To describe the prevalence of menopausal symptoms, define the mean age of menopause, and determine contributory factors, which influence the experience of symptoms among Singaporean women of different racial groups.
The objective of the study was to assess nutritional and health status as well as nutritional knowledge in urban middle-aged Malaysian women. The impact of menopause on diet and health indices was also studied. The study included 360 disease free women, non users of HRT,aged > or =45 years with an intact uterus recruited from November 1999 to October 2001. Personal characteristics, anthropometric measurements and blood sample were acquired followed by clinical examination. Nutrient intake and nutritional knowledge was determined by a quantitative FFQ and KAP. The findings showed that urban middle-aged women, aged 51.65+/-5.40 years had energy intakes (EI) 11% below RDA, consisting of 53% carbohydrates, 15% protein and a 32% fat which declined with age. The sample which comprised of 42.5% postmenopausal women had a satisfactory diet and healthy lifestyle practices. Premenopausal women consumed more dietary fat (6%) with other aspects of diet comparable to the postmenopausal women. Iron intake was deficient in premenopausal women, amounting to 56% RDA contributing to a 26% prevalence of anaemia. Overall, calcium intake reached 440 mg daily but dairy products were not the main source. The postmenopaused had a more artherogenic lipid profile with significantly higher total cholesterol (TC) and LDL-C, but more premenopausal women were overweight/obese (49% versus 35%). EI was the strongest predictor for BMI and waist circumference (WC), with WC itself an independent predictor of fasting blood sugar and TC with BMI strongly affecting glucose tolerance. High nutritional knowledge was seen in 39% whereas 20% had poor knowledge. Newspapers and magazines, followed by the subject's social circle, were the main sources of nutritional information. Nutritional knowledge was positively associated with education, household income, vitamin/ mineral supplementation and regular physical activity but inversely related to TC. In conclusion, middle-aged urban women had an adequate diet with low iron and calcium intakes. Nutritional knowledge was positively associated to healthier lifestyle practices and lower TC. A comparable nutrient intake and lifestyle between pre and postmenopausal women suggested that health changes associated with menopause was largely independent of diet.
The conventional use of probiotics to modulate gastrointestinal health, such as in improving lactose intolerance, increasing natural resistance to infectious diseases in the gastrointestinal tract, suppressing traveler's diarrhea, and reducing bloating, has been well investigated and documented. Most of the mechanisms reported to date are mainly caused by the suppression of pathogenic bacteria. Currently, the potential applications of probiotics are being expanded beyond alleviating gastrointestinal disorders to include benefits involving antihypertension, immunomodulation, improving serum lipid profiles, and the alleviation of postmenopausal disorders. Although they seem promising, most of these postulated benefits are based on in vitro evaluations, and the lack of in vivo evidence and/or incompatible outcomes between in vitro experiments and in vivo trials has led to inconclusive claims. This present review highlights some of the previous roles of probiotics on gut health and addresses several potential roles currently being investigated.
The objective of this study is to evaluate the relationship between reproductive exposures and age-related cataract among women. This was a hospital based case-control study. The study population included female patients, aged 50 years and above who attended the Eye clinic at the University of Malaya Medical Centre. The outcome measurement was based on ophthalmologic examination by an ophthalmologist. The data on exposure was obtained from face to face interview using a structured questionnaire. In order to reduce the recall bias, patients' medical records were used to substantiate the exposure status. Multiple logistic regression was used to assess the association of age-related cataract with exogenous estrogen usage (HRT and OCP) and duration of menses. Important confounders such as age, history of diabetes, cigarette smoking and steroids usage were controlled for in the analysis. Females with 29 years or less of endogenous estrogen exposure of, have almost three times the risk of developing age related cataract (adjusted OR 3.42: 95% CI: 1.28, 9.16), similarly among those with exposure of 30-32 years (adjusted OR 3.64: 95% CI: 1.08, 12.26). Hormone Replacement Therapy used for more than three years was found to be a protective factor of age-related cataract. There is evidence that reproductive exposure may play a role in reducing the occurrence of age-related cataract among Malaysian women.
