Kupperman Index Research Articles

Efficacy, safety and mechanism of Honghua Xiaoyao Pill in the treatment of peri-menopausal syndrome: A study protocol for a randomized controlled trial.

Background: Peri-menopausal syndrome (PMPS) has a high incidence rate and seriously affects the physical and mental health of women. Honghua Xiaoyao Pill (HHXYP) is a Chinese patent medicine, which has been reported to be used to treat PMPS. However, there is still a lack of randomized clinical trial to evaluate the efficacy and safety of HHXYP on life quality, mood and vasomotor symptoms for PMPS women. This study aims to investigate whether HHXYP is effective and safe in treating PMPS and the possible mechanism. Methods: A multicenter, randomized, controlled clinical trial will be conducted in China to evaluate the efficacy and safety of HHXYP. Sixty women with peri-menopausal syndrome will be recruited at three centers and randomly in a 1:1 ratio to a treatment group using HHXYP (HHXYP group) and a control group using oryzanol (OC group). Participants will be treated with HHXYP or oryzanol for 12 weeks and followed up for 4 weeks. The primary outcome is the modified Kupperman Index (KI), which will be measured at baseline and 4, 8, 12, 16 weeks after randomization. The secondary outcomes include Hot flash scale (HFs), Menopause-Specific Quality of Life Scale (MENQOL) and Hamilton Depression/Anxiety Scale (HAMD/HAMA). The HFs are measured at the same point as the KI, other secondary outcomes are measured at baseline and 12, 16 weeks after randomization. The other outcomes are the levels of serum sex hormone, monoamine neurotransmitter, vascular vasomotor factor and the expression of phosphatidylinositol 3-active enzyme (PI3K)/protein activator enzyme B (Akt), which will be measured at baseline and 12 weeks after randomization. Adverse events will also be reported. Discussion: HHXYP is a potential alternative Chinese patent medicine for PMPS. This trial will provide evidence for HHXYP on improving the quality of life, mood and vasomotor symptoms, and sex hormone levels of PMPS patients.

Factors associated with the high susceptibility to depression of women during the perimenopause.

This study investigated the factors associated with the high susceptibility of perimenopausal women to depression. A total of 66 perimenopausal women participated in this study. The Zung self-rating depression scale (SDS) was used to evaluate the intensity of depressive symptoms. The modified Kupperman index (KI) was used to assess common perimenopausal symptoms. Psychosocial factors were assessed via the Eysenck Personality Questionnaire, attitudes toward menopause checklist, and metacognition questionnaire (MCQ). Levels of serum estradiol, testosterone, and progesterone were determined. There were statistically significant associations between SDS standard score and the KI scale score (β=.361, p=.001), years of education (β=-.309, p=.005), and F3 cognitive self-consciousness score of MCQ (β=-.234, p=.032; adjusted R2 =.264, F=8.759, p<.001). High susceptibility to depression of perimenopausal women may be related to lower educational level, more severe perimenopausal symptoms, and altered metacognition.

Efficacy of Non-Soy Isoflavone (Pueraria phaseoloides) on The Symptoms Severity Scoring by Kupperman Index in Menopausal Women

Introduction: Menopause is defined by a decline in estrogen levels, which causes various symptoms. Treatments based on foods or supplements enriched in phytoestrogens, notably isoflavones, plant-derived compounds with estrogenic effects, have recently become quite popular. This study aims to see how effective non-soy isoflavone supplementation is for menopausal symptoms in women. Methods: 26 menopausal women were given 67.5 mg of non-soy isoflavone, and 25 menopausal women were given a placebo daily for 12 weeks in an analytical double-blind, randomized clinical trial (RCT). Inclusion criteria were (1) RCT, (2) perimenopausal or postmenopausal women experiencing menopausal symptoms, (3) intervention with an oral non-soy isoflavone. Symptoms Severity Score (SSS) based on the Kupperman index (KI) questionnaire was administered to the patients before starting and at the end of the study. The Statistical Package for Social Sciences (SPSS) software was used to analyze the responses. Results: The difference in SSS scores between the treatment and control groups was significant (p = 0.000). Women receiving 67.5 mg of non-soy isoflavone daily, reduced myalgia, fatigue, and hot flushes by 92.3%, 77%, and 53.8%, respectively. For clinical significance rating, relative risk reduction (RRR) is used. A significant RRR value resulted from myalgia symptoms (76.6%), fatigue (55.7%), hot flushes (39.2%), and SSS (68.7%). Conclusion: Isoflavones did not bring a significant change in Kupperman Index compared to placebo but provided significantly improved Symptoms Severity Scoring in menopausal women.

