Climacteric Symptoms In Postmenopausal Women Research Articles

The relation of insomnia and obstructive sleep apnea on sexual function and climacteric symptoms in postmenopausal women

ObjectiveThe aim of this study was to investigate the effects of insomnia combined with obstructive sleep apnea (OSA) on sexual function and climacteric symptoms in postmenopausal women. MethodsOur sample comprised 47 postmenopausal women distributed into 3 groups: 1) insomnia group, 2) OSA group, and 3) OSA + insomnia group. All participants completed the following questionnaires: the Insomnia Severity Index, the Female Sexual Function Index, and the Blatt-Kupperman menopausal index. Of the 47 participants, 34 women undergone polysomnography. The 3 groups were compared in respect of climacteric symptoms, sexual function score, and sleep. ResultsOur results showed that 85.1% of the postmenopausal women were classified with insomnia, 46.8% were diagnosed with OSA, and 82.9% had low sexual function. All groups had sleep efficiency of < 80%, wake after sleep onset of > 65 min, and a total sleep time of < 6 h, indicating poor sleep quality. There were no statistically significant differences among the groups in all sexual domains (desire, arousal, lubrication, orgasm, satisfaction, and pain). According to climacteric symptoms, the group of OSA + insomnia reported more climacteric symptoms when compared to OSA group. ConclusionsIn our sample, the presence of insomnia and OSA associated with postmenopause revealed a low score for sexual function. Climacteric symptoms were higher in the groups with insomnia, and the association with low sexual function can lead to worsening of clinical condition. This study emphasizes the importance to identify the sleep disorders that postmenopausal women may present and to consider the possible effects they may have in sexual dysfunction.

Does Obesity Aggravate Climacteric Symptoms in Postmenopausal Women?

To determine if there is a correlation between body mass index (BMI) and climacteric symptoms in postmenopausal women. The study sample was composed of 109 postmenopausal women with a mean age of 57 ± 8 years, mean body mass index (BMI) of 30 ± 6 kg/m2, and 8 ± 8 years after menopause. For the assessment of the climacteric symptoms, the Blatt-Kupperman Index (BKI), the Menopause Rating Scale (MRS), and the Cervantes Scale (CS) were used. Data analysis was performed through the Chi-squared test, analysis of variance (ANOVA) with the Bonferroni post hoc test, and multiple linear regression. The level of significance adopted was of p < 0.05. The statistical analyses were performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 26.0. The multiple linear regression showed a positive association (p < 0.01) between BMI values and menopause symptoms when adjusted for age and time after menopause in the 3 questionnaires used (BKI: B = 0.432; CS: B = 304; and MRS: B = 302). Regarding symptom scores, the obese women had higher mean scores (p < 0.05) when compared to eutrophic women (BKI = 28 ± 10 and 20 ± 10; and MRS = 20 ± 10 and 13 ± 7, respectively). In the Chi-squared analysis, 28% of obese women had severe symptoms and 46% had moderate symptoms, while only 1% and 46% of eutrophic women had these same symptoms. There is an association between BMI and climacteric symptoms, and overweight or obese women have more intense and moderate symptoms than eutrophic women.

Effects of an equol-containing supplement on advanced glycation end products, visceral fat and climacteric symptoms in postmenopausal women: A randomized controlled trial.

Equol, an isoflavone derivative whose chemical structure is similar to estrogen, is considered a potentially effective agent for relieving climacteric symptoms, for the prevention of lifestyle-related diseases, and for aging care in postmenopausal women. We investigated the effect of an equol-containing supplement on metabolism and aging and climacteric symptoms with respect to internally produced equol in postmenopausal women. A single-center, randomized controlled trial (registration number: UMIN000030975) on 57 postmenopausal Japanese women (mean age: 56±5.37 years) was conducted. Twenty-seven women received the equol supplement, while the remaining received control. Metabolic and aging-related biomarkers were compared before and after the 3-month intervention. Climacteric symptoms were assessed every month using a validated self-administered questionnaire in Japanese postmenopausal women. Three months post-intervention, the treatment group showed significant improvement in climacteric symptoms compared to the control group (81% vs. 53%, respectively, p = 0.045). We did not observe any beneficial effect on metabolic and aging-related biomarkers in the intervention group. However, in certain populations, significant improvement in skin autofluorescence, which is a measurement of AGE skin products, and visceral fat area was observed, especially among equol producers. Women receiving equol supplementation showed improved climacteric symptoms. This study offered a new hypothesis that there may be a synergy between supplemented equol and endogenously produced equol to improve skin aging and visceral fat in certain populations.

