Effects of Resistance Training and Soy Isoflavone on Body Composition in Postmenopausal Women

Objective. To investigate the independent and additive effects of resistance training (RT) and soy isoflavone (ISO) on body composition in postmenopausal women (PW). Method. This study used a placebo-controlled, double-blind (soy), randomized (ISO versus placebo) × (RT versus No RT) design. A total of 80 PW, aged 45–70 years, were randomly (71 completed 9-months intervention): RT + ISO (n = 15), No RT + ISO (n = 20), RT + placebo (n = 18), and No RT + placebo (n = 18). ISO received 100 mg a day of isoflavone; and to RT attended supervised resistance training sessions. At baseline and 9-months, fat and muscle mass were estimated by DXA. ANOVA and test t were used. Results. RT groups showed significantly increased muscle strength (35.2%) and muscle mass (1.4%). Exercising attenuated gains in fat trunk and % body fat (P < .05). Significant decreases in muscle mass (−1.8%) and increases in fat mass of the whole-body (1.6%) and trunk (9.7%) was found in no-RT groups (P < .05). In ISO groups, there were no differences in body composition and muscle strength. ISO and RT had no additive effects. Conclusion. In PW: RT improved muscle mass and strength and attenuated gain of fat mass; ISO did not alter body composition and muscle strength; there were no additive effects of RT and ISO

Clinical Study Effects of Resistance Training and Soy Isoflavone on Body Composition in Postmenopausal Women

Objective. To investigate the independent and additive effects of resistance training (RT) and soy isoflavone (ISO) on body composition in postmenopausal women (PW). Method. This study used a placebo-controlled, double-blind (soy), randomized (ISO versus placebo) × (RT versus No RT) design. A total of 80 PW, aged 45-70 years, were randomly (71 completed 9-months intervention): RT + ISO (n = 15), No RT + ISO (n = 20), RT + placebo (n = 18), and No RT + placebo (n = 18). ISO received 100 mg a day of isoflavone; and to RT attended supervised resistance training sessions. At baseline and 9-months, fat and muscle mass were estimated by DXA. ANOVA and test t were used. Results. RT groups showed significantly increased muscle strength (35.2%) and muscle mass (1.4%). Exercising attenuated gains in fat trunk and % body fat (P &lt; .05). Significant decreases in muscle mass (−1.8%) and increases in fat mass of the whole-body (1.6%) and trunk (9.7%) was found in no-RT groups (P &lt; .05). In ISO groups, there were no differences in body composition and muscle strength. ISO and RT had no additive effects. Conclusion. In PW: RT improved muscle mass and strength and attenuated gain of fat mass; ISO did not alter body composition and muscle strength; there were no additive effects of RT and ISO

Estados hiperprolactinêmicos: inter-relações com o psiquismo

Hyperprolactinemia is the most frequent endocrine disorder of the hypothalamus-hypophysis axis observed in women of reproductive age. It is characterized by elevated serum prolactin levels. Prolactin production is regulated by the inhibitory action of a neurotransmitter, dopamine. Clinical manifestations include irregular menstrual cycle, amenorrhea, galactorrhea, infertility and libido decrease, but psychological symptoms, especially anxiety and depression, have also been associated with hyperprolactinemia. Nonetheless, few studies about this condition are available. In the pathogenesis of psychiatric disorders, prolactin may have either a direct action on the central nerve system or an indirect effect via gonadal hormones or function as independent factors as a result of dopamine depletion. Thus, since the prevalence of psychiatric disorders in patients with hyperprolactinemia was detected, it was concluded that further studies are necessary to investigate the basis of a potential relationship between both hyperprolactinemic and psychiatric conditions.A hiperprolactinemia é o distúrbio endócrino mais freqüente do eixo hipotálamo-hipofisário, observado em mulheres na idade reprodutiva. Caracteriza-se pela elevação consistente dos valores plasmáticos de prolactina. A regulação da produção da prolactina dá-se por meio da ação inibitória de um neurotransmissor, a dopamina. As manifestações clínicas são distúrbios do ciclo menstrual, amenorréia, galactorréia, infertilidade e diminuição da libido. Entretanto, sintomas psicológicos, especialmente ansiedade e depressão, têm sido associados à hiperprolactinemia. Contudo, há poucos estudos clínicos publicados sobre o tema. O papel da prolactina na patogênese dos distúrbios psiquiátricos pode refletir ação direta sobre o sistema nervoso central, efeito indireto por meio dos hormônios gonadais ou constituir fatores independentes, resultantes da depleção de dopamina. Assim, detectada a prevalência de distúrbios psiquiátricos em pacientes com hiperprolactinemia, conclui-se pela necessidade de maior número de pesquisas que investiguem as bases da possível inter-relação entre os estados hiperprolactinêmicos e o psiquismo

