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Lamba A, Mohajir N, Rahman S. A review of the psychosocial factors that contribute to sexuality, female sexual dysfunction, and sexual pain among Muslim women. Sex Med Rev 2023:7160016. [PMID: 37169514 DOI: 10.1093/sxmrev/qead019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 05/13/2023]
Abstract
INTRODUCTION Sexual pain disorders are complex conditions experienced by women around the world. Muslim women experience sexuality and sexual dysfunction in a distinct manner that is influenced by religious and cultural standards. Muslim women experiencing sexual pain are a unique patient population whose cultural background should be understood by health care professionals to provide culturally competent care. OBJECTIVES To identify the psychosocial factors that influence Muslim women's experience of sexual pain. METHODS A comprehensive review of the literature through PubMed and Google Scholar was conducted to compile information related to sexual dysfunction, sexual pain, and treatment options in the Muslim women population in the United States and internationally. RESULTS Painful sex among Muslim women has been associated with female genital cutting, cultural taboos, lack of sex education, absence of language to discuss sex, negative cognitions about sex, expectations to bear the male partner's inconsiderate sexual performance, and familial interference. Typical treatments for sexual pain in Islamic countries were explored, with new treatments that have recently been tested. CONCLUSION Understanding sexual pain among Muslim women, including the religious and cultural factors that are potentially associated with this pain, is important for health care professionals to care for their Muslim patients in a culturally competent manner and reduce the implicit bias that may affect quality of care. It appears that providing sexual education, with treatment modalities such as psychotherapy and physical therapy, is useful in treating female sexual pain. We suggest that sexual education, as well as a cultural shift that embraces women's sexual agency, is needed to reduce and prevent sexual pain.
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Affiliation(s)
- Arleen Lamba
- Stritch School of Medicine, Loyola University Chicago, Maywood, IL 60153, United States
| | - Nadiah Mohajir
- HEART Women and Girls, HEART, Chicago, IL 60637, United States
| | - Sameena Rahman
- Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-3008, United States
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Karimi FZ, Nazari N, Rakhshandeh H, Mazloum SR. The effect of nettle vaginal cream on subjective symptoms of vaginal atrophy in postmenopausal women. Eur J Obstet Gynecol Reprod Biol 2023; 285:41-45. [PMID: 37044017 DOI: 10.1016/j.ejogrb.2023.03.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Vaginal atrophy is a condition where the vaginal epithelium gets thinner and includes symptoms, such as vaginal dryness, abnormal vaginal discharge, vaginal bleeding, dyspareunia, and sexual problems. Hormone therapy is associated with some problems and some women prefer herbal medicine to reduce vaginal atrophy. Considering the phytoestrogenic compounds present in the nettle, this study aimed to investigate the effect of the nettle vaginal cream on subjective symptoms of vaginal atrophy in postmenopausal women. MATERIALS AND METHODS This triple-blind randomized placebo-controlled clinical trial study was conducted on 84 eligible postmenopausal women aged 45-60 years, who referred to comprehensive health service centers in Aliabad Katul in 2021-2022. Women eligible for the study received 5% nettle vaginal cream and placebo for 8 weeks. Subjective symptoms of vaginal atrophy were assessed before, four and eight weeks after the intervention. Data collection tools included a checklist for research unit selection, individual and midwifery characteristics questionnaire, vaginal assessment scale (VAS), vaginal pH, laboratory results of the vaginal maturation value (VMV). Data analysis was performed using SPSS software (version 21) and independent t-test, Mann-Whitney, chi-square, Two-way analysis of variance and analysis of covariance. P value less than 0.05 was considered significant. RESULTS Subjective symptoms of vaginal atrophy decreased significantly after the intervention compared to before the intervention in both the nettle and placebo groups (p < 0.001), but in the comparison between groups four weeks and eight weeks after the intervention, the subjective symptoms of vaginal atrophy in nettle group decreased significantly (p < 0.001). In the nettle group, the scores of vaginal burning, vaginal dryness, vaginal itching and dyspareunia significantly improved after the intervention compared to before the intervention (p < 0.001). Also, in the nettle group compared to the placebo group, after the intervention, vaginal burning and vaginal dryness score (p < 0.001) and vaginal itching score (0.004) improved significantly. CONCLUSION Based on the results of the present study, Nettle vaginal cream reduced subjective symptoms of vaginal atrophy, including vaginal burning, vaginal dryness, vaginal itching, and dyspareunia in postmenopausal women, so it is a cost-effective, available and do not have the side effects product that can be useful for menopausal women.
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Affiliation(s)
- Fatemeh Zahra Karimi
- Department of Midwifery, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Nahid Nazari
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Hassan Rakhshandeh
- Department of Pharmacology, Medicinal Plants Pharmacological Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Reza Mazloum
- Department of Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Jenabi E, Khazaei S, Aghababaei S, Moradkhani S. Effect of Fennel-Valerian Extract on Hot Flashes and Sleep Disorders in Postmenopausal Women: A Randomized Trial. J Menopausal Med 2023; 29:21-28. [PMID: 37160299 PMCID: PMC10183764 DOI: 10.6118/jmm.22026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/01/2023] [Accepted: 04/16/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the effect of a mixture of fennel and valerian extracts on hot flashes and sleep disorders of postmenopausal women in Iran. A randomized trial was conducted. METHODS A total of 76 postmenopausal women were randomly assigned to either of the two groups: fennel-valerian extract or control. One 500 mg fennel-valerian extract capsule was given twice, daily for 8 weeks. The 500 mg oral placebo capsule (starch) was given the same way. RESULTS The mean duration of hot flashes increased in both the groups over time (P < 0.001). The mean frequency and severity of hot flashes in the intervention group were significantly lower than in the control group, in the first and second months after intervention (P < 0.050). Women in the fennel-valerian extract group had a significantly lower Pittsburgh Sleep Quality Index score than the control group 2 months after intervention (P = 0.030). CONCLUSIONS This study found that fennel-valerian extract was effective for relieving sleep disorders as well as the severity and frequency of hot flashes compared with a placebo.
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Affiliation(s)
- Ensiyeh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soodabeh Aghababaei
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirin Moradkhani
- Department of Pharmacognosy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Mexican traditional medicines for women's reproductive health. Sci Rep 2023; 13:2807. [PMID: 36797354 PMCID: PMC9935858 DOI: 10.1038/s41598-023-29921-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 02/13/2023] [Indexed: 02/18/2023] Open
Abstract
Like China, Mexico has a traditional system of medicine dating back almost 5000 years that incorporates the healing practices of pre-Columbian civilizations, including the Maya and Aztec. Mexican Traditional Medicine (MTM) women depend on MTM practices and herbal medicines for their primary healthcare needs as limited access and high costs of Western medicine is a significant problem. The aims of this work were to determine the medicinal plants more commonly used in MTM for women's reproductive health issues and assess the clinical data supporting their use. Data from multiple sources was compiled and information on plants commonly used by women in Mexico MTM for the treatment of fertility and menstruation issues, pregnancy, and menopause was analyzed. Analysis of the data show that 185 species of plants representing > 60 families were used for a wide range of reproductive health issues. Some of these plants have been used in MTM for fertility regulation in women of which 35 species were used as emmenagogues and abortifacients. Approximate 40 species were used for the symptoms of premenstrual syndrome, heavy menstrual bleeding, and dysmenorrhea. In terms of pregnancy, 35 species were used for postpartum care and to facilitate breastfeeding, 16 species were used as oxytocic agents to induce labor and speed birth, and six plant species were used to prevent miscarriage. Fourteen plant species were reported to treat infertility or promote fertility, and seven species were used to treat uterine prolapse. Three plants species were reported to treat menopause and two plants were used for osteoporosis. Analysis of the clinical data for commonly used medicinal plants showed some clinical support for the use of these plants in MTM. In Mexico, women use medicinal plants for almost every aspect of reproductive health. While some plants have clinical data, most medicinal plants used in MTM have no safety or efficacy data available and could serve as the basis of future investigations.
