No description available.

Falling significantly affects quality of life, morbidity, and mortality among older adults. We sought to evaluate the prospective association between sedentary time, physical activity, and falling among post-menopausal women aged 50-79 years recruited to the Women's Health Initiative Observational Study between 1993 and 1998 from 40 clinical centers across the United States. Baseline (B) and change in each of the following were evaluated at year 3 (Y3) and year 6 (Y6; baseline n= 93,676; Y3 n= 76,598; Y6 n= 75,428): recreational physical activity (MET-h/wk), sitting, sleeping (min/day), and lean body mass by dual energy X-ray absorptiometry (subset N= 6475). Falls per year (0, 1, 2, >= 3) were assessed annually by self-report questionnaire and then dichotomized as = 1 and = 2 falls/year. Logistic regression models were adjusted for demographics, body mass index, fall history, tobacco and alcohol use, medical conditions, and medications. Higher baseline activity was associated with greater risk of falling at Y6 (18%; p for trend <0.0001). Increasing sedentary time minimally decreased falling (1% Y3; 2% Y6; p < 0.05). Increasing activity up to >= 9 MET-h/wk. (OR: 1.12, 95% CI: 1.03-1.22) or maintaining >= 9 MET-h/wk. (OR: 1.20, 95% CI: 1.13-1.29) increased falling at Y3 and Y6 (p for trend <0.001). Adding lean body mass to the models attenuated these relationships. Physically active lifestyles increased falling among post-menopausal women. Additional fall prevention strategies, such as balance and resistance training, should be evaluated to assist post-menopausal women in reaching or maintaining levels of aerobic activity known to prevent and manage several chronic diseases.

Class of 2006 Abstract / Objectives: To determine the effect of compounded bio-identical hormone replacement therapy (BHRT) on menopause-related quality of life through comparing the results of the Menopause Rating Scale (MRS) before beginning BHRT and seven weeks into BHRT. Methods: This study used a one group pre-test/post-test design, also known as pre-experimental. Twenty-one patients participating in a BHRT consultation with the pharmacist at Reed’s Compounding Pharmacy completed an MRS at the time of consultation before beginning BHRT. Seven weeks into treatment with BHRT, patients were mailed a second MRS that they were asked to complete and return to the pharmacy. Results: The average age of the 21 study participants was 54.9±6.3 years. There was a statistically significant reduction in symptom severity for the total MRS and each of the three subscales after seven weeks of treatment with compounded BHRT (p<0.001). Additionally, there were statistically significant reductions in symptom severity related to hot flushes and sweating, sleep problems, depressive mood, irritability, and anxiety (p<0.001). Conclusions: Compounded BHRT is effective in improving menopause-related quality of life in women suffering from menopausal symptoms.

