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PubMed2000

[Test on knowledge about climacteric: development and validation process].

OBJECTIVE: To construct and validate a test of knowledge about the menopause. SETTING: The context for use of this test is the Autonomous Community of Andalusia. METHOD: 1. Construction of the theoretical universe through the Delphi Technique. 2. Weighting of each of the dimensions of the theoretical universe. 3. Formulation and selection of the conceptual elements to introduce into the questionnaire and formulation of the corresponding items. 4. Selection of items and analysis of their internal consistency, homogeneity, stability and equivalence after a pilot study. PARTICIPANTS: The questionnaire's pilot study was run with 150 Andalusian women, chosen through sampling by quotas of age, habitat and educational background. MEASUREMENTS AND RESULTS: A questionnaire with 56 true and false (T/F) items grouped in four dimensions was obtained: biological aspects (14 items), psychological and social aspects (14), health risks linked to the menopause (6), care and preventive and health-improvement activities at the menopause (22). Its validity and reliability were determined by the following results: internal consistency and overall homogeneity (Cronbach's alpha = 0.86); stability or absence of significant differences at the moment the questionnaire is run (Student's t = 1.09; p = 0.28); intra-class correlation coefficient (ICC) = 0.753; equivalence or absence of bias of the questioners (Student's t = 1.09; p = 0.28), ICC = 0.761. CONCLUSIONS: The results lead us to conclude that the instrument is stable, allowing for the independence of the time and questioner variables, with high internal consistency and representing well the conceptual elements that shape the theoretical universe.

Adult↗
PubMed1997

Climacteric hormone therapy in medical and lay texts in Finland from 1955 to 1992.

The "social shaping of technologies" approach holds that a technology is both socially embedded and that it shapes the social environment. The aim of this study was to investigate how hormone therapy use during the climacterium and subsequently was socially shaped in texts published in the main Finnish medical journals and lay magazines during 1955-1992. In these two arenas physicians, especially gynecologists, played the major role in the debate and their professional knowledge on hormone therapy was mixed with their views on women's status and roles, the quality of life and fears about aging when they were promoting hormone use, especially in the lay magazines. This type of argument for the promotion of hormone use persisted in the most recent texts, despite the availability of substantial evidence both for the against of hormone therapy. Overall, the texts clearly favored the benefits of the therapy. Three periods of differing orientation can be discerned. Attitudes towards hormone therapy tended to be cautious from 1955 through the 1970s, more enthusiastic in the 1980s, and mixed at the start of the 1990s. In the most recent texts critical comments came from individual women who had used the therapy or decided not to, including female physicians and other professionals. The results suggest that hormone therapy is socially embedded, but may also shape perceptions and the understanding of women's aging. The social shaping of the technology approach may improve our understanding of the development of health policy towards women at and after the age of the climacterium.

Adult↗
PubMed1998

The menopausal age, related factors and climacteric symptoms in Turkish women.

An interview based survey to reveal age at menopause and associated factors was conducted in a clinic based sample of Turkish women living mainly in an urban area. Interviews by a psychologist were obtained from 1500 women aged 41-70. The study included only women who had undergone natural menopause and had their last menstrual bleeding at least 1 year previously. The mean and median age at menopause was 47.8 +/- 4.0 and 51, respectively. Parity and BMI had a statistically significant impact on the age of menopause (P = 0.0397 and 0.0403). The most common symptoms were muscle and- or joint and- or bone pain (82.3%) and hot flushes (73.9%). Although the population was clinic based, this study is the first one of its kind in Turkish women.

Adult↗
PubMed2002

[Premature climacteric as a special form of secondary ovarian insufficiency].

In western countries menopause is expected to occur at 50-52 years of age. Cessation of ovarian function before the age of 40 is defined as premature ovarian failure (POF). POF can be associated with chromosomal aberrations as well as with autoimmune diseases or general endocrine or metabolic disorders. Prevalence of POF is significantly increased in patients undergoing chemotherapy or radiation for treatment of malignant diseases. In some patients however etiology of POF remains unknown. Therefore therapeutic options are limited. For counseling patients it cannot be over-emphasized that HRT is mandatory to prevent long term symptoms of estrogen deprivation.

Adult↗
PubMed2002

[Endocrinology of climacteric and postmenopause].

