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Vallejo MS, Blümel JE, Chedraui P, Tserotas K, Salinas C, Rodrigues MA, Rodríguez DA, Rey C, Ojeda E, Ñañez M, Monterrosa-Castro Á, Gómez-Tabares G, Espinoza MT, Escalante C, Elizalde A, Dextre M, Calle A, Aedo S. Association of muscle disorders in late postmenopausal women according to the type of experienced menopause. Menopause 2024:00042192-990000000-00322. [PMID: 38688462 DOI: 10.1097/gme.0000000000002367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
OBJECTIVE Musculoskeletal disorders frequently affect postmenopausal women. This study aims to compare muscle disorders between women according to the type of experienced menopause: premature (PM) or normal age of menopause (NAM). METHODS This was a cross-sectional study conducted in nine Latin American countries in which late postmenopausal women (55 to 70 years) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS: item #4 exploring musculoskeletal discomfort), and the trength, assistance with walking, rising from a chair, climbing stairs, and falling questionnaire (risk of sarcopenia). RESULTS A total of 644 women were included: 468 who had NAM, and 176 who had PM (116 spontaneous and 60 surgical). The overall mean age of the participants was 60.9 ± 4.2 years. Women who had PM experienced more musculoskeletal discomfort (33.5% vs 20.9%, P < 0.001) and a higher likelihood of sarcopenia (35.2% vs 19.9%, P < 0.001) than women who had a NAM. Women who had surgical PM exhibited a higher prevalence of severe musculoskeletal discomfort (46.7% vs 29.3%, P < 0.02) and a higher likelihood of sarcopenia (45.0% vs 27.6%, P < 0.02) than women who had a NAM. After adjusting for covariates (age, body mass index, menopausal hormone therapy use, physical activity, education, cigarette consumption, use of antidepressants, sexual activity, comorbidities, and having a partner), our logistic regression model determined that spontaneous PM was not associated with higher odds of musculoskeletal discomfort and higher odds of sarcopenia. On the other hand, women who had surgical PM were more likely to experience musculoskeletal discomforts (odds ratio: 2.26; 95% confidence interval: 1.22-4.17) and higher odds for sarcopenia (odds ratio: 2.05; 95% confidence interval: 1.16-3.65) as compared to women who experienced a NAM. CONCLUSIONS Women experiencing surgical PM have a higher likelihood of developing muscle disorders. This underscores the potential significance of hormonal levels in influencing musculoskeletal health during postmenopause.
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Affiliation(s)
- María S Vallejo
- From the Servicio de Obstetricia y Ginecología, Hospital Clínico de la Universidad de Chile, Santiago de Chile, Chile
| | - Juan E Blümel
- Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | | | - Carlos Salinas
- Servicio de Obstetricia y Ginecología, Hospital Ángeles, Puebla, México
| | - Marcio A Rodrigues
- Department of Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Doris A Rodríguez
- Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Claudia Rey
- Asociación Argentina para el Estudio del Climaterio, Buenos Aires, Argentina
| | - Eliana Ojeda
- Departamento Académico de Medicina Humana, Universidad Andina del Cusco, Cusco, Perú
| | - Mónica Ñañez
- II Cátedra de Ginecología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | | | - Gustavo Gómez-Tabares
- Departamento de Ginecología, Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia
| | - María T Espinoza
- Unidad de Ginecología Obstétrica, Clínica Los Ángeles, Cochabamba, Bolivia
| | - Carlos Escalante
- Departamento de Ginecología, Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica
| | - Alejandra Elizalde
- Departamento de la Mujer, Niñez y Adolescencia, Facultad de Medicina de la Universidad Nacional del Nordeste, Corrientes, Argentina
| | - Maribel Dextre
- Ginecología Obstetricia, Clínica Internacional - Clínica Javier Prado, Lima, Perú
| | - Andrés Calle
- Centro Integral de Salud Obstétrica y Femenina. Ginecología, Universidad Indoamérica, Academia Ecuatoriana de Medicina, Quito, Ecuador
| | - Sócrates Aedo
- Escuela Medicina, Universidad Finis Terra, Santiago de Chile, Chile
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Blümel JE, Arteaga E, Vallejo MS, Ojeda E, Meza P, Martino M, Rodríguez-Vidal D, Ñañez M, Tserotas K, Rojas J, Rodrígues MA, Espinoza MT, Salinas C, Párraga-Párraga J, Chedraui P. Association of bilateral oophorectomy and menopause hormone therapy with mild cognitive impairment: the REDLINC X study. Climacteric 2021; 25:195-202. [PMID: 34323137 DOI: 10.1080/13697137.2021.1951203] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dementia is a major public health problem. Estrogen is a regulator of the central nervous system and its deficit could be involved in cognitive decline in older women. OBJECTIVE This study aimed to evaluate the association of bilateral oophorectomy, menopause hormone therapy (MHT) and other factors on