Postmenopausal Symptoms Research Articles

The need for biopsychosocial menopause care: a narrative review.

Menopause is a reproductive transition affecting half the world's population. Stigma and limited availability of evidence-based treatments that support biopsychosocial well-being mean that this life stage is often associated with challenging symptoms and reduced quality of life (QoL). The aim of this review was to examine the extent literature on psychological and mind-body interventions to manage perimenopausal and postmenopausal symptoms, and apply an interdisciplinary clinical, research, and cultural knowledge framework to guide recommendations for improving QoL and healthy aging in this population. We also aimed to understand the ideal delivery mode for such interventions. Using Scopus, Medline, and PubMed, a review of systematic reviews, guidelines, and randomized controlled trials was undertaken to examine the use of psychological and mind-body interventions to improve menopause-related QoL and symptoms, including hot flushes, depression, anxiety, fatigue, pain, and sleep; conclusions were based on an analysis of this available evidence and linked to clinical and cultural considerations. Empirical support exists for a number of psychological and mind-body approaches to support QoL and symptoms during the menopause transition. The literature also identifies the need for menopause care that is culturally responsive.An online multimodal model of menopause care is thus recommended, incorporating evidence-based treatments (eg, cognitive behavioral therapy, yoga, hypnosis) and treatment techniques (eg, mindfulness, and education including nutrition support), as well as First Nations wisdom. We also recommend financial well-being approaches to support people undergoing menopause. Integrated, multimodal approaches should be available online to remove time, location, and healthcare access barriers, and be designed with diverse consumers to ensure equity for those underserved due to region, LGBTIQ+ assigned female at birth status, and for multicultural and First Nations people.

Administration of Young Coconut (Cocos nucifera L.) Juice Ameliorates Memory Impairment in a Menopausal Rat Model.

In Southeast Asia, the traditional use of young coconut (Cocos nucifera L.) juice (YCJ) by women to alleviate postmenopausal symptoms suggests potential estrogenic properties. However, few studies explore the impact of YCJ on pathologies associated with estrogen deficiency in postmenopausal animal models. This study examines the impact of YCJ supplementation on memory impairment and depression-like behavior in ovariectomized (Ovx) rats. Ten-week-old female rats underwent either a sham operation (Sham) or bilateral Ovx. The rats in the Ovx + YCJ group received 5×-concentrated YCJ by gavage at a dose of 15 mL/kg body weight. Twelve weeks later, the Morris water maze and forced swim tests were used to evaluate hippocampus-dependent spatial memory and depression-like behavior, respectively. The Ovx rats displayed significant memory impairment (p < 0.05) and depression-like behaviors (p < 0.05), while the memory performance in the rats in the Ovx + YCJ group resembled that of the Sham rats. However, the administration of YCJ did not result in the improvement of depression-like behavior. These findings suggest that YCJ consumption may help ameliorate memory impairment in postmenopausal women.

Styphnolobium japonicum Fruit and Germinated Soybean Embryo Complex Extract for Postmenopausal-Symptom Relief.

Hormonal alterations during menopause result in substantial physiological changes. Although hormone replacement therapy (HRT) is widely used as a treatment strategy for these changes, its use remains controversial due to its associated risks. Plant isoflavones are phytoestrogens that are considered a potential alternative therapy for postmenopausal syndrome. We aimed to investigate the efficacy of ethanolic extracts from Styphnolobium japonicum fruit (SJF) and germinated soybean embryo (GSE) in alleviating prominent menopausal symptoms. A cell model (MCF7 human breast cancer cells) was used to investigate estrogen-like activity. A rat ovariectomy model was used to simulate estrogen depletion after menopause and to evaluate the efficacy of the SJF-GSE complex extract at ratios of 1:1, 1:2, and 2:1. Treatment with the SJF-GSE extract elicited estrogen-like effects, raising pS2 and estrogen receptor α expression in MCF7 cells. The extract was found to contain 48-72 mg/g sophoricoside and 8-12 mg/g soyasaponin 1, identified as active compounds. In ovariectomized rats, the extract effectively reduced body weight and fat content, alleviated vasomotor symptoms, improved vaginal mucosal health, and exerted osteoprotective effects by enhancing bone density and structure, reducing bone-resorption markers and positively altering estradiol levels and lipid profiles. The SJF-GSE extract, working synergistically, provides a safe and effective alternative to HRT for managing postmenopausal symptoms and enhancing bone health, without adverse effects. These findings support the inclusion of SJF and GSE in health-functional foods and underscore the importance of further research into plant-based therapies for menopause.

