The relationship between carotid intima-media thickness and cognitive function and depression in postmenopausal women.

Introduction: Atherosclerosis, cognitive impairment, and depression are common entities in postmenopausal patients. Our aim was to ascertain the relationship between the carotid intima-media thickness (IMT) and cognitive function and depression in postmenopausal women. Material and methods: This was an observational, cross-sectional, comparative study among postmenopausal women. A carotid artery ultrasound was performed, and the IMT was measured. Mental function was assessed with the mini-mental state examination (MMSE), and the presence of depression with the Hamilton Depression Rating Scale (HDRS). For statistical analysis the Mann-Whitney U test and Spearman correlation were used. Sensitivity, specificity, positive predictive value, negative predictive value, and odds ratio (OR) were calculated. Results: Seventy-five patients were studied. The median of age was 52 years (31-76), and the IMT was 1.1 mm (0.6-0.20). The HDRS score was 8.9 (1-21), and that of the MMSE was 29 (18-30). After dividing the group according to the presence or absence of depression, it was found that age and IMT were greater in the group with depression, and the MMSE score was greater in the group without depression. After dividing according to the MMSE score, age and HDRS score were significantly greater in the group with cognitive impairment. The intima-media thickness had an OR of 12.2 (2.6-58.0) for cognitive impairment and an OR of 5.2 (1.9-14.1) for depression. Conclusions: The intima-media thickness is associated with greater risk of cognitive impairment and depression.

Frequency of olfactory dysfunction in pregnant women with SARS-CoV-2 infection.

INTRODUCTION: In patients with COVID-19, olfactory dysfunction and anosmia have been reported, which in pregnant women occur in up to 24.2 %. OBJECTIVE: To know the frequency at which pregnant women with SARS-CoV-2 infection have olfactory dysfunction. METHODS: Age, gestational age, temperature, presence of nasal constipation or rhinorrhea, myalgia, headache, cough or chest pain were asked. Whether patients perceived and identified the scent of grape juice, coffee powder and menthol was evaluated. Central tendency and dispersion measures, frequencies and percentages were used. Sensitivity, specificity, positive and negative predictive value were calculated. Mann-Whitney's U-test and contrast of proportions were used for comparisons between groups. RESULTS: There was a higher proportion of women with cough, headache, dyspnea, myalgia, odynophagia, rhinorrhea, chest pain, and anosmia in SARS-CoV-2-positive women. In patients without COVID-19, 88.9 % detected each one of the scents; only 31.8 % of the positive group detected grapes scent, 47.7 % coffee and 59.1 % menthol, which had the highest percentages of sensitivity (40 %), specificity (21 %), positive predictive value (59 %) and negative predictive value (11 %). CONCLUSION: Olfactory dysfunction occurs in a significant percentage of pregnant women with COVID-19.

INTRODUCCIÓN: En pacientes con COVID-19 se ha reportado disfunción olfatoria y anosmia; en la mujer embarazada se presenta hasta en 24.2 %. OBJETIVO: Conocer la frecuencia con la que las mujeres embarazadas e infección por SARS-CoV-2 tienen disfunción olfatoria. MÉTODOS: Se preguntó edad, edad gestacional, temperatura, presencia de constipación nasal o rinorrea, mialgias, cefalea, tos o dolor torácico, además de evaluar si las mujeres percibían e identificaban el aroma de jugo de uva, café en polvo y mentol. Se utilizaron medidas de tendencia central y dispersión, frecuencias y porcentajes. Se calculó sensibilidad, especificidad, valor predictivo positivo y negativo. La U de Mann-Whitney y el contraste de proporciones sirvieron para las comparaciones entre los grupos. RESULTADOS: Hubo mayor proporción de mujeres con tos, cefalea, disnea, mialgias, odinofagia, rinorrea, dolor torácico y anosmia en mujeres positivas a SARS-CoV-2. De las pacientes sin COVID-19, 88.9 % detectó cada uno de los aromas; solo 31.8 % del grupo positivo detectó el aroma a uva, 47.7 % el de café y 59.1 % el de mentol, el cual tuvo los porcentajes más altos en sensibilidad (40 %), especificidad (21 %), valores predictivos positivo (59 %) y negativo (11 %). CONCLUSIÓN: la disfunción olfatoria se presenta en un porcentaje importante de las mujeres embarazadas con COVID-19.

