Bakgrund: Klimakteriet är en naturlig del av kvinnans liv. Klimakteriet som även kallas övergångsåldern, är en period då kvinnans fysiologiska kropp genomgår hormonella förändringar. Tiden då klimakteriet infinner sig är individuellt. Vanligast är dock att klimakteriet infinner sig då kvinnan passerat en ålder av 40. Syfte: Syftet med denna studie var att beskriva nordiska kvinnors upplevelser av klimakteriet. Metod: Metoden som används följer Friberg (2006) rekommendationer vad beträffar en litteraturöversikt. Resultat: Resultatet bygger på nio vetenskapliga artiklar, vilka är såväl kvalitativa som kvantitativa. I resultatet presenteras fyra teman. Personlig utveckling, Livskvalitet, Kroppsliga förändringar och symtom samt Det sexuella samlivet. Konklusion: Studiens fynd visar att kvinnors upplevelser av klimakteriet skiljer sig åt. Vi är alla unika och uppfattar således livets prövningar olika. Trots individuella upplevelser visar studiens resultat att många kvinnor upplever klimakteriet positivt. De upplever att de utvecklats som person likväl som de ser att de blivit bättre rustade inför det kommande livet. Författarna kopplar kvinnornas positiva upplevelser till KASAM, Känsla av sammanhang, som talar för att människan lättare kan möta livets utmaningar om hon kan förstå dess relevans och mening. / Background: Menopause is a natural part of a woman's life. The climacteric also known as the menopausal, is a period when a woman's physiological body undergoes hormonal changes. The days of climacteric appear individually. Most common is that climacteric is present when the woman passed the age of 40. Aim: The purpose of this study was to describe the Nordic women's experience of climacteric. Method: The method used follows Friberg (2006) recommendations regarding a literature review. Result: The result is based on nine research articles, which are both qualitative and quantitative. The result is presented in four themes, Personal growth, Quality of life, Bodily changes and symptoms and The sexual life together. Conclusion:  The study findings show that women's experiences of climacteric are different. We are all unique and therefore understands the trials of life different. Although individual experiences shows results of the study that many women experience climacteric positively. They perceive that they developed as a person as well as they see that they become better prepared for the next life. The authors link women's positive experiences to the KASAM, sense of coherence, which suggests that humans can better meet the challenges of life if she can understand its relevance and meaning.

Title from PDF of title page. / Document formatted into pages; contains 165 pages. / Thesis (M.A.)--University of South Florida, 2002. / Includes bibliographical references. / Text (Electronic thesis) in PDF format. / ABSTRACT: The doctrine of informed consent, defined as respect for autonomy, is the tool used to govern the relationship between physicians and patients. Its framework relies on rights and duties that mark these relationships. The main purpose of informed consent is to promote human rights and dignity. Some researchers claim that informed consent has successfully replaced patients&softsign; historical predispositions to accept physicians' advice without much explicit resistance. / Although the doctrine of informed consent promotes ideals worth pursuing, a successful implementation of these ideals in practice has yet to occur. What has happened in practice is that attorneys, physicians, and hospital administrators often use consent forms mainly to protect physicians and medical facilities from liability. Consequently, ethicists, legal theorists, and physicians need to do much more to explain how human rights and human dignity relate to the practice of medicine and how the professionals can promote them in practice. / This is especially important because patients' vulnerability has increased just as the complexity and power of medical science and technology have increased. Certain health care practices can shed light on the difficulties of implementing the doctrine of informed consent and explain why it is insufficient to protect patients' rights and dignity. Defining a normal biological event as a disease, and routinely prescribing hormone drug therapy to menopausal women for all health conditions related to menopause, does not meet the standards of free informed consent. / Clinicians provide insufficient disclosure about risks related to long-term use of hormone therapies and about the absence of solid evidence to support their bias toward hormone therapies as a treatment of choice for menopause related health conditions. The contributing problem is women's failure to act as autonomous agents because they either choose not to take an active part in their own therapy or because they fear to question physicians' medical authority. To insure that patients' autonomy and free choice are a part of every physician-patient interaction, physicians and patients need actively to promote them as values that are absolutely indispensable in physicians' offices, clinics, and hospitals. / System requirements: World Wide Web browser and PDF reader. / Mode of access: World Wide Web.

