Yoga practice can reduce metabolic syndrome and cardiovascular risk in climacteric women.

To evaluate the effect of yoga on the frequency of MetS and its impact on cardiovascular risk markers in climacteric women. We recruited 84 sedentary women between 40 and 65 years diagnosed with MetS. Participants were randomly assigned to a 24-week yoga intervention or control group. We evaluated the frequency of MetS and changes in the individual components of MetS at baseline and after 24 weeks. We also assessed the impact of yoga practices on cardiovascular risk through the following markers: High-sensitivity C-reactive Protein (hs-CRP), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), and Atherogenic Index of Plasma (AIP). The frequency of MetS reduced significantly after 24 weeks of yoga practice (- 34.1%; p < 0.001). Statistical analysis showed that the frequency of MetS was significantly lower in the yoga group (65.9%; n = 27) than in the control group (93.0%; n = 40) after 24 weeks (p = 0.002). Regarding the individual components of MetS, yoga practitioners had statistically lower waist circumference, systolic blood pressure, triglycerides, HDLc, and glucose serum concentrations than the control group after 24 weeks. Yoga practitioners also had a significant decrease in hs-CRP serum concentrations (3.27 ± 2.95 mg/L vs. 2.52 ± 2.14 mg/L; p = 0.040) and a lower frequency of moderate or high cardiovascular risk (48.8% vs. 34.1%; p = 0.001) after 24 weeks of practice. The yoga group had LAP values significantly lower than the control group after the intervention period (55.8 ± 38.04 vs. 73.9 ± 40.7; p = 0.039). Yoga practice demonstrated to be an effective therapeutic to manage MetS and reduce cardiovascular risk in climacteric women.

Efficacy of Jiao's scalp acupuncture in combination with Xiangshao granules on chronic tension-type headache with concomitant nonalcoholic fatty liver disease in climacteric women.

OBJECTIVE: This study aimed to assess the efficacy of Jiao's scalp acupuncture in combination with Xiangshao granules on chronic tension-type headache (CTTH) with concomitant nonalcoholic fatty liver disease (NAFLD) in climacteric women. METHODS: In this study, we enrolled 150 climacteric women with CTTH and concomitant NAFLD. The participants were divided into three groups based on the random number table: medication group, acupuncture group, and acupuncture-medication group. Treatment continued for 2 months. The efficacy of CTTH was assessed based on the visual analog scale/score (VAS). The influence on NAFLD was assessed based on body mass index (BMI), controlled attenuation parameter (CAP), and the ratio of hepatic-splenic computed tomography (CT) value. The Participant Health Questionnaire-9 (PHQ-9) score was compared among the three groups. RESULTS: A total of 123 participants completed the trial, including 37 participants in the medication group, 41 participants in the acupuncture group, and 45 participants in the acupuncture-medication group. Results are summarized hereinafter. (1) The total clinical efficiency rates of the medication group, acupuncture group, and acupuncture-medication group were 89.19% (33 of 37), 90.24% (37 of 41), and 95.65% (44 of 46), respectively. (2) Except for the BMI of the medication group ( P = 0.063), a significant difference in VAS, BMI, CAP, the ratio of hepatic-splenic CT value, and PHQ-9 score was found in the three groups ( P < 0.01). (3) There was a significant difference in VAS, BMI, CAP, and PHQ-9 among the three groups ( P < 0.01), with those in the acupuncture-medication group being superior. No difference in the ratio of hepatic-splenic CT value was found ( P = 0.440). (4) The efficacy differed significantly among the three groups ( χ2 = 8.130, P = 0.017), and it was significantly superior in the acupuncture-medication group ( P = 0.008, P = 0.013). CONCLUSIONS: Jiao's scalp acupuncture, in combination with Xiangshao granules, was superior in treating CTTH in climacteric women compared with either acupuncture or medication. Jiao's scalp acupuncture, in combination with Xiangshao granules, was superior in subsiding the negative moods in participants with CTTH and concomitant NAFLD.

Uso de fitoterápicos na saúde da mulher / Use of herbal medicines in women's health / Uso de hierbas medicinales en la salud de la mujer

Objetivo: elencar os benefícios do uso de fitoterápicos na saúde da mulher com base na literatura. Método: revisão integrativa literatura. Pergunta norteadora: Quais os principais fitoterápicos utilizados na saúde da mulher e seus benefícios conforme a literatura? O acesso e seleção dos artigos ocorreu entre os meses de janeiro a fevereiro de 2023. Para a busca dos artigos foram utilizadas informações encontradas nas bases de dados: MedLine, SciELO, BDENF e LILACS, Foram incluídos os artigos completos publicados na íntegra, nos idiomas português e inglês, dentro do período de 10 anos (2012 a 2022), sendo excluídos artigos que não respondiam à pergunta norteadora. Resultados: foram encontrado 6 artigos que apresentaram como as plantas medicinais mais conhecidas ligadas ao tratamento dos sistemas endócrino e reprodutivo feminino no climatério, sendo elas: Glycine max, Angelica sinensis, Vitex agnus castus, Uncaria tomentosa, Lepidium meyenii, Panax ginseng. Conclusão: os fitoestrógenos apresentados no estudo demonstram eficácia para combater os sintomas climatéricos, sendo mais comum as isoflavonas, porém outras plantas também têm benefícios importantes para manter a saúde da mulher no que se refere ao trato genital

Objecive: list the benefits of the use of herbal medicines in women's health based on the literature. Method: integrative literature review. Guide question: What are the main herbal medicines used in women's health and their benefits according to the literature? The access and selection of articles occurred between January and February 2023. For the search of the articles, information found in the databases: MedLine, SciELO, BDENF and LILACS were included, the complete articles published in full, in Portuguese and English, within the period of 10 years (2012 to 2022), being excluded articles that did not answer the guide question. Results: six articles were found that presented the best known medicinal plants linked to the treatment of the endocrine and reproductive systems in the climacteric, which were: Glycine max, Angelica sinensis, Vitex agnus castus, Uncaria tomentosa, Lepidium meyenii, Panax ginseng. Conclusion: the phytoestrogens presented in the study demonstrate efficacy to combat climacteric symptoms, being more common isoflavones, but other plants also have important benefits to maintain women's health with regard to the genital tract.