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Pandozzi C, Giannetta E, Tarsitano MG. Phytotherapic approach in menopause: light and darkness. Minerva Endocrinol (Torino) 2022; 47:421-436. [PMID: 35420287 DOI: 10.23736/s2724-6507.22.03712-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Menopause is a critical period of the woman life, characterized by a peculiar modification in estrogens concentration and accompanied by different signs and symptoms. To prevent and contrast unfavorable consequences of menopause, different therapeutic approaches could be evaluated. The hormone replacement therapy (HRT) is the most known, but it has several contraindications. The increasing interest in phytotherapy introduces the necessity for endocrinologist involved in menopause to suggest different therapeutic approaches, considering the state of health of patient and the real efficacy of the drugs. We aim to outline the main phytotherapy treatments to choose in menopause. EVIDENCE ACQUISITION This review is based on focused research of the current literature on PubMed and Scopus such as research databases. We selected 4120 papers through these keywords: "MENOPAUSE" AND "phytotherapy," "natural therapy," "phytoterapy drugs." Then, the literature was scanned selecting English papers of last 10 years (last research on October 1, 2021), excluding reviews. Separately, two researchers MGT and CP examined and read 212 full selected papers. We included clinical trials and randomized clinical trials written in English and excluded duplicates, animal studies and studies with lack of group of interest, non-relevant outcomes, inappropriate methodology. Retrospective studies, case reports, case series, original articles, brief communications, and letter to the editor were included in our research. We furthermore completed our research by the examination of every study's bibliography. EVIDENCE SYNTHESIS Phytotherapy involves the use of plants or plant extracts for the treatment of diseases thanks to the activities of their compounds and metabolites. In particular, many of them have an estrogen-like activity and are identified as phytoestrogens, because thanks to their chemical structure are able to bind the estrogen receptors and carry out biological estrogenic or antiestrogenic activities. The supplementing diet with these compounds can ensure an advantage on various aspects of the climacteric syndrome and some of them also have a beneficial impact on cardiovascular risk, bone health and sleep complaint. These substances can be used with safety due to their good tolerability and low rate of side effects. There are no known serious adverse events associated with their consumption, but as a precaution, its use is not recommended during pregnancy and in association with hormonal therapies or in women with hormone responsive cancers. CONCLUSIONS Phytotherapy must be considered an interesting tool in the treatment of signs and symptoms in selected menopause woman.
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Affiliation(s)
- Carla Pandozzi
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Elisa Giannetta
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Maria G Tarsitano
- Department of Clinical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
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Sarmento ACA, Costa APF, Lírio J, Eleutério Jr J, Baptista PV, Gonçalves AK. Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:986-994. [PMID: 36446564 PMCID: PMC9708399 DOI: 10.1055/s-0042-1756148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women. DATA SOURCES We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied. SELECTION OF STUDIES We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women. DATA COLLECTION Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors. DATA SYNTHESIS A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO2 laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study). CONCLUSION We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).
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Affiliation(s)
| | - Ana Paula Ferreira Costa
- Postgraduate Program student in Health Science, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Juliana Lírio
- Department of Obstetrics and Gynecology, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - José Eleutério Jr
- Department of Obstetrics and Gynecology, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | | | - Ana Katherine Gonçalves
- Postgraduate Program student in Health Science, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil,Address for correspondence Ana Katherine Gonçalves, Professor rua Major Laurentino de Morais, 1.218/1.301, Natal, RN, 59020-390Brazil
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Azimi M, Niayesh H, Raeiszadeh M, Khodabandeh-Shahraki S. Efficacy of the herbal formula of Foeniculum vulgare and Rosa damascena on elderly patients with functional constipation: A double-blind randomized controlled trial. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:230-236. [PMID: 35339396 DOI: 10.1016/j.joim.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Constipation is a common chronic bowel disorder with an incidence of more than 50% in the elderly population. Complementary and alternative medicine is a cost-effective and satisfactory treatment for constipation used widely by the elderly. OBJECTIVE This study evaluates the efficacy of an herbal formula made from Foeniculum vulgare Mill. and Rosa damascena for the treatment of constipation in an elderly population and consequent changes to their quality of life. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION This double-blind randomized active controlled clinical trial, with parallel group allocation ratio of 1:1, was conducted in a referral clinic in Afzalipour Hospital, affiliated to Kerman University of Medical Sciences in Kerman, Southeastern Iran. Individuals over 60 years of age, diagnosed with functional constipation (based on the Rome IV criteria), were included in this study. Participants received a sachet of 10 g F. vulgare and R. damascena (herbal formula group) or polyethylene glycol 4000 (PEG 4000 group) with a glass of warm water two times a day for 4 weeks and were followed up for 4 additional weeks. MAIN OUTCOME MEASURES Constipation severity, stool consistency, and the quality of life were used as the primary outcomes. Drug side effects were used as a secondary outcome. The outcomes were assessed using the Constipation Assessment Scale, the Bristol Stool Form Scale, and the Patient Assessment of Constipation Quality of Life questionnaire. RESULTS A total of 25 participants in each group completed the four-week treatment cycle and the eight-week follow-up. At the end of the four-week treatment cycle, all clinical outcomes had significant improvements in both groups (P < 0.05). The analysis of constipation severity (P < 0.001), stool consistency (P < 0.001), and the quality of life (P < 0.001) showed significant improvements with fewer side effects (mild diarrhea) and a longer duration of symptom relief in the herbal formula group compared to the PEG 4000 group. CONCLUSION Although both interventions significantly improved the treatment outcomes, constipation severity, stool consistency and the quality of life were improved more effectively by the herbal formula than by PEG 4000; however, the mechanism of action is not yet understood. TRIAL REGISTRATION This trial was registered in the Iranian Registry of Clinical Trials (IRCTID: IRCT20200108046056N1).
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Affiliation(s)
- Maryam Azimi
- Gastroenterology and Hepatology Research Center, Kerman University of Medical Sciences, Kerman 7716913555, Iran; Department of Traditional Medicine, School of Persian Medicine, Kerman University of Medical Sciences, Kerman 7716913555, Iran
| | - Hanieh Niayesh
- Student Research Committee, Afzalipour Faculty of Medicine, Kerman University of Medical Sciences, Kerman 7716913555, Iran
| | - Mahboobeh Raeiszadeh
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman 7716913555, Iran
| | - Sedigheh Khodabandeh-Shahraki
- Department of Community Health Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman 7716913555, Iran.
