Menopausal symptoms and associated factors in HIV-positive women

Orientador: Lúcia Helena Simões da Costa Paiva, Ana Lúcia Ribeiro ValadaresDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Introdução: Com o surgimento da terapia antirretroviral ocorreu significativa queda da mortalidade por doenças relacionadas ao HIV, transformando assim esta infecção em uma doença crônica. Com o envelhecimento, maior sobrevida da população infectada e, também, pelo surgimento de novos casos na faixa etária climatérica, tem havido aumento significativo na prevalência de mulheres portadoras desse vírus em idade mais avançada. Estudos atuais sugerem que estas mulheres experimentam a menopausa e o climatério de forma diferente das mulheres soronegativas, tanto pela idade mais precoce da menopausa, quanto por sintomas mais intensos. Objetivo: Em mulheres HIV soropositivas avaliar os sintomas climatéricos e fatores associados. Sujeitos e métodos: Realizou-se um estudo de corte transversal em 537 mulheres, entre 40 e 60 anos, sendo 273 HIV soropositivas e 264 soronegativas. Todas foram submetidas à entrevista para avaliação das características sociodemográficas e sintomas climatéricos. Resultados: A média etária foi 47,7±5,8 anos nas mulheres HIV soropositivas e 49,8±5,3 anos nas soronegativas (p<0,001). Análise bivariada mostrou menor prevalência de sintomas vasomotores no grupo soropositivo (p=0,009), especificamente fogachos (p<0,002) e sudorese (p=0,049). Ressecamento vaginal também foi menos prevalente no grupo soropositivo (p<0,005). Depressão e insônia não apresentaram diferença estatística. Análise múltipla mostrou que os fogachos estiveram associados a estar na peri ou pós-menopausa (RP=2,12, IC95% 1,52-2,94). Ressecamento vaginal foi menos frequente em mulheres sem companheiro (RP=0,67, IC95% 0,49-0,90), e esteve associado à maior idade (RP=1,03, IC95% 1,01-1,06) e a estar na peri e pós-menopausa (RP=1,69, IC95% 1,10-2,60). Depressão esteve inversamente associada com realizar trabalho (RP=0,74, IC95% 0,58-0,96) e diretamente associada à presença de doenças crônicas (RP=1,30, IC95% 1,01-1,067). Insônia esteve associada ao IMC (RP=0,96, IC95% 0,95-0,97) e à peri ou pós-menopausa (RP=1,48, IC95% 1,11-1,97). O estado sorológico em relação ao HIV não esteve associado a nenhum dos sintomas climatéricos avaliados. Conclusões: A infecção pelo HIV nos grupos estudados não se associou aos sintomas vasomotores, geniturinários, psicológicos e insôniaAbstract: Introduction: The advent of antiretroviral therapy (ART) significantly decreased the mortality caused by HIV-related diseases, transforming this condition into a chronic disease. With the aging of the infected population, the prevalence of HIV in older women increased significantly, a fact that is attributed both to the greater survival of those infected and to the appearance of new cases of the disease in climacteric individuals. Current studies suggest that these women experience menopause differently than seronegative women, trying earlier age of menopause and larger symptomatology. Objective: To evaluate menopausal symptoms and their associated factors in HIV-positive women. Methods: A cross-sectional study was conducted with 537 women of 40-60 years of age, 273 of whom were HIV-positive and 264 HIV-negative. The women were interviewed to obtain data on their sociodemographic characteristics and menopausal symptoms. Results: The mean age of the seropositive women was 47.7 ± 5.8 years compared to 49.8 ± 5.3 for the seronegative women (p<0.001). Bivariate analysis showed a lower prevalence of vasomotor symptoms in the seropositive group (p=0.009), specifically hot flashes (p<0.002) and sweating (p=0.049). Vaginal dryness was also less prevalent in this group (p<0.005). There were no statistically significant differences between the groups with respect to depression or insomnia. Multiple analyses showed that hot flashes were associated with being peri- or postmenopausal (PR=2.12; 95%CI: 1.52-2.94). Vaginal dryness was less common in women without a partner (PR=0.67; 95%CI: 0.49-0.90) and was associated with older age (PR=1.03; 95%CI: 1.01-1.06) and being in the peri- or post menopause (PR=1.69; 95%CI: 1.10-2.60). Depression was inversely associated with being employed (PR=0.74; 95%CI: 0.58-0.96) and directly associated with the presence of chronic diseases (PR=1.30; 95%CI: 1.01-1.067). Insomnia was associated with a lower body mass index (PR=0.96; 95%CI: 0.95-0.97) and with being peri- or postmenopausal (PR=1.48; 95%CI: 1.11-1.97). No correlation was found between HIV serological status and any of the menopausal symptoms. Conclusions: In this study, after controlling for confounding variables, HIV infection was not found to be associated with vasomotor, genitourinary or psychological symptoms or with insomniaMestradoFisiopatologia GinecológicaMestre em Ciências da Saúd