mild cognitive impairment (MCI). METHOD The case-control study included 941 otherwise healthy postmenopausal women aged 60 years and over from six Latin American countries. Personal and family data were recorded and MCI was assessed using the Montreal Cognitive Assessment test (MoCA). RESULTS Average age, years of education and body mass index were 66.1 ± 5.8 years, 12.4 ± 5.0 years and 26.0 ± 4.3 kg/m2, respectively. A total of 30.2% had undergone bilateral oophorectomy and 40.3% had used MHT. A total of 232 women (24.7%) had MCI. The prevalence of MCI was higher in women with intact ovaries and non-MHT users as compared to MHT users (29.3% vs. 11.7% [odds ratio (OR) 0.32; 95% confidence interval (CI) 0.20-0.51]). Among oophorectomized women, MCI prevalence was higher among non-MHT users as compared to MHT users (45.2% vs. 12.8% [OR 0.18; 95% CI 0.10-0.32]). Logistic regression analysis determined that the variables associated with MCI were age >65 years (OR 1.69; 95% CI 1.20-2.38), parity (having >2 children; OR 1.69; 95% CI 1.21-2.37), bilateral oophorectomy (OR 1.56; 95% CI 1.09-2.24), hypertension (OR 1.41; 95% CI 1.01-1.96), being sexually active (OR 0.56; 95% CI 0.40-0.79), education >12 years (OR 0.46; 95% CI 0.32-0.65) and MHT use (OR 0.31; 95% CI 0.21-0.46). CONCLUSION Age, parity, bilateral oophorectomy and hypertension are independent factors associated with MCI; contrary to this, higher educational level, maintaining sexual activity and using MHT are protective factors.
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Affiliation(s)
- J E Blümel
- Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - E Arteaga
- Departamento de Endocrinología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - M S Vallejo
- Clínica Quilín, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - E Ojeda
- Departamento de Obstetricia y Ginecología, Universidad Andina, Cusco, Perú
| | - P Meza
- Departamento de Medicina Familiar, Universidad San Martin de Porres, Lima, Perú
| | - M Martino
- Departamento de Obstetricia y Ginecología, Universidad Nacional de Rosario, Rosario, Argentina
| | - D Rodríguez-Vidal
- Departamento de Obstetricia y Ginecología, Hospital de Clínicas José de San Martin, Buenos Aires, Argentina
| | - M Ñañez
- Cátedra de Ginecología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - K Tserotas
- Complejo Hospitalario Dr. Arnulfo Arias Madrid, Caja del Seguro Social, Panamá, Panamá
| | - J Rojas
- Departamento de Ginecología Obstetricia, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - M A Rodrígues
- Department of Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - M T Espinoza
- Unidad de Climaterio, Clínica Los Ángeles, Cochabamba, Bolivia
| | - C Salinas
- Servicio de Obstetricia y Ginecología, Hospital Ángeles Puebla, Puebla, México
| | - J Párraga-Párraga
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - P Chedraui
- Instituto de Investigación e Innovación en Salud Integral, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.,Facultad de Ciencias de la Salud, Universidad Católica 'Nuestra Señora de la Asunción', Asunción, Paraguay
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3
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Danckers L, Blümel JE, Witis S, Vallejo MS, Tserotas K, Sánchez H, Salinas C, Saavedra J, Rojas JA, Onatra W, Ojeda E, Mostajo D, Morera F, Monterrosa A, Montaño A, Meruvia N, Martino M, Martínez J, Lima S, González E, Gómez G, Espinoza MT, Castillo O, Campostrini B, Calle A, Broutin G, Bencosme A, Arteaga E, Ayala F, Chedraui P. Personal and professional use of menopausal hormone therapy among gynecologists: A multinational study (REDLINC VII). Maturitas 2016; 87:67-71. [PMID: 27013290 DOI: 10.1016/j.maturitas.2016.02.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 02/09/2016] [Accepted: 02/25/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormone therapy (MHT) was its low rate of prescription by doctors. OBJECTIVE To determine the use of MHT and perceived related risks among gynecologists. METHODS A self-administered and anonymous questionnaire was delivered to certified gynecologists in 11 Latin American countries. RESULTS A total of 2154 gynecologists were contacted, of whom 85.3% responded to the survey (n = 1837). Mean age was 48.1 ± 11.4 years; 55.5% were male, 20.3% were faculty members and 85% had a partner. Overall, 85.4% of gynecologists responded that they would use MHT if they had menopausal symptoms (81.8% in the case of female gynecologists) or prescribe it to their partner (88.2% in the case of male gynecologists; p < 0.001). Perceived risk related to MHT use (on a scale from 0 to 10) was higher among female than among male gynecologists (4.06 ± 2.09 vs. 3.83 ± 2.11, p < 0.02). The top two perceived reported risks were thromboembolism (women 33.6% vs. men 41.4%, p < 0.009) and breast cancer (women 38.5% vs. men 33.9%, p < 0.03). Overall, gynecologists reported prescribing MHT to 48.9% of their symptomatic patients (women 47.3% vs. men 50.2%, p < 0.03) and 86.8% currently prescribed non-hormonal remedies and 83.8% alternative therapies for the management of the menopause. Gynecologists who were older and academic professionals prescribed MHT more often. CONCLUSION Although this Latin American survey showed that gynecologists are mostly supporters of MHT use (for themselves or their partners), this is not necessarily reflected in their clinical practice.
