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1.
In Vivo ; 35(6): 3489-3493, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34697186

RESUMO

BACKGROUND/AIM: We investigated the changes in and characteristics of renal function in Japanese patients with high-risk prostate cancer (PCa) who underwent radiotherapy and long-term androgen deprivation therapy (ADT), including those seen after the ADT was discontinued. PATIENTS AND METHODS: Among 60 patients who were pathologically diagnosed with PCa and received ADT for 24 months and radiotherapy, 36 patients who underwent treatment for stage B or C PCa were eligible. We assessed renal function using the estimated glomerular filtration rate (eGFR) and investigated the rate of change in the eGFR (ΔeGFR) during and after ADT. Univariate and multivariate logistic analyses were carried out to identify clinical factors that were significantly associated with renal dysfunction at 36 months. RESULTS: The incidence of renal dysfunction at 36 months was 75% (27/36). Multivariate analysis showed that the presence/absence of HF was an independent predictor of renal dysfunction at 36 months. CONCLUSION: Renal function tended to recover after ADT was received for 24 months and subsequently discontinued. The presence/absence of HF represents new and meaningful information for patients receiving ADT, and high-risk PCa patients prior to ADT.


Assuntos
Nefropatias , Neoplasias da Próstata , Antagonistas de Androgênios/efeitos adversos , Androgênios , Fogachos , Humanos , Japão/epidemiologia , Masculino , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/radioterapia
2.
Ther Umsch ; 78(8): 473-481, 2021.
Artigo em Alemão | MEDLINE | ID: mdl-34555973

RESUMO

Evidence-based Facts of non-hormonal treatment of menopausal symptom Abstract. Menopausal symptoms like hot flushes and night sweats can have a great impact on quality of life. As first line, hormonal therapy with estrogens in combination with progestins is used, and shows beneficial effects on these symptoms. Some women, however, have contraindications against hormonal therapy or do not wish to take hormones at all. In these women, alternative treatments are needed to treat vasomotor symptoms. Pharmacologic substances like antidepressants, anticonvulsants or antihypertensive drugs show a significant reduction of these symptoms in menopausal women. Phytopharmaceutical products may show beneficial effects but study designs often do not fulfil strict scientific criteria. Furthermore, dosage and composition of the products may differ considerably. Best data are available for isoflavons and extracts of cimicifuga racemosa. Other alternative therapies like yoga, exercise, hypnosis and acupuncture showed promising results in small studies and may be recommended individually.


Assuntos
Qualidade de Vida , Sudorese , Exercício Físico , Feminino , Fogachos/tratamento farmacológico , Humanos , Menopausa
3.
J Altern Complement Med ; 27(11): 959-967, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34399063

RESUMO

Objectives: Soy and hop extracts have been investigated as alternatives for hormone replacement therapy. However, their combined efficacy is not known. We investigated the efficacy and safety of a combined soy and hop extract on postmenopausal symptoms. Design: Double-blinded, randomized controlled trial. Settings/Location: Gynecological outpatient clinic of tertiary hospital. Subjects: Seventy-eight women with moderate or severe menopausal symptoms assessed as modified Kupperman Menopoausal Index (KMI) scores >20. Interventions: They received either a combined soy and hop extract (n = 38) or placebo (n = 40). Outcome measures: Menopausal symptoms were evaluated through self-reporting of modified Kupperman Menopausal Index (KMI) scores at baseline and after 6 and 12 weeks. We assessed serum levels of bone metabolism biomarkers, ultrasonographic parameters, hormone profiles, compliance, and safety. Results: After 12 weeks of the treatment, treatment group scores decreased by 20.61 points compared with 14.80 points in the placebo group (p < 0.05). Fatigue, paresthesia, arthralgia, and myalgia, palpitation and vaginal dryness significantly improved more in the treatment group compared with the placebo group after 12 weeks (p < 0.05). Urine N-telopeptide in participants ≥50 years in the treatment group showed a reduced increase. Endometrial thickness and hormonal profiles did not show significant changes in either group. No serious adverse events were reported. Conclusion: The results suggest that 190 mg of combined soy and hop extract is safe and effective for improvement of menopausal symptoms. CRIS No.: KCT0006019.


