RESUMEN
Introduction: We started the gender-specific clinic for women to provide sufficient treatment for female patients. The purpose of this study was to clarify the characteristics of patients using the gender-specific clinic for women, and to assess the association among depression, physical and mental subjective symptoms.Methods: This observational study included female patients aged 16-84 years who visited our clinic between June 2012 and December 2015 (N=97). In addition to general attributes, we collected data on physical and mental symptoms, and depression status using the Cornell Medical Index (CMI) and Self-rating Depression Scale (SDS), respectively, at the first visit. We conducted analyses to assess patient characteristics and the association between subjective symptoms and depression, and between physical and mental symptoms by estimating odds ratios (ORs) and 95% confidence intervals (CIs).Results: The average age of subjects was 50.4 years. The average CMI score was 42.7 points and 55.9% of the subjects were suggested to be neurotic. The average SDS score was 45.0 points and 64.0% of them were suggested to be depressed. The association with depression by SDS was observed in subjective symptoms of CMI such as fatigue (OR [95%CI]: 7.66 [2.26-25.99], p-value: 0.001) and anxiety (OR [95%CI]: 11.73 [1.80-∞], p-value: 0.006). Physical symptoms in the cardiovascular system were positively association with some mental symptoms such as tension.Conclusion: As female patients often have mental symptoms, it is essential for doctors engaging in gender-specific medicine for women to approach patients while considering psychological and mental aspects.
RESUMEN
In the United States, gender-specific medicine has advanced since 1980, and medical centers dealing with women's disease have been established. In Japan, number of the outpatient care units which address women's disease exclusively, have been established over the past two to three years. We believe that this is because the following kinds of medical care are being sought:<br>1) The gender-specific medical care<br>2) Medical treatments that are tailored individually, based on specific female body structures and psychology<br>3) All-round medical care, based on mind-body correlations<br>4) Care which improves the patients' quality of life<br>The goal of Kampo medicine is not only all-round medical care, but also therapy tailored to the individual. In the climacteric period of a woman's life, ovary activity declines against increased secretion of gonadotropin in the sexual center. In other words, endocrine disorders such as a rapid decline of estrogen secretion, affect the autonomic nervous system via catecholamine in the hypothalamus, patients consequently present with various indefinite complaints. This phenomenon is called climacteric disorder. In addition, this decrease of estrogen increases the frequency of the bone mass loss, lipid metabolism abnormalities, urinary disease, and vaginal wall atrophies seen. Not to mention the increased frequency of life-style related diseases (diabetes mellitus, obesity, malignant tumor, liver cirrhosis, etc.) that will arise.<br>Although climacteric disorder is triggered by endocrine disturbance, it takes on the symptoms of autonomic instability as time passes, and therefore cannot necessarily be called an estrogen deficiency syndrome. Kampo drugs are very effective in the treatment of such functional diseases. However, Kampo therapy must be carried out in accordance with oriental medical concepts, and their diagnostic techniques. It is useful to introduce the concept of “ki-ketsu-sui”, when treating climacteric symptoms. From a Kampo standpoint, many climacteric symptoms are pathological conditions, with “oketsu” at their core, which can be modified by “ki” and “sui”.<br>Here we show prescriptions which are frequently used in clinical practice. In addition, we review the effectiveness and limitations of Kampo therapy, for the treatment of climacteric diseases other than climacteric disorder. Finally, we refer to future issues, concerning outpatient care exclusively for women.