Alterations in haematological and clotting profile of post-menopausal women in Benin City, Nigeria

Background: The cessation of ovarian functions at menopause and the accompanying decline in the production of ovarian steroid hormones creates a unique set of health concerns for women. Reductions in sex steroid levels, particularly oestrogen, have been associated with various diseases and conditions, including bleeding disorders, coronary heart disease (CHD), osteoporosis, cognitive dysfunction, urinary incontinence, hot flushes, and mood changes, among others. Objective: To determine changes in haemorheological and clotting profile in post-menopausal women. Methods: Two hundred participants comprising one hundred and fifty post-menopausal women and fifty healthy pre-menopausal control subjects were studied. The investigations carried out include whole blood viscosity, plasma viscosity, fibrinogen concentration, Prothrombin time (PT), Activated partial thromboplastin time with kaolin (APTTK) levels and complete blood count using standard methods. Results: The mean age (p=0.01), platelet count (p= 0.013), neutrophil (p= 0.03), neutrophil to lymphocyte ratio (p= 0.045) and platelet to lymphocyte ratio (p=0.044) in postmenopausal women were significantly higher while lymphocyte count (p= 0.004) was significantly lower in postmenopausal compared to premenopausal women. Similarly, plasma oestradiol (p= 0.001), plasma viscosity (p= 0.03), relative blood viscosity (p= 0.03), whole blood viscosity (p= 0.03) and PTTK(p= 0.04) were significantly lower among postmenopausal women compared to premenopausal control subjects. Conclusion: Relative plasma viscosity correlated positively with age. There were significantly lower levels of haemorheological and clotting profile in post-menopausal women. These changes may be due to age or a decline in circulating oestrogen levels.

Prevalence and factors associated with dynapenia in older women using different diagnostic criteria

Abstract Aim: This study aimed to identify the prevalence and factors associated with dynapenia in older women, considering different cutoff points as diagnostic criteria. Methods: This epidemiological study was conducted with 205 older women (72.7 ± 7.1 years). Dynapenia was diagnosed using the handgrip strength test (HGS) using two cutoff points (< 16 or < 20 kgf). Socio-demographic, behavioral, and health status information was obtained from a specific form; nutritional status was assessed by body mass index, and the International Physical Activity Questionnaire identified the level of physical activity. Results: The prevalence of dynapenia was 14.1% (HGS < 16 kgf) and 46.3% (HGS < 20 kgf) (p < 0.001). It was also observed that older women with family income ≤ 1 minimum wage and those with low weight presented, respectively, 2.22 (95%CI: 1.12-4.39) and 4.72 (95%CI: 1.64-13.58) times higher probability of dynapenia identified by HGS < 16 kgf. Moreover, for the cutoff point < 20 kgf, the probability of dynapenia was higher in women aged ≥ 80 years (PR:1.91; 95%CI: 1.23-2.95), in insufficiently active women (PR: 1.34; 95%CI: 1.01-2.57), among those with low weight (PR: 1.61; 95%CI: 1.01-2.57), and in those who reported falls (PR:1.42; 95%CI: 1.04-1.96). Conclusion: Therefore, it is concluded that there is a difference between the prevalence and factors associated with dynapenia when different cutoff points are adopted.

Research Progress on Animal Models of Menopausal Syndrome： A Review / 中国实验方剂学杂志

In order to explore the pathological mechanism of perimenopausal syndrome and seek prevention and treatment measures， it is necessary to establish animal models that similar to human perimenopausal syndrome， so as to provide reference for drug research， new drug development and clinical application. In this paper， the keywords of "perimenopausal period" "perimenopausal syndrome" "menopause" "menopausal syndrome""menopausal period" "menopausal syndrome" and "animal" were searched in China National Knowledge Infrastructure （CNKI）， Chongqing Weipu， China Biomedical Literature Database （CBM） and Pubmed. In addition， the selection of domestic peripheral menopausal syndrome model animals in recent years and the advantages and disadvantages of corresponding models were summarized. A total of 673 studies were identified， of which 61 were included in the analysis. The most common animal model of perimenopausal syndrome is castration model， while the immunodeficiency model is less used. With the aging of the population and the rapid increase of psychosocial stress， the incidence of perimenopausal syndrome is high. Therefore， it is particularly important to explore the mechanism of perimenopausal syndrome. According to the experimental purpose， experimental period， experimental technology and other factors， the selection of appropriate model animals and modeling methods is the key of the success of the experiment of perimenopausal syndrome.

