Possible association between subclinical hypothyroidism and age at menopause in Colombian women.

OBJECTIVE: To evaluate the association between subclinical hypothyroidism with early menopause, premature menopause, and last menstrual bleeding before the natural age of menopause. METHODS: This was a cross-sectional study conducted in 643 postmenopausal women aged 40-69 years. Groups were formed according to last menstrual episode: ≥45 [Natural age at menopause], 40-44 and [Early menopause], <40 [Premature menopause], and <45 [last menstrual episode before the natural age of menopause]. The Zulewski scale was applied to identify manifestations related to hypothyroidism and subclinical hypothyroidism, diagnosed with a serum TSH > 4.5 µIU/mL plus T4-free between 0.7 and 1.9 ng/dL. RESULTS: It was found that 24.4% had the last menstrual episode before the natural age of menopause, 18.6% had early menopause, and 5.7% had premature menopause. Subclinical hypothyroidism was diagnosed in 4.5% of patients. Among women with subclinical hypothyroidism, there was a higher frequency of early menopause, premature menopause, and last menstrual episode before the natural age of menopause, than in women without subclinical hypothyroidism (p < 0.05). Paresthesia (50%) and dry skin (40.7%) were the most reported hypothyroidism-related manifestations. Early menopause, premature menopause, and last menstrual episode before the natural age of menopause were associated with subclinical hypothyroidism, OR: 3.37 [95% CI: 1.40-8.10], OR: 4.31 [95% CI: 1.24-14.97], and OR: 3.57 [95% CI: 1.57-8.10], respectively. CONCLUSIONS: The last menstrual episode before the natural age of menopause, early menopause, and premature menopause were significantly associated with a higher chance of subclinical hypothyroidism.

Positive maternal mental health in pregnant women and its association with obstetric and psychosocial factors.

OBJECTIVE: To estimate the frequency of Positive Maternal Mental Health (PMMH) interpretation levels in pregnant women who attended prenatal consultation and to identify their association with obstetric and psychosocial factors. METHODS: A cross-sectional study that included pregnant women who attended prenatal care at 12 or more weeks of gestation. The following scales were applied: Positive Mental Health Questionnaire (PMHQ), Goldberg Anxiety and Depression Scale, and Jong Gierveld Loneliness Scale. RESULTS: 702 pregnant women were evaluated; 634 (90.3%) had flourishing PMMH, and 68 (9.7%) had non-flourishing PMMH. Among the latter, all were at an intermediate level, and none were languishing. Flourishing PMMH was more frequent in adults (91.2%) compared to adolescents (75.0%) and in women with higher education (93.0%) than in those with basic education (83.9%). The PMHQ factors and global score correlated positively with maternal age and negatively with anxiety, depression, emotional, social, and general loneliness. Associated with a higher frequency of non-flourishing PMMH were general loneliness OR:6.32[CI95%:3.38-11.82], social loneliness OR:5.98[CI95%:3.42-10.42], adolescence OR:3.47[CI95%:1.61-7.45], emotional loneliness OR:3.12[1.83-5.32], anxiety OR:2.14[CI95%:1.27-3.60], and depression OR:1.88[CI95%:1.09-3.25]. Less frequently: work occupation outside the home OR:0.41[CI95%:0.24-0.68], technical/technological studies OR:0.22[CI95%:0.08-0.60] and university OR:0.27[CI95%:0.10-0.71]. Preconception consultation, desired pregnancy, cesarean section, and fetal or neonatal death were not associated. In the adjusted model: general loneliness OR:3.02[CI95%:1.10-8.31], social loneliness OR:2.82[CI95%:1.38-5.79] and anxiety OR:1.93[CI95%:1.02-3.67], retained statistical significance. CONCLUSION: Nine out of ten pregnant women had flourishing PMMH, and none had languishing PMMH. None of the obstetric factors were associated with non-flourishing PMMH but with general loneliness, social loneliness, and anxiety.

Association of muscle disorders in late postmenopausal women according to the type of experienced menopause.

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 strength, 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.

Clinical considerations for sarcopenia in older Colombian Afro-descendant and mestizo women.

