Actual status of veralipride use

During the climacteric period, several symptoms exist that motivate women to seek medical advice; one of the most common is the hot flush, which presents in 75%–85% of these during a variable time span. For the treatment of hot flush, several non-hormonal treatments exist; among them, veralipride has shown to be a useful treatment of vasomotor symptoms during the climacteric period. In recent times, several medical societies have discredited its use. The purpose of this review, therefore, is to define a measured position in relation to the use of this drug. On completion of this review, it was possible to conclude that this drug has an antidopaminergic mechanism of action. The recommended schedule is: 100 mg/day for 20 days, with 10 days drug free. Since the risk of undesirable secondary effects such as galactorrhea, mastodynia, and extrapyramidal can increase with use, no more than 3 treatment cycles are recommended. This drug has a residual effect that can allow drug-free intervals, which permit a longer time between schedules

Safety, efficacy and patient acceptability of drospirenone and estradiol in the treatment of menopausal vasomotor symptoms: a review

During menopause vasomotor symptoms are one of the main complaints about which women seek medical advice. For symptom control, several therapies have been used, among which hormone therapy has produced good results. One of these is estrogen monotherapy, which unfortunately may induce endometrial hyperplasia in women with an intact uterus. A progestin must be added to avoid this risk. Progestins may induce several secondary effects such as breast tenderness, hirsutism, edema and unfavorable lipid profile modifications. Recently a new progestin called drospirenone has been synthesized and used in combination with estradiol for the treatment of postmenopausal women. This progestin is derived from spironolactone, and lacks estrogenic, androgenic and glucocorticoid activities. Several studies have evaluated safety, efficacy and patient tolerability, and have shown a good profile in all these parameters. All studies agree that the combination of estradiol 1 mg plus drospirenone 2 mg is a good choice for postmenopausal women with vasomotor symptoms

Differences in the What’s My M3? test between pre- and postmenopausal women

Aim of the study : To evaluate the differences in the What’s My M3 test between pre and postmenopausal women. Material and methods: Pre- and postmenopausal women who attended an endocrine gynaecology consultation were studied. In all them, the What’s My M3? test was applied. Descriptive statistics, central tendency and dispersion measures were used. Differences between groups were assessed with Mann Whitney U test, and Spearman correlation analysis was carried out for age and time since menopause with the What's My M3? score. Results: A total of 404 patients, aged 45 to 55 years, were surveyed. Women with previous diagnosis of depressive disorder, antidepressant use, history of hysterectomy with or without bilateral salpingo-oophorectomy were excluded. Finally 202 premenopausal and 164 postmenopausal were studied. A score in the What’s My M3? test ≥ 33 was considered as abnormal. Postmenopausal women had a higher score in the test than premenopausal women, 15 (0-69) and 6 (0-42) respectively (p < 0.001). In the sub-analysis of the What’s My M3? test, also the postmenopausal women had statistically significant greater score in depression, anxiety, bipolar disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. It was found that when older, the women had a higher score (p < 0.001), (Spearman’s Rho, p < 0.005). Conclusions : Postmenopausal women had higher score in the What’s My M3? test than premenopausal women

Brachial artery Doppler flux parameters before and after hot flush in Mexican postmenopausal women: preliminary report

Objective : To analyse brachial artery flux parameters in postmenopausal women before and after hot flush. Material and methods : Two groups of postmenopausal women were studied: Group I, without vasomotor symptoms (n = 10) and Group II, with vasomotor symptoms (n = 10). In all them a brachial artery Doppler ultrasound was done, measuring before and after hyperaemic stimulus of the arterial diameter (AD), the pulsatility index (PI), and the resistive index (RI). In Group I, measurements were done at baseline and five minutes after. In Group II, measurements were at baseline, and one and five minutes after the hot-flush. Comparison between the groups was done with Mann-Whitney U test, and within the groups with Wilcoxon test. Results : No differences were found among the groups in Doppler parameters. When comparing each group separately, in Group I, at baseline and at five minutes measurements, the AD was greater after the hyperaemic stimulus than before it. In group II at baseline, the PI was significantly greater after the hyperaemic stimulus than before to it. At the first and fifth minute, the AD was significantly greater after the hyperaemic stimulus than before to it. Conclusions : No differences were found between those who did not have and those who had hot flushes

