Metabolic disorder and obesity in 5027 Brazilian postmenopausal women.

OBJECTIVES: To evaluate the frequency of obesity in postmenopausal women and assess the potential effects of increased body mass index (BMI) on lipoprotein profile and on risk factors for arterial hypertension and diabetes. DESIGN: A cross-sectional study was conducted with 5027 postmenopausal Brazilian women. Analyses were performed of BMI and cardiovascular factors (systemic blood pressure [BP], total cholesterol, low-density lipoprotein, high-density lipoprotein [HDL-C], triglyceride, and fast glucose). The statistical analysis included the chi-square and Mann-Whitney tests. The significance level was set at 5%. RESULTS: Obesity (BMI >30) in our study characterized approximately 30% of the 5027 postmenopausal women. The comparison of patients with normal BMI and those with high BMI showed that high BMI had a significant negative effect on BP, as evidenced by the increased frequency of hypertension in overweight and obese patients (>25) (p < 0.001), that it also negatively and significantly affected triglyceride (p < 0.001) and fast glucose levels (p < 0.001), and that it was linked significantly to low levels of HDL-C. CONCLUSION: Our data showed the high frequency of obesity in our population and of the cardiovascular risks (glucose, systemic arterial hypertension, and low HDL-C) associated with high BMI.

Gynecological cancer and metabolic screening of 1001 elderly Brazilian women.

OBJECTIVE: The aim of this study was to evaluate gynecological cancer and metabolic screening of Brazilian women aged 65 years or older. METHODS: This retrospective descriptive study was conducted by including 1,001 Brazilian patients of the gynecological geriatric outpatient office of our institution to evaluate the influence of age on gynecological cancer and metabolic screening parameters at the first clinical visit. All patients were divided into three groups: a) 65 to 69 years; b) 70 to 74 years; c) ≥ 75 years. We considered clinical, laboratorial, and image data as variables of this study. The Chi-square test was used to assess the proportion of differences among the age groups, and Kruskal-Wallis was used for quantitative variables. RESULTS: The values of BMI and height in the group over 75 years was lower than that of the 65 to 69 years (p = 0.001). Regardless of the age group, high arterial blood pressure levels were found in 85.45% of participants. Also, many patients had glucose intolerance in the blood. The pelvic ultrasonography showed abnormal endometrial echo thickness (> 5 mm) in 6.14% of patients, but with no significant statistical difference between the age groups. A total of 4.04% of patients had ovaries with high volume values ( > 6.1 mL). Abnormal mammography (BI-RADS 3 or 4) was observed in 12.21%. CONCLUSIONS: our data suggest that a great reduction in BMI and stature is more frequent in the group over 75 years. Also, systemic arterial hypertension and carbohydrate disturbance are frequent morbidities in women over 65 years.

Brazilian Women's Health after 65 Years of Age.

Purpose The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age. Design This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a cross-sectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data. Results The age of the patients on their first clinic visit ranged from 65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the body mass index (BMI) found decreases in BMI with increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years. Conclusions Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.

Objetivo Avaliar os aspectos de saúde das mulheres brasileiras após os 65 anos de idade. Métodos O estudo foi retrospectivo, e incluiu 1.001 mulheres brasileiras atendidas no ambulatório de ginecologia geriátrica de nossa instituição. Foi feita uma análise transversal de mulheres com idade acima de 65 anos, incluindo dados demográficos, sintomas clínicos (sintomas vasomotores), morbidades associadas, bem como alterações no exame físico e queixas em relação à atividade sexual. Utilizamos o teste qui-quadrado para avaliar os dados. Resultados A idade das pacientes na primeira visita clínica variou de 65 a 98 anos, com média etária de 68,56 ± 4,47 anos. A média etária de entrada na menopausa foi de 48,76 ± 5,07 anos. Os sintomas clínicos mais frequentes relatados durante o período analisado foram os sintomas vasomotores (n = 188), seguidos de artropatia, astenia e vagina seca. As morbidades associadas mais frequentes após os 65 anos foram hipertensão arterial sistêmica, distúrbios gastrintestinais, diabete melito e depressão, entre outras. A avaliação do índice de massa corporal (IMC) mostrou redução deste parâmetro antropométrico com o progredir da idade. No momento da visita, 78 pacientes relataram ter relações sexuais. A maioria das mulheres que relatou ter relações sexuais (89,75%, n = 70) estava entre 65 e 69 anos, 8,97% (n = 7) tinham entre 70 e 74 anos, e apenas 1,28% (n = 1) eram mais velhas do que 75 anos de idade. Conclusões Nossos achados sugerem que os sintomas vasomotores podem persistir após os 65 anos. Houve uma diminuição significativa na relação sexual com o aumento da idade. Os distúrbios cardiovasculares em nosso estudo são preocupações de saúde nestas mulheres.

