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1.
Einstein (Sao Paulo) ; 19: eAO5701, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33729286

RESUMEN

OBJECTIVE: To examine epidemiologic, anthropometric and clinical variables associated with stress urinary incontinence in obese women, before and after bariatric surgery, and to identify predictive factors of stress urinary incontinence resolution. METHODS: Prospective observational study with women enrolled in a bariatric surgery program between 2015 and 2016. Patients were assessed prior to and 6 months after bariatric surgery using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale. Patient assessment also included physical examination and bladder stress tests. RESULTS: A total of 43 women completed the study. There was a 72.7% reduction in stress urinary incontinence (p=0.021). Predictive factors for preoperative diagnosis of stress urinary incontinence included age (p=0.024) and abdominal waist circumference (p=0.048). Urinary symptoms improved after weight loss, especially nocturia (p=0.001) and stress urinary incontinence (p=0.026). Menopause was the most significant predictive factor for persistence of stress urinary incontinence within six months of bariatric surgery (p=0.046). Self-reported outcomes and scores obtained in the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form, the Patient Global Impression of Improvement and the Visual Analogue Scale were associated with significant improvement (p=0.012, p=0.025, and p=0.002 respectively). CONCLUSION: Older women with larger waist circumference have a higher risk of developing stress urinary incontinence prior to bariatric surgery. Menopausal women are highly prone to persistent stress urinary incontinence, even after weight loss. Weight loss achieved through bariatric surgery improved stress urinary incontinence symptoms and mitigated related impacts on quality of life in the vast majority of women.


Asunto(s)
Cirugía Bariátrica , Obesidad Mórbida , Incontinencia Urinaria de Esfuerzo , Factores de Edad , Femenino , Humanos , Menopausia , Obesidad Mórbida/complicaciones , Obesidad Mórbida/cirugía , Estudios Prospectivos , Calidad de Vida , Encuestas y Cuestionarios , Resultado del Tratamiento , Incontinencia Urinaria de Esfuerzo/etiología , Circunferencia de la Cintura
2.
Post Reprod Health ; 27(1): 10-18, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33673758

RESUMEN

Menopause is a major life event affecting all women in a variety of ways, both short and long term. All women should have access to accurate information, available in all forms and through all recognised sources. All healthcare professionals should have a basic understanding of the menopause and know where to signpost women for advice, support and treatment whenever appropriate. Every primary care team should have at least one nominated healthcare professional with a special interest and knowledge in menopause. All healthcare professionals with a special interest in menopause should have access to British Menopause Society Menopause Specialists for advice, support, onward referral and leadership of multidisciplinary education. With the introduction of the comprehensive British Menopause Society Principles and Practice of Menopause Care programme, the society is recognised throughout the UK as the leading provider of certificated menopause and post reproductive health education and training for healthcare professionals. Restrictions imposed by the coronavirus pandemic have been a springboard for the British Menopause Society to bring innovations to the services provided for our membership and for healthcare professionals throughout the UK.


Asunto(s)
Menopausia , Programas Nacionales de Salud , Grupo de Atención al Paciente , Calidad de Vida , /epidemiología , Femenino , Disparidades en el Estado de Salud , Humanos , Comunicación Interdisciplinaria , Menopausia/fisiología , Menopausia/psicología , Salud Mental/normas , Programas Nacionales de Salud/organización & administración , Programas Nacionales de Salud/tendencias , Innovación Organizacional , Atención al Paciente/métodos , Atención al Paciente/normas , Grupo de Atención al Paciente/organización & administración , Grupo de Atención al Paciente/tendencias , Mejoramiento de la Calidad , Conducta de Reducción del Riesgo , Reino Unido/epidemiología
3.
Menopause ; 28(3): 255-262, 2021 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-33570873

