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Srinivasa Gopalan S, Mann C, Rhodes RE. Impact of symptoms, experiences, and perceptions of the menstrual cycle on recreational physical activity of cyclically menstruating individuals: A systematic review. Prev Med 2024; 184:107980. [PMID: 38704099 DOI: 10.1016/j.ypmed.2024.107980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/13/2024] [Accepted: 04/30/2024] [Indexed: 05/06/2024]
Abstract
OBJECTIVE The menstrual cycle often presents barriers to participation in daily life activities, including physical activity (PA), which is a cornerstone of health and well-being. The purpose of this systematic review was to explore and summarize the impact of symptoms, experiences, and perceptions of the menstrual cycle on recreational PA (RPA), including sports, exercise and active recreation, in the general population. METHODS Six databases were searched for studies that investigated the impact of the menstrual cycle on PA among individuals who were cyclically menstruating, healthy, and not involved in professional sports training. RESULTS The search yielded 3025 studies that were screened for relevance and eligibility, resulting in 25 eligible studies, which were found to be of moderate-to-high quality following a quality and risk-of-bias assessment. Thematic synthesis of qualitative and quantitative data from the selected studies, constituting 16,557 adults and 3715 adolescents, identified the impact of menstrual symptoms on the physical and psychological capability to participate in RPA, social opportunity barriers to RPA (e.g., social pressure due to the sociocultural taboo against menstruation), as well reflective (knowledge) and automatic (habit) motivation on RPA behaviours. CONCLUSION The variability in menstrual symptoms and corresponding experiences suggested the need for an individualized approach to RPA promotion. Furthermore, this review highlighted the need to address the sociocultural taboo against menstruation, as well as improve the provision of knowledge and resources related to the menstrual cycle and RPA, in order to promote and facilitate RPA for cyclically menstruating individuals throughout the menstrual cycle.
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Affiliation(s)
- Sharan Srinivasa Gopalan
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.
| | - Caitlin Mann
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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Sánchez-Zarza SC, Armeni AK, Chedraui P, Pérez-López FR, Gavilanes AWD. Prevalence of menopausal symptoms and severity related factors among mid-aged Paraguayan women as measured with the 10-item Cervantes Scale. Gynecol Endocrinol 2023; 39:2235427. [PMID: 37478894 DOI: 10.1080/09513590.2023.2235427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/10/2023] [Indexed: 07/23/2023] Open
Abstract
Objective: To determine the prevalence of menopausal symptoms and factors related to severity in mid-aged women.Methods: Cross-sectional study in which 216 urban-living women from Asunción-Paraguay (40-60 years) were surveyed with the 10 item Cervantes Scale (CS-10) and a general questionnaire (personal and partner data).Results: Median (interquartile range [IQR]) age of the sample was 48 [9] years, 48.1% were postmenopausal, 8.8% used menopausal hormone therapy, 39.4% psychotropic drugs, 43.5% had hypertension, 6.5% diabetes, 51.9% abdominal obesity, and 89.3% had a partner (n = 193). A history of sexual abuse was present in 2.8%. Median total CS-10 score was 8.5 [9.75]. Overall, 93.3% (180/193) of women having a partner were sexually active, with a median coital frequency of 8 times per month. According to the CS-10, the three most prevalent menopausal symptoms were: aching in muscles and/or joints (70.8%), anxiety and nervousness (70.8%) and hot flashes/night sweats (54.2%). Factors associated with higher CS-10 scores were: female age and educational level, marital status, menopausal status, and marital sexual aspects. Partner educational level was inversely correlated (rho Spearman coefficient) with CS-10 total scores. However, multiple linear regression analysis found that higher total CS-10 scores (more severe menopausal symptoms) negatively correlated to coital frequency and positively correlated with peri- and postmenopausal status, parity, sedentary lifestyle and a history of sexual abuse.Conclusion: Menopausal symptoms in this mid-aged urban female Paraguayan sample were related to hormonal, sexual and other female aspects.
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Affiliation(s)
- Sandra C Sánchez-Zarza
- Instituto de Previsión Social (IPS), Hospital Central, Dr. Emilio Cubas, Asunción, Paraguay
- Facultad de Ciencias de la Salud, Universidad Católica "Nuestra Señora de la Asunción", Asunción, Paraguay
| | - Anastasia K Armeni
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Patras Medical School Greece, Researcher Mentee for the EMAS Junior Mentorship Programme
| | - Peter Chedraui
- Facultad de Ciencias de la Salud, Universidad Católica "Nuestra Señora de la Asunción", Asunción, Paraguay
- Instituto de Investigación e Innovación en Salud Integral, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Faustino R Pérez-López
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Antonio W D Gavilanes
- School of Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
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Hutchings HA, Taylor N, Remesh A, Rafferty J. A study evaluating quality of life and factors affecting it before, during and after menopause. Eur J Obstet Gynecol Reprod Biol 2023; 289:100-107. [PMID: 37657139 DOI: 10.1016/j.ejogrb.2023.08.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/31/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVE To determine if quality of life (QoL) changes before, during and after menopause and whether these changes are linked to symptoms, demographics, and/or lifestyle factors. METHODS We undertook a cross-sectional online survey. We invited women aged between 35 and 60 years to complete the survey which included the Short-Form 36 (SF-36) generic quality of life measure, the menopause specific Utian-Quality of life (UQOL) measure, and questions about health and wellbeing, menopause symptoms and hormonal stage. The data were analysed with one-way ANOVA analysis and multivariate regression modelling. RESULTS 279 women completed the survey. Most were aged between 51 and 55 years. In the unadjusted analysis there was a tendency for QoL to deteriorate from pre to peri to menopause and then increase slightly post menopause. This was however not significant in multivariate analysis. Multivariate analysis identified that lifestyle factors significantly influenced QoL. Regular exercise resulted in better QoL scores across a number of the UQol and SF-36 sub-scales. Being very overweight and having more menopause symptoms resulted in worse QoL. CONCLUSIONS Although there was a trend towards worse quality of life in the peri and menopause stages this was not significantly different in adjusted multivariate analyses. Those experiencing more symptoms had significantly worse QoL. Lifestyle factors may affect QoL, but the picture is not straightforward. It is promising that there was a trend toward improved QoL in the post-menopausal stage. These findings should inform education material and promote awareness of the menopause and its impact on QoL. (245).
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Affiliation(s)
- Hayley A Hutchings
- School of Medicine, Faculty of Medicine, Health and Life Science, Swansea University, Swansea University, Singleton Park, SA2 8PP, Wales.
| | - Nia Taylor
- School of Medicine, Faculty of Medicine, Health and Life Science, Swansea University, Swansea University, Singleton Park, SA2 8PP, Wales
| | - Anagha Remesh
- School of Medicine, Faculty of Medicine, Health and Life Science, Swansea University, Swansea University, Singleton Park, SA2 8PP, Wales
| | - James Rafferty
- School of Medicine, Faculty of Medicine, Health and Life Science, Swansea University, Swansea University, Singleton Park, SA2 8PP, Wales
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Kulak A, Toros T, Ogras EB, Etiler IE, Bagci E, Gokyurek B, Bilgin U. The Impact of Sustainable Exercise on Self-Efficacy and Life Satisfaction in Women before and after Menopause. Behav Sci (Basel) 2023; 13:759. [PMID: 37754037 PMCID: PMC10525491 DOI: 10.3390/bs13090759] [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: 06/20/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
The study aims at elucidating the association between sustainable exercise and its influence on self-efficacy and life satisfaction in women during their premenopausal and postmenopausal stages. A relational screening model was employed on a sample of 422 women, with 215 premenopausal and 207 postmenopausal participants, utilizing convenience sampling. Participants' regularity of exercise and its duration was taken into consideration. Evaluation tools included the General Self-Efficacy Scale (GSES) and the Satisfaction with Life Scale (SWLS). Data were analyzed using a statistical software package with significance set at 0.05. Sustainable exercise demonstrated no significant difference in SWLS or GSES subdimensions among premenopausal women. However, postmenopausal women engaging in regular exercise reported significantly higher scores in SWLS and all GSES subdimensions. Moreover, positive correlations between age and SWLS scores, as well as between age and certain GSES subdimensions, were found in both pre- and postmenopausal periods. While sustainable exercise does not evidently impact the life satisfaction and self-efficacy of premenopausal women, it significantly enhances these parameters in postmenopausal women. Additionally, age appears to influence life satisfaction and specific self-efficacy subdimensions across both phases.
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Affiliation(s)
- Abdulaziz Kulak
- Physical Education and Sports School, Harran University, Sanliurfa 63300, Turkey
| | - Turhan Toros
- Department of Coaching Education, Mersin University, Mersin 33000, Turkey
| | - Emre Bulent Ogras
- Faculty of Sport Sciences, Mersin University, Mersin 33000, Turkey; (E.B.O.); (I.E.E.)
| | - Ibrahim Efe Etiler
- Faculty of Sport Sciences, Mersin University, Mersin 33000, Turkey; (E.B.O.); (I.E.E.)
| | - Emre Bagci
- Faculty of Sport Sciences, Gazi University, Ankara 06560, Turkey
| | - Belgin Gokyurek
- Faculty of Sport Sciences, Gazi University, Ankara 06560, Turkey
| | - Ulviye Bilgin
- Faculty of Sport Sciences, Gazi University, Ankara 06560, Turkey
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Thuraisingham C, Nalliah S. Is menopause managed well enough in general practice? MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2023; 18:49-100. [PMID: 37719692 PMCID: PMC10504900 DOI: 10.51866/cm.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Menopause is an important phase in the life of older women. Women's life expectancy has increased worldwide. As women experience and perceive menopause differently depending on their personal, family and sociocultural backgrounds, perimenopausal symptoms can often go unnoticed and missed by general practitioners. General practitioners are uniquely placed in the healthcare delivery pyramid to close this gap and improve patients' quality of life by identifying perimenopausal signs and symptoms early. This article shares knowledge about continuing medical education for general practitioners to close the existing gap. As there is great variability within each menopausal woman's experience as well as among individual women, there is a need to individualise and render personalised care. By being able to discuss accepted and safe standards of care and by advocating for a holistic approach incorporating both non-pharmacological and pharmacological strategies, general practitioners would be able to improve the confidence of their patients for better health outcomes.
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Affiliation(s)
- Chandramani Thuraisingham
- MBBS, FAFP, FRACGP, AM, DRM, PDOH, Department of Family Medicine, International Medical University, Clinical Campus Seremban, Seremban, Negeri Sembilan, Malaysia.
| | - Sivalingam Nalliah
- MBBS, MCGP, FRCOG, FAMM, FICS, M Ed, MIDT, Department of Obstetrics & Gynaecology, International Medical University, Clinical Campus Seremban, Seremban, Negeri Sembilan, Malaysia
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Bień A, Korżyńska-Piętas M, Zarajczyk M, Wysokiński M, Niewiadomska I, Jurek K, Rzońca E. Factors Determining the Quality of Life of Polish Women during Menopause Based on the Menopause-Specific Quality of Life Questionnaire. Healthcare (Basel) 2023; 11:healthcare11081173. [PMID: 37108007 PMCID: PMC10138136 DOI: 10.3390/healthcare11081173] [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: 02/21/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The aim of the study was to present the process of cultural adaptation to Polish conditions and the validation of a scale assessing the quality of life of Polish women during the menopause and to identify the factors determining this quality of life. METHODS The research tools were the menopause-specific quality of life (MENQOL) questionnaire and a standardized interview questionnaire comprising questions on the participants' characteristics. The study involved 516 women using health care services who had symptoms caused by the menopause. RESULTS The value of the Cronbach's alpha coefficient was 0.923. The discriminative power coefficients of all the questionnaire items were higher than 0.3. The study confirmed the validity and internal consistency of the Polish version of the MENQOL questionnaire for measuring the quality of life of postmenopausal women, suggesting that the tool can be used for screening menopausal symptoms in women. There was a relationship between general quality of life and age (p = 0.002), marital status (p < 0.001), education (p = 0.021), the impact of professional work (p < 0.001), the impact of physical activity (p < 0.001) and the impact of social life (p < 0.001). CONCLUSION In the group of women who took part in the study, the authors observed a lower quality of life during menopause reported by older women who were married/in a stable relationship, with no formal education (no formal education) and who, according to their subjective assessment, negatively evaluated the impact of the accompanying menopause-related symptoms on their work, physical activity and social life.
