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Spachmann PJ, Radlmaier M, Denzinger S, Burger M, Breyer J, Otto W, Schnabel MJ, Vergho D. Recurrent Cystitis in Women-A Real-World Analysis of Bacteria Spectrum and Resistance Situation for Calculated Therapy. Antibiotics (Basel) 2024; 13:890. [PMID: 39335063 PMCID: PMC11428551 DOI: 10.3390/antibiotics13090890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 09/03/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Recurrent cystitis in women represents an everyday challenge; however, little to no data regarding this population are available. This study aimed to evaluate this collective with respect to a rational calculated antibiotic therapy. Urine cultures and antibiograms from a urological office were retrospectively evaluated from patient data collected between January 2017 and June 2019. The evaluation was conducted using SPSS ©. In total, 84 female patients, who were aged between 18 and 87 years old (median 60 years), suffered from recurrent cystitis. Escherichia coli was found in 53.9% of cases, Staphylococcus aureus and enterococci were each found in 6.7%, and Proteus spp. and Streptococcus agalactiae were each found in 5.6%. The resistance levels to ciprofloxacin (CIP), trimethoprim-sulfamethoxazole (TRS), nitrofurantoin (NIT), and nitroxoline (NOX) were 18.2%, 30.7%, 16.1%, and 12.5% in the tested cases, respectively. Regarding E. coli, resistance to CIP, TRS, and NIT was found in 17.8%, 25%, and 4.2% of the tested cases, and no resistance to NOX was found. The resistance level to CIP was in a tolerable range of <20% in the overall cohort and the E. coli subgroup. More than a quarter of the bacteria were resistant to TRS. The low resistance rates for NIT and NOX are remarkable, promoting the use of these substances if they are not yet used.
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Affiliation(s)
- Philipp J. Spachmann
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
- Urologie Landau and Urologie Plattling, 94405 Landau/Isar, Germany
| | - Maximilian Radlmaier
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
| | - Stefan Denzinger
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
| | - Johannes Breyer
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
| | - Wolfgang Otto
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
| | - Marco J. Schnabel
- Department of Urology, Caritas St. Josef Medical Center Regensburg, University of Regensburg, 93053 Regensburg, Germany
| | - Daniel Vergho
- Urologie Landau and Urologie Plattling, 94405 Landau/Isar, Germany
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Some Observations on the Demographic Variables of Marriage System in Greek Thrace: Evidence from Several Anthropological Populations. GENEALOGY 2022. [DOI: 10.3390/genealogy6010012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The examination of demographic patterns and their variables is essential for our understanding of the anthropological and cultural processes that shape modern societies. Greek Thrace plays an important role in such analyses due to the cultural and socioeconomic variability it presents. This study is based on vital registration data of the 20th century, derived by various populations that inhabit the Department of Rhodopi, which are defined by discrete socio-economic, cultural, and historic backgrounds. We analyze and present various aspects of the social lives observed in these populations: marriage patterns, mean age at marriage of the spouses, mean age of mothers at first and last child, reproductive span, the children ever born, as well as other parameters related to reproduction. Our analyses show that several changes in marriage patterns have been undertaken throughout time, indicating an ongoing fertility transition. In that way, this study contributes to our knowledge on the anthropological populations from this part of Greece in relation to their socio-economic environment and it proposes possible analogies and differences that affected the evolution of the embedded populations.
