RESUMEN
OBJECTIVE: Menopause may augment age-dependent increases in arterial stiffness, with black women having greater progression in midlife compared with white women. We sought to determine whether and when women experience changes in arterial stiffness relative to the final menstrual period (FMP) and whether these changes differ between black and white midlife women. Approach and Results: We evaluated 339 participants from the SWAN (Study of Women's Health Across the Nation) Heart Ancillary study (Study of Women's Health Across the Nation). Women had ≤2 carotid-femoral pulse-wave velocity (cfPWV) exams over a mean±SD of 2.3±0.5 years of follow-up. Annual percentage changes in cfPWV were estimated in 3 time segments relative to FMP and compared using piecewise linear mixed-effects models. At baseline, women were 51.1±2.8 years of age and 36% black. Annual percentage change (95% CI) in cfPWV varied by time segments: 0.9% (-0.6% to 2.3%) for >1 year before FMP, 7.5% (4.1% to 11.1%) within 1 year of FMP, and -1.0% (-2.8% to 0.8%) for >1 year after FMP. Annual percentage change in cfPWV within 1 year of FMP was significantly greater than the other 2 time segments; P<0.05 for both comparisons. Adjusting for concurrent cardiovascular disease risk factors explained part of the change estimates but did not eliminate the difference. Black women had greater increase in cfPWV compared with white women in the first segment; P for interaction, 0.04. CONCLUSIONS: The interval within 1 year of FMP is a critical period for women when vascular functional alterations occur. These findings underscore the importance of more intensive lifestyle modifications in women transitioning through menopause.
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Población Negra , Menopausia/etnología , Menopausia/fisiología , Rigidez Vascular/fisiología , Población Blanca , Enfermedades Cardiovasculares/fisiopatología , Arterias Carótidas/fisiología , Femenino , Arteria Femoral/fisiología , Humanos , Persona de Mediana Edad , Análisis de la Onda del Pulso , Factores de Riesgo , Factores de TiempoRESUMEN
OBJECTIVE: Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women. METHODS: This review summarizes the central findings of SWAN to date that can inform women and their healthcare providers about the impact of the MT and midlife aging on overall health and well-being. RESULTS: SWAN characterized changes in reproductive axis and menstrual cycle patterns that informed the development of the reproductive aging staging system Staging of Reproductive Aging Workshop+10; MT-related symptoms and mental health (vasomotor symptoms, sleep complaints, psychological symptoms, cognitive performance, and urogenital and sexual health); and physiological systems and functions (cardiovascular and cardiometabolic health, bone health, physical function performance) that are influenced by the MT. SWAN demonstrated substantial interrelations among these changes and significant racial/ethnic differences in the rate and magnitude of change in multiple health indictors in midlife women. The findings point to midlife as a critical stage for adopting healthy behavior and preventive strategies. CONCLUSIONS: Over the past 23 years, SWAN has advanced our understanding of the impact of the MT and midlife aging on health and well-being in women. SWAN will be instrumental to determine whether MT-related changes during midlife are related to unfavorable health and well-being in early old age.
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Estado de Salud , Menopausia/fisiología , Salud de la Mujer , Adulto , Anciano , Envejecimiento/fisiología , Etnicidad , Femenino , Sofocos/psicología , Humanos , Menopausia/etnología , Salud Mental , Persona de Mediana Edad , Grupos Raciales , Informe de Investigación , Salud SexualRESUMEN
RESUMEN Objetivo: Relacionar la pertenencia a la etnia Mapuche y los síntomas climatéricos de indicación de Terapia Hormonal de la Menopausia (THM), en una población del sector rural de Boyeco, región de La Araucanía. Materiales y métodos: Estudio observacional realizado en mujeres rurales en control de salud en CESFAM Boyeco entre octubre de 2016 y enero de 2017. Ninguna de las participantes evaluadas recibía THM. Para el estudio, se consideró el número de apellidos mapuches. Se utilizó el instrumento validado para población chilena, "Escala MRS" (Menopause Rating Scale), el cual permite discriminar los diferentes dominios sintomáticos del climaterio. Resultados: El grupo en estudio lo componen 36 mujeres de 41 a 78 años de edad, promedio (DE) 52,8(8,6) años, un 52,8% tiene dos apellidos mapuches y 25% uno. Un 92,8% de las mujeres mapuche tiene indicación de terapia, versus todas las no mapuche. En las menores de 50 años, todas tiene indicación de terapia, frente a un 71,4% en las mayores de 50 años. Conclusiones: Las pacientes mapuches tienen mayor sintomatología en los dominios somáticos y psicológicos, especialmente aquellas bajo 50 años. Todas las mujeres estudiadas bajo 50 años requieren terapia, sin variación estadísticamente significativa x etnicidad.