Relationships between follicle-stimulating hormone level and lipid profiles in post-menopausal women / 吉林大学学报(医学版)

Objective: To explore the relationships between the follicle-stimulating hormone (FSH) level and the lipid profiles in the post-menopausal women, and to provide evidence for assessing the risk of dyslipidemia in the post-menopausal women. Methods: A total of 129 women with menopause for more than 1 year were selected as the subjects and divided into low FSH group (FSH57. 6 IU · L-1) according to the median of FSH. The data including height, weight, body mass index (BMI), age, menopausal age, duration of menopause, history of smoking, chronic diseases history of the subjects were collected; the serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-density lipoprotein cholesterol (non-HDL-C), estradiol (E2), FSH, fasting blood glucose, serum uric acid of the subjects were detected with the same method. Multivariate Logistic regression analysis was applied to analyze the relationship between the FSH level and dyslipidemia. Results: The average age of the post-menopausal women was (61. 22 + 7. 30) years, the age of menopause was (49. 97 + 4. 00) years, and the duration of menopause was (11. 16 + 7. 98) years. The proportion of post-menopausal women with dyslipidemia was 65. 9% (85/129), and there was no significant difference between two groups (P>0.05). Compared with high FSH group, the TG level of the subjects in low FSH group was increased (P<0.01) and the HDL-C level was decreased (P<0.01). There were no significant differences in the TC, LDL-C and non-HDL-C levels between two groups. The Logistic regression analysis showed that after adjusting the E2 level, age, duration of menopause, hypertension history, diabetes history, fatty liver and the BMI grade, FSH level had a negative correlation with TG increase (≥2. 3 mmol · L-1) (P<0.05). Each 10-unit increase in FSH was associated with a 29. 5% lower risk of elevated TG (95% CI: 3. 5% - 48. 5%). FSH was not significantly associated with the elevated TC (≥6. 2 mmol · L-1), elevated LDL-C (≥4. 1 mmol · L-1), decreased HDL-C (<1. 0 mmol · L-1) and elevated non-HDL-C. Conclusion: The FSH level is negatively associated with elevated TG in the post-menopausal women, suggesting that low FSH appears to be a risk factor of dyslipidemia in the post-menopausal women.

Health seeking behaviour among post menopausal women in rural and urban field practice areas of Gandhi Medical College, Hyderabad: a cross-sectional study

Background: The phase of menopause is a physiological event which occurs as a result of progression of reproductive ageing. Women from developing countries view variations due to menopause as natural process and there is no need for medical care. The objective of the study was to assess the health seeking behaviour among the post menopausal women.Methods: A cross-sectional study was conducted in the rural and urban field practice areas of department of Community Medicine of Gandhi Medical College, Hyderabad. About 300 urban and 300 rural women were interviewed using a semi-structured and pretested questionnaire from August 2015 to September 2017.Results: Among the rural women, 100 (25.4%) women did not seek health care and among those who sought health care, majority (34.3%) preferred government healthcare services followed by 23% who consulted private facility. Of the urban women, 14.7% did not seek health care, 42% of the women approached private practitioner followed by 23% who sought health care in government hospital. Majority of the women (42.2%) did not seek health care as they thought they will be normal with time.Conclusions: More than one third of the women are not aware of menopause and related problems. Among those who did not seek health care, higher proportion felt they will be Ok with time followed by financial constraints, fear/shy, family problems and lack of transport.

Relationship between serum lipids level and bone mineral density in postmenopausal OSAHS patients / 中华老年心脑血管病杂志

Objective To study the relationship between serum lipids level and bone mineral density( BMD)in postmenopausal OSAHS patients.Methods One hundred and twelve postmenopausal OSAHS patients were divided into osteoporosis group(n=35)with a T value＜-2.5,osteopenia group(n=39)with a T value=-2.5-1.0,and normal BMD group(n=38)woth a T value＞ -1.0,36postmenopausal OSAHS-free patients served as a control group and their BMD was detected. The relationship between blood lipids level and BMD was analyzed.Results The serum TC,TG and LDL-C levels were significantly higher in normal BMD group,osteopenia group and osteoporosis group than in control group(P＜0.05).The serum TG and LDL-C levels were significantly higher while the serum phosphorus level was significantly lower in osteopenia group and osteoporosis group than in normal BMD group (P ＜0.05).Pearson correlation analysis showed that the serum ALP and LDL-C levels were negatively related with the BMD of lumbar vertebrae 1-4(r=-0.145,P=0.041;r=-0.331,P=0.000)while the serum phosphorus and TG levels were positively related with the BMD of double femoral neck(r=0.290,P=0.000;r=0.085,P=0.031;r=0.310,P=0.000;r=0.160,P=0.029).Conclusion The serum TG and LDLC levels are related with the BMD in postmenopausal OSAHS patients.Serum blood lipids level is an indicator for the early diagnosis and treatment of osteoporosis.

