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[The atherogenic lipid profile parameters and fibrinogen serum concentration in climacteric women under various routes of hormone replacement therapy administration].

OBJECTIVES: Influence of various routes of HTR on atherogenic lipid profile parameters and serum fibrinogen concentration was investigated. DESIGN: In 85 women in four groups receiving HRT transvaginally, transdermally, orally and intramuscularly, the total cholesterol, HDL-cholesterol, triglycerides, apoB, apoA, LpA and fibrinogen serum concentration was assessed before treatment and after six month. RESULTS: Most of tested parameters: total cholesterol, LpAI, apoB, LDL cholesterol, non HDL cholesterol, changed favorably (lowered concentration) in group using HRT orally and intramuscularly. CONCLUSION: Orally and intramuscularly route of administration HRT have better cardioprotective effects.

Administration, Cutaneous↗

[Morphometric examinations of the uterus in puberty, pregnancy and climacteric].

The text deals with morphometric examinations of histological specimen of cervical and corporal parts of the uterus in puberty, pregnancy and menopause. The results show the different relations between muscular and connective tissue elements in corpus and cervix and point to significant differences in the composition of specific layers of uterine wall.

Adolescent↗

Prevalence of climacteric symptoms according to years after menopause.

OBJECTIVE: To study the prevalence of menopausal symptoms of women attending the menopause and gynecology clinics at Chulalongkorn Hospital. STUDY DESIGN: A descriptive study was conducted at the menopause and gynecology clinics at Chulalongkorn Hospital. After inclusion and exclusion were done, four hundred and twenty seven participants with premenopause, perimenopause and postmenopause were studied. All the women were classified into seven groups of premenopause, perimenopause and one, two, three, four and > or =five years after menopause. The interview was performed by well-trained social workers using standardized questionnaires. RESULTS: The average age at menopause of the postmenopausal women was 49.46 + 3.30 years. Prevalence of vasomotor symptoms eg. hot flushes in premenopause, perimenopause and one, two, three, four and > or =five years after menopause were 4.4 per cent, 25 per cent, 27.3 per cent, 38.8 per cent, 40 per cent, 11.1 per cent and 10.3 per cent, respectively. Prevalence of psychological symptoms eg. moodiness were 26.5 per cent, 25 per cent, 54.6 per cent, 38.7 per cent, 32.2 per cent, 11.2 per cent and 11.8 per cent, respectively. But the prevalence of headache in this category was 29.4 per cent, 23.3 per cent, 23.7 per cent, 22.6 per cent, 25.0 per cent, 11.1 per cent and 13.2 per cent, respectively. Prevalence of urinary symptoms seemed to increase continuously after menopause. Prevalence of genital symptoms eg. vaginal dryness were 5.9 per cent, 13.3 per cent, 25.5 per cent, 25.8 per cent, 15.0 per cent, 16.7 per cent and 20.6 per cent, respectively. Prevalence of other symptoms eg. muscle and joint pain were 22.1 per cent, 43.3 per cent, 56.4 per cent, 58.0 per cent, 45.0 per cent, 27.8 per cent and 28.0 per cent, respectively. CONCLUSION: The prevalence of menopausal symptoms in this postmenopausal group appeared to increase during the first and second years after menopause and tended to decrease afterwards. The prevalence of other symptoms eg. dry eyes and headache appeared to be unchanged after menopause.

Adult↗

[Training experience in climacteric and menopause among physicians of the IMSS].

OBJECTIVE: To analyze the level of knowledge concerning climateric and menopause among family physicians and gynecologists and obstetricians of the Instituto Mexicano del Seguro Social (IMSS), after a training process in institutional technical guidelines and in educational content for population. We also analyze possible changes in frequency of medical attention for climateric and menopause in the first level of medical care. MATERIAL AND METHODS: Prospective and descriptive study on 1) results of the knowledge evaluation by means of 23 questions with multiple answers, and 2) analysis of rates of medical care for menopausal and perimenopausal disturbances (N95 code, X Revision, IDC) from 1995 to 2000. RESULTS: The percentage of correct answers prior to training was 62.2 for family physicians and 65.9 for gynecologists and obstetricians; after training, 79.3 and 81.4, respectively. Both groups had on increase in knowledge levels (p < 0.001) but there were no differences among them. An increase was registered in medical care rates for menopausal and perimenopausal disturbances in the group from 45 to 64 years of age in the period from 1995 to 2000. CONCLUSIONS: All physicians had on increase in knowledge on climateric and menopause issues but without differences among them, probably because the care of this health problem is referred to specialized services and as well as to more attention on other more frequent problems in women's health. In addition, we did not find changes yet in the rates of medical attentions attributable to training and information to population.

Climacteric↗

[Psycho-organic comorbidity of climacteric: acknowledgement of denial].

Considering psychiatric co-morbidity of menopause within the context of a new historical and psychosocial view of woman and femininity, the recommendations of current scientific literature focused to its attention, treatment and prevention, become different from the traditional sociomedical observations. In order to reach a new more effective assistance, prevailing prejudices must be overcame to achieve an adequate updating before being really effective. That is, to be suitable to the psychosocial needs of those who suffer a physiological condition. The change in the social role of women (which requires a genuine community acceptance) is not consolidated to new favorable attitudes which is required in the general thinking in our country, in order to offer better therapeutic alternatives to women's problems and its complications. Such situation is reflected even the medical and psychological handling of cases, where women are the main protagonists. This paper offers a brief discussion of this issue and some recommendations for diffusion purposes.

Climacteric↗

[New SBU-report on estrogen replacement therapy in climacteric. Moderate risk of breast cancer after long-term use].

In 1966 the Swedish Council on Technology Assessment in Health Care (SBU) published a scientific review of estrogen treatment following menopause. A new report by SBU has now reviewed, classified and graded the scientific literature on hormone replacement therapy 1995-2001. In some cases the scientific evidence has become stronger (risk for breast cancer after long-term treatment) while in other cases the uncertainty identified in the earlier report remains (effect on cardiovascular disease and stroke).

Breast Neoplasms↗

Comparison of bone remodeling indicators in climacteric women.

OBJECTIVE: The objective was to study the polymorphism of collagen type 1 alpha 1 (COL1 A1) gene as a genetic marker, the biochemical markers of formation (osteocalcin) and bone reabsorption (cross-links of pyridinoline-CTx), bone mineral density and bone ultrasonometry compared to bone densitometry (DEXA). METHOD: The study included 82 women ranging in age from 45 to 60 years, menopausal from 1 to 10 years. Polymorphism of COL1 A1 was assessed by PCR (polymerase chain reaction), by the specific allele technique. Bone formation markers were studied using an ELISA (Novocalcin and Active Crosslaps). A Hologic 4500 A QDR (DEXA) densitometer and DBM Sonic 1200 IGEA ultrasonograph were employed. RESULTS: The bone reabsorption marker (cross-links of pyridinoline-CTx) demonstrated statistically significant negative correlation with bone mineral density (lumbar and femoral neck), while the bone formation marker (osteocalcin) did not display a correlation with bone mineral density. Bone ultrasonometry yielded a statistically significant positive correlation with bone densitometry. Collagen type 1 alpha 1 polymorphism was not identified by the technique employed. CONCLUSION: The bone reabsorption marker (cross-links of pyridinoline) and bone ultrasonometry and densitometry are measurements enabling evaluation of bone remodeling.

Amino Acids↗