Menopausal night sweats: more evidence for long-term repercussions of childhood abuse on women's health No abstract available

Midlife sexuality in women's words No abstract available

An opportunity to enhance health and well-being in menopausal women: educate their male partners! No abstract available

Childhood abuse and vasomotor symptoms among midlife women Objective: Childhood maltreatment is related to adverse health outcomes. However, the relation of childhood maltreatment to the menopause transition—a universal transition for women often accompanied by troubling symptoms such as vasomotor symptoms—is relatively underexplored. This study tested whether childhood abuse and neglect are associated with menopausal vasomotor symptoms, utilizing both physiologic and prospective self-report measures of vasomotor symptoms. Methods: In all, 295 nonsmoking perimenopausal and postmenopausal women aged 40 to 60 years with and without vasomotor symptoms completed psychosocial measures, including the Child Trauma Questionnaire, ambulatory physiologic (sternal skin conductance) and self-report measurement of vasomotor symptoms during wake and sleep, and actigraphy measurement of sleep. Relationships between childhood abuse/neglect and vasomotor symptoms during wake and sleep were tested in linear regression models controlling for demographics, body mass index, and menopause stage. Results: 44% of the sample reported abuse or neglect during childhood. Among women reporting vasomotor symptoms, childhood sexual or physical abuse was associated with more frequent physiologically-recorded vasomotor symptoms during sleep (sexual abuse: b [SE] = 1.45 [0.52], P = 0.006; physical abuse: b [SE] = 0.97 [0.47], P = 0.03) in multivariable models. Among these women, women with a physical or sexual abuse history had approximately 1.5 to 2-fold the number of sleep vasomotor symptoms than women without this history. Conclusions: Childhood abuse is associated with more frequent physiologically-detected vasomotor symptoms during sleep.

Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis Objective: Sexual well-being can contribute significantly to the overall quality of women's lives. This qualitative study aimed to examine sexual activity, functioning, and satisfaction in a large sample of postmenopausal women from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) Methods: Thematic analysis was used to evaluate the free-text data of the Fallowfield Sexual Activity Questionnaire (FSAQ) completed by UKCTOCS participants at baseline before annual screening. Results: A total of 24,305 women completed the baseline FSAQ and 4,525 (19%) provided free-text data, with 4,418 comments eligible for analysis. Median age was 64 years; 65% had a partner and 22.5% were sexually active. Four interrelated themes were derived: partner availability, physical and sexual health, mental well-being, and interpersonal relationships. Primary reason for absence of sexual activity was lack of a partner, mainly due to widowhood (n = 1,000). Women discussed how partner's medical condition (27%) or sexual dysfunction (13.5%), their own physical health (18%) or menopause-related symptoms (12.5%), and prescribed medication (7%) affected sexual activity. Impact of low libido in self (16%) or partner (7%), relationship problems (10.5%) or logistics (6%), and perceptions of ageing (9%) were also mentioned. Few (3%) referred to positive sexual experiences or had sought medical help for sexual problems (6%). Conclusions: This qualitative analysis explored postmenopausal women's perspective on their sexual functioning. Having an intimate partner and good physical health are key factors for continuation of sexual activity and satisfaction. Further sexual education for healthcare professionals is needed to raise awareness about sexuality and sexual difficulties in later life. Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A426.

The MATE survey: men's perceptions and attitudes towards menopause and their role in partners’ menopausal transition Objective: The perceptions and attitudes of menopause shared by men are largely unknown. This analysis characterized men's awareness and their understanding of their partner's menopausal transition. Methods: A 35-question, online survey was used to assess men's perceptions and attitudes toward menopause. Men were recruited from an online research marketplace and were eligible to participate if their female partners (45-64 years old) experienced ≥1 of the following symptoms: hot flashes, night sweats, sleepless nights, difficulty sleeping, low libido, mood swings, pain during sex, or vaginal dryness. Couples either lived together full time, or, if living separately, resided together regularly two or more times a week. Results: Of the 1,356 surveys sent to eligible men, 450 (33%) were completed. Most men were between 50 and 69 years (80%), married and not separated (90%), and lived with their partner full time (97%). Men were aware of the symptoms regularly experienced by their partner, with difficulty sleeping (54%) and lack of energy (49%) being frequently identified; these symptoms were attributed to menopause (26%) and/or aging (22%). Of those who were affected by symptoms (63%), most men reported they negatively impacted them (77%), their partners (70%), and relationships (56%). Men engaged in discussions with their partners regarding menopausal symptoms (72%) and believed they were somewhat/very influential (75%) in their partner's decision to seek treatment or make lifestyle adjustments. Conclusions: Overall, men are aware of their partner's menopausal transition and may influence decisions relating to symptom management. Educational interventions would further benefit men's awareness of menopause and available treatment options. Video Summary:http://links.lww.com/MENO/A424.

Personality traits and the risk of coronary heart disease or stroke in women with diabetes – an epidemiological study based on the Women's Health Initiative Objective: We studied the associations between personality traits and the risk of coronary heart disease (CHD) or stroke in women with diabetes. Methods: From the Women's Health Initiative, 15,029 women aged 50 to 79 years at enrollment and with self-reported treated diabetes at baseline or follow-up, were followed for a mean of 10 years. Personality traits measured from validated scales included hostility, optimism, ambivalence over emotional expressiveness, and negative emotional expressiveness. Multivariable Cox proportional-hazards regression models were used to examine associations between personality traits and the risk of adjudicated CHD (nonfatal myocardial infarction and CHD death) or stroke outcomes. Progressively adjusted regression approach was used in the multivariable models to adjust for demographics, depression, anthropometric variables, and lifestyle factors. Results: A total of 1,118 incident CHD and 710 incident stroke cases were observed. Women in the highest quartile of hostility had 22% (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.01-1.48) increased risk for CHD compared with women in the lowest quartile of hostility. P values for trend were greater than 0.05. Stratified analysis by prevalent or incident diabetes showed that the highest quartile of hostility had 34% increased risk for CHD (HR 1.34, 95% CI 1.03-1.74) among women with incident diabetes. Other personality traits were not significantly associated with stroke or CHD. Conclusions: Hostility was associated with incidence of CHD among postmenopausal women with diabetes, especially among incident diabetes. These results provide a basis for targeted prevention programs for women with a high level of hostility and diabetes.

