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Sample records for alleviate menopausal symptoms

  1. Management of Menopausal Symptoms

    PubMed Central

    Kaunitz, Andrew M.; Manson, JoAnn E.

    2015-01-01

    Most menopausal women experience vasomotor symptoms, with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms, with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women’s Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen affected all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appears to represent a sound strategy for optimizing the benefit: risk profile and safety of hormone therapy. Systemic HT should not be arbitrarily stopped at age 65; instead treatment duration should be individualized based on patients’ risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely impacts the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit: risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms. PMID:26348174

  2. Menopause. How Exercise Mitigates Symptoms.

    ERIC Educational Resources Information Center

    Hargarten, Kathleen M.

    1994-01-01

    During menopause and the climacteric, women experience many changes that can affect nearly every organ system and cause psychological symptoms. This article reviews the specific changes and explains how exercise can address each symptom; outlines a practical approach physicians can use to help menopausal patients improve their quality of life. (SM)

  3. Complementary and alternative medicine and physical activity for menopausal symptoms.

    PubMed

    McMillan, Taya L; Mark, Saralyn

    2004-01-01

    Forty percent of all menopausal women seek medical attention to alleviate symptoms of menopause, a natural physiologic process. Severe symptoms and an overall decrease in quality of life have prompted many women to demand additional information and treatment. Although menopausal hormone therapy has been the standard, increasing evidence suggests that women are looking to complementary and alternative therapies for management and treatment of menopausal symptoms. Modalities such as physical activity, diet supplements, body work, and mind-body techniques are often used without evaluation or treatment by conventional health care providers. Many of these treatments may present varying risks and contraindications. Consequently, there is a great need for ongoing education and research to ensure alternative therapy use is not only effective, but also safe. This paper provides a systematic review of current complementary and alternative modalities and of physical activity used in the management and treatment of menopausal symptoms.

  4. [Symptoms, life habits and risk factors in Italian menopause women].

    PubMed

    Ricci, S; Manna, P; Piscicelli, C; Serra, G B

    1997-01-01

    Authors report selected demographic, clinical and behavioral characteristics and symptoms of 2181 post-menopausal women enrolled in the CIOM study (collaborazione inter-ospedaliera per la menopausa) in the period 1990-1994. A computerized clinical record was used which was filled by gynecologist during the first and subsequent visits. The study allows to better understand some epidemiological aspects of menopause in comparison with other national and international surveys. The results support the need of educational interventions, both for women and medical doctors, to promote healthy lifestyle and the use of hormonal replacement therapy to alleviate symptoms and to prevent post-menopausal diseases.

  5. Mind-body Therapies for Menopausal Symptoms: A Systematic Review

    PubMed Central

    Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek

    2010-01-01

    Objective To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. Methods To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Results Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Conclusions Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. PMID

  6. Menopause: Symptom Relief and Treatments

    MedlinePlus

    ... of menopause and tips for dealing with them. Hot flashes Try to notice what triggers your hot flashes and avoid those things. Possible triggers to ... foods, alcohol, caffeine, stress, or being in a hot place. Dress in layers and remove some when ...

  7. Menopausal symptoms among Thai women in Bangkok.

    PubMed

    Sukwatana, P; Meekhangvan, J; Tamrongterakul, T; Tanapat, Y; Asavarait, S; Boonjitrpimon, P

    1991-09-01

    A random probability cluster area sampling of 614 women living in Bangkok was conducted to determine the prevalence of abnormal symptoms related to the menopause. Women interviewed were aged 40 and above currently registered as living in the Bangkok Metropolitan area. Sixty-nine percent of the women interviewed experienced abnormal symptoms. Eighty-two percent of those with abnormal symptoms reported having hot flushes. Palpitation, increased heat intolerance and emotional liability were common symptoms. Minor abnormalities included insomnia, weakness, anxiety and urinary symptoms. Changes related to sexual function were difficult to elicit due to cultural limitations. Economic and cultural factors might play important roles in the way these women perceived symptoms related to the menopause and sought medical assistance.

  8. Symptoms: Menopause, Infertility, and Sexual Health.

    PubMed

    Barton, Debra L; Ganz, Patricia A

    2015-01-01

    By 2022, the number of survivors is expected to grow to nearly 18 million. Therefore, addressing acute and chronic negative sequelae of a cancer diagnosis and its treatments becomes a health imperative. For women with a history of breast cancer, one of the common goals of treatment and prevention of recurrence is to reduce circulating concentrations of estradiol, especially in women with hormone receptor positive breast cancer. Hormone deprivation after a diagnosis of breast cancer impacts physiological targets other than in the breast tissue and can result in unwanted side effects, all of which can negatively impact quality of life and function and cause distress. Symptoms that are most strongly linked by evidence to hormone changes after cancer diagnosis and treatment include hot flashes, night sweats, sleep changes, fatigue, mood changes, and diminishing sexual function, including vaginal atrophy (decreased arousal, dryness and dyspareunia), infertility, decreased desire and negative self-image. Weight gain and resulting body image changes are often concomitants of the abrupt onset of treatment-induced menopause. The purpose of this chapter is to briefly review what is known about the advent of premature menopause in women treated for breast cancer, menopausal symptoms that are exacerbated by endocrine treatments for breast cancer, and the associated concerns of hot flashes and related menopausal symptoms, sexual health and fertility issues. We will discuss limitations in the current research and propose strategies that address current limitations in order to move the science forward. PMID:26059933

  9. Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition

    PubMed Central

    Avis, Nancy E.; Crawford, Sybil L.; Greendale, Gail; Bromberger, Joyce T.; Everson-Rose, Susan A.; Gold, Ellen B.; Hess, Rachel; Joffe, Hadine; Kravitz, Howard M.; Tepper, Ping G.; Thurston, Rebecca C.

    2015-01-01

    IMPORTANCE The expected duration of menopausal vasomotor symptoms (VMS) is important to women making decisions about possible treatments. OBJECTIVES To determine total duration of frequent VMS (≥6 days in the previous 2 weeks) (hereafter total VMS duration) during the menopausal transition, to quantify how long frequent VMS persist after the final menstrual period (FMP) (hereafter post-FMP persistence), and to identify risk factors for longer total VMS duration and longer post-FMP persistence. DESIGN, SETTING, AND PARTICIPANTS The Study of Women’s Health Across the Nation (SWAN) is a multiracial/multiethnic observational study of the menopausal transition among 3302 women enrolled at 7 US sites. From February 1996 through April 2013, women completed a median of 13 visits. Analyses included 1449 women with frequent VMS. MAIN OUTCOMES AND MEASURES Total VMS duration (in years) (hot flashes or night sweats) and post-FMP persistence (in years) into postmenopause. RESULTS The median total VMS duration was 7.4 years. Among 881 women who experienced an observable FMP, the median post-FMP persistence was 4.5 years. Women who were premenopausal or early perimenopausal when they first reported frequent VMS had the longest total VMS duration (median, >11.8 years) and post-FMP persistence (median, 9.4 years). Women who were postmenopausal at the onset of VMS had the shortest total VMS duration (median, 3.4 years). Compared with women of other racial/ethnic groups, African American women reported the longest total VMS duration (median, 10.1 years). Additional factors related to longer duration of VMS (total VMS duration or post-FMP persistence) were younger age, lower educational level, greater perceived stress and symptom sensitivity, and higher depressive symptoms and anxiety at first report of VMS. CONCLUSIONS AND RELEVANCE Frequent VMS lasted more than 7 years during the menopausal transition for more than half of the women and persisted for 4.5 years after the FMP

  10. Phytoestrogens for menopausal bone loss and climacteric symptoms.

    PubMed

    Lagari, Violet S; Levis, Silvina

    2014-01-01

    Women have always looked for non-hormonal options to alleviate menopausal vasomotor symptoms and prevent menopausal bone loss. The use of complementary and alternative medicine for these purposes has particularly increased after the publication of the Women's Health Initiative's results suggesting that there might be more risks than benefits with hormone replacement. Phytoestrogens are plant-derived estrogens that, although less potent than estradiol, bind to the estrogen receptor and can function as estrogen agonists or antagonists. Soy isoflavones extracted from soy are the phytoestrogens most commonly used by menopausal women. Because typical Western diets are low in phytoestrogens and taking into account the general difficulty in changing dietary habits, most clinical trials in Western women have used isoflavone-fortified foods or isoflavone tablets. Although some women might experience a reduction in the frequency or severity of hot flashes, most studies point towards the lack of effectiveness of isoflavones derived from soy or red clover, even in large doses, in the prevention of hot flashes and menopausal bone loss. This article is part of a Special Issue entitled 'Phytoestrogens'.

  11. Phytoestrogens for menopausal bone loss and climacteric symptoms.

    PubMed

    Lagari, Violet S; Levis, Silvina

    2014-01-01

    Women have always looked for non-hormonal options to alleviate menopausal vasomotor symptoms and prevent menopausal bone loss. The use of complementary and alternative medicine for these purposes has particularly increased after the publication of the Women's Health Initiative's results suggesting that there might be more risks than benefits with hormone replacement. Phytoestrogens are plant-derived estrogens that, although less potent than estradiol, bind to the estrogen receptor and can function as estrogen agonists or antagonists. Soy isoflavones extracted from soy are the phytoestrogens most commonly used by menopausal women. Because typical Western diets are low in phytoestrogens and taking into account the general difficulty in changing dietary habits, most clinical trials in Western women have used isoflavone-fortified foods or isoflavone tablets. Although some women might experience a reduction in the frequency or severity of hot flashes, most studies point towards the lack of effectiveness of isoflavones derived from soy or red clover, even in large doses, in the prevention of hot flashes and menopausal bone loss. This article is part of a Special Issue entitled 'Phytoestrogens'. PMID:23246986

  12. Treatment options for vasomotor symptoms in menopause: focus on desvenlafaxine

    PubMed Central

    Umland, Elena M; Falconieri, Laura

    2012-01-01

    Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical health of women experiencing VMS, leading to their pursuance of treatment to alleviate these symptoms. Management of VMS includes lifestyle modifications, some herbal and vitamin supplements, hormonal therapies including estrogen and tibolone, and nonhormonal therapies including clonidine, gabapentin, and some of the serotonin and serotonin–norepinephrine reuptake inhibitors. The latter agents, including desvenlafaxine, have been the focus of increased research as more is discovered about the roles of serotonin and norepinephrine in the thermoregulatory control system. This review will include an overview of VMS as they relate to menopause. It will discuss the risk factors for VMS as well as the proposed pathophysiology behind their occurrence. The variety of treatment options for VMS will be discussed. Focus will be given to the role of desvenlafaxine as a treatment option for VMS management. PMID:22870045

  13. Treatment options for vasomotor symptoms in menopause: focus on desvenlafaxine.

    PubMed

    Umland, Elena M; Falconieri, Laura

    2012-01-01

    Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical health of women experiencing VMS, leading to their pursuance of treatment to alleviate these symptoms. Management of VMS includes lifestyle modifications, some herbal and vitamin supplements, hormonal therapies including estrogen and tibolone, and nonhormonal therapies including clonidine, gabapentin, and some of the serotonin and serotonin-norepinephrine reuptake inhibitors. The latter agents, including desvenlafaxine, have been the focus of increased research as more is discovered about the roles of serotonin and norepinephrine in the thermoregulatory control system. This review will include an overview of VMS as they relate to menopause. It will discuss the risk factors for VMS as well as the proposed pathophysiology behind their occurrence. The variety of treatment options for VMS will be discussed. Focus will be given to the role of desvenlafaxine as a treatment option for VMS management.

  14. Menopause

    MedlinePlus

    ... cream, low-dose antidepressants, soy products and certain herbal supplements may help ease some menopausal symptoms. Discuss these ... symptoms? I’ve heard that soy products or herbal supplements may help. Are these effective? Are they good ...

  15. A succinate-based composition reverses menopausal symptoms without sex hormone replacement therapy.

    PubMed

    Maevsky, E I; Peskov, A B; Uchitel, M L; Pogorelov, A G; Saharova, N Yu; Vihlyantseva, E F; Bogdanova, L A; Kondrashova, M N

    2008-01-01

    Menopausal transition is often accompanied by a variety of adverse pathological symptoms, currently treated with hormone replacement therapy, which is associated with a number of health risks. This report investigated the role of a food supplement--a composition of energy-exchange metabolites, with succinate as the main component--for treating menopausal syndrome. We studied the impact of a 4-week succinate-based food composition (SBC) treatment on the estral cycle, and bone mass and calcium content of aging mice. The impact of SBC on hormone levels and on the progression of several neurovegetative and psycho-emotional symptoms was further investigated in a randomized, double-blind, placebo-controlled clinical study of early menopausal women. Data were collected from questionnaires, Kupperman index scores, Spielberger-Hanin tests, and blood analysis of hormone levels taken at baseline and throughout the 5-week study. A "rejuvenating" effect of SBC on menopausal animals was observed, expressed as restoration of the estral cycle and an increase in the weight and calcium content of bone tissue. Furthermore, in the randomized, placebo-controlled clinical study in menopausal women, SBC-based monotherapy significantly lowered most subjectively evaluated characteristics of menopausal syndrome and increased blood serum levels of estradiol fourfold. This monotherapy also alleviated symptoms of some neurovegetative and psycho-emotional disorders, such as hot flushes, headache, and anxiety. Succinate-based therapy alleviated many biochemical symptoms of menopause in aging mice and early menopausal women, as well as neurovegetative and psycho-emotional disorders in women. Succinate-based therapy appeared to be free of adverse side effects.

  16. Hormone therapy for the management of menopause symptoms.

    PubMed

    Collins Fantasia, Heidi; Sutherland, Melissa A

    2014-01-01

    Many women will undergo menopause without incident, but others will experience bothersome effects resulting from declining estrogen levels. Vasomotor symptoms, which manifest as intense feelings of warmth, flushing, and perspiration, are the most common symptoms for which women seek treatment. Hormone therapy is indicated for the relief of vasomotor symptoms related to menopause. We review current Food Drug Administration-approved options for hormone therapy and discuss implications for practice and patient education.

  17. A National Multiethnic Online Forum Study on Menopausal Symptom Experience

    PubMed Central

    Im, Eun-Ok; Lee, Bok Im; Chee, Wonshik; Dormire, Sharon; Brown, Adama

    2010-01-01

    Background Little is known about how culture influences menopausal symptom experience, and few comparative qualitative studies have been conducted among multiethnic groups of midlife women in the United States. Objectives To explore commonalities and differences in menopausal symptom experience among four major ethnic groups in the US (Whites, Hispanics, African Americans, and Asians). Methods This was a secondary analysis of qualitative data from a larger national Internet-based study. The qualitative data from 90 middle-aged women in the US who attended four ethnic-specific online forums of the larger study were examined using thematic analysis. Results The themes reflecting commonalities across the ethnic groups were: just a part of life, trying to be optimistic, getting support, and more information needed. The themes reflecting the differences among the ethnic groups were: open and closed, universal and unique, and controlling and minimizing. Overall, the findings indicated positive changes in women’s menopausal symptom experience, and supported the existence of cultural influences on women’s menopausal symptom experience across the ethnic groups. Discussion Systematic efforts need to be made to empower midlife women in their management of menopausal symptoms. PMID:20010042

  18. Effects of Calci Soya Balance and Vitagnus on Menopausal Symptoms

    PubMed Central

    Golian Tehrani, Shahnaz; Bazzazian, Shahin; Bakhtiarian, Azam; Ghobadzadeh, Maryam

    2014-01-01

    Background: Menopause is a period of women’s lives with changes and symptoms that affect their work, sleep and quality of life. Therefore, it is important to overcome these symptoms. Objectives: The aim of the present study was to compare the effects of Calci soya balance and Vitagnus on menopausal symptoms. Patients and Methods: This double-blinded controlled trial study was performed in public health centers of Tehran University of Medical Sciences (2011-2012). Seventy postmenopausal women with menopausal symptoms were randomly divided into two groups of treatments with Vitagnus and Calci soya balance. Data were collected using interviews, answering Cooperman’s index questionnaires before four and eight weeks after the treatment. Descriptive and analytic statistics were used for analyzing the data. Results: In both groups, Wilcoxon test showed a significant decrease in the mean of Cooperman’s menopausal index as well as after four and eight weeks of treatment (P = 0.000). Mann-Whitney test did not show any significant differences between the two groups, before and after four and eight weeks of treatment. Conclusions: The results showed that both Vitagnus and Calci soya balance were effective on reduction of menopausal symptoms to a similar extent and medical community can administer each of these two drugs based on patients’ conditions and costs. PMID:25763190

  19. Vitamin D levels and menopause-related symptoms

    PubMed Central

    LeBlanc, Erin S.; Desai, Manisha; Perrin, Nancy; Wactawski-Wende, Jean; Manson, JoAnn E.; Cauley, Jane A.; Michael, Yvonne L.; Tang, Jean; Womack, Catherine; Song, Yiqing; Johnson, Karen C.; O’Sullivan, Mary J.; Woods, Nancy; Stefanick, Marcia L.

    2015-01-01

    Objective To determine whether vitamin D levels are associated with menopause-related symptoms in older women. Methods A randomly selected subset of 1,407 women, among 26,104 potentially eligible participants of the Women’s Health Initiative Calcium and Vitamin D (CaD) trial of postmenopausal women aged 51-80 years, had 25-hydroxyvitamin D [25(OH)D] levels measured at the CaD trial baseline visit. Information about menopause-related symptoms at baseline was obtained by questionnaire and included overall number of symptoms and composite measures of sleep disturbance, emotional well-being, and energy/fatigue, as well as individual symptoms. After exclusions for missing data, 530 women [mean age 66.2 years (SD 6.8)] were included in these analyses. Results There were borderline significant associations between 25(OH)D levels and total number of menopausal symptoms (p values ranging from 0.05 to 0.06 for fully adjusted models); however, the effect was clinically insignificant and disappeared with correction for multiple testing. There were no associations between 25(OH)D levels and composite measures of sleep disturbance, emotional well-being, or energy/fatigue (p’s > 0.10 for fully adjusted models). Conclusions There was no evidence of a clinically important association between serum 25(OH)D levels and menopause-related symptoms in postmenopausal women. PMID:24736200

  20. Effects of stretching on menopausal and depressive symptoms in middle-aged women: a randomized controlled trial

    PubMed Central

    Kai, Yuko; Nagamatsu, Toshiya; Kitabatake, Yoshinori; Sensui, Hiroomi

    2016-01-01

    Abstract Objective: Exercise may help alleviate menopausal and depressive symptoms in middle-aged women, but sufficient evidence does not currently exist to fully support this theory. Whereas frequent moderate- to vigorous-intensity exercise may be associated with the risk of menopausal hot flashes, light-intensity exercise, such as stretching, is not likely to increase the occurrence of hot flashes. Little is, however, known about the effects of light-intensity exercise on menopausal and depressive symptoms. We examined the effects of a 3-week stretching program on the menopausal and depressive symptoms in middle-aged, Japanese women. Methods: Forty Japanese women, aged 40 to 61 years, were recruited (mean age, 51.1 ± 7.3 y). The participants were randomly assigned to either a stretching or a control group. The stretching group (n = 20) participated in a 3-week intervention program that involved 10 minutes of daily stretching, just before bedtime. The control group (n = 20) was assigned to a waiting list. Menopausal symptoms were evaluated using the Simplified Menopausal Index, which measures vasomotor, psychological, and somatic symptoms. Depressive symptoms were assessed using the Self-Rating Depression Scale. Results: The compliance rate was 75.8% during the 3-week intervention program. The total Simplified Menopausal Index scores, including the vasomotor, psychological, and somatic symptoms, and the Self-Rating Depression Scale scores significantly decreased in the stretching group compared with that in the control group. No adverse events, including increased hot flashes, were reported by the participants during the study period. Conclusions: These findings suggest that 10 minutes of stretching before bedtime decreases menopausal and depressive symptoms in middle-aged, Japanese women. PMID:27300113

  1. Hops for Menopausal Vasomotor Symptoms: Mechanisms of Action

    PubMed Central

    Abdi, Fatemeh; Mobedi, Hamid

    2016-01-01

    Menopause is a critical stage of women's life associated with various complaints and distresses. Vasomotor symptoms (VMS), such as hot flushes, night sweats, sleep disturbances, and fatigue, are the most common menopause symptoms affecting about 50% to 80% of middle-aged women. Obviously, these symptoms, resulting from estrogen deficiency during menopause, can exert negative effects on women's health and quality of life and thus require to be managed through approaches such as hormone replacement therapy (HRT). Many herbal treatments for menopause symptoms contain and its components such as 8-prenylnaringenin, 6-PN, isoxanthohumol and xanthohumol. Recent in-vivo studies have highlighted the ability of 8-prenylnaringenin to reduce serum-luteinizing hormone (LH) and follicle-stimulating hormone (FSH), to increase serum prolactin levels and uterine weight, and to induce vaginal hyperplastic epithelium. Previous research has shown that hops extract can strongly bind to both estrogen receptors, stimulate alkaline phosphatase activity in Ishikawa cells, and upregulate presenelin-2 and progesterone receptor mRNA in Ishikawa cells. Numerous clinical trials have documented significant reductions in the frequency of hot flushes following the administration of hop-containing preparations. Nevertheless, further clinical trials with larger sample size and longer follow-up are warranted to confirm such benefits.

  2. Hops for Menopausal Vasomotor Symptoms: Mechanisms of Action.

    PubMed

    Abdi, Fatemeh; Mobedi, Hamid; Roozbeh, Nasibeh

    2016-08-01

    Menopause is a critical stage of women's life associated with various complaints and distresses. Vasomotor symptoms (VMS), such as hot flushes, night sweats, sleep disturbances, and fatigue, are the most common menopause symptoms affecting about 50% to 80% of middle-aged women. Obviously, these symptoms, resulting from estrogen deficiency during menopause, can exert negative effects on women's health and quality of life and thus require to be managed through approaches such as hormone replacement therapy (HRT). Many herbal treatments for menopause symptoms contain and its components such as 8-prenylnaringenin, 6-PN, isoxanthohumol and xanthohumol. Recent in-vivo studies have highlighted the ability of 8-prenylnaringenin to reduce serum-luteinizing hormone (LH) and follicle-stimulating hormone (FSH), to increase serum prolactin levels and uterine weight, and to induce vaginal hyperplastic epithelium. Previous research has shown that hops extract can strongly bind to both estrogen receptors, stimulate alkaline phosphatase activity in Ishikawa cells, and upregulate presenelin-2 and progesterone receptor mRNA in Ishikawa cells. Numerous clinical trials have documented significant reductions in the frequency of hot flushes following the administration of hop-containing preparations. Nevertheless, further clinical trials with larger sample size and longer follow-up are warranted to confirm such benefits. PMID:27617238

  3. Hops for Menopausal Vasomotor Symptoms: Mechanisms of Action

    PubMed Central

    Abdi, Fatemeh; Mobedi, Hamid

    2016-01-01

    Menopause is a critical stage of women's life associated with various complaints and distresses. Vasomotor symptoms (VMS), such as hot flushes, night sweats, sleep disturbances, and fatigue, are the most common menopause symptoms affecting about 50% to 80% of middle-aged women. Obviously, these symptoms, resulting from estrogen deficiency during menopause, can exert negative effects on women's health and quality of life and thus require to be managed through approaches such as hormone replacement therapy (HRT). Many herbal treatments for menopause symptoms contain and its components such as 8-prenylnaringenin, 6-PN, isoxanthohumol and xanthohumol. Recent in-vivo studies have highlighted the ability of 8-prenylnaringenin to reduce serum-luteinizing hormone (LH) and follicle-stimulating hormone (FSH), to increase serum prolactin levels and uterine weight, and to induce vaginal hyperplastic epithelium. Previous research has shown that hops extract can strongly bind to both estrogen receptors, stimulate alkaline phosphatase activity in Ishikawa cells, and upregulate presenelin-2 and progesterone receptor mRNA in Ishikawa cells. Numerous clinical trials have documented significant reductions in the frequency of hot flushes following the administration of hop-containing preparations. Nevertheless, further clinical trials with larger sample size and longer follow-up are warranted to confirm such benefits. PMID:27617238

  4. Therapy for menopausal symptoms during and after treatment for breast cancer : safety considerations.

    PubMed

    Baber, Rodney; Hickey, Martha; Kwik, Michelle

    2005-01-01

    Breast cancer is the most common newly diagnosed cancer in women. Life-time risk in the US is 1 in 8 (13.2%), in the UK it is 1 in 9 and in Australia it affects 1 in 11 women, of whom approximately 27% will be premenopausal at the time of their diagnosis. Many of these women will experience a sudden menopause as a result of chemotherapy, endocrine therapy or surgical interventions. For these women, the onset of menopausal symptoms is often sudden and severe. The management of such symptoms remains controversial. Women experiencing menopausal symptoms after breast cancer should be encouraged to avoid identifiable triggers for their symptoms and to consider lifestyle modification as a means of controlling those symptoms. When such measures fail, non-hormonal treatments may also be considered. These include clonidine, gabapentin and some antidepressants. Randomised trials have shown a significant difference in the symptom relief associated with various selective serotonin reuptake inhibitors and selective serotonin and noradrenaline (norepinephrine) reuptake inhibitors compared with placebo. Many women elect to use non-prescription complementary therapies to alleviate their menopausal symptoms. Systematic reviews of phytoestrogens have, however, failed to demonstrate significant relief of menopausal symptoms. More than 20 clinical trials have been conducted examining the relationship between postmenopausal hormone replacement therapy and breast cancer recurrence. The majority of these have been observational and have shown no increased risk of recurrence. However, the largest randomised trial that has thus far been conducted was recently halted because of a reported increase in the risk of recurrence amongst users of hormone replacement therapy. Tibolone, a selective tissue estrogen activity regulator, is a compound that exerts clinical effects both by receptor-mediated actions and tissue selective enzyme inhibition, and has been shown in preclinical studies to have

  5. Controlled flax interventions for the improvement of menopausal symptoms and postmenopausal bone health: a systematic review.

    PubMed

    Dew, Tristan P; Williamson, Gary

    2013-11-01

    Concerns regarding hormone therapy safety have led to interest in the use of phytoestrogens for a variety of menopause-related health complaints. Recent meta-analyses concerning soy and postmenopausal bone mineral density, flax and serum cholesterol indicate that significant benefits may be achieved in postmenopausal women. This study aimed to systematically review controlled flax interventions that had reported on menopausal symptoms and bone health in perimenopausal/postmenopausal women. A general search strategy was used to interrogate the Cochrane Library, Embase, MEDLINE, and SciFinder databases. Of 64 initial articles retrieved, we included 11 distinct interventions using flax without cotreatment. Interventions considering hot flush frequency/severity (five studies) and menopausal index scores (five studies) reported improvements from baseline with both flax and control treatments, with no significant difference between groups. There was little evidence to suggest that flax consumption alters circulating sex hormones, but flaxseed intervention increased the urinary 2α-hydroxyestrone/16α-hydroxyestrone ratio, which has been associated with a lower risk of breast cancer. Few studies considered bone mineral density (two studies) or markers of bone turnover (three studies). Flaxseed is currently not indicated for the alleviation of vasomotor symptoms in postmenopausal women. A paucity of appropriate randomized controlled trials means that the effects of flax intervention on postmenopausal bone mineral density are inconclusive.

  6. Colostrum in menopause effects on vaginal cytology/symptoms.

    PubMed

    Tucci, S; Mancini, R; De Vitis, C; Noto, A; Marra, E; Lukic, A; Giovagnoli, M R; Moscarini, M

    2013-01-01

    The aim of this study was to assess the effects of three weeks of daily colostrum cream on vaginal cytology and local symptoms related to menopause. Genito-urinary symptoms and cell morphology were analyzed at time 0 (T0) and after three weeks (16 +/- days since the end of treatment) at time 1 (T1). Dyspareunia, vaginal dryness, and maturation index (MI) reached a statistically significant difference between T0 and T1. The results proved to be an alternative treatment for vaginal distress caused by lack of hormones in patients in which hormonal treatment is contraindicated.

  7. Influences of Natural Menopause on Psychological Characteristics and Symptoms of Middle-Aged Healthy Women.

    ERIC Educational Resources Information Center

    Matthews, Karen A.; And Others

    1990-01-01

    Investigated psychological and symptom consequences of natural menopause in longitudinal study of 541 initially premenopausal healthy women. Findings 3 years later from 101 menopausal women and control group of 101 premenopausal women revealed that natural menopause led to few changes in psychological characteristics, with only decline in…

  8. Yale Study: African-American Women Report More Menopause Symptoms than White Women

    ERIC Educational Resources Information Center

    Black Issues in Higher Education, 2005

    2005-01-01

    A study of African-American women in menopause shows that while they experience many of the same symptoms as White women, they report more vasomotor symptoms such as dizziness and bloating, according to a study by a Yale School of Nursing researcher. The women reported symptoms common among White women in menopause--hot flashes, irregular…

  9. Botanical modulation of menopausal symptoms: mechanisms of action?

    PubMed

    Hajirahimkhan, Atieh; Dietz, Birgit M; Bolton, Judy L

    2013-05-01

    Menopausal women suffer from a variety of symptoms, including hot flashes and night sweats, which can affect quality of life. Although it has been the treatment of choice for relieving these symptoms, hormone therapy has been associated with increased breast cancer risk leading many women to search for natural, efficacious, and safe alternatives such as botanical supplements. Data from clinical trials suggesting that botanicals have efficacy for menopausal symptom relief have been controversial, and several mechanisms of action have been proposed including estrogenic, progestogenic, and serotonergic pathways. Plant extracts with potential estrogenic activities include soy, red clover, kudzu, hops, licorice, rhubarb, yam, and chasteberry. Botanicals with reported progestogenic activities are red clover, hops, yam, and chasteberry. Serotonergic mechanisms have also been proposed since women taking antidepressants often report a reduction in hot flashes and night sweats. Black cohosh, kudzu, kava, licorice, and dong quai all either have reported 5-hydroxytryptamine receptor 7 ligands or inhibit serotonin reuptake, therefore have potential serotonergic activities. Understanding the mechanisms of action of these natural remedies used for women's health could lead to more efficacious formulations and to the isolation of active components which have the potential of becoming effective medications in the future. PMID:23408273

  10. Intensification of menopausal symptoms among female inhabitants of East European countries.

    PubMed

    Bojar, Iwona; Lyubinets, Oleh; Novotny, Jozef; Stanchak, Yaroslav; Tiszczenko, Evgenii; Owoc, Alfred; Raczkiewicz, Dorota

    2016-07-15

    The objective of the study was analysis of the occurrence and intensity of menopausal symptoms in postmenopausal women from Poland, Belarus, Ukraine, Czech Republic, Slovakia and Poland. The study was conducted during the period 2014-2015 among postmenopausal women living in the areas of Poland, Belarus, Ukraine, Czech Republic and Slovakia. The degree of menopausal complaints was assessed using the Kupperman Menopausal Index and Greene Climacteric Scale. The respondents were additionally asked about age, educational level, place of residence, marital status and age at last menstrual period. Into the study were enrolled women aged 50-65, minimum 2 years after the last menstrual period, who had a generally good state of health and did not use hormone replacement therapy. The results were subjected to statistical analysis. The intensity of all menopausal symptoms measured by the Kupperman Menopausal Index and Greene Climacteric Scale was similar in Poland, Czech Republic and Slovakia. In these countries, severe, moderate and mild menopausal symptoms measured by Kupperman Menopausal Index occurred with a similar frequency. Similar results were also obtained in the subscales of psychological, somatic and vasomotor symptoms according to the Greene Climacteric Scale. Nearly a half of the women from Belarus did not report symptoms measured by Kupperman Menopausal Index. They obtained significantly lower menopausal complaints in the subscales of psychological and somatic symptoms according to the Greene Climacteric Scale, compared to the inhabitants of the remaining countries. The majority of women from the Ukraine had mild menopausal symptoms as measured by the Kupperman Menopausal Index. They had significantly more severe complaints in the subscales of psychological, somatic and vasomotor symptoms according to the Greene Climacteric Scale, compared to the inhabitants of the remaining countries in the study. The intensity of menopausal symptoms in women from Ukraine and

  11. Intensification of menopausal symptoms among female inhabitants of East European countries.

    PubMed

    Bojar, Iwona; Lyubinets, Oleh; Novotny, Jozef; Stanchak, Yaroslav; Tiszczenko, Evgenii; Owoc, Alfred; Raczkiewicz, Dorota

    2016-09-01

    The objective of the study was analysis of the occurrence and intensity of menopausal symptoms in postmenopausal women from Poland, Belarus, Ukraine, Czech Republic, Slovakia and Poland. The study was conducted during the period 2014-2015 among postmenopausal women living in the areas of Poland, Belarus, Ukraine, Czech Republic and Slovakia. The degree of menopausal complaints was assessed using the Kupperman Menopausal Index and Greene Climacteric Scale. The respondents were additionally asked about age, educational level, place of residence, marital status and age at last menstrual period. Into the study were enrolled women aged 50-65, minimum 2 years after the last menstrual period, who had a generally good state of health and did not use hormone replacement therapy. The results were subjected to statistical analysis. The intensity of all menopausal symptoms measured by the Kupperman Menopausal Index and Greene Climacteric Scale was similar in Poland, Czech Republic and Slovakia. In these countries, severe, moderate and mild menopausal symptoms measured by Kupperman Menopausal Index occurred with a similar frequency. Similar results were also obtained in the subscales of psychological, somatic and vasomotor symptoms according to the Greene Climacteric Scale. Nearly a half of the women from Belarus did not report symptoms measured by Kupperman Menopausal Index. They obtained significantly lower menopausal complaints in the subscales of psychological and somatic symptoms according to the Greene Climacteric Scale, compared to the inhabitants of the remaining countries. The majority of women from the Ukraine had mild menopausal symptoms as measured by the Kupperman Menopausal Index. They had significantly more severe complaints in the subscales of psychological, somatic and vasomotor symptoms according to the Greene Climacteric Scale, compared to the inhabitants of the remaining countries in the study. The intensity of menopausal symptoms in women from Ukraine and

  12. Assessment of menopausal symptoms among women attending various outreach clinics in South Canara District of India

    PubMed Central

    Joseph, Nitin; Nagaraj, Kondagunta; Saralaya, Vittal; Nelliyanil, Maria; Rao, PP Jagadish

    2014-01-01

    Introduction: Menopausal symptoms experienced by women are known to affect their quality-of-life. The symptoms experienced at menopause are quite variable and their etiology is found to be multifactorial. This study was hence done to assess the pattern and severity of menopausal symptoms and to find out the factors associated with these symptoms. Materials and Methods: This cross-sectional study was conducted in various outreach clinics of Kasturba Medical College, Mangalore. Women in the age group of 40-65 years were included in the study by convenient sampling method. Data regarding menopausal symptom was obtained by interviewing each participant using the menopause rating scale questionnaire. Results: Mean age of the participants were 54.2 ± 7.2 years and mean age of attainment of menopause was 48.4 ± 4.5 years. Mean duration of menopause was found to be 7.5 ± 5.3 years. Commonest symptom reported was joint and muscular discomfort and physical and mental exhaustion seen in 94 (85.4%) participants. The mean number of symptoms reported by participants was 7.6 ± 2.8. Educated women reported significantly more symptoms (F = 2.218, P = 0.047). Somatic and urogenital symptoms were more among perimenopausal women and somatic symptoms were more among postmenopausal women. Fifty-eight (52.7%) participants had one or more severe symptoms. Severe symptoms were most among premenopausal women. Conclusion: The high proportion and severity of menopausal symptoms observed in this study group proves that menopausal symptoms are common and cannot be ignored. More of menopausal clinics are needed for awareness generation, early recognition and treatment of related morbidities. PMID:24970987

  13. Exercise, Behavioral Therapy Reduce Menopausal Symptoms Caused by Breast Cancer Treatment

    Cancer.gov

    Women with breast cancer who were suffering from treatment-related menopausal symptoms experienced symptom relief with cognitive behavioral therapy, physical exercise, or both, according to a Dutch study.

  14. AN ONLINE FORUM ON MENOPAUSAL SYMPTOM EXPERIENCE OF WHITE WOMEN IN THE U.S.

    PubMed Central

    2008-01-01

    Aims Using a feminist approach, the study aimed at exploring menopausal symptom experience of 23 White midlife women through a six-month online forum. Background Recent cross-cultural investigations have indicated significant ethnic differences in menopausal symptoms and have challenged the universality of menopausal symptoms. Currently available cultural knowledge on menopausal experience, however, is inadequate to guide appropriate and adequate care even for White midlife women in the menopausal transition. Data source Qualitative data collected through an online forum in 2007. Method The study was a cross-sectional qualitative online forum study. A total of 23 midlife women who self-identify as non-Hispanic Whites were recruited for the study using a convenience sampling method. Seven topics related to menopausal symptom experience were used to guide the online forum for 6-months. The data were analyzed using thematic analysis involving line-by-line coding, categorization, and theme extraction. Results The experience of menopause caused women to redefine themselves within their busy daily life schedules. The women were optimistic about their symptoms, and tried to laugh at the experience to boost their inner strength and motivate themselves persevere. Many women thought that both generational and life styles differences were much more important than ethnic differences in menopausal symptom experience. In seeking assistance with the symptoms of menopause, women were not satisfied with the guidance of their physicians. Conclusion Nurses need to carefully listen to what the women themselves talked about their own experience with menopausal symptoms and help them to adequately manage and live with the symptoms. PMID:18373610

  15. Association of menopausal vasomotor symptoms with increased bone turnover during the menopausal transition.

    PubMed

    Crandall, Carolyn J; Tseng, Chi-Hong; Crawford, Sybil L; Thurston, Rebecca C; Gold, Ellen B; Johnston, Janet M; Greendale, Gail A

    2011-04-01

    The purpose of this study was to determine the longitudinal association between menopausal vasomotor symptoms (VMS) and urinary N-telopeptide level (NTX) according to menopausal stage. We analyzed data from 2283 participants of the Study of Women's Health Across the Nation, a longitudinal community-based cohort study of women aged 42 to 52 years at baseline. At baseline and annually through follow-up visit 8, participants provided questionnaire data, urine samples, serum samples, and anthropometric measurements. Using multivariable repeated-measures mixed models, we examined associations between annually assessed VMS frequency and annual NTX measurements. Our results show that mean adjusted NTX was 1.94 nM of bone collagen equivalents (BCE)/mM of creatinine higher among early perimenopausal women with any VMS than among early perimenopausal women with no VMS (p < .0001). Mean adjusted NTX was 2.44 nM BCE/mM of creatinine higher among late perimenopausal women with any VMS than among late perimenopausal women with no VMS (p = .03). Among premenopausal women, VMS frequency was not significantly associated with NTX level. When NTX values among women with frequent VMS (≥6 days in past 2 weeks) were expressed as percentages of NTX values among women without frequent VMS, the differences were 3% for premenopausal women, 9% for early perimenopausal women, 7% for late perimenopausal women, and 4% for postmenopausal women. Adjustment for serum follicle-stimulating hormone (FSH) level greatly reduced the magnitudes of associations between VMS and NTX level. We conclude that among early perimenopausal and late perimenopausal women, those with VMS had higher bone turnover than those without VMS. Prior to the final menstrual period, VMS may be a marker for risk of adverse bone health.

  16. Menopause Symptoms and Attitudes of African American Women: Closing the Knowledge Gap and Expanding Opportunities for Counseling

    ERIC Educational Resources Information Center

    Huffman, Shirley B.; Myers, Jane E.; Tingle, Lynne R.; Bond, Lloyd A.

    2005-01-01

    Menopause, a normal midlife transition for women, remains poorly understood, especially for minority women. A total of 226 African American midlife women completed the Menopause Symptoms List (J. M. Perz, 1997); Menopause Attitude Scale (C. Bowles, 1986); Attitudes Toward Menopause checklist (B. L. Neugarten, V. Wood, R. J. Kraines, & B. Loomes,…

  17. S-equol: a potential nonhormonal agent for menopause-related symptom relief.

    PubMed

    Utian, Wulf H; Jones, Michelle; Setchell, Kenneth D R

    2015-03-01

    Many women suffering from vasomotor symptoms (VMS) are now seeking nonpharmaceutical treatments for symptom relief. Recently, S-equol, an intestinal bacterial metabolite of the soybean isoflavone daidzein has received attention for its ability to alleviate VMS and provide other important health benefits to menopausal women. S-equol is found in very few foods and only in traces. About 50% of Asians and 25% of non-Asians host the intestinal bacteria that convert daidzein into S-equol. Clinical trials that evaluated the efficacy of an S-equol-containing product found that VMS were alleviated but these trials were limited in scope and primarily involved Japanese women for whom hot flashes are a minor complaint. The only trial in the United States evaluating hot flashes found symptoms were significantly reduced by S-equol, but the study lacked a placebo group, although it did include a positive control. The daily dose of S-equol used in most trials was 10 mg, and because the half-life of S-equol is 7-10 hours, to maximize efficacy, it was taken twice daily. Subanalysis of epidemiologic studies suggests that equol producers are more likely to benefit from soyfood consumption than nonproducers with respect to both cardiovascular disease and osteoporosis, although the data are inconsistent. The limited safety data for S-equol do not suggest cause for concern, especially with regard to its effects on breast and endometrial tissue. Further studies are needed before definitive conclusions of its effectiveness for VMS can be made, but the preliminary evidence warrants clinicians discussing the potential of S-equol for the alleviation of VMS with patients.

  18. Menopause

    MedlinePlus

    ... stopping estrogen therapy in the Women's Health Initiative randomized, placebo-controlled trial. Menopause . 2010;17(5):946- ... extended poststopping phases of the Women's Health Initiative randomized trials. JAMA . 2013;310(13):1353-68. PMID: ...

  19. Treatment of Insomnia, Insomnia Symptoms, and Obstructive Sleep Apnea During and After Menopause: Therapeutic Approaches

    PubMed Central

    Tal, Joshua Z.; Suh, Sooyeon A.; Dowdle, Claire L.; Nowakowski, Sara

    2015-01-01

    Understanding sleep complaints among menopausal women is an emerging area of clinical and research interest. Several recent reviews have focused on mechanisms of menopausal insomnia and symptoms. In this review, we present a discussion on the most relevant and recent publications on the treatment of sleep disorders for menopausal women, with a focus on menopause-related insomnia, insomnia symptoms, and obstructive sleep apnea. We discuss both nonpharmacological and pharmacological treatments, including cognitive-behavioral therapy for insomnia (CBT-I), complementary and alternative medicine, hormone replacement therapy, sedative hypnotics, antidepressants, and continuous positive airway pressure. In addition, we briefly discuss methods and considerations of assessment of sleep disorders in menopausal women. PMID:26478725

  20. The body self and the frequency, intensity and acceptance of menopausal symptoms

    PubMed Central

    Wycisk, Jowita

    2015-01-01

    Introduction There are many studies on the concept of body image (usually understood narrowly as body acceptance) in menopausal women, but relationships between the body self and menopausal symptoms have not been explored yet. In the research discussed in this paper, a complex model of the body self, including its functions, body identity and body image, has been presented. Aim of the study Aim of the study was to explore the relationships between different aspects of the body self, and the frequency, intensity and acceptance of menopausal symptoms. Material and methods The investigated sample consisted of 81 women (age: 51.8 ± 4.2 years; range: 45-58 years). The authors used an extended version of the Menopause Symptom List and the Body Self Questionnaire. Results Perception of sensations, interpretation and regulation of emotions and physical states as well as body identity were the most important correlates of the intensity and frequency of menopausal symptoms (psychological, vasomotor and somatic). Among the body image aspects investigated in the study, the appearance evaluation was associated with the frequency of vasomotor and psychological symptoms. The level of acceptance of symptoms was only related to the ability to cope with emotions and physical needs. Conclusions The findings indicate that aspects of the body self (which are stable personality traits) are significant for the way women experience menopausal symptoms. PMID:26327894

  1. Comparative study of gabapentin and isoflavone in menopausal vasomotor symptoms

    PubMed Central

    Singhal, Savita Rani; Shullai, Wansalan Kuru

    2016-01-01

    Objective: This study was planned to compare the effects of gabapentin and isoflavones in menopausal vasomotor symptoms. Materials and Methods: This prospective comparative study was conducted on 100 patients with complaints of hot flashes, divided into two groups of 50 each. Group I received 900 mg of gabapentin and Group II received 60 mg of isoflavones daily for 3 months. The patients were interviewed to calculate hot flash, global and depression scores and were rescored after 2, 4, 8, and 12 weeks. The primary outcome measure was a change in the hot flash score from baseline. The secondary outcome was an improvement in sleep, depression, and lipid profile. Data were analyzed using Chi-square test and Student's t-test. Results: Both groups showed significant improvement in hot flash score at the end of 12 weeks (82% Group I, 74% Group II; P = 0.076). Statistically significant difference was seen at 12 weeks in sleep quality in favor of gabapentin (P = 0.011) and in depression in favor of isoflavones (0.026). Isoflavone had significant improvement in cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides profiles after 12 weeks (P < 0.001, 0.009, 0.024 and <0.001, respectively) as compared to gabapentin. Conclusion: Isoflavone and gabapentin are equally effective in the treatment of hot flashes; however, isoflavones have better response in patients who have associated with complaints of depression and gabapentin is better who have associated sleep disturbance. PMID:27721641

  2. Effect of persistent menopausal symptoms on the wellbeing of Japanese breast cancer survivors.

    PubMed

    Yamamoto, Sena; Masutani, Eiko; Arao, Harue

    2016-09-01

    While more women with breast cancer survive because of advances in cancer treatment including hormonal therapy, they are at a risk of menopausal symptoms, which can threaten their psychological wellbeing. We examined the effect of menopausal symptoms on women's psychological wellbeing during three different phases of breast cancer: short-term (0-1 years since diagnosis), medium-term (2-5 years), and long-term (more than 5 years). In this cross-sectional study, 425 survivors treated with hormonal therapy were recruited from a convenience sample in Japan and completed an anonymous self-administered questionnaire. Multiple regression analysis revealed that menopausal symptoms significantly contributed to psychological wellbeing in all phases. In long-term survivors, menopausal symptoms were significantly milder; however, the negative effect was prolonged. One in three to four survivors was suspected to have poor psychological wellbeing, irrespective of time. Although the effect of menopausal symptoms on psychological wellbeing has been described in short-term survivors, little is known about the long-term effect. This study examines the effect of menopausal symptoms on psychological wellbeing, thereby providing useful information regarding long-term quality of life. PMID:27101769

  3. What Are the Treatments for Other Symptoms of Menopause?

    MedlinePlus

    ... menopause, health care providers may order a bone density test, such as a dual-energy X-ray ... bedroom at night. Sip a cold drink of water or juice. Avoid smoking, caffeine, and alcohol. When ...

  4. Severity and clustering of menopausal symptoms among obese and nonobese postmenopausal women in India

    PubMed Central

    Sharanya Shre, E. S.; Trout, Kate; Singh, Sonia Pant; Singh, Awnish Kumar; Mohan, Surapaneni Krishna; Joshi, Ashish

    2016-01-01

    Background: The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India. Methodology: The Menopausal Rating Scale (MRS) was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross-sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal health history, and hormonal disorder issues were investigated. Results: The results have shown that 24% of the participants had complaint of mild to severe hot flushes, half of them had reported heart ailments (49%; n = 74), and disturbed sleep (48%; n = 72). The proportion of overweight/obese participants was higher in married (64%) than widows (41%), and this difference was found statistically significant (P = 0.005). There were no significant differences in MRS scores of obese and nonobese postmenopausal participants. Conclusion: There is a need of developing interactive, user friendly, technology based education module for addressing the chronic ailments of postmenopausal women. PMID:27134461

  5. Psychosocial and socioeconomic burden of vasomotor symptoms in menopause: A comprehensive review

    PubMed Central

    Utian, Wulf H

    2005-01-01

    Many women experience vasomotor symptoms at or around the time of menopause. Hot flushes and night sweats are considered primary menopausal symptoms that may also be associated with sleep and mood disturbances, as well as decreased cognitive function. All of these symptoms may lead to social impairment and work-related difficulties that significantly decrease overall quality of life. Hot flushes have shown a great deal of variability in their frequency and severity in women. In some women, hot flushes persist for several months; in others, they may last for more than 10 years. Traditionally vasomotor symptoms were reported to begin 5 to 10 years prior to the cessation of the final menstrual cycle, corresponding with the initial decline in circulating gonadal hormones; however, night sweats in particular most often begin in perimenopause. The pathogenesis of hot flushes has not yet been fully elucidated, but the circuitry involving estrogen and neurotransmitters, norepinephrine and serotonin specifically, are hypothesized to play a major role in the altered homeostatic thermoregulatory mechanisms underlying these events. Menopause-associated vasomotor symptoms are associated with significant direct and indirect costs. Overall costs of traditional pharmacotherapy or complementary and alternative medicine modalities, including over-the-counter treatments and dietary supplements, for managing menopause-related vasomotor symptoms are substantial and include initial and follow-up physician visits and telephone calls. Additional costs include laboratory testing, management of adverse events, loss of productivity at work, and personal and miscellaneous costs. Pharmacoeconomic analyses, including those that consider risks identified by the Women's Health Initiative, generally support the cost-effectiveness of hormonal therapy for menopause-associated vasomotor symptoms, which have been the mainstay for the management of these symptoms for more than 50 years. However

  6. Protocol for systematic review and meta-analysis: hop (Humulus lupulus L.) for menopausal vasomotor symptoms

    PubMed Central

    Abdi, Fatemeh; Kazemi, Farideh; Ramezani Tehrani, Fahimeh; Roozbeh, Nasibeh

    2016-01-01

    Introduction Menopause is a critical stage in every woman's life. It can cause a distressing time for women by creating various vasomotor symptoms (VMS). Phytoestrogens can potentially exert various favourable effects and alleviate VMS in postmenopausal women. The hop (Humulus lupulus L.) contains 8-prenylnaringenin (8-PN), the most potent phytoestrogen known to date. The hop is eight times stronger than any other herbal oestrogens. This study aims to conduct a comprehensive systematic review and a meta-analysis survey of the effects of hop in the management of VMS in postmenopausal women. Methods Only randomised controlled clinical trials, with cluster randomisation and crossover, blinded and non-blinded designs, conducted between 2000 and 2015, will be included in this review. Quasi-experimental and observational studies as well as case reports will be excluded. The studies will be selected if their participants were aged 40–60 years, had elevated follicle-stimulating hormone (FSH) levels and/or menstrual irregularities, and experienced discomforting VMS (at least hot flashes or night sweats). The primary outcome will be the rate of response to treatment, such as changes in frequency and intensity of symptoms in the intervention and placebo groups. ‘Hop’, ‘Humulus’, ‘menopause’, ‘vasomotor’, ‘hot flashes’, ‘phytoestrogen’ and ‘night sweats’ will be used as search key words. Prior to their inclusion in the review, the selected papers will be assessed by two independent reviewers for methodological validity. Any disagreements will be resolved through a third reviewer. The risk of bias will be independently determined using the Cochrane Risk of Bias Tool. The quality of the papers will be assessed based on the CONSORT checklist. Ethics and dissemination Results will be disseminated through traditional academic literature. Dissemination of results will occur by peer-reviewed publications. The results of our project can help

  7. Behaviours and attitudes influencing treatment decisions for menopausal symptoms in five European countries

    PubMed Central

    Graham, Shelli; Clerinx, Cathy; Bernick, Brian A; Krassan, Mitchell; Mirkin, Sebastian; Currie, Heather

    2016-01-01

    Objective To assess women’s behaviours and attitudes regarding the treatment of menopausal symptoms in five European countries. Study design Women aged ≥45 years in France, Germany, Italy, Spain, and the United Kingdom participated in an internet survey. Completers were those who reported menopausal symptoms and had treated their symptoms. Women were equally stratified by age (45–54 years, 55–64 years, ≥65 years). Main outcome measures Behaviours, attitudes, and experiences regarding treatment of menopausal symptoms. Results Of 3890 peri- to postmenopausal women screened, 67% experienced symptoms and 54% sought either medical input or some treatment concerning their symptoms. Hot flushes, the most common symptom, decreased with age but remained prevalent after age 64. Roughly 75% of women who sought relief consulted a physician, mostly a gynaecologist or a general practitioner (GP) as in the United Kingdom. The decision to seek treatment was influenced by age, number, and severity of symptoms. Approximately 79% visiting a physician received prescription therapy. Of the women who received non-hormone therapy (HT) treatment instead of HT: patients refused HT (20–44%), physicians did not discuss HT (32–46%), or advised against HT (24–43%). Women in the United Kingdom were most familiar with and favorable to HT. Interest in a new HT (34–50%) was higher than use (19–28%). Conclusions Menopausal symptoms are common, persistent, and bothersome, but many fail to seek treatment. Sources and types of treatment vary among age groups and countries. Education regarding women’s attitudes toward treatment should be provided to those physicians who treat menopausal symptoms in each country. PMID:26895640

  8. The influence of selected socio-demographic variables on symptoms occurring during the menopause

    PubMed Central

    Kryś-Noszczyka, Karolina; Jakiel, Grzegorz

    2015-01-01

    Introduction It is considered that the lifestyle conditioned by socio-demographic or socio-economic factors determines the health condition of people to the greatest extent. The aim of this study is to evaluate the influence of selected socio-demographic factors on the kinds of symptoms occurring during menopause. Material and methods The study group consisted of 210 women aged 45 to 65, not using hormone replacement therapy, staying at healthcare centers for rehabilitation treatment. The study was carried out in 2013-2014 in the Silesian, Podlaskie and Lesser Poland voivodeships. The set of tools consisted of the authors’ own survey questionnaire and the Menopause Rating Scale (MRS). Results The most commonly occurring symptom in the group of studied women was a depressive mood, from the group of psychological symptoms, followed by physical and mental fatigue, and discomfort connected with muscle and joint pain. The greatest intensity of symptoms was observed in the group of women with the lowest level of education, reporting an average or bad material situation, and unemployed women. Conclusions An alarmingly high number of reported psychological symptoms in the group of menopausal women was observed, and in particular among the group of low socio-economic status. Career seems to be a factor reducing the risk of occurrence of psychological symptoms. There is an urgent need for health promotion and prophylaxis in the group of menopausal women, and in many cases for implementation of specialist psychological assistance. PMID:26327884

  9. Influence of Toxoplasma Gondii Infection on Symptoms and Signs of Menopause

    PubMed Central

    Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Hernández-Tinoco, Jesús; Calzada-Torres, Edwin Adiel; Estrada-Martínez, Sergio; Pérez-Álamos, Alma Rosa; Vaquera-Enriquez, Raquel; Díaz-Herrera, Arturo; Segura-Moreno, Raúl; de Lourdes Guerrero-Carbajal, María; Rentería-López, María Guadalupe; García, Isabel Beristain; Rábago-Sánchez, Elizabeth; Liesenfeld, Oliver

    2016-01-01

    Some symptoms of menopause have also been described in patients with toxoplasmosis. Whether Toxoplasma gondii (T. gondii) infection has any influence on clinical manifestations of menopause is yet unknown. We sought to determine whether T. gondii exposure is associated with symptoms and signs of menopause. We performed a cross-sectional study of women attending a public health center in Durango City, Mexico. Participants were examined for the presence of anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays. A questionnaire including 47 symptoms and signs potentially associated with menopause was applied. Association of seroprevalence for T. gondii with clinical characteristics of women was assessed by bivariate and multivariate analyses. Bivariate analysis showed that bouts of rapid heartbeat, breast pain, electric shock sensation, dizziness, digestive problems, low back pain, and migraine were associated with seropositivity to either IgG anti-T. gondii alone or both IgG and IgM anti-T. gondii. Breast pain was the only variable that was found to be associated with IgG seropositivity to T. gondii by multivariate analysis: (OR = 2.84; 95% CI: 1.35–5.90; P = 0.005). Our results suggest that T. gondii exposure may influence on the clinical manifestations of menopause. Results deserve further research. PMID:27141314

  10. Menopausal Symptom Experience of Hispanic Midlife Women in the U.S.

    PubMed Central

    Im, Eun-Ok; Lim, Hyun-Ju; Lee, Seung Hee; Dormire, Sharon; Chee, Wonshik; Kresta, Kimberly

    2009-01-01

    Using a feminist approach, we examined the menopausal symptom experience of Hispanic midlife women in the U.S. This was a qualitative online forum study among 27 Hispanic midlife women in the U.S. Seven topics related to menopausal symptom experience were used to administer the 6-month online forum. The data were analyzed using thematic analysis. Four themes were identified: (a) “Cambio de vida (change of life),” (b) “being silent about menopause,” (c) “trying to be optimistic,” and (d) “getting support.” More in-depth studies with diverse groups of Hispanic women are needed while considering family as a contextual factor. PMID:19742365

  11. Menopausal symptoms in women with breast cancer: prevalence and treatment preferences.

    PubMed

    Hunter, Myra S; Grunfeld, Elizabeth A; Mittal, Sangeeta; Sikka, Pooja; Ramirez, Amanda-Jane; Fentiman, Ian; Hamed, Hisham

    2004-11-01

    Menopausal symptoms are common and problematic for women receiving adjuvant treatment for breast cancer and management presents a challenge. This cross-sectional descriptive study aimed to investigate the experience of menopausal symptoms, current management and treatment preferences of 113 patients with breast cancer. These women (who were prescribed tamoxifen and were on average 3 years post-diagnosis) were recruited from a breast unit database. They completed the Hot Flush and Night Sweats Questionnaire (HFNSQ), the Women's Health Questionnaire (WHQ) and subscales of the EORTC-QLQ-C30 and the BR23, as well as questions about treatments. Forty-four of this sample were also interviewed. The prevalence of hot flushes and night sweats was 80 and 72%, respectively (average 30 per week). Having more problematic hot flushes and night sweats were associated with more anxiety and sleep problems (WHQ), and with poorer emotional and social functioning and worse body image (EORTC-QLQ-C30). The women had used a range of treatments for menopausal symptoms but there was often no evidence for the efficacy for many of these treatments. Strongest preferences were for non-medical treatments, particularly vitamins and herbal remedies and cognitive behavioural therapy (CBT). The evidence for the effectiveness of the former is weak, whereas CBT has been shown to reduce menopausal symptoms, but needs to be evaluated in a population of women who have been treated for breast cancer.

  12. Association between Menopausal Symptoms and Overactive Bladder: A Cross-Sectional Questionnaire Survey in China

    PubMed Central

    Zhu, Lingping; Cheng, Xiaoxia; Sun, Jiaxin; Lv, Shiyi; Mei, Suzhen; Chen, Xing; Xi, Sisi; Zhang, Jin; Yang, Mukun; Bai, Wenpei; Yan, Xiaoyan

    2015-01-01

    Purpose The association between menopause and overactive bladder is controversial. The purpose of this study was to determine the association between menopausal symptoms and overactive bladder, and identify the risk factors for overactive bladder. Methods A cross-sectional study was performed. The study included 403 women aged 36–76 years who visited the menopause clinic at Peking University First Hospital between September 2012 and December 2013. The overactive bladder symptom score and modified Kupperman index questionnaires were used. Differences were assessed using descriptive statistics to determine any association between the overactive bladder symptom score and modified Kupperman index score, and to evaluate the risk factors for overactive bladder. Results A total of 304 women were finally enrolled. The prevalence of overactive bladder was 9.43%, and the modified Kupperman index score; number of sexual problems; and frequency of urinary tract infections, vertigo, melancholia, and mood swings were significantly higher in patients with overactive bladder than in the patients without overactive bladder (p < 0.05). Menopausal symptoms (modified Kupperman index score ≥ 15) (odds ratio: 1.049, 95% confidence interval: 1.006–1.095, p = 0.025) and a low frequency of sexual intercourse in the last 6 months (odds ratio: 2.580, 95% confidence interval: 1.228–5.422, p = 0.012) were identified as independent risk factors for overactive bladder. The frequency of sexual intercourse was found to decrease with an increase in the severity of overactive bladder (p = 0.004, linear-by-linear association = 0.001). Conclusion Menopausal symptoms may be closely associated with overactive bladder, and sexual activity may be associated with the severity of overactive bladder. Moreover, sexual problems, urinary tract infections, vertigo, melancholia, and mood swings may be associated with overactive bladder. PMID:26448626

  13. Menopausal symptoms and physical activity in multiethnic groups of midlife women: A secondary analysis

    PubMed Central

    Chang, Sun Ju; Chee, Wonshik; Im, Eun-Ok

    2013-01-01

    Aims To explore the effect of diverse types of women’s physical activity on menopausal symptoms among multiethnic groups of midlife women in the USA. Background Although physical activity is one of the most widely used non-pharmacological methods for managing menopausal symptoms, there is a paucity of clinical guidelines for women and healthcare providers because the relationship between physical activity and menopausal symptoms has been found inconsistent in previous studies. Design A secondary analysis of the data from a lager Internet survey study conducted in 2008 – 2010. Methods A total of 481 midlife women among four ethnic groups were selected from the original study. The data were collected using the Kaiser Physical Activity Survey and the Midlife Women’s Symptom Index. Bivariate correlation analyses and hierarchical multiple regression analyses were used to analyze the data. Results/Findings The household/caregiving activity index was positively associated with the prevalence scores of the psychological symptoms in both Non-Hispanic Asians and Non-Hispanic African Americans. The increased sports/exercise activity index was negatively associated with the severity scores of the physical symptoms in both Hispanics and Non-Hispanic Whites. The occupational activity index and the active living activity index significantly predicted the severity scores of the psychosomatic symptoms in Hispanics and Non-Hispanic African Americans, respectively. Conclusion Nurses who take care of multiethnic groups of midlife women who experience menopausal symptoms should be aware of diverse types of women’s physical activities within the cultural context. PMID:23171423

  14. Alternative treatments for menopausal symptoms. Systematic review of scientific and lay literature.

    PubMed Central

    Seidl, M. M.; Stewart, D. E.

    1998-01-01

    OBJECTIVE: To review the scientific literature on common alternative remedies for treatment of symptoms attributed to menopause and to contrast this with available lay literature. QUALITY OF EVIDENCE: Scientific articles were identified by searching MEDLINE, CINAHL, and HEALTH databases from 1966 to mid-1997 for English-language articles. More than 200 references were reviewed; 85 were selected for citation based on specific reference to alternative medicine for symptoms commonly attributed to menopause (e.g., hot flashes), to the effects of changing estrogen levels (e.g., irregular menses, vaginal dryness), and to reported side effects of the treatments. MAIN FINDINGS: The scientific literature was categorized under the headings nutritional supplements, herbal remedies, homeopathic remedies, and physical approaches. Some scientific evidence of the safety and efficacy of alternative treatments during menopause was uncovered, with the strongest evidence emerging in favour of phytoestrogens, which occur in high concentrations as isoflavones in soy products. CONCLUSIONS: In available controlled studies, the strongest data support phytoestrogens for their role in diminishing menopausal symptoms related to estrogen deficiency and for possible protective effects on bones and the cardiovascular system. Randomized controlled trials, standardization of dosage, and accurate safety and efficacy labeling are required to ensure proper use of alternative remedies. PMID:9640524

  15. Acupuncture for menopausal vasomotor symptoms: study protocol for a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Hot flushes and night sweats (vasomotor symptoms) are common menopausal symptoms, often causing distress, sleep deprivation and reduced quality of life. Although hormone replacement therapy is an effective treatment, there are concerns about serious adverse events. Non-hormonal pharmacological therapies are less effective and can also cause adverse effects. Complementary therapies, including acupuncture, are commonly used for menopausal vasomotor symptoms. While the evidence for the effectiveness of acupuncture in treating vasomotor symptoms is inconclusive, acupuncture has a low risk of adverse effects, and two small studies suggest it may be more effective than non-insertive sham acupuncture. Our objective is to assess the efficacy of needle acupuncture in improving hot flush severity and frequency in menopausal women. Our current study design is informed by methods tested in a pilot study. Methods/design This is a stratified, parallel, randomised sham-controlled trial with equal allocation of participants to two trial groups. We are recruiting 360 menopausal women experiencing a minimum average of seven moderate hot flushes a day over a seven-day period and who meet diagnostic criteria for the Traditional Chinese Medicine diagnosis of Kidney Yin deficiency. Exclusion criteria include breast cancer, surgical menopause, and current hormone replacement therapy use. Eligible women are randomised to receive either true needle acupuncture or sham acupuncture with non-insertive (blunt) needles for ten treatments over eight weeks. Participants are blinded to treatment allocation. Interventions are provided by Chinese medicine acupuncturists who have received specific training on trial procedures. The primary outcome measure is hot flush score, assessed using the validated Hot Flush Diary. Secondary outcome measures include health-related quality of life, anxiety and depression symptoms, credibility of the sham treatment, expectancy and beliefs about

  16. Efficacy and Side Effects of Chinese Herbal Medicine for Menopausal Symptoms: A Critical Review

    PubMed Central

    Xu, Lian-Wei; Jia, Man; Salchow, Roland; Kentsch, Michael; Cui, Xue-Jun; Deng, Hong-Yong; Sun, Zhuo-Jun; Kluwe, Lan

    2012-01-01

    This study evaluates 23 (9 Chinese and 14 non-Chinese) randomized controlled trials for efficacy and side effects of Chinese herbal medicine on menopausal symptoms. Menopause was diagnosed according to western medicine criteria in all studies while seven Chinese studies and one non-Chinese study further stratified the participants using traditional Chinese medical diagnosis “Zheng differentiation.” Efficacy was reported by all 9 Chinese and 9/14 non-Chinese papers. Side effects and adverse events were generally mild and infrequent. Only ten severe adverse events were reported, two with possible association with the therapy. CHM did not increase the endometrial thickness, a common side effect of hormone therapy. None of the studies investigated long-term side effects. Critical analysis revealed that (1) high-quality studies on efficacy of Chinese herbal medicine for menopausal syndrome are rare and have the drawback of lacking traditional Chinese medicine diagnosis (Zheng-differentiation). (2) Chinese herbal medicine may be effective for at least some menopausal symptoms while side effects are likely less than hormone therapy. (3) All these findings need to be confirmed in further well-designed comprehensive studies meeting the standard of evidence-based medicine and including Zheng-differentiation of traditional Chinese medicine. PMID:23365599

  17. Depressive symptoms in the transition to menopause: the roles of irritability, personality vulnerability, and self-regulation.

    PubMed

    Mauas, Viviana; Kopala-Sibley, Daniel C; Zuroff, David C

    2014-08-01

    Although the transition to menopause represents a period of risk for depressive symptoms, there is little research into personality or trait-like factors that may confer vulnerability to depression during the transition to menopause. This study investigated whether the personality trait of self-criticism moderated the effects of irritability on depressive symptoms in women transitioning to menopause and whether these effects were mediated by lower levels of emotional regulation. Participants were 376 women, of whom 157 had entered the transition phase to menopause. These women in the transition phase completed measures of self-criticism, irritable mood, emotional regulation, and depressive symptoms. All analyses controlled for attitudes toward menopause and somatic symptoms. Moderated mediation regression analyses showed that higher levels of irritability were associated with poorer emotional regulation in highly self-critical women, but not in less self-critical women, and poorer emotional regulation was, in turn, related to higher levels depressive symptoms. Findings suggest that the transition to menopause may represent an especially vulnerable period for women with high levels of self-criticism. Although irritability is transitory for most women, for women who are highly self-critical, irritability may tax their ability to self-regulate and lead to more encompassing symptoms of depression.

  18. Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and postmenopausal women

    PubMed Central

    Bener, Abdulbari; Saleh, Najah M.

    2015-01-01

    Background: The reported association between vitamin D level and loss of Bone mineral densitometry measurements (BMD) has been controversial. Objective: The objectıve of the current study was to determine whether low vitamin D level and BMD are associated with depresive symptoms as burden in Arab women during the menopausal and postmenopausal period. Design and Setting: A cross-sectional descriptive study design was used at the Primary Health Care (PHC) Centers in Qatar. Subjects: A multi-stage sampling design was used and a representative sample of 1436 women aged 45-65 years were included during July 2012 and November 2013 and 1106 women agreed to participate (77.2%) and responded to the study. Materials and Methods: BMD (g/m2) was assessed at the BMD unit using a Lunar Prodigy DXA system (Lunar Corp., Madison, WI). The antero-posterior lumbar spine (L2-L4) and the mean of the proximal right and left femur were be measured by two technician and then reviewed by one radiologist. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes. Results: Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%) and responded to the study. The mean age and standard deviation of the subjects was 53.8 ± 3.2. The median age of natural menopausal in the present study was 49 years (mean and standard deviation 49.5 ± 3.1 and postmenopausal was 58.1 ± 3.3). There were statistically significant differences between menopausal stages with regards to ethnicity, education level, systolic and dialostic blood pressure, parity, sheesha smoking and depressive symptoms. Overall 30.4% of women were affected with osteopenia/osteoporosis in premenopausal and postmenopausal (24.4% vs 35.7%; P = 0.0442). Osteopenia in premenopausal and postmenopausal (18.7% vs 29.3%; P = 0.030) and Osteoporosis (9.9% vs 15.9%; P = 0.049) were

  19. Effect of Education through Support ­Group on Early Symptoms of Menopause: a Randomized Controlled Trial

    PubMed Central

    Sehhatie Shafaie, Fahimeh; Mirghafourvand, Mozhgan; Jafari, Maryam

    2014-01-01

    Introduction: Menopause is one of the most important crises in the life of women. The control of menopause symptoms is a main challenge in providing care to this population. So, the aim of present study was to investigate the effect of education through support ­group on early symptoms of menopause. Methods: In this randomized controlled clinical trial 124 postmenopausal women who had a health records in Valiasr participatory health center of Eslamshahr city were participated. These women were allocated by block randomization method into support group (62 women) and control group (62 women).Women in support group was assigned into 6 groups. Three 60-minutes educational sessions were conducted in 3 sequential weekly sessions. Early menopausal symptoms were measured before and 4 weeks after the intervention by using Greene scale (score ranged from 0 to 63). Data analysis was performed by ANCOVA statistical test. Results: There were no statistical differences between two groups in demographic characteristics and the total score of the Greene scale before intervention. The mean score of the Greene scale in support group was statistically less than control group 4 weeks after intervention. The number of hot flashes in the support group was significantly lower than control group, 4 weeks after intervention.Conclusion: Education through support group was effective in reducing the early symptoms of menopause. Thus, this educational method can be used as an appropriate strategy for enhancing women’ health and their dealing with annoying symptoms of menopause. PMID:25709980

  20. Estrogenic effects of herbal medicines from Costa Rica used for the management of menopausal symptoms

    PubMed Central

    Doyle, Brian J.; Frasor, Jonna; Bellows, Lauren E.; Locklear, Tracie D.; Perez, Alice; Gomez- Laurito, Jorge; Mahady, Gail. B.

