Affective response of postmenopausal women to resistance training on stable and unstable surfaces: a randomized cross-over study / Respostas afetivas de mulheres pós-menopausadas submetidas ao treinamento com pesos em superfície estável e instável: um estudo cross-over randomizado

Objective: To compare the affective response of postmenopausal women who undergo 6 weeks of resistance training on stable and unstable surfaces. Methods: This randomized counterbalanced cross-over study carried included 14 postmenopausal women (55 [SD, 3] years; height 1.55 [SD, 0.03] m; body mass 78.70 [SD, 12.00] kg; and body mass index 32.80 [SD, 4.90] kg/m²), who underwent 6 weeks of resistance training on stable and unstable surfaces. The participants were initially allocated to 1 experimental condition (stable or unstable) in a randomized counterbalanced manner. The intervention consisted of 8 exercises in 3 series of 8-10 repetitions, with intervals of 60-90 seconds, for 3 weeks. After the first 3-week protocol, they were switched to the other experimental condition for another 3 weeks. To evaluate affective response, the Hardy and Rejeski Sensation Scale was applied weekly at the end of each exercise and again at the end of the 6 weeks. Results: Affective response was similar to the general affect observed at the end of the sessions (stable surface: 5.00 [3.00]; unstable surface: 5.00 [1.00]; p = 0.114), except for the bridge exercise (stable surface: 3.00 [2.00]; unstable surface: 4.00 [2.00]; p = 0.048]). Conclusions: The affective response of these women was not affected by training on unstable surfaces, except for the bridge exercise, in which the unstable surface increased affective response

Objetivo: Comparar as respostas afetivas de mulheres pós-menopausadas submetidas a seis semanas de treinamento com pesos realizado em superfície estável e instável. Metodologia: Trata-se de um estudo cross-over, randomizado e contrabalanceado realizado com 14 mulheres pós-menopausadas (55 ± 3 anos; estatura de 1,55 ± 0,03 m; massa corporal 78,70 ± 12,00 kg; e índice de massa corporal de 32,80 ± 4,90 kg/m²) submetidas a seis semanas de treinamento com pesos em superfície estável e instável. As participantes foram alocadas, inicialmente, numa das condições experimentais de forma randomizada e contrabalanceada. A intervenção foi composta por oito exercícios em três séries de oito a dez repetições, com intervalos entre 60 e 90 segundos, durante três semanas. Para avaliação das respostas afetivas, foi aplicada a Escala de Sensação de Hardy e Rejeski ao fim da última série de cada exercício e ao final das sessões, durante as seis semanas. Resultados: As respostas afetivas foram similares para o afeto geral observado ao final das sessões [Superfície estável: 5,00 (3,00); Superfície instável: 5,00 (1,00); p = 0,114], mas não para o exercício de ponte [Superfície estável: 3,00 (2,00); Superfície instável: 4,00 (2,00); p = 0,048)]. Conclusões: Conclui-se que as respostas afetivas de mulheres pós-menopausadas, observadas ao final da sessão, não foram afetas pela instabilidade. Contudo, as sensações de prazer, no exercício de ponte, foram maiores com a inserção da instabilidade

Evaluation of obesity influence in the sexual function of postmenopausal women: A cross- sectional study / Avaliação da influência da obesidade na função sexual de mulheres após a menopausa: um estudo transversal

Abstract Objective The incidence of obesity, which is a chronic condition, has increased in recent years. The association between obesity and female sexual dysfunction remains unclear, particularly in postmenopausal women. In the present study, we evaluated whether obesity is a risk factor for sexual dysfunction in postmenopausal women. Methods This is a cross-sectional study that analyzed data from interviews of postmenopausal women at the Climacteric Outpatient Clinic from 2015 to 2018. After applying the inclusion and exclusion criteria, 221 women aged between 40 and 65 years old were selected and invited to participate in the study. Obesity was diagnosed according to body mass index (BMI). The participants were grouped into the following BMI categories: group 1, 18.5-24.9 kg/m2 (normal); group 2, 25.0- 29.9 kg/m2 (overweight); and group 3, ≥30.0 kg/m2 (obese). Sexual function was assessed using the Female Sexual Function Index (FSFI) questionnaire. Cutoff points of ≥23 and ≥26.5 were adopted to define a diagnosis of female sexual dysfunction (FSD) based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision by the American Psychiatric Association (DSM-IV-TR). Results The desire and arousal scores were statistically higher in the normal BMI group than in the obese group (p=0.028 and p=0.043, respectively). The satisfaction scores were statistically higher in the normal BMI group than in the overweight and obese groups (p<0.05). The total FSFI score statistically differed among the BMI categories (p=0.027). Conclusion In the present study, obese and overweight postmenopausal women had higher total scores than women with normal BMI. Our results show that obese and overweight postmenopausal women had a higher index of dysfunction in desire and arousal and lower sexual satisfaction than normal-weight women.

