1
|
Willmann S, Lloyd A, Austin R, Joseph S, Solms A, Zhang Y, Schneider ARP, Frechen S, Schultze-Mosgau MH. Population pharmacokinetic-pharmacodynamic model of elinzanetant based on integrated clinical phase I and II data. CPT Pharmacometrics Syst Pharmacol 2024. [PMID: 39295152 DOI: 10.1002/psp4.13226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/23/2024] [Accepted: 07/26/2024] [Indexed: 09/21/2024] Open
Abstract
Elinzanetant is a potent and selective dual neurokin-1 (NK-1) and -3 (NK-3) receptor antagonist that is currently developed for the treatment of women with moderate-to-severe vasomotor symptoms (VMS) associated with menopause. Here, we report the development of a population pharmacokinetic (popPK) model for elinzanetant and its principal metabolites based on an integrated dataset from 366 subjects (including 197 women with VMS) collected in 10 phase I or II studies. The pharmacokinetics of elinzanetant and its metabolites could be well described by the popPK model. Within the investigated dose range of 40-160 mg, the oral bioavailability of elinzanetant was dose independent and estimated to be 36.7%. The clearance of elinzanetant was estimated to be 7.26 L/h and the central and peripheral distribution volume were 23.7 and 168 L. No intrinsic or extrinsic influencing factors have been identified in the investigated population other than the effect of a high-fat breakfast on the oral absorption of elinzanetant. The popPK model was then coupled to a pharmacodynamic model to predict occupancies of the NK-1 and NK-3 receptors. After repeated once-daily administration of the anticipated therapeutic dose of 120 mg elinzanetant, the model-predicted median receptor occupancies are >99% for NK-1 and >94.8% for NK-3 during day and night-time, indicating sustained and near-complete inhibition of both target receptors during the dosing interval.
Collapse
Affiliation(s)
- Stefan Willmann
- Bayer AG, Pharmaceuticals, Pharmacometrics/Modeling and Simulation, Wuppertal/Leverkusen/Berlin, Germany
| | | | | | | | - Alexander Solms
- Bayer AG, Pharmaceuticals, Pharmacometrics/Modeling and Simulation, Wuppertal/Leverkusen/Berlin, Germany
| | - Yang Zhang
- Bayer AG, Pharmaceuticals, Pharmacometrics/Modeling and Simulation, Wuppertal/Leverkusen/Berlin, Germany
| | - Annika R P Schneider
- Bayer AG, Pharmaceuticals, Pharmacometrics/Modeling and Simulation, Wuppertal/Leverkusen/Berlin, Germany
| | - Sebastian Frechen
- Bayer AG, Pharmaceuticals, Pharmacometrics/Modeling and Simulation, Wuppertal/Leverkusen/Berlin, Germany
| | | |
Collapse
|
2
|
Kiss P, Depypere H, De Meester M, Vingerhoets I, Van Hoecke M, Braeckman L. Need for recovery after work and associated risk factors in working menopausal women. Maturitas 2024; 187:108054. [PMID: 38905864 DOI: 10.1016/j.maturitas.2024.108054] [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: 02/18/2024] [Revised: 06/02/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVES To explore relationships between 'need for recovery' (NFR), a strong predictor of burnout, and menopause symptoms and to identify work-related factors that are associated with a high NFR in Belgian menopausal women. STUDY DESIGN 760 menopausal women took part in a cross-sectional questionnaire study. NFR, presence of menopause symptoms, job type, age category, work activity, physical workload, psychosocial and physical work environment, balance of work and private life and the opportunity to discuss menopause at work were assessed. MAIN OUTCOME MEASURES Uni- and multivariate logistic regression analyses were used to calculate the odds ratios for the presence of a high NFR. RESULTS Of menopausal women currently experiencing menopause symptoms, 53.3 % reported problems while performing their work. The overall prevalence of a high NFR in menopausal women was 41.2 %. Women who experienced problems at work had the highest prevalence of a high NFR (61.1 %), and constituted a separate risk group for having a high NFR (OR 3.31 vs. never symptoms; 95%CI 1.72-6.38). The following factors were significantly associated with a high NFR: poor balance of work and private life (OR 7.89; 95%CI 4.32-14.39), physical workload (OR 1.17; 95%CI 1.08-1.28), discomfort from cognitive demands (OR 1.17; 95%CI 1.09-1.26), organizational justice (OR 0.86; 95%CI; 0.78-0.94), and social support from colleagues (OR 0.87; 95%CI 0.79-0.96). CONCLUSIONS Maintaining a good balance of work and private life, reducing physical workload, addressing discomfort from cognitive work demands and assuring a fair work distribution are measures that require a culture where open and easy discussion about menopause is possible.
