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  • Artigos Originais

    Factors associated with menopausal symptoms in women from a metropolitan region in Southeastern Brazil: a population-based household survey

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):152-158

    Summary

    Artigos Originais

    Factors associated with menopausal symptoms in women from a metropolitan region in Southeastern Brazil: a population-based household survey

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(4):152-158

    DOI 10.1590/SO100-720320150005282

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    PURPOSE:

    To determine the average age at the onset of menopause and to investigate menopausal symptoms in women in a metropolitan region in Southeastern Brazil.

    METHODS:

    A descriptive, exploratory, cross-sectional study was conducted with 749 women (a population-based household survey). The dependent variable was the intensity of menopausal symptoms assessed by th Menopause Rating Scale (MRS). The independent variables were sociodemographic data, health-related habits and problems, self-perception of health, and gynecological background. Statistical analysis was carried out by the χ2 test and Poisson regression using the backward selection criteria.

    RESULTS:

    The mean age of the women was 52.5 (±4.4) years. With regard to menopausal status, 16% were premenopausal, 16% perimenopausal and 68% postmenopausal. The mean age at the onset of menopause was 46.5 (±5.8) years. The intensity of menopausal symptoms was defined according to the median MRS score and was considered severe for values ​​above 8. Depression/anxiety (PR=1.8; 95%CI 1.5-2.2; p<0.01), rheumatic diseases (PR 1.5; 95%CI 1.2-1.7; p<0.01), self-perception of health as fair/poor/very poor (PR 1.4; 95% CI 1.2-1.7; p<0.01), history of abortion (PR 1.3; 95%CI 1.1-1.4; p<0.01), current or previous treatment for menopausal symptoms (PR 1.2; 95%CI 1.1-1.4; p<0.01), peri- or postmenopausal status (PR 1.4; 95%CI 1.1-1.7; p<0.01), number of normal deliveries >1 (PR 1.2; 95%CI 1.02-1.4; p<0.01) and asthma (PR 1.2; 95%CI 1.01-1.4; p<0.01) were associated with more severe menopausal symptoms. Older age (PR 0.96; 95%CI 0.96-0.97; p<0.01) was associated with less severe symptoms.

    CONCLUSION:

    The severity of menopausal symptoms was related to a wild range of factors, especially presence of chronic diseases, a larger number of pregnancies, use of hormone therapy, and worse self-rated health. A better understanding of these factors can help to reduce the impact of symptoms on quality of life, and to identify groups of women who are likely to need more care during and beyond menopause.

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  • Artigos Originais

    Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):157-162

    Summary

    Artigos Originais

    Cardiovascular risk in middle-aged breast cancer survivors: a comparison between two risk models

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(4):157-162

    DOI 10.1590/S0100-720320140050.0002

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    PURPOSE:

    It was to assess the risk of cardiovascular disease (CVD) in breast cancer survivors (BCS).

    METHODS:

    This cross-sectional study analyzed 67 BCS, aged 45 -65 years, who underwent complete oncological treatment, but had not received hormone therapy, tamoxifen or aromatase inhibitors during the previous 6 months. Lipid profile and CVD risk were evaluated, the latter using the Framingham and Systematic COronary Risk Evaluation (SCORE) models. The agreement between cardiovascular risk models was analyzed by calculating a kappa coefficient and its 95% confidence interval (CI).

    RESULTS:

    Mean subject age was 53.2±6.0 years, with rates of obesity, hypertension, and dyslipidemia of 25, 34 and 90%, respectively. The most frequent lipid abnormalities were high total cholesterol (70%), high LDL-C (51%) and high non-HDL-C (48%) concentrations. Based on the Framingham score, 22% of the participants had a high risk for coronary artery disease. According to the SCORE model, 100 and 93% of the participants were at low risk for fatal CVD in populations at low and high risk, respectively, for CVD. The agreement between the Framingham and SCORE risk models was poor (kappa: 0.1; 95%CI 0.01 -0.2) for populations at high risk for CVD.

    CONCLUSIONS:

    These findings indicate the need to include lipid profile and CVD risk assessment in the follow-up of BCS, focusing on adequate control of serum lipid concentrations.

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  • Artigos Originais

    The effect of an exercise program to strengthen pelvic floor muscles in multiparous women

    Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):10-15

    Summary

    Artigos Originais

    The effect of an exercise program to strengthen pelvic floor muscles in multiparous women

    Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):10-15

    DOI 10.1590/S0100-72032013000100003

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    PURPOSES: To investigate the effect of an individualized and supervised exercise program for the pelvic floor muscles (PFM) in the postpartum period of multiparous women, and to verify the correlation between two methods used to assess PFM strength. METHODS: An open clinical trial was performed with puerperal, multiparous women aged 18 to 35 years. The sample consisted of 23 puerperal women divided into two groups: Intervention Group (IG, n=11) and Control Group (CG, n=12). The puerperal women in IG participated in an eight-week PFM exercise program, twice a week. The puerperal women in CG did not receive any recommendations regarding exercise. PFM strength was assessed using digital vaginal palpation and a perineometer. The statistical analysis was performed using the following tests: Fisher's exact, c², Student's t, Kolmogorov-Smirnov for two samples, and Pearson's correlation coefficient. Significance was defined as p<0.05. RESULTS: The participants' mean age was 24±4.5 years in IG and 25.3±4 years in CG (p=0.4). After the exercise program, a significant difference was found between the groups in both modalities of muscle strength assessment (p<0.001). The two muscle strength assessment methods showed a significant correlation in both assessments (1st assessment: r=0.889, p<0.001; 2nd assessment: r=0.925, p<0.001). CONCLUSIONS: The exercise program promoted a significant improvement in PFM strength. Good correlation was observed between digital vaginal palpation and a perineometer, which indicates that vaginal palpation can be used in clinical practice, since it is an inexpensive method that demonstrated significant correlation with an objective method, i.e. the use of a perioneometer.

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  • Artigos Originais

    Quality of life of women with chronic pelvic pain: a cross-sectional analytical study

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(5):247-253

    Summary

    Artigos Originais

    Quality of life of women with chronic pelvic pain: a cross-sectional analytical study

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(5):247-253

    DOI 10.1590/S0100-72032010000500008

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    PURPOSE: to compare the quality of life (QL) of women with and without chronic pelvic pain (CPP) and to investigate the factors associated with QL in women with CPP. METHODS: a cross-sectional study was conducted on 30 women with CPP and 20 women without CPP. Sociodemographic and clinical characteristics were evaluated. QL was investigated by applying the SF-36 questionnaire, which contains eight domains: functional capacity, physical aspects, pain, general health status, vitality, social aspects, emotional aspects, and mental health. These domains can be summarized into two groups: physical component summary (PCS) and mental component summary (MCS). Pain intensity was investigated by applying the visual analogue scale. Linear regression analysis was used to compare QL scores between women with and without CPP and to identify factors associated with the QL of women with CPP. RESULTS: the mean age of women with and without CPP was 35.2±7.5 and 36±9.3 years (p=0.77), respectively. Women with CPP had a lower monthly family income (p=0.04) and a higher prevalence of dysmenorrhea (87 versus 40%; p<0.01) and depression (30 versus 5%; p=0.04) compared to women without CPP. Adjusted analysis for potential confounding variables revealed that women with CPP had lower QL scores in the pain (p<0.01) and social aspects (p<0.01) domains. Depression was negatively associated with the emotional aspects domain (p=0.05) and with the MCS (p=0.03), while pain intensity was negatively related to the pain domain (p<0.01) of the QL of women with CPP. CONCLUSIONS: women with CPP presented a worse QL compared to women without CPP. Depression and pain intensity were negatively related to the QL of women with CPP. Thus, the evaluation and treatment of pain and depressive symptoms must be among the priorities that aim to improve the QL of women with CPP.

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  • Editorial

    Quality of life

    Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):535-535

    Summary

    Editorial

    Quality of life

    Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(11):535-535

    DOI 10.1590/S0100-72032008001100001

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  • Revisão

    Quality of life in breast cancer survivors

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):195-204

    Summary

    Revisão

    Quality of life in breast cancer survivors

    Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):195-204

    DOI 10.1590/S0100-72032006000300010

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    Breast cancer is one of the most common malignancies among women. Its diagnosis and treatment have social, economic, physical, emotional/psychological and sexual repercussions. The main parameters used to assess the results of anticancer therapy are disease-free survival and overall survival. More recently, quality of life (QOL) has been considered an additional parameter. No consensus exists about the definition of QOL. However, most definitions take into account multidimensional and subjective aspects of QOL. The identification of factors related to QOL and comprehension of how these factors contribute to the perception of QOL are reasons for debate, since the concept of QOL is directly related to the social and cultural context in which the individual is inserted. Age at diagnosis, chemotherapy, type of surgery, climacteric symptoms, relationship between the couple, and sexuality are several factors associated with QOL in women with breast cancer. QOL associated with different antineoplastic therapies may help patients and physicians choose the best therapeutic modality. Towards this end, the current article addresses various aspects of QOL of breast cancer women, and presents the state-of-the-art knowledge on the topic.

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  • Resumos de Teses

    Breast cancer, menopause, and quality of life

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):502-502

    Summary

    Resumos de Teses

    Breast cancer, menopause, and quality of life

    Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):502-502

    DOI 10.1590/S0100-72032005000800014

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  • Trabalhos Originais

    Factors associated with hot flashes in climacteric women: a population-based study

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):765-771

    Summary

    Trabalhos Originais

    Factors associated with hot flashes in climacteric women: a population-based study

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(10):765-771

    DOI 10.1590/S0100-72032004001000003

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    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.

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