Severe Climacteric Symptoms Research Articles

Relationship between Climacteric Symptom Intensity, Physical Activity Level, Spine Mobility, Balance, and Quality of Life in Women

Objective: The climacteric period contains more than 1/3 of a woman's life and causes various symptoms stemming from physiological and hormonal changes. Our study investigated the relationship of climacteric symptom intensity with physical activity level, spine mobility, balance, and quality of life. Methods: 64 women (49,5 ± 4,24 years) in the climacteric period were included in the study. Climacteric symptom severity was assessed with the Blatt-Kupperman Index, physical activity levels with the International Physical Activity Questionnaire, quality of life with the Menopause-Specific Quality of Life Questionnaire, and balance with the single-leg stance test. The correlations between the variables were analyzed with the Pearson and Spearman Correlation analysis. Results: Of the participants, 15.6% had minor severe symptoms, 59.4% had mild severe symptoms, 18.8% had moderately severe symptoms and 6.3% had severe climacteric symptoms. The climacteric duration was negatively correlated to spinal mobility measures (r= -0.26 - -0.30) and the quality of life (r= 0.26) (p

Antimüllerian Hormone as a Tool to Predict the Age at Menopause.

This study aimed to assess an eligible cut-off value of anti-Müllerian hormone (AMH) to detect ovarian senescence in a group of premenopausal Greek women to evaluate the possible link between AMH-values and the severity of climacteric symptoms during a follow-up of 24 months. This study included 180 women (group A, 96 women of late reproductive stage/early perimenopause; group B, 84 women in late perimenopause). We measured AMH blood levels and assessed climacteric symptoms using the Greene scale. Log-AMH is inversely associated with postmenopausal status. The AMH cut-off of 0.012 ng/mL predicts the postmenopausal status with a sensitivity of 24.2% and specificity of 30.5%. The postmenopausal stage associated with age (OR = 1.320, 95%CI: 1.084-1.320) and AMH (values ≥ vs. <0.012 ng/mL, OR = 0.225, 95%CI: 0.098-0.529, p-value < 0.001). Moreover, the severity of vasomotor symptoms (VMS) was only associated inversely with AMH (b-coefficient = -0.272, p-value = 0.027). In conclusion, AMH levels measured in the late premenopausal period are inversely associated with the time to ovarian senescence. In contrast, AMH levels measured in the perimenopausal period are inversely associated only with the severity of VMS. Therefore, a cut-off of 0.012 ng/mL predicts menopause with low sensitivity and specificity, making it challenging to use in a clinical setting.

Disfunção sexual no climatério e fatores associados

Abstract Objectives: to evaluate associated factors with sexual dysfunction among middle-aged women. Methods: cross-sectional and analytical study was carried out with climacteric women attended at a Family Health Strategy Unit in the city of Montes Claros, MG. Brazil. The eligible women answered a question form containing sociodemographic, behavioral, anthropometric, gynecological factors and sexuality. The Body Mass Index and waist circumference were used to assess nutritional status and metabolic risk. To evaluate quality of life and sexual performance the Menopause Rating Scale and the Sexual Quotient - Female Version were used, respectively. Bivariate analysis and hierarchical multiple regression were used to identify associated factors with sexual dysfunction in the climacteric period. Results: among 195 women, 29.6% had sexual dysfunction. The prevalence of unsatisfactory sexual performance was higher among women who reported moderate to severe climacteric symptoms (OR=2.47) and lower schooling level was also associated (OR=1.95). However, age at menarche below 12 years (OR=0.43) and non-white (OR=0.36) seem to have a protective effect for good sexual performance. Conclusion: the prevalence of sexual dysfunction was high and the level of schooling and climacteric symptomatology were associated factors with this outcome.

Female orgasmic dysfunction and severe climacteric symptomatology in women aged 40 to 59 years: an independent association from an analysis of a multicenter Latin American study.