Associated Factors of Ischemic Heart Disease Identified Among Post-Menopausal Women

OBJECTIVES: This study identifies associated factors of ischemic heart disease (IHD) among post-menopausal Korean women at the biomedical (age, family history of hypertension, dyslipidemia, type 2 diabetes mellitus, or cerebro-cardiovascular disease, body mass index, and metabolic syndrome), biosocial (socioeconomic status and educational level), and psychosocial levels (stress, depression, smoking, binge alcohol consumption, and physical activity). METHODS: This study used a cross-sectional design with secondary data analysis of the 2013–2016 Korean National Health and Nutrition Examination Survey. Data from 3,636 women were analyzed by logistic regression analysis using a complex sample procedure. RESULTS: Of the biomedical factors, older age [odds ratio (OR): 2.99, 95% confidence interval (CI): 1.87–4.80, p < 0.001], family history (OR: 2.29, 95% CI: 1.44–3.65, p = 0.001), and metabolic syndrome (OR: 1.93, 95% CI: 1.27–2.95, p = 0.002) were associated with IHD in post-menopausal women. Of the psychosocial factors, depression (OR: 2.56, 95% CI: 1.66–3.96, p < 0.001) and smoking (OR: 1.92, CI: 1.04–3.55, p = 0.038) were associated with IHD in post-menopausal women. CONCLUSION: These findings suggest that healthcare providers need to consider the contributing adverse effects of older age, family history, metabolic syndrome, depression and smoking when evaluating risk factors for IHD in post-menopausal women.

Combination therapy of curcumin and alendronate modulates bone turnover markers and enhances bone mineral density in postmenopausal women with osteoporosis

ABSTRACT Objective: This study evaluated the effects of combination therapy of curcumin and alendronate on BMD and bone turnover markers in postmenopausal women with osteoporosis. Subjects and methods: In a randomized, double-blind trial study, 60 postmenopausal women were divided into three groups: control, alendronate, and alendronate + curcumin. Each group included 20 patients. Total body, total hip, lumbar spine and femoral neck BMDs were measured by dual-energy X-ray absorptiometry (DXA) at baseline and after 12 months of therapy. Bone turnover markers such as bone-specific alkaline phosphatase (BALP), osteocalcin and C-terminal cross-linking telopeptide of type I collagen (CTx) were measured at the outset and 6 months later. Results: Patients in the control group suffered a significant decrease in BMD and increased bone turnover markers at the end of study. The group treated with only alendronate showed significantly decreased levels of BALP and CTx and increased levels of osteocalcin compared to the control group. The alendronate group also showed significant increases in the total body, total hip, lumbar spine and femoral neck BMDs at the end of study compared to the control group. In the curcumin + alendronate group, BALP and CTx levels decreased and osteocalcin levels increased significantly at the end of study compared to the control and alendronate groups. BMD indexes also increased in four areas significantly at the end of study compared to the control and alendronate groups. Conclusion: The combination of curcumin and alendronate has beneficial effects on BMD and bone turnover markers among postmenopausal women with osteoporosis. Arch Endocrinol Metab. 2018;62(4):438-45

Leiomioma parauretral en la postmenopausia reporte de un caso / Paraurethral leiomyoma in the postmenopause report of a case

El leiomioma parauretral es una patología poco frecuente, se trata de un tumor mesenquimatoso no dependiente de uretra y que ocasiona sintomatología uroginecológica en la paciente. Su manejo es principalmente quirúrgico. No se reportan casos de malignización, recidiva, ni metástasis y su diagnóstico diferencial se debe realizar con todas las patologías de masas uretrales y para-uretrales. El presente caso describe la presencia de este tumor en una mujer post-menopaúsica de 60 años, que además de presentar incontinencia urinaria mixta, refería signos obstructivos urinarios, fue diagnosticada y manejada de manera quirúrgica: Resección de tumor y posterior ubicación de cinta suburetral.

The paraurethral leiomyoma is a rare pathology, it is a mesenchymal tumor not dependent of the urethra which causes urogynecological symptoms in the patient. Its management is mainly surgical. No cases of malignancy, recurrence or metastasis are reported and its differential diagnosis must be performed with all pathologies of urethral and para-urethral masses. The present case describes the presence of this tumor in a 60-year-old post-menopausal woman who, in addition to presenting mixed urinary incontinence, referred obstructive urinary signs, was diagnosed and managed surgically: tumor resection and subsequent placement of suburethral tape.

Osteoporosis primaria: estratificación del riesgo de fractura en la atención primaria / Primary osteoporosis: stratification of the risk of fracture in primary care

Resumen La osteoporosis es una enfermedad esquelétita caracterizada por compromiso en la fuerza ósea, que predispone a fracturas de fragilidad. El diagnóstico de la osteoporosis se establece tanto por fracturas de bajo impacto, así como por medio de la densitometría ósea.

Abstract Osteoporosis is a skeletal disorder characterized by compromised bone strenght, which predisposes to the development of fragility fractures. The diagnosis of osteoporosis is established by the presence of a true fragility or, in patients who have never sustained a fragility fracture, by measurement of bone mineral density.