Relationship of vitamin D blood concentration with muscle mass and cognitive function in postmenopausal women.

INTRODUCTION: Low levels of vitamin D have been associated with muscle mass loss and cognitive function alteration. OBJECTIVE: To find out the relationship of vitamin D blood levels with muscle mass and cognitive function in postmenopausal women. MATERIALS AND METHODS: Ninety-nine postmenopausal women aged ≥ 50 years were studied. Calf circumference, and tricipital, bicipital, subscapular and suprailiac skinfolds were measured. Arm muscle area, bone-free arm muscle area, and muscle mass were calculated. The short physical performance battery (SPPB) was performed, and the sarcopenia rapid diagnostic questionnaire (SARC-F), as well as the Mini Mental State Examination (MMSE) were applied. A blood sample was taken to measure vitamin D blood concentration. For statistical analysis, Mann-Whitney's U-test and Spearman's correlation analysis were used. RESULTS: It was found that, the older the age, the higher the vitamin D levels, as well as higher SARC-F score. Vitamin D levels were negatively correlated with grip strength and SPPB. There was a negative correlation between vitamin D levels and MMSE global score. CONCLUSIONS: Vitamin D did not have a positive influence on muscle mass. A better MMSE performance was observed in those with lower vitamin D levels.

INTRODUCCIÓN: Las concentraciones bajas de vitamina D se han asociado con la pérdida de masa muscular y la alteración de la función cognitiva. OBJETIVO: Conocer la relación de la concentración sanguínea de vitamina D con la masa muscular y la función cognitiva en mujeres posmenopáusicas. MATERIALES Y MÉTODOS: Se estudiaron 99 mujeres posmenopáusicas ≥ 50 años. Se midió la circunferencia de la pantorrilla, los pliegues cutáneos tricipital, bicipital, subescapular y suprailíaco. Se calcularon: el área muscular del brazo, el área muscular libre de hueso y la masa muscular total. Se realizó la prueba corta de desempeño físico (PCDF), se aplicó el cuestionario de diagnóstico rápido de sarcopenia (SARC-F) y el Mini Examen del Estado Mental (MMSE). Se tomó una muestra de sangre para medir la concentración de vitamina D en sangre. Para el análisis estadístico se utilizó la prueba U de Mann-Whitney y análisis de correlación de Spearman. RESULTADOS: Se encontró que a mayor edad hubieron mayores concentraciones de vitamina D y mayor puntaje SARC-F. Las concentraciones de vitamina D se correlacionaron negativamente con la fuerza de agarre, la PCDF y la puntuación total del MMSE. CONCLUSIONES: La vitamina D no tuvo una influencia positiva sobre la masa muscular. Se observó un mejor desempeño en el MMSE en aquellas con concentraciones más bajas de vitamina D.

Relationship of the neutrophil/lymphocyte ratio with cardiovascular risk markers in premenopausal and postmenopausal women.

INTRODUCTION: Cardiovascular disease is more frequent in postmenopausal women. Atherosclerosis is associated with inflammation and the neutrophil/lymphocyte ratio (NLR) is a marker of inflammation whose behavior in postmenopause is unknown. AIM OF THE STUDY: To know the relationship of the NLR with cardiovascular risk markers in premenopausal and postmenopausal women. MATERIAL AND METHODS: Premenopausal and postmenopausal women were studied, in all of them a complete hemogram and the NLR, platelet/lymphocyte ratio (PLR) were calculated, also glucose and lipids levels were measured. In all of them subcutaneous and visceral fat, carotid intima-media thickness (IMT), epicardial fat were measured by ultrasound Also baseline and and after flow-mediated stimulus the arterial diameter, the pulsatility index and the resistive index of the brachial artery were measured by ultrasound. The results are reported with medians and intervals, Mann-Whitney U and Spearman correlation analysis were performed. RESULTS: Eighty two patients were recruited, 41 premenopausal and 41 postmenopausal. When comparing both groups there was no difference in glucose, lipids, NLR, PLR, carotid IMT, epicardial fat, subcutaneous fat, visceral fat or Doppler parameters of the brachial artery. CONCLUSION: NLR was not different between premenopausal and postmenopausal women but abnormal PLR was greater in those postmenopausal with vasomotor symptoms.