To evaluate the association between the severity of climacteric symptoms (CS) and orgasmic dysfunction (OD), controlled by demographic, clinical, and partner variables. We carried out a secondary analysis of a multicenter Latin American cross-sectional study that surveyed sexually active women 40 to 59 years old. We assessed CS (global, somatic, psychological, or urogenital domains) and OD. Also, we explored clinical variables and partner sexual conditions. We performed logistic regression models with nonparametric bootstrap resampling to estimate crude and adjusted odds ratios (aOR) with 95% confidence intervals (CI). We included data of 5,391 women in the analysis. Regarding CS, 24.8%, 10.8%, 28.4%, and 32.9% had respectively severe symptoms according to total, somatic, psychological, and urogenital domain scores of the Menopause Rating Scale. OD was found in 25.4% of women. The adjusted model (including menopausal status and partner sexual dysfunction) showed that severe CS increased the odds of OD (aOR = 2.77; 95% CI: 2.41-3.19 [total Menopause Rating Scale score]; aOR = 1.65; 95% CI: 1.37-2.00 [somatic domain]; aOR = 2.02; 95% CI: 1.76-2.32 [psychological domain] and aOR = 3.89; 95% CI: 3.40-4.45 [urogenital]). Severe CS were associated with OD independently of demographic, clinical, and partner variables. Severe urogenital symptoms had the strongest association.

The effect of diet and exercise on climacteric symptomatology.

This study aimed to explore the effects of health education, diet and exercise interventions on the climacteric symptoms of perimenopausal women. A total of 78 perimenopausal women in a gynaecological clinic from June 2018 to August 2018 were recruited and divided randomly into the following three groups: A (centralised education alone), B (health education + per-sonalised diet guidance) and C (health education + personalised diet guidance + intensive resistance exercise). The changes in diet score, exercise habits and climacteric symptoms were observed after 3 months. There was no difference between groups in food intake scores and total scores before the interventions. After the interventions, the total diet score of group C was higher than in groups A and B, and the red meat score decreased significantly (p<0.05). After the interventions, the number of resistance exercises per week in group B increased significantly. The number of aerobic exercises and resistance exercises per week in group C also increased significantly (p<0.05). The total score for climacteric symptoms in the three groups decreased significantly before and after the interventions (p<0.05), and the scores for insomnia and sexual disorders in group A decreased significantly (p<0.01). In group B, there was a significant effect on the improvement of moderate and severe climacteric symptoms (p<0.01), and the scores for seven other common symptoms (i.e. hot flushes, sweating, irritability, depression, suspicion, fatigue, joint pain, muscle pain, palpitations and sexual disorders) decreased significantly (p<0.05). Centralised health education, personalised dietary guidance and intensive resistance exercise improved the menopausal symptoms experienced by peri-menopausal women; the most indicative changes of this improvement were obtained using combined health education and personalised dietary guidance.

Prevalence and risk factors associated with urinary incontinence in climate women

To investigate the prevalence and factors associated with urinary incontinence (IU) in climacteric women attending the Family Health Strategies. Cross-sectional study with 874 climacteric women, selected by probabilistic sampling. The variables were investigated by a structured/pre-tested questionnaire. Bivariate analysis was performed using the chi-square test for variable selection for the multiple model adopting p≤0.25. In multivariate analysis, binary logistic regression was used to obtain adjusted odds ratios. After the analysis, the final model was constructed, adopting a significance level of p ≤ 0.05. The prevalence of urinary tract infection was 22.5%. After adjustments, the odds of urinary incontinence referred to these variables: single, sedentary/irregularly active women, smokers, overweight, obese women with severe climacteric symptoms, having episiotomy and presenting ovarian cysts. It was concluded that the presence of modifiable factors were associated with urinary incontinence.

Severity of climacteric symptoms among Peruvian women from an urban coastal community and a rural Andean community.

The aim of this study was to evaluate the severity of climacteric symptoms among two Peruvian communities, adjusted for sociodemographic and clinical variables in climacteric women. A cross-sectional study was conducted on 90 subjects from two different communities (an urban coastal and a rural Andean district from Peru). The Menopause Rating Scale was used to assess climacteric symptoms. Prevalence ratios with 95% confidence interval (PR 95%CI) were estimated using generalized linear Poisson models with family robust standard errors. A higher probability of severe climacteric symptoms was found in women who were from the Andean community than those who were from the coastal one (PR 2.42, 95%CI 1.47-3.99; p=0.001), which remained in the adjusted model (RP 1.72, 95%CI 1.04-2.86; p=0.035). Understanding the variation of climacteric symptoms among geographically distinct communities could contribute to improving women's quality of life.

