Climacteric Period Research Articles

Cardiovascular Risk Factors, Functionality, and Quality of Life in Climacteric Women

Background: Cardiovascular disease (CVD) comprises a group of cardiac and circulatory diseases. Despite the high incidence in males, women after menopause have an exponential increase in the risk of CVD. Objective: To identify the leading risk factors for CVD and describe quality of life and functionality in women hospitalized for cardiac causes during the climacteric period. Materials and methods: Observational descriptive study. Quality of life was assessed through the SF-36 questionnaire, and functionality through the Functional Independence Measurement (FIM) [...]

Climacteric Period and Cardiovascular risk: a Golden Opportunity to Watch and Succeed!

The gradual loss of ovarian function with concomitant decrease in estrogen levels, characteristic of the climacteric period, leads to several metabolic changes and symptoms. Significant effects on the health and quality of life of women occur, and vasomotor symptoms during this transitional period are almost universally recognized. Among physical symptoms, hot flushes and night sweats are very prevalent and may be very disturbing. However, cardiovascular risk is frequently neglected not only by these women, but surprisingly, also by part of [...]

Menopausal Management Practices in Sub-Saharan Africa: A Cross Sectional Study of Cameroonian Women

Background Menopause is a physiological state which induce deep changes in women’s life. Although the climacteric syndrome is very little studied within sub-Saharan women, certainly because of the impact of traditional culture, it have a considerable impact on the quality of life of post-menopausal women. The present study aims at evaluating menopausal management practices during menopause in Cameroonian women. Methods This study is a cross-sectional and analytical survey of a representative sample of 327 Cameroonian menopausal women. The main inclusion criteria was natural menopause. Investigation form was administrated to woman after their informed consent. Comparison of proportions and student t-test with a significance threshold of less than 0.05 was used. Results Women exhibit the majority of climacteric syndrome symptoms: hot flushes (57.80 %), night sweats (47.09%), sleep disturbances (59.63 %) and libido decline (66.67 %) among others. 69.72 % of menopausal women were not followed up although the majority of women (58.88 %) wished such medical care. 34.25 % of women of the study used self-medication to ease their symptoms. Attitude facing climacteric period is indifferent for 27.83 %. Socio-economic level was positively correlate to the attitude at menopause (Correlation index = 0.1644; p < 0.05) while professional statute was negatively correlate to medical care (Correlation index =-0.1610; p < 0.05). Conclusion Cameroonian women managed mainly climacteric symptoms by self-medication. Their socio-economic statute has a positive impact on their attitude during menopause. Furthermore, their professional statute is a decisive factor for medical care of climacteric symptoms.

The Relationship between the Attitudes towards Menopause and Sexual Functions among Women in the Climacteric Period, Turkey

Background & aim: An investigation of the attitudes towards menopause is considered to help to understand the menopausal period better in order to plan more comprehensive health promotion approaches. This study aimed to investigate the relationship between the attitudes towards menopause and sexual functions among women in the climacteric period. Methods: This cross-sectional study was conducted between the 1st May 2019 and the 1st January 2020 in Turkey. The study was completed with 153 women in climadteric period, who were selected using the simple random sampling method. Data were collected through the socio-demographic questionnaire, the Attitude towards Menopause Questionnaire (ATMQ), and the Female Sexual Function Index (FSFI). Data analysis was done using descriptive statistics, independent t-test, and Pearson correlation test. Results: Themean scores of ATMQ and FSFI were found 34.39±12.30 and 20.05±9.18, respectively. The ATMQ indicated positive, and significant relationship with all FSFI sub-scales and total scores (p 0.05). Conclusion: The results showed that two-thirds of the participating women had negative attitudes towards menopause, and increased negative attitudes of women affected their sexual functions, negatively. It is recommended to design health promotion programs and counseling services to promote positive attitude towards menopause in women in the climacteric period.

