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2.
Epidemiol. serv. saúde ; 31(1): e2021502, 2022. tab
Article in English, Portuguese | LILACS | ID: biblio-1375385

ABSTRACT

Objetivo: Descrever os medicamentos prescritos para o tratamento hormonal do processo transexualizador em estabelecimentos de saúde de atendimento especializado para pessoas transexuais e travestis no Rio Grande do Sul, Brasil. Métodos: Estudo descritivo, com coleta de dados nesses estabelecimentos, no período maio-setembro/2020, utilizando-se instrumento elaborado pelos(as) pesquisadores(as). Obtiveram-se dados sobre o perfil de usuários(as) e características do cuidado farmacológico de tratamento hormonal. Resultados: A pesquisa contemplou todos os sete serviços do estado. Para mulheres transexuais e travestis, medicamentos antiandrogênicos e espironolactona foram prescritos em todos os serviços. Apenas um estabelecimento não prescreveu ciproterona. Todos os estabelecimentos de saúde realizaram prescrição de medicamentos a base de estrógenos, com diferenças na via de administração; para homens transexuais, todos prescreveram andrógenos por via intramuscular. Conclusão: A pesquisa aponta os medicamentos prescritos e sua diversidade, ratificando a necessidade da produção de informação para implementação das políticas de equidade no Sistema Único de Saúde.


Objetivo: Describir los medicamentos prescritos para el tratamiento hormonal en establecimientos de salud que brindan atención especializada a transexuales y travestis en Rio Grande do Sul, Brasil. Métodos: Estudio descriptivo, con recolección de datos en los establecimientos, entre mayo y septiembre de 2020, utilizando el instrumento desarrollado por los investigadores. Se obtuvieron datos sobre el perfil de usuarios (as) y características del cuidado farmacológico de tratamiento hormonal. Resultados: La encuesta abarcó los siete servicios estatales. Para las mujeres transgénero y travestis se prescribieron antiandrógenos y espironolactona en todos los servicios. Sólo un establecimiento no prescribió ciproterona. Todos los establecimientos de salud prescribieron medicamentos a base de estrógenos con diferencias en la vía de administración. Para los hombres transgénero, todos los andrógenos se recetan por vía intramuscular. Conclusión: La investigación destaca la diversidad de medicamentos prescritos, ratificando la necesidad de producir información para la implementación de políticas de equidad en el Sistema de Salud Brasileño.


Objective: To describe the drugs prescribed for hormone treatment as part of the transsexualization process in health facilities providing specialized care for transsexual and transvestite persons in the state of Rio Grande do Sul, Brazil. Methods: This was a descriptive study based on data collected in health facilities between May and September 2020 using the instrument developed by the researchers. Results: The survey covered all seven services in the state. Antiandrogen drugs and spironolactone were prescribed for transsexuals and transvestites women in all services. Only one service did not prescribe cyproterone. All health facilities prescribed estrogen-based drugs, although with differences in the route of administration. In the case of transsexuals men, all services prescribed androgens to be administered via the intramuscular route. Conclusion: The study indicates which drugs are prescribed and their diversity, ratifying the need to produce information for the implementation of equity policies in the Brazilian National Health System.


Subject(s)
Humans , Male , Female , Transsexualism , Hormone Replacement Therapy/statistics & numerical data , Sexual and Gender Minorities , Brazil , Epidemiology, Descriptive , Medication Therapy Management , Hormones
3.
repert. med. cir ; 31(1): 58-62, 2022. tab.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1366993

