Ovarian Follicular Activity Research Articles

A Spotlight on Menopause in Africa

Background: Menopause is a retrospective diagnosis defined by the World Health Organization as thepermanent cessation of menstruation resulting from the loss of ovarian follicular activity. With morewomen living longer, all those above the age of 50 years will experience menopause, with a smallernumber experiencing this before 40 – 49 years without their knowledge. Menopause contributes tosignificant public health conditions, such as cardiovascular, bone, cognitive, and mental healthconditions. The Menopause Rating Scale (MRS) is an internationally validated tool for measuring theseverity of menopausal symptoms. The WHO notes a challenge in awareness and access tomenopause-related information and treatment for women and health care providers in most countries.Little is known about the experience of menopause in African women, and the MRS scale has limited usein the Kenyan setting, presenting gaps in research and practice.Objectives: To raise awareness of menopause and test the usability and local context of MRS in theassessment of menopausal symptoms in African women.Methods: 304 of 403 attendees on an urban community health education day voluntarily completed asurvey adapted from the MRS.Results: While 80% of women globally report hot flushes as the commonest symptom, only 41% ofwomen over 50 years if age had hot flushes. The most common symptoms were musculoskeletal painand mood swings at 74.1% and 45.8%, respectively.Conclusion: Work is needed to streamline the use and adaptability of the MRS for Swahili-speakingcountries. More community health awareness, research, and advocacy are needed to address thepublic health concerns arising from menopause in Africa.

Correlation of anthropometric determinants, body fat distribution, and pulmonary function in postmenopausal women – An observational study

Abstract: BACKGROUND: Menopause is the permanent cessation of menstruation resulting from loss of ovarian follicular activity. This induces a reduction in resting metabolic rate, physical activity, and fat-free mass. Buildup of adipose tissues in the anterior abdominal wall and in the intra-abdominal visceral tissue hinders diaphragmatic movement and diminishes basal lung expansion during inspiration causes ventilation–perfusion abnormalities. Very few evidence of the correlation between body fat distribution and pulmonary function in menopausal women. AIM: The aim of this study was to evaluate the association between anthropometry determinants, body fat distribution, and pulmonary function in postmenopausal women. SETTING AND DESIGN: After ethical committee approval, an observational study of 101 postmenopausal women fulfilling the criteria were selected from the tertiary care center. METHODOLOGY: Anthropometric measurements of participants such as height, weight, body mass index, waist circumference, and waist-to-hip ratio (WHR) were measured. Body fat distribution is evaluated by measuring skinfold at five sites (biceps, triceps, abdominal, suprailiac, and subscapular) with the help of Lange caliper. Pulmonary function (forced expiratory volume in 1st second [FEV1], forced vital capacity [FVC], FEV1/FVC, and peak expiratory flow rate) recorded on a computerized portable lung function unit. STATISTICAL ANALYSIS: As the data were not in normal distribution, Spearmen’s correlation test was used. RESULTS: It showed that strong negative correlation existed between age and FVC (r = −0.742) and WHR and FEV1/FVC (r = −0.796). Furthermore, moderate negative correlation was found between biceps and FEV1 and FVC (r = −0.433 and r = −0.475), respectively, and abdominal skinfold and FEV1 and FVC (r = −0.628, r = −0.646) (P < 0.05). CONCLUSION/CLINICAL IMPLICATION: It could be concluded that in postmenopausal women, there may be a negative correlation between anthropometry, body fat distribution, and pulmonary function.

Primary ovarian insufficiency: a toolkit for the busy clinician.

Primary ovarian insufficiency (sometimes known as premature ovarian insufficiency) is a result of loss of ovarian follicular activity before the age of 40 years. It is an endocrine deficiency state in women, characterized by premature estrogen deprivation. In the absence of estrogen replacement, women experience bothersome menopause symptoms and a predisposition to accelerated aging and multimorbidity accumulation. Unless a true contraindication exists, estrogen therapy is recommended at least until the age of natural menopause. This Practice Pearl summarizes the clinical manifestations, diagnostic evaluation, and management of primary ovarian insufficiency.

