Resilience and related factors during female Ecuadorian mid-life.

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.

Assessment of sexual function of mid-aged Ecuadorian women with the 6-item Female Sexual Function Index.

BACKGROUND: Assessing sexuality is a difficult task, hence used tools should be straight forward and easy to use. OBJECTIVE: To assess sexual function in mid-aged Ecuadorian women. METHOD: In this cross sectional study, 904 otherwise healthy women 40-59 years completed the short 6-item Female Sexual Function Index (FSFI-6) and a general socio-demographic questionnaire containing personal/partner data. Internal consistency of the tool was also assessed. RESULTS: Median age of the whole sample was 49 years, 51.1% were postmenopausal, 43.8% lived at high altitude, 12.6% used hormone therapy (HT), 58.5% presented hot flushes, 43.5% were abdominally obese and 80.8% had a partner. Overall, 72.4% of surveyed women reported sexual activity (n=655/904) with 65% of these presenting total FSFI-6 scores equal or below 20 the calculated median (lower sexual function). A 10.2% of those having a partner were sexually inactive. Internal consistency of tool was high (Cronbach's alpha=0.91). Total FSFI-6 scores positively correlated with coital frequency and female and partner educational level and inversely with female age, waist circumference, hot flush intensity and partner age (bivariate analysis). Multiple linear regression analysis determined that lower scores (lower sexual function) were related to high altitude, history of sexual abuse, sedentarism, hot flush intensity, partner age and sexual dysfunction whereas partner educational level, coital frequency and female parity were significantly related to higher scores (better sexual function). CONCLUSION: As assessed with a consistent, short, and easy to use tool lower sexual function of this mid-aged series was related to several female and partner factors. More research with this tool is warranted.

Resultados de una encuesta epidemiológica de hábitos de higiene íntima en mujeres latinoamericanas / Resultof of an epidemiological survery about hygiene habits in latin american women

Describir los hábitos higiénicos íntimos femeninos de algunas mujeres de Latinoamérica durante 2008. Se aplicó una encuesta piloto, previamente diseñada, a un total de mil mujeres que acudieron a la consulta de un grupo de ginecólogos de Latinoamérica durante 2008 y aceptaron contestar voluntariamente la encuesta. Los países participantes fueron: Colombia, Costa Rica, Ecuador, Guatemala, Honduras, México, Panamá, Perú, República Dominicana y Venezuela. El 95,4 por ciento de las mujeres refirió realizar aseo corporal una o más veces al día y 2,8 por ciento, una o dos veces por semana. El 71 por ciento realiza aseo del área genital de adelante hacia atrás (de vulva a ano). El tipo de jabón más comúnmente usado es el jabón en barra, seguido de la presentación líquida. Se evidenció un porcentaje de 66,9 por ciento de mujeres que depilan su área genital. El área circunscrita al bikini es la más depilada con 32,8 por ciento y la depilación del área genital en su totalidad es de 28,8 por ciento. El material de la ropa interior en la región vulvar más utilizado por las mujeres latinoamericanas encuestadas es el algodón (65,5 por ciento), que sumado a 20,2 por ciento de las mujeres que utilizan ropa interior de cualquier material con algodón fue cercano al 86 por ciento. En relación con el uso de elementos de aseo genital durante las relaciones sexuales, 29,7 por ciento de las mujeres encuestadas refiere utilizar duchas vaginales; de las cuales 42 por ciento refirió su uso siempre que tiene relaciones sexuales y 43 por ciento, ocasionalmente. A la costumbre de orinar antes y después de tener relaciones sexuales se encontró que 37,9 por ciento de las mujeres orina después del coito; 17 por ciento, antes y 11,8 por ciento orina antes y después. Las mujeres realizan en un gran porcentaje lavado de manos después de orinar o defecar, pero el hábito de lavarse las manos antes, sigue siendo bajo. En cuanto a la técnica de aseo genital, el porcentaje de técnica inadecuada...

To describe the intimate hygienic feminine habits of some women of Latin-America during 2008. A previously designed pilot survey was applied to a total of one thousand women who assisted to the office of a group of gynecologists of Latin America during 2008 and agreed to voluntarily answer the survey. The participant countries were: Colombia, Costa Rica, Ecuador, Guatemala, Honduras, Mexico, Panama, Peru, Dominican Republic and Venezuela.95.4 percent of these women practiced corporal hygiene at least once daily and 2.8 percent, once or twice a week. 71 percent cleaned their genital area backwards (from vulva to anus). The type of soap most commonly used is the bar soap followed by liquid body wash. Evidence showed that 66.9 percent of women depilate their genital area. The bikini surrounding area is the most depilated one, with a 32.8 percent and the total depilation of the genital area is 28.8 percent. Cotton is the most commonly used material for underwear on the vulvar area by surveyed Latin American women (65.5 percent), which added to a 20.2 percent of women who use underwear of any material with cotton was nearly 86 percent. When the use of genital hygiene devices during sexual intercourse is questioned, 29.7 percent of the surveyed women opted to use vaginal showers; of which 42 percent used it every time they had sexual intercourse and 43 percent just occasionally. In relation to the habit of urinating before and after having sexual intercourse it was established that 37.9 percent of women urinate after the coitus; 17 percent before it, and 11.8 percent urinates before and after. Women, in a great percentage, wash their hands after urinating or defecating, but the habit of washing their hands before is still not as frequent. Regarding the genital (feminine) hygiene technique, the percentage of "inadequate" hygiene technique is surprisingly as low as about 28 percent. With this in mind, it is fundamental to reinforce training, improve information...

