Calle Miñaca, Andrés
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Calle Miñaca, Andrés
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Quito

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Impact of hysterectomy without oophorectomy on the health of postmenopausal women: Assessment of physical, psychological, and cognitive factors

2025 , Juan E. Blümel , Peter Chedraui , María S. Vallejo , Carlos Escalante , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez Vidal , Marcio A. Rodrigues , Carlos Salinas , Konstantinos Tserotasl , Calle Miñaca, Andrés , Maribel Dextre , Alejandra Elizalde , María T. Espinoza

Objective: To determine the impact of hysterectomy without bilateral oophorectomy on the physical, psychological, and cognitive health of postmenopausal women. Methods: This study was a sub-analysis of a cross-sectional, observational study carried out during gynecological consultations in nine Latin American countries. We collected sociodemographic and clinical data and evaluated the women's health using the EQ-5D for health status, the Menopause Rating Scale for menopausal symptoms, the 6-item Female Sexual Function Index for sexual function, the Jenkins Sleep Scale for sleep disturbances, the SARC-F for the risk of sarcopenia, and the Montreal Cognitive Assessment test for cognitive function. Results: The sub-analysis involved 782 postmenopausal women with an average age of 56.9 years and an average body mass index of 26.5 kg/m2. The participants had an average of 13.9 years of education, and 45.9 % of them had a university degree. The group of 104 women who had undergone hysterectomy without oophorectomy had a higher body mass index (27.5 ± 4.9 vs 26.3 ± 5.1 kg/m2, p < 0.03), displayed more comorbidities (63.5 % vs 41.7 %, p < 0.001), worse self-perceived health (Odds ratio, OR 2.00, 95 % CI: 1.27–3.15), higher rates of severe menopausal symptoms (OR 2.39, 95 % CI: 1.51–3.77) and sleep disturbances (OR 1.75, 95 % CI: 1.10–2.79), and a higher likelihood of sarcopenia (OR 1.74, 95 % CI: 1.03–2.97) than those who had not undergone hysterectomy. No significant differences were observed regarding sexual function or cognitive performance between the two groups. Moreover, in the six assessed health domains, menopausal hormone therapy (ever use) was found to be a protective factor, regardless of whether or not the woman had undergone a hysterectomy. Conclusion: Women who undergo hysterectomy without oophorectomy may experience persistent physical and psychological symptoms that affect their mental health and quality of life. Menopausal hormone therapy is associated with improved health outcomes.

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Severe menopausal symptoms linked to cognitive impairment: an exploratory study

2024 , Calle Miñaca, Andrés , Juan E. Blümel , Peter Chedraui , María S. Vallejo , Alejandra Belardo , Maribel Dextre , Alejandra Elizalde-Cremonte , Carlos Escalante , María T. Espinoza , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez , Marcio A. Rodrigues , Carlos Salinas , Konstantinos Tserotas , Sócrates Aedo

Objective To evaluate the association between menopausal symptoms and cognitive decline in postmenopausal women. Methods This was a subanalysis of a cross-sectional, observational study conducted among women attending gynecological consultations across nine Latin American countries. The survey involved late postmenopausal women who were asked to complete a general questionnaire and the Menopause Rating Scale (MRS) to assess menopausal symptoms, with the Montreal Cognitive Assessment used to evaluate cognitive function as an outcome. A Montreal Cognitive Assessment score of less than 21 was used to define women with mild cognitive impairment (MCI). Results The study included 1,287 postmenopausal women with a mean age of 55.5 years and a mean body mass index of 26.3 kg/m2. On average, participants had 13.8 years of education and 2.3 ± 1.8 children, with 72.8% reporting having a partner. Additionally, 36.7% ever used menopausal hormone therapy. Regarding lifestyle factors, 50.3% engaged in a sedentary lifestyle, whereas 70.5% had never smoked. 15.3% of women had MCI exhibited significantly more intense menopausal symptoms compared with those without MCI (MRS total score 15.24 ± 12.58 vs 10.53 ± 8.84, respectively, P < 0.001). Logistic regression analysis revealed a significant association between severe menopausal symptoms (MRS total score ≥14 points) and MCI (odds ratio [OR], 1.74; 95% CI, 1.25-2.42). Conversely, a lower body mass index (OR, 0.96; 95% CI, 0.95-0.98), sexual activity (OR, 0.70; 95% CI, 0.51-0.96), physical exercise (OR, 0.55; 95% CI, 0.39-0.76), menopausal hormone therapy use (OR, 0.36; 95% CI, 0.24-0.55), and higher educational level (OR, 0.31; 95% CI, 0.21-0.46) were associated with lower odds for MCI. Conclusion Severe menopausal symptoms in postmenopausal women were associated with cognitive impairment. This study highlights the intricate interplay between hormonal, lifestyle, and sociodemographic factors and cognitive health.

