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Elhosary EAM, Ewidea MM, Ahmed HAH, El Khatib A. Effect of aerobic exercises versus laser acupuncture in treatment of postmenopausal hot flushes: a randomized controlled trial. J Phys Ther Sci 2018; 30:328-331. [PMID: 29545706 PMCID: PMC5851375 DOI: 10.1589/jpts.30.328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/29/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To compare the effect of aerobic exercises versus laser acupuncture in
treatment of postmenopausal hot flushes. [Subjects and Methods] This study was designed as
single blind randomized controlled trial. A total of 48 postmenopausal women complained of
hot flushes. Their ages ranged between 45 to 55 years and were randomly assigned into 2
equal groups: group (A), which received an aerobic exercises, and group (B), which
received laser acupuncture. Both groups recieved 3 sessions per week for two months. The
level of follicular stimulating hormone, lutelizing hormone, and hot flushes dairy card
were assessed the severity of hot flahes before and after treatment program. [Results]
There were Significant reduction in FSH, LH, and menopausal daily hot flush scale in group
A compared with group B at the post treatment. [Conclusion] Eight week program of an
aerobic exercises yields improvement in FSH, LH, and decrease in severity of hot flushes
assessed by hot flush dairy card than laser acupuncture in the treatment of postmenopausal
hot flashes.
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Affiliation(s)
| | - Mahmoud Mohamed Ewidea
- Department of Basic Science, Faculty of Physical Therapy, Kafrelsheikh University, Egypt
| | | | - Ayman El Khatib
- Department of Physical Therapy, Faculty of Health Sciences, Beirut Arab University, Lebanon
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Loja-Chango R, Pérez-López FR, Simoncini T, Escobar GS, Chedraui P. Increased mood symptoms in postmenopausal women related to the polymorphism rs743572 of the CYP17 A1 gene. Gynecol Endocrinol 2016; 32:827-830. [PMID: 27117436 DOI: 10.1080/09513590.2016.1177015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Menopausal and depressive symptoms are highly prevalent after the menopause; but may vary from one population to another and genetics play a key role. OBJECTIVE To analyze the intensity of these symptoms in relation to the genetic variants of the rs743572 polymorphism of the CYP17 A1 gene in postmenopausal women. METHODS DNA was extracted from the whole blood of 168 natural postmenopausal women (40-65 years) and tested for the rs743572 polymorphism of the CYP17 A1 gene. Intensity of menopausal (Menopause Rating Scale, MRS) and depressive symptoms (Hospital Anxiety and Depressive Scale, HADS) were correlated to polymorphism genotypes. RESULTS Women with the GG genotype of the rs743572 polymorphism displayed significantly higher scores for the MRS (items 5 and 6 [irritability and anxiety] and the psychological subscale) and the HADS (total and subscales). CONCLUSION The intensity of menopausal symptoms related to mood was found higher among postmenopausal women presenting the GG genotype of the rs743572 polymorphism of the CYP17 A1 gene. There is a need for more research in this regard.
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Affiliation(s)
- Rita Loja-Chango
- a Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil, Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
| | - Faustino R Pérez-López
- b Department of Obstetrics and Gynecology , Facultad de Medicina, Universidad de Zaragoza, Lozano Blesa University Hospital , Zaragoza , Spain , and
| | - Tommaso Simoncini
- c Department of Clinical and Experimental Medicine , Division of Obstetrics and Gynecology, University of Pisa , Pisa , Italy
| | - Gustavo S Escobar
- a Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil, Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
| | - Peter Chedraui
- a Facultad de Ciencias Médicas , Institute of Biomedicine, Research Area for Women's Health, Universidad Católica de Santiago de Guayaquil, Enrique C. Sotomayor Obstetrics and Gynecology Hospital , Guayaquil , Ecuador
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Cortés-Bonilla M, Alonso-Campero R, Bernardo-Escudero R, Francisco-Doce MT, Chavarín-González J, Pérez-Cuevas R, Chedraui P. Improvement of quality of life and menopausal symptoms in climacteric women treated with low-dose monthly parenteral formulations of non-polymeric microspheres of 17β-estradiol/progesterone. Gynecol Endocrinol 2016; 32:831-834. [PMID: 27187320 DOI: 10.1080/09513590.2016.1183628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVE To evaluate the short term effect over menopausal symptoms and quality of life (QoL) of monthly parenteral formulations of 17β-estradiol (E)/progesterone (P) non-polymeric microspheres. METHODS This is a secondary analysis of a multicenter, randomized, single-blinded study that included peri- and post-menopausal symptomatic women assigned to receive a monthly intramuscular injection of 0.5 mg E + 15 mg P (Group A, n = 34), 1 mg E + 20 mg P (Group B, n = 24), or 1 mg E + 30 mg P (Group C, n = 26) for 6 months. Intensity of menopausal symptoms was assessed before and after treatment with the Greene Climacteric Scale (GCS) and QoL with the Utian Quality of Life Scale (UQoLS). RESULTS Menopausal symptoms improved for all groups at six months evidenced by lower cluster/sub-cluster GCS scores. Equally, there was an overall trend for QoL improvement for all groups evidenced by higher domain UQoLS scores at six months; but only significant for the emotional (Groups A and B) and occupational domains (Groups A and C). CONCLUSION The three low-dose continuous sequential intramuscular monthly formulations of E/P microspheres exerted a positive effect over menopausal symptoms and QoL. Long-term research is warranted with these formulations. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov Identifiers NCT 00775242.
