ABSTRACT
BACKGROUND: Menopausal hormone therapy (HT) has shown benefits for women; however, associated drawbacks (i.e. risks, costs, fears) have currently determined its low use. OBJECTIVE: To determine the prevalence of current HT use among mid-aged women and describe the characteristics of those who have never used, have abandoned or are currently using HT. In addition, reasons for not using HT were analyzed. METHOD: This was a cross-sectional study that analyzed a total of 6731 otherwise healthy women (45-59 years old) of 15 cities in 11 Latin American countries. Participants were requested to fill out the Menopause Rating Scale (MRS) and a questionnaire containing sociodemographic data and items regarding the menopause and HT use. RESULTS: The prevalence of current HT use was 12.5%. Oral HT (43.7%) was the most frequently used type of HT, followed by transdermal types (17.7%). The main factors related to the current use of HT included: positive perceptions regarding HT (odds ratio (OR) 11.53, 95% confidence interval (CI) 9.41-14.13), being postmenopausal (OR 3.47, 95% CI 2.75-4.36) and having a better socioeconomic level. A total of 48.8% of surveyed women had used HT in the past, but abandoned it due to symptom improvement or being unconcerned; fear of cancer or any other secondary effects were also reported but in less than 10%. Among women who had never used HT, 28% reported the lack of medical prescription as the main reason, followed by the absence of symptoms (27.8%). Among those reporting lack of prescription as the main reason for not using HT, 30.6% currently had severe menopausal symptoms (total MRS score > 16); 19.5% of women were using alternative 'natural' therapies, with 35.1% of them displaying severe menopausal symptoms as compared to a 22.5% observed among current HT users. CONCLUSION: The use of HT has not regained the rates observed a decade ago. Positive perceptions regarding HT were related to a higher use. Lack of medical prescription was the main reason for not using HT among non-users, many of whom were currently displaying severe menopausal symptoms.
Subject(s)
Estrogen Replacement Therapy , Hot Flashes , Practice Patterns, Physicians'/statistics & numerical data , Treatment Refusal , Confidence Intervals , Cross-Sectional Studies , Demography , Estrogen Replacement Therapy/economics , Estrogen Replacement Therapy/methods , Estrogen Replacement Therapy/psychology , Estrogen Replacement Therapy/statistics & numerical data , Fear , Female , Hot Flashes/epidemiology , Hot Flashes/etiology , Hot Flashes/physiopathology , Hot Flashes/prevention & control , Hot Flashes/psychology , Humans , Latin America , Menopause/psychology , Middle Aged , Needs Assessment , Odds Ratio , Prevalence , Quality of Life , Risk Assessment , Socioeconomic Factors , Surveys and Questionnaires , Treatment Refusal/psychology , Treatment Refusal/statistics & numerical data , Women's HealthABSTRACT
BACKGROUND: Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. OBJECTIVES: To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. METHODS: A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. RESULTS: The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confidence interval (CI) 3.47-5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22-1.94), hormonal therapy (OR 1.46; 95% CI 1.11-1.92), ≥ 50 years of age (OR 1.48; 95% CI 1.17-1.86), overweight or obese (OR 1.47; 95% CI 1.15-1.89), and waist circumference ≥ 88 cm (OR 1.32; 95% CI 1.06-1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35-0.87), alcohol (OR 0.73; 95% CI 0.54-0.98) and living in cities > 2500 meters above sea level (OR 0.70; 95% CI 0.53-0.91) or with high temperatures (OR 0.67; 95% CI 0.51-0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. CONCLUSION: Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age.
Subject(s)
Diabetes Mellitus, Type 2/epidemiology , Menopause , Adult , Age Factors , Cross-Sectional Studies , Female , Health Surveys , Humans , Latin America/epidemiology , Middle Aged , Prevalence , Risk FactorsABSTRACT
El objeto de este estudio fue demostrar la influencia de las distintas variables en la producción del infarto agudo de miocardio (IAM), así como su incidencia y mortalidad en los últimos 7 años en personas de bajos recursos económicos. Por lo que, mediante un estudio retrospectivo en el HPAS se analizaron 26 historias clínicas con diagnóstico de IAM. Entre los factores de riesgo predominaron el sexo masculino (80.8 por ciento), edad avanzada (58.96 años), tabaquismo (68.8 por ciento), y la HTA (30.8 por ciento). Entre los datos clínicos, la tipicidad del cuadro se observó en el 57.7 por ciento de los casos. La electrocardiografía y las enzimas fueron de gran valor en la mayoría de pacientes. El tratamiento trombolítico (de elección) nu fue utilizado...
