Women's Health Questionnaire Research Articles

Embracing Self-collecting cervico-vaginal Human Papilloma Virus testing for cervical cancer screening: An exploratory study of acceptability among women in Penang

Objective: This study aims to assess the acceptability and awareness of Penang women regarding self-collected cervico-vaginal specimens for HPV testing. Method: The study was conducted in Penang State throughout January to December 2020, in collaboration with the Penang West Hat Community Programme. The study's target population included women aged 25-60 from the Little Siradan, North West, Terenga, and Barat daya communities, who self-collected cervicovaginal samples using a cervicovaginal brush. Following sample collection, participants completed brief questionnaires to gauge their acceptance and perceptions of this self-sampling approach. They also received counseling and guidance at local health departments for Pap test follow-ups. Result: Vaginal microbiota examination revealed a significant correlation between baseline (W0) and twelve weeks later (W12) across various parameters, encompassing the Women's Health Questionnaire (WHQ), blood samples, fecal samples, distributed products to subjects, and vaginal samples (p < 0.001). Analysis of DNA concentration (VM) demonstrated a substantial difference in A260/280 ratios (p < 0.001), while A260/230 ratios showed no statistical significance (p=0.212). Additionally, the vaginal microbiome results displayed noteworthy distinctions between fecal and vaginal samples. Conclusion: The findings of this study hold promise for the initial community-wide implementation of HPV testing, which is anticipated to be introduced in Malaysia in the near future.

Validation of the Brazilian 10-item Cervantes Scale for the assessment of menopausal symptoms.

To validate the 10-item Cervantes Scale (CS-10) among Brazilian women. This is a cross-sectional observational study involving women in the community aged 40-55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women's Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach's alpha coefficient was used for internal consistency. A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach's alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041). The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.

Salivary inflammatory burden in pre- and postmenopausal women: Associations with body mass index, patient-reported health, serum cytokines, and periodontal parameters.

The decline of estrogen levels during menopause impacts weight, mood, and overall health, both orally and systemically. This study assessed salivary levels of tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6), IL-10, and IL-7 in postmenopausal (PMW) and regularly menstruating premenopausal (RMPW) women, while considering serum cytokine levels, body mass index (BMI), periodontal health, and self-reported physical and emotional well-being. In this study, 75 PMW and 71 RMPW were included. Clinical and periodontal parameters were evaluated, and perceived health was assessed with the Women's Health Questionnaire (WHQ). Cytokine levels in both saliva and serum were quantified by enzyme-linked immunosorbent assay (ELISA). Covariate evaluations of salivary cytokines were conducted using hierarchical linear regression modeling. Cytokines weredetectablein saliva from 71 PMW and 67 RMPW. In the initial unadjusted model, IL-7, IL-10, and TNF-α exibited significant differences between RMPW and PMW. However, these differences became non-significant (p>0.05) in the final model after adjusting for age, which implies a negligible effect of the investigated covariates on salivary cytokine levels when age was considered. Lower levels of IL-6 in PMW, which initially showed no significant difference, became borderline (p=0.054) in the final model after adjusting for age. After adjusting for multiple factors, no significant difference was found in the salivary levels of the investigated cytokines between RMPW and PMW. Factors such as BMI, perceived health, serum cytokine levels, and periodontal parameters seem to minimally influence these levels in PMW. However, age may be a stronger confounding factor.

Changes in Food Consumption in Postmenopausal Women during the COVID-19 Pandemic: A Longitudinal Study.

