Relationship between loss of libido and signs and symptoms of depression in a sample of Puerto Rican middle-aged women

Female sexual dysfunction is a multi-causal and multidimensional problem combining sexual, physiological, physical, psychological, and interpersonal determinants. Loss of libido or loss of sexual desire, as a symptom of one of the primary sexual dysfunctions described in females, is highly prevalent in the general female population. Research on the psychological aspect associated with loss of libido among Hispanic female populations is limited. The objective of this study was to determine how the loss of libido is affected by signs and symptoms of depression, once potential confounders are controlled. Nine-hundred and nineteen Puerto Rican women ages 40 to 59 years living in Puerto Rico participated in health-fairs conducted in twenty-two municipalities between May 2000 and November 2001. Contingency tables and chi-square statistics were used to evaluate the bivariate associations of loss of libido with demographic and lifestyle characteristics, symptom experience and obstetric and gynecologic histories. A logistic regression model was used to estimate the magnitude of the association between loss of libido and signs and symptoms of depression, after controlling for confounders. The overall prevalence of loss of libido in this population was 40.8%. Loss of libido was significantly associated with depressive symptoms (p < 0.05) after adjusting for age, educational attainment, employment status, physical activity, menopausal status/ hormone therapy use and genitourinary symptoms. Women reporting 1-2 depressive symptoms were 67% (95% CI = 1.08-2.60) more likely than women reporting no symptomatology to report loss of libido. The odds of loss of libido increased as the number of depressive symptoms increased [(3-4 symptoms: POR = 3.67, 95% CI = 2.16-5.56); (5-6 symptoms: POR = 5.52, 95% CI = 3.16-9.66)]. Consistent with previous studies, signs and symptoms of depression were significantly associated with loss of libido. Future longitudinal studies should further elucidate the temporal sequence between depression and sexual dysfunctions in this population.     

Thinness expectations and weight cycling in a sample of middle-aged adults

BackgroundThe False Hope Syndrome suggests that unrealistic expectations of dieting and weight loss are key constructs in the prediction of behavioral failure and may exacerbate weight cycling. The objective of this study was to determine cross-sectional associations among dieting and thinness expectations and weight cycling history within the framework of the False Hope Syndrome.MethodsParticipants were middle-aged (45 ± 12 years) women (n = 116) and men (n = 98) recruited via worksite intranet distributions. Information on dieting and thinness expectations, weight loss attempts, and weight cycling history was gathered using standard questionnaires.ResultsMore women than men reported currently dieting (43% vs. 26%; p < 0.01). Moderate [OR = 2.54; 95%CI: 1.01–6.45] and higher [OR = 2.70; 95%CI: 1.07–6.80] levels of the thinness expectation score were significantly associated with the greater odds of weight cycling, independent of age, sex, BMI, and weight loss attempts.ConclusionsThese data are the first to extend the pervasive and potent influence of thinness expectancy to middle-aged persons and in particular, to men.     

中老年妇女高血压社区规范化管理模式和效果

目的 分析中老年妇女高血压社区规范化项目管理模式及其效果,为完善社区卫生服务体系提供基层资料。方法 选择45～63岁在本中心辖区确诊为高血压病（288人）及高危者（101人）为研究对象,实施有关高血压的知识、态度和行为等基线调查,据2010中国高血压防治指南,建立健康档案,实行分级管理,随访包括血压测量、健康教育和治疗方案调整,在基线调查的基础上,实施为期2年的社区规范管理。结果 实施规范管理后,中老年高血压高危妇女在高血压知识、态度和行为方面的正确率均有显著性改善（χ^2分别为5．298、5．592、4．457,均P＜0．05）,高血压患者对高血压知识、态度和行为的正确率也均有显著性改善（χ^2分别为7．871、6．970、6．856,均P＜0．01）,高危妇女收缩压显著降低（t＝4．619,P＜0．01）,舒张压也显著降低（t＝2．220,P＜0．05）,高血压患者收缩压和舒张压均显著降低者t值分别为23．598、11．884,均P＜0．01。经过1年的规范管理,与心血管健康相关的一些生化指标也获得了改变,与规范管理前比较,高血压妇女的总胆固醇、三酰甘油、低密度脂蛋白均显著降低（t值分别为2．679、2．281、3．288,均P＜0．05）,且高危妇女的总胆固醇、三酰甘油水平均显著下降（t值分别为2．039、1．981,均P＜0．05）。规范管理后患者治疗率、血压控制的优良率和控制率均有改善（χ^2分别为159．625、16．359、21．387,均P＜0．05）,而不良率却显著下降（χ^2＝5．641,P＜0．05）。结论 社区规范管理有助于改善高血压患者的治疗和控制。     