OBJECTIVES: To identify the frequencies of clinical suspicion of sarcopenia (CSS) and probable sarcopenia (PS) and their association with ethnic groups. METHODS: This cross-sectional study categorized 700 women into Afro-descendant and mestizo ethnic groups. Calf circumference, muscle strength, and gait speed were measured. CSS was assessed using a sarcopenia risk scale and the measurement of calf circumference; the muscle strength of the dominant hand was used to establish PS. Unadjusted logistic regressions assessed associations between CSS/PS and ethnicity. Two adjusted logistic regression models included relevant covariates. RESULTS: CSS and PS were identified in 10.4% to 20.7% and 7.8% to 14.1% of study participants, respectively. Compared with mestizos, Afro-descendants had a more favorable sarcopenia risk score, greater calf circumference, and greater muscle strength and were associated with a lower risk for CSS (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06-0.28 and OR: 0.12, 95% CI: 0.07-0.21) and PS (OR: 0.12, 95% CI: 0.05-0.30 and OR: 0.11, 95% CI: 0.06-0.21). CONCLUSION: Compared with mestizos, CSS and PS were less frequent among Afro-descendants, who had 87% to 88% lower probability of CSS and 88% to 89% lower probability of PS.

Validity and Reliability of the Spanish Version of Fear of COVID-19 Scale in Colombian Physicians.

The Fear COVID-19 Scale (FCV-19S) is a tool that assesses fears related to COVID-19. The objective was to know the validity and reliability of the FCV-19S in Colombian physicians. Five hundred thirty-one physicians aged between 21 and 69 years participated (M = 30.0, SD = 9.4). Internal consistency was estimated with Kuder-Richardson and McDonald's omega coefficients. The one-dimensional structure was corroborated with confirmatory factor analysis and goodness of fit coefficients. The FCV-19S showed Kuder-Richardson's coefficient of 0.16 and McDonald's omega of 0.42. The five-item version (FCV-19S-5), without items 3 and 7, showed Kuder-Richardson's coefficient of 0.67 and McDonald's omega of 0.68. In conclusion, the FCV-19S presented a poor psychometric performance in Colombian doctors, and the FCV-19S-5 showed acceptable internal consistency and dimensionality.

Clinical suspicion of sarcopenic obesity and probable sarcopenic obesity in Colombian women with a history of surgical menopause: a cross-sectional study.

OBJECTIVES: To identify the frequency of clinical suspicion of sarcopenic obesity (CSSO) and probable sarcopenic obesity (PSO) and to estimate the association between them and surgical menopause. METHODS: A cross-sectional study carried out in women residing in Colombia, ages 60 to 75 years. Body mass index, the SARC-F scale, SARC-CalF < 31, and SARC-CalF <33 versions adding the calf circumference measurement in the last two were used to identify CSSO. Muscle strength measurement was added to the above measures to establish PSO. Surgical menopause was defined in women who underwent bilateral oophorectomy simultaneously with hysterectomy before natural menopause. Adjusted and unadjusted logistic regression were performed between CSSO or PSO with surgical menopause, bilateral oophorectomy after natural menopause, and abdominal hysterectomy with ovarian preservation. All participants provided informed consent. P < 0.05 was statistically significant. RESULTS: Seven hundred women 67.0 ±â€Š4.8 years old were included; 23.7% were obese, 68.1% had reduced muscle strength, and 4.2% had surgical menopause. CSSO was found in 3.0% with SARC-F and with SARC-CalF < 31; whereas 2.0% were found with SARC-CalF <33. PSO was found in 2.4%, 1.5%, and 2.2% with SARC-F, SARC-CalF <31, and SARC-CalF <33, respectively. Surgical menopause was associated with PSO but was not associated with CSSO. Bilateral oophorectomy after menopause and hysterectomy with ovarian preservation were not associated with CSSO or PSO. CONCLUSIONS: In a group of older adult women, the frequency of CSSO was up to 3.0% and PSO up to 2.4%. Surgical menopause was statistically significantly associated with PSO. On the contrary, CSSO was not associated.

Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19 / Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19

Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.

