Chedraui Peter, Blümel Juan E, Baron German, Belzares Emma, Bencosme Ascanio, Calle Andres, Danckers Luis, Espinoza Maria T, Flores Daniel, Gomez Gustavo, Hernandez-Bueno Jose A, Izaguirre Humberto, Leon-Leon Patricia, Lima Selva, Mezones-Holguin Edward, Monterrosa Alvaro, Mostajo Desire, Navarro Daysi, Ojeda Eliana, Onatra William, Royer Monique, Soto Edwin, Tserotas Konstantinos
Instituto para la Salud de la Mujer, Vélez 616y García, Guayaquil, Ecuador.
Maturitas. 2008 Dec 20;61(4):323-9. doi: 10.1016/j.maturitas.2008.09.026. Epub 2008 Nov 17.
Several studies indicate that quality of life (QoL) is impaired in middle aged women. Assessment of QoL using a single validated tool in Latin American climacteric women has not been reported to date at large scale.
The Menopause Rating Scale (MRS) was used to assess QoL among middle aged Latin American women and determine factors associated with severe menopausal symptoms (QoL impairment).
In this cross-sectional study, 8373 healthy women aged 40-59 years, accompanying patients to healthcare centres in 18 cities of 12 Latin American countries, were asked to fill out the MRS and a questionnaire containing socio-demographic, female and partner data.
Mean age of the entire sample was 49.1+/-5.7 years (median 49), a 62.5% had 12 or less years of schooling, 48.8% were postmenopausal and 14.7% were on hormonal therapy (HT). Mean total MRS score (n=8373) was 11.3+/-8.5 (median 10); for the somatic subscale, 4.1+/-3.4; the psychological subscale, 4.6+/-3.8 and the urogenital subscale, 2.5+/-2.7. The prevalence of women presenting moderate to severe total MRS scorings was high (>50%) in all countries, Chile and Uruguay being the ones with the highest percentages (80.8% and 67.4%, respectively). Logistic regression determined that impaired QoL (severe total MRS score > or =17) was associated with the use of alternatives therapies for menopause (OR: 1.47, 95% CI [1.22-1.76], p=0.0001), the use of psychiatric drugs (OR: 1.57, 95% CI [1.29-1.90], p=0.0001), attending a psychiatrist (OR: 1.66, 95% CI [1.41-1.96], p=0.0001), being postmenopausal (OR: 1.48, 95% CI [1.29-1.69, p=0.0001]), having 49 years or more (OR: 1.24, 95% CI [1.08-1.42], p=0.001), living at high altitude (OR: 1.43, 95% CI [1.25-1.62, p=0.0001]) and having a partner with erectile dysfunction (OR: 1.69, 95% CI [1.47-1.94, p=0.0001]) or premature ejaculation (OR: 1.34, 95% CI [1.16-1.55, p=0.0001]). Lower risk for impaired QoL was related to living in a country with a lower income (OR: 0.77, 95% CI [0.68-0.88], p=0.0002), using HT (OR: 0.65, 95% CI [0.56-0.76], p=0.0001) and engaging in healthy habits (OR: 0.59, 95% CI [0.50-0.69], p=0.0001).
To the best of our knowledge this is the first and largest study assessing QoL in a Latin American climacteric series with a high prevalence of impairment related to individual female and male characteristics and the demography of the studied population.
多项研究表明,中年女性的生活质量(QoL)会受到损害。迄今为止,尚未有大规模研究报告使用单一经过验证的工具来评估拉丁美洲更年期女性的生活质量。
使用更年期评定量表(MRS)评估拉丁美洲中年女性的生活质量,并确定与严重更年期症状(生活质量受损)相关的因素。
在这项横断面研究中,8373名年龄在40 - 59岁的健康女性,她们陪同患者前往12个拉丁美洲国家18个城市的医疗中心,被要求填写MRS以及一份包含社会人口统计学、女性和伴侣数据的问卷。
整个样本的平均年龄为49.1±5.7岁(中位数49岁),62.5%的女性受教育年限为12年或更少,48.8%已绝经,14.7%正在接受激素治疗(HT)。MRS总评分的平均值(n = 8373)为11.3±8.5(中位数10);躯体亚量表为4.1±3.4;心理亚量表为4.6±3.8;泌尿生殖亚量表为2.5±2.7。所有国家中,中度至重度MRS总评分的女性患病率都很高(>50%),智利和乌拉圭的比例最高(分别为80.8%和67.4%)。逻辑回归分析确定,生活质量受损(严重MRS总评分≥17)与使用更年期替代疗法(比值比:1.47,95%置信区间[1.22 - 1.76],p = 0.0001)、使用精神科药物(比值比:1.57,95%置信区间[1.29 - 1.90],p = 0.0001)、看精神科医生(比值比:1.66,95%置信区间[1.41 - 1.96],p = 0.0001)、已绝经(比值比:1.48,95%置信区间[1.29 - 1.69],p = 0.0001)、年龄49岁或以上(比值比:1.24,95%置信区间[1.08 - 1.42],p = 0.001)、生活在高海拔地区(比值比:1.43,95%置信区间[1.25 - 1.62],p = 0.0001)以及伴侣患有勃起功能障碍(比值比:1.69,95%置信区间[1.47 - 1.94],p = 0.0001)或早泄(比值比:1.34,95%置信区间[1.16 - 1.55],p = 0.0001)有关。生活质量受损风险较低与生活在低收入国家(比值比:0.77,95%置信区间[0.68 - 0.88],p = 0.0002)、使用HT(比值比:0.65,95%置信区间[0.56 - 0.76],p = 0.0001)以及保持健康生活习惯(比值比:0.59,95%置信区间[0.50 - 0.69],p = 0.0001)有关。
据我们所知,这是第一项也是规模最大的一项研究,评估拉丁美洲更年期女性群体的生活质量,该群体中生活质量受损的患病率较高,并与个体的女性和男性特征以及所研究人群的人口统计学相关。