Symptoms In Perimenopausal Women Research Articles

Prevalence of Psychiatric Morbidity and Somatic Symptoms in Perimenopausal Women

ABSTRACT Background: During the perimenopausal phase, women experience a myriad of somatic symptoms as well as changes in mood and emotions which could be related to the endocrine changes and psychological factors during this transition. Aim: The aim was to assess the prevalence of somatic symptoms and psychiatric morbidity in perimenopausal women. Material and Methods: By purposive sampling, 100 women in the age group of 45–55 years were included in the study with their consent. They were assessed with a self-made sociodemographic proforma, Mini-International Neuropsychiatric Interview (MINI), depression, anxiety, stress scale (DASS 21), Menopause Rating Scale, big five inventory scale (BFI-10), and social support scale. Results: Psychiatric morbidity was seen in 41% of perimenopausal women, out of which 32% showed somatic symptoms. Seventeen percent had mild-to-moderate depressive features, 17% showed mild-to-moderate anxiety, and 7% were dysthymic. Conclusion: Prevalent life stressors seemed to affect the transition into menopause for many women which directly corresponded to the prevalence of psychiatric morbidity and somatic symptoms in them.

A systematic review and critical appraisal of menopause guidelines

Objective and rationaleTo identify and appraise current national and international clinical menopause guidance documents, and to extract and compare the recommendations of the most robust examples.DesignSystematic review.Data sourcesOvid MEDLINE, EMBASE,...

Evaluating the cost utility of estradiol plus dydrogesterone for the treatment of menopausal women in China

AimEvaluate the cost utility of menopausal hormone therapy for women in China.Materials and methodsA bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China’s Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks.ResultsAccording to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of −7,184$ (−47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China.ConclusionContingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.

A cross-sectional study of symptoms and health-related quality of life in menopausal-aged women in China

ObjectiveTo measure symptoms and health-related quality of life in a cross-sectional cohort of menopausal-aged women in China.MethodA cross-sectional survey was conducted in a general population cohort of 2,000 Chinese females over the age of 45 years. Patients completed the Chinese version of the EuroQol-5D five level (EQ5D5L) health-related quality of life instrument via Personal Digital Assistant. Raw scores were converted to utility tariffs using value sets for China. Statistical analysis included Pearson’s chi-square test, z test for multiple comparisons with adjustment by the Bonferroni method, independent-sample t-test, ANOVA, and adjustment by the Tukey method for multiple comparison. Results were considered statistically significant when p < 0.05 and the study was reported according to the STROBE recommendations.ResultsIn a cohort of 2000 women, 732 (37%) were premenopausal, 798 (40%) were perimenopausal and 470 (23%) were postmenopausal. Perimenopausal women reported significantly more symptoms (91%) compared to premenopausal (77%) and postmenopausal (81%) women. Health-related quality of life was significantly lower in symptomatic perimenopausal women compared to premenopausal (0.919, p < 0.05) and postmenopausal (0.877, p < 0.05) women. Within each group there was a statistically significant difference between the health-related quality of life of women with symptoms compared to without symptoms.ConclusionThe perimenopausal phase of menopause is associated with significantly more symptoms and significantly lower HRQoL compared to premenopausal and postmenopausal phases.

Effects of exercise on sleep in perimenopausal women: A meta-analysis of randomized controlled trials.

Whether an exercise intervention has significant effects on improving the sleep quality in perimenopausal women is controversial. This review explores different ways of exercise interventions (intervention item, intervention period, intervention frequency, and intervention duration of each time) on the improvement of sleep in perimenopausal women. Based on the PICOS method, two researchers independently searched the PubMed database, Excerpta Medica database (EMBASE), Cochrane Library database, Web of Science (WoS) database, Chinese National Knowledge Infrastructure (CNKI) database, Wanfang database and VIP database, evaluated the literature quality using the Cochrane system evaluation manual, and performed a meta-analysis of the included literature. A total of 12 randomized controlled trials involving 1493 subjects were included in the study. Exercise intervention items included yoga, walking, fitness Qigong, and aerobic exercise. The meta-analysis showed that exercise could effectively improve sleep in perimenopausal women (SMD=-0.44, 95%CI (-0.66, -0.22), P < 0.00001), and had significant effects on the sleep quality and insomnia symptoms in perimenopausal women. Subgroup analysis showed that fitness Qigong with a period of 10 to 12 weeks, a frequency of more than 3 times a week, and a duration of each time of 30 to 60min was the most effective in improving sleep.