Quality of Life and Climacteric Symptoms in Postmenopausal Women Receiving Hormone Therapy for Breast Cancer.

To assess quality of life and climacteric symptoms for post-menopausal women receiving hormone therapy for breast cancer. A prospective observational study of women treated at the Mastology Outpatient Clinic of the Department of Obstetrics and Gynecology was conducted between 2015 and 2019. Post-menopausal patients who had been diagnosed with breast cancer and who were experiencing climacteric symptoms were selected. These patients had undergone surgery, radiotherapy, and/or chemotherapy more than one year prior and were receiving tamoxifen or an aromatase inhibitor. A total of 57 women were recruited and during visits completed a sociodemographic questionnaire, the Blatt-Kupperman Menopausal Index (KI), and the World Health Organization Quality of Life version-bref (WHOQOL-bref) scale. Repeated measures ANOVA, and Friedman and Pearson tests were conducted. Patients had a mean age of 54.4 ± 5.9 years, 86% had ductal carcinoma, 98% had undergone surgery, 70% had received chemotherapy, and 96% had received radiotherapy. Scores on the KI (P < 0.001) and WHOQOL-bref scale (P < 0.046) had improved by the 6-month follow-up. Correlation of the KI and WHOQOL-bref scales showed that less intense climacteric symptoms were associated with higher scores on quality of life domains, and these results were statistically significant (P < 0.001). The correlation of the scales showed that reduction in climacteric symptoms is associated with significant improvements in quality of life measures.

Occurrence of climacteric symptoms in postmenopausal women after prophylactic bilateral ovariectomy

To analyse the quality of life in postmenopausal women after prophylactic bilateral ovariectomy depending on the time from menopause. The study involved 252 postmenopausal women grouped according to the time from last menstruation: one to five years (group A), five to ten years (group B), and > ten years (group C). All women were ovariectomized during laparotomy performed for benign diseases of the uterus. Climacteric symptoms were measured with the Kupperman Index one day before and three months after surgery. Highly significant age differences and no substantial BMI differences were demonstrated among the study groups. Before and after surgery climacteric symptoms were reported by 17.06% and 57.8% of women, respectively. After surgery, group A women significantly more often had hot flushes, sweating, nervousness, and sleep disorders, the women in group B significantly more often reported sleep disorders, nervousness, and sweating, and the women in group C significantly more often complained of nervousness. In postmenopausal women, ovaries play the most important role during the first ten years from the last menstruation.

Association between pelvic organ prolapse and climacteric symptoms in postmenopausal women

ObjectiveTo evaluate whether climacteric symptoms are related to pelvic organ prolapse (POP) in postmenopausal women. Study designA cross-sectional investigation was performed on 1382 postmenopausal women attending an outpatient service for menopause at a university hospital. Main outcome measuresData regarding climacteric symptoms, as captured by the Greene Climacteric Scale, and objective POP were retrieved from an electronic database. Additional data retrieved were age, anthropometric measures, personal and reproductive history, use of medication or drugs, coffee, smoking, state of anxiety (STAI scale score) and depression (Zung scale score). ResultsThe score of Greene Climacteric Scale was higher (p=0.02) in women with (n=538) than in those without (n=844) POP (29.6±13.6 vs. 27.8±13.; p=0.02). In multiple logistic regression models, the score was independently related to POP as a whole (OR 1.012; 95%CI 1.003,1.022; p=0.009), and to bladder prolapse (OR 1.011; 95%CI 1.007,1.07; p=0.02) or to uterus prolapse (OR 1.003; 95%CI 0.99,1.016; p=0.63) or rectum prolapse (rectocele) (OR 1.004; 95%CI 0.988,1.02; p=0.62). ConclusionsIn postmenopausal women, a higher burden of climacteric symptoms, is associated with POP. Underlying mechanisms were not assessed and deserve further investigation.

Association between urinary incontinence and climacteric symptoms in postmenopausal women.

The aim of the study was to evaluate whether climacteric symptoms are related to urinary incontinence (UI) in postmenopausal women. A cross-sectional investigation was performed on 1,502 postmenopausal women attending the outpatient service for menopause at a University Hospital. Data regarding climacteric symptoms, evaluated by the Greene Climacteric Scale, objective pelvic floor defects, and UI of any type, were retrieved from an electronic database. Additional information retrieved were age, anthropometric measures, personal and reproductive history, use of medication or drugs, smoking, state of anxiety (State-Trait Anxiety Inventory scale score), and depression (Zung's scale score). The score of the Greene Climacteric Scale was higher (P = 0.0001) in women with (n = 534) than without (n = 902) UI (32.3 ± 13.1 vs 26.5 ± 12.5; P < 0.0011). The same was true when considering stress (n = 370) (31.4 ± 13.4; P = 0.0007), urge (n = 84) (34.5 ± 13.5; P = 0.005), or mixed (n = 89) (34.3 ± 11.4; P = 0.006) UI. In multiple logistic regression models, the Greene climacteric score was independently related to UI (odds ratio [OR] 1.05; 95% CI, 1.03-1.07), along with the presence of a bladder prolapse (OR 3.72; 95% CI, 2.59-5.34), age at menopause (OR 1.05; 95% CI, 1.01-1.09), and previous hysterectomy (OR 1.80; 95% CI, 1.08-3.01). Women in the fourth quartile of the Greene Climacteric Scale score had an OR of UI of 2.09 (95% CI, 1.5-2.9). In postmenopausal women, higher symptom burden, as captured by the Greene Climacteric Scale, relates to UI. Underlying mechanisms were not assessed, and deserve further investigation.

Anxiogenic CO2 stimulus elicits exacerbated hot flash-like responses in a rat menopause model and hot flashes in postmenopausal women.

As longitudinal studies determined that anxiety is a strong risk factor for hot flashes, we hypothesized that an anxiogenic stimulus that signals air hunger (hypercapnic, normoxic gas) would trigger an exacerbated hot flash-associated increase in tail skin temperature (TST) in a rat ovariectomy (OVEX) model of surgical menopause and hot flashes in symptomatic postmenopausal women. We also assessed TST responses in OVEX serotonin transporter (SERT) rats that models a common polymorphism that is associated with increased climacteric symptoms in postmenopausal women and increases in anxiety traits. OVEX and sham-OVEX rats (initial experiment) and wildtype and SERT OVEX rats (subsequent experiment) were exposed to a 5-minute infusion of 20% carbon dioxide (CO2) normoxic gas while measuring TST. Postmenopausal women were given brief 20% and 35% CO2 challenges, and hot flashes were self-reported and objectively verified. Compared to controls, OVEX rats had exacerbated increases in TST, and SERT OVEX rats had prolonged TST increases following CO2. Most women reported mild/moderate hot flashes after CO2 challenges, and the hot flash severity to CO2 was positively correlated with daily hot flash frequency. The studies demonstrate that this anxiogenic stimulus is capable of inducing cutaneous vasomotor responses in OVEX rats, and eliciting hot flashes in postmenopausal women. In rats, the severity of the response was mediated by loss of ovarian function and increased anxiety traits (SERT), and, in women, by daily hot flash frequency. These findings may provide insights into anxiety-related triggers and genetic risk factors for hot flashes in thermoneutral environments.

