Dissertations / Theses: 'Menopause'

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Antoine, Caroline. "Menopause, breast cancer and menopausal treatments." Doctoral thesis, Universite Libre de Bruxelles, 2018. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/271843.

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RESUME Introduction: Le cancer du sein (CS) est le cancer le plus fréquent chez la femme. Le risque de CS est influencé par de nombreux facteurs. Le traitement hormonal de la ménopause (THM) est l’un d’entre eux. Le risque de CS associé au THM varie probablement en fonction de la population traitée, du type de traitement utilisé, de la durée du traitement et du moment où il est instauré par rapport au début de la ménopause. Il existe des alternatives au THM pour soulager les symptômes de la ménopause. Quelques traitements ont montré une certaine efficacité mais présentent des effets secondaires. D’autres traitements doivent faire l’objet d’études plus approfondies. Objectifs: 1) Contribuer à l’analyse de l’influence du THM sur le CS. 2) Contribuer à l’amélioration de la qualité de vie des patientes ayant eu un CS. Résultats: 1) Nous avons analysé l’évolution de l’incidence du CS et des ventes de THM en Belgique et montré une corrélation entre ces deux paramètres. Nous avons réalisé une revue systématique des études analysant l’association entre l’incidence du CS et l’utilisation de THM. Toutes présentaient des limitations et leur hétérogénéité les rendait difficilement comparables. Nous avons analysé l’évolution des ventes de THM en Europe et montré une diminution importante au cours de la dernière décennie dans l’ensemble des pays étudiés. Nous avons analysé l’évolution de l’incidence du CS et de l’utilisation des THM dans différents pays européens et n’avons pas trouvé d’association entre ces deux paramètres. Nous avons réalisé une revue systématique des études évaluant l’influence du THM sur les caractéristiques du CS et montré que les CS développés sous THM n’étaient pas de meilleur pronostic. 2) Nous avons réalisé deux revues systématiques sur la sécurité d’emploi des THM et des traitements non hormonaux de la ménopause chez les femmes ayant eu un CS. Nous avons montré que le CS représentait une contre-indication au THM et que peu de données existaient concernant les traitements alternatifs. Nous avons mené deux études concernant l’utilisation de traitements de la ménopause chez les femmes ayant eu un CS et montré qu’une proportion importante des femmes ayant eu un CS présentait des symptômes de la ménopause mais que peu d’entre elles utilisaient un traitement. Certains de ces traitements pouvaient potentiellement réduire l’efficacité de leur traitement contre le CS. Conclusions: 1) L’influence exacte du THM sur l’incidence du CS reste difficile à déterminer. D’autres facteurs interviennent également. Nous avons montré l’importance du temps lorsqu’on observe l’évolution de deux paramètres. 2) Les traitements sûrs et efficaces des symptômes de la ménopause chez les femmes ayant eu un CS sont limités. La qualité de vie des patientes ménopausées, ayant souffert d’un CS, peut cependant être nettement améliorée.
ABSTRACT Introduction: Breast cancer (BC) is the most common cancer in women. BC risk is influenced by many factors. Menopausal hormone therapy (MHT) is one of them. BC risk associated with MHT may vary depending on the treated population, the type of MHT used, the treatment duration and the delay between the beginning of the treatment and the onset of the menopause. There are alternatives to MHT for the treatment of menopausal symptoms. Some of them have shown some efficacy but have side-effects. Others need further research. Objectives: (1) To contribute to the analysis of the influence of MHT on BC; (2) to contribute to the improvement of the quality of life of BC patients. Results: (1) We analysed changes in BC incidence and MHT sales in Belgium and showed a correlation between these two parameters. We made a systematic review of studies analysing the association between BC incidence and MHT use. All the studies had limitations and were heterogeneous, making them difficult to compare. We analysed changes in MHT sales in Europe and showed an important decrease during the last decade in all the studied countries. We analysed changes in BC incidence and MHT sales in several European countries and found no association between these two parameters. We made a systematic review of studies assessing the influence of MHT on BC characteristics and showed that cases of BC developed under MHT did not have a better prognosis. (2) We made two systematic reviews on the safety of MHT and non-hormonal treatments in BC patients. We showed that BC was a contra-indication to MHT and that few data on alternative treatments were available. We conducted two studies on the use of treatments to alleviate menopausal symptoms in BC patients and showed that an important proportion of these women suffered menopausal symptoms but that few of them were using a treatment. Some of these treatments could reduce the efficacy of their BC treatment. Conclusions: (1) The exact influence of MHT on BC incidence is difficult to evaluate. Other factors are also involved. We showed that long follow-ups are needed when analysing time trends. (2) Efficient and safe treatments for menopausal symptoms in BC patients are limited. However, the quality of life of BC patients may be improved.
Doctorat en Sciences biomédicales et pharmaceutiques (Médecine)
info:eu-repo/semantics/nonPublished

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Pimenta, Filipa. "Menopause and midlife: menopausal symptoms, body weight and well-being." Doctoral thesis, ISPA - Instituto Universitário, 2011. http://hdl.handle.net/10400.12/1346.

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Dissertação apresentado ao ISPA-Instituto Universitário para obtenção do grau de Doutor em Psicologia Aplicada: Especialidade Psicologia da Saúde
A menopausa tem sido genericamente definida como um fenómeno bio-médico, tendo como consequência a emergência de sintomas físicos e psicológicos decorrentes da diminuição de estrogénios endógenos. O presente trabalho pretende alargar esta conceptualização da menopausa, contextualizando-a no modelo bio-psico-sócio-cultural, explorando se variáveis pessoais (como a espiritualidade) e contextuais (por exemplo, acontecimentos de vida) podem predizer sintomas reconhecidos como de menopausa. É ainda objectivo deste estudo explorar que variáveis estão associadas ao aumento de peso na transição para a menopausa e na pós-menopausa, e se uma intervenção breve cognitivo-comportamental pode promover a diminuição de peso em mulheres com obesidade e excesso de peso. Finalmente, pretende-se construir um modelo causal de bem-estar subjectivo na meia-idade. Uma amostra comunitária constituída por 1.003 mulheres com idades compreendidas entre os 42 e os 60 anos, recolhida maioritariamente através de estabelecimentos de ensino na área de Lisboa, preencheu um questionário para recolha de informação sócio-demográfica, relacionada com saúde, menopausa e estilo de vida. As participantes responderam ainda a instrumentos validados para averiguar o bem-estar subjectivo, depressão, ansiedade e stress, sintomas de menopausa, percepção de controlo sobre os afrontamentos, espiritualidade, acontecimento de vida e preocupações com a forma corporal. Desta amostra, 17 mulheres com excesso de peso ou obesidade participaram numa intervenção cognitivo-comportamental individual para a perda de peso. Antes da intervenção, imediatamente após e quatro meses depois do seu término, as participantes foram avaliadas em relação a medidas antropométricas, psicológicas e de comportamento alimentar. Os resultados mostram que, tanto os acontecimentos de vida, como a espiritualidade, predizem de forma significativa a gravidade dos sintomas de menopausa. Além destes, também variáveis de estilo de vida, sócio-demográficas e relacionadas com o estado de saúde associam-se de forma significativa a estes sintomas. Dos doze grupos de sintomas de menopausa averiguados (psicológicos e físicos), apenas três são preditos pelo estado de menopausa. Assim, sintomas vasomotores, sexuais e alterações na pele e nos pêlos faciais são os únicos sintomas que parecem decorrer das alterações hormonais. Observou-se ainda que mulheres com uma escolaridade mais baixa, com uma prática de exercício físico mais reduzida, com um problema psicológico auto-relatado, mais preocupadas com a forma corporal e em pós-menopausa apresentavam um ganho de peso maior. A perda de peso após a intervenção mostrou-se estatisticamente significativa, comparando o peso antes da intervenção e quatro meses após a mesma, ficando contudo abaixo dos 5% do peso corporal. Verificou-se ainda que o bem-estar subjectivo na meia-idade é predito pelo humor deprimido, presença de um problema psicológico, espiritualidade, stress, acontecimentos de vida e ainda consumo de café. Esta investigação permite concluir que a maior parte dos sintomas identificados como decorrentes da menopausa são, nesta amostra, determinados por factores não hormonais, sendo a única sintomatologia consequente do estado de menopausa os sintomas sexuais, vasomotores e alterações na pele/pêlos faciais. Tal contribui para uma compreensão da menopausa para além da abordagem medicalizada que tem vigorado na literatura. Adicionalmente, são identificados factores de vulnerabilidade em relação ao aumento de peso e bem-estar na meia-idade, que permitem potenciar mudanças neste âmbito. ---------- ABSTRACT ---------- Menopause has been generically defined as a bio-medical phenomenon, having as consequence the emergence of physical and psychological symptoms, subsequent to the decrease of endogenous estrogens. The present research intends to broaden this conceptualization of menopause, contextualizing it in the bio-psycho-socio-cultural model. Therefore, we will explore if personal (such as spirituality) and contextual variables (for example, life events) can predict symptoms recognized as menopausal ones. It is also the aim of this study to investigate which variables are associated with weight gain in the menopausal transition and post-menopause. Also, it is our objective to explore if a brief cognitive-behavioural intervention can promote a weight decrease in obese and overweight women. Finally, we intend to build a causal model of subjective well-being in midlife. A community sample of 1,003 women, aged between 42 and 60 years, mainly collected in schools and universities in Lisbon, answered a questionnaire to gather socio-demographic, health and menopause-related, and lifestyle information. Moreover, participants filled in validated instruments to assess subjective well-being, depression, anxiety and stress, menopausal symptoms, perceived control over hot flashes, spirituality, life events and body shape concerns. From this sample, 17 overweight and obese women participated in an individual cognitive-behavioural intervention for weight loss. Before the intervention, immediately after and at a 4-month follow-up, participants were assessed regarding anthropometric, psychological and eating behaviour variables. Results show that both life events and spirituality significantly predicted menopausal symptoms’ severity. Besides these two, also lifestyle, socio-demographic and health-related variables were significantly associated with menopausal symptoms. From the twelve sets of menopausal symptoms assessed (psychological and physical), only three were predicted by the menopausal status. Therefore, vasomotor and sexual symptoms, and skin and facial hair changes are the only ones which appear to be a consequence of hormonal changes. Women with less schooling years, less physical activity, the presence of a self-reported psychological problem, more concerned with body shape and in post-menopause, manifested higher weight gain. The weight loss consequent to the cognitive-behavioural intervention was statistically significant, when comparing body weight prior to the intervention and weight at the follow-up; however, the loss was lower than 5% of body weight. Subjective well-being in midlife was predicted by depressive mood, presence of a psychological problem, spirituality, stress, life events and coffee intake. This research allows the conclusion that the majority of symptoms identified as menopausal are, in this sample, determined by non-hormonal factors; the only symptoms consequent to menopausal status are sexual, vasomotor and skin/facial hair changes. This outcome contributes to an understating of menopause beyond the medicalized approach that is common in the literature. Additionally, vulnerability factors for weight modifications and well-being in midlife, which allow the development of changes in this field, were identified.
Programa Operacional Ciência e Inovação (POCI 2010) da Fundação para a Ciência e Tecnologia

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Al-Sejari, Maha M. "Age at natural menopause and menopausal symptoms among Saudi Arabian women in Al-Khobar." Connect to this title online, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1116611916.

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Thesis (Ph. D.)--Ohio State University, 2005.
Title from first page of PDF file. Document formatted into pages; contains xx, 207 p.; also includes graphics Includes bibliographical references (p. 181-207). Available online via OhioLINK's ETD Center

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Stephan, Cristina [UNESP]. "Associação entre a densidade mineral óssea da coluna lombar e do fêmur e do perfil lipídico e lipoprotéico em pacientes pós-menopáusicas com osteoporose." Universidade Estadual Paulista (UNESP), 2006. http://hdl.handle.net/11449/95372.

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Fundação para o Desenvolvimento Médico e Hospitalar (Famesp)
O objetivo deste estudo foi avaliar a associação entre a densidade mineral óssea da coluna lombar e do fêmur e o perfil lipídico e lipoprotéico em pacientes pósmenopáusicas com osteoporose. Foram avaliadas 351 pacientes com média etária de 64,4 anos, em estudo de corte transversal. Foram analisadas as correlações entre a densidade mineral óssea da coluna lombar e as distintas variáveis do perfil lipídico e lipoprotéico. Iguais correlações também foram estudadas em relação à densidade mineral óssea do colo do fêmur. Levou-se em conta para as referidas análises o tempo de pós-menopausa e o índice de massa corporal das pacientes. Ao final, pode-se concluir pela existência de associação significativa entre os níveis plasmáticos de HDLC e a presença de osteoporose do colo do fêmur somente nas pacientes com mais de 10 anos de pós-menopausa. Estas apresentaram níveis plasmáticos de HDL-C significativamente mais elevados. Não houve associação entre a densidade mineral óssea do colo do fêmur e as demais variáveis do perfil lipídico e lipoprotéico (CT, LDL-C e TG). Também não houve associação entre a densidade mineral óssea da coluna vertebral e as variáveis analisadas do perfil lipídico e lipoprotéico (CT, LDL-C, HDL-C e TG)
The aim of this study was to analyze the association between the bone mineral density (BMD) in the lumbar spine and hip and the lipid and lipoprotein profile in post-menopause women with osteoporosis. A sectional study was performed with 351 women. Their mean age was 64,4 years. We performed a linear correlation between the lumbar spine BMD and the variables of the lipid and lipoprotein profile (CT: total cholesterol; HDL-C: high lipoprotein density; LDL-C: low lipoprotein density; TG: tryglicerides). The same procedure was done with the hip BMD. We also analized the time since menopause and bone mass index. In the end of the study we concludes that there was a significant association between HDL-C plasmatic levels in the hip only in women with more than 10 years since menopause. They had HDL-C plasmatic levels signifcantly higher. There wasnþt an association between the hip BMD and the other lipid and lipoprotein variables (CT, LDL-C,TG). Also, there wasnþt an association between the lumbar spine BMD and the lipid and lipoprotein variables (CT, HDL-C, LDl-C, TG)

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Fernandes, Ana Lucia Ribeiro Valadares. "Sexualidade em mulheres entre 40 e 65 anos e com onze anos ou mais de escolaridade : estudo de base populacional." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313666.

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Orientador: Aarão Mendes Pinto-Neto, Delio Marques Conde
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Objetivos: Avaliar aspectos da sexualidade e seus fatores associados em mulheres de meia-idade, com 11 anos ou mais de escolaridade. Métodos: Estudo populacional de corte transversal, com questionário anônimo auto-respondido por 378 mulheres brasileiras residentes em Belo Horizonte, Minas Gerais, entre 40 e 65 anos, com 11 anos ou mais de escolaridade, no período de maio a setembro de 2005. o instrumento de avaliação baseou-se no Short Personal Experiences Questionnaire (SPEQ). O escore de sexualidade foi calculado através da análise multivariada de sete componentes: presença de fantasias sexuais, grau de desejo, freqüência de atividade sexual, satisfação nas atividades sexuais, freqüência de excitação, orgasmo e a autoclassificação da vida sexual. Considerou-se escore de sexualidade abaixo da mediana como sexualidade ruim e maior ou igual à mediana como sexualidade boa. Para se investigar os fatores associados, os dados foram analisados usando-se a análise bivariada, com aplicação dos testes qui-quadrado e exato de Fisher. Por último, a análise por regressão múltipla de Poisson foi realizada. A razão de prevalência (RP) e o respectivo intervalo de confiança de 95% (IC 95%) foram calculados. Resultados: 276 questionários foram avaliados e, destes, 219 mulheres relataram ter parceiro sexual. A mediana do escore de sexualidade foi 9,0 (variação: 2,45-13,77). A análise de regressão múltipla mostrou que a prevalência de escore de sexualidade abaixo da mediana foi maior nas mulheres com mais idade e naquelas com insônia. Ter parceiro sexual e sentir-se bem indicaram efeito protetor contra baixo escore de sexualidade. Em mulheres com parceiro sexual, a prevalência de escore abaixo da mediana foi maior nas que moravam com o parceiro, que estavam na transição menopausal ou na pós menopausa e nas hipertensas. Ter relações sexuais com penetração e satisfação com o parceiro como amante indicaram efeito protetor contra escore de sexualidade abaixo da mediana. Conclusões: Mulheres com mais idade e que relataram insônia tiveram maior chance de ter sexualidade ruim, enquanto as com parceiro sexual e que se sentiram bem tiveram maior probabilidade de apresentar sexualidade boa. No grupo de mulheres que tinham parceiro sexual, a sexualidade foi negativamente associada ao fato de residir com o parceiro, estar na transição menopausal ou pós-menopausa e ser hipertensa. A satisfação com o parceiro como amante e ter relações sexuais com penetração diminuíram a probabilidade de apresentar sexualidade baixa
Abstract: Objectives: To evaluate aspects of sexuality and associated factors in middle aged women with 11 or more years of formal education. Methods: with living in Belo Horizonte (Minas Gerais), between 4, in the period between May and September 2005. The evaluation instrument was based on the Short Personal Experíences Questíonnaíre (SPEQ). Sexuality score was calculated from the multivariate analysis of the seven components: presence of sexual fantasies, intensity of desire, frequency of sexual activities, satisfaction in sexual activities, frequency of arousal, orgasm and self-classification of sexual life. The sexuality score below the median was considered bad sexuality and equal or higher than median as good sexuality. To investigate associated factors, data were analyzed using bivariate analysis and chi-squared and Fisher's exact tests were applied. Finally, Poisson multiple regression analysis was performed. The software used was Stata 7.0. Prevalence ratios (PR) and their 95% confidence intervals (95% CI) were calculated. Results: 276 questionnaires were evaluated and from these 219 women reported having sexual partners. The median sexuality score was 9.0 (range: 2.45-13.77). Multiple regression analysis showed that the prevalence of below median scores was higher in older women and in those with insomnia. Having a sexual partner and feeling well was associated with a protective effect against a below median sexuality score. In women with sexual partner, the prevalence of below median scores was higher in women who lived with their sexual partner, were in the menopausal transition or postmenopausal and in hypertensive women. Sexual activities involving penetration and a score of 6 for satisfaction with partner as a lover were indicative of a protective effect against below median sexuality score. Conclusions: Older women and those with insomnia were more likely to have a bad sexuality, whereas the ones with a sexual partner and who felt well were more likely to have a good sexuality. In the group which had sexual partner, the sexuality of women in midlife was negatively associated with the fact of living with a sexual partner, being in the menopausal transition or postmenopausal and being hypertensive. Satisfaction with the sexual partner as a lover and having sexual activities with penetration decreased the chance of poor sexuality
Doutorado
Tocoginecologia
Mestre em Tocoginecologia

