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L Dennerstein

Publications and source records attributed to L Dennerstein.

At least 37 records · Page 2Linked to original sources
PubMed2001

The physical, sexual and emotional violence history of middle-aged women: a community-based prevalence study.

OBJECTIVES: To determine current and lifetime rates of the experience of partner abuse and sexual violence in a community-based sample of middle-aged women and compare these to figures obtained in a general practice setting. DESIGN AND METHODS: This research was part of the Melbourne Women's Midlife Health Project (MWMHP), an observational, longitudinal, population-based study of 438 Australian-born women conducted over nine years. In 1996, during the sixth year of the study, we asked the MWMHP participants to complete a self-administered "violence questionnaire", incorporating a modified Conflict Tactics Scale and questions on sexual abuse experienced during childhood and adult life. RESULTS: Of the 395 women remaining in the sixth year of follow-up of the MWMHP, 362 (92%) completed the questionnaire. Overall, 28.5% (n = 101) of the women had experienced some form of domestic violence (physical, sexual or emotional) during their lifetime; 5.5% (n = 15) of women had experienced severe physical abuse in the past year at the hands of a partner; and 11.8% (n = 42) of the women had experienced rape or attempted rape between the age of 16 and the time of our survey. Regarding abuse in childhood, 8.9% (n = 32) of women had experienced physical abuse, 42.3% (n = 152) had experienced non-contact sexual abuse, and 35.7% (n = 128) contact sexual abuse. Compared with the general-practice-based study, rates of childhood physical abuse and penetrative sexual abuse were similar, but rates of less intrusive child sexual abuse were significantly higher in our study. CONCLUSIONS: Doctors in all areas of medicine who are dealing with middle-aged women need to be aware of the levels of violence sustained by women throughout their lives. Such experiences may have a substantial impact on women's physical and mental wellbeing.

Adolescent↗
PubMed2001

Are changes in sexual functioning during midlife due to aging or menopause?

OBJECTIVE: To determine whether changes in women's sexual functioning during midlife are due to aging or menopause. DESIGN: Prospective, observational study. SETTING: Population-based sample assessed in own homes. PATIENT(S): Four hundred thirty-eight Australian-born women aged 45-55 years and still menstruating at baseline. One hundred ninety-seven were studied for effects of the natural menopausal transition. Control group A (n = 44) remained premenopausal or early perimenopausal for 7 years. Control group B (n = 42) remained postmenopausal over 5 years. INTERVENTION(S): Nil; questionnaires and blood sampling annually. MAIN OUTCOME MEASURE(S): Shortened version of the Personal Experiences Questionnaire. RESULT(S): By the late perimenopause, there was a significant decline in the factors we had derived of sexual responsivity and total score, and there was an increase in the partner's problems factor. By the postmenopausal phase, there was a further decline in the factors sexual responsivity, frequency of sexual activities, libido, and in the total score, and a significant increase in vaginal dyspareunia and partner's problems. Sexual responsivity significantly declined in both control groups. CONCLUSION(S): Sexual responsivity is adversely affected by both aging and the menopausal transition. Other domains of female sexual functioning were significantly adversely affected when the women became postmenopausal. The relationship with the partner and his ability to perform sexually is adversely affected by the menopausal transition.

Australia↗
PubMed2001

Is incontinence associated with menopause?

OBJECTIVES: To estimate (1) the prevalence of urinary incontinence in a population-based sample of Australian women aged 45-55 and to identify the factors associated with urinary incontinence; (2) the incidence of urinary incontinence over a 7-year follow-up period and to identify whether the transition from pre- to postmenopause is associated with the development of urinary incontinence. METHODS: This was a cross-sectional study of 1897 women and a 7-year longitudinal follow-up of 373 of these women who were premenopausal at baseline. Annual interviews and physical measurements were taken in their homes. RESULTS: Cross-sectional: the prevalence of urinary incontinence was 15%; multivariate analysis found that urinary incontinence patients were significantly more likely than those without incontinence to have higher body mass index (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.15, 1.95), have had gynecologic surgery (OR 2.17, 95% CI 1.42, 3.32), report urinary tract infections (OR 4.75, 95% CI 2.28, 9.90), diarrhea or constipation (OR 1.95, 95% CI 1.27, 3.00), and have had three or more children (OR 1.47, 95% CI 1.06, 2.05). Longitudinal: during the 7-year follow-up, the average prevalence of urinary incontinence was 18% and the overall incidence 35%. Women who experienced a hysterectomy during the follow-up period had a higher incidence. CONCLUSION: Urinary incontinence in middle-aged women is more closely associated with mechanical factors than with menopausal transition.

