title: Menopausal symptoms appear before the menopause and persist 5 years beyond: a detailed analysis of a multinational study.
abstract: OBJECTIVE
  Few Latin American studies have described menopausal symptoms in detail by means of a standardized assessment tool. The objective of this study was to assess the prevalence and severity of menopausal symptoms and their impact over quality of life among mid-aged Latin American women.
  
  
  METHODS
  In this cross-sectional study, 8373 otherwise healthy women aged 40-59 years from 12 Latin American countries were asked to fill out the Menopause Rating Scale (MRS) and a questionnaire containing personal sociodemographic data. Menopause status (pre-, peri- and postmenopausal) was defined according to the criteria of the Stages of Reproductive Aging Workshop.
  
  
  RESULTS
  Of all the studied women, 90.9% had at least one menopausal symptom (complaint) that they rated. Muscle and joint discomfort, physical and mental exhaustion and depressive mood were highly prevalent and rated as severe-very severe (scores of 3 and 4), at a higher rate than vasomotor symptoms (15.6%, 13.8% and 13.7% vs. 9.6%, respectively). Of premenopausal women (40-44 years), 77.0% reported at least one rated complaint, with 12.9% displaying MRS scores defined as severe (> 16). The latter rate increased to 26.4% in perimenopausal, 31.6% in early postmenopausal and 29.9% among late postmenopausal women. As measured with the MRS, the presence of hot flushes increased the risk of impairment of overall quality of life in both premenopausal (odds ratio 12.67; 95% confidence interval 9.53-16.83) and peri/postmenopausal women (odds ratio 9.37; 95% confidence interval 7.85-11.19).
  
  
  CONCLUSIONS
  In this large, mid-aged, female Latin American series, muscle/joint discomfort and psychological symptoms were the most prevalent and severely rated menopausal symptoms. The symptoms appear early in the premenopause, significantly impair quality of life and persist 5 years beyond the menopause.
authors.affiliation: Institute of Biomedicine, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
authors.forename: J E
authors.initials: JE
authors.lastname: Blümel
authors.forename: P
authors.initials: P
authors.lastname: Chedraui
authors.forename: G
authors.initials: G
authors.lastname: Baron
authors.forename: E
authors.initials: E
authors.lastname: Belzares
authors.forename: A
authors.initials: A
authors.lastname: Bencosme
authors.forename: A
authors.initials: A
authors.lastname: Calle
authors.forename: L
authors.initials: L
authors.lastname: Danckers
authors.forename: M T
authors.initials: MT
authors.lastname: Espinoza
authors.forename: D
authors.initials: D
authors.lastname: Flores
authors.forename: G
authors.initials: G
authors.lastname: Gomez
authors.forename: J A
authors.initials: JA
authors.lastname: Hernandez-Bueno
authors.forename: H
authors.initials: H
authors.lastname: Izaguirre
authors.forename: P
authors.initials: P
authors.lastname: Leon-Leon
authors.forename: S
authors.initials: S
authors.lastname: Lima
authors.forename: E
authors.initials: E
authors.lastname: Mezones-Holguin
authors.forename: A
authors.initials: A
authors.lastname: Monterrosa
authors.forename: D
authors.initials: D
authors.lastname: Mostajo
authors.forename: D
authors.initials: D
authors.lastname: Navarro
authors.forename: E
authors.initials: E
authors.lastname: Ojeda
authors.forename: W
authors.initials: W
authors.lastname: Onatra
authors.forename: M
authors.initials: M
authors.lastname: Royer
authors.forename: E
authors.initials: E
authors.lastname: Soto
authors.forename: K
authors.initials: K
authors.lastname: Tserotas
authors.forename: M S
authors.initials: MS
authors.lastname: Vallejo
mesh_terms: D000328:Adult; D018771:Arthralgia; D001526:Behavioral Symptoms / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003863:Depression; D005260:Female; D019584:Hot Flashes / Q000453:epidemiology; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D008875:Middle Aged; D009132:Muscles; D010146:Pain; D047648:Perimenopause / Q000502:physiology*; D017698:Postmenopause / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013546:Sweating; D063189:Symptom Assessment; D001745:Urinary Bladder Diseases / Q000453:epidemiology; D014623:Vaginal Diseases / Q000453:epidemiology