Additive effects of low concentrations of estradiol-17β and progesterone on nitric oxide production by human vascular endothelial cells through shared signaling pathways

Potential cardiovascular benefits of low-dose formulations of estrogens and progesterone (P4) for treating climacteric symptoms in postmenopausal women remain unclear because information is lacking on their combined vascular effects. Protective effects of low concentrations (5nM) of P4 and estradiol-17β (E2), alone and in combination (P4+E2), were investigated in a nongenomic model of vascular protection which measured acute increases in nitric oxide (NO) production by cultured human umbilical vein endothelial cells (HUVECs). Treatment with 5nM P4+E2 for twenty minutes significantly increased NO production and endothelial NO synthase (eNOS) phosphorylation, whereas 5nM treatments with either steroid alone were ineffective. The 5nM P4+E2 treatment also increased phosphorylation of ERK and Akt, mimicking the effects of higher concentrations of P4 and E2 alone. Pre-treatment with inhibitors of PI3K (wortmannin), Akt (ML-9), and MAP kinase (AZD6244 and U0126) completely blocked the NO response to 5nM P4+E2. Combined 5nM treatments with specific estrogen and progesterone receptor agonists showed an involvement of membrane progesterone receptor alpha (mPRα, also known as PAQR7), G protein-coupled estrogen receptor 1 (GPER), and estrogen receptor alpha (ERα), but not ERβ, in P4+E2 stimulation of NO production. P4+E2 also exerted genomic actions, increasing mPRα, GPER, cyclooxygenase-1, and prostacyclin-synthase mRNA levels. Taken together, the results show that a low concentration of P4+E2 rapidly increases NO production in HUVECs through mPRα, ERα, and GPER and involves common signaling pathways, PI3K/Akt and MAP kinase. These in vitro findings suggest that low doses of E2 and P4 may also have some beneficial cardiovascular effects in vivo when administered as hormone replacement therapy (HRT) for post-menopausal women.

Tibolone protects astrocytic cells from glucose deprivation through a mechanism involving estrogen receptor beta and the upregulation of neuroglobin expression

Tibolone, a synthetic steroid used for the prevention of osteoporosis and the treatment of climacteric symptoms in post-menopausal women, may exert tissue selective estrogenic actions acting on estrogen receptors (ERs). We previously showed that tibolone protects human T98G astroglial cells against glucose deprivation (GD). In this study we have explored whether the protective effect of tibolone on these cells is mediated by ERs. Experimental studies showed that both ERα and ERβ were involved in the protection by tibolone on GD cells, being ERβ preferentially involved on these actions over ERα. Tibolone increased viability of GD cells by a mechanism fully blocked by an ERβ antagonist and partially blocked by an ERα antagonist. Furthermore, ERβ inhibition prevented the effect of tibolone on nuclear fragmentation, ROS and mitochondrial membrane potential in GD cells. The protective effect of tibolone was mediated by neuroglobin. Tibolone upregulated neuroglobin in T98G cells and primary mouse astrocytes by a mechanism involving ERβ and neuroglobin silencing prevented the protective action of tibolone on GD cells. In summary, tibolone protects T98G cells by a mechanism involving ERβ and the upregulation of neuroglobin.

Intensity of climacteric symptoms in postmenopausal women

Intensity of climacteric symptoms in postmenopausal women

Relationship Between Body Mass Index And Physical Activity With Climacteric Symptoms In Postmenopausal Women

Relationship Between Body Mass Index And Physical Activity With Climacteric Symptoms In Postmenopausal Women

The assessment of the relationship between personality, the presence of the 5HTT and MAO-A polymorphisms, and the severity of climacteric and depressive symptoms in postmenopausal women.

The purpose of this study is to determine the relationship between personality, the serotonin transporter (5HTT) and monoamine oxidase A (MAO-A) polymorphisms and the severity of climacteric and depressive symptoms in postmenopausal women. The study involved 272 healthy postmenopausal women from Poland. This survey-based study was performed using the following: the Beck Depression Inventory for depressive symptoms, the Blatt–Kupperman Menopausal Index and the Neuroticism-Extroversion-Openness-Five Factor Inventory for personality. A polymerase chain reaction was employed to identify the DNA polymorphisms. The women were aged 55.4 ± 5.5 years on average. Significant correlations were proved between the allele frequency of the 30-bp variable-number tandem repeat (VNTR) polymorphism in the MAO-A promoter region and the incidence of depressive symptoms in the women analysed (p ≤ 0.05), as well as between the severity of climacteric symptoms in the postmenopausal women and the allele frequency of the polymorphism in the 5HTT gene (the 5HTT ‘s’ variant) (p ≤ 0.05). There was a significant correlation between the severity of climacteric and depressive symptoms (p < 0.001). (1) The severity of climacteric and depressive symptoms depends on personality traits. (2) Personality traits are biologically determined, and the level of their expression is associated with the 5HTT polymorphism. (3) Identification of homogeneous groups of women having predispositions to depressive and severe climacteric symptoms may help to implement early prevention programmes for this group of recipients.

