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1.
Menopause ; 28(9): 1012-1025, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34313615

RESUMO

OBJECTIVE: The aim of this study was to examine the occurrence of a variety of symptoms, their frequency, bother, burden, and interference in the lives of women in the late reproductive stage (LRS) and compare their experiences to that of women in the menopausal transition (MT) stage. METHODS: Women ages 35 to 55 years responded to an 82-question online survey offered by Women Living Better. Participants reported current menstrual patterns, recent changes and symptom frequency, bother, and interference. Women's cycles were classified as LRS or MT using Stages of Reproductive Aging Workshop +10 criteria. RESULTS: Of 2,406 respondents, 946 met criteria for LRS and 583 for MT. Participants included 30% from outside the United States, 31% from diverse racial/ethnic groups, and 18% reported having difficulty paying for basics. A similar proportion of women in the LRS and MT+ groups reported each of the symptoms: there was a less than 10% difference for 54 of the 61 symptoms. Of mean bother ratings for all symptoms, only hot flashes differed significantly between the LRS and MT groups. LRS women experienced similar levels of symptom-related interference with personal relationships and daily living to those in the MT stage but did not anticipate these symptoms occurring until they were 50 years old. CONCLUSIONS: Women in the LRS experience symptoms strikingly similar to those often associated with the MT. Women do not expect these changes until the age of 50 years or later and are surprised by such symptoms before cycle irregularity. Research about the epidemiology and management of LRS symptoms, anticipatory guidance for women, and education for clinicians who care for them warrant increased attention.


Assuntos
Fogachos , Menopausa , Adulto , Envelhecimento , Feminino , Fogachos/epidemiologia , Humanos , Pessoa de Meia-Idade , Reprodução , Inquéritos e Questionários
2.
J Obstet Gynaecol Res ; 47(10): 3677-3690, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34278662

RESUMO

AIM: To assess prevalence and characteristics of vasomotor symptoms in community-dwelling Japanese women. METHODS: These were cross-sectional analyses using data from the National Institute for Longevity Sciences-Longitudinal Study of Aging. The main outcome measures were prevalence and severity of hot flashes and sweating. Associations between hot flashes/sweating (slight, moderate, or severe vs none) and sleep problems were explored using logistic regression, with and without adjustment for age, daily physical activity, and number of urinations/night. Associations between hot flashes/sweating and sleep problems, depressive symptoms, and dietary variables were explored in logistic regression models or general linear models. RESULTS: A total of 1152 women between 40 and 91 years of age were enrolled. Hot flashes were reported by 24.5% of participants; with prevalence and severity highest in those 50-54 years or 2-5 years postmenopause. Sleep problems were reported 15 percentage points more frequently by women who reported hot flashes than by those without hot flashes. Adjusted odds ratios [95% CI] for difficulty in falling asleep and difficulty in sleeping through were 2.09 [1.565-2.796] and 2.07 [1.549-2.763]), respectively. Also, hot flashes were associated with higher risk of depressive symptoms (adjusted odds ratio [95% CI]: 2.99 [2.07-4.32]) and lower life satisfaction, self-esteem, and self-rated health status. A similar pattern was observed in women with and without sweating. No associations were found between hot flashes and dietary factors. CONCLUSIONS: Clear associations were found between hot flashes and sleeping problems, even after adjusting for potential confounding factors. Women who reported hot flashes also reported worse mental and physical health than those who did not report hot flashes.


Assuntos
Vida Independente , Transtornos do Sono-Vigília , Estudos Transversais , Depressão/epidemiologia , Feminino , Fogachos/epidemiologia , Humanos , Japão/epidemiologia , Estudos Longitudinais , Menopausa , Transtornos do Sono-Vigília/epidemiologia
3.
Maturitas ; 150: 42-48, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34274075

RESUMO

OBJECTIVE: The aim of this study was to determine the relationship between carbohydrate quality intake and menopausal symptoms. STUDY DESIGN: This is a cross-sectional study of 393 postmenopausal women attending municipality health houses and health centers in the south of Tehran, Iran, from September 2016 to January 2017. MAIN OUTCOME MEASURES: The dietary intake and menopausal symptoms of the participants were assessed with a validated food frequency questionnaire and a menopause rating scale (MRS) carbohydrate quality index (CQI) was calculated using three indices: dietary fiber, glycemic index, and the ratio of solid carbohydrates to total carbohydrates. Linear and logistic regressions were used to assess the relationship between CQI and menopausal symptoms. RESULTS: After adjustment for age, education, time passed since menopause, body mass index, physical activity and energy intake, an inverse association was found between CQI and total MRS score (TMRSS) (ß -0.61; p <0.001), somatic score (SS) (ß -0.27; p <0.001) and psychological score (PS) (ß -0.37; p <0.001) in multivariable linear regression. In addition, logistic regression analysis revealed that compared with the lowest quartile of CQI, participants in the highest quartile of CQI had a lower TMRSS (odds ratio (OR) 0.36, 95% confidence interval (CI) 0.19-0.68). Moreover, CQI was inversely related to SS (OR 0.34; 95% CI 0.17-0.68) and PS (OR 0.32; 95% CI 0.16-0.61). However, there was no significant association between CQI and urogenital score (US). CONCLUSIONS: Higher-quality carbohydrate intake was found to be associated with lower somatic and psychological symptoms of menopause. These findings suggest that CQI may be an important basis for developing an effective dietary modification for reducing menopausal symptoms.


