Sentimentos vivenciados pela mulher acerca da sexualidade no período do climatério / Feelings experienced by women about sexuality in the climacteric period / Sentimientos experimentados por las mujeres sobre la sexualidad en el período climatérico

Objetivo: descrever os sentimentos vivenciados pela mulher acerca da sexualidade no período do climatério. Método: O percurso metodologia deu-se por abordagem qualitativa e método de história oral conforme pressupostos de Halbwachs. Resultados: Foram entrevistadas 6 mulheres com idade acima de 45 anos e que receberam nomes fictícios de flores como forma de manter o anonimato das mesmas. Resultados: Os relatos deram origem a 3 categorias e 4 subcategorias conforme a seguir: Mudanças fisiológicas, Mudanças na sexualidade, Desejo sexual, Desempenho sexual, Prazer sexual, Vivência da sexualidade e Necessidade da sexualidade. Conclusão: As dificuldades em lidar com os sintomas do climatério sinaliza a necessidade de criar políticas públicas de saúde, onde profissionais da saúde possam disponibilizar conhecimento em forma de vivencias, materiais e divulgação do que pode ser feito para acompanhar mulheres nesse período. Os profissionais da saúde precisam estar mais atentos para atuar junto às mulheres em crise e desenvolver ações que visem à apropriação do conhecimento e do bem-estar, bem como o desenvolvimento pessoal, para que possam usar mecanismos de enfrentamento eficazes a fim de superar as modificações e os conflitos causados pelo climatério.

Objective: to describe the feelings experienced by women about sexuality in the climacteric period. Method: The methodological course took place through a qualitative approach and oral history method according to Halbwachs assumptions. Results: Six women over 45 years of age were interviewed who received fictitious names of flowers as a way of maintaining their anonymity. Discussion: The reports originated 3 categories and 4 subcategories as follows: Physiological changes, Changes in sexuality, Sexual desire, Sexual performance, Sexual pleasure, Experience of sexuality and Need for sexuality. Conclusion: Difficulties in dealing with climacteric symptoms indicate the need to create public health policies, where health professionals can provide knowledge in the form of experiences, materials and dissemination of what can be done to accompany women in this period. Health professionals need to be more attentive to work with women in crisis and develop actions aimed at appropriating knowledge and well-being, as well as personal development, so that they can use effective coping mechanisms in order to overcome the changes and the conflicts caused by the climacteric.

Objetivo: describir los sentimientos experimentados por las mujeres acerca de la sexualidad en el período climatérico. Método: El curso metodológico se llevó a cabo a través de un enfoque cualitativo y método de historia oral según los presupuestos de Halbwachs. Resultados: Se entrevistaron seis mujeres mayores de 45 años que recibieron nombres ficticios de flores como forma de mantener su anonimato. Resultados: Los relatos originaron 3 categorías y 4 subcategorías así: Alteraciones fisiológicas, Alteraciones en la sexualidad, Deseo sexual, Desempeño sexual, Placer sexual, Experiencia de la sexualidad y Necesidad de la sexualidad. Conclusión: Las dificultades en el enfrentamiento de los síntomas del climaterio indican la necesidad de crear políticas públicas de salud, donde los profesionales de la salud puedan aportar conocimientos en forma de experiencias, materiales y difusión de lo que se puede hacer para acompañar a las mujeres en este período. Los profesionales de la salud necesitan estar más atentos para trabajar con mujeres en crisis y desarrollar acciones encaminadas a la apropiación del conocimiento y del bienestar, así como del desarrollo personal, de manera que puedan utilizar mecanismos de afrontamiento efectivos para superar los cambios y los conflictos provocados por el climaterio.

Climaterio relacionado al estilo de vida en mujeres de una población mexiquense / Climacteric related to lifestyle in women of a Mexican population

Introducción: La mujer en el climaterio presenta diversos cambios fisiológicos, físicos, psicológicos y sociales, debidos no solo a la disminución hormonal, sino también al estilo de vida Objetivo: Analizar la relación entre el climaterio y el estilo de vida en una población mexiquense. Metodología: Estudio cuantitativo, correlacional y transversal. La muestra se conformó por 143 mujeres de 45 a 59 años de edad, muestreo no probabilístico a conveniencia. Se aplicaron dos instrumentos: Perfil de Estilo de Vida (PEPS-I) de Nola Pender y escala de Blatt Kupperman (IMK). Proyecto aprobado por Comité de Ética en Investigación. Los datos fueron analizados con el programa SPSS Vs 25. Se estableció estadísticos descriptivos y rho de Spearman. Resultados: El estilo de vida resultó ser regular en la mayoría de las mujeres participantes (91.2%), se observó μ= 108.87±14.21 mínima de 76 y máxima de 147; respecto a los síntomas del climaterio se observó μ= 10.09±4.9 mínima de 0 y máxima de 23. Se obtuvo una correlación estadísticamente significativa de las dos variables estudio (Rho= p≤ 0.05). Conclusión: El estilo de vida de las mujeres durante el climaterio es regular y se relaciona con el estilo de vida. (AU)

Introduction: The woman in the climacteric presents diverse physiological, physical, psychological and social changes, due not only to the hormonal decrease, but also to the lifestyle. Women in the climacteric period present diverse physiological, physical, psychological and social changes, due not only to hormonal decline, but also to lifestyle. Objective: To analyze the relationship between climacteric and lifestyle in a population of The State of Mexico. Methodology: Quantitative, correlational and cross-sectional study. The sample consisted of 143 women aged 45 and 59 years, non-probabilistic convenience sampling. Two instruments were applied: Nola Pender's Lifestyle Profile (PEPS-I) and Blatt Kupperman's scale (IMK). The Project was approved by the Research Ethics Committee. The data were analyzed with the SPSS Vs 25 program. Descriptive statistics and Spearman's rho were established. Results: Lifestyle was found to be regular in most of the participating women (91.2%), μ= 108.87±14.21 minimum of 76 and maximum of 147; regarding climacteric symptoms μ= 10.09±4.9 minimum of 0 and maximum of 23 was observed. A statistically significant correlation of the two study variables was obtained (Rho= p≤ 0.05). Conclusion: The women lifestyle during climacteric is regular and is related to lifestyle. (AU)

