Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.632
Filtrar
1.
Menopause ; 29(7): 868-876, 2022 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-35796559

RESUMO

OBJECTIVE: All women will experience menopause transition, and a majority will experience symptoms that negatively affect their quality of life. Current validated menopause symptom scales are time consuming, phrased in clinical language, and difficult to adopt for digital use. This study seeks to validate a short novel survey which can be reliably completed without coaching and accurately represents the experience of the menopause transition. METHODS: We developed a patient-centric questionnaire (Menopause Transition Scale, MTS) to examine for symptoms of menopause. Survey responders represented a total of 144 women with at least one symptom of menopause. Survey responders included women affected by cancer aged 30 to 65 (n = 72) and women not affected by cancer aged 45 to 60 (n = 72). Cronbach Alpha was used to examine for internal consistency and dimensionality was assessed using exploratory factor analysis. The cross-validation was analyzed against established patient scales using Spearman correlations or Chi-Square analysis, as appropriate. RESULTS: The MTS questions showed internal consistency with a Cronbach Alpha of 0.63. The individual questions loaded into three unique domains. The MTS overall correlated with validated scales for menopause symptoms, the Menopause-Specific Quality of Life Questionnaire (r = -0.86, P < 0.0001) and Greene Climacteric Scale (r = -0.65, P < 0.0001). Libido correlated with scales (P = 0.0150) and subscales (r = -0.70, P < 0.0001) relating low sexual desire. Energy (r = -0.62, P < 0.0001), Mood (r = -0.48, P < 0.0001), and Hot Flashes/Night Sweats (r = -0.77, P < 0.0001) correlated with scales and subscales related to mood, depression, and vasomotor symptoms. The majority of our responders expressed mild vaginal bleeding. The highest frequency of severe symptoms were low libido and poor energy. CONCLUSIONS: The MTS is a short thorough patient-centric survey that is readily amenable to digital adoption to measure symptoms of menopause as women transition in the out-patient setting. Further study is needed for the longitudinal assessment of symptoms through the transition process and the response of women to therapeutic options.Video Summary: http://links.lww.com/MENO/A938.


Assuntos
Climatério , Qualidade de Vida , Feminino , Fogachos , Humanos , Libido , Menopausa/fisiologia , Inquéritos e Questionários
2.
Menopause ; 29(6): 707-713, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35674651

RESUMO

OBJECTIVES: Perimenopause is commonly viewed as a window of vulnerability for developing psychiatric and eating disorders, especially for women who experience severe symptoms. However, menopausal symptoms may have a lasting effect on older women's mental health and quality of life (QOL) into postmenopause. The current study examined older (60+) postmenopausal women's mental health and QOL as a function of retrospective menopausal symptom severity. METHODS: Participants were recruited via public online postings and included 227 postmenopausal women, ages 60 to 94 years old (M = 68.84, SD = 6.53). Participants completed an online questionnaire to assess past menopausal symptoms as well as current depression, anxiety, sleep difficulties, binge eating, QOL, and demographics. The relation between the retrospective severity of menopausal symptoms and mental health/QOL was evaluated using linear regressions, while controlling for demographic covariates. RESULTS: Retrospective menopause symptom severity was significantly associated with depression, sleep difficulties, binge eating severity, and most QOL measures. Regarding covariates, having a psychiatric history was significantly associated with all outcome variables, except for anxiety. Time since menopause and body mass index were significantly associated with binge eating severity. Regarding specific symptom subgroups, psychological and somato-vegetative symptoms were most associated with mental health and QOL. CONCLUSION: The menopausal transition is a significant change in a woman's life and the challenges of menopausal symptoms can have lasting impacts on women's health. It is imperative that future research seeks to further understand the lasting impacts of this transition on the lives of older women to ensure proper interventions are implemented for successful aging.