Assuntos
Dieta Saudável , Dieta , Carboidratos da Dieta/administração & dosagem , Menopausa , Pós-Menopausa , Ansiedade/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Depressão/epidemiologia , Ingestão de Energia , Exercício Físico , Feminino , Fogachos/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Transtornos da Memória/epidemiologia , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Inquéritos e Questionários
4.
Breast Cancer Res Treat ; 188(2): 343-350, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34159473

RESUMO

PURPOSE: Vasomotor symptoms (VMS) such as hot flashes and night sweats are common in breast cancer patients and can affect both quality of life and treatment adherence. However, there is limited practical data to guide clinicians in the optimal selection of therapeutic strategies. A survey of health care providers was performed to better understand perspectives and prescribing practices for managing this problem. METHODS: Canadian health care providers who treat patients with early stage breast cancer (EBC) participated in an anonymous electronic survey. Participants provided their perspectives on the prevalence and severity of VMS among patients with EBC, outlined their management strategies, and provided feedback on the perceived efficacy of interventions for VMS. RESULTS: Responses were received from 65 providers including breast oncologists (36/65, 55%) and nurses with oncology expertise (29/65, 45%). Seventy-seven percent of participants reported regularly asking patients about VMS, and most indicated that bothersome VMS occurred in the majority of patients. Health care providers cited hot flash severity and sleep disruption as the most important issues for patients. The most common first- and second-line interventions recommended were lifestyle modifications (n = 32/65, 49.2%) and pharmacologic strategies (n = 27/65, 41.5%), respectively. Most respondents felt that interventions, including pharmacologic, over-the-counter, and complementary therapies, were only "somewhat effective". Overall, half of respondents (n = 35/65, 54%) reported being "confident" in managing VMS. CONCLUSION: Given the variability of treatment recommendations, and health care provider uncertainty around the benefits of therapies for VMS, more 'real-world' trials are needed to optimize patient care.


Assuntos
Neoplasias da Mama , Menopausa , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Canadá , Feminino , Pessoal de Saúde , Fogachos/epidemiologia , Fogachos/etiologia , Fogachos/terapia , Humanos , Qualidade de Vida , Inquéritos e Questionários , Sudorese
5.
BMC Cancer ; 21(1): 570, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34006247

RESUMO

BACKGROUND: Adjuvant endocrine therapies are known to induce undesirable adverse effects such as vasomotor, vaginal and musculoskeletal symptoms among breast cancer patients. Drugs used in these therapies are often metabolised by cytochrome P450 (CYP) enzymes, in which their metabolising activities can be modified by single nucleotide polymorphisms (SNP) in CYP genes and CYP genotypes. This review aims to explore whether SNPs or genotypes of CYP are associated with the occurrence, frequency and severity of vasomotor, vaginal and musculoskeletal symptoms in breast cancer patients on adjuvant endocrine therapies. METHODS: A literature review was conducted using five electronic databases, resulting in the inclusion of 14 eligible studies, and their findings were presented narratively. Selected items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist were used for critical appraisal of the reporting quality of the included studies. RESULTS: Most of the included studies showed that SNPs or genotypes of CYP that modify its metabolising activity have no effect on the occurrence, frequency or severity of vasomotor symptoms, including hot flashes. One study showed no correlation of these genetic variations in CYP with musculoskeletal symptoms, and no data were available on the association between such genetic variations and vaginal symptoms. CONCLUSIONS: Overall, genetic variations in CYP have no effect on the experience of hot flashes among breast cancer patients. We recommend exploration of the link between the active metabolites of chemotherapeutic drugs and the molecules shown to affect the occurrence or severity of hot flashes, and the establishment of the relationship between such genetic variations and patients' experience of musculoskeletal and vaginal symptoms. Subgroup analyses based on patients' duration of adjuvant endocrine therapies in such studies are recommended.