Objetivo: elaborar una aproximación a la prevalencia de los problemas de sueño (PDS) en mujeres climatéricas colombianas durante la pandemia COVID-19. Materiales y Métodos: estudio transversal que pertenece al proyecto de investigación Calidad de Vida en la Menopausia y Etnias Colombianas bajo condiciones de pandemia [CAVIMEC+COVID STUDY]. Se incluyeron mujeres naturales y residentes en Colombia entre 40 y 59 años, quienes en los primeros cinco días de junio del 2020 participaron de forma anónima y voluntaria, previo consentimiento informado en el diligenciamiento de un formulario alojado en una plataforma virtual. Los PDS fueron identificados con el tercer ítem de Menopause Rating Scale. Se exploraron características sociodemográficas, la presencia y severidad de los PDS y el estado menopáusico. Se hace estadística descriptiva. Resultados: participaron 984 mujeres, la mediana de edad fue 47,0 [RIC: 42,0-53,5] años. El 84,5% de las participantes eran mestizas, el 13,7% afrodescendientes y 1,7% indígenas. El 39,3% posmenopáusicas. El 70% residían en la región caribe colombiana. Informaron PDS 637 (64,7%) de las participantes y 112 (11,3%) tenían PDS severos. Las posmenopáusicas informaron un 65,1% de PDS, en forma severa el 10,1%, y las premenopáusicas informaron 64,5%, en forma severa el 12,2%. Conclusiones: los PDS podrían ser un problema frecuente en las mujeres en estado premenopáusico y postmenopáusico. Se debe explorar este problema en la consulta ginecológica para ofrecer soluciones. Se requieren estudios poblacionales que confirmen estas observaciones.

Perceived Loneliness and Severe Sleep Disorders in Adult Women during the Covid-19 Quarantine: A Cross-Sectional Study in Colombia.

BACKGROUND: Quarantine is a measure to control COVID-19 spread, resulting in an increased perception of loneliness. In turn, sleep disorders (SD) may be more frequently reported in uncertain circumstances. OBJECTIVES: To identify the association between loneliness and severe SD, in women quarantined due to the COVID-19 pandemic. METHODS: A cross-sectional study carried out in women, between 40 and 79 years and living in Colombia. The women were invited through social network to complete 5 digital instruments: de Jong Gierveld Loneliness Scale, Menopause Rating Scale, Fear of COVID-19 Five-item Version, Coronavirus Anxiety Scale, and Francis Religion Scale. Bivariate analysis and adjusted logistic regression between loneliness and SD were performed. RESULTS: 1133 women participated, half of them under 50 years old. 43.1% had emotional loneliness, 39.9% social loneliness and 43.3% general loneliness. SD were identified in 6 out of 10 women, those with mild SD presented an OR of 1.84, 1.85, and 1.64, for emotional, social and general loneliness, respectively. Loneliness was associated twice with moderate SD, and more than twice with severe SD. Very severe SD reached OR:5.81 for emotional loneliness, OR:4.38 social loneliness and OR:4.02 general loneliness. In the presence of religiosity, fear and anxiety due to COVID-19, statistical significance was retained for associations, except intense SD with general loneliness. CONCLUSIONS: SD were significantly associated with loneliness in our study population. It is important to assess sleep quality and perception of loneliness in middle-aged women, especially during periods of quarantine due to a pandemic to avoid health implications.

Online assessment of the perception of loneliness and associated factors in Colombian climacteric women during the COVID-19 pandemic: A cross-sectional study.

Background: The coronavirus disease 2019 (COVID-19) pandemic has generated changes due to confinement, this measure can increase the perception of loneliness. The objective was to estimate the frequencies of emotional, social and general loneliness and their association with fear and anxiety with COVID-19, religiosity and severe deterioration of quality of life in middle-aged women. Methods: A cross-sectional study in Colombian women (40-59 y, n=984) surveyed with an electronic form that included sociodemographic characteristics and validated measures (Menopause Rating Scale, de Jong Gierveld Loneliness Scale, fear of COVID-19 scale, Coronavirus Anxiety Scale and Francis Scale for Religiosity). Associations of emotional, social and general loneliness (dependent variables) with severe somatic, psychological, urogenital and quality of life deterioration, as well as with high religiosity, anxiety and high fear of COVID-19 (independent variables), were estimated. Results: The median age was 47 years old, and 39.2% [95% CI: 36.2-42.3] postmenopausal. Severe deterioration in somatic, psychological, urogenital domains and quality of life in women with emotional, social and general loneliness was found (P <0.001). In adjusted models, high fear of COVID-19, severe deterioration of psychological and urogenital domains and quality of life were associated with emotional, social and general loneliness. Anxiety with COVID-19, somatic domain and high religiosity were not associated with loneliness. Conclusion: Emotional, social and general loneliness were identified in 4/10 middle-aged Colombian women surveyed, and the associated factors were high fear of COVID-19, severe deterioration of quality of life and psychological and urogenital domains. Professionals who care for climacteric women should explore the perception of loneliness when assessing menopausal symptoms.