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Affiliation(s)
- Agnieszka Bień
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Magdalena Korżyńska-Piętas
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Marta Zarajczyk
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Mariusz Wysokiński
- Chair of Nursing Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Iwona Niewiadomska
- Department of Social Psychoprevention, John Paul II Catholic University of Lublin, 20-950 Lublin, Poland
| | - Krzysztof Jurek
- Institute of Sociological Sciences, John Paul II Catholic University of Lublin, 20-950 Lublin, Poland
| | - Ewa Rzońca
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 00-575 Warsaw, Poland
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Gavilán-Carrera B, Delgado-Fernández M, Álvarez-Gallardo IC, Acosta-Manzano P, Borges-Cosic M, Estévez-López F, Soriano-Maldonado A, Carbonell-Baeza A, Aparicio VA, Segura-Jiménez V. Longitudinal association of sedentary time and physical activity with pain and quality of life in fibromyalgia. Scand J Med Sci Sports 2023; 33:292-306. [PMID: 36326665 DOI: 10.1111/sms.14258] [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: 03/25/2022] [Revised: 10/21/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To analyze changes over time and the predictive value of baseline and changes of sedentary time (ST) and physical activity (PA) on pain, disease impact, and health-related quality of life (HRQoL) at 2- and 5-year follow-up in women with fibromyalgia. METHODS This is a longitudinal and exploratory study with three time points. A total of 427 women with fibromyalgia (51.4 ± 7.6 years) were followed after 2 (n = 172) and 5 years (n = 185). ST and PA (light and moderate-to-vigorous [MVPA]) were assessed using triaxial accelerometers. Pain, disease impact, and HRQoL were measured using: pressure pain threshold, the pain subscale of the revised fibromyalgia impact questionnaire (FIQR), the bodily pain subscale of the 36-item short-form health survey (SF-36), a visual analog scale (VAS), the FIQR, and the SF-36 physical and mental components. RESULTS Over 5 years, pressure pain threshold, ST, light PA, and MVPA variables were worsened, while FIQR and SF-36 variables were improved (Cohen's d < 0.1-0.3). Baseline ST or light PA were not associated with future outcomes, whereas greater MVPA at baseline was associated with better SF-36 bodily pain at 5-year follow-up (β = 0.13). Reducing ST and increasing light PA were associated with better bodily pain (β = -0.16 and 0.17, respectively) and SF-36 physical component (β = -0.20 and 0.17, respectively) at 5-year follow-up. Increasing MVPA was associated with less pain (pressure pain threshold, VAS, and FIQR-pain) and better SF-36 physical component at 2- and 5-year follow-up (β's from -0.20 to 0.21). CONCLUSIONS Objectively measured variables slightly worsened over years, while for self-reported outcomes there was a trend for improvement. Reductions in ST and increases in light PA and MVPA were associated with better HRQoL at 5-year follow-up, and increases in MVPA were additionally associated with better pain and HRQoL at 2-year follow-up.
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Affiliation(s)
- Blanca Gavilán-Carrera
- Departamento de Medicina Interna, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,PA-HELP "Physical Activity for Health Promotion, CTS-1018" research group. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain.,Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain
| | - Manuel Delgado-Fernández
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" research group. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain.,Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain
| | - Inmaculada C Álvarez-Gallardo
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cadiz, Spain.,Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain
| | - Pedro Acosta-Manzano
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" research group. Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain.,Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain.,Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Milkana Borges-Cosic
- GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cadiz, Spain.,Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Fernando Estévez-López
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Massachusetts, Boston, USA
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,Sport Research Group (Cts-1024), Cernep Research Center, University of Almería, Almería, Spain
| | - Ana Carbonell-Baeza
- Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain.,MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
| | - Virginia A Aparicio
- Sport and Health University Research Institute (IMUDS), University of Granada, Granada, Spain.,Department of Physiology, School of Pharmacy, University of Granada, Granada, Spain.,Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Víctor Segura-Jiménez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.,GALENO research group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cadiz, Spain.,Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cadiz, Spain.,UGC Neurotraumatología y Rehabilitación, Hospital Universitario Virgen de las Nieves, Granada, Spain
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Blümel JE, Vallejo MS, Bencosme A, Calle A, Dextre M, Díaz K, López M, Miranda C, Ñañez M, Ojeda E, Rey C, Rodrigues MAH, Salinas C, Tserotas K, Aedo S, Pérez-López FR. Post-COVID-19 syndrome in a sample of climacteric women living in Latin America. Menopause 2023; 30:165-173. [PMID: 36477574 DOI: 10.1097/gme.0000000000002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this study was to assess resilience, fear of COVID-19, sleep disorders, and menopause-related symptoms after the acute phase of COVID-19 in middle-aged women with positive reverse transcription-polymerase chain reaction and noninfected women. METHODS This is a cross-sectional, analytical study of climacteric women from 9 Latin American countries, aged 40-64 years, attending a routine health checkup. We evaluated clinical characteristics and used the Connor-Davidson Resilience Scale, the Fear of COVID-19 Scale, the Jenkins Sleep Scale, and the Menopause Rating Scale to evaluate their health. RESULTS A total of 1,238 women were studied, including 304 who were positive for COVID-19 reverse transcription-polymerase chain reaction. The median (interquartile range) age was 53 (12) years; years of studies, 16 (6); body mass index, 25.6 (5.1) kg/m 2 ; and time since first COVID-19 symptom, 8 (6) months. COVID-19 patients reported fatigability (18.8%), joint and muscular discomfort (14.1%), and anosmia (9.5%). They had a significantly lower resilience score (26.87 ± 8.94 vs 29.94 ± 6.65), higher Fear of COVID-19 score (17.55 ± 7.44 vs 15.61 ± 6.34), and a higher Jenkins Scale score (6.10 ± 5.70 vs 5.09 ± 5.32) compared with control women. A logistic regression model confirmed these results. There was not a significant difference in the total Menopause Rating Scale score, although the odds ratios for both severe menopausal symptoms (1.34; 95% confidence interval, 1.02-1.76) and the use of hypnotics were higher in women with COVID-19 (1.80; 95% confidence interval, 1.29-2.50) compared with those without infection. We found no decrease in studied outcomes between the initial 7 months versus those reported after 8 to 18 months since first COVID-19 symptoms. CONCLUSIONS COVID-19 climacteric women have sleep disorders, lower resilience and higher fear of COVID-19.
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Affiliation(s)
- Juan Enrique Blümel
- From the Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - María Soledad Vallejo
- Clínica Quilín, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - Ascanio Bencosme
- Ginecología Obstetricia, Hospital Metropolitano de Santiago, Santiago de los Caballeros, República Dominicana
| | - Andrés Calle
- Centro Integral de Salud Obstétrica y Femenina, Quito, Ecuador
| | - Maribel Dextre
- Ginecología Obstetricia, Clínica Internacional-Clínica Javier Prado, Lima, Perú
| | - Karen Díaz
- Centro Ciudad Mujer, Ministerio de Salud, Asunción, Paraguay
| | | | - Carlos Miranda
- Hospital Central FAP-Instituto Médico Miraflores, Lima, Perú
| | - Mónica Ñañez
- Segunda Cátedra de Ginecología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Eliana Ojeda
- Departamento Académico de Medicina Humana, Universidad Andina del Cusco, Cusco, Perú
| | - Claudia Rey
- Medicina Ginecológica Consultorios Médicos, Buenos Aires, Argentina
| | | | | | | | - Sócrates Aedo
- School of Medicine, University Finis Terrae, Santiago de Chile, Chile
| | - Faustino R Pérez-López
- Instituto Aragonés de Ciencias de la Salud, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
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Baral S, Kaphle HP. Health-related quality of life among menopausal women: A cross-sectional study from Pokhara, Nepal. PLoS One 2023; 18:e0280632. [PMID: 36662806 PMCID: PMC9858775 DOI: 10.1371/journal.pone.0280632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Menopause is the permanent cessation of menstruation. Quality of life is a broad concept affected by an individual's physical health, psychological state, level of independence, societal relationship, and environmental features. During the menopausal period, women can experience various symptoms affecting their quality of life. This study assesses the factors associated with health-related quality of life among menopausal women. MATERIALS AND METHODS A community-based cross-sectional study was carried out among 249 menopausal women to assess their health-related quality of life, associated factors, and self-reported health problems. A pre-tested structured interview schedule was used to conduct face-to-face interviews to obtain the information per the study's objective. The Menopausal Rating Scale (MRS) was used to assess the health-related quality of life. Data was entered in Epi-data, and analysis was done using the Statistical Package for Social Sciences (SPSS). Univariate, bivariate, and multivariate analyses were carried out to obtain results per our objectives. RESULTS The study found that 51.4% of menopausal women had poor quality of life. The mean and standard deviation of the total MRS score was found to be 9.5±5.3. Ultimately, the factors such as educational attainment {Adjusted Odds Ratio (AOR) = 5.779, 95% Confidence Interval (CI): 2.029-16.459}, medication/treatment of the health problems (AOR = 4.828, 95% CI: 1.662-14.023), alcohol intake status (AOR = 8.006, 95% CI: 2.016-31.785) and physical activity (AOR = 5.746, 95% CI: 1.144-28.872) were significant determinants of quality of life among menopausal women. CONCLUSION There is a need to pay proper attention to factors affecting the quality of life to improve the status of menopausal women.
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Affiliation(s)
- Samjhana Baral
- School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki, Nepal
| | - Hari Prasad Kaphle
- School of Health and Allied Sciences, Pokhara University, Pokhara, Gandaki, Nepal
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10
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Psychological and social health outcomes of physical activity around menopause: A scoping review of research. Maturitas 2022; 164:88-97. [DOI: 10.1016/j.maturitas.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/30/2022] [Accepted: 07/27/2022] [Indexed: 12/18/2022]
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Ahmad A, Shahril MR, Wan-Arfah N, Mohd Abu Bakar WA, Piernas C, Lua PL. Changes in health-related lifestyles and food insecurity and its association with quality of life during the COVID-19 lockdown in Malaysia. BMC Public Health 2022; 22:1150. [PMID: 35676643 PMCID: PMC9177343 DOI: 10.1186/s12889-022-13568-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/30/2022] [Indexed: 11/28/2022] Open
Abstract
Background The pandemic of SARS CoV2 virus has severely impacted the entire world population. The lockdown imposed during the pandemic has created enormous challenges particularly on the health, economic and social life of most individuals. This study aimed to investigate the changes in health-related lifestyle and food security during the lockdown and how they influenced the quality of life (QoL) of Malaysian adults. Methods An online survey using a structured questionnaire consisting of sociodemographic, body weight, diet quality, physical activity, sleep quality, food insecurity, and QoL was conducted among adult respondents across Malaysia. Multivariate linear regression analyses were conducted to assess the associations between the changes in each component and QoL based on the total score before and during the lockdown. Results A total of 759 valid responses were included in the final analysis (75% female and 24.5% male). There was a significant improvement in diet quality during the lockdown while sleep quality and food insecurity worsened significantly. As for physical activity, metabolic equivalents (METs) in moderate activity increased significantly, whilst there was a significant decrease in the METs in walking and total minutes spent on physical activity during the lockdown. Overall, independent of age, gender, ethnicity, and religion, there were significant associations between QoL during lockdown and changes in BMI, METs of moderate activity, sleep quality, and food insecurity. Conclusions The unprecedented COVID-19 outbreak and the lockdown measure during the pandemic have caused significant negative changes in health-related lifestyles and affected the QoL of Malaysian adults. Despite the new norms and rules to prevent disease transmission, efforts to maintain a healthy lifestyle and food security among the population must be rolled out to improve the QoL and prevent further adverse mental and physical health outcomes.