CLINICO-ANATOMICAL ASEPCTS OF AARTAVA AAGNEYATVYA WITH REFERENCE TO POST MENOPAUSAL SYMPTOMS

Menopause means permanent cessation of menstruation at the end of reproductive life due to the loss of ovarian follicular activity. Due to increased life expectancy about 1/3rd of life span of the female will be spent during the period of estrogen deprivation stage with long term symptomatic and metabolic complications.
 According to Ayurveda menstruation starts from 12 years of the age and ends at the age of 45 years and structure is termed as Aartava. This Aartava is Agni Guna Dominant. In this article focus is on various Clinico-anatomical aspects of Post Menopausal Symptoms with respect to Aagneyatvya of Aartava
 Keywords:-
 Aartava, Agni, Menopause.

ASSESSMENT OF PSYCHOLOGICAL PROBLEMS AND COPING STRATEGIES OF PERI-MENOPAUSAL WOMEN IN SELECTED DISTRICT OF WEST BENGAL

Peri-menopause is natural event where ovarian follicular activity is reduced, for this reason women are prone to develop various physical and psychological symptoms. A descriptive study was conducted to detect psychological problems and coping strategies among peri- menopausal women in selected district of West Bengal. 200 participants were selected through non- probability purposive sampling technique to assess psychological problems and coping strategies among them and to find out the association between identified psychological problems and coping strategies with selected demographic variables. Conceptual framework of this study was based on Lazarus & Folkman’s Transactional Model of stress and coping. Semi-structured questionnaire, DASS 21 Questionnaire and Brief COPE Inventory were used to collect data. Result revealed that 63.5% peri- menopausal women had no depression, 2% had extremely severe depression. 71% had no anxiety; 55.5% had no stress and 10% had severe stress. Most of the peri- menopausal women (57.5 %) adopted moderate coping strategies. Chi-square test revealed that there was significant association between depression and educational status (p< 0.05). Coping strategies were also significantly associated with their monthly family income (p<0.05).

Focused nutrition during oestrus synchronization in Pelibuey ewes with different body conditions

The aim of this study was to evaluate ovarian follicular activity, ovulation percentage, and body weight change in response to focused nutrition during synchronization of oestrus with an intravaginal device (CIDR®) (9 days) in Pelibuey ewes with high and low body condition. Seventy-two non-pregnant ewes without offspring were randomly distributed to one of four treatments, namely T1: (n = 18) ewes without focused nutrition and low body condition; T2: (n = 18) ewes without focused nutrition and high body condition; T3: (n = 18) ewes with focused nutrition and low body condition; and T4: (n = 18) ewes with focused nutrition and high body condition. While the CIDR device was in place, the ewes with focused nutrition received a supplement of 1.5 kg ewe/day, which contained 2.9 MCal metabolizable energy, 16% crude protein, 88.5% dry matter, 11.8% crude fibre, and 6.7% of ash. The concentration of progesterone (P4) was measured to determine ovulation percentage. The follicular population was quantified (2–3 mm, 4–5 mm, and >6 mm in diameter). The number of follicles between 2–3 mm and 4–5 mm in diameter was similar among treatments. The number of follicles >6 mm in diameter was higher in T4 ewes (2.2 ± 0.2) compared with T1, T2, and T3. The response to oestrus, the onset of oestrus, and the ovulation percentage were similar among treatments. Focused nutrition increased the number of ovarian follicles >6 mm in diameter in ewes with high body condition.

Effect of Stress on Ovarian Follicular Activity in Postpartum Sahiwal Cows during Hot-humid Season

Present investigation was carried out to study the effect of stress on ovarian follicular activity in postpartum acyclic Sahiwal cows during hot-humid months. Postpartum ovarian activity was monitored using trans-rectal ultrasound scanning on alternate days beginning between day 60 and 90 postpartum in Sahiwal cows (n=16) up to next 21 days.Daily maximum temperature and relative humidity was recorded andtemperature-humidity index (THI)was calculated during study period. Six animals (37.5 %) showed presence of dominant follicle (≥10 mm, cyclic) and 10 animals (62.5 %) were classified as acyclic (ovarian follicle < 10 mm diameter). Present study demonstrated that as the value of THI reduced, the mean follicular diameter proportionately increased and vice versa. Based on the findings of present study, it may be concluded that development of ovarian follicle is highly affected by THI value during hot-humid season in Sahiwal cows and the reproductive performance of animal may be predicted using THI values.