Australia↗
PubMed2001

Impaired fasting glycaemia in middle-aged women: a prospective study.

OBJECTIVES: To investigate: (i) the incidence of impaired fasting glycaemia (IFG) developed over 5 y in a population-based sample of Australian-born women; (ii) prospectively the factors which are associated with the development of IFG; (iii) the association of the menopausal transition with the onset of IFG and an increase in serum insulin concentrations. DESIGN AND METHODS: A total of 265 women (110 pre-, 138 peri-, 17 postmenopausal) participants in the longitudinal phase of the Melbourne Women's Midlife Health Project, aged 46-57 and with normal fasting plasma glucose concentrations at the time of the initial measure, were interviewed, had physical measurements and blood taken annually over a 5 y follow-up period. RESULTS: During the study period 43 women (16%) recorded a fasting glucose concentration of > or =6.1 mmol/l (IFG). Women who recorded IFG prospectively had, at the time of the initial measure when fasting glucose concentrations were normal: higher body mass index (BMI), trunk skinfold thicknesses, waist and hip circumferences (P<0.005), lower SHBG, higher free androgen index and serum insulin concentrations (P<0.05), higher systolic blood pressure, serum triglyceride and lower HDL-cholesterol concentrations (P<0.05) than women whose fasting glucose concentrations remained normal. The onset of IFG was not triggered by the menopausal transition or hormone use. Changes in insulin concentration were associated with changes in BMI (P<0.05). CONCLUSION: Women who developed IFG during the menopausal transition exhibited significantly higher levels of body fatness and dyslipidemia, premenopausally, compared with the women who did not develop IFG. The menopausal transition did not have an effect on the development of IFG, but weight gain during this period was associated with an increase in insulin concentration.

Australia↗
PubMed2001

Factors contributing to positive mood during the menopausal transition.

This study determined which variables affect women's positive mood state during the menopausal transition using nine prospective annual assessments of a population based sample of 267 Australian mid-aged women. Longitudinal data analysis carried out by analysis of covariance on Summary Statistics found that positive mood scores remained stable over time and were not related to natural menopausal transition, age, or education. In the early phase of the menopausal transition, positive mood was adversely influenced by baseline interpersonal stress (p = .009) and negative attitudes to aging (p = .026). The most important predictor of positive mood at the phase of late peri-/ postmenopause was positive mood in the premenopause (p = .000). Other factors affecting positive mood in the late peri-/postmenopause were changes in dysphoric symptoms (p = .000), major life events (p = .041), daily hassles (p = .014), marital status (p = .007), and work satisfaction (p = .001). Structural equation modelling found a goodness of fit index of .821.

Affect↗
PubMed2001

Attitudes of middle-aged women to aging: contribution of the Reactions to Aging Questionnaire.

Attitudes to aging in mid-life have been found to be a predictor of health and well-being. The main purpose of the study was to assess the contribution of the Reactions to Aging Questionnaire (RAQ) to the understanding of middle-aged women's attitudes towards their aging. An additional purpose was to expand the existing information regarding the dimensions of the new version of the RAQ. Middle-aged Melbourne women (n = 381) were asked to complete the RAQ, in addition to another attitudes-to-aging scale (Worries About Aging). Factor analysis of the RAQ was used to explore its dimensionality, and frequencies of responses were used to assess the spread of response of both instruments. The factors extracted in the factor analysis of the RAQ were interpretable and meaningful in terms of emotions related to aging. They were also similar to the factors described by previous data. The RAQ was more effective in its distribution ability than the Worries About Aging Scale. With some modifications, the RAQ may be more informative than was the Worries About Aging Scale in its ability to assess emotions, opinions and beliefs associated with aging in middle-aged women.

Aging↗
PubMed2000

Longitudinal study of risk factors for coronary heart disease across the menopausal transition.

