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Vanden Noven ML, Larson M, Lee E, Reilly C, Tracy MF, Keller-Ross ML. Perceptions, Benefits, and Use of Complementary and Integrative Therapies to Treat Menopausal Symptoms: A Pilot Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:136-147. [PMID: 37008184 PMCID: PMC10061331 DOI: 10.1089/whr.2022.0105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 03/29/2023]
Abstract
Background Menopause symptoms can be debilitating, and the use of menopausal hormone therapy (MHT) has declined significantly since the Women's Health Initiative. Materials and Methods We surveyed 508 peri- and postmenopausal females to determine (1) the use of complementary and integrative therapies (CIT), MHT; and pharmacotherapies; (2) the perceptions, perceived benefits/risks of CIT, MHT; and pharmacotherapy use; and (3) factors associated with CIT and MHT use for menopause symptom treatment. Results The majority of respondents used CIT to treat menopause symptoms based on physician recommendation and research studies. Treatments that were perceived as most beneficial included exercise, mind-body therapies, diet, and spiritual practices, with exercise and mind-body therapies chosen to treat the most common symptoms of sleep disturbances, depressive mood, and anxiety. Higher education level was the main predictive variable for choosing exercise (odds ratio [OR] = 1.27, p = 0.02) and mind-body therapies (OR = 1.57, p = 0.02) to treat menopausal symptoms. Perceptions, beliefs, and use of different CIT by primarily white, affluent, and educated peri- and postmenopausal females to treat menopause symptoms, including sleep disturbances, depression, and anxiety, are driven by conversations with physicians and evidence-based research. Conclusion These findings reinforce the necessity for both additional research in more diverse populations, as well as comprehensive, individualized personalized care from an interdisciplinary team that considers the best options available for all female patients.
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Affiliation(s)
- Marnie L. Vanden Noven
- Department of Exercise Science, College of Health Sciences and Nursing, Belmont University, Nashville, Tennessee, USA
| | - Mia Larson
- Medical Specialists of Kentuckiana, Owensboro, Kentucky, USA
| | - Emma Lee
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cavan Reilly
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mary Fran Tracy
- Adult and Gerontological Health Cooperative, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Manda L. Keller-Ross
- Division of Physical Therapy, Medical School, University of Minnesota, Minneapolis, Minnesota, USA
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Vallejo MS, Witis S, Ojeda E, Mostajo D, Morera F, Meruvia N, Martino M, Lima S, Espinoza M, Castillo O, Campostrini B, Danckers L, Blümel JE, Tserotas K, Sánchez H, Salinas C, Saavedra J, Rojas JA, Onatra W, Monterrosa A, Montaño A, Martínez J, González E, Gómez G, Calle A, Broutin G, Bencosme A, Arteaga E, Ayala F, Chedraui P. Does the menopausal status of female gynecologists affect their prescription of menopausal hormone therapy? Climacteric 2016; 19:387-92. [DOI: 10.1080/13697137.2016.1191460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. S. Vallejo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - S. Witis
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - E. Ojeda
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - D. Mostajo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - F. Morera
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - N. Meruvia
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - M. Martino
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - S. Lima
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - M.T. Espinoza
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - O. Castillo
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - B. Campostrini
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - L. Danckers
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - J. E. Blümel
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
- Departamento de Medicina Interna Sur, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile
| | - K. Tserotas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - H. Sánchez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - C. Salinas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - J. Saavedra
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - J. A. Rojas
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - W. Onatra
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - A. Monterrosa
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - A. Montaño
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - J. Martínez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - E. González
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - G. Gómez
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - A. Calle
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - G. Broutin
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - A. Bencosme
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - E. Arteaga
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - F. Ayala
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
| | - P. Chedraui
- Collaborative Group for Research of the Climacteric in Latin America (REDLINC)
- Institute of Biomedicine, Research Area for Women’s Health, Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Critical review of complementary and alternative medicine use in menopause: focus on prevalence, motivation, decision-making, and communication. Menopause 2015; 21:536-48. [PMID: 24104604 DOI: 10.1097/gme.0b013e3182a46a3e] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study aims to undertake the first critical review of complementary and alternative medicine (CAM) use among menopausal women (a term here used to include premenopausal, perimenopausal and postmenopausal women) by focusing on the prevalence of CAM use and CAM users' characteristics, motivation, decision-making, and communication with healthcare providers. METHODS A comprehensive search of 2002-2012 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and menopause. RESULTS A considerable level of CAM use was observed among women in menopause. Many menopausal women use CAM concurrently with their conventional medicine. However, communication regarding CAM between menopausal women and healthcare providers seems less than optimal, with a demand for further information on the safety and efficacy of medicines. Existing literature is of variable methodological rigor, often presenting small sample sizes and low-quality data collection. Further rigorous research on this topic-including quantitative and qualitative methods using large national samples, where relevant-is required. CONCLUSIONS The findings of this critical review provide insights for those practicing and managing health care in this area of women's health. Healthcare providers should prepare to inform menopausal women about all treatment options, including CAM, and should be aware of the possible adverse effects of CAM and potential interactions between CAM and conventional medicine among women in menopause who are under their care.