Efecto de la frecuencia de aplicación de estrógenos locales sobre el grosor endometrial en mujeres posmenopáusicas.

INTRODUCTION: Conjugated estrogens, when used by the vaginal route for the relief of vaginal dryness and atrophy, can produce endometrial changes. OBJECTIVE: To know the effect of vaginal conjugated estrogens application frequency on endometrial thickness in postmenopausal women. METHOD: Seventy postmenopausal women with vaginal dryness who received conjugated estrogen cream (0.625 mg/1 g) for 12 weeks were studied. The women were divided according to application frequency as follows: group 1, twice-weekly (n = 35), and group 2, thrice-weekly (n = 35). At baseline and at end-of-treatment, vaginal cytology was examined to determine the estrogenic value, and an endovaginal ultrasound was performed to measure endometrial thickness. The comparison between groups was carried out with Mann Whitney's U-test, and the comparison between baseline and post-treatment values, with Wilcoxon's test. RESULTS: Of 70 recruited women, only 38 were studied, 19 in each group, paired by baseline estrogenic value. No difference was found between groups, neither at baseline nor after treatment, in the maturation index, estrogenic value or endometrial thickness. CONCLUSION: There were no differences in endometrial thickness between the conjugate estrogen cream different application frequencies.

INTRODUCCIÓN: Los estrógenos conjugados vía vaginal para aliviar la atrofia y sequedad vaginales pueden producir cambios endometriales. OBJETIVO: Conocer el efecto de la frecuencia de aplicación de estrógenos conjugados vía vaginal en el grosor endometrial en mujeres posmenopáusicas. MÉTODO: Se estudiaron 70 mujeres posmenopáusicas con sequedad vaginal que recibieron estrógenos conjugados en crema (0.625 mg/1 g) durante 12 semanas divididas de la siguiente manera según la frecuencia de aplicación: grupo 1, dos veces por semana (n = 35) y grupo 2, tres veces por semana (n = 35). Al inicio y final del tratamiento se determinó el valor estrogénico en la citología vaginal y se realizó ultrasonido endovaginal para medir el grosor endometrial. La comparación entre los grupos se realizó con U de Mann-Whitney y entre los valores pre y postratamiento con prueba de Wilcoxon. RESULTADOS: De 70 mujeres reclutadas solo se estudiaron 38 mujeres, 19 en cada grupo, pareadas por valor estrogénico inicial. No se encontró diferencia entre los grupos, ni antes ni después del tratamiento, en el índice de maduración, valor estrogénico ni grosor endometrial. CONCLUSIÓN: No hubo diferencias en el grosor endometrial entre las distintas frecuencias de aplicación de estrógenos conjugados en crema.

Sexual dysfunction prevalence in a group of pre- and postmenopausal Mexican women.

INTRODUCTION: To determine the prevalence of sexual dysfunction in pre and postmenopausal women. MATERIAL AND METHODS: A cross-sectional, descriptive, comparative study was done in climacteric women from 40 to 59 years of age. Female sexual function was evaluated with the female sexual function index (FSFI) on the day of consultation. The comparison between pre and postmenopausal women and between those with or without sexual dysfunction was done with Mann Whitney U test, χ2, and Spearman's correlation analysis was done. RESULTS: One hundred and ten women were studied, 55 were premenopausal (group 1) and 55 postmenopausal (group 2). The median of age in group 1 was 46 (40-58) years and in group 2 it was 53 (45-60) years. Premenopausal women had higher education level than postmenopausal women (p < 0.023). From those sexually active, 62.1% had sexual dysfunction. No statistically significant difference was found in education level, religion and marital status between women with or without sexual dysfunction. No difference in sexual dysfunction was found between premenopausal (62.1%) and postmenopausal (62.5%) women, but greater sexual dysfunction was found starting from 50 years age. Age negatively correlated with FSFI score (ρ = -0.324, p < 0.001). CONCLUSION: In postmenopausal women, those older had a greater impairment in sexual function.