The patterns of change in blood lipids, diastolic blood pressure, body mass index, smoking and drinking behaviors, and exercise were examined in an ongoing longitudinal study from 1991 to 1995 of 150 middle-aged Melbourne, Australia, women as they passed through menopause. Changes in risk factors over time were examined with reference to time of the final menstrual period (FMP). Random effects models were fitted with adjustments for repeated measures and other covariates, including age. There were overall net increases between 3 years before and the 3 years after menopause of 0.25 mmol/liter for low density lipoprotein cholesterol, 0.05 mmol/liter for high density lipoprotein cholesterol (HDL cholesterol), 0.34 mmol/liter for triglycerides, 0.12 kg/m2 for body mass index, and 0.48 mmHg for diastolic pressure. The proportion of drinkers decreased by 13%, that of smokers increased by 17%, and that of women who exercised at least once a week increased by 6%. The only change dependent on the FMP was a significant decrease in HDL cholesterol (counterbalanced by a similar rise in HDL cholesterol in the year before the FMP), and the rate of decrease was maximal around 9 months after menses ceased, with an instantaneous estimate of slope of 0.55 mmol/liter per year.

Blood Pressure↗
PubMed2000

A prospective population-based study of menopausal symptoms.

OBJECTIVE: To identify symptoms that change in prevalence and severity during midlife and evaluate their relationships to menopausal status, hormonal levels, and other factors. METHODS: In a longitudinal, population-based study of 438 Australian-born women observed for 7 years with an 89% retention rate, 172 advanced from premenopause to perimenopause or postmenopause. Annual measures included a 33-item symptom check list; psychosocial, lifestyle, and health-related factors; menstrual status; hormone usage; and blood levels of follicle-stimulating hormone and estradiol (E2). RESULTS: Increasing from early to late perimenopause were the number of women who reported five or more symptoms (+14%), hot flushes (+27%), night sweats (+17%) and vaginal dryness (+17%) (all P <.05). Breast soreness-tenderness decreased with the menopausal transition (-21%). Trouble sleeping increased by +6%. The major change in prevalence was from early to late perimenopause, except for insomnia, which showed a gradual increase. Those variables most related to onset of hot flushes were number of symptoms at early perimenopause (P <.05), having an unskilled or no occupation (P <.05), more than 10 pack-years of smoking (P <.01), and decreased E2 (P <.01). The onset of night sweats increased with the change in E2 (P <.05). The onset of vaginal dryness decreased with more years of education (P <.05). Trouble sleeping was predicted by prior lower well-being (P <.01), belief at baseline that women with many interests hardly notice menopause (P <.01), and hot flushes (P <.01). CONCLUSION: Although middle-aged women are highly symptomatic, the symptoms that appear to be specifically related to hormonal changes of menopausal transition are vasomotor symptoms, vaginal dryness, and breast tenderness. Insomnia reflected bothersome hot flushes and psychosocial factors.

Adult↗
PubMed2000

Retrospective self-report compared with menstrual diary data prospectively kept during the menopausal transition.

OBJECTIVE: To investigate the reliability of self-report of menstrual frequency and flow changes in the context of determining menopausal status categories, using data from the longitudinal phase of the Melbourne Women's Midlife Health Project (MWMHP). METHODS: Women reporting at interview at least one menstrual period during the previous 3 months are assigned pre- or perimenopausal status according to their responses to questions about changes in menstrual frequency and flow. For a sample of 72 such women, menstrual diary information was converted into standardized scores measuring change in frequency and flow of menses during the 2 years prior to interview. These scores, coded into categories, were used to derive measures of the sensitivity, specificity and predictive values of the interview responses. RESULTS: Self-report of change in menstrual frequency and flow have low sensitivity to measures based on prospectively kept menstrual diaries. CONCLUSIONS: Retrospective self-report at interview of changes in menstrual frequency and flow should not be regarded as reliable measures of actual changes in cycle parameters.

Australia↗
PubMed2000

Dietary phytoestrogen intake in mid-life Australian-born women: relationship to health variables.