A cross sectional study to estimate the health care needs of perimenopausal and postmenopausal women

Perimenopause is the period when a woman moves from the reproductive phase to non-reproductive. Postmenopause is a complete cessation of menstrual cycles for 12 months or more. Menopausal symptoms may affect their health and quality of life. To estimate the health care needs of perimenopausal and postmenopausal women. It is a cross-sectional study of one hundred women. Participants of the age group 40-70 years were recruited by using consecutive sampling technique. Data was collected by interviewing participants as per a pretested, and validated questionnaire. Apart from the information profile, data was collected regarding the reproductive profile; Obstetrics history; prevalence of perimenopausal and postmenopausal symptoms; and sources used to acquire information about menopause. The mean age of participants was 53.04 ± 7.35 years. Mean age of attaining menopause was 46.88 ± 4.93 years. Majority of the participants (96%) were vegetarian, half (50%) were overweight as per their BMI. More than half (56%) of the participants reported never doing exercises. The commonly prevalent menopausal symptoms were hot flushes (88%), more tired than usual (86%), joint pains (82%), depressed mood (78%), facing difficulty falling asleep (65%). Most of the participants (74%) rated their level of knowledge little regarding menopausal symptoms and their management. The most frequently used source of information were television/ internet (52%), and friends (47%). Participants require education, appropriate health-related information, counselling services, and availability of affordable, reliable, and accurate health care services for the management of menopausal symptoms.

Efficacy and Safety of Intravaginal Estrogen in the Treatment of Atrophic Vaginitis: A Systematic Review and Meta-Analysis.

Postmenopausal females often experience genitourinary symptoms like vulvovaginal dryness due to estrogen decline. Hormone replacement therapy is effective in alleviating vaginal atrophy and genitourinary syndrome in this population. Evaluate local estrogen's safety and effectiveness for alleviating postmenopausal vaginal symptoms, including endometrial thickness, dyspareunia, vaginal pH, and dryness. We searched Google Scholar, Cochrane Library, ClinicalTrial.Gov, PubMed, and ScienceDirect databases until July 2023. All randomized controlled trials (RCTs) linking intravaginal estrogen supplementation to vaginal atrophy or vaginitis were included. The risk of bias was evaluated with RoB 2, and publication bias was assessed using Egger and Beggs analysis. All evidence pertains to females. Eighteen studies (n = 4,723) compared estrogen with placebo. Patients using estrogen showed a significant increase in superficial cells (mean differences [MD]: 19.28; 95% confidence intervals [CI]: 13.40 to 25.16; I² = 90%; P < 0.00001) and a decrease in parabasal cells (MD: -24.85; 95% CI: -32.96 to -16.73; I² = 92%; P < 0.00001). Vaginal pH and dyspareunia significantly reduced in estrogen users (MD: -0.94; 95% CI: -1.05 to -0.84; I² = 96%) and (MD: -0.52; 95% CI: -0.63 to -0.41; I² = 99%), respectively. Estrogen did not significantly affect vaginal dryness (MD: -0.04; 95% CI: -0.18 to 0.11; I² = 88%). Adverse events like vulvovaginal pruritis, mycotic infection, and urinary tract infection were reported, but the association was insignificant (risk ratio: 0.95; 95% CI: 0.88 to 1.02; I² = 0%). Our meta-analysis of 18 RCTs suggests promising potential for intravaginal estrogen therapy in alleviating vaginal atrophy and vaginitis in postmenopausal females.

Epidemiological study of health profile and quality of life of postmenopausal women in the urban field practice area of a teaching medical institute in a metropolitan city.

