Menopause Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):229-233
DOI 10.1590/S0100-72032000000400007
Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):229-233
DOI 10.1590/S0100-72032000000400007
Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):69-74
DOI 10.1590/S0100-72032005000200005
PURPOSE: to determine the prevalence of overweight, obesity, and associated factors among women who visited a general gynecologic clinic in a secondary hospital of reference. METHODS: the following variables were studied: age, race, educational level, family income, job (paid work done by the women), type of the women's job, current partner, menstrual cycle characteristics at the time of interview, and body mass index (BMI). The patients were divided into three groups, according to their BMI values: <25 kg/m² (normal), between 25-29 kg/m² (overweight) and >30 kg/m² (obesity). The odds ratio (OR) and respective 95% confidence interval (95% CI) were calculated in the overweight and obese groups. Subsequently, the OR was calculated and adjusted for other variables. RESULTS: among the 676 studied women, 89.8% had received up to 8 years of formal education, 83.0% had a partner, 77.6% were Caucasian, 61.4% earned less than 5 minimum wages, and 36.0% of these women were menopausal. The prevalence of overweight was 35.6% and of obesity 24.6%. Overweight was related to age ranging from 50 to 59 years (OR: 3.22; 95% CI: 1.67-6.20) and menopause (OR: 1.52; 95% CI: 1.03-2.26), and obesity was related to menopause (OR: 2.57; 95% CI: 1.66-4.00) and to age range above 40 years (OR: 2.95; 95% CI: 1.37-6.37). According to the multiple regression analysis, only obesity was associated with age range above 40 years (OR: 2,51; 95% CI: 1.05-6.00). CONCLUSION: the prevalence rates of overweight and obesity were high in our sample of low-income women and those with less education. Obesity was associated with women aged over 40. Attempts should be made to reduce the prevalence of overweight and obesity in women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(2):69-74
DOI 10.1590/S0100-72032005000200005
PURPOSE: to determine the prevalence of overweight, obesity, and associated factors among women who visited a general gynecologic clinic in a secondary hospital of reference. METHODS: the following variables were studied: age, race, educational level, family income, job (paid work done by the women), type of the women's job, current partner, menstrual cycle characteristics at the time of interview, and body mass index (BMI). The patients were divided into three groups, according to their BMI values: <25 kg/m² (normal), between 25-29 kg/m² (overweight) and >30 kg/m² (obesity). The odds ratio (OR) and respective 95% confidence interval (95% CI) were calculated in the overweight and obese groups. Subsequently, the OR was calculated and adjusted for other variables. RESULTS: among the 676 studied women, 89.8% had received up to 8 years of formal education, 83.0% had a partner, 77.6% were Caucasian, 61.4% earned less than 5 minimum wages, and 36.0% of these women were menopausal. The prevalence of overweight was 35.6% and of obesity 24.6%. Overweight was related to age ranging from 50 to 59 years (OR: 3.22; 95% CI: 1.67-6.20) and menopause (OR: 1.52; 95% CI: 1.03-2.26), and obesity was related to menopause (OR: 2.57; 95% CI: 1.66-4.00) and to age range above 40 years (OR: 2.95; 95% CI: 1.37-6.37). According to the multiple regression analysis, only obesity was associated with age range above 40 years (OR: 2,51; 95% CI: 1.05-6.00). CONCLUSION: the prevalence rates of overweight and obesity were high in our sample of low-income women and those with less education. Obesity was associated with women aged over 40. Attempts should be made to reduce the prevalence of overweight and obesity in women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):7-11
DOI 10.1590/S0100-72032005000100004
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):7-11
DOI 10.1590/S0100-72032005000100004
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.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):765-771
DOI 10.1590/S0100-72032004001000003
PURPOSE: to identify factors associated with the occurrence of hot flashes in climacteric women living in Campinas, São Paulo. METHODS: data bank secondary analysis of a cross-sectional descriptive population-based study. The selection of 456 women aged 45-60 years was done through area cluster sampling. Data were collected via home interviews using structured, pre-tested questionnaires provided by the International Health Foundation/International Menopause Society and by the North American Menopause Society and adapted by the authors. The analyzed variables were age, race, use of contraceptive methods and hormonal therapy, tubal ligation, body mass index, menopausal status, time since menopause, hysterectomy, and cigarette smoking. Statistical analysis was performed using the mean, median and the prevalence ratio (PR). Multiple logistic regression was performed using the stepwise selection process with a 95% confidence interval (95% CI). RESULTS: bivariate analysis showed that postmenopausal women (PR: 1.42, CI 95%: 1.06-1.90) and those who were submitted to hysterectomy (PR: 1.50, CI 95%: 1.05-2.14) had a significantly greater chance of presenting hot flashes. After applying multiple regression analysis, there was no significant association between hot flashes and any of the evaluated variables. CONCLUSION: results were consistent with previous studies. Many doubts still exist about which factors are associated with hot flashes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):765-771
