國際時事跟讀VIP Ep. L103: 更年期前期不該被忽視 Perimenopause Symptoms Demand Attention

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國際時事跟讀VIP Ep. L103: Perimenopause Symptoms Demand Attention

Highlights 主題摘要

• Nearly 40% of late perimenopausal women experience severe hot flushes, yet no specific treatments are approved.
• Australian research shows hot flushes should define perimenopause, not just menstrual irregularities.
• England's NHS will add menopause screening to health checks from 2026 to improve support.

Australian researchers have uncovered a troubling gap in women's healthcare. A landmark study published in the examined over 5,500 women and found that 37.3% of those in late perimenopause experience moderately to severely bothersome hot flushes. These vasomotor symptoms proved five times more prevalent than in pre-menopausal women. Severe vaginal dryness also doubled in frequency. Despite this burden, pharmaceutical companies have historically excluded perimenopausal women from clinical trials because their fluctuating hormone levels complicate study designs.

澳洲研究人員揭露了婦女醫療照護中一個令人憂心的缺口。一項發表於《刺胳針》期刊的里程碑研究檢視了超過五千五百名女性，發現百分之三十七點三處於更年期前期後段的女性經歷中重度困擾的熱潮紅。這些血管舒縮症狀的盛行率是更年期前女性的五倍。嚴重陰道乾燥的發生率也增加一倍。儘管負擔沉重，製藥公司卻長期將更年期前期女性排除在臨床試驗之外，因為她們波動的荷爾蒙濃度會使研究設計複雜化。

Treating perimenopause presents distinct challenges compared to post-menopause. Women are still ovulating unpredictably, contraception remains necessary, and standard hormone therapy can worsen bleeding and premenstrual symptoms. Lead researcher Professor Susan Davis criticized the common medical approach where doctors dismiss perimenopausal concerns by insisting regular periods rule out the condition. The study revealed that women with regular but changing periods—becoming heavier or lighter—exhibited the same symptom patterns as those with irregular cycles. "Ignoring hot flushes and night sweats is wrong," Davis emphasized, advocating for symptom-based diagnosis.

治療更年期前期面臨的挑戰有別於更年期後。女性仍在不規則排卵，仍需避孕，標準荷爾蒙療法可能加重出血與經前症候群。首席研究員蘇珊‧戴維斯教授批評常見的醫療做法：醫師堅持只要月經規律就排除更年期前期的可能，因而輕忽患者的擔憂。研究顯示，月經規律但有變化(變多或變少)的女性，其症狀模式與週期不規則者相同。「忽視熱潮紅與夜間盜汗是錯的」戴維斯強調，主張應以症狀為基礎進行診斷。

Recognition is slowly improving. England's NHS announced it will incorporate menopause questions into health checks offered to adults aged 40 to 74, starting in 2026. Health Secretary Wes Streeting acknowledged that women have been "suffering in silence for far too long" and facing debilitating symptoms without adequate support. The initiative aims to identify candidates for hormone replacement therapy, medications, and counseling. Research indicates three-quarters of women experience menopausal symptoms lasting an average of seven years, yet fewer than one in ten feel sufficiently informed to manage them.

認知正在逐漸進步。英格蘭國民保健署宣布，從二○二六年起，將在提供給四十至七十四歲成人的健康檢查中納入更年期相關問題。英國衛生及社會關懷大臣韋斯·斯特里廷承認，女性「默默承受痛苦太久了」，面對使人衰弱的症狀卻缺乏適當支持。此措施旨在找出適合接受荷爾蒙替代療法、藥物與諮商的對象。研究指出，四分之三的女性會經歷平均持續七年的更年期症狀，但只有不到十分之一覺得獲得充分資訊來應對。

However, campaigners warn that health check attendance remains problematically low, particularly among marginalized communities. Current figures show fewer than half of invited individuals actually attend these appointments. Experts stress that healthcare providers need proper training to maximize the program's effectiveness, and that progress on menopause support must reach women from ethnic minorities and economically disadvantaged backgrounds. As Professor Martha Hickey noted, perimenopause has been traditionally overlooked in research, making this study an important step toward filling critical knowledge gaps and improving care for millions of women worldwide.

然而，倡議人士警告，健康檢查的出席率仍然低得令人憂心，尤其在邊緣的社群中。目前數據顯示，受邀者中實際出席的不到一半。專家強調，醫療提供者需要適當訓練以發揮計畫最大效益，而且更年期支持的進展必須觸及少數族裔與經濟弱勢背景的女性。如瑪莎‧希奇教授所指出，更年期前期在研究中向來被忽視，使這項研究成為填補關鍵知識缺口、改善全球數百萬女性照護的重要一步。

Keyword Drills 關鍵字

1. Vasomotor [adjective, relating to blood vessel constriction and dilation]: These vasomotor symptoms proved five times more prevalent than in pre-menopausal women.
2. Perimenopause [noun, the transitional period before menopause]: A landmark study examined over 5,500 women and found that 37.3% of those in late perimenopause experience moderately to severely bothersome hot flushes.
3. Ovulating [verb, releasing eggs from the ovaries]: Women are still ovulating unpredictably, contraception remains necessary, and standard hormone therapy can worsen bleeding and premenstrual symptoms.
4. Incorporate [verb, to include as part of something]: England's NHS announced it will incorporate menopause questions into health checks offered to adults aged 40 to 74, starting in 2026.
5. Debilitating [adjective, causing severe impairment]: Health Secretary Wes Streeting acknowledged that women have been "suffering in silence for far too long" and facing debilitating symptoms without adequate support.

Reference article:
1. https://www.theguardian.com/society/2025/jul/26/ignoring-hot-flushes-is-wrong-study-challenges-assumptions-about-perimenopause-symptoms
2. https://www.bbc.com/news/articles/cq50z185d78o