    2009-01-01

    Objective Outcomes from the Women's Health Initiative have demonstrated adverse effects associated with hormone therapy (HT), and have prioritized the need to develop new alternative treatments for the management of menopause and osteoporosis. To this end, we have been investigating natural herbal medicines used by Costa Rican women to manage menopausal symptoms. Design Seventeen plant species were collected and extracted in Costa Rica. To establish possible mechanisms of action, and determine their potential future use for menopause or osteoporosis, the estrogenic activities of the herbal extracts were investigated in an estrogen reporter gene ERβ-CALUX® assay in U2-OS cells, and in reporter and endogenous gene assays in MCF-7 cells. Results Six of the plant extracts bound to the estrogen receptors. Four of the six extracts stimulated reporter gene expression in the ERβ-CALUX® assay. All six extracts modulated expression of endogenous genes in MCF-7 cells, with four extracts acting as estrogen agonists and two extracts, Pimenta dioica and Smilax domingensis, acting as partial agonist/antagonists by enhancing E2-stimulated pS2 mRNA expression, but reducing E2-stimulated PR and PTGES mRNA expression. Both P. dioica and S. domingensis induced a 2ERE-luciferase reporter gene in transient transfected MCF-7 cells, which was inhibited by the ER antagonist ICI 182780. Conclusions This work presents a plausible mechanism of action for many of the herbal medicines used by Costa Rican women to treat menopausal symptoms. However, it further suggests that studies of safety and efficacy are needed before these herbs should be used as alternative therapies to HT. PMID:19424091

  1. Symptoms, Attitudes and Treatment Choices Surrounding Menopause among the Q’eqchi Maya of Livingston, Guatemala”

    PubMed Central

    Michel, Joanna L.; Veliz, Mario; Soejarto, Doel D.; Caceres, Armando; Mahady, Gail B

    2006-01-01

    The present study explored symptoms, attitudes and treatments surrounding women’s health and menopause among the Q’eqchi Maya of the eastern tropical lowlands of Guatemala. Data were obtained through participant observation, semi-structured interviews, focus groups and plant walks with 50 Q’eqchi community members from the state of Izabal, Municipality of Livingston, including 5 midwives, 5 traditional male healers and 8 postmenopausal women. Results indicate that the Q’eqchi Maya of Livingston possess their own cultural perceptions of women’s health which affect attitudes, symptoms and treatment choices during the menopausal transition. Since discussions of menstruation and menopause are considered cultural taboos among the Q’eqchi, many women mentioned experiencing excessive preoccupation when unanticipated and unfamiliar symptoms occurred. Furthermore, many women suffered from additional hardship when their spouse misinterpreted menopausal symptoms (vaginal dryness, sexual disinterest) as infidelity. Seven of the eight postmenopausal women interviewed indicated experiencing one or more symptoms during the menopausal transition, including headaches, anxiety, muscular pain, depression, and hot flashes. These results differ from the lack of symptomatology reported in previous studies in Mexico, but are in line with the result of menopausal research conducted among other Maya groups from the highlands of Guatemala. Although the Q’eqchi did not use a specific term for “hot flash”, three Q’eqchi women used the expression “baja presion” or a “lowering of blood pressure” to explain symptoms of profuse sweating followed by chills, heart palpitations, and emotional instability. The Q’eqchi Maya mentioned a number of herbal remedies to treat menopausal symptoms. Further research on these botanical treatments is needed in order to ascertain their safety and efficacy for continued use. PMID:16580764

  2. Menopausal Symptoms and Its Correlates: A Study on Tribe and Caste Population of East India

    PubMed Central

    Dasgupta, Doyel; Karar, Priyanka; Ray, Subha; Ganguly, Nandini

    2015-01-01

    Present study aimed to compare the incidence of menopausal problems and concomitants between tribe and caste population. This cross section study was conducted in five villages of West Bengal, a state in the eastern part of India. This study was conducted between two different ethnic groups—one of the “Particularly Vulnerable Tribal Groups (PTG)” of India named as “Lodha” and the other was a Bengali speaking caste population. A total number of 313 participants were finally recruited for this study. Study participants were married, had at least one child, had no major gynaecological problems, and had stopped menstrual bleeding spontaneously for at least 1 year. Additionally, data on sociodemographic status and menstrual and reproductive history were collected using a pretested questionnaire/schedule. Bivariate analyses (chi square test) revealed that significantly more number of caste participants suffered from urinary problems than their tribe counterpart. The reverse trend has been noticed for the frequency of vaginal problems. Multivariate analyses (binary logistic regression) show that sociodemographic variables and menstrual and reproductive history of the present study participants seem to be the concomitants of menopausal symptoms. Tribe and caste study population significantly differed with respect to the estrogen deficient menopausal problems and the concomitants to these problems. PMID:26294906

  3. Glutamic acid ameliorates estrogen deficiency-induced menopausal-like symptoms in ovariectomized mice.

    PubMed

    Han, Na-Ra; Kim, Hee-Yun; Yang, Woong Mo; Jeong, Hyun-Ja; Kim, Hyung-Min

    2015-09-01

    Some amino acids are considered alternative therapies for improving menopausal symptoms. Glutamic acid (GA), which is abundant in meats, fish, and protein-rich plant foods, is known to be a neurotransmitter or precursor of γ-aminobutyric acid. Although it is unclear if GA functions in menopausal symptoms, we hypothesized that GA would attenuate estrogen deficiency-induced menopausal symptoms. The objective to test our hypothesis was to examine an estrogenic effect of GA in ovariectomized (OVX) mice, estrogen receptor (ER)-positive human osteoblast-like MG-63 cells, and ER-positive human breast cancer MCF-7 cells. The results demonstrated that administration with GA to mice suppressed body weight gain and vaginal atrophy when compared with the OVX mice. A microcomputed tomographic analysis of the trabecular bone showed increases in bone mineral density, trabecular number, and connectivity density as well as a significant decrease in total porosity of the OVX mice treated with GA. In addition, GA increased serum levels of alkaline phosphatase and estrogen compared with the OVX mice. Furthermore, GA induced proliferation and increased ER-β messenger RNA (mRNA) expression, estrogen response element (ERE) activity, extracellular signal-regulated kinase phosphorylation, and alkaline phosphatase activity in MG-63 cells. In MCF-7 cells, GA also increased proliferation, Ki-67 mRNA expression, ER-β mRNA expression, and ERE activity. Estrogen response element activity increased by GA was inhibited by an estrogen antagonist. Taken together, our data demonstrated that GA has estrogenic and osteogenic activities in OVX mice, MG-63 cells, and MCF-7 cells.

  4. Menopausal status, moderate-intensity walking, and symptoms in midlife women.

    PubMed

    Wilbur, JoEllen; Miller, Arlene Michaels; McDevitt, Judith; Wang, Edward; Miller, Josephine

    2005-01-01

    The purpose of this randomized clinical trial study was to determine the effectiveness of a 24-week, home-based, moderate-intensity, walking intervention in improving symptoms (vasomotor, uro-genital/sexual, sleep, psychological, cognitive, physical) experienced by midlife women. One hundred and seventy-three Caucasian and African American women aged 45 to 65 who were not on hormone therapy, had no major signs or symptoms of cardiovascular disease, and were sedentary in their leisure activity were randomly assigned to the moderate-intensity walking group or the nonexercise control group. The exercise prescription was walking at a frequency of 4 times a week for a duration of 20 to 30 minutes. The symptom impact inventory included the frequency, intensity, and bothersomeness of 33 symptoms collected at baseline and 24 weeks. Adherence was measured with a heart rate monitor and exercise log. Average adherence to frequency of walking was 71.6% of the expected walks. After 24 weeks, there were no differences between the walking and control group on change in symptoms. However, multiple regression revealed that frequency of adherence to walking along with change in physical symptoms and menopausal status were significant predictors of change in sleep symptoms. While walking did not improve most symptoms experienced by midlife women, frequency of walking may improve sleep. PMID:16025696

  5. Menopausal symptoms of postmenopausal women in a rural community of Delhi, India: A cross-sectional study

    PubMed Central

    Singh, Akanksha; Pradhan, Shishir Kumar

    2014-01-01

    Background: There is very little data on the consequence of menopause on women in South East Asia region, especially from rural India. Importance is always given to reproductive health from menarche to menopause. Menopausal health demands priority in Indian scenario due to rising population of postmenopausal women. Objectives: The aim was to determine the mean age at attaining menopause and the prevalence of various self-reported menopausal symptoms complained by postmenopausal women (40-54 years). Furthermore, to determine the prevalence of anxiety and depression among postmenopausal women. Materials and Methods: A cross-sectional study was conducted in a rural area of New Delhi among 252 postmenopausal women from October 2011 to March 2013. A pretested, self-designed, semi structured, interview based, oral questionnaire was used. The Statistical Package for Social Sciences software Version 21.0 (SPSS) was used for analyses. Results: The mean age at attaining menopause was 46.24 (Standard Deviation = 3.38) years. Only 4 (1.6%) postmenopausal women had premature menopause. A total of 225 (89.3%) postmenopausal women experienced at least one or more menopausal symptom(s). The most common complaints of postmenopausal women were sleep disturbances (62.7%), muscle or joint pain (59.1%), hot flushes (46.4%) and night sweats (45.6%). A total of 32.1% (n=81) postmenopausal women suffered from depression and 21.0% (n=53) postmenopausal women suffered from anxiety. Conclusion: It is necessary to critically introspect health needs of postmenopausal women and specific components can be incorporated in the national health programs. PMID:24970983

  6. Use of Alternative Medications for Menopause-Related Symptoms in Three Major Ethnic Groups of Ipoh, Perak, Malaysia.

    PubMed

    Ohn Mar, Saw; Malhi, Fatehpal; Syed Rahim, Syed Hamid; Chua, Chin Tong; Sidhu, Sarjeet Singh; Sandheep, Sugathan

    2015-11-01

    This cross-sectional study investigated the use of alternative medications to alleviate menopause-related symptoms among Malay, Chinese, and Indian women of Ipoh city. The prevalence, types, effectiveness, and associated factors were determined. The prevalence of alternative medication use was 41.4%. Evening primrose oil (EPO) was the most popular medication used (18.1%), followed by soy-based products (12.3%), green tea (6.8%), and gingko (5.8%). The medication was reported to be highly effective by 58.3% of soya bean diet users and 41.1% of EPO users. Significant variables associated with the use were Chinese or Indian ethnicity (P < .001), age between 50 and 54 years (P < .01), lower self-health rating (P < .05), education level of diploma or professional degree (P < .05), employment as professionals or entrepreneurs (P < .05), and the use of hormone replacement therapy (P < .05). Regression analysis showed that Chinese and Indians had significantly higher odds for the use than Malays (Chinese: odds ratio [OR] = 4.33, 95% confidence interval [CI] = 2.392-7.837; Indians: OR = 3.248, 95% CI = 1.586-6.654). PMID:25972428

  7. Patient considerations in the management of menopausal symptoms: role of conjugated estrogens with bazedoxifene

    PubMed Central

    Kagan, Risa; Goldstein, Steven R; Pickar, James H; Komm, Barry S

    2016-01-01

    Menopausal symptoms (eg, hot flushes and vaginal symptoms) are common, often bothersome, and can adversely impact women’s sexual functioning, relationships, and quality of life. Estrogen–progestin therapy was previously considered the standard care for hormone therapy (HT) for managing these symptoms in nonhysterectomized women, but has a number of safety and tolerability concerns (eg, breast cancer, stroke, pulmonary embolism, breast pain/tenderness, and vaginal bleeding) and its use has declined dramatically in the past decade since the release of the Women’s Health Initiative trial results. Conjugated estrogens paired with bazedoxifene (CE/BZA) represent a newer progestin-free alternative to traditional HT for nonhysterectomized women. CE/BZA has demonstrated efficacy in reducing the frequency and severity of vasomotor symptoms and preventing loss of bone mineral density in postmenopausal women. CE/BZA provides an acceptable level of protection against endometrial hyperplasia and does not increase mammographic breast density. Compared with traditional estrogen–progestin therapy, it is associated with lower rates of breast pain/tenderness and vaginal bleeding. Patient-reported outcomes indicate that CE/BZA improves menopause-specific quality of life, sleep, some measures of sexual function (especially ease of lubrication), and treatment satisfaction. This review looks at the rationale for selection and combination of CE with BZA at the dose ratio in the approved product and provides a detailed look at the efficacy, safety, tolerability, and patient-reported outcomes from the five Phase III trials. Patient considerations in the choice between CE/BZA and traditional HT (eg, tolerability, individual symptoms, and preferences for route of administration) are also considered. PMID:27103814

  8. A Situation-specific Theory of Asian Immigrant Women’s Menopausal Symptom Experience in the U.S.

    PubMed Central

    Im, Eun-Ok

    2010-01-01

    In this paper, a situation-specific theory that explains the menopausal symptom experiences of Asian immigrant women in the U.S. is presented. Using an integrative approach, the theory was developed based on the transition theory, a review of the relevant literature, and a study on Asian immigrant women’s menopausal symptom experiences in the U.S. The proposed theory includes transition conditions, patterns of response, and nursing therapeutics as major concepts and explains the relationships among these major concepts. This theory should be further validated and developed in intervention studies and nursing practice with this specific population. PMID:20460960

  9. Effects of Isoflavones and Amino Acid Therapies for Hot Flashes and Co-occurring Symptoms during the Menopausal Transition and Early Post Menopause: A Systematic Review

    PubMed Central

    Thomas, Annette; Ismail, Rita; Taylor-Swanson, Lisa; Cray, Lori; Schnall, Janet G.; Mitchell, Ellen Sullivan; Woods, Nancy Fugate

    2014-01-01

    Aims Review controlled clinical trials of isoflavones and amino acid preparation effects on hot flashes and at least one other symptom including mood, sleep, pain, and cognitive function that women report during the menopausal transition and early postmenopause. Methods An experienced reference librarian searched PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for English-language randomized controlled trials between 2004 to July 2011. Seventeen trials of isoflavones and amino acid effects on hot flashes and one additional symptom were identified. Results In five trials of soy isoflavone preparations, two (6g soy germ extract and 25g soy protein in soy nuts) significantly decreased hot flashes, but no other symptoms. In the seven trials of other isoflavones, six significantly reduced hot flashes; in addition, Red Clover (80 mg) significantly reduced mood symptoms; Rexflavone (350 mg) for women with Kupperman Index > 20 significantly reduced sleep symptoms; two trials had significant reductions for pain: Isoflavone powder (90 mg) and Red Clover (80 mg). The only trial in this systematic review that significantly reduced cognitive symptoms was Red Clover (80 mg). In one trial, Red Clover isoflavone (80 mg/d) significantly relieved hot flashes, mood, pain, and cognitive symptoms. Amino acids yielded no significant results. Equol supplements of 30 mg/d for non-Equol producing women significantly reduced mood symptoms in one trial. The Magnolia Bark Extract combination significantly reduced hot flashes, mood, and sleep symptoms. Conclusions Isoflavone trials yielded significant reductions on hot flashes and co-occurring symptoms during the menopausal transition and postmenopause, but studies require replication with larger sample sizes and attention to measurement of outcomes. PMID:24951101

  10. Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment.

    PubMed

    Williams, Phoebe D; Lantican, Leticia S; Bader, Julia O; Lerma, Daniela

    2014-10-01

    Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen. PMID:25253108

  11. Symptom monitoring, alleviation, and self-care among Mexican Americans during cancer treatment.

    PubMed

    Williams, Phoebe D; Lantican, Leticia S; Bader, Julia O; Lerma, Daniela

    2014-10-01

    Monitoring the occurrence and severity of symptoms among Mexican American adults undergoing cancer treatments, along with their self-care to alleviate symptoms, are understudied; the current study aimed to fill this gap in the literature. A total of 67 Mexican Americans receiving outpatient oncology treatments in the southwestern United States participated. Instruments included a patient-report checklist, the Therapy-Related Symptom Checklist (TRSC), the Symptom Alleviation: Self-Care Methods tool, and a demographic and health information form. At least 40% of participants reported the occurrence of 12 symptoms: hair loss, feeling sluggish, nausea, taste change, loss of appetite, depression, difficulty sleeping, weight loss, difficulty concentrating, constipation, skin changes, and numb fingers and toes. More than a third also reported pain, vomiting, decreased interest in sexual activity, cough, and sore throat. The helpful self-care strategies reported included diet and nutrition changes; lifestyle changes; and mind, body control, and spiritual activities. Patient report of symptoms during cancer treatments was facilitated by the use of the TRSC. Patients use symptom alleviation strategies to help relieve symptoms during their cancer treatment. The ability to perform appropriate, effective self-care methods to alleviate the symptoms may influence adherence to the treatment regimen.

  12. Perspective on prescribing conjugated estrogens/bazedoxifene for estrogen-deficiency symptoms of menopause: a practical guide.

    PubMed

    Palacios, Santiago; Currie, Heather; Mikkola, Tomi S; Dragon, Erika

    2015-04-01

    Current guidelines recommend that hormone therapy (HT) in postmenopausal women with a uterus include a progestin to protect against endometrial hyperplasia. However, many concerns relating to HT use appear to be related to the progestin component, including cardiovascular risk, breast stimulation, and irregular vaginal bleeding. Conjugated estrogens (CE) combined with the selective estrogen receptor modulator bazedoxifene (BZA) is a new progestin-free HT option for alleviating estrogen deficiency symptoms in postmenopausal women with a uterus for whom treatment with progestin-containing therapy is not appropriate. Five double-blind, randomized, placebo-controlled, phase 3 studies, known as the Selective estrogens, Menopause, And Response to Therapy (SMART) trials have investigated the efficacy of CE/BZA for relieving vasomotor symptoms (VMS), and effect on bone mass, as well as endometrial and breast safety in postmenopausal women. In a 12-week study, CE 0.45 mg/BZA 20 mg significantly reduced the number and severity of hot flushes compared with placebo at weeks 4 and 12. Unlike estrogen-progestin therapy (EPT), CE 0.45 mg/BZA 20 mg did not increase breast density compared with placebo. In clinical trials up to 2 years, CE/BZA had a favorable tolerability profile, demonstrated by amenorrhea rates similar to placebo. Vascular disorders including venous thromboembolic events (pulmonary embolism, retinal vein thrombosis, deep vein thrombosis, and thrombophlebitis) were rare events, occurring in less than 1 per 1000 patients. CE/BZA was associated with significantly higher incidences of amenorrhea and lower incidences of bleeding compared with CE/medroxyprogesterone acetate in 2 comparative trials. Therefore, CE 0.45 mg/BZA 20mg provides an effective, well-tolerated, progestin-free alternative to EPT for postmenopausal women with a uterus.

  13. Effects of 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women

    PubMed Central

    Lee, Haelim; Caguicla, Joy Matthew Cuasay; Park, Sangseo; Kwak, Dong Jick; Won, Deuk-Yeon; Park, Yunjin; Kim, Jeeyoun; Kim, Myungki

    2016-01-01

    The aim of this study was to investigate the effects of an 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women. In total, 74 postmenopausal women were recruited and randomly allocated to a Pilates exercise group (n=45) and a control group (n=29). Menopausal symptoms were measured through a questionnaire, while lumbar strength was measured through a lumbar extension machine, and lumbar flexibility was measured through sit-and-reach and trunk lift tests performed before and after the Pilates exercise program, respectively. The Pilates exercises consisted of 7–10 min for warm-up, 35–40 min for the main program modified from Pilates Academy International, and 5–7 min for the cool-down, and were performed 3 times a week for 8 weeks. The results showed a significant decrease in menopausal symptoms except urogenital symptoms. Also, the results presented a significant increase in lumbar strength and flexibility after 8 weeks of the Pilates exercise program. We concluded that an 8-week Pilates exercise program is effective in decreasing menopausal symptoms and increasing lumbar strength and flexibility. PMID:27419122

  14. Effects of 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women.

    PubMed

    Lee, Haelim; Caguicla, Joy Matthew Cuasay; Park, Sangseo; Kwak, Dong Jick; Won, Deuk-Yeon; Park, Yunjin; Kim, Jeeyoun; Kim, Myungki

    2016-06-01

    The aim of this study was to investigate the effects of an 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women. In total, 74 postmenopausal women were recruited and randomly allocated to a Pilates exercise group (n=45) and a control group (n=29). Menopausal symptoms were measured through a questionnaire, while lumbar strength was measured through a lumbar extension machine, and lumbar flexibility was measured through sit-and-reach and trunk lift tests performed before and after the Pilates exercise program, respectively. The Pilates exercises consisted of 7-10 min for warm-up, 35-40 min for the main program modified from Pilates Academy International, and 5-7 min for the cool-down, and were performed 3 times a week for 8 weeks. The results showed a significant decrease in menopausal symptoms except urogenital symptoms. Also, the results presented a significant increase in lumbar strength and flexibility after 8 weeks of the Pilates exercise program. We concluded that an 8-week Pilates exercise program is effective in decreasing menopausal symptoms and increasing lumbar strength and flexibility.

  15. Effects of 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women.

    PubMed

    Lee, Haelim; Caguicla, Joy Matthew Cuasay; Park, Sangseo; Kwak, Dong Jick; Won, Deuk-Yeon; Park, Yunjin; Kim, Jeeyoun; Kim, Myungki

    2016-06-01

    The aim of this study was to investigate the effects of an 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women. In total, 74 postmenopausal women were recruited and randomly allocated to a Pilates exercise group (n=45) and a control group (n=29). Menopausal symptoms were measured through a questionnaire, while lumbar strength was measured through a lumbar extension machine, and lumbar flexibility was measured through sit-and-reach and trunk lift tests performed before and after the Pilates exercise program, respectively. The Pilates exercises consisted of 7-10 min for warm-up, 35-40 min for the main program modified from Pilates Academy International, and 5-7 min for the cool-down, and were performed 3 times a week for 8 weeks. The results showed a significant decrease in menopausal symptoms except urogenital symptoms. Also, the results presented a significant increase in lumbar strength and flexibility after 8 weeks of the Pilates exercise program. We concluded that an 8-week Pilates exercise program is effective in decreasing menopausal symptoms and increasing lumbar strength and flexibility. PMID:27419122

  16. Investigation of the relationship between personality characteristics and vasomotor symptoms in menopausal women

    PubMed Central

    Ghorbani, Mahboubeh; Azhari, Sedigheh; Esmaily, Habib Allah; GhanbariHashemabadi, Bahram Ali

    2016-01-01

    Background: Research demonstrates that most of the menopausal symptoms and problems are the reflection of individual and social circumstances rather than the endocrine events of the menopause. As majority of women live 30 years or more through postmenopausal period, treatment and following up their problems during this period is among the main duties of a midwife. The aim of this study is to determine the relationship between personality traits and vasomotor symptoms in postmenopausal women. Materials and Methods: This correlation study was conducted on 400 postmenopausal women referring to the training maternity centers of Mashhad, Iran. Subjects were selected through simple sampling method and filled NEO Five-Factor Inventory (NEO-FFI (questionnaire. Their daily records of hot flashes and night sweats were also collected. NEO-FFI questionnaire assesses the five personality aspects of neuroticism, extraversion, openness to experience, conscientiousness, and agreeableness. After the data were collected, they were analyzed by Pearson and Spearman correlation coefficients, Mann-Whitney, Kruskal-Wallis, and linear regression statistical tests. P < 0.05 was considered as a statistically significant value. Results: Most of the women were in average level of personality traits. Among the aspects of personality traits, there was a significant correlation between intensity of hot flashes (P = 0.041) and night sweats (P = 0.028), and conscientiousness. Conclusions: According to the results of the study, during treatment of the vasomotor symptoms, a midwife should pay close attention to the personality of postmenopausal women to achieve an effective treatment. These women should also be referred to a psychologist, if needed. PMID:27563331

  17. Clinical Inquiries: Does exercise alleviate symptoms of depression?

    PubMed

    Gill, Alan; Womack, Rosalind; Safranek, Sarah

    2010-09-01

    Yes. Exercise reduces patient-perceived symptoms of depression when used as monotherapy (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with significant heterogeneity). It relieves symptoms as effectively as cognitive behavioral therapy (CBT) or pharmacologic anti-depressant therapy (SOR: B, meta-analysis) and more effectively than bright light therapy (SOR: B, meta-analysis). Resistance exercise and mixed exercise (resistance and aerobic) work better than aerobic exercise alone (SOR: B, meta-analysis). High-frequency exercise is more effective than low-frequency exercise (SOR: B, small RCT). "Mindful" exercise, which has a meditative focus, such as tai chi and yoga, also reduces symptoms of depression (SOR: B, systematic review of RCTs).

  18. Association of Vasomotor and Other Menopausal Symptoms with Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis

    PubMed Central

    Colpani, Veronica; Kunutsor, Setor; Chowdhury, Susmita; Chowdhury, Rajiv

    2016-01-01

    Importance Vasomotor symptoms (hot flushes and night sweats) and other symptoms, including depression, anxiety and panic attacks, are commonly experienced by menopausal women and have been associated with an unfavourable cardiovascular risk profile. Objective To investigate whether presence of menopausal symptoms is associated with the development of cardiovascular disease (CVD). Methods Five electronic databases (Medline, EMBASE and Web of Science) were search until February 17th, 2015 to identify relevant studies. Observational cohort studies or randomised intervention studies were eligible for inclusion if they followed participants prospectively (at least 1 year of follow-up), and reported relevant estimates on the association of any vasomotor symptoms, or other menopausal symptoms, with risk of CVD, coronary heart disease (CHD), or stroke in perimenopausal, menopausal, or postmenopausal women. Data were extracted by two independent reviewers using a pre-designed data collection form. Separate pooled relative risks (RRs) for age and non-established cardiovascular risk factors (e.g., education, ethnicity) adjusted data and for established cardiovascular risk factors and potential mediators-adjusted data (e.g., smoking, body mass index, and hypertension) were calculated. Results Out of 9,987 initially identified references, ten studies were selected, including 213,976 women with a total of 10,037 cardiovascular disease outcomes. The age and non-established cardiovascular risk factors adjusted RRs) [95% confidence intervals] for development of CHD, Stroke and CVD comparing women with and without any menopausal symptoms were 1.34 [1.13–1.58], 1.30 [0.99–1.70], 1.48 [1.21–1.80] respectively, and the corresponding RRs adjusted for cardiovascular risk factors and potential mediators were 1.18 [1.03–1.35], 1.08 [0.89–1.32], 1.29 [0.98–1.71]. However, these analyses were limited by potential unmeasured confounding and the small number of studies on this

  19. Hormone replacement therapy: I. A pharmacoeconomic appraisal of its therapeutic use in menopausal symptoms and urogenital estrogen deficiency.

    PubMed

    Whittington, R; Faulds, D

    1994-05-01

    Menopause and the accompanying reduction in estrogen production may cause a number of symptoms in women which include hot flushes, sweating, mood and sleep disturbances, fatigue and urogenital dysfunction. The effectiveness of estrogen-based hormone replacement therapy (HRT) in ameliorating these symptoms, and in preventing long term sequelae such as osteoporosis, is well established. Comparative trials indicate that oral conjugated estrogens 0.625mg, oral ethinyl estradiol 0.02mg and transdermal estradiol 0.05mg have equivalent efficacy in relief of mild to moderate menopausal symptoms and prevention of bone mineral loss. Concomitant progestogen therapy is usually prescribed for women with intact uteri to protect against endometrial hyperplasia and carcinoma. The addition of progestogen maintains and may even enhance the bone-conserving effects of estrogen, and continuous regimens appear to reduce the incidence of irregular menses. Adverse reactions are predominantly local skin irritation with transdermal preparations (14% of patients) and systemic effects common to most forms of HRT including breast tenderness, flushing, headache and irregular bleeding, occurring in less than or equal to 2% of patients. Data concerning the effect of HRT on quality of life are limited, but most analyses have assigned utility values of 0.99 for mild and 0.95 for severe menopausal symptoms. However, recent clinical data suggest that these utility values may underestimate the impact of menopausal symptoms on quality of life. The cost benefit and cost effectiveness of HRT in the treatment of menopausal symptoms have not been fully researched, although preliminary results suggest that conjugated estrogens and transdermal estradiol compare well with alternative therapies such as veralipride and Chinese medicines. A Swedish study using a prevalence-based approach estimated that estriol treatment in all women with urinary incontinence aged greater than or equal to 65 years resulted in

  20. Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis.

    PubMed

    Ghazanfarpour, M; Sadeghi, R; Roudsari, R Latifnejad; Khorsand, I; Khadivzadeh, T; Muoio, B

    2016-01-01

    This study evaluated the efficacy of red clover to relieve hot flashes and menopausal symptoms in peri/postmenopausal women. Electronic databases (MEDLINE, Scopus and the Cochrane Library) were searched. The mean frequency of hot flashes in red clover groups was lower compared with that in the control groups (close to statistical significance). Difference in means (MD) of hot flashes frequency was - 1.99 (- 4.12-0.139; p = 0.067; heterogeneity P > 0.01; I(2) = 94.93%; Random effect model). Subjective (vaginal dryness) and objective (maturation value) symptoms of vaginal atrophy showed a significant improvement with 80-mg dose of red clover. Red clover showed less therapeutic effect on psychology status, sexual problems and sleeping disorders. Red clover consumption may decrease frequency of hot flashes, especially in women with severe hot flashes (≥ 5 per day). Red clover may reduce other menopausal symptoms. Further trials are needed to confirm the current systematic review findings.

  1. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia

    PubMed Central

    Leweke, F M; Piomelli, D; Pahlisch, F; Muhl, D; Gerth, C W; Hoyer, C; Klosterkötter, J; Hellmich, M; Koethe, D

    2012-01-01

    Cannabidiol is a component of marijuana that does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. We previously reported that an elevation of anandamide levels in cerebrospinal fluid inversely correlated to psychotic symptoms. Furthermore, enhanced anandamide signaling let to a lower transition rate from initial prodromal states into frank psychosis as well as postponed transition. In our translational approach, we performed a double-blind, randomized clinical trial of cannabidiol vs amisulpride, a potent antipsychotic, in acute schizophrenia to evaluate the clinical relevance of our initial findings. Either treatment was safe and led to significant clinical improvement, but cannabidiol displayed a markedly superior side-effect profile. Moreover, cannabidiol treatment was accompanied by a significant increase in serum anandamide levels, which was significantly associated with clinical improvement. The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol potentially representing a completely new mechanism in the treatment of schizophrenia. PMID:22832859

  2. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia.

    PubMed

    Leweke, F M; Piomelli, D; Pahlisch, F; Muhl, D; Gerth, C W; Hoyer, C; Klosterkötter, J; Hellmich, M; Koethe, D

    2012-03-20

    Cannabidiol is a component of marijuana that does not activate cannabinoid receptors, but moderately inhibits the degradation of the endocannabinoid anandamide. We previously reported that an elevation of anandamide levels in cerebrospinal fluid inversely correlated to psychotic symptoms. Furthermore, enhanced anandamide signaling let to a lower transition rate from initial prodromal states into frank psychosis as well as postponed transition. In our translational approach, we performed a double-blind, randomized clinical trial of cannabidiol vs amisulpride, a potent antipsychotic, in acute schizophrenia to evaluate the clinical relevance of our initial findings. Either treatment was safe and led to significant clinical improvement, but cannabidiol displayed a markedly superior side-effect profile. Moreover, cannabidiol treatment was accompanied by a significant increase in serum anandamide levels, which was significantly associated with clinical improvement. The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol potentially representing a completely new mechanism in the treatment of schizophrenia.

  3. A study of menopausal symptoms in relation to habits of smoking and make-up using in Japanese women aged 35-59.

    PubMed

    Oi, N; Ohi, K

    2012-08-01

    We conducted a survey to elucidate the influence with menopause symptoms and the impact of not only smoking but also using make-up among for Japanese women, included ages above and below the menopausal generation. The subjects of this study were 335 Japanese women from 35 to 59 years of age who were examined for the first time in the specialized women's outpatient clinic of our institution from July 2010 to June 2011 for 1 year period. We used the items of the Menopause-Specific Quality of Life Questionnaire. Similarly, we analysed the scores in relation to menopausal symptoms and whether the subject smoked, whether the subject used make-up depend on women (including foundation, lip rouge, brush one's eyebrows), how frequently she used make-up. The JMP version 9.0 software program was used to statistically analyse the score data. Significant associations were observed in psychosocial (P = 0.0196), tended to be more severe in women before menopause and after climacteric. Furthermore, the frequency of using make-up were negative relations with menopause symptoms (P = 0.0251) after climacteric. Smoking had made worse for physical symptoms (P < 0.001). Menopause symptoms are already experienced by younger women, especially, psychological symptoms. Also, physical conditions were influenced by smoking. Using make-up frequently was often seen after climacteric because of appearance changes by oestrogen dynamic decline.

  4. Decreasing menopausal symptoms in women undertaking a web-based multi-modal lifestyle intervention: The Women's Wellness Program.

    PubMed

    Anderson, Debra; Seib, Charrlotte; McGuire, Amanda; Porter-Steele, Janine

    2015-05-01

    Menopausal transition can be challenging for many women. This study tested the effectiveness of an intervention delivered in different modes in decreasing menopausal symptoms in midlife women. The Women's Wellness Program (WWP) intervention was delivered to 225 Australian women aged between 40 and 65 years through three modes (i.e., on-line independent, face-to-face with nurse consultations, and on-line with virtual nurse consultations). All women in the study were provided with a 12-week Program Book outlining healthy lifestyle behaviors while women in the consultation groups were supported by a registered nurse who provide tailored health education and assisted with individual goal setting for exercise, healthy eating, smoking and alcohol consumption. Pre- and post-intervention data were collected on menopausal symptoms (Greene Climacteric Scale), health related quality of life (SF12), and modifiable lifestyle factors. Linear mixed-effect models showed an average 0.87 and 1.23 point reduction in anxiety (p<0.01) and depression scores (p<0.01) over time in all groups. Results also demonstrated reduced vasomotor symptoms (β=-0.19, SE=0.10, p=0.04) and sexual dysfunction (β=-0.17, SE=0.06, p<0.01) in all participants though women in the face-to-face group generally reported greater reductions than women in the other groups. This lifestyle intervention embedded within a wellness framework has the potential to reduce menopausal symptoms and improve quality of life in midlife women thus potentially enhancing health and well-being in women as they age. Of course, study replication is needed to confirm the intervention effects. PMID:25818771

  5. Decreasing menopausal symptoms in women undertaking a web-based multi-modal lifestyle intervention: The Women's Wellness Program.

    PubMed

    Anderson, Debra; Seib, Charrlotte; McGuire, Amanda; Porter-Steele, Janine

    2015-05-01

    Menopausal transition can be challenging for many women. This study tested the effectiveness of an intervention delivered in different modes in decreasing menopausal symptoms in midlife women. The Women's Wellness Program (WWP) intervention was delivered to 225 Australian women aged between 40 and 65 years through three modes (i.e., on-line independent, face-to-face with nurse consultations, and on-line with virtual nurse consultations). All women in the study were provided with a 12-week Program Book outlining healthy lifestyle behaviors while women in the consultation groups were supported by a registered nurse who provide tailored health education and assisted with individual goal setting for exercise, healthy eating, smoking and alcohol consumption. Pre- and post-intervention data were collected on menopausal symptoms (Greene Climacteric Scale), health related quality of life (SF12), and modifiable lifestyle factors. Linear mixed-effect models showed an average 0.87 and 1.23 point reduction in anxiety (p<0.01) and depression scores (p<0.01) over time in all groups. Results also demonstrated reduced vasomotor symptoms (β=-0.19, SE=0.10, p=0.04) and sexual dysfunction (β=-0.17, SE=0.06, p<0.01) in all participants though women in the face-to-face group generally reported greater reductions than women in the other groups. This lifestyle intervention embedded within a wellness framework has the potential to reduce menopausal symptoms and improve quality of life in midlife women thus potentially enhancing health and well-being in women as they age. Of course, study replication is needed to confirm the intervention effects.

  6. Hormone use for menopausal symptoms and risk of breast cancer. A Danish cohort study.

    PubMed

    Ewertz, M; Mellemkjaer, L; Poulsen, A H; Friis, S; Sørensen, H T; Pedersen, L; McLaughlin, J K; Olsen, J H

    2005-04-11

    Numerous studies and meta-analyses have shown that hormone replacement therapy (HRT) for menopausal symptoms increases the risk of developing breast cancer, estimated to be 2.3% for each year of use. The influence of different oestrogen-progestin regimens has still not been fully evaluated. Using longitudinal data from the population-based prescription database of the county of North Jutland, Denmark, and the Danish Cancer Registry, we examined the risk of developing breast cancer in relation to HRT in a cohort of 78,380 women aged 40-67 years from 1989 to 2002. A total of 1462 cases of breast cancer were identified during a mean follow-up of 10 years. Use of HRT did not increase the risk of breast cancer in women aged 40-49 years. Restricting the cohort to 48,812 women aged 50 years or more at entry, of whom 15 631 were HRT users, we found an increased risk associated with current use of HRT (relative risk 1.61, 95% confidence interval 1.38-1.88). The risk increased with increasing duration of use and decreased with time since last HRT prescription, reaching unity after 5 years. No material risk difference was observed among the various HRT-regimens. This population-based cohort study provides further confirmation that HRT increases the risk of developing breast cancer in women aged 50 years or more.

  7. Non-hormonal treatment of vulvo-vaginal atrophy-related symptoms in post-menopausal women.

    PubMed

    Tersigni, C; Di Simone, N; Tempestilli, E; Cianfrini, F; Russo, R; Moruzzi, M C; Amar, I D; Fiorelli, A; Scambia, G; Villa, P

    2015-01-01

    In post-menopausal period vulvo-vaginal atrophy (VVA)-related symptoms may seriously affect women's quality of life. Hormonal replacement therapy effectively relieves these symptoms but it is not always safe or accepted, and a non-hormonal treatment is often needed instead. Over a period of 12 weeks, we tested the effect of a twice-a-week vulvo-vaginal application of a hyaluronic acid, AC collagen, isoflavones and vitamins-based cream (Perilei Pausa) on 35 women in post-menopausal period, reporting VVA-related symptoms. After 12 weeks of treatment with Perilei Pausa a significant improvement in vaginal dryness, vulvo-vaginal itching, dyspareunia (P < 0.001), dysuria (P = 0.02), nocturia (P = 0.009) and pollakiuria (P = 0.005) was reported by the women. Colposcopical score assessing the intensity of atrophic colpitis, cervico-vaginal paleness and petechiae was also reduced (P = 0.037, P = 0.016 and P = 0.032, respectively). No significant difference in terms of maturation value of cervico-vaginal epithelium was observed. In conclusion, Perilei Pausa may represent an effective and safe alternative treatment of symptomatic VVA in post-menopausal women.

  8. Depressive symptoms and bone mineral density in menopause and postmenopausal women: A still increasing and neglected problem

    PubMed Central

    Bener, Abdulbari; Saleh, Najah M.; Bhugra, Dinesh

    2016-01-01

    Background: The association between depression and loss of bone mineral density (BMD) has been reported as controversial. Objective: The objectıve of the current study was to investigate whether an association exists between depression and low BMD during the menopausal and postmenopausal period. Materials and Methods: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the Primary Health Care Centers in Qatar. A multi-stage sampling design was used, and a representative sample of 1650 women aged 45–65 years were included during July 2012 and November 2013. This prospective study explored the association between bone density and major depressive disorder in women. Bone mineral densitometry measurements (BMD) (g/m2) were assessed at the BMD unit using a lunar prodigy DXA system (Lunar Corp., Madison, WI). Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory was administered for depression purposes. Results: Out of 1650 women 1182 women agreed to participate in the study (71.6%). The mean age and standard deviation (SD) of the menopausal age were 48.71 ± 2.96 with depressed and 50.20 ± 3.22 without depressed (P < 0.001). Furthermore, the mean and SD of postmenopausal age were 58.55 ± 3.27 with depression and 57.78 ± 3.20 without depression (P < 0.001). There were statistically significant differences between menopausal stages with regards to a number of parity, and place of living. There were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, Vitamin D deficiency, calcium deficiency and shisha smoking habits. Overall, osteopenia and osteoporosis and bone loss were significantly lower in postmenopausal women than in menopausal women (P < 0.001). Similarly, T-score and Z-score were lower with depression menopause and postmenopausal women (P < 0

  9. [Psychosocial effects of the onset of menopause and physical symptoms in early postmenopause].

    PubMed

    Baum, E

    1990-06-01

    57 women were studied who were GMP patients, whose spontaneous menopause had occurred 6 to 36 months ago and who did not take any sexual hormones. Purpose of the study was to determine psychosocial influences on the time of onset of the menopause and on climacteric complaints. It was found that the overall impairment by hot flushes and pain in the limbs during this phase of life was largely independent of the studied parameters. With regard to the time of onset of the menopause there was a trend to an linear relationship between the factor "social dependence" and the age at which menopause occurred, as well as a link between that age and period intervals 5 years before cessation of menstrual bleeding. An enhanced tendency to exhaustion representing a nonspecific menopause syndrome was found particularly often in women who were highly "socially dependent". There was no relationship between climacteric complaints on the one hand and, on the other hand, experiences of loss, social stress and relief factors, partnership relations, experiences of menarche, menstruation and menopause as well as basic feeling tone; however, a depressive tone, as defined by the Giessen test, was clearly predominant in the examined population. It is concluded from these results that flushes in the early postmenopausal phase are mostly a biological phenomenon, whereas vegetative concomitant complaints are markedly dependent on psychosocial factors that correspond to a typically "feminine" role enactment as postulated by social convention. PMID:2381999

  10. Exercise through Menopause.

    ERIC Educational Resources Information Center

    Stuhr, Robyn M.

    2002-01-01

    Menopause is associated with many different health effects and symptoms. This paper explains that regular exercise can play a critical role in protecting health and battling the increased risk of cardiovascular disease, osteoporosis, pelvic floor atrophy, and joint stiffness associated with menopause. Exercise programs for menopausal women should…

  11. The Effect of Melatonin on Climacteric Symptoms in Menopausal Women; A Double-Blind, Randomized Controlled, Clinical Trial

    PubMed Central

    PARANDAVAR, Nehleh; ABDALI, Khadijeh; KESHTGAR, Sara; EMAMGHOREISHI, Maasoumeh; AMOOEE, Seddegheh

    2014-01-01

    Abstract Background Menopause is one of the most critical periods of woman’s life. With reducing of ovarian estrogen; women are more prone to psychological and physical symptoms. The present study aimed to investigate the effect of melatonin on the climacteric symptoms. Methods The present double blind, placebo randomized controlled clinical trial was conducted on 240 menopausal women (40 - 60 years old) referring to the gynecology clinics of Shiraz University of Medical Sciences (January - November 2012). The participants were randomly divided into two groups through sortition. Demographic characteristics, Goldberg’s general health questionnaire (GHQ), Greene Climacteric Scale and level of Follicle Stimulating Hormone (FSH) were determined for both groups before the intervention. The intervention group received one 3mg melatonin tablet each night for 3 months and the control group received the placebo in the same period. Changes of climacteric symptoms and drug complications were measured 1, 2 and 3 months after the intervention Results We analyzed the data of 99 postmenopausal women in the intervention group and 101 postmenopausal women in the control group. In the melatonin group, the climacteric symptoms score decreased from 35.73+11.6 to 17.09+10.22 during the 3-month study period and regardless of time, a significant difference was observed between the two groups (P<0.001). In addition, a significant difference was found between the two groups regarding various dimensions of the climacteric symptoms over time (P<0.001). No significant difference was found regarding side effects between the two groups (P= 0.135). Conclusion The study findings showed that using melatonin improved the climacteric symptoms. PMID:26060703

  12. Menopause and Cancers.

    PubMed

    Einstein, Mark H; Levine, Nanci F; Nevadunsky, Nicole S

    2015-09-01

    Cancer is a disease of aging, and therefore is more prevalent after menopause. Menopausal symptoms resulting from cancer treatments are an important survivorship issue in cancer care. This article reviews the preventive strategies, utilization of health resources, and management of menopausal symptoms after cancer treatment. Preventive screening as informed by genetic and lifestyle risk, and lifestyle modification, may mitigate the risk of cancer and cancer mortality. Despite potential benefits to quality of life, hormone replacement is rarely prescribed to survivors of gynecologic malignancies. Special considerations are needed for the treatment and supportive care of menopausal symptoms in cancer survivors.

  13. Bazedoxifene and Conjugated Equine Estrogen: A Combination Product for the Management of Vasomotor Symptoms and Osteoporosis Prevention Associated with Menopause.

    PubMed

    Umland, Elena M; Karel, Lauren; Santoro, Nanette

    2016-05-01

    Bazedoxifene (BZA), a third-generation selective estrogen receptor modulator (SERM), has been combined with conjugated equine estrogen (CE) to create a tissue selective estrogen complex (TSEC) for the management of vasomotor symptoms (VMS) and the prevention of osteoporosis (OP) associated with menopause. Both of these outcomes of menopause contribute to significant negative effects on quality of life and increases in utilization of health care resources and dollars. Current treatment modalities for VMS and OP include estrogen therapy that requires the use of progestin in women who have a uterus to reduce the risk of endometrial hyperplasia and resultant cancer. However, progestin use results in nuisance bleeding as well as a further increased risk of breast cancer when combined with estrogen. And while SERMs can be used to prevent OP, their use alone has been shown to increase hot flashes. The combination of BZA and CE does not require progestin treatment with CE as the BZA component acts as an antagonist on endometrial tissue. The U.S. Food and Drug Administration approval of BZA/CE in 2013 was based on a series of five phase 3 studies known as the Selective estrogens, Menopause And Response to Therapy (SMART) trials. These trials, in their entirety, evaluated the impact of BZA/CE on VMS frequency and severity, bone mineral density, bone turnover markers, vaginal symptoms, lipid profiles, sleep, quality of life, breast density, and endometrial safety. The approved dose of BZA/CE is 20 mg BZA and 0.45 mg CE. Although this TSEC manages VMS while opposing breast and endometrial proliferation, preventing bone resorption, and improving lipid profiles, long-term experience with BZA/CE is currently lacking. PMID:27027527

  14. Cost-effectiveness of physical activity among women with menopause symptoms: findings from a randomised controlled trial.

    PubMed

    Kolu, Päivi; Raitanen, Jani; Nygård, Clas-Håkan; Tomás, Eija; Luoto, Riitta

    2015-01-01

    Menopause is a period that may predispose one to a decrease in muscle strength, cardiorespiratory fitness, and quality of life. A study was carried out to evaluate the cost-effectiveness of physical activity among women displaying symptoms of menopause. The cost-effectiveness analysis was based on data from a six-month randomised controlled trial (n = 151). The women in the intervention group engaged in an unsupervised session of at least 50 minutes of physical activity four times a week. The control group continued their physical activity as before. An incremental cost-effectiveness ratio (ICER) was calculated in terms of maximal oxygen consumption, lean muscle mass, and quality-adjusted life years (QALYs) gained. A bootstrap technique was utilised to estimate uncertainty around the point estimate for ICER associated with the intervention. The mean total cost in the intervention group was €1,307 (SEM: €311) and in the control group was €1,253 (SEM: €279, p = 0.10) per person. The mean intervention cost was €208 per person. After six months of the behaviour-change intervention, the ICER was €63 for a 1 ml/kg/min improvement in cardiorespiratory fitness, the additional cost per one-gram increase in lean muscle mass was €126, and the cost per QALY gained was €46. According to the findings, physical activity among menopausal women was cost-effective for cardiorespiratory fitness, for lean muscle mass, and for QALYs gained, since the intervention was more effective than the actions within the control group and the additional effects of physical activity were gained at a very low price. From the societal perspective, the intervention used may promote ability to work and thereby save on further costs associated with early retirement or disability pension if the physical-activity level remains at least the same as during the intervention. PMID:26258804

  15. Menopausal symptoms within a Hispanic cohort: SWAN, the Study of Women’s Health Across the Nation

    PubMed Central

    Green, R.; Polotsky, A. J.; Wildman, R. P.; McGinn, A. P.; Lin, J.; Derby, C.; Johnston, J.; Ram, K. T.; Crandall, C. J.; Thurston, R.; Gold, E.; Weiss, G.; Santoro, N.

    2012-01-01

    Introduction Since the designation of people as Hispanic involves the amalgamation of a number of different cultures and languages, we sought to test the hypothesis that menopausal symptoms would differ among Hispanic women, based upon country of origin and degree of acculturation. Methods A total of 419 women, aged 42–52 years at baseline, were categorized as: Central American (CA, n = 29) or South American (SA, n = 106), Puerto Rican (PR, n = 56), Dominican (D, n = 42), Cuban (Cu, n = 44) and non-Hispanic Caucasian (n = 142). We assessed vasomotor symptoms, vaginal dryness and trouble in sleeping. Hispanics and non-Hispanic Caucasians were compared using the χ2 test, t test or non-parametric alternatives; ANOVA or Kruskal–Wallis testing examined differences among the five Hispanic sub-groups. Multivariable regression models used PR women as the reference group. Results Hispanic women were overall less educated, less acculturated (p < 0.001 for both) than non-Hispanic Caucasians and more of them reported vasomotor symptoms (34.1–72.4% vs. 38.3% among non-Hispanic Caucasians; p = 0.0293) and vaginal dryness (17.9–58.6% vs. 21.1% among non-Hispanic Caucasians, p = 0.0287). Among Hispanics, more CA women reported vasomotor symptoms than D, Cu, SA, or PR women (72.4% vs. 45.2%, 34.1%, 50.9%, and 51.8%, respectively). More CA (58.6%) and D women (38.1%) reported vaginal dryness than PR (17.9%), Cu (25.0%) and SA (31.4%) women. More PR and D women reported trouble in sleeping (66.1 and 64.3%, respectively) compared to CA (51.7%), Cu (36.4%), and SA (45.3%) women. Conclusion Symptoms associated with menopause among Hispanic women differed by country of origin but not acculturation. Central American women appear to be at greatest risk for both vasomotor symptoms and vaginal dryness. PMID:20136411

  16. Soy consumption during menopause.

    PubMed

    Bolca, S; Bracke, M; Depypere, H

    2012-01-01

    In developed countries, the life expectancy of women is currently extending more than 30 years beyond the age of menopause. The menopausal transition is often associated with complaints. The conflicting results on the effectivity of phytoestrogens to alleviate menopausal symptoms. This discrepancy in treatment effect may be due to the large interindividual variation in isoflavone bioavailability in general and equol production in particular. Equol, a microbial metabolite of daidzein, has been hypothesized as a clue to the effectiveness of soy and its isoflavones, but only about 30-50% of the population harbor an intestinal microbial ecosystem supporting the conversion of daidzein into equol. There is much concern on breast cancer, since this incidence of this disease increases with age. There is indication that soy phytoestrogens may decrease this breast cancer incidence. In order to evaluate the estrogenic potential of these exposure levels, we studied the isoflavone-derived E2α- and E2β-equivalents (i.e. 17β-estradiol (E2)-equivalents towards ERα and ERβ, respectively) in human breast tissue. Total isoflavones showed a breast adipose/glandular tissue distribution of 40/60 and their derived E2β-equivalents exceeded on average 21 ± 4 and 40 ± 10 times the endogenous E2 concentrations in corresponding adipose and glandular biopsies, respectively, whereas the E2α/E2 ratios were 0.4 ± 0.1 and 0.8 ± 0.2 in adipose and glandular breast tissue, respectively. These calculations suggest that, at least in this case, soy consumption could elicit partial ERβ agonistic effects in human breast tissue. We are currently characterizing the differential activation of estrogen-responsive genes between dietary isoflavones, the chemopreventive selective ER modulators tamoxifen and raloxifene and exogenous estrogens in a controlled dietary intervention trial that integrates data on the exposure to estrogenically active compounds, expression of isoflavone

  17. Short-Term Isoflavone Intervention in the Treatment of Severe Vasomotor Symptoms after Surgical Menopause: A Case Report and Literature Review

    PubMed Central

    Teekachunhatean, Supanimit; Mattawanon, Natnita; Khunamornpong, Surapan

    2015-01-01

    Isoflavones are soy phytoestrogens that potentially exert various favorable effects in postmenopausal women, for example, alleviating vasomotor episodes, attenuating bone loss, and stimulating vaginal epithelial maturation. There has, however, been lack of consensus regarding those therapeutic effects. Most clinical studies of isoflavones have been conducted with women who had undergone natural menopause, but not those who had undergone surgical menopause. This study reports on a 51-year-old woman who presented with severe vasomotor episodes after undergoing a hysterectomy and a bilateral oophorectomy due to hypermenorrhea secondary to myoma uteri. She refused hormone therapy due to fear of adverse drug reactions so was treated with oral soy isoflavones (two capsules twice daily, equivalent to at least 100 mg daily dose) for 8 weeks. The number and severity of hot flushes and her menopause-specific quality of life dramatically improved from baseline values. The serum bone resorption marker (beta C-telopeptide) decreased markedly, while vaginal epithelial maturation improved slightly, suggesting the potential of isoflavones in attenuating bone loss and stimulating vaginal maturation. The intervention did not adversely affect the hormonal profile (FSH, LH, and estradiol) and liver or renal functions. Thus, isoflavones could be an option for women experiencing severe vasomotor episodes after surgical menopause. PMID:26605099

  18. Does lavender aromatherapy alleviate premenstrual emotional symptoms?: a randomized crossover trial

    PubMed Central

    2013-01-01

    modality could alleviate premenstrual emotional symptoms, which, at least in part, is attributable to the improvement of parasympathetic nervous system activity. This study further implies that HRV could evaluate the efficacy of aromatherapy using various fragrances to relieve premenstrual symptoms, and ultimately, support the mind and body health of women. PMID:23724853

  19. Swimming exercise alleviates the symptoms of attention-deficit hyperactivity disorder in spontaneous hypertensive rats.

    PubMed

    Ko, Il-Gyu; Kim, Sung-Eun; Kim, Tae-Woon; Ji, Eun-Sang; Shin, Mal-Soon; Kim, Chang-Ju; Hong, Min-Ha; Bahn, Geon Ho

    2013-08-01

    Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, hyperactivity and impulsivity. In the present study, we investigated the effects of swimming exercise on the symptoms of ADHD in correlation with the expression levels of dopamine and the dopamine D2 receptor. Adult male spontaneous hypertensive rats (SHRs) were used as animal models of ADHD and Wistar-Kyoto rats were used as controls. The activity, impulsivity and levels of non-aggressive and aggressive behaviors in rats were measured. The short-term memory in the animal models of ADHD was assessed using an open-field test. The social interaction test, elevated plus maze test and step-through avoidance test were additionally performed. The expression levels of tyrosine hydroxylase (TH), which catalyzes the rate‑limiting step of dopamine synthesis, and the dopamine D2 receptor in the prefrontal cortex, substantia nigra and striatum were evaluated. The expression levels of TH and the dopamine D2 receptor were detected using immunohistochemistry and western blotting, respectively. In ADHD rats, the activity, impulsivity and levels of non-aggressive and aggressive behaviors were higher than that in control rats. By contrast, short-term memory in ADHD rats deteriorated. Swimming exercise suppressed hyperactivity, impulsivity and non-aggressive and aggressive behaviors, and alleviated the short-term memory impairment observed in ADHD rats. The expression levels of TH and the dopamine D2 receptor were decreased and increased in ADHD rats, respectively, when compared with control rats. Swimming exercise enhanced the expression of TH and suppressed the expression of the dopamine D2 receptor in ADHD rats. In the present study, swimming exercise improved the symptoms of ADHD by upregulating the expression of dopamine and downregulating the expression of the dopamine D2 receptor. PMID:23779147

  20. Swimming exercise alleviates the symptoms of attention-deficit hyperactivity disorder in spontaneous hypertensive rats.

    PubMed

    Ko, Il-Gyu; Kim, Sung-Eun; Kim, Tae-Woon; Ji, Eun-Sang; Shin, Mal-Soon; Kim, Chang-Ju; Hong, Min-Ha; Bahn, Geon Ho

    2013-08-01

    Attention-deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, hyperactivity and impulsivity. In the present study, we investigated the effects of swimming exercise on the symptoms of ADHD in correlation with the expression levels of dopamine and the dopamine D2 receptor. Adult male spontaneous hypertensive rats (SHRs) were used as animal models of ADHD and Wistar-Kyoto rats were used as controls. The activity, impulsivity and levels of non-aggressive and aggressive behaviors in rats were measured. The short-term memory in the animal models of ADHD was assessed using an open-field test. The social interaction test, elevated plus maze test and step-through avoidance test were additionally performed. The expression levels of tyrosine hydroxylase (TH), which catalyzes the rate‑limiting step of dopamine synthesis, and the dopamine D2 receptor in the prefrontal cortex, substantia nigra and striatum were evaluated. The expression levels of TH and the dopamine D2 receptor were detected using immunohistochemistry and western blotting, respectively. In ADHD rats, the activity, impulsivity and levels of non-aggressive and aggressive behaviors were higher than that in control rats. By contrast, short-term memory in ADHD rats deteriorated. Swimming exercise suppressed hyperactivity, impulsivity and non-aggressive and aggressive behaviors, and alleviated the short-term memory impairment observed in ADHD rats. The expression levels of TH and the dopamine D2 receptor were decreased and increased in ADHD rats, respectively, when compared with control rats. Swimming exercise enhanced the expression of TH and suppressed the expression of the dopamine D2 receptor in ADHD rats. In the present study, swimming exercise improved the symptoms of ADHD by upregulating the expression of dopamine and downregulating the expression of the dopamine D2 receptor.

  1. Menopause Treatments | NIH MedlinePlus the Magazine

    MedlinePlus

    ... of this page please turn Javascript on. Feature: Menopause: A Woman's Change of Life Menopause Treatments Past Issues / Spring 2013 Table of Contents ... you should use hormones to help relieve some menopause symptoms. It's hard to know what to do, ...

  2. Management of cardiovascular risk in the peri-menopausal woman: a consensus statement of European cardiologists and gynaecologists.

    PubMed

    Collins, Peter; Rosano, Guiseppe; Casey, Catherine; Daly, Caroline; Gambacciani, Marco; Hadji, Peyman; Kaaja, Risto; Mikkola, Tomi; Palacios, Santiago; Preston, Richard; Simon, Tabassome; Stevenson, John; Stramba-Badiale, Marco

    2007-08-01

    Cardiovascular risk is poorly managed in women, especially during the menopausal transition when susceptibility to cardiovascular events increases. Clear gender differences exist in the epidemiology, symptoms, diagnosis, progression, prognosis, and management of cardiovascular risk. Key risk factors that need to be controlled in the peri-menopausal woman are hypertension, dyslipidaemia, obesity, and other components of the metabolic syndrome, with the avoidance and careful control of diabetes. Hypertension is a particularly powerful risk factor and lowering of blood pressure is pivotal. Hormone replacement therapy is acknowledged as the gold standard for the alleviation of the distressing vasomotor symptoms of the menopause, but the findings of the Women's Health Initiative (WHI) study generated concern for the detrimental effect on cardiovascular events. Thus, hormone replacement therapy cannot be recommended for the prevention of cardiovascular disease. Whether the findings of WHI in older post-menopausal women can be applied to younger peri-menopausal women is unknown. It is increasingly recognized that hormone therapy is inappropriate for older post-menopausal women no longer displaying menopausal symptoms. Both gynaecologists and cardiovascular physicians have an important role to play in identifying peri-menopausal women at risk of cardiovascular morbidity and mortality and should work as a team to identify and manage risk factors such as hypertension.

  3. Menopause, a Self Care Manual.

    ERIC Educational Resources Information Center

    Lopez, Maria Cristina; And Others

    Written for women from the three main cultural groups in New Mexico (Native American, Hispanic, and Anglo), this pamphlet discusses the causes and symptoms, some remedies for the symptoms of menopause, and presents ideas for organizing support groups to help middle-aged women and their families deal with menopausal problems. Explanations of the…

  4. Evaluation of estrogenic activity of licorice species in comparison with hops used in botanicals for menopausal symptoms.

    PubMed

    Hajirahimkhan, Atieh; Simmler, Charlotte; Yuan, Yang; Anderson, Jeffrey R; Chen, Shao-Nong; Nikolić, Dejan; Dietz, Birgit M; Pauli, Guido F; van Breemen, Richard B; Bolton, Judy L

    2013-01-01

    The increased cancer risk associated with hormone therapies has encouraged many women to seek non-hormonal alternatives including botanical supplements such as hops (Humulus lupulus) and licorice (Glycyrrhiza spec.) to manage menopausal symptoms. Previous studies have shown estrogenic properties for hops, likely due to the presence of 8-prenylnarigenin, and chemopreventive effects mainly attributed to xanthohumol. Similarly, a combination of estrogenic and chemopreventive properties has been reported for various Glycyrrhiza species. The major goal of the current study was to evaluate the potential estrogenic effects of three licorice species (Glycyrrhiza glabra, G. uralensis, and G. inflata) in comparison with hops. Extracts of Glycyrrhiza species and spent hops induced estrogen responsive alkaline phosphatase activity in endometrial cancer cells, estrogen responsive element (ERE)-luciferase in MCF-7 cells, and Tff1 mRNA in T47D cells. The estrogenic activity decreased in the order H. lupulus > G. uralensis > G. inflata > G. glabra. Liquiritigenin was found to be the principle phytoestrogen of the licorice extracts; however, it exhibited lower estrogenic effects compared to 8-prenylnaringenin in functional assays. Isoliquiritigenin, the precursor chalcone of liquiritigenin, demonstrated significant estrogenic activities while xanthohumol, a metabolic precursor of 8-prenylnaringenin, was not estrogenic. Liquiritigenin showed ERβ selectivity in competitive binding assay and isoliquiritigenin was equipotent for ER subtypes. The estrogenic activity of isoliquiritigenin could be the result of its cyclization to liquiritigenin under physiological conditions. 8-Prenylnaringenin had nanomolar estrogenic potency without ER selectivity while xanthohumol did not bind ERs. These data demonstrated that Glycyrrhiza species with different contents of liquiritigenin have various levels of estrogenic activities, suggesting the importance of precise labeling of botanical

  5. Evaluation of estrogenic activity of licorice species in comparison with hops used in botanicals for menopausal symptoms.

    PubMed

    Hajirahimkhan, Atieh; Simmler, Charlotte; Yuan, Yang; Anderson, Jeffrey R; Chen, Shao-Nong; Nikolić, Dejan; Dietz, Birgit M; Pauli, Guido F; van Breemen, Richard B; Bolton, Judy L

    2013-01-01

    The increased cancer risk associated with hormone therapies has encouraged many women to seek non-hormonal alternatives including botanical supplements such as hops (Humulus lupulus) and licorice (Glycyrrhiza spec.) to manage menopausal symptoms. Previous studies have shown estrogenic properties for hops, likely due to the presence of 8-prenylnarigenin, and chemopreventive effects mainly attributed to xanthohumol. Similarly, a combination of estrogenic and chemopreventive properties has been reported for various Glycyrrhiza species. The major goal of the current study was to evaluate the potential estrogenic effects of three licorice species (Glycyrrhiza glabra, G. uralensis, and G. inflata) in comparison with hops. Extracts of Glycyrrhiza species and spent hops induced estrogen responsive alkaline phosphatase activity in endometrial cancer cells, estrogen responsive element (ERE)-luciferase in MCF-7 cells, and Tff1 mRNA in T47D cells. The estrogenic activity decreased in the order H. lupulus > G. uralensis > G. inflata > G. glabra. Liquiritigenin was found to be the principle phytoestrogen of the licorice extracts; however, it exhibited lower estrogenic effects compared to 8-prenylnaringenin in functional assays. Isoliquiritigenin, the precursor chalcone of liquiritigenin, demonstrated significant estrogenic activities while xanthohumol, a metabolic precursor of 8-prenylnaringenin, was not estrogenic. Liquiritigenin showed ERβ selectivity in competitive binding assay and isoliquiritigenin was equipotent for ER subtypes. The estrogenic activity of isoliquiritigenin could be the result of its cyclization to liquiritigenin under physiological conditions. 8-Prenylnaringenin had nanomolar estrogenic potency without ER selectivity while xanthohumol did not bind ERs. These data demonstrated that Glycyrrhiza species with different contents of liquiritigenin have various levels of estrogenic activities, suggesting the importance of precise labeling of botanical

  6. Early Menopause (Premature Menopause)

    MedlinePlus

    ... has been called “premature menopause” or “premature ovarian failure.” But a better term is “primary ovarian insufficiency,” ... and what procedures might cause it. Premature Ovarian Failure: Premature Menopause (Copyright © American Pregnancy Association) - This article ...

  7. Combined estrogenic and anti-estrogenic properties of estetrol on breast cancer may provide a safe therapeutic window for the treatment of menopausal symptoms.

    PubMed

    Gérard, Céline; Mestdagt, Mélanie; Tskitishvili, Ekaterine; Communal, Laudine; Gompel, Anne; Silva, Elisabete; Arnal, Jean-François; Lenfant, Françoise; Noel, Agnès; Foidart, Jean-Michel; Péqueux, Christel

    2015-07-10

    Increased risk of breast cancer is a critical side effect associated with the use of a menopausal hormone therapy (MHT). Estetrol (E4) is a natural estrogen produced by the human fetal liver and is a promising compound for clinical use in MHT. However, its impact on breast cancer is controversial and poorly defined. In this preclinical study, we show that E4 acts as a weak estrogen by stimulating the growth of hormone-dependent breast cancer only at concentrations exceeding menopausal therapeutic needs. E4 presents also an antitumor activity by decreasing the strong proliferative effect of estradiol (E2). While estrogen receptor alpha (ERα) is the predominant receptor mediating its effects, the dual weak-estrogenic/anti-estrogenic feature of E4 results from differential signaling pathways activation. Both nuclear and rapid extra-nuclear signaling pathway are necessary for a complete estrogenic effect of E4. However, the antitumor action of E4 is not due to a capacity to antagonize E2-induced nuclear activity. Altogether, our results highlight that E4 has a limited impact on breast cancer and may offer a safe therapeutic window for the treatment of menopausal symptoms. PMID:26056044

  8. Combined estrogenic and anti-estrogenic properties of estetrol on breast cancer may provide a safe therapeutic window for the treatment of menopausal symptoms

    PubMed Central

    Gérard, Céline; Mestdagt, Mélanie; Tskitishvili, Ekaterine; Communal, Laudine; Gompel, Anne; Silva, Elisabete; Arnal, Jean-François; Lenfant, Françoise; Noel, Agnès; Foidart, Jean-Michel; Péqueux, Christel

    2015-01-01

    Increased risk of breast cancer is a critical side effect associated with the use of a menopausal hormone therapy (MHT). Estetrol (E4) is a natural estrogen produced by the human fetal liver and is a promising compound for clinical use in MHT. However, its impact on breast cancer is controversial and poorly defined. In this preclinical study, we show that E4 acts as a weak estrogen by stimulating the growth of hormone-dependent breast cancer only at concentrations exceeding menopausal therapeutic needs. E4 presents also an antitumor activity by decreasing the strong proliferative effect of estradiol (E2). While estrogen receptor alpha (ERα) is the predominant receptor mediating its effects, the dual weak-estrogenic/anti-estrogenic feature of E4 results from differential signaling pathways activation. Both nuclear and rapid extra-nuclear signaling pathway are necessary for a complete estrogenic effect of E4. However, the antitumor action of E4 is not due to a capacity to antagonize E2-induced nuclear activity. Altogether, our results highlight that E4 has a limited impact on breast cancer and may offer a safe therapeutic window for the treatment of menopausal symptoms. PMID:26056044

  9. Impact of Hypnosis Intervention in Alleviating Psychological and Physical Symptoms During Pregnancy.

    PubMed

    Beevi, Zuhrah; Low, Wah Yun; Hassan, Jamiyah

    2016-04-01

    Physical symptoms (e.g., vomiting) and psychological symptoms (stress, anxiety, and depression) during pregnancy are common. Various strategies such as hypnosis are available to reduce these symptoms. The objective of the authors in this study is to investigate the impact of a hypnosis intervention in reducing physical and psychological symptoms during pregnancy. A pre-test/post-test quasi-experimental design was employed in this study. The hypnosis intervention was given to the experimental group participants at weeks 16 (baseline), 20 (time point 1), 28 (time point 2), and 36 (time point 3) of their pregnancy. Participants in the control group received only the traditional antenatal care. Participants from both groups completed the Depression Anxiety Stress Scale-21 (DASS-21) and a Pregnancy Symptoms Checklist at weeks 16, 20, 28 and 36 of pregnancy. Results indicated that stress and anxiety symptoms were significantly reduced for the experimental group, but not for the control group. Although mean differences for the depressive symptoms were not significant, the experimental group had lower symptoms at time point 3. The physical symptoms' results showed significant group differences at time point 3, indicating a reduction in the experience of physical symptoms for the experimental group participants. Our study showed that hypnosis intervention during pregnancy aided in reducing physical and psychological symptoms during pregnancy. PMID:27003486

  10. The application of soy isoflavones for subjective symptoms and objective signs of vaginal atrophy in menopause: A systematic review of randomised controlled trials.

    PubMed

    Ghazanfarpour, M; Sadeghi, R; Roudsari, R Latifnejad

    2016-01-01

    Vaginal atrophy is a common complaint among many women in their menopause, presenting with a cluster of symptoms including dryness, itching, burning/soreness, discharge, irritation and painful intercourse. We searched for existing pertinent data in three chief registries. Specified time brackets included 1996-2013 for Medline, 1990-2013 for Scopus and 2013 for Cochrane Central Register of Controlled Trials (issue 1). Of 110 potentially relevant publications, 17 and 9 trials (7 on maturation value and 2 on vaginal dryness) were selected for qualitative and quantitative analysis, respectively. In general, soy isoflavones seem to improve vaginal symptoms as opposed to control arms. Soy isoflavones were also shown to be more efficacious in quantitative analysis, though this was statistically non-significant. Standardised difference in means of maturation value change was 0.072 (95% confidence interval [CI]: - 0.42 to 0.57), p = 0.777; heterogeneity P = 0.00; I(2) = 85.15%. Difference in means of vaginal dryness was - 0.204 (95% CI: - 0.28 to - 0.126), p < 0.001; heterogeneity P = 0.423; I(2) = 0.00. Soy isoflavones may relieve vaginal symptoms during menopause; nevertheless beneficial effects still remain uncertain due to possible publication bias or vast heterogeneity of the selected studies. Further studies with consistency in design as well as statistics are warranted.

  11. Equol status and changes in fecal microbiota in menopausal women receiving long-term treatment for menopause symptoms with a soy-isoflavone concentrate.

    PubMed

    Guadamuro, Lucía; Delgado, Susana; Redruello, Begoña; Flórez, Ana B; Suárez, Adolfo; Martínez-Camblor, Pablo; Mayo, Baltasar

    2015-01-01

    The knowledge regarding the intestinal microbial types involved in isoflavone bioavailability and metabolism is still limited. The present work reports the influence of a treatment with isoflavones for 6 months on the fecal bacterial communities of 16 menopausal women, as determined by culturing and culture-independent microbial techniques. Changes in fecal communities were analyzed with respect to the women's equol-producing phenotype. Compared to baseline, at 1 and 3 months the counts for all microbial populations in the feces of equol-producing women had increased strongly. In contrast, among the non-producers, the counts for all microbial populations at 1 month were similar to those at baseline, and decreased significantly by 3 and 6 months. Following isoflavone intake, major bands in the denaturing gradient gel electrophoresis (DGGE) profiles appeared and disappeared, suggesting important changes in majority populations. In some women, increases were seen in the intensity of specific DGGE bands corresponding to microorganisms known to be involved in the metabolism of dietary phytoestrogens (Lactonifactor longoviformis, Faecalibacterium prausnitzii, Bifidobacterium sp., Ruminococcus sp.). Real-Time quantitative PCR revealed that the Clostridium leptum and C. coccoides populations increased in equol producers, while those of bifidobacteria and enterobacteria decreased, and vice versa in the non-producers. Finally, the Atopobium population increased in both groups, but especially in the non-producers at three months. As the main findings of this study, (i) variations in the microbial communities over the 6-month period of isoflavone supplementation were large; (ii) no changes in the fecal microbial populations that were convincingly treatment-specific were seen; and (iii) the production of equol did not appear to be associated with the presence of, or increase in the population of, any of the majority bacterial types analyzed.

  12. Equol status and changes in fecal microbiota in menopausal women receiving long-term treatment for menopause symptoms with a soy-isoflavone concentrate

    PubMed Central

    Guadamuro, Lucía; Delgado, Susana; Redruello, Begoña; Flórez, Ana B.; Suárez, Adolfo; Martínez-Camblor, Pablo; Mayo, Baltasar

    2015-01-01

    The knowledge regarding the intestinal microbial types involved in isoflavone bioavailability and metabolism is still limited. The present work reports the influence of a treatment with isoflavones for 6 months on the fecal bacterial communities of 16 menopausal women, as determined by culturing and culture-independent microbial techniques. Changes in fecal communities were analyzed with respect to the women’s equol-producing phenotype. Compared to baseline, at 1 and 3 months the counts for all microbial populations in the feces of equol-producing women had increased strongly. In contrast, among the non-producers, the counts for all microbial populations at 1 month were similar to those at baseline, and decreased significantly by 3 and 6 months. Following isoflavone intake, major bands in the denaturing gradient gel electrophoresis (DGGE) profiles appeared and disappeared, suggesting important changes in majority populations. In some women, increases were seen in the intensity of specific DGGE bands corresponding to microorganisms known to be involved in the metabolism of dietary phytoestrogens (Lactonifactor longoviformis, Faecalibacterium prausnitzii, Bifidobacterium sp., Ruminococcus sp.). Real-Time quantitative PCR revealed that the Clostridium leptum and C. coccoides populations increased in equol producers, while those of bifidobacteria and enterobacteria decreased, and vice versa in the non-producers. Finally, the Atopobium population increased in both groups, but especially in the non-producers at three months. As the main findings of this study, (i) variations in the microbial communities over the 6-month period of isoflavone supplementation were large; (ii) no changes in the fecal microbial populations that were convincingly treatment-specific were seen; and (iii) the production of equol did not appear to be associated with the presence of, or increase in the population of, any of the majority bacterial types analyzed. PMID:26300856

  13. Yoga and menopausal transition.

    PubMed

    Vaze, Nirmala; Joshi, Sulabha

    2010-07-01

    With increased life expectancy, today, women spend one-third of their life after menopause. Thus more attention is needed towards peri- and post-menopausal symptoms. Estrogen replacement therapy is the most effective treatment, however, it has its own limitations. The present need is to explore new options for the management of menopausal symptoms. Yogic life style is a way of living which aims to improve the body, mind and day to day life of individuals. The most commonly performed Yoga practices are postures (asana), controlled breathing (pranayama), and meditation (dhyana). Yoga has been utilized as a therapeutic tool to achieve positive health and control and cure diseases. The exact mechanism as to how Yoga helps in various disease states is not known. There could be neuro-hormonal pathways with a selective effect in each pathological situation. There have been multiple studies that have combined the many aspects of Yoga into a general Yoga session in order to investigate its effects on menopausal symptoms. Integrated approach of Yoga therapy can improve hot flushes and night sweats. There is increasing evidence suggesting that even the short-term practice of Yoga can decrease both psychological and physiological risk factors for cardiovascular disease (CVD). Studies conclude that our age old therapy, Yoga, is fairly effective in managing menopausal symptoms.

  14. Design and Methods of a Multi-Site, Multi-Behavioral Treatment Trial for Menopausal Symptoms: The MsFLASH Experience

    PubMed Central

    Sternfeld, Barbara; LaCroix, Andrea; Caan, Bette J.; Dunn, Andrea L.; Newton, Katherine M.; Reed, Susan D.; Guthrie, Katherine A; Booth-LaForce, Cathryn; Sherman, Karen J; Cohen, Lee; Freeman, Marlene P.; Carpenter, Janet S.; Hunt, Julie R.; Roberts, Melanie; Ensrud, Kristine E.

