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PubMed2005

Climacteric symptoms and quality of life: validity of women's health questionnaire.

OBJECTIVE: To evaluate the reliability and validity of the Portuguese version of the Women's Health Questionnaire. METHODS: In order to evaluate the Women's Health Questionnaire (WHQ), an analytical cross-sectional study was carried out at the women's menopause outpatient clinic of a university hospital in São Paulo, Brazil. There were studied 87 women in perimenopause or menopause, defined as experiencing at least one year's absence of menstrual flow. The following variables were collected: demographic data, clinical variables (Kupperman index and correlate numeric scale) and quality of life indexes (SF-36 and utility). RESULTS: The WHQ proved to be a questionnaire easily translated into Portuguese and well-adjusted to Brazilian women. The internal consistency of the overall WHQ was excellent (Cronbach alpha =0.83; 95% CI: 0.71-0.91). Test-retest reliability was also excellent (intraclass correlation coefficient [ICC]=0.92; 95% IC: 0.86-0.96) and had good absolute agreement (0.84; 95% CI: 0.71-0.92). A satisfactory clinical validity was observed. The construct validity was corroborated by clear associations with others scales. A good index of responsiveness after the intervention was reached. CONCLUSIONS: The Portuguese version of the WHQ is of easy and fast administration and understanding. Its measuring properties were related, allowing its use in the evaluation of Brazilian climacteric women's quality of life for various purposes.

Adult↗
PubMedDate not supplied

[Calcium/protein relation of women on the climacteric].

OBJECTIVE: To evaluate the calcium/protein relation of the diet of climacteric women. METHODS: In a transversal study the diet was evaluated of 154 women 35-65 years old and matriculated in the Health Clinic of the Climateric Woman of Health Center of Public Health College of the São Paulo University. The food intake of calcium and protein was investigated by "24 hours recall" method. The evaluation of calcium/protein relation was made according to Massey and Heaney (1998), that is 20/1 (mg/g). RESULTS: The mean of intake of calcium was 624.9 mg, the mean of intake of protein was 86.7 g and the calcium/protein relation was 7/1 (624.9 mg/86.7 g). CONCLUSION: The studied population presents inadequated consumation of the calcium and protein nutrients. It could result in serious risk for health.

Adult↗
PubMed1979

Uterine and ovarian estrogen receptor levels in climacteric women.

High affinity cytoplasmic estrogen receptors in the endometrium, myometrium and ovary of 15 climacteric women were studied. In addition, the concurrent serum estradiol and progesterone level of each woman was estimated and the endometrium examined histologically. The cytoplasmic estrogen receptor level of the endometrium and myometrium had remained extremely high in some cases several years after the menopause and in the presence of a completely atrophied endometrium. The lowest endometrial and myometrial estrogen receptor levels in pre-menopausal women were measured towards the end of the menstrual cycle. The eodometrial estrogen receptor level was roughly 2--3 times the comparable myometrial level. Estrogen receptors were also encountered in all cases in the cervical myometrium. The estrogen receptor levels of the ovary were low in all cases.

Adult↗
PubMed1981

Treatment with oral estrone sulphate in the female climacteric. II. Hormonal aspects.

Of forty-three perimenopausal women aged 40.1-56.5 years with climacteric complaints 25 were treated with sodium piperazine estrone sulphate 2.5 mg daily and 18 were given methyl scopolamine. All subject had initial serum FSH levels in the postmenopausal range (20 U/l). The serum levels of FSH, LH, unconjugated immunoreactive estrogens, total estrone, total dehydroepiandrosterone (DHAS), and the urinary low polar estrogens were followed during 18 months of treatment. In the estrogen treated group serum unconjugated immunoreactive estrogens and total estrone as well as urinary low polar estrogens increased significantly during treatment. The serum levels of FSH decreased significantly during the whole test period; LH only at three months. No effects could be seen on serum DHAS. In the group given methyl scopolamine the only changes found were a decrease in FSH at three months and a positive trend for LH (during the whole treatment period). In the total material, positive correlations were found between pretreatment values of unconjugated immunoreactive estrogens and total estrone and between total estrone and DHAS. A negative correlation was found between unconjugated immunoreactive estrogens and FSH. It is concluded that the effects of estrogens on the endocrine system in peri- and postmenopausal women are influenced by chemical structure, dosage and mode of administration of the estrogen as well as by the endogenous hormone profile.