SUMMARY Objective: To stablish the relationship between belonging to Mapuche ethnic group on the climacteric symptoms for indication of menopause hormone therapy (HTM), in the rural population of Boyeco, inside of Araucania's region, Chile. Materials and methods: An observational and descriptive study, in a sample in time of 36 women belonging to the sector who attended CESFAM Boyeco, between October 2016 and January 2017. None of the evaluated participants received THM. As exposure variable, it was considered the number the mapuche surnames. We used the Menopause Rating Scale (MRS), an international instrument validated for Chilean population, to discriminate the different symptomatic domains of the climacteric period. Results: 94.7% of mapuche women and all non-mapuche population had prescribed hormonal therapy. Independent of ethnicity, those under 50 years of age, 100% have an indication for therapy compared to 71.4% in those over 50 years of age. Conclusions: Mapuche patients have greater symptomatology in the somatic-psychological domains, especially in those under 50 years of age. The totality of women under 50 requires therapy, however, variation according to ethnicity.
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Humanos , Femenino , Persona de Mediana Edad , Climaterio , Menopausia/etnología , Indígenas Sudamericanos , Terapia de Reemplazo de Hormonas , Pueblos Indígenas , Atención Primaria de Salud/estadística & datos numéricos , Psicometría/métodos , Chile/epidemiologíaAsunto(s)
Menopausia , Anciano , Costa Rica , Cultura , Femenino , Humanos , Irán , Menopausia/etnología , Persona de Mediana Edad , Puerto RicoRESUMEN
The objective of this study was to explore the beliefs and attitudes toward menopause, depressive symptoms and sexual function in both premenopausal and postmenopausal Mexican women. The Beliefs about and Attitudes toward Menopause Questionnaire, the Female Sexual Function Index and the Center for Epidemiologic Studies Depression Scale were answered by 253 women between the ages of 46 and 59 years. Negative attitudes toward menopause were associated with a more depressive symptomatology, but there was no association between positive attitudes and depressive symptomatology. Among sexually active women (92% premenopausal and 70% postmenopausal), positive attitudes were associated with better sexual function, while negative attitudes were associated with worse sexual function. Our findings suggest that besides biological factors, psychosocial factors may also play an important role in middle-aged women's sexual functioning and in their psychological adjustment.
Asunto(s)
Depresión/etnología , Conocimientos, Actitudes y Práctica en Salud/etnología , Menopausia/etnología , Conducta Sexual/etnología , Femenino , Humanos , México/etnología , Persona de Mediana EdadRESUMEN
Every woman experiences the menopause transition period in a very individual way. Menopause symptoms and management are greatly influenced by socioeconomic status in addition to genetic background and medical history. Because of their very unique cultural heritage and often holistic view of health and well-being, menopause symptoms and management might differ greatly in aboriginals compared to non-aboriginals. Our aim was to investigate the extent and scope of the current literature in describing the menopause experience of aboriginal women. Our systematic literature review included nine health-related databases using the keywords 'menopause' and 'climacteric symptoms' in combination with various keywords describing aboriginal populations. Data were collected from selected articles and descriptive analysis was applied. Twenty-eight relevant articles were included in our analysis. These articles represent data from 12 countries and aboriginal groups from at least eight distinctive geographical regions. Knowledge of menopause and symptom experience vary greatly among study groups. The average age of menopause onset appears earlier in most aboriginal groups, often attributed to malnutrition and a harsher lifestyle. This literature review highlights a need for further research of the menopause transition period among aboriginal women to fully explore understanding and treatment of menopause symptoms and ultimately advance an important dialogue about women's health care.
