Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 87
Filtrar
1.
Mayo Clin Proc ; 96(6): 1407-1417, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33890576

RESUMO

OBJECTIVE: To assess the presence of clinically actionable results and other genetic findings in an otherwise healthy population of adults seen in a medical practice setting and offered "predictive" genomic testing. PATIENTS AND METHODS: In 2014, a predictive genomics clinic for generally healthy adults was launched through the Mayo Clinic Executive Health Program. Self-identified interested patients met with a genomic nurse and genetic counselor for pretest advice and education. Two genome sequencing platforms and one gene panel-based health screen were offered. Posttest genetic counseling was available for patients who elected testing. From March 1, 2014, through June 1, 2019, 1281 patients were seen and 301 (23.5%) chose testing. Uptake rates increased to 36.3% [70 of 193]) in 2019 from 11.8% [2 of 17] in 2014. Clinically actionable results and genetic findings were analyzed using descriptive statistics. RESULTS: Clinically actionable results were detected in 11.6% of patients (35 of 301), and of those, 51.7% (15 of 29) with a cancer or cardiovascular result = did not have a personal or family history concerning for a hereditary disorder. The most common actionable results were in the BCHE, BRCA2, CHEK2, LDLR, MUTYH, and MYH7 genes. A carrier of at least one recessive condition was found in 53.8% of patients (162 of 301). At least one variant associated with multifactorial disease was found in 44.5% (134 of 301) (eg, 25 patients were heterozygous for the F5 factor V Leiden variant associated with thrombophilia risk). CONCLUSION: Our predictive screening revealed that 11.6% of individuals will test positive for a clinically actionable, likely pathogenic/pathogenic variant. This finding suggests that wider knowledge and adoption of predictive genomic services could be beneficial in medical practice, although additional studies are needed.

2.
Menopause ; 28(6): 619-625, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33878089

RESUMO

OBJECTIVE: To evaluate associations between sleep and female sexual function. METHODS: A cross-sectional analysis from the Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS) was performed using questionnaires in women presenting for menopause or sexual health consult at Mayo Clinic from December, 2016 to September, 2019. Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and the Pittsburgh Sleep Quality Index (PSQI) assessed sexual function and sleep parameters, respectively. Associations between sleep quality (PSQI score ≥ 5 poor sleep quality), sleep durations (< 5 h, 5-6 h, 6-7 h, > 7 h) and female sexual dysfunction (FSFI ≤ 26.55 and FSDS-R ≥ 11) were evaluated utilizing a multivariable logistic model adjusting for multiple factors. A secondary analysis evaluated sleep quality by sexual activity and also included sexually inactive women. RESULTS: A total of 3,433 women were included (mean age 53). Sexually active women (N = 2,487; 72.4%) were included in the primary analysis; 75% had poor sleep quality, and 54% met criteria for female sexual dysfunction. On multivariable analysis, women with poor sleep quality were 1.48 times more likely to report female sexual dysfunction (95% CI 1.21-1.80, P < 0.001). Of women who reported sleeping < 5 hours nightly, 63.3% had female sexual dysfunction, and their Female Sexual Function Index total and domain scores were significantly lower than women sleeping > 7 hours nightly (P = 0.004); however, this was not statistically significant in multivariable analysis. Sexually active women were more likely to report good sleep quality compared with sexually inactive women (25.3% vs 20.5%, P = 0.003). CONCLUSIONS: Poor sleep quality, but not sleep duration, was associated with greater odds of female sexual dysfunction. Good sleep quality was linked to sexual activity. In addition to its myriad effects on health, poor sleep quality is associated with female sexual dysfunction.


Assuntos
Disfunções Sexuais Psicogênicas , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Comportamento Sexual , Disfunções Sexuais Psicogênicas/epidemiologia , Sono , Inquéritos e Questionários
3.
Menopause ; 28(4): 347-348, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33534432
4.
Menopause ; 28(6): 642-649, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33534429