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Affiliation(s)
- Manuel Cortés-Bonilla
- a Instituto Nacional de Perinatología "Isidro Espinosa de los Reyes" , Ciudad de México , México
| | - Rosalba Alonso-Campero
- b Centro A.F. de Estudios Tecnológicos , S.A. de C.V. (CAFET), Ciudad de México , México
| | | | - María T Francisco-Doce
- b Centro A.F. de Estudios Tecnológicos , S.A. de C.V. (CAFET), Ciudad de México , México
| | - Juan Chavarín-González
- b Centro A.F. de Estudios Tecnológicos , S.A. de C.V. (CAFET), Ciudad de México , México
| | - Ricardo Pérez-Cuevas
- c Unidad de Investigación Epidemiológica y en Servicios de Salud, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social , Ciudad de México , México , and
| | - Peter Chedraui
- d Facultad de Ciencias Médicas , Instituto de Biomedicina, Área de Investigación para la Salud de la Mujer, Universidad Católica de Santiago de Guayaquil , Guayaquil , Ecuador
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von Holzen JJ, Capaldo G, Wilhelm M, Stute P. Impact of endo- and exogenous estrogens on heart rate variability in women: a review. Climacteric 2016; 19:222-8. [PMID: 26872538 DOI: 10.3109/13697137.2016.1145206] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Measurement of heart rate variability (HRV) is an established method to assess the activity of the autonomic nervous system. The aim of this review was to examine the link between HRV, reproductive life stages and menopausal hormone therapy. A literature review was performed using the Medline database. Based on title and abstract, 45 studies were extracted out of 261 citations screened. Due to different study designs and evaluation methods, HRV indices were not directly comparable. Qualitative comparisons in between the vast majority of studies, however, demonstrated a decrease of the vagal dominance on the heart from the follicular to the luteal cycle phase, although some studies asserted no change. The intake of oral contraceptives appeared not to alter the vagal modulation of the heart. All investigations agreed on a decline of HRV towards higher sympathetic control after menopause. Different menopausal hormone therapy approaches showed a supporting impact of estrogen on HRV in most studies. A combined therapy of estrogen and progestogens revoked this benefit. Further research is needed to demonstrate how this process might be attenuated by different menopausal hormone therapies.
