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1.
Zhen Ci Yan Jiu ; 44(7): 516-9, 2019 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-31368284

RESUMO

OBJECTIVE: To observe the therapeutic effect of body acupuncture combined with auricular acupuncture in the treatment of woman menopause insomnia induced by disharmony between the heart and kidney. METHODS: A total of 111 outpatients with menopausal insomnia were randomly divided into treatment group (n=55, body acupoints plus auricular points) and control group (n=56, body acupoints). For control group, Shenmen (HT7), Sanyinjiao (SP6), Anmian, Zhaohai (KI6), Shenmai (BL62), Sishencong (EX-HN1), Xinshu (BL15) and Shenshu (BL21) were needled with filiform needles, and HT7, SP6, Anmian, BL15 and BL21 were also stimulated with electroacupuncture (EA) for 30 min, once every other day, 3 times a week for 3 weeks. For the treatment group, auricular points as Kidney, Shenmen, Sympathetic and Endocrine around the ear canal and the ear cavity were punctured with filiform needles in combination with the same intervention methods mentioned above in the control group. The quality and efficiency of sleep were assessed by using Pittsburgh Sleep Quality Index (PSQI) scale before and after the treatment. The symptom scores of traditional Chinese medicine (TCM) and the therapeutic effect were determined according to the "Guide Principles for Clinical Research of New Drugs of TCM" (formulated by Chinese Ministry of Health, 1997). RESULTS: After the treatment, the scores of sleep quantity and effective rate of PSQI scale, and those of insomnia and dreaminess, dysphoria with feverish sensation in chest, palms and soles, paplpitation and irritability, fatigue and forgetfulness of TCM were reduced significantly in both groups compared with their own pre-treatment (P<0.05). Of the 56 and 55 cases in the control and treatment groups, 18 (32.1%) and 30 (54.5%) experienced a marked improvement in their symptoms, 28 (50.0%) and 22 (40.0%) were effective, and 10 (17.9%) and 3 (5.5%) failed, with the effective rate being 82.1% and 94.5%, respectively. The therapeutic effect of stimulation of the body acupoints plus auricular acupoints was significantly superior to that of stimulation of simple body acupoints in lowering scores of PSQI scale, insomnia and dreaminess, dysphoria with feverish sensation in chest, palms and soles, dizziness and tinninus, paplpitation and irritability, and tital fever and night sweating of TCM, as well as the effective rate (P<0.05). CONCLUSION: Both body acupuncture and body acupuncture combined with auricular acupuncture are effective in the treatment of woman menopause insomnia due to disharmony between the heart and kidney, and the two combined treatment was evidently better.


Assuntos
Acupuntura Auricular , Distúrbios do Início e da Manutenção do Sono , Pontos de Acupuntura , Feminino , Coração , Humanos , Rim , Menopausa , Distúrbios do Início e da Manutenção do Sono/terapia , Resultado do Tratamento
2.
Eur J Histochem ; 63(3)2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31455072

RESUMO

The aim of this study was to describe the structural and ultrastructural aspects of the myotendinous junction (MTJ) and the proximal and distal sarcomeres of the sternomastoid of aged Wistar rats subjected to an experimental model of menopause and swimming training. A total of 20 female elderly rats were divided into the following four groups (n=5 in each group): sedentary/no-menopausal (SNM), trained/no-menopausal (TNM), sedentary/menopausal (SM), and trained/menopausal (TM). The MTJ samples were dissected and analyzed using transmission electron microscopy. We showed that the TNM Group rats exhibited changes in morphological characteristics as a consequence of physical exercise, which included an increase of 36.60% (P<0.001) in the evagination length of the MTJ and a reduction in the length of the distal (77.38%) (P<0.0001) and proximal (68.15%) (P<0.0001) sarcomeres. The SM Group exhibited a reduction of about 275.93% (P<0.001) in the muscle-tendon interface and in the lengths of distal sarcomeres (55.87%) (P<0.0001) compared with SNM Group. Our results suggest that the swimming training under experimental model of menopause promoted tissue reorganization and increased muscle-tendon interaction with a drastic development in the length and thickness of the sarcoplasmatic invaginations and evaginations. In addition, the sarcomeres exhibited different lengths and a reduction in both groups subjected to swimming training.