Síntomas climatéricos y calidad de vida mediante índice de Kupperman-Blatt y escala de Cervantes / Climacteric Symptoms and Quality of Life according to the Kupperman-Blatt Index and the Cervantes Scale

Introducción: Durante el climaterio o perimenopausia se reflejan una serie de síntomas asociados a la disminución progresiva de las secreciones hormonales de estrógeno y progesterona, estas deficiencias provocan diversos síntomas de orden somático, vasomotor, sexual y psicológico que perjudican la calidad de vida en general de las mujeres, además de las alteraciones en el ciclo menstrual. Objetivo: Determinar la severidad de los síntomas climatéricos en mujeres perimenopáusicas mediante el índice de Kupperman-Blatt y la Escala de Cervantes. Métodos: Se trató de un estudio de corte cuantitativo, tipo descriptivo, observacional, y correlacional, en pacientes que asistían al Centro de Salud Las Moras, en el Departamento de Huánuco, Distrito Huánuco Perú. La muestra estuvo conformada por 60 mujeres que cumplieron con los criterios de inclusión. Se aplicaron el Índice Menopáusico de Kupperman-Blatt y la Escala de calidad de vida de Cervantes. Resultados: La evaluación global del Índice Menopáusico de Kupperman-Blatt clasificó a 55 por ciento de las pacientes con intensidad de síntomas leve, seguido de 35 por ciento en pacientes que declararon no tener síntomas. Esto se correspondió en la Escala de calidad de vida de Cervantes con 45 por ciento en pacientes clasificadas con compromiso leve de su calidad de vida, seguido de 40 por ciento con mediano compromiso de calidad de vida. Conclusiones: Con un nivel de significancia de p < 0,05, se demostró que durante la etapa climatérica ambos test presentan una correlación positiva, entre la intensidad de la sintomatología medida con el Índice Menopáusico de Kupperman-Blatt y la calidad de vida valorada con la Escala de Cervantes(AU)

Introduction: During climacteric or perimenopause, a series of symptoms are reflected in association with a progressive decrease in estrogen and progesterone hormone secretion. These deficiencies cause diverse somatic, vasomotor, sexual and psychological symptoms that impair the general quality of life of women, in addition to alterations in their menstrual cycle. Objective: To determine the severity of climacteric symptoms in perimenopausal women, using the Kupperman-Blatt index and the Cervantes scale. Methods: This was a quantitative, descriptive, observational and correlational study with patients attending Las Moras health center, Huanuco Department, Huanuco District, Peru. The sample consisted of 60 women who met the inclusion criteria. The Kupperman-Blatt Menopausal Index and the Cervantes Quality of Life Scale were applied. Results: According to the global assessment using the Kupperman-Blatt Menopausal Index, 55 percent of the patients were classified as presenting mild symptom intensity, followed by 35 percent of patients who reported no symptoms. This values were consistent with the Cervantes Quality of Life scale, with 45 percent of patients classified as presenting mild compromise of their quality of life, followed by 40 percent with medium compromise of quality of life. Conclusions: With a significance level of P<0.05, it was demonstrated that, during the climacteric stage, both tests present a positive correlation, regarding the intensity of the symptoms measured with the Kupperman-Blatt Menopausal Index and the quality of life assessed with the Cervantes scale(AU)

Eficacia y seguridad de la tibolona, en mujeres posmenopáusicas: revisión sistemática de la literatura

Introducción: la tibolona ha demostrado franca mejoría de las molestias del climaterio, sin afectar el grosor endometrial, el perfil lipídico, la glucemia o el sistema cardiovascular. El objetivo fue evaluar la eficacia y seguridad de la tibolona en mujeres posmenopáusicas, comparado con estrógenos conjugados de origen equino, 17 beta-estradiol 2 mg / acetato de noretisterona 1 mg, valerato de estradiol, estradiol transdérmico y placebo. Materiales y métodos: se hizo una búsqueda sistemática de la literatura médica mediante las siguientes bases de datos: Medline vía PubMed, Central, CINAHL, entre otras. La búsqueda se limitó a ensayos clínicos aleatorizados, metaanálisis y revisiones bibliográficas, que tuvieran disponible el texto completo, en inglés y español; publicados entre 1980 y 2021. Los desenlaces evaluados incluyeron alivio del síndrome climatérico, mejora de la actividad y gratificación sexual, proporción de cáncer de mama y eventos adversos.   Resultados: se incluyeron sesenta y uno estudios. La tibolona demostró diferencias significativas frente al placebo, en el alivio del síndrome climatérico. Mostró mayor mejoría de la actividad y gratificación sexual, y menor proporción de eventos adversos que los estrógenos, las combinaciones de 17 beta-estradiol 2 mg / acetato de noretisterona 1 mg, y el estradiol transdérmico. Conclusiones: tibolona tiene una eficacia similar para mejorar el síndrome vasomotor con otros comparadores, con ventajas frente a los estrógenos en la mejoría de la actividad y gratificación sexual: y frente a las combinaciones de 17 beta-estradiol 2 mg / acetato de noretisterona 1 mg y estradiol transdérmico y en eventos adversos. (provisto por Infomedic International)