Psychoemotional state and quality of life of nulliparous women with recurrent squamous epithelial exocervical dysplasia of the cervical epithelium in the perimenopausal period

The objective: to study the features of the psychoemotional state and quality of life of nulliparous women with recurrent squamous epithelial exocervical dysplasia of the cervical epithelium in the perimenopausal period.Materials and methods. 60 nulliparous women with recurrent cervical epithelial flat dysplasia that occurred after treatment with surgical methods in the perimenopausal period (the main group) and 38 women without gynecological and somatic pathologies in the perimenopausal period (control group) were examined. All patients were examined in accordance with the regulatory orders of the Ministry of Health of Ukraine. The assessment of neurovegetative and psychoemotional manifestations was carried out according to the Kupperman index, indicators of the quality of life and the Lusher color test.Results. The data of the medical history and clinical examination of patients were evaluated. This makes possible to identify a risk group among nulliparous women in the perimenopausal period for the development of recurrent squamous epithelial exocervical dysplasia of the cervical epithelium.In the main group, an increase in the Kupperman menopausal index by almost 1.5 times was found, as well as a significant decrease in indicators of psychosocial adaptation according to Lusher test to 40% and quality of life (physical component of health was 72.5±6.4 and 93,1±4,7 points in the main and control groups, respectively, mental component – 54.2±4.1 and 91,4±2,3 points, respectively).Conclusions. In infertile women with the menopausal changes, the recurrent squamous epithelial exocervical dysplasia of the cervical epithelium is a form of complicated course of dysplasia, and has a multifactorial genesis, in which conditions arise for the implementation of the neoplastic process. The clinical manifestations of the complicated course of the perimenopausal period significantly worsen the quality of life and general health in nulliparous women, especially on the background of recurrent squamous epithelial exocervical dysplasia of the cervical epithelium after surgical treatment, which is evidenced by more pronounced climacteric manifestations, reduction of physical and social activities, and emotional status.

Effects of health coaching on menopausal symptoms in postmenopausal and perimenopausal women.

This study aimed to determine the effects of health coaching on reducing menopausal symptoms in postmenopausal and perimenopausal women. This randomized controlled study was performed on 94 postmenopausal and perimenopausal women aged 45 to 55 years. The participants were randomly divided into intervention and control groups. In the intervention group, health coaching was performed in five coaching sessions biweekly (30-45 minutes each) by a midwifery coach. The primary outcome of this study was the menopausal score based on the modified Kupperman Index at 4 months after randomization. Depression (based on Zung's Self-Rating Depression Scale), physical activity (based on the International Physical Activity Questionnaire), quality of life (based on the 12-Item Short-Form Survey), smoking, alcohol intake, and anthropometric indices were also evaluated as secondary outcomes. There was a significant mean difference between the coaching and control groups in terms of change in the scores of menopausal symptoms from baseline (T0) to 4 months after the intervention (T1; -12.51; 95% confidence interval [CI], -10.59 to -14.42; P = 0.001). Moreover, a significant mean difference was observed between the two groups in terms of change in depression symptoms from T0 to T1 (-5.72; 95% CI, -7.61 to -3.83; P < 0.001) and in terms of quality of life (4.13; 95% CI, 2.95 to 5.31; P < 0.001). Health coaching, however, had no effects on the physical activity of the participants. Based on the present results, the coaching intervention is a suitable method to improve quality of life by reducing weight, waist circumference, body mass index, depression, and menopausal symptoms in postmenopausal and perimenopausal women. It can have important effects on the development of health promotion programs to reduce menopausal symptoms in menopause clinics.

