Trastorno neurocognitivo leve en el climaterio con Evaluación Cognitiva Montreal / Mild neurocognitive disorder in the climacteric with Montreal Cognitive Assessment

Las mujeres en climaterio o transición menopáusica frecuentemente reportan quejas de memoria. El Estudio Esmeralda busca relacionar los Síntomas del Climaterio (SC) femenino en sus diferentes etapas: premenopausia (etapa -2, temprana de la transición menopáusica), perimenopausia (etapas -1 y +1ª, tardía de la transición menopáusica y temprana de postmenopausia) y postmenopausia (etapas +1b, +1c y +2, temprana de postmenopausia con tardía de postmenopausia), con posible deterioro del funcionamiento intelectual, que pudiera llevar a sospechar de Trastorno Neurocognitivo leve (TNCl). La muestra final quedó conformada por 100 mujeres con alto nivel de escolaridad entre 40 y 60 años de edad. Se realizó un estudio no experimental transversal con muestreo no probabilístico, utilizando la Evaluación Cognitiva Montreal (MoCA). Se obtuvieron resultados normativos en 43.27% de la muestra y Deterioro Cognitivo Leve (DCL) en 56.73%, encontrando diferencia de medias significativas al nivel 0.05 en las tres etapas de climaterio, resultando la mayor incidencia en perimenopausia, etapa de mayor disminución de estrógenos. Se concluye que cambios en la función intelectual, pueden estar asociados a variación hormonal. Se puede determinar TNCl en forma temprana, en busca de una atención primaria y puesta en marcha de reactivación de funciones intelectuales.

Women in the climacteric stage or menopausal transition, frequently report complaint in memory. Emerald Study search relate feminine climacteric syndrome in their different steps: premenopause (stage -2 early menopausal transition), perimenopause (stages -1 and +1a late menopausal transition and early postmenopause) and postmenopause (stages +1b, +1 c and +2 early postmenopause with late postmenopause), with a possible mild cognitive impairment, that carry on suspect of Mild Neurocognitve Disorder (mNCD). The final sample were 100 women with high schooling level between 40 and 60 years old. A nonexperimental, non-probability cross-sectional study was conducted through the Montreal Cognitive Assessment (MoCA). Normative results were obtained in 43.27% and mNCD in 56.73%, finding difference of significant means at the 0.05 level in the three stages of climacteric, resulting in the highest incidence in perimenopause, stage of greatest decrease in estrogen. It is concluded that changes in intellectual function may be associated with hormonal variation. mNCD can be determined early, in search of primary care and start-up of reactivation of intellectual functions.

Síntomas psicológicos en la transición menopáusica / Psychological symptoms in the menopausal transition

RESUMEN OBJETIVO: Conocer los síntomas en la Transición Menopáusica, mediante el autoinforme de la mujer, clasificado en tres grupos: 1er. Temprana de la Transición Menopáusica (etapa −2), 2°. Tardía de la Transición Menopáusica y Temprana de Postmenopausia (etapas −1 y +1a) y 3er. grupo Temprana de Postmenopausia con Tardía de Postmenopausia (etapas +1b, +1c y +2), analizando síntomas psicológicos. MATERIAL Y MÉTODO: Estudio no experimental transversal muestreo no probabilístico. Participantes 116 mujeres en un rango de edad entre 40 y 60 años con alto nivel de escolaridad, mediante la Escala de Clasificación en la Menopausia MRS, el Inventario de Ansiedad y Depresión de Beck. RESULTADOS: La muestra quedó conformada por un total de 100 mujeres con al menos un síntoma, con alto nivel de escolaridad y en el rango de edad de 40 a 60 años, agrupadas por etapa de Transición Menopáusica: 1er. grupo 36 mujeres, 2°. grupo 16 y 3er. grupo con 48 personas. Los síntomas psicológicos medidos con MRS son los más frecuentes en 41.60%; reportan queja subjetiva de pérdida de memoria 57% de las mujeres. Alfa Cronbach de .74 en MRS. CONCLUSIONES: Los síntomas psicológicos están presentes como un continuo a lo largo de la Transición Menopáusica, posiblemente debidos a la disminución de concentración de estrógenos, lo que conlleva en algunos casos al diagnóstico de Trastorno Neurocognitivo Leve.

