Hormone therapy and sleep quality in women around menopause

Objective: To obtain data on sleep quality in women attending menopause clinics in Italy. Design: A cross-sectional study was conducted on the sleep quality of postmenopausal women attending a network of first-level outpatient menopause clinics in Italy for general counseling about menopause or treatment of its symptoms. Eligible for the study were women observed consecutively during the study period with natural or spontaneous menopause. All participating centers enrolled women into the study who had never used hormone therapy (HT) (group 1, 819 women), current users of transdermal estrogens with or without progestins (group 2, 819 women), and current users of oral estrogens with or without progestins (group 3, 790 women). The women were asked about their quality of sleep using the Basic Nordic Sleep Questionnaire, their quality of life using the Short Form-12 questionnaire, and the intensity of hot flushes using a visual analogue scale. Results: Women in groups 2 and 3 tended to report difficulties in sleeping less often than those in group 1. For example, never users of HT more frequently reported sleeping poorly and needed more time to sleep or had problems falling asleep; these differences were significant (P < 0.05). Otherwise, no difference emerged from the Basic Nordic Sleep Questionnaire between women in groups 2 and 3. Conclusions: This study gives support to the suggestion that HT improves the quality of sleep. The effect was similar in women taking oral or transdermal therapy with or without progestins

Correlates of sexual functioning in Italian menopausal women.

Abstract OBJECTIVES: To analyze the sexuality of Italian menopausal women. DESIGN: Cross-sectional study. POPULATION: Menopausal women consecutively observed during the study period in menopause clinics. METHODS: Women were interviewed about their current and premenopausal sexual activity: sexual intercourse frequency and self-rated sexual desire, capacity for orgasm and sexual satisfaction were recorded. Women were defined as having poor sexual functioning if they had one or less sexual intercourses per week or answered 'absent/poor' to the questions about the sexual domains. RESULTS: Oral hormone therapy (HT) use (odds ratio (OR) 0.43 for desire, 0.54 for orgasm and 0.56 for overall sexual satisfaction, all p < 0.001) and transdermal HT (OR 0.38, 0.53 and 0.53, respectively, all p < 0.001) were significantly associated with lower risk of poor sexual functioning. Higher physical and mental component scores (PCS and MCS, range 0-100) of the Short Form-12 are inversely related to poor sexual functioning (OR by point 0.96, 0.95, 0.95 for PCS and 0.96, 0.96 and 0.95, for MCS, respectively, all p < 0.001). Pain during and symptoms after sexual intercourse were significantly related to desire (OR 1.96 and 1.78, respectively), orgasm (OR 2.22 and 2.06, respectively) and sexual satisfaction (OR 2.02 and 1.79, respectively). The partner's health problems were associated with low sexual intercourse frequency (OR 4.18, p < 0.001) and absent/poor overall satisfaction (OR 2.61, p < 0.001). CONCLUSIONS: This study shows that, in menopausal Italian women attending menopause clinics, sexual function is associated with the quality of sexual life in reproductive age, partner's health status, current quality of life, HT and occurrence of pain during and symptoms after sexual intercour