Dataset Information

Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: a cross-sectional survey among midlife Nepalese women.

ABSTRACT:

Background

Majority of Nepalese women live in remote rural areas, where health services are not easily accessible. We determined the validity of Menopause Rating Scale (MRS) as a screening tool for identification of women with severe menopausal symptoms and cut-off MRS score for referral.

Methods

A cross-sectional survey was carried out between February and August, 2008. Trained health workers administered MRS and a questionnaire to 729 women (40 to 65 years) attending health screening camps in Kaski district of Western Development Region of Nepal. Information about demographics, menopausal status, and use of hormone replacement therapy (HRT), chronic disease, self-perceived general health and reproductive history was also collected. Menopausal status was classified according to the Staging of Reproductive Ageing Workshop (STRAW). We calculated rates of menopausal symptoms, sensitivity, and specificity and likelihood ratios of MRS scores for referral to a gynaecologist. We also carried out multivariate analyses to identify the predictors for referral to a gynaecologist for severe symptoms.

Results

A total 729 women were interviewed. Mean age at menopause was 49.9 years (SD 5.6). Most frequently reported symptoms were, sleeping problems (574, 78.7%), physical and mental exhaustion (73.5%), hot flushes (508, 69.7%), joint and muscular discomfort (500, 68.6%) and dryness of vagina (449, 61.6%). Postmenopausal women (247, 33.9%) and perimenopausal (215, 29.5%) women together experienced significantly higher prevalence of all symptoms than the premenopausal (267, 36.6%) women. MRS score of ?16 had highest ratio for (sensitivity + specificity)/2. Women who reported urogenital symptoms [OR 5.29, 95% CI 2.59, 10.78], and self perceived general health as poor [OR 1.29, 95% CI 1.11, 1.53] were more likely to be referred to a gynaecologist for severe menopausal symptoms. While women reporting somatic [OR 0.72, 95% CI 0.63, 0.82] and psychological [OR 0.86, 95% CI 0.74, 0.99] symptoms were less likely to be referred.

Conclusion

MRS may be used as a screening tool at a cut-off score of ?16 with least misclassification rate. However, its utility may be limited by woman's general health status and occurrence of urogenital symptoms.

SUBMITTER: Chuni N

PROVIDER: S-EPMC3126771 | biostudies-literature | 2011 Jun

REPOSITORIES: biostudies-literature

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Publications

Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: a cross-sectional survey among midlife Nepalese women.

Chuni Neena N Sreeramareddy Chandrashekhar T CT

BMC women's health 20110614

<h4>Background</h4>Majority of Nepalese women live in remote rural areas, where health services are not easily accessible. We determined the validity of Menopause Rating Scale (MRS) as a screening tool for identification of women with severe menopausal symptoms and cut-off MRS score for referral.<h4>Methods</h4>A cross-sectional survey was carried out between February and August, 2008. Trained health workers administered MRS and a questionnaire to 729 women (40 to 65 years) attending health scre ...[more]

PMID: 21672198

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Project description:BACKGROUND:To measure the severity of menopausal complaints and determine the pattern of menopausal symptoms, a valid and reliable instrument is needed in women's healthcare. The Menopause Rating Scale (MRS) is one of the best-known tools in response to the lack of standardized scales. The purpose of this study was to examine the psychometric properties of the MRS in an Iranian example. METHODS:Participants were randomly selected from women referred to healthcare centers in Miandoab, West Azerbaijan, Iran. A total of 330 questionnaires were completed (response rate of 96.9%). Two samples were considered for analysis in the validation process. An exploratory factor analysis (EFA) was conducted on the first sample (n1?=?165), and a confirmatory factor analysis (CFA) was done using a second study sample (n2?=?165). The psychometric properties process was concluded with assessment of internal consistency and test-retest reliability. RESULTS:The EFA with Principal Component Analysis extracted three factors explaining 75.47% cumulative variance. The CFA confirmed a three-factor structure of the 11-items MRS. All fit indices proved to be satisfactory. The relative chi-square (?2/df) was 3.686 (p?<?.001). The Root Mean Square Error of Approximation (RMSEA) of the model was .04 (90% CI?=?.105-.150). All comparative indices of the model, including the Comparative Fit Index, Normed Fit Index, and Relative Fit Index, were more than .80 (.90, .87, and .80, respectively). For the overall scale, Cronbach's alpha was .931, whereas the alpha for the subscales ranged from 0.705-0.950. The intraclass correlation was .91 (95% CI?=?.89-.93), p?<?0.001. CONCLUSION:The results of the study indicate that the Persian model of the MRS is a valid and reliable scale. As a screening tool, the Persian MRS could be used to identify the pattern of symptoms among menopausal, premenopausal, and postmenopausal women to care for and educate them on how to identify and treat the symptoms.

