Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy.

OBJECTIVE: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. METHODS: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. RESULTS: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. CONCLUSIONS: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms.

Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study.

OBJECTIVE: To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause. SUBJECTS: Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. METHODS: Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year. RESULTS: Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73). CONCLUSIONS: This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.

Attitudes towards menopause in a group of women followed in a public service for menopause counseling.

This preliminary study addressed some specific attitudes towards menopause, and behavioral styles in menopausal women. The study was conducted during the period January-May 1998 at the Menopausal Service of the Magenta Hospital (Milano) in 88 women, representing almost one half of the patients followed during that period; 43 women were treated with HRT. Some traits characterizing women's life during menopause were examined, such as presence of disturbing physical symptoms, changes in interests and discovery of new interests, and feelings of loss and uselessness. We used different psychological tests in order to evaluate anxiety and depression, in particular, the STAI (State-Trait Anxiety Inventory), the SDS (Self-rating Depression Scale), and 16 cartoon-like images representing stereotypes of menopause. The answers of our subjects showed high individual variation, with negative symptoms (e.g., hot flashes, memory loss) frequently associated with positive experiences (e.g., new hobbies, new life-styles). However, even the most frequent negative symptom (memory loss) was reported only by 70%. The experience of a change represented by menopause was described both in terms of objective change (e.g., weight increase, hot flashes, memory loss), and of subjective change (e.g., character, feeling of not being attractive, new life-styles). Treatment with HRT seems to reduce the onset of hot flashes considerably. The occurrence of anxious-depressive states was comparable to that observed in other studies; it was not associated with HRT, but rather to losses (loss of desire, memory loss, insomnia). In conclusion, menopause represents a transitional moment in which physical and psychological changes are generally integrated by the persons experiencing them. In order to preserve a good quality of life in menopause, it seems relevant to check memory loss and stabilize the mood in persons who are most "at risk" of psychological disease.

[Benzalkonium in local contraception and sexually-transmitted diseases]. / Il benzalconio nella contraccezione locale e nelle MTS.

In 96 women, followed in ambulatory from 1983 to 1986, the use as a local contraceptive of a sponge treated with benzalkonium has been studied. This substance has not only shown itself a good contraceptive but may result even a useful precautionary measure against STD.

[Non-stress test. Evaluation of a new scheme for reading the results]. / Non stress test. Valutazione di un nuovo schema di lettura.

The reliability of a new Non-Stress Test reading protocol is assessed. The protocol provides for an assessment time of between 20 and 60 minutes and considers deceleration as an additional parameter to the ones commonly used. The results confirm the importance of both these factors in reducing the number of false positives.