Asuka Hirose

Prevalence and predictors of storage lower urinary tract symptoms in perimenopausal and postmenopausal women attending a menopause clinic.

Objective:This study was undertaken to evaluate the prevalence and predictors of storage lower urinary tract symptoms (LUTS) in perimenopausal and postmenopausal women attending a menopause clinic. Methods:The records of 351 women aged 40 to 76 years who enrolled in a health and nutrition education program at a menopause clinic were analyzed cross-sectionally. The prevalence of frequency, nocturia, urge incontinence, and stress incontinence was estimated based on womens responses to the Menopausal Health-Related Quality of Life Questionnaire. Effects of background characteristics, including age, menopause status, vaginal dryness, body composition, cardiovascular parameters, physical fitness, and psychological symptoms, on storage LUTS were assessed using multivariate logistic regression analysis. Results:Frequency, nocturia, urge incontinence, and stress incontinence were reported by 45.9%, 10.8%, 11.4%, and 32.8% of women, respectively. Multiple logistic regression analysis revealed independent associations between storage LUTS and the following predictors after adjustment: frequency was associated with nonrestorative sleep score (odds ratio, 1.63; 95% CI, 1.35-1.95); nocturia was associated with nonrestorative sleep score (odds ratio, 2.26; 95% CI, 1.57-3.25) and waist-to-hip ratio (odds ratio, 1.12; 95% CI, 1.05-1.18); urge incontinence was associated with reaction time (odds ratio, 1.10; 95% CI, 1.01-1.19); and stress incontinence was associated with body fat (odds ratio, 1.06; 95% CI, 1.03-1.09). Conclusions:Storage LUTS are highly prevalent in perimenopausal and postmenopausal women attending a menopause clinic. Nonrestorative sleep score is associated with frequency and nocturia; body fat and visceral fat accumulation are associated with nocturia and stress incontinence; and delayed reaction time is associated with urge incontinence. Careful evaluation of nonrestorative sleep, body fat and visceral fat accumulation, or delayed reaction time might reveal undisclosed storage LUTS in this population.

Subjective insomnia is associated with low sleep efficiency and fatigue in middle-aged women

Abstract Objectives: Many middle-aged women are affected by sleep disturbance. We investigated how subjective insomnia is associated with objective sleep parameters and other background characteristics. Methods: This cross-sectional study used baseline data obtained from 95 women aged 40–59 years who participated in another study assessing the effects of a dietary supplement. Participants wore an actigraph unit for 3 days to collect information concerning physical activities and objective sleep parameters and were then evaluated for body composition, cardiovascular parameters, and menopausal symptoms including insomnia and fatigue, and lifestyle factors. Stratifying Athens Insomnia Scale scores as low (0–5 points, control group) and high (≥ 6 points, subjective insomnia group), we sought to identify the parameters that are independently associated with subjective insomnia. Results: Women with subjective insomnia (n = 30) had lower sleep efficiency than did the controls. They were also older; had more live births, lower height, higher body mass index, lower ankle brachial index, and more severe menopausal symptoms including fatigue; took more naps; smoked more cigarettes; and more of them were full-time workers. Multivariate logistic regression analysis revealed that low sleep efficiency (adjusted odds ratio, 1.44 per 1% decrease in sleep efficiency; 95% confidence interval 1.06–2.05) and fatigue assessed with Brief Fatigue Inventory (BFI) (adjusted odds ratio, 1.57 per 1-point increase in BFI score; 95% confidence interval 1.19–2.13) were independent contributors to subjective insomnia. Conclusions: Low sleep efficiency and feeling of fatigue were found to be independently associated with subjective insomnia in middle-aged women.

Subgrouping of Japanese middle-aged women attending a menopause clinic using physical and psychological symptom profiles: a cross-sectional study

