Menopausal Symptoms In Women Research Articles

Effect of physical exercise on work ability and daily strain in symptomatic menopausal women: A randomized controlled trial

Menopause related symptoms modify quality of life and may also have an impact on work ability. The aim of this study was to investigate the effects of physical exercise on work ability and daily strain among women with menopausal symptoms. Occupationally active symptomatic menopausal women (n=123) were randomized into 24-week aerobic exercise intervention and control groups. Mobile phone questionnaires were used to collect daily data on perceived physical and mental strain in a randomised and controlled setting. Work ability was measured with the Work Ability Index (WAI) and with questions about work strain. In all 123 women aged 44-62 (mean age 53.8 ± 3.4) years who worked full- or part-time participated in the study. Women were randomized into a control (n=60) and intervention group (n=63). The subjects were mostly working in mentally demanding jobs (e.g., office worker), but also in physical (e.g., cleaner) and mixed (physical and mental) jobs (e.g., nurse). The increase in mental resources and decrease in physical strain from baseline to end were statistically significantly greater among the intervention group than among the control group. Between-group differences in the change in WAI were, however, statistically non-significant. A 6-month physical exercise intervention among symptomatic menopausal women seems not to be enough to increase perceived work ability but the physical exercise may increase perceived mental resources and decrease perceived daily physical strain.}

Prescribing menopausal hormone therapy: an evidence-based approach

The constantly changing landscape regarding menopausal hormone therapy (MHT) has been challenging for providers caring for menopausal women. After a decade of fear and uncertainty regarding MHT, reanalysis of the Women’s Health Initiative data and the results of recent studies have provided some clarity regarding the balance of risks and benefits of systemic MHT. Age and years since menopause are now known to be important variables affecting the benefit-risk profile. For symptomatic menopausal women who are under 60 years of age or within 10 years of menopause, the benefits of MHT generally outweigh the risks. Systemic MHT initiated early in menopause appears to slow the progression of atherosclerotic disease, thereby reducing the risk of cardiovascular disease and mortality. During this window of opportunity, MHT might also provide protection against cognitive decline. In older women and women more than 10 years past menopause, the risk-benefit balance of MHT is less favorable, particularly with regard to cardiovascular risk and cognitive impairment. For women entering menopause prematurely (<40 years), MHT ameliorates the risk of cardiovascular disease, osteoporosis, and cognitive decline. Nonoral administration of estrogen offers advantages due to the lack of first-pass hepatic metabolism, which in turn avoids the increased hepatic synthesis of clotting proteins, C-reactive protein, triglycerides, and sex hormone-binding globulin. The duration of combined MHT use is ideally limited to less than 5 years because of the known increase in breast cancer risk after 3–5 years of use. Limitations to use of estrogen only MHT are less clear, since breast cancer risk does not appear to increase with use of estrogen alone. For women under the age of 60 years, or within 10 years of onset of natural menopause, MHT for the treatment of bothersome menopausal symptoms poses low risk and is an acceptable option, particularly when nonhormonal management approaches fail.

Effect of daily supplementation of soy isoflavones on hot flashes and night sweats in African menopausal women

The aim of this study was to evaluate the effectiveness of a pharmaceutical grade isoflavone supplement (Inoclim?) 40 mg per capsule of soy extract rich in daidzin and genistin) on the number of hot flashes and night sweats in menopausal African women. This open, prospective, multicenter study involved 140 menopausal women with climacteric symptoms (i.e., a minimum of five hot flashes and/or moderate to severe night sweats per day). These patients received a daily 40-mg supplement of soy isoflavone contained in an Inoclim? capsule (Laboratoire Innotech International, France). The dose was increased to two capsules per day when there were more than five hot flashes or when the women could not sleep because of night sweats. The patients were followed up over a 4-month period and data were analyzed using EPI-InfoTM version 3.5.1. The outcome measure was fewer hot flashes and night sweats. The mean daily number of episodes of hot flashes was 5.7 at baseline and 1.8 at week 16, corresponding to a decrease of 68.4% (n = 93 patients at baseline and n = 66 at 16 weeks). The mean number of daily episodes of night sweats was 3.7 at baseline and 0.8 at week 16, corresponding to a decrease of 78.4% (n = 127 patients in the first week and n = 73 at 16 weeks). Over 80% of patients took a single one 40 mg capsule per day. The percentage of patients who adhered to the prescription was more than 95% during the 4-month follow-up period. These results confirm the effectiveness of a pharmaceutical grade isoflavone supplement (40 mg, rich in genistin and daidzin) on vasomotor symptoms in menopausal women.

