Disfunción sexual en mujeres climatéricas afrodescendientes del Caribe Colombiano / Sexual dysfunction in climacteric women of African descent from the Colombian Caribbean region

Introducción: Colombia es el tercer país americano con mayor población afrodescendiente, después de Estados Unidos y Brasil. Objetivo: calcular la prevalencia de disfunción sexual (DS) en mujeres climatéricas afrodescendientes. Metodología: estudio transversal con el Índice de Función Sexual Femenina (FSFI), en mujeres afrodescendientes saludables (40-59 años), hijas de padres de raza negra, naturales de municipios del Caribe Colombiano, voluntarias, anónimas y captadas en sus comunidades. A mayor puntaje mejor sexualidad. La DS se establece con un puntaje total de 26,55 o menos. Resultados: se estudiaron 461 mujeres; 305 de ellas (66,2%) con actividad sexual, 70,8% eran premenopáusicas y 29,2%, posmenopáusicas. Los puntajes promedio de los dominios fueron: deseo (4,1 ± 1,1), excitación (4,4 ± 1,0), lubricación (4,9 ± 1,0), orgasmo (4,7 ± 1,0), satisfacción (5,3 ± 1,0) y dolor (4,3 ± 1,5). La media del puntaje total fue 27,7 ± 4,7 y la prevalencia de disfunción sexual, 38,4%. El hábito de fumar (OR: 3,3 [IC95%: 1,0-10,6; p = 0,041] y la hipertensión arterial (OR: 2,2 [IC95%: 1,1-4,4; p = 0,026] incrementaron el riesgo de DS, mientras que la escolaridad mayor de diez años (OR: 0,4 [IC95%: 0,2-0,8; p = 0,003] lo redujo. La prevalencia de DS aumentó con el cambio en el estado menopáusico (p <0,001). Todos los dominios se deterioraron, excepto el dolor, con el paso a la posmenopausia (p <0,001). Conclusión: en mujeres afrodescendientes del Caribe Colombiano, una de cada tres premenopáusicas y la mitad de las posmenopáusicas presentan DS.

Introduction: After the United States and Brazil, Colombia is the third American country with the greatest population of African descent. Objective: To estimate the prevalence of sexual dysfunction (SD) in climacteric women of African descent. Methods: Cross sectional study carried out with the Female Sexual Function Index (FSFI), in healthy women, whose mother and father were of black race, living in municipalities from the Colombian Caribbean region, who volunteered to anonymously participate in the study, and were recruited in their communities. Higher scores correlated with better sexuality. Results: 461 women were studied; 305 (66.2%) with sexual activity; 70.8% were premenopausal and 29.2%, postmenopausal. Average scores of the domains were: Sexual desire (4.1 ± 1.1), sexual arousal (4.4 ± 1.0), lubrication (4.9 ± 1.0), orgasm (4.7 ± 1.0), satisfaction (5.3 ± 1.0) and pain (4.3 ± 1.5). Average total score was 27.7 ± 4.7. Prevalence of SD was 38.4%. Smoking (OR: 3.3 [IC95%: 1.0-10.6; p = 0.041] and arterial hypertension (OR: 2.2 [IC95%:1.1-4.4; p = 0.026] increased the risk of SD, while schooling higher than ten years (OR: 0.4 [IC95%: 0.2-0.8; p = 0.003] decreased it. Prevalence of SD increased with the change in the menopausal status (p <0,001). All domains deteriorated, except pain, with the transition to the postmenopausal status (p <0.001). Conclusion: In females of African descent from the Colombian Caribbean region, one third of the premenopausal and half of the postmenopausal have SD.