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Borges, Pítia Cárita de Godoy [UNESP]. "Correlação ultrassonográfica e histeroscópica no diagnóstico de pólipos endometriais em mulheres na pós-menopausa." Universidade Estadual Paulista (UNESP), 2010. http://hdl.handle.net/11449/99249.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Para o diagnóstico de pólipo endometrial, dispõe-se da ultrassonografia e da histeroscopia ambulatorial, sendo a última considerada padrão ouro. A ultrassonografia avalia a espessura do endométrio, sua alteração de ecogenicidade e seus limites. Os resultados de tal exame pode sugerir a doença. A histeroscopia ambulatorial, por sua vez, é um exame mais preciso, pois permite uma melhor identificação do pólipo endometrial. Além disso, ela permite a confirmação do diagnóstico através da biópsia, assim como o tratamento. Comparar a ultrassonografia e a histeroscopia ambulatorial como métodos propedêuticos dos pólipos endometriais nas mulheres menopausadas do Serviço de Endoscopia Ginecológica e Planejamento Familiar da Disciplina de Ginecologia do Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Botucatu–Hospital das Clínicas (UNESP). Estudo analítico e retrospectivo cujos dados foram obtidos através de consultas a 323 prontuários de mulheres menopausadas submetidas a ultrassonografia e a histeroscopia ambulatorial no referido setor, no período de março de 2003 a março de 2009. Foram incluídas no estudo 281 mulheres menopausadas na faixa etária de 41 a 82 anos, que haviam sido submetidas à histeroscopia ambulatorial por apresentarem sangramento uterino e/ou ultrassonografia transvaginal alterada (EE≥5 mm), e que, por esses motivos, foram encaminhadas ao ambulatório. A idade média das pacientes foi de 61,3 anos, sendo que 27,6% apresentaram diabetes mellitus tipo II, 70,5% eram hipertensas, 5,7% eram tabagistas. A média do índice de massa corpórea (IMC) foi de 31,6 kg/m2, e 73% eram multíparas (com 3 ou mais partos). A média do tempo de menopausa (amenorreia) foi de 10,7anos, sendo que 15,3% das pacientes eram usuárias de terapia hormonal, e 6,8% estavam em tratamento de câncer de mama com tamoxifeno. Do total de pacientes, 38,1%...
Ultrasonography and outpatient hysteroscopy are considered the “golden standard” for the diagnostic of endometrial polyp. Ultrasonography evaluates the endometrial thickness, the echogenicity and the limits. Its results can suggest the pathology. Outpatient hysteroscopy, on the other hand, is a more accurate exam, providing a better identification of the endometrial polyp and confirming the diagnostic through histological examination. It also may be used as a treatment. Comparison of the ultrasonography with the outpatient hysteroscopy as diagnostic methods for endometrial polyps in postmenopausal women from the Endoscopic and Gynecologic Service of the Medical School of Botucatu – UNESP. Analytical and retrospective study based on the files of 323 postmenopausal women submitted to ultrasonography and to outpatient hysteroscopy from March 2003 to March 2009, wich were performed in the Gynecologic and Obstetric Department of the Medical School of Botucatu (UNESP) – Gynecology Discipline of Botucatu Medical School. In this study, 281 postmenopausal women, with ages between 41 and 82 years, and that had been submitted to outpatient diagnostic hysteroscopy, were included. They had uterine bleeding and/or altered transvaginal ultrasound (EE≥5 mm). Patients mean age was 61,3 years; 27,6% had diabetes mellitus II; 70,5% had systemic arterial hypertension; and 5,7% were smokers. IMC was 31,6 kg/m2, and 73% were multiparae (3 or more deliveries). Average menopause time (amnorrhea) was 10,7 years; 15,3% were under hormonal therapy; and 6,8% were under breast cancer treatment with taximofen. From the 323 patients, 38,1% had uterine bleeding and 61,9% were asymptomatic. Ultrasonography detected endometrial polyp in 22,8% of the patients, endometrial thickness in 59,8%, being 10,5mm the mean thickeness. Comparing the ultrasonography with the histopathology, it was observed that endometrial... (Complete abstract click electronic access below)

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Orsatti, Fábio Lera. "Efeito da isoflavona da soja e treinamento resistido sobre a composição corporal e densidade mineral óssea em mulheres na pós-menopausa /." Botucatu : [s.n.], 2008. http://hdl.handle.net/11449/106384.

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Resumo: Investigar o efeito independente e aditivo do treinamento resistido (TR) e da isoflavona de soja (ISO) sobre a densidade mineral óssea (DMO) e a composição corporal de mulheres na pós-menopausa. Foi conduzido estudo clínico prospectivo, duplo-cego (ISO), placebocontrolado e randomizado dois (ISO x Placebo) por dois (TR x sem TR). Oitenta mulheres sedentárias na pós-menopausa (amenorréia últimos 12 meses, FSH > 40UIml), idade entre 45 a 70 anos, foram randomizadas a um dos quatro grupos (71 completaram 9 meses de intervenção): ISO + TR (n=15; 55,7±7,0); ISO + sem TR (n=20; 56,6±8,8); placebo + TR (n=18; 56,0±5,8); placebo + sem TR (n=18; 55,3±8,0). As participantes randomizadas para ISO receberam 250mg de extrato de soja, total de 100mg/dia de isoflavona. Aquelas randomizadas para TR realizaram sessões de exercícios resistidos supervisionados, mínimo de dois dias na semana, durante 9 meses, que incluiu 2-3 exercícios para os grupamentos musculares maiores (coxa, peito e costa) e 1 exercício para os menores (bíceps e tríceps), em 3 séries de 8-12 repetições máximas. No momento basal e aos 9 meses, a composição corporal (massa gordurosa e muscular) e a DMO (corpo inteiro, colo de fêmur e coluna lombar) foram estimadas pela absortometria radiológica de feixes duplos de energia (DXA, Hologic QDR-2000). Valores plasmáticos de CTX (serum levels of C-terminal cross-linked telopeptides of type I collagen) e de osteocalcina foram dosados como marcadores da reabsorção e formação óssea, respectivamente. Para avaliação antropométrica foram obtidos: peso, estatura, índice de massa corpórea (IMC=peso/altura2), circunferência da cintura (CC) e relação cintura/quadril (RCQ). Valores plasmáticos de isoflavona foram realizados ao final da intervenção para analisar a aderência ao tratamento. Na análise... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: To investigate the independent and additive effects of resistance training (RT) and soy isoflavone (ISO) on bone mineral density (BMD) and body composition in postmenopausal women. This study used a placebo-controlled, double-blind (soy), randomized two (ISO vs placebo) x two (RT vs no-RT) design. A total of 80 sedentary postmenopausal women (>12 months amenorrhea and FSH >40mIU/ml), aged 45- 70 years, was randomized one of four groups (71 completed 9-months intervention): ISO + RT (n=15; 55.7±7.0); ISO + no-RT (n=20; 56.6±8.8); placebo + RT (n=18; 56.0±5.8); placebo + no-RT (n=18; 55,3±8,0). Participants randomized to ISO received 250mg of standardized soy extract, total of 100mg/day of isoflavone. Subjects randomized to RT attended supervised resistance exercise sessions, three days/week for 9-months and included 2-3 exercises for the larger muscle groups, and 1 exercise for smaller groups in 3 series of 8-12 repetitions. At baseline and 9-months, body composition (fat and muscle mass) and BMD (whole body, lumbar spine and femoral neck) were estimated by dual-energy x-ray absorptiometry (DXA, Hologic QDR-2000). Serum levels of C-terminal cross-linked telopeptides of type I collagen (CTX) and osteocalcin were measured as markers of bone resorption and formation, respectively. The anthropometric indicators included: weight, height, body mass index (BMI= weight/height2), waist circumference (WC) and waist/hip ratio (WHR). The plasma levels of isoflavones were measured to assess compliance. The Shapiro-Wilk, Kolmogorov & Smirnov for distribution statistics, and Levene's test for homogeneity of variances, ANOVA-repeated measure, ANOVAone way and post hoc Fisher test, Pearson's correlation, test t and analyze regression forward stepwise were used in the statistical analysis. There were no significant difference... (Complete abstract click electronic access below)
Orientador: Eliana Aguiar Petri Nahás
Coorientador: Jorge Nahás Neto
Banca: Nailza Maestá
Banca: Leone A. Simonetti
Banca: Cesar Eduardo Fernandes
Banca: Aarão Mendes Pinto Neto
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Stephan, Cristina. "Associação entre a densidade mineral óssea da coluna lombar e do fêmur e do perfil lipídico e lipoprotéico em pacientes pós-menopáusicas com osteoporose /." Botucatu : [s.n.], 2006. http://hdl.handle.net/11449/95372.

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Orientador: César Eduardo Fernandes
Banca: César Eduardo Fernandes
Banca: Eliana Aguiar Petri Nahás
Banca: Sérgio Peixoto
Resumo: O objetivo deste estudo foi avaliar a associação entre a densidade mineral óssea da coluna lombar e do fêmur e o perfil lipídico e lipoprotéico em pacientes pósmenopáusicas com osteoporose. Foram avaliadas 351 pacientes com média etária de 64,4 anos, em estudo de corte transversal. Foram analisadas as correlações entre a densidade mineral óssea da coluna lombar e as distintas variáveis do perfil lipídico e lipoprotéico. Iguais correlações também foram estudadas em relação à densidade mineral óssea do colo do fêmur. Levou-se em conta para as referidas análises o tempo de pós-menopausa e o índice de massa corporal das pacientes. Ao final, pode-se concluir pela existência de associação significativa entre os níveis plasmáticos de HDLC e a presença de osteoporose do colo do fêmur somente nas pacientes com mais de 10 anos de pós-menopausa. Estas apresentaram níveis plasmáticos de HDL-C significativamente mais elevados. Não houve associação entre a densidade mineral óssea do colo do fêmur e as demais variáveis do perfil lipídico e lipoprotéico (CT, LDL-C e TG). Também não houve associação entre a densidade mineral óssea da coluna vertebral e as variáveis analisadas do perfil lipídico e lipoprotéico (CT, LDL-C, HDL-C e TG)
Abstract: The aim of this study was to analyze the association between the bone mineral density (BMD) in the lumbar spine and hip and the lipid and lipoprotein profile in post-menopause women with osteoporosis. A sectional study was performed with 351 women. Their mean age was 64,4 years. We performed a linear correlation between the lumbar spine BMD and the variables of the lipid and lipoprotein profile (CT: total cholesterol; HDL-C: high lipoprotein density; LDL-C: low lipoprotein density; TG: tryglicerides). The same procedure was done with the hip BMD. We also analized the time since menopause and bone mass index. In the end of the study we concludes that there was a significant association between HDL-C plasmatic levels in the hip only in women with more than 10 years since menopause. They had HDL-C plasmatic levels signifcantly higher. There wasnþt an association between the hip BMD and the other lipid and lipoprotein variables (CT, LDL-C,TG). Also, there wasnþt an association between the lumbar spine BMD and the lipid and lipoprotein variables (CT, HDL-C, LDl-C, TG)
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Kelly, Jennifer Mary. "Lesbians' experiences of menopause." Connect to this title online, 2003. http://tux.lib.deakin.edu.au/adt-VDU/public/adt-VDU20050825.105816/.

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Kelly, Jennifer Mary, and mikewood@deakin edu au. "Lesbians' experiences of menopause." Deakin University. School of social and International Studies, 2003. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050825.105816.

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This thesis examines the menopausal experiences of a non-clinical sample of lesbians living in Australia. Research on menopause to date has largely been conducted from a medicalised and heterosexual perspective: thus lesbians experiences remain unknown and invisible. Using a qualitative feminist multiple method research methodology combining content analysis and questionnaire/interview research, two hundred questionnaires were posted upon request to self-identified lesbians living in every Australian state and territory. Follow up in-depth interviews were conducted with twenty lesbians. Responses were grouped into four major themes: body image, sex and sexuality, hormone replacement therapy and health services and homophobia. The findings show that lesbians at menopause face some different and additional issues from those experienced by heterosexual midlife women. For many of the study participants, commonly discussed concerns at menopause such as weight gain and other physical signs of ageing, decreased fertility, lack of libido, sexual difficulties and hormone replacement therapy were of little relevance and importance. Lesbians in this study frequently raised other issues such as the universal assumption of heterosexuality and homophobia experienced when interacting with health professionals, which led to less than satisfactory health care and reinforced feelings of invisibility. In the Conclusion I argue that the study participants' views and experiences challenge negative, stereotypical views of both lesbians and menopause. The data thus add a new dimension to the presently narrow, heterosexist and medicalised view of women at midlife and contribute new knowledge to the body of literature on menopause. This thesis is a first important step in recording the experiences of lesbians regarding menopause in Australia. I include recommendations for further research in the area of lesbian health and improved practice, and discuss old and new obstacles lesbians face in a heteropatriarchal society in which lesbians continue to be invisible.

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Lee, Cheuk-kiu Kathy. "Menopause and cognitive functionings." Click to view E-thesis via HKUTO, 2006. http://sunzi.lib.hku.hk/hkuto/record/B3710181X.

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李卓翹 and Cheuk-kiu Kathy Lee. "Menopause and cognitive functionings." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B3710181X.

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Orru, A. J. "Vulvovaginal atrophy during menopause." Thesis, Sumy State University, 2017. http://essuir.sumdu.edu.ua/handle/123456789/58732.

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Objective: To present a basic clinical research based on current evidence about advanced treatment methods for vulvovaginal atrophy during menopause.And on principles of management of patients with vulvovaginal atrophy.Vulvovaginal atrophy (VVA) is a common and underreported condition associated with decreased estrogenization of the vaginal tissue. Symptoms include dryness, irritation, soreness, and dyspareunia with urinary frequency, urgency, and urge incontinence. It can occur at any time in a woman's life cycle, although more commonly in the postmenopausal phase, during which the prevalence is close to 50%. Clinical findings include the presence of pale and dry vulvovaginal mucosa with petechiae. Vaginal rugae disappear, and the cervix may become flush with the vaginal wall

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Hägg, Fanny. "Evolutionary Theories of Menopause." Thesis, Linköpings universitet, Institutionen för fysik, kemi och biologi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-167618.

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Menopause, the cessation of female reproduction well before death, is a puzzling phenomenon, because evolutionary theory suggests there should be no selection for survival when reproduction has ended. Nevertheless, menopause does exist in a limited number of species, and besides humans it has predominately evolved among toothed whales (Odontoceti). The aim of this thesis is to review both adaptive and non-adaptive theories. Of the latter, the most prominent proposes that menopause is a product of a physiological trade-offs between reproductive benefits early in life and negative late-life reproduction. Among the adaptive theories the grandmother hypothesis is the most acknowledged. This theory is based on inclusive fitness benefits gained from increasing the reproductive success of kin at an advanced age, when prospects of successfully raising additional offspring is reduced. Alternatively, the mother hypothesis suggests that increased investment in already produced offspring at late life explains menopause. There are support for both the care of mothers and grandmothers, but whether this is enough to compensate for repressed reproduction is debated. The reproductive conflict hypothesis provides a complementary explanation, and suggests that inter-generational conflict between either in-laws or kin selects the older female to shift investment into the younger female’s offspring due to asymmetries in how older and younger females are related to one another’s offspring. The evolution of menopause is a complex issue, containing many factors, kinship dynamics among the most important. Theories apply unequally to various species and populations, meaning an integrated approach is necessary for decrypting the evolution of menopause.

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Nordgren, Lisa. "Don't pause for menopause." Thesis, Malmö högskola, Fakulteten för kultur och samhälle (KS), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-21464.

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I dagens samhälle finns en allmänt negativ inställning till klimakteriet som grundar sig i genusnormer. Majoriteten av de metoder som finns för att behandla klimakteriebesvär är medicinska och de personer som av olika anledningar inte använder dem lämnas utan alternativ.Den här studien undersökte hur produktdesign kan användas för att underlätta klimakteriebesvär och samtidigt synliggöra klimakteriet. Syftet var att synliggöra klimakteriet och genom det bidra till en positiv inställning till det. Det konkreta målet var att ta fram ett förslag på en produkt som i största möjliga mån uppnår syftet. Studien vilar på en teoretisk grund av genusvetenskap, historisk syn på gynekologin och kvinnosyn, normkritik, normkreativitet samt normkreativ- och användarcentrerad design. Den empiriska insamlingen bestod huvudsakligen av intervjuer och diskussioner med representanter för målgruppen (personer med klimakteriebesvär) samt undersökningar av den befintliga marknaden för klimakterieprodukter och varför den ser ut som den gör.Studiens slutsats visar att en produkt som ska kunna underlätta klimakteriebesvär och samtidigt synliggöra klimakteriet måste uppfylla tre kriterier; underlätta besvären rent praktiskt, vara uppseendeväckande samt vara något som målgruppen är bekväm med att använda bland folk. Den produkt som har tagits fram i den här studien ses enbart som ett av många möjliga lösningsförslag då det inte finns ett korrekt svar på hur en klimakterieprodukt kan se ut eller fungera. Genom att se bortom de normer som vanligtvis styr hur klimakteriebesvär behandlas går det att ta fram nya innovativa alternativ.
Due to gender norms, the general attitude towards menopause in today’s society is negative. The majority of available methods to ease menopause symptoms are medical alternatives and the ones who choose not to use those, for different reasons, are left without an option.This study examined how product design can be used to ease menopausal related problems and contribute to put focus on menopause. The purpose was to make menopause more visible and by that contribute to a positive attitude towards it. The overarching goal was to develop a proposal for a product achieving that. The study relies on a theoretical foundation of gender studies, a historical view of gynecology and perception of women, norm criticism, norm creativity, norm creative design and human-centered design. The empirical evidence consisted mainly of interviews and discussions with representatives from the target group (people with menopausal related problems) and market research of existing menopausal products.The conclusion of the study shows that for making it possible for a product to both ease menopausal problems and make menopause more visible it needs to fulfil three criteria; in a way practically ease the symptoms, be eye-catching and be something the target group are comfortable using around other people. The product that has been developed in this study is only to be considered as one of many possible solutions since there is no correct answer to how a menopausal product should look or function. By moving beyond the norms, that usually control how menopausal problems are treated, it is possible to develop new and innovative alternatives.