An Intraoperative Sub-Anesthetic Dose of Esketamine on Postoperative Depressive Symptoms in Perimenopausal Women with Breast Cancer Undergoing Modified Radical Mastectomy: Protocol for a Randomized, Triple-Blinded, Controlled Trial.

Depressive symptoms are common among perimenopausal women with breast cancer having modified radical mastectomy. Esketamine exerts antidepressant effects. This study aims to assess whether an intraoperative sub-anesthetic dose of esketamine prevents postoperative depressive symptoms in these patients. In this randomized, triple-blinded, placebo-controlled trial, we will enroll 130 perimenopausal women (aged 45-60 years) with breast cancer undergoing unilateral modified radical mastectomy. Patients will be randomly assigned with a 1:1 ratio to receive either esketamine (0.25 mg/kg i.v.) or normal saline after anesthesia induction and before skin incision. The primary outcome is the incidence of depressive symptoms at day 30 postoperatively, assessed using the Beck's Depression Inventory (BDI). Secondary outcomes include incidence of depressive symptoms and BDI scores at day 1, 3, and 180 postoperatively, anxiety symptoms and scores at day 1, 3, 30, and 180 postoperatively, pain intensity and quality of recovery at day 1 and 2 postoperatively, nausea and vomiting within 48 hours postoperatively, length of postoperative hospital stay, and cancer-specific outcomes. Data will be analyzed in the modified intention-to-treat population. This is the first trial to evaluate the effects of a sub-anesthetic dose of esketamine on depressive symptoms in perimenopausal women after modified radical mastectomy. The results of this study will help to improve their mental health and recovery after breast cancer surgery. Chinese Clinical Trial Registry (ChiCTR2200064348).

Development and verification of the Menopause Emotional Symptom Questionnaire.

A detailed, well-validated scale for measuring emotional symptoms in menopausal women is lacking. We aimed to develop the Menopause Emotional Symptom Questionnaire (MESQ) and to confirm its reliability and validity among Koreans. Eighteen primary items based on previous research results were selected using exploratory factor analysis and confirmatory factor analysis (CFA). New data, including answers to the novel MESQ, Menopause Rating Scale, Kupperman Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, were collected from 200 perimenopausal women and 100 young men through a research company. Exploratory factor analysis and CFA were performed again to determine whether the MESQ accurately measures emotional symptoms in perimenopausal women. Receiver operating characteristic curve and k-means cluster analyses were used to identify the most appropriate cutoff value. The MESQ showed high internal consistency (Cronbach α = 0.926), and the CFA revealed that the factor structure comprised two subscales: nine items for mood/anxiety symptoms and four items for sleep symptoms. A high correlation between the total MESQ score and total scores of the existing scales was confirmed, indicating high convergence validity. Comparison of the mean MESQ scores between men and women showed significant sex difference, indicating secure known-group validity. The cutoff point of the total MESQ score between the high-risk and low-risk groups was 26. The novel MESQ has high validity and reliability, and this study confirmed that the MESQ is a valid tool for screening for and measuring emotional symptoms in menopausal women in Korea.

Latent Profile Analysis for Classification of Psychosomatic Symptoms in Perimenopausal Women.