ABSTRACT

Objetivo: establecer la efectividad de la acupuntura en el control de los síntomas de la menopausia. Materiales y métodos:se seleccionaron menopaúsicas sanas entre 48 y 57 años que presentaban síntomas relacionados con la menopausia que no recibían terapia hormonal. El tratamiento consistió en 24 sesiones de acupuntura y se evaluó la intensidad de los síntomas con el puntaje del índice de Kupperman antes de iniciar y a las 4 y 8 semanas después de iniciadas las sesiones de acupuntura. Resultados: en 50 menopáusicas con edad promedio de 53,4 +/- 3,2 años después de 4 y 8 semanas de tratamiento no se observaron diferencias estadísticamente significativas en la intensidad de calorones, sudoración, trastorno del sueño, depresión, vértigo, cefalea, artralgia, palpitaciones, debilidad y síntomas vaginales (p = ns). El valor promedio de índice de Kupperman inicial fue de 30,6 +/- 4,7 puntos, el cual aumentó a 32,1 +/- 5,6 puntos a las cuatro semanas para luego alcanzar un valor de 31,1 +/- 4,8 puntos a las 8 semanas. No se demostraron diferencias significativas en los valores promedio de la escala a las 4 (p = 0,150) y 8 semanas (p = 0,596). Conclusión: la acupuntura no es efectiva para controlar los síntomas causados por la menopausia, por lo que no es una alternativa de la terapia de reemplazo hormonal.


Objective: to establish the effectiveness of acupuncture in controlling menopause symptoms. Materials and Methods: healthy menopausal women aged 48 to 57 years, experiencing menopause-related symptoms, not receiving hormone therapy, were selected. The treatment consisted of 24 acupuncture sessions evaluating symptoms severity using the Kupperman index score before initiation of therapy and at 4 and 8 weeks after undergoing acupuncture therapy. Results: no statistically significantdifferences were observed in 50 menopausal women with mean age of 53.4 +/- 3.2 years after 4 and 8 weeks undergoing acupuncture therapy regarding the severity of hot flashes, sweating, sleep disorder, depression, vertigo, headache, arthralgia, palpitations, weakness and vaginal symptoms (p = ns). The mean initial Kupperman index score was 30.6 +/- 4.7, which increased to 32.1 +/- 5.6 at four weeks and then reached a value of 31.1 +/- 4.8 at 8 weeks. No significant differences were demonstrated in the mean scale values at 4 (p = 0.150) and 8 weeks (p = 0.596). Conclusion: acupuncture is not effective in controlling symptoms caused by menopause, so it is not an alternative to hormone replacement therapy.


Subject(s)
Humans , Female , Middle Aged , Menopause , Acupuncture , Signs and Symptoms , Hormone Replacement Therapy , Methods
7.
Rev. enferm. UFSM ; 12: e41, 2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1392219

ABSTRACT

Objetivo: identificar o conhecimento e as condutas de enfermeiras na Atenção Primária à Saúde sobre climatério e menopausa. Método: estudo descritivo exploratório, de abordagem qualitativa, realizado junto a 15 enfermeiras do município de Pesqueira, Pernambuco, Brasil. Os dados foram coletados por meio de entrevista semiestruturada e analisados pelo método de Bardin. Resultados: foi identificado conhecimento limitado em relação a definição de climatério, menopausa e de sinais e sintomas característicos, como também referente à terapia de reposição hormonal vaginal. A captação destas mulheres para as consultas de enfermagem se dava por demanda espontânea e ao realizar exame do colpocitopatológico. Conclusão: o conhecimento acerca do climatério é limitado nas práticas das enfermeiras na abordagem às mulheres que estão passando por esta fase. Na busca de minimizar as lacunas relacionadas ao desconhecimento profissional, é relevante a continuidade de estudos sobre a assistência a esse público.


Objective: to identify the knowledge and conduct of nurses who work in Primary Health Care about climacteric and menopause. Method: descriptive, exploratory study, of qualitative approach, carried out with 15 nurses from the municipality of Pesqueira, Pernambuco, Brazil. Data were collected through semi-structured interviews and analyzed using the Bardin method. Results: limited knowledge was identified regarding the definition of climacteric, menopause and characteristic signs and symptoms, as well as the vaginal hormone replacement therapy. The recruitment of these women for nurse consultations happened by spontaneous demand and when performing the colpocytopathological examination. Conclusion: knowledge about climacteric is limited in nurses' practices in addressing women who are going through this stage. In order to minimize the gaps related to professional ignorance, it is relevant to continue studies on assistance to this public.


