Quality of life after the menopause: a population study
Introduction
Since ovarian hormones do not only act on genital organs, but also on extragenital target tissues, estrogen deficiency occurring during menopause will affect both the gynecological area and the whole body. Although many women may consider the end of menstruation and even fertility as an advantage, menopausal symptoms, such as hot flushes, headache, and sleep and mood disorders, can strongly impair quality of life (QoL) in women. [1]
The term “quality of life” is widely used, but there is no consensus for its definition, since it encompasses several constructs including physical, functional, emotional, social and cognitive variables. When studies on QoL are performed, several tests are used in an attempt to quantify those characteristics, but such tests do not take into account the sociocultural and historical setting of the subjects and their feelings about it [2]. Furthermore, not all instruments can be used to assess QoL in the different diseases, since the clinical features are not equal. Therefore, specific tools are required for each condition; menopause is not an exception [3], [4].
Several studies have shown that hormone replacement therapy (HRT) improves quality of life [5], [6], [7], [8], [9], [10], [11], [12]. However, there are virtually no studies on the effects of menopause on QoL; only one such study has been published [1] that used a QoL instrument nonspecific for menopause. Hence, it was only found that in four of the six QoL areas measured, postmenopausal women showed a greater impairment than women still menstruating and, additionally, the effects of sociodemographic variables were not evaluated. This lack of data was what induced us to undertake this study to assess the impact of menopause and several sociodemographic variables in QoL.
Section snippets
Subjects and methods
Samples were taken from women attending the Southern Metropolitan Health Service in Santiago de Chile, covering an estimated population of 59,133 women in 1997, according to the data provided by the Statistical Unit of the Patient Program Department of the Southern Metropolitan Health Service. Sample size was established based on the fact that the condition studied, menopause, affects all women, since it is a natural event occurring between approximately 40 and 59 years of age; the variable is
Results
The 481 women included were allocated in to 5-year age groups (Table 2). Their mean age was 49.5±5.8 years, and almost 90% had 12 or less years of education, and 53.2% had nine or less years. Two-thirds of the women were housewives, a percentage similar to the values in Chile for the whole country [14]. The mean age at menarche was 13.0±1.8 years and that at menopause 47.5±4.3 years. Most of them were married, 59.7%, and 71.3% had sexual activity in the past year. The mean number of children
Discussion
This was a cross-sectional study to assess the effect of menopause and some sociodemographic variables on QoL. Our results show that perceived QoL is worse for postmenopausal women than for women of the same age who are still menstruating. The impact of menopause on QoL is attributed to its symptoms, particularly the classic vasomotor disorders, and some physical symptoms such as palpitations or dyspareunia [13], [15], [16]. Moreover, middle-aged women with menopausal symptoms have a severely
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