Over 80% of perimenopausal women experience various physical and neuropsychiatric symptoms due to changes in hormones. However, accurate evaluation and treatment of menopausal symptoms are lacking due to limited evidence regarding customized treatment for each symptom type. This study aimed to identify and cluster psychosomatic symptoms in Korean perimenopausal women and to investigate the characteristics of each cluster type. This Web-based survey assessed 1060 Korean perimenopausal women recruited from nationally representative panels available from a commercial research company. Menopausal symptoms were evaluated using the Menopause Rating Scale, Patient Health Questionnaire-15, Patient Health Questionnaire-9, Insomnia Severity Index, Subjective Memory Complaints Questionnaire, and Overactive Bladder Symptom Score. Data were analyzed using latent profile analysis and multinomial logistic regression. Latent profile analysis identified 4 latent classes: "all unimpaired (class 1)," "impaired sexual function, while others are unimpaired (class 2)," "unimpaired sexual function, while others are impaired (class 3)," and "all impaired (class 4)." Classes 3 and 4 were significantly more likely to have a family history of perimenopausal syndrome and a history of other mental disorders, postpartum depression, and postpartum psychosis than classes 1 and2. Psychosomatic symptoms appear during perimenopause along with depression, somatic symptoms, insomnia, impaired memory, and overactive bladder symptoms. Individuals with these symptoms are more likely to have a history of postpartum depression, psychosis, and other psychiatric disorders. Therefore, sexual dysfunction must be independently treated. Further studies are needed to develop and verify individualized treatments according to symptom class.

Роль білків теплового шоку в прогнозуванні перебігу клімактеричного синдрому

The problem of menopause has been relevant for many decades. A pathogenetically justified method of treatment, taking into account the change in the hormonal background of a woman, is hormone replacement therapy. Determination of immune markers of cellular homeostasis is one of the promising directions, therefore, the study of changes in the levels of antibodies to HSP60 can become a reliable marker of both the course and compensation of disorders of the neurovegetative state in perimenopause. Purpose - to study the role of anti-Müllerian, follicle-stimulating, luteinizing, thyroid-stimulating hormones, antibodies (IgG) to human heat shock protein 60 (HSP60) and its bacterial homologue (GroEl), and obstetric history on the diagnosis and treatment of vasomotor symptoms in perimenopausal women. Materials and methods. 158 patients with climacteric syndrome in perimenopause were examined in the period October 2019 - March 2022. The Group 1 (main) included 80 patients who agreed to treatment and received it according to the standard scheme: combined treatment in a cyclical regimen - estrogens (17β-estradiol) + progestogens (dydrogesterone); the Group 2 (comparison) included 78 women who refused treatment due to estrogen deficiency. Results. Revealed a decrease (p&lt;0.01) in the risk of not achieving a high treatment effect with vasomotor symptoms for treated patients, OR=0.04 (95% CI: 0.01-0.18) compared to the group of untreated patients. With the number of deliveries, the risk of not achieving a high treatment effect in women with vasomotor symptoms increases (p=0.01), OR=2.27 (95% CI: 1.2-4.27) for each delivery. A lower (p=0.039) risk of not achieving a high treatment effect was found in women with vasomotor symptoms at a higher GroEl level, ОR=0.994 (95% CI: 0.987-1.000) for each ng. When standardizing by the thyrotropin hormone and the manifestation of vasomotor symptoms before or without treatment, a decrease (p&lt;0.001) in the risk of not achieving a high effect of treatment in women with vasomotor symptoms for treated patients was found, OR=0.04 (95% CI: 0.01-0.20). Conclusions. This study found that there is no informative indicator for predicting the effectiveness of treatment in women with vasomotor symptoms. It was established that the HSP60 indicator does not affect, and the GroEl indicator affects the effectiveness of the treatment of vasomotor clinical manifestations. The research was carried out in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institutions. The informed consent of the women was obtained for conducting the studies. No conflict of interest was declared by the authors.