Thesis (Ph. D.)--University of Washington, 2002. / Vita. Includes bibliographical references (leaves 117-132).

published_or_final_version / Medicine / Master / Doctor of Medicine

 As the aging in reproductive system proceeds, females will eventually enter the period of menopause, during which a series of physiological changes occurs. The decline of estrogen level during menopausal transition is thought to associate with various menopausal symptoms. Although hormone replacement therapy can be adopted to deal with the estrogen-deficient state, side effects such as cancer risk cannot be overlooked. Alternatively, Erxian Decoction (EXD), a Chinese medicine formula for treating menopausal symptoms has been used clinically for more than 60 years without adverse effects reported. Some pharmacological properties of EXD have been reported in previous research, which are thought to be contributed by its multiple bioactive components. Thus in the present study, the pharmacological properties of EXD have been further evaluated. The drug compatibility of Traditional Chinese Medicine (TCM) formula, EXD, was also demonstrated. At last, a novel approach for identification of bioactive components from Chinese medicine formula was introduced using EXD as study model. To evaluate the multiple pharmacological properties of EXD, proteins involved in steroidogenesis in ovaries of aged female rats were measured by immunoblotting analysis. On top of that, serum lipid profiles and the related proteins were determined by colorimetric assay and immunoblotting analysis respectively. Also, anti-osteoporotic properties and drug compatibility of EXD were evaluated by in vitro methods such as proliferation assay, osteoclast differentiation assay, ELISA assay or immunoblotting analysis. Lastly, a novel approach for identification of bioactive components in relation to the subsequent bioactivity from traditional Chinese medicinal formula was introduced using HPLC profiles. From the results, it was demonstrated that EXD can modulate steroidogenesis in aged female rat model at least through up-regulation of ovarian aromatase, protein kinase B and estrogen receptor beta at protein level. Besides, EXD also exerts antihyperlipidemic effects in aged female rats as reflected from the decreased serum total cholesterol and LDL-cholesterol levels via regulation of HMG CoA reductase and LDL-receptor, the key proteins for cholesterol synthesis and LDL-cholesterol clearance. In vitro study has also demonstrated the anti-osteoporotic properties of EXD through stimulation of osteoblast proliferation and inhibition of proliferation and differentiation of osteoclast precursor cells. The later was proved to be mediated by down-regulation of NFATc1 proteins, a key protein for osteoclastogenesis. The roles of the drugs categories according to the drug compatibility of traditional Chinese medicine contributing to the optimal anti-osteoporotic properties of EXD were also elucidated. Since the diverse pharmacological properties of a Chinese medicinal formula are often the results of the effects of complex bioactive constituents in the extract, yet identification of the bioactive components has been a tedious task. Thus in the last part of the study, a novel approach for identification of bioactive component from Chinese medicinal formula has been developed. By comparing the HPLC profiles of EXD extracted by different decoction method in relation to their pharmacological properties, six bioactive chemicals were successfully identified which may contribute to the stimulatory effect of EXD on ovarian aromatase and hepatic catalase expression. / published_or_final_version / Chinese Medicine / Master / Master of Philosophy

The purpose of this study was to determine the factors that influence women's decisions to use hormone replacement therapy (HRT) during menopause. Using the Theory of Planned Behavior and constructs of risk perception, this study was able to explore the beliefs and attitudes of women about HRT use during menopause. The study was also able to explore how risk perception of HRT and the conditions that affect women during midlife impact their decision to use HRT during that time. Focus groups were conducted to develop the questionnaire used in the larger study. A community-based sample of women from Houston area churches participated in the study. The major theme that emerged from the focus groups was the weighing of cancer risks and the protection benefits of HRT. The most interesting factor that emerged as a barrier to HRT use was "negative publicity" and myths toward taking HRT. Results from the larger study demonstrated that the construct of attitude was the predominate predictor of intention when direct measures were used in a model to predict intention. Meaning that women's attitudes towards HRT use during menopause (whether they are safe, wise to use, good or bad, beneficial, risky, pleasant, or valuable) played a significant role in their intention. In contrast when the belief-based measures were used in the model, subjective norm and perceived behavioral control were significant predictors of intention. Meaning that the intention to use HRT was based more on the influence of their husbands, physicians, and families. This also meant that the dosage form, cost, negative publicity, family history of cancer, personal fear of developing cancer, and education about HRT would affect their intention to use HRT during menopause more than the advantages and disadvantages of using HRT (advantages such as protection from osteoporosis, relief from hot flashes; or, disadvantages such as risk of breast cancer). Finally, women's perception of risk with regards to HRT was highest for breast cancer followed by heart disease, endometrial cancer, and osteoporosis. This study found that there are many factors that may affect the decision to use HRT during menopause and that overall these factors affect women’s attitudes towards HRT and their intention to use it. / text