Assuntos
Saúde Mental , Pós-Menopausa , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e Questionários , Avaliação de Sintomas
3.
Curr Pain Headache Rep ; 26(7): 505-516, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35679008

RESUMO

PURPOSE OF REVIEW: We seek to update readers on recent advances in our understanding of sex and gender in episodic migraine with a two part series. In part 1, we examine migraine epidemiology in the context of sex and gender, differences in symptomatology, and the influence of sex hormones on migraine pathophysiology (including CGRP). In part 2, we focus on practical clinical considerations for sex and gender in episodic migraine by addressing menstrual migraine and the controversial topic of hormone-containing therapies. We make note of data applicable to gender minority populations, when available, and summarize knowledge on gender affirming hormone therapy and migraine management in transgender individuals. Finally, we briefly address health disparities, socioeconomic considerations, and research bias. RECENT FINDINGS: Migraine is known to be more prevalent, frequent, and disabling in women. There are also differences in migraine co-morbidities and symptomatology. For instance, women are likely to experience more migraine associated symptoms such as nausea, photophobia, and phonophobia. Migraine pathophysiology is influenced by sex hormones, e.g., estrogen withdrawal as a known trigger for migraine. Other hormones such as progesterone and testosterone are less well studied. Relationships between CGRP (the target of new acute and preventive migraine treatments) and sex hormones have been established with both animal and human model studies. The natural course of migraine throughout the lifetime suggests a contribution from hormonal changes, from puberty to pregnancy to menopause/post-menopause. Treatment of menstrual migraine and the use of hormone-containing therapies remains controversial. Re-evaluation of the data reveals that stroke risk is an estrogen dose- and aura frequency-dependent phenomenon. There are limited data on episodic migraine in gender minorities. Gender affirming hormone therapy may be associated with a change in migraine and unique risks (including ischemic stroke with high dose estrogen). There are key differences in migraine epidemiology and symptomatology, thought to be driven at least in part by sex hormones which influence migraine pathophysiology and the natural course of migraine throughout the lifetime. More effective and specific treatments for menstrual migraine are needed. A careful examination of the data on estrogen and stroke risk suggests a nuanced approach to the issue of estrogen-containing contraception and hormone replacement therapy is warranted. Our understanding of sex and gender is evolving, with limited but growing research on the relationship between gender affirming therapy and migraine, and treatment considerations for transgender people with migraine.


Assuntos
Transtornos de Enxaqueca , Acidente Vascular Cerebral , Peptídeo Relacionado com Gene de Calcitonina/uso terapêutico , Estrogênios/uso terapêutico , Feminino , Hormônios Esteroides Gonadais/fisiologia , Hormônios Esteroides Gonadais/uso terapêutico , Humanos , Masculino , Menopausa/fisiologia , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Gravidez
5.
Aging Cell ; 21(6): e13621, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35509177

RESUMO

For women, menopausal transition is a time of significant hormonal changes, which may contribute to altered body composition and regional adipose tissue accumulation. Excess adiposity, and especially adipose tissue accumulation in the central body region, increases women's risk of cardiovascular and metabolic conditions and affects physical functioning. We investigated the associations between menopausal progression and total and regional body adiposity measured with dual-energy X-ray absorptiometry and computed tomography in two longitudinal cohort studies of women aged 47-55 (n = 230 and 148, mean follow-up times 1.3 ± 0.7 and 3.9 ± 0.2 years, mean baseline BMI 25.5 kg/m2 ). We also examined associations between menopausal progression and skeletal muscle fiber characteristics, as well as adipose tissue-derived adipokines. Relative increases of 2%-14% were observed in regional and total body adiposity measures, with a pronounced fat mass increase in the android area (4% and 14% during short- and long-term follow-ups). Muscle fiber oxidative and glycolytic capacities and intracellular adiposity were not affected by menopause, but were differentially correlated with total and regional body adiposity at different menopausal stages. Menopausal progression and regional adipose tissue masses were positively associated with serum adiponectin and leptin, and negatively associated with resistin levels. Higher diet quality and physical activity level were also inversely associated with several body adiposity measures. Therefore, healthy lifestyle habits before and during menopause might delay the onset of severe metabolic conditions in women.


Assuntos
Adiposidade , Menopausa , Tecido Adiposo , Composição Corporal , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Menopausa/fisiologia , Obesidade
6.
Artigo em Inglês | MEDLINE | ID: mdl-35382992

RESUMO

With life expectancy for women on the rise, most women will experience menopausal transition and spend a significant number of years of their life in the menopausal phase. Menopausal transition involves a myriad of physical, endocrine, and psychological changes which are influenced by ethnic, psychological, and socio-cultural factors. Every woman's experience of the menopausal transition is unique, and a one-size-fits-all approach to the management of symptoms does not work. An understanding of the pathophysiology and severity of menopausal symptoms and the benefits and risks associated with both hormonal and non-hormonal treatments is important when individualising treatment options for menopausal symptoms.