PSEUDO-HERMAFRODITISMO MASCULINO EM CÃO DA RAÇA AMERICAN PIT-BULL TERRIER

Foi atendido, no Hospital Veterinário-UNESP Jaboticabal, um cão da raça American Pit Bull Terrier, de sete meses de idade, apresentando comportamento sexual masculino exacerbado, apesar de fenótipo feminino. Ao exame clínico e posteriormente cirúrgico, constatou-se a presença de testículos e clitóris peniano. Alguns exames complementares foram realizados como radiografia pélvica e cariótipo, confirmando um caso de pseudo-hermafrodita masculino 78 XY cromossomos. PALAVRAS-CHAVES: American Pit Bull Terrier, cão, pseudo-hermafroditismo

Factors associated with menopausal symptoms in women from a metropolitan region in southeastern Brazil: a population-based household survey

To determine the average age at the onset of menopause and to investigate menopausal symptoms in women in a metropolitan region in Southeastern Brazil. A descriptive, exploratory, cross-sectional study was conducted with 749 women (a population-based household survey). The dependent variable was the intensity of menopausal symptoms assessed by th Menopause Rating Scale (MRS). The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and gynecological background. Statistical analysis was carried out by the χ2 test and Poisson regression using the backward selection criteria. The mean age of the women was 52.5 (± 4.4) years. With regard to menopausal status, 16% were premenopausal, 16% perimenopausal and 68% postmenopausal. The mean age at the onset of menopause was 46.5 (± 5.8) years. The intensity of menopausal symptoms was defined according to the median MRS score and was considered severe for values ​​above 8. Depression/anxiety (PR = 1.8; 95%CI 1.5-2.2; p 1 (PR 1.2; 95%CI 1.02-1.4; p < 0.01) and asthma (PR 1.2; 95%CI 1.01-1.4; p < 0.01) were associated with more severe menopausal symptoms. Older age (PR 0.96; 95%CI 0.96-0.97; p < 0.01) was associated with less severe symptoms. The severity of menopausal symptoms was related to a wild range of factors, especially presence of chronic diseases, a larger number of pregnancies, use of hormone therapy, and worse self-rated health. A better understanding of these factors can help to reduce the impact of symptoms on quality of life, and to identify groups of women who are likely to need more care during and beyond menopause.To determine the average age at the onset of menopause and to investigate menopausal symptoms in women in a metropolitan region in Southeastern Brazil. A descriptive, exploratory, cross-sectional study was conducted with 749 women (a population-based hous374152158FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO2011/14526-

Climacteric symptoms among brazilian middle-aged women : a populational household survey