Menopause is one of the most significant phases in the life of a woman which brings about various physiological changes called postmenopausal syndrome. A health programme catering to the needs of postmenopausal women is lacking in our health system. A cross-sectional study was conducted in an urban health and training centre. Sample size of 171 was taken by simple random sampling. Women of age more than or equal to 45 and having 12 months of amenorrhea were enrolled in the study after obtaining their consent. The mean age of menopause was found to be 45.31 years. In the vasomotor domain, the most common postmenopausal symptom was hot flushes (47.95%) followed by sweating (25.73%) while in the psychological domain it was seen that the most common symptom was feeling depressed down or blue (37.43%) followed by being dissatisfied with personal life, feeling anxious or nervous (36.26%) and being impatient with other people and feelings of wanting to be alone (34.50%). In physical domain, the most common symptom was ache in muscles and joints (92.98%) followed by low backache (86.55%), feeling tired or worn out (84.80%), decrease in physical strength (83.63%) and aches in the back of neck or head (81.87%). The other domain was the sexual domain in which the most common symptom was a change in sexual desire (93.57%) followed by avoiding intimacy (92.98%). It was found that the domain, most severely affecting quality of life was sexual followed by physical and psychological domain. Awareness should be created regarding the psychosocial, physical, nutritional and sexual needs of postmenopausal women.

Use of an estradiol transdermal spray in women with menopausal symptoms: a non-interventional study

Objective This study aimed to investigate the effectiveness, tolerability and application of estradiol metered-dose transdermal spray (EMDTS) in postmenopausal women during real-world use. Methods This was a prospective, non-interventional, multicenter, observational phase IV cohort study. The Menopause Rating Scale II (MRS II) was used to assess symptoms and clinical response. Safety was assessed by the occurrence of adverse events and adverse drug reactions (ADRs). Results A total of 451 postmenopausal women were enrolled at 52 gynecological practices across Germany; 383 patients were evaluated for effectiveness and 430 patients for safety. Mean age was 54.3 ± 7.4 years. In total, 228 patients (59.5%) received EMDTS monotherapy and 155 patients (40.5%) received EMDTS plus progestogens. Significant improvements (p < 0.0001) from baseline in symptom severity were recorded for all 11 items of the MRS II at 3, 6 and 12 months of treatment. At 12 months, 81.4% of patients reported improvement in hot flushes/sweating. At final visit, 73% of patients and 77% of physicians were ‘satisfied/very pleased’ with EMDTS. Most common ADRs were headache (n = 6), nausea (n = 4), dizziness (n = 4) and pruritus (n = 3). Conclusions EMDTS is an effective, well tolerated and easily applied hormone replacement therapy for women experiencing postmenopausal symptoms.

Pterocarpus soyauxii (Fabaceae) aqueous extract to prevent neuropsychiatric disorders associated with menopause by triggering ROS-dependent oxidative damage and inhibiting acetylcholinesterase, GABA-transaminase, and monoamine oxidase A: In vitro, in vivo, and in silico approaches

Pterocarpus soyauxii (PS) is traditionally used in Cameroon medicine to alleviate postmenopausal symptoms. Previous research has shown that it has tissue-selective potential and estrogen-mimetic effects on vaginal atrophy. Phytoestrogens like 7-O-acetyl formononetin, khrinone A, and 3′,5′-dimethoxy-4-stilbenol were found in its water extract by UHPLC, but there is no evidence of its effects on neurological disorders linked to post-menopause (ND-PO). The study aimed to investigate the phytochemical profile of PS aqueous extract, assess its neuroprotective potential in rats, and explore possible underlying pathways. We used colorimetric assays to study the phytochemical profile of PS extract. Effects of the extract on behavioral parameters, neuronal signaling, and integrity in an 84-day ovariectomized rat model. Molecular docking was performed to assess the ability of 7-O-acetyl formononetin, an isoflavone contained in PS, to cross the BBB and its binding affinity to the active sites of AChE, MAO-A, and GABA-T. Besides, the anti-AChE/BChE, antioxidant, and anti-inflammatory effects of PS were assessed by in vitro tests. PS aqueous extract contains polyphenols (656.58 ± 9.18 mgEAG/100gMS), flavonoids (201.25 ± 5.52 mgEQ/100gDW), and tannins (18.42 ± 1.25 mg/100gDW). It slows down anxiety, depressive disorders, cellular disorganization, and neuronal death in the hippocampus, dentate gyrus, and neocortex. In silico modeling was a powerful tool to assess the 7-O-acetylformononetin's ability to cross the BBB and strongly bind and inhibit AChE, MAO-A, and GABA-T. Thus, by combining GABAergic, cholinergic, and serotoninergic modulation, PS aqueous extract also possesses remarkable anti-AChE/BChE in vitro and induces antioxidant and anti-inflammatory potential in macrophages. Such estromimetics, antioxidant, anti-inflammatory, cholinergic, and monoaminergic modulators represent promising activities to develop neuroprotective drugs with optimal therapeutic profiles for menopausal women.

