中年婦女血中荷爾蒙濃度與停經狀態－橫斷式研究初探

Hormone Levels and Menopausal Status in Middle Aged Women: A cross-sectional Study

張珏(Chuen Chang) ； 吳佩樺(Pei-Hua Wu) ； 張菊惠(Chu-Hui Chang) ； 蔡宗仁(Tzong-Jen Tsai) ； 徐黎玲(Li-Ling Hsu) ； 李旻貞(Ming-Jean Lee)

《中華公共衛生雜誌》 18卷3期 (1999/06) Pp. 209-221

https://doi.org/10.6288/CJPH1999-18-03-05

摘要

目標：欲瞭解醫界建議以荷爾蒙補充療法處理婦女更年期，其所採用的指標與影響荷爾蒙改變的因素。方法：對753位參與某健檢中心健康檢查婦女進行檢測，測量其自述停經不適，以及生化檢測其血中荷爾蒙卵泡刺激灘二作為分析改變血中荷爾蒙值面經婦女其FSH皆大於40mIU/ml，並以停經階段及抽煙、運動等健康行為FSH及E2間相關不大，停經後期與手術停ml高。影響FSH及E2的因素，最大的否使用荷爾蒙、BM-及吸菸的影響，經標準相符，E2介於41-85pd/ml間，較一般標準20pg/ml高。影響FSH及E2的因素，最大的皆是年齡（解釋力約39%及22%）：FSH略有受到經期改變、是否使用荷爾蒙、BMI及吸菸的影響，而E2受年齡與經期影響，對未使用任何藥物婦女則除了年齡與經期因素外，另有BMI與運動的因素。結論：一般婦女不論何種停經階段，其FSH與E2變異性仍大；停經不適與FSH及E2間相關不大。此外對醫界常以症狀作為給藥標準，是否客觀？但若用現運動或不吸菸等保健行爲對FSH的維持有部分影響，在公共衛生立場也建議對更年期婦女增加健康促進的行爲

關鍵字

卵泡刺激素 ； 雄二醇 ； 停經 ； 荷爾蒙補充療法 ； 健康行為

並列摘要

Objectives: Due to the interest in the effectiveness and appropriateness of hormone replacement therapy (HRT) for menopausal women in Taiwan, we investigated the hormone level of follicle stimulating hormone (FSH) and estradiol (E2) for their value and affecting variables. Method: 753 women prior, during, and post to their menopausal periods who checked in at a clinic for routine wellness exams were invited to participate in this study. Measurements included serum level of FSH and E2 and self-reported questionnaires on physical and mental wellness as well as those health behaviors. Results: There were no significant association between the subjects physical and mental discomfort and their FSH and E2 levels. The correlation between FSH and sexual discomfort was significant, but the correlation coefficients were small. The average FSH level for post-menopause women was greater than 40 m 1U/mi. The range of E2 level were 41-85 pg/ml for subjects without or with medication, two times greater than the standard 20 pg/ml, level used to determine need for HRT supplementation. A multivariable regression with the inclusion of age, menopausal status, BMI, use of hormone, and smoking status in the model explained approximately 50% of FSH level for women. Among these variables, age alone explained about 39% of the FSH level, and 22% of the E2 level. Relatively, the menopausal status contribution was minor. Conclusions: hormone level does not explain the menopausal discomfort for women. The E2 level may not be an appropriate indicator for hormonal therapy prescription. Furthermore, how to find objective indicators and attention on health behaviors affecting the level of FSH should be studied in the future too.

並列關鍵字

FSH ； E2 ； Menopause ； HRT ； Health Behavior