Objetivo: identificar el conocimiento y la conducta de los enfermeros de la Atención Primaria de Salud sobre el climaterio y la menopausia. Método: estudio descriptivo exploratorio, con abordaje cualitativo, realizado con 15 enfermeros del municipio de Pesqueira, Pernambuco, Brasil. Los datos fueron recolectados a través de entrevistas semiestructuradas y analizados utilizando el método de Bardin. Resultados: se identificó conocimiento limitado sobre la definición de climaterio, menopausia y signos y síntomas característicos, así como sobre la terapia de reemplazo hormonal vaginal. Estas mujeres fueron reclutadas para consultas de enfermería por demanda espontánea y mediante la realización de una prueba de Papanicolaou. Conclusión: el conocimiento sobre el climaterio es limitado en las prácticas de enfermería en el abordaje de mujeres que pasan por esta fase. En la búsqueda de minimizar las lagunas relacionadas con el desconocimiento profesional, es importante continuar los estudios sobre la atención a este público.


Subject(s)
Humans , Primary Health Care , Climacteric , Women's Health , Hormone Replacement Therapy , Nursing Care
8.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(3): 01022105, Jul-Set 2021.
Article in Portuguese | LILACS | ID: biblio-1370030

ABSTRACT

RESUMO Introdução: O climatério corresponde ao período de transição entre a etapa reprodutiva e a não reprodutiva, onde há a menopausa caracterizada pela ausência de menstruação por 12 meses consecutivos, resultante da perda da atividade folicular ovariana. A Terapia de Reposição Hormonal (TRH) pode ser uma opção de tratamento com o intuito de melhorar as condições de saúde da mulher. O objetivo, deste estudo, foi investigar o perfil de idosas e sintomas climatéricos, além da utilização da TRH por mulheres em uma cidade do Sul de Santa Catarina. Métodos: Estudo epidemiológico com delineamento transversal quantitativo utilizando-se questionário para coleta de dados que ocorreu entre julho a setembro de 2017 e analisados no EpiInfo®. Resultados: Foram entrevistadas 107 idosas, média de idade 69,7 (± 8,9) anos. Das entrevistadas, 52,3% relataram algum sintoma climatérico, sendo mais frequente o fogacho. Pequena parcela das entrevistadas fez uso de TRH (15,9%), obtendo-se benefícios com a utilização. Destas, maioria foi administração via oral (88,2%), sendo que 35,3% usaram por mais de cinco anos, 82,4% relataram alguma reação adversa, sendo citada a mastalgia e o ganho de peso, e 64,7% realizavam consulta médica semestral. Somente 8,4% fizeram uso de chás, sendo a Amora Branca (Morus alba L) a mais citada. Conclusões: O esquema de TRH prescrito mais frequente foi a associação de estrógenos e progestógenos para administração por via oral, com acompanhamento médico semestral e obtendo-se resultados favoráveis. Medidas não farmacológicas foram adotadas por minoria das mulheres, adotando-se essencialmente o uso de planta medicinal na forma de chá. PALAVRA-CHAVE: Climatério, menopausa, terapia de reposição hormonal, saúde da mulher


