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1.
Maturitas ; 144: 4-10, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33358207

RESUMO

OBJECTIVE: To assess the impact of confinement due to the coronavirus (Covid-19) pandemic on health-related quality of life (HRQoL) and resilience in peri- and postmenopausal women. MATERIAL AND METHODS: We used an online questionnaire which was sent between April 30th and May 13th, 2020 to women aged 40-70 years who were peri- or postmenopausal according to STRAW criteria. We used the 16-item Cervantes short-form scale (Cervantes-SF) to measure HRQoL, and the 14-item Wagnild and Young Resilience Scale (RS-14) to measure resilience. High scores on the Cervantes-SF indicate low HRQoL and high scores on the RS-14 indicate high levels of resilience. Covid-19 status, sociodemographic descriptors, and lifestyle variables were also evaluated. RESULTS: We included 2430 peri- and postmenopausal women with valid questionnaires. All items of the Cervantes-SF were completed in 2151 cases, whilst the RS-14 was completed in 2413 cases. There was a negative correlation between scores on the Cervantes-SF and RS-14 scales (Rho -0.350; p < 0.0001). Multiple linear regression analysis revealed a statistically significant association between Cervantes-SF scores and living with others (ß-coefficient -10.2; p < 0.001), use of antidepressants (ß 9.3; p < 0.001), physical activity (ß -8.6; p < 0.001) and sexual activity (ß -2.7; p < 0.001). Resilience was associated with the use of antidepressants (ß -5.9; p < 0.001), physical activity (ß 3.2; p < 0.001) and sexual activity (ß 1.7; p = 0.005). According to the multivariate analysis, there were no associations between either Covid-19 or menopausal status and HRQoL or resilience scores. CONCLUSIONS: During the period of mandatory Covid-19 confinement, peri- and postmenopausal women who engaged in physical and sexual activity had higher HRQoL and higher levels of resilience, whilst women who were using antidepressants had lower HRQoL and lower levels of resilience. HRQoL was greater in women who lived with others.


Assuntos
Perimenopausa/psicologia , Pós-Menopausa/psicologia , Qualidade de Vida/psicologia , Quarentena/psicologia , Resiliência Psicológica , Adulto , Idoso , Estudos Transversais , Exercício Físico/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
2.
Medicine (Baltimore) ; 99(36): e22048, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32899065

RESUMO

Owing to hormonal changes, women experience various psychophysiological alterations over a wide age range, which may result in decreased quality of life as well as in increased risks of diseases, such as cardiovascular diseases. Although studies have been performed to research complementary methods, such as meditation, the research field still requires an adequate amount of studies for public health guidelines. This pilot cross-sectional study aims to investigate a potential association of meditation with menopausal symptoms and blood chemistry for healthy women. In this study, data of 65 healthy women (age range 25-67) including 33 meditation practitioners and 32 meditation-naïve controls were analyzed to compare the Menopausal Rating Scale scores and blood chemistry with 7 more dropouts in the blood chemistry. For blood chemistry, nine components including glucose (GLU) and high-density lipoprotein cholesterol (HDL) were measured. Two-way analysis of variance was performed by dividing the total participants into 2 groups: premenopausal and postmenopausal participants. Compared to the control group, the meditation group showed a trend of reductions in the Menopausal Rating Scale total score (P = .054) and its 2 subcomponents: depressive mood (P = .064) and irritability (P = .061). In HDL level, there was a significant interaction between group and menopausal state (P = .039) with following post hoc results: among the premenopausal participants, a significant increase in the meditation group compared to the control group (P = .005); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .030). In GLU level, there was a mild interaction between group and menopausal state (P = .070) with following post hoc results: among the postmenopausal participants, a trend of increase in the control group compared to the meditation group (P = .081); among the control group, a significant increase in the postmenopausal compared to the premenopausal participants (P = .040). Our research suggests a potential association of practicing meditation with alleviations in menopausal symptoms and changes in blood chemistry, warranting further studies with a longitudinal study design and larger populations to understand the underlying causal relationships.


Assuntos
Análise Química do Sangue/métodos , Meditação/métodos , Menopausa/sangue , Menopausa/psicologia , Adulto , Glicemia , Estudos de Casos e Controles , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Voluntários Saudáveis , Humanos , Menopausa/fisiologia , Pessoa de Meia-Idade , Pós-Menopausa/sangue , Pós-Menopausa/psicologia , Pré-Menopausa/sangue , Pré-Menopausa/psicologia , Qualidade de Vida
3.
Artigo em Inglês | MEDLINE | ID: mdl-32784630