Introduction: tibolone has shown clear improvement of climacteric discomfort, without affecting endometrial thickness, lipid profile, glycemia or cardiovascular system. The objective was to evaluate the efficacy and safety of tibolone in postmenopausal women, compared with conjugated estrogens of equine origin, 17 beta-estradiol 2 mg / norethisterone acetate 1 mg, estradiol valerate, transdermal estradiol and placebo. Materials and methods: a systematic search of the medical literature was carried out using the following databases: Medline via PubMed, Central, CINAHL, among others. The search was limited to randomized clinical trials, meta-analyses and literature reviews, which had the full text available, in English and Spanish; published between 1980 and 2021. The outcomes evaluated included relief of climacteric syndrome, improvement of sexual activity and gratification, proportion of breast cancer and adverse events. Results: Sixty-one studies were included. Tibolone showed significant differences against placebo in the relief of climacteric syndrome. It showed greater improvement in sexual activity and gratification, and a lower proportion of adverse events than estrogens, 17 beta-estradiol 2 mg / norethisterone acetate 1 mg combinations, and transdermal estradiol. Conclusions: tibolone has similar efficacy in improving vasomotor syndrome with other comparators, with advantages over estrogens in improving sexual activity and gratification: and over 17 beta-estradiol 2 mg / norethisterone acetate 1 mg and transdermal estradiol combinations and in adverse events. (provided by Infomedic International)

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)

A percepção da mulher com relação à consulta do climatério / La percepción de las mujeres respecto a la cita del climaterio / The woman´s perception regarding the climacteric consultation

Objetivo: Descrever a percepção da consulta de enfermagem no Climatério sob a ótica das mulheres atendidas na Atenção Básica. Método: Estudo descritivo qualitativo com abordagem intencional realizado numa Unidade de Saúde Escola no município de Caruaru-PE, durante o período de abril e maio de 2021. Foram entrevistadas 07 mulheres usuárias do serviço na fase do climatério. Resultados: a partir das entrevistas foram obtidas 3 categorias, sendo duas sobre a vivência do climatério pelas mulheres e uma sobre a percepção da mulher com relação à consulta de enfermagem. Conclusão: Conclui-se que as mulheres se sentem bem ao passarem pela consulta de climatério feita pela enfermagem, pois traz sentimento de alívio e entendimento. A consulta de enfermagem é um elemento chave na assistência à saúde, atingindo a proposta da PNAISM e oferecendo uma melhor qualidade de vida para as mulheres no climatério(AU)

Objective: To describe the perception of the nursing consultation in climateric from the perspective of women assisted in Primary Care. methods: Qualitative descriptive study with intentional approach conducted in a School Health Unit in the municipality of Caruaru-PE, during the period April and May 2021. We interviewed 07 women users of the service in the climacteric phase. Results: from the interviews, 3 categories were obtained, two of which were about the experience of the climacteric period by women and one about the perception of women regarding the nursing consultation. Conclusion: It is concluded that women feel well when they go through the climacteric consultation made by nursing, because it brings a feeling of relief and understanding. The nursing consultation is a key element in health care, achieving the proposal of PNAISM and offering a better quality of life for women in climateric.(AU)

Objetivo: Describir la percepción de la consulta de enfermería en el climaterio desde la perspectiva de las mujeres atendidas en Atención Primaria. Método: Estudio descriptivo cualitativo con abordaje intencional realizado en una Unidad de Salud Escolar de la ciudad de Caruaru-PE, de abril a mayo de 2021. Se entrevistaron 07 mujeres usuarias del servicio en la fase climatérica. Resultados: Por las entrevistas se obtuvieron 3 categorías, dos sobre la experiencia del climaterio por parte de las mujeres y una sobre la percepción de la mujer sobre la consulta de enfermería. Conclusión: Se concluye que las mujeres se sienten bien al pasar por la consulta climatérica realizada por la enfermería, ya que les brinda una sensación de alivio y comprensión. La consulta de enfermería es un elemento clave en el cuidado de la salud, llegando a la propuesta del PNAISM y ofreciendo una mejor calidad de vida a las mujeres en el climaterio(AU)

Más allá de la "falla hormonal": concepciones de profesionales de atención primaria sobre el climaterio en Santiago, Chile / Beyond the "ovarian failure": primary healthcare practitioners' views on climacteric in Santiago, Chile

OBJETIVO: El presente artículo busca conocer cómo los profesionales conciben la sexualidad de mujeres en etapa de climaterio, enfatizando aspectos relativos a la salud sexual, al deseo sexual y a los problemas de la sexualidad. MÉTODOS: Enfoque cualitativo basado en la Teoría Fundamentada (Grounded Theory). Se realizaron diez entrevistas en profundidad a profesionales de dos Centros de Salud Familiar (CESFAM) del sector sur de Santiago. RESULTADOS: Los resultados muestran que, si bien existe cierta tendencia a concebir el climaterio desde un punto de vista biologicista centrada principalmente en la "falla hormonal", los/as profesionales muestran diversos grados de reflexividad respecto a cómo aspectos socioculturales, económicos y de género moldean la sexualidad de mujeres en la etapa de climaterio. CONCLUSIONES: Los/as profesionales asumen posturas críticas respecto al rol de las instituciones y programas en salud, a las limitaciones laborales en los centros de salud (por ej. materiales, tiempo, etc.) y a la formación profesional. Este artículo promueve la formulación de políticas de salud en la materia, así como la revisión de los planes de estudio de las carreras de la salud.

OBJECTIVE: This article aims to examine how professional practitioners view womens sexuality in the climacteric stage, emphasizing aspects related to sexual health, sexual desire, and sexual disorders. METHODS: Qualitative approach based on the Grounded Theory. Ten in-depth interviews were conducted with professionals from two Family Health Centers (CESFAM) in southern Santiago. RESULTS: The results show that, although there is a certain tendency to approach the climacteric from a biological viewpoint focused mainly on the “ovarian failure”, practitioners show different degrees of reflexivity regarding how sociocultural, economic and gender aspects shape womens sexuality in the climacteric stage. CONCLUSIONS: Practitioners adopt critical positions regarding the role of health institutions and programs, work limitations in health centers, and the practitioners training. This article promotes the development of health policies in the matter, as well as the revision of study plans of health careers.