Psychosocial factors associated with symptoms of generalized anxiety disorder in general practitioners during the COVID-19 pandemic.

Healthcare providers commonly experience symptoms of anxiety during public health crises and pandemics. The objective of the study was to identify the frequency of symptoms of generalized anxiety disorder (GAD) in general practitioners and to estimate the association with particular psychosocial and demographic factors. This is a cross-sectional study, where a total of 531 general practitioners completed an online form that contained sociodemographic variables, questions about fear and perceptions concerning medical work during the COVID-19 pandemic, 7-Item Generalized Anxiety Disorder Scale (GAD-7), questionnaire on psychosomatic problems and Fear of COVID-19 Scale. The presence of symptoms of GAD was defined by a GAD-7 score of 10 or more points. Voluntary and anonymous participation, acceptance of terms, and informed consent were requested. A p value of <0.05 was considered statistically significant. Symptoms of GAD were identified in 4 out of 10 Colombian general practitioners; the following psychosocial and demographic factors were associated with a greater presence of these symptoms: female gender, social discrimination, anguish, job disappointment, nightmares, stress and other symptoms of fear regarding the pandemic. Conversely, feeling protected by the state or employer, being satisfied with their job as a physician, and trusting government measures and information were associated with a lower presence of symptoms of GAD. These findings highlight the importance of timely psychotherapeutic and psychopharmacological interventions in these individuals. The authors suggest mental health providers should be deployed during times of crisis to decrease the risk of developing mental illness.

Pentraxin-3 is a candidate biomarker on the spectrum of severity from pre-eclampsia to HELLP syndrome: GenPE study.

Pentraxin-3 has been reported as a promising biomarker of pre-eclampsia and its severity; however, available studies have small sample sizes, and analyses are not always adjusted for confounders. The aim of this study is to establish the strength of the association between maternal Pentraxin-3 level and pre-eclampsia or HELLP syndrome. It was a case-control study. Women with pre-eclampsia or HELLP syndrome were defined as cases, and women with healthy pregnancies at term (>37 weeks) were classified as controls. Plasma concentrations of Pentraxin-3 were determined at the time of delivery by quantitative enzyme immunoassay. Associations between Pentraxin-3 and pre-eclampsia and HELLP syndrome were assessed by multinomial logistic regression. Subsidiary analysis for the time of disease onset was also carried out. Odds ratios and 95% confidence intervals are reported. A total of 1024 pregnant women were included (461 controls, 368 pre-eclampsia, 195 HELLP). A positive log-linear relationship was found between the top pentraxin-3 quintile and HELLP syndrome. After adjustment for confounders (maternal age, ethnicity, socioeconomic position, date and place of recruitment, family history of pre-eclampsia, smoking, body mass index at beginning of pregnancy, gestational age and multiple pregnancy), the strength of the association was higher for HELLP syndrome [OR 1.13 (95% CI 1.08; 1.18)] than for pre-eclampsia [OR 1.03 (95% CI 1.03; 1.10)]. No difference according to time of onset or pentraxin-3 level was found. In summary, pentraxin-3 level was associated with pre-eclampsia, but it was more strongly associated with HELLP syndrome. Longitudinal studies with a lower probability of residual confounding are necessary to improve our knowledge about the role of pentraxin-3 in pre-eclampsia.

Prevalence of sarcopenia and associated factors in climacteric women of the Colombian Caribbean.

