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1.
BMC Womens Health ; 24(1): 60, 2024 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-38263123

RESUMO

BACKGROUND: Menopause hormone therapy (MHT), as an effective method to alleviate the menopause-related symptoms of women, its benefits, risks, and potential influencing factors for the cardiovascular system of postmenopausal women are not very clear. OBJECTIVES: To evaluate cardiovascular benefits and risks of MHT in postmenopausal women, and analyze the underlying factors that affect both. SEARCH STRATEGY: The EMBASE, MEDLINE, and CENTRAL databases were searched from 1975 to July 2022. SELECTION CRITERIA: Randomized Clinical Trials (RCTs) that met pre-specified inclusion criteria were included. DATA COLLECTION AND ANALYSIS: Two reviewers extracted data independently. A meta-analysis of random effects was used to analyze data. MAIN RESULTS: This systematic review identified 33 RCTs using MHT involving 44,639 postmenopausal women with a mean age of 60.3 (range 48 to 72 years). There was no significant difference between MHT and placebo (or no treatment) in all-cause death (RR = 0.96, 95%CI 0.85 to 1.09, I2 = 14%) and cardiovascular events (RR = 0.97, 95%CI 0.82 to 1.14, I2 = 38%) in the overall population of postmenopausal women. However, MHT would increase the risk of stroke (RR = 1.23, 95%CI 1.08 to 1.41,I2 = 0%) and venous thromboembolism (RR = 1.86, 95%CI 1.39 to 2.50, I2 = 24%). Compared with placebo, MHT could improve flow-mediated arterial dilation (FMD) (SMD = 1.46, 95%CI 0.86 to 2.07, I2 = 90%), but it did not improve nitroglycerin-mediated arterial dilation (NMD) (SMD = 0.27, 95%CI - 0.08 to 0.62, I2 = 76%). Compared with women started MHT more than 10 years after menopause, women started MHT within 10 years after menopause had lower frequency of all-cause death (P = 0.02) and cardiovascular events (P = 0.002), and more significant improvement in FMD (P = 0.0003). Compared to mono-estrogen therapy, the combination therapy of estrogen and progesterone would not alter the outcomes of endpoint event. (all-cause death P = 0.52, cardiovascular events P = 0.90, stroke P = 0.85, venous thromboembolism P = 0.33, FMD P = 0.46, NMD P = 0.27). CONCLUSIONS: MHT improves flow-mediated arterial dilation (FMD) but fails to lower the risk of all-cause death and cardiovascular events, and increases the risk of stroke and venous thrombosis in postmenopausal women. Early acceptance of MHT not only reduces the risk of all-cause death and cardiovascular events but also further improves FMD, although the risk of stroke and venous thrombosis is not reduced. There is no difference in the outcome of cardiovascular system endpoints between mono-estrogen therapy and combination therapy of estrogen and progesterone.


Assuntos
Acidente Vascular Cerebral , Tromboembolia Venosa , Trombose Venosa , Feminino , Humanos , Pessoa de Meia-Idade , Idoso , Pós-Menopausa , Progesterona , Artérias , Estrogênios , Terapia de Reposição Hormonal , Medição de Risco
2.
Aust N Z J Psychiatry ; 58(8): 636-640, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38761367

RESUMO

Menopause is a biological process experienced by all people assigned female at birth. A significant number of women experience mental ill health related to the major brain gonadal hormone shifts that occur in their midlife. There is poor understanding and management of the complex mental ill health issues, with the biological brain hormone changes receiving little formal attention. The current treatment advice is to manage this special type of mental ill health in the same way that all mental ill health is managed. This leads to poor outcomes for women and their families. Many women leave the workforce earlier than expected due to menopause-related depression and anxiety, with subsequent loss of salary and superannuation. Others describe being unable to adequately parent or maintain meaningful relationships - all ending in a poor quality of life. We are a large and diverse group of national and international clinicians, lived experience and social community advocates, all working together to innovate the current approaches available for women with menopausal mental ill health. Above all, true innovation is only possible when the woman with lived experience of menopause is front and centre of this debate.