The Effects of Aging on the Brain Stem Speech Encoding in Spontaneous Post-menopause Women / 听力学及言语疾病杂志

Objective To investigate the effects of aging on the brain stem speech encoding in spontaneous post-menopause women.Methods There were twenty post-menopause women with normal hearing for test and twenty ovariectomized women with normal hearing for contrast.Speech-evoked auditory brainstem response (speech-ABR) was used.The speech syllable /da/ as stimulus sound was transmitted to right ear by the insert earphones in speech-ABR test.Results Response waves of speech-ABR in ovariectomized women were similar to those in post-menopause women, which contained the onset response (peak V and A), the transition (peak C), the frequency following responses (peak D, E and F) and the offset response (peak O).The characteristics of speech-ABR's peak latency and magnitude were similar between the two groups.Except that the bilateral ovariectomized women had a shorter latency of waves O for the transient response (P0.05).After the combination of ovariectomized women and post-menopause women, the age of these subjects was positively correlated with the latency of O wave (P<0.05).Others had no correlation with age in the amplitude and latency of the waves of speech-ABR.Conclusion Aging does not affect on brain stem speech encoding in spontaneous post-menopause women.

Effect of a gel containing pilocarpine on vaginal atrophy in castrated rats

OBJECTIVES: To evaluate the effect of Carbopol gel formulations containing pilocarpine on the morphology and morphometry of the vaginal epithelium of castrated rats. METHODS: Thirty-one female Wistar-Hannover rats were randomly divided into four groups: the control Groups I (n=7, rats in persistent estrus; positive controls) and II (n=7, castrated rats, negative controls) and the experimental Groups, III (n=8) and IV (n=9). Persistent estrus (Group I) was achieved with a subcutaneous injection of testosterone propionate on the second postnatal day. At 90 days postnatal, rats in Groups II, III and IV were castrated and treated vaginally for 14 days with Carbopol gel (vehicle alone) or Carbopol gel containing 5% and 15% pilocarpine, respectively. Next, all of the animals were euthanized and their vaginas were removed for histological evaluation. A non-parametric test with a weighted linear regression model was used for data analysis (p<0.05). RESULTS: The morphological evaluation showed maturation of the vaginal epithelium with keratinization in Group I, whereas signs of vaginal atrophy were present in the rats of the other groups. Morphometric examinations showed mean thickness values of the vaginal epithelium of 195.10±12.23 μm, 30.90±1.14 μm, 28.16±2.98 μm and 29.84±2.30 μm in Groups I, II, III and IV, respectively, with statistically significant differences between Group I and the other three groups (p<0.0001) and no differences between Groups II, III and IV (p=0.0809). CONCLUSION: Topical gel formulations containing pilocarpine had no effect on atrophy of the vaginal epithelium in the castrated female rats.

Female aging / Envelhecimento feminino

SUMMARY Female aging is a process that involves hypoestrogenism time, the individual impact on each woman, and what we can do as experts to reduce morbidity and provide quality of life. This natural process in the female life cycle has been of concern to women after menopause. Changes in different biophysical and psychosocial aspects, and their individual experiences, have repercussions on the lives of patients seeking specialized and multidisciplinary support to reduce the harmful effects of prolonged hypoestrogenism. Overweight and obesity, inadequate living habits and the presence of multi-morbidities cause damage to the quality of life and impact the functional capacity. Behavioral prescription and hormone therapy are among the treatments given to ease symptoms and reduce morbidity. A better understanding of these factors can help identify groups that require more care after menopause.

RESUMO O envelhecimento feminino é um processo em que devemos correlacionar o tempo do hipoestrogenismo com o impacto individual em cada mulher e o que poderemos fazer, enquanto especialistas, para reduzir morbidades e proporcionar qualidade de vida. Esse processo natural no ciclo de vida da mulher tem sido motivo de preocupação das mulheres na pós-menopausa. As transformações nos diferentes aspectos biofísicos, psicossociais e em suas vivências individuais trazem repercussões na vida das pacientes, que buscam apoio especializado e multiprofissional para reduzir os efeitos deletérios do hipoestrogenismo prolongado. O sobrepeso e a obesidade, inadequados hábitos de vida e a presença de multimorbidades trazem prejuízos à qualidade de vida e impactam a capacidade funcional. A prescrição comportamental e a terapia hormonal são tratamentos indicados para amenizar os sintomas e reduzir morbidades. Assim, uma melhor compreensão desses fatores pode ajudar a identificar grupos propensos a cuidados na pós-menopausa.

A comparative study on postmenopausal symptoms in rural and urban women.

