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Kingsberg SA, Schulze-Rath R, Mulligan C, Moeller C, Caetano C, Bitzer J. Global view of vasomotor symptoms and sleep disturbance in menopause: a systematic review. Climacteric 2023; 26:537-549. [PMID: 37751852 DOI: 10.1080/13697137.2023.2256658] [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: 06/06/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023]
Abstract
Studies have shown racial/ethnic differences in the prevalence of vasomotor symptoms (VMS), sleep disturbance and VMS treatment in menopause. To assess the reproducibility of these differences, we systematically reviewed observational studies, published in 2000-2021, reporting the prevalence/incidence of VMS, sleep disturbance or treatment use in menopausal women stratified by race/ethnicity. We screened 3799 records from PubMed and Embase and included 27 papers (19 studies). No incidence data were found. Prevalence data varied widely, but some common patterns emerged. In all five studies comparing VMS between Black women and White, Hispanic and/or East Asian women, the prevalence was highest in Black women and lowest in East Asian women. The prevalence of sleep disturbance overall was compared among Black, White and East Asian women in two study populations, and was highest in White women in both papers. Sleep disturbance was more common than VMS in East Asian women. In all four studies comparing hormone therapy use between White women and Black and/or East Asian women, treatment use was more common in White women. These results highlight the need for individualized counseling and treatment, outreach to under-served minorities, and standardized definitions and outcome measures for VMS and sleep disturbance for future studies.
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Affiliation(s)
- S A Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - R Schulze-Rath
- Medical Affairs & Pharmacovigilance, Pharmaceuticals, Bayer AG, Berlin, Germany
| | - C Mulligan
- Evidence Synthesis, Beacon Medical Communications, Brighton, UK
| | - C Moeller
- Medical Affairs & Pharmacovigilance, Pharmaceuticals, Bayer AG, Berlin, Germany
| | - C Caetano
- Pharmaceuticals, Medical Affairs Women's Healthcare, Bayer AG, Basel, Switzerland
| | - J Bitzer
- Department of Obstetrics and Gynecology, University Hospital, University of Basel, Basel, Switzerland
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Sievert LL, Sharmeen T, Begum K, Muttukrishna S, Chowdhury O, Bentley GR. Frequency of Phytoestrogen Consumption and Symptoms at Midlife among Bangladeshis in Bangladesh and London. Nutrients 2023; 15:3676. [PMID: 37686708 PMCID: PMC10490262 DOI: 10.3390/nu15173676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
There is a longstanding interest in the relationship between diet and hot flash symptoms during midlife, especially in whether phytoestrogens ease menopausal symptoms. The purpose of this study was to examine hot flashes, night sweats, trouble sleeping, and vaginal dryness in relation to the intake of foods rich in phytoestrogens among Bangladeshi women aged 35 to 59 years who were living either in Sylhet, Bangladesh (n = 157) or as migrants in London (n = 174). Consumption ranges for phytoestrogens were constructed from food frequencies. We hypothesized that diets rich in isoflavones, lignans, and coumestrol would be associated with lower symptom frequencies. However, adjusted logistic regression results showed that with each incremental increase in general phytoestrogen consumption (scale of 0 to 10), the likelihood of hot flashes increased by 1.4%. Each incremental increase in lignan consumption raised the likelihood of hot flashes by 1.6%. In contrast, the odds of vaginal dryness decreased by 2%, with each incremental increase in phytoestrogen and lignan consumption, and by 4%, with each incremental increase in isoflavone consumption. Night sweats and trouble sleeping were not associated with phytoestrogen intake in logistic regressions. Our findings add to the conflicting data on relationships between phytoestrogens and symptoms associated with menopause.
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Affiliation(s)
| | - Taniya Sharmeen
- Nuffield Department of Medicine, University of Oxford, Oxford OX3 7BN, UK
| | - Khurshida Begum
- Department of Anthropology, Durham University, Durham DH1 3LE, UK
| | - Shanthi Muttukrishna
- Department of Obstetrics and Gynecology, University College Cork, T12 E7WX Cork, Ireland
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Sievert LL, Whitcomb BW, Verjee MA, Gerber LM. Limited evidence of a threshold effect for increasing adiposity on risk of symptoms at midlife. Menopause 2022; 29:1381-1387. [PMID: 36166728 DOI: 10.1097/gme.0000000000002074] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess the nature of relationships between increasing body mass index (BMI) and the prevalence of midlife symptoms in a population with high adiposity. METHODS In the cross-sectional Study of Women's Health in Qatar, 841 participants aged 40 to 60 years were recruited from nine primary health centers in Doha. Face-to-face interviews collected demographic, menopause, and symptom information. BMI (kg/m 2 ) was categorized as healthy, overweight, or class I, II, or III obesity. Multivariate logistic regression models were used to examine aches/stiffness in joints, trouble sleeping, shortness of breath, urinary incontinence, and hot flashes with BMI categories. Restricted cubic splines (RCSs) were used to estimate relationships between continuous BMI and each symptom and to conduct formal tests of nonlinearity. RESULTS Mean BMI was 34.3 kg/m 2 (SD, 6.0 kg/m 2 ). Women with class II and III obesity had higher odds of reporting aches/stiffness than women with a healthy BMI, and the odds of reporting urinary incontinence were three times higher among women with class III obesity (odds ratio, 3.08; 95% confidence interval, 1.17-8.14). Using restricted cubic spline models, a significant nonlinear association ( P = 0.002) was observed between aches/stiffness and BMI with an apparent threshold of 38 kg/m 2 . Linear relationships were observed with BMI for urinary incontinence ( P < 0.001 for linear trend) and shortness of breath ( P = 0.005 for linear trend). Trouble sleeping and hot flashes were not associated with BMI. CONCLUSIONS Even at very high levels of BMI, likelihood of urinary incontinence and shortness of breath increases with BMI. