Calorões, insônia, diminuição da libido e por aí vai. Se você, leitora, tem por volta de 50 anos, provavelmente já sentiu algum dos sinais da famigerada menopausa. E mais: assim como outras tantas mulheres, pode estar repleta de dúvidas e inseguranças sobre essa fase que marca o fim do período fértil e traz importantes mudanças hormonais.
Por isso, Donna abriu espaço para as leitoras enviarem questionamentos sobre o tema por meio dos grupos da revista nas redes sociais, como o Grupo de Mães Donna no Facebook. Abaixo, as ginecologistas e obstetras Gislaine Casanova, médica da Unidade de Endocrinologia Ginecológica do Hospital de Clínicas de Porto Alegre, e Silvane Nenê Portela, professora da faculdade Medicina da Universidade de o Fundo (UPF) e da Universidade Federal da Fronteira Sul (UFFS), ambas membros da Associação de Obstetrícia e Ginecologia do Rio Grande do Sul (Sogirgs), respondem às principais perguntas sobre o tema.
1. Quais as dicas para diminuir os calorões (fogacho) característicos do período?
Pergunta enviada por Maria Valéria e Rossana Lisboa, de Porto Alegre
Resposta da médica Gislaine Casanova: "Embora os calorões sejam o principal sintoma do climatério e da menopausa, podem não acontecer para algumas mulheres, além de apresentar intensidade variada. Medidas comportamentais e de redução do estresse, como fazer exercícios físicos regularmente, ou investir em atividades que envolvam relaxamento, como ioga, podem ajudar e diminuir o desconforto com os calorões. Terapias com apoio emocional, como a cognitivo-comportamental, também trazem benefícios neste período. Para aquelas que apresentam calorões frequentes e, mesmo com medidas de comportamento e atividade física, mantém os sintomas, deve ser discutido com o ginecologista o apoio de terapia com medicamentos, que pode ser tanto terapia hormonal quanto medicamentos não hormonais".
2. Qual a diferença entre menopausa e climatério?
Pergunta enviada por Paula Oliveira de Sá, de Porto Alegre
Resposta da médica Gislaine Casanova: "A menopausa é definida como a última menstruação da vida de uma mulher. Para fazer o diagnóstico da menopausa é preciso que a mulher esteja há um ano sem menstruar a partir da idade natural de ocorrência, ou seja, após os 40 anos. Já o climatério é um período em que ocorrem as mudanças hormonais que marcam a agem da vida reprodutiva da mulher para a fase não reprodutiva. Importante ressaltar que não há idade certa: pode ocorrer dos 40 anos aos 65 anos".
3. Toda mulher precisa fazer terapia hormonal (reposição de estrogênio) quando chega na menopausa? Por quê?
Pergunta enviada por Giovana Neves Peixoto, de Santo Antônio da Patrulha
Resposta da médica Gislaine Casanova: "Não, nem toda mulher precisa fazer terapia hormonal com estrógenos. A terapia hormonal com estrogênio é o tratamento medicamentoso mais eficaz para o alívio dos sintomas da menopausa. Deve ser indicada para mulheres que apresentem sintomas da menopausa, em conjunto com outras recomendações para estimular a saúde e o bem-estar. A terapia hormonal é, portanto, uma escolha da mulher para tratar seus sintomas, e deve ser individualizada, levando em conta os sintomas apresentados, a saúde geral e a presença ou não de contraindicações ao tratamento".
4. É verdade que a menopausa reduz a libido?
Pergunta enviada por Paula Oliveira de Sá, de Porto Alegre
Resposta da médica Gislaine Casanova: "Sim, durante a fase da transição para a menopausa e ou no período pós-menopausa podem ocorrer mudanças hormonais que interferem no desejo sexual".
5. Como saber se estou na menopausa? Quais os primeiros sintomas?
Pergunta enviada por Cláudia Maria Beretta, de Porto Alegre
Resposta da médica Gislaine Casanova: "Menopausa é a ausência de menstruação por, pelo menos, um ano. Antes da última menstruação, uma série de eventos hormonais ocorrem, dando origem aos sintomas do climatério. Em geral, o primeiro sintoma é a mudança de padrão da menstruação, que a a ocorrer em um intervalo menor de tempo ou com mais volume de sangramento. Após esse período, a mulher percebe falhas na menstruação, ou seja, menstruações irregulares. Geralmente, os primeiros sintomas são modificações da menstruação".
6. Quanto tempo demora para ar os sintomas da menopausa, como os calorões e a instabilidade de humor?
Pergunta enviada por Alina Andrade
Resposta da médica Gislaine Casanova: "O tempo que cada mulher vai sentir calorões varia muito. Algumas não sentem em nenhum momento, e outras apresentam fogachos por longos períodos. Segundo um amplo estudo que acompanhou mulheres neste período, o tempo médio de duração dos sintomas da menopausa foi de sete anos. Além do período, varia também a intensidade com que os sintomas se manifestam para cada mulher. Algumas apresentam sintomas leves, que não comprometem sua qualidade de vida, enquanto outras têm sinais mais intensos e precisam de ajuda especializada".
7. Tive câncer de mama e tenho contraindicação à reposição hormonal. Quais as alternativas para amenizar os sintomas">
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