RESUMO

OBJECTIVE: The objective of this pilot study was to evaluate the change in sexual function following treatment with fractional CO2 laser therapy in breast cancer (BC) survivors with genitourinary syndrome of menopause (GSM). METHODS: A single-arm feasibility study of BC survivors with symptoms of GSM, including dyspareunia and/or vaginal dryness, was conducted. Participants who received three treatments with fractional CO2 laser and 4-week follow-up were contacted for patient-reported outcomes and adverse events at 12 months. Sexual function was measured using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale Revised (FSDS-R). Descriptive statistics were calculated for patient demographics and disease characteristics for the set of participants who agreed to long-term follow-up and those who were lost to follow-up. FSFI and FSDS-R scores were summarized at baseline, 4 weeks and 12 months, as well as the change from baseline, and were compared using a Wilcoxon signed rank test. RESULTS: A total of 67 BC survivors enrolled, 59 completed treatments and 4-week follow-up; 39 participated in the 12 month follow-up. The overall FSFI score improved from baseline to 4-week follow-up (median Δ 8.8 [Q1, Q3] (QS) (2.2, 16.7)], P < 0.001). There were improvements at 4 weeks in all domains of the FSFI (P < 0.001 for each) including desire (median Δ 1.2; QS [0.6, 1.8]), arousal (median Δ 1.2; QS [0.3, 2.7]), lubrication (median Δ 1.8 (0, 3.3), orgasm (median Δ 1.2; QS [0, 3.6]), satisfaction (median Δ 1.6 (0.4, 3.2)), and pain (median Δ 1.6 (0, 3.6). The FSDS-R score also improved from baseline to 4-week follow-up (median Δ -10.0; QS [-16, -5] P < 0.001) indicating less sexually related distress. The scores of the FSFI and FSDS-R remained improved at 12 months and there were no serious adverse events reported. CONCLUSIONS: In BC survivors with GSM, the total and individual domain scores of the FSFI and the FSDS-R improved after fractional CO2 laser therapy.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Doenças Urogenitais Femininas , Terapia a Laser , Lasers de Gás , Neoplasias da Mama/radioterapia , Dióxido de Carbono , Feminino , Doenças Urogenitais Femininas/etiologia , Doenças Urogenitais Femininas/cirurgia , Humanos , Lasers de Gás/uso terapêutico , Menopausa , Medidas de Resultados Relatados pelo Paciente , Projetos Piloto , Síndrome
5.
Maturitas ; 143: 209-215, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33308631

RESUMO

OBJECTIVE: To examine the association of adverse childhood experiences (ACEs) with overall menopausal symptom burden in midlife women. STUDY DESIGN: This was a cross-sectional study of women between the ages of 40 and 65 years who were seen for specialty consultation in the Menopause and Women's Sexual Health Clinic, Mayo Clinic, Rochester, MN between May 1, 2015 and December 31, 2016. MAIN OUTCOME MEASURES: Participants completed the ACE questionnaire to assess childhood abuse and neglect, the Menopause Rating Scale (MRS) to assess menopausal symptom burden, the Patient Health Questionnaire (PHQ-9) to assess depression, the Generalized Anxiety Disorder questionnaire (GAD-7) to assess anxiety, and provided information on current abuse (physical, sexual and verbal/emotional). RESULTS: Women meeting inclusion criteria (N = 1670) had a median age of 53.7 years (interquartile range: 49.1, 58.0). Of these women, 977 (58.5 %) reported any ACE and 288 (17.2 %) reported ≥4 ACEs. As menopausal symptoms increased in severity from the first to fourth quartile, the odds ratio of ACE 1-3 (vs. 0) increased from 1 to 2.50 (trend p < 0.01), and the odds ratio of ACE ≥ 4 (vs. 0) increased from 1 to 9.61 (trend p < 0.01), a pattern that was consistent across all menopausal symptom domains. The association between severe menopausal symptoms and higher childhood adversity (ACE score 1-3 or ≥4 vs. ACE = 0) remained significant after adjusting for age, partner status, education, employment, depression, anxiety, and hormone therapy use (OR 1.84 and 4.51, p < 0.01). CONCLUSION: In this large cross-sectional study, there was a significant association between childhood adversity and self-reported menopausal symptoms that persisted even after adjustment for multiple confounders. These associations highlight the importance of screening women with bothersome menopausal symptoms for childhood adversity, and of offering appropriate management and counseling for the adverse experiences, when indicated.


