Women's midlife health最新文献

{"title":"Perceived stress across the midlife: longitudinal changes among a diverse sample of women, the Study of Women's health Across the Nation (SWAN).","authors":"Elizabeth Hedgeman,&nbsp;Rebecca E Hasson,&nbsp;Carrie A Karvonen-Gutierrez,&nbsp;William H Herman,&nbsp;Siobán D Harlow","doi":"10.1186/s40695-018-0032-3","DOIUrl":"https://doi.org/10.1186/s40695-018-0032-3","url":null,"abstract":"<p><strong>Background: </strong>In women, midlife is a period of social and physiological change. Ostensibly stressful, cross-sectional studies suggest women experience decreasing stress perceptions and increasing positive outlook during this life stage. The aim of this paper was to describe the longitudinal changes in perceived stress as women transitioned through the midlife.</p><p><strong>Methods: </strong>Premenopausal women (<i>n</i> = 3044) ages 42-52 years at baseline, were recruited from seven sites in the Study of Women's Health Across the Nation, and followed approximately annually over 13 visits with assessment of perceived stress and change in menopausal status. Longitudinal regression models were used to assess the effects of age, menopausal status and baseline sociodemographic variables on the trajectory of perceived stress over time.</p><p><strong>Results: </strong>At baseline, mean age was 46.4 ± 2.7 years; participants were white (47%), black (29%), Hispanic (7%), Japanese (9%), or Chinese (8%). Hispanic women, women with lesser educational attainment, and women reporting financial hardship were each more likely to report high perceived stress levels at baseline (all <i>p</i> < 0.0001). After adjustment for baseline sociodemographic factors, perceived stress decreased over time for most women (<i>p</i> < 0.0001), but increased for both Hispanic and white participants at the New Jersey site (<i>p</i> < 0.0001). Changing menopausal status was not a significant predictor of perceived stress.</p><p><strong>Conclusions: </strong>Self-reported stress decreased for most women as they transitioned across the midlife; changing menopausal status did not play a significant role after adjustment for age and sociodemographic factors. Future studies should explore the stress experience for women by racial/ethnic identity and demographics.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-018-0032-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36284866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depressed mood during the menopausal transition: is it reproductive aging or is it life?","authors":"Ellen Sullivan Mitchell,&nbsp;Nancy Fugate Woods","doi":"10.1186/s40695-017-0030-x","DOIUrl":"10.1186/s40695-017-0030-x","url":null,"abstract":"<p><strong>Background: </strong>Although there has been noteworthy attention to both depressed mood symptoms and majordepressive disorder during the menopausal transition (MT), recently investigators have questioned whether there is an over-pathologizing of the MT by emphasizing hormonal effects on depression and deflecting attention from the everyday conditions of women's lives as they relate to depressed mood. In addition, fluctuation of mood over short periods of time may not be captured by measures of depressed mood symptoms such as the CESD, especially when administered using a reference period such as a week or more. The purpose of this study was to examine the association of menopausal transition factors, health-related factors, stress factors, social factors and symptoms with repeated measures of depressed mood reported for a 24 h period.</p><p><strong>Methods: </strong>Seattle Midlife Women's Health Study participants (<i>n</i> = 291, 6977 observations) provided data from 1990 to 2013 including annual questionnaires, symptom diaries and urine specimens assayed for hormones several times per year. Multilevel modeling was used to test bivariate and multivariable models accounting for depressed mood severity.</p><p><strong>Results: </strong>In individual models with age as the measure of time, being in early postmenopause, exercising more, and being partnered were associated with less severe depressed mood; greater perceived stress, having a history of sexual abuse, difficulty getting to sleep, early awakening, and awakening at night were each associated with higher depressed mood severity. In a multivariable model (<i>n</i> = 234, 6766 observations), being older, being in the early postmenopause, exercising more, being partnered, were associated with less severe depressed mood; reporting greater perceived stress, history of sexual abuse, difficulty getting to sleep and early awakening were associated with more severe depressed mood.</p><p><strong>Conclusions: </strong>Clinicians need to consider the context in which midlife women experience the menopausal transition and mood symptoms as well as hormonal transitions during this part of the lifespan.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2017-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0030-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36561023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception pathway: application for midlife women.","authors":"Chi-Son Kim,&nbsp;Deanna Tikhonov,&nbsp;Lena Merjanian,&nbsp;Adrian C Balica","doi":"10.1186/s40695-017-0029-3","DOIUrl":"https://doi.org/10.1186/s40695-017-0029-3","url":null,"abstract":"<p><strong>Objective: </strong>To create a system where evidence based medicine can be applied to accommodate every woman's needs by designing a contraceptive pathway that can be utilized by any healthcare provider, regardless of the patient's age, and to offer appropriate counseling in order to maximize patient outcomes, especially for the midlife woman.</p><p><strong>Methods: </strong>United States Medical Eligibility Criteria for Contraceptive Use, 2016 (US MEC) was used as the framework for these recommendations for a contraceptive care pathway that can be incorporated into care for midlife women.</p><p><strong>Discussion: </strong>By utilizing a total office approach that includes the scheduler, receptionist, medical assistant, nurse and health care provider as members of a team, the entire spectrum of the patient population in need of contraception from teenagers to midlife can be captured. Specifically for midlife women the need for an effective form of contraception may be overlooked as fecundity declines in this age group. This paper will highlight the use of this pathway for midlife women.