Objetivo: enumere los beneficios del uso de hierbas medicinales en la salud de la mujer según la literatura. Metodo: Revisión integradora de la literatura. Pregunta guía: ¿Cuáles son las principales hierbas medicinales utilizadas en la salud de la mujer y sus beneficios según la literatura? El acceso y la selección de artículos ocurrieron entre enero y febrero de 2023. Para la búsqueda de los artículos, se incluyeron informaciones encontradas en las bases de datos: MedLine, SciELO, BDENF y LILACS, siendo excluidos los artículos completos publicados en su totalidad, en portugués e inglés, dentro del período de 10 años (2012 a 2022), quedando excluidos los artículos que no respondieron a la pregunta de la guía. Resultados: se encontraron seis artículos que presentaron las plantas medicinales más conocidas vinculadas al tratamiento de los sistemas endocrino y reproductivo en el climaterio, que fueron: Glycine max, Angelica sinensis, Vitex agnus castus, Uncaria tomentosa, Lepidium meyenii, Panax ginseng. Conclusión: Los fitoestrógenos presentados en el estudio demuestran eficacia para combatir los síntomas climatéricos, siendo más comunes las isoflavonas, pero otras plantas también tienen importantes beneficios para mantener la salud de la mujer con respecto al tracto genital.

Saberes e práticas de cuidado à saúde no climatério / Conocimientos y prácticas de atención de la salud en el climaterio / Knowledge and practices of health care in the climacteric

Objetivo: conhecer os saberes e as práticas de cuidado à saúde adotados no climatério por um grupo de mulheres vinculadas a uma Estratégia de Saúde da Família de um município da Serra Gaúcha. Método: pesquisa qualitativa, desenvolvida com oito mulheres, em fevereiro e março de 2015. Utilizou-se entrevista grupal e individuais, associadas à oficina de bonecas de pano. Adotou-se a proposta operativa para análise dos dados. Resultados: os saberes advêm da própria vivência e/ou das experiências de outras mulheres do seu meio social. As práticas de cuidado estão associadas aos desconfortos no climatério, envolvendo o uso de ervas e plantas medicinais, água fria e toalhas úmidas, alimentos derivados da soja, atividade física e lazer. Conclusões: os saberes e práticas de cuidado são repassados entre as gerações e estão ligados às condições de vida e de trabalho, a história e o meio social.(AU)

Objective: to know the knowledge and practices of health care adopted in the climacteric by a group of women linked to a Family Health Strategy of a municipality of serra gaúcha. Method: qualitative research, developed with eight women in February and March 2015. A group and individuals' interview were used, associated with the workshop of cloth dolls. The operative proposal for data analysis was adopted. Results: knowledge comes from your own experiences and/or experiences of other women in their social environment. Care practices are associated with discomforts in the climacteric, involving the use of herbs and medicinal plants, cold water and wet towels, foods derived from soybean, physical activity, and leisure. Conclusions: knowledge and care practices are passed on between generations and are linked to living and working conditions, history, and the social environment.(AU)

Objetivo: conocer los conocimientos y prácticas de atención de salud adoptados en el climaterio por un grupo de mujeres vinculadas a una Estrategia de Salud de la Familia de un municipio de serra gaúcha. Método: investigación cualitativa, desarrollada con ocho mujeres en febrero y marzo de 2015. Se utilizó entrevista grupal e individuáis, asociadas al taller de muñecas de tela. Se adoptó la propuesta operativa de análisis de datos. Resultados: el conocimiento proviene de sus proprias experiencias y/o experiencias de otras mujeres en su entorno social. Las prácticas de cuidado se asocian con molestias en el climaterio, que implican el uso de hierbas y plantas medicinales, agua fría y toallas húmedas, alimentos derivados de la soja, actividad física y ocio. Conclusiones: el conocimiento y las prácticas de cuidado se transmiten entre las generaciones y están vinculados a las condiciones de vida y de trabajo, la historia y el entorno social.(AU)

Long-term effects of a combination of isoflavones, agnus castus and magnolia extracts on climacteric symptoms and cardiometabolic risk profile in postmenopausal women.

OBJECTIVE: To evaluate the long-term effects of a combination of isoflavones, agnus castus and magnolia extracts (combined isoflavone compound [CIC]) on climacteric symptoms and cardiometabolic risk in symptomatic postmenopausal women. METHODS: This interventional, prospective study evaluated climacteric symptoms, mood and sleep disorders using the 21-item Greene Climacteric Scale (GCS) and 7-item Insomnia Severity Index (ISI) questionnaires; and cardiovascular, metabolic and thrombotic risk markers at baseline (T0) and after 12 months of CIC treatment (T1). RESULTS: In healthy postmenopausal women (N = 71), 12-month CIC treatment significantly reduced patient-reported vasomotor symptoms (100% vs. 17%), mood disorders (67% vs. 25%) and sleep disorders (89% vs. 19%%) (all p < .001) compared with baseline; and significantly improved GCS psychological, somatic, and vasomotor domain scores and ISI sleep disturbance scores (all p < .05). CIC significantly reduced systolic (p = .022) and diastolic blood pressure (p < .001), and heart rate (p < .001); glucose concentrations (p = .018), HOMA index (p = .013), and ALT (p = .035), homocysteine (p = .005) and NT-proBNP (p = .003) levels. CONCLUSIONS: Long-term CIC therapy improved vasomotor symptoms, mood disorders, sleep disorders, hemodynamic measurements and cardiometabolic risk markers in healthy postmenopausal women. CLINICALTRIALS.GOV IDENTIFIER: NCT03699150.