Background: Health issues of postmenopausal women pose a significant challenge to public health. Menopause is an unspoken, unattended, reality of life, the cause of which is still deciphered completely by man. Objective: To compare the post-menopausal symptoms among rural & urban women. Methods: The present cross sectional study was conducted in the month of September 2014, which continued for 2 months in rural and urban area. Predesigned, pretested questionnaire was used to interview 500 participants who met the selection criteria. Data was analysed using SPSS software. Results: 250 from rural area and 250 from urban area. Nearly half 223 (44.6%) of them were in the age group of 55-64 years. Majority 161 (32.2%) of them belonged to the upper middle class, 346 (69.2) were pre obese according to WHO classification. Majority (385) 77% had no h/o gynecological problems. Almost all had one or the other menopausal symptom. Conclusions: The prevalence of postmenopausal symptoms was higher in urban women compared to the rural population

Efeitos de um programa de treinamento concorrente sobre a autonomia funcional em idosas pós-menopáusicas / Effects of a concurrent training program on functional autonomy in postmenopausal elderly

A perda da autonomia funcional no idoso relaciona-se não somente com a limitação no estado físico, mas também a função cognitiva e psíquica, tornando-o mais inativo no meio social em que convive. Dessa forma, é de suma importância à inserção do idoso em programas que estimulem a prática regular de exercício físico e o convívio social. O presente estudo centrou-se em avaliar os efeitos de um programa de treinamento concorrente sobre a autonomia funcional de idosas pós-menopáusicas. Foram selecionadas 51 idosas, residentes no município de Muriaé (MG), voluntárias, distribuídas em dois grupos, um grupo treinamento concorrente (GTC=25), com média de idade de 69,44±6,82 anos e um grupo controle (GC=26) com média de idade de 68,30±6,34 anos. Os parâmetros biofísicos foram estimados por meio da massa corporal, estatura e índice de massa corporal. A avaliação da autonomia funcional foi feita pela bateria de testes do Grupo de Desenvolvimento Latino-Americano para a Maturidade (GDLAM), composta de: caminhar 10m (C10m), levantar-se da posição sentada (LPS), levantar-se da posição decúbito ventral (LPDV), levantar-se da cadeira e locomover-se pela casa (LCLC) e o teste de vestir e tirar uma camiseta (VTC). Após a intervenção, o GTC apresentou um valor fraco nos testes C10m e LPDV; regular nos testes LCLC, VTC e no índice de GDLAM e bom no teste LPS. Os resultados mostraram que o GTF no pós-teste apresentou melhores resultados em todas as variáveis da autonomia funcional, exceto no teste de LPDV (p=0,057) em relação ao GC (p<0,0125). Na avaliação intragrupos no GTC, encontrouse diferenças estatisticamente significativas para os testes de autonomia funcional C10m (p=0,007), LPS (p=0,000) e IG (p=0,007). Esta pesquisa confirma que a prática regular de exercício físico é essencial para a restauração e controle da autonomia funcional na população de idosos.(AU)

The loss of functional independence in the elderly is related not only to the limitation in physical state, but also the cognitive and mental function, making it inactive in the social environment in which lives. Thus, it is of paramount importance to the insertion of the elderly in programs that encourage the regular practice of physical exercise and social interaction. This study focused on evaluating the effects of a concurrent training program on functional autonomy of postmenopausal elderly. 51 elderly were selected residents in the city of Muriaé (MG), volunteers, divided into two groups, a concurrent training group (CTG=25), with a mean age of 69.44±6.82years and a control group (CG=26) with mean age of 68.30±6.34 years. The biophysical parameters were estimated using the body mass, height and body mass index. The assessment of function0061l autonomy was made by the test battery of the Latin American Development Group for Maturity (LADGM), composed of: walk 10m (W10m), rising from a sitting position (RSP), rising from a recumbent position ventral (RRPV), rising from a chair and walk around the house (RCWH) and the test of wear and take a T-shirt (WTT). After the intervention, the CTG offered very little value in W10m and RRPV tests; regular in RCWH testing, WTT and index LADGM and good in RSP test. The results showed that the CTG in the post-test showed better results in all the variables of the functional autonomy, except in the test RRPV (p=0.057) compared to the CG (p <0.0125). In intragroup evaluation in CTG, we found statistically significant differences in the functional autonomy tests W10m (p=0.007), RSP (p=0.000) and index LADGM (p=0.007). This research confirms that regular physical activity is essential for the restoration and control of the functional autonomy of the elderly population.(AU)

Factors associated with the severity of menopausal symptoms in post menopausal Brazilian women / Fatores associados com a intensidade dos sintomas menopausais em mulheres brasileiras na pós-menopausa

