Elsevier

Maturitas

Volume 56, Issue 1, 20 January 2007, Pages 45-53
Maturitas

Quality of life among postmenopausal Ecuadorian women participating in a metabolic syndrome screening program

https://doi.org/10.1016/j.maturitas.2006.05.008Get rights and content

Abstract

Background

Quality of life decreases after the menopause as it has been assessed by several designed tools. Despite this, few studies have reported correlations between quality of life and the metabolic syndrome and its determinants.

Objective

Evaluate quality of life and determine factors related to its impairment among postmenopausal Ecuadorian women.

Methods

Postmenopausal women that participated in a metabolic syndrome screening and educational program at the Institute of Biomedicine of the Universidad Católica of Guayaquil, Ecuador were interviewed using the Menopause-Specific Quality of Life Questionnaire (MENQOL). Mean domain scores as well as factors associated to higher scores within each of the domains of the questionnaire (vasomotor, psycho-social, physical and sexual) were determined.

Results

Three hundred twenty-five postmenopausal women (n = 325) were surveyed. Mean age of participants was 55.9 ± 8.1 years (median: 54 years). Women presented metabolic syndrome, hypertension, hyperglycemia, hypertriglyceridemia and abdominal obesity in 41.5%, 38.8%, 16.6%, 56.9% and 54.2% respectively. Mean scores obtained for each domain were: vasomotor: 3.5 ± 2.5 (median 3); psycho-social: 3.7 ± 1.5 (median 3.6); physical: 3.8 ± 1.2 (median 3.8); sexual: 4.9 ± 2.3 (median 5.3). More than 50% of women had scores above the median for each domain of the questionnaire. Logistic regression determined that vasomotor score decreased with age. Abdominal obesity increased the risk of having vasomotor, psycho-social and physical scores above the median. Hypertension and hyperglycemia increased the risk for higher scores within the psycho-social and sexual domain respectively.

Conclusion

In this postmenopausal Ecuadorian population, impairment of quality of life was found to be associated to age and related conditions such as abdominal obesity, hypertension and hyperglycemia.

Introduction

While the climacteric delineates the transitional phase between an active to an inactive female reproductive stage characterized by increasing estrogenic deficiency, the menopause, the last menses, refers to a specific period-of-time within this phase [1]. The age at menopause presentation in Latin America varies but in general has been reported to occur earlier than in women from developed countries [2]. Factors that may affect menopause onset have been described: genetic, race, habits, geographical region of habitat, and socio-economic and educational level [2]. In a recent study of the Collaborative Group for Research of the Climacteric in Latin America (REDLINC) it was determined that women coming from countries with lower income and those accessing free or low cost health care, among those Ecuador, had an earlier age at menopause onset [3]. Therefore the earlier the onset of the menopause the longer the exposition to the negative effects of hypoestrogenism.

Quality of life (QOL) has been defined by the World Health Organization as the “individual's perceptions of their position in life in the context of the cultural and value systems in which they live and in relation to their goals, expectations, standards and concerns” [4]. Although currently the multidimensionality of the QOL concept has been accepted, disease on the other hand does not only affect the individual, physically and emotionally, yet it may affect his economic capacity, and his religious and political values. The need to create the term health related QOL surges, defined as the subjective evaluation of the patient oriented toward his exterior and centered on the impact of his health over his capacity to live a satisfactory subjective life [5]. It is a general consensus that the transition through the climacteric causes physiological and psycho-social changes, which in turn affect women's QOL. Particularly in Ecuador, these changes have been described among climacteric (vasomotor symptoms, headaches, decreased libido and loss of bone mass) and postmenopausal women (increased prevalence of hyperglycemia, hypertension and dyslipidemias) [2], [6], [7], [8].

Various validated tools have been used to quantify the influence of the climacteric over QOL [9], among them the Menopause-Specific Quality of Life Questionnaire (MENQOL) proposed by Hilditch et al. [10] which is based upon women's own perspective. This tool has been validated upon a climacteric Chilean population and used to determine that the menopause causes QOL impairment [11]. Despite this, to best of our knowledge no study, addressing a Latin American population, has reported correlations between QOL, as measured with a validated tool (MENQOL), and the metabolic syndrome and its determinants.

The objective of the present research was to assess QOL and determine factors related to its impairment among postmenopausal Ecuadorian women that participated in a metabolic syndrome screening program.

Section snippets

Subjects

After Institutional Review Board approval from February 1, 2005 to March 31, 2005 a metabolic syndrome screening and educational program aimed to determine the prevalence of this entity and related risk factors among postmenopausal women was carried out at the Institute of Biomedicine of the Universidad Católica of Guayaquil with the support of the Foundation for Health And Well Being In The Climacteric “FUCLIM” Guayaquil, Ecuador. Prior to its initiation, the program was advertised through a

Results

During the study period, a total of 325 (n = 325) postmenopausal women fulfilling inclusion criteria participated in the MS screening program. Age of participants ranged from 40 to 70 years (mean: 55.9 ± 8.1; median: 54 years) of which 21.2% were aged 40–49 years; 51.4% (50–59 years) and 27.4% (60–70 years). Socio-demographic data as well as the prevalence of the MS and its determinants according to ATP III criteria are depicted on Table 1. Other findings regarding subject's lipid profile, medical

Discussion

The climacteric is a period characterized by progressive estrogenic deficiency, commencing with the decline of female's reproductive capacity and extending years after the onset of the menopause [2]. Age at menopause presentation in Latin America has been determined to occur earlier than in women from USA and Europe, where lower income and geographical location have been determined to be significant associated factors [3]. Therefore the earlier the onset of the menopause the longer the

Acknowledgement

This study was supported by the Development and Research System of the Universidad Católica de Santiago de Guayaquil, Ecuador through Grant No. 2003-10-83 and presented as a free oral communication at the 11th World Congress on the Menopause, 18–22 October 2005, Buenos Aires, Argentina.

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