Studying the dietary habits and symptoms of postmenopausal women during situations such as the COVID-19 pandemic is important to mitigate long-term post-pandemic health problems. We compared the menopausal symptoms and food consumption in postmenopausal women before and during the COVID-19 pandemic. A longitudinal survey was conducted on postmenopausal Brazilian women between 2018 and 2021. The Kupperman-Blatt Menopausal Index, Women's Health Questionnaire, and 24 h food recall were used. Of 274 women, 78 (28.5%) participated in the study during the COVID-19 pandemic. The intensity of the symptoms was lower during the pandemic than during the previous period (p < 0.05). Energy and processed food consumption were lower during the pandemic than before (p = 0.003 and p = 0.003, respectively). Milk and plain yogurt consumption were also lower (p = 0.043), while the consumption of sugar-sweetened beverages and sweet foods was higher (p = 0.007 and p = 0.001, respectively) during the pandemic. There was also a decrease in the consumption of proteins and lipids (p = 0.001 and p = 0.004, respectively). In conclusion, we found that postmenopausal women consumed sweet foods and sugar-sweetened beverages in higher quantities and had a lower consumption of milk and plain yogurt and processed foods during the pandemic than during the pre-pandemic period. Furthermore, decreases in energy and macronutrient consumption were observed.

Testing the effectiveness of two psychosocial interventions – ACCENT and Didactic – to prevent HIV/AIDS behavioral risk factors in Mozambican women: a randomized controlled study

ABSTRACT In Mozambique, women are the most affected by HIV/AIDS and heterosexual encounters remain the main route for HIV/AIDS. Condom use is the most effective method of HIV/AIDS prevention, and the intention to use and buy/get condoms has a significant role in safe sex behavior. This study aimed to evaluate the efficacy of two psychosocial interventions – the Didactic and ACCENT Interventions – to prevent HIV/AIDS among Mozambican Women. Participants were Mozambican women (n = 150), users of the gynecology clinic of the Central Hospital of Beira. The study design was a randomized controlled trial (RCT) with assignment to three groups: Didactic intervention, ACCENT intervention, and Control group. Measures were from an adaption of the Women's Health Questionnaire, which includes questions about sociodemographic, clinical, and behavioral variables related to HIV prevention/risk. There was a significant group effect on condom use and safer sex preparatory behaviors, F(2, 146) = 6.45, p = .002, with Bonferroni post-hoc tests showing differences between the ACCENT vs. Control groups and ACCENT vs. Didactic groups (all p = .022). There were no statistically significant time effects on both condom use and safer sex preparatory behaviors. Results are promising for HIV/AIDS prevention in Mozambican women at sexual risk, but replication is needed for generalizability of findings.

Assessment of the quality of life in peri- and postmenopausal women living in Yerevan based on Women's Health Questionnaire

Objective: To assess the impact of peri- and postmenopause and some social-demographic and medical factors on scales of the quality of life (QoL) of women living in Yerevan. Material and methods. Across-sectional study was conducted among 353 women in the &gt;40 age group. WHQ (Women Health Questionnaire) was used for the assessment of quality of life. Results. Negative indicators in peri- and postmenopausal women compared to women with a regular cycle were revealed on the scales "Vasomotor disorders" (0.46±0.05 and 0.51±0.03 vs. 0.17±0.03, p&lt;0.001) and "Anxiety/fears" (0.40±0.04 and 0.38±0.02 vs. 0.27±0.03, p=0.013). The difference only between the groups of postmenopausal women and those with a regular cycle was registered on the scales "Somatic symptoms" (0.53±0.02 vs. 0.49±0.04, p=0.003), "Memory and concentration of attention" (0.47±0.03 vs. 0.39±0.04, p=0.015), Sexual Behavior (0.43±0.03 vs. 0.21±0.03, p&lt;0.001) and "Attractiveness" (0.37±0.03 vs. 0.24±0.04, p=0.015). The presence of chronic diseases had a negative impact on QoL. From socio-demographic characteristics, negative was impact of age, low level of education, lack of employment, unfavorable family and financial status. Conclusions. There was a deterioration in all indicators of the QoL, except "Depressed mood", "Sleep problem", "Menstrual symptoms", in women of peri- and postmenopausal age. Age, low level of education, lack of employment, unfavorable family and financial status, the presence of chronic diseases had a negative impact on the QoL of the study participants.