Gynecology and sexuality in middle-aged women

In Sweden and other Western societies, the number of women above the age of 40 is increasing and health and well-being of middle-aged women is an increasing matter of concern. This study examines menstrual histories, gynecological operations, urinary incontinence, and reproductive functions in a representative sample of middle-aged women, as well as the frequency of climacteric symptoms and how to predict the women at risk for acquiring these symptoms. The sexuality of the mature woman as also explored. Women aged 37 to 66 years were randomly selected from the Census Register in Goteborg, Sweden. The bulk of information was obtained by means of questionnaires. Among the findings are that the median age for natural menopause was 50.9 years. Forty percent of the postmenopausal women reported frequent vasomotor symptoms. The occurrence of climacteric complaints is strongly connected to psychosocial variables. Every tenth woman reported frequent urinary leakage. Fifty-three percent of the women had undergone a D&C and 9% were hysterectomized. The woman around 40 reported few sexual partners (median 3) and her first intercourse occurred at age 18. Extramarital sex was uncommon. The masturbation rate was low and the frequency of homosexuality was extremely low. The majority of women had experienced orgasm.     

Erythrocyte fatty acid composition is associated with the risk of hypertension in middle-aged and older women

Experimental studies have suggested different effects of various fats on blood pressure. However, epidemiologic evidence of these relations remains limited and inconsistent. We therefore assessed the association of fatty acid (FA) composition in erythrocyte membranes with the risk of hypertension. We selected 516 cases of incident hypertension and 516 matched controls during 12.9 y of follow-up in the Women's Health Study. Erythrocyte FA was measured in baseline bloods using GC. After controlling matching factors and lifestyle factors, erythrocyte SFA showed a positive association, whereas total cis PUFA, cis (n-3) PUFA, and the ratio of PUFA:SFA (PS ratio) showed an inverse association with the risk of hypertension. The multivariable RR of hypertension across the increasing quartiles of erythrocyte FA subtypes were 1.00, 1.19, 1.44, and 1.76 for total SFA; 1.00, 0.84, 0.88, and 0.56 for total cis PUFA; 1.00, 0.87, 0.66, and 0.65 for cis (n-3) PUFA; and 1.00, 0.99, 0.70, and 0.51 for the PS ratio. After further adjusting for obesity-related metabolic factors, these associations were attenuated and remained significant only for the PS ratio. cis MUFA, cis (n-6) PUFA, and trans unsaturated FA in erythrocyte membranes were not associated with the risk of hypertension. Our study showed that FA composition in erythrocyte membranes is associated with the risk of hypertension in middle-aged and older women. However, after controlling for obesity-related metabolic factors, the associations remained significant only for the PS ratio.     

Screening for hypertension in a middle-aged population in Southwest Finland

The occurrence and treatment of hypertension were investigated and the benefit of screening for hypertension was evaluated in a middle-aged population in two rural districts in southwest Finland. A total of 1223 (93.2%) of the women and 1042 (93.1%) of the men, 40–64 years of age, participated in the hypertension screening program. With the criterion of ? 105 mm Hg, the prevalence of hypertension based on three separate measurements was 12.5 and 8.4% for the women and men, respectively, when those already being treated were included. If in the present study a single blood pressure reading had been considered sufficient, the prevalence of “hypertension” would have been almost twofold (20.4%) that based on three measurements for women and it would have been more than twofold for men (21.4%). Seventy-three percent of the female hypertensives and 59% of the male hypertensives were being treated. Only 10% of the female and 15% of the male hypertensives were unaware of their hypertension. The majority (75%) of these persons had consulted a doctor or a nurse during the previous year without their hypertension being detected. Because the majority of the hypertensives were already being treated and, moreover, most of those untreated were already aware of their disease, a systematic screening of the rural middle-aged population in southwest Finland is not considered necessary, especially since community plans for health care services in Finland should double the contact between the physicians in the community health centers and the residents during the next few years.     

35岁以上内科首诊人群3年高血压情况调查研究

目的:观察内科门诊35岁以上(含35岁)首诊人群高血压的变化情况.方法:在2004～2006年间持续3年对内科门诊35岁以上首诊人群血压情况进行调查分析.结果:本组人群6673人中,检出高血压的患者2312例,患病率为34.7%.随着年龄的增长而增高,以1级高血压比例最高,男女性别无差异.高血压组患者所伴随的高血糖或肥胖的比例高于非高血压组.3年间内科门诊首诊人群高血压患病率逐步下降,知晓率和控制率逐步提高.结论:随着年龄的增长,高血压患病率不断增加;但高血压的控制率及认知度也在不断提高.     