The relationship of early postmenopausal symptoms, sexual function, and serum levels of dehydroepiandrosterone with anxiety score in postmenopausal women referring to health centers of tabriz

Background. Anxiety is independently associated with severe quality of life impairment and severe postmenopausal symptoms. The aim of this study was to evaluate the relationship of early postmenopausal symptoms, sexual function, and serum levels of dehydroepiandrosterone (DHEA) with anxiety scores. Methods. In this cross-sectional descriptive correlational study, 117 eligible postmenopausal women aged 50-60 years with mild to moderate anxiety were selected using convenience sampling method. The Beck Anxiety Inventory, Green's Menopause Symptoms Scale, and Female Sexual Function Index (FSFI) were completed. Data were analyzed using Pearson and Spearman tests and linear regression model. Results. By adjusting the confounding variables, the total score of FSFI and its sub-domains had no statistically significant relationship with Beck Anxiety Inventory score (P&gt;0.05). The total score of Greene Climacteric Scale (r=0.535; P&lt;0.001) and sub-domains of anxiety (r=0.448; P&lt;0.001), depression (r=0.344; P&lt;0.001), and physical symptoms (r=0.509; P&lt;0.001), as well as the serum level of DHEA (r=-0.754; P&lt;0.001) had statistically significant relationship with Beck Anxiety Inventory score. The total score of Greene Climacteric Scale and its sub-domains, except for the sexual dimension, and DHEA level could predict anxiety score. Conclusion. The score of menopausal symptoms and its subdomains, except for the sexual domain and DHEA level, could predict the anxiety score. The findings of this study show the importance of the relationship between early menopause symptoms and serum level of dihydroepiandrosterone with anxiety score in postmenopausal women. Practical Implications. It is suggested to conduct a more comprehensive study considering a wider sample size and socio-cultural factors and barriers.

Borago Officinalis L.: A Review Oon Extraction, Phytochemical, and Pharmacological Activities.

Borago officinalis L., an annual herb belonging to the Boraginaceae family, is used in the traditional medical practices of various countries and for multiple treatments, including respiratory disorders, colds, influenza, diarrhea, cramps, inflammation, palpitation, hypertension menopause, and post-menopausal symptoms. Its pharmacological properties and biological activities - among them antioxidant, antimicrobial, anticancer, anti-inflammatory, insecticidal, antigenotoxic, and anti-obesity activity - were demonstrated in vitro and in vivo and are related to its rich content of bioactive compounds (mainly phenolic acids, flavonoids, anthocyanins, alkaloids, and terpenes) extracted from various parts of B. officinalis including leaves, flowers, seeds, and roots. This review summarizes all updated information on applied extraction processes, phytochemistry, pharmacology, and toxicity of B. officinalis.

Efficacy and Safety of Shatavari Root Extract for the Management of Menopausal Symptoms: A Double-Blind, Multicenter, Randomized Controlled Trial.

