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Ojeda E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Monterrosa A.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Blumel J.E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Escobar-Lopez J.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Chedraui P.,Collaborative Group for Research of the Climacteric in Latin America REDLINC
Climacteric | Year: 2011

Background Latin American women present more severe menopausal symptoms when compared to those from other regions of the world. Since this population is an ethnic blend of Caucasian and indigenous people, we sought to test the hypothesis that severe menopausal symptoms in Latin American women are associated with an indigenous origin. Objective To assess menopausal symptoms among two specific indigenous Latin American populations. Method A total of 573 natural postmenopausal indigenous women aged 45-59 years (288 Quechua (Peru) and 285 Zenú (Colombia)) living in isolated communities were surveyed with a general questionnaire and the Menopause Rating Scale (MRS). Results The total MRS score was significantly higher among Quechua women as compared to Zenú ones (22.7±5.7 vs. 14.7±2.5, p<0.0001); both figures were higher than those described for Hispanic or European populations. Quechua women presented more intense somatic and psychological symptoms as compared to Zenú (8.8±2.3 vs. 5.3±1.8; and 7.8±2.4 vs. 3.2±1.7, p<0.0001); however, both indigenous groups presented similar intense urogenital symptoms (6.1±1.6 vs. 6.2±1.4, not significant). These differences persisted after adjusting for age, years since menopause onset and parity. The percentage of women presenting severe somatic and psychological symptoms significantly increased with aging among Quechua. This was not the case for Zenú women. More than 90% of indigenous women (Quechua and Zenú) at all age intervals presented severe urogenital scores, a percentage that is much higher than that described in the world literature. Conclusion Severe menopausal symptoms found among Latin American women could be the result of their indigenous ethnic origin; the urogenital domain is the most affected. © 2011 International Menopause Society. Source


Blumel J.E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Chedraui P.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Chedraui P.,Catholic University of Santiago de Guayaquil | Baron G.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | And 21 more authors.
Maturitas | Year: 2013

Background: Muscle and joint aches (MJA) are frequently observed among menopausal women. They impair quality of life and are a burden to the healthcare system. Objective: To analyze the relation between MJA and several variables related to the menopause. Methods: In this cross-sectional study, 8373 healthy women aged 40-59 years, accompanying patients to healthcare centers in 18 cities of 12 Latin American countries, were asked to fill out the Menopause Rating Scale (MRS) and a questionnaire containing personal data. Results: Mean age of the whole sample was 49.1 ± 5.7 years, 48.6% were postmenopausal and 14.7% used hormone therapy (HT). A 63.0% of them presented MJA, with a 15.6% being scored as severe to very severe according to the MRS (scores 3 or 4). Logistic regression model determined that vasomotor symptoms (OR: 6.16; 95% CI, 5.25-7.24), premature menopause (OR: 1.58; 95% CI, 1.02-2.45), postmenopausal status (OR: 1.43; 95% CI, 1.20-1.69), psychiatric consultation (OR: 1.93; 95% CI, 1.60-2.32) and the use of psychotropic drugs (OR: 1.35; 95% CI, 1.08-1.69) were significantly related to the presence of severe-very severe MJA. Other significant variables included: age, tobacco consumption and lower education. Self perception of healthiness (OR: 0.49; 95% CI, 0.41-0.59), private healthcare access (OR: 0.77; 95% CI, 0.67-0.88) and HT use (OR: 0.75; 95% CI, 0.62-0.91) were significantly related to a lower risk for the presence of severe-very severe MJA. Conclusion: In this large mid-aged sample the prevalence of MJA was high, which was significantly associated to menopausal variables, especially vasomotor symptoms. This association may suggest a potential role of mid-life female hormonal changes in the pathogenesis of MJA. © 2013 Elsevier Ireland Ltd. Source


Danckers L.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Blumel J.E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Blumel J.E.,University of Chile | Witis S.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | And 28 more authors.
Maturitas | Year: 2016

Background Previously, the REDLINC VI study showed that the main reason for the low use of menopausal hormone therapy (MHT) was its low rate of prescription by doctors. Objective To determine the use of MHT and perceived related risks among gynecologists. Methods A self-administered and anonymous questionnaire was delivered to certified gynecologists in 11 Latin American countries. Results A total of 2154 gynecologists were contacted, of whom 85.3% responded to the survey (n = 1837). Mean age was 48.1 ± 11.4 years; 55.5% were male, 20.3% were faculty members and 85% had a partner. Overall, 85.4% of gynecologists responded that they would use MHT if they had menopausal symptoms (81.8% in the case of female gynecologists) or prescribe it to their partner (88.2% in the case of male gynecologists; p < 0.001). Perceived risk related to MHT use (on a scale from 0 to 10) was higher among female than among male gynecologists (4.06 ± 2.09 vs. 3.83 ± 2.11, p < 0.02). The top two perceived reported risks were thromboembolism (women 33.6% vs. men 41.4%, p < 0.009) and breast cancer (women 38.5% vs. men 33.9%, p < 0.03). Overall, gynecologists reported prescribing MHT to 48.9% of their symptomatic patients (women 47.3% vs. men 50.2%, p < 0.03) and 86.8% currently prescribed non-hormonal remedies and 83.8% alternative therapies for the management of the menopause. Gynecologists who were older and academic professionals prescribed MHT more often. Conclusion Although this Latin American survey showed that gynecologists are mostly supporters of MHT use (for themselves or their partners), this is not necessarily reflected in their clinical practice. © 2016 Elsevier Ireland Ltd. All rights reserved. Source