The effect of tryptophan and serotonin levels on the severity of depressive and climacteric symptoms in perimenopausal women.

The dysfunctional serotonergic system is a factor contributing to the development of depression. The aim of this study was to assess the effect of serotonin and tryptophan on the severity of climacteric and depressive symptoms in perimenopausal women. The study involved data collection and biochemical analysis. The research instruments were: the Blatt-Kuppermann index, the Beck Depression Inventory, and the proprietary questionnaire. There was no significant effect of tryptophan (r=0.05; p=0.219) and serotonin (r= -0.03; p=0.537) on the severity of depressive symptoms, or tryptophan on the severity of climacteric symptoms (r=0.019; p=0.657). However, a weak negative correlation was found between the level of serotonin and the severity of climacteric symptoms (r=-0.09; p=0.022). Additionally, it was found that severe depressive symptoms were associated with a significant exacerbation of climacteric symptoms (β=0.379; p<0.001), while higher serotonin levels alleviated them (β=-0.604; p=0.005). Higher severity of depressive symptoms may exacerbate climacteric symptoms. Serotonin levels may influence the severity of climacteric symptoms. Moreover, the higher the serotonin level, the lower the odds of depressive disorders, irrespective of the severity of climacteric symptoms. Tryptophan levels had no effect on the severity of depressive and climacteric symptoms in the perimenopausal women.

Influence of overcommitment on the quality of life and on climacteric symptoms in nursing professionals.

To describe the general characteristics of nursing professionals and assess the influence of overcommitment on perceived climacteric symptoms and on the quality of life of nursing professionals. A cross-sectional, analytical study of 152 nursing auxiliaries and assistants aged 40 years or older was conducted at 3 hospitals in the interior of São Paulo state. Sociodemographic data were collected and the Blatt-Kupperman Menopausal Index, Women´s Health Questionnaire, Medical Outcome Study 36-item Short Form Health Survey and Effort-Reward Imbalance were applied in 2017. A descriptive analysis was performed and network analysis was carried out. Participants had a mean age of 50.23 years (SD ±7.1). Group 1 comprising 61 (40.1%) women with overcommitment had poorer quality of life as well as more severe climacteric symptoms. Presence of overcommitment seems to influence the negative perception of climacteric symptomatology and quality of life.

Prevalence of hormone-related mood disorder symptoms in women with ADHD

This is the first study to assess the prevalence of symptoms of premenstrual dysphoric disorder (PMDD), episodes of postpartum depression symptoms (PPD) after first childbirth, and climacteric mood symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD). 209 consecutive women (18–71 years) with ADHD completed the PMDD chapter of the Neuropsychiatric Interview Plus version 5.0.0 to assess PMDD, the Edinburgh Postnatal Depression Scale to assess PPD, and the Greene Climacteric Scale to assess climacteric symptoms. Comorbid psychiatric disorders, medication use, and chronobiological sleep characteristics were also assessed. The prevalence of PMDD and PPD were high in ADHD, compared to the general population. PMDD symptoms were associated with less use of contraceptives. Antidepressants were associated with more PMDD symptoms. The following GCS scores were significant increased: anxiety, depression, and sexual dysfunction, vasomotor and somatic complaints. No significant differences were found in sleep characteristics or current comorbidity between the groups with and without PPD or PMDD, or increased climacteric scores. The prevalences of PMDD, PPD and climacteric scores were high in women with ADHD. This is the first study in women with ADHD that suggests that female ADHD patients suffer from significant PMDD symptoms, experience PPD during the first child birth, and experience more severe climacteric symptoms.

Menopause symptoms delineated by HIV clinical characteristics in African American women with HIV.

To obtain data on prevalence and severity of climacteric symptoms in women with HIV (WWH) during the menopausal transition and early menopause and to evaluate for any differences in symptoms by CD4 count and viral load. We conducted an in-person survey of female patients attending the Johns Hopkins HIV clinic, ages 40 to 50 years with at least one menstrual period within 6 months before the survey. Interviews utilized the Greene Climacteric scale, a validated menopause questionnaire. We also queried patients, (1) if they were informing their primary care physician of menopause symptoms and (2) if their menopause symptoms were being treated. The study used nonparametric Mann-Whitney rank sum tests with significance defined as P < 0.05 to perform symptom severity comparisons of distributions and Fischer exact tests for comparisons of categorical variables such as comparing prevalence of anxiety and depression in the population. Twenty-three women aged 40 to 50 years were interviewed with a median age of 47 years [25 percentile = 46, 75 percentile = 49]. All were African American with median length of HIV diagnosis of 12 years [25 percentile = 7, 75 percentile = 20.5]. Most of the patients, 87% (n = 20), reported experiencing at least one menopause symptom with intense frequency and extreme detrimental effects on quality of life. All women interviewed, 100% (n = 23), reported hot flashes, ranging from infrequent to persistent. Sleeping difficulty was reported by 78% (n = 18) of women. Most women, 78% (n = 18), reported feeling tired or lacking energy with moderate frequency. The majority of the women, 87% (n = 20), said they reported menopause symptoms to their primary care provider. Of these, only 20% received treatment for menopause symptoms. These findings suggest that WWH undergoing the menopausal transition experience intense symptoms severely impacting quality of life. Although the majority of women reported experiencing menopause symptoms to medical providers, most remained untreated. An opportunity exists to educate providers caring for WWH on menopause medicine.

Cervical cancer survivors' attitudes and understanding of menopause and hormone therapy.

We designed a survey study to assess the presence and severity of climacteric symptoms, in addition to better understand patients' knowledge and understanding of hormone therapy (HT). We administered a 23-question survey during a patient's clinic visit or over the phone. Study enrollment spanned from March, 2019 to May, 2019. The primary outcomes were severity of menopausal symptoms and willingness to try HT, calculated as a summarized overall score. Chi-square and logistic regression were used for analysis. Our response rate was 38% (n = 34). Our participants were diverse-67% women were black and 21% women were Hispanic. Stage 1 and 2 disease was reported in 32% and 41% of women. Also, 82% and 94% of women reported ever receiving any chemotherapy or radiation therapy. There was no association between willingness to try HT for relief of menopausal symptoms and income (χ [1, 29] = 0.56, P = 0.81) or education level (χ [1, 29] = 2.78, P = 0.10). The most common climacteric symptoms experienced were hot flushes (85%) and decreased libido (77%). Neither symptom severity (odds ratio [OR] 1.31, 95% confidence interval [CI] 0.89-1.94) nor concern for side effects (OR 1.06, 95% CI 0.82-1.36) of HT significantly predicted willingness to try HT. Menopausal symptoms were prevalent in this population. Our data indicate that women are experiencing climacteric symptoms, but are overall unmotivated to address symptoms using HT. Factors such as symptom severity, fear of side effects, income level, or education level were not associated with acceptability of HT for premature menopause.

Estudo comparativo da qualidade do sono e insônia entre mulheres no climatério e com ciclo menstrual regular

INTRODUÇÃO: Climatério é a passagem entre o período reprodutivo e não reprodutivo da mulher, caracterizado pelos fogachos e sudorese que geram alterações em sua qualidade de vida, podendo interferir no sono e nas atividades rotineiras. OBJETIVO: Avaliar a qualidade do sono e nível de insônia de mulheres no climatério e comparar com mulheres de ciclo menstrual regular. MÉTODO: A coleta de dados foi realizada de janeiro a abril de 2018. Foram coletados dados pessoais, data da última menstruação, uso de medicações, se pratica atividade física, uso de bebida alcoólica ou cigarro, além de dados antropométricos. Aplicou-se 3 questionários: o Índice Menopausal de Kupperman (IMK), aplicado nas mulheres que estavam no climatério; Índice de Qualidade do Sono de Pittsburgh (PSQI-BR) e o Índice de gravidade da insônia. RESULTADOS: A amostra foi constituída por 53 mulheres sendo 30 com ciclo menstrual regular e 23 no período do climatério. A média de idade foi de 45±9 anos, peso de 70±7 kg e altura de 158 ±4 cm. Observou-se que em relação à gravidade da sintomatologia climatérica, 61% das mulheres obtinham sintomas moderados e apresentavam qualidade do sono ruim onde apenas as mulheres no climatério foram avaliadas com presença de distúrbio do sono e 67% das mulheres que estavam no climatério obtinham insônia leve a moderada. Houve diferença significativa entre a qualidade do sono (p=0,001) e a gravidade da insônia (p=0,014) entre os grupos. CONCLUSÕES: Mulheres climatéricas possuem pior qualidade do sono e insônia leve a moderada em comparação com mulheres que menstruam regularmente.