Comparison of Gonadal Toxicity of Single-Fraction Ultra-High Dose Rate and Conventional Radiation in Mice

PurposeIncreasing evidence suggests that ultra-high-dose-rate (UHDR) radiation could result in similar tumor control as conventional (CONV) radiation therapy (RT) while reducing toxicity to surrounding healthy tissues. Considering that radiation toxicity to gonadal tissues can cause hormone disturbances and infertility in young patients with cancer, the purpose of this study was to assess the possible role of UHDR-RT in reducing toxicity to healthy gonads in mice compared with CONV-RT. Methods and MaterialsRadiation was delivered to the abdomen or pelvis of female (8 or 16 Gy) and male (5 Gy) C57BL/6J mice, respectively, at conventional (∼0.4 Gy/s) or ultrahigh (>100 Gy/s) dose rates using an IntraOp Mobetron linear accelerator. Organ weights along with histopathology and immunostaining of irradiated gonads were used to compare toxicity between radiation modalities. ResultsCONV-RT and UHDR-RT induced a similar decrease in uterine weights at both studied doses (∼50% of controls), which indicated similarly reduced ovarian follicular activity. Histologically, ovaries of CONV- and UHDR-irradiated mice exhibited a comparable lack of follicles. Weights of CONV- and UHDR-irradiated testes were reduced to ∼30% of controls, and the percentage of degenerate seminiferous tubules was also similar between radiation modalities (∼80% above controls). Pairwise comparisons of all quantitative data indicated statistical significance between irradiated (CONV or UHDR) and control groups (from P ≤ .01 to P ≤ .0001) but not between radiation modalities. ConclusionsThe data presented here suggest that the short-term effects of UHDR-RT on the mouse gonads are comparable to those of CONV-RT.

Early Menopause: Reproductive Adaptation of Javanese Women in Oransbari Distric West Papua

Menopause is the permanent cessation of menstruation due to loss of ovarian follicular activity. Assessment of the age of menopause is particularly important because previous studies have shown a high risk of osteoporosis, hypertension, stroke, and coronary heart disease. This study aims to determine the risk factors for early menopause in Javanese women in Oransbari District, West Papua Province. The cross-sectional sampling method was carried out on women aged 51.73 years with an interval of 40.07-78.58 years. Age at menopause was calculated using the Probit Generalized Linear Model (GLM) analysis. We used a binary logit regression (BLR) model to estimate risk factors for early menopause. BLR analysis was fitted to estimate the odds ratio (OR) and 95% confidence interval (CI). Age at menopause is divided into two categories, normal (≥45 years) and early (<45 years). Our results show that the average age of menopause is 43.1 years, or the early menopause category, with an age range of 39.61 to 55.28 years. The results of the partial parameter significance test at the 10% significance level showed that no formal education (OR: 2.348; CI 1.4213.917) had the most significant risk factor for experiencing early menopause, followed by parity (OR: 0.623; CI: 0.377-1.023), contraception (OR: 0.118; CI: 0.038-0.296), and the lowest risk was the age at first delivery (OR: 0.389; CI: 0.207-0.716). The biocultural conditions experienced early in life in Oransbari shape the character of a younger reproductive age as an adaptive response to maximize fitness.

Knowledge, Attitude, Symptoms, and Management Practices among Middle-aged Menopausal Women: A Cross-sectional Study