Assuntos
Menopausa , Feminino , Humanos , Menopausa/fisiologia , Menopausa/psicologia
7.
Int J Mol Sci ; 23(8)2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35456937

RESUMO

Sex-specific differences in biology and physiology likely start at the time of conception and progress and mature during the pre-puberty time frame and then during the transitions accompanying puberty. These sex differences are impacted by both genetics and epigenetic alterations during the maturation process, likely for the purpose of preparing for successful reproduction. For females, later in life (~45-50) they undergo another transition leading to a loss of ovarian hormone production at menopause. The reasons for menopause are not clear, but for a subset of females, menopause is accompanied by an increased risk of a number of diseases or conditions that impact a variety of tissues. Most research has mainly focused on the target cells in each of the affected tissues rather than pursue the alternative option that there may be commonalities in the development of these post-menopausal conditions in addition to influences on specific target cells. This review will address some of the potential commonalities presented by an integration of the literature regarding tissue-specific aspects of these post-menopausal conditions and data presented by space flight/microgravity (a condition not anticipated by evolution) that could implicate a loss of a regulatory function of the microvasculature in the risk attached to the affected tissues. Thus, the loss of the integration of the paracrine relationships between endothelial cells of the microvasculature of the tissues affected in the post-menopausal environment could contribute to the risk for post-menopausal diseases/conditions. The validation of this concept could lead to new approaches for interventions to treat post-menopausal conditions, as well as provide new understanding regarding sex-specific biological regulation.


Assuntos
Pós-Menopausa , Caracteres Sexuais , Células Endoteliais , Feminino , Humanos , Masculino , Menopausa/fisiologia , Ovário
8.
Maturitas ; 162: 23-30, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35489132

RESUMO

OBJECTIVES: To evaluate whether single measurements of serum estradiol (E2), estrone (E1) and sex hormone-binding globulin (SHBG) concentration distinguishes between women with and without menopausal symptom bother. STUDY DESIGN: We analyzed baseline data from two clinical trials conducted in 2012-2017: MsFLASH 03 (178 peri-/post-menopausal women aged 40-62 years with bothersome vasomotor symptoms, mean age 54) and MsFLASH 05 (181 post-menopausal women aged 45-70 years with moderate-to-severe vulvovaginal symptoms, mean age 61). MAIN OUTCOME MEASURES: Symptom bother (hot flushes or flashes, night sweats, sweating, aching in muscles and joints, change in sexual desire, vaginal dryness during intercourse, and avoiding intimacy) in the past month was assessed using the Menopause-Specific Quality of Life questionnaire. Using logistic regression, we calculated the area under the receiver operating characteristic curve (AUC) values for E1, E2, and SHBG concentration in relation to being at least somewhat bothered (symptom bother score ≥3) by each symptom within each trial study population. RESULTS: AUC values (95% confidence interval) ranged between 0.51 (0.41-0.60) and 0.62 (0.53, 0.72) for MsFLASH 03 and between 0.51 (0.42, 0.59) and 0.64 (0.53, 0.75) for MsFLASH 05. There was little evidence of associations between serum hormone levels and bother by a given menopausal symptom. CONCLUSION: These findings do not support the clinical utility of a single measurement of serum of E1, E2, or SHBG concentrations in differentiating between women who are bothered by a given menopausal symptom and those who are not.


Assuntos
Pós-Menopausa , Qualidade de Vida , Idoso , Estrogênios/uso terapêutico , Feminino , Fogachos/epidemiologia , Humanos , Menopausa/fisiologia , Sudorese
9.
Menopause ; 29(4): 430-439, 2022 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-35357366

RESUMO

OBJECTIVE: Women living with HIV (WLWH) are commonly symptomatic during perimenopause and menopause (≥1 y without menstruation), however, little is known of risks for symptoms and their timing. We analyzed these unwanted experiences to inform care. METHODS: WLWH (≥40 y) in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study rated midlife experiences for seven symptoms and a symptom composite (from 0 to 21). Timing was categorized into four phases: i) perimenopause (flow in the last year), ii) 1-2 years from final menstrual period (FMP), iii) 2-5 years post-FMP; and iv) >5 years post-FMP. Resilience (standardized out of 100) was assessed based on Wagnild's Resilience Scale. Univariable/multivariable mixed effects linear regression assessed correlates of symptom intensity by composite score. RESULTS: Among 457 peri-/menopausal women mean age 54.7 (±6.6) over two time points (703 observations), 88% experienced ≥1 mild symptom; 75% were of moderate and 55% severe intensity. The most frequently reported symptoms were joint/muscle stiffness (67%), depressed mood (67%), and hot flashes (57%). After adjusting for reproductive phase, we found that women with greater resilience had fewer/lower intensity symptoms (symptom score 1.37 [2.30 to 0.44] lower; P = 0.004); those with depressive symptoms and recreational drug use (respectively) had more/higher intensity symptoms (scores 1.71 [0.61 to 2.82] [P = 0.002]; 2.89 [2.09 to 3.77] [P<0.001] higher). Symptoms were most intense in perimenopause and declined with increasing menopausal years (P = 0.03). CONCLUSIONS: WLWH experiences a high burden of midlife symptoms, decreased by resilience and most intense during perimenopause. Unwanted experiences were linked to psychosocial and behavioral factors. These data encourage HIV providers to adopt a bio-psychosocial approach to midlife management.


