Health Status Of Perimenopausal And Postmenopausal Women In The Community Of Shanghai: Cross-sectional Study And Intervention Study

Background: The menopause is a universal physiological period for women with the drop in ovarian hormone secretions that occurs as the stock of ovarian follicles is depleted, causing a series of diseases and symptoms. However, Chinese perimenopausal and senile women currently have little knowledge about the diseases and symptoms caused by menopause. With the aging of the society, it is of great importance to provide reproductive health guidance and help to increase their knowledge and form a healthy behavior, which will eventually improve their living quality and prevent serious reproductive diseases.Objective: This project has three objects: 1) To obtain the latest reproductive health information of premenopausal and postmenopausal women in Shanghai; 2) To improve their knowledge and attitude about reproductive health through various interventions; 3) To propose a management and promotion model of the reproductive health of perimenopausal and postmenopausal women and optimize the prevention and intervention system of community health services in Shanghai.Methods: 1) We randomly selected 3320 perimenopausal and postmenopausal women in four district of Shanghai by multi-level, group, and random method, and then conducted a comprehensive assessment of their Knowledge-Attitude-Practice(KAP) level and health status in reproductive aspects through a series of questionnaires including the basic information table, the KAP questionnaire and reproductive health self-assessment forms. 2) After the investigation of their health status, 3320 women were randomly divided into intervention and control groups. We provided reproductive health education seminars, health counseling and books to people in intervention group and nothing to control group. A month later, we re-assessed their KAP level and health status of people in two groups to evaluate the effectiveness of our intervention means.Results: 1) The average age of natural menopause was: 50.06±3.82 years. People had a better KAP level in regular gynecological examination, perimenopausal syndrome and genital tract inflammation, but a worse understanding of hysteromyoma and human papilloma virus(HPV). They also had a lower score in the aspects of pelvic organ prolapse and urinary incontinence. Of all the respondents, the frequency of reproductive symptoms in descending order was: perimenopausal syndrome, sexual function, genital inflammation, reproductive system tumor, urinary incontinence and pelvic organ prolapse. 2) Compared with control group, people in the intervention group had a significant increase in their knowledge and attitude, but didn’t statistically improve their practice through this intervention. Moreover, they also statistically improved their symptoms in genital tract inflammation, perimenopausal syndrome and sexual function. However, the improvement rate of sexual function is the lowest.Conclusion: We found people had better knowledge and awareness of reproductive diseases through this intervention, and some symptoms were significantly improved, suggesting the intervention worthy of promotion. Based on the characteristics of the crowd, the intervention is better practiced through television, newspaper and magazine, which are more vivid. Also, attention should be paid on postmenopausal people and people of low income and education. People have a poor understanding of pelvic organ prolapse and urinary incontinence and are embarrassed and unwilling to see doctors, so attentions should also be paid on these aspects.