Assuntos
Menopausa , Humanos , Feminino , Menopausa/psicologia , Menopausa/fisiologia , Depressão/terapia , Qualidade de Vida , Transtorno Depressivo/terapia
3.
BMC Endocr Disord ; 23(1): 21, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36691016

RESUMO

BACKGROUND: To evaluate the endocrine hormone and metabolic indices in postmenopausal women with euthyroid and mild subclinical hypothyroidism after menopause hormone therapy (MHT). METHODS: A retrospective study of 587 postmenopausal women receiving MHT was conducted. Median (25-75th percentile) age was 52 (49-54) years. According to thyroid stimulating hormone (TSH) levels at initial diagnosis, the patients were divided into three groups: I (euthyroid with low normal TSH range, n = 460), II (euthyroid with upper normal TSH range, n = 106) and III (mild subclinical hypothyroidism, n = 21). After a continuous oral MHT regimen using the same estradiol potency for 6-18 month cycles, serum endocrine hormone and metabolic indices were reassessed. RESULTS: Compared with baseline, serum TSH levels in groups I and II significantly changed but all values were within the normal range. No significant difference was observed in serum TSH levels in group III. After treatment, all serum free tri-iodothyronine and free thyroxine levels were within the normal range. Serum total cholesterol, triglyceride, fasting plasma glucose, fasting insulin levels and homeostasis model assessment of insulin resistance index had significantly decreased in group I. There were no significant differences in all observed lipid and glucose parameters in group III, before and after treatment. CONCLUSION: MHT did not affect thyroid function in postmenopausal women with euthyroid and mild subclinical hypothyroidism. MHT led to an improvement in lipid and glucose indicators in euthyroid women with low normal TSH range.


Assuntos
Hipotireoidismo , Tireotropina , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Pós-Menopausa , Hipotireoidismo/tratamento farmacológico , Triglicerídeos , Glucose , Terapia de Reposição Hormonal , Tiroxina
4.
Climacteric ; 26(1): 47-54, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36351874

RESUMO

OBJECTIVE: This article aimed to study the use of menopausal hormone therapy (MHT) among Spanish perimenopausal and postmenopausal women, the presence of menopausal symptoms and the sources of information. METHODS: The epidemiological study using a survey included Spanish perimenopausal or postmenopausal women aged between 40 and 70 years in August 2021. RESULTS: A total of 1254 women were included. In the postmenopausal group, 86% reported one or more menopausal symptoms; the most frequent was vulvovaginal dryness (57%). Among the symptomatic women, 15.2% used some treatment. Vasomotor symptoms (p = 0.001), vulvovaginal atrophy (p < 0.001) and symptoms related to sexuality (p < 0.001) were associated with greater use of treatments; 2.5% of postmenopausal women used MHT. In the perimenopausal group, 75.1% were symptomatic, hot flashes being the most frequent. Only insomnia was related to greater use of some treatment (p = 0.021); 1.6% of perimenopausal women used MHT. The most common reason for women's rejection of MHT was the fear of side effects, especially cancer. The gynecologist was the most frequently used source of information. CONCLUSIONS: Although there is a high prevalence of symptoms, the use of MHT in Spanish perimenopausal and postmenopausal women is very low.


Assuntos
Fogachos , Distúrbios do Início e da Manutenção do Sono , Feminino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Fogachos/tratamento farmacológico , Fogachos/epidemiologia , Terapia de Reposição de Estrogênios , Inquéritos e Questionários , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Menopausa
5.
Climacteric ; 26(3): 216-221, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37011666

RESUMO

In the last 20 years, the prevalence of type 2 diabetes mellitus (T2DM) has tripled in adults aged 20-79 years, affecting more than 25% of people over 50 years of age and especially women during menopause. After the menopause transition, women gain weight, increasing abdominal fat and decreasing lean body mass, with a significant reduction in energy expenditure. Increased insulin resistance and hyperinsulinism characterize this period, aggravated by an increase in plasma proinflammatory cytokines and free fatty acids, and a state of relative hyperandrogenism. Previous recommendations systematically excluded women with T2DM from menopause hormone therapy (MHT); new evidence confirms that MHT significantly reduces the diagnosis of new-onset T2DM and may be beneficial in terms of glycemic control when used for menopause symptom management in patients with pre-existing T2DM. A comprehensive and individualized approach is considered the first line of management for women during this period, especially in T2DM patients or in women at risk of developing the disease. The objectives of this presentation are to review the etiopathogenic factors involved in the increased incidence of new cases of T2DM during menopause, the impact of menopause on T2DM and the role of MHT.


Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/epidemiologia , Menopausa
6.
Mol Med ; 28(1): 44, 2022 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-35468719

RESUMO

BACKGROUND: Menopausal hormone therapy (MHT) is recommended for only five years to treat vasomotor symptoms and vulvovaginal atrophy because of safety concerns with long-term treatment. We investigated the ability of 2',3',4'-trihydroxychalcone (2',3',4'-THC) to modulate estrogen receptor (ER)-mediated responses in order to find drug candidates that could potentially prevent the adverse effects of long-term MHT treatment. METHODS: Transfection assays, real time-polymerase chain reaction, and microarrays were used to evaluate the effects of 2',3',4'-THC on gene regulation. Radioligand binding studies were used to determine if 2',3',4'-THC binds to ERα. Cell proliferation was examined in MCF-7 breast cancer cells by using growth curves and flow cytometry. Western blots were used to determine if 2',3',4'-THC alters the E2 activation of the MAPK pathway and degradation of ERα. Chromatin immunoprecipitation was used to measure ERα binding to genes. RESULTS: The 2',3',4'-THC/E2 combination produced a synergistic activation with ERα on reporter and endogenous genes in human U2OS osteosarcoma cells. Microarrays identified 824 genes that we termed reprogrammed genes because they were not regulated in U2OS-ERα cells unless they were treated with 2',3',4'-THC and E2 at the same time. 2',3',4'-THC blocked the proliferation of MCF-7 cells by preventing the E2-induced activation of MAPK and c-MYC transcription. The antiproliferative mechanism of 2',3',4'-THC differs from selective estrogen receptor modulators (SERMs) because 2',3',4'-THC did not bind to the E2 binding site in ERα like SERMs. CONCLUSION: Our study suggests that 2',3',4'-THC may represent a new class of ERα modulators that do not act as a direct agonists or antagonists. We consider 2',3',4'-THC to be a reprogramming compound, since it alters the activity of ERα on gene regulation and cell proliferation without competing with E2 for binding to ERα. The addition of a reprogramming drug to estrogens in MHT may offer a new strategy to overcome the adverse proliferative effects of estrogen in MHT by reprogramming ERα as opposed to an antagonist mechanism that involves blocking the binding of estrogen to ERα.


Assuntos
Neoplasias Ósseas , Neoplasias da Mama , Feminino , Humanos , Neoplasias da Mama/genética , Neoplasias da Mama/metabolismo , Proliferação de Células , Estradiol/metabolismo , Estradiol/farmacologia , Receptor alfa de Estrogênio/agonistas , Receptor alfa de Estrogênio/genética , Receptor alfa de Estrogênio/metabolismo , Estrogênios/farmacologia , Moduladores Seletivos de Receptor Estrogênico/metabolismo , Moduladores Seletivos de Receptor Estrogênico/farmacologia
7.
Climacteric ; 25(6): 579-585, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36179737

RESUMO

OBJECTIVE: This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women. METHODS: A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status. RESULTS: A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety. CONCLUSION: Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.


Assuntos
Transtornos do Humor , Pós-Menopausa , Feminino , Humanos , Transtornos do Humor/tratamento farmacológico , Estudos Transversais , Sobrepeso , Terapia de Reposição Hormonal , Menopausa/psicologia
8.
Climacteric ; 25(2): 195-202, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34323137

RESUMO

BACKGROUND: Dementia is a major public health problem. Estrogen is a regulator of the central nervous system and its deficit could be involved in cognitive decline in older women. OBJECTIVE: This study aimed to evaluate the association of bilateral oophorectomy, menopause hormone therapy (MHT) and other factors on mild cognitive impairment (MCI). METHOD: The case-control study included 941 otherwise healthy postmenopausal women aged 60 years and over from six Latin American countries. Personal and family data were recorded and MCI was assessed using the Montreal Cognitive Assessment test (MoCA). RESULTS: Average age, years of education and body mass index were 66.1 ± 5.8 years, 12.4 ± 5.0 years and 26.0 ± 4.3 kg/m2, respectively. A total of 30.2% had undergone bilateral oophorectomy and 40.3% had used MHT. A total of 232 women (24.7%) had MCI. The prevalence of MCI was higher in women with intact ovaries and non-MHT users as compared to MHT users (29.3% vs. 11.7% [odds ratio (OR) 0.32; 95% confidence interval (CI) 0.20-0.51]). Among oophorectomized women, MCI prevalence was higher among non-MHT users as compared to MHT users (45.2% vs. 12.8% [OR 0.18; 95% CI 0.10-0.32]). Logistic regression analysis determined that the variables associated with MCI were age >65 years (OR 1.69; 95% CI 1.20-2.38), parity (having >2 children; OR 1.69; 95% CI 1.21-2.37), bilateral oophorectomy (OR 1.56; 95% CI 1.09-2.24), hypertension (OR 1.41; 95% CI 1.01-1.96), being sexually active (OR 0.56; 95% CI 0.40-0.79), education >12 years (OR 0.46; 95% CI 0.32-0.65) and MHT use (OR 0.31; 95% CI 0.21-0.46). CONCLUSION: Age, parity, bilateral oophorectomy and hypertension are independent factors associated with MCI; contrary to this, higher educational level, maintaining sexual activity and using MHT are protective factors.


