Climacteric Symptoms: Importance and Management

et al. 2020

Preprint

Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to a further reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), and any significant changes in neoplasm mortality (β=0.07; 95% CI, -0.01. 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.

Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

et al. 2020

Preprint

“…1 Menopause is the transition period in a woman's life from the reproductive to the nonreproductive cycle. 2 At such a time, clinical changes occur in association with prolonged, permanent, and physiological hypoestrogenism, 3 and they may be related to the onset or aggravation of chronic noncommunicable diseases. 4 In this period, ranging from age 40 to 65 years, a woman can benefit from health prevention and promotion actions taken by SUS and PNAISM.…”

Section: Introductionmentioning

confidence: 99%

National Policy of Comprehensive Women’s Health Care and Mortality in Menopause: Has Anything Changed?

et al. 2020

Preprint

Background: The National Policy of Comprehensive Women’s Health Care was implemented more than two decades ago, and the monitoring of potential benefits should be explored. Menopause is a period of life for which there are prevention and health promotion actions carried out by the government’s all-encompassing sole Unify Health System (UHS) and factored into Brazilian policies. It is thus our purpose to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: This is an ecological study with secondary data analysis conducted by the Setor de Atenção Primária, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the IT Department of SUS between 1996 and 2016, divided in two periods 1996 to 2004 and 2005 to 2006 according to implementation of the National Police. The data included the death records of Brazilian women aged 35 to 64 years who had a precise diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was set at 5%. Stata 11® (StataCorp, LCC) was used. Results: Menopausal women’s main causes of death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), but not to any significant changes in neoplasm mortalities (β=0.07; 95% CI, -0.01 to 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death among menopausal women are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality. The trend of mortality rates among menopausal women, following PNAISM implementation, was a decline in circulatory system diseases and in nutritional, metabolic, and endocrine diseases, with no changes for neoplasms and respiratory system diseases.

“…[1][2][3] Climacteric is the transition period in a woman's life from the potential for reproducing to a nonreproductive phase. 5 At such a time, clinical changes occur in association with prolonged, permanent, and physiological hypoestrogenism, [5][6][7] and they may be related to the onset or aggravation of chronic noncommunicable diseases. 8,9 In this period, ranging from age 40 to 65 years, a woman can bene t from health prevention and promotion actions taken by the SUS and PNAISM.…”

Section: Introductionmentioning

confidence: 99%

Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

et al. 2020

Preprint

Background: The National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 to correspond with the implementation of the National Policy. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women from 1996 to 2016 were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Mortality from circulatory system diseases was reduced following implementation of the PNAISM (β=-0.58; 95% CI -0.68 to -0.48; r²=0.93; p<0.001), but no significant changes were observed in mortality from neoplasms (β=0.07; 95% CI -0.01 to 0.15; r²=0.22; p=0.070).Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.