Perfil de mulheres climatéricas em Estratégia de Saúde da Família no interior paulista / Health profile of climacteric women from the Family Health Strategy in the countryside of the state of São Paulo

Introdução: o climatério pode ser influenciado por mudanças psicossociais simultâneas, que associadas às alterações hormonais, como o hipoestrogenismo e a diminuição dos níveis de progesterona, podem intensificar os sintomas e agravos na mulher. Objetivo: identificar os perfis sociodemográficos, obstétricos, ginecológicos, de saúde e hábitos de vida das mulheres climatéricas atendidas na rede básica de saúde, por meio da aplicação de questionário, escalas de Hamilton de Ansiedade e Depressão, e Índice Menopausal de Kupperman e Blatt. Material e Método: estudo transversal descritivo exploratório de relato de experiência, desenvolvido por graduandas em Medicina e Enfermagem. As participantes apresentam idade entre 45 e 60 anos, atendidas em quatro unidades de Estratégia de Saúde da Família. Resultados: participaram 41 mulheres, com idade média de 52,3 anos. Prevaleceram brancas, casadas, com filhos, ensino médio completo, sem plano de saúde, escore de depressão leve, índice menopausal leve, ansiedade normal e uso regular de medicamentos. Conclusão: as mulheres climatéricas necessitam de um espaço para verbalizar seus sentimentos e dúvidas em relação ao climatério e ter acesso à escuta atenta por profissionais capacitados, visando o atendimento integral de saúde com resolutividade.

Introduction: climacteric can be influenced by simultaneous psychosocial changes, which associated with hormonal changes, such as hypoestrogenism and decreased progesterone levels, can intensify symptoms and health problems in women. Objective: to identify the health profile of climacteric women in primary care regarding their obstetrics, gynecological, social, and demographic aspects, and their lifestyle as well, through a questionnaire and the application of the Hamilton Anxiety Scale, Depression Scale, and the Blatt-Kupperman Menopausal Index. Materials and Methods: it is an exploratory-descriptive cross-sectional study presented as an experience report, developed by medical and nursing students. The participants had 45 to 60 years-old and visited four units of the Family Health Strategy. Results: 41 women participated in the research, with an average age of 52.3-year-old. The majority were white, married, high school graduates, with no health insurance; had children, normal anxiety levels, mild depression, mild menopausal index, and reported regular use of medication. Conclusion: the climacteric women need some time to verbalize their feelings and doubts about the climacteric to trained professionals, aiming for a resolutive and comprehensive health care.

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.

Climatério e menopausa: conhecimento e condutas de enfermeiras que atuam na Atenção Primária à Saúde / Climacteric and menopause: knowledge and conduct of nurses working in Primary Health Care / Climatérico y menopausia: saberes y conductas de enfermeros que actúan en la Atención Primaria de Salud

Objetivo: identificar o conhecimento e as condutas de enfermeiras na Atenção Primária à Saúde sobre climatério e menopausa. Método: estudo descritivo exploratório, de abordagem qualitativa, realizado junto a 15 enfermeiras do município de Pesqueira, Pernambuco, Brasil. Os dados foram coletados por meio de entrevista semiestruturada e analisados pelo método de Bardin. Resultados: foi identificado conhecimento limitado em relação a definição de climatério, menopausa e de sinais e sintomas característicos, como também referente à terapia de reposição hormonal vaginal. A captação destas mulheres para as consultas de enfermagem se dava por demanda espontânea e ao realizar exame do colpocitopatológico. Conclusão: o conhecimento acerca do climatério é limitado nas práticas das enfermeiras na abordagem às mulheres que estão passando por esta fase. Na busca de minimizar as lacunas relacionadas ao desconhecimento profissional, é relevante a continuidade de estudos sobre a assistência a esse público.

Objective: to identify the knowledge and conduct of nurses who work in Primary Health Care about climacteric and menopause. Method: descriptive, exploratory study, of qualitative approach, carried out with 15 nurses from the municipality of Pesqueira, Pernambuco, Brazil. Data were collected through semi-structured interviews and analyzed using the Bardin method. Results: limited knowledge was identified regarding the definition of climacteric, menopause and characteristic signs and symptoms, as well as the vaginal hormone replacement therapy. The recruitment of these women for nurse consultations happened by spontaneous demand and when performing the colpocytopathological examination. Conclusion: knowledge about climacteric is limited in nurses' practices in addressing women who are going through this stage. In order to minimize the gaps related to professional ignorance, it is relevant to continue studies on assistance to this public.

Objetivo: identificar el conocimiento y la conducta de los enfermeros de la Atención Primaria de Salud sobre el climaterio y la menopausia. Método: estudio descriptivo exploratorio, con abordaje cualitativo, realizado con 15 enfermeros del municipio de Pesqueira, Pernambuco, Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas y analizados utilizando el método de Bardin. Resultados: se identificó conocimiento limitado sobre la definición de climaterio, menopausia y signos y síntomas característicos, así como sobre la terapia de reemplazo hormonal vaginal. Estas mujeres fueron reclutadas para consultas de enfermería por demanda espontánea y mediante la realización de una prueba de Papanicolaou. Conclusión: el conocimiento sobre el climaterio es limitado en las prácticas de enfermería en el abordaje de mujeres que pasan por esta fase. En la búsqueda de minimizar las lagunas relacionadas con el desconocimiento profesional, es importante continuar los estudios sobre la atención a este público.