Assuntos
Disfunção Cognitiva , Hipertensão , Idoso , Estudos de Casos e Controles , Criança , Disfunção Cognitiva/epidemiologia , Feminino , Terapia de Reposição Hormonal , Humanos , Menopausa , Pessoa de Meia-Idade , Ovariectomia
9.
Circulation ; 142(25): e506-e532, 2020 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-33251828

RESUMO

Cardiovascular disease (CVD) is the leading cause of death in women, who have a notable increase in the risk for this disease after menopause and typically develop coronary heart disease several years later than men. This observation led to the hypothesis that the menopause transition (MT) contributes to the increase in coronary heart disease risk. Over the past 20 years, longitudinal studies of women traversing menopause have contributed significantly to our understanding of the relationship between the MT and CVD risk. By following women over this period, researchers have been able to disentangle chronological and ovarian aging with respect to CVD risk. These studies have documented distinct patterns of sex hormone changes, as well as adverse alterations in body composition, lipids and lipoproteins, and measures of vascular health over the MT, which can increase a woman's risk of developing CVD postmenopausally. The reported findings underline the significance of the MT as a time of accelerating CVD risk, thereby emphasizing the importance of monitoring women's health during midlife, a critical window for implementing early intervention strategies to reduce CVD risk. Notably, the 2011 American Heart Association guidelines for CVD prevention in women (the latest sex-specific guidelines to date) did not include information now available about the contribution of the MT to increased CVD in women. Therefore, there is a crucial need to discuss the contemporary literature on menopause and CVD risk with the intent of increasing awareness of the significant adverse cardiometabolic health-related changes accompanying midlife and the MT. This scientific statement provides an up-to-date synthesis of the existing data on the MT and how it relates to CVD.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Menopausa , Prevenção Primária , Saúde da Mulher , Adulto , Fatores Etários , Idoso , American Heart Association , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Terapia de Reposição de Estrogênios , Feminino , Nível de Saúde , Humanos , Hipolipemiantes/uso terapêutico , Pessoa de Meia-Idade , Fatores de Proteção , Medição de Risco , Fatores de Risco , Comportamento de Redução do Risco , Fatores Sexuais , Fatores de Tempo , Tempo para o Tratamento , Resultado do Tratamento , Estados Unidos
10.
Climacteric ; 24(2): 171-178, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-32914657

RESUMO

BACKGROUND: Menopause is a natural important transition in women's life. Having adequate knowledge and perception about menopause at a young age is critical for women to cope better with its associated consequences and improve their well-being. OBJECTIVE: This study evaluated the awareness, knowledge, and perception of menopause and menopause hormone therapy (MHT) among premenopausal females from Jordan. METHODS: A cross-sectional study including females aged 20-40 years (n = 450) was conducted from November 2018 to March 2019 in two hospitals in Irbid, Jordan. A structured questionnaire was developed based on previous literature and using the Green Climacteric Scale to assess participants' knowledge and awareness of signs and symptoms of menopause and MHT. Data were collected by face-to-face interview. Factors associated with the degree of menopausal knowledge were identified. RESULTS: The mean ± standard deviation age of participants was 29.1 ± 6.3 years. More than half of participants were knowledgeable about several aspects of menopause. Education to college or more was significantly and positively associated with knowledge about menopause (ß = 0.504, p = 0.005). The majority of participants did not know the roles, benefits, and risks of MHT. There was an almost equal distribution for participants' positive (47.6%) and negative (50%) attitudes toward menopause. CONCLUSIONS: The findings suggest that premenopausal females in Jordan are knowledgeable about various aspects of menopause. Nevertheless, there is still a need to develop educational programs and implement proper counseling to improve young females' awareness about menopause, particularly its health implications and treatment options.