Soy, Red Clover, and Isoflavones and Breast Cancer: A Systematic Review

BackgroundSoy and red clover isoflavones are controversial due to purported estrogenic activity and possible effects on breast cancer. We conducted a systematic review of soy and red clover for efficacy in improving menopausal symptoms in women with breast cancer, and for potential impact on risk of breast cancer incidence or recurrence.MethodsWe searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to March 2013 for human interventional or observational data pertaining to the safety and efficacy of soy and red clover isoflavones in patients with or at risk of breast cancer. ResultsOf 4179 records, we included a total of 131 articles: 40 RCTs, 11 uncontrolled trials, and 80 observational studies. Five RCTs reported on the efficacy of soy for hot flashes, showing no significant reductions in hot flashes compared to placebo. There is lack of evidence showing harm from use of soy with respect to risk of breast cancer or recurrence, based on long term observational data. Soy intake consistent with that of a traditional Japanese diet (2-3 servings daily, containing 25-50mg isoflavones) may be protective against breast cancer and recurrence. Human trials show that soy does not increase circulating estradiol or affect estrogen-responsive target tissues. Prospective data of soy use in women taking tamoxifen does not indicate increased risk of recurrence. Evidence on red clover is limited, however existing studies suggest that it may not possess breast cancer-promoting effects. ConclusionSoy consumption may be associated with reduced risk of breast cancer incidence, recurrence, and mortality. Soy does not have estrogenic effects in humans. Soy intake consistent with a traditional Japanese diet appears safe for breast cancer survivors. While there is no clear evidence of harm, better evidence confirming safety is required before use of high dose (≥100mg) isoflavones can be recommended for breast cancer patients.

Determination of the use of complementary and alternative medicine by women in the climacteric period in the Turkish city of Samsun

This quantitative descriptive study was carried out in order to determine the use of complementary and alternative medicine (CAM) for management of menopausal symptoms in women in Samsun, Turkey. Data on general demographic characteristics, menopause-related symptoms, and the use of CAM and herbal therapy were collected from 281 women undergoing the process of the climacteric period, admitted to the gynaecology polyclinic of a hospital in Samsun province. To evaluate the data, descriptive statistics, Student t-tests, and logistic regression analysis were used. In this study the most common CAM methods were identified as herbal therapy (29.9%), dieting (29.5%), exercise (29.2%), and massage (27.8%). Approximately one-third of the women identified as benefitting from CAM methods. More than half identified as not having informed a health care professional about their use of these methods of achieving symptom relief.

Flax and Breast Cancer

Flax is a food and dietary supplement commonly used for menopausal symptoms. Flax is known for its lignan, α-linolenic acid, and fiber content, components that may possess phytogestrogenic, anti-inflammatory, and hormone modulating effects, respectively. We conducted a systematic review of flax for efficacy in improving menopausal symptoms in women living with breast cancer and for potential impact on risk of breast cancer incidence or recurrence. We searched MEDLINE, Embase, the Cochrane Library, and AMED from inception to January 2013 for human interventional or observational data pertaining to flax and breast cancer. Of 1892 records, we included a total of 10 studies: 2 randomized controlled trials, 2 uncontrolled trials, 1 biomarker study, and 5 observational studies. Nonsignificant (NS) decreases in hot flash symptomatology were seen with flax ingestion (7.5 g/d). Flax (25 g/d) increased tumor apoptotic index (P< .05) and decreased HER2 expression (P< .05) and cell proliferation (Ki-67 index; NS) among newly diagnosed breast cancer patients when compared with placebo. Uncontrolled and biomarker studies suggest beneficial effects on hot flashes, cell proliferation, atypical cytomorphology, and mammographic density, as well as possible anti-angiogenic activity at doses of 25 g ground flax or 50 mg secoisolariciresinol diglycoside daily. Observational data suggests associations between flax and decreased risk of primary breast cancer (adjusted odds ratio [AOR] = 0.82; 95% confidence interval [CI] = 0.69-0.97), better mental health (AOR = 1.76; 95% CI = 1.05-2.94), and lower mortality (multivariate hazard ratio = 0.69; 95% CI = 0.50-0.95) among breast cancer patients. Current evidence suggests that flax may be associated with decreased risk of breast cancer. Flax demonstrates antiproliferative effects in breast tissue of women at risk of breast cancer and may protect against primary breast cancer. Mortality risk may also be reduced among those living with breast cancer.