BackgroundWomen in the menopausal transition and the postmenopausal period are affected with vasomotor symptoms, urogenital atrophy, sexual dysfunction, somatic symptoms, cognitive difficulty, sleep disturbance, and psychological problems. It is important to gain a better understanding of the complexity and diversity of climacteric disturbance in order to optimize treatments for individual patients. The aim of this study was to identify subgroups of Japanese perimenopausal and postmenopausal women attending a menopause clinic based on their physical and psychological symptom profiles.MethodsWe administered the Menopausal Health-Related Quality of Life questionnaire to 491 Japanese women aged 40-64 years who had enrolled in the Systematic Health and Nutrition Education Program at the Menopause Clinic of the Tokyo Medical and Dental University Hospital between 2005 and 2012. We performed a principal component analysis followed by a hierarchical cluster analysis of the responses to 9 physical and 12 psychological items on the questionnaire.ResultsThe first analysis extracted 3 principal components that defined the variance of physical and psychological symptom profiles: depression, somatic, and vasomotor/sleep. A subsequent cluster analysis was performed based on the 3 principal components to generate 4 clusters, CL8 (N = 162; 33.0%), CL6 (N = 111; 22.6%), CL5 (N = 102; 20.8%), and CL4 (N = 116; 23.6%). CL8 included women who only had mild-to-moderate musculoskeletal pains and tiredness. All women in CL6, CL5, and CL4 described their musculoskeletal pains and tiredness as moderate to severe. The women in CL5 also had moderate-to-severe vasomotor symptoms, while the women in CL4 also suffered from moderate-to-severe psychological symptoms, such as depression, anxiety, and insomnia.ConclusionsDistinct subgroups of Japanese perimenopausal and postmenopausal women were identified based on their symptom profiles. Menopausal symptoms were shown to accumulate in this population in the order of musculoskeletal pains and tiredness, vasomotor symptoms, and psychological symptoms.

Higher intake of cryptoxanthin is related to low body mass index and body fat in Japanese middle-aged women

OBJECTIVES The prevalence of cardiovascular diseases increases with age, especially in postmenopausal women. In this study, we investigated the dietary patterns associated with body mass and body fat in Japanese middle-aged women. STUDY DESIGN Cross-sectional. MAIN OUTCOME MEASURES This study used baseline data collected in a previous study in 88 women aged 40-60 years. Participants were assessed for age, menopausal status, lifestyle factors, body composition, and dietary habits using a brief-type self-administered diet history questionnaire, which provides information on the amounts of nearly 100 nutritional factors consumed during the previous month. Classifying body mass index (BMI) as low (≤22kg/m2) or high (>22kg/m2) and percentage body fat as low (≤25%) or high (>25%), we sought to identify the nutritional factors associated with BMI and percentage body fat. RESULTS Consumption differences between high/low BMI and high/low body fat percentage groups were not significant for any nutritional factors except cryptoxanthin. Multiple logistic regression analysis adjusting for age, menopausal status, working, exercise, and smoking revealed that higher cryptoxanthin intake was associated with low BMI (adjusted odds ratio, 1.22 per 100μg/day increase of cryptoxanthin intake; 95% confidence interval, 1.01-1.52) and low body fat percentage (adjusted odds ratio, 1.36 per 100μg/day increase of cryptoxanthin intake; 95% confidence interval, 1.13-1.70). CONCLUSIONS Higher intake of cryptoxanthin was shown to be related to low body mass and body fat in Japanese middle-aged women.

Feelings of unattractiveness in peri- and postmenopausal women are associated with depressed mood, poor memory and unsatisfactory sexual relationships

Abstract Objectives: This study aimed to investigate the prevalence of, and risk factors associated with, the feeling of unattractiveness in peri- and postmenopausal women. Methods: The records of 351 women aged 40–76 who enrolled in a health and nutrition education program at a menopause clinic were analyzed in a cross-sectional manner. Perceptions of unattractiveness were estimated according to responses for the item ‘feeling less attractive than before’ on the Menopausal Health-Related Quality of Life Questionnaire. Age, menopausal status, body composition, cardiovascular parameters, physical fitness, and genitourinary, physical, and psychological symptoms of menopause were assessed for associations with feeling unattractive. Results: The percentage of women who felt they were less attractive than before for more than half of the previous week was 33.6%. Multivariate logistic regression analysis revealed that independent risk factors for feeling unattractive included depression (adjusted odds ratio (OR) 1.35; 95% confidence interval (CI) 1.24–1.47), dissatisfaction with sexual relationship (adjusted OR 1.74; 95% CI 1.21–2.57), and poor memory (adjusted OR 1.89; 95% CI 1.46–2.49). Conclusions: Feelings of unattractiveness are highly prevalent in peri- and postmenopausal women. Such feelings are associated with depressed moods, poor memory, and unsatisfactory sexual relationships, rather than with age or body composition.