The relationship between postmenopausal women's body image and the severity of menopausal symptoms

From couplepause to doublepause: the impact of midlife physical, psychological, and social changes on the sexual life of aging couples

INTRODUCTION

Midlife men and women are facing frequent sexual problems that affect not only individuals' sexual health but also the sexual health of aging couples.

OBJECTIVES

To review the main sexual life challenges faced by midlife couples, to present the concepts of couplepause and doublepause as 2 new paradigms to address the sexual health needs of aging couples, and to discuss key aspects in couple-focused care.

METHODS

An online meeting attended by 5 European experts in sexual health was carried out in June 2023 to discuss the topic. The conversation centered on their clinical experience and expert opinion. Additionally, the indexed literature was reviewed to endorse and complement the expert opinions obtained in the aforementioned meeting.

RESULTS

Midlife men and women face physical, psychological, and sociocultural changes that affect their sexual activity. These changes may be experienced differently between genders. Both members of a couple may experience age-related changes concurrently or in an unsynchronized manner affecting their sexual health. Communication, sharing expectations, defining sexual dynamics, and couple goals are determinant for the sexual health of a midlife couple. Couplepause and doublepause are 2 new complementary paradigms that effectively address the sexual health needs of aging couples as a unit, considering physical, psychological, cultural, social, and dyadic-related factors. Couple-centered strategies should promote open communication about couple intimacy issues, understanding the diverse expectations according to gender and orientation, communication styles, and goals. The following are identified as crucial aspects to promote couple-focused care: education and training of health care professionals, the provision of information to aging couples, physician involvement in addressing sexual problems, the need for collaboration across medical specialties, and the development of effective tools and strategies.

CONCLUSIONS

The sexual problems of aging couples should be managed following couple-centered strategies that effectively address their sexual health needs as a couple.

Association of body image perception and (dis)satisfaction with adiposity in adults: The Pró-Saúde study

INTRODUCTION

Body image distortion and/or dissatisfaction may occur primarily due to body fat accumulation and/or distribution. The aim of this study was to evaluate the frequency of body image perception and (dis)satisfaction categories in adult men and women according to the adiposity classification.

METHODS

This is a cross-sectional study (n = 514; 33-79 years; 265 women) that is part of a prospective cohort (Pró-Saúde study). Adiposity measurements were determined by two methods: anthropometry, used to calculate the body mass index (BMI) and dual-energy X-ray absorptiometry (DXA), to estimate body fat percentage. Participants were grouped as "no excess adiposity" and "excess adiposity", considering BMI and body fat percentage (>30% for men, >40% for women). Perception and (dis)satisfaction with body image were evaluated using the Kakeshita scale, composed by 15 silhouettes, developed for the Brazilian population. Degree of distortion (perceived BMI - real BMI) and dissatisfaction (perceived BMI - desired BMI) were calculated.

RESULTS

A high proportion of men (58.6%; 74.3%), and especially of women (82.6%; 86.8%), presented body size overestimation and dissatisfaction due to excess weight, respectively. A relevant fraction of the women (32.6%) and men (30.8%) who were dissatisfied due to excess weight did not present excess adiposity, especially if classified by DXA. Variability in degree of distortion was hardly explained by anthropometric and DXA variables in women (<5%) and men (∼22%). Both anthropometric and DXA measurements accounted for ∼30% and ∼50% of the variability in degree of dissatisfaction among women and men, respectively.

CONCLUSION

Our results suggest a high frequency of body image distortion in Brazilian adult individuals, as well as dissatisfaction with excess weight, especially among women with excess adiposity. The findings indicate that anthropometric measurements explain much of the variability in degree of body image dissatisfaction in men, with no apparent advantage of the use of more refined DXA measurements.

Prevalence of poor body image and its correlation with self-esteem and depression in middle-aged women

OBJECTIVE

This study aimed to determine the prevalence and predictors of poor body image and its influence on low self-esteem and depression in middle-aged women.

METHODS

The study was a cross-sectional survey of 372 women using a predesigned online questionnaire. Main outcome measures were mean scores on the nine-point body image scale (BIS) and prevalence of poor body image (BIS ≥ 10). Significant sociodemographic, physical and mental health predictors of BIS ≥ 10 were established using logistic regression analysis. Correlation of body image with self-esteem, assessed by Rosenberg's self-esteem scale, and depression, assessed by Beck's Depression Inventory, was established using Pearson's correlation coefficient and the odds ratios were determined using logistic regression analysis.