Female aging.

Female aging is a process that involves hypoestrogenism time, the individual impact on each woman, and what we can do as experts to reduce morbidity and provide quality of life. This natural process in the female life cycle has been of concern to women after menopause. Changes in different biophysical and psychosocial aspects, and their individual experiences, have repercussions on the lives of patients seeking specialized and multidisciplinary support to reduce the harmful effects of prolonged hypoestrogenism. Overweight and obesity, inadequate living habits and the presence of multi-morbidities cause damage to the quality of life and impact the functional capacity. Behavioral prescription and hormone therapy are among the treatments given to ease symptoms and reduce morbidity. A better understanding of these factors can help identify groups that require more care after menopause.

[Assessment of orgasmic capacity of postmenopausal women]. / Avaliação da capacidade orgástica em mulheres na pós-menopausa.

OBJECTIVE: To correlate the capacity of healthy postmenopausal women to have orgasms (during intercourse or by solitary masturbation) with psychosocial, behavioral, climacteric, hormonal and interpersonal factors. METHODS: Nine hundred and ninety-nine women (aged from 41 to 60 years) underwent physical and supplementary tests and answered questionnaires regarding sexual behaviour. Sixty healthy women, sexually active, with one or more years of amenorrhea, without hormone therapy and with a partner capable of intercourse were chosen from this group. A Logistic Regression Model with one dependent variable -- orgasmic capacity -- and seventeen independent variables -- psychosocial, behavioral, interpersonal, climacteric and hormonal factors -- was developed. RESULTS: The orgasmic capacity correlated significantly with the practice of masturbation (p=0.000), with pleasure in embracing and caressing the partner's body (p=0.036) and with the presence of vaginal dryness (p=0.021). CONCLUSIONS: This study shows that the most important factors were interpersonal and behavioral and that the other parameters considered were not statistically significant. Women with vaginal dryness, who however engage in masturbation and maintain an affective relationship with their partner, obtain an equal or a greater number of orgasms when compared to the frequency of sexual intercourse.

Gynecological cancer and metabolic screening of 1001 elderly Brazilian women

SUMMARY OBJECTIVE The aim of this study was to evaluate gynecological cancer and metabolic screening of Brazilian women aged 65 years or older. METHODS This retrospective descriptive study was conducted by including 1,001 Brazilian patients of the gynecological geriatric outpatient office of our institution to evaluate the influence of age on gynecological cancer and metabolic screening parameters at the first clinical visit. All patients were divided into three groups: a) 65 to 69 years; b) 70 to 74 years; c) ≥ 75 years. We considered clinical, laboratorial, and image data as variables of this study. The Chi-square test was used to assess the proportion of differences among the age groups, and Kruskal-Wallis was used for quantitative variables. RESULTS The values of BMI and height in the group over 75 years was lower than that of the 65 to 69 years (p = 0.001). Regardless of the age group, high arterial blood pressure levels were found in 85.45% of participants. Also, many patients had glucose intolerance in the blood. The pelvic ultrasonography showed abnormal endometrial echo thickness (> 5 mm) in 6.14% of patients, but with no significant statistical difference between the age groups. A total of 4.04% of patients had ovaries with high volume values ( > 6.1 mL). Abnormal mammography (BI-RADS 3 or 4) was observed in 12.21%. CONCLUSIONS our data suggest that a great reduction in BMI and stature is more frequent in the group over 75 years. Also, systemic arterial hypertension and carbohydrate disturbance are frequent morbidities in women over 65 years.