Project description:ImportanceLittle is known about the prevalence of traumatic exposures among midlife and older women and the association of these traumatic exposures with health issues.ObjectiveTo examine the associations of intimate partner violence (IPV), sexual assault, and posttraumatic stress with menopause symptoms among midlife and older women.Design, setting, and participantsA cross-sectional analysis of data from a multiethnic cohort of 2016 women 40 to 80 years of age in the Kaiser Permanente Northern California health care system was conducted from November 15, 2008, to March 30, 2012. Statistical analysis was conducted from June 8, 2016, to September 6, 2017.ExposuresLifetime physical or emotional IPV, sexual assault, and current symptoms of posttraumatic stress disorder, assessed with standardized questionnaires.Main outcomes and measuresDifficulty sleeping, vasomotor symptoms, and vaginal symptoms, assessed with standardized questionnaires.ResultsAmong the 2016 women enrolled, the mean (SD) age was 60.5 (9.5) years, and 792 of 2011 with race/ethnicity data (39.4)% were non-Latina white (403 [20.0%] Latina, 429 [21.3%] black, and 387 [19.2%] Asian). Lifetime emotional IPV was reported by 423 women (21.0%), lifetime physical IPV was reported by 316 women (15.7%), sexual assault was reported by 382 women (18.9%), and 450 of 2000 women (22.5%) had current clinically significant symptoms of posttraumatic stress disorder. In multivariable analyses adjusted for age, race/ethnicity, educational level, body mass index, menopause status, hormone therapy, and parity, symptoms of posttraumatic stress disorder were associated with difficulty sleeping (odds ratio [OR], 3.02; 95% CI, 2.22-4.09), vasomotor symptoms (hot flashes: OR, 1.69; 95% CI, 1.34-2.12; night sweats: OR, 1.72; 95% CI, 1.37-2.15), and vaginal symptoms (vaginal dryness: OR, 1.73; 95% CI, 1.37-2.18; vaginal irritation: OR, 2.20; 95% CI, 1.66-2.93; pain with intercourse: OR, 2.16; 95% CI, 1.57-2.98). Emotional IPV was associated with difficulty sleeping (OR, 1.36; 95% CI, 1.09-1.71), night sweats (OR, 1.50; 95% CI, 1.19-1.89), and pain with intercourse (OR, 1.60; 95% CI, 1.14-2.25). Physical IPV was associated with night sweats (OR, 1.33; 95% CI, 1.03-1.72). Sexual assault was associated with vaginal symptoms (vaginal dryness: OR, 1.41; 95% CI, 1.10-1.82; vaginal irritation: OR, 1.42; 95% CI, 1.04-1.95; pain with intercourse: OR, 1.44; 95% CI, 1.00-2.06).Conclusions and relevanceLifetime history of IPV or sexual assault and current clinically significant symptoms of posttraumatic stress disorder are common and are associated with menopause symptoms. These findings highlight the need for greater recognition of these exposures by clinicians caring for midlife and older women.