PURPOSES: To identify the socio-demographic and anthropometric profile and correlate them with the severity of menopausal symptoms in postmenopausal women. METHODS: Cross-sectional study with 201 postmenopausal women attended in a Gynecology Outpatient Department in Rio de Janeiro city (RJ, Brazil). A questionnaire was applied for collection of demographic, socioeconomic, clinical and lifestyle variables. The Blatt–Kupperman Menopausal Index was used to evaluate the menopausal symptoms. RESULTS: Women with moderate to severe symptoms ( ≥20) corresponded to 57.7% (116) of the sample. Obesity was not associated with the severity of menopausal symptoms (p < 0.90). Severe to moderate symptoms were inversely associated with age (PR 0.96; CI 95% 0.94–0.99;p < 0.01). Women within 6–10 years of menopause presented nearly 1.4 times higher prevalence of moderate to severe symptoms compared with those with more than 10 years of menopause. Unemployed women (PR 1.52; CI 95% 1.13–2.04; p < 0.01) and housewives (PR1.53; CI 95% 1.12–2.09; p < 0.01) presented higher prevalence of menopausal symptoms compared with working women. Tobaccoism was associated with higher prevalence of moderate to severe symptoms (p < 0.01). CONCLUSIONS: Age constituted a protection factor for moderate to severe symptoms, whereas having within 6–10 years of menopause, smoking and being unemployed or a housewife were factors related to higher prevalence of moderate to severe menopausal symptoms.

OBJETIVO: Identificar o perfil sociodemográfico e antropométrico e associá-los com a intensidade dos sintomas menopausais em mulheres na pós-menopausa.MÉTODOS: Estudo transversal com 201 mulheres na pós-menopausa atendidas em um ambulatório de ginecologia no Rio de Janeiro/RJ. Foi aplicado um questionário para coleta das variáveis demográficas, socioeconômicas, clínicas e hábitos de vida. O Índice Menopausal de Blatt–Kupperman (IMBK) foi utilizado para avaliar os sintomas menopausais.RESULTADOS: Mulheres com sintomas moderados a grave (≥20) corresponderam a 57,7% (116)da amostra. A obesidade não foi associada com a intensidade de sintomas menopausais (p < 0,90). Os sintomas moderados a intensos associaram-se inversamente com a idade (RP0,96; IC95% 0,94–0,99; p < 0,01). Mulheres com tempo de menopausa entre 6 e 10 anos apresentaram cerca de 1,4 vezes maior prevalência de sintomas moderados a intensos quando comparadas com aquelas com mais de 10 anos de menopausa. Mulheres desempregadas (RP 1,52; IC95% 1,13–2,04; p < 0,01) e donas de casa (RP 1,53; IC95% 1,12–2,09; p < 0,01) apresentaram maior prevalência de sintomas menopausais quando comparadas com mulheres trabalhando. O tabagismo foi associado a maior prevalência de sintomas moderados a intensos(p < 0,01). CONCLUSÕES: A idade constituiu fator de proteção para sintomas moderados a intensos. Enquanto que ter entre 6 à 10 anos de tempo de menopausa, ser tabagista e ser desempregada ou dona de casa foram fatores associados a uma maior prevalência de sintomas menopausais moderados a intensos.

Parâmetros acústicos de vozes de mulheres na pós-menopausa / Acoustic parameters of voices of women in post-menopause

INTRODUÇÃO: O envelhecimento da voz caracteriza-se por alterações decorrentes do envelhecimento do corpo, interferindo na entonação vocal reveladora de estados da alma e do corpo. Investigar a qualidade vocal de mulheres na pós-menopausa por meio dos parâmetros objetivos torna-se importante para fomentar as pesquisas nessa área, bem como auxiliar na melhoria da qualidade de vida desse grupo. OBJETIVO: Verificar os valores dos parâmetros acústicos das vozes de mulheres no período de pós-menopausa. Método: Realizou-se estudo de caráter quantitativo e corte transversal com 23 mulheres em período de pós-menopausa, utilizando o software Praat 5.2.0. Os parâmetros considerados foram frequência fundamental, jitter, shimmer, proporção harmônico ruído e análise espectrográfica. A amostra foi composta por mulheres matriculadas numa Universidade Aberta da Terceira Idade em Salvador-BA. A análise dos dados foi descritiva, por porcentagem simples, e usou-se o teste t para verificar a relação entre aumento de idade e piora vocal. RESULTADOS: Apresentaram valores da frequência fundamental abaixo de 150Hz 13% da amostra, e 34% entre 150 e 217Hz, demonstrando agravamento da voz. Observou-se significância estatística para piora desse parâmetro relacionado ao aumento da idade (p=0,02471). Houve diferença quanto aos parâmetros jitter e shimmer de acordo com o aumento da idade, porém sem significância estatística. Esses parâmetros acústicos estão relacionados a alterações no padrão vibratório das pregas vocais (ciclo vibratório). Os valores da proporção harmônico-ruído foram acima de 15.000 para todas as mulheres, mas também foram observados valores diminuídos com o aumento da idade, sem significância ...