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Hocké C, Diaz M, Bernard V, Frantz S, Lambert M, Mathieu C, Grellety-Cherbero M. [Genitourinary menopause syndrome. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2021; 49:394-413. [PMID: 33757926 DOI: 10.1016/j.gofs.2021.03.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Genitourinary menopause syndrome (SGUM) is defined as a set of symptoms associated with a decrease of estrogen and other sexual steroids during menopause. The main symptoms are vulvovaginal (dryness, burning, itching), sexual (dyspareunia), and urinary (urinary infections, pollakiuria, nycturia, pain, urinary incontinence by urgenturia). SGUM leads to an alteration of the quality of life, and affects especially women's sexuality. OBJECTIVE The objective of this review was to elaborate guidelines for clinical practice regarding the management of SGUM in postmenopausal women, and in particular, in women with a history of breast cancer, treated or not with hormone therapy. MATERIALS AND METHODS A systematic review of the literature on SGUM management was conducted on Pubmed, Medline and Cochrane Library. Recommendations from international scholarly societies were also taken into account: International Menopause Society (IMS) https://www.imsociety.org, The North American Menopause Society (NAMS) https://www.menopause.org, Canadian Menopause Society https://www.sigmamenopause.com, European Menopause and Andropause Society (EMAS) https://www.emas-online.org, International Society for the Study of Women's Sexual Health (ISSWSH) https://www.isswsh.org. RESULTS Vaginal use of lubricants, moisturizers and hyaluronic acid improves the symptoms of SGUM and may be offered to all patients. For postmenopausal women, local estrogen will be preferred to the oral route because of their safety and efficacy on all symptoms of SGUM during low-dose use. Prasterone is a local treatment that can be proposed as an effective alternative for the management of dyspareunia and sexual function disorder. Current data on oral testosterone, tibolone, oral or transdermal DHEA and herbal medicine are currently limited. Ospemifène, which has shown a significant improvement in sexual symptoms, is not currently marketed in France. In the particular case of women with a history of breast cancer, non-hormonal regimens are a first-line therapy. Current data on the risk of breast cancer recurrence when administering low-dose local estrogen are reassuring but do not support a conclusion that this treatment is safe. CONCLUSION SGUM is a common symptom that can affect the quality of life of postmenopausal women. A treatment should be systematically proposed. Local non-hormonal treatment may be offered in all women. Local low-dose estrogen therapy and Prasterone has shown an interest in the management of symptoms. In women before a history of breast cancer, local non-hormonal treatment should be offered first-line. The safety of low-dose local estrogen therapy and Prasterone cannot be established at this time. Other alternatives exist but are not currently recommended in France due to lack of data.
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Affiliation(s)
- C Hocké
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
| | - M Diaz
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - V Bernard
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - S Frantz
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Lambert
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - C Mathieu
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Grellety-Cherbero
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
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Variation in outcome reporting and measurement tools in clinical trials of treatments for genitourinary symptoms in peri- and postmenopausal women: a systematic review. ACTA ACUST UNITED AC 2021; 27:1070-1080. [PMID: 32852462 DOI: 10.1097/gme.0000000000001570] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
IMPORTANCE Genitourinary symptoms affect 40% to 60% of postmenopausal women. Evidence-based approaches to diagnosing and managing these symptoms are limited by inconsistencies in outcomes and measures used in clinical trials. OBJECTIVE The aim of the study was to systematically review all outcomes and measurement tools reported in randomized clinical trials of interventions for genitourinary symptoms associated with menopause. EVIDENCE REVIEW We searched PubMed, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to December 2018. Randomized controlled trials with a primary or secondary outcome of genitourinary symptoms associated with menopause, English language, and sample size of 20 or more women per study arm were included. Study characteristics, outcomes, and measurement methods were collected. FINDINGS The search yielded 3,478 articles of which 109 met inclusion criteria. Forty-eight different outcomes were reported with "atrophy" as the most common (56/109, 51%) followed by measures of sexual function (19/109, 17%). Almost all (108/109, 99%) trials included patient-reported measures, with 21 different measures and 39 symptom combinations. Clinician-reported scales of vulvovaginal appearance were used in 36 of 109 (33%) trials, with extensive variation in what was measured and reported. Cytological measures from the vaginal epithelium were the most commonly used objective tools (76/109, 70%). CONCLUSIONS AND RELEVANCE There is heterogeneity in reported outcomes and measures used in clinical trials of treatments for genitourinary symptoms at menopause and uncertainty as to which outcomes best reflect patient priorities and symptoms. The findings from this systematic review have informed an international survey of stakeholders to determine priorities for outcome selection and reporting. This survey will then inform the development of a Core Outcome Set for use in future clinical trials by the COMMA (Core OutcoMes in MenopAuse) consortium. : Video Summary:http://links.lww.com/MENO/A599.
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Abdi F, Rahnemaei FA, Roozbeh N, Pakzad R. Impact of phytoestrogens on treatment of urogenital menopause symptoms: A systematic review of randomized clinical trials. Eur J Obstet Gynecol Reprod Biol 2021; 261:222-235. [PMID: 33962824 DOI: 10.1016/j.ejogrb.2021.03.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/08/2021] [Accepted: 03/28/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Menopause symptoms affect the various dimensions of women's lives and they can lead to reduction of their quality of life. Phytoestrogens can be used as an approach to diminish these symptoms. The aim of this systematic review was to investigate the effect of phytoestrogens on the treatment of urogenital menopause symptoms. STUDY DESIGN PubMed, EMBASE, Web of Science, Cochrane library,Scopus and ProQuest were systematically searched from 2000-2020. All randomized clinical trials were included. The quality of the selected papers was evaluated by the CONSORT checklist. RESULTS 33 eligible high-quality papers were reviewed. Various forms of phytoestrogens such as Pueraria Mirifica, fennel, Hop plant(Humuluslupulus L.), Glycine Max (L.) Merr, soy, red clover, black cohosh, ginsing, cimicifugaracemosa, genistein, diadzein, glycitein and isoflavone in the form of oral capsules and pill, food supplement, enriched powder, vaginal gel, cream and suppository could improve menopausal urogenital symptoms. The recovery rate in vaginal use of these phytoestrogens was greater than other consumptions. CONCLUSIONS After using a variety of phytoestrogens in different forms indicators of urogenital atrophy and urinary disorders improved and women's sexual function improved after treatment. The use of phytoestrogens as a safe, low-risk compared to hormone therapy and almost accessible method for women can relieve urogenital symptoms and promote the sexual satisfaction and quality of life.
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Affiliation(s)
- Fatemeh Abdi
- Assistant Professor, School of nursing and midwifery, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Alsadat Rahnemaei
- Student Research Committee, Nursing and Midwifery Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nasibeh Roozbeh
- Mother and Child Welfare Research Center, Hormozgan Universiy of Medical Sciences, BandarAbbas, Iran
| | - Reza Pakzad
- Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
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The Effect of Jazar Supplement on Quality of Life and Sexual Function in Postmenopausal Women: A Double-Blind, Randomized, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8854182. [PMID: 33708258 PMCID: PMC7932778 DOI: 10.1155/2021/8854182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/15/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022]
Abstract
Background Menopause is one of the most critical stages of a woman's life and is accompanied by symptoms including hot flashes, night sweats, mood swings, sexual dysfunction, mucus atrophy, and vaginal dryness. Women tend to use complementary and alternative medicine such as herbs rather than hormone replacement therapy to alleviate these symptoms. The purpose of this study is to examine the effects of Jazar supplement (herbal supplement comprising Vitex, fennel, and carrot seeds) on sexual function, quality of life, and vaginal atrophy in postmenopausal women. Methods This study was a randomized clinical trial conducted on ninety postmenopausal women. Participants were randomized to intervention/control groups using block randomization. The intervention group received four Jazar capsules (500 mg each) daily, while the control group received a placebo for eight weeks. Data were gathered using a socio-demographic questionnaire, the Female Sexual Function Index (FSFI), and the Menopause-Specific Quality of Life (MENQOL) before the intervention and at weeks 4, 8, and 10. Vaginal pH and vaginal maturation index (VMI) were measured before and at the end of the study. Results Eighty-four women completed the trial, and six women withdrew. There were no remarkable differences between the two groups in terms of quality of life, sexual function, VMI, and vaginal pH at baseline. At the end of the study, participants in the intervention group had a significantly lower score in terms of quality of life (P < 0.001) and vaginal pH (P=0.001), and a higher FSFI (P < 0.001) and VMI (P=0.030) score compared to the control group. Conclusion Based on the findings of the present study on menopausal women, the Jazar supplement significantly improved quality of life and sexual function and prevented or delayed vaginal atrophy.