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Affiliation(s)
- Aryati Ahmad
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kampus Gong Badak, 21300, Kuala Nerus, Terengganu, Malaysia. .,Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, University of Oxford, OX2 6GG, Oxford, UK.
| | - Mohd Razif Shahril
- Centre for Healthy Ageing & Wellness (HCARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nadiah Wan-Arfah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kampus Gong Badak, 21300, Kuala Nerus, Terengganu, Malaysia
| | - Wan Azdie Mohd Abu Bakar
- Department of Nutrition Sciences, Kulliyyah of Allied Health Sciences, International Islamic University Malaysia, 25200, Kuantan, Pahang, Malaysia
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, Radcliffe Primary Care Building, University of Oxford, OX2 6GG, Oxford, UK
| | - Pei Lin Lua
- Faculty of Pharmacy, Universiti Sultan Zainal Abidin, Kampus Besut, 22200, Besut, Terengganu, Malaysia
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Gould LM, Gordon AN, Cabre HE, Hoyle AT, Ryan ED, Hackney AC, Smith-Ryan AE. Metabolic effects of menopause: a cross-sectional characterization of body composition and exercise metabolism. Menopause 2022; 29:377-389. [PMID: 35231009 DOI: 10.1097/gme.0000000000001932] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate body composition, fat distribution, and metabolism at rest and during exercise in premenopausal, perimenopausal, and postmenopausal women. METHODS This cross-sectional study in 72 women ages 35 to 60 years evaluated body composition via a fourcompartment model, fat distribution using dual-energy x-ray absorptiometry-derived android to gynoid ratio, metabolic measures via indirect calorimetry, and lifestyle factors using surveys. One-way analyses of variance and one-way analyses of covariance covaried for age and hormone levels (estrogen and progesterone) were used to compare groups. RESULTS Body fat percent was significantly lower in premenopausal than perimenopausal women (mean difference ± standard error: - 10.29 ± 2.73%, P = 0.026) despite similarities in fat mass and fat-free mass between groups (P≥0.217). Android to gynoid ratio was significantly lower in premenopausal than perimenopausal women (MD ± SE: -0.16 ± 0.05 a.u., P = 0.031). Resting energy expenditure was similar between groups (P = 0.999). Fat oxidation during moderate intensity cycle ergometer exercise was significantly greater in premenopausal than postmenopausal women (MD ± SE: 0.09 ± 0.03 g/min, P = 0.045). The change in respiratory exchange ratio between rest and moderate intensity exercise was significantly lower in premenopausal women than peri- (MD ± SE: -0.05 ± 0.03 a.u., P = 0.035) and postmenopausal women (MD ± SE: -0.06 ± 0.03 a.u., P = 0.040). Premenopausal women reported significantly fewer menopause symptoms than peri- (MD ± SE: -6.58 ± 1.52 symptoms, P = 0.002) and postmenopausal participants (MD ± SE: -4.63 ± 1.52 symptoms, P = 0.044), while similarities between groups were observed for lifestyle factors including diet and physical activity (P>0.999). CONCLUSIONS Perimenopause may be the most opportune window for lifestyle intervention, as this group experienced the onset of unfavorable body composition and metabolic characteristics. VIDEO SUMMARY http://links.lww.com/MENO/A932.
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Affiliation(s)
- Lacey M Gould
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Amanda N Gordon
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Hannah E Cabre
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
| | - Andrew T Hoyle
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Eric D Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
| | - Anthony C Hackney
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
| | - Abbie E Smith-Ryan
- Applied Physiology Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Human Movement Science Curriculum, Department of Allied Health Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC; and
- Department of Nutrition, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC. Funding/support: This research study was supported by a grant from the Center for Women's Health Research
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Carcelén-Fraile MDC, Hita-Contreras F, Martínez-Amat A, Loureiro VB, Marques de Loureiro NE, Jiménez-García JD, Fábrega-Cuadros R, Aibar-Almazán A. Impact of Qigong exercises on the severity of the menopausal symptoms and health-related quality of life: a randomized controlled trial. Eur J Sport Sci 2022; 23:656-664. [PMID: 35179431 DOI: 10.1080/17461391.2022.2044915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ABSTRACTThe aim of the present study was to analyze the effects of a Qigong exercise program on the severity of the menopausal symptoms and health-related quality of life (HRQoL) of community-dwelling postmenopausal women. This was done by means of a randomized clinical trial with a sample of 125 women who were assigned to either a control (n = 62) or an experimental group (n = 63). The severity of their menopause-related symptoms and HRQoL were assessed through the Menopause Rating Scale (MRS) and the 36-item Short-Form Health Survey (SF-36) respectively, before and after the intervention period. The main findings of our study reveal significant improvement in the severity of menopausal symptoms at the somatic, psychological, and urogenital levels, as well as in the total score of the MRS. Additionally, participants assigned to the Qigong group experienced improvement in the general health, physical functioning, role-physical, bodily pain, vitality, and mental health domains of the 36-item Short-Form Health Survey, as well as in its physical component and mental component summaries. We can therefore conclude that, among Spanish postmenopausal women, a twelve-week Qigong exercise program has beneficial effects on the severity of menopausal symptoms and HRQoL.Trial registration: ClinicalTrials.gov identifier: NCT03989453..
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Affiliation(s)
| | - Fidel Hita-Contreras
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | | | | | | | - Raquel Fábrega-Cuadros
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén. Jaén, Spain
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Wratsangka R, Herwana E, Yenny Y, Xavieress E, Krishnamurti A. High-density Lipoprotein Cholesterol as a Risk Factor of Health-Related Quality of Life in 50–70-Year-Old Community-Dwelling Women. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The prevalence of dyslipidemia, a risk factor of cardiovascular disease, is at present sufficiently high, particularly in the elderly. Health-related quality of life (HRQoL) is also an important outcome in the treatment of dyslipidemia, which is currently more targeted at lowering the low-density lipoprotein cholesterol (LDL-C) concentration.
AIM: The aim of this study was to determine the relationship between the high-density lipoprotein cholesterol (HDL-C) concentration and HRQoL in community-dwelling women aged 50–70 years.
METHODS: A cross-sectional study involving 137 women aged 50–70 years who underwent blood sampling for determining the concentrations of hemoglobin, total cholesterol (TC), LDL-C, and HDL-C. A questionnaire was given to all subjects regarding data on age, menopausal status, level of education, and also another questionnaire of SF-36 for evaluation HRQoL. Bivariate and multivariate logistic regression analysis was used to identify risk factors associated with HRQoL.
RESULTS: In bivariate logistic regression analysis, age, menopausal status, education level, anemia, TC, and LDL-C were found to have non-statistically significant association with HRQoL, but HDL-C was significantly associated with HRQoL (odds ratio = 0.44; 95% Confidence interval [CI] = 0.20–0.97; p = 0.042). In multivariate analysis, menopausal status and education level have a non-statistically significant association with HRQoL, but those normal level of HDL cholesterol was found 0.18 times less likely to be associated with poor HRQoL (Adjusted odds ratio 0.18; 95% CI = 0.03–0.91; p = 0.038).
CONCLUSION: This study showed that HDL-C levels were risk factors of HRQoL in women 50–70 years of age.
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Lewandowska J, Tomaczak M, Wilk I, Lwow F. Obesity and low levels of physical activity are associated with a decreased health-related quality of life
in postmenopausal women: a Wroclaw pilot study. MEDICAL SCIENCE PULSE 2021. [DOI: 10.5604/01.3001.0015.3944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Menopause is associated with numerous somatic dysfunctions, an increased risk of chronic
diseases, and complications in the mental and social components of health that lower the quality of life
(QoL). Obesity and related comorbidities affect over 60% of postmenopausal women in Poland. A significant
role for systematic physical activity (PA) in the prevention of dysfunctions and chronic diseases, including
obesity and mental disorders, has been observed previously. A low level of PA is observed across the Polish
population, especially in postmenopausal women.
Aim of the study: To examine QoL in postmenopausal women participating in a community health promotion
program as it relates to obesity and levels of PA.
Material and methods: The study sample consisted of 76 postmenopausal women (aged 65.75±5.14 years)
participating in the Active Wrocław 55+ program. Before starting the program, anthropometric measurements
were taken, and QoL and PA were assessed using the 36-Item Short Form Health Survey (SF-36) and
the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively.
Results: Most women had a PA level above 600 MET -min/week (78.95%), and were overweight or obese
(86.84%). A waist circumference over 80 cm, indicating an increased risk for metabolic syndrome, was observed
in 85.89% of the participants. BMI and waist circumference negatively correlated with the level of PA
(p=0.001 and p=0.017, respectively). Women exhibiting low levels of PA and higher BMIs showed a significantly
lower QoL compared to those with higher PA and lower BMIs, particularly with regard to the physical
domains of QoL.
Conclusions: Obesity and a low level of PA are associated with a significant decline in the health-related QoL
(especially in the PF and PCS domains) of postmenopausal women an urban setting.
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Affiliation(s)
- Joanna Lewandowska
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Mateusz Tomaczak
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Iwona Wilk
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
| | - Felicja Lwow
- Department of Physiotherapy, University School of Physical Education in Wroclaw, Poland
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Hong YS, Kim H. Hand grip strength and health-related quality of life in postmenopausal women: a national population-based study. Menopause 2021; 28:1330-1339. [PMID: 34547005 DOI: 10.1097/gme.0000000000001863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Muscle strength progressively decreases after menopause. Hand grip strength (HGS) reflects overall muscle strength and may be associated with health-related quality of life (HRQoL). We aimed to assess the association between HGS and HRQoL in postmenopausal women. METHODS We used nationally representative data on 6,059 postmenopausal women from the Korea National Health and Nutrition Examination Survey (2014-2018). HGS was determined as the maximum value in kilograms (kg) achieved using either hand. HRQoL was estimated using the European Quality of Life Questionnaire-Five Dimensions (EQ-5D) questionnaire. The prevalence ratios of having moderate/severe problems on the EQ-5D were evaluated with adjustment for covariates using complex survey analysis. RESULTS The prevalence of having a problem in at least one of the HRQoL dimensions among postmenopausal women was 43.6%. Compared with participants with the lowest quintile of HGS, women in the highest quintile had a significantly lower prevalence of moderate/severe problems in most dimensions (fully adjusted prevalence ratios [95% confidence intervals]; 0.73 [0.60-0.89], 0.45 [0.28-0.72], 0.52 [0.38-0.71], 0.74 [0.63-0.87], and 0.91 [0.70-1.18] for mobility, self-care, usual activity, pain/discomfort, and anxiety/depression, respectively). The associations between HGS and EQ-5D index were stronger among the participants who were older (65-79 y), had a higher body mass index (≥ 25.0 kg/m2), had low physical activity, had a longer duration since menopause (≥ 10 y), and had a chronic disease. CONCLUSIONS Higher HGS was associated with a lower prevalence of moderate/severe problems in each dimension of the EQ-5D in postmenopausal women. These associations were more apparent in individuals who were older, had higher body mass index, or had a chronic disease.