INTRODUCTION: Voice aging is characterized by changes caused by body aging, interfering with the vocal intonations, revealing states of soul and body. To investigate the vocal quality of postmenopausal women using objective parameters is important to foster research in this area, as well as assisting in improving the quality of life of this group. OBJECTIVE: To determine the acoustic parameters of the voice of women in post-menopause. METHOD: Quantitative cross-sectional study was conducted with 23 women in the postmenopausal period, using the Praat software 5.2.0. The parameters considered were fundamental frequency, jitter, shimmer, harmonic noise and spectrographic analysis. The sample consisted of women enrolled in the Open University of Third Age in Salvador-BA. Data analysis was descriptive, using percentages, and t test to check the relationship between increasing age and vocal worsening. RESULTS: In this sample, 13% had values below the fundamental frequency of 150Hz and 34% between 150 and 217Hz, demonstrating voice deepening. There was a statistically significant worsening of this related to increasing age parameter (p=0.02471). There was difference between the jitter and shimmer parameters according to increasing age, but without statistical significance. These acoustic parameters are related to changes in the vibratory pattern of the vocal folds (vibration cycle). A harmonic noise ratio was above 15.000 in all women, but also had lower values with increasing age, with no statistical significance. CONCLUSION: The observed changes in acoustic parameters show that postmenopausal women had changes in vocal patterns, which can lead to decreased quality of life. Therefore, it requires a closer look at the need of speech therapy in this group. .

An overview on the treatment of postmenopausal osteoporosis / Uma visão geral sobre o tratamento da osteoporose pós-menopausa

Osteoporosis is a worldwide health problem related to the aging of the population, and it is often underdiagnosed and undertreated. It is related to substantial morbidity, mortality and impairment of the quality of life. Estrogen deficiency is the major contributing factor to bone loss after menopause. The lifetime fracture risk at 50 years of age is about 50% in women. The aim of the treatment of osteoporosis is to prevent fractures. Non-pharmacological treatment involves a healthy diet, prevention of falls, and physical exercise programs. Pharmacological treatment includes calcium, vitamin D, and active medication for bone tissue such, as anti-resorptives (i.e., SERMs, hormonal replacement therapy, bisphosphonates, denosumab), bone formers (teriparatide), and mixed agents (strontium ranelate). Bisphosphonates (alendronate, risedronate, ibandronate, and zoledronate) are the most used anti-resorptive agents for the treatment of osteoporosis. Poor compliance, drug intolerance, and adverse effects can limit the benefits of the treatment. Based on the knowledge on bone cells signaling, novel drugs were developed and are being assessed in clinical trials.

A osteoporose é um problema de saúde mundial relacionada com o envelhecimento da população e muitas vezes é subdiagnosticada e subtratada. Relaciona-se à significativa morbidade, mortalidade e redução da qualidade de vida. A deficiência de estrogênio é o principal fator que contribui para a perda óssea após a menopausa. O risco de fratura a partir dos 50 anos de idade é de cerca de 50% em mulheres. O objetivo do tratamento da osteoporose é a prevenção de fraturas. O tratamento não farmacológico envolve uma dieta saudável, prevenção de quedas e de programas de exercícios físicos. O tratamento farmacológico inclui cálcio, vitamina D e medicação ativa em tecido ósseo, tais como antirreabsortivos (SERMs, terapia de substituição hormonal, bifosfonatos, denosumabe), formadores de osso (PTH e análogos) e agentes mistos (ranelato de estrôncio). Os bisfosfonatos (alendronato, risedronato, ibandronato e zoledronato) são os mais utilizados agentes antirreabsortivos para o tratamento da osteoporose. A baixa aderência, a intolerância medicamentosa e os efeitos adversos podem limitar os benefícios do tratamento. Com base no conhecimento da sinalização entre as células ósseas, novos medicamentos foram desenvolvidos e estão sendo avaliados em ensaios clínicos.

Reproductive Hormonal Profile of Post-menopausal Women in Ebonyi State, Nigeria.

Background: Assessment of the concentrations of reproductive hormones during postmenopause has been suggested as a confirmatory test for menopause due to irregularities in rise and fall of sex hormones in menopausal transition. In this study, we assessed the concentrations of estrogen, progesterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) in post-menopausal women in Ebonyi state, Nigeria. In addition we tried to establish if relationships exist between the pituitary hormones and the ovarian (sex) hormones and between the reproductive hormones and age and body mass index (BMI). Method: The study population comprised forty post-menopausal women of mean age 59.6 years and forty young female adult controls of mean age 27.8 years. Blood samples were collected into heparin container and the serum used for the analysis of estrogen, progesterone, FSH and LH using ELISA method. Result: Post-menopausal women had significantly (P<0.001) higher mean serum FSH and LH concentrations compared to their controls. In contrast, the control group had significantly (P<0.001) higher progesterone and estradiol levels compared to the postmenopausal women. There was inverse correlation (P<0.01) between estradiol and FSH levels, but no significant correlations were observed between FSH and Progestrone; LH and Progestrone; and LH and Estradiol respectively. In addition, after adjusting for BMI, the concentrations of LH was significantly associated with age (P<0.01) but FSH, estradiol and progesterone levels were not. Furthermore, estradiol and FSH levels were significantly associated (P<0.001 and P<0.05) with BMI after controlling for age. Conclusion: The present findings underscore the importance of understanding the reproductive hormonal profile of post-menopausal women and the need to consider age and body mass when studying hormonal changes of menopausal women. These data may help clinicians make optimal therapeutic decisions for hormone replacement therapy and life-style changes that may reduce the risk of some of the conditions associated with menopause.