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Lee HW, Ang L, Kim E, Lee MS. Fennel (Foeniculum vulgare Miller) for the management of menopausal women's health: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 43:101360. [PMID: 33725577 DOI: 10.1016/j.ctcp.2021.101360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/15/2021] [Accepted: 03/04/2021] [Indexed: 11/19/2022]
Abstract
This review aimed to evaluate the current evidence on the effectiveness and safety of fennel (Foeniculum vulgare Miller) for managing menopausal women's health. Fourteen databases were searched. We included randomized controlled trials (RCTs) that evaluated any type of fennel treatment in menopausal women. Seven RCTs that met our inclusion criteria were identified and analyzed. The included RCTs had concerning risks of bias in general. Two RCTs compared the effects of fennel with placebo, and the meta-analysis results favored fennel for improving menopausal symptoms (n = 145, standard mean difference -1.32 [-1.76, -0.87], p < 0.00001). Other studies failed to show beneficial effects of fennel in terms of sexual function, quality of life (QoL), and psychological health. No serious adverse events were reported. Our review presented evidence for fennel improving menopausal symptoms. However, the effectiveness and safety of fennel in improving QoL, and psychological health remains unclear.
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Affiliation(s)
- Hye Won Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
| | - Lin Ang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; Faculty of Korean Convergence Medicine, Korea University of Science & Technology, Daejeon, Republic of Korea.
| | - Eunseop Kim
- You & Green Korean Medical Clinic, Daejeon, South Korea.
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea; Faculty of Korean Convergence Medicine, Korea University of Science & Technology, Daejeon, Republic of Korea.
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The effect of Fennel seed powder on estradiol levels, menopausal symptoms, and sexual desire in postmenopausal women. ACTA ACUST UNITED AC 2020; 27:1281-1286. [DOI: 10.1097/gme.0000000000001604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Effects of a Combination of Foeniculum vulgare, Melissa officinalis Extract, and Nigella saliva Powder on Healthy Menopausal Women with Sexual Dysfunction: A Randomized Clinical Trial. Jundishapur J Nat Pharm Prod 2020. [DOI: 10.5812/jjnpp.89925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Menopause is a critical period with frequent sexual disorders. Objectives: The current study assessed the therapeutic effect of a combination of the aerial part of Melissa officinalis, fennel fruit extract, and Nigella sativa seed powder on the sexual dysfunction of postmenopausal women. Methods: This randomized clinical trial was performed on 48 menopausal women from April 2015 to October 2017. The participants included the menopausal women referring to the clinic of Gorgan health centers aged between 41 and 54 years with natural menopause (amenorrhea for at least 12 months) and discomfort in sexual activity. They were randomized into two treatment groups. Group 1 (n = 27) received 1000 mg capsules (Melissa officinalis, fennel extract, and Nigella sativa powder), and group 2 (n = 21) received a placebo (1000 mg starch capsules (in an eight-week course of treatment (one capsule per day for each group). The variables in the female sexual function index (FSFI) questionnaire were compared in the two groups before and after the intervention. Results: The results showed that the mean scores of sexual dysfunction in the domains of arousal, lubrication, orgasm, satisfaction, and pain were not significantly different between the two groups (P > 0.05). Conclusions: Despite many studies on the effectiveness of Melissa, Foenculum, and Nigella, this study showed that a combination of Foeniculum vulgare, Melissa officinalis extract, and Nigella sativa seed powder does not improve the sexual function of postmenopausal women with sexual dysfunction, and it might be the synergism effect of this combination.
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Lima SMRR, Honorato JV, Silva MALG. Glycine Max (L.) Merr isoflavone gel improves vaginal vascularization in postmenopausal women. Climacteric 2020; 23:505-510. [PMID: 32338067 DOI: 10.1080/13697137.2020.1752172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/04/2020] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
Objective: This study aimed to analyze the effects of isoflavones from Glycine max (L.) Merr (soy) used topically as a vaginal gel on the induction of vascularization of the vaginal tissue in postmenopausal women.Study design: A placebo-controlled, randomized, double-blind trial was conducted with 22 postmenopausal women, randomly allocated for treatment with Glycine max (L.) Merr isoflavone 4% vaginal gel daily for 12 weeks or with placebo gel for the same period.Main outcome measure: Vaginal microbiopsies were collected before and after the 12-week treatment. Immunohistochemistry analyses were performed to provide a blood vessel count per field in the vaginal tissue, pre and post intervention.Results: The isoflavone group exhibited a significant increase in blood vessels per field relative to baseline, whereas the placebo group showed no difference compared to baseline. There was a significant difference in the increase of the number of blood vessels between the isoflavone and placebo groups.Conclusion: The results showed that local administration of Glycine max (L.) Merr isoflavone gel promoted a significant improvement in the number of blood vessels in the vaginal tissue of postmenopausal women.
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Affiliation(s)
- S M R R Lima
- Endocrine Gynecology and Climacteric Department, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - J V Honorato
- Endocrine Gynecology and Climacteric Department, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - M A L G Silva
- Department of Pathology, Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
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Mazalzadeh F, Hekmat K, Namjouyan F, Saki A. Effect of Trigonella foenum (fenugreek) vaginal cream on vaginal atrophy in postmenopausal women. J Family Med Prim Care 2020; 9:2714-2719. [PMID: 32984113 PMCID: PMC7491783 DOI: 10.4103/jfmpc.jfmpc_1220_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/25/2020] [Accepted: 05/20/2020] [Indexed: 11/04/2022] Open
Abstract
Background and Objective Menopause forms one-third of women's lives. During this period, many women continue their sexual activities. One of the most prevalent postmenopausal complications is vaginal atrophy whose symptoms could have destructive effects on the life quality among postmenopausal women. Complications of using estrogen hormone to improve these symptoms are inevitable. One of the objectives of the present study is the assessment of the vaginal cream of Fenugreek on vaginal inflammation of atrophic vaginitis in postmenopausal women. Materials and Methods For assessment of the effect of fenugreek vaginal cream among postmenopausal women who suffer from vaginal atrophy, the present study was carried out in the form of a double-blind clinical trial among sixty postmenopausal women, mainly who had been referred to Health Center 1 located in the east of Ahvaz in 2017. All participants of the present study who were diagnosed with vaginal atrophy were assigned into two groups of 30 randomly. One of these groups received placebo and the other one fenugreek 5% vaginal cream for a period of 8 weeks. Symptoms related to vaginal atrophy were investigated by means of a 4-degree scale (none, mild, moderate, and severe) and maturation vaginal index (MVI) through preparing the vaginal smears technique at baseline and a period of 8 weeks after cytology and intervention experiment. Finally, the process of analyzing statistical data, at a statistical significance level of 0.05, was carried out by means of SPSS Software. Results The results of the present study demonstrated that the fenugreek vaginal cream treatment group experienced a significant improvement in vaginal atrophy symptoms compared to the onset of the study (P < 0.001). Conclusion Fenugreek vaginal cream was effective in treating vaginal atrophy; therefore, postmenopausal women are recommended to use this cream instead of synthetic estrogen to reduce the complications of this hormone.