RESULTS

The mean scores obtained for body image were 5.52 (standard deviation 4.82) and the prevalence of BIS ≥ 10 was 17.4%. Significant predictors of poor body image were education status (0.59, 95% confidence interval [CI] = 0.39-0.89), body mass index (2.26, 95% CI = 1.12-4.55), social support structure (0.35, 95% CI = 0.16-0.79), diagnosis of mental illness (3.74, 95% CI = 1.31-10.66) and perception of menopause (positive vs. negative: 0.20, 95% CI = 0.07-0.55). Body image scores correlated with self-esteem (r = -0.46; 95% CI = -0.54 to -0.38) and depression (r = 0.59; 95% CI = 0.52-0.65). BIS ≥ 10 significantly increased the odds of low self-esteem (5.71; 95% CI = 2.66-12.26) and depression (11.25; 95% CI = 4.9-27.7).

CONCLUSIONS

The prevalence of poor body image in middle-aged women was 17.4%. This strongly correlated with low self-esteem and depression. A lower education status, higher body mass index, a negative perception of menopause, poor social support structure and a history of mental health diagnosis increased the odds of poor body image prevalence in middle-aged women.

Dissatisfaction with body image and weight gain in middle-aged women: A cross sectional study

OBJECTIVES

To investigate the relationship between weight gain and body image perception in in middle-aged women.

METHODS

Cross-sectional study with 453 women. Body image was assessed using the Stunkard scale, in which women were classified as: satisfied or dissatisfied (general, thinness or obesity). The identification of possible factors associated with body image dissatisfaction was performed using binary logistic regression analysis.

RESULTS

The mean age was 55.7 (±9.6) years; 80.8% were classified as dissatisfied with body image. As for body composition, women satisfied with their body image had lower values of body fat and higher values of lean mass. In the logistic regression, for general dissatisfaction and obesity, the associated variables were BMI, education and physical activity. As for "dissatisfaction with thinness", only BMI was associated.

CONCLUSION

Thus, the prevalence of body image dissatisfaction is high in women and part of associated factors are linked to lifestyle behaviors.

Study on the mediator role of self-esteem in the relationship between female self-objectification and social physique anxiety

BACKGROUND

Women's perception of body image plays an important role in their psychological health; self-objectification and social physique anxiety can affect self-esteem. The purpose of this study was to investigate the role of the mediator of self-esteem in the relationship between self-objectification and social physique anxiety in female students at Hakim Sabzevari University in Sabzevar.

MATERIALS AND METHOD

The method of this descriptive research is correlational. The statistical population of this study is all the female students of Sabzevar, Department of Humanities. Using Morgan's table, 291 subjects were selected as a sample. To collect data, Rosenberg's Self-Esteem Questionnaire, McKinley and Hyde's Self-Objectification Questionnaire, and Hart et al., Social Physique Anxiety Questionnaire were used. After filling out the questionnaires, the data were analyzed using Statistical Package for the Social Sciences (SPSS) software version 24 and descriptive indexes were used. Also, for correlation, to test the research question, a suitable statistical test such as hierarchical regression was used.

RESULTS

The results of the analysis of statistical data showed that there is a negative and significant relationship between self-objectification and self-esteem. Also, there is a significant positive correlation between this variable and social physique anxiety. Also, using hierarchical regression, the role of mediating self-esteem was confirmed in the relationship between self-objectification and social physique anxiety.

CONCLUSION

Those who have a high score in self-objectification think of themselves as an object and are always concerned about evaluating others based on their body image, so if their body image is not approved by others, they will have a negative assessment of themselves that causes a decrease in their self-esteem followed by an increase in the social anxiety of the organs.

A situation analysis on postmenopausal women's self-care needs and priorities in Tehran: a population-based study

BACKGROUND

Women need special care during and after menopause. Due to the emphasis of the World Health Organization on promoting self-care in postmenopausal women, this study aims to analyze the situation and prioritize the self-care needs of postmenopausal women in the Tehran-Iran.

METHODS

This was a descriptive-analytical study on 486 postmenopausal women aged 46-85 years living in Tehran in 2021. The Subjects were recruited using a multi-stage sampling method. Data were collected using a socio-demographic and a valid and reliable questionnaire to assess postmenopausal women's self-care status with four domains including physical health, psychosocial health, reproductive-sexual health, and screening tests. The data were analyzed by SPSS-24.