Assuntos
Antineoplásicos Hormonais/efeitos adversos , Artralgia/epidemiologia , Neoplasias da Mama/terapia , Sistema Enzimático do Citocromo P-450/genética , Fogachos/epidemiologia , Vagina/patologia , Antineoplásicos Hormonais/farmacocinética , Artralgia/induzido quimicamente , Artralgia/diagnóstico , Artralgia/genética , Atrofia/induzido quimicamente , Atrofia/diagnóstico , Atrofia/epidemiologia , Atrofia/genética , Neoplasias da Mama/genética , Quimioterapia Adjuvante/efeitos adversos , Quimioterapia Adjuvante/métodos , Sistema Enzimático do Citocromo P-450/metabolismo , Antagonistas de Estrogênios/efeitos adversos , Antagonistas de Estrogênios/farmacocinética , Estrogênios/metabolismo , Feminino , Predisposição Genética para Doença , Fogachos/induzido quimicamente , Fogachos/diagnóstico , Fogachos/genética , Humanos , Mastectomia , Estudos Observacionais como Assunto , Polimorfismo de Nucleotídeo Único , Índice de Gravidade de Doença , Tamoxifeno/efeitos adversos , Tamoxifeno/análogos & derivados , Tamoxifeno/farmacocinética , Vagina/efeitos dos fármacos
7.
Menopause ; 28(7): 741-747, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34033601

RESUMO

OBJECTIVE: Palpitation, or the sensation of rapid or irregular heartbeats, is common in menopausal women; however, the precise underlying mechanisms are unknown. We aimed to investigate factors associated with palpitation in middle-aged women. METHODS: Medical records of 394 women aged 40 to 59 years (108 premenopausal, 85 perimenopausal, and 201 postmenopausal) were analyzed cross-sectionally. Palpitation severity was estimated based on responses to the Menopausal Symptom Scale. Effects of background characteristics, including age, menopausal status, body composition, cardiovascular parameters, basal metabolism, physical fitness, lifestyle factors, vasomotor, and psychological symptoms on palpitation were assessed using multivariate logistic regression analysis. The association between autonomic nervous system activity and palpitation was also analyzed in 198 participants. RESULTS: Prevalence of palpitation by severity was as follows: none, 26.4%; mild, 32.7%; moderate, 29.4%; severe, 11.4%. In univariate analyses, the more severely the women were affected by palpitation, 1) the higher their systolic blood pressure, 2) the less exercise they performed, 3) the lower they scored in the sit-and-reach test, 4) the higher their vasomotor symptoms score in the Menopausal Health Related-Quality of Life questionnaire, and 5) the higher their Hospital Anxiety and Depression Scale. Multiple logistic regression analysis revealed that moderate to severe palpitation was independently associated with the vasomotor symptom score (adjusted odds ratio [95% confidence interval]: 1.18 [1.07-1.31]) and Hospital Anxiety and Depression Scale anxiety subscale score (1.19 [1.12-1.27]). CONCLUSIONS: Rapid or irregular heartbeats are highly prevalent in middle-aged women. It is not associated with age, menopausal status, heart rate, arrhythmia, autonomic nervous system activity, caffeine, or alcohol consumption, but with vasomotor symptoms and anxiety.


Assuntos
Ansiedade , Qualidade de Vida , Ansiedade/epidemiologia , Arritmias Cardíacas/epidemiologia , Estudos Transversais , Feminino , Fogachos/epidemiologia , Humanos , Menopausa , Pessoa de Meia-Idade , Inquéritos e Questionários , Sistema Vasomotor
8.
Menopause ; 28(8): 875-882, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34033602

RESUMO

OBJECTIVE: To determine prevalence and health-related quality of life (HRQOL) of moderate-to-severe vasomotor symptoms (VMS) in postmenopausal women in Europe, the US, and Japan, and among subgroups of women not taking hormone therapy (HT). METHODS: Screening surveys were sent to a random sample of women aged 40 to 65 years; full questionnaires followed to those who completed them and met inclusion criteria. Women with successfully treated VMS, breast cancer, or on HT for medical conditions were excluded. The Menopause-Specific QOL (MENQOL) and Work Productivity and Activity Impairment (WPAI) questionnaires were included in the questionnaire. RESULTS: Of 25,161 women completing the screening survey, 11,771 were postmenopausal and 3,460 met inclusion criteria and completed the full questionnaire. Prevalence of moderate-to-severe VMS was 40%, 34%, and 16% in Europe, the US, and Japan, respectively. A large proportion were HT averse, albeit eligible (Europe 56%, US 54%, Japan 79%). In total, 12%, 9%, and 8% in Europe, the US, and Japan, respectively, were HT-contraindicated. A high proportion were HT-cautious (Europe 70%, US 69%, Japan 52%). Most common menopausal symptoms reported in the MENQOL were feeling tired or worn out (Europe/US 74%, Japan 75%), aching in muscles and joints (Europe 69%, US 68%, Japan 61%), difficulty sleeping (Europe 69%, US 66%, Japan 60%), and hot flashes (Europe 67%, US 68%, Japan 62%). Overall, the most bothersome symptom was weight gain. As measured by the WPAI, hot flashes and night sweats had a greater impact on daily activities than on working activities. CONCLUSIONS: A high proportion of women experienced moderate-to-severe VMS, with associated symptoms impacting QOL.