ABSTRACT Introduction: The climacteric corresponds to the transition period between the reproductive and non-reproductive stages, where there is the menopause, characterized by the absence of menstruation for 12 consecutive months, resulting from the loss of ovarian follicular activity. Hormone Replacement Therapy (HRT) can be a treatment option with the aim of improving women's health conditions. The aim of this study was to investigate the profile of elderly women and climacteric symptoms, as well as the use of HRT by women in a city in southern Santa Catarina. Methods: Epidemiological study with a quantitative cross-sectional design using a questionnaire for data collection that was answered between July and September 2017 and analyzed in EpiInfo®. Results: 107 elderly women were interviewed, mean age 69.7 (± 8.9) years. Of the interviewees, 52.3% reported some climacteric symptom, with hot flashes being more frequent. A small portion of the interviewees used HRT (15.9%), obtaining benefits from its use. Of these, most were administered orally (88.2%), and 35.3% used it for more than five years, 82.4% reported some adverse reaction, mentioning breast tenderness and weight gain, and 64.7% had medical consultations every six months. Only 8.4% made use of teas, with the white blackberry (Morus alba L) being the most mentioned. Conclusions: The most frequent prescribed HRT regimen was the combination of estrogens and progestins for oral administration, with medical follow-up every six months and obtaining favorable results. Non-pharmacological measures were adopted by a minority of women, essentially adopting the use of medicinal plants in the form of tea. KEYWORDS: Climacteric, menopause, hormone replacement therapy, women's health


Subject(s)
Humans , Female , Climacteric , Menopause , Women's Health , Hormone Replacement Therapy
9.
Revagog ; 3(3): 88-103, Jul-Sept. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344264

ABSTRACT

Describe los planteamientos sobre el beneficio de la terapia de reemplazo hormonal en las mujeres en la menopausia y el riesgo de contraer cáncer de mama con el uso prolongado del mismo.


Subject(s)
Humans , Female , Menopause/drug effects , Hormone Replacement Therapy/adverse effects , Estradiol/adverse effects , Breast Neoplasms/prevention & control , Cardiovascular Diseases/prevention & control , Osteoporosis, Postmenopausal/prevention & control , Hormone Replacement Therapy/classification
10.
Revagog ; 3(3): 104-110, Jul-Sept. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344331

ABSTRACT

El climaterio es una etapa fisiológica que permite al médico reconocer tempranamente los riesgos de patologías y la gran oportunidad de revertirlas. Este trabajo examinará la evidencia actual de la terapia hormonal en la prevención primaria de la enfermedad cardiovascular en mujeres, así como la importancia que igualmente tienen la indemnidad de los ovarios, el peso normal, el uso correcto de antibióticos, la preservación de la microbiota intestinal, las dietas antioxidantes, los estilos de vida saludables y el obligatorio abandono del hábito de fumar.


Subject(s)
Humans , Female , Climacteric/physiology , Menopause/physiology , Cardiovascular Diseases/prevention & control , Hormone Replacement Therapy , Heart Disease Risk Factors , Smoking/adverse effects , Andropause/physiology , Estradiol/therapeutic use , Atherosclerosis/prevention & control , Gastrointestinal Microbiome/drug effects , Healthy Lifestyle
11.
Revagog ; 3(3): 78-79, Jul-Sept. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1343840

ABSTRACT

La pandemia de coronavirus-2 (SARS-CoV-2) relacionada con el SARS 2019-2020 ha traído desafíos sin precedentes a los sectores de la salud en todo el mundo. Hasta noviembre de 2020, ha habido más de 64 millones de casos confirmados y se acercan a 2 millones de muertes en todo el mundo. A pesar de la gran cantidad de casos positivos, existen muy pocos estándares establecidos de atención y opciones terapéuticas disponibles. Hasta la fecha, (Diciembre 2020) todavía no existe una vacuna aprobada por la Administración de Alimentos y Medicamentos (FDA) para COVID-19, aunque existen varias ensayos clínicos en diferentes. etapas de desarrollo. En este documento, hemos realizado una revisión global que evalúa los roles de la edad y el sexo en las hospitalizaciones por COVID-19, las admisiones a la UCI, las muertes en hospitales y las muertes en hogares de ancianos. Hemos identificado una tendencia en la que las personas mayores y los pacientes masculinos se ven afectados significativamente por los resultados adversos.