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Conocimientos, Actitudes y Práctica en Salud/etnología , Menopausia/etnología , Salud de la Mujer/etnología , Adulto , Australia/etnología , Bolivia/etnología , Canadá/etnología , Colombia/etnología , Femenino , Guatemala/etnología , Servicios de Salud del Indígena , Humanos , India/etnología , Malasia/etnología , México/etnología , Persona de Mediana Edad , Nueva Zelanda/etnología , Perú/etnología , Grupos de Población , Clase Social , Taiwán/etnología , Estados Unidos/etnologíaRESUMEN
OBJECTIVE: The purpose of the study was to examine the relationships between psychological and cardiovascular symptoms in a multiethnic group of midlife women while controlling for other influencing factors, and to determine the association of race/ethnicity to the relationships between psychological and cardiovascular symptoms. METHODS: This was a secondary analysis of the data among 1,054 midlife women from two Internet surveys. The instruments included the questions on background characteristics, health, and menopause status and the Midlife Women's Symptom Index. The data were analyzed using correlation analyses, chi-squared tests, analysis of variance, and multivariate linear and logistic regression analyses. RESULTS: The total numbers and total severity scores of psychological symptoms were significantly related to those of cardiovascular symptoms as a whole and in each racial/ethnic group (P < 0.01). In total participants, both the total numbers and total severity scores of psychological symptoms were significantly associated with increased risk for cardiovascular symptoms after adjusting for race/ethnicity (P < 0.01), and there were no interactions between race/ethnicity and psychological symptoms. The existence of diagnosed cardiovascular diseases was significantly associated with the total numbers of and total severity scores of psychological symptoms only in Asian women. CONCLUSIONS: Further studies on the mechanisms through which psychological symptoms are related to cardiovascular symptoms are needed while controlling for race/ethnicity.
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Enfermedades Cardiovasculares/epidemiología , Etnicidad/psicología , Menopausia/fisiología , Menopausia/psicología , Trastornos Mentales/epidemiología , Adulto , Negro o Afroamericano , Asiático , Índice de Masa Corporal , Femenino , Encuestas Epidemiológicas , Hispánicos o Latinos , Humanos , Internet , Menopausia/etnología , Persona de Mediana Edad , Factores de Riesgo , Población Blanca , Salud de la Mujer/etnologíaRESUMEN
Introducción: La menopausia es el resultado de la pérdida de la actividad folicular del ovario . En México el aumento de la esperanza de vida nos sitúa ante un nuevo perfil epidemiológico, se espera que para el año 2035, una de cada 3 mujeres estará en la etapa del climaterio o menopausia . El objetivo de esta Guía de Práctica Clínica (GPC) es establecer un referente nacional para generar intervenciones de enfermería en el cuidado de la mujer en el proceso de climaterio y menopausia. Metodología: La búsqueda sistemática de información se enfocó en documentos relacionados con el tema, intervenciones de enfermería en el climaterio y menopausia, para dar respuesta a las preguntas estructuradas, a partir de las climacteric, menopause, postmenopause, premenopause, diagnosis, etiology, metabolism, psychology, complications, therapy, drug effects. Se utilizaron los buscadores PUBMED, LILACS, CINAHL y TRIP DATABASE. Las recomendaciones se tomaron de GPC internacionales, meta-análisis, ensayos clínicos aleatorizados y estudios observaciones. La información se expresa en niveles de evidencia (E) y grado de recomendación (R) de acuerdo al características del diseño y tipo de estudio.Resultados: Esta GPC ofrece evidencia sobre las intervenciones del profesional de enfermería al cuidado de la mujer en el proceso de climaterio y menopausia, para la promoción de la salud, detección oportuna y limitación de daños y riesgos en el climaterio y menopausia. Conclusión: La aplicación de la GPC permite homogeneizar criterios en el cuidado del climaterio y la menopausia para otorgar una atención con calidad.
Introduction: Menopause is the result of loss of ovarian follicular activity. In Mexico the increase in life expectancy presents us with a new epidemiological profile, it is expected that by the year 2035, one out of every 3 women will be in menopause or climacteric. The objective of this Clinical Practice Guideline (CPG) is to establish a national benchmark to generate nursing interventions in the care of women in the process of menopause and menopause.Methodology: The systematic search for information focused on related subject, nursing interventions in climacteric and menopause, to respond to structured questions from keywords documents: climacteric, menopause, postmenopause, premenopause, diagnosis, etiology, metabolism, psychology, complications, therapy, drug effects. the PUBMED, LILACS, CINAHL and TRIP DATABASE searchers were used. The recommendations were taken from international GPC, meta-analyzes, randomized trials and observational studies. The information is expressed in levels of evidence (E) and grade of recommendation (R) according to the characteristics of the design and type of study.Results: This CPG provides evidence on interventions nurse to care for women in menopause and menopause process, for health promotion, early detection and damage limitation and risks in the climacteric and menopause. Conclusion: The application of the GPC allows homogenize criteria in the care of climacteric and menopause to provide quality care.