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Affiliation(s)
- J J von Holzen
- a Department of Obstetrics and Gynecology , Inselspital, University of Bern , Switzerland
| | - G Capaldo
- a Department of Obstetrics and Gynecology , Inselspital, University of Bern , Switzerland
| | - M Wilhelm
- b Department of Cardiology , Inselspital, University of Bern , Switzerland
| | - P Stute
- a Department of Obstetrics and Gynecology , Inselspital, University of Bern , Switzerland
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Korkmaz V, Ozkaya E, Cekmez Y, Leblebıcı D, Dagdevıren G, Cınar M, Kara F, Kucukozkan T. Relationship between the body iodine status and menopausal symptoms during postmenopausal period. Gynecol Endocrinol 2015; 31:61-4. [PMID: 25211538 DOI: 10.3109/09513590.2014.958986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM The aim of this study was to assess the effect of body iodine status on hot flashes and cardiovascular disease risk in postmenopausal women. METHODS Two hundred and ten consecutive postmenopausal women without known any risk factor for cardiovascular disease risk or systemic disorder were recruited for the study. All participants underwent serum screening consisted of lipid profile including lipoprotein-a (Lp(a)) and urinary iodine excretion. Participants were also asked for the frequency and the duration of hot flashes. All parameters were assessed for the association between urine iodine excretion and other parameters. RESULTS Urine spot iodine level was significantly correlated with Lp(a) (r = -0.287, p < 0.001), low-density lipoprotein cholesterol (LDL-C) (r = -0.187, p = 0.006), cholesterol level (r = -0.573, p < 0.001), TG level (r = -0.211, p = 0.02), frequency of hot flashes per a day (r = -0.467, p < 0.001), durations of hot flashes (r = -0.424, p < 0.001), fasting glucose level (r = 0.331, p < 0.001), and fT3 level (r = 0.475, p < 0.001). In multivariate analysis, Lp(a) levels were significantly associated with the urine iodine level (beta coefficient = -0.342, p < 0.001) after adjustment for LDL-C (beta coefficient = 0.225, p < 0.001), glucose (beta coefficient = 0.303, p < 0.001), and age (beta coefficient = 0.146, p < 0.017). CONCLUSION Body iodine status during postmenopausal period is associated with the menopausal symptoms and lipid profile including Lp(a).
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Affiliation(s)
- Vakkas Korkmaz
- Department of Obstetrics and Gynecology, Ankara Education and Research Hospital , Ankara , Turkey
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Abstract
OBJECTIVE To investigate the hypothesis that postmenopausal women demonstrate greater cardiovascular stress reactivity during mental stress tasks than do both premenopausal women and men. METHODS The study included 979 Japanese participants (338 men and 641 women [238 postmenopausal]) aged 16 to 82 years. Blood pressure, heart rate, heart rate variability, and peripheral blood flow were measured at rest and during a mirror drawing stress task and a maze task. Differences between measured variables during tasks and at rest were calculated and considered to represent reactivity to stress. Analyses were adjusted for age and other potential confounding factors. RESULTS After adjusting for multiple factors, significant group effects were found for systolic blood pressure (SBP), diastolic blood pressure, heart rate, low-frequency (LF), LF/high-frequency, and peripheral blood flow (effect size: partial η = 0.015, 0.011, 0.013, 0.013, 0.008, and 0.009, respectively). Postmenopausal women were more reactive than men to stress for SBP (15.4 ± 0.8 versus 11.7 ± 0.6 mm Hg), diastolic blood pressure (10.4 ± 0.6 versus 8.0 ± 0.5 mm Hg), heart rate (2.7 ± 0.5 versus 0.7 ± 0.4 beats/min), LF (23.0 ± 5.2 versus 3.2 ± 3.8 ms/Hz), and peripheral blood flow (-39.0 ± 3.8 versus -25.9 ± 2.8 Laser Doppler Perfusion Units) and more reactive than premenopausal women (p < .050) for SBP (15.4 ± 0.8 versus. 12.4 ± 0.5 mm Hg) and LF/high-frequency (1.7 ± 0.1 versus 1.3 ± 0.1). CONCLUSIONS Postmenopausal Japanese women evidenced greater cardiovascular stress reactivity during mental stress tasks than did Japanese men or premenopausal women. Cardiovascular hyperreactivity could play a role in the higher risks of cardiovascular diseases in postmenopausal women.
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Herzfrequenzvariabilität in der Postmenopause. GYNAKOLOGISCHE ENDOKRINOLOGIE 2013. [DOI: 10.1007/s10304-013-0553-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cianci A, Cicero AFG, Colacurci N, Matarazzo MG, De Leo V. Activity of isoflavones and berberine on vasomotor symptoms and lipid profile in menopausal women. Gynecol Endocrinol 2012; 28:699-702. [PMID: 22313171 DOI: 10.3109/09513590.2011.652250] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to evaluate the efficacy of a food supplement combination based on isoflavones and berberine (ISB) in the treatment of menopausal symptoms and dyslipidaemia. Isoflavones are extracted from soy and absorbed in the body after being activated by lactobacillus. Berberine, extracted from the plant Berberis aristata, lowers plasma cholesterol and triglycerides (TG) by increasing low-density lipoprotein (LDL) receptors and reducing hepatic synthesis of TG. One hundred twenty women with a mean age of 54.8 ± 0.6 years were enrolled and randomized to treatment with ISB (estromineral lipid [EL] = 60 cases) or calcium and vitamin D(3) (CaD = 60 cases). Menopausal symptoms, plasma cholesterol, and TG were evaluated at baseline, and after 4 and 12 weeks. EL treatment significantly lowered plasma total cholesterol (-13.5% ± 0.7 vs -0.2% ± 0.5), LDL cholesterol (-12.4% ± 1.5 vs + 0.8 % ± 0.7) and TG (-18.9% ± 2.5 vs -1.3% ± 1.2) and improved menopausal symptoms compared with CaD treatment. Safety parameters were unchanged during the study. The combination of berberine and isoflavones was effective in lowering cardiovascular (CV) risk factors in menopausal women with moderate dyslipidaemia and in improving their quality of life.