Subject(s)
Humans , Female , Middle Aged , Aged , Gonadal Steroid Hormones/pharmacology , Hormone Replacement Therapy , SARS-CoV-2 , COVID-19/mortality , Estrogens , Gender Role , COVID-19/drug therapy
12.
Int. j. cardiovasc. sci. (Impr.) ; 34(4): 486-489, July-Aug. 2021. tab, graf
Article in English | LILACS | ID: biblio-1286836

ABSTRACT

Abstract Swyer syndrome is one of the disorders of sexual differentiation. Previous studies have demonstrated increased sympathetic activity with heart rate variability (HRV) analysis with decreasing estradiol levels. One patient presented a pure 46, XY gonadal dysgenesis with female phenotype. Cardiac autonomic modulation was assessed through HRV analysis while at rest. This research analyzed linear and nonlinear indexes. HRV analysis showed reduced parasympathetic and global modulation with an apparent increase in sympathetic tone and a loss of HR fractal dynamics toward correlated behavior, characterized by low entropy and high determinism of time series.


Subject(s)
Humans , Female , Middle Aged , Cardiovascular Diseases/complications , Gonadal Dysgenesis, 46,XY/complications , Progestins/therapeutic use , Linear Models , Nonlinear Dynamics , Hormone Replacement Therapy , Estrogens/therapeutic use
13.
Rev. argent. cir. plást ; 27(2): 82-85, 20210000. fig, graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1357889

ABSTRACT

El síndrome genitourinario de la menopausia se refiere a los signos y síntomas relacionados a la disminución estrogénica dando como resultado una atrofia vaginal, esto ocasiona un gran impacto negativo en las actividades cotidianas de las mujeres, existen varios tratamientos para aliviar y resolver los síntomas, siendo los más frecuentes la incontinencia urinaria por esfuerzo y resequedad vaginal. Dentro de los distintos tratamientos, el láser tiene como objetivo la restauración de la mucosa vaginal, estimulando los fibroblastos para obtener la neo colagenogenesis y vascularización, recuperando su funcionalidad y obteniendo mejoría de los síntomas junto con la calidad de vida de las pacientes


Genitourinary syndrome of menopause refers to a group of signs and symptoms related to the decreased estrogen and as a result, the vaginal atrophy, this has a great negative impact on the daily activities of women, there are several treatments to alleviate and resolve the symptoms, the most frequent being stress urinary incontinence and vaginal dryness. Among the different treatments, the laser aims to restore the aavaginal mucosa, stimulating fibroblasts to obtain neo-collagen oogenesis and revascularization, recovering their functionality and obtaining an improvement in symptoms along with the quality of life of patients


Subject(s)
Humans , Female , Middle Aged , Atrophy , Urogenital System , Menopause , Cross-Sectional Studies , Retrospective Studies , Hormone Replacement Therapy/methods , Estrogens , Lasers, Gas/therapeutic use , Treatment Adherence and Compliance
14.
Revagog (Impresa) ; 3(2): 62-63, Abr-Jun. 2021. graf.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344619

ABSTRACT

El hematometra es la retención de sangre en el útero y comúnmente se presenta en mujeres jóvenes con anomalías mullerianas pero puede aparecer también en mujeres postmenopausicas por causas secundarias como traumas, tumores, terapia de remplazo hormonal, estenosis cervical, entre otras. En esta presentación de caso interesante se describe una mujer postmenopáusica bajo terapia de remplazo hormonal. Dicha mujer inicia con hemorragia uterina anormal por lo que se le realiza ultrasonido evidenciando hematómetra y hematocervix. Como método diagnóstico y terapéutico de la hemorragia postmenopáusica se le realiza histerectomía abdominal en la cual la patología evidencia leiomiomatosis uterina con endometrio secretor


Hematometra is the retention of blood in the uterus and commonly occurs in young women with Mullerian abnormalities but can also appear in postmenopausal women due to secondary causes such as trauma, tumors, hormone replacement therapy, cervical stenosis, among others. In this presentation an interesting case is described a postmenopausal woman under hormone replacement therapy. She said woman began with abnormal uterine bleeding, so an ultrasound was performed showing hematometer and hematocervix. As a method diagnosis and treatment of postmenopausal hemorrhage, abdominal hysterectomy is performed in which the pathology shows uterine leiomyomatosis with secretory endometrium