RESUMO

This study investigated the efficacy of participation in culture-specific dancing to meet current physical activity recommendations and increase cardio-respiratory fitness in postmenopausal women. Sedentary postmenopausal women (n = 24), aged 63 ± 8 years and with BMI of 28 ± 3 kg/m2 completed a 4-week Scottish dancing study. The dancing sessions of approximately 75 min were performed twice a week and each session was based on five Scottish dances performed in 3 sets. Heart rate (HR) measurements were obtained during all dances to evaluate whether the intervention achieves the criteria of moderate to vigorous aerobic exercise intensity. Body composition, waist circumference, and HR during Chester Step test were measured before and after dancing intervention. HR achieved during individual dances ranged from 64 ± 5% to 80 ± 5% of HRmax and the mean HR of the five dances corresponded to 72 ± 7% of HRmax. Post-intervention mean HR was lower throughout Level 2 (Pre, 112 ± 13 bpm; Post, 106 ± 13 bpm; p = 0.005) and Level 3 (Pre, 122 ± 14 bpm; Post, 115 ± 14 bpm; p = 0.006) of the Chester test compared with baseline values. The intervention had no impact on body weight or body fat but reduced waist circumference (Pre, 94 ± 8 cm; Post, 91 ± 9 cm; p = 0.006). Thus, traditional Scottish dancing should be advocated to sedentary postmenopausal women, emphasising its potential in meeting current physical activity recommendations in relation of weekly duration and exercise intensity and improving cardiorespiratory fitness.


Assuntos
Terapia através da Dança/métodos , Dança , Exercício Físico , Frequência Cardíaca/fisiologia , Pós-Menopausa/psicologia , Idoso , Teste de Esforço , Feminino , Humanos , Pessoa de Meia-Idade , Aptidão Física , Escócia , Circunferência da Cintura
4.
BMC Womens Health ; 20(1): 104, 2020 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-32410601

RESUMO

BACKGROUND: Quality of life (QoL) after menopause could be influenced by a host of personal and social factors. This study aimed to determine the factors associated with quality of life among postmenopausal women. METHODS: This cross-sectional study was conducted among 405 postmenopausal women selected using a multi-stage randomized sampling. The data-collection tools were the WHO Quality of Life-BREF (WHOQOL-BREF), the Menopause Rating Scale (MRS), and a researcher-designed questionnaire. The relationship between QoL and its potentially correlated factors was examined using t-test, ANOVA, Pearson's correlation, Spearman's correlation coefficient, and multiple linear regression. RESULTS: A negative correlation was found between the scores of QoL (total and all subscales) and the MRS total scores. The total scores of QoL were negatively correlated with duration of menopause (r = - 0.127, P = 0.010), gravida (r = - 0.177, P < 0.001), parity (r = - 0.165, P = 0.001), frequency of stillbirth (r = - 0.104, P = 0.037), vaginal delivery (r = - 0.161, P = 0.001), and waist-to-hip ratio (r = - 0.195, P < 0.001). The QoL total scores were positively correlated with the educational level of the participants (r = 0.207, P < 0.001) and that of their spouses (r = 0.160, P = 0.001) along with their level of monthly family income (r = 0.218, P < 0.001). Multiple-linear-regression analysis showed that the total score of QoL decreased with inadequate income, waist-to-hip ratio, and the total score of MRS. CONCLUSIONS: Personal and social factors along with the severity of menopausal symptoms affect QoL post-menopause. These factors need to have a bearing on any effort to improve QoL among postmenopausal women.


Assuntos
Menopausa/psicologia , Pós-Menopausa/psicologia , Qualidade de Vida/psicologia , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Renda , Irã (Geográfico) , Saúde Mental , Pessoa de Meia-Idade , Pós-Menopausa/etnologia , Inquéritos e Questionários , Saúde da Mulher/estatística & dados numéricos
5.
Health Qual Life Outcomes ; 18(1): 123, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375779

RESUMO

BACKGROUND: It is known that the elderly population remains most of the time in light activity. Physical activity plays a key role in the primary prevention of chronic diseases to mitigate various deleterious effects of aging and improve quality of life. The objective of the present study was to evaluate whether the time that postmenopausal women remain in light activities during the day are related to better quality of life and compare these results with the quality of life of those who remain longer in moderate intensity and vigorous activity. METHODS: This is a cross sectional study there were evaluated 102 women, aged 50 to 79 years, all postmenopausal. Physical activity was measured by triaxial accelerometers. The quality of life was assessed using a Brazilian validated version of the SF-36 questionnaire. The sample was divided in three groups (G1, G2 and G3) according to tercile of time spent per week on light, moderate and moderate+vigorous physical activity. The comparisons between groups were made by ANOVA One Way, and the relationship between variables were made through the Spearman's correlation coefficient, and the significance was set at 5%. RESULTS: We found that the amount of time of light physical activity shows a higher correlation values compared to the moderate and moderate+vigorous physical activity (p < 0,05) and presented significant correlation in all domains of quality of life. Vigorous physical activity did not presented significant correlation in all domains of quality of life. CONCLUSION: Our data suggests that light intensity physical activity presented influence on the quality of life of postmenopausal women. TRIAL REGISTRATION: (NCT02804308). Registered on 17 june 2016 (retrospectively registred).


Assuntos
Exercício Físico , Pós-Menopausa/psicologia , Qualidade de Vida , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
6.
Health Qual Life Outcomes ; 18(1): 122, 2020 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375796

RESUMO

BACKGROUND AND OBJECTIVE: Health Promoting Lifestyle Profile-II (HPLP-II), developed in the West, evaluates 52 health promoting behaviors (HPB) under six subscales. In this study we evaluated the applicability of HPLP-II to assess the HPB of postmenopausal women (PMW) conversant in the Sinhala language in Sri Lanka. METHODS: The Sinhala version of HPLP-II was adapted following standard methodology of cross cultural adaptation. It included forward and backward translations, review by an expert group, focus group discussion and pre-testing. It was self-administered among randomly selected healthy, Sinhalese, community-dwelling PMW (n = 245, aged 55.9 ± 3.4 years), along with the Short Form 36 (SF-36) survey. The Sinhala version of HPLP-II was re-administered among a subsample (n = 105) after two weeks of first administration. Psychometric properties - reliability and validity, were evaluated. RESULTS: In the Sinhala version of HPLP-II, both internal consistency (Cronbach's alpha = 0.98) and test-retest reliability (intra class correlation / ICC = 0.98, 95%CI = 0.97-0.99) were high. Structural validity assessment with Factor analysis using Principal Component Analysis extracted seven factors explaining 80.65% cumulative variance with few exceptions from the original version. Health responsibility (HR) and spiritual growth (SG) subscales of HPLP-II and physical and psychological health dimensions scores of SF-36 scores correlated significantly (r > 0.63, p < 0.001) ensuring strong concurrent validity. CONCLUSIONS: The Sinhala version of HPLP-II adapted by us is a tool with high reliability and validity.


Assuntos
Estilo de Vida Saudável , Pós-Menopausa/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Análise Fatorial , Feminino , Promoção da Saúde/organização & administração , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sri Lanka , Traduções
7.
Internist (Berl) ; 61(6): 558-564, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32333087

RESUMO

Peri- and postmenopausal disorders can have a significant impact on quality of life. Hormone replacement therapy (HRT) might be necessary in order to decrease women's symptoms. The German S3 guideline "Peri- and Postmenopause-Diagnostics and Therapy" (2020) provides recommendations that include the most recent evidence as well as the Women's Health Initiative (WHI) study results from 2002 and 2004. These results led to reduced prescription patterns due to a high risk of cardiovascular diseases as well as an increased risk for breast cancer if HRT had been administered. Both ongoing analyses of subgroups and other studies extenuated the WHI data, since the increased risks were neither generalizable to the typical postmenopausal patient (regarding age and risk profile) nor to the medication being used today. This article summarizes all aspects of HRT in peri- and postmenopausal women (indications, contraindications, practical approaches, risks, prevention) and provides recommendations with respect to the most recent S3 guideline.


Assuntos
Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/efeitos adversos , Terapia de Reposição Hormonal , Perimenopausa/efeitos dos fármacos , Pós-Menopausa/efeitos dos fármacos , Pós-Menopausa/psicologia , Progesterona/efeitos adversos , Idoso , Terapia de Reposição de Estrogênios/métodos , Estrogênios/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Perimenopausa/psicologia , Pós-Menopausa/fisiologia , Progesterona/uso terapêutico , Qualidade de Vida , Saúde da Mulher
8.
BMC Womens Health ; 20(1): 64, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228557

RESUMO

BACKGROUND: Impaired sleep is common in menopausal women. The aim was to examine associations between uses of systemic menopausal hormone therapy (MHT) and sleep disturbance in a large population sample. METHODS: Female participants aged 45 to 75 years were selected from the Norwegian Health Study in Nord-Trøndelag (HUNT3, 2006-2008) (N = 13,060). Data were linked to the Norwegian Prescription Database, identifying use of prescribed MHT and use of sleep medication. Data were analyzed using multiple linear regression. RESULTS: In total, 996 women used systemic MHT (7.6%), with the highest prevalence of 10.3% among women 55 to 64 years of age. Despite high reports of frequent nocturnal awakening (24.7%) and high reports of hot flashes, use of MHT was low in this large population based survey. Although MHT use was associated with more sleep disturbance in unadjusted analyses, the association was not significant after adjusting for relevant covariates. Using sleep medication, reporting poor health, tobacco and alcohol use, doing daily exercise, having higher levels of anxiety, and being less satisfied with life were factors showing the strongest associations with sleep disturbance. CONCLUSION: The lack of association between MHT and sleep disturbance suggests that other factors, such as self-perceived good health, a healthy lifestyle and anxiety/depression, are more relevant to sleep than MHT.


