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Einkenni breytingaskeiðs og meðferð þeirra hjá 50 ára íslenskum konum

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Authors
Bryndís Benediktsdóttir
Kristinn Tómasson
Þórarinn Gíslason
Issue Date
2000-07-01

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Other Titles
Climateric symptoms and hormone replacement treatment among 50 years old Icelandic women
Citation
Læknablaðið 2000, 86(7/8):501-7
Abstract
Objective: The objective of the research was to estimate the prevalence and treatment of climacteric symptoms among 50 years old women, including which doctors are prescribing the hormone replacement treatment (HRT) and what information is given about the risk and benefit of HRT. Material and methods: All (n=956) 50 years old women living in Reykjavík and neighbouring towns were included. A detailed questionnaire was posted to the women with two follow-up reminders. A non-response survey was conducted by phone among those not responding. Results: The response rate was 72.2% (n=690). Sleep disturbances were the most common climacteric complaint occurring every day, mainly difficulty in maintaining sleep (14.8%). Hot flushes occuring every day (3.6%) and every night (2.2%) were more common than palpitations occuring every day (0.5%) and every night (0.2%). One fourth of the women had been to a doctor because of anxiety and 17% because of depression. Women who had been oophorectomised, were suffering from insomnia, hypertension, had high body mass index (BMI) or were not on HRT were more likely to suffer from hot flushes and palpitations. More than every other woman was on HRT (54%). Combination of oestrogen and progesterone were most commonly used. Hot flushes were less common in women on HRT and one third reported better sleep after starting HRT. Women on HRT more frequently visited doctors, were more often suffering from anxiety, chronic tiredness, fibromyalgia and pain. They more often were heavy smokers and had chronic bronchitis. Most often the HRT was started by gynaecologists (67%) but continued by family doctors (56%). About one fifth claimed that they had not received information about the risk and benefit of HRT. Conclusions: More than every other 50 years old woman is on HRT. These women differ in various ways from women not receiving HRT, which underlines the importance of accurate diagnosis and treatment of climacteric symptoms. Better patient information is needed.
Tilgangur: Markmið rannsóknarinnar var að rannsaka meðal fimmtugra kvenna einkenni breytingaskeiðs, algengi þeirra og meðferð. Hvaða læknar sjá um þessa meðferð og hvernig fræðslu um breytingaskeið og hormónameðferð er háttað. Efniviður og aðferðir: Rannsóknin náði til allra (n=956) fimmtugra kvenna á Stór-Reykjavíkursvæðinu. Spurningalisti var sendur út ásamt tveimur ítrekunum og eftirleit með símhringingum. Niðurstöður: Alls tóku 690 konur þátt í rannsókninni (72,2%). Af einkennum sem gerðu vart við sig daglega voru svefntruflanir í einhverri mynd algengastar, oftast að konurnar vöknuðu upp að nóttu (14,8%). Hitakóf bæði að nóttu (2,2%) og degi (3,6%) voru algengari en hjartsláttarköst að nóttu (0,2%) og degi (0,5%). Konur með hitakóf og hjartsláttarköst voru líkegri til að hafa svefntruflanir, háþrýsting, vera of þungar, hafa gengist undir brottnám eggjastokka og þær voru síður á hormónameðferð. Þreyta (12,3%) og syfja (9,4%) voru algeng dagleg einkenni. Tæplega fjórðungur hafði leitað læknis vegna kvíða og spennu en 16,5% vegna þunglyndis. Rúmlega helmingur kvennanna var á hormónameðferð. Blöndur östrógens og prógesteróns voru algengastar. Hitakóf og hjartsláttarköst voru marktækt færri hjá konum á hormónameðferð og þriðjungur taldi sig sofa betur eftir að hormónameðferð hófst. Tengsl voru milli þess að vera á hormónameðferð og hafa oft verið hjá læknum undanfarið ár, vera stórreykingakona, með langvinna berkjubólgu, vera kvíðin og undir læknishendi vegna þreytu, vefjagigtar og verkja. Ekki var munur á tíðni kransæðasjúkdóma eða blóðtappa eftir því hvort konur voru á hormónameðferð eða ekki. Kvensjúkdómalæknar höfðu oftast (67%) hafið meðferðina en heimilislæknar haldið henni áfram (56%). Þriðjungur kvenna hafði ekki fengið fræðslu um hormónameðferð. Ályktanir: Rúmlega helmingur fimmtugra kvenna er á hormónameðferð. Þessi hópur kvenna er að ýmsu leyti ólíkur þeim sem ekki eru á hormónameðferð sem undirstrikar nauðsyn á markvissri greiningu og meðferð einkenna breytingaskeiðs. Ljóst er að fræðslu um áhrif og hugsanlega fylgikvilla hormónagjafar á heilsufar kvenna er ábótavant.
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