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Rostami Dovom M, Bidhendi-Yarandi R, Mohammad K, Farahmand M, Azizi F, Ramezani Tehrani F. Prevalence of premature ovarian insufficiency and its determinants in Iranian populations: Tehran lipid and glucose study. BMC Womens Health 2021; 21:79. [PMID: 33622308 PMCID: PMC7903639 DOI: 10.1186/s12905-021-01228-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 02/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Premature ovarian insufficiency (POI) considered as a concerning health issue for women of reproductive age. In this study we aim to estimate the prevalence of POI and assessing the influential factors. METHODS Data was obtained from Tehran lipid and glucose study (TLGS). All eligible post-menarcheal female participants of the TLGS, ages 20-65, were recruited (n = 6521). Participants were followed for the event of menopause, and age at menopause was recorded. Kaplan Meier analysis was applied to estimate mean and median for age at menopause. Weibull accelerated failure time survival regression model (AFT), was applied to assess influential determinants of POI. Conditional probability approach was used to provide estimation for prevalence of POI. RESULTS In this population-based study, the prevalence of POI (menopause age < 40 years) and early menopause (menopause age < 45 years) were estimated 3.5% and 24.6%, respectively. AFT model showed that in comparison to normal weight women, time to menopause was decreased by - 0.09 year (95% CI - 0.27, - 0.01, p = 0.023) and - 0.03 year (95% CI - 0.05, - 0.02, p = 0.000) in underweight and overweight women, respectively. Moreover, time to natural menopause was increased by 0.12 year (95% CI 0.07 to 0.17, p = 0.000) in women used oral contraceptives for > 6 months. CONCLUSION About one quartile of Iranian women experienced menopause at an age less than 45, especially the non-normal weight ones; this high prevalence is a critical public health concerns that needs to be addressed by health policy makers.
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Affiliation(s)
- Marzieh Rostami Dovom
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Shahid Arabi St., Yaman Ave, Velenjak, P.O.Box, 19395-4763, Tehran, Iran
| | - Razieh Bidhendi-Yarandi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Shahid Arabi St., Yaman Ave, Velenjak, P.O.Box, 19395-4763, Tehran, Iran.
| | - Kazem Mohammad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Farahmand
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Shahid Arabi St., Yaman Ave, Velenjak, P.O.Box, 19395-4763, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Shahid Arabi St., Yaman Ave, Velenjak, P.O.Box, 19395-4763, Tehran, Iran
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Abstract
Objective: Recent evidence suggests that early or induced menopause increases the risk for cognitive impairment and dementia. Given the potential for different cognitive outcomes due to menopause types, it is important that present research on menopause and cognition distinguishes between types. The aim of this project was to determine to what extent research looking at cognition in postmenopausal women published in one year, 2016, accounted for menopausal type. Methods: We searched MEDLINE, EMBASE, and PsychINFO using keywords and MeSH terms for menopause and cognition. We included any research paper reporting a cognitive outcome measure in a menopausal human population. Differentiation between the types of menopause was defined by four categories: undifferentiated, demographic differentiation (menopause type reported but not analyzed), partial differentiation (some but not all types analyzed), and full differentiation (menopause types factored into analysis, or recruitment of only one type). Results: Fifty research articles were found and analyzed. Differentiation was distributed as follows: undifferentiated, 38% (19 articles); demographic differentiation, 16% (8); partial differentiation, 28% (14); and full differentiation, 18% (9). Conclusions: This review revealed that although some clinical studies differentiated between the many menopauses, most did not. This may limit their relevance to clinical practice. We found that when menopause types are distinguished, the differing cognitive outcomes of each type are clarified, yielding the strongest evidence, which in turn will be able to inform best clinical practice for treating all women.
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Association of menopausal symptoms with sociodemographic factors and personality traits. MENOPAUSE REVIEW 2020; 18:191-197. [PMID: 32132882 PMCID: PMC7045358 DOI: 10.5114/pm.2019.93117] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/21/2019] [Indexed: 11/17/2022]
Abstract
Aim of the study To investigate the association of personality traits with the severity of vasomotor symptoms (VMS) in a predominantly Greek population. Material and methods A questionnaire-based study of women from the Menopause Clinic of a University Hospital in Athens, Greece. Sociodemographic parameters were documented through a structured interview. All women completed the Menopause Rating Scale (MRS) for the assessment of severity of menopausal symptoms, the Hot Flush Beliefs Scale (HFBS) for the assessment of how women were coping with their symptoms and the Big Five Inventory questionnaires for the assessment of personality traits. Associations between baseline parameters and menopausal symptoms were assessed with univariate and multivariate regression analyses. Results One hundred women were included. Employed women had lower MRS sub-scores (psychological p< 0.001, somatic p< 0.047, urogenital p< 0.008). Married women scored higher in the psychological and somatic domains. Women of university educational level coped significantly better with hot flushes (β coefficient [SE]: 0.72 [0.25], p< 0.01) and night sweats (0.57 [0.19], p< 0.01) than women of primary education, although the significance of these findings was not replicated when taking into account confounders. Regarding personality traits, women with low openness (-0.33 [0.11], p< 0.01) and empathy (-0.83 [0.37], p = 0.03) and high agreeableness (1.13 [0.21], p< 0.001) had more severe menopausal symptoms. In contrast, women with high agreeableness could better cope with their menopausal symptoms (-0.75 [0.36], p = 0.04). These associations were independent of sociodemographic factors. Conclusions Personality traits, especially agreeableness, openness and empathy are associated with menopausal symptoms and functionality in postmenopausal women. These associations might serve as indicators of women at risk of experiencing more severe VMS.