Assuntos
Experiências Adversas da Infância , Envelhecimento , Menopausa , Adulto , Idoso , Envelhecimento/fisiologia , Envelhecimento/psicologia , Ansiedade/epidemiologia , Criança , Maus-Tratos Infantis , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Menopausa/fisiologia , Menopausa/psicologia , Pessoa de Meia-Idade , Sexualidade
9.
Menopause ; 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32810078

RESUMO

OBJECTIVE: Hypertensive disorders of pregnancy and menopausal symptoms, specifically vasomotor symptoms, have both been associated with cardiovascular disease risk in women. However, data are sparse on the association between these two female-specific cardiovascular risk factors. This study was conducted to investigate the association between a history of a hypertensive disorder of pregnancy and menopausal symptoms. METHODS: This was a cross-sectional study of women aged 40 to 65 years seen for specialty consultation in women's health clinics at Mayo Clinic Rochester, MN and Scottsdale, AZ, between May, 2015 and September, 2019. A self-reported history of hypertensive disorders of pregnancy served as the independent variable, and menopause symptoms as assessed by the Menopause Rating Scale were the primary outcome measure. RESULTS: Of 2,684 women included in the analysis, 180 had a self-reported history of a hypertensive disorder of pregnancy. The total menopausal symptom scores as well as somatic and psychological domain scores were higher in women with a history of a hypertensive disorder of pregnancy compared to women without a history of a hypertensive disorder of pregnancy or to women without a pregnancy. On multivariable analysis, women with a hypertensive disorder of pregnancy using hormone therapy had significantly higher total menopause symptom scores than women with no such history. CONCLUSIONS: In this large cross-sectional study, a history of hypertensive disorders of pregnancy was associated with more bothersome menopausal symptoms. Additional study is needed to determine the strength of this association, underlying mechanisms of the association, and clinical implications for cardiovascular risk prediction in women.

10.
J Sex Med ; 17(10): 1971-1980, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32771351

RESUMO

BACKGROUND: Obesity and female sexual dysfunction (FSD) are prevalent conditions, and both are associated with significant adverse effects on health and well-being. AIM: To investigate the association between body mass index and FSD, as well as potential moderators. METHODS: This cross-sectional study was performed by analyzing medical records of 6,688 women seeking consultation for menopause-related or sexual health-related concerns at women's health clinics at Mayo Clinic Rochester, MN, and Scottsdale, AZ, between May 1, 2015, and September 15, 2019. OUTCOMES: Female sexual function was assessed by the Female Sexual Function Index, and sexual distress was assessed by the Female Sexual Distress Scale-Revised. RESULTS: Being overweight or obese was associated with a lack of sexual activity. Among sexually active women, those who were overweight or obese had lower Female Sexual Function Index total scores and sexual function domain scores (indicating worse sexual function), including sexual arousal, lubrication, satisfaction, orgasm, and pain, and higher levels of sexual distress than those with normal weight. However, on multivariable analysis, these associations were found to be mediated by other factors, including age, level of education, reproductive stage, medication use, and mood disturbances, which are known to impact body weight and sexual function in women. CLINICAL IMPLICATIONS: Overweight and obesity were associated with sexual inactivity and greater odds of having FSD, which should prompt proactive assessment of sexual function. STRENGTHS AND LIMITATIONS: The strengths of this study include the large cohort size and assessment of sexual problems in addition to sexual distress, a key component of the definition of sexual dysfunction. This study also took into account multiple potential moderating factors. Limitations include the cross-sectional design, which precludes determination of causality as well as lack of diversity in the cohort, potentially limiting generalizability of results. In addition, sexual function was not assessed in women reporting no recent sexual activity, which may confound results. CONCLUSION: Overweight/obesity and FSD are highly prevalent conditions, which appear to be indirectly associated. These results highlight the need to identify and address FSD in all overweight and obese women, with particular attention to potential contributing factors. Faubion SS, Fairbanks F, Kuhle CL, et al. Association Between Body Mass Index and Female Sexual Dysfunction: A Cross-sectional Study from the Data Registry on Experiences of Aging, Menopause, and Sexuality. J Sex Med 2020;17:1971-1980.

12.
Maturitas ; 135: 1-5, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32252960

RESUMO

OBJECTIVES: The STOP-BANG questionnaire (snoring, tiredness, observed apneas, high blood pressure, body mass index, age, neck size, gender) was originally validated to screen for obstructive sleep apnea (OSA) in the surgical population. It has been validated in mixed populations of men and women. We aimed to evaluate its reliability for OSA screening of midlife women. STUDY DESIGN: We retrospectively evaluated midlife women seen at the Women's Health Clinic at Mayo Clinic in Rochester, Minnesota, who completed the STOP-BANG questionnaire and subsequently underwent diagnostic polysomnography (PSG) or home sleep apnea testing (HSAT). MAIN OUTCOME MEASURES: The questionnaire's predictive ability was assessed with the apnea hypopnea index (AHI) measured at PSG and HSAT. RESULTS: Because participants were female, the gender question response was consistently 0, making the mean (SD) STOP-BANG score low at 3 (1.2). The most sensitive item to detect any OSA and moderate to severe OSA through STOP-BANG was observed apneas; the most specific item to detect OSA and moderate to severe OSA was neck circumference exceeding 40 cm. A score of 3 or more had a sensitivity of 77 % and a specificity of 45 % to detect moderate to severe OSA. The area under the curve with the STOP-BANG score to predict moderate to severe OSA was 0.67 (95 % CI, 0.51-0.84). CONCLUSIONS: Interpretation of the STOP-BANG questionnaire is nuanced for midlife women. Given the nature of its questions, a lower score may be predictive of more severe OSA in women, necessitating use of a lower threshold to trigger further testing.