Climaterio y sueño: revisión narrativa / Climacteric and sleep: narrative revision

RESUMEN Introducción: El sueño es un proceso dinámico y complejo fundamental para mantener un adecuado estado de salud física y psicológica. Los trastornos del sueño se incrementan durante la transición menopáusica con efectos deletéreos sobre la salud, la calidad de vida, el uso de los recursos de salud y la productividad laboral. Aunque la relación sueño-climaterio es abordada con frecuencia no hay consenso sobre la asociación entre síntomas vasomotores, calidad del sueño y los tratamientos. En Cuba los estudios son escasos lo que dificulta comprender su impacto en la vida cotidiana de la mujer de edad mediana. Objetivo: Actualizar aspectos relacionados con la interrelación síndrome climatérico: calidad del sueño, factores asociados y sus opciones terapéuticas. Métodos: Se revisaron las bases de datos Google Scholar, PubMed Central y SciELO Regional, por intermedio del buscador web de Google. El artículo se estructuró como: características del sueño en el climaterio, factores biológicos y sociales de la relación síndrome climatérico - sueño y tratamientos de los trastornos del sueño. Conclusiones: Durante la transición a la menopausia se incrementan los autoreportes de trastornos del sueño relacionados con la intensidad de los síntomas vasomotores, los estados emocionales, enfermedades y factores sociales. Hay falta de uniformidad en los métodos clínicos para el diagnóstico de los problemas del sueño y en los enfoques psicoterapéuticos y farmacológicos. Debido a la escasez de estudios nacionales sería pertinente caracterizar los problemas de sueño en la mujer cubana de edad mediana.

ABSTRACT Introduction: Sleep is a dynamic and complex process, essential to maintain an adequate state of physical and psychological health. Sleep disorders increase during the menopausal transition with deleterious effects on health, quality of life, use of health resources, and work productivity. Although the sleep-climacteric relationship is frequently addressed, there is no consensus on the association between vasomotor symptoms, sleep quality, and treatments. In Cuba, studies are scarce, which makes it difficult to understand their impact on the daily life of middle-aged women. Objective: To update aspects related to the interrelation of climacteric syndrome: sleep quality, associated factors and their therapeutic options. Methods: Google Scolar, PubMed and SciELO Regional data bases were reviewed with Google web search engine. The article was structured: sleep characteristics in the climacteric, relationship between Climacteric Syndrome and sleep and treatment for sleep disorders. Conclusions: During the transition to menopause, self-reports of sleep disorders related to the intensity of vasomotor symptoms, emotional states, illnesses and social factors increased. There is a lack of uniformity in clinical methods for the diagnosis of sleep problems and in psychotherapeutic and pharmacological approaches. Due to the scarcity of national studies, it would be pertinent to characterize sleep problems in middle-aged Cuban women.

Probable sarcopenia and obesity in women with urinary incontinence in the climacteric period / Provável sarcopenia e obesidade em mulheres com incontinência urinária no climatério

Abstract Introduction: Sarcopenia and obesity are associated with several health conditions. Few studies, however, have analyzed the presence of these conditions in climacteric women with incontinence, and the association between these conditions and the severity of urinary incontinence (UI) is not clear. Objective: To analyze probable sarcopenia, sarcopenia, and obesity in climacteric women with different UI severities, and the association between sarcopenia and UI severity. Methods: This was a cross-sectional study in a public maternity hospital in Northeast Brazil, with women aged ≥ 40 years. Sociodemographic issues, urogynecological history, UI severity (Incontinence Severity Index - ISI), grip strength, and anthropometric measures (waist circumference and body mass index - BMI) were evaluated. Means, standard deviations, absolute and relative frequencies, T test, and Fisher exact test were used (significance at 5%). Results: The sample comprised 177 women, with a mean age of 56.3 (± 9.7) years. Regarding UI, 69 (39.0%) women presented mixed UI, and 53.1% presented moderate UI severity. Only 18.1% women had normal BMIs, and 46.8% had general obesity and 80.3% had abdominal obesity. Probable sarcopenia (low strength) was observed in 35 (20%) women, and sarcopenia, in 3.4%. Women with severe/very severe UI presented lower grip strengths (p = 0.02) and higher BMIs (p = 0.04). Sarcopenia was associated with greater UI severity (p = 0.005). Conclusion: Probable sarcopenia and higher BMI were observed in women with greater UI severities, and sarcopenia was associated with greater UI severity. Preventive measures are needed in such conditions to avoid future complications.

Resumo Introdução: Sarcopenia e obesidade têm relação com diversas condições de saúde. Poucos estudos, entretanto, têm analisado a presença destas condições em mulheres incontinentes no climatério, e não está claro se existe associação destas com a gravidade da incontinência urinária (IU). Objetivo: Analisar provável sarcopenia, sarcopenia e obesidade em mulheres com diferentes gravidades de IU na fase do climatério e a associação da sarcopenia com a gravidade da IU. Métodos: Estudo transversal realizado em maternidade pública do nordeste do Brasil, em mulheres com IU a partir de 40 anos. Foram avaliadas questões sociodemográficas, histórico uroginecológico, gravidade da IU (Incontinence Severity Index - ISI), força de preensão e medidas antropométricas (circunferência abdominal e índice de massa corporal - IMC). Foram analisadas médias e desvios-padrão, frequências absolutas e relativas, teste T e exato de Fisher (significância de 5%). Resultados: Amostra de 177 mulheres com média de 56,3 (± 9,7) anos. Sobre a IU, 69 (39,0%) mulheres apresentavam IU mista e 53,1% gravidade moderada. Apenas 18,1% apresentavam IMC normal, 46,8% obesidade geral e 80,3% obesidade abdominal. Provável sarcopenia (baixa força) foi observada em 35 (20%) mulheres e sarcopenia em 3,4%. Mulheres com IU grave ou muito grave apresentaram menor força de preensão (p = 0,02) e maior IMC (p = 0,04). A sarcopenia foi associada à maior gravidade de IU (p = 0,005). Conclusão: Observou-se provável sarcopenia e maior IMC em mulheres com maior gravidade de IU e associação da sarcopenia com a maior gravidade de IU. São necessárias medidas preventivas quanto a tais condições, evitando futuras complicações.