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Rodrigues, Edna Talarico. "Avaliação do efeito da isoflavona sobre o epitélio cérvico-vaginal e sintomas da menopausa." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/60/60135/tde-03042009-115328/.

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A menopausa é conseqüência da falência ovariana, caracterizada pela queda na produção de estrógenos, podendo causar na mulher vários sintomas e condições patológicas como vaginite atrófica, osteoporose e doençsa cardiovasculares. A terapia estroprogestiva é largamente prescrita na pós-menopausa, no entanto existem freqüentes efeitos colaterais e contra-indicações, inclusive possibilidade de aumento do câncer de mama. Devido a toda esta polêmica as terapias alternativas para combaterem os sintomas da menopausa estão largamente sendo exploradas, neste contexto cita-se os fitohormônios. A isoflavona é um deles obtido de várias plantas e mais usualmente da soja, que possui na sua molécula uma estrutura fenólica que se liga aos receptores de estrogênio e exerce um efeito estrogênico. Neste estudo enfocando a isoflavona, extraída da soja Glycine max, para o tratamento dos sintomas da menopausa, avaliou-se o efeito desse composto sobre a maturação do epitélio cérvico-vaginal e microbiota vaginal. Para isto propô-se um estudo randomizado, duplo cego, placebo controlado do qual participaram 49 voluntárias. Um grupo de 23 mulheres recebeu 1 cápsula/dia de 40 mg de caseína de leite, constituindo o grupo placebo e o outro grupo de 26 mulheres tratadas com 1 cápsula/dia de 40 mg de isoflavona. Amostras de urina e secreção vaginal para colpocitograma, colpocitograma com coleta úmida, bacterioscopia foram colhidas antes do início e ao término do tratamento. Foram determinados índice de maturação (I.M.) e valor de maturação (V.M.) pela técnica da citologia hormonal. O estudo da microbiota foi avaliado por exame direto a fresco e bacterioscopia de Gram. As mulheres participantes do estudo forneceram dados através de entrevistas mensais, antes do início e após o término do estudo, respondendo a questionários sobre queixas, sintomas, história da vida sexual, percepção da menopausa, estado de saúde e questões sócio demográficas. A avaliação destes dados aparece no índice de Kuppermann, nas maiores queixas e melhoras mais evidentes das mulheres tratadas com isoflavona. A avaliação do I.M. resultou no grupo tratado com isoflavona em redução significativa das células parabasais (P=0,003) no colpocitograma tradicional, em aumento significativo das células superficiais cianofílicas (P=0,006) e tendência de aumento das células superficiais eosinofílicas (P=0,18). No colpocitograma obtido por coleta úmida houve diminuição significativa das células parabasais (P=0,004), aumento significativo na porcentagem de células superficiais cianofílicas (P=0,008) e tendência de aumento das células superficiais eosinofílicas (P=0,18). No urocitograma houve redução significativa de células parabasais (P=0,008), aumento significativo na porcentagem de células superficiais cianofílicas (P=0,013) e aumento das células superficiais eosinofílicas (P=0,002). No grupo placebo não se observou variação significativa nos índices acima mencionados. O V.M. no grupo tratado com isoflavona apresentou aumento significativo (P=0,007) no colpocitograma tradicional, colpocitograma, obtido por coleta úmida (P=0,004); e no urocitograma (P=0,0008). No grupo placebo houve diminuição significativa (P=0,02) para este índice. Após o tratamento pela isoflavona houve aumento significativo de bacilos de Döederlein (P=0,005), diminuição significativa de 19,3% nos casos de vaginose bacteriana (índice de Nugent) e diminuição de outros agentes microbiológicos patogênicos. Houve diminuição dos sintomas da menopausa após o tratamento com isoflavona, também se observou diminuição das queixas após o tratamento com placebo.
The lack of estrogens characterizes postmenopausal condition and is associated with pathological conditions and symptoms, including atrophic vaginites, osteoporosis and cardiovascular disease. Hormone replacement therapy is recommended for postmenopausal women but there are contraindications and side effects. There are many alternative therapy researches in order to alleviate these symptoms. Soy isoflavone has hormonal effects in postmenopausal women, by binding a common phenolic structure to estrogens receptors. The aim of this study focusing isoflavone, extracted from soy beans Glycine max, was to evaluate the effects of isofavone on vaginal cytology, vaginal maturation index (M.I.), maturation value (M.V.), vaginal microbiota and menopausal symptoms. This study involved 49 postmenopausal women, a randomized double blind placebo controlled. The first group of 23 women was treated with 40 mg/day capsule of placebo (caseyne) and the second group of 26 women was treated with 40 mg/day capsule of isoflavone. Urine and vaginal samples for 3 slides: colpocytogram, wet sample colpocytogram, Gram-stained smears was taken at baseline and after treatment in order to determine M.I., M.V., vaginal microbiological findings and colpocytologic findings. Study participants answered an in-person interview with questions in order to determine menopausal symptoms, complains, menopause perception, sexual life, general health to determine, for instance the Kuppermann menopausal index (KMI) at baseline, every month and after six-months of treatment. The M.I. from traditional colpocytogram reduced significantly the parabasal cells (P=0,003), increased significantly the percentage of Superficial Cianophilic cells (P=0,006), there was a tendence of increasing the Superficial Eosinofilic cells (P=0,18). From wet sample colpocytogram, similar results were obtained: reduced significantly the parabasal cells (P=0,004), increased significantly the percentage of Superficial Cianophilic cells (P=0,008) there was a tendence of increasing the Superficial Eosinofilic cells (P=0,18).. In urocytogram, the results obtained were: reduced significantly the parabasal cells (P=0,008), increased significantly the percentage of Superficial Cianophilic cells (P=0,013), increase of Superficial Eosinofilic cells (P=0,002). For placebo group there were no significative changes. The Maturation Value, M.V. increased significtively (P=0,007) in traditional colpocytogram; in wet sample colpocytogram (P=0,004) and in urocytogram (P=0,0008), comparing with placebo was observed significant decrease (P=0,02) for M.V. After treatment with isoflavone there was significative increase of Döederlein bacillus (P=0,005), decrease of 19,3% in cases of bacterial vaginosis (Nugent score) and decrease of others pathogenic microbial agents. The symptoms decreased significatively in woman treated with placebo and decreased significatively in women treated with isoflavone.

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Gourley, Catherine Anne Caldwell. "Alternative discourse on menopause : an examination of the decision-making processes of women regarding menopausal concerns /." Full text (PDF) from UMI/Dissertation Abstracts International, 2001. http://wwwlib.umi.com/cr/utexas/fullcit?p3008340.

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Borges, Pítia Cárita de Godoy. "Correlação ultrassonográfica e histeroscópica no diagnóstico de pólipos endometriais em mulheres na pós-menopausa /." Botucatu, 2010. http://hdl.handle.net/11449/99249.

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Orientador: Rogério Dias
Banca: Jorge Nahas Neto
Banca: Reginaldo Guedes Coelho Lopes
Resumo: Para o diagnóstico de pólipo endometrial, dispõe-se da ultrassonografia e da histeroscopia ambulatorial, sendo a última considerada padrão ouro. A ultrassonografia avalia a espessura do endométrio, sua alteração de ecogenicidade e seus limites. Os resultados de tal exame pode sugerir a doença. A histeroscopia ambulatorial, por sua vez, é um exame mais preciso, pois permite uma melhor identificação do pólipo endometrial. Além disso, ela permite a confirmação do diagnóstico através da biópsia, assim como o tratamento. Comparar a ultrassonografia e a histeroscopia ambulatorial como métodos propedêuticos dos pólipos endometriais nas mulheres menopausadas do Serviço de Endoscopia Ginecológica e Planejamento Familiar da Disciplina de Ginecologia do Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Botucatu-Hospital das Clínicas (UNESP). Estudo analítico e retrospectivo cujos dados foram obtidos através de consultas a 323 prontuários de mulheres menopausadas submetidas a ultrassonografia e a histeroscopia ambulatorial no referido setor, no período de março de 2003 a março de 2009. Foram incluídas no estudo 281 mulheres menopausadas na faixa etária de 41 a 82 anos, que haviam sido submetidas à histeroscopia ambulatorial por apresentarem sangramento uterino e/ou ultrassonografia transvaginal alterada (EE≥5 mm), e que, por esses motivos, foram encaminhadas ao ambulatório. A idade média das pacientes foi de 61,3 anos, sendo que 27,6% apresentaram diabetes mellitus tipo II, 70,5% eram hipertensas, 5,7% eram tabagistas. A média do índice de massa corpórea (IMC) foi de 31,6 kg/m2, e 73% eram multíparas (com 3 ou mais partos). A média do tempo de menopausa (amenorreia) foi de 10,7anos, sendo que 15,3% das pacientes eram usuárias de terapia hormonal, e 6,8% estavam em tratamento de câncer de mama com tamoxifeno. Do total de pacientes, 38,1%... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Ultrasonography and outpatient hysteroscopy are considered the "golden standard" for the diagnostic of endometrial polyp. Ultrasonography evaluates the endometrial thickness, the echogenicity and the limits. Its results can suggest the pathology. Outpatient hysteroscopy, on the other hand, is a more accurate exam, providing a better identification of the endometrial polyp and confirming the diagnostic through histological examination. It also may be used as a treatment. Comparison of the ultrasonography with the outpatient hysteroscopy as diagnostic methods for endometrial polyps in postmenopausal women from the Endoscopic and Gynecologic Service of the Medical School of Botucatu - UNESP. Analytical and retrospective study based on the files of 323 postmenopausal women submitted to ultrasonography and to outpatient hysteroscopy from March 2003 to March 2009, wich were performed in the Gynecologic and Obstetric Department of the Medical School of Botucatu (UNESP) - Gynecology Discipline of Botucatu Medical School. In this study, 281 postmenopausal women, with ages between 41 and 82 years, and that had been submitted to outpatient diagnostic hysteroscopy, were included. They had uterine bleeding and/or altered transvaginal ultrasound (EE≥5 mm). Patients mean age was 61,3 years; 27,6% had diabetes mellitus II; 70,5% had systemic arterial hypertension; and 5,7% were smokers. IMC was 31,6 kg/m2, and 73% were multiparae (3 or more deliveries). Average menopause time (amnorrhea) was 10,7 years; 15,3% were under hormonal therapy; and 6,8% were under breast cancer treatment with taximofen. From the 323 patients, 38,1% had uterine bleeding and 61,9% were asymptomatic. Ultrasonography detected endometrial polyp in 22,8% of the patients, endometrial thickness in 59,8%, being 10,5mm the mean thickeness. Comparing the ultrasonography with the histopathology, it was observed that endometrial... (Complete abstract click electronic access below)
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Pereira, Elaine Cri. "Distúrbios do sono em mulheres na transição menopausal e pós-menopausa." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-17082015-134324/.

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Objetivo - Estimar a incidência dos distúrbios do sono e identificar seus fatores de risco em mulheres livres de problemas com o sono na primeira fase do Projeto de Saúde de Pindamonhangaba (PROSAPIN) realizado em 2007. Metodologia - Consiste da segunda etapa do PROSAPIN, realizada em 21 Unidades da Estratégia de Saúde da Família com 1.200 mulheres de 35 a 72 anos divididas entre participantes novas (sorteadas em 2014) e antigas (participantes do PROSAPIN 2007). Foram pesquisados por meio de questionários os seguintes distúrbios do sono: 1) sono ruim, pelo Índice de Qualidade do Sono de Pittsburgh; 2) insônia, também pelo questionário de Pittsburgh; 3) sonolência diurna excessiva, pela Escala de Sonolência de Epworth e 4) apnéia obstrutiva do sono, pelo Questionário de Berlin. Como variáveis independentes foram investigadas características sócio demográficas; história ginecológica; presença de morbidades; sintomas emocionais, climatéricos e musculoesqueléticos; hábitos de vida; uso de medicamentos; medidas antropométricas e exames de sangue. As análises, realizadas no Programa Stata versão 11.0, consistiram em: a) estimativa da prevalência de distúrbios do sono em geral e separada por tipos em 2014; b) comparação das prevalências entre os estudos de 2007 e 2014; c) identificação dos fatores associados a prevalência de distúrbios do sono em 2014; e d) estimativa da incidência dos distúrbios do sono em 2014 e seus fatores de risco. Resultados- A incidência de distúrbios do sono em sete anos foi de 75,0 por cento e os fatores de risco foram o triglicerídeo 150 mg/dl e a circunferência abdominal 100,5 cm; como proteção, o HDL 50 mg/dl e a escolaridade 1°colegial. As prevalências em 2007 e 2014 foram respectivamente: distúrbios do sono em geral 63,4 por cento e 82,7 por cento ; sono ruim 45,1 por cento e 54,9 por cento ; insônia 13,3 por cento e 19,0 por cento ; sonolência diurna excessiva 23,1 por cento e 24,1 por cento e apnéia obstrutiva do sono 25,1 por cento e 60,5 por cento . Os fatores associados a prevalência de distúrbios do sono em 2014 foram como risco a ansiedade intensa, o estresse relatado, o uso de antidepressivos e a glicose > 100mg/dl, como fatores de proteção, ser aposentada e considerada fisicamente muito ativa. Conclusão- A incidência dos distúrbios do sono em sete anos foi alta e seus fatores de risco foram metabólicos. A comparação das prevalências em dois pontos, 2007 e 2014, demonstrou aumento expressivo nos distúrbios do sono.
Objective - Estimate the incidence of sleep disorders and identify theirs risk factors in women without trouble sleeping this was the first step Pindamonhangaba Health Project (PROSAPIN) conducted in 2007. Methodology It was consist of in the second stage of PROSAPIN project realized on 21 units of the Family Health Strategy 1,200 women between 35 to 72 age was divided with brand new volunteers (chosen in 2014) and old (volunteers PROSAPIN 2007). They were surveyed by questionnaire the following sleep disorders:1) poor sleep by the Pittsburgh Sleep Quality Index; 2) insomnia, by the questionnaire Pittsburgh;3) excessive daytime sleepiness, the Epworth Sleepiness Scale and 4) obstructive sleep apnea, by Berlin Questionnaire. As independent socio demographic characteristics were investigated; gynecological history; presence of comorbidities; emotional symptoms, climatic and musculoskeletal; lifestyle; use of medications; anthropometric measurements and blood tests. These analysis, were performed for Stata version 11.0, were a)estimate the prevalence of sleep disorders separate for type during the year of 2014b) compare the prevalence studies between 2007 and 2014 c) identification of factors associated with prevalence of sleep disorders in 2014; d) estimate the incidence of sleep disorders during the year of 2014 and their risks factors. Results- The incidence of sleep disorders in seven years was 75.0 per cent and the risk factors were the triglycerides 150 mg / dl and waist circumference 100.5 cm; as protection, HDL 50 mg / dl and schooling 1 high school. The prevalence rates in 2007 and 2014 were as follows: sleep disorders in general 63.4 per cent and 82.7 per cent ; poor sleep 45.1 per cent and 54.9 per cent ; insomnia 13.3 per cent and 19.0 per cent ; EDS 23.1 per cent and 24.1 per cent and obstructive sleep apnea 25.1 per cent and 60.5 per cent . Factors associated with the prevalence of sleep disorders in 2014 were a risk to intense anxiety, stress reported, the use of antidepressants and glucose> 100 mg / dl, as protective factors be considered retired and physically very active. Conclusion - The incidence of sleep disorders in seven years was high and their risk factors were metabolic. Comparison of the prevalence of two points, 2007 and 2014 Showed a significant Increase in sleep disorders.

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Nelson, Marian. "The menopause : another maternal strategy?" Thesis, University of Liverpool, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.415651.

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Pokoradi, Alida Jennifer. "Long-term sequelae of menopause." Thesis, University of Aberdeen, 2012. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=192389.