Assuntos
Apneia Obstrutiva do Sono/diagnóstico , Feminino , Humanos , Pessoa de Meia-Idade , Minnesota , Polissonografia , Inquéritos e Questionários
13.
JNCI Cancer Spectr ; 4(1): pkz088, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32337497

RESUMO

Background: Hot flashes (HFs) negatively affect quality of life among perimenopausal and postmenopausal women. This study investigated the efficacy of oxybutynin vs placebo in decreasing HFs. Methods: In this randomized, multicenter, double-blind study, women with and without breast cancer with 28 or more HFs per week, lasting longer than 30 days, who were not candidates for estrogen-based therapy, were assigned to oral oxybutynin (2.5 mg twice a day or 5 mg twice a day) or placebo for 6 weeks. The primary endpoint was the intrapatient change from baseline in weekly HF score between each oxybutynin dose and placebo using a repeated-measures mixed model. Secondary endpoints included changes in weekly HF frequency, HF-related daily interference scale questionnaires, and self-reported symptoms. Results: We enrolled 150 women. Baseline characteristics were well balanced. Mean (SD) age was 57 (8.2) years. Two-thirds (65%) were taking tamoxifen or an aromatase inhibitor. Patients on both oxybutynin doses reported greater reductions in the weekly HF score (5 mg twice a day: -16.9 [SD 15.6], 2.5 mg twice a day: -10.6 [SD 7.7]), placebo -5.7 (SD 10.2); P < .005 for both oxybutynin doses vs placebo), HF frequency (5 mg twice a day: -7.5 [SD 6.6], 2.5 mg twice a day: -4.8 [SD 3.2], placebo: -2.6 [SD 4.3]; P < .003 for both oxybutynin doses vs placebo), and improvement in most HF-related daily interference scale measures and in overall quality of life. Patients on both oxybutynin arms reported more side effects than patients on placebo, particularly dry mouth, difficulty urinating, and abdominal pain. Most side effects were grade 1 or 2. There were no differences in study discontinuation because of adverse effects. Conclusion: Oxybutynin is an effective and relatively well-tolerated treatment option for women with HFs.

14.
Support Care Cancer ; 28(8): 3669-3677, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31811486

RESUMO

PURPOSE: Fractional CO2 laser therapy is an emerging treatment for genitourinary syndrome of menopause (GSM). The objective of this study was to determine the feasibility and preliminary efficacy of fractional CO2 laser therapy in breast cancer survivors. METHODS: This was a single arm feasibility study of breast cancer survivors with dyspareunia and/or vaginal dryness. Participants received three treatments of fractional CO2 laser therapy at 30-day intervals and returned for a 1-month follow-up. Feasibility was defined as treatment completion without serious adverse events (SAE) in 80% of patients. We collected data on the Vaginal Assessment Scale (VAS), the Female Sexual Function Index (FSFI), the Urinary Distress Index (UDI), and SAE. RESULTS: A total of 64 patients participated in the study. The majority of women had Estrogen receptor/Progesterone receptor (ER/PR) positive/Her2neu negative (n = 37; 63%), stage I (n = 32, 54%) or II (n = 19, 32%) breast cancer. Most were receiving endocrine therapy (n = 54, 92%), most commonly aromatase inhibitors (AI; n = 40, 68%). Fifty-nine (88.1%) of those enrolled completed all treatments according to protocol with no reported SAE. No patient withdrew due to SAE. The scores of the VAS (mean Δ - 0.99; 95% CI [- 1.19, - 0.79], p < 0.001)), FSFI (mean Δ 9.67; 95% CI [7.27, 12.1], p < 0.001), and UDI (mean Δ - 8.85; 95% CI [- 12.75, - 4.75], p < 0.001)) improved from baseline to follow-up. CONCLUSION: Fractional CO2 laser treatment for breast cancer survivors is feasible and appears to reduce GSM symptoms across treatment and follow-up.