Assuntos
Fogachos , Isoflavonas , Fitoterapia , Extratos Vegetais , Método Duplo-Cego , Feminino , Fogachos/tratamento farmacológico , Humanos , Humulus , Isoflavonas/uso terapêutico , Menopausa , Extratos Vegetais/uso terapêutico , Soja
4.
BMC Womens Health ; 21(1): 293, 2021 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372846

RESUMO

BACKGROUND: To investigate the relationship between sweating from hot flashes, anxiety, depression, and sleep quality in peri- and postmenopausal women. And also the role of anxiety and depression in mediating sweating from hot flashes and sleep quality. METHODS: 467 women aged 40-60 years with menopausal problems were enrolled. The sleep quality; hot flashes; sweating; anxiety and depression symptoms were quantitatively evaluated by Pittsburgh Sleep Quality Scale (PSQI), Kupperman Menopause Index, Self-rating Anxiety Scale and Self-rating Depression Scale. Spearman correlation analysis and mediating effect model were used to analyze the relationship between the three. RESULTS: 262 patients' PSQI score were higher than 6 (58.2%). Total scores of sleep quality were positively correlated with hot flashes, sweating and anxiety and depression symptoms. Anxiety and depression played a mediating role between hot flashes, sweating and sleep quality where the mediating effect of anxiety symptoms accounted for 17.86% (P < 0.01) and depression symptoms accounted for 5.36% (P < 0.01). CONCLUSIONS: The hot flashes, sweating, anxiety and depression of peri/postmenopausal women are risk factors affecting sleep quality. By alleviating these risk factors, the sleep quality of peri- and postmenopausal women could be improved, which prevents the physical and mental diseases due to long-term severe insomnia.


Assuntos
Fogachos , Sudorese , Ansiedade , Feminino , Humanos , Menopausa , Perimenopausa , Pós-Menopausa , Sono
5.
BMC Public Health ; 21(1): 1599, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34461857

RESUMO

BACKGROUND: Body image is the main element of an individual's personality that may be influenced by many factors during menopause. We aimed to assess the relationship between postmenopausal women's body image with the severity of menopausal symptoms. METHODS: This was a cross-sectional study on 300 postmenopausal women, aged 45 to 65 years old, in Tehran, Iran. We recruited the samples using the multi-stage sampling method. Tools for data collection were: 1) the Menopausal Rating Scale (MRS), 2) the Fisher's Body Image questionnaire and 3) a socio-demographic questionnaire. We analyzed data using the independent samples t-test, Pearson correlation coefficient, Spearman's correlation coefficient, and multiple linear regression tests. RESULTS: Three hundred women aged 55.11 ± 3.99 years old, participated in the study. Mean scores for body image and MRS were 163.07 ± 21.17 (Range: 46-230) and 16.45 ± 8.38 (Range: 0-44), respectively. About 50% of women had severe symptoms of menopause (MRS score ≥ 17). There was a negative correlation between the total score and the score of all dimensions of body image with the total score and all dimensions of MRS (P < 0.001). There were also significant relationships between women's body image with: their education (P < 0.001, r = 0.20) the spouse's education (P < 0.001, r = 0.26), adequacy of monthly household income (P < 0.001, r = 0.32), marital status (P = 0.36), their occupation (P = 0.007) and housing status (P = 0.012). There was also a significant negative correlation between women's lower body organs image with the number of children (P = 0.017, r = - 0.14). According to the multiple linear regressions model, severity of menopausal symptoms (Beta = - 0.45, P < 0.001) and adequacy of monthly household income (Beta = 0.15, P = 0.005) are the significant related factors with postmenopausal women's body image. CONCLUSIONS: Body image is correlated with menopausal symptoms of women during menopause. Therefore, it seems that interventions aimed at relieving the annoying symptoms of menopause can help to improve their body image. Also, body image could be influenced by some socio-demographic factors which should be considered in menopause health promotion programs.