The Effect of Prophylactic Adnexectomy on the Quality of Life and Psychosocial Functioning of Women with the BRCA1/BRCA2 Mutations.

The main purpose of this study was to analyze the effect of risk-reducing salpingo-oophorectomy (RRSO) on the quality of life (QoL) and psychosocial functioning of patients with the BRCA1/BRCA2 mutations. This survey-based study was conducted using the Blatt-Kupperman Index, the Women’s Health Questionnaire, the Perceived Stress Scale, the State-Trait Anxiety Inventory, the Beck Depression Inventory-II, and the authors’ questionnaire. All calculations were done using Statistica 13.3. The QoL after RRSO was statistically significantly lower in most domains compared with the state before surgery. The greatest decline in the QoL was observed in the vasomotor symptoms domain (d = 0.953) and the smallest in the memory/concentration domain (d = 0.167). We observed a statistically significant decrease in the level of anxiety as a state (d = 0.381), as well as a statistically significant increase in the severity of climacteric symptoms (d = 0.315) and depressive symptoms (d = 0.125). Prophylactic surgeries of the reproductive organs have a negative effect on the QoL and psychosocial functioning of women with the BRCA1/2 mutations, as they increase the severity of depressive and climacteric symptoms. At the same time, these surgeries reduce anxiety as a state, which may be associated with the elimination of cancerophobia.

Quality of life in climacteric women assisted by primary health care.

This cross-sectional study evaluated the quality of life and associated factors of climacteric women in Brazil using a random and representative sample of women assisted by primary care professionals. We investigated the variables using the Menopause-Specific Quality of Life Questionnaire, MENQOL, whose mean scores were compared using Mann–Whitney and Kruskal–Wallis tests according to the sample characteristics. The variables associated with the outcomes in univariate analyses with a p≤0.2 were jointly evaluated using multiple linear regression. In this study, 849 women ranging in age from 40 to 65 years were evaluated. The predictors of poor quality of life in the vasomotor domain were women with severe climacteric symptoms (p<0.001), increased Body Mass Index (BMI) (p = 0.006), sleep (p = 0.022), and postmenopausal (p<0.001) alterations. For the psychosocial domain, the associated variables were severe climacteric symptoms (p<0.001) and sleep alterations (p<0.001); for the physical domain, the associated variables were severe climacteric symptoms (p<0.001), increased BMI (p<0.001), sleep (p<0.001), and postmenopausal (p<0.001) alterations. Severe climacteric symptoms, low sleep quality, increased BMI, and postmenopausal status were factors that were more associated with impairments in quality of life. With the increase in life expectancy, we suggest that greater attention should be paid to women’s quality of life associated with climacteric symptoms.

The role of magnesium in the treatment of symptoms climacteric syndrome

According to epidemiological studies, about 30% of residents in Russia receive less than 70% of the daily magnesium intake, while magnesium deficiency manifests much more often in women than in men. The prevalence of magnesium deficiency is 1.3 times higher among the female population. Women are more sensitive to magnesium deficiency and normally have higher deposited concentrations of this element. Objective of the study: evaluate the effectiveness of magnesium in the management of menopausal syndrome symptoms. Materials and methods: 30 female patients, aged 47 to 57 years, with various menopausal syndrome symptoms underwent clinical and laboratory examination. In addition to the general clinical examination, all patients underwent atomic absorption spectroscopy to determine serum Mg2+ ions concentrations. All patients received menopausal hormone therapy in combination with magnesium supplement using Magnesium Diasporal 300. Results and discussions: The severe climacteric symptoms relief and an increase in the serum magnesium levels were recorded against the background of the therapy.

Aberrant Cerebral Activity in Early Postmenopausal Women: A Resting-State Functional Magnetic Resonance Imaging Study.