Assuntos
Neoplasias da Mama/complicações , Doenças Urogenitais Femininas/etiologia , Doenças Urogenitais Femininas/terapia , Terapia a Laser/métodos , Neoplasias da Mama/metabolismo , Sobreviventes de Câncer , Dispareunia/terapia , Feminino , Humanos , Lasers de Gás , Menopausa , Pessoa de Meia-Idade , Receptores de Progesterona/metabolismo , Síndrome , Resultado do Tratamento , Doenças Vaginais
15.
Am J Obstet Gynecol ; 222(2): 103-113, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31473229

RESUMO

Genitourinary syndrome of menopause is a condition describing the hypoestrogenic effects on the female genitals and lower urinary tract leading to symptoms such as vaginal dryness, vulvar and vaginal burning, dyspareunia and dysuria. Genitourinary syndrome of menopause is experienced by over half of postmenopausal women, and is even more pervasive in women with cancer. Due to treatments such as surgery, chemotherapy, radiation, and hormonal therapy, women may experience early menopause resulting in earlier and more severe symptoms. Understanding the scope of this issue in female breast and gynecologic cancer survivors and identifying treatment options for this complex patient population are paramount. Tailored patient treatments include nonhormonal therapies (vaginal moisturizers, lubricants, pelvic floor physical therapy, dilator therapy, counseling), systemic and local hormonal therapies. Consensus recommendations by medical societies and associated evidence are reviewed, with emphasis on safety and efficacy of local vaginal hormonal therapies, and management variations noted depending on cancer type and characteristics. With knowledge and understanding of the unmet need associated with under-recognition and under-treatment of genitourinary syndrome of menopause, providers caring for women with cancer are in a position to improve the quality of life of their patients by providing safe and effective treatments.


Assuntos
Neoplasias da Mama , Terapia de Reposição de Estrogênios/métodos , Doenças Urogenitais Femininas/terapia , Neoplasias dos Genitais Femininos , Menopausa , Administração Intravaginal , Anestésicos Locais/uso terapêutico , Sobreviventes de Câncer , Dispareunia/terapia , Disuria/terapia , Feminino , Humanos , Terapia a Laser , Lidocaína/uso terapêutico , Lipídeos/uso terapêutico , Lubrificantes/uso terapêutico , Seleção de Pacientes , Diafragma da Pelve , Modalidades de Fisioterapia
16.
Maturitas ; 130: 1-5, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31706430

RESUMO

OBJECTIVE: To determine the association between relationship distress and menopausal symptoms. STUDY DESIGN: A retrospective analysis was conducted of questionnaires completed by women 40-65 years of age seeking menopause or sexual health consultation between May, 2015 and May, 2017. MAIN OUTCOME MEASURES: Associations between menopausal symptoms assessed using the Menopause Rating Scale (MRS) and relationship distress measured on the Kansas Marital Satisfaction Scale (KMSS) were evaluated with two-sample t-tests. Linear regression was used to assess associations after adjusting for potential confounders. RESULTS: The sample of 1884 women averaged 53 years of age (SD = 6.1); most were white (95%), employed (66%), married (90%), and well-educated (≥ college graduate, 64%). Women reporting no relationship distress (KMSS ≥ 17) had less severe menopausal symptoms overall compared with women reporting relationship distress (total MRS score 13.1 vs 16.0, P < 0.001), with similar findings in each MRS domain. In multivariable analyses, this relationship persisted for total MRS scores and for psychological symptoms among women with no relationship distress, who scored an estimated 1.15 points (95% CI 0.52-1.78) lower on the total MRS and 0.82 points (95% CI 0.53-1.10) lower in the psychological symptom. CONCLUSIONS: The absence of relationship distress was associated with less severe menopausal symptoms, particularly in the psychological domain, in women presenting to a women's health clinic. Given the cross = sectional design, the direction of the relationship is unknown.