Assuntos
Infecções por HIV , Menopausa , Canadá/epidemiologia , Estudos de Coortes , Feminino , Infecções por HIV/complicações , Fogachos/psicologia , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade
10.
Maturitas ; 159: 1-6, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35337608

RESUMO

OBJECTIVES: To evaluate the association between vasomotor symptoms (VMS) and carotid intima-media thickness (CIMT) in Korean midlife women. STUDY DESIGN: This cross-sectional study included 918 Korean women aged 45-65 years who attended their routine health checkup at a single institution between 2013 and 2016. MAIN OUTCOME MEASURES: All participants' results on the Menopause Rating Scale were used to assess the VMS. Severe and very severe VMS were combined into severe VMS. CIMT and blood flow velocities were measured on the common carotid arteries using duplex ultrasound. RESULTS: All participants' mean age was 54.73 ± 5.37 years, and 627 (68.3%) were postmenopausal. A total of 401 (43.7%) women reported VMS: 217 (23.6%), mild; 109 (11.9%), moderate; and 75 (8.2%), severe. The mean CIMT was 0.062 ± 0.017 mm and 0.064 ± 0.019 mm in premenopausal and menopausal women, respectively. In the multivariate linear regression analysis, the CIMT of women with moderate VMS was 0.102 mm (95% confidence interval [CI] = 0.002-0.009) more than that of women with no VMA, and the CIMT of women with severe VMS was 0.246 mm (95% CI = 0.012-0.021) more than that of women with no VMS, after adjusting for several confounders, including age, body mass index, and lifestyle factors. Severe VMS were associated with the risk of thickened CIMT (≥0.075 mm) and/or plaques (odds ratio = 2.90, 95% CI = 1.74-4.84) in the logistic regression analysis after adjusting for the same variables. CONCLUSIONS: Moderate and severe VMS are independently associated with increased CIMT in otherwise healthy Korean midlife women. Clinicians managing midlife women with bothersome VMS should consider screening for subclinical cardiovascular diseases.


Assuntos
Espessura Intima-Media Carotídea , Menopausa , Idoso , Artérias Carótidas/diagnóstico por imagem , Estudos Transversais , Feminino , Humanos , Menopausa/fisiologia , República da Coreia/epidemiologia
11.
Circ Res ; 130(3): 312-322, 2022 02 04.
Artigo em Inglês | MEDLINE | ID: mdl-35113663

RESUMO

BACKGROUND: Whether changes in blood pressure (BP) over women's midlife are more driven by chronological aging or the menopause transition has been debated. We sought to determine whether women can be classified into distinct trajectory groups based on pattern and level of systolic BP (SBP), diastolic BP, pulse pressure (PP), and mean arterial pressure (MAP) over the menopause transition, and to assess whether menopause-related factors predict the group and level of BP measures. METHODS: Participants were from the SWAN (Study of Women's Health Across the Nation). Group-based trajectory modeling was used to identify women who shared distinct BP trajectories over time relative to menopause onset and to assess associations of menopause-related factors with trajectory group and level of BP measures. An accelerated rise relative to menopause onset suggests a menopause contribution. RESULTS: The study included 3302 multiracial and multiethnic women with BP measures over 17 follow-up visits (baseline age [SD]: 46.3 [2.7]). Women were classified into either low, medium, or high trajectory group in each BP measure. The low SBP, PP, and MAP trajectories (in 35%, 53%, and 28% of the cohort, respectively) were rising slowly before menopause but showed a significant accelerated rise 1 year after menopause, indicating a menopause contribution. The remaining BP trajectories were rising up until menopause and either continued with the same rise or declined after menopause. A younger menopause age predicted the low SBP, PP, and MAP trajectories. A greater follicle-stimulating hormone level predicted lower SBP and PP levels, while vasomotor symptoms occurrence predicted higher SBP, PP, and MAP levels over time. Estradiol did not predict trajectory or level of any BP measure. CONCLUSIONS: Distinct BP trajectories over the menopause transition exist that revealed a group of women whose SBP, PP, and MAP trajectories are consistent with a menopause contribution. Our findings support frequent monitoring of BP during the menopause transition.