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Affiliation(s)
- Fakhriyeh Mazalzadeh
- Instructor, Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Khadijeh Hekmat
- Instructor, Department of Midwifery, Nursing and Midwifery Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Foroogh Namjouyan
- Assistant Professor, Department of Pharmacy, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amal Saki
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Rashidi Fakari F, Simbar M, Nasab MB, Ghazanfarpour M, Rashidi Fakari F. A Review of Pharmacological Treatments for Vaginal Atrophy in Postmenopausal Women in Iran. J Menopausal Med 2020; 26:104-111. [PMID: 32893511 PMCID: PMC7475289 DOI: 10.6118/jmm.19021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 04/30/2020] [Accepted: 06/18/2020] [Indexed: 12/03/2022] Open
Abstract
Vaginal atrophy is one of the most common menopausal complications and is often overlooked. There are various pharmacological and non-pharmacological treatment approaches to reduce vaginal atrophy; however, no comprehensive study on a convenient, affordable, inexpensive, and noninvasive treatment with fewer complications has been conducted so far. Thus, the current study aimed to provide a systematic review of pharmacological treatment for vaginal atrophy in postmenopausal women in Iran. In this systematic review, all Iranian articles published in Persian or English during 2009 to 2019 were collected and analyzed by searching the Scopus, PubMed, Web of Science, Magiran, Iranian Registry of Clinical Trials (IRCT), and Cochrane Library databases. The inclusion criteria were clinical trials for vaginal atrophy and menopause. Based on the selection criteria, articles with a Jadad scale score of 3 and above were included in the study and qualitatively analyzed. Overall, 15 clinical trials met the inclusion criteria. In total, 12 articles examined the efficacy of pharmacological treatments (including three herbal medicines, three vitamins and dietary supplements, and two chemical drugs) in treating vaginal atrophy in postmenopausal women. Various types of medication have been used to improve vaginal atrophy, and effective treatments include licorice, chamomile, royal jelly, vitamin E, vitamin D, hyaluronic acid, and Vagifem; however, the results of studies on fennel have been inconsistent. However, considering the small number of studies reviewed, further studies with a stronger methodology are needed to confirm the efficacy of these medications.
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Affiliation(s)
- Farzaneh Rashidi Fakari
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Beheshti Nasab
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoumeh Ghazanfarpour
- Department of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Fahimeh Rashidi Fakari
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Zohrabi I, Abedi P, Ansari S, Maraghi E, Shakiba Maram N, Houshmand G. The effect of oxytocin vaginal gel on vaginal atrophy in postmenopausal women: a randomized controlled trial. BMC WOMENS HEALTH 2020; 20:108. [PMID: 32429977 PMCID: PMC7236919 DOI: 10.1186/s12905-020-00935-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 03/26/2020] [Indexed: 12/02/2022]
Abstract
Background Around 90% of postmenopausal women are suffering from vaginal atrophy. This study aimed to evaluate the effect of oxytocin vaginal gel on vaginal atrophy among postmenopausal women. Methods This was a randomized controlled trial that was conducted on 96 postmenopausal women who suffered from vaginal atrophy. The inclusion criteria were: literate women, age 40–60, at least 1 year passed from their last menstrual period or the level of FSH > 40 IU, monogamous women with the sexual relationship. Women in the intervention group, requested to use one applicator of 400 IU oxytocin gel per night and women in the placebo group used placebo each night. The subjective symptoms of vaginal atrophy, vaginal PH, maturation index were measured before and after the intervention. Results The number of superficial cells was increased significantly in the oxytocin group compared to placebo (38.7 ± 7.18 vs. 3.69 ± 2.76, p = 0.0001), while the number of parabasal cells was decreased significantly in the oxytocin compared to placebo after the intervention. The improvement of the maturation index was more dominant in the oxytocin group (increased from 7.76 ± 4.68 to 52.48 ± 7.54) in comparison to the placebo group (increased from 8.58 ± 4.35 to 13.25 ± 5.06). The PH of the vagina decreased significantly in the oxytocin group in comparison to the placebo group (p = 0.0001). After 8 weeks, 88.6 and 7.1% of women in the oxytocin and placebo groups did not show the severe symptoms of vaginal atrophy (p = 0.001). Conclusion The results of this study showed that eight- week intervention with oxytocin vaginal gel (400 IU) could significantly improve the vaginal maturation index, subjective symptoms of vaginal atrophy and reduce the PH of the vagina. Using this medication in women who have a contraindication for hormone therapy is recommended. Trial registration IRCT20160602028220N2.
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Affiliation(s)
- Ilnaz Zohrabi
- Menopause Andropause Research Center, Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran
| | - Parvin Abedi
- Menopause Andropause Research Center, Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran.
| | - Somayeh Ansari
- Menopause Andropause Research Center, Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Golestan Ave, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nader Shakiba Maram
- Pharmaceutics Department, Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Houshmand
- Department of Pharmacology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Critical analysis of methods for assessing genitourinary syndrome of menopause used in clinical trials. ACTA ACUST UNITED AC 2019; 26:1436-1442. [DOI: 10.1097/gme.0000000000001406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Naseri R, Farnia V, Yazdchi K, Alikhani M, Basanj B, Salemi S. Comparison of Vitex agnus-castus Extracts with Placebo in Reducing Menopausal Symptoms: A Randomized Double-Blind Study. Korean J Fam Med 2019; 40:362-367. [PMID: 31067851 PMCID: PMC6887765 DOI: 10.4082/kjfm.18.0067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 06/05/2018] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Menopausal symptoms have remarkable negative effects on women's quality of life, justifying the need to assess various therapeutic options. This research aimed to determine the effectiveness of Vitex agnus-castus extracts in alleviating menopausal symptoms in comparison with that of placebo. METHODS This study was a randomized controlled double-blind clinical trial with a study group of 52 women referred to a clinic in Kermanshah in 2017. The participants were randomly divided into two groups: Vitex group (26 subjects) and placebo group (26 subjects). Menopausal symptoms were assessed using the Greene Scale before and 8 weeks after the intervention. RESULTS After the intervention, the mean scores for total menopausal disorder, anxiety, and vasomotor dysfunction were significantly lower in the Vitex group than in the placebo group (P<0.05). The mean scores of the variables of somatic complications, depression, and sexual dysfunction did not show significant differences between the Vitex and placebo groups (P>0.05). CONCLUSION Administration of Vitex agnus-castus extracts as a phytoestrogenic medicine can alleviate menopausal symptoms in women.
