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In order to determine the age of onset of the post menopausal stage in women, the parameters selected were the age of the last menstrual period, the fertility of women in their forties and the age of onset of menopausal symptoms. Last menstrual periods were seen from the age 36 to 56 in our series, showing a wide divergence in ages. The most frequent age group were women in their early fifties, with 86.6% falling between the ages of 45-54. The average age for the last menstrual period was 49.1 yrs. Our findings are in close agreement with those of other investigators, and a tendency toward an increased age at last menstrual period is suggested. Fertility stufies of women in their forties revealed an induced abortion rate of 9.0% of the total, and a birth rate of 0.5% of the total of these figures, 90.0% and 96.0% respectively were in the age group of 40-44. These data reveal a persistent fertility among women in their 40's. An incidence of menopausal syndromes by age revealed 11.6% for the 40-44 age group, 82.4% for the 45-54 age group and 6% for the 55-59 age group. From these findings, we proposed an age for the onset of the menopause as being from 40-59 and suggest a classification in accordance with individual "life cycle" as follows. Ages 20-39 as the "mature period", 40-44 as the "late mature period" as well as be the "premenopausal period", 40 55 as the "menopausal period" and 55 59 as the "late menopausal period" Further, we propose that 60-64 be called the "preold age", and 65 and over as the "old age". From the above listed material, we suggest the classification of the "Menopausal Syndrome", as those cases in which the women being in their menopause, are subjected to an alteration in ovarian function, accompanied by various and numerous psycho-vegetative symptoms. Manifestation of the "Menopausal Syndrome" is dependent upon the individual's innate ability to compensate for the altered (decreased) varian function, as well as her inherent physiological and psychological personality, all of which play an important role in the presence or lack of symptoms. Symptoms which appear in the menopausal period which are overt manifestations of psycho-vegetative disorders are not limited to the so called "Menopausal Syndrome". Other entities which may be present are masked depression, psychosomatic disorders, psychoneurotic problems (anxiety reactions, hypochondriasis), all of which are common during the menopause. Thus we suggest that all these problems be classified under a broader category which we propose to call the "Menopausal-Psycho-vegetative Syndrome". A differential diagnosis of these various entities is made possible only through an approach based on psychosomatic clinical techniques.
日本心身医学会の論文
1980-04-01

更年期障害の再検討

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