Assuntos
Menopausa , Qualidade de Vida , Estudos Transversais , Feminino , Fogachos/epidemiologia , Humanos , Prevalência , Inquéritos e Questionários , Sudorese
9.
Support Care Cancer ; 29(11): 6233-6242, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33844082

RESUMO

PURPOSE: We sought to determine the association between 'trouble sleeping', alcohol intake, hot flashes, and quality of life (QOL) in early-stage breast cancer survivors attending the Sydney Cancer Survivorship Clinic (SCSC). METHODS: Survivors who had completed primary adjuvant treatment completed questionnaires assessing the following: symptoms, QOL (mean global score on FACT-G), and alcohol intake (drinks per day for past week), on the first visit to SCSC. Trouble sleeping and hot flashes were scored from 0 (no trouble at all) to 10 (worst I can imagine), with scores ≥ 4 classified as at least moderate and ≥ 7 severe. RESULTS: 238 breast cancer survivors attended SCSC from September 2013 to May 2019, with data available for 227 (median age 53 years; 70% on endocrine therapy). Trouble sleeping was at least moderate in 54% and severe in 19%. 47% reported consuming alcohol (mean 4.9 drinks/week). Scores for trouble sleeping were no different between survivors reporting alcohol consumption and not (mean 4.13 vs. 3.6; p = 0.17). Survivors reporting at least moderate trouble sleeping (vs. less than moderate) were no more likely to drink alcohol (OR 1.74, 95% CI 0.96-3.14, p = 0.067) but had poorer mean QOL scores (69.1 vs. 78.3; p = 0.0006). Survivors reporting at least moderate hot flashes (vs. less than moderate) were more likely to report at least moderate trouble sleeping (OR 3.78, 95% CI 2.02-6.71, p < 0.0001) and had worse mean QOL scores (68 vs. 78; p = 0.001). CONCLUSION: Trouble sleeping is common amongst breast cancer survivors and associated with hot flashes and poorer QOL, but not with self-reported alcohol consumption.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Consumo de Bebidas Alcoólicas/epidemiologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Feminino , Fogachos/epidemiologia , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Sono , Sobreviventes , Sobrevivência
10.
Bratisl Lek Listy ; 122(5): 301-304, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33848177

RESUMO

OBJECTIVES: The aim of this study was to assess the possibility of using the DT56a for the therapy of acute climacteric syndrome in women in Slovakia and the Czech Republic. DESIGN: Prospective interventional unblinded study. RESULTS: A sample of 453 women with symptoms of acute climacteric syndrome took 644 mg of soybeans´ phyotestrogenes DT56a in the period of 4 weeks. In course of the therapy, the total number of hot flushes decreased by 48 %, and the intensity decreased by 35 % (p < 0.01). In 85 % of women, the quantity or intensity of hot flushes decreased. Sleep quality increased in 65 % of women, headaches improved or significantly improved in 51 % of women, muscle aches and joint pains decreased by 40 %. Life quality improved in 72 % of women. CONCLUSIONS: DT56a is a possible alternative for the treatment of acute climacteric syndrome. In the Central European population, the efficacy of a daily dose of 644 mg corresponds with the effects observed in the Mediterranean population (Tab. 2, Fig. 3, Ref. 21). Text in PDF www.elis.skKEY WORDS: DT56a, climacteric syndrome, menopause, non-hormonal treatment.


