Grażyna Jarząbek-Bielecka

Overweight, obesity and female sexuality in perimenopause: a preliminary report

Introduction The research was conducted among patients of the Department of Perinatology and Gynaecology of the Poznań University of Medical Sciences. Its aim was to investigate the influence of overweight and obesity on female sexuality during the perimenopausal period. Preliminary results of the research are presented in the thesis, which was as a matter of fact intended as a preliminary report. The examination of sexual functions of the patients was performed with the use of the Female Sexual Function Index (FSFI) form. Material and methods Sixty-one women during the perimenopausal period filled out the survey, with the average age of these women being 51 years. Forty-two of the examined women had an appropriate body mass index (BMI), i.e. between 18.5 and 25, while for 19 of the women, the BMI was above normal. For statistical analysis and in order to assess the differences between the two above-mentioned groups of patients, the nonparametric Mann-Whitney test was applied. A statistically significant value was assumed at p < 0.05. The results of the conducted research indicated no such difference between the women with differing BMI for the specific domains of the FSFI test. Results The results obtained show that research in the area needs to be continued. Conclusions All the hitherto existing scientific studies also seem to indicate that the influence of overweight and obesity on female sexuality during the perimenopause has not yet been unambiguously proven. Beyond any doubt, however, sexual disorders appear in women at this time of life and the factors which determine them can vary greatly. Given the character of the situation, women ought to be supported both by a team of specialists representing different branches of medicine as well as by their relatives. The whole situation also calls for more research of the important subject matter.

Functional hypothalamic amenorrhoea – diagnostic challenges, monitoring, and treatment

Functional hypothalamic amenorrhoea (FHA) is associated with functional inhibition of the hypothalamic-pituitary-ovarian axis. Causes of FHA can be classified into the three groups: 1) stress-related factors, 2) consequences of weight loss and/or underweight, and 3) consequences of physical exercise or practicing sports. Diagnosis of FHA should be based on a history of menstrual disorders. During physical examination, patients with FHA present with secondary and tertiary sex characteristics specific for the pubertal stage preceding development of the condition and with the signs of hypoestrogenism. Laboratory results determine further management of patients with amenorrhea, and thus their correct interpretation is vital for making appropriate therapeutic decisions. Treatment of chronic anovulation, menstrual disorders, and secondary amenorrhea resulting from hypothalamic disorders should be aimed at the elimination of the primary cause, i.e. a decrease in psycho-emotional strain, avoidance of chronic stressors, reduction of physical exercise level, or optimisation of BMI in patients who lose weight. If menses do not resume after a period of six months or primary causative treatment is not possible, neutralisation of hypoestrogenism consequences, especially unfavourable effects on bone metabolism, become the main issue. Previous studies have shown that oestroprogestagen therapy is useful in both the treatment of menstrual disorders and normalisation of bone mineral density. Hormonal preparations should be introduced into therapeutic protocol on an individualised basis.

The impact of physical activity during pregnancy on maternal weight and obstetric outcomes

OBJECTIVES The goal of the paper was to compare weight gain in pregnant women in relation to the week of gestation at birth, the delivery method, and the occurrence of macrosomia and low birth weights for patients with different durations of physical activity during pregnancy. MATERIALS AND METHODS The full course of study was completed by 57 pregnant women enrolled in an 18-week physical activity programme during their second and third trimesters. The actual duration of their physical activity was monitored with the ActiGraph GT3X monitor. The patients were divided into two groups: L_MPA (n = 28) - pregnant women with daily physical activity of over 21.38 minutes and S_MPA (n = 29) - pregnant women who exercised less than 21.38 minutes a day. The study compared obstetric results in both groups. RESULTS Significantly more patients in the S_MPA group exhibited excess weight gain as compared with the L_MPA group (p = 0.01). There was found to be no significant impact from the duration of physical activity on the occurrence of macrosomia or low birth weight, the gestation age at birth or the delivery method. However, there were two times fewer cases of macrosomia in the L_MPA group. CONCLUSIONS The results demonstrate that physical activity during pregnancy for at least 21 minutes per day in the second half of the pregnancy reduces the risk of excess weight gain during pregnancy.

Child sexual abuse as an etiological factor of overweight and eating disorders — considerations for primary health care providers

Despite the recognition of the clinical importance of child sexual abuse, primary health care providers are often not ad-equately prepared to perform medical evaluations and diagnose child sexual maltreatment. Paper presents basic symptoms and signs of CSA, which may suggest the need for further patients diagnosis and referral. Since the great majority of sexually abused children do not have any abnormal physical findings, special attention is paid to the silent warning signs of CSA, such as changes in attitude towards own body and eating habits. Numerous studies suggest that victims of CSA may develop obesity or eating disorders of various forms and intensities.

Metabolic syndrome, hypothyroidism and depression at consultation: a case history

This case report describes a 54-year-old obese woman presenting with metabolic syndrome, hypothyroidism and depression. Her medical history includes conditions of pubertal obesity and polycystic ovary syndrome (PCOS). After 3 months of receiving drug and dietary therapy, the patient achieved reduced body weight and an improvement of laboratory test results. However, further healthcare is required in areas of internal medicine, psychiatry and dietetics.

Disorders of sex development

Płeć człowieka to zespół cech somatycznych i psychicznych odróżniających kobietę od mężczyzny. Określenie płci w ujęciu biologicznym to zdolność organizmu do wytwarzania komórek rozrodczych. Płeć psychologiczna rozumiana jest jako spontaniczna gotowość do posługiwania się wymiarem płci w odniesieniu do siebie i świata [1]. W celach klinicznych i naukowych wyodrębnia się szereg kryteriów określających płeć. Wyróżnia się pojęcie płci chromosomalnej, czyli genetycznej, gonadalnej, hormonalnej, genitalnej (zewnętrznych narządów płciowych), płci metrykalnej (określanej po urodzeniu, zgodnie z wyglądem zewnętrznych narządów płciowych) i psychicznej, czyli orientację psychoseksualną. Rozwój psychoseksualStreszczenie