Project description:BACKGROUND: It is a well accepted status that socio-cultural characteristics may affect the onset of menopause and its characteristics. The aims of this study were to describe the prevalence rates of menopausal symptoms and these symptoms related factors, and to assess the women's attitudes towards some climacteric issues. METHODS: This survey was conducted between Jan., 1st 2008 and March, 31st 2008 to research the menopause status of the female population in a city of western Turkey. The study group consisted of 1551 women selected with a multistage area sampling method: a random sample of individuals aged 40-65 years. The questionnaire included questions pertaining to women's sociodemographic characteristics, women's menopausal status, some statements about the climacteric, use of hormones at menopause or before menopause, and some climacteric myths. The data was analyzed by Chi-square (x2) analysis and percent (%) ratios with a significant value of P < 0.05. RESULTS: The mean age of the women was 49.1 years. Over 90% of the women were of the negative opinion that the climacteric is "the end of youth", "the end of fecundity", and "the end of unclean days". Most women said that cessation of menstrual periods was the most positive thing because they do not have to wait for monthly bleedings, use sanitary equipment, or take birth control methods. There were significant connections between age groups and nearly all the items, with the exception of the items "the end of life" and "the end of fecundity". Among the women, hot flushes were the most common complaint occurring in 96.5% of women: being severe in 32.9%, moderate in 43.1% and mild in 20.4%. This was followed by low backache or muscle pain 95.0% (25.9% severe, 46.0% moderate and mild 23.1%), headache 91.7% (21.9% severe, 34.9% moderate and 34.9% mild) and feeling tired 91.0% (15.3% severe, 38.6% moderate and 37.1% mild). CONCLUSIONS: Most of the women in this study had mixed ideas of opinions concerning the climacteric, and the majority was also suffering from climacteric complaints. This data could assist healthcare providers in the provision of culturally competent health care to midlife Turkish women.

Project description:Background: Parabens are antimicrobial agents prevalently found in daily-use products that can interfere with the endocrine and reproductive systems. In this study, we examined the cross-sectional associations of parabens with hot flashes, hormone concentrations, and ovarian volume in a subsample of 101 nonsmoking, non-Hispanic 45- to 54-year-old women from the Midlife Women's Health Study. Materials and Methods: Women self-reported their hot flash history and underwent a transvaginal ultrasound to measure ovarian volume. Participants provided blood for quantification of serum hormones (by enzyme-linked immunosorbent assay or radioimmunoassay) and urine samples for measurements of urinary paraben biomarker levels (by high-performance liquid chromatography negative-ion electrospray ionization-tandem mass spectrometry). Linear or logistic regression models evaluated associations of specific gravity-adjusted paraben biomarker concentrations with hot flashes, hormone concentrations, and ovarian volume. Results: We observed marginal associations of propylparaben, methylparaben, and ∑parabens biomarkers (molar sum of four parabens) with hot flashes and follicle-stimulating hormone (FSH) concentrations, and of these paraben biomarkers and ethylparaben with ovarian volume. For example, women tended to have 32% (95% confidence intervals [CI]: 0.9 to 1.81), 40% (95% CI: 1.0 to 1.95), and 40% (95% CI: 0.98 to 2.01) higher odds of having recent, monthly, and mild hot flashes, respectively, for every two-fold increase in ∑parabens. Similarly, women tended to have 14.54% (95% CI: -0.10 to 31.32) higher FSH concentrations, but 5.67% (95% CI: -12.54 to 1.75) reduced ovarian volume for every two-fold increase in ∑parabens Conclusions: Overall, our preliminary findings suggest that urinary paraben biomarkers may be associated with menopause-related outcomes in midlife women. Additional studies in larger and diverse populations are needed to expand on these findings.

Dataset Information

Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: a cross-sectional survey among midlife Nepalese women.

Background

Methods

Results

Conclusion

Publications

Frequency of symptoms, determinants of severe symptoms, validity of and cut-off score for Menopause Rating Scale (MRS) as a screening tool: a cross-sectional survey among midlife Nepalese women.

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