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Affiliation(s)
- Yun Soo Hong
- Departments of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Jongno-gu, Seoul, Korea
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Postmenopausal Symptoms and Their Correlates among Saudi Women Attending Different Primary Health Centers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136831. [PMID: 34202185 PMCID: PMC8296999 DOI: 10.3390/ijerph18136831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/19/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
(1) Background and objectives: Due to increasing life expectancy, more than one-third of women’s life can be spent in the postmenopausal period. In this period, women have different somatic, psychological, and urogenital symptoms. The present study was done to evaluate postmenopausal symptoms and their correlations among Saudi women attending different primary health centers. (2) Methods: adopting a cross-sectional study was done among 845 postmenopausal women attending different primary health centers. The menopause rating scale (MRS) was utilized to investigate the prevalence and severity of different menopausal manifestations. Data collection was done using a structured anonymous questionnaire disseminated during face-to-face interviews. Analysis of data was done utilizing the SPSS program, version 24. (3) Results: The total MRS score was 15.68 ± 6.85. The mean score of the subscales were: 5.56 ± 2.78 for the somatic domain, 6.04 ± 2.89 for the psychological domain, and 4.08 ± 2.32 for the urogenital domain. Joint and muscle pain (25.2%) and sleep problems (18.6%) were the most prevalent severe/very severe somatic symptoms. The most severe/very severe symptoms of the psychological domain were mental and physical exhaustion (20.2%) and depressed mode (19.2%), while that of the urogenital domain were sexual problems (20.1%) and bladder problems (16.3%). Significant predictors of the subscales of MRS were sociodemographic characteristics such as age, residence, marital status, educational level, and occupation. Furthermore, history of chronic diseases, parity, and menopause duration were significant predictors of the subscales of MRS. (4) Conclusion: women in the present study experience different postmenopausal symptoms. Health care providers should consider this crucial stage of women’s life to help elderly women manage these different postmenopausal manifestations.
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Ahmadi N, Delavar MA, Mashayekh-Amiri S, Esmaeilzadeh S. Exploring the Relationship between Depression on Menopausal Symptoms and Personality Trails. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 43:125-131. [PMID: 33818209 DOI: 10.1177/0272684x211004926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to explore the potential relationships between menopausal symptoms, sleep quality, hot flash, and depressive symptoms in postmenopausal women. A cross-sectional study was designed with 150 healthy postmenopausal women (45-60 years of age) who had referred to the menopausal clinic in Babol. The participants completed the following instruments throughout the study: the Beck Depression Inventory for depressive symptoms, the Modified Blatt-Kupperman Menopausal Index for measuring menopausal symptoms, and the NEO-FFI for identifying the personality traits. After controlling all the covariates, high depressive symptoms were found to be associated with moderate/sever menopausal symptoms, poor sleep quality, and the average and high level of neuroticism. The results also demonstrated that the risk of depressive symptoms was lower in menopausal women with high level extroversion, high level agreeableness, and the average and high level of conscientiousness. The findings of the present study indicated that personality traits, menopausal symptoms, and poor sleep quality in particular can partially account for depression in Iranian menopausal women. It is highly imperative that effective health education or implement appropriate strategies to improve the quality of life for these women.
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Affiliation(s)
- Niloufar Ahmadi
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mouloud Agajani Delavar
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | | | - Sedighe Esmaeilzadeh
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Ferreira Freitas R, Santos Brant Rocha J, Ives Santos L, de Carvalho Braule Pinto AL, Rodrigues Moreira MH, Piana Santos Lima de Oliveira F, Marques MS, Souza Guerra Júnior GE, de Oliveira Silva Guerra KD, Araújo Drummond AM, Villas Boas Spelta JV, Ananias Meira Trovão C, Schmidt França D, Borges Oliveira L, Prates Caldeira A, Silveira Vasconcelos D’Angelo MF. Validity and precision of the International Physical Activity Questionnaire for climacteric women using computational intelligence techniques. PLoS One 2021; 16:e0245240. [PMID: 33444409 PMCID: PMC7808655 DOI: 10.1371/journal.pone.0245240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
This study aimed to evaluate the validity and precision of the International Physical Activity Questionnaire (IPAQ) for climacteric women using computational intelligence techniques. The instrument was applied to 873 women aged between 40 and 65 years. Considering the proposal to regroup the set of data related to the level of physical activity of climacteric women using the IPAQ, we used 2 algorithms: Kohonen and k-means, and, to evaluate the validity of these clusters, 3 indexes were used: Silhouette, PBM and Dunn. The questionnaire was tested for validity (factor analysis) and precision (Cronbach's alpha). The Random Forests technique was used to assess the importance of the variables that make up the IPAQ. To classify these variables, we used 3 algorithms: Suport Vector Machine, Artificial Neural Network and Decision Tree. The results of the tests to evaluate the clusters suggested that what is recommended for IPAQ, when applied to climacteric women, is to categorize the results into two groups. The factor analysis resulted in three factors, with factor 1 being composed of variables 3 to 6; factor 2 for variables 7 and 8; and factor 3 for variables 1 and 2. Regarding the reliability estimate, the results of the standardized Cronbach's alpha test showed values between 0.63 to 0.85, being considered acceptable for the construction of the construct. In the test of importance of the variables that make up the instrument, the results showed that variables 1 and 8 presented a lesser degree of importance and by the analysis of Accuracy, Recall, Precision and area under the ROC curve, there was no variation when the results were analyzed with all IPAQ variables but variables 1 and 8. Through this analysis, we concluded that the IPAQ, short version, has adequate measurement properties for the investigated population.
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Affiliation(s)
| | - Josiane Santos Brant Rocha
- State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Fipmoc University Center, Montes Claros, Minas Gerais, Brazil
| | | | | | | | | | - Maria Suzana Marques
- State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Fipmoc University Center, Montes Claros, Minas Gerais, Brazil
| | | | | | | | | | | | - Dorothéa Schmidt França
- State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Fipmoc University Center, Montes Claros, Minas Gerais, Brazil
| | - Lanuza Borges Oliveira
- State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Fipmoc University Center, Montes Claros, Minas Gerais, Brazil
| | - Antônio Prates Caldeira
- State University of Montes Claros, Montes Claros, Minas Gerais, Brazil
- Fipmoc University Center, Montes Claros, Minas Gerais, Brazil
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Abstract
Objective: To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA). Methods: Based on a hormonal analysis and bleeding diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and high. Associations between variables were analyzed using multivariate linear regression adjusted for age, marital and employment status, parity, self-reported mental disorder, use of psycholeptics and psychoanaleptics, and menopausal symptoms. Results: Depressive symptoms were lower amongst the pre than postmenopausal women (B = 0.07, confidence interval 0.01-0.13). Menopausal symptoms attenuated these associations. Menopausal status showed no associations with life satisfaction, or with positive or negative affectivity. Women with high PA scored higher on positive affectivity, and the pre, early peri, and postmenopausal women scored higher on life satisfaction (B = 0.79, P < 0.001; B = 0.63, P = 0.009; B = 0.42, P = 0.009, respectively) and scored lower on depressive symptoms (B = −0.13, P = 0.039; B = −0.18, P = 0.034; and B = −0.20, P < 0.001, respectively) than their low PA counterparts. The pre and postmenopausal women with medium PA scored higher on life satisfaction (B = 0.54, P = 0.001; B = 0.038, P = 0.004, respectively) than those with low PA. Conclusions: Postmenopausal women reported marginally higher depressive symptoms scores compared with premenopausal women, but menopause was not associated with positive mental well-being. However, this association varies with the level of PA. Video Summary:
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Darbandi M, Najafi F, Pasdar Y, Rezaeian S. Structural equation model analysis for the evaluation of factors associated with overweight and obesity in menopausal women in RaNCD cohort study. ACTA ACUST UNITED AC 2020; 27:208-215. [PMID: 31895176 DOI: 10.1097/gme.0000000000001452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Weight gain and increased body fat mass are among the common complications of menopause. In addition to hormonal changes, behavioral and environmental factors aggravate transition through this phase. This study uses a structural equation model (SEM) to evaluate factors associated with overweight and obesity in menopausal women. METHODS This is a cross-sectional study of 4,471 women (pre/perimenopausal 3,150, menopausal 1,321) from baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study in the west region of Iran in 2018. Obesity and overweight were the outcome variables. SEM was used to examine the relationships, using IBM SPSS, AMOS version 23. RESULTS The mean body fat percentage and visceral fat area in menopausal women was significantly greater than among pre/perimenopause women. The direct association of higher socioeconomic status (SES) with a healthy dietary pattern was stronger among pre/perimenopausal women than among menopausal women (ß = 0.574 vs ß = 0.552). In both groups, less physical activity was associated with depression and musculoskeletal disorders, and this association was stronger in menopausal women (ß = -0.174 vs ß = -0.215; P > 0.05). Overweight and obesity were directly decreased (ß = -0.011, P > 0.05) and indirectly increased (ß = 0.013, P > 0.05) in pre/perimenopausal women by sleep duration, but they were directly and indirectly decreased in menopausal women. CONCLUSIONS The direct and indirect effects of well-known risk factors associated with overweight and obesity were found to be different in pre/perimenopausal and menopausal groups. Some risk factors showed stronger effects among menopausal women compared with the pre/perimenopausal women. Physical activity and healthy dietary pattern had a mediator impact in the two study groups.
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Affiliation(s)
- Mitra Darbandi
- Student Research Committee, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Woods R, Hess R, Biddington C, Federico M. Association of lean body mass to menopausal symptoms: The Study of Women's Health Across the Nation. Womens Midlife Health 2020; 6:10. [PMID: 32944260 PMCID: PMC7490966 DOI: 10.1186/s40695-020-00058-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
Background The purpose of this study was to examine the association of lean body mass (LBM) to the development of vasomotor symptoms (VMS) as women transition through menopause. Methods This study is a secondary use of data available for public use from follow up visits six through 10 for participants in the Study of Women’s Health Across the Nation. The study examined 2533 women, between the ages 42–52 years, each year over a10-year period. Data was modeled for associations of lean body mass and VMS. Changes in LBM since prior visit and since baseline were also modeled along with differences in means using binary logistic regression, adjusting for covariates. Results LBM was significantly associated to concurrent VMS (p = .036), percent change in LBM since prior visit (p = .003), percent change since baseline (p < .001), and overall means associations (p = .023). LBM was not significant for VMS at individual visit measures. In mixed regression modeling, time was significant (p < .0001) at all visits. The estimated probability of developing VMS decreases significantly as LBM increases. Conclusions Lean body mass is negatively associated with incident VMS. Our data suggests that maintaining higher levels of LBM during the menopausal transition may be protective against the development of VMS. Every woman will experience menopause in her life and the ability to potentially prevent the onset of specific symptoms through basic interventions, such as resistance training to increase lean body mass, may positively impact this large population.
