Exosomas como tratamiento alternativo del síndrome genitourinario de la menopausia / Exosomes as an alternative treatment for genitourinary syndrome of menopause

Objetivo: Evaluar el efecto de los exosomas como tratamiento alternativo en la restauración del síndrome genitourinario de la menopausia en pacientes que acuden a una consulta ginecológica, en Valencia, Estado Carabobo, en el período junio - agosto de 2023. Métodos: Estudio prospectivo, descriptivo, exploratorio, incluyó tres casos de mujeres con diagnóstico de síndrome genitourinario de la menopausia. Se evaluó la respuesta en cuanto a los síntomas, examen clínico según el índice de salud vaginal, la satisfacción con el tratamiento y la tolerabilidad. Se aplicó el tratamiento con exosomas: 2 cc con técnica de punto a punto en todas las paredes vaginales y 1 cc en el vestíbulo, en 3 sesiones, con intervalo de 15 días. Resultados: La edad de las pacientes estuvo entre 53 y 56 años, con un promedio de tiempo de menopausia de 6,6 años. Previo al tratamiento, había un nivel alto de irritación vaginal (100 %), dolor en el introito (100 %), sequedad vaginal, dispareunia, hipersensibilidad y las no relaciones sexuales (66,67 %). Postratamiento predominó la ausencia de los síntomas: sequedad vaginal, dispareunia, hipersensibilidad y dolor en introito (100 %); irritación vaginal y no relaciones sexuales (66,67 %) (p = 0,0001). La mediana del índice de salud vaginal previa fue 13 (10 ­ 13) y posterior fue 18 (17 ­ 20) (p = 0,0476). La satisfacción y tolerabilidad fue de 66,67 %. Una paciente refirió dolor leve. Conclusión: La terapia con exosomas es eficaz para reducir los síntomas y signos del síndrome genitourinario de la menopausia, y bien tolerado(AU)

Objective: To evaluate the effect of exosomes as an alternative treatment in the restoration of genitourinary syndrome of menopause in patients attending a gynecological consultation in Valencia, Carabobo State, in the period June - August 2023. Methods: A prospective, descriptive, exploratory study included three cases of women diagnosed with genitourinary syndrome of menopause. Response was assessed in terms of symptoms, clinical examination according to vaginal health index, satisfaction with treatment and tolerability. Treatment with exosomes was applied: 2 cc with point-to-point technique on all vaginal walls and 1 cc in the vestibule, in 3 sessions, with an interval of 15 days. Results: The age of the patients was between 53 and 56 years, with a mean menopause time of 6.6 years. Prior to treatment, there was a high level of vaginal irritation (100%), pain in the introitus (100%), vaginal dryness, dyspareunia, hypersensitivity and non-sexual intercourse (66.67%). Post-treatment, the absence of symptoms predominated: vaginal dryness, dyspareunia, hypersensitivity and pain in the introitus (100%); vaginal irritation and no sexual intercourse (66.67%) (p = 0.0001). The median index of previous vaginal health was 13 (10 ­ 13) and subsequent was 18 (17 ­ 20) (p = 0.0476). Satisfaction and tolerability was 66.67%. One patient reported mild pain. Conclusion: Exosome therapy is effective in reducing the symptoms and signs of genitourinary syndrome of menopause, and well tolerated(AU)

Función sexual y síndrome climatérico en mujeres de 45 a 64 años / Sexual function and climacteric syndrome in women from 45 to 64 years old

Objetivo: Analizar la función sexual y el síndrome climatérico en mujeres de 45 a 64 años residentes de la Región de Ñuble. Métodos: Se realizó un muestreo no probabilístico a conveniencia con 251 mujeres. Se utilizaron dos instrumentos, Menopause Rating Scale y Female Sexual Function Index. El análisis estadístico incluyó pruebas descriptivas, ANOVA y correlación de Pearson. Resultados: El grupo etario más frecuente fue de 45 a 49 años. En síntomas climatéricos, se destacan molestias moderadas en lo somático. La función sexual evaluada por la escala Female Sexual Function Index, muestra variabilidad. La correlación entre Menopause Rating Scale y Female Sexual Function Index indica que un mayor puntaje en el primero se relaciona con menor función sexual. Conclusiones: Existe una prevalencia significativa de síntomas climatéricos en mujeres, con molestias moderadas en lo somático y leves en lo psicológico y urogenital. Variabilidad en la función sexual; puntajes más altos en dolor y más bajos en lubricación y orgasmo. Existe una correlación inversa entre las escalas Menopause Rating Scale y el Female Sexual Function Index(AU)