Assuntos
Imagem Corporal , Pós-Menopausa , Idoso , Estudos Transversais , Feminino , Fogachos , Humanos , Irã (Geográfico)/epidemiologia , Menopausa , Pessoa de Meia-Idade , Inquéritos e Questionários
6.
Clin Obstet Gynecol ; 64(4): 757-771, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34231526

RESUMO

Menopause is a universal experience for midlife women. The physiological decline in endogenous estrogen can be associated with vasomotor symptoms or hot flashes, sleep disruption, and mood disorders. Long-term concerns arise with sequelae of estrogen loss such as genitourinary syndrome of menopause and osteoporosis. Although the pendulum has swung widely since the 1942 approval of conjugated equine estrogens, estrogen therapy, now available in an ever-expanding menu of preparations, routes of administration, and dosing, remains the most effective means to collectively address these, and potentially, additional concerns. Refinement of knowledge of risks and benefits facilitates patient selection and counseling.


Assuntos
Estrogênios , Fogachos , Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/uso terapêutico , Estrogênios Conjugados (USP)/uso terapêutico , Feminino , Terapia de Reposição Hormonal , Fogachos/tratamento farmacológico , Humanos , Menopausa
7.
Handb Clin Neurol ; 179: 455-460, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34225982

RESUMO

The preoptic area of the hypothalamus is the central hub of thermoregulation in mammals, coordinating autonomic heat-effector pathways in response to sensory information from the ambient and internal environment. This aims to maintain temperature homeostasis at a predetermined thermoregulatory set-point. However, hormonal and neuronal changes during the menopause, including estrogen deficiency, disrupt these normal thermoregulatory responses. This results in abnormal activation of heat dissipation effectors, manifesting clinically as hot flush symptoms. Neurokinin B (NKB) signaling via the neurokinin-3 receptor (NK3R) within the preoptic area is thought to play an important role in the pathophysiology of hot flushes. Therefore attenuation of the NKB/NK3R signaling pathway has garnered much interest as a novel therapeutic target for the amelioration of menopausal hot flushes. Recent clinical trials have demonstrated that NK3R antagonists can produce rapid and sustained improvements in hot flush frequency, severity, and quality of life, without the need for estrogen exposure. Therefore NK3R antagonists are fast emerging as a safe and efficacious alternative to hormone replacement therapy, the current gold standard of treatment.


Assuntos
Neuroendocrinologia , Área Pré-Óptica , Animais , Feminino , Fogachos/terapia , Humanos , Menopausa , Qualidade de Vida
8.
Ann Intern Med ; 174(7): ITC97-ITC112, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34251902

RESUMO

This review focuses on the diagnosis and management of menopause, highlighting both hormonal and nonhormonal treatment options. In particular, the article focuses on recent data on the risks and benefits of hormone therapy to help clinicians better counsel their patients about decision making with regard to understanding and treating menopause symptoms.


Assuntos
Menopausa/fisiologia , Neoplasias da Mama/etiologia , Doenças Cardiovasculares/prevenção & controle , Transtornos Cognitivos/etiologia , Contraindicações de Medicamentos , Terapia de Reposição de Estrogênios/efeitos adversos , Feminino , Estilo de Vida Saudável , Fogachos/tratamento farmacológico , Fogachos/terapia , Humanos , Menopausa/sangue , Menopausa/psicologia , Osteoporose Pós-Menopausa/prevenção & controle , Educação de Pacientes como Assunto , Medição de Risco , Inibidores de Captação de Serotonina/uso terapêutico , Sudorese/fisiologia , Vagina/fisiologia , Sistema Vasomotor/fisiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-34202185

