Factors associated with the severity of menopausal symptoms in postmenopausal Brazilian women

AbstractPurposesTo identify the socio-demographic and anthropometric profile and correlate them with the severity of menopausal symptoms in postmenopausal women.MethodsCross-sectional study with 201 postmenopausal women attended in a Gynecology Outpatient Department in Rio de Janeiro city (RJ, Brazil). A questionnaire was applied for collection of demographic, socioeconomic, clinical and lifestyle variables. The Blatt–Kupperman Menopausal Index was used to evaluate the menopausal symptoms.ResultsWomen with moderate to severe symptoms (≥20) corresponded to 57.7% (116) of the sample. Obesity was not associated with the severity of menopausal symptoms (p<0.90). Severe to moderate symptoms were inversely associated with age (PR 0.96; CI 95% 0.94–0.99; p<0.01). Women within 6–10 years of menopause presented nearly 1.4 times higher prevalence of moderate to severe symptoms compared with those with more than 10 years of menopause. Unemployed women (PR 1.52; CI 95% 1.13–2.04; p<0.01) and housewives (PR 1.53; CI 95% 1.12–2.09; p<0.01) presented higher prevalence of menopausal symptoms compared with working women. Tobaccoism was associated with higher prevalence of moderate to severe symptoms (p<0.01).ConclusionsAge constituted a protection factor for moderate to severe symptoms, whereas having within 6–10 years of menopause, smoking and being unemployed or a housewife were factors related to higher prevalence of moderate to severe menopausal symptoms

Ratas esqueleticamente maduras são um modelo satisfatório para estudar osteoporose?

OBJECTIVE: To analyze if female Wistar rats at 56 weeks of age are a suitable model to study osteoporosis. MATERIALS AND METHODS: Female rats with 6 and 36 weeks of age (n = 8 per group) were kept over a 20-week period and fed a diet for mature rodents complete in terms of Ca, phosphorous, and vitamin D. Excised femurs were measured for bone mass using dual-energy x-ray absorptiometry, morphometry, and biomechanical properties. The following serum mar-kers of bone metabolism were analyzed: parathyroid hormone (PTH), osteocalcin (OC), osteoprotegerin (OPG), receptor activator of nuclear factor &#922;appa B ligand (RANKL), C-terminal peptides of type I collagen (CTX-I), total calcium, and alkaline phosphatase (ALP) activity. RESULTS: Rats at 56 weeks of age showed important bone metabolism differences when compared with the younger group, such as, highest diaphysis energy to failure, lowest levels of OC, CTX-I, and ALP, and elevated PTH, even with adequate dietary Ca. CONCLUSION: Rats at 26-week-old rats may be too young to study age-related bone loss, whereas the 56-week-old rats may be good models to represent the early stages of age-related changes in bone metabolism.OBJETIVO: Avaliar se ratas Wistar com 56 semanas de idade são um modelo satisfatório para estudar osteoporose. MATERIAIS E MÉTODOS: Ratas com 6 e 36 semanas de idade (n = 8 por grupo) foram criadas por um período de 20 semanas e alimentadas com dieta completa em Ca, fósforo e vitamina D para ratas adultas. Os fêmures foram analisados quanto à massa óssea pela técnica de absortiometria por dupla fonte de raios-X, morfometria e propriedades biomecânicas; os marcadores séricos do metabolismo ósseo analisados foram paratormônio (PTH), osteocalcina (OC), osteoprotegerina (OPG), fator receptor ativador nuclear &#922;appa B ligante (RANKL), peptídeos C-terminal de colágeno tipo I (CTX-I), cálcio total e atividade da fosfatase alcalina (FA). RESULTADOS: As ratas com 56 semanas de vida apresentaram uma importante diferença no metabolismo ósseo quando comparadas ao grupo das ratas jovens, como, por exemplo, maior energia para quebrar a diáfise do fêmur, menores níveis de OC, CTX-I e ALP e maiores níveis de PTH mesmo com dieta adequada em cálcio. CONCLUSÃO: As ratas com 26 semanas de vida podem ser consideradas muito jovens para estudar a perda óssea relacionada à idade, porém, as ratas com 56 semanas de vida podem representar um bom modelo dos estágios iniciais das alterações associadas à idade no metabolismo ósseo.25926

Depression, anxiety, suicidal ideation and female climacteric: a narrative review

