title: Symptoms at pre- and postmenopause in rural and urban women from three States of Mexico.
abstract: OBJECTIVE
  We studied the possible influence of modern cultural conditions on symptoms at menopause in three distant populations, comparing urban vs. rural women from three different States of Mexico: Guanajuato, Coahuila and Yucatán. In these groups we compared the age at menopause and symptoms at pre- and postmenopause.
  
  
  METHODS
  A total of 7632 volunteers were selected from Guanajuato, Coahuila and Yucatán. In house visits, an oral questionnaire was applied to women 45-60 years old, non-pregnant or lactating, without hysterectomy, chronic illness, or hormone treatment. We collected general and personal data, clinical, somatometric variables, and symptoms: hot flashes, vaginal dryness, dispareunia, and diminished sexual interest. Depressive mood and anxiety were evaluated with the Hamilton-Bech-Rafaelsen Scale.
  
  
  RESULTS
  The mean age at menopause was 48.0 years. A logistic regression identified the association of age at menopause with urban or rural residence, and the State of origin. Scores for depression and anxiety were lower in Yucatán, and they were higher in rural women. Hot flashes, vaginal dryness and the diminished sexual interest were increased at postmenopause. Hot flashes varied from 73 to 32%, and were associated with menopause, low schooling, rural residence, body mass index (BMI), and State of residence. Similar factors were associated with vaginal dryness, dispareunia, and loss of sexual interest. Depressive mood was associated with rural residence, State of residence, menopause, high BMI, smoking habit, age, and schooling. Anxiety was associated with menopause, rural residence, low schooling, high BMI, and age. The loss of sexual interest was associated with age, BMI, menopause and number of pregnancies.
  
  
  CONCLUSIONS
  The frequencies of symptoms at menopause have similar ranges to other countries. Ethic and socio-cultural and environmental factors are involved in the appearance or symptoms.
authors.affiliation: Instituto de Investigaciones Médicas, Universidad de Guanajuato, 20 de Enero 929, 37320 León, Gto, Mexico. jmmalacara@hotmail.com
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Malacara
authors.forename: Thelma
authors.initials: T
authors.lastname: Canto de Cetina
authors.forename: Susana
authors.initials: S
authors.lastname: Bassol
authors.forename: Nancy
authors.initials: N
authors.lastname: González
authors.forename: Leticia
authors.initials: L
authors.lastname: Cacique
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Vera-Ramírez
authors.forename: Laura Eugenia
authors.initials: LE
authors.lastname: Nava
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D015992:Body Mass Index; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D004414:Dyspareunia / Q000150:complications; D005260:Female; D019584:Hot Flashes / Q000150:complications; D006801:Humans; D016015:Logistic Models; D008800:Mexico; D008875:Middle Aged; D017698:Postmenopause; D017697:Premenopause; D011569:Psychiatric Status Rating Scales; D012424:Rural Population; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population; D014623:Vaginal Diseases / Q000150:complications