Assuntos
Terapia de Reposição de Estrogênios/efeitos adversos , Menopausa/psicologia , Pós-Menopausa/psicologia , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Idoso , Terapia de Reposição de Estrogênios/métodos , Feminino , Fogachos/epidemiologia , Humanos , Pessoa de Meia-Idade , Noruega/epidemiologia , Sono , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos do Sono-Vigília/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
9.
BMC Womens Health ; 20(1): 71, 2020 04 09.
Artigo em Inglês | MEDLINE | ID: mdl-32290849

RESUMO

BACKGROUND: Pro-health behaviours aim at disease prevention, recovery from an illness and maintenance of good health in a physical, mental and social sphere. The study had two main objectives: (a) to analyse health behaviours of postmenopausal women and their understanding of the notion of health, and (b) to analyse the relationship between individual categories of health behaviours and prophylactic activities undertaken by postmenopausal women. METHODS: A cross-sectional study was conducted among a convenience sample of 510 postmenopausal women. Three study instruments were used: an original questionnaire and two instruments designed by Juczynski: the List of Health Criteria and the Health Behaviour Inventory. RESULTS: In the view of the respondents health was primarily synonymous with a feature, because the following three associations were given the highest priority when defining health: to be healthy means 'have all body parts functioning well' (M = 1.82), 'do not experience any physical problems' (M = 1.43) and 'not be sick, only occasionally suffer from flu, cold or indigestion'. The score for health behaviours was average (M = 86.18). The highest score was achieved in the area of prophylactic behaviours. General indicator of health-related behaviours was higher in women who rated their health as very good (p < 0.05). Women whose general indicator of health-related behaviours was higher regularly performed prophylactic gynaecological examinations (p < 0.05). CONCLUSIONS: Results showed that women after menopause treat health mainly as a feature of their body and condition specific for this period of life. The analysis of postmenopausal women's health behaviours and their perception of health helped to identify areas that require the focus of medical personnel in regard to health promotion and prophylaxis. The average general indicator of health-related behaviours is positive for this group of women as it shows that they care about their health, especially in terms of prophylaxis.


Assuntos
Comportamentos Relacionados com a Saúde , Menopausa , Pós-Menopausa , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/fisiologia , Pós-Menopausa/psicologia , Inquéritos e Questionários
10.
Cancer ; 126(8): 1766-1775, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-31972054

RESUMO

BACKGROUND: We evaluated associations between perceived social support, social integration, living alone, and colorectal cancer (CRC) outcomes in postmenopausal women. METHODS: The study included 1431 women from the Women's Health Initiative who were diagnosed from 1993 through 2017 with stage I through IV CRC and who responded to the Medical Outcomes Study Social Support survey before their CRC diagnosis. We used proportional hazards regression to evaluate associations of social support (tertiles) and types of support, assessed up to 6 years before diagnosis, with overall and CRC-specific mortality. We also assessed associations of social integration and living alone with outcomes also in a subset of 1141 women who had information available on social ties (marital/partner status, community and religious participation) and living situation. RESULTS: In multivariable analyses, women with low (hazard ratio [HR], 1.52; 95% CI, 1.23-1.88) and moderate (HR, 1.21; 95% CI, 0.98-1.50) perceived social support had significantly higher overall mortality than those with high support (P [continuous] < .001). Similarly, women with low (HR, 1.42; 95% CI, 1.07-1.88) and moderate (HR, 1.28; 95% CI, 0.96-1.70) perceived social support had higher CRC mortality than those with high social support (P [continuous] = .007). Emotional, informational, and tangible support and positive interaction were all significantly associated with outcomes, whereas affection was not. In main-effects analyses, the level of social integration was related to overall mortality (P for trend = .02), but not CRC mortality (P for trend = .25), and living alone was not associated with mortality outcomes. However, both the level of social integration and living alone were related to outcomes in patients with rectal cancer. CONCLUSIONS: Women with low perceived social support before diagnosis have higher overall and CRC-specific mortality.


Assuntos
Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/psicologia , Pós-Menopausa/psicologia , Neoplasias Retais/mortalidade , Neoplasias Retais/psicologia , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Análise Multivariada , Modelos de Riscos Proporcionais , Fatores de Risco , Integração Social , Apoio Social , Saúde da Mulher
11.
Menopause ; 27(2): 134-142, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31688416

