reliable. Further application of optimized screening criteria and performance of a series of bioinformatics analyses allowed the selection of 35 optimal differentially expressed proteins. Gene ontology annotation results suggested that the differentially expressed proteins are mainly annotated as protein binding, cell, and single organism process in terms of molecular function, cell composition, and biological process, respectively. KEGG pathway analysis indicated that the PI3-Akt pathway has the highest aggregation degree of differentially expressed proteins. Protein-protein interaction analysis noted GLUT4 as an important node protein. This research is the first to comprehensively analyze plasma protein changes, together with estrogen efficacy, in ovariectomized rats. The findings facilitate our understanding of the molecular mechanism of systemic menopausal changes and provide valuable clues for developing diagnostic biomarkers for menopausal dysfunctions and selecting clinical therapeutic strategies.
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Affiliation(s)
- Hai Jiang
- Department of Anatomy and Histoembryology, School of Basic Medical Science, Peking University, Beijing, China
| | - Wenpei Bai
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Wenjuan Wang
- Department of Anatomy and Histoembryology, School of Basic Medical Science, Peking University, Beijing, China
| | - Ke Wang
- Department of Anatomy and Histoembryology, School of Basic Medical Science, Peking University, Beijing, China
| | - Jing Jia
- Department of Stomatology, General Hospital of Chinese People's Armed Police Forces, Beijing, China
| | - Jing Zhang
- Department of Anatomy and Histoembryology, School of Basic Medical Science, Peking University, Beijing, China
| | - He Diao
- Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lihua Qin
- Department of Anatomy and Histoembryology, School of Basic Medical Science, Peking University, Beijing, China.
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Fu C, Zhao N, Liu Z, Yuan LH, Xie C, Yang WJ, Yu XT, Yu H, Chen YF. Acupuncture Improves Peri-menopausal Insomnia: A Randomized Controlled Trial. Sleep 2018; 40:4259343. [PMID: 29029258 DOI: 10.1093/sleep/zsx153] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Study Objectives To evaluate the short-term efficacy of acupuncture for the treatment of peri-menopausal insomnia (PMI). Methods Design: A randomized, participant-blind, placebo-controlled trial consisted of the acupuncture group (n = 38) and placebo-acupuncture group (n = 38). Setting: A tertiary teaching and general hospital. Participants: 76 peri-menopausal women with insomnia disorder based on the International Classification of Sleep Disorders, Third Edition. Interventions: A 10-session of acupuncture at bilateral Shenshu (BL 23) and Ganshu (BL 18) with unilateral Qimen (LR 14) and Jingmen (GB 25) or Streitberger needles at the same acupoints was performed for over 3 weeks. Measurements: Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) with over-night polysomnography (PSG) exam were completed at baseline and post-treatment. Results After the treatments, the decrease from baseline in PSQI score was 8.03 points in acupuncture group and 1.29 points in placebo-acupuncture group. The change from baseline in ISI score was 11.35 points in acupuncture group and 2.87 points in placebo-acupuncture group. In PSG data, acupuncture significantly improved the sleep efficiency and total sleep time, associated with less wake after sleep onset and lower percent stage 1 after the treatment. No significant differences from baseline to post-treatment were found in placebo-acupuncture group. Conclusions Acupuncture can contribute to a clinically relevant improvement in the short-term treatment of PMI, both subjectively and objectively. Clinical Trial Registration Acupuncture for peri-menopause insomnia: a randomized controlled trial, http://www.chictr.org.cn/showproj.aspx?proj=12118 ChiCTR-IPR-15007199, China.