Differences in the What's My M3? test between pre- and postmenopausal women.

AIM OF THE STUDY: To evaluate the differences in the What's My M3 test between pre and postmenopausal women. MATERIAL AND METHODS: Pre- and postmenopausal women who attended an endocrine gynaecology consultation were studied. In all them, the What's My M3? test was applied. Descriptive statistics, central tendency and dispersion measures were used. Differences between groups were assessed with Mann Whitney U test, and Spearman correlation analysis was carried out for age and time since menopause with the What's My M3? score. RESULTS: A total of 404 patients, aged 45 to 55 years, were surveyed. Women with previous diagnosis of depressive disorder, antidepressant use, history of hysterectomy with or without bilateral salpingo-oophorectomy were excluded. Finally 202 premenopausal and 164 postmenopausal were studied. A score in the What's My M3? test ≥ 33 was considered as abnormal. Postmenopausal women had a higher score in the test than premenopausal women, 15 (0-69) and 6 (0-42) respectively (p < 0.001). In the sub-analysis of the What's My M3? test, also the postmenopausal women had statistically significant greater score in depression, anxiety, bipolar disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. It was found that when older, the women had a higher score (p < 0.001), (Spearman's Rho, p < 0.005). CONCLUSIONS: Postmenopausal women had higher score in the What's My M3? test than premenopausal women.

Changes in microscopic analysis of the urinary sediment in postmenopausal women who receive vaginal conjugated oestrogens.

INTRODUCTION: Microscopic haematuria is common in adults and it has been reported in 13% of postmenopausal women. OBJECTIVE: To evaluate the changes in urinary sediment after the use of vaginal conjugated oestrogens. MATERIAL AND METHODS: Postmenopausal women with vaginal dryness were studied. In all them a urinalysis was done, looking for density, pH, and the presence of leukocytes and erythrocytes. In order to be included in the study, all of the women had to have microscopic haematuria, considered as the presence of 3 or more erythrocytes in the urinary sediment. All received vaginally 1 g of conjugated equine oestrogens cream 3 times per week for one month, moment in which a new urinalysis was carried out and the same parameters were evaluated. RESULTS: Twenty-four women were studied. The median age was 62 years (40-83), and the time since menopause was 144 months (24-336). When comparing the values between baseline and end of treatment urinalyses, no significant differences in pH and urinary density were found. The number of leukocytes significantly decreased after treatment (3.0 [1-6] vs. 1.0 [1-6], p < 0.026), and the erythrocytes number decreased (4.5 [3-12] vs. 0.0 [0-2], p < 0.001). CONCLUSION: In postmenopausal women with microscopic haematuria and vaginal dryness, it is worth considering administration of local oestrogen for one month, and after repeat the urine exam, before deciding to begin the microscopic haematuria study protocol.

Brachial artery Doppler flux parameters before and after hot flush in Mexican postmenopausal women: preliminary report.

OBJECTIVE: To analyse brachial artery flux parameters in postmenopausal women before and after hot flush. MATERIAL AND METHODS: Two groups of postmenopausal women were studied: Group I, without vasomotor symptoms (n = 10) and Group II, with vasomotor symptoms (n = 10). In all them a brachial artery Doppler ultrasound was done, measuring before and after hyperaemic stimulus of the arterial diameter (AD), the pulsatility index (PI), and the resistive index (RI). In Group I, measurements were done at baseline and five minutes after. In Group II, measurements were at baseline, and one and five minutes after the hot-flush. Comparison between the groups was done with Mann-Whitney U test, and within the groups with Wilcoxon test. RESULTS: No differences were found among the groups in Doppler parameters. When comparing each group separately, in Group I, at baseline and at five minutes measurements, the AD was greater after the hyperaemic stimulus than before it. In group II at baseline, the PI was significantly greater after the hyperaemic stimulus than before to it. At the first and fifth minute, the AD was significantly greater after the hyperaemic stimulus than before to it. CONCLUSIONS: No differences were found between those who did not have and those who had hot flushes.