RESUMEN

OBJECTIVE: To examine whether blood pressure (BP) accelerates more rapidly during the menopause transition for women with a history of preterm or term small for gestational age (SGA) delivery compared to women with all term and appropriate for gestational age (AGA) births. METHODS: A longitudinal analysis was conducted with 1,008 parous women who had BP data at ≥2 study visits. We used generalized linear modeling to examine BP before the final menstrual period, at the final mentrual period, and up to 10 years after the final menstrual period, according to pregnancy group. We assessed maternal changes in BP over time in relation to years near the final menstrual period using a piece-wise linear model, consistent with menopause-induced changes. Models were adjusted for socio-demographics, body mass index, smoking, physical activity, medications, parity, age at first birth, gestational diabetes, and gestational hypertension/preeclampsia. RESULTS: At baseline, women were on average 46 years old, 101 (10%) reported a prior preterm birth, and 102 (10.1%) reported a term SGA birth. Compared to women with all term AGA births, women with a term SGA birth had higher BP before the final menstrual period, at the final menstrual period, and up to 10 years after the final menstrual period; women with a preterm birth had higher BP in the postmenopausal years. Annual rate of change in BP during the menopause transition did not differ between pregnancy groups. CONCLUSIONS: Women with a history preterm and term SGA delivery have higher BP than women with all term AGA births during the menopause transition, but rate of change in BP does not differ in these groups relative to final menstrual period.


Asunto(s)
Presión Sanguínea/fisiología , Hipertensión/complicaciones , Menopausia/fisiología , Nacimiento Prematuro/epidemiología , Premenopausia/fisiología , Femenino , Edad Gestacional , Humanos , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Persona de Mediana Edad , Vigilancia de la Población , Embarazo , Factores de Riesgo , Salud de la Mujer
4.
Artículo en Inglés | MEDLINE | ID: mdl-33572819

RESUMEN

Although estradiol (E2) has been believed to be the most critical factor in the menopause-associated decrease in bone mineral density (BMD), the role of increasing follicle stimulating hormone (FSH) during menopause is relatively unclear. We determined the extent to which hip and lumbar spine BMD differ among the stages of menopause in healthy women, and whether BMD is associated with FSH and E2 levels. A cross-sectional study of 141 healthy women classified as premenopausal (Pre; 38 ± 6 yrs; mean ± SD, n = 30), early perimenopausal (EPeri; 50 ± 3yrs, n = 31), late perimenopausal (LPeri; 50 ± 4yrs, n = 30), early postmenopausal (EPost; 55 ± 3yrs, n = 24), or late postmenopausal (LPost; 62 ± 4 yrs, n = 26), was conducted. Spine/hip BMD and sex hormones were measured using dual-energy X-ray absorptiometry and enzymatic/colorimetric methods, respectively. Compared to EPeri, spine BMD was lower (p < 0.05) in LPeri, EPost, and LPost and hip BMD was lower (p < 0.05) in EPost and LPost. BMD was inversely associated with FSH (spine: r = -0.341; hip: r = -0.271, p < 0.05) and directly associated with E2 (spine: r = 0.274; hip: r = 0.256, p < 0.05). The menopause-related loss of spine and hip BMD is associated not only with low E2 but also higher FSH. Future studies are essential to delineating the mechanisms by which FSH regulates bone health in aging women.


Asunto(s)
Densidad Ósea , Menopausia , Absorciometría de Fotón , Estudios Transversales , Femenino , Hormona Folículo Estimulante , Humanos
5.
Obstet Gynecol ; 137(3): 423-429, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33543899

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), uses two primary receptors, type II transmembrane serine protease and angiotensin-converting enzyme-2, for priming and cellular invasion, respectively. Both proteins have been demonstrated to be present in different concentrations in females and males, which may explain a mechanism for the reported higher case-fatality rate in males. Despite the known sex difference in COVID-19 disease mortality, preliminary data suggest there are certain female populations, including pregnant and menopausal women and possibly polycystic ovarian syndrome patients who are more susceptible to COVID-19-related morbidity. This commentary analyzes the interplay between sex differences, hormones, and the immune function in each of these populations with respect to the risk and severity of COVID-19 and proposes biological rationales to explain these differences.