RESUMO

OBJECTIVE: To quantify the association between vulvovaginal atrophy and depression, major depressive disorder, and anxiety. METHODS: Women with vulvovaginal atrophy from the Truven Health MarketScan Commercial and Medicare Supplemental Databases (01/2010-09/2016) with ≥365 days of continuous insurance coverage before and after the first vulvovaginal atrophy/dyspareunia diagnosis (index date) were selected. Women with vulvovaginal atrophy were matched 1:3 to women without (controls) according to age, calendar year, health plan, and region. The study period spanned from 12 months before to 12 months after index date. The ratios of diagnosed depression, major depressive disorder, and anxiety among women with vulvovaginal atrophy and the controls were calculated. Logistic regressions adjusting for proxies of menopause were used to compare prevalence. RESULTS: In all, 125,889 women with vulvovaginal atrophy and 376,057 controls were included (mean age 60.7 [45-101]). The prevalence of depression, major depressive disorder, and anxiety was higher among women with vulvovaginal atrophy compared with controls (23.9% vs 18.9%, 6.3% vs 4.7%, 16.6% vs 11.3%), with prevalence ratios of 1.26, 1.33, and 1.47, respectively (all P < 0.0001). Highest prevalences and differences were observed in younger women. Findings were consistent when analyzing newly diagnosed conditions. When adjusting for proxies of menopause (insomnia, vasomotor symptoms, dysuria, and estrogen therapy), vulvovaginal atrophy remained significant (prevalence odds ratios; depression 1.23, major depressive disorder 1.22, anxiety 1.39; all P < 0.0001). CONCLUSIONS: Vulvovaginal atrophy is associated with a significantly higher prevalence/incidence of depression, major depressive disorder, and anxiety. The higher prevalence/incidence and greater differences in younger women highlight the need for a multidisciplinary approach and early diagnosis/management of vulvovaginal atrophy.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Dispareunia/psicologia , Pós-Menopausa/psicologia , Doenças Vaginais/psicologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Atrofia , Depressão/etiologia , Transtorno Depressivo Maior/etiologia , Feminino , Humanos , Medicare , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologia , Vagina/patologia , Doenças Vaginais/patologia , Vulva/patologia
12.
Menopause ; 27(2): 194-198, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31738736

RESUMO

OBJECTIVE: The purpose of this study was to determine the efficacy and safety of evening primrose oil on women's psychological symptoms during menopause. METHODS: A double-blinded randomized placebo-controlled trial carried out from September 2018 to February 2019 in Bandar Abbas, Iran. Eligible women randomly received either 1,000 mg of evening primrose oil capsules daily or matching placebo for 8 weeks. The Main outcome measures were psychological symptoms based on the psychological subscale of the Menopause Rating Scale. Independent samples t test was used for intergroup comparisons and paired samples t test for pre- and post-treatment comparisons. P ≤ 0.05 was considered statistically significant. RESULTS: The 8-week treatment was completed by 189 women. The mean baseline psychological score did not differ among the two groups. After intervention, the psychological score, however, differed significantly among groups (P < 0.01). To distinguish the effect of evening primrose oil, we compared the reduction in the psychological score in each group. Regarding mean differences of the psychological score in both groups, there was a prominent alleviation in the intervention group mean difference: -3.44 (95% confidence interval of difference: -4.01 to -1.20) (P < 0.01). In addition, only one patient reported gastric upset in the intervention group. CONCLUSIONS: This study could provide evidence regarding the potential benefits of evening primrose oil for the psychological symptoms of postmenopausal women. Longer trials are necessary to make more reliable decisions about the use of evening primrose oil and its safety in clinical practice.


Assuntos
Ácidos Linoleicos/administração & dosagem , Transtornos Mentais/tratamento farmacológico , Óleos Vegetais/administração & dosagem , Pós-Menopausa/psicologia , Ácido gama-Linolênico/administração & dosagem , Método Duplo-Cego , Feminino , Humanos , Irã (Geográfico) , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Resultado do Tratamento
13.
Maturitas ; 131: 91-101, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31740049

RESUMO

INTRODUCTION: Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70 % greater in women. The perimenopause is considered to be a time of increased risk for the development of depressive symptoms and major depressive episodes. AIM: The aim of this position statement is to provide a comprehensive model of care for the management of depressive symptoms in perimenopausal and early menopausal women, including diagnosis, treatment and follow-up. The model integrates the care provided by all those involved in the management of mild or moderate depression in midlife women. MATERIALS AND METHODS: Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS: Awareness of depressive symptoms, early detection, standardized diagnostic procedures, personalized treatment and a suitable follow-up schedule need to be integrated into healthcare systems worldwide. Recommended treatment comprises antidepressants, psychosocial therapies and lifestyle changes. Alternative and complementary therapies, although widely used, may help with depression, but a stronger evidence base is needed. Although not approved for this indication, menopausal hormone therapy may improve depressive symptoms in peri- but not in postmenopausal women, especially in those with vasomotor symptoms.


Assuntos
Depressão/terapia , Transtorno Depressivo Maior/terapia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Adulto , Idoso , Antidepressivos/uso terapêutico , Terapias Complementares , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Europa (Continente) , Feminino , Hormônios/uso terapêutico , Humanos , Estilo de Vida , Menopausa/psicologia , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Sociedades Médicas , Resultado do Tratamento
14.
J Sex Med ; 17(1): 117-125, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31812686