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Ege E, Kal HE, Altuntuğ K. The use of alternative methods in reducing menopausal complaints in Turkey. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES 2014; 11:295-300. [PMID: 25435612 DOI: 10.4314/ajtcam.v11i2.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Millions of women experience menopause every year, therefore the aim of this study is to determine the rates of application of alternative methods applied by women in order to reduce their complaints caused by menopause and alternative application methods. MATERIALS AND METHODS This study was carried out on 246 women in their menopausal period. The data was obtained by the researcher through face to face interviews during the home visits. During the collection of data, a questionnaire form by the researcher that was developed in accordance with the literature information was applied. RESULTS 37.4% of women were determined to use alternative methods to reduce their menopausal symptoms. In the consequence of statistical analysis, a significant relation was found between the menopausal complaints such as hot flashes, night sweats and sleeping problem and the use of alternative methods in order to reduce their menopausal complaints (p<0.05). CONCLUSION It was determined that the women at their menopausal ages experienced vasomotor complaints and sleeping problems and they used alternative methods to reduce those problems.
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Affiliation(s)
- Emel Ege
- The Faculty of Health Sciences, Nursing Department, University of Necmettin Erbakan, Konya, Turkey
| | | | - Kamile Altuntuğ
- The Faculty of Health Sciences, Nursing Department, University of Necmettin Erbakan, Konya, Turkey
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Koç Z, Saglam Z, Topatan S. Determination of the use of complementary and alternative medicine by women in the climacteric period in the Turkish city of Samsun. Contemp Nurse 2014; 45:197-209. [PMID: 24299248 DOI: 10.5172/conu.2013.45.2.197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This quantitative descriptive study was carried out in order to determine the use of complementary and alternative medicine (CAM) for management of menopausal symptoms in women in Samsun, Turkey. Data on general demographic characteristics, menopause-related symptoms, and the use of CAM and herbal therapy were collected from 281 women undergoing the process of the climacteric period, admitted to the gynaecology polyclinic of a hospital in Samsun province. To evaluate the data, descriptive statistics, Student t-tests, and logistic regression analysis were used. In this study the most common CAM methods were identified as herbal therapy (29.9%), dieting (29.5%), exercise (29.2%), and massage (27.8%). Approximately one-third of the women identified as benefitting from CAM methods. More than half identified as not having informed a health care professional about their use of these methods of achieving symptom relief.
