16 research outputs found
Impact of Violence against Women on Sexual and Reproductive Health: Research Protocol and Results from a Pilot Study
Objectives: Violence against women (VAW) is associated with a deterioration of endocrine function with consequences similar to those
of premature ovarian failure in women. The main objective of this study is to evaluate the hormonal repercussions of VAW and, secondly,
to analyse the cardio-metabolic, bone, cognitive, psychological, and psychosexual consequences of hypoestrogenism secondary to VAW.
Materials and Methods: A cross-sectional study will be conducted on women of any age who have suffered VAW at some point in
their lifespan, whether psychological, sexual, or physical. Clinical, hormonal, cardio-metabolic, bone, psychological, and psychosexual
parameters will be analysed. Results: The pilot study from the first 23 women show that all of them are suffering from severe sexual
dysfunction. In addition, all women reported menstrual irregularity and hypoestrogenism (including two cases of premature ovarian
failure) since the VAW episode. Conclusions: VAW is a pandemic that affects all women equally, regardless of their age, status, social
background, or education. Despite the claims made by certain groups, VAW does not depend on women, but rather it affects women and
is clearly harmful to their sexual, reproductive, and general health.Vice-rectorate for Equality of the University of Granada CTS.515-30G570000
Treatment of Female Sexual Dysfunction Due to Dyspareunia with Solid-State Vaginal Laser and Recombinant Platelet-Derived Epidermal Growth Factors: A Viable Possibility?
Objective: To examine the efficacy and safety of non-pharmacological and non-ablative options (or a combination of these) for postmenopausal
dyspareunia. Mechanism: Narrative review on non-pharmacological and non-ablative options (or a combination of these)
for postmenopausal dyspareunia. Findings in Brief: Dyspareunia is the most bothersome symptom of the genitourinary syndrome
of menopause, often complicated by decreased sexual interest and arousal. Solid-state vaginal laser (SSVL) and recombinant plateletderived
epidermal growth factors (RGFs) are new alternatives are new alternatives that improve female sexual dysfunction resulting from
dyspareunia. Conclusions: SSVL is a new alternative the treatment of postmenopausal dyspareunia either alone or in combination with
other alternatives with efficacy and safety similar to the classical options
Application of a new ultrasound criterion for the diagnosis of polycystic ovary syndrome
Objective: To define which ultrasound criteria could replace the classic
Rotterdam criteria as the best indicator of the risk of developing endocrine–
metabolic changes in women with polycystic ovary syndrome (PCOS).
Materials and methods: This multicenter cross-sectional study included 200
women with PCOS and one control group of 111 women without PCOS. The
primary outcomes to be considered were follicular count, hirsutism, total
testosterone levels, free androgen index (FAI), and insulin sensitivity (HOMAIR),
and the secondary outcome was the anti-Müllerian hormone (AMH) level.
Results: The main finding in this study points toward a different ultrasound
criterion—23 or more follicles of any size in at least one ovary, which is
postulated as an alternative to the classic criterion described in the
Rotterdam consensus. This criterion correlates better with the other two
PCOS criteria and also identifies women at increased risk of hirsutism
(Ferriman–Gallwey score: 6.08 ± 3.54 vs. 4.44 ± 3.75, p < 0.0001), total
testosterone levels (2.24 ± 0.298 vs. 1.42 ± 1.530, p = 0.0001), FAI
(4.85 ± 0.83 vs. 2.12 ± 1.93, p < 0.001), and insulin resistance (HOMA-IR:
1.74 ± 0.182 vs. 1.504 ± 0.230, p = 0.001) more accurately. Regarding AMH,
large differences in their mean values were observed between the groups (7.07
vs. 4.846 ng/ml, p = 0.000). However, these differences depended on age.
Conclusion: The ovarian ultrasound examination with 23 or more follicles of
any size in any of the ovaries constitutes a powerful tool to accurately diagnose
PCOS and to associate it with metabolic–endocrine processes such as
hyperandrogenism and insulin resistance
Observer Influence with Other Variables on the Accuracy of Ultrasound Estimation of Fetal Weight at Term
Background and Objectives: The accuracy with which the estimation of fetal weight (EFW)
at term is determined is useful in order to address obstetric complications, since it is a parameter
that represents an important prognostic factor for perinatal and maternal morbidity and mortality.
The aim of this study was to determine the role of the experienced observers with other variables
that could influence the accuracy of the ultrasound used to calculate EFW at term, carried out within
a period of seven days prior to delivery, in order to assess interobserver variability. Materials and
Methods: A cross-sectional study was performed including 1144 pregnancies at term. The validity
of the ultrasound used to calculate EFW at term was analyzed using simple error, absolute error,
percentage error and absolute percentage error, as well as the percentage of predictions with an
error less than 10 and 15% in relation to maternal, obstetric and ultrasound variables. Results: Valid
predictions with an error less than 10 and 15% were 74.7 and 89.7% respectively, with such precision
decreasing according to the observer as well as in extreme fetal weights. The remaining variables
were not significant in ultrasound EFW at term. The simple error, absolute error, percentage error
and absolute percentage error were greater in cases of extreme fetal weights, with a tendency to
overestimate the low weights and underestimate the high weights. Conclusions: The accuracy of
EFW with ultrasound carried out within seven days prior to birth is not affected by maternal or
obstetric variables, or by the time interval between the ultrasound and delivery. However, accuracy
was reduced by the observers and in extreme fetal weights
Sexuality in Postmenopausal Women with Genital Prolapse
Background: One of the most common complaints among menopausal women concerns
changes in sexual function. This is attributed to various factors, including anatomical defects in the
genital tract, with pelvic organ prolapse (POP) being one of the most prevalent problems affecting
women during this stage of their lives. Additionally, symptoms resulting from gonadal hypofunction
can also contribute to the development of sexual dysfunction during menopause. This research
aimed to explore the way in which postmenopausal patients with POP experienced their sexuality
in our setting. Methods: To achieve the proposed objective, we conducted a descriptive, crosssectional
study involving a total of 133 postmenopausal women with POP. Results: The results of
our series are consistent with the scarce literature available in our setting and suggest a high rate of
sexual dysfunction in postmenopausal patients with POP. Conclusions: We can conclude that POP is
associated with the presence of female sexual dysfunctio
The AHAWOMEN project: study protocol of a multi‑design research for exploring HAPA predictors of exercise in postmenopausal women
This research is funded by FEDER/Junta de Andalucía — Consejería de Transformación Económica, Industria, Conocimiento y Universidades (I + D + I Programa Operativo FEDER de Andalucía 2014–2020). Research Project B-CTS-342-UGR20 (2021–23).