RESUMO

(1) Background and objectives: Due to increasing life expectancy, more than one-third of women's life can be spent in the postmenopausal period. In this period, women have different somatic, psychological, and urogenital symptoms. The present study was done to evaluate postmenopausal symptoms and their correlations among Saudi women attending different primary health centers. (2) Methods: adopting a cross-sectional study was done among 845 postmenopausal women attending different primary health centers. The menopause rating scale (MRS) was utilized to investigate the prevalence and severity of different menopausal manifestations. Data collection was done using a structured anonymous questionnaire disseminated during face-to-face interviews. Analysis of data was done utilizing the SPSS program, version 24. (3) Results: The total MRS score was 15.68 ± 6.85. The mean score of the subscales were: 5.56 ± 2.78 for the somatic domain, 6.04 ± 2.89 for the psychological domain, and 4.08 ± 2.32 for the urogenital domain. Joint and muscle pain (25.2%) and sleep problems (18.6%) were the most prevalent severe/very severe somatic symptoms. The most severe/very severe symptoms of the psychological domain were mental and physical exhaustion (20.2%) and depressed mode (19.2%), while that of the urogenital domain were sexual problems (20.1%) and bladder problems (16.3%). Significant predictors of the subscales of MRS were sociodemographic characteristics such as age, residence, marital status, educational level, and occupation. Furthermore, history of chronic diseases, parity, and menopause duration were significant predictors of the subscales of MRS. (4) Conclusion: women in the present study experience different postmenopausal symptoms. Health care providers should consider this crucial stage of women's life to help elderly women manage these different postmenopausal manifestations.


Assuntos
Fogachos , Pós-Menopausa , Idoso , Estudos Transversais , Feminino , Humanos , Menopausa , Arábia Saudita/epidemiologia , Inquéritos e Questionários
10.
Maturitas ; 150: 42-48, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34274075

RESUMO

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


Assuntos
Dieta Saudável , Dieta , Carboidratos da Dieta/administração & dosagem , Menopausa , Pós-Menopausa , Ansiedade/epidemiologia , Índice de Massa Corporal , Estudos Transversais , Depressão/epidemiologia , Ingestão de Energia , Exercício Físico , Feminino , Fogachos/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Transtornos da Memória/epidemiologia , Pessoa de Meia-Idade , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Inquéritos e Questionários
11.
J Obstet Gynaecol Res ; 47(10): 3677-3690, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34278662

RESUMO

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


Assuntos
Vida Independente , Transtornos do Sono-Vigília , Estudos Transversais , Depressão/epidemiologia , Feminino , Fogachos/epidemiologia , Humanos , Japão/epidemiologia , Estudos Longitudinais , Menopausa , Transtornos do Sono-Vigília/epidemiologia
12.
Menopause ; 28(10): 1150-1156, 2021 07 12.
Artigo em Inglês | MEDLINE | ID: mdl-34260478

RESUMO

OBJECTIVE: This study aimed to assess the effects of the combination of a low-fat plant-based diet and soybeans on the frequency and severity of menopausal hot flashes. METHODS: Postmenopausal women (n = 38) reporting two or more hot flashes/day were randomly assigned to a low-fat, vegan diet, including ½ cup (86 g) of cooked soybeans daily, or to no diet changes for 12 weeks. Frequency and severity of hot flashes were recorded using a mobile application, and vasomotor, psychosocial, physical, and sexual symptoms were assessed using the Menopause-Specific Quality of Life Questionnaire. Significance was assessed using t-tests (continuous outcomes) and chi-squared/McNemar tests (binary outcomes). RESULTS: Total hot flashes decreased 79% in the intervention group (P < 0.001) and 49% in the control group (P = 0.002; between-group P = 0.01). Moderate-to-severe hot flashes decreased 84% in the intervention group (P < 0.001) and 42% in the control group P = 0.009; between-group P = 0.01). From 0 to 12 weeks, 59% (10/17) of intervention-group participants reported becoming free of moderate and severe hot flashes (P = 0.002). There was no change in this variable in the control group (between-group P < 0.001). The Menopause-Specific Quality of Life Questionnaire revealed significantly greater reductions in the intervention group in vasomotor (P < 0.0001), psychosocial (P = 0.04), physical (P < 0.002), and sexual (P = 0.01) domains. CONCLUSIONS: The combination of a low-fat, vegan diet and whole soybeans was associated with reduced frequency and severity of hot flashes and improved quality of life in vasomotor, psychosocial, physical, and sexual domains in postmenopausal women. During the 12-week study period, the majority of intervention-group participants became free of moderate-to-severe hot flashes.