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)

ASPECTOS QUE INFLUENCIAM A VIVÊNCIA DA SEXUALIDADE PELA MULHER CLIMATÉRICA / ASPECTS THAT INFLUENCE THE EXPERIENCE OF SEXUALITY BY CLIMATERIC WOMEN

Objetivo: Descrever evidências científicas que abordem os aspectos que influenciam na vivência da sexualidade pela mulher climatérica e discutir as principais intervenções que o enfermeiro pode realizar na tentativa de promover a qualidade da vida sexual destas. Método: Trata-se de uma Revisão integrativa. Foram adotados os seguintes critérios de inclusão: artigos científicos com texto completo disponível, em português, inglês e espanhol, publicado nos últimos dez anos e relacionados à temática proposta. Resultados: A amostra foi composta por 19 artigos, 18 disponíveis no idioma português e um em espanhol, publicados entre os anos de 2006 a 2016. Conclusão: Os sintomas climatéricos nem sempre são o fator principal que influenciam na vivência da sexualidade da mulher climatérica, mas pode vir associado a fatores psicológicos. A contribuição do enfermeiro ao conhecimento sobre o assunto ainda apresenta respostas que permanecem abertas.

Objective: To describe scientific evidences about the aspects that influence the climacteric woman's experience of sexuality, as well as the interventions that the nurse can perform in an attempt to seek to promote quality for the sexual life of these women. Method: This study is an integrative review. It was used the following inclusion criterias: scientific articles with full text available in Portuguese, English and Spanish, published in the last ten years and related to the proposed theme. Results: 19 articles were selected and analyzed,18 available in the Portuguese language and one in Spanish, published between the years 2006 and 2016. Conclusion: Climacteric symptoms are not always the main factor influencing the climacteric woman's sexuality, but may be associated with psychological factors. The nurse's contribution to the knowledge on the subject still presents answers that remain open.

Can Supervised Pelvic Floor Muscle Training Through Gametherapy Relieve Urinary Incontinence Symptoms in Climacteric Women? A Feasibility Study / O treinamento por meio de gameterapia pode aliviar os sintomas de incontinência urinária em mulheres climatéricas? Um estudo de viabilidade

Abstract Objective To investigate the feasibility of pelvic floor muscle training (PFMT) through gametherapy for relieving urinary symptoms of climacteric women with stress ormixed urinary incontinence (UI). Methods Randomized clinical trial, divided into two groups: Gametherapy (G_Game) and Control (G_Control). Both groups received recommendations about unsupervised PFMT, and G_Game also received supervised PFMT through gametherapy. After 5 consecutive weeks, the feasibility was investigated considering participant adherence, urinary symptoms (evaluated by the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF] questionnaire), and pelvic floor function (PERFECT Scheme: power, endurance, repetition and fast). The Fisher exact, Kruskal-Wallis, Wilcoxon sign paired, and Mann-Whitney U tests were used by intention-to-treat analysis, using STATA 15.1 (StataCorp, College Station, TX, USA) software. Results The present study included 20 women per group and observed a higher adherence in G_Game. In the intragroup analysis, a decrease in the ICIQ-UI-SF score was observed in both groups (14.0 to 10.0; 13.5 to 0), associated with increased endurance (2.5 to 3.5; 2.5 to 4.0) in G_Control and G_Game, respectively. Moreover, there was a concomitant increase in pelvic floor muscles (PFMs) power (2.0 to 3.0), repetition (3.0 to 5.0), and fast (10.0 to 10.0) in G_Game. In the intergroup analysis, a reduction of UI was observed (p<0.001; r=0.8), as well an increase in PFM power (p=0.027, r=0.2) and endurance (p=0.033; r=0.3) in G_Game. Conclusion The feasibility of supervised PFMT through gametherapy was identified by observing participant adherence, relief of urinary symptoms, and improvement in PFM function.

Resumo Objetivo Investigar a viabilidade do treinamento dos músculos do assoalho pélvico (TMAP) por meio de gameterapia no alívio de sintomas urinários em mulheres climatéricas com incontinência urinária (IU) de esforço ou mista. Métodos Ensaio clínico randomizado, dividido em dois grupos: Gameterapia (G_Game) e Controle (G_Controle). Ambos os grupos receberam recomendações sobre TMAP não supervisionado, e G_Gametambém recebeu TMAP supervisionado por meio de gameterapia. Após 5 semanas consecutivas, a viabilidade foi investigada considerando a aderência das participantes, sintomas urinários (avaliados pelo questionário International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI-SF]) e função do assoalho pélvico (esquema PERFECT: power, endurance, repetition, fast). Os testes exatos de Fisher, Kruskal-Wallis, sinal de Wilcoxon pareado e Mann-Whitney U foram usados pela análise de intenção de tratar, usando o software STATA 15.1 (StataCorp, College Station, TX, EUA). Resultados O presente estudo incluiu 20 mulheres por grupo e observou uma maior adesão no G_Game. Na análise intragrupo, foi observada diminuição no escore do ICIQUI- SF emambos os grupos (de 14,0 para 10,0; de 13,5 para 0), associada ao aumento da resistência (de 2,5 para 3,5; de 2,5 para 4,0) em G_Control e G_Game, respectivamente. Além disso, houve um aumento concomitante no power (de 2,0 para 3,0), repetition (de 3,0 para 5,0) e fast (de 10,0 para 10,0) dosmúsculos do assoalho pélvico (MAPs) no G_Game. Na análise intergrupos, foi observada redução da IU (p<0,001; r=0,8), assim como do power (p=0,027; r=0,2) e da endurance (p=0,033; r=0,3) dos MAPs no G_Game. Conclusão A viabilidade do TMAP supervisionado por meio de gameterapia foi identificada pela observação da aderência das participantes, pelo alívio dos sintomas urinários e pela melhora da função dos MAPs.