Detailed Sub-study Analysis of the SECRAB Trial: Quality of Life, Cosmesis and Chemotherapy Dose Intensity

AimsSECRAB was a prospective, open-label, multicentre, randomised phase III trial comparing synchronous to sequential chemoradiotherapy (CRT). Conducted in 48 UK centres, it recruited 2297 patients (1150 synchronous and 1146 sequential) between 2 July 1998 and 25 March 2004. SECRAB reported a positive therapeutic benefit of using adjuvant synchronous CRT in the management of breast cancer; 10-year local recurrence rates reduced from 7.1% to 4.6% (P = 0.012). The greatest benefit was seen in patients treated with anthracycline–cyclophosphamide, methotrexate, 5-fluorouracil (CMF) rather than CMF. The aim of its sub-studies reported here was to assess whether quality of life (QoL), cosmesis or chemotherapy dose intensity differed between the two CRT regimens. Materials and methodsThe QoL sub-study used EORTC QLQ-C30, EORTC QLQ-BR23 and the Women's Health Questionnaire. Cosmesis was assessed: (i) by the treating clinician, (ii) by a validated independent consensus scoring method and (iii) from the patients' perspective by analysing four cosmesis-related QoL questions within the QLQ-BR23. Chemotherapy doses were captured from pharmacy records. The sub-studies were not formally powered; rather, the aim was that at least 300 patients (150 in each arm) were recruited and differences in QoL, cosmesis and dose intensity of chemotherapy assessed. The analysis, therefore, is exploratory in nature. ResultsNo differences were observed in the change from baseline in QoL between the two arms assessed up to 2 years post-surgery (Global Health Status: –0.05; 95% confidence interval –2.16, 2.06; P = 0.963). No differences in cosmesis were observed (via independent and patient assessment) up to 5 years post-surgery. The percentage of patients receiving the optimal course-delivered dose intensity (≥85%) was not significantly different between the arms (synchronous 88% versus sequential 90%; P = 0.503). ConclusionsSynchronous CRT is tolerable, deliverable and significantly more effective than sequential, with no serious disadvantages identified when assessing 2-year QoL or 5-year cosmetic differences.

Role of dietary habits in menstrual disorders among adolescent girls in Navi Mumbai, Western Maharashtra

BACKGROUND: India is a developing country where malnutrition is the most common problems; we are dealing with emerging problems of consumption of convenience food and street food. These foods are easily available, awesome taste, have some packages and advertisements which attracts the new generations and skipping meals starts. Adolescent girls are getting the problems of overweight, underweight, thyroid disorders, anemia, and other hematological disorders. Ultimate aim of this research is to find out an association about between dietary habits and menstrual disorders in adolescent girls. METHODOLOGY: An observational study was carried out in adolescent girls of MGM School, Navi Mumbai, India, from October 2021 to December 2021, to find out the relation between dietary pattern verses menstrual disorders among adolescent girls. Numerical pain scale, modified women's health questionnaire, and daily diary were used to collect data from 100 adolescent girls. Nonprobability purposive sampling technique was used to select adolescent girls. STATISTICAL ANALYSIS: Statistical analysis was done using SPSS 24.0 software. RESULTS: The average age of menarche was 12.9 ± 2.7 years. The study showed that girls experienced moderate menstrual pain (54%), severe menstrual pain (21%), and premenstrual symptoms in 36% of adolescence girls. More than 42% of participants were eating street food and many of the girls had habits of skipping the meals in the afternoon. It was found that there was a significant association between dietary habits and menstrual problems (P ≤ 0.0001). The correlation coefficient between dietary habits and menstrual disorders was identified as r = 0.7 with P &lt; 0.05. CONCLUSION: The menstrual disorders were arising problems among girls of schools of Navi Mumbai. Daily intake of appropriate amount of protein, CHO, fat, vitamins, and minerals can help reduce menstrual problems facing by adolescent girls.