Climacterium is the transition from a cyclical ovarian function with ovulation to primarily irregularities and ultimately cessation of follicular maturation with its cyclical production of estrogens and progestins. The reason is the decline in follicle count and the decreasing sensitivity of follicles to pituitary gonadotropins. In this transition a phase of elevated androgen action is found in early menopause ultimately in late menopause the ovarian androgen production decreases while the androgen production through the adrenal glands is maintained and especially prohormones which are metabolished peripherally to active androgens and estrogens are produced. In the late menopause also the adrenal androgen production is decreased. This deficiency of estrogens results in processes of deprivation and degeneration which also are dependent on the decreasing growth hormone action according to decreased production and secretion.

Aged↗
PubMed2001

Impact of urinary and climacteric symptoms on social and sexual life after surgical treatment of stress urinary incontinence in women: a long-term outcome.

AIM: The aim of the present study was to evaluate the long-term results of surgical treatment of stress urinary incontinence (SUI) using both subjective and objective methods. BACKGROUND: Few studies have focused on the influence of biological and social changes in a woman's life on the long-term outcome of surgical treatment of stress urinary incontinence. METHODS: The study included 45 women with genuine SUI treated with either retropubic urethrocystopexy (n=30) or puboccocygeal repair (n=15). The assessment included interviews, questionnaires, urinary diary, pad test, continence test and urodynamic investigation. RESULTS: The results were evaluated at intervals of 3 months, 1 year and 5--7 years after the treatment. One year after the surgical treatment 71% of the women in the urethrocystopexy group and 80% in the pubococcygeal repair group were subjectively cured, while 5--7 years after surgery the corresponding values were 43% vs. 60%. However, according to pad test a 67% of the women in the urethrocystopexy group and 47% in the pubococcygeal repair group had ceased to leak urine 1 year after the operation whereas at the long-term follow-up the corresponding values were 64% vs. 71%. According to the questionnaire at the long-term follow-up only 35% of the women in the whole group had genuine SUI whereas 21% had urge-incontinence. Moreover, 37% experienced sweating, 23% flushing and 44% vaginal dryness. The number of women with adiposity had increased significantly (P < 0.001) at the long-term follow-up. Twenty-eight per cent of the women decreased their activities whereas the majority experienced no impediment. Seventy-nine per cent reported that they were sexually active and the majority reported satisfaction with their sexual lives. CONCLUSIONS: Accurate assessment of postoperative results of SUI demands rigorous recording of subjective and objective data taking into consideration psychological and social factors, otherwise there is a high risk of bias in the interpretation of the results of the treatment for SUI. This study indicates that, in order to give women with SUI adequate treatment the nursing care should comprehend the women's divergent experiences of urinary incontinence and its impact on social and sexual life.

Activities of Daily Living↗
PubMed2005

Blood rheology and risk of thromboembolism in adult and climacteric women.

Increased age is associated with an increased thrombosing tendency, especially deep vein thrombosis and pulmonary embolism. We investigated blood flow in women of various age groups and found that blood flow decreases with advancing age. Because decreased blood flow can lead to platelet and leukocyte activation, it could be related to the pathogenesis of venous thromboembolism with age.

Adult↗
PubMed1994

[Oral or transdermal estrogen substitution therapy in climacteric?].

There are several preparations available for hormone substitution in the postmenopause. The aim of this paper is to give a short review on oral and transdermal hormone substitution therapy. Are there different effects, side effects or metabolic interactions? Both the oral and the transdermal application are similar in reduction of menopausal symptoms. Neither vaginal cytologic differences, nor different bleeding patterns and no increase in weight or blood pressure changes can be observed with either application form. Despite a local irritation of the skin (3-7%) with transdermal oestradiol, only 4% of the patients show systemic side effects either with oral or transdermal hormone substitution. The oral administration results in higher 17 beta-oestradiol levels, higher oestrone levels and an increase in some liver proteins, possibly as a result of the first pass effect of the liver. The cardioprotective effects of oral hormone substitution are well known. Furthermore transdermal oestradiol therapy results, also in a decrease of cholesterol and atherogenic LDL-C levels. In contrast to oral oestrogens, no effect on triglycerides or its decrease can be observed; in view of conflicting results regarding HDL-C, further studies are necessary. With both applications, there are no clinically relevant alterations in thyroid, carbohydrate- or blood coagulation metabolism: Even the prevention of osteoporosis in postmenopausal women, which is establish with oral hormone therapy, can also be observed with transdermal hormone substitution.

Administration, Cutaneous↗
PubMed1991

[Eye manifestations as climacteric symptom].