Heart geometry in climacteric syndrome on the background of type 1 diabetes mellitus

Background. The climacteric period in women with type 1 diabetes mellitus (DM1) initiates an additional damaging effect on the existing cardinal pathology associated with DM. The purpose was to establish the features of geometric remodeling of the left ventricle (LV) of the heart in women with DM1 during the climacteric period. Materials and methods. The study involved 60 women with type 1 diabetes at the age of 48.74 ± 0.65 years, including 41 perimenopausal and 19 postmenopausal ones. The control group consisted of 20 women without diabetes mellitus at the age of 50.02 ± 0.71 years. According to echocardiography, taking into account the stage of menopause, the indicators of the end-diastolic volume (EDV) and size (EDS), the posterior wall thickness of the LV (LVPWT) and the interventricular septum (IVST) were analyzed. The frequency of various types of geometric remodeling of the left ventricle of the heart was analyzed using the Penn Convention formula; for this, the LV myocardial mass index (LVMI) was calculated according to the formulas LVMI=1.04 [(EDS + LVPWT + IVST)3– EDS3]– 13.6 (LVMI=ratio LVMI to the plane of the body surface (A) in m2; AM2=1 + Weight + Δh / 100, where Δh is the difference between the height of a woman and 160 cm) and the relative wall thickness of the LV (LVRWT) LVRWT=2LVPWT / EDS. Based on these data, the frequency of various types of geometric remodeling was established: normal geometry, concentric remodeling, concentric or eccentric LV hypertrophy. Results. The data obtained indicate that postmenopausal women present a significant decrease in the frequency of normal heart geometry compared to perimenopausal women (26.4 versus 75.6%, p&lt;0.001) and the frequency of concentric LV remodeling 3.5 times increases (26.3 versus 7.3%, respectively). Concentric hypertrophy and eccentric LV hypertrophy prevailed 2.5 times in postmenopausal women (31.6 versus 12.1% and 12.7 versus 4.9%). Conclusions. In perimenopausal women with type 1 diabetes mellitus, in almost a quarter of cases, geometric remodeling of the left ventricle of the heart takes place. In postmenopausal women with estrogen deficiency, the frequency of pathological forms of heart geometry exceeds 75%. The strategy of therapy for cardiac pathology in menopausal women against the background of DM1 should take into account the pathogenetic mechanisms of pathology associated with impaired carbohydrate metabolism and atherogenic measurements against the background of estrogen deficiency as well as limit polypharmacy.

Therapeutic effects of lignans in women in perimenopausal and postmenopausal periods (review of literature)

Today, there is a tendency towards an increase of the number of the female population that has crossed the line of menopause, which makes it more urgent to improve the quality of life of women and to develop safe methods for the prevention and treatment of climacteric syndrome (CS), which is an integral medical, social and economic problems. In view of the presence of contraindications for use and defined risks of complications with the use of hormone menopausal therapy (HRT), it is necessary to develop alternative methods for the prevention and treatment of perimenopausal symptoms. This literary review of domestic and foreign sources demonstrates information about the role of the plant lignan 7-hydroxymatairezinol (7-HMR) in maintaining the physical and psychoemotional health of women in the period of peri- and postmenopause. As a result of the analysis of the therapeutic effects of the 7-HMR molecule, the ability to relieve the main symptoms of CS (neurovegetative presentations and emotional disorders), to improve the general state of health and metabolic profile of perimenopausal women was revealed. High safety and low incidence of side effects were noted, as well as a positive effect on the dynamics of body weight. The presence of a stable anti-inflammatory and antioxidant activity 7-HMR makes it possible to recommend this lignan to women in the climacteric period as an effective drug for the prevention of the formation of immune deficiency, which contributes to the development of oncological and autoimmune diseases. The proven antitumor activity confirms the promise of using the 7-HMR for the implementation of oncopreventive measures in women of peri- and postmenopausal age.

Brazilian National Policy of Comprehensive Women\u2019s Health Care and mortality during climacteric period: has anything changed?