Asunto(s)
/epidemiología , Predisposición Genética a la Enfermedad , /genética , Cromosomas Humanos X , Susceptibilidad a Enfermedades , Femenino , Humanos , Masculino , Menopausia/fisiología , Morbilidad , Síndrome del Ovario Poliquístico/epidemiología , Embarazo , Serina Endopeptidasas/genética , Factores Sexuales
6.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud, LIS-bvsms | ID: lis-48024

RESUMEN

A menopausa corresponde ao último ciclo menstrual, ou seja, a última menstruação. Ocorre, em geral, entre os 45 e 55 anos. Quando ocorre por volta dos 40 anos, é chamada de menopausa prematura ou precoce. O termo menopausa é, muitas vezes, utilizado indevidamente para designar o climatério, que é a fase de transição do período reprodutivo, ou fértil, para o não reprodutivo na vida da mulher.


Asunto(s)
Menopausia , Climaterio , Salud de la Mujer
7.
Int J Pharm Compd ; 25(1): 14-17, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33503005

RESUMEN

This represents part two of a two-part article on the topic of gender bias within hormone replacement therapy and the well-orchestrated attempt by the pharmaceutical industry to eliminate bioidentical hormones, as well as to downplay the important role of compounding pharmacies in fulfilling the needs of women in this longstanding gender gap. Part one of this two-part article was published in the November/December 2020 issue of the International Journal of Pharmaceutical Compounding. That article discussed two of the four most prevalent reasons for this bias, Protecting the Bottom Line and Lack of Patent Protection. This article concludes this discussion with reasons three and four, Exclusion of Women in Medical Research and Fear and Retribution.


Asunto(s)
Menopausia , Sexismo , Composición de Medicamentos , Terapia de Reemplazo de Estrógeno , Femenino , Terapia de Reemplazo de Hormonas , Humanos , Masculino
8.
Med Care ; 59: S70-S76, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33438886

RESUMEN

BACKGROUND: Among midlife and older women, menopause symptoms and menopausal hormone therapy have been linked to mental health disorders and other comorbidities related to suicide. However, the role of hormone therapy as a prognostic factor of suicide risk is largely unknown. OBJECTIVES: To examine associations between menopausal hormone therapy, suicide attempts, and suicide among midlife and older women Veterans. RESEARCH DESIGN: In this longitudinal analysis of national Veterans Health Administration data from women Veterans aged 50 years and above, we used Fine-Gray proportional hazards models to examine associations between menopausal hormone therapy (prescribed in 2012-2013) and incident suicide attempts and suicide (index date-2016). MEASURES: Menopausal hormone therapy and psychoactive medications from pharmacy records; suicide attempts and suicide from national suicide data repositories; demographic variables, medical and psychiatric diagnoses, and substance use disorders from electronic medical record data and International Classification Diagnoses-9-CM codes. RESULTS: In this national sample of 291,709 women Veterans (mean age 60.47, SD 9.81), 6% were prescribed menopausal hormone therapy at baseline. Over an average of 4.5 years, 2673 had an incident suicide attempt (93%) or death by suicide (7%). Adjusting for age, race, and medical diagnoses, menopausal hormone therapy was associated with increased risk of suicide attempt (hazard ratio 1.41; 95% confidence interval, 1.22-1.64) and over 2-fold increased risk of death by suicide (hazard ratio 2.47; 95% confidence interval, 1.58-3.87). Associations with death by suicide remained significant after accounting for psychiatric comorbidity and psychoactive medications. CONCLUSIONS: Menopausal hormone therapy may be an important indicator of suicide risk among midlife and older women.