Bakgrund: Sexualitet hos äldre är precis som hos yngre en viktig del av livskvaliteten. Den sexuella förmågan och de sexuella behoven fortsätter långt upp i åren. Ett aktivt sexualliv har visat sig vara bra för välbefinnandet. Syfte: Syftet var att undersöka vilka faktorer som har en positiv påverkan på äldre kvinnors sexuella välbefinnande. Metod: En kvantitativ metod har används på ett redan insamlat datamaterial. Detta material består av omfattande enkäter som samlades in under åren 2000-2003. Huvudvariabel sexuellt välbefinnande har testats mot flera relevanta variabler. Analysmetoderna som användes var Chi-square test, univariat analys och slutligen en multivariat analys. Vi har valt att titta på den positiva odds kvoten, det vill säga vad som påverkar det sexuella välbefinnandet positivt. Resultat: Av den undersökta populationen skattade 25 % av kvinnorna att de hade ett bra sexuellt välbefinnande. Studien visade ett starkt samband mellan att känna sig uppskattad i hemmet och att vara nöjd med sitt sexuella välbefinnande. Att vara nöjd med sin kropp var en positiv faktor för det sexuella välbefinnandet. Signifikans fanns också för att ha ett bra humör, att vara icke rökare och att inte ha passerat menopaus. / Background: Sexuality among older persons are just as important to quality of life as it is to younger people. The sexual ability and sexual needs will continue up in years. An active sex life is good for the sexual satisfaction. Objective: The objective was to examine factors that have a positive impact on older women's sexual satisfaction. Method: A quantitative method was used on already collected material, consisting of extensive surveys collected during the years of 2000-2003. The main variable sexual satisfaction has been tested against several relevant variables. The analytical methods used were chi-square test, univariate analysis and finally a multivariate analysis. We chose to examine the positive odds ratio, (POR), that affects the sexual satisfaction positively. Results: Among the respondents 25% estimated that they had very good sexual satisfaction. The results indicates to be appreciated at home and happy with ones own body affected the sexual satisfaction positively. Having a good mood and not have passed menopause also have a positive affect of the older womens sexual satisfaction.

The effects of exogenous estrogen administration on aspects of memory and cognition in women were examined in two studies. In Study 1, women receiving estrogen replacement therapy were compared to untreated women on four measures of verbal memory. Those receiving estrogen had significantly better scores on a measure of delayed memory for propositional material. In Study 2, women in the early stages of Alzheimer's Disease (AD) were administered either estrogen or placebo on a double-blind basis for six months. Women given estrogen showed improvement on a measure of verbal memory and spatial attention compared to the placebo controls. The combined results of these studies provide evidence that estrogen enhances aspects of verbal memory in both healthy postmenopausal women and in postmenopausal women in the early stages of AD as measured by neuropsychological tests. These effects might be mediated by actions of estrogen on neuronal morphology and physiology in brain areas important for memory and cognition.