Assuntos
Menopausa/fisiologia , Músculos do Pescoço/metabolismo , Condicionamento Físico Animal , Sarcômeros/metabolismo , Tendões/metabolismo , Animais , Feminino , Microscopia Eletrônica de Transmissão , Músculos do Pescoço/ultraestrutura , Ratos Wistar , Sarcômeros/ultraestrutura , Natação , Tendões/ultraestrutura
3.
Expert Rev Clin Pharmacol ; 12(8): 729-739, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31282768

RESUMO

Introduction: Many women seek treatment to alleviate menopausal vasomotor symptoms (VMS). Numerous women use combination compounded hormone therapy (CHT) to achieve the benefits of estrogen/progesterone for endometrial protection. TX-001HR is a combination of bioidentical 17ß-estradiol (E2) and progesterone (P4) in a single capsule designed for continuous daily use to treat moderate to severe VMS. Areas covered: This drug profile describes the efficacy and safety of 4 doses of this E2/P4 (mg/mg: 1/100, 0.5/100, 0.5/50, 0.25/50) for treating moderate to severe VMS in menopausal woman with a uterus. Expert opinion: In REPLENISH (NCT01942668), the two highest doses of TX-001HR significantly reduced VMS frequency and severity at 4 and 12 weeks versus placebo (co-primary endpoints); all doses met the primary endpoint of endometrial safety. Rates of amenorrhea were high and improved over time; the Menopause Quality of Life and Medical Outcomes Study-Sleep instruments improved with E2/P4. TX-001HR was well tolerated and had no clinically significant impact on vital signs, metabolic or coagulation parameters, or breast safety. The combination bioidentical E2/P4 capsule (1 mg/100 mg dose was FDA-approved as Bijuva in October 2018) may provide a safe, effective, rigorously studied alternative for women with a uterus who prefer CHT for relief of VMS.


Assuntos
Estradiol/administração & dosagem , Menopausa , Progesterona/administração & dosagem , Qualidade de Vida , Administração Oral , Cápsulas , Relação Dose-Resposta a Droga , Estradiol/efeitos adversos , Estradiol/farmacologia , Feminino , Fogachos/tratamento farmacológico , Humanos , Progesterona/efeitos adversos , Progesterona/farmacologia , Índice de Gravidade de Doença , Sudorese/efeitos dos fármacos
4.
Rev Assoc Med Bras (1992) ; 65(6): 864-869, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340318

RESUMO

OBJECTIVE: This study aims to verify the association between risk factors for the onset of SUI and transobturator suburethral sling surgical treatment outcomes. PATIENTS AND METHODS: A retrospective study was conducted with 57 patients operated by the Pelvic Floor Surgery Service. Demographic data were compiled from the sample, the body mass index (BMI) was calculated, and the patients were divided according to the response to the surgical treatment. RESULTS: A total of 77.2% of the sample was cured or improved after surgical treatment. Out of the total sample, 75.4% of the women were postmenopausal, and 73.7% denied current or past smoking. The median age was 61 years, the median number of births was 4.0, the median BMI was 28.6 kg/m2, and 50.9% of the sample was classified as pre-obese. BMI, menopausal status, age, smoking, and sexual activity were not factors associated with the surgical outcome. However, parity equal to or greater than 5 was associated with worse postoperative results (p = 0.004). CONCLUSIONS: among risk factors associated with the emergence of SUI, only parity greater than 4 showed a negative impact on transobturator sling surgery outcomes.