Objective: To analyze sexual function and climacteric syndrome in women aged 45 to 64 years residing in the Ñuble Region. Methods: A non-probabilistic convenience sampling was carried out with 251 women. Two instruments were used, Menopause Rating Scale and Female Sexual Function Index. Statistical analysis included descriptive tests, ANOVA and Pearson correlation. Results: The most common age group was 45 to 49 years. In climacteric symptoms, moderate somatic discomfort stands out. Sexual function, assessed by the Female Sexual Function Index scale, shows variability. The correlation between Menopause Rating Scale and Female Sexual Function Index indicates that a higher Menopause Rating Scale score is related to lower sexual function. Conclusions: There is a significant prevalence of climacteric symptoms in women, with moderate somatic discomfort and mild psychological and urogenital discomfort. Variability in sexual function; higher scores on pain and lower on lubrication and orgasm. There is an inverse correlation between the Menopause Rating Scale and Female Sexual Function Index scales(AU)

Cobertura de MRS e indicación de terapia hormonal en Pedro Aguirre Cerda, septiembre de 2019 / MRS coverage and hormone replacement therapy indication at Pedro Aguirre Cerda, September 2019

Introducción: El envejecimiento de la población en todo el mundo es un fenómeno progresivo y Chile no se queda atrás frente a esto. Actualmente existe un subprograma de climaterio mujeres entre los 45 a 64 años, que presenta diversas acciones y propósitos. Objetivo: Describir la cobertura de la aplicación de la Menopause Rating Scale (MRS) e indicación de terapia de reemplazo hormonal en mujeres inscritas en los CESFAM de la comuna de Pedro Aguirre Cerda. Método: Descriptivo transversal. Resultados: La cobertura de aplicación de MRS en mujeres entre 45-64 años fue de un 62,6%. Un 34,3% de mujeres presentaron un puntaje MRS alterado, indicándose terapia hormonal en un 37,8% de los casos, en las indicaciones un 21,8% eran usuarias candidatas acorde a criterios médicos y un 78,2% no lo eran. Conclusiones: Se debe aumentar la cobertura de MRS y recursos para exámenes de laboratorio, de imágenes y capacitaciones, esto para mejorar la entrega de las prestaciones en el subprograma climaterio.

Introduction: The aging of the population worldwide is a progressive phenomenon and Chile is not lagging behind in this. Currently, there is a climacteric subprogram for women between 45 and 64 years of age, which has various actions and purposes. Objective: To describe the coverage of the application of the Menopause Rating Scale (MRS) and indication of hormone replacement therapy in women enrolled in the CESFAM of the commune of Pedro Aguirre Cerda. Method: Cross-sectional descriptive study. Results: The coverage of the MRS application in women between 45-64 years old was 62.6%. A 34.3% of women presented an altered MRS score, indicating hormone therapy in 37.8% of the cases, 21.8% of the indications were candidates according to medical criteria and 78.2% were not. Conclusions: There is a lack of labs and images tests in the climacteric controls, resulting in a mayor number of women no candidates to the hormonal therapy according to medical criteria.

Scale development and validation of perimenopausal women disability index in the workplace

BACKGROUND@#Menopausal disorders include obscure symptomatology that greatly reduce work productivity among female workers. Quantifying the impact of menopause-related symptoms on work productivity is very difficult because no such guidelines exist to date. We aimed to develop a scale of overall health status for working women in the perimenopausal period.@*METHODS@#In September, 2021, we conducted an Internet web survey which included 3,645 female workers aged 45-56 years in perimenopausal period. We asked the participants to answer 76 items relevant to menopausal symptomatology, that were created for this study and performed exploratory and confirmatory factor analyses for the scale development. Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis were used to verify the developed scale.@*RESULTS@#Approximately 85% participants did not have menstruation or disrupted cycles. Explanatory factor analysis using the maximum likelihood method and Promax rotation identified 21 items with a four-factor structure: psychological symptoms (8 items, α = 0.96); physiological symptoms (6 items, alpha = 0.87); sleep difficulty (4 items, alpha = 0.92); human relationship (3 items, alpha = 0.92). Confirmatory factor analyses found excellent model fit for the four-factor model (RMSR = 0.079; TLI = 0.929; CFI = 0.938). Criterion and concurrent validity were confirmed with high correlation coefficients between each of the four factors, previously validated menopausal symptom questionnaire, and Copenhagen Burnout Inventory scales, respectively (all ps < 0.0001). The developed scale was able to predict absenteeism with 78% sensitivity, 58% specificity, and an AUC of 0.727 (95%CI: 0.696-0.757). Higher scores of each factor as well as total score of the scale were more likely to be associated with work absence experience due to menopause-related symptoms even after adjusting for Copenhagen Burnout Inventory subscales (all ps < 0.0001).@*CONCLUSION@#We found that the developed scale has high validity and reliability and could be a significant indicator of absenteeism for working women in perimenopausal period.