    2013-01-01

    Background Behavioral strategies are recommended for menopausal symptoms, but little evidence exists regarding efficacy. Purpose Describe design and methodology of a randomized controlled 3 by 2 factorial trial of yoga, exercise and omega-3 fatty acids. Methods Women from three geographic areas with a weekly average of ≥14 hot flashes/night sweats, who met exclusion/inclusion criteria, were randomized to 12 weeks of: 1) yoga classes and daily home practice; 2) supervised, facility-based aerobic exercise training; or 3) usual activity. Women in each arm were further randomized to either omega-3 supplement or placebo. Standardized training, on-going monitoring, and site visits were adopted to ensure consistency across sites and fidelity to the intervention. Participant adherence to the intervention protocol was monitored continuously, and retention was actively encouraged by staff. Information on adverse events was systematically collected. Results Of 7,377 women who responded to mass mailings, 355 (4.8%) were randomized; mean age was 54.7 (sd=3.7), 26.2% were African American, 81.7% were post-menopausal, and mean baseline frequency of daily hot flashes/night sweats was 7.6 (sd=3.8). Adherence of ≥ 80% was 59% for yoga, 77% for exercise training, and 80% for study pills. Final week 12 data were collected from 95.2% Conclusions Conducting a multi-site, multi-behavioral randomized trial for menopausal symptoms is challenging but feasible. Benefits included cost-effective study design, centralized recruitment, and methodologic standardization. PMID:23462342

  15. Verbal memory and menopause.

    PubMed

    Maki, Pauline M

    2015-11-01

    Midlife women frequently report memory problems during the menopausal transition. Recent studies validate those complaints by showing significant correlations between memory complaints and performance on validated memory tasks. Longitudinal studies demonstrate modest declines in verbal memory during the menopausal transition and a likely rebound during the postmenopausal stage. Clinical studies that examine changes in memory following hormonal withdrawal and add-back hormone therapy (HT) demonstrate that estradiol plays a critical role in memory. Although memory changes are frequently attributed to menopausal symptoms, studies show that the memory problems occur during the transition even after controlling for menopausal symptoms. It is well established that self-reported vasomotor symptoms (VMS) are unrelated to objective memory performance. However, emerging evidence suggests that objectively measured VMS significantly correlate with memory performance, brain activity during rest, and white matter hyperintensities. This evidence raises important questions about whether VMS and VMS treatments might affect memory during the menopausal transition. Unfortunately, there are no clinical trials to inform our understanding of how HT affects both memory and objectively measured VMS in women in whom HT is indicated for treatment of moderate to severe VMS. In clinical practice, it is helpful to normalize memory complaints, to note that evidence suggests that memory problems are temporary, and to counsel women with significant VMS that memory might improve with treatment.

  16. Migraine and the menopausal transition.

    PubMed

    Martin, Vincent T

    2014-05-01

    The menopausal transition or "perimenopause" represents a time period of turbulent changes in ovarian hormones as middle-aged women progress into menopause. The purpose of this article is to review the literature to determine the effect of the menopausal transition on migraine headaches and to develop a rational treatment approach to these patients. The menopausal transition is divided into early and stages based upon patterns of menstruation and specific reproductive hormones. Studies would suggest that the prevalence of migraine and other climacteric symptoms tend to peak during the late menopausal transition particularly in those with a past history of premenstrual stress disorder. Treatment approaches vary by stage of the menopausal transition and include conventional daily preventatives, mini-prophylaxis and hormonal therapies.

  17. Premature Menopause

    PubMed Central

    Okeke, TC; Anyaehie, UB; Ezenyeaku, CC

    2013-01-01

    Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk. PMID:23634337

  18. [Does Prefrontal Noninvasive Brain Stimulation Alleviating Symptoms in Depression and Schizophrenia Impact Mood and Emotion Processing?].

    PubMed

    Psomiades, Marion; Fonteneau, Clara; Suaud-Chagny, Marie-Françoise; Haesebaert, Frédéric; Brunelin, Jérôme

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive brain stimulation techniques currently used as therapeutic tools in various psychiatric conditions. Applied over the dorsolateral prefrontal cortex (DLPFC), they showed their efficacy in reducing drug-resistant symptoms in patients with major depression and in patients with schizophrenia with predominantly negative symptoms. The DLPFC is a brain structure involved in the expression of these symptoms as well as in other dysfunctional functions observed in theses conditions such as emotional processes. The goal of this review is to establish whether or not a link exists between clinical improvements and modulation of emotional processes following the stimulation of the DLPFC in both conditions. The data collected show that improved emotional processes is not linked to a clinical improvement neither in patients with depression nor in patients with negative schizophrenia. Our results suggests that although sharing common brain structures, the brain networks involved in both symptoms and in emotional processes would be separate. PMID:27570958

  19. Social and Cultural Factors Affecting Complementary and Alternative Medicine (CAM) Use during Menopause in Sydney and Bologna

    PubMed Central

    van der Sluijs, Corinne; Lombardo, Flavia L.; Lesi, Grazia; Bensoussan, Alan; Cardini, Francesco

    2013-01-01

    Background. Previous surveys found CAM use during menopause to be popular. This paper compares the results from two surveys (Sydney and Bologna) to examine factors that determine the extent and pattern of CAM use to alleviate menopausal symptoms. Methods. Women, aged 45–65 years, who were symptomatic when transitioning through menopause or asymptomatic but taking menopause-specific treatments, were recruited in Sydney (n=1,296) and Bologna (n=1,106) to complete the same voluntary, anonymous, and self-administered questionnaire. The results were reanalysed using stratified analyses to determine similarities and differences. Results. Demographics of the two cohorts differed significantly. CAM was more popular in Sydney. The most significant determinants of CAM use were the use of CAM for other conditions besides menopause and the severity of vasomotor symptoms. Occupational status was a determinant of CAM use amongst Bologna respondents only. In order to relieve symptoms, Australian and Italian women used different CAM modalities whose effectiveness was generally perceived as good. Conclusion. CAM use is popular amongst menopausal women from Sydney and Bologna. Differences in the patterns of CAM use seem to depend on CAM availability and on the educational level and professional status of users. The complex interaction between market, social, and cultural factors of CAM use seems to be more influential on women's choice of CAM than the available evidence of their effectiveness. PMID:24459531

  20. Relations between fertility, body shape and menopause in Austrian women.

    PubMed

    Kirchengast, S

    1992-10-01

    The influence of number and date of pregnancies, births, and spontaneous and induced abortions on body shape, age at menopause and menopausal symptoms have been studied for 110 postmenopausal Viennese women. A significant correlation between fertility and age at menopause was not found, but several menopausal symptoms showed statistically significant correlations with fertility. With a higher number of pregnancies the individual symptoms became more severe.

  1. Efficacy and Safety of Remifemin on Peri-Menopausal Symptoms Induced by Post-Operative GnRH-a Therapy for Endometriosis: A Randomized Study versus Tibolone

    PubMed Central

    Chen, Jiming; Gao, Hongyan; Li, Qin; Cong, Jing; Wu, Jie; Pu, Dahua; Jiang, Guohua

    2014-01-01

    Background The aim of this study was to investigate clinical efficacy and safety of Remifemin on peri-menopausal symptoms in endometriosis patients with a post-operative GnRH-a therapy. Material/Methods We treated 116 women who had endometriosis with either Remifemin (n=56) 20 mg bid po or Tibolone (n=60) 2.5 mg qd po for 12 weeks after GnRH-a injection. The efficacy was evaluated by Kupperman menopausal index (KMI), and hot flash/sweating scores. The safety parameters such as liver and renal functions, lipid profile, endometrial thickness, and serum sex hormone level, as well as the incidence of adverse events were recorded. Results (1) After GnRH-a therapy, KMI and hot flash/sweating scores in both groups increased significantly (P<0.05) but we found no significant difference for KMI (2.87±1.40 for Remifemin and 2.70±1.26 for Tibolone) and hot flash/sweating scores (0.94±1.72 for Remifemin and 1.06±1.78 for Tibolone) between the 2 groups (P>0.05). (2) No statistical change was observed in liver or renal functions and lipid profile in both groups before and after the treatment (P>0.05). The post-therapeutic serum FSH, LH, and E2 level and endometrial thickness decreased remarkably in both groups (P<0.05). E2 level in the Remifemin group was obviously lower than that in the Tibolone group (P<0.05), and FSH and LH levels were strongly higher (P<0.05). No significant difference in thickness were found in either group (P>0.05). The Remifemin group had far fewer adverse events than the Tibolone group (P<0. 05). Conclusions Compared with Tibolone, Remifemin had a similar clinical efficacy and was safer for the peri-menopausal symptoms induced by GnRH-a in endometriosis patients. PMID:25321621

  2. Genitourinary syndrome of menopause and the use of laser therapy.

    PubMed

    Hutchinson-Colas, Juana; Segal, Saya

    2015-12-01

    Genitourinary syndrome of menopause is a common condition that left untreated can progress and negatively affect quality of life and sexual function. Laser therapy has a therapeutic role for several gynecologic conditions and most recently has gained interest as a non-hormonal treatment for genitourinary syndrome of menopause (GSM). The laser is well tolerated and may increase thickness of the squamous epithelium and improve vascularity of the vagina. These morphological changes presumably alleviate symptoms of dryness, dyspareunia, and irritation. However, the duration of therapeutic effects and safety of repeated applications at this point is not clear. Further research is needed in the form of controlled studies of the laser and other non-hormonal GSM therapies. The objective of this paper is to review the existing literature describing laser therapy for GSM.

  3. Electroacupuncture Alleviates Depressive-Like Symptoms and Modulates BDNF Signaling in 6-Hydroxydopamine Rats

    PubMed Central

    Sun, Min; Wang, Ke; Yu, Yan; Su, Wen-Ting; Jiang, Xin-Xin

    2016-01-01

    Previous studies have identified the beneficial effects of electroacupuncture (EA) on motor behaviors in Parkinson's disease (PD). However, the role and potential mechanisms of EA in PD-associated depression remain unclear. In the present study, a rat model of PD with unilateral 6-hydroxydopamine (6-OHDA) lesions in the medial forebrain bundle was treated using EA for 4 weeks. We found that 100 Hz EA improved several motor phenotypes. In addition, tyrosine hydroxylase (TH) immunohistochemical analysis showed that EA had a minimal impact on the TH-positive profiles of the ipsilateral ventral tegmental area. Compared with the 6-OHDA group, long-term EA stimulation significantly increased sucrose solution consumption and decreased immobility time in the forced swim test. EA treatment did not alter dopamine, norepinephrine, and serotonin levels in the striatum and hippocampus. Noticeably, EA treatment reversed the 6-OHDA-induced abnormal expression of brain-derived neurotrophic factor (BDNF) and tropomyosin-related kinase B (TrkB) in the midbrain and hippocampus. These results demonstrate that EA at 100-Hz possesses the ability to improve depressive-like symptoms in PD rats, which is, at least in part, due to the distinct effect of EA on the mesostriatal and mesocorticolimbic dopaminergic pathways. Moreover, BDNF seems to participate in the effect of EA in PD. PMID:27525025

  4. Electroacupuncture Alleviates Depressive-Like Symptoms and Modulates BDNF Signaling in 6-Hydroxydopamine Rats.

    PubMed

    Sun, Min; Wang, Ke; Yu, Yan; Su, Wen-Ting; Jiang, Xin-Xin; Yang, Jian; Jia, Jun; Wang, Xiao-Min

    2016-01-01

    Previous studies have identified the beneficial effects of electroacupuncture (EA) on motor behaviors in Parkinson's disease (PD). However, the role and potential mechanisms of EA in PD-associated depression remain unclear. In the present study, a rat model of PD with unilateral 6-hydroxydopamine (6-OHDA) lesions in the medial forebrain bundle was treated using EA for 4 weeks. We found that 100 Hz EA improved several motor phenotypes. In addition, tyrosine hydroxylase (TH) immunohistochemical analysis showed that EA had a minimal impact on the TH-positive profiles of the ipsilateral ventral tegmental area. Compared with the 6-OHDA group, long-term EA stimulation significantly increased sucrose solution consumption and decreased immobility time in the forced swim test. EA treatment did not alter dopamine, norepinephrine, and serotonin levels in the striatum and hippocampus. Noticeably, EA treatment reversed the 6-OHDA-induced abnormal expression of brain-derived neurotrophic factor (BDNF) and tropomyosin-related kinase B (TrkB) in the midbrain and hippocampus. These results demonstrate that EA at 100-Hz possesses the ability to improve depressive-like symptoms in PD rats, which is, at least in part, due to the distinct effect of EA on the mesostriatal and mesocorticolimbic dopaminergic pathways. Moreover, BDNF seems to participate in the effect of EA in PD. PMID:27525025

  5. Whole-Foods, Plant-Based Diet Alleviates the Symptoms of Osteoarthritis

    PubMed Central

    Clinton, Chelsea M.; O'Brien, Shanley; Law, Junwen; Renier, Colleen M.; Wendt, Mary R.

    2015-01-01

    Objective. To evaluate the effectiveness of a whole-foods, plant-based diet (WFPB) to reduce symptoms of osteoarthritis. Methods. Six-week, prospective randomized open-label study of patients aged 19–70 with osteoarthritis. Participants were randomized to a WFPB (intervention) or continuing current diet (control). Outcomes were assessed by mixed models analysis of participant self-assessed weekly SF-36v2 domain t scores, weekly Patient Global Impression of Change (PGIC) scales, and mean weekly Visual Analog Scale (VAS) pain assessment. Mixed models analysis also evaluated pre-post change from baseline level for standard clinical measures: weight, BMI, body temperature, pulse, and blood pressure. Results. Forty participants were randomized. Thirty-seven of them, 18 control and 19 intervention, completed the study. The intervention group reported a significantly greater improvement than the control group in SF-36v2 energy/vitality, physical functioning, role physical, and the physical component summary scale. The differences between the intervention and control PGIC scales were statistically significant over time. Intervention group improvement in VAS weekly mean was also significantly greater than that of the control group from week 2 onward. Conclusion. Study results suggest that a whole-foods, plant-based diet significantly improves self-assessed measures of functional status among osteoarthritis patients. PMID:25815212

  6. Treatment of menopausal symptoms with three low-dose continuous sequential 17β-estradiol/progesterone parenteral monthly formulations using novel non-polymeric microsphere technology

    PubMed Central

    Cortés-Bonilla, Manuel; Bernardo-Escudero, Roberto; Alonso-Campero, Rosalba; Francisco-Doce, María T.; Hernández-Valencia, Marcelino; Celis-González, Cuauhtémoc; Márquez-Oñate, Ricardo; Chedraui, Peter; Uribe, Juan A.

    2015-01-01

    Abstract Objective: To analyze the short-term efficacy and safety over menopausal symptoms of three low-dose continuous sequential 17β-estradiol (E)/progesterone (P) parental monthly formulations using novel non-polymeric microspheres. Methods: This was a multicenter, randomized, single blinded study in which peri- and postmenopausal women were assigned to receive a monthly intramuscular injection of 0.5 mg E + 15 mg P (Group A, n = 34), 1 mg E + 20 mg P (Group B, n = 24) or 1 mg E + 30 mg P (Group C, n = 26) for 6 months. Primary efficacy endpoints included mean change in the frequency and severity of hot flushes and the effect over urogenital atrophy symptoms at 3 and 6 months. Safety variables included changes in the rate of amenorrhea, endometrial thickness and histopathology, and local and systemic adverse events. Results: Compared to baseline at month 6, the three treatment schemes significantly decreased the rate of urogenital atrophy symptoms and the frequency (mean number per day) and severity (mean number graded as moderate and severe per month) of hot flushes. No differences in studied efficacy parameters were observed between studied groups at baseline or at the end of the study. For all groups the most frequent adverse event was pain at the injection site; however they were all rated as mild. At the end of the study peri- and postmenopausal women displayed no significant changes in endometrial thickness or histopathology in all treated groups. The rate of amenorrhea at the end of the study decreased for all studied groups yet was less evident among postmenopausal women as compared to perimenopausal ones. Conclusions: The three low-dose continuous sequential intramuscular monthly treatments of E/P using novel microsphere technology were effective at reducing menopausal symptoms at short-term with a low rate of adverse events. More long-term and comparative research is warranted to support our positive findings

  7. Menopause and the vaginal microbiome.

    PubMed

    Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M

    2016-09-01

    For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis. PMID:27451320

  8. Menopause and the vaginal microbiome.

    PubMed

    Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M

    2016-09-01

    For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis.

  9. Cognition and the menopause transition.

    PubMed

    Maki, Pauline M; Henderson, Victor W

    2016-07-01

    Complaints about forgetfulness, "brain fog," and difficulty concentrating are common in women transitioning through menopause. Women with these cognitive complaints often express concern about whether these problems are normal, related to menopause, or represent a symptom of Alzheimer disease or another serious cognitive disorder. In this Practice Pearl, we provide a brief summary of the scientific literature on the frequency of cognitive complaints in midlife women, the validity of complaints in relation to performance on standardized cognitive tests, and the influence of menopause on cognitive performance. We then offer recommendations for healthcare providers and women to address cognitive concerns. PMID:27272226

  10. [Phytoestrogens and menopause].

    PubMed

    Torella, M; La Rezza, F; Labriola, D; Ammaturo, F P; Ambrosio, D; Zarcone, R; Trotta, C; Schettino, M T; De Franciscis, P

    2013-12-01

    Menopause is the interruption of menstrual and reproductive capacity, therefore, that occurs naturally in all women between 48 and 55 years, due to a lower production of gonadal steroids. The period becomes progressively irregular and lack of ovulation and menstrual flow decrease, and finally disappears. The time between the first symptoms and the cessation of the menstrual cycle is called menopause. With the onset of menopause the woman undergoes a series of changes related to estrogen deficiency, which occur in all tissues of the body. In this period one can distinguish an early stage, characterized by hot flashes, mood swings, night sweats and insomnia, and a late phase in which we highlight more symptoms related to the interruption of hormonal such as osteoporosis, obesity, at urogenital and increased incidence of cardiovascular disease. In Italy, only 5.2% of women aged 45-64 years used hormone replacement therapy, and only 20-30% follow a therapy for more than two years, both for psychological reasons, and for fear of side effects. Not surprisingly, therefore, phytoestrogens are given a high importance, as they are considered a natural alternative tank to to their plant origin. Interest in phytoestrogens was born from the observation that postmenopausal women who live in the East have a lower incidence of symptoms, cardiovascular disease, cancer and osteoporosis hormone use, compared to Western women.

  11. Association between depressive symptoms and reproductive variables in a group of perimenopausal women attending a menopause clinic in México City.

    PubMed

    Flores-Ramos, Mónica; Heinze, Gerhard; Silvestri-Tomassoni, Roberto

    2010-02-01

    The aim of this study was to explore the association between depressive symptoms and some variables related to the reproductive life, such as history of premenstrual dysphoric disorder, antecedent of postpartum depression, previous use of hormonal contraceptives, and current hot flushes, in a group of perimenopausal women attending a menopause clinic. Perimenopausal women, 45 to 55 years old, who had not received hormonal replacement therapy and/or psychotropic medication, were invited to participate in this study. 141 perimenopausal women were included; we obtained their psychiatric and gynecological data, and we evaluated their depressive symptomatology using the CES-D scale. There were a significantly higher number of cases of previous depressive episodes, PMDD and PPD history in depressed patients compared with non-depressed women; current hot flushes prevalence was similar between depressed and non-depressed women. Patients with a PMDD history were more likely to have experienced previous depressive episodes, a PPD history and high levels of depression. Variables associated with the level of depression were a previous history of PMDD, current hot flushes, and previous depressive episodes. The occurrence of perimenopausal depression is related to a previous history of PMDD, PPD, and depressive episodes; hot flushes only increase the severity of the depressive episode. PMID:19730981

  12. North American Menopause Society

    MedlinePlus

    ... Menopause Guidebook MenoNotes MenoPro Mobile App MenoPause Blog Sexual Health & Menopause Online Changes at Midlife How to Navigate ... Bone Health and Heart Health Exercise and Diet Sexual Health Mental Health at Menopause Women's Health and Menopause ...

  13. Lactococcus lactis expressing food-grade β-galactosidase alleviates lactose intolerance symptoms in post-weaning Balb/c mice.

    PubMed

    Li, Jingjie; Zhang, Wen; Wang, Chuan; Yu, Qian; Dai, Ruirui; Pei, Xiaofang

    2012-12-01

    The endogenous β-galactosidase expressed in intestinal microbes is demonstrated to help humans in lactose usage, and treatment associated with the promotion of beneficial microorganism in the gut is correlated with lactose tolerance. From this point, a kind of recombinant live β-galactosidase delivery system using food-grade protein expression techniques and selected probiotics as vehicle was promoted by us for the purpose of application in lactose intolerance subjects. Previously, a recombinant Lactococcus lactis MG1363 strain expressing food-grade β-galactosidase, the L. lactis MG1363/FGZW, was successfully constructed and evaluated in vitro. This study was conducted to in vivo evaluate its efficacy on alleviating lactose intolerance symptoms in post-weaning Balb/c mice, which were orally administered with 1 × 10⁶ CFU or 1 × 10⁸ CFU of L. lactis MG1363/FGZW daily for 4 weeks before lactose challenge. In comparison with naïve mice, the mice administered with L. lactis MG1363/FGZW showed significant alleviation of diarrhea symptoms in less total feces weight within 6 h post-challenge and suppressed intestinal motility after lactose challenge, although there was no significant increase of β-galactosidase activity in small intestine. The alleviation also correlated with higher species abundance, more Bifidobacterium colonization, and stronger colonization resistance in mice intestinal microflora. Therefore, this recombinant L. lactis strain effectively alleviated diarrhea symptom induced by lactose uptake in lactose intolerance model mice with the probable mechanism of promotion of lactic acid bacteria to differentiate and predominantly colonize in gut microbial community, thus making it a promising probiotic for lactose intolerance subjects.

  14. Management of menopause in women with breast cancer.

    PubMed

    Vincent, A J

    2015-10-01

    Increasing breast cancer incidence and decreasing mortality have highlighted the importance of survivorship issues related to breast cancer. A consideration of the issues related to menopause is therefore of great importance to both women and clinicians. Menopause/menopausal symptoms, with significant negative effects on quality of life and potential long-term health impacts, may in women with breast cancer be associated with: (1) natural menopause occurring concurrently with a breast cancer diagnosis; (2) recurrence of menopausal symptoms following cessation of hormone replacement therapy; (3) treatment-induced menopause (chemotherapy, ovarian ablation/suppression) and adjuvant endocrine therapy. A variety of non-hormonal pharmacological and non-pharmacological therapies have been investigated as therapeutic options for menopausal symptoms with mixed results, and ongoing research is required. This review presents a summary of the causes, common problematic symptoms of menopause (vasomotor, genitourinary and sexual dysfunction), and longer-term consequences (cardiovascular disease and osteoporosis) related to menopause. It proposes an evidenced-based multidisciplinary approach to the management of menopause/menopausal symptoms in women with breast cancer.

  15. Effect of Isopropanolic Cimicifuga racemosa Extract on Uterine Fibroids in Comparison with Tibolone among Patients of a Recent Randomized, Double Blind, Parallel-Controlled Study in Chinese Women with Menopausal Symptoms

    PubMed Central

    Liske, Eckehard; Wang, Shuyu; Liu, Jianli; Zhang, Zhonglan; Geng, Li; Hu, Lina; Zheng, Shurong; Zepelin, Hans-Heinrich Henneicke-von; Bai, Wenpei

    2014-01-01

    Objective. Effect of isopropanolic Cimicifuga racemosa extract (iCR) on uterine fibroid size compared with tibolone. Method. The randomized, double-blind, controlled study in China enrolled 244 patients aged 40–60 years with menopausal symptoms (Kupperman Menopause Index ≥ 15). The participants were treated with either iCR of 40 mg crude drug/day (N = 122) or tibolone 2.5 mg/day (N = 122) orally for 3 months in 2004. Now, we investigated the subset of all women (N = 62) with at least one uterine fibroid at onset of treatment for the effect of iCR (N = 34) on fibroid size compared with tibolone (N = 28) by transvaginal ultrasonography. Results. The median myoma volume decreased upon iCR by as much as −30% (P = 0.016) but increased upon tibolone by +4.7%. The percentage of volume change, mean diameter change and geometric mean diameter change of the iCR group compared to tibolone were statistically significant (P = 0.016, 0.021, 0.016 respectively). Conclusion. Our results suggest that iCR (Remifemin) is a valid herbal medicinal product in patients with uterine myomas as it provides adequate relief from menopausal symptoms and inhibits growth of the myomas in contrast to tibolone. PMID:24719645

  16. Cancer treatment - early menopause

    MedlinePlus

    Premature menopause; Primary ovarian insufficiency; POI ... Cancer treatments that can cause early menopause include: Surgery. Having both ovaries removed causes menopause to happen right away. If you are age 50 or younger, your provider may ...

  17. Menopause and Hormones

    MedlinePlus

    ... Consumer Information by Audience For Women Menopause and Hormones: Common Questions Share Tweet Linkedin Pin it More ... reproduction and distribution. Learn More about Menopause and Hormones Menopause--Medicines to Help You Links to other ...

  18. The urogenital system and the menopause.

    PubMed

    Calleja-Agius, J; Brincat, M P

    2015-01-01

    The major cause of urogenital atrophy in menopausal women is estrogen loss. The symptoms are usually progressive in nature and deteriorate with time from the menopausal transition. The most prevalent urogenital symptoms are vaginal dryness, vaginal irritation and itching. The genitourinary syndrome of menopause includes vulvovaginal atrophy and the postmenopausal modifications of the lower urinary tract. Dyspareunia and vaginal bleeding from fragile atrophic skin are common problems. Other urogenital complaints include frequency, nocturia, urgency, stress urinary incontinence and urinary tract infections. Atrophic changes of the vulva, vagina and lower urinary tract can have a large impact on the quality of life of the menopausal woman. However, hormonal and non-hormonal treatments can provide patients with the solution to regain the previous level of function. Therefore, clinicians should sensitively question and examine menopausal women, in order to correctly identify the pattern of changes in urogenital atrophy and manage them appropriately.

  19. Contemporary Alternatives to Plant Estrogens for Menopause

    PubMed Central

    Geller, Stacie E.; Studee, Laura

    2006-01-01

    Objectives Every year, millions of women begin the peri-menopause and may experience a number of symptoms related to this transition. Many women are reluctant to use exogenous hormone therapy for treatment of menopausal symptoms and are turning to botanical and dietary supplements (BDS) for relief. This paper reviews the literature on alternatives to plant estrogens for relief of menopausal symptoms. Methods The MEDLINE database was searched for clinical trials of non-estrogenic plant extracts for menopausal symptoms. To be included, studies had to include peri- or postmenopausal women as subjects. All clinical trials (randomized-controlled trials, open trials, and comparison group studies) were included for this review. Results Black Cohosh appears to be one of the most effective botanicals for relief of vasomotor symptoms, while St. John’s wort can improve mood disorders related to the menopausal transition. Many other botanicals have limited evidence to demonstrate safety and efficacy for relief of symptoms related to menopause. Conclusions A growing body of evidence suggests that some botanicals and dietary supplements could result in improved clinical outcomes. Health care providers should discuss these issues with their patients so they can assist them in managing these alternative therapies through an evidence-based approach. PMID:16884867

  20. A psychological intervention reduces inflammatory markers by alleviating depressive symptoms: Secondary analysis of a randomized controlled trial

    PubMed Central

    Thornton, Lisa M.; Andersen, Barbara L.; Schuler, Tammy A.; Carson, William E.

    2013-01-01

    Objective Depression and inflammation are common among cancer patients. Data suggest that inflammation can contribute to depressive symptoms, while the converse remains untested. We experimentally test whether a psychological intervention reduces depression-related symptoms and markers of inflammation among cancer patients, and further, we test one mechanism for the intervention effects. Methods As part of a randomized clinical trial, newly diagnosed breast cancer patients (N=45) with clinically significant depressive symptoms were evaluated and randomized to Psychological Intervention with assessment or Assessment only study arms. The intervention spanned 12 months, with assessments at baseline, 4, 8, and 12, months. Mixed effects modeling tested the hypothesis that the intervention reduced self reported depressive symptoms (Center for Epidemiological Studies Depression scale, Profile of Mood States Depression and Fatigue subscales, and SF-36 Bodily Pain subscale) and immune cell numbers that are elevated in the presence of inflammation (white blood cell [WBC] count, neutrophil count, and helper:suppressor ratio). Mediation analyses tested whether change in depressive symptoms, pain, or fatigue predicted change in WBC count, neutrophil count, or the helper:suppressor ratio. Results The intervention significantly reduced depressive symptoms, pain, fatigue, and inflammation markers. Moreover, the intervention effect on inflammation was mediated by its effect on depressive symptoms. Conclusions This is the first experiment to test whether psychological treatment effective in reducing depressive symptoms would also reduce indicators of inflammation. Data show that the intervention directly reduced depressive symptoms and indirectly reduced inflammation. Psychological treatment may effectively treat depressive symptoms, pain, and fatigue among cancer patients. PMID:19622708

  1. Hypothalamic orexin's role in exacerbated cutaneous vasodilation responses to an anxiogenic stimulus in a surgical menopause model.

    PubMed

    Federici, Lauren M; Caliman, Izabela Facco; Molosh, Andrei I; Fitz, Stephanie D; Truitt, William A; Bonaventure, Pascal; Carpenter, Janet S; Shekhar, Anantha; Johnson, Philip L

    2016-03-01

    Distressing symptoms such as hot flashes and sleep disturbances affect over 70% of women approaching menopause for an average of 4-7 years, and recent large cohort studies have shown that anxiety and stress are strongly associated with more severe and persistent hot flashes and can induce hot flashes. Although high estrogen doses alleviate symptoms, extended use increases health risks, and current non-hormonal therapies are marginally better than placebo. The lack of effective non-hormonal treatments is largely due to the limited understanding of the mechanisms that underlie menopausal symptoms. One mechanistic pathway that has not been explored is the wake-promoting orexin neuropeptide system. Orexin is exclusively synthesized in the estrogen receptor rich perifornical hypothalamic region, and has an emerging role in anxiety and thermoregulation. In female rodents, estrogens tonically inhibit expression of orexin, and estrogen replacement normalizes severely elevated central orexin levels in postmenopausal women. Using an ovariectomy menopause model, we demonstrated that an anxiogenic compound elicited exacerbated hot flash-associated increases in tail skin temperature (TST, that is blocked with estrogen), and cellular responses in orexin neurons and efferent targets. Furthermore, systemic administration of centrally active, selective orexin 1 or 2 and dual receptor antagonists attenuated or blocked TST responses, respectively. This included the reformulated Suvorexant, which was recently FDA-approved for treating insomnia. Collectively, our data support the hypothesis that dramatic loss of estrogen tone during menopausal states leads to a hyperactive orexin system that contributes to symptoms such as anxiety, insomnia, and more severe hot flashes. Additionally, orexin receptor antagonists may represent a novel non-hormonal therapy for treating menopausal symptoms, with minimal side effects. PMID:26765933

  2. Dangers of the menopause. 1910.

    PubMed

    Perkins, Anne E

    2012-06-01

    Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over the last century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times.This month's article, from the September 1910 issue, is "Dangers of the Menopause." The author, Anne E. Perkins, MD, states that its purpose is to correct "popular fallacies," so nurses can "disseminate knowledge of the real dangers" of menopause. It's interesting how much information in the article is still valid 100 years later, such as the need to investigate any postmenopausal bleeding. It's also noteworthy that the three symptoms causing women the most distress-hot flashes, insomnia, and mood problems-haven't changed, although a comparison of Dr. Perkins's article with "Managing Menopausal Symptoms" in this issue reveals that menopause management certainly has: from a "trip abroad" and avoiding "fancy work" in 1910 to physical exercise and acupuncture in 2012. To read the complete article from our archives, go to http://bit.ly/IZkCiD.

  3. Experience of menopause in aboriginal women: a systematic review.

    PubMed

    Chadha, N; Chadha, V; Ross, S; Sydora, B C

    2016-01-01

    Every woman experiences the menopause transition period in a very individual way. Menopause symptoms and management are greatly influenced by socioeconomic status in addition to genetic background and medical history. Because of their very unique cultural heritage and often holistic view of health and well-being, menopause symptoms and management might differ greatly in aboriginals compared to non-aboriginals. Our aim was to investigate the extent and scope of the current literature in describing the menopause experience of aboriginal women. Our systematic literature review included nine health-related databases using the keywords 'menopause' and 'climacteric symptoms' in combination with various keywords describing aboriginal populations. Data were collected from selected articles and descriptive analysis was applied. Twenty-eight relevant articles were included in our analysis. These articles represent data from 12 countries and aboriginal groups from at least eight distinctive geographical regions. Knowledge of menopause and symptom experience vary greatly among study groups. The average age of menopause onset appears earlier in most aboriginal groups, often attributed to malnutrition and a harsher lifestyle. This literature review highlights a need for further research of the menopause transition period among aboriginal women to fully explore understanding and treatment of menopause symptoms and ultimately advance an important dialogue about women's health care.

  4. Comparing the Effects of Yoga & Oral Calcium Administration in Alleviating Symptoms of Premenstrual Syndrome in Medical Undergraduates

    PubMed Central

    Bharati, Mehta

    2016-01-01

    Introduction: Medical undergraduates are heavily burdened by their curriculum. The females, in addition, suffer from vivid affective or somatic premenstrual syndrome (PMS) symptoms such as bloating, mastalgia, insomnia, fatigue, mood swings, irritability, and depression. The present study was proposed to attenuate the symptoms of PMS by simple lifestyle measures like yoga and/or oral calcium. Methods: 65 medical female students (18-22 years) with a regular menstrual cycle were asked to self-rate their symptoms, along with their severity, in a validated questionnaire for two consecutive menstrual cycles. Fifty-eight students were found to have PMS. Twenty girls were given yoga training (45 minutes daily, five days a week, for three months). Another group of 20 was given oral tablets of calcium carbonate daily (500 mg, for three months) and rest 18 girl served as control group. Data were analyzed by SPSS ver.13 software. Results: The yoga and calcium groups showed a significant decrease in number and severity of premenstrual symptoms whereas in the control group there was not the significant difference. Conclusion: Encouraging a regular practice of yoga or taking a tablet of calcium daily in the medical schools can decrease the symptoms of premenstrual syndrome. PMID:27752483

  5. Menopause: Every Experience is Different | NIH MedlinePlus the Magazine

    MedlinePlus

    ... emotional problems connected to their menstrual periods. Why did you volunteer for the trial? I've always ... guess menopause comes in many forms! How long did actual menopause symptoms last for you? They came ...

  6. Menopause and Stroke: An Epidemiologic Review

    PubMed Central

    Lisabeth, Lynda; Bushnell, Cheryl

    2012-01-01

    Although women have a lower risk of stroke during middle age, the menopausal transition is a time when many women develop cardiovascular risk factors. In addition, during the 10 years after menopause, the risk of stroke roughly doubles in women. Endogenous estrogen levels decline by 60% during the menopausal transition, leading to a relative androgen excess, which could contribute to the increased cardiovascular risk factors in women. Earlier onset of menopause may influence the risk of stroke, but the data are not clear. Because of the stroke risk associated with hormone therapy, this is only indicated for treatment of vasomotor symptoms, but some formulations may be safe than others. More research is needed to understand which women are at greatest stroke risk during midlife and to determine the safest formulation, dose, and duration of hormone therapy that will treat vasomotor symptoms without increasing the risk for stroke. PMID:22172623

  7. Does alleviating poverty affect mothers’ depressive symptoms? A quasi-experimental investigation of Mexico’s Oportunidades programme

    PubMed Central

    Ozer, Emily J; Fernald, Lia CH; Weber, Ann; Flynn, Emily P; VanderWeele, Tyler J

    2011-01-01

    Background Depression is a major cause of disability, particularly among women; poverty heightens the risk for depression. Beyond its direct effects, maternal depression can harm children’s health and development. This study aimed to assess the effects of a large-scale anti-poverty programme in Mexico (Oportunidades) on maternal depressive symptoms. Methods In 2003, 5050 women living in rural communities who had participated in Oportunidades since its inception were assessed and compared with a group of 1293 women from matched communities, whose families had received no exposure to Oportunidades at the time of assessment but were later enrolled. Self-reported depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Ordinary least squares regressions were used to evaluate the treatment effect of programme participation on depression while adjusting for covariates and clustering at the community level. Results Women in the treatment group had lower depressive symptoms than those in the comparison group (unadjusted mean CES-D scores: 16.9 ± 9.8 vs 18.6 ± 10.2). In multivariable analyses, programme participation was associated with lower depression whilst controlling for maternal age, education and household demographic, ethnicity and socio-economic variables [β = −1.7 points, 95% confidence interval (95% CI) −2.46 to −0.96, P < 0.001]. Reductions in perceived stress and increases in perceived control were mediators of programme effects on women. Conclusions Although Oportunidades did not target maternal mental health directly, we found modest but clinically meaningful effects on depressive symptoms. Our design permits stronger causal inference than observational studies that have linked poverty and depressive symptoms. Our results emphasize that the well-being of individuals is responsive to macro-level economic policies and programmes. PMID:21737404

  8. Menopause, local biologies, and cultures of aging.

    PubMed

    Lock, M; Kaufert, P

    2001-01-01

    Menopause marks the end of menstruation, once generally accepted as the closure of women's reproductive lives. The current medical view of menopause, however, is as a pathological event with its own distinct set of symptoms and diseases. Researchers have described women as facing a dramatic increase in the risk of heart disease, osteoporosis, stroke, and Alzheimer's, all as the result of the impact of changing hormone levels, particularly the decline in estrogen. The clinical literature has interpreted these findings in terms of the absolute necessity of replacing these lost hormones for all women who are menopausal regardless of any other physiological, social, or cultural characteristic they might possess. Using research done in Japan, Canada, and the United States, this paper challenges the notion of a universal menopause by showing that both the symptoms reported at menopause and the post-menopause disease profiles vary from one study population to the next. For most of the symptoms commonly associated with menopause in the medical literature, rates are much lower for Japanese women than for women in the United States and Canada, although they are comparable to rates reported from studies in Thailand and China. Mortality and morbidity data from these same societies are used to show that post-menopausal women are also not equally at risk for heart disease, breast cancer, or osteoporosis. Rather than universality, the paper suggests that it is important to think in terms of "local biologies", which reflect the very different social and physical conditions of women's lives from one society to another. PMID:11400220

  9. Staying Healthy After Menopause

    MedlinePlus

    ... http://womenshealth.gov/menopause/menopause-basics/index.html Staying healthy after menopause may mean making some changes in the way you live. Don't smoke. If you do use any type of tobacco, stop—it's never too late to benefit from quitting smoking. Eat a healthy ...

  10. The Impact of Menopause: Implications for Mental Health Counselors.

    ERIC Educational Resources Information Center

    Baldo, Tracy D.; Schneider, Mercedes K.; Slyter, Marty

    2003-01-01

    The purpose of this article is to present a brief, informative view of the impact of menopause along with implications for mental health counselors. Menopause and associated stages are defined; symptoms associated with these stages are discussed; the benefits, risks, and consequences of hormone replacement therapy are considered; and…

  11. Ancillary Benefits for Caregivers of Children with Asthma Participating in an Environmental Intervention Study to Alleviate Asthma Symptoms

    PubMed Central

    Kubzansky, Laura D.; Spengler, John D.; Levy, Jonathan I.

    2009-01-01

    Providing care for children with asthma can be demanding and time-intensive with far-reaching effects on caregivers’ lives. Studies have documented childhood asthma symptom reductions and improved asthma-related quality of life (AQOL) with indoor allergen-reducing environmental interventions. Few such studies, however, have considered ancillary benefits to caregivers or other family members. Ancillary benefits could be derived from child health improvements and reduced caregiving burden or from factors such as improved living environments or social support that often accompanies intensive residential intervention efforts. As part of the Boston Healthy Public Housing Initiative (HPHI), a longitudinal single-cohort intervention study of asthmatic children, we examined trends in caregivers’ quality of life related to their child’s asthma (caregiver AQOL) using monthly Juniper Caregiver Asthma Quality of Life Questionnaires (AQLQ) for 32 primary caregivers to 42 asthmatic children aged 4 to 17 years. Longitudinal analyses were used to examine caregiver AQOL trends and their relationship to the child’s AQOL, then to consider additional predictors of caregiver AQOL. Caregiver AQLQ improved significantly over the course of the study with overall improvements significantly correlated with child AQOL (p = 0.005). However, caregiver AQOL improved most in the months before environmental interventions, while children’s AQOL improved most in the months following. Time trends in caregiver AQOL, controlling for child AQOL, were not explained by available social support or caregiver stress measures. Our findings suggest potential participation effects not adequately captured by standard measures. Future environmental intervention studies should more formally consider social support and participation effects for both children and caregivers PMID:19184446

  12. Ancillary benefits for caregivers of children with asthma participating in an environmental intervention study to alleviate asthma symptoms.

    PubMed

    Clougherty, Jane E; Kubzansky, Laura D; Spengler, John D; Levy, Jonathan I

    2009-03-01

    Providing care for children with asthma can be demanding and time-intensive with far-reaching effects on caregivers' lives. Studies have documented childhood asthma symptom reductions and improved asthma-related quality of life (AQOL) with indoor allergen-reducing environmental interventions. Few such studies, however, have considered ancillary benefits to caregivers or other family members. Ancillary benefits could be derived from child health improvements and reduced caregiving burden or from factors such as improved living environments or social support that often accompanies intensive residential intervention efforts. As part of the Boston Healthy Public Housing Initiative (HPHI), a longitudinal single-cohort intervention study of asthmatic children, we examined trends in caregivers' quality of life related to their child's asthma (caregiver AQOL) using monthly Juniper Caregiver Asthma Quality of Life Questionnaires (AQLQ) for 32 primary caregivers to 42 asthmatic children aged 4 to 17 years. Longitudinal analyses were used to examine caregiver AQOL trends and their relationship to the child's AQOL, then to consider additional predictors of caregiver AQOL. Caregiver AQLQ improved significantly over the course of the study with overall improvements significantly correlated with child AQOL (p = 0.005). However, caregiver AQOL improved most in the months before environmental interventions, while children's AQOL improved most in the months following. Time trends in caregiver AQOL, controlling for child AQOL, were not explained by available social support or caregiver stress measures. Our findings suggest potential participation effects not adequately captured by standard measures. Future environmental intervention studies should more formally consider social support and participation effects for both children and caregivers. PMID:19184446

  13. Multipotent stromal cells alleviate inflammation, neuropathology, and symptoms associated with globoid cell leukodystrophy in the twitcher mouse

    PubMed Central

    Scruggs, Brittni A.; Zhang, Xiujuan; Bowles, Annie C.; Gold, Peter A.; Semon, Julie A.; Fisher-Perkins, Jeanne M.; Zhang, Shijia; Bonvillain, Ryan W.; Myers, Leann; Li, Su Chen; Kalueff, Allan V.; Bunnell, Bruce A.

    2013-01-01

    Globoid cell leukodystrophy (GLD) is a common neurodegenerative lysosomal storage disorder caused by a deficiency in galactocerebrosidase (GALC), an enzyme that cleaves galactocerebroside during myelination. Bone marrow transplantation has shown promise when administered to late-onset GLD patients. However, the side effects (e.g., graft versus host disease), harsh conditioning regimens (e.g., myelosuppression), and variable therapeutic effects make this an unsuitable option for infantile GLD patients. We previously reported modest improvements in the twitcher mouse model of GLD after intracerebroventricular (ICV) injections of a low dose of multipotent stromal cells (MSCs). Goals of this study were to improve bone marrow-derived MSC (BMSC) therapy for GLD by increasing the cell dosage and comparing cell type (e.g., transduced v. native), treatment timing (e.g., single v. weekly), and administration route (e.g., ICV v. intraperitoneal). Neonatal twitcher mice received (1) 2×105 BMSCs by ICV injection, (2) 1×106 BMSCs by intraperitoneal (IP) injection, (3) weekly IP injections of 1×106 BMSCs, or (4) 1×106 lentiviral-transduced BMSCs overexpressing GALC (GALC-BMSC) by IP injection. All treated mice lived longer than untreated mice. However, the mice receiving peripheral MSC therapy had improved motor function (e.g., hind limb strength and rearing ability), twitching symptoms, and weight compared to both the untreated and ICV-treated mice. Inflammatory cell, globoid cell, and apoptotic cell levels in the sciatic nerves were significantly decreased as a result of the GALC-BMSC or weekly IP injections. The results of this study indicate a promising future for peripheral MSC therapy as a non-invasive, adjunct therapy for patients affected with GLD. PMID:23606584

  14. Complementary and Alternative Approaches to Menopause.

    PubMed

    Taylor, Maida

    2015-09-01

    Given the persistent confusion about the risks and benefits of hormone therapy since 2002 and the first publication from the Women's Health Initiative's primary findings, women and health care providers are increasingly motivated to find effective, nonhormonal approaches to treat menopause-related symptoms. Complementary and alternative medicine has grown increasingly popular in the last decade. A wide array of botanic medicines is offered as an alternative approach to hormone therapy for menopause, but data documenting efficacy and safety are limited. None of the available botanicals is as effective as hormone therapy in the management of vasomotor symptoms. PMID:26316247

  15. The Menopause Time of Life.

    ERIC Educational Resources Information Center

    National Inst. on Aging (DHHS/NIH), Bethesda, MD.

    This pamphlet examines menopause and the changes associated with it. Menopause is briefly described, surgical menopause is explained, and the relationship between menopause and the reproductive cycle is discussed. Signs of menopause are described, including hot flashes and vaginal and urinary tract changes. Postmenopausal osteoporosis is explained…

  16. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

    PubMed

    Daily, James W; Yang, Mini; Park, Sunmin

    2016-08-01

    Although turmeric and its curcumin-enriched extracts have been used for treating arthritis, no systematic review and meta-analysis of randomized clinical trials (RCTs) have been conducted to evaluate the strength of the research. We systemically evaluated all RCTs of turmeric extracts and curcumin for treating arthritis symptoms to elucidate the efficacy of curcuma for alleviating the symptoms of arthritis. Literature searches were conducted using 12 electronic databases, including PubMed, Embase, Cochrane Library, Korean databases, Chinese medical databases, and Indian scientific database. Search terms used were "turmeric," "curcuma," "curcumin," "arthritis," and "osteoarthritis." A pain visual analogue score (PVAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used for the major outcomes of arthritis. Initial searches yielded 29 articles, of which 8 met specific selection criteria. Three among the included RCTs reported reduction of PVAS (mean difference: -2.04 [-2.85, -1.24]) with turmeric/curcumin in comparison with placebo (P < .00001), whereas meta-analysis of four studies showed a decrease of WOMAC with turmeric/curcumin treatment (mean difference: -15.36 [-26.9, -3.77]; P = .009). Furthermore, there was no significant mean difference in PVAS between turmeric/curcumin and pain medicine in meta-analysis of five studies. Eight RCTs included in the review exhibited low to moderate risk of bias. There was no publication bias in the meta-analysis. In conclusion, these RCTs provide scientific evidence that supports the efficacy of turmeric extract (about 1000 mg/day of curcumin) in the treatment of arthritis. However, the total number of RCTs included in the analysis, the total sample size, and the methodological quality of the primary studies were not sufficient to draw definitive conclusions. Thus, more rigorous and larger studies are needed to confirm the therapeutic efficacy of turmeric for arthritis. PMID:27533649

  17. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

    PubMed

    Daily, James W; Yang, Mini; Park, Sunmin

    2016-08-01

    Although turmeric and its curcumin-enriched extracts have been used for treating arthritis, no systematic review and meta-analysis of randomized clinical trials (RCTs) have been conducted to evaluate the strength of the research. We systemically evaluated all RCTs of turmeric extracts and curcumin for treating arthritis symptoms to elucidate the efficacy of curcuma for alleviating the symptoms of arthritis. Literature searches were conducted using 12 electronic databases, including PubMed, Embase, Cochrane Library, Korean databases, Chinese medical databases, and Indian scientific database. Search terms used were "turmeric," "curcuma," "curcumin," "arthritis," and "osteoarthritis." A pain visual analogue score (PVAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used for the major outcomes of arthritis. Initial searches yielded 29 articles, of which 8 met specific selection criteria. Three among the included RCTs reported reduction of PVAS (mean difference: -2.04 [-2.85, -1.24]) with turmeric/curcumin in comparison with placebo (P < .00001), whereas meta-analysis of four studies showed a decrease of WOMAC with turmeric/curcumin treatment (mean difference: -15.36 [-26.9, -3.77]; P = .009). Furthermore, there was no significant mean difference in PVAS between turmeric/curcumin and pain medicine in meta-analysis of five studies. Eight RCTs included in the review exhibited low to moderate risk of bias. There was no publication bias in the meta-analysis. In conclusion, these RCTs provide scientific evidence that supports the efficacy of turmeric extract (about 1000 mg/day of curcumin) in the treatment of arthritis. However, the total number of RCTs included in the analysis, the total sample size, and the methodological quality of the primary studies were not sufficient to draw definitive conclusions. Thus, more rigorous and larger studies are needed to confirm the therapeutic efficacy of turmeric for arthritis.

  18. Ecology drives intragenomic conflict over menopause.

    PubMed

    Úbeda, Francisco; Ohtsuki, Hisashi; Gardner, Andy

    2014-02-01

    Menopause is the transition from reproductive to non-reproductive life well before natural death. Rather than involving a smooth, rapid change, it is normally preceded by a long period of erratic hormonal fluctuation that is accompanied by a plethora of unpleasant symptoms. Here, we (1) suggest that this turbulent period owes to conflict, between a woman's maternally inherited (MI) and paternally inherited (PI) genes, over the trade-off between reproduction and communal care; (2) perform a theoretical analysis to show that this conflict is resolved either through silencing or fluctuating expression of one of the genes; (3) highlight which of the symptoms preceding menopause may result from antagonistic co-evolution of MI and PI genes; (4) argue that ecological differences between ancestral human populations may explain the variability in menopause among different ethnic groups; (5) discuss how these insights may be used to inform family planning and cancer risk assessment based on a woman's ancestral background. PMID:24320989

  19. Ecology drives intragenomic conflict over menopause

    PubMed Central

    Úbeda, Francisco; Ohtsuki, Hisashi; Gardner, Andy; Baalen, Minus

    2014-01-01

    Menopause is the transition from reproductive to non-reproductive life well before natural death. Rather than involving a smooth, rapid change, it is normally preceded by a long period of erratic hormonal fluctuation that is accompanied by a plethora of unpleasant symptoms. Here, we (1) suggest that this turbulent period owes to conflict, between a woman's maternally inherited (MI) and paternally inherited (PI) genes, over the trade-off between reproduction and communal care; (2) perform a theoretical analysis to show that this conflict is resolved either through silencing or fluctuating expression of one of the genes; (3) highlight which of the symptoms preceding menopause may result from antagonistic co-evolution of MI and PI genes; (4) argue that ecological differences between ancestral human populations may explain the variability in menopause among different ethnic groups; (5) discuss how these insights may be used to inform family planning and cancer risk assessment based on a woman's ancestral background. PMID:24320989

  20. Dermatosis associated with menopause

    PubMed Central

    Nair, Pragya A.

    2014-01-01

    Menopause is defined as permanent irreversible cessation of menses brought by decline in ovarian follicular activity. Hormonal alteration results in various physical, psychological, and sexual changes in menopausal women. Associated dermatological problems can be classified as physiological changes, age-related changes, changes due to estrogen deficiency and due to hormone replacement therapy. Dermatosis seen due to estrogen deficiency includes Atrophic Vulvovaginitis, Vulvar Lichen Sclerosus, Dyaesthetic Vulvodynia, Hirsutism, Alopecia, Menopausal Flushing, Keratoderma Climactericum, Vulvovaginal Candidiasis. Dermatologists and gynecologists need to be familiar with the problems of menopausal women, as with increase in life expectancy, women passing through this phase is rising. PMID:25540566

  1. Metabolic disorders in menopause

    PubMed Central

    Pertyński, Tomasz; Pertyńska-Marczewska, Magdalena

    2015-01-01

    Metabolic disorders occurring in menopause, including dyslipidemia, disorders of carbohydrate metabolism (impaired glucose tolerance – IGT, type 2 diabetes mellitus – T2DM) or components of metabolic syndrome, constitute risk factors for cardiovascular disease in women. A key role could be played here by hyperinsulinemia, insulin resistance and visceral obesity, all contributing to dyslipidemia, oxidative stress, inflammation, alter coagulation and atherosclerosis observed during the menopausal period. Undiagnosed and untreated, metabolic disorders may adversely affect the length and quality of women's life. Prevention and treatment preceded by early diagnosis should be the main goal for the physicians involved in menopausal care. This article represents a short review of the current knowledge concerning metabolic disorders (e.g. obesity, polycystic ovary syndrome or thyroid diseases) in menopause, including the role of a tailored menopausal hormone therapy (HT). According to current data, HT is not recommend as a preventive strategy for metabolic disorders in menopause. Nevertheless, as part of a comprehensive strategy to prevent chronic diseases after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered (after balancing benefits/risks and excluding women with absolute contraindications to this therapy). Life-style modifications, with moderate physical activity and healthy diet at the forefront, should be still the first choice recommendation for all patients with menopausal metabolic abnormalities. PMID:26327890

  2. Menopause in the workplace: What employers should be doing.

    PubMed

    Jack, Gavin; Riach, Kathleen; Bariola, Emily; Pitts, Marian; Schapper, Jan; Sarrel, Philip

    2016-03-01

    Large numbers of women transition through menopause whilst in paid employment. Symptoms associated with menopause may cause difficulties for working women, especially if untreated, yet employers are practically silent on this potentially costly issue. This review summarises existing research on the underexplored topic of menopause in the workplace, and synthesises recommendations for employers. Longstanding scholarly interest in the relationship between employment status and symptom reporting typically (but not consistently) shows that women in paid employment (and in specific occupations) report fewer and less severe symptoms than those who are unemployed. Recent studies more systematically focused on the effects of menopausal symptoms on work are typically cross-sectional self-report surveys, with a small number of qualitative studies. Though several papers established that vasomotor (and associated) symptoms have a negative impact on women's productivity, capacity to work and work experience, this is not a uniform finding. Psychological and other somatic symptoms associated with menopause can have a relatively greater negative influence. Physical (e.g., workplace temperature and design) and psychosocial (e.g., work stress, perceptions of control/autonomy) workplace factors have been found to influence the relationship between symptoms and work. Principal recommendations for employers to best support menopausal women as part of a holistic approach to employee health and well-being include risk assessments to make suitable adjustments to the physical and psychosocial work environment, provision of information and support, and training for line managers. Limitations of prior studies, and directions for future research are presented.

  3. Menopause in the workplace: What employers should be doing.

    PubMed

    Jack, Gavin; Riach, Kathleen; Bariola, Emily; Pitts, Marian; Schapper, Jan; Sarrel, Philip

    2016-03-01

    Large numbers of women transition through menopause whilst in paid employment. Symptoms associated with menopause may cause difficulties for working women, especially if untreated, yet employers are practically silent on this potentially costly issue. This review summarises existing research on the underexplored topic of menopause in the workplace, and synthesises recommendations for employers. Longstanding scholarly interest in the relationship between employment status and symptom reporting typically (but not consistently) shows that women in paid employment (and in specific occupations) report fewer and less severe symptoms than those who are unemployed. Recent studies more systematically focused on the effects of menopausal symptoms on work are typically cross-sectional self-report surveys, with a small number of qualitative studies. Though several papers established that vasomotor (and associated) symptoms have a negative impact on women's productivity, capacity to work and work experience, this is not a uniform finding. Psychological and other somatic symptoms associated with menopause can have a relatively greater negative influence. Physical (e.g., workplace temperature and design) and psychosocial (e.g., work stress, perceptions of control/autonomy) workplace factors have been found to influence the relationship between symptoms and work. Principal recommendations for employers to best support menopausal women as part of a holistic approach to employee health and well-being include risk assessments to make suitable adjustments to the physical and psychosocial work environment, provision of information and support, and training for line managers. Limitations of prior studies, and directions for future research are presented. PMID:26857886

  4. Understanding and Managing Menopause | NIH MedlinePlus the Magazine

    MedlinePlus

    ... life," is different for each woman. For example, hot flashes and sleep problems may trouble your sister. ... But you might not have menopause symptoms like hot flashes right then because if your ovaries are ...

  5. Exercise in the menopausal woman.

    PubMed

    Shangold, M M

    1990-04-01

    An exercise program for menopausal women that includes both aerobic and resistance training may prevent or relieve problems such as cardiovascular disease, obesity, muscle weakness, osteoporosis, and depression. The risk of cardiovascular disease increases in women after menopause; in both men and women, regular aerobic exercise may improve cardiorespiratory endurance and reduce the risk of cardiovascular disease. Aerobic exercise also prevents some age-related increases in body fat and it elevates resting metabolic rate, which correlates directly with lean body mass. Inactivity, not hormonal change, is the most common cause of obesity. Resistance training can improve muscle strength and bone density. Increases in bone mineral content have been found at lumbar vertebral and distal radial sites in women who participate in exercise programs. Weight-bearing exercise in conjunction with estrogen replacement therapy and calcium supplementation helps to prevent osteoporosis. Many women experience mood changes at menopause. Some of these symptoms are caused by chronic sleep deprivation due to night flushes and respond best to estrogen; others are related to levels of brain chemicals and respond favorably to exercise. PMID:2179791

  6. Exercise in the menopausal woman.

    PubMed

    Shangold, M M

    1990-04-01

    An exercise program for menopausal women that includes both aerobic and resistance training may prevent or relieve problems such as cardiovascular disease, obesity, muscle weakness, osteoporosis, and depression. The risk of cardiovascular disease increases in women after menopause; in both men and women, regular aerobic exercise may improve cardiorespiratory endurance and reduce the risk of cardiovascular disease. Aerobic exercise also prevents some age-related increases in body fat and it elevates resting metabolic rate, which correlates directly with lean body mass. Inactivity, not hormonal change, is the most common cause of obesity. Resistance training can improve muscle strength and bone density. Increases in bone mineral content have been found at lumbar vertebral and distal radial sites in women who participate in exercise programs. Weight-bearing exercise in conjunction with estrogen replacement therapy and calcium supplementation helps to prevent osteoporosis. Many women experience mood changes at menopause. Some of these symptoms are caused by chronic sleep deprivation due to night flushes and respond best to estrogen; others are related to levels of brain chemicals and respond favorably to exercise.

  7. The role of traditional Japanese medicine (Kampo) in the practice of psychosomatic medicine: the usefulness of Kampo in the treatment of the stress-related symptoms of women, especially those with peri-menopausal disorder.

    PubMed

    Ushiroyama, Takahisa

    2013-10-22

    A serious problem currently plaguing the medical field is the widening gap between academic medicine, which studies the features and causes of illness, and the medical care that patients desire. An example of this gap can be observed in the practice of psychotherapy, which is effective only for certain patients. Kampo medicine that combines the advantages of Western medicine with those of traditional Japanese medicine is currently undergoing a revival in the healthcare sector. The therapeutic policies underlying Kampo medicine are based on the physical constitution and current symptoms of each patient. For this reason, Kampo medicine is referred to as "tailor-made medicine" and has properties similar to "mind and body" or psychosomatic medicine. Some women exhibit multiple undefined stress-related symptoms during the peri-menopausal period. In order to accurately diagnose and provide patient-specific treatment, physicians should not only investigate the various stress factors in patients' lives but should also provide a Sho, or a Kampo diagnosis. The therapeutic approach in Kampo medicine is aimed at harmonizing the mind, body, and spirit; this practice involves the use of narrative and holistic medication that treats the entire being of the patient, resulting in an increased number of specialized treatment plans.There are many Kampo prescriptions tailored to treat women who exhibit various stress-related symptoms. Both Kampo and psychosomatic medicine are based on the principles of narrative-based medicine, and by integrating these two medical systems, an ideal system can be devised to better cope with the various needs of patients. This new medical system established by integrating and harmonizing Western and Eastern medicine can be used for the treatment of women with stress-related symptoms.

  8. Managing Depression during the Menopausal Transition

    ERIC Educational Resources Information Center

    Pearson, Quinn M.

    2010-01-01

    The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling…

  9. HIV and the menopause.

    PubMed

    Fan, Maria D; Maslow, Bat-Sheva; Santoro, Nanette; Schoenbaum, Ellie

    2008-12-01

    Dramatic improvement in the survival of the HIV population has occurred with the ascendance of highly active antiretroviral therapy (HAART). In the foreseeable future, HIV-infected women who acquired disease during the peak years of the epidemic are expected to survive to experience menopause and even years beyond. The HIV epidemic may be viewed as 'mature', as its earlier victims become part of the geriatric population. Research about the process of menopause in HIV-infected women and, conversely, about HIV infection in women undergoing menopause is currently limited. Existing research suggests that the process of menopause is affected by HIV infection, inasmuch as infected women appear to experience menopause at an earlier age, with greater symptomatology, and with different reproductive hormone profiles compared with HIV-uninfected women. HIV infection also appears to affect bone mineral density, cardiovascular disease and cognition, with some age-related interactions. Lifestyle and demographic factors have pervasive importance for both HIV infection and the menopause in women. This article reviews the current state of knowledge about the menopausal process in HIV-infected women, and the common conditions in postmenopausal women that are likely to be affected by HIV infection. Clinicians should appreciate the potential role of HIV infection in caring for menopause-aged women. PMID:19037065

  10. Menopause and Methodological Doubt

    ERIC Educational Resources Information Center

    Spence, Sheila

    2005-01-01

    Menopause and methodological doubt begins by making a tongue-in-cheek comparison between Descartes' methodological doubt and the self-doubt that can arise around menopause. A hermeneutic approach is taken in which Cartesian dualism and its implications for the way women are viewed in society are examined, both through the experiences of women…

  11. Guidelines for dietary management of menopausal women with simple obesity

    PubMed Central

    Piecha, Dariusz; Nowak, Justyna; Koszowska, Aneta; Kulik-Kupka, Karolina; Dittfeld, Anna; Zubelewicz-Szkodzińska, Barbara

    2015-01-01

    The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient's needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause. PMID:26327888

  12. Guidelines for dietary management of menopausal women with simple obesity.

    PubMed

    Brończyk-Puzoń, Anna; Piecha, Dariusz; Nowak, Justyna; Koszowska, Aneta; Kulik-Kupka, Karolina; Dittfeld, Anna; Zubelewicz-Szkodzińska, Barbara

    2015-03-01

    The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman's life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient's needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.

  13. Managing menopause.

    PubMed

    Reid, Robert; Abramson, Beth L; Blake, Jennifer; Desindes, Sophie; Dodin, Sylvie; Johnston, Shawna; Rowe, Timothy; Sodhi, Namrita; Wilks, Penny; Wolfman, Wendy; Fortier, Michel; Reid, Robert; Abramson, Beth L; Blake, Jennifer; Desindes, Sophie; Dodin, Sylvie; Graves, Lisa; Guthrie, Bing; Khan, Aliya; Johnston, Shawna; Rowe, Timothy; Sodhi, Namrita; Wilks, Penny; Wolfman, Wendy

    2014-09-01

    Objectif : Offrir, aux fournisseurs de soins de santé, une mise à jour de la directive clinique quant à la prise en charge de la ménopause chez les femmes asymptomatiques en santé, ainsi que chez les femmes qui présentent des symptômes vasomoteurs ou urogénitaux; cette mise à jour se penche également sur les facteurs associés à la maladie cardiovasculaire, au cancer du sein, à l’urogynécologie et à la sexualité. Issues : Les interventions quant au mode de vie, les médicaments d’ordonnance et les traitements de médecine complémentaire et parallèle sont présentés en fonction de leur efficacité dans la prise en charge des symptômes ménopausiques. Des stratégies de counseling et thérapeutiques en ce qui concerne les préoccupations en matière de sexualité au cours de la périménopause et de la postménopause sont passées en revue. Des approches quant à l’identification et à l’évaluation des femmes exposées à un risque élevé d’ostéoporose (ainsi que des options en matière de prévention et de traitement) sont présentées dans la directive clinique sur l’ostéoporose qui accompagne les présentes. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed et The Cochrane Library, en août et en septembre 2012, au moyen d’un vocabulaire contrôlé (p. ex. « hormone replacement therapy », « menopause », « cardiovascular diseases » et « sexual function ») et de mots clés (p. ex. « HRT », « perimenopause », « heart disease » et « sexuality »). Les résultats ont été restreints aux directives cliniques, aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Les résultats ont également été restreints aux documents publiés, en anglais ou en français, à partir de 2009. Les recherches ont été mises à jour de façon régulière et intégrées à la

  14. Hand osteoarthritis, menopause and menopausal hormone therapy.

    PubMed

    Watt, Fiona E

    2016-01-01

    Hand osteoarthritis (OA) is one of the commonest musculoskeletal conditions, primarily affecting women over the age of 50, typically around the age of the menopause. Symptomatic disease can give rise to substantial pain, impairment of hand function and quality of life, leading to significant socioeconomic cost. There is currently no disease-modifying therapy, representing a huge unmet clinical need. The evidence for a relationship between hand OA and the menopause is summarised. Whether there is evidence for an effect of menopausal hormonal therapy on the incidence, prevalence or severity of symptomatic hand OA is critically reviewed, and gaps in our knowledge identified. Lastly, the potential mechanisms by which estrogen, or newer agents such as SERMs, might act to interfere with disease pathogenesis are overviewed. The need for specifically designed, controlled trials of agents in cohorts with symptomatic hand OA, refractory to standard symptomatic management is highlighted.

  15. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

    PubMed Central

    Daily, James W.; Yang, Mini

    2016-01-01

    Abstract Although turmeric and its curcumin-enriched extracts have been used for treating arthritis, no systematic review and meta-analysis of randomized clinical trials (RCTs) have been conducted to evaluate the strength of the research. We systemically evaluated all RCTs of turmeric extracts and curcumin for treating arthritis symptoms to elucidate the efficacy of curcuma for alleviating the symptoms of arthritis. Literature searches were conducted using 12 electronic databases, including PubMed, Embase, Cochrane Library, Korean databases, Chinese medical databases, and Indian scientific database. Search terms used were “turmeric,” “curcuma,” “curcumin,” “arthritis,” and “osteoarthritis.” A pain visual analogue score (PVAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were used for the major outcomes of arthritis. Initial searches yielded 29 articles, of which 8 met specific selection criteria. Three among the included RCTs reported reduction of PVAS (mean difference: −2.04 [−2.85, −1.24]) with turmeric/curcumin in comparison with placebo (P < .00001), whereas meta-analysis of four studies showed a decrease of WOMAC with turmeric/curcumin treatment (mean difference: −15.36 [−26.9, −3.77]; P = .009). Furthermore, there was no significant mean difference in PVAS between turmeric/curcumin and pain medicine in meta-analysis of five studies. Eight RCTs included in the review exhibited low to moderate risk of bias. There was no publication bias in the meta-analysis. In conclusion, these RCTs provide scientific evidence that supports the efficacy of turmeric extract (about 1000 mg/day of curcumin) in the treatment of arthritis. However, the total number of RCTs included in the analysis, the total sample size, and the methodological quality of the primary studies were not sufficient to draw definitive conclusions. Thus, more rigorous and larger studies are needed to confirm the therapeutic efficacy

  16. Reproductive Hormones and the Menopause Transition

    PubMed Central

    Santoro, Nanette; Randolph, John F

    2011-01-01

    The hormonal correlates of reproductive aging and the menopause transition reflect an initial loss of the follicle cohort, while a responsive ovary remains, and an eventual complete loss of follicle response, with persistent hypergonadotropic amenorrhea. The physiology of the process is described, along with key findings of relevant studies, with an emphasis on SWAN, the Study of Women’s Health Across the Nation. A clinical framework is provided to help clinicians forecast the major milestones of the menopausal transition and to predict potential symptoms or disease. PMID:21961713

  17. Treatment of the genitourinary syndrome of menopause.

    PubMed

    Palacios, S; Mejía, A; Neyro, J L

    2015-01-01

    The vagina, vulva, vestibule, labia majora/minora, and bladder trigone have a high concentration of estrogen receptors; therefore, they are a sensitive biological indicator of serum levels of these hormones in women. The estrogen loss in postmenopausal women produces a dysfunction called genitourinary syndrome of menopause. The principal therapeutic goal in the genitourinary syndrome of menopause is to relieve symptoms. Treatment options, as well as local and systemic hormonal treatment are changes in lifestyle and non-hormonal treatments mainly based on the use of moisturizers and lubricants. New treatments that have recently appeared are ospemifeme, the first selective hormone receptor modulator for dyspareunia and vulvovaginal atrophy treatment, and the use of vaginal laser. This review has been written with the intention of giving recommendations on the prevention and treatment of genitourinary syndrome of menopause. PMID:26366797

  18. Perspectives on menopause and women with HIV

    PubMed Central

    Andany, Nisha; Kennedy, V Logan; Aden, Muna; Loutfy, Mona

    2016-01-01

    Since the implementation of effective combination antiretroviral therapy, HIV infection has been transformed from a life-threatening condition into a chronic disease. As people with HIV are living longer, aging and its associated manifestations have become key priorities as part of HIV care. For women with HIV, menopause is an important part of aging to consider. Women currently represent more than one half of HIV-positive individuals worldwide. Given the vast proportion of women living with HIV who are, and will be, transitioning through age-related life events, the interaction between HIV infection and menopause must be addressed by clinicians and researchers. Menopause is a major clinical event that is universally experienced by women, but affects each individual woman uniquely. This transitional time in women’s lives has various clinical implications including physical and psychological symptoms, and accelerated development and progression of other age-related comorbidities, particularly cardiovascular disease, neurocognitive dysfunction, and bone mineral disease; all of which are potentially heightened by HIV or its treatment. Furthermore, within the context of HIV, there are the additional considerations of HIV acquisition and transmission risk, progression of infection, changes in antiretroviral pharmacokinetics, response, and toxicities. These menopausal manifestations and complications must be managed concurrently with HIV, while keeping in mind the potential influence of menopause on the prognosis of HIV infection itself. This results in additional complexity for clinicians caring for women living with HIV, and highlights the shifting paradigm in HIV care that must accompany this aging and evolving population. PMID:26834498

  19. Working women and the menopause.

    PubMed

    Kopenhager, T; Guidozzi, F

    2015-06-01

    Women are living longer, working more and retiring later. About 45% of the over 50-year-old workforce in virtually all forms of employment are women, all of whom will experience the menopause and its symptoms, which in some women will be mild to moderate, whilst in others they may be severe and debilitating. About half of these women will find it somewhat, or fairly difficult, to cope with their work, about half will not be affected and only about 5% will be severely compromised. Poor concentration, tiredness, poor memory, depression, feeling low, lowered confidence, sleepiness and particularly hot flushes are all cited as contributing factors. As with any longstanding health-related condition, the need for support and understanding from line management is crucial and can make a major difference to how a woman will deal with the adverse impact the menopausal symptoms may have on her productivity, her job satisfaction and her efficiency. A number of plausible strategies have been proposed that can be realistically implemented in the workplace and which could certainly make a significant difference. Careful thought, planning, consideration and effort may be required but, if instituted, they will, in the final analysis, benefit both employer and employee.

  20. Menopause, only for women? The social construction of menopause as an exclusively female condition.

    PubMed

    Oudshoorn, N E

    1997-06-01

    Over the last three decades the menopause has continued to interest the medical profession, the pharmaceutical industry and the mass media. Although there exist many different views on the menopause, there is one common denominator. Menopause is depicted as an exclusively female condition. The medical discourse on menopause seems to exclude men. However, a closer look at the history of the medical sciences reveals that there have been and still are, attempts to classify symptoms of ageing men as male menopause or climacterium. Despite these attempts to put men on the menopausal agenda, most attention is focused on women. How can we understand this almost exclusive focus on female bodies? Why does there exist such an emphasis on the medicalization of the third age of women rather than of men? Maybe we might be inclined to think of a male conspiracy, as has been suggested by feminists: women take the pills, while men cash the bills. We might consider the enormous profits of the pharmaceutical industry. This paper is concerned with finding an alternative explanation for the almost exclusive attention for the female menopause. Based on historical data and more recent discussions in medical journals, the paper shows that the medicalization of the female menopause and the relative silence around the male climacterium can be understood in terms of the social and cultural processes that underly the classification of health problems as specific diseases. The imbalance in medical treatment of climacteric health problems in women and men is not simply rooted in biological sex differences, but can be ascribed to men's attitudes towards health problems and organizational infrastructures of the medical institutions.

  1. Evaluation of menopausal interventions at a Japanese company.

    PubMed

    Ariyoshi, Hiromi

    2009-03-01

    The purpose of this research was to evaluate the impact of interventions for menopausal symptoms among employees at a newspaper company in Japan and to clarify the role of the occupational health nurse. Since 2000, the company has focused on creating a comfortable work environment for its female employees. As part of this effort, this research study also aimed to evaluate a system to support employees experiencing menopausal symptoms. Methods of evaluation included surveys of current employees or former employees with symptoms of menopause and case studies of three women. As a result of these data, it became clear that differentiating between menopausal disorders and mental health issues was not always easy. However, comparisons before and after implementing changes in the health system revealed that the number of women describing symptoms of menopause decreased from 5 to 0, and the number of women retiring, dying while still employed, or taking more than 4 days of sick leave in a month decreased from 3 to 0. This research revealed that interventions for menopause, similar to mental health interventions, require specific human resources and systemic support.

  2. Skin academy: hair, skin, hormones and menopause - current status/knowledge on the management of hair disorders in menopausal women.