Study site: Eye clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Prevalence and signs and symptoms of menopause have been extensively studied among Malaysian women but no one had investigated the level of knowledge and perception of menopause. This study aimed to examine the knowledge and perception of menopause among young to middle aged women (15 to 49 years old). A cross-sectional survey using 20-items questionnaire was conducted in three randomly chosen districts in Federal Territory, Kuala Lumpur. Women in this survey were aware of the meaning of the term menopause and its symptoms. However, the majority lacked comprehensive understanding about the health risks associated with menopause. Commonly cited sources of knowledge were magazines and family members. Lack of official sources for accurate information on menopause was reported. Communication with health care personnel regarding menopause was uncommon. An exploration into respondents' perceptions on menopause revealed that the majority displayed positive thinking towards menopause. Young respondents seemed to have better perception regarding menopause compared to middle aged women. Although the women had good knowledge about menopause, they expressed feelings of sadness and nervousness upon the approach of their own menopause. Our data provides insight on the knowledge and perception of menopause that will guide future public health initiatives for premenopausal women in order for them to cope better when approaching this stage of life cycle.
A household survey was carried out in Peninsular Malaysia to determine the prevalence rate of depressive symptoms in middle-aged women and to explore its associated factors. Women aged 45 to 60 years were assessed on sociodemographic profiles, menopausal status, depressive symptoms, marital dissatisfaction, and coping strategies. A total of 3934 women participated, and the mean age was 51 years. The prevalence rate of depressive symptoms was 54.2%. Of the married women, 38.4% had poor to very severe problems in their marriage. Depressive symptoms were significantly associated with marital status (P < .001), ethnicity (P < .001), educational levels (P < .001), occupational status ( P < .001), domicile (P < .001), and menopausal status ( P < .05). Depressive symptoms were correlated with marital dissatisfaction scores. Women who consulted professionals, shared with relatives, kept problems to themselves, or consulted parents/siblings had higher mean scores on depressive symptoms compared with those who did not use these coping strategies.
OBJECTIVES:
To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia.
METHODS:
A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause.
RESULTS:
The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual).
CONCLUSIONS:
The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.
Cancers and related treatments have devastating effects on psychosexual life of patients. This study helps us to understand the cultural perspectives of 50 Asian women diagnosed with cancer. Median age was 50+ years. Median duration of time from diagnosis to interview was 23 months. Thirty-eight per cent stopped sex before illness, 36% stopped sex completely whereas 18% stopped gradually after diagnosis; 8% continued to have sex till time of interview. Overall, 70% were living with spouse but not engaged in sexual intercourse; 31.4% slept in different room, 48.6% slept in the same room but without any form of sexual contact. Thirty-eight per cent believed sexual activity could cause cancer recurrence, and 30% believed cancer could be sexually transmitted. Eighty-two per cent reported acceptance of changes to physical appearance. Approximately 70-86% did not discuss sexuality with their doctor or spouse; 90% agreed doctors should ask about psychosexual issues on a routine basis. Approximately 74.4% reported good cooperation from spouse. Cultural beliefs of Asians pose as barriers to providing and receiving psychosexual affection between women diagnosed with cancer and their spouse. However, these beliefs also serve as protective factors in their mutual acceptance of change in psychosexual activities. Health-care professionals need to be sensitive to the vast cultural differences in psychosexual expressions and needs of women diagnosed with cancer.
The neurological manifestations of chronic hepatitis C is most often a peripheral sensory neuropathy characterised by numbness, burning and sensation of "pins and needles". Peripheral motor neuropathy, mononeuropathy, mononeuropathy multiplex and transverse myelitis also occur. Ischemic stroke and transient cerebral ischemia have also been reported. Anterior ischemic optic neuropathy is seen, often following interferon therapy. We report an exceptional case of neuromyelitis optica in chronic hepatitis C infection in the absence of interferon therapy.
