Menopause Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Performance of the Fracture Risk Assessment Tool Associated with Muscle Mass Measurements and Handgrip to Screen for the Risk of Osteoporosis in Young Postmenopausal Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):32-39

    Summary

    Original Article

    Performance of the Fracture Risk Assessment Tool Associated with Muscle Mass Measurements and Handgrip to Screen for the Risk of Osteoporosis in Young Postmenopausal Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):32-39

    DOI 10.1055/s-0041-1741408

    Views16

    Abstract

    Objective

    To evaluate the improvement in screening accuracy of the Fracture Risk Assessment Tool (FRAX) for the risk of developing osteoporosis among young postmenopausal women by associating with it clinical muscle mass measures.

    Methods

    A sample of postmenopausal women was submitted to calcaneal quantitative ultrasound (QUS), application of the FRAX questionnaire, and screening for the risk of developing sarcopenia at a health fair held in the city of São Bernardo do Campo in 2019. The sample also underwent anthropometric measurements, muscle mass, walking speed and handgrip tests. A major osteoporotic fracture (MOF) risk ≥ 8.5% on the FRAX, a classification of medium risk on the clinical guideline of the National Osteoporosis Guideline Group (NOGG), and a QUS T-score ≤ -1.8 sd were considered risks of having low bone mass, and QUS T-score ≤ -2.5sd, risk of having fractures.

    Results

    In total, 198 women were evaluated, with a median age of 64±7.7 years, median body mass index (BMI) of 27.3±5.3 kg/m2 and median QUS T-score of -1.3±1.3 sd. The accuracy of the FRAX with a MOF risk ≥ 8.5% to identify women with T-scores ≤ -1.8 sd was poor, with an area under the curve (AUC) of 0.604 (95% confidence interval [95%CI]: 0.509-0.694) for women under 65 years of age, and of 0.642 (95%CI: 0.571-0.709) when age was not considered. Including data on muscle mass in the statistical analysis led to a significant improvement for the group of women under 65 years of age, with an AUC of 0,705 (95%CI: 0.612-0.786). The ability of the high-risk NOGG tool to identify T-scores ≤ -1.8 sd was limited.

    Conclusion

    Clinical muscle mass measurements increased the accuracy of the FRAX to screen for osteoporosis in women aged under 65 years.

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    Performance of the Fracture Risk Assessment Tool Associated with Muscle Mass Measurements and Handgrip to Screen for the Risk of Osteoporosis in Young Postmenopausal Women
  • Original Article

    The Effectiveness of Melissa Officinalis L. versus Citalopram on Quality of Life of Menopausal Women with Sleep Disorder: A Randomized Double-Blind Clinical Trial

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):126-130

    Summary

    Original Article

    The Effectiveness of Melissa Officinalis L. versus Citalopram on Quality of Life of Menopausal Women with Sleep Disorder: A Randomized Double-Blind Clinical Trial

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):126-130

    DOI 10.1055/s-0040-1721857

    Views22

    Abstract

    Objective

    The present study aimed to assess the effect of Melissa Officinalis L. (a combination of lemon balm with fennel fruit extract) compared with citalopram and placebo on the quality of life of postmenopausal women with sleep disturbance.

    Methods

    The present study is a randomized, double-blind, placebo clinical trial among 60 postmenopausal women with sleep disturbance who were referred to a university hospital from 2017 to 2019. The participants were randomized to receive M. Officinalis L. (500 mg daily), citalopram (30 mg) or placebo once daily for 8 weeks. The Menopause-Specific Quality of Life (MENQOL) questionnaire was self-completed by each participant at baseline and after 8 weeks of the intervention and was compared between groups.

    Results

    The mean for all MENQOL domain scores were significantly improved in the M. Officinalis L. group compared with citalopram and placebo (p < 0.001). The mean ± standard deviation (SD) after 8 weeks in the M. Officinalis L., citalopram and placebo groups was 2.2 ± 0.84 versus 0.56 ± 0.58 versus 0.36 ± 0.55 in the vasomotor (p < 0.001), 1.02 ± 0.6 versus 0.28 ± 0.2 versus 0.17 ± 0.1 in the psychomotor-social (p < 0.001), 0.76 ± 0.4 versus 0.25 ± 0.1 versus 0.11 ± 0.1 in the physical and 2.3 ± 1.0 versus 0.35 ± 0.5 versus 0.41 ± 0.5 in the sexual domain, respectively.