BackgroundThe National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented in 2004, with monitoring of potential benefits. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion are actions carried out by the Brazil National Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after implementation of PNAISM.MethodsAn ecological study was conducted from 2018 to 2020. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 the latter to correspond with the implementation of the National Policy. The death records of Brazilian women aged 40 to 64 years who had a designated cause of death were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%.ResultsThe main causes of death in women from 1996 to 2016 were circulatory system diseases (22.47%, 697,636 deaths), neoplasms (19.69%, 611,495 deaths), respiratory system diseases (5.5%, 170,716 deaths), endocrine, nutritional, and metabolic disorders (5.27%, 163,602 deaths), and digestive system diseases (3.74%, 116.280 deaths). Analyzing the changes in the major causes of death of climacteric women after implementation of the PNAISM we observed that mortality from circulatory system diseases and endocrine and nutritional diseases were significantly declined in post-PNAISM period: (β = − 3.63; 95% CI – 4.54 to − 2.73 r2 = 0.87; p < 0.001; β = − 0.51; 95% CI, − 0.71 to − 0.31; R2 = 0.73; p < 0.001, respectively). No changes were observed in mortality from neoplasms and respiratory system diseases in post-PNAISM period (p = 0,765; p = 0,233, respectively).ConclusionsAfter implementation of the PNAISM, we observed a downward trend in rates of mortality from diseases of the circulatory and digestive systems and from endocrine, nutritional, and metabolic diseases but stability in the rates of death from neoplasm and respiratory system diseases.

Menopause as a stage of female development: psychoanalytic perspective

The object of this research is the psychoanalytic concepts of female development. The subject of this research is the phenomenon of the climacteric period in female development. The article analyzes and summarizes the psychoanalytic ideas on the development of women during menopause. 1. Climacteric period &amp;ndash; the crisis period (G. Bibring); 2. Menopause as a trauma, narcissistic insult, backward development of libido, regression (H. Deutsch) 3. Menopause as a narcissistic rage (R. Lax); 4. Same as in puberty period, body is the focus of attention during menopause; climacteric period as part of femininity and emotions (D. Pines); 5. Menopause as a punishment (M. Klein). The author also include the examples from personal research practice. The novelty of this work consists in the summary of psychoanalytic ideas on the female development during climacteric period; as well as in elucidation of the phenomenon of menopausal complex. The menopausal complex implies: 1. Menopause as a traumatic event, accompanied by the emotions of narcissistic rage; aggression as a protection mechanism, resemblance of the aging process and its irreversibility; 2. Regression and re-actualization of castration emotions and narcissistic wounds, experience of inferiority and inability to control your body; 3. Experiencing the loss and mourning over the reproductive abilities and femininity; 4. Reaching menopause is likely in same age as mother; 5. Menopausal complex is accompanied by the fear of aging (or future), fear of being left and loneliness.

Щитовидная железа у женщин в пери- и постменопаузе: физиология и заболевания

The incidence of most thyroid diseases – hypothyroidism, nodular goiter, and cancer – is highest among peri- and postmenopausal women. Diagnosis of thyroid dysfunction in this group of patients is difficult, since the symptoms may be nonspecific, with complaints typical for the climacteric period. Interpreting thyroid function tests, physiological changes in the secretion and metabolism of thyrotropin and thyroid hormones, as well as the effect of concomitant diseases, must be considered. Unrecognized thyroid dysfunction leads to an increased risk of cardiovascular disease, bone fractures, cognitive impairment, depression, and mortality. Thyroid dysfunction therapy differs in peri- and postmenopausal women of reproductive age; hypothyroidism should be treated with caution because high doses of L-thyroxine can lead to cardiac arrhythmias and an increased risk of bone osteoporosis, and hyperthyroidism should preferably be treated with radioactive iodine. Thyroid cancer often affects women over the age of 50, the diagnostic and therapeutic approach is the same as in the general population, but the prognosis of cancer is worse than in younger patients. The article presents data concerning the differential diagnosis of menopausal symptoms and thyroid gland pathology in perimenopausal women, as well as the peculiarities of therapy for revealed thyroid disorders in this age group.