Relation between visceral fat and carotid intimal media thickness in Mexican postmenopausal women: a preliminary report.

AIM OF THE STUDY: To investigate the relationship between visceral fat and carotid IMT (intima media thickness) in Mexican postmenopausal women. MATERIAL AND METHODS: In 71 postmenopausal women divided in two groups: group 1, IMT > 1 mm and group 2, IMT ≤ 1 mm, blood pressure, body mass index (BMI), waist hip ratio (WHR), visceral and subcutaneous fats and carotid IMT were analyzed. Descriptive statistics were used and the comparison among those with abnormal and normal IMT was carried out using Mann-Whitney U test; also Spearman's correlation analysis was done. RESULTS: When comparing group 1 (n = 9, 12.7%) with group 2 (n = 62, 87.3%), it was found that the subcutaneous fat, visceral fat and systolic blood pressure were significantly greater in group 1 (p < 0.018, p < 0.001 and p < 0.006, respectively), and also in this group there was a correlation between BMI and subcutaneous fat (ρ = 0.686, p < 0.041) and between visceral fat and the systolic blood pressure (ρ = 0.712, p < 0.031). In group 2, there was a correlation between IMT and diastolic blood pressure (ρ = 0.251, p < 0.049). CONCLUSION: Subcutaneous and visceral fat have an unfavorable effect in the carotid IMT and in blood pressure.

Relation of skinfold thickness and visceral fat with the endothelial function in Mexican postmenopausal women.

OBJECTIVE: To determine the relationship between skinfolds and visceral fat with vascular reactivity according to body weight, fat distribution and time since menopause in Mexican postmenopausal women. MATERIAL AND METHODS: In postmenopausal women, tricipital, suprailiac and subscapular skinfolds as well as blood pressure were measured, and body mass index (BMI) and waist-hip ratio (WHR) were calculated. Brachial artery Doppler ultrasound at baseline and after the hyperemic stimulus was done and Doppler parameters were assessed. For statistical analysis, Pearson and Spearman correlation analysis, as well as Student t were used. RESULTS: Sixty-six postmenopausal women were studied; age was 54.5 ± 7.4 years. Skinfold thickness was related with subcutaneous and visceral fat. In all groups, the arterial diameter increased after the hyperemic stimulus among 6.5% and 9% of women. The pulsatility index decreased in the whole group and in those with BMI ≤ 27, WHR ≤ 0.85 and time since menopause ≤ 10 years. Negative correlations were observed between the percentage of change in arterial dilatation and the subscapular skinfold and subcutaneous fat in the whole group and in the subgroups with BMI > 27 and WHR > 0.85. CONCLUSIONS: Skinfolds are indirectly related with visceral fat, and skinfold thickness permit to conclude about impact in endothelial environment.

Prevalence of fibromyalgia in premenopausal and postmenopausal women and its relation to climacteric symptoms.

AIM OF THE STUDY: To compare fibromyalgia prevalence in premenopausal and postmenopausal women and its relation to the climacteric symptoms. MATERIAL AND METHODS: Two hundred and nine women were studied, who attended the gynecology consultation at the hospital. They were divided in two groups: group I (premenopausal, n = 113) and group II (postmenopausal, n = 96). In all of them, climacteric symptoms and fibromyalgia diagnostic criteria were investigated; for the latter, the evaluations were done according to the 1990 and 2010 criteria of the American College of Rheumatology. RESULTS: When groups I and II were compared, no differences were found in somatometry, medicament consumption and associated diseases. When analyzing the general group, the fibromyalgia prevalence was greater in the postmenopausal women. However, when comparing the groups according to climacteric symptoms, in group I, 29% of symptomatic women had fibromyalgia, while only 4% of asymptomatic ones (p < 0.002). In group II, 15.7% of symptomatic women, and 2.5% of asymptomatic ones had fibromyalgia (p < 0.02). In group I, the more common painful points were the lower back (45.5%), neck (35.7%), and upper back (32.1%). The more frequent symptoms were non-restful sleep (49%), followed by fatigue and cognitive symptoms (42% for each one). In group II, the more common painful points were the lower back (42%), neck (40%) and upper back (38.5%). The more frequent symptoms were fatigue (69.6%), cognitive symptoms (59.3%) and non-restful sleep (57%). CONCLUSIONS: In premenopausal women, fibromyalgia was related to the presence of climacteric symptoms and in postmenopausal women - to their absence.