Assuntos
Terapia de Reposição de Estrogênios/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Menopausa/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pré-Menopausa/psicologia , Adulto , Estudos Transversais , Escolaridade , Feminino , Humanos , Jordânia , Percepção , Inquéritos e Questionários , Saúde da Mulher , Adulto Jovem
11.
Acta Endocrinol (Buchar) ; 17(1): 90-100, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34539915

RESUMO

OBJECTIVES: The present paper aims to investigate the effects of both progesterone and progestin treatment mainly related to the occurrence of breast cancer in women. MATERIALS AND METHODS: Extensive systematic bibliographic review of Greek and International articles was conducted through the electronic databases Pubmed, Cinahl, Uptodate, and Google Scholar for the identification of articles related to progesterone, progestins and breast cancer treatment. RESULTS: Hormone therapy with the use of estrogen alone presents a small increased risk or does not present at all an increased risk of breast cancer. With ORs in some studies below 1.0 in current users for 3 plus years and safe option until 7 years, while in other studies the risk was increased with the ORs 1.29. However, the use of estrogen in combination with progestogens, depending on the type of progestogens, shows an increased risk of breast cancer, with the ORs to vary between 1.14- 2.38 from 3 to 5 years and is inversely proportional to the time of its use. This risk varies depending on the combination of the preparations. Other factors that are associated with breast cancer risk when receiving hormone therapy are the years that hormone therapy is taken, directly proportional to the risk. At higher risk are older women, women with low body mass index in menopause (BMI <25kg/m2) and women with increased mammographic breast density. Continued use of hormone therapy is associated with an increased risk for breast cancer compared to sequential. The risk became visible sooner to women who used in the past hormone therapy and were using it again. Starting hormone therapy in the immediate postmenopausal period also increased the risk for breast cancer. Hormone therapy was associated with tumors with positive estrogen and progesterone receptors, and also the lobular histological type was associated with its use. Tibolone use was associated with an increased risk.

12.
Climacteric ; 23(6): 614-621, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32543223

RESUMO

OBJECTIVE: This study aims to understand the attitude of health-care professionals (HPs) in mainland China toward menopause management (MM) as well as the knowledge they have received regarding MM during training. METHODS: An anonymous survey recruited 3709 medical workers nationwide (including physicians, orthopedists, obstetricians and gynecologists, and general practitioners) through online surveys and on-site interviews at professional meetings. RESULTS: Of the 3709 questionnaires completed, 3426 questionnaires met the inclusion criteria. Of the participants, 1532 HPs had not received menopause management training (MMT) in nearly 1 year. Among the residents and physician assistants, 103 reported they were not familiar with MM. Satisfyingly, 98.3% of HPs considered it very important or essential to accept MM. Although most interviewees replied some correct menopausal knowledge, nearly half of them could not correctly identify the contraindications for menopause hormone therapy (MHT). Additionally, 73.1% of HPs would advise patients with premature ovarian insufficiency to receive hormone replacement therapy at least until the average age of menopause. CONCLUSION: This survey indicated that HPs have some knowledge regarding MM, but a gap remains to master the basic theory of MHT. In order to manage the growing menopausal population in China, creating more in-depth educational MMT programs for HPs is necessary.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Menopausa , Médicos/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Saúde da Mulher/estatística & dados numéricos , Adulto , Atitude do Pessoal de Saúde , China , Educação Médica , Terapia de Reposição de Estrogênios/psicologia , Feminino , Clínicos Gerais/educação , Clínicos Gerais/psicologia , Ginecologia/educação , Ginecologia/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Obstetrícia/educação , Obstetrícia/estatística & dados numéricos , Cirurgiões Ortopédicos/educação , Cirurgiões Ortopédicos/psicologia , Inquéritos e Questionários
13.
BMC Womens Health ; 20(1): 277, 2020 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-33371883