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Affiliation(s)
- Luis Danckers
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Juan E Blümel
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile; Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Silvina Witis
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - María S Vallejo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Konstantino Tserotas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Hugo Sánchez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Carlos Salinas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Javier Saavedra
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - José A Rojas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - William Onatra
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Eliana Ojeda
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Desireé Mostajo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Flory Morera
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Alvaro Monterrosa
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Armando Montaño
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Nelva Meruvia
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Mabel Martino
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Jaime Martínez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Selva Lima
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Erik González
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Gustavo Gómez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - María T Espinoza
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Olivia Castillo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Blanca Campostrini
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Andrés Calle
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Gerardo Broutin
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Ascanio Bencosme
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Eugenio Arteaga
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Félix Ayala
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile
| | - Peter Chedraui
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago, Chile; Institute of Biomedicine, Research Area for Women's Health, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
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4
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Blümel JE, Chedraui P, Aedo S, Fica J, Mezones-Holguín E, Barón G, Bencosme A, Benítez Z, Bravo LM, Calle A, Flores D, Espinoza MT, Gómez G, Hernández-Bueno JA, Laribezcoa F, Martino M, Lima S, Monterrosa A, Mostajo D, Ojeda E, Onatra W, Sánchez H, Tserotas K, Vallejo MS, Witis S, Zúñiga MC. Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women. Maturitas 2014; 80:100-5. [PMID: 25459364 DOI: 10.1016/j.maturitas.2014.10.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/14/2014] [Accepted: 10/16/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND The prevalence of obesity increases during female mid-life and although many factors have been identified, data from Latin America is lacking. OBJECTIVE To assess factors related to obesity among middle-aged women and determine the association with depressive symptoms, sedentary lifestyle and other factors. METHODS A total of 6079 women aged 40-59 years of 11 Latin American countries were asked to fill out the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index and a general questionnaire containing personal socio-demographic data, anthropometric measures and lifestyle information. Obesity was defined as a body mass index (BMI) ≥30 kg/m(2). RESULTS Obesity was observed in 18.5% and sedentary lifestyle in 63.9%. A 55.5% presented vasomotor symptoms, 12.2% had severe menopausal symptoms and 13.2% used hormone therapy for the menopause. Prevalence of depressive symptoms was 46.5% and anxiety 59.7%. Our logistic regression model found that significant factors associated to obesity included: arterial hypertension (OR: 1.87), depressive symptoms (OR: 1.57), sedentary lifestyle (OR: 1.50) diabetes mellitus (OR: 1.34), higher number of individuals living at home (OR: 1.31), sleep problems (OR:1.22), anxiety (OR: 1.21), having a stable partner (OR: 1.20), parity (OR: 1.16) and vasomotor symptoms (OR:1.14). A lower risk for obesity was found among women using hormonal contraceptives (OR: 0.69). CONCLUSION Obesity in middle-aged women is the consequence of the interaction of multiple factors. It was associated to hypertension, depressive symptoms, sedentary lifestyle, climacteric symptoms and other factors.
