Clinical Data Analysis Of 583 Cases Of Menopausal Women

Objective:to survey and analyze the clinical data of 583 cases of menopausal women and understand the main symptom and menopausal health awareness; to compare the influence of different factors such as age, degree of education, occupation on patients’main menopausal symptoms, severity and acceptance rate of menopausal hormone therapy (MHT) and provide certain reference for the menopausal management.Methods:one-on-one face-to-face questionnaire survey is conducted on the patients older than 40 and with natural menopause or menopausal symptoms or whose blood indicator suggests ovarian function decreases treated in the gynaecological clinic of the Second Affiliated Clinical Hospital of Chongqing Medical University from July 2013 to October 2014; the general situations, main menopausal symptoms, the quantitative symptom severity of the improved Kupperman Menopause Index (KMI), the understanding of the menopausal period and MHT usage are analyzed; and the subjects are grouped according to different factors; statistical methods are used to analyze the differences between groups.Results:1. Among 583 valid questionnaires,349 ones have natural menopause, with the averaged natural menopausal age being 48.7± 3.4.2. Main menopausal symptoms and severity:93.14% (543/583) of patients have at least one menopausal symptom; the most common symptom is hot flashes (57.46%,335/583). KMI shows the incidence of menopausal symptoms was 82.50% (481/583); among them, there are 274 mild cases (47%),166 moderate cases (28.47%) and 41 severe cases (7.03%),and the highest scores is 43.3. Comparison of the influence of different factors on main menopausal symptoms and severity(1) Age:the patients are divided into five ages according to age, hot flashes and insomnia mainly occur to 51--55 years old group; and vaginal dryness dyspareunia, urinary tract symptoms and joint muscle pain aggravate with age increases.(2) Menstrual status:349 patients with natural menopause are divided into disorder group and non-disorder group according to the premenopausal presence of menstrual disorder; the climacteric syndrome prevalence of disorder group (91.37%) and the proportion (50.59%) of patients with moderately severe symptoms is significantly higher than non-disorder group (56.38%,7.45%), the difference was statistically significant. The incidence of menopausal symptoms of different ways of menstrual disorders in disorder group and the proportion of moderately severe symptoms have no statistically significant difference.(3) Age of menopause:the age of menopause of 349 patients with natural menopause is 40-57; KMI scores of all patients with natural menopause are 0-43;The correlation analysis of menopausal age and KMI shows that which are not relevant.(4)Educational status:the patients are divided into three groups based on educational status; with the improvement of education degree, the incidence of menopausal symptoms and the proportion of moderate/severe symptoms increase and the difference is meaningful.(5) Occupation:the patients are divided into mental labor group, physical labor group and the other group for statistics; the proportion of patients with the symptoms in physical labor group (73.26%) and the proportion of the number of moderately severe patients (18.60%) are obviously lower than that in group mental work and the other group, the difference was statistically significant; the differences between mental work group and other group have no statistical significance.4. Menopausal clinic treatment conditions:In 583 patients,283 cases (40.82%) receive treatment in menopause outpatient clinic for Self-induction symptomatic; 90 cases (15.44%) receive treatment for menstrual disorders; only 4 cases (0.69%) patients with menopause check voluntary requirements; and there were 36 cases (6.17%) ask for the other department for menopausal symptoms, the nor-gynecologist suggest referral menopause outpatient service. In 583 patients,29.16%(170/583) ones receive MHT.5. Analysis of influencing factors of MHT acceptance rate(1) Age:MHT acceptance rate of patients older than 60 is 10.14%, significantly less than the average vales of MHT acceptance rate of patients at the age of 60 or below(31.71%). MHT acceptance rate difference of the patients at the age of 60 or below has no statistical significance (P> 0.008).(2) Educational status:MHT acceptance rate of the groups with College degree or above is significantly higher than those with poorer educational background, meaningful difference; Between the difference groups of poorer educational background has no statistical significance.(3) Perimenopausal symptoms severity:as the symptom is aggravating, patients are more likely to receive hormone therapy, meaningful difference. The hormone therapy rate of patients with mild symptoms is significantly lower than that of patients with moderate and severe symptoms, the difference was statistically significant; the differences between moderate group and severe group are not obvious.(4) Occupation:the patients are divided into medical workers and non-medical workers for statistics; and MHT acceptance rate of medical workers (26.32%) is not higher than that of non-medical workers (29.47%) and the statistics shows that difference is insignificant.(5) Concomitant diseases:MHT acceptance rate of the group without any concomitant diseases is 27.27%, obviously lower that of the group with osteoporosis or osteoporosis fracture (71.43%), the difference was statistically significant; the group without any concomitant diseases comparison with uterine fibroids (34.09%) or with breast disease group (34.09%), the comparative differences are all not obvious.Conclusions:Through the investigation of 583 menopausal women, we have found that there was a high rate of menopause syndrome. The most frequent menopausal symptom was hot flashes, and vaginal dryness dyspareunia, urinary tract and joint muscle pain aggravate gradually with age increases. A number of patients still could not correctly understand the knowledge of menopause, which led to delayed diagnosis and treatment, highlights the importance of the menopausal knowledge propaganda.There are higher incidence and more serious symptoms in the women with menopausal menstrual disorder and higher education degree. On the contrast, manual labor patients had milder menopausal symptoms, suggesting relieve work stress and exercise properly is benefit for alleviating symptoms.The statistics suggested that lower education degree, milder symptoms, and the absence of long-term forward around menopausal symptoms were the main factors influencing the patients to receive MHT. Part of the medical workers also had concerns for using MHT, further strengthen the menopausal knowledge popularization, especially the long-term effects of menopausal estrogen decrease and MHT is a therapeutic instead of health protection measures; besides, patients with lower education level and medical workers are the focus crowd of popularization and education.