    PubMed

    Blume-Peytavi, Ulrike; Atkin, Stephen; Gieler, Uwe; Grimalt, Ramon

    2012-01-01

    Menopause is defined by 12 months of amenorrhea after the final menstrual period. The reduction in ovarian hormones and increased androgen levels can manifest as hair and skin disorders. Although hirsutism, unwanted facial hair, alopecia, skin atrophy and slackness of facial skin are common issues encountered by post-menopausal women, these problems receive very little attention relative to other menopausal symptoms. The visibility of these disorders has been shown to cause significant anxiety and may impact on patients' self-esteem and quality of life, particularly given the strong association of hair and skin with a woman's femininity and beauty, which is demonstrated by extensive marketing by the cosmetic industry targeting this population and the large expenditure on these products by menopausal women. The proportion of the female population who are in the post-menopausal age group is rising. Therefore, the prevalence of these dermatological symptoms is likely to increase. Current therapies aim to rectify underlying hormonal imbalances and improve cosmetic appearance. However, there is little evidence to support treatment for these disorders specifically in post-menopausal women. This review discusses the assessment and treatment of both the physiological and psychological aspects of hair and skin disorders pertinent to the growing post-menopausal population. PMID:22503791

  3. Menopause accelerates biological aging.

    PubMed

    Levine, Morgan E; Lu, Ake T; Chen, Brian H; Hernandez, Dena G; Singleton, Andrew B; Ferrucci, Luigi; Bandinelli, Stefania; Salfati, Elias; Manson, JoAnn E; Quach, Austin; Kusters, Cynthia D J; Kuh, Diana; Wong, Andrew; Teschendorff, Andrew E; Widschwendter, Martin; Ritz, Beate R; Absher, Devin; Assimes, Themistocles L; Horvath, Steve

    2016-08-16

    Although epigenetic processes have been linked to aging and disease in other systems, it is not yet known whether they relate to reproductive aging. Recently, we developed a highly accurate epigenetic biomarker of age (known as the "epigenetic clock"), which is based on DNA methylation levels. Here we carry out an epigenetic clock analysis of blood, saliva, and buccal epithelium using data from four large studies: the Women's Health Initiative (n = 1,864); Invecchiare nel Chianti (n = 200); Parkinson's disease, Environment, and Genes (n = 256); and the United Kingdom Medical Research Council National Survey of Health and Development (n = 790). We find that increased epigenetic age acceleration in blood is significantly associated with earlier menopause (P = 0.00091), bilateral oophorectomy (P = 0.0018), and a longer time since menopause (P = 0.017). Conversely, epigenetic age acceleration in buccal epithelium and saliva do not relate to age at menopause; however, a higher epigenetic age in saliva is exhibited in women who undergo bilateral oophorectomy (P = 0.0079), while a lower epigenetic age in buccal epithelium was found for women who underwent menopausal hormone therapy (P = 0.00078). Using genetic data, we find evidence of coheritability between age at menopause and epigenetic age acceleration in blood. Using Mendelian randomization analysis, we find that two SNPs that are highly associated with age at menopause exhibit a significant association with epigenetic age acceleration. Overall, our Mendelian randomization approach and other lines of evidence suggest that menopause accelerates epigenetic aging of blood, but mechanistic studies will be needed to dissect cause-and-effect relationships further. PMID:27457926

  4. Risk of Psychiatric Disorders Following Symptomatic Menopausal Transition

    PubMed Central

    Hu, Li-Yu; Shen, Cheng-Che; Hung, Jeng-Hsiu; Chen, Pan-Ming; Wen, Chun-Hsien; Chiang, Yung-Yen; Lu, Ti

    2016-01-01

    Abstract Menopausal transition is highly symptomatic in at least 20% of women. A higher prevalence of psychiatric symptoms, including depression, anxiety, and sleep disturbance, has been shown in women with symptomatic menopausal transition. However, a clear correlation between symptomatic menopausal transition and psychiatric disorders has not been established. We explored the association between symptomatic menopausal transition and subsequent newly diagnosed psychiatric disorders, including schizophrenia as well as bipolar, depressive, anxiety, and sleep disorders. We investigated women who were diagnosed with symptomatic menopausal transition by an obstetrician-gynecologist according to the data in the Taiwan National Health Insurance Research Database. A comparison cohort comprised age-matched women without symptomatic menopausal transition. The incidence rate and the hazard ratios of subsequent newly diagnosed psychiatric disorders were evaluated in both cohorts, based on the diagnoses of psychiatrists. The symptomatic menopausal transition and control cohorts each consisted of 19,028 women. The incidences of bipolar disorders (hazard ratio [HR] = 1.69, 95% confidence interval [CI] = 1.01–2.80), depressive disorders (HR = 2.17, 95% CI = 1.93–2.45), anxiety disorders (HR = 2.11, 95% CI = 1.84–2.41), and sleep disorders (HR = 2.01, 95% CI = 1.73–2.34) were higher among the symptomatic menopausal transition women than in the comparison cohort. After stratifying for follow-up duration, the incidence of newly diagnosed bipolar disorders, depressive disorders, anxiety disorders, and sleep disorders following a diagnosis of symptomatic menopausal transition remained significantly increased in the longer follow-up groups (1–5 and ≥ 5 years). Symptomatic menopausal transition might increase the risk of subsequent newly onset bipolar disorders, depressive disorders, anxiety disorders, and sleep disorders. A prospective study

  5. Toward a Biology of Menopause.

    ERIC Educational Resources Information Center

    Goodman, Madeleine

    1980-01-01

    Discusses research dealing with the study of menopause. Underscores the problems with the case study method. Discusses two population-based studies and the problems of age adjustment and measurement in menopause research. Highlights alternate research strategies. (MK)

  6. Phytoestrogens as alternative hormone replacement therapy in menopause: What is real, what is unknown.

    PubMed

    Moreira, Ana C; Silva, Ana M; Santos, Maria S; Sardão, Vilma A

    2014-09-01

    Menopause is characterized by an altered hormonal status and by a decrease in life quality due to the appearance of uncomfortable symptoms. Nowadays, with increasing life span, women spend one-third of their lifetime under menopause. Understanding menopause-associated pathophysiology and developing new strategies to improve the treatment of menopausal-associated symptoms is an important topic in the clinic. This review describes physiological and hormone alterations observed during menopause and therapeutic strategies used during this period. We critically address the benefits and doubts associated with estrogen/progesterone-based hormone replacement therapy (HRT) and discuss the use of phytoestrogens (PEs) as a possible alternative. These relevant plant-derived compounds have structural similarities to estradiol, interacting with cell proteins and organelles, presenting several advantages and disadvantages versus traditional HRT in the context of menopause. However, a better assessment of PEs safety/efficacy would warrant a possible widespread clinical use.

  7. Poor sleep in middle-aged women is not associated with menopause per se.

    PubMed

    Tao, M F; Sun, D M; Shao, H F; Li, C B; Teng, Y C

    2016-01-01

    Whether sleep problems of menopausal women are associated with vasomotor symptoms and/or changes in estrogen levels associated with menopause or age-related changes in sleep architecture is unclear. This study aimed to determine if poor sleep in middle-aged women is correlated with menopause. This study recruited women seeking care for the first time at the menopause outpatient department of our hospital. Inclusion criteria were an age ≥40 years, not taking any medications for menopausal symptoms, and no sleeping problems or depression. Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), modified Kupperman Index (KI), and Menopause Rating Scale (MRS). A PSQI score of <7 indicated no sleep disorder and ≥7 indicated a sleep disorder. Blood specimens were analyzed for follicle-stimulating hormone and estradiol levels. A total of 244 women were included in the study; 103 (42.2%) were identified as having a sleep disorder and 141 as not having one. In addition, 156 (64%) women were postmenopausal and 88 (36%) were not menopausal. Follicle-stimulating hormone and estradiol levels were similar between the groups. Patients with a sleep disorder had a significantly higher total modified KI score and total MRS score (both, P<0.001) compared with those without a sleep disorder. Correlations of the PSQI total score with the KI and MRS were similar in menopausal and non-menopausal women. These results do not support that menopause per se specifically contributes to sleep problems.

  8. Alternative treatments for the menopause.

    PubMed

    Rees, Margaret

    2009-02-01

    Concerns about the safety of oestrogen-based hormone replacement therapy after publication of the Women's Health Initiative study and Million Women Study has led to women turning to alternative therapies, erroneously believing that they are safer and 'more natural'. Evidence from randomized trials that alternative and complementary therapies improve menopausal symptoms or have the same benefits as conventional pharmacopoeia is poor. There are no recognized international criteria for the design of clinical trials of alternative therapies as there are for standard medicines and medical devices for endpoints of treatment and safety evaluations. Studies may have limitations such as design, sample size and duration. There is a wide range of different preparations, making comparison difficult. The evidence regarding botanicals, homeopathy, steroids, vitamin supplements, dietary changes and functional foods, and physical interventions are discussed in this chapter. Standard pharmacopoeia such as clonidine, selective serotonin re-uptake inhibitors and progestogens are also examined.

  9. Endometriosis after menopause.

    PubMed

    Inceboz, Umit

    2015-08-01

    Endometriosis is a common but an enigmatic disease in which endometrial glands and stroma are found outside the uterus. Worldwide, 80 million women are affected by the disease. It has generally been accepted as a problem of reproductive ages and affects 6-10% of those women. It is more common in women with infertility. Moreover, since it is an estrogen dependent problem, it is generally believed that endometriosis connotes 'active ovarian function' and is 'healed' after the menopause. However, there are reports on endometriosis beyond the reproductive ages. In this article, endometriosis after the menopause will be discussed.

  10. Novel use of the ovarian follicular pool to postpone menopause and delay osteoporosis.

    PubMed

    Andersen, Claus Yding; Kristensen, Stine Gry

    2015-08-01

    Life expectancy has increased by more than 30 years during the last century and continues to increase. Many women already live decades in menopause deprived of naturally produced oestradiol and progesterone, leading to an increasing incidence of menopause-related disorders such as osteoporosis, cardiovascular diseases and lack of general well-being. Exogenous oestradiol has traditionally been used to alleviate menopause-related effects. This commentary discusses a radical new method to postpone menopause. Part of the enormous surplus of ovarian follicles can now be cryostored in youth for use after menopause. Excision of ovarian tissue will advance menopause marginally and will not reduce natural fertility. Grafted tissue restores ovarian function with circulating concentrations of sex steroids for years in post-menopausal cancer survivors. Future developments may further utilize the enormous store of ovarian follicles. Currently, the main goal of ovarian cryopreservation is fertility preservation, but grafting of ovarian tissue may also serve endocrine functions as a physiological solution to prevent the massive medical legacy of osteoporosis and menopause-related conditions in the ageing population. This intriguing solution is now technically available; the question is whether this method qualifies for postponing menopause, perhaps initially for those patients who already have cryostored tissue?

  11. 'Chaos, restitution and quest': one woman's journey through menopause.

    PubMed

    Nosek, Marcianna; Kennedy, Holly Powell; Gudmundsdottir, Maria

    2012-09-01

    Menopause, a natural stage in a woman's reproductive life, is not an illness; yet some women experience severe enough symptoms to cause a breakdown in the body similar to illness or other major health disruptions. As part of a larger narrative analysis investigation of distress during menopause, this case study presents one woman's transformational journey through menopause, analysed through Frank's health and illness narratives - chaos, restitution and quest. The narratives were retranscribed using Labov's elements of a true story and Gee's poetic restructuring. This report of one woman's experience of distress during the menopause transition describes a poetic chaos narrative of incessant night sweats resulting in a loss of physicality and a deep-rooted belief in self-healing; a restitution narrative of restored health that mandated the surrender to a new healing discourse, experienced simultaneously as a victory and a defeat; and a quest narrative of seeking meaning, insight and new-found values and identities. PMID:22471763

  12. Sleep disorders in menopause: results from an Italian Multicentric Study.

    PubMed

    Fabbrini, Monica; AricÃ, Irene; Tramonti, Francesco; Condurso, Rosaria; Carnicelli, Luca; De Rosa, Anna; Di Perri, Caterina; Bonsignore, Maria Rosaria; Zito, Anna; Russo, Giovanna; Pagliarulo, Maria Giovanna; Guarnieri, Biancamaria; Cerroni, Gianluigi; Mennuni, Gianfranco; Della Marca, Giacomo; Bonanni, Enrica; Silvestri, Rosalia

    2015-01-01

    Menopause in the female life cycle is a special period due to important hormonal, physical and psychological changes. Sleep disruption represents a common complaint for midlife and menopausal women, related to primary sleep disorders, including insomnia, sleep disordered breathing, restless legs syndrome (RLS), mood and anxiety disorder, other medical illness, hormonal-related vasomotor symptoms, and aging per se. Aims of our study were to evaluate the prevalence of sleep disorders in a sample of pre and post menopausal women, and to investigate the relationship between sleep and other medical disorders, and life habits. Among workers in the six participant centers, we enrolled 334 women, aged between 40 and 60 years, that completed a questionnaire that included screening on menarche, menstrual cycle, fertility, parity, menopause, life habits, personal medical and sleep history and related treatment, and self-administered scales for sleep quality (PSQI), excessive daytime sleepiness [Epworth Sleepiness Scale (ESS)], mood disorder [Beck Depression Inventory (BDI)], Berlin Questionnaire for sleep disordered breathing (SDB), IRLS diagnostic interview and Rating Scale. Menopausal and perimenopausal women showed an increased prevalence of poor sleep, high risk of SDB, and mood disorder; menopausal women also reported increased RLS severity. Mood disorder had a significant impact on night sleep measures and excessive daytime sleepiness, as well as on RLS severity, and had a greater prevalence in hypertensive women. Sleep disturbances are frequent in menopausal women. Their aetiology is unclear, but probably multifactorial, and many factors contribute to the sleep disruption. Our data suggest the importance of correctly investigate and address sleep problems associated with menopause, through sleep history, and a sleep study could be obtained if clinically warranted. Pharmacological and behavioural treatment strategies should then be aimed at improving sleep and life

  13. Effect of reproductive hormones and selective estrogen receptor modulators on mood during menopause.

    PubMed

    Soares, Claudio N; Poitras, Jennifer R; Prouty, Jennifer

    2003-01-01

    Periods of intense hormonal fluctuations have been associated with heightened prevalence and exacerbation of underlying psychiatric illness, particularly the occurrence of premenstrual dysphoria, puerperal depression and depressive symptoms during perimenopause. It has been speculated that sex steroids such as estrogens, progestogens, testosterone and dehydroepiandrosterone (DHEA) exert a significant modulation of brain functioning, possibly through interactions with various neurotransmitter systems. It is therefore intuitive that abrupt alterations of these hormones would interfere with mood and behaviour. On the other hand, accumulating data suggest that hormonal interventions may also promote relief or even remission of depressive symptoms, as already demonstrated in studies with patients experiencing postpartum depression and perimenopausal depressive disorders. The extent to which perimenopause, alone, may increase the risk for depression is unclear. However, existing data strongly suggest that some women are particularly vulnerable to developing significant physical and psychological disturbances when entering perimenopause. This article reviews the effect of sex hormones and selective estrogen receptor modulators (SERMs) on mood among peri- and postmenopausal women. There are preliminary, though promising, data on the use of estradiol (particularly transdermal estradiol) to alleviate depression during perimenopause, use of a combination of estrogens and selective serotonin reuptake inhibitors for depression during the postmenopausal period, and the use of testosterone to improve psychological well-being and increase libido among women with induced menopause. Further studies would help to better delineate the usage of hormones as an antidepressant strategy (monotherapy or augmenting treatment) for peri- and postmenopausal women. A brief review of some nonhormonal interventions for the treatment of menopause-related symptoms that may significantly affect a

  14. Exploring Australian Aboriginal Women’s experiences of menopause: a descriptive study

    PubMed Central

    2014-01-01

    Background Despite extensive literature demonstrating differing experiences in menopause around the world, documentation of the experience of menopause in Australian Aboriginal women is scarce, and thus their menopausal experience is relatively unknown. This study aimed to understand Australian Aboriginal women’s understanding and experience of menopause and its impact on their lives. Methods The study was an exploratory qualitative study. Twenty-five Aboriginal women were recruited from a regional centre in the Mid-West region of Western Australia using opportunistic and snowballing sampling. Interviews and focus group discussions were undertaken from February 2011 to February 2012 using open-ended questioning with a yarning technique. Thematic analysis was undertaken of the transcribed interviews. Results A number of themes were revealed. These related to the language used, meanings and attitudes to menopause, symptoms experienced, the role of men, a lack of understanding, coping mechanisms and the attribution of menopausal changes to something else. The term “change of life” was more widely recognised and signified the process of ageing, and an associated gain of respect in the local community. A fear of menopausal symptoms or uncertainty about their origin was also common. Overall, many women reported insufficient understanding and a lack of available information to assist them and their family to understand the transition. Conclusion There are similarities between Aboriginal and non-Aboriginal experiences of menopause, including similar symptom profiles. The current language used within mainstream health settings may not be appropriate to this population if it fails to recognise the importance of language and reflect the attributed meaning of menopause. The fear of symptoms and uncertainty of their relationship to menopause demonstrated a need for more information which has not adequately been supplied to Australian Aboriginal women through current

  15. What Are the Symptoms of Menopause?

    MedlinePlus

    ... 2006). Extent and health consequences of chronic sleep loss and sleep disorders. In Colten, H. R., & Altevogt, B. M. (Eds.), Sleep disorders and sleep deprivation: An unmet public health problem (page 55). Washington, ...

  16. Class, gender and culture in the experience of menopause. A comparative survey in Tunisia and France.

    PubMed

    Delanoë, Daniel; Hajri, Selma; Bachelot, Annie; Mahfoudh Draoui, Dorra; Hassoun, Danielle; Marsicano, Elise; Ringa, Virginie

    2012-07-01

    The experience of menopause can vary strongly from one society to another: frequency of hot flushes, other somatic and psychological symptoms, and changes in family and social relations. Several studies have shown that country of residence, country of birth, ethnicity, and social class all play roles in these variations. But few comparative anthropological studies have analysed the social processes that construct the experience of menopause or considered menopausal women's social and financial autonomy. To study the impact of the social status accorded to menopausal women and their social resources, during 2007 and 2008 we conducted a series of 75 in-depth interviews with women in different sociocultural settings: Tunisian women in Tunisia, Tunisian women in France, and French women in France, all aged from 45 to 70 years. Our methodological approach to the data included content analysis, typology development and socio-demographic analysis. Quite substantial differences appeared, as a function of social class and cultural environment. We identified three principal experiences of menopause. Tunisian working class women, in Tunisia and France, experience menopause with intense symptoms and strong feelings of social degradation. Among Tunisian middle-class women in both countries, menopause was most often accompanied by a severe decline in aesthetic and social value but few symptoms. For most of the French women, menopause involved few symptoms and little change in their social value. The distribution of types of experiences according to social but not geographic or national factors indicates that, in the populations studied here, the differences in symptoms are not biologically determined. Different experiences of menopause are linked to social class and to the degree of male domination. A given level of independence and emancipation allows women an identity beyond their reproductive function and a status unimpaired by menopause.

  17. "I should live and finish it": A qualitative inquiry into Turkish women's menopause experience

    PubMed Central

    Cifcili, Serap Y; Akman, Mehmet; Demirkol, Abdullah; Unalan, Pemra C; Vermeire, Etienne

    2009-01-01

    Background While bio-medically, menopause could be treated as an illness, from a psychosocial and cultural perspective it could be seen as a "natural" process without requiring medication unless severe symptoms are present. Our objective is to explore the perceptions of Turkish women regarding menopause and Hormone Therapy (HT) to provide health care workers with an insight into the needs and expectations of postmenopausal women. Methods A qualitative inquiry through semi-structured, in-depth interviews was used to explore the study questions. We used a purposive sampling and included an equal number of participants who complained about the climacteric symptoms and those who visited the outpatient department for a problem other than climacteric symptoms but when asked declared that they had been experiencing climacteric symptoms. The interview questions focused on two areas; 1) knowledge, experiences, attitudes and beliefs about menopause and; 2) menopause-related experiences and ways to cope with menopause and perception of HT. Results Most of the participants defined menopause as a natural transition process that one should go through. Cleanliness, maturity, comfort of not having a period and positive changes in health behaviour were the concepts positively attributed to menopause, whereas hot flushes, getting old and difficulties in relationships were the negatives. Osteoporosis was an important concern for most of the participants. To deal with the symptoms, the non-pharmacological options were mostly favoured. Conclusion To our knowledge, this is the first qualitative study which focuses on Turkish women's menopausal experiences. Menopause was thought to be a natural process which was characterised by positive and negative features. Understanding these features and their implications in these women's lives may assist healthcare workers in helping their clients with menopause. PMID:19134179

  18. The efficacy of Iranian herbal medicines in alleviating hot flashes: A systematic review

    PubMed Central

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Abdolahian, Somayeh; Latifnejad Roudsari, Robab

    2016-01-01

    Background: Hot flashes are the most common symptoms experienced by women around the time of menopause. Many women are interested in herbal medicines because of fear of side effects of hormone therapy. Objective: The aim of this systematic review was to assess the effectiveness of Iranian herbal medicines in alleviating hot flashes. Materials and Methods: MEDLINE (1966 to January 2015), Scopus (1996 to January 2015), and Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 1, 2015) were searched along with, SID, Iran Medex, Magiran, Medlib and Irandoc. Nineteen randomized controlled trials met the inclusion criteria. Results: Overall, studies showed that Anise (Pimpinella anisum), licorice (Glycyrrhizaglabra), Soy, Black cohosh, Red clover, Evening primrose, Flaxseed, Salvia officinalis, Passiflora، itex Agnus Castus, Piascledine (Avacado plus soybean oil), St. John's wort (Hypericum perforatum), and valerian can alleviate the side effects of hot flashes. Conclusion: This research demonstrated the efficacy of herbal medicines in alleviating hot flashes, which are embraced both with people and health providers of Iran Therefore, herbal medicine can be seen as an alternative treatment for women experiencing hot flashes. PMID:27294213

  19. The timing hypothesis: Do coronary risks of menopausal hormone therapy vary by age or time since menopause onset?

    PubMed

    Bassuk, Shari S; Manson, JoAnn E

    2016-05-01

    The Women's Health Initiative (WHI), a landmark randomized trial of menopausal hormone therapy (HT) for prevention of chronic disease in postmenopausal women aged 50-79, established that such therapy neither prevents coronary heart disease (CHD) nor yields a favorable balance of benefits and risks in such women as a whole. However, a nuanced look at the data from this trial, considered alongside other evidence, suggests that timing of HT initiation affects the relation between such therapy and coronary risk, as well as its overall benefit-risk balance. Estrogen may have a beneficial effect on the heart if started in early menopause, when a woman's arteries are likely to be relatively healthy, but a harmful effect if started in late menopause, when those arteries are more likely to show signs of atherosclerotic disease. However, even if HT-associated relative risks are constant across age or time since menopause onset, the low absolute risk of CHD in younger or recently menopausal women translates into low attributable risks in this group. Thus, HT initiation for relief of moderate to severe vasomotor symptoms in early menopausal patients who have a favorable coronary profile remains a viable option.

  20. Alleviation of thermoregulatory dysfunction with the new serotonin and norepinephrine reuptake inhibitor desvenlafaxine succinate in ovariectomized rodent models.

    PubMed

    Deecher, Darlene C; Alfinito, Peter D; Leventhal, Liza; Cosmi, Scott; Johnston, Grace H; Merchenthaler, Istvan; Winneker, Richard

    2007-03-01

    Hot flushes and night sweats, referred to as vasomotor symptoms (VMS), are presumed to be a result of declining hormone levels and are the principal menopausal symptoms for which women seek medical treatment. To date, estrogens and/or some progestins are the most effective therapeutics for alleviating VMS; however, these therapies may not be appropriate for all women. Therefore, nonhormonal therapies are being evaluated. The present study investigated a new reuptake inhibitor, desvenlafaxine succinate (DVS), in animal models of temperature dysfunction. Both models used are based on measuring changes in tail-skin temperature (TST) in ovariectomized (OVX) rats. The first relies on naloxone-induced withdrawal in morphine-dependent (MD) OVX rats, resulting in an acute rise in TST. The second depends on an OVX-induced loss of TST decreases during the dark phase as measured by telemetry. An initial evaluation demonstrated abatement of the rise in TST with long-term administration of ethinyl estradiol or with a single oral dose of DVS (130 mg/kg) in the MD model. Further evaluation showed that orally administered DVS acutely and dose dependently (10-100 mg/kg) abated a naloxone-induced rise in TST of MD rats and alleviated OVX-induced temperature dysfunction in the telemetry model. Oral administration of DVS to OVX rats caused significant increases in serotonin and norepinephrine levels in the preoptic area of the hypothalamus, a key region of the brain involved in temperature regulation. These preclinical studies provide evidence that DVS directly impacts thermoregulatory dysfunction in OVX rats and may have utility in alleviating VMS associated with menopause.

  1. Menopausal Estrogen Therapy Benefits and Risks Vary by Age, WHI Analysis Suggests

    Cancer.gov

    Long-term follow-up data from the Women’s Health Initiative (WHI) provide new information about the potential risks and benefits of hormone therapy to treat symptoms related to menopause, including its effect on breast cancer risk,

  2. Insomnia in women approaching menopause: Beyond perception.

    PubMed

    Baker, Fiona C; Willoughby, Adrian R; Sassoon, Stephanie A; Colrain, Ian M; de Zambotti, Massimiliano

    2015-10-01

    The menopausal transition is marked by increased prevalence in disturbed sleep and insomnia, present in 40-60% of women, but evidence for a physiological basis for their sleep complaints is lacking. We aimed to quantify sleep disturbance and the underlying contribution of objective hot flashes in 72 women (age range: 43-57 years) who had (38 women), compared to those who had not (34 women), developed clinical insomnia in association with the menopausal transition. Sleep quality was assessed with two weeks of sleep diaries and one laboratory polysomnographic (PSG) recording. In multiple regression models controlling for menopausal transition stage, menstrual cycle phase, depression symptoms, and presence of objective hot flashes, a diagnosis of insomnia predicted PSG-measured total sleep time (p < 0.01), sleep efficiency (p = 0.01) and wakefulness after sleep onset (WASO) (p = 0.01). Women with insomnia had, on average, 43.5 min less PSG-measured sleep time (p < 0.001). There was little evidence of cortical EEG hyperarousal in insomniacs apart from elevated beta EEG power during REM sleep. Estradiol and follicle stimulating hormone levels were unrelated to beta EEG power but were associated with the frequency of hot flashes. Insomniacs were more likely to have physiological hot flashes, and the presence of hot flashes predicted the number of PSG-awakenings per hour of sleep (p = 0.03). From diaries, women with insomnia reported more WASO (p = 0.002), more night-to-night variability in WASO (p < 0.002) and more hot flashes (p = 0.012) compared with controls. Women who develop insomnia in the approach to menopause have a measurable sleep deficit, with almost 50% of the sample having less than 6h of sleep. Compromised sleep that develops in the context of the menopausal transition should be addressed, taking into account unique aspects of menopause like hot flashes, to avoid the known negative health consequences associated with insufficient sleep and insomnia in

  3. Behavioral Treatment of Menopausal Hot Flashes: Evaluation by Objective Methods.

    ERIC Educational Resources Information Center

    Germaine, Leonard M.; Freedman, Robert R.

    1984-01-01

    Used latency to hot flash onset under heat stress to evaluate the effects of relaxation treatment or a control procedure in 14 menopausal women. Following treatment, the latency to hot flash onset during heat stress was increased in relaxation subjects. Reported symptom frequency was significantly reduced in relaxation subjects. (BH)

  4. Oral administration of Lactobacillus paracasei alleviates clinical symptoms of colitis induced by dextran sulphate sodium salt in BALB/c mice.

    PubMed

    Pan, T; Guo, H Y; Zhang, H; Liu, A P; Wang, X X; Ren, F Z

    2014-09-01

    The aim of this study was to investigate the alleviating effect of Lactobacillus paracasei subsp. paracasei LC-01 (LC-01) on the murine model of colitis induced by dextran sulphate sodium (DSS). 50 pathogen-free, 6-week-old male BALB/c mice were divided randomly into 5 groups, including a control group and four DSS-LC-01-treated groups (DSS, DSS-106, DSS-108, and DSS-1010 with 0, 1×106, 1×108 and 1×1010 cfu/ml LC-01, respectively). To test the effectiveness of LC-01 as a prophylactic it was administered for 7 days before the onset of the disease in DSS-LC-01-treated mice. After 7 days, colitis was induced by administration of 2.5% (w/v) DSS in drinking water for a further 7 days. The disease activity index (DAI), histological score, myeloperoxidase (MPO) activity and the level of the pro-inflammatory cytokines interleukin-1β (IL-1β) and tumour necrosis factor α (TNF-α) were measured. DAI, histological scores and MPO activity of mice treated with a medium or high dose of LC-01 were significantly lower compared to a low-dose of LC-01 and DSS treatment alone (P<0.05). Colon length shortening could be prevented with increasing dose of LC-01. In addition, the levels of IL-1β and TNF-α were suppressed significantly by treatment with a medium and high dose of LC-01. However, no significant difference in the indices mentioned above were observed between a low dose of LC-01 and treatment with DSS alone (P≯0.05). An appropriate dose of LC-01 can prevent intestinal damage in mice with DSS-induced colitis. The expression of inflammatory cytokines related to pathogenesis of DSS-induced colitis decreased following treatment with LC-01. PMID:24889889

  5. Ginseng for managing menopausal woman's health

    PubMed Central

    Lee, Hye Won; Choi, Jiae; Lee, YoungJoo; Kil, Ki-Jung; Lee, Myeong Soo

    2016-01-01

    Abstract Background: The aim of this systematic review was to update, complete, and critically evaluate the evidence from placebo-controlled randomized clinical trials (RCTs) of ginseng for managing menopausal women's health. Methods: We searched the literature using 13 databases (MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean Medical, and 3 Chinese Databases) from their inception to July 2016 and included all double-blind RCTs that compared any type of ginseng with a placebo control in postmenopausal women. The methodological quality of all studies was assessed using a Cochrane risk of bias tool. Results: Ten RCTs met our inclusion criteria. Most RCTs had unclear risk of bias. One RCT did not show a significant difference in hot flash frequency between Korean red ginseng (KRG) and placebo. The second RCT reported positive effects of KRG on menopausal symptoms. The third RCT found beneficial effects of ginseng (Ginsena) on depression, well-being, and general health. Four RCTs failed to show significant differences in various hormones between KRG and placebo controls except dehydroepiandrosterone. Two other RCTs failed to show effects of KRG on endometrial thickness in menopausal women. The other RCT also failed to show the effects of American ginseng on oxidative stress markers and other antioxidant enzymes. Conclusion: Our systematic review provided positive evidence of ginseng for sexual function and KRG for sexual arousal and total hot flashes score in menopausal women. However, the results of KRG or ginseng failed to show specific effects on hot flash frequency, hormones, biomarkers, or endometrial thickness. The level of evidence for these findings was low because of unclear risk of bias. PMID:27661038

  6. Depression during the Menopausal Transition

    ERIC Educational Resources Information Center

    Avis, Nancy E.

    2003-01-01

    The perception that menopause leads to mood disturbances such as depression has a long history. How did these beliefs come about, and are they supported by the scientific literature? This article reviews the theories of menopause and depression, the scientific literature, and the implications of these findings for prevention and treatment.…

  7. Menopause: Salient Issues for Counselors.

    ERIC Educational Resources Information Center

    Patterson, Marilyn M.; Lynch, Ann Q.

    1988-01-01

    Discusses issues surrounding menopause, with the idea that counselors are in an ideal position to help change attitudes toward viewing menopause as a time of positive change rather than a time of psychological distress. Reviews historical, sociological, psychological, and attitudinal factors that account for negative responses associated with…

  8. Menopause: A Life Cycle Transition.

    ERIC Educational Resources Information Center

    Evarts, Barbara Kess; Baldwin, Cynthia

    1998-01-01

    Family therapists need to address the issue of menopause proactively to be of benefit to couples and families during this transitional period in the family life cycle. Physical, psychological, and psychosocial factors affecting the menopausal woman and her family, and ways to address these issues in counseling are discussed. (Author/EMK)

  9. Cardiovascular Disease and Menopause

    PubMed Central

    Dosi, Rupal; Bhatt, Nikita; Shah, Priyanki; Patell, Rushad

    2014-01-01

    Aim: The aim of the study was to study the abnormalities in the cardiovascular profile in postmenopausal Indian women and to compare the same with the cardiovascular profile of pre menopausal Indian women belonging to the same age group; taken as controls. The goal was to throw some light on the cardiovascular risk in postmenopausal women of the Indian population as this population is thought to be at higher risk than their western counterparts and significant studies of the same kind in this population have been few. Materials and Methods: A cross-sectional comparative study on 100 women who were either postmenopausal or premenopausal and were between the age group of 40 to 55 years was carried out over a period of ten months at our hospital. The variations in the cardiovascular profile between both groups were studied. All the women were subjected to a detailed history, thorough examination, investigations and imaging studies. Results: The evaluation revealed that Coronary Artery Disease (CAD), hypertension, abnormal Body Mass Index (BMI) and abnormal Waist Hip Ratio (WHR) were significantly higher in the postmenopausal group as compared to the premenopausal group. The post menopausal women had significantly higher prevalence of abnormal lipid profiles as compared to their premenopausal counterparts. The postmenopausal women with a normal lipid profile also had increased prevalence of CAD and SAHT, which emphasizes the non-lipid cardiovascular benefits of estrogen. Conclusion: Thus, we can conclude that cardiovascular disease was more common in postmenopausal women of age group 40-55 years as compared to those not yet achieved menopause in a population of western Indian women. And this risk was significantly associated with central obesity, an abnormal lipid profile and the postmenopausal state in itself. PMID:24701484

  10. Methods for the Design of Vasomotor Symptom Trials: The MsFLASH Network

    PubMed Central

    Newton, Katherine M.; Carpenter, Janet S.; Guthrie, Katherine A.; Anderson, Garnet L.; Caan, Bette; Cohen, Lee S.; Ensrud, Kristine E.; Freeman, Ellen W.; Joffe, Hadine; Sternfeld, Barbara; Reed, Susan D.; Sherman, Sheryl; Sammel, Mary D.; Kroenke, Kurt; Larson, Joseph C.; LaCroix, Andrea Z.

    2013-01-01

    Objective This report describes the "Menopausal Strategies: Finding Lasting Answers to Symptoms and Health” (MsFLASH) network and methodological issues addressed in designing and implementing vasomotor symptom trials. Methods Established in response to a National Institute of Health request for applications, the network was charged with conducting rapid throughput randomized trials of novel and understudied available interventions postulated to alleviate vasomotor and other menopausal symptoms. Included are descriptions of and rationale for criteria used for interventions and study selection, common eligibility and exclusion criteria, common primary and secondary outcome measures, consideration of placebo response, establishment of a biorepository, trial duration, screening and recruitment, statistical methods, and quality control. All trial designs are presented including: 1) a randomized, double-blind, placebo-controlled clinical trial designed to evaluate effectiveness of the selective serotonin reuptake inhibitor escitalopram in reducing vasomotor symptom frequency and severity; 2) a 2×3 factorial design trial to test three different interventions (yoga, exercise, and omega-3 supplementation) for improvement of vasomotor symptom frequency and bother; and 3) a three-arm comparative efficacy trial of the serotonin-norepinephrine reuptake inhibitor venlafaxine and low-dose oral estradiol versus placebo for reducing vasomotor symptom frequency compared to placebo. The network’s structure and governance are also discussed. Conclusions The methods used and lessons learned in the MsFLASH trials are shared to encourage and support the conduct of similar trials and encourage collaborations with other researchers. PMID:23760428

  11. Non-obligatory role of prostaglandin D2 receptor subtype 1 in rosacea: laropiprant in comparison to a placebo did not alleviate the symptoms of erythematoelangiectaic rosacea.

    PubMed

    Krishna, Rajesh; Guo, Ying; Schulz, Valerie; Cord-Cruz, Evyan; Smith, Shanna; Hair, Suzanne; Nahm, Walter K; Draelos, Zoe D

    2015-02-01

    Erythematotelangiectatic rosacea shares facial flushing features with those seen after niacin. This study was performed to test the hypothesis whether prostaglandin D2 (PGD2) receptor subtype 1 antagonist (laropiprant) will improve the symptoms of rosacea. The purpose of this study was to evaluate the effect of laropiprant 100 mg administered once daily for 4 weeks on the signs and symptoms of erythematotelangiectatic rosacea. Subjects received laropiprant 100 mg once-daily (n = 30) or placebo (n = 30) for 4 weeks. The primary pharmacodynamics endpoint was change in Clinician's Erythema Assessment (CEA) score from baseline to week 4. The patient self-assessment (PSA) was a secondary endpoint. Laropiprant was generally well tolerated in this study for the primary endpoint of change in CEA score from Baseline to Week 4, the least-squares mean of change from baseline to visit 4/week 4 was -3.7 and -3.4 for placebo and laropiprant (100 mg), respectively. The least-squares mean difference (placebo minus laropiprant) with 90% confidence interval of change in CEA score from baseline to visit 4/week 4 was estimated as -0.3 (-1.6, 1.0). For the secondary endpoint, the least-squares mean difference (placebo minus laropiprant) with 90% confidence interval of change from baseline to visit 4/week 4 was estimated as -0.7 (-7.7, 6.4) for PSA total score, -4.5 (-14.2, 5.3) for PSA emotion score, -1.3 (-7.8, 5.3) for PSA symptoms score, and 3.6 (-4.3, 11.4) for PSA functioning score. Laropiprant administered once daily for 4 weeks was generally well tolerated in this population of subjects with rosacea. However, there were no clinically meaningful changes in the primary endpoint of CEA given that the response to laropiprant could not be differentiated from that to placebo. There was also no clinically meaningful change in the secondary endpoint, PSA. A DP1 antagonist is not likely to be effective in rosacea.

  12. Metabonomic Analysis Reveals Efficient Ameliorating Effects of Acupoint Stimulations on the Menopause-caused Alterations in Mammalian Metabolism

    NASA Astrophysics Data System (ADS)

    Zhang, Limin; Wang, Yulan; Xu, Yunxiang; Lei, Hehua; Zhao, Ying; Li, Huihui; Lin, Xiaosheng; Chen, Guizhen; Tang, Huiru

    2014-01-01

    Acupoint stimulations are effective in ameliorating symptoms of menopause which is an unavoidable ageing consequence for women. To understand the mechanistic aspects of such treatments, we systematically analyzed the effects of acupoint laser-irradiation and catgut-embedding on the ovariectomy-induced rat metabolic changes using NMR and GC-FID/MS methods. Results showed that ovariectomization (OVX) caused comprehensive metabolic changes in lipid peroxidation, glycolysis, TCA cycle, choline and amino acid metabolisms. Both acupoint laser-irradiation and catgut-embedding ameliorated the OVX-caused metabonomic changes more effectively than hormone replacement therapy (HRT) with nilestriol. Such effects of acupoint stimulations were highlighted in alleviating lipid peroxidation, restoring glucose homeostasis and partial reversion of the OVX-altered amino acid metabolism. These findings provided new insights into the menopause effects on mammalian biochemistry and beneficial effects of acupoint stimulations in comparison with HRT, demonstrating metabonomics as a powerful approach for potential applications in disease prognosis and developments of effective therapies.

  13. Cellulite in menopause.

    PubMed

    Leszko, Marta

    2014-10-01

    Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here.

  14. Cellulite in menopause

    PubMed Central

    2014-01-01

    Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here. PMID:26327870

  15. An innovative metal base denture design for a 55-year-old menopausal woman

    PubMed Central

    Bhatia, Vishwas; Bhatia, Garima; Jain, Nitul; Jadon, Ashwani Kumar

    2013-01-01

    Menopause is a normal developmental stage in a woman's life, marking the permanent cessation of menstruation resulting from irreversible changes in the hormonal and reproductive functions of the ovaries and is associated with a large number of symptoms ranging from physical to psychological. Some of the common oral manifestations are oral burning sensation with associated mucosal infections, pain, altered taste perception, and alveolar bone loss. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to devise newer methods that would add along to the treatment modalities advised by gynecologists in relieving menopausal women from above symptoms. The present case report describes an innovative method of fabricating a metal base denture in an edentulous female that would help perimenopausal/menopausal/post-menopausal edentulous women feel hot/cold sensations of food/liquids, thereby giving them relief from pain, better taste perception, and relief from associated allergic and candidal infections that are common with conventional acrylic base dentures. PMID:24082754

  16. A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation.

    PubMed

    Mezzasalma, Valerio; Manfrini, Enrico; Ferri, Emanuele; Sandionigi, Anna; La Ferla, Barbara; Schiano, Irene; Michelotti, Angela; Nobile, Vincenzo; Labra, Massimo; Di Gennaro, Patrizia

    2016-01-01

    Background and Aim. The efficacy of supplementation treatment with two multispecies probiotic formulates on subjects diagnosed with IBS-C and the assessment of their gut microbiota were investigated. Methods. A randomized, double-blind, three-arm parallel group trial was carried out on 150 IBS-C subjects divided into three groups (F_1, F_2, and F_3). Each group received a daily oral administration of probiotic mixtures (for 60 days) F_1 or F_2 or placebo F_3, respectively. Fecal microbiological analyses were performed by species-specific qPCR to assess the different amount of probiotics. Results. The percentage of responders for each symptom was higher in the probiotic groups when compared to placebo group during the treatment period (t60) and was maintained quite similar during the follow-up period (t90). Fecal analysis demonstrated that probiotics of the formulations increased during the times of treatment only in fecal DNA from subjects treated with F_1 and F_2 and not with F_3, and the same level was maintained during the follow-up period. Conclusions. Multispecies probiotic supplementations are effective in IBS-C subjects and induce a different assessment in the composition of intestinal microbiota. This clinical study is registered with the clinical study registration number ISRCTN15032219. PMID:27595104

  17. A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation

    PubMed Central

    Manfrini, Enrico; Ferri, Emanuele; La Ferla, Barbara; Schiano, Irene; Michelotti, Angela; Nobile, Vincenzo

    2016-01-01

    Background and Aim. The efficacy of supplementation treatment with two multispecies probiotic formulates on subjects diagnosed with IBS-C and the assessment of their gut microbiota were investigated. Methods. A randomized, double-blind, three-arm parallel group trial was carried out on 150 IBS-C subjects divided into three groups (F_1, F_2, and F_3). Each group received a daily oral administration of probiotic mixtures (for 60 days) F_1 or F_2 or placebo F_3, respectively. Fecal microbiological analyses were performed by species-specific qPCR to assess the different amount of probiotics. Results. The percentage of responders for each symptom was higher in the probiotic groups when compared to placebo group during the treatment period (t60) and was maintained quite similar during the follow-up period (t90). Fecal analysis demonstrated that probiotics of the formulations increased during the times of treatment only in fecal DNA from subjects treated with F_1 and F_2 and not with F_3, and the same level was maintained during the follow-up period. Conclusions. Multispecies probiotic supplementations are effective in IBS-C subjects and induce a different assessment in the composition of intestinal microbiota. This clinical study is registered with the clinical study registration number ISRCTN15032219.

  18. Effect of traditional Chinese medicine for treating human immunodeficiency virus infections and acquired immune deficiency syndrome: Boosting immune and alleviating symptoms.

    PubMed

    Zou, Wen; Wang, Jian; Liu, Ying

    2016-01-01

    To respond to the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic in China, the integration of antiretroviral therapy (ART) and traditional Chinese medicine (TCM) has important implications in health outcomes, especially in China where the use of TCM is widespread. The National Free TCM Pilot Program for HIV Infected People began in 5 provinces (Henan, Hebei, Anhui, Hubei, and Guangdong) in 2004, and quickly scaled up to 19 provinces, autonomous regions, and municipalities in China including some places with high prevalence, 26,276 adults have been treated thus far. Usually, people with HIV infection seek TCM for four main reasons: to enhance immune function, to treat symptoms, to improve quality of life, and to reduce side effects related to medications. Evidences from randomized controlled clinical trials suggested some beneficial effects of use of traditional Chinese herbal medicine for HIV infections and AIDS. More proofs from large, well-designed, rigorous trials is needed to give firm support. Challenges include interaction between herbs and antiretroviral drugs, stigma and discrimination. The Free TCM Program has made considerable progress in providing the necessary alternative care and treatment for HIV-infected people in China, and has strong government support for continued improvement and expansion, establishing and improving a work mechanism integrating Chinese and Western medicines.

  19. Effect of traditional Chinese medicine for treating human immunodeficiency virus infections and acquired immune deficiency syndrome: Boosting immune and alleviating symptoms.

    PubMed

    Zou, Wen; Wang, Jian; Liu, Ying

    2016-01-01

    To respond to the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic in China, the integration of antiretroviral therapy (ART) and traditional Chinese medicine (TCM) has important implications in health outcomes, especially in China where the use of TCM is widespread. The National Free TCM Pilot Program for HIV Infected People began in 5 provinces (Henan, Hebei, Anhui, Hubei, and Guangdong) in 2004, and quickly scaled up to 19 provinces, autonomous regions, and municipalities in China including some places with high prevalence, 26,276 adults have been treated thus far. Usually, people with HIV infection seek TCM for four main reasons: to enhance immune function, to treat symptoms, to improve quality of life, and to reduce side effects related to medications. Evidences from randomized controlled clinical trials suggested some beneficial effects of use of traditional Chinese herbal medicine for HIV infections and AIDS. More proofs from large, well-designed, rigorous trials is needed to give firm support. Challenges include interaction between herbs and antiretroviral drugs, stigma and discrimination. The Free TCM Program has made considerable progress in providing the necessary alternative care and treatment for HIV-infected people in China, and has strong government support for continued improvement and expansion, establishing and improving a work mechanism integrating Chinese and Western medicines. PMID:26577109

  20. A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation

    PubMed Central

    Manfrini, Enrico; Ferri, Emanuele; La Ferla, Barbara; Schiano, Irene; Michelotti, Angela; Nobile, Vincenzo

    2016-01-01

    Background and Aim. The efficacy of supplementation treatment with two multispecies probiotic formulates on subjects diagnosed with IBS-C and the assessment of their gut microbiota were investigated. Methods. A randomized, double-blind, three-arm parallel group trial was carried out on 150 IBS-C subjects divided into three groups (F_1, F_2, and F_3). Each group received a daily oral administration of probiotic mixtures (for 60 days) F_1 or F_2 or placebo F_3, respectively. Fecal microbiological analyses were performed by species-specific qPCR to assess the different amount of probiotics. Results. The percentage of responders for each symptom was higher in the probiotic groups when compared to placebo group during the treatment period (t60) and was maintained quite similar during the follow-up period (t90). Fecal analysis demonstrated that probiotics of the formulations increased during the times of treatment only in fecal DNA from subjects treated with F_1 and F_2 and not with F_3, and the same level was maintained during the follow-up period. Conclusions. Multispecies probiotic supplementations are effective in IBS-C subjects and induce a different assessment in the composition of intestinal microbiota. This clinical study is registered with the clinical study registration number ISRCTN15032219. PMID:27595104

  1. Menopausal experiences of Thai women. Part 2: The cultural context.

    PubMed

    Punyahotra, S; Dennerstein, L

    1997-01-01

    This paper describes the cultural context of middle-aged Thai women who took part in a survey of symptoms and attitudes to menopause. The women lived in Nonthaburi province, adjacent to Bangkok, which has undergone a transition from rural to urban. Household structure often includes three generations. There have been changing opportunities for women in areas of education, occupation and family size and women's power increases with age. Thai women perceive menstruation as an indicator of health and take special care during menstruation. There is a special idiom in Thai 'leod cha pai-lom cha ma' (the blood will go--the wind will come) used to describe changes in a woman's behaviour, emotions and well-being during the menopause. These changes are expected to happen occasionally, not in every woman. Some women looked forward to menopause, while others were found to be ambivalent towards it.

  2. EMAS recommendations for conditions in the workplace for menopausal women.

    PubMed

    Griffiths, Amanda; Ceausu, Iuliana; Depypere, Herman; Lambrinoudaki, Irene; Mueck, Alfred; Pérez-López, Faustino R; van der Schouw, Yvonne T; Senturk, Levent M; Simoncini, Tommaso; Stevenson, John C; Stute, Petra; Rees, Margaret

    2016-03-01

    Women form a large part of many workforces throughout Europe. Many will be working throughout their menopausal years. Whilst the menopause may cause no significant problems for some, for others it is known to present considerable difficulties in both their personal and working lives. During the menopausal transition women report that fatigue and difficulties with memory and concentration can have a negative impact on their working lives. Furthermore, hot flushes can be a source of embarrassment and distress. Some consider that these symptoms can impact on their performance. Greater awareness among employers, together with sensitive and flexible management can be helpful for women at this time. Particular strategies might include: fostering a culture whereby employees feel comfortable disclosing health problems, allowing flexible working, reducing sources of work-related stress, providing easy access to cold drinking water and toilets, and reviewing workplace temperature and ventilation.

  3. EMAS recommendations for conditions in the workplace for menopausal women.

    PubMed

    Griffiths, Amanda; Ceausu, Iuliana; Depypere, Herman; Lambrinoudaki, Irene; Mueck, Alfred; Pérez-López, Faustino R; van der Schouw, Yvonne T; Senturk, Levent M; Simoncini, Tommaso; Stevenson, John C; Stute, Petra; Rees, Margaret

    2016-03-01

    Women form a large part of many workforces throughout Europe. Many will be working throughout their menopausal years. Whilst the menopause may cause no significant problems for some, for others it is known to present considerable difficulties in both their personal and working lives. During the menopausal transition women report that fatigue and difficulties with memory and concentration can have a negative impact on their working lives. Furthermore, hot flushes can be a source of embarrassment and distress. Some consider that these symptoms can impact on their performance. Greater awareness among employers, together with sensitive and flexible management can be helpful for women at this time. Particular strategies might include: fostering a culture whereby employees feel comfortable disclosing health problems, allowing flexible working, reducing sources of work-related stress, providing easy access to cold drinking water and toilets, and reviewing workplace temperature and ventilation. PMID:26857884

  4. Herbs, menopause, and dialysis.

    PubMed

    Roemheld-Hamm, Beatrix; Dahl, Naomi V

    2002-01-01

    Women with chronic kidney disease (CKD) are at increased risk for menstrual disorders, early menopause, and osteoporosis, and rarely discuss gynecologic and reproductive issues with their nephrologist. Various complementary and alternative medicine (CAM) products are of interest to women with end-stage renal disease (ESRD) who have these disorders. However, very little is known about the specifics of using herbal medicines in patients on chronic dialysis, resulting in numerous problems when patients and providers try to ascertain the safety and efficacy of these products. This article reviews evidence regarding the safety and efficacy of black cohosh, ginseng, chastetree, dong quai, evening primrose oil, soy products, and the so-called natural hormones. Pharmacologic parameters important to evaluating the quality of botanical products are discussed, along with recommendations and information resources. PMID:11874595

  5. Exercise beyond menopause: Dos and Don'ts.

    PubMed

    Mishra, Nalini; Mishra, V N; Devanshi

    2011-07-01

    With a significant number of women belonging to the status of menopause and beyond, it is imperative to plan a comprehensive health program for them, including lifestyle modifications. Exercise is an integral part of the strategy. The benefits are many, most important being maintenance of muscle mass and thereby the bone mass and strength. The exercise program for postmenopausal women should include the endurance exercise (aerobic), strength exercise and balance exercise; it should aim for two hours and 30 minutes of moderate aerobic activity each week. Every woman should be aware of her target heart rate range and should track the intensity of exercise employing the talk test. Other deep breathing, yoga and stretching exercises can help to manage the stress of life and menopause-related symptoms. Exercises for women with osteoporosis should not include high impact aerobics or activities in which a fall is likely. The women and the treating medical practitioner should also be aware of the warning symptoms and contraindications regarding exercise prescription in women beyond menopause. The role of exercise in hot flashes, however, remains inconclusive. Overall, exercising beyond menopause is the only noncontroversial and beneficial aspect of lifestyle modification and must be opted by all. PMID:22408332

  6. Exercise beyond menopause: Dos and Don’ts

    PubMed Central

    Mishra, Nalini; Mishra, V. N.; Devanshi

    2011-01-01

    With a significant number of women belonging to the status of menopause and beyond, it is imperative to plan a comprehensive health program for them, including lifestyle modifications. Exercise is an integral part of the strategy. The benefits are many, most important being maintenance of muscle mass and thereby the bone mass and strength. The exercise program for postmenopausal women should include the endurance exercise (aerobic), strength exercise and balance exercise; it should aim for two hours and 30 minutes of moderate aerobic activity each week. Every woman should be aware of her target heart rate range and should track the intensity of exercise employing the talk test. Other deep breathing, yoga and stretching exercises can help to manage the stress of life and menopause-related symptoms. Exercises for women with osteoporosis should not include high impact aerobics or activities in which a fall is likely. The women and the treating medical practitioner should also be aware of the warning symptoms and contraindications regarding exercise prescription in women beyond menopause. The role of exercise in hot flashes, however, remains inconclusive. Overall, exercising beyond menopause is the only noncontroversial and beneficial aspect of lifestyle modification and must be opted by all. PMID:22408332

  7. East is east and West is west: perspectives on the menopause in Asia and The West.

    PubMed

    Baber, R J

    2014-02-01

    There is a school of thought that believes that menopausal symptoms are a peculiarly 'Western' phenomenon, not experienced by women from other regions and particularly not from Asia where, it has been claimed, dietary, social and cultural factors afforded protection for women living in that region. More recently, studies conducted in multi-ethnic communities living in Western countries as well as in Asian communities have found that the menopause and its consequences are similar world-wide. Ethnic differences within Asia account for small differences in endogenous hormone levels and age at menopause between Asian and Western women, and the type of menopause symptoms and their prevalence also differ between those two communities. However, like in the West and perhaps because of a Western influence, the long-term health problems of postmenopausal women including cardiovascular disease, osteoporosis and breast cancer are of major importance to Asian women and health services in the 21st century.

  8. Daydreaming in 40- to 60-Year-Old Women: Menopause, Health, Values, and Sexuality.

    ERIC Educational Resources Information Center

    Giambra, Leonard M.

    1983-01-01

    Investigated midlife influences on daydreaming for 477 women from 40 to 60 years of age. Examined 42 variables including health status, symptom presence, menstruation difficulties, sexual activities, and effects of menopause. Results indicated daydreaming was more prevalent among women with various psychological symptoms. (PAS)

  9. The Quality of Life During and After Menopause Among Rural Women

    PubMed Central

    G K, Poomalar; Arounassalame, Bupathy

    2013-01-01

    Introduction: The overall health and well-being of middle-aged women has become a major public health concern around the world. More than 80% of the women experience physical or psychological symptoms in the years when they approach menopause, with various distresses and disturbances in their lives, leading to a decrease in the quality of life. The aim of our study was to assess the quality of life and the impact of hormonal changes in perimenopausal and postmenopausal women and to correlate the prevalence of the symptoms with their duration since menopause. Material and Methods: A cross- sectional study was done at Sri Manakula Vinayagar Medical College and Hospital, Puducherry, from January 2012 to April 2012. Five hundred women who were in the age group of 40-65 years, who came from rural areas to our hospital, were included in the study. The women who were receiving hormonal treatment and those who refused to participate in the study were excluded. The data such as the socio-demographic information and the menstruation status, which were based on the reported length of time since the last menstrual period and the experience of the symptoms, as were tested in the Menopause Specific Quality of Life (MENQOL) questionnaire, were collected from each patient. The women who were included in the study were divided into three groups as the menopause transition, early postmenopausal and the late postmenopausal groups. All the data which were gathered were analyzed by using SAS 9.2. The Chi square test and the relative risk and the confidence interval calculations were applied to compare the frequencies of the symptoms among the women with different menopausal statuses. A p-value of less than 0.05 was considered to be statistically significant. Results: Mean menopausal age in the study group was 45 years. The most common symptom within study subjects were low back ache (79%) and muscle-joint pain (77.2%). The least frequent symptoms were increase in facial hair (15%) and

  10. Study of general practice consultations and menopausal problems. Oxford General Practitioners Menopause Study Group.

    PubMed Central

    Barlow, D H; Brockie, J A; Rees, C M

    1991-01-01

    OBJECTIVE--To investigate the nature of work related to the menopause in general practice. DESIGN--Questionnaire study over six months among general practitioners after each consultation with a woman aged 40-69 at which issues related to the climacteric had been discussed. SETTING--9 General practices in the Oxford area. SUBJECTS--416 Women who had 572 consultations. MAIN OUTCOME MEASURES--Age, menopausal state, and first or subsequent consultation. Symptoms were classified together with the treatment and the outcome of the consultation. RESULTS--The consultation rate varied greatly between practices, the overall rate being 4.4%. There were many premenopausal women and women in their 60s presenting; women with hysterectomies presented more often--36% (37/103) of women with hysterectomies had more than one consultation compared with 26% (38/144) for premenopausal women and 24% (38/155) for postmenopausal women. 409 women had symptoms and 218 were prescribed oestrogen treatment. 156 of the consultations involved discussion and advice only. Only four women were referred to a local specialist clinic. CONCLUSION--There is a low overall use of hormone replacement therapy in the general postmenopausal population despite the recent media coverage of its benefits in the prevention of osteoporosis and subsequent fractures. PMID:1998795

  11. Factors affecting sexual function in menopause: A review article.

    PubMed

    Nazarpour, Soheila; Simbar, Masoumeh; Tehrani, Fahimeh Ramezani

    2016-08-01

    This study aimed to systematically review the articles on factors affecting sexual function during menopause. Searching articles indexed in Pubmed, Science Direct, Iranmedex, EMBASE, Scopus, and Scientific Information Database databases, a total number of 42 studies published between 2003 and 2013 were selected. Age, estrogen deficiency, type of menopause, chronic medical problems, partner's sex problems, severity of menopause symptoms, dystocia history, and health status were the physical factors influencing sexual function of menopausal women. There were conflicting results regarding the amount of androgens, hormonal therapy, exercise/physical activity, and obstetric history. In the mental-emotional area, all studies confirmed the impact of depression and anxiety. Social factors, including smoking, alcohol consumption, the quality of relationship with husband, partner's loyalty, sexual knowledge, access to health care, a history of divorce or the death of a husband, living apart from a spouse, and a negative understanding of women's health were found to affect sexual function; however, there were conflicting results regarding the effects of education, occupation, socioeconomic status, marital duration, and frequency of sexual intercourse. PMID:27590367

  12. Intravaginally applied oxytocin improves post-menopausal vaginal atrophy

    PubMed Central

    Uvnäs-Moberg, Kerstin; Jonasson, Aino F

    2015-01-01

    Objective To explore the efficacy of local oxytocin for the treatment of post-menopausal vaginal atrophy. Design Double-blinded randomised controlled trial. Setting Healthy post-menopausal women in Stockholm, Sweden. Participants Sixty four post-menopausal women between February and June 2012 at the Karolinska University Hospital Huddinge/Sweden. Main outcome measures The efficacy of oxytocin for treatment of vaginal atrophy after seven weeks and cytological evaluation. Results The percentage of superficial cells in the vaginal smears and the maturation values were significantly increased after seven weeks of treatment with vagitocin 400 IU (p = 0.0288 and p = 0.0002, respectively). The vaginal pH decreased significantly after seven weeks of treatment with vagitocin 100 IU (p = 0.02). The scores of vaginal atrophy, according to the histological evaluation, were significantly reduced after administration of vagitocin 100 IU (p = 0.03). The thickness of the endometrium did not differ between the treatment and placebo groups after seven weeks of treatment. The symptom experienced as the most bothersome was significantly reduced after seven weeks of treatment in the women receiving vagitocin 400 IU compared to women in the placebo group (p = 0.0089). Conclusions Treatment with intravaginally applied oxytocin could be an alternative to local estrogen treatment in women with post-menopausal vaginal atrophy. PMID:25995333

  13. Evaluation of Bioelectrical Activity of Pelvic Floor Muscles and Synergistic Muscles Depending on Orientation of Pelvis in Menopausal Women with Symptoms of Stress Urinary Incontinence: A Preliminary Observational Study

    PubMed Central

    Halski, Tomasz; Słupska, Lucyna; Dymarek, Robert; Bartnicki, Janusz; Halska, Urszula; Król, Agata; Paprocka-Borowicz, Małgorzata; Dembowski, Janusz; Zdrojowy, Romuald

    2014-01-01

    Objectives. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles (PFM) and the synergistic muscles, depending on the orientation of the pelvis, in anterior (P1) and posterior (P2) pelvic tilt. Design. Preliminary, prospective observational study. Setting. Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Participants. Thirty-two menopausal and postmenopausal women with stress urinary incontinence were recruited. Based on inclusion and exclusion criteria, sixteen women aged 55 to 70 years were enrolled in the study. Primary Outcome Measures. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles by electromyography (sEMG) and vaginal probe. Secondary Outcome Measures. Evaluation of activity of the synergistic muscles by sEMG and surface electrodes. Results. No significant differences between orientations P1 and P2 were found in functional and resting sEMG activity of the PFM. During resting and functional PFM activity, higher electrical activity in P2 than in P1 has been recorded in some of the synergistic muscles. Conclusions. This preliminary study does not provide initial evidence that pelvic tilt influences PFM activation. Although different activity of synergistic muscles occurs in various orientations of the pelvic tilt, it does not have to affect the sEMG activity of the PFM. PMID:24701567

  14. Does menopausal transition really influence mental health? Findings from the prospective long‐term Zurich study

    PubMed Central

    Rössler, Wulf; Ajdacic‐Gross, Vladeta; Riecher‐Rössler, Anita; Angst, Jules; Hengartner, Michael P.

    2016-01-01

    In the prospective long‐term Zurich study, we re‐examined the hypothesized association between mental health problems in women and the transition through menopausal stages. One hundred sixty‐eight women from a population‐based Swiss community cohort were prospectively followed up from age 21 to 50. At age 50, the occurrence of hot flushes/night sweats and sleep disturbances was significantly more frequent in peri‐ and post‐menopausal women. Irritability/nervousness was increased only in peri‐menopausal women, but that association was accounted for by neuroticism trait scores at age 30. Transitions to peri‐ or post‐menopause were not related to changes in either the prevalence rates of DSM major depressive episode or anxiety disorders, or the course of psychopathological syndromes as assessed by the Symptom Checklist 90 ‐ Revised. The null associations held when adjusting for duration of reproductive period or age at menopause. Preceding mental health problems between ages 21 and 41, increased neuroticism trait scores at age 30, and concurrent psychosocial distress were significantly related to mental health problems occurring between ages 41 and 50. Depending upon the cut‐off point that was chosen, the arbitrary dichotomization of a continuous depression outcome produced spurious associations with the menopausal transition. We conclude that mental health problems between ages 41 and 50 are probably not directly related to the menopausal transition, and that previously reported associations could be false positives due to inadequate dichotomizations, reporting bias, undisclosed multiple adjustments or overfitting. PMID:27265705

  15. Does menopausal transition really influence mental health? Findings from the prospective long-term Zurich study.

    PubMed

    Rössler, Wulf; Ajdacic-Gross, Vladeta; Riecher-Rössler, Anita; Angst, Jules; Hengartner, Michael P

    2016-06-01

    In the prospective long-term Zurich study, we re-examined the hypothesized association between mental health problems in women and the transition through menopausal stages. One hundred sixty-eight women from a population-based Swiss community cohort were prospectively followed up from age 21 to 50. At age 50, the occurrence of hot flushes/night sweats and sleep disturbances was significantly more frequent in peri- and post-menopausal women. Irritability/nervousness was increased only in peri-menopausal women, but that association was accounted for by neuroticism trait scores at age 30. Transitions to peri- or post-menopause were not related to changes in either the prevalence rates of DSM major depressive episode or anxiety disorders, or the course of psychopathological syndromes as assessed by the Symptom Checklist 90 - Revised. The null associations held when adjusting for duration of reproductive period or age at menopause. Preceding mental health problems between ages 21 and 41, increased neuroticism trait scores at age 30, and concurrent psychosocial distress were significantly related to mental health problems occurring between ages 41 and 50. Depending upon the cut-off point that was chosen, the arbitrary dichotomization of a continuous depression outcome produced spurious associations with the menopausal transition. We conclude that mental health problems between ages 41 and 50 are probably not directly related to the menopausal transition, and that previously reported associations could be false positives due to inadequate dichotomizations, reporting bias, undisclosed multiple adjustments or overfitting. PMID:27265705

  16. Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women

    PubMed Central

    Tao, MinFang; Shao, HongFang; Li, ChangBing; Teng, YinCheng

    2013-01-01

    Background The severity of menopausal symptoms can vary according to ethnicity and geography. Two common menopausal symptom scales, the modified Kupperman Index (KI) and the Menopausal Rating Scale (MRS), are accepted internationally. In this study, we evaluated the correlation between these scales and their relevance to women in the People’s Republic of China. Methods We enrolled treatment-naïve women who visited the menopause outpatient department at a major teaching hospital in Shanghai, People’s Republic of China. The women were required to complete two questionnaires, ie, the modified KI and the MRS. We assessed the correlation between the tools using a correlation analysis. Results We enrolled 277 women of average age 51.5 ± 4.8 years. There was a strong positive correlation between total scores on the modified KI and the MRS (0.74, 95% confidence interval 0.69–0.79) and subscores for the somatic and psychological domains (0.74 and 0.77, respectively), with a moderate correlation for urogenital symptoms. According to the modified KI, 15 (5.4%) women were categorized as asymptomatic, and when using the MRS, 33 (11.9%) were categorized as asymptomatic. Women categorized as having none/minimal symptoms by the MRS were diagnosed as having mild to severe symptoms using the modified KI. The highest agreement (74%) was found when symptoms were moderate. Conclusion The modified KI and the MRS do correlate in Chinese women, but the modified KI is more likely to identify menopausal symptoms than the MRS in screening if there is doubt about the diagnosis of menopause. PMID:23569361

  17. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis

    PubMed Central

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Khadivzadeh, Talat; khorsand, Imaneh; Afiat, Maliheh; Esmaeilizadeh, Mahdi

    2016-01-01

    Objective: In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women Materials and Methods: We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used “menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. Results: Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. Conclusion: The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review. PMID:27462550

  18. A systematic review of the longitudinal relationships between subjective sleep disturbance and menopausal stage.

    PubMed

    Xu, Qunyan; Lang, Cathryne P; Rooney, Naomi

    2014-12-01

    Sleep disturbance is a common complaint for women going through the menopausal transition. A previous systematic review and meta-analysis of cross-sectional studies showed a small but significant relationship between self-reported sleep disturbance and menopausal stage and highlighted a possible influence of culture. However, the longitudinal relationship between self-reported sleep disturbance and menopausal transition has not been explored. This paper aimed to review literature on the longitudinal relationship between self-reported sleep disturbance and menopausal transition among community dwelling midlife women. Multiple electronic databases were systematically searched. Literature published prior to 2013 was reviewed. A narrative synthesis was used to analyse the results due to high level of heterogeneity across the included studies. Overall, review of eligible studies showed a small increased risk of self-reported sleep disturbance as women go through the menopausal transition after adjustment of potential confounders. Although the methodological quality of the majority of included studies was classified as high, the impact of culture on this relationship could not be explored, as all of the included studies were conducted in western countries. Like vasomotor symptoms, self-reported sleep disturbance is one of the core menopausal symptoms. Management strategies should be put in place to help women manage sleep disturbance to prevent complications and to improve health related quality of life.

  19. An assessment of Manasika Bhavas in menopausal syndrome and its management

    PubMed Central

    Santwani, Khyati; Shukla, V. D.; Santwani, M. A.; Thaker, Gayatri

    2010-01-01

    The present clinical trial was conducted to evaluate the efficacy of Shirodhara and Saraswatarishta as compared to hormone replacement therapy (HRT) in the management of menopausal syndrome, along with the assessment of Manasika Bhavas. The subjects were randomly divided into three groups. A total 48 patients were selected for the study, out of which 43 patients completed the study. Specialized Ayurvedic rating scales like Manasa Pariksha Bhavas as well as the Hamilton Anxiety Rating Scale, Hamilton Depression Rating scale, and Menopause Rating Scale were adopted to assess the effect of therapy. The effects were examined on the chief complaints as well as the associated complaints. Patients undergoing Shirodhara had better relief of the disturbances of Manasa Bhavas and psychic symptoms of menopause as compared to the other two groups. Saraswatarishta also showed encouraging results in managing the associated somatic symptoms and the psychic symptoms. Hence, we conclude that it can be used as an alternative therapy to HRT. PMID:22131732

  20. Menopause prediction and potential implications.

    PubMed

    Daan, Nadine M P; Fauser, Bart C J M

    2015-11-01

    Reproductive ageing in women is characterized by a decline in both the quantity and quality of oocytes. Menopause is reached upon exhaustion of the resting primordial follicle pool, occurring on average at 51 years of age (range 40-60 years). The mean global age at natural menopause (ANM) appears robust, suggesting a distinct genetic control. Accordingly, a strong correlation in ANM is observed between mothers and daughters. Few specific genetic determinants of ANM have been identified. Substantial efforts have been made to predict ANM by using anti-Müllerian hormone (AMH) levels. AMH serum concentrations at reproductive age predict ANM, but precision is currently limited. Early ANM is associated with early preceding fertility loss, whereas late menopause is associated with reduced morbidity and mortality later in life. Menopause affects various women's health aspects, including bone density, breast, the cardiovascular system, mood/cognitive function and sexual well-being. If the current trend of increasing human life expectancy persists, women will soon spend half their life postmenopause. Unfortunately, increased longevity does not coincide with an equal increase in years spend in good health. Future research should focus on determinants of long term health effects of ANM, and efforts to improve women's postmenopausal health and quality of life.

  1. Gincosan (a combination of Ginkgo biloba and Panax ginseng): the effects on mood and cognition of 6 and 12 weeks' treatment in post-menopausal women.

    PubMed

    Hartley, D E; Elsabagh, S; File, S E

    2004-01-01

    As memory and concentration impairments are a frequent complaint in post-menopausal women, this well-defined population was selected to investigate the effect on mood and cognition of chronic treatment with Gincosan. In a double-blind placebo controlled study, post-menopausal women aged 51-66 were randomly assigned to 12 weeks' treatment with Gincosan (320mg/day), containing 120mg Ginkgo biloba, and 200mg Panax ginseng (n = 30), or matched placebo (n = 27). They were given measurements of mood, somatic anxiety, sleepiness, and menopausal symptoms and a battery of cognitive tests before treatment and after 6 and 12 weeks of treatment. There were no significant effects of Gincosan treatment on ratings of mood, bodily symptoms of somatic anxiety, menopausal symptoms, or sleepiness or on any of the cognitive measures of attention, memory or frontal lobe function. Thus, after chronic administration, Gincosan appeared to have no beneficial effects in post-menopausal women.

  2. Oophorectomy, menopause, estrogen treatment, and cognitive aging: clinical evidence for a window of opportunity.

    PubMed

    Rocca, Walter A; Grossardt, Brandon R; Shuster, Lynne T

    2011-03-16

    The neuroprotective effects of estrogen have been demonstrated consistently in cellular and animal studies but the evidence in women remains conflicted. We explored the window of opportunity hypothesis in relation to cognitive aging and dementia. In particular, we reviewed existing literature, reanalyzed some of our data, and combined results graphically. Current evidence suggests that estrogen may have beneficial, neutral, or detrimental effects on the brain depending on age at the time of treatment, type of menopause (natural versus medically or surgically induced), or stage of menopause. The comparison of women who underwent bilateral oophorectomy with referent women provided evidence for a sizeable neuroprotective effect of estrogen before age 50 years. Several case-control studies and cohort studies also showed neuroprotective effects in women who received estrogen treatment (ET) in the early postmenopausal stage (most commonly at ages 50-60 years). The majority of women in those observational studies had undergone natural menopause and were treated for the relief of menopausal symptoms. However, recent clinical trials by the Women's Health Initiative showed that women who initiated ET alone or in combination with a progestin in the late postmenopausal stage (ages 65-79 years) experienced an increased risk of dementia and cognitive decline regardless of the type of menopause. The current conflicting data can be explained by the window of opportunity hypothesis suggesting that the neuroprotective effects of estrogen depend on age at the time of administration, type of menopause, and stage of menopause. Therefore, women who underwent bilateral oophorectomy before the onset of menopause or women who experienced premature or early natural menopause should be considered for hormonal treatment until approximately age 51 years.

  3. An Evaluation of a Health Education Intervention for Mid-Aged Women: Five Year Follow-up of Effects upon Knowledge, Impact of Menopause and Health.