Satisfaction of Quechua-speaking women in climacteric stage with the care provided by midwives.

OBJECTIVE: To determine the satisfaction of Quechua-speaking women in climacteric stage of a rural Peruvian area with respect to primary health care provided by midwives. METHOD: Descriptive cross-sectional observational study, with a total of 690 Quechua-speaking women in climacteric stage from the rural community of Macashca (3,384 masl), Huaraz province, Ancash-Peru, whose primary health care was carried out by midwives. A questionnaire was applied between October 2019 and February 2020. The information was processed using the IBM SPSS version 22.0® statistical package, applying a descriptive statistical analysis. RESULTS: 72.1% of the women were totally satisfied with the health care provided by midwives, highlighting the interest shown in the health status of the users (71.3%), use of the Quechua language (75.4%), treatment received (74.3%), resolution of doubts (69.5%), information on the relief of climacteric symptoms (67.1%) and home follow-up (74.9%). CONCLUSIONS: The majority of Quechua-speaking women in climacteric stage stated that they were fully satisfied with the primary health care provided by midwives, where the most highly valued aspects were the use of the Quechua language, home follow-up, treatment received, and interest shown in the health status of the women; being able to consider improvements with respect to the information on the relief of climacteric symptoms and the resolution of doubts.

Effects of a Cereal Bar with a Combination of Phytoestrogens on the Climacteric Symptoms: A Placebo-Controlled, Randomized Trial.

OBJECTIVE: This study evaluated whether the consumption of a cereal bar combining different phytoestrogens could contribute to the reduction of climacteric symptoms in women. METHODS: This is a clinical, prospective, randomized, simple-blind trial. Forty-eight women, aged 40-65 years, with climacteric symptoms, from a city in southwestern Paraná, Brazil. Participants were randomly assigned into two groups; Phytoestrogens group (PHY = 24), which received for 90-day period a cereal bar containing 80.73 milligrams of soybean and flaxseed phytoestrogens, and the placebo group (PLA = 24), which consumed rice flakes biscuit. Clinical, sociodemographic and anthropometric data were collected and climacteric symptoms were assessed using the Kupperman Index (KI). RESULTS: Forty-three women were analyzed (PHY = 21 and PLA = 22). There were significant reductions in the overall KI score in both groups at the end of the intervention period (p < 0.05). However, the comparison between the groups using linear regression models presented expressively better symptom improvement in the PHY group -6.43 over time (95% CI: -11.6; -1.26; p < 0.05) KI points, with perimenopausal -15.15 (95% CI: -28.95; -1.35) and postmenopausal women -19.34 (95% CI: -33.68; -4.99) showed considerably greater reductions in symptoms at the end of the intervention period compared to premenopausal women. There was also significant reduction in symptoms of hot flushes, paresthesia, sexual complaints, insomnia and melancholy. CONCLUSION: The consumption of a cereal bar containing phytoestrogens was able to improve the symptoms of climacteric syndrome.

Morbidities and medications used by practicing nurses during the climacteric.

OBJECTIVE: This study aimed to identify the morbidities and medications used by nurses practicing in São Paulo, Brazil, during the climacteric period to raise awareness and contribute to future preventive health measures in this population. METHODS: A descriptive, cross-sectional study of 218 nurses aged 46-65 years based on data collected between January 2018 and July 2019 using a self-administered questionnaire was conducted. RESULTS: Respondents had a mean age of 53.9±5.1 years, mean weight of 71.3±13.6 kg, mean waist circumference of 91.6±14.5 cm, and mean body mass index of 27.8±4.9 kg/m2. Notably, 70.5% did not menstruate, had a mean age at last menstruation of 47.5±6.2 years and mean total score (Menopause Rating Scale) of 10.8±8.1, and reported the following morbidities: dyslipidemia (35.5%), subarachnoid hemorrhage (31.0%), rheumatologic diseases (14.8%), coronary heart disease (10.3%), diabetes (10.2%), malignant tumors (5.5%), deep venous thrombosis (3.2%), stroke (2.8%), and pulmonary embolism (0.5%). Medications used are antihypertensive agents (28.7%), antidyslipidemic agents (20.6%), antidiabetic agents (10.2%), antidepressants (9.6%), and anxiolytic agents (8.9%). CONCLUSIONS: The most prevalent climacteric symptoms were somatic and psychological, most notably physical and mental exhaustion and muscle and joint issues. The most common morbidities were anxiety, dyslipidemia, arterial hypertension, depression, arthrosis, arthritis and rheumatologic diseases, osteoporosis, diabetes mellitus, and coronary heart disease. The most frequently used medications were antihypertensive agents, antidyslipidemic agents (statins), antidiabetic agents, antidepressants, and calcium supplements. The study results furnish information on the health of practicing nurses during the climacteric period to inform preventive measures aimed at the main risk factors for morbidities to which nurses are exposed during this period.

