Impact des facteurs biologiques et socioculturels sur l’âge à la ménopause en France

International audienc

L’âge à la ménopause naturelle et ses déterminants dans une population française (cohorte Gazel)

International audienc

L’âge à la ménopause naturelle et ses déterminants dans une population française (cohorte Gazel)

International audienc

Mode of delivery and fecal incontinence at midlife: a study of 2,640 women in the Gazel cohort.

International audienceOBJECTIVE: To estimate obstetric risk factors of fecal incontinence among middle-aged women. METHODS: We conducted a mail survey of the Gazel cohort of volunteers for epidemiologic research. In 2000, a questionnaire on anal incontinence was mailed to 3,114 women who were then between the ages of 50 and 61 years; 2,640 (85%) women returned the completed questionnaire. Fecal incontinence was defined by involuntary loss of stool. Logistic regression was used to estimate the effect of obstetric and general risk factors. RESULTS: Prevalence of fecal incontinence in the past 12 months was 9.5% (250). Significant risk factors for fecal incontinence were completion of high school (adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.0), self-reported depression (OR 2.1, 95% CI 1.6-2.7), overweight or obesity measured by body mass index (BMI) (OR 1.5 for BMI of 25-30, 95% CI 1.1-2.0; OR 1.6 for BMI more than 30, 95% CI 1.1-2.5), surgery for urinary incontinence (OR 3.5, 95% CI 2.0-6.1), and anal surgery (OR 1.7, 95% CI 1.1-2.9). No obstetric variable (parity, mode of delivery, birth weight, episiotomy, or third-degree perineal tear) was significant. Prevalence of fecal incontinence was similar for nulliparous, primiparous, secundiparous, and multiparous women (11.3%, 9.0%, 9.0%, and 10.4%, respectively), and among parous women, it was similar for women with spontaneous vaginal, instrumental (at least one), or only cesarean deliveries (9.3%, 10.0%, and 6.6%, respectively). CONCLUSION: In our population of women in their 50s, fecal incontinence was not associated with either parity or mode of delivery

Impact des facteurs biologiques et socioculturels sur l’âge à la ménopause en France

International audienc

Symptomatic pelvic organ prolapse at midlife, quality of life, and risk factors.: POP symptoms, Qol and risk factors

International audienceOBJECTIVE: To estimate quality of life, prevalence, and risk factors associated with symptomatic pelvic organ prolapse (POP) among middle-aged women. METHODS: This was a cross-sectional study. A questionnaire was mailed to 3,114 women aged 50-61 years in the GAZEL cohort; 2,640 (85%) returned it. Symptomatic POP was defined by feeling a bulge from the vagina (sometimes, often, or all the time compared with never or rarely). Quality of life was determined with the Nottingham Health Profile questionnaire. Multiple linear regression was used to examine the association between frequency of POP symptoms and the quality-of-life score. Logistic regression was used to estimate the effect of risk factors on past or present symptomatic POP (current symptoms or previous surgery for POP). RESULTS: The prevalence of symptomatic POP was 3.6% (96 of 2,640) and that of surgery for POP was 2.7% (70 of 2,640). Pelvic organ prolapse symptoms were associated with difficulty defecating, lower abdominal pain, and difficulty voiding. The frequency of POP symptoms was associated with a poorer quality-of-life score in each Nottingham Health Profile domain (physical mobility, pain, emotional reaction, social isolation, energy, and sleep). Even when we took general characteristics, medical history, and lifestyle associated with quality of life into account, the global Nottingham Health Profile score was significantly impaired by POP symptoms. Factors significantly associated with past or present symptomatic POP were high body mass index and the number of vaginal deliveries. CONCLUSION: In our population of women in their 50s, POP symptoms are associated with impaired quality of life, and the number of vaginal deliveries is a risk factor for past or present symptomatic POP

Discontinuation of hormone therapy in the French GAZEL cohort 1990-2006.: Hormone therapy in France 1990-2006

International audienceOBJECTIVE: To analyze changes in hormone therapy (HT) use after the publication of the Women's Health Initiative (WHI) results, in a country (France) where HT is different from that assessed in the WHI. DESIGN: Longitudinal study. SETTING: Women in the GAZEL cohort of employees of the French national power company. PARTICIPANT(S): One thousand six hundred five postmenopausal women ever-users of HT. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Discontinuation of HT. RESULT(S): Rates of discontinuation were higher after 2002: 65% of users who began HT in 1998 were still using it after 5 years. In contrast, >90% of those who began before 1994 were still using it after 5 years. Discontinuation was associated with women's social and medical characteristics and with factors related to side effects and expectations concerning HT. After adjustment for these factors, women were twice as likely to stop HT after publication of the WHI. CONCLUSION(S): Even in France, publication of the WHI has led to a decline in HT use

Hot flushes, common symptoms, and social relations among middle-aged nonmenopausal French women in the GAZEL cohort.

OBJECTIVE:: Many symptoms, including hot flushes (HFs) may appear during the years preceding menopause. Hypotheses to explain these symptoms include biomedical, demographic, and cultural risk factors. Social relations are also associated with various aspects of health. The aim of this study was to analyze the association between social relations and the reporting of HFs and other common symptoms among middle-aged nonmenopausal French women taking into account other factors, including biomedical characteristics. DESIGN:: Data came from self-administered questionnaires mailed to 1,180 pre- or perimenopausal women aged 45 to 54 years participating in the French GAZEL cohort. Bivariate and multivariate analyses examined the association between symptoms (HFs, general, psychological, osteoarticular, and breast symptoms) and three scores of social relations (social network, social relations, and satisfaction with social relations). RESULTS:: After adjustment, low social support was associated with psychological symptoms (odds ratio [OR] = 2.65; 95% CI: 1.33-5.29) and unsatisfactory social relations were associated with psychological (OR = 2.04; 95% CI: 1.49-2.79) and breast symptoms (OR = 1.38; 95% CI: 1.03-1.84). HFs were not associated with social relations but were related to common symptoms (OR = 2.80; 95% CI: 1.94-4.03). Perimenopausal women were more likely to report HF than premenopausal women (OR = 2.63; 95% CI: 1.88-3.71). CONCLUSION:: Social relations were associated with psychological and breast symptoms, but not with HFs. The strong association between common symptoms and HFs suggests that biomedical factors have a greater influence than social relations on the occurrence of HFs