    ERIC Educational Resources Information Center

    Hunter, Myra; O'Dea, Irene

    1999-01-01

    Discusses an evaluation of the long-term impact of a health education intervention for premenopausal women (N=86). Five years after the intervention questionnaire results showed that greater knowledge of menopause and fewer symptoms attributed to menopause. The evaluation was positive in terms of increasing knowledge and helping women to deal with…

  4. Selective estrogen modulators in menopause.

    PubMed

    Gambacciani, M

    2013-12-01

    Hypoestrogenism is the primary etiologic factor for osteoporosis and related fractures, as well as for a number of clinical symptoms that can reduce the quality of life in postmenopausal women. Alternative to classical hormone replacement therapy (HRT) are needed for women that cannot or don't want to be treated with hormones. Selective estrogen receptor modulators (SERMs) are compounds that lack the steroid structure of estrogens, but interact with estrogen receptors (ERs) as agonists or antagonists depending on the target tissue. Tamoxifen, the first generation of SERMs, has been used for decades in the primary prevention and treatment of breast cancer. Tamoxifen exerts positive estrogenic effect on bone protecting bone mineral density (BMD). However, tamoxifen acts as agonist also on the endometrium, leading to an increased risk of endometrial hyperplasia and cancer. In addition, tamoxifen administration is associated with significantly increased risks of stroke, venous thromboembolism, including both deep-vein thrombosis and pulmonary emboli. Thus, these actions, in addition to the increased risk of and hot flushes, prevent the use of tamoxifen for the prevention of osteoporosis. Further generations of SERM, Raloxifene and bazedoxifene were developed for the prevention and treatment of postmenopausal osteoporosis and are now licensed for this indication. In addition. Raloxifene is as effective as tamoxifen in reducing the risk of invasive breast cancer. On the other hand, the available data indicate that Bazedoxifene exerts a greater anti-fracture activity than Raloxifene. At variance of tamoxifen, both raloxifene and bazedoxifene reduce the risk of endometrial hyperplasia and cancer. However, they are associated with a significant increase the risks of venous thromboembolic events. Although raloxifene and Bazedoxifene prevent postmenopausal osteoporosis, they have not been associated with reductions in climacteric symptoms, particularly hot flushes. In order

  5. Ovarian adrenal interactions during the menopausal transition

    PubMed Central

    Lasley, B. L.; Crawford, S. L.; Mcconnell, D. S.

    2015-01-01

    Observations over the past decade using longitudinal data reveal a gender-specific shift in adrenal steroid production. This shift is represented by an increase in the circulating concentrations of delta 5 steroids in 85% of all women and is initiated only after the menopausal transition has begun. While the associated rise in the major adrenal androgen, dehydroepiandrosterone sulfate (DHEAS), is modest, the parallel rises in dehydroepiandrosteone (DHEA) and androstenediol (Adiol) are much more robust. These increases in circulating steroid concentrations are qualitatively similar on average between ethnicities but quantitatively different between individual women. Both circulating testosterone (T) and androstenedione (Adione) also rise concomitantly but modestly by comparison. This phenomenon presents a new and provocative aspect to the endocrine foundations of the menopausal transition and may provide important clues to understanding the fundamentals of mid-aged women's healthy aging, particularly an explanation for the wide diversity in phenotypes observed during the MT as well as their different responses to hormone replacement therapies. Experimental studies using the nonhuman primate animal model show an acute adrenal response to human chorionic gonadotropin (hCG) challenge as well as the presence of luteinizing hormone receptors (LHR) in their adrenal cortices. These experimental results support the concept that LHRs are recruited to the adrenal cortices of mid-aged women that subsequently function to respond to increasing circulating LH to shunt pregnenolone metabolites towards the delta 5 pathway. Future investigations are required to determine the relationship of these changes in adrenal function to symptoms and health outcomes of mid-aged women. PMID:24346252

  6. Progestogens in menopausal hormone therapy

    PubMed Central

    Woroń, Jarosław

    2015-01-01

    Progestogens share one common effect: the ability to convert proliferative endometrium to its secretory form. In contrast, their biological activity is varied, depending on the chemical structure, pharmacokinetics, receptor affinity and different potency of action. Progestogens are widely used in the treatment of menstrual cycle disturbances, various gynaecological conditions, contraception and menopausal hormone therapy. The administration of progestogen in menopausal hormone therapy is essential in women with an intact uterus to protect against endometrial hyperplasia and cancer. Progestogen selection should be based on the characteristics available for each progestogen type, relying on the assessment of relative potency of action in experimental models and animal models, and on the indirect knowledge brought by studies of the clinical use of different progestogen formulations. The choice of progestogen should involve the conscious use of knowledge of its benefits, with a focus on minimizing potential side effects. Unfortunately, there are no direct clinical studies comparing the metabolic effects of different progestogens. PMID:26327902

  7. Menopausal hormone therapy and venous thromboembolism

    PubMed Central

    2014-01-01

    Menopausal hormone therapy (MHT) is the most effective method of treating vasomotor symptoms and other climacteric symptoms related to estrogen deficiency in peri- and postmenopausal period. In addition to estrogen replacement, women with preserved uterus require the addition of progestagen in order to ensure endometrial safety. One of rare but severe complications of MHT is venous thromboembolism (VTE). The incidence of VTE rises in parallel to women's age and body weight. The condition is also linked to hereditary and acquired risk factors. Oral estrogens increase the risk of venous thromboembolic complications to varying extents, probably depending on their type and dose used. Observational studies have not found an association between an increased risk of VTE and transdermal estrogen treatment regardless of women's age and body mass index (BMI). Micronized progesterone and pregnanes, including dydrogesterone, have no effect on the risk of VTE, whereas norpregnane progestagens cause an additional increase in risk. Among hormonal preparations which are commercially available in Poland, the combination of transdermal estradiol with oral dydrogesterone appears to be the optimum choice, as it does not elevate the risk of VTE (compared to patients not using MHT), and dydrogesterone seems to be the progestagen of choice. PMID:26327865

  8. Menopause: developing a rational treatment plan.

    PubMed

    Vitiello, Danielle; Naftolin, Frederick; Naftoilin, Frederick; Taylor, Hugh S

    2007-12-01

    In recent years, growing importance has been afforded to assisting women in coping with the menopausal transition. Menopause is a normal stage of development and a woman's attitude toward this transition embodies biological, psychological and social influences. An enlarging body of conflicting data concerning menopausal hormone therapy (MHT) demands reassessment of established paradigms of disease prevention and menopausal health. Currently, a woman's decision to participate in or abstain from menopausal HT is personal. It involves not only consideration of risk stratification of potential harm and benefit, but also involves her expectations and attitudes toward perceived physical and emotional changes associated with this change. Through the use of extensive patient history, quality-of-life questionnaires and powerful biological profiling, we may be able to develop a rational approach to menopausal HT that safely guides our patients through this transition.

  9. Complementary/alternative and conventional medicine use amongst menopausal women: results from the Australian Longitudinal Study on Women's Health.

    PubMed

    Peng, Wenbo; Adams, Jon; Hickman, Louise; Sibbritt, David W

    2014-11-01

    Large population-based studies of complementary and alternative medicine (CAM) and conventional medicine use amongst menopausal women are lacking. This study helps address this gap by analysing data from a nationally representative sample of 10011 Australian women aged 59-64 years. Overall, 39% of menopausal women consulted CAM practitioners, 75% used self-prescribed CAM, 95% consulted general practitioners (GP) and 50% consulted specialists during the previous year, and 12% were current hormone replacement therapy (HRT) users. Our findings suggest that CAM is a significant healthcare option utilized by women to treat menopausal symptoms, and so requires attention from GPs and specialists. PMID:25190368

  10. Complementary/alternative and conventional medicine use amongst menopausal women: results from the Australian Longitudinal Study on Women's Health.

    PubMed

    Peng, Wenbo; Adams, Jon; Hickman, Louise; Sibbritt, David W

    2014-11-01

    Large population-based studies of complementary and alternative medicine (CAM) and conventional medicine use amongst menopausal women are lacking. This study helps address this gap by analysing data from a nationally representative sample of 10011 Australian women aged 59-64 years. Overall, 39% of menopausal women consulted CAM practitioners, 75% used self-prescribed CAM, 95% consulted general practitioners (GP) and 50% consulted specialists during the previous year, and 12% were current hormone replacement therapy (HRT) users. Our findings suggest that CAM is a significant healthcare option utilized by women to treat menopausal symptoms, and so requires attention from GPs and specialists.

  11. Osteoporosis in menopause.

    PubMed

    Khan, Aliya; Fortier, Michel; Fortier, Michel; Reid, Robert; Abramson, Beth L; Blake, Jennifer; Desindes, Sophie; Dodin, Sylvie; Graves, Lisa; Guthrie, Bing; Johnston, Shawna; Khan, Aliya; Rowe, Timothy; Sodhi, Namrita; Wilks, Penny; Wolfman, Wendy

    2014-09-01

    Objectif : Offrir aux fournisseurs de soins de santé des lignes directrices quant à la prévention, au diagnostic et à la prise en charge clinique de l’ostéoporose postménopausique. Issues : Stratégies visant à identifier et à évaluer les femmes exposées à des risques élevés; utilisation de la densité minérale osseuse et des marqueurs du renouvellement des cellules osseuses pour l’évaluation du diagnostic et de la réaction à la prise en charge; et recommandations quant à la nutrition, à l’activité physique et au choix du traitement pharmacologique en vue de prévenir l’ostéoporose et d’en assurer la prise en charge. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans MEDLINE et The Cochrane Library le 30 août et le 18 septembre 2012, respectivement, au moyen d’un vocabulaire contrôlé (p. ex. « osteoporosis », « bone density », « menopause ») et de mots clés (p. ex. « bone health », « bone loss », « BMD ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles publiés en anglais ou en français. Les résultats ont été restreints aux documents publiés à partir de 2009. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en mars 2013. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques, auprès de sociétés de spécialité médicale nationales et internationales, et dans des collections de directives cliniques Valeurs : La qualité des résultats est évaluée au moyen des critères d

  12. Escitalopram Reduces Hot Flashes in Non-depressed Menopausal Women: A Pilot Study

    PubMed Central

    Dobkin, Roseanne DeFronzo; Menza, Matthew; Allen, Lesley A.; Marin, Humberto; Bienfait, Karina L.; Tiu, Jade; Howarth, Jennifer

    2009-01-01

    Background Hot flashes are one of the most troubling manifestations of menopause, affecting about 80% of women. Due to recent controversies about hormone replacement therapy (HRT), many women are seeking alternative treatments. The use of antidepressants to treat hot flashes and other menopausal symptoms has been an active area of investigation. However, the majority of past research in this area has included women with significant medical or psychiatric histories that may influence treatment response. This was the first study to examine the impact of escitalopram on hot flashes, mood, sleep, and quality of life in a healthy sample of non-depressed menopausal women. Methods Twenty-five menopausal women, with no significant psychiatric or medical history, were enrolled. All women were treated with escitalopram (10-20mg flexibly dosed) for 8 weeks. The active treatment phase was preceded by a single blind placebo lead-in period. Results Over the course of the study, women reported significant decreases in both hot flash frequency and severity and improvements in dysphoria, anxiety, quality of life, and sleep. Conclusions These preliminary findings suggest that escitalopram may be a feasible and effective option for treating hot flashes and other menopausal symptoms in healthy women who might not ordinarily consider antidepressant treatment. PMID:19439155

  13. Menopausal hormone therapy in cancer survivors: A narrative review of the literature.

    PubMed

    Kuhle, Carol L; Kapoor, Ekta; Sood, Richa; Thielen, Jacqueline M; Jatoi, Aminah; Faubion, Stephanie S

    2016-10-01

    Decision making regarding the use of menopausal hormone therapy (MHT) for the treatment of bothersome menopausal symptoms in a cancer survivor can be complex, and includes assessment of its impact on disease-free or overall survival. Estrogen receptors are present in several cancer types, but this does not always result in estrogen-mediated tumor proliferation and adverse cancer-related outcomes. Estrogen may even be protective against certain cancers. Menopausal hormone therapy is associated with an increased risk of recurrence and mortality after diagnosis of some cancer types, but not others. We provide a narrative review of the medical literature regarding the risk of cancer recurrence and associated mortality with initiation of MHT after the diagnosis of breast, gynecologic, lung, colorectal, hematologic cancers, and melanoma. Menopausal hormone therapy may be considered for management of bothersome menopausal symptoms in women with some cancer types (e.g., colorectal and hematologic cancer, localized melanoma, and most cervical, vulvar and vaginal cancers), while nonhormonal treatment options may be preferred for others (e.g., breast cancer). In women with other cancer types, recommendations are less straightforward, and the use of MHT must be individualized. PMID:27621244

  14. Genetics of Early and Normal Menopause.

    PubMed

    Laven, Joop S E

    2015-11-01

    Menopause is defined as the permanent cessation of ovulation and hence menstruation due to ovarian failure. The median age of menopause is 51 years. However, early menopause might occur at 40 years of age while late menopause might happen as late as 62 years of age. Premature menopause is defined as the cessation of ovulation prior to the age of 40 years, a condition generally referred to as primary ovarian insufficiency (POI). Menopause is also a highly heritable condition. Genetic variants are known to contribute to ∼50% of the variation in age at menopause. Several genetic studies have tried to unravel this genetic background making use of different genetic techniques in population studies as well as in animal models. Genome-wide linkage studies have identified only a limited amount of genetic variants that seem to be associated with menopause. Population-based studies as well as animal research into the genetic background of POI have identified several genetic variants that seem to be associated with POI. However, a lot of these studies suffer from methodological flaws because results are generally not replicated in different independent samples and most of these studies are underpowered. Hence, results are conflicting. Recent genome-wide association studies (GWAS) have identified several genetic variants that are associated with menopause and POI. Genes seem to be involved in DNA repair and maintenance as well as in immune function. Biological as well as epidemiological data seem to indicate that reproductive performance, age at menopause, and longevity are interlinked through common genetic factors involved in DNA repair and maintenance. In case these systems fail, cell death and accelerated aging occur. Consequently, it seems that the aging of the soma, as a result of dysfunctional DNA repair, is responsible for failure to reproduce and the subsequent occurrence of menopause. Hence, reproductive performance constitutes a good predictor for general health

  15. Menopausal complaints in Slovak midlife women and the impact of CYP1B1 polymorphism on their incidence.

    PubMed

    Luptáková, Lenka; Sivtáková, Daniela; Cernanová, Veronika; Cvicelová, Marta

    2012-01-01

    A wide variety of symptoms have been attributed to menopause, negatively influencing women's physical and psychological health. In addition to lifestyle parameters and personal history, genetic factors are considered to be the main source of this variation. This study aims to investigate the incidence of menopausal symptoms among midlife women according to their menopausal status, and to evaluate the contribution to their manifestation from CYP1B1 Leu432Val polymorphism as a predisposing factor for menopausal symptoms. The studied cohort consisted of 299 women ranging from 39 to 59 years of age. Women were recruited from the western and middle parts of Slovakia, and all participants completed a menopause-specific questionnaire and provided blood or saliva samples for genotyping. Our results indicated that all women are at risk of typical menopausal symptoms, but there is a higher number of postmenopausal women affected than premenopausal ones. Regression analysis showed that the CYP1B1 Leu/Leu genotype can increase the experience of bloated stomach and facial hair increase in all the sampled women, while the Leu/Leu genotype may increase experience of palpitations and involuntary urination in the premenopausal women. The Leu/Leu genotype may increase the experience of nausea, bloated stomach, and vaginal dryness in peri- and postmenopausal women. We determined that women with the Leu/Leu, or Leu/Val genotypes were approximately five times more likely to suffer from vaginal dryness than the Val/Val women (OR = 4.948; 95% CI, 1.259-19.447). We therefore suggest that CYP1B1 Leu432Val polymorphism could be involved in individual susceptibility to menopausal symptoms in Slovak midlife women. PMID:23350153

  16. Mystified by Menopause? A Major Life Transition

    MedlinePlus

    ... because there are 40 million menopausal or postmenopausal women right now in this country, and a growing number are entering menopause each year,” says Dr. Howard N. Hodis, a cardiovascular ... period. On average, women have their last period around age 51, but ...

  17. Menopausal Experiences of Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Willis, D. S.; Wishart, J. G.; Muir, W. J.

    2011-01-01

    Background: Little is known about the menopause in women with intellectual disabilities (ID) save that its onset is earlier than in the general population, and earlier still in women with Down's syndrome (DS). This study directly explored menopausal experiences in women with ID, both with and without DS, with the aim of identifying levels of…

  18. Memory Decline in Peri- and Post-menopausal Women: The Potential of Mind-Body Medicine to Improve Cognitive Performance.

    PubMed

    Sliwinski, Jim R; Johnson, Aimee K; Elkins, Gary R

    2014-01-01

    Cognitive decline is a frequent complaint during the menopause transition and among post-menopausal women. Changes in memory correspond with diminished estrogen production. Further, many peri- and post-menopausal women report sleep concerns, depression, and hot flashes, and these factors may contribute to cognitive decline. Hormone therapy can increase estrogen but is contraindicated for many women. Mind-body medicine has been shown to have beneficial effects on sleep, mood, and hot flashes, among post-menopausal women. Further, mind-body medicine holds potential in addressing symptoms of cognitive decline post-menopause. This study proposes an initial framework for how mind-body interventions may improve cognitive performance and inform future research seeking to identify the common and specific factors associated with mind-body medicine for addressing memory decline in peri- and post-menopausal women. It is our hope that this article will eventually lead to a more holistic and integrative approach to the treatment of cognitive deficits in peri- and post-menopausal women.

  19. Menopause and Crisis? Fake or Real: Comprehensive Search to The Depth of Crisis Experienced: A Mixed-method Study

    PubMed Central

    avar, Nehle Parand; Mosalanejad, Leili; Ramezanli, Somaye; Ghavi, Fatemeh

    2014-01-01

    Introduction: Menopause is beyond the lack of menstruation and fertility decline in estrogen. Menopause is associated with at least three types of crisis: Biological, psychological and social. The aim of this study was to investigate psychiatric problems related to menopausal stress and experiences about psychological conditions related to menopause as a developmental crisis. Material and Methods: This mixed-method study (by triangulation approach) was done on 300 women in menopause age (44-54 years) by consensus sampling. Data gathering was from questionnaire conclude psychosomatic listed and hypochondria’s criterion that has been specified by DSMIV. The severity of the disorder was also collected by self-reported question. In the qualitative part, as a phenomenology study, data were gathered with Purposive sampling by a deep semi-structured interview. Data analysis was from content analysis). Results: Results showed that most of the disorders from psychosomatic listed experienced by women conclude: sexual problems 101(33.7%), hypertension 39(13%), and constipation 30(10%); 2.9% had experienced hypochondrias disorder. In the qualitative part, 5 themes were driven from the results of this study which described the structures of psychological experiences of the menopause as follows: change in emotion and mood, change in attitude, change in self-concept and change in interpersonal relationships. Conclusion: Menopause is a physiological process in women’s life, but due to many symptoms and complications, it requires culturally appropriate education, appropriate coping with problems and mental health promotion in this sexual crisis. PMID:24576387

  20. Menopause and dry eye. A possible relationship.

    PubMed

    Versura, Piera; Campos, Emilio C

    2005-05-01

    The hormonal status and in particular sex steroids play a role in the ocular surface homeostasis and function, during the whole life and in both sexes, accomplished by estrogenic and androgenic receptors located on corneal and conjunctival epithelia and Meibomian gland. The ocular surface is an integrated unit and any dysfunction results in a scarce or unstable preocular tear film which produces dry eye, a chronic inflammatory condition with increasing incidence as people get older but always more frequent among females. In post-menopausal women endocrine changes join the aging effects in the pathogenesis of dry eye, but still it remains controversial whether estrogen or androgen deficiency or their imbalance impair ocular surface function. Another questionable issue concerns the efficacy of hormonal replacement therapy in the amelioration of dry eye symptoms and recovery of tear function, since the scientific literature stands in between a therapeutic or a promoting effect of eye dryness. Therapy of dry eye is usually based upon topical administration of tear substitutes; estrogen or androgen-based eye drops represents a promising innovative treatment based upon important scientific rationale.

  1. Menopause and dry eye. A possible relationship.

    PubMed

    Versura, Piera; Campos, Emilio C

    2005-05-01

    The hormonal status and in particular sex steroids play a role in the ocular surface homeostasis and function, during the whole life and in both sexes, accomplished by estrogenic and androgenic receptors located on corneal and conjunctival epithelia and Meibomian gland. The ocular surface is an integrated unit and any dysfunction results in a scarce or unstable preocular tear film which produces dry eye, a chronic inflammatory condition with increasing incidence as people get older but always more frequent among females. In post-menopausal women endocrine changes join the aging effects in the pathogenesis of dry eye, but still it remains controversial whether estrogen or androgen deficiency or their imbalance impair ocular surface function. Another questionable issue concerns the efficacy of hormonal replacement therapy in the amelioration of dry eye symptoms and recovery of tear function, since the scientific literature stands in between a therapeutic or a promoting effect of eye dryness. Therapy of dry eye is usually based upon topical administration of tear substitutes; estrogen or androgen-based eye drops represents a promising innovative treatment based upon important scientific rationale. PMID:16019376

  2. Cysteine Prevents Menopausal Syndromes in Ovariectomized Mouse.

    PubMed

    Han, Na-Ra; Kim, Na-Rae; Kim, Hyung-Min; Jeong, Hyun-Ja

    2016-05-01

    Cysteine (Cys) is well known to be involved in oxidation-reduction reactions, serving as a source of sulfides in the body. Amino acids are known to improve menopausal symptoms and significantly reduce morbidity. This study aims to find an unrevealed effect of Cys with estrogenic and osteogenic actions. Ovariectomized (OVX) mice were treated with Cys daily for 8 weeks. Estrogen-related and osteoporosis-related factors were analyzed in the vagina, serum, and tibia. Cys was treated in estrogen receptor (ER)-positive human osteoblast-like MG-63 cells and ER-positive human breast cancer Michigan Cancer Foundation-7 (MCF-7) cells. Cysteine administration ameliorated overweightness of the body and vaginal atrophy in the OVX mice. Cysteine increased the levels of alkaline phosphatase (ALP) and 17β-estradiol in the serum of the OVX mice and improved the bone mineral density in the OVX mice. In MG-63 cells, Cys increased the proliferation, ERβ messenger RNA (mRNA) expression, and estrogen response element (ERE) activity. Cysteine increased the ALP activity and the phosphorylation of extracellular signal-regulated kinase. In MCF-7 cells, Cys also increased the proliferation, ERβ mRNA expression, and ERE activity. Taken together, these results demonstrated that Cys has estrogenic and osteogenic activities in OVX mice, MG-63 cells, and MCF-7 cells. The novel insights gained here strongly imply the potential use of Cys as a new agent for postmenopausal women. PMID:26494699

  3. The menopausal age and climacteric complaints in Thai women in Bangkok.

    PubMed

    Chompootweep, S; Tankeyoon, M; Yamarat, K; Poomsuwan, P; Dusitsin, N

    1993-07-01

    Age at menopause, associated factors and related clinical symptoms were recorded in a sample of Thai women living in the Bangkok area. Interviews by trained nurses were offered to a sample of 2375 women aged 45-59 years selected at random in 19 of the 54 Bangkok Metropolis Administration health centers. Full reports were obtained from 2354 women. Fifty-six percent of the study population were classified as postmenopausal, i.e. having no vaginal bleeding during the last 12 months, 12% were perimenopausal, i.e. having irregular vaginal bleeding during the last 12 months and 31% were premenopausal, i.e. having regular vaginal bleeding during the last 12 months. The average age at menopause was 49.5 +/- 3.6 years and was not related to body weight, height, age at menarche, level of education, smoking or use of oral contraceptives. However, high parity was significantly correlated to delayed menopause. Clinical symptoms of oestrogen deficiency were reported at a significantly higher rate in the perimenopause group, but the premenopause and postmenopause groups did not differ in their complaints about any symptom, including hot flushes. The most striking effect of menopause was a dramatic loss of sexual desire in 86.9% of postmenopausal women. However, the situation did not induce any specific complaint or any request for medical support.

  4. El cambio de vida: conceptualizations of menopause and midlife among urban Latina women.

    PubMed

    Villarruel, Antonia M; Harlow, Sioban D; Lopez, Maria; Sowers, MaryFran

    2002-01-01

    The experience of menopause among Latina women has seldom been described. The purpose of this study was to conceptualize and contextualize the experience of menopause from the perspective of Latina women. A series of focus group sessions were conducted with postmenopausal Latina women living in a large midwestern city. Themes derived from content analysis included: (a) The primacy of health and the importance of harmony and balance; (b) El cambio de vida--something you have to go through; and (c) This time is for me: reorientation and restructuring. Rediscovery and redefinition as opposed to being defined by physical symptoms marked this life phase. Implications of study findings are discussed within the context of an emerging biopsychosocial perspective of midlife and menopause transition.

  5. Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society

    PubMed Central

    2009-01-01

    Objective To update for both clinicians and the lay public the evidence-based position statement published by The North American Menopause Society (NAMS) in March 2007 regarding its recommendations for menopausal hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at various times through menopause and beyond. Design An Advisory Panel of clinicians and researchers expert in the field of women’s health was enlisted to review the March 2007 NAMS position statement, evaluate new evidence through an evidence-based analysis, and reach consensus on recommendations. The Panel’s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. The document was provided to other interested organizations to seek their endorsement. Results Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered. This paper lists all these areas along with explanatory comments. Conclusions that vary from the 2007 position statement are highlighted. Addenda include a discussion of risk concepts, a new component not included in the 2007 paper, and a recommended list of areas for future HT research. A suggested reading list of key references is also provided. Conclusions Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both. The benefit-risk ratio for menopausal HT is favorable close to menopause but decreases with aging and with time since menopause in previously untreated women. PMID:18580541

  6. Menopause

    MedlinePlus

    ... with questions about grants, contracts & research areas Training, Education & Career Development Support for Training at Universities & Other Institutions Extramural training, fellowships & career development opportunities Training at ...

  7. Menopause

    MedlinePlus

    ... y Cuidadores Hormones and Health Journey Through the Endocrine System Endocrine Disrupting Chemicals (EDCs) Endocrine Glands and Types ... Women's Health Hormones and Health Journey Through the Endocrine System Endocrine Disrupting Chemicals (EDCs) Endocrine Glands and Types ...

  8. Using Internet technologies to improve and simplify counseling about menopause: the WISDOM website.

    PubMed

    Col, Nananda F

    2007-05-20

    Although much attention has been given to measuring the risks associated with menopausal hormone therapy (HT), decisions about HT should be guided largely by individual patient preferences and values. Because the magnitude of the risks associated with HT for healthy 50-year-old women are exceedingly small (typically <1 in 1000) and its impact on survival are negligible, patient preferences and values become the most critical considerations. To make a rational and informed decision about HT, a woman needs to weigh any short-term gains in quality of life from HT against its longer term risks. To do this, clinicians need to gauge the patient's risks for the conditions affected by HT, the effects of HT on these risks, understand the woman's menopausal symptoms and identify the best treatment. This can be time consuming and challenging for clinicians to perform, and appears to be rarely done in clinical practice. Decision support tools can more rationally use available resources by shifting responsibilities away from those least able to perform them towards those most appropriate to perform them. The Internet presents new opportunities for delivering and disseminating individualized decision support tools that can help with menopausal counseling. A web-based decision support tool, Women's Interactive System about Decision On Menopause (WISDOM), was designed to improve the quality of treatment decisions around menopause and HT by providing individualized information about the impact of menopausal treatments on symptoms and risks. Preliminary trial results suggest a positive impact on clinicians and patients. The unique challenges and opportunities in developing and testing web-based decision support tools are discussed.

  9. Comparison of menopause healthcare considerations between Japanese and Filipino women living in local communities.

    PubMed

    Matsuo, Hiroya; Yamanaka, Rie; Senba, Naomi; Beltran, Ruth; Ladines-Llave, Cecilia; Blanco-Capito, Loudes

    2012-12-13

    To investigate the involvement of psychological/social factors in the condition of climacteric disturbance in Japan and the Philippines, we examined the menopausal symptoms and psychological/social factors in menopausal women living in local communities and compared among both countries whether differences in culture, lifestyle, etc. affected the condition of climacteric disturbance. High percentages of Japanese women reported mental symptoms, while relatively high percentages of Filipino women also experienced motor neurological symptoms in addition to psychoneurological symptoms. Japanese and Filipino women were found to have different stressors: a high percentage of the Japanese women had problems involving human relationships, such as providing nursing care, while a high percentage of the Filipino women had household problems, including husband's health and financial problems. Stress severity was associated with SMI scores in both countries. A poorer marital relationship in Japan than in the Philippines and an association between marital relationship and SMI scores were found. The present study suggests the association of differences in psychological/social factors between Japanese and Filipino women with differences in menopausal symptoms.

  10. Comparison of menopause healthcare considerations between Japanese and Filipino women living in local communities.

    PubMed

    Matsuo, Hiroya; Yamanaka, Rie; Senba, Naomi; Beltran, Ruth; Ladines-Llave, Cecilia; Blanco-Capito, Loudes

    2012-01-01

    To investigate the involvement of psychological/social factors in the condition of climacteric disturbance in Japan and the Philippines, we examined the menopausal symptoms and psychological/social factors in menopausal women living in local communities and compared among both countries whether differences in culture, lifestyle, etc. affected the condition of climacteric disturbance. High percentages of Japanese women reported mental symptoms, while relatively high percentages of Filipino women also experienced motor neurological symptoms in addition to psychoneurological symptoms. Japanese and Filipino women were found to have different stressors: a high percentage of the Japanese women had problems involving human relationships, such as providing nursing care, while a high percentage of the Filipino women had household problems, including husband's health and financial problems. Stress severity was associated with SMI scores in both countries. A poorer marital relationship in Japan than in the Philippines and an association between marital relationship and SMI scores were found. The present study suggests the association of differences in psychological/social factors between Japanese and Filipino women with differences in menopausal symptoms. PMID:23660453

  11. Herbal preparations for the menopause: beyond isoflavones and black cohosh.

    PubMed

    Depypere, Herman T; Comhaire, Frank H

    2014-02-01

    Complementary and alternative medicines (CAM) such as isoflavones and black cohosh are commonly used to deal with menopausal symptoms, but benefit a limited proportion of women. The aim of this minireview is to summarize the evidence of the efficacy and safety of other herbal preparations. Randomized controlled trials (RCTs) find that the extracts of Mediterranean pine bark (Pycnogenol(®)), linseed, and Lepididium meyenii (Maca) reduce vasomotor symptoms. The results of RCTs of the hop flavonoid 8-prenylnaringenin are conflicting. Animal and human studies suggest that Dioscorea villosa (Wild yam),and Broccoli may protect against osteoporosis and breast and gynecological cancers but further evidence is required. Linseed may protect against breast cancer but the results are conflicting. PMID:24314619

  12. Heart Risk Factors Rise Before Menopause

    MedlinePlus

    ... https://medlineplus.gov/news/fullstory_160227.html Heart Risk Factors Rise Before Menopause 'Danger zone' for women earlier ... WEDNESDAY, Aug. 3, 2016 (HealthDay News) -- Heart disease risk factors -- such as abnormal cholesterol levels and high blood ...

  13. Menopause 101: A Primer for the Perimenopausal

    MedlinePlus

    ... 40 and 58. The average age is 51. Physical changes begin years before the final menstrual period. This ... of menopause is different. Many women report no physical changes during perimenopause except irregular menstrual periods that stop ...

  14. Effects of menopausal hormonal therapy on occult breast tumors.

    PubMed

    Santen, Richard J; Song, Yan; Yue, Wei; Wang, Ji-Ping; Heitjan, Daniel F

    2013-09-01

    TSEC. Xenograft studies with the BZA/CEE combination show that it blocks the growth of occult, hormone dependent tumors in nude mice. These pre-clinical data suggest that the BZA/CEE TSEC combination may prevent the growth of occult breast tumors in women. Based on the beneficial effects of this TSEC combination on symptoms and fracture prevention in menopausal women, the combination of BZA/CEE might be used as a means both to treat menopausal symptoms and to prevent breast cancer. This article is part of a Special Issue entitled 'CSR 2013'.

  15. [A physiopathological overview of climacteric and menopause].

    PubMed

    Aranda Gallegos, J E; Barrón Vallejo, J; Ortega Díaz, R; Pereyra Quiñones, R; Kably Ambe, A

    1998-06-01

    Today, million of woman in the world lived enough to experience the menopause ant it's seculae. In the last few years the research of the events associated with this age has gained enormous attention. Hormonal replacement therapy has been shown to reduce the incidence of cardiovascular disease, osteoporosis and other complications in postmenopausal woman. In this paper we review the endocrinology of the menopause, benefits and risks of hormonal replacement therapy, Prescription choices, compliance and health care professional attitudes are too analysed.

  16. Menopause - Multiple Languages: MedlinePlus

    MedlinePlus

    ... الطمث (سن اليأس - العربية Bilingual PDF Health Information Translations Chinese - Simplified (简体中文) Managing Menopause 顺利渡过停经期 - 简体中文 (Chinese - Simplified) Bilingual PDF Health Information Translations Menopause English 女性更年期 - 简体中文 (Chinese - Simplified) PDF Chinese ...

  17. Menopause: Genome stability as new paradigm.

    PubMed

    Laven, Joop S E; Visser, Jenny A; Uitterlinden, Andre G; Vermeij, Wilbert P; Hoeijmakers, Jan H J

    2016-10-01

    Menopause is defined as the age-dependent permanent cessation of menstruation and ovulation due to ovarian failure. Menopause occurs on average around the age of 51 years. Recent genome-wide association studies (GWAS) have identified over 44 genetic variants that are associated with age of onset of natural menopause. Genes linked with menopause can be classified into three major groups: genes implicated in genome stability (DNA repair), immune function and mitochondrial biogenesis. Biological and epidemiological data indicate that reproductive performance, age at menopause and longevity are interlinked through common genetic factors, which play a pivotal role in DNA repair and genome maintenance, which has been linked before with the process of ageing. Consequently, ageing of the soma as a result of inefficient DNA repair appears also to be responsible for failure to reproduce and the subsequent occurrence of menopause. In this way reproductive performance may be strongly linked to the physical condition of the soma and may be a very good predictor of general health in later life. PMID:27621233

  18. The age and symptomatology of natural menopause among United Arab Emirates women.

    PubMed

    Rizk, D E; Bener, A; Ezimokhai, M; Hassan, M Y; Micallef, R

    1998-06-17

    A population-based survey of 742 United Arab Emirates women aged 40 years and over who had attained natural menopause (amenorrhea of at least 6 months' duration) investigated age at onset and the prevalence of climacteric symptoms. Women from both urban and rural areas of Al-Ain City and Abu Dhabi, Dubai, and Sharjah Emirates were recruited through use of the multi-stage stratified cluster sampling technique. The median age at menopause in this sample was 48 years (mean, 47.3 +or- 3.29 years; range, 40-59 years)--significantly lower than the 50.3 year mean recorded among Western women. Median age at menopause was significantly associated with that of the mother (p 0.001) and older sister (p 0.001), parity (p 0.0001), and a history of use of oral contraceptives for more than 1 year (p 0.001). 394 women (53%) reported at least one climacteric symptom. Most common were hot flushes, reported by 47% of women. 145 women (19.5%) were currently taking hormone replacement therapy. The relatively low age at menopause in this population could reflect additional social, economic, environmental, or genetic factors that were not explored in this study.

  19. Is it Safe to Take Hormones to Treat Menopause Symptoms?

    MedlinePlus

    ... state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin. This brief should not be viewed as a substitute for a consultation with a medical or health professional. It is provided to enhance communication with your doctor, not replace it. 3 Is ...

  20. Menopause Symptoms | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Your waist could get larger. You could lose muscle and gain fat. Your skin could get thinner. You might have memory problems, and your joints and muscles could feel stiff and achy. Are these a ...

  1. Premenstrual symptoms.

    PubMed

    1973-03-24

    Data is reviewed on premenstrual symptoms which have been related to high suicide and accident rates, employment absentee rates, poor academic performance and acute psychiatric problems. A recent study of healthy young women indicated that 39% had troublesome premenstrual symptoms, 54% passed clots in their menses, 70% had cyclical localized acneiform eruptions and only 17% failed to experience menstrual pain. Common menstrual disorders are classified as either dysmenorrhea or the premenstrual syndrome. Symptoms for the latter usually begin 2-12 days prior to menstruation and include nervous tension, irritability, anxiety, depression, bloated breasts and abdomen, swollen fingers and legs, headaches, dizziness, occasional hypersomia, excessive thirst and appetite. Some women may display an increased susceptibility to migraine, vasomotor rhinitis, asthma, urticaria and epilepsy. Symptoms are usually relieved with the onset of menses. While a definitive etiological theory remains to be substantiated, symptomatic relief has been reported with salt and water restriction and simple diuretics used 7 to 10 days premenstrually. Diazapam or chlordiazepoxide treatment is recommended before oral contraceptive therapy. The premenstrual syndrome may persist after menopause, is unaffected by parity, and sufferers score highly on neuroticism tests. Primary or spasmodic dysmenorrhea occurs in young women, tends to decline with age and parity and has no correlation with premenstrual symptoms or neuroticism. Spasmodic or colicky pain begins and is most severe on the first day of menstruation and may continue for 2-3 days. Treatment of dysmenorrhea with psychotropic drugs or narcotics is discouraged due to the risk of dependence and abuse. Temporary relief for disabling pain may be obtained with oral contraceptives containing synthetic estrogen and progestogen but the inherent risks should be acknowledged. Both disorders have been correlated to menstrual irregularity. Amenorrhea in

  2. Manufacturing Menopause: An Analysis of the Portrayal of Menopause and Information Content on Pharmaceutical Web Sites

    ERIC Educational Resources Information Center

    Charbonneau, Deborah Hile

    2010-01-01

    Consumer-targeted prescription drug advertising serves as an interesting lens through which we can examine the portrayal of menopause in online drug advertisements. The aim of this study was to explore the portrayal of menopause on web sites sponsored by pharmaceutical companies for hormone therapies (HT). To unravel this question, a qualitative…

  3. Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers: a case-control study.

    PubMed

    Kotsopoulos, Joanne; Huzarski, Tomasz; Gronwald, Jacek; Moller, Pal; Lynch, Henry T; Neuhausen, Susan L; Senter, Leigha; Demsky, Rochelle; Foulkes, William D; Eng, Charis; Karlan, Beth; Tung, Nadine; Singer, Christian F; Sun, Ping; Lubinski, Jan; Narod, Steven A

    2016-01-01

    Many BRCA1 mutation carriers undergo elective surgical oophorectomy (often before menopause) to manage their elevated risk of developing ovarian cancer. It is important to clarify whether or not the use of hormone replacement therapy (HRT) to mitigate the symptoms associated with surgical or natural menopause is safe in women with an inherited BRCA1 mutation and no personal history of breast or ovarian cancer. We conducted a case-control analysis of 432 matched pairs of women with a BRCA1 mutation. Detailed information on HRT use after menopause (duration, type, age at first/last use, formulation) was obtained from a research questionnaire administered at the time of study enrollment. Conditional logistic regression was used to estimate the odds ratio (OR) and 95 % confidence intervals (CI) associated with HRT use. The mean duration of HRT use after menopause was 4.3 years among the cases and 4.4 years among the controls (P = 0.83). The adjusted OR for breast cancer comparing all women who ever used HRT to those who never used HRT was 0.80 (95 % CI 0.55-1.16; P = 0.24). Findings did not differ by type of menopause (natural vs. surgical), by recency of use, by duration of use, and by formulation type. These findings suggest that a short course of HRT should not be contra-indicated for BRCA1 mutation carriers who have undergone menopause and who have no personal history of cancer.

  4. Female Sexual Function During the Menopausal Transition in a Group of Iranian Women

    PubMed Central

    Eftekhar, Tahereh; Dashti, Mahboobeh; Shariat, Mamak; Haghollahi, Fedyeh; Raisi, Firoozeh; Ghahghaei-Nezamabadi, Akram

    2016-01-01

    Objective: To determine the prevalence of sexual problems in Iranian women and association of sexual dysfunction with menopausal symptoms. Materials and methods: In this cross-sectional study, 151 married women with the age of 40-60 yearsold who were referred for treatmentto Department of Gynecology in Vali-e-Asr Hospital (Tehran, Iran) from April to July 2012, were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire.Menopause rating scale (MRS) was developed for the diagnosis and quantification of climacteric symptoms. Results: Total frequency of sexual dysfunction was 53% with the domains of lubrication, arusal and desire being commonly affected 62%, 70% and 98.5% of cases respectively. There is a relationship between severity of somatic and urogenital symptoms with sexual dysfunction (p = 0.03, p = 0.00 respectively). Conclusion: A considerable percentage of women experienced sexual dysfunctions in this period. Somatic and urogenital symptoms during the menopausal period could be a factor to maintain or intensity of sexual dysfunctions. PMID:27648093

  5. Female Sexual Function During the Menopausal Transition in a Group of Iranian Women

    PubMed Central

    Eftekhar, Tahereh; Dashti, Mahboobeh; Shariat, Mamak; Haghollahi, Fedyeh; Raisi, Firoozeh; Ghahghaei-Nezamabadi, Akram

    2016-01-01

    Objective: To determine the prevalence of sexual problems in Iranian women and association of sexual dysfunction with menopausal symptoms. Materials and methods: In this cross-sectional study, 151 married women with the age of 40-60 yearsold who were referred for treatmentto Department of Gynecology in Vali-e-Asr Hospital (Tehran, Iran) from April to July 2012, were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire.Menopause rating scale (MRS) was developed for the diagnosis and quantification of climacteric symptoms. Results: Total frequency of sexual dysfunction was 53% with the domains of lubrication, arusal and desire being commonly affected 62%, 70% and 98.5% of cases respectively. There is a relationship between severity of somatic and urogenital symptoms with sexual dysfunction (p = 0.03, p = 0.00 respectively). Conclusion: A considerable percentage of women experienced sexual dysfunctions in this period. Somatic and urogenital symptoms during the menopausal period could be a factor to maintain or intensity of sexual dysfunctions.

  6. Harnessing motivation to alleviate neglect.

    PubMed

    Russell, Charlotte; Li, Korina; Malhotra, Paresh A

    2013-01-01

    The syndrome of spatial neglect results from the combination of a number of deficits in attention, with patients demonstrating both spatially lateralized and non-lateralized impairments. Previous reports have hinted that there may be a motivational component to neglect and that modulating this might alleviate some of the debilitating symptoms. Additionally, recent work on the effects of reward on attention in healthy participants has revealed improvements across a number of paradigms. As the primary deficit in neglect has been associated with attention, this evidence for reward's effects is potentially important. However, until very recently there have been few empirical studies addressing this potential therapeutic avenue. Here we review the growing body of evidence that attentional impairments in neglect can be reduced by motivation, for example in the form of preferred music or anticipated monetary reward, and discuss the implications of this for treatments for these patients. Crucially these effects of positive motivation are not observed in all patients with neglect, suggesting that the consequences of motivation may relate to individual lesion anatomy. Given the key role of dopaminergic systems in motivational processes, we suggest that motivational stimulation might act as a surrogate for dopaminergic stimulation. In addition, we consider the relationship between clinical post stroke apathy and lack of response to motivation.

  7. Harnessing Motivation to Alleviate Neglect

    PubMed Central

    Russell, Charlotte; Li, Korina; Malhotra, Paresh A.

    2013-01-01

    The syndrome of spatial neglect results from the combination of a number of deficits in attention, with patients demonstrating both spatially lateralized and non-lateralized impairments. Previous reports have hinted that there may be a motivational component to neglect and that modulating this might alleviate some of the debilitating symptoms. Additionally, recent work on the effects of reward on attention in healthy participants has revealed improvements across a number of paradigms. As the primary deficit in neglect has been associated with attention, this evidence for reward’s effects is potentially important. However, until very recently there have been few empirical studies addressing this potential therapeutic avenue. Here we review the growing body of evidence that attentional impairments in neglect can be reduced by motivation, for example in the form of preferred music or anticipated monetary reward, and discuss the implications of this for treatments for these patients. Crucially these effects of positive motivation are not observed in all patients with neglect, suggesting that the consequences of motivation may relate to individual lesion anatomy. Given the key role of dopaminergic systems in motivational processes, we suggest that motivational stimulation might act as a surrogate for dopaminergic stimulation. In addition, we consider the relationship between clinical post stroke apathy and lack of response to motivation. PMID:23761744

  8. Life Course Exposure to Smoke and Early Menopause and Menopausal Transition

    PubMed Central

    Tawfik, Heba; Kline, Jennie; Jacobson, Judith; Tehranifar, Parisa; Protacio, Angeline; Flom, Julie D.; Cirillo, Piera; Cohn, Barbara A.; Terry, Mary Beth

    2015-01-01

    Objective Early age at menopause is associated with increased risk of cardiovascular disease, stroke, osteoporosis and all-cause mortality. Cigarette smoke exposure in adulthood is an established risk factor for earlier age at natural menopause and may be related to age at menopausal transition. Using data from two U.S. birth cohorts, we examined the association between smoke exposure at various stages of the life course (prenatal, childhood exposure to parental smoking and adult smoke exposure) with menopause status in 1,001 women aged 39 – 49 years at follow-up. Methods We used logistic regression analysis, adjusting for age at follow-up, to estimate odds ratios (ORs) and 95% confidence intervals (CI) relating smoke exposure to natural menopause and menopausal transition. Results The magnitudes of the associations for natural menopause were similar, but not statistically significant after adjustment for confounders for i) women with prenatal smoke exposure who did not smoke at adult follow-up (OR= 2.7 [95% CI 0.8, 9.4]) and ii) current adult smokers who were not exposed prenatally (OR= 2.8 [95% CI 0.9, 9.0]). Women who had been exposed to prenatal smoke and were current smokers had three times the risk of experiencing natural menopause (adjusted OR=3.4 [95% CI 1.1, 10.3]) compared to women without smoke exposure in either time period. Only current smoking of long duration (>26 years) was associated with the timing of the menopausal transition. Conclusion Our data suggest that exposure to smoke both prenatally and around the time of menopause accelerates ovarian aging. PMID:25803667

  9. HIV and Menopause: A Systematic Review of the Effects of HIV Infection on Age at Menopause and the Effects of Menopause on Response to Antiretroviral Therapy.

    PubMed

    Imai, Kentaro; Sutton, Madeline Y; Mdodo, Rennatus; Del Rio, Carlos

    2013-01-01

    More than half of persons living with HIV infection in the United States (U.S.) will be ≥50 years of age by 2020, including postmenopausal women. We conducted a systematic literature review about the effects of (1) HIV infection on age at menopause and (2) menopause on antiretroviral therapy (ART) response, in order to inform optimal treatment strategies for menopausal women living with HIV infection. We used the Ovid Medline database from 1980 to 2012. We included studies that focused on HIV-infected persons, included postmenopausal women, and reported outcome data for either age at menopause or response to ART across menopause. We identified six original research articles for age at menopause and five for response to ART across menopause. Our review revealed that current data were conflicting and inconclusive; more rigorous studies are needed. Disentangling the effects of menopause requires well-designed studies with adequate numbers of HIV-infected and HIV-uninfected women, especially disproportionately affected women of color. Future studies should follow women from premenopause through menopause, use both surveys and laboratory measurements for menopause diagnoses, and control for confounders related to normal aging processes, in order to inform optimal clinical management for menopausal women living with HIV.

  10. Concomitant use of prescription medications and dietary supplements in menopausal women; an approach to provider preparedness

    PubMed Central

    Gardiner, Paula; Stargrove, Mitchell Bebel; Dog, Tieraona Low

    2010-01-01

    Dietary supplements are becoming increasingly popular as therapies for symptom relief among menopause-age women in the United States. However, a large gap exists between research in the concomitant use of prescription medications and dietary supplements and provider preparedness to guide patient decision making. Many menopausal women take prescription medications, over the counter medications, and herbs and dietary supplements for climactic symptoms or other health conditions. With any drug, there is the potential for interactions. Women taking medications with a narrow therapeutic index, such as anticoagulants, anticonvulsants, and drugs for the treatment of chronic diseases, are at particular risk. Patients should be queried regarding their use of dietary supplements when starting or stopping a prescription drug, or if unexpected reactions occur. When counseling patients, one must carefully consider the risks and benefits of each supplement and medication being taken by each individual. PMID:21168291

  11. [Phytoestrogens--whether can they be an alternative to hormone replacement therapy for women during menopause period?].

    PubMed

    Dittfeld, Anna; Koszowska, Aneta; Brończyk, Anna Puzoń; Nowak, Justyna; Gwizdek, Katarzyna; Zubelewicz-Szkodzińska, Barbara

    2015-01-01

    Menopause is a turning point in a woman's life. Decreasing of secretion of estrogens can cause appearing of many health problems, which make that life is becoming harder in each partof life. Hormonal ReplacementTherapy (HRT) is using for relieving the symptoms of menopause, however, because of the possibility of adverse reactions cannot be used by all women. Alternative for HTC are phytoestrogens--compounds naturally occurring in plants, structurally similar to endogenous estrogen, so that they have an affinity for estrogen receptors, and in this way they can modulate functions of endocrine system. Phytoestrogens can play an important role in symptoms of menopause, but their positive impacts are being described for cardiovascular system, especially for lipid metabolism, bone metabolism. Moreover consumption of phytoestrogens could relieve as symptoms as: fatigue, insomnia, problems with concentrations and depression symptoms. Phytoestrogens are acting as antioxidants against free radicals, and reactive oxygen forms which are known as carcinogenic factors. Article is a review of the most important information about phitoestrogens and their influence on women organism during menopausal period.

  12. Menopause: Not All Hot Flashes Are Created Equal

    MedlinePlus

    ... gov/news/fullstory_160027.html Menopause: Not All Hot Flashes Are Created Equal Weight, race, education and ... 2016 FRIDAY, July 22, 2016 (HealthDay News) -- The hot flashes and night sweats of menopause don't ...

  13. Menopausal Estrogen Therapy Benefits and Risks Vary by Age, WHI Analysis Suggests | Division of Cancer Prevention

    Cancer.gov

    Long-term follow-up data from the Women’s Health Initiative (WHI) provide important new information about the potential risks and benefits of hormone therapy to treat symptoms or conditions related to menopause, including its effect on breast cancer risk. The results were published April 5 in the Journal of the American Medical Association. |

  14. Discourses on menopause--Part II: How do women talk about menopause?

    PubMed

    Hvas, Lotte; Gannik, Dorte Effersøe

    2008-04-01

    The aim of this article is to describe which of the different available discourses women relate to as revealed in the way they talk about menopause. We use a discourse analytic approach, which implies that meaning is ascribed to things according to how we talk about them. Twenty-four menopausal women from Denmark were interviewed. They were selected to cover a broad spectrum of Danish women with different menopausal experiences and social background factors. Seven previously identified discourses could be found in the interviews, though to varying degrees from woman to woman. Nearly all women used terms from the biomedical sphere like 'a period of decline and decay', even if they did not necessarily agree with this view. Also the existential discourse permeated most of the interviews, especially when the conversation turned to the ageing process, femininity and self-development. The way the menopause was talked about almost became kaleidoscopic when images speedily changed from the decrepit osteoporotic woman or a woman with lack of vitality and sex-appeal to a healthy and strong woman with control over her body and self. Since many women contact doctors in relation to menopause, and since the way doctors talk about menopause is influential, doctors should carefully consider which words and images they use in the counselling. The medical way of perceiving menopause is just one of many, and doctors must be aware that there are other different and partially contradicting discourses at play in society and in the women's universes.

  15. Cryopreservation and transplantation of ovarian tissue exclusively to postpone menopause: technically possible but endocrinologically doubtful.

    PubMed

    von Wolff, Michael; Stute, Petra

    2015-12-01

    Transplantation of cryopreserved ovarian tissue has been shown to induce pregnancies and puberty successfully. Therefore, using cryopreserved ovarian tissue to postpone menopause (tissue hormone therapy [THT]) seems to be an interesting option to avoid conventional menopause hormone therapy (MHT). Pregnancy induction and replacing MHT by THT, however, are completely different topics as different requirements need to be met. First, MHT requires long-lasting and continuous hormone production. It still needs to be proven if the transplanted tissue is active for at least 5 years with a continuous follicle growth to avoid phases with low oestrogen production, which would otherwise cause menopausal symptoms and could reduce the postulated benefit for women's health. Second, the advantage of a physiological hormone production over a non-physiological MHT is still hypothetical. Third, women who have undergone hysterectomies who do not need progesterone for endometrial protection would only require oestrogens, imposing more health benefits (cardiovascular system, mammary gland) than oestrogen and progesterone production or replacement. Therefore, transplanting ovarian tissue exclusively to postpone menopause is endocrinologically doubtful and should only be carried out within clinical trials. PMID:26380862

  16. Cryopreservation and transplantation of ovarian tissue exclusively to postpone menopause: technically possible but endocrinologically doubtful.

    PubMed

    von Wolff, Michael; Stute, Petra

    2015-12-01

    Transplantation of cryopreserved ovarian tissue has been shown to induce pregnancies and puberty successfully. Therefore, using cryopreserved ovarian tissue to postpone menopause (tissue hormone therapy [THT]) seems to be an interesting option to avoid conventional menopause hormone therapy (MHT). Pregnancy induction and replacing MHT by THT, however, are completely different topics as different requirements need to be met. First, MHT requires long-lasting and continuous hormone production. It still needs to be proven if the transplanted tissue is active for at least 5 years with a continuous follicle growth to avoid phases with low oestrogen production, which would otherwise cause menopausal symptoms and could reduce the postulated benefit for women's health. Second, the advantage of a physiological hormone production over a non-physiological MHT is still hypothetical. Third, women who have undergone hysterectomies who do not need progesterone for endometrial protection would only require oestrogens, imposing more health benefits (cardiovascular system, mammary gland) than oestrogen and progesterone production or replacement. Therefore, transplanting ovarian tissue exclusively to postpone menopause is endocrinologically doubtful and should only be carried out within clinical trials.

  17. Impairment of granulation tissue formation after menopause.

    PubMed

    Gniadecki, R; Wyrwas, B; Kabala, A; Matecka, J

    1996-04-01

    Formation of connective tissue is an essential step in the process of wound healing. After menopause an atrophy of connective tissues in skin, bone, and reproductive organs takes place. Using a dead-space wound healing model we measured collagen synthesis and deposition, and cell replication in the granulation tissue of 18 premenopausal and 23 peri- and postmenopausal women not receiving any hormonal therapy. In the postmenopausal group collagen synthesis and deposition and cell number in the granulation tissue were diminished. These results document the impairment of the granulation tissue formation after menopause.

  18. Buffet Load Alleviation

    NASA Technical Reports Server (NTRS)

    Ryall, T. G.; Moses, R. W.; Hopkins, M. A.; Henderson, D.; Zimcik, D. G.; Nitzsche, F.

    2004-01-01

    High performance aircraft are, by their very nature, often required to undergo maneuvers involving high angles of attack. Under these conditions unsteady vortices emanating from the wing and the fuselage will impinge on the twin fins (required for directional stability) causing excessive buffet loads, in some circumstances, to be applied to the aircraft. These loads result in oscillatory stresses, which may cause significant amounts of fatigue damage. Active control is a possible solution to this important problem. A full-scale test was carried out on an F/A-18 fuselage and fins using piezoceramic actuators to control the vibrations. Buffet loads were simulated using very powerful electromagnetic shakers. The first phase of this test was concerned with the open loop system identification whereas the second stage involved implementing linear time invariant control laws. This paper looks at some of the problems encountered as well as the corresponding solutions and some results. It is expected that flight trials of a similar control system to alleviate buffet will occur as early as 2001.

  19. Women's perspectives toward menopause: A phenomenological study in Iran.

    PubMed

    Hakimi, Sevil; Simbar, Masoumeh; Ramezani Tehrani, Fahimeh; Zaiery, Farid; Khatami, Shiva

    2016-01-01

    This study explores the attitude and feelings toward menopause among Azeri menopausal women using hermeneutic phenomenology based on Van Manen's approach. A total of 18 menopausal women who were attended in urban health centers of Tabriz, Iran, were recruited using a purposive sampling method. Data were gathered through semistructured interviews. Each interview was transcribed verbatim and analyzed simultaneously. Data analysis led to the emergence of five main themes: positive attitude, neutral attitude, negative attitude, positive feelings, and negative feelings. Participants had different feelings and attitude. Acceptance of menopause as a natural process helps women to have a neutral attitude toward menopause.

  20. Genetic and genomic insights into age at natural menopause.

    PubMed

    Moron, Francisco Jesus; Ruiz, Agustin; Galan, Jose Jorge

    2009-01-01

    The age at natural menopause shows great variability. It has been proposed that early age at menopause is a risk factor for osteoporosis and cardiovascular disease, whereas later age at menopause is a risk factor for breast cancer. In addition, it is thought that the genetic factors accounting for the genetic variability in age at menopause could also play a role in those diseases, as well as infertility in women. In this minireview we comment on the latest genetics and genomics insights into age at natural menopause.

  1. Menopause as a long-term risk to health: implications of general practitioner accounts of prevention for women's choice and decision-making.

    PubMed

    Murtagh, Madeleine J; Hepworth, Julie

    2003-03-01

    Over the past two decades medical researchers and modernist feminist researchers have contested the meaning of menopause. In this article we examine various meanings of menopause in major medical and feminist literature and the construction of menopause in a semi-structured interview study of general practitioners in rural South Australia. Three discursive themes are identified in these interviews; (i) .the hormonal menopause - symptoms, risk, prevention; (ii). the informed menopausal woman; and (iii). decision-making and hormone replacement therapy. By using the discourse of prevention, general practitioners construct menopause in relation to women's health care choices, empowerment and autonomy. We argue that the ways in which these concepts are deployed by general practitioners in this study produces and constrains the options available to women. The implications of these general practitioner accounts are discussed in relation to the proposition that medical and feminist descriptions of menopause posit alternative but equally-fixed truths about menopause and their relationship with the range of responses available to women at menopause. Social and cultural explanations of disease causality (c.f. Germov 1998, Hardey 1998) are absent from the new menopause despite their being an integral part of the framework of the women's health movement and health promotion drawn on by these general practitioners. Further, the shift of responsibility for health to the individual woman reinforces practice claims to empower women, but oversimplifies power relations and constructs menopause as a site of self-surveillance. The use of concepts from the women's health movement and health promotion have nevertheless created change in both the positioning of women as having 'choices' and the positioning of some general practitioners in terms of greater information provision to women and an attention to the woman's autonomy. In conclusion, we propose that a new menopause has evolved

  2. Serum Dioxin Concentrations and Age at Menopause

    PubMed Central

    Eskenazi, Brenda; Warner, Marcella; Marks, Amy R.; Samuels, Steven; Gerthoux, Pier ario; Vercellini, Paolo; Olive, David L.; Needham, Larry; Patterson, Donald G.; Mocarelli, Paolo

    2005-01-01

    2,3,7,8-Tetrachlorobenzo-p-dioxin (TCDD), a halogenated compound that binds the aryl hydrocarbon receptor, is a by-product of numerous industrial processes including waste incineration. Studies in rats and monkeys suggest that TCDD may affect ovarian function. We examined the relationship of TCDD and age at menopause in a population of women residing near Seveso, Italy, in 1976, at the time of a chemical plant explosion. We included 616 of the women who participated 20 years later in the Seveso Women’s Health Study. All women were premenopausal at the time of the explosion, had TCDD levels measured in serum collected soon after the explosion, and were ≥ 35 years of age at interview. Using proportional hazards modeling, we found a 6% nonsignificant increase in risk of early menopause with a 10-fold increase in serum TCDD. When TCDD levels were categorized, compared with women in the lowest quintile (< 20.4 ppt), women in quintile 2 (20.4–34.2 ppt) had a hazard ratio (HR) of 1.1 (p = 0.77), quintile 3 (34.3–54.1 ppt) had an HR of 1.4 (p = 0.14), quintile 4 (54.2–118 ppt) had an HR of 1.6 (p = 0.10), and quintile 5 (> 118 ppt) had an HR of 1.1 (p = 0.82) for risk of earlier menopause. The trend toward earlier menopause across the first four quintiles is statistically significant (p = 0.04). These results suggest a nonmonotonic dose-related association with increasing risk of earlier menopause up to about 100 ppt TCDD, but not above. PMID:16002373

  3. Menopausal Quality of Life: A RCT of Yoga, Exercise and Omega-3 Supplements

    PubMed Central

    REED, Susan D; GUTHRIE, Katherine A; NEWTON, Katherine M; ANDERSON, Garnet L; BOOTH-LAFORCE, Cathryn; CAAN, Bette; CARPENTER, Janet S; COHEN, Lee S; DUNN, Andrea L; ENSRUD, Kristine E; FREEMAN, Ellen W; HUNT, Julie R; JOFFE, Hadine; LARSON, Joseph C; LEARMAN, Lee A; ROTHENBERG, Robin; SEGUIN, Rebecca A; SHERMAN, Karen J; STERNFELD, Barbara S; LACROIX, Andrea Z

    2014-01-01

    Objective Determine efficacy of three non-hormonal therapies for improving menopause-related quality of life (QOL) in women with vasomotor symptoms (VMS). Methods 12-week 3×2 randomized, controlled, factorial design trial. Peri- and postmenopausal women, ages 40-62 years, were randomized to yoga (n=107), exercise (n=106), or usual activity (n=142), and also randomized to double-blind comparison of omega-3 (n=177) or placebo (n=178) capsules. Interventions: 1) weekly 90-minute yoga classes with daily at-home practice; 2) individualized facility-based aerobic exercise training 3 times/week; and 3) 0.615 gram omega-3 supplement, 3 times/day. Outcomes: Menopausal Quality of Life Questionnaire (MENQOL) total and domain (VMS, psychosocial, physical and sexual) scores. Results Among 355 randomized women, average age 54.7 years, 338 (95%) completed 12-week assessments. Mean baseline VMS frequency was 7.6/day and mean baseline total MENQOL score was 3.8 (range 1-8 from better to worse) with no between-group differences. For yoga compared to usual activity, baseline to 12-week improvements were seen for MENQOL total -0.3 (95% CI -0.6 to 0.0, p=0.02), and VMS (p=0.02) and sexuality (p=0.03) domain scores. For exercise and omega-3 compared to controls, improvements in baseline to 12-week total MENQOL scores were not observed. Exercise showed benefit in the MENQOL physical domain score at 12-weeks (p=0.02). Conclusion All women become menopausal and many seek medical advice on ways to improve quality of life; little evidence-based information exists. We found, among healthy sedentary menopausal women, yoga appears to improve menopausal QOL - the clinical significance of our finding is uncertain due to modest effect. PMID:24215858

  4. Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition

    PubMed Central

    Karvonen-Gutierrez, Carrie; Kim, Catherine

    2016-01-01

    The mid-life period is a critical window for increases in body weight and changes in body composition. In this review, we summarize the clinical experience of the menopausal transition by obesity status, and examine the evidence regarding the menopausal transition and reproductive hormones effects on body weight, body composition, or fat distribution. Mid-life obesity is associated with a different menopausal experience including associations with menstrual cycle length prior to the final menstrual period (FMP), age at the FMP, and higher prevalence of vasomotor symptoms. The menopausal transition is associated with weight gain and increased central body fat distribution; the majority of evidence suggests that changes in weight are due to chronological aging whereas changes in body composition and fat distribution are primarily due to ovarian aging. Continuous and regular physical activity during mid-life may be an efficacious strategy to counteract the age-related and menopause-related changes in resting energy expenditure and to prevent weight gain and abdominal adiposity deposition. PMID:27417630

  5. Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition.

    PubMed

    Karvonen-Gutierrez, Carrie; Kim, Catherine

    2016-01-01

    The mid-life period is a critical window for increases in body weight and changes in body composition. In this review, we summarize the clinical experience of the menopausal transition by obesity status, and examine the evidence regarding the menopausal transition and reproductive hormones effects on body weight, body composition, or fat distribution. Mid-life obesity is associated with a different menopausal experience including associations with menstrual cycle length prior to the final menstrual period (FMP), age at the FMP, and higher prevalence of vasomotor symptoms. The menopausal transition is associated with weight gain and increased central body fat distribution; the majority of evidence suggests that changes in weight are due to chronological aging whereas changes in body composition and fat distribution are primarily due to ovarian aging. Continuous and regular physical activity during mid-life may be an efficacious strategy to counteract the age-related and menopause-related changes in resting energy expenditure and to prevent weight gain and abdominal adiposity deposition. PMID:27417630

  6. Menopause in crisis post-Women's Health Initiative? A view based on personal clinical experience.

    PubMed

    Neves-E-Castro, Manuel

    2003-12-01

    Menopausal women should not consider that hormonal treatment is an obligatory long-term commitment. Estrogen-based treatments are extremely effective for vasomotor symptom relief and for vaginal atrophy. HRT also is one of several effective methods for the primary prevention of osteoporosis. If trials were done early after the menopause when the endothelium is likely still to be intact, estrogen-based treatment might be shown to prevent coronary heart disease. However, greater efficacy is to be expected from smoking cessation, proper nutrition, exercise, moderate alcohol consumption, statins, beta-blockers and angiotensin-converting enzyme inhibitors. The treatment options for a menopausal woman should include non-drug-related strategies, non-hormonal pharmaceutical therapies as well as hormonal treatments. The first objective of this contribution is to call to the attention of practising physicians the fact that the Women's Health Initiative (WHI) and Heart and Estrogen/Progestin Replacement Study (HERS) studies involved women much older than the early postmenopausal age groups for whom HRT is prescribed because of symptoms. The second objective is to emphasize that the attending physicians must not only treat the symptomatic women but also prevent the occurrence of diseases more prevalent after 60 years of age. Hormones can safely be used for the former, when not contraindicated, whereas for the latter non-pharmacological interventions and non-hormonal medications are preferable.

  7. Does oseltamivir shorten flu symptom duration?

    PubMed

    Broadhurst, Richard; Mounsey, Anne

    2016-08-01

    Treatment of influenza virus infection with oral oseltamivir reduces time to alleviation of symptoms in adults and children by approximately one day compared with placebo. It reduces symptom duration even when initiated more than 2 days after symptom onset. PMID:27660842

  8. Menopause status and attitudes in a Turkish midlife female population: an epidemiological study

    PubMed Central

    2010-01-01

    Background It is a well accepted status that socio-cultural characteristics may affect the onset of menopause and its characteristics. The aims of this study were to describe the prevalence rates of menopausal symptoms and these symptoms related factors, and to assess the women's attitudes towards some climacteric issues. Methods This survey was conducted between Jan., 1st 2008 and March, 31st 2008 to research the menopause status of the female population in a city of western Turkey. The study group consisted of 1551 women selected with a multistage area sampling method: a random sample of individuals aged 40-65 years. The questionnaire included questions pertaining to women's sociodemographic characteristics, women's menopausal status, some statements about the climacteric, use of hormones at menopause or before menopause, and some climacteric myths. The data was analyzed by Chi-square (x2) analysis and percent (%) ratios with a significant value of P < 0.05. Results The mean age of the women was 49.1 years. Over 90% of the women were of the negative opinion that the climacteric is "the end of youth", "the end of fecundity", and "the end of unclean days". Most women said that cessation of menstrual periods was the most positive thing because they do not have to wait for monthly bleedings, use sanitary equipment, or take birth control methods. There were significant connections between age groups and nearly all the items, with the exception of the items "the end of life" and "the end of fecundity". Among the women, hot flushes were the most common complaint occurring in 96.5% of women: being severe in 32.9%, moderate in 43.1% and mild in 20.4%. This was followed by low backache or muscle pain 95.0% (25.9% severe, 46.0% moderate and mild 23.1%), headache 91.7% (21.9% severe, 34.9% moderate and 34.9% mild) and feeling tired 91.0% (15.3% severe, 38.6% moderate and 37.1% mild). Conclusions Most of the women in this study had mixed ideas of opinions concerning the

  9. Age at Natural Menopause and Related Factors in Isfahan, Iran

    PubMed Central

    Golshiri, Parastoo; Abdollahzadeh, Mohammad Reza

    2016-01-01

    Objective This study was aimed to evaluate the age at natural menopause and related factors among women in a population based study in 2015 in Isfahan, Islamic Republic of Iran. Methods In this cross-sectional study 960 menopausal women were selected by cluster sampling. Demographic, socioeconomic, lifestyle behavior and reproductive history aspects were collected using a structured questionnaire. Woman and her husband's educational level and occupation with family income were the variables to construct socioeconomic status using principal component analysis. Results Mean and median of natural menopause age were 48.66 and 48 years, respectively. Women body mass index (BMI) more than 30 kg/m2 had significantly higher menopausal age than women with lower BMI (P value = 0.022). The mean of menopausal age was not statistically significant in regard to marital status, physical activity, smoking status, menarche age, age at first pregnancy and history of abortion. Menopause age with pregnancy numbers and age at last pregnancy had a significant positive association. Women with better socioeconomic status had significantly higher natural menopause age. Multiple linear regression shows significant relationship between lower age at menopause with higher age at marriage, higher number of pregnancy and lower socioeconomic status. Conclusion Age at menopause in our studied sample is similar to previous estimates reported for other Iranian populations. Age at marriage, higher number of pregnancy and lower socioeconomic status were the significant factors in relations to age at menopause. PMID:27617243

  10. Age at Natural Menopause and Related Factors in Isfahan, Iran

    PubMed Central

    Golshiri, Parastoo; Abdollahzadeh, Mohammad Reza

    2016-01-01

    Objective This study was aimed to evaluate the age at natural menopause and related factors among women in a population based study in 2015 in Isfahan, Islamic Republic of Iran. Methods In this cross-sectional study 960 menopausal women were selected by cluster sampling. Demographic, socioeconomic, lifestyle behavior and reproductive history aspects were collected using a structured questionnaire. Woman and her husband's educational level and occupation with family income were the variables to construct socioeconomic status using principal component analysis. Results Mean and median of natural menopause age were 48.66 and 48 years, respectively. Women body mass index (BMI) more than 30 kg/m2 had significantly higher menopausal age than women with lower BMI (P value = 0.022). The mean of menopausal age was not statistically significant in regard to marital status, physical activity, smoking status, menarche age, age at first pregnancy and history of abortion. Menopause age with pregnancy numbers and age at last pregnancy had a significant positive association. Women with better socioeconomic status had significantly higher natural menopause age. Multiple linear regression shows significant relationship between lower age at menopause with higher age at marriage, higher number of pregnancy and lower socioeconomic status. Conclusion Age at menopause in our studied sample is similar to previous estimates reported for other Iranian populations. Age at marriage, higher number of pregnancy and lower socioeconomic status were the significant factors in relations to age at menopause.

  11. Efficacy of proline in the treatment of menopause

    PubMed Central

    Nam, Sun-Young; Yoou, Myoung-Schook

    2016-01-01

    The amino acids in the placenta have multiple functions; however, the therapeutic effects of proline remain poorly for relief postmenopausal symptoms. The aim of present study was to evaluate the effects of proline in the treatment of menopause using in vitro and in vivo models. We assessed the therapeutic effects and regulatory mechanisms of proline by using MCF-7 estrogen-dependent cells, MG63 osteoblast cells, and ovariectomized mice model. An in vivo study was carried out in eight-week-old sham and ovariectomized group. The ovariectomized mouse was further subdivided into two groups administered orally with 17β-estradiol or proline (10 mg/kg/day) for eight weeks. Proline significantly increased cell proliferation and Ki-67 levels in MCF-7 cells and enhanced cell proliferation, alkaline phosphatase activity, extracellular signal-regulated kinase phosphorylation, and glutamyl-prolyl-tRNA synthetase activation in MG63 cells. The estrogen receptor-β and estrogen-response elements luciferase activity were significantly increased by proline in MCF-7 and MG63 cells. In ovariectomized mice, oral administration of proline (10 mg/kg/day) for eight weeks significantly reduced body and vaginal weights. Proline also significantly increased serum estradiol and alkaline phosphatase levels, whereas serum luteinizing hormone was decreased by proline. In addition, detailed microcomputed tomography analysis showed that the proline notably enhanced bone mineral density, trabecular bone volume, and trabecular number in ovariectomized mice. Those findings implied that proline can be a promising candidate for the treatment of menopause. PMID:26830682

  12. MENOPAUSAL HOT FLASHES: MECHANISMS, ENDOCRINOLOGY, TREATMENT

    PubMed Central

    Freedman, Robert R.

    2015-01-01

    Hot flashes (HFs) are a rapid and exaggerated heat dissipation response, consisting of profuse sweating, peripheral vasodilation, and feelings of intense, internal heat. They are triggered by small elevations in core body temperature (Tc) acting within a greatly reduced thermoneutral zone, i.e., the Tc region between the upper (sweating) and lower (shivering) thresholds. This is due in part, but not entirely, to estrogen depletion at menopause. Elevated central sympathetic activation, mediated through α2-adrenergic receptors, is one factor responsible for narrowing of the thermoneutral zone. Procedures which reduce this activation, such as paced respiration and clonidine administration, ameliorate HFs as will peripheral cooling. HFs are responsible for some, but not all, of the sleep disturbance reported during menopause. Recent work calls into question the role of serotonin in HFs. PMID:24012626

  13. Minimising menopausal side effects whilst treating endometriosis and fibroids.

    PubMed

    Simpson, Paul D; McLaren, James S; Rymer, Janice; Morris, Edward P

    2015-03-01

    Medical management of endometriosis and fibroids involves manipulation of the hypothalamic-pituitary-gonadal axis to alter the balance of sex hormones thereby inhibiting disease progression and ameliorate symptoms. Unfortunately, resultant menopausal symptoms sometimes limit the tolerability and duration of such treatment. The use of gonadotrophin-releasing hormone agonists to treat these diseases can result in short-term hypoestrogenic and vasomotor side effects as well as long-term impacts on bone health and cardiovascular risk. The routine use of add-back hormone replacement has reduced these risks and increased patient compliance, making this group of drugs more useful as a medium-term treatment option. The estrogen threshold hypothesis highlights the concept of a 'therapeutic window' in which bone loss is minimal but the primary disease is not aggravated. It explains why add-back therapy is appropriate for such patients and helps to explain the basis behind new developments in the treatment of hormonally responsive gynaecological conditions such as gonadotrophin-releasing hormone antagonists and progesterone receptor modulators. PMID:25802141

  14. Minimising menopausal side effects whilst treating endometriosis and fibroids.

    PubMed

    Simpson, Paul D; McLaren, James S; Rymer, Janice; Morris, Edward P

    2015-03-01

    Medical management of endometriosis and fibroids involves manipulation of the hypothalamic-pituitary-gonadal axis to alter the balance of sex hormones thereby inhibiting disease progression and ameliorate symptoms. Unfortunately, resultant menopausal symptoms sometimes limit the tolerability and duration of such treatment. The use of gonadotrophin-releasing hormone agonists to treat these diseases can result in short-term hypoestrogenic and vasomotor side effects as well as long-term impacts on bone health and cardiovascular risk. The routine use of add-back hormone replacement has reduced these risks and increased patient compliance, making this group of drugs more useful as a medium-term treatment option. The estrogen threshold hypothesis highlights the concept of a 'therapeutic window' in which bone loss is minimal but the primary disease is not aggravated. It explains why add-back therapy is appropriate for such patients and helps to explain the basis behind new developments in the treatment of hormonally responsive gynaecological conditions such as gonadotrophin-releasing hormone antagonists and progesterone receptor modulators.

