The Effect of Body Practices and Physical Exercise on Sexual Function of Menopausal Women. A Systematic Review with Meta-Analysis.

Objective: To review randomized clinical trials on Body Practices (BP) and Physical Exercise (PE) in menopausal women and describe their effect on sexual function. Methods: Searches carried out electronically in five databases, with a temporal criterion of 10 years of publication, from August to September 2022. Methodological quality and risk of bias were assessed using the Cochrane collaboration scale and PEDro (Physiotherapy Evidence Database Physiotherapy Evidence Database) scale score. Results: The majority of the studies presented a "'low" or "'uncertain" risk of bias. The instruments for assessing sexual function were heterogeneous. Interventions included mindfulness, relaxation hypnosis, Kegel exercises, yoga, and aerobic exercise, and generally lasted 12 weeks. Seven studies were included, of which six made up the meta-analysis, showing high heterogeneity (I2 = 94.2%; p < 0.0001). The analysis of subgroups with BP showed high heterogeneity (I2 = 94.2%; p < 0.01); interventions with PE presented more favorable results (I2 = 0%; 0; p = 0.90); the sexual function instruments showed high heterogeneity (I2 = 90%; p < 0.01); and instruments of quality of life and menopausal symptoms with domains of sexual function presented favorable results for BP and PE (I2 = 0%; p = 0.63). The funnel chart presents the studies in a dispersed manner, which implies publication bias. Conclusions: Interventions with PE proved to be more efficient compared to BP, however, there are a low number of studies with PE, and those found are limited to aerobic training, without sufficient data on intensity, volume, and frequency. Further studies with PE are needed for the treatment of sexual function symptoms in order to more comprehensively describe their effect.

Factors Associated with Cardiorespiratory Fitness in Breast Cancer Survivors from the State of Santa Catarina, Brazil: Cross-Sectional Study

Introduction: Oxygen consumption (VO2 ) is indicative of cardiorespiratory fitness (CRF) and lower levels are related to a higher risk of total mortality among individuals with cancer whose therapy can have adverse consequences on the cardiovascular system. Objective: To examine the associations of patient-reported sociodemographic, clinical, anthropometric outcomes and functional variables with CRF in 69 women (55±10 years) and to identify whether walking is a predictor of peak VO2 variation in this population with breast cancer (BC). Method: Female BC survivors receiving hormone therapy after two types of surgery (breast-conserving and mastectomy) underwent a CRF test on a cycle ergometer to measure peak VO2 . A questionnaire containing sociodemographic, clinical data, patient reported outcomes (PROs) (depressive symptoms, sleep quality, fatigue, body image) and self-reported walking and tests to measure body fat percentage, waist circumference, flexibility and shoulder range of motion (RoM) were performed. Results: Unemployment and retirement were associated with low CRF, as was the use of aromatase inhibitors instead of tamoxifen. Depressive symptoms, worse body image, greater waist circumference, less flexibility and shoulder RoM were also associated with low CRF. Walking duration, controlled for age and body mass index (BMI), is a 13% predictor of peak VO2 variance in this sample. Conclusion: These factors must be considered in understanding the CRF profile of BC survivors. As walking was a predictor of peak VO2 variance, it should be recommended as a type of physical activity for patients with BC using hormone therapy.

