Osteoporosis and depression are prevalent among older postmenopausal women 65 years or older. Bisphosphonates (BPs) and selective serotonin reuptake inhibitors (SSRIs) or serotonin norepinephrine reuptake inhibitors (SNRIs) are commonly used medications to treat these conditions. Inhibitory effects of BPs on osteoclasts are responsible for the reduction in fracture risk. SSRIs, however, are associated with increased fracture risk through decreasing osteoblasts and increasing osteoclastic activity. These effects of SSRIs could attenuate the beneficial effects of BPs. This dissertation describes the concomitant use of BPs and SSRIs among postmeopausa women and reports findings from examining the association between concomitant use of BPs and SSRIs and fracture risk. Separate cross-sectional analyses were performed using data from the 2004-2008 Medical Expenditure Panel Survey (MEPS) and Medicare Part D prescriptions claims data (2008-2010) to examine usage patterns of BPs and SSRIs/SNRIs for women aged ≥45 years and ≥65 years, respectively. For our second objective, a nested-case control was conducted using Medicare claims data (2008-2010). Data from Medicare inpatient claims were linked to Medicare Part D data for all female BP users 65 years or older. We used Cox proportional hazards model to assess the increased risk of osteoporotic-related fractures among propensity score matched (1:1 ratio) cohorts of concomitant users of BPs and SSRIs and BP alone users. Concomitant use of BPs and SSRIs was prevalent and increased with age for each timeframe examined. Findings showed that approximately 12% (using MEPS) and 28% (using Medicare data) of women on BPs were also on SSRIs. For the second objective, 4,214 propensity score matched pairs (average age=80.4 years) of subjects were analyzed. Findings showed that concomitant use of BPs and SSRIs was associated with statistically significant increased risk for any fracture (HR=1.29, 95% CI, 1.07-1.57), but statistically non-significant increased risk for hip (HR=1.16, 95% CI, 0.92-1.47) and vertebral fractures (HR=1.55, 95% CI, 0.97-2.48). Current findings indicate that concomitant use of BPs and SSRIs is not uncommon among postmenopausal women and suggest potential attenuation of antifracture efficacy of BPs by SSRIs. Further studies are needed to understand the clinical impact of concomitant use of these medications among older postmenopausal women.

Objetivo: investigar o efeito de intervenções com treinamento resistido sobre a força muscular e densidade mineral óssea nos sítios de maior ocorrência de fraturas relacionadas a osteoporose em mulheres no estágio de vida após a menopausa. Metodologia: estudo de atualização por meio de revisão sistemática de ensaios controlados randomizados e meta-análise nas bases de dados do Colégio Americano de Medicina Esportiva e da Biblioteca Cochrane no período compreendido entre os anos de 1985 e fevereiro de 2005. Resultados: foram encontrados vinte e seis estudos que atenderam os critérios de inclusão, realizados nos países Alemanha, Austrália, Áustria, Canadá, China, Estados Unidos, França, e Japão, com um total de 2300 mulheres com idades entre os 40 e 92 anos. Intervenções com treinamento resistido apresentaram resultados estatisticamente significantes sobre a força muscular e a densidade mineral óssea nos sítios vértebras lombares, fêmur (triângulo de Ward/trocanter) e quadril total. Conclusão: treinamento resistido mostrou ser capaz de prover estímulo para aumentar força muscular e formação óssea, influenciando os fatores de risco relacionados com osteoporose e quedas seguidas de fratura em mulheres no estágio de vida após a menopausa. / Objective: to investigate the effect of interventions with resistance training on muscular strength and bone mineral density in the sites of larger occurrence of osteoporotic fractures in postmenopausal women. Methodology: updating study through systematic review of randomized controlled trials and meta-analysis in the databases of the American College of Sports Medicine and the Cochrane Library was conducted from 1985 up to and including February 2005. Results: twenty-six studies met the inclusion criteria from the Germany, Australia, Austria, Canada, China, United States, France and Japan, with a total of 2300 women aged 40 and 92 yrs. Interventions with resistance training showed results statistically significant on the muscular strength and bone mineral density of the lumbar spine, femur (Ward/ trochanter) and total hip. Conclusion: resistance training markedly influences osteoporotic risk factors concerning falls (muscular strength) and bone mineral density in postmenopausal women.