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2017-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0029-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36561022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unintended pregnancy: a framework for prevention and options for midlife women in the US.","authors":"Versie Johnson-Mallard, Elizabeth A Kostas-Polston, Nancy Fugate Woods, Katherine E Simmonds, Ivy M Alexander, Diana Taylor","doi":"10.1186/s40695-017-0027-5","DOIUrl":"10.1186/s40695-017-0027-5","url":null,"abstract":"<p><p>Recently unintended pregnancies have been described as \"a new kind of mid-life crisis.\" Given the high prevalence of unwanted or mistimed pregnancy in the US, we examined the sexual and reproductive health patterns of sexually active midlife women. An examination of the prevalence of unintended pregnancy among midlife women revealed a gap in data indicating unmet sexual and reproductive health needs of midlife women. The application of a framework for primary, secondary and tertiary prevention for unintended pregnancy may assist with guiding care for women and identifying implications for reproductive health policy and potential political interference as they relate to sexual and reproductive health in midlife women.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2017-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36561021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception for midlife women: lack of information? Lack of interest? Lack of investment?","authors":"Nancy Fugate Woods,&nbsp;Gloria Bachmann","doi":"10.1186/s40695-017-0025-7","DOIUrl":"https://doi.org/10.1186/s40695-017-0025-7","url":null,"abstract":"<p><p>Despite the growing population of midlife women in the USA and in other economically-advantaged countries, there is scant research focusing on this population, especially regarding contraceptive choices in those at risk for unwanted or unplanned pregnancy. As women approach menopause, the increasing irregularity of their menstrual cycles and changing endocrine patterns present challenges for preventing unintended pregnancy, or, on the flip side, planning for a desired pregnancy. In this thematic series, we have brought together researchers and clinicians who address many of these tough clinical scenarios and offer suggestions not only for clinical management of optimal contraceptive choices for midlife women, but also suggestions for future research in this area.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2017-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0025-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36561020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive preferences and unmet need for contraception in midlife women: where are the data?","authors":"Siobán D Harlow,&nbsp;Jennifer R Dusendang,&nbsp;Michelle M Hood,&nbsp;Nancy Fugate Woods","doi":"10.1186/s40695-017-0026-6","DOIUrl":"10.1186/s40695-017-0026-6","url":null,"abstract":"<p><p>This commentary discusses the limited availability of information on contraceptive preferences and unmet need for contraception among midlife women in both high and low income countries. Given that risk of pregnancy continues until women reach menopause and given the increased risk of pregnancy complications, elective abortion, and maternal mortality in women aged 45 to 54 years old, increased focus on gathering basic data on midlife women's preferences and unmet need is warranted.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2017-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0026-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Müllerian hormone and its relationships with subclinical cardiovascular disease and renal disease in a longitudinal cohort study of women with type 1 diabetes.","authors":"Catherine Kim,&nbsp;Yuanyuan Pan,&nbsp;Barbara H Braffett,&nbsp;Valerie L Arends,&nbsp;Michael W Steffes,&nbsp;Hunter Wessells,&nbsp;Aruna V Sarma","doi":"10.1186/s40695-017-0023-9","DOIUrl":"https://doi.org/10.1186/s40695-017-0023-9","url":null,"abstract":"<p><strong>Background: </strong>Reproductive age may be a risk factor for vascular disease. Anti-Müllerian hormone (AMH) is produced by viable ovarian follicles and reflects reproductive age. We examined whether AMH concentrations were associated with markers of subclinical cardiovascular disease (CVD) and kidney disease among women with type 1 diabetes.</p><p><strong>Methods: </strong>We performed a cross-sectional analysis of the Epidemiology of Diabetes Interventions and Complications Study<b>.</b> Participants included women with type 1 diabetes and ≥1 AMH measurement (<i>n</i> = 390). In multivariable regression models which adjusted for repeated measures, we examined the associations between AMH with CVD risk factors, estimated glomerular filtration rate, and albumin excretion ratio. We also examined whether initial AMH concentrations were associated with the presence of any coronary artery calcification (CAC) or carotid intima media thickness (cIMT).</p><p><strong>Results: </strong>After adjustment for age, AMH was not associated with waist circumference, blood pressure, lipid profiles, or renal function. Higher initial AMH concentrations had borderline but non-significant associations with the presence of CAC after adjustment for age (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.00, 1.16) which were minimally altered by addition of other CVD risk factors, although women in the 3rd quartile of AMH had lower odds of CAC than women in the lowest quartile (OR 0.40, 95% CI 0.17, 0.94). After adjustment for age, higher AMH was associated with statistically significant but only slightly higher cIMT (0.005 mm, <i>p</i> = 0.0087) which was minimally altered by addition of other CVD risk factors.</p><p><strong>Conclusions: </strong>Among midlife women with type 1 diabetes, AMH has slight but significant associations with subclinical measures of atherosclerosis. Future studies should examine whether these associations are clinically significant.