Effect of acupuncture on hypothalamic functional connectivity in patients with premature ova-rian insufficiency based on resting-state functional magnetic resonance imaging

To compare the differences in functional connectivity(FC) between the hypothalamus and whole brain regions in patients with premature ovarian insufficiency (POI) and healthy volunteers based on resting-state functional magnetic resonance imaging (rs-fMRI) and investigate the mechanism of acupuncture on treatment of POI. Twelve POI patients were recruited to the acupuncture group and 12 healthy volunteers to the control group. Patients in the acupuncture group received acupuncture at two groups of acupoints alternatively, including Baihui (GV20), Zhongwan (CV12), Shenting (GV24), Shenshu (BL23), Ciliao（BL32） and so on, 30 min once time, 3 times per week for 12 weeks. The state of patients was evaluated by modified Kupperman Index (KI) and self-rating anxiety scale (SAS). Follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), and anti-mullerian hormone (AMH) were tested by microparticle-based chemiluminescence. B ultrasonography was used to detect the antral follicle count (AFC). Meanwhile, POI patients and healthy volunteers underwent the rs-fMRI examination before and after acupuncture treatment and after enrollment, respectively. With hypothalamus as the region of interest, the differences in FC between the hypothalamus and other brain regions in POI patients and healthy volunteers and the changes of FC between the hypothalamus and whole brain regions in POI patients before and after acupuncture were observed. The SAS and KI scores of pre-treatment POI patients were higher than those in the control group （P<0.01）.In compa-rison with those pre-treatment, FSH, LH, and SAS and KI scores of POI patients decreased after treatment, while AFC increased (P<0.05). Compared with the control group, the FC of the left hypothalamus with left central sulcus, right middle occipital gyrus, and left paracentral lobule increased, but decreased with left globus pallidus of the lenticular nucleus in POI patients. Furthermore, the FC of the right hypothalamus with the left hippocampus, the left para-central lobule, and the right central sulcus increased, while the FC between the right hypothalamus and the right superior frontal gyrus decreased (P<0.05). For the acupuncture group, compared with the conditions before treatment, the FC of the right hypothalamus with the left inferior frontal gyrus, the left insula, and right inferior frontal gyrus was strengthened, but weakened with the left gyrus rectus (P<0.05). The abnormal FC between the hypothalamus and whole brain regions may be one of the central pathological factors of POI. Acupuncture can improve the ovarian function and clinical symptoms of patients with POI, which may be related to its effect in regulating the FC between the hypothalamus and multiple brain regions.

Treatment of Postmenopausal Syndrome with UBPN01: A Randomized, Double-blind, Placebo-controlled Study

This study evaluated the efficacy of UBPN01 (Salvia miltiorrhiza extract) for alleviating menopausal syndrome. This study was a randomized, double-blind, placebo-controlled clinical trial involving female subjects (40 – 60 years) with menopausal syndrome. Subjects were administered 600 mg/day UBPN01 or placebo, and efficacy endpoints were menopausal symptoms according to the total Kupperman Index (KI) score and individual categories. After 12 weeks, the total KI scores decreased and depression and vaginal dryness symptoms improved, especially in UBPN01 compared to placebo. Moreover, we observed no significant difference between the two groups in estradiol, follicle stimulating hormone, or luteinizing hormone. These results demonstrated that UBPN01 alleviates menopausal symptoms without notable side effects and improves quality of life, suggesting its efficacy as an alternative supplement for women ineligible for hormone therapy.

Evaluation of the Effectiveness of Fermented Soybean-Lettuce Powder for Improving Menopausal Symptoms.

Menopause syndrome causes a decline in the quality of life of postmenopausal women. Hormone therapy is recommended for the treatment of menopausal syndromes. However, it has several side effects. Soybean has been safely used to relieve the symptoms of menopause. Lettuce has antidiabetic and anti-inflammatory effects and improves sleep quality. Natural nitric oxide metabolites are produced through fermentation, which increases the effectiveness of the functional substances. This study assessed the alleviation of menopausal syndrome symptoms by natural nitric oxide-containing soybean lettuce extract using the Kupperman index. This study included adult women with menopausal syndrome and a Kupperman index of ≥15. After a four-week study with 40 participants, the final analysis included 39 participants in the experimental group (n = 19) and the placebo group (n = 20). Body mass index, waist circumference, and the total cholesterol, low-density and high-density lipoprotein cholesterol, and triglyceride levels were not altered before and after treatment in both groups. There was a significant decrease in the Kupperman index after treatment in the experimental group, but no significant change was observed in the placebo group. Soybean lettuce extract alleviates menopause syndrome without any special side effects.