This research project has obtained formal ethical review by the Ethics Committee on Human Research of the University of Granada (Spain), reg. B-CTS-342-UGR20 (17/11/2021) and has undergone independent peer-review from the funding body (29/07/2021).
The funding body has no role in the design of the study, the collection, analysis and interpretation of data and the writing of the manuscript.Background
The postmenopausal period can represent an opportunity for women to improve their health and well-being. The Active and Healthy Ageing in Women during early postmenopause (AHAWOMEN) study aims to identify the key determinants of an active lifestyle among middle-aged women, with a focus on the stages and the social-cognitive variables outlined in the Health Action Process Approach (HAPA) model, a theoretical framework for understanding health behaviour change. We expected that HAPA factors and processes of intention creation (motivational phase) and action adoption (volitional phase) will be significant predictors of exercise initiation and maintenance, supporting both the HAPA tenets and the efficacy of HAPA-based interventions.
Methods/design
This study was approved by the authors’ Institutional Review Committee. Postmenopausal women aged between 45 and 65 years will voluntarily participate. The participants will be allocated to one of three groups: Intervention-Initiators (n = 100, random allocation), Control-Sedentary (n = 100, random allocation) or Control-Active (n = 100, non-random allocation). The intervention group will engage in a supervised exercise programme lasting at least 3 months, supplemented with a HAPA-based intervention for behaviour change. The sedentary control group will not receive any intervention to change their physical activity, while the active control group will consist of women who are already regularly adhering to an active lifestyle. Study variables will be measured at baseline and postintervention phases, as well as at 1, 3, 6 and 12-month follow-ups. The predictors of exercise behaviour in the different phases of the behavioural change process will be explored and compared within and between groups throughout the study. These analyses will help identify the factors that determine the adoption of a healthy active behaviour. Additionally, the effectiveness of the model and the intervention for changing active behaviour will be evaluated.
Discussion
This paper describes the rationale, development and methods used in the AHAWOMEN project. Supporting women who intend to become active can help them to translate their goals into sustainable action. Verifying that the HAPA predictions are applicable to postmenopausal women’s adoption of exercise would provide the basis for designing effective interventions for promoting healthy and active ageing that are also tailored to the experiences of middle-aged women.FEDER/Junta de Andalucía
B-CTS-342-UGR20University of Granada B-CTS-342-UGR2
Relationship of breast volume, obesity and central obesity with different prognostic factors of breast cancer
The objective of this study was to investigate whether the BC tumor biology in women with larger
breast volume, in obese women and especially in women with central adiposity at the moment of
diagnosis of BC is more aggressive than in those women without these characteristics. 347 pre- and
postmenopausal women with a recent diagnosis of BC were analyzed. In all patients, anthropometric
measurements at the time of diagnosis was collected. In 103 of them, the breast volume was
measured by the Archimedes method. The Breast volume, BMI, WHR and the menopausal status
were related to different well-known pathological prognostic factors for BC. At the time of diagnosis,
35.4% were obese (BMI > 30 kg/m2), 60.2% had a WHR ≥ 0.85, 68.8% were postmenopausal and 44.7%
had a breast volume considered "large" (> 600 cc). Between patients with a large breast volume, only
a higher prevalence of ER (+) tumors was found (95.3% vs. 77.2%; p = 0.04) compared to those with
small breast volumes. The obese BC patients showed significantly higher rates of large tumors (45.5%
vs. 40.6%; p = 0.04), axillary invasion (53.6% vs. 38.8%; p = 0.04), undifferentiated tumors (38.2%
vs. 23.2%) and unfavorable NPI (p = 0.04) than non-obese women. Those with WHR ≥ 0.85 presented
higher postsurgical tumor stages (61.7% vs. 57.8%; p = 0.03), higher axillary invasion (39.9% vs.
36.0%; p = 0.004), more undifferentiated tumors (30.0% vs. 22.3%; p = 0.009), higher lymphovascular
infiltration (6.5% vs. 1.6%; p = 0.02), and a higher NPI (3.6 ± 1.8 vs. 3.2 ± 1.8; p = 0.04). No statistically
significant differences were found according to menopausal status. We conclude that obesity, but
especially central obesity can be associated with a more aggressive tumour phenotype. No relation
between breast volume and tumoral prognostic factors was found, except for a higher proportion of
ER (+) tumor in women with higher breast volume