Asunto(s)
Terapia de Reemplazo de Hormonas/psicología , Menopausia/psicología , Intento de Suicidio/estadística & datos numéricos , Suicidio Completo/estadística & datos numéricos , Veteranos/psicología , Anciano , Centers for Medicare and Medicaid Services, U.S. , Femenino , Humanos , Incidencia , Estudios Longitudinales , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Factores de Riesgo , Estados Unidos/epidemiología , United States Department of Veterans Affairs , Veteranos/estadística & datos numéricos , Salud de los Veteranos
10.
JAMA Netw Open ; 4(1): e2030405, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33404618

RESUMEN

Importance: Although estrogen level is positively associated with bone mineral density, there are limited data on the risk of fractures after menopause. Objective: To investigate whether female reproductive factors are associated with fractures among postmenopausal women. Design, Setting, and Participants: This population-based retrospective cohort study used data from the Korean National Health Insurance Service database on 1 272 115 postmenopausal women without previous fracture who underwent both cardiovascular and breast and/or cervical cancer screening from January 1 to December 31, 2009. Outcome data were obtained through December 31, 2018. Exposures: Information was obtained about reproductive factors (age at menarche, age at menopause, parity, breastfeeding, and exogenous hormone use) by self-administered questionnaire. Main Outcomes and Measures: Incidence of any fractures and site-specific fractures (vertebral, hip, and others). Results: Among the 1 272 115 participants, mean (SD) age was 61.0 (8.1) years. Compared with earlier age at menarche (≤12 years), later age at menarche (≥17 years) was associated with a higher risk of any fracture (adjusted hazard ratio [aHR], 1.24; 95% CI, 1.17-1.31) and vertebral fracture (aHR, 1.42; 95% CI, 1.28-1.58). Compared with earlier age at menopause (<40 years), later age at menopause (≥55 years) was associated with a lower risk of any fracture (aHR, 0.89; 95% CI, 0.86-0.93), vertebral fracture (aHR, 0.77; 95% CI, 0.73-0.81), and hip fracture (aHR, 0.88; 95% CI, 0.78-1.00). Longer reproductive span (≥40 years) was associated with lower risk of fractures compared with shorter reproductive span (<30 years) (any fracture: aHR, 0.86; 95% CI, 0.84-0.88; vertebral fracture: aHR, 0.73; 95% CI, 0.71-0.76; and hip fracture: aHR, 0.87; 95% CI, 0.80-0.95). Parous women had a lower risk of any fracture than nulliparous women (aHR, 0.96; 95% CI, 0.92-0.99). Although breastfeeding for 12 months or longer was associated with a higher risk of any fractures (aHR, 1.05; 95% CI, 1.03-1.08) and vertebral fractures (aHR, 1.22; 95% CI, 1.17-1.27), it was associated with a lower risk of hip fracture (aHR, 0.84; 95% CI, 0.76-0.93). Hormone therapy for 5 years or longer was associated with lower risk of any factures (aHR, 0.85; 95% CI, 0.83-0.88), while use of oral contraceptives for 1 year or longer was associated with a higher risk of any fractures (aHR, 1.03; 95% CI, 1.01-1.05). Conclusions and Relevance: The findings of this cohort study suggest that female reproductive factors are independent risk factors for fracture, with a higher risk associated with shorter lifetime endogenous estrogen exposure. Interventions to reduce fracture risk may be needed for women at high risk, including those without osteoporosis.


Asunto(s)
Fracturas Osteoporóticas/epidemiología , Posmenopausia/fisiología , Anciano , Lactancia Materna/estadística & datos numéricos , Terapia de Reemplazo de Estrógeno/estadística & datos numéricos , Femenino , Fracturas Óseas/epidemiología , Humanos , Incidencia , Menarquia/fisiología , Menopausia/fisiología , Persona de Mediana Edad , República de Corea , Estudios Retrospectivos , Factores de Riesgo
11.
Eur J Endocrinol ; 184(2): 337-346, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33428587