Collapse
Affiliation(s)
- Philippe Kiss
- Securex Occupational Health Service, Verenigde Natieslaan 1, Gent, Belgium; Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| | - Herman Depypere
- Department of Human Structure and Repair, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| | - Marc De Meester
- Securex Occupational Health Service, Verenigde Natieslaan 1, Gent, Belgium; Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| | - Ilse Vingerhoets
- Securex Occupational Health Service, Verenigde Natieslaan 1, Gent, Belgium.
| | | | - Lutgart Braeckman
- Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Gent, Belgium.
| |
Collapse
|
3
|
Sassarini J, Anderson RA. Elinzanetant: a phase III therapy for postmenopausal patients with vasomotor symptoms. Expert Opin Investig Drugs 2024; 33:19-26. [PMID: 38224099 DOI: 10.1080/13543784.2024.2305122] [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: 10/19/2023] [Accepted: 01/10/2024] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Menopausal vasomotor symptoms (VMS) are experienced by most women and are often debilitating and can last for years. While hormone replacement therapy is effective, it carries risks that have impacted its wider use, and it can be contraindicated. There is a large unmet need for a safe, effective non-hormonal therapy. AREAS COVERED The importance of the neurokinin (NK) system in the hypothalamic regulation of the vasomotor center has become clear. NK antagonists, previously developed for other indications, have therefore been investigated for the treatment of VMS. Elinzanetant is a potent antagonist at both NK1 (endogenous ligand Substance P) and NK3 (neurokinin B) receptors, whereas other related drugs in development are selective NK3 antagonists. Elinzanetant has been investigated in 2 Phase II trials for menopausal VMS, demonstrating rapid onset and dose-dependant efficacy for the relief of VMS and improvement in quality of life for up to 12 weeks. Phase III trials are underway in women both with physiological menopause and after treatment for breast cancer. EXPERT OPINION Elinzanetant is a very promising non-hormonal approach to a highly prevalent symptom constellation, with rapid onset and high efficacy. Wider indications are being explored in current Phase III trials.
Collapse
Affiliation(s)
- Jenifer Sassarini
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK
| | - Richard A Anderson
- Centre for Reproductive Health, Institute for Repair and Regeneration, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
4
|
Huang DR, Goodship A, Webber I, Alaa A, Sasco ER, Hayhoe B, El-Osta A. Experience and severity of menopause symptoms and effects on health-seeking behaviours: a cross-sectional online survey of community dwelling adults in the United Kingdom. BMC Womens Health 2023; 23:373. [PMID: 37452317 PMCID: PMC10347781 DOI: 10.1186/s12905-023-02506-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Almost all women will experience menopause, and the symptoms can have a severely detrimental impact on their quality of life. However, there is limited research exploring health-seeking behaviours and alternative service design or consultation formats. Group consultations have been successfully deployed in perinatal and diabetic care, improving accessibility and outcomes. This cross-sectional online survey was conducted to explore women's personal experiences of menopause, including perspectives on group consultations. METHODS An online survey investigated the experiences of individuals at all stages of menopause and their receptiveness towards group consultations for menopause. Respondents were categorised by menopause stage according to the STRAW + 10 staging system. Associations between menopause stage, acceptability of group consultations and participant demographics were assessed using logistic regression. RESULTS Respondents experienced an average of 10.7 menopausal symptoms, but only 47% of respondents felt they had the knowledge and tools to manage their symptoms. Advice on menopause was sought from a healthcare professional (HCP) by 61% of respondents, the largest trigger for this being severity of symptoms and the main barrier for this was the perception that menopause wasn't a valid enough reason to seek help. Of the respondents seeking advice from HCPs, 32% were prescribed transdermal HRT, 29% received oral HRT, 19% were offered antidepressants, 18% received local oestrogen and 6% were prescribed testosterone. Over three quarters (77%) of respondents indicated that they would join a group consultation for menopause and would be comfortable sharing their experiences with others (75%). Logistic regression indicated premenopausal respondents were 2.84 times more likely than postmenopausal women to be interested in a group consultation where they can meet or learn from others' experiences. CONCLUSIONS This study highlighted a strong willingness of women aged 35-70 to participate in group consultations for menopause, with motivation being strongest amongst premenopausal women. Low awareness of self-management and lifestyle interventions to manage the symptoms of menopause highlight the need for greater outreach, research and interventions to build knowledge and confidence in the general population at scale. Future studies should focus on investigating the effectiveness and economic impact of menopause group consultations and the lived experience of individuals participating in group consultations.
Collapse
Affiliation(s)
- David Roy Huang
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Abigail Goodship
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Iman Webber
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Aos Alaa
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Eva Riboli Sasco
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Benedict Hayhoe
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| | - Austen El-Osta
- Self-Care Academic Research Unit (SCARU), Department of Primary Care & Public Health, Imperial College, London, W6 8RF UK
| |
Collapse
|
5
|
Baquedano L, Fasero M, Gabasa L, Coronado P, Presa J, Mendoza N. What do Spanish women know about menopause? COMEM study. J OBSTET GYNAECOL 2022; 42:1448-1454. [PMID: 35019792 DOI: 10.1080/01443615.2021.1998892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the study was to evaluate the level of knowledge that women have about menopause and to analyse whether sociodemographic aspects can influence it. For this, a multi-centre observational study was conducted in Spain using a survey including 2500 women between 35 and 75 years. Participants were administered a 10-question questionnaire with a maximum score of 45 points. The responses of 2355 women were analysed. The median age was 52 years (IQR 45-59) and the median of knowledge score was 22 points (IQR 16-27). Age (p < .001), menopausal status (p = .030), early menopause (p = .001), educational level (p < .001), type of healthcare (p < .001) and sources of information on menopause (p < .001) were factors related to the score on the questionnaire. We conclude that Spanish women have limited knowledge about menopause and it is urgent to implement training programs that can improve it.IMPACT STATEMENTWhat is already known on this subject? The knowledge and attitudes about menopause among women can vary across countries and also according to sociocultural context. It also seems that negative attitudes towards menopause and poor knowledge of the physiology and the most frequent symptoms have an increasing effect on the severity of the specific symptoms of menopause that cause further discomfort.What do the results of this study add? There are very few available reports or research on the issue of postmenopausal health in Spain. We believe that it is appropriate to explore the level of knowledge of women in our country. We have verified that the level of knowledge of Spanish women is low and that some sociodemographic aspects can influence itWhat are the implications of these findings for clinical practice and/or further research? Taking into account our results, it is a priority to implement health training programs to improve knowledge about menopause in Spanish women and overcome false myths and wrong beliefs.
Collapse
Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Lourdes Gabasa
- Gynecology Department of Miguel, Servet University Hospital, Zaragoza, Spain
| | - Pluvio Coronado
- Women's Health Institute of the Hospital Clínico San Carlos, IdISSC, Complutense University, Madrid, Spain
| | - Jesus Presa
- Service of Obstetrics and Gynecology, University Hospital Jaén, Jaén, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Spain
| | | |
Collapse
|
6
|
Vaccaro CM, Capozzi A, Ettore G, Bernorio R, Cagnacci A, Gambacciani M, Coletta V, Maffei S, Nappi RE, Scambia G, Viora E, Lello S. What women think about menopause: An Italian survey. Maturitas 2021; 147:47-52. [PMID: 33744064 DOI: 10.1016/j.maturitas.2021.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Menopause is a critical period for most women who experience associated symptoms while they are still socially and individually active. OBJECTIVES The objective of this study is to report how Italian women perceive and approach menopause. MATERIALS AND METHODS A survey of 1028 Italian women aged 45-65 years was conducted by the Italian Center for Studies of Social Investments (CENSIS) through anonymous interviews using two methods: CATI (Computer Assisted Telephone Interviewing) and CAWI (Computer Assisted Web Interviewing). PRINCIPAL OUTCOME MEASURES Principal outcome measures were women's perceptions and experiences of menopause and its treatments. RESULTS The global consciousness and understanding of menopause was common (82.8 %) among Italian women and it was usually considered a physiological condition (77 %). Overall, 74.6 % of the sample were postmenopausal. Hot flushes were reported to be the most frequent (37.9 %) and bothersome symptoms (43.1 %) while 12.9 % of the women were asymptomatic. As for menopausal therapies, 24.5 % were on treatment; herbal medications were the most common remedy (63.3 %) whereas 7.6 % of the women took hormone replacement therapy (HRT). About half of the sample (50.4 %) had not sought help from the Italian National Health System (INHS). Medical expertise in the field of menopause was thought to be moderately satisfactory by 54.5 % of the sample. CONCLUSIONS Italian women consider menopause a physiological condition. Most postmenopausal women had experienced symptoms but relied on non-hormonal treatments. The median women's satisfaction with the role of the INHS and medical competence suggests the need to improve current knowledge and awareness concerning menopause.