OBJECTIVE: The aim of the study was to determine the prevalence of sarcopenia and associated factors in climacteric middle-aged women. METHODS: This was a cross-sectional study carried out in Colombian Caribbean women (40-59 y, n = 403), who were surveyed with a form that included sociodemographic information and two validated tools (the Menopause Rating Scale and the SF-36 Health questionnaire). Calf circumference, handgrip, and gait speed were measured. Low muscle mass (calf circumference <31 cm), reduced muscle strength (<20 kg in handgrip), and lower physical performance (<0.8 m/s gait speed) were estimated. Criteria of the European Working Group on Sarcopenia in Older People were used to identify sarcopenia. Association between sarcopenia (dependent variable) and menopausal symptoms and health perception (independent variables) was estimated. RESULTS: Median age of surveyed women was 48 years, with 44.5% being postmenopausal. 9.6% had low muscle mass, 18.1% had reduced muscle strength, and 6.9% had lower physical performance. Presarcopenia was identified in 9.6% and sarcopenia in 7.9% (nonsevere sarcopenia 7.1% and severe sarcopenia 0.8%). Most important factors associated with sarcopenia were feeling full of life only sometimes, feeling a lot of energy only sometimes, having joint/muscular discomfort, history of hysterectomy, hot flashes, mestizo ethnic group, age 50 or more, being postmenopausal, and sleep problems. CONCLUSIONS: Sarcopenia was present in this middle-aged female Colombian Caribbean sample and associated with various factors such as ethnicity, age, and menopausal symptoms and status.

Histerectomía abdominal y deterioro de la función física en mujeres adultas mayores colombianas / Abdominal hysterectomy and impaired physical function in colombian older women

Resumen OBJETIVO: Estimar, en mujeres adultas mayores colombianas, la asociación entre histerectomía abdominal con el deterioro de la función física y con la limitación para las actividades de la vida diaria. MATERIALES Y MÉTODOS: Estudio transversal llevado a cabo en mujeres colombianas entre 60 y 75 años que firmaron el consentimiento informado, permitieron mediciones antropométricas y contestaron un formulario con preguntas acerca de datos sociodemográficos y clínicos. Se aplicó la subescala de función física del Cuestionario SF-36. Se realizaron regresiones logísticas bivariadas: limitación para las actividades habituales o deterioro en la función física (variables dependientes) con el antecedente de histerectomía con o sin ooforectomía en la pre o posmenopausia (variables independientes). Además, se aplicaron cuatro modelos de regresión logística ajustada. RESULTADOS: Se evaluaron 700 mujeres con promedio de edad de 67.0 ± 4.8 años y 18.9 ± 6.3 años trascurridos a partir de la menopausia. A todas se les practicó histerectomía con ooforectomía durante los años de premenopausia (4.2%); histerectomía sin ooforectomía en la premenopausia (18.1%); histerectomía con ooforectomía en la posmenopausia (2.1%) e histerectomía sin ooforectomía en la posmenopausia (8.4). La histerectomía con ooforectomía, o sin esta última en la premenopausia, se relacionó con deterioro de la función física (RM: 2.67; IC95%:1.19-5.97) y 2.02 (IC95%:1.34-3.09). Igual sucedió con las actividades habituales (p < 0.05). La histerectomía con preservación o extirpación ovárica durante la posmenopausia no se asoció con deterioro de la función física (p > 0.05). CONCLUSIÓN: En la muestra estudiada se encontró relación entre la histerectomía con limitación para actividades diarias y con deterioro de la función física. La histerectomía con o sin ooforectomía practicada durante los años de premenopausia, a diferencia de la adelantada en posmenopausia, se asoció, significativamente, con deterioro del funcionamiento físico.

Abstract OBJECTIVE: To estimate the association of abdominal hysterectomy with impaired physical function and limitation of activities of daily living in elderly Colombian women. MATERIALS AND METHODS: Cross-sectional study in Colombian women aged 60-75 years who signed informed consent, allowed anthropometric measurements, and completed a form with questions on socio-demographic and clinical data. The physical function subscale of the SF-36 questionnaire was used. Bivariate logistic regressions were performed: limitation of usual activities or impairment of physical function (dependent variables) with history of hysterectomy with or without oophorectomy in pre- or postmenopause (independent variables). Four adjusted logistic regression models were also used. RESULTS: Seven hundred women with a mean age of 67.0 ± 4.8 years and 18.9 ± 6.3 years since menopause were evaluated. All had undergone hysterectomy with oophorectomy in the premenopausal years (4.2%); hysterectomy without oophorectomy in the premenopausal years (18.1%); hysterectomy with oophorectomy in the postmenopausal years (2.1%); and hysterectomy without oophorectomy in the postmenopausal years (8.4%). Hysterectomy with or without oophorectomy in premenopause was associated with impaired physical function (MR: 2.67; 95%CI: 1.19-5.97) and 2.02 (95%CI: 1.34-3.09), respectively. The same was true for usual activities (p < 0.05). Postmenopausal hysterectomy with ovarian preservation or removal was not associated with impaired physical function (p > 0.05). CONCLUSION: In the sample studied, an association was found between hysterectomy with limitation of daily activities and impaired physical function. Hysterectomy with or without oophorectomy in the premenopausal years, as opposed to early postmenopausal hysterectomy, was significantly associated with physical function impairment.