Resumo Objetivo A incidência de obesidade, que é uma condição crônica, aumentou nos últimos anos. A associação entre obesidade e disfunção sexual feminina ainda não está clara, particularmente emmulheres após amenopausa. No presente estudo, avaliamos se a obesidade é um fator de risco para disfunção sexual em mulheres após a menopausa. Métodos Este é umestudo transversal que analisou dados de entrevistas demulheres após a menopausa no Ambulatório de Climatério a partir de 2015 até 2018. Após a aplicação dos critérios de inclusão e exclusão, 221 mulheres com idade entre 40 e 65 anos foram selecionadas e convidadas a participar do estudo. Obesidade foi diagnosticada de acordo com o índice de massa corpórea (IMC). Os participantes foram agrupados nas seguintes categorias de IMC: grupo 1: 18,5-24,9 kg/m2 (normal); grupo 2: 25,0-29,9 kg/m2 (sobrepeso); e grupo 3: ≥30,0 kg/m2 (obesidade). A função sexual foi avaliada através do questionário Female Sexual Function Index (FSFI, na sigla em inglês). Pontos de corte de ≥23 e ≥26,5 foram adotados para definir um diagnóstico de disfunção sexual feminina (DSF) com base no Manual de Diagnóstico e Estatística das Perturbações Mentais, 4ª Edição, Texto Revisto DSM-IV-TR. Resultados Os escores de desejo e excitação foram estatisticamente maiores no grupo com IMC normal do que no grupo obesidade (p=0,028 e p=0,043, respectivamente). Os escores de satisfação foram estatisticamente maiores no grupo com IMC normal do que nos grupos comsobrepeso e obesidade (p<0,05). A pontuação total do FSFI diferiu estatisticamente entre as categorias de IMC (p=0,027). Conclusão No presente estudo,mulheres após a menopausa obesas e com sobrepeso tiveram escores totais mais altos do que mulheres com IMC normal. Nossos resultados mostram que mulheres obesas e com sobrepeso após a menopausa apresentaram índices mais altos de disfunção no desejo e excitação e menor satisfação sexual do que mulheres com peso normal.

Aspectos éticos y sociales de la sexualidad de la mujer en el climaterio y la posmenopausia / Ethical and Social Aspects of Women's Sexuality in the Climacteric and Postmenopause / Ethical and Social Aspects of Women's Sexuality in the Climacteric and Postmenopause

RESUMEN Introducción: La esfera sexual en el ser humano tiene una notable relevancia, por ser un mundo de sentimientos y sentidos dentro del universo humano que genera armonía, bienestar, autoestima, ternura, complicidad, y protección, tan beneficiosos para cualquiera, por lo que la misma comprende también aspectos éticos intrínsecos que son de gran importancia. Objetivos: Determinar los aspectos éticos y sociales de la sexualidad de la mujer en el climaterio y la menopausia. Métodos: Se realizó un estudio descriptivo transversal en las mujeres que acudieron a consulta de climaterio y menopausia del Municipio Playa, comprendidas en edades entre 40 y 64 años. El estudio se realizó entre el 1º de julio de 2017 y el 30 de septiembre de 2018. Variables estudiadas: Edad, etapa del climaterio, estado conyugal, principales síntomas referidos y factores sociales Resultados: Predominaron las mujeres más jóvenes comprendidas entre 40 y 44 años (25,3 %) y entre 45 y 49 años (22,9 %). El motivo de consulta no fue relacionado con problemas de la sexualidad, sino que la gran mayoría (79 pacientes; 95,1 %) asistió a consulta por otros motivos. Conclusiones: La mayoría de las pacientes presentan dudas, así como también síntomas relacionados con la sexualidad y no consultan por estos motivos. El aspecto ético resulta de gran importancia en estas mujeres, por lo que se recomienda brindarles asesoría sobre la sexualidad cuando acudan a la consulta, independientemente del motivo por el cual asistan.

ABSTRACT Introduction: The sexual sphere in the human being has remarkable relevance, as it is a world of feelings and senses within the human universe that generates harmony, well-being, self-esteem, tenderness, complicity, and protection, so beneficial to anyone, so that it also includes intrinsic ethical aspects that are of great importance. Objectives: To determine the ethical and social aspects of women's sexuality in the climacteric and menopause. Methods: A descriptive cross-sectional study was carried out in women who attended the climacteric and menopause consultation in Playa Municipality. Ages ranged 40 and 64 years. The study was conducted from July 1, 2017 to September 30, 2018. Variables studied were age, climacteric stage, marital status, main referred symptoms, and social factors. Results: Younger women between 40 and 44 years (25.3%) and between 45 and 49 years (22.9%) predominated. The reason for consultation was not related to sexuality problems, the vast majority (79 patients; 95.1%) attended consultation for other reasons. Conclusions: Most patients have doubts, as well as symptoms related to sexuality and do not consult for these reasons. The ethical aspect is of great importance in these women, so it is recommended to provide advice on sexuality when they attend the consultation, regardless of the reason they attend.