Introduction: La ménopause est le résultat de la perte de l'activité folliculaire ovarienne. Au Mexique, l'augmentation de l'espérance de vie nous présente un nouveau profil épidémiologique, il est prévu que d'ici l'an 2035, une personne sur 3 femmes seront en ménopause ou climatérique. L'objectif de ce guide de pratique clinique (CPG) est d'établir une référence nationale pour générer des interventions de soins infirmiers dans les soins des femmes dans le processus de la ménopause et de la ménopause.Méthodologie: La recherche systématique de l'information axée sur sujet connexe, les interventions infirmières en climatère et la ménopause, pour répondre à des questions structurées à partir des mots-clés: documents climatérique, la ménopause, la postménopause, la préménopause, le diagnostic, effets étiologie, le métabolisme, la psychologie, les complications, la thérapie, la drogue. PubMed, LILACS, CINAHL et TRIP chercheurs DATABASE ont été utilisés. Les recommandations ont été prises à partir de GPC, les méta-analyses internationales, des essais randomisés et des études d'observation. L'information est exprimée en niveaux de preuve (E) et la teneur de la recommandation (R) en fonction des caractéristiques de la conception et le type d'étude. Résultats: Ce CPG fournit la preuve sur les interventions infirmières aux soins pour les femmes en ménopause et le processus de la ménopause, pour la promotion de la santé, la détection précoce et la limitation des dommages et des risques dans la ménopause et la ménopause.Conclusion: L'application de la GPC permet d'homogénéiser les critères de la prise en charge de la ménopause et de la ménopause pour fournir des soins de qualité.
Asunto(s)
Femenino , Menopausia/etnología , Menopausia/metabolismo , Menopausia/psicología , Climaterio/inmunología , Climaterio/metabolismo , Climaterio/psicologíaRESUMEN
OBJECTIVE: The aim of this study was to determine the relationship between self-reported sleep quality, menopausal symptom intensity, and correlates (including ethnicity) among middle-aged women. METHODS: The present cross-sectional study involved 1,078 Colombian women aged 40 to 59 years who completed the Pittsburgh Sleep Quality Index (PSQI), the Menopause Rating Scale (MRS), and a general questionnaire exploring sociodemographic data. RESULTS: The median [interquartile range] age of the whole sample was 49.0 [9.0] years. Among the participants, 45.4% were postmenopausal, 57.2% had increased body mass index values, 13.9% were black, 20.7% had hypertension, 74.1% had a stable partner, and 3.8% used hormone therapy. The prevalence of poor sleep quality was 57.1% (PSQI global score ≥5). Significant correlations between PSQI global scores and MRS total and subscale scores were found. Multiple linear regression analysis found that higher PSQI scores (poorer quality of sleep) correlated with higher MRS psychological and somatic subscale scores (more severe symptoms), smoking habit, and hypertension. Menopause status and black ethnicity were excluded from the final regression model. CONCLUSIONS: Despite study limitations, poor sleep quality is highly prevalent in this large middle-aged Colombian female sample and is related to menopausal symptom severity, tobacco use, and presence of hypertension.
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Menopausia/fisiología , Sueño/fisiología , Adulto , Índice de Masa Corporal , Colombia/epidemiología , Estudios Transversales , Terapia de Reemplazo de Estrógeno/estadística & datos numéricos , Femenino , Sofocos/epidemiología , Humanos , Hipertensión/complicaciones , Modelos Lineales , Menopausia/etnología , Menopausia/psicología , Persona de Mediana Edad , Posmenopausia , Parejas Sexuales , Trastornos del Sueño-Vigilia/epidemiología , Fumar/efectos adversos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: to compare the climacteric symptoms between women from Mexico City and those from a Mayan community of the state of Yucatan. METHODS: In two groups of women, Group I) Spanish-speaking women from Mexico City and Group II) Maya speaking women from the state of Yucatan, 22 climacteric symptoms were evaluated using an analog visual scale (AVS) and the SUMEVA index. For statistical analysis t student test was used as well as Chi squared. RESULTS: 105 women, 50 of Mexico City and 55 of Maxcanu, Yucatan were studied. When comparing the groups no difference was found in age (52.5 +/- 6.5 vs 53.7 +/- 6.2, for group I and II respectively), the body mass index was significantly smaller in group I (29.7 +/- 5.0 vs 34.0 +/- 6.0, p < 0.001). In group 1, 15 of the 22 evaluated symptoms were significantly more intense in Group I, as well as the SUMEVA (Sum of Analog Visual Scale) index (71.4 +/- 44.5 vs 45.8 +/- 24.8, p < 0.001). The proportion of symptomatic women for each one of the symptoms was similar in both groups except for hair fall that was significantly greater in group I (74% vs 52%). CONCLUSION: climacteric symptoms were perceived with more intensity by Mexico City women, which allows suppose that western culture influence can be the responsible.