Insomnia and sexual dysfunction associated with severe worsening of the quality of life in sexually active hysterectomized women.

Hysterectomy is a common gynecologic surgery carried out to remove the pathologic uterus. Objective: To establish if sleep disorders and sexual function are associated with deterioration of the quality of life (QoL) in hysterectomized and sexually active women. Methods: A cross-sectional study was carried out with inhabitants from two cities of the Colombian Caribbean. The pollsters invited women aged between 40-59 years to participate; in their communities they applied surveys with demographic characteristics: Female Sexual Function Index, Atenas Insomnia Scale and Menopause Rating Scale. Sexually active women were selected; then the association was established with logistic regression. Results: 522 women were studied with an average age of 50 years: 30% oophorectomized, 59.8% Hispanic, 40.2% afro-descendants and 22.2% hormonal therapy users. 80% of them had somato/vegetative, psychological or urogenital deterioration; 29.1% with severe deterioration of QoL and 47.5% with insomnia. Out of 390 (74.7%) with sexual activity, 59.7% suffered from sexual dysfunction. Insomnia: OR:3.05 [95%CI:1.86-4.99], sexual dysfunction OR:3.52 [95%CI:2.01-6.17], dissatisfaction about sexuality OR:4.77 [95%CI:2.08-10.93], low or non-existent sexual desire OR:2.94 [95%CI:1.65-5.25], daytime drowsiness OR:3.15 [95%CI:1.59-6.24] and decrease in daytime well-being OR:3.18 [95%CI:1.79-5.64]. These were factors associated with severe worsening of QoL, while the presence of genital lubrication was protective, OR: 0.44 [95%CI:0.21-0.93], p=0.0332. Conclusion: It was observed that insomnia and sexual dysfunction behaved as factors associated with three times more severe deterioration of the QoL in climacteric and sexually active women previously hysterectomized.

Evaluation of depressive symptoms in mid-aged women: report of a multicenter South American study.

OBJECTIVE: To evaluate depressive symptoms and related factors among mid-aged women using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). METHODS: This was a cross-sectional multicenter study in which women aged 40 to 65 from various South American countries were surveyed with the CESD-10 and a general questionnaire containing personal and partner data. RESULTS: In all, 864 women were interviewed from Colombia (Afro-Colombian, n = 215), Ecuador (Mestizo, n = 202), Perú (Quechua at high altitude, n = 231), and Paraguay (Mestizo, n = 216). Mean age of the whole sample was 49.1 ±â€Š6.0 years. Although the rate of postmenopausal status was similar among studied sites, differences were observed in relation to age, parity, hormone therapy use, hot flush rate, sedentary lifestyle, chronic medical conditions, habits, and partner aspects. Median total CESD-10 score for all sites was 7.0, with a 36.0% (n = 311) having scores equal to 10 or more (suggestive of depressed mood). Higher scores were observed for Afro-Colombian and Quechua women, and also for postmenopausal and perimenopausal ones. Multivariate linear regression analysis found that depressed mood (higher CESD-10 total scores) was significantly associated with ethnicity (Afro-Colombian), hot flush severity, hormone therapy use, sedentary lifestyle, postmenopause, perceived unhealthy status, and lower education. Higher monthly coital frequency and having a healthy partner without premature ejaculation was related to lower scores, hence less depressed mood. CONCLUSION: In this mid-aged female South American sample, depressive symptoms correlated to menopausal status and related aspects, ethnicity, and personal and partner issues. All these features require further research.

Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19 / Prevalence of sleep disorders in menopausal women during the COVID-19 pandemic in Colombia

RESUMEN Objetivo: Elaborar una aproximación a la prevalencia de los problemas de sueño (PDS) en mujeres climatéricas colombianas durante la pandemia COVID-19. Materiales y Métodos: Estudio transversal que pertenece al proyecto de investigación Calidad de Vida en la Menopausia y Etnias Colombianas bajo condiciones de pandemia [CAVIMEC+COVID STUDY]. Se incluyeron mujeres naturales y residentes en Colombia entre 40 y 59 años, quienes en los primeros cinco días de junio del 2020 participaron de forma anónima y voluntaria, previo consentimiento informado en el diligenciamiento de un formulario alojado en una plataforma virtual. Los PDS fueron identificados con el tercer ítem de Menopause Rating Scale. Se exploraron características sociodemográficas, la presencia y severidad de los PDS y el estado menopáusico. Se hace estadística descriptiva. Resultados: Participaron 984 mujeres, la mediana de edad fue 47,0 [RIC: 42,0-53,5] años. El 84,5% de las participantes eran mestizas, el 13,7% afrodescendientes y 1,7% indígenas. El 39,3% posmenopáusicas. El 70% residían en la región caribe colombiana. Informaron PDS 637 (64,7%) de las participantes y 112 (11,3%) tenían PDS severos. Las posmenopáusicas informaron un 65,1% de PDS, en forma severa el 10,1%, y las premenopáusicas informaron 64,5%, en forma severa el 12,2%. Conclusiones: Los PDS podrían ser un problema frecuente en las mujeres en estado premenopáusico y postmenopáusico. Se debe explorar este problema en la consulta ginecológica para ofrecer soluciones. Se requieren estudios poblacionales que confirmen estas observaciones.

ABSTRACT Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic. Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.

Somnolencia diurna excesiva identificada con la escala de Epworth en gestantes que acuden a consulta prenatal ambulatoria / Excessive daytime sleepiness identified with the Epworth scale in pregnant women attending an outpatient prenatal consultation

INTRODUCCIÓN: Durante el embarazo se reportan a menudo trastornos del sueño, pero son poco explorados en el control prenatal. El objetivo fue estimar la frecuencia e identificar los factores asociados a somnolencia diurna excesiva (SDE) en gestantes de bajo riesgo obstétrico que acudieron a consulta prenatal. MÉTODO: Estudio transversal dentro del proyecto «Salud biopsicosocial en gestantes», aprobado por el comité de ética de la Clínica Santa Cruz de Bocagrande, Cartagena, Colombia. Se estudiaron mujeres con 12 o más semanas de gestación. Se aplicó un formulario que incluía las escalas de somnolencia diurna de Epworth (ESE), de estrés percibido de 10 ítems (EPP-10) y revisada de depresión del Centro de Estudios Epidemiológicos (CESD-R10). Se realizó regresión logística ajustada y no ajustada de SDE con las otras escalas y variables cualitativas. Se buscó correlación entre variables cuantitativas y la escala de Epworth. Se consideró significativo p < 0,05. RESULTADOS: Se estudiaron 683 mujeres de 28,3 ± 6,3 años y 31,5 ± 6,9 semanas de gestación. Puntuación en la escala de Epworth: 3,82 ± 3,45. En el 4,9% se identificó SDE: 50% leve, 32,2% moderada y 17,6% importante. No se observó en el primer trimestre de gestación y la frecuencia fue similar en los otros; la SDE importante solo se observó en el tercer trimestre. Depresión: odds ratio [OR]: 3,69, intervalo de confianza del 95% [IC95%]:1,83-7,43. Anemia: OR 3,10, IC95%:1,50-6,38. Fatiga: OR 3,22, IC95%:1,23-8,44. Nerviosismo: OR 2,49, IC95%:1,22-5,12. Estrés: OR: 2,38, IC95%:1,12-5,05. Gran paridad: OR: 2,64, IC95%: 1,01-6,89. Trabajar fuera de casa: OR: 2,33, IC95%: 1,05-5,15. Todas estas variables se asociaron con SDE. En el modelo ajustado, la anemia (OR: 3,05, IC95%: 1,44-6,45) y la depresión (OR: 2,72, IC95%: 1,26-5,85) conservaron la asociación. Se observó correlación positiva, despreciable y estadísticamente significativa, de la ESE con la CESD-R10 y con la EPP-10; y ausencia de correlación con la edad materna, la edad gestacional, el número de abortos y el número de cesáreas. CONCLUSIONES: En una de cada 20 gestantes de bajo riesgo obstétrico se identificó SDE, y varias situaciones biopsicosociales se asociaron con mayor presencia.