Vasomotor menopausal symptoms: is it just hot flashes? Alternative non-hormonal methods of treatment with proven effectiveness (literature review)

Taking into account the modern life expectancy, a third of their lives, on average, women live in conditions of estrogen deficiency, which negatively affects the quality of life and the level of morbidity in older people. For doctors of other specialties, besides ObGyn, the climacteric period is strongly associated exclusively with hot flashes. However, early menopausal symptoms include sleep disturbances, mood changes, the risk of depression and decrease in self-esteem, sexual dysfunction. The predominance of vegetative symptoms makes the patient seek help not only from the gynecologist, but also from other specialists, however, the lack of knowledge in menopause medicine leaves them unsatisfied. In this regard, a therapeutic approach requires a comprehensive understanding of the problem.The “gold standard” for managing patients with climacteric complaints is menopausal hormone therapy. However, there are women with contraindications to this group of drugs or the predominance of vegetative symptoms, when only hormonal correction is not enough. Among alternative non-hormonal agents, inhibitors of serotonin reuptake, in particular the most popular drug venlafaxine, hold a strong leadership with proven efficacy against a complex of symptoms. Also, other medications have been studied that can stop both vasomotor and vegetative symptoms of menopause. The review presents the literature data on the role of alternative agents in the correction of vasomotor symptoms of menopause, along with the known efficacy against autonomic complaints for increasing the effectiveness of counseling for older women.

Особенности взаимосвязи реоэнцефалографических показателей и суточного профиля артериального давления при артериальной гипертензии у женщин в климактерическом периоде

The incidence of arterial hypertension (AH) in women increases significantly with the onset of menopause. Age-related hypoestrogenism leads both to an increase in blood pressure (BP) and to a violation of its daily profile. It can lead to impaired cerebral blood flow. Objective: to study the features of cerebral disorders in women in the perimenopausal period with and without hyper-tension using rheoencephalography, as well as their relationship with some indicators of the daily blood pressure profile. Materials and methods. A clinical and instrumental examination of 190 women in the climacteric period (141 people with hypertension and 49 without hypertension) was carried out, who were divided into groups depending on the presence of hypertension and the period of perimenopause. Instrumental research included 24-hour blood pressure monitoring and rheoencephalography. Results. The onset of menopause was accompanied by an increase in the degree of arterial hypertension, with an in-crease mainly in systolic blood pressure. Changes in its daily profile was also noted, especially insufficient or excessive de-crease at night, as well as an increased speed and magnitude of the morning rise both in women with hypertension and without it. The revealed disorders were more pronounced in postmenopausal women and were accompanied by changes in cerebral circulation, which can lead to ischemic and hemorrhagic cerebral complications. Conclusion. Comparison of indicators of rheoencephalography and daily monitoring of blood pressure in menopausal women revealed changes in cerebral circulation, most pronounced in the presence of arterial hypertension and after meno-pause.

M.P. Ayzeshptadt. - Two cases of ovaryotomy. (Protok, sent by the General Minsk doctors for 1893/4, Minsk, 1894 p. 152).

1st case. 50 years old, multiparous. 6 years ago, the climacteric period began. 3 months ago, the tumor covered up in the belly. Cystoma ovarii sinistri recognized. Gluttony on January 8, 1894. The cyst was opened with a knife. There are no splices. The cut surface of the leg is sheathed with a peritoneum. Recovery. The tumor turned out to be a multichamber colloid cyst of the left ovary.

THE EFFECT OF HEALTH EDUCATION ABOUT MENOPAUSE AGAINST READINESS IN FACING MENOPAUSEIN CLIMACTERIUM MOTHER IN MOJOROTO BUJEL PMB KEDIRI CITY IN 2019

Menopause is a period experienced by women when they will enter old age. Women will first encounter climacteric period. Data from a total of 100 climacteric mothers who examined health units 65 of them experienced physical and psychological complaints (SKRT, 2005). The impact that arises on someone's readiness in facing menopause is a lack of mental readiness such as lack of self-confidence, anxiety, and stress due to changes, upper neck and chest, difficulty sleeping, lack of concentration, depletion of the vaginal wall due to reduced estrogen, decreased sexual desire(1). The solution that can be done to overcome the lack of readiness in the face of menopause is to provide counseling to climacteric mothers. The purpose of this study was to determine the effect of health counseling about menopause on readiness in coping with menopause in climacteric mothers. This research is a pre-experimental research with One Group Pre Test Post Test Design approach where researchers can test whether there are changes that occur after the treatment. The results of the study were that of the 16 respondents obtained half of the respondents 8 people (50.0%) were in the category of not ready. There is an influence of counseling about menopause on readiness to face menopause in climacteric mothers. Keywords: Climacteric mother, Menopause, Health Counseling