Assuntos
Pressão Sanguínea , Menopausa/fisiologia , Adulto , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Menopausa/sangue , Pessoa de Meia-Idade
12.
PLoS One ; 17(2): e0263374, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35139096

RESUMO

PURPOSE: This study aimed to determine the effect of reproductive, hormonal, lifestyle and nutritional factors on breast cancer development among Tanzanian black women. METHODOLOGY: We undertook a case-control study age-matched to ±5years in 2018 at Muhimbili National Hospital. The study recruited 105 BC patients and 190 controls giving it 80% power to detect an odds ratio of ≥2 at the alpha error of <5% for exposure with a prevalence of 30% in the control group with 95% confidence. Controls were recruited from in patients being treated for non-cancer related conditions. Information regarding hormonal, reproductive, nutritional and lifestyle risk for breast cancer and demography was collected by interviews using a predefined data set. Conditional multinomial logistic regression used to determine the adjusted odds ratio for variables that had significant p-value in the binomial logistic regression model with 5% allowed error at 95% confidence interval. RESULTS: The study recruited 105 cases and 190 controls. Only old age at menopause had a significant risk, a 2.6 fold increase. Adolescent obesity, family history of breast cancer, cigarette smoking and alcohol intake had increased odds for breast cancer but failed to reach significant levels. The rural residency had 61% reduced odds for developing breast cancer though it failed to reach significant levels. CONCLUSION: Older age at menopause is a significant risk factor for the development of breast cancer among Tanzanian women. This study has shed light on the potential role of modifiable risk factors for breast cancer which need to be studied further for appropriate preventive strategies in similar settings.


Assuntos
Neoplasias da Mama/epidemiologia , Hormônios/sangue , Estilo de Vida , Estado Nutricional/fisiologia , Reprodução/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Neoplasias da Mama/etnologia , Neoplasias da Mama/etiologia , Estudos de Casos e Controles , Feminino , Hormônios/fisiologia , Humanos , Estilo de Vida/etnologia , Menopausa/fisiologia , Pessoa de Meia-Idade , Paridade/fisiologia , Obesidade Pediátrica/complicações , Obesidade Pediátrica/epidemiologia , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Tanzânia/epidemiologia , Adulto Jovem
14.
Circ Res ; 130(4): 673-690, 2022 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-35175849

RESUMO

Cardiovascular disease remains the leading cause of death in women. Given accumulating evidence on sex- and gender-based differences in cardiovascular disease development and outcomes, the need for more effective approaches to screening for risk factors and phenotypes in women is ever urgent. Public health surveillance and health care delivery systems now continuously generate massive amounts of data that could be leveraged to enable both screening of cardiovascular risk and implementation of tailored preventive interventions across a woman's life span. However, health care providers, clinical guidelines committees, and health policy experts are not yet sufficiently equipped to optimize the collection of data on women, use or interpret these data, or develop approaches to targeting interventions. Therefore, we provide a broad overview of the key opportunities for cardiovascular screening in women while highlighting the potential applications of artificial intelligence along with digital technologies and tools.


Assuntos
Inteligência Artificial/tendências , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/fisiopatologia , Tecnologia Digital/tendências , Programas de Rastreamento/tendências , Doenças Cardiovasculares/epidemiologia , Tecnologia Digital/métodos , Feminino , Humanos , Longevidade/fisiologia , Programas de Rastreamento/métodos , Menopausa/fisiologia , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/epidemiologia , Complicações Cardiovasculares na Gravidez/fisiopatologia
15.
Support Care Cancer ; 30(5): 4437-4446, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35112212

