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Prevenção de doenças na menopausa

Abordagem holistica do climatério


Palestra realizada

Conheça uma Nova Medicina da

Qualidade de Vida

Para viver Mais e Melhor

(ver a conferência na íntegra em Conferencias proferidas em 2012)


     O exercício clínico diário de qualquer Médico baseia-se em estratégias fundamentais:

a)      Identificar a doença que causa os sintomas

b)      Identificar e modificar os fatores de risco que causam doenças

c)       Promover uma medicina do estilo de vida

d)      Melhorar a qualidade de vida

e)      Promover a Saúde e o Bem-estar

A Saúde é “ um estado completo de bem-estar  físico,  mental e social e não apenas  a ausência de doença ou enfermidade “ (Organização Mundial da Saúde).

Nem sempre as mulheres necessitam de  tratamentos hormonais na Menopausa.  Se forem necessários há regras importantes que devem cumprir-se.

Mas TODAS as mulheres necessitam  praticar uma Medicina do Estilo de Vida !

Serão dados conselhos sobre o que é indispensável para manter a Saúde e o Bem-Estar com base em recentes progressos da Medicina.






Os  estudos publicados esta semana revelam que, ao contrário do que muitos pensavam, os tratamentos durante a menopausa não só não causam o cancro da mama mas também reduzem para metade os riscos de doenças do coração que são a principal causa de morte das mulheres idosas.


Já tenho vindo a defender estes fatos desde que foi publicado o tristemente célebre estudo WHI , de há dez anos atras, que causou grande pânico e fez com que muitas mulheres deixassem de melhorar a sua qualidade de vida como também defendi em artigos publicados que vos envio em anexo.


Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial


Hormone Therapy Has Many Favorable Effects in Newly Menopausal Women: Initial Findings of the Kronos Early Estrogen Prevention Study (KEEPS)


15 Top Medical Organizations Agree on Hormone Therapy Use

Press release July 9, 2012


After 10 years of debate regarding the risks and benefits of hormone therapy, 15 top medical organizations have come together to issue a statement of agreement regarding the benefits of hormone therapy for symptomatic menopausal women. The American Society for Reproductive Medicine (ASRM), and The Endocrine Society, concludes that hormone therapy is still an acceptable treatment for menopausal symptoms. This statement has been endorsed by 12 other leading organizations in women’s health.


The purpose of this statement is to reassure women and their providers that hormone therapy is acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women. Over the last 10 years, there has been a complete abandonment of hormone therapy in some settings accompanied by reluctance to treat women who would benefit from relief of their symptoms.


As a result, some women have sought unproven alternative therapies.


“We believe that too many symptomatic women are missing out on the proven benefits of hormone therapy because the results of the WHI, which studied the long-term use of hormones to prevent chronic disease, were misinterpreted for women with menopausal symptoms” said Dr. Margery Gass, Executive Director for NAMS. “Women and clinicians are frustrated by the many conflicting recommendations. That’s why we initiated this effort to bring these notable medical organizations together in agreement regarding the use of hormone therapy.”


Roger Lobo, MD, Past President of the American Society for Reproductive Medicine added, “Physicians can help patients determine, based on their own particular characteristics and history, whether or not they are good candidates for hormone therapy and what type of HT will provide them the greatest relief at the lowest risk. A decade of research and analysis has shown us that the generalized conclusions of the WHI do not apply to younger women at the beginning of the menopausal transition.”


“The results of the WHI and the conflicting reports that followed led many women to believe hormone therapy may not be a safe treatment for menopausal symptoms,” said Janet E. Hall, MD, immediate Past President of The Endocrine Society. “We want women to know that there are options out there for relief of their menopausal symptoms. The level of risk depends on the individual, her health history, age, and the number of years since her menopause began.”


Major points of agreement among the societies include:


treatments are low doses of vaginal estrogen.



Study Finds Estrogen Therapy Improves Depression and Anxiety in Recently Menopausal Women Without Adverse Cognitive Effects

Press release October 5, 2012

The results of the cognitive study showed that menopausal hormone therapy, especially o-CEE, had beneficial effects on depression and anxiety. In contrast to the Women's Health Initiative Memory Study (WHIMS), which found deleterious effects of HT on cognition in women 65 years and older, KEEPS found no adverse effects of HT on any test of cognition, including the 3MSE memory test, a test of global cognitive abilities used in WHIMS.

For more information about the KEEPS study results, visit:




KEEPS Reports Hormone Therapy Provides Quality of Life Benefits for Newly Menopausal Women


Orlando, Florida (October 3, 2012) – Today at the North American Menopause Society’s Annual Meeting, investigators presented the first results of the highly anticipated Kronos Early Estrogen Prevention Study (KEEPS). Designed and funded by the Kronos Longevity Research Institute to answer questions that the Womens Health Initiative (WHI) study raised, KEEPS shows that estrogen-progesterone treatment started soon after menopause not only relieves many menopausal symptoms but also improves mood and some markers of cardiovascular risk.


Keeps results also showed no significant adverse effects or benefits of hormone therapy on the rates of breast cancer, endometrial cancer, heart attacks, stroke, transient ischemic attacks (“mini strokes”), or venous thromboembolic disease (blood clots), but the study was too small to draw definite conclusions about these clinical events.


Hormone Therapy Has Many Favorable Effects in Newly Menopausal Women: Initial Findings of the Kronos Early Estrogen Prevention Study (KEEPS)

PHOENIX, Oct. 3, 2012 -- Estrogen/progesterone treatment started soon after menopause appears safe and relieves many of the symptoms menopausal women face as well as improving mood and markers of cardiovascular risk, according to a multicenter randomized study presented at the North American Menopause Society (NAMS) Annual Meeting in Orlando, Florida.

"The KEEPS provides invaluable information for women close to menopause and their clinicians," said S. Mitchell Harman, MD, Ph.D., director of the the Kronos Longevity Research Institute, the organization that sponsored the study. "The data showed improvements in cognition, mood, menopausal symptoms, and sexual function in younger women.  In addition, some measures showed slight evidence that hormone therapy might be cardio-protective in this age group, although results were not definitive and would require additional study."

No significant differences in adverse events (breast cancer, endometrial cancer, myocardial infarction, TIA, stroke, or venous thromboembolic disease) were found among groups. However, the absolute numbers of such events were extremely small in all three treatment groups, making definitive conclusions impossible.

Conclusions:  KEEPS found many favorable effects of HT in newly menopausal women.



Date of release: 08 October, 2012

The good news is that, in this young cohort, no safety issues were found to be related to HT.

In conclusion, KEEPS found many favorable effects of HT in newly menopausal women. The results provide reassurance for women who are recently menopausal and taking HT for short-term treatment of menopausal symptoms. KEEPS also highlights the need for individualized decision-making about HT, given that oral CEE and transdermal estradiol may have different profiles of effects and different women have different symptom profiles and priorities for treatment.

The good news is that, in this young cohort, no safety issues were found to be related to HT.



The Relaxation Response

By Herbert Benson, M.D.

We reviewed the Eastern and Western religious, cultic, and lay practices that led to the Relaxation Response. From those age-old techniques we have extracted four basic components necessary to bring forth that response:


(1) A Quiet Environment

Ideally, you should chose a quiet, calm environment with as few distractions as possible.  A quiet room is suitable, as is a place of worship.  The quiet environment contributes to the effectiveness of the repeated word or phrase by making it easier to eliminate distracting thoughts.


(2) A Mental Device

To shift the mind from logical, externally oriented thought, there should be a constant stimulus: a sound, word, or phrase repeated silently or aloud; or fixing gazing at an object.   Since one of the major difficulties in the elicitation of the Relaxation Response is "mind wandering," the repetition of the word or phrase is a way to help break the train of distracting thoughts.  Your eyes are usually closed if you are using a repeated sound or word; of course your eyes are open if you are gazing.    Attention to the normal rhythm of breathing is also useful and enhances the repetition of the sound or the word.


(3) A Passive Attitude

When distracting thoughts occur, they are to be disregarded and attention redirected to the repetition or gazing; you should not worry about how well you are performing the technique, because this may well prevent the Relaxation Response from occurring.   Adopt a "let it happen" attitude.  The passive attitude is perhaps the most important element in eliciting the Relaxation Response.  Distracting thoughts will occur.  Do not worry about them.  When these thoughts do present themselves and you become aware of them, simply return to the repetition of the mental device.  These other thoughts do not mean you are performing the technique incorrectly.  They are to be expected."


(4) A Comfortable Position

A comfortable posture is important so that there is no undue muscular tension.   Some methods call for a sitting position.  A few practitioners use the cross-legged "lotus" position of the Yogi.  If you are lying down, there is a tendency to fall asleep.  As we have noted previously, the various postures of kneeling, swaying, or sitting in a cross-legged position are believed to have evolved to prevent falling asleep.  You should be comfortable and relaxed.


1. Sit quietly in a comfortable position.


2. Close your eyes.


3. Deeply relax all your muscles, beginning at your feet and progressing up to your face. Keep them relaxed.


4. Breathe through your nose. 


5. Become aware of your breathing. 


6. As you breathe out, say the word, "one"* silently to yourself. For example, breathe in ... out, "one"; breath in .. out, "one", etc. 


7. Breathe easily and naturally.


8. Continue for 10 to 20 minutes. 


You may open your eyes to check the time, but do not use an alarm. 
When you finish, sit quietly for several minutes, at first with your eyes closed and later with your eyes opened. Do not stand up for a few minutes.

Do not worry about whether you successful achieve a deep level of relaxation. 

Maintain a passive attitude and permit relaxation to occur at its own pace. When distracting thoughts occur, try to ignore them by not dwelling upon them and return to repeating "one."

With practice, the response should come with little effort. Practice the technique once or twice daily, but not within 2 hours after any meal since the digestive processes may interfere with the elicitation of the Relaxation Response.

The more you relax the lower is the oxygen consumption.




Aspirina reduz risco de carcinoma hepatocelular


Benefits of menopausal hormone therapy-timing is key


Coronary Heart Disease in Women


Effect of daily aspirin on long-term risk of death due to cancer


Effect of reducing total fat intake on body weight


Maio 2013


   The 2013 British Menopause Society & Women's Health Concern

   recommendations on hormone replacement therapy 


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