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Affiliation(s)
- Antonio Cianci
- Department of Medical-Surgical Specialities, Obstetrics and Gynaecology Section, Policlinico G. Rodolico, University of Catania, Catania, Italy
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Chen JT, Kotani K. An inverse relation between the Simplified Menopausal Index and biological antioxidant potential. Climacteric 2012; 16:288-91. [DOI: 10.3109/13697137.2012.696291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Tolstov SN, Mychka VB, Salov IA, Prokhorova YV, Vyshivanyuk VA. Comparative effectiveness of the approaches to correct vascular structural and functional disturbances in postmenopausal women. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2012. [DOI: 10.15829/1728-8800-2012-4-23-35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim.To compare the effects of Mildronate and hormone replacement therapy (HRT) with estradiol (1 mg) and drospirenone, DSPR (2 mg) on circadian blood pressure (BP) profile, arterial structure and function, and vascular stiffness parameters in women with early postmenopause and climacteric syndrome (CS).Material and methods.The study included 94 women with early postmenopause and CS, who provided written informed consent to participate and were divided into two groups. Group I included 36 women receiving Mildronate (500 mg twice a day), while Group II included 28 women who were administered, according to clinical indications, HRT (1 mg 17β-estradiol and 2 mg DRSP once a day). The control group (CG) included 30 women who did not receive either Mildronate or DRSP. At baseline and 16 weeks later, all participants underwent the assessment of blood biochemistry; intima-media thickness (IMT) of common carotid artery (CCA); endothelium-dependent vasodilatation (EDVD) of brachial artery (BA); antithrombogenic activity of vascular wall; aortal pulse wave velocity (aPWV); arterial stiffness; and 24-hour BP monitoring (BPM).Results.The study demonstrated positive effects of Mildronate therapy and HRT (1 mg 17β-estradiol and 2 mg DRSP) on metabolic status, circadian dynamics and variability (Var) of BP, and arterial structure and function. The largest positive changes in blood lipid profile were observed in Group I and II patients. By the end of the study, these patients demonstrated significantly decreased levels of systolic and diastolic BP and reduced BP Var, particularly in Group II. Mildronate therapy, but not HRT, was associated with normalisation of vascular wall antiaggregant potential. Group II demonstrated a significant reduction in CCA IMT levels, with a similar tendency in Group I. In both groups, the degree of endothelial dysfunction (ED) decreased, which was manifested in increased BA EDVD, decreased aPWV, and reduced arterial stiffness and was more pronounced in Group II.Conclusion.In menopausal women with CS, the effects of Mildronate and HRT on metabolic, structural, and functional disturbances were similar. Therefore, Mildronate therapy could be a new method of correction of these systemic disturbances.