Assuntos
Fogachos , República Tcheca/epidemiologia , Feminino , Fogachos/tratamento farmacológico , Fogachos/epidemiologia , Humanos , Extratos Vegetais , Estudos Prospectivos , Eslováquia
11.
Environ Res ; 197: 110891, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33722529

RESUMO

CONTEXT: Phthalate exposure is associated with altered reproductive function, but little is known about associations of phthalate exposure with risk of hot flashes. OBJECTIVE: To investigate associations of urinary phthalate metabolite levels with four hot flash outcomes in midlife women. DESIGN: A cross-sectional study of the first year of a prospective cohort of midlife women, the Midlife Women's Health Study (2006-2015), a convenience sample from an urban setting. PARTICIPANTS: 728 multi-racial/ethnic pre- and perimenopausal women aged 45-54 years. OUTCOME MEASURES: Women completed questionnaires about hot flash experience and provided 1-4 urine samples over four consecutive weeks that were pooled for analysis. Phthalate metabolites were assessed individually and as molar sums representative of common compounds (all phthalates: Æ©Phthalates; DEHP: Æ©DEHP), exposure sources (plastics: Æ©Plastic; personal care products: Æ©PCP), and modes of action (anti-androgenic: Æ©AA). Covariate-adjusted logistic regression models were used to assess associations of continuous natural log-transformed phthalate metabolite concentrations with hot flash outcomes. Analyses were conducted to explore whether associations differed by menopause status, body mass index (BMI), race/ethnicity, and depressive symptoms. RESULTS: Overall, 45% of women reported a history of hot flashes. Compared to women who never experienced hot flashes, every two-fold increase in Æ©Plastic was associated with 18% (OR: 1.18; 95%CI: 0.98, 1.43) and 38% (OR: 1.38; 95%CI: 1.11, 1.70) higher odds of experiencing hot flashes in the past 30 days and experiencing daily/weekly hot flashes, respectively. Some associations of phthalates with certain hot flash outcomes differed by menopause status, BMI, race/ethnicity, and depressive symptoms. CONCLUSIONS: This study suggests that phthalates are associated with hot flash experience and may impact hot flash risk in women who are susceptible to experiencing hot flashes.


Assuntos
Fogachos , Menopausa , Estudos Transversais , Feminino , Fogachos/induzido quimicamente , Fogachos/epidemiologia , Humanos , Ácidos Ftálicos , Estudos Prospectivos
12.
Obstet Gynecol Clin North Am ; 48(1): 215-229, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33573787

RESUMO

The World Health Organization estimates that more than 260 million people are affected by depression worldwide, a condition that imposes a significant burden to individuals, their families, and society. Women seem to be disproportionately more affected by depression than men, and it is now clear that some women may experience windows of vulnerability for depression at certain reproductive stages across their life span, including the midlife transition. For some, age, the presence of cardiovascular or metabolic problems, and the emergence of significant, bothersome vasomotor symptoms and sleep problems may result in a compounded, deleterious impact on well-being and overall functioning.


Assuntos
Depressão/epidemiologia , Depressão/terapia , Antidepressivos/uso terapêutico , Ansiedade/epidemiologia , Cognição , Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo Maior/epidemiologia , Estrogênios/uso terapêutico , Feminino , Fogachos/epidemiologia , Humanos , Acontecimentos que Mudam a Vida , Menopausa , Pessoa de Meia-Idade , Prevalência , Qualidade de Vida , Fatores de Risco , Sono
13.
Breast Cancer Res Treat ; 187(2): 427-435, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33575860

RESUMO

PURPOSE: To determine the nature and severity of vasomotor symptoms, sexual problems, mood and sleep disturbance in community-dwelling breast cancer patients, whether and where they received treatment for these symptoms and their satisfaction with treatment received. METHODS: Online cross-sectional survey distributed through Breast Cancer Network Australia (BCNA). RESULTS: 524/2286 women responded to the invitation to participate. Of these, 74% (385/523) reported symptoms of interest and were included in the analysis. Mean age was 55.2 years and mean time since breast cancer diagnosis was 5.7 years. Most (66%) had received chemotherapy and were taking endocrine therapy (64%). The most common symptoms were hot flushes/night sweats and sleep disturbance (both 89%), vaginal dryness (75%), mood swings (62%) and sexual problems (60%). Symptoms were mild (21-33%) or moderate (21-38%) in around one third and severe in up to one quarter (8-26%). Symptoms affected the ability to "get on with their life" for 36%, predicted by severity of hot flushes (OR 1.4), sleep disturbance (OR 1.3), mood disturbance (OR 1.3), and sexual problems (OR 1.3). Only 32% were offered treatment, mostly delivered by GPs (33%) or oncologists (26%). Only 49% found this "somewhat effective" and 34% found it ineffective. The majority (60%) wanted more support to manage their symptoms. CONCLUSION: Menopausal symptoms, sexual problems, mood and sleep difficulties are common after breast cancer and often not effectively managed. There is an unmet need for coordinated care providing effective treatments.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Transtornos do Sono-Vigília , Austrália/epidemiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Estudos Transversais , Feminino , Fogachos/epidemiologia , Fogachos/etiologia , Fogachos/terapia , Humanos , Menopausa , Pessoa de Meia-Idade , Sono , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Transtornos do Sono-Vigília/terapia
14.
J Assoc Nurses AIDS Care ; 32(2): 174-187, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33449581