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Golezar S, Ramezani Tehrani F, Khazaei S, Ebadi A, Keshavarz Z. The global prevalence of primary ovarian insufficiency and early menopause: a meta-analysis. Climacteric 2019; 22:403-411. [PMID: 30829083 DOI: 10.1080/13697137.2019.1574738] [Citation(s) in RCA: 153] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Objective: The aim of this study was to estimate the global prevalence of primary ovarian insufficiency (POI) and early menopause (EM). Methods: A comprehensive literature search was performed in several databases to retrieve relevant English articles published between 1980 and 2017. To assess the methodological quality of the studies, the Newcastle-Ottawa Scale was used. The heterogeneity of results across the studies was assessed using Cochran's Q test and quantified by the I2 statistic. Prevalence estimates of all studies were pooled using a random-effects meta-analysis model at a confidence level of 95%. Results: A total of 8937 potentially relevant articles were identified from the initial searches. Thirty-one studies met the inclusion criteria and were included in this meta-analysis. The pooled prevalence of POI and EM was calculated as 3.7% (95% confidence interval: 3.1, 4.3) and 12.2% (95% confidence interval: 10.5, 14), respectively. The prevalence of POI was higher in medium and low Human Development Index countries. The prevalence trend did not change over time. Conclusion: The prevalence of POI and EM in women is considerable. The results of this study could contribute to consciousness-raising of health policy-makers toward the necessity of prioritizing, planning, and allocating health resources as preventive and treatment interventions for these women.
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Affiliation(s)
- S Golezar
- a Student Research Committee, School of Nursing and Midwifery , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - F Ramezani Tehrani
- b Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences , Shahid Beheshti University of Medical Sciences , Tehran , Iran
| | - S Khazaei
- c Department of Epidemiology, School of Public Health , Hamadan University of Medical Sciences , Hamadan , Iran
| | - A Ebadi
- d Behavioral Sciences Research Center, Life Style Institute , Nursing Faculty of Baqiyatallah University of Medical Sciences , Tehran , Iran
| | - Z Keshavarz
- e Midwifery and Reproductive Health Research Center and Department of Midwifery and Reproductive Health, School of Nursing and Midwifery , Shahid Beheshti University of Medical Sciences , Tehran , Iran
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Do social determinants of health make a difference in the age at natural menopause in Canada? Menopause 2018; 25:250-251. [DOI: 10.1097/gme.0000000000001030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Age at natural menopause and its associated factors in Canada: cross-sectional analyses from the Canadian Longitudinal Study on Aging. Menopause 2018; 25:265-272. [DOI: 10.1097/gme.0000000000000990] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
Premature menopause, that is, menopause – spontaneous or iatrogenic – occurring at or before the age of 40 years, affects sexual identity, sexual function and sexual relationships. The woman's health, wellbeing and achievement of life's goals may be variably impaired. Factors modulating the individual's sexual outcome after premature menopause include: etiological heterogeneity of premature menopause and associated medical and sexual comorbidities; psychosexual vulnerability to premature menopause and associated infertility in survivors of childhood and adolescent cancers; impact of premature menopause on women's sexual identity, sexual function – particularly the biological basis of desire, arousal, orgasm and vaginal receptivity – and sexual relationships; partner-related factors; fertility issues; and preventive/therapeutic measures. Hormone therapy is indicated but long-term safety data are lacking. An interdisciplinary medical and psychosexual approach comprises appropriate counseling, fertility protection, when feasible, individualized hormone therapy and specific psychosexual treatment(s). Further research on fertility protection and the safety of long-term hormone therapy after premature menopause is needed.
