CC BY-NC-ND 4.0 · Rev Bras Ginecol Obstet 2017; 39(11): 608-613
DOI: 10.1055/s-0037-1604200
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Brazilian Women's Health after 65 Years of Age

Saúde de brasileiras acima dos 65 anos de idade
Angela Maggio da Fonseca
1   Gynecology and Obstetrics Departament, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
,
Vicente Renato Bagnoli
1   Gynecology and Obstetrics Departament, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
,
Josefina Odete Polak Massabki
1   Gynecology and Obstetrics Departament, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
,
Wilson Maça Yuki Arie
1   Gynecology and Obstetrics Departament, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
,
Raymundo Soares Azevedo
2   Pathology Departament, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
,
José Maria Soares Jr
1   Gynecology and Obstetrics Departament, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
,
Edmund C. Baracat
1   Gynecology and Obstetrics Departament, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

23 December 2016

11 May 2017

Publication Date:
10 August 2017 (online)

Abstract

Purpose The aim of this study was to evaluate the health aspects of Brazilian women older than 65 years of age.

Design This was a retrospective study that included 1,001 Brazilian women cared for in the gynecological geriatric outpatient office of our institution. We report a cross-sectional analysis of female adults aged over 65 years, including data on demographics, clinical symptoms such as vasomotor symptoms, associated morbidities, physical examination and sexual intercourse. We used the chi-squared test to assess the data.

Results The age of the patients on their first clinic visit ranged from 65 to 98 years, with a mean age of 68.56 ± 4.47 years; their mean age at the time of natural menopause was 48.76 ± 5.07 years. The most frequent clinical symptoms reported during the analyzed period were hot flashes (n = 188), followed by arthropathy, asthenia, and dry vagina. The most frequent associated morbidities after 65 years of age were systemic arterial hypertension, gastrointestinal disturbance, diabetes mellitus, and depression, among others. The assessment of the body mass index (BMI) found decreases in BMI with increased age. At the time of the visit, 78 patients reported sexual intercourse. The majority of women reporting sexual intercourse (89.75%, n =  70) were between 65 and 69 years of age, 8.97% (n = 7) were between 70 and 74 years of age, and only 1.28% (n = 1) of those were aged older than 75 years.

Conclusions Our findings suggested that vasomotor symptoms can persist after 65 years of age. There was a significant decrease in sexual intercourse with increased age. The cardiovascular disturbances in our study are health concerns in these women.

Resumo

Objetivo Avaliar os aspectos de saúde das mulheres brasileiras após os 65 anos de idade.

Métodos O estudo foi retrospectivo, e incluiu 1.001 mulheres brasileiras atendidas no ambulatório de ginecologia geriátrica de nossa instituição. Foi feita uma análise transversal de mulheres com idade acima de 65 anos, incluindo dados demográficos, sintomas clínicos (sintomas vasomotores), morbidades associadas, bem como alterações no exame físico e queixas em relação à atividade sexual. Utilizamos o teste qui-quadrado para avaliar os dados.

Resultados A idade das pacientes na primeira visita clínica variou de 65 a 98 anos, com média etária de 68,56 ± 4,47 anos. A média etária de entrada na menopausa foi de 48,76 ± 5,07 anos. Os sintomas clínicos mais frequentes relatados durante o período analisado foram os sintomas vasomotores (n = 188), seguidos de artropatia, astenia e vagina seca. As morbidades associadas mais frequentes após os 65 anos foram hipertensão arterial sistêmica, distúrbios gastrintestinais, diabete melito e depressão, entre outras. A avaliação do índice de massa corporal (IMC) mostrou redução deste parâmetro antropométrico com o progredir da idade. No momento da visita, 78 pacientes relataram ter relações sexuais. A maioria das mulheres que relatou ter relações sexuais (89,75%, n =  70) estava entre 65 e 69 anos, 8,97% (n = 7) tinham entre 70 e 74 anos, e apenas 1,28% (n =  1) eram mais velhas do que 75 anos de idade.

Conclusões Nossos achados sugerem que os sintomas vasomotores podem persistir após os 65 anos. Houve uma diminuição significativa na relação sexual com o aumento da idade. Os distúrbios cardiovasculares em nosso estudo são preocupações de saúde nestas mulheres.

 
  • References

  • 1 United Nations. [Internet]. World Populations Prospects: the 2002 revision, highlights. New York: United Nations; 2003 [cited 2004 Jan 21]. (ESA/P/WP. 180). Available from: http://www.un.org/esa/population/publications/wpp2002
  • 2 World Health Organization. World Health Statistics Annual – Statistics of Seniors. Geneva: WHO; 2014
  • 3 Instituto Brasileiro de Geografia e Estatística. População. Rio de Janeiro: IBGE; 2014
  • 4 Rodrigues GH, Gebara OC, Gerbi CC, Pierri H, Wajngarten M. Depression as a clinical determinant of dependence and low quality of life in elderly patients with cardiovascular disease. Arq Bras Cardiol 2015; 104 (06) 443-449
  • 5 Randolph Jr JF, Sowers M, Gold EB. , et al. Reproductive hormones in the early menopausal transition: relationship to ethnicity, body size, and menopausal status. J Clin Endocrinol Metab 2003; 88 (04) 1516-1522
  • 6 Ranzijn R, Luszcz M. Measurement of subjective quality of life of elders. Int J Aging Hum Dev 2000; 50 (04) 263-278
  • 7 Kupperman HS, Wetchler BB, Blatt MH. Contemporary therapy of the menopausal syndrome. J Am Med Assoc 1959; 171: 1627-1637
  • 8 Quételet A. Antropométrie ou mesure des différentes facultés de l'homme. Brussels: C. Muquardt; 1870
  • 9 Bagnoli VR, Fonseca AM, Arie WM. , et al. Metabolic disorder and obesity in 5027 Brazilian postmenopausal women. Gynecol Endocrinol 2014; 30 (10) 717-720
  • 10 Makara-Studzińśka MT, Kryś-Noszczyk KM, Jakiel G. Epidemiology of the symptoms of menopause - an intercontinental review. Przegl Menopauz 2014; 13 (03) 203-211
  • 11 Da Fonseca AM, Bagnoli VR, Souza MA. , et al. Impact of age and body mass on the intensity of menopausal symptoms in 5968 Brazilian women. Gynecol Endocrinol 2013; 29 (02) 116-118
  • 12 Zeleke BM, Davis SR, Fradkin P, Bell RJ. Vasomotor symptoms and urogenital atrophy in older women: a systematic review. Climacteric 2015; 18 (02) 112-120
  • 13 Huicochea-Gómez L, Sievert LL, Cahuich-Campos D, Brown DE. An investigation of life circumstances associated with the experience of hot flashes in Campeche, Mexico. Menopause 2017; 24 (01) 52-63
  • 14 Vousoura E, Spyropoulou AC, Koundi KL. , et al. Vasomotor and depression symptoms may be associated with different sleep disturbance patterns in postmenopausal women. Menopause 2015; 22 (10) 1053-1057
  • 15 Palacios S, Henderson VW, Siseles N, Tan D, Villaseca P. Age of menopause and impact of climacteric symptoms by geographical region. Climacteric 2010; 13 (05) 419-428
  • 16 van Dam RM, Li T, Spiegelman D, Franco OH, Hu FB. Combined impact of lifestyle factors on mortality: prospective cohort study in US women. BMJ 2008; 337: a1440
  • 17 European Society of Hypertension-European Society of Cardiology Guidelines Committee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21 (06) 1011-1053
  • 18 American Psychiatric Association. Diagnostic and statistical manual of mental disorders, text revised. Washington (DC): American Psychiatric Association; 2003
  • 19 Coleman MP. Trends in breast cancer incidence, survival, and mortality. Lancet 2000; 356 (9229): 590-591 , author reply 593
  • 20 Lynch CP, McTigue KM, Bost JE. , et al. Excess weight and physical health-related quality of life in postmenopausal women of diverse racial/ethnic backgrounds. J Womens Health (Larchmt) 2010; 19 (08) 1449-1458
  • 21 McMinn J, Steel C, Bowman A. Investigation and management of unintentional weight loss in older adults. BMJ 2011; 342: d1732
  • 22 Wellings K, Collumbien M, Slaymaker E. , et al. Sexual behaviour in context: a global perspective. Lancet 2006; 368 (9548): 1706-1728
  • 23 Syme ML, Cohn TJ. Examining aging sexual stigma attitudes among adults by gender, age, and generational status. Aging Ment Health 2016; 20 (01) 36-45
  • 24 Zeleke BM, Bell RJ, Billah B, Davis SR. Vasomotor and sexual symptoms in older Australian women: a cross-sectional study. Fertil Steril 2016; 105 (01) 149-55.e1
  • 25 Smith RL, Gallicchio L, Flaws JA. Factors affecting sexual activity in midlife women: results from the Midlife Health Study. J Womens Health (Larchmt) 2017; 26 (02) 103-108
  • 26 Nazarpour S, Simbar M, Ramezani Tehrani F, Alavi Majd H. The impact of a sexual enhancement program on the sexual function of postmenopausal women. Climacteric 2016; 19 (05) 506-511