Climacteric complaints among very low-income women from a tropical region of Brazil / Sintomas climatéricos em mulheres com baixa renda de uma região tropical do Brasil

CONTEXT AND OBJECTIVE: Climacteric symptoms may vary between different countries and cultures. Socioeconomic factors and climate may be implicated. The aim of this study was to identify climacteric symptomatology among very low-income Brazilian women, living in a hot and humid region. DESIGN AND SETTING: This cross-sectional population-based study was conducted in Cuiabá, at Júlio Müller University Hospital, a tertiary institution. METHODS: The study enrolled 354 climacteric women. The variables analyzed were social class, symptomatology and abnormal concurrent conditions. The study was approved by the hospital's research ethics committee. RESULTS: Sixty-five percent of the participants (232/354) were very poor and had had little schooling. The number of symptoms per woman was 8.0 ± 5.7. Hot flushes, nervousness, forgetfulness and fatigue were each found in nearly 60.0 percent. Tearfulness, depression, melancholy and insomnia were also frequent. Sexual problems were reported by 25 percent. The most relevant concurrent abnormal conditions reported were hypertension (33.9 percent), obesity (26.5 percent), arthritis/arthrosis (15.0 percent) and diabetes mellitus (9.6 percent). Hot flushes were associated with tearfulness, nervousness and forgetfulness. CONCLUSION: Brazilian climacteric women of low income and low schooling present multiple symptoms. Vasomotor and psychosexual symptoms were the most prevalent disorders. Hot flushes were associated with nervousness, forgetfulness and tearfulness.

CONTEXTO E OBJETIVO: Sintomas climatérios podem mudar em diferentes culturas e países. Aspectos sócio-econômicos e clima podem estar envolvidos. Este estudo tem como proposta identificar os sintomas em mulheres climatéricas brasileiras de baixa renda de uma região quente e úmida do Brasil. TIPO DE ESTUDO E LOCAL: Estudo de coorte transversal, realizado no Hospital Universitário Julio Muller em Cuiabá. MÉTODOS: Este estudo incluiu todas as 354 mulheres climatéricas do Distrito Oeste de Cuiabá. Incluiu-se na análise as variáveis classe social, sintomas e doenças coexistentes. Possíveis associações foram examinadas pelo teste chi2 e regressão logística. RESULTADOS: 65 por cento das pacientes eram muito pobres e de baixa escolaridade. O número médio de sintomas referidos por mulher foi de 8.0 ± 5.7. Fogachos, nervosismo, esquecimento e fadiga foram encontrados em quase 60 por cento das mulheres. Choro imotivado, melancolia, depressão e insônia também foram freqüentes. Disfunções sexuais foram relatadas por cerca de 25 por cento das mulheres. Fogachos foram associados com esquecimento, nervosismo e choro imotivado. As doenças coexistentes mais freqüentes foram hipertensão arterial (33,9 por cento), obesidade (26,5 por cento), artrite/artrose (15,0 por cento) e diabetes mellitus (9,6 por cento). CONCLUSÃO: Mulheres climatéricas brasileiras de baixa renda e baixa escolaridade são plurisintomáticas. Os sintomas vasomotores e psicosexuais foram os mais prevalentes. Fogachos foram associados a nervosismo, esquecimento e choro imotivado.

Developing an Instrument to Measure Climacteric Symptoms among Korean and Japanese Women / 간호학회지

PURPOSE: The purpose of this study was to construct a measurement instrument for climacteric symptoms among Korean and Japanese women. METHODS: From Dec. 1st of 2003 to March 30th of 2004, in-depth interviews were made with 26 women (15 in Jinju, Korea and 11 in Nagasaki, Japan) aged from 45 to 59 years who had not taken hormone replacement therapy to relieve the climacteric symptoms. A draft questionnaire with 45 items was constructed on the basis of the interview data and literature review. Three obstetricians, three PhDs in nursing science, and a chief nurse who was exclusively in charge of the climacteric management, examined the draft questionnaire to evaluate content validity. After deletions 39 items remained for a preliminary questionnaire. A survey was conducted by using a convenient sampling method in Jinju of Korea and Nagasaki of Japan during the period from April 1st, 2004 to July 10th, 2005. RESULTS: Factor analysis identified 4 factors, which were "mental and psychological symptoms", "physical symp-toms", "loss of autonomic nervous system symptoms", "sexual symptoms". These four factors explained 46.9% of total variance. CONCLUSIONS: The results demonstrated that climacteric symptom scale was multidimensional, and the reliability and validity of the scale was supported.