Susceptibility of Women of Reproductive Age to Overweight and Obesity and Their Causes

The purpose of the work was to study the predisposition of women of reproductive age to overweight and obesity, as well as the reasons that contribute to the formation of these conditions. Materials and methods. With the help of the Women's Health Questionnaire, a survey was conducted among women in Baku. The questionnaire included a block of questions reflecting the state of women's predisposition to overweight and obesity and contributing to their causes, as well as women's needs for relevant information. 4,000 questionnaires were distributed, 2,838 questionnaires were collected (71.0%), of which 1,748 questionnaires contained answers to all questions (61.6%), the analysis of which was carried out in this study. The age of women ranged from 16 to 47 years, all respondents were of Azerbaijani nationality. Results and discussion. Overweight was found in 15.6 ± 0.9% of women, various degrees of obesity – in 25.5 ± 1.0% (P&lt;0.001). Women in the questionnaires noted 13 main reasons for the formation of overweight and obesity, for 1 woman with normal body weight there were an average of 2.06 ± 0.21 reasons, for overweight women – 4.19 ± 0.23 reasons (P&lt;0.001), for obese women – 5.42 ± 0.22 reasons (P&lt;0.001). The first group of women expressed the need for an average of 2.51 ± 0.28 forms of information on the control and correction of overweight and obesity, the second group – 5.43 ± 0.35 forms, respectively (P&lt;0.001), the third group – 8.01 ± 0.32 forms. It was also found that the possible reasons of formation of overweight and obesity are common to all groups of women surveyed, however, there are differences in their frequencies: a number of indicators of frequency of causes of overweight women significantly exceed a similar number of indicators of women with normal weight, and a number of indicators of women with obesity – a number of indicators of overweight women, respectively. Low physical activity is recognized as the main cause of weight gain. It is no coincidence that the surveyed women were primarily interested in information about the body's daily need for physical activity. Taking into account the modern rhythm of life of urban women (work, household, raising children), which creates difficulties in special physical activities, they were very interested in information about the possibility of covering the body's daily needs by moderate walking. Conclusion. The prevalence of overweight and obesity among women can be limited through available outreach work on an ongoing basis and appropriate information support. For this purpose, it is necessary to activate the assistance bodies for the control and correction of overweight and obesity among women

Correlation among four questionnaires that evaluate menopausal symptoms.

The number of specific scales to measure menopausal symptoms has increased significantly in the last decades. However, the lack of standardization as well as prioritization of which scale should be used in exploring menopausal symptoms poses problems in most populations. Thus, we aimed at demonstrating the correlation among four questionnaires evaluating menopausal symptoms: the Menopause Rating Scale (MRS), Greene Climacteric Scale (GCS), Kupperman Menopausal Index, and Women's Health Questionnaire (WHQ). We recruited 336 women between 40 and 65 years of age who responded to all four questionnaires. For each questionnaire, we calculated the overall score and the subscale scores. We then compared variables using the Spearman rank correlation coefficient (Rho). We found a very strong correlation (Rho > 0.80; P < 0.001) between all the questionnaires. The strongest correlations were those observed in the comparisons involving the GCS (Rho 0.92-0.95; P < 0.001), whereas the weakest ones were observed using the WHQ scale (Rho -0.86 to -0.89; P < 0.001). Like in the overall score analyses, vasomotor, somatic, and psychological symptoms demonstrated the strongest correlations in the GCS comparisons and the weakest correlations between the WHQ and MRS. The MRS, GCS, Kupperman Menopausal Index, and WHQ assessed menopausal symptoms in a very similar way. We recommend further studies to adjust and improve the existing questionnaires, test their robustness in different settings, and ensure their applicability in research and clinical practice.