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Affiliation(s)
- Cong Fu
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Na Zhao
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhen Liu
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lu-Hua Yuan
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chen Xie
- Editorial Department of Journal of Acupuncture and Tuina Science, Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai 200030, China
| | - Wen-Jia Yang
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xin-Tong Yu
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huan Yu
- Sleep and Wake Disorders Center and Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Yun-Fei Chen
- Laboratory Center of Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Prince MJ, Acosta D, Guerra M, Huang Y, Jimenez-Velazquez IZ, Llibre Rodriguez JJ, Salas A, Sosa AL, Chua KC, Dewey ME, Liu Z, Mayston R, Valhuerdi A. Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; A 10/66 population-based cohort study. PLoS One 2018; 13:e0192889. [PMID: 29489847 PMCID: PMC5831083 DOI: 10.1371/journal.pone.0192889] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 01/08/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Exposure to endogenous estrogen may protect against dementia, but evidence remains equivocal. Such effects may be assessed more precisely in settings where exogenous estrogen administration is rare. We aimed to determine whether reproductive period (menarche to menopause), and other indicators of endogenous estrogen exposure are inversely associated with dementia incidence. METHODS Population-based cohort studies of women aged 65 years and over in urban sites in Cuba, Dominican Republic, Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, including ages at menarche, birth of first child, and menopause, and parity, with ascertainment of incident 10/66 dementia, and mortality, three to five years later. RESULTS 9,428 women participated at baseline, with 72-98% responding by site. The 'at risk' cohort comprised 8,466 dementia-free women. Mean age varied from 72.0 to 75.4 years, lower in rural than urban sites and in China than in Latin America. Mean parity was 4.1 (2.4-7.2 by site), generally higher in rural than urban sites. 6,854 women with baseline reproductive period data were followed up for 26,463 person years. There were 692 cases of incident dementia, and 895 dementia free deaths. Pooled meta-analysed fixed effects, per year, for reproductive period (Adjusted Sub-Hazard Ratio [ASHR] 1.001, 95% CI 0.988-1.015) did not support any association with dementia incidence, with no evidence for effect modification by APOE genotype. No association was observed between incident dementia and; ages at menarche, birth of first child, and menopause: nulliparity; or index of cumulative endogenous estrogen exposure. Greater parity was positively associated with incident dementia (ASHR 1.030, 95% CI 1.002-1.059, I2 = 0.0%). CONCLUSIONS We found no evidence to support the theory that natural variation in cumulative exposure to endogenous oestrogens across the reproductive period influences dementia incidence in late life.
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Affiliation(s)
- Martin J. Prince
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- * E-mail:
| | - Daisy Acosta
- Internal Medicine Department, Geriatric Section, Universidad Nacional Pedro Henriquez Ureña (UNPHU), Santo Domingo, Dominican Republic
| | - Mariella Guerra
- Instituto de la Memoria y Desordenes Relacionados, Lima, Perú
| | - Yueqin Huang
- Peking University, Institute of Mental Health, Beijing, China
| | - Ivonne Z. Jimenez-Velazquez
- Internal Medicine Dept, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Aquiles Salas
- Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela
| | - Ana Luisa Sosa
- The Cognition and Behavior Unit, National Institute of Neurology and Neurosurgery of Mexico and Autonomous National University of Mexico, Mexico City, Mexico
| | - Kia-Chong Chua
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Michael E. Dewey
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Zhaorui Liu
- Internal Medicine Dept, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Rosie Mayston
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Chu K, Song Y, Chatooah ND, Weng Q, Ying Q, Ma L, Qu F, Zhou J. The use and discontinuation of hormone replacement therapy in women in South China. Climacteric 2017; 21:47-52. [PMID: 29166793 DOI: 10.1080/13697137.2017.1397622] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The use of hormone replacement therapy (HRT) started later in China than in European countries. The purpose of the present study was to investigate HRT patterns and reasons for the initiation and discontinuation of HRT among women in South China. METHODS A telephone survey about menopausal status, the use of HRT, reasons for HRT discontinuation and duration of HRT treatment was conducted in 2014. RESULTS A total of 825 telephone surveys were carried out, and 217 previous HRT users and 390 current users were recruited for this study. Among these 607 subjects, 50.7% of the women sought out HRT for hot flushes, 41.6% for fatigue and 41.5% for sleeplessness. Approximately one-third (35.9%) of the patients abandoned HRT during the following year. The reasons for stopping HRT were mainly fear of breast and uterine cancer (28.4%), reduced menopausal symptoms (22.9%) and the inconvenience of taking pills or seeing a doctor (17.9%). The factors related to HRT discontinuation were the age when HRT was initiated (odds ratio 1.59, 95% confidence interval 1.19-2.13) and education level (odds ratio 0.78, 95% confidence interval 0.62-0.98). CONCLUSIONS The duration of HRT use in women in south China was short, and a high proportion of the women discontinued HRT. Given the high discontinuation rate and the low medical compliance, Chinese health-care providers still have much to do to let women know about the advantages and disadvantages of HRT and to encourage the use of HRT appropriately.