Relationship between sexual hormones, quality of life and postmenopausal sexual function / Relação entre hormônios sexuais, qualidade de vida e função sexual na pós-menopausa

Abstract Objective To assess the relationship between sexual hormones, sexual function and quality of life in postmenopausal women. Method A cross-sectional study was conducted with a convenience sample of 36 postmenopausal women between the ages of 45 and 65 in follow-up at a climacteric outpatient clinic. Mood, quality of life, sexual function and hormonal profile were assessed. Results With regard to sexual hormones and sexual function, a relationship was found between orgasm and luteinizing hormone (r=0.37), orgasm and sex hormone-binding globulin (SHBG) (r=0.39), SHBG and less pain (r=0.44), dehydroepiandrosterone (DHEA) and desire (r=-0.45), as well as between prolactin and lubrication (r=0.33). Sexual hormones and quality of life were related as follows: progesterone and limitations due to physical aspects (r=0.35), SHBG and social aspects (r=0.35), cortisol and pain (r=0.46), DHEA and social aspects (r=-0.40). Finally, the following relationships were found between sexual function and quality of life: sexual desire and vitality, social aspects, state of general health and mental health (r=0.46, r=0.51, r=0.35, and r=0.38, respectively). Arousal, orgasm and satisfaction with sexual life showed a relationship with less physical pain (r=0.40, r=0.42, and r=0.43, respectively). Satisfaction with sexual life was correlated with vitality (r=0.33). Conclusion Different correlations than expected were found in this study regarding the effect of some hormones on sexual function and some aspects of the quality of life of postmenopausal women.

Resumo Objetivo Avaliar a relação entre hormônios sexuais, função sexual e qualidade de vida em mulheres na pós-menopausa. Métodos Estudo transversal com amostra de conveniência de 36 mulheres na pós-menopausa, com idades entre 45 e 65 anos, em seguimento ambulatorial de climatério. Humor, qualidade de vida, função sexual e perfil hormonal foram avaliados. Resultados Entre hormônios sexuais e função sexual, foi encontrada relação entre orgasmo e hormônio luteinizante (r=0,37), orgasmo e globulina ligadora de hormônios sexuais (SHBG) (r=0,39), SHBG e menos dor (r=0,44), desidroepiandrosterona (DHEA) e desejo (r=-0,45), bem como entre prolactina e lubrificação (r=0,33). Entre hormônios sexuais e qualidade de vida: progesterona e limitações por aspectos físicos (r=0,35), SHBG e aspectos sociais (r=0,35), cortisol e dor (r=0,46), DHEA e aspectos sociais (r=-0,40). Por fim, entre função sexual e qualidade de vida: desejo sexual e vitalidade, aspectos sociais, estado geral de saúde e saúde mental (r=0,46, r=0,51, r=0,35 e r=0,38, respectivamente). Excitação, orgasmo e satisfação com a vida sexual mostraram uma relação com menos dor física (r=0,40, r=0,42 e r=0,43, respectivamente). A satisfação com a vida sexual foi correlacionada com a vitalidade (r=0,33). Conclusão Correlações diferentes das esperadas foram encontradas neste estudo em relação ao efeito de alguns hormônios sobre a função sexual e alguns aspectos da qualidade de vida de mulheres na pós-menopausa.

Personality traits of postmenopausal women with sexual dysfunction / Características de personalidade de mulheres na pós-menopausa com disfunção sexual

Abstract Objective The aim of the present study is to identify the association between personality traits of postmenopausal women and the occurrence of sexual dysfunction. Methods A total of 43 postmenopausal women were evaluated according to their self-perception of the quality of their sexual life. They answered the following questionnaires: Sociodemographic Profile Questionnaire, Female Sexual Function Index (FSFI), Beck Depression Inventory (BDI) and Factorial Personality Inventory (FPI-II). Results Women with poorer sexual self-perception showed low affective need (p< 0.01) and low need for organization (p< 0.01). Based on the need for control and opposition, there was no difference between the groups. Groups separated by the scores obtained on the FSFI showed no significant differences. Conclusion Postmenopausal women with lower schooling and personality characteristics that demonstrate low affective and organizational needs are more likely to present sexual dysfunction.

Resumo Objetivo O objetivo do presente estudo foi identificar a associação entre características de personalidade de mulheres na pós-menopausa e ocorrência de disfunção sexual. Método No total, 43 mulheres na pós-menopausa foram avaliadas de acordo com suas percepções da qualidade de suas vidas sexuais. Elas responderam aos seguintes questionários: Perfil Sociodemográfico, Índice de Função Sexual Feminino (FSFI, na sigla em inglês), Inventário de Depressão Beck (BDI, na sigla em inglês) e Inventário Fatorial de Personalidade (IFP-II). Resultados Mulheres com pior percepção sexual demonstraram baixa necessidade afetiva (p< 0,01) e baixa necessidade de organização (p< 0,01). Com base na necessidade de controle e oposição, não houve diferença entre os grupos. Os grupos de mulheres separadas pelo FSFI não demonstraram diferenças significativas. Conclusão Mulheres na pós-menopausa com menor escolaridade e características de personalidade que demonstre baixa necessidade afetiva e de organização possuem maior chance de apresentar disfunção sexual.

