Modified Kupperman Index Research Articles

Clinical observation on acupuncture for perimenopausal syndrome

To observe the clinical efficacy of acupuncture for perimenopausal syndrome. A total of 40 perimenopausal syndrome cases who met the inclusion criteria were randomized into an observation group and a control group, 20 in each group. Acupuncture combining with ginger-partitioned moxibustion was used in the observation group, whereas acupuncture was used in the control group. Modified Kupperman Index (KI) was evaluated respectively before and after treatment. In addition, the clinical efficacies in the two groups were compared. The total effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, KI in both groups were significantly reduced (P<0.01) and there was a statistical difference between the two groups (P<0.01). Acupuncture combining with ginger-partitioned moxibustion could obtain a higher total effective rate for perimenopausal syndrome than acupuncture alone. Furthermore, it was also superior to acupuncture alone in improving hot flushes, insomnia, melancholia and arthralgia or myalgia.

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

BackgroundThe 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.MethodsWe 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.ResultsWe 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.ConclusionThe 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.

The effect of rexflavone (Sophorae Fructus Extract) on menopausal symptoms in postmenopausal women: A randomized double-blind placebo controlled clinical trial

To observe the protective effect of orally administrated Rexflavone (Sophorae fructus extract) for the postmenopausal symptoms, a randomized double-blind placebo controlled clinical trial was designed. Rexflavone significantly improved 11 menopausal symptoms including hot flash, which was evaluated by the modified Kupperman Index (KI), while hormone level and lipid profile were little changed by consumption. Rexflavone group significantly decreased KI score (-14.91 +/- 8.79) compared to placebo group (-11.45 +/- 6.62) as a representative index for improvement of menopausal symptoms (p < 0.05). We found that Rexflavone has no adverse effect to be safe for long term consumption. It was shown that the consumption of Rexflavone possessed beneficial effects on the postmenopausal symptoms in postmenopausal women.

The Effect of Isoflavone and Gamma-linolenic Acid Supplementation on Serum Lipids and Menopausal Symptoms in Postmenopausal Women

This study was performed to examine the combined effects of gamma linolenic acid and isoflavone supplementation on menopausal symptoms and serum lipids in 73 postmenopausal women. A total subjects were randomly assigned to isoflavone (30 ㎎) + gamma-linolenic acid (110 ㎎) group or placebo group. We measured menopausal symptoms by modified Kupperman Index (KI) and oxidized LDL, lipid peroxides, blood components and anthropometric parameters before and after the 12 week intervention period. After the 12 weeks of supplementation, supplement group and placebo group showed a significant reduction of modified kupperman index (p < 0.001). Isoflavone (30 ㎎) + gamma-linolenic acid (110 ㎎) supplement group showed a significant reduction of oxidized LDL cholesterol concentration (p = 0.006) whereas placebo group did not show significant change. Isoflavone and gamma-linolenic acid consumption did not significantly affect plasma concentrations of total, LDL, HDL cholesterol, triglyceride, apo A1, B and blood components. The result of present study demonstrated the supplementation of 30 ㎎ isoflavone and 110 ㎎ gamma-linolenic acid per day for 12 weeks may protect LDL cholesterol from oxidative stress.

Effect of intestinal production of equol on menopausal symptoms in women treated with soy isoflavones

Objective: To evaluate the effect of soy isoflavones on menopausal symptoms in women who do and who do not produce equol, a daidzein metabolite. Method: A randomized, double-blind, placebo-controlled clinical trial was conducted over 6 months with 96 healthy menopausal women. After taking take 135 mg of isoflavones daily for 1 week, the women in the study group were assigned to the equol-producing (EP) or the non-EP group according to the presence or absence of equol in their urine. Menopausal symptoms were evaluated using a modified Kupperman Index. Result: Compared with the placebo group, the scores for hot flashes and excessive sweating were significantly reduced after 3 months, and the scores for weakness, palpitations, limb paresthesia, and total symptoms after 6 months, in the EP group only. Conclusions: Isoflavone supplementation improves menopausal symptoms only in women with the ability to produce equol.