Adult↗
PubMed1981

Treatment with oral estrone sulphate in the female climacteric. III. Effects on bone density and on certain biochemical parameters.

Thirty-eight women were treated with estrone sulphate over a period of 30 months for climacteric problems. A random control group of 29 women were given methyl scopolamine. Bone mineral assays were performed by means of dual photon absorptiometry before the start of treatment and after 6, 12, 18, and 30 months. There was a difference in the mineral loss of trabecular bone between the two groups after 30 months of treatment, that the control group being significantly higher (p less than 0.001). In the estrogen-treated group there was a decrease in serum phosphorus (p less than 0.01), alkaline phosphatase activity (p less than 0.001), and albumin (p less than 0.001). In the control group, serum albumin showed the same decrease, while the other factors either showed no differences or even increased. The urinary excretion of calcium was not significantly reduced in the estrogen group, whereas there was an increase in the control group (p less than 0.01). There was an increase in hematocrit in both groups. Positive correlation was found between parity and loss of trabecular bone mineral (p less than 0.01).U

Adult↗
PubMed1985

Mental health in the climacteric. The longitudinal study of women in Gothenburg.

A representative sample of 899 middle-aged urban Swedish women underwent a psychiatric interview on two occasions with 6 years between studies (waves). The point prevalence of all mental disorders was 39.9% at the first wave and 39.0% at the second. The corresponding one-year onset rates of all mental disorders were 18.0% and 14.2%. No significant differences were found between ages or between waves. Major depressive episodes accounted for about half of the psychiatric morbidity. Those women whose menopause started early were more often mentally impaired than others and they also tended to have been more often impaired even before the climacteric (ages 30-39). Menopause was not associated with any onset risk of mental disorder, but a relationship was found between this rate and the weighted sum of other life events. The latter association remained significant even when correction was made for age, social class and marital status. Divorced and the childless women ran an increased risk of developing a mental disorder with functional impairment in the 6-year period between the waves. Women from the lower social classes evidenced an increased risk of contracting some mental disorder during the same period.

Adult↗
PubMed1985

Estrogen-progestogen replacement in climacteric women, particularly as regards a new type of continuous regimen.

Twenty-six peri- and postmenopausal women were treated with daily dose of 2 mg 17-beta-estradiol, 1 mg estriol and 1 mg norethisterone-acetate in a continuous regimen for 12 months. Clinical parameters such as vasomotor symptoms, bleeding patterns and histopathology were recorded. Blood samples were collected before, after 3 months and after 12 months of treatment and were analysed for estradiol-17-beta, estrone, androstenedione in serum and lipoprotein lipids. A marked reduction of hot flushes and sweatings was noted and the number of days with bleeding gradually decreased during treatment, especially in the postmenopausal group of women. No signs of hyperplasia of the endometrium were recorded. A decrease in the serum concentration of testosterone and androstenedione was found during treatment. The reduction in triglycerides in very low density lipoproteins after 3 months, concomitant with a decrease in the cholesterol content of high density lipoproteins, was interpreted as an effect mainly of the progestogen component in the preparation. The present formulation of estrogen-progestogen, continuously administered, may be an appropriate alternative treatment regimen for many women. One proposition of how to treat women with climacteric complaints around the menopause is presented.

Adult↗
PubMed1997

Is severity of premenstrual symptoms related to illness in the climacteric.

The purpose of this study was to investigate whether women in the climacteric who have previously had severe premenstrual problems have a different pattern of reporting sick than other women. The material in the study comprised women with different degrees of severity of premenstrual symptoms who participated in an epidemiological study in 1982 on patterns of reporting sick and those women who at this time were of premenopausal or menopausal age were included. Women who previously had had such serious premenstrual problems that they had to be put on the sick-list were compared with women who had had moderate or no premenstrual problems. Information about to which extent these women have reported themselves sick has been obtained from the Regional Social Insurance Office in Uppsala County. The results show that women who have previously had severe premenstrual problems and who are now of menopausal age have a significantly greater number of diagnoses and occasions and have more long-term absences from work than women in the two control groups. They also have a greater number of sick days per year compared with statistics from the National Social Insurance Board on all women in the country.