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Women who experience early natural menopause, or surgical menopause, may be prone to any morbidity and mortality risk related to oestrogen deficiency. The thesis aimed to explore the long-term sequelae of the menopause by investigating current knowledge about the relationship between early age at natural menopause, any surgical menopause, and early age at surgical menopause, and future mortality, incident cancer, and incident circulatory disease. The thesis also investigated the long-term sequelae of menopause using data from a nested cohort of UK women from the Royal College of General Practitioners’ Oral Contraception Study [RCGP OCS]. Methods A portfolio of systematic reviews was conducted. To assess whether a young age at natural menopause, any surgical menopause, and a young age at surgical menopause were associated with mortality and ill-health, data from the RCGP OCS were analysed using Cox regression and competing risks. Results Systematic reviews: 153 papers were included, of varying quality. The heterogeneity of included studies’ exposure and reference groups meant that meta-analysis was not possible. Younger age at natural menopause was strongly associated with an increased risk of all-cause mortality, but not cancer-related death. A suggestion of an increased risk was found for cardiovascular death. Young natural menopause protected strongly against incident endometrial and weakly against ovarian cancers. Few studies examined cervical cancer and age at natural menopause was not a risk factor. Colorectal cancer was not consistently associated with age at natural menopause. Young age at natural menopause was associated with an increased risk of coronary heart disease [CHD], but not cerebrovascular disease. Little evidence was found that surgical, compared with natural menopause was associated with any mortality outcomes. Surgical menopause tended to protect against ovarian cancer but no effect was found for cervical cancer. The relationship between colorectal cancer, or cerebrovascular disease, and surgical menopause is unclear. More evidence showed that surgical menopause may increase the risk of CHD. Limited evidence for young age at combined natural and surgical menopause found it to increase the risk of all-cause mortality and perhaps cardiovascular death. There was no association with risk of cancer death. No clear associations were found for early age at combined natural and surgical menopause and any of the specific cancers examined, or cerebrovascular disease. There may be an association with CHD, but its evidence base was weak. Nested cohort of the RCGP OCS: Premature menopause was associated with decreased risk of: all-cause, cancer-, and circulatory-related mortality, all incident cancer, other cancers, and CHD. Premature menopause was not associated with: incident breast, main gynaecological, or colorectal cancer; all circulatory disease, cerebrovascular disease, or other circulatory disease. For early natural menopause, a significantly decreased risk was observed for: death from all causes, cancer, and non-cancer, non-circulatory causes; incident all cancer, colorectal cancer (borderline), other cancers; incident all circulatory disease and CHD. No significant risk was observed for circulatory mortality; incident breast or main gynaecological cancer; incident cerebrovascular disease or other circulatory disease. Compared with natural menopause, surgical menopause increased circulatory-related mortality only. The risk of incident main gynaecological cancers was decreased. The other incident cancer outcomes were not associated with surgical menopause. Risk of any, and each type of incident circulatory disease was not significantly altered with surgical menopause.

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Lunn, Sarah. "Female menopause : a male perspective." Thesis, University of East London, 2000. http://roar.uel.ac.uk/3651/.

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Despite recent research into female menopause from the woman's perspective, men's views on this subject have received minimal attention. The few exceptions have been marred by the use of a female research paradigm where the variables under study have been derived from assumptions rather than empirical means. This qualitative study aims to explore the male perspective on this 'woman's issue' using grounded theory analysis. In-depth interviews were conducted with eight men, all of whom were in a relationship with a woman aged between 45 and 55 years. Men's accounts reflected two conflicting yet simultaneously held perspectives. The dominant theme, 'Journey through a taboo', conceptualized a hazardous journey for both women and men, where both were pulled into unknown territory and suffered losses along the way. The indignities of these losses and the association of menopause with sex created the status of taboo. An etiquette was described that restricted discussion, thus protecting the reputation of both sexes, and contributed towards a male 'ignorance'. By contrast, 'The alternative journey' presented a more positive vision where the experience was less arduous, challenges were laudably met and benefits were available to both parties. Despite an enduring taboo, men sought to overcome barriers inhibiting knowledge and dialogue. A future society, less constrained by the taboo, was envisaged. The ways in which these accounts reflect ongoing (often derogatory) social discourses are discussed. The implications of these findings are explored in relation to the psychological well-being of both women and men.

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GUEYDAN, COLIN MADELEINE. "Femmes en menopause, nouvelle temporalite." Montpellier 3, 1991. http://www.theses.fr/1991MON30006.

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Dans la vie d'une femme, cinquante ans c'est le temps d'un remaniement libidinal important, le temps pour comprendre la feminite, autrement dit le temps d'une perlaboration. Les cas cliniques nous permettent d'avancer qu'apres la phase de deuil de la procreation, de la beaute, de la jeunesse, de nouvelles issues, axees sur des oeuvres de sublimation, s'ouvrent, mais ce deuil, lorsqu'il ne peut se faire, entraine depression et melancolie, supprimant tout acces a cette nouvelle temporalite, laissant la femme dependante de la pulsion mortifere. La pulsion creative qui jusque la etait investie dans la fonction maternelle peut ressurgir pour realiser les aspirations personnelles laissees en suspens au profit du mariage et de la maternite
Within a woman's life, 50 years old is time to understand feminity, in other words time for a working-through. Clinical cases allos us to advance that after the period of mourning, of procreation, of beauty, of youth, new issues centered on sublimation work do appear. But this mourring, when it can't be, leads ,to nervous breakdown and melancholy, leaving the women dependant upon the death instinct. The creative drive which until there was invested in the maternel function may suddendly reappear in order to fulfill personal wishes which were delayted for the benefit of mariage and motherhood

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MERTZ, ANNE-CATHERINE. "Risque cardio-vasculaire lie a la menopause et au traitement hormonal substitutif de la menopause." Strasbourg 1, 1992. http://www.theses.fr/1992STR15056.

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Orsatti, Fábio Lera [UNESP]. "Efeito da isoflavona da soja e treinamento resistido sobre a composição corporal e densidade mineral óssea em mulheres na pós-menopausa." Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/106384.

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Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-08-25Bitstream added on 2014-06-13T18:47:00Z : No. of bitstreams: 1 orsatti_fl_dr_botfm.pdf: 388914 bytes, checksum: 4ebcdb325956efbf43f2f32282b28137 (MD5)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Investigar o efeito independente e aditivo do treinamento resistido (TR) e da isoflavona de soja (ISO) sobre a densidade mineral óssea (DMO) e a composição corporal de mulheres na pós-menopausa. Foi conduzido estudo clínico prospectivo, duplo-cego (ISO), placebocontrolado e randomizado dois (ISO x Placebo) por dois (TR x sem TR). Oitenta mulheres sedentárias na pós-menopausa (amenorréia últimos 12 meses, FSH > 40UIml), idade entre 45 a 70 anos, foram randomizadas a um dos quatro grupos (71 completaram 9 meses de intervenção): ISO + TR (n=15; 55,7±7,0); ISO + sem TR (n=20; 56,6±8,8); placebo + TR (n=18; 56,0±5,8); placebo + sem TR (n=18; 55,3±8,0). As participantes randomizadas para ISO receberam 250mg de extrato de soja, total de 100mg/dia de isoflavona. Aquelas randomizadas para TR realizaram sessões de exercícios resistidos supervisionados, mínimo de dois dias na semana, durante 9 meses, que incluiu 2-3 exercícios para os grupamentos musculares maiores (coxa, peito e costa) e 1 exercício para os menores (bíceps e tríceps), em 3 séries de 8-12 repetições máximas. No momento basal e aos 9 meses, a composição corporal (massa gordurosa e muscular) e a DMO (corpo inteiro, colo de fêmur e coluna lombar) foram estimadas pela absortometria radiológica de feixes duplos de energia (DXA, Hologic QDR-2000). Valores plasmáticos de CTX (serum levels of C-terminal cross-linked telopeptides of type I collagen) e de osteocalcina foram dosados como marcadores da reabsorção e formação óssea, respectivamente. Para avaliação antropométrica foram obtidos: peso, estatura, índice de massa corpórea (IMC=peso/altura2), circunferência da cintura (CC) e relação cintura/quadril (RCQ). Valores plasmáticos de isoflavona foram realizados ao final da intervenção para analisar a aderência ao tratamento. Na análise...
To investigate the independent and additive effects of resistance training (RT) and soy isoflavone (ISO) on bone mineral density (BMD) and body composition in postmenopausal women. This study used a placebo-controlled, double-blind (soy), randomized two (ISO vs placebo) x two (RT vs no-RT) design. A total of 80 sedentary postmenopausal women (>12 months amenorrhea and FSH >40mIU/ml), aged 45- 70 years, was randomized one of four groups (71 completed 9-months intervention): ISO + RT (n=15; 55.7±7.0); ISO + no-RT (n=20; 56.6±8.8); placebo + RT (n=18; 56.0±5.8); placebo + no-RT (n=18; 55,3±8,0). Participants randomized to ISO received 250mg of standardized soy extract, total of 100mg/day of isoflavone. Subjects randomized to RT attended supervised resistance exercise sessions, three days/week for 9-months and included 2-3 exercises for the larger muscle groups, and 1 exercise for smaller groups in 3 series of 8-12 repetitions. At baseline and 9-months, body composition (fat and muscle mass) and BMD (whole body, lumbar spine and femoral neck) were estimated by dual-energy x-ray absorptiometry (DXA, Hologic QDR-2000). Serum levels of C-terminal cross-linked telopeptides of type I collagen (CTX) and osteocalcin were measured as markers of bone resorption and formation, respectively. The anthropometric indicators included: weight, height, body mass index (BMI= weight/height2), waist circumference (WC) and waist/hip ratio (WHR). The plasma levels of isoflavones were measured to assess compliance. The Shapiro-Wilk, Kolmogorov & Smirnov for distribution statistics, and Levene's test for homogeneity of variances, ANOVA-repeated measure, ANOVAone way and post hoc Fisher test, Pearson’s correlation, test t and analyze regression forward stepwise were used in the statistical analysis. There were no significant difference... (Complete abstract click electronic access below)

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Kantoviscki, Andréia Lara Lopatko. "A vivência do processo de menopausa para mulheres: uma contribuição para a enfermagem." Universidade do Estado do Rio de Janeiro, 2010. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=2705.

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Estima-se que, no ano de 2025, 23% da população total dos países desenvolvidos estarão com mais de 60 anos, evidenciando-se assim o envelhecimento gradativo do contingente populacional destes países. Deste modo, é perceptível o contingente de mulheres que estarão vivenciando a fase da menopausa com seus efeitos biológicos, psicológicos e sociais. As mudanças hormonais e fisiológicas que acontecem nas mulheres durante a fase da menopausa, acompanhadas pela desvalorização estética do corpo e por toda uma sintomatologia física e psíquica, têm sido interpretadas como perda da feminilidade, sinalizando o envelhecimento inevitável e a finitude. No entanto, muitos dos desconfortos que as mulheres vivenciam nesta fase não se devem às mudanças biológicas, mas ao seu processo de socialização, caracterizando a influência de gênero. Neste contexto, este trabalho teve como objeto o estudo da influência da relação de gênero na vivência e no significado do processo da menopausa, tendo como objetivos: descrever a vivência da menopausa a partir da perspectiva de mulheres que a vivenciam e identificar as particularidades relacionadas ao gênero diretamente envolvidas na experiência da menopausa a partir da perspectiva das mulheres. Para desenvolvimento do trabalho foi utilizada abordagem qualitativa de natureza descritiva com vinte mulheres de idade entre 45 e 55 anos que apresentavam menopausa espontânea e eram clientes das Unidades Básicas de Saúde da cidade de Curitibanos-SC, no período de 1 a 15 de outubro de 2009. Para a coleta de dados foi utilizado um roteiro de entrevista semi-estruturada com uma questão norteadora: Fale-me como é para você estar vivenciando a menopausa. A interpretação e análise foram feitas através de análise de conteúdo do tipo temática descritas por Bardin. Nas narrativas, identificaram-se categorias que foram integradas em quatro temas principais: 1- Vivenciando a Menopausa, 2- Identificando Transformações no Corpo e na Vida, 3- Cuidando de Si, 4- Buscando Informações/Influências e Construindo Conhecimento. Foi possível identificar nessas categorias que as mulheres trazem o conceito de que a fase da menopausa é uma doença, e relacionam essa fase com envelhecimento e declínio físico, a qual traz grandes sofrimentos, o que demonstra a influência de gênero no vivenciar desta fase. As entrevistadas explicitaram em suas falas diversos sintomas que as incomodavam e interferiam em suas atividades diárias e na sua maneira de ser, repercutindo muitas vezes no seu comportamento familiar e profissional. O conhecimento sobre a menopausa, neste grupo de mulheres, foi construído ao longo de suas vidas e reflete as suas realidades culturais e sociais, deixando evidente a escassez de fontes de informação e os tabus relacionados com relação à fase da menopausa. Este estudo contribui com a geração de conhecimentos levando em consideração os efeitos que a influência de gênero pode ter na vivência e percepção da menopausa, desmistificando-a para que a vivência das mulheres durante esse período não seja condicionada por estereótipos e crenças relacionadas ao gênero.
They is esteem that, in the year of 2025, 23% of the total population of the developed countries will be with more than 60 years, what show the gradual aging of the population contingent of these countries. In this way, is perceivable the contingent of women who will be living deeply the phase of the menopause with its biological, psychological and social effects. The physiological and chemical changes that happen in the women during the menopauses phase, followed with the aesthetic depreciation of the body, have been interpreted as loss of the feminine characteristics, signaling the inevitable aging and the end of the life. However, many of the discomforts that the women live in this phase not must to the biological changes, but to its process of socialization, characterizing the genre influence. In this context, this work had as object the study of the influence of the relation of genre in the experience and meaning of the process of the menopause, having as objective: describes the experience of the menopause on the perspective of women and to identify the particularitities involved to the genre in the experience of the menopause on the perspective of the women. For development of the work, was done one research descriptive-qualitative with customers of the Basic Units of Health of the city of Curitibanos-SC, in the period of 1 to 15 of October of 2009. For the collect of data, one structured interview was used with an orienting question: It speaks to me, as are for you to be living the menopause. The interviews were done with 20 women, with ages between 45 and 55 years and that had presented spontaneous menopause. The interpretation and analysis was done by analysis of content of the thematic type described by Bardin. In the narratives, was done the identification of categories that was integrated in four main subjects: Living on the Menopause, Identifying Transformations in the Woman Body and in the Life, Cares Myself, Research Information/Influences and Building Knowledge. Was possible identify in these categories that the women bring the idea that the menopause phase is an illness, and relate this phase with aging and physical decline, which brings great sufferings, what it demonstrates to the influence of genre in this phase. The interviewed ones showed diverse symptoms in its words, this bother and intervene in the daily activities and its way to be, and this situation, influence many times in its familiar and professional behavior. The knowledge on the menopause, in this group of women, was constructed throughout its lives and reflects its cultural and social realities, leaving evident the scarcity of information sources and the taboos related with the subject. This work improve of knowledge in consideration the effect that the genre influence can have in the experience and perception of the menopause, demystifying the experience mode of the women during this period, not conditioning for stereotypes and beliefs related to the genre.

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Giorno, Cecilia Del. "Efeitos do Trifolium pratense nos sintomas da menopausa e na satisfação sexual em mulheres climatéricas." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-22022010-170555/.

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Objetivo: avaliar os efeitos do tratamento com o Trifolium pratense nos sintomas menopausais em mulheres climatéricas utilizando o Índice Menopausal de Kupperman (IMK) e pelo Inventário de Satisfação Sexual Golombok e Rust versão feminina (GRISS) l. Metodologia: Este estudo foi prospectivo, randomizado, duplo cego e controlado com placebo, e realizado no setor de Ginecologia Endócrina e Climatério da Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia do Hospital das Clínicas, da Faculdade de Medicina da Universidade de São Paulo. Foram selecionadas 100 mulheres na faixa etária de 45 a 65 anos com sintomas menopausais, com amenorréia superior há 1 ano e sem tratamento nos últimos 6 meses. Após a seleção, as mulheres foram divididas em dois grupos: Grupo I (n = 50) receberam Trifolium pratense na dose de 40 mg, 1 capsula/dia, por via oral; Grupo II (n = 50) receberam placebo (controle), contendo lactose, 1 cápsula/dia por via oral. A duração do tratamento foi de 12 meses e as mulheres foram avaliadas antes do tratamento com quatro, oito e 12 meses de tratamento, por exames clínico e laboratorial. Aplicaram-se o teste de t Student e o ANOVA para avaliar as diferenças entre os grupos. Resultados: Houve melhora significante dos sintomas após quatro meses de tratamento no IMK, principalmente, as ondas de calores, em relação aos dados antes do tratamento nos dois grupos. Não observamos melhora na avaliação da sexualidade (GRISS). Conclusão: Nossos dados sugerem que o efeito da ministração de 40mg ao dia de Trifolium pratense pode não ser superior ao do placebo, na redução dos sintomas da pós-menopausa durante um ano de estudo
Objective: to evaluate the effects of Trifolium pratense treatment on the climacteric symptoms and sexualiy in postmenopausal women through Kuppermann Menopausal Index (KMI) and the Golombok Rust Inventory of Sexual Satisfaction (GRISS), respectively. Methods: This study was prospective, randomized, double-blind and placebo-controlled study. Hundred women were selected, aged between 45 and 65 years with climacteric symptoms, with menstruation absence (amenorrhea) that was more then one year and without any treatment for last six months. After selection, women were divided into two groups: GI (n = 50) received 40 mg Trifolium pratense (one capsule per day); GII (n = 50) received placebo (control, one capsule of lactose per day). The length of treatment was 12 months and women were evaluated before and after four, eight and twelve months of treatment through clinical and laboratorial exams. The t Student test and ANOVA were applied for analyzing the differences between groups. Results: There was significant ameliorate in the symptoms after four months of treatment through the KMI, mainly in hot flashes, compared to baseline data of both groups. The sexuality evaluation did not found any difference before and after treatment in both groups. Conclusion: Our data suggested that the 40 mg Trifolium pratense effect may be not superior than placebo in relation to decrease the postmenopausal symptoms during one year of study

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Mvundura, Mercy. "Menopause Transition and Labor Market Outcomes." Digital Archive @ GSU, 2007. http://digitalarchive.gsu.edu/econ_diss/38.