RESUMO

OBJECTIVE: To study what women think about menopause treatments and assess their knowledge about them. To analyze adherence to treatment during COVID-19 confinement as a secondary objective. METHODS: A multi-center cross-sectional observational study was conducted using a survey of 2500 women between January and June 2019. This was administered following a non-probability sampling procedure including women between 35 and 75 years. An extension study was conducted during the coronavirus pandemic, between March and June 2020. RESULTS: The responses of 2355 surveyed women were analyzed. Of this sample, 42% knew about menopause hormone therapy (MHT). The most frequently identified indication was the treatment of hot flashes (65.6%). The MHT risks most frequently perceived were weight gain (24.2%) and breast cancer (21.7%); the main reason for rejecting MHT was a lack of information (96.1%). Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care and level of education. During the coronavirus confinement period, 85 women using MHT were located, of which 84.7% continued it. CONCLUSIONS: Women hold certain false beliefs about menopause, and their knowledge of the available treatments is somewhat limited. Adherence to MHT during the COVID-19 confinement in Spain has been high.


Assuntos
COVID-19 , Terapia de Reposição de Estrogênios , Conhecimentos, Atitudes e Prática em Saúde , Menopausa , Estudos Transversais , Feminino , Humanos , Adesão à Medicação/estatística & dados numéricos , Espanha
14.
Climacteric ; 22(1): 34-37, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30407085

RESUMO

As global life expectancy improves, women are expected to spend more than one-third of their lives in the status of menopause. In China, many women suffer from menopausal symptoms during this period, which impacts their well-being and quality of life. However, most Chinese women simply endure menopausal symptoms. Since the Chinese Menopause Society was founded in 1999, several versions of the guidelines for menopause management and menopausal hormone therapy (MHT) have been published; international cooperation has strengthened; menopause-related activities have been advocated; and popular knowledge of menopause and MHT has gradually improved. Medical workers, menopausal women, and the general population have come to realize that MHT is the most effective treatment for menopausal symptoms and could improve quality of life. In addition to MHT, non-hormone management (traditional Chinese medicine, lifestyle changes, social/psychological interventions, dietary management, etc.) of menopausal symptoms is an important consideration, especially in situations when MHT is contra-indicated. This review summarizes the literature and research studies to help health care acknowledge the population and prevent underuse of effective therapies or use of inappropriate or ineffective therapies, which, in turn, is expected to improve public health management and women's quality of life. More efforts should be made to better disseminate the knowledge on perimenopausal management among Chinese women.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Terapia de Reposição Hormonal/efeitos adversos , Terapia de Reposição Hormonal/métodos , Perimenopausa , Qualidade de Vida , China , Feminino , Pessoal de Saúde , Humanos , Saúde da Mulher
15.
Medicina (Kaunas) ; 55(10)2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31581598

RESUMO

During the menopausal transition, which begins four to six years before cessation of menses, middle-aged women experience a progressive change in ovarian activity and a physiologic deterioration of hypothalamic-pituitary-ovarian axis function associated with fluctuating hormone levels. During this transition, women can suffer symptoms related to menopause (such as hot flushes, sleep disturbance, mood changes, memory complaints and vaginal dryness). Neurological symptoms such as sleep disturbance, "brain fog" and mood changes are a major complaint of women transitioning menopause, with a significant impact on their quality of life, productivity and physical health. In this paper, we consider the associations between menopausal stage and/or hormone levels and sleep problems, mood and reduced cognitive performance. The role of estrogen and menopause hormone therapy (MHT) in cognitive function, sleep and mood are also discussed.


Assuntos
Terapia de Reposição de Estrogênios , Fogachos/tratamento farmacológico , Menopausa , Afeto/fisiologia , Cognição , Feminino , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Sono
16.
Climacteric ; 21(3): 256-266, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29521155

RESUMO

Migraine is a common, disabling and incapacitating headache disorder that may be triggered by many factors, such as hormones especially during the perimenopausal period, where large alterations in estradiol levels can occur. The evidence implies that hormonal fluctuations are one of the important triggers of migraine. During reproductive life and during hormonal contraception, the course of migraine can be impacted. Different types of migraine with and without aura can be variously influenced by hormones. Migraine can constitute a risk factor for stroke and this must be taken in account for menopause hormone therapy. Hormone therapy is a possible approach to prevent migraine that happens during the menopause transition. Scarce data on the various regimens and types of hormone therapy are available. Transdermal estradiol displays a more favorable profile on migraine than oral estrogens because it may provide more constant levels of estrogens.