Orientadores: Adriana Orcesi Pedro, Lucia Helena Simões Costa PaivaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Introdução: A menopausa é a interrupção permanente não cirúrgica das menstruações nas mulheres, e normalmente ocorre por entre 40 e 60 anos de idade. O climatério é o período de transição da fase reprodutiva para o período não reprodutivo, e é associado a flutuação dos níveis hormonais e caracterizado por uma série de sintomas físicos e psicológicos, como ciclos menstruais irregulares, sintomas vasomotores, alterações de humor ou cognição e disfunção sexual. Objetivos: Avaliar a idade à menopausa, prevalência e os fatores associados aos sintomas climatéricos e aos seus diferentes domínios em mulheres da região metropolitana de Campinas. Métodos: Realizou-se um estudo de corte-transversal de base populacional, entre setembro de 2012 e junho de 2013, com 749 mulheres entre 45 e 60 anos residentes na Região Metropolitana de Campinas. As variáveis dependentes foram a intensidade dos sintomas menopausais e em seus diversos domínios avaliadas através do questionário Menopause Rating Scale (MRS). As variáveis independentes foram características sociodemográficas, problemas e hábitos de saúde, auto-percepção de saúde e antecedentes ginecológicos. A análise estatística foi realizada através do teste do qui-quadrado e regressão de Poisson. Resultados: A média etária das mulheres entrevistadas foi 52,5 (±4,4) anos. Com relação ao estado menopausal, 16% das mulheres encontravam-se na pré-menopausa, 16% na perimenopausa e 68% estavam na pós-menopausa. A média de idade de ocorrência da menopausa foi 46,5 ± 5,8 anos. A intensidade dos sintomas menopausais foi definida de acordo com a mediana do escore total do MRS e de seus domínios. Foi considerada severa para valores do escore total do MRS acima de oito, e para valores acima de três, dois e um para sintomas somatovegetativos, psicológicos e genitourinários, respectivamente. Depressão/ansiedade (RP=1,82, IC95% 1,49-2,21, p<0,01), doenças osteoarticulares (RP=1,46, IC95% 1,23-1,73, p<0,01), auto-percepção do estado geral de saúde regular, ruim ou péssimo (RP=1,44, IC95% 1,21-1,72, p<0,01), estar na perimenopausa ou pós-menopausa (RP=1,38, IC95% 1,08-1,76, p=0,01), antecedente de algum aborto (RP=1,26, IC95% 1,09-1,47, p<0,01), tratamento atual ou prévio para sintomas da menopausa (RP=1,23, IC95% 1,06-1,43, p<0,01), asma (RP=1,21, IC95% 1,01-1,45, p=0,03) e dois ou mais partos normais (RP=1,19, IC95% 1,02-1,39, p=0,02) associaram-se a maior severidade de sintomas menopausais totais. Apresentar maior idade (RP=0,96, IC95% 0,96-0,97, p<0,01) associou-se a menor intensidade de sintomas totais da menopausa. Os fatores associados a sintomas somatovegetativos mais severos foram antecedente tuberculose (RP=1,65, IC95% 1,23-2,22, p=0.001), auto-percepção do estado geral de saúde regular, ruim ou péssimo (RP=1,57, IC95% 1,36-1,81, p<0,001), doenças osteoarticulares (RP=1,44, IC95% 1,27-1,63, p<0,001), depressão ou ansiedade (RP=1,23, IC95% 1,04-1,45, p=0,016), histerectomia prévia (RP=1,23, IC95% 1,03-1,47, p=0,024), história de algum aborto (RP=1,21, IC95% 1,03-1,42, p=0,018), mais de um parceiro sexual durante a vida (RP=1,19, IC95% 