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Affiliation(s)
- Rosanne Woods
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Rebecca Hess
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Carol Biddington
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Marc Federico
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
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Effect of eight weeks of low, moderate, and high-intensity TRX training on hot flashes, mood, fat percentage, and muscular endurance in postmenopausal women. APUNTS SPORTS MEDICINE 2020. [DOI: 10.1016/j.apunsm.2020.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gropper H, John JM, Sudeck G, Thiel A. The impact of life events and transitions on physical activity: A scoping review. PLoS One 2020; 15:e0234794. [PMID: 32569282 PMCID: PMC7307727 DOI: 10.1371/journal.pone.0234794] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 06/02/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Physical activity (PA) is a fluctuating behavior and prone to change across the life course. Changes in PA may be particularly due to the experience of life events and transitions. For well-timed and successful PA interventions, it is important to understand when and why individuals take up or terminate PA. OBJECTIVES This scoping review aims to examine the extent, range, and nature of research on the impact of life events and transitions on PA and to summarize key findings. METHODS A systematic literature search was conducted in PubMed, PsycINFO, PsycARTICLES, SPORTDiscus, and Web of Science. Articles were included if they had been published in peer-reviewed journals between 1998 and 2020 and assessed the impact of at least one life event or transition on PA. RESULTS 107 studies that assessed 72 distinct life events and transitions were included and summarized in ten categories. Events and transitions that are primarily associated with decreases in PA were starting cohabitation, getting married, pregnancy, evolving parenthood, and the transitions from kindergarten to primary school, from primary to secondary school, and from high school to college or into the labor market. Retirement was associated with increases in PA; yet, long-term trajectories across retirement indicated a subsequent drop in activity levels. Divorce was associated with no changes in PA. No trends could be identified for changing work conditions, quitting or losing a job, starting a new relationship, widowhood, moving, and diagnosis of illness. CONCLUSION Life events and transitions can be conceptualized as natural interventions that occur across the life course and that are oftentimes associated with changes in PA behavior. Our study indicates that, despite some emerging trends, similar events do not necessarily have similar impacts on PA across individuals. It also shows that the research landscape is characterized by a lack of conceptual clarity and by disparate methodologies, making it difficult to synthesize results across studies.
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Affiliation(s)
- Hannes Gropper
- Institute of Sports Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Jannika M. John
- Institute of Sports Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Gorden Sudeck
- Institute of Sports Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Ansgar Thiel
- Institute of Sports Science, Eberhard Karls University Tübingen, Tübingen, Germany
- Interfaculty Research Institute for Sport and Physical Activity, Eberhard Karls University Tübingen, Tübingen, Germany
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Ryu KJ, Park H, Kim YJ, Yi KW, Shin JH, Hur JY, Kim T. Comparison of various menopausal symptoms and risk factor analysis in Korean women according to stage of menopause. Maturitas 2020; 140:41-48. [PMID: 32972634 DOI: 10.1016/j.maturitas.2020.05.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/09/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the prevalence and severity of menopausal symptoms and their related risk factors among middle-aged Korean women according to their reproductive stages. METHODS This cross-sectional study included 3039 Korean women, aged 45-65 years, who attended their routine health checkup. Their scores from the Menopause Rating Scale (MRS) were compared and participants were categorized into four groups according to stage of menopause: premenopause, early menopause (≤2 years from their last menstruation), mid-menopause (2-8 years), and late menopause (>8 years). RESULTS The mean age of the participants was 52.81 ± 5.39 years, and 98.5 % of them reported one or more symptoms included in the MRS. The most common symptom was physical/mental exhaustion, experienced by 86.7 % of participants. The prevalence of moderate to severe symptoms, including vasomotor symptoms, heart discomfort, sleep problems, sexual problems, vaginal dryness, and joint/muscular discomfort, increased in the early menopausal period. This increased in the late menopausal period compared with its prevalence at premenopause. The prevalence of moderate to severe psychological symptoms, heart discomfort, and sleep problems followed a U-shaped trend after menopause: high at early menopause, low at mid-menopause, and high again at late menopause. A low level of physical exercise was an independent risk factor for a high total MRS score; however, the menopausal stages, age, and weight were also variously associated with menopausal symptoms. CONCLUSIONS Several menopausal symptoms remain severe, or are aggravated, until the late menopausal period among Korean women. More attention is warranted to manage these symptoms in postmenopausal women.
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Affiliation(s)
- Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea.
| | - Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
| | - Kyong Wook Yi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
| | - Jung Ho Shin
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
| | - Jun Young Hur
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 02841, South Korea
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Sharifi K, Tagharrobi Z, Sooki Z. Quality of Life among Iranian Postmenopausal Women: A Systematic Review and Meta-Analysis. Galen Med J 2020; 9:e1649. [PMID: 34466562 PMCID: PMC8344182 DOI: 10.31661/gmj.v9i0.1649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/16/2019] [Accepted: 10/17/2019] [Indexed: 11/18/2022] Open
Abstract
Menopause can cause mental, physical, vasomotor, and sexual symptoms and problems, which negatively affect the quality of life (QOL). The aim of this study was to systematically evaluate QOL among Iranian postmenopausal women. This systematic review was conducted on cross-sectional studies that were published between 2000 and 2018. An online search to find studies published in English or Persian was conducted in the databases of Web of Science, PubMed, ScienceDirect, Scopus, Google Scholar, Scientific Information Database, Magiran, and IranMedex. Search key terms were "quality of life", "menopause", and "Iran". Fourteen studies were eligible for this study. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used for quality appraisal. The mean and standard deviation of QOL and its domains were extracted from the selected studies. Study data were analyzed using the Review Manager (v. 5.0) and the STATA (v. 12.0) software. The mean of total QOL among 3413 postmenopausal women was 57.89±12.8 (in the possible range of 0–174). The means of its vasomotor, psychosocial, physical, and sexual domains were 7.86±2.14, 19.43±2.05, 40.58±3.33, and 6.71±1.77, respectively. The QOL among Iranian postmenopausal women is nearly higher than the moderate level. The lowest and the highest levels of QOL are related to the physical and sexual domains, respectively. Health authorities need to develop educational interventions to promote postmenopausal women’s QOL, particularly in the physical domain.
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Affiliation(s)
- Khadijeh Sharifi
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Tagharrobi
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Zahra Sooki
- Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
- Correspondence to: Zahra Sooki, Trauma Nursing Research Centre, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Ravand Street, Kashan, IR Iran Telephone Number: +989121461374 Email Address:
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Janjetic MA, Rossi ML, Acquavía C, Denevi J, Marcolini C, Torresani ME. Association Between Anxiety Level, Eating Behavior, and Nutritional Status in Adult Women. J Am Coll Nutr 2019; 39:200-205. [DOI: 10.1080/07315724.2019.1633970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Mariana A. Janjetic
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Argentina
| | - María L. Rossi
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - Cintia Acquavía
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - Julieta Denevi
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - Cecilia Marcolini
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
| | - María E. Torresani
- Universidad de Buenos Aires (UBA), Facultad de Medicina, Escuela de Nutrición, Buenos Aires, Argentina
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Špacírová Z, Epstein D, García-Mochón L, Aparicio VA, Borges-Cosic M, López Del Amo MP, Martín-Martín JJ. Cost-effectiveness of a primary care-based exercise intervention in perimenopausal women. The FLAMENCO Project. GACETA SANITARIA 2018; 33:529-535. [PMID: 30340794 DOI: 10.1016/j.gaceta.2018.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 05/14/2018] [Accepted: 05/23/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Adequate physical activity levels and a healthy lifestyle may prevent all kinds of non-communicable diseases, promote well-being and reduce health-care costs among perimenopausal women. This study assessed an exercise programme for perimenopausal women. METHOD A total of 150 women (aged 45-64 years) not engaged in regular physical activity were randomly assigned to either a 16 week exercise intervention or to the control group. The study was conducted from the perspective of the National Health System. Health outcomes were quality-adjusted life years (QALYs), measured by the EuroQol-5D-5L questionnaire. The total direct costs of the programme were the costs of visits to primary care, specialty care, emergency, medicines, instructor cost and infrastructure cost. The results were expressed as the incremental cost-effectiveness ratio. Sensitivity analysis was undertaken to test the robustness of the analysis. RESULTS Mean QALYs over 16 weeks were.228 in the control group and.230 in the intervention group (mean difference: .002; 95% confidence interval [95%CI]: -0.005 to 0.009). Improvements from baseline were greater in the intervention group in all dimensions of the EuroQol-5D-5L but not statistically significant. The total costs at the end of the intervention were 160.38 € in the control group and 167.80 € in the intervention group (mean difference: 7.42 €; 95%CI: -47 to 62). The exercise programme had an incremental cost-effectiveness ratio of 4,686 €/QALY. CONCLUSIONS The programme could be considered cost-effective, although the overall difference in health benefits and costs was very modest. Longer term follow-up is needed.
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Affiliation(s)
- Zuzana Špacírová
- Department of Applied Economics, Faculty of Economics, University of Granada, Granada, Spain.
| | - David Epstein
- Department of Applied Economics, Faculty of Economics, University of Granada, Granada, Spain
| | | | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain; VU University and EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - M Puerto López Del Amo
- Department of Applied Economics, Faculty of Economics, University of Granada, Granada, Spain
| | - José J Martín-Martín
- Department of Applied Economics, Faculty of Economics, University of Granada, Granada, Spain
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de Almeida SA, Claudio ERG, Mengal V, Brasil GA, Merlo E, Podratz PL, Graceli JB, Gouvea SA, de Abreu GR. Estrogen Therapy Worsens Cardiac Function and Remodeling and Reverses the Effects of Exercise Training After Myocardial Infarction in Ovariectomized Female Rats. Front Physiol 2018; 9:1242. [PMID: 30233413 PMCID: PMC6134041 DOI: 10.3389/fphys.2018.01242] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 08/16/2018] [Indexed: 01/24/2023] Open
Abstract
There is an increase in the incidence of cardiovascular events such as myocardial infarction (MI) after menopause. However, the use of estrogen therapy (E2) remains controversial. The aim of this study was to evaluate the effects of E2, alone and combined with exercise training (ET), on cardiac function and remodeling in ovariectomized (OVX) rats after MI. Wistar female rats underwent ovariectomy, followed by MI induction were separated into five groups: S; MI; MI+ET; MI+E2; and MI+ET+E2. Fifteen days after MI or sham surgery, treadmill ET and/or estrogen therapy [17-β estradiol-3-benzoate (E2), s.c. three times/week] were initiated and maintained for 8 weeks. After the treatment and/or training period, the animals underwent cardiac hemodynamic evaluation through catheterization of the left ventricle (LV); the LV systolic and diastolic pressures (LVSP and LVEDP, respectively), maximum LV contraction and relaxation derivatives (dP/dt+ and dP/dt−), and isovolumic relaxation time (Tau) were assessed. Moreover, histological analyses of the heart (collagen and hypertrophy), cardiac oxidative stress [advanced oxidation protein products (AOPPs)], pro- and antioxidant protein expression by Western blotting and antioxidant enzyme activity in the heart were evaluated. The MI reduced the LVSP, dP/dt+ and dP/dt− but increased the LVEDP and Tau. E2 did not prevent the MI-induced changes in cardiac function, even when combined with ET. An increase in the dP/dt+ was observed in the E2 group compared with the MI group. There were no changes in collagen deposition and myocyte hypertrophy caused by the treatments. The increases in AOPP, gp91-phox, and angiotensin II type 1 receptor expression induced by MI were not reduced by E2. There were no changes in the expression of catalase caused by MI or by the treatments, although, a reduction in superoxide dismutase (SOD) expression occurred in the groups subjected to E2 treatment. Whereas there were post-MI reductions in activities of SOD and catalase enzymes, only that of SOD was prevented by ET. Therefore, we conclude that E2 therapy does not prevent the MI-induced changes in cardiac function and worsens parameters related to cardiac remodeling. Moreover, E2 reverses the positive effects of ET when used in combination, in OVX infarcted female rats.