Percepções de mulheres acerca do climatério / Women's insights about the climacteric period / Percepciones de mujeres acerca del climaterio

Objetivo: Conhecer as percepções de mulheres acerca do climatério. Métodos: Pesquisa qualitativa com 18 mulheres que vivenciam o período do climatério, que pertencem a uma Estratégia em Saúde da Família de um município da região Sul do Brasil. Os dados foram coletados por meio de entrevista semiestruturada em setembro de 2016. A análise dos dados foi a partir da Análise de Conteúdo Temática de Minayo. Resultados: Os elementos emergidos das compreensões das mulheres acerca do climatério demonstram percepções voltadas à negatividade, ao envelhecimento do corpo, ao desequilíbrio emocional e à sintomatologia manifestada nesse período. Conclusão: Portanto, é preciso implementar medidas que ofereçam a essas mulheres um maior conhecimento e entendimento sobre o climatério, pois refletirá de maneira positiva, de modo que a mulher vivencie esse período com tranquilidade e qualidade de vida

Objective: To know the perceptions of women about climacteric. Methods: Qualitative research with 18 women living in the climacteric period, who belong to a Family Health Strategy of a municipality in the Southern region of Brazil. Data were collected through a semistructured interview in September 2016. Data analysis was based on the Minayo Thematic Content Analysis. Results: The emergence of women's understanding of climacteric shows perceptions of negativity, body aging, emotional imbalance, and symptomatology manifested during this period. Conclusion: Therefore, it is necessary to implement measures that offer these women a greater knowledge and understanding about the climacteric, as it will reflect in a positive way, allowing women to experience this period with tranquility and quality of life

Objetivo: Conocer las percepciones de las mujeres sobre la menopausia. Métodos: La investigación cualitativa con 18 mujeres que experimentan período de la perimenopausia, que pertenecen a una estrategia de salud em un municipio del sur de Brasil. Los datos fueron recolectados a través de entrevista semiestructurada en septiembre de 2016. El análisis de los datos fue a partir del análisis cualitativo de Minayo. Resultados: Los elementos surgieron la comprensión de las mujeres sobre la menopausia demostrar percepciones centradas en la negatividad, el cuerpo de envejecimiento, desequilibrio emocional y síntomas que se manifiestan en este periodo. Conclusión: Por lo tanto, es necesario poner en práctica medidas que brinden a estas mujeres un mayor conocimiento y comprensión del climaterio, como se refleja positivamente causando la mujer para experimentar este periodo de tranquilidad y calidad de vida

Abordagem sobre as alterações psicofísicas do climatério e menopausa: representações e significados na saúde da mulher / Approach on the psychophysical changes of climacteric and menopause: representations and meanings in women's health

Há muito a ser estudado e discutido com relação ao processo de amadurecimento e de envelhecimento, principalmente com relação às expectativas sociais, emocionais nos aspectos biopsicossociais, que formam o entorno desse processo; a reflexão sobre perdas e ganhos característicos das diferentes fases de vida pode ser bastante enriquecedora melhorando a qualidade de vida destas mulheres

Fatores associados à obesidade geral e ao percentual de gordura corporal em mulheres no climatério da cidade de São Paulo, Brasil / Factors associated with general obesity and the percentage of body fat of women during the menopause in the city of São Paulo, Brazil

Resumo Para verificar a associação entre obesidade e variáveis demográficas, clínicas e relacionadas ao estilo de vida em mulheres no climatério, foi realizado um estudo transversal com 469 mulheres de 40 a 65 anos em dois ambulatórios públicos da cidade de São Paulo. As variáveis dependentes foram: obesidade, segundo índice de massa corporal (IMC) e obesidade, segundo percentual de gordura corporal (%GC). A variável explanatória principal foi: fase do climatério (pré ou pós-menopausa); e as variáveis de controle foram: idade; anos de estudo; paridade; uso de terapia hormonal da menopausa; prática de atividade física e hábito de fumar. Realizou-se análise de regressão "glm" múltipla, utilizando para as análises o software Stata 9.2. Segundo o IMC, a obesidade associou-se positivamente, à paridade (RP = 1,62; IC 95% = 1,11-2,37) e, negativamente, aos anos de estudo (RP = 0,71; IC 95% = 0,55-0,91) e à prática de atividade física (RP = 0,45; IC 95% = 0,33-0,61). De acordo com o %GC, a obesidade associou-se positivamente à paridade (RP = 1,60; IC 95% = 1,03-2,49) e, negativamente, à prática de atividade física (RP = 0,43; IC 95% = 0,29-0,63). Enquanto a prática de atividade física foi um fator protetor, a multiparidade constituiu-se como fator de risco para a prevalência de obesidade no grupo de mulheres deste estudo.