Serum total bilirubin and new-onset hypertension in perimenopausal women: a cross-sectional study.

Previous studies have shown negative associations between total bilirubin (TBIL) and hypertension. However, the association of TBIL with new-onset hypertension in perimenopausal women is unknown. A total of 196 perimenopausal women were included in this cross-sectional study of which 85 had new-onset hypertension. All participants underwent 24-hour ambulatory blood pressure monitoring and a clinical assessment including anthropometrics. Sociodemographic, lifestyle, and menopausal symptoms (modified Kupperman Index [mKI]) were measured by questionnaire. A fasting blood sample was taken to measure a wide range of biomarkers and hormone levels. Restricted cubic spline regression was used to investigate potential nonlinearity. Multivariable logistic and robust linear regression analyses adjusting for minimal sufficient adjustment sets based on directed acyclic graphs were performed to test the association of TBIL with hypertension/blood pressure. We examined mKI-stratified analyses and a TBIL-mKI interaction term to explore potential effect modification by number of menopausal symptoms. Hypertensive women had significantly lower TBIL levels than did normotensive women (11.15 vs 12.55 μmol/L, P = 0.046). Univariate restricted cubic spline regression showed nonsignificant nonlinearity ( P value for nonlinearity, 0.339). Multivariable regression analyses adjusted for minimal sufficient adjustment sets revealed that higher TBIL level was associated with lower odds of hypertension (odds ratio, 0.91 per μmol/L TBIL; 95% confidence interval [CI], 0.84-0.98; P = 0.019). Total bilirubin showed a significant inverse association with average 24-hour diastolic blood pressure ( β = -0.36 mm Hg per μmol/L TBIL; 95% CI, -0.62 to -0.10; P = 0.008) but not with 24-hour systolic blood pressure ( β = -0.37 mm Hg per μmol/L TBIL; 95% CI, -0.79 to 0.06; P = 0.090). Stratified analyses suggested stronger inverse associations of TBIL with hypertension and 24-hour blood pressure in women with fewer menopausal symptoms (mKI ≤10), although the TBIL-mKI interaction was not significant. In perimenopause, TBIL was inversely associated with diastolic blood pressure and new-onset hypertension, diagnosed using 24-hour ambulatory blood pressure monitoring.

Effect of Aromatic Massage on Somatic Problems among a Cohort of Menopausal Women

Context: Menopause is a significant event in women's lives. It marks the end of a woman's natural reproductive life; it is usually accompanied by symptoms that affect the women's ability to perform their normal daily activities. Massage is one of the non-pharmacological methods that can help women cope with menopausal symptoms.&#x0D; Aim: The study aimed to evaluate the effect of aromatic massage on somatic problems among a cohort of menopausal women.&#x0D; Methods: A comparative quasi-experimental time serial (pre-posttest, study/control) design was used. The study was conducted at outpatient clinics of Ain shams University Maternity Hospital. A purposive sample of 74 menopausal women with menopausal symptoms was recruited in this study and divided randomly into an intervention group (Aromatic massage) and a control group (Massage only). Data were collected through three tools. A structured interviewing questionnaire is divided into three parts: general data, obstetrics, and menstrual history, the Kupperman index (menopausal assessment symptoms tool) to assess somatic menopausal symptoms, and the Visual Analogue Scale to assess the history of menstrual pain degree among menopausal women.&#x0D; Results: It revealed two matched groups of women with a mean age of 47.83±5.23 vs. 49.05±3.98 in the aromatic and massage-only groups, respectively. The pre/post-intervention results revealed a significant improvement in most somatic menopausal symptoms, decreasing the frequency of hot flushes attacks, paresthesia, vertigo, fatigue, myalgia, headache, heart palpitation, and formication in the aromatherapy massage group post-intervention and in the follow up (p&lt;0.05). The comparison between the aromatic and massage-only groups revealed a significant difference between the two groups with a significantly lower mean score in total menopausal somatic symptoms.&#x0D; Conclusion: Aromatic massage with lavender, clary sage, jasmine, and rose dissolved in almond oil was effective in easing somatic menopausal symptoms compared to their pre-intervention level and compared to the massage-only group. The study recommended developing counseling programs for women about aromatic massage therapy at gynecological clinics.