Nanostructured transdermal hormone replacement therapy for relieving menopausal symptoms: a confocal Raman spectroscopy study

OBJECTIVE:To determine the safety and efficacy of a transdermal nanostructured formulation of progesterone (10%) combined with estriol (0.1%) + estradiol (0.25%) for relieving postmenopausal symptoms.METHODS:A total of 66 postmenopausal Brazilian women with climacteric symptoms of natural menopause received transdermal nanostructured formulations of progesterone and estrogens in the forearm daily for 60 months to mimic the normal ovarian secretory pattern. Confocal Raman spectroscopy of hormones in skin layers was performed. Clinical parameters, serum concentrations of estradiol and follicle-stimulating hormone, blood pressure, BI-RADS classification from bilateral mammography, and symptomatic relief were compared between baseline and 60 months post-treatment. Clinicaltrials.gov: NCT02033512.RESULTS:An improvement in climacteric symptoms was reported in 92.5% of women evaluated before and after 60 months of treatment. The serum concentrations of estradiol and follicle-stimulating hormone changed significantly (p<0.05) after treatment; the values of serum follicle-stimulating hormone decreased after 60 months from 82.04±4.9 to 57.12±4.1 IU/mL. A bilateral mammography assessment of the breasts revealed normal results in all women. No adverse health-related events were attributed to this hormone replacement therapy protocol.CONCLUSION:The nanostructured formulation is safe and effective in re-establishing optimal serum levels of estradiol and follicle-stimulating hormone and relieving the symptoms of menopause. This transdermal hormone replacement therapy may alleviate climacteric symptoms in postmenopausal women.

The 5HTT and MAO-A polymorphisms associate with depressive mood and climacteric symptoms in postmenopausal women

The aim of this study was to assess the influence of the 44-bp polymorphism in the 5HTTLPR (SLC 6A4) (serotonin-transporter-linked polymorphic region, solute carrier family 6 member 4) promoter region and the 30-bpVNTR (variable number of tandem repeats) polymorphism in the MAO-A (monoamine oxidase A) promoter region on the prevalence of depressive mood and the severity of climacteric symptoms in postmenopausal women. The study involved 630 women from northern Poland who had their last menstrual period at least one year before the study. The women did not abuse alcohol or cigarettes, had not been diagnosed as having endocrinological, cancerous or mental diseases, and had not received psychiatric treatment by the time. This survey-based study was performed using the following research instruments: the Beck Depression Inventory (BDI), to evaluate depressive symptoms, and the Blatt-Kupperman Menopausal Index, to measure the severity of climacteric symptoms. The average age of the women was 57.5 ± 6.4 years. Depressive symptoms of different severity according to the BDI were diagnosed in 29.2% of the women (minor-18.6%, moderate-7.1%, severe-3.5%) and according to the Blatt-Kupperman Menopausal Index were diagnosed in 42% of the women (minor-24.1%, moderate-9.2%, severe-8.7%). Allele 'l' was significantly more common in the women without climacteric symptoms than those with minor, moderate or severe climacteric complaints (p ≤ 0.05). There was a significant correlation between the severity of climacteric and depressive symptoms (p ≤ 0.05). The women who had severe climacteric symptoms also had more severe depressive symptoms. 1. The 5HTTLPR gene polymorphism contributes to climacteric symptoms in postmenopausal women. 2. The Blatt-Kupperman Menopausal Index is an instrument which can not only be used for the measurement of the severity of climacteric symptoms but also the early detection of perimenopausal women at the risk of developing depressive symptoms.