Fitoestrógenos no climatério: proposição de um cardápio rico em fitoestrógenos para mulheres climatéricas / Phytoestrogens in climacteric: proposition of a menu rich in phytoestrogens for climacteric women

Introdução: A terapia de reposição hormonal é uma das principais formas de tratamento utilizadas no combate dos déficits hormonais durante o climatério. Entretanto, muitas mulheres buscam alternativas terapêuticas mais seguras e/ou naturais, como por exemplo, os fitoestrógenos. Objetivo: Elaborar um cardápio alimentar baseado em alimentos fontes de fitoestrógenos. Material e métodos: Trata-se de um estudo qualitativo e quantitativo descritivo, realizado nos meses de junho a setembro de 2019 no Núcleo de estudos em Alimentação e Nutrição da Universidade CEUMA. Foi elaborado um cardápio baseado na alimentação padrão da população brasileira (2000 kcal) segundo a Pesquisa de Orçamentos Familiares e Vigitel Brasil. Foram feitas adaptações nessa alimentação conforme a Pirâmide Alimentar Brasileira, incluindo alimentos fonte de fitoestrógenos. A adequação calórica de macronutrientes e compostos bioativos seguiram as recomendações da OMS, DRI's e IOM. Os dados foram analisados através do software NutriLife® e do programa Excel®, onde estavam contidas a Tabela de Composição dos Alimentos e a Tabela de Medidas Caseiras. Resultados: As principais fontes de fitoestrógenos são leguminosas e grãos (até três porções/dia). A fonte primordial de isoflavonas é a soja (295,55 mg/100g); de lignanas é a linhaça (370 mg/100g) e de coumestanos é a ervilha (8,11 mg/100g). A quantidade de fitoestrógenos totais atingida no cardápio foi de 42,2 a 55,2 mg/dia, com valores oscilantes para isoflavonas, lignanas e coumestanos durante a semana. Conclusão: O cardápio rico em fitoestrógenos configura uma alternativa adaptável e natural na remissão de determinados sintomas climatéricos, onde a baixa ocorrência de efeitos adversos facilita sua adesão.(AU)

Introduction: Hormone replacement therapy is one of the main forms of treatment used to combat hormonal deficits during the climac- teric. However, many women seek safer and/or natural therapeutic alternatives, such as phytoestrogens. Objective: To elaborate a food menu based on foods that are sources of phytoestrogens. Material and Methods: This is a qualitative and quantitative descriptive study, conducted in the months of June to September 2019 in the Center for Food and Nutrition Studies at CEUMA University. A menu was elaborated based on the standard feeding of the Brazilian population (2000 kcal) according to Family Budget Survey and Vigitel Brazil. Adaptations were made to this menu according to the Brazilian Food Pyramid, including foods source of phytoestrogens. The caloric adequacy of macronutrients and bioactive compounds followed the recommendations of the WHO, DRI's and IOM. The data were analyzed using NutriLife® software and Excel® program, which contained the Food Composition Table and the Homemade Measures Table. Results: The main sources of phytoestrogens are legumes and grains (up to three servings/day). The primary source of isoflavones is soy (295,55 mg/100g); of lignans is flaxseed (370 mg/100g) and of coumestans is pea (8,11 mg/100g). The total amount of phytoestrogens reached in the menu was 42,2 to 55,2 mg/day, with oscillating values for isoflavones, lignans and coumestans during the week. Conclusion: The menu is rich in phytoestrogens and constitutes an adaptable and natural alternative in the remission of certain climacteric symptoms, in which the low occurrence of adverse effects facilitates their adhesion.(AU)

Climatério e Terapia de Reposição Hormonal por mulheres em um município do Sul de Santa Catarina / Climacteric and Hormone Replacement Therapy for women in a city in southern Santa Catarina

RESUMO Introdução: O climatério corresponde ao período de transição entre a etapa reprodutiva e a não reprodutiva, onde há a menopausa caracterizada pela ausência de menstruação por 12 meses consecutivos, resultante da perda da atividade folicular ovariana. A Terapia de Reposição Hormonal (TRH) pode ser uma opção de tratamento com o intuito de melhorar as condições de saúde da mulher. O objetivo, deste estudo, foi investigar o perfil de idosas e sintomas climatéricos, além da utilização da TRH por mulheres em uma cidade do Sul de Santa Catarina. Métodos: Estudo epidemiológico com delineamento transversal quantitativo utilizando-se questionário para coleta de dados que ocorreu entre julho a setembro de 2017 e analisados no EpiInfo®. Resultados: Foram entrevistadas 107 idosas, média de idade 69,7 (± 8,9) anos. Das entrevistadas, 52,3% relataram algum sintoma climatérico, sendo mais frequente o fogacho. Pequena parcela das entrevistadas fez uso de TRH (15,9%), obtendo-se benefícios com a utilização. Destas, maioria foi administração via oral (88,2%), sendo que 35,3% usaram por mais de cinco anos, 82,4% relataram alguma reação adversa, sendo citada a mastalgia e o ganho de peso, e 64,7% realizavam consulta médica semestral. Somente 8,4% fizeram uso de chás, sendo a Amora Branca (Morus alba L) a mais citada. Conclusões: O esquema de TRH prescrito mais frequente foi a associação de estrógenos e progestógenos para administração por via oral, com acompanhamento médico semestral e obtendo-se resultados favoráveis. Medidas não farmacológicas foram adotadas por minoria das mulheres, adotando-se essencialmente o uso de planta medicinal na forma de chá. PALAVRA-CHAVE: Climatério, menopausa, terapia de reposição hormonal, saúde da mulher

ABSTRACT Introduction: The climacteric corresponds to the transition period between the reproductive and non-reproductive stages, where there is the menopause, characterized by the absence of menstruation for 12 consecutive months, resulting from the loss of ovarian follicular activity. Hormone Replacement Therapy (HRT) can be a treatment option with the aim of improving women's health conditions. The aim of this study was to investigate the profile of elderly women and climacteric symptoms, as well as the use of HRT by women in a city in southern Santa Catarina. Methods: Epidemiological study with a quantitative cross-sectional design using a questionnaire for data collection that was answered between July and September 2017 and analyzed in EpiInfo®. Results: 107 elderly women were interviewed, mean age 69.7 (± 8.9) years. Of the interviewees, 52.3% reported some climacteric symptom, with hot flashes being more frequent. A small portion of the interviewees used HRT (15.9%), obtaining benefits from its use. Of these, most were administered orally (88.2%), and 35.3% used it for more than five years, 82.4% reported some adverse reaction, mentioning breast tenderness and weight gain, and 64.7% had medical consultations every six months. Only 8.4% made use of teas, with the white blackberry (Morus alba L) being the most mentioned. Conclusions: The most frequent prescribed HRT regimen was the combination of estrogens and progestins for oral administration, with medical follow-up every six months and obtaining favorable results. Non-pharmacological measures were adopted by a minority of women, essentially adopting the use of medicinal plants in the form of tea. KEYWORDS: Climacteric, menopause, hormone replacement therapy, women's health

Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women.

The menopausal transition can be a challenging period for women's health and a trigger of uncomfortable symptoms. Beer is the main food source of isoxanthohumol, a precursor of 8-prenylnaringenin, the strongest phytoestrogen identified to date. As phytoestrogens are reported to reduce perimenopausal symptoms, we evaluated if a daily moderate consumption of beer with (AB) and without alcohol (NAB) could improve menopausal symptoms and modify cardiovascular risk factors. A total of 37 postmenopausal women were enrolled in a parallel controlled intervention trial and assigned to three study groups: 16 were administered AB (330 mL/day), 7 NAB (660 mL/day), and 14 were in the control group. After a 6-month follow-up of the 34 participants who finished the trial, both interventions (AB and NAB) significantly reduced the severity of the menopause-related symptoms (p-value AB vs. Control: 0.009; p-value NAB vs. Control: 0.033). Moreover, AB had a beneficial net effect on psychological menopausal discomforts compared to the control group. As the sex hormone profile did not differ significantly between the study groups, the effects of both types of beers (AB and NAB) are attributed to the non-alcoholic fraction of beer. Furthermore, moderate NAB consumption improved the lipid profile and decreased blood pressure in postmenopausal women.

Assessment of the climacteric syndrome: a narrative review.

PURPOSE: Many menopausal women suffer from a variety of estrogen deficiency-related symptoms and chronic medical conditions. Health care professionals should be able to identify and quantify symptoms to facilitate diagnosis, indicate and monitor treatment. Therefore, various questionnaires have been developed and are used as a simple, time-saving and cost-effective mean to assess and monitor menopausal complaints. The aim of this review is to provide an overview and comparison of the available tools for climacteric syndrome assessment. METHODS: Three electronic databases (Pubmed, EMBASE and Cochrane Database of Systematic Reviews/CDRS) were searched covering a time period of 10 years using a combination of relevant controlled vocabulary terms and free-text terms. Relevant references were evaluated for inclusion in a stepwise approach. RESULTS: The literature research revealed four questionnaires (Kupperman Index, Menopause Rating Scale, Menopause Specific Quality of Life Questionnaire and Greene Climacteric Scale) that are used to holistically assess the climacteric syndrome, varying in type of assessment, included symptoms, rating system of severity, weighing of symptoms, resulting total rating score and validation status. Further questionnaires are available to assess single symptoms or group of symptoms relating to specific aspects of menopause (e.g., vasomotor symptoms, insomnia, etc.). CONCLUSION: Four holistic questionnaires addressing menopausal symptoms have been developed [KI, MRS, MENQOL (-Intervention), Greene Climacteric Scale]. All but one (KI) have been validated and are available in different languages. However, there are still several shortcomings such as the lack of recognition of ethnic and cultural background and missing thresholds for treatment initiation and monitoring.

Percepções de enfermeiros sobre a atenção ao climatério / Nurses' perceptions about climateric care / Percepciones de los enfermeros sobre la atención al climaterio

Objetivo: analisar a atenção à saúde das mulheres acerca do manejo do climatério por enfermeiros de Atenção Primária à Saúde. Método: trata-se de um estudo qualitativo, descritivo, que tem, como referencial teórico, o conceito de percepção. Analisaram-se os dados transcritos por meio de Análise Temática Dedutiva. Resultados: informa-se que surgiram quatro categorias temáticas: Educação permanente e continuada; Organização dos serviços; Abordagem às mulheres em climatério e Utilização de terapias complementares. Acredita-se que os resultados contribuirão para novas perspectivas na atenção à saúde da mulher. Conclusão: conclui-se que a atenção à saúde da mulher em climatério ocorre de forma fragmentada e descontínua. Percebeu-se a necessidade de realizar educação permanente voltada ao tema climatério, bem como a elaboração de protocolos, normas e diretrizes atuais que orientem a atuação profissional.(AU)

Objective: to analyze women's health care regarding climateric management by Primary Health Care nurses. Method: it is a qualitative, descriptive study, which has, as theoretical reference, the concept of perception. The data transcribed was analyzed by means of a Deductive Thematic Analysis. Results: It is informed that four thematic categories have emerged: Permanent and continuous education; Organization of services; Approach to climacteric women and Use of complementary therapies. It is believed that the results will contribute to new perspectives in women's health care. Conclusion: it is concluded that the women's health care in the climacteric period occurs in a fragmented and discontinuous way. The need for permanent education on the subject of the climacteric period was perceived, as well as the elaboration of protocols, norms and current guidelines that guide the professional action.(AU)