The menopausal syndrome consists of a variety of psychic and physical signs of different intensity. At our outpatient department for problems in menopause and prevention of osteoporosis (1. Dept. of Gynaecol. and Obstetrics, Vienna) 1287 women who were consulting this department for the first time because of prevailing complaints or prophylactic reasons, were registered during the years 1988 and 1989. In the course of this work we paid particular attention to the symptom "eye complaint" as a sign of the beginning of the menopausal period. 98 out of 430 patients with eye complaints were examined ophthalmologically. Referring to our patient population we tried to analyse epidemiologically the frequency and the degree of severity of menopausal eye complaints as well as the therapeutical response to a hormone substitution therapy. To what extent an endocrinological explanation can be found and which facts lead us assume such a statement, we have tried to demonstrate in the discussion.

Climacteric↗
PubMed1987

[A transdermal therapeutic system for hormonal therapy of climacteric deficiency pictures. A multicenter study].

In an open study 112 women with menopausal symptoms were treated with a transdermal therapeutic system delivering estradiol at a rate of 25, 50 or 100 micrograms per day resp. The study, which was to measure the therapeutic efficacy and systemic and local tolerability, lasted 3 months. At the end of the treatment period 46% of the women were completely free of symptoms and a further 46% very much improved. In 64% the hot flushes disappeared entirely and in the remaining women their frequency and intensity, with a few exceptions, were markedly diminished. Nocturnal bouts of sweating were completely prevented in 67% of those complaining of this symptom. Pollakiuria improved in 93%. Before commencement of the therapy 24 patients felt unwell; during the study only two. The proportion of women who felt well or very well rose from 36% to 83%. The systemic tolerability was rated good or excellent by 97% of patients and in no case was it rated poor. Blood pressure and body weight were not affected. The local tolerability was considered good or very good by 80% of the women; it was poor in 5 cases (4.6%) and only in one case did it lead to discontinuation of the therapy. Ninety percent of the participants wanted to continue treatment beyond the duration of the study.

Administration, Cutaneous↗
PubMed1982

[Depression and climacteric (psychometric studies on 116 women in a gynecologic polyclinic)].

In 166 women who desired estrogen treatment for menopausal symptoms, psychosocial data were obtained prior to treatment, six weeks, three months and six months after treatment. The data were obtained by questionnaire and psychometric testing. 1. Of the 25% of women with significant depressive tendencies (according to EDS) 7 of 10 were also very anxious (according to EDS). 2. Emotional stability (according to MPI-N) present in every third woman without depressive mood changes but only in 3% of women with depressive changes. 3. Every third woman with depressive changes reported sexual fantasies or dreams. Only 3% of the women without depression had these fantasies. Discharge was complained of twice as often by depressive women (according to EPS) than in those without depression. 4. Pain on micturition was a complaint of half the women with depressive mood but only 1/8 of those without depression. 5. Heart palpitations were complained of by women without depression only half as often as by the other women. 6. The satisfaction with the role as women had a significant relationship to depression scores as expected. 7. The antidepressive and anxiolytic effect of estrogen treatment in the menopause was shown objectively by psychometric studies. The findings are discussed in view of a gynaecological office practice.

Adult↗
PubMed2002

Efficacy and safety of a phytoestrogen preparation derived from Glycine max (L.) Merr in climacteric symptomatology: a multicentric, open, prospective and non-randomized trial.

A multicentric, open, prospective, observational and no-randomized clinical trial was carried out in Spain with 190 postmenopausal women receiving a soy preparation rich in isoflavones (PHYTO SOYA, capsules containing 17.5 mg isoflavones). The main object of the present study was to investigate its efficacy in alleviating the symptomatology derived from the lack of estrogen, mainly hot flushes, but also other symptoms such as sleep disorder, anxiety, depression, vaginal dryness, loss of libido and bone pain. Each patient received 35 mg isoflavones per day in two doses. During the four months' treatment, a statistically significant decrease in the number of hot flushes with PHYTO SOYA was experienced by 80.82% women; only 5,48% patients did not improve with the treatment. The average reduction was 47.8%, which is equivalent to 4 hot flushes. All the other studied parameters also showed a statistically significant decrease. No severe side-effects were reported and tolerance was excellent. Treatment with PHYTO SOYA resulted in a significant improvement of the symptomatology that accompanies the lack of estrogen during menopause.

Anxiety↗