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Affiliation(s)
- Zeliha Koç
- Ondokuz Mayıs University Samsun School of Nursing, Samsun, Turkey
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Burich R, DeGregorio M. Current treatment options for vulvovaginal atrophy. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/eog.11.3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Lee PS, Lee CL, Hu ST, Tsao LI. Relieving my discomforts safely: the experiences of discontinuing HRT among menopausal women. J Clin Nurs 2013; 23:2481-9. [PMID: 24351027 DOI: 10.1111/jocn.12429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2013] [Indexed: 11/29/2022]
Abstract
AIM AND OBJECTIVES To generate a descriptive theoretical framework about the experiences of women who discontinued hormone replacement therapy. BACKGROUND Some menopausal women would depend on hormone replacement therapy for relieving their menopausal symptoms. However, most of them feared of hormone replacement therapy's side effects and tried to discontinue hormone replacement therapy immediately. How did these women self-manage their discomforts without using dependent medicine--hormone replacement therapy? There are few studies conducted on this issue. DESIGN A grounded theory research was applied. METHODS Nineteen Taiwanese women discontinuing hormone replacement therapy for three months, aged 45 to 67 years, participated in face-to-face audio-taped interviews. Data collection, and coding of interviews, and data analysis occurred simultaneously. All conversations were audio-recorded and then transcribed as verbatim text. The constant comparative method was used to analyse the interview data. RESULTS 'Relieving my discomforts safely' was the core theme for describing and guiding the process of discontinuing hormone replacement therapy. 'Immediately discontinuing hormone replacement therapy--it would hurt my body' was identified as the antecedent condition. Analyses showed five dimensions to the women's relieving my discomforts safely: (1) symptoms bothered me again, (2) negative emotions, (3) learning to let it go, (4) trying to use nonhormone replacement therapy or products and (5) choosing safely therapies as first priority. Finally, some women would choose their suitable nonhormone replacement therapy way, and some women would reuse hormone replacement therapy cautiously. CONCLUSIONS 'Relieving my discomforts safely' was the first-priority consideration for the menopausal women discontinuing hormone replacement therapy. It is the challenge to establish the health programme or management for helping these women felt safety and security to relieve their menopausal symptoms by using hormone replacement therapy or nonhormone replacement therapy. RELEVANCE TO CLINICAL PRACTICE Healthcare providers need to empower women the rights of decision-making of using hormone replacement therapy and assist them in monitoring their health status to reduce their fear and uncertainty.
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Affiliation(s)
- Pei-Shan Lee
- Department of Nursing, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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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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Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B, Imhof M. Effect of Red Clover Isoflavones over Skin, Appendages, and Mucosal Status in Postmenopausal Women. Obstet Gynecol Int 2011; 2011:949302. [PMID: 22135679 PMCID: PMC3206499 DOI: 10.1155/2011/949302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Accepted: 08/31/2011] [Indexed: 11/23/2022] Open
Abstract
Objective. Evaluate in postmenopausal women the effect of red clover extract (RCE) isoflavones over subjective status of skin, appendages, and several mucosal sites. Method. Postmenopausal women (n = 109) were randomly assigned to receive either two daily capsules of the active compound (80 mg RCE, 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. Subjective improvement of skin, appendages, and several mucosal site status was assessed for each studied group at 90 and 187 days using a visual analogue scale (VAS). In addition, libido, tiredness, and urinary, sleep, and mood complaints were also evaluated. Results. Women after RCE intervention (both groups) reported better subjective improvement of scalp hair and skin status, libido, mood, sleep, and tiredness. Improvement of urinary complaints, nail, body hair, and mucosa (oral, nasal, and ocular) status did not differ between treatment phases (intra- and intergroup). Overall satisfaction with treatment was reported higher after RCE intervention (both groups) as compared to placebo. Conclusion. RCE supplementation exerted a subject improvement of scalp hair and skin status as well as libido, mood, sleep, and tiredness in postmenopausal women.
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Affiliation(s)
- Markus Lipovac
- Division of Obstetrics and Gynecology, General Public Teaching Hospital Korneuburg, 2100 Korneuburg, Austria
| | - Peter Chedraui
- Instituto para la Salud de la Mujer, Facultad de Ciencias Médicas, Universidad Católica de Santiago Guayaquil, 196 Guayaquil, Ecuador
| | | | - Anca Gocan
- Study Center Med XIX, Grinzingerstr 83, 1190 Vienna, Austria
| | - Christine Kurz
- Division of Obstetrics and Gynecology, Medical University of Vienna, 1090 Vienna, Austria
| | - Benedikt Neuber
- Division of Obstetrics and Gynecology, General Public Teaching Hospital Korneuburg, 2100 Korneuburg, Austria
| | - Martin Imhof
- Division of Obstetrics and Gynecology, General Public Teaching Hospital Korneuburg, 2100 Korneuburg, Austria
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Thacker HL. Assessing risks and benefits of nonhormonal treatments for vasomotor symptoms in perimenopausal and postmenopausal women. J Womens Health (Larchmt) 2011; 20:1007-16. [PMID: 21675874 DOI: 10.1089/jwh.2010.2403] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Vasomotor symptoms (VMS); (hot flushes and night sweats) are the most common menopausal complaint for which women seek treatment. Several therapies can be considered to help manage these complaints. The objective of this review is to assess the risks and benefits of available and emerging therapeutic options for the management of menopausal VMS. METHODS A review of the literature was conducted based on relevant publications identified through a PubMed search for clinical trials of agents used in the treatment of VMS. RESULTS Hormone therapy (HT) remains the most effective treatment available, but there will always remain a need for nonhormonal options. Evidence does not support the efficacy of alternative or over-the-counter products, such as phytoestrogens and black cohosh, and their long-term safety is largely unknown. There is evidence supporting the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the management of VMS from clinical trials of paroxetine, venlafaxine, and desvenlafaxine. Gabapentin appears to be effective, but the doses required may cause poor tolerability and reduced patient adherence. Data also suggest that clonidine has a modest effect at the expense of considerable adverse effects. CONCLUSIONS Choosing an appropriate treatment approach for the management of VMS requires careful assessment of the riskbenefit ratio of each alternative, as well as individual patient preference.