RESUMEN

Objective: Staphylococcus aureus is a major human pathogen, and nasal carriers have an increased risk for infection and disease. The exploration of host determinants for nasal carriage is relevant to decrease infection burden. Former studies demonstrate lower carriage prevalence in women and among users of progestin-only contraceptives. The aim of this study was to investigate the possible associations between circulating sex-steroid hormones and nasal carriage of Staphylococcus aureus in a general population. Methods: In the population-based sixth Tromsø study (2007-2008) nurses collected nasal swab samples from 724 women aged 30-87 not using any exogenous hormones, and 700 of the women had a repeated nasal swab taken (median interval 28 days). We analysed a panel of serum sex-steroids by liquid chromatography tandem mass spectrometry, and collected information about lifestyle, health and anthropometric measures. Multivariable logistic regression was used to study the association between circulating sex-steroids and Staphylococcus aureus carriage (one swab) and persistent carriage (two swabs), while adjusting for potential confounding factors. Women in luteal phase were excluded in the analysis of androgens. Results: Staphylococcus aureus persistent nasal carriage prevalence was 22%. One standard deviation increase in testosterone and bioavailable testosterone was associated with lower odds of persistent nasal carriage, (OR = 0.57; 95% CI = 0.35-0.92 and OR = 0.52, 95% CI = 0.30-0.92) respectively. Analysis stratified by menopause gave similar findings. Persistent carriers had lower average levels of androstenedione and DHEA, however, not statistically significant. Conclusion: This large population-based study supports that women with lower levels of circulating testosterone may have increased probability of Staphylococcus aureus persistent carriage.


Asunto(s)
Portador Sano/microbiología , Hormonas Esteroides Gonadales/sangre , Cavidad Nasal/microbiología , Staphylococcus aureus , Adulto , Anciano , Anciano de 80 o más Años , Androstenodiona/sangre , Portador Sano/epidemiología , Deshidroepiandrosterona/sangre , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Posmenopausia , Prevalencia , Infecciones Estafilocócicas/epidemiología , Testosterona/sangre
12.
Rev. enferm. UFPE on line ; 15(1): [1-11], jan. 2021.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1145773

RESUMEN

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)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Percepción , Atención Primaria de Salud , Climaterio , Menopausia , Salud de la Mujer , Atención Integral de Salud , Enfermeras y Enfermeros , Epidemiología Descriptiva , Investigación Cualitativa , Educación Continua
14.
Eur J Endocrinol ; 184(3): 399-411, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33444226

RESUMEN

Objective: To investigate the impact of age, obesity and metabolic parameters on 13 circulating steroids in reproductive and menopausal age. To define reference intervals (RIs). Design: Cross-sectional. Methods: Three hundred and twenty five drug-free, healthy and eumenorrheic women were selected from the general population. Independent relationships of LC-MS/MS-determined steroid levels with age, BMI and metabolic parameters were estimated. Reference sub-cohorts were defined for calculating upper and lower limits in reproductive age, menstrual phases and menopause, and these were compared with limits in dysmetabolic sub-cohorts. Results: Lower androgens, pro-androgens and estrogens, but higher cortisol and metabolites were found in menopausal compared to reproductive age women. Androgens and precursors decreased during reproductive age (P < 0.001-P = 0.002) but not after menopause. 17OH-progesterone decreased with BMI (P = 0.006) and glucocorticoids with waist circumference (P < 0.001P = 0.002) in reproductive age, but increased with triglycerides (P=0.011P=0.038) after menopause. Inverse associations of dihydrotestosterone with BMI (P=0.004) and HDL-cholesterol (P=0.010), estrone with total cholesterol (P=0.033) and estradiol with triglycerides (P=0.011) were found in reproductive age. After menopause, estrone increased with waist circumference (P<0.001) and decreased with insulin resistance (P=0.012). Ovarian steroid RIs were estimated in menstrual phases and menopause. Age- and reproductive status-specific RIs were generated for androgens, precursors and corticosteroids. Lower limits for reproductive age cortisol (P=0.020) and menopausal 11-deoxycortisol (P=0.003) in dysmetabolic sub-cohorts were reduced and increased, respectively, compared to reference limits. Conclusions: Obesity and dysmetabolism differently influence circulating steroids in reproductive and menopausal status. Age, menstrual and menopausal status-specific RIs were provided by LC-MS/MS for a broad steroid panel.