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Affiliation(s)
| | - V. B. Mychka
- A. L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex, Moscow
| | | | - Yu. V. Prokhorova
- A. I. Evdokimov Moscow State Medico-Stomatological University, Moscow
| | - V. A. Vyshivanyuk
- A. I. Evdokimov Moscow State Medico-Stomatological University, Moscow
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Martínez Pérez JA, Palacios S, Chavida F, Pérez M. Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors. Climacteric 2012; 16:226-34. [PMID: 22871028 DOI: 10.3109/13697137.2012.688077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To assess whether the severity of menopausal symptoms is related to increased cardiovascular and osteoporosis risk factors, and to determine whether women with more severe menopausal symptoms present a greater percentage of osteoporosis disease. METHODS This was a cross-sectional, descriptive study encompassing women aged 45-65 years in the whole Spanish territory. The study population sample was collected through random sampling. A total of 10 514 women were included. Their sociodemographic, medical history and lifestyle data were assessed by means of a survey. The Kupperman Index was used to assess the severity of menopausal symptoms. Bone mineral density was measured by the dual X-ray absorptiometry method. RESULTS The prevalences of risk factors for osteoporosis and cardiovascular disease were 67.6% and 74.8%, respectively. Women with a higher intensity of symptoms also had a greater percentage of cardiovascular (p < 0.001) and osteoporosis (p < 0.001) risk factors and suffered more from osteoporosis disease (p < 0.001). In the logistic regression analysis, those variables that contributed to the severity of menopausal symptoms were: arterial hypertension (odds ratio (OR) 2.14; 95% confidence interval (CI) 1.49-2.79; p < 0.001), dyslipidemia (OR 1.94; 95% CI 1.48-2.4; p < 0.001), obesity (OR 2.23; 95% CI 1.55-2.91; p < 0.001), family history (OR 1.38; 95% CI 1.17-1.59; p < 0.01), medication use (OR 1.12; 95% CI 0.52-1.72; p < 0.01) and osteoporosis disease (OR 3.71; 95% CI 2.9-4.52; p < 0.001). CONCLUSIONS Women with more severe menopausal symptoms had a greater prevalence of cardiovascular and osteoporosis disease risk factors and suffered more from osteoporosis disease compared to those who had milder or no menopausal symptoms.
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Tolstov SN, Mychka VB, Salov IA, Prokhorova YV, Vyshivanyuk VA. Cardiorenal disturbances in perimenopausal women. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2012. [DOI: 10.15829/1728-8800-2012-3-16-29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To identify early signs of renal dysfunction; to investigate the associations between renal function and vascular remodelling; to evaluate the role of metabolic and hydrodynamic disturbances in the development of cardiorenal syndrome among perimenopausal women; and to assess the potential of hormone replacement therapy (17β-estradiol 1 mg and drospirenone 2 mg) for the correction of the above-mentioned disturbances. Material and methods. In total, 69 perimenopausal women were divided into two groups. Group I included 69 premenopausal women, while Group II consisted of 43 women in early postmenopause. Mean age in Group I was 49,0 years (95% CI 48,0-51,0 years); in Group II, it was 54,0 (50,0-56,0) years (p<0,01). Age at menopause reached 50,3 (48,0-52,0) years, with median duration of menopause of 3,5 (2,0-5,0) years. All participants underwent biochemical blood tests (creatinine (Cr), uric acid (UA), lipid profile, and glucose tolerance test (GTT)). Large elastic artery remodelling was assessed by intima-media thickness (IMT) of common carotid artery (CCA). Non-invasive assessment of endothelial vasoregulatory function involved the measurement of brachial artery (BA) endothelium-dependent vasodilatation (EDVD) in the reactive hyperemia test (RHT). Renal function was assessed by glomerular filtration rate (GFR) and Cr clearance (CrC). Monoalbuminuria (MAU) was qualitatively assessed with a urine strip test. Postmenopausal women were additionally divided into two groups: 23 patients were administered HRT (17β-estradiol 1 mg and drospirenone 2 mg; Angelique medication), while 20 women not receiving HRT comprised a control group. At the end of the study, after 12 months, the assessment of metabolic status, body mass dynamics, endothelial vasoregulatory function, and CCA IMT was repeated. Results. In most postmenopausal women, lipid and carbohydrate metabolism disturbances were observed, which were typical for metabolic syndrome (MS). Lipid metabolism disturbances were observed as early as in premenopause, but reached their maximum during early postmenopause. Postmenopausal women, compared to their peers in premenopause, had significantly higher fasting and postprandial levels of blood glucose. Structural and functional changes in vascular wall were more severe in postmenopausal vs. premenopausal women (p<0,001). While blood flow velocity in the RHT was comparable in both groups, postmenopausal women did not demonstrate a comparable increase in BA EDVD, in contrast to premenopausal females. This could point to the decrease in BA sensitivity to endothelial shear stress among women in postmenopause. Reduced GFR was observed only in postmenopausal women. MAU was registered in premenopausal women with normal GFR, as well as in postmenopausal females. These data on independent role of MAU and reduced GFR suggest an increase in the proportion of women with subclinical renal injury, as a manifestation of target organ damage. Conclusion. The associations between vascular structure and function, renal function, and main MS components were demonstrated. HRT (17β-estradiol 1 mg and drospirenone 2 mg) had beneficial effects on BP dynamics, visceral obesity, metabolic status, and arterial structure and function.