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Affiliation(s)
- Holly L Thacker
- Center for Specialized Women's Health, Cleveland Clinic, Cleveland, OH 44195, USA.
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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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Menopausal symptom experience before and after stopping estrogen therapy in the Women's Health Initiative randomized, placebo-controlled trial. Menopause 2011; 17:946-54. [PMID: 20505547 DOI: 10.1097/gme.0b013e3181d76953] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to assess vasomotor and other menopausal symptoms before starting estrogens or placebo, 1 year later, again at trial closure, and after stopping estrogens or placebo. The role of baseline symptoms and age was examined, as was the frequency and determinants of hormone use and symptom management strategies after discontinuing conjugated equine estrogens (CEE) or placebo. METHODS Intent-to-treat analyses of 10,739 postmenopausal women before and 1 year after randomization to CEE or placebo at 40 clinical centers and a cohort analysis of participants (n = 3,496) who continued taking assigned study pills up to trial closure and completed symptom surveys shortly before (mean, 7.4 +/- 1.1 y from baseline) and after (mean, 306 +/- 55 d after trial closure) stopping pills were performed. Generalized linear regression modeled vasomotor symptoms, vaginal dryness, breast tenderness, pain/stiffness, and mood swings as a function of treatment assignment and baseline symptoms, before and after stopping study pills. RESULTS Approximately one third of participants reported at least one moderate to severe symptom at baseline. Fewer symptoms were reported with increasing age, except joint pain/stiffness, which was similar among age groups. At 1 year, hot flashes, night sweats, and vaginal dryness were reduced by CEE, whereas breast tenderness was increased. Breast tenderness was also significantly higher in the CEE group at trial closure. After stopping, vasomotor symptoms were reported by significantly more women who had reported symptoms at baseline, compared with those who had not, and by significantly more participants assigned to CEE (9.8%) versus placebo (3.2%); however, among women with no moderate or severe symptoms at baseline, more than five times as many reported hot flashes after stopping CEE (7.2%) versus placebo (1.5%). CONCLUSIONS CEE significantly reduced vasomotor symptoms and vaginal dryness in women with baseline symptoms but increased breast tenderness. The likelihood of experiencing symptoms was significantly higher after stopping CEE than placebo regardless of baseline symptom status. These potential effects should be considered before initiating CEE to relieve menopausal symptoms.
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15
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Yuksel N. Aider les femmes à traverser la ménopause: rôle des pharmaciens. Can Pharm J (Ott) 2010. [DOI: 10.3821/1913-701x-143.sp2.s19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Nesé Yuksel
- Nesé Yuksel est professeure agrégée à la faculté de pharmacie et des sciences pharmaceutiques de l'Université de l'Alberta, à Edmonton. Courriel:
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Adaikan PG, Srilatha B, Wheat AJ. Efficacy of red clover isoflavones in the menopausal rabbit model. Fertil Steril 2009; 92:2008-13. [DOI: 10.1016/j.fertnstert.2008.09.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Revised: 09/04/2008] [Accepted: 09/04/2008] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE There is currently a gap in treatment options for menopausal symptoms and a need for comprehensive therapies that are safe and effective for postmenopausal women. This review discusses challenges in the management of menopausal symptoms and the effect of the Women's Health Initiative (WHI) study findings on current treatment patterns. It also examines present and future therapies. RESEARCH DESIGN AND METHODS A literature search was conducted using Medline, the Cochrane Database, and the National Heart Lung and Blood Institute WHI website with the following search terms: primary care, menopause, vasomotor symptoms, hormone therapy, osteoporosis, and vaginal atrophy. Searches were limited to articles published between 1995 and 2009. RESULTS Comprehensive therapies that target several aspects of menopause, such as vasomotor symptoms and chronic disease prevention, are currently hormone based. These hormone-based approaches are considered more effective than currently available nonhormonal therapies for the relief of menopausal symptoms. However, hormone therapy is not recommended for women at high risk for venous thromboembolic events, cardiovascular disease, and/or breast cancer. A need exists for novel therapies that mitigate menopausal symptoms, provide protection from osteoporosis, and encourage patient compliance without promoting cancer, heart disease, or stroke. Emerging modalities and strategies, such as the tissue selective estrogen complex (TSEC), Org 50081, MF101, and desvenlafaxine, may provide improved options for postmenopausal women. CONCLUSIONS Several new menopausal therapies that may help to address the ongoing unmet need for safe and effective therapies for postmenopausal women are currently in development. In particular, the TSEC, which provides the benefits of both a selective estrogen receptor modulator and conjugated estrogens with an improved tolerability profile, may offer advantages over currently available treatment options. Limitations of this review include the narrow search criteria and limited search period.