Efeitos da isoflavona de soja sobre os sintomas climatéricos e espessura endometrial: ensaio clínico, randomizado duplo-cego e controlado

OBJETIVO: avaliar o efeito da isoflavona de soja sobre os sintomas climatéricos e espessura endometrial em mulheres na pós-menopausa. MÉTODOS: ensaio clínico randomizado, duplo-cego e controlado envolvendo 90 mulheres pós-menopausadas, entre 45 e 60 anos, com queixas de fogachos, acompanhados ou não de outros sintomas climatéricos. Foram randomizadas para receber 50 mg de isoflavona a cada 12 horas, diariamente, por 12 semanas (n=42), ou placebo (n=48), e avaliadas antes e ao final do tratamento, pelo índice menopausal de Kupperman (IK), no qual se registrava a intensidade dos sintomas climatéricos, utilizando uma escala visual analógica de 100 mm. Os fogachos foram avaliados separadamente também. Foram submetidas a uma ultra-sonografia transvaginal para a avaliação da espessura do eco endometrial. Para a análise estatística, empregaram-se o teste do chi2, ANOVA ou t de Student e Mann-Whitney, ao nível de significância de 5%. RESULTADOS: não foram observadas diferenças significantes no IK (64 versus 82, p>0,05) nem nos fogachos (20 versus 20, p>0,05), entre os grupos tratados com isoflavona ou placebo, respectivamente. Também não foram observadas diferenças significantes no IK e nos fogachos, antes e após o tratamento, quando os grupos tratados com isoflavona ou placebo foram analisados separadamente. Nenhuma diferença foi observada na espessura do endométrio após o tratamento entre os grupos tratados com isoflavona ou placebo (0,28 versus 0,26 mm, respectivamente, p>0,05). CONCLUSÕES: a isoflavona de soja, na dose de 100 mg/dia, não é mais efetiva que o placebo para a redução das ondas de calor e sintomas do hipoestrogenismo em mulheres na pós-menopausa e não apresenta efeitos sobre a espessura endometrial.

Subjective sleep quality in perimenopausal women and its related factors

Objective To evaluate the sleep quality and its related factors among perimenopausal women. Methods A self-designed questionnaire was administered to 506 perimenopausai women. The questionnaire included the influencing factors on the sleep quality, the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scales (SDS), the Zung Self-Rating Anxiety (SAS) and the Modified Kupperman Index (KI). Data were analyzed by SPSSll.5. Results The mean PSQI was 5.97±4.30. Twenty-four percent of perimenopausal women reported poor sleep. Age and perimenopausal symptoms were significantly correlated with sleep quality. The sleep quality of the 45∼49 age group was the poorest and the 40∼44 age group was the best. The women who had higher Kupperman index were more likely to be poor sleepers. There was no significant correlation between occupation and sleep quality. Night sweat, depression, anxiety, hot flash, stressful life event, and regular exercise were significantly and independently related with sleep quality. Among them, regular exercise was a protective factor of sleep quality. Conclusion High incidence of poor sleep quality exists among perimenopausal women. Some effective interventions should be taken to improve the sleep quality of perimenopausal women.

Efficacy of citalopram on climacteric symptoms

The aim of this study was to evaluate the efficacy of citalopram for climacteric symptoms and to assess the combined effect of citalopram and hormone therapy (HT) on climacteric symptoms in women inadequately responsive to HT alone. The study included 100 postmenopausal women who were allocated into one of four groups: (1) citalopram, (2) placebo, (3) citalopram+HT, or (4) placebo+HT. The women who were unable or unwilling to take HT were randomly placed in groups 1 and 2. The women who were inadequately responsive to HT were randomly placed in groups 3 and 4. The initial dose of citalopram was 10 mg/day in groups 1 and 3. After 1 week, the dose was increased to 20 mg/day. After starting the medication, follow-up visits took place during the fourth and eighth weeks of treatment. During the first and eighth weeks, women completed two questionnaires: a modified Kupperman index and the Menopause-Specific Quality of Life Questionnaire. Mean hot flash scores significantly improved in all groups (P<0.05). The reduction rates were 37% in group 1, 13% in group 2, 50% in group 3, and 14% in group 4. Psychosocial complaints and mean values on the Kupperman index significantly decreased in all groups (P<0.05). Physical well-being significantly improved in groups 1, 3, and 4 (P<0.05). The decrease in all scores was significantly greater in groups 1 and 3 compared to groups 2 and 4 (P<0.01). Citalopram is an effective alternative treatment option for patients who do not want to take HT for the alleviation of climacteric symptoms. Adjuvant treatment with a selective serotonin reuptake inhibitor increases the effectiveness of HT for the treatment of climacteric symptoms in women who had responded inadequately to HT.