To provide current insights into the opinions, attitudes, and knowledge of menopausal women in Asia regarding menopause and hormone replacement therapy (HRT).
Surgical menopause, in comparison with natural menopause, has traditionally been claimed to lead to faster onset of more severe menopausal symptoms. There is little prospective research to support this view. We aimed to evaluate the speed of onset and magnitude of climacteric symptoms after oophorectomy and whether they relate to serum hormone changes. This would aide in counseling women before surgery.
INTRODUCTION: Female sexual dysfunction (FSD) is a highly prevalent sexual health problem but poorly investigated at the primary care level.
AIM: This article examines the prevalence of sexual dysfunction and its possible risk factors associated with women at high risk of FSD in a hospital-based primary practice.
METHODS: A validated Malay version of the Female Sexual Function Index (MVFSFI) was utilized to determine FSD in a cross-sectional study design, involving 163 married women, aged 18-65 years, in a tertiary hospital-based primary care clinic in Kuala Lumpur, Malaysia. Sociodemographic, marital profile, health, and lifestyle for women at high risk of FSD and those who were not at high risk were compared and their risk factors were determined.
MAIN OUTCOME MEASURES: Prevalence of FSD in Malaysian women based on the MVFSFI, and its risk factors for developing FSD.
RESULTS: Some 42 (25.8%) out of 163 women had sexual dysfunction. Prevalence of sexual dysfunction increased significantly with age. Sexual dysfunctions were detected as desire problem (39.3%), arousal problem (25.8%), lubrication problem (21.5%), orgasm problem (16.6%), satisfaction problem (21.5%) and pain problems (16.6%). Women at high risk of FSD were significantly associated with age (OR 4.1, 95% CI 1.9 to 9.0), husband's age (OR 4.3 95% C.I 1.9 to 9.3), duration of marriage (OR 3.3, 95% CI 1.6 to 6.8), medical problems (OR 8.5, 95% CI 3.3 to 21.7), menopausal status (OR 6.6, 95% CI 3.1 to 14.3), and frequency of sexual intercourse (OR 10.7, 95% CI 3.6 to 31.7). Multivariate analysis showed that medical problem (adjusted OR 4.6, 95% CI 1.6 to 14.0) and frequency of sexual intercourse (adjusted OR 7.2, 95% CI 2.1 to 24.0) were associated with increased risk of having FSD. Those who practiced contraception were less likely to have FSD.
CONCLUSION: Sexual health problems are prevalent in women attending primary care clinic where one in four women were at high risk of FSD. Thus, primary care physician should be trained and prepared to address this issue.
Study site: Primary Care Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Honey is a highly nutritional natural product that has been widely used in folk medicine for a number of therapeutic purposes. We evaluated whether Malaysian Tualang honey (AgroMas, Malaysia) was effective in reducing menopausal syndrome in ovariectomised female rats; an animal model for menopause.
Objective: The purpose of this study was to evaluate the clinical behaviour, pathological findings, survival and prognostic factors in young women in comparison to menopausal women with epithelial ovarian malignancy. Methods: A retrospective analysis of 141 patients (67 for age below 40 years and 74 menopausal) treated between 1980 and 2000 was conducted. Results: Irrespective of the stage, the most common clinical presentation was abdominal distension in both young (78%) and menopausal women (66%). In young women, 52% presented at an early stage of the disease and in menopausal women this was seen in 22% (p-value
Studies have shown that comprehensive interventions by pharmacists can improve adherence and persistence to osteoporosis therapy, but the association between adherence and bone turnover markers (BTMs) has never been studied. Therefore, the aim of this study was to evaluate the effects of pharmaceutical care on medication adherence (and its effects on BTMs), as well as persistence of postmenopausal osteoporotic women to prescribed bisphosphonates.