RESUMO

INTRODUCTION: Clinical research and management of postmenopausal vaginal symptoms have been limited by the lack of validated measures for assessing symptom impact. AIM: To evaluate convergent-divergent validity of the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire among postmenopausal women with moderate-to-severe vulvovaginal symptoms and identify demographic and clinical factors associated with greater symptom impact. METHODS: We examined baseline data from postmenopausal women with moderate-to-severe vulvovaginal itching, pain, irritation, dryness, or pain with intercourse in a randomized trial of vaginal estradiol, moisturizer, or placebo. In addition to completing the DIVA questionnaire, participants rated the severity of their most bothersome vulvovaginal symptom, underwent assessment of vaginal pH and epithelial cytology, and completed other self-report measures including the Female Sexual Function Index (FSFI), Female Sexual Distress Scale (FSDS), and Patient Health Questionnaire-8 for depression (PHQ-8). MAIN OUTCOME MEASURE: The main outcome measures were the unadjusted correlations and multivariable-adjusted associations with 4 DIVA domain scales designed to assess symptom impact on day-to-day activities, sexual functioning, emotional well-being, and body image/self-concept on a scale of 0 to 4. RESULTS: Among 301 women, we detected moderately strong correlations between the DIVA emotional well-being scale and PHQ-8 scores (Pearson correlation coefficient [r] = 0.39) and strong correlations between the DIVA sexual functioning scale and FSFI and FSDS scores (r > 0.50). No significant correlations were detected between any DIVA scales and vaginal pH or epithelial cytology. In adjusted linear-regression analyses, greater vulvovaginal symptom severity was associated with worse DIVA scores for emotional well-being, sexual functioning, and self-concept/body image (average 0.3- to 0.5-point higher DIVA score for each 1-point difference in vulvovaginal symptom severity). Depression symptoms were associated with worse DIVA scores for activities of daily living and emotional well-being (0.2- to 0.4-point higher DIVA score for each 5- point worsening of PHQ-8 score). Women reporting recent sexual activity had lower symptom impact on sexual functioning and self-concept/body image domains (-0.3- to -0.4-point lower DIVA score with weekly sexual activity). CLINICAL IMPLICATIONS: Findings suggest that the impact of postmenopausal vaginal symptoms on functioning and well-being is greater in women with co-morbid depression symptoms and less frequent sexual activity, independent of symptom severity. STRENGTHS & LIMITATIONS: Strengths include the multicenter sample and wide array of measures. Results may not generalize to women with mild symptoms. CONCLUSION: Our results support the construct validity of the DIVA questionnaire for clinical practice and research and indicate that depression and lower frequency of sexual activity are markers of greater impact of postmenopausal vaginal symptoms on multiple dimensions of functioning and quality of life. Hunter MM, Guthrie KA, Larson JC, et al. Convergent-Divergent Validity and Correlates of the Day-to-Day Impact of Vaginal Aging Domain Scales in the MsFLASH Vaginal Health Trial. J Sex Med 2020;17:117-125.


Assuntos
Estradiol/administração & dosagem , Pós-Menopausa/psicologia , Qualidade de Vida , Doenças Vaginais/tratamento farmacológico , Atividades Cotidianas , Idoso , Envelhecimento/psicologia , Imagem Corporal , Emoções , Estrogênios/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Autoimagem , Autorrelato , Inquéritos e Questionários , Avaliação de Sintomas
15.
Ann Agric Environ Med ; 26(4): 585-591, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885232

RESUMO

INTRODUCTION AND OBJECTIVE: There is a significantly higher risk of lipid disorders occurrence, including atherogenic dyslipidemia in women after menopause than it is in general population. The aim of the work was to investigate the correlation between health behaviours and the occurrence of lipid disorders in women after menopause working in agriculture. MATERIAL AND METHODS: The study was conducted in years 2015-2016 and included 843 post-menopausal women working in agriculture. The following were used: a questionnaire including socio-demographic data, laboratory lipid tests, inventory of health behaviours. The following were estimated: logistic regression models for serum lipids concentration versus frequency of health behaviours in the examined women. RESULTS: Adverse lipid profile was found in over a half of post-menopausal women working in agriculture, whereas the frequency of health behaviours were estimated at the average level, although the frequency of correct eating habits and health practices was significantly lower than preventive behaviours and positive psychological attitudes. A correlation was found between the frequency of health behaviours and the occurrence of lipid disorders in women after menopause working in agriculture: more frequent health practices co-existed with the lower concentration of total cholesterol and a higher concentration of HDL-cholesterol, more frequent preventive behaviours co-existed with lower concentration of LDL-cholesterol. Women with higher concentration of triglycerides undertook pro-health practices relatively more often. CONCLUSIONS: The study revealed a high prevalence of lipid disorders in postmenopausal women working in agriculture. More effective health education programmes are necessary in the area of reduction the risk factors of CVD in the population of women working in agriculture.


Assuntos
Aterosclerose/sangue , Comportamentos Relacionados com a Saúde , Lipídeos/sangue , Pós-Menopausa/sangue , Idoso , Agricultura , Aterosclerose/psicologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Fazendeiros/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/psicologia , Triglicerídeos/sangue , Mulheres Trabalhadoras/psicologia
16.
Ann Agric Environ Med ; 26(4): 600-605, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885234

RESUMO

OBJECTIVE: The aim of the study was evaluation of the relationship between severity of symptoms of climacteric syndrome, depressive disorders and sleep problems, and the self-rated work ability of peri-menopausal and post-menopausal women in non-manual employment. MATERIAL AND METHODS: The study included 287 women aged 45-60 years, employed in various institutions as non-manual workers. Work Ability Index, Greene Climacteric Scale, Beck Depression Inventory, and Athens Insomnia Scale were used. RESULTS: The examined peri-menopausal and post-menopausal women in non-manual employment obtained good work ability on the Work Ability Index. The severity of menopausal syndrome, according to the Greene Climacteric Scale, was moderate, placing the examined women between results for the general population of women and the pattern for menopausal women. Depressive disorders ranked between low mood and moderate depression. No depression was observed in 59% of the women, whereas moderate depression was observed in 39%, and severe depression in only 2%. Sleep disorders were on the border of normal range. As many as 46% of the women had no sleep problems, which was on the border of normal range in 36%. Only 19% of the examined women suffered from insomnia. Work ability correlated negatively with depression and insomnia severity, as well as with psychological and vasomotor symptoms of climacteric syndrome, but not to its somatic symptoms. CONCLUSIONS: Preventing the occurrence and treatment of menopausal symptoms, sleep and mood disorders may contribute to maintaining the work ability of women in peri- and post-menopausal age.


Assuntos
Climatério/fisiologia , Depressão/fisiopatologia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Climatério/psicologia , Depressão/economia , Depressão/psicologia , Emprego , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Distúrbios do Início e da Manutenção do Sono/economia , Distúrbios do Início e da Manutenção do Sono/psicologia , Avaliação da Capacidade de Trabalho
17.
Menopause ; 26(10): 1117-1124, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31479031

RESUMO

OBJECTIVE: We studied the associations between personality traits and the risk of coronary heart disease (CHD) or stroke in women with diabetes. METHODS: From the Women's Health Initiative, 15,029 women aged 50 to 79 years at enrollment and with self-reported treated diabetes at baseline or follow-up, were followed for a mean of 10 years. Personality traits measured from validated scales included hostility, optimism, ambivalence over emotional expressiveness, and negative emotional expressiveness. Multivariable Cox proportional-hazards regression models were used to examine associations between personality traits and the risk of adjudicated CHD (nonfatal myocardial infarction and CHD death) or stroke outcomes. Progressively adjusted regression approach was used in the multivariable models to adjust for demographics, depression, anthropometric variables, and lifestyle factors. RESULTS: A total of 1,118 incident CHD and 710 incident stroke cases were observed. Women in the highest quartile of hostility had 22% (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.01-1.48) increased risk for CHD compared with women in the lowest quartile of hostility. P values for trend were greater than 0.05. Stratified analysis by prevalent or incident diabetes showed that the highest quartile of hostility had 34% increased risk for CHD (HR 1.34, 95% CI 1.03-1.74) among women with incident diabetes. Other personality traits were not significantly associated with stroke or CHD. CONCLUSIONS: Hostility was associated with incidence of CHD among postmenopausal women with diabetes, especially among incident diabetes. These results provide a basis for targeted prevention programs for women with a high level of hostility and diabetes.


Assuntos
Doença das Coronárias/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Hostilidade , Personalidade , Acidente Vascular Cerebral/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Estudos Epidemiológicos , Feminino , Seguimentos , Humanos , Incidência , Estudos Longitudinais , Pessoa de Meia-Idade , Pós-Menopausa/psicologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Autorrelato , Estados Unidos/epidemiologia
18.
J Cancer Surviv ; 13(4): 632-640, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31321612

RESUMO

PURPOSE: Among a cohort of postmenopausal breast cancer survivors, we aimed to compare the risk of dementia associated with aromatase inhibitor (AI) therapy versus tamoxifen. METHODS: Using UK primary care electronic health records, we identified 14,214 postmenopausal breast cancer survivors (aged ≥ 54 years) with a first AI or tamoxifen prescription between January 2002 and December 2015 and no previous dementia diagnosis. Women were followed-up to identify incident cases of dementia. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) to quantify the association between AI exposure (vs. tamoxifen) and dementia, adjusted for confounders. RESULTS: A total of 368 incident dementia cases was identified over 57,102 person-years of follow-up. The crude incidence rate of dementia was 7.46 per 1000 person-years (95% CI 6.43-8.65) among women starting endocrine treatment on an AI, and 6.32 per 1000 person-years (95% CI 5.34-7.47) among women starting on tamoxifen. After accounting for age differences and assessing other potential confounders, there was no evidence of a difference in dementia risk between exposure groups (HR for AI vs tamoxifen 1.04, 95% CI 0.83-1.03). There was no evidence of effect modification by age. CONCLUSION: There was no evidence for a difference in dementia risk between AI and tamoxifen users among postmenopausal breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Our findings suggest that there is no reason for concern about a difference in dementia risk with AI vs. tamoxifen, which is relevant to postmenopausal breast cancer patients recommended these treatments.