Perceived control over menopausal hot flushes in mid-aged women.

BACKGROUND: Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Perceived control of this complaint may vary from one population to another. OBJECTIVE: To assess perceived control over menopausal HFs and determinant factors among mid-aged Ecuadorian women. METHODS: In this cross-sectional study healthy women aged 40-59 years, seeking healthcare centres of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the Menopause Rating Scale (MRS) and those presenting HFs were requested to fill out the Perceived Control Index (PCI) and a questionnaire containing socio-demographic data (female and partner). RESULTS: A total of 1154 women participated in this study of which 56% presented HFs (n = 646). According to the MRS, 29.1% and 9.1% of these HFs were graded as severe and very severe, respectively. Mean age of women presenting HFs was 49.5 +/- 5.2 years, with 51.9% having 12 years or less of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on hormone therapy, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. There was a significant decreasing trend for PCI scores (total and difficulty in control items) from one menopausal stage to the next, with no differences observed for time since menopause onset. Despite this, logistic regression analysis determined that HF severity, as determined with the MRS, was the only single predictive factor related to lower HF perceived control (total PCI score <38) (OR: 1.83 CI 95% [1.15-2.90], p < 0.01). CONCLUSION: As determined with the PCI, HF severity was related to a lower perceived control among mid-aged women.

Beliefs regarding menopausal hot flushes among climacteric women as assessed with the Hot Flush Beliefs Scale.

BACKGROUND: Hot flushes (HFs) and night sweats are frequent complaints among both peri- and postmenopausal women. Beliefs regarding these complaints may vary from one population to another. OBJECTIVE: To assess HF beliefs and factors related to negative beliefs in a climacteric Hispanic population using the Hot Flush Beliefs Scale (HFBS). METHODS: A total of 1154 healthy women (40-59 years) were assessed with the Menopause Rating Scale (MRS), those presenting HFs were requested to fill out the HFBS and a questionnaire containing socio-demographic data (female and partner). RESULTS: A total of 646 presented HFs (56%) graded according to the first item of the MRS as mild (28.6%), moderate (33.2%), severe (29.1%) and very severe (9.1%). Mean age of these women was 49.5+/-5.2 years, with 51.9% having 12 or less years of education, 61.5% being postmenopausal and 47.2% living in high altitude. At the moment of the survey 13.9% were on HT, 12.8% on phytoestrogens and 7.1% on psychotropic drugs. Women strongly disagreed in more negatively oriented items of those contained in subscale one (beliefs about self in social context). Contrary to this, women strongly agreed in more negative oriented items contained in subscale two which assesses beliefs about coping with HFs. Women presenting with severe-very severe HFs displayed higher HFBS total and subscale scores indicating a more negative belief regarding HFs. Logistic regression analysis determined that HF severity was related to higher HFBS scores for the total and subscales one and two. Current smoking, higher parity, lower female education, female psychiatric consultation, time since menopause and partner unhealthiness and alcohol consumption were also related to higher HFBS scorings. Postmenopausal status and church attendance were related to lower scores. CONCLUSION: In this mid-aged Ecuadorian female series negative beliefs regarding HFs were related to the severity of HFs and individual female or partner characteristics. Data provided from clinical research using this tool, alone or in combination with other tests, is warranted.

Gabapentin vs. low-dose transdermal estradiol for treating post-menopausal women with moderate to very severe hot flushes.