Background: Early postmenopausal women frequently suffer from cognitive impairments and emotional disorders, such as lack of attention, poor memory, deficits in executive function and depression. However, the underlying mechanisms of these impairments remain unclear.Method: Forty-three early postmenopausal women and forty-four age-matched premenopausal controls underwent serum sex hormone analysis, neuropsychological testing and resting-state functional magnetic resonance imaging (rs-fMRI). Degree centrality (DC) analysis was performed to confirm the peak points of the functionally abnormal brain areas as the centers of the seeds. Subsequently, the functional connectivity (FC) between these abnormal seeds and other voxels across the whole brain was calculated. Finally, the sex hormone levels, neuroimaging indices and neuropsychological data were combined to detect potential correlations.Results: Compared with the premenopausal controls, the early postmenopausal women exhibited significantly higher serum follicle-stimulating hormone (FSH) levels, more severe climacteric and depressive symptoms, worse sleep quality and more extensive cognitive impairments. Concurrently, the neuroimaging results showed elevated DC values in the left amygdala (AMYG.L), reduced DC values in the left middle occipital gyrus (MOG.L) and right middle occipital gyrus (MOG.R). When we used the AMYG.L as the seed point, FC with the left insula (INS.L), bilateral prefrontal cortex (PFC) and right superior frontal gyrus (SFG.R) was increased; these regions are related to depressive states, poor sleep quality and decreased executive function. When bilateral MOG were used as the seed points, FC with left inferior parietal gyrus (IPG.L), this area closely associated with impaired memory, was decreased.Conclusion: These results illuminated the regional and network-level brain dysfunction in early postmenopausal women, which might provide information on the underlying mechanisms of the different cognitive impairments and emotional alterations observed in this group.

Impact of Chemotherapy-induced Menopause in Women of Childbearing Age With Non-metastatic Breast Cancer – Preliminary Results From the MENOCOR Study

BackgroundYoung patients with breast cancer treated with chemotherapy can experience ovarian failure, which can lead to chemotherapy-induced menopause (CIM) impacting the quality of life (QoL). A prospective study was set out to evaluate the impact of CIM on QoL in women of childbearing age with non-metastatic breast cancer, and this article reports results of the interim analysis conducted to evaluate feasibility and to see preliminary results. Patients and MethodsA total of 58 women (age, 18-46 years) with newly diagnosed breast cancer and treated with chemotherapy were eligible. QoL was assessed by self-administered questionnaires (Quality of Life Questionnaire-Core 30 [QLQ-C30], Quality of Life Questionnaire-Breast 23 [QLQ-BR23], and Kupperman index) and hormonal variations (anti-Müllerian hormone [AMH], follicle-stimulating hormone, and estradiol) were explored. We compared patients with ≥ 12 months amenorrhea (CIM) (n = 41) to patients with < 12 months of amenorrhea (non-CIM) (n = 17). ResultsA good inclusion rate (approximately 4/month) and sufficient data enabled us to perform this analysis. QLQ-C30 failed to show any difference between CIM and non-CIM patients (P = .5). In contrast, at 6 months post-chemotherapy, CIM patients tended to have lower QoL as shown by QLQ-BR23 (P = .16) and more severe climacteric symptoms (P = .01). Regarding hormonal variations, AMH pre-treatment level was higher in non-CIM patients (P = .0032). We also noted that CIM patients were older (P = .00013), had shorter menstruation cycle (P = .082), and experienced faster amenorrhea (P = .088). ConclusionsThe study is technically feasible, and our preliminary results underline that age in association with pre-treatment AMH level could be helpful to predict ovarian function. QLQ-BR23 seemed to be stronger, more precise, and appropriate to evaluate QoL changes in patients with breast cancer than the QLQ-C30.