Objetivo: analizar la atención de la salud de la mujer sobre el manejo del climaterio por enfermeros de Atención Primaria de Salud Método: se trata de un estudio cualitativo, descriptivo, que tiene como referencia teórica el concepto de percepción. Los datos transcritos fueron analizados mediante Análisis Temático Deductivo. Resultados: se informa que han surgido cuatro categorías temáticas: Educación permanente y continua; Organización de servicios; Aproximación a la mujer en climaterio y uso de terapias complementarias. Se cree que los resultados contribuirán a nuevas perspectivas en la atención de la salud de la mujer. Conclusión: se concluye que la atención a la salud de la mujer en el climaterio se da de forma fragmentada y discontinua. Se advirtió la necesidad de realizar una educación permanente enfocada en el tema climatérico, así como la elaboración de protocolos, reglas y pautas vigentes que orienten el desempeño profesional.(AU)

Case reports: Electroacupuncture decreases the climacteric symptoms by calcitonin gene-related peptide modulation.

OBJECTIVE: The purpose of the current study was to evaluate the modulation of Calcitonin gene-related peptide (CGRP) associated to the efficacy of Electroacupuncture (EA) in the reduction of climacteric symptoms. METHODS: Nine women between 51 and 59 years old with climacteric syndrome in menopause or perimenopause were included. Patients with hormone replacement therapy, psychiatric treatment with antidepressants, or acupuncture treatment in the last 3 months were excluded. A 4 Hz EA treatment was performed at acupoints Shenshu (BL-23), Pishu (BL-20), Guanyuan (REN-4), Taixi (KID-3), Fuliu (KID-7), Sanyinjiao (SP-6) and Neiguan (P-6) points. Women were treated two times a week for five consecutive weeks for a total treatment of 10 sessions. The menopause rating scale (MRS) was used to evaluate symptoms reduction and CGRP gene expression was measured before and after 10 EA session. RESULTS: The results shown that climacteric symptoms diminish significantly after EA therapy. CGRP gene expression was down-regulated, evidencing a decrease of 5-fold after EA therapy respect to the initial condition. CONCLUSION: EA treatment was associated with improvement in patients with climacteric syndrome and may be related to modulation of CGRP levels.

Developing an ICF Core Set for Climacteric Syndrome based on the International Classification of Functioning, Disability and Health (ICF).

BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) provides a globally accepted framework for the assessment of problems in functioning in relation to health conditions. ICF Core Sets are internationally accepted shortlists of the most relevant and essential ICF categories that can be used to assess and document the functioning of patients living with specific health conditions. OBJECTIVES: The objective of this paper is to outline the process of developing an ICF Core Set for Climacteric Syndrome. STUDY DESIGN: The development of an ICF Core Set follows an established, evidence-based process and will produce a comprehensive and a brief version of the ICF Core Set. The process includes four preliminary studies: 1) a systematic literature review; 2) a multi-center, cross-sectional study in a clinical setting with women 40+ years old; 3) an online expert survey with health professionals involved in caring for the health of women with climacteric syndrome; and 4) a qualitative study with focus groups of women 40+ years old. The results will be integrated at an international consensus conference, where it will be decided which ICF categories will be included in the ICF Core Set for Climacteric Syndrome. CONCLUSION: An ICF Core Set for Climacteric Syndrome could provide a holistic assessment of limitations in peri- and post-menopausal women and integrate the psycho-social perspective into health care practice. It could further facilitate communication between health care providers, be useful for research and teaching, and support both the transparency and the comparability of information.

Efeitos da terapia floral sobre o estado de ansiedade em mulheres no climatério / Effects of floral therapy on the state of anxiety in climacteric women

