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Terapia hormonal da menopausa
Pardini, Dolores;
Arquivos Brasileiros de Endocrinologia & Metabologia , 2007, DOI: 10.1590/S0004-27302007000600007
Abstract: although estrogen has been clinically available for more than 6 decades, women have been confused by different opinions regarding the risks and benefits of menopausal hormone therapy (ht), estrogen therapy (et), and estrogen-progestin therapy (ept). the main indication for ht use in postmenopausal women remains the relief of vasomotor symptoms and vulvovaginal atrophy, and is effective in the prevention of osteoporosis. in other areas of research, notably in cardiovascular and central nervous system effects, the recent literature has produced conflicting results. treatment for up to 5 years does not add significantly to lifetime risk of breast cancer, but significantly decreases bone loss and risk of osteoporotic fractures. some women may be susceptible to early thrombotic risk, but when appropriate ht is given after individual clinical evaluation, the benefits will far outweigh any potential risks and the treatment should be recommended. clinical research continues into genetic factors influencing the response to et/ht, different estrogen formulations, different modes of delivery and lower-dose options. patients and clinicians should make treatment decisions on the basis of an individual?s needs and risks, and should enhance a woman?s ability to undergo the menopausal transition with minimal disruption to her quality of life. in women experiencing distressing climacteric symptoms during the peri and postmenopause there is conclusive evidence from abundant randomized controlled trials that systemic hormone therapy (ht) of any type affords symptom relief, with no alternative treatment producing similar effect. future research is needed to identify new indications for hrt and to diminish or abolish its potential risks.
Fidedignidade do Teste-reteste na Aplica??o do índice Menopausal de Blatt e Kupperman
Sousa, Rilva Lopes de;Sousa, Eduardo Sérgio Soares;Silva, José Carlos Barros;Filizola, Rosália Gouveia;
Revista Brasileira de Ginecologia e Obstetrícia , 2000, DOI: 10.1590/S0100-72032000000800003
Abstract: purpose: based on the knowledge that the reliability of an instrument is essential for a correct interpretation of the results of research, the purpose of the present study is to evaluate the reliability of one of the menopausal indexes more often used in clinical practice and research, the blatt and kupperman menopausal index (bkmi). methods: the population consisted of 60 climacteric patients attended at the gynecology outpatient clinic of the lauro wanderley university hospital of the federal university of paraíba in jo?o pessoa city. the reliability coefficient was analyzed by the test-retest method, whose application was done on two different occasions with an interval of four weeks, without administration of medicines. results: the variation of the score observed with the application of bkmi at the first measurement was 2 to 41, with a median of 18 and mean of 18.8 (± 10.76), while at the second measurement, the menopausal index was 20.2 (± 10.51), median 19, and values ranging from 2 to 39. despite these results, a speaman (rs) coefficient of 0.68 (p = 0.001), which is a coefficient of only moderate intensity, was observed. conclusions: the test-retest reliability in the application of the bkmi shows that, although this instrument presented a statistically moderate reliability, the intensity observed does not represent a reliable measurement. considering that a correlational study is only a type of screening of the quality of a measurement method, we concluded that other studies must be performed with the purpose of evaluating the reliability and the validity of the bkmi. it is possible that the attribuition of different values to the items of bkmi and the inclusion of symptoms directly related to the estrogenic defficiency, like symptoms of vaginal atrophy, would make the instrument more reliable.
Prevalência de sobrepeso e obesidade no climatério
De Lorenzi, Dino Roberto Soares;Basso, Eliane;Fagundes, Petr?nio de Oliveira;Saciloto, Bruno;
Revista Brasileira de Ginecologia e Obstetrícia , 2005, DOI: 10.1590/S0100-72032005000800008
Abstract: purpose: to evaluate the prevalence of overweight and obesity among climacteric women. methods: this cross-sectional study included 611 women aged between 45 and 60 years attended at a climacteric clinic from january to june 2003. the prevalence of overweight and obesity was evaluated through the body mass index (bmi). overweight or obesity was considered when there was a bmi equal or higher than 25 kg/m2. sociodemographic and reproductive variables as well as life style were also evaluated. the c2 test followed by logistic regression was performed for statistical analysis. results: the average age of the studied women was 51.4 (±4.4) years, whereas 52.9% of them were postmenopausal. about 63.7% of them had a bmi equal or higher than 25 kg/m2. the prevalence of overweight and obesity was 33.6 and 30.1%, respectively. the prevalence of overweight and obesity was higher among older women (or=1.2; 95%ic: 1.1-1.4) or non hormonal therapy users (or=1.8; 95%ic: 1.2-2.8). the opposite was observed among the women without a professional occupation (or=0.6; 95%ic: 0.5-0.9) or a steady partner (or=0.7; 95%ic: 0,4-0,9). conclusions: in this study, the prevalence of overweight and obesity was influenced by age, but not by the menopausal status. the association between the marital status and occupation and the bmi strengthens the hypothesis that the health of the climacteric women may be influenced by biological factors as well as by psychosocial factors and life style. the lowest prevalence of overweight and obesity among the users of hormonal therapy may be explained by possible restrictions in relation to its prescription for women with previous overweight or obesity. further studies are necessary to get more conclusive results, in particular with longitudinal studies.