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Affiliation(s)
- K Chu
- a School of Medicine , Women's Hospital, Zhejiang University , Hangzhou , PR China
| | - Y Song
- a School of Medicine , Women's Hospital, Zhejiang University , Hangzhou , PR China
| | - N D Chatooah
- a School of Medicine , Women's Hospital, Zhejiang University , Hangzhou , PR China
| | - Q Weng
- b Yuhang First Hospital , Hangzhou , PR China
| | - Q Ying
- c Zhejiang Cancer Hospital , Hangzhou , PR China
| | - L Ma
- a School of Medicine , Women's Hospital, Zhejiang University , Hangzhou , PR China
| | - F Qu
- a School of Medicine , Women's Hospital, Zhejiang University , Hangzhou , PR China
| | - J Zhou
- a School of Medicine , Women's Hospital, Zhejiang University , Hangzhou , PR China
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Thompson JJ, Ritenbaugh C, Nichter M. Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making. BMC Womens Health 2017; 17:97. [PMID: 28969624 PMCID: PMC5625649 DOI: 10.1186/s12905-017-0449-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 09/20/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)-despite concerns within the medical community and the availability of new FDA approved "bioidentical" products. This study aims to characterize the motivations for using CBHT in a U.S. sample of ordinary midlife women. METHODS We analyze data collected from 21 current and former users of CBHT who participated in a larger qualitative study of menopausal decision-making among U.S. women. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed thematically using an iterative inductive and deductive process. RESULTS Although women's individual motivations varied, two overarching themes emerged: "push motivations" that drove women away from conventional HT and from alternative therapies, and "pull motivations" that attracted women to CBHT. Push motivations focused on (1) fear and uncertainty about the safety of conventional HT, (2) an aversion to conjugated estrogens in particular, and (3) and overarching distrust of a medical system perceived as dismissive of their concerns and overly reliant on pharmaceuticals. Participants also voiced dissatisfaction with the effectiveness of herbal and soy supplements. Participants were attracted to CBHT because they perceive it to be (1) effective in managing menopausal symptoms, (2) safer than conventional HT, (3) tailored to their individual bodies and needs, and (4) accompanied by enhanced clinical care and attention. CONCLUSIONS This study finds that women draw upon a range of "push" and "pull" motivations in their decision to use CBHT. Importantly, we find that women are not only seeking alternatives to conventional pharmaceuticals, but alternatives to conventional care where their menopausal experience is solicited, their treatment goals are heard, and they are engaged as agents in managing their own menopause. The significance of this finding goes beyond understanding why women choose CBHT. Women making menopause treatment decisions of all kinds would benefit from greater shared decision-making in the clinical context in which they are explicitly invited to share their experiences, priorities, and preferences. This would also provide an opportunity for clinicians to discuss the pros and cons of conventional HT, CBHT, and other approaches to managing menopause.
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Affiliation(s)
- Jennifer Jo Thompson
- Department of Crop and Soil Sciences, University of Georgia, 3111 Miller Plant Sciences, Athens, GA 30602 USA
| | - Cheryl Ritenbaugh
- Department of Family and Community Medicine, University of Arizona, 1450 N. Cherry Ave, Tucson, AZ 85719 USA
| | - Mark Nichter
- School of Anthropology, University of Arizona, 1009 E. South Campus Drive, Tucson, AZ 85721 USA
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Prevalence, severity, and associated factors of menopausal symptoms in middle-aged Chinese women: a community-based cross-sectional study in southeast China. Menopause 2017; 24:1200-1207. [DOI: 10.1097/gme.0000000000000906] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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40
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Guo C, Sung H, Zheng S, Guida J, Li E, Li J, Hu N, Deng J, Figueroa JD, Sherman ME, Gierach GL, Lu N, Yang XR. Age-related terminal duct lobular unit involution in benign tissues from Chinese breast cancer patients with luminal and triple-negative tumors. Breast Cancer Res 2017; 19:61. [PMID: 28545469 PMCID: PMC5445352 DOI: 10.1186/s13058-017-0850-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/02/2017] [Indexed: 01/20/2023] Open