Influência da menopausa, idade, etnia e do sexo sobre as lipoproteínas e suas subfrações nas três fases da vida (adolescentes, adultos e idosos) / Influence of menopause, age, ethnicity and sex on lipoproteins and their subfractions in the three stages of life (adolescents, adults and the elderly)

Introdução: A prevalência de doenças cardiovasculares tem crescido em todo o mundo. Além da hipercolesterolemia, fatores como o envelhecimento, menopausa, diferenças no metabolismo do colesterol entre homens e mulheres e entre etnias, provavelmente contribuem para as prevalências dessas doenças. Objetivo: Avaliar a influência da menopausa, da idade (adolescentes, adultos e idosos), do sexo e da etnia sobre as subfrações lipoproteicas aterogênicas. Métodos: Trata-se de um estudo transversal, de base populacional e amostra probabilística de residentes da cidade de São Paulo. Foram utilizados dados de participantes "ISA-CAPITAL 2015" que tiveram coleta de dados bioquímicos. Foram realizadas análises de partículas de LDL e HDL respectivamente, em 827 amostras. O tamanho das partículas de LDL e HDL foi determinado pelo sistema Lipoprint® System (Quantimetrix Corporation. Todos os testes estatísticos foram realizados com o auxílio do programa SPSS 16. Foi considerado significativo p<0,05. Resultados: As análises com adolescentes mostraram que as meninas apesar de possuírem maior IMC, CC e concentração de TG, apresentaram melhor perfil de subfrações de LDL (LDL grande% 17,8; LDL pequena% 1,7) do que os meninos (LDL grande% 13,5; LDL pequena% 3,4) p<0,001 e p=0,002, respectivamente. Entre os indivíduos adultos, foi identificado um perfil mais aterogênico entre homens, com maior percentual de LDL pequena, quando comparados às mulheres (4,9% vs 2,7%; p<0,001, respectivamente). Com relação à população idosa, os resultados demonstraram que apesar do avanço da idade, as idosas quando comparadas aos idosos possuíam maior concentração LDL grande (32,5mg/dL vs 28,5mg/dL; p=0,007 respectivamente). As mulheres idosas tiveram uma piora das subfrações lipoproteicas se comparadas com as mulheres adultas (razão de LDL mg/dL=12,3 mulheres adultas vs 10,7 mulheres idosas; p=0,002) se aproximando ao perfil mais aterogênico encontrado entre os homens (razão de LDLmg/dL=9,9 homens adultos vs 9,0 homens idosos; p=0,027). Entretanto, quando pareadas por homens de mesma idade, as mulheres idosas, ainda assim, demonstraram um perfil menos aterogênico do que os homens idosos (razão de LDL mg/dL=10,7 mulheres idosas vs 9,0 homens idosos; p=0,001). Ao analisar a presença de menopausa, foi identificado que as mulheres no período pós menopausa tiveram piora do perfil lipídico clássico com aumento do IMC (p=0,025), CC (p<0,001), glicose (p<0,001), PAS (p<0,001), PAD (p=0,005) e TG (p<0,001), assim como tiveram piora do perfil lipoproteico com diminuição de LDL grande% quando comparadas com as mulheres no período pré menopausa (17,6% vs 14,6%; p=0,001). Quanto à etnia, foi identificado que os indivíduos brancos apresentaram valores maiores para IMC (p=0,005), CC (p=0,001), glicose (p=0,015) e TG (p=0,010). Após ajustes para etnia, idade e IMC, houve associação positiva com HDL grande (=0,122; R2=0,013; p=0,001), demonstrando maior aterogenicidade entre os indivíduos brancos. Conclusão: Em todas as faixas etárias o sexo feminino apresentou perfil menos aterogênico quando comparado ao masculino. A presença de menopausa e da etnia branca demonstrou um perfil lipídico clássico e lipoproteico mais aterogênico.