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Risk of sarcopenia: A red flag for cognitive decline in postmenopause?

2025 , María S. Vallejo , Juan E. Blümel , Peter Chedraui , Konstantinos Tserotas , Carlos Salinas , Marcio A. Rodrigues , Doris Rodríguez-Vidal , Claudia Rey , Eliana Ojeda , Mónica Ñañez , Álvaro Monterrosa-Castro , Gustavo Gómez-Tabares , María T. Espinoza , Carlos Escalante , Alejandra Elizalde , Maribel Dextre , Andrés Calle , Sócrates Aedo

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Association of muscle disorders in late postmenopausal women according to the type of experienced menopause

2024 , María S. Vallejo , Juan E. Blümel , Peter Chedraui , Konstantinos Tserotas , Carlos Salinas , Marcio A. Rodrigues , Doris A. Rodríguez , Claudia Rey , Eliana Ojeda , Mónica Ñañez , Álvaro Monterrosa-Castro , Gustavo Gómez-Tabares , María T. Espinoza , Carlos Escalante , Alejandra Elizalde , Maribel Dextre , Calle Miñaca, Andrés , Sócrates Aedo

Objective Musculoskeletal disorders frequently affect postmenopausal women. This study aims to compare muscle disorders between women according to the type of experienced menopause: premature (PM) or normal age of menopause (NAM). Methods This was a cross-sectional study conducted in nine Latin American countries in which late postmenopausal women (55 to 70 years) were surveyed with a general questionnaire, the Menopause Rating Scale (MRS: item #4 exploring musculoskeletal discomfort), and strength, assistance with walking, rising from a chair, climbing stairs, and falling questionnaire (risk of sarcopenia). Results A total of 644 women were included: 468 who had NAM, and 176 who had PM (116 spontaneous and 60 surgical). The overall mean age of the participants was 60.9 ± 4.2 years. Women who had PM experienced more musculoskeletal discomfort (33.5% vs 20.9%, P < 0.001) and a higher likelihood of sarcopenia (35.2% vs 19.9%, P < 0.001) than women who had a NAM. Women who had surgical PM exhibited a higher prevalence of severe musculoskeletal discomfort (46.7% vs 29.3%, P < 0.02) and a higher likelihood of sarcopenia (45.0% vs 27.6%, P < 0.02) than women who had a NAM. After adjusting for covariates (age, body mass index, menopausal hormone therapy use, physical activity, education, cigarette consumption, use of antidepressants, sexual activity, comorbidities, and having a partner), our logistic regression model determined that spontaneous PM was not associated with higher odds of musculoskeletal discomfort and higher odds of sarcopenia. On the other hand, women who had surgical PM were more likely to experience musculoskeletal discomforts (odds ratio: 2.26; 95% confidence interval: 1.22-4.17) and higher odds for sarcopenia (odds ratio: 2.05; 95% confidence interval: 1.16-3.65) as compared to women who experienced a NAM. Conclusions Women experiencing surgical PM have a higher likelihood of developing muscle disorders. This underscores the potential significance of hormonal levels in influencing musculoskeletal health during postmenopause.