[Comparison of the frequency and magnitude of the vasomotor symptoms in premenopausal and postmenopausal women from Mexico City]. / Comparación de la frecuencia y magnitud de los síntomas vasomotores en mujeres pre y posmenopáusicas de la Ciudad de México.

BACKGROUND: Decreased ovarian function is associated with several symptoms, being the more frequent the vasomotor and these are associated to several factors. OBJECTIVE: To describe the frequency and magnitude of vasomotor symptoms in premenopausal and postmenopausal women from Mexico City. MATERIAL AND METHODS: A comparative, cross-sectional study was carried out from July 2011 to February 2012 in which somatometry was done and a questionnaire was applied to women beginning from 35 years age, evaluating their menopausal status, educational level, occupation, vasomotor symptoms (hot-flushes and sweats), intensity, frequency and the number of days per week with symptoms. Sample size was calculated considering a confidence interval of 99%, a power of 80%, with a frequency of symptoms presentation in premenopausal women of 55% and 85% in those postmenopausal, with a relationship of 1:1, considering 60 patients in each group. STATISTICAL ANALYSIS: A comparison among the groups was done for continuous variables with Student t test for independent samples and for discontinuous variables with chi2, a p level < 0.05 was considered statistically significant. RESULTS: Of the total population (144 women), 65 (45%) had vasomotor symptoms, 38% did physical exercise and 50% had some chronic illness. Of the 79 premenopausal women (Group 1) 49% was symptomatic and of the 65 postmenopausal women, 46% (Group II). Of the symptomatic ones in the Group I, 100% presented hot-flushes and 77% considered their symptoms severe; in Group II 85% had hot-flushes and the symptoms were considered severe by 63%. CONCLUSION: The vasomotor symptoms were only associated to time since menopause.

[Comparison of Doppler flowmetry in brachial artery in Mexican postmenopausal women with and without symptoms]. / Comparación de la flujometria doppler de la arteria braquial en mujeres posmenopáusicas mexicanas con y sin sintomas vasomotores.

BACKGROUND: Brachial artery doppler fluxometry permits to evaluate the endothelial function in a non-invasive way. OBJECTIVE: To know the effect of vasomotor symptoms in brachial artery flux ultrasonographic parameters in Mexican postmenopausal women. MATERIAL AND METHODS: A prospective study was done including postmenopausal women divided into two groups: I) without hot-flushes and II) with hot-flushes. To all them Doppler fluxometry was done. The pulsatility index resistance index and arterial diameter were determined previous and after the hyperemic stimulus. The intensity of vasomotor symptoms (hot-flushes, throbs and sweatings) was determined using an analog visual scale; and the number of each one of them was determined. For statistical analysis Student t test for independent and paired samples was used. Correlation analysis was done between age, time since menopause, hot flushes, throbs and sweating with pulsatility index, resistance index and arterial diameter previous and after hyperemic stimulus. RESULTS: Thirty patients were divided into two groups of 15 women each. No differences were found between the groups neither in age, anthropometric variables, pulsatility index, resistance index nor arterial diameter neither before nor after hyperemic stimulus; only there was a statistically significant increase in arterial diameter after hyperemic stimulus in group I (p < 0.001). In group I a positive correlation was found between age and baseline resistance index and in group II between baseline resistance index and the number of throbs per week. CONCLUSION: Women with hot-flushes have a healthier endothelium.

[Variability of the menstrual cycle in Mexican women according to the weight and the distribution of the adipose fabric]. / Variabilidad del ciclo menstrual en mujeres mexicanas según el peso y la distribución del tejido adiposo.

