T Sharmeen

Patterns of occurrence and concordance between subjective and objective hot flashes among Muslim and Hindu women in Sylhet, Bangladesh

This study examined the pattern of occurrence and the rate of concordance between objective hot flashes measured by sternal skin conductance and the subjective experience of “gorom vap laga” (feeling steaming hot) among Muslim and Hindu women living in Sylhet, Bangladesh. Participants were aged 40–55, not pregnant or lactating, not using hormone therapy, and with no history of hysterectomy. Thirty women wore an ambulatory hot flash monitor for 8 h on average, from mid‐morning to early evening. True positive, false negative, and false positive measures of hot flashes were examined in relation to demographic, reproductive, and lifestyle variables. On body diagrams, women were most likely to indicate hot flashes on the top of their head (64%) and upper chest (68%). The greatest number of objective hot flashes occurred during the hour of 17:00, perhaps due to the heat of the day, and the clothing and activity associated with prayer. Muslim participants demonstrated more objective hot flashes per woman than Hindu participants (1.5 vs. 0.1, P < 0.05), and Muslims had more false positive measures (86%) compared with Hindu participants (0%, P = 0.06). Among all women who reported subjective hot flashes (n = 19), the proportion of true positive scores was 19%. Overall, the frequency of objective hot flashes was low compared with reports from studies in the United States. The pattern of sweating assessed by body diagrams was not associated with variation in hot flash experience. Am. J. Hum. Biol., 2008.

Life course effects on age at menopause among Bangladeshi sedentees and migrants to the UK

To assess how different variables experienced across the life course, but particularly during early life, might affect age at menopause among 174 Bangladeshi migrants to London by comparing them to 157 nonmigrant sedentees and 154 women of European descent in London.

Ethnicity or environment: effects of migration on ovarian reserve among Bangladeshi women in the United Kingdom

OBJECTIVE To assess whether the quality of early childhood environments among different groups of Bangladeshi women, including migrants to the United Kingdom (UK), contributes to variation in ovarian reserve and the rate of reproductive aging in later life. DESIGN Cross-sectional study. SETTING Not applicable. PATIENT(S) A total of 179 healthy women volunteers aged 35-59 years were divided into four groups: [1] 36 Bangladeshis living in Sylhet, Bangladesh; [2] 53 Bangladeshis who migrated to the UK as adults; [3] 40 Bangladeshis who migrated to the UK as children aged 0-16 years; and [4] a reference group of 50 women of European origin living in London. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Levels of serum antimüllerian hormone, inhibin B, FSH, and E2, and anthropometrics derived from biomarkers; reproductive, demographic, and health variables from structured questionnaires. RESULT(S) Bangladeshi migrants who moved to the UK as children and European women had a highly significantly larger, age-related ovarian reserve compared with migrant Bangladeshis who had moved to the UK as adults or Bangladeshi women still living in Bangladesh. There were no other significant covariates in the model aside from age and menopausal status. CONCLUSION(S) The study points to the importance of childhood development in considering variation in ovarian reserve across different ethnic groups. Clinical studies and research in assisted reproductive technology have emphasized the role of genes or race in determining inter-population variation in ovarian reserve. Early life developmental factors should be given due consideration when evaluating inter-group differences in response to assisted reproductive technology.

Hot flushes and reproductive hormone levels during the menopausal transition

INTRODUCTION Evidence suggests that hot flushes are associated with fluctuating levels of oestradiol (E2) during menopause, as well as changes in the levels of follicle-stimulating hormone (FSH) and inhibin B. The relationship between hot flushes and anti-Müllerian hormone (AMH) is unknown. AIM To examine specific hormone levels and ethnic differences in relation to hot flushes. METHODS Data were drawn from 108 women aged 40-59 years. There were three groups of participants: European women in London, UK; Bangladeshi women in Sylhet, Bangladesh; and Bangladeshi women who had migrated to London as adults. Symptom information was collected via questionnaires. Serum blood samples were collected to detect inhibin B, AMH, FSH, and E2. RESULTS AMH and FSH were significantly associated with the experience of hot flushes in the past 2 weeks. Inhibin B and E2 were not associated with hot flushes. Body mass index (BMI), ethnicity, and education level were associated with both the occurrence and the frequency hot flushes. Menopausal status was also associated with the frequency of hot flushes. CONCLUSION Relationships between AMH, FSH and symptoms are indicative of womens progress through the menopausal transition. The influence of BMI and education suggest that lifestyle changes may contribute to the management of symptoms. This merits further research.

Somatic, mood, and vasomotor symptoms at midlife in relation to family structure and household workloads in Sylhet, Bangladesh

Abstract The purpose of this study was to test whether the frequencies of vasomotor, somatic, and emotional symptoms at midlife were associated with household composition or workloads. Patrilocal family arrangements are common in Bangladesh and, since mothers-in-law hold a position of power vis-à-vis their daughters-in-law, we hypothesized that living with a mother-in-law would increase the likelihood of symptoms at midlife, while living with a daughter-in-law would decrease likelihood of symptoms. We also hypothesised that women with high levels of household workloads would be more likely to report symptoms associated with midlife. Women aged 35-59 living in Sylhet, Bangladesh, (n=157) participated in interviews and anthropometric measures. Symptom frequencies during the past two weeks were collected. Household workloads were computed as minutes spent in housework, caring for dependents, and cooking. Daily values were multiplied by times per week the activity was carried out. Logistic regression was used to evaluate the association between family composition, workloads, and symptoms. Dizzy spells, nervous tension, lack of energy, aches/stiffness in joints, and trouble sleeping were most frequent. Hot flashes were reported by 46% of participants. Women spent more hours caring for dependents than cooking or doing housework. The likelihood of hot flashes increased with time spent in housework and cooking, with daughters in the household, and with chewing betel nut. Daughters-in-law in the household decreased the likelihood of hot flashes. The likelihood of nervous tension increased with peri-menopausal status, stress, and sons in the household, and decreased with more hours spent caring for dependents. The frequency of somatic symptoms and depressed mood exceeded the frequency of hot flashes. Household composition and workloads were more important than menopausal status in explaining variation in symptom frequencies. After controlling for other variables, the presence of mothers-in-law did not increase the likelihood of reporting symptoms at midlife; however, the presence of a daughter-in-law reduced the likelihood of hot flashes, perhaps because of fewer hours spent on housework and cooking.