Climacteric is the period in a woman’s life cycle that involves perimenopause, menopause and postmenopause. It represents the end of the reproductive period and the beginning of female aging in the biological sense. Over the past 10 years, an emphasis has been placed on the study of mental health in the female climacteric. Studies about the prevalence of depression, anxiety, suicidal ideation and association with different factors have shown important results on the relevance of these disorders during female climacteric. Considering the importance of these findings in the field of public health and epidemiology, we conducted a narrative review aiming to discuss the current knowledge about the prevalence of depression, anxiety and suicidal ideation in the female climacteric, analyzing methods and results in different studies, selected from a literature review between 2009 and 2019, in the PubMed, Lilacs, Embase, Web of Science and Google Scholar databases. Our results showed that the methodology, cultural and sociodemographic differences, as well as a variety of biopsychosocial factors studied, generate some uncertainties about the exact relationship between depression, anxiety, suicidal ideation and female climacteric. We conclude that more research, greater methodological rigor, more accurate results and a biopsychosocial view are needed and urgent for effective interventions, cost reduction in mental health care, as well as prevention and control of depression, anxiety and suicide in climacteric.Climacteric is the period in a woman’s life cycle that involves perimenopause, menopause and postmenopause. It represents the end of the reproductive period and the beginning of female aging in the biological sense. Over the past 10 years, an emphasis has been placed on the study of mental health in the female climacteric. Studies about the prevalence of depression, anxiety, suicidal ideation and association with different factors have shown important results on the relevance of these disorders during female climacteric. Considering the importance of these findings in the field of public health and epidemiology, we conducted a narrative review aiming to discuss the current knowledge about the prevalence of depression, anxiety and suicidal ideation in the female climacteric, analyzing methods and results in different studies, selected from a literature review between 2009 and 2019, in the PubMed, Lilacs, Embase, Web of Science and Google Scholar databases. Our results showed that the methodology, cultural and sociodemographic differences, as well as a variety of biopsychosocial factors studied, generate some uncertainties about the exact relationship between depression, anxiety, suicidal ideation and female climacteric. We conclude that more research, greater methodological rigor, more accurate results and a biopsychosocial view are needed and urgent for effective interventions, cost reduction in mental health care, as well as prevention and control of depression, anxiety and suicide in climacteric

Prevalência do risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres brasileiras na pós-menopausa

Observa-se uma forte tendência de envelhecimento da população mundial levando a um aumento da prevalência de doenças como a osteoporose e fraturas. O objetivo deste estudo foi determinar a prevalência de risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres na pós-menopausa, residentes na Ilha de Paquetá, Rio de Janeiro, Brasil. Realizamos medidas antropométricas e ultra-sonometria óssea de calcâneo com aparelho Sonost 2000 em 385 mulheres pós-menopausadas. Observamos que 59,22% da amostra apresentava T-score < -1, sendo que 16,88% tinham T-score < -2,5. Houve variação em todos os parâmetros do exame conforme o aumento da idade, e diferença estatisticamente significativa (p < 0,05) entre os grupos de risco para fratura por idade, tempo de menopausa, peso, IMC e percentual de gordura corpórea. Houve correlação entre velocidade do som e IMC (r = 0,155; p = 0,002). Concluímos que cerca de 60% da população feminina estudada apresenta algum grau de risco para fraturas. As mulheres do grupo de maior risco (T-score < -2,5) eram mais velhas, com maior tempo de menopausa, maior peso e IMC do que as dos outros grupos

Diabetes melito como fator associado às disfunções do trato urinário inferior em mulheres atendidas em serviço de referência The association between diabetes mellitus and lower urinary tract dysfunctions in women assisted in a reference service