    Conclusions

    The results revealed that M. Officinalis L. may be recommended for improving the quality of life of menopausal women with sleep disturbance. Trial registration The present study was registered by the name “Comparison of the efficacy of citalopram and compound of Asperugo procumbens and foeniculum vulgare in treatment of menopausal disorders” with the code in the Iranian Registry of Clinical Trials (IRCT).

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  • Original Article

    Construct and Criterion Validity of the Postmenopause Sexuality Questionnaire – PMSQ

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):26-34

    Summary

    Original Article

    Construct and Criterion Validity of the Postmenopause Sexuality Questionnaire – PMSQ

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):26-34

    DOI 10.1055/s-0040-1701461

    Views1

    Abstract

    Objective

    To assess the construct and criterion validity of the Postmenopause Sexuality Questionnaire (PMSQ).

    Methods

    The present methodological questionnaire validation study included postmenopausal women. The construct validity was tested by factor analysis and the criterion validity was performed using the correlation between the PMSQ and the Female Sexual Function Index (FSFI). The ROC curve was used to verify sensitivity, specificity and to determine the cutoff point of the PMSQ.

    Results

    A total of 181 women with amean age of 56.4 ± 5.7 years old were evaluated. The exploratory factor analysis showed that the PMSQ presented Kaiser test = 0.88 and χ2 = 3293.7 (p < 0.001), commonalities ≥ 0.5, and extraction of 9 factors with eigenvalue ≥ 1; explaining 66.3% of the total variance. The PMSQ presented factor loadings between 0.4 and 0.8. A strong correlation between the 2 questionnaires (r = 0.79; p = 0.000) was shown. The cutoff point of the PMSQ was ≤ 55.5, assuming 87.9% sensitivity and 78.9% specificity (p < 0.001).

    Conclusion

    Since the PMSQ showed a strong correlation with the FSFI questionnaire, it presented good psychometric properties to assess the sexuality in postmenopausal women. Based on these results, the PMSQ could be widely tested as a specific instrument to examine the sexual function in postmenopausal women. Future studies, designed to examine the PMSQ instrument in different populations, are needed.

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    Construct and Criterion Validity of the Postmenopause Sexuality Questionnaire – PMSQ
  • Original Articles

    Evaluation of Obesity Influence in the Sexual Function of Postmenopausal Women: A Cross- Sectional Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(11):660-667

    Summary

    Original Articles

    Evaluation of Obesity Influence in the Sexual Function of Postmenopausal Women: A Cross- Sectional Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(11):660-667

    DOI 10.1055/s-0039-1700795

    Views15

    Abstract

    Objective

    The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women.

    Methods

    This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0- 29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR).

    Results

    The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p=0.028 and p=0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p<0.05). The total FSFI score statistically differed among the BMI categories (p=0.027).

    Conclusion

    In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.

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    Evaluation of Obesity Influence in the Sexual Function of Postmenopausal Women: A Cross- Sectional Study
  • Original Article

    Validation of the Six-item Female Sexual Function Index in Middle-Aged Brazilian Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):432-439

    Summary

    Original Article

    Validation of the Six-item Female Sexual Function Index in Middle-Aged Brazilian Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):432-439

    DOI 10.1055/s-0039-1692694

    Views34

    Abstract

    Objective

    To validate the six-item female sexual function index (FSFI-6) in middleaged Brazilian women.

    Methods

    Cross-sectional observational study, involving 737 (premenopausal n = 117, perimenopausal n = 249, postmenopausal n = 371) Brazilian sexually active women, aged between 40 and 55 years, not using hormonal contraceptive methods. The Brazilian FSFI-6 was developed from the translation and cultural adaptation of the Portuguese FSFI-6 version. The participants completed a general questionnaire, the FSFI-6, and the menopause rating scale (MRS). The validation was performed by AMOS 16.0 software (SPSS, Inc., Chicago, IL, USA) for a confirmatory factor analysis (CFA). The chi-square of degrees of freedom (χ2/df), the comparative fit index (CFI), the Tucker- Lewis index (TLI) and the root-mean-square error of approximation (RMSEA) were used as indices of goodness of fit. Cronbach α coefficient was used for internal consistency.

    Results

    The process of cultural adaptation has not altered the Brazilian FSFI-6, as compared with the original content. The CFA for the FSFI-6 score showed an acceptable fit (χ2/df = 3.434, CFI = 0.990, TLI = 0.980, RMSEA = 0.058, 90% confidence interval (90%CI) = 0.033-0.083, p ≤ 0.001) and a good reliability was established in FSFI-6 and MRS (Cronbach α = 0.840 and = 0.854, respectively). In addition, 53.5% of the sample had low sexual function.