A rising percentage of women with risk factors for cardiovascular disease (CVD) reach menopause and experience postmenopausal symptoms. In consequence they require assessment concerning the appropriate combination and safety of a hormone replacement therapy. Clinical trials using the combination of equine estrogens and medroxyprogesterone acetate (MPA) reported an increased risk of thromboembolic events and no cardiovascular protective effects in women receiving this type of hormone replacement therapy. However unopposed estradiol and different regimes estrogens/progestins in vitro and in animal studies have proved to be beneficial for the cardiovascular system. Thus it is possible that the negative outcomes of the clinical trials are an exclusive feature of the regime equine estrogens plus MPA. The present study was initiated to evaluate the cardiovascular effects and possible mechanism of damage of the regime MPA plus 17ß-estradiol in comparison to unopposed 17ß-estradiol during cardiac disease. The role of 17ß-estradiol and MPA during left ventricular dysfunction and chronic heart failure was studied in female Wistar rats that received myocardial infarction. After 8 weeks of treatment the combination of MPA plus estradiol aggravated left ventricular remodelling and dysfunction as judged by increased heart weight, elevated left ventricular end diastolic pressure and decreased left ventricular fractional shortening, effects that were accompanied by increase left ventricular oxidative stress and expression of rac 1 and p67phox regulatory subunits of the NADPH oxidase. In contrast ovariectomy as well as 17ß- estradiol supplementation conferred neutral effects on cardiac function and remodelling post myocardial infarction. Suggesting that the aggravating symptoms of the regime MPA plus 17ß –estradiol are inherent to this pharmacological regime and are not a class effect of the progesterone receptor ligands and are neither due to inhibition of estradiol beneficial effects. Considering that aldosterone plays an important role in the development and aggravation of cardiovascular disease the cardiovascular effects of MPA plus 17ß –estradiol was studied in a model of mineralocorticoid receptor activation and compared to the effects of regimes based in drospirenone, a new progestin with antimineralocorticoid properties. The complex pattern of cardiovascular injury in ovariectomized Wistar rats induced by 8 weeks of continuous chronic aldosterone infusion and high-salt diet was significantly attenuated in sham-ovariectomized rats and by coadministration of 17 ß-estradiol in ovariectomized animals. The beneficial role of 17 ß-estradiol on blood pressure, cardiac hypertrophy, vascular osteopontin expression and perivascular fibrosis was completely abrogated by coadministration of MPA. In contrast, drospirenone was either neutral or additive to 17 ß-estradiol in protecting against aldosterone salt-induced cardiovascular injury and inflammation. Taking into account that the kidney plays a major role for the development and aggravation of hypertension a further characterization of fluid balance, renal morphology and renal gene expression in the aldosterone salt treated rats was conducted. Aldo-salt treatment resulted in remnant kidney hypertrophy without structural damage, effects that were not modified by 17 ß-estradiol. However combination of MPA with 17 ß-estradiol enhanced kidney hypertrophy, fluid turnover, renal sodium retention and potassium excretion and was associated with increased renal ENaC expression, extensive renal lesions, tubular damage and enhanced p67phox expression and protein tyrosin nitrosylation. Different to the protective effects of drospirenone that included a complete blockade of kidney hypertrophy and sodium retention and enhanced renal expression of angiotensin II type-2 receptors. Therefore the loss of 17 ß-estradiol cardiovascular beneficial effects and the renal harmful effects in the aldosterone salt treated rats receiving MPA can not be extrapolated to other progestins. Indeed drospirenone conferred protective effects due to its antimineralocorticoid properties. In conclusion, the choice of specific synthetic progestins has profound implications on the development of cardiovascular and renal injury; MPA aggravated cardiac disease, which contributes to explain the adverse outcomes of clinical trials on the prevention of cardiovascular disease by combined estrogen and MPA treatment. / Eine zunehmende Zahl postmenopausaler Frauen mit kardiovaskulären Risikofaktoren leidet unter menopausalen Beschwerden. Diese Patientinnen benötigen daher eine Beratung hinsichtlich der Sicherheit einer post-menopausalen Hormonersatz-THerapie da klinische Studien ein gehäuftes Auftreten thromboembolischer Ereignisse unter einer kombinierten Gabe von Östrogenen und Medroxyprogesteron Acetat (MPA) nachgewiesen haben. Zudem war eine Protektion gegen kardiovaskuläre Erkrankungen, die nach der Menopause gehäuft auftreten, nicht nachweisbar. Im Gegensatz hierzu belegt eine Vielzahl von experimentellen Studien eine günstige Wirkung einer alleinigen Östrogensubstitution. Es erscheint daher möglich, dass die ungünstigen Wirkungen einer Hormonersatz-Therapie im Wesentlichen auf die Progesteron Komponente zurückzuführen ist, welche bei Frauen mit intaktem Uterus jedoch erforderlich ist um einer Endometriumhyperplasie vorzubeugen. Wenige experimentelle Studien haben bislang die Wirkungen unterschiedlicher, synthetischer Progestine im Herz- Kreislaufsystem untersucht. In der vorliegenden Studie war es daher erstmalig die Wirkung einer alleinigen Gabe von Östradiol mit einer kombinierten Applikation von Östradiol und MPA nach experimentellem Myokardinfarkt bei weiblichen Ratten verglichen. Die Kombination von Östradiol und MPA, nicht jedoch Östradiol allein oder natives Progesteron, führte zu einer Verschlechterung myokardialer Umbauprozesse (remodeling) welches in einer weiteren Verschlechterung der linksventrikulären Pumpfunktion resultierte. Diese sehr ungünstigen funktionellen Effekte waren mit einer vermehrten Generierung freier Sauerstoffradikale durch NADPH Oxidasen verbunden. Diese Beobachtungen unterstützen die Hypothese, dass MPA möglicherweise einen wesentlichen Anteil an den ungünstigen Wirkungen einer Hormonersatz-Therapie hat. Hierbei handelt es sich nicht um einen Klassen-Effekt aller Progestine sondern um eine spezifische Eigenschaft von MPA. Mineralokortikoid-Rezeptoren, welche durch Aldosteron und durch MPA aktiviert werden, besitzen auch eine wesentliche Funktion für pathologische Umbauprozesse im Myokard und im Gefäßsystem. Daher wurde in einem weiteren Ansatz die Frage untersucht, ob Östrogene und unterschiedliche synthetische Progestine (MPA, Drospirenon) aldosteron-gesteuerte, pathologische Umbauprozesse im Herzkreislaufsystem möglicherweise gegensinnig beeinflussen. Nach 8-wöchiger Aldosteron-Salz Behandlung zeigten zuvor normotensive Wistar Ratten eine arterielle Hypertonie, eine Myokardhypertrophie sowie ausgeprägte, perivaskuläre inflammatorisch-fibrosierende Veränderungen im Myokard und der Aorta. Diese wurden durch eine Ovarektomie verstärkt und durch die Substitution von Östradiol gemindert. Die Kombination von Östradiol und MPA, nicht jedoch von Östradiol und Drospirenon führte zu einer massiven Verstärkung des kardiovaskulären remoidelings. Gleichsinnige Beobachtungen wurden auch an den Nieren der Tiere gemacht; MPA, nicht jedoch DRSP, induzierte eine massive Nephropathie mit extensiver Glomerulosklerose, inflammatorischen Infiltraten und einer stark ausgeprägten Tubulo- und Vaskulopathie. Die ungünstigen Effekte von MPA waren auch hier wiederum mit einer verstärkten Expression und Aktivität der NADPH Oxidase verbunden. An der Niere MPA behandelter Tiere wurde zudem eine verstärkte Expression des endothelialen Natrium Kanals (ENaC) nachgewiesen, welche als kausaler Mechanismus der unter MPA exzessiv gesteigerten Natriumresorption in Betracht kommt. Drospirenon, welches neben seiner Wirkung als Progestin auch eine starke anti-mineralokortikoide Wirkung besitzt, führte in Kombination mit Östradiol zu einer kompletten Normalisierung des kardiovaskulären und renalen Phänotyps. Zusammenfassend besitzt die Wahl eines spezifischen, synthetischen Progestins (MPA, DRSP) einen hohen Stellenwert für die Sicherheit und Effizienz einer Hormonersatz-Therapie bei Patientinnen mit bereits bestehenden Herz- Kreislauferkrankungen zu besitzen. Neuere Progestine (DRSP) mit einem genau definierten Wirkungsspektrum könnten auch klinisch zu einer besseren Verträglichkeit einer HRT führen und die protektiven Wirkungen von Östrogenen unterstützen. Hierzu sind weitere klinische und experimentelle Untersuchungen erforderlich.

Chen Juhua. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 114-133). / Abstract --- p.1 / Chapter Chapter One: --- Background and Literature Review / Chapter Part One: --- Population at Risk --- p.3 / Chapter Part Two: --- Review of Physiology of the Menopause --- p.5 / Chapter Part Three: --- Review of the Definition of Terms --- p.7 / Chapter Part Four: --- Significance of Menopausal Age --- p.8 / Chapter Part Five: --- Symptoms Associated with the Menopause --- p.11 / Chapter Part Six: --- Disturbance in Sexuality --- p.13 / Chapter Part Seven: --- Implication on the Health Status --- p.14 / Chapter Part Eight: --- Contraception for Perimenopausal Women --- p.18 / Chapter Part Nine: --- Significance and Objectives of This Study --- p.22 / Chapter Chapter Two: --- Methodology / Chapter Part One: --- Method of Data Collection --- p.23 / Chapter Part Two: --- Method of Data Analyses --- p.31 / Chapter Chapter Three: --- Results / Chapter Part One: --- Sociodemographic Characteristic --- p.36 / Chapter Part Two: --- Age at Natural Menopause --- p.38 / Chapter Part Three: --- Symptoms Associated with the Menopause --- p.41 / Chapter Part Four: --- Disturbance in Sexuality --- p.51 / Chapter Part Five: --- Illness Results from the Menopause --- p.60 / Chapter Part Six: --- Contraceptive Status --- p.66 / Chapter Chapter Four: --- Discussion / Chapter Part One: --- Age at Natural Menopause --- p.74 / Chapter Part Two: --- Symptoms Associated with the Menopause --- p.78 / Chapter Part Three: --- Disturbance in Sexuality --- p.82 / Chapter Part Four: --- Illness Results from Menopausal Transition --- p.86 / Chapter Part Five: --- Contraception for Perimenopausal Women --- p.91 / Conclusion --- p.99 / Implication and Recommendation --- p.100 / Limitation --- p.102 / Appendix --- p.105 / Reference --- p.114