Background Menopause is a physiological state that occurs in all women and refers to the halt of the reproductive phase. The cessation of the reproductive phase occurs through various stages and presents different symptoms such as hot flashes, night sweats, insomnia, anxiety, depression, and irritability. Such pre- and post-menopausal symptoms may affect the daily activities and production capacities of women, impacting the quality of life (QoL) of women. Hormone replacement therapy (HRT) is primarily used to manage menopausal symptoms. However, various side effects have been reported related to HRT. Therefore, women are choosing alternative medicine such as Ayurveda that can benefit them with less or no adverse effects. Shatavari (Asparagus racemosus) is known in Ayurveda as an effective medicinal plant source for various women's health remedies since ancient times.This study aimed to evaluate the safety and efficacy of the Ayurvedic Shatavari formulation on menopausal symptoms compared to the placebo. Methodology This is a randomized, double-blinded, multicenter, placebo-controlled, clinical study. Altogether, 70 patients were randomized to two groups, i.e., the test group (active group) and the placebo group (microcrystalline cellulose), with 35 participants in each group. Results The study outcomes showed a positive and significant effect of the active test ingredient over the placebo in terms of reduction in hot flashes, night sweats, insomnia, anxiety, nervousness, vaginal dryness, and loss of libido. The Utian QoL improved significantly in the test group compared to the placebo group. No significant adverse events were recorded in the test group, suggesting the safety of this formulation. Conclusions The test compound could be a safe alternative to modern drugs. The findings of this study support the traditional use of Shatavari. Further clinical and pharmacological studies with longer duration and larger and more diverse sample sizes are required to understand the generalized effect of Shatavari root extract in menopausal women.

A Comparative Study to Assess the Knowledge Regarding Post-Menopausal Symptoms and Coping Strategies Adopted by Employed and Unemployed Post-Menopausal Women Residing in Selected Areas of the City

A Comparative Study to Assess the Knowledge Regarding Post-Menopausal Symptoms and Coping Strategies Adopted by Employed and Unemployed Post-Menopausal Women Residing in Selected Areas of the City

Does hormone therapy exacerbate other venous thromboembolism risk factors?

Postmenopausal symptoms in women at higher risk for venous thromboembolism (VTE) due to comorbidities are often undertreated because of concerns that hormone therapy (HT) may increase VTE risk; however, it is unclear how much HT impacts risk of VTE when compared with other risk factors. This is a case-control study in a commercial claims database from 2007 to 2019. Women aged 50 to 64 years (n = 223,949) were classified as cases if they had an International Classification of Diseases code indicating an acute VTE plus a filled prescription for an anticoagulant, placement of intravascular vena cava filter, or death within 30 days of diagnosis. Controls were matched 10:1 to each case by index date and age. Risk factors and comorbidities present within the year before index were examined. Exposure was defined as a HT prescription within 60 days before index. There were 20,359 VTE cases and 203,590 matched controls. A conditional logistic regression indicated that the greatest risks for VTE were from metastatic cancer (odds ratio [OR], 13.66; 95% CI, 12.64-14.75), hospitalization/surgery (OR, 8.51; 95% CI, 8.09-8.96), trauma (OR, 3.52; 95% CI, 3.32-3.73), comorbidity burden (OR, 3.51; 95% CI, 3.34-3.69), history of hypercoagulable condition (OR, 3.10; 95% CI, 2.87-3.36), and varicose veins (OR, 2.87; 95% CI, 2.56-3.22). Regarding hormone exposure, we observed ORs of 1.51 (95% CI, 1.43-1.60) for any recent hormone exposure; 1.13 (95% CI, 1.04-1.23; number needed to harm, 4,274) for unopposed estrogen menopausal HT; 1.23 (95% CI, 1.10-1.38; number needed to harm, 2,440) for combined menopausal HT; and 5.22 (95% CI, 4.67-5.84) for combined hormonal contraceptives compared with no recent HT exposure. Hormone therapy exposure did not appear to adversely influence other risk factors, and exposure generally played a minor role in VTE risk. Contraceptives, however, were a strong risk factor.

Phytoestrogen: A protective shield for post-menopausal symptoms and breast cancer risk