Bleeding pattern and management of unexpected bleeding/spotting with an extended regimen of a combination of ethinylestradiol 20 mcg and drospirenone 3 mg

Objective: To compare the bleeding pattern in women using ethinylestradiol 20 mcg/ drospirenone 3 mg (EE 20 mcg/DRSP 3 mg) in a 24/4-day cyclic regimen with an extended regimen. Unexpected bleeding/spotting in the extended regimen group was managed by allowing a 4-day hormone-free interval (HFI). Methods: This was a randomized, prospective, open-label, multicenter study. Participants (N = 348) were randomized to receive EE 20 mcg/DRSP 3 mg in either an extended regimen (EE/DRSPes group) or a 24/4-day cyclic regimen (EE/DRSP24/4 group) and followed for 168 days. In the EE/DRSPes group, a 4-day HFI was allowed whenever unexpected bleeding/ spotting persisted for ≥7 consecutive days. The participants assessed their bleeding daily as “no bleeding,” “spotting,” or “light,” “moderate,” or “heavy” bleeding according to a predefined scale. Results: EE/DRSPes group experienced fewer days of bleeding than those using a 24/4 cyclic regimen (P < 0.001). After 168 days, 57.5% of women in the EE/DRSPes group achieved complete amenorrhea (i.e., neither bleeding nor spotting) and 73.9% achieved “no bleeding” (i.e., no bleeding with or without spotting) during the final 28-day interval of the study period. Women in the extended group who instituted the 4-day HFI experienced a 94.1% rate of successful management of unexpected bleeding/spotting. Conclusion: The use of EE 20 mcg/DRSP 3 mg in an extended regimen resulted in high rates of amenorrhea and “no bleeding”. Unexpected bleeding/spotting in the EE/DRSPes group could be managed effectively with a 4-day HFI

Síndrome de insuficiência androgênica: critérios diagnósticos e terapêuticos

The womens androgen insufficiency syndrome (AIS) arises, even nowadays, many debates and clears a lot of controversies. It is known, however, that the plasmatic levels of testosterone gradually decline through the reproductive period. AIS is appraised as a set of clinical symptoms, bioavailability presence diminished of testosterone and normal levels of estrogen. Among the main symptoms that remind the diagnosis are the well-being impairment, dysphoric mood, the fatigue without apparent cause, the sexual desire impairment, the loss of weight and the vasomotor instability in postmenopausal women receiving estrogen. These, however, are potentially attributable to the different etiologies and make it difficult to give the correct diagnosis in the majority of the cases, even though it is reminded, often, in patients who submit to bilateral oophorectomy. The diagnosis of the SIA seems to be essentially clinical, not having the needs of laboratorial dosages for its proof. It shouldnt indicate the androgenic therapy (AT) in patients without concomitant estrogen therapy. Testosterone is considered the ideal hormone for AT. Patients with suggestive SIA symptoms, excluded other identifiable causes, especially the post-menopauses ones, are candidates to AT. There are no safety data about AT in long stated period users. The transdermal patches, creams and gel seems to be preferable to the oral formulations.A síndrome da insuficiência androgênica na mulher (SIA) desperta, mesmo nos dias atuais, muitas discussões e encerra muitas controvérsias. Sabe-se, no entanto, que os níveis plasmáticos de testosterona declinam progressivamente ao longo do período reprodutivo. Conceitua-se a SIA como o conjunto de sintomas clínicos, a presença de biodisponibilidade diminuída de testosterona e os níveis normais de estrogênios. Entre os principais sintomas, citam-se o comprometimento do bem-estar, o humor disfórico, a fadiga sem causa aparente, o comprometimento do desejo sexual, o emagrecimento e a instabilidade vasomotora em mulheres pós-menopáusicas sob terapêutica estrogênica. Esses sintomas, no entanto, são potencialmente atribuíveis a diferentes etiologias e dificultam o correto diagnóstico na maioria dos casos, ainda que ele seja lembrado com freqüência em pacientes que se submetem à ooforectomia bilateral. O diagnóstico da SIA parece ser essencialmente clínico, não havendo a necessidade das dosagens laboratoriais para a sua comprovação. Não se deve indicar a terapêutica androgênica (TA) em pacientes que não estejam adequadamente estrogenizadas. Considera-se a testosterona o hormônio ideal para a TA. As pacientes com sintomas sugestivos de SIA, excluídas outras causas identificáveis, especialmente se pós-menopáusicas, são candidatas à TA. Não existem dados de segurança sobre a TA em usuárias em longo prazo. A via transdérmica - através de adesivos, cremes e gel - parece ser preferível à oral