The dynamics of quality of life indicators in women against the background of personalized therapy of menopausal syndrome combined with perimenopausal melatonin deficiency syndrome

Introduction. Climacteric syndrome (CS) significantly reduces the quality of life (QOL) of peri— and postmenopausal women. Along with sex steroid deficiency in KS, there is a change in the synthesis of the epiphysis hormone melatonin (MT), which leads to the formation of perimenopausal melatonin deficiency syndrome (SPDM) (Patent 2019118500/14(035525) of 16.05.2020). The aim of the work was to evaluate clinical efficacy and QOL dynamics in women against the background of personalized treatment of CS in combination with SPDM. Methods and Materials. The study included 163 women. Groups 1, 2, 3 and 4 consisted of patients with CF and SPDM, control group 5 consisted of women with a normal course of the menopausal period and the absence of clinical manifestations of MT deficiency. After collecting medical history, determining the degree of CS severity with the help of the modified menopausal index (MMI) (H. Kuppermanetal. 1959, modified by E.V. Uvarova 1983), CS was assessed by the SF-36 general questionnaire and special women's health questionnaire (WHQ). The presence of MT deficiency was determined by the MT deficiency test-questionnaire and the WHQ scales. According to the «Stratification Algorithm for Women in the Menopausal Transition and Postmenopause with CS in Combination with SPDM for Selecting Differentiated Therapy» that we developed, Group 1 patients received MT monotherapy, Group 2 — synthetic gynestein, Group 3 — menopausal hormone therapy in combination with MT, and Group 4 — synthetic gynestein with MT for 5-6 months. The data were statistically processed using SPSSv13.0 software. The χ2 criterion was determined at baseline and the Wilcoxon test was used for dynamic follow-up. Results. Patients in groups 1, 2, 3, and 4 experienced relief of both the clinical manifestations of CS and SPDM and an increase in the physical and psychological components of QOL according to the SF-36 general questionnaire and the vast majority of the scales of the special WHQ questionnaire. Discussion. We hypothesized that the lack of complete efficacy of CS therapy in peri— and postmenopausal women is associated with the absence of a differentiated approach based on the active detection of SPDM. In the course of the study, it was proved that individual selection of CS therapy taking into account the presence of MT synthesis deficiency allows to achieve a 100% positive result of treatment in women of all four groups. Conclusions. Against the background of personalized treatment of CS in combination with SPDM in women, not only CS has been stopped, but also the level of QOL has been increased.

Life habits of postmenopausal women: Association of menopause symptom intensity and food consumption by degree of food processing

ObjectiveTo evaluate in postmenopausal women the association between menopause symptom intensity and the quality of life and clinical, anthropometric, and lifestyle factors, focusing on food consumption by degree of processing. Study designA cross-sectional study of 288 postmenopausal women using interviews. Main outcome measuresThe Kupperman-Blatt Menopausal Index and the Women's Health Questionnaire were used to evaluate the main outcomes of menopausal symptom intensity and quality of life, respectively. Data on socioeconomic, clinical, anthropometric, and lifestyle variables (smoking, alcohol intake, physical activity, and food consumption) were collected. ResultsMost women had moderate to severe intensity of menopausal symptoms. The highest tertile of ultra-processed food consumption was associated with a greater intensity of vasomotor symptoms (prevalence ratio [PR] 0.73, 95% confidence intervals [CI] 0.55–0.96) and sexual behavior (PR 1.22, CI 1.01–1.49). Higher intakes of sugar-sweetened beverages and sausages were associated with somatic symptoms (PR 1.23, CI 1.01–1.49) and poorer memory/concentration (PR 1.22, CI 1.02–1.47/ PR 1.22, CI 1.01–1.48). The highest tertile of vegetable intake was associated with greater protection against depressive mood (PR 0.64, CI 0.43–0.96), vasomotor symptoms (PR 0.79, CI 0.63–0, 99), and sleep disorders (PR 0.83, CI 0.69–0.99), and better quality of life (PR 0.79, CI 0.62–0.99). ConclusionMore intense vasomotor, sexual, somatic, and memory and concentration symptoms are associated with a higher consumption of ultra-processed foods, whereas those with a higher consumption of vegetables reported lower menopause symptom intensity and a better quality of life.