Effects of long-term tibolone treatment on nuclear sex steroid hormone receptors and G-protein–coupled estrogen receptor-1 expression in the macaque uterus

Tibolone is an alternative hormone treatment for managing climacteric symptoms in postmenopausal women. The aim of this study was to determine the effects of long-term tibolone (TIB) treatment in comparison with conventional hormone therapy on the expression and distribution of estrogen receptor (ER) α, ER-β, G-protein-coupled ER-1 (GPER), progesterone receptor (PR) A, PRB, androgen receptor (AR), and syndecan-1 in the macaque uterus. Eighty-eight cynomolgus macaques (Macaca fascicularis) were ovariectomized and treated orally with TIB, a combination of conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA), CEE alone, or vehicle for 2 years. Immunohistochemistry was used to evaluate the protein expression and distribution of the receptors in the monkey uterus. In the TIB group, immunostaining of ER-α and GPER was higher in the luminal and glandular epithelium, respectively, as compared with the CEE + MPA group. PRA and PRB protein expression was increased in the stroma and myometrium of the TIB group as compared with the controls. AR immunoreactivity was also up-regulated by TIB treatment in the stroma as compared with no treatment. Furthermore, epithelial immunoreactivity of AR was higher after TIB treatment as compared with CEE + MPA treatment. TIB treatment influences the protein expression of sex hormone receptors in monkey endometrium differently from that observed after conventional hormone therapy. We suggest that the observed differences in AR expression by TIB as compared with combined treatment may be of importance for endometrial atrophy as well as for the beneficial bleeding profile associated with this treatment.

Effect of desvenlafaxine on mood and climacteric symptoms in menopausal women with moderate to severe vasomotor symptoms

ABSTRACTObjective To assess effects of desvenlafaxine (administered as desvenlafaxine succinate) on secondary outcomes of mood, climacteric symptoms, and treatment satisfaction in postmenopausal women with moderate to severe menopausal vasomotor symptoms (VMS).Methods A 12-week, multicenter, double-blind, placebo-controlled trial was conducted in postmenopausal women with ≥ 50 moderate to severe hot flushes per week. Participants were randomly assigned to desvenlafaxine 100 mg/day, desvenlafaxine 150 mg/day, or placebo. Secondary outcome efficacy variables included Profile of Mood States (POMS), Greene Climacteric Scale (GCS), and Menopausal Symptoms Treatment Satisfaction Questionnaire (MS-TSQ) scores. Change from baseline in POMS total mood disturbance (TMD) score and subdomain scores were evaluated using analysis of covariance, adjusting for treatment and study site as factors and baseline score. GCS total and subdomain scores were analyzed similarly. Treatment satisfaction was analyzed using the row mean score test.Results A total of 458 women were enrolled. At week 12, desvenlafaxine 100 mg/day significantly improved POMS TMD scores (p <0.001) and four of six POMS subdomains compared with placebo (all p ≤ 0.005). Women taking desvenlafaxine 100 mg/day experienced significantly greater improvement in GCS total scores (p <0.001) and five of six subdomains (all p ≤ 0.029) compared with placebo. Treatment with desvenlafaxine 100 mg/day resulted in significantly greater treatment satisfaction overall and in six of seven additional MS-TSQ items (all p ≤0.042). Desvenlafaxine 150-mg/day results were similar.Conclusions Desvenlafaxine treatment improved mood and climacteric symptoms in postmenopausal women with moderate to severe VMS compared with placebo, and more women were satisfied with desvenlafaxine treatment than with placebo.

Nutritional Status, Quality of Diet and Quality of Life in Postmenopausal Women with Mild Climacteric Symptoms Based on Food Group Intake Patterns

This study was conducted to examine the nutritional status, quality of diet and quality of life in postmenopausal women with mild climacteric symptoms based on their food group intake patterns. The data for nutritional status were obtained using 3-day records. Quality of diet was assessed by INQ, NAR, MAR, DDS, DVS, DQI-I. Climacteric symptoms were analyzed by the questionnaire of Kupperman's index and MENoL. The subjects were classified into the five groups, GMVDF, GMVdF, GMVDf, GMVdf, GmVDF according to their food group intake patterns. Analysis of nutrient intakes showed that the GMVDF group took significantly higher levels of kcal, carbohydrate, protein, fat, vitamin A, thiamin, riboflavin, folate, vitamin C, vitamin E, calcium, phosphorous, sodium, iron, zinc and fiber than GMVdf group did (p < 0.05). INQ of Ca and Fe appeared to be higher in GMVDF than in GMVdf groups (p < 0.05). Analysis of NARs showed that missing milk groups took lower riboflavin, Ca and P than other groups did as the same result with MAR (p < 0.05). Analysis of DDS and DQI showed that GMVdf group had the lowest quality of diet (p < 0.05); however, no difference was found on DVS. The GMVdf group showed the worst climacteric symptoms compared with those of the other groups (p < 0.05). However, we couldn't observe any differences in menopause-specific quality of life among the groups. In conclusion, it would be beneficial to meet all five food groups to increase the quality of diet and to reduce the climacteric symptoms in postmenopausal women. (Korean J Community Nutr 17(1) : 69~80, 2012)