Avaliação dos fatores de risco de quedas em mulheres na pós-menopausa inicial / Evaluation of risk factors of falls in early postmenopausal Women

OBJETIVO: Foi avaliar a frequência e os fatores de risco de quedas em mulheres na pós-menopausa. MÉTODOS: Estudo clínico, transversal, envolvendo 358 mulheres (idade entre 45 e 65 anos e amenorreia >12 meses) com tempo de pós-menopausa <10 anos. Os critérios de exclusão foram: doença neurológica ou músculo esquelético, vestibulopatias, hipertensão arterial não controlada, hipotensão postural, déficit visual sem correção, uso de medicamentos (sedativos e hipnóticos). A queda foi definida como mudança de posição inesperada, não intencional, que faz com que o indivíduo permaneça em nível inferior à posição inicial. Foram analisados o histórico de quedas (últimos 24 meses) e as características clínicas, antropométricas (índice de massa corpórea (IMC) e circunferência da cintura (CC)) e densidade mineral óssea. Na comparação segundo grupo de mulheres com e sem histórico de queda, foi empregado o Teste do Qui-quadrado ou Exato de Fisher e regressão logística com cálculo do odds ratio (OR). RESULTADOS: Entre as mulheres incluídas, 48,0% (172/358) referiram queda, com fratura em 17,4% (30/172). A queda ocorreu dentro de casa em 58,7% (101/172). A média de idade foi 55,7±6,5 anos, tempo de menopausa de 5,8±3,5anos, IMC 28,3±4,6 kg/m² e CC 89,0±11,4 cm. Foi observada maior frequência de tabagismo e diabetes entre as mulheres com histórico de quedas quando comparadas àquelas sem queda, de 25,6 versus 16,1% e 12,8 versus 5,9%, respectivamente (p<0,05). Na análise multivariada em função das variáveis clínicas influentes, o risco de queda aumentou com o tabagismo atual (OR 1,93; IC95% 1,01-3,71). Demais variáveis clínicas e antropométricas não influenciaram no risco de queda. CONCLUSÕES: Em mulheres na pós-menopausa inicial houve expressiva frequência de quedas. O tabagismo foi indicador clínico de risco para queda. Com o reconhecimento de fatores determinantes para queda, medidas preventivas são importantes, como a orientação de abolir o tabagismo.

PURPOSE: It was to evaluate the frequency and the risk factors of falls in early postmenopausal women. METHODS: A cross-sectional study was conducted on 358 women (age: 45-65 years and amenorrhea >12 months) with time since menopause <10 years. Exclusion criteria were: neurological or musculoskeletal disorders, vestibulopathies, uncorrected visual deficit, uncontrolled hypertension and postural hypotension, or drug use (sedative and hypnotic agents). A fall was identified as an unexpected unintentional change in position which causes an individual to remain in a lower level in relation to the initial position. The history of self-reported falls during the previous 24 months, and clinical and anthropometric data (body mass index (BMI) and waist circumference (WC)) and bone densitometric measures were analyzed. For statistical analysis, c² trend test and the logistic regression method (odds ratio (OR)) were used for the comparison between groups of women with and without falls. RESULTS: Of the 358 women, 48.0% (172/358) had a history of falls and 17.4% (30/172) had fractures. The fall occurred indoors (at home) in 58.7% (101/172). The mean age was 53.7±6.5 years, time since menopause 5.8±3.5 years, BMI 28.3±4.6 kg/m² and WC 89.0±11.4 cm. There were differences as the occurrence of smoking and diabetes, with greater frequency among fallers vs. non-fallers, 25.6 versus 16.1% and 12.8 versus 5.9%, respectively (p<0.05). By evaluating the risk of falls in the presence of influential variables, it was observed that risk increased with current smoking status (OR 1.93; 95%CI 1.01-3.71), whereas other clinical and anthropometric variables did not influence this risk. CONCLUSIONS: In early postmenopausal women there was higher frequency of falls. Current smoking was clinical indicators of risk for falls. With the recognition of factors for falling, preventive measures become important, as the orientation of abolishing smoking.