Menopause international最新文献

Advanced nursing practice is a complex term that has been explored over the last 10 years within nursing as nurses have changed the boundaries of their clinical care to try and meet the needs of their patients in a rapidly changing health-care setting. These roles are attractive to nurses as they can remain primarily clinically based as they progress within their careers. However there is currently no standardization in relation to job titles, educational provisions or regulations. The Department of Health issued guidance in 2010, but there is nothing mandatory to date. This short article will look at the issues involved in advanced practice in menopause nursing.

Background and methodology: Sociodemographic trends mean increasing numbers of new relationships in later life. These trends may not only have health consequences for women and health services but also impact on the targeting of sexual health messages. This study aimed to examine attitudes and knowledge surrounding contraception, sexual health and unwanted pregnancy among those accessing the website www.menopausematters.co.uk. A voluntary online survey was completed.

Results: Survey was completed by 550 respondents. Three hundred and sixty-six women, 94% of whom self-classified as pre- or perimenopausal, had been sexually active with a male partner in the previous four weeks. Commonest contraceptive methods used by perimenopausal and postmenopausal women were condoms, combined oral contraceptive pill (COCP) and male sterilization. Up to 42% of women surveyed were unhappy with their contraception. A total of 27% premenopausal, 32% perimenopausal women and 40% postmenopausal used no contraception. One-third of women were unhappy about this and 19 unplanned pregnancies had occurred. The majority of women were informed regarding COCP use over 35 years, hormone replacement therapy, emergency contraception and ceasing contraception. The majority of women were unaware that more terminations of pregnancy are performed in women over 40 than any other age group per total pregnancies.Almost a third of women were unaware that chlamydia incidence is increasing in older women. Most would use condoms in new relationship.

Discussion and conclusions: Women accessing www.menopausematters.co.uk are well informed about contraception and sexual health. The majority of those accessing the site are sexually active, but many use no contraception, or are unhappy with their chosen method, leaving them vulnerable to unwanted pregnancy or sexually transmitted infection.

Objective: To find out the association of menopause-specific quality of life of women with both working status and duration of postmenopausal years.

Study design: We conducted a cross-sectional study on 250 postmenopausal women belonging to Bengali-speaking Hindu ethnic group, aged 47-62 years in the city of Kolkata, West Bengal, India. The participants were literate, living in wedlock with at least one surviving child, attained natural menopause at least two years ago and have never taken hormone replacement treatment. Menopause-specific quality of life was measured using a self-administered standard questionnaire (Menopause-Specific Quality of Life questionnaire, or MENQOL). MENQOL consisted of 29 menopausal symptoms (items) that are grouped under four domains. Additional information on sociodemographic aspect and reproductive history of the participants were collected using a pretested questionnaire. Main outcome measures Both bivariate and multivariate analyses showed that menopause-specific quality of life decreases with the increase in duration of postmenopausal years. Although bivariate analysis demonstrated that working women had a better menopause-specific quality of life than their non-working counterpart, multivariate linear regression model did not corroborate to this finding.

Conclusion: Duration of postmenopausal years had a significant association with menopause-specific quality of life of women.

Objective: This paper describes the investigation, categorization/characterization and viewing of pelvic floor muscle exercises (PFME) on YouTube from the perspective of the 'wisdom of the crowd'. The aim of the research was to increase awareness of the type of clips that individuals are likely to come across when searching YouTube and to describe trends and popularity. This awareness will be useful for the design of continence promotion services, especially for hard-to-reach individuals.

Study design: Web-based videos relating to PFE were identified by searching YouTube using the snowball technique. Main outcome measures Number of views; the approach taken (health, fitness, sexual and pregnancy); product promotion; and the use of music, visual cues and elements designed to encourage exercise. The number of views of each video was recorded at three points over a seven-month period.

Results: Twenty-two videos were identified. Overall these videos had been viewed over 430,000 times during the study period. One video was viewed over 100,000 times and overall the median increase in views was 59.4%.

Conclusions: YouTube is increasingly used to access information about pelvic floor exercises. Different approaches are used to communicate PFME information but there are no formal structures for quality control. Further research is required to identify which elements of the video clips are effective in communicating information and in motivating exercise and to establish appropriate protocols. Kitemarking is recommended in order that women obtain correct advice.

Premenstrual disorders have been recognized as affecting innumerable women for decades but unlike most other medical conditions universally accepted criteria for definition and diagnosis are not established. Although premenstrual syndrome (PMS) occurs throughout reproductive life, there are some women who become particularly troubled. Those approaching the menopause may also have a mixture of PMS and menopause symptoms, not to mention heavy periods. Furthermore, some of the symptoms are similar in nature and so it is a challenge to identify which set of symptoms belongs to which spectrum. This is an area that has not been explored well. Various classifications have been proposed over the last few decades. A further effort towards the classification was made by an international multidisciplinary group of experts established as the International Society for Premenstrual Disorders (ISPMD) in Montreal in September 2008. Their deliberations resulted in a unified diagnosis, classification of premenstrual disorders (PMD) along with their quantification and guidelines on clinical trial design. This classification of PMS is far more comprehensive and inclusive than previous attempts. PMD in the ISPMD Montreal consensus are divided into two categories: Core and Variant PMD. Core PMD are typical, pure or reference disorders associated with spontaneous ovulatory menstrual cycles while Variant PMD exist where more complex features are present. Further, the consensus group considered that PMD may be subdivided into three subgroups predominantly physical, predominantly psychological and mixed. Variant PMD encompass primarily four different types; premenstrual exacerbation, PMD with anovulatory ovarian activity, PMD with absent menstruation and progestogen-induced PMD.