Experience and attitudes toward menopause in Chinese women living in Sydney—A cross sectional survey

ObjectivesTo investigate the menopausal experience of Chinese women living in Sydney and to explore the prevalence of symptoms, and the relationship between the frequency of symptoms and various socio-demographic factors.MethodsA cross-sectional survey was conducted among 310 Chinese women aged between 45 and 65 years. The menopause-specific quality of life (MENQOL) questionnaire was used to collect information on menopausal symptoms. The MENQOL questionnaire was translated into Chinese by an experienced bilingual health worker and then translated back into English by a different interpreter for accuracy.ResultsThe mean and median ages at menopause for this study were 50.3 and 50.5 years, respectively (95% CI 49.8–50.8 years). Only 34% of women reported hot flushes, and 27% reported night sweats. Chinese women in Sydney more commonly reported psychological symptoms such as poor memory and physical symptoms such as dry skin, aching in muscles and joints and decreased physical strength. Changes in sexual desire and vaginal dryness were significantly different in perimenopausual women, compared with premenopausal and postmenopausal women.ConclusionsChinese women living in Sydney report fewer vasomotor symptoms compared with Caucasian women. Menopause was still experienced negatively, especially in its impact on sexual function and muscular–skeletal symptoms.     

Ambulatory blood pressure and heart rate in relation to hot flash experience among women of menopausal age

OBJECTIVE: The purpose of this study was to evaluate whether ambulatory blood pressure and heart rate varied with hot flash experience among women of menopausal age. SUBJECTS AND METHODS: A total of 1149 ambulatory blood pressure and heart rate measurements from 20 women aged 44-55 were examined. Women were categorized by hot flash experience as (1) having had hot flashes during the study period (Symptomatic during Study; n = 5; 302 measurements), (2) having a past history of hot flashes, but no hot flashes during the study period (Historically Symptomatic; n = 7; 385 measurements), and (3) never having had a hot flash (Asymptomatic; n = 8; 462 measurements). Using repeated measures, nested ANOVA models that also adjusted for posture, the variation in blood pressure and heart rate associated with hot flash experience over the whole day and by location of measurement (microenvironment) was evaluated. RESULTS: The results show that, overall, systolic pressure did not differ among the hot flash experience groups although the Symptomatic during Study group had higher pressures at work than the other two groups (p<0.01), and tended to have higher pressures during sleep (p<0.08). The sleep diastolic pressure of the Asymptomatic group was significantly lower than that of the women who had hot flashes on the study day (p<0.01), but women who had a past history of hot flashes had slightly lower diastolic pressure (p<0.01) than those in the other two groups overall. Heart rates of the Asymptomatic group, however, were significantly lower (4-6 b.p.m.; p<0.001) in each microenvironment and over the whole day than both groups who had hot flash experience. CONCLUSIONS: These data suggest first that there may be a relationship between the experience of hot flashes and accelerated heart rate, and second that women who do not experience hot flashes may have lower sleep blood pressures than women who do.     

Ambulatory blood pressure and heart rate in relation to hot flash experience among women of menopausal age

Objective: The purpose of this study was to evaluate whether ambulatory blood pressure and heart rate varied with hot flash experience among women of menopausal age.

Subjects and methods: A total of 1149 ambulatory blood pressure and heart rate measurements from 20 women aged 44–55 were examined. Women were categorized by hot flash experience as (1) having had hot flashes during the study period (Symptomatic during Study; n = 5; 302 measurements), (2) having a past history of hot flashes, but no hot flashes during the study period (Historically Symptomatic; n = 7; 385 measurements), and (3) never having had a hot flash (Asymptomatic; n = 8; 462 measurements). Using repeated measures, nested ANOVA models that also adjusted for posture, the variation in blood pressure and heart rate associated with hot flash experience over the whole day and by location of measurement (microenvironment) was evaluated.

Results: The results show that, overall, systolic pressure did not differ among the hot flash experience groups although the Symptomatic during Study group had higher pressures at work than the other two groups (?p<0.01), and tended to have higher pressures during sleep (?p<0.08). The sleep diastolic pressure of the Asymptomatic group was significantly lower than that of the women who had hot flashes on the study day (?p<0.01), but women who had a past history of hot flashes had slightly lower diastolic pressure (?p<0.01) than those in the other two groups overall. Heart rates of the Asymptomatic group, however, were significantly lower (4–6?b.p.m.; p<0.001) in each microenvironment and over the whole day than both groups who had hot flash experience.

Conclusions: These data suggest first that there may be a relationship between the experience of hot flashes and accelerated heart rate, and second that women who do not experience hot flashes may have lower sleep blood pressures than women who do.     