Altered vascular stiffness and central pulse wave parameters in climacteric women

Aim: to assess changes in parameters of vascular stiffness, central aortic pressure (CAP) as well as reflected pulse wave in women in different phases of the climacteric period.Materials and Methods. An open non-randomized single-center comparative study was conducted with 384 menopausal women subdivided into: Group 1 – 168 women at menopausal transition, Group 2 – 216 women at early postmenopause. A 24-hour blood pressure (BP) monitoring was performed with assessing daily dynamics of parameters of arterial stiffness, CAP and reflected pulse wave. The aortic pulse wave velocity and local aortic stiffness were estimated.Results. It was found that women in early postmenopausal period vs. menopausal transition showed significantly higher values of daily central BP combined with more prominent changes in vascular stiffness. Menopausal women were characterized by lowered difference between nocturnal central and peripheral BP level (less amplified nocturnal vs. diurnal peripheral BP magnitude), which is associated with a greater augmented CAP at this time point. Such pattern was more pronounced in women at postmenopausal period.Conclusion. Women in climacteric period were found to have increased vascular stiffness combined with elevated CAP, decreased amplification of pulse pressure and increased amplitude of the reflected pulse wave may be associated with increased risk of cardiovascular complications. Much more prominent changes were noted in women in early postmenopausal period.

Práticas de educação em saúde para promoção da qualidade de vida de mulheres climatéricas

Objetivo: Identificar práticas de educação em saúde para promoção da qualidade de vida de mulheres climatéricas. Método: Trata-se de uma revisão integrativa da literatura. A coleta de dados ocorreu em outubro de 2018 nas bases de dados LILACS, BDENF, MEDLINE, IBECS e CUMED. Os descritores da Biblioteca Virtual da Saúde utilizados foram: Climatério; Educação em Saúde; Qualidade de vida. Foram utilizados. Recorte temporal 2008 a 2018. Resultados: As práticas de educação em saúde encontradas foram: orientações durante a consulta de enfermagem, grupos de autoajuda para que essas mulheres encontrem espaços para discutir coletivamente suas necessidades individuais e coletivas. Todas as práticas apontadas são de aplicabilidade na atenção primária í saúde. Conclusões: A educação em saúde, em suas diversas práticas, é um instrumento de promoção í qualidade de vida no perí­odo climatérico. Evidenciou-se que mulheres submetidas í s práticas educativas têm impacto positivo na sua qualidade de vida.

Lennander. — Myom des Uteruskörpers mit Trennung des Cervix vom Körper. (Centralbl. F. Gynaek., 1895, No. 6)

Virgo intacta, 49 years old, in the climacteric period. For the first time, she covered up a tumor in herself, when she was 35 years old. The tumor occupies mainly the left half of the abdomen, reaching along the nipple line to the ribs, along the middle line up to 8 cm. above the navel. The probe is inserted into the canal of the uterus only 4 cm. Excessively with the removal of the tumor, uterus and appendages (the patient died of peritonitis, as a result of a peritiflytic abscess).

Prevalência de disfunção sexual em idosas participantes de grupos de convivência no município de Natal/RN

Introdução: Alterações no ciclo de resposta sexual podem caracterizar uma disfunção, a mulher idosa tende a passar por um tempo considerável no período do climatério onde ocorrem modificações orgânicas na mulher e na sua resposta sexual. Objetivo: Verificar a prevalência de disfunções sexuais (DS) em mulheres idosas residentes do Município de Natal/RN. Metodologia: Estudo transversal, com amostra de 34 mulheres idosas com vida sexual ativa participantes de grupos de convivência. Utilizou-se questionário estruturado e Function Sexual Female Index (FSFI). A análise estatística foi realizada através da análise descritiva e a analise bivariada, por meio do teste Qui-quadrado de Pearson e Exato de Fisher. Resultados: Verificou-se uma prevalência de DS de 79,4%. As análises das variáveis não apresentaram associação estatisticamente significativa. Conclusão: Observa-se alta prevalência de DS nas idosas, o que evidencia a necessidade de implantação de novas práticas de atuação que visem à prevenção e tratamento da DS nessa faixa etária.