Subject(s)
Humans , Female , Middle Aged , Uterine Hemorrhage/diagnostic imaging , Menopause/drug effects , Misoprostol/pharmacology , Hormone Replacement Therapy/adverse effects , Hematometra/diagnosis , Leiomyomatosis/complications , Leiomyomatosis/drug therapy , Hysterectomy/methods
15.
Revagog (Impresa) ; 3(2): 60-61, Abr-Jun. 2021.
Article in Spanish | LILACS, LIGCSA | ID: biblio-1344618

ABSTRACT

Más de nueve millones de sobrevivientes de cáncer de mama en todo el mundo sufren un deterioro en la calidad de vida atribuible a los síntomas de la menopausia relacionados con el déficit de los estrógenos y con los efectos secundarios de la terapia contra el cáncer. La terapia de reemplazo hormonal (TRH) es muy eficaz para controlar estos síntomas en la población general y en las sobrevivientes de cáncer de mama. Sin embargo, la preocupación de la recurrencia del cáncer de mama como resultado del uso de TRH impide que muchos oncólogos utilicen este enfoque en el tratamiento de los síntomas menopáusicos. La evidencia de ensayos aleatorizados, estudios observacionales y meta-nálisis sobre el impacto del uso de TRH en la recurrencia y supervivencia del cáncer de mama sigue siendo controvertida.


More than nine million breast cancer survivors in everyone suffers a deterioration in the quality of life attributable to the symptoms of menopause related to the deficiency of the estrogens and with the side effects of anti-estrogen therapy Cancer. Hormone replacement therapy (HRT) is very effective in controlling these symptoms in the general population and in survivors of breast cancer. However, the concern of recurrence of breast cancer as a result of the use of HRT prevents many oncologists use this approach in the treatment of menopausal symptoms. Evidence from randomized trials, observational studies, and meta-analysis on the impact of the use of HRT on recurrence and Breast cancer survival remains controversial


Subject(s)
Humans , Female , Breast Neoplasms/etiology , Menopause/drug effects , Estrogen Replacement Therapy/adverse effects , Hormone Replacement Therapy/adverse effects , Survivors , Estrogens/pharmacology , Life Style
17.
Cuad. Hosp. Clín ; 62(1): 63-71, jun. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1284353

ABSTRACT

La enfermedad de Addison es una patología endocrinológica ocasionada por la disminución en la secreción de hormonas esteroideas por parte de la corteza adrenal; debida a múltiples etiologías (más comúnmente la tuberculosis en países en vías de desarrollo); con una evolución lenta, insidiosa y progresiva. Pudiendo llegar a una insuficiencia adrenal aguda, misma que puede llegar a ser de extrema gravedad; y en caso de no ser diagnosticada y tratada adecuadamente puede llevar a la muerte. El tratamiento primordial lo constituye la terapia hormonal sustitutiva con fármacos corticoesteroideos.


Addison's disease is an endocrinological pathology caused by the decrease in the secretion of steroid hormones by the adrenal cortex, due to multiple etiologies (most commonly tuberculosis in developing countries); with a slow, insidious and progressive evolution. Being able to reach an acute adrenal insufficiency, which can become extremely serious, and if it is not diagnosed and treated properly, it can lead to death. The primary treatment is hormone replacement therapy with corticosteroid drugs


Subject(s)
Humans , Female , Adult , Addison Disease , Adrenal Cortex Hormones , Adrenal Insufficiency , Tuberculosis , Hormone Replacement Therapy , Hormones , Hypothyroidism
18.
Arch. endocrinol. metab. (Online) ; 65(2): 212-230, Mar.-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1248814

ABSTRACT

ABSTRACT Hypopituitarism is a disorder characterized by insufficient secretion of one or more pituitary hormones. New etiologies of hypopituitarism have been recently described, including head trauma, cerebral hemorrhage, and drug-induced hypophysitis. The investigation of patients with these new disorders, in addition to advances in diagnosis and treatment of hypopituitarism, has increased the prevalence of this condition. Pituitary hormone deficiencies can induce significant clinical changes with consequent increased morbidity and mortality rates, while hormone replacement based on current guidelines protects these patients. In this review, we will first discuss the different etiologies of hypopituitarism and then address one by one the clinical aspects, diagnostic evaluation, and therapeutic options for deficiencies of TSH, ACTH, gonadotropin, and GH. Finally, we will detail the hormonal interactions that occur during replacement of pituitary hormones.


