title: Climacteric symptoms in Quechua and Mestizo women from the Andean region of Cusco, Peru: effects of altitude and ethnicity.
abstract: BACKGROUND
  Latin-American women present a greater severity of climacteric symptoms than women from other parts of the world. Previous studies suggest that this could be due to either its Amerindian crossbreeding or the altitude in which a huge proportion of the Latin-American population lives.
  
  
  OBJECTIVE
  To answer this question, climacteric symptoms between Peruvian women ("Hispanic-Mestizas" and "Quechuas") living in similar altitude (around 3000 MASL) were compared.
  
  
  METHODS
  This is a cross sectional descriptive study of healthy women of 40-59 years of age living in Departamento de El Cusco, Peru. Using the MRS questionnaire climacteric symptoms were assessed in 395 "Hispanic-Mestizas" (Quechua-Spaniard breeding) and 376 pure "Quechuas".
  
  
  RESULTS
  The "Quechuas" compared with "Hispanic-Mestizas" have comparable similar age, but less: obesity, schooling years, cigarette smoking, use of hormonal therapy, diabetes and hypertension; and a greater: proportion of postmenopausal women and number of children. "Quechuas" showed a greater prevalence in ten of the eleven symptoms evaluated by the MRS scale, except for insomnia. The total MRS score was 14.54±7.51 vs. 9.87±6.26 (p<0.0001), respectively. As a consequence of this, 46.5% of the "Quechuas" had a deteriorated quality of life due to severe climacteric symptomatology, compared to only 14.2% of "Hispanic-Mestizas" women (p<0.0001). After adjusting for confounding variables menopause was associated with increased risk of severe menopausal symptoms (OR: 5.86, 95% CI: 3.93-8.75), followed by lack of partner (OR: 3.52, 95% CI: 1.91-6.48), arterial hypertension (OR: 2.62, 95% CI: 1.28-5.39) and Quechua being (OR: 2.38, 95% CI: 1.27-4.45).
  
  
  CONCLUSIONS
  Peruvian "Quechuas" women have severer climacteric symptoms than the Peruvian "Hispanic-Mestizas" who live in a comparable altitude. This could suggest that the ethnicity could be one of the factors that could explain the augmented symptoms in Latin-American climacteric woman.
authors.affiliation: Departamento de Obstetricia and Ginecología, Universidad Andina of Cusco, Avenida San Martín Mz. D Lt. 2, Cusco, Peru. Electronic address: eojeda@terra.com.pe.
authors.forename: Eliana
authors.initials: E
authors.lastname: Ojeda
authors.affiliation: Departamento de Medicina Sur, Universidad de Chile, Chile. Electronic address: jeblumel@vtr.net.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Blümel
authors.affiliation: Clínica Quilín, Universidad de Chile, Orquídeas 1068, Dpto 302, Providencia 7510258, Santiago de Chile, Chile. Electronic address: solvallejo@vtr.net.
authors.forename: María Soledad
authors.initials: MS
authors.lastname: Vallejo
authors.affiliation: Departamento de Obstetricia y Ginecología Sur, Universidad de Chile, Gran Avenida 3204, Santiago de Chile, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Lavín
mesh_terms: D000328:Adult; D000531:Altitude; D002979:Climacteric / Q000208:ethnology* / Q000502:physiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007199:Indians, South American; D016015:Logistic Models; D008875:Middle Aged; D010568:Peru; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Climacteric symptoms; Ethnicity; Hispanic-mestizas; Menopause rate scale; Quechuas