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Affiliation(s)
- Simone Alves de Almeida
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Erick R G Claudio
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Vinicius Mengal
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Girlandia A Brasil
- Núcleo de Pesquisas em Ciências Farmacêuticas - Nupecfarma, Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Vila Velha, Vila Velha, Brazil
| | - Eduardo Merlo
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Priscila L Podratz
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Jones B Graceli
- Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Sonia A Gouvea
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
| | - Gláucia Rodrigues de Abreu
- Laboratório de Regulação Neurohumoral da Circulação, Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, Brazil
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Abstract
Objective: The Menopause-Specific Quality-of-Life (MENQOL) questionnaire was developed as a specific tool to measure the health-related quality-of-life of postmenopausal women. Thus far, the Chinese version questionnaire has not been subjected to psychometric assessment with a large sample. This study aims to evaluate the validity and reliability of the Chinese version of the MENQOL specific to postmenopausal women in China. Methods: A total of 1,137 menopausal symptomatic and 491 menopausal asymptomatic women from eight cities in China were recruited using a convenience sampling method. Psychometric properties were evaluated by descriptive statistics, validity, and reliability. Reliability was assessed for each subscale of the MENQOL through internal consistency reliability with Cronbach's α and intersubscale correlations. Item-domain correlations, principal components analysis (PCA), and confirmatory factor analysis were performed to determine construct validity. t tests were used to compare the differences between the menopausal symptomatic and asymptomatic women and to evaluate the discriminate validity. Pearson correlation coefficients were calculated between MENQOL scores and the Kupperman index to assess criterion-related validity. Results: The most common symptoms in Chinese menopausal symptomatic women were “experiencing poor memory” (94.4%), “feeling tired or worn out” (93.8%), “aching in muscle and joints” (89.4%), “low backache” (86.9%), “decrease in physical strength” (86.6%), “aches in back of neck or head” (86.2%), “difficulty sleeping” (83.6%), “accomplishing less than I used to” (83.4%), “feeling a lack of energy” (83.3%), “change in your sexual desire” (81%), and “hot flash” (80.7%) among others. The symptoms of “increased facial hair” were rarely seen (9.9%). The vasomotor domain, as well as psychosocial, physical, and sexual domains showed high reliability (Cronbach's α 0.84, 0.87, 0.89, and 0.86, respectively). Item-domain correlation analysis showed that all items correlated more strongly with their own domains than with other domains. In the PCA, after deleting the “increased facial hair” item, items in the vasomotor, sexual, and psychosocial subscales loaded on their respective domains by and large, and items in the physical subscale divided into two factors. The PCA revealed a latent structure of the Chinese version of MENQOL nearly identical to the original MENQOL domains. The confirmatory factor analysis demonstrated that the questionnaire fits well with a four-domain model. The MENQOL can discriminate between menopausal symptomatic women with asymptomatic women as it showed good discriminate validity. Criterion-related validity was confirmed by a significant correlation between MENQOL scores and the Kupperman index. Conclusions: This study showed that Chinese version of MENQOL has good psychometric properties and would be suitable to measure the health-related quality-of-life of Chinese menopausal women except for item 21 (increased facial hair).
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Sedentary lifestyle in middle-aged women is associated with severe menopausal symptoms and obesity. Menopause 2018; 23:488-93. [PMID: 26818013 DOI: 10.1097/gme.0000000000000575] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the association between sedentary lifestyle and the severity of menopausal symptoms and obesity in middle-aged women. METHODS The Menopause Rating Scale, the Goldberg Anxiety and Depression Scale, and the Athens Insomnia Scale were administered to 6,079 Latin American women aged 40 to 59 years. Sedentary lifestyle was defined as fewer than three weekly, 30-minute periods of physical activity. RESULTS Sedentary women had more severe menopausal symptoms (total Menopause Rating Scale score: 9.57 ± 6.71 vs 8.01 ± 6.27 points, P < 0.0001) and more depressive symptoms (Goldberg), anxiety (Goldberg), and insomnia (Athens Scale) compared with non-sedentary women. They also had greater mean waist circumference (86.2 ± 12.3 vs 84.3 ± 1.8 cm, P < 0.0001) and a higher prevalence of obesity (20.9% vs 14.3%, P < 0.0001). Logistic regression analysis showed that both obesity (odds ratio [OR] 1.52; 95% CI, 1.32-1.76) and severe menopausal symptoms (OR 1.28; 95% CI, 1.06-1.53), including insomnia and depressive mood, were positively associated with a sedentary lifestyle. Having a stable partner (OR 0.85; 95% CI, 0.76-0.96), using hormone therapy (OR 0.75; 95% CI, 0.64-0.87) and having a higher educational level (OR 0.66; 95% CI, 0.60-0.74) were negatively related to sedentary lifestyle. CONCLUSIONS There was a high prevalence of sedentary lifestyle in this middle-aged Latin American female sample which was associated with more severe menopausal symptoms and obesity.
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Costa JG, Giolo JS, Mariano IM, Batista JP, Ribeiro ALA, Souza TCF, de Oliveira EP, Resende APM, Puga GM. Combined exercise training reduces climacteric symptoms without the additive effects of isoflavone supplementation: A clinical, controlled, randomised, double-blind study. Nutr Health 2017; 23:271-279. [PMID: 29214925 DOI: 10.1177/0260106017727359] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Exercise and supplementation with isoflavones are therapies used to prevent and treat climacteric symptoms. AIM To verify the effects of 10 weeks of combined aerobic and resistance training and isoflavone supplementation on climacteric symptoms in postmenopausal women. METHODS A randomised, double-blind, controlled clinical trial was performed. A total of 32 postmenopausal women, aged 54.4 ± 5.4 years, with a body mass index of 26.6 ± 3.0 kg/m2 and 5.6 ± 4.6 years after menopause, were randomly assigned to groups: placebo and exercise (PLA + EXE, n = 15) or 100 mg of isoflavone and exercise (ISO + EXE, n = 17). At the beginning and after 10 weeks of aerobic + resistance (20 min each, moderate intensity) training, climacteric symptoms were evaluated using the Blatt-Kupperman Menopausal Index, Cervantes Scale and Menopause Rating Scale. ANCOVA was used for analysis between groups and at different times, with the covariate adjusted by the pre-value. The level of significance considered was p < 0.05. RESULTS A reduction in climacteric symptoms was observed in both groups, without differences between the interventions. The reductions were 45% and 50% for the Blatt-Kupperman Menopausal Index, 41% and 52% for the MRS and 39% and 39% for the Cervantes Scale in the ISO + EXE and PLA + EXE groups, respectively. In the descriptive analysis of the Blatt-Kupperman Menopausal Index values, there was an increase in the absence of symptoms from 48-77% in the ISO + EXE group and 24-58% in the PLA + EXE group. CONCLUSIONS A period of 10 weeks of combined training was effective in improving climacteric symptoms in post-menopausal women. However, isoflavone supplementation did not promote additional effects in improving symptoms.
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Affiliation(s)
- Juliene G Costa
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | - Jéssica S Giolo
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | - Igor M Mariano
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | - Jaqueline P Batista
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | - Ana Luiza A Ribeiro
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | - Tállita Cristina F Souza
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | | | - Ana Paula M Resende
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
| | - Guilherme M Puga
- 1 Laboratory of Cardiorespiratory and Metabolic Physiology, Federal University of Uberlândia, Brazil
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Hu L, Zhu L, Lyu J, Zhu W, Xu Y, Yang L. Benefits of Walking on Menopausal Symptoms and Mental Health Outcomes among Chinese Postmenopausal Women. INT J GERONTOL 2017. [DOI: 10.1016/j.ijge.2016.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Factors associated with sexual quality of life among midlife women in Serbia. Qual Life Res 2017; 26:2793-2804. [PMID: 28580495 DOI: 10.1007/s11136-017-1608-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To assess factors associated with better sexual quality of life (QOL) in midlife period among women who are and are not sexually active. METHODS Participants were 500 women aged 40-65 years from Belgrade, Serbia. Data were collected through general questionnaire (regarding socio-demographic characteristics, lifestyle habits, general medical, and gynecological history) in which one item investigated having partnered sexual activity (heterosexual intercourses). The sexual domain of the Utian Quality of Life Scale was used to assess the sexual QOL. The sexual QOL consisted of reflections on the satisfaction with frequency of sexual interactions, as well as sexual and romantic life in general. Higher scores indicated better sexual QOL. RESULTS Most women were sexually active in midlife (81.6%). The mean sexual QOL score for the overall sample was 9.99 (range 3-15). The level of sexual QOL did not differ between sexually active and non-active women. Factors associated with better sexual QOL in sexually active menopausal women were being married or coupled, being physically active, having more children, having hot flushes, and not having tachycardia. Factors associated with better sexual QOL in sexually inactive menopausal women were drinking alcohol, being physically active, not having insomnia or skin rash. CONCLUSIONS Sexual QOL among Serbian urban midlife women was good and did not differ between women who were sexually active and those who were not. Further studies are needed to determine in what manner women who are not sexually active in midlife achieve high level of satisfaction with their sexual QOL.
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Abstract
Health-related quality of life (HRQoL) refers to the effects of an individual's physical state on all aspects of psychosocial functioning. For postmenopausal women, HRQoL is the only global criterion that is decisive for their daily well-being. Symptoms experienced during menopause and sociodemographic characteristics affect quality of life in postmenopausal women. In younger, symptomatic, postmenopausal women, HRQoL may be significantly diminished. However, quality of life after menopause is influenced by many additional, non-menopausal factors. In the last decades, more specific symptom lists or other questionnaires have been developed. Such scales would qualify as standardized or disease-specific by fulfilling four criteria: (1) they have been constructed on the basis of a factor analysis; (2) they consist of several subscales, each measuring a different aspect of a specific symptomatology; (3) the scales possess sound psychometric properties; and (4) they have been standardized using adequate populations of women. A variety of instruments currently dominating international practice are here reviewed. Therapeutic approaches that treat climacteric symptoms and all measures ameliorating unfavorable non-hormonal factors could improve HRQoL among postmenopausal women. This includes partnership and sexual counseling as well as psychosocial measures. Menopausal hormone therapy (MHT) may reverse this deterioration of HRQoL if it is due to postmenopausal estrogen deficiency. On the contrary, when MHT is prescribed to asymptomatic younger and older postmenopausal women, no gain in HRQoL can be obtained.
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Affiliation(s)
- H P G Schneider
- a Department of Obstetrics and Gynecology , University of Muenster , Muenster , Germany
| | - M Birkhäuser
- b Department of Obstetrics and Gynecology , University of Berne , Berne , Switzerland
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Moratalla-Cecilia N, Soriano-Maldonado A, Ruiz-Cabello P, Fernández MM, Gregorio-Arenas E, Aranda P, Aparicio VA. Association of physical fitness with health-related quality of life in early postmenopause. Qual Life Res 2016; 25:2675-2681. [PMID: 27085340 PMCID: PMC5010831 DOI: 10.1007/s11136-016-1294-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 01/22/2023]
Abstract
Objective To assess the association of different components of physical fitness with HRQoL in early postmenopause and to test which physical fitness components are independently associated with the physical and mental components of HRQoL. Methods The final sample comprised 67 early postmenopausal women. Physical fitness was assessed with the Senior Fitness Test battery (additionally including handgrip strength test), and HRQoL was evaluated with the Short-Form Health Survey-36 (SF-36). We also analyzed plasma gonadotropic hormones and estradiol. Results Overall, most of the fitness components were positively associated with HRQoL. Lower-body flexibility, upper-body muscle strength and cardiorespiratory fitness were the fitness components more strongly associated with HRQoL (r range from 0.28 to 0.56). Static balance was especially associated with mental health (r = −0.46, P < 0.001). Lower-body flexibility (assessed with the chair sit-and-reach test) and upper-body muscle strength (assessed with handgrip dynamometry) were independently associated with the SF-36 Physical Component Summary (both, P < 0.001). Upper-body muscle strength (P < 0.01) and cardiorespiratory fitness (assessed with the 6-min walk test, P < 0.05) were independently associated with the SF-36 Mental Component Summary. Conclusions Higher physical fitness is associated with better HRQoL in early postmenopause. Lower-body flexibility and upper-body muscle strength were the most important independent fitness indicators, explaining ~30 % of HRQoL.