HRT optimization, using transdermal estradiol plus micronized progesterone, a safer HRT

ABSTRACTHormone replacement therapy (HRT) remains the gold standard for treatment of climacteric symptoms in menopausal women; it is relatively safe in healthy subjects for at least 5 years, provided it had been initiated before the age of 60 years and/or within 10 years from menopause. Estrogen probably adds some cardioprotection, that can, however, be obscured by progestogens, especially medroxyprogesterone acetate (MPA). Oral HRT is associated with an increased risk of venous thromboembolism (VTE), gallbladder disease and possibly stroke. The increased occurrence of all these events can be prevented by the use of the transdermal route of estradiol administration; this route seems also advantageous for women with diabetes, hypertension and other cardiovascular risk factors, and also especially with advancing age. Endometrial protection by any progestogen is insufficient in the mid to long term when cyclical, sequential regimens are used; full protection can be secured only by continuous combined estrogen + progestogen. Natural, ‘body-identical’ progesterone, devoid of any androgenic as well as glucocorticoid activities but being slightly hypotensive due to its antimineralocorticoid activity, appears to be the optimal progestogen in terms of cardiovascular effects, blood pressure, VTE, probably stroke and even breast cancer (contrary to synthetic progestogens and particularly MPA, which appear to be mitogenic on breast cells, in synergism with estrogen). HRT optimization can thus be achieved by combining low doses of estrogen given transdermally with micronized oral progesterone; such optimized HRT will allow us to treat symptomatic women for as long as required. Asymptomatic women at risk of (osteoporotic) fractures can also be treated with this optimized HRT as long as their individual risk/benefit ratio remains favorable (thanks to the absence of increased risks of VTE, stroke and breast cancer).

Structure Determination of Isoxanthohumol and 8-Prenylnaringenin Glucuronides Formed by Human Liver Microsomes

Isoxanthohumol (IX) and 8-prenylnaringenin (8-PN) are prenylated flavonoids of hops (Humulus lupulus L.) with estrogenic activity that are under investigation as dietary supplements for the treatment of menopausal symptoms in women. Previous studies suggest a variety of phase I metabolites for IX and 8-PN and some conjugates, but there is less information on the regiochemistry of their phase II conjugates.1 – 3 The aim of this study was to investigate regiochemistry of glucuronidation of IX and 8-PN by human liver microsomes. Four glucuronide metabolites of IX and 8-PN were obtained from the incubation of alamethicin-activated liver microsomes with uridine-5'-diphosphoglucuronic acid (UDPGA). Their characterization and structural confirmation were achieved by enzymatic formation with or without UDPGA, hydrolysis by β-glucuronidase hydrolysis, and by LC-MS/MS and 1H, 13C and 2D-NMR and after large-scale incubation and semi-preparative HPLC.

Evaluation of Contextual and Demographic Factors on Licorice Effects on Reducing Hot Flashes in Postmenopause Women

Menopause is an important stage in the life of every woman. Hot flashes are the most common climacteric symptom and a major cause of suffering in postmenopausal women. Licorice is one of the plants that is used to relieve menopausal symptoms. The present study was undertaken to evaluate the effects of licorice on hot flash symptoms in menopausal women. The participants of this randomized, double blind, clinical trial study were 60 menopausal women randomly allocated to licorice or hormone replacement therapy (HRT) groups. The participants in this trial received licorice (1140 mg/day) or HRT (a conjugated estrogen 0.312 mg/day and Medroxyprogesterone 2.5 mg/day) for 90 days. In this study we observed that licorice is not very different from hormones in terms of reducing the number and duration of hot flashes, but that HRT can reduce the severity of hot flashes significantly better than licorice can. In addition, there was no significant difference between age, education level, marital status, occupation, income, number of pregnancies, time from cessation of menstruation, and severity of hot flashes in the two groups. We observed that licorice seems more effective than HRT in improving hot flash duration, but that HRT can reduce the duration and severity of hot flashes more than licorice.