Introduction: Menopause is defined as the permanent cessation of menstrual periods following the loss of ovarian follicular activity. It typically occurs between the ages of 45 and 55. Almost all women experience this phase and undergo various symptoms. However, menopause and its symptoms are often perceived as a normal phenomenon by women. Therefore, it is necessary to educate women about the complications of menopause and strategies to cope with them. Aim: To assess knowledge and attitude on menopause and management practices of menopausal symptoms among women aged 40-55 years. Materials and Methods: A cross-sectional observational study was conducted for seven months, from June 11, 2019, to December 31, 2019, among 196 naturally menopausal women aged between 40 and 55 years residing in Ashok Nagar, Belagavi, Karnataka, India. Data were collected using a pretested questionnaire that included information on sociodemographic profiles, Knowledge, Attitudes, and Practices (KAP) towards menopause. Descriptive statistics were used to analyse the data using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Of the study participants, 109 (55.6%) were found to have average knowledge regarding menopause, 176 (89.8%) had a neutral attitude towards menopause, and approximately 173 (88.3%) had average practices towards managing menopausal symptoms. Conclusion: The study participants exhibited average knowledge and neutral attitudes towards menopause. Their management practices for menopausal symptoms were also found to be average. There is an urgent need to raise awareness among women regarding knowledge about menopause.

A Comparative Clinical Study of Shatavaryadi and Guduchyadi Churna on Rajonivrutti Avastha with special reference to Postmenopausal Syndrome

The menopause is permanent cessation of menstruation at the end of reproductive life due to loss of ovarian follicular activity. Shatavaryadi Churna and Guduchyadi Churna– both drugs are 6grams twice daily before meal with milk for 2 months in two groups has been given. Both are effective in the management of Postmenopausal Syndrome. Shatavaryadi Churna is more effective than Guduchyadi Churna in the management of Postmenopausal Syndrome but both are an effective, safe, promising and cost effective remedy. Vata-Pittashamaka, Rasayana, Dhatuvardhaka, Agnidipaka, Pachana, Medhya, Vedanasthapana, Hridya, Anidranash drug in Shatavaryadi Churna helped to deliver such promising results. Guduchyadi Churna had also delivered satisfactory results treating in Postmenopausal Syndrome due toits Tridoshahara & Vata-Kaphashamaka activity along with Rasayana, Dipana, Pachana, Dhatuvardhaka, Balya, Hridya, Nidrajanana, Medhya and Vedanasthapana properties. The age at menopause appears to be genetically determined and is unaffected by race, socioeconomic status, age at menarche, or number of prior ovulations. Factors that are toxic to the ovary often result in an earlier age of menopause; for e.g., who smoke experience an earlier menopause. Women who have had surgery on their ovaries, have had a hysterectomy, despite retention of their ovaries, may also experience early menopause

Thermal Stress Influence and Seasonal Pattern of Ovarian Follicular Growth Assessed through Ultrasonography in Sunandhini Cows under A Humid Tropical Climate

The impact of thermal stress (TS) on reproductive processes starts early and persists more extended than the influence on other physiological manifestations. Since the cyclical reproductive activity begins with the growth of ovarian follicles, the present study focused on the effect of TS and its seasonal variations on the growth of ovarian follicles in ‘Sunandhini’ cows reared under the tropical climate. The year-round study was performed on 60 postpartum cows between days 28 to 91, involving eight cows at a time. The cows were replaced sequentially so that the study animals were of almost similar postpartum period throughout the year and formed a continuously changing study group. The ovarian follicular activity of each cow was monitored (nine to ten times) at weekly intervals using B mode ultrasonography. Serum samples collected during the scanning were subjected to ELISA for heat shock protein (HSP) 70 and Cortisol. A comparison of the follicle types, stress indicators, and weather parameters to assess their correlations and seasonal pattern using SPSS software. The maximum temperature of the locality was around 33ºC without significant variation between seasons. Further, the extended rainy season caused moderate to high (66 to 85 %) relative humidity (RH), contributing to a temperature-humidity index (THI) exceeding 78 and putting the animals under moderate to severe TS throughout the year. HSP 70 level showed significant (P<0.001) elevation during summer (6.24 ng/mL), associated with high THI (r=0.701, P<0.001), while serum cortisol had no significant correlation with weather parameters. Only large follicles (9-14 mm) manifested the influence of TS as an increase in number (P<0.05) and size (P<0.01) together with a positive correlation (P<0.01) of HSP 70 and THI. It is inferred that TS causes stagnation of the large follicles from attaining the largest size and functional capability for ovulation. In contrast, other follicle types are unaffected even under moderate to severe TS.