DOI 10.1590/S0100-72032004001000003
PURPOSE: to identify factors associated with the occurrence of hot flashes in climacteric women living in Campinas, São Paulo. METHODS: data bank secondary analysis of a cross-sectional descriptive population-based study. The selection of 456 women aged 45-60 years was done through area cluster sampling. Data were collected via home interviews using structured, pre-tested questionnaires provided by the International Health Foundation/International Menopause Society and by the North American Menopause Society and adapted by the authors. The analyzed variables were age, race, use of contraceptive methods and hormonal therapy, tubal ligation, body mass index, menopausal status, time since menopause, hysterectomy, and cigarette smoking. Statistical analysis was performed using the mean, median and the prevalence ratio (PR). Multiple logistic regression was performed using the stepwise selection process with a 95% confidence interval (95% CI). RESULTS: bivariate analysis showed that postmenopausal women (PR: 1.42, CI 95%: 1.06-1.90) and those who were submitted to hysterectomy (PR: 1.50, CI 95%: 1.05-2.14) had a significantly greater chance of presenting hot flashes. After applying multiple regression analysis, there was no significant association between hot flashes and any of the evaluated variables. CONCLUSION: results were consistent with previous studies. Many doubts still exist about which factors are associated with hot flashes.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(5):287-292
DOI 10.1590/S0100-72032000000500006
Purpose: to evaluate the effects of hormone replacement therapy (HRT) on the systolic and diastolic blood pressure of postmenopausal women. Methods: a total of 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM -- Unicamp, where the variations of these parameters were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through Student's t test, Mann-Whitney test, and the Wilcoxon nonparametric test. Results: we observed that the systolic blood pressure of HRT users was statistically lower at the end of the third year of use, compared to the initial values (p = 0.01). There was no significant difference in the diastolic blood pressure between users and non-users. Conclusion: hormone replacement therapy did not produce changes in the parameters studied in women properly assisted during the use of HRT.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(5):287-292
DOI 10.1590/S0100-72032000000500006
Purpose: to evaluate the effects of hormone replacement therapy (HRT) on the systolic and diastolic blood pressure of postmenopausal women. Methods: a total of 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM -- Unicamp, where the variations of these parameters were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through Student's t test, Mann-Whitney test, and the Wilcoxon nonparametric test. Results: we observed that the systolic blood pressure of HRT users was statistically lower at the end of the third year of use, compared to the initial values (p = 0.01). There was no significant difference in the diastolic blood pressure between users and non-users. Conclusion: hormone replacement therapy did not produce changes in the parameters studied in women properly assisted during the use of HRT.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):573-578
DOI 10.1590/S0100-72032004000700010
PURPOSE: to evaluate the effects of raloxifene on plasma homocysteine concentration and lipid profile in postmenopausal women. METHODS: twenty-four healthy postmenopausal women, aged 50 to 70 years, with osteopenia and/or osteoporosis, were submitted to raloxifene therapy, 60 mg/day, for six months. Plasma homocysteine concentration was determined before and after three and six months of therapy, as well as total cholesterol, HDL-cholesterol LDL-cholesterol and triglyceride levels. Plasma homocysteine was measured by a polarized immunofluorescence assay and serum lipids by the enzymatic and colorimetric method. Data were analyzed statistically by ANOVA, Newman-Keuls test and Pearson's correlation test. RESULTS: a significant decrease in total cholesterol of 15.3% (227.6±56.3 vs 200.6±29.8 vs 192.8±32.1 mg/dl; p<0.001) and LDL-cholesterol of 21.4% (151.4±46.3 vs 122.7±29.4 vs 119.0±28.6 mg/dl; p<0.001), and a significant increase in HDL-cholesterol of 9.5% (44.7±10.8 vs 52.2±12.6 vs 49.0±10.8 mg/dl; p<0.05) were observed. There was no reduction in triglyceride levels (134.9±50.3 vs 127.5±50.0 vs 121.0±36.0 mg/dl; p>0.05). Although not significant, a decrease in homocysteine by 4.5% (11.7±3.0 vs 11.0±2.9 vs 11.2±2.1 muM/l; p>0.05) was observed between the pre-and posttreatment periods, with a significant negative correlation between basal levels and posttreatment percentual reduction (r=-0.71; p<0.0001). CONCLUSIONS: raloxifene treatment, 60 mg/day, for six months caused a significant decrease in total and LDL-cholesterol and an increase in HDL-cholesterol in postmenopausal women. Plasma homocysteine concentration tended to decrease, this effect being more favorable in patients with elevated baseline levels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(7):573-578
DOI 10.1590/S0100-72032004000700010