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Affiliation(s)
- Alessandra Graziottin
- San Raffaele Resnati Hospital, Center for Gynecology and Medical Sexology, Via E. Panzacchi 6, 20123 Milan, Italy, Tel.: +39 027 200 2177; Fax: +39 028 767 58;Web:
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Haller-Kikkatalo K, Uibo R, Kurg A, Salumets A. The prevalence and phenotypic characteristics of spontaneous premature ovarian failure: a general population registry-based study. Hum Reprod 2015; 30:1229-38. [DOI: 10.1093/humrep/dev021] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 01/19/2015] [Indexed: 01/01/2023] Open
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Markatseli AE, Hatzi E, Pamporaki C, Bouba I, Xita N, Tigas S, Georgiou I, Tsatsoulis A. Association of the (TAAAA)n repeat polymorphism of SHBG gene with the age at menopause in Greek postmenopausal women. Maturitas 2014; 78:113-6. [DOI: 10.1016/j.maturitas.2014.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 03/20/2014] [Accepted: 03/26/2014] [Indexed: 11/28/2022]
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Farahmand M, Tehrani FR, Pourrajabi L, Najafi M, Azizi F. Factors associated with menopausal age in Iranian women: Tehran Lipid and Glucose Study. J Obstet Gynaecol Res 2012; 39:836-41. [PMID: 23279558 DOI: 10.1111/j.1447-0756.2012.02050.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 08/26/2012] [Indexed: 11/30/2022]
Abstract
AIM Menopause, considered a special event in a woman's life, has a wide age range, 40-60 years, and there is no consensus regarding the factors influencing it. We aimed to assess factors affecting the menopausal age in a population of women participants of the Tehran Lipid and Glucose Study. MATERIAL AND METHODS For the present study, 1114 women were selected from among participants of the Tehran Lipid and Glucose Study. Following implementation of our inclusion criteria, their reproductive histories and demographic background as well as anthropometric parameters were assessed, and ordinal regression analysis was conducted using spss version 15. RESULTS The mean estimated age at menopause ± standard deviation was 49.6 ± 4.5 years. Menopausal age was considerably lower among women with a history of smoking (P = 0.05), and it increased with increasing age of menarche (P = 0.04) and number of children (P = 0.05). There was no significant correlation between the mean age of menopause and the educational level and anthropometric parameters. CONCLUSION The smoking status, parity and the age of menarche are the influencing factors of age at menopause among the Iranian population.
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Affiliation(s)
- Maryam Farahmand
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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The association between anxiety and C-reactive protein (CRP) levels: results from the Northern Finland 1966 birth cohort study. Eur Psychiatry 2011; 26:363-9. [PMID: 21570260 DOI: 10.1016/j.eurpsy.2011.02.001] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 01/31/2011] [Accepted: 02/06/2011] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Anxiety frequently accompanies low-grade inflammation-associated conditions like depression, insulin resistance, coronary heart disease and metabolic syndrome. The association between anxiety and low-grade inflammation is, unlike between depression and low-grade inflammation, a very sparsely studied area in general populations. The aim of the present study was to investigate whether anxiety symptoms as well as comorbid anxiety and depressive symptoms are associated with low-grade inflammation at population level. METHODS The general population-based Northern Finland 1966 Birth Cohort was followed until age 31 (n=2688 males and 2837 females), when the highly sensitive CRP concentrations were measured. Anxiety and depressive symptoms were defined by Hopkins Symptom Checklist-25 (HSCL-25). RESULTS After adjusting for confounders, logistic regression analyses showed that anxiety symptoms alone increased the probability for elevated hs-CRP levels (>3.0mg/L) in males over two-fold (2.19 CI 95% 1.08-4.46), while comorbid anxiety and depressive symptoms caused a 1.7-fold (1.76 CI 95% 1.13-2.74) increase in the probability for elevated hs-CRP levels (1.0-3.0mg/L). CONCLUSIONS Our results support the hypothesis that anxiety as well as comorbid anxiety and depression can be associated with an increased risk for low-grade inflammation in males at population level.