Introdução: O climatério corresponde ao período de vida da mulher onde ocorre a transição do ciclo reprodutivo para o não reprodutivo. Ocorre habitualmente entre os 40 e 65 anos, constituindo-se por um período de inúmeras mudanças. O uso da terapia floral nesta fase de vida pode ser visto como terapêutica única ou complementar ao tratamento convencional. Objetivos específicos: analisar as queixas clínicas de mulheres no climatério sob acompanhamento e sua relação com os indicadores do Diagnóstico de Enfermagem Ansiedade; avaliar os efeitos da terapia floral no autocontrole do estado de ansiedade em mulheres vivendo o climatério. Método: Intervenção clínica individualizada, quase- experimental, comparativo, do tipo antes-depois, com abordagem quantitativa, aprovado por Comitê de Ética em Pesquisa, tendo respeitado todos os preceitos éticos de pesquisas com seres humanos. O campo da pesquisa foi o Núcleo de Atenção em Práticas Integrativas e Complementares de Saúde (NAPICS), da Rede de Atenção Básica do município de Maricá/RJ. As participantes foram mulheres na faixa etária compreendida entre 40 e 65 anos, independentemente de estarem, ou não, em uso de terapia hormonal, selecionadas por conveniência. A coleta de dados foi realizada no período de março a novembro de 2019, através de consulta de enfermagem individual, com acompanhamento por seis meses seguidos, sendo um encontro a cada mês. Adotou-se a entrevista individual, guiada por um roteiro semiestruturado, seguido da aplicação da escala tipo Likert para classificação dos resultados de enfermagem relacionados ao Autocontrole da Ansiedade, empregada em todas as consultas. Os frascos contendo os florais foram preparados pela pesquisadora e entregues às mulheres a partir da terceira consulta. Todas as consultas foram gravadas em meio magnético e transcritas na íntegra para posterior análise. O programa utilizado para análise foi o IBM SPSS Statistics version 24. Descrição apresentada na forma de frequência observada, porcentagem, valores mínimo e máximo, medidas de tendência central e de variabilidade. O teste não paramétrico de Friedman comparou os escores do autocontrole da ansiedade entre as consultas. O nível alfa de significância utilizado foi de 5%. Adotou-se conceitos da Teoria de Martha Elizabeth Rogers como sustentação da terapia implementada. Resultados e Discussão: Todas as consultas de enfermagem seguiram os preceitos de acolhimento e integralidade no cuidado em saúde, preconizados pelo SUS. Os resultados confirmam o perfil das mulheres que substancialmente procuram a rede básica de saúde: baixa renda familiar, ocupações compatíveis a pouca escolaridade e, ainda, desemprego. Não realizam atividadfísica 79,37% das participantes. Além da ansiedade, as mulheres apresentam tristeza (100,00%); fadiga/cansaço (98,41%); dor nas articulações (96,83%); fogachos/ondas de calor (95,24%), insônia (93,65%), cefaleia (88,89%) e dormência (88,89%). No âmago das tecnologias de cuidado no climatério, a terapia floral vem angariando espaço, vez que atende aos princípios de integralidade da mulher, elevando sua autoestima e bem-estar. Conclusão: Os resultados da investigação após o desenvolvimento de três consultas 'pré intervenção' e três consultas 'pós intervenção', constataram que a terapia floral proporcionou às participantes responderem ao DE Ansiedade de forma satisfatória, quando se compara as consultas pré e pós intervenção. Portanto, houve redução dos níveis de ansiedade das participantes do estudo com o uso da terapia floral, deferindo o desfecho pretendido.

Introduction: O climacteric corresponds to the life period of the woman where the transition from the reproductive cycle to the non-reproductive cycle occurs. It usually occurs between 40 and 65 years, constituting for a period of numerous changes. The use of floral therapy in this phase of life can be seen as a single therapy or complementary to conventional treatment. Specific objectives: to analyze the clinical complaints of women in the climacteric under follow-up and their relationship with the indicators of the Anxiety Nursing Diagnosis; evaluate the effects of floral therapy on self-control of anxiety status in women living in climacteric. Method: Individualized, almost experimental, comparative clinical intervention, of the type before-after, with quantitative approach, approved by the Research Ethics Committee, having respected all ethical precepts of research with human beings. The field of research was the Center for Attention in Integrative and Complementary Health Practices (NAPICS), of the Primary Care Network of the municipality of Maricá/RJ. The participants were women between 40 and 65 years old, regardless of whether or not they were using hormone therapy, selected for convenience. Data collection was performed from March to November 2019, through individual nursing consultation, with follow-up for six months in a row, being a meeting each month. The individual interview was adopted, guided by a semi- structured script, followed by the application of the Likert scale to classify nursing outcomes related to Self-Control Anxiety, used in all consultations. The vials containing the florals were prepared by the researcher and delivered to the women from the third consultation. All consultations were recorded in magnetic medium and transcribed in full for further analysis. The program used for analysis was IBM SPSS Statistics version 24. Description presented in the form of observed frequency, percentage, minimum and maximum values, measures of central tendency and variability. Friedman's nonparametric test compared anxiety self-control scores between appointments. The alpha level of significance used was 5%. Concepts of Martha Roger's Theory were adopted as support for the implemented therapy. Results and Discussion: All nursing consultations followed the precepts of reception and integrality in health care, recommended by the SUS. The results confirm the profile of women who substantially seek the basic health network: low family income, occupations compatible with low schooling and also unemployment. 79.37% of the participants did not perform physical activity. In addition to anxiety, women present sadness (100.00%); fatigue/tiredness (98.41%); joint pain (96.83%); hot flashes (95.24%), insomnia (93.65%), headache (88.89%) and numbness (88.89%). At the heart of climacteric care technologies, floral therapy has been gathering space, since it meets the principles of integrality of women, raising their self-esteem and well-being. Conclusion: The results of the research after the development of three 'pre- intervention' consultations and three 'post-intervention' consultations found that floral therapy allowed participants to respond to ED Anxiety satisfactorily when com commencing pre- and post-intervention consultations. Therefore, there was a reduction in the anxiety levels of the study participants with the use of floral therapy, deferring the intended outcome.

Isoflavonas como tratamento alternativo na sintomatologia climatérica: uma revisão sistemática / Isoflavones as alternative treatment in climacteric symptomatology: a systematic review

O climatério é uma fase natural da vida da mulher que ocorre entre os 40 e 65 anos de idade e é caracterizado pela transição entre a fase reprodutiva e não reprodutiva. Neste período, devido às alterações hormonais, ocorrem alterações biológicas, endócrinas e clínicas. Sintomas vasomotores são típicos do hipoestrogenismo e podem interferir negativamente na qualidade de vida das mulheres. Este estudo teve como objetivo revisar os resultados dos estudos de intervenção que utilizaram isoflavonas na sintomatologia de mulheres climatéricas não usuárias de Terapia de Reposição Hormonal (TRH). Realizou-se uma revisão sistemática de artigos publicados entre os anos de 2008 e 2019 na base de dados PubMed. Foram encontrados 169 estudos, e considerando os critérios de inclusão, 18 artigos foram selecionados, em que houve intervenção com isoflavonas por meio de cápsulas e/ou suplementos ou alimentos para tratamento da síndrome climatérica. Foram verificados resultados positivos nos sintomas globais, com destaque para sintomas vasomotores, em mais da metade dos estudos avaliados, em que doses entre 45 mg a 160 mg diárias de isoflavonas por pelo menos 12 semanas foram administradas, especificadamente nas mulheres no período da pós-menopausa.