OBJECTIVES: To estimate the dietary intake of isoflavone-rich foods in a population-based cohort of Australia-born women, and to investigate whether a high intake of isoflavone-rich foods is associated with health-related variables. METHOD: The study considered a population-based cohort of Australian-born women aged 51-62 years, with interviews, blood and physical measurements taken in their own homes. Food frequency questionnaires included usual eating habits and isoflavone-rich foods. RESULTS: In total, 354 women (98%) returned both dietary questionnaires. Some 222 women (62%) reported consuming isoflavone-rich foods. Soy breads and milk provided the most servings per month. The mean intake of isoflavones calculated from soy beans, soy grits, tofu, soy milk, and soy and linseed bread in the whole cohort was 17 (standard deviation 35, range 0-340) mg/day. Fifty-one women (14%) consumed > 40 mg isoflavone/day. Compared with the rest of the cohort they had higher intakes of fruit, energy, protein, vitamins and minerals; ate a greater variety of vegetables; were more likely to exercise; were less likely to smoke; had lower mean body mass index, waist and hip measures and higher bone mineral density of the femoral neck; and had lower negative mood scores (all p < 0.05). CONCLUSION: Australian-born women in Melbourne have a wide range of intake of isoflavone-rich foods. For those with a high intake it seems to be one component of a healthier life-style. It is thus not possible to assign particular health benefits to the one dietary component.

Australia↗
PubMed2000

Tubal ligation, hysterectomy and D&C: evidence from the Melbourne Women's Midlife Health Project.

The question of whether tubal ligation (TL) is associated with increased risk of hysterectomy or dilatation and curettage (D&C) is examined using data from a population-based study. Retrospective information on TL, D&C and hysterectomy was gathered from 1,810 Australian-born women aged 45-55 who were randomly selected from the population of Melbourne, Australia. Odds ratios for the outcomes were adjusted via logistic regression for age, years of education, smoking status, alcohol consumption, history of premenopausal complaints, number of lost pregnancies, and whether women have discussed menstruation or menopause with their doctor. With these variables taken into account, TL does not emerge as a risk factor for hysterectomy. Though there was a significant association between TL and the probability of ever experiencing a D&C, related extraneous variables which appear to link these events are identified.

Alcohol Drinking↗
PubMed2000

A prospective longitudinal study of serum testosterone, dehydroepiandrosterone sulfate, and sex hormone-binding globulin levels through the menopause transition.

The aims of this study were to describe, in relation to date of final menses, the average androgen levels of women in the years before and after this date, and to determine the extent to which these average levels were dependent on age and body mass index (BMI) and the degree of tracking in residual androgen levels, or the extent to which individuals above (below) the mean for their age or time relative to final menstrual period (FMP) and BMI remain above (below) the mean as time progresses. Serial levels of serum sex hormone-binding globulin (SHBG), testosterone (T), and dehydroepiandrosterone sulfate (DHEAS) were measured annually in 172 women from the Melbourne Women's Midlife Health Project who experienced a natural menopause during 7 yr of follow-up. Fasting blood samples were drawn between days 4-8 if women were still menstruating or after 3 months of amenorrhea. The free androgen index (FAI) was calculated as the ratio ofT to SHBG x 100. Means of the log-transformed androgen levels were analyzed as a double logistic function of time relative to FMP as well as age and BMI, and correlations between repeated androgen levels were measured. Mean SHBG levels decreased by 43% from 4 yr before to 2 yr after the FMP. The time of most change was 2 yr before FMP [95% confidence interval (CI), 0.8-3.2]. SHBG levels were, on the average, 5% lower for each halving of estradiol (E2) levels and 4% lower for each kilogram per m2 of BMI (P < 0.0001). About one third of the decline in SHBG was explained by E2 and BMI. After adjusting for all variables, SHBG showed strong tracking. Mean T levels did not vary with time relative to FMP and were independent of age and BMI. Residual values of T showed weak tracking. The FAI increased by 80% from 4 yr before FMP to 2 yr after FMP, and changed maximally 2.2 yr before FMP (95% CI, 1.2-3.2). The FAI was not related to age or E2, but was, on the average, 4% higher for each kilogram per m2 of BMI (P < 0.0001). Residual values of FAI showed moderate tracking. Mean DHEAS levels were not related to the FMP, but were 1.5% lower for each year of age (P < 0.01) and 3.8% lower for each kilogram per m2 of BMI (P < 0.0001). Residual values of DHEAS showed strong tracking. It is concluded that SHBG and FAI levels change at the time of the menopause, at least partially due to the decline in E2. DHEAS decreases as a function of age, not time relative to FMP, and T remains unchanged during the menopausal years. SHBG and DHEAS show a high degree of stability within an individual over time.