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Affiliation(s)
- Juan E Blümel
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile; Departamento Medicina Sur, Facultad de Medicina, Universidad de Chile Orquídeas 1068, Dpto 302 PO Box 7510258, Providencia, Santiago de Chile, Chile.
| | - Peter Chedraui
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile; Institute of Biomedicine, Research Area for Women's Health, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Av. Carlos J Arosemena km 1.5, PO Box 09-01-4671, Guayaquil, Ecuador
| | - Sócrates Aedo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile; Departamento Medicina Sur, Facultad de Medicina, Universidad de Chile Orquídeas 1068, Dpto 302 PO Box 7510258, Providencia, Santiago de Chile, Chile
| | - Juan Fica
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Edward Mezones-Holguín
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Germán Barón
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Ascanio Bencosme
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Zully Benítez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Luz M Bravo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Andrés Calle
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Daniel Flores
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - María T Espinoza
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Gustavo Gómez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - José A Hernández-Bueno
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Fiorella Laribezcoa
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Mabel Martino
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Selva Lima
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Alvaro Monterrosa
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Desiree Mostajo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Eliana Ojeda
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - William Onatra
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Hugo Sánchez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Konstatinos Tserotas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - María S Vallejo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - Silvina Witis
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
| | - María C Zúñiga
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC), Santiago de Chile, Chile
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5
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Blümel JE, Chedraui P, Barón G, Benítez Z, Flores D, Espinoza MT, Gomez G, González E, Hernández L, Lima S, Martino M, Montaño A, Monterrosa A, Mostajo D, Ojeda E, Onatra W, Robles C, Saavedra J, Sánchez H, Tserotas K, Vallejo MS, Vallejo C. A multicentric study regarding the use of hormone therapy during female mid-age (REDLINC VI). Climacteric 2014; 17:433-41. [PMID: 24443950 DOI: 10.3109/13697137.2014.882305] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Menopausal hormone therapy (HT) has shown benefits for women; however, associated drawbacks (i.e. risks, costs, fears) have currently determined its low use. OBJECTIVE To determine the prevalence of current HT use among mid-aged women and describe the characteristics of those who have never used, have abandoned or are currently using HT. In addition, reasons for not using HT were analyzed. METHOD This was a cross-sectional study that analyzed a total of 6731 otherwise healthy women (45-59 years old) of 15 cities in 11 Latin American countries. Participants were requested to fill out the Menopause Rating Scale (MRS) and a questionnaire containing sociodemographic data and items regarding the menopause and HT use. RESULTS The prevalence of current HT use was 12.5%. Oral HT (43.7%) was the most frequently used type of HT, followed by transdermal types (17.7%). The main factors related to the current use of HT included: positive perceptions regarding HT (odds ratio (OR) 11.53, 95% confidence interval (CI) 9.41-14.13), being postmenopausal (OR 3.47, 95% CI 2.75-4.36) and having a better socioeconomic level. A total of 48.8% of surveyed women had used HT in the past, but abandoned it due to symptom improvement or being unconcerned; fear of cancer or any other secondary effects were also reported but in less than 10%. Among women who had never used HT, 28% reported the lack of medical prescription as the main reason, followed by the absence of symptoms (27.8%). Among those reporting lack of prescription as the main reason for not using HT, 30.6% currently had severe menopausal symptoms (total MRS score > 16); 19.5% of women were using alternative 'natural' therapies, with 35.1% of them displaying severe menopausal symptoms as compared to a 22.5% observed among current HT users. CONCLUSION The use of HT has not regained the rates observed a decade ago. Positive perceptions regarding HT were related to a higher use. Lack of medical prescription was the main reason for not using HT among non-users, many of whom were currently displaying severe menopausal symptoms.