Quality of life and menopausal symptoms in women with liver transplants

PURPOSE: To assess quality of life and climacteric symptoms in women with and without liver transplants. METHODS: This was a cross-sectional study of 52 women undergoing follow-up at a university hospital in southeastern Brazil from February 4th, 2009 to January 5th, 2011. Twenty-four of these women were 35 years old or older and had undergone liver transplantation at least one year before study entry. The remaining 28 women had no liver disease and were matched by age and menstrual patterns to the patients with transplants. The abbreviated version of the World Health Organization (WHOQOL-BREF) questionnaire was used to assess quality of life. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS). Statistical analysis was carried out by Student's t-test, Mann-Whitney test and analysis of variance. Correlations between MRS and the WHOQOL-BREF were established by correlation coefficients. RESULTS: The mean age of the women included in the study was 52.2 (±10.4) years and the mean time since transplantation was 6.1 (±3.3) years. Women with liver transplants had better quality of life scores in the environment domain (p=0.01). No difference was noted between the two groups in any domain of the MRS. For women in the comparison group, there was a strongly negative correlation between somatic symptoms in the MRS and the physical domain of the WHOQOL-BREF (p<0.01; r=-0.8). In contrast, there was only a moderate association for women with liver transplants (p<0.01; r=-0.5). CONCLUSIONS: Women with liver transplants had better quality of life scores in the domain related to environment and did not exhibit more intense climacteric symptoms than did those with no liver disease. Climacteric symptoms negatively influenced quality of life in liver transplant recipients, although less intensely than in women without a history of liver disease.

Determining the association between Turkish women’s menopausal symptoms and their marital adjustment

To determine the association between women's menopausal symptoms and their marital adjustment. Materials and methods: A descriptive cross-sectional study was conducted on 263 Turkish women chosen using an improbable randomized sampling method. A questionnaire, the Menopause Symptom Rating Scale (MSRS), and the Dyadic Adjustment Scale (DAS) were used to collect data. Percentage distributions, the t-test in independent groups, the one-way ANOVA test, Pearson correlation analysis, and the Kruskal-Wallis test were used in the evaluation of the data. Results: The mean of the overall MSRS score for women was 22.67 ± 8.06 and the mean of the overall DAS score for women was 105.93 ± 16.60. There was a significantly negative relationship between menopausal symptoms and marital adjustment (r: -0.357, P < 0.001), while the differences between MSRS total point averages according to women's age at marriage and total number of pregnancies were found to be statistically significant (P < 0.05). According to the comparison of the subscale mean score and the overall mean score obtained from the MSRS and DAS based on how women entered menopause, the difference between groups was statistically significant (P < 0.05, P < 0.001). Conclusion: The level of marital adjustment decreased in line with the increase in menopausal symptoms suffered by women. It was determined that women whose age at marriage was 20 and over, according to MSRS total point averages, suffered from menopausal symptoms less. It was seen that women who had 6 or more pregnancies had more menopausal complaints. Women who entered menopause due to surgery experienced more menopausal complaints than those who entered menopause naturally, and women who entered menopause due to surgery had a better level of marital adaptation.

Prunus mumeandLithospermum erythrorhizonExtracts Synergistically Prevent Visceral Adiposity by Improving Energy Metabolism through Potentiating Hypothalamic Leptin and Insulin Signalling in Ovariectomized Rats

We investigated the antiobesity and hypoglycemic properties of Prunus mume Sieb. et Zucc (PMA; Japanese apricot) and Lithospermum erythrorhizon Sieb. et Zucc (LES; gromwell) extracts in ovariectomized (OVX) rats that impaired energy and glucose homeostasis. OVX rats consumed either 5% dextrose, 5% PMA extract, 5% LES extract, or 2.5% PMA+2.5% LES extract in the high fat diet. After 8 weeks of treatment, PMA+LES prevented weight gain and visceral fat accumulation in OVX rats by lowering daily food intake and increasing energy expenditure and fat oxidation. PMA+LES prevented the attenuation of leptin and insulin signaling by increasing the expression of leptin receptor in the hypothalamus in OVX rats. PMA+LES significantly reversed the decrease of energy expenditure in OVX rats by increasing expression of UCP-1 in the brown adipose tissues and UCP-2 and UCP-3 in the quadriceps muscles. PMA+LES also increased CPT-1 expression and decreased FAS, ACC, and SREBP-1c in the liver and quadriceps muscles to result in reducing triglyceride accumulation. PMA+LES improved insulin sensitivity in OVX rats. In conclusion, PMA+LES synergistically prevented the impairment of energy, lipid, and glucose metabolism by OVX through potentiating hypothalamic leptin and insulin signaling. PMA+LES may be a useful intervention for alleviating the symptoms of menopause in women.