Depressive symptoms and associated factors among Iranian women at midlife: a community-based, cross-sectional study Objective: Little is known of depressive symptoms in Iranian women at midlife. This population-based study was undertaken to document the prevalence of, and factors associated with, depressive symptoms using validated questionnaires. Methods: A total of 1,520 community-dwelling women, aged 40 to 64 years, residing in Sari, Northern Iran, were recruited, using multistage cluster sampling, to this cross-sectional study, between October 2016 and April 2017. Participants completed the Menopause Quality of Life Questionnaire, the Beck Depression Inventory-II, and the World Health Organization Well-being Index. Results: Participants’ mean age was 49.1 (7.0) years and 88.7% were married. Overall, 167 (11%) women had moderate–severe depressive symptoms, 837 (55.1%) had low psychological well-being, and 172 (11.3%) reported taking psychotropic medication in the prior month. Factors independently associated with moderate–severe depressive symptoms included moderate–severe vasomotor symptoms (VMS) (adjusted odds ratio [AOR] 2.6, 95% CI, 1.5-4.6; P = 0.001), age 60 years or older (AOR = 1.9, 95% CI, 1.1-3.5; P = 0.03), body mass index 30 to 39 kg/m2 (AOR = 1.8, 95% CI, 1.0-3.1; P = 0.04), and housing insecurity (AOR = 5.6, 95% CI, 3.7-8.3; P < 0.001). Education beyond high school was associated with a lower risk (AOR = 0.5, 95% CI, 0.3-0.9; P = 0.04). Women reporting low marital satisfaction (19.2% of married women) were more likely than women who were very satisfied to have moderate–severe depressive symptoms (AOR = 27.9, 95% CI, 10.5-74.2; P < 0.001). Conclusions: Marital relationship dissatisfaction, reported by one in five women, was strongly associated with moderate–severe depressive symptoms in women at midlife in Iran, in addition to moderate–severe VMS, housing insecurity, obesity, and older age.

Medication use and climacteric syndrome: a cross-sectional population-based study Objective: The aim of this study was to evaluate medication use during the climacteric period and assess its association with sociodemographic factors, morbidities, and climacteric symptoms. Methods: Secondary analysis of data from a previous exploratory cross-sectional population-based study, conducted with 749 women (45-60 y), with the help of home interviews. Associations between medication use and climacteric symptoms were analyzed, and their correlations with other variables were made. Univariate analysis was made using the χ2 test, followed by Bonferroni correction (multiple comparison method). Values were adjusted for age using the polytomic logistic multivariate regression analysis. Using Poisson regression analysis, simple and multiple, we identified the main factors for medication use, with forward stepwise variable selection criteria (95% CI). Results: The mean age was 52.5 years and menopause occurred at 46.5 years (mean). The overall prevalence of medication use was 68.8%. The use of exclusive medications for relieving climacteric symptoms was associated with the absence of diseases (prevalence ratio [PR] = 8.2; 95% CI = 3.5-18.9; P<0.001) and menopause onset between 40 and 44 years (PR = 4.9; 95% CI = 2.0-11.9; P<0.001). Polypharmacy was associated with the highest number of diseases (PR = 10.6; 95% CI = 4.6-24.2; P<0.001) and somatic Menopause Rating Scale (MRS) score >3 (PR = 1.4; 95% CI = 1.01-1.96; P = 0.044). Conclusions: The prevalence of medication use among middle-aged women was high and was associated with the age of menopause onset, chronic diseases, and obesity/overweight status.

Sleep quality and fatigue in women with premature ovarian insufficiency receiving hormone therapy: a comparative study Objective: To compare sleep quality and fatigue between women with premature ovarian insufficiency (POI) receiving hormone therapy (HT) and women of the same age with preserved ovarian function. Methods: This was a cross-sectional study of 61 women with POI receiving HT (POI group) and 61 women with preserved ovarian function (control group) who were matched by age (±2 years). The Pittsburgh Sleep Quality Index (PSQI) and Chalder Fatigue Scale were used to assess sleep quality and fatigue. Apart from correlation analysis, the Mann-Whitney, chi-square, or Fisher test was used to compare the groups. Results: Women from the POI and control groups were 35.03 ± 7.68 and 34.49 ± 7.55 years of age, respectively (P = 0.63). In the PSQI evaluation, the scores were 7.69 ± 4.18 and 8.03 ± 4.53, respectively (P = 0.79), showing no difference between the POI and control groups. However, the POI group had higher and therefore worse scores for the sleep latency component (1.74 ± 0.66 and 1.18 ± 0.87, respectively; P < 0.001) and use of medication to sleep (1.28 ± 0.88 and 0. 85 ± 0.8; P = 0.008). The POI group had a higher fatigue index than that of the control group (5.25 ± 2.78 and 3.49 ± 1.78, respectively; P < 0.001), with sleep quality being classified as poor in 69% and fatigue present in 59% of patients. Conclusions: Women with POI receiving HT have poor sleep quality. They take longer to fall asleep and have a higher fatigue index.