Collapse
Affiliation(s)
| | - Anna Capozzi
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
| | - Giuseppe Ettore
- Women and Children's Department, Unit of Obstetrics and Gynaecology, ARNAS 'Garibaldi-Nesima', Catania, Italy
| | - Roberto Bernorio
- Italian Association for Applied Sexology and Psychology (AISPA), Milan, Italy
| | - Angelo Cagnacci
- Obstetrics and Gynaecology Unit, Obstetrics and Gynaecology University of Genova, Genova, Italy
| | - Marco Gambacciani
- Department of Obstetrics and Gynaecology, Pisa University Hospital, Pisa, Italy
| | | | - Silvia Maffei
- Cardiovascular and Gynaecological Endocrinology Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| | - Rossella Elena Nappi
- Research Center for Reproductive Medicine, Gynaecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Giovanni Scambia
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | | | - Stefano Lello
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| |
Collapse
|
7
|
Baquedano L, Espiau A, Fasero M, Ortega S, Ramirez I, Mendoza N. Beliefs, knowledge and the impact of COVID19 on menopause therapies in Spanish women: COMEM-treatment study. BMC Womens Health 2020; 20:277. [PMID: 33371883 PMCID: PMC7768270 DOI: 10.1186/s12905-020-01151-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To study what women think about menopause treatments and assess their knowledge about them. To analyze adherence to treatment during COVID-19 confinement as a secondary objective. METHODS A multi-center cross-sectional observational study was conducted using a survey of 2500 women between January and June 2019. This was administered following a non-probability sampling procedure including women between 35 and 75 years. An extension study was conducted during the coronavirus pandemic, between March and June 2020. RESULTS The responses of 2355 surveyed women were analyzed. Of this sample, 42% knew about menopause hormone therapy (MHT). The most frequently identified indication was the treatment of hot flashes (65.6%). The MHT risks most frequently perceived were weight gain (24.2%) and breast cancer (21.7%); the main reason for rejecting MHT was a lack of information (96.1%). Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care and level of education. During the coronavirus confinement period, 85 women using MHT were located, of which 84.7% continued it. CONCLUSIONS Women hold certain false beliefs about menopause, and their knowledge of the available treatments is somewhat limited. Adherence to MHT during the COVID-19 confinement in Spain has been high.
Collapse
Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain.
| | - Andrea Espiau
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Silvia Ortega
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - Isabel Ramirez
- Sexual and Reproductive Health Service, UGC Dr Cayetano Roldan San Fernando Health Centre, Cadiz, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
| |
Collapse
|
8
|
Vargiu V, Amar ID, Rosati A, Dinoi G, Turco LC, Capozzi VA, Scambia G, Villa P. Hormone replacement therapy and cervical cancer: a systematic review of the literature. Climacteric 2020; 24:120-127. [PMID: 33236658 DOI: 10.1080/13697137.2020.1826426] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Gynecological tumor treatment, including cervical cancer (CC) treatment, often leads to iatrogenic premature menopause. This highlights the critical importance of investigating indications for hormone replacement therapy (HRT), as most patients, thanks to the improvement in diagnosis and treatment, have to deal with the sequelae of their cancer treatments for many years. This systematic review aims to provide an overview of the current knowledge regarding the risks of HRT and CC. In particular, we aim to investigate whether the use of HRT can increase CC incidence, and evaluate its risk in CC survivors. A systematic review, in agreement with PRISMA guidelines, of the English literature present in PubMed and SCOPUS has been performed. A total of 2805 articles have been screened, of which 10 were considered eligible. Several studies reported a significantly reduced risk of developing cervical squamous cell carcinoma in postmenopausal women treated with HRT, while a weak increase in the incidence of adenocarcinoma has been shown. No evidence reports a harmful effect of HRT on CC oncological outcome, while several benefits, in terms of reduced metabolic risk and increased quality of life, have been described, thus concluding that HRT should be offered to young CC survivors for the management of early menopause.