Testing the Effectiveness of Two Psychosocial Interventions on Socio-Cognitive Risk Factors for HIV/AIDS in Mozambican Women: A Randomized Controlled Trial.

The objective of this study was to evaluate the efficacy of two psychosocial interventions (Didactic and ACCENT) on socio-cognitive risk factors, in vulnerable Mozambican women at risk for HIV/AIDS infection. The study design was a randomized controlled trial on Mozambican women at HIV/AIDS risk (n = 150). The participants were randomized into three groups: Didactic Intervention (experimental group), ACCENT intervention (experimental group), and control group. We used an adapted version of the Women's Health Questionnaire, which includes a series of scales and questionnaires assessing psychosocial relevant dimensions to female protection towards HIV/AIDS: HIV/AIDS knowledge, condom use negotiation self-efficacy, and perceived barriers against safer sex. Both interventions were equally effective in increasing HIV/AIDS knowledge. The ACCENT intervention was especially effective in promoting condom use negotiation self-efficacy and in decreasing perceived barriers against safer sex, essential variables for sexual protection. These results support the adaptation of Western interventions to the African context.

Climacteric symptoms and quality of life in yoga practitioners

BackgroundYoga is among the most commonly studied complementary therapies for managing climacteric symptoms. However, it is unclear whether yoga practices in premenopause can affect the occurrence of symptoms when women reach menopause. ObjectiveTo assess climacteric symptoms and quality of life in regular yoga practitioners and to determine whether yoga practices before menopause may avoid or mitigate climacteric-related symptoms. DesignThis study of 108 women between 40 and 65 years old included 28 women who started to practice yoga in premenopause and had already practiced for at least five years, and as controls 30 physical activity practitioners (PA) who had practiced for at least five years, and 50 sedentary women. Main outcome measuresClimacteric symptoms were evaluated with the Kupperman Menopausal Index (KMI) and the Women's Health Questionnaire (WHQ). Moreover, we measured the quality of life with the WHQ. ResultsThe KMI showed that 39.3% of yoga practitioners had no menopausal symptoms, and none reported severe symptoms. The WHQ indicated a few symptoms and a good quality of life for yoga practitioners (3.56; 3.35–3.80). In addition, we found that the yoga group had significantly less moderate and severe symptoms (p = 0.002) compared with the sedentary group. We also observed that yoga practitioners had less vasomotor symptoms and memory/concentration disorders than PA practitioners (p = 0.010 and p = 0.047) and sedentary women (p = 0.001 and p = 0.001) and also used fewer drugs than the PA (p < 0.001) and the sedentary groups (p = 0.001). ConclusionsYoga practitioners who started to practice in premenopause had satisfactory results on the frequency and intensity of climacteric symptoms and quality of life. Although further research is required to support our findings, we conclude that yoga practice may represent an efficient non-pharmacological approach to manage and prevent climacteric symptoms.

Evaluation of the quality of life of women in the climacteric attended by the basic care of the municipality of Sinop-MT

The World Health Organization (WHO) defines climacteric as a biological phase of life and not a pathological process, which refers to the transition between the reproductive and non-reproductive periods of women's lives. The objective of this study was to evaluate the quality of life of climacteric women attended by the Carlos Scholtão Family Health Units and Jardim Botânico. This is a quantitative study, in which 41 women were evaluated, with symptoms related to the climacteric, age from 40 to 65 years, without hormonal therapy. To collect data, two questionnaires were applied, first one with questions related to socio-demographic data, health status and life habits, and to collect data on women's health, the Women's Health Questionnaire (QSM), developed and validated by Hunter in 1992. Through the study it was demonstrated that the climacteric symptoms did not significantly interfere in the quality of life of the women surveyed. It was also observed that even without reported symptoms, many reported using antidepressant medications, which may interfere with the intensity of the climacteric symptomatology. Research has shown to be different from most studies that deal with women's quality of life in the climacteric, which reinforces the importance of local studies with different approaches. Through the research the interest was aroused by the self-knowledge in the participants and evidenced that the nursing has an important role in the incentive of self-care. At the end of the research it was observed that some women had difficulty understanding the questionnaires, which suggests the application of other methodologies in future studies.