ABSTRACT OBJECTIVE: To know the symptoms in the Menopausal Transition, through the self-report of the women, classified into three groups: 1st. Early Menopausal Transition (stage −2), 2nd. Late Menopausal Transition and Early Postmenopause (stages −1 and +1a) and 3rd. group Early Postmenopause with Late Postmenopause (stages +1b, +1 c and +2), analyzing psycological symptoms. MATERIAL & METHOD: Non-experimental transversal study, non-probabilistic sampling. The participants were 116 women between 40 and 60 years old with high schooling level, through The Menopause Rating Scale MRS, Beck Anxiety Inventory and Depression Inventory. RESULTS: The final sample consisted of 100 women with at least one symptom, with a high schooling level in the range of 40 to 60 years, grouped by Menopausal Transition stage: 1st. 36 women, 2nd. Group 16 and 3rd. group with 48. The psycological symptoms measured with MRS were the most frequently in 41.60%; report subjective complaint of memory loss 57% of women. Alfa Cronbach of .74 in MRS. CONCLUSION: Psychological symptoms are present as a continuum throughout the Menopausal Transition, possibly due to the decreased concentration of estrogen, which in some cases leads the diagnosis of Mild Neurocognitive Disorder.

Clinical Study on Electroacupuncture in Mitigating the Symptoms Related to Menopausal Transition / 上海针灸杂志

Objective To observe and compare the regulating effect between electroacupuncture and sham electroacupuncture on the symptoms of menopausal transition and levels of estradiol (E2), follicle-stimulating hormone (FSH), and luteinizing hormone (LH), for evaluating the clinical efficacy of electroacupuncture in mitigating the relevant symptoms of menopausal transition. Method Thirty eligible subjects with menopausal transition were randomized into a treatment group and a control group, 15 cases in each group. The treatment group was intervened by electroacupuncture at the ordinary acupoints, while the control group was by electroacupuncture at non-meridian points. The E2, FSH, and LH contents were detected after intervention and at the 20th week during the follow-up study, the flush score and Menopause Rating Scale (MRS) were evaluated respectively after 4-week and 8-week treatment and at the 20th week and 32nd week during the follow-up study, and the safety of electroacupuncture was also estimated.Result The flush and MRS scores were significantly changed after 4-week and 8-week treatment and at the 20th week and 32nd week during the follow-up study in both groups compared to that before the treatment in the same group (P<0.01,P<0.05). There was a significant difference in comparing the changes of MRS score after 8-week treatment between the two groups (P<0.01). There were significant differences in comparing the changes of flushing scores between the two groups after 8-week treatment and at the 20th week and 32nd week during the follow-up study (P<0.01). The serum levels of E2, FSH, and LH were significantly changed in the treatment group after 8-week treatment (P<0.05). There were significant differences in comparing the changes of FSH and LH levels between the two groups after 8-week treatment (P<0.05). The difference in comparing the change of serum E2 level between the two groups at the 20th week during the follow-up study was statistically significant (P<0.05). Conclusion Electroacupuncture can improve the flushing intensity and produce a benign regulation on the relevant hormone levels in menopausal transition, though this regulation is insignificant when the treatment terminates.

Força muscular do assoalho pélvico e desempenho sexual de mulheres na transição menopausal / Pelvic floor of muscular strength and sexual performance of women in menopausal transition

A transição menopausal pode representar um momento crítico para a sexualidade da mulher, já que nessa fase ocorre deficiência de hormônios esteroides sexuais, resultante da insuficiência ovariana, secundária à diminuição dos folículos primordiais. O estudo teve como objetivo avaliar a relação da força muscular do assoalho pélvico com a satisfação sexual de mulheres na transição menopausal. Foi avaliado o desempenho sexual por meio do Quociente Sexual - Versão Feminina (QS-F) e a força muscular do assoalho pélvico pela avaliação funcional do assoalho pélvico (AFA) e perineômetro de quatro mulheres na transição menopausal, com média de idade 48,5 ± 5,5 anos. Observou-se que as duas mulheres com menor força muscular do assoalho pélvico (AFA 2 e 7-8 cmH2O) foram as que obtiveram a classificação de regular a bom do desempenho sexual (78 e 80 pontos, respectivamente) e as com maior força muscular (AFA 4 e 3) foram classificadas com desempenho sexual bom a excelente (84 e 90 pontos, respectivamente). Embora seja necessária uma amostra maior para a comprovação desta conexão, os resultados mostraram que há relação entre a força muscular do assoalho pélvico e a satisfação sexual em mulheres na transição menopausal, ou seja, quanto maior a força muscular, melhor o desempenho sexual...