Adult↗
PubMed2000

[Comparative study between estradiol valerate combined with cyproterone acetate, and conjugated equine estrogens combined with medroxyprogesterone acetate as hormone replacement therapy in climacteric].

OBJECTIVE: To compare the effectiveness in the control of climacteric symptoms, the tolerability and the uterine bleeding pattern between two types of hormone replacement therapy. MATERIAL AND METHODS: 81 postmenopausal women between 40 and 60 years age with vasomotor symptoms were studied. Randomly it was administered: I. Conjugated equine estrogens (CEE)-Medroxyprogesterone acetate (MPA): 21 tablets with 0.625 mg of CEE and 10 tablets with 5 mg of MPA which were taken with the last ten tablets of CEE in each cycle (n = 3 7). II. E2V-CPA: 11 tablets with 2 mg of E2V and 10 tablets with 2 mg of E2V and 1 mg of CPA (n = 44). Each cycle comprised 28 days. The treatments were compared with squared Chi and Mann-Whitney U test. RESULTS: The hot flushes presence was significantly greater in the group with CEE-MPA (p < 0.03). Severe throbs at the end of the study had a trend to be more frequent in the group with EC-MPA (p < 0.06). At the end of the study there was a greater frequency of breast tenderness in the group with CEE-MPA (P = 0.009). CONCLUSIONS: Both treatments have good effectiveness, tolerability and same bleeding pattern. Only the frequency of hot flushes, the presence of severe throbs and breast tenderness were lower in the group with E2V-CPA, that makes this preparation an option that can have a better acceptance by the women.

Adult↗
PubMed2001

[Osteoporosis and climacteric].

The climacteric period, menopause, constitutes a physiological process in a woman's life which can modify her health and increase the occurrence of some diseases which are related to estrogen deprivation; among these, osteoporosis stands out. After analyzing its etiology and risk factors, the author provides a detailed description of various preventive measures against this disease: nutrition, physical exercise, healthy living habits, etc.

Age Factors↗
PubMed2001

Influence of the hormonal status on somatic, psychopathological and mood symptoms in climacteric women.

OBJECTIVE: To evaluate the influence of hormonal status on somatic, psychopathological and mood symptoms in climacteric women. METHOD: 122 postmenopausal women have been evaluated by the PISA-system and P.O.M.S. (Profile of Mood States) to evaluate somatic, psychopathological and mood symptoms in a 3-intervention trial (perimenopausal women, postmenopausal women on replacement therapy, and postmenopausal women without any therapy). RESULT: We found no statistically significant difference among the three groups. A clear trend has however resulted: sex hormones seem to decrease the depressive mood, aggressiveness/anger and sexual dissatisfaction. CONCLUSION: Our results are inconclusive but they suggest that hormones influence some psychological and mood symptoms during the climacterium.

Adult↗
PubMed2001

[Estrogen therapy in climacteric. Current views in an evidence-based perspective].

In Sweden, approximately 65,000 women enter menopause each year. Hormone replacement therapy (HRT) for the treatment of climacteric symptoms is well documented, but the role of HRT in the prevention of other diseases is more questionable. The existing literature is discussed from an evidence-based perspective. There is strong evidence supporting the treatment of subjective symptoms, and also a scientific basis for long term treatment of women at increased risk of osteoporosis. Few studies address the issue as to how HRT should be prescribed and followed-up. It is important to consider the issue of quality of life in times of limited resources.

Aged↗
PubMed1976

[Treatment of the climacteric symptom complex with a new combined hormone preparation].