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OlaOlorun F, Lawoyin T. Age at menopause and factors associated with attainment of menopause in an urban community in Ibadan, Nigeria. Climacteric 2010; 12:352-63. [PMID: 19065309 DOI: 10.1080/13697130802521282] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To determine the age at natural menopause and identify sociodemographic, reproductive and other factors associated with the attainment of natural menopause among women in Ibadan, Nigeria. METHODS This was a cross-sectional, descriptive, community-based study, using a cluster sample of eligible women 40-60 years of age residing in selected areas. Questionnaires were administered to women at home or in their work place. Data were analyzed using SPSS 16.0. RESULTS A total of 1189 Nigerian women responded. Their mean age (+/- SD) was 48.0 +/- 5.9 years and their median age 48 years. The majority, 1000 (84.1%), were currently married. Of the women, 581 (48.9%) were premenopausal, 119 (10.0%) perimenopausal and 489 (41.1%) postmenopausal. The median age at menopause using probit analysis was 50.2 years. Following logistic regression analysis, women who were not married and those who had no formal education were more likely to have attained menopause. Similarly, women who were younger, had managerial or professional jobs, and had used oral contraceptive pills were less likely to have attained natural menopause. CONCLUSIONS Efforts should be made to provide education about the menopause to all women in their respective communities, especially to those who are approaching their fifth decade and who have no formal education, to better prepare them for this change of life.
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Affiliation(s)
- F OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Sioka C, Fotopoulos A, Georgiou A, Xourgia X, Papadopoulos A, Kalef-Ezra JA. Age at menarche, age at menopause and duration of fertility as risk factors for osteoporosis. Climacteric 2010; 13:63-71. [DOI: 10.3109/13697130903075337] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Parente RC, Faerstein E, Celeste RK, Werneck GL. The relationship between smoking and age at the menopause: A systematic review. Maturitas 2008; 61:287-98. [PMID: 19019585 DOI: 10.1016/j.maturitas.2008.09.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Revised: 08/15/2008] [Accepted: 09/20/2008] [Indexed: 11/19/2022]
Abstract
CONTEXT AND OBJECTIVE Increasing life expectancy has made it ever more important to study the factors that influence the age at the menopause, given that when it is reached outside of the normal range, it is associated with increased risk of osteoporosis and cardiovascular diseases, among other conditions. Among the factors studied in relation to early menopause, smoking is prominent. Destruction of the ovarian follicles is one of the mechanisms postulated for this effect. The aim of this study was to review and describe the associations between age at the menopause and the habit of smoking, its duration and its intensity. METHOD A systematic review of the literature indexed in the MEDLINE and LILACS databases was conducted, without restriction on publication date. After initially identifying 1325 articles and preselecting 161 articles for consideration of their complete texts, 96 articles reporting on the results from 109 studies were selected for analysis. RESULTS A great majority of the studies reported an association between the habit of smoking and early menopause, but there was no clear evidence that the duration of smoking and quantity of cigarettes smoked had any association with age at the natural menopause. CONCLUSION Additional studies are needed, preferably of prospective nature and with a large number of women, in order to deepen the knowledge of the effects of various aspects of smoking on age at the menopause. Experimental studies on animals may also contribute towards clarifying the physiopathological mechanisms through which smoking influences age at the menopause.
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Affiliation(s)
- Raphael C Parente
- Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
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Chen Y, Lin SQ, Wei Y, Gao HL, Wu ZL. Menopause-specific quality of life satisfaction in community-dwelling menopausal women in China. Gynecol Endocrinol 2007; 23:166-72. [PMID: 17454171 DOI: 10.1080/09513590701228034] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The present study aimed to evaluate the satisfaction with quality of life of menopausal women living in an urban community of Beijing, People's Republic of China, using the Chinese version of the menopause-specific quality of life questionnaire (MENQOL). Menopause-related complaints were assessed for 353 women aged 40-60 years during their menopausal transition (MT) or postmenopause (PM) using MENQOL. The Kruskal-Wallis non-parametric test and Pearson correlation were used for statistical analysis. The mean age of the subjects was 51.20 +/- 4.62 years. The most frequent symptom was 'experiencing poor memory' (84.1%) and the least frequent was 'dissatisfaction with personal life' (26.9%). Mean scores of vasomotor and sexual symptoms in PM women were higher than in MT women (2.60 +/- 1.74 and 3.39 +/- 2.35 vs. 1.96 +/- 1.46 and 2.10 +/- 1.48, respectively; p = 0.0001). The prevalence of menopause-related symptoms varied between self-assessed health status groups (chi(2) = 29.12, p = 0.0001). In conclusion, MENQOL is a good self-administered tool in the assessment of climacteric complaints, with convenient application. The most frequent climacteric symptom of Chinese women living in an urban community was 'experiencing poor memory'. PM women seemed to suffer from more symptoms, especially in vasomotor and sexual domains, than did MT women. Symptom reports might be associated with self-assessed health status.