Introdução: O tratamento hormonal para amenizar sintomas do climatério é bem conhecido, mas nem sempre pode ser indicado para grande parte das mulheres. Por estes motivos, tem-se testado várias opções de tratamento não hormonal, cujos resultados nem sempre são satisfatórios e conclusivos. Objetivo: Avaliar a eficácia da cinarizina no tratamento dos sintomas climatéricos. Casuística e método: Foram estudadas prospectivamente 62 mulheres climatéricas sintomáticas com predomínio de ondas de calor que preencheram os critérios de inclusão e exclusão com idade variando de 45 a 60 anos, as quais foram avaliadas pelo Índice Menopausal de Kupperman (IMK), e atendidas no Setor de Ginecologia Endócrina e Climatério do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foram divididas aleatoriamente em dois grupos: S com 27 pacientes (25 mg de Cinarizina a cada 12 hs, v.o., por 6 meses) e M com 35 pacientes (1 comprimido de placebo a cada 12hs, v.o., por 6 meses). Resultados: No grupo S a média etária foi 53,9 anos; 51,9% brancas e 48,1% negras; e no grupo M a média etária foi de 54,7 anos; 51,4% brancas e 48,6% negras. Os níveis pressóricos e o índice de massa corpórea foram semelhantes, entre os grupos. A análise do IMK e suas variantes comparativamente nos grupos S e M nos tempos 0 e 1 foi p=0,235 e p=0,406, respectivamente. Conclusões: A cinarizina foi semelhante ao placebo no alívio dos sintomas do climatério avaliados pelo IMK. Houve melhora significante do sintoma vertigem nas pacientes que receberam cinarizina. / Introduction: The hormonal treatment for relief of climateric symptoms is well-known but most women can not be treated with homones. For this reason several treatments without hormones has been evaluated with no conclusive results yet. Objective: Evaluate the efficacy of cinnarizine in the treatment of climacteric symptoms. Casuistry and Method: Were prospectively studied 62 symptomatic climacteric women with prevalence of hot flashes who met the inclusion and exclusion criteria aged from 45 to 60 years, evaluated by Kupperman\'s Menopause Index (KMI) attended at the Sector of Endocrinology Gynecology and Climacteric from the Medical School of the Hospital das Clinicas of the University of São Paulo. The subjects were divided alleatory in two: 27 patients Group S (Cinnarizine 25mg every 12h) and Group M with 35 (1 Placebo each 12h). Results: In group S the mean age was 53.9 years; 51.9% white and 48.1% black; and in group M the mean age was 54.7 years; 51.4% white and 48.6% black. Blood pressure levels and body mass index were similar in both groups. The analysis of the KMI and their variables comparision betwen groups (S and M) at time 0 and 1 was p=0.235 and p=0.406 respectively. Conclusions: Cinnarizine was similar to placebo for recipe of climacteric symptoms evaluated by KMI. There was significant improvement of symptom vertigo in patients treated with cinnarizine.

Objetivo: investigar o efeito de intervenções com treinamento resistido sobre a força muscular e densidade mineral óssea nos sítios de maior ocorrência de fraturas relacionadas a osteoporose em mulheres no estágio de vida após a menopausa. Metodologia: estudo de atualização por meio de revisão sistemática de ensaios controlados randomizados e meta-análise nas bases de dados do Colégio Americano de Medicina Esportiva e da Biblioteca Cochrane no período compreendido entre os anos de 1985 e fevereiro de 2005. Resultados: foram encontrados vinte e seis estudos que atenderam os critérios de inclusão, realizados nos países Alemanha, Austrália, Áustria, Canadá, China, Estados Unidos, França, e Japão, com um total de 2300 mulheres com idades entre os 40 e 92 anos. Intervenções com treinamento resistido apresentaram resultados estatisticamente significantes sobre a força muscular e a densidade mineral óssea nos sítios vértebras lombares, fêmur (triângulo de Ward/trocanter) e quadril total. Conclusão: treinamento resistido mostrou ser capaz de prover estímulo para aumentar força muscular e formação óssea, influenciando os fatores de risco relacionados com osteoporose e quedas seguidas de fratura em mulheres no estágio de vida após a menopausa. / Objective: to investigate the effect of interventions with resistance training on muscular strength and bone mineral density in the sites of larger occurrence of osteoporotic fractures in postmenopausal women. Methodology: updating study through systematic review of randomized controlled trials and meta-analysis in the databases of the American College of Sports Medicine and the Cochrane Library was conducted from 1985 up to and including February 2005. Results: twenty-six studies met the inclusion criteria from the Germany, Australia, Austria, Canada, China, United States, France and Japan, with a total of 2300 women aged 40 and 92 yrs. Interventions with resistance training showed results statistically significant on the muscular strength and bone mineral density of the lumbar spine, femur (Ward/ trochanter) and total hip. Conclusion: resistance training markedly influences osteoporotic risk factors concerning falls (muscular strength) and bone mineral density in postmenopausal women.

Osteoporosis is considered to be the most adverse public health disease associated with substantial mortality among postmenopausal women. Hysterectomy, surgically induced menopause, contributes to the early onset of menopause. However, there was no evidence of an association between early menopause following hysterectomy and osteoporosis among postmenopausal women. The purpose of this quantitative study was to examine the association between demographic and behavioral factors and the prevalence of osteoporosis among hysterectomized postmenopausal women. The integrated theory of health behavior change theoretical framework guided study. Cross-sectional secondary data from the 2009-2010 National Health and Nutrition Examination Survey were used. Multiple logistic regression models were used to examine the associations between demographic and behavioral factors and the prevalence of osteoporosis among the study population. The results of this study indicate that the prevalence of osteoporosis was inversely associated with age, education, and annual family income. Non-Hispanic Whites with age of hysterectomy 36-45 were significantly associated with the prevalence of osteoporosis. Moderate recreational activity and calcium/vitamin D intake were associated with decreased prevalence of osteoporosis. Demographic and behavioral factors play substantial roles in the prevalence of osteoporosis. The study results may be used to facilitate risk-prevention strategies to reduce the incidence of osteoporosis. This study may drive positive social change by facilitating public health to promote and implement effective behavioral interventions to prevent osteoporosis in the potential hysterectomized postmenopausal women.

<p>Generalni cilj ovog istraživanja je da se utvrdi da li postoji uticaj primenjenog<br />programa vežbanja na parametre ko&scaron;tane gustine i biohemijske markere ko&scaron;tanog<br />remodelovanja kod žena u periodu premenopauze i postmenopauze.<br />Uzorak ispitanica je činilo 26 žena starosti 45 do 55 godina, od kojih su 13 u periodu<br />premenopauze, a 13 u periodu postmenopauze. Ispitanice su učestvovale u programu vežbanja<br />u trajanju od 6 meseci, koji se realizovao u Novom Sadu, 4 puta nedeljno u trajanju od sat<br />vremena. Za utvrđivanje uticaja programa vežbanja na ko&scaron;tanu gustinu merena su 3<br />osteodenzitometrijska parametra na kičmi, vratu butne kosti i kuku i 5 parametara<br />biohemijskih markera ko&scaron;tanog remodelovanja.<br />Da bi se utvrdio uticaj vežbanja kod ispitanica, primenjena je multivarijatna analize<br />varijanse (MANOVA). Na celokupnom uzorku ispitanica nije utvrđena statistički značajna<br />razlika ni u jednom merenom parametru ko&scaron;tane gustine. U odnosu na biohemijske markere,<br />do&scaron;lo je do značajnog smanjenja nivoa ukupne alkalne fosfataze. Kod žena u periodu<br />premenopauze i kod žena u periodu postmenopauze, program vežbanja nije značajno uticao<br />na parametre ko&scaron;tane gustine merene na kičmi, vratu butne kosti i kuku (DXA, Lunar<br />Prodrigy), kao ni na parametre biohemijskih markera ko&scaron;tanog remodelovanja.<br />Primenom multivarijatne analize kovarijanse (MANCOVA) utvrđena je značajna<br />razlika u uticaju programa vežbanja između žena u pre- i postmenopauzi u mineralnoj<br />ko&scaron;tanoj gustini vrata butne kosti (BMD VF) i markera beta-crosslaps (CTX). Mineralna<br />ko&scaron;tana gustina je nakon programa vežbanja veća, a nivo beta-crosslapsa niži kod žena u<br />premenopauzi nego kod žena u periodu postmenopauze.<br />Na osnovu dobijenih rezultata, zaključujemo da je potreban duži vremenski period<br />realizacije programa vežbanja kako bi se mogla primetiti statistički značajna promena<br />merenih parametara. Ispitanicama se savetuje da nastave sa vežbanjem kako bi usporile<br />gubitak kosti</p> / <p>The genaral aim of this research is to determine is there an effects of the applied exercise<br />program on bone mineral density and and biochemical markers of bone turnover in the<br />premenopausal and postmenopausal period.<br />The sample was consisted of 26 women aged 45 to 55 years, of which 13 were in<br />premenopausal and 13 in postmenopausal period. Subjects were included (had performing) in 6-month<br />exercise program, which was implemented (maintained) in Novi Sad, 4 times a week in duration for an<br />hour. Three osteodensitometric parameters on lumbar spine, femoral neck and hip (DXA, Lunar<br />Prodrigy) and five parameters of biochemical markers of bone turnover were measured to assessed<br />(to determine) the effects of exercise program on bone density.<br />Multivariate analysis of variance (MANOVA) was used to determine the effect of exercise.<br />For the entire sample of subjects, there were no statistically significant difference in any measured<br />bone density parameter, but looking at biochemical markers, total alkaline phosphatase level were<br />significanly reduced. There were no significant changes in bone density parameters on the lumbar<br />spine, femoral neck and hip nor on the parameters of biochemical markers of bone turnover in women<br />in premenopausal and postmenopausal period.<br />Applying multivariate analyse of covariance it was found a significant difference in the<br />exercise program effect between pre- and postmenopausal women in bone mineral density of femoral<br />neck (BMD VF) and beta-crosslaps marker of turnover (CTX). Femoral neck BMD was higher, and<br />beta-crosslaps level was lower in premenopausal women than in postmenopausal women after<br />completion exercise program.<br />Based on obtained results, we conclude that is required a longer perod of exercise program<br />ralization in order to notice a statistically significant change in measured parameters. Subjects are<br />advised to continue their exercising in order to slow down the bone loss</p>

Objectifs: Évaluer si un programme d’entraînement en résistance d’une durée d’un an prévient le regain de poids et majore l’amélioration du profil inflammatoire. Le second objectif de cette étude était de déterminer si la variation du tissu adipeux viscéral est associée aux changements dans les concentrations sanguines des marqueurs inflammatoires. Méthodes: Soixante-dix femmes post-ménopausées en surpoids ou obèses ont été randomisées dans un des deux groupes suivants : (1) Contrôle ou (2) Entraînement en résistance. La composition corporelle (absorptiométrie double à rayons X et tomographie axiale) et les marqueurs inflammatoires (protéine C-réactive, orosomucoïde, haptoglobine) ont été évalués avant et après la période de suivi d’une durée d’un an. Résultats: Suite à la période de suivi, un regain significatif de poids corporel et de masse grasse était observé dans le groupe contrôle et le groupe entraînement en résistance (p < 0,05). Une réduction des concentrations sériques de l’orosomucoïde et une hausse des niveaux sériques de l’haptoglobine étaient également notées dans les deux groupes (p < 0,05). La variation du tissu adipeux viscéral était seulement associée aux changements dans les concentrations sériques de la protéine C-réactive (r = 0,373, p < 0,05). Conclusion: Nos résultats suggèrent que l’entraînement en résistance ne prévient pas le regain de poids corporel et ne majore pas l’amélioration du profil inflammatoire chez des femmes post-ménopausées en surpoids ou obèses. De plus, nos résultats indiquent que la variation du tissu adipeux viscéral ne semble pas être un facteur clé impliqué dans les changements des concentrations sanguines des marqueurs inflammatoires. / Objectives: To evaluate if a 1-year resistance training program improved weight loss maintenance and the inflammatory profile in overweight and obese postmenopausal women. The second objective of this study was to determine if the variation in visceral adipose tissue was associated with the changes in inflammatory markers concentrations. Methods: Seventy overweight and obese postmenopausal women were randomized to a control group or a resistance training group. Body composition (dual energy X-ray absorptiometry and computed tomography) and inflammatory markers (C-reactive protein, orosomucoid, haptoglobin) were measured before and after the 1-year weight loss maintenance intervention. Results: Following the weight loss maintenance intervention, we observed a significant body weight and fat mass regain in the control group and the resistance training group (p < 0.05). Significant reductions in orosomucoid and increases in haptoglobin concentrations were noted in both groups (p < 0.05). The variation in visceral adipose tissue was only associated with the changes in C-reactive protein concentrations (r = 0,373, p < 0.05). Conclusion: Our results suggest that resistance training do not improve weight loss maintenance and the inflammatory profile in overweight and obese postmenopausal women. Moreover, our results indicate that the variation in visceral adipose tissue may not be a key factor implicated in the changes in inflammatory markers concentrations.