Asunto(s)
Envejecimiento/sangre , Análisis Químico de la Sangre/normas , Metabolismo Energético/fisiología , Hormonas Esteroides Gonadales/sangre , Menopausia/sangre , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/metabolismo , Análisis Químico de la Sangre/métodos , Cromatografía Liquida/normas , Estudios Transversales , Técnicas de Diagnóstico Endocrino/normas , Femenino , Hormonas Esteroides Gonadales/análisis , Hormonas Esteroides Gonadales/normas , Humanos , Menopausia/metabolismo , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Espectrometría de Masas en Tándem/normas , Adulto Joven
15.
Support Care Cancer ; 29(1): 369-375, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32367228

RESUMEN

OBJECTIVE: To compare sexual function and quality of life (QoL) in breast cancer survivors with and without a history of bilateral salpingo-oophorectomy (BSO). METHODS: A cross-sectional study of breast cancer survivors treated at a tertiary referral hospital in Western Australia. The Female Sexual Function Index was used to determine rates of female sexual dysfunction (FSD) and hypoactive sexual desire disorder (HSDD). Participants also completed the Relationship Assessment Scale, Menopause-specific quality of life questionnaire and Short Form Health Survey-36. RESULTS: A total of 427 women were invited to participate: 119 had undergone BSO and 308 were controls with at least one ovary remaining. A total of 172 women participated (overall response rate 40.3%), consisting of 76 women in the BSO group (response rate 63.9%) and 96 women with at least one ovary remaining (response rate 31.2%). There was no difference in FSD between the two groups: 63/76 (82.9%) women who had undergone BSO had FSD compared to 75/96 (78.1%) controls (p = 0.458). No difference in HSDD was observed (p = 0.084) between the BSO group 70/76 (96.0%) and the controls 96/96 (100%). Women who had undergone BSO had lower general health scores compared to the control group (p = 0.034). Both groups had similar energy levels, emotional well-being, pain scores, physical functioning levels and social functioning levels. CONCLUSIONS: In this study, women with prior treatment for breast cancer had high levels of FSD and HSDD, irrespective of whether they had undergone BSO. Both groups reported similar sexual function scores and QoL.


Asunto(s)
Neoplasias de la Mama/cirugía , Calidad de Vida/psicología , Salpingooforectomía/psicología , Disfunciones Sexuales Psicológicas/psicología , Adulto , Anciano , Supervivientes de Cáncer/psicología , Estudios Transversales , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Conducta Sexual/psicología , Sexualidad/psicología , Encuestas y Cuestionarios , Australia Occidental
16.
Environ Pollut ; 269: 116216, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33316492

RESUMEN

Evidence has shown associations between air pollution and traffic-related exposure with accelerated aging, but no study to date has linked the exposure with age at natural menopause, an important indicator of reproductive aging. In this study, we sought to examine the associations of residential exposure to ambient particulate matter (PM) and distance to major roadways with age at natural menopause in the Nurses' Health Study II (NHS II), a large, prospective female cohort in US. A total of 105,996 premenopausal participants in NHS II were included at age 40 and followed through 2015. Time-varying residential exposures to PM10, PM2.5-10, and PM2.5 and distance to roads was estimated. We calculated hazard ratios (HR) and 95% confidence intervals (CIs) for natural menopause using Cox proportional hazard models adjusting for potential confounders and predictors of age at menopause. We also examined effect modification by region, smoking, body mass, physical activity, menstrual cycle length, and population density. There were 64,340 reports of natural menopause throughout 1,059,229 person-years of follow-up. In fully adjusted models, a 10 µg/m3 increase in the cumulative average exposure to PM10 (HR: 1.02, 95% CI: 1.00, 1.04), PM2.5-10 (HR: 1.03, 95% CI: 1.00, 1.05), and PM2.5 (HR: 1.03, 95% CI: 1.00, 1.06) and living within 50 m to a major road at age 40 (HR: 1.03, 95%CI: 1.00, 1.06) were associated with slightly earlier menopause. No statistically significant effect modification was found, although the associations of PM were slightly stronger for women who lived in the West and for never smokers. To conclude, we found exposure to ambient PM and traffic in midlife was associated with slightly earlier onset of natural menopause. Our results support previous evidence that exposure to air pollution and traffic may accelerate reproductive aging.


Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Adulto , Contaminantes Atmosféricos/análisis , Exposición a Riesgos Ambientales , Femenino , Humanos , Incidencia , Menopausia , Material Particulado/análisis , Estudios Prospectivos
17.
Maturitas ; 144: 37-44, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33358206

RESUMEN

PURPOSE: The objectives of this study were to evaluate the feasibility and efficacy of fractional CO2 laser therapy in gynecologic cancer survivors. METHODS: This was a pilot, multi-institutional randomized sham-controlled trial of women with gynecologic cancers with dyspareunia and/or vaginal dryness. Participants were randomized to fractional CO2 laser treatment or sham laser treatment. The primary aim was to estimate the proportion of patients who had improvement in symptoms based on the Vaginal Assessment Scale (VAS). Secondary aims included changes in sexual function assessed using the Female Sexual Functioning Index (FSFI) and urinary symptoms assessed using the the Urinary Distress Inventory (UDI-6). RESULTS: Eighteen women participated in the study, ten in the treatment arm and eight in the sham arm. The majority of participants had stage I (n = 11, 61.1 %) or II (n = 3, 16.7 %) endometrial cancer with adenocarcinoma histology (n = 9, 50 %). In total, 15 (83.3 %) of the participants completed all treatments and follow-up visit. There was no difference in the change in the median VAS score from baseline to follow-up. However, there was an improvement in change in the median total FSFI score with treatment compared with sham (Δ 6.5 vs -0.3, p = 0.02). The change in the median UDI-6 score was lower in the treatment arm (Δ -14.6 vs -2.1, p = 0.17), but this was not statistically significant. There were no reported serious adverse events. CONCLUSIONS: Fractional CO2 laser therapy is feasible in gynecologic cancer survivors, with preliminary evidence of safety. In addition, there was preliminary evidence of improvement in sexual function compared with sham treatment. Clinicaltrial.gov Identifier: NCT03372720 (OSU-17261; NCI-2017-02051).


Asunto(s)
Dióxido de Carbono/uso terapéutico , Enfermedades Urogenitales Femeninas/cirugía , Terapia por Láser , Láseres de Gas , Adulto , Anciano , Supervivientes de Cáncer , Femenino , Humanos , Menopausia , Persona de Mediana Edad , Proyectos Piloto , Método Simple Ciego , Síndrome , Vagina/cirugía
18.
Maturitas ; 144: 81-86, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33358213

RESUMEN

OBJECTIVES: An association between hot flushes and night sweats (HFNS) and psychopathology, including depression, is well established for some women. However, the relationship between HFNS and anxiety needs further exploration. Self-compassion may be a psychosocial factor which influences the experience of HFNS and anxiety for midlife women. The aim of this study was to investigate the extent to which HFNS are associated with anxiety and examine the additional importance of self-compassion. STUDY DESIGN: A cross-sectional design using questionnaire data from 109 women aged 45-66 years was employed and multiple hierarchical regression was used to explore relationships between HFNS, anxiety and self-compassion. RESULTS: The results indicated that interference of HFNS in everyday life (ß =.31), but not frequency of HFNS, predicted anxiety. However, once self-compassion was included in the model it was the only predictor of anxiety (ß=-.46) and this relationship was significant for the items positive self-compassion (ß=-0.37) and negatively worded self-coldness (ß=.43). CONCLUSIONS: Interference of HFNS in everyday life may predict increased anxiety during menopause for some women. However, self-compassion may have a stronger relationship with anxiety than menopausal symptoms.