Asunto(s)
Etnicidad , Indígenas Norteamericanos , Menopausia/etnología , Población Urbana , Afecto , Alopecia/etnología , Altitud , Índice de Masa Corporal , Estudios Transversales , Características Culturales , Dispareunia/etnología , Dispareunia/psicología , Etnicidad/psicología , Femenino , Sofocos/etnología , Humanos , Indígenas Norteamericanos/psicología , Menopausia/psicología , Dolor/etnología , Dolor/psicología , Perimenopausia/etnología , Perimenopausia/psicología , Posmenopausia/etnología , Posmenopausia/psicología , Factores Socioeconómicos , España/etnología , Evaluación de SíntomasRESUMEN
BACKGROUND: Studies reporting on resilience (capacity to overcome life adversity) and the menopausal transition are scarce. OBJECTIVE: To assess resilience and related factors in mid-aged Ecuadorian women. METHOD: This was a cross sectional study in which 904 women aged 40-59 completed the 14-item Wagnild and Young Resilience Scale (WYRS) and a general socio-demographic questionnaire containing personal and partner data. Lower total WYRS scores indicate less resilience. Internal consistency of the tool was also assessed. RESULTS: Median age of all surveyed women was 49 years. A 51.1% were postmenopausal, 43.8% lived high altitude, 43.5% were abdominally obese, 12.6% used hormone therapy and 80.8% had a partner. Internal consistency was high for the WYRS tool (Cronbach's alpha: 0.94). Multiple linear regression analysis determined that lower total WYRS scores (less resilience) correlated with high altitude residency, more severe hot flushes, sedentarism, higher abdominal circumferences and having a partner with erectile dysfunction. Contrary to this, higher WYRS scores correlated with higher parity and sexual activity. CONCLUSION: As assessed with the WYRS tool, lower resilience of this mid-aged Ecuadorian female sample was related to various female and partner lifestyle and health issues, not necessarily related per se to the ageing process. More research using the tool is warranted.
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Menopausia/fisiología , Menopausia/psicología , Resiliencia Psicológica , Adulto , Altitud , Estudios Transversales , Recolección de Datos , Ecuador , Femenino , Terapia de Reemplazo de Hormonas , Humanos , Estilo de Vida , Menopausia/etnología , Persona de Mediana Edad , Obesidad Abdominal , Clase SocialRESUMEN
Objetivo: evaluar con la escala MRS (Menopause Rating Scale) la frecuencia y gravedad de los síntomas menopáusicos presentes en un conjunto de mujeres saludables en la edad media de la vida. Metodología: estudio transversal con aplicación de la escala MRS entre noviembre de 2006 y enero de 2009 a 1.215 mujeres saludables de 40-59 años de edad, originarias y residentes en distintas comunidades de la región Caribe colombiana. El grupo incluyó afrodescendientes, indígenas y mestizas (hispano-colombianas). Se las dividió en premenopáusicas, perimenopáusicas y postmenopáusicas. Resultados: las molestias musculares y articulares, oleadas de calor, cansancio físico y mental e irritabilidad se presentaron en más del 60% de las mujeres, pero el síntoma predominante fue diferente en cada estado menopáusico. El cansancio físico y mental predominó en la premenopausia (58,9%), las molestias musculares y articulares en la perimenopausia (78,9%) y las oleadas de calor en la postmenopausia (83,2%). Se evidenció un deterioro progresivo de la calidad de vida, en todos los ítems evaluados, al pasar del estado premenopáusico al posmenopáusico. También se halló deterioro de la calidad de vida con el paso del estado premenopáusico al perimenopáusico en todos los ítems (con excepción de los problemas vesicales); de la perimenopausia a la posmenopausia se observó deterioro a expensas de oleadas de calor, problemas sexuales y de vejiga, sequedad vaginal y molestias músculo-articulares, en tanto que los puntajes de molestias cardíacas, trastornos del sueño, estado de ánimo depresivo, irritabilidad, ansiedad, cansancio físico y mental se redujeron en la posmenopausia, aunque permanecieron por encima de los puntajes de la premenopausia. Conclusiones: Caracterizar los síntomas climatéricos y su comportamiento a lo largo de los estados menopáusicos permite establecer medidas de prevención y de intervención que mejoren la calidad de vida de la mujer en esta etapa.