Relation between visceral fat and carotid intimal media thickness in Mexican postmenopausal women: a preliminary report

Aim of the study: To investigate the relationship between visceral fat and carotid IMT (intima media thickness) in Mexican postmenopausal women. Material and methods: In 71 postmenopausal women divided in two groups: group 1, IMT > 1 mm and group 2, IMT ≤ 1 mm, blood pressure, body mass index (BMI), waist hip ratio (WHR), visceral and subcutaneous fats and carotid IMT were analyzed. Descriptive statistics were used and the comparison among those with abnormal and normal IMT was carried out using Mann-Whitney U test; also Spearman’s correlation analysis was done. Results When comparing group 1 (n = 9, 12.7%) with group 2 (n = 62, 87.3%), it was found that the subcutaneous fat, visceral fat and systolic blood pressure were significantly greater in group 1 (p < 0.018, p < 0.001 and p < 0.006, respectively), and also in this group there was a correlation between BMI and subcutaneous fat ( = 0.686, p < 0.041) and between visceral fat and the systolic blood pressure (= 0.712, p < 0.031). In group 2, there was a correlation between IMT and diastolic blood pressure (= 0.251, p < 0.049). Conclusion : Subcutaneous and visceral fat have an unfavorable effect in the carotid IMT and in blood pressure

Changes in microscopic analysis of the urinary sediment in postmenopausal women who receive vaginal conjugated oestrogens

Introduction: Microscopic haematuria is common in adults and it has been reported in 13% of postmenopausal women. Objective : To evaluate the changes in urinary sediment after the use of vaginal conjugated oestrogens. Material and methods : Postmenopausal women with vaginal dryness were studied. In all them a urinalysis was done, looking for density, pH, and the presence of leukocytes and erythrocytes. In order to be included in the study, all of the women had to have microscopic haematuria, considered as the presence of 3 or more erythrocytes in the urinary sediment. All received vaginally 1 γ of conjugated equine oestrogens cream 3 times per week for one month, moment in which a new urinalysis was carried out and the same parameters were evaluated. Results : Twenty-four women were studied. The median age was 62 years (40-83), and the time since menopause was 144 months (24-336). When comparing the values between baseline and end of treatment urinalyses, no significant differences in pH and urinary density were found. The number of leukocytes significantly decreased after treatment (3.0 [1-6] vs. 1.0 [1-6], p < 0.026), and the erythrocytes number decreased (4.5 [3-12] vs. 0.0 [0-2], p < 0.001). Conclusion : In postmenopausal women with microscopic haematuria and vaginal dryness, it is worth considering administration of local oestrogen for one month, and after repeat the urine exam, before deciding to begin the microscopic haematuria study protocol

Latin American position on the current status of hormone therapy during the menopausal transition and thereafter

Objective: Data from placebo-controlled, randomized clinical trials conducted during the past few years resulted in critical re-evaluation of the overall health benefits of hormone therapy (HT) in women during the menopausal transition and thereafter. These data stimulated vigorous debate among experts and produced several position papers by North American and European authorities providing guidance on the use of HT. It is well known that cultural, geographic and ethnic differences influence the acceptance and risk perception of HT. Therefore, it was considered essential to present a position specifically relevant to Latin American countries. Methods: A Latin American Expert Panel, convening in Salvador, Bahia, Brazil, obtained consensus on re commendations for HT that incorporated the findings of the most recently published reports. The panelists' opinions were surveyed by means of the Likert scale along five categories ranging from complete agreement to complete disagreement. Results: The Panel presented 13 recommendations and considered three additional issues relevant to HT use. There was consensus that HT during the perimenopause and thereafter is warranted in Latin American women in particular for the management of vasomotor symptoms. HT may also be an option for osteoporosis prevention in women at significant risk, after evaluation of risks/benefits and after consideration of alternative therapies. HT should be individualized and prescribed at the lowest effective dose. Conclusions: The Panel concluded that HT remains a safe and effective treatment option for peri- and postmenopausal Latin American women