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Affiliation(s)
- N Moratalla-Cecilia
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
- Pinos Puente Clinical Management Unit, Granada, Spain
| | - A Soriano-Maldonado
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - P Ruiz-Cabello
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - M M Fernández
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - E Gregorio-Arenas
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
- Pinos Puente Clinical Management Unit, Granada, Spain
| | - P Aranda
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - V A Aparicio
- Department of Physiology, Faculty of Pharmacy, Faculty of Sport Sciences, and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain.
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
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Twelve-week exercise training and the quality of life in menopausal women - clinical trial. MENOPAUSE REVIEW 2016; 15:20-5. [PMID: 27095954 PMCID: PMC4828504 DOI: 10.5114/pm.2016.58769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 11/25/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The menopause transition is associated with decreased health functioning. About 80-90% of women experience mild to severe physical or physiological menopause-related complaints per year when approaching menopause. Physical activity may reduce some climacteric symptoms and improve the quality of life. AIM OF THE STUDY Aim of the study was to investigate the influence of a 12-week training programme on the quality of life (QoL) in menopausal-aged women living in a rural area. MATERIAL AND METHODS Participants were 80 women aged 40-65 years and divided into two randomly selected groups in training sessions (exercising group, n = 40 and control group, n = 40). SF36 was used to assess the quality of life in both groups before and after 12 weeks. Exercising women participated in training session 3 times a week. Each 60-minute exercise session included warming-up exercises, walking, stretching, strengthening exercises with an elastic band and cooling down exercises. RESULTS A non-significant positive difference in all SF36 domains in the exercising group was observed. The results of the study showed a statistically significant higher QoL in the exercising group compared to the control group after 12-week training in two domains: vitality and mental health. The improvement in the quality of life in the study group was 0.19 points (role limits - physical domain, least change) and 4.96 (vitality domain, most change). CONCLUSIONS Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. Sedentary women should consider modification of their lifestyle to include physical activity as it leads to improvement of their quality of life.
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Diniz TA, Neves LM, Rossi FE, Fortaleza ACDS, Rosa CS, Tebar WR, Christofaro DGD, Freitas-Junior IF. Weekly time spent in the standing position is independently related to a better quality of life in postmenopausal women. Eur J Obstet Gynecol Reprod Biol 2016; 199:150-5. [PMID: 26930043 DOI: 10.1016/j.ejogrb.2016.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 01/14/2016] [Accepted: 02/11/2016] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To analyze the relationship between standing, sitting and reclining behaviors and quality of life in postmenopausal women. STUDY DESIGN Cross-sectional study composed of forty postmenopausal women (aged 59.58±5.32) who do not practice regular physical exercise. Body composition was measured using Dual-energy X-ray absorptiometry and quality of life by the Short Form 36 Health Survey (SF-36). Physical activity level was assessed using an accelerometer (Actigraph GTX3x) and is reported as minutes per week of moderate-to-vigorous physical activity (MVPA). Inclinometer analysis was also measured using this accelerometer model and reported as a weekly percentage of time spent standing, sitting and reclining. All analyses were performed using SPSS 17.0 software with the significance level set at 5%. RESULTS The percentage of time in the standing position was lower among women with poor quality of life (p<0.05). Adjusted analysis (age, years since menopause, percentage of fat mass, MVPA and occupation status) was used to evaluate the relationship between quality of life and accelerometer inclinometer measures. The relationship between time standing and general health status (β=0.353; 95%CI=0.017; 0.377), social function (β=0.429; 95%CI=0.060; 0.396) and overall score (β=0.336; 95%CI=0.015; 0.442) were statistically significant. The relationship between the reclining position and both overall score (β=-0.320; 95%CI=-0.492; 0.006) and emotional aspects (β=-0.337; 95%CI=-0.191; 0.001) showed a tendency to present statistical significance. CONCLUSION In summary, our results suggest that postmenopausal women who spend more time in the standing position have a better overall quality of life regardless of confounders.
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Affiliation(s)
- Tiego A Diniz
- Center of Studies and Laboratory of Evaluation and Prescription of Motor Activities (CELAPAM), Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil; Exercise and Immunometabolism Research Group, Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil.
| | - Lucas M Neves
- Center of Studies and Laboratory of Evaluation and Prescription of Motor Activities (CELAPAM), Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil.
| | - Fabricio E Rossi
- Center of Studies and Laboratory of Evaluation and Prescription of Motor Activities (CELAPAM), Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil; Exercise and Immunometabolism Research Group, Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil.
| | - Ana Claudia de S Fortaleza
- Center of Studies and Laboratory of Evaluation and Prescription of Motor Activities (CELAPAM), Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil.
| | - Clara Suemi Rosa
- Center of Studies and Laboratory of Evaluation and Prescription of Motor Activities (CELAPAM), Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil.
| | - William Rodrigues Tebar
- Institute of Bioscience, Department of Physical Education, Sao Paulo State University (UNESP), Rio Claro, SP, Brazil.
| | | | - Ismael F Freitas-Junior
- Center of Studies and Laboratory of Evaluation and Prescription of Motor Activities (CELAPAM), Department of Physical Education, Sao Paulo State University (UNESP), 19060-900 Presidente Prudente, SP, Brazil.
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Huang JJ, Lin HS, Lee BO, Chen CH. Perceived exercise barriers and their associations with regular exercise across three age groups of rural women in Taiwan. J Women Aging 2016; 28:68-79. [DOI: 10.1080/08952841.2014.950902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Relationship between menopause status, attitude toward menopause, and quality of life in Chinese midlife women in Hong Kong. Menopause 2016; 23:67-73. [DOI: 10.1097/gme.0000000000000566] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ghorbani R, Nassaji M, Shahbazi A, Rostami B, Taheri M. Association between quality of life, menopausal status, and sociodemographic factors among middle-aged women in Iran. J Egypt Public Health Assoc 2015; 90:166-170. [PMID: 26854898 DOI: 10.1097/01.epx.0000475545.75242.80] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Assessment of overall health, well-being, and quality of life (QoL) during middle age and menopause deserves special attention. The aim of this study was to investigate the effect of menopausal status and some sociodemographic variables on QoL among middle-aged women in Semnan, Iran. PARTICIPANTS AND METHODS This cross-sectional survey was conducted in 2012 in Semnan, Iran. The participants included 770 women aged 45-60 years. The data were collected by interview using a structured questionnaire that included sociodemographic characteristics, data on menopausal status, and QoL measurement using the Menopause-Specific Quality of Life questionnaire. RESULTS The mean±SD age of the women was 50.9±4.7 years. The overall unadjusted mean scores obtained for each domain were as follows: vasomotor: 1.83±1.86; psychosocial: 1.62±1.41; physical: 1.98±1.28; and sexual: 1.63±1.87. Logistic regression analysis showed that menopausal status was significantly associated with QoL in all domains, except the psychosocial domain. Age, BMI, household income, and number of children were significantly associated with impairment in QoL. Marital status, educational level, and residential area did not show any association with QoL in multivariate analysis. CONCLUSION AND RECOMMENDATIONS Our findings confirm previous literature on the negative impact of menopausal symptoms on QoL, and show the interaction of some sociodemographic characteristics including age, number of children, household income, and BMI, on QoL. Health professionals should ensure that they consider a range of factors in middle-aged women's lives and provide insight into possible treatment strategies and lifestyle interventions for improving QoL.
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Affiliation(s)
- Raheb Ghorbani
- Departments of aBiostatistics bSocial Determinants of Health Research Center cDepartment of Social Medicine, Semnan University of Medical Sciences dSemnan University of Medical Sciences, Semnan, Iran
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Mansikkamäki K, Raitanen J, Nygård CH, Tomás E, Rutanen R, Luoto R. Long-term effect of physical activity on health-related quality of life among menopausal women: a 4-year follow-up study to a randomised controlled trial. BMJ Open 2015; 5:e008232. [PMID: 26362664 PMCID: PMC4567675 DOI: 10.1136/bmjopen-2015-008232] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES The aim of the study was to explore the long-term effects of physical activity intervention on quality of life (QoL) 4 years after an original randomised controlled trial (RCT). DESIGN Cohort study after an RCT. SETTING 95 of the 159 women from the original RCT participated in weight, height and waist circumference measurements, performed the UKK 2 km Walk Test and completed the SF-36 Health Survey questionnaire. Multilevel mixed regression models were performed in order to compare the original and current group in an RCT setting. PARTICIPANTS There were 159 participants in the original RCT; 2.5 years later, 102 of the women responded to a questionnaire and 4-year after the trial, there were 95 respondents. The inclusion criteria in the original RCT were: being symptomatic, experiencing daily hot flushes, age between 40 and 63 years, not using hormone therapy now or in the past 3 months, sedentary lifestyle and having last menstruated 3-36 months earlier. MAIN OUTCOME MEASURE Health-related QoL as measured with the SF-36 instrument. RESULTS Women in the intervention group had a significantly higher probability of improved physical functioning (OR 1.41; 95% CI 1.00 to 1.99) as compared with women in the control group. In addition, women in the intervention group had higher odds of good role functioning (OR 1.21; 95% CI 0.88 to 1.67), physical health (OR 1.33; 95% CI 0.96 to 1.84) and general health (OR 1.14; 95% CI 0.81 to 1.62), relative to women in the control group, although the differences did not reach statistical significance. CONCLUSIONS Women in the intervention group showed positive long-term effects on physical and mental dimensions of QoL after 4 years. TRIAL REGISTRATION NUMBER ISRCTN54690027.
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Affiliation(s)
- Kirsi Mansikkamäki
- UKK Institute for Health Promotion Research, Tampere, Finland
- Tampere University of Applied Sciences, Tampere, Finland
| | - Jani Raitanen
- UKK Institute for Health Promotion Research, Tampere, Finland
- School of Health Sciences, University of Tampere, Tampere, Finland
| | | | - Eija Tomás
- Tampere University Central Hospital, Tampere, Finland
| | - Reetta Rutanen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Riitta Luoto
- UKK Institute for Health Promotion Research, Tampere, Finland
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Bień A, Rzońca E, Iwanowicz-Palus G, Pańczyk-Szeptuch M. The influence of climacteric symptoms on women's lives and activities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:3835-46. [PMID: 25854298 PMCID: PMC4410218 DOI: 10.3390/ijerph120403835] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 03/12/2015] [Accepted: 03/25/2015] [Indexed: 11/16/2022]
Abstract
In the present study, we performed an analysis of the influence of climacteric symptoms on women's lives and activities, i.e. their quality of life (QoL). The study was performed between October 2011 and February 2012. It included 148 women aged 44-62. The study used a diagnostic survey with questionnaires. The research instrument was the Blatt-Kupperman index. The respondents were asked to complete a questionnaire on socio-demographic data, quality of life, and the influence of climacteric symptoms on life and its various aspects. The respondents experiencing moderate or severe climacteric symptoms also had stronger feelings of failure (p = 0.005), feeling that opportunities are still available (p = 0.002), of losing their youth and beauty (p < 0.0001), compared to those who had slight or no symptoms. The intensity of climacteric symptoms significantly affects women's lives and activities, i.e., their QoL. The reported intensity of climacteric symptoms is influenced by the respondents' education, residence, marital status and professional activity. The more severe the climacteric symptoms, the lower the women's quality of life, as evidenced for example by the feeling of failure and of losing one's youth, beauty and opportunities.