Objective: To determine, by means of the MRS scale (Menopause Rating Scale), the frequency and severity of menopausal symptoms in a group of healthy middle-aged, Colombian women. Methods: A cross sectional study was carried out between November 2006 and January 2009. A survey form and the MRS were applied to 1.215 healthy women 40-59 years old, native and resident in different communities of the Colombian Caribbean coast, who were from African, indigenous or mestizo descent. According to their menopausal status they were divided into premenopausal, menopausal and postmenopausal. Results: Joint and muscular discomfort, hot flashes, physical and mental exhaustion, and irritability were present in more than 60% of the whole group. The predominant symptom, however, differed according to the menopausal status: physical and mental exhaustion in premenopausal women (58.9%), joint and muscular discomfort in the perimenopausal ones (78.9%) and hot flashes during the postmenopause (83.2%). A gradual decline in the quality of life (QOL) was evident from premenopause through perimenopause to postmenopause. Deterioration in the QOL was found from premenopause to perimenopause in all items (with the exception of bladder problems). Decline was also observed from perimenopause to postmenopause centered on hot flashes, sex and bladder problems, vaginal dryness and joint and muscular discomfort. In contrast, the scores of heart discomfort, sleep disturbances, depressed mood, irritability, anxiety and physical and mental exhaustion decreased in the postmenopause although they remained higher than those of the premenopausal women. Conclusions: Knowledge of the profile of climacteric symptoms and of their behavior through the menopausal statuses is the basis for preventive strategies and appropriate interventions that improve the quality of life of women.
Asunto(s)
Femenino , Calidad de Vida , Estrógenos/deficiencia , Menopausia , Menopausia/etnología , Perimenopausia , Posmenopausia , Premenopausia , Trastornos de la Menstruación , Pueblos IndígenasRESUMEN
BACKGROUND: Increased frequency and severity of menopausal symptoms have been associated to black race. However, this situation has not been described in any Latin American population. OBJECTIVE: Compare frequency and severity of menopausal symptoms among Afro and non-Afro Hispanic Colombian climacteric women. METHODS: In this cross-sectional study, healthy Afro and non-Afro-Colombian women aged 40-59 years were asked to fill out the Menopause Rating Scale (MRS) questionnaire in order to compare symptom frequency and intensity. RESULTS: A total of 578 women were surveyed (201 Afro-Colombian and 377 non-Afro-Colombian). Mean age of the whole sample was 47.9+/-5.9 years (median 47), with no differences among studied groups in terms of age, parity, and hormone therapy (HT) use. Intensity of menopausal symptoms, assessed with the total MRS score, was found to be significantly higher among Afro-Colombian women (10.6+/-6.7 vs. 7.5+/-5.7, p=0.0001), which was due to higher somatic and psychological subscale scores. In this group, the frequency of somatic symptoms, heart discomfort and muscle and joint problems, was found to be higher than in non-Afro-Colombian women (38.8% vs. 26.8% and 77.1% vs. 43.5%, respectively, p<0.05); equally, all items of the psychological subscale (depressive mood, irritability, anxiety and physical exhaustion) were also found to be higher among black women. On the other hand, compared to black women non-Afro-Colombian ones presented more bladder problems (24.9% vs. 14.9%, p=0.005). After adjusting for confounding factors, logistic regression analysis determined that black race increased the risk for presenting higher total MRS scorings (OR: 2.31; CI 95%: 1.55-3.45, p=0.0001). CONCLUSION: Despite the limitations of this study, as determined with the MRS Afro-Colombian women exhibited more impaired quality of life (QoL) when compared to non-Afro-Colombian ones, due to a higher rate and severity of menopausal somatic and psychological symptoms.
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Población Negra/etnología , Indicadores de Salud , Menopausia/etnología , Menopausia/fisiología , Adulto , Ansiedad/etnología , Ansiedad/fisiopatología , Ansiedad/psicología , Artralgia/etnología , Artralgia/fisiopatología , Artralgia/psicología , Colombia , Estudios Transversales , Depresión/etnología , Depresión/fisiopatología , Depresión/psicología , Fatiga/etnología , Fatiga/fisiopatología , Fatiga/psicología , Femenino , Encuestas Epidemiológicas , Humanos , Menopausia/psicología , Persona de Mediana Edad , Trastornos del Sueño-Vigilia/etnología , Trastornos del Sueño-Vigilia/fisiopatología , Trastornos del Sueño-Vigilia/psicologíaRESUMEN
The aim of this article is to shed light on the experiential and contextual sources influencing menopausal manifestations, or discomforts. To do so, I propose the concept of life's lesions, suggesting that women's experiences of physiological changes occurring during the menopausal transition may be heightened by specific aspects of their lives embedded in society and culture. The concept of life's lesions advances the notion that the lived experience tends to order a person's life and shape a person's experience of his or her body, including during menopause. Indisputably, menopausal discomforts will be due to inexorable biological changes that take place when a woman reaches a certain age, but they will also be promoted by external factors that prevail in a given society, such as economic scarcity, malnutrition and public health deficits, environmental or political upheavals, civil wars, forced migration, and racism, especially in developing nations; most important, they will be furthered by irresolvable contradictions, irreconcilable incongruities, and moral indignations in their lives that lead to anger and anguish. Rooted in the notion of life's lesions is the fundamental assumption that human beings the world over exist in a moral and ideological universe, that they engage in moral evaluations by distinguishing between right and wrong in the social environment. All these factors become part of their physiology and amplify the experience of bodily changes. By pointing to the moral domain and the existence of irresolvable conundrums in human life, which could also be felt as moral affronts and injustice, the concept of life's lesions introduces an important new dimension to our understanding of the extrasomatic causality of discomforts that may occur during the menopausal transition. Although the concept of life's lesions must be studied qualitatively, requiring us to attend to the cultural and experiential characteristics of women during the menopausal transition, the article proposes several ways of applying this concept to the study of menopause that will also generate new hypotheses, which could then be tested using quantitative methodologies.