In the present study, researchers explored attitudes toward midlife crises, experience with midlife crises, help-seeking, and needs among multi-ethnic Malaysian women. A total of 14 focus group discussions were conducted with 89 Malaysian women of different ages and socioeconomic backgrounds. Women expressed concern over physical aging and decline in their physical functional health. Having a midlife crisis was frequently reported. Issues that were frequently reported to trigger a midlife crisis, such as empty nest syndrome, impact of aging on sexual and reproductive function, extended parenthood, caring for aging or ill parents, and career challenges were noted by the study participants (listed here in order of most to least frequently reporting of these themes across the group discussions). Overall, these issues were associated with attitudes about aging. A comparatively less open attitude toward sexual attitudes and help-seeking for sexual problems were found among the Malay and Indian women. This may imply that intervention to increase positive attitudes concerning both sexuality and help-seeking intentions should be culturally specific. The use of religious coping for comfort and consolation was frequently reported; therefore, those providing midlife crisis prevention and intervention programs should consider involving faith-based interventions in the Malaysian setting.
Introduction: Metabolic syndrome (MetS) is a condition that includes the presence of a cluster of risk factors specific for cardiovascular disease (CVD). The criteria used to aid the diagnosis of MetS includes abdominal obesity, elevated triglycerides, low high density lipoprotein (HDL) cholesterol, hypertension or use of antihypertensive medication, elevated fasting blood glucose and other risk factors. Objective: This study aimed to determine the prevalence of metabolic syndrome (MetS) among postmenopausal women and its associated factors in a tertiary center in Malaysia Methods: This is a cross-sectional study done among 411 postmenopausal women attending Gynaecology clinic and Family Medicine clinic in a tertiary center in Malaysia. Socio demographic data, reproductive profile, menopausal profile and medical history were obtained. Then waist circumference (WC), weight, height and blood pressure (BP) were also recorded. A fasting blood sample was obtained for serum glucose and lipid profile determinations. Metabolic syndrome was defined according to the criteria of International Diabetes Federation. Results: The mean age of participants was 57.2 + 6.9 years. The prevalence of metabolic syndrome was 36.7%. The risk of MetS increased with the presence of obstetrics history of hypertension (HPT) (odds ratio (OR) 2.64, 95% (CI) 1.25-5.62), previous usage of contraception (odds ratio (OR) 1.56, 95% (CI) 1.02-2.42), family history of HPT (odds ratio (OR) 1.71, 95% (CI) 1.13-2.59) and obesity (odds ratio (OR) 2.59, 95% (CI) 1.08-6.23). Conclusion: There was a high prevalence of the metabolic syndrome in postmenopausal women seeking gynaecologic and primary health care in the tertiary center Malaysia. The associated factors of MetS include previous obstetrics history of HPT, family history of HPT and obesity.
This is a randomized, double-blind, placebo-controlled study comparing the effects of a water extract of Labisia pumila var. alata at 280 mg/day with placebo, given for 6 months in postmenopausal Malay women. There were 29 patients treated with Labisia pumila and 34 patients in the placebo group. Menopausal symptoms were assessed at baseline and at 6 months. The blood pressure, body mass index, waist circumference, fasting blood sugar, lipid profile, and hormonal profile (follicle stimulating hormone/luteinizing hormone/estradiol) were measured during visits every two months. ANCOVA model analysis showed significantly lower triglycerides levels in LP subjects at 6 months after treatment as compared to placebo (1.4 versus 1.9 mmol/L; adj. mean difference 0.5, 95% CI: 0.02, 0.89 after adjusted for the baseline values, age, BMI, and duration of menopause placebo). Other parameters in both groups did not differ significantly. In conclusion, daily intake of Labisia pumila at 280 mg/day for six months was found to provide benefit in reducing the triglyceride (TG) values.
The objective of this study was to examine the risk of female sexual orgasmic disorder among a group of women with hypertension in Malaysia. The associated factors were also examined.