Maximizing health in menopausal women with disabilities

There are nearly 30 million women with disabilities in the United States. Of these, more than 16 million are over the age of 50. Years ago, women with disabilities did not commonly live to the age of menopause, and, if they did, they reached this stage of life in a very debilitated condition. Now, women with disabilities are entering their mature years as active members of society who can look forward to productive futures. Because the health needs of women with disabilities might differ from those of other women, special attention should be focused on how physiological changes of perimenopausal and menopausal states affect this population. In addition to functional changes that might affect menopausal women with disabilities, basic health maintenance issues may be adversely affected by environmental factors. Physical barriers can influence compliance with preventive health screening that is essential in aging populations. Treatment options might need to be tailored to the individual. The disabling condition itself may progress, resulting in secondary conditions requiring creative interventions. A comprehensive evaluation and the development of a suitable management plan, which takes into account the multifactorial nature of aging as a disabled woman, are essential in delivering optimal care to this population.     

Pregnancy: Oocyte donation in menopausal women

Oocyte donation was performed by in-vitro fertilization andembryo transfer in 82 women. The average age of the patientswas 48 years (range 26–60), and 71 were over 40 yearsold, with an average follicle stimulating hormone (FSH) valueof 74±14 IU and oestradiol concentration of 30 ±9 pg/ml. Overall 32 clinical pregnancies were achieved, of which21 reached term, three are ongoing, and eight were lost (sixmiscarriages, one abruptio placentae, and one severe gestationalproteinuria hypertension in the second trimester). The 21 termpregnancies produced 26 newborns; one patient who had had threeembryos replaced delivered triplets and three patients had twins.Before the embryo transfer was performed, the endometrium thicknesswas accurately determined by vaginal ultrasound probe. The highestnumber of implanted embryos was reached when the endometriumthickness was 9–12 mm.     

The use of complementary and alternative medicine among people living with diabetes in Sydney

Background  

Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature.     

Plasma cortisol concentrations in women with menopausal flushes

A wide variety of stressful stimuli has been shown to increase cortisol secretion. Women with post-menopausal flushes report that their flushes cause acute physical discomfort. We studied the effect of hot flushes on plasma cortisol concentrations in 7 women with frequent post-menopausal flushes. Subjects were monitored subjectively and objectively with a skin temperature recorder over a 3-h period (8:00–11:00 a.m.). The 8:00 a.m. cortisol levels were the highest. These were followed by a decline in plasma levels, suggesting the normal circadian variation in cortisol concentrations. No increase in plasma cortisol levels was found during or after the flush episodes. These results suggest that, in our experimental setting, post-menopausal flushes do not increase cortisol secretion.     

Effects of menopausal status on sleep in midlife women

Disturbed sleep is a common complaint of midlife women often attributed to menopause, though few studies have examined direct effects of menopausal status on sleep. Our objective was to assess this issue in healthy midlife women. We examined sleep polysomnographically on 2 consecutive nights in 25 women (ages 45 - 56 yrs) without sleep complaints (13 pre-menopausal; 12 post-menopausal). Groups differed in Stage 1 % (lower in post-menopausal) and slow wave sleep latency (shorter in post-menopausal). Subjective sleep reports did not differ. Age correlated negatively with Stage 1 % and positively with Stage 4 %. These results indicate that menopausal status plays a minimal role in sleep quality and sleep stage distribution in healthy midlife women without sleep complaints.     

The menopausal age,related factors and climacteric symptoms in Turkish women

An interview based survey to reveal age at menopause and associated factors was conducted in a clinic based sample of Turkish women living mainly in an urban area. Interviews by a psychologist were obtained from 1500 women aged 41–70. The study included only women who had undergone natural menopause and had their last menstrual bleeding at least 1 year previously. The mean and median age at menopause was 47.8±4.0 and 51, respectively. Parity and BMI had a statistically significant impact on the age of menopause (P=0.0397 and 0.0403). The most common symptoms were muscle and–or joint and–or bone pain (82.3%) and hot flushes (73.9%). Although the population was clinic based, this study is the first one of its kind in Turkish women.     

Sexual function in menopausal women in Kelantan, Malaysia

OBJECTIVES: The aim of the study was to document sexual function in Kelantanese postmenopausal women. METHOD: A semi-structured questionnaire in Malay language was administered to 326 women (mean age of 57.1+/-6.58 (S.D.) years) residing in Kelantan. The subjects comprised of naturally menopaused, healthy women. RESULTS: Of the total respondents, 70% (n=227) were with a spouse at the time of the study. Of these, more than two-thirds reported a decrease in sexual activity following menopause. Varying degree of dyspareunia was reported by 44% of the women. A small fraction (8.8%) reported inability of the vagina to stretch sufficiently to enable the complete penetration of an erect penis. Of the total married respondents, vaginal secretion during sexual intercourse was decreased in 52.4%, did not change in 31% but increased in 1.3% of the women following menopause. Sexual desire was reportedly decreased or absent in two-thirds of the total respondents (n=326). CONCLUSION: It appears that sexual function significantly decreases during menopause. This may be due to dyspareunia, poor lubrication, loss of sexual desire, and the spouse's health status and ageing itself. Although declining sexual function was recognised by nearly two-thirds of the women, more than half did not take any action to improve their sexual function. Of those who did, they used hormonal therapy, traditional, alternative medicine or practiced healthy lifestyle or a varied combination of above self-help actions.     