The effect of probiotics on mood and sleep quality in postmenopausal women: A triple-blind randomized controlled trial.

Symptoms associated with menopause could be a public health issue in the world, characterized by a permanent cessation of menstruation due to lack of ovarian follicular activity 12 months after menopause. It leads to mood swings, sleep disturbances and hot flashes. Modification of lifestyle and proper nutrition program are involved in improving mood and sleep quality. Thus, the aim of present study was to evaluate the effect of probiotics on mood and sleep quality (primary outcomes), quality of life, satisfaction with the intervention and side effects (secondary outcomes) in postmenopausal women. This triple-blind randomized controlled trial was conducted on 66 postmenopausal women aged 45-55 years in Behbahan city-Iran in 2020-2021. Women were randomly assigned to the intervention and control groups. Intervention group received 100g of yogurt containing probiotics and control group received 100g of ordinary yogurt daily after lunch for 6 weeks. Before the intervention and 6 weeks after the intervention, the participants completed the Pittsburgh sleep quality scale, DASS-21 (Depression, Anxiety, and Stress Scale-21 items), and the menopause quality of life (MENQOL) questionnaire. Independent t-test, Mann-Whitney U and ANCOVA tests were used for data analysis. There was no statistically significant difference between the two groups in terms of socio-demographic characteristics and baseline values. Six weeks after the intervention, based on ANCOVA test and by adjusting the baseline score, the mean anxiety score (adjusted mean difference (AMD): -0.56, 95% confidence interval (95% CI): -0.01 to -1.12; P=0.044), mean stress score (AMD: -0.76, 95% CI: -0.01 to -1.52; P=0.046) and mean quality of life score (AMD: -4.86, 95% CI: 3.06 to -6.66; P<0.001) in the group receiving probiotic yogurt were significantly lower than those in the control group. However, in terms of mean scores of depression and sleep quality, there was no statistically significant difference between the two groups. The results of this study suggest the effects of consuming probiotic yogurt on improving anxiety, stress and quality of life in postmenopausal women. However, further studies are needed to obtain a definite conclusion in this regard. Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N57; Date of registration: 30/06/2020. URL: https://en.irct.ir/user/trial/47177/view; Date of first registration: 21/07/2020.

The effect of self instruction module on knowledge and attitude regarding premenopausal symptoms of women between the age 34-45 Years

Menopause is a normal occurrence in the life of every woman. It is the period in woman’s life when reproductive functions cease. “Menopause means permanent cessation of menstruation attend of reproductive life due to loss of ovarian follicular activity”. The clinical diagnosis is confirm following stoppage of menses for six consecutive month. Even though samples had heard and received information on menopause through various sources their level of knowledge was not adequate. All the women felt that information provided in the booklet was beneficial and practical use for them. The study will be help to reveal the existing knowledge of the women regarding premenopausal symptoms.Research Design - Pre-experimental one-group pre-test post-test research design , Research Setting- The physical location and conditions in which the data collection takes place in a study is the setting. Settings are the more specific places. The settings for the present study area were: Mayur Hospital and Research Centre Indore &amp; Life Line Hospital Indore The Sample- In this study the samples were 60 premenopausal women of selected hospitals of Indore, who fulfilled the inclusion criteria. Data shows, 21 (35.0%) of the subjects has poor knowledge score, 37 (61.7%) of the subjects belongs to average knowledge and 2 (3.3%) of the subjects has good knowledge. that attitude of premenopausal women in pre-test was, 514 (42.8%) were disagree, 393 (21.8%) were agree, 212(35.3%) were strongly agree. But after post-test 954 (53%) of women were strongly agree, 404 (33.67%) were agree and 80(13.3%) were disagree. knowledge level in premenopausal women was 10.45 and mean score of post-test was 16.33. Mean difference in between pre-test and post-test knowledge was 0.69 and SD was 4.85 for pre-test and for post-test was 1.67. Computed ‘t’ value (t = 8.59) and ‘p’ value (p = 0.55) shows that there was significant difference between pre-test and post-test score at the level of p&amp;#60;0.05. The main aim of this pre-experimental study was to assess the knowledge and attitude of premenopausal women. 60 samples were selected by purposive sampling technique, women to change their knowledge and attitude.Thus the intervention SIM that is found to Increase knowledge.