1,01-1,39, p=0,033) e tratamento atual ou prévio para sintomas da menopausa (RP=1,18, IC95% 1,02-1,35, p=0,025). Realizar exercícios físicos (RP=0,81, IC95% 0,68-0,95, p=0,012) esteve associado a sintomas somatovegetativos mais brandos. Os fatores associados a sintomas psicológicos mais severos foram depressão ou ansiedade (RP=2,05, IC95% 1,69-2,50, p<0,001), auto-percepção do estado geral de saúde regular, ruim ou péssimo (RP=1,46, IC95% 1,24-1,72, p<0,001), doenças osteoarticulares (RP=1,24, IC95% 1,06-1,45, p=0,007), dislipidemia (RP=1,23, IC95% 1,06-1.42, p=0.005) e tabagismo atual ou prévio (RP=1,19, IC95% 1,04-1,35, p=0,010). Apresentar maior idade (RP=0,97, IC95% 0,97-0,98, p<0,001) esteve relacionado com sintomas psicológicos menos severos. Os fatores associados a sintomas urogenitais mais severos foram a presença de parceiro (RP=1,56, IC95% 1,25-1,72, p=0,001), estar na peri ou pós-menopausa (RP=1,48, IC95% 1,10-1,99, p=0,010), auto-percepção do estado geral de saúde regular ruim ou péssima (RP=1,47, IC95% 1,25-1,72, p<0,001), depressão ou ansiedade (RP=1,32, IC95% 1,09-1,59, p=0,004) e presença de doenças osteoarticulares (RP=1,29, IC95% 1,10-1,52, p=0,002). Infarto do miocárdio prévio (RP=0,38, IC95% 0,18-0,80, p=0,011) e estrato socioeconômico categorias C, D ou E (RP=0,82, IC95% 0,69-0,98, p=0,027) estiveram associados a sintomas urogenitais menos severos. Conclusão: A intensidade dos sintomas menopausais está relacionada a um amplo conjunto de fatores. A despeito da prevalência considerável dos sintomas, fatores clínicos tiveram mais relação com maior intensidade de sintomas, evidenciando que um cuidado clínico multidisciplinar apropriado é altamente recomentado para manejo adequado das mulheres durante o período climatéricoAbstract: Introduction: Menopause is the permanent non-surgical cessation of menstruation, usually occurring between 40 and 60 years of age. Climacteric is the period of transition from reproductive to non-reproductive period, and it is associated with fluctuation of hormonal levels, and can be characterized by a series of physical and psychological symptoms such as irregular menstrual cycles, vasomotor symptoms, mood or cognition variations and sexual dysfunction. Objective: To determine the average age of menopause onset, prevalence and associated factors of severe climacteric symptoms and its domains in women in Campinas Metropolitan Region. Methods: A cross-sectional population-based household study was conducted between September 2012 and June 2013, with 749 women aged 45-60 years old living at Campinas Metropolitan Region. The dependent variable was the intensity of global menopausal symptoms and its domains assessed using MRS (Menopause Rating Scale). The independent variables were sociodemographic data, health related habits and problems, self-perception of health, and gynecological background. Statistical analysis was carried out by Chi-square test and Poisson regression using the backward selection criteria. Results: The mean age of the women was 52.5 (±4.4) years. With regard to menopausal status, 16% were premenopausal, 16% perimenopausal and 68% postmenopausal. The mean age of menopause occurrence was 46.5 (±5.8) years. The