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.

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.

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.