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.

Assessment of self-esteem in mid-aged women.

OBJECTIVE: To assess self-esteem and affecting factors in a middle-aged Ecuadorian female population using the Rosenberg Self-Esteem Scale (RSES). STUDY DESIGN: This was a cross-sectional study in which 149 women (40-59 years) were requested to fill out the RSES and a general socio-demographic form containing personal and partner data. RESULTS: Mean age of sample was 47.6+/-5.5 years, a 67.8% had less than 12 years of schooling and 33.6% were postmenopausal. At the moment of the survey 2.7% were on hormone therapy, and 2% were taking psychotropic drugs. Mean total RSES score was 26.6+/-3.1 (median 26, range 17-35). A 35.6% and 18.1% of women respectively presented total RSES scores below 26 (median) and 25 (25th percentile) suggesting lower self-esteem. Total scores did not differ when comparing older age, menopausal phases or time since the menopause. Logistic regression analysis determined that women with lower parity and an unhealthy partner were related to lower total RSES scores (below the 25th percentile) suggesting lower self-esteem. CONCLUSIONS: In this mid-aged series lower self-esteem was not related to the aging process per se yet to socio-demographic female/male aspects. More research is needed in this regard that incorporates other sociological aspects.

Factors related to increased daytime sleepiness during the menopausal transition as evaluated by the Epworth sleepiness scale.

BACKGROUND: Sleep disorders and sleep-apnea/hypopnea syndromes are very frequent in women, being misdiagnosed in many cases. The menopause, regardless of age, is associated to poor sleep quality and daytime sleepiness that can lead to impaired quality of life, and reduced productivity and functioning. OBJECTIVE: To assess daytime sleepiness and related risk factors among middle aged Ecuadorian women using the Epworth Sleepiness Scale (ESS). METHODS: In this cross-sectional study 149 women aged 40-59 years were assessed for hot flush presence and intensity using the Menopause Rating Scale (MRS) and requested to fill out the ESS and a questionnaire containing personal and partner data. RESULTS: Mean age of surveyed women was 47.6+/-5.5 years, with 67.8% having less than 12 years of schooling, 33.6% being postmenopausal, and 2.7% on hormone therapy. A 10.1% were current smokers and 20.8% were sedentary. According to the MRS (item 1) 51.7% presented hot flushes, which were graded as severe-very severe in 42.8% of cases. Regarding the partner (n=132), erectile dysfunction was present in 10.6%, premature ejaculation 6.1% and 17.4% abused alcohol. Mean total ESS score was 8+/-4.4 (median 8), with 33.6% considered having some degree of daytime sleepiness (ESS score >or=10). Logistic regression analysis determined that postmenopausal status (OR 6.58, CI 95% [2.51-17.23], p=0.001), sedentarism (OR 3.43, CI 95% [1.14-10.26], p=0.02) and hot flush presence (OR 2.61, CI 95% [1.02-6.65], p=0.04) among women were risk factors for increased daytime sleepiness (ESS total score >or=10) whereas partner faithfulness decreased this risk (OR 0.47, CI 95% [0.24-0.90], p=0.02). CONCLUSION: Increased daytime sleepiness in this middle aged series was related to female (hormonal status and sedentarism) and partner factors; several which are susceptible of intervention.