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Affiliation(s)
- Rozita Naseri
- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahid Farnia
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Katayoun Yazdchi
- Department of Gynecology and Obstetrics, Kermanshah University Of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrad Basanj
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Safora Salemi
- Department of Psychiatry, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Mahboubi M. Foeniculum vulgare as Valuable Plant in Management of Women's Health. J Menopausal Med 2019; 25:1-14. [PMID: 31080784 PMCID: PMC6487283 DOI: 10.6118/jmm.2019.25.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 09/03/2018] [Accepted: 09/23/2018] [Indexed: 12/05/2022] Open
Abstract
This review paper evaluates use of Foeniculum vulgare extracts as a popular female plant in management of different ailments of women. Information in this paper was gathered from accessible sources (PubMed, Science Direct, Springer, Wiley, and Google), and traditional books (Persian or English modern traditional books), unpublished data (R&D reports, thesis and dissertation) by keywords based on the words F. vulgare or fennel and women. Efficacy of oral fennel oil in management of dysmenorrhea, premenstrual syndrome, amenorrhea, menopause, lactation, and polycystic ovary syndrome were confirmed according to results of clinical studies. Results of clinical efficacy of fennel oil on menstrual bleeding is complicated, but results of one meta-analysis study revealed that fennel oil significantly increased means of bleeding in the first menstrual periodic cycle (P = 0.001), while fennel oil had no significant effect on bleeding in the second menstrual cycle (P = 0.67). Topical and vaginal fennel extract (5%) exhibited good efficacy in treatment of sexual function, vaginal atrophy, and hirsutism. Fennel had no effect on bone density, or body mass index of menopause women. Results of clinical studies introduce fennel as a valuable medicinal plant in management of women's ailments, but understanding the mechanism of action could be the subject of future studies.
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Affiliation(s)
- Mohaddese Mahboubi
- Medicinal Plants Research Department, Research and Development, TabibDaru Pharmaceutical Company, Kashan, Iran
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Sadeghi M, Namjouyan F, Cheraghian B, Abbaspoor Z. Impact of Glycyrrhiza glabra (licorice) vaginal cream on vaginal signs and symptoms of vaginal atrophy in postmenopausal women: A randomized double blind controlled trial. J Tradit Complement Med 2019; 10:110-115. [PMID: 32257873 PMCID: PMC7109473 DOI: 10.1016/j.jtcme.2019.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 02/23/2019] [Accepted: 02/25/2019] [Indexed: 11/25/2022] Open
Abstract
Background Vaginal atrophy is one of the most common menopausal complications affecting women's quality of life. The present study aimed to investigate the impact of Glycyrrhiza glabra (licorice) vaginal cream on vaginal signs and symptoms of vaginal atrophy in postmenopausal women. Methods This randomized controlled trial was conducted on 70 menopausal women, referring to health centers of Izeh city, located in the south west of Iran, from May to November 2017. The participants with vaginal atrophy were randomly assigned into two groups of 35. One of the groups received licorice 2% vaginal cream while the other was given placebo over a period of 8 weeks. Data were analyzed using SPSS software at the significance level of 0.05. Results The results indicated that at the baseline, none of the subjects (0%) in either groups had a vaginal cells maturation Index within 65–100 in MVI category. However, after 8 weeks of therapy, it improved significantly to 82.9% in Licorice group and 11.4% in the placebo group (p < 0.001). Also, the vaginal mucus cells changed from the baseline cells to intermediate and superficial cells within and between the two groups after the treatment (p < 0.001). Finally, the pH level significantly decreased in licorice group over time (p < 0.001). Conclusion Therapeutic use of licorice vaginal cream can improve the signs and symptoms of vaginal atrophy in postmenopausal women. Accordingly, use of licorice as a natural vaginal cream in vaginal atrophy can be suggested.
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Affiliation(s)
- Mastaneh Sadeghi
- Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Foroogh Namjouyan
- Pharmacognosy Department, Marine Pharmaceutical Research Center, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Epidemiology and Biostatistics, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Abbaspoor
- Department of Midwifery, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Dizavandi FR, Ghazanfarpour M, Roozbeh N, Kargarfard L, Khadivzadeh T, Dashti S. An overview of the phytoestrogen effect on vaginal health and dyspareunia in peri- and post-menopausal women. Post Reprod Health 2019; 25:11-20. [PMID: 30786797 DOI: 10.1177/2053369118823365] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this overview was to evaluate the effectiveness of phytoestrogens on vaginal health and dyspareunia in peri- and post-menopausal women. MATERIAL AND METHODS Three databases including MEDLINE, Scopus and the Cochrane Central Register of Controlled Trials were from inception to August 2017. RESULT Two systematic reviews and 11 RCTs were included in the overview. According to the findings, isoflavones increased the maturation value and attenuated the vaginal atrophy in the post-menopausal women. Topical isoflavones had beneficial effects on the vaginal atrophy. Similar efficacy was found in Pueraria mirifica and conjugated estrogen cream on dryness ( p = 0.277), soreness ( p = 0.124) and irritation ( p = 0.469), as well as discharge ( p = 0.225) and dyspareunia ( p = 0.089). However, the conjugated estrogen cream was more effective compared to Pueraria mirifica ( p > 0.005) regarding maturation index improvement. Comparison of fennel 5% vaginal cream and placebo gel showed significant difference in superficial cells ( p < 0.01), parabasal cells ( p < 0.01) and intermediate cells ( p < 0.01), whereas no difference was found between the oral fennel and placebo in terms of superficial, parabasal and intermediate cells as well as Maturation value. Administration of 80 mg red clover oil had a significant effect on superficial ( p < 0.005), intermediate ( p < 0.005) and parabasal and vaginal dryness ( p < 0.005) compared to the placebo. Flaxseed had also a trivial effect on maturation value. Genistein had a more prominent effect on the genital score. The severity of dyspareunia decreased by 27%. CONCLUSION Phytoestrogens have various effects based on administration route and type on the vaginal atrophy.
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Affiliation(s)
- Fatemeh R Dizavandi
- 1 Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Ghazanfarpour
- 2 Department of Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Nasibeh Roozbeh
- 3 Mother and Child Welfare Research Center, Hormozgan University of Medical Science, Bander Abbas, Iran
| | - Leila Kargarfard
- 4 Instructor of Fatemeh School Nursing and Midwifery, Shiraz University of Medical Science, Shiraz, Iran
| | - Talat Khadivzadeh
- 5 Department of Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sareh Dashti
- 6 Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Selangor, Malaysia
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Afiat M, Dizavandi FR, Kargarfard L, Vahed SHM, Ghazanfarpour M. Effect of Foeniculum Vulgare (Fennel) on Sleep Quality of Menopausal Women: A Double-blinded, Randomized Placebo-controlled Trial. J Menopausal Med 2018; 24:204-209. [PMID: 30671414 PMCID: PMC6336564 DOI: 10.6118/jmm.2018.24.3.204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 08/12/2018] [Accepted: 08/29/2018] [Indexed: 11/17/2022] Open
Abstract
Objectives Aim of present study was designed to investigate the soporific effect of fennel among menopausal women. Methods The present double-blinded and placebo-controlled trial examined the fennel effect on Pittsburgh Sleep Quality Index (PSQI). Total score and relevant 7 components, including sleep duration, sleep latency, use of sleeping medication, subjective sleep quality, sleep disturbances, daytime dysfunction and habitual sleep efficiency among 50 menopausal women compared to control group within a 12-week follow-up. Results The patients in both groups reported no certain side effects and all subjects completed the study. The mean actual sleep duration was 5 hours and 66 minutes. Intergroup comparison revealed no statistically significant differences in the mean total PSQI score (P = 0.439), subjective sleep quality (P = 0.826), habitual sleep efficiency (P = 0.127), sleep disturbances (P = 0.130), use of sleeping medication (P = 0.52) and daytime dysfunction (P = 0.439). A tendency toward significant between 2 groups was seen concerning the sleep duration (P = 0.059). Intergroup comparison showed significantly borderline levels (P = 0.059). Conclusions The treatment of 12 weeks with fennel caused a slight effect that did not reach to significant. These findings should be considered cautiously because of small sample size, short-term follow-up and subjective measure of sleep quality.