Collapse
Affiliation(s)
- V Vargiu
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - I D Amar
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A Rosati
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - G Dinoi
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - L C Turco
- Gynecology and Breast Care Unit, Mater Olbia spa, Olbia, Italy.,Division of Gynecologic Oncology, Gemelli Molise spa, Università Cattolica del Sacro Cuore, Campobasso, Italy
| | - V A Capozzi
- Department of Gynecology and Obstetrics, University of Parma, Parma, Italy
| | - G Scambia
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Women's and Children's Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Villa
- Department of Women's and Children's Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Women's and Children's Health, Università Cattolica del Sacro Cuore, Rome, Italy
| |
Collapse
|
9
|
KURT G, ARSLAN H. Kadınların menopoz döneminde yaşadıkları sağlık sorunları ve baş etme yöntemleri. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.694473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
|
10
|
Bahri N, Latifnejad Roudsari R. "Moving from uncertainty toward acceptance": a grounded theory study on exploring Iranian women's experiences of encountering menopause. J Psychosom Obstet Gynaecol 2020; 41:154-164. [PMID: 31623492 DOI: 10.1080/0167482x.2019.1678018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Purpose: Menopause as a universal phenomenon is influenced by social norms so that women's experiences during menopausal transition are related to the social values and cultural symbols. This qualitative study was conducted to discover the Iranian women's experiences of encountering menopause.Materials and Methods: In this grounded theory study 27 women living in Mashhad and Gonabad, North East of Iran, from May 2013 to July, 2016 were selected using purposive and theoretical sampling. Semi structured in-depth interviews were conducted for data collection until data saturation was achieved. Data was analyzed using Strauss and Corbin's (1998) recommended method through open, axial and selective coding. MAXQDA 2007 software was used for organizing data and managing the process of analysis.Results: The analysis revealed the core category of "moving from uncertainty toward acceptance". The interrelated categories subsumed under the core category included challenging aging, observing the symptoms of menopause, responding to the menopausal symptoms, understanding the need for preparation, and assessing the right time to prepare.Conclusion: Moving from uncertainty toward acceptance was identified as the core concept in the Iranian women's experiences of encountering menopause. Modifying the beliefs of people about menopause and aging as well as increasing their knowledge and information about menopause can help women to experience the menopausal transition with more ease.
Collapse
Affiliation(s)
- Narjes Bahri
- Reproductive Health, Social Development & Health Promotion Research Center, Department of Midwifery, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | | |
Collapse
|
11
|
Current Evidence of the Oncological Benefit-Risk Profile of Hormone Replacement Therapy. ACTA ACUST UNITED AC 2019; 55:medicina55090573. [PMID: 31500261 PMCID: PMC6780494 DOI: 10.3390/medicina55090573] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/30/2019] [Accepted: 09/03/2019] [Indexed: 02/07/2023]
Abstract
Hormone replacement therapy (HRT) remains the most effective treatment for menopausal symptoms and has been shown to prevent bone loss and fracture. The progestogen is added to provide endometrial protection in women with an intact uterus. After the publication of the initial WHI (Women's Health Initiative) results in 2002 reporting an overall increased risk of breast cancer, many women discontinued HRT. Despite the re-analysis of the results by subgroups of patients and updates with extended follow-up, much controversy remains, which we will analyze later in the text. Different types of estrogen or progestogen, as well as different formulations, doses, and durations, may play a role in HRT's effects on breast tissue. Evidence states that conjugated equine estrogen (CEE), compared to estro-progestin therapy, shows a better profile risk (HR 0.79, CI 0.65-0.97) and that, among different type of progestins, those structurally related to testosterone show a higher risk (RR 3.35, CI 1.07-10.4). Chronic unopposed endometrial exposure to estrogen increases the risk of endometrial hyperplasia and cancer, whereas the association with progestins, especially in continuous combined regimen, seems to reduce the risk (RR 0.71, CI 0.56-0.90). HRT was also associated with a protective effect on colon cancer risk (HR 0.61, CI 0.42-0.87). Data about ovarian and cervical cancer are still controversial.