Abstract To verify the association between obesity and demographic, clinical and lifestyle variables in climacteric women, a cross-sectional study was conducted in outpatient clinics, with 469 women aged 40 to 65 years in the city of São Paulo, Brazil. The dependent variables were: obesity according to body mass index (BMI) and obesity according to percentage of body fat (% BF). The main explanatory variable was: climacteric phase (pre or postmenopausal); and control variables were: age; years of formal study; parity; menopausal hormone therapy (MHT) use; physical activity practice and smoking habit. Multiple regression analysis was performed using the Stata 9.2 software. According to the BMI, obesity was positively associated with parity (RR = 1.62, 95% CI = 1.11-2.37) and, negatively, with years of formal study (RP = 0.71, CI 95% = 0.55-0.91) and with physical activity practice (PR = 0.45, 95% CI = 0.33-0.61). According to the % BF, obesity was positively associated with parity (PR = 1.60, 95% CI = 1.03-2.49) and negatively with physical activity practice (PR = 0.43; 95% CI = 0.29-0.63). While being active physically was protective, multiparity was a risk factor for developing obesity for women in this study.

Metabolic syndrome and sexual function in postmenopausal women

ABSTRACT Objective The purpose of this study was to evaluate whether female sexual dysfunction (FSD) is associated with metabolic syndrome (MS) and to identify factors that contribute to FSD in postmenopausal women. Subjects and methods This was a cross-sectional study in 111 sexually active women aged 45-65 years. We applied the Female Sexual Function Index (FSFI) to evaluate the participant’s sexual function and a structured questionnaire to collect demographic, socioeconomic, clinical, anthropometric, and laboratory data. Results The prevalences of MS and FSD were 68.5% and 70.3%, respectively. After logistic regression analysis, we identified the following variables associated with FSD: married status (prevalence ratio [PR] 1.69, 95% confidence interval [95% CI] 1.16-2.47, p < 0.01), 6-10 years elapsed since menopause (PR 1.60, 95% CI 1.22-2.09, p < 0.01), occurrence of climacteric symptoms (PR 1.01, 95% CI 1.00-1.02, p = 0.03), and history of sexual abuse (PR 1.40, 95% CI 1.12-1.73, p < 0.01). Conclusion We found a high prevalence of MS and FSD, but no association between both. Married status, time elapsed since menopause, climacteric symptoms, and history of sexual abuse emerged as factors associated with FSD on multivariate analysis.

Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms / Migrânea no período pós-menopausal se associa a maiores índices de alterações do humor, de incapacidade e de sintomas de menopausa

ABSTRACT Objective To assess the prevalence of headache in post-menopausal women. Methods Women attending gynecology outpatient services in the coastal region of the state of Sao Paulo, Brazil were invited to participate in this study. Only those with non-surgical menopause and no hormone replacement therapy were included. Prevalence and characterization of headaches were assessed, as well as the burden of migraine, traits of anxiety and depression, and menopausal symptomatology. Results One hundred and three women were included in the study. Migraine affected 14.7% of them. Some previous type of headache was reported by 86.2% of the women, most of whom improved during menopause but still presented with headache attacks. There was a correlation between higher migraine disability and depressive traits. Conclusions Many women believe that their headaches, particularly migraine, will end after menopause. This is, unfortunately, not the case for many of them.

RESUMO Objetivo Avaliar a prevalência de cefaleia em mulheres no período pós-menopausal. Métodos Mulheres atendidas em serviços de ginecologia na região costeira do estado de São Paulo, Brasil foram convidadas a participar deste estudo. Apenas mulheres com menopausa não-cirúrgica e sem terapia de reposição hormonal foram incluídas. Foram avaliados prevalência e características das cefaleias, incapacidade por enxaqueca, traços de ansiedade e depressão e sintomatologia menopausal. Resultados Centro e três mulheres foram incluídas neste estudo. Enxaqueca afetava 14,7% delas. Antecedente de algum tipo de dor de cabeça foi relatada por 86,2% das mulheres, a maioria das quais melhorou durante a menopausa, mas ainda apresentava crises. Houve correlação entre maior incapacidade por enxaqueca e traço depressivo. Conclusão Muitas mulheres acreditam que suas cefaleias, particularmente enxaqueca, terminarão quando começar a menopausa. Este, infelizmente, não é o caso para muitas delas.

Representações do corpo feminino na menopausa: estudo etnográfico em um hospital-escola brasileiro / Representaciones del cuerpo femenino en la menopausia: estudio etnográfico en un hospital-escuela brasileño / Representations of the female body in menopause: ethnographic study in a brazilian university hospital

Resumo: O pensamento científico sobre o corpo da mulher sofreu várias modificações no decorrer do tempo. Isto ocorre porque a biologia interage com a história e a cultura para produzir uma experiência única sobre a saúde. No caso específico da menopausa, ela deixou de ser entendida como uma ocorrência natural do processo de envelhecimento da mulher e passou a ser vista como uma doença que requer intervenção médica e farmacêutica. Este artigo analisa como esta nova perspectiva sobre a menopausa aparece no contexto de atendimento do Ambulatório de Menopausa do Centro de Atenção Integral à Saúde da Mulher - CAISM. Buscou-se em particular conhecer as narrativas das mulheres atendidas em função da menopausa e identificar a influência do modelo médico-científico vigente em tais narrativas. A análise se baseia em material coletado no hospital-escola durante o período de setembro de 2009 a outubro de 2010, abrangendo observações no Ambulatório de Menopausa e dos materiais informativos que lá são distribuídos, entrevistas com mulheres e profissionais de saúde, além do acompanhamento do grupo de apoio psicológico oferecido no local. São apresentadas evidências da construção do conhecimento médico-científico sobre a menopausa a partir de um padrão "masculino" de normalidade, que representa o corpo feminino como doente e inferior.