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Affiliation(s)
- Maliheh Afiat
- Women's Health Research Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Rajab Dizavandi
- Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Kargarfard
- Department of Fatemeh School of Nursing and Midwifery, Shiraz University of Medical Science, Shiraz, Iran
| | - Seyede Houra Mosavi Vahed
- Women's Health Research Center, Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masumeh Ghazanfarpour
- Department of Nursing and Midwifery, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Pitsouni E, Grigoriadis T, Douskos A, Kyriakidou M, Falagas ME, Athanasiou S. Efficacy of vaginal therapies alternative to vaginal estrogens on sexual function and orgasm of menopausal women: A systematic review and meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol 2018; 229:45-56. [PMID: 30103082 DOI: 10.1016/j.ejogrb.2018.08.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 02/06/2023]
Abstract
Genitourinary syndrome of menopause (GSM) increases the probability of female sexual dysfunction (FSD). The aim of the current study is to systematically assess data regarding sexual function and use of vaginal therapies, alternative to vaginal estrogens (VE), in menopausal women with GSM. PubMed, Scopus and Cochrane Library were searched (May-September 2017) using combination keywords: "dyspareunia and vaginal therapy", "sexual function and vaginal therapy", "orgasm and vaginal therapy", "vaginal atrophy" and "genitourinary syndrome of menopause". Eligible studies were RCTs focusing on the use of vaginal therapies, alternative to VE, in menopausal women. These studies were written in English language and published in peer-reviewed journals with impact factor. Assessment of risk of bias was performed using the Cochrane Risk of Bias Tool. Outcomes involved dyspareunia, vaginal dryness, orgasm and all parameters of sexual function. Twenty-nine RCTs including 3689 menopausal women, were included. Vaginal therapies, alternative to VE included non-hormonal (vaginal laser, lubricants/moisturizers, phytoestrogens and lidocaine) and hormonal ones (Dehyadroapiandrosterone (DHEA), testosterone and oxytocin). Dyspareunia and/or vaginal dryness were assessed in 72% of the articles, while the FSD and orgasm in 45% and 28% of articles, respectively. Dyspareunia and vaginal dryness improved in all relevant studies. Sexuality scores of lubricants were inferior to estrogens [3 studies, n = 138, standardized mean difference (smd) -0.64, (95%CI -1.1, -0.2)]. Orgasm domain was the same for the DHEA 0.5% and placebo (2 studies, n = 663, smd 1.29 (95% -0.47, 3.05), I2:90%). Sexual satisfaction and sexuality score were the same when testosterone was compared or added to estrogen therapy (2 studies, n = 99, smd 0.16 (95%CI-0.23,0.56), I2:12% and 2 studies (n = 87), smd 0.20 (95%CI-0.23,0.62), I2:0%, respectively. Available data are not adequate to provide counseling by the physicians in menopausal women regarding the efficacy of vaginal therapies as an alternative to estrogens, on all parameters of sexual function.
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Affiliation(s)
- Eleni Pitsouni
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece
| | - Themos Grigoriadis
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece
| | - Athanasios Douskos
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece
| | | | - Matthew E Falagas
- Alfa Institute of Biomedical Sciences (AIBS), Athens, Greece; Department of Internal Medicine, Henry Dunant Hospital Center, Athens, Greece; Department of Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Stavros Athanasiou
- Urogynaecology Unit, 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Greece.
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Ghazanfarpour M, Najafi MN, Sharghi NB, Mousavi MS, Babakhanian M, Rakhshanded H. A double-blind, placebo-controlled trial of Fennel (Foeniculum vulgare) on menopausal symptoms: A high placebo response. J Turk Ger Gynecol Assoc 2018; 19:122-127. [PMID: 29755029 PMCID: PMC6085528 DOI: 10.4274/jtgga.2017.0124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: The present study aimed to evaluate the effects of oral fennel on menopausal symptoms. Material and Methods: This double-blind, randomized, placebo-controlled trial was conducted on 50 postmenopausal women in Mashhad (Iran). Patients were randomly divided into two groups of fennel (n=25) and placebo (n=25). Measurements were performed at baseline and after three months using the Menopause-Specific Quality of Life questionnaire. Results: Both placebo and treatment groups revealed significant improvements in the hot flush score (p<0.001 for fennel and p<0.01 for placebo), night sweats (p=0.007 for fennel and p<0.01 for placebo), sweating (p=0.002 for fennel and p<0.01 for placebo), symptoms of anxiety (p=0.05 for fennel and p=0.001 for placebo), feeling depressed (p<0.01 for fennel and p=0.006 for placebo), and impatience with other people (p<0.01 for fennel and p=0.003 for placebo). There were no significant differences in any menopausal symptoms between the fennel and placebo groups, except for coughing and sneezing when urinating (p=0.03). Conclusion: The failure to indicate a significant effect may have been caused by a high placebo response. It is suggested that future trials should include a placebo run-in phase or design a sequential, parallel study with larger sample sizes to mitigate the placebo effect.
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Affiliation(s)
- Masumeh Ghazanfarpour
- Department of Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mona Najaf Najafi
- Department of Community Medicine, Imam Reza Clinical Research Units, Mashhad University of Medicl Sciences School of Medicine, Mashhad, Iran
| | | | - Mahsa Sadat Mousavi
- Department of Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Masoudeh Babakhanian
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Hassan Rakhshanded
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
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Khadivzadeh T, Najafi MN, Kargarfard L, Ghazanfarpour M, Dizavandi FR, Khorsand I. Effect of Fennel on the Health Status of Menopausal Women: A Systematic and Meta-analysis. J Menopausal Med 2018; 24:67-74. [PMID: 29765930 PMCID: PMC5949311 DOI: 10.6118/jmm.2018.24.1.67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of the present study is the systematic and critical investigation of the effectiveness of fennel on the climacteric symptoms among menopausal females. METHODS A search of the trials studying the effect of fennel on menopausal females was conducted in 2017 using the MEDLINE and Scopus databases and the Cochrane Library with the following keywords: fennel, Foeniculum vulgare, and menopause. RESULTS Fennel combined with officinalis is more effective in the attenuating of sleep disorders compared to Citalopram. The comparison of these two groups regarding the mean bone mineral density and bone mineral content (P = 0.14, P = 0.504); the total hip femoral (P = 0.42, P = 0.66); the trochanter (P = 0.075, P = 0.07); the intertrochanter (P = 0.84, P = 0.93); and the femoral neck (P = 0.43, P = 0.64) did not show any significant statistical differences; however, a statistically significant difference regarding the vasomotor symptoms (P < 0.01) was found. The other significant differences are related to the values of the total cholesterol (P = 0.103); low-density lipoprotein cholesterol, or LDL-C (P = 0.104); high-density lipoprotein cholesterol, or HDL-C (P = 0.266); triglyceride (P = 0.679); body weight (P = 0.212); body mass index (P = 0.041); waist and hip circumferences (P = 0.365); and fat distribution (P = 0.337) between the two groups. The standardized mean difference (SMD) values of sexual activity (SMD = 0.638; P < 0.001), and maturation value (SMD = 0.601; P = 0.003) are highly significant among the fennel-treated women compared with the placebo group. CONCLUSIONS According to the findings of the present study, fennel is important in the relieving of vasomotor symptoms, vaginal itching, dryness, dyspareunia, sexual function, sexual satisfaction, and sleep distribution.