Estima-se que, no ano de 2025, 23% da população total dos países desenvolvidos estarão com mais de 60 anos, evidenciando-se assim o envelhecimento gradativo do contingente populacional destes países. Deste modo, é perceptível o contingente de mulheres que estarão vivenciando a fase da menopausa com seus efeitos biológicos, psicológicos e sociais. As mudanças hormonais e fisiológicas que acontecem nas mulheres durante a fase da menopausa, acompanhadas pela desvalorização estética do corpo e por toda uma sintomatologia física e psíquica, têm sido interpretadas como perda da feminilidade, sinalizando o envelhecimento inevitável e a finitude. No entanto, muitos dos desconfortos que as mulheres vivenciam nesta fase não se devem às mudanças biológicas, mas ao seu processo de socialização, caracterizando a influência de gênero. Neste contexto, este trabalho teve como objeto o estudo da influência da relação de gênero na vivência e no significado do processo da menopausa, tendo como objetivos: descrever a vivência da menopausa a partir da perspectiva de mulheres que a vivenciam e identificar as particularidades relacionadas ao gênero diretamente envolvidas na experiência da menopausa a partir da perspectiva das mulheres. Para desenvolvimento do trabalho foi utilizada abordagem qualitativa de natureza descritiva com vinte mulheres de idade entre 45 e 55 anos que apresentavam menopausa espontânea e eram clientes das Unidades Básicas de Saúde da cidade de Curitibanos-SC, no período de 1 a 15 de outubro de 2009. Para a coleta de dados foi utilizado um roteiro de entrevista semi-estruturada com uma questão norteadora: Fale-me como é para você estar vivenciando a menopausa. A interpretação e análise foram feitas através de análise de conteúdo do tipo temática descritas por Bardin. Nas narrativas, identificaram-se categorias que foram integradas em quatro temas principais: 1- Vivenciando a Menopausa, 2- Identificando Transformações no Corpo e na Vida, 3- Cuidando de Si, 4- Buscando Informações/Influências e Construindo Conhecimento. Foi possível identificar nessas categorias que as mulheres trazem o conceito de que a fase da menopausa é uma doença, e relacionam essa fase com envelhecimento e declínio físico, a qual traz grandes sofrimentos, o que demonstra a influência de gênero no vivenciar desta fase. As entrevistadas explicitaram em suas falas diversos sintomas que as incomodavam e interferiam em suas atividades diárias e na sua maneira de ser, repercutindo muitas vezes no seu comportamento familiar e profissional. O conhecimento sobre a menopausa, neste grupo de mulheres, foi construído ao longo de suas vidas e reflete as suas realidades culturais e sociais, deixando evidente a escassez de fontes de informação e os tabus relacionados com relação à fase da menopausa. Este estudo contribui com a geração de conhecimentos levando em consideração os efeitos que a influência de gênero pode ter na vivência e percepção da menopausa, desmistificando-a para que a vivência das mulheres durante esse período não seja condicionada por estereótipos e crenças relacionadas ao gênero. / They is esteem that, in the year of 2025, 23% of the total population of the developed countries will be with more than 60 years, what show the gradual aging of the population contingent of these countries. In this way, is perceivable the contingent of women who will be living deeply the phase of the menopause with its biological, psychological and social effects. The physiological and chemical changes that happen in the women during the menopauses phase, followed with the aesthetic depreciation of the body, have been interpreted as loss of the feminine characteristics, signaling the inevitable aging and the end of the life. However, many of the discomforts that the women live in this phase not must to the biological changes, but to its process of socialization, characterizing the genre influence. In this context, this work had as object the study of the influence of the relation of genre in the experience and meaning of the process of the menopause, having as objective: describes the experience of the menopause on the perspective of women and to identify the particularitities involved to the genre in the experience of the menopause on the perspective of the women. For development of the work, was done one research descriptive-qualitative with customers of the Basic Units of Health of the city of Curitibanos-SC, in the period of 1 to 15 of October of 2009. For the collect of data, one structured interview was used with an orienting question: It speaks to me, as are for you to be living the menopause. The interviews were done with 20 women, with ages between 45 and 55 years and that had presented spontaneous menopause. The interpretation and analysis was done by analysis of content of the thematic type described by Bardin. In the narratives, was done the identification of categories that was integrated in four main subjects: Living on the Menopause, Identifying Transformations in the Woman Body and in the Life, Cares Myself, Research Information/Influences and Building Knowledge. Was possible identify in these categories that the women bring the idea that the menopause phase is an illness, and relate this phase with aging and physical decline, which brings great sufferings, what it demonstrates to the influence of genre in this phase. The interviewed ones showed diverse symptoms in its words, this bother and intervene in the daily activities and its way to be, and this situation, influence many times in its familiar and professional behavior. The knowledge on the menopause, in this group of women, was constructed throughout its lives and reflects its cultural and social realities, leaving evident the scarcity of information sources and the taboos related with the subject. This work improve of knowledge in consideration the effect that the genre influence can have in the experience and perception of the menopause, demystifying the experience mode of the women during this period, not conditioning for stereotypes and beliefs related to the genre.

Rates of obesity and the associated comorbidities continue to increase for women in the United States. Despite information available, efforts at weight loss are often unsuccessful because women lack integral knowledge of how to approach the various components essential for weight loss. This doctoral project was created to address the practice question of whether obesity can be reduced through a step-wise weight loss program that identifies essential elements to reduce weight in menopausal age women. Guided by the information-motivation-behavioral skills model, this project led 17 volunteer participants from a Northwest, Florida primary care clinic through 6 weeks of protocols supplemented with Facebook interactions. A pretest/posttest comparison showed increased knowledge regarding weight loss and increased self-efficacy as measured by the PANSE scale. All participants had some decrease in weight and an average of a drop in systolic blood pressure of 4 mmHg. This supports the use of a nurse-lead structured education and support model for improved weight loss in women. This project can lead to positive social change with the ability to assist women with obesity and hypertensive disorders, thus reducing morbidity and mortality as well as improving quality of life.

No description available.

Thesis (M.S.)--Rutgers University, 2009. / "Graduate Program in Nutritional Sciences." Includes bibliographical references (p. 42-49).

Menopausal symptoms, including sleep problems, occur as a result of reduced production of ovarian hormones in middle-aged women, and are often treated with replacement of these hormones. However, the efficacy of hormone replacement for improving sleep is controversial. We assessed sleep/wake patterns during baseline and recovery following 6 h of sleep deprivation in ovariectomized middle-aged rats treated with oil, estradiol, or estradiol and progesterone. We found that, at baseline, hormone administration reduced rapid eye movement (REM) sleep initiation and non-REM sleep amount, promoting wakefulness, particularly during the dark (active) phase, but that, during recovery following sleep deprivation, hormonal treatment reduced sleep intensity initially and lengthened REM sleep recovery. These results indicate that in middle-aged female rats ovarian hormones modulate baseline and recovery sleep differently, possibly by modulating circadian and homeostatic regulation of sleep in an age-dependent manner.