Collapse
|
12
|
Carpenter JS, Schmidt KK, Jarvis LM, Lapum JL, Kesling MD. Focus group reactions to an arts-based educational exhibit on menopausal hot flashes. Menopause 2019; 26:981-988. [PMID: 31453959 DOI: 10.1097/gme.0000000000001351] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess public reactions to an arts-based educational exhibit designed to immerse and engage people in scientific facts to increase their conceptual understanding of hot flashes. Our ultimate goals were to stimulate learning and conversations about menopausal hot flashes to change interactions between menopausal women and providers, and menopausal women and other people (family, friends, etc). Focus groups reacted to the concept art (graphics, miniaturized model); and a questionnaire for quickly assessing reactions. METHODS Using a qualitative descriptive methodology, six focus groups of diverse people (n = 50) aged 13 to 64 years described their reactions to the art and questionnaire. Recruitment methods were word of mouth, advertisements on university websites, and a university-based participant registry. Data were analyzed using qualitative content analysis and inductively derived codes. RESULTS Reactions to the concept art were generally favorable. Participants remarked on appealing and less appealing aspects and age appropriateness. Appealing aspects were resonance with women's experiences, clear information, use of symbolism, and overall design. Less appealing aspects lacked resonance, contained confusing information, or unappealing design elements. Participants felt the exhibit should be open to all ages. The final questionnaire reflected participants' descriptions of the art's ability to stimulate learning, dispel myths, spur dialog, and increase empathy. CONCLUSIONS The concept art is an appropriate tool for improving knowledge and communication about hot flashes. Displaying the concept art and/or future full-scale exhibit in healthcare settings or public venues may facilitate learning and communication among three groups-menopausal women, healthcare providers, and others.
Collapse
Affiliation(s)
| | | | - Lynsey M Jarvis
- Indiana University, School of Nursing, Indianapolis, IN
- Ball State University, Muncie, IN
| | - Jennifer L Lapum
- Ryerson University, Daphne Cockwell School of Nursing, Toronto, ON
| | | |
Collapse
|
13
|
Carpenter JS, Rand KL, Schmidt KK, Lapum JL, Kesling MD. Public survey reactions to an arts-based educational menopausal hot flash exhibit. Menopause 2019; 26:989-993. [PMID: 31453960 DOI: 10.1097/gme.0000000000001352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of this study was to obtain public survey reactions to concept art for an exhibit about menopausal hot flashes designed to stimulate learning, dispel myths, spur dialogue, and increase empathy. METHODS Immediately before viewing the art, participants provided demographic information and answered one open-ended question. Immediately after viewing the art, participants answered the same open-ended question, one additional open-ended question, and completed quantitative survey questions. RESULTS Overall, public reactions to the concept art were positive. Qualitative and quantitative data indicated that the public thought the exhibit was appealing, stimulated learning, dispelled myths, spurred desire to have conversations about hot flashes, and increased empathy for women with menopausal hot flashes. CONCLUSIONS The exhibit concept art was appealing and was reported to have a positive impact on the public. Study findings provide support for building the exhibit full-scale as a traveling educational resource that might change public discourse around menopausal hot flashes.