    Conclusion

    The FSFI-6 was translated and adapted to the Brazilian culture and is a consistent and reliable tool for female sexual dysfunction screening in Brazilianmiddleaged women.

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    Validation of the Six-item Female Sexual Function Index in Middle-Aged Brazilian Women
  • Original Article

    Mandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):663-669

    Summary

    Original Article

    Mandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):663-669

    DOI 10.1055/s-0037-1606622

    Views14

    Abstract

    Objective

    To examine the role of the panoramic mandibular radiograph in the diagnosis of low bone mineral density (BMD) in postmenopausal women.

    Methods

    A cross-sectional study including volunteer women aged over 40 years in amenorrhea due to ovarian failure for at least 12 months, who were cared for at the climacteric outpatient clinic of a university hospital in the city of Cuiabá, in the state of Mato Grosso, Brazil. The panoramic radiographs were evaluated using a specific software. Two aspects were analyzed in the mandibular panoramic radiograph: a qualitative aspect regarding the shape of the mandibular cortical bone, and a quantitative aspect regarding thewidth of themandibular cortical bone. Themorphology of themandibular cortical bone in the digital panoramic radiograph was determined bilaterally by the observation of the bone structure between the mental foramen and the base of the jaw. The mandibular cortical bonewas categorized into three groups. Themental index (MI)was used to evaluate the thickness of themandibular cortical bone through a perpendicular line drawn fromthe base of the mandible at the height of the center of the mental foramen, with another line drawn tangent to the inferior border of the mandible, and a third line parallel to the line at the superior border of themandible. The MI data are expressed in millimeters, with a normal value of 3.0 mm. The densities of the lumbar spine and femur, expressed in g/cm2, were categorized as normal, osteopenia or osteoporosis.

    Results

    The agreement index between the MI and the BMD of the lumbar spine was good (Kappa = 0.718), but the same index between the MI and the BMD of the femoral neck was poor (Kappa = 0.443). An excellent agreement occurred when the mandibular cortical index (MCI) was compared with the BMD of the lumbar spine (Kappa = 0.912). The agreement between MCI and the BMD in the femur was moderated (Kappa = 0.579).

    Conclusion

    The radiomorphometric indices evaluated in the mandibular panoramic radiograph are capable of identifying postmenopausal women with low mineral density in the mandible, and the results can be used to refer these women to appropriate medical investigation and/or treatment.

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    Mandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women
  • Original Article

    Brazilian Women’s Health after 65 Years of Age

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):608-613

    Summary

    Original Article

    Brazilian Women’s Health after 65 Years of Age

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):608-613

    DOI 10.1055/s-0037-1604200.

    Views8

    Abstract

    Purpose

    The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age.

    Design

    This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a crosssectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data.

    Results

    The age of the patients on their first clinic visit ranged from65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the bodymass index (BMI) found decreases inBMIwith increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years.

    Conclusions

    Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.

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    Brazilian Women’s Health after 65 Years of Age
  • Original Article

    Evaluation of Quality of life, Physical Activity and Nutritional Profile of Postmenopausal Women with and without Vitamin D Deficiency

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):337-343

    Summary

    Original Article

    Evaluation of Quality of life, Physical Activity and Nutritional Profile of Postmenopausal Women with and without Vitamin D Deficiency

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):337-343

    DOI 10.1055/s-0037-1603892

    Views9

    Abstract

    Introduction

    Vitamin D deficiency is associated with various diseases. Prevalent in Brazil, it can result from inadequate lifestyle habits.

    Objective

    To demonstrate that postmenopausal women with vitamin D deficiency have worse quality of health, expressed as worse quality of life, lower levels of physical activity, and worse nutritional profile.

    Methods

    Postmenopausal women answered questionnaires about physical activity and quality of life, provided a 24-hour food record, and had serum vitamin D levels measured.

    Results

    Among the more active women, those who perform a daily average of one hour of physical activity had vitamin D levels above 20 ng/mL (76.9%), and those, which expose themselves to sunlight, had vitamin D levels above 30 ng/mL (34.6%). Meanwhile the percentages for the women who are less physically active and less exposed to sunlight were 42.2% and 8.9% respectively. Being more active and more exposed to sunlight resulted in a lower fat percentage. Serum vitamin D levels were not correlated with quality of life.

    Conclusion

    Walking and gardening increased serum vitamin D levels and decreased the percentage of body fat. The limitations of the study prevented the impact of 25hidroxyvitamin D on the quality of life and nutritional aspects of the women from being evaluated.

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    Evaluation of Quality of life, Physical Activity and Nutritional Profile of Postmenopausal Women with and without Vitamin D Deficiency

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