OBJETIVO: Descrever as disfunções do trato urinário inferior e as características demográficas e clínicas de mulheres com queixas urinárias, estimando a prevalência de diabetes melito e de alterações urodinâmicas nestas mulheres. MÉTODOS: Estudo observacional, transversal, retrospectivo, com análise de 578 prontuários. As prevalências de diabetes melito e de cada diagnóstico urodinâmico nas pacientes com disfunções do trato urinário inferior foram estimadas, com seus respectivos intervalos de confiança de 95%. Foram calculadas as razões de prevalência das alterações urodinâmicas segundo o diagnóstico de diabetes. RESULTADOS: Setenta e sete pacientes (13,3%) eram diabéticas e a maioria (96,1%) tinha diabetes tipo 2. O diagnóstico urodinâmico mais frequente nas pacientes diabéticas foi o de incontinência urinária de esforço (39%), seguido de hiperatividade do detrusor (23,4%). A prevalência de urodinâmica alterada foi associada à de diabetes melito (RP=1,31; IC95%=1,17-1,48). As alterações de contratilidade do detrusor (hiper ou hipoatividade) estiveram presentes em 42,8% das pacientes diabéticas e em 31,5% das não diabéticas. CONCLUSÕES: As mulheres diabéticas apresentaram maior prevalência de alterações urodinâmicas do que as não diabéticas. Não houve associação entre o diabetes e as alterações de contratilidade do detrusor (p=0,80).<br>PURPOSE: to describe lower urinary tract dysfunctions and clinical demographic characteristics of patients with urinary symptoms. This study assessed the prevalence of diabetes mellitus and urodynamic changes in these women. METHODS: We conducted a cross-sectional, retrospective study on 578 women. The prevalence of diabetes mellitus and urodynamic diagnoses was assessed in patients with lower urinary tract dysfunctions, with their respective 95% confidence intervals. The prevalence ratios of urodynamic alterations were calculated according to the diabetes mellitus diagnoses. RESULTS: Seventy-seven patients (13.3%) had diabetes and type 2 diabetes was predominant (96.1%). Stress urinary incontinence was the most frequent urodynamic diagnosis (39%) in diabetic patients, followed by detrusor overactivity (23.4%). The prevalence of urodynamic alterations was associated with diabetes (PR=1.31; 95%CI=1.17-1.48). Changes in detrusor contractility (over- or underactivity) were diagnosed in 42.8% diabetic patients and in 31.5% non-diabetic patients. CONCLUSIONS: Diabetic women had a greater prevalence of urodynamic alterations than the non-diabetic ones. There was no association between diabetes mellitus and detrusor contractility alterations (p=0.80)

Diagnóstico Laboratorial do Hipogonadismo Masculino Tardio (An-dropausa)

Submitted by Lizanka Marinheiro ([email protected]) on 2015-02-06T20:27:08Z No. of bitstreams: 1 v52n9a05.pdf: 262748 bytes, checksum: 9bfd79cf3da3eff9fa9b4655b6ca5e32 (MD5)Approved for entry into archive by Santos Bárbara ([email protected]) on 2015-02-09T13:30:55Z (GMT) No. of bitstreams: 1 v52n9a05.pdf: 262748 bytes, checksum: 9bfd79cf3da3eff9fa9b4655b6ca5e32 (MD5)Approved for entry into archive by Santos Bárbara ([email protected]) on 2015-02-09T13:48:08Z (GMT) No. of bitstreams: 1 v52n9a05.pdf: 262748 bytes, checksum: 9bfd79cf3da3eff9fa9b4655b6ca5e32 (MD5)Made available in DSpace on 2015-02-09T13:48:08Z (GMT). No. of bitstreams: 1 v52n9a05.pdf: 262748 bytes, checksum: 9bfd79cf3da3eff9fa9b4655b6ca5e32 (MD5) Previous issue date: 2008Hospital da Lagoa. Rio de Janeiro, RJ, Brasil.Hospital da Lagoa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Brasil. Ministério da Saúde. Instituto Nacional de Traumato Ortopedia. Rio de Janeiro, RJ, Brasil.Diagnósticos da América. Rio de Janeiro, RJ, Brasil.Objetivos:Avaliar os fatores que influenciam o diagnóstico laboratorial do hipogonadismo masculino tardio. Métodos:Avaliamos 216 homens entre 52 e 84 anos. O diagnóstico laboratorial foi definido como dois valores de testos-terona livre calculada (TLC) <6,5 ng/dl, segundo a fórmula de Vermeulen, a partir das dosagens de testosterona total (TT), SHBG e albumina. Resultados: Na primeira dosagem, a TLC foi <6.5 ng/dl em 27% da amostra. Hipogonad-ismo laboratorial (confi rmado por duas dosagens) esteve presente em 19%, no entanto a TT foi baixa em apenas 4.1% dos homens. A idade influenciou a TT (p=0.0051) bem como o IMC; 23,5% dos homens ≥70 anos e 38,9% dos obesos com TT dentro dos níveis de referência eram, na verdade, hipogonádi-cos. Conclusão:Especialmente em homens obesos e nos ≥70 anos a dosa-gem de SHBG é importante para calcular TL e diagnosticar o hipogonadismo.Objectives: To evaluate which factors influence the laboratorial diagnosis of late-onset male hypogonadism (LOH). Methods:Total testosterone (TT), SHBG and albumin were measured in 216 men aged 52-84 years. The labora-torial definition of LOH was two values of calculated free testosterone (cFT) <6.5 ng/dl, according to Vermeulen’s formula. Results:At the first blood test, cFT was <6.5 ng/dl in 27% of the men. Laboratorial LOH (confirmed by two tests) was present in 19%, but TT levels were low in only 4.1%. Age influenced TT (p=0.0051) as well as BMI; 23.5% of patients ≥70 years and 38.9% of the obese men who had TT within the reference range were, in fact, hypogonad-al. Conclusion: Especially in obese men and in those ≥70 years old, SHBG dosage is important to calculate FT levels and diagnose hypogonadism