Oral low-dose estradiol plus norethisterone acetate with or without simvastatin in dyslipidemic and symptomatic menopausal women: A randomized clinical trial

Context and Objective: Cardiovascular diseases are the leading causes of death in postmenopausal women and dyslipidemia has important contributing factor. The objective of the study was to evaluate low-dose estrogen plus progestogen therapy (EPT) + simvastatin for vasomotor symptoms and lipid and lipoprotein profiles. Design and Setting: Clinical trial was conducted in a private clinical research center. Methods: Two hundred forty symptommatic postmenopausal women with dyslipidemia were randomized to one of three treatment groups: A) 1 mg estradiol/ 0.5 mg norethisterone acetate (E2/NETA) + 20 mg simvastatin; B) E2/NETA + placebo; or C) 20 mg simvastatin + placebo. Lipid and lipoprotein profiles and menopausal symptoms were evaluated after 16 weeks. Results: Total cholesterol, LDL cholesterol, non-HDL cholesterol decreased (P cholesterol, non-HDL cholesterol, LDL cholesterol, Apo B and ApoB/Apoa1 (P Conclusions: Thus in postmenopausal women with dyslipidemia, the association of E2/ NETA low-dose with simvastatin relieved climacteric symptoms similar to that observed with isolated E2/NETA and improved lipid and lipoprotein profile similar to the isolated use of simvastatin. The use of E2/NETA alone decreased menopausal symptoms, but did not improve dyslipidemia.

Influência do exercício físico na sintomatologia de mulheres climatéricas

O objetivo deste estudo foi verificar as alterações da sintomatologia climatérica em mulheres, decorrentes da prática de um programa de exercício físico aeróbio. Constituiu pesquisa descritiva do tipo experimental e cunho quantitativo. Participaram do estudo oito mulheres com faixa etária 55,25 ± 2,71 anos, estatura 1,49 ± 0,04m, massa corporal 64,55 ± 14,73 Kg, IMC 29,98 ± 5,48 Kg/ m², e pressão arterial média 120/82 mmHg, que executaram programa de exercícios físicos (oito semanas), em dois estágios de quatro semanas cada, sendo em quatro delas sem controle da intensidade e em quatro com controle (70% FC) As participantes, ao iniciarem o protocolo tiveram avaliada sintomatologia a cada quatro semanas de exercício. Para a análise estatística dos dados, utilizaram-se a relação de média, desvio-padrão, valores máximos e mínimos, coeficiente de variância e o teste t para observações pareadas. Com efeito significativo em 5%, os resultados obtidos foram a melhora na sintomatologia climatérica, segundo os escores do Índice Menopausal de Blatt Kupperman, com a prática do protocolo de exercício físico aeróbio proposto em 15,62% após quatro semanas, e 16,28% após oito semanas; e melhora na capacidade aeróbia da classificação boa para excelente segundo a American Heart Association, com ganhos de 27,82%. Conclui-se que a execução do protocolo de exercício físico proposto trouxe melhoras na sintomatologia climatérica nas mulheres participantes do estudo nos dois estágios, com melhora total de 23,85%, apesar da duração de apenas oito semanas.