Risk of Depression during Menopause in Women from Poland, Belarus, Belgium, and Greece.

Introduction: Menopause is a physiological period in a woman’s life, but it is often accompanied by symptoms that affect mental well-being and general health, including a tendency for depression. Aim of the study: To evaluate the predisposition to the symptoms of depression in women from Poland, Belarus, Belgium, and Greece. Material and methods: the method of diagnostic survey was used, and the research tools were: The Menopause Rating Scale, the Kupperman Index, Beck Depression Inventory, and a self-made survey questionnaire. Results: Hormone replacement therapy (HRT) was used by 15.8% of Polish, 19% of Belgian, 14.3% of Belarusian, and 15.2% of Greek women patients. The mean value of the Kupperman Index (range 0–63) in Poland was 14.8 ± 8.6, in Belgium—15.5 ± 6.6, Belarus—14.0 ± 9.4, and Greece—10.8 ± 6.5, while the total measure of Menopause Rating Scale (MRS) (range 0–44) was 12.2 ± 7.6 in Poland, 13.8 ± 6.5 in Belgium, 10.8 ± 8.0 in Belarus and 12.9 ± 7.4 in Greece. The severity of mental distress followed a similar pattern across all countries (slightly stronger than mild). The results for somatic complaints were similar, whereas the level of sexual issues varied, with the highest in Belgium and the lowest in Belarus. The mildest symptoms of menopause were experienced by Belarusian women and the most severe by Belgian women. The severity of depression, according to the Beck Depression Inventory (range 0–63), was as follows: Poland 10.5 ± 7.9; Belgium—11.1 ± 5.7; Belarus—13.7 ± 5.7; Greece—11.8 ± 6.6. Conclusions: The differences between the development of perimenopausal-related symptoms across countries were statistically significant. The incidence and severity of depression showed statistically significant differences between the countries studied—the highest was in Belarus and the lowest in Poland. Depression levels were not differentiated by subjects’ age or the use of hormone therapy but by subjects’ education. In Poland and Belarus, increased menopausal pain measured by the Kupperman Index altered levels of depression; in Belgium, there were no such correlations, and in Greece, the correlation was statistically significant, but its strength was negligible. A clearer correlation of the effects of development in menopausal symptoms on the level of depression was shown when measured with the MRS scale—in Greece and Belgium, the correlation was relatively weak, but in Poland and Belarus, it was relatively high.

Determinants of body image in perimenopausal and postmenopausal women

ABSTRACT Body image plays an important role in women’s well-being. The aim of our study was to determine the influence of selected variables (menopausal symptoms, depressive symptoms, sexual dysfunctions, health behaviours) on body image among perimenopausal and postmenopausal women. Six hundred eighty-eight women aged 45–65 served as participants. The Kupperman Index, Beck Depression Inventory, Female Sexual Function Index, Body Esteem Scale, and a questionnaire that we created (sociodemographic factors and health status) were used. Structural equation modelling with the maximum likelihood method was used to test a model examining the relations among variables. The resulting model was satisfactory in fit (p = 0.610). The model predicted a significant percentage of the variance in all components of body esteem, including 30.9% of the variation in physical condition, 23.9% of weight control, and 37.6% of sexual attractiveness. Results of the direct effects analysis indicated a significant role for sexual dysfunction (p < 0.001) and intensity of depressive (p < 0.001) and menopausal (p = 0.001) symptoms in predicting overall body self-esteem. Additionally, health-related behaviours affected both weight control (p < 0.001) and sexual attractiveness (p < 0.001).

Clinical and morphological features of post-castration syndrome in women after surgical menopause