Introduction: The prevalence of cardiovascular diseases has increased throughout the world. In addition to hypercholesterolemia, factors such as aging, menopause, differences in cholesterol metabolism between men and women and between ethnicities probably contribute to the prevalence of these diseases. Objective: To evaluate the influence of menopause, age (adolescents, adults and elderly), sex and ethnicity on atherogenic lipoprotein subfractions. Methods: This is a cross-sectional, population-based study with a probabilistic sample of residents of the city of São Paulo. Data from "ISA-CAPITAL 2015" participants who had biochemical data collected were used. LDL and HDL particle analyzes were carried out respectively in 827 samples. The size of LDL and HDL particles was determined using the Lipoprint® System (Quantimetrix Corporation. All statistical tests were performed with the aid of the SPSS 16 program. Was considered significant p<0.05. Results: Analyzes with adolescents showed that girls, despite having higher BMI, WC and TG concentration, presented a better profile of LDL subfractions (LDL large% 17.8; LDL small% 1.7) than boys (LDL large% 13.5; LDL small% 3.4) p<0.001 and p=0.002, respectively. Among adult individuals, a more atherogenic profile was identified among men, with a higher percentage of LDL small, when compared to women (4.9% vs 2.7%; p<0.001, respectively). Regarding the elderly population, the results demonstrated that despite advancing age, elderly women, when compared to elderly men, had a higher large LDL concentration (32.5mg/dL vs 28.5mg/dL; p=0.007 respectively). Elderly women had a worsening of lipoprotein subfractions compared to adult women (LDL ratio mg/dL=12.3 adult women vs 10.7 elderly women; p=0.002) approaching the more atherogenic profile found among men (LDLmg/dL ratio=9.9 adult men vs 9.0 elderly men; p=0.027). However, when paired with men of the same age, elderly women still demonstrated a less atherogenic profile than elderly men (LDL ratio mg/dL=10.7 elderly women vs 9.0 elderly men; p=0.001). When analyzing the presence of menopause, it was identified that women in the postmenopausal period had a worsening of the classic lipid profile with an increase in BMI (p=0.025), WC (p<0.001), glucose (p<0.001), SBP (p< 0.001), DBP (p=0.005) and TG (p<0.001), as well as a worsening of the lipoprotein profile with a reduction in LDL large when compared to women in the premenopausal period (17.6% vs 14.6%; p=0.001). Regarding ethnicity, it was identified that white individuals presented higher values for BMI (p=0.005), WC (p=0.001), glucose (p=0.015) and TG (p=0.010). After adjustments for ethnicity, age and BMI, there was a positive association with HDL large (=0.122; R2=0.013; p=0.001), demonstrating greater atherogenicity among white individuals. Conclusion: In all age groups, females presented a less atherogenic profile when compared to males. The presence of menopause and white ethnicity demonstrated a more atherogenic classic lipid and lipoprotein profile.

Laser therapy for genitourinary syndrome of menopause: systematic review and meta-analysis of randomized controlled trial

Abstract Objective: This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM). Data sources: Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction. Studies selection: RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy. Data collection: Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author. Data synthesis: Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=−0.85; 95% CI=−1.59 to −0.10), dryness (MD=−0.62; 95% CI=−1.12 to −0.12) and burning (MD= −0.64; 95% CI=−1.28 to −0.01) decreased. No serious adverse effects were reported. Conclusion: CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.

Prevalencia y caracterización de las disfunciones sexuales en mujeres en transición a la menopausia / Prevalence and characterization of sexual dysfunctions in women in transition to menopause

Objetivo: Caracterizar las disfunciones sexuales y estimar la prevalencia en un grupo de mujeres en transición a la menopausia, así como evaluar la frecuencia de la sintomatología climatérica. Método: Estudio de corte transversal, entre 2017 y 2020, que incluyó 411 mujeres en transición a la menopausia, residentes en el Quindío, con pareja estable y actividad sexual en las últimas 6 semanas. Se utilizó como instrumento el FSFI-6 (6-Item Female Sexual Function Index). Resultados: La edad promedio fue de 46,53 ± 2,87 años. La prevalencia de disfunciones sexuales fue del 38,92%, caracterizadas por dificultades con el deseo sexual (38,92%), seguido de dolor/dispareunia (35,52%). El promedio general en la puntuación del FSFI-6, en la totalidad de la población participante, fue de 22,29 ± 0,84 puntos; en la población afectada (< 19 puntos) fue de 15,78 ± 3,94. En los dominios, la puntuación más baja estuvo en el deseo (3,14 ± 0,56). La mediana de disfunciones sexuales por mujer fue de tres (23,84%). Conclusiones: más de un tercio de las mujeres del Quindío en transición a la menopausia presentan disfunciones sexuales; el trastorno más común fue el bajo deseo. Se deben hacer esfuerzos para aumentar la conciencia en los asuntos de salud sexual.

Objective: To characterize sexual dysfunctions and estimate the prevalence in a group of women in transition to menopause, as well as to evaluate the frequency of climacteric symptoms. Method: Cross-sectional study, between 2017 and 2020, included 411 women in transition to menopause, residents of Quindío, with a stable partner and sexual activity in the last 6 weeks. The FSFI-6 (6-Item Female Sexual Function Index) was used as an instrument. Results: The mean age was 46.53 ± 2.87 years. The prevalence of sexual dysfunctions was 38.92%, characterized by difficulties with sexual desire (38.92%), followed by pain/dyspareunia (35.52%). The general average, in the FSFI-6 score, in the entire participating population, was 22.29 ± 0.84 points; while in the affected population (< 19 points), it was 15.78 ± 3.94. In the domains, the lowest score was in desire (3.14 ± 0.56). The median number of sexual dysfunctions per woman was three (present in 23.84%). Conclusions: This study showed that more than one third of the women in Quindío, in transition to menopause, had sexual dysfunctions; the most common type of disorder was low desire. Efforts should be made to increase awareness about sexual health issues.

La relación entre la transición a la menopausia y los trastornos del estado de ánimo / The relationship between menopause transition and mood disorders

Este estudio tuvo como objetivo examinar la relación entre la transición a la menopausia y los trastornos del estado de ánimo, específicamente la ansiedad y la depresión. Se llevó a cabo una revisión narrativa de la literatura relevante sobre la transición a la menopausia y los trastornos del estado de ánimo. Se revisaron estudios que se enfocaron en el impacto de los cambios hormonales durante la menopausia en el bienestar psicológico y se evaluaron diversas opciones de tratamiento para los trastornos del estado de ánimo. La disminución de los niveles hormonales de estrógenos y progesterona durante la menopausia puede llevar a diversos cambios psicológicos, como ansiedad y depresión. La terapia hormonal con estrógenos solo o en combinación con progesterona puede mejorar los síntomas depresivos en mujeres en la menopausia, pero este tratamiento no está exento de riesgos. Otros tratamientos no hormonales, como la terapia cognitivo-conductual, el ejercicio y una buena higiene del sueño, también pueden ser efectivos para manejar los trastornos del estado de ánimo. Se concluyó que existe una compleja interacción entre factores hormonales, biológicos y psicosociales para desarrollar intervenciones efectivas que mejoren el bienestar psicológico de las mujeres en la menopausia.

This study aimed to examine the relationship between menopause transition and mood disorders, specifically anxiety and depression. The authors conducted a narrative review of relevant literature on menopause transition and mood disorders. They reviewed studies that focused on the impact of hormonal changes during menopause on psychological well-being and evaluated various treatment options for mood disorders. The decline in estrogen and progesterone hormone levels during menopause can lead to various psychological changes, such as anxiety and depression. Hormonal therapy with estrogen alone or in combination with progesterone can improve depressive symptoms in menopausal women, but this treatment is not without risks. Other non-hormonal treatments, such as cognitive-behavioral therapy, exercise, and good sleep hygiene, can also be effective in managing mood disorders. The study highlights the need for recognition of the complex interplay between hormonal, biological, and psychosocial factors in developing effective interventions to improve the psychological well-being of menopausal women. Further research is needed to fully understand the potential relationship between menopause transition and mood disorders.

Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis / Incidência e resultados associados ao estado da menopausa em pacientes com COVID-19: Uma revisão sistemática e metanálise

Abstract Objective Menopause causes several changes in the body that may affect the response to COVID-19. We aimed to investigate the possible association between menopausal status and incidence and outcomes in COVID-19 patients. Methods Combinations of keywordsCOVID-19, menopause, and estrogen were used to search the PubMed, Embase, Web-of-Science, and Scopus databases for articles reporting the incidence and outcomes of COVID-19 (discharge, length-of-admission, intensive care, or mortality) in premenopausal women, available through December 29, 2022. Data from studies comparing the incidence of COVID-19 infection with the age-matched male population were pooled and meta-analyzed using a random-effects model. Results Overall, 1,564 studies were retrieved, of which 12 were finally included in the systematic review to compare disease outcomes, and 6 were meta-analyzed for the incidence of COVID-19 in premenopausal and postmenopausal women. All studies reported better COVID-19-associated outcomes in premenopausal women compared with postmenopausal women. After adjusting for confounding factors, three studies found better outcomes in postmenopausal women, and two found no association between menopausal status and COVID-19 outcomes. Our meta-analysis found a higher incidence of COVID-19 infection among premenopausal women than postmenopausal women, when compared with age-matched men (odds ratio = 1.270; 95% confidence interval: 1.086-1.486; p= 0.003). Conclusion The incidence of COVID-19 was significantly higher in premenopausal women than in postmenopausal women when compared with age-matched men. Although premenopausal women may have more favorable COVID-19-associated outcomes, the presumed preventive effect of estrogens on the incidence and related outcomes of COVID-19 in premenopausal women cannot be proven at present. Further longitudinal studies comparing pre- and post-menopausal women are required to provide further insight into this matter.