The climacteric is a natural phase during women’s life, which occurs between 40 and 65 years. It is characterized by the transition from their reproductive to non-reproductive phase. In this period, due to hormonal changes, biological, endocrine and clinical modifications also occur. Vasomotor symptoms are characteristic of hypoestrogenism and can negatively affect women’s quality of life. This study aimed to review the results of intervention studies which used isoflavones to treat the symptoms of climacteric women who did not undergo Hormone Replacement Therapy (HRT). A systematic review of articles published between 2008 and 2019 in the PubMed database was carried out. 169 studies were found, and considering the inclusion criteria, 18 articles were selected, in which it was described isoflavones intervention with capsules and/ or supplements or foods for the treatment of climacteric syndrome. Positive results were observed regarding to global symptoms, with emphasis on vasomotor symptoms in more than half of the studies, in which daily doses of isoflavones, between 45 mg to 160 mg, for at least 12 weeks, were administered specifically in postmenopausal women.

[Hormonal profile of women with metabolic syndrome in the background of multimodal non-medicinal correction of climacteric disorders.]

The inability to use hormone replacement therapy in women requires the search for effective non-pharmacological methods for the correction of menopausal disorders. Purpose of work. To assess the effect of non-drug programs for the correction of age-related disorders in women with metabolic syndrome (MS) on the level of sex hormones. Of the 330 women 45-50 years old with menopausal syndrome (CS) and MS, 5 groups were formed. Applied: basic treatment, physiotherapy, balneotherapy, multivitamins and minerals, physiotherapy (vibration therapy, chromotherapy, melotherapy, aromatherapy, aeroionotherapy) in various combinations. The levels of follicle-stimulating (FSH) and luteinizing (LH) hormones, estradiol were determined. In patients with mild CS, when using physiotherapy, after 3 months of treatment, FSH, LH decreased, estradiol increased. In patients with moderate KS, the best results were achieved using a full set of physiotherapeutic factors: after 6 months, FSH decreased by 19,3% (p<0,0001) and LH by 23,9% (p<0,0001), estradiol increased by 22,3% (p=0,0084). Comprehensive non-drug correction has a positive effect on the functioning of the hypothalamic-pituitary system in patients with CS and MS. In moderate-grade CS, a program with the use of vibration therapy, chromotherapy, melotherapy, aromatherapy and aeroionotherapy is a priority.

Blood pressure and cardiovascular risk factors in women treated for climacteric symptoms with acupuncture, phytoestrogens, or hormones.

OBJECTIVE: To evaluate the response of cardiovascular risk factors to the treatment of climacteric symptoms. METHODS: In this prospective study, women reporting climacteric symptoms were randomized to 3 months of treatment with either acupuncture (n = 19), phytoestrogens (75 mg soy isoflavones, BID; n = 22), or low-dose hormone therapy (HT; 0.3 mg conjugated equine oestrogens plus 1.5 mg medroxyprogesterone acetate; n = 20). Greene's climacteric scale, blood pressure (BP), lipids, glucose, insulin, and homeostatic model assessment of insulin resistance were assessed before and after treatment. Observed changes were compared by analysis of variance. RESULTS: HT and acupuncture reduced Greene climacteric score to a similar extent, but the effect of phytoestrogens was significantly lower (P < 0.05). With acupuncture, systolic (-7.4 ±â€Š15.3 mm Hg; P < 0.05) and diastolic BP (-8.3 ±â€Š7.7mm Hg; P < 0.01) decreased, and the same occurred with phytoestrogens (-8.4 ±â€Š9.0 mm Hg [P < 0.01] and -6.6 ±â€Š7.9 mm Hg [P < 0.01]). Neither BP systolic (1.9 ±â€Š17.5 mm Hg) nor BP diastolic (-1.4 ±â€Š9.6 mm Hg) changed during HT. Low-density lipoprotein cholesterol decreased with phytoestrogens (-9.9 ±â€Š19.6 mg/dL; P < 0.05), and triglycerides increased with both HT (34.5 ±â€Š12.2 mg/dL; P < 0.01) and phytoestrogens (17.41 ±â€Š24.4 mg/dL; P < 0.01). A slight but significant increase in homeostatic model assessment of insulin resistance (0.14 ±â€Š0.5; P < 0.05) was observed after HT. CONCLUSIONS: Treatment of climacteric symptoms with acupuncture and phytoestrogens, but not HT, is associated with a clear BP reduction, and phytoestrogens with potentially positive alterations in low-density lipoprotein cholesterol level. TRIAL REGISTRATION: EudractCT Number 2008-006053-41. : Video Summary:http://links.lww.com/MENO/A637.

Análise dos Métodos de Medicina Tradicional Chinesa no Tratamento do Climatério / Analisys of Chinese Traditional Medicine Methods in the Climacteric Treatment

O climatério é o período em que se inicia a perda da capacidade reprodutiva da mulher, culminando no momento de envelhecimento com a baixa de hormônios, principalmente do estrogênio, causando vários sintomas desagradáveis. Para a Medicina Tradicional Chinesa, este momento ocorre com a queda do Yin, causando uma mudança energética. Por isso acredita-se que o corpo e a mente da mulher precisam se preparar e se adaptar a essas mudanças. O presente artigo demonstra, através de uma revisão bibliográfica, as principais mudanças físicas e emocionais, e quais são os principais fitoterápicos, bem como os principais pontos de acupuntura a serem utilizados.