Resumen: El pensamiento científico sobre el cuerpo de la mujer sufrió varias modificaciones a lo largo del tiempo. Esto ocurre porque la biología interactúa con la historia y la cultura para producir una experiencia única sobre la salud. En el caso específico de la menopausia, la misma dejó de ser entendida como un evento natural del proceso de envejecimiento de la mujer y pasó a ser vista como una enfermedad que requiere intervención médica y farmacéutica. Este artículo analiza cómo esta nueva perspectiva sobre la menopausia aparece en el contexto de atención de la Clínica de Menopausia del Centro de Atención Integral a la Salude de la Mujer - CAISM. Se buscó conocer en particular las narrativas de las mujeres atendidas en función de la menopausia e identificar la influencia del modelo médico-científico vigente en tales narrativas. El análisis se basa en material recolectado en el hospital-escuela entre septiembre de 2009 y octubre de 2010 a partir de observaciones en la Clínica, materiales informativos allí distribuidos, entrevistas con mujeres y profesionales de la salud, y acompañamiento del grupo de apoyo psicológico allí ofrecido. Se presentan evidencias de la construcción del conocimiento médico-científico sobre la menopausia a partir de un patrón "masculino" de normalidad, que representa el cuerpo femenino como enfermo e inferior.

Abstract: Scientific thinking about the woman body has changed over time, as a result of the strong link between biology, history, and culture. In the specific case of menopause, its definition has moved from a natural occurrence of the aging process to a disease that needs medical and pharmaceutical intervention. This paper analyzes how this new perspective on menopause appears in the context of the Menopause Outpatient Facility at the Center for Women's Integral Care - CAISM. In particular, it explores the narratives of the women about menopause, and attempts to identify the role of the medical-scientific discourse on such narratives. The analysis is based on material collected at the university hospital between September 2009 and October 2010, including field observations, informative materials, interviews with women and health professionals, and participation in a psychologic support group. Evidence is provided that current medical knowledge constructs menopause from a standard of 'masculine' normalcy, and represents the female body as sick and in need of control.

Female aging / Envelhecimento feminino

SUMMARY Female aging is a process that involves hypoestrogenism time, the individual impact on each woman, and what we can do as experts to reduce morbidity and provide quality of life. This natural process in the female life cycle has been of concern to women after menopause. Changes in different biophysical and psychosocial aspects, and their individual experiences, have repercussions on the lives of patients seeking specialized and multidisciplinary support to reduce the harmful effects of prolonged hypoestrogenism. Overweight and obesity, inadequate living habits and the presence of multi-morbidities cause damage to the quality of life and impact the functional capacity. Behavioral prescription and hormone therapy are among the treatments given to ease symptoms and reduce morbidity. A better understanding of these factors can help identify groups that require more care after menopause.

RESUMO O envelhecimento feminino é um processo em que devemos correlacionar o tempo do hipoestrogenismo com o impacto individual em cada mulher e o que poderemos fazer, enquanto especialistas, para reduzir morbidades e proporcionar qualidade de vida. Esse processo natural no ciclo de vida da mulher tem sido motivo de preocupação das mulheres na pós-menopausa. As transformações nos diferentes aspectos biofísicos, psicossociais e em suas vivências individuais trazem repercussões na vida das pacientes, que buscam apoio especializado e multiprofissional para reduzir os efeitos deletérios do hipoestrogenismo prolongado. O sobrepeso e a obesidade, inadequados hábitos de vida e a presença de multimorbidades trazem prejuízos à qualidade de vida e impactam a capacidade funcional. A prescrição comportamental e a terapia hormonal são tratamentos indicados para amenizar os sintomas e reduzir morbidades. Assim, uma melhor compreensão desses fatores pode ajudar a identificar grupos propensos a cuidados na pós-menopausa.

A terapia aquática como coadjuvante na variação do humor em mulheres pós-menopáusicas / Aquatic Therapy Supporting the Variation of humor in women post menopausal women