intensity of menopausal symptoms was defined according to the median of the total score of MRS and its domains. It was considered severe for total values above eight, and for values above three, two and one for somato-vegetative, psychological and urogenital symptoms respectively. Depression/anxiety (PR=1.82, 95%CI 1.49-2.21, p<0.01), rheumatic diseases (PR=1.46, 95%CI 1.23-1.73, p<0.01), self-perception of health as fair/poor/very poor (PR=1.44, 95%CI 1.21-1.72, p<0.01), perimenopausal or postmenopausal status (PR=1.38, 95%CI 1.08-1.76, p<0.01), history of abortion (PR=1.26, 95%CI 1.09-1.47, p<0.01), current or previous treatment for menopausal symptoms (PR=1.23, 95%CI 1.06-1.43, p<0.01), asthma (PR1.21, 95%CI 1.01-1.45, p<0.01) and number of normal deliveries ? 2 (PR=1.19, 95%CI 1.02-1.39, p<0.01) were associated with more severe global menopausal symptoms. Older age (PR=0.96, 95%CI 0.96-0.97, p<0.01) was associated with less severe global symptoms. Factors associated with moderate to severe somato-vegetative symptoms were history of tuberculosis (PR=1.65, 95%CI 1.23-2.22, p=0.001), self-perceived health status fair, poor or very poor (PR=1.57, 95%CI 1.36-1.81, p<0.001), osteoarticular diseases (PR=1.44, 95%CI 1.27-1.63, p<0.001), depression or anxiety (PR=1.23, 95%CI 1.04-1.45, p=0.016), prior hysterectomy (PR=1.23, 95%CI 1.03-1.47, p=0.024), history of abortion (PR=1.21, 95%CI 1.03-1.42, p=0.018), more than one sexual partner over a lifetime (PR=1.19, 95%CI 1.01-1.39, p=0.033) and current or previous treatment for menopause (PR=1.18, 95%CI 1.02-1.35, p=0.025). Physical exercises (PR=0.81, 95%CI 0.68-0.95, p=0.012) were associated to less severe somatic symptoms. Factors associated with moderate to severe psychological symptoms were depression or anxiety (PR=2.05, 95%CI 1.69-2.50, p<0.001), self-perceived health status fair, poor or very poor (PR=1.46, 95%CI 1.24-1.72, p<0.001), osteoarticular diseases (PR=1.24, 95%CI 1.06-1.45, p=0.007), dyslipidemia (PR=1.23, 95%CI 1.06-1.42, p=0.005) and current or previous smoking (PR=1.19, 95%CI 1.04-1.35, p=0.010). Older age (PR=0.97, 95% CI 0.97-0.98, p<0.001) was associated with less severe psychological symptoms. Factors associated with moderate to severe urogenital symptoms were have a partner (PR=1.56, 95%CI 1.25-1.72, p=0.001), perimenopausal or postmenopausal status (PR=1.48, 95%CI 1.10-1.99, p=0.010), self-perceived health status fair, poor or very poor (PR=1.47, 95%CI 1.25-1.72, p<0.001), depression or anxiety (PR=1.32, 95%CI 1.09-1.59, p=0.004) and osteoarticular diseases (PR=1.29, 95%CI 1.10-1.52, p=0.002). Previous myocardial infarction (PR=0.38, 95%CI 0.18-0.80, p=0.011) and socioeconomical status categories C, D or E (PR=0.82, 95%CI 0.69-0.98, p=0.027) were associated with less severe urogenital symptoms. Conclusion: The severity of menopausal symptoms was related to a wild range of factors. Despite the considerable symptom prevalence, clinical factors were more related to severity of symptoms showing an evidence of appropriate clinical multidisciplinary care is highly recommended for adequate management of women during climacteric periodDoutoradoFisiopatologia GinecológicaDoutor em Ciências da Saúde2011/14526-9FAPES