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Affiliation(s)
- Ying Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, PR China
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Kaczmarek M. The timing of natural menopause in Poland and associated factors. Maturitas 2007; 57:139-53. [PMID: 17307314 DOI: 10.1016/j.maturitas.2006.12.001] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2006] [Revised: 12/07/2006] [Accepted: 12/12/2006] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The outcome of interest was the assessment of age at natural menopause and the variables hypothesized as covariates of age at menopause were indicators of demographic and social status, characteristics of the reproductive history and lifestyle behaviour. METHODOLOGY Seven thousand one hundred and eighty-three women from all social strata of non-clinical population, and aged between 35 and 65 years were investigated in cross-sectional survey across Poland in 2000-2004. The demographic, social, lifestyle behaviour and reproductive history aspects of the menopause-specific questionnaire were examined. The non-parametric Kaplan-Meier cumulative survivorship estimates were used to assess the timing of natural menopause. Univariate and multivariate Cox proportional hazards regression models were used to assess the association of age at natural menopause with factors of interest and to estimate relevant relative risk (the hazard ratio) for earlier age at menopause. RESULTS The overall median age at natural menopause was 51.25 years; 25th percentile 49; 75th percentile 54 years. Temporal changes in age at menopause were not demonstrated in the sample (p=0.9 for differences among age cohorts). Univariate Cox models were first fitted to the age at natural menopause for all covariates singly. The findings revealed that marital status, living environment, employment, BMI, age at first live birth delivered by a woman, breastfeeding, physical activity, smoking amount, and consumption of alcohol were not associated with age at menopause (p>0.05). The multiple Cox model revealed that early menarche, short menstrual cycle length, smoking cigarettes, a low level of education, and a negative health perception were associated with younger age at menopause (p<0.01). Use of oral contraceptives and parity were associated with later menopause (p<0.01). CONCLUSION The present study provides an estimate of median age at natural menopause in Poland that may be used as a measure of health for the growing number of Polish women whose survival is calculated at 30 years after menopause. This study has revealed that the pattern of relationship between age at menopause and the study factors reflects its population-specific character for its social and cultural backgrounds, socio-economic status, and social behaviours.
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Affiliation(s)
- Maria Kaczmarek
- Institute of Anthropology, The Adam Mickiewicz University, Collegium Biologicum, Umultowska 89, 61-614 Poznań, Poland.
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Kim MD, Kim S, Kim NK, Lee MH, Ahn EH, Kim HJ, Cho JH, Cha SH. Long-Term Results of Uterine Artery Embolization for Symptomatic Adenomyosis. AJR Am J Roentgenol 2007; 188:176-81. [PMID: 17179361 DOI: 10.2214/ajr.05.1613] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Controversy exists regarding the effectiveness of uterine artery embolization (UAE) in the management of symptomatic adenomyosis. The aim our study was to determine the long-term clinical efficacy of UAE in the management of symptomatic adenomyosis without fibroids. MATERIALS AND METHODS The cases of all patients who underwent UAE for adenomyosis without fibroids between 1998 and 2000 were analyzed. This study was a retrospective review of a prospectively collected database. Of the 66 patients, 54 patients with a follow-up period of 3 years or longer were enrolled in the study. Twelve patients were lost to follow-up. The patients' ages ranged from 29 to 49 years (mean, 40.2 years). The mean follow-up period was 4.9 years (range, 3.5-5.8 years). The primary embolic agent was polyvinyl alcohol particles (250-710 microm). All patients underwent MRI before UAE. Long-term follow-up MRI was performed on 29 patients; 22 of these patients had undergone short-term (3.5 months) follow-up MRI. Uterine volume was calculated with MR images. Symptom status in terms of menorrhagia and dysmenorrhea was scored on a scale of 0-10, 0 being no symptoms and 10 being the baseline, or initial symptoms. RESULTS Thirty-one (57.4%) of the 54 women who underwent follow-up had long-term success. Four had immediate treatment failure, and 19 had relapses. Changes in mean menorrhagia and dysmenorrhea scores at long-term follow-up were -5.3 and -5.1, respectively (p < 0.001), representing significant relief of symptoms. The time between UAE and recurrence of symptoms ranged from 4 to 48 months (mean, 17.3 months). Five patients underwent hysterectomy because of symptom recurrence. Mean reduction in volume of the uterus was 26.3% at short-term follow-up and 27.4% at long-term follow-up. CONCLUSION We found that UAE is effective in the management of symptomatic adenomyosis and has an acceptable long-term success rate. UAE should be considered a primary treatment method for patients with symptomatic adenomyosis. However, all patients should be given an explanation of the possibility of treatment failure, recurrence, and the need for hysterectomy.