BACKGROUND: Gabapentin (GPT), a widely used drug in neurology, has been proposed as a non-hormonal option for the management of hot flushes in menopausal women with contraindications for estrogen therapy. OBJECTIVE: To compare GPT versus low-dose transdermal estradiol (E(2)) for treating post-menopausal women with moderate to very severe hot flushes. METHODS: A total of 45 post-menopausal women with moderate to very severe hot flushes were prospectively and single-blinded randomised to receive oral GPT 600 mg/night or transdermal 25 microg/day E(2) per week. Hot flush intensity and frequency were assessed with the Menopause Rating Scale and a numeric scale respectively at baseline and at 1, 4 and 8 weeks. Side effects were also assessed. RESULTS: Hot flush intensity and frequency significantly decreased for both groups at 1, 4 and 8 weeks of treatment as compared to baseline; however, this decrease was statistically more evident for the E(2) group. Although the percentage of hot flush intensity and frequency reduction at the end of the treatment was higher for E2, this was not statistically significant (68.2% vs. 60.6% for intensity and 70.1% vs. 58.9% for frequency, respectively, p > 0.05, NS). Encountered side effects included: drowsiness, dizziness, fatigue (GPT group) and mastodynia, vaginal spotting and a local allergic reaction (E(2) group). Compliance to treatment was 95.6% (GPT group) as compared to 90.9% for the E(2) group. CONCLUSION: Despite statistical significant differences, from a clinical point of view oral GPT 600 mg was as effective as low-dose transdermal E(2) in controlling moderate to severe hot flushes in post-menopausal women, and should be recommended as an alternative option in those with contraindications to estrogen therapy. More research is warranted in this regard.

Risk factors related to the presence and severity of hot flushes in mid-aged Ecuadorian women.

BACKGROUND: Several studies drawn from the Ecuadorian population have previously reported that more than half of mid-aged women present hot flushes, which can impair their quality of life. However up-to-date risk factors for their presence and severity have not been assessed. OBJECTIVE: To assess hot flush frequency and intensity and related risk factors among middle-aged Ecuadorian women. METHODS: In this cross-sectional study, 1154 healthy women aged 40-59 years, visiting healthcare centers of eight main cities of Ecuador with more than 100,000 inhabitants, were assessed with the first item of the Menopause Rating Scale (MRS) and a questionnaire containing female and partner socio-demographic data. RESULTS: Mean age of the entire sample was 48.8+/-5.6 years (median 48), a 48.7% had 12 or less years of schooling, 52.8% were postmenopausal, 43.6% lived at high altitude, 56.8% were married and 10% were on hormonal therapy (HT). Hot flushes accounted for 56% (n=646) of the whole sample, of which 29.1% and 9.1% were respectively graded as severe and very severe. Logistic regression determined that female sedentarism (OR: 2.42, CI 95% [1.63-3.59]), accessing a free healthcare system (OR: 1.96, CI 95% [1.30-2.96]), living at high altitude (OR: 1.82, CI 95% [1.14-2.90]) and having a partner abusing alcohol (OR: 1.92, CI 95% [1.09-3.35]) were significant risk factors related to the presence of hot flushes. The regression model also determined that among women with hot flushes (n=646), sedentarism (OR: 1.73, CI 95% [1.14-2.62]) and having a partner with erectile dysfunction (OR: 2.57, CI 95% [1.44-4.59]) were significant risk factors related to severe/very severe hot flushes whereas married status (OR: 0.53, CI 95% [0.32-0.86]), living at high altitude (OR: 0.46, CI 95% [0.26-0.78]) and partner healthiness (OR: 0.59, CI 95% [0.36-0.95]) were not. CONCLUSION: To the best of our knowledge this is the first and largest study assessing hot flushes in a mid-aged Ecuadorian population. We found that the presence and severity were not significantly related to age and hormonal status yet to other individual female/male characteristics and the demography of the studied population.

Assessing menopausal symptoms among healthy middle aged women with the Menopause Rating Scale.

BACKGROUND: The frequency and intensity of menopausal symptoms within a given population, as assessed by several tools, vary and depend on several factors among them age, menopausal status, chronic conditions and socio-demographic profile. OBJECTIVE: Determine the frequency and intensity of menopausal symptoms as well as associated risk factors among healthy middle aged Ecuadorian women. DESIGN: In this cross-sectional study healthy women aged 40 or more, with intact uterus and ovaries, working at the Luis Vernaza Hospital, Guayaquil, Ecuador, were asked to fill out the Menopause Rating Scale (MRS) questionnaire. Symptom frequency and intensity, as well as obtained scores, were assessed and correlated to demographic data. RESULTS: During the study period, 300 subjects were surveyed. Mean age was 45.1+/-3.1 years (median 45). According to menopausal status women were premenopausal (40.6%); perimenopausal (48%) and postmenopausal (11.4%). A 62% of women were not sexually active and 8.3% had less than 12 years of schooling. The 5 most frequent symptoms of the 11 composing the MRS (n=300) were: muscle and joint problems (77%), depressive mood (74.6%), sexual problems (69.6%), hot flushes (65.5%) and sleeping disorders (45.6%). In general, peri- and postmenopausal women significantly presented higher rates of menopausal symptoms when compared to premenopausal women. Total and subscale MRS scores significantly increased in relation to age and the menopausal stage. Women with lower educational level presented higher somatic and psychological scorings in comparison to their counterparts. Sexually inactive women presented higher total as well as somatic, psychological and urogenital scorings. Logistic regression analysis confirmed significant associations found during univariate analysis. CONCLUSION: In this specific healthy population, age, the menopause, sexual inactivity and educational level were independent risk factors predicting more severe menopausal symptoms.