  15. The menopause and aging, a comparative perspective

    PubMed Central

    Finch, Caleb E

    2013-01-01

    The neuroendocrinology of menopause is reviewed from a comparative perspective, with emphasis on laboratory rodent models. These changes are compared by the 2011 STRAW Criteria (Stages of Reproductive Aging Workshop). Ovarian cell loss begins prenatally in all mammals studied, with exponential depletion of primary follicles and oocytes in association with loss of fecundity by midlife. Rodents and humans also share progressively increasing irregularity in ovulatory cycles and increasing fetal aneuploidy as oocyte depletion become imminent. Hypothalamic impairments of the estrogen-induced surge of pituitary gonadotrophins (luteinizing hormone, LH; follicle stimulating hormone, FSH) are prominent in middle-aged rodents, but sporadic in peri-menopausal women. In aging rodents, hypothalamic impairments of the LH surge have been experimentally associated with prolonged phases of sustained estradiol (E2) and very low progesterone (P4) (‘unopposed estradiol’). Although peri-menopausal women also show hyper-estrogenic cycles, there is no indication for irreversible hypothalamic desensitization by E2. Ongoing cognitive assessments in clinical trials of estrogen therapy with and without P4 or other progestins may further inform about possible persisting effects of unopposed estrogens. PMID:23583565

  16. The menopausal hot flush--anything new?

    PubMed

    Sturdee, David W

    2008-05-20

    Although the hot flush is generally recognised by women and the medical profession as the most characteristic and often a very distressing symptom of the climacteric, it remains an enigma. The physiological changes associated with the hot flush are different from any other flushing condition, with an increased peripheral blood flow, increased heart rate and in particular a decrease in galvanic skin resistance, which is unique to the flush. Flushing occurs as a result of disturbance of the temperature regulating mechanism situated in the hypothalamus, and probably a reduction in the thermoneutral zone, within which fluctuations of basal body temperature do not provoke compensatory vascular responses. Many factors have been implicated, including hormone releasing factors, gonadotrophins and neurohumorals. However, the role of oestrogen is critical and the clinical value of oestrogen therapy is well established and has been confirmed by a Cochrane review. Nevertheless, the precise mechanism by which reduced circulating levels of oestrogen are involved in causing the flush has not yet been established. Priming with oestrogen seems to be an essential pre-requisite for flushing, as young women with ovarian dysgenesis and very low circulating levels of oestrogen never have hot flushes unless they are given oestrogen replacement therapy, which is later discontinued. Oestrogen antagonist activity by selective oestrogen receptor modulators such as tamoxifen and raloxifene can also cause flushing. A link with gonadotrophins is demonstrated by a temporal association of flushes with the pulsatile release of luteinising hormone (LH). However, if LH pulses are eliminated by GnRH analogue, the frequency of flushing is not altered, which confirms that LH is merely associated with the flush rather than being causative. It is probable that the flush is initiated by a supra-pituitary mechanism which is influenced by the hypothalamic factors responsible for pulsatile LH release. A

  17. Physical exercise alleviates ADHD symptoms: regional deficits and development trajectory.

    PubMed

    Archer, Trevor; Kostrzewa, Richard M

    2012-02-01

    The heterogeneous, chronic, and proliferating aspect of attention deficit hyperactivity disorder (ADHD) and comorbidities covers heritability, cognitive, emotional, motor, and everyday behavioral domains that place individuals presenting the condition at some considerable disadvantage. Disruption of "typical developmental trajectories" in the manifestation of gene-environment interactive predispositions implies that ADHD children and adolescents may continue to perform at defective levels as adults with regard to academic achievement, occupational enterprises, and interpersonal relationships, despite the promise of pharmacotherapeutic treatments. Physical exercise provides a plethora of beneficial effects against stress, anxiety, depression, negative affect and behavior, poor impulse control, and compulsive behavior concomitant with improved executive functioning, working memory and positive affect, as well as improved conditions for relatives and care-givers. Brain-derived neurotrophic factor, an essential element in normal brain development that promotes health-associated behaviors and quality-of-life, though reduced in ADHD, is increased markedly by the intervention of regular physical exercise. Functional, regional, and biomarker deficits, as well as hypothalamic-pituitary-adrenal disruptions, have been improved through regular and carefully applied exercise programs. In view of the complications involving ADHD with co-morbidities, such as obesity, the influence of regular physical exercise has not been found negligible. Physical exercise bestows a propensity for eventual manifestation of "redifferentiated" developmental trajectories that may equip ADHD adults with a prognosis that is more adaptive functionally, independent of the applications of other therapeutic agents and treatments. PMID:21850535

  18. Physical exercise alleviates ADHD symptoms: regional deficits and development trajectory.

    PubMed

    Archer, Trevor; Kostrzewa, Richard M

    2012-02-01

    The heterogeneous, chronic, and proliferating aspect of attention deficit hyperactivity disorder (ADHD) and comorbidities covers heritability, cognitive, emotional, motor, and everyday behavioral domains that place individuals presenting the condition at some considerable disadvantage. Disruption of "typical developmental trajectories" in the manifestation of gene-environment interactive predispositions implies that ADHD children and adolescents may continue to perform at defective levels as adults with regard to academic achievement, occupational enterprises, and interpersonal relationships, despite the promise of pharmacotherapeutic treatments. Physical exercise provides a plethora of beneficial effects against stress, anxiety, depression, negative affect and behavior, poor impulse control, and compulsive behavior concomitant with improved executive functioning, working memory and positive affect, as well as improved conditions for relatives and care-givers. Brain-derived neurotrophic factor, an essential element in normal brain development that promotes health-associated behaviors and quality-of-life, though reduced in ADHD, is increased markedly by the intervention of regular physical exercise. Functional, regional, and biomarker deficits, as well as hypothalamic-pituitary-adrenal disruptions, have been improved through regular and carefully applied exercise programs. In view of the complications involving ADHD with co-morbidities, such as obesity, the influence of regular physical exercise has not been found negligible. Physical exercise bestows a propensity for eventual manifestation of "redifferentiated" developmental trajectories that may equip ADHD adults with a prognosis that is more adaptive functionally, independent of the applications of other therapeutic agents and treatments.

  19. Hypertrophic cardiomyopathy. Tools for identifying risk and alleviating symptoms.

    PubMed

    DeLuca, M; Tak, T

    2000-06-01

    Hypertrophic cardiomyopathy is characterized by left or right ventricular hypertrophy that is usually asymmetric and involves the interventricular septum. The condition has numerous genetic, anatomic, and clinical variations and continues to stimulate interest and investigation into causes and treatment options. New genetic forms of the disorder are being identified because of the rapid growth of molecular genetics. However, even with technological advances and a large database of information, risk stratification and treatment of hypertrophic cardiomyopathy remain difficult and controversial. Because of the high risk of sudden death, it is imperative that patients be advised against participation in competitive sports.

  20. Sex-specific risk of cardiovascular disease and cognitive decline: pregnancy and menopause

    PubMed Central

    2013-01-01

    Understanding the biology of sex differences is integral to personalized medicine. Cardiovascular disease and cognitive decline are two related conditions, with distinct sex differences in morbidity and clinical manifestations, response to treatments, and mortality. Although mortality from all-cause cardiovascular diseases has declined in women over the past five years, due in part to increased educational campaigns regarding the recognition of symptoms and application of treatment guidelines, the mortality in women still exceeds that of men. The physiological basis for these differences requires further research, with particular attention to two physiological conditions which are unique to women and associated with hormonal changes: pregnancy and menopause. Both conditions have the potential to impact life-long cardiovascular risk, including cerebrovascular function and cognition in women. This review draws on epidemiological, translational, clinical, and basic science studies to assess the impact of hypertensive pregnancy disorders on cardiovascular disease and cognitive function later in life, and examines the effects of post-menopausal hormone treatments on cardiovascular risk and cognition in midlife women. We suggest that hypertensive pregnancy disorders and menopause activate vascular components, i.e., vascular endothelium and blood elements, including platelets and leukocytes, to release cell-membrane derived microvesicles that are potential mediators of changes in cerebral blood flow, and may ultimately affect cognition in women as they age. Research into specific sex differences for these disease processes with attention to an individual’s sex chromosomal complement and hormonal status is important and timely. PMID:23537114

  1. Dealing with premature menopause in women at high-risk for hereditary genital and breast cancer.

    PubMed

    Nappi, Rossella E; Cassani, Chiara; Rossi, Margherita; Zanellini, Francesca; Spinillo, Arsenio

    2016-10-01

    Risk-reducing salpingo-oophorectomy is the mainstay of ovarian cancer prevention in BRCA mutation carriers. However, premature menopause exerts many short and long-term consequences on the individual health that are preventable with a tailored approach. Even though our level of knowledge on BRCA1 and -2 mutation carriers is still in its infancy, the basic principles governing the management of menopausal symptomatology and the prevention of diseases should be applied, including the use of hormone replacement therapy (HRT), approximately until the age of 50. Indeed, short-term HRT significantly ameliorate quality of life and symptoms associated to vulvo-vaginal atrophy, without displaying an adverse effect on oncologic outcomes in BRCA1 and BRCA2 mutation carriers without a personal history of breast cancer. Premature menopause affects significantly also bone health, cardiovascular parameters and cognition. A standard of care is required in order to identify those women at higher risk of developing chronic conditions at midlife and beyond. Appropriate counseling on both hormonal and non-hormonal treatments is an essential part of a shared decision on the most effective management of women at high-risk for hereditary genital and breast cancer. PMID:26928421

  2. Vaginal microbiome and epithelial gene array in post-menopausal women with moderate to severe dryness.

    PubMed

    Hummelen, Ruben; Macklaim, Jean M; Bisanz, Jordan E; Hammond, Jo-Anne; McMillan, Amy; Vongsa, Rebecca; Koenig, David; Gloor, Gregory B; Reid, Gregor

    2011-01-01

    After menopause, many women experience vaginal dryness and atrophy of tissue, often attributed to the loss of estrogen. An understudied aspect of vaginal health in women who experience dryness due to atrophy is the role of the resident microbes. It is known that the microbiota has an important role in healthy vaginal homeostasis, including maintaining the pH balance and excluding pathogens. The objectives of this study were twofold: first to identify the microbiome of post-menopausal women with and without vaginal dryness and symptoms of atrophy; and secondly to examine any differences in epithelial gene expression associated with atrophy. The vaginal microbiome of 32 post-menopausal women was profiled using Illumina sequencing of the V6 region of the 16S rRNA gene. Sixteen subjects were selected for follow-up sampling every two weeks for 10 weeks. In addition, 10 epithelial RNA samples (6 healthy and 4 experiencing vaginal dryness) were acquired for gene expression analysis by Affymetrix Human Gene array. The microbiota abundance profiles were relatively stable over 10 weeks compared to previously published data on premenopausal women. There was an inverse correlation between Lactobacillus ratio and dryness and an increased bacterial diversity in women experiencing moderate to severe vaginal dryness. In healthy participants, Lactobacillus iners and L. crispatus were generally the most abundant, countering the long-held view that lactobacilli are absent or depleted in menopause. Vaginal dryness and atrophy were associated with down-regulation of human genes involved in maintenance of epithelial structure and barrier function, while those associated with inflammation were up-regulated consistent with the adverse clinical presentation.

  3. Twelve-week exercise training and the quality of life in menopausal women – clinical trial

    PubMed Central

    Dąbrowska, Jolanta; Rutkowska, Magdalena; Michalski, Bogdan Adam

    2016-01-01

    Introduction The menopause transition is associated with decreased health functioning. About 80-90% of women experience mild to severe physical or physiological menopause-related complaints per year when approaching menopause. Physical activity may reduce some climacteric symptoms and improve the quality of life. Aim of the study Aim of the study was to investigate the influence of a 12-week training programme on the quality of life (QoL) in menopausal-aged women living in a rural area. Material and methods Participants were 80 women aged 40-65 years and divided into two randomly selected groups in training sessions (exercising group, n = 40 and control group, n = 40). SF36 was used to assess the quality of life in both groups before and after 12 weeks. Exercising women participated in training session 3 times a week. Each 60-minute exercise session included warming-up exercises, walking, stretching, strengthening exercises with an elastic band and cooling down exercises. Results A non-significant positive difference in all SF36 domains in the exercising group was observed. The results of the study showed a statistically significant higher QoL in the exercising group compared to the control group after 12-week training in two domains: vitality and mental health. The improvement in the quality of life in the study group was 0.19 points (role limits – physical domain, least change) and 4.96 (vitality domain, most change). Conclusions Controlled and regular exercise for 12 weeks was significantly correlated with a positive change in vitality and mental health. Sedentary women should consider modification of their lifestyle to include physical activity as it leads to improvement of their quality of life. PMID:27095954

  4. Life history evolution: what does a menopausal killer whale do?

    PubMed

    Whitehead, Hal

    2015-03-16

    Menopause evolved in humans and whales, presumably because older females can help their kin. But how do they help? New research shows that post-menopausal female killer whales lead foraging groups. This leadership is most significant when food is scarce. PMID:25784039

  5. Life history evolution: what does a menopausal killer whale do?

    PubMed

    Whitehead, Hal

    2015-03-16

    Menopause evolved in humans and whales, presumably because older females can help their kin. But how do they help? New research shows that post-menopausal female killer whales lead foraging groups. This leadership is most significant when food is scarce.

  6. Cognitive effects of chemotherapy-induced menopause in breast cancer.

    PubMed

    Vearncombe, Katharine J; Rolfe, Margaret; Andrew, Brooke; Pachana, Nancy A; Wright, Margaret; Beadle, Geoffrey

    2011-11-01

    This study examined whether chemotherapy-induced menopause affects cognitive functioning in women with early breast cancer. The neuropsychological performance of 121 breast cancer patients (age M=49.62, SD=8.11, range=25.25-67.92) treated with chemotherapy was assessed pre-chemotherapy, as well as 1, 6, and 18 months post-chemotherapy completion. Linear mixed modeling was used to evaluate the data. Type of menopause (pre, chemotherapy-induced, and post menopause) was found to significantly interact with cognitive performance on two cognitive variables. Specifically, chemotherapy-induced menopausal women did not show any significant changes in performance on an abstract reasoning task, while the pre-menopausal and post-menopausal groups significantly improved over time. A significant interaction on a test of finger dexterity and coordination was also found, although inspection of the results indicated that this was due to a significant improvement in the pre-menopausal groups at 6 months post chemotherapy. After chemotherapy most cognitive variables showed improvements over time, although two indicators of verbal memory showed significant declines immediately after chemotherapy, with improvement by 18 months post completion. The current study found little evidence to suggest that chemotherapy-induced menopause broadly affects cognitive functioning after treatment administration. However, longer follow-up assessments are warranted to assess the long-term effects of combined chemotherapy and endocrine treatment.

  7. Counseling Women in Midlife: An Integrative Approach to Menopause.

    ERIC Educational Resources Information Center

    Huffman, Shirley B.; Myers, Jane E.

    1999-01-01

    Proposes that counselors who use an integrative approach to menopause can not only provide accurate biomedical information but also conceptualize menopause as a normative midlife transition. Provides a foundation in biomedical issues and considers how these in interaction with cultural and psychosocial factors influence the experience of…

  8. Starting Hormone Therapy at Menopause Increases Breast Cancer Risk

    Cancer.gov

    According to a January 28, 2011 article in the Journal of the National Cancer Institute, women who start taking menopausal hormone therapy around the time of menopause have a higher risk of breast cancer than women who begin taking hormones a few years later.

  9. Position of the Spanish Menopause Society regarding the management of perimenopause.

    PubMed

    Mendoza, N; Sánchez-Borrego, R; Cancelo, M J; Calvo, A; Checa, M A; Cortés, J; Elorriaga, M A; Díaz, T; González, J V; Lete, I; Lobo, P; Martínez-Astorquiza, T; Nieto, A; Olalla, M A; Pérez-Campos, E; Porqueras, R; Quereda, F; Salamanca, A; De La Viuda, E

    2013-03-01

    Perimenopause is an imprecise period in woman over 40 years of age, which comprises the time between the moment that the first changes in the menstrual cycle appear and the year following the definitive cessation of the menses. Besides irregular bleeding, many women also complain of hot flashes and other characteristic symptoms of postmenopause. Moreover, most of them are concerned about the future impact that these events may have on their health, such as needing health exams or continuing to use contraceptive methods. A panel of experts from the Spanish Menopause Society has met to establish diagnostic and therapeutic guidelines for this period based on the best available evidence.

  10. Menopausal hot flashes: Randomness or rhythmicity

    NASA Astrophysics Data System (ADS)

    Kronenberg, Fredi

    1991-10-01

    Menopausal hot flashes are episodes of flushing, increased heart rate, skin blood flow and skin temperature, and a sensation of heat. The thermoregulatory and cardiovascular concomitants of hot flashes are associated with peaks in the levels of various hormones and neurotransmitters in the peripheral circulation. Although hot flashes affect about 75% of women, and are the primary reason that women at menopause seek medical attention, the mechanism of hot flashes is still not understood. Hot flashes vary in frequency and intensity both within and between individuals, and have been thought of as occurring randomly. Yet, some women report that their hot flashes are worse at a particular time of day or year. Initial examination of subjects' recordings of their hot flashes showed diurnal patterns of hot flash occurrence. There also seems to be a diurnal rhythm of hot flash intensity. Continuous physiological monitoring of hot flashes is facilitating the analysis of these patterns, which is revealing circadian and ultradian periodicities. The occurrence of hot flashes can be modulated by external and internal factors, including ambient temperature and fever. Rhythms of thermoregulatory and endocrine functions also may influence hot flash patterns. Examination of the interrelationships between the various systems of the body involved in hot flashes, and a multidisciplinary approach to the analysis of hot flash patterns, will aid our understanding of this complex phenomenon.

  11. Menopausal bone loss and estrogen replacement.

    PubMed

    Meema, S; Meema, H E

    1976-07-01

    Throughout adult life the bone mineral mass of the radius is greater in males than in females. In males, it decreases after 60 years of age, while in females, it decreases earlier, at approximately 50 years, and the loss is greater. At the average age of 67 years, one half of the normal white female population has less than the normal amount of bone in the radius. Premenopausal women over the age of 50 do not show any decline of bone mineral mass, while in postmenopausal women, regardless of age, there is a loss of bone mass related to the number of years after menopause. Castrated women have significantly less bone mass than premenopausal women of the same average age. No decrease in cortical thickness of the radius was found in oophorectomized women treated with estrogens after castration. In a long-term, follow-up study, untreated postmenopausal women (after a natural or an artifical menopause) showed a significant loss of bone mass, while estrogen-treated, postmenopausal women showed no such loss. Estrogen treatment thus appears to prevent postmenopausal bone loss.

  12. An overview of chronic vaginal atrophy and options for symptom management.

    PubMed

    Woods, Nancy Fugate

    2012-12-01

    During the menopausal transition and after menopause, up to 45 percent of women will develop vaginal atrophy as a consequence of decreased levels of circulating estrogen. Symptoms include vaginal dryness, itching, soreness, bleeding, increased susceptibility to infection and pain with sexual intercourse. Treatments are often underused because of patient and clinician lack of knowledge of available treatments, embarrassment about initiating a discussion of symptoms and reluctance to initiate hormonal therapy. Methods of symptom management include self-care with over-the-counter agents and prescription treatment with various forms of localized estrogen. Clinicians should consider each woman's unique situation and health history before recommending a management strategy.

  13. Association Between Hypertension, Menopause, and Cognition in Women.

    PubMed

    Zilberman, Judith M; Cerezo, Gustavo H; Del Sueldo, Mildren; Fernandez-Pérez, Cristina; Martell-Claros, Nieves; Vicario, Augusto

    2015-12-01

    The aim of this study was to investigate the cognitive state in women and its relation to menopause and hypertension (HTN). The authors included 1034 women aged 47.13±15.71 years. The prevalence of HTN was 47.1%, with 67.8% of patients treated and 48.6% controlled. Cognitive impairment was higher among hypertensive menopausal (mini-Boston Naming Test: 7.4±3.1 vs 8.5±2.4, P<.001; Clock-Drawing Test: 5.2±2 vs 5.6±1.6, P<.01). Using logistic regression adjusted by age and education level, statistical differences were found in the results from the mini-Boston Naming Test between menopausal hypertensive vs menopausal normotensive women (odds ratio, 1.48; 95% confidence interval, 1.06-2.07; P=.021), and no difference between nonmenopausal hypertensive vs menopausal normotensive women (odds ratio, 0.89; 95% confidence interval, 0.51-1.57; P=.697). The P interaction between both groups was significant (P=.038). The possibility of alteration in cortical functions in menopausal hypertensive woman showed a relative increment of 48% (P=.021). The association between HTN and menopause increases the possibility of compromising the semantic memory by 50%. PMID:26252810

  14. Association Between Hypertension, Menopause, and Cognition in Women.

    PubMed

    Zilberman, Judith M; Cerezo, Gustavo H; Del Sueldo, Mildren; Fernandez-Pérez, Cristina; Martell-Claros, Nieves; Vicario, Augusto

    2015-12-01

    The aim of this study was to investigate the cognitive state in women and its relation to menopause and hypertension (HTN). The authors included 1034 women aged 47.13±15.71 years. The prevalence of HTN was 47.1%, with 67.8% of patients treated and 48.6% controlled. Cognitive impairment was higher among hypertensive menopausal (mini-Boston Naming Test: 7.4±3.1 vs 8.5±2.4, P<.001; Clock-Drawing Test: 5.2±2 vs 5.6±1.6, P<.01). Using logistic regression adjusted by age and education level, statistical differences were found in the results from the mini-Boston Naming Test between menopausal hypertensive vs menopausal normotensive women (odds ratio, 1.48; 95% confidence interval, 1.06-2.07; P=.021), and no difference between nonmenopausal hypertensive vs menopausal normotensive women (odds ratio, 0.89; 95% confidence interval, 0.51-1.57; P=.697). The P interaction between both groups was significant (P=.038). The possibility of alteration in cortical functions in menopausal hypertensive woman showed a relative increment of 48% (P=.021). The association between HTN and menopause increases the possibility of compromising the semantic memory by 50%.

  15. Korean urban women's experience of menopause: new life.

    PubMed

    Lee, K H

    1997-01-01

    The purpose of this article is to share with nurses around the world the findings of a phenomenological study of the meaning of menopause as experienced by modern Korean women. Four rhythmical patterns of the process of menopause were found: from suffering to comfort, from oppression to freedom, from being a good wife and mother to becoming a woman, and from a productive life to a transformed life. This unique nursing perspective on women's experience of menopause can further nurses' understanding of this human health experience and contribute to their participation in the quality of women's lives.

  16. Adiponectin and Metabolic Syndrome in Women at Menopause

    PubMed Central

    Mankowska, Aneta; Nowak, Lena; Sypniewska, Grazyna

    2009-01-01

    Obesity is associated with premature atherosclerosis, as well as with many metabolic alterations including insulin resistance, dyslipidemia and hypertension. Visceral fat accumulation, particularly, is closely associated with the development of metabolic syndrome. The menopause transition, as well as the early postmenopausal period, is associated with increase in total and central obesity. Among adipocytokines secreted by the adipose tissue adiponectin is the only one that has a protective role in the development of obesity-related disorders, such as type 2 diabetes and cardiovascular disease. This review aims to present a role that adiponectin may play during the progress of menopause in relation to development of menopausal metabolic syndrome.

  17. Menoprogen, a TCM Herbal Formula for Menopause, Increases Endogenous E2 in an Aged Rat Model of Menopause by Reducing Ovarian Granulosa Cell Apoptosis

    PubMed Central

    Li, Yu; Ma, Hong; Lu, Ye; Tan, B. J.; Xu, L.; Lawal, Temitope O.; Mahady, Gail B.; Liu, Daniel

    2016-01-01

    The effect of Menoprogen (MPG) on ovarian granulosa cell (GC) apoptosis was investigated in vitro and in vivo in an aged rat model of menopause. Intragastric administration of Menoprogen or estradiol valerate to 14-month-old senile female rats for eight weeks increased plasma E2 levels, as well as the weight of both ovarian and uterine tissues. Flow cytometric (FCM) analysis of isolated GCs from MPG-treated aged rats showed reductions in the G0/G1 ratio and apoptotic peaks. Isolated GCs also exhibited an increase in cell size and the number of cytoplastic organelles and intracellular gap junctions, the reappearance of secretory granules, and a lack of apoptotic bodies as determined by TEM. Results from a TdT-mediated dUTP nick end-labeling (TUNEL) assay revealed a reduction in TUNEL-positive GCs after MPG treatment. Immunohistochemical analysis showed a downregulation of proapoptotic Bax proteins and an upregulation of antiapoptotic Bcl-2 proteins. The addition of MPG-medicated serum to the media of cultured GCs also reduced cadmium chloride-induced apoptosis and downregulated caspase-3 protein expression. This work demonstrates that Menoprogen inhibits GC apoptosis in aged female rats and thereby increases E2 production. This represents a novel mechanism of action for this herbal medicine in the treatment of menopausal symptoms. PMID:26981526

  18. Estrogen and cerebrovascular regulation in menopause.

    PubMed

    Raz, Limor

    2014-05-25

    Estrogen (E2), classically viewed as a reproductive steroid hormone, has non-reproductive functions throughout the body including in the brain and vasculature. Studies report diminished neuroprotection with declining E2 levels, corresponding with higher incidence of cerebrovascular and neurological disease. However, the effects of menopausal hormone therapy (MHT) on the cerebral vasculature and brain function remain controversial. This review will focus on evidence of 17β-estradiol actions in the cerebral vasculature, with a particular emphasis on the vasoactive, anti-inflammatory, anti-oxidant, metabolic and molecular properties. Controversies surrounding MHT in relation to cerebrovascular disease and stroke risk will be discussed, particularly the emerging evidence from clinical trials supporting the critical period hypothesis of estrogen protection.

  19. Safety and efficacy of ospemifene for the treatment of dyspareunia associated with vulvar and vaginal atrophy due to menopause.

    PubMed

    Wurz, Gregory T; Kao, Chiao-Jung; DeGregorio, Michael W

    2014-01-01

    During the menopausal transition, women experience a number of symptoms due to declining estrogen levels, including vasomotor symptoms and vulvar and vaginal atrophy (VVA). Unlike vasomotor symptoms, vaginal dryness and dyspareunia, the main symptoms of VVA, typically worsen without treatment and can significantly impact the quality of life. Up to 60% of postmenopausal women may be affected by VVA, but many women unfortunately do not seek treatment due to embarrassment or other factors. After 20+ years in development, ospemifene (Osphena™) was approved by the US Food and Drug Administration in 2013 for treatment of moderate-to-severe dyspareunia associated with VVA due to menopause. As the first non-hormonal alternative to estrogen-based products for this indication, the approval of ospemifene represents a significant milestone in postmenopausal women's health. Ospemifene is a non-steroidal estrogen receptor agonist/antagonist, also known as a selective estrogen receptor modulator (SERM), from the same chemical class as the breast cancer drugs tamoxifen and toremifene. Unlike other selective estrogen receptor modulators, ospemifene exerts a strong, nearly full estrogen agonist effect in the vaginal epithelium, making it well suited for the treatment of dyspareunia in postmenopausal women. Results of Phase III clinical trials showed that ospemifene significantly improved the vaginal maturation index (decreased parabasal cells and increased superficial cells), decreased vaginal pH, and decreased severity of the self-identified most bothersome symptom (dyspareunia or vaginal dryness) compared to placebo. Long-term safety studies revealed that 60 mg ospemifene given daily for 52 weeks was well tolerated and was not associated with any endometrium or breast-related safety concerns. This review discusses the preclinical and clinical data supporting the use of ospemifene for the treatment of dyspareunia associated with VVA due to menopause and provides an overview of

  20. Hormone Therapy Won't Help Memory After Menopause

    MedlinePlus

    ... page: https://medlineplus.gov/news/fullstory_159955.html Hormone Therapy Won't Help Memory After Menopause 5-year ... important risk cognitively associated with the use of hormone therapy over at least five years," said lead researcher ...

  1. Early life circumstances and their impact on menarche and menopause

    PubMed Central

    Mishra, Gita D; Cooper, Rachel; Tom, Sarah E; Kuh, Diana

    2012-01-01

    Ages at menarche and menopause have been shown to be associated with adverse health outcomes in later life. For example, earlier menarche and later menopause have been independently linked to higher risk of breast cancer. Earlier menarche may also be associated with an increased risk of endometrial cancer, menstrual problems and adult obesity. Given the associations of ages at menarche and menopause with future health outcomes, it is important to establish what factors across life, and generations, may influence these. This article examines the associations of early life factors, namely birthweight, bodyweight and growth during childhood, childhood socioeconomic circumstances and psychosocial factors with ages at menarche and menopause. It examines possible explanations of the associations found, including life history theory, and discusses areas for future research. PMID:19245355

  2. Critical appraisal of paroxetine for the treatment of vasomotor symptoms

    PubMed Central

    Carroll, Dana G; Lisenby, Katelin M; Carter, Tracy L

    2015-01-01

    Background Vasomotor symptoms (VMS), characterized by hot flashes and night sweats, are the most commonly reported symptoms associated with estrogen deficiency during menopause and occur in up to 70% of women. The goal of treatment is to reduce the frequency and severity of symptoms. Although hormone therapy (HT) is generally recommended as first-line treatment, it is not appropriate for all patients. Antidepressants, specifically selective serotonin reuptake inhibitors, have been evaluated and utilized internationally for alternative treatment for VMS. In 2013, paroxetine mesylate (Brisdelle®) received a US Food and Drug Administration-labeled indication for moderate-to-severe hot flashes, making it the first nonhormonal treatment for VMS associated with menopause. The objective of this review is to critically evaluate available clinical data regarding the efficacy and safety of paroxetine for the treatment of VMS in menopausal women. Methods MEDLINE, PubMed, and Google Scholar were searched using the keywords paroxetine, vasomotor symptoms, hot flashes, and menopause. Searches were limited to humans, English language, and clinical trial design with a primary outcome of hot flash/vasomotor changes. Results Paroxetine (hydrochloride and mesylate) has been associated with a 33%–67% reduction in hot flash frequency with 6–12 weeks of treatment compared to 13.7%–37.8% reductions with placebo in patients both with and without a history of breast cancer. It was also associated with significant reductions in hot flash severity. Benefits of treatment persisted through 24 weeks in the study of the longest duration. Most adverse effects reported were of mild-to-moderate severity, with improved tolerability associated with lower doses (7.5–12.5 mg/day). Conclusion Paroxetine is a safe and effective therapy for the treatment of VMS during menopause. Paroxetine (7.5–12.5 mg/day) should be considered a first-line therapy option for VMS in patients when HT is either

  3. Voices from the Hilo Women's Health Study: Talking Story About Menopause

    PubMed Central

    Morrison, Lynn A.; Sievert, Lynnette L.; Brown, Daniel E.; Reza, Angela; Rahberg, Nichole; Mills, Phoebe; Goodloe, Amber

    2013-01-01

    Our purpose in conducting this qualitative study was to examine how a multi-ethnic sample of women living in Hilo, Hawaii describe menopause. Interviews were conducted with 185 pre-, peri-, and post-menopausal women aged 45 to 55. We found that pre-menopausal women felt anxious compared to peri- and post-menopausal women's more affirmative attitudes of increasing confidence and freedom in this new cycle of life. A dominant theme was the construction of a post-menstrual identity. Peri-and post-menopausal women's attitudes were not biomedically oriented. Local culture and the island lifestyle may provide a positive atmosphere for women going through menopause. PMID:24134306

  4. Influence of SULT1A1 genetic variation on age at menopause, estrogen levels, and response to hormone therapy in recently postmenopausal white women

    PubMed Central

    Moyer, Ann M.; de Andrade, Mariza; Weinshilboum, Richard M.; Miller, Virginia M.

    2016-01-01

    Abstract Objective: Onset and symptoms of menopause, and response to hormone therapy (HT) show large interindividual variability. SULT1A1 encodes for a highly expressed enzyme that metabolizes estrogens. We evaluated the relationship between genetic variation in SULT1A1, menopause age, symptoms, and response to HT. Methods: Women enrolled in the Kronos Early Estrogen Prevention Study at Mayo Clinic were randomized to 48 months of treatment with oral conjugated equine estrogen (n = 34), transdermal 17β-estradiol (E2) (n = 33), or placebo (n = 35). Linear regression models and ANOVA were used to test for association of SULT1A1 copy number, rs3760091, rs750155, and rs9282861 (SULT1A1∗2), with age at menopause and symptoms, levels of estrogens (estrone [E1], estrone sulfate [E1S], E2, and estradiol sulfate [E2S]), before and after HT. Results: SULT1A1 gene copy number affected the minor allele frequency for each single nucleotide polymorphisms tested. Before administration of exogenous hormones, increasing number of G alleles at rs9282861 was associated with earlier age at menopause (P = 0.014), lower frequency of night sweats (P = 0.009), and less severe insomnia (P = 0.046). After 48 months of treatment, SULT1A1 genotype was not associated with the presence of menopausal symptoms. In women randomized to oral conjugated equine estrogen, increasing number of the A allele at rs750155 was associated with lower E1S and E2S (P = 0.004 and 0.017), whereas increasing number of the C allele at rs3760091 was associated with lower E2S/E2 (P = 0.044). Conclusions: Interindividual variability in onset of menopause and symptoms before initiation of HT is explained in part by genetic variation in SULT1A1 and may represent a step toward individualizing HT treatment decisions. PMID:27300114

  5. Altruistic colony defense by menopausal female insects.

    PubMed

    Uematsu, Keigo; Kutsukake, Mayako; Fukatsu, Takema; Shimada, Masakazu; Shibao, Harunobu

    2010-07-13

    Recent studies have suggested that an extended postreproductive life span, such as life after menopause in human females, will evolve when the indirect (kin-selected) fitness benefits from altruistic behavior are greater than the direct fitness benefits from continuing reproduction. Under some conditions in which postreproductive altruism is more beneficial and/or continuing reproduction is more costly, the postreproductive life span can be shaped by natural selection. However, indirect fitness benefits during postreproductive survival have been documented mainly in intelligent mammals such as humans and cetaceans, in which elder females possess enhanced social knowledge through learning. Here we show that postreproductive females of the gall-forming aphid Quadrartus yoshinomiyai (Nipponaphidini) can gain indirect fitness benefits through their altruistic colony defense. These females cease reproduction around the time of gall opening and defend the colony by sticking themselves to intruding predators with a waxy secretion that is accumulated in their body with aging. Our results suggest that the presence of an age-related trait for altruistic behavior promotes the evolution of postreproductive altruism in this social insect via kin selection under natural selection imposed by predators.

  6. Anthrax: Symptoms

    MedlinePlus

    ... hands Inhalation anthrax symptoms can include: Fever and chills Chest Discomfort Shortness of breath Confusion or dizziness ... aches Gastrointestinal anthrax symptoms can include: Fever and chills Swelling of neck or neck glands Sore throat ...

  7. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?

    PubMed

    Edwards, D; Panay, N

    2016-04-01

    Vaginal dryness is a common condition that is particularly prevalent during and after the menopause, and is one of the symptoms of vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underestimated. Furthermore, barriers exist to treatment-seeking, and this condition is often underreported and undertreated. Greater education about vaginal dryness and the range of available treatments is essential to encourage more women to seek help for this condition. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. However, there is a distinction between lubricants and moisturizers, and notable differences between commercially available products. Women should be advised to choose a product that is optimally balanced in terms of both osmolality and pH, and is physiologically most similar to natural vaginal secretions. A series of recommendations for the use of vaginal lubricants and moisturizers, either on their own or in combination with systemic or topical hormone replacement therapy, is presented.

  8. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer composition?

    PubMed Central

    Edwards, D.; Panay, N.

    2016-01-01

    Abstract Vaginal dryness is a common condition that is particularly prevalent during and after the menopause, and is one of the symptoms of vulvovaginal atrophy/genitourinary syndrome of menopause. The impact of vaginal dryness on interpersonal relationships, quality of life, daily activities, and sexual function can be significant, but is frequently underestimated. Furthermore, barriers exist to treatment-seeking, and this condition is often underreported and undertreated. Greater education about vaginal dryness and the range of available treatments is essential to encourage more women to seek help for this condition. Personal lubricants and moisturizers are effective at relieving discomfort and pain during sexual intercourse for women with mild to moderate vaginal dryness, particularly those who have a genuine contraindication to estrogen, or who choose not to use estrogen. However, there is a distinction between lubricants and moisturizers, and notable differences between commercially available products. Women should be advised to choose a product that is optimally balanced in terms of both osmolality and pH, and is physiologically most similar to natural vaginal secretions. A series of recommendations for the use of vaginal lubricants and moisturizers, either on their own or in combination with systemic or topical hormone replacement therapy, is presented. PMID:26707589

  9. Menopausal Hormone Therapy, Age, and Chronic Diseases: Perspectives on Statistical Trends

    PubMed Central

    2016-01-01

    The release of the Women’s Health Initiative (WHI) study in 2002 was a shock to the medical community. Hormone therapy (HT) had generally been considered to be highly beneficial for postmenopausal women since it was the gold standard for relief of menopausal symptoms (hot flashes, night sweats, vaginal atrophy) and it was thought to protect women from osteoporosis, heart disease, and cognitive decline and to generally improve quality of life. However, WHI showed a statistically significant increase in a number of disease states, including breast cancer, cardiovascular disease, and stroke. One problem with the WHI study was that the average age of women in the study was 63, which is considerably older than the age at which most women enter menopause (about 51). The timing hypothesis attempts to rationalize the effect of age on response to HT and risk of various diseases. The data suggests that younger women (50–60) may be protected from heart disease with only a slight increase in breast cancer risk. In contrast, older women (>65) are more susceptible to breast cancer and heart disease and should avoid HT. This Perspective on Statistical Trends evaluates the current data on HT and risk for chronic diseases as a function of age. PMID:27636306

  10. The role of menopause in the development of chronic mountain sickness.

    PubMed

    León-Velarde, F; Ramos, M A; Hernández, J A; De Idiáquez, D; Muñoz, L S; Gaffo, A; Córdova, S; Durand, D; Monge, C

    1997-01-01

    The objective of this study was to investigate the role of menopause in the appearance of the physiopathological sequence that leads to chronic mountain sickness (CMS) in a high-altitude female population. The females studied are 30-54 yr old (n = 152) and have permanent residence in Cerro de Pasco (Pasco, Peru; 4,300 m). The sample was divided into postmenopausal and premenopausal groups for comparison. Blood oxygen saturation (SaO2), excessive erythrocytosis [EE, measured by the level of hematocrit (Het)], peak expiratory flow rates (PEFR), and a score that represents the main signs and symptoms of CMS (CMSscore) were measured. Postmenopausal women had higher Het (50.2 +/- 4.04 vs. 47.4 +/- 4.13%, P < 0.001), lower SaO2 (81.9 +/- 4.12 vs. 84.7 +/- 3.14%, P < 0.001) and PEFR values (489 +/- 101 vs. 534 +/- 90 l/min, P < 0.02), and slightly higher CMSscore (19.1 +/- 3.37 vs. 17.9 +/- 3.48, P < 0.06) than premenopausal women. The prevalence of women with EE (EE = Hct > 56%) was found to be 8.8%. Forty-five percent of the postmenopausal subjects presented a high CMSscore (> 21), whereas only 22% of the premenopausal subjects presented this high value (P < 0.02). We can therefore conclude that menopause may represent a contributing factor for the development of CMS.

  11. Impact of Sex Hormone Metabolism on the Vascular Effects of Menopausal Hormone Therapy in Cardiovascular Disease

    PubMed Central

    Masood, Durr-e-Nayab; Roach, Emir C.; Beauregard, Katie G.; Khalil, Raouf A.

    2010-01-01

    Epidemiological studies have shown that cardiovascular disease (CVD) is less common in pre-menopausal women (Pre-MW) compared to men of the same age or post-menopausal women (Post-MW), suggesting cardiovascular benefits of estrogen. Estrogen receptors (ERs) have been identified in the vasculature, and experimental studies have demonstrated vasodilator effects of estrogen/ER on the endothelium, vascular smooth muscle (VSM) and extracellular matrix. Several natural and synthetic estrogenic preparations have been developed for relief of menopausal vasomotor symptoms. However, whether menopausal hormone therapy (MHT) is beneficial in postmenopausal CVD remains controversial. Despite reports of vascular benefits of MHT from observational and experimental studies, randomized clinical trials (RCTs), such as the Heart and Estrogen/progestin Replacement Study (HERS) and the Women’s Health Initiative (WHI), have suggested that, contrary to expectations, MHT may increase the risk of CVD. These discrepancies could be due to age-related changes in sex hormone synthesis and metabolism, which would influence the effective dose of MHT and the sex hormone environment in Post-MW. Age-related changes in the vascular ER subtype, structure, expression, distribution, and post-ER signaling pathways in the endothelium and VSM, along with factors related to the design of RCTs, preexisting CVD condition, and structural changes in the blood vessels architecture have also been suggested as possible causes of MHT failure in CVD. Careful examination of these factors should help in identifying the causes of the changes in the vascular effects of estrogen with age. The sex hormone metabolic pathways, the active versus inactive estrogen metabolites, and their effects on vascular function, the mitochondria, the inflammatory process and angiogenesis should be further examined. Also, the genomic and non-genomic effects of estrogenic compounds should be viewed as integrated rather than discrete

  12. All sex steroids are made intracellularly in peripheral tissues by the mechanisms of intracrinology after menopause.

    PubMed

    Labrie, Fernand

    2015-01-01

    Following the arrest of estradiol secretion by the ovaries at menopause, all estrogens and all androgens in postmenopausal women are made locally in peripheral target tissues according to the physiological mechanisms of intracrinology. The locally made sex steroids exert their action and are inactivated intracellularly without biologically significant release of the active sex steroids in the circulation. The level of expression of the steroid-forming and steroid-inactivating enzymes is specific to each cell type in each tissue, thus permitting to each cell/tissue to synthesize a small amount of androgens and/or estrogens in order to meet the local physiological needs without affecting the other tissues of the organism. Achieved after 500 million years of evolution, combination of the arrest of ovarian estrogen secretion, the availability of high circulating levels of DHEA and the expression of the peripheral sex steroid-forming enzymes have permitted the appearance of menopause with a continuing access to intratissular sex steroids for the individual cells/tissues without systemic exposure to circulating estradiol. In fact, one essential condition of menopause is to maintain serum estradiol at biologically inactive (substhreshold) concentrations, thus avoiding stimulation of the endometrium and risk of endometrial cancer. Measurement of the low levels of serum estrogens and androgens in postmenopausal women absolutely requires the use of MS/MS-based technology in order to obtain reliable accurate, specific and precise assays. While the activity of the series of steroidogenic enzymes can vary, the serum levels of DHEA show large individual variations going from barely detectable to practically normal "premenopausal" values, thus explaining the absence of menopausal symptoms in about 25% of women. It should be added that the intracrine system has no feedback elements to adjust the serum levels of DHEA, thus meaning that women with low DHEA activity will not be

  13. Estrogen Deficiency and the Origin of Obesity during Menopause

    PubMed Central

    Lizcano, Fernando; Guzmán, Guillermo

    2014-01-01

    Sex hormones strongly influence body fat distribution and adipocyte differentiation. Estrogens and testosterone differentially affect adipocyte physiology, but the importance of estrogens in the development of metabolic diseases during menopause is disputed. Estrogens and estrogen receptors regulate various aspects of glucose and lipid metabolism. Disturbances of this metabolic signal lead to the development of metabolic syndrome and a higher cardiovascular risk in women. The absence of estrogens is a clue factor in the onset of cardiovascular disease during the menopausal period, which is characterized by lipid profile variations and predominant abdominal fat accumulation. However, influence of the absence of these hormones and its relationship to higher obesity in women during menopause are not clear. This systematic review discusses of the role of estrogens and estrogen receptors in adipocyte differentiation, and its control by the central nervous systemn and the possible role of estrogen-like compounds and endocrine disruptors chemicals are discussed. Finally, the interaction between the decrease in estrogen secretion and the prevalence of obesity in menopausal women is examined. We will consider if the absence of estrogens have a significant effect of obesity in menopausal women. PMID:24734243

  14. The effect of herbal extract (EstroG-100) on pre-, peri- and post-menopausal women: a randomized double-blind, placebo-controlled study.

    PubMed

    Chang, Albert; Kwak, Bo-Yeon; Yi, Kwontaek; Kim, Jae Soo

    2012-04-01

    This clinical research study was designed to evaluate the efficacy of a new herbal product, EstroG-100, containing a mixture of standardized extracts of Cynanchum wilfordii, Phlomis umbrosa and Angelica gigas, on menopausal symptoms. This randomized double-blind, placebo-controlled trial was performed for 12 weeks with 64 pre-, peri- and postmenopausal White Hispanic, White non-Hispanic and African American women who were randomly allocated to either the EstroG-100 group (n = 31) or the placebo group (n =  33). Primary end-points were the mean change in scores of the Kupperman menopause index (KMI) that evaluates 11 symptoms, and the mean change in scores of vaginal dryness. The mean KMI score was significantly reduced in the EstroG-100 group from 29.5 ± 7.4 at baseline to 11.3 ± 5.8 (p < 0.01) compared with change of the placebo group (29.2 ± 6.6 at baseline vs 23.7 ± 7.7 at week 12). The constituting symptoms of vasomotor, paresthesia, insomnia, nervousness, melancholia, vertigo, fatigue and rheumatic pain were significantly improved in the EstroG-100 group in comparison with the placebo group (p < 0.05). Statistically significant improvement in vaginal dryness in the EstroG-100 group was also observed compared with that of the placebo group (p < 0.05). In conclusion, EstroG-100 significantly improved the menopausal symptoms of pre-, peri- and post-menopausal women without weight gain or any serious side effects.

  15. The impact of years since menopause on the development of impaired glucose tolerance.

    PubMed

    Wu, S I; Chou, P; Tsai, S T

    2001-02-01

    This is a community-based population survey carried out by the Yang-Ming Crusade to investigate the impact of years since menopause on the development of glucose intolerance in post-menopausal women. A total of 5412 women were screened with fasting plasma glucose. Those with fasting plasma glucose levels between 5.5 and 7.8 mM were given an oral glucose tolerance test. Among the 5412 women screened, 2039 (37.7%) were post-menopausal with a median age at menopause of 49 years. Pre-menopausal women showed impaired glucose tolerance (IGT) and diabetes mellitus (DM) prevalences of 3.7% and 3.1% respectively, whereas the corresponding figures for post-menopausal women were 8.4% and 17.6%, respectively. Comparing DM versus normal glucose tolerance (NGT) and IGT versus NGT as dependent variables in logistic regression analysis, menopause status was significantly associated with DM and IGT. In post-menopausal women, after maintaining body mass index, waist-hip ratio, systolic blood pressure, diastolic blood pressure, family history of DM, age at menopause, cholesterol, high density lipoprotein cholesterol and triglycerides as controls, years since menopause was the only significant factor associated with IGT (OR = 1.05, 95%CI 1.01-1.08) and years since menopause was not associated with DM. Further analysis indicated years since menopause (OR = 1.06, 95%CI, 1.01-1.11) was the only factor significantly associated with IGT for women whose age at menopause was greater than 49 years. Our study indicates that in subjects who have not undergone hormone replacement therapy and whose age at menopause is greater than 49 years, an increase in years since menopause confers a negative influence on glucose tolerance and increases the risk of IGT by 6% for each year after menopause.

  16. Treatment of hyperprolactinemia in post-menopausal women: pros.

    PubMed

    Iacovazzo, D; De Marinis, L

    2015-02-01

    The incidence of hyperprolactinemia in women peaks during the 3rd-4th decade and then greatly decreases after the menopause. Apart from the effects on the hypothalamic-pituitary-gonadal axis, prolactin can act directly on bone metabolism. Hyperprolactinemia is a recognized cause of secondary osteoporosis, and treatment with dopamine agonists can lead to improved BMD. Moreover, hyperprolactinemia has been linked to weight gain and insulin resistance, which can be ameliorated following medical treatment. Although relatively rare, prolactinomas can be observed in post-menopausal women and are frequently large and invasive; dopamine agonists appear to be as effective in these patients as in younger women to induce reduction of prolactin levels and tumour shrinkage. Here, we review data potentially favouring medical treatment with dopamine agonists in post-menopausal women diagnosed with hyperprolactinemia.

  17. Women, menopause, and (Ms.)information: communication about the climacteric.

    PubMed

    Buchanan, Merry C; Villagran, Melinda Morris; Ragan, Sandra L

    2002-01-01

    This research utilizes a communication perspective to examine the dissemination of information about menopause in terms of women's attitudes, beliefs, and knowledge. Specifically, this study uses a grounded theory approach (Glaser & Strauss, 1967) to explore the communicative processes of misinformation concerning women's lived experiences in relation to the climacteric. Five emergent themes extracted from premenopausal, perimenopausal, and postmenopausal women's discourse are identified and described through qualitative data analysis. Findings suggest that due to a lack of consistent communication, women are generally either unknowledgeable or misinformed about menopause and its related issues. Inaccurate information concerning a health-related experience that all women undergo has negative implications for women, their practitioners, and society. Moreover, a clearer understanding of women's experiences concerning menopause may enhance communication in physician-patient interactions (PPIs). PMID:11853211

  18. Menopause and risk of diabetes in the Diabetes Prevention Program

    PubMed Central

    Kim, Catherine; Edelstein, Sharon L.; Crandall, Jill P.; Dabelea, Dana; Kitabchi, Abbas E.; Hamman, Richard F.; Montez, Maria G.; Perreault, Leigh; Foulkes, Mary A.; Barrett-Connor, Elizabeth

    2012-01-01

    Objective The study objective was to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopausal status modifies response to diabetes prevention interventions. Methods The study population included women in premenopause (n=708), natural postmenopause (n=328), and bilateral oophorectomy (n=201) in the Diabetes Prevention Program (DPP), a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy (HT) use. Results After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (HR 0.19, 95% CI 0.04, 0.94), although observations were too few to determine if this was independent of HT use. No significant differences were seen in the metformin (HR 1.29, 95% CI 0.63, 2.64) or placebo arms (HR 1.37, 95% CI 0.74, 2.55). Conclusions Among women at high-risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with decreased diabetes risk. PMID:21709591

  19. Post-menopausal Osteoporosis: Can it Be Prevented?

    PubMed Central

    Wade, John P.; Vreede-Brown, Elizabeth F.

    1990-01-01

    The prevention of post-menopausal osteoporosis is a challenge for primary care physicians. Recently available technology to determine bone density can help determine whether intervention other than dietary calcium recommendations and an exercise program is appropriate. Estrogen replacement therapy can be used for post-menopausal women who have no contra-indications. The use of concomitant progestational agents in a cyclic fashion or with a low-dose continuous regimen reduces the risk of endometrial malignancy. In the future new investigational agents that modulate bone turnover could be recommended. PMID:21234073

  20. Clinical Hypnosis in the Treatment of Post-Menopausal Hot Flashes: A Randomized Controlled Trial

    PubMed Central

    Elkins, Gary R.; Fisher, William I.; Johnson, Aimee K.; Carpenter, Janet S.; Keith, Timothy Z.

    2012-01-01

    Objective The use of estrogen and progesterone to manage vasomotor symptoms (i.e., hot flashes, night sweats) has declined due to concerns over their risks and there is an increased interest in alternate, effective, and low-risk treatments. This study reports the results of a randomized, controlled trial of clinical hypnosis in treating vasomotor symptoms among post-menopausal women. Methods Randomized, single-blind, controlled, clinical trial involving 187 post-menopausal women reporting a minimum of seven hot flashes per day, or at least 50 hot flashes a week at baseline between December 2008 and April 2012. Eligible participants received five weekly sessions of either clinical hypnosis or structured-attention control. Primary outcomes were hot flash frequency (subjectively and physiologically recorded) and hot flash score assessed by daily diaries at weeks 2–6, and 12. Secondary outcomes included measures of hot flash related daily interference, sleep quality and treatment satisfaction. Results In a modified intent-to-treat analysis that included all randomized participants that provided data, reported subjective hot flash frequency from baseline to week 12 showed a mean reduction of 55.82 hot flashes for the clinical hypnosis intervention (74.16%), versus a 12.89 hot flash reduction (17.13%) for the control (p<.001, 95% CI, 36.15–49.67). Mean reduction in hot flash score was 18.83 (80.32%) for the clinical hypnosis intervention as compared to 3.53 (15.38%) for the control (p<.001, 95% CI, 12.60–17.54). At 12 week follow-up, the mean reduction in physiologically monitored hot flashes was 5.92 (56.86%) for clinical hypnosis and .88 (9.94%) for the control (p<.001, 95% CI, 2.00–5.46). Secondary outcomes were significantly improved compared to control at 12 week follow-up in hot flash related interference (p<.001, 95% CI, 2.74–4.02), sleep quality (p<.001, 95% CI, 3.65–5.84), and treatment satisfaction (p<.001, 95% CI, 7.79–8.59). Conclusion Compared

  1. Cryptorchidism --disease or symptom?

    PubMed

    Toppari, Jorma; Rodprasert, Wiwat; Virtanen, Helena E

    2014-05-01

    Testes descend to the scrotum normally before birth. When they fail to do so, the boy is cryptorchid and has an increased risk for testicular germ cell cancer and subfertility later in life. Early correction of maldescent by orchiopexy operation improves the spermatogenetic capacity of the testis but does not return the testicular cancer risk to the control level. Testicular descent is regulated by testis-derived hormones testosterone and insulin-like peptide 3. Cryptorchidism can therefore be considered a symptom of impaired testicular function that may also be linked to other testicular diseases, such as germ cell cancer and subfertility. Early orchiopexy can alleviate the effects of cryptorchidism on spermatogenesis, but alertness for testicular cancer should be maintained. In searching the genetic and environmental reasons for these diseases, it is useful to consider their connection with each other. PMID:24786701

  2. HIV Symptoms

    MedlinePlus

    ... Submit Home > HIV/AIDS > What is HIV/AIDS? HIV/AIDS This information in Spanish ( en español ) HIV symptoms Photo courtesy of AIDS.gov More information ... and brain Return to top More information on HIV symptoms Explore other publications and websites Basic Information ...

  3. Lifestyle and dietary factors determine age at natural menopause.

    PubMed

    Sapre, Shilpa; Thakur, Ratna

    2014-01-01

    A literature search was done using PubMed. The age at natural menopause (ANM) depends on various factors like genetic, environmental, socioeconomic, reproductive, dietary, and lifestyle of which some like nulliparity, vegetarian diet, smoking, high fat intake, cholesterol, and caffeine accelerates; while others like parity, prior use of oral contraceptive pills, and Japanese ethnicity delays the ANM. ANM is an important risk factor for long-term morbidity and mortality; and hence, the need to identify the modifiable risk factors like diet and lifestyle changes. Delayed menopause is associated with increased risk of endometrial and breast cancer, while early ANM enhances the risk for cardiovascular diseases and osteoporosis. The correlation between diet and ANM has not been extensively studied; however, whatever studies have been done till now point towards role of high intake of total calories, fruits, and proteins in delaying the ANM, while high polyunsaturated fat intake accelerates it. The role of dietary soy, total fat, saturated fat, red meat, and dietary fiber in determining the ANM has been controversial and needs further studies to substantiate it. The lifestyle factors like current smoking and vigorous exercise have been significantly associated with early menopause, while moderate alcohol consumption delays the ANM. Large prospective studies are needed to study the association of ANM and other modifiable factors like passive smoking fish consumption, soy, and various types of tea. The knowledge of modifiable determinants of ANM can help in setting up menopausal clinics and initiating health programs specially in developing countries.

  4. Autosomal Translocation Patient Who Experienced Premature Menopause: A Case Report

    PubMed Central

    Kim, Yesol; Jeong, Do-won; Lee, Eun-gyeong; Jeon, Dong-Su; Kim, Jun-Mo

    2015-01-01

    Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosome-autosome translocation with a literature review. PMID:26356509

  5. Ovarian aging and menopause: current theories, hypotheses, and research models.

    PubMed

    Wu, Julie M; Zelinski, Mary B; Ingram, Donald K; Ottinger, Mary Ann

    2005-12-01

    Aging of the reproductive system has been studied in numerous vertebrate species. Although there are wide variations in reproductive strategies and hormone cycle components, many of the fundamental changes that occur during aging are similar. Evolutionary hypotheses attempt to explain why menopause occurs, whereas cellular hypotheses attempt to explain how it occurs. It is commonly believed that a disruption in the hypothalamic-pituitary-gonadal axis is responsible for the onset of menopause. Data exist to demonstrate that the first signs of menopause occur at the level of the brain or the ovary. Thus, finding an appropriate and representative animal model is especially important for the advancement of menopause research. In primates, there is a gradual decline in the function of the hypothalamic-pituitary-gonadal (HPG) axis ultimately resulting in irregularities in menstrual cycles and increasingly sporadic incidence of ovulation. Rodents also exhibit a progressive deterioration in HPG axis function; however, they also experience a period of constant estrus accompanied by intermittent ovulations, reduced progesterone levels, and elevated circulating estradiol levels. It is remarkable to observe that females of other classes also demonstrate deterioration in HPG axis function and ovarian failure. Comparisons of aging in various taxa provide insight into fundamental biological mechanisms of aging that could underlie reproductive decline.

  6. Lifestyle and dietary factors determine age at natural menopause.

    PubMed

    Sapre, Shilpa; Thakur, Ratna

    2014-01-01

    A literature search was done using PubMed. The age at natural menopause (ANM) depends on various factors like genetic, environmental, socioeconomic, reproductive, dietary, and lifestyle of which some like nulliparity, vegetarian diet, smoking, high fat intake, cholesterol, and caffeine accelerates; while others like parity, prior use of oral contraceptive pills, and Japanese ethnicity delays the ANM. ANM is an important risk factor for long-term morbidity and mortality; and hence, the need to identify the modifiable risk factors like diet and lifestyle changes. Delayed menopause is associated with increased risk of endometrial and breast cancer, while early ANM enhances the risk for cardiovascular diseases and osteoporosis. The correlation between diet and ANM has not been extensively studied; however, whatever studies have been done till now point towards role of high intake of total calories, fruits, and proteins in delaying the ANM, while high polyunsaturated fat intake accelerates it. The role of dietary soy, total fat, saturated fat, red meat, and dietary fiber in determining the ANM has been controversial and needs further studies to substantiate it. The lifestyle factors like current smoking and vigorous exercise have been significantly associated with early menopause, while moderate alcohol consumption delays the ANM. Large prospective studies are needed to study the association of ANM and other modifiable factors like passive smoking fish consumption, soy, and various types of tea. The knowledge of modifiable determinants of ANM can help in setting up menopausal clinics and initiating health programs specially in developing countries. PMID:24672198

  7. Effect of soy isoflavone supplementation on menopausal quality of life

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Recent clinical trials have found an increased risk of health problems in women using menopausal hormone therapy. As a result, women are in search of alternative strategies to improve their quality of life. The purpose of this study was to assess the effect of soy isoflavone supplementation on quali...

  8. Autosomal Translocation Patient Who Experienced Premature Menopause: A Case Report.

    PubMed

    Kim, Tae-Hee; Kim, Yesol; Jeong, Do-Won; Lee, Eun-Gyeong; Jeon, Dong-Su; Kim, Jun-Mo

    2015-08-01

    Premature ovarian failure (POF) is a condition in which the ovarian functions of hormone production and oocyte development become impaired before the typical age for menopause. POF and early menopause are present in a broad spectrum of gonad dysgenesis, from a complete cessation of ovarian function to an intermittent follicle maturation failure. Actually POF has been identified as a genetic entity (especially chromosome X), but data on genetic factors of premature menopause are limited. Until now, several cases revealed that inactivation of X chromosomes has an effect on ages of premature menopause and females with balanced or unbalanced X-autosome translocations can have several reproductive problems. On the other hand, there have been a few data that was caused by autosome-autosome translocation can lead. Therefore we report a relevant case of POF with translocation between chromosomes 1 and 4. She had her first menstrual period at the age of 12, and after 7 years she stopped menstruation. Chromosomal analysis showed 46, XX, t (1;4) (p22.3;q31.3). While evaluating this rare case, we could review various causes (especially genetic factors) of POF. To remind clinicians about this disease, we report a case of POF caused by autosome-autosome translocation with a literature review. PMID:26356509

  9. Reassuring the Woman Facing Menopause: Strategies and Resources.

    ERIC Educational Resources Information Center

    Cobb, Janine O'Leary

    1998-01-01

    Women in menopause require reassurance and reliable information. Based on concerns expressed in letters (N=7,000), women in premenopause want to know what to expect, in perimenopause they want to know whether their experiences are normal, and in postmenopause they need help in making sensible decisions about the use of hormone therapy. (Author/EMK)

  10. Contextual Influences on Women's Health Concerns and Attitudes toward Menopause

    ERIC Educational Resources Information Center

    Strauss, Judy R.

    2011-01-01

    Social factors that affect women's attitudes toward menopause were examined in a sample of 1,037 baby boomer women who took part in two waves of the Midlife in the United States survey. Survey data were collected in 1996 and 2005 from a nationally representative sample of women born between 1946 and 1964 residing in the United States. Women's…

  11. Menopause and Physical Activity: What Is the Relationship?

    ERIC Educational Resources Information Center

    Lutter, Judy Mahle; And Others

    1993-01-01

    Examines the results of a 1991 pilot study of the characteristics of the menopausal experience for women between the ages of 45 and 55. Specific items reported are physical health data and perceptions of factors affecting health status (diet, health characteristics, stress factors, and life changes). (GLR)

  12. Teaching Taboo Topics: Menstruation, Menopause, and the Psychology of Women

    ERIC Educational Resources Information Center

    Chrisler, Joan C.

    2013-01-01

    The purpose of this article is (a) to consider reasons why women's reproductive processes receive so little attention in psychology courses and (b) to make an argument for why more attention is needed. Menstruation, menopause, and other reproductive events are important to the psychology of women. Reproductive processes make possible a social role…

  13. Acute Morphine Treatments Alleviate Tremor in 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine-Treated Monkeys

    PubMed Central

    Yan, Ting; Rizak, Joshua Dominic; Yang, ShangChuan; Li, Hao; Huang, BaiHui; Ma, YuanYe; Hu, XinTian

    2014-01-01

    Parkinson’s disease (PD) is a chronic and progressive neurodegenerative disorder associated with decreased striatal dopamine levels. Morphine has been found to elevate dopamine levels, which indicates a potential therapeutic effect in PD treatment that has not been investigated previously. To evaluate this hypothesis, an investigation of the acute effects of morphine on PD symptoms was carried out in male rhesus PD monkeys that had been induced with MPTP. All MPTP induced monkeys displayed progressive and irreversible PD motor symptoms. The behavioral response of these animals to morphine and L-Dopa were quantified with the Kurlan scale. It was found that L-Dopa alleviated bradykinesia, but did not significantly improve tremor. In contrast, acute morphine alleviated tremor significantly. These results suggested that, compared to L-Dopa, morphine has different therapeutic effects in PD therapy and may act through different biological mechanisms to alleviate PD symptoms. PMID:24520383

  14. Plague Symptoms

    MedlinePlus

    ... Search The CDC Cancel Submit Search The CDC Plague Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Plague Home Ecology & Transmission Symptoms Diagnosis & Treatment Maps & Statistics ...

  15. The Internet and the menopause consultation: menopause management in the third millennium.

    PubMed

    Cumming, Grant P; Currie, Heather

    2005-09-01

    The Internet was born in 1969; it was originally developed so that computers could share information on research and development in the scientific and military fields. The original Internet consisted of four university computers networked in the United States. Email became available two years later. The infant Internet initially required complex computing knowledge to be used. However, this was all to change with the development of the World Wide Web in the early 1990s, which made the Internet much more widely accessible. The Internet has since grown at a phenomenal rate and has evolved into a global communications tool. It is by nature anarchic, in that it is an unrestricted broadcast medium. Although this lack of censorship is a strength, it is also a weakness. The quality of information available on the Web is variable and discernment is required. With the growth of e-health, medicine and its allied specialties are faced with the challenges of providing their services in a novel way while maintaining the first principle of medicine, primum non nocere (first, do no harm). This provision of e-health care is in its infancy and this review explores issues arising from the use of the Internet as a medium for organizing menopausal health care in the third millennium. PMID:16157001

  16. Menopausal Women's Access Path to Bioidentical Hormone Replacement Therapy: An Exploratory.

    PubMed

    Moro, Doris; Young, Wendy; Stein, Richard; Isaac, Winston; Goodman, Deborah

    2010-01-01

    The objective of this exploratory qualitative study was to describe (1) the key factors affecting women's initial decision to explore the use of bioidentical hormone, (2) where women gather their information on bioidentical hormones, (3) the enablers and barriers to obtaining bioidentical hormones, and (4) how to improve the bioidentical hormone replacement therapy access path. The study was conducted in a compounding pharmacy located in a large urban area in southern Ontario, Canada. The participants included four postmenopausal women between the ages of 46 and 72 who self-identified as users of bioidentical hormone replacement therapy and with comprehensive provincial healthcare coverage. Participants were recruited at a compounding pharmacy with the use of tri-fold brochures, tear-sheets, and posters. The women participated in an audio-taped mini focus group. Discussion was guided by six open-ended questions. Verbatim quotes were analyzed using an affinity diagram. Participants identified three key factors related to their initial decision: (1) symptoms unalleviated by synthetic hormone replacement therapy, (2) side effects from synthetic hormone replacement therapy, and (3) personal preference. They obtained information and support from many sources, including: family/friends, publications, and specialists in menopausal health. Once participants had made a decision, they obtained a prescription and accessed bioidentical hormone replacement therapy at a compounding pharmacy. Knowledgeable primary care physicians and compounding pharmacists were seen as enablers. Lack of support/Information and costs were identifies as barriers. Improvements to bioidentical hormone replacement therapy access path were suggested. The results of this study suggest that there may be value in implementing strategies to further encourage family physicians and other specialists in menopausal health to discuss options regarding hormone replacement therapy with patients. For example, the

  17. Menopausal Women's Access Path to Bioidentical Hormone Replacement Therapy: An Exploratory.

    PubMed

    Moro, Doris; Young, Wendy; Stein, Richard; Isaac, Winston; Goodman, Deborah

    2010-01-01

    The objective of this exploratory qualitative study was to describe (1) the key factors affecting women's initial decision to explore the use of bioidentical hormone, (2) where women gather their information on bioidentical hormones, (3) the enablers and barriers to obtaining bioidentical hormones, and (4) how to improve the bioidentical hormone replacement therapy access path. The study was conducted in a compounding pharmacy located in a large urban area in southern Ontario, Canada. The participants included four postmenopausal women between the ages of 46 and 72 who self-identified as users of bioidentical hormone replacement therapy and with comprehensive provincial healthcare coverage. Participants were recruited at a compounding pharmacy with the use of tri-fold brochures, tear-sheets, and posters. The women participated in an audio-taped mini focus group. Discussion was guided by six open-ended questions. Verbatim quotes were analyzed using an affinity diagram. Participants identified three key factors related to their initial decision: (1) symptoms unalleviated by synthetic hormone replacement therapy, (2) side effects from synthetic hormone replacement therapy, and (3) personal preference. They obtained information and support from many sources, including: family/friends, publications, and specialists in menopausal health. Once participants had made a decision, they obtained a prescription and accessed bioidentical hormone replacement therapy at a compounding pharmacy. Knowledgeable primary care physicians and compounding pharmacists were seen as enablers. Lack of support/Information and costs were identifies as barriers. Improvements to bioidentical hormone replacement therapy access path were suggested. The results of this study suggest that there may be value in implementing strategies to further encourage family physicians and other specialists in menopausal health to discuss options regarding hormone replacement therapy with patients. For example, the

  18. Vascular effects of phytoestrogens and alternative menopausal hormone therapy in cardiovascular disease.

    PubMed

    Gencel, V B; Benjamin, M M; Bahou, S N; Khalil, R A

    2012-02-01

    long-term follow-up. Further investigation of the cellular mechanisms underlying the vascular effects of phytoestrogens and careful evaluation of the epidemiological evidence and clinical trials of their potential vascular benefits would put forward the use of phytoestrogens as an alternative MHT for the relief of menopausal symptoms and amelioration of postmenopausal CVD.

  19. Phytoestrogens in menopausal supplements induce ER-dependent cell proliferation and overcome breast cancer treatment in an in vitro breast cancer model.

    PubMed

    van Duursen, Majorie B M; Smeets, Evelien E J W; Rijk, Jeroen C W; Nijmeijer, Sandra M; van den Berg, Martin

    2013-06-01

    Breast cancer treatment by the aromatase inhibitor Letrozole (LET) or Selective Estrogen Receptor Modulator Tamoxifen (TAM) can result in the onset of menopausal symptoms. Women often try to relieve these symptoms by taking menopausal supplements containing high levels of phytoestrogens. However, little is known about the potential interaction between these supplements and breast cancer treatment, especially aromatase inhibitors. In this study, interaction of phytoestrogens with the estrogen receptor alpha and TAM action was determined in an ER-reporter gene assay (BG1Luc4E2 cells) and human breast epithelial tumor cells (MCF-7). Potential interactions with aromatase activity and LET were determined in human adrenocorticocarcinoma H295R cells. We also used the previously described H295R/MCF-7 co-culture model to study interactions with steroidogenesis and tumor cell proliferation. In this model, genistein (GEN), 8-prenylnaringenin (8PN) and four commercially available menopausal supplements all induced ER-dependent tumor cell proliferation, which could not be prevented by physiologically relevant LET and 4OH-TAM concentrations. Differences in relative effect potencies between the H295R/MCF-7 co-culture model and ER-activation in BG1Luc4E2 cells, were due to the effects of the phytoestrogens on steroidogenesis. All tested supplements and GEN induced aromatase activity, while 8PN was a strong aromatase inhibitor. Steroidogenic profiles upon GEN and 8PN exposure indicated a strong inhibitory effect on steroidogenesis in H295R cells and H295R/MCF-7 co-cultures. Based on our in vitro data we suggest that menopausal supplement intake during breast cancer treatment should better be avoided, at least until more certainty regarding the safety of supplemental use in breast cancer patients can be provided. PMID:23541764

  20. Phytoestrogens in menopausal supplements induce ER-dependent cell proliferation and overcome breast cancer treatment in an in vitro breast cancer model.

    PubMed

    van Duursen, Majorie B M; Smeets, Evelien E J W; Rijk, Jeroen C W; Nijmeijer, Sandra M; van den Berg, Martin

    2013-06-01

    Breast cancer treatment by the aromatase inhibitor Letrozole (LET) or Selective Estrogen Receptor Modulator Tamoxifen (TAM) can result in the onset of menopausal symptoms. Women often try to relieve these symptoms by taking menopausal supplements containing high levels of phytoestrogens. However, little is known about the potential interaction between these supplements and breast cancer treatment, especially aromatase inhibitors. In this study, interaction of phytoestrogens with the estrogen receptor alpha and TAM action was determined in an ER-reporter gene assay (BG1Luc4E2 cells) and human breast epithelial tumor cells (MCF-7). Potential interactions with aromatase activity and LET were determined in human adrenocorticocarcinoma H295R cells. We also used the previously described H295R/MCF-7 co-culture model to study interactions with steroidogenesis and tumor cell proliferation. In this model, genistein (GEN), 8-prenylnaringenin (8PN) and four commercially available menopausal supplements all induced ER-dependent tumor cell proliferation, which could not be prevented by physiologically relevant LET and 4OH-TAM concentrations. Differences in relative effect potencies between the H295R/MCF-7 co-culture model and ER-activation in BG1Luc4E2 cells, were due to the effects of the phytoestrogens on steroidogenesis. All tested supplements and GEN induced aromatase activity, while 8PN was a strong aromatase inhibitor. Steroidogenic profiles upon GEN and 8PN exposure indicated a strong inhibitory effect on steroidogenesis in H295R cells and H295R/MCF-7 co-cultures. Based on our in vitro data we suggest that menopausal supplement intake during breast cancer treatment should better be avoided, at least until more certainty regarding the safety of supplemental use in breast cancer patients can be provided.

  1. Efficacy of Escitalopram for Hot Flashes in Healthy Menopausal Women: A Randomized Controlled Trial

    PubMed Central

    Freeman, Ellen W.; Guthrie, Katherine A.; Caan, Bette; Sternfeld, Barbara; Cohen, Lee S.; Joffe, Hadine; Carpenter, Janet S.; Anderson, Garnet L.; Larson, Joseph C.; Ensrud, Kristine E.; Reed, Susan; Newton, Katherine M.; Sherman, Sheryl; Sammel, Mary D.; La Croix, Andrea Z.