Lifetime estrogen exposure and cognition in late life: the Cache County Study.

Prevalence of Alzheimer's disease (AD) is higher for women, possibly influenced by sex-dependent effects of the estrogen. We examined the association between estrogen and cognitive decline in over 2,000 older adult women in a 12-year population-based study in Cache County, Utah. The baseline sample included 2,114 women (mean age = 74.94 y, SD = 6.71) who were dementia-free at baseline and completed a women's health questionnaire, asking questions regarding reproductive history and hormone therapy (HT). Endogenous estrogen exposure (EEE) was calculated taking the reproductive window (age at menarche to age at menopause), adjusted for pregnancy and breastfeeding. HT variables included duration of use, HT type (unopposed; opposed), and time of HT initiation. A modified version of the Mini-Mental State Examination (3MS) was administered at four triennial waves to assess cognitive status. Linear mixed-effects models examined the relationship between estrogen exposure and 3MS score over time. EEE was positively associated with cognitive status (β = 0.03, P = 0.054). In addition, longer duration of HT use was positively associated with cognitive status (β = 0.02, P = 0.046) and interacted with age; older women had greater benefit compared with younger women. The timing of HT initiation was significantly associated with 3MS (β = 0.55, P = 0.048), with higher scores for women who initiated HT within 5 years of menopause compared with those initiating HT 6-or-more years later. Our results suggest that longer EEE and HT use, especially in older women, are associated with higher cognitive status in late life.

Health-Related Quality of Life, Sexuality and Hormone Status after Laparoscopic Roux-En-Y Gastric Bypass in Women.

Few studies have been carried out concerning the influence of bariatric surgery on female sexuality and hormones, particularly utilizing hormone-based questionnaires. The effect of bariatric surgery on sex hormone levels, sexual function and health-related quality of life (HRQL) in women was analyzed in this study. Participants were included in a single-center study at a regional hospital in Sweden, with a duration of one-year follow-up. One hundred non-smoking women, undergoing laparoscopic Roux-en-Y gastric bypass, were included in the study. Blood assay for sex-hormone binding globulin (SHBG), testosterone, estrogen, progesterone, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) was analyzed. Participants completed the Female Sexual Function Index (FSFI), Women's Health Questionnaire (WHQ) and Psychological General Well-being Inventory (PGWB) parallel to lab testing. At one-year follow-up, several significant results were found concerning hormones and questionnaires. Testosterone decreased and SHBG increased, N = 68/100. Desire, arousal, orgasm, satisfaction and total score domains for the FSFI increased after one year, N = 53/100. WHQ domains concerning depressed mood, somatic symptoms, memory, anxiety, sexual behavior and attractiveness improved after one year, N = 47/100. All domains in the PGWB (N = 52), including anxiety, depressed mood, positive well-being, self-control, general health, vitality and total score improved at follow-up. Spearman's Rho coefficient analysis found correlation between testosterone/WHQ-sexual problems (0.3), SHBG/WHQ-general health (0.3) and SHBG/FSFI-arousal (-0.3). Bariatric surgery normalizes levels of sex-hormones in women, and results in improved sexual function, health-related quality of life and psychological well-being.

