title: Women's health issues in haemodialysis patients.
abstract: OBJECTIVE
  To describe reproductive health issues in women with end-stage renal disease (ESRD) treated with haemodialysis.
  
  
  METHODS
  Cross-sectional survey based on structured interviews.
  
  
  METHODS
  Nephrology units of two major metropolitan tertiary referral hospitals in Victoria and their satellite dialysis centres between 1 November 1998 to 30 June 1999.
  
  
  METHODS
  Women aged 20 years or over in haemodialysis programs.
  
  
  METHODS
  Menstrual status; prevalence of menstrual and climacteric symptoms; use of gynaecological screening; and prevalence of comorbidities that may benefit from hormone replacment therapy.
  
  
  RESULTS
  48 women completed the survey. They were similar to the 485 women undergoing haemodialysis in Victoria in age (mean age, 55.5 years; range, 20-84 years), years on dialysis (mean age, 3.9 years; range, 1 month-17 years) and primary diagnosis. Eleven of the 15 premenopausal women reported menstrual cycles of 22-35 days, 13 reported common premenstrual symptoms, and six reported dysmenorrhoea that interfered with daily activities. Average age at menopause was 47.7 years (95% CI, 45.6-49.9 years), and six of the 31 postmenopausal women underwent menopause before 45 years. Eight had ever been prescribed hormone replacement therapy (oral in all cases). Over half the women (26) had not had a Pap smear in the last two years, and 12 of those aged over 50 (38%) had not had a mammogram in the same period.
  
  
  CONCLUSIONS
  Despite their risk of early menopause, cardiovascular disease and bone fracture, few women undergoing haemodialysis were offered hormone replacement therapy. Nor were they adequately screened for gynaecological cancers. Women's health issues seem to be neglected among haemodialysis patients.
authors.affiliation: Jean Hailes Foundation Research Unit, Melbourne, Vic.
authors.forename: C
authors.initials: C
authors.lastname: Jang
authors.forename: R J
authors.initials: RJ
authors.lastname: Bell
authors.forename: V S
authors.initials: VS
authors.lastname: White
authors.forename: P S
authors.initials: PS
authors.lastname: Lee
authors.forename: K M
authors.initials: KM
authors.lastname: Dwyer
authors.forename: P G
authors.initials: PG
authors.lastname: Kerr
authors.forename: S R
authors.initials: SR
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D006436:Hemodialysis Units, Hospital / Q000592:standards*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008875:Middle Aged; D009398:Nephrology / Q000592:standards*; D017063:Outcome Assessment, Health Care; D010346:Patient Care Management; D015995:Prevalence; D011795:Surveys and Questionnaires; D014739:Victoria / Q000453:epidemiology; D014932:Women's Health Services / Q000458:organization & administration / Q000592:standards*