Asunto(s)
Acontecimientos que Cambian la Vida , Menopausia/psicología , Características Culturales , Femenino , Humanos , Menopausia/etnología , México , Modelos PsicológicosRESUMEN
For several decades, hormone replacement therapies have been prescribed to women, not only to prevent disease but to improve the sexual functioning of menopausal women. The medical promotion of continued sexual activity in a woman's post-reproductive years is exported to locations outside of North America and Europe, which provides an opportunity to critically examine the cultural roots that have informed expert biomedical representations. This ethnographic study examined menopause and social class in Oaxaca de Juarez, Mexico using interviews, questionnaires, and textual analysis. The research found that biomedicine in conjunction with the pharmaceutical industry promoted culturally constructed gender hierarchies under the guise of optimal menopausal health. However, women's actual experience of gender and sexuality in mid-life diverged significantly from these expert representations. Themes that emerged in interviews and questionnaires included the importance of motherhood in old age, diminished sexual desire as not problematic, and greater sexual freedom at a post-reproductive age. Ultimately, biomedical discourse was not the sole arbiter of appropriate menopausal womanhood and femininity.
Asunto(s)
Características Culturales , Terapia de Reemplazo de Estrógeno/psicología , Heterosexualidad/etnología , Estilo de Vida/etnología , Menopausia/etnología , Salud de la Mujer/etnología , Adulto , Femenino , Heterosexualidad/psicología , Humanos , Masculino , Menopausia/psicología , México , Persona de Mediana Edad , Narración , Parejas Sexuales/psicología , Clase Social , Encuestas y Cuestionarios , Población UrbanaRESUMEN
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.
Asunto(s)
Terapia de Reemplazo de Estrógeno , Menopausia/etnología , Adulto , Factores de Edad , Altitud , Anticonceptivos Orales Combinados , Estudios Transversales , Femenino , Humanos , América Latina/epidemiología , Modelos Logísticos , Menopausia/fisiología , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , América del Sur/epidemiología , Encuestas y CuestionariosRESUMEN
The present study explored symptoms, attitudes and treatments surrounding women's health and menopause among the Q'eqchi Maya of the eastern tropical lowlands of Guatemala. Data were obtained through participant observation, semi-structured interviews, focus groups and plant walks with 50 Q'eqchi community members from the state of Izabal, Municipality of Livingston, including five midwives, five traditional male healers and eight postmenopausal women. Results indicate that the Q'eqchi Maya of Livingston possess their own cultural perceptions of women's health which affect attitudes, symptoms and treatment choices during the menopausal transition. Since discussions of menstruation and menopause are considered cultural taboos among the Q'eqchi, many women mentioned experiencing excessive preoccupation when unanticipated and unfamiliar symptoms occurred. Furthermore, many women suffered from additional hardship when their spouse misinterpreted menopausal symptoms (vaginal dryness, sexual disinterest) as infidelity. Seven of the eight postmenopausal women interviewed indicated experiencing one or more symptoms during the menopausal transition, including headaches, anxiety, muscular pain, depression, and hot flashes. These results differ from the lack of symptomatology reported in previous studies in Mexico, but are in line with the result of menopausal research conducted among other Maya groups from the highlands of Guatemala. Although the Q'eqchi did not use a specific term for "hot flash", three Q'eqchi women used the expression "baja presion" or a "lowering of blood pressure" to explain symptoms of profuse sweating followed by chills, heart palpitations, and emotional instability. The Q'eqchi Maya mentioned a number of herbal remedies to treat menopausal symptoms. Further research on these botanical treatments is needed in order to ascertain their safety and efficacy for continued use.