RESUMO OBJETIVO O objetivo deste trabalho foi estudar retrospectivamente alguns dados clínicos, laboratoriais e imagens de um grupo de idosas brasileiras. MÉTODOS Estudo observacional retrospectivo realizado com inclusão de 1.001 mulheres brasileiras atendidas no ambulatório de geriatria ginecológica de nossa instituição. Foram analisados: a idade dos pacientes na primeira consulta clínica e a idade na menopausa natural; alguns achados clínicos durante um exame ginecológico; resultados de análises laboratoriais. Considerou-se a relação dessas variáveis com o grupo da idade das mulheres. O teste do qui-quadrado foi utilizado para avaliar os dados e para algumas variáveis, Kruskal-Wallis ou Anova. RESULTADOS A avaliação do IMC e da estatura nas diferentes faixas etárias das mulheres mostrou que, com o aumento da idade, há diminuição do IMC e da estatura (p=0,001). Nível anormal de pressão arterial estava presente em 85,45%. De acordo com o grupo de idade, as medidas laboratoriais foram avaliadas pelo método estatístico Kruskal-Wallis, e a Anova mostrou diferença estatisticamente significante apenas no valor da creatinina, com pequeno aumento com a idade. A ultrassonografia pélvica foi alterada com espessura endometrial normal (>5 mm) em 29 (6,14%), mas sem diferença estatística significativa com os grupos de idade, e os ovários mostraram sete (4,04%) com volume anormal (>6,1). Mamografia anormal (BI-Rads 3 ou 4) foi observada em 104 pacientes (12,21%). CONCLUSÕES O estudo conclui que, com o aumento da idade, há redução do IMC e da estatura. A hipertensão é morbidade frequente. Os dados laboratoriais e a avaliação de imagens deste estudo são importantes para aumentar o conjunto de informações sobre mulheres idosas e talvez para melhorar a assistência à saúde.

Anteroposterior displacement behavior of the center of pressure, without visual reference, in postmenopausal women with and without lumbar osteoporosis.

OBJECTIVE: The aims of this study were to evaluate the anteroposterior displacement behavior of the center of pressure without any visual reference and determine its relationship with knee muscle strength and reports of falls in postmenopausal women. Among those with osteoporosis, the specific objective was to evaluate the correlation of thoracic kyphosis and vitamin D with center of pressure displacement. METHODS: This was a cross-sectional observational study without intervention. The assessments were performed on 126 postmenopausal women (aged 55-65 years) who were grouped according to their lumbar bone density into osteoporosis and control groups. Center of pressure was evaluated on a force platform (100 Hz frequency and 10 Hz filter), with the subjects standing on both feet with eyes closed for 60 seconds. Knee muscle strength was evaluated using an isokinetic dynamometer in concentric/concentric mode at a velocity of 60°/s. In the osteoporosis group, vitamin D was assayed, and the thoracic spine was radiographed. RESULTS: In the control group, there was a correlation between the center of pressure and knee strength (r = 0.37; p<0.003). Reports of falls were not associated with center of pressure displacement (p = 0.056). In the osteoporosis group, thoracic kyphosis and vitamin D levels were not correlated with the center of pressure. CONCLUSION: Anteroposterior center of pressure displacement without visual influence was not associated with falls, thoracic kyphosis or vitamin D in the osteoporosis group. Only knee muscle strength was associated with center of pressure displacement in the control group.

Brazilian Women's Health after 65 Years of Age / Saúde de brasileiras acima dos 65 anos de idade

Abstract Purpose The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age. Design This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a crosssectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data. Results The age of the patients on their first clinic visit ranged from65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the bodymass index (BMI) found decreases inBMIwith increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n = 70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years. Conclusions Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.