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Affiliation(s)
| | - V. B. Mychka
- A. L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex, Moscow
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Resilience and related factors during female Ecuadorian mid-life. Maturitas 2012; 72:152-6. [DOI: 10.1016/j.maturitas.2012.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 03/01/2012] [Accepted: 03/03/2012] [Indexed: 11/19/2022]
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Abstract
OBJECTIVE The aim of this study was to investigate the impact of women's personality traits and some sociodemographic variables on quality of life (QoL). METHODS This cross-sectional and correlational study was conducted among 320 Turkish women aged between 45 and 64 years who attended the Menopausal Polyclinic. Data were collected from the Turkish version of the Cervantes Personality Scale and the Turkish version of the Menopause-Specific Quality of Life Questionnaire. RESULTS The mean (SD) age of the participants was 51.8 (5.3) years. The average (SD) age since menopause was found to be 46 (3.3) years. The menopausal QoL was correlated with education status, income level, working status, exercise routine, chronic health problems, family's/friends' support, and negative life events. Logistic regression analyses showed that the QoL in vasomotor, psychological, and sexual domains were 6.1, 9.2, and 11.4 times, respectively, lower in neurotic women than in emotionally stable women. In addition, the QoL in sexual domains were 3.3 times lower in introverted women than in extraverted women. CONCLUSION These findings indicate that higher levels of introversion and higher levels of neuroticism lead to lower QoL among postmenopausal women. The results of this study support the hypothesis that personality would play an important role in women's QoL during the transition period of menopause.
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Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B, Imhof M. The effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal women. Gynecol Endocrinol 2012; 28:203-7. [PMID: 21870906 DOI: 10.3109/09513590.2011.593671] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the effect of red clover isoflavone supplementation over vasomotor and overall menopausal symptoms in postmenopausal women. METHODS One hundred and nine postmenopausal women aged 40 or more were assigned to randomly receive either two daily capsules of the active compound (80 mg red clover isoflavones, Group A) or placebo of equal appearance (Group B) for a 90-day period. After a washout period of 7 days, medication was crossed over and taken for 90 days more. Daily hot flush and night sweat frequency and overall menopausal symptom intensity (Kupperman Index) were measured at baseline, 90, 97 and 187 days. RESULTS Daily hot flush/night sweat frequency and Kupperman Index values were similar in both studied groups at baseline. All indices significantly decreased after red clover phase in Group A, corresponding, respectively to a 73.5%, 72.2% and 75.4% average decrement. These decrements were significantly higher than those observed for Group B after placebo phase (8.2%, 0.9% and 6.7% respectively). In Group A, after washout and placebo phases all values significantly increased. In Group B, all indices remained similar after placebo and washout phases, however significantly dropping after red clover treatment. These values were also significantly lower than those observed in Group A after placebo phase. No side effects were encountered after treatment with the active compound or placebo. CONCLUSION Red clover isoflavone supplementation was more effective than placebo in reducing daily vasomotor frequency and overall menopausal intensity in postmenopausal women.
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Affiliation(s)
- Markus Lipovac
- Division of Obstetrics and Gynecology, General Teaching Hospital Korneuburg, Austria
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Chedraui P, Jaramillo W, Pérez-López FR, Escobar GS, Morocho N, Hidalgo L. Pro-inflammatory cytokine levels in postmenopausal women with the metabolic syndrome. Gynecol Endocrinol 2011; 27:685-91. [PMID: 20937002 DOI: 10.3109/09513590.2010.521270] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Prevalence of the metabolic syndrome (METS) and its components significantly increase after the menopause. Related increased cardiovascular risk may partially be explained by a pro-inflammatory state. OBJECTIVE To assess pro-inflammatory cytokine serum levels in postmenopausal women with and without the METS. METHODS Serum of 90 postmenopausal women who previously participated in a METS screening programme was analysed for tumour necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6). Cytokine levels were compared among those with and without the syndrome, and for each of its components. Linear relationships were also assessed between cytokine levels and several continuous variables including each diagnostic METS criteria and menopausal symptoms assessed with the Menopause Specific Quality of Life tool (MENQOL). RESULTS For all studied women mean age was 55.1 ± 7.3 years with 63.3% having abdominal obesity, 15.6% hyperglycaemia, 58.9% high triglycerides, 44.4% hypertension and 25.6% high total cholesterol levels. Women with the METS (n = 45) significantly had higher body mass index values, and higher rates of abdominal obesity, hyperglycaemia, hypertriglyceridemia, hypertension and lower HDL-C levels. Cytokine levels did not differ among women with or without the METS; however, independent of METS diagnosis those with abdominal obesity displayed significantly higher IL-6 levels and those with hypertension higher levels of both cytokines. Levels of both cytokines positively correlated with age and time since menopause, IL-6 positively correlating with waist circumference values and TNF-α positively with both systolic and diastolic blood pressure levels. A significant positive correlation was also found between the number of positive METS criteria (0-5) and both cytokine levels. Cytokine levels did not correlate with vasomotor and psycho-social MENQOL scores. CONCLUSION Pro-inflammatory cytokine levels in this postmenopausal series positively correlated with age, time since the menopause, abdominal circumference, blood pressures levels and the number of positive METS diagnostic criteria. There is a need for more research in this regard.
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Affiliation(s)
- Peter Chedraui
- Facultad de Ciencias Médicas, Instituto de Biomedicina, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
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17
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Yureneva SV, Mychka VB, Ilyina LM, Tolstov SN. Cardiovascular risk factors in women and the role of sex hormones. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2011. [DOI: 10.15829/1728-8800-2011-4-128-135] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Despite certain success in the recent years, the problem of cardiovascular disease (CVD) in women remains one of the greatest challenges of the 21st century. Its social and economic burden will continue to increase, due to increasing proportion of older women in the population. Recently, cardiologists have been focusing on menopause as a specific CVD risk factor in women. At the same time, other conditions, also increasing CVD risk, such as certain pregnancy complications and premature menopause, have not received enough attention. Hormone replacement therapy (HRT) remains the first-line treatment and the most effective strategy in young women with estrogen deficiency and postmenopausal women with menopausal symptoms. HRT effectiveness and safety is based on its timely start, low dose, and individually appropriate combination of estrogens and progestins. Interdisciplinary approach is essential for early identification of high-risk women, since lifestyle modification recommendations, diagnostic procedures, and, if needed, an active therapeutic intervention could reduce future CVD incidence in these women.
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Affiliation(s)
- S. V. Yureneva
- V.I. Kulakov Research Centre of Obstetrics, Gynecology, and Perinatology
| | - V. B. Mychka
- A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
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18
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Abstract
Hot flushes are complained of by approximately 75% of all postmenopausal women, and hormone therapy (HT) is the most effective way to alleviate them. Hot flushes are characterized by altered vascular function and sympathetic nervous system activity. Hot flushes occurred more often in women attending large, non-randomized observational studies (e.g. Nurses' Health Study), where HT use protected against cardiovascular disease (CVD). However, they were absent (or mild) in randomized HT trials where HT use was accompanied with an elevated risk for CVD. Hot flushes, if a factor for cardiovascular health, could partly explain the conflict between observational and randomized trials. Several cross-sectional studies imply that hot flushes are detrimental to the cardiovascular system. However, the data are not uniform, and hot flushes were recalled retrospectively or during HT use. In our prospective study hot flushes were accompanied with a vasodilatory effect during endothelial testing, and this was related to the severity of hot flushes. Night-time hot flushes were followed with transient rises in ambulatory blood pressure (BP). However, no effect of hot flushes on diurnal BP was detected. The use of estradiol showed no harmful effects on endothelial function in women with hot flushes, but in non-flushing women oral, but not transdermal, estradiol led to vasoconstrictive changes. Estradiol complemented with medroxyprogesterone acetate eliminated the vasoconstrictive effect of sole oral estradiol. Thus, both oral and transdermal estradiol are applicable in flushing women, whereas a transdermal route should be favored in non-flushing women if used e.g. for bone protection.