Glycemic intake influences the rise in blood glucose concentration following consumption of a carbohydrate containing meal, known as the postprandial glycemic response. The glycemic response is a result of both the type and amount of carbohydrate foods consumed and is commonly measured as the glycemic index (GI) or glycemic load (GL), where the GI is a ranking in comparison to glucose and the GL is an absolute value encompassing both the GI and amount of carbohydrate consumed. Evidence from controlled trials in rat models suggests that glycemic intake has a role in development of insulin resistance, however trials and observational studies of humans have produced conflicting results. As insulin resistance is a precursor to type 2 diabetes mellitus, lifestyle factors that could prevent development of this condition have important public health implications. Previous observational studies have used food frequency questionnaires to assess usual diet, which could have resulted in a lack of precision in assessment of individual serve sizes, and have been limited to daily measures of glycemic intake. Daily measures do not take fluctuations in glycemic intake on a per meal basis into account, which may be a more relevant measure for investigation in relation to disease outcomes. This PhD research was conducted in a group of Brisbane women aged 42 to 81 years participating in the multidisciplinary Brisbane Longitudinal Assessment of Ageing in Women (LAW study). Older women may be at particular risk of insulin resistance due to age, hormonal changes, and increases in abdominal obesity associated with menopause, and the LAW study provided an ideal opportunity to study the relationship between diet and insulin resistance. Using the diet history tool, we aimed to assess the glycemic intake of the population and hypothesised that daily GI and daily GL would be significantly positively associated with increased odds of insulin resistant status. We also hypothesised that a new glycemic measure representing peaks in GL at different meals would be a stronger predictor of insulin resistant status than daily measures, and that a specially designed questionnaire would be an accurate and repeatable dietary tool for assessment of glycemic intake. To address these hypotheses, we conducted a series of studies. To assess glycemic intake, information on usual diet was obtained by detailed diet history interview and analysed using Foodworks and the Australian Food and Nutrient (AUSNUT) database, combined with a customised GI database. Mean ± SD intakes were 55.6 ± 4.4% for daily GI and 115 ± 25 for daily GL (n=470), with intake higher amoung younger participants. Bread was the largest contributor to intakes of daily GI and GL (17.1% and 20.8%, respectively), followed by fruit (15.5% and 14.2%, respectively). To determine whether daily GI and GL were significantly associated with insulin resistance, the homeostasis model assessment of insulin resistance (HOMA) was used to assess insulin resistant status. Daily GL was significantly higher in subjects who were insulin resistant compared to those who were not (134 ± 33 versus 114 ± 24 respectively, P<0.001) (n=329); the odds of subjects in the highest tertile of GL intake being insulin resistant were 12.7 times higher when compared with the lowest tertile of GL (95% CI 1.6-100.1, P=0.02). Daily GI was not significantly different in subjects who were insulin resistant compared to those who were not (56.0 ± 3.3% versus 55.7 ± 4.5%, P=0.69). To evaluate whether a new glycemic measure representing fluctuations in daily glycemic intake would be a stronger predictor of insulin resistant status than other glycemic intake measures, the GL peak score was developed to express in a single value the magnitude of GL peaks during an average day. Although a significant relationship was seen between insulin resistant status and GL peak score (Nagelkerke’s R2=0.568, P=0.039), other glycemic intake measures of daily GL (R2=0.671, P<0.001) and daily GL per megajoule (R2=0.674, P<0.001) were stronger predictors of insulin resistant status. To develop an accurate and repeatable self-administered tool for assessment of glycemic intake, two sub-samples of women (n=44 for the validation study and n=52 for the reproducibility study) completed a semi-quantitative questionnaire that contained 23 food groupings selected to include the top 100 carbohydrate foods consumed by the study population. While there were significant correlations between the glycemic intake questionnaire and the diet history for GL (r=0.54, P<0.01), carbohydrate (r=0.57, P<0.01) and GI (r=0.40, P<0.01), Bland-Altman plots showed an unacceptable difference between individual intakes in 34% of subjects for daily GL and carbohydrate, and 41% for daily GI. Reproducibility results showed significant correlations for daily GL (r=0.73, P<0.001), carbohydrate (r=0.76, P<0.001) and daily GI (r=0.64, P<0.001), but an unacceptable difference between individual intakes in 25% of subjects for daily GL and carbohydrate, and 27% for daily GI. In summary, our findings show that a significant association was observed between daily glycemic load and insulin resistant status in a group of older women, using a diet history interview to obtain precise estimation of individual carbohydrate intake. Both the type and quantity of carbohydrate are important to consider when investigating relationships between diet and insulin resistance, although our results suggest the association is more closely related to overall daily glycemic intake than individual meal intake variations. A dietary tool that permits precise estimation of carbohydrate intake is essential when evaluating possible associations between glycemic intake and individual risk of chronic diseases such as insulin resistance. Our results also suggest that studies using questionnaires to estimate glycemic intake should state degree of agreement as well as correlation coefficients when evaluating validity, as imprecise estimates of carbohydrate at an individual level may have contributed to the conflicting findings reported in previous studies.

This dissertation is focused on the problematic period in postmenopausal women. The women in age from 45 to 60 are in our current society under many pressures which can have a negative influence on their quality of living. The goal of this dissertation is to define these specific factors into biological, psychological and social factors and also to analyse their possible negative consequences and suggest the ways of prevention. The climacterium, partnership relations, divorces, children´s walk-out from home, the part of grandparents or also the old parent-care belong among these factors. These could be marked as a difficult living situations which could cause stress, coflicts or frustration. If this stage stays uncontrolled, many psychological troubles could start leading up to many kinds of addictions or self-destructions. That is why is the last chapter focused on the possibilities of prevention, both from the women point of view and from the society.

Introdução: O tratamento hormonal para amenizar sintomas do climatério é bem conhecido, mas nem sempre pode ser indicado para grande parte das mulheres. Por estes motivos, tem-se testado várias opções de tratamento não hormonal, cujos resultados nem sempre são satisfatórios e conclusivos. Objetivo: Avaliar a eficácia da cinarizina no tratamento dos sintomas climatéricos. Casuística e método: Foram estudadas prospectivamente 62 mulheres climatéricas sintomáticas com predomínio de ondas de calor que preencheram os critérios de inclusão e exclusão com idade variando de 45 a 60 anos, as quais foram avaliadas pelo Índice Menopausal de Kupperman (IMK), e atendidas no Setor de Ginecologia Endócrina e Climatério do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foram divididas aleatoriamente em dois grupos: S com 27 pacientes (25 mg de Cinarizina a cada 12 hs, v.o., por 6 meses) e M com 35 pacientes (1 comprimido de placebo a cada 12hs, v.o., por 6 meses). Resultados: No grupo S a média etária foi 53,9 anos; 51,9% brancas e 48,1% negras; e no grupo M a média etária foi de 54,7 anos; 51,4% brancas e 48,6% negras. Os níveis pressóricos e o índice de massa corpórea foram semelhantes, entre os grupos. A análise do IMK e suas variantes comparativamente nos grupos S e M nos tempos 0 e 1 foi p=0,235 e p=0,406, respectivamente. Conclusões: A cinarizina foi semelhante ao placebo no alívio dos sintomas do climatério avaliados pelo IMK. Houve melhora significante do sintoma vertigem nas pacientes que receberam cinarizina. / Introduction: The hormonal treatment for relief of climateric symptoms is well-known but most women can not be treated with homones. For this reason several treatments without hormones has been evaluated with no conclusive results yet. Objective: Evaluate the efficacy of cinnarizine in the treatment of climacteric symptoms. Casuistry and Method: Were prospectively studied 62 symptomatic climacteric women with prevalence of hot flashes who met the inclusion and exclusion criteria aged from 45 to 60 years, evaluated by Kupperman\'s Menopause Index (KMI) attended at the Sector of Endocrinology Gynecology and Climacteric from the Medical School of the Hospital das Clinicas of the University of São Paulo. The subjects were divided alleatory in two: 27 patients Group S (Cinnarizine 25mg every 12h) and Group M with 35 (1 Placebo each 12h). Results: In group S the mean age was 53.9 years; 51.9% white and 48.1% black; and in group M the mean age was 54.7 years; 51.4% white and 48.6% black. Blood pressure levels and body mass index were similar in both groups. The analysis of the KMI and their variables comparision betwen groups (S and M) at time 0 and 1 was p=0.235 and p=0.406 respectively. Conclusions: Cinnarizine was similar to placebo for recipe of climacteric symptoms evaluated by KMI. There was significant improvement of symptom vertigo in patients treated with cinnarizine.