RESUMO

BACKGROUND: Despite the frequency of vasomotor symptoms (VMS) in patients with early breast cancer (EBC), their optimal management remains unknown. A patient survey was performed to determine perspectives on this important clinical challenge. METHODS: Patients with EBC experiencing VMS participated in an anonymous survey. Patients reported on the frequency and severity of VMS using the validated Hot Flush Rating Scale (HFRS) and ranked their most bothersome symptoms. Respondents were also asked to determine endpoints that defined effective treatment of VMS and report on the effectiveness of previously tried interventions. RESULTS: Responses were received from 373 patients, median age 56 years (range 23-83), who experienced an average of 5.0 hot flashes per day (SD 6.57). Patients reported the most bothersome symptoms to be feeling hot/sweating (155/316, 49%) and sleeping difficulties (86/316, 27%). Fifty-five percent (201/365) of patients would consider a treatment to be effective if it reduced night-time awakenings. While 68% of respondents were interested in trying interventions from their healthcare team to manage VMS, only 18% actually did so. Of the 137 patients who had tried an intervention for VMS, pharmacological treatments, exercise, and relaxation strategies were more likely to be effective, while therapies such as melatonin and black cohosh were deemed less effective. CONCLUSION: VMS are a common and bothersome problem for EBC patients, with a minority receiving interventions to manage these symptoms. Further research is needed to identify patient-centered strategies for managing these distressing symptoms.


Assuntos
Neoplasias da Mama , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/complicações , Neoplasias da Mama/terapia , Feminino , Fogachos/etiologia , Fogachos/terapia , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Avaliação de Resultados da Assistência ao Paciente , Sudorese , Adulto Jovem
16.
Climacteric ; 25(4): 395-400, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35048756

RESUMO

OBJECTIVES: This study aimed to evaluate the relation between blood pressure (BP) or heart rate and genito-urinary symptoms in 504 women across the menopausal age (40-55 years old). METHODS: In this multicenter, cross-sectional study, data of office systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were related to the presence of vaginal dryness, dyspareunia, vaginal atrophy (VA), recurrent urinary infection (RUI), hot flushes (HF) or menopausal status. RESULTS: Vaginal dryness (coefficient of linear regression ß = 5.45, 95% confidence interval [CI] 2.01-8.89; p = 0.0001), VA (ß = 3.79, 95% CI 0.84-6.74; p = 0.002) and RUI (ß = 3.91, 95% CI 0.72-7.09; p = 0.0163) were independently related to SBP. Vaginal dryness (ß = 3.28, 95% CI 0.95-5.61; p = 0.0058), and HF (ß = 2.29, 95% CI 0.29-4.28; p = 0.025) were independently related to DBP. Dyspareunia (ß = 2.11, 95% CI 0.50-3.72; p = 0.010) was independently related to heart rate. Hypertension was present in 17% of women. When corrected for body mass index (BMI), risk factors for hypertension were VA (OR 2.50, 95% CI 1.43-4.40; p = 0.0014), RUI (OR 1.94 95% CI 1.06-3.52; p = 0.0302) and HF (OR 2.01, 95% CI 1.15-3.50; p = 0.0141). CONCLUSIONS: In women across the menopausal age, genito-urinary symptoms, more than HF, are associated with higher values of SBP, DBP, heart rate and hypertension.


Assuntos
Dispareunia , Hipertensão , Doenças Vaginais , Adulto , Pressão Sanguínea/fisiologia , Estudos Transversais , Feminino , Fogachos , Humanos , Hipertensão/epidemiologia , Menopausa/fisiologia , Pessoa de Meia-Idade , Doenças Vaginais/epidemiologia
17.
Post Reprod Health ; 28(1): 19-22, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34889118

RESUMO

OBJECTIVES: Cardiovascular diseases (CVD) exert a heavy toll on health of women, mainly due to hypertension said to cluster around the period of transition to menopause. This makes this period a good window to target for prevention and control. We therefore sought to determine if this period really heralds arterial hypertension and CVD in women in our environment. STUDY DESIGN: We secondarily analysed our population data on CVD risk factors in free living rural residents. MAIN OUTCOME VARIABLES: The data considered were blood pressure, anthropometric and biochemical variables in women stratified based on menstruation status. RESULTS: There were 488 females, with 218 still menstruating. They were younger (p = .000), had lower systolic and diastolic blood pressures (p = .000), lower anthropometric indices attaining significance only with waist circumference (p = .001) and lower total cholesterol (p = .001). Controlling for age, statistically significant differences remained for systolic and diastolic blood pressures, body mass index, waist and hip circumferences, and total cholesterol. CONCLUSION: The menopause transition comes with a worse CVD profile. Blood pressure rises and so are the anthropometric variables and some biochemical parameters that fuel CVD. This could be ascribed to age which is higher with those post-menopausal. Controlling for age in this cohort still showed that transiting from pre- to post-menopause still came with CVD burden. Clinicians should take the opportunity presented by menopause transition to screen for CVD risk factors and initiate either preventive or control measures to mitigate morbi-mortality consequences.