Asunto(s)
Actitud Frente a la Salud/etnología , Conducta de Elección , Menopausia/etnología , Cultura , Dietoterapia , Ejercicio Físico , Femenino , Fertilidad , Grupos Focales , Guatemala , Medicina de Hierbas , Humanos , Entrevistas como Asunto , Masculino , Menopausia/efectos de los fármacos , Menopausia/fisiología , Persona de Mediana Edad , ParteríaRESUMEN
BACKGROUND: The occurrence and timing of menstrual and reproductive events such as menarche, regularity of menses, births, maternal breastfeeding and menopause play an important role in a woman's life. AIM: To study the variability of reproductive live from menarche to menopause in different age groups in Chilean Caucasian and Mapuche aborigine females in a southern location of Chile. SUBJECTS AND METHODS: A questionnaire about reproductive history was answered by 502 women consulting in six general emergency rooms of different public hospitals of the 8th region of Chile, between May and September 2002. RESULTS: The median age at menarche was 12.8 years among adolescents and 13.7 years among older women (p <0.001). Fecundity rate was 5.2, 3.9 and 1.8 among older women, adults and young adults, respectively. Forty seven percent of adolescent had at least one child. The median age for natural menopause was 47 years. Eighty one percent of older women and 65% of adult women had given breastfeeding for more than six months. No statistical differences in reproductive characteristics were observed between Chilean Caucasians and Mapuche aborigines. CONCLUSIONS: Among these women, the age of menarche in younger women is similar to that of women from industrialized countries. Fecundity has been progressively decreasing. Menopause tends to occur sooner than in other geographical regions, probably due to the high number of surgical sterilizations in our population. Adolescent pregnancy still is a problem.
Asunto(s)
Menarquia/etnología , Menopausia/etnología , Historia Reproductiva , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Chile , Escolaridad , Servicio de Urgencia en Hospital , Femenino , Humanos , Indígenas Sudamericanos/estadística & datos numéricos , Persona de Mediana Edad , Embarazo , Encuestas y CuestionariosRESUMEN
Background: The occurrence and timing of menstrual and reproductive events such as menarche, regularity of menses, births, maternal breastfeeding and menopause play an important role in a woman's life. Aim: To study the variability of reproductive live from menarche to menopause in different age groups in Chilean Caucasian and Mapuche aborigine females in a southern location of Chile. Subjects and Methods: A questionnaire about reproductive history was answered by 502 women consulting in six general emergency rooms of different public hospitals of the 8th region of Chile, between May and September 2002. Results: The median age at menarche was 12.8 years among adolescents and 13.7 years among older women (p <0.001). Fecundity rate was 5.2, 3.9 and 1.8 among older women, adults and young adults, respectively. Forty seven percent of adolescent had at least one child. The median age for natural menopause was 47 years. Eighty one percent of older women and 65% of adult women had given breastfeeding for more than six months. No statistical differences in reproductive characteristics were observed between Chilean Caucasians and Mapuche aborigines. Conclusions: Among these women, the age of menarche in younger women is similar to that of women from industrialized countries. Fecundity has been progressively decreasing. Menopause tends to occur sooner than in other geographical regions, probably due to the high number of surgical sterilizations in our population. Adolescent pregnancy still is a problem.
Asunto(s)
Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Menarquia/etnología , Menopausia/etnología , Historia Reproductiva , Chile , Escolaridad , Servicio de Urgencia en Hospital , Indígenas Sudamericanos/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
BACKGROUND: Although it is well accepted that socio-cultural influences may affect the onset of menopause and the symptoms experienced, there are scant data related to native indigenous populations. OBJECTIVE: Our purpose was to study in a native population of South America (The Movima, Bolivia) the menopausal transition. SUBJECTS AND METHODS: In this cross-sectional survey a total of 125 Movima women between 35 and 54 years old was included. All of them answered a questionnaire and a face-to-face interview focused on the menopausal experiences of middle-aged Movima women and additionally, history and physical examination, demographic and socio-economic information were obtained. RESULTS: The onset of natural menopause in the Movima was at 42.3+/-6.17 years. Loss of libido was the main complaint of the menopause, occurring in a 51% of interviewed women, hot flushes in a 45%, genital itching in a 40.8% and dyspareunia in a 40% were also frequently reported. CONCLUSION: This is the first data recorded on menopausal transition of the Movima natives. The age of menopause and the symptoms experienced are different to those from women of developed countries. Data related to minority groups are important to adapt the health system to their particular requirements.