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Association between type of menopause and mild cognitive impairment: The REDLINC XII study

2024 , María T. Espinoza , Juan E. Blümel , Peter Chedraui , María S. Vallejo , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez , Marcio A. Rodrigues , Carlos Salinas , Konstantinos Tserotas , Calle Miñaca, Andrés , Maribel Dextre , Alejandra Elizalde , Carlos Escalante , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro

Objective: To evaluate the association between type of menopause (spontaneous or surgical) and mild cognitive impairment (MCI). Study design: This study was a cross-sectional, observational, and sub-analytical investigation conducted within gynecological consultations across nine Latin American countries. Method: We assessed sociodemographic, clinical, and anthropometric data, family history of dementia, and the presence of MCI using the Montreal Cognitive Assessment (MoCA) tool. Results: The study involved 1185 postmenopausal women with a mean age of 55.3 years and a body mass index of 26.4 kg/m2. They had an average of 13.3 years of education, and 37 % were homemakers. Three hundred ninety-nine experienced menopause before 40, including 136 with surgical menopause (bilateral oophorectomy). Out of the 786 women who experienced menopause at 40 or more years, 110 did so due to bilateral oophorectomy. There were no differences in MoCA scores among women who experienced menopause before or after the age of 40. However, lower MoCA scores were observed in women with surgical menopause than in those with spontaneous menopause (23.8 ± 4.9 vs. 25.0 ± 4.3 points, respectively, p < 0.001). Our logistic regression model with clustering of patients within countries found a significant association between MCI and surgical menopause (OR 1.47, 95 % CI: 1.01–2.16), use (ever) of menopausal hormone therapy (OR 0.33, 95 % CI: 0.21–0.50), and having >12 years of education (OR 0.21, 95 % CI: 0.14–0.30). Conclusion: When comparing women who experience spontaneous menopause over the age of 40 with those who undergo it before this age, there was no observed increased risk of developing MCI, while those with surgical menopause, independent of age, are more prone to cognitive decline. Women who have ever used menopausal hormone therapy have a lower MCI risk. Further research is warranted to delve deeper into this topic.

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Severe obesity and menopause symptoms are associated with cognitive impairment in postmenopausal women from Latin America

2025 , Juan Enrique Blümel , Maria Soledad Vallejo , Peter Chedraui , Socrates Aedo , Marcio Alexandre Hipolito Rodrigues , Carlos Salinas , Konstantinos Tserotas , Calle Miñaca, Andrés , Maribel Dextre , Alejandra Elizalde , Carlos Escalante Gomez , Gustavo Gómez-Tabares , Álvaro de Jesus Monterrosa-Castro , Maria T. Espinoza , Monica Ñañez , Eliana Ojeda , Claudia Rey , Doris Rodríguez-Vidal

Objective: This study aimed to evaluate the association between obesity and cognitive impairment. Methods: This study is a sub-analysis of an observational, cross-sectional study in nine Latin American counties. Sociodemographic, clinical and anthropometric data were collected, and cognition was assessed using the Montreal Cognitive Assessment (MoCA) tool in 722 postmenopausal women. Results: The mean age, body mass index (BMI) and years of education of the cohort were 56.9 years, 26.8 kg/m2 and 13.6 years, respectively. Women with cognitive impairment, compared to those without, had a higher BMI (27.8 ± 5.9 vs. 26.6 ± 4.9 kg/m2, p = 0.037), had more children (3.1 ± 2.4 vs. 2.5 ± 1.7, p = 0.023), experienced more severe menopausal symptoms (56.3% vs. 31.9%, p < 0.001) and presented more comorbidities (60.0% vs. 43.8%, p = 0.006). They also had fewer years of study (10.8 ± 5.1 vs. 13.9 ± 4.9 years, p = 0.001), were less physically active (35.0% vs. 49.1%, p = 0.018) and were less likely to use menopausal hormone therapy (MHT) (11.3% vs. 28.8%, p = 0.001). In binary logistic regression analysis, BMI ≥ 35.0 kg/m2 (odds ratio [OR] 2.27, 95% confidence interval [CI] 1.08–4.76) and severe menopausal symptoms (OR 2.10, 95% CI 1.29–3.43) were associated with cognitive impairment. In the model, factors related to lower risk were ever use of MHT (OR 0.44, 95% CI 0.21–0.92) and having more years of education (OR 0.38, 95% CI 0.20–0.64). Conclusion: Severe obesity and severe menopausal symptoms increased the risk of cognitive impairment in postmenopausal women, while higher education and ever use of MHT were protective factors.

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