Collapse
Affiliation(s)
| | - Kevin L Rand
- Indiana University-Purdue University, Indianapolis, IN
| | | | - Jennifer L Lapum
- Ryerson University, Daphne Cockwell School of Nursing, Toronto, ON, Canada
| | | |
Collapse
|
14
|
Abstract
OBJECTIVE The aim of this study was to describe the development process, science, and symbolism of an arts-based educational exhibit designed to address myths, misinformation, negative imagery, and use of unproven treatments related to menopausal hot flashes. METHODS The development process included iterative and informal feedback from a variety of individuals, a partnership with an experienced exhibit designer, and collaborations between artists and scientists. RESULTS The resulting exhibit creates an environment where the public is immersed in accurate information about hot flashes. Although based on an iterative process, the resulting exhibit content reflects an estimated 500+ scientific studies, including those referenced in The North American Menopause Society position statements on hormone and nonhormone management of hot flashes. The seven main exhibit pieces convey scientific information and symbolize various aspects of women's experiences. CONCLUSIONS This innovative exhibit has high potential to be a disruptive innovation to address the preponderance of myths, misinformation, and negative imagery surrounding menopausal hot flashes and potentially decrease the use of unproven therapies.
Collapse
|
15
|
Marlatt KL, Beyl RA, Redman LM. A qualitative assessment of health behaviors and experiences during menopause: A cross-sectional, observational study. Maturitas 2018; 116:36-42. [PMID: 30244777 PMCID: PMC6223619 DOI: 10.1016/j.maturitas.2018.07.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/14/2018] [Accepted: 07/19/2018] [Indexed: 01/12/2023]
Abstract
OBJECTIVES A qualitative research study was performed to assess the health and lifestyle behaviors of middle-aged women during the menopause transition, as well as to inform the development of interventions designed to combat menopause symptoms and improve quality of life during and after menopause. STUDY DESIGN Data were collected from 1611 women via a 21-item questionnaire distributed electronically. Only women who self-reported age ≥40 years and who were either peri-menopausal or post-menopausal were included in the analyses. OUTCOME MEASURES Women responded to questions about their health behaviors and experiences during menopause, including use of hormone replacement therapy (HRT), symptom ratings, and use of diet/lifestyle, exercise, and holistic remedies to relieve menopause symptoms. RESULTS More than 80% of women were interested in a structured lifestyle program to alleviate menopause symptoms, with 72% of these women wanting targeted strategies for weight loss or weight maintenance. Insomnia and hot flashes were the most severe symptoms reported. Although HRT is a well-established treatment of menopausal symptoms, more than 60% of women denied use of HRT, stating that they 'never considered HRT' as a treatment option or 'preferred to not take HRT'. Most women (65%) did not feel prepared for menopause. CONCLUSIONS Women do not feel prepared for menopause and report interest in a structured lifestyle program containing weight-loss and weight-maintenance strategies to combat menopause symptoms.
Collapse
Affiliation(s)
- Kara L Marlatt
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Robbie A Beyl
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States.
| |
Collapse
|
16
|
Kim MK, Seo SK, Chae HD, Hwang KJ, Kim T, Yoon BK, Lee BS. Perceptions of Postmenopausal Symptoms and Treatment Options among Middle-Aged Korean Women. Yonsei Med J 2017; 58:533-539. [PMID: 28332358 PMCID: PMC5368138 DOI: 10.3349/ymj.2017.58.3.533] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the perceptions of postmenopausal symptoms and treatment options among middle-aged Korean women. MATERIALS AND METHODS This cross-sectional study included 2330 Korean women. The women were administered a structured questionnaire to collect sociodemographic data and information regarding menopause and its treatment. RESULTS More than half (65%) of the participants perceived menopause as a disease, and 66.8% knew hormone therapy (HT) is available for menopausal symptom treatment. However, only 19.7% of participants visited clinics for HT. The most common reasons for having negative views about HT were its adverse reactions (47.3%) and concerns about developing cancer (41.1%). For symptom management, 36.5% of the participants tried lifestyle modification instead of HT. CONCLUSION The majority of Korean women regarded menopause as a disease. They were aware of HT for menopausal symptom treatment, but the use of HT was relatively low. Education about the safety and positive effects of HT and the importance of professional healthcare should be provided.
Collapse
Affiliation(s)
- Min Kyoung Kim
- Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Kyo Seo
- Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Dong Chae
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung Joo Hwang
- Department of Obstetrics and Gynecology, Ajou University College of Medicine, Suwon, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Byung Koo Yoon
- Department of Obstetrics and Gynecology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Korea
| | - Byung Seok Lee
- Division of Gynecologic Endocrinology, Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
| |
Collapse
|