title: Impaired quality of life among middle aged women: a multicentre Latin American study.
abstract: BACKGROUND
  Several studies indicate that quality of life (QoL) is impaired in middle aged women. Assessment of QoL using a single validated tool in Latin American climacteric women has not been reported to date at large scale.
  
  
  OBJECTIVE
  The Menopause Rating Scale (MRS) was used to assess QoL among middle aged Latin American women and determine factors associated with severe menopausal symptoms (QoL impairment).
  
  
  METHODS
  In this cross-sectional study, 8373 healthy women aged 40-59 years, accompanying patients to healthcare centres in 18 cities of 12 Latin American countries, were asked to fill out the MRS and a questionnaire containing socio-demographic, female and partner data.
  
  
  RESULTS
  Mean age of the entire sample was 49.1+/-5.7 years (median 49), a 62.5% had 12 or less years of schooling, 48.8% were postmenopausal and 14.7% were on hormonal therapy (HT). Mean total MRS score (n=8373) was 11.3+/-8.5 (median 10); for the somatic subscale, 4.1+/-3.4; the psychological subscale, 4.6+/-3.8 and the urogenital subscale, 2.5+/-2.7. The prevalence of women presenting moderate to severe total MRS scorings was high (>50%) in all countries, Chile and Uruguay being the ones with the highest percentages (80.8% and 67.4%, respectively). Logistic regression determined that impaired QoL (severe total MRS score > or =17) was associated with the use of alternatives therapies for menopause (OR: 1.47, 95% CI [1.22-1.76], p=0.0001), the use of psychiatric drugs (OR: 1.57, 95% CI [1.29-1.90], p=0.0001), attending a psychiatrist (OR: 1.66, 95% CI [1.41-1.96], p=0.0001), being postmenopausal (OR: 1.48, 95% CI [1.29-1.69, p=0.0001]), having 49 years or more (OR: 1.24, 95% CI [1.08-1.42], p=0.001), living at high altitude (OR: 1.43, 95% CI [1.25-1.62, p=0.0001]) and having a partner with erectile dysfunction (OR: 1.69, 95% CI [1.47-1.94, p=0.0001]) or premature ejaculation (OR: 1.34, 95% CI [1.16-1.55, p=0.0001]). Lower risk for impaired QoL was related to living in a country with a lower income (OR: 0.77, 95% CI [0.68-0.88], p=0.0002), using HT (OR: 0.65, 95% CI [0.56-0.76], p=0.0001) and engaging in healthy habits (OR: 0.59, 95% CI [0.50-0.69], p=0.0001).
  
  
  CONCLUSIONS
  To the best of our knowledge this is the first and largest study assessing QoL in a Latin American climacteric series with a high prevalence of impairment related to individual female and male characteristics and the demography of the studied population.
authors.affiliation: Instituto para la Salud de la Mujer, Vélez 616y García, Guayaquil, Ecuador. institutochedraui@gmail.com
authors.forename: Peter
authors.initials: P
authors.lastname: Chedraui
authors.forename: Juan E
authors.initials: JE
authors.lastname: Blümel
authors.forename: German
authors.initials: G
authors.lastname: Baron
authors.forename: Emma
authors.initials: E
authors.lastname: Belzares
authors.forename: Ascanio
authors.initials: A
authors.lastname: Bencosme
authors.forename: Andres
authors.initials: A
authors.lastname: Calle
authors.forename: Luis
authors.initials: L
authors.lastname: Danckers
authors.forename: Maria T
authors.initials: MT
authors.lastname: Espinoza
authors.forename: Daniel
authors.initials: D
authors.lastname: Flores
authors.forename: Gustavo
authors.initials: G
authors.lastname: Gomez
authors.forename: Jose A
authors.initials: JA
authors.lastname: Hernandez-Bueno
authors.forename: Humberto
authors.initials: H
authors.lastname: Izaguirre
authors.forename: Patricia
authors.initials: P
authors.lastname: Leon-Leon
authors.forename: Selva
authors.initials: S
authors.lastname: Lima
authors.forename: Edward
authors.initials: E
authors.lastname: Mezones-Holguin
authors.forename: Alvaro
authors.initials: A
authors.lastname: Monterrosa
authors.forename: Desire
authors.initials: D
authors.lastname: Mostajo
authors.forename: Daysi
authors.initials: D
authors.lastname: Navarro
authors.forename: Eliana
authors.initials: E
authors.lastname: Ojeda
authors.forename: William
authors.initials: W
authors.lastname: Onatra
authors.forename: Monique
authors.initials: M
authors.lastname: Royer
authors.forename: Edwin
authors.initials: E
authors.lastname: Soto
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tserotas
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007843:Latin America; D008297:Male; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*