Resumo Objetivo A menopausa causa diversas alterações no corpo que podem afetar a resposta ao COVID-19. Nosso objetivo foi investigar a possível associação entre o status da menopausa e a incidência e os resultados em pacientes com COVID-19. Métodos Combinações de palavras-chave COVID-19, menopausa e estrogênio foram usadas para pesquisar os bancos de dados PubMed, Embase, Web-of-Science e Scopus para artigos relatando a incidência e os resultados do COVID-19 (alta, tempo de internação, tratamento intensivo cuidados ou mortalidade) em mulheres na pré-menopausa, disponível até 29 de dezembro de 2022. Dados de estudos comparando a incidência de infecção por COVID-19 com a população masculina da mesma idade foram agrupados e meta-analisados usando um modelo de efeitos aleatórios. Resultados No geral, 1.564 estudos foram recuperados, dos quais 12 foram finalmente incluídos na revisão sistemática para comparar os resultados da doença e 6 foram meta-analisados para a incidência de COVID-19 em mulheres na pré e pós-menopausa. Todos os estudos relataram melhores resultados associados ao COVID-19 em mulheres na pré-menopausa em comparação com mulheres na pós-menopausa. Após o ajuste para fatores de confusão, três estudos encontraram melhores resultados em mulheres na pós-menopausa e dois não encontraram associação entre o status da menopausa e os resultados do COVID-19. Nossa meta-análise encontrou uma maior incidência de infecção por COVID-19 entre mulheres na pré-menopausa do que mulheres na pós-menopausa, quando comparadas com homens da mesma idade (odds ratio = 1,270; intervalo de confiança de 95%: 1,086-1,486; p = 0,003). Conclusão A incidência de COVID-19 foi significativamente maior em mulheres na pré-menopausa do que em mulheres na pós-menopausa quando comparadas com homens da mesma idade. Embora as mulheres na pré-menopausa possam ter resultados mais favoráveis associados ao COVID-19, o efeito preventivo presumido dos estrogênios na incidência e nos resultados relacionados ao COVID-19 em mulheres na pré-menopausa não pode ser comprovado no momento. Mas estudos longitudinais comparando mulheres pré e pós-menopausa são necessários para fornecer mais informações sobre este assunto.

Confiabilidad de cuestionarios electrónicos para evaluar calidad de vida y actitudes hacia la vejez en mujeres de 40 a 69 años / Reliability of electronic questionnaires to evaluate quality of life and attitudes towards old age in women aged 40 to 69 years

Introducción: el uso de cuestionarios electrónicos se ha convertido en algo común, sin embargo, depende de diversos factores (como la edad y las habilidades digitales), por lo que es necesario determinar la confiabilidad de estos instrumentos para su aplicación. Objetivo: determinar la concordancia y reproducibilidad de los cuestionarios Calidad de vida breve de la OMS (WHOQoL-B) y Actitudes autoevaluadas hacia la vejez (AAV) en formato electrónico para su aplicación vía remota a mujeres de edad madura y adulta mayor. Metodología: se realizó un estudio instrumental con el método test-retest con 35 mujeres (40-69 años). Se transfirieron ambos cuestionarios a un formulario de Google y se enviaron vía WhatsAppen dos ocasiones, con una diferencia mayor a 15 días entre la aplicación. Se calcularon los parámetros de confiabilidad por estabilidad temporal y concordancia estadística. Resultados: el WHOQoL-B obtuvo a y CCI = 0.880 y r = 0.785 en la calificación total; para sus dimensiones a > 0.740 y r > 0.590. La calificación total del AAV mostró a y CCI = 0.708 y r = 0.552 y sus dimensiones a > 0.710 y r de 0.295 a 0.508. Conclusiones: los cuestionarios WHOQoL-B y AAV en formato electrónico pueden ser utilizados para aplicación vía remota, aunque el AAV es menos consistente...(AU)

Abstract Introduction: The electronic tests have been used on a regular basis, although their use depends on several factors such as age and digital ability, therefore it is necessary to determine the confidence of these instruments for their application. Objective: To determine the agreement and reproducibility of the WHO Quality of Life-Bref (WHOQoL-B) and the Self-Assessed Attitudes Towards Old Age (SATO) questionnaires in electronic format for application in middle-aged and older women. Methods: An instrumental study with a test-retest method was carried out with 35 women (40-69 years). Both questionnaires were transferred to a Google form and sent to the women by WhatsApp twice with a difference of more than 15 days between applications. We calculate the confidence by temporal stability and the statistical agreement. Results: For the WHOQoL-B, an a and ICC= 0.880, and r = 0.785 were obtained in the total rating; for their dimensions the result for a was > 0.740, and r > 0.590. The total rating of SATO shows an a and ICC= 0.708, and r = 0.552; for their dimensions, the a was > 0.710, and r from 0.295 to 0.508. Conclusions: The electronic tests WHOQoL and SATO can be used for remote application, although SATO is less consistent.

