Anthropometric and gynaecological history according to the socioeconomic status of postmenopausal women: Poverty and the menopause

Abstract

Less advantaged social classes usually have unhealthier lifestyles and have more difficult access to health resources. In this work we study the possible association between poverty and the prevalence of obesity and oophorectomy in a population of postmenopausal women. Cross-sectional observational study. To study in a population of postmenopausal women in poverty the possible differences in the prevalence of obesity and oophorectomy, and to compare some other gynaecological data: age at menarche, age at menopause, fertile years, number of pregnancies, breastfeeding and the use of hormonal replacement therapy (HRT). All patients were interviewed personally. A questionnaire was used to find out about their lifestyles and the medication they were taking. Their medical records were reviewed to confirm the existence of some diseases. A complete physical examination was performed with every patient. Weight and height were measured with the patient dressed in light clothes. Blood was obtained in a fasting state in order to carry out some analyses. Poverty was defined according to the Spanish National Institute of Statistics criteria. We enrolled 1225 postmenopausal women; 449 (36.6%) were under the threshold of poverty, defined by the Spanish National Institute of Statistics. Postmenopausal women in poverty had higher body mass index (29.2 ± 4.8 versus 27.0 ± 4.7 kg/m2 P < 0.001), and a higher prevalence of obesity than postmenopausal women not in poverty (44.2% versus 24.3%, P = 0.001). The prevalence of oophorectomy was also higher in women in poverty (32.7% versus 27.2%, P < 0.04). Women in poverty had had a greater number of pregnancies (3 versus 2, P = 0.001). They also showed a higher rate of breastfeeding than women in medium and high social classes (65% versus 59%, P = 0.037). There were no statistically significant differences between the groups in either the age of menopause or fertile years, nor in the use of HRT. Postmenopausal women in poverty have higher levels of obesity, and also a greater prevalence of oophorectomy than women of medium and high social classes. They also presented a higher rate of breastfeeding and a greater number of pregnancies than those women not in poverty.