この女性は閉経前期ですか?

Lori A Bastian¹, Crystal M Smith, Kavita Nanda

¹Department of Internal Medicine, Duke University, Durham, NC, USA. basti001@mc.duke.edu

JAMA

|February 18, 2003

まとめ

閉経前期を正確に診断することは,中年女性にとって極めて重要です. ホットフラッシュや検査などの症状は手がかりを提供できるが,月経歴と年齢の組み合わせが最も信頼性の高い診断方法である.

科学分野:

生殖内分泌学生殖内分泌学
女性の健康女性の健康
クリニカル診断士

背景:

閉経前期は,中年女性の移行期を意味し,適切なカウンセリングとケアのための正確な識別を必要とします.
医師は,閉経前期を診断するために信頼性の高い方法を必要とし,高潮期症状,避妊,疾患予防 (例えば,骨粗鬆症) などの懸念に対処する必要があります.

研究の目的:

自己評価,症状,臨床的徴候,および閉経前期を特定するための検査検査の診断の正確性を体系的に検討する.

主な方法:

広範なMEDLINE検索 (1966-2001) で,閉経前期の診断に関する英語の記事を特定しました.
対象となった研究には,40歳以上で3~11ヶ月のアメノレアまたは不規則な月経を患った女性,閉経前対照群,および報告された臨床結果を含む16件の研究が分析されました.

主要な成果:

年齢は,閉経前期の可能性の主な要因です.
ポジティブな指標には,自己評価による変異,発熱,夜の汗,の乾燥,卵泡刺激ホルモン (FSH) 濃度の上昇,低インヒビンB濃度などがあります.
閉経前期の状態の自己評価は,最も低い負の確率比を示し,この状態を排除する有用性が限られていることを示しました.

結論:

単一の症状や検査では,閉経前期を決定的に確認したり,排除したりすることはできません.
臨床診断は,研究室の検査結果のみではなく,患者さんの月経歴と年齢に主に基づくべきである.

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