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Over the past 50 years, women have become important participants in the labor market. With the increase in the number of middle-aged women going through the menopause transition, the question arises as to the effect of this transition on the labor market. Previous studies have shown that reproductive cycles have a non-trivial negative effect on women’s labor market outcomes. Thus, the cessation of these reproductive cycles (menopause) should bring relief for these women. However, another body of literature asserts that the menopause transition itself has a negative effect on women’s mental and physical health and so may have a negative effect on labor market outcomes. This study seeks to explore the effect of the menopause transition on labor market outcomes. The empirical analyses are done using data from the National Longitudinal Survey of Young Women, with the key explanatory variables being the menopause transition stages: premenopause, perimenopause, surgical menopause and natural postmenopause. The regressions include a control for whether the woman experienced early menopause and whether she had a hysterectomy. The first part of the study examines the impact of the menopause transition on health using depression and the scores on the activities of daily living as the measures of health status. These analyses use cross sectional data drawn from the 1995 wave of the survey for activity limitations and the 2003 wave for the depression measure. The findings of these analyses indicate that the menopause transition increases the likelihood of depression and functional limitations. The main part of the study explores the effect of the menopause transition on the following labor market outcomes: labor force participation, hours worked, full time employment, wages, and self-employment. Ordinary Least Squares, the fixed effects model, the random effects model, and the family fixed effects (siblings) model are used to examine these questions. The analysis also uses 2SLS to correct for endogeneity of the menopause variables and the Heckman two-step procedure to correct for sample selection bias. The findings show that women in premenopause are less likely to be in the labor force than women in natural postmenopause, even after controlling for life-cycle variables. The results also indicate that there are certain benefits from using hormone replacement therapy (HRT), as women who had surgical menopause and are using hormones are more likely to be in the labor force than women with surgical menopause who are not using HRT. Women in premenopause and women in perimenopause are less likely to work full-time compared to women who experienced natural postmenopause. The findings also show that there are no significant differences in hours worked by women in the different menopause stages. Women in premenopause typically earn more than women in natural postmenopause. Furthermore, women in perimenopause and women with surgical menopause are more likely to be self employed. The findings indicate that, among a generally healthy population, the menopause transition results in an increase in labor supply. However, a wage penalty is observed among women in postmenopause, when compared to women who are premenopause. The implications of the findings are that menopause should not be medicalized but should be viewed in a social and cultural context as the changes that occur during the transition may open up possibilities for positive individual development. Thus the cessation of menstrual cycles brings relief for women and results in an increase in labor supply, albeit one associated with a wage penalty.

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LORCY, DANIEL. "La menopause mythique de jean brodie." Nantes, 1986. http://www.theses.fr/1986NANT3011.

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Cette these porte sur l'etude detaillee du personnage qui a donne son nom au roman -jean brodie- etude qui nous permet de mieux comprendre l'auteur -muriel spark- dans les aspects les plus importants de son art du romancier qui lui tiennent le plus a coeur et qui sont : son affirmation de sa foi catholique, l'im- portance capitale a ses yeux d'un monde plus reel que le notre qui est celui de la vie eternelle. C'est parce que jean brodie ne mettra en avant, dans sa vie et dans son enseignement, que le monde des sens qu'elle sera condamnee par l'auteur. Ainsi la menopause qu'elle voulait transformer en legende, en mythe ne sera qu'une banale vieillesse
This ph. D dissertation is a detailed study of jean brodie, the character that gave its name to the novel. This study enables us to understand better the writer, muriel spark, in these two aspects which are most important in the art of the novelist: her assertion of her catholic belief and the capital importance to her, of another world more real than ours : the world of the eternal life. It is because jean brodie will only put forward the world of the senses in her life and in her teaching, that she will be condemned by the author. So this menopause that jean brodie wanted to transform into a legend, a myth, will only be a trivial oldage

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Bremer, Eleanor. "Anxiety in Menopause: A Qualitative Inquiry." VCU Scholars Compass, 2018. https://scholarscompass.vcu.edu/etd/5315.

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Background: Anxiety is one of the mood symptoms experienced by menopausal women; however, anxiety symptoms during menopause have received little attention in the literature despite the potential impact on quality of life. Many of the tools used to evaluate and measure anxiety associated with menopause assume that menopausal anxiety shares similar criteria as anxiety disorders and this may not be entirely true. There are very few studies that have assessed anxiety in the context of menopause leaving the concept of menopausal anxiety not well defined and raising the question: Is menopausal anxiety a unique and distinctly different syndrome? The purpose of this study was to explore and gain an in-depth understanding of the experience of anxiety in menopausal women. Methods: Twenty menopausal women were recruited for this qualitative study to explore the experience of anxiety in menopause. Through the use of a semi-structured interview using open-ended questions, participants were asked to share their experience with anxiety that was new or different with the onset of menopause. Interviews were audio recorded by the researcher and lasted approximately 30 - 60 minutes. Participants described their experience with anxiety and discussed how the anxiety is different in menopause. Results: Emergent themes revealed that anxiety in menopause is a unique and individual experience. The substantial variation in the onset, timing and severity of the symptoms made it impossible to construct a uniform and consistent definition of the experience. Participants discussed their preferences for management which included non-pharmacologic, lifestyle, relaxation based interventions. Conclusions: This research supports the existence of a unique and individualized experience of anxiety in menopause. A better understanding of the experience and patient preferences will assist healthcare providers in developing individualized treatment options aimed at improving quality of life.

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Rubinstein, Helena. "The meanings of menopause : identifying the bio-psycho-social predictors of the propensity for treatment at menopause." Thesis, University of Cambridge, 2013. https://www.repository.cam.ac.uk/handle/1810/245082.

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All women will experience menopause by the time they have reached mid life. So it is surprising that, in comparison with other female reproductive experiences such as menarche, pregnancy and childbirth, there is relatively little research from a psychological perspective. The main aims of this study were to explore how women make sense of the menopause, to assess which factors predict symptom severity and treatment utilisation and to explore how women’s beliefs about menopause are located within their social context. The study comprised three stages. Study 1 was a quantitative study with 149 women to develop new measures to assess women’s beliefs. The new belief scales were incorporated into study 2 which was a larger study with 344 women recruited from the general population and from specialist menopause clinics. This study sought to identify the factors that predict symptom severity and treatment utilisation. The main analysis was with 295 women who were peri- and postmenopause. A range of validated scales were used and a treatment utilisation scale was created. Hierarchical multiple regression and structural equation modelling were used to identify predictors of symptom severity and treatment utilisation. A sub-sample of 30 women from study 2 went on to participate in study 3 which was a qualitative study designed to explore how beliefs about menopause influence symptom perception and decisions about treatment in the context of women’s daily lives. Diaries were completed and used in interviews in study 3 to enable more accurate recall of the social context of menopause events. Thematic analysis was used to analyse the data. Ninety one percent of the women in this study had sought treatment for menopause symptoms and the main predictors of treatment utilisation was symptom severity and the belief that menopause was a pathological illness. A key finding was that four social constructions of menopause were prevalent in this sample: menopause renders women invisible and unvalued, menopause is an illness that changes women, menopause is amenable to treatment with hormone therapy, and menopause is a temporary phase after which there is recovery. These four beliefs were significantly predictive of perceptions of symptom severity and of treatment utilisation. Furthermore, the social constructions mediated between symptom severity and different categories of treatment utilisation. Qualitative analysis revealed that women have inadequate knowledge of menopause and can be surprised and distressed by its onset, menopause is little talked of and is still 'taboo', menopause is regarded by women as a significant phenomenon that changes them but this is not often acknowledged publicly, women and clinicians have difficulty in making attributions to menopause and neither women nor clinicians are able to define 'normality' at menopause. These findings have major implications for how women interpret their symptoms, for how to manage the expectations of women in their 40s and 50s, and for how clinicians advise women at this stage of their life.

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Buttros, Daniel de Araújo Brito [UNESP]. "Síndrome metabólica em mulheres na pós-menopausa tratadas de câncer de mama." Universidade Estadual Paulista (UNESP), 2012. http://hdl.handle.net/11449/93095.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Avaliar o risco de síndrome metabólica (SM) em mulheres na pós-menopausa tratadas de câncer de mama, comparadas às mulheres na pós-menopausa sem câncer de mama. Realizou-se estudo clínico, analítico e transversal, com 104 mulheres tratadas de câncer de mama comparadas a 208 mulheres na pós-menopausa (controle), atendidas em Hospital Universitário. Foram incluídas no grupo de estudo mulheres com amenorréia >12 meses e idade ≥45 anos, tratadas de câncer de mama e livre de doença há pelo menos cinco anos. O grupo controle foi constituído de mulheres com amenorréia >12 meses e idade ≥45 anos sem câncer de mama, pareadas pela idade, na proporção 1:2. Por meio de entrevista foram coletados dados clínicos e antropométricos. Na análise bioquímica foram solicitadas dosagens de colesterol total (CT), HDL, LDL, triglicerídeos (TG), glicemia e proteína C-reativa (PCR). Foram consideradas com SM as mulheres que apresentaram três ou mais critérios diagnósticos: circunferência da cintura (CC) > 88 cm; TG ≥ 150 mg/dL; HDL colesterol < 50 mg/dL; pressão arterial ≥ 130/85 mmHg; glicemia de jejum ≥ 100 mg/dL. Para análise estatística foram empregados o teste t-student, o teste do Qui-Quadrado e a regressão logística (odds ratio-OR). A média de idade da pacientes tratadas de câncer de mama foi de 60,6 ± 8,6 anos com tempo médio de seguimento de 9,4 ± 4,4 anos. Maior porcentagem de pacientes tratadas de câncer de mama (46,2%) era obesa quando comparadas ao controle (32,7%) (p<0,05). E menor porcentagem de mulheres tratadas de câncer apresentou valores considerados ótimos de LDL, glicemia e PCR quando comparadas ao controle (p<0,05). A SM foi diagnosticada em 50% das mulheres tratadas de câncer de mama e 37,5% no grupo controle (p<0,05). Entre os critérios...
To assess the risk of metabolic syndrome (MetS) in postmenopausal women breast cancer survivors compared to postmenopausal women without breast cancer. In this cross-sectional study, 104 women breast cancer survivors were compared with 208 postmenopausal women (control), seeking healthcare at a University Hospital. Eligibility criteria included women with amenorrhea > 12 months and age ≥ 45 years, treated for breast cancer and no recorrences for at least five years. The control group consisted of women with amenorrhea >12 months and age ≥ 45 years without breast cancer matched by age, in proportion 1:2. Dates on clinical antecedents and anthropometric indicators were collected. The biochemical parameters, including total cholesterol, HDL, LDL, triglycerides, glucose and C-reactive protein (CRP), were measured. MetS was diagnosed as the presence of at least three components among: waist circumference (WC) >88cm, blood pressure ≥130/85mmHg, triglycerides ≥150mg/dl, HDL <50mg/dl and glucose ≥100mg/dl. For statistical analysis were used: Student t-test, Chi-square test, and logistic regression method (odds ratio-OR). The mean age of women breast cancer survivors was 60.6 ± 8.6 years with a mean follow-up of 9.4 ± 4.4 years. A higher percentage of women breast cancer survivors (46.2%) were obese compared to control (32.7%) (p <0.05). And a smaller percentage of women breast cancer survivors had optimal values of LDL, glucose and CRP compared to controls (p <0.05). MetS was diagnosed in 50% of women breast cancer survivors and 37.5% in the control group (p <0.05). The most prevalent diagnostic criteria of MetS was abdominal obesity (WC> 88 cm) affecting 62.5% of women breast cancer survivors and 67.8% of control group. Women breast cancer survivors had a higher risk for metabolic syndrome... (Complete abstract click electronic access below)

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33

Cangussu, Luciana Mendes [UNESP]. "Avaliação do equilíbrio postural em mulheres na pós-menopausa e sua relação com a densidade mineral óssea." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/99189.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Avaliar a associação entre o equilíbrio postural e a densidade mineral óssea (DMO) em mulheres na pós-menopausa e correlacionar com o risco de quedas. Realizou-se estudo de corte transversal com 225 mulheres, idade 45-75 anos, atendidas em Hospital Universitário. Incluíram-se mulheres em amenorréia >12 meses e idade ≥ 45 anos, com valores de DMO (coluna lombar e colo de fêmur) pelo DXA, dos últimos 12 meses. E se excluíram aquelas com doenças neurológicas ou musculoesqueléticas, história atual de vestibulopatias, déficit visual sem correção, obesidade grau III e usuárias de drogas que alterem o equilíbrio. As mulheres foram divididas segundo a DMO em > -2,0 DP (n=140) e ≤ -2 DP (n=85). Foram analisados o histórico de quedas (últimos 24 meses) e as características clínicas e antropométricas. O equilíbrio postural foi avaliado pela estabilometria (plataforma de força), teste de Romberg, alcance funcional e teste do agachamento. Para análise estatística foram empregados o Teste de Wilcoxon para variáveis quantitativas, o teste do Qui-Quadrado ou Exato de Fisher para variáveis categóricas e o método de regressão logística para o risco de quedas (Odds Ratio-OR). As pacientes com DMO > -2,0 DP eram mais jovens e com menor tempo de menopausa, assim como apresentavam maior IMC e circunferência da cintura quando comparadas aquelas com baixa DMO (≤ -2 DP) (p<0,05). Observou-se que 57,8% (130/225) das participantes relataram episódio de queda nos últimos dois anos, sem diferença significativa na distribuição percentual entre os grupos (p=0,055). Nos parâmetros estabilométricos e no alcance funcional não foram demonstradas diferenças na comparação entre os grupos (p>0,05). No teste de Romberg notou-se aumento progressivo da positividade à medida que aumentava a dificuldade do teste, sendo observada diferença significante entre os grupos apenas com...
To analyze the association between postural balance and bone mineral density (BMD) in postmenopausal women and correlate it with risk for falls. A cross-sectional study was conducted on 225 women aged 45-75 years and cared for at a University Hospital. Women in amenorrhea >12 months and age ≥ 45 years, with BMD values (lumbar spine and femur neck) by DXA for the last 12 months, were included. Those with neurological or musculoskeletal disorders, current history of vestibulopathies, uncorrected visual deficit, level-III obesity or drug use that could affect balance were excluded. The women were divided, according to BMD, in > -2.0 DP (n=140) and ≤ -2 DP (n=85). Histories of falls (last 24 months) as well as clinical and anthropometric characteristics were evaluated. Postural balance was assessed by stabilometry (strength platform), Romberg’s test, functional reach test and the crouching test. For statistical analysis, Wilcoxon’s test was used for quantitative variables, the Chi-square or Fisher’s exact test for categorical variables and the logistic regression method for fall risk (Odds Ratio-OR). Patients with BMD > -2.0 DP were younger and had been menopausal for a shorter period of time; they also showed higher BMI and larger waist circumference as compared to those with low BMD (≤ -2 DP) (p<0.05). It was observed that 57.8% (130/225) of the participants reported fall episodes in the last two years, without significant difference in the percent distribution between the groups (p=0.055). No differences were found in the comparison between the groups (p>0.05) for stabilometric parameters or functional reach test. Concerning Romberg’s test, progressive positive increase was observed as the test difficulty increased, and significant difference between the groups was found only when the women kept their feet in a series and their eyes closed (p<0.05). When evaluating the ... (Complete abstract click electronic access below)

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34

Netto, Claudia Cardoso. "Avaliação da biopotencia dos frutooligossacarideos (FOS) e da terapia de reposição hormonal (TRH) no metabolismo de calcio de ratas ovarectomizadas." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/256027.

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Orientador: Celio Kenji Miyasaka
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos
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Mestrado
Nutrição Experimental e Aplicada à Tecnologia de Alimentos
Mestre em Alimentos e Nutrição

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35

Carmignani, Lucio Omar 1965. "Fitoestrogenios como alimento funcional no tratamento da sindrome climateria : ensaio clinico randomizado duplo-cego e controlado." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313700.

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Orientador: Adriana Orcesi Pedro
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Objetivos: Comparar os efeitos da ingestão diária de um suplemento alimentar à base de soja, terapia hormonal (TH) de baixa dosagem e placebo sobre os sintomas menopausais psicológicos, somáticos e urogenitais em mulheres na pós-menopausa e avaliar os efeitos sobre os principais marcadores de risco cardiovascular. Métodos: Ensaio clínico randomizado, duplo-cego e controlado envolvendo 60 mulheres sintomáticas com tempo médio desde a menopausa de 4,1 anos, com idade entre 40 e 60 anos. Foram selecionadas e randomizadas em três grupos: um grupo recebeu um suplemento alimentar à base de soja (isoflavona 90mg/dia), outro grupo recebeu terapia hormonal de baixa dose (estradiol 1mg e acetato de noretisterona 0,5mg) e um grupocontrole que recebeu placebo, por um período de 16 semanas. Foi utilizado o Menopause Rating Scale (MRS) para avaliar as mudanças nos sintomas climatéricos no início e após 16 semanas de tratamento. Também foram avaliados o perfil lipídico, glicemia, índice de massa corpórea, pressão arterial e relação cintura-quadril em todas as participantes no início e final do tratamento. Com o intuito de avaliar os efeitos deste tratamento sobre os níveis hormonais endógenos, foi medida a concentração sérica do hormônio folículo-estimulante (FSH) e o 17'beta'-estradiol. A análise estatística foi realizada usando-se o teste do qui-quadrado, teste exato de Fisher, análise de co-variância, teste não paramétrico de Kruskal-Wallis, teste t de Student pareado, teste de Kruskal-Wallis (seguido por Mann-Whitney), teste de Wilcoxon pareado, teste ANOVA (seguido de Tukey) e teste não paramétrico de Kruskal-Wallis (seguido de Mann-Whitney). Resultados: os resultados mostraram uma diminuição da pontuação do MRS total, comparando-se o início e o final do tratamento em todos os grupos, não havendo diferença estatística entre eles. Houve uma melhora significativa dos sintomas somáticos (fogachos e queixas articulares/musculares) e urogenitais (secura vaginal) nos grupos TH e soja. Em relação aos sintomas psicológicos, não houve diferença entre os grupos estudados: todos apresentaram uma melhora semelhante. Após 16 semanas de intervenção, o colesterol total diminuiu em 11,3% e o LDL-colesterol diminuiu 18,6% apenas no grupo TH. As triglicérides, HDL-colesterol, glicemia, índice de massa corpórea, pressão arterial, e relação cintura-quadril não se alteraram durante o tratamento nos três grupos. O FSH diminuiu e o 17'beta'-estradiol aumentou apenas no grupo TH. Conclusões: Este estudo sugere que o tratamento com suplemento alimentar à base de soja pode ser uma terapia alternativa efetiva para os sintomas somáticos e urogenitais relacionados à menopausa. O suplemento alimentar à base de soja não mostrou efeito favorável significativo sobre os marcadores de risco cardiovascular quando comparados ao uso da TH
Abstract: Objectives: To compare the effects of daily ingestion of soy dietary supplement, low-dose hormone therapy (HT) and placebo on menopausal psychological, somatic and urogenital symptoms in postmenopausal women and to assess the effects on the main biomarkers of cardiovascular health. Methods: This was a double-blind, randomized and controlled intention-to-treat trial. Sixty healthy postmenopausal women, aged 40-60, 4.1 years mean time since menopause were recruited and randomly assigned to three groups: a soy dietary supplement group (isoflavone 90mg/day), a low-dose HT group (estradiol 1mg plus noretisterone acetate 0.5mg) and a placebo group. The Menopause Rating Scale (MRS) was used to assess change in menopausal symptoms at baseline and after 16 weeks of treatment. Lipid profile, glucose level, body mass index, blood pressure and abdominal/hip ratio were evaluated in all the participants at the baseline and after 16 weeks. To examine the effects of this regime on endogenous hormone levels, follicle-stimulating hormone (FSH) and 17 'beta'-estradiol were measured. Statistical analyses were performed using chi-square test, Fisher¿s exact test, repeated-measures analysis of co-variance, Kruskal-Wallis non-parametric test, paired Student¿s t test, Kruskal-Wallis test (followed by Mann-Whitney test), paired Wilcoxon test, ANOVA test (followed by Tukey test) and Kruskal-Wallis non-parametric test (followed by Mann-Whitney test). Results: The data showed decrease in MRS total score comparing baseline values and after 16 weeks in all of the groups, but without statistical difference among the groups. There was significant improvement in somatic (hot flashes and joint/muscle complaints) and urogenital (vaginal dryness) symptoms from baseline to after 16 weeks for both the HT and soy groups, compared with the placebo group. There was no difference among the studied groups concerning psychological symptoms: all three groups showed a similar improvement. After a 16 weeks intervention period, total cholesterol decreased 11.3% and LDLcholesterol decreased 18.6% in HT group, but in the soy dietary supplement and placebo groups it did not change. The values for triglycerides, HDL-cholesterol, glucose level, body mass index, blood pressure, and abdominal/hip ratio did not change over the time in all of the three groups. FSH decreased and 17'beta'-estradiol increased only in the HT group. Conclusions: This study suggests that a soy dietary supplement may be an effective alternative therapy for somatic and urogenital symptoms. The use of dietary soy supplement did not show a significant favorable effect on cardiovascular health biomarkers comparing with HT
Mestrado
Tocoginecologia
Mestre em Tocoginecologia

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36

Baccaro, Luiz Francisco Cintra 1980. "Fatores associados à densidade mineral óssea de mulheres submetidas a transplante de fígado." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313668.