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Affiliation(s)
- Vivian Lewis
- University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
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Theroux R. Postmenopausal hormone use: what does the latest evidence show? Nurs Womens Health 2008; 12:56-61. [PMID: 18257887 DOI: 10.1111/j.1751-486x.2007.00276.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Rosemary Theroux
- Graduate School of Nursing, University of Massachusetts, Worcester, MA, USA.
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Gold EB, Bair Y, Zhang G, Utts J, Greendale GA, Upchurch D, Chyu L, Sternfeld B, Adler S. Cross-sectional analysis of specific complementary and alternative medicine (CAM) use by racial/ethnic group and menopausal status: the Study of Women's Health Across the Nation (SWAN). Menopause 2007; 14:612-23. [PMID: 17327812 DOI: 10.1097/gme.0b013e31802d975f] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the relationships of race/ethnicity, menopausal status, health characteristics, and symptoms with use of 21 types of complementary and alternative medicine (CAM) in midlife women. DESIGN Cross-sectional, multiple logistic regression analyses of 2,118 women completing the sixth annual visit in the Study of Women's Health Across the Nation, a multisite, multiethnic, longitudinal study. RESULTS More than half of women used some type of CAM. Use of most types of CAM differed significantly by race/ethnicity, except the use of ginkgo biloba and glucosamine. Significantly more African Americans at most sites and Chinese women used ginseng. Use of most types of CAM did not differ significantly by menopausal status or vasomotor symptoms, except the use of soy supplements, which was significantly greater among women who reported vasomotor symptoms. Women reporting somatic symptoms were significantly more likely to use glucosamine. Women reporting psychological symptoms were significantly more likely to use ginkgo biloba and soy supplements. The number of comorbidities, moderate or high socioeconomic status, number of healthy behaviors, symptom sensitivity, age, and dietary genistein intake were significantly positively associated with use of several types of CAM. CONCLUSIONS The use of most types of CAM is not related to menopausal status or symptom reporting but to sociodemographic factors, comorbidities, and health behaviors. Given the large proportion of midlife women who use CAM and the potential for interactions with prescribed medications, healthcare practitioners should inquire about CAM use and be aware of which factors influence the use of different types of CAM.
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Affiliation(s)
- Ellen B Gold
- School of Medicine, University of California, Davis, CA 95616, USA.
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Daley A, MacArthur C, McManus R, Stokes-Lampard H, Wilson S, Roalfe A, Mutrie N. Factors associated with the use of complementary medicine and non-pharmacological interventions in symptomatic menopausal women. Climacteric 2007; 9:336-46. [PMID: 17000582 DOI: 10.1080/13697130600864074] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Hormone replacement therapy is now thought to have serious adverse effects; consequently, many menopausal women are seeking to use complementary and alternative medicine (CAM), including non-pharmacological interventions (NPI), to alleviate symptoms. The prevalence and perceived effectiveness of CAM and NPI for ameliorating menopausal symptoms are not widely known and factors likely to predict CAM and NPI utilization for menopausal symptom management have not been comprehensively documented. OBJECTIVES The objectives of this study were to (1) determine the prevalence of using CAM and NPI for menopausal symptoms; (2) describe the perceived effectiveness of CAM and NPI for symptom management; and (3) investigate lifestyle and demographic factors associated with CAM/NPI use among menopausal women with vasomotor symptoms. METHODS Women aged 46-55 years were recruited via six socioeconomically diverse general practices. Participants completed a postal questionnaire that contained items relating to demographics, lifestyle factors, weight, height, exercise behavior, menopausal status, vasomotor symptoms and utilization and perceived effectiveness of a range of CAM/NPI for symptom management. RESULTS Of 1,206 women who responded, 563 (47%) were symptomatic. The most commonly used CAM/NPI for symptom management were diet/nutrition (44.3%), exercise/yoga (41.5%), relaxation/stress management (27.4%) and homeopathic/naturopathic remedies (25.4%). Of women who used these interventions, large proportions reported them to be helpful. The characteristics that were independently associated with use of CAM/NPI were White ethnicity, being physically active, and not smoking. CONCLUSIONS Many menopausal symptomatic women are using a wide range of CAM/NPI and report these to be effective, particularly those who are white, physically active and do not smoke.