Assuntos
Pós-Menopausa , Soja , Dieta Vegetariana , Fogachos , Humanos , Menopausa , Qualidade de Vida
13.
Womens Health (Lond) ; 17: 17455065211031492, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34253105

RESUMO

Hot flashes are a primary reason for medical visits during menopause. They can interfere with sleep, cause mood disturbances, decrease the overall quality of life, and are associated with significant health care and societal costs. This case report examines the safety and effectiveness of Lepidium peruvianum (maca) for the management of menopausal-related symptoms. A 32-year-old White female presented with hot flashes, night sweats, anxiety, and mood changes following a hysterectomy and oophorectomy. She was provided with a personalized nutrition plan, Lepidium peruvianum (maca), targeted nutrient supplementation, and lifestyle recommendations. These interventions resulted in the safe and effective resolution of hot flashes and anxiety in 2 months and significantly improved her moods and sleep. This case report demonstrated that the use of Lepidium peruvianum, in conjunction with dietary and targeted supplement modifications, appeared to be safe and resulted in the rapid improvements and resolution of symptoms associated with menopause.


Assuntos
Menopausa , Qualidade de Vida , Adulto , Feminino , Fogachos , Humanos , Histerectomia , Ovariectomia
14.
Menopause ; 28(9): 1012-1025, 2021 07 26.
Artigo em Inglês | MEDLINE | ID: mdl-34313615

RESUMO

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


Assuntos
Fogachos , Menopausa , Adulto , Envelhecimento , Feminino , Fogachos/epidemiologia , Humanos , Pessoa de Meia-Idade , Reprodução , Inquéritos e Questionários
15.
Breast Cancer Res Treat ; 188(2): 343-350, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34159473

RESUMO

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


Assuntos
Neoplasias da Mama , Menopausa , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Canadá , Feminino , Pessoal de Saúde , Fogachos/epidemiologia , Fogachos/etiologia , Fogachos/terapia , Humanos , Qualidade de Vida , Inquéritos e Questionários , Sudorese
17.
BJOG ; 128(12): 2024-2033, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33982872

RESUMO

OBJECTIVE: To assess whether folic acid supplementation ameliorates hot flushes. DESIGN: Double-blind, placebo-controlled randomised trial. SETTING: Nine hospitals in England. POPULATION: Postmenopausal women experiencing ≥50 hot flushes weekly. METHODS: Women (n = 164) were randomly assigned in a 1:1 ratio to receive folic acid 5 mg tablet or placebo daily for 12 weeks. Participants recorded frequency and severity of hot flushes in a Sloan Diary daily and completed Greene Climacteric and Utian Quality of Life (UQoL) Scales at 4-week intervals. MAIN OUTCOME MEASURES: The change in daily Hot Flush Score at week 12 from randomisation based on Sloan Diary Composite Score B calculation. RESULTS: Data of 143 (87%) women were available for the primary outcome. The mean change (SD) in Hot Flush Score at week 12 was -6.98 (10.30) and -4.57 (9.46) for folic acid and placebo group, respectively. The difference between groups in the mean change was -2.41 (95% CI -5.68 to 0.87) (P = 0.149) and in the adjusted mean change -2.61 (95% CI -5.72 to 0.49) (P = 0.098). Analysis of secondary outcomes indicated an increased benefit in the folic acid group regarding changes in total and emotional UQoL scores at week 8 when compared with placebo. The difference in the mean change from baseline was 5.22 (95% CI 1.16-9.28) and 1.88 (95% CI 0.23-3.52) for total and emotional score, respectively. CONCLUSIONS: The study was not able to demonstrate that folic acid had a statistically significant greater benefit in reducing Hot Flush Score over 12 weeks in postmenopausal women when compared with placebo. TWEETABLE ABSTRACT: Folic acid may ameliorate hot flushes in postmenopausal women but confirmation is required from a larger study.


Assuntos
Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Fogachos/tratamento farmacológico , Pós-Menopausa/efeitos dos fármacos , Método Duplo-Cego , Inglaterra , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
20.
Menopause ; 28(8): 875-882, 2021 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-34033602

RESUMO

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


Assuntos
Menopausa , Qualidade de Vida , Estudos Transversais , Feminino , Fogachos/epidemiologia , Humanos , Prevalência , Inquéritos e Questionários , Sudorese
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