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Orientadores: Aarão Mendes Pinto Neto, Ilka de Fátima Santana Ferreira Boin
Dissertação (mestrado) - Universidade Estadual de Campinas. Faculdade de Ciências Médicas
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Resumo: Objetivos: avaliar a massa óssea e os fatores associados em mulheres submetidas a transplante de fígado em acompanhamento no Ambulatório da Unidade de Transplante Hepático do Hospital das Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas Sujeitos e Métodos: estudo de corte transversal com mulheres transplantadas hepáticas em acompanhamento no Ambulatório da Unidade de Transplante Hepático do Hospital das Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas. Foram incluídas todas as mulheres que realizaram transplante hepático há pelo menos um ano e com idade igual ou superior a 35 anos. Foram identificadas 33 mulheres que preenchiam os critérios de inclusão. Dessas, 6 não responderam ao contato telefônico e 4 não quiseram participar, sendo o número final de mulheres participantes igual a 23. Foi realizada entrevista, sempre pelo mesmo pesquisador, onde foram obtidos dados clínicos, sócio-demográficos e realizados exame físico geral e ginecológico. Após a avaliação clínica as mulheres foram encaminhadas para realização de exames laboratoriais (aspartato aminotransferase, alanina aminotransferase, fosfatase alcalina, gama glutamiltransferase, bilirrubina total e frações) e densitometria óssea de coluna lombar e fêmur. A análise estatística foi realizada através do teste exato de Fisher, OR simples e coeficiente de correlação de Spearman. Todas assinaram o termo de consentimento livre e esclarecido previamente à entrevista, e o estudo foi aprovado no Comitê de Ética em Pesquisa da UNICAMP. Resultados: A média de idade das mulheres foi de 52,5 ± 10,9 anos e a média de tempo pós transplante foi de 5,8 ± 3,1 anos. Do total de 23 mulheres incluídas no estudo, 56,5% apresentaram massa óssea alterada. Estar na pós menopausa foi fator de risco para diminuição da massa óssea: OR 69,0 (95% IC 2,89-1647,18; p < 0,0001). Ter idade superior a 44 anos na realização do procedimento aumentou o risco para diminuição da massa óssea: OR 49,50 (95% IC 3,84-638,43; p <0,0001). Ter idade superior a 49 anos aumentou o risco para diminuição na massa óssea: OR 13,33 (95% IC 1,78-100,15; p = 0,0123). Apresentar um período de tempo maior que 5,8 anos da realização do transplante foi fator protetor para diminuição na massa óssea: OR 0,11 (95% IC 0,02-0,78; p = 0,0361). Conclusão: mais da metade das mulheres transplantadas hepáticas apresentaram diminuição da massa óssea. O estado menopausal, a idade, a idade ao transplante e o tempo pós transplante foram os fatores associados à alteração da massa óssea em mulheres transplantadas hepáticas
Abstract: Objectives: to evaluate bone mass and risk factors associated with bone mass alterations in women undergoing liver transplantation followed at the Liver Transplant Outpatient Unit in the Clinics Hospital of the Campinas State University Medical School. Subjects and Methods: a cross-sectional study of women undergoing liver transplantation and followed at the Liver Transplant Outpatient Unit in the Clinics Hospital of the Campinas State University Medical School was carried out. All women aged 35 years or older who had received a liver transplant at least one year before enrollment were included in the study. Thirty-three women satisfied the criteria for study inclusion. Of the total, 6 did not respond to telephone contact and 4 declined to participate. As a result, the final number of women participating in the study was 23. An interview was conducted always by the same investigator for collection of clinical and sociodemographic data, as well as the performance of a general physical and gynecological examination. After clinical evaluation, the women underwent laboratory tests (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma glutamyltransferase, total and fractionated bilirubin) and bone mineral density measurement of the lumbar spine and femur. Statistical analysis was performed by Fisher's exact test, simple OR and Spearman's rank correlation coefficient. All women signed a written informed consent term prior to the interview. The study was approved by the Research Ethics Committee of UNICAMP. Results: The mean age of the women was 52.5 ± 10.9 years and mean time since transplantation was 5.8 ± 3.1 years. Of the total number (23) of women included in the study, 56.5% had alteration in bone mass. Being postmenopausal was a risk factor for decreased bone mass: OR 69.0 (95% CI 2.89-1647.18; p < 0.0001). Being over 44 years of age at the time of the surgical procedure increased the risk for decreased bone mass: OR 49.50 (95% CI 3.84-638.43; p < 0.0001). Being over 49 years of age increased the risk for decreased bone mass: OR 13.33 (95% CI 1.78-100.15; p = 0.0123). A period of time longer than 5.8 years since transplantation was a protective factor for decreased bone mass: OR 0.11 (95% CI 0.02-0.78; p = 0.0361). Conclusion: more than 50% of the women undergoing liver transplantation had decreased bone mass. Menopausal status, current age, age at the time of transplantation and time since transplantation were factors associated with bone mass alterations in women receiving a liver transplant
Mestrado
Tocoginecologia
Mestre em Tocoginecologia

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37

Carvalho, Euller Duarte de. "Associação entre o nível de atividade física, qualidade de vida e características das mulheres com 60 anos ou mais." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313675.

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Orientador: Aarão Mendes Pinto-Neto
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Objetivo: Avaliar o nível de atividade física e a qualidade de vida em mulheres idosas e os fatores associados. Sujeitos e Métodos: Estudo de corte transversal através de entrevistas individuais com 271 mulheres com 60 anos ou mais que frequentavam o Serviço Social do Comércio de Campinas - SESC / Campinas e pacientes do Ambulatório de Menopausa do Centro de Atenção Integral à Saúde da Mulher - CAISM/UNICAMP. Os instrumentos utilizados foram o International Physical Activity Questionnaire (IPAQ - Versão 8) e o World Health Organization Quality of Life in Older Adults (WHOQOL - OLD). Os resultados do IPAQ foram avaliados através de tercis e a associação entre resultados do WHOQOL-OLD e IPAQ e características das mulheres pelos testes de T de Student/Mann-Whitney ou ANOVA/Kruskal - Wallis, e de análises múltiplas. Resultados: A média etária das mulheres foi de 67,4 + 5,3 anos. A análise de cada domínio da atividade física mostrou que 60,8% do tempo foram em atividades sentadas. Ser frequentadora do SESC, ter maior idade, sem companheiro, maior escolaridade e boa autopercepção do estado de saúde foram características que se associaram significativamente à prática de exercícios físicos moderados ou vigorosos. Evidenciou-se com a análise múltipla que frequentar o SESC aumentou 11,4 vezes as chances de praticar exercícios físicos moderados vigorosos, ter 70 anos ou mais aumentaram em 3,3 vezes as chances e escolaridade entre segundo grau completo ou mais em 2,4 vezes as chances de praticar exercícios físicos de intensidade moderada ou vigorosa. O escore médio de qualidade de vida foi de 66,9 + 11,7. O maior valor foi observado no domínio referente às habilidades sensoriais (72,0 + 18,8) e o menor à autonomia (60,3+ 16,2). Mulheres frequentadoras do SESC, com maior idade, sem companheiro, menor escolaridade, com boa autopercepção da saúde, que não usavam medicamentos, sem antecedentes de doenças e de estrato social mais elevado apresentaram melhor escore de qualidade de vida. Com a regressão linear observou-se que uma boa autopercepção da saúde aumentou o escore de qualidade de vida em 7,3 pontos, número maior de medicamentos diminuiu em 4,4 pontos e a pratica de exercícios físicos moderados ou vigorosos aumentou em 4,8 pontos o escore. Observou-se uma associação estatisticamente significativa entre a prática de exercício físico de intensidade moderado/vigorosa e melhores escores de qualidade de vida. Conclusões: Evidenciou-se a necessidade de esforços para a mudança do tipo e intensidade da atividade física em mulheres com 60 anos ou mais, com diminuição significativa do tempo gasto em atividades sentadas, com o objetivo de se atingir as recomendações para uma melhora nas condições físicas e manutenção da saúde. Da mesma maneira são necessários investimentos educacionais, bem como a criação de centros de convívio cultura e lazer, acessíveis a essa e outras populações para que possam compreender cada vez mais a importância da prática de atividades físicas para uma melhor qualidade de vida
Abstract: Objective: To evaluate the level of physical activity and quality of life in elderly women and factors associated. Subjects and Methods: A cross-sectional study was conducted using individual interviews with 271 women aged 60 years or older who belonged to the Trade Social Service (SESC), in Campinas, and patients attended in the Menopause Outpatient Clinic at the Women's Integrated Healthcare Center-CAISM/UNICAMP. The instruments used were the International Physical Activity Questionnaire (IPAQ - Version 8) and World Health Organization Quality of Life in Older Adults (WHOQOL - OLD). IPAQ results were evaluated by tertiles and the association between the WHOQOL-OLD and IPAQ results and subject characteristics was assessed by the Student's t test and Mann-Whitney test or ANOVA/Kruskal - Wallis, and multiple analyses. Results: The mean age of the women was 67.4 + 5.3 years. Analysis of each physical activity domain showed that 60.8% of the time was spent doing sitting activities. Belonging to SESC, being older, having no partner, having a higher school education and a good selfperception of health were characteristics significantly associated with the performance of moderate-intensity or vigorous-intensity physical activity. Multiple analysis indicated that belonging to SESC, being 70 years or older and having finished secondary education (or higher) increased the chance of engaging in moderate-intensity or vigorous-intensity physical activity by 11.4, 3.3 and 2.4 times, respectively. The mean quality of life score was 66.9 + 11.7. The highest value was observed in the domain related to sensory abilities (72.0 + 18.8) and the lowest score related to autonomy (60.3+ 16.2). Women belonging to SESC, those who were older, had no partner, had a lower school education, had a good selfperception of health, did not take medication, had no history of diseases and were from a higher social stratum had better quality of life scores. Using linear regression analysis, it was observed that a good self-perception of health increased the quality of life score by 7.3 points, the amount of medication taken decreased by 4.4 points and the performance of moderate or vigorous-intensity physical activity increased by 4.8 points. A statistically significant association was observed between the performance of moderate/vigorous intensity physical activity and better quality of life scores. Conclusions: It became evident that efforts are needed to change the type and intensity of physical activity in women aged 60 or older to significantly decrease time spent doing sitting activities, with the purpose of carrying out the recommendations for improving physical condition and maintaining health. In a similar manner, it is necessary to make an investment in education, as well as to establish cultural and leisure facilities, accessible to this population (and other populations) so that they may understand the increasing importance of performing physical activity to have a better quality of life
Mestrado
Ciencias Biomedicas
Mestre em Tocoginecologia

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38

Santos, Valter Fausto dos 1959. "Estudo comparativo entre dois meios de distensão durante a histeroscopia diagnóstica em mulheres após a menopausa = Comparative study between two distension media during diagnostic hysteroscopy in postmenopausal women." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309676.

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Orientador: Ilza Maria Urbano Monteiro
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: Atualmente, a histeroscopia é o procedimento padrão ouro para descrever a morfologia da cavidade uterina e a presença de lesões. Para a realização do procedimento é necessária a distensão da cavidade uterina. A distensão pode causar desconforto, dor e às vezes desistência do procedimento. Hoje em dia, duas técnicas de distensão têm sido utilizadas para a histeroscopia diagnóstica: com gás carbônico ou com coluna líquida (solução salina). Objetivos: Comparar a dor da paciente e a opinião do operador em relação à qualidade da imagem durante o procedimento, assim como a taxa de complicações do exame, relacionando-os com o tempo de duração do mesmo e características clínicas dessas mulheres, utilizando-se o gás carbônico (C02) ou solução salina como distensores da cavidade uterina. Sujeitos e método: Todas as mulheres após a menopausa que vieram encaminhadas da rede básica de saúde do município de Campinas ou região e dos ambulatórios de especialidades do CAISM/UNICAMP para realização de histeroscopia, no período de 07 de fevereiro de 2011 a 27 de fevereiro de 2012, foram convidadas a participar do estudo. Selecionou-se 140 pacientes que preencheram os critérios de inclusão e aceitaram participar do estudo. Foram então submetidas ao exame histeroscópico no ambulatório de Histeroscopia do DTG/CAISM/UNICAMP. A escolha da técnica para cada grupo foi feita por meio da randomização realizada através do programa SAS (distribuição de probabilidade uniforme) versão 9.2. A dor foi analisada pelo pesquisador, logo após a realização do exame, aplicando-se a escala visual analógica de dor (EVA). Os outros dados foram colhidos através de um questionário feito durante o exame e após o mesmo. Análise dos dados: Para a análise dos dados: dor, tempo de procedimento e qualidade da imagem, considerou-se um poder de 80% com um nível de significância de 5%. Foram utilizados teste t de Student, teste exato de Fisher, teste do qui quadrado e o teste não paramétrico de Mann Whitney, para comparação das médias de variáveis quantitativas. Resultados: Setenta e duas pacientes constituíram o grupo do CO2 e 68, o grupo da solução salina. A idade média, o tempo de menopausa e o índice de massa corporal (IMC) foram semelhantes nos dois grupos. O antecedente de cesárea foi maior no grupo do líquido (1,1±1,2) que no do gás (0,5±0,8) (p=0,0046). O escore médio de dor referido foi igual nos dois grupos, sendo (5,5±2,3 e 5,8±3,0), no grupo do CO2 e solução salina, respectivamente. O tempo total do exame foi maior no grupo da solução salina (3,5±1,57min) que com CO2 (2,6±1,55min) (p=0.0002). Quase a totalidade das pacientes aceitariam realizar o exame novamente (84,7% vs 89,7%, nos grupos de CO2 e líquido, respectivamente) (p=0.37). No grupo com líquido foi maior a taxa de falha por estenose de canal cervical (16,2%) que no grupo com gás (5,6%) (p=0.04). A qualidade da imagem foi considerada satisfatória em 100% e 96,3%, nos grupos com gás e líquido, respectivamente (p=0.37). Conclusões: A dor referida e a qualidade da imagem durante a histeroscopia diagnóstica foram iguais quando se utillizou CO2 ou líquido. A taxa de falha por estenose cervical, o antecedente de cesárea e o tempo total de procedimento foram maiores no grupo do líquido
Abstract: Presently hysteroscopy has been a "gold-standard" procedure to describe the morphology of the uterine cavity and the presence of lesions. The distension of the uterine cavity is necessary for the procedure and may cause discomfort, pain and sometimes its interruption. Two distension techniques have been utilized for the diagnostic hysteroscopy: one with carbon dioxide and another with liquid column (saline solution).Objectives: To compare the patient's pain and the surgeon's opinion in relation to the quality of the image during the procedure as well as the rate of complications of the test, relating them to their duration and clinical characteristics of the patients utilizing either carbon dioxide (CO2) or saline solution as distension media. Subjects and Method: All the post-menopausal women sent from health services of Campinas and neighboring cities and CAISM UNICAMP for the hysteroscopy procedure from February 7,2011 to February 27,2012 were invited to participate of the study. 140 patients who met the inclusion criteria were selected and underwent an office hysteroscopy at the DTG/CAISM/UNICAMP center. The technique was chosen by SAS program randomization distribution of uniform probability version 9.2 and reported to the patient afterwards. The pain was analyzed by the researcher soon after the procedure applying the visual analogue scale (VAS). The other data were collected by means of a questionnaire during and after the procedure. Data Analysis: For the analysis of pain, time of procedure and image quality an 80% power with 5% significance level was considered. The student't test, the exact Fisher's test, the square qui test and the Mann Witney test were utilized to compare the averages of the quantitative variables. Results: 72 and 68 patients comprised the CO2 saline solution groups, respectively. The average age, date of the last period and mass body index (MBI) were similar in both groups. The previous cesarean section was higher in the saline solution group (1.1±1.2) then in the CO2 group (0.5±0.8) ( p= 0.0046) . The pain average score was the same in both groups, i.e. (5.5±2.3) and (5.8±3.0) in the CO2 and saline solution groups, respectively. The total time of the procedure was longer in the saline solution group (3.5±1.57 minutes) than in the CO2 group (2.6±1.55 min) ( p= 0.0002). Almost all patients agreed on undergoing the procedure again ( 84.7% vs 89.7% in the CO2 and saline solution groups respectively)(p=0.37). The rate of failure by cervical stenosis was higher in the saline solution group (16.2%) than in the group CO2 group (5.6%)(p=0.04).The image quality was satisfactory (100% in the saline solution group and 96.3% in the CO2 group(p=0.37).Conclusions: Both pain and image quality during the diagnostic hysteroscopy were the same. The rate of failure by cervical stenosis, the cesarean section and the total time of the procedure were higher in the saline solution group
Mestrado
Fisiopatologia Ginecológica
Mestre em Tocoginecologia

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39

Fernandes, Tatiane Rosa 1981. "Influencia do uso tópico do estrogênio ou testosterona ou acido poliacrilico sobre a funçao sexual em mulheres na pós menopausa = ensaio clinico controlado e aleatorizado = Eficcacy of vaginally applied estrogen, testosterone, polyacrylic acid on sexual function in postmenopausal women: a randomized controlled trail." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313671.