    2011-01-01

    Context Concerns for the risks of hormone therapy have resulted in its decline and a demand for non-hormonal treatments with demonstrated efficacy for hot flashes. Objective Determine the efficacy and tolerability of 10–20 mg/day escitalopram, a selective serotonin reuptake inhibitor, in alleviating the frequency, severity and bother of menopausal hot flashes. Design, Setting and Patients Randomized, double-blind, placebo-controlled, parallel arm trial for 8 weeks in a sample stratified by race (African American n=95; white n=102) and conducted at 4 MsFlash network sites between July 2009 and June 2010. Of 205 women randomized, 194 (95%) completed week 8 (intervention endpoint), and 183 completed post-treatment follow-up. Main Outcome Measures Primary outcomes were the frequency and severity of hot flashes assessed by prospective daily diaries. Secondary outcomes were hot flash "bother" recorded on daily diaries and clinical improvement (hot flash frequency >=50% decrease from baseline). Results Hot flash frequency was 9.78/day (SD 5.60) at baseline. At week 8, reduction in hot flash frequency was greater in the escitalopram group versus placebo (−4.60, SD 4.28 and −3.20, SD 4.76, respectively, P=0.004). Fifty-five percent of the escitalopram group (versus 36% of the placebo group) reported >=50% decreases in hot flash frequency (P=0.009). Differences in decreases in the severity and bother of hot flashes were significant (P=0.003 and P=0.013, respectively), paralleling the decreases in hot flash frequency. Three weeks after treatment ended, hot flash frequency increased in the escitalopram group to the level of the placebo group, which remained stable in the follow-up interval (P=0.020). Overall discontinuation due to side effects was 4% (7 drug, 2 placebo). Conclusion Escitalopram 10–20 mg/day provides non-hormonal off-label treatment for menopausal hot flashes that is effective and well-tolerated in healthy women. PMID:21245182

  2. Randomized Controlled Trial of Low-Dose Estradiol and the SNRI Venlafaxine for Vasomotor Symptoms

    PubMed Central

    Joffe, Hadine; Guthrie, Katherine A.; LaCroix, Andrea Z.; Reed, Susan D.; Ensrud, Kristine E.; Manson, JoAnn E.; Newton, Katherine M.; Freeman, Ellen W.; Anderson, Garnet L.; Larson, Joseph C.; Hunt, Julie; Shifren, Jan; Rexrode, Kathryn M.; Caan, Bette; Sternfeld, Barbara; Carpenter, Janet S.; Cohen, Lee

    2014-01-01

    Importance Estrogen therapy is the gold standard treatment for hot flashes and night sweats, but some women are unable or unwilling to use it because of associated risks. The serotonin-norepinephrine reuptake inhibitor venlafaxine is used widely as a non-hormonal treatment. While clinical impression is that serotonin-norepinephrine reuptake inhibitors are less effective than estrogen, these medications have not been simultaneously evaluated in one clinical trial. Objective To determine the efficacy and tolerability of low-dose oral 17-beta-estradiol and low-dose venlafaxine XR in alleviating vasomotor symptoms. Design and Participants 339 peri- and postmenopausal women with ≥2 bothersome vasomotor symptoms per day (mean 8.1, SD 5.3/day) were recruited from the community to MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) clinical network sites November 2011—October 2012. Interventions Participants were randomized to double-blinded treatment with low-dose oral 17-beta-estradiol 0.5-mg/day (n=97), low-dose venlafaxine XR 75-mg/day (n=96), or placebo (n=146) for 8 weeks. Main Outcomes Primary outcome was the mean daily frequency of vasomotor symptoms after 8 weeks of treatment. Secondary outcomes were vasomotor symptom severity, bother and interference. Intent-to-treat analyses compared change in vasomotor symptom frequency between each active intervention and placebo and between the two active treatments. Results Compared to baseline, mean vasomotor symptom frequency at week 8 decreased by 53% with estradiol, 48% with venlafaxine, and 29% with placebo. Estradiol reduced the frequency of symptoms by 2.3 (95% CI 1.3–3.4) more per day than placebo (p<0.001), and venlafaxine by 1.8 (95% CI 0.8–2.7) more per day than placebo (p=0.005). Results were consistent for VMS severity, bother and interference. Low-dose estradiol reduced symptom frequency by 0.6 more per day than venlafaxine (95% CI, 1.8 more per day to 0.6 fewer per day than

  3. [The representations of menopause: social products of age and sex].

    PubMed

    Delanoë, D

    1997-11-01

    The aim of this survey is to identify the representations of the menopause in general population and to identify socioculturals determinants of attitudes toward hormone replacement therapy (HRT). For this qualitative study 60 through interviews were performed with women aged between 40 and 65. Four representations were found: negative, ambivalent, neutral and positive. The negative pole, which is dominant, corresponds to the assignation of women to domestic and reproduction functions. The positive pole corresponds to access of women to some social autonomy. Thus, representations of the menopause form a major element of the symbolic domination on middle aged women. Medicalisation and cosmetic practices are the most strongly correlated variables with taking HRT. Three dimensions appear in the social uses of HRT: medical, cosmetic and symbolic, which intervene in various ways according different representations. PMID:9471289

  4. Adenomyosis a variant not a disease? Evidence from Hysterectomized Menopausal Women in the SWAN Study

    PubMed Central

    Weiss, Gerson; Maseelall, Priya; Schott, Laura L; Brockwell, Sarah E; Schocken, Miriam; Johnston, Janet M

    2009-01-01

    Objective Our study evaluates the symptoms commonly attributed to adenomyosis in women undergoing the menopausal transition. We hypothesized that adenomyosis is more commonly seen in women with fibroids, pelvic pain, abnormal uterine bleeding, and in the presence of endometriosis. Design Retrospective cohort Setting multi-site community based study Patients SWAN study enrollees who had hysterectomies Interventions None Main Outcome Measurements Relationship of Adenomyosis to other entities Results Adenomyosis was found in 48% of 137 patients. Frequencies of presenting symptoms were similar in those with and without evidence of adenomyosis. The same prevalence of fibroids, 37 % versus 43% (p=0.39), endometriosis, 3% versus 5% (p=0.41), abnormal bleeding, 27% versus 33% (p=0.72), or chronic pelvic pain in the presence of fibroids 12% versus 17%, (p=0.58), was seen in the presence or absence of adenomyosis. Conclusions Adenomyosis is a common diagnosis seen in hysterectomized specimens from women undergoing the perimenopausal transition. Adenomyosis is equally common in women who also have fibroids, endometriosis, pelvic pain, or abnormal uterine bleeding, and those women that do not. Therefore, adenomyosis is an incidental finding, not the source of the symptomatology. It appears not to be a “disease” per se, but a normal variant. PMID:18243177

  5. Climacteric and menopause in seven south-east Asian countries.

    PubMed

    Boulet, M J; Oddens, B J; Lehert, P; Vemer, H M; Visser, A

    2008-01-01

    The menopause is universal, but what about the climacteric? In an attempt to answer this question, a study was conducted in seven south-east Asian countries, namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and Taiwan. Samples of approximately 400 women in each country were questioned about a number of climacteric complaints, incontinence and dyspareunia, consultation of a physician, menopausal status and several background characteristics. Special care was taken to overcome linguistic and cultural problems, and the data collected were kept as objective as possible. From the results obtained we were able to show that the climacteric was indeed experienced in south-east Asian countries, although in a mild form. The prevalence of hot flushes and of sweating was lower than in western countries, but was nevertheless not negligible. The percentages of women who reported the more psychological types of complaint were similar to those in western countries. The occurrence of climacteric complaints affected perceived health status. A physician was consulted for climacteric complaints by 20% of the respondents, although this was most frequently associated with the occurrence of psychological complaints and less so with that of hot flushes and sweating. The median age at menopause (51.09) appeared to be within the ranges observed in western countries. Ethnic background and age at menarche were found to have a significant influence on age at menopause. The study clearly demonstrated that climacteric complaints occur in south-east Asia. The findings suggest, however, that vasomotor-complaint-related distress might be 'translated' into psychological complaints, which are more frequently considered to warrant consulting a physician.

  6. Climacteric and menopause in seven South-east Asian countries.

    PubMed

    Boulet, M J; Oddens, B J; Lehert, P; Vemer, H M; Visser, A

    1994-10-01

    The menopause is universal, but what about the climacteric? In an attempt to answer this question, a study was conducted in seven south-east Asian countries, namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and Taiwan. Samples of approximately 400 women in each country were questioned about a number of climacteric complaints, incontinence and dyspareunia, consultation of a physician, menopausal status and several background characteristics. Special care was taken to overcome linguistic and cultural problems, and the data collected were kept as objective as possible. From the results obtained we were able to show that the climacteric was indeed experienced in south-east Asian countries, although in a mild form. The prevalence of hot flushes and of sweating was lower than in western countries, but was nevertheless not negligible. The percentages of women who reported the more psychological types of complaint were similar to those in western countries. The occurrence of climacteric complaints affected perceived health status. A physician was consulted for climacteric complaints by 20% of the respondents, although this was most frequently associated with the occurrence of psychological complaints and less so with that of hot flushes and sweating. The median age at menopause (51.09) appeared to be within the ranges observed in western countries. Ethnic background and age at menarche were found to have a significant influence on age at menopause. The study clearly demonstrated that climacteric complaints occur in south-east Asia. The findings suggest, however, that vasomotor-complaint-related distress might be 'translated' into psychological complaints, which are more frequently considered to warrant consulting a physician.

  7. Lipids, Menopause and Early Atherosclerosis in SWAN Heart Women

    PubMed Central

    Woodard, Genevieve A.; Brooks, Maria M.; Barinas-Mitchell, Emma; Mackey, Rachel H.; Matthews, Karen A.; Sutton-Tyrrell, Kim

    2011-01-01

    Objective The risk of cardiovascular disease increases after menopause. Recent evidence suggests that it is possible for HDL to become proatherogenic or dysfunctional in certain situations. Our objective was to evaluate whether the relationship of HDL-C to subclinical cardiovascular disease differed across the menopausal transition, which would provide insight for this increased risk. Methods Aortic calcification (AC), coronary artery calcification (CAC), carotid plaque and intima media thickness (IMT) were measured in the Study of Women’s Health Across the Nation (SWAN Heart). Women, not using hormone therapy, were stratified into premenopausal or early-perimenopausal (Pre/EP, n=316) and late-perimenopausal or postmenopausal (LP/Post, n=224). Results The inverse relationship of HDL-C to subclinical atherosclerosis measures among Pre/EP women was weaker or reversed among LP/post women, adjusted for age, site, race, SBP, glucose, BMI, smoking, menopausal status and LDL-C. Specifically: Multivariable modeling demonstrated an inverse association between HDL-C and AC and IMT, among Pre/EP women; however, the protective effect of HDL-C for AC, left main CAC, carotid plaque and IMT was not seen in LP/Post women. In a small subset (n=53), LP/Post women had more total and small HDL particles, higher triglycerides and more total LDL particles compared to Pre/EP women (p<0.05). Conclusion These results suggest that the protective effect of HDL may be diminished as women transition the menopause. Future studies should examine whether this may be due to changes in HDL size, functionality, or related changes in other lipids or lipoproteins. PMID:21107300

  8. The effect of outside work on the menopausal woman.

    PubMed

    Maoz, B; Antonovsky, A; Apter, A; Datan, N; Hochberg, J; Salomon, Y

    1978-06-01

    1,148 women between the ages of 45 and 54 from five different ethnic groups in Israel, representing a traditional-modern continuum were investigated with regard to the relationship of their menopausal symptomatology with their work situations now and what they were when the women were aged 40. A relatively low symptomatology was found among European Jews, North African Jews and Arabs in the peri- or postmenopause where their work load was unchanged or somewhat more than before. On the other hand, the Persian Jews showed a remarkable contrast, namely: those who had never worked at all outside the home suffered less than all the others in all the stages of menopause. These results cannot be explained only by the socioeconomic differences between the five groups, as the North Africans and Persians both belong to the lower urban socioeconomic class and the Arabs to the low rural socioeconomic class, with the Europeans belonging to the middle urban class. Nor can the results be explained merely by the difference in modernity and traditionalism. The matter is more complicated, and additional factors such as physical health, marital relationships and general stability are almost certainly involved. The advice to "go out and work" which is so often given by medical practitioners to menopausal women is thus not always correct, and should not be given automatically. PMID:755953

  9. Treatment of Menopausal Hot Flashes with 5-Hydroxytryptophan

    PubMed Central

    Freedman, Robert R.

    2010-01-01

    Objective Much recent research has focused on nonhormonal treatments for menopausal hot flashes. The purpose of the present study was to determine the effects of 5-Hydroxytroptophan (5-HTP), the immediate precursor of serotonin, upon menopausal hot flashes. Selective, serotonergic, reuptake inhibitors (SSRI’s), which increase the amount of serotonin in the synaptic gap, have shown some promise in the amelioration of hot flashes. Methods We administered 5-HTP or placebo, in double-blind fashion, to 24 postmenopausal women reporting frequent hot flashes. Treatment outcome was measured using a miniature, electronic, hot flash recorder. Results No significant effects of 150 mg/day 5-HTP upon hot flash frequency were found. The 5-HTP group had 23.8 ± 5.7 (SD) hot flashes/24 hours prior to treatment and 18.5 ± 9.6 at the end of treatment. The placebo group had 18.5 ± 9.6 before treatment and 22.6 ± 12.4 at treatment completion. Conclusions At the dose given, 5-HTP does not significantly ameliorate frequency of menopausal hot flashes, as measured objectively with an electronic recorder. Given the small size, this study must be considered preliminary in nature. PMID:20031347

  10. Vascular Aging across the Menopause Transition in Healthy Women

    PubMed Central

    Moreau, Kerrie L.; Hildreth, Kerry L.

    2015-01-01

    Vascular aging, featuring endothelial dysfunction and large artery stiffening, is a major risk factor for developing cardiovascular disease (CVD). In women, vascular aging appears to be accelerated during the menopause transition, particularly around the late perimenopausal period, presumably related to declines in ovarian function and estrogen levels. The mechanisms underlying endothelial dysfunction and large artery stiffening with the menopause transition are not completely understood. Oxidative stress and the proinflammatory cytokine tumor necrosis factor-α contribute to endothelial dysfunction and large artery stiffening in estrogen-deficient postmenopausal women. Habitual endurance exercise attenuates the age-related increase in large artery stiffness in estrogen-deficient postmenopausal women and can reverse arterial stiffening to premenopausal levels in estrogen-replete postmenopausal women. In contrast, estrogen status appears to play a key permissive role in the adaptive response of the endothelium to habitual endurance exercise in that endothelial improvements are absent in estrogen-deficient women but present in estrogen-replete women. We review here the current state of knowledge on the biological defects underlying vascular aging across the menopause transition, with particular focus on potential mechanisms, the role of habitual exercise in preserving vascular health, and key areas for future research. PMID:25984561

  11. Determinants of blood lead levels across the menopausal transition.

    PubMed

    Hernandez-Avila, M; Villalpando, C G; Palazuelos, E; Hu, H; Villalpando, M E; Martinez, D R

    2000-01-01

    In this study, the authors sought to evaluate the impact of menopause on lead remobilization from bone-lead stores. The study was conducted between 1993 and 1995 in Mexico City and included 903 women (mean age = 46.8 y [standard deviation = 8.2 y]). Participants provided information about reproductive variables and known risk factors for high PbB levels. PbB levels were determined with graphite furnace atomic absorption spectrophotometry. The authors used linear-regression models to describe the relationship between PbB levels and variables of interest. PbB levels ranged from 1.0 microg/dl to 43.8 microg/dl (mean = 11.0 microg/dl). Menopausal women at baseline had the highest PbB levels; the mean difference between pre- and postmenopausal women was 0.76 microg/dl (95% confidence interval = 0.024, 1.48). We observed an inverted U-shaped relationship between PbB level and age. The highest PbB levels were observed in women aged 47-50 y. Other important predictors of PbB levels were use of lead-glazed ceramics, number of pregnancies, history of cigarette smoking, and height. Our results support the hypothesis that bone lead may be mobilized during menopause and may constitute an important source of exposure.

  12. Effects of Estrogen or Venlafaxine on Menopause Related Quality of Life in Healthy Postmenopausal Women with Hot Flashes: A Placebo-Controlled Randomized Trial

    PubMed Central

    Caan, Bette; LaCroix, Andrea Z.; Joffe, Hadine; Guthrie, Katherine A.; Larson, Joseph C.; Carpenter, Janet S.; Cohen, Lee S.; Freeman, Ellen W.; Manson, JoAnn E.; Newton, Katherine; Reed, Susan; Rexrode, Kathy; Shifren, Jan; Sternfeld, Barbara; Ensrud, Kris

    2015-01-01

    OBJECTIVE To evaluate the effects of low-dose estradiol (ET) or venlafaxine on menopause-related quality of life and associated symptoms in healthy peri- and postmenopausal women with hot flashes. METHODS A double-blind, placebo-controlled randomized trial of low-dose oral 17-beta-estradiol 0.5-mg/day, venlafaxine XR 75-mg/day, vs. identical placebo was conducted among 339 women ages 40–62 years with ≥2 (mean 8.07, SD 5.29) daily VMS recruited at 3 clinical sites from November 2011 to October 2012. The primary trial outcome, reported previously, was the frequency of VMS at 8 weeks. Here, we report on secondary endpoints of total and domain scores from the Menopause-Specific Quality of Life Questionnaire (MENQOL) and measures of pain (PEG), depression (PHQ-9), anxiety (GAD-7) and perceived stress (PSS). RESULTS Treatment with both estradiol and venlafaxine resulted in significantly greater improvement in quality of life, as measured by total MENQOL scores compared to placebo (mean difference for ET at 8 weeks of −0.4; 95% confidence interval (CI) −0.7 to −0.2; p<0.001 and for venlafaxine of −0.2; 95% CI −0.5 to 0.0; p 0.04). Quality of life (QOL) domain analyses revealed that ET had beneficial treatment effects in all domains of the MENQOL except psychosocial, while venlafaxine benefits were observed only in the psychosocial domain. Neither ET nor venlafaxine improved pain, anxiety or depressive symptoms, although baseline symptom levels were low. Modest benefits were observed for perceived stress with venlafaxine. CONCLUSIONS Both low-dose estradiol and venlafaxine are effective pharmacologic agents for improving menopause-related quality of life in healthy women with vasomotor symptoms. PMID:25405571

  13. Serum Estradiol Levels Are Not Associated with Urinary Incontinence in Mid-life Women Transitioning through Menopause

    PubMed Central

    Waetjen, L. Elaine; Johnson, Wesley O.; Xing, Guibo; Feng, Wen-Ying; Greendale, Gail A.; Gold, Ellen B.

    2012-01-01

    Objective We evaluated the relationship between annually measured serum endogenous estradiol and the development or worsening of stress and urge incontinence symptoms over 8 years in women transitioning through menopause. Methods This is a longitudinal analysis of women with incontinence in the Study of Women’s Health Across the Nation (SWAN), a multi-center, multi-racial/ethnic prospective cohort study of community-dwelling women transitioning through menopause. At baseline and each of 8 annual visits, SWAN elicited frequency and type of incontinence in a self-administered questionnaire and drew a blood sample on days 2-5 of the menstrual cycle. All endocrine assays were performed using a double-antibody chemiluminescent immunoassay. We analyzed data using discrete Cox survival models and generalized estimating equations with time dependent covariates. Results Estradiol levels drawn at either the annual visit concurrent with or previous to the first report of incontinence were not associated with the development of any (hazard ratio (HR) = 0.99, 95% CI 0.99, 1.01), stress, or urge incontinence in previously continent women. Similarly, estradiol levels were not associated with worsening of any (odds ratio (OR) = 1.00, 95% CI 0.99, 1.01), stress, or urge incontinence in incontinent women. Change in estradiol levels from one year to the next was also not associated with the development (HR = 0.98, 95% confidence interval 0.97, 1.00) or worsening (OR = 1.03, 95% CI 0.99, 1.05) of incontinence. Conclusions We found that annually measured values and year-to-year changes in endogenous estradiol levels had no effect on the development or worsening of incontinence in women transitioning through menopause. PMID:21785372

  14. Gust alleviation - Criteria and control laws

    NASA Technical Reports Server (NTRS)

    Rynaski, E. G.

    1979-01-01

    The relationships between criteria specified for aircraft gust alleviation and the form of the control laws that result from the criteria are considered. Open-loop gust alleviation based on the linearized, small perturbation equations of aircraft motion is discussed, and an approximate solution of the open-loop control law is presented for the case in which the number of degrees of freedom of the aircraft exceeds the rank of the control effectiveness matrix. Excessive actuator lag is compensated for by taking into account actuator dynamics in the equations of motion, resulting in the specification of a general load network. Criteria for gust alleviation when output motions are gust alleviated and the closed-loop control law derived from them are examined and linear optimal control law is derived. Comparisons of the control laws reveal that the effectiveness of an open-loop control law is greatest at low aircraft frequencies but deteriorates as the natural frequency of the actuators is approached, while closed-loop methods are found to be more effective at higher frequencies.

  15. Alleviation of Communication Apprehension: An Individualized Approach.

    ERIC Educational Resources Information Center

    Watson, Arden K.

    Communication apprehension (CA) affects from 15% to 20% of the college population, indicating inherent problems of negative cognitive appraisal, conditioned anxiety, or skills deficits. Use of an individualized approach to the alleviation of CA has been shown to increase students' class interaction and to improve their verbal skills. During an…

  16. Norovirus Symptoms

    MedlinePlus

    ... Infection, National Institutes of Health NoroCORE Food Virology Symptoms Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir Español: SÃntomas Prevent Dehydration Drink plenty of liquids to replace fluids that ...

  17. Rotavirus Symptoms

    MedlinePlus

    ... Rotavirus Vaccine Program American Academy of Pediatrics Symptoms Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ... PATH's Rotavirus Vaccine Program American Academy of Pediatrics Language: English Español (Spanish) File Formats Help: How do I ...

  18. Serum lipid responses to psyllium fiber: differences between pre- and post-menopausal, hypercholesterolemic women

    PubMed Central

    Ganji, Vijay; Kuo, Jennifer

    2008-01-01

    Background Cardiovascular disease is the leading cause of death in women and men. Psyllium, a soluble fiber has been known to reduce serum lipids. In this pilot study, we evaluated whether menopausal status would affect the serum lipid responses to psyllium fiber in women. Methods Eleven post-menopausal and eight pre-menopausal women with serum total cholesterol >200 mg/dL were included in the study. Subjects consumed their habitual diet and 15 g psyllium/d for 6 weeks. Psyllium was incorporated into cookies. Each cookie contained ≈5 g of psyllium fiber. Subjects ate one cookie in each meal. Results With psyllium fiber, total cholesterol concentration was significantly lower (≈5.2%, P < 0.05) in post-menopausal women but not in pre-menopausal women (≈1.3%). Also, there was a significant decrease in HDL-cholesterol in post-menopausal women (≈10.2%, P < 0.05). There were no significant changes observed in concentrations of LDL-cholesterol, triglycerides, apolipoprotein A1, and apolipoprotein B in both pre- and post-menopausal women with psyllium. Conclusion In this pilot study, post- and pre-menopausal, hypercholesterolemic women responded differently to psyllium fiber supplementation. Post-menopausal women would benefit from addition of psyllium to their diets in reducing the risk for heart diseases. The results of this study should be used with caution because the study was based on a small sample size. PMID:18727833

  19. Turning Anxiety into Creativity: Using Postmodern Principles to Alleviate Anxiety and Stress through the Art Curriculum and Beyond

    ERIC Educational Resources Information Center

    Ferry, Lisa Marie

    2016-01-01

    The purpose of this action research study is to help students alleviate their anxiety and stress symptoms using activities based on Olivia Gude's postmodern principles. The activities included are the participants own take-along visual art journal kit and classroom projects. Professional learning outcomes include the knowledge to equip teachers…

  20. Increasing iron and zinc in pre-menopausal women and its effects on mood and cognition: a systematic review.

    PubMed

    Lomagno, Karla A; Hu, Feifei; Riddell, Lynn J; Booth, Alison O; Szymlek-Gay, Ewa A; Nowson, Caryl A; Byrne, Linda K

    2014-11-01

    Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or zinc supplementation and its impact on mood or cognition in pre-menopausal women. Searches included MEDLINE complete, Excerpta Medica Database (EMBASE), psychINFO, psychARTICLES, pubMED, ProQuest Health and Medical Complete Academic Search complete, Scopus and ScienceDirect. Ten randomized controlled trials and one non-randomized controlled trial were found to meet the inclusion criteria. Seven studies found improvements in aspects of mood and cognition after iron supplementation. Iron supplementation appeared to improve memory and intellectual ability in participants aged between 12 and 55 years in seven studies, regardless of whether the participant was initially iron insufficient or iron-deficient with anaemia. The review also found three controlled studies providing evidence to suggest a role for zinc supplementation as a treatment for depressive symptoms, as both an adjunct to traditional antidepressant therapy for individuals with a diagnosis of major depressive disorder and as a therapy in its own right in pre-menopausal women with zinc deficiency. Overall, the current literature indicates a positive effect of improving zinc status on enhanced cognitive and emotional functioning. However, further study involving well-designed randomized controlled trials is needed to identify the impact of improving iron and zinc status on mood and cognition.

  1. Effects of age, ethnicity and menopause on ambulatory blood pressure: Japanese-American and Caucasian school teachers in Hawaii.

    PubMed

    Brown, D E; Sievert, L L; Aki, S L; Mills, P S; Etrata, M B; Paopao, R N; James, G D

    2001-01-01

    Ambulatory blood pressure (BP) measurements of 120 female teachers of Japanese-American or Caucasian ethnicity working in public schools located in Hilo, Hawaii, were recorded. BP was measured at 15-min intervals during waking hours and 30-min intervals during sleep over a 24-hr period that included a full work day. These measurements were averaged during three daily settings: at work, at home while awake ("home"), and during sleep. ANCOVAs using ethnicity as a predictor variable of BP, with age and the body mass index (BMI) as covariates, show a significant interaction effect between age and ethnicity in some daily settings. Among Japanese-Americans partial correlations between age and systolic BP controlling for the BMI are significant in these settings, while among Caucasians none of the correlations are significant. Menopausal status is not significantly related to BP when age is controlled in analyses. There was no significant ethnic difference in number of symptoms reported, including frequency of "hot flushes/flashes," within the past two weeks. Those who reported hot flushes had significantly elevated BP in waking settings but not during sleep. The greater increase in BP with age in Japanese-Americans may be related to their elevated risk for development of hypertension. The lack of a significant relationship between menopausal status and BP may be due to the high rate of usage of hormonal replacement therapy in this sample, as well as an unusually high rate of hysterectomy. PMID:11400219

  2. Age at menopause, reproductive history and venous thromboembolism risk among postmenopausal women

    PubMed Central

    Canonico, Marianne; Plu-Bureau, Geneviève; O’Sullivan, Mary Jo; Stefanick, Marcia L.; Cochrane, Barbara; Scarabin, Pierre-Yves; Manson, JoAnn E.

    2013-01-01

    Objectives To investigate VTE risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy and time since menopause, as well as any interaction with randomized HT assignment among postmenopausal women. Methods Using pooled data from the Women’s Health Initiative HT clinical trials including 27,035 postmenopausal women ages 50 to 79 years with no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy and time since menopause by Cox proportional hazard models. Linear trends, quadratic relationships and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. Results During the follow-up, 426 women reported a first VTE, including 294 nonprocedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected and there was any significant association of VTE with age at menarche, age at menopause, parity, oophorectomy or time since menopause. However, analyses restricted to nonprocedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (p<0.01). Compared to women aged 40 to 49 years at menopause, those with early menopause (age<40 years) or with late menopause (age>55 years) had a significant increased VTE risk (HR=1.8;95%CI:1.2–2.7 and HR=1.5;95%CI:1.0–2.4, respectively). Conclusion Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for nonprocedure-related VTE. PMID:23760439

  3. Placebo-controlled cross-over study of effects of Org OD 14 in menopausal women.

    PubMed

    Kicovic, P M; Cortés-Prieto, J; Luisi, M; Milojevic, S; Franchi, F

    1982-01-01

    A double-blind cross-over study with Org OD 14 and placebo was performed in 82 menopausal patients presenting with hot flushes and associated symptoms. Patients were randomly allocated to Org OD 14 or placebo as first treatment, and switched to placebo or Org OD 14 as second treatment. Each treatment period lasted for 16 weeks; no wash-out period was introduced. Tablets containing 2.5 mg of Org OD 14 or matched placebo tablets were supplied. Data on the following variables were obtained and analysed by the non-parametric randomization test for paired observations: hot flushes, sweating, dizziness, palpitations, fatiguability, headache, sleeplessness, irritability, breathlessness, backache and loss of libido and, in 16 patients, on circulating levels of FSH, LH, PRL, T3, T4, cortisol (F), SHBG, TBG and CBG. Twenty patients (13 placebo, 7 Org OD 14) withdrew, because their symptoms did not improve and one patient withdrew for reasons unrelated to treatment, so that 61 patients completed the study. The data demonstrated a good clinical effect and statistically significant differences in favour of Org OD 14 for hot flushes and a number of associated symptoms. Many patients reported on a general feeling of well being and a mood-elevating effect following Org OD 14. Org OD 14 significantly suppressed FSH and LH levels, while those of PRL remained unchanged. Although there was slight suppression of TBG and T4 which attained statistical significance, there was no influence on the most important parameter, T3. SHBG levels were slightly suppressed, whereas F and CBG levels were unaffected.

  4. Aerodynamic side-force alleviator means

    NASA Technical Reports Server (NTRS)

    Rao, D. M. (Inventor)

    1980-01-01

    An apparatus for alleviating high angle of attack side force on slender pointed cylindrical forebodies such as fighter aircraft, missiles and the like is described. A symmetrical pair of helical separation trips was employed to disrupt the leeside vortices normally attained. The symmetrical pair of trips starts at either a common point or at space points on the upper surface of the forebody and extends along separate helical paths along the circumference of the forebody.

  5. Gust Alleviation Using Direct Gust Measurement

    NASA Technical Reports Server (NTRS)

    Hoppe, Sven Marco

    2000-01-01

    The increasing competition in the market of civil aircraft leads to operating efficiency and passenger comfort being very important sales arguments. Continuous developments in jet propulsion technology helped to reduce energy consumption, as well as noise and vibrations due to the engines. The main problem with respect to ride comfort is, however, the transmittance of accelerations and jerkiness imposed by atmospheric turbulence from the wings to the fuselage. This 'gust' is also a design constraint: Light airplane structures help to save, energy, but are more critical to resist the loads imposed by turbulence. For both reasons, efficient gust alleviation is necessary to improve the performance of modern aircraft. Gust can be seen as a change in the angle of attack or as an additional varying vertical component of the headwind. The effect of gust can be very strong, since the same aerodynamic forces that keep the airplane flying are involved. Event though the frequency range of those changes is quite low, it is impossible for the pilot to alleviate gust manually. Besides, most of the time during the flight, the, autopilot maintains course and the attitude of flight. Certainly, most autopilots should be capable of damping the roughest parts of turbulence, but they are unable to provide satisfactory results in that field. A promising extension should be the application of subsidiary, control, where the inner (faster) control loop alleviates turbulence and the outer (slower) loop controls the attitude of flight. Besides the mentioned ride comfort, another reason for gust alleviation with respect to the fuselage is the sensibility of electrical devices to vibration and high values of acceleration. Many modern airplane designs--especially inherently instable military aircraft--are highly dependent on avionics. The lifetime and the reliability of these systems is thus essential.

  6. Effects of red clover on hot flash and circulating hormone concentrations in menopausal women: a systematic review and meta-analysis

    PubMed Central

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Mirzaii Najmabadi, Khadijeh; mousavi bazaz, Mojtaba; abdolahian, Somayeh; Khadivzadeh, Talat

    2015-01-01

    Objective: To critically evaluate the effect of red clover on hot flash, endometrial thickness, and hormones status in postmenopausal and peri- and post-menopausal women. Materials and Methods: MEDLINE (1966 to July 2014), Scopus (1990 to July 2014), and the Cochrane Central Register of Controlled Trials (The Cochrane Library issue 1, 2014) were searched for published randomized controlled Trials (RCTs). Results: Of 183 relevant publication trials, 11 RCTs met the inclusion criteria. The mean hot flashes frequency in red clover was lower than the control groups (MD -1.99; p=0.067). There was larger decrease in FSH (SMD -0.812; CI: -1.93 to 0.312; p=0.157) and SHBG (SMD -0.128; CI-0.425 to 0.170; P=0.4) in red clover group, compared with placebo, which was not however statistically significant. LH (SMD 0.144; CI-0.097 to 0.384, p=0.242), estradiol (SMD 0.240; CI-0.001 to 0.482, p=0.051), testosterone (MD 0.083; CI: -0.560 to 0.726; p=0.901), and endometrial thickness (SDM 0.022; CI: -0.380 to 0.424, p=0.915) showed greater increase in red clover, compared with placebo, although the effect of estradiol was only significant. Conclusion: Red clover had a positive effect of alleviating hot flash in menopausal women. Our data, however, suggested very slight changes in FSH, LH, testosterone, and SHBG and significant effect in estrogen status by red clover consumption. However, the interpretation of results of the current study is limited due to methodological flaws of the included studies, menopause status, and large heterogeneity among them. Further trials are still needed to confirm the current finding. PMID:26693407

  7. Carer Knowledge and Experiences with Menopause in Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Willis, Diane S.; Wishart, Jennifer G.; Muir, Walter J.

    2010-01-01

    Overall life expectancy for women with intellectual disabilities (ID) is now significantly extended, and many will live long enough to experience menopause. Little is known about how carers support women with ID through this important stage in their lives. This study investigated carer knowledge of how menopause affects women with ID under their…

  8. Health in middle-aged and elderly women: A conceptual framework for healthy menopause.

    PubMed

    Jaspers, Loes; Daan, Nadine M P; van Dijk, Gabriella M; Gazibara, Tatjana; Muka, Taulant; Wen, Ke-Xin; Meun, Cindy; Zillikens, M Carola; Roeters van Lennep, Jeanine E; Roos-Hesselink, Jolien W; Laan, Ellen; Rees, Margaret; Laven, Joop S E; Franco, Oscar H; Kavousi, Maryam

    2015-05-01

    Middle-aged and elderly women constitute a large and growing proportion of the population. The peri and postmenopausal period constitutes a challenging transition time for women's health, and menopausal health is a crucial aspect in healthy and successful aging. Currently, no framework for the concept of healthy menopause exists, despite its recognized importance. Therefore, we aimed to: (i) characterize healthy menopause; (ii) identify aspects that contribute to it; and (iii) explore potential approaches to measure it. We propose healthy menopause as a dynamic state, following the permanent loss of ovarian function, which is characterized by self-perceived satisfactory physical, psychological and social functioning, incorporating disease and disability, allowing the attainment of a woman's desired ability to adapt and capacity to self-manage. The concept of healthy menopause applies to all women from the moment they enter the menopausal transition, up until they reach early and late postmenopause and includes women with spontaneous, iatrogenic, and premature menopause. This conceptualization can be considered as a further step in the maintenance and improvement of health in menopausal women from different perspectives, foremost the woman's own perspective, followed by the clinical, public health, and societal perspectives, and can be seen as a further step in delineating lines for future research. Furthermore, it could facilitate the improvement of adequate preventive and treatment strategies, guide scientific efforts, and aid education and communication to health care practitioners and the general public, allowing women the achievement of their potential and the fulfillment of their fundamental role in society.

  9. Midlife Women and Menopause: A Challenge for the Mental Health Counselor.

    ERIC Educational Resources Information Center

    Mansfield, Phyllis Kernoff; And Others

    1992-01-01

    Surveyed women (n=99) aged 35 to 55 about their medical histories, current menstrual events and symptomatology, and perceptions and experiences with menopause. Discovered menopausal women reported their needs were not being met because clinicians lacked sufficient understanding and because of shortage of information resources. Mental health…

  10. It's All in Your Head: Feminist and Medical Models of Menopause (Strange Bedfellows).

    ERIC Educational Resources Information Center

    Posner, Judith

    1979-01-01

    This article describes the medical model of menopause as it exists in contemporary gynecological textbooks and some popular books written by gynecologists for the general public. The feminist position on menopause is then compared and contrasted with the medical model. (Author/EB)

  11. Impaired cardiac response to exercise in post-menopausal women: relationship with peripheral vascular function.

    PubMed

    Yoshioka, J; Node, K; Hasegawa, S; Paul, A K; Mu, X; Maruyama, K; Nakatani, D; Kitakaze, M; Hori, M; Nishimura, T

    2003-04-01

    Endothelial dysfunction has been demonstrated in post-menopausal women. To assess the relationship between peripheral vascular reserve and cardiac function during exercise in post-menopausal women, 91 subjects, who had no ischaemic findings on myocardial SPECT, were assigned to four groups: pre-menopausal women (n=13), post-menopausal women (n=33), younger men aged < or =50 years (n=10), and older men aged >50 years (n=35). First-pass radionuclide angiography was performed before and during bicycle exercise to calculate ejection fraction (EF) and peripheral vascular resistance (VR). There were no differences in haemodynamic variables among the groups at baseline. The per cent increase in EF=(exercise EF - resting EF)x100/resting EF, and the per cent decrease in VR=(resting VR - exercise VR)x100/resting VR were depressed in the post-menopausal women (0.4+/-2% and 35+/-3%, respectively) compared to the pre-menopausal women (10+/-3% and 47+/-3%, respectively; P<0.05 each). Although the age dependent impairment is thought to cause this depression, neither the per cent increase in EF nor the per cent decrease in VR in the older men was significantly different from that in the younger men. Post-menopausal women exhibited depressed cardiac function during exercise, which may be related to the impairment of peripheral vascular function after menopause. PMID:12673166

  12. Impaired cardiac response to exercise in post-menopausal women: relationship with peripheral vascular function.

    PubMed

    Yoshioka, J; Node, K; Hasegawa, S; Paul, A K; Mu, X; Maruyama, K; Nakatani, D; Kitakaze, M; Hori, M; Nishimura, T

    2003-04-01

    Endothelial dysfunction has been demonstrated in post-menopausal women. To assess the relationship between peripheral vascular reserve and cardiac function during exercise in post-menopausal women, 91 subjects, who had no ischaemic findings on myocardial SPECT, were assigned to four groups: pre-menopausal women (n=13), post-menopausal women (n=33), younger men aged < or =50 years (n=10), and older men aged >50 years (n=35). First-pass radionuclide angiography was performed before and during bicycle exercise to calculate ejection fraction (EF) and peripheral vascular resistance (VR). There were no differences in haemodynamic variables among the groups at baseline. The per cent increase in EF=(exercise EF - resting EF)x100/resting EF, and the per cent decrease in VR=(resting VR - exercise VR)x100/resting VR were depressed in the post-menopausal women (0.4+/-2% and 35+/-3%, respectively) compared to the pre-menopausal women (10+/-3% and 47+/-3%, respectively; P<0.05 each). Although the age dependent impairment is thought to cause this depression, neither the per cent increase in EF nor the per cent decrease in VR in the older men was significantly different from that in the younger men. Post-menopausal women exhibited depressed cardiac function during exercise, which may be related to the impairment of peripheral vascular function after menopause.

  13. Association between Estrogen Receptor Gene Polymorphisms and Depression in Post-Menopausal Women: A Preliminary Study

    PubMed Central

    Pae, Chi Un; Kim, Mi Ran; Min, Jung Ah; Kim, Kyung Hee; Lee, Chang Uk; Lee, Chul; Paik, In Ho

    2010-01-01

    Post-menopausal women experience variable biological and psychological changes. The effect of reduced levels of estrogen can effect on post-menopausal depression. Estrogen triggers physiological responses by binding to the estrogen receptor (ER). Two subtypes of ER, ERa and ERb are now known. We investigated the significance of ERa and ERb polymorphisms and post-menopasal depression in this study. Forty three women with post-menopausal depression and 63 post-menopausal women without depression as normal controls were recruited. Polymerase chain reaction-restriction fragment length polymorphism method was used to investigate genotypes of ERa and ERb polymorphisms. Genotypes of PvuII and XbaI polymorphism of ERa receptor were significantly different in patients with post-menopausal depression comparing with controls. Genotypes of ERb did not show association with post-menopausal depression. Our study showed that ERa receptor polymorphism had an association with depression in post-menopausal women. It suggests that investigation of ER genes and their functions might be important for understanding pathophysilogical mechanism of post-menopausal depression. PMID:20927313

  14. Menopause is a Determinant of Breast Adipose Inflammation

    PubMed Central

    Iyengar, Neil M.; Morris, Patrick G.; Zhou, Xi Kathy; Gucalp, Ayca; Giri, Dilip; Harbus, Michael D.; Falcone, Domenick J.; Krasne, Margaret D.; Vahdat, Linda T.; Subbaramaiah, Kotha; Morrow, Monica; Hudis, Clifford A.; Dannenberg, Andrew J.

    2015-01-01

    Chronic inflammation is recognized as a risk factor for the development of several malignancies. Local white adipose tissue (WAT) inflammation, defined by the presence of dead or dying adipocytes encircled by macrophages which form crown-like structures (CLS), occurs in the breasts (CLS-B) of most overweight and obese women. Previously, we showed that the presence of CLS-B is associated with elevated tissue levels of proinflammatory mediators and aromatase, the rate-limiting enzyme for estrogen biosynthesis. The associated increased levels of aromatase in the breast provide a plausible mechanistic link between WAT inflammation and estrogen-dependent breast cancers. Thus, breast WAT inflammation could be relevant for explaining the high incidence of estrogen-dependent tumors with aging despite diminished circulating estrogen levels after menopause. To explore this possibility, we determined whether menopause in addition to body mass index (BMI) is associated with breast WAT inflammation among 237 prospectively enrolled women. The presence of CLS-B and its severity (CLS-B/cm2) as indicators of WAT inflammation correlated with menopausal status (P=0.008 and P<0.001) and BMI (P<0.001 for both). In multivariable analyses adjusted for BMI, the postmenopausal state was independently associated with the presence (P=0.03) and severity of breast WAT inflammation (P=0.01). Mean adipocyte size increased in association with CLS-B (P<0.001). Our findings demonstrate that breast WAT inflammation, which is associated with elevated aromatase levels, is increased in association with the postmenopausal state independent of BMI. Breast WAT inflammation, a process that can potentially be targeted, may help to explain the high incidence of estrogen-dependent tumors in postmenopausal women. PMID:25720743

  15. Functional and molecular neuroimaging of menopause and hormone replacement therapy

    PubMed Central

    Comasco, Erika; Frokjaer, Vibe G.; Sundström-Poromaa, Inger

    2014-01-01

    The level of gonadal hormones to which the female brain is exposed considerably changes across the menopausal transition, which in turn, is likely to be of great relevance for neurodegenerative diseases and psychiatric disorders. However, the neurobiological consequences of these hormone fluctuations and of hormone replacement therapy in the menopause have only begun to be understood. The present review summarizes the findings of thirty-five studies of human brain function, including functional magnetic resonance imaging, positron and single-photon computed emission tomography studies, in peri- and postmenopausal women treated with estrogen, or estrogen-progestagen replacement therapy. Seven studies using gonadotropin-releasing hormone agonist intervention as a model of hormonal withdrawal are also included. Cognitive paradigms are employed by the majority of studies evaluating the effect of unopposed estrogen or estrogen-progestagen treatment on peri- and postmenopausal women's brain. In randomized-controlled trials, estrogen treatment enhances activation of fronto-cingulate regions during cognitive functioning, though in many cases no difference in cognitive performance was present. Progestagens seems to counteract the effects of estrogens. Findings on cognitive functioning during acute ovarian hormone withdrawal suggest a decrease in activation of the left inferior frontal gyrus, thus essentially corroborating the findings in postmenopausal women. Studies of the cholinergic and serotonergic systems indicate these systems as biological mediators of hormonal influences on the brain. More, hormonal replacement appears to increase cerebral blood flow in several cortical regions. On the other hand, studies on emotion processing in postmenopausal women are lacking. These results call for well-powered randomized-controlled multi-modal prospective neuroimaging studies as well as investigation on the related molecular mechanisms of effects of menopausal hormonal

  16. ESTROGEN RELATED MECHANISMS OF HYPERTENSION IN MENOPAUSAL WOMEN.

    PubMed

    Buleishvili, M; Lobjanidze, N; Ormotsadze, G; Enukidze, M; Machavariani, M; Sanikidze, T

    2016-06-01

    The aim of our investigation was to establish the role of estrogens in the pathogenesis of hypertension during menopause. Menopausal women (40-55 years) with hypertension who had been admitted to "The N. Kipshidze Central University Clinic" (Tbilisi, Georgia) during 2011-2015 and without hypertension were investigated. Essential hypertension was defined as elevated blood pressure while in a sitting position, exceeding 160±10/90±10 mm Hg 60/95 mm Hg, for three consecutive measurements over a period of at least 4 weeks. Determination and verification of menopause was provided based on the criteria of at least 12 months of amenorrhea. All the patients had given their informed consent before any procedure. Study protocol was approved by Local Ethical Committee of Davit Agmashenebeli University. In each group blood content of estradiol, free nitric oxide (NO) and nitrosilated hemoglobin (HbNO), endothelin-1 and angiotensin II (ANG) were investigated. Decrease free nitric oxide (NO) (by 10%) and increase in endothelin-1 (by 14%) and Angiotensin II (ANG) (by 12%) content in the blood of menopausal women with hypertension were identified. In some patients with hypertension it was detected low intensity of NOHb EPR signal in blood (~1,5±0,07 mm/mg). In blood of hypertensive postmenopausal women there was revealed statistically significant correlation between estrogen level and NO content (r=-0,7935, p=0,0061), estrogen level and ANG II content (r=-0,7080, p=0,0328), statistically nonsignificant dependence between NOHb EPR signal intensity and estradiol content (r=-0,29, p=0,12). In normotensive postmenopausal women correlation between blood estrogen and NO level, blood estrogen and ANGII level was not statistically significant (r=-0,4342, p=0,2429; r=-0,2676, p=0,4547). These data indicate that in postmenopausal women in the regulation of arterial pressure in addition to the estrogens involve other factors, like as was shown in our previous investigation, oxidative

  17. Reassuring the woman facing menopause: strategies and resources.

    PubMed

    Cobb, J O

    1998-03-01

    Reassurance and reliable information are the prime requirements of women in premenopause, perimenopause and postmenopause. Women in premenopause want to know what to expect; women in perimenopause want to know that their experiences fall within the range of 'normal'; women in peri- and postmenopause need help in making sensible decisions about the use of hormone therapy. Based on the concerns expressed in over 7000 letters and other messages sent to the international newsletter, A Friend Indeed, this article discusses the concerns of North American women facing menopause in the last decade of the 20th century.

  18. Endometriosis After Surgical Menopause Mimicking Pelvic Malignancy: Surgeons’ Predicament

    PubMed Central

    Bhat, Rani A.; Teo, Melissa; Bhat, Akhil Krishnanand

    2014-01-01

    Prevalence of persistent endometriosis in women after menopause without any hormonal replacement therapy is very rare. This is a case of a woman with previous history of total hysterectomy and bilateral salpingo-oophorectomy for endometriosis who presented with hemoperitoneum, vaginal bleeding, pelvic mass, and pulmonary thromboembolism mimicking as rectovaginal septum carcinoma. This is the first case report with a unique mode of presentation wherein the patient presented with hemoperitoneum requiring emergency embolization of the vessel to stabilize the patient. She underwent en bloc resection of the tumor with high anterior resection of the rectum. Histopathology confirmed endometriosis. PMID:24936277

  19. Effect of radiation on age at menopause among atomic bomb survivors.

    PubMed

    Sakata, Ritsu; Shimizu, Yukiko; Soda, Midori; Yamada, Michiko; Hsu, Wan-Ling; Hayashi, Mikiko; Ozasa, Kotaro

    2011-12-01

    Exposure to ionizing radiation has been thought to induce ovarian failure and premature menopause. Proximally exposed female atomic bomb survivors were reported to experience menopause immediately after the exposure more often than those who were distally exposed. However, it remains unclear whether such effects were caused by physical injury and psychological trauma or by direct effects of radiation on the ovaries. The objective of this study was to see if there are any late health effects associated with the exposure to atomic bomb radiation in terms of age at menopause in a cohort of 21,259 Life Span Study female A-bomb survivors. Excess absolute rates (EAR) of natural and artificial menopause were estimated using Poisson regression. A linear threshold model with a knot at 0.40 Gy [95% confidence interval (CI): 0.13, 0.62] was the best fit for a dose response of natural menopause (EAR at 1 Gy at age of 50 years = 19.4/1,000 person-years, 95% CI: 10.4, 30.8) and a linear threshold model with a knot at 0.22 Gy (95% CI: 0.14, 0.34) was the best fit for artificial menopause (EAR at 1 Gy at age of 50 years for females who were exposed at age of 20 years = 14.5/1,000 person-years, 95% CI: 10.2, 20.1). Effect modification by attained age indicated that EARs peaked around 50 years of age for both natural and artificial menopause. Although effect modification by age at exposure was not significant for natural menopause, the EAR for artificial menopause tended to be larger in females exposed at young ages. On the cumulative incidence curve of natural menopause, the median age at menopause was 0.3 years younger in females exposed to radiation of 1 Gy compared with unexposed females. The median age was 1 year younger for combined natural and artificial menopause in the same comparison. In conclusion, age at menopause was thought to decrease with increasing radiation dose for both natural and artificial menopause occurring at least 5 years after the exposure.

  20. Effect of radiation on age at menopause among atomic bomb survivors.

    PubMed

    Sakata, Ritsu; Shimizu, Yukiko; Soda, Midori; Yamada, Michiko; Hsu, Wan-Ling; Hayashi, Mikiko; Ozasa, Kotaro

    2011-12-01

    Exposure to ionizing radiation has been thought to induce ovarian failure and premature menopause. Proximally exposed female atomic bomb survivors were reported to experience menopause immediately after the exposure more often than those who were distally exposed. However, it remains unclear whether such effects were caused by physical injury and psychological trauma or by direct effects of radiation on the ovaries. The objective of this study was to see if there are any late health effects associated with the exposure to atomic bomb radiation in terms of age at menopause in a cohort of 21,259 Life Span Study female A-bomb survivors. Excess absolute rates (EAR) of natural and artificial menopause were estimated using Poisson regression. A linear threshold model with a knot at 0.40 Gy [95% confidence interval (CI): 0.13, 0.62] was the best fit for a dose response of natural menopause (EAR at 1 Gy at age of 50 years = 19.4/1,000 person-years, 95% CI: 10.4, 30.8) and a linear threshold model with a knot at 0.22 Gy (95% CI: 0.14, 0.34) was the best fit for artificial menopause (EAR at 1 Gy at age of 50 years for females who were exposed at age of 20 years = 14.5/1,000 person-years, 95% CI: 10.2, 20.1). Effect modification by attained age indicated that EARs peaked around 50 years of age for both natural and artificial menopause. Although effect modification by age at exposure was not significant for natural menopause, the EAR for artificial menopause tended to be larger in females exposed at young ages. On the cumulative incidence curve of natural menopause, the median age at menopause was 0.3 years younger in females exposed to radiation of 1 Gy compared with unexposed females. The median age was 1 year younger for combined natural and artificial menopause in the same comparison. In conclusion, age at menopause was thought to decrease with increasing radiation dose for both natural and artificial menopause occurring at least 5 years after the exposure. PMID:21988524

  1. Symptoms: Lymphedema.

    PubMed

    Paskett, Electra D

    2015-01-01

    Lymphedema is one of the main late effects from breast cancer treatment affecting 3-60% of breast cancer survivors. Primarily occurring in the hand, arm, and/or affected breast, symptoms of lymphedema include swelling, pain, redness, restriction of arm/hand movement, tightness and feelings of fullness. These symptoms not only may limit physical functioning but also negatively affect quality of life, body image, social functioning, and financial status of breast cancer survivors with lymphedema. Unfortunately, there are no standardized methods for prevention, diagnosis, and treatment of breast cancer-related lymphedema. Despite its prevalence and lack of clinical guidelines, lymphedema is one of the most poorly understood, relatively underestimated, and least researched complications of cancer treatment. This chapter reviews the current problem of breast cancer-related lymphedema by investigating prevention and risk reduction strategies, diagnosis, and treatment. In addition, this chapter identifies future research opportunities focusing on prevention and risk reduction strategies, quality of life and physical function, surveillance, patient education, cost, diagnosis, and treatment. Challenges and recommendations for future research in these areas, particularly among underserved populations, are discussed. PMID:26059932

  2. Predictors of weight variation and weight gain in peri- and post-menopausal women.

    PubMed

    Pimenta, Filipa; Maroco, João; Ramos, Catarina; Leal, Isabel

    2014-08-01

    This research encompasses a community sample of 497 women in peri- and post-menopause and uses structural equation modelling to investigate the structural models of weight variation and weight gain. Variables such as body shape concerns, depression, stress and life events are explored. Weight gain (from pre-menopause to current menopausal status) was observed in 69 per cent of participants. The predictors of weight gain were lower education level (β = -.146, p = .017), less or no physical exercise (β = -.111, p = .021), having a recent psychological problem (β = .191, p < .001), transition from peri- to post-menopause (β = .147, p = .013) and more frequent body shape concerns (β = .313, p < .001). Prevention of weight gain in pre-menopause is recommended; risk groups should be targeted considering the predictors of weight increase.

  3. The immune system in menopause: pros and cons of hormone therapy.

    PubMed

    Ghosh, Mimi; Rodriguez-Garcia, Marta; Wira, Charles R

    2014-07-01

    With aging, a general decline in immune function is observed leading to immune-senescence. Several of these changes are gender specific affecting postmenopausal women. Menopause is a normal part of a woman's lifecycle and consists of a series of body changes that can last from one to ten years. It is known that loss of sex hormones due to aging results in a reduction of immune functions. However, there remains a major gap in our understanding regarding the loss of immune functions particularly in the female reproductive tract (FRT) following menopause and the role of menopausal hormone therapy (MHT) in protecting against immune senescence. The current review presents an overview of changes in the immune system due to aging, focusing on genital tract immunity in menopausal women and the risks and benefits of using MHT. This article is part of a Special Issue entitled 'Menopause'.

  4. Minireview: translational animal models of human menopause: challenges and emerging opportunities.

    PubMed

    Diaz Brinton, Roberta

    2012-08-01

    Increasing importance is placed on the translational validity of animal models of human menopause to discern risk vs. benefit for prediction of outcomes after therapeutic interventions and to develop new therapeutic strategies to promote health. Basic discovery research conducted over many decades has built an extensive body of knowledge regarding reproductive senescence across mammalian species upon which to advance animal models of human menopause. Modifications to existing animal models could rapidly address translational gaps relevant to clinical issues in human menopausal health, which include the impact of 1) chronic ovarian hormone deprivation and hormone therapy, 2) clinically relevant hormone therapy regimens (cyclic vs. continuous combined), 3) clinically relevant hormone therapy formulations, and 4) windows of opportunity and optimal duration of interventions. Modifications in existing animal models to more accurately represent human menopause and clinical interventions could rapidly provide preclinical translational data to predict outcomes regarding unresolved clinical issues relevant to women's menopausal health. Development of the next generation of animal models of human menopause could leverage advances in identifying genotypic variations in estrogen and progesterone receptors to develop personalized menopausal care and to predict outcomes of interventions for protection against or vulnerability to disease. Key to the success of these models is the close coupling between the translational target and the range of predictive validity. Preclinical translational animal models of human menopause need to keep pace with changes in clinical practice. With focus on predictive validity and strategic use of advances in genetic and epigenetic science, new animal models of human menopause have the opportunity to set new directions for menopausal clinical care for women worldwide.

  5. Uncertainty in medicine: meanings of menopause and hormone replacement therapy in medical textbooks.

    PubMed

    Niland, Patricia; Lyons, Antonia C

    2011-10-01

    Menopause is understood, portrayed, and experienced in diverse ways. The dominant biomedical perspective medicalizes menopause as a biological 'hormone deficiency' requiring 'treatment' with hormone replacement therapy (HRT). Alternative perspectives view menopause as discursively located within particular socio-historical times and places, or privilege women's embodied experiences of menopause. We argue that the meanings of menopause and HRT should be debated within a context where the biological and the social, or the body and culture, intersect. The present study examined international medical student textbooks as sites of current biomedical knowledge, communicated for a new generation of health professionals. We undertook a Foucauldian discourse analysis on eight widely-used, international medical textbooks across physiology, pathology and pharmacology subject areas to identify the ways in which menopause and HRT are portrayed. Our results showed that menopause continues to be represented through dominant culturally infused 'failure' discourses and is portrayed as a 'precursor to disease' with HRT as the treatment. However, this knowledge is somewhat destabilized by a discourse of 'uncertainty and speculation' regarding the physiology of menopause and the potential effects of HRT. Knowledge about menopause, osteoporosis, and HRT was constructed as tentative, but the 'quest' for new knowledge was constructed as on the verge of 'exciting discoveries'. We argue that bio-social understandings of menopause and HRT, and their medical uncertainties, need to be addressed in medical curricula to ensure that doctors engage with midlife women in appropriate and positive ways, especially given the increased call for women's involvement in decision-making at this time.

  6. Relationship between arsenic skin lesions and the age of natural menopause

    PubMed Central

    2014-01-01

    Background Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women’s reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh. Methods We compared menopausal age in two groups of women – with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies— participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women. Results Women with arsenic skin lesions were 1.5 years younger (p <0.001) at the time of menopause compared to those without arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups’ age at menopause was 2.1 years earlier (p <0.001) for respondents with arsenic skin lesions. Conclusions The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure. PMID:24886424

  7. Metabolic syndrome in menopausal transition: Isfahan Healthy Heart Program, a population based study

    PubMed Central

    2010-01-01

    Introduction There is a remarkable increase in cardiovascular disease after menopause. On the other hand, metabolic syndrome as a collection of risk factors has a known effect on cardiovascular diseases. Hormone changes are considered as one of the main relevant factor regarding cardiovascular disease as well as some recognized relationship with metabolic syndrome's components. This study was carried out in order to search for prevalence of metabolic syndrome during menopausal transition. Method In a cross sectional study in urban and rural areas of Isfahan, Najafabad and Arak cities, 1596 women aged more than 45 years were investigated using Isfahan Healthy Heart Program's (IHHP) samples. Participants were categorized into three groups of pre-menopause, menopause and post-menopause. Leisure time physical activity and global dietary index were included as life style factors. The association of metabolic syndrome and its components with menopausal transition considering other factors such as age and life style was analyzed. Results there were 303, 233 and 987 women in premenopausal, early menopausal and postmenopausal groups respectively. Metabolic syndrome was found in 136(44.9%) premenopausal participants and significantly increased to 135(57.9%) and 634(64.3%) in early menopausal and postmenopausal participants respectively, when age was considered (P = 0.010). Except for hypertension and hypertriglyceridemia, there was no significant difference between three groups of menopausal transition when metabolic syndrome's components were considered. Conclusion In contrary to the claims regarding the role of waist circumference and blood glucose in increasing of metabolic syndrome during the menopausal transition, this study showed this phenomenon could be independence of them. PMID:20923542

  8. Symptomatic Ovarian Steroid Cell Tumor not Otherwise Specified in a Post-Menopausal Woman

    PubMed Central

    Sood, Neha; Desai, Kaniksha; Chindris, Ana-Maria; Lewis, Jason; Dinh, Tri A.

    2016-01-01

    Steroid cell tumor not otherwise specified (NOS) is a rare subtype of sex cord stromal tumor of the ovary and contributes less than 0.1% of all ovarian neoplasms. The majority of tumors occur in pre-menopausal women (mean age: 43 years), in which 56-77% of patients present with virilization due to excess testosterone. An 80-year-old woman with worsening alopecia and excessive growth of coarse hair on abdomen and genital area was found to have elevated serum testosterone level (462 ng/mL). Radiologic studies were consistent with bilateral adrenal adenomas. Bilateral adrenal venous sampling ruled out the adrenal gland as origin of hormone secretion. A diagnostic and therapeutic bilateral salpingo-oophorectomy confirmed steroid cell tumor NOS of the left ovary. Post-operatively, the patient had complete resolution of her symptoms and normalization of testosterone level. Our case emphasizes the importance of a clinical suspicion for an occult testosterone secreting ovarian tumor in a symptomatic patient without obvious ovarian mass on imaging. PMID:27441075

  9. Food matrix and isoflavones bioavailability in early post menopausal women: a European clinical study.

    PubMed

    Chanteranne, Brigitte; Branca, Francesco; Kaardinal, A; Wahala, K; Braesco, Véronique; Ladroite, Philippe; Brouns, Fred; Coxam, Véronique

    2008-01-01

    The estrogenic effects of soy isoflavones (IF) on symptoms of menopause are of particular interest. The aim of the present study was to improve compliance of IF in two IF-enriched foods providing the same IF circulating levels in postmenopausal women. Forty-two healthy postmenopausal women (mean age: 53.28 years) were recruited for a randomized, crossover, multicenter trial conducted in the Netherlands, Italy and France. Over 18 days, volunteers were assigned to two groups and supplemented with two different IF-enriched foods (100 mg IF aglycones/two servings). The first group had to eat two biscuits daily for three days. After a wash-out period (11 d), they received cereal bars for three days. The second group started with the cereal bars and finished with biscuits. After IF intake, plasma and urinary levels of genistein, daidzein, O desmethyl angolensin and equol significantly increased and returned to baseline level after the washout period. There was no difference between biscuits and cereals bars intake, as shown by group values at each end of experimental period (day 4 or day 18). Both matrixes are comparable in terms of IF-circulating levels and could be used independently. PMID:19281063

  10. Bioidentical Hormones, Menopausal Women, and the Lure of the “Natural” in U.S. Anti-Aging Medicine

    PubMed Central

    Fishman, Jennifer R.; Flatt, Michael A.; Settersten, Richard A.

    2015-01-01

    In 2002, the Women’s Health Initiative, a large-scale study of the safety of hormone replacement therapy (HRT) for women conducted in the United States, released results suggesting that use of postmenopausal HRT increased women’s risks of stroke and breast cancer. In the years that followed, as rates of HRT prescription fell, another hormonal therapy rose in its wake: bioidentical hormone replacement therapy (BHRT). Anti-aging clinicians, the primary prescribers of BHRT, tout it as a safe and effective alternative to treat menopausal symptoms and, moreover, as a preventative therapy for age-related diseases and ailments. Through in-depth interviews with 31 U.S.-based anti-aging clinicians and 25 female anti-aging patients, we analyze attitudes towards BHRT. We illustrate how these attitudes reveal broader contemporary values, discourses, and discomforts with menopause, aging, and biomedicine. The attraction to and promise of BHRT is rooted in the idea that it is a “natural” therapy. BHRT is given both biomedical and embodied legitimacy by clinicians and patients because of its purported ability to become part of the body’s “natural” processes. The normative assumption that “natural” is inherently “good” not only places BHRT beyond reproach, but transforms its use into a health benefit. The clinical approach of anti-aging providers also plays a role by validating patients’ embodied experiences and offering a “holistic” solution to their symptoms, which anti-aging patients see as a striking contrast to their experiences with conventional biomedical health care. The perceived virtues of BHRT shed light on the rhetoric of anti-aging medicine and a deeply complicated relationship between conventional biomedicine, hormonal technologies, and women’s bodies. PMID:25795991

  11. Bioidentical hormones, menopausal women, and the lure of the "natural" in U.S. anti-aging medicine.

    PubMed

    Fishman, Jennifer R; Flatt, Michael A; Settersten, Richard A

    2015-05-01

    In 2002, the Women's Health Initiative, a large-scale study of the safety of hormone replacement therapy (HRT) for women conducted in the United States, released results suggesting that use of postmenopausal HRT increased women's risks of stroke and breast cancer. In the years that followed, as rates of HRT prescription fell, another hormonal therapy rose in its wake: bioidentical hormone replacement therapy (BHRT). Anti-aging clinicians, the primary prescribers of BHRT, tout it as a safe and effective alternative to treat menopausal symptoms and, moreover, as a preventative therapy for age-related diseases and ailments. Through in-depth interviews with 31 U.S.-based anti-aging clinicians and 25 female anti-aging patients, we analyze attitudes towards BHRT. We illustrate how these attitudes reveal broader contemporary values, discourses, and discomforts with menopause, aging, and biomedicine. The attraction to and promise of BHRT is rooted in the idea that it is a "natural" therapy. BHRT is given both biomedical and embodied legitimacy by clinicians and patients because of its purported ability to become part of the body's "natural" processes. The normative assumption that "natural" is inherently "good" not only places BHRT beyond reproach, but transforms its use into a health benefit. The clinical approach of anti-aging providers also plays a role by validating patients' embodied experiences and offering a "holistic" solution to their symptoms, which anti-aging patients see as a striking contrast to their experiences with conventional biomedical health care. The perceived virtues of BHRT shed light on the rhetoric of anti-aging medicine and a deeply complicated relationship between conventional biomedicine, hormonal technologies, and women's bodies.

  12. Vasomotor symptoms and cardiovascular events in postmenopausal women

    PubMed Central

    Szmuilowicz, Emily D.; Manson, JoAnn E.; Rossouw, Jacques E.; Howard, Barbara V.; Margolis, Karen L.; Greep, Nancy C.; Brzyski, Robert G.; Stefanick, Marcia L.; O'Sullivan, Mary Jo; Wu, Chunyuan; Allison, Matthew; Grobbee, Diederick E.; Johnson, Karen C.; Ockene, Judith K.; Rodriguez, Beatriz L.; Sarto, Gloria E.; Vitolins, Mara Z.; Seely, Ellen W.

    2010-01-01

    Objective Emerging evidence suggests that women with menopausal vasomotor symptoms (VMS) have increased cardiovascular disease (CVD) risk as measured by surrogate markers. We investigated the relationships between VMS and clinical CVD events and all-cause mortality in the Women's Health Initiative Observational Study (WHI-OS). Methods We compared the risk of incident CVD events and all-cause mortality between four groups of women (total N=60,027): (1) No VMS at menopause onset and no VMS at WHI-OS enrollment (no VMS [referent group]); (2) VMS at menopause onset, but not at WHI-OS enrollment (early VMS); (3) VMS at both menopause onset and WHI-OS enrollment (persistent VMS [early and late]); and (4) VMS at WHI-OS enrollment, but not at menopause onset (late VMS). Results For women with early VMS (N=24,753), compared to no VMS (N=18,799), hazard ratios (HRs) and 95% confidence intervals (CIs) in fully-adjusted models were: major CHD, 0.94 (0.84, 1.06); stroke, 0.83 (0.72, 0.96); total CVD, 0.89 (0.81, 0.97); and all-cause mortality, 0.92 (0.85, 0.99). For women with persistent VMS (N=15,084), there was no significant association with clinical events. For women with late VMS (N=1,391) compared to no VMS, HRs and 95% CIs were: major CHD, 1.32 (1.01, 1.71); stroke, 1.14 (0.82, 1.59); total CVD, 1.23 (1.00, 1.52); and all-cause mortality, 1.29 (1.08, 1.54). Conclusions Early VMS were not associated with increased CVD risk. Rather, early VMS were associated with decreased risk of stroke, total CVD events, and all-cause mortality. Late VMS were associated with increased CHD risk and all-cause mortality. The predictive value of VMS for clinical CVD events may vary with onset of VMS at different stages of menopause. Further research examining the mechanisms underlying these associations is needed. Future studies will also be necessary to investigate whether VMS that develop for the first time in the later postmenopausal years represent a pathophysiologic process distinct

  13. Pineal calcification in relation to menopause in schizophrenia.

    PubMed

    Sandyk, R

    1992-01-01

    I have suggested that critical changes in melatonin secretion, as mediated by the pineal gland, may exert a crucial role in the onset and pathogenesis of schizophrenia. Since pineal calcification (PC) is thought to reflect the metabolic and secretory activity of the gland, I investigated in 29 randomly selected chronic institutionalized female schizophrenic patients the association of PC on CT scan with premenopausal (prior to age 40) versus menopausal (ages 40-55) onset of illness. The premenopausal patients were found to show a significantly higher prevalence of PC than the menopausal patients (55.5% vs. 18.1%; X2 = 3.93, df = 1, p < .05). Since PC was unrelated to historical, demographic, and treatment variables, these findings highlight the importance of the pineal gland for the timing of the onset of schizophrenia, particularly in relation to the female reproductive state. The results carry theoretical implications on the pathogenesis of schizophrenia and suggest that the pineal gland may exert a protective effect against its onset. PMID:1305625

  14. Menopause effect on blood Fe and Cu isotope compositions.

    PubMed

    Jaouen, Klervia; Balter, Vincent

    2014-02-01

    Iron (δ(56) Fe) and copper (δ(65) Cu) stable isotope compositions in blood of adult human include a sex effect, which still awaits a biological explanation. Here, we investigate the effect of menopause by measuring blood δ(56) Fe and δ(65) Cu values of aging men and women. The results show that, while the Fe and Cu isotope compositions of blood of men are steady throughout their lifetime, postmenopausal women exhibit blood δ(65) Cu values similar to men, and δ(56) Fe values intermediate between men and premenopausal women. The residence time of Cu and Fe in the body likely explains why the blood δ(65) Cu values, but not the δ(56) Fe values, of postmenopausal women resemble that of men. We suggest that the Cu and Fe isotopic fractionation between blood and liver resides in the redox reaction occurring during hepatic solicitation of Fe stores. This reaction affects the Cu speciation, which explains why blood Cu isotope composition is impacted by the cessation of menstruations. Considering that Fe and Cu sex differences are recorded in bones, we believe this work has important implications for their use as a proxy of sex or age at menopause in past populations.

  15. Phthalate metabolite levels and menopausal hot flashes in midlife women.

    PubMed

    Ziv-Gal, Ayelet; Gallicchio, Lisa; Chiang, Catheryne; Ther, Sara N; Miller, Susan R; Zacur, Howard A; Dills, Russell L; Flaws, Jodi A

    2016-04-01

    During the menopausal transition, a woman's reproductive capacity declines, her hormone milieu changes, and her risk of hot flashes increases. Exposure to phthalates, which can be found in personal care products, can also result in altered reproductive function. Here, we investigated the associations between phthalate metabolite levels and midlife hot flashes. Eligible women (45-54 years of age) provided detailed information on hot flashes history and donated urine samples (n=195). Urinary phthalate metabolite levels were measured by HPLC-MS/MS. A higher total sum of phthalate metabolites commonly found in personal care products was associated with an increased risk of ever experiencing hot flashes (odds ratio (OR)=1.45; 95% confidence interval (CI)=1.07-1.96), hot flashes in the past 30days (OR=1.43; 95%CI=1.04-1.96), and more frequent hot flashes (OR=1.47; 95%CI=1.06-2.05). These data suggest that some phthalate exposures from personal care products are associated with menopausal hot flashes in women.

  16. Cosmetics use and age at menopause: is there a connection?

    PubMed

    Chow, Erika T; Mahalingaiah, Shruthi

    2016-09-15

    Cosmetics contain a vast number of chemicals, most of which are not under the regulatory purview of the Food and Drug Administration. Only a few of these chemicals have been evaluated for potential deleterious health impact: parabens, phthalates, polycyclic aromatic hydrocarbons, and siloxanes. A review of the ingredients in the best-selling and top-rated products of the top beauty brands in the world, as well as a review of highlighted chemicals by nonprofit environmental organizations, reveals 11 chemicals and chemical families of concern: butylated hydroxyanisole/butylated hydroxytoluene, coal tar dyes, diethanolamine, formaldehyde-releasing preservatives, parabens, phthalates, 1,4-dioxane, polycyclic aromatic hydrocarbons, siloxanes, talc/asbestos, and triclosan. Age at menopause can be affected by a variety of mechanisms, including endocrine disruption, failure of DNA repair, oxidative stress, shortened telomere length, and ovarian toxicity. There is a lack of available studies to make a conclusion regarding cosmetics use and age at menopause. What little data there are suggest that future studies are warranted. Women with chronic and consistent use of cosmetics across their lifespan may be a population of concern. More research is required to better elucidate the relationship and time windows of vulnerability and the effects of mixtures and combinations of products on ovarian health.

