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Introdução: Na menopausa a síntese ovariana de estrogénios e progesterona diminui, o que pode originar uma variedade de sintomas e alterações que podem influenciar a qualidade de vida da mulher. Das terapêuticas disponíveis a terapêutica hormonal de substituição (THS) constitui a mais utilizada para aliviar os sintomas e consequências que a menopausa acarreta. A decisão em iniciar a THS é complexa: os riscos e benefícios devem ser ponderados bem como o seu impacto na qualidade de vida.
Objectivo: Analisar as percepções e padrões de prescrição dos especialistas de medicina geral e familiar (MGF) e de ginecologia/obstetrícia (G/O).
Materiais e Métodos: Foi realizado um estudo de carácter observacional transversal. Para o efeito foram administrados questionários de auto-preenchimento aos médicos especialistas de ginecologia/obstetrícia e de medicina geral e familiar, presentes no “XI Congresso Português de Ginecologia” e no “XIV Congresso Nacional de Medicina Geral e Familiar”, respectivamente.
Resultados: Participaram no estudo 326 médicos, 18,1% especialistas de ginecologia/obstetrícia e 81,9% especialistas de medicina geral e familiar. Da amostra 43,7% dos especialistas licenciaram-se entre 2005-2008. 97,3% dos especialistas de MGF e 98,3% dos especialistas de G/O consideram que a menopausa afecta a qualidade de vida da mulher. 71,2% dos especialistas de MGF e 57,6% dos especialistas de G/O consideram que a THS se deve realizar apenas em mulheres com sintomatologia embora também considerem que poderá ser utilizada na prevenção de outras patologias, principalmente da osteoporose. 71% dos especialistas de MGF e 98,3% dos especialistas de G/O referem prescrever THS na sua prática clínica diária, sendo que os primeiros preferem utilizar a forma oral e os segundos a forma transdérmica. 100% dos especialistas de MGF e 93,3% dos especialistas de G/O consideram que a qualidade de vida da mulher pós-menopáusica melhorou com a THS.
Discussão e conclusão: A maioria dos participantes deste estudo revela conhecimentos adequados acerca dos sintomas, alterações e impacto na qualidade de vida da mulher pós-menopáusica e também em relação à utilização e riscos-benefícios da THS. Não obstante foi possível evidenciar ainda algumas discrepâncias entre as especialidades, principalmente na prescrição da THS. Este facto poderá estar relacionado com a escassa existência de protocolos e normas/guidelines que permitam aos especialistas uniformizar os seus conhecimentos, estratégias de intervenção e formas de prescrição da THS na menopausa.
Introduction: At menopause the ovarian synthesis of estrogen and progesterone decreases, leading to a variety of symptoms and physiological changes that according to its intensity may influence women’s quality of life. Among available therapies, hormone replacement therapy (HRT) is the most widely used to relieve its symptoms and consequences. The decision to start HRT is complex: benefits must be weighed against risks and their impact on quality of life. Objectives: To analyze the perceptions and prescribing patterns of “general and family medicine” (GFM) and “gynecology/obstetrics” (G/O) specialists. Materials and Methods: A cross-sectional observational study was conducted. A selfadministered questionnaire was distributed to “gynecology/obstetrics” and “general and family medicine” specialists attending the “XI Portuguese Congress of Gynecology” and the “XIV National Congress of General and Family Medicine”, respectively. Results: 326 physicians participated in the study – 18,1% G/O specialists and 81,9% GFM specialists. 43,7% specialists are recent graduates (2005-2008). 97,3% GFM specialists and 98,3% G/O specialists admitted that menopause severely affects the quality of life of women. 71,2% GFM specialists and 57,6% G/O specialists felt that HRT should be used only in women with symptoms although they also consider that can be used to prevent others diseases, mainly osteoporosis. 71% GFM specialists and 98,3% G/O specialists prescribe HRT in their daily clinical practice, the former prefer to use the oral form and the second the transdermal form. 100% GFM specialists and 93,3% G/O specialists consider that the quality of life of post-menopausal women improved with HRT. Discussion and conclusion: The study participants demonstrated having appropriate knowledge about symptoms, physiological changes and the impact on quality of life of postmenopausal women as well as of HRT recommendations and risks-benefits. Nevertheless we have identified some discrepancies between the specialties, particularly on what concerns HRT prescription. This may be explained by the limited availability of protocols and standards/guidelines that allow experts to standardize their knowledge, intervention strategies and prescribing patterns of HRT.
Introduction: At menopause the ovarian synthesis of estrogen and progesterone decreases, leading to a variety of symptoms and physiological changes that according to its intensity may influence women’s quality of life. Among available therapies, hormone replacement therapy (HRT) is the most widely used to relieve its symptoms and consequences. The decision to start HRT is complex: benefits must be weighed against risks and their impact on quality of life. Objectives: To analyze the perceptions and prescribing patterns of “general and family medicine” (GFM) and “gynecology/obstetrics” (G/O) specialists. Materials and Methods: A cross-sectional observational study was conducted. A selfadministered questionnaire was distributed to “gynecology/obstetrics” and “general and family medicine” specialists attending the “XI Portuguese Congress of Gynecology” and the “XIV National Congress of General and Family Medicine”, respectively. Results: 326 physicians participated in the study – 18,1% G/O specialists and 81,9% GFM specialists. 43,7% specialists are recent graduates (2005-2008). 97,3% GFM specialists and 98,3% G/O specialists admitted that menopause severely affects the quality of life of women. 71,2% GFM specialists and 57,6% G/O specialists felt that HRT should be used only in women with symptoms although they also consider that can be used to prevent others diseases, mainly osteoporosis. 71% GFM specialists and 98,3% G/O specialists prescribe HRT in their daily clinical practice, the former prefer to use the oral form and the second the transdermal form. 100% GFM specialists and 93,3% G/O specialists consider that the quality of life of post-menopausal women improved with HRT. Discussion and conclusion: The study participants demonstrated having appropriate knowledge about symptoms, physiological changes and the impact on quality of life of postmenopausal women as well as of HRT recommendations and risks-benefits. Nevertheless we have identified some discrepancies between the specialties, particularly on what concerns HRT prescription. This may be explained by the limited availability of protocols and standards/guidelines that allow experts to standardize their knowledge, intervention strategies and prescribing patterns of HRT.
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Keywords
Terapêutica hormonal de substituição Terapêutica hormonal de substituição - Menopausa Terapêutica hormonal de substituição - Factores de risco Terapêutica hormonal de substituição - Benefícios Pós-menopausa
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Universidade da Beira Interior