A total of 387 women with severe climacteric complaints were treated for a period of 4 years with a new combined hormone preparation containing 200 mg DHEAO (dehydroepiandrosterone oenanthate) and 4 mg oestradiol valerate in 1 ml oily solution. As a depot preparation it has a duration of action of about 6 weeks when administered parenterally. The therapeutic effect is as good as that of the known androgen-oestrogen combinations. There were no observations of voice changes or hirsutism as signs of virilisation. Hormone-cytological studies in all cases showed that proliferation of the endometrium in the sense of hyperplasia cannot be induced by the administered hormones. Cytologically, there is no evidence at all for an androgenic effect. With the exception of transient mastodynia, no mammary changes were observed. Curettage must be performed in existing or suddenly occurring bleeding disturbances, and continuous cytological and hormone-cytological studies are advisable.

Adult↗
PubMed1992

[Transdermal administration of estrogens in women with the postcastration and climacteric syndromes].

The authors report on the results of a follow-up of 64 women aged 25-64 years, to whom oestrogens were administered transdermally by means of the preparation Estraderm TTS 25 or 50 for three months. 55 women were treated for postcastration syndrome and nine women for climacteric syndrome. The authors deal with the problems of dosage of the transdermal oestrogen therapy, study the side-effects of treatment and evaluate the results of therapy. In conclusion, they recommend the transdermal form of treatment by Estraderm TTS because of its very good therapeutic effect, acceptability by the patients, and only minimal local and general side-effects.

Administration, Cutaneous↗
PubMed2003

[Women in climacteric. Results of the implementation of a health program].

Menopause is a very important period in the life of a woman due to the physiological and psychological changes which happen during this period. The authors apply an educational program providing integrated attention to women during this phase of their lives to evaluate possible improvements in the conflictive aspects which menopause generates. The authors carried out a longitudinal study with interventions before and after their study. The sample was a group of 28 women between the ages of 45 and 64. The educational intervention consisted of the application of a program providing integrated attention to women by the Generalitat Valenciana, the autonomous government in the Valencia Autonomous Region. This program had a positive influence on the knowledge and aptitudes of these women regarding this period of their lives. Their physical and psychological health improved, with a decrease in the most common symptoms caused by menopause and there were very significant differences found on the Kupperman test. The application of this program succeeded in relating the material taught to these women with a positive repercussion in their physical, psychological and social states during their climacteric years.

Climacteric↗
PubMed1992

Mydocalm treatment of muscular and vascular complaints accompanying climacterics.

Coated Mydocalm tablet, known as striated muscle relaxant and peripheral vasodilator, has been used in climacteric women. The women suffered from muscular and vascular complaints besides the common symptoms of decreased or lacking ovarian function which could not be controlled with oestrogen substitution therapy. Mydocalm significantly moderated these complaints without causing unwanted effects and the majority of the women could be maintained in a complaint-free condition in this respect. According to the opinion of the author the drug is a valuable adjuvant to an adequate hormone therapy.

Climacteric↗
PubMed2004

Alleviation of the climacteric symptoms with oral sequential hormone replacement therapy.

The efficacy of the oral hormone replacement therapy (HRT) preparation estradiol valerate/levonorgestrel (EV/LNG, Klimonorm) in the alleviation of the menopausal complaints of peri- and postmenopausal Thai women was studied in a prospective, open, uncontrolled phase IV clinical trial. Of the 50 peri- or postmenopausal women screened, 39 completed the study. From them 31 were postmenopausal and 8 perimenopausal. The participants received EV/LNG over a period of 6 cycles. The Menopause Rating Scale II (MRS II) was used to assess the effect of EV/LNG on the menopausal symptoms. The changes in the main parameters of the MRS II during the treatment with EV/LNG showed that the general score decreased by 34.9 per cent after 3 months and was kept at the same value after 6 months of treatment. The somato-vegetative complaints decreased by 32.5 per cent after 3 months and by 35 per cent after 6 months. The psychological complaints decreased by 34.1 per cent after 3 months and by 32.9 per cent after 6 months. The urogenital complaints decreased by 29.3 per cent after 3 months, and remained at the same level after 6 months of treatment. In conclusion, the 6-months administration of the oral HRT preparation estradiol valerate/levonorgestrel caused a considerable alleviation of the climacteric symptoms in menopausal women.

Climacteric↗