RESUMO

ABSTRACT: As persons living with HIV live longer, it is important to understand the symptoms experienced by menopausal women living with HIV (WLWH). This study used best-worst scaling (BWS) to determine the menopausal symptoms that are most burdensome for Cambodian WLWH. Participants were asked to rate a list of menopausal symptoms in terms of the most and least burdensome in their lives via BWS. The final analysis included 183 participants, 67 of whom were premenopausal, 47 perimenopausal, and 69 postmenopausal women. Physical and mental exhaustion (mean best-worst score = 319) was rated as the most burdensome symptom, and hot flushes and sweating were the least burdensome (mean best-worst score = -181). The BWS provides information on priorities for the distribution of health care resources. Understanding how Cambodian WLWH prioritize burdensome menopausal symptoms is crucial for choosing the most contextually sensitive method to provide health care services and interventions.


Assuntos
Infecções por HIV/psicologia , Fogachos/epidemiologia , Menopausa/fisiologia , Adulto , Camboja/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Humor Irritável/fisiologia , Pessoa de Meia-Idade , Inquéritos e Questionários , Sudorese , Avaliação de Sintomas
15.
BMC Complement Med Ther ; 21(1): 29, 2021 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-33441145

RESUMO

BACKGROUND: Little is known about factors associated with a clinically relevant reduction in menopausal symptoms through a brief acupuncture approach for women with moderate-to-severe menopausal symptoms. METHODS: Post hoc analysis of a randomized controlled trial where participants were allocated to early versus late standardized acupuncture. Both the early group and the late group are included in this study. The late group got an identical intervention parallel staged by 6 weeks. By means of the relative importance, the effect was evaluated for both early versus late women with a 6-week follow-up. We included four symptom subscales from the validated MenoScores Questionnaire: hot flushes, day and night sweats, general sweating, menopausal-specific sleeping problems, as well as an overall score, which is the sum of the four outcomes in the analysis. RESULTS: 67 women with moderate to severe menopausal symptoms were included of whom 52 (77.6%) experienced a clinically relevant reduction in any of the four surveyed symptom subscales or overall score. 48 (71.6%) women experienced a clinically relevant reduction in any of the vasomotor symptom subscales: hot flushes, day and night sweats, general sweating. Women with vocational education were most likely to experience improvement compared to women with higher education. Beyond education, other factors of some importance for a clinically relevant reduction were no alcohol consumption, two or more births and urinary incontinence. CONCLUSIONS: Level of education was the most consistent factor associated with improvement. Beyond education, other factors of some importance were no alcohol consumption, two or more births and urinary incontinence. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov at April 21, 2016. The registration number is NCT02746497 .


Assuntos
Terapia por Acupuntura , Fogachos/epidemiologia , Fogachos/terapia , Escolaridade , Feminino , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Resultado do Tratamento
16.
Menopause ; 28(5): 517-528, 2021 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-33438893

RESUMO

OBJECTIVE: Sleep problems and menopausal symptoms are both common complaints among midlife women. However, the associations of the quality and quantity of sleep problems with the severity of menopausal symptoms have not been well studied. Thus, this study aims to examine the relationships between individual sleep problems and the additive number of sleep problems with severe menopausal symptoms among women during the menopausal transition. METHODS: Using the convenience sampling, a total of 848 middle-aged women in China were investigated from December 2017 to August 2018. All participants completed a questionnaire on sleep problems, Menopause Rating Scale, and the general information questionnaire. Based on the cutoff of the Menopause Rating Scale, participants were divided into the nonsevere menopausal symptom group and severe menopausal symptoms group. Propensity score matching was used to balance covariates between the two groups. Stepwise binary logistic regression and restricted cubic spline were applied to analyze the associations of individual and additive sleep problems with severe menopausal symptoms. RESULTS: After propensity score matching, no significant difference was observed between the nonsevere menopausal symptoms group and severe menopausal symptoms group (Ps > 0.05). Logistic regression analysis showed that five sleep problems ("feeling too hot," "having pain," "restless legs syndrome," "taking medicine to help sleep," and "having trouble staying awake") were closely associated with severe menopausal symptoms. The restricted cubic spline curve showed an upward trend in odds ratios between the number of these five sleep problems and severe menopausal symptoms, and women were more than twice as likely to suffer severe menopausal symptoms when they experienced more than three of these individual sleep problems. CONCLUSION: Both the individual and additive number of sleep problems exerted significant effects on severe menopausal symptoms. It might be useful for healthcare providers to set guidelines to support a healthy menopausal transition for midlife women.