FATORES ASSOCIADOS A DISFUNÇÕES SEXUAIS NO CLIMATÉRIO

A Disfunção Sexual Feminina (DSF) é um problema de saúde pública de alta prevalência mundial, relatado por cerca de 40% de todas as mulheres no mundo. O climatério compreende a transição entre o período reprodutivo e o não reprodutivo da vida da mulher, sendo uma fase biológica, e não um processo patológico (BRASIL, 2008). Nessa fase, as mulheres tornam-se mais vulneráveis às disfunções sexuais, em virtude das consequências do hipoestrogenismo (Cabral et al., 2012; Cavalcanti et al., 2014; Crowley, 2018). Por isso, é fundamental compreender o climatério e as mudanças que acontecem nesse período da vida da mulher, incluindo a função sexual, visto que, com o aumento da expectativa de vida, há aumento também da quantidade de anos vividos no climatério. Objetivo: verificar se há diferença na prevalência de disfunção sexual e nos escores dos domínios sexuais segundo status menopausal e avaliar quais sintomas climatéricos estão associados à disfunção. Metodologia: estudo transversal no qual foram incluídas 84 mulheres com idade entre 18 e 68 anos, sexualmente ativas. Avaliou-se idade, estado civil, escolaridade, renda, status menopausal e tabagismo e aplicou-se o Índice de Função Sexual Feminina (IFSF) e o Menopause Rating Scale (MRS), para mulheres pós-menopausa. Para avaliar variáveis categóricas, foi utilizado o teste Qui-Quadrado de Pearson, o nível de significância adotado foi de 5% e software utilizado foi o R Core Team 2018. Resultados: a prevalência global de disfunção sexual (IFSF ≤ 26,5) foi de 42,9%. Segundo estado menopausal, não houve diferença significativa na prevalência de disfunção sexual (37,9 e 53,8%, p = 0,234), mas houve diferença significativa nos domínios da lubrificação (5,1 e 3,9 p = 0,003 e D = 0,750) e excitação (3,3 e 2,7 p = 0,006 e D = 0,673). No grupo pós-menopausa, verificou-se disfunção sexual em 50% das mulheres com sintomas climatéricos severos. Maior frequência de disfunção foi associada a sintomas somatovegetativos (92,9%, 50%, p = 0,036) e urogenitais (92,9%, 58,3%, p = 0,018). Conclusões: a prevalência de disfunção sexual foi alta, não houve diferença na prevalência segundo status menopausal e sintomas climatéricos severos, particularmente, somatovegetativos e urogenitais associaram-se à pior função sexual.

Prophylactic salpingo-oophorectomy & surgical menopause for inherited risks of cancer: the need to identify biomarkers to assess the theoretical risk of premature coronary artery disease

BackgroundSome women with genetic risk of breast and/or ovarian cancer (e.g., BRCA1/2) opt to undergo prophylactic salpingo-oophorectomy (PSO, or surgical removal of the ovaries & fallopian tubes) in order to reduce their risk of cancer. As a consequence, these women experience “surgical menopause” – accompanied by more severe climacteric symptoms that occur in a much shorter time frame. While the risk of coronary artery disease (CAD) rises with menopause, little is known about how the sudden loss of ovarian function from PSO alters the whole-body physiology, and whether it predisposes women to premature CAD.Methods/DesignTo manage CAD risk there is a prerequisite for reliable biomarkers that can help guide risk assessment and therapeutic interventions. To address these needs, this prospective, observational cohort study will evaluate surrogate markers reflective of CAD health in women experiencing surgical menopause after PSO. Twenty women representing each of the following groups will be enrolled over 3 years (total participants = 240): (i) pre-menopausal PSO, (ii) post-menopausal PSO, (iii) pre-menopausal women undergoing other pelvic surgery, and (iv) pre-menopausal controls (no surgery). All participants will provide blood plasma samples pre- and 1, 3, 6, & 12 months post-operatively, with serial samples collectively assessed for measurements of the study’s primary endpoints of interest. These include a hormone profile (estradiol, follicle stimulating hormone (FSH), luteinizing hormone (LH), and progesterone) and both conventional (lipid profile) and novel biomarkers (Heat Shock Protein 27 (HSP27), HSP27-antibodies (HSP27 Ab), proprotein convertase subtilisin/kexin 9 (PCSK9), inflammatory cytokines) of CAD. Another aspect of this study is the measurement and analysis of retinal vessel diameters – an emerging physiological parameter reflective of CAD risk. Finally, a patient engagement exercise will result in the drafting of patient-generated questionnaires that address the well-being and health concerns of these women as they transition through premature menopause and work with our research team to identify and discuss their health priorities.DiscussionThe protocol of our planned study investigating the effects of PSO on CAD is described herein. Characterization of novel CAD markers in women experiencing surgical menopause will yield new insights into the role of the functional ovary in modulating lipid parameters and other CAD risk factors such as HSP27 and HSP27 Ab.