Effect of therapeutic massage on insomnia and climacteric symptoms in postmenopausal women

ABSTRACTIntroduction Physiological and psychological alterations in the climacteric period frequently influence women's quality of life. Hot flushes, nocturia, mood alterations, respiratory disturbances, insomnia and restless leg syndrome all affect sleep, and the altered hormonal state in this period impacts the aging process. As hormonal therapy is not indicated in some cases, the search for complementary therapies, such as massage therapy, to improve insomnia in the climacteric period is increasing.Objective To evaluate the effect of therapeutic massage on insomnia and climacteric symptoms in postmenopausal women.Methods Forty-four volunteers were randomly distributed into three groups: therapeutic massage (TM), passive movement (PM) and control (CTL). The women received 32 therapeutic massage sessions and passive movement twice a week. Questionnaires were given in the pre-trial and the 16th and 32nd sessions. The Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Menopause Quality of Life questionnaire (MENQOL), Kupperman Menopausal Index and Lipp Symptoms of Stress Inventory were assessed. In addition, the women underwent polysomnography at baseline and post-treatment. Statistical analyses were calculated using Friedman and Wilcoxon non-parametric tests. The level of significance was fixed at p ≤ 0.05.Results There was an improvement in ISI in the TM group (p = 0.000) and in the PM group (p = 0.001). A decrease in the BDI occurred in the TM group (p = 0.004), and the MENQOL improved in the TM group (p = 0.015). Furthermore, there were no significant differences in polysomnography parameters in the TM group, with only an increase in minimal saturation (p = 0.053).Conclusion The TM group exhibited improved subjective data considering the changes in symptoms according to the ISI and the MENQOL and a decrease in symptoms according to the BDI.

Comparing the effects of intrauterine progestin system and oral progestin on health‐related quality of life and Kupperman index in hormone replacement therapy

The aim of this study was to compare the effects of intrauterine-system-releasing 20 µg daily of levonorgestrel (LNG IUS) plus 1 mg 17 beta-estradiol daily, orally with combined oral pill containing 1 mg 17 beta-estradiol/2 mg drospirenone daily as hormone replacement therapy, on health-related quality of life (HRQoL) and climacteric symptoms in postmenopausal women. A 6-month prospective clinical trial was conducted at the Department of Obstetrics and Gynecology, Dr Lutfi Kirdar Kartal Education and Research Hospital, Istanbul, Turkey. Ninety postmenopausal women were accepted to be part of the study. The Euro Quality of Life-5 Dimensions (EQ-5D) and Euro Quality of Life Visual Analogue Scale (EQ VAS) indexes for HRQoL and Kupperman indexes were compared between two groups of patients. Kupperman indexes of both treatment groups decreased gradually over 6 months, but indexes decreased significantly more in the group with intrauterine-system-releasing 20 µg daily of levonorgestrel. Elevations were observed in EQ-5D indexes and VAS values of both groups. EQ VAS values significantly increased in the group on intrauterine progestogen system. Similar changes were observed in the EQ-5D indexes of both groups. A hormone replacement therapy regimen that includes an intrauterine progestin system decreased climacteric symptoms and increased HRQoL in postmenopausal women during a follow-up period of 6 months. The extent of the relief of symptoms was greater in this group than in women receiving oral combined hormone replacement therapy. It seems therefore that the intrauterine progestin system could represent a method of choice for endometrial suppression in women using estrogen replacement therapy with distinct advantages over systemically administered progestogens, which have been the subject of considerable debate as reported in the recent literature.