Assuntos
Fogachos , Transtornos do Sono-Vigília , China/epidemiologia , Estudos Transversais , Feminino , Fogachos/epidemiologia , Humanos , Menopausa , Pessoa de Meia-Idade , Sono , Transtornos do Sono-Vigília/epidemiologia
17.
Menopause ; 28(5): 529-537, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33470756

RESUMO

OBJECTIVE: To comprehensively investigate and evaluate the prevalence, severity, and associated factors of menopausal symptoms in women with premature ovarian insufficiency (POI). In this study, the specific symptomatology experienced by women with POI and women with natural menopause was also compared. METHODS: In this cross-sectional study, 293 Chinese women with POI from an outpatient clinic were recruited between June 2014 and January 2019. The prevalence and severity of menopausal symptoms were assessed with modified Kupperman Menopausal Index. Participants completed a structured questionnaire, including medical history, menstrual characteristics, and sociodemographic data. Serum levels of reproductive hormones were measured. RESULTS: Among 293 women with POI (33.76 ±â€Š5.47 y), the most prevalent symptoms were mood swings (73.4%), insomnia (58.7%), sexual problems (58.7%), and fatigue (57.3%). Moderate-to-severe mood swings were most frequently reported (23.9%), followed by formication (17.4%) and hot flashes/sweating (17.1%). Compared with women with natural menopause, women with POI exhibited significantly higher risks for fatigue (odds ratio  = 1.42; 95% confidence interval, 1.04-1.94), melancholia (3.12; 1.94-5.01), mood swings (3.57; 2.33-5.45), insomnia (1.41; 1.02-1.96), and significantly lower risks for moderate-to-severe sexual problems (0.40; 0.23-0.69), any and moderate-to-severe muscle/joint pain (0.41; 0.27-0.62 and 0.45; 0.25-0.78, respectively). Living in urban areas and higher gravidity were independently associated with menopausal symptoms in women with POI. CONCLUSIONS: Women with POI experienced a high prevalence of menopausal symptoms, particularly related to psychological and sexual domains. Furthermore, women with POI tended to have more distressing menopausal symptoms compared with women with natural menopause.


Assuntos
Fogachos , Menopausa Precoce , Estudos Transversais , Feminino , Fogachos/epidemiologia , Humanos , Menopausa , Prevalência , Inquéritos e Questionários
18.
J Clin Endocrinol Metab ; 106(1): 1-15, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33095879

RESUMO

CONTEXT: Menopause, the permanent cessation of menses, reflects oocyte depletion and loss of gonadal steroids. It is preceded by a transition state, the perimenopause, which is characterized by the gradual loss of oocytes, altered responsiveness to gonadal steroid feedback, wide hormonal fluctuations, and irregular menstrual patterns. The goal of this mini-review is to discuss the basic pathophysiology of the menopausal transition and the hormonal and nonhormonal management of clinicopathology attributed to it. EVIDENCE ACQUISITION: A Medline search of epidemiologic, population-based studies, and studies of reproductive physiology was conducted. A total of 758 publications were screened. EVIDENCE SYNTHESIS: The reproductive hormonal milieu of the menopausal transition precipitates bothersome vasomotor symptoms, mood disruption, temporary cognitive dysfunction, genitourinary symptoms, and other disease processes that reduce the quality of life of affected women. The endocrine tumult of the menopause transition also exposes racial and socioeconomic disparities in the onset, severity, and frequency of symptoms. Hormone therapy (HT) treatment can be effective for perimenopausal symptoms but its use has been stymied by concerns about health risks observed in postmenopausal HT users who are older than 60 and/or women who have been postmenopausal for greater than 10 years. CONCLUSIONS: The menopause transition is a disruptive process that can last for over a decade and causes symptoms in a majority of women. It is important for clinicians to recognize early signs and symptoms of the transition and be prepared to offer treatment to mitigate these symptoms. Many safe and effective options, including HT, are available.