Adult↗
PubMed2000

Menopausal symptoms: experience of Chinese women.

OBJECTIVES: To investigate the prevalence of symptoms in middle-aged Chinese rural and city women of different occupations; and to explore the relationship between symptoms, hormone levels and other factors. METHODS: This cross-sectional study included 806 women aged 41-60 years, selected by multistage cluster sampling and a structured interview questionnaire. The response rate was 95%. The sample compromised 402 professional urban women and 404 women farmers living in rural areas. Some 209 women were randomly selected from the two groups for hormonal assay and bone mineral density screening. RESULTS: The professional group was more symptomatic than the farming group (p < 0.01). The presence of symptoms was significantly related to an increasing level of education. There were no significant differences between occupational groups in levels of estradiol follicle stimulating hormone (FSH) and luteinizing hormone (LH). Estradiol level and bone mineral density were decreased and FSH and LH increased in the postmenopausal group (p < 0.05) compared with the other menopausal groups. Hot flushes were the only symptom to be significantly associated with hormone levels (estradiol and LH). The occurrence of symptoms was significantly related to indications of bone and joint disease, heart disease, primary dysmenorrhea, decline in sexual interest, irregular menses and feelings of becoming older, sad and lost. These factors were all reported more often by the professional women than by the farmers. CONCLUSION: Symptom experience in mid-life Chinese women is related to both biological and psychosocial factors.

Adult↗
PubMed1999

Hormone therapy use in Australian-born women: a longitudinal study.

OBJECTIVES: To describe the pattern of use of hormone therapy (HT) among Australian women, and its side-effects and benefits, and to compare baseline characteristics of HT users with never users. DESIGN: Longitudinal community-based study with annual interviews. SETTING: Melbourne, May 1991-October 1997. PARTICIPANTS: 357 Australian-born women aged 45-55 years who were pre- or perimenopausal and not using HT at baseline. MAIN OUTCOME MEASURES: Rates of HT use; baseline characteristics of users and non-users; side effects and benefits of HT use. RESULTS: 151 women (42%) used HT over the six years and 93 (26%) were current users at six-year follow-up. HT users did not differ significantly from non-users in lifestyle, sociodemographic and cardiovascular risk factors or in most health status factors at baseline. However, HT users were significantly more likely to have had a breast examination by a health professional (odds ratio [OR], 2.60; 95% CI, 1.62-4.17), to have had a tubal ligation (OR, 1.73; 95% CI, 1.09-2.74), to report a history of premenstrual complaints (OR, 1.72; 95% CI, 1.08-2.74), to agree that women "regret when their period stops for the last time" (OR, 1.69; 95% CI, 1.04-2.74), and to report that they took non-prescription medications (OR, 1.62; 95% CI, 1.02-2.59). Most (84%) HT users described benefits (most commonly relief of hot flushes and improved wellbeing), while 53% complained of side effects (most commonly weight gain and breast tenderness). CONCLUSIONS: HT users did not differ significantly from non-users at baseline in most characteristics. Long-term follow-up of this cohort is now required to assess any difference in cardiovascular events or other health outcomes between HT users and non-users.

Australia↗
PubMed1999

Mood and the menopausal transition.

This study determined which variables affect women's mood state during the menopausal transition by using six prospective annual assessments of a community-based sample of 354 Australian mid-aged women. Repeated measures multivariate analysis of covariance found that negative mood scores decreased significantly over time and were not related to natural menopausal transition, follicle-stimulating hormone, estradiol, inhibin, age, or education. The magnitude of negative mood was significantly predicted by baseline reporting of premenstrual complaints, negative attitudes to ageing and menopause, and parity of one. During follow-up, the magnitude of negative mood was significantly adversely affected by: prior experience of negative mood, experience of bothersome symptoms, poor self-rated health, negative feelings for partner, no partner, current smoking, low exercise, daily hassles, and high stress. Negative mood was reduced by decreasing symptoms, improving health, positive feelings for partner, gaining a partner, and reducing stress. The menopausal transition had an indirect effect in amplifying the effect of reducing paid work, poor health, and daily hassles.