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Affiliation(s)
- Agnieszka Bień
- Independent Obstetric Skills Unit, Faculty of Health Sciences, Medical University of Lublin, 4 Staszica St., 20-081 Lublin, Poland.
| | - Ewa Rzońca
- Independent Obstetric Skills Unit, Faculty of Health Sciences, Medical University of Lublin, 4 Staszica St., 20-081 Lublin, Poland.
| | - Grażyna Iwanowicz-Palus
- Independent Obstetric Skills Unit, Faculty of Health Sciences, Medical University of Lublin, 4 Staszica St., 20-081 Lublin, Poland.
| | - Małgorzata Pańczyk-Szeptuch
- Department of Gynecology, Obstetrics and Pathology of Pregnancy, John Paul II Independent Public Regional Hospital, 10 Aleje Jana Pawła II St., 22-400 Zamość, Lublin, Poland.
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The role of physical activity in preventing obesity in midlife women. MENOPAUSE REVIEW 2015; 14:13-9. [PMID: 26327883 PMCID: PMC4440193 DOI: 10.5114/pm.2015.49252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/05/2014] [Accepted: 12/08/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Obesity is one of the most common nutrition-related disorders worldwide and one of the major health problems in menopausal women, which significantly worsens the quality of life and can lead to severe diseases or even premature death. The aim of the study was to evaluate the relation between physical activity in different domains undertaken by menopausal women while performing daily activities and their body mass index (BMI). MATERIAL AND METHODS The study was conducted on a random sample of 400 healthy Polish women aged 45-55. The questionnaire contained questions concerning the respondents' socio-economic status, medical history and the long format of the International Physical Activity Questionnaire was used. RESULTS Fifty-one percent (50.6%) of women had normal body mass, 43.75% of respondents were overweighed and 5.65% of women were obese. A moderate physical activity level was presented by most midlife women in domestic and garden domain, active transportation and leisure time. Pearson's correlation showed that such factors as age, education and physical activity level in different domains have a significant correlation with BMI. CONCLUSIONS Most respondents presented a moderate physical activity level in all domains except work, where the respondents had a high physical activity (PA) level. A high PA level especially at work (r = -0.5788) and during leisure time (r = -0.5175) strongly correlate with lower BMI.
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Heesch KC, van Gellecum YR, Burton NW, van Uffelen JGZ, Brown WJ. Physical activity, walking, and quality of life in women with depressive symptoms. Am J Prev Med 2015; 48:281-91. [PMID: 25595606 DOI: 10.1016/j.amepre.2014.09.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity (PA) has a positive association with health-related quality of life (HRQL) in the general population. The association between PA and HRQL in those with poor mental health is less clear. PURPOSE To examine the concurrent and prospective dose-response relationships between total PA (TPA) and walking only with HRQL in women aged 50-55 years with depressive symptoms in 2001. METHODS Participants were 1,904 women born in 1946-1951 who completed mailed surveys for the Australian Longitudinal Study on Women's Health in 2001, 2004, 2007, and 2010, and reported depressive symptoms in 2001. At each time point, they reported their weekly minutes of walking, moderate PA, and vigorous PA. A summary TPA score was created that accounted for differences in energy expenditure among the three PA types. Mixed models were used to examine associations between TPA and HRQL (short form-36 [SF-36] component and subscale scores) and between walking and HRQL, for women who reported walking as their only PA. Analyses were conducted in 2013-2014. RESULTS Concurrently, higher levels of TPA and walking were associated with better HRQL (p<0.05). The strongest associations were found for physical functioning, vitality, and social functioning subscales. In prospective models, associations were attenuated, yet compared with women doing no TPA or walking, women doing "sufficient" TPA or walking had significantly better HRQL over time for most SF-36 scales. CONCLUSIONS This study extends previous work by demonstrating trends between both TPA and walking and HRQL in women reporting depressive symptoms.
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Affiliation(s)
- Kristiann C Heesch
- Queensland University of Technology, Institute of Health & Biomedical Innovation and the School of Public Health and Social Work, QLD, Australia; The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia.
| | - Yolanda R van Gellecum
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia
| | - Nicola W Burton
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia
| | - Jannique G Z van Uffelen
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia; Victoria University, Institute of Sport, Exercise and Active Living, Melbourne, VIC, Australia
| | - Wendy J Brown
- The University of Queensland, School of Human Movement Studies and Centre for Research on Exercise, Physical Activity and Health Brisbane, QLD, Australia
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Mansikkamäki K, Raitanen J, Malila N, Sarkeala T, Männistö S, Fredman J, Heinävaara S, Luoto R. Physical activity and menopause-related quality of life - a population-based cross-sectional study. Maturitas 2014; 80:69-74. [PMID: 25449820 DOI: 10.1016/j.maturitas.2014.09.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 11/26/2022]
Abstract
The aim of the research was to study the association between engagement in the recommended level of physical activity and quality of life (QoL) among middle-aged women. In total, 2606 Finnish women aged 49 years responded to a postal questionnaire on lifestyle, quality of life, and health, wherein QoL was assessed with a shorter version of the menopause-specific Women's Health Questionnaire (WHQ). Proportional odds ratios (PORs) from ordered logistic regression models were used to test the association between the physical-activity and WHQ domains or three quality-of-life variables. Physically inactive women had an increased probability of anxiety/depressed mood (POR 1.44; 95% confidence interval (CI) 1.26-1.65), of decreased well-being (POR 1.96; 95% CI 1.71-2.25), of somatic symptoms (POR 1.61; 95% CI 1.40-1.85), of memory/concentration problems (POR 1.48; 95% CI 1.29-1.70), and of vasomotor symptoms (POR 1.19; 95% CI 1.03-1.36) as compared to physically active women. Women with the recommended level of physical activity had a higher self-perceived health level, better relative health, and better global quality of life in relation to other women their age. Physically active women showed higher quality of life in four menopause-specific WHQ dimensions and in global quality of life when compared to inactive women.
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Affiliation(s)
- Kirsi Mansikkamäki
- UKK Institute for Health Promotion, Tampere, Finland; University of Applied Sciences, Tampere, Finland.
| | - Jani Raitanen
- UKK Institute for Health Promotion, Tampere, Finland; School of Health Sciences, University of Tampere, Tampere, Finland
| | | | - Tytti Sarkeala
- National Institute for Health and Welfare, Helsinki, Finland
| | - Satu Männistö
- National Institute for Health and Welfare, Helsinki, Finland
| | | | | | - Riitta Luoto
- UKK Institute for Health Promotion, Tampere, Finland; National Institute for Health and Welfare, Helsinki, Finland
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Wieder-Huszla S, Szkup M, Jurczak A, Samochowiec A, Samochowiec J, Stanisławska M, Rotter I, Karakiewicz B, Grochans E. Effects of socio-demographic, personality and medical factors on quality of life of postmenopausal women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:6692-708. [PMID: 24972032 PMCID: PMC4113838 DOI: 10.3390/ijerph110706692] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/22/2014] [Accepted: 06/19/2014] [Indexed: 11/16/2022]
Abstract
UNLABELLED Numerous studies show that changes occurring in a woman's organism during menopause may lower her quality of life. This study involved 630 healthy postmenopausal women from Poland. Its purpose was to assess their quality of life in relation to socio-demographic variables, medical data and personality profiles. The authors used the Short Form Health Survey (SF-36) to assess quality of life, the NEO-Five Factor Inventory to measure personality traits, and the Blatt-Kupperman Menopausal Index to estimate severity of climacteric symptoms. The study demonstrated significant relationships between quality of life and variables such as: age, education, employment status, and the use of menopausal hormone therapy. An analysis of personality traits revealed correlations between the openness to experience scores and the quality of life within physical functioning, vitality, and mental health. Neuroticism, agreeableness and extroversion significantly correlated with all quality of life domains. CONCLUSIONS (1) Age, education and employment status have significant effects on the selected quality of life domains after menopause. (2) Quality of life within the general health domain was assessed lower by MHT-users (Menopausal hormone theraphy (MHT)). (3) Health-related quality of life is also influenced by personality traits, which are relatively stable throughout life.
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Affiliation(s)
- Sylwia Wieder-Huszla
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.
| | - Anna Jurczak
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.
| | - Agnieszka Samochowiec
- Department of Clinical Psychology, Institute of Psychology, University of Szczecin, 18 Szwoleżerów St., 71-79 Krakowska, Poland.
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University in Szczecin, 26 Broniewskiego St., 71-460 Szczecin, Poland.
| | - Marzanna Stanisławska
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.
| | - Iwona Rotter
- Department of Rehabilitation Medicine, Szczecin University in Szczecin, 31 Grudziądzka St., 70-103 Szczecin, Poland.
| | - Beata Karakiewicz
- Public Health Department, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland.
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49
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To exercise, or, not to exercise, during menopause and beyond. Maturitas 2014; 77:318-23. [PMID: 24548848 DOI: 10.1016/j.maturitas.2014.01.006] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/15/2014] [Accepted: 01/16/2014] [Indexed: 11/22/2022]
Abstract
Menopausal symptoms in women can be severe and disruptive to overall quality of life. Hormone replacement therapy, is known to be effective in ameliorating symptoms, however, reporting of side effects has resulted in alternative treatment options. Exercise has been assessed as an alternative treatment option for alleviating menopausal symptoms, including, psychological, vasomotor, somatic and sexual symptoms. Here we report the effects of physical activity and exercise on menopause symptoms in menopausal women.
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50
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Liu K, He L, Tang X, Wang J, Li N, Wu Y, Marshall R, Li J, Zhang Z, Liu J, Xu H, Yu L, Hu Y. Relationship between menopause and health-related quality of life in middle-aged Chinese women: a cross-sectional study. BMC WOMENS HEALTH 2014; 14:7. [PMID: 24410885 PMCID: PMC3893455 DOI: 10.1186/1472-6874-14-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 12/17/2013] [Indexed: 11/10/2022]
Abstract
Background Chinese menopausal women comprise a large population and the women in it experience menopausal symptoms in many different ways. Their health related quality of life (HRQOL) is not particularly well studied. Our study intends to evaluate the influence of menopause on HRQOL and explore other risk factors for HRQOL in rural China. Methods An interview study was conducted from June to August 2010 in Beijing based on cross-sectional design. 1,351 women aged 40–59 were included in the study. HRQOL was measured using the EuroQol Group’s 5-domain (EQ5D) questionnaire. Comparison of HRQOL measures (EQ5D index and EQ5D-VAS scores) was done between different menopausal groups. Logistic regression and multiple regression analysis were performed to adjust potential confounders and explore other risk factors for health problems and HRQOL measures. Results Postmenopausal women who had menopause for 2–5 years (+1b stage) were more likely to suffer mobility problems (OR = 1.835, p = 0.008) after multiple adjustment. Menopause was also related to impaired EQ5D index and EQ5D-VAS scores after adjustment for age. Among menopausal groups categorized by menopausal duration, a consistent decrement in EQ5D index and EQ5D-VAS scores, that is, worsening HRQOL, was observed (p < 0.05). Multiple regression analysis revealed low education level and physical activity were associated with EQ5D index (β = -0.080, p = 0.003, and β = 0.056, p = 0.040, respectively). Cigarette smoking and chronic disease were associated with EQ5D index (β = -0.135, p < 0.001 and β = -0.104, p < 0.001, respectively) and EQ5D-VAS (β = -0.057, P = 0.034 and β = -0.214, p < 0.001, respectively). Conclusions Reduction in physical function was found within the first five years after menopause. Worsening EQ5D index and EQ5D-VAS scores were related to menopause. Education level, physical activity, cigarette smoking, and chronic disease history were associated with HRQOL in middle aged Chinese rural women.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Yonghua Hu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing, China.
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