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Orientador: Aarão Mendes Pinto-Neto
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: A atrofia vaginal é uma condição crônica frequente em mulheres na pós-menopausa que acarreta alterações em sua sexualidade e consequentemente em sua qualidade de vida. Recentes estudos avaliam novas alternativas de tratamento para essa ascendente queixa da população feminina. Entretanto, atualmente dispomos de poucas opções terapêuticas adequadamente avaliadas. Objetivo: Comparar a função sexual feminina após o uso tópico de estrogênio, testosterona e ácido poliacrílico com o uso de lubrificante vaginal. Métodos: Ensaio clinico randomizado com 80 mulheres na pós-menopausa, entre 40 e 70 anos, em seguimento no Ambulatório de Menopausa do CAISM Unicamp. As mulheres foram randomizadas para o tratamento tópico via vaginal com estrogênio, testosterona, ácido poliacrílico e lubrificante, três vezes na semana, por um período de 12 semanas, entre novembro de 2011 a janeiro 2013. Utilizou-se o Índice de Função Sexual Feminina para avaliar as mudanças da resposta sexual no início e após 6 e 12 semanas. Resultados: O ácido poliacrílico e a testosterona tópica, em comparação com o lubrificante após 12 semanas de tratamento, apresentaram aumento nos domínios: desejo sexual, lubrificação, satisfação, dor na relação sexual e escore total. O tratamento com o estrogênio tópico em comparação com o lubrificante apresentou melhora no domínio desejo. A análise intragrupo ao longo do tempo de tratamento evidenciou melhora nos domínios desejo, lubrificação, dor para as mulheres que utilizaram ácido poliacrílico, testosterona e estrogênio. Além disso, as mulheres que utilizaram testosterona apresentaram melhora ao longo do tempo nos domínios excitação, orgasmo e satisfação. Conclusão: O tratamento por 12 semanas- em mulheres na pós-menopausa com sintomas de atrofia vaginal - realizado com ácido poliacrílico, testosterona e estrogênio demonstrou melhora na função sexual feminina. quando comparado ao uso de lubrificante vaginal
Abstract: Introduction. Female libido is multifactorial and complex. Declining estrogen levels in postmenopausal women affects vaginal function. Aim. To evaluate female sexual function after using topical estrogen, testosterone or polyacrylic acid as vaginal lubricants with K-Y jelly as a placebo lubricant. Methods. This was a randomized controlled clinical trial on 80 postmenopausal women between 40 and 70 years of age with follow-up at the Menopause Clinic of the CAISM / Unicamp. The women were randomized to treatment with topical vaginal estrogen, testosterone, polyacrylic acid or oil lubricant alone, three times a week for a period of 12 weeks from November 2011 to January 2013. Main Outcome Measures. We used the Female Sexual Function Index (FSFI) to assess changes in sexual response at baseline, and after 6 and 12 weeks. Results. After 12 weeks of treatment, polyacrylic acid and topical testosterone produced improvements in the FSFI domains of sexual desire, lubrication, satisfaction, reduced pain during intercourse and total score compared with lubricant alone. Treatment with topical estrogen in comparison with lubricant alone showed an improvement in the FSFI field of desire. The intragroup analysis over the time of the treatment showed improvements in the fields of desire, lubrication, and reduced pain for polyacrylic acid, testosterone and estrogen. Furthermore, women who used testosterone showed improvements over time in the fields of arousal, orgasm and satisfaction. Conclusions. Treatment of postmenopausal women with symptoms of vaginal atrophy with polyacrylic acid, testosterone and estrogen for 12 weeks produced improvements in self-reported female sexual function when compared with a lubricant
Mestrado
Fisiopatologia Ginecológica
Mestra em Ciências da Saúde

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40

Gomes, Débora Alessandra de Castro 1972. "Densidade mineral óssea e infecção pelo HIV em mulheres climatéricas = Bone mineral density and HIV infection in climateric women." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312829.

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Orientadores: Lúcia Helena Simões da Costa Paiva, Ana Lúcia Ribeiro Valadares
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Os avanços científicos com a utilização da terapia antiretroviral altamente potente (TARV), proporcionaram significativo aumento na expectativa de vida das mulheres HIV soropositivas. Por outro lado, elas estão vivenciando afecções próprias do envelhecimento, como a osteoporose de etiologia provavelmente multifatorial. Objetivo: Avaliar a densidade mineral óssea e fatores associados em mulheres climatéricas HIV soropositivas. Sujeitos e Métodos: Realizado estudo de corte transversal com 273 mulheres HIV soropositivas e 264 mulheres HIV soronegativas de 40 a 60 anos de idade, acompanhadas em atendimento ambulatorial especializado. Foram avaliadas características clínicas, laboratoriais e densidade mineral óssea. Análise estatística: Foram utilizados os testes de Yates, qui-quadrado de Pearson, Mann-Whitney e análises de regressão múltipla de Poisson e regressão linear. Resultados: A média etária das mulheres HIV soropositivas foi 47,7 anos e das soronegativas 49,8 anos. As mulheres HIV soropositivas apresentavam IMC menor que 25Kg/m² (51,6%) e 59,3% estavam na pré ou perimenopausa enquanto as HIV soronegativas 29,3% tinham IMC menor que 25 kg/m² e 42,1% estavam na pré ou peri menopausa. A prevalência de baixa massa óssea em L1-L4 foi de 33,5% no grupo soropositivo e 33,2 % no grupo soronegativo (p>0.999). No colo do fêmur foi de 33,1% no grupo HIV soropositivo e 27,6 % no grupo soronegativo (p=0,266). A análise de regressão linear múltipla mostrou associação inversa entre DMO da coluna lombar e estar na pós menopausa, ser HIV soropositiva, FSH > 40 mUI/ml e direta com IMC >25 Kg/m² . Em relação a DMO no colo do fêmur houve uma associação inversa com estar na pós menopausa, cor branca e associação direta com maior paridade e IMC >25 Kg/m². Dentre as mulheres HIV soropositivas o tempo médio da infecção era de 9.9 anos, 92% usavam TARV, tempo médio de TARV era de 9,4 anos, tempo decorrido desde o diagnóstico foi em média 9,9 anos. Os fatores associados à baixa massa óssea em L1-L4 foram maior idade (p<0,001), paridade > 2 (p=0,03), estar na pós menopausa (p<0,01) e FSH > 40 mUI/ml (p<0,001). No colo do fêmur a baixa massa óssea esteve associada à maior idade (p<0,001), não usar drogas ilícitas (p=0,03), estar na pós menopausa (p<0,01) e FSH >40 mUI/ml (p<0,001). Não houve associação de baixa massa óssea na coluna lombar (L1-L4) e colo do fêmur com variáveis associadas diretamente ao HIV. A análise de regressão múltipla de Poisson verificou associação entre baixa DMO em L1-L4 e colo do fêmur apenas com estar na pós menopausa. Conclusão: Não houve diferença significativa na DMO na coluna lombar L1-L4 e no colo do fêmur nas mulheres climatéricas HIV soropositivas e soronegativas. A prevalência de osteopenia/osteoporose em mulheres climatéricas HIV soropositivas recebendo TARV foi de 33,5% em L1-L4 e de 33,1% no colo do fêmur, enquanto nas soronegativas foram 33,2 % em L1-L4 e 27,6% no colo do fêmur. Os principais fatores associados à baixa DMO foram estar na pós menopausa e menor IMC em mulheres HIV soropositivas e negativas. Ser HIV soropositivo esteve associado a baixa DMO apenas em L1-L4
Abstract: Scientific advances in the use of highly active antiretroviral therapy (HAART), have provided a significant increase in the life expectancy of HIV positive women. Moreover, they themselves are experiencing disorders of aging, such as osteoporosis probably multifactorial etiology. Objective: To evaluate bone mineral density and associated factors in menopausal women HIV positive. Subjects and Methods: Conducted cross-sectional study of 273 HIV seropositive women and 264 HIV-seronegative women 40-60 years old, followed in a specialized outpatient care. Clinical and laboratory characteristics and bone mineral density were evaluated. Statistical analysis: tests Yates Mann-Whitney analysis of multiple Poisson regression and linear regression were used chi-square test, and. Results: The mean age of the HIV positive women was 47.7 years and 49.8 years for seronegative. HIV seropositive women had a BMI less than 25 kg / m² (51.6%) and 59.3% were pre- or perimenopausal HIV seronegative while 29.3% had a BMI less than 25 kg / m² and 42.1% were in pre- or peri-menopausal. The prevalence of low bone mass in L1-L4 was 33.5% in the HIV-positive group and 33.2% in the seronegative group (p> 0.999). Femoral neck was 33.1% in HIV-seropositive group and 27.6% in the seronegative group (p = 0.266). A stepwise multiple linear regression analysis showed an inverse association between lumbar spine BMD and being postmenopausal, be HIV seropositive, FSH> 40 mIU / ml and direct with BMI> 25 kg / m². In relation to BMD at the femoral neck there was an inverse association with being postmenopausal, white and direct association with higher parity, and BMI> 25 kg / m². Among the HIV-seropositive women the average time of infection was 9.9 years, 92% were using HAART, median time to ART was 9.4 years, time since diagnosis averaged 9.9 years. Factors associated with low bone mass in L1-L4 were older age (p <0.001), parity> 2 (p = 0.03), being postmenopausal (p <0.01) and FSH> 40 mIU / ml (p <0.001). Femoral neck low bone mass was associated with older age (p <0.001), not using illicit drugs (p = 0.03), being postmenopausal (p <0.01) and FSH> 40 mIU / ml (p <0.001). There was no association between low bone mass at the lumbar spine (L1-L4) and femoral neck variables associated directly with HIV. The analysis of multiple Poisson regression found an association between low BMD at L1-L4 and femoral neck only to be postmenopausal. Conclusion: There was no significant difference in BMD at the L1-L4 lumbar spine and femoral neck in women seropositive and seronegative climatic HIV. The prevalence of osteopenia / osteoporosis in menopausal women seropositive HIV receiving ART was 33.5% in L1-L4 and 33.1% at the femoral neck, while 33.2% were seronegative at L1-L4 and 27.6 % in the femoral neck. The main factor associated with low BMD were being menopausal and have lower BMI in HIV positive and negative women. HIV seropositive was associated with low BMD only in L1-L4
Doutorado
Fisiopatologia Ginecológica
Doutora em Ciências da Saúde

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41

Rezende, Débora Aparecida Paccola de. "Prevalência de quedas referidas e fatores associados na transição e após menopausa." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/6/6136/tde-13032014-082136/.

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INTRODUÇÃO: Frente ao aumento gradativo de quedas da própria altura com o avançar da idade, torna-se imprescindível conhecer os fatores de risco implicados na sua ocorrência em mulheres na transição e após menopausa, com o intuito de contribuir com estratégias de prevenção e promoção da saúde no cotidiano. OBJETIVO: Estimar a prevalência de quedas referidas e caracterizar a associação entre as quedas com variáveis clínicas e epidemiológicas das mulheres da Estratégia de Saúde da Família do Município de Pindamonhangaba, SP. MÉTODOS: Em estudo com delineamento observacional do tipo transversal vinculado ao Projeto de Saúde de Pindamonhangaba (PROSAPIN), foram utilizados dados secundários randomizados de 875 mulheres com idade entre 35 a 65 anos e investigadas por meio de um inquérito domiciliar e medidas antropométricas. A variável queda foi incluída como dependente, enquanto que as independentes foram representadas pela idade, estado civil, renda, escolaridade, raça, ocupação, histórico ginecológico, doenças crônicas referidas e mensuradas, medicamentos, obesidade (índice de massa corpórea), hábito alimentar, consumo de bebidas alcoólicas, tabagismo, sono, depressão e atividade física habitual. RESULTADOS: Participaram do estudo 749 mulheres com média de 47,7 anos (com desvio padrão de 8,1); a prevalência de quedas da própria altura foi de 17,6 por cento (IC de 14,9 - 20,5), sendo a maioria (54,6 por cento) na pós menopausa. Das mulheres que caíram, a prevalência de recorrência foi de 45,2 por cento. As principais causas foram escorregões (29,4 por cento) e tropeços (19,8 por cento). Após análise multivariada constatou-se associação das quedas com a idade (p=0,018), qualidade do sono ruim (0,007) e comorbidades como a hipertensão arterial (p=0,032) e depressão (p=0,003). As comorbidades hipertensão arterial (p=0,055) e depressão (p=0,001) associaram-se também as quedas recorrentes, bem como restrições às atividades de vida diária (p=0,000). CONCLUSÃO: A maior prevalência de quedas ocorreu após a menopausa e entre os principais fatores associados à sua gênese emergiram a idade, hipertensão arterial, depressão e sono ruim
INTRODUCTION: Faced the gradual increase of falls from height with advancing age, it becomes essential to know the risk factors of the falls on women in transition and after menopause, in order to contribute with strategies for prevention and health promotion in their daily routine. OBJECTIVE: To estimate the prevalence of referred falls and characterize the association between falls and clinical and epidemiological variables of women of the Family Health Strategy of Pindamonhangaba City, SP. METHODS: In a study with observational design of the type cross-sectional linked to Health Project of Pindamonhangaba (PROSAPIN), it was used secondary randomized data from 875 women from 35 to 65 years old and they were investigated through a household survey and anthropometric measurements. The falls were included as a dependent variable and age, marital status, income, education, race, occupation, gynecologic history, chronic disease and those measured, medicines, obesity (body mass index), dietary habits, alcohol consumption, smoking, sleep, depression and physical activity. RESULTS: There were 749 women investigated with average age of 47.7 years (standard deviation 8.1); the prevalence of falls from height was 17.6 percent (95 percentCI: 14.9 - 20.5), the majority (54.2 percent) of the fallers were in the post menopausal. Of the women who fell, the prevalence of recurrence was 45.2 percent. The main causes were slipping (29.4 percent) and setbacks (19.8 percent). After multivariate analysis, it was found an association of falls with age (p=0.018), poor sleep quality (p=0.007) and comorbidities as hypertension (p=0.032) and depression (p=0.003). The comorbidities hypertension (p=0.055) and depression (p=0,001) associated too with recurrent falls, as well restricted the activities of daily living (p=0.000). CONCLUSION: The highest prevalence of falls occurred after the menopause and among the main factors associated its genesis emerged the age, hypertension, depression and bad sleep

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Kumpula, Back Mirja, and Rondik Mohamad. "Barnmorskors uppfattningar om kvinnors behov i klimakteriet." Thesis, Högskolan i Skövde, Institutionen för hälsa och lärande, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-11264.

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Tanna, Nuttan. "The role of a specialist menopause pharmacist." Thesis, King's College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.393644.

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Utian, Wulf Hessel. "Menopause and its management the physiopathologic foundation." Doctoral thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/32811.

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An historical survey of all issues relating to the menopause was considered integral to understanding attitudes and the existing state of knowledge at the time of my planning and designing my initial investigations. While the research literature up to late 1966 was essentially narrative in nature, there were many indirect areas of research that could help define both the level of existing knowledge as well as attitudes and perceptions at that time. Above all, by understanding and documenting a comprehensive historical survey, it became possible to define the pertinent questions that needed answers. Key papers in which I documented the history and summarized the state of the art at that time are references 1-5, 107, 109, and my monograph, “Menopause in Modern Perspective (Appleton, Century, Crofts, New York, 1979). I can best summarize the background to my future studies by quoting from my first published analysis of the literature in 1968.107 The critical review opened with the observation that “most of what is published is based on emotional and philosophical premises; the 'change of life' is an emotional subject not only to women, but to men and doctors.” The purpose of the review was then listed as: “1. To analyse the current thoughts regarding the menopause. 2. To draw attention to the paucity of authoritative research and published data. 3. To serve as an indication for the urgent need for research, particularly into the nature of the menopause and the methods for the relief of menopausal symptoms and disorders; the process of 'ageing' and, in particular, the occurrence of osteoporosis and atherosclerosis in postmenopausal women; and the metabolic and vascular changes following acute hormone withdrawal, e.g. after bilateral oophorectomy in the pre- and postmenopausal female.” The conclusions of that 1968 critical review determined my future career path: “Several questions urgently require answers: 1. Is the climacteric a normal physiologic stage in the life of the human female, or is it a simple result of ovarian failure and oestrogen deficiency? 2. Are the manifestations of ageing directly related to diminution of circulating sex hormones? 3. Can the administration of exogenous oestrogen or other sex hormones prevent the manifestations of ageing? 4. Are the oestrogens at present available for administration equivalent in effect to circulating endogenous oestrogens? 5. Does long-term oestrogen administration result in an increased incidence of breast or uterine carcinoma? 6. Do oestrogens have a direct effect on the psychological state and sense of well-being in the postmenopausal patient? To these ends the development of more precise diagnostic techniques and methods of evaluation is vital.