Caregiving and well-being in a sample of women in midlife

A survey of 742 women in midlife found that 12% were involved in the care of another person with a chronic health disorder. Of note was the diversity of circumstances that led to the women becoming caregivers. Further, about a third of the carers were supporting more than one person. Carers did not differ on measures of depression or subjective health ratings from persons not involved in care. Burden scores were predicted by co-residence, low satisfaction with social support, and poorer health ratings on the part of the carers but not by the relationship between the person cared for and the carer.     

The relationship between traditional and innovative sex-role adaptations and innovative sex-role adaptations and sexual satisfaction among a homogeneous sample of middle-aged Caucasian women

This paper examines sexual experiences and satisfaction among a homogeneous sample of middle-aged, middle and upper socioeconomic status, Caucasian women. The hypothesis that women who occupy more traditional social roles on the traditional-innovative continuum would have greater sexual satisfaction is rejected. Relationships among a variety of indicators of sexual satisfaction and position on the innovative-traditional continuum indicated lack of consistent directionality or strong associations. Voluntary association memberships serendipitously emerged as a relatively strong indicator of social activities related to sexual satisfaction.     

Distribution of calcium absorption in middle-aged women

Distribution of true fractional absorption of calcium in estrogen-deprived, nonosteoporotic, middle-aged women was examined in 273 person-studies, using a double-tracer method. Fractional absorption averaged 0.266 (+/- 0.096). Calcium intake averaged 0.802 g/day (+/- 0.419) and urine calcium, 0.144 g/day (+/- 0.062). Fractional absorption was inversely correlated with intake. Using parameters of the regression equation for the two variables, each absorption value was adjusted to the mean intake of the group so that absorption could be evaluated apart from the effect of intake. The distribution of such diet-adjusted values revealed that 55% of these estrogen-deprived women had insufficient absorption to maintain calcium balance at an intake equal to the 1980 RDA. Nearly one-fourth would still be in negative balance at an intake of 1.5 g/day. Since urine calcium was positively correlated with absorbed calcium (r = 0.521), we conclude that defective absorption and not bone breakdown is the basis for low absorptive performance in these women.     

Calcium supplementation and bone loss in middle-aged women

This 4-y study investigated the effects of a calcium carbonate supplement on bone loss in 169 women aged 35-65 y, randomly assigned to placebo and treatment (1500 mg Ca/d) groups in a double-blind design. Bone mineral content (BMC) and width (W) were measured bilaterally on the radius, ulna, and humerus. BMC and BMC/W loss rates were consistently lower in treatment than in control subjects. Loss was significantly reduced in the left and right humerus and the right radius. In premenopausal subjects, only left humerus BMC loss was significantly reduced by Ca supplementation. In postmenopausal treatment subjects, BMC and BMC/W bone loss was reduced in all 12 (bilateral radius, ulna, and humerus) of the bone variables measured, 5 at p less than 0.01 and 2 at p less than 0.05. Ca supplementation counteracted a large portion of the additional bone loss attributable to menopause in this population.     

Smoking cessation and lung cancer mortality in a cohort of middle-aged Canadian women

PURPOSE: To determine the impact of smoking cessation on lung cancer mortality among women. METHODS: Survival analysis is used to assess the effect of smoking cessation on lung cancer death in the dietary cohort of 49,165 women aged 40 to 59 years enrolled in the Canadian National Breast Screening Study. RESULTS: During an average of 10.3 years of follow-up, 106 women died of lung cancer. The risk of lung cancer mortality among women who quit before age 50 (HR=0.26; 95% CI, 0.13-0.55 among women who quit at ages 40-49) or quit in the previous 10 years (HR=0.39; 95% CI, 0.22-0.69) is substantially lower than the risk among current smokers. Women who quit after age 40 or have quit for less than 20 years are at substantially higher risk of lung cancer mortality compared with never smokers. Both duration of smoking cessation and age at quitting have independent effects on lung cancer mortality, after controlling for number of cigarettes smoked per day and number of years smoked, as well as other potential confounding variables. CONCLUSION: These findings suggest that programs and policies to promote early cessation of smoking and prevention of relapse should be a public health priority.     