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Affiliation(s)
- Talat Khadivzadeh
- Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad,Iran
| | - Mona Najaf Najafi
- Department of Community Medicine, Imam Reza Clinical Research Units, Mashhad University of Medical Sciences, Mashhad,Iran
| | - Leila Kargarfard
- Department of Fatemeh School Nursing and Midwifery, Shiraz University of Medical Science, Shiraz,Iran
| | - Masumeh Ghazanfarpour
- Evidence-Based Care Research Center, Mashhad University of Medical Sciences, Mashhad,Iran
| | - Fatemeh Rajab Dizavandi
- Department of Community Health and Psychiatric Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad,Iran
| | - Imaneh Khorsand
- Department of Parasitology and Mycology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad,Iran
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Lee HW, Lim HJ, Jun JH, Lim HS, Lee MS. Fennel (Foeniculum vulgare) on management of menopausal symptoms: A protocol for systematic review of randomized controlled trials. Medicine (Baltimore) 2018; 97:e0223. [PMID: 29595668 PMCID: PMC5895370 DOI: 10.1097/md.0000000000010223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Fennel (Foeniculum vulgare) is often used in women's health care to treat dysmenorrhea, increase the milk supply, and address symptoms of menopause. The object of this review is to evaluate the current evidence on the efficacy of fennel for the management menopausal symptoms. METHODS AND ANALYSES Thirteen databases will be searched from their inception to the present. These include PubMed, AMED, EMBASE, the Cochrane Library, six Korean medical databases (Korean Studies Information Service System, DBPIA, the Korean Institute of Science and Technology Information, the Research Information Service System, KoreaMed, and the Korean National Assembly Library), and 3 Chinese databases (the China National Knowledge Infrastructure Database [CNKI], the Chongqing VIP Chinese Science and Technology Periodical Database [VIP], and Wanfang Database). Study selection, data extraction, and assessments will be performed independently by 2 researchers. The risk of bias will be assessed using the Cochrane risk of bias tool. ETHICS AND DISSEMINATION Ethical approval is not required, given that this protocol is for a systematic review only. The review will be published in a peer-reviewed journal and disseminated both electronically and in print. The review will be updated to inform and guide healthcare practice and policy. TRIAL REGISTRATION NUMBER PROSPERO 2018 CRD42018085698.
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Affiliation(s)
- Hye Won Lee
- Korea Institute of Oriental Medicine, Daejeon
| | - Hyun-Ja Lim
- Department of Nursing, Chodang University, Muan
| | - Ji Hee Jun
- Korea Institute of Oriental Medicine, Daejeon
| | | | - Myeong Soo Lee
- Korea Institute of Oriental Medicine, Daejeon
- Department of Korean Medicine Life Science, Korea University of Science & Technology, Daejeon, Republic of Korea
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Ghazanfarpour M, Shokrollahi P, Khadivzadeh T, Baharian Sharghi N, Mirzaii Najmabadi K, Babakhanian M, Jafarian AH. Effect of Foeniculum vulgare (fennel) on vaginal atrophy in postmenopausal women: A double-blind, randomized, placebo-controlled trial. Post Reprod Health 2017; 23:171-176. [PMID: 28990439 DOI: 10.1177/2053369117733629] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objectives This study was conducted to evaluate the effects of orally administered fennel on vaginal atrophy. Materials and methods In this double-blind, randomized, placebo-controlled trial, 60 postmenopausal women living in Mashhad, Iran, were randomly divided into an oral fennel group (n = 30) and a placebo group (n = 30). The Maturation Vaginal Index and maturation values were measured once at baseline and again upon a three-month follow-up. Results The paired t-test showed statistically significant changes in the Maturation Vaginal Index (i.e. a decline in the parabasal cells and an increase in the intermediate and superficial cells) and maturation values in both the fennel and placebo groups at the end of the trial compared to at baseline. Nonetheless, no significant differences were observed in the percentages of the parabasal (P = 0.191), intermediate (P = 0.219) and superficial (P = 0.82) cells, which was also the case for the maturation values (P = 0.64). Conclusion Fennel had no significant positive effects on vaginal atrophy in postmenopausal women. Nonetheless, more studies are recommended to be conducted using higher doses of fennel and larger sample sizes so as to verify the results of this study.
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Affiliation(s)
- Masumeh Ghazanfarpour
- 1 Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Talat Khadivzadeh
- 1 Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nosrat Baharian Sharghi
- 1 Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
- 3 Omolbanin Hospital, Mashhad, Iran
| | - Khadijeh Mirzaii Najmabadi
- 1 Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Amir Hossine Jafarian
- 5 Department of Pathology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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Kargozar R, Azizi H, Salari R. A review of effective herbal medicines in controlling menopausal symptoms. Electron Physician 2017; 9:5826-5833. [PMID: 29403626 PMCID: PMC5783135 DOI: 10.19082/5826] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/24/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Acute menopausal syndrome especially hot flashes, is one of the most common gynecological problems during menopause. Due to the side effects of hormone therapy, herbal and complementary medicines are always of immense interest to people in the treatment and management of the symptoms and complications of menopause. OBJECTIVE The aim of this study was to investigate the mechanisms and effects of medicinal plants employed in the treatment of menopausal symptoms. METHODS This review article was carried out by examining clinical trial studies between the period of 1994 and 2016. The keywords, which include menopause, climacteric, hot flushes, flashes, herb and phytoestrogens were used to search for herbal medicines used in clinical trials for the treatment of menopausal symptoms using databases such as PubMed, Medline, Scopus, Google scholar, SID and Magiran. RESULTS The results of the study showed that the medicinal plants, which include Sage herb (Salvia officinalis), Lemon balm (Melissa officinalis), Valerina officinalis, Black cohosh (Cimicifuga racemosa), Fenugreek (Trigonella foenum-graecum), Black cumin (Nigella sativa), Vitex (Vitex agnus-castus), Fennel (Foeniculum vulgare), Evening primrose (Oenothera biennis), Ginkgo biloba, Alfalfa (Medicago sativa), Hypericum perforatum, Panax ginseng, Pimpinella anisum, Licorice (Glycyrrhiza glabra), Passiflora incarnata, Red clover (Trifolium pratense), and Glycine soja were effective in the treatment of acute menopausal syndrome with different mechanisms. CONCLUSION Medicinal plants can play an imperative role in the treatment of acute menopausal syndrome; however, further studies are required to buttress their efficacy in the treatment of acute menopausal syndrome.
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Affiliation(s)
- Rahele Kargozar
- Ph.D. student of Persian Medicine, Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Azizi
- M.D., Assistant Professor, Department of Chinese and Complementary Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Roshanak Salari
- Ph.D. of Drug Control, Assistant Professor, Department of Clinical Persian Pharmacy, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Effect of Foeniculum vulgare Mill. (fennel) on menopausal symptoms in postmenopausal women: a randomized, triple-blind, placebo-controlled trial. Menopause 2017; 24:1017-1021. [DOI: 10.1097/gme.0000000000000881] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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