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Affiliation(s)
- Pauliina Tuomikoski
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Finland
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19
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Chedraui P, San Miguel G, Schwager G. The effect of soy-derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index. Gynecol Endocrinol 2011; 27:307-13. [PMID: 20528204 DOI: 10.3109/09513590.2010.490614] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Risk-benefit issues raised after the WHI have significantly increased the use of alternative treatments for the menopause. Despite this, data regarding the effect of soy isoflavones over mood and menopausal symptoms in high risk populations is still lacking. OBJECTIVE To evaluate the effect of soy derived isoflavones over hot flushes, menopausal symptoms and mood in climacteric women with increased body mass index (BMI). METHODS Fifty symptomatic climacteric women aged 40 to 59 with increased BMI (≥ 25) were recruited to receive oral 100 mg/day of soy derived isoflavones (Climasoy) for 3 months. Hot flushes (frequency/intensity), menopausal symptoms (Menopause Rating Scale [MRS]) and mood (Hamilton Depressive Rating Scale [HDRS]) were evaluated at baseline and at 90 days. RESULTS A total of 45 women completed the study. After 3 months of soy isoflavone supplementation hot flushes significantly decreased in percentage, number and severity (100% to 31.1%; 3.9 ± 2.3 to 0.4 ± 0.8 and 2.6 ± 0.9 to 0.4 ± 0.8, respectively, p < 0.001). MRS scores (total and for subscales) reflecting general menopausal symptoms also significantly decreased compared to baseline. Regarding mood, after three months total HDRS scores and the rate of women presenting depressed mood (scores ≥ 8) significantly decreased (16.3 ± 5.4 to 6.9 ± 5.2 and 93.3% to 28.9%, respectively, p < 0.05). There was no effect on blood pressure levels or BMI values after treatment. CONCLUSION In this high risk climacteric population, soy derived isoflavone treatment improved mood as well as vasomotor and general menopausal symptoms. More research is required to determine if the positive effect over mood is a direct or an indirect one through hot flush alleviation.
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Affiliation(s)
- Peter Chedraui
- Instituto para La Salud de La Mujer, Guayaquil, Ecuador.
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20
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Sassarini J, Fox H, Ferrell W, Sattar N, Lumsden MA. Vascular function and cardiovascular risk factors in women with severe flushing. Clin Endocrinol (Oxf) 2011; 74:97-103. [PMID: 21050255 DOI: 10.1111/j.1365-2265.2010.03921.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Seventy per cent of postmenopausal women suffer from hot flushes causing significant morbidity in 25%. Oestrogen replacement provides symptom relief, but its use has declined following safety issues and there is, as yet, no good alternative. Pathophysiology is poorly understood, but one proposed mechanism is altered peripheral vascular reactivity. It has recently been suggested that the presence of flushing may be a marker of underlying cardiovascular risk. AIM To measure (i) peripheral vascular reactivity in subcutaneous vessels (ii) routine and novel cardiovascular risk factors in postmenopausal women who flush, and compare results to a matched group of women who do not flush. METHODS Thirty-two postmenopausal women with at least 20 flushes/week and 14 nonflushing postmenopausal women were recruited. Cutaneous microvascular perfusion was measured using laser Doppler imaging, and endothelial function was assessed by iontophoresis (administration of vasoactive agents through the skin by an electric current) of acetylcholine [Ach] (endothelial-dependent) and sodium nitroprusside [SNP] (endothelial independent). Blood samples for risk factors were taken following vascular assessment. RESULTS Both study groups were well matched demographically. The response of the subcutaneous vessels was greater in women who flushed than those who did not, following administration of both the endothelium-dependent and independent vasodilators, (ACh, P ≤ 0·001, SNP, P = 0·001, 2-way anova). By contrast, levels of High Density Lipoprotein (HDL)-cholesterol and ApoA1 were significantly lower in the flushing women compared with the control women (P = 0·02 and 0·002, respectively), and levels of inter-cellular adhesion molecule-1 (ICAM-1) were higher (P = 0·03), findings robust to adjustment for confounders, suggesting an adverse cardiovascular risk profile. CONCLUSION These results confirm a better vascular response in women but paradoxically, such women appear to have worse (not better) cardiovascular disease risk factors in particular lower HDL-cholesterol but also higher non-HDL-c to HDL-c ratio and increased ICAM-1. Further studies are needed to assess vascular risk factors in women who flush.
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Affiliation(s)
- J Sassarini
- Centre for Population & Health Sciences, University of Glasgow, UK.
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Innes KE, Selfe TK, Vishnu A. Mind-body therapies for menopausal symptoms: a systematic review. Maturitas 2010; 66:135-49. [PMID: 20167444 PMCID: PMC3031101 DOI: 10.1016/j.maturitas.2010.01.016] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Accepted: 01/23/2010] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. METHODS To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. RESULTS Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low-frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. CONCLUSIONS Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms.
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Affiliation(s)
- Kim E Innes
- Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV 26506-9190, USA.
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Risk factors related to the presence and severity of hot flushes in mid-aged Ecuadorian women. Maturitas 2010; 65:378-82. [DOI: 10.1016/j.maturitas.2009.11.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Revised: 11/23/2009] [Accepted: 11/25/2009] [Indexed: 11/18/2022]
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