Menopause is a physiological unavoidable condition in women’s life which leads to vasomotor, psychological, urogenital and chronic diseases collectively termed as post-menopausal symptoms (PMS). Hormone replacement therapy (HRT) is conventional line of treatment for treating PMS in which estrogens replacement is major choice for better therapeutic efficacy against symptoms like hot flushes, osteoporosis, hormonal balances, insomnia, obesity etc. However, estrogen is reported risk factor for breast cancer. The review discusses Ayurveda based strategies for management of PMS with phytoestrogen herbs, diet, lifestyle modification, de-addiction measures, yoga, aroma therapies etc. supported by evidence-based documentation.Herbs namely Dhanyaka (Coriander sativum), Manjishtha (Rubia cordifolia L), Chandana (Santalum album L), Ashwagandha (Withania somnifera L. Dunal), Jatamansi (Nardostachys jatamansi DC), Shatavari (Asparagus racemosus L), Kumari (Aloe vera L), Yashtimadhu (Glycyrrhiza glabra L), Haridra (Curcuma longa L), Triphala (Combination of fruits of Haritaki, Bibhitak, Amalaki in the proportion 1:2:4), Gokshura (Tribulus terrestris L), Arjuna (Terminalia Arjuna L.), Guduchi (Tinospora cordifolia L.), Ela (Elettaria cardamomum L), Narikela (Coccus nucifera L), Masha (Phaseolus vulgaris L), Mudga (Vigna radiata L). Shunthi (Zinziber officinale Roxb), Methika (Trigonella foenumgraecum L), Tila (Sesamum indicum L) are the natural sources of phytoestrogens. Phytoestrogen don’t exert side effects like synthetic estrogen molecules. These herbs are useful for management of various symptoms of PMS. Having anti-cancer potential against breast carcinoma these are useful for prevention of risk of breast cancer.

Agomelatine alleviates pain-related behaviour in ovariectomized rats

Aim: Menopause is a physiological process that results in the cessation of ovarian follicle activity. Research suggests that postmenopausal women may experience changes in pain sensitivity. Ovariectomized (Ovx) rats are commonly used to mimic postmenopausal pain symptoms in research. Agomelatine is a unique antidepressant that acts as both a melatonergic receptor agonist and a 5-HT2C receptor antagonist. Preclinical studies have suggested potential analgesic effects associated with Agomelatine. This study aims to investigate the influence of agomelatine on pain behavior in Ovx rats. Materials and Methods: Forty female Sprague Dawley rats were divided into four groups: Sham, Ovx, Ago20 and Ago40. The Ovx, Ago20 and Ago40 groups underwent bilateral ovariectomy, while the Sham group underwent all surgical procedures except ovarian ligation. After four months, the Sham and Ovx groups received vehicle, while the Ago20 (20mg/kg) and Ago40 (40mg/kg) groups received agomelatine by oral gavage for two months. Pain sensitivity assessments were conducted using electronic von Frey, hot plate, tail flick, and tail immersion methods after the final drug administration. Results: In the Ovx group, there was an increase in pain sensitivity observed in the hot plate, electronic von Frey, tail flick, and tail immersion tests (p &lt; 0.05). Agomelatine treatment significantly reduced the heightened nociceptive response (p &lt; 0.05). Conclusion: Agomelatine effectively attenuates the increased sensitivity to pain observed in Ovx rats.

Potential of covalently linked tamoxifen hybrids for cancer treatment: recent update.

Cancer is a complex disease and the second leading cause of death globally, and breast cancer is still a leading cause of cancer death in women. Tamoxifen is the most commonly used drug for breast cancer (ER-positive) treatment and chemoprevention, saving the lives of millions of patients every year. In addition, the tamoxifen template has been explored extensively for the development of selective estrogen receptor modulators (SERMs) applicable in breast cancer, osteoporosis, and postmenopausal symptom treatment. Numerous anticancer drugs, including tamoxifen, are in use, but the complexity and heterogeneous nature of cancer complicate the effect of conventional targeted drugs, leading to adverse reactions and resistance. One of the significant approaches to overcome these shortcomings is drug hybrids, generated by covalently linking two or more active pharmacophores. These drug hybrids are remarkably effective in acting on multiple drug targets with higher selectivity and specificity. In recent years, several tamoxifen hybrids have been discovered as potential candidates for cancer treatment. The review highlights the recent progress in developing anticancer hybrids, including organometallic, fluorescent, photocaged, and novel ligand-based tamoxifen hybrids. It also demonstrates the significance of merging various pharmacophores with tamoxifen to produce more potent, precise, and effective anticancer agents. The study offers valuable knowledge to researchers working on cancer research with the hope of enhancing drug potency and reducing drug toxicity to improve cancer patients' lives.

