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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.,Instituto Para La Salud Of La Mujer | Baron G.,Collaborative Group for Research of the Climacteric in Latin America REDLINC | And 21 more authors.
Menopause | Year: 2011

Objective: The aim of this study was to determine vasomotor symptom (VMS) prevalence, duration, and impact on quality of life in middle-aged women using a validated menopausal tool. Methods: The Menopause Rating Scale (MRS) and an itemized questionnaire containing personal sociodemographic data were used to examine 8,373 women aged 40 to 59 years from 22 healthcare centers in 12 Latin American countries. Results: Less than half (48.8%) of all women studied were postmenopausal, 14.7% used hormone therapy (HT), 54.5% presented VMS of any degree, and 9.6% presented severe/bothersome symptoms. The rate of VMS (any degree) significantly increased from one menopausal stage to the next. HT users presented more VMS (any degree) than did nonusers (58.6% vs 53.8%, P = 0.001). When surgical postmenopausal women were compared, non-HT users displayed a higher prevalence of severe VMS (16.1% vs 9.0%, P = 0.0001). The presence of VMS of any degree was related to a more impaired quality of life (higher total MRS score; odds ratio, 4.7; 95% CI, 4.1-5.3). This effect was even higher among women presenting severe VMS. Logistic regression analysis determined that the presence of severe psychological/urogenital symptoms (MRS), lower educational level, natural perimenopause-postmenopause status, nulliparity, surgical menopause, and living at high altitude were significant risk factors for severe VMS. HT use was related to a lower risk. A second regression model determined that surgical menopause, intense psychological/urogenital symptoms, and a history of psychiatric consultation were factors related to severe VMS persisting into the late postmenopausal stage (5 or more years). Conclusions: In this Latin American middle-aged series, VMS prevalence was high, persisting into the late postmenopausal phase in a high rate and severely impairing quality of life. HT use was related to a lower risk of severe VMS. © 2011 by The North American Menopause Society.

Tserotas K.,Complejo Hospitalario Dr. Arnulfo Arias Madrid | Hernandez L.,Gyneco Endocrinologist | Morera F.,University of Costa Rica | Pineda R.,Public Knowledge | Chedraui P.,Instituto Para La Salud Of La Mujer
Gynecological Endocrinology | Year: 2011

Background. Data on social and personal aspects of Central America are lacking in relation to hormone therapy (HT) and other treatments for the menopause. Objective. To gain information regarding the treatment of the menopause (HT/alternative): use, knowledge, perceptions and attitudes among middle-aged Central American women. Methods. A total of 720 urban living women (35-65 years) from six Central American countries (Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica and Panama) were surveyed with a structured questionnaire that included socio-demographic data and information regarding the menopause and its treatment. Results. Participating countries displayed significant socio-demographic differences. Forty-one percent of all women were postmenopausal and 5.8% had no education at all. Knowledge regarding menopausal treatment options varied; while 27.2% (196/720) indicated HT as an option a higher rate (36.3%) either did not respond or answered not knowing anything. HT use for the whole sample was rather low 2.7% with differences seen among countries. 13.8% (27/196) indicated to have been on HT but abandoned treatment because of medical indication (51.9%), undesired side effects (29.6%) and costs (11.1%). While more than 50% considered HT served to replace hormones a smaller percentage (<14%) referred HT as bad for health, reduces cancer risk or has many side effects. 9.3% (67/720) acknowledged the existence of phytoestrogens as a menopausal treatment option, considering them as natural estrogens and good for health in 38.8% and 25.4%, respectively. Conclusions. HT use in this mid-aged series was rather low in which the demography of Central America may be related factors. Education to women and physicians should be encouraged. © 2011 Informa UK, Ltd.