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Blümel JE, Cano A, Mezones-Holguín E, Barón G, Bencosme A, Benítez Z, Bravo LM, Calle A, Flores D, Espinoza MT, Gómez G, Hernández-Bueno JA, Laribezcoa F, Martino M, Lima S, Monterrosa A, Mostajo D, Ojeda E, Onatra W, Sánchez H, Tserotas K, Vallejo MS, Witis S, Zúñiga MC, Chedraui P. A multinational study of sleep disorders during female mid-life. Maturitas 2012; 72:359-66. [PMID: 22717489 DOI: 10.1016/j.maturitas.2012.05.011] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 05/23/2012] [Accepted: 05/24/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although sleep disturbances are common during female mid-life, few studies have described in detail the prevalence of this problem and related risk factors. OBJECTIVE To determine the prevalence of sleep disturbances in mid-aged women using validated tools. Assessment of determinants capable of influencing the prevalence of insomnia and poor sleep quality was also performed. METHODS A total of 6079 women aged 40-59 of 11 Latin American countries were invited to fill out the Athens Insomnia Scale (AIS), the Pittsburgh Sleep Quality Index (PSQI), the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale (MRS), the Brief Scale of Abnormal Drinking and a general socio-demographic questionnaire. RESULTS Overall, 56.6% of surveyed women suffered of either insomnia, poor sleep quality, or both. Specifically, 43.6% and 46.2% presented insomnia and poor sleep quality in accordance to the AIS and the PSQI respectively. The prevalence of insomnia increased with female age (from 39.7% in those aged 40-44 to 45.2% in those aged 55-59, p<0.0001) and menopausal stage (from 39.5% in premenopausal aged 40-44 to 46.3% in late postmenopausal ones, p<0.0001). "Awakening during the night" (AIS: Item 2) was the most highly rated of all items and contributing in a higher degree (mean 16%) to the total score of the scale in all menopausal phases. Sleep quality also worsened with age and menopausal status, impairment particularly affecting sleep efficiency and latency and the increased use of hypnotics. Vasomotor symptoms (VMS), depressive mood and anxiety were associated to sleep disturbances. Women presenting sleep disturbances displayed a 2-fold increase in the severity of menopausal symptoms (higher total MRS scores) which was translated into a 6-8 times higher risk of impaired quality of life. Logistic regression analysis determined that female age, the presence of chronic disease, troublesome drinking, anxiety, depression, VMS, drug use (hypnotics and hormone therapy) were significant risk factors related to the presence of sleep disturbances. Higher educational level related to less insomnia and better sleep quality. CONCLUSION Insomnia and poor sleep quality were highly prevalent in this mid-aged female sample in which the influence of age and the menopause was only modest and rather linked to menopausal symptoms already occurring since the premenopause.