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Affiliation(s)
- A Daley
- Division of Primary Care, Public and Occupational Health, University of Birmingham, Birmingham, UK
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Shrader SP, Ragucci KR. Life After the Women's Health Initiative: Evaluation of Postmenopausal Symptoms and Use of Alternative Therapies After Discontinuation of Hormone Therapy. Pharmacotherapy 2006; 26:1403-9. [PMID: 16999650 DOI: 10.1592/phco.26.10.1403] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
STUDY OBJECTIVE To determine the number of women who have menopausal symptoms after discontinuing hormone therapy, to determine how many of these women subsequently require nonhormonal alternatives to manage their symptoms, and to assess the effectiveness of those therapies. DESIGN One-year retrospective study. SETTING Department of Family Medicine outpatient clinic at a university medical center. PATIENTS From 378 postmenopausal women who discontinued hormone therapy between August 1, 2002, and August 31, 2003, we randomly selected 78 using electronic medical records to provide a sample with a 95% confidence interval and a 10% margin of error. MEASUREMENTS AND MAIN RESULTS Reasons why the women discontinued therapy and any nonhormonal alternative therapies that they may have used to manage subsequent menopausal symptoms were recorded. The primary investigator contacted the 78 women to complete a telephone survey. In most women, at least one menopausal symptom recurred. Vasomotor symptoms (hot flashes) were most common and occurred in 41 (53%) women. In addition, 59 (76%) women reported using nonhormonal alternative therapies, and 40 (68%) of this group deemed the alternatives helpful. CONCLUSION We strongly believe that health care providers, including pharmacists, must continue to communicate with and educate women regarding treatment options for menopausal symptoms. Clinical pharmacists are ideally suited to contribute to ongoing research in this area.
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Affiliation(s)
- Sarah P Shrader
- Department of Pharmacy and Clinical Sciences/Family Medicine, South Carolina College of Pharmacy, Medical University of South Carolina Campus, Charleston, South Carolina 29425, USA.
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Abstract
OBJECTIVE In 2002, the combination estrogen-progestin hormone therapy (HT) treatment arm of the Women's Health Initiative was terminated early because cardiovascular and cancer risks were identified, while the estrogen-only therapy (ET) arm of this trial continued. We investigated hormone therapy prescription practice changes between 2001 and 2003 to explore the effects of the clinical trial results. METHODS Data were obtained from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey for the years 2001 through 2003. These nationally representative surveys sample medical encounters in nonfederally employed physician's offices and outpatient departments of nonfederal short-stay and general hospitals. The proportion and rate of visits with ET and HT prescriptions were calculated. Logistic regression was used to estimate change over time accounting for patient and provider characteristics. RESULTS Between 2001 and 2003, the number of visits with menopausal hormone prescriptions fell from 26.5 million to 16.9 million. Almost three-quarters of hormone visits were for ET prescriptions. The decrease in the rate of visits was slightly larger for HT prescription visits (44%) than ET prescription visits (35%). The rate of decline was highest among women 50 years of age and over. After controlling for covariates, there was no significant difference in the decline by hormone type. CONCLUSION These nationally representative data indicate substantial declines in menopausal hormone prescriptions coinciding with clinical trial results on HT. These declines occurred among all types of therapy and patient characteristics. LEVEL OF EVIDENCE II-3.
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Affiliation(s)
- Esther Hing
- Division of Health Care Statistics, and Office of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA.
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