Introdução: O consumo de oxigênio (VO2 ) é indicativo de aptidão cardiorrespiratória (ACR), e níveis mais baixos estão relacionados a um maior risco de mortalidade total entre indivíduos com câncer cuja terapia pode ter consequências adversas no sistema cardiovascular. Objetivo: Examinar as associações de desfechos sociodemográficos, clínicos, antropométricos relatados pelo paciente e variáveis funcionais com a ACR de 69 mulheres (55±10 anos), e identificar se a caminhada é um preditor de variação do pico de VO2 nessa população com câncer de mama (CM). Método: Mulheres sobreviventes de CM recebendo terapia hormonal após dois tipos de cirurgias (conservadora e mastectomia) realizaram um teste de ACR em cicloergômetro para medir o VO2 pico. Um questionário contendo dados sociodemográficos e clínicos; resultados relatados pelos pacientes (RRP) (sintomas depressivos, qualidade do sono, fadiga, imagem corporal); caminhada autorreferida; e testes para medir o percentual de gordura, circunferência da cintura, flexibilidade e amplitude do movimento ADM do ombro foram realizados. Resultados: Desemprego e aposentadoria foram associados à baixa ACR, assim como o uso de inibidores de aromatase ao invés de tamoxifeno. Sintomas depressivos, pior imagem corporal, maior circunferência da cintura, menor flexibilidade e ADM do ombro também foram associados à baixa ACR. A duração da caminhada, controlada por idade e índice de massa corporal (IMC), é um preditor de 13% da variância do VO2 pico nesta amostra. Conclusão: Tais fatores devem ser considerados na compreensão do perfil de ACR de sobreviventes de CM. Como a caminhada foi um preditor da variância do VO2 pico, deve ser recomendada atividade física para pacientes com CM em uso de hormonioterapia.

Introducción: El consumo de oxígeno (VO2 ) es indicativo de aptitud cardiorrespiratoria (ACR) y los niveles más bajos se relacionan con un mayor riesgo de mortalidad total entre las personas con cáncer cuya terapia puede tener consecuencias adversas sobre el sistema cardiovascular. Objetivo: Examinar las asociaciones de los resultados sociodemográficos, clínicos, antropométricos y variables funcionales informados por las pacientes con la ACR en 69 mujeres (55±10 años) e identificar si caminar es un predictor de la variación del VO2 máximo en esta población con cáncer de mama (CM). Método: Mujeres sobrevivientes de CM que recibieron terapia hormonal después de dos tipos de cirugía (conservadora y mastectomía) se sometieron a una prueba de ACR en un cicloergómetro para medir el VO2 máximo. Se aplicó un cuestionario que contenía datos sociodemográficos, clínicos, resultados informados por los pacientes (RIP) (síntomas depresivos, calidad del sueño, fatiga, imagen corporal) y caminata autoinformada y pruebas para medir el porcentaje de grasa corporal, la circunferencia de la cintura, la flexibilidad y el rango de movimiento (RoM) del hombro. Resultados: El desempleo y la jubilación se asociaron con una baja ACR, al igual que el uso de inhibidores de la aromatasa en lugar de tamoxifeno. Síntomas depresivos, peor imagen corporal, mayor perímetro de cintura, menor flexibilidad y RoM de los hombros también se asociaron con una baja ACR. La duración de la caminata, controlada por edad e índice de masa corporal (IMC), es un predictor del 13% de la variación del VO2 pico en esta muestra. Conclusión: Estos factores deben ser considerados para comprender el perfil de ACR de los sobrevivientes de CM. Como la caminata fue un predictor de la variación del VO2 pico, debe recomendarse actividad física para pacientes con CM en terapia hormonal.

Association between menopausal symptoms, sexual function, and sexual activity - a cross-sectional study.

Introduction: To analyse the possible association between menopausal symptoms (somatic-vegetative, psychological, and urogenital) and sexual function with the maintenance of the sexual activity of women in menopause. Material and methods: This cross-sectional study comprised 96 menopausal women aged 40-59 (52.88 ±4.05) years, who presented a positive score to the menopause rating scale (MRS) and had serum levels of follicle stimulating hormone ≥ 25 IU/ml. Participants who used hormone replacement therapy were excluded. Results: It was observed that participants who had an active sexual life had lower medians in the somatic-vegetative (p < 0.001) and psychological symptoms (p = 0.006), as well as in the general score (p = 0.001) at the MRS; in addition, they had better sexual function in 4 domains (p < 0.005): excitement, lubrication, orgasm, and pain, as well as in the total score of the female sexual function index questionnaire (p < 0.005). It was also found that, regardless of the type of menopause (surgical or natural), women who did not engage in sexual activity had a score of 5.651 points more in the MRS (p = 0.004), demonstrating that the practice of sexual activity predicts in 10.4% the variation in the symptom score. Conclusions: Menopausal women who maintain sexual activity had a lower score on the menopause symptom score and better sexual function compared to those who did not perform sexual activity.