Objetivo: Observar a influência de um programa de exercícios terapêuticos em piscina, nas sintomatologias menopáusica e depressiva em um grupo de mulheres na menopausa. Material e Métodos: Estudo de intervenção do tipo longitudinal, com abordagem quantitativa e medidas pré e pós-tratamento, em população de mulheres menopáusicas. Instrumentos de coleta de dados: Índice Menopausal de Blatt e Kuppermanne Escala de Depressão Geriátrica de Black & Yesavage. Osdados foram analisados utilizando-se o software Statiscal Package for the Social Sciences (SPSS) versão 16.0 para Windows, além do teste estatístico Wilcoxon e do teste de Correlação de Spearman. Resultados: No que diz respeito àsintomatologia menopáusica, observou-se Média (SD) antes de 11,73 (9,90) e depois da intervenção de 7,60 (5,60), com uma diferença significativa (z=-3,293; p=0,001) entre as medidas pré e pós-tratamento. Quanto aos sintomas de depressão, observou-se Média (SD) antes de 13,3 (5,5) e depois de 9,0 (5,9), houve diferença significativa (z=-2,003;p=0,045) entre as medidas pré e pós-tratamento, resultados confirmados pelo teste de Correlação de Spearman.Conclusão: Verificou-se que a hidroterapia proporciona benefícios físicos e funcionais, tais como alívio nas ondas de calor e melhoria no humor e na imagem corporal,aumentando a auto-estima feminina e diminuindo asintomatologia depressiva abundantemente encontrada nas mulheres menopáusicas.

Objective: To observe the influence of an aquatic therapeuticexercise program on menopausal symptoms and depressionin a group of menopausal women. Material and Methods:This was a longitudinal intervention study, with a quantitativeapproach and pre- and post-treatment measures in apopulation of menopausal women. Instruments for datacollection: Blatt and Kuppermann Menopausal Index and Black& Yesavage Geriatric Depression Scale. Data were analyzedusing the software Statistical Package for Social Sciences(SPSS) version 16.0 for Windows, in addition to Wilcoxonstatistical test and Spearman’s correlation test. Results: The mean (SD) of menopausal symptoms before and afterintervention was found to be 11.73 (9.90) and 7.60 (5.60),respectively, with a significant difference (z=-3.293; p=0.001) between pre- and post-treatment measures. For symptoms of depression, means (SD) of 13.3 (5.5) and 9.0 (5.9) were observed before and after intervention, with a significant difference (z=-2.003; p=0.045) between pre- and post treatment measures, confirmed by the Spearman correlationtest. Conclusion: Hydrotherapy was found to provide physicaland functional benefits, such as relief of heat waves and improvement in mood and body image, increasing female self esteem and reducing depression symptoms abundantly found in menopausal women.

Knowledge and attitude of primary care doctors towards management of postmenopausal symptoms

According to the current recommendations, women with post-menopausal symptoms should be managed. Knowledge and perception of primary care physicians towards management of postmenopausal symptoms are deficient. The aim of the present study was to explore knowledge and attitude of primary care doctors towards management of postmenopausal symptoms. This study is a cross-sectional survey that was conducted from October to December 2010 in the five health regions in Kuwait. Two centers were selected randomly from each health region. All physicians who were currently working in the selected centers were asked to participate in the study. Out of 209 physicians, 142 agreed to participate and completed a self-administered questionnaire. The study revealed that 82.4% of physicians had moderate knowledge about treatment options for postmenopausal symptoms, 88.0% discussed postmenopausal symptoms with their patients, and 45.1% of them either described or referred their patients for hormonal replacement therapy [HRT]. The correct answers regarding 10 statements related to the Women Health Initiative finding were ranging from 2.8% to 78.9% which indicated low level of knowledge. Regarding the effectiveness of hormonal replacement therapy in post menopausal women, the majority of the physicians agreed correctly that HRT is effective in prevention of osteoporosis [87.3%], treatment of vasomotor symptoms [83.7%], and treatment of vulvo-vaginal symptoms [82.4%]. There was a variation among physicians opinion about the effectiveness of certain treatment options for managing hot flushes in postmenopausal women. The results suggest that there is a lack of primary care physicians knowledge and confidence in recognizing signs and symptoms of menopause and in identifying and prescribing appropriate management

Síntomas climatéricos y calidad de vida de usuarias de consultorios de atención primaria de salud, Santiago / Lifestyles and quality of life of post menopausal women

Background: During menopause the quality of life of women can be seriously deteriorated and influenced by lifestyles. Aim: To assess the prevalence of menopausal symptoms and their relationship with lifestyles and quality of life. Material and Methods: The Menopause Rating Scale (MRS), a survey that measures menopausal symptoms and has questions related to lifestyles, was applied to 1023 women aged 54 ± 6years (range 45 to 64years), consulting in primary health care clinics. A multiple linear regression analysis was used to evaluate the association between menopausal symptoms and lifestyle. Results: Fifty six percent of women did not have a paid work, 64 percent were nonsmokers and 90 percent did not perform any physical exercise. The most frequent menopausal symptoms referred were muscle and joint ailments (85 percent) followed by mental and physical exhaustion (80 percent). Sedentary women, smokers or those who did not to have time for leisure activities showed worst quality of life scores. Conclusions: Postmenopausal women with unhealthy lifestyles had the lower quality of life scores and more menopausal symptoms.