Subject(s)
Humans , Endocrinology , Hypopituitarism/etiology , Hypopituitarism/drug therapy , Pituitary Hormones , Brazil , Hormone Replacement Therapy
19.
Rev. chil. obstet. ginecol. (En línea) ; 86(2): 217-227, abr. 2021. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388639

ABSTRACT

El objetivo de este manuscrito es realizar una revisión y actualización de la literatura de la insuficiencia ovárica primaria (IOP) en población adolescente, a partir del diagnóstico, manejo y seguimiento de un caso clínico. La insuficiencia ovárica primaria se define como la menopausia en una mujer antes de los 40 años, acompañada de amenorrea, hipogonadismo hipergonadotrópico e infertilidad. Su prevalencia varía entre 1 a 2%, y en mujeres menores de 20 años su prevalencia es un caso de cada 10,000. Aunque se sabe que muchas afecciones pueden llevar a una IOP, la más común es la causa idiopática. La presentación clínica es diversa, y varios trastornos diferentes pueden también, llevar a esta condición. CASO CLÍNICO: Se presenta el caso de una adolescente de 17 años, previamente sana, con historia de amenorrea secundaria, no embarazada, con examen físico general y ginecológico normal. Se solicita estudio analítico complementario resultando con niveles de hormona folículo estimulante (FHS), estradiol (E2) y hormona antimülleriana (AMH) compatibles con una insuficiencia ovárica como la observada en la posmenopausia. Se inicia terapia hormonal (TH) clásica con estradiol y progesterona, siendo posteriormente reemplazada por anticoncepción hormonal combinada (AHC) oral, coincidente con el inicio de vida sexual, con respuesta favorable y sangrados regulares. La IOP tiene graves consecuencias para la salud incluyendo trastornos psicológicos como angustia, síntomas depresivos o depresión, infertilidad, osteoporosis, trastornos autoinmunes, cardiopatía isquémica, y un mayor riesgo de mortalidad. La enfermedad de Hashimoto es el trastorno autoinmune más frecuente asociado a la IOP. Su tratamiento y diagnóstico deben establecerse de forma precoz para evitar consecuencias a largo plazo. La terapia con estrógenos es la base del tratamiento para eliminar los síntomas de la deficiencia de estrógenos, además de evitar las consecuencias futuras del hipogonadismo no tratado. También el manejo debe incluir los siguientes dominios: fertilidad y anticoncepción, salud ósea, problemas cardiovasculares, función psicosexual, psicológica y neurológica, informando a los familiares y a la paciente sobre la dimensión real de la IOP y la necesidad de tratamiento multidisciplinario en muchos casos. CONCLUSIÓN: El caso presentado, pese a ser infrecuente, permite abordar de manera sistematizada el diagnostico de IOP y evaluar alternativas de manejo plausibles para evitar graves consecuencias en la salud, así como conocer respuesta clínica y de satisfacción de la adolescente.