BACKGROUND: Menstrual cycle characteristics have been studied throughout the world in several populations. OBJECTIVE: To analyze the frequency of occurrence of menstruation, duration and volume loss during it and its relationship with age, weight and body fat distribution in Mexican women. MATERIAL AND METHODS: prospective, cross-sectional and descriptive study conduced in women which accompanied patients to hospital consultation, with menstrual cycles considered normal by them, age was documented; body mass index (BMI) and waist hip ratio (WHR) were calculated. They were questioned about: periodicity of the cycle, duration, number and type of pads used per day, and the quantity of menstrual bleeding was calculated. STATISTICAL ANALYSIS: Central tendency and dispersion measurements, as well as percentages were calculated. For the comparison between the groups ANOVA was used and Pearson correlation analysis was done. RESULTS: 161 women were studied. Average age was 23.9 +/- 6.1 years, BMI 26.1 +/- 4.3 and WHR 0.9 +/- 0.1. The cycle periodicity was 29.3 +/- 3.1 days, being 86.4% between 28 and 30 days. The periodicity of menstrual bleeding was affected neither by age nor by BMI and WHR. Bleeding duration was 4.9 +/- 1.6 days, and the most common was from 4-7 days, only in those older than 35 years was from 1-3 days. The calculated average volume was 151.5 +/- 81.0 mL. In those with BMI < 20 loses were between 81and 120 ml, and in those with BMI > 35 from 121-160 ml; 85.5% of women with WHR < or = 0.85 had loses between 81 and 160 ml and 39.3% of those with WHR > 0.85. CONCLUSION: BMI greater than 35 is associated with more abundant bleeding, and android distribution of body fat with smaller bleeding.

[Anti-Müllerian hormone serum levels in women with and without uterine fibroids]. / Concentraciones en suero de hormona antimülleriana en mujeres con y sin miomatosis uterina.

BACKGROUND: The etiology of uterine leiomyomatosis is multifactorial and it is unknown if a relation between anti-Müllerian hormone (hormona anti-mülleriana) and uterine leiomyomatosis exists. OBJECTIVE: To determine the differences of hormona anti-mülleriana levels in women with and without uterine leiomyomatosis. METHODS: 60 women were studied (30 with and 30 without uterine leiomyomatosis). The diagnosis was confirmed by histopathology. Both groups were paired by age and in all them serum levels of hormona antimülleriana were measured using ELISA, also estradiol and progesterone serum levels were determined. hormona anti-mülleriana-RII immunohistochemistry was done in healthy myometrium and in leiomyomas. RESULTS: The mean age between the groups didn't show statistical difference (41.8 +/- 5.6 years vs. 41.4 +/- 5.7 years). Also no differences were found in weight, height and body mass index. Serum levels of hormona antimülleriana were lower in those with leiomyomatosis [0.21 (0-10.4) ng/ml vs. 1.83 (0-6.38) ng/ml, p < 0.005]. No statistical differences were found in estradiol and progesterone serum levels between the groups. The hormona antimülleriana receptor was no expressed neither in the healthy myometrium nor in the leiomyomas. CONCLUSIONS: Women with leiomyomatosis had lower hormona antimülleriana levels. More studies are needed to determine if a relation exists between hormona antimülleriana and uterine leiomyomas.

[Comparison of climacteric symptoms among women in Mexico City and women of a Mayan community of Yucatan]. / Comparación de los síntomas del climaterio entre mujeres de la Ciudad de México y mujeres de una comunidad maya del estado de Yucatán.

OBJECTIVE: to compare the climacteric symptoms between women from Mexico City and those from a Mayan community of the state of Yucatan. METHODS: In two groups of women, Group I) Spanish-speaking women from Mexico City and Group II) Maya speaking women from the state of Yucatan, 22 climacteric symptoms were evaluated using an analog visual scale (AVS) and the SUMEVA index. For statistical analysis t student test was used as well as Chi squared. RESULTS: 105 women, 50 of Mexico City and 55 of Maxcanu, Yucatan were studied. When comparing the groups no difference was found in age (52.5 +/- 6.5 vs 53.7 +/- 6.2, for group I and II respectively), the body mass index was significantly smaller in group I (29.7 +/- 5.0 vs 34.0 +/- 6.0, p < 0.001). In group 1, 15 of the 22 evaluated symptoms were significantly more intense in Group I, as well as the SUMEVA (Sum of Analog Visual Scale) index (71.4 +/- 44.5 vs 45.8 +/- 24.8, p < 0.001). The proportion of symptomatic women for each one of the symptoms was similar in both groups except for hair fall that was significantly greater in group I (74% vs 52%). CONCLUSION: climacteric symptoms were perceived with more intensity by Mexico City women, which allows suppose that western culture influence can be the responsible.