Assuntos
Slings Suburetrais , Incontinência Urinária por Estresse/cirurgia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Feminino , Humanos , Modelos Logísticos , Menopausa/fisiologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Paridade/fisiologia , Estudos Retrospectivos , Fatores de Risco , Comportamento Sexual/fisiologia , Fumar/efeitos adversos , Resultado do Tratamento
5.
Medicine (Baltimore) ; 98(30): e16421, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348242

RESUMO

Cervical cancer is among the most frequent cancer types in women worldwide. Radiotherapy, including external beam radiation and brachytherapy, is one of the commonly used treatment options for cervical cancer. However, the adverse effects of radiation therapy on cervical cancer survival have been poorly investigated with inconclusive results. Therefore, the aim of this study was to determine the suitable radiotherapy modality according to patients' characteristics. A retrospective survival analysis of 44,602 patients was performed using the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate proportional hazard Cox model was used to evaluate the prognostic impact of different radiotherapy modalities, primary surgery, age, TNM stage, and tumor size. Our results indicated that patients without primary surgery, diagnosed at older age (≥45 years' old), at advanced TNM stages (III/IV) or with larger tumor size (≥3 cm) could benefit from radiotherapy. However, radiotherapy was detrimental in patients with primary surgery, diagnosed at younger age (<45 years' old), at earlier TNM stages (I/II) or with smaller tumor size (<3 cm). In addition, external beam radiation was in most cases less effective compared with combined external beam and brachytherapy. These results highlighted the necessity of realizing personalized radiotherapy treatments for patients with cervical cancer.


Assuntos
Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/radioterapia , Adulto , Fatores Etários , Idoso , Braquiterapia/métodos , Feminino , Humanos , Estimativa de Kaplan-Meier , Menopausa , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Observacionais como Assunto , Prognóstico , Estudos Retrospectivos , Programa de SEER , Fatores Socioeconômicos , Carga Tumoral , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia
6.
Gene ; 711: 143937, 2019 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-31228541

RESUMO

BACKGROUND & OBJECTIVES: Vaginal atrophy is characterized by thinning of vaginal epithelial layers and decreased local blood flow. We aimed to evaluate the regenerative effects of Adipose derived mesenchymal stem cells (ADMSC) and Bone marrow derived mesenchymal stem cells (BMDSC) on vaginal atrophy in rat menopause model. MATERIALS AND METHODS: Rats were randomly divided into 4 (four) groups: sham, control, ADMSC, BMDSC. Vaginal epithelial thickness, structure of the lamina propria, blood vessels in the lamina propria, collagen deposition, and muscle structure were evaluated. Anti ER α, VEGF, VEGFR 1, Bax and bcl-2 antibodies were analyzed. Beta actin gene was used as endogenous control. Genetical differences among the groups were compared by using Kruskal Wallis and Mann Whitney U test. p < 0.05 was regarded as statistically significant. RESULTS: Epithelial thickness of ADMSC group was higher than control group, but less than sham group Epithelial thickness of BMDSC group was less than sham group. Lamina propria and muscle tissue of ADMSC and BMDSC groups were found to be similar to sham group. VEGFR-1, VEGF, Bax and ER-α staining levels were higher in ADMSC and BMDSC groups than control group. ADMSC group stained stronger with VEGFR-1 and VEGF than BMDSC group. Bcl-2 staining level was increased in ADMSC applied group. No statistically significant difference was detected in Bax and Bcl-2 genes and Bax-/Bcl-2 ratio. CONCLUSIONS: Although genetic expression might have ended and could not be significantly demonstrated, histological and immunohistochemical results favor ADMSC application in vaginal atrophy rather than BMDSC.


Assuntos
Tecido Adiposo/citologia , Biomarcadores/metabolismo , Células da Medula Óssea/citologia , Menopausa/fisiologia , Transplante de Células-Tronco Mesenquimais/métodos , Vagina/patologia , Tecido Adiposo/metabolismo , Animais , Atrofia , Células da Medula Óssea/metabolismo , Células Cultivadas , Modelos Animais de Doenças , Receptor alfa de Estrogênio/metabolismo , Feminino , Humanos , Menopausa/metabolismo , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Ratos , Vagina/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/metabolismo , Proteína X Associada a bcl-2/metabolismo
7.
Artigo em Chinês | MEDLINE | ID: mdl-31163520