Assuntos
Doenças Cardiovasculares , Hipertensão , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Menopausa/fisiologia , Fatores de Risco , Circunferência da Cintura
18.
Curr HIV/AIDS Rep ; 19(1): 133-139, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34878617

RESUMO

PURPOSE OF REVIEW: To describe research advances in the menopausal transition (MT) and its effects on HIV replication, immune activation, and metabolic parameters in women living with HIV (WLWH). RECENT FINDINGS: Physiologic changes due to declines in ovarian reserve characterize the MT. Evidence suggests that estrogen depletion influences HIV replication and the latent reservoir. Changes in markers of immune activation, waist circumference, and neurocognition, independent of chronologic age, occur before the final menstrual period (FMP). HIV effects on gut microbial translocation and adipose tissue, as well as health disparities in WLWH may contribute. Improved biomarker sensitivity to predict FMP provides opportunities to study MT in WLWH. Research is needed to determine the effects of MT and HIV on virologic and clinical outcomes, using accurate assessments to predict the FMP and menopausal stages. These findings could inform the timing of interventions to prevent early onset of adverse outcomes in WLWH.


Assuntos
Infecções por HIV , Feminino , Humanos , Menopausa/fisiologia , Replicação Viral
19.
Behav Sleep Med ; 20(4): 500-512, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34176385

RESUMO

BACKGROUND: Sleep disturbances are common during the menopausal transition and several factors can contribute to this increased incidence. This study examined the association between sleep reactivity, arousal predisposition, sleep disturbances, and menopause. METHODS: Data for this study were derived from a longitudinal, population-based study on the natural history of insomnia. A total of 873 women (40-60 years) were divided into two groups according to their menopausal status at baseline: reproductive (n = 408) and postmenopausal (n = 465). Participants were evaluated annually throughout the five-year follow-up period. Four questionnaires were used to examine sleep quality, insomnia severity, sleep reactivity, and arousal predisposition. The data were analyzed using two approaches: cross-sectional with a multivariate analysis and binary regression, and longitudinal with a linear mixed models using menopausal groups (3) x time (5) design. RESULTS: Cross-sectional analyses showed that postmenopausal women reported significantly more severe insomnia and poorer sleep quality than reproductive women. Sleep reactivity and arousal predisposition were significant predictors of sleep disturbances. Longitudinal analyses revealed increased sleep disturbances in the two years before and after the menopausal transition. Sleep reactivity and arousal predisposition did not moderate the temporal relationship between menopausal transition and sleep disturbances. CONCLUSION: More sleep disturbances were reported during the menopausal transition, but those difficulties were not explained by sleep reactivity and arousal predisposition. These results suggest the involvement of other psychophysiological factors in the development of sleep disturbances during the menopause.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Nível de Alerta , Estudos Transversais , Feminino , Humanos , Menopausa/fisiologia , Sono/fisiologia , Transtornos do Sono-Vigília/epidemiologia
20.
Best Pract Res Clin Obstet Gynaecol ; 81: 134-144, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34965909

RESUMO

Vasomotor symptoms (VMS) affect 2 out of 3 women during menopause and are highly disruptive and intolerable. They exert a negative impact on a woman's physical and mental well-being and are considered a high clinical priority requiring effective treatment. Although hormone therapy remains the gold-standard treatment for hot flushes, it is associated with several side effects and contraindications. Furthermore, alternative treatments for VMS are currently less efficacious and have limited availability; therefore, a new medication to treat VMS would benefit millions of women worldwide. Neurokinin 3 receptor (NK3R) antagonists have recently been developed as novel therapeutic agents for the amelioration of VMS through their action on NK3 receptors within the hypothalamus and consequent regulation of the thermoregulatory centre. So far, three NK3R antagonists have been studied in menopausal women, which have demonstrated significant reductions in VMS frequency and severity and have shown their ability to transform patients' quality of life.


Assuntos
Menopausa , Qualidade de Vida , Feminino , Fogachos/tratamento farmacológico , Humanos , Menopausa/fisiologia , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...