The specialty of Obstetrics and Gynaecology (O and G) plays an important role in women’s health, particularly in the reproductive years. Now with a global ageing epidemic and women outnumbering men in older age, the focus turns to post-reproductive health.¹ Many countries do not have a strong family medicine foundation and, even in those that do, much of the care traditionally provided is being challenged by chronic illnesses with management being transferred to primary care. Globally, many women come to view their O and G provider as their primary physician. This unique position has facilitated rethinking in the management of midlife women, moving away from the traditional single condition/disease focus toward holistic care.² The postmenopausal period now comprises, on average, over 30 years of a woman’s life. In Singapore, many women do not see the need to detect or prevent health problems early, reflected in low screening programme participation and unhealthy lifestyle choices.³ Yet important conditions, such as cardiovascular disease, osteoporosis and osteoarthritis, metabolic disease and dementia, have shared risk factors of hormones, diet, sedentary lifestyle, stress and sleep disturbances, in addition to tobacco and alcohol consumption. An integrated approach provides care for the primary need (e.g. hot flushes, dyspareunia or an overactive bladder), but also identifies and manages parallel needs, led by public health priorities and the woman’s individual concerns. The approach of optimizing opportunities for health promotion has the potential to decrease inefficiency, undertake screening which might not otherwise have been undertaken, empower women to self-care, improve health and quality of life, reduce health care costs and broaden clinician skills. In practice, there is little in the medical literature evaluating this vertical needs approach.¹ Models reported are linked to primary care⁴ or comprise a cluster of academic specialities.^5,6 Effectiveness beyond the short term remains to be seen;⁷ however, access to primary health care, health promotion, disease prevention and cross-cultural influences have been identified as priority areas in ‘ageing’ research.¹ The Integrated Women’s Health Programme (IWHP) is a prospective cohort study of health issues experienced by Singaporean women aged 45–69 years. It was developed in collaboration with co-investigators (J.C., S.S.) from the University of Pittsburgh and approved by the Domain Specific Review Board (DSRB) of the National Healthcare Group, Singapore (reference number 2014/00356). The specific objectives of the study were the following:

• to describe the holistic health needs of midlife women by identifying the primary self-reported and objective health concerns;

• to collect continuous outcome data on important risk factors for clinical outcomes by bone mineral density, body composition, visceral adiposity, muscle mass, anthropometry, biophysical and physical performance measurements, with menopausal health issues;

• to collect serum and DNA for future biological markers of ageing and menopausal health;

• to explore novel correlates of many health issues;

• to describe longitudinal changes in risk factors.

中文翻译：

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队列简介：综合妇女健康计划（IWHP）：对中年新加坡妇女关键健康问题的研究

妇产科的专业（O和G）在妇女的健康，尤其是生殖年中，起着重要的作用。现在，随着全球流行病的流行和老年妇女的人数超过男性，重点转向了生殖健康。¹许多国家没有强大的家庭医学基础，即使在那些国家中，传统上提供的许多护理也正受到慢性病的挑战，而管理则转移到了初级护理上。在全球范围内，许多女性开始将其O和G提供者视为他们的主要医师。这种独特的地位促使人们对中年妇女的管理方式进行了重新思考，从传统的单一病情/疾病侧重于整体护理。^2个现在，绝经后平均包括妇女一生的30年以上。在新加坡，许多妇女不认为需要及早发现或预防健康问题，这反映在筛查计划参与率低和生活方式不健康的选择上。³然而重要的疾病，例如心血管疾病，骨质疏松症和骨关节炎，代谢性疾病和痴呆，除了吸烟和饮酒外，还具有激素，饮食，久坐的生活方式，压力和睡眠障碍等危险因素。综合方法可满足主要需求（例如潮热，性交困难或膀胱过度活动），但也可识别和管理由公共卫生优先事项和女性个人关注引起的平行需求。优化健康促进机会的方法有可能减少低效率，进行筛查（否则可能无法进行），赋予妇女自我保健能力，改善健康和生活质量，降低卫生保健成本并扩大临床医生技能。在实践中，¹报告的模型与基层医疗服务^4相关，或包含一组学术专业知识。^{5 ，6个}效能短期之外还有待观察; ⁷然而，在“老龄化”研究中，获得初级保健，促进健康，预防疾病和跨文化影响已被确定为优先领域。^1个综合妇女健康计划（IWHP）是一项针对年龄在45-69岁之间的新加坡妇女所经历的健康问题的前瞻性队列研究。它是与匹兹堡大学的共同研究人员（JC，SS）合作开发的，并由新加坡国家医疗保健集团的领域特定审查委员会（DSRB）批准（参考号2014/00356）。该研究的具体目标如下：

• 通过确定主要自我报告和客观的健康问题来描述中年妇女的整体健康需求；

• 收集有关临床结局的重要危险因素的连续结局数据，包括骨矿物质密度，身体组成，内脏脂肪，肌肉质量，人体测量学，生物物理和物理性能测量以及绝经期健康问题；

• 收集血清和DNA，作为未来衰老和更年期健康的生物学标记；

• 探索许多健康问题的新颖关联；

• 描述风险因素的纵向变化。