Dietary vanillic acid prevents postmenopausal symptoms in ovariectomized mice

Dietary vanillic acid prevents postmenopausal symptoms in ovariectomized mice

Phytoestrogens of Trifolium pratense L. as therapeutics: A review

Trifolium pratense L., commonly known as red clover, is a dicotyledonous allogamous diploid plant. It is known to have antioxidant, anti-inflammatory, chemo-preventive and anti-spasmodic capabilities among other medicinal properties. Studies have indicated that it is extremely beneficial in managing postmenopausal symptoms and has a positive role to play in moderating rheumatoid arthritis. Products obtained from the plant, specifically phytoestrogens, are being explored for their role in cognitive therapeutics. It is also being studied as a potential cure for cancers, such as breast cancer. In this paper, we have reviewed the genomic details of Trifolium and its possible applications in the field of medicine. Phytoestrogens, their mechanism of action, isoflavones and their biosynthetic pathway along with factors affecting isoflavone concentration are also reviewed. Thus, this review summarizes the existing literature about the phytoestrogens of T. pratense and their potential use for human health and the gaps in this information. Future prospects have been enumerated to guide further research on phytoestrogens of T. pratense.

Efficacy and safety of fezolinetant, a neurokinin-3 antagonist, in treating vasomotor symptoms in postmenopausal women: A systematic review and meta-analysis.

Menopause causes a variety of symptoms such as hot flashes and night sweats. While menopausal hormonal therapy has been used for managing postmenopausal vasomotor symptoms (VMS) for quite a while, it has a considerably poor safety profile. To review and analyze existing data to evaluate the efficacy of the neurokinin-3 antagonist, fezolinetant, in treating postmenopausal VMS and to assess its safety profile. A thorough literature search was performed on PubMed, Cochrane Library, and Google Scholar in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020, to find publications on the efficacy of fezolinetant for postmenopausal VMS. Changes in the frequency and severity scores of moderate/severe VMS and changes in the Hot Flash-Related Daily Interference Scale (HFRDIS), Greene Climacteric Scale (GCS), and Menopause-Specific Quality of Life (MENQoL) were the efficacy outcomes. Adverse events, drug-related treatment-emergent adverse effects (TEAEs), drug-related dropouts, hepatotoxicity, endometrial hyperplasia or tumor, and uterine bleeding were all safety outcomes. We used Review Manager 5.4 for pooling risk ratios (RRs) and mean differences (MDs) for dichotomous and continuous outcomes, respectively. A P value of < .05 was considered significant. There was a significant reduction in mean daily VMS frequency at weeks 4 and 12 (MD, -2.36; 95% confidence interval [CI], -2.85 to -1.87; P < .00001, for week 12) and also a significant decrease in VMS severity scores in the treatment group. Furthermore, improvements in MENQoL, HFRDIS, and GCS scores were observed. There was no significant difference in adverse events while drug-related TEAEs (RR, 1.21; 95% CI, 0.90-1.63; P = .21) showed a slight increase with fezolinetant. Drug-related dropouts were again similar across the 2 groups. Uterine bleeding had a lower incidence while endometrial events and hepatotoxicity showed a statistically insignificant, increasing trend in the fezolinetant group. Fezolinetant can be a treatment option for postmenopausal VMS but warns of a risk increase in endometrial hyperplasia or tumors. The heterogeneity in the data being analyzed, short follow-up period, and small sample size in most of the included randomized controlled trials were the greatest limitations, which must be considered in further research and safety profile exploration.

Prevalence and Factors Influencing Severity of Post-Menopausal Symptoms among women of Rural Odisha: An Explorative study

Background: Menopause simply means that the stoppage of menstruation. It also refers to the changes a women goes through around this period. In present date also the word menopause require many unturned stones to be turned on. Objectives: The main aim of this study is to investigate the current prevalence of severity of menopausal symptoms among women along with to explore the factors which may influence the severity of those symptoms. Methods and materials: the current paper adopted an exploratory descriptive design to study among 200 women between the age of 45-55yr in 3 villages namely Shayampur, Bharatpur and Rental Colony of rural Odisha. The data collected by using the self structured sociodemographic proforma and Standardized menopause rating scale for exploring the factors influencing the severity of symptoms. Result: The study resulted that almost all the women present with postmenopausal symptoms where as severe symptoms are seen among 17-18% of women. The factors which influence most for the severity of symptom are age, parity and with history of substance abuse. Conclusion: hence it can be concluded that advance age of achieving menopause, multiparity and use of substance makes the postmenopausal women suffer more with severity of menopausal symptoms.