Assuntos
Terapia de Reposição de Estrogênios , Menopausa/fisiologia , Avaliação de Sintomas , Terapia de Reposição de Estrogênios/métodos , Terapia de Reposição de Estrogênios/estatística & dados numéricos , Feminino , Hormônios Esteroides Gonadais/sangue , Hormônios Esteroides Gonadais/fisiologia , Hormônios Esteroides Gonadais/uso terapêutico , Fogachos/diagnóstico , Fogachos/epidemiologia , Fogachos/etiologia , Fogachos/terapia , Humanos , Perimenopausa/fisiologia , Qualidade de Vida , Avaliação de Sintomas/métodos , Sistema Vasomotor/fisiopatologia
19.
BJOG ; 128(3): 603-613, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33135854

RESUMO

OBJECTIVE: To examine the association between age at menarche and risk of vasomotor menopausal symptoms (VMS) and whether midlife body mass index (BMI) modified the association. DESIGN: A pooled analysis of six cohort studies. SETTING: The International collaboration on the Life course Approach to reproductive health and Chronic disease Events (InterLACE). POPULATION: 18 555 women from the UK, USA and Australia. METHODS: VMS frequency data (never, rarely, sometimes and often) were harmonised from two studies (n = 13 602); severity data (never, mild, moderate and severe) from the other four studies (n = 4953). Multinominal logistic regression models were used to estimate relative risk ratios (RRRs) and 95% CIs adjusted for confounders and incorporated study as random effects. MAIN OUTCOME MEASURES: Hot flushes and night sweats. RESULTS: Frequency data showed that early menarche ≤11 years was associated with an increased risk of 'often' hot flushes (RRR 1.48, 95% CI 1.24-1.76) and night sweats (RRR 1.59, 95% CI 1.49-1.70) compared with menarche at ≥14 years. Severity data showed similar results, but appeared less conclusive, with RRRs of 1.16 (95% CI 0.94-1.42) and 1.27 (95% CI 1.01-1.58) for 'severe' hot flushes and night sweats, respectively. BMI significantly modified the association as the risk associated with early menarche and 'often' VMS was stronger among women who were overweight or obese than those of normal weight, while this gradient across BMI categories was not as strong with the risk of 'severe' VMS. CONCLUSIONS: Early age at menarche is a risk factor for VMS, particularly for frequent VMS, but midlife BMI may play an important role in modifying this risk. TWEETABLE ABSTRACT: Overweight and obesity exacerbate the risk of vasomotor symptoms associated with early menarche.


Assuntos
Fatores Etários , Fogachos/etiologia , Menarca/fisiologia , Menopausa/fisiologia , Sistema Vasomotor/fisiopatologia , Austrália/epidemiologia , Índice de Massa Corporal , Criança , Estudos de Coortes , Feminino , Fogachos/epidemiologia , Humanos , Hiperidrose/epidemiologia , Hiperidrose/etiologia , Modelos Logísticos , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Razão de Chances , Fatores de Risco , Sudorese , Reino Unido/epidemiologia , Estados Unidos/epidemiologia
20.
J Womens Health (Larchmt) ; 30(4): 533-538, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33217253

RESUMO

Background: Study to describe the degree of menopausal palpitation distress and its demographic, clinical, symptom, and quality-of-life (QOL) correlates. Analysis of existing, baseline, data from peri- and postmenopausal women, 42 to 62 years of age, who participated in the Menopause Strategies-Finding Lasting Answers for Symptoms and Health (MsFLASH) clinical trials testing interventions for vasomotor symptoms (n = 759). Up to 46.8% of menopausal women report having palpitations, yet the symptom is relatively understudied. Little is known about palpitation distress or its correlates. Materials and Methods: Degree of distress from "heart racing or pounding" was self-reported over the past two weeks as "not at all," "a little bit," "moderately," "quite a bit," or "extremely." Other measures included self-report forms, clinic-verified body mass index (BMI), vasomotor symptom diaries, and validated symptom and QOL tools. Results: The percentage who reported palpitation distress was 19.6%, 25.2%, and 33.5% in the three trials or 25.0% overall. In multivariate analysis, the odds of reporting palpitation distress was lower in past smokers (odds ratio [OR] = 0.59 [95% confidence interval (CI) 0.38-0.90]) and current smokers (OR = 0.48 [0.27-0.87]) relative to never-smokers and lower with every 5 kg/m2 higher BMI (OR = 0.82 [0.69-0.98]).The odds of reporting palpitation distress was higher with every five point more severe insomnia (OR = 1.28 [1.05-1.54]), five point worse depressive symptoms (OR = 1.47 [1.11-1.95]), five point worse perceived stress (OR = 1.19 [1.01-1.39]), and one point worse menopausal QOL (OR = 1.29 [1.06-1.57]). Conclusions: Menopausal palpitation distress is common and associated with demographic, clinical, symptom, and QOL factors. Findings can be used for screening in clinical practice and to justify additional research on this understudied symptom.


Assuntos
Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono , Feminino , Fogachos/epidemiologia , Humanos , Menopausa , Autorrelato
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