A mulher climatérica
Silveira, Geraldo G. Gomes da;
Revista Brasileira de Medicina do Esporte , 1997, DOI: 10.1590/S1517-86921997000400005
Abstract: the author reviews many aspects that involve the clinical approach of climacteric women. emphasis is placed on exercise practice and on the fact that inconsistent results in the literature regarding physical activity and climacteric syndrome may result from inadequate assessment measurements.
Gómez M,Claudia; Carmi K,Carolina; Espinosa F,Victoria; Sepúlveda B,Silvia; López A,Fanny;
Revista chilena de obstetricia y ginecología , 2007, DOI: 10.4067/S0717-75262007000500008
Abstract: objective: to determine the grade of knowledge of the climateric phase and their relationship with the instruction level that has a group of 40-64 year-old women users of primary care. method: the sample was probabilistics made up of 150 women of 40 to 64 years and were submitted to a validated survey of questions with multiple answers, punctuated for its evaluation. the variables included in this study were divided in three groups: a) those that define the social-demographic profile of the women; b) variables related with the grade of knowledge of causes, symptoms, treatments, cares, changes in the health and quality of life of the climateric stage; c) sources of information. the analysis of these variables was carried out through the determination of measures of central tendency, and the non parametric kruskal-wallis test with a significance level p<0.05. results: the profile of the women studied was, 51.89 ± 7.35 years, 52% married, 52% health forecast fonasa-a (poverty and indigence) and 60% with incomplete high school. only the 11% of the interviewed population referred to have attended lectures of the topic, and 40% refers to have received doctors' information and/or midwife. in relation to the population's general knowledge on the climateric stage, 72% has a medium level of knowledge and 2% had low level. conclusions: did not exists relationship with significant statistics among the grade of knowledge on the climateric stage and age of the women in the study, as well as neither for the acquisition of information from valid sources but exists with the educational level of the women
Freqüência da atividade sexual em mulheres menopausadas
De Lorenzi, Dino Roberto Soares;Saciloto, Bruno;
Revista da Associa??o Médica Brasileira , 2006, DOI: 10.1590/S0104-42302006000400027
Abstract: objective: to identify factors related to the frequency of sexual activity of postmenopausal women methods: a cross-section study of 206 postmenopausal women between 45 and 60 years of age was made at a university health care service in the south of brazil between june and october 2002. evaluations were made of sexual activity according to the number of sexual intercourses in the previous month and the climacteric symptoms using the kupperman index. statistical analysis was performed with multiple linear regression analysis. results: of those surveyed 176 (85%) women were sexually active. although 60.6% reported a decrease in sexual activity after menopause, mostly attributing it to the husband's sexual impotence (41.7%). approximately 25.7% stated they had no satisfaction with sexual intercourse. by means of multiple linear regression analysis the following aspects were associated to sexual activity: age (p<0.1), degree of sexual satisfaction (p=0.01), and climacteric symptomatology (p=0.02). as age increased the climacteric symptoms were more intense and sexual activity was less frequent with lower sexual satisfaction. the climacteric symptoms correlated with sexual activity were: hot flashes (p=0.05), irritability (p=0.04), melancholy/sadness (p=0.04), arthralgia/myalgia (p<0.01) and weakness/tiredness (p<0.01). conclusion: findings of this study were similar to those in literature. they agree with the hypothesis that sexuality of climacteric women is not only influenced by factors related to hypoestrogenism, but also by psychosocial and cultural aspects associated with aging itself. nevertheless, longitudinal studies are necessary to provide more conclusive data. special attention should be given to the sexual dysfunction of men.
Climacterium: Effects and Management among Women
J. A. Olanipekun,E. O. Osakinle,B. A. Falana
International Journal of Asian Social Science , 2012,
Abstract: This paper examined the signs symptoms effects and management of menopausal problems among women folks. Issues related to the concept, physiological view and types of menopause were discussed. The predisposing factors responsible for menopausal discomforts and health psychological consequences of menopause were also reviewed. The management therapies for menopausal problems among women were also investigated. Recommendations were made towards relieving menopausal problems such as regular exercises, intake of balanced diet, engaging in mental exercises and the application of vaginal lubricants.