Sexual Function and Associated Factors in Postmenopausal Women / Função sexual e fatores associados em mulheres na pós-menopausa

Abstract Objective To assess the sexual function and associated factors in postmenopausal women. Methods This a descriptive, cross-sectional study with 380 women aged 40 to 65 years, users of public health services in 2019. Questionnaires were applied on demographic characteristics, on climacteric symptoms (menopause rating scale) and on sexual function (sexual quotient, female version). Bivariate andmultiple analyses by logistic regression were performed, with adjusted odds ratios (ORad) and 95% confidence intervals (95%CIs). Results More than half (243/64%) of the participating women were at risk of sexual dysfunction, with lower scores in the domains of sexual desire and interest, comfort, orgasm, and satisfaction. Women with a partner (ORad 2.07; 95%CI 1.03-4.17) and those who reported sleep problems (ORad 2.72; 95%CI 1.77-4.19), depressed mood (ORad 2.03; 95%CI 1.32-3.10), sexual complaints (ORad 8.16; 95%CI 5.06-13.15), and vaginal dryness (ORad 3.44; 95%CI 2.22-5.32) showed greater chance of sexual dysfunction. Conclusion There was a high prevalence of sexual dysfunction, with the influence of conjugality and climacteric symptoms on sexual function.

Resumo Objetivo Avaliar a função sexual e fatores associados em mulheres na pósmenopausa. Métodos Este é umestudo descritivo, transversal, com380 mulheres de 40 a 65 anos, usuárias de serviços de saúde públicos em 2019. Foram aplicados questionários sobre características demográficas, sobre sintomas climatéricos (menopause rating scale) e sobre a função sexual (Quociente Sexual, versão feminina). Análises bivariada e múltipla por regressão logística foram realizadas, com cálculo de odds ratio ajustado (ORaj) e intervalos de confiança de 95% (ICs95%). Resultados Mais da metade (243/64%) das mulheres participantes no estudo apresentou risco de disfunção sexual, com escores mais baixos dos domínios desejo e interesse sexual, conforto, orgasmo e satisfação. Mulheres com companheiro (ORaj 2,07; IC95% 1,03-4,17) e aquelas que relataram problemas de sono (ORaj 2,72; IC95% 1,77-4,19), ânimo depressivo (ORaj 2,03; IC95% 1,32-3,10), queixas sexuais (ORaj 8,16; IC95% 5,06-13,15) e ressecamento vaginal (ORaj 3,44; IC95% 2,22-5,32) apresentaram maior chance de disfunção sexual. Conclusão Houve prevalência elevada de disfunção sexual, com influência da conjugalidade e dos sintomas climatéricos sobre a função sexual.

Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19 / Prevalence of sleep disorders in menopausal women during the COVID-19 pandemic in Colombia

RESUMEN Objetivo: Elaborar una aproximación a la prevalencia de los problemas de sueño (PDS) en mujeres climatéricas colombianas durante la pandemia COVID-19. Materiales y Métodos: Estudio transversal que pertenece al proyecto de investigación Calidad de Vida en la Menopausia y Etnias Colombianas bajo condiciones de pandemia [CAVIMEC+COVID STUDY]. Se incluyeron mujeres naturales y residentes en Colombia entre 40 y 59 años, quienes en los primeros cinco días de junio del 2020 participaron de forma anónima y voluntaria, previo consentimiento informado en el diligenciamiento de un formulario alojado en una plataforma virtual. Los PDS fueron identificados con el tercer ítem de Menopause Rating Scale. Se exploraron características sociodemográficas, la presencia y severidad de los PDS y el estado menopáusico. Se hace estadística descriptiva. Resultados: Participaron 984 mujeres, la mediana de edad fue 47,0 [RIC: 42,0-53,5] años. El 84,5% de las participantes eran mestizas, el 13,7% afrodescendientes y 1,7% indígenas. El 39,3% posmenopáusicas. El 70% residían en la región caribe colombiana. Informaron PDS 637 (64,7%) de las participantes y 112 (11,3%) tenían PDS severos. Las posmenopáusicas informaron un 65,1% de PDS, en forma severa el 10,1%, y las premenopáusicas informaron 64,5%, en forma severa el 12,2%. Conclusiones: Los PDS podrían ser un problema frecuente en las mujeres en estado premenopáusico y postmenopáusico. Se debe explorar este problema en la consulta ginecológica para ofrecer soluciones. Se requieren estudios poblacionales que confirmen estas observaciones.

ABSTRACT Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic. Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.

Satisfaction of Quechua-speaking women in climacteric stage with the care provided by midwives. / Satisfacción de mujeres quechuahablantes en etapa climatérica con la atención brindada por matronas.

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.

Intensidad del síndrome vasomotor y su relación con la función endotelial en mujeres de edad mediana / Intensity of the vasomotor syndrome and its relation with endothelial function in middle age women