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Affiliation(s)
- Juan E Blümel
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
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Royer M, Castelo-Branco C, Blümel JE, Chedraui PA, Danckers L, Bencosme A, Navarro D, Vallejo S, Espinoza MT, Gómez G, Izaguirre H, Ayala F, Martino M, Ojeda E, Onatra W, Saavedra J, Tserotas K, Pozzo E, Manriquez V, Prada M, Grandia E, Zuniga C, Lange D, Sayegh F. The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III): prevalence of the metabolic syndrome in postmenopausal Latin American women. Climacteric 2009; 10:164-70. [PMID: 17453865 DOI: 10.1080/13697130701258895] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Metabolic syndrome (METS) is a strong predictor of cardiovascular risk. Since the prevalence of METS increases after menopause, gynecological routine consultation offers an excellent screening opportunity. OBJECTIVES To assess the prevalence of METS in Latin American postmenopausal women and factors modifying its risk; as well as to assess the role of simple routine care measurements in the diagnosis of the METS. METHODS A total of 3965 postmenopausal women, aged 45-64 years, seeking health care at 12 gynecological centers in major Latin American cities were included in this cross-sectional study. The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) guidelines were applied to assess METS. This was present if three or more of the following conditions were present: waist circumference > or = 88 cm; blood pressure > or = 130/85 mmHg; fasting plasma triglycerides > or = 150 mg/dl; high density lipoprotein (HDL) cholesterol < 50 mg/dl; glucose > or = 110 mg/dl or subjects were receiving treatment for their condition. RESULTS The prevalences of having at least two, three, four or five components were 62.5, 35.1, 13.5 and 3.2%, respectively. The prevalence increased from 28.1% in those aged 40-44 years to 42.9% in those aged 60-64 years. The risk of METS detection (multivariate analysis) increased with age (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.03-1.43), time elapsed since menopause (OR 1.18, 95% CI 1.00-1.38), smoking cigarettes (OR 1.40, 95% CI 1.19-1.65), obesity (OR 13.01, 95% CI 10.93-15.49) and hypertension (OR 9.30, 95% CI 7.91-10.94). In contrast, hormone therapy reduces this risk (OR 0.59, 95% CI 0.51-0.70). CONCLUSION There is a high prevalence of the metabolic syndrome in postmenopausal Latin American women seeking gynecologic health care. Age, years since menopause, obesity and hypertension are strong predictors of this condition.
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Castelo-Branco C, Blümel JE, Chedraui P, Calle A, Bocanera R, Depiano E, Figueroa-Casas P, Gonzalez C, Martino M, Royer M, Zuñiga C, Dulon A, Espinoza MT, Futchner C, Mostajo D, Soto E, Albernaz MA, Marco AA, Aravena H, Busquets M, Campodonico I, Germain A, Alba A, Baron G, Gomez G, Monterrosa A, Onatra W, Broutin G, Manzano B, Gabriela A, Hidalgo L, Leon P, Orbea M, Sanchez H, Vallejo S, Vallecillo G, Hernandez-Bueno J, Hernandez-Bueno JA, Motta E, Andrade R, Tserotas K, Gonzalez MC, Gonzalez CM, Benitez Z, Calle E, Danckers L, Del Castillo A, Izaguirre H, Ojeda E, Rojas J, Bencosme A, Lima S, Motta E, Figueroa-Casas P. Age at menopause in Latin America. Menopause 2006; 13:706-12. [PMID: 16837893 DOI: 10.1097/01.gme.0000227338.73738.2d] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the age at menopause (AM) in Latin America urban areas. DESIGN A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. RESULTS The mean age of the entire sample was 49.4 +/- 5.5 years. Mean educational level was 9.9 +/- 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P < 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P < 0.001) or living in countries with low gross national product (OR = 2.1, 95% CI: 1.5-2.9, P < 0.001) were more prone to an earlier onset of menopause. CONCLUSIONS The AM varies widely in Latin America. Lower income and related poverty conditions influence the onset of menopause.
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Affiliation(s)
- Camil Castelo-Branco
- Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Hospital Clínic Provincial, Villarroel, Barcelona, Spain [corrected]
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