Effects of menopause on depressive and anxiety symptoms in community women in Beijing

Objective: To determine the effects of menopausal stage, age and other associated risk factors on symptoms of anxiety and depression among women in a community in Beijing. Methods: This study was a community-based prospective cohort. Participants who had transitioned through natural menopause, completed two or more depressive and anxiety symptoms evaluations, aged 35 to 64 years, and did not use hormone therapy were selected from the Peking Union Medical College Hospital aging longitudinal cohort of women in midlife to this analysis. The primary outcome variables were depressive and anxiety symptoms, assessed by hospital anxiety and depression scale (HADS). The generalized estimation equation was used in the statistical analysis. Results: Followed up from 2006 to 2014, 430 women and 2 533 HADS assessments were retained in the cohort. Depressive symptoms were more common than anxiety symptoms during all menopausal stages. The incidences of depressive and anxiety symptoms were 14.5% (19/191) and 3.1% (4/191) in the premenopausal -3 stage, respectively. The incidence increased in both menopausal transition and postmenopausal stage, with the highest incidence in the +1c stage [20.6% (155/751) and 8.8% (66/751), respectively]. However, these differences were not statistically significant (all P>0.05). Depressive symptoms were highest in the ≥60-<65 age group [20.8% (74/355)], and anxiety symptoms were highest in the ≥50-<55 age group [8.2% (62/754)]; but there were no statistical significances between different age groups and depressive and anxiety symptoms (all P>0.05). Multivariable analysis showed that high body mass index, low education status, and poor health status were independently associated with depressive symptoms (all P<0.05), and that poor health status, trouble falling asleep, and early awakening were independently associated with anxiety symptoms (all P<0.01). Conclusions: Depressive and anxiety symptoms are more common during menopausal transition and postmenopausal stage compared with reproductive stage. Depressive symptoms are more common than anxiety symptoms. To screen and assess depressive and anxiety symptoms in perimenopausal women is essential, especially for women with high risk factors.

Efficacy of Deep Breathing Exercise and Aerobic Exercise on Perimenopausal Women

Introduction: Perimenopause means “around the menopause”. The hormonal changes that occur during the perimenopausal transition are the gametogenic failure which is characterized by the reduced inhibin secretion which occurs in the early follicular phase, increased serum FSH and decreased fertility. The aim of this study is to deterine the effectiveness of deep breathing exercises and aerobic exercises on perimenopausal Women Methods: A total of 50participants will take part in the study. The participants will be chosen based on Inclusion criteria by a convenient sampling method. The participants will be divided into two groups: Group A: Control group (n=25) and Group B: Experimental group(n=25). The level of perimenopausal symptoms will assessed using menopause rating scale before the commencement of the intervention in both the groups. The Control group will receive Jacobson’s relaxation technique and the experimental group will receive deep breathing exercise and aerobic exercise. The treatment will be demonstrated to the participants through video demonstration. After the completion of the treatment protocol the perimenopausal symptoms will be evaluated again using the menopause rating scale in both the groups to assess the reduction of perimenopausal symptoms in both the groups and to find the effectiveness of deep breathing exercise and aerobic exercise in reduction perimenopausal symptoms. Results: The values were statistically analyzed using the Wilcoxon signed-rank test. There was a statistically significant improvement in the experimental group. The result was significant at p&lt;.05. Conclusion: This study, therefore, displays that deep breathing exercise and aerobic exercise are effective in reducing the somatic, psychological, and urogenital symptoms in perimenopausal women. KEYWORDS: Deep breathing exercise, Aerobic exercise, and perimenopausal symptoms.

Physical activity and vasomotor symptoms in perimenopausal women at Wukirsari Village, Yogyakarta, Indonesia