[Consensus conference of the Mexican Association for the Study of Climateric on veralipride prescription for patients with vasomotor symptoms]. / Consenso de la Asociación Mexicana para el Estudio del Climaterio para la indicación de veraliprida a pacientes con síntomas vasomotores.

Vasomotor symptoms are one of the main reasons for climateric women to consult a physician. Hormone therapy is the first treatment choice, but it is not indicated to all patients. Veralipride is an option for those who cannot or will not try hormone treatment. The Mexican Association for the Study of Climateric (AMEC) assembled an interdisciplinary group of medical experts so that they revised the medical literature on the subject and reached a consensus on veralipride indication, doses, counterindications and safety. The recommendations of the consensus conference on veralipride are: (1) Physicians must be familiar with its indication, side effects, pharmacokinetics and dosage. (2) Patients must be informed on other therapeutical options. (3) Patients' mental and neurological state must be evaluated, in particular to identify movement disorders, extrapyramidal symptoms (tremor or dystonia), anxiety and depression that can be mistaken for climateric symptoms. (4) Any adverse effect associated with the drug must be reported. (5) A random multicenter trial must be carried out in order to identify the frequency and severity of side effects, and (6) Written information on possible health risks when using the drug must be provided.

[Changes in maturation index and vaginal dryness in postmenopausal women who use or not calcitriol]. / Índice de maduración y sequedad vaginal en la posmenopausia con uso de calcio o calcitriol.

BACKGROUND: it is known that vitamin D increases the population of superficial cells, so the objective of the present work was to evaluate the effect in Mexican postmenopausal women who were using or not oral calcitriol. METHODS: postmenopausal women with vaginal dryness that received at random: calcium 500 mg orally every 24 h or calcitriol 0.25 µg every 24 h during two months. At the beginning of treatment and at two months a vaginal Pap smear was performed. The maturation index was determined and the estrogenic value was calculated. Vaginal dryness was evaluated using an analog visual scales and vaginal by the moistening of a pH test strip. Student's t test was used for statistical analysis. RESULTS: 23 postmenopausal women were studied and divided as follows: group I (calcium) = 11 women and group II (calcitriol) = 12 women. In the analyzed parameters only the average of superficial cells was significantly greater at the end of treatment in the calcitriol group. CONCLUSION: calcitriol use increased the average of superficial cells in vaginal cytology, but didn't modify vaginal dryness.

[Changes in maturation index and vaginal dryness after treatment with topical conjugated estrogens in low and conventional dose]. / Índice de maduración y sequedad vaginales. Evaluación de dos dosis de estrógenos tópicos vía vaginal.

BACKGROUND: local estrogen treatments have been used for vaginal dryness management. The objective was to determine the maturation index (MI) and vaginal dryness after the treatment with topic conjugated estrogens (TCE) in low and conventional doses in Mexican women. METHODS: postmenopausal women that received vaginal TCE cream. Group I Low-dose which received 0.5 g of TCE twice a week and Group II Conventional-dose with one g of TCE twice a week. The MI was determined and estrogenic value (EV) was calculated. Vaginal dryness was evaluated with an analog visual scale, and vaginal humidity by the moistening of a pH test strip measured in millimeters. Statistical analysis with Student's t test for independent and paired samples was done. RESULTS: 27 women were studied, group I (n = 13), group II (n = 14). There weren't any differences in the analyzed parameters. Both treatments increased the MI and decreased the vaginal dryness. CONCLUSIONS: low and conventional dose of TCE had similar effect in vaginal scope in Mexican women.