Nutrição no climatério: quais os benefícios? Revisão integrativa / Nutrition in Menopause: What are the Benefits? An Integrative Review / Nutrición en el Climaterio: ¿Cuáles son los Beneficios? Una Revisión Integradora

Introdução:A menopausa é uma fase transitória entre o período reprodutivo para o período não fértil na vida da mulher, sendo dividido em três períodos: pré-menopausa, perimenopausa e pós-menopausa, podendo durar de 12 meses a 03 anos. Anutrição e a alimentação possuem um importante papel durante esse período, visando evitar ou minimizar problemas como: osteoporose, constipação, desidratação, hipertensão, ansiedade, diminuição da libido, depressão, alterações no sono, dores nas articulações e ganho de peso. Objetivo:Descrever os possíveis benefícios relacionados à nutrição durante o climatérioMetodologia:Revisão da literatura que utilizou as bases de dados Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed) e Scientific Electronic Library Online (Scielo), por meio dos Descritores em Ciência da Saúde (DeCS) "Diet", "Climacteric" combinados com o operador booleano AND. Nossa pesquisa considerou estudos originais publicados nos últimos cinco anos, tanto de acesso livre quanto restrito, sem restrição de idioma. Excluímos revisões, duplicatas e artigos não relacionados ao tema. Encontramos um total de 122 artigos com os descritores utilizados e selecionamos 19 para a amostra desta revisão. Resultados:Observou-se uma perda de peso significativa entreas mulheres no climatério, assim como ondas de calor em decorrência dos sintomas da menopausa. A compulsão alimentar dos grupos randomizados mostrou-se baixa bem como a pressão arterial. Pode-se constatar, ainda, que o IMC dessas mulheres apresentou declínio e os sintomas relacionados à depressão igualmente registraram uma redução. Conclusões:A intervenção nutricional no climatério resultou em benefícios significativos, incluindo perda de peso, redução dos sintomas da menopausa, melhora da saúde cardiovascular, diminuição do IMC e alívio dos sintomas relacionados à depressão. Esses resultados destacam a importância da nutrição como uma abordagem eficaz para melhorar a qualidade de vida das mulheres nessa fase de transição (AU).

Introduction:Menopause is a transitional phase between the reproductive and the non-fertile periods of women, divided into pre-menopause, perimenopause and post-menopause, lasting from 12 months to 3 years. Nutritionand diet play a relevant role, aiming to avoid or minimize problems such as osteoporosis, constipation, dehydration, hypertension, anxiety, decreased libido, depression, changes in the sleep cycle, joint pain, and weight gain. Objective:Describing the possible benefits related to nutrition during menopause. Methodology:AThis paper presents a literature review that used the Virtual Health Library (VHL), National Library of Medicine (PubMed) and Scientific Electronic Library Online (Scielo) databases, through the Health Science Descriptors (DeCS) "Diet", "Climacteric" combined with the Boolean operator AND. The research considered original studies published in the last five years, both of open and restricted access, without restrictions for languages. Reviews, duplicates and articles unrelated to the topic were excluded. A total of 122 articles were found using these descriptors, and 19 were selected for the sample of this review. Results:Significant weight loss was observed among climacteric women, as well as hot flashes due to menopausal vasomotor symptoms. Binge eating in the randomized groups was low, as was blood pressure. It was also observed that the BMI of these women showed a decline and symptoms related to depression were also reduced. Conclusions:A nutritional intervention during menopause resulted in significant benefits, including weight loss, reduced symptoms, improved cardiovascular health, decreased BMI, and relief of symptoms related to depression. The importance of nutrition is highlighted as an effective approach to improve the quality of life of women in this transition phase (AU).