Background: Menopause is an event that marks the end of the reproductive phase of a woman. Vasomotor symptoms are one of the primary symptoms of menopausal women and affect about 40-60% of perimenopausal women. This research aims to investigate the relationship of physical activity with vasomotor symptoms in perimenopausal women.Methods: The population in this study were 173 women aged 45-54 years who are still experiencing menstruation in the Wukirsari village working area of Puskesmas Cangkringan Sleman-Yogyakarta. The instrument for measuring vasomotor symptoms adopted two questions from the menopause rating scale (hot flushes and night sweats) questionnaire while measuring physical activity using a questionnaire from Riskesdas. Data were analyzed using SPSS version 23 for Windows.Results: Most of the participants were in the 45-50 years age group (75.73%), followed by severe vasomotor symptoms (95.95%), sufficient physical activity (91.91%), medium level education (49.71%), and informal occupation (94.80%). In addition, this study found that most of the participants were normal Body Mass Index (BMI) (54.34%), passive smoking (64.74%), and pre-hypertension (46.20%). There was a significant relationship between physical activities and BMI to the vasomotor symptoms among women of perimenopausal age (p&lt;0.05).Conclusion: There was a significant relationship between physical activities and BMI the vasomotor symptoms among women of perimenopausal age.

The effect of tryptophan and serotonin levels on the severity of depressive and climacteric symptoms in perimenopausal women.

The dysfunctional serotonergic system is a factor contributing to the development of depression. The aim of this study was to assess the effect of serotonin and tryptophan on the severity of climacteric and depressive symptoms in perimenopausal women. The study involved data collection and biochemical analysis. The research instruments were: the Blatt-Kuppermann index, the Beck Depression Inventory, and the proprietary questionnaire. There was no significant effect of tryptophan (r=0.05; p=0.219) and serotonin (r= -0.03; p=0.537) on the severity of depressive symptoms, or tryptophan on the severity of climacteric symptoms (r=0.019; p=0.657). However, a weak negative correlation was found between the level of serotonin and the severity of climacteric symptoms (r=-0.09; p=0.022). Additionally, it was found that severe depressive symptoms were associated with a significant exacerbation of climacteric symptoms (β=0.379; p<0.001), while higher serotonin levels alleviated them (β=-0.604; p=0.005). Higher severity of depressive symptoms may exacerbate climacteric symptoms. Serotonin levels may influence the severity of climacteric symptoms. Moreover, the higher the serotonin level, the lower the odds of depressive disorders, irrespective of the severity of climacteric symptoms. Tryptophan levels had no effect on the severity of depressive and climacteric symptoms in the perimenopausal women.

Predictors of irritability symptoms in mildly depressed perimenopausal women

ObjectiveIrritability is a highly burdensome complaint, commonly, but not universally, linked with depressive symptoms. While increased variability in estradiol has been associated with depressive symptoms during perimenopause, more insight is needed into reproductive hormone dynamics and other factors that predispose perimenopausal women to irritable mood. MethodsAmong 50 mildly depressed perimenopausal women (mean (SD) age 48.4 (3.9) years), severity of irritability symptoms (on Symptom Questionnaire Hostility subscale, range 0–23) was assessed weekly for eight weeks, concurrent with potential predictors. Associations between these were examined using generalized estimating equating models. ResultsMost women (82.0%) reported having moderate to severe irritability at least once. However, the severity of irritability was highly variable from week-to-week (between-subject mean coefficient of variation [CV] 72.9% and within-subject mean CV 63.7%). In multivariate analyses, less variable serum estradiol levels (standardized β within-person CV −0.23 95%CI [−0.32, −0.14], p < 0.001), greater depression severity (0.45 [0.35, 0.56], p < 0.001), younger age (−0.23, [−0.28, −0.09], p < 0.001), and more frequent vasomotor symptoms (0.14 [0.05, 0.23], p = 0.002) were associated with more irritability. Depression severity explained the largest portion of the variance in irritability, but still not more than 20.3%. Neither crude values, weekly change in, or variability of progesterone or FSH levels were associated with irritability. ConclusionsIrritability was highly prevalent among mildly depressed perimenopausal women. In contrast to depressive symptoms, decreased rather than increased variability in estradiol levels was associated with more irritability. This highlights that irritable mood can be disentangled from depressive symptoms in perimenopausal women and might be linked with different estradiol dynamics.

Biopsychosocial predictors of depressive symptoms in the perimenopause-findings from the Swiss Perimenopause Study.