  17. Cosmetics use and age at menopause: is there a connection?

    PubMed

    Chow, Erika T; Mahalingaiah, Shruthi

    2016-09-15

    Cosmetics contain a vast number of chemicals, most of which are not under the regulatory purview of the Food and Drug Administration. Only a few of these chemicals have been evaluated for potential deleterious health impact: parabens, phthalates, polycyclic aromatic hydrocarbons, and siloxanes. A review of the ingredients in the best-selling and top-rated products of the top beauty brands in the world, as well as a review of highlighted chemicals by nonprofit environmental organizations, reveals 11 chemicals and chemical families of concern: butylated hydroxyanisole/butylated hydroxytoluene, coal tar dyes, diethanolamine, formaldehyde-releasing preservatives, parabens, phthalates, 1,4-dioxane, polycyclic aromatic hydrocarbons, siloxanes, talc/asbestos, and triclosan. Age at menopause can be affected by a variety of mechanisms, including endocrine disruption, failure of DNA repair, oxidative stress, shortened telomere length, and ovarian toxicity. There is a lack of available studies to make a conclusion regarding cosmetics use and age at menopause. What little data there are suggest that future studies are warranted. Women with chronic and consistent use of cosmetics across their lifespan may be a population of concern. More research is required to better elucidate the relationship and time windows of vulnerability and the effects of mixtures and combinations of products on ovarian health. PMID:27545020

  18. How cultivation alleviates soil water repellency

    NASA Astrophysics Data System (ADS)

    Orfanus, Tomas; Dlapa, Pavel; Fodor, Nandor; Rajkai, Kalman

    2010-05-01

    Prolonged droughts are still more frequent and last longer in Central Europe. Under high temperature and low water content, the wettability of organic substances, which cover soil particles, decreases and the infiltration process can be retarded or even entirely prevented. This phenomenon (usually called the soil water repellency - SWR) is very common in sandy soils, especially under natural-state vegetation (forests, grasslands). The objective of this study was to examine to what extent the SWR can be alleviated by sandy soil cultivation. Two study sites in Pannonian basin were selected; Sekule in south-western Slovakia and Őrbottyán in northern Hungary. Both have sandy soils with similar textural composition and elementary structure. They differ only by land use. The first is an untreated meadow while the other has been cultivated for decades and contains small after-fertilization residual amount of carbonates. As the reference material, pure aeolian sand with no organic matter from the Sekule study site was taken, since no SWR has been detected there. Infiltration tests under small positive pressure and comparative infiltration tests with water and ethanol under small negative pressure were performed on the three materials, after several prolonged dry seasons. The results show that, water infiltration is considerably retarded in both sandy soils, which contain organic matter (meadow and arable) when compared to the reference material. In arable soil the effect was partially alleviated by cultivation. One evident reason is the presence of residual after-fertilization carbonates in this soil. Carbonates on the one side enlarged the hydrophilic/hydrophobic surface ratio and on the other increased pH, which causes enhanced dissociation of carboxylic groups and by this way also overall hydrophilicity of soil organic matter. This assumption was proved by laboratory experiments with the meadow soil from Sekule, when after calcite addition into the soil the

  19. Pain Management and Symptom-Oriented Drug Therapy in Palliative Care

    PubMed Central

    Klein, Carsten; Lang, Ute; Bükki, Johannes; Sittl, Reinhard; Ostgathe, Christoph

    2011-01-01

    Summary Patients with advanced life-limiting disease often suffer from symptoms that considerably impair their quality of life and that of their families. Palliative care aims to alleviate these symptoms by a multidimensional approach. Pharmacotherapy is an essential component. The objective of this review is to give an overview of symptom-oriented drug therapy for the most important symptoms in palliative care. Leading symptoms that affect quality of life include pain, dyspnea, nausea and emesis, weakness and disorientation. Careful examination and history taking help to understand the individual mechanisms underlying these symptoms. Specific pharmacotherapy provides an efficient way to achieve symptom control in the context of palliative care. PMID:21547023

  20. How to alleviate degradation of mangroves?

    PubMed

    Kathiresan, K

    2004-10-01

    This work has experimentally proved that hyper salinity, a major cause for degradation of coastal mangrove habitats, can be alleviated by flushing of hyper saline soil with tidal water and/or with rainwater. Over a period of three years after digging the creeks to flush hyper saline soil with tidal water, an appreciable reduction in soil salinity and a moderate increase in colonization of mangroves are observed. Soil analysis showed a significant reduction in salinity after 2 months of storage of rainwater with a significant and concomitant increase of heterotrophic bacterial counts and nutrients. This study raises the possibility of converting degrading mangrove habitats to luxuriant ones through man-made efforts.

  1. Effects of Smoking on Menopausal Age: Results From the Korea National Health and Nutrition Examination Survey, 2007 to 2012

    PubMed Central

    Yang, Hee Jung; Suh, Pae Sun; Kim, Soo Jeong; Lee, Soon Young

    2015-01-01

    Objectives: Decreased fertility and impaired health owing to early menopause are significant health issues. Smoking is a modifiable health-related behavior that influences menopausal age. We investigated the effects of smoking-associated characteristics on menopausal age in Korean women. Methods: This study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Menopausal age in relation to smoking was analyzed as a Kaplan-Meier survival curve for 11 510 women (aged 30 to 65 years). The risk of entering menopause and experiencing early menopause (before age 48) related to smoking were assessed using a Cox proportional hazards model. Results: The menopausal age among smokers was 0.75 years lower than that among non-smokers (p<0.001). The results of the Cox proportional hazards model showed pre-correction and post-correction risk ratios for entering menopause related to smoking of 1.26 (95% confidence interval [CI], 1.09 to 1.46) and 1.27 (95% CI, 1.10 to 1.47), respectively, and pre-correction and post-correction risk ratios for experiencing early menopause related to smoking of 1.36 (95% CI, 1.03 to 1.80) and 1.40 (95% CI, 1.05 to 1.85), respectively. Conclusions: Smokers reached menopause earlier than non-smokers, and their risk for experiencing early menopause was higher. PMID:26265667

  2. Neural predictive control for active buffet alleviation

    NASA Astrophysics Data System (ADS)

    Pado, Lawrence E.; Lichtenwalner, Peter F.; Liguore, Salvatore L.; Drouin, Donald

    1998-06-01

    The adaptive neural control of aeroelastic response (ANCAR) and the affordable loads and dynamics independent research and development (IRAD) programs at the Boeing Company jointly examined using neural network based active control technology for alleviating undesirable vibration and aeroelastic response in a scale model aircraft vertical tail. The potential benefits of adaptive control includes reducing aeroelastic response associated with buffet and atmospheric turbulence, increasing flutter margins, and reducing response associated with nonlinear phenomenon like limit cycle oscillations. By reducing vibration levels and thus loads, aircraft structures can have lower acquisition cost, reduced maintenance, and extended lifetimes. Wind tunnel tests were undertaken on a rigid 15% scale aircraft in Boeing's mini-speed wind tunnel, which is used for testing at very low air speeds up to 80 mph. The model included a dynamically scaled flexible fail consisting of an aluminum spar with balsa wood cross sections with a hydraulically powered rudder. Neural predictive control was used to actuate the vertical tail rudder in response to strain gauge feedback to alleviate buffeting effects. First mode RMS strain reduction of 50% was achieved. The neural predictive control system was developed and implemented by the Boeing Company to provide an intelligent, adaptive control architecture for smart structures applications with automated synthesis, self-optimization, real-time adaptation, nonlinear control, and fault tolerance capabilities. It is designed to solve complex control problems though a process of automated synthesis, eliminating costly control design and surpassing it in many instances by accounting for real world non-linearities.

  3. A Turkish study on menarche and menstrual experiences and their effects on attitudes towards menopause.

    PubMed

    Erbil, Nülüfer; Boyacı, Serap; Kurt, Ipek; Akdoğan, Yasemin; Kaya, Ilknur

    2012-04-01

    The purpose of this study was to investigate women's menarche and menstrual experiences and their effects on attitudes towards menopause. This research was planned as cross-sectional. A total of 300 women who had applied for a physical examination at the Maternity and Gynecology and Children's Hospital of Ordu province of Turkey were recruited for the study using the convenience sampling method. The study was conducted between 16 April and 28 May 2008. The research data were gathered using the Menopause Attitude Scale and a questionnaire. The average score for women on the Menopause Attitude Scale was 37.85 ± 10.34. Significant differences were found between attitudes of women towards menopause and the information they had received before menarche about menstruation (P = 0.024), the meaning of menstruation (P = 0.014), the interval time between menstrual periods (P = 0.017), problems experienced before menstruation (P = 0.035) and the desire of some women to continue menstruating and delay menopause (P = 0.005). Results of this study showed that more than half of the women had negative attitudes towards menopause. In order to help girls and women develop positive attitudes about menarche, menstruation and menopause, they need to have access to information during all phases of these important physical changes.

  4. 2016 IMS Recommendations on women's midlife health and menopause hormone therapy.

    PubMed

    Baber, R J; Panay, N; Fenton, A

    2016-04-01

    The International Menopause Society (IMS) has produced these new 2016 recommendations on women's midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.

  5. Rheumatoid symptoms following breast cancer treatment: a controlled comparison.

    PubMed

    Andrykowski, M A; Curran, S L; Carpenter, J S; Studts, J L; Cunningham, L; McGrath, P C; Sloan, D A; Kenady, D E

    1999-08-01

    The prevalence of rheumatoid symptoms following breast cancer (BC) treatment was examined. Breast cancer patients (n = 111) who were a mean of 27.6 months postcompletion of BC treatment and 99 otherwise healthy women with benign breast problems (BBP) completed a self-report measure that assessed current joint pain, swelling, and stiffness, as well as measures of quality of life. Results supported a hypothesized link between BC and rheumatoid symptoms: (1) the BC group was more likely to report joint stiffness lasting more than 60 min following morning waking; (2) the prevalence of unilateral or bilateral joint point or swelling was greater (P < 0.10) in the BC group for four of 10 joint-symptom combinations examined, with differences between the BC and BBP groups in upper extremity joint swelling particularly pronounced; and (3) 41% of the BC group reported that current rheumatoid symptoms exceeded those experienced prior to diagnosis. Within the BC group, the data did not support postchemotherapy rheumatism as an explanation for rheumatoid symptoms. Rather, data suggested that symptoms were associated with surgical management of BC. Finally, among women in the BC group with the most severe joint pain, only a minority were receiving medication for these symptoms. Given the relationship between rheumatoid symptoms and quality of life, more systematic research examining potential contributing factors such as menopausal status, concurrent lymphedema, and weight gain is warranted.

  6. Comparison of the Hyaluronic Acid Vaginal Cream and Conjugated Estrogen Used in Treatment of Vaginal Atrophy of Menopause Women: A Randomized Controlled Clinical Trial

    PubMed Central

    Jokar, Azam; Davari, Tayebe; Asadi, Nasrin; Ahmadi, Fateme; Foruhari, Sedighe

    2016-01-01

    Background: Vaginal atrophy is a common complication in menopause which does not improve with time and, if untreated, can affect the quality of life for women. The aim of this study was to compare the effectiveness of the vaginal cream of hyaluronic acid and conjugated estrogen (Premarin) in treatment of vaginal atrophy. Methods: This study was a randomized controlled clinical trial on 56 menopausal women with symptoms of vaginal atrophy; they were randomly allocated to two groups (recipient conjugated estrogen and hyaluronic acid). The severity of each sign of atrophy was evaluated by visual analog signals (VAS) and on the basis of a four point scale. Also to recognize the cellular maturation with pap smear and the maturation degree were calculated according to the formula and scores 0-100. As to the vaginal PH, we used PH marker band, the rate of which was divided into 4 degrees. Data were analyzed using SPSS, version 20, and P≤0.05 was considered as significant. Results: The results of this study showed that the symptoms of vaginal atrophy compared with the baseline level were relieved significantly in both groups. Dryness, itching, maturation index, PH and composite score of the vaginal symptoms were relieved significantly in both groups (P<0.001). Dyspareunia in Premarin (P<0.05) and hyaluronic acid (P<0.001) decreased compared with pre-treatment. Urinary incontinence only showed improvement in the hyaluronic acid group (P<0.05). Improvement in urinary incontinence, dryness, maturation index (P<0.05) and composite score of vaginal symptoms (P<0.001) in the hyaluronic acid group was better than those in the Premarin group. Conclusion: According to the results of the present study, hyaluronic acid and conjugated estrogen improved the symptoms of vaginal atrophy. But hyaluronic acid was more effective and this drug is suggested for those who do not want to or cannot take local hormone treatment. Trial Registration Number: IRCT2013022712644N1 PMID:26793732

  7. Menopausal hormone therapy and breast cancer: what is the true size of the increased risk?

    PubMed Central

    Jones, Michael E; Schoemaker, Minouk J; Wright, Lauren; McFadden, Emily; Griffin, James; Thomas, Dawn; Hemming, Jane; Wright, Karen; Ashworth, Alan; Swerdlow, Anthony J

    2016-01-01

    Background: Menopausal hormone therapy (MHT) increases breast cancer risk; however, most cohort studies omit MHT use after enrolment and many infer menopausal age. Methods: We used information from serial questionnaires from the UK Generations Study cohort to estimate hazard ratios (HRs) for breast cancer among post-menopausal women with known menopausal age, and examined biases induced when not updating data on MHT use and including women with inferred menopausal age. Results: Among women recruited in 2003–2009, at 6 years of follow-up, 58 148 had reached menopause and 96% had completed a follow-up questionnaire. Among 39 183 women with known menopausal age, 775 developed breast cancer, and the HR in relation to current oestrogen plus progestogen MHT use (based on 52 current oestrogen plus progestogen MHT users in breast cancer cases) relative to those with no previous MHT use was 2.74 (95% confidence interval (CI): 2.05–3.65) for a median duration of 5.4 years of current use, reaching 3.27 (95% CI: 1.53–6.99) at 15+ years of use. The excess HR was underestimated by 53% if oestrogen plus progestogen MHT use was not updated after recruitment, 13% if women with uncertain menopausal age were included, and 59% if both applied. The HR for oestrogen-only MHT was not increased (HR=1.00; 95% CI: 0.66–1.54). Conclusions: Lack of updating MHT status through follow-up and inclusion of women with inferred menopausal age is likely to result in substantial underestimation of the excess relative risks for oestrogen plus progestogen MHT use in studies with long follow-up, limited updating of exposures, and changing or short durations of use. PMID:27467055

  8. Menopausal Age and Chronic Diseases in Elderly Women: A Cross-Sectional Study in Northeast China

    PubMed Central

    Fu, Yingli; Yu, Yaqin; Wang, Shibin; Kanu, Joseph Sam; You, Yueyue; Liu, Yingyu; Zhang, Yangyu; Liu, Yawen; Li, Bo; Tao, Yuchun; Kou, Changgui

    2016-01-01

    Many factors affect menopausal age, and early or late onset of menopause may be associated with many chronic health problems. However, limited data are available regarding this phenomenon in the Northeast China population. For this study, 2011 elderly women were selected as a sample from participants in a cross-sectional survey performed using stratified, clustered multistage, and random sampling methods. Early menopause was more prevalent in subjects born from 1943 to 1947 (OR = 1.708, 95% CI = 1.205, 2.420) and 1933 to 1937 (OR = 2.445, 95% CI: 1.525, 3.921) and in physical laborers (OR = 1.413, 95% CI = 1.021, 1.957). Women with less than nine years of education (OR = 0.515, 95% CI: 0.327, 0.812) and who were current smokers (OR = 0.577, 95% CI: 0.347, 0.959) were less likely to have late menopause. BMIs between 25 and 30 (OR = 1.565, 95% CI: 1.152, 2.125) and greater than 30 (OR = 2.440, 95% CI: 1.482, 4.016) were associated with later menopausal age. Late menopause was positively associated with diabetes (OR = 1.611, 95% CI: 1.142, 2.274) but protective against chronic gastroenteritis/peptic ulcers (OR = 0.533, 95% CI: 0.333, 0.855). Results showed that (1) Being born in an earlier year, having a lower education, and engaging in physical labor were associated with an earlier menopausal age, while a higher BMI was associated with a later menopausal age; and that (2) menopausal age was associated with diabetes and gastroenteritis in elderly women living in Northeast China. PMID:27669270

  9. Menopausal Age and Chronic Diseases in Elderly Women: A Cross-Sectional Study in Northeast China.

    PubMed

    Fu, Yingli; Yu, Yaqin; Wang, Shibin; Kanu, Joseph Sam; You, Yueyue; Liu, Yingyu; Zhang, Yangyu; Liu, Yawen; Li, Bo; Tao, Yuchun; Kou, Changgui

    2016-01-01

    Many factors affect menopausal age, and early or late onset of menopause may be associated with many chronic health problems. However, limited data are available regarding this phenomenon in the Northeast China population. For this study, 2011 elderly women were selected as a sample from participants in a cross-sectional survey performed using stratified, clustered multistage, and random sampling methods. Early menopause was more prevalent in subjects born from 1943 to 1947 (OR = 1.708, 95% CI = 1.205, 2.420) and 1933 to 1937 (OR = 2.445, 95% CI: 1.525, 3.921) and in physical laborers (OR = 1.413, 95% CI = 1.021, 1.957). Women with less than nine years of education (OR = 0.515, 95% CI: 0.327, 0.812) and who were current smokers (OR = 0.577, 95% CI: 0.347, 0.959) were less likely to have late menopause. BMIs between 25 and 30 (OR = 1.565, 95% CI: 1.152, 2.125) and greater than 30 (OR = 2.440, 95% CI: 1.482, 4.016) were associated with later menopausal age. Late menopause was positively associated with diabetes (OR = 1.611, 95% CI: 1.142, 2.274) but protective against chronic gastroenteritis/peptic ulcers (OR = 0.533, 95% CI: 0.333, 0.855). Results showed that (1) Being born in an earlier year, having a lower education, and engaging in physical labor were associated with an earlier menopausal age, while a higher BMI was associated with a later menopausal age; and that (2) menopausal age was associated with diabetes and gastroenteritis in elderly women living in Northeast China. PMID:27669270

  10. IBD patients find symptom relief in the Cannabis field

    PubMed Central

    Schicho, Rudolf; Storr, Martin

    2014-01-01

    Cannabis (or marijuana) has been used in traditional medicine to treat intestinal inflammation and is used as a self-medication by patients with inflammatory bowel disease (IBD). A survey by Ravikoff Allegretti et al. 1 at a specialized IBD clinic shows that, in the US, marijuana is used by a significant number of patients with IBD to alleviate their symptoms. PMID:24366227

  11. Relationships between menstrual and menopausal attitudes and associated demographic and health characteristics: the Hilo Women's Health Study.

    PubMed

    Morrison, Lynn A; Sievert, Lynnette L; Brown, Daniel E; Rahberg, Nichole; Reza, Angela

    2010-07-01

    The objective of this study was to examine the relation of menstrual attitudes to menopausal attitudes and the demographic and health characteristics associated with each. This cross-sectional study consisted of a randomly selected sample of 1,824 respondents aged 16 to 100 years in multi-ethnic Hilo, Hawai'i. Women completed questionnaires for demographic and health information, such as age, ethnicity, education, residency in Hawai'i, menopausal status, exercise, and attitudes toward menstruation and menopause. Women more often chose positive terms, such as "natural," to describe menstruation (60.8%) and menopause (59.4%). In bivariate analyses, post-menopausal women were significantly more likely to have positive menstrual and menopausal attitudes than pre-menopausal women. Factor analyses were used to cluster attitudes followed by linear regression to identify demographic characteristics associated with factor scores. Asian-American ethnicity, higher education, reporting more exercise, and growing up outside of Hawai'i were associated with positive menstrual attitudes. Higher education, older age, post-menopausal status, growing up outside of Hawai'i and having hot flashes were associated with positive menopausal attitudes. Bivariate correlation analyses suggested significant associations between factor scores for menstrual and menopausal attitudes. Both negative and positive menstrual attitudes were positively correlated with the anticipation of menopause, although negative attitudes toward menstruation were negatively correlated with menopause as a positive, natural life event. Demographic variables, specifically education and where one grows up, influenced women's attitudes toward menstruation and menopause and should be considered for inclusion in subsequent multi-ethnic studies. Further research is also warranted in assessing the relationship between menstrual and menopausal attitudes.

  12. Neuroprotective effects of Estrogen Therapy for Cognitive and Neurobiological Profiles of Monkey Models of Menopause

    PubMed Central

    Voytko, Mary Lou; Tinkler, Gregory Paul; Browne, Carole; Tobin, Joseph R.

    2010-01-01

    Many postmenopausal women question whether to start or continue hormone therapy because of recent clinical trial negative results. However, evidence from other studies of postmenopausal women, and from studies in menopausal monkeys, indicate that estrogen has neurocognitive protective effects, particularly when therapy is initiated close to the time of menopause before neural systems become increasingly compromised with age. In this review, we present studies of menopausal women and female monkeys that support the concept that estrogen therapies protect both cognitive function and neurobiological processes. PMID:19475542

  13. Menopause, the metabolic syndrome, and mind-body therapies

    PubMed Central

    Innes, Kim E.; Selfe, Terry Kit; Taylor, Ann Gill

    2009-01-01

    Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health. PMID:18779682

  14. Organon OD 14 (tibolone) and menopausal dynamic hormone profiles.

    PubMed

    Abdalla, H I; Hart, D M; Lindsay, R; Beastall, G H

    1986-03-01

    Hormonal profiles were studied in 15 post-menopausal women, 7 of whom had been treated with Organon OD 14 (Tibolone) and 8 with placebo tablets for 3 yr. In the Tibolone-treated group, the sex hormone binding globulin (SHBG) levels were significantly lower, while the estimated free testosterone levels, the testosterone/SHBG ratio and the thyroid-stimulating hormone (TSH) response to thyrotrophin-releasing hormone (TRH) were significantly higher than in the placebo group. Prolactin and triiodothyronine (T3) concentrations were lower in the actively treated group, although the differences were not statistically significant. No significant differences were observed with respect to thyroxine (T4), TSH, basal cortisol or cortisol response to synacthen.

  15. [Health education during menopause. A long-range evaluation].

    PubMed

    Jiménez de Luque, M P; Serrano Monzó, I; Sabaté Baruque, I; Satrústegui Sáez, B; Azcona Montero, C

    2000-01-01

    After annually evaluating the repercussions that a health program during menopause has on women, The authors carry out a study to determine if the results obtained last over a much longer time period. This cross-sectional study was carried out in 1998 on a random sample taken from all the women who participated in this program during the years 1995 and 1996. Furthermore, the authors made comparisons between both sample year groups. The study results demonstrate that once women have acquired the knowledge necessary to serve as a foundation to practice healthy habits, they integrate these habits into their life style on a permanent basis. Part of this paper was presented orally in the Andalucian Conference on Nursing in Gynecology which took place in November 1998 in Seville.

  16. [Debit and credit. Menopause between illusion and reality].

    PubMed

    Sies, C; Nestler, V

    1992-04-01

    Middle-aged women in patriarchial societies are still widely considered as deficient and damaged and therefore can easily become objects of medical attention. The authors seek the reasons for this in fact that the different changes of male and female potency in the 45 to 55 age-group provoke defense mechanisms. These are meant to ensure the intactness of the male--who then is supposedly in his 'best age'--for the sake of both men and women. Apart from this, psychoanalytical theories--like the one of the "depressive position", held by Melanie Klein--confirm the prejudice that a woman going through the change of life is damaged, and thus has to mourn the "desease" of menopause. PMID:1635990

  17. Hormone replacement therapy diminishes hearing in peri-menopausal mice.

    PubMed

    Price, Katharine; Zhu, Xiaoxia; Guimaraes, Patricia F; Vasilyeva, Olga N; Frisina, Robert D

    2009-06-01

    We recently discovered that progestin in hormone replacement therapy (HRT) for post-menopausal women has detrimental effects on the ear and central auditory system [Guimaraes, P., Frisina, S.T., Mapes, F., Tadros, S.F., Frisina, D.R., Frisina, R.D., 2006. Progestin negatively affects hearing in aged women. Proc. Natl. Acad. Sci. - PNAS 103, 14246-14249]. To start determining the generality and neural bases of these human findings, the present study examined the effects of combination HRT (estrogen+progestin) and estrogen alone on hearing in peri-menopausal mice. Specifically, auditory brainstem responses (ABRs-sensitivity of the auditory system) and distortion-product otoacoustic emissions (DPOAEs-cochlear outer hair cell system) were employed. Middle age female CBA mice received either a time-release, subcutaneous implanted pellet of estrogen+progestin, estrogen alone, or placebo. Longitudinal comparisons of ABR threshold data obtained at 4 months of treatment revealed statistically significant declines in auditory sensitivity over time for the combined estrogen+progestin treatment group, with the estrogen only group revealing milder changes at 3, 6 and 32 kHz. DPOAE testing revealed statistically significant differences for the estrogen+progestin treatment group in the high and middle frequency ranges (15-29 and 30-45 kHz) after as early as 2 months of treatment (p<0.01 and p<0.001, respectively). Statistically significant changes were also seen at 4 months of treatment across all frequencies for the combined HRT group. These data suggest that estrogen+progestin HRT therapy of 4 months duration impairs outer hair cell functioning and overall auditory sensitivity. These findings indicate that estrogen+progestin HRT may actually accelerate age-related hearing loss, relative to estrogen monotherapy; findings that are consistent with the clinical hearing loss observed in aging women that have taken combination HRT.

  18. Menopause and menarche in patients with primary blepharospasm: an exploratory case-control study.

    PubMed

    Martino, Davide; Livrea, Paolo; Giorelli, Maurizio; Masi, Gianluca; Aniello, Maria Stella; Defazio, Giovanni

    2002-01-01

    We studied the relationships between blepharospasm (BSP) and menopause/menarche in female patients with primary BSP (n = 83) and age-matched healthy (n = 83) and disease controls (n = 83). BSP patients and matched controls had comparable age at menopause, and there was no correlation between age at menopause and age at BSP onset. Thus, menopause probably exerts no significant influence on the age-dependent development of BSP. BSP cases tended to have a later menarche than either group of controls. The association was independent of age, disease duration and education level. Because the higher the age at menarche, the higher the age at BSP onset, later menarche was unlikely to be a risk factor for BSP. Rather, the two conditions may share pathophysiologic mechanisms, for example minor abnormality of neurotransmitter systems controlling both the motor system and the maturation of the hypothalamic-pituitary-gonadal axis responsible for the onset of puberty.

  19. The Association of Menopausal Age and NT-proBrain Natriuretic Peptide: The Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    Ebong, Imo A.; Watson, Karol E.; Goff, David C.; Bluemke, David A.; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G.

    2014-01-01

    Objective Menopausal age could affect the risk of developing cardiovascular disease (CVD). The purpose of this study was to investigate the associations of early menopause (menopause occurring before 45 years of age) and menopausal age with NT-pro brain natriuretic peptide (NT-proBNP), a potential risk marker of CVD and heart failure (HF). Methods Our cross-sectional study included 2275 postmenopausal women, aged 45–85 years, without clinical CVD (2000–2002), from the Multi-Ethnic Study of Atherosclerosis. Participants were classified as having or not having early menopause. NT-proBNP was log-transformed. Multivariable linear regression was used for analysis. Results There were 561 women with early menopause. The median NT-proBNP value was 79.0 (41.1–151.6) pg/ml for all participants with values of 83.4 (41.4–164.9) pg/ml and 78.0 (40.8–148.3) pg/ml for women with and without early menopause respectively. The mean (SD) age was 65 (10.1) and 65 (8.9) years for women with and without early menopause respectively. There were no significant interactions between menopausal age and ethnicity. In multivariable analysis, early menopause was associated with a 10.7% increase in NT-proBNP while each year increase in menopausal age was associated with a 0.7% decrease in NT-proBNP. Conclusion Early menopause is associated with greater NT-proBNP levels while each year increase in menopausal age is associated with lower NT-proBNP levels in postmenopausal women. PMID:25290536

  20. Symptoms of Depressed Mood, Disturbed Sleep, and Sexual Problems in Midlife Women: Cross-Sectional Data from the Study of Women's Health Across the Nation

    PubMed Central

    Wisniewski, Stephen R.; Luther, James; Hess, Rachel; Thurston, Rebecca C.; Wisner, Katherine L.; Bromberger, Joyce T.

    2015-01-01

    Abstract Background: Women report many nonvasomotor symptoms across the menopausal transition, including sleep disturbances, depressed mood, and sexual problems. The co-occurrence of these three symptoms may represent a specific menopausal symptom triad. We sought to evaluate the interrelatedness of disturbed sleep, depressed mood, and sexual problems in the Study of Women's Health Across the Nation (SWAN) and determine the characteristics of women exhibiting this symptom triad. Methods: SWAN is a multisite, multiethnic observational cohort study of the menopausal transition in the United States. Sleep disturbance, sexual problems, and depressed mood were determined based on self-report. Women who reported all three symptoms simultaneously were compared to those who did not. Logistic regression models estimated the association of demographic, psychosocial, and clinical characteristics with the symptom triad. Results: Study participants (n=1716) were 49.8 years old on average and primarily in very good or excellent health. Sixteen and a half percent had depressed mood, 36.6% had a sleep problem, and 42.2% had any sexual problem. Five percent of women (n=90) experienced all three symptoms. Women with the symptom triad compared with those without had lower household incomes, less education, were surgically postmenopausal or late perimenopausal, rated their general health as fair or poor, and had more stressful life events and lower social support. Conclusions: The symptom triad of sleep disturbance, depressed mood, and sexual problems occurred in only 5% of women, and occurred most often among women with lower socioeconomic status, greater psychosocial distress, and who were surgically menopausal or in the late perimenopause. PMID:25621768

  1. Phytoestrogens in menopausal supplements induce ER-dependent cell proliferation and overcome breast cancer treatment in an in vitro breast cancer model

    SciTech Connect

    Duursen, Majorie B.M. van; Smeets, Evelien E.J.W.; Rijk, Jeroen C.W.; Nijmeijer, Sandra M.; Berg, Martin van den

    2013-06-01

    Breast cancer treatment by the aromatase inhibitor Letrozole (LET) or Selective Estrogen Receptor Modulator Tamoxifen (TAM) can result in the onset of menopausal symptoms. Women often try to relieve these symptoms by taking menopausal supplements containing high levels of phytoestrogens. However, little is known about the potential interaction between these supplements and breast cancer treatment, especially aromatase inhibitors. In this study, interaction of phytoestrogens with the estrogen receptor alpha and TAM action was determined in an ER-reporter gene assay (BG1Luc4E2 cells) and human breast epithelial tumor cells (MCF-7). Potential interactions with aromatase activity and LET were determined in human adrenocorticocarcinoma H295R cells. We also used the previously described H295R/MCF-7 co-culture model to study interactions with steroidogenesis and tumor cell proliferation. In this model, genistein (GEN), 8-prenylnaringenin (8PN) and four commercially available menopausal supplements all induced ER-dependent tumor cell proliferation, which could not be prevented by physiologically relevant LET and 4OH-TAM concentrations. Differences in relative effect potencies between the H295R/MCF-7 co-culture model and ER-activation in BG1Luc4E2 cells, were due to the effects of the phytoestrogens on steroidogenesis. All tested supplements and GEN induced aromatase activity, while 8PN was a strong aromatase inhibitor. Steroidogenic profiles upon GEN and 8PN exposure indicated a strong inhibitory effect on steroidogenesis in H295R cells and H295R/MCF-7 co-cultures. Based on our in vitro data we suggest that menopausal supplement intake during breast cancer treatment should better be avoided, at least until more certainty regarding the safety of supplemental use in breast cancer patients can be provided. - Highlights: • Supplements containing phytoestrogens are commonly used by women with breast cancer. • Phytoestrogens alter steroidogenesis in a co-culture breast

  2. Increasing Iron and Zinc in Pre-Menopausal Women and Its Effects on Mood and Cognition: A Systematic Review

    PubMed Central

    Lomagno, Karla A.; Hu, Feifei; Riddell, Lynn J.; Booth, Alison O.; Szymlek-Gay, Ewa A.; Nowson, Caryl A.; Byrne, Linda K.

    2014-01-01

    Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or zinc supplementation and its impact on mood or cognition in pre-menopausal women. Searches included MEDLINE complete, Excerpta Medica Database (EMBASE), psychINFO, psychARTICLES, pubMED, ProQuest Health and Medical Complete Academic Search complete, Scopus and ScienceDirect. Ten randomized controlled trials and one non-randomized controlled trial were found to meet the inclusion criteria. Seven studies found improvements in aspects of mood and cognition after iron supplementation. Iron supplementation appeared to improve memory and intellectual ability in participants aged between 12 and 55 years in seven studies, regardless of whether the participant was initially iron insufficient or iron-deficient with anaemia. The review also found three controlled studies providing evidence to suggest a role for zinc supplementation as a treatment for depressive symptoms, as both an adjunct to traditional antidepressant therapy for individuals with a diagnosis of major depressive disorder and as a therapy in its own right in pre-menopausal women with zinc deficiency. Overall, the current literature indicates a positive effect of improving zinc status on enhanced cognitive and emotional functioning. However, further study involving well-designed randomized controlled trials is needed to identify the impact of improving iron and zinc status on mood and cognition. PMID:25405366

  3. Increasing iron and zinc in pre-menopausal women and its effects on mood and cognition: a systematic review.

    PubMed

    Lomagno, Karla A; Hu, Feifei; Riddell, Lynn J; Booth, Alison O; Szymlek-Gay, Ewa A; Nowson, Caryl A; Byrne, Linda K

    2014-11-01

    Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or zinc supplementation and its impact on mood or cognition in pre-menopausal women. Searches included MEDLINE complete, Excerpta Medica Database (EMBASE), psychINFO, psychARTICLES, pubMED, ProQuest Health and Medical Complete Academic Search complete, Scopus and ScienceDirect. Ten randomized controlled trials and one non-randomized controlled trial were found to meet the inclusion criteria. Seven studies found improvements in aspects of mood and cognition after iron supplementation. Iron supplementation appeared to improve memory and intellectual ability in participants aged between 12 and 55 years in seven studies, regardless of whether the participant was initially iron insufficient or iron-deficient with anaemia. The review also found three controlled studies providing evidence to suggest a role for zinc supplementation as a treatment for depressive symptoms, as both an adjunct to traditional antidepressant therapy for individuals with a diagnosis of major depressive disorder and as a therapy in its own right in pre-menopausal women with zinc deficiency. Overall, the current literature indicates a positive effect of improving zinc status on enhanced cognitive and emotional functioning. However, further study involving well-designed randomized controlled trials is needed to identify the impact of improving iron and zinc status on mood and cognition. PMID:25405366

  4. Omega-3 fatty acids for major depressive disorder associated with the menopausal transition: a preliminary open trial

    PubMed Central

    Freeman, Marlene P.; Hibbeln, Joseph R.; Silver, Michael; Hirschberg, April M.; Wang, Betty; Yule, Amy M.; Petrillo, Laura F.; Pascuillo, Erica; Economou, Nicole I.; Joffe, Hadine; Cohen, Lee S.

    2011-01-01

    Objectives We sought to obtain preliminary data regarding the efficacy of omega-3 fatty acids for major depressive disorder associated with the menopausal transition. Secondary outcomes were assessed for vasomotor symptoms (or hot flashes). Methods After a single-blind placebo lead-in, participants received 8 weeks of treatment with open-label omega-3 fatty acid capsules (eicosapentaenoic acid and docosahexaenoic acid, 2 g/d). The Montgomery-Asberg Depression Rating Scale (MADRS) was the primary outcome measure. Hot flashes were monitored prospectively using daily diaries and the Hot Flash Related Daily Interference Scale. Blood samples for plasma pretreatment and post treatment essential fatty acid assays were obtained. Because of the small sample size, data were analyzed using nonparametric techniques. Results Of 20 participants treated with omega-3 fatty acids, 19 (95%) completed the study. None discontinued because of adverse effects. The pretreatment and final mean MADRS scores were 24.2 and 10.7, respectively, reflecting a significant decrease in MADRS scores (P G 0.0001). The response rate was 70% (MADRS score decrease of Q50%), and the remission rate was 45% (final MADRS score of e7). Responders had significantly lower pretreatment docosahexaenoic acid levels than nonresponders did (P = 0.03). Hot flashes were present in 15 (75%) participants. Among those with hot flashes at baseline, the number of hot flashes per day improved significantly from baseline (P = 0.02) and Hot Flash Related Daily Interference Scale scores decreased significantly (P = 0.006). Conclusions These data support further study of omega-3 fatty acids for major depressive disorder and hot flashes in women during the menopausal transition. PMID:21037490

  5. Cognitive effects of long-term dydrogesterone treatment used alone or with estrogen on rat menopausal models of different ages.

    PubMed

    Liu, J; Lin, H; Huang, Y; Liu, Y; Wang, B; Su, F

    2015-04-01

    Menopause can cause cognitive decline. Hormone Replacement Therapy (HRT) is the most effective treatment for the climacteric symptoms. However, its cognitive effect has not been well clarified, especially for the progestin component. The study investigated the effects of dydrogesterone (DG) on spatial learning and memory of the ovariectomized (OVX) rat models and the impact of aging on its cognitive effects. Eighty female Sprague-Dawley rats were included in the experiment. They belonged to two cohorts, the adult (7 months) and the aged (18 months). Each cohort was divided into five groups: Sham, OVX, OVX+E2 (OVX+17β-estrogen), OVX+E2/DG and OVX+DG. The replacement therapy lasted for 20 weeks. Two classical behavioral tests were performed: open field test (OFT) and the Morris water maze (MWM). The breast morphology and uterine weight were obtained to assess the safety and complication of dydrogesterone. In MWM, the OVX group displayed prolonged latency and less target quadrant time than the other groups. Across 5 days' testing, all the adult groups receiving hormone therapy, except the OVX+DG group, performed better than the OVX group (P<0.001); but there was no significant difference among the aged groups. The uterus weight/body weight ratio of OVX+E2/DG group was lower than the sham and OVX+E2 group. The mammary glands of OVX+E2/DG group displayed normal structure or mild hyperplasia. The results suggested that DG-alone treatment had no significant benefit for the OVX rats of both adult and aged groups on the behavioral tests. DG combined with E2 could ameliorate cognition in adult rats with uterus protection and without breast harm. The cognitive-improve effects were more remarkable for the adult rats than the aged ones. The findings support the potential clinical application of dydrogesterone combined with estrogen in preventing cognitive decline, especially for the early iatrogenic menopausal women. PMID:25637796

  6. Racial/Ethnic Differences in Cardiovascular Symptoms in Four Major Racial/Ethnic Groups of Midlife Women: A Secondary Analysis.

    PubMed

    Im, Eun-Ok; Ham, Ok Kyung; Chee, Eunice; Chee, Wonshik

    2015-01-01

    Ethnic minority midlife women frequently do not recognize cardiovascular symptoms that they experience during the menopausal transition. Racial/ethnic differences in cardiovascular symptoms are postulated as a plausible reason for their lack of knowledge and recognition of the symptoms. The purpose of this study was to explore racial/ethnic differences in midlife women's cardiovascular symptoms and to determine the factors related to these symptoms in each racial/ethnic group. This was a secondary analysis of the data from a larger study among 466 participants, collected from 2006 to 2011. The instruments included questions on background characteristics, health and menopausal status, and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics, including Poisson regression and logistic regression analyses. Significant racial/ethnic differences were observed in the total numbers and total severity scores of cardiovascular symptoms (p < .01). Non-Hispanic Asians had significantly lower total numbers and total severity scores compared to other racial/ethnic groups (p < .05). The demographic and health factors associated with cardiovascular symptoms were somewhat different in each racial/ethnic group. Further studies are needed about possible reasons for the racial/ethnic differences and the factors associated with cardiovascular symptoms in each racial/ethnic group. PMID:25826460

  7. A Microsatellite Polymorphism in IGF1 Gene Promoter and Timing of Natural Menopause in Caucasian Women

    PubMed Central

    Kaczmarek, Maria; Pacholska-Bogalska, Joanna; Kwaśniewski, Wojciech; Kotarski, Jan; Halerz-Nowakowska, Barbara; Goździka-Józefiak, Anna

    2015-01-01

    Background: Genes involved in the IGF-1 aging pathways in the human ovary can be considered strong candidates for predictors of the natural menopause timing. This study evaluates the association between a cytosine-adenine (CA) microsatellite polymorphism in the IGF1 gene promoter P1 and age at natural menopause. Methods: Genomic DNA was extracted from the peripheral blood, PCR was performed using primers designed to amplify the polymorphic (CA)n repeat of the human IGF1 gene, an allele dose effect for the most common (CA)19 repeats allele, Cox proportional hazard regression models and the Kaplan-Meier cumulative survivorship method with the log-rank test were used to determine statistical significance of studied associations in a sample of 257 Polish women aged 40-58 years. Results: Crude Cox proportional hazard regression analysis confirmed the association between the IGF1 gene polymorphism and the menopause timing (p=0.038). This relationship remained statistically significant after controlling for other menopause confounders in multivariate modelling. Out of the input variables, the (CA)n polymorphism in the IGF1 gene promoter, age at menarche and smoking status were independent covariates of the natural menopause timing (χ2 =12.845; df=3; p=0.034). The onset of menopause at a younger age was likely associated with the IGF1 genotype variant not carrying the (CA)19 repeats allele, menarche before the age of 12 and a current cigarette smoker status (HR=1.6). Conclusion: This study provides evidence that a common cytosine-adenine (CA) microsatellite repeat polymorphism in the P1 promoter region of the IGF1 gene is an independent predictive factor for age at natural menopause in Caucasian women also after adjusting for other menopause covariates. PMID:25552916

  8. A Comparative Study of Lipid Profile and Oestradiol in Pre- and Post-Menopausal Women

    PubMed Central

    Reddy Kilim, Srinivas; Chandala, Srinivasa Rao

    2013-01-01

    Objectives: To investigate the relationship between the menopausal status and related hormonal variation of oestradiol with plasma lipid concentrations. Material and Methods: Fifty premenopausal women and fifty postmenopausal women subjects were selected. Data was collected through clinical evaluation from questionnaires and laboratory investigations. Plasma oestradiol and lipid profile determinations were done by using competitive binding immunoassay methods and enzymatic methods respectively. Student’s T test and Pearson’s test of correlation were used for the statistical analysis. P-values of < 0.05 were considered to be statistically significant. Results: There was a significant increase in serum Total Cholesterol (TC), Triglycerides (TG), LDL-cholesterol and VLDL-cholesterol levels in post-menopausal women. HDL-cholesterol level was significantly decreased in post-menopausal women. The calculated atherogenic index (Total Cholesterol/HDL ratio) was significantly increased in post-menopausal women as compared to that in premenopausal women. Oestradiol concentration was significantly lower (p<0.001) in post-menopausal women. Discussion: Oestrogen changes the vascular permeability by increasing nitrous oxide production. It maintains a healthy lipoprotein profile. It stabilizes the endothelial cells, enhances antioxidant effect and alters fibrinolysis protein. All these cardioprotective mechanisms are lost in menopause. Postmenopausal women develop an increased risk for cardiovascular disease. Conclusion: Menopause leads to changes in lipid profile by reducing HDL, and elevating Total Cholesterol (TC), triglycerides (TG), LDL-cholesterol and VLDL-cholesterol, thus increasing the risk for cardiovascular disease. These changes are caused by reduced oestrogen concentrations which are seen in menopause. PMID:24086849

  9. Body mass index and colon cancer risk in Chinese people: Menopause as an effect modifier

    PubMed Central

    Hou, Lifang; Ji, Bu-Tian; Blair, Aaron; Dai, Qi; Gao, Yu-Tang; Potter, John D.; Chow, Wong-Ho

    2006-01-01

    High body mass index (BMI) has consistently been associated with increased colon cancer risk in men, but not in women. It is hypothesised that menopause-related changes in oestrogen levels play a role in gender-specific risk patterns. Most studies have been conducted in Western countries, where high incidence rates are coupled with a high prevalence of obesity and relatively common use of hormone replacement therapy (HRT) in post-menopausal women. This study evaluated the correlation between body mass index (BMI) and colon cancer risk in a relatively lean population, comprising 931 cases and 1552 controls, in Shanghai, China, where HRT use was extremely rare among women, during 1990–1993. Among men, colon cancer risk significantly increased with increasing BMI (P-trend = 0.005). Among women, the risk varied with age and menopause status in a similar pattern. Within each menopause stratum, however, the BMI-related risk was similar for those aged under 55 years and those aged 55 years and over, indicating a menopause rather than age effect. Among pre-menopausal women, the odds ratios (ORs) for subjects in the highest versus lowest quintile were 1.9 (95% CI 1.1–4.9) for those under 55 years of age, and 2.2 (95% CI 1.4–8.2) for those aged 55 years and over. Among post-menopausal women, the corresponding ORs were 0.6 (95% CI 0.5–0.91) and 0.7 (95% CI 0.5–0.95), respectively. Our findings suggest that BMI predicts colon cancer risk in both genders. Among women, however, the risk is modified by menopause status, possibly through altered endogenous oestrogen levels. PMID:16321519

  10. Hyperuricemia is independently associated with left ventricular hypertrophy in post-menopausal women but not in pre-menopausal women in rural Northeast China.

    PubMed

    Yu, Shasha; Yang, Hongmei; Guo, Xiaofan; Zheng, Liqiang; Sun, Yingxian

    2015-01-01

    The aim of this article is to estimate the relationship between hyperuricemia and left ventricular hypertrophy (LVH) and to investigate whether menopause was associated with the relationship between hyperuricemia and LVH. This survey was conducted from July 2012 to August 2013. A total of 6029 women (3508, 58.2% were post-menopause) from the rural Northeast China were randomly selected and examined. LVH was defined using the 2007 Guidelines for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Age, body mass index, glucose, estimated glomerular filtration rate and lipid level were significantly correlated with serum uric acid level. LVH showed a gradual increase in accordance with the serum uric acid level in entire study population (<4.0 mg/dL, 11.4%; 4 to <5 mg/dL, 14.9%; 5 to <6 mg/dL, 18.9%; ≥6 mg/dL, 27.4%; p < 0.001). Multivariate analysis revealed that hyperuricemia was a significantly independent risk factor for LVH in post-menopausal women [OR (95% CI): 1.367 (1.026, 1.821)], but not in pre-menopausal women [OR (95% CI): 1.290 (0.669, 2.486)]. These findings suggested that hyperuricemia can be used as a risk marker of LVH in a female population and, in particular, as an independent risk factor in post-menopausal women but not in pre-menopausal women.

  11. Patient Satisfaction with Physician Discussions of Treatment Impact on Fertility, Menopause and Sexual Health among Pre-menopausal Women with Cancer

    PubMed Central

    Scanlon, Maura; Blaes, Anne; Geller, Melissa; Majhail, Navneet S; Lindgren, Bruce; Haddad, Tufia

    2012-01-01

    PURPOSE: Pre-menopausal women with cancer are at risk of therapy-associated infertility, premature menopause, and sexual dysfunction. However, it is unknown whether oncologists adequately address these risks during treatment planning. We conducted a study to evaluate physician-patient discussions addressing the impact of cancer treatment and actual treatment effects on fertility, menopause status, and general sexual health. METHODS: A questionnaire was administered in four oncology clinics specializing in breast, gynecologic, general hematology-oncology, and blood and marrow transplantation (BMT) cancer care at a single institution. Eligible participants were pre-menopausal at the time of diagnosis and either actively receiving or within 24 months from completion of treatment. Participants completed the questionnaire at enrollment and at 1-year follow-up. RESULTS: Of the 104 eligible women, a majority were satisfied with the quality (68%) and length (66%) of reproductive health discussions, with the highest satisfaction levels in the gynecologic cancer clinic (85%) and the lowest levels in the BMT clinic (53%). Fertility preservation was desired by 20% of women, including some >40 years old. Women were more interested in discussing treatment impact on menopause status and sexual health than fertility. Rates of discussions on treatment impact on sexual health were low despite 77% of women reporting severe sexual dysfunction at 1-year follow-up. CONCLUSIONS: One-third of women are dissatisfied with the quality and length of discussions regarding the impact of cancer treatment on reproductive health. There is notably inadequate counseling on the effect of treatment on fertility in women > 40 and on sexual function in all women. Oncologists must offer better resources and improve communication on the effect of treatment on reproductive health to pre-menopausal women with cancer. PMID:22606211

  12. Meta-analysis of loci associated with age at natural menopause in African-American women

    PubMed Central

    Chen, Christina T.L.; Liu, Ching-Ti; Chen, Gary K.; Andrews, Jeanette S.; Arnold, Alice M.; Dreyfus, Jill; Franceschini, Nora; Garcia, Melissa E.; Kerr, Kathleen F.; Li, Guo; Lohman, Kurt K.; Musani, Solomon K.; Nalls, Michael A.; Raffel, Leslie J.; Smith, Jennifer; Ambrosone, Christine B.; Bandera, Elisa V.; Bernstein, Leslie; Britton, Angela; Brzyski, Robert G.; Cappola, Anne; Carlson, Christopher S.; Couper, David; Deming, Sandra L.; Goodarzi, Mark O.; Heiss, Gerardo; John, Esther M.; Lu, Xiaoning; Le Marchand, Loic; Marciante, Kristin; Mcknight, Barbara; Millikan, Robert; Nock, Nora L.; Olshan, Andrew F.; Press, Michael F.; Vaiyda, Dhananjay; Woods, Nancy F.; Taylor, Herman A.; Zhao, Wei; Zheng, Wei; Evans, Michele K.; Harris, Tamara B.; Henderson, Brian E.; Kardia, Sharon L.R.; Kooperberg, Charles; Liu, Yongmei; Mosley, Thomas H.; Psaty, Bruce; Wellons, Melissa; Windham, Beverly G.; Zonderman, Alan B.; Cupples, L. Adrienne; Demerath, Ellen W.; Haiman, Christopher; Murabito, Joanne M.; Rajkovic, Aleksandar

    2014-01-01

    Age at menopause marks the end of a woman's reproductive life and its timing associates with risks for cancer, cardiovascular and bone disorders. GWAS and candidate gene studies conducted in women of European ancestry have identified 27 loci associated with age at menopause. The relevance of these loci to women of African ancestry has not been previously studied. We therefore sought to uncover additional menopause loci and investigate the relevance of European menopause loci by performing a GWAS meta-analysis in 6510 women with African ancestry derived from 11 studies across the USA. We did not identify any additional loci significantly associated with age at menopause in African Americans. We replicated the associations between six loci and age at menopause (P-value < 0.05): AMHR2, RHBLD2, PRIM1, HK3/UMC1, BRSK1/TMEM150B and MCM8. In addition, associations of 14 loci are directionally consistent with previous reports. We provide evidence that genetic variants influencing reproductive traits identified in European populations are also important in women of African ancestry residing in USA. PMID:24493794

  13. Distinguishing 6 Population Subgroups by Timing and Characteristics of the Menopausal Transition

    PubMed Central

    Huang, Xiaobi; Harlow, Siobán D.; Elliott, Michael R.

    2012-01-01

    Changes in women’s menstrual bleeding patterns precede the onset of menopause. In this paper, the authors identify population subgroups based on menstrual characteristics of the menopausal transition experience. Using the TREMIN data set (1943–1979), the authors apply a Bayesian change-point model with 8 parameters for each woman that summarize change in menstrual bleeding patterns during the menopausal transition. The authors then use estimates from this model to classify menstrual patterns into subgroups using a K-medoids algorithm. They identify 6 subgroups of women whose transition experience can be distinguished by age at onset, variability of the menstrual cycle, and duration of the early transition. These results suggest that for most women, mean and variance change points are well aligned with proposed bleeding markers of the menopausal transition, but for some women they are not clearly associated. Increasing understanding of population differences in the transition experience may lead to new insights into ovarian aging. Because of age inclusion criteria, most longitudinal studies of the menopausal transition probably include only a subset of the 6 subgroups of women identified in this paper, suggesting a potential bias in the understanding of both the menopausal transition and the linkage between the transition and chronic disease. PMID:22138039

  14. Relationship between psychosocial factors and health behaviours for women experiencing menopause.

    PubMed

    Anderson, Debra; Posner, Natasha

    2002-10-01

    This study investigated the psychosocial factors related to the health behaviours of women at menopause. These health behaviours included choice of intervention by women for menopause, particularly consultation of health professionals, use of hormone replacement therapy and preferred information sources. A postal questionnaire was distributed to a structured random population-based sample of 400 women in the 45-54 years age group living in south-east Queensland, Australia. Explanatory variables were: attitudes to menopause, social functioning, mental health, vitality, preventive health practices and lifestyle factors. This study found that information, preventive health practices, attitudes towards menopause, exercise, number of children living at home, years of formal education and working in paid employment, were related to the health behaviours of women at menopause. The study concludes that a number of related psychosocial factors not associated with hormonal changes may influence the health behaviours of menopausal women. It will be important for nurses, other health professionals and counsellors to decide how best to respond to these findings in consultation with the women affected by their decisions. PMID:12225353

  15. Long-term health consequences of premature or early menopause and considerations for management

    PubMed Central

    Faubion, Stephanie S.; Kuhle, Carol L.; Shuster, Lynne T.; Rocca, Walter A.

    2015-01-01

    Aim To review the current evidence concerning the long-term harmful effects of premature or early menopause, and to discuss some of the clinical implications. Material and methods Narrative review of the literature. Results Women undergoing premature or early menopause, either following bilateral salpingo-oophorectomy or because of primary ovarian insufficiency, experience the early loss of estrogen and other ovarian hormones. The long-term consequences of premature or early menopause include adverse effects on cognition, mood, cardiovascular, bone, and sexual health, as well as an increased risk of early mortality. The use of hormone therapy has been shown to lessen some, although not all of these risks. Therefore, multiple medical societies recommend providing hormone therapy at least until the natural age of menopause. It is important to individualize hormone therapy for women with early estrogen deficiency, and higher dosages may be needed to approximate physiological concentrations found in premenopausal women. It is also important to address the psychological impact of early menopause and to review the options for fertility and the potential need for contraception, if the ovaries are intact. Conclusions Women who undergo premature or early menopause should receive individualized hormone therapy and counseling. PMID:25845383

  16. Dynamics of the ovarian reserve and impact of genetic and epidemiological factors on age of menopause.

    PubMed

    Pelosi, Emanuele; Simonsick, Eleanor; Forabosco, Antonino; Garcia-Ortiz, Jose Elias; Schlessinger, David

    2015-05-01

    The narrow standard age range of menopause, ∼50 yr, belies the complex balance of forces that govern the underlying formation and progressive loss of ovarian follicles (the "ovarian reserve" whose size determines the age of menopause). We show here the first quantitative graph of follicle numbers, distinguished from oocyte counts, across the reproductive lifespan, and review the current state of information about genetic and epidemiological risk factors in relation to possible preservation of reproductive capacity. In addition to structural X-chromosome changes, several genes involved in the process of follicle formation and/or maintenance are implicated in Mendelian inherited primary ovarian insufficiency (POI), with menopause before age 40. Furthermore, variants in a largely distinct cohort of reported genes-notably involved in pathways relevant to atresia, including DNA repair and cell death-have shown smaller but additive effects on the variation in timing of menopause in the normal range, early menopause (age <45), and POI. Epidemiological factors show effect sizes comparable to those of genetic factors, with smoking accounting for about 5% of the risk of early menopause, equivalent to the summed effect of the top 17 genetic variants. The identified genetic and epidemiological factors underline the importance of early detection of reproductive problems to enhance possible interventions.

  17. Women With Early Menopause Have Higher Rates of Target Lesion Revascularization After Percutaneous Coronary Intervention.

    PubMed

    Zhang, Linlin; Wang, Zhijian; Liu, Xiaoli; Zhou, Zhiming; Zhao, Yingxin; Shi, Dongmei; Liu, Yuyang; Liang, Jing; Yang, Lixia; Chai, Meng; Zhou, Yujie

    2016-04-01

    Early menopause has been found to be associated with higher risk of cardiovascular disease. Our objective was to investigate the impact of early menopause on clinical outcomes for women undergoing percutaneous coronary intervention (PCI). We observed female patients with coronary artery disease (CAD) undergoing PCI and found that women with early menopause (≤46 years old) were more likely to have CAD risk factors and more severe coronary lesions. During the 18-month follow-up, early menopause was associated with similar risk of death and myocardial infarction but higher risk of target lesion revascularization (TLR; 7.8% vs 5.3%, P = .003) and major adverse cardiovascular events (MACEs; 11.3% vs 9.0%, P = .007). After adjustment, early menopause was an independent risk factor for 18-month MACEs (hazard ratio [HR], 1.54; 95% confidence interval [CI] 1.18-2.00) and TLR (HR 1.61; 95% CI 1.21-2.13). In conclusion, for women undergoing PCI, early menopause is associated with higher risk of MACE, which is mainly driven by risk of TLR.

  18. Oxidative Stress: An Effective Prognostic Tool for an Early Detection of Cardiovascular Disease in Menopausal Women

    PubMed Central

    Mahajan, Mridula; Mohan, Gurinder

    2016-01-01

    Background. Menopause, a form of reproductive aging, is marked by many hormonal variations which cause imbalance in the oxidative processes resulting in onset of endothelial dysfunction leading to cardiovascular disease (CVD). We aimed to analyze the effect of oxidative stress in an early detection of CVD in all menopausal women both normolipidemic and hyperlipidemic. Methods and Results. Study included 523 menopausal women (265 CVD and 258 non-CVD). They were screened for lipid profile, serum malondialdehyde (MDA), serum LDL carbonyl protein, and serum superoxide dismutase (SOD). Pearson's correlation was observed between MDA and atherogenic index of plasma (AIP) in both normolipidemic (r = 0.650; p < 0.001) and hyperlipidemic (r = 0.207; p < 0.01) CVD group as compared to non-CVD menopausal women. Significant correlation was also observed between LDL carbonyl content and AIP in normolipidemic (r = 0.650; p < 0.001) and hyperlipidemic (r = 0.248; p < 0.01) CVD menopausal women as compared to non-CVD ones. Conclusion. Strong correlation between atherogenic index of plasma and oxidative stress in CVD menopausal women reveals oxidative stress as an effective prognostic tool for an early detection of cardiovascular risk. PMID:27069688

  19. Meta-analysis of loci associated with age at natural menopause in African-American women.

    PubMed

    Chen, Christina T L; Liu, Ching-Ti; Chen, Gary K; Andrews, Jeanette S; Arnold, Alice M; Dreyfus, Jill; Franceschini, Nora; Garcia, Melissa E; Kerr, Kathleen F; Li, Guo; Lohman, Kurt K; Musani, Solomon K; Nalls, Michael A; Raffel, Leslie J; Smith, Jennifer; Ambrosone, Christine B; Bandera, Elisa V; Bernstein, Leslie; Britton, Angela; Brzyski, Robert G; Cappola, Anne; Carlson, Christopher S; Couper, David; Deming, Sandra L; Goodarzi, Mark O; Heiss, Gerardo; John, Esther M; Lu, Xiaoning; Le Marchand, Loic; Marciante, Kristin; Mcknight, Barbara; Millikan, Robert; Nock, Nora L; Olshan, Andrew F; Press, Michael F; Vaiyda, Dhananjay; Woods, Nancy F; Taylor, Herman A; Zhao, Wei; Zheng, Wei; Evans, Michele K; Harris, Tamara B; Henderson, Brian E; Kardia, Sharon L R; Kooperberg, Charles; Liu, Yongmei; Mosley, Thomas H; Psaty, Bruce; Wellons, Melissa; Windham, Beverly G; Zonderman, Alan B; Cupples, L Adrienne; Demerath, Ellen W; Haiman, Christopher; Murabito, Joanne M; Rajkovic, Aleksandar

    2014-06-15

    Age at menopause marks the end of a woman's reproductive life and its timing associates with risks for cancer, cardiovascular and bone disorders. GWAS and candidate gene studies conducted in women of European ancestry have identified 27 loci associated with age at menopause. The relevance of these loci to women of African ancestry has not been previously studied. We therefore sought to uncover additional menopause loci and investigate the relevance of European menopause loci by performing a GWAS meta-analysis in 6510 women with African ancestry derived from 11 studies across the USA. We did not identify any additional loci significantly associated with age at menopause in African Americans. We replicated the associations between six loci and age at menopause (P-value < 0.05): AMHR2, RHBLD2, PRIM1, HK3/UMC1, BRSK1/TMEM150B and MCM8. In addition, associations of 14 loci are directionally consistent with previous reports. We provide evidence that genetic variants influencing reproductive traits identified in European populations are also important in women of African ancestry residing in USA.

  20. National Institutes of Health Symptom Science Model sheds light on patient symptoms.

    PubMed

    Cashion, Ann K; Gill, Jessica; Hawes, Rebecca; Henderson, Wendy A; Saligan, Leorey

    2016-01-01

    Since the establishment of the nursing profession, identifying and alleviating the subjective symptoms experienced by patients has been at the core of nursing practice. In supporting the scientific foundation for clinical practice, nursing science has maintained a consistent commitment to prevent, manage, and eliminate symptoms. Scientists from the intramural research program at the National Institute of Nursing Research (NINR), a component of the National Institutes of Health, developed a National Institutes of Health Symptom Science Model (NIH-SSM) to guide symptom science research programs engaged in the use of emerging "omic" methods such as the genotyping of symptom phenotypes. The NIH-SSM was developed based on the NINR intramural research program's success in designing and implementing methods for examining identified symptoms or symptom clusters. The NIH-SSM identifies the research process of characterizing symptom phenotypes, identifying and testing biomarkers, and ultimately developing clinical interventions in cancer-related fatigue, gastrointestinal disorders, and traumatic brain injuries. The purpose of this article was to demonstrate how scientists can apply the NIH-SSM, leading the broader scientific community in advancing personalized and precise clinical interventions. PMID:27349632

  1. Ovarian Leydig cell tumor in a peri-menopausal woman with severe hyperandrogenism and virilization.

    PubMed

    Nardo, L G; Ray, D W; Laing, I; Williams, C; McVey, R J; Seif, M W

    2005-10-01

    The authors report a case of Leydig cell tumor in a 46-year-old woman who first presented with severe clinical hyperandrogenism and associated complex medical history. Investigations revealed markedly raised serum concentrations of testosterone (28.3 nmol/l) and free androgen index (54.4), whereas sex hormone binding globulin, random cortisol, androstenedione, 17-hydroxyprogesterone and dehydroepiandrosterone sulphate concentrations were all within the normal range. Transabdominal ultrasound and computed tomography scan of the pelvis and abdomen showed a slightly bulky right ovary, but no other abnormalities. An ovarian source of androgens was suspected and surgery was arranged. Following a three-year history of defaulting appointments due to agoraphobia, she underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and intraoperative selective ovarian venous sampling. Histopathological examination revealed a 2 cm Leydig cell tumor within the right ovary. Successful intraoperative ovarian venous sampling demonstrated significantly elevated testosterone levels (>260 nmol/l) from the right ovarian vein. Hyperandrogenaemia normalized post-operatively. The patient showed significant regression of clinical signs and symptoms, including the anxiety disorder. Clinical presentation, biochemistry and imaging modalities should allow to detect androgen-secreting ovarian tumors, while selective venous sampling should be reserved for patients whom uncertainty remains. The present case confirms that androgen-secreting ovarian tumors represent a diagnostic and therapeutic challenge. They have to be considered in the differential diagnosis of severe hyperandrogenism even in peri-menopausal women. Although selective venous sampling is of diagnostic value, however, its impact on future management should be considered on individual basis.

  2. Determination of elements by atomic absorption spectrometry in medicinal plants employed to alleviate common cold symptoms.

    PubMed

    Küçükbay, F Zehra; Kuyumcu, Ebru

    2014-09-01

    Eleven important medicinal plants generally used by the people of Turkey for the treatment of common cold have been studied for their mineral contents. Eleven minor and major elements (essential, non-essential and toxic) were identified in the Asplenium adiantum-nigrum L. , Althaea officinalis L. , Verbascum phlomoides L., Euphorbia chamaesyce L., Zizyphus jujube Miller, Peganum harmala L., Arum dioscoridis Sm., Sambucus nigra L., Piperlongum L., Tussilago farfara L. and Elettaria cardamomum Maton by employing flame atomic absorption and emission spectrometry and electro-thermal atomic absorption spectrometry. Microwave digestion procedure for total concentration was applied under optimized conditions for dissolution of medicinal plants. Plant based biological certified reference materials (CRMs) served as standards for quantification. These elements are found to be present in varying concentrations in the studied plants. The baseline data presented in this work can be used in understanding the role of essential, non-essential and toxic elements in nutritive, preventive and therapeutic properties of medicinal plants. PMID:25532362

  3. The Role of Vitamins and Minerals in the Alleviation of Asthma Symptoms

    ERIC Educational Resources Information Center

    Oberholzer, H. M.; Pretorius, E.

    2010-01-01

    The primary focus in managing asthma is the control of inflammation, as asthma is an inflammatory disease. Because of this chronic airway inflammation, the lungs of asthmatic patients are exposed to oxidative stress due to the generation of reactive oxygen- and nitrogen species (ROS and NOS). Oxidative stress therefore plays an important role in…

  4. Determination of elements by atomic absorption spectrometry in medicinal plants employed to alleviate common cold symptoms.

    PubMed

    Küçükbay, F Zehra; Kuyumcu, Ebru

    2014-09-01

    Eleven important medicinal plants generally used by the people of Turkey for the treatment of common cold have been studied for their mineral contents. Eleven minor and major elements (essential, non-essential and toxic) were identified in the Asplenium adiantum-nigrum L. , Althaea officinalis L. , Verbascum phlomoides L., Euphorbia chamaesyce L., Zizyphus jujube Miller, Peganum harmala L., Arum dioscoridis Sm., Sambucus nigra L., Piperlongum L., Tussilago farfara L. and Elettaria cardamomum Maton by employing flame atomic absorption and emission spectrometry and electro-thermal atomic absorption spectrometry. Microwave digestion procedure for total concentration was applied under optimized conditions for dissolution of medicinal plants. Plant based biological certified reference materials (CRMs) served as standards for quantification. These elements are found to be present in varying concentrations in the studied plants. The baseline data presented in this work can be used in understanding the role of essential, non-essential and toxic elements in nutritive, preventive and therapeutic properties of medicinal plants.

  5. Baculovirus-mediated interferon alleviates dimethylnitrosamine-induced liver cirrhosis symptoms in a murine model.

    PubMed

    Nishibe, Y; Kaneko, H; Suzuki, H; Abe, T; Matsuura, Y; Takaku, H

    2008-07-01

    The wild-type baculovirus Autographa californica multiple nuclear polyhedrosis virus (AcMNPV) infects a range of mammalian cell types in vitro but does not replicate in these cells. The current study investigated the in vivo effect of AcMNPV in the mouse model of liver cirrhosis induced by the mutagen dimethylnitrosamine. Intraperitoneal injection of AcMNPV induced an immune response. The baculovirus was taken up by the liver and spleen where it suppressed liver injury and fibrosis through the induction of interferons. This study presents the first evidence of the feasibility of using baculovirus to treat liver cirrhosis. PMID:18369328

  6. In vitro and in vivo effects of ethanol extract combined with Curcumae Radix and Glycyrrhizae Radix et Rhizoma on menopausal metabolic disturbances

    PubMed Central

    Park, InSil; Ryuk, JinAh; Lee, HyeWon; Go, Hiroe; Ko, ByoungSeob

    2015-01-01

    Curcumae Radix (CR) and Glycyrrhizae Radix et Rhizoma (GR) extracts have been used as health supplements in traditional medicine. This study was performed to evaluate the effects of combined CR and GR extracts (CR+GR) on metabolic complications related menopausal symptoms. We found a significant results that CR+GR extracted using ethanol stimulated the growth of MCF-7 cells in estrogen activity and was attenuated in lipid deposition of HepG2 cells treated with MβCD compared to CR and GR treatments each. To investigate the situation, an experimental menopause rat model with dyslipidemia was induced by surgical bilateral ovariectomy (OVX) and high fat high cholesterol (HFHC) diet in female rats. OVX rats fed HFHC (OVX-HFHC) showed a shift in weight gain, elevated serum cholesterol, altered liver enzymatic parameters and enhanced liver injury compared to the NC and HFHC groups. However, administration of CR+GR, in particular 200 or 450 mg/kg/day, inhibited the increase in body weight gain and lipid metabolic disturbances, lowering total cholesterol (TC), triglycerides (TG) and low density lipoprotein cholesterol (LDL-C) compared to the OVX-HFHC group. Furthermore, CR+GR (200 or 450 mg/kg/day) ameliorated the serum levels of the liver enzymes aspartate aminotransferase (AST) and alanine transaminase (ALT) compared to the OVX-HFHC group. Moreover, CR+GR (200 or 450 mg/kg/day) attenuated not only hepatic steatosis but also larger adipocytes. Our study demonstrated that combined treatment with CR and GR attenuated metabolic complications induced by OVX and HFHC diet, suggesting that this effect may regulate and prevent the acceleration of cardiovascular disease (CVD) after menopause. PMID:26628991

  7. Lactobacillus plantarum CCFM639 alleviates aluminium toxicity.

    PubMed

    Yu, Leilei; Zhai, Qixiao; Liu, Xiaoming; Wang, Gang; Zhang, Qiuxiang; Zhao, Jianxin; Narbad, Arjan; Zhang, Hao; Tian, Fengwei; Chen, Wei

    2016-02-01

    Aluminium (Al) is the most abundant metal in the earth's crust. Al exposure can cause a variety of adverse physiological effects in humans and animals. Our aim was to demonstrate that specific probiotic bacteria can play a special physiologically functional role in protection against Al toxicity in mice. Thirty strains of lactic acid bacteria (LAB) were tested for their aluminium-binding ability, aluminium tolerance, their antioxidative capacity, and their ability to survive the exposure to artificial gastrointestinal (GI) juices. Lactobacillus plantarum CCFM639 was selected for animal experiments because of its excellent performance in vitro. Forty mice were divided into four groups: control, Al only, Al plus CCFM639, and Al plus deferiprone (DFP). CCFM639 was administered at 10(9) CFU once daily for 10 days, followed by a single oral dose of aluminium chloride hexahydrate at 5.14 mg aluminium (LD50) for each mouse. The results showed that CCFM639 treatment led to a significant reduction in the mortality rates with corresponding decrease in intestinal aluminium absorption and in accumulation of aluminium in the tissues and amelioration of hepatic histopathological damage. This probiotic treatment also resulted in alleviation of hepatic, renal, and cerebral oxidative stress. The treatment of L. plantarum CCFM639 has potential as a therapeutic dietary strategy against acute aluminium toxicity.

  8. Wakeful rest alleviates interference-based forgetting.

    PubMed

    Mercer, Tom

    2015-01-01

    Retroactive interference (RI)--the disruptive influence of events occurring after the formation of a new memory--is one of the primary causes of forgetting. Placing individuals within an environment that postpones interference should, therefore, greatly reduce the likelihood of information being lost from memory. For example, a short period of wakeful rest should diminish interference-based forgetting. To test this hypothesis, participants took part in a foreign language learning activity and were shown English translations of 20 Icelandic words for immediate recall. Half of the participants were then given an 8-min rest before completing a similar or dissimilar interfering distractor task. The other half did not receive a rest until after the distractor task, at which point interference had already taken place. All participants were then asked to translate the Icelandic words for a second time. Results revealed that retention was significantly worse at the second recall test, but being allowed a brief rest before completing the distractor task helped reduce the amount of forgetting. Taking a short, passive break can shield new memories from RI and alleviate forgetting. PMID:24410154

  9. An Advanced Buffet Load Alleviation System

    NASA Technical Reports Server (NTRS)

    Burnham, Jay K.; Pitt, Dale M.; White, Edward V.; Henderson, Douglas A.; Moses, Robert W.

    2001-01-01

    This paper describes the development of an advanced buffet load alleviation (BLA) system that utilizes distributed piezoelectric actuators in conjunction with an active rudder to reduce the structural dynamic response of the F/A-18 aircraft vertical tails to buffet loads. The BLA system was defined analytically with a detailed finite-element-model of the tail structure and piezoelectric actuators. Oscillatory aerodynamics were included along with a buffet forcing function to complete the aeroservoelastic model of the tail with rudder control surface. Two single-input-single-output (SISO) controllers were designed, one for the active rudder and one for the active piezoelectric actuators. The results from the analytical open and closed loop simulations were used to predict the system performance. The objective of this BLA system is to extend the life of vertical tail structures and decrease their life-cycle costs. This system can be applied to other aircraft designs to address suppression of structural vibrations on military and commercial aircraft.

  10. The toxic impact of local anaesthetics in menopausal women: causes, prevention and treatment after local anaesthetic overdose. Local anaesthetic systemic toxicity syndrome

    PubMed Central

    Sobolewski, Bogusław; Doman, Paweł; Oszukowski, Przemysław; Woźniak, Piotr

    2015-01-01

    Gynaecologists often use local anaesthetics in their medical practice. Some concomitant diseases during the menopausal period may cause problems during the qualification of postmenopausal women for general anaesthesia in gynaecological surgery. Many authors suggest the application of local analgesia for particular kinds of gynaecological surgery procedures performed on postmenopausal women, taking into consideration health determinants. While applying local anaesthetics, the possibility of their overdose has to be taken into account. Generalised toxic symptoms which appeared after the local anaesthesia are rare, but potentially are lethal complications. Toxic symptoms after local anaesthetic administration are manifested after accidental administration of a medicine into a blood vessel, when extravascular administration of a large volume of a local anaesthetic is absorbed into a bloodstream or with the reproducible doses of local anaesthetics which are administered when metabolism does not work sufficiently and cannot eliminate these substances. Clinical overdose of local anaesthetics is manifested by disorders in two systems. Firstly, the pathological symptoms come from the central nervous system (CNS). In the second phase, the pathological symptoms will additionally appear in the cardiovascular system. The aim of the present thesis is to remind clinical manifestations of the local anaesthetic overdose and suggest the management of patients with the aforementioned symptoms, especially in the case of intravenous lipid emulsions which have the status of an antidote in life-threatening conditions caused by cardiotoxic effects of local anaesthetics. PMID:26327891

  11. Can house dust mite-triggered atopic dermatitis be alleviated using acaricides?

    PubMed

    Cameron, M M

    1997-07-01

    House dust mite (HDM) allergens are the most important triggers for atopic dermatitis. Reducing exposure to these allergens may alleviate clinical symptoms. Chemicals with acaricidal activity have been used to treat upholstered furniture, carpets and bedding with the aim to reduce HDM allergen exposure. These chemicals, by reducing HDM, can decrease the concentration of mite allergens in dust but improvements in clinical symptoms are not always apparent. Clinical improvement is more likely to occur if bedding has been treated rather than carpets