Trends of determinants of hormone therapy use in Italian women attending menopause clinics, 1997-2003

OBJECTIVE: Analysis of patterns of hormone therapy (HT) use among postmenopausal Italian women, before and after publication of results from the Heart and Estrogen/progestin Replacement Study and the Women's Health Initiative. DESIGN: This was a cross-sectional study conducted between 1997 and 2003 on the characteristics of women around the age of menopause. The study population consisted of 106,784 women (mean age 53 y) attending menopause clinics in Italy. Postmenopausal women were defined as women with surgical menopause (ie, bilateral oophorectomy with or without hysterectomy), women older than 55 years who underwent hysterectomy without bilateral oophorectomy, and women whose menstrual cycles had stopped more than 1 year before their interview. RESULTS: A total of 15,657 women (14.7%) reported ever using HT. The prevalence of HT prescription was 17.6% among women observed in 1997-1998, 14.9% in 1999, 12.2% in 2000, 12.1% in 2001, and 11.4% in 2002-2003. HT use was related to age at menopause and level of education in all the periods considered and was more frequent in women reporting surgical menopause. The odds ratio of HT prescription tended to decrease in women with surgical menopause, with slight fluctuations in the intermediate years. Ever users of oral contraceptives and nulliparae were more frequently HT users. CONCLUSIONS: In our population the percentage of current HT users dropped from 17.6% in 1997-1998 to 11.4% in 2002-2003. However, the determinants of use were largely unchanged during the study period: women with higher education, nulliparae, and smokers reported more frequent HT use. ©2008The North American Menopause Society

Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy

Objective: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. Methods: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. Results: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. Conclusions: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms

FACTORS ASSOCIATED WITH CLIMATERIC SYMPTOMS IN WOMEN AROUND MENOPAUSE ATTENDING MANOPAUSE CLINICS IN ITALY

Objective: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy. Methods: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient\u2019s clinics in Italy. A total of 66,501 (mean age 54.4 years) women are considered in the present paper. Results: The odds ratios of moderate and severe hot flashes/night sweats were lower in more educated women and (for severe symptoms only) in women reporting regular physical activity. Depression, difficulty to sleep, forgetfulness and irritability tended to be less frequent in more educated women and (depression only) in women reporting regular physical activity. Parous women reported more frequently these symptoms. Conclusions: This large study confirms in Southern European population that low education, body mass index and low physical activity are associated with climacteric symptoms. Parous women are at greater risk of psychological symptoms. \ua9 2005 Elsevier Ireland Ltd. All rights reserved

Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study

OBJECTIVE: To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause. SUBJECTS: Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. METHODS: Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year. RESULTS: Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73). CONCLUSIONS: This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy

Premature ovarian failure: frequency and risk factors among women attending a network of menopause clinics in Italy

Objective To determine the frequency and causes of preterm ovarian failure (menopause before 40 years of age) and early menopause (menopause between 40 and 45 years). Design Cross sectional study. Setting Menopause clinics in Italy. Population Women attending menopause clinics in Italy. Methods Between 1997 and 1999 we conducted a large cross sectional study on the characteristics of women around menopause attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. Eligible for the study were all women aged 45-75 years consecutively observed for the first time at the participating centres on randomly selected days during the study period. Main outcome measure Factors associated with preterm ovarian failure. Results Out of 15,253 women aged 55 years or more with spontaneous menopause who entered the study, 269 (1.8%) reported preterm ovarian failure, and 1085 (7.1%) reported spontaneous menopause at age 40-45 years. The risk of preterm ovarian failure and of early menopause was higher in women reporting lifelong irregular menstrual cycles: in comparison with women reporting menopause at age greater than or equal to45 years, the OR (irregular vs regular mestrual cycles) of preterm ovarian failure was 1.3 (95% CI 1.0-1.7) and of early menopause of 1.2 (95% CI 1.0-1.5). Parous women reported less frequently preterm ovarian failure (chi(2) trend P < 0.05) and early menopause (OR 0.8, 95% CI 0.7-1.0). No significant association emerged between risk of preterm ovarian failure or menopause at age 40 to <45 and education, age at menarche, oral contraceptive use and smoking habits. Conclusion Nulliparity and lifelong irregular menstrual cycles are associated with an increased risk of preterm ovarian failure

Factors associated with total cholesterol levels in women around menopause attending menopause clinics in Italy

OBJECTIVE: To obtain data on correlates of total cholesterol (TC) levels in women around menopause attending menopause clinics in Italy. METHODS: Since 1997, a large cross-sectional study has been conducted concerning the characteristics of women around the time of the menopause attending a network of first-level menopause out-patient clinics in Italy for general counselling about the menopause or treatment of menopausal symptoms. Women observed consecutively at the participating centers were eligible for the study. Up to March 2000, TC was measured in 23 018 cases, which are considered in this analysis. RESULTS: The adjusted mean level of TC rose with age, from 216 mg/dl in women aged 57 years. Mean TC increased with body mass index (BMI, kg/m2), being 224 mg/dl in women with BMI 26. Considering menopausal status, the crude mean TC level was 216 mg/dl in premenopausal women, 227 mg/dl in women reporting a surgical menopause and 229 mg/dl in women reporting a natural menopause. These differences were still present when the analysis took into account the effect of age and other potential covariates, the adjusted values being 221, 225 and 227, respectively. Similar findings emerged when we considered the distribution of study subjects according to selected levels of TC ( 250 mg/dl vs. 57 years in comparison with women aged 26 vs. < 24, and for women in spontaneous menopause vs. premenopause, were all 1.2 (all statistically significant). CONCLUSIONS: This analysis, based on a large data set, confirms the role of overweight as a determinant of TC in postmenopausal women, and indicates the role of the menopause as a determinant of TC level in women aged 50-60 years

Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study

To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause