Hormonal replacement for climacterics increases skin collagen content.

Objective: To investigate whether clinical criteria could differentiate between women with vulvovaginitis who were culture positive or negative for vaginal Candida species. Methods: Vulvovaginal specimens were obtained from 501 women with a vaginal discharge and/or pruritis. Clinical information and wet mount microscopy findings were obtained. All specimens were sent to a central laboratory for species identification. Results: A positive culture for Candida species was obtained from 364 (72.7%) of the specimens. C. albicans was identified in 86.4% of the positive cultures, followed by C. glabrata in 4.5%, C. parapsilosis in 3.9%, C. tropicalis in 2.7% and other Candida species in 1.4%. Women with a positive Candida culture had an increased utilization of oral contraceptives (26.1% vs. 16.8%, p = 0.02) and antibiotics (8.2% vs. 0.7%, p = 0.001), and were more likely to be pregnant (9.1% vs. 3.6%, p = 0.04) than the culture-negative women. Dyspareunia was more frequent in women without Candida (38.0% vs. 28.3%, p = 0.03) while vaginal erythema (p = 0.01) was more common in women with a positive Candida culture. Conclusions: Although quantitative differences were observed, the presence of vaginal Candida vulvovaginitis cannot be definitively identified by clinical criteria. Key words: VULVOVAGINITIS; CANDIDA SPECIES; DIFFERENTIAL DIAGNOSISIt is difficult to obtain accurate information regarding the prevalence and incidence of vulvovaginitis associated with a Candida species infection. Although up to 75% of women will acknowledge having had a vaginal Candida infection during their lifetime 1 , this diagnosis is suspect. The skyrocketing sales of over-the-counter medications for Candida vaginitis, at a rate many times that of the number of infected women, highlights the prevalent overdiagnosis of this disorder. Many women, and unfortunately also many clinicians, label any vaginal discharge, itching, pain or burning as a 'yeast' infection. In three studies, more than half of the women with a supposed vaginal yeast infection were misdiagnosed [2][3][4] . Conversely, in many women a true vaginal Candida infection may remain unrecognized. Detection of a vaginal Candida infection by microscopic examination of a vaginal specimen diluted in potassium hydroxide is relatively insensitive, especially for non-albicans species 3,5 . False-positive microscopic examinations are also possible 5 and are Dis Obstet Gynecol 2001;9:221-225 Infect

Many students engage in high-risk sexual behavior with multiple partners and use condoms inconsistently. Knowledge of the acquisition and modes of sexual and vertical transmission of HIV are strikingly deficient.

Physical exercises can reduce menopausal symptoms and enhance HRQOL, independent of whether hormone therapy is taken.

One hundred forty-two women with polycystic ovary syndrome (PCOS) with an average body mass index (BMI) of 29.1 kg/m(2) and average age of 25.12 years were studied. By BMI, 30.2% were normal, 38.0% were overweight and 31.6% were obese. Thirty-one eumenorrheic women matched for BMI and age, with no evidence of hyperandrogenism, were recruited as controls. The incidence of dyslipidemia in the PCOS group was twice that of the Control group (76.1% versus 32.25%). The most frequent abnormalities were low high-density lipoprotein cholesterol (HDL-C; 57.6%) and high triglyceride (TG) (28.3%). HDL-C was significantly lower in all subgroups of women with PCOS when compared to the subgroups of normal women. No significant differences were seen in the total cholesterol (p = 0.307), low-density lipoprotein cholesterol (LDL-C; p = 0.283) and TGs (p = 0.113) levels among the subgroups. An independent effect on HDL-C was detected for glucose (p = 0.004) and fasting insulin (p = 0.01); on TG for age (p = 0.003) and homeostatic model assessment insulin resistance (p = 0.03) and on total cholesterol and LDL-C for age (p = 0.02 and p = 0.033, respectively). In conclusion, dyslipidemia is common in women with PCOS, mainly due to low HDL-C levels. BMI has a significant impact on this abnormality.

Our data showed the high frequency of obesity in our population and of the cardiovascular risks (glucose, systemic arterial hypertension, and low HDL-C) associated with high BMI.

Both metformin and lifestyle changes may increase the number of menstrual cycles in PCOS. This effect was related to a decrease in BMI.

Conflict of interest: noneFemale aging is a process that involves hypoestrogenism time, the individual impact on each woman, and what we can do as experts to reduce morbidity and provide quality of life. This natural process in the female life cycle has been of concern to women after menopause. Changes in different biophysical and psychosocial aspects, and their individual experiences, have repercussions on the lives of patients seeking specialized and multidisciplinary support to reduce the harmful effects of prolonged hypoestrogenism. Overweight and obesity, inadequate living habits and the presence of multi-morbidities cause damage to the quality of life and impact the functional capacity. Behavioral prescription and hormone therapy are among the treatments given to ease symptoms and reduce morbidity. A better understanding of these factors can help identify groups that require more care after menopause.Keywords: post-menopause, women, aging.Aging is a physiological process in life and, in women, it is influenced by hypoestrogenism the greater their longevity. The increase in life expectancy among women brought changes in the mortality panorama. 1 Currently, the prevalence of chronic diseases, malignancies and repercussions of hypoestrogenism in each individual serves as motivation for health professionals in clinical and gynecological settings to offer prevention and promotion actions for women seeking quality of life and reduced morbidity. 2,3Also, concern about the quality of life and prevention of chronic diseases and cancer are the demands of women seeking a gynecologist.3,4 The notion of health has been a concern of the very patients interested in weight maintenance, adoption of healthy lifestyle habits, cessation of legal and illegal adictions, and the use of medications for adequate control of chronic diseases. 5Changes in biophysical aspects also affect the quality of life caused by prolonged hypoestrogenism related to urogenital disorders, changes in sexual behavior and libido, memory, skin tropism, effects on lipid profile, and bone metabolism. Psychosocial factors contribute to a positive or negative perception of women's health, which depends on how she experiences and sees life after menopause.7 There are occurrences such as loss of loved ones, change in marital status, retirement process, and prior preparation of this phase in which women turn their attention to themselves, their achievements and accomplishments, their wishes and needs. 8 It is known that age, overweight and obesity, smoking, and the presence of multi-morbidities impair the quality of life and impact the functional capacity.9 According to Fonseca et al., the most relevant information in medical history declared at the time of the initial treatment in women after menopause were: hypertension (44.94%), diabetes (10.1%), smoking (8.39%), thyroid disorders (7.7%), malignancies (6.41%), cardiovascular disease (17.1%), dyslipidemia (0.88%) and psychiatric disorders (0.06%).