Black cohosh and fluoxetine in the treatment of postmenopausal symptoms: A prospective, randomized trial

The objective of this study was to evaluate the efficacy of fluoxetine and black cohosh in the treatment of women with postmenopausal symptoms. A total of 120 healthy women with menopausal symptoms were recruited to this prospective study with a follow-up period of 6 mo. They were randomly assigned to 1 of 2 groups and were treated with fluoxetine or black cohosh. After entry into the study, patients were examined at the first, second, third, and sixth months of the treatment period. The women kept diaries in which they reported the daily number and intensity of hot flushes and night sweats. In addition, at the beginning and end of the third month, they completed questionnaires consisting of a modified Kupperman Index, Beck's Depression Scale, and a RAND-36 Quality-of-Life Questionnaire. Statistically significant differences were noted in the Kupperman Index and Beck's Depression Scale at the end of the third month in both groups compared with baseline values. In the black cohosh group, the Kupperman Index decreased significantly compared with that in the fluoxetine group by the end of the third month. On the other hand, in the fluoxetine group, Beck's Depression Scale decreased significantly compared with that in the black cohosh group. Monthly scores for hot flushes and night sweats decreased significantly in both groups; however, black cohosh reduced monthly scores for hot flushes and night sweats to a greater extent than did fluoxetine. At the end of the sixth month of treatment, black cohosh reduced the hot flush score by 85%, compared with a 62% result for fluoxetine. By the sixth month of the study, 40 women had discontinued the study--20 (33%) in the fluoxetine group and 20 (33%) in the black cohosh group. Compared with fluoxetine, black cohosh is more effective for treating hot flushes and night sweats. On the other hand, fluoxetine is more effective in improvements shown on Beck's Depression Scale.

Acupuncture for Perimenopausal Symptoms in Women who Underwent Oophorectomy – a Comparative Study

Objective: To explore the effects of acupuncture on perimenopausalsymptoms in women who underwentoophorectomy. Methods: 67 women who had undergoneoophorectomy were divided into an acupuncture group(n = 36) and a comparison group (n = 31) according totheir wishes. The first group was treated by acupunctureand the latter group by Livial®. Clinical symptoms wereassessed by the modified Kupperman index. The levelsof venous blood serum ß-endorphin (ß-EP), follicle stimulatinghormone (FSH), luteinizing hormone (LH), estradiol(E2) and the maturation index (MI) of vaginal epithelialcells were assessed. Results: There were no significantgroup differences for the MI of vaginal exfoliative cellsnor for the levels of FSH, LH and E2 after treatment (p >0.05), but Kupperman scoring and the levels of ß-EP differedsignificantly between the acupuncture and theLivial group (p < 0.05). No side-effects were reported ineither group. Conclusion: Acupuncture results in a significantimprovement in perimenopausal symptoms inwomen who have had an oophorectomy. Acupunctureperforms as well or better than Livial. Yet, this result mayhave been influenced by a potential bias and the smallsample size.

A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts

Objectives To examine the efficacy of a hop extract enriched in 8-prenylnaringenin (8-PN, the phytoestrogen in hops, Humulus lupulus L.) on relief of menopausal discomforts. Methods A prospective, randomized, double-blind, placebo-controlled study over 12 weeks with 67 menopausal women, who were administered a hop extract standardized on 8-PN (100 or 250 μg). The responses were determined by means of a modified Kupperman index (KI) and a patients’ questionnaire. Results All groups, including placebo, showed a significant reduction of the KI both after 6 weeks and after 12 weeks. The hop extract at 100 μg 8-PN was significantly superior to placebo after 6 weeks ( P = 0.023) but not after 12 weeks ( P = 0.086). No dose–response relationship could be established, as the higher dose (250 μg) was less active than the lower dose both after 6 weeks and after 12 weeks. Still, a trend for a more rapid decrease of KI was noticed for both active groups as compared to placebo. In particular, the decrease in hot flush score (isolated from the KI) was found significant for both treatment groups after 6 weeks ( P < 0.01) with respect to placebo. Results of the patients’ questionnaire were consistent with those of the KI, with the most pronounced effects being observed for the 100-μg treatment. Conclusions Daily intake of a hop extract, standardized on 8-PN as a potent phytoestrogen, exerted favorable effects on vasomotor symptoms and other menopausal discomforts. Hop-derived prenylated flavonoids may provide an attractive addition to the alternative treatments available for relief of hot flushes and other menopausal discomforts.

Effect of a combination of isoflavones and Actaea racemosa Linnaeus on climacteric symptoms in healthy symptomatic perimenopausal women: a 12-week randomized, placebo-controlled, double-blind study

To investigate the effects of a novel dietary supplement containing soy isoflavones and Actaea racemosa Linnaeus (formerly called Cimicifuga racemosa L.) on climacteric symptoms in healthy perimenopausal women. In a multicenter, randomized, placebo-controlled, double-blind study, 124 women experiencing at least five vasomotor symptoms every 24 hours were randomized to receive daily either a phytoestrogen-containing supplement (n = 60) or placebo (n = 64) for 12 weeks. The modified Kupperman Index and Greene Climacteric Scale, a visual analogue scale designed to measure quality of life and the daily number and severity of hot flushes, was used in the screening period and in weeks 6 and 12. Changes in these scores from baseline were calculated. At weeks 6 and 12, all scores in both groups had improved compared with baseline, though the overall difference in scores between the groups was not statistically significant. The supplement containing soy isoflavones and A racemosa L. had no statistically significant effect on climacteric symptoms in perimenopausal women experiencing at least five vasomotor symptoms per day.