INTRODUCTION: Sleep disturbances are constantly reported during pregnancy, although they are not often taken care of in prenatal care. The aim was to estimate the regularity and identify factors associated with excessive daytime sleepiness (EDS) in pregnant women at low obstetric risk who attended prenatal consultation. METHOD: Cross-sectional study belonging to the project “Biopsychosocial health in pregnant women”, approved by the ethics committee of the Santa Cruz de Bocagrande Clinic, Cartagena, Colombia. Pregnant women with 12 or more weeks of gestation were studied. A form including: Epworth Daytime Sleepiness Scale, 10-item Perceived Stress and the Revised Depression Scale of the Centre for Epidemiological Studies was applied. Adjusted and unadjusted logistic regression was performed between EDS with the other scales and qualitative variables. In addition, correlation between quantitative variables and the Epworth scale. P<0.05 was significant. RESULTS: 683 pregnant women were studied, maternal age 28.3 ± 6.3 years and gestational age 31.5±6.9 weeks. Epworth Scale score: 3.82 ± 3.45. EDS was identified in 4.9%, 50% mild, 32.2% moderate and 17.6% severe. It was not observed in the first gestational trimester and the frequency was similar in the others, severe EDS only in the third trimester. Depression OR: 3.69 [95% CI: 1.83-7.43], anemia OR: 3.10 [95% CI: 1.50-6.38], fatigue OR: 3.22 [95% CI: 1.23-8.44], nervousness OR: 2.49 [95% CI: 1.22-5.12, stress OR: 2.38 [95% CI: 1.12-5.05], high parity OR: 2.64 [95% CI: 1.01-6.89] and working outside the home OR: 2.33 [95% CI: 1.05-5.15, were associated with EDS. In the adjusted model, anemia OR: 3.05 [95% CI: 1.44-6.45] and depression OR: 2.72 [95% CI: 1.26-5.85] retained the association. CONCLUSIONS: In one out of every twenty low obstetric risk pregnant women EDS was identified and several biopsychosocial situations were associated with more presence.

Instruments to study sleep disorders in climacteric women.

To identify the scales to assess sleep disorders applied to women with climacteric stage. Bibliographical research without intervention, the available information in scientific databases. Performed in PubMed, ScienceDirect, Scopus, Ebscohos OvidSP and Health Library. The words used in this article: insomnia, adjustment sleep disorder, questionnaires, studies and menopause. Publications of all types were included. Seven scales were identified: Insomnia Severity Index, Athens Insomnia Scale, Pittsburgh Quality of sleep Index, Epworth Sleepiness Scale, Jenkins Sleep Scale, Basic Nordic Sleep Questionnaire and The St Mary's Hospital Sleep Questionnaire. There are validated scales in multiple languages and considered appropriate for studying sleep disorders.

Differential Item Functioning of the Psychological Domain of the Menopause Rating Scale.

Introduction. Quality of life could be quantified with the Menopause Rating Scale (MRS), which evaluates the severity of somatic, psychological, and urogenital symptoms in menopause. However, differential item functioning (DIF) analysis has not been applied previously. Objective. To establish the DIF of the psychological domain of the MRS in Colombian women. Methods. 4,009 women aged between 40 and 59 years, who participated in the CAVIMEC (Calidad de Vida en la Menopausia y Etnias Colombianas) project, were included. Average age was 49.0 ± 5.9 years. Women were classified in mestizo, Afro-Colombian, and indigenous. The results were presented as averages and standard deviation (X ± SD). A p value <0.001 was considered statistically significant. Results. In mestizo women, the highest X ± SD were obtained in physical and mental exhaustion (PME) (0.86 ± 0.93) and the lowest ones in anxiety (0.44 ± 0.79). In Afro-Colombian women, an average score of 0.99 ± 1.07 for PME and 0.63 ± 0.88 for anxiety was gotten. Indigenous women obtained an increased average score for PME (1.33 ± 0.93). The lowest score was evidenced in depressive mood (0.50 ± 0.81), which is different from other Colombian women (p < 0.001). Conclusions. The psychological items of the MRS show differential functioning according to the ethnic group, which may induce systematic error in the measurement of the construct.