Acculturation and blood pressure in a community-based sample of Chaldean-American women

With the steady increase of non-European, non-English speaking immigrants to the United States, the relationship between acculturation and risk for cardiovascular disease (CVD) is an issue of growing importance to researchers interested in the health of new immigrant populations. The influence of acculturation processes on adverse changes in blood pressure (BP), a major risk factor for CVD, has been examined in Hispanic-Americans and Asian-Americans. Published studies on this relationship in Arab-Americans are lacking, however, despite their growing numbers. With a specific focus on Chaldean-Americans, a major subgroup of the large Arab-American population located in metropolitan Detroit, Michigan, the current study investigates the influence of level of acculturation on BP in a community probability sample of 130 Chaldean-American women. Study participants were interviewed in their homes (92% response rate). Physical measurements included BP, body mass index (BMI), and waist–hip ratio. Demographic and acculturation data were obtained through a standardized questionnaire. The crude hypertension prevalence in the sample was 16%. Three dimensions of acculturation were identified through content and factor analysis: English language preference, parental school involvement, and ethnic identity. In unadjusted analyses, both English language preference and Chaldean-American ethnic identity were associated (p < 0.01) with lower mean BP, but these differences became nonsignificant when age, BMI, and waist–hip ratio were statistically controlled. Parental school involvement was not associated with BP in any analyses. In this study, the strongest predictors of BP were BMI and waist–hip ratio, both of which were inversely correlated with age, education, English language preference, employment outside the home, and parental school involvement. Future studies of acculturation and BP in Chaldean-Americans (and other Arab-American populations) should use improved measures of acculturation, broader assessments of behavioral and socioeconomic status, and larger samples that includes both genders.     

中老年妇女真菌性阴道炎的临床分析

目的探讨中老年妇女真菌性阴道炎的病因和防治对策。方法选择2009年1月-2010年1月在医院门诊检查的120例真菌性阴道炎患者,随机分为观察组和对照组,各60例;对照组仅用2%碳酸氢钠液体冲洗外阴阴道,观察组在此基础上采用卫生宣教、改变不良卫生习惯和局部加用硝酸咪康唑阴道栓综合治疗;观察两组治疗7 d后的疗效以及治愈者1个月后的复发率。结果观察组有效率为93.3%,复发率为3.6%;对照组有效率为73.3%,复发率为15.9%;两组有效率和复发率差异均有统计学意义。结论卫生宣教、改善不良生活习惯及局部应用硝酸咪康唑阴道栓治疗真菌性阴道炎疗效好、复发少、安全可靠。     

Dietary predictors of symptom-associated gallstones in middle-aged women

In 1980, 88,837 women aged 34-59 y completed a semiquantitative food frequency questionnaire and were followed for 4 y. Four hundred thirty-three women reported a cholecystectomy for recent cholecystitis, and 179 reported unremoved, newly symptomatic gallstones diagnosed by ultrasound or x ray. Among the 59,306 women with Quetelet's index of relative weight less than 25 kg/m2, inverse associations were observed between intakes of vegetable fat and vegetable protein and the risk of reportedly symptomatic gallastones, after adjusting for age, Quetelet's index in 1980, weight change between 1976 and 1980, energy intake, and alcohol intake. The relative risk in the highest quintile of vegetable fat intake, as compared with the lowest quintile, was 0.6 [95% confidence interval (CI), 0.4-0.9], and the corresponding relative risk for vegetable protein intake was 0.7 (95% CI, 0.6-0.9). No significant associations were found with energy-adjusted intakes of cholesterol, animal fat, animal protein, carbohydrate, or sucrose.     

Body mass index and mortality in middle-aged Korean women

PURPOSE: We sought to evaluate the association between body mass index (BMI) and mortality in Korean women and to determine whether the association differs depending on menopausal status. METHODS: A total of 338,320 Korean women ages 40 to 64 years categorized into seven groups by BMI level were prospectively followed for mortality from approximately 1994 to 2004. RESULTS: Multivariable-adjusted analysis using Cox proportional hazards model showed a U-shaped association between BMI and all-cause deaths, with the lowest risk at BMI between approximately 25 and 26.9 kg/m2, even after excluding earlier deaths, which did not change when we did a stratified analysis according to menopausal status. A U-shaped association was observed between BMI and cancer death, and the risk associated with low BMI decreased significantly after excluding earlier cancer deaths. There was a J-shaped association between BMI and coronary heart disease (CHD) with a significantly increased risk at greater BMI (>26 kg/m2). Additional adjustment for possible biological effects of obesity (i.e., serum total cholesterol, glucose, and systolic blood pressure) changed the U-shaped association between BMI and all-causes mortality into an inverse shape and substantially reduced the size of risk for CHD death associated with high BMI level. In stratified analysis, the association between BMI and CHD was positive linear in women at premenopausal status, whereas it was U-shaped in women at postmenopausal status. CONCLUSIONS: Obesity was associated with an increased risk of mortality in both premenopausal and postmenopausal Korean women, indicating that preventive strategies to control obesity are important even in population with a relatively low mean BMI level.