Objective: In order to offer data on the epidemiological profile of women with low bone density (LBD), we have considered information collected in the framework of a large cross-sectional study conducted on women around menopause attending a network of first level outpatients menopause clinics in Italy. Methods: During 1997 and 2000, a large cross sectional study was conducted on the characteristics of women around menopause attending a network of first level outpatients menopause clinics in Italy for general counseling about menopause or treatment of menopausal symptoms. Eligible for the study were women consecutively observed during the study period. Up to March 2000 a total of 42464 women (mean age 53 years) were observed at the 268 participating centers. Bone mass density was measured in 25 113 cases, which are considered in this analysis. LBD (i.e. osteopenia or osteoporosis) was defined according to WHO classification. Results: The frequency of LBD increased with age: in comparison with women aged less than or equal to 51 years, the odds ratio (OR) of LBD was 1.5 and 2.2, respectively, in women aged 52-55 and greater than or equal to 56. No association emerged between LBD and parity: in comparison with nulliparae, the OR of LBD were 1.1 and 1.0, respectively, in women reported 1 or 2 or more full term pregnancies. Smokers were at increased risk of LBD, the corresponding OR being for smokers, in comparison with non smokers, 1.2 (95% confidence interval, CI, 1.1-1.3). In comparison with women in the lower tertile of body mass index, the OR of LBD decreased in subsequent tertiles, being, respectively, 0.9 and 0.7 in the middle and highest tertile. The OR of LBD was 2.2 in postmenopausal women, in comparison with premenopausal ones and the OR decreased increasing age at menopause. Ever OC users were at slightly decreased risk of LBD: in comparison with never OC users, the OR was 0.9 (95% CI 0.8-1.0) in ever OC users. Conclusion: The results of this large study confirm, in a Souther European population, the association of age at menopause and body mass on the risk of LBD, and suggest that ever OC women are at decreased risk of LBD. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

Objective: The objective of the study was to analyze medical and general factors associated with hormone replacement therapy (HRT) use in women attending a network of menopause clinics in Italy.Design: Between 1997 and 1999, we conducted a large cross-sectional study on the characteristics of women around menopause attending a network of first level outpatient menopause clinics for general counseling about menopause or treatment of menopausal symptoms. All women consecutively observed during the study period at the participating centers were eligible for the study. A total of 42,464 women (mean age 54 years) entered the study. The characteristics of women who had at some time used HRT were compared with those of women who were never users.Results: Of the 42,464 women considered, 4,909 ( 11.6%) reported having used HRT at some time. In comparison with premenopausal women, the odds ratio (OR) of HRT use was 2.1 and 4.0, respectively, in women with natural and surgical menopause; the frequency of use tends to be lower in women with later age at menopause. In comparison with women reporting primary school education, the OR was 1.4 in women with a secondary or university degree. In comparison with nulliparity, the OR of HRT use was 0.7 (95% confidence interval [CI] 0.6-0.7) in women with two or more births. HRT use was less frequent in women reporting a history of diabetes (OR 0.7, in comparison with women with no history, 95% CI 0.5-0.9) and cardiovascular diseases (OR 0.8, 95% CI 0.7-0.8) and more frequent in women with a history of osteopenia/osteoporosis (OR 1.2, 95% CI 1.0-1.5), but the latter finding was not statistically significant.Conclusion: The results of the study indicate that HRT use is more common in this population in women of higher education with early age at menopause and with a history of osteoporosis/osteopenia and less frequent in women with a history of cardiovascular disease and diabetes.

Objective : To analyse determinants of hysterectomy for benign uterine conditions with or without oophorectomy in Italy, a country with among the lowest rates of hysterectomy worldwide. Methods: Between 1997 and 1999, a large cross sectional study was conducted on the characteristics of women around menopause attending a network of first level outpatients menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. A total of 25 644 women entered the study. Characteristics of women who underwent and women who did not undergo hysterectomy and oophorectomy were compared. Results: Out of the 25 644 women considered, 4727 were hysterectomized (18.4%). Mean age at surgery was 46.8 years. The OR of hysterectomy decreased with increasing educational level: in comparison with women with primary and none education, the OR of hysterectomy was 0.8 (95% CI 0.7- 0.9) and 0.6 (95% CI 0.5-0.7) respectively for women with intermediate or high/university degree. Body mass index (BMI, kg m(-2)) was related to the frequency of hysterectomy; in comparison with women with BMI less than or equal to 23.8, the OR of hysterectomy was 1.2 (95% CI 1.1-1.3) and 1.4 (95% CI 1.2-1.5) respectively for women with a BMI 23.8-27.2 and > 27.2. The frequency, of bilateral oophorectomy increased with age at hysterectomy: in comparison with women who have had hysterectomy when aged less than or equal to 43 years, the OR of bilateral oophorectomy during hysterectomy was respectively 1.9, 3.4 and 4.3 in women who had hysterectomy at age 44-47, 48-51 and greater than or equal to 52 years. The Frequency of bilateral oophorectomy was lower in more educated women: in comparison with women reporting none or primary degree, the OR was 1.0 and 0.8 respectively for women with intermediate and high/university degree. Conclusions: The results of this analysis indicate that hysterectomy for benign conditions is more frequently performed in less educated women, in nulliparae and in women with higher BMI. During hysterectomy for benign conditions, bilateral oophorectomy is more frequent in less educated women and its frequency increases with women's age. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.

Objective: To analyze determinants/risk factors for uterine prolapse in a population of women around menopause. Methods: Between 1997 and 1999, we conducted a large cross sectional study on the characteristics of women around menopause attending a network of first level outpatients menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms. Eligible for the study were women consecutively observed during the study period. All women underwent a gynecological examination. Results: Considering the 21 449 non-hysterectomized women, uterine prolapse was diagnosed in 1182 cases (5.5%). Of those, 772 (65.3%) had prolapse degree I and 410 (34.7%) degree II or III. The frequency of uterine prolapse increases with age: In comparison with women aged less than or equal to 51 years, the odds ratio OR of uterine prolapse was 1.3 and 1.7 respectively for women aged 52-55 and greater than or equal to 56 years. In comparison with women with none/primary education, the OR of uterine prolapse was 0.8 (95% confidential interval CI 0.7-0.9) and 0.8 (95% CI 0.6-0.9), respectively, for women with intermediate or high school/university degree. The risk of uterine prolapse increased with body mass index (BMI; kg/m(2)) value: In comparison with women with BMI<23.8, the OR was 1.4 (95% CI 1.2-1.7) and 1.6 (95% CI 1.3-1.9) for women with BMI 23.8-27.2 and >27.2. In comparison with nulliparae, the OR of uterine prolapse increased with number of births, being 3.0 (95% CI 2.1-4.3) in women reporting greater than or equal to3 births. A history of caesarean section or of a delivery of a fetus weighing >4500 g were not associated with increased risk of uterine prolapse. When the analysis was conducted separately in strata of grade of uterine prolapse (I and greater than or equal to II), no marked differences emerged in the OR estimates. Conclusions: This study indicates that, in this population, the risk of uterovaginal prolapse increase with the number of vaginal births and was higher in overweight women, offering some quantitative estimates of the role of these factors on the risk of the condition. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.

The objective of this study was to analyze determinants of age at menopause in a large sample of Italian women consecutively attending a network of 235 outpatients menopausal clinics in Italy. A total of 6961 women aged greater than or equal to 55 years and in spontaneous menopause are included in the present analysis. Main determinants of age at menopause were: current smoking and regular menstrual cycles and age at menarche.