Efeitos dos Fitoestrogênios sobre Alguns Parametros Clínicos e Laboratoriais no Climatério
Han, Kyung Koo;Soares Júnior, José Maria;Haidar, Mauro Abi;Gir?o, Manoel Jo?o Batista C.;Nunes, Marcia Gaspar;Lima, Geraldo Rodrigues de;Baracat, Edmund C.;
Revista Brasileira de Ginecologia e Obstetrícia , 2002, DOI: 10.1590/S0100-72032002000800008
Abstract: purpose: to evaluate the estrogenic effects of soy phytoestrogens in postmenopausal patients. method: we selected postmenopausal patients from the climacteric service of the gynecology department of the federal university of s?o paulo - escola paulista de medicina. the patients were divided into two groups: gi (n=40) received daily 100 mg isoflavone (3 x 33.3 mg/day); and gctr (n=40) received daily placebo. we included in this study the kuppermann menopausal index, physical examination and the biochemical determination of total and fractions of cholesterol, triglycerides, estradiol, fsh e lh. we also performed sonographic examination to measure endometrial thickness. to compare baseline and after treatment values of both groups, the nonparametric kruskal-wallis test was used for the kuppermann index, while the t test was performed for other data. results: evaluation of the kupperman menopausal index, 80% patients of gi showed a decrease in the total score, while the improvement of symptoms in gctr was 12,5%. the analysis of total cholesterol levels showed that 35 patients of gi had levels above 200 mg/dl, and only 13 of gctr presented similar levels. the body mass index reduction occurred in gi and the control group showed no changes. we also verified that echo endometrial thickness and fsh levels were similar to baseline values. however the values of estrogen increased after isoflavone treatment. conclusion: we concluded that 100 mg/day isoflavone may be an alternative treatment for attenuating the climacteric symptoms in 80% of isoflavone users and that it reduced total cholesterol.
Fatores indicadores da sintomatologia climatérica
De Lorenzi, Dino Roberto Soares;Danelon, Claudia;Saciloto, Bruno;Padilha Jr., Irineu;
Revista Brasileira de Ginecologia e Obstetrícia , 2005, DOI: 10.1590/S0100-72032005000100004
Abstract: purpose: to identify factors associated with climacteric symptoms. methods: a cross-sectional study of 254 women aged between 45 and 60 years was carried out at the climacterium outpatient clinic of caxias do sul university, rs, from june to october 2002. women with previous hysterectomy or under hormonal therapy were excluded. the climacteric symptoms were evaluated by means of the kuppermann index and the attitudes toward menopause by a specific questionnaire. data were analyzed by student's t test, analysis of variance (anova) and multiple linear regression analysis. results: twenty eight percent of the women reported mild climacteric symtoms, whereas 42.3% reported moderate symptoms and 30.7%, intense symptoms. the most prevalent symptoms were: irritability (87.1%), arthralgias/myalgias (77.5%) and melancholy (73.2%), while the most severe were hot flushes in 60.2% of the women, irritability and insomnia. attitudes toward menopause, skin color and physical activity were predictors of climacteric symptoms. positive attitudes toward menopause (p=0.01), white color (p=0.02) and the habit of practicing physical activity (0.04) were associated with less intense climacteric symptoms. negative attitudes toward menopause were associated with worse climacteric symptoms (p<0.01). conclusions: in the current study, the climacteric symptoms were influenced by psychosocial factors and physical activity, as well as by climacteric hypoestrogenism.
Depress?o e ansiedade em mulheres climatéricas: fatores associados
Polisseni, álvaro Fernando;Araújo, Dimas Augusto Carvalho de;Polisseni, Fernanda;Mour?o Junior, Carlos Alberto;Polisseni, Juliana;Fernandes, Eduardo Siqueira;Guerra, Martha de Oliveira;
Revista Brasileira de Ginecologia e Obstetrícia , 2009, DOI: 10.1590/S0100-72032009000100006
Abstract: purpose: to determine the prevalence of depression and anxiety in climacteric women and the probable factors responsible for its occurrence. methods: a transversal study that has selected 93 women attended at a climacteric outpatient clinic, from may 2006 to august 2007. inclusion criteria were: women from 40 to 65 years old who agreed with participating in the project. exclusion criteria: patients in hormonal therapy, hormone-therapy by implant, dius and depo injections in the preceding six months, endocrinopathies leading to menstrual irregularities, hepatopathies, thrombopathies, use of drugs which interfere in the menstrual cycle, anxiolytics and antidepressants (as their use indicates previous diagnosis of mood disorders), hysterectomy, oophorectomy, cancer or psychiatric disease, and patients who had been submitted to radio or chemotherapy. during the interview, four questionnaires were applied: anamnesis, containing socio-demographic, clinical and living habits data; blatt-kupperman's menopausal index for climacteric syndrome diagnosis; anxiety sub-scale of the hospital anxiety and depression scale (hads-a) for anxiety diagnosis; and beck's depression inventory for the diagnosis of depression. descriptive and correlation analysis among the variables, χ2 and hosmer-lemeshow tests were performed using the statistica software program, version 6. results: the average depression prevalence among the patients was 36.8%, while that of anxiety was 53.7%. there was no significant difference between the prevalence of depression and anxiety in the three phases of climacterium. there was a significant relationship between the presence of moderate climacteric symptoms and the presence of mood alterations (p<0.001). depression was more frequent in women with anxiety (or=4.2) and insomnia (or=4.9), having a job being a protection factor (or=0.2). risk factors related to anxiety were the presence of depression (or=6.1) and antecedents of pre-menstrual tension (or=7.0). concl
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