The perimenopause is associated with increased hormone fluctuations and an elevated risk of depression. A number of predictors of depressive symptoms in the menopausal transition have previously been suggested. The purpose of this study was to investigate a set of biopsychosocial predictors of depressive symptoms in perimenopausal women. This cross-sectional study, investigating 114 perimenopausal women (according to the STRAW criteria) aged 40-56 years, was conducted within the scope of the Swiss Perimenopause Study. Multiple regression analyses were performed to identify the most accurate model predicting perimenopausal depressive symptoms. Depressive symptoms were assessed with the German version of the Center of Epidemiologic Studies Depression Scale (CES-D). Validated questionnaires were used to examine psychophysiological complaints, stress, self-esteem, self-compassion, body image, and social support. Estradiol (E2) and progesterone (P4) were assessed through saliva samples, and follicle-stimulating hormone and luteinizing hormone were determined through dried blood spot samples. Seven saliva samples per participant were used to investigate absolute levels and fluctuations of sex steroids. All other variables were measured once. Multiple regression analyses revealed that E2 fluctuations (β=0.15, P = 0.015), history of depression (β=0.14, P = 0.033), menopausal symptoms (β=0.47, P < 0.0001), perceived stress (β=0.17, P = 0.014), body image (β= -0.25, P = 0.014) and self-esteem (β=-0.35, P < 0.0001) were predictive of perimenopausal depressive symptoms (R2 = 0.60). P4 fluctuations and absolute levels of hypothalamic-pituitary-gonadal hormone were not statistically significant. E2 fluctuations were shown to be predictive of depressive symptoms in the perimenopause. Moreover, the presence of burdensome complaints and chronic stress as well as a poor self-evaluation seem to promote depressive symptoms in perimenopausal women.

Estrogen variability and stress-induced Interleukin-6 reactivity: A pilot study in perimenopausal women

The aim of this study was to review the association of dietary intake of oleic and linoleic acids (OA and LA, respectively) with depressive symptoms in perimenopausal women.This cross-sectional study used data from the Study of Women's Health Across the Nation (SWAN). Linear and logistic regressions and restricted cubic spline models were performed to examine the association of intake of OA and LA with depression.We included 2793 women 42 to 52 y of age in the present study. Intake of the two acids was positively associated with the Center for Epidemiologic Studies Depression Scale (CES-D) scores in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted linear regression model. The fully adjusted regression coefficients were β = 0.089 and β = 0.145 for oleic and linoleic acid intake, respectively. OA and LA intake was positively associated with depressive symptoms (CES-D score ≥16) in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted logistic regression model. The fully adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were 1.994 (1.298–3.063) and 1.592 (1.047–2.421) for the highest versus lowest quartile of intake of OA and LA, respectively.Intake of OA and LA may be positively associated with depressive symptoms in perimenopausal women.

Associations between dietary oleic acid and linoleic acid and depressive symptoms in perimenopausal women: The Study of Women's Health Across the Nation.

The aim of this study was to review the association of dietary intake of oleic and linoleic acids (OA and LA, respectively) with depressive symptoms in perimenopausal women. This cross-sectional study used data from the Study of Women's Health Across the Nation (SWAN). Linear and logistic regressions and restricted cubic spline models were performed to examine the association of intake of OA and LA with depression. We included 2793 women 42 to 52 y of age in the present study. Intake of the two acids was positively associated with the Center for Epidemiologic Studies Depression Scale (CES-D) scores in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted linear regression model. The fully adjusted regression coefficients were β = 0.089 and β = 0.145 for oleic and linoleic acid intake, respectively. OA and LA intake was positively associated with depressive symptoms (CES-D score ≥16) in unadjusted and age-, race/ethnicity-, total family income- and education-adjusted logistic regression model. The fully adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were 1.994 (1.298-3.063) and 1.592 (1.047-2.421) for the highest versus lowest quartile of intake of OA and LA, respectively. Intake of OA and LA may be positively associated with depressive symptoms in perimenopausal women.