PURPOSE: to evaluate the effects of raloxifene on plasma homocysteine concentration and lipid profile in postmenopausal women. METHODS: twenty-four healthy postmenopausal women, aged 50 to 70 years, with osteopenia and/or osteoporosis, were submitted to raloxifene therapy, 60 mg/day, for six months. Plasma homocysteine concentration was determined before and after three and six months of therapy, as well as total cholesterol, HDL-cholesterol LDL-cholesterol and triglyceride levels. Plasma homocysteine was measured by a polarized immunofluorescence assay and serum lipids by the enzymatic and colorimetric method. Data were analyzed statistically by ANOVA, Newman-Keuls test and Pearson's correlation test. RESULTS: a significant decrease in total cholesterol of 15.3% (227.6±56.3 vs 200.6±29.8 vs 192.8±32.1 mg/dl; p<0.001) and LDL-cholesterol of 21.4% (151.4±46.3 vs 122.7±29.4 vs 119.0±28.6 mg/dl; p<0.001), and a significant increase in HDL-cholesterol of 9.5% (44.7±10.8 vs 52.2±12.6 vs 49.0±10.8 mg/dl; p<0.05) were observed. There was no reduction in triglyceride levels (134.9±50.3 vs 127.5±50.0 vs 121.0±36.0 mg/dl; p>0.05). Although not significant, a decrease in homocysteine by 4.5% (11.7±3.0 vs 11.0±2.9 vs 11.2±2.1 muM/l; p>0.05) was observed between the pre-and posttreatment periods, with a significant negative correlation between basal levels and posttreatment percentual reduction (r=-0.71; p<0.0001). CONCLUSIONS: raloxifene treatment, 60 mg/day, for six months caused a significant decrease in total and LDL-cholesterol and an increase in HDL-cholesterol in postmenopausal women. Plasma homocysteine concentration tended to decrease, this effect being more favorable in patients with elevated baseline levels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):45-52
DOI 10.1590/S0100-72032004000100007
PURPOSE: to evaluate the relationship between epidemiologic, anthropometric, reproductive and hormonal factors and mammographic density in postmenopausal women. METHODS: this is a retrospective, cross-sectional study, including 144 women aged 45 years or more, with at least 12 months of amenorrhea and who were non users of hormone replacement therapy during the last six months. Medical charts were reviewed to evaluate age, weight, body mass index (BMI), parity, age at menarche, age at menopause and levels of estradiol, follicle stimulating (FSH) and luteinizing hormones. Mammograms were analyzed by two blinded investigators. The films were taken in the craniocaudal and mediolateral views and mammography was classified as dense and nondense, according to the Wolfe criteria. For statistical analysis, the frequency, median, minimum and maximum values, the Wilcoxon test and the odds ratio were used. Multiple logistic regression was performed, using the stepwise selection, with a 5% significance level. RESULTS: the frequency of dense breasts was 45%. Women with dense breasts were of lower weight (60.5 vs. 71.9 kg - p<0.01), had a lower BMI (25.9 vs 31.0 kg/m² - p<0.01), a shorter time since onset of menopause (6.0 vs 10 years - p<0.01) and higher levels of FSH (75.2 vs 60.3 mU/mL - p<0.01). The probability of having dense breasts decreased in women whose weight was 67 kg or more (OR = 4.0, CI 95% = 1.50-10.66), BMI was higher than 30 kg/m² (OR = 6.69, CI 95% = 1.67-36.81), time since onset of menopause was superior or equal to seven years (OR = 2.05, CI 95% = 1.05-3.99) and FSH levels were lower than 134.8 mU/mL. CONCLUSION: weight, BMI, parity, time since menopause and FSH levels were significantly associated with mammographic density patterns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):45-52
DOI 10.1590/S0100-72032004000100007
PURPOSE: to evaluate the relationship between epidemiologic, anthropometric, reproductive and hormonal factors and mammographic density in postmenopausal women. METHODS: this is a retrospective, cross-sectional study, including 144 women aged 45 years or more, with at least 12 months of amenorrhea and who were non users of hormone replacement therapy during the last six months. Medical charts were reviewed to evaluate age, weight, body mass index (BMI), parity, age at menarche, age at menopause and levels of estradiol, follicle stimulating (FSH) and luteinizing hormones. Mammograms were analyzed by two blinded investigators. The films were taken in the craniocaudal and mediolateral views and mammography was classified as dense and nondense, according to the Wolfe criteria. For statistical analysis, the frequency, median, minimum and maximum values, the Wilcoxon test and the odds ratio were used. Multiple logistic regression was performed, using the stepwise selection, with a 5% significance level. RESULTS: the frequency of dense breasts was 45%. Women with dense breasts were of lower weight (60.5 vs. 71.9 kg - p<0.01), had a lower BMI (25.9 vs 31.0 kg/m² - p<0.01), a shorter time since onset of menopause (6.0 vs 10 years - p<0.01) and higher levels of FSH (75.2 vs 60.3 mU/mL - p<0.01). The probability of having dense breasts decreased in women whose weight was 67 kg or more (OR = 4.0, CI 95% = 1.50-10.66), BMI was higher than 30 kg/m² (OR = 6.69, CI 95% = 1.67-36.81), time since onset of menopause was superior or equal to seven years (OR = 2.05, CI 95% = 1.05-3.99) and FSH levels were lower than 134.8 mU/mL. CONCLUSION: weight, BMI, parity, time since menopause and FSH levels were significantly associated with mammographic density patterns.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):53-58
DOI 10.1590/S0100-72032004000100008
PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(1):53-58
DOI 10.1590/S0100-72032004000100008
PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.