Prevalência da incontinência urinária e sua associação com a obesidade em mulheres na transição menopausal e após-menopausa / Prevalence of urinary incontinence and its association with obesity among women in the menopausal transition and postmenopause

A Incontinência Urinária (IU) é a perda involuntária de urina e, entre os fatores envolvidos no seu determinismo, a obesidade assume particular importância. Entretanto, ainda não está claro se o fator determinante é a gordura abdominal, mensurada pela medida da circunferência abdominal (CA), ou o excesso de gordura corpórea, avaliado pelo Índice de Massa Corpórea (IMC). Objetivos: Estimar a prevalência de IU em mulheres na transição menopausal e após a menopausa; verificar se há associação com o IMC e com a medida da CA em seu determinismo além de avaliar a qualidade de vida nas mulheres incontinentes estudadas. Métodos: Em estudo transversal, foram obtidos dados secundários a partir do banco de dados do Projeto de Saúde de Pindamonhangaba, pertencentes ao Programa de Saúde da Família, do referido Município. A população do estudo foram mulheres nos estágios da transição menopausal e pós menopausa, com idade entre 35 e 65 anos. Todas foram submetidas a uma entrevista sistematizada, que incluiu questões sobre perfil sociodemográfico, história ginecológica e obstétrica, incontinência urinária, morbidade e avaliações antropométricas, como altura, peso e medida da CA e coleta de sangue. Resultados: A prevalência da IU foi de 17,0 por cento e entre os fatores significativos associados ao seu determinismo incluíram-se episiotomia, religião evangélica, depressão, tabagismo atual, síndrome metabólica e medida da CA acima de 88 cm. Com relação à qualidade de vida das incontinentes, 16,1 por cento das mulheres relataram que a incontinência tem impacto na qualidade de vida e 3,2 por cento classificaram esse impacto como grave. Conclusão: A prevalência da IU foi menor em comparação a outros estudos, porém, constatou-se piora da qualidade de vida das incontinentes; com relação à obesidade, observou-se que a medida da CA maior que 88 cm se associou significativamente com a IU, o mesmo não ocorrendo com o IMC.

Urinary Incontinence (UI) is the involuntary loss of urine and among the factors involved in its determinism, obesity takes particular importance. However, it is unclear whether the determinant factor is the abdominal fat measured by measuring the Abdominal Circumference (AC) and or the excess of body fat assessed by the Body Mass Index (BMI). Objectives: To estimate the prevalence of UI in women in menopausal transition and after menopause; check for an association between the BMI with the AC measure in its determinism and evaluate the quality of life in studied incontinent women. Methods: In cross-sectional study were obtained secondary data from the database of the Pindamonhangaba's Health Project, belonging to the Family Health Program of that municipality. The study population were women in transition and postmenopause stages, aged between 35 and 65. All were subjected to a systematic interview that included questions about Sociodemographic profile, obstetrical and gynecological history, urinary incontinence, morbidity and anthropometric measurements such as height, weight, AC measurement and blood collection. Results: The prevalence of U was 17.0 per cent and among the significant factors associated with its determinism is included episiotomy, evangelical religion, depression, current tabagism, metabolic syndrome and CA measurement above 88 cm. Regarding the quality of life, 16.1 per cent of incontinent women reported having an impact on quality of life and 3.2 per cent classified it as severe. Conclusion: The prevalence of UI was lower compared to other studies, however, it was found a worsening in incontinents' quality of life; in relation to obesity, it was observed that the measurement of AC > 88 cm was significativelly...

Mullerian inhibiting substance as a predictive marker of menopausal transition / 대한산부인과학회지

OBJECTIVE: To identified whether serum Mullerian inhibiting substance (MIS) level may be used as a predictive marker of menopausal transition. METHODS: Serum MIS level was measured in reproductive women (n=87), in menopausal transition women (n=58), and in menopausal women (n=5) by ELISA. And we examined the immunohistochemical staining of the MIS in the ovarian tissues of 15 reproductive, 15 menopausal transition, and 5 menopausal women. RESULTS: 1. In the reproductive women, mean serum MIS level was 1.73+/-1.07 ng/ml. In the menopausal transition women, mean serum MIS level was 0.18+/-0.11 ng/ml. Serum MIS level did not show any significant fluctuation patterns according to follicular development. In menopausal transition women, serum MIS level was significantly lower than that of reproductive women (P<0.001). The cutoff value of serum MIS level for menopausal transition was 0.5 ng/mg. In the menopausal women, serum MIS level was not detected. 2. Serum MIS level was significantly decreased as patient age was increased. 3. In the reproductive group, the immunohistochemical staining demonstrated strong expression of MIS in the granulosa cells of the primary follicles and the growing follicles, but not in corpus luteum, preovulatory mature follicle, atretic follicle, and corpus luteum. In the menopausal transition women, immunohistochemical staining for MIS was observed in the nearly same pattern as that of thereproductive women, but with weaker expression. In the menopausal women, immunohistochemical staining of the MIS was not observed. CONCLUSION: MIS is a good candidate for predictive marker for ovarian aging and perimenopausal transition.