Assuntos
Menopausa , Transtornos de Enxaqueca/prevenção & controle , Administração Cutânea , Anticoncepção , Estradiol/administração & dosagem , Terapia de Reposição de Estrogênios , Estrogênios/administração & dosagem , Feminino , Humanos , Transtornos de Enxaqueca/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/etiologia
17.
Climacteric ; 21(4): 321-325, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29583028

RESUMO

It is well established that unopposed estrogen for hormone therapy in postmenopausal women (MHT) induces a dose-related stimulation of the endometrium associated with an increased risk of hyperplasia and endometrial cancer. Progesterone acts physiologically to counteract the proliferative effects of estradiol during the menstrual cycle. In MHT, progestogens protect the endometrium against the proliferative effects of estrogens in women with a uterus. Recent data suggest that, whereas micronized progesterone is apparently safer for the breast, it could be less efficient than synthetic progestin on the endometrium. An update on progestogen and endometrial safety in MHT is the subject of this review.


Assuntos
Mama/efeitos dos fármacos , Endométrio/efeitos dos fármacos , Terapia de Reposição de Estrogênios/métodos , Progesterona/fisiologia , Progestinas/fisiologia , Neoplasias da Mama/induzido quimicamente , Neoplasias do Endométrio/induzido quimicamente , Terapia de Reposição de Estrogênios/efeitos adversos , Feminino , Humanos , Perimenopausa , Progesterona/efeitos adversos , Progestinas/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
J Obstet Gynaecol Res ; 44(8): 1445-1450, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29845685

RESUMO

AIM: To investigate the differences in leiomyoma pathophysiology by patient age at the time of surgery and the possible significance of postmenopausal uterine leiomyomas, particularly variants. METHODS: We retrospectively reviewed data from 471 patients who underwent surgery for uterine leiomyomas and evaluated their clinical data. RESULTS: Overall, 441 (93.4%) women were premenopausal and 30 (6.4%) were postmenopausal. There were no differences in the frequency of the coexistence of ovarian steroid-dependent diseases among age groups. Common histopathological features were observed in most cases despite menopausal status; however, the incidence of variants among postmenopausal patients was high compared to that among premenopausal women (23.3% [7/30] vs 3.2% [14/441], respectively). Among the variant leiomyomas in postmenopausal patients, lipoleiomyomas comprised six. CONCLUSION: Although progesterone is known to play a vital role in promoting leiomyoma growth, it reportedly performs dual actions and does not always stimulate leiomyoma growth. Our study may support the idea that the dual action of progesterone is the primary reason for the surgical treatment required for uterine leiomyomas in the postmenopausal period. We also found that lipoleiomyoma might be the most common uterine leiomyoma variant requiring surgical treatment among postmenopausal women. Thus, we must consider the diagnosis of uterine lipoleiomyoma in postmenopausal women with uterine leiomyomas.


Assuntos
Leiomioma/patologia , Pós-Menopausa , Neoplasias Uterinas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Leiomioma/classificação , Leiomioma/cirurgia , Pessoa de Meia-Idade , Pré-Menopausa , Estudos Retrospectivos , Neoplasias Uterinas/classificação , Neoplasias Uterinas/cirurgia , Adulto Jovem
19.
Climacteric ; 19(2): 109-50, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26872610

RESUMO

The International Menopause Society (IMS) has produced these new 2016 recommendations on women's midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.


Assuntos
Terapia de Reposição de Estrogênios , Menopausa/fisiologia , Saúde da Mulher , Adulto , Peso Corporal , Doenças Cardiovasculares , Dieta , Medicina Baseada em Evidências , Exercício Físico , Feminino , Humanos , Estilo de Vida , MEDLINE , Menopausa Precoce , Neoplasias , Guias de Prática Clínica como Assunto , Qualidade de Vida , Sociedades Médicas
20.
J Obstet Gynaecol India ; 74(3): 196-200, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38974746

RESUMO

There is an interest in menopause that demands answers and solutions. Menopause affects each women differently and hence it is unique and needs to be talked about. This focus has led to improvement in women's health bringing about better outcome in physical and mental health. Increase in life expectancy has led to menopausal health care, an important issue. Menopause is not disease but causes symptoms that can differ individually. Occasionally, surgery, radiation, and medications can cause menopause. Menopause hormone therapy (MHT), nonhormonal therapy, and lifestyle modifications under supervision can improve menopausal outcome. It also gives window of opportunity to evaluate and reduce risk of cardiovascular, bone, and urogenital health. Menopausal women should be provided with all options that are suitable and feasible for improvement in their life.

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