Evaluation of postural balance in postmenopausal women and its relationship with bone mineral density- a cross sectional study

Background: Low bone mineral density (BMD) and falls are common problems encountered in the postmenopausal women. The purpose was to evaluate the association between postural balance and BMD in postmenopausal women and its relation to risk for falls.Methods: In this cross-sectional study, 225 women in amenorrhea > 12 months and age >= 45 years were included and divided, according to BMD, in T-score values > -2.0 SD (n = 140) and <= -2 SD (n = 85). Those with neurological or musculoskeletal disorders, history of vestibulopathies, uncorrected visual deficit or drug use that could affect balance were excluded. History of falls (last 24 months), clinical and anthropometric characteristics were evaluated. Postural balance was assessed by stabilometry (force platform). For statistical analysis were used Wilcoxon's Test, Chi-Square Test and logistic regression method for fall risk (Odds Ratio-OR).Results: Patients with BMD > -2.0 SD were younger, with shorter time since menopause, and showed higher BMI as compared to those with low BMD (<= -2 SD) (p < 0.05). It was observed that 57.8% of the participants reported fall episodes without significant difference distribution between the groups (p = 0.055). No differences were found from the comparison between the groups (p > 0.05) for stabilometric parameters. Risk for falls increased with age (OR 1.07; CI 95% 1.01-1.13), current smoking (OR 2.19; CI 95% 1.22-3.21) and corrected visual deficit (OR 9.06; CI 95% 1.14-4.09). In contrast, hormone therapy (HT) use was significantly associated with reduced risk for falls (OR 0.48; CI 95% 0.26-0.88).Conclusions: In postmenopausal women, BMD did not show association with postural balance or risk for falls. Age, smoking and corrected visual deficit were clinical indicators of risk for falls whereas HT use showed to be a protective factor

Avaliação dos fatores de risco de quedas em mulheres na pós-menopausa inicial

OBJETIVO: Foi avaliar a frequência e os fatores de risco de quedas em mulheres na pós-menopausa. MÉTODOS: Estudo clínico, transversal, envolvendo 358 mulheres (idade entre 45 e 65 anos e amenorreia >12 meses) com tempo de pós-menopausa 12 months) with time since menopause <10 years. Exclusion criteria were: neurological or musculoskeletal disorders, vestibulopathies, uncorrected visual deficit, uncontrolled hypertension and postural hypotension, or drug use (sedative and hypnotic agents). A fall was identified as an unexpected unintentional change in position which causes an individual to remain in a lower level in relation to the initial position. The history of self-reported falls during the previous 24 months, and clinical and anthropometric data (body mass index (BMI) and waist circumference (WC)) and bone densitometric measures were analyzed. For statistical analysis, c² trend test and the logistic regression method (odds ratio (OR)) were used for the comparison between groups of women with and without falls. RESULTS: Of the 358 women, 48.0% (172/358) had a history of falls and 17.4% (30/172) had fractures. The fall occurred indoors (at home) in 58.7% (101/172). The mean age was 53.7±6.5 years, time since menopause 5.8±3.5 years, BMI 28.3±4.6 kg/m² and WC 89.0±11.4 cm. There were differences as the occurrence of smoking and diabetes, with greater frequency among fallers vs. non-fallers, 25.6 versus 16.1% and 12.8 versus 5.9%, respectively (p<0.05). By evaluating the risk of falls in the presence of influential variables, it was observed that risk increased with current smoking status (OR 1.93; 95%CI 1.01-3.71), whereas other clinical and anthropometric variables did not influence this risk. CONCLUSIONS: In early postmenopausal women there was higher frequency of falls. Current smoking was clinical indicators of risk for falls. With the recognition of factors for falling, preventive measures become important, as the orientation of abolishing smoking