The US National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III): prevalence of the metabolic syndrome in postmenopausal Latin American women.

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.

Sexual dysfunction and related risk factors in a cohort of middle-aged Ecuadorian women.

Sexuality is a complex phenomena that can be affected by psychological and physiological influences, among them the climacteric. The present study aimed to assess the incidence of sexual dysfunction and related risk factors in a cohort of low socioeconomic middle-aged Ecuadorian women. For this, 385 healthy sexually active women between 40 and 65 years old accompanying patients being attended at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital of Guayaquil, Ecuador were asked to take part in the study. Subjects were surveyed using DSM IV criteria to assess sexual dysfunctions and record coital frequency over the past 12 months. Mean age of the sample was 47 +/- 5.6 years (median: 46), 43.1% were postmenopausal and a 17.9% of them were on hormone therapy (HT). A total of 53.5% maintained at least four sexual intercourses per month. Masculine erectile dysfunction and premature ejaculation was present in 21.3% and 59.2%, respectively. Female sexual dysfunction was present in a 78.4% of women included in the study. Desire dysfunction was the most frequent disorder (62.6%). The incidence of sexual dysfunction increased from 71.6% in the 40 - 44 year group, to 92.3% in the 60 - 64 year group (p < 0.05). The risk of sexual dysfunction was increased 7.6-fold when male erectile dysfunction was present (CI: 1.7 - 33.8), 5.8 in cases of premature ejaculation (CI: 2.9 - 11.3), 2.9 by marital status (married) (CI: 1.5 - 5.7) and 4.1 by antidepressant therapies (CI: 1 - 15.7), whereas schooling > or =12 years, having only one sexual partner and > or =4 intercourses per month were factors that decreased sexual dysfunction risk. In conclusion, the incidence of sexual dysfunction in this low socioeconomic Ecuadorian women cohort was higher than expected. Male sexual dysfunctions, marital status and antidepressant use were the most important predicting risk factors.