Blumel J.E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Cano A.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Mezones-Holguin E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Baron G.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | And 22 more authors.
Maturitas | Year: 2012

Background: Although sleep disturbances are common during female mid-life, few studies have described in detail the prevalence of this problem and related risk factors. Objective: To determine the prevalence of sleep disturbances in mid-aged women using validated tools. Assessment of determinants capable of influencing the prevalence of insomnia and poor sleep quality was also performed. Methods: A total of 6079 women aged 40-59 of 11 Latin American countries were invited to fill out the Athens Insomnia Scale (AIS), the Pittsburgh Sleep Quality Index (PSQI), the Goldberg Anxiety and Depression Scale, the Menopause Rating Scale (MRS), the Brief Scale of Abnormal Drinking and a general socio-demographic questionnaire. Results: Overall, 56.6% of surveyed women suffered of either insomnia, poor sleep quality, or both. Specifically, 43.6% and 46.2% presented insomnia and poor sleep quality in accordance to the AIS and the PSQI respectively. The prevalence of insomnia increased with female age (from 39.7% in those aged 40-44 to 45.2% in those aged 55-59, p < 0.0001) and menopausal stage (from 39.5% in premenopausal aged 40-44 to 46.3% in late postmenopausal ones, p < 0.0001). "Awakening during the night" (AIS: Item 2) was the most highly rated of all items and contributing in a higher degree (mean 16%) to the total score of the scale in all menopausal phases. Sleep quality also worsened with age and menopausal status, impairment particularly affecting sleep efficiency and latency and the increased use of hypnotics. Vasomotor symptoms (VMS), depressive mood and anxiety were associated to sleep disturbances. Women presenting sleep disturbances displayed a 2-fold increase in the severity of menopausal symptoms (higher total MRS scores) which was translated into a 6-8 times higher risk of impaired quality of life. Logistic regression analysis determined that female age, the presence of chronic disease, troublesome drinking, anxiety, depression, VMS, drug use (hypnotics and hormone therapy) were significant risk factors related to the presence of sleep disturbances. Higher educational level related to less insomnia and better sleep quality. Conclusion: Insomnia and poor sleep quality were highly prevalent in this mid-aged female sample in which the influence of age and the menopause was only modest and rather linked to menopausal symptoms already occurring since the premenopause. © 2012 Elsevier Ireland Ltd. All rights reserved. Source


Vallejo M.S.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Witis S.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Ojeda E.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | Mostajo D.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | And 26 more authors.
Climacteric | Year: 2016

Abstract: Objective: To evaluate whether menopausal status and symptoms among female gynecologists would influence their clinical behavior related to menopausal hormone therapy (MHT). Methods: Female gynecologists of 11 Latin American countries were requested to fill out the Menopause Rating Scale and a questionnaire containing personal information and that related to MHT use. Results: A total of 818 gynecologists accepted to participate (86.4%). Overall, the mean age was 45.0 ± 10.7 years, 32.2% were postmenopausal, and 17.6% worked in an academic position; 81.8% reported that they would use MHT if they have symptoms, regardless of menopausal status. Academic gynecologists favor personal MHT use at a higher rate (p = 0.04) and have a higher MHT prescription rate as compared to non-academic ones (p = 0.0001). The same trend was observed among post- as compared to premenopausal ones (p = 0.01) and among those who had hysterectomy alone as compared to those experiencing natural menopause (p = 0.002). The presence of menopausal symptoms did not influence their MHT prescription. Current use of MHT and alternative therapy was higher among post- than premenopausal gynecologists (both, p = 0.0001) and among those who had undergone hysterectomy than those experiencing natural menopause. A 38.5% perceived breast cancer as the main risk related to MHT, and a high proportion prescribed non-hormonal drugs (86.4%) or alternative therapies (84.5%). Conclusion: Most female gynecologists in this survey would use MHT if menopausal symptoms were present. Postmenopausal physicians use MHT and prescribe it to their symptomatic patients at a higher rate than premenopausal physicians. © 2016 International Menopause Society. Source

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