Assuntos
Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Sobreviventes de Câncer/estatística & dados numéricos , Demência/epidemiologia , Tamoxifeno/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/uso terapêutico , Sobreviventes de Câncer/psicologia , Estudos de Coortes , Demência/induzido quimicamente , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Pós-Menopausa/psicologia , Atenção Primária à Saúde/estatística & dados numéricos , Fatores de Risco , Reino Unido/epidemiologia
19.
PLoS One ; 14(7): e0219093, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31291302

RESUMO

This cross-sectional study is aimed at assessing the quality of life in a cohort of breast cancer patients at the Oncology Department, King Abdulaziz University Hospital (KAUH), King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA), and to differentiate QoL among different groups. Mean time since diagnosis was 3.97±1.90 years. European Organization for Research and Treatment of Cancer Quality of Life Questionnaires-Core30 and BR23 (EORTC QLQ-C30 & BR23) were used to assess QoL in breast cancer survivors. ANOVA and independent t-test (parametric tests) were used for the categorical variables and Kruskal-Wallis and Mann-Whitney tests used for non-parametric tests. Linear regression analysis was done to measure predictors' significance and to calculate the coefficient of determination. Two hundred and eighty-four patients completed the survey. Global health status and functional scales, in most of the domains, were high, while symptom scales were moderate-to-low for most items, showing better QoL. Insomnia and fatigue were the most disturbing symptoms. Patients exhibited higher scores for body image and future perspective, while the least score is for sexual functioning. Global health, physical functioning, and role functioning were better in the age group ≤50 years (p<0.05). Premenopausal and perimenopausal patients showed a better level of functioning as compared to postmenopausal patients (p = 0.001). Premenopausal patients scored higher for sexual enjoyment, as compared to peri- and post-menopausal patients (p = 0.04). Systemic therapy side effects were more evident in the breast conservative surgery group. Predictors explained 8% of the variation in Physical functioning (R-squared = 0.08). A predictor that had a remarkable influence on physical functioning, as compared to the other predictors in the model, was menopausal status (P = 0.02). So, it was concluded that the breast cancer patients visiting our institute had a better quality of life regarding overall global health status as well as functional and symptom scales. Some issues, for instance, fatigue, insomnia, hair loss, and others, warrant good supportive therapy.


Assuntos
Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Fadiga/psicologia , Qualidade de Vida/psicologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Adulto , Neoplasias da Mama/terapia , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Pessoa de Meia-Idade , Pós-Menopausa/psicologia , Pré-Menopausa/psicologia , Psicometria , Análise de Regressão , Arábia Saudita , Inquéritos e Questionários , Centros de Atenção Terciária
20.
Womens Health Issues ; 29(4): 299-307, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31277914

RESUMO

PURPOSE: To investigate associations between past-year verbal and/or physical abuse (VA/PA) and sexual (dis)satisfaction, that is, global or frequency-related (dis)satisfactions with sexual activity, among postmenopausal women in the Women's Health Initiative. PROCEDURES: A cross-sectional analysis of archival data was performed from the subset of 83,329 Women's Health Initiative participants (clinical trial and/or observational study components) who reported sexual activity in the year before baseline. Associations between VA/PA and global frequency (dis)satisfactions were modeled using logistic regression. MAIN FINDINGS: Most participants reported sexual satisfaction (global, 77%; frequency related, 66%). Disappointment with sexual frequency, specifically a desire for more frequent sex, was the most common dissatisfaction expressed. Past-year VA/PA exposure was reported by 9,410 participants (11%). In regression models adjusted for sociodemographic, health and health risk, and menopausal symptom variables, VA/PA was associated with higher rates of global (35% VA/PA exposed vs. 22% non-exposed; adjusted odds ratio, 1.66; 95% confidence interval, 1.53-1.80) and frequency-related dissatisfactions (50% of VA/PA exposed vs. 32% of non-exposed; adjusted odds ratio, 1.73; 95% confidence interval, 1.57-1.90). CONCLUSIONS: Sexual satisfaction was common, but not universally reported by study participants. Sexual dissatisfactions were overrepresented in VA/PA-exposed participants and associated with a desire for more frequent sexual activity. Opportunities for postmenopausal women to receive clinician-led education about safe and healthy ways to increase sexual activity are needed. Further research on this topic, particularly efforts to characterize safety concerns as well as modifiable barriers to satisfying sexual activity among postmenopausal women with recent VA/PA, would ensure that these interventions are evidence based.


Assuntos
Violência por Parceiro Íntimo/psicologia , Orgasmo , Satisfação Pessoal , Pós-Menopausa/psicologia , Comportamento Sexual/estatística & dados numéricos , Idoso , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Violência por Parceiro Íntimo/estatística & dados numéricos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Pós-Menopausa/fisiologia , Comportamento Sexual/psicologia , Saúde da Mulher
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