Resumo Objetivo Avaliar os aspectos de saúde das mulheres brasileiras após os 65 anos de idade. Métodos O estudo foi retrospectivo, e incluiu 1.001mulheres brasileiras atendidas no ambulatório de ginecologia geriátrica de nossa instituição. Foi feita uma análise transversal de mulheres com idade acima de 65 anos, incluindo dados demográficos, sintomas clínicos (sintomas vasomotores), morbidades associadas, bem como alterações no exame físico e queixas em relação à atividade sexual. Utilizamos o teste qui-quadrado para avaliar os dados. Resultados A idade das pacientes na primeira visita clínica variou de 65 a 98 anos, com média etária de 68,56 ± 4,47 anos. A média etária de entrada na menopausa foi de 48,76 ± 5,07 anos. Os sintomas clínicos mais frequentes relatados durante o período analisado foram os sintomas vasomotores (n = 188), seguidos de artropatia, astenia e vagina seca. Asmorbidades associadasmais frequentes após os65anos foram hipertensão arterial sistêmica, distúrbios gastrintestinais, diabete melito e depressão, entre outras. A avaliação do índice de massa corporal (IMC) mostrou redução deste parâmetro antropométrico com o progredir da idade. No momento da visita, 78 pacientes relataram ter relações sexuais. A maioria das mulheres que relatou ter relações sexuais (89,75%, n = 70) estava entre 65 e 69 anos, 8,97% (n = 7) tinham entre 70 e 74 anos, e apenas 1,28% (n = 1) eram mais velhas do que 75 anos de idade. Conclusões Nossos achados sugerem que os sintomas vasomotores podem persistir após os 65 anos. Houve uma diminuição significativa na relação sexual com o aumento da idade. Os distúrbios cardiovasculares em nosso estudo são preocupações de saúde nestas mulheres.

Effects of Trifolium pratense on the climacteric and sexual symptoms in postmenopause women.

OBJECTIVE: To evaluate the effects of treatment with Trifolium pratense on climacteric symptoms and sexual satisfaction in postmenopausal women. METHODS: This is a prospective, randomized, double-blind, placebo-controlled study. Initially, 120 women aged 45-65 years with menopausal symptoms, more than 12-month amenorrhea and no treatment in the past six months were selected. The participants were then divided into two groups: TG ­ receiving 40 mg Trifolium pratense, 1 capsule/day; PG ­ receiving placebo capsules containing lactose (control), 1 capsule/day. The duration of treatment was 12 months. The patients underwent clinical and laboratory evaluation before treatment and at four, eight and 12 months of treatment. The Kupperman Menopausal Index and the Golombok Rust Inventory of Sexual Satisfaction (GRISS) were used. At the end of the study, each group comprised 50 patients. RESULTS: According to the Kupperman Menopausal Index, there was significant improvement in menopausal symptoms after four months of treatment, especially in relation to hot flashes, when compared to baseline data in both groups. However, no significant differences were observed between groups. There was no improvement in sexual satisfaction after treatment. CONCLUSION: A 12-month treatment with a daily dose of 40 mg Trifolium pratense did not yield a significant improvement in menopausal symptoms and sexual satisfaction.

Female aging / Envelhecimento feminino

SUMMARY Female aging is a process that involves hypoestrogenism time, the individual impact on each woman, and what we can do as experts to reduce morbidity and provide quality of life. This natural process in the female life cycle has been of concern to women after menopause. Changes in different biophysical and psychosocial aspects, and their individual experiences, have repercussions on the lives of patients seeking specialized and multidisciplinary support to reduce the harmful effects of prolonged hypoestrogenism. Overweight and obesity, inadequate living habits and the presence of multi-morbidities cause damage to the quality of life and impact the functional capacity. Behavioral prescription and hormone therapy are among the treatments given to ease symptoms and reduce morbidity. A better understanding of these factors can help identify groups that require more care after menopause.

RESUMO O envelhecimento feminino é um processo em que devemos correlacionar o tempo do hipoestrogenismo com o impacto individual em cada mulher e o que poderemos fazer, enquanto especialistas, para reduzir morbidades e proporcionar qualidade de vida. Esse processo natural no ciclo de vida da mulher tem sido motivo de preocupação das mulheres na pós-menopausa. As transformações nos diferentes aspectos biofísicos, psicossociais e em suas vivências individuais trazem repercussões na vida das pacientes, que buscam apoio especializado e multiprofissional para reduzir os efeitos deletérios do hipoestrogenismo prolongado. O sobrepeso e a obesidade, inadequados hábitos de vida e a presença de multimorbidades trazem prejuízos à qualidade de vida e impactam a capacidade funcional. A prescrição comportamental e a terapia hormonal são tratamentos indicados para amenizar os sintomas e reduzir morbidades. Assim, uma melhor compreensão desses fatores pode ajudar a identificar grupos propensos a cuidados na pós-menopausa.

Sexuality in women with polycystic ovary syndrome: a pilot study.