Abstract
Background Terminal duct lobular unit (TDLU) involution is a physiological process of breast tissue aging characterized by a reduction in the epithelial component. In studies of women with benign breast disease, researchers have found that age-matched women with lower levels of TDLU involution are at increased risk of developing breast cancer. We previously showed that breast cancer cases with core basal phenotype (CBP; estrogen receptor negative [ER−], progesterone receptor-negative [PR−], human epidermal growth factor receptor 2-negative [HER2−], cytokeratins (CK 5 or CK5/6)-positive [CK5/6+] and/or epidermal growth factor receptor-positive [EGFR+]) tumors had significantly reduced TDLU involution compared with cases with luminal A (ER+ and/or PR+, HER2−, CK5/6−, EGFR−) tumors from a population-based case-control study in Poland. We evaluated the association of TDLU involution with tumor subtypes in an independent population of women in China, where the breast cancer incidence rate, prevalence of known risk factors, and mammographic breast density are thought to be markedly different from those of Polish women. Methods We performed morphometric assessment of TDLUs by using three reproducible semiquantitative measures that inversely correlate with TDLU involution (TDLU count/100 mm2, TDLU span in micrometer, and acini count/TDLU) by examining benign tissue blocks from 254 age-matched luminal A and 250 triple-negative (TN; ER−, PR−, HER2−, including 125 CBP) breast cancer cases treated in a tertiary hospital in Beijing, China. Results Overall, we found that TN and particularly CBP cases tended to have greater TDLU measures (less involution) than luminal A cases in logistic regression models accounting for age, body mass index, parity, and tumor grade. The strongest association was observed for tertiles of acini count among younger women (aged <50 years) (CBP vs. luminal A; ORtrend 2.11, 95% CI 1.22–3.67, P = 0.008). Conclusions These data extend previous findings that TN/CBP breast cancers are associated with reduced TDLU involution in surrounding breast parenchyma compared with luminal A cases among Chinese women, providing further support for differences in the pathogenesis of these tumor subtypes. Electronic supplementary material The online version of this article (doi:10.1186/s13058-017-0850-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Changyuan Guo
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hyuna Sung
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Shan Zheng
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jennifer Guida
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erni Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Li
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nan Hu
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joseph Deng
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jonine D Figueroa
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Mark E Sherman
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA
| | - Gretchen L Gierach
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ning Lu
- National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong R Yang
- Division of Cancer Epidemiology & Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
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Kim MK, Seo SK, Chae HD, Hwang KJ, Kim T, Yoon BK, Lee BS. Perceptions of Postmenopausal Symptoms and Treatment Options among Middle-Aged Korean Women. Yonsei Med J 2017; 58:533-539. [PMID: 28332358 PMCID: PMC5368138 DOI: 10.3349/ymj.2017.58.3.533] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the perceptions of postmenopausal symptoms and treatment options among middle-aged Korean women. MATERIALS AND METHODS This cross-sectional study included 2330 Korean women. The women were administered a structured questionnaire to collect sociodemographic data and information regarding menopause and its treatment. RESULTS More than half (65%) of the participants perceived menopause as a disease, and 66.8% knew hormone therapy (HT) is available for menopausal symptom treatment. However, only 19.7% of participants visited clinics for HT. The most common reasons for having negative views about HT were its adverse reactions (47.3%) and concerns about developing cancer (41.1%). For symptom management, 36.5% of the participants tried lifestyle modification instead of HT. CONCLUSION The majority of Korean women regarded menopause as a disease. They were aware of HT for menopausal symptom treatment, but the use of HT was relatively low. Education about the safety and positive effects of HT and the importance of professional healthcare should be provided.