Efficacy of self - care practices on promoting quality of life of diabetic women with menopausal symptoms

This study aims to assess the efficacy of Self - care practices on promoting quality of life of diabetic women with menopausal symptoms. A quasi - experimental design was used. The study was carried out in diabetic clinics of Maternity Hospital and Ain Shams University Hospital, affiliated to Ain Shams University. A purposive sample included 130 diabetic women with the age above 40 years, visiting the diabetic clinic over a period of three months. Tools: 1] An interviewing questionnaire sheet [pre / post tests] to determine women's knowledge about Self - care practices during menopause, 2] Menopausal symptoms assessment sheet [pre / post tests] and 3] An observation check list [pre / post tests], to assess women's practical skills regarding to self care. There are statistically significant differences between women's knowledge and practices in pre / post tests added to significant reduction in the menopausal symptoms disturbances in post test, which reveals women's QOL improvement. Acquisition of self - care practices through training intervention were helpful in promoting QOL for diabetic women with menopausal symptoms. Training sessions about self care practices during menopause should be generalized for the diabetic women. Further studies are required to study the effect of menopausal symptoms on the women's activities of daily living

Menopausal and post-menopausal women of health status at Assiut Governorate

According to the WHO increase in life - expectancy and aging associated problems are increased, in developing countries 5 to 8% of the population arc postmenopausal women [WHO 1996]. The aim of this study is to assess menopausal and postmenopausal women health status in Assiut Governorate. A descriptive study was conducted; the target population was four hundred postmenopausal women, 220 from urban [Assiut city] and 180 women from rural [El-Asara and Mosha village].During the period from first March 2009 to the end of August 2009, Data was collected through home visits by using an interview questionnaire sheet developed by the investigator. . It includes three parts. First part includes socio demographic characteristics [age, residence, education, occupation, marital status, and income]. Second Part includes Physical characteristics, [height, weight, blood pressure, elimination, nutritional habits, teeth, sleeping hours and daily activities]. Third Part includes Health characteristics; [periodic check-up, health problems, exposure to accident some physiological changes related to age].The results reveled that the mean age of the studied sample at menopause was 45.9+3.7.The most common symptoms hot flushes [61%] and insomnia [51%].About Three quarter [76%] percent of women had health problems, the most common were hypertension [36.5] and diabetes [20.5%]. The percentage of agreement was statistically significant higher among women of post- menopause more than 60 years p<0.05. In .conclusion most of postmenopausal women were suffering from hot flushes and insomnia with menopause and had health problems .The present study recommended Increase the awareness of women regarding menopausal changes through mass media, educational programs in postmenopausal clinics

[Survey on sexual satisfaction situation and some of affecting agents in postmenopausal women]

Menopause is defined as the ability of fertility to infertility and has a significant role in personality, social and cultural aspects. Menopause has a special situation in reproductive health. One of the problems during the menopause period is decreasing of sexual desire or sexual satisfaction. Sexual aspects of postmenopausal women can promote their health and quality of life. This study was conducted to determine affecting agents on sexual satisfaction of postmenopausal women referring to healthcare clinics affiliated to Shahid Beheshti University of Medical Sciences in Tehran in 2007. In this descriptive study 270 menopause women were selected by convenience sampling method. A questionnaire was used for data collection comprising of two parts: demographic and sexual satisfaction questions. Mean age of menopause women was 52.49 +/- 4.93 years. A desirable sexual satisfaction rate was 58.9% and 66.3% had undesirable sexual satisfaction. Sexual desire dimension was associated with womens' job [P<0.05]. Sexual excitation dimension was associated with primary and intermediate education of postmenopausal women, intermediate husband's education and spouse; free job. Sexual orgasm and relaxation after coitus was associated with unmasturbation and sexual activity of their women. Total sexual satisfaction rate was associated with age of menopause [P< 0.01], primary and intermediate education of postmenopausal women [P< 0.05], primary and intermediate education of spouse and satisfaction rate from sexual activity [P< 0.01]. Although postmenopausal stage is associated with decreased level of sexual hormones and drive intimate relationship with spouse, increasing education level leading to increasing knowledge and adaptation with menopause, can elevate sexual satisfaction

Factors Influencing the Severity of Menopause Symptoms in Korean Post-menopausal Women

We have relatively limited knowledge of symptomatic aspects of the postmenopause, rather than perimenopause. We tried to determine the factors associated with experiencing menopausal symptoms by Korean postmenopausal women. A total of 657 Korean women who underwent a natural menopause completed multiple questionnaires, which included questions regarding their attitudes to menopause, depressive symptoms, state anxiety, self-esteem, dyadic relationships, sociodemographic variables, and 11-item Menopause Rating Scale (MRS). Multiple regression analyses were performed to collectively examine the relative impact of each independent variable on the quality of life, as determined by the MRS. Decreased severity of menopausal symptoms was associated with more time spent in education, an employed status, a history of pregnancy, longer postmenopausal duration, positive attitudes to menopause, higher state anxiety, heightened self-esteem, and higher dyadic consensus. Increased severity of menopausal symptoms was also associated with absence of a partner, alcohol consumption, a history of hormone replacement therapy, a history of probable premenstrual dysphoric disorder, and increased severity of depressive symptoms. Sociodemographic characteristics, lifestyle factors, premenstrual dysphoric disorder, attitudes to menopause, a dyadic relationship with a partner, and the inner psychological status can be associated with the severity of menopause symptoms specifically in Korean postmenopausal women.