Research objective: to assess the clinical and morphological features of the course of post-castration syndrome (PS) in women after surgical menopause.Materials and methods. The main group (with surgical menopause) consisted of 67 women aged 45 to 55 years, who underwent surgical treatment with removal of the uterus with or without appendages. 30 women with natural menopause were included in the comparison group.The assessment of morphological changes in the reproductive organs in both groups was carried out according to the results of the histological examination of reproductive organs removed during the operation, and according to the results of the pathological examination of endometrium after curettage of uterine mucosa.Results. The leading indication for surgical treatment, which led to surgical menopause, was uterine leiomyoma in 71.1% of women. Extirpation of the uterus was performed in 64.2% of patients, complete exclusion of ovarian function was observed in 68.7%.There was a deficiency of estrogen in women with surgical menopause, even before the operation, as evidenced by the presence of morphological signs of hypoestrogenism in the form of endometrial atrophy in 41.8% of them, which is 6.2 times (p &lt; 0.001) more often compared with women with natural menopause.The morphological signs of the inflammatory process in reproductive organs in more than half of women with surgical menopause (significantly more than in women with natural menopause, p &lt; 0.001) increase the likelihood of depletion of the ovarian hormonal function and increase the intensity of PS symptoms. This is evidenced by a significant 2.8-fold increase in women with surgical menopause in the frequency of severe PS and the median of the modified Kupperman index compared with women with natural menopause (p &lt; 0.001). The decrease in the ovarian hormonal function in women after surgical menopause increases the frequency of ovarian cysts by 12 times compared with women with natural menopause (p &lt; 0.001).Conclusions. It is necessary to establish the significance of the investigated clinical and morphological features observed in women with surgical menopause to predict the severity of PS in them.

Relationships between psychological symptoms and quality of life in pre- and postmenopausal Turkish and Polish women: A cross-sectional study

Introduction: The climacteric period is the time during which women exit the reproductive period and enter a stage of diminishing reproductive ability. Purpose: This study was conducted to evaluate menopausal symptoms, depression, and quality of life in pre- and postmenopausal women living in two different countries. Materials and methods: The study sample comprised a total of 499 pre- and postmenopausal women between the ages of 40 and 65 living in Turkey and Poland. The data in this descriptive and comparative study were collected using a descriptive questionnaire, the Kupperman Index, the Beck Depression Inventory, and the WHOQOL-BREF Scale. Results: The mean depression scores of Turkish and Polish women were higher in the postmenopausal period (p&lt;0.01). The mean depression scores were higher in the premenopausal period in Turkey, whereas they were higher in the postmenopausal period in Poland (p&lt;0.01). When all the subdimensions of quality of life were compared between the two countries, psychological health, social relationships, and environment scores were found to be lower in Poland than Turkey (p&lt;0.01). Conclusions: The menopausal period is affected by the lifestyles and cultures of women. For this reason, healthcare personnel who can reach individuals more easily in daily practice, should take cultural differences into account when providing care to women in the climacteric period. This will help to improve their quality of life during this period. Keywords: Menopause, quality of life, menopausal symptoms, depression

A Complex of Cirsium japonicum var. maackii (Maxim.) Matisum. and Thymus vulgaris L. Improves Menopausal Symptoms and Supports Healthy Aging in Women.

We evaluated the efficacy and safety of MS-10® for the treatment of menopausal symptoms. A double-blind randomized placebo-controlled clinical trial was performed in 71 premenopausal women for 4 and 12 weeks. A total of 12 individual menopausal symptom scores were assessed using the Kupperman index. MS-10 treatment effectively improved the symptoms by ∼48%. In addition, the quality of life of the women improved by 36% from four perspectives: vasomotor, psychosocial, physical, and sexual symptoms as evaluated using the menopause-specific quality of life (MenQoL) questionnaire. Our results show that MS-10 improves insulin-like growth factor-1 (IGF-1) and estrogen utilization through receptor activation, which are thought to have causative therapeutic effects on menopause and aging inhibition in women. Improvement of Enthotheline-1 (ET-1) in the blood after MS-10 intake led to an improvement in menopausal vascular symptoms. Improvements in bone formation and absorption markers such as osteocalcin, bone-specific alkaline phosphatase (BSALP), C-telopeptides of type I collagen (CTx), deoxypyridinoline (deoxyPYD), and N-telopeptides of type I collagen (NTx) in blood or urine indicate that MS-10 fundamentally improves bone health in women. By confirming the improvement of the psychological well-being index based on the improvement of stress hormone cortisol, MS-10 can solve causative psychological and physical stress-related symptoms. Moreover, various safety tests, such as those for female hormones, were confirmed. Therefore, it can be confirmed that MS-10 is a natural pharmaconutraceutical that causatively and safely improves health of women and aids in antiaging processes.

Efficacy of Rubus coreanus Miq. and Astragalus membranaceus Bunge Extract for Postmenopausal Syndrome: A Randomised, Double-Blind, Placebo Comparative Clinical Trial.