RESUMO

Objective:To investigate relationship between the level of estrogen, calcium and phosphorus concentration in serum with benign paroxysmal positional vertigo(BPPV). Method:A total of 84 patients with idiopathic BPPV were enrolled in the experimental group, including 32 non-menopausal women, 24 menopausal women, and 28 males; 83 healthy people without vertigo and vestibular disease were selected as the control group consisted with 32 non-menopausal women, 24 menopausal women and 27 males. The levels of estradiol, serum calcium and serum inorganic phosphorus were measured in all participants. The difference of estrogen level, serum calcium and serum inorganic phosphorus concentration between the experimental group and the control group was analyzed by t test. Result:The total number, age distribution and gender composition of the experimental group and the control group were basically paired, and the age difference was not statistically significant (P=0.71). The overall estrogen level in the experimental group was lower than that in the control group (P<0.01). Among them, the female group's estrogen level, menopausal female estrogen level and male estrogen level in the experimental group were lower than the control group (P<0.01); there was no significant difference in serum calcium and serum inorganic phosphorus concentration between the experimental group and the control group (P=0.55, 0.11, respectively). Conclusion:The decrease of estrogen level may be a risk factor for idiopathic BPPV. The relationship between serum calcium and serum inorganic phosphorus concentration and BPPV needs further study.


Assuntos
Vertigem Posicional Paroxística Benigna , Cálcio , Estrogênios , Fósforo , Adulto , Vertigem Posicional Paroxística Benigna/sangue , Cálcio/sangue , Estrogênios/sangue , Feminino , Humanos , Masculino , Menopausa , Pessoa de Meia-Idade , Fósforo/sangue
8.
Pan Afr Med J ; 32: 1, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31182986

RESUMO

Introduction: In Africa, sex life after menopause remains an under-explored topic due to the fact that it is a taboo. This study aims to evaluate the quality of couple's sex life during menopause. Methods: We conducted a cross-sectional survey of a representative sample of 320 postmenopausal women. The inclusion criteria were natural menopause. Patients who had experienced early or iatrogenic menopause were excluded. Investigation form was divided into 4 sections: social and cultural characteristics, clinical data, psycho-sexual data and therapeutic data. Comparison of proportions and chi-squared test with a significance threshold of less than 0.05 were used. Results: The average age of women was 60 years; the average age of onset of menopause was 48 years and the age of the menopause was 11.3 years. All woman suffered from climacteric syndrome. Hot flushes occured in 85.9% of women, vaginal dryness in 62.8% and urinary disorders in 52.5%. Only married women reported having sex with their partner (62.1%). Women had sex occasionally in 68.9% of cases, while 18.1% of women reported no sexual activity. Decreased sexual activity was due to partner's erectile dysfunction (62% of couples) and the lack of sexual desire (83.5% of women). Lack of sexual appetite and orgasm were also reported in 92% and 100% of cases. However, 93.5% of married women thought their life was bearable. Conclusion: Marital status, dyspareunia, vaginal dryness and partner's erectile dysfunction have a significant impact on sexuality of menopausal women in Senegal.


Assuntos
Pós-Menopausa , Comportamento Sexual/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Sexualidade/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Dispareunia/epidemiologia , Disfunção Erétil/epidemiologia , Feminino , Humanos , Masculino , Menopausa/fisiologia , Pessoa de Meia-Idade , Senegal , Parceiros Sexuais , Inquéritos e Questionários , Doenças Vaginais/epidemiologia
9.
Maturitas ; 125: 57-62, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31133219

RESUMO

OBJECTIVES: Treatments for genitourinary syndrome of menopause (GSM) may not be suitable for all women, may not be completely effective, and may cause adverse effects. Therefore, there is a need to explore new treatment approaches. The objectives were to evaluate the feasibility of using a pelvic floor muscle training (PFMT) program in postmenopausal women with GSM, and to investigate its effect on symptoms, signs, activities of daily living (ADL), quality of life (QoL) and sexual function. STUDY DESIGN: Postmenopausal women with GSM participated in a single-arm feasibility study embedded in a randomized controlled trial (RCT) on PFMT for urinary incontinence. This substudy was composed of two pre-intervention evaluations, a 12-week PFMT program and a post-intervention evaluation. MAIN OUTCOME MEASURES: Feasibility was defined as study completion and participation in physiotherapy sessions and in-home exercises. The effects of the PFMT program were assessed by measuring GSM symptoms ('Most Bothersome Symptom' approach, ICIQ-UI SF), GSM signs (Vaginal Health assessment scale), GSM's impact on ADL (Atrophy Symptom questionnaire), QoL and sexual function (ICIQ-VS, ICIQ-FLUTSsex) and leakage episodes. RESULTS: Thirty-two women participated. The study completion rate was high (91%), as was participation in treatment sessions (96%) and in-home exercises (95%). Post-intervention, there were significant reductions in GSM symptoms and signs (p < 0.01) as well as in its impacts on ADL, QoL and sexual function (p < 0.05). CONCLUSIONS: A study including a PFMT program is feasible, and the outcomes indicate PFMT to be an effective treatment approach for postmenopausal women with GSM and urinary incontinence. This intervention should be assessed through a RCT.


