Hormone therapy for the management of the menopause in Ecuador: perception, use and knowledge among middle-aged women

Treatment for the menopause in Central America: use, knowledge, perceptions and attitudes among urban living middle-aged women

BACKGROUND

Data on social and personal aspects of Central America are lacking in relation to hormone therapy (HT) and other treatments for the menopause.

OBJECTIVE

To gain information regarding the treatment of the menopause (HT/alternative): use, knowledge, perceptions and attitudes among middle-aged Central American women.

METHODS

A total of 720 urban living women (35-65 years) from six Central American countries (Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panama) were surveyed with a structured questionnaire that included socio-demographic data and information regarding the menopause and its treatment.

RESULTS

Participating countries displayed significant socio-demographic differences. Forty-one percent of all women were postmenopausal and 5.8% had no education at all. Knowledge regarding menopausal treatment options varied; while 27.2% (196/720) indicated HT as an option a higher rate (36.3%) either did not respond or answered not knowing anything. HT use for the whole sample was rather low 2.7% with differences seen among countries. 13.8% (27/196) indicated to have been on HT but abandoned treatment because of medical indication (51.9%), undesired side effects (29.6%) and costs (11.1%). While more than 50% considered HT served to replace hormones a smaller percentage (<14%) referred HT as bad for health, reduces cancer risk or has many side effects. 9.3% (67/720) acknowledged the existence of phytoestrogens as a menopausal treatment option, considering them as natural estrogens and good for health in 38.8% and 25.4%, respectively.

CONCLUSIONS

HT use in this mid-aged series was rather low in which the demography of Central America may be related factors. Education to women and physicians should be encouraged.

Quality of life impairment during the female menopausal transition is related to personal and partner factors

OBJECTIVE

To assess the female quality of life (QoL) during the menopausal transition and determine factors (personal and partner) related to its impairment. The frequency of menopausal symptoms was also assessed.

METHODS

In this cross-sectional study, healthy women aged 40-59 years were asked to fill out the Menopause Rating Scale (MRS) and a questionnaire assessing personal and partner demographic data.

RESULTS

During the study period, a total of 409 women were surveyed. Mean age was 47 +/- 5.3 years (median 46). Mean educational level was 13.2 +/- 4.1 years (median 14), with 28.1% having 12 or less years of schooling; premenopausal (42.1%), perimenopausal (24.4%) and postmenopausal (33.5%). At the time of the survey, 9.8% were receiving hormonal therapy (HT) for the menopause, 1.5% were on psychotropic drugs and 1.2% on alternative treatments for the menopausal. Regarding partner profile, 10.3% had erectile dysfunction, 11.2% had precocious ejaculation and 7.3% had abused alcohol. Mean total MRS score was 9.1 +/- 6.4 (median 9); for the somatic subscale, 4 +/- 2.7; the psychological subscale, 3 +/- 2.8 and the urogenital subscale, 2.1 +/- 2.5. Of the surveyed women, 50.6% presented a total MRS scoring of 9 or more (moderate to severe intensity). The four most frequently found symptoms of those composing the MRS were hot flushes (68.9%), sleeping problems (68.4%), depressive mood (55.2%) and irritability (51.6%). After adjusting for confounding factors, logistic regression analysis determined that female age, menopause and partner precocious ejaculation increased the risk for presenting higher total MRS scores (impaired female QoL) whereas HT use, church assistance and partner faithfulness decreased this risk.

CONCLUSIONS

A high rate of middle-aged women in this series presented impaired QoL associated to female age and hormonal status and additionally to partner's health and sexual behavior.