</p><p><strong>Trial registration: </strong>NCT00360815 and NCT00360893 Study Start Date April 1994.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2017-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0023-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Midlife Women's Health Study - a study protocol of a longitudinal prospective study on predictors of menopausal hot flashes.","authors":"Ayelet Ziv-Gal,&nbsp;Rebecca L Smith,&nbsp;Lisa Gallicchio,&nbsp;Susan R Miller,&nbsp;Howard A Zacur,&nbsp;Jodi A Flaws","doi":"10.1186/s40695-017-0024-8","DOIUrl":"https://doi.org/10.1186/s40695-017-0024-8","url":null,"abstract":"<p><strong>Background: </strong>The Midlife Women's Health Study (MWHS) was developed to address some of the gaps in knowledge regarding risk factors for hot flashes among generally healthy midlife women during their menopausal transition. This manuscript describes the methods from the study and the main findings that were published to date, with a focus on predictors of hot flashes. This study was initially funded to test the hypothesis that obesity is associated with an increased risk of hot flashes through mechanisms that involve ovarian failure, altered sex steroid hormone levels, and selected genetic polymorphisms.</p><p><strong>Methods/design: </strong>The MWHS was conducted between 2006 and 2015 as a prospective longitudinal population-based study of generally healthy midlife women (ages 45 to 54 years) during their natural menopausal transition. Women were eligible if they had intact uteri and both ovaries and reported having at least 3 menstrual periods in the last 12 months. Exclusion criteria included pregnancy, cancer, and use of hormonal/hormone-like supplements. Overall, 780 women were recruited into the study. The majority of study participants were followed for 4 to 7 years. At annual visits, women donated blood and urine samples, completed questionnaires, had a vaginal ultrasound, and had their anthropometric measurements taken.</p><p><strong>Discussion: </strong>Several risk factors for menopausal hot flashes were identified or confirmed, including older age, perimenopausal status, current and former cigarette smoking, lower estradiol levels, lower progesterone levels, black race, and depressive symptoms. Factors that were associated with decreased odds of hot flashes included moderate alcohol consumption and more than 5 years of cessation of cigarette smoking. Body mass index was not associated with hot flashes. The MWHS has provided important information regarding hot flashes. The study methods are rigorous and can be easily adopted by research groups investigating naturally occurring menopausal hot flashes.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2017-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0024-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception and conception in Mid-life: a review of the current literature.","authors":"Kristin Van Heertum, James Liu","doi":"10.1186/s40695-017-0022-x","DOIUrl":"10.1186/s40695-017-0022-x","url":null,"abstract":"<p><p>In the United States, there are an increasing number of couples who are intentionally delaying child-bearing. As the average age of mothers continues to rise, more and more women are being faced with the difficulties of attempting conception at the various stages leading up to the menopausal transition. Not only do the chances of conception drastically decrease after the age of 40 years, but the probability of fetal loss (both early and late in pregnancy) significantly increases during this period as well. The aims of this review include providing an overview of the natural progression of the menopausal transition, examining the importance of appropriate contraception, and identifying the difficulties that women face when attempting conception during this physiologically dynamic stage of life. Finally, we will discuss the non-contraceptive benefits of contraception in preparation for pregnancy during the mid-life.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2017-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6300028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender disparities in midlife hypertension: a review of the evidence on the Arab region.","authors":"Christelle Akl,&nbsp;Chaza Akik,&nbsp;Hala Ghattas,&nbsp;Carla Makhlouf Obermeyer","doi":"10.1186/s40695-017-0020-z","DOIUrl":"https://doi.org/10.1186/s40695-017-0020-z","url":null,"abstract":"<p><strong>Objective: </strong>While gender differences in hypertension and increased prevalence rates among women at midlife have been documented in multiple settings, the evidence on the Arab world has not been systematically examined. This review summarizes the evidence related to gender disparities in midlife hypertension in this region.</p><p><strong>Methods: </strong>We searched MEDLINE and Social Sciences Citation Index (SSCI) databases for studies, published between January 2000 and August 2015, on hypertension in the 22 countries of the Arab region. We abstracted information on the prevalence of hypertension among women and men, in general populations during midlife.</p><p><strong>Results: </strong>Nineteen studies provided data on the prevalence of hypertension by gender and age in the Arab world. Higher rates of hypertension were found among Arab women at midlife in most countries. In studies that included subjects younger than 35 years old, a decrease in sex ratios (M/F) at midlife was observed in all countries except Palestine. Higher female prevalence rates are observed in the 4^th decade of life in most countries of the region, almost two decades earlier than in other parts of the world.</p><p><strong>Conclusions: </strong>This review highlights the need for more systematic examinations of hypertension in the Arab region, its risk factors, and the reasons for the particular patterns of gender differences that are observed. Such research would have considerable implications for prevention, treatment, and improved well-being.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2017-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0020-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}