Chedraui P.,Instituto Para La Salud Of La Mujer | Perez-Lopez F.R.,University of Zaragoza | Mezones-Holguin E.,Peruvian University of Applied Sciences | San Miguel G.,Catholic University of Santiago de Guayaquil | Avila C.,Catholic University of Santiago de Guayaquil
Maturitas | Year: 2011

Objective: To assess predictors of sexual function in mid-aged women. Methods: We analyzed data of 262 healthy sexually active women (40-59 years) who filled out the Female Sexual Functioning Index (FSFI), the Menopause Rating Scale (MRS) and a general questionnaire containing female/partner data. Correlations between these two measures were also analyzed. Results: Significant inverse correlations were found between all FSFI and MRS scores. This was most evident for the MRS urogenital score in relation to FSFI total, pain and lubrication scores. Multiple linear regression analysis determined best model predicting total FSFI index scores that explained a 66% of the variance. In this model, MRS urogenital score was an important predictor of female sexual function (total FSFI scores) with a significant inverse relation. Additionally total FSFI scores displayed a significant positive correlation with female educational level and HT use and an inverse relation with partner age and female parity. Conclusion: Several female/partner factors predicted female sexual function in this mid-aged series. MRS urogenital scores significantly correlated with total FSFI scores. © 2010 Elsevier Ireland Ltd. All rights reserved.

Chedraui P.,Instituto Para La Salud Of La Mujer | Chedraui P.,Catholic University of Santiago de Guayaquil | San Miguel G.,Instituto Para La Salud Of La Mujer | Schwager G.,Instituto Para La Salud Of La Mujer
Gynecological Endocrinology | Year: 2011

Background. Risk-benefit issues raised after the WHI have significantly increased the use of alternative treatments for the menopause. Despite this, data regarding the effect of soy isoflavones over mood and menopausal symptoms in high risk populations is still lacking. Objective. To evaluate the effect of soy derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index (BMI). Methods. Fifty symptomatic climacteric women aged 40 to 59 with increased BMI (≥25) were recruited to receive oral 100 mg/day of soy derived isoflavones (Climasoy®) for 3 months. Hot flushes (frequency/intensity), menopausal symptoms (Menopause Rating Scale [MRS]) and mood (Hamilton Depressive Rating Scale [HDRS]) were evaluated at baseline and at 90 days. Results. A total of 45 women completed the study. After 3 months of soy isoflavone supplementation hot flushes significantly decreased in percentage, number and severity (100% to 31.1%; 3.9 ± 2.3 to 0.4 ± 0.8 and 2.6 ± 0.9 to 0.4 ± 0.8, respectively, p < 0.001). MRS scores (total and for subscales) reflecting general menopausal symptoms also significantly decreased compared to baseline. Regarding mood, after three months total HDRS scores and the rate of women presenting depressed mood (scores ≥ 8) significantly decreased (16.3 ± 5.4 to 6.9 ± 5.2 and 93.3% to 28.9%, respectively, p < 0.05). There was no effect on blood pressure levels or BMI values after treatment. Conclusion. In this high risk climacteric population, soy derived isoflavone treatment improved mood as well as vasomotor and general menopausal symptoms. More research is required to determine if the positive effect over mood is a direct or an indirect one through hot flush alleviation. © 2011 Informa UK, Ltd.

Lipovac M.,Gynecology General Teaching Hospital Korneuburg | Chedraui P.,Instituto Para La Salud Of La Mujer | Gruenhut C.,Study Center Med | Gocan A.,Study Center Med | And 2 more authors.
Maturitas | Year: 2010

Objective: To evaluate the effect of isoflavones derived from red clover extracts (MF11RCE) over anxiety and depressive symptoms among postmenopausal women. Methods: One hundred and nine postmenopausal women aged 40 or more were randomly assigned to receive two daily capsules of MF11RCE (80 mg red clover isoflavones, Group A) or placebo of equal appearance (Group B) for a 90-day period. After a washout period of 7 days, medication was crossed over and taken for 90 days more. Anxiety and depressive symptoms were measured at baseline, 90 and 187 days with the Hospital Anxiety and Depression Scale (HADS) and Zung's Self Rating Depression Scale (SDS). Results: After receiving the MF11RCE compound the total HADS (anxiety and depression subscale scores also) and the total SDS scores decreased significantly. This effect was equivalent to a 76.9% reduction in the total HADS score (76% for anxiety and 78.3% for depression) and an 80.6% reduction in the total SDS score. After placebo, total HADS (anxiety and depression subscale also) and total SDS scores also decreased significantly in comparison to baseline but only equivalent to an average 21.7% decline. Conclusion: Red clover derived isoflavones (MF11RCE) were effective in reducing depressive and anxiety symptoms among postmenopausal women. © 2009 Elsevier Ireland Ltd. All rights reserved.

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