Introducción: La menopausia es una fase transitoria entre el período reproductivo y el período no fértil en la vida de la mujer, siendo dividido en tres fases: premenopausia, perimenopausia y posmenopausia, pudiendo durar de 12 meses a 03 años. La nutrición y la alimentación tienen un importante papel durante este período, buscando evitar o minimizar problemas como: osteoporosis, estreñimiento, deshidratación, hipertensión, ansiedad, disminución de la libido, depresión, cambios en el sueño, dolor en las articulaciones y aumento de peso. Objetivo: Describir los posibles beneficios relacionados con la nutrición durante el climaterioMetodología: Revisión de la literatura que utilizó las bases de datos Biblioteca Virtual en Salud (BVS), National Library of Medicine (PubMed) y Scientific Electronic Library Online (Scielo), por medio de los descriptores en Ciencia de la Salud (DeCS) "Diet", "Climacteric" combinados con el operador booleano AND. Nuestra investigación consideró estudios originales publicados en los últimos cinco años, tanto de acceso libre como restringido, sin limitación de idiomas. Excluimos revisiones, duplicados y artículos no relacionados con el tema. Encontramos un total de 122 artículos con los descriptores utilizados y seleccionamos 19 para la muestra de esta revisión. Resultados: Se observó una pérdida de peso significativa entre las mujeres en el climaterio, al igual que una reducción de loscalores súbitos como consecuencia de los síntomas de la menopausia. La compulsión alimentaria de los grupos aleatorizados demostró ser baja, así como la presión arterial. Se puede constatar, además, que el IMC de esas mujeres presentó una disminución y los síntomas relacionados a la depresión igualmente registraron una reducción. Conclusiones: La intervención nutricional en el climaterio ocasionó beneficios significativos, incluyendo pérdida de peso, reducción de los síntomas de la menopausia, mejora de la salud cardiovascular, disminución del IMC y alivio de los síntomas relacionados con la depresión. Estos resultados resaltan la importancia de la nutrición como un enfoque efectivo para mejorar la calidad de vida de las mujeres en esta fase de transición (AU).

Time - sensitive effects of Zhuang medicated thread moxibustion on estrogen level in female perimenopausal model rats / Efectos sensibles al tiempo de la moxibustión con hilo medicado de Zhuang sobre el nivel de estrógeno en ratas modelo perimenopáusicas hembras

The present study was conducted to ascertain the estrogenic effect of Zhuang Medicated Thread Moxibustion (ZMTM) and explore its time - sensitive impact on estradiol (E2) in female perimenopausal rats. 40 female rats were randomized into four gr oups: the control, model, ZMTM, and acupuncture groups. The perimenopausal syndrome was induced in the last three groups with a daily subcutaneous dose of 80 mg/kg of 4 - vinylcyclohexene diepoxide for 15 days. Afterward, rats in the model and control group s were fed routinely, while rats in the ZMTM and acupuncture groups were treated with six ZMTM and acupuncture courses, respectively. Results of the study suggested that following the six courses of treatment, the E2 level in the model group was significan tly the lowest, while the regular group was the highest (P < 0.05). There was also a gradual increase in the E2 level of the ZMTM group compared to the model and acupuncture groups, e.g. after the 5th and 6th courses of treatment, their E2 level was signif icantly higher than the model and acupuncture groups. The ZMTM group was better than the model and acupuncture groups. In summary, ZMTM can improve perimenopausal induced rats' estrogen level.

El presen te estudio se llevó a cabo para determinar el efecto estrogénico de la moxibustión con hilo medicado Zhuang (ZMTM) y explorar su impacto sensible al tiempo en el estradiol (E2) en ratas hembras perimenopáusicas. Se dividió al azar una muestra de 40 ratas h embras en cuatro grupos: control, modelo, ZMTM y acupuntura. El síndrome perimenopáusico se indujo en los últimos tres grupos con una dosis subcutánea diaria de 80 mg/kg de diepóxido de 4 - vinilciclohexeno durante 15 días. Después, las ratas en los grupos m odelo y control fueron alimentadas rutinariamente, mientras que las ratas en los grupos ZMTM y acupuntura recibieron seis cursos de ZMTM y acupuntura, respectivamente. Los resultados del estudio sugieren que después de los seis cursos de tratamiento, el ni vel de E2 en el grupo modelo fue significativamente más bajo, mientras que el grupo regular fue más alto ( p < 0,05). También hubo un aumento gradual en el nivel de E2 del grupo ZMTM en comparación con los grupos modelo y acupuntura, por ejemplo, desp ués del quinto y sexto cursos de tratamiento, su nivel de E2 fue significativamente más alto que los grupos modelo y acupuntura. El grupo ZMTM fue mejor que los grupos modelo y acupuntura. En resumen, el ZMTM puede mejorar el nivel de estrógeno de las rata s inducidas por la perimenopausia.