RESULTS

The mean age of the participants was 62.58 ± 7.75 years. The mean score of self-care was 44.63 ± 21.64% in the postmenopausal women. The lowest score and highest scores were related to psychosocial health (25.12 ± 28.21%) and periodic tests (50.62 ± 24.40%) respectively. There were significant positive correlations between self-care with women's education level (r = 0.277; p < 0.001), husband's education level (r = 0.258; p < 0.001), as well as monthly income (r = 0.153; p = 0.001). There was a negative correlation between self-care with the number of children (r = - 0.215; p < 0.001). The level of self-care was higher in employed women (p = 0.001) and also, in women whose husbands were employed (p = 0.012). Multiple linear regression test showed the level of education of the husband (B = 2.72, p = 0.038) and the family size (B = -1.54, p = 0.023) are predictors of the self-care of postmenopausal women.

CONCLUSION

The findings showed more than 55% of challenges in the self-care behaviors of postmenopausal women in Tehran. The most and least challenging self-care behaviors were related to psychosocial health and performing periodic tests. The priorities were in psychosocial health and reproductive-sexual health dimensions. Self-care promotion is necessary, especially in postmenopausal women, who need special care due to various physical, psychological, and social changes.

Associations between menopause and body image: A systematic review

BACKGROUND

The menopausal transition involves multiple biological and psychosocial challenges that may render middle-aged women vulnerable to body image concerns.

OBJECTIVE

The aim of this study was to summarize evidence on the associations between menopause and body image perception in healthy middle-aged women.

DESIGN

This study is a systematic review of observational studies.

DATA SOURCES AND METHODS

Menopause-related exposure measures included menopausal stages, menopausal symptoms, and reproductive hormone levels during the menopausal transition. Studies investigating body image as an outcome, including through a positive (e.g. body self-esteem) or negative (e.g. body dissatisfaction) lens, were considered eligible. Articles published before March 2023 were identified through MEDLINE, PsycINFO, and Embase and underwent double screening, extraction, and quality assessment by two independent investigators. Characteristics and results were summarized using narrative synthesis.

RESULTS

A total of 820 non-duplicate records were identified, with 18 observational studies deemed eligible for inclusion after full-text screening. All studies investigating menopausal symptoms and body image (n = 6) found some significant association between them, with a higher frequency, intensity, or number of symptoms being associated with greater body image concern. Differences in body image perception between menopausal stages were inconsistent across studies (n = 12), while evidence of potential associations between reproductive hormones and body image was minimal (n = 2). Findings should be interpreted with caution as 17 of the included studies used a cross-sectional design, and not all studies adjusted their analyses for relevant confounders.

CONCLUSION

Overall, menopausal symptoms showed relatively consistent associations with a more negative body image perception. Additional research is required to understand the potential role of menopausal stages and reproductive hormone levels in the body image perception of middle-aged women and to confirm the direction of reported associations.

REGISTRATION

PROSPERO-CRD42021241637.

Sick Leave Patterns in Common Rheumatological Diseases

Objectives The study aims to analyze the patterns and determinants of sick leaves (SL) associated with the most common rheumatological diseases and estimate the associated productivity loss cost (PLC). Method A retrospective study reviewed all SLs that were issued from a rheumatology outpatient clinic between 2016 and 2019 for the following diagnoses: low back pain (LBP), knee osteoarthritis (OA), rheumatoid arthritis (RA), and disc disorders. The duration of each sick leave was captured and analyzed by patients' age category, gender, and diagnosis. The human capital method was used to estimate the PLC. Result One thousand and two SLs have been issued during the study period, for a cumulative 4,649 days. The majority of the patients were female (86.3%), and the mean (SD) age was 42.01 (10.71) years. SL durations ranged from 2 to 14 days. The most frequent diagnosis was RA (34.3%), followed by LBP (30.1%). Disc disorder, knee OA, and RA were independently associated with 2.01 (p=0.014), 9.07 (p<0.001), and 7.75 (p<0.001) odd ratios for long SL (≥7 days), by reference to LBP. The average PLC was estimated at $235.29 per day of sick leave, for a total cumulative cost of $235,755.30. Conclusion Rheumatological diseases are responsible for approximately 4.5 days of SL prescribing per day in our clinic, with an average yearly cost of $58,938.83. Monitoring the pattern of sick leave and identifying the interplay between their cofactors are essential to developing a comprehensive approach to enable evidence-based clinical practices along with advancements in work-based protective measures and policies.