Adult↗
PubMed1999

Prospectively measured levels of serum follicle-stimulating hormone, estradiol, and the dimeric inhibins during the menopausal transition in a population-based cohort of women.

The aims of this study were: 1) to describe, in relation to the date of final menses, the average hormone levels of women in the years before and after this date and to determine the extent to which these average levels were dependent on age and body mass index (BMI); and 2) to determine the degree of tracking in residual hormone levels [i.e., the extent to which individuals above (below) the mean for their age or time relative to final menstrual period (FMP) and BMI remain above (below) the mean as time progresses]. Serial levels of serum FSH, circulating estradiol (E2), and the dimeric inhibins (INH) A and B were measured annually in 150 women who experienced a natural menopause during 6 years of follow-up. Means of the log-transformed hormonal levels were analyzed as a double-logistic function of time relative to FMP, as well as age and BMI and correlations between repeated hormonal levels, were measured. Mean FSH levels started to increase from about 2 years before the FMP, increased most rapidly about 10 months before the FMP, and had virtually plateaued by 2 years after the FMP. FSH levels were, on average, 3% greater for each year of age and 2% lower for each kg/m2 of BMI. After adjusting for time relative to the FMP, logFSH showed modest tracking. Age-adjusted values of logFSH were moderately correlated across time, and much of this tracking was explained by the actual timing of a woman's FMP. Mean E2 levels started to decrease about 2 years before the FMP, decreased most rapidly around the time of the FMP, and had virtually plateaued by 2 years after the FMP. E2 levels were lower, on average, by about 9% per year of age, and residual values showed weak tracking. Levels of both INHA and INHB decreased, on average, in the years before the FMP and were undetectable (INHA, < 10 pg/mL; INHB, < 25 pg/mL) in the majority of women by the time of the FMP and in almost all women by 4 years post-FMP. Significant negative correlations between log serum FSH and log E2 (r = -0.73) and log INHA (r = -0.41) and log INHB (r = -0.36) were observed. It is concluded that substantial changes in reproductive hormone levels occur within 1-2 yr on each side of the FMP, that falling concentrations of E2 and the INH contribute to the rising concentrations of FSH, and that there is no single reliable hormonal marker of menopausal status for an individual woman.

Aging↗
PubMed1999

Weight gain and the menopause: a 5-year prospective study.

OBJECTIVE: To investigate prospectively changes in weight, skin-fold measurements, waist circumference and waist/hip ratio in relation to changes in menopausal status, hormone therapy use and life-style factors. METHOD: The study was a 5-year follow-up of volunteers from a population-based cohort of Australian-born women aged 46-57 years at baseline: 106 premenopausal, 106 perimenopausal and 21 hormone therapy users. RESULTS: Mean (SD) weight gain of the entire cohort over 5 years was 2.1 (5.1) kg. Baseline age was negatively associated with weight change (regression coefficient = -0.4, SE 0.1, p < 0.05). After 5 years, 20 women remained premenopausal, 80 were perimenopausal, 112 had become naturally postmenopausal and 21 remained on hormone therapy. Changes in weight were greater than zero (p < 0.05) in all groups except for the women who remained on hormone therapy. There was no significant difference in weight gain between women who remained premenopausal and those who had a natural menopause. Increases in suprailiac skin-fold measurements (p < 0.05) and in waist circumference and waist/hip ratio occurred in women who experienced the menopausal transition but not in those who took hormone therapy continuously. There was no association between weight change and baseline weight, exercise, alcohol intake or smoking. CONCLUSION: Weight gain was not related to change in menopausal status nor to any life-style factors measured. Women who were older at baseline gained less weight than the younger members. Suprailiac skin-fold measurements, waist circumference and waist/hip ratio all increased during the menopausal transition. Continuous hormone therapy users showed no gain in mean weight, suprailiac skin-fold measurements or waist measurements over the follow-up period.

Australia↗