Acupuncture in the management of menopausal symptoms in women diagnosed with breast cancer: an uncontrolled experimental pilot study

Acupuncture in the management of menopausal symptoms in women diagnosed with breast cancer: an uncontrolled experimental pilot study

Sleep quality and aerobic training among menopausal women—A randomized controlled trial

BackgroundMenopause is associated with poor sleep quality and daytime sleepiness, which may lead to impaired quality of life and impaired functioning in daily activities. ObjectiveTo study whether exercise training improves sleep quality or decreases the amount of night time hot flushes among menopausal women with vasomotor symptoms. Study designA randomized controlled trial. Sedentary women (N=176) aged 43–63 years with menopausal symptoms were randomized to a six-month unsupervised aerobic training intervention (50min 4 times per week) or a control group. Both groups attended lectures on physical activity and health once a month. Main outcome measuresSleep quality and the amount of hot flushes disturbing sleep. The women reported daily via mobile phone whether hot flushes had disturbed their sleep and how they had slept (scale 1–5). Responses received by mobile phone over the 6-month period totaled on average 125 (5.2 per week) responses per participant. ResultsAt baseline there was no difference between the groups in the demographic variables. Sleep quality improved significantly more in the intervention group than in the control group (OR 1.02; 95% CI=1.0–1.05, p=0.043). The odds for sleep improvement were 2% per week in the intervention group and a decrease of 0.5% per week in the control group. The amount of hot flushes related to sleep diminished (p=0.004) by the end of the intervention. ConclusionsAerobic training for 6 months may improve sleep quality and reduce hot flushes among symptomatic menopausal women.

407 Facilitating Lifestyle Changes to Manage Menopausal Symptoms in Women with Breast Cancer: Delivering the Pink Women's Wellness Program

Women diagnosed as having breast cancer may experience difficulties with posttreatment effects such as menopausal symptoms. The aims of this pilot study were to (1) evaluate the impact of a multimodal lifestyle program on reducing menopausal symptoms in women with breast cancer and (2) examine the impact of the program on health-related quality of life (HRQoL) and adherence to lifestyle recommendations.

Recent Developments in Pharmacotherapy for Vasomotor Symptoms

Many women experience vasomotor symptoms (VMS) at or around the time of menopause. Hot flashes and night sweats are considered primary menopausal symptoms that may also be associated with sleep and mood disturbances, as well as decreased cognitive function. All of these symptoms may lead to social impairment and work-related difficulties that significantly decrease overall quality of life. Hot flashes have shown a great deal of variability in their frequency and severity in women. In some women, hot flashes persist for several months, but in others, they may last for more than 10 years. Traditionally, VMS were reported to begin after menopause, but night sweats in particular most often begin in perimenopause, several years before the final period. The pathogenesis of hot flashes has not yet been fully elucidated. Hormonal therapy for menopause-associated VMS has been the mainstay for the management of these symptoms for more than 50 years. However, because many women now want to avoid hormone therapy, there is a need for additional targeted therapies, validated by results from controlled clinical trials, that are safe, efficacious, cost-effective, and well tolerated by symptomatic menopausal women. The current status of these new pharmacotherapies for VMS is reviewed.

Mind over menopausal symptoms in women with breast cancer

Mind over menopausal symptoms in women with breast cancer

Therapeutic value of multivitamin: Reducing emerging symptoms of menopausal women helping as a child care giver in Nigeria

Menopause is becoming an increasingly important aspect of women’s health. This aim of this study was to determine the socio-demographic characters of menopausal women and the therapeutic value of multivitamin in reducing emerging symptoms. This is an intervention study of menopausal women aged 40 years and above who are helping as a child care giver in Ilorin metropolis. Information on their socio-demographic characteristics and symptoms experienced was obtained with the aid of a questionnaire. The mean age of the respondents was 57.2 ± 1.2 years. Moslems constituted 72.5% of the women, while 27.5% were Christians. Nearly all (80.9%) were of the Yoruba ethnic group. Amongst the women, 52.8% had formal education, 65.7% were married and most belonged to one or more social groups. Vasomotor symptoms, such as internal heat/hot flushes was common among the study group of 54 (30.3%), while the control was 44 (27.2%), night sweats was high in the study group, 51 (28.7%). Post-intervention analysis showed that respondents became more conscious of signs/symptoms of menopause with hot flushes/internal heat, weakness/tiredness and insomnia being the most common complaints. This change in reported symptoms was statistically significant for the study group (P = 0.041296), unlike the control group where it was not significant (P = 0.558667) for the study and control groups. Multivitamins and health education are good therapeutic values in reducing menopausal symptoms; thus, they assist women in taking care of their grand children. It is important to take these factors into account when planning health strategies to improve the lives of these women. Key words: Menopause, therapeutic value, emerging symptoms, multivitamin, child care giver.