OBJECTIVE: The objective of this study was to evaluate the sexual behavior of women with polycystic ovary syndrome and the relationship between sexual behavior and the clinical parameters related to this syndrome (obesity, hirsutism and menstrual irregularities). METHODS: A cross-sectional study was carried out involving 48 women with polycystic ovary syndrome. The evaluation was based on the complaints reported by the women with particular emphasis on sexual satisfaction, the presence of a sexual partner, phases of the sexual response cycle (desire, arousal, orgasm and resolution phases), sexual frequency, practice of masturbation, evaluation of less usual sexual habits, degree of intimacy and the quality of communication in the women's involvement with their sexual partner. The variables of sexual behavior (sexual satisfaction, masturbation, sexual fantasies, frequency of desire, arousal and orgasm) were compared with three clinical parameters: menstrual cycle, hirsutism and body mass index (BMI). RESULTS: The sexual initiation, ways of expressing sexuality, communication and intimacy with partner and sexual satisfaction were not influenced by the clinical aspects of the syndrome. With respect to association of polycystic ovary syndrome clinical parameters with sexual behavior, a statistically significant correlation was found with the menstrual cycle. CONCLUSION: The absence of menstruation affected sexual interest in activities not involving the partner, thus increasing the frequency of masturbation.

Anteroposterior displacement behavior of the center of pressure, without visual reference, in postmenopausal women with and without lumbar osteoporosis

OBJECTIVE: The aims of this study were to evaluate the anteroposterior displacement behavior of the center of pressure without any visual reference and determine its relationship with knee muscle strength and reports of falls in postmenopausal women. Among those with osteoporosis, the specific objective was to evaluate the correlation of thoracic kyphosis and vitamin D with center of pressure displacement. METHODS: This was a cross-sectional observational study without intervention. The assessments were performed on 126 postmenopausal women (aged 55-65 years) who were grouped according to their lumbar bone density into osteoporosis and control groups. Center of pressure was evaluated on a force platform (100 Hz frequency and 10 Hz filter), with the subjects standing on both feet with eyes closed for 60 seconds. Knee muscle strength was evaluated using an isokinetic dynamometer in concentric/concentric mode at a velocity of 60°/s. In the osteoporosis group, vitamin D was assayed, and the thoracic spine was radiographed. RESULTS: In the control group, there was a correlation between the center of pressure and knee strength (r = 0.37; p<0.003). Reports of falls were not associated with center of pressure displacement (p = 0.056). In the osteoporosis group, thoracic kyphosis and vitamin D levels were not correlated with the center of pressure. CONCLUSION: Anteroposterior center of pressure displacement without visual influence was not associated with falls, thoracic kyphosis or vitamin D in the osteoporosis group. Only knee muscle strength was associated with center of pressure displacement in the control group. .

Anorexia nervosa: revisão baseada em evidências / Anorexia nervosa: evidence-based review

Este trabalho de revisão baseada em evidências foi idealizado para analisar aspectos relevantes de pacientes com anorexia nervosa, pois esta afeta grande número de mulheres, principalmente na adolescência, antes dos 25 anos, causando vários distúrbios clínicos. O objetivo foi avaliar, de acordo com a literatura, por meio de metodologia adequada, o quadro clínico mais característico, como fazer o diagnóstico e a melhor abordagem de tratamento. Os resultados desta revisão apontaram as melhores evidências de que o quadro clínico mostra distúrbios emocionais relacionados ao medo de engordar, perda de peso e suas repercussões clínicas. O diagnóstico é fundamentalmente clínico e o tratamento mais adequado consta de reabilitação alimentar, atendimento por equipe de especialistas, cuidados gerais e outras medidas, estas ainda sem evidências conclusivas de benefícios

This evidence-based review paper was organized in order to analyze relevant aspects of patients with anorexia nervosa because it affects a larger number of women, especially teenagers, before 25 years old, and causing a lot of clinical outcomes. The objective of the study was to evaluate according the literature by a proper methodology, the main clinical aspects, how to make the diagnosis and the best approach for treatment. The results of this review showed the best evidences of clinical aspects that were emotional disturbances related to gain weight, loss of weight and its clinical outcomes. The diagnostic is essentially by clinical data and the best treatment consists of assistance by a team of specialists, nutrition intervention, general cares and other treatments still without conclusive evidences of benefits