Assuntos
Atrofia/fisiopatologia , Terapia por Exercício/métodos , Menopausa , Diafragma da Pelve/fisiopatologia , Incontinência Urinária/reabilitação , Vagina/fisiopatologia , Atividades Cotidianas , Idoso , Atrofia/patologia , Terapia por Estimulação Elétrica , Estudos de Viabilidade , Feminino , Doenças dos Genitais Femininos/psicologia , Doenças dos Genitais Femininos/reabilitação , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Sexualidade , Inquéritos e Questionários , Resultado do Tratamento , Incontinência Urinária/psicologia , Vagina/patologia
10.
Maturitas ; 125: 70-80, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31133221

RESUMO

OBJECTIVES: The aim of this study was to prospectively assess the relationship between several reproductive factors in women and the likelihood of reaching the age of 90 years (achieving longevity). STUDY DESIGN: For this study, data from the oldest birth cohort (1916-17) of the prospective Netherlands Cohort Study (NLCS) were used. These participants filled in a baseline questionnaire in 1986 (at age 68-70 years). Follow-up for vital status information until the age of 90 years (2006-07) was >99.9% complete. MAIN OUTCOME MEASURES: Multivariable-adjusted Cox regression analyses with a fixed follow-up time were based on 2,697 women with complete exposure and co-variable data to calculate risk ratios (RR) of reaching age 90. RESULTS: No associations were observed between the likelihood of reaching the age of 90 years, and age at menarche, age at menopause, parity, menstrual lifespan, and oral contraceptive use after adjustment for potential confounders. A later age at first childbirth pointed towards a higher chance of achieving longevity (age ≥30 vs. 20-24; RR,1.17; 95%CI,0.98-1.39). Ever-use of hormone replacement therapy (HRT) was significantly associated with a higher chance of achieving longevity compared with never HRT-users, but only in women who had had an early menopause (<50 years)(RR,1.32; 95% CI, 1.07-1.61). CONCLUSION: Age at first childbirth, and ever-use of HRT in women with an early menopause (<50 years) were associated with the likelihood of reaching the age of 90 years.


Assuntos
Terapia de Reposição Hormonal/métodos , Longevidade , Idade Materna , Menarca , Menopausa , Adolescente , Adulto , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Países Baixos , Razão de Chances , Paridade , Gravidez , Modelos de Riscos Proporcionais , Estudos Prospectivos , História Reprodutiva , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
12.
Biomed Res Int ; 2019: 3842312, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31058188

RESUMO

There are about 1-2 million follicles presented in the ovary at birth, while only around 1000 primordial follicles are left at menopause. The ovarian function also decreases in parallel with aging. Folliculogenesis is vital for ovarian function, no matter the synthesis of female hormones or ovulation, yet the mechanisms for its changing with increasing age are not fully understood. Early follicle growth up to the large preantral stage is independent of gonadotropins in rodents and relies on intraovarian factors. To further understand the age-related molecular changes in the process of folliculogenesis, we performed microarray gene expression profile analysis using total RNA extracted from young (9 weeks old) and old (32 weeks old) mouse ovarian secondary follicles. The results of our current microarray study revealed that there were 371 (≥2-fold, q-value ≤0.05) genes differentially expressed in which 174 genes were upregulated and 197 genes were downregulated in old mouse ovarian secondary follicles compared to young mouse ovarian secondary follicles. The gene ontology and KEGG pathway analysis of differentially expressed genes uncovered critical biological functions such as immune system process, aging, transcription, DNA replication, DNA repair, protein stabilization, and apoptotic process were affected in the process of aging. The considerable changes in gene expression profile may have an adverse influence on follicle quality and folliculogenesis. Our study provided information on the processes that may contribute to age-related decline in ovarian function.