To Develop and Implementation of Community Based Educational Intervention on Knowledge, Attitude, Stress and Coping Among Postmenopausal Women

Menopause is a permanent halt of menstrual bleeding caused by the reduction of ovarian follicular activity in a woman's body.Perimenopause, or the transition to menopause, is a period of time that starts with irregular menstrual periods and concludes with prior menstruation Vasomotor symptoms, physical symptoms, psychological symptoms, and sexual symptoms.The aim of the study is to develop and implement Community Based Educational Intervention on Knowledge, Attitude, Stress and Coping among Postmenopausal women.Quantitative evaluation approach, true experimental research design of pre and post-testing with a control group will be for the present study. The target population of the present study will be postmenopausal women who met the inclusion criteria.In the proposed research investigator planned to develop community-based educational package on care of women after menopause. It is obvious that after menopause, women must face a great deal of stress because of physical, psychological, and emotional changes.

Neuroendocrine Changes during Menopausal Transition

Menopause is the permanent cessation of menstrual cycles following the loss of ovarian follicular activity. Quality of life of postmenopausal woman is the result of a series of psychobiological transformations, that see in the reduction of sex hormones and steroids the etiopathogenetic determinant moment. Symptoms of menopause range from somatic side such as metabolic changes, increased cardiovascular disease, irregular vaginal bleeding, urogenital symptoms, vaginal dryness, osteoporosis and risk of bones fractures to changes of central nervous system as vasomotor symptoms, sleep disruption, mood changes, migraine, sexual dysfunctions. It is fundamental to know the mechanisms underlying changes in the central nervous system during menopause, related to hypoestrogenism, to be able to create appropriate target therapy for patients, improving their quality of life. In fact, the central nervous system is now one of the major targets of sex steroids that cannot be achieved disregard when dealing with the problem of choice of a particular type of MHT.

Perimenopausal Stress Reactions: A Qualitative Study on the Awareness of Spouses

Menopause is the complete cessation of the mentstrual cycle, which is caused by loss in the ovarian follicular activity. Women reach their non-reproductive years when they reach menopause. But the journey towards it is not that easy as it sounds. The transition period may take less or long time depending on individuals.The menopausal transition can be a period of stress, even lead to trauma if left unnoticed or unsupported. The menopausal transition period is called the perimenopausal period. Perimenopause is considered to be the period (3-8 years) before and after the final menstrual cycle. It is a phase in a woman's life that needs immense support and care from the spouse. But still, researchers are skeptical about the information men have regarding the period. Even though many studies highlight the physiological changes that happen during the perimenopausal or menopausal transition period, there is still a lack in the number of studies that emphasize the psychological difficulties women face in the perimenopausal period. Emotional support from the husband is of significance amid many such difficulties. For assisting, the spouse should be completely aware of what his wife is going through. The significance of the study lies here, as it focuses on the awareness of the spouses about the perimenopausal period. The study intends to investigate the level of awareness men have about the perimenopausal period.The study also attempts to find out how the spouses perceive themselves to have supported their wives during the perimenopausal period. The study followed a qualitative approach in data collection and analysis. The data was collected using a semi-structured interview. 34 men (spouses of perimenopausal women) from Thiruvananthapuram, Ernakulam, and Thrissur districts of Kerala, India were selected using purposive sampling. The method of thematic analysis was used to analyze the data. For the analysis, the software NVivo was used. The final themes extracted were, unawareness, attitude, regret, and techniques to be adopted. The results revealed the unawareness majority of the participants had about the phase and throws light on the need to create awareness among men to help women cope better with the phase. Participants also reported the reasons they felt which led to this level of unawareness and how they felt there is a need to adopt many techniques which may help their wives cope better with the phase. The major reasons, the partcipants noted as reasons for their unawareness were, lack of information from the family, lack of communication from their spouses, which led to major confusions in them. From the results it could be understood that there is high level of unawareness among the participants regarding the perimenopausal period. There is a need to create awareness among men to understand the phase better to help their spouses cope better with the perimenopausal period.