Introducción: El síndrome vasomotor constituye la manifestación clínica más frecuente de la transición menopaúsica y a menudo se asocia con cambios en la función endotelial. Objetivo: Determinar la relación entre la intensidad del síndrome vasomotor y la función endotelial en mujeres de edad mediana aparentemente sanas. Método: Estudio descriptivo transversal, en 133 mujeres de 40-59 años sin factores de riesgo cardiovascular. Se excluyeron aquellas mujeres con menopausia quirúrgica, uso previo de terapia hormonal de reemplazo seis meses antes. Se evaluó la función endotelial mediante la prueba de dilatación mediada por el flujo de la arteria braquial, y la intensidad del síndrome vasomotor mediante la escala de Pérez Piñeiro. Las mujeres fueron distribuidas en dos subgrupos: uno con disfunción endotelial y el otro con función endotelial normal. Para identificar la asociación entre variables se utilizó la prueba Kruskal-Wallis y la prueba Chi Cuadrado para evaluar la significación estadística, considerándose significativos los valores de p < 0,05. Resultados: El 63 por ciento de las mujeres presentaron síndrome vasomotor, 29 de intensidad leve, 31 moderado y muy molesto 33 mujeres. Del total de mujeres, 51 tuvieron disfunción endotelial, para un 38,3 por ciento, mostrando un promedio de dilatación dependiente del endotelio de 1,81±1,57 cm. No se encontró asociación significativa entre la intensidad del síndrome vasomotor y la función endotelial p = 0,139. Conclusiones: La intensidad del síndrome vasomotor no se relacionó con la disfunción endotelial en mujeres de edad mediana. Se necesita ampliar la muestra y realizar estudios prospectivos para identificar el daño vascular en ese grupo de mujeres(AU)

Introduction: The vasomotor syndrome is the most frequent clinical manifestation of the menopausal transition and it is often associated with changes in the endothelial function. Objective: Determine the relation among the intensity of the vasomotor syndrome and the endothelial function in apparently healthy middle age women. Methods: Descriptive cross-sectional study in 113 women of 40-59 years without cardiovascular risk factors. There were excluded women with surgical menopause, and use of replacement hormonal therapy six months before. It was assessed the endothelial function through the dilation test and the flow of the brachial artery, and the intensity of the vasomotor syndrome through the scale of Pérez. The women were organized in two groups: one group of women with endothelial dysfunction and the other of women with normal endothelial function. It was used the Kruskal-Wallis test to identify the association among variables and the chi-Square test to assess the statistical significance considering important the values of p < 0.05. Results: 63 percent of the women presented vasomotor syndrome, 29 of them of slight intensity, 31 moderate and 33 women had a very uncomfortable one. Of the total, 51 women presented endothelial dysfunction representing a 38.3 percent and showing an average of dilation dependant of endothelium of 1.81±1.57 cm. There was not found significant association among the intensity of the vasomotor syndrome and the endothelial function p = 0.139. Conclusions: The intensity of the vasomotor syndrome was not related with the endothelial dysfunction in middle age women. It is needed to expand the sample and to implement prospective studies in order to identify the vascular damage in that group of women(AU)

Síndrome climatérico y funcionalidad familiar / Climacteric syndrome and family functionality

Introducción: el climaterio representa el inicio del cese de la menstruación y el final de la vida reproductiva de la mujer, e involucra procesos fisiológicos, endocrinos, psicosexuales, sociales y familiares. Objetivo: determinar la relación entre la calidad de vida en la etapa del climaterio y la funcionalidad familiar de las usuarias adscritas a una Unidad de Medicina Familiar (UMF) en Culiacán, Sinaloa. Metodología: estudio descriptivo, observacional, transversal y correlacional, que incluyó mujeres de 40 a 59 años que asisten a consulta en una UMF. Se utilizaron una cédula de datos personales, la Menopause Rating Scale (MRS-11) y la escala Adaptación, Participación, Gradiente de recurso personal, Afecto y Recursos familiares (APGAR-5) familiar. Los datos fueron analizados con el paquete estadístico SPSS. El estudio se apegó a lo dispuesto en la Ley General de Salud en materia de investigación. Resultados: el 42.6% presentó molestias moderadas, el 30.1% leves y el 21.3% graves. El 33% tiene familia funcional, el 29% disfunción familiar leve, el 20% moderada y el 18% severa. Se encontró asociación en la calidad de vida por grupo etario, somática, psicológica y urogenital (p = 0.01); el grupo de 50 a 60 años presentó molestias moderadas y graves. Las participantes tienen (OR=1.5, IC 95%, 1.02- 2.44, p=0.04) y (OR=1.5, IC 95%, 1.02 - 2.44, p=0.04) de disfunción familiar con dispareunia y líbido disminuida. Existe correlación negativa y significativa entre la calidad de vida y funcionalidad familiar (rs= -.349, p=0.01). Existe correlación negativa y significativa entre la calidad de vida y la funcionalidad familiar (rs = −0.349; p = 0.01). Conclusiones: las usuarias viven con molestias moderadas, el grupo de 50-59 vive con molestias psicológicas y urogenitales leves a moderadas, y existe correlación negativa y significativa entre la calidad de vida y la funcionalidad familiar.

Introduction: The climacteric represents the beginning of the cessation of menstruation and the end of reproductive life in women, it involves physiological, endocrine, psychosexual, social and family processes. Objective: To determine the relationship between the quality of life in the climacteric stage and the family functionality of the users assigned to a family medicine unit (FMU) in Culiacán, Sinaloa. Methods: Descriptive, observational, crosssectional, and correlational study, included women between 40 and 59 years old who attend a consultation in a FMU. A personal data card, the menopause rating scale (MRS-11) and family APGAR were used. The data were analyzed with the SPSS statistical package. The study adhered to the provisions of the general health law regarding research. Results: 42.6% presented moderate discomfort, 30.1% mild, 21.3% severe. 33% have a functional family, 29% mild family dysfunction, 20% moderate, 18% severe. An association was found in quality of life by age group, somatic, psychological and urogenital (p = 0.01); the group of 50 to 60 years presented moderate and severe discomfort.The participants had (OR = 1.5, 95% CI, 1.02-2.44, p = 0.04) and (OR = 1.5, 95% CI, 1.02 - 2.44, p = 0.04) of family dysfunction with dyspareunia and decreased libido.There is a negative and significant correlation between quality of life and family functionality (rs= −0.349; p = 0.01). Conclusions: The users live with moderate discomfort, the group of 50-59 lives with mild to moderate psychological and urogenital discomfort; there is a negative and significant correlation between quality of life and family functionality