Assuntos
Envelhecimento/genética , Folículo Ovariano/crescimento & desenvolvimento , Ovário/crescimento & desenvolvimento , RNA/genética , Animais , Reparo do DNA/genética , Replicação do DNA/genética , Feminino , Regulação da Expressão Gênica no Desenvolvimento/genética , Humanos , Menopausa/genética , Camundongos , Oócitos/crescimento & desenvolvimento , Oócitos/metabolismo , Folículo Ovariano/metabolismo , Ovário/metabolismo , Ovulação/genética , RNA/biossíntese , Transcriptoma/genética
13.
Med Clin North Am ; 103(4): 601-612, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078195

RESUMO

Women undergo developmental and cyclic changes in hormonal exposures that affect brain function and mental health. Some women are more vulnerable to the effects of these hormonal exposures, for reasons that remain to be determined. Evidence to date indicates that anxiety and mood disorders are the most sensitive to hormonal fluctuations in women but there is also growing evidence for a protective effect of female reproductive hormones on schizophrenia. The hormonal exposures of the menstrual cycle, pregnancy, the postpartum period, lactation, and menopause are quite different and may be associated with at least partially distinct symptom profiles.


Assuntos
Hormônios/metabolismo , Desenvolvimento Humano/fisiologia , Menopausa/metabolismo , Sistemas Neurossecretores/fisiologia , Estrogênios/metabolismo , Feminino , Humanos , Saúde da Mulher
14.
Med Clin North Am ; 103(4): 651-667, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31078198

RESUMO

Windows of vulnerability for depression have been associated with increased sensitivity to hormonal changes experienced by some women during the luteal phase, postpartum, and/or menopause. Increased awareness has resulted in greater adoption of screening tools for mood and behavioral changes and tailored therapies. This article discusses study results and controversies surrounding therapies uniquely designed for menopause-related depression.


Assuntos
Antidepressivos/uso terapêutico , Terapia de Reposição de Estrogênios/estatística & dados numéricos , Menopausa/fisiologia , Transtornos do Humor/etiologia , Adulto , Feminino , Fogachos/tratamento farmacológico , Fogachos/etiologia , Humanos , Transtornos do Humor/diagnóstico , Transtornos do Humor/terapia , Saúde da Mulher
15.
Medicine (Baltimore) ; 98(20): e15637, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096480

RESUMO

BACKGROUND: Warm needle acupuncture (WNA) is a traditional Chinese medicine (TCM) therapy which combines technical advantages of acupuncture and moxibustion. Climacteric insomnia is a common symptom in climacteric women, which can seriously affect the physical and mental health of patients. Relevant studies have been reported that WNA can improve insomnia in climacteric women. In this protocol, the effectiveness and safety of WNA on insomnia in climacteric women will be explored. METHODS: Seven electronic databases include 3 English databases [Excerpta Medica database (EMBASE), PubMed, the Cochrane Central Register of Controlled Trials (Cochrane Library)] and 4 Chinese databases [Chinese VIP Information, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM) and Wanfang Database] for randomised controlled trials (RCT) of WNA on insomnia in climacteric women will be searched. The changes of the Pittsburgh sleep quality index was used as the main outcome, and the secondary outcome includes the changes of the Kupperman score, serum hormone level, and TCM syndrome score, as well as the adverse events caused by WNA. We will use RevMan software V5.3 to help us to analyze all data and use a Cochrane risk of bias tool to help us to assess the methodological quality for RCTs. RESULT: This study will provide reliable evidence for WNA on insomnia in climacteric women CONCLUSION:: The findings will be an available reference to evaluate the effectiveness and safety of WNA on insomnia in climacteric women. REGISTRATION: PROS-PERO CRD42019125743.