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BAUMANN, BILLMANN VALERIE. "Traitement hormonal substitutif lors de la menopause." Université Louis Pasteur (Strasbourg) (1971-2008), 1989. http://www.theses.fr/1989STR15002.

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Baumann, Billmann Valérie. "Traitement hormonal substitutif lors de la menopause." Strasbourg 1, 1989. http://www.theses.fr/1989STR10896.

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Tardivo, Ana Paula [UNESP]. "Investigação do consumo alimentar e dos indicadores da composição corporal das mulheres na pós-menopausa." Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/93108.

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Made available in DSpace on 2014-06-11T19:26:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-02-28Bitstream added on 2014-06-13T20:07:35Z : No. of bitstreams: 1 tardivo_ap_me_botfm.pdf: 1077694 bytes, checksum: 57e3978e7fcac10ecc9d0405496b1af5 (MD5)
Investigar o consumo alimentar e os indicadores da composição corporal de mulheres na pós-menopausa. Métodos: Trata-se de estudo clínico, transversal, com amostra de conveniência composta por 173 mulheres na pós-menopausa, seguidas no Ambulatório de Climatério e Menopausa do Hospital das Clínicas-Faculdade de Medicina de Botucatu – UNESP no período de junho de 2005 a junho de 2006. Foram incluídas no estudo mulheres com data da última menstruação há pelo menos 12 meses, usuárias e não usuárias de terapia hormonal (TH). Os hábitos alimentares foram avaliados por meio do recordatório de 24 horas e pelo Índice de Alimentação Saudável (IAS). Para avaliação antropométrica foram obtidos peso, estatura, índice de massa corpórea (IMC=peso/altura2), circunferência abdominal (CA), relação cintura-quadril (RCQ), gordura corporal (%GC) e massa magra (%MM). Foram mensurados colesterol total, HDL, LDL, triglicerídios e glicemia. Na análise estatística utilizou-se o teste t de Student e a Correlação de Pearson. Resultados: A média de idade foi de 54±7,6 anos. O sobrepeso e a obesidade estiveram presentes em 76% das participantes. De acordo com o IAS, 91% das mulheres apresentaram alimentação de má qualidade. O consumo de proteínas e carboidratos estava adequado, entretanto, a qualidade de lipídios ingerida foi inadequada, com gorduras saturadas acima de 7% e poliinsaturadas acima de 10%. Somente 9% das participantes tiveram consumo adequado de cálcio e 7% de ferro. Pela medida da RCQ, o risco para a doença cardiovascular foi considerado alto Resumo em 39% e muito alto 36% das mulheres. Cerca de 89% das mulheres apresentaram CA elevada (>80 cm) contribuindo para complicações metabólicas. Os valores médios de colesterol total, LDL e triglicerídios estavam acima do recomendável em 46%, 55% e 79% das mulheres, respectivamente, com HDL baixo em 55%.
To investigate the food consumption and indicators of body composition in post-menopausal women. Methods: This cross-sectional, clinical study was undertaken in a convenience sample consisting of 173 were at menopause and registered, as well as followed up, at the Menopause and Climacterium Outpatient Clinic of Botucatu Medical School Hospital- São Paulo State University/UNESP between June/2005 and June/2006. All women without menstruation for at least 12 months, users and non-users of hormone therapy (HT), were included in the study. The food consumption was assessed by the 24h-record food inquiry and the healthy eating index (HEI). The anthropometric indicators included: weight, height, body mass index (BMI= weight/height2), abdominal circumference (AC), waist/hip ratio (WHR), body fat (%BF) and lean mass (%LM). Data on total cholesterol, HDL, LDL, triglycerides and glycemia were also collected. The nonparametric t test of Student and Pearson’s correlation were used in the statistical analysis. Results: Mean age was 54 years ± 7.6. Overweight and obesity were observed in 76% of the patients. Based on the HEI values obtained, diet quality was poor in 91% of the cases. Protein and carbohydrate intakes were adequate, but the quality of the lipids consumed was inadequate in relation to saturated fat >7% and polyunsaturated fat > 10%. Calcium and iron intakes were adequate in only 9% and 7% of the cases, respectively. The risk of cardiovascular disease, as determined by the waist/hip ratio, was considered high in 39% and very high in 36% of the women. Abdominal circumference was Summary elevated (> 80 cm) in 89% of the patients, which contributed for the occurrence of metabolic complications.

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Mendes, Paula de Holanda. "Fumar antecipa a menopausa ? Evidências do Estudo Pró-Saúde." Universidade do Estado do Rio de Janeiro, 2009. http://www.bdtd.uerj.br/tde_busca/arquivo.php?codArquivo=5211.

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A menopausa é definida pelo momento em que a menstruação cessa permanentemente como conseqüência da falência ovariana. Uma vez estabelecida, há um aumento no risco de doença coronariana, doença de Alzheimer, osteoporose e fraturas e sua antecipação está relacionada a maiores índices de mortalidade. Com o envelhecimento geral da população mundial, as mulheres passaram a viver de um terço a metade de suas vidas no período pós-menopáusico e, conseqüentemente, a pesquisa de condições associadas à menopausa ganham importância. A idade da menopausa e os fatores que a influenciam variam entre os diversos estudos e poucos estudos brasileiros abordam o tema. O fumo tem sido associado à Antecipação da idade da menopausa. O objetivo deste estudo é analisar as diversas dimensões de associação entre o fumo e a idade da menopausa, levando em consideração possíveis relações de dose-resposta. Com base em dados do Estudo Pró-Saúde, foi realizado um estudo seccional utilizando-se para a análise o modelo de sobrevida paramétrico de riscos proporcionais com distribuição de Weibull. Os resultados apontam para uma redução em 32% do risco de menopausa entre fumantes ativas, que a alcançam 2,5 anos mais tarde que nunca fumantes, ajustando-se para escolaridade e paridade. Entre fumantes ativas, no entanto, foram sugeridos aumentos de risco de 123% e 192% para fumantes de 10 a 20 cigarros por dia e de mais de 20 maços-ano respectivamente, quando comparadas às fumantes de menos de 10 cigarros por dia e menos de 10 maços-ano. Nesses grupos, a menopausa foi antecipada em 3,3 anos e 4,4 anos, respectivamente. Em relação ao tempo decorrido entre cessar o tabagismo e a idade menopausa, duração do fumo ou idade de início, não foram encontradas associações. Neste estudo, em possíveis efeitos de dose-resposta, o fumo apresenta-se como fator associado à antecipação da idade da menopausa em alguns aspectos, embora não em outros.
The definition of menopause is the moment when the ovarian function stops definitively. Once occurred, there is an increased risk of cardiovascular disease, Alzheimer disease, osteoporosis and bone fractures. When anticipated, menopause is related with higher risk of all-cause mortality and several serious illnesses. Because of the increasing population life expectancy, women may spend between one third to one half of their lives after menopause, and thats why postmenopausal health condition studies are important. There are many studies of factors that influence the age at menopause which have many different results and few of them are Brazilian ones. Smoking has been associated with earlier menopausal age. This studys aims are to analyses different aspects of the associations between smoking and the age of menopause, considering possible effects of smoking dose. The Pró-Saúde study data base was utilized with sectional analyses and a parametric proportional hazard survival regression model with a Weibull distribution. Our results point to a reduction of the menopause risk related to current smoking about 32% with active smokers achieving menopause 2,5 years latter than nonsmokers, adjusted to education and parity. However among current smokers, this study suggests a higher risk of 132% and 192% to those women who smoke about 10 to 20 cigarettes a day and those who smoke more than 20 pack-years, respectively, compared to those smokers of less than 10 cigarettes a day and less than 10 pack-years. Those groups achieved menopause 3.3 and 4.4 years earlier than controls, respectively. There was no evidence of association relating age at menopause with age at start smoking, time since stopped smoking or smoking duration. In this study, considering possible dose-response effects, smoking is shown as a factor related to anticipation of menopausal age in some aspects, although not in others.

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Menna, Barreto Ana Lúcia V. "Sintomas vasomotores e associação entre adipocinas séricas (adiponectina e PAI-1), moléculas de adesão (ICAM-1 E VCAM-1) e estado nutricional de mulheres peri e pós-menopáusicas." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2013. http://hdl.handle.net/10183/88430.

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Introdução: O climatério é definido como a fase que compreende a transição entre o período reprodutivo e o não reprodutivo da vida da mulher. Durante esse período e, principalmente, no período pós-menopáusico as mulheres tendem a ganhar mais peso e modificar o padrão de distribuição de gordura corporal. Sabe-se que adipocinas liberadas pelo tecido adiposo, que têm ações diversas como função imunológica, cardiovascular, metabólica e endócrina, podem contribuir para o desenvolvimento de comorbidades, como aterosclerose e diabetes melitus tipo 2. Outras moléculas estão envolvidas nos processos metabólicos, como as moléculas de adesão celular (CAM), que já foram estudadas como preditoras de eventos cardiovasculares. Sabe-se ainda que na mulher pós-menopausa há uma relação inversa entre o exercício praticado regularmente e as principais causas de comorbidades. Objetivos: Analisar os sintomas vasomotores e sua associação com os níveis séricos de adipocinas( ADIPONECTINA E PAI- 1), moléculas de adesão (ICAM-1 e VCAM-1) e a relação com o estado nutricional em um grupo de mulheres peri e pós-menopáusicas atendidas no ambulatório de Climatério do Serviço de Ginecologia do HCPA. Métodos: Estudo transversal com 102 mulheres pré e pósmenopáusicas, com idade entre 40 e 65 anos, atendidas no Ambulatório de Climatério do Serviço de Ginecologia do HCPA. Todas participantes foram avaliadas quanto a massa corporal massa, estatura, circunferência da cintura IMC, circunferência da cintura, determinação de percentual de gordura através da mensuração das dobras cutâneas: triciptal, supra-ilíaca e coxa. Níveis séricos de colesterol total, HDL colesterol, LDL colesterol e triglicerídeos, glicose, adipocinas (ADIPONECTINA E PAI-1), moléculas de adesão (ICAM-1 e VCAM-1) foram investigados. Resultados: A média de idade foi 53,8 ± 5,4 anos, mediana de tempo de menopausa 48 (10-96) meses, e 68 (66,7 %) das mulheres estava na pósmenopausa. A avaliação antropométrica mostrou que 42 (41,2 %) delas tinham sobrepeso segundo Índice de masa corporal (IMC), e 51 (50,0 %) apresentaram risco cardiovascular muito elevado para circunferência de cintura, a média de % de massa gorda era de 33,3 ± 5,3 e 38 (37,25%) delas eram hipertensas. Os valores médios (± DP) dos exames laboratoriais foram: colesterol total de 214,4 (±42,3), glicose 91,9 (± 37,8), adiponectina 22,5 (± 11,8), PAI-1 284,9 (± 134,1), ICAM 1 457,0 (± 210,6) e VCAM 1 202,0 (± 61,3). Em relação aos sintomas, 76 (74,5%) delas tinham fogachos, 45 (44,1 %) depressão leve a moderada segundo escore de Beck, e 79 (77,5 %) tinham insônia conforme escore de Pisttburg (PSQI). Setenta e três das pacientes (71,6 %) foram classificadas como ativas segundo escore de atividade física IPAQ. Não foi observada relação estatisticamente significativa entre os níveis de adipocinas ou moléculas de adesão e fogachos. A adiponectina foi negativamente e inversamente associada com o IMC. Houve uma correlação inversa estatisticamente significativa entre idade e intensidade dos fogachos. Conclusão: As alterações em vários parâmetros estudados como a presença de sobrepeso/obesidade, circunferência de cintura e % de massa gorda aumentados e hipercolesterolemia contribuem para um maior risco de doença cardiovascular nesta amostra de mulheres peri e pós-menopáusicas, apesar de não termos encontrado correlação entre os fogachos e adipocinas ou moléculas de adesão.
Backgroud: Climacteric is defined as the phase comprising the transition between reproductive and non-reproductive life of women. Besides vasomotor symptoms, mood swings and sleep at this time, women tend to gain more weight and modify the pattern of body fat distribution. It is known that adipokines released by adipose tissue, which have different actions as a function of immune, cardiovascular, metabolic and endocrine function may contribute to the development of comorbidities, such as atherosclerosis and type 2 diabetes mellitus. Other molecules are involved in metabolic processes such as cell adhesion molecules (CAM), which have been studied as predictors of cardiovascular events. It is known that in postmenopausal women, an inverse relationship between exercise practiced regularly and the main causes of comorbidities. Objectives: To analyze the association between climacteric vasomotor symptoms (VMS) and adiponectin, plasminogen activator inhibitor 1 (PAI-1), intercellular adhesion molecule 1(ICAM-1), vascular cell adhesion molecule 1 (VCAM-1), lipid profile and nutritional status. Methods: This was a cross sectional study with 102 peri- and postmenopausal women from 40 and 65 years old that evaluated VMS, body mass index (BMI), waist circumference (WC), body fat percentage (BF%), adiponectin, PAI-1, ICAM-1 e VCAM-1, lipid profile, and glycemia. Results: Mean age 53.8 (± 5.4) years, median 48 (10.96) months from the last menstrual period. Overweight was observed in 41.2% of women, very high cardiovascular risk (WC ≥ 88 cm) in 50.0%, and BF% (mean ± standard deviation) was 33.3 ± 5.3%. Mean values were 22.5 (± 11.8) ng/dL for adiponectin, 284.9 (± 134.1) ng/dL for PAI-1, 457.0 (± 210.6) ng/dL for ICAM-1, 202.0 (± 61.3) ng/dL for VCAM-1, 214.4 (±42.3) mg/dL for total cholesterol, 51.0 (± 2.8) mg/dL for high-density level cholesterol (HDL-c), 138.8 (± 2.2) mg/dL for lowdensity level cholesterol (LDL-c), and 129.4 (± 67.8) mg/dL for triglycerides. 76 (74.5%) had hot flashes, 45 (44.1%) mild to moderate depression according Beck’s score, and 79 (77.5%) had insomnia according Pisttburg’s score (PSQI). 73 (71.6%) were classified as active according physical activity’s (IPAQ) score. No significant relationship was observed between adipokine or CAM levels and VMS. Adiponectin was negatively inversely associated with BMI. There was a statistically significant inverse correlation between age and hot flash intensity. Conclusions: VMS intensity was inversely related with age, and VMS were not associated with adiponectin, PAI- 1, ICAM-1 and VCAM-1. Changes in several study parameters, such as presence of overweight/obesity, increased WC and BF%, and hypercholesterolemia contribute to a higher risk for cardiovascular disease in this sample of peri and postmenopausal women, although we found no correlation between hot flashes and adipokines or adhesion molecules.

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Borba, Clarissa Moreira. "Uso de sulpirida versus placebo na redução de fogachos durante o climatério : ensaio clínico randomizado." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/180980.

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Objetivo: Avaliar os efeitos da Sulpirida 50mg/dia comparado a placebo sobre os sintomas vasomotores (frequência e intensidade) e na qualidade de vida de mulheres climatéricas. Métodos: Mulheres climatéricas (N=28), idade entre 47 e 62 anos, com pelo menos cinco episódios de sintomas vasomotores por dia, foram recrutadas em uma clínica especializada de um hospital terciário no sul do Brasil e através de chamamentos na mídia; após os critérios de inclusão e de exclusão, elas foram randomizadas. Placebo (n=14) e Sulpirida 50mg/dia (n=14) foram administrados durante o ensaio. O número e a intensidade dos fogachos foram registrados 1 semana antes e ao longo de 8 semanas após intervenção. Aplicou-se o WHQ – 36 itens para avaliação da qualidade de vida. Resultados: As frequências e as intensidades dos fogachos/dia foram similares em ambos os grupos, observando-se uma redução em ambos os parâmetros durante as semanas de follow-up após a intervenção com Sulpirida (p=0,019 e p=0,009, respectivamente). Quanto à qualidade de vida das mulheres, Sulpirida 50mg/dia reduziu os escores dos problemas com o sono após 8 semanas de tratamento, quando comparada ao grupo placebo (p=0,017). Conclusions: Nossos resultados sugerem que o tratamento com a Sulpirida 50mg/dia se apresentou com tendências significativas na redução dos sintomas climatéricos, se justificando a replicação e outros estudos que investiguem os possíveis mecanismos pelos quais a Sulpirida poderia reduzir os fogachos, de forma segura.
Objective: To assess the effects of Sulpiride 50mg/day compared with placebo on vasomotor symptoms (frequency and intensity) and on quality of life of climacteric women. Methods: Climacteric women (N=28), aged between 47–62 years, with at least five episodes of vasomotor symptoms per day were recruited from a specialized outpatient clinic at a tertiary hospital in the south of Brazil and through a media call after inclusion and exclusion criteria were ensured. Placebo (n=14) and Sulpiride 50mg/day (n=14) were administrated during all trial period. The number and intensity records of hot flushes were evaluated for 1 week before and along 8 weeks after the intervention. The 36-item version Women’s Health Questionnaire (WHQ) was applied to assess the quality of life. Results: The frequencies and the intensities of hot flushes /day happened in a similar way in both groups, with an observed reduction of both parameters during the weekly follow up after the Sulpiride intervention (p=0.019 and p=0.009, respectively). Regarding women’s quality of life, Sulpiride 50mg/day reduced sleep problems scores after 8 weeks of treatment, when compared to placebo group (p=0.017. Conclusions: Our results suggest that the Sulpiride 50mg/day treatment showed significant trends on reducing climacteric vasomotor symptoms, justifying replication and further studies addressing the possible mechanisms by which Sulpiride could safely reduce hot flushes.

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