Prevalence of fracture risk estimated by quantitative ultrasound of the calcaneus in a population of postmenopausal women

Submitted by Jenifer Paula ([email protected]) on 2015-06-26T13:59:58Z No. of bitstreams: 1 Prevalência do risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres brasileiras na pós-menopausa.pdf: 111725 bytes, checksum: 0d8faa405ef1fbac9796a5b5c0167a95 (MD5)Approved for entry into archive by Santos Bárbara ([email protected]) on 2015-06-30T14:51:06Z (GMT) No. of bitstreams: 1 Prevalência do risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres brasileiras na pós-menopausa.pdf: 111725 bytes, checksum: 0d8faa405ef1fbac9796a5b5c0167a95 (MD5)Made available in DSpace on 2015-07-01T12:51:44Z (GMT). No. of bitstreams: 1 Prevalência do risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres brasileiras na pós-menopausa.pdf: 111725 bytes, checksum: 0d8faa405ef1fbac9796a5b5c0167a95 (MD5) Previous issue date: 2007Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Rio de Janeiro. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Observa-se uma forte tendência de envelhecimento da população mundial levando a um aumento da prevalência de doenças como a osteoporose e fraturas. O objetivo deste estudo foi determinar a prevalência de risco para fraturas estimado pela ultra-sonometria óssea de calcâneo em uma população de mulheres na pós-menopausa, residentes na Ilha de Paquetá, Rio de Janeiro, Brasil. Realizamos medidas antropométricas e ultra-sonometria óssea de calcâneo com aparelho Sonost 2000 em 385 mulheres pós-menopausadas. Observamos que 59,22% da amostra apresentava T-score < -1, sendo que 16,88% tinham T-score < -2,5. Houve variação em todos os parâmetros do exame conforme o aumento da idade, e diferença estatisticamente significativa (p < 0,05) entre os grupos de risco para fratura por idade, tempo de menopausa, peso, IMC e percentual de gordura corpórea. Houve correlação entre velocidade do som e IMC (r = 0,155; p = 0,002). Concluímos que cerca de 60% da população feminina estudada apresenta algum grau de risco para fraturas. As mulheres do grupo de maior risco (T-score < -2,5) eram mais velhas, com maior tempo de menopausa, maior peso e IMC do que as dos outros grupos.A strong aging tendency is currently being observed in the world population, leading to an increase n the prevalence of such diseases as osteoporosis and fractures. This study aimed to determine the prevalence of fracture risk, estimated by quantitative ultrasound of the calcaneus in a population of postmenopausal women residing in the Ilha de Paquetá neighborhood of Rio de Janeiro, Brazil. We conducted anthropometric measurements and quantitative ultrasound of the calcaneus using Sonost 2000 in 385 postmenopausal women. Some 59.22% of the sample showed a T-score < -1, while 16.88% had T-score < -2.5. The test parameters varied with increasing age, with a statistically significant difference (p < 0.05) between fracture risk groups according to age, time since menopause, weight, BMI, and body fat. There was a correlation between sound velocity and BMI (r = 0.155; p = 0.002). We concluded that some 60% of the female study population showed some degree of fracture risk. The women at highest risk (T-score < -2.5) were older, with more time since menopause, and had higher weight and BMI as compared to the other groups

Metabolic syndrome and sexual function in postmenopausal women

ABSTRACT Objective The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. Subjects and methods This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant’s sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. Results The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). Conclusion We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis