Climacteric Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):163-169
DOI 10.1590/S0100-7203201400040002
To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically.
A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms.
Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint.
The prevalence of CS was high among women from São Luís, Maranhão, Brazil.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):163-169
DOI 10.1590/S0100-7203201400040002
To assess the prevalence of Climacteric Syndrome (CS) in women from a municipality of Northeastern Brazil which is less developed socioeconomically.
A prospective household survey was performed in São Luís, Maranhão, Brazil with 1,210 climacteric women aged 45 to 60 years. Interviews were applied using previously tested standard questionnaires from April to July 2008. The severity of climacteric symptoms was analyzed by circulatory and psychological indexes and the latter were associated with menopausal status. Multiple correspondence analysis was used to assess the relation among climacteric symptoms.
Most patients were 55 to 60 years old (35.3%), mulatto (37.9%), with 9-11 years of schooling (39.8%), with a partner (56%), Catholic (73.9%) and belonged to the socioeconomic class C (51.1%). The prevalence of CS was 85.9%, and hot flashes (56.4%) and sweating (50.4%) were the most prevalent symptoms. The most frequent psychological symptoms were nervousness (45%) and emotional liability (44.8%). The severity of vasomotor and psychological symptoms was significantly higher during the peri and postmenopausal period (p<0.05). Vaginal dryness (62.7%) was the most prevalent urogenital complaint.
The prevalence of CS was high among women from São Luís, Maranhão, Brazil.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):90-96
DOI 10.1590/S0100-72032014000200008
To evaluate the frequency of sleep disorders, such as obstructive sleep apnea,
restless leg syndrome and insomnia in overweight/obese postmenopausal women seen
in a climacteric sleep disorders clinic.
Thirty-four postmenopausal women were selected using the following inclusion
criteria: age between 50 and 70 years; at least 12 months of amenorrhea; body mass
index (BMI) greater than or equal to 25 kg/m2; and sleep-related
complaints with at least one previous polysomnography. Patients provided responses
to 6 questionnaires related to sleep characteristics and menopausal symptoms.
Weight and height were measured using standardized scales, and abdomen and hip
circumferences were also measured. The statistical analyses were performed using
the χ2 test for qualitative variables and using Student's t-test for
quantitative variables.
Patients' characteristics were as follows: mean age of 60.35 years; mean BMI of
31.62; an average of 11.61 postmenopausal years and an average Kupperman Index of
19. A total of 85.2% of the patients had a waist/hip ratio of less than 0.8. The
Epworth Scale score was greater than or equal to 9 in 50% of patients; 68% had
sleep disturbances according to the Pittsburgh Index, and 68% were classified as
high-risk for sleep apnea by the Berlin Questionnaire. On polysomnography, 70.58%
of the patients had a sleep efficiency lower than 85%; 79.41% had a sleep latency
of less than 30 min; 58.82% had a REM sleep latency of less than 90 min, and
44.11% had mild apnea. When the groups were compared, a linear association was
identified between BMI and the AHI average, and a relationship between high BMI
and use of drugs for thyroid treatment was found.
There was a high prevalence of sleep-disordered breathing, initial insomnia,
fragmented sleep, and thyroid disorders in the group with higher BMI.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(2):90-96
DOI 10.1590/S0100-72032014000200008
To evaluate the frequency of sleep disorders, such as obstructive sleep apnea,
restless leg syndrome and insomnia in overweight/obese postmenopausal women seen
in a climacteric sleep disorders clinic.
Thirty-four postmenopausal women were selected using the following inclusion
criteria: age between 50 and 70 years; at least 12 months of amenorrhea; body mass
index (BMI) greater than or equal to 25 kg/m2; and sleep-related
complaints with at least one previous polysomnography. Patients provided responses
to 6 questionnaires related to sleep characteristics and menopausal symptoms.
Weight and height were measured using standardized scales, and abdomen and hip
circumferences were also measured. The statistical analyses were performed using
the χ2 test for qualitative variables and using Student's t-test for
quantitative variables.
Patients' characteristics were as follows: mean age of 60.35 years; mean BMI of
31.62; an average of 11.61 postmenopausal years and an average Kupperman Index of
19. A total of 85.2% of the patients had a waist/hip ratio of less than 0.8. The
Epworth Scale score was greater than or equal to 9 in 50% of patients; 68% had
sleep disturbances according to the Pittsburgh Index, and 68% were classified as
high-risk for sleep apnea by the Berlin Questionnaire. On polysomnography, 70.58%
of the patients had a sleep efficiency lower than 85%; 79.41% had a sleep latency
of less than 30 min; 58.82% had a REM sleep latency of less than 90 min, and
44.11% had mild apnea. When the groups were compared, a linear association was
identified between BMI and the AHI average, and a relationship between high BMI
and use of drugs for thyroid treatment was found.
There was a high prevalence of sleep-disordered breathing, initial insomnia,
fragmented sleep, and thyroid disorders in the group with higher BMI.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):178-184
DOI 10.1590/S0100-72032013000400008
PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight and mild and severe menopausal symptoms during the postmenopausal period.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(4):178-184
DOI 10.1590/S0100-72032013000400008
PURPOSE: To analyze the climacteric symptoms, nutritional status and distribution of abdominal fat in postmenopausal women using or not hormone therapy. METHODS: exploratory analytical study of the population survey type in the urban area of Maringa, Parana, conducted on 456 postmenopausal women aged 45 to 69 years. Data collection was based on the urbanized census sector (368) of the municipality, according to the Brazilian Demographic Census. A simple random sample proportional to women residing in each census sector was used, and a questionnaire was applied during a home visit, when anthropometric measurements were performed and blood pressure was determined. The Blatt and Kupperman Menopausal Index was used for the evaluation of climacteric symptoms. The outcome variable was the use of hormone therapy. RESULTS: Mean subject age was 58.7 years. Overweight was present in 72.6% of the women and abdominal obesity in 81.4% of them. Mild climacteric symptoms were observed in 69.5% of the women. Only 18.4% of the women studied were using hormone therapy and they were white, non-smokers, had no comorbidities, and had a partner. Users of hormone therapy had a lower frequency of overweight and obesity and had a lower prevalence of severe climacteric symptoms. CONCLUSION: Overweight and obesity were prevalent in this sample. Although fewer in number, the hormone therapy users had a lower frequency of overweight and mild and severe menopausal symptoms during the postmenopausal period.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):329-334
DOI 10.1590/S0100-72032012000700007
PURPOSE: To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS: A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI), while the menopause symptoms by the Menopause Rating Scale (MRS). RESULTS: In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5). All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were lower in women with risk for sexual dysfunction (p<0.001). The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001). Logistic regression analysis revealed that the likelihood of women with risks of sexual dysfunction to present hot flushes, depression, sexual problems, and vaginal dryness was, respectively, 2.1 (95%CI 1.2 - 3.5); 2.4 (95%CI 1.5 - 4.1); 2.3 (95%CI 1.4 - 3.8), and 2.2 (95%CI 1.3 - 3.6) times higher, respectively, compared to those without any risk. CONCLUSION: Climacteric symptoms seem to influence the sexual function in middle-aged women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):329-334
DOI 10.1590/S0100-72032012000700007
PURPOSE: To evaluate the influence of climacteric symptoms on the sexual function in middle-aged women. METHODS: A cross-sectional population study was conducted on a sample of 370 middle-aged women, aged 40 to 65 years-old, cared for at the Basic Health Units in Natal, in the state of Rio Grande do Norte, Brazil. We used a questionnaire containing questions on sociodemographic, clinical, and behavioral characteristics. Sexual function was evaluated by the Female Sexual Function Index (FSFI), while the menopause symptoms by the Menopause Rating Scale (MRS). RESULTS: In the studied group, 67% of the women reported risk for sexual dysfunction (FSFI≤26.5). All FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were lower in women with risk for sexual dysfunction (p<0.001). The arousal, orgasm, and pain domains were most likely to contribute to lower FSFI scores. All somatovegetative, urogenital, and psychological MRS symptoms were more elevated in women with risk for sexual dysfunction, being significant for all comparisons (p<0.001). Logistic regression analysis revealed that the likelihood of women with risks of sexual dysfunction to present hot flushes, depression, sexual problems, and vaginal dryness was, respectively, 2.1 (95%CI 1.2 - 3.5); 2.4 (95%CI 1.5 - 4.1); 2.3 (95%CI 1.4 - 3.8), and 2.2 (95%CI 1.3 - 3.6) times higher, respectively, compared to those without any risk. CONCLUSION: Climacteric symptoms seem to influence the sexual function in middle-aged women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):175-183
DOI 10.1590/S0100-72032012000400007
PURPOSE: To associate the quality of life with the nutritional status of climacteric women. METHODS: This was a cross-sectional study on a sample of 200 climacteric women aged 40 to 65 years who responded to a 24-hour food recall and to questions about socioeconomic factors and current, previous and family medical history. Body mass index (BMI), waist circumference (WC) and waist-hip ratio were used for anthropometric evaluation. To assess the quality of life, we applied the MRS-menopause rating scale. RESULTS: The average BMI and waist circumference were 30.1 kg/m² (obesity grade 1) and 99 cm (very increased risk for cardiovascular disease), respectively. Increased protein consumption and decreased fiber, calcium and vitamin D intake were detected. The most prevalent disease was hypertension, 48.5% of the women studied were taking medication for cardiovascular disease and 23% were taking antidepressant medications. Regarding quality of life, significant results related to BMI as well as blood pressure were found. CONCLUSIONS: A nutritional intervention aiming to correct or improve food consumption and anthropometric profile may result in health benefits for climacteric women. The prevalence of obesity, associated with a poorer quality of life, morbidity and mortality underscores the need for a feeding re-education program during the climacteric.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):175-183
DOI 10.1590/S0100-72032012000400007
PURPOSE: To associate the quality of life with the nutritional status of climacteric women. METHODS: This was a cross-sectional study on a sample of 200 climacteric women aged 40 to 65 years who responded to a 24-hour food recall and to questions about socioeconomic factors and current, previous and family medical history. Body mass index (BMI), waist circumference (WC) and waist-hip ratio were used for anthropometric evaluation. To assess the quality of life, we applied the MRS-menopause rating scale. RESULTS: The average BMI and waist circumference were 30.1 kg/m² (obesity grade 1) and 99 cm (very increased risk for cardiovascular disease), respectively. Increased protein consumption and decreased fiber, calcium and vitamin D intake were detected. The most prevalent disease was hypertension, 48.5% of the women studied were taking medication for cardiovascular disease and 23% were taking antidepressant medications. Regarding quality of life, significant results related to BMI as well as blood pressure were found. CONCLUSIONS: A nutritional intervention aiming to correct or improve food consumption and anthropometric profile may result in health benefits for climacteric women. The prevalence of obesity, associated with a poorer quality of life, morbidity and mortality underscores the need for a feeding re-education program during the climacteric.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):214-220
DOI 10.1590/S0100-72032011000800008
ABSTRACT Hyperandrogenic syndromes include diseases that manifest through an increased biological activity of androgens and that can originate from neoplastic or functional diseases. Androgen-secreting ovarian tumors represent about 1% of ovarian neoplasias. Steroid cell tumors are among the more rare types which account for less than 0.1% of all ovarian tumors. They are usually benign, of small dimensions and unilateral. We report here a rare case of a unilateral steroid cell tumor. A 60-year-old woman was seen after four months of evolution of hirsutism, clitoris hypertrophy and elevation of serum estradiol levels. Her total testosterone and 17-OH-progesterone levels were also increased.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):214-220
DOI 10.1590/S0100-72032011000800008
ABSTRACT Hyperandrogenic syndromes include diseases that manifest through an increased biological activity of androgens and that can originate from neoplastic or functional diseases. Androgen-secreting ovarian tumors represent about 1% of ovarian neoplasias. Steroid cell tumors are among the more rare types which account for less than 0.1% of all ovarian tumors. They are usually benign, of small dimensions and unilateral. We report here a rare case of a unilateral steroid cell tumor. A 60-year-old woman was seen after four months of evolution of hirsutism, clitoris hypertrophy and elevation of serum estradiol levels. Her total testosterone and 17-OH-progesterone levels were also increased.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(2):72-76
DOI 10.1590/S0100-72032010000200004
PURPOSE: to translate into Brazilian Portuguese and culturally adapt the Short Personal Experiences Questionnaire (SPEQ) to climacteric women. METHODS: the original English version from the University of Melbourne, Australia, was initially translated into Portuguese and back-translated into English. A sociocultural adaptation of vocabulary and linguistic constructions was performed to facilitate comprehension. The questionnaire was then pretested in successive stages in 50 women, until no doubts remained. The final version of the adapted instrument was self-responded by 378 Brazilian-born women, between 40 to 65 years old, with 11 years or more of schooling in a population-based study. The reliability (internal consistency as measured by Cronbach's alpha), the construct validity (correlation coefficients between the items comprising the SPEQ and selected variables) and the criterion validity (correlation coefficient between sexual dysfunction score and overall score of sexual life classification) were analyzed. RESULTS: one hundred and eight women answered all the questions of the SPEQ and were included in the study. Internal consistency (Cronbach's alpha) for all the nine SPEQ items ranged from 0.55 to 0.77 and the general alpha was 0.68. In the construct validity analysis, most of the correlation coefficients were significant (p<0.005). The criterion validity analysis showed significant correlation coefficients in most cases. CONCLUSIONS: following the adaptation process, the Portuguese version of the SPEQ was deemed useful and appropriate for collecting data on sexual function and dyspareunia in Brazilian women, aged 45 to 65 years, with at least 11 years of schooling.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(2):72-76
DOI 10.1590/S0100-72032010000200004
PURPOSE: to translate into Brazilian Portuguese and culturally adapt the Short Personal Experiences Questionnaire (SPEQ) to climacteric women. METHODS: the original English version from the University of Melbourne, Australia, was initially translated into Portuguese and back-translated into English. A sociocultural adaptation of vocabulary and linguistic constructions was performed to facilitate comprehension. The questionnaire was then pretested in successive stages in 50 women, until no doubts remained. The final version of the adapted instrument was self-responded by 378 Brazilian-born women, between 40 to 65 years old, with 11 years or more of schooling in a population-based study. The reliability (internal consistency as measured by Cronbach's alpha), the construct validity (correlation coefficients between the items comprising the SPEQ and selected variables) and the criterion validity (correlation coefficient between sexual dysfunction score and overall score of sexual life classification) were analyzed. RESULTS: one hundred and eight women answered all the questions of the SPEQ and were included in the study. Internal consistency (Cronbach's alpha) for all the nine SPEQ items ranged from 0.55 to 0.77 and the general alpha was 0.68. In the construct validity analysis, most of the correlation coefficients were significant (p<0.005). The criterion validity analysis showed significant correlation coefficients in most cases. CONCLUSIONS: following the adaptation process, the Portuguese version of the SPEQ was deemed useful and appropriate for collecting data on sexual function and dyspareunia in Brazilian women, aged 45 to 65 years, with at least 11 years of schooling.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):293-299
DOI 10.1590/S0100-72032009000600005
PURPOSE: to generate and validate a proper questionnaire to evaluate the sexual function in post-menopause women. METHODS: 251 women, within 2 to 15 years postmenopause, were included in the study. Questionnaire's reproductibility/reliability was evaluated by Pearson, intraclass and Lin's correlation coefficients. The internal consistance was examined by the Cronbach's alpha coefficient. Classical item theory guidelines were used for face, content and construct validation. RESULTS: an instrument with 57 items and nine domains was generated. Fourteen questions (24.5%) were eliminated by either poor correlation with the scale or low discriminative power. The final version with 43 items has shown good reproductibility (r=0.719, 95%CI=0.690-0.750; pc=0.887; 95%CI=0.850-0.930; p<0.001). Internal consistance was also adequate (α=0.951). About 60% of the reviewers have confirmed face and content validation. The construct validation was assessed by the Cronbach alpha 0.951. CONCLUSIONS: it was concluded that the new instrument is appropriate for evaluating the sexual function in post-menopause women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):293-299
DOI 10.1590/S0100-72032009000600005
PURPOSE: to generate and validate a proper questionnaire to evaluate the sexual function in post-menopause women. METHODS: 251 women, within 2 to 15 years postmenopause, were included in the study. Questionnaire's reproductibility/reliability was evaluated by Pearson, intraclass and Lin's correlation coefficients. The internal consistance was examined by the Cronbach's alpha coefficient. Classical item theory guidelines were used for face, content and construct validation. RESULTS: an instrument with 57 items and nine domains was generated. Fourteen questions (24.5%) were eliminated by either poor correlation with the scale or low discriminative power. The final version with 43 items has shown good reproductibility (r=0.719, 95%CI=0.690-0.750; pc=0.887; 95%CI=0.850-0.930; p<0.001). Internal consistance was also adequate (α=0.951). About 60% of the reviewers have confirmed face and content validation. The construct validation was assessed by the Cronbach alpha 0.951. CONCLUSIONS: it was concluded that the new instrument is appropriate for evaluating the sexual function in post-menopause women.
