Recommended measurement instruments for genitourinary symptoms associated with menopause: the COMMA (Core outcomes in menopause) consortium.

OBJECTIVE: The aim of the study is to identify appropriate definitions and patient-reported outcome measures (PROMs) for each of the eight core outcomes previously selected for genitourinary symptoms associated with menopause: pain with sex, vulvovaginal dryness, vulvovaginal discomfort or irritation, discomfort or pain when urinating, change in most bothersome symptom, distress, bother or interference of genitourinary symptoms, satisfaction with treatment, and side effects. METHODS: We conducted a systematic review to identify possible definitions and PROMs, including their measurement properties. Identified definitions and relevant PROMs with acceptable measurement properties were entered into an international consensus process involving 28 participants from 10 countries to achieve final recommendations for each core outcome. RESULTS: A total of 87 publications reporting on 34 PROMs were identified from 21,207 publications screened. Of these 34 PROMs, 29 were not considered to sufficiently map onto the core outcomes, and 26 of these also had insufficient measurement properties. Therefore, only five PROMs corresponding to two core outcomes were considered for recommendation. We recommend the PROMIS Scale v2.0 - Sexual Function and Satisfaction: Vaginal Discomfort with Sexual Activity to measure the outcome of "pain with sexual activity" and the Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire to measure "distress, bother or interference" from genitourinary symptoms. Six definitions of "side effects" were identified and considered. We recommend that all trials report adverse events in study participants, which is a requirement of Good Clinical Practice. CONCLUSIONS: Suitable PROMs and definitions were identified to measure three of eight core outcomes. Because of the lack of existing measures, which align with the core outcomes and have evidence of high-quality measurement properties, future work will focus on developing or validating PROMs for the remaining five core outcomes.

Correlates of serum estradiol concentration among postmenopausal women in Ilorin, North-Central Nigeria.

OBJECTIVES: There are limited data on the associated factors of circulating endogenous estradiol among Nigerian postmenopausal women. The main objective of this study is to assess the relationship between serum estradiol levels and some menstrual, clinical, and sociodemographic factors in postmenopausal women attending a family medicine clinic in Nigeria. METHODS: This was a hospital-based cross-sectional study involving 372 postmenopausal women. Sociodemographic, menstrual, and clinical data of the participants were collected, and their serum estradiol concentrations were assayed. The collected data were analyzed using IBM SPSS version 21 statistical software. A χ2 test of association and logistic regression analysis were done to identify significant correlates of serum estradiol concentration among the participants. RESULTS: The mean ages at menarche and menopause among the participants were 15.6 and 48.1 years respectively. Approximately half of them (51.1%) were receiving chronic medical care for systemic hypertension and/or diabetes. The mean estradiol concentration of the participants in the study was 20.69 pg/mL. The participants' marital status and clinical presentation pattern (chronic vs others) were found to have statistically significant associations with their serum estradiol concentration; P = 0.048 and P = 0.001, respectively. Logistic regression analysis revealed that only the clinical presentation pattern had a significant relationship with serum estradiol concentration among the participants ( P = 0.002). CONCLUSION: Of all the studied factors, the only significant correlate of low serum estradiol concentration found in this study was chronic medical care presentation for hypertension and/or diabetes.

Pattern and Predictors of Sexual Activity among Postmenopausal Women Attending a Family Medicine Clinic in Ilorin, North-Central Nigeria.

OBJECTIVES: Sexual activity tends to decline with age and is greatly impacted in postmenopausal women. This study aimed to describe the sexual activity pattern among postmenopausal Nigerian women and also detect socio-demographic and menopause-related predictors of their sexual activity. METHODS: In this hospital-based cross-sectional study, 357 postmenopausal women between 45-60 years participated. Data was collected using the sexual activity questionnaire and a socio-demographic questionnaire developed by the authors. RESULTS: The prevalence of sexual inactivity among the participants was 60%. This was attributed mainly to the unavailability of male partners (50.5%) and negative menopause-related sociocultural beliefs (23.8%). Among sexually active participants, 83.2% of them reported having pleasurable experiences and 53.8% of them reported no associated sexual discomfort. Only being in a marital relationship was found to be a statistically significant predictor of sexual activity among the participants (regression coefficient = 3.125, degree of freedom = 1, P < 0.0001). CONCLUSIONS: We reported a high prevalence of sexual inactivity among the participants; the most important reasons given were the unavailability of their husbands and the belief that sexual intercourse was taboo during the postmenopausal period. The study also provided positive evidence for the importance of marriage for sexual activity among the participants.