Comparison of therapeutic effects between ear point seed-embedding method and acupuncture in the treatment of female menopause syndrome

To observe and compare the therapeutic effects of treating female menopausal syndrome with auricular-point-pressing therapy and acupuncture, 86 patients were randomly divided into auricular-point pressing group and acupuncture group, the comparative observation was conducted according to a modified Kupperman index. Statistical analysis showed that there's no significant difference between the therapeutic effects of the two groups. Auricular-point-pressing therapy and acupuncture were both effective in treating female menopausal syndrome, while auricular-point-pressing had the advantages of easy operation and acceptance.

Effects of breastfeeding on hypoestrogenic symptoms in postpartum women

Objective: To assess the frequency and severity of hypoestrogenic symptoms in lactating and nonlactating women during the postpartum period.Study design: Women were recruited in the immediate postpartum period and evaluated during the immediate postpartum period, at 3 weeks postpartum and at 6 weeks postpartum, using self-ranked symptoms questionnaires. Hypoestrogenic symptoms were assessed using a modified Kupperman index, a menopausal symptoms questionnaire. Mood changes were evaluated using the Stein Survey, a postpartum mood changes questionnaire.Results: Of 233 women recruited, 74% intended to breastfeed. The frequency and severity of most hypoestrogenic symptoms, including hot flashes, were low for both groups. However, at the 3- and 6-week postpartum evaluations, breastfeeding women were more likely to report vaginal dryness than those who did not breastfeed (17% versus 2% at 6 weeks,P <0.05).Conclusions: The isolated finding of increased reported vaginal dryness among breastfeeding women may suggest that lower estrogen levels are clinically evident in these women, but not to the extent that hot flashes would be prevalent.

Low-dose esterified estrogens (0.3 mg/day): long-term and short-term effects on menopausal symptoms and quality of life in postmenopausal women

Objective To study the impact of low-dose unopposed esterified estrogens on menopausal symptoms and quality of life.Methods In a long-term, 2-year, randomized, double-blind, placebo-controlled study, 204 postmenopausal women were treated with esterified estrogens 0.3 mg daily or placebo. Menopausal symptoms were assessed with a modified Kupperman index at baseline, 3, 6 and thereafter every 6 months. In a second 12-week, open-label, short-term pilot study, 25 postmenopausal women with moderate to severe vasomotor symptoms were treated with esterified estrogens 0.3 mg daily for 12 weeks. Vasomotor symptoms and quality of life were assessed using the Greene scale and Quality of Life Menopause Scale (QUALMS).Results In the long-term study, significant (p < 0.05) reductions in total symptom scores were observed at each time point with esterified estrogens compared with placebo. Somatic symptom scores (hot flushes, night sweats, vaginal dryness) decreased significantly (p < 0.01) in patients treated with esterified estrogens 0.3 mg compared to baseline and placebo. In the short-term, open-label pilot study, the incidence of vasomotor symptoms was significantly (p < 0.01) reduced with esterified estrogens 0.3 mg from week 4 until the study end. Significant (p < 0.05) improvements versus baseline were seen in the somatic and vasomotor/sleep domains and in the total quality-of-life score.Conclusions Esterified estrogens 0.3 mg given daily provide adequate menopausal symptom relief and improved quality of life in postmenopausal women.

Members of the House of Delegates, 1922

To evaluate the sleep quality and its related factors among perimenopausal women.A self-designed questionnaire was administered to 506 perimenopausai women. The questionnaire included the influencing factors on the sleep quality, the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scales (SDS), the Zung Self-Rating Anxiety (SAS) and the Modified Kupperman Index (KI). Data were analyzed by SPSSll.5.The mean PSQI was 5.97±4.30. Twenty-four percent of perimenopausal women reported poor sleep. Age and perimenopausal symptoms were significantly correlated with sleep quality. The sleep quality of the 45∼49 age group was the poorest and the 40∼44 age group was the best. The women who had higher Kupperman index were more likely to be poor sleepers. There was no significant correlation between occupation and sleep quality. Night sweat, depression, anxiety, hot flash, stressful life event, and regular exercise were significantly and independently related with sleep quality. Among them, regular exercise was a protective factor of sleep quality.High incidence of poor sleep quality exists among perimenopausal women. Some effective interventions should be taken to improve the sleep quality of perimenopausal women.