Objectives The most effective way to improve menopausal symptoms is to supplement deficient oestrogen; however, long-term administration of synthetic oestrogen increases the risk for breast and uterine cancers. Here, we report results from a clinical trial of Rubus coreanus Miq. and Astragalus membranaceus Bunge as agents for improving the menopause syndrome. Methods This study was a single-centre, double-blinded, parallel-group, placebo-controlled study. The efficacy of an extract of R. coreanus Miq. and A. membranaceus Bunge was investigated. Participants were females with postmenopausal syndrome in the menopausal or menopausal transition period. The primary endpoint of validation was improvement in the Kupperman index (KI) score of women. The secondary end point was change in the Menopause Rating Scale (MRS) and lipid profile. The participants were randomly allocated at a 1 : 1 ratio into R. coreanus Miq. and A. membranaceus Bunge extract (RCAM) or placebo groups and were administered 2000 mg of the extract or placebo, respectively, daily for 12 weeks. Outcomes were measured at visits 2 (day 0) and 5 (week 12). Results The RCAM group demonstrated decreased KI score and MRS compared with the placebo group after 12 weeks. In the safety evaluation, laboratory tests and vital signs demonstrated no clinically significant changes in subjects, and there was no difference in adverse reactions between the groups. The R. coreanus Miq. and A. membranaceus Bunge extract was effective in reducing postmenopausal symptoms in women. Moreover, the extract was found to be safe. Conclusions For females with menopausal symptoms in the menopausal transitional and postmenopausal periods, ingestion of the R. coreanus Miq. and A. membranaceus Bunge extract for 12 weeks was effective, as demonstrated by a decrease in KI score and MRS relative to that in the placebo group, and significantly improved the menopausal symptoms.

Effect of isoflavone supplementation on menopausal symptoms: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND/OBJECTIVESComplementary and alternative medicines can be used to alleviate climacteric symptoms that significantly affect the quality of life of postmenopausal women. Isoflavones are the most common plant-based therapies for postmenopausal changes, but the results of previous studies have been controversial.MATERIALS/METHODSTo investigate whether isoflavones would affect menopausal symptoms as well as ovarian hormones, we performed a systematic review and meta-analysis. The PubMed and EMBASE databases were used to perform the systematic search. Included studies were limited to randomized controlled trials (RCTs) assessing the impact of isoflavone supplementation on menopausal symptoms.RESULTSEleven studies were included for the final quantitative assessment. Isoflavone intervention was varied between 49.3 and 135 mg of isoflavones per day for 12 wk–2 yrs. The meta-analysis showed that supplementation of isoflavones significantly increased the estradiol levels (standardized mean difference [SMD] = 0.615, P = 0.035) and Kupperman index (SMD = 3.121, P = 0.003) but had no significant effect on hot flashes, follicle-stimulating hormone, and luteinizing hormone. However, both estradiol and the Kupperman index showed significant heterogeneity among studies (I2 = 94.7%, P < 0.001 and I2 = 98.1%, P < 0.001, respectively).CONCLUSIONSAlthough the results showed a significant SMD in estradiol and the Kupperman index, the results should be interpreted with caution due to the high heterogeneity. Further validation with a larger RCT will be necessary. Overall, isoflavone supplementation has distinct effects on the climacteric symptoms and hormonal changes in postmenopausal women.

How Effective the Mindfulness-Based Cognitive Behavioral Therapy on Quality of Life in Women With Menopause.

Introduction:In woman's life menopause can cause psychological and somatic disturbances. Psychological and behavioural intervention is effective in reducing menopause-related symptoms.Aims:The present study was done to find effectiveness of mindfulness-based cognitive behavioural therapy (MBCT) on quality of life among menopausal women.Methods and Material:The present study was double-blind randomized trial conducted among menopausal women at tertiary care hospital, Chennai, Tamil Nadu. The study was conducted among 50 women who had attained menopause. They were randomly divided into intervention (n = 25) and control (n = 25) groups. The MBCT was given once a week to intervention group over eight one-hour sessions and control group received no intervention. The data collection instruments included a demographic questionnaire, Kupperman's index, and menopause-related quality of life questionnaire, which were fulfilled by both groups before, immediately after, and 2 weeks after completion of intervention. Paired t-test was applied before intervention and at 10 weeks for both the groups.Results:The difference between the scores before and after intervention i.e after 10 weeks in all the domains and total domain was significant in intervention group compared to control group.Conclusions:Mindfulness based approaches may improve severity of vasomotor and psychological symptoms of menopause, thus enhancing quality of life.