The objective of this manuscript is to review and update the literature on primary ovarian insufficiency (POI) in an adolescent population, based on the diagnosis, management and follow-up of a clinical case. Primary ovarian insufficiency is defined as menopause in a woman before the age of 40, accompanied by amenorrhea, hypergonadotropic hypogonadism, and infertility. Its prevalence varies between 1 to 2%, and in women under 20 years of age its prevalence is one case in every 10,000. Although it is known that many conditions can lead to POI, the most common is the idiopathic cause. The clinical presentation is diverse, and several different disorders can also lead to this condition. CLINICAL CASE: The case of a 17-year-old adolescent, previously healthy, with a history of secondary amenorrhea, not pregnant, with a normal general physical and gynecological examination is presented. A complementary analytical study is requested, resulting in levels of follicle stimulating hormone (FHS), estradiol (E2) and anti-müllerian hormone (AMH) compatible with ovarian insufficiency such as that observed in postmenopause. Classic hormonal therapy (HT) with estradiol and progesterone was started, later being replaced by combined hormonal contraception (CHC), coinciding with the beginning of sexual life, with a favorable response and regular bleeding. POI has serious health consequences including psychological disorders such as distress, depressive symptoms or depression, infertility, osteoporosis, autoimmune disorders, ischemic heart disease, and an increased risk of mortality. Hashimoto's disease is the most common autoimmune disorder associated with POI. Its treatment and diagnosis must be established early to avoid long-term consequences. Estrogen therapy is the mainstay of treatment to eliminate the symptoms of estrogen deficiency, in addition to avoiding the future consequences of untreated hypogonadism. Management should also include the following domains: fertility and contraception, bone health, cardiovascular problems, psychosexual, psychological and neurological function, informing family members and the patient about the real dimension of POI and the need for multidisciplinary treatment in many cases. CONCLUSION: The case, although infrequent, allows a systematic approach to the diagnosis of POI and evaluate plausible management alternatives to avoid serious health consequences, as well as to know the clinical response and satisfaction of the adolescent.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Primary Ovarian Insufficiency/diagnosis , Primary Ovarian Insufficiency/drug therapy , Menopause, Premature , Hormone Replacement Therapy , Estradiol/analysis , Anti-Mullerian Hormone/analysis , Amenorrhea/etiology , Follicle Stimulating Hormone/analysis , Infertility, Female
20.
Rev. Méd. Paraná ; 79(1): 14-18, 2021.
Article in Portuguese | LILACS | ID: biblio-1282384

ABSTRACT

Climatério é período de transição hormonal da mulher, com manifestações genitais e extragenitais que requerem ou não tratamento. Este estudo transversal analisou o conhecimento básico de mulheres de Curitiba-PR entre 45 e 60 anos sobre terapia de reposição hormonal através de questionário autoaplicado. Das 623 mulheres participantes a minoria fez ou fazia uso da terapia de reposição hormonal, sendo sintomas prevalentes dessa fase fogachos, distúrbio do sono, alteração do humor e diminuição da libido. Mais de 80% delas acreditavam que terapia de reposição hormonal pode melhorar qualidade de vida. No entanto, muitas disseram ter medo de iniciar esse tipo de tratamento. Maioria das entrevistadas foram orientadas sobre a menopausa, porém apenas uma parte delas foi instruída sobre benefícios e riscos da terapia. Esses dados corroboram a premissa de que ainda faltam orientações e medidas voltadas para o cuidado integral das mulheres no climatério


The climateric is a biological transition phase of the woman's life, being accompanied by genital and extra-genital manifestations whose symptons may, or may not, require treatment. The present transversal study intends to analyze the basic knowledge of the women between 45 and 60 years old about the hormone replacement therapy through a self-administered questionnaire. It has been observed that only few women have used or use hormone replacement therapy and that the most prevalent symptoms on this phase are hot flushes, sleep disturbance, mood changes and decreased libido. More than 80% of the interviewees believe that the hormone replacement therapy can improve life quality. However, many reported being afraid to initiate such treatment. The majority of the interviewees have been previously oriented about the menopause, but only a part of them have been warned about the benefits and risks of the said therapy. These data corroborate the premise that there is a lack of guidance and measures aimed at the integral care of women in the climateric


Subject(s)
Humans , Female , Middle Aged , Quality of Life , Climacteric , Menopause , Hot Flashes , Hormone Replacement Therapy , Knowledge , Libido
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