Age at Natural Menopause and Influencing Factors in Women Attending the Gynecological Outpatient Clinic at a Tertiary Care Hospital.

Background: Menopause is the irreversible cessation of menstruation that results from the lack of ovarian follicular function and is diagnosed after 12 consecutive months of amenorrhea without reasonable cause. This study aims to determine the average age at natural menopause and identify its associated factors among Somali women. Methods: This is a cross-sectional study conducted at the Mogadishu Somalia Türkiye Recep Tayyip Erdogan research and training hospital's Obstetrics and Gynecology outpatient clinic between June 1 and July 1, 2023. Data was collected from subjects during the data collection period using face-to-face interviews with structured questionnaires consisting of sociodemographic, lifestyle, dietary, and reproductive characteristics. A multivariate logistic regression analysis was conducted to find the association between menopause age and target variables. Results: Out of the 188 participants recruited for the study, the median age of menopause was 45.00 (95% CI = 44.50-45.62), and 48.9% had either premature or early menopause. The majority (53.7%) of the participants had a minimum of eight children. In Spearman's rank correlation analysis, we found a significantly positive correlation between menopausal age and age at first (p<0.01), last childbirth (p<0.01), number of parities (p<0.05), and age at marriage (p<0.05). In multivariate logistic regression, we found that the odds of developing premature or early menopause among unemployed women were 59% lower than those of employed women (AOR = 0.41, 95% CI = 0.18-0.93). Conclusion: In this study, we established that the age of natural menopause was lower than the findings reported by previous authors. We also found that employment status, education, history of contraceptive use, BMI, age at first and last childbirth, and parity were associated with age at natural menopause, suggesting that social, lifestyle, and reproductive factors may have an impact on menopausal age.

Frequency of cervical premalignant lesions in the gynecologic patients of a tertiary hospital in Mogadishu, Somalia.

BACKGROUND: Cervical cancer is the fourth most common cancer worldwide and is the most frequently diagnosed cancer in 23 countries and the most common cause of death in 36 countries, mostly from Sub-Saharan African countries. Cervical screening is a key element to reduce the incidence and mortality of cervical cancer. Cancer screening is low in Sub-Saharan Africa. This study aims to provide information about cervical premalignant lesions frequency in Somalia. METHODS: The pathology results of cervicovaginal smear samples obtained from patients aged 25-65 years who applied to the gynecology outpatient clinic between October 5 and December 5, 2021 were analyzed retrospectively. SPSS 22.0 was used for the statistical analysis of the data. RESULT: Among the 497 results, 63 premalignant lesions were detected. The rate of premalignant lesions (63/497) was found to be 12.3%. The most common premalignant lesion was atypical squamous cells of undetermined significance (ASC-US). CONCLUSION: In this study, the frequency of cervical premalignant lesions in Somalia was found to be higher than in the literature. Vaccination, screening, and early diagnosis are the most important components in the fight against cervical cancer. Access to vaccination, screening, and early diagnosis, which are the most important components in the fight against cervical cancer in Somalia, will be possible with the cooperation of the national health system and international organizations.

Management approach of a postmenopausal woman with a completely massive molar pregnancy: A case report.

Introduction and importance: Molar pregnancy typically manifests in the first trimester and is associated with several symptoms, including vaginal bleeding and larger than expected uterine size. The hallmark symptoms of this disorder are rapid uterine growth, nausea and vomiting, and an unusually high quantitative bhCG level. Ultrasonography is a reliable and sensitive technique for the diagnosis of complete molar pregnancy, which showed a "snow storm" pattern as a result of hydropic degeneration in chorionic villi.Total hysterectomy is the best treatment option for older-age women who do not desire to have children. It appears to greatly minimize the risk of later GTN. Case presentation: In this case study, we present a 46-year-old female patient who presented with vaginal bleeding and weakness. A transvaginal Ultrasound revealed a mixed solid and cystic mass-like structure in her pelvis. A total abdominal hysterectomy was performed on the patient due to severe vaginal bleeding.After three months, the beta-HCG level had entirely stabilized. During the follow-up, no symptoms of gestational trophoblastic neoplasia were found. Clinical discussion: A case report of postmenopausal women with a completely massive molar pregnancy with significant grape-like bleeding is a rare case of life-threatening conditions that may be discovered as a result of persistent significant vaginal bleeding. Conclusions: complete hysterectomy should be performed to avoid significant complications such as bleeding, hypovolemic shock, and risk of GTN.