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Affiliation(s)
- Man Deuk Kim
- Department of Diagnostic Radiology, Bundang CHA General Hospital, Pochon CHA University, 351 Yatap-dong, Bundang-gu, Sungnam-si, Kyonggi-do, 463-712, Republic of Korea.
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Abstracts of the 11th World Congress on the Menopause. Climacteric 2005; 8 Suppl 2:1-238. [PMID: 16183612 DOI: 10.1080/13697130512331390481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
The purpose of the present paper is to review recent research on the relationship of culture and menopausal symptoms and propose a biocultural framework that makes use of both biological and cultural parameters in future research. Medline was searched for English-language articles published from 2000 to 2004 using the keyword 'menopause' in the journals--Menopause, Maturitas, Climacteric, Social Science and Medicine, Medical Anthropology Quarterly, Journal of Women's Health, Journal of the American Medical Association, American Journal of Epidemiology, Lancet and British Medical Journal, excluding articles concerning small clinical samples, surgical menopause or HRT. Additionally, references of retrieved articles and reviews were hand-searched. Although a large number of studies and publications exist, methodological differences limit attempts at comparison or systematic review. We outline a theoretical framework in which relevant biological and cultural variables can be operationalized and measured, making it possible for rigorous comparisons in the future. Several studies carried out in Japan, North America and Australia, using similar methodology but different culture/ethnic groups, indicate that differences in symptom reporting are real and highlight the importance of biocultural research. We suggest that both biological variation and cultural differences contribute to the menopausal transition, and that more rigorous data collection is required to elucidate how biology and culture interact in female ageing.
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Affiliation(s)
- Melissa K Melby
- Department of Anthropology, Emory University, Atlanta, GA 30322, USA
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Abstract
OBJECTIVE To discuss assessment and management of sexual dysfunctions associated with premature menopause. DESIGN Literature review plus clinical observations. RESULTS Studies on assessment and management of sexual dysfunctions associated with premature menopause are minimal. Premature menopause affects sexual identity, sexual function, and sexual relationship. Major modulating factors include etiology, life cycle stage, factors personal to the woman, and family and societal influences. Loss of ovarian function in adolescence may delay psychosexual maturity via psychological and biological mechanisms. Maternity becomes impossible, unless ovodonation is feasible, accepted, and legally available. Loss of sexual desire, subjective and genital arousal, and orgasm may be highly distressing. Reduction of sex hormones and psychological reactions of both partners to the prematurity and infertility are etiologically important. Estrogen therapy is usually indicated, but long-term safety data in this population are lacking. Testosterone therapy, also lacking in safety data and mainly investigational, may be needed to restore sexual arousability. Presence, age, and sexual health of the partner, having children, and quality of intimacy in previous and present relationships modulate coping attitudes and clinical outcome. CONCLUSIONS An interdisciplinary medical and psychosexual approach comprises individualized hormone therapy and specific psychosexual treatment(s). Research into optimal management of sexual dysfunction with premature menopause is urgently needed.
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Affiliation(s)
- Alessandra Graziottin
- Center of Gynecology and Medical Sexology, H. San Raffaele Resnati, 10112 Milano, Italy.
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