Assuntos
Terapia por Acupuntura/métodos , Menopausa/fisiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/terapia , Estrogênios/sangue , Feminino , Humanos , Medicina Tradicional Chinesa , Agulhas , Ensaios Clínicos Controlados Aleatórios como Assunto , Sono/fisiologia
16.
Maturitas ; 124: 25-31, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097174

RESUMO

OBJECTIVE: Evidence suggests the menopausal period may be a unique window of vulnerability for the development or exacerbation of eating disorder symptoms among middle-aged women; however, it is unclear who is most at risk during this period. The goal of this study was to evaluate whether appearance-related aging concerns and body comparison, two sociocultural factors, moderated the association between menopausal status and disordered eating behaviors and body image concerns among middle-aged women. METHOD: Participants (N = 310) completed an online survey about their menopausal status, aging concerns, body comparison, disordered eating, and body image concerns. RESULTS: Tests of moderator models revealed that at low levels of aging concerns, peri-menopausal women reported greater dietary restraint than pre-menopausal or post-menopausal women. Additionally, among women with high scores for body comparison, post-menopausal women reported significantly more dietary restraint than either pre- or peri-menopausal women. DISCUSSION: These findings suggest that the effects of menopause on dietary restraint may be stronger for some women than others.


Assuntos
Envelhecimento/psicologia , Imagem Corporal/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Menopausa/psicologia , Adulto , Idoso , Atitude , Índice de Massa Corporal , Comportamento Alimentar , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
17.
Maturitas ; 124: 32-34, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097175

RESUMO

Obstructive sleep apnoea (OSA) is a common disorder, in which loss of pharyngeal dilator muscle tone during sleep causes recurrent collapse of the upper airway and temporary cessation of breathing. Repeated apneas and hypopneas lead to cycles of intermittent hypoxia/hypercapnia, increased negative intrathoracic pressure and arousals from sleep. These consequences of OSA are associated with a cascade of cardiovascular and neurohumoral consequences, including sympathetic nervous system hyperactivity, raised heart rate variability, increases in blood pressure, myocardial wall stress, oxidative stress, systemic inflammation, platelet aggregation and impaired vascular endothelial function, which contribute, in turn, to increased cardiovascular risk and, in particular, to the development of chronic systemic arterial hypertension and arrhythmias, especially atrial fibrillation (AF). Given that the prevalence of OSA is modified by age and gender, OSA-related cardiovascular diseases may also be affected by the same factors. This review focuses on the potential role of OSA in systemic arterial hypertension and AF, and discusses the most interesting studies on age and gender as predisposing factors.


Assuntos
Fibrilação Atrial/epidemiologia , Hipertensão/epidemiologia , Menopausa/fisiologia , Apneia Obstrutiva do Sono/epidemiologia , Pressão Arterial , Feminino , Humanos , Prevalência , Fatores de Risco , Apneia Obstrutiva do Sono/fisiopatologia
18.
Maturitas ; 124: 35-38, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097176

RESUMO

Obstructive sleep apnea (OSA) is a chronic and common adult disorder characterized by recurrent episodes of upper-airway obstruction and reopening during sleep. OSA is associated with intermittent hypoxia, sympathetic overactivity, oxidative stress and high cardiovascular mortality and morbidity. It is known to be more common in men than women, partly due to differences in anatomy and functional respiratory components. There are also gender differences in reported symptoms, leading to potential under-diagnosis in females. This gender difference tends to decrease after menopause, demonstrating a role of menopausal status itself in OSA phenotypes. Aging, fat mass distribution, sex hormones and upper-airway collapsibility are postulated to play a major role in these findings. This review focuses on the most recent studies exploring gender differences in the prevalence, pathogenesis and clinical features of OSA. It discusses the role of menopause in this, and explore the underlying pathophysiological mechanisms.