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Affiliation(s)
- Min Kyoung Kim
- Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Kyo Seo
- Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Dong Chae
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung Joo Hwang
- Department of Obstetrics and Gynecology, Ajou University College of Medicine, Suwon, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Byung Koo Yoon
- Department of Obstetrics and Gynecology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea
| | - Byung Seok Lee
- Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
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You H, Kong Y, Hou J, Wei L, Zhang Y, Niu J, Han T, Ou X, Dou X, Shang J, Tang H, Xie Q, Ding H, Ren H, Xu X, Xie W, Liu X, Xu Y, Li Y, Li J, Chow SC, Zhuang H, Jia J. Female gender lost protective effect against disease progression in elderly patients with chronic hepatitis B. Sci Rep 2016; 6:37498. [PMID: 27892487 PMCID: PMC5124962 DOI: 10.1038/srep37498] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 10/19/2016] [Indexed: 02/05/2023] Open
Abstract
Female gender and younger age are protective factors against disease progression in chronic hepatitis B (CHB). However, it is not clear whether the disease progression still remains slow in elderly females. This study investigated the interaction of female gender and older age on the development of cirrhosis in patients recorded in China Registry of Hepatitis B. A total of 17,809 CHB patients were enrolled in this multi-center cross-sectional study. The prevalence of cirrhosis in female CHB patients increased faster than that in male CHB patients over 50 years old. Multivariate analysis showed that the increase of adjusted ORs for developing cirrhosis in females started to accelerate after 50 years old: 11.19 (95% CI: 5.93-21.11) in women versus 14.75 (95% CI: 8.35-26.07) in men at ages of 50-59 years, 21.67 (95% CI: 11.05-42.47) versus 24.4 (95% CI: 13.00-45.80) at ages 60-69 years, and 18.78 (95% CI: 6.61-53.36) versus 12.09 (95% CI: 4.35-33.61) in those over 70 years. In conclusion, the protective effect of female gender against cirrhosis gradually lost with increasing age, therefore disease progression should be monitored more closely in elderly women with CHB.
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Affiliation(s)
- Hong You
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China
| | - Yuanyuan Kong
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China
| | - Jinlin Hou
- Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Lai Wei
- Peking University People’s Hospital, Beijing, 100044, China
| | - Yuexin Zhang
- First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
| | - Junqi Niu
- First Hospital of Jilin University, Changchun, 130021, China
| | - Tao Han
- Tianjin Third Central Hospital, Tianjin Medical University, Tianjin, 300170, China
| | - Xiaojuan Ou
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China
| | - Xiaoguang Dou
- Shengjing Hospital of China Medical University, Shenyang, 110022, China
| | - Jia Shang
- Henan Provincial People’s Hospital, Zhengzhou, 450003, China
| | - Hong Tang
- West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qing Xie
- Shanghai Ruijin Hospital, Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Huiguo Ding
- Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Hong Ren
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Xiaoyuan Xu
- Peking University First Hospital, Beijing, 100034, China
| | - Wen Xie
- Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China
| | - Xiaoqing Liu
- Peking Union Medical College Hospital, Beijing, 100730, China
| | - Youqing Xu
- Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Yujie Li
- The Third People’s Hospital of Taiyuan, Taiyuan, 030012, China
| | - Jie Li
- Peking University Health Science Center, Beijing, 100191, China
| | - Shein-Chung Chow
- Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, 27710, USA
| | - Hui Zhuang
- Peking University Health Science Center, Beijing, 100191, China
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medical University; Beijing Key Laboratory of Translational Medicine on Liver Cirrhosis; National Clinical Research Center for Digestive Disease, Beijing, 100050, China
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Menopause in the workplace: What employers should be doing. Maturitas 2015; 85:88-95. [PMID: 26857886 DOI: 10.1016/j.maturitas.2015.12.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 12/12/2015] [Indexed: 11/22/2022]
Abstract
Large numbers of women transition through menopause whilst in paid employment. Symptoms associated with menopause may cause difficulties for working women, especially if untreated, yet employers are practically silent on this potentially costly issue. This review summarises existing research on the underexplored topic of menopause in the workplace, and synthesises recommendations for employers. Longstanding scholarly interest in the relationship between employment status and symptom reporting typically (but not consistently) shows that women in paid employment (and in specific occupations) report fewer and less severe symptoms than those who are unemployed. Recent studies more systematically focused on the effects of menopausal symptoms on work are typically cross-sectional self-report surveys, with a small number of qualitative studies. Though several papers established that vasomotor (and associated) symptoms have a negative impact on women's productivity, capacity to work and work experience, this is not a uniform finding. Psychological and other somatic symptoms associated with menopause can have a relatively greater negative influence. Physical (e.g., workplace temperature and design) and psychosocial (e.g., work stress, perceptions of control/autonomy) workplace factors have been found to influence the relationship between symptoms and work. Principal recommendations for employers to best support menopausal women as part of a holistic approach to employee health and well-being include risk assessments to make suitable adjustments to the physical and psychosocial work environment, provision of information and support, and training for line managers. Limitations of prior studies, and directions for future research are presented.
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