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Advisor(s)
Abstract(s)
A esperança média de vida é cada vez maior, o que significa que há cada vez mais mulheres a chegar à menopausa e a permanecerem cada vez mais tempo nesta fase das suas vidas. A menopausa reflete falência ovárica e traduz-se na cessação permanente do período menstrual. A transição da menopausa envolve uma infinidade de mudanças físicas, endócrinas e psicológicas que são influenciadas por fatores étnicos, psicológicos e socioculturais.
Assim, numa primeira parte, pretendeu-se definir o conceito de menopausa e qual o mecanismo fisiológico pela qual esta ocorre, assim como, expor as várias manifestações clínicas resultantes da transição menopáusica. Os sintomas experienciados pelas mulheres são variados, estando alguns diretamente relacionados com a menopausa como os sintomas vasomotores e a síndrome geniturinária, enquanto que as restantes manifestações clínicas como as alterações cardiovasculares, osteoporose e alterações cutâneas entre outras, têm alguma componente relacionada com o envelhecimento.
Nos últimos 20 anos, a procura por terapêuticas mais seguras alternativas à terapia hormonal e a outras terapias farmacológicas tem vindo a aumentar devido à maior probabilidade de ocorrência de efeitos adversos com estas últimas. Esta mudança foi precipitada pelos resultados do Women´s Health Initiative que mostraram que a terapia hormonal está associada a um risco aumentado de acidente vascular cerebral, trombose venosa, cancro da mama invasivo e doença coronária.
Na segunda parte desta monografia, foram apresentadas as opções de fitoterapia com maior evidência científica relativa à eficácia nos sintomas da menopausa. Sendo elas a Cimicifuga racemosa que tem principalmente ação serotoninérgica e a soja e o trevo vermelho cujo modo de ação se deve à sua atividade estrogénica. Com base na literatura, foi feita uma descrição das plantas, identificados os principais compostos químicos responsáveis pela ação farmacológica e, por fim, foram abordados os efeitos farmacológicos, a segurança e possíveis contraindicações das plantas selecionadas com base em estudos experimentais e clínicos.
The average life expectancy is increasing, which means that more and more women are reaching menopause and remaining in this phase of their lives for a longer period of time. Menopause reflects ovarian failure and results in the permanent cessation of the menstrual period. The menopause transition involves a variety of physical, endocrine and psychological changes that are influenced by ethnic, psychological and sociocultural factors. Thus, in the first part, we intend to define the concept of menopause and the physiological mechanism by which it occurs, as well as to expose the various clinical manifestations resulting from the menopausal transition. The symptoms experienced by women are diverse, with some being directly related to menopause, such as vasomotor symptoms and genitourinary syndrome, while the remaining clinical manifestations, such as cardiovascular changes, osteoporosis and skin changes, among others, have at least some component related to aging. Over the last 20 years, the search for safer therapeutic alternatives in relation to hormonal therapy and other pharmacological therapies has increased due to the greater likelihood of adverse effects occurring with the latter. This shift was precipitated by results from the Women’s Health Initiative, which demonstrated that hormone therapy is associated with an increased risk of stroke, venous thrombosis, invasive breast cancer, and coronary heart disease. In the second part of this monograph, the herbal medicine options with the greatest scientific evidence regarding their effectiveness in menopausal symptoms were presented. These are Cimicifuga racemosa, which has mainly serotonergic action, and soy and red clover, whose mechanism of action is due to their estrogenic activity. Based on the literature, a description of the plants was made, the main chemical compounds responsible for the pharmacological action were identified and, finally, the pharmacological effects, safety and possible contraindications of the selected plants were addressed based on experimental and clinical studies.
The average life expectancy is increasing, which means that more and more women are reaching menopause and remaining in this phase of their lives for a longer period of time. Menopause reflects ovarian failure and results in the permanent cessation of the menstrual period. The menopause transition involves a variety of physical, endocrine and psychological changes that are influenced by ethnic, psychological and sociocultural factors. Thus, in the first part, we intend to define the concept of menopause and the physiological mechanism by which it occurs, as well as to expose the various clinical manifestations resulting from the menopausal transition. The symptoms experienced by women are diverse, with some being directly related to menopause, such as vasomotor symptoms and genitourinary syndrome, while the remaining clinical manifestations, such as cardiovascular changes, osteoporosis and skin changes, among others, have at least some component related to aging. Over the last 20 years, the search for safer therapeutic alternatives in relation to hormonal therapy and other pharmacological therapies has increased due to the greater likelihood of adverse effects occurring with the latter. This shift was precipitated by results from the Women’s Health Initiative, which demonstrated that hormone therapy is associated with an increased risk of stroke, venous thrombosis, invasive breast cancer, and coronary heart disease. In the second part of this monograph, the herbal medicine options with the greatest scientific evidence regarding their effectiveness in menopausal symptoms were presented. These are Cimicifuga racemosa, which has mainly serotonergic action, and soy and red clover, whose mechanism of action is due to their estrogenic activity. Based on the literature, a description of the plants was made, the main chemical compounds responsible for the pharmacological action were identified and, finally, the pharmacological effects, safety and possible contraindications of the selected plants were addressed based on experimental and clinical studies.
Description
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Keywords
Menopausa Fitoterapia Cimicifuga racemosa Glycine max Trifolium pratense Mestrado Integrado - 2023