Calle Miñaca, Andrés
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Calle Miñaca, Andrés
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Quito

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Unraveling the association between obesity and climacteric symptoms: a generalized structural equation modeling approach

2025 , Sócrates Aedo , Juan Enrique Blümel , María Soledad Vallejo , Claudia Rey , Marcio Alexandre Rodrigues , Doris Rodríguez-Vidal , Carlos Salinas , Konstantinos Tserotas , Calle Miñaca, Andrés , Maribel Dextre , Alejandra Elizalde , Carlos Escalante , María Teresa Espinoza , Gustavo Gómez-Tabares , Álvaro Monterrosa-Castro , Eliana Ojeda , Mónica Ñañez

Objective: To assess the direct and indirect associations between obesity and the severity of menopausal symptoms in postmenopausal women, considering related conditions such as chronic diseases and physical activity. Methods: This observational subanalysis utilized data from the REDLINC XII multinational study, which included 722 postmenopausal women aged 70 or younger from 9 Latin American countries. Menopausal symptoms were measured using the Menopause Rating Scale (MRS). Clinical, behavioral, and sociodemographic data were obtained through physician-administered surveys. Generalized Structural Equation Modeling was employed to examine the direct and indirect relationships between obesity, chronic cardiovascular and respiratory diseases, chronic hypertension, diabetes mellitus, and physical activity, and MRS scores. Odds ratios (ORs) were calculated to enhance interpretability. Results: A total of 722 participants were included. Obesity was directly associated with higher MRS scores (OR = 1.75). In addition, obesity exhibited indirect associations with MRS scores, with an odds ratio of 19.07, through chronic arterial hypertension, diabetes mellitus, physical inactivity, and chronic cardiovascular or respiratory diseases. The total association between obesity and MRS scores was reflected in an OR of 33.45. Furthermore, physical inactivity and the use of antidepressants were associated with greater symptom severity, whereas higher educational attainment, regular physical activity, and menopausal hormone therapy were associated with lower MRS scores. Conclusions: Obesity is strongly associated with more severe menopausal symptoms, both directly and through related chronic conditions and behavioral factors. Longitudinal studies are needed to establish temporal and causal inferences.

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Association of menopausal symptoms on work performance in midlife Latin American women

2026 , Konstantinos Tserotas , Juan E. Blümel , Peter Chedraui , María S. Vallejo , Mónica Ñañez , Eliana Ojeda , Claudia Rey , Ana L. Valadares , Doris Rodríguez-Vidal , Marcio A. Rodrigues , Javier Saavedra , Carlos Salinas , Lida Sosa , Acuña Margot San-Martín , Marcela S. Aguirre , Eugenio Arteaga , Félix Ayala , Ascanio Bencosme , Calle Miñaca, Andrés , Lucia Costa-Paiva , Maribel Dextre , Karen Díaz , Alejandra Elizalde-Cremonte , Santiago Elizalde-Cremonte , Carlos Escalante , María T. Espinoza , Ircania García , Gustavo Gómez-Tabares , Hugo Gutiérrez-Crespo , Marcela López , Juan P. Matzumura-Kasano , Paolo Meza , Álvaro Monterrosa-Castro

OBJECTIVE: To explore the association between the severity of menopausal symptoms and work-related outcomes and performance. METHODS: This cross-sectional study involved 3,523 women aged 40-60 from 30 health care centres across 12 Latin American countries. The severity of menopausal symptoms was assessed with the Menopause Rating Scale (MRS). Work-related outcomes were surveyed, including absenteeism, medical visits, perceived reduced work performance, impact of menopause on work performance, and job loss. Comparisons employed suitable tests based on data distribution, and logistic regression was used to assess associations, adjusting for covariates such as menopausal symptoms, comorbidities, age, and education. RESULTS: Women with severe menopausal symptoms (total MRS score ≥14 points) were significantly older (51.1 ± 5.1 vs 49.7 ± 5.6y), had a higher body mass index (27.4 ± 4.8 vs 26.7 ± 4.6 kg/m 2 ), were postmenopausal in a higher proportion (69.9% vs 52.2%), had more comorbidities (42.8% vs 27.6%), higher smoking prevalence, and lower educational attainment. In addition, these women significantly reported more medical leaves (42.4% vs 29.5%), more medical visits (mean: 3.9 vs 2.5 visits), and a more significant perceived reduction of work performance (82.1% vs 56.7%). They also were more likely to believe that menopause significantly reduced their work capacity (67.0% vs 24.0%), had a higher prevalence of job dismissals (6.9% vs 2.0%), and more voluntary resignations or early retirements (8.1% vs 4.7%). Binary logistic regression determined that severe menopausal symptoms, subsequently adjusted for covariates, were primarily associated with more work absenteeism (aOR: 1.64; 95% CI: 1.41-1.90), more medical visits (aOR: 2.45; 95% CI: 1.97-3.05), decreased work performance (aOR: 3.13; CI 95%: 2.65-3.69), the perception of menopause negatively impacting their work performance (aOR: 5.84; 95% CI: 5.01-6.80), more job dismissals (aOR: 3.23; 95% CI: 2.21-4.72), and more voluntary resignations or early retirements (aOR: 1.44; 95% CI: 1.08-1.93). CONCLUSION: In this large sample of midlife Latin American women, severe menopausal symptoms were associated with reduced work capacity and adverse work-related outcomes. Copyright © 2025 by The Menopause Society.

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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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