Middle-aged Female Sexual Dysfunction And Multimorbidity: A Population-based Study.

The aim of the study was to evaluate the association between multimorbidity and sexual dysfunction in women aged 45 to 60 years in a cross-sectional population-based study in a specific Brazilian city. It was also to evaluate the main factors associated with sexual dysfunction in the group with multimorbidity. Cross-sectional population-based study conducted with 736 women (household survey), representative of a population of 257,434 women, to obtain data on multimorbidity and sexual dysfunction, as part of a broader study on women's health. The instrument used to evaluate sexual dysfunction was the Short Personal Experiences Questionnaire. Associations were determined between multimorbidity and sexual dysfunction and sexual dysfunction and demographic, behavioral, and medical characteristics. 53% of the women reported multimorbidity and 49.6% of them reported sexual dysfunction. Multiple regression analysis showed no association between sexual dysfunction and multimorbidity. Sexual dysfunction in the whole sample (with and without multimorbidity) was associated with sexual activity in the last month (prevalence ratio [PR] = 0.27, 95% CI 0.22-0.33, P < 0.001), having physical activity greater than or equal to 2 times a week (PR = 0.70, 95% CI 0.58-0.84, P < 0.001), menopause rating symptoms greater than 8 (PR = 1.25, 95% CI 1.09-1.43, P = 0.002), perimenopausal or postmenopausal status (PR = 1.57, 95% CI 1.13-2.17, P = 0.007), alcohol use greater than or equal to 1 drink/week (PR = 0.81, 95% CI 0.67-0.97, P = 0.025), and anxiety (PR = 1.15, 95% CI 1.01-1.31, P = 0.039). In the group with multimorbidity, the main factors associated with sexual dysfunction were sexual activity in the last month (PR = 0.31, 95% CI 0.25-0.39, P < 0.001), anxiety (PR = 1.33, 95% CI 1.15-1.53, P < 0.001), and physical activity (PR = 0.70, 95% CI 0.56-0.87, P = 0.002). There was no evidence that multimorbidity was associated with sexual dysfunction in this sample of middle-aged women. The main factors associated with sexual dysfunction in women with multimorbidity in this sample were lack of sexual activity in the last month, physical inactivity, and anxiety. This highlights the importance of sexual activity, psychological health, and physical activity for a satisfactory sexual life in the case of women with multimorbidity.2

