Quality of life among postmenopausal Ecuadorian women participating in a metabolic syndrome screening program
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.
References (43)
- et al.
Measuring climacteric symptoms in an Ecuadorian population with the Greene Climacteric Scale
Maturitas
(2005) - et al.
A menopause-specific quality of life questionnaire: development and psychometric properties
Maturitas
(1996) - et al.
Quality of life after the menopause: a population study
Maturitas
(2000) - et al.
Age, menopause and hormone replacement therapy influences on cardiovascular risk factors in a cohort of middle-aged Chilean women
Maturitas
(2003) - et al.
Validation of the quality of life questionnaire in arterial hypertension (HQALY) for its use in Spain. Relationship between clinical variables and quality of life. Investigator Group of the HQALY study
Aten Primaria
(2000) - et al.
Body mass, depressive symptoms and menopausal status: an examination of the “Jolly Fat” hypothesis
Womens Health Issues
(2005) - et al.
Self-reported urogenital symptoms in postmenopausal women: Women's Health Initiative
Maturitas
(2004) - et al.
Menopause-related symptoms: what are the background factors? A prospective population-based cohort study of Swedish women (The Women's Health in Lund Area Study)
Am J Obstet Gynecol
(2003) - et al.
Climacteric symptoms in a representative Dutch population sample as measured with the Greene Climacteric Scale
Maturitas
(2001) - et al.
Executive summary: Stages of Reproductive Aging Workshop (STRAW)
Climacteric
(2001)
Quality of life assessment: international perspectives
Developing and evaluating cross-cultural instruments from minimum requirements to optimal models
Qual Life Res
Lumbar spine bone mineral density in climacteric Ecuadorian women
Rev Ecuat Ginecol Obstet
Quantitative ultrasound at radius and its correlation with serum osteocalcin levels in climacteric women
Rev Ecuat Ginecol Obstet
Metabolic syndrome in postmenopausal Ecuadorian women
Climacteric
Literature review of instruments to assess health-related quality of life during and after menopause
Qual Life Res
Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP)
J Am Med Assoc
Obstetrical and neonatal outcome in young adolescents of low socio-economic status: a case control study
Arch Gynecol Obstet
Menopause and perceived health status among the women of the French GAZEL cohort
Maturitas
Modified MENQOL
Menopause
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