Weekly estradiol fluctuation predicts anxiety symptoms in perimenopausal women

Anxiety is a common mood symptom that may be experienced by some menopausal women; however, few studies have explored the concept of anxiety in the context of menopause. Consequently, the anxiety experience in menopause is not well defined and raises the question: Is menopausal anxiety a unique and distinctly different syndrome? The aim of this qualitative study was to gain an in-depth understanding of the experience of new-onset anxiety in menopausal women.

A comparitive study to evaluate the efficacy of selected Yoga techniques in Perimenopausal Women

Background: Menarche and menopause are the two major components of women’s reproductive life. Perimenopause is a transition stage from reproductive phase to non reproductive phase, which begins several years before the actual menopause. It demands priority in the Indian scenario due to increase in life expectancy and growing population of menopausal women. During this phase there is imbalance in the hormonal levels which causes both physical and emotional symptoms. Yoga, a potential alternative to hormone therapy, is currently being assessed for its therapeutic value in decreasing stress and other symptoms associated with Perimenopause. Hence this study was undertaken to see the effect of selected yoga techniques in reducing the physical and psychological symptoms in Perimenopause women. Materials and Methods: It was an Open Randomized Comparitive Clinical Trial of 2 groups was adopted with pre-test and post-test design. 25 subjects in each group were selected using the inclusion and diagnostic criteria with selected Yogasanas and Pranayama and selected Pranayama respectively. The subjects were taught with selected Yoga techniques for a week and given printed protocol. They were asked to continue the therapy for 60 days. The criteria assessed were irregular menstruation, hot flushes, night sweats, palpitation, fatigue, weakness, depression, insomnia, irritability, mood swing and anxiety on 0th, 30th, 60th and 90th day. Results: Selected Yogasanas and Pranayama has given statistically significant results in reducing all the physiological and psychological symptoms in Perimenopausal women whereas Selected Pranayama showed statistical significance in symptoms like Hot Flushes, Night Sweats, Palpitation, Fatigue, weakness, Insomnia and Irritability and showed no statistical significance in Irregular Menstruation, Depression and Anxiety. Conclusion: The symptoms were reduced statistically in Selected Yogasanas and Pranayama when compared to Selected Pranayama Group. Thus, Perimenopause condition will be effectively managed with Selected Yogasanas and Pranayama.

Association between HIV status and psychological symptoms in perimenopausal women.

HIV-infected women are burdened by depression and anxiety, which may impact adherence to antiretroviral therapy and overall quality of life. Yet, little is known about the scope of psychological symptoms in the growing number of HIV-infected women reaching menopause, when affective symptoms are more prevalent in the general population. We conducted a longitudinal study to compare affective symptoms between perimenopausal HIV-infected and non-HIV-infected women. The Center for Epidemiologic Studies Depression Scale (CES-D), and the Generalized Anxiety Disorder scale (GAD-7) were completed at baseline and 12 months among 33 HIV-infected and 33 non-HIV-infected perimenopausal women matched by race, age, menstrual patterns, and BMI. Linear regression models estimated the relationship of baseline GAD-7 and CES-D scores with clinical factors. All women were perimenopausal at baseline, and the vast majority remained perimenopausal throughout follow-up. HIV status was associated with higher baseline CES-D scores (median [interquartile range] 21 [12, 29] vs 10 [5, 14]; P = 0.03) and GAD-7 scores (7 [5, 15] vs 2 [1, 7]; P = 0.01), controlling for smoking, substance use, and antidepressant use. Depressive symptoms and anxiety remained significantly higher in the HIV-infected women at 12 months (P ≤ 0.01). Significant relationships of depressive symptoms (P = 0.048) and anxiety (P = 0.02) with hot flash severity were also observed. Perimenopausal HIV-infected women experienced a disproportionately high level of affective symptom burden over a 12-month observation period. Given the potential for these factors to influence adherence to HIV clinical care and quality of life, careful assessment and referral for treatment of these symptoms is essential.