Medication use and climacteric syndrome : a cross-sectional population-based study

The aim of this study was to evaluate medication use during the climacteric period and assess its association with sociodemographic factors, morbidities, and climacteric symptoms. Secondary analysis of data from a previous exploratory cross-sectional population-based study, conducted with 749 women (45-60 y), with the help of home interviews. Associations between medication use and climacteric symptoms were analyzed, and their correlations with other variables were made. Univariate analysis was made using the chi(2) test, followed by Bonferroni correction (multiple comparison method). Values were adjusted for age using the polytomic logistic multivariate regression analysis. Using Poisson regression analysis, simple and multiple, we identified the main factors for medication use, with forward stepwise variable selection criteria (95% CI). The mean age was 52.5 years and menopause occurred at 46.5 years (mean). The overall prevalence of medication use was 68.8%. The use of exclusive medications for relieving climacteric symptoms was associated with the absence of diseases (prevalence ratio [PR] = 8.2; 95% CI = 3.5-18.9; P3 (PR = 1.4; 95% CI = 1.01-1.96; P = 0.044). The prevalence of medication use among middle-aged women was high and was associated with the age of menopause onset, chronic diseases, and obesity/overweight status261011331140FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2011/14526-

Medication use and sexual function: a population-based study in middle aged women

Medications used to treat chronic diseases have contributed to increasing longevity and improving quality of life. These medications are considered an indispensable resource in the management of most treatable diseases. However, they can affect sexual function through their effects on the central or the peripheral nervous system or due to hormonal effects. Aim: To evaluate the association between the use of medication for chronic diseases and sexual dysfunction in Brazilian women 45-60 years of age. Methods: A secondary analysis of household survey data from a previous cross-sectional, population-based study conducted with a sample of 749 women of a population of 257,434 female urban residents in the age bracket of interest. Sexual function was evaluated using the Short Personal Experiences Questionnaire (SPEQ). Associations between the use of medication and sexual function were evaluated, as were correlations with other variables. Main Outcome Measure: We found associations of the individual SPEQ domains with the use of some medications. Results: Mean age of participants was 52.5 +/- 4.4 years. Mean age at menopause was 46.5 +/- 5.8 years. The overall prevalence of medication use was 68.8%, with the drugs predominantly consisting of those used for cardiovascular diseases. In the Poisson regression analysis, sexual dysfunction, as based on the overall SPEQ score, was associated with sexual inactivity (prevalence ratio [PR] = 4.05; 95% CI 3.16-d5.20; P <.001), a sedentary lifestyle (PR = 1.49; 95% CI 1.06-2.09; P =.021), and untreated anxiety (PR = 1.44; 95% CI 1.08-1.92; P =.014). Analysis of the individual SPEQ domains revealed that women who scored low in the desire domain were more likely to use antihypertensive agents (P =.019), whereas a lower score for the arousal domain was associated with the use of antidepressants, with treatment for osteoarticular diseases and with polypharmacy (P =.003). Women with lower scores in the satisfaction domain were more likely to use antidepressants, drugs for osteoarticular diseases, diabetes medication, and polypharmacy (P =.019). A lower score in the orgasm domain was associated with the use of antidepressants, the treatment of osteoarticular diseases, and diabetes (P<.001). Hormone therapy proved protective against loss of libido (P =.036). Clinical Implications: Some medications can interfere with sexual function negatively and, clinicians have to be aware of it to choose the treatment with fewer collateral effects. Strength & Limitations: The strength of our study is the large, population-based sample of middle-aged women evaluated for sexual dysfunction with the SPEQ. However, it was a self-reported cross sectional study. Conclusion: This study found no association between the use of medication for chronic diseases and the overall SPEQ score, whereas untreated anxiety was 1 of the main factors associated with female sexual dysfunction. On the other hand, medical treatments were found to contribute to lower scores in the different sexual function domains. Common drug culprits included antihypertensives, antidepressants, treatment for osteoarticular disease, diabetes medications, and polypharmacy. Hormone therapy protected against loss of libido16913711380FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPES

Opinions and main sources of information about menopause among middle-aged brazilian women

The aim of this study was to evaluate women's opinions about menopause and the sources of information they use to deepen their understanding of the topic. Population-based study with 749 Brazilian women aged 45 to 60 years. The answers to the question "What is menopause?" were typed and coded, and categories that emerged from the interviewees' own speech were created. The answers to the question: "Where or from whom did you get information about menopause?" were also analyzed. The mean age of women was 52.5 (+/- 4.4) years. Of them, 68% were postmenopausal. According to 67.5% of the interviewees, the concept of menopause encompassed changes in the menstrual cycle and hormones. For 48%, menopause meant physical changes such as "hot flushes and vaginal dryness." For 22.7%, menopause represented psychological changes. The concept of menopause was associated with some change in sexuality for 7.6% of the interviewees. Approximately 18% could not explain what menopause meant. Regarding the sources of information, 44.5% of the women attributed this knowledge to friends and relatives. Doctors or health services were mentioned by 44.3% of women. Television or radio was cited by 22.0%; magazines, newspapers, or books were cited by 14.0%; and the Internet was cited by 6.8% of women. Fifty-two women (6.9%) reported having no source of information about menopause. Most of the interviewees relate the term "menopause" to physiological events. There seems to be a suppressed demand for information on the various aspects of the menopausal transition among middle-aged Brazilian women261011541159FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2011/14526-

Effect of stocking density on the performance of growing rabbits

This experiment evaluated the effect of an increase in stocking density on the performance of growing rabbits. Eighty New Zealand White rabbits were used in an entirely randomized experimental design with four treatments and four repeats. The evaluated densities were: 4.16, 8.33, 12.5 and 16.67 rabbits/m2. Weight gain, feed consumption, food conversion, meat production per m2 and economic viability were studied. No differences were observed (P>0.05) among the densities with regard to food conversion, final weight, and weight gain. The increase in stocking density reduced (P<0.05) the daily feed consumption, which was smaller in the animals grown in the highest evaluated density. There was an increase (P<0.01) in the meat production per square meter due to the higher density, and consequently an increase in gross income and operational profit. It was concluded that the greatest density evaluated (16.67 rabbits/m2) could be adopted, because it reduced the feed consumption and increased the total meat production and operational profit