Use of evaluation tools to evaluate symptoms and changes in climacteric women in the Czech Republic and abroad

Aim: The paper surveys empirical research on the use of evaluation tools with the purpose of evaluating symptoms and changes in climacteric women in the Czech Republic and other countries. In order to evaluate the range of individual symptoms, a great number of standardized questionnaires and measuring scales have been created, which are logically designed for clear statistic evaluation, and are used on a global scale to measure the severity of disorders, or quality of life of women. Design: A literature review. Methods: In outline, the article is an overview making use of content analysis of studies published in scientific databases, e.g. EBSCO, PubMed, ProQuest, and ScienceDirect, during the years 2012 to 2018. The overview focuses on articles dealing with the use of evaluation tools in connection with menopause. After screening for eligibility, 25 articles were eventually analyzed. Results: Following analysis of the results of foreign empirical research, it was apparent that the most common evaluation tool for defining the types and level of symptoms in climacteric women was the Menopausal Rating Scale. Besides this tool, other tools, such as the Greene Climacteric Scale, the Kuperrman index, the Menopause-Specific Quality of Life Questionnaire, the Women's Health Questionnaire, and the Utian Quality of life Scale were used in this field. Two studies focusing on the Czech Republic were analyzed. The standardized tool used in these cases was the Menopausal Rating Scale. Conclusion: A number of foreign studies have been conducted regarding climacteric women monitoring symptoms and changes in psychological condition and behaviour, and changes in their cognitive and emotional states, or evaluating their quality of life. However, only two such studies have been undertaken in the Czech Republic.

Climacteric-related symptoms in menopause transition and beyond: a prospective 19-year follow-up study on previously hysterectomized women

Only a few extended follow-up studies have investigated the natural progress of climacteric-related symptoms. The results have been conflicting. Thus, our aim was to evaluate, through a 19-year longitudinal study, whether these symptoms decrease or disappear as time elapses after menopause. Our study was a prospective follow-up survey of 65 hysterectomized peri or postmenopausal women. The women were interviewed at the baseline, and at 6 and 19 years thereafter. Changes in various climacteric-related symptoms were evaluated by repeated-measures analysis of variance with time as the independent variable. The analyses were adjusted for baseline age, body mass index, employment, and use of hormone therapy. Climacteric-related symptoms were evaluated with the Women's Health Questionnaire, of which we included seven symptom domains (vasomotor, sleep, depressive, anxiety/fears, cognitive, sexual, and somatic). Vasomotor symptoms decreased remarkably during the follow-up period. In addition, a statistically significant decrease was found in sleep problems and cognitive difficulties. However, the decrease was minor, and thus probably clinically insignificant. The only symptom with notable decrease was vasomotor symptoms. The etiology of other symptoms, commonly connected to menopause transition, is probably multifactorial and not substantially dependent on the climacteric.

Quality of Life of Peri and Postmenopausal Women attending Outpatient Department of Obstretics and Gynecology of A Tertiary Care Hospital

Many women experience menopausal symptoms during menopausal transition and postmenopausal years. This natural phenomenon often results in various psychological, somatic and urinary symptoms which impair the overall quality of life of women. This study aimed to access the quality of life of women during perimenopausal and early postmenopausal years attending outpatient department of OBGYN at Kathmandu Medical College Teaching Hospital. A descriptive cross-sectional study of 240 perimenopausal women of aged 45-60 years attending gynaecological outpatient clinic was carried out between 15th January to 13th April 2017. Data were collected using Women Health Questionnaire, containing 37 questions by interview technique and analyzed using chi-square test to assess the association between sociodemographic information and the quality of life. The median age of onset of menopause was 50 years and 50.8% of respondents were having good quality of life. Sociodemographic variables such as age of women, marital status, educational level, last menstrual period and regular menstrual period were statistically significant with the quality of life of peri and postmenopausal women. Menopausal symptoms are common but due to lack of awareness, they do not seek medical advice. Hence priority lies on generating awareness among women about menopause and menopausal symptoms and establishment of dedicated elderly clinic to help these women live a healthy and comfortable life.