Hubungan Tingkat Pengetahuan dan Sikap dengan Perilaku Mengatasi Ketidaknyamanan pada Masa Klimakterium

Climacteric is a transitional period from the reproductive phase to the old age phase (senium). Climacteric period 40-85% of women have complaints both physically and psychologically. The differences in knowledge based on personal backgrounds cause the attitude of each individual is different in overcoming the inconvenience of the climacteric phase. This study aims to determine the relationship between the level of knowledge and attitudes towards overcoming discomfort during the climacteric phase. It was a descriptive-analytic research method using a cross-sectional research design. The research sample was 81 respondents. Sampling was stratified random sampling, that is, samples taken per work area randomly. Statistical tests use logistic regression. The results of 81 mothers showed that the proportion of mothers with good knowledge was 87.9%, compared to a lack of knowledge as many as 20.8%. There was a significant relationship between knowledge and behavior to overcome climacteric discomfort (p = 0.029; CI95% = 1.2-27.1). Mothers with good knowledge had a 5.7 times higher chance to behave well in dealing with discomfort during climacteric times, compared to mothers with less knowledge after being controlled by attitude, family roles, and health worker roles.

Impacto de um Protocolo de Exercícios na Sexualidade e Qualidade de Vida de Mulheres Climatéricas

Introdução: O climatério é um período de transição entre as fases reprodutiva e não reprodutiva da mulher consequente ao hipoestrogenismo. Sintomas vasomotores, alterações do trato urogenital e disfunções sexuais são algumas condições características deste período que podem interferir negativamente na qualidade de vida. Entretanto, exercícios específicos podem influenciar positivamente na melhora dessas condições. Objetivo: Verificar o impacto de um protocolo de exercícios supervisionado por fisioterapeuta nos sintomas menopausais, na sexualidade e na qualidade de vida de mulheres no climatério. Métodos: Estudo quase-experimental com intervenção fisioterapêutica por meio de protocolo de exercícios específicos. Participaram do estudo 18 mulheres usuárias do Instituto da Mulher e da Gestante, do município de Santos (SP). Resultados: As mulheres foram submetidas à avaliação fisioterapêutica inicial, responderam aos questionários de sexualidade Female Sexual Function Index, Índice Menopausal de Kupperman e de qualidade de vida SF-36. Foram então submetidas a grupo de exercício supervisionado por fisioterapeuta, uma vez por semana, com duração de 50 minutos, por 12 semanas. Os mesmos questionários foram reaplicados ao final deste período. Conclusão: O protocolo de exercícios específicos em grupo e supervisionado por fisioterapeuta não influenciou a função sexual, mas foi eficaz para melhor qualidade de vida e enfrentamento da sintomatologia do climatério.

Sentimentos vivenciados por mulheres climatéricas: percepções de usuárias da atenção primária em saúde

Objetivo: Conhecer os sentimentos de mulheres que vivenciam o climatério acerca desta fase da vida. Método: Pesquisa qualitativa com 18 mulheres que vivenciam o período do climatério realizada em uma Estratégia em Saúde da Família de um município da região sul do Brasil. Os dados foram coletados por meio de um roteiro de entrevista semiestruturada em setembro de 2016. A análise dos dados foi a partir da Análise de Conteúdo de Minayo. Resultados: Os sentimentos citados pelas depoentes com maior frequência foram a melancolia, a baixa autoestima e depressão, pois o climatério é percebido como um período desconhecido e misterioso, que remete ao envelhecimento, a perdas e a negação. Nesse sentido, o cuidado de enfermagem precisa consubstanciar-se nos aspectos emocionais, sociais, biológicos, sexuais, ambientais e culturais que perpassam o climatério. Conclusão: Nessa perspectiva, para uma atuação qualificada na área da assistência à saúde da mulher climatérica, é essencial práticas que valorizem o conhecimento prévio e sentimentos experienciados, facultando, assim, um espaço de construção de saberes e fazeres neste campo de conhecimento.