Asunto(s)
Ansiedad/psicología , Empatía , Sofocos/psicología , Menopausia/psicología , Sudoración , Anciano , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios
19.
Nutr Metab Cardiovasc Dis ; 31(2): 641-649, 2021 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-33358713

RESUMEN

BACKGROUND AND AIMS: This study examined if the weight loss and metabolic benefits of alternate day fasting (ADF) varies according to sex and menopausal status in adults with obesity. METHODS AND RESULTS: This secondary analysis pooled the data of men and women (n = 75) who participated in three 12-week ADF studies (500 kcal fast day; alternated with an ad libitum intake feast day). Body weight decreased in premenopausal women (-4.6 ± 3.2%), postmenopausal women (-6.5 ± 3.2%) and men (-6.2 ± 4.4%) (main effect of time, P < 0.001), with no difference between groups (no group × time interaction). Energy intake on fast days was higher than prescribed in all groups (∼400-500 excess kcal consumed), with no differences between groups. Fat mass, lean mass, fasting insulin, and insulin resistance, and blood pressure decreased similarly in all groups (main effect of time, P < 0.05 for all comparisons). LDL cholesterol decreased more in postmenopausal versus premenopausal women (group × time interaction, P = 0.01). Fasting glucose, HDL cholesterol, and triglycerides remained unchanged in all groups. CONCLUSION: These findings suggest that the weight loss and metabolic benefits of ADF do not generally vary according to sex or menopausal status in adults with obesity. TRIAL REGISTRATION: Clinicaltrials.gov, NCT00960505; NCT03528317.


Asunto(s)
Restricción Calórica , Ayuno , Menopausia , Obesidad/dietoterapia , Pérdida de Peso , Adulto , Ensayos Clínicos como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/fisiopatología , Posmenopausia , Premenopausia , Factores Sexuales , Factores de Tiempo , Resultado del Tratamiento
20.
Nat Rev Endocrinol ; 17(1): 47-66, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33173188

RESUMEN

Obesity is associated with many adverse health effects, such as an increased cardiometabolic risk. Despite higher adiposity for a given BMI, premenopausal women are at lower risk of cardiometabolic disease than men of the same age. This cardiometabolic advantage in women seems to disappear after the menopause or when type 2 diabetes mellitus develops. Sexual dimorphism in substrate supply and utilization, deposition of excess lipids and mobilization of stored lipids in various key metabolic organs (such as adipose tissue, skeletal muscle and the liver) are associated with differences in tissue-specific insulin sensitivity and cardiometabolic risk profiles between men and women. Moreover, lifestyle-related factors and epigenetic and genetic mechanisms seem to affect metabolic complications and disease risk in a sex-specific manner. This Review provides insight into sexual dimorphism in adipose tissue distribution, adipose tissue, skeletal muscle and liver substrate metabolism and tissue-specific insulin sensitivity in humans, as well as the underlying mechanisms, and addresses the effect of these sex differences on cardiometabolic health. Additionally, this Review highlights the implications of sexual dimorphism in the pathophysiology of obesity-related cardiometabolic risk for the development of sex-specific prevention and treatment strategies.


Asunto(s)
Enfermedades Cardiovasculares/fisiopatología , Obesidad/fisiopatología , Caracteres Sexuales , Tejido Adiposo/fisiopatología , Animales , Femenino , Humanos , Resistencia a la Insulina/fisiología , Hígado/metabolismo , Hígado/fisiopatología , Masculino , Menopausia/fisiología , Músculo Esquelético/fisiopatología , Obesidad/complicaciones , Factores de Riesgo
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