Acid-base regulation, as reflected by hydrogen ion concentration ([H+]), and the chemoreflex control of breathing were examined in healthy pre- (PRE; n=20) and postmenopausal (POST; n=15) women of a comparable age (45 ± 2.7 vs. 52 ± 1.8 years). [H+] behaviour was examined in both groups at rest and during exercise above the ventilatory threshold using Stewart’s physicochemical approach to acid-base analysis. Ventilatory chemoreflex characteristics were assessed using Duffin’s modified rebreathing protocol that includes 5 min of prior hyperventilation and maintenance of either hyperoxic (150 mmHg) or hypoxic (50 mmHg) iso-oxia. As expected, the ovarian hormones progesterone ([P4]) and estrogen ([E2]) were significantly lower in the POST group. [H+] was unaffected by menopausal status at rest or during exercise. At rest the POST group exhibited significantly higher PaCO2 and [SID] values relative to the PRE group. In general, the acidifying effects of increased PaCO2 were offset by the alkalizing effect of increases in [SID] (or vice versa) in the POST group such that [H+] did not differ between PRE and POST groups. The central ventilatory chemoreflex also differed between groups with the POST group exhibiting a significantly higher threshold and a lower sensitivity in the response to CO2 relative to the PRE group. [P4] was found to partially account for the significant group differences in acid-base and central ventilatory chemoreflex control characteristics supporting the role of [P4] as an important determinant of acid-base status and the chemical control of ventilation in healthy women. Findings of the current study may have potential relevance in understanding the increased occurrence of various health conditions such as osteoporosis and sleep disordered breathing in females following the onset of menopause. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2007-09-21 08:53:00.841

AIMS. To determine the cardio-metabolic risk profile and incidence of low bone mineral density in African and Indian postmenopausal women attending the IALCH menopause clinic and to determine whether there is a correlation between cardio-metabolic parameters and low bone mineral density. METHODS. A retrospective, descriptive study involving all Indian and African postmenopausal women, above the age of 40, referred to the menopause outpatient clinic at IALCH from 01 July 2009 to 31 December 2010 was conducted. Data was collected from the medi-com database using a structured questionnaire. Cardio-metabolic data was analysed as continuous variables and summarized using means and standard deviations. Bone mineral density was treated as a quantitative variable and correlation analysis was used to assess relationships between the variables. This was done for each race group separately. The Students T-test was used to compare cardio-metabolic variables between the two ethnic groups. SPSS version 18.0 was used to analyse data. RESULTS. The records of 106 women were analysed (51 African and 55 Indian). In African and Indian women, the prevalence of hypertension was 54.9% vs 65.5%, the prevalence of diabetes was 31.4% vs 56.4%, the prevalence of dyslipidaemia was 17.6% vs 32.7% and the prevalence of ischaemic heart disease was 5.9% vs 14.9% respectively. The prevalence of low bone mineral density was higher in Indian women (40%) compared to African women (23.5%). The mean body mass index (BMI) of African women was significantly higher than Indian women, (33 vs 29). There were no significant differences between African and Indian postmenopausal women regarding their lipid profile, fasting glucose, fasting insulin and thyroid profile. The mean bone mineral density (BMD) in the hip and spine was lower in Indian women compared to African women, however the prevalence of osteopaenia and osteoporosis, as defined by T-scores, was not statistically significant. Statistically significant positive correlations were observed between an increasing BMI and BMD (p<0.001) and increases in weight and BMD (p<0.001). A statistically significant correlation were observed between serum LDL-cholesterol values and BMD (p=0.03), where serum LDL-cholesterol values were inversely proportional to BMD. There were no significant correlations between BMD and the remaining cardio-metabolic variables (ie blood pressure; waist-hip ratio; clinical stigma of dyslipidaemia; clinical stigma of insulin resistance; cholesterol; HDL; triglycerides; fasting glucose; fasting insulin and thyroid function). CONCLUSIONS. There is a high prevalence of cardiovascular risks and low BMD amongst the local menopausal population, irrespective of ethnicity. African and Indian postmenopausal women had a high prevalence of hypertension (60%), diabetes (44%), dyslipidaemia (25%) and obesity (54%). In African women, the incidence of low BMD was 35% in the hip, 53% in the neck of femur and 55% in the lumbar spine. In Indian women, the incidence of low BMD was 55% in the hip, 67% in the neck of femur and 69% in the lumbar spine. BMI and weight showed a positive correlation with bone mineral density. Regarding the cardio-metabolic variables, an increasing LDL value was negatively correlated with bone mineral density. It thus is apparent that a screening lipid profile during the peri-menopausal years, coupled with early and appropriate lifestyle management regarding body mass index/ weight may limit the burden of morbidity in later life. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2013.