A Cross-Sectional Study to Determine Effect of Menopause on Quality of Life and Pain in Women Aged 40-60 Years

Background: Menopause means the permanent cessation of menstruation at the end of reproductive life dueto loss of ovarian follicular activity. Menopause has a profound impact on a woman’s physical and mentalhealth as a whole. Quality of life and pain are measured to study and compare the effect of menopause onthem.Objective: The aim of this study was to compare quality of life and pain among pre-, peri- and postmenopausalwomen and find the effect of menopause on the above-mentioned factors.Methodology: This cross-sectional study included 258 women between the age group of 40-60 years whowere classified according to their menstrual status into premenopause, perimenopause and postmenopause.They were selected on the basis of inclusion and exclusion criteria. All the participants agreed to participatein the study. Outcome measures SF-20, VAS was measured. Statistical analysis of the data was performedusing SPSS version 20 through application of descriptive statistics, t-test and multivariate analysis.Result: The data measure of outcome variables of the premenopausal, perimenopausal and postmenopausalgroups was compared using descriptive statistics, multivariate analysis and t-test. The components of SF-20which were significantly reduced for postmenopausal women as compared to premenopausal were physicalfunctioning (p=0.000), role functioning (p= &lt;0.00001), social functioning (p= &lt;0.00001), mental health (p=0.0000), health perception (&lt;0.00001). The component of pain was significantly increased (p = 0.0158) inpostmenopausal women compared to premenopausal women.Conclusion: Thus, we can conclude there is significant deterioration in components of quality of life andpain in postmenopausal women as compared to premenopausal women even after controlling for age. Thesefindings will help to add valuable input to current research on menopause.

English

BACKGROUND Universally every woman faces menopause and feeling of onset of uncomfortable physical, psychological and emotional changes. Many fear about their loss of beauty and sexual life. The word menopause has come from Greek word “Menos” meaning menstruation and “Pause” meaning stopping of the menstrual period. 1 The loss of ovarian follicular activity or the dwindling function of ovaries at the end of reproductive life which leads to permanent cessation of menstruation is known as menopause or climacteric. The period of time when women passes from reproductive to non–reproductive stage is menopause transition. The life after menopause is the stage of postmenopausal period. In majority of women, menopause occurs without any physical or psychological symptoms. But in some of the women there will be marked physical and psychological symptoms. Symptoms of the climacteric are multiple and vague. These climacteric symptoms are due to decrease in oestrogen level and increase in Gonadotrophin level in the body, but the exact mechanism is unknown. The climacteric symptoms are grouped into vasomotor symptoms (hot flushes, night sweats), cardiovascular symptoms and cerebro-vascular effects (hypertension, palpitation, heart disease), neurological &amp; psychological symptoms (anxiety, depression, insomnia, irritability, malaise, loss of libido / lethargy), general symptoms (fatigue, headache, general weakness, vertigo, breast tenderness, skin pigmentation, dyspareunia, indigestion or constipation, obesity), physical symptoms / changes (atrophy of secondary sexual characters, atrophy of internal genital organs, osteoporosis, skin becomes thick and coarse, straggling growth of hair).2 KEY WORDS Flax Seed, Climacteric Symptoms, Menopause

Hormone replacement therapy: update and practical prescribing

Peri-menopause and menopause are a normal part of ageing. Nikki Noble gives an overview of hormone replacement therapy and practical prescribing tips Menopause is a physiological event of ovarian failure due to a loss of ovarian follicular activity. This leads to a lack of oestrogen, resulting in the cessation of menstruation and loss of reproductive function. This article discusses the symptoms of menopause and treatment with hormone replacement therapy. This includes practical prescribing, side effects and long-term benefits and risks. The current shortages of hormone replacement therapy are also addressed. The aim of this article is to enable health professionals to define menopause and gain an understanding of the symptoms associated with it. After reading this article you should be able to: describe when peri-menopause and menopause occur, describe the common symptoms that may be experienced during peri-menopause and menopause, understand of the hormones used in hormone replacement therapy, and understand the practical prescribing of hormone replacement therapy and the benefits, risks, contraindications and side-effects.