Assuntos
Relações Interpessoais , Menopausa/psicologia , Estudos Transversais , Feminino , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Avaliação de Sintomas
17.
J Womens Health (Larchmt) ; 28(12): 1601-1605, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31553258

RESUMO

The Clinical Update series is intended to help busy providers stay up to date with important and potentially practice changing articles that have been published on topics pertinent to the care of women. The rates of obesity and the resultant morbidities are rising worldwide, making it a high-priority health issue for the medical community. Moreover, the pathophysiology and management of obesity and visceral fat accumulation in women has important nuances, distinct from those in men. It is important to consider the effect of unique female-specific influences such as reproductive stage and pregnancy. Therefore, we have chosen to review six high-impact recent studies relating to obesity and its management in women. These include guidelines for management of obesity in pregnancy, risk of nonmelanoma skin cancer in overweight/obese women, the association of vascular fat and decline in physical function in midlife women, the predictors for weight gain in premenopausal women with early-stage breast cancer, dietary patterns and obesity in postmenopausal women, and finally, normal weight obesity and mortality risk in postmenopausal women.


Assuntos
Obesidade/complicações , Índice de Massa Corporal , Neoplasias da Mama/complicações , Feminino , Humanos , Menopausa , Sobrepeso/complicações , Pós-Menopausa , Gravidez , Neoplasias Cutâneas/complicações , Ganho de Peso
18.
Menopause ; 26(12): 1425-1435, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31513091

RESUMO

OBJECTIVE: Statins are a class of drugs that competitively bind to the active site of HMG-CoA reductase enzyme, thereby inhibiting the initial steps in cholesterol synthesis. Originally approved for use in lowering serum cholesterol, a risk factor for developing atherosclerosis and coronary heart disease, statins have subsequently been noted to have myriad extrahepatic effects, including potential effects on cognition, diabetes, breast cancer, bone, and muscle. This narrative review assesses the current state of the science regarding the risks and benefits of statin therapy in women to identify areas where additional research is needed. METHODS: Basic and clinical studies were identified by searching PubMed with particular attention to inclusion of female animals, women, randomized controlled trials, and sex-specific analyses. RESULTS: Statin therapy is generally recommended to reduce the risk of cardiovascular disease. None of the current clinical guidelines, however, offer sex-specific recommendations for women due to lack of understanding of sex differences and underlying mechanisms of disease processes. In addition, conclusions regarding efficacy of treatments do not consider lipid solubility for the drug, dosing, duration of treatment, interactions with estrogen, or comorbidities. Pleiotropic effects of statins are often derived from secondary analysis of studies with cardiovascular events as primary outcomes. CONCLUSIONS: Many of the trials that have established the efficacy and safety of statins were conducted predominantly or entirely in men, with results extrapolated to women. Additional research is needed to guide clinical recommendations specific to women. : Video Summary:http://links.lww.com/MENO/A462.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Fatores Sexuais , Saúde da Mulher , Animais , Relação Dose-Resposta a Droga , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Medição de Risco
19.
Menopause ; 26(10): 1110-1116, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31188286

RESUMO

OBJECTIVE: The perceptions and attitudes of menopause shared by men are largely unknown. This analysis characterized men's awareness and their understanding of their partner's menopausal transition. METHODS: A 35-question, online survey was used to assess men's perceptions and attitudes toward menopause. Men were recruited from an online research marketplace and were eligible to participate if their female partners (45-64 years old) experienced ≥1 of the following symptoms: hot flashes, night sweats, sleepless nights, difficulty sleeping, low libido, mood swings, pain during sex, or vaginal dryness. Couples either lived together full time, or, if living separately, resided together regularly two or more times a week. RESULTS: Of the 1,356 surveys sent to eligible men, 450 (33%) were completed. Most men were between 50 and 69 years (80%), married and not separated (90%), and lived with their partner full time (97%). Men were aware of the symptoms regularly experienced by their partner, with difficulty sleeping (54%) and lack of energy (49%) being frequently identified; these symptoms were attributed to menopause (26%) and/or aging (22%). Of those who were affected by symptoms (63%), most men reported they negatively impacted them (77%), their partners (70%), and relationships (56%). Men engaged in discussions with their partners regarding menopausal symptoms (72%) and believed they were somewhat/very influential (75%) in their partner's decision to seek treatment or make lifestyle adjustments. CONCLUSIONS: Overall, men are aware of their partner's menopausal transition and may influence decisions relating to symptom management. Educational interventions would further benefit men's awareness of menopause and available treatment options.Video Summary:http://links.lww.com/MENO/A424.


Assuntos
Atitude , Menopausa/fisiologia , Menopausa/psicologia , Percepção , Parceiros Sexuais/psicologia , Adulto , Idoso , Conscientização , Fadiga , Fogachos , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sexual , Distúrbios do Início e da Manutenção do Sono , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...