The prevalence of symptoms in menopausal women in the far east: Singapore segment

Questionnaires (4000) on experience of menopausal symptoms in Singaporean women aged 40–55 were distributed by students. In total, 524 envelopes were returned (13.1%) and of these 420 were analyzed. Of these, 366 were classified as either pre-, peri-or postmenopaual on the basis of their menstrual patterns. Menopausal symptoms in this sample of Singaporean women were, in general, similar to those experienced in the West though the prevalence was low compared to European studies. No significant differences in individual symptoms were found between the 3 groups but, taken together, symptoms were significantly highest in the perimenopausal and lowest in the other menopausal groups. In the postmenopausal group 50% had been menopausal for at least 1 year at 50.5 years.     

Prevalence of menopausal symptoms in women in Kelantan, Malaysia

OBJECTIVES: The aim of the study was to document the prevalence of 16 symptoms commonly associated with menopause, in women living in Kelantan. METHOD: After verification, a semi-structured questionnaire in the Malay language was administered to 326 naturally menopaused healthy women in Kelantan (mean age of 57.1+/-6.58 (S.D.) years) to assess the prevalence of 16 common symptoms, which had been identified through focus group discussions and those that have been repeatedly reported in the literature. RESULTS: Mean age at menopause was 49.4+/-3.4 (S.D.) years while both the mode and median were 50 years. Of these, 75% were within the first 10 years of menopause and the rest were within the range of 11 to more than 20 years postmenopause. The mode for the number of symptoms complained by each woman was 8 (range 0-16). The prevalence of atypical symptoms was as follows: tiredness (79.1%), reduced level of concentration (77.5%), musculo-skeletal aches (70.6%) and backache (67.7%). Night sweats (53%), headache (49.4%) and hot flushes (44.8%) were the typical vasomotor symptoms, whereas mood swings (51%), sleep problems (45.1%), loneliness (41.1%), anxiety (39.8%) and crying spells (33.4%) were the main psychological symptoms. Uro-genital symptoms such as vaginal discomfort (45.7%), occasional stress incontinence (40%), weak bladder control (24%) and urinary tract infection (19.3%) were also reported. CONCLUSION: The symptoms are somewhat similar to those experienced by postmenopausal women elsewhere, albeit at different frequencies. There was a tendency for the women to admit to having more of the atypical symptoms, the prevalence of some which increased with increasing menopausal status, and lesser of the vasomotor and psychological symptoms.     

Predictors of sleep quality in women in the menopausal transition

STUDY OBJECTIVES: To determine associations between menopausal status, reproductive hormone levels, menopausal symptoms, and poor sleep quality. DESIGN: The present study examines subjective sleep quality over an 8-year period in participants in an ongoing longitudinal study of ovarian aging in a randomly identified cohort of African American and Caucasian women. PARTICIPANTS: The Penn Ovarian Aging Study, a population-based cohort of 436 women from Philadelphia County who were 35 to 47 years of age and had regular menstrual cycles at enrollment. INTERVENTIONS: N/A. MEASUREMENTS AND RESULTS: The primary outcome measure was the Sleep Quality factor score, derived from the St. Mary's Hospital Sleep Questionnaire, which was adapted for this population and collected at each assessment period over the 8-year follow-up. Associations between menopausal status, reproductive hormone levels, menopausal symptoms, sleep quality, age, and race were examined in multivariable linear mixed regression models for repeated measures. Menopausal status was not significantly associated with sleep quality (P = 0.12). In the adjusted model, independent predictors of sleep quality were hot flashes (P < 0.0001), Center for Epidemiological Studies Depression Scale scores (P < 0.0001) and levels of the reproductive hormone inhibin B (P = 0.05). CONCLUSIONS: Sleep quality was predicted by hormone levels and symptoms that occur in the menopausal transition but did not worsen with advancing menopausal status alone. Lower inhibin B levels, hot flashes, and symptoms of depression were all strong and independent predictors of difficulty sleeping. Race was not a significant contributor to sleep quality. Together, the findings demonstrate that women who experience other perimenopausal symptoms are likely to experience sleep problems during the menopausal transition.     

Oocyte donation in menopausal women aged over 40 years

In order to investigate the pregnancy potential of menopausalwomen over 40 years of age by use of donor eggs, we retrospectivelyanalysed the results of our ovum donation programme. Forty-oneclinical pregnancies were established in 134 recipient cycles.The recipients were divided into three age groups (40–43,44–47 and 48 years) in order to investigate the implantationrate with respect to age. The 30.6% pregnancy rate per embryotransfer cycle and 9.7% implantation rate per embryo appearedto be constant in all age groups studied. Fourteen pregnanciesended in miscarriage, there was one ectopic pregnancy and 25healthy babies have been delivered. The oldest woman to deliverwas 54 years of age. This report highlights the question ofage limit for application of the new reproductive technologies,and especially of oocyte donation.