Tesis
Hirsutismo autorreportado e comorbidades na pós-menopausa
Fecha
2017-01-13Autor
Wippel, Cássia dos Santos
Institución
Resumen
Polycystic Ovarian Syndrome (PCOS) is the most frequent metabolic disorder in the female
population. It affects 10% of women of childbearing age, and its pathophysiology, although not
completely known, is associated with insulin resistance, hyperandrogenism and gonadotropin
alteration. The diagnosis is of exclusion and is difficult due to the multiple phenotypes found,
being fundamental the presence of menstrual dysfunction and alteration of the levels of
androgens. Hirsutism, increased pilification in androgen-dependent areas, is a frequent
complaint and correlates with PCOS in up to 95% of cases. Women with PCOS are at greater
risk for developing metabolic syndrome and cardiovascular disease. These comorbidities
usually manifest with aging and there are no guidelines for diagnosing PCOS after menopause.
Because of this, we have attempted to prove the hypothesis that the history of self-reported
hirsutism and / or oligomenorrhea influences the calculation of risk for comorbidities after
menopause (type 2 diabetes mellitus, asthma, chronic bronchitis or emphysema, osteoarthritis,
stroke, Heart failure, angina or myocardial infarction, multiple sclerosis, neoplasia, and
Parkinson's disease). This cross-sectional study investigated women (1057) with at least 55
years of age, post-menopausal, with no cognitive deficit and / or communication difficulty who
were seen in primary care services in a municipality in the south of Brazil during the 24-month
period, Through a structured questionnaire that collected self-reported data on the presence of
comorbidities, reproductive history and complaint of hirsutism in menacme. A significantly
higher prevalence of comorbidities was found in women with a history of hirsutism and / or
oligomenorrhea [OR = 1.6 (95% CI 1.1-2.4), or = hirsutism [OR 2.0 95% CI 1.3-3.2), P =
0.004]. As well as the prevalence of stroke, angina or myocardial infarction, heart failure,
chronic obstructive pulmonary disease and osteoarthritis were significantly higher (p <0.03).
Therefore, the presence of hirsutism and oligomenorrhea in menacing are risk factors for
comorbidities, mainly cardiovascular, these alterations are possibly associated with the
presence of PCOS, so its correct diagnosis in the menacme could avoid the reduction of quality
of life in senectude.