Avaliação da elegibilidade para terapia hormonal em pacientes em menopausa com queixas geniturinárias: um estudo retrospectivo no Huem
Tipo
TCC
Data de publicação
2025-05-29
Periódico
Citações (Scopus)
Autores
Buscke, Ellen Dumsch
Elias, Isabella Lambert
Elias, Isabella Lambert
Orientador
Pachnicki, Jan Pawel Andrade
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Resumo
Introdução: A Síndrome Geniturinária da Menopausa (SGM) é uma condição prevalente entre mulheres climatéricas, impactando significativamente sua qualidade de vida. A Terapia de Reposição Hormonal (TRH), especialmente com estrogênio local, é considerada o tratamento padrão ouro para os casos moderados a graves, desde que não haja contraindicações. Objetivo: Avaliar a prevalência da SGM e a elegibilidade para TRH em mulheres com mais de 10 anos de menopausa atendidas nos ambulatórios de Ginecologia do Hospital Universitário Evangélico Mackenzie. Metodologia: Trata-se de um estudo transversal retrospectivo, observacional e descritivo. Foram analisados 193 prontuários de pacientes com mais de 10 anos de menopausa, cujos dados clínicos foram extraídos e avaliados por meio de testes estatísticos apropriados. Resultados: Das 193 pacientes analisadas, 89% apresentavam sintomas compatíveis com SGM, sendo os mais prevalentes a atrofia do epitélio vaginal (67,8%) e o colo atrófico (66,7%). Cerca de 76% das mulheres foram consideradas elegíveis para o uso de TRH, enquanto os principais fatores de inelegibilidade foram ausência de sintomas (44%) e câncer de mama ativo (30%). Não foi observada correlação significativa entre tempo de menopausa e número de sintomas (p = 0,97). Conclusão: O estudo revelou que a SGM é uma condição muito prevalente e frequentemente subnotificada em mulheres com longos períodos pós-menopausa. A maioria das pacientes avaliadas poderia se beneficiar da TRH, desde que avaliadas individualmente. Os achados deste estudo ressaltam a importância da anamnese ativa e da escuta qualificada para o diagnóstico adequado, bem como o potencial de impacto positivo da ampliação do acesso à TRH no contexto do SUS.
Introduction: Genitourinary Syndrome of Menopause (GSM) is a prevalent condition among climacteric women, significantly affecting their quality of life. Hormone Replacement Therapy (HRT), especially local estrogen therapy, is considered the gold standard treatment for moderate to severe cases, provided there are no contraindications. Objective: To assess the prevalence of GSM and the eligibility for HRT among women with more than 10 years of menopause, treated at the gynecology outpatient clinics of the Hospital Universitário Evangélico Mackenzie. Methods: This is a retrospective cross-sectional, observational, and descriptive study. A total of 193 medical records of women with over 10 years of menopause were analyzed, with clinical data extracted and evaluated using appropriate statistical tests. Results: Among the 193 patients assessed, 89% presented symptoms consistent with GSM, with the most common being vaginal epithelial atrophy (67.8%) and atrophic cervix (66.7%). Approximately 76% of women were considered eligible for HRT, while the main reasons for ineligibility were absence of symptoms (44%) and active breast cancer (30%). No significant correlation was found between the duration of menopause and the number of symptoms (p = 0.97). Conclusion: This study revealed that GSM is a highly prevalent and often underreported condition in women with long postmenopausal periods. Most patients evaluated could benefit from HRT, provided individualized clinical assessment is performed. The findings emphasize the importance of active anamnesis and qualified listening for accurate diagnosis, as well as the potential positive impact of expanding access to HRT within the Brazilian public health system (SUS).
Introduction: Genitourinary Syndrome of Menopause (GSM) is a prevalent condition among climacteric women, significantly affecting their quality of life. Hormone Replacement Therapy (HRT), especially local estrogen therapy, is considered the gold standard treatment for moderate to severe cases, provided there are no contraindications. Objective: To assess the prevalence of GSM and the eligibility for HRT among women with more than 10 years of menopause, treated at the gynecology outpatient clinics of the Hospital Universitário Evangélico Mackenzie. Methods: This is a retrospective cross-sectional, observational, and descriptive study. A total of 193 medical records of women with over 10 years of menopause were analyzed, with clinical data extracted and evaluated using appropriate statistical tests. Results: Among the 193 patients assessed, 89% presented symptoms consistent with GSM, with the most common being vaginal epithelial atrophy (67.8%) and atrophic cervix (66.7%). Approximately 76% of women were considered eligible for HRT, while the main reasons for ineligibility were absence of symptoms (44%) and active breast cancer (30%). No significant correlation was found between the duration of menopause and the number of symptoms (p = 0.97). Conclusion: This study revealed that GSM is a highly prevalent and often underreported condition in women with long postmenopausal periods. Most patients evaluated could benefit from HRT, provided individualized clinical assessment is performed. The findings emphasize the importance of active anamnesis and qualified listening for accurate diagnosis, as well as the potential positive impact of expanding access to HRT within the Brazilian public health system (SUS).
Descrição
Palavras-chave
menopausa , síndrome geniturinária da menopausa. , terapia de reposição hormonal , terapia de reposição de estrogênios , menopause , atrophy , hormone replacement therapy , estrogen replacement therapy