Assuntos
Menopausa/fisiologia , Apneia Obstrutiva do Sono/epidemiologia , Adiposidade , Fatores Etários , Feminino , Hormônios Esteroides Gonadais/sangue , Humanos , Músculos Faríngeos/fisiopatologia , Prevalência , Índice de Gravidade de Doença , Fatores Sexuais , Apneia Obstrutiva do Sono/fisiopatologia
19.
Fertil Steril ; 111(4): 780-786, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30929733

RESUMO

OBJECTIVE: To observe the effects of menopause, age at natural menopause (ANM), and aging on the trend in body mass index (BMI). DESIGN: Prospective cohort with a 15-year follow-up of 929 women. Data obtained from the Tehran Lipid and Glucose Study. SETTING: Not applicable. INTERVENTION(S): none. PARTICIPANT(S): Of women participating in the Tehran Lipid and Glucose Study, 929 who were reproductive during the study and menopaused at the last follow-up were included. Anthropometric data were measured repeatedly every 3 years, and the trend in BMI, associated with menopause and ANM, was tested using the generalized estimating equation. MAIN OUTCOME MEASURE(S): Body mass index in each follow-up session. RESULT(S): The adjusted model of the generalized estimating equation illustrates that BMI increases by age (ß = 0.16) and menopausal status (ß = 1.11). It also shows that women with higher ANM experienced a decreasing BMI (ß = -0.03) compared with women with lower ANM. The interaction term of menopause and time (menopause × time) has a negative effect on BMI; that is, the usual increase in BMI after menopause is attenuated by time. (ß = -0.4, 95% confidence interval -0.6, -0.3). CONCLUSION(S): Menopause and aging are independently correlated with increasing BMI. The trend in BMI, however, depends on the ANM of study participants: women with higher ANM than mean ANM of our population (i.e., 49 years) face a decreasing BMI compared with those with lower ANM.


Assuntos
Envelhecimento/fisiologia , Índice de Massa Corporal , Menopausa/fisiologia , Adulto , Fatores Etários , Feminino , Seguimentos , Humanos , Irã (Geográfico)/epidemiologia , Pessoa de Meia-Idade , Estudos Prospectivos
20.
Gynecol Oncol ; 153(3): 580-588, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30935715

RESUMO

OBJECTIVE: Evidence on the endometrial and ovarian cancer burden preventable through modifications to current causal behavioural and hormonal exposures is limited. Whether the burden differs by population subgroup is unknown. METHODS: We linked pooled data from six Australian cohort studies to national cancer and death registries, and quantified exposure-cancer associations using adjusted proportional hazards models. We estimated exposure prevalence from representative health surveys. We then calculated Population Attributable Fractions (PAFs) with 95% confidence intervals (CIs), accounting for competing risk of death, and compared PAFs for population subgroups. RESULTS: During a median 4.9 years follow-up, 510 incident endometrial and 303 ovarian cancers were diagnosed. Overweight and obesity explained 41.9% (95% CI 32.3-50.1) of the endometrial cancer burden and obesity alone 34.5% (95% CI 27.5-40.9). This translates to 12,800 and 10,500 endometrial cancers in Australia in the next 10 years, respectively. The body fatness-related endometrial cancer burden was highest (49-87%) among women with diabetes, living remotely, of older age, lower socio-economic status or educational attainment and born in Australia. Never use of oral contraceptives (OCs) explained 8.1% (95% CI 1.8-14.1) or 2500 endometrial cancers. A higher BMI and current long-term MHT use increased, and long-term OC use decreased, the risk of ovarian cancer, but the burden attributable to overweight, obesity or exogenous hormonal factors was not statistically significant. CONCLUSIONS: Excess body fatness, a trait that is of high and increasing prevalence globally, is responsible for a large proportion of the endometrial cancer burden, indicating the need for effective strategies to reduce adiposity.


Assuntos
Diabetes Mellitus/epidemiologia , Neoplasias do Endométrio/epidemiologia , Obesidade/epidemiologia , Neoplasias Ovarianas/epidemiologia , Adiposidade , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Índice de Massa Corporal , Estudos de Coortes , Anticoncepcionais Orais/uso terapêutico , Neoplasias do Endométrio/prevenção & controle , Feminino , Inquéritos Epidemiológicos , Terapia de Reposição Hormonal , Humanos , Incidência , Menopausa , Pessoa de Meia-Idade , Neoplasias Ovarianas/prevenção & controle , Fatores de Proteção , Sistema de Registros , Características de Residência , Fatores de Risco , População Rural , Fatores Socioeconômicos , Adulto Jovem
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