State of metabolic processes and ways to improve them in premenopausal women due to the life extension strategy

Increasing the duration and improving the quality of life of older women is a significant problem of current medicine. Metabolic disorders in the form of type II diabetes mellitus and atherogenic dyslipidemia lead to a significant level of cardiovascular complications. It is known that hormone replacement therapy cannot normalize age-related metabolic disorders. Therefore, the search for new methods of cardiovascular health is extremely relevant. Research objective: to study the state of autonomic nervous regulation, carbohydrate and lipid metabolism in perimenopausal women using the life extension approach.Materials and methods. Group I (control) consisted of 35 apparently healthy women of reproductive age. Group II (main) consisted of 71 patients whom was administered a solution of xylitol with electrolytes (Xylate) by infusion from the first days of the reduction diet for 5 days, and also L-arginine (Tivortin) was injected intravenously for 5 days, 200 ml once a day, followed by taking a drinking solution of this drug for another three weeks. All patients followed a 28-day diet, and also performed daily aerobic morning exercises for 3 months.Results. A significant decrease in body mass index in patients of the main group due to the proposed treatment and prevention program was found. At the same time, Kupperman index declined significantly. Decreased body mass index in patients of the main group was the basis for improved autonomic nervous regulation and metabolic processes. Xylate-Tivortin complex has allowed emphasizing the overcoming of insulin resistance, dyslipidemia and chronic inflammation.Conclusions. The developed 3-month program allowed to significantly improving the metabolic processes and hemodynamic parameters in women of perimenopausal age. This is the basis for the introduction of Xylate-Tivortin complex life extension into the practice of family physicians, obstetricians and gynecologists and specialists in the field of aesthetic medicine.

Electroacupuncture for the treatment of perimenopausal syndrome: a systematic review and meta-analysis of randomized controlled trials.

To assess the efficacy, comparative effectiveness and safety of electroacupuncture (EA) in the treatment of perimenopausal syndrome (PMS). Nine databases were searched until June 2019. Only relevant randomized controlled trials (RCTs) of EA for PMS were included. Twelve trials involving 746 women were included. EA and hormone therapy (HT) did not significantly differ in terms of effective rate (risk ratio (RR) = 0.98, 95% confidence interval (CI) = 0.93 to 1.04), Kupperman index (KI) (mean difference (MD) = -0.25, 95% CI = -0.76 to 0.26) and serum levels of follicle-stimulating hormone (FSH) (MD = -3.80, 95% CI = -11.59 to 3.98) or luteinizing hormone (LH) (MD = -2.51, 95% CI = -10.72 to 5.70). Serum estradiol (E2) levels were significantly lower in EA versus HT groups (MD = -60.58, 95% CI = -71.93 to -49.23). Compared with sham EA, EA had a significantly greater effect on reductions in KI (MD = -4.71, 95% CI = -6.57 to -2.86) and hot flushes score/24 h (MD = -2.43, 95% CI = -2.93 to -1.93). There were no significant differences between EA and manual acupuncture (MA) in terms of effective rate (RR = 1.14, 95% CI = 0.98 to 1.33) or serum FSH (MD = -2.87, 95% CI = -29.65 to 23.91), LH (MD = 2.73, 95% CI = -9.65 to 15.11) or E2 (MD = 26.80, 95% CI = -12.06 to 65.65). However, it seemed that EA had a better effect than MA on KI (MD = -2.44, 95% CI = -4.80 to -0.08). Subgroup analyses indicated that EA may have more of a benefit in the pre-menopausal state (hot flushes score/24 h: MD = -1.66, 95% CI = -3.49 to 0.17) compared to post-menopause (p > 0.05). The effect of EA appeared broadly similar to HT and MA in the treatment of PMS, although EA-associated reductions in KI were superior to MA and sham EA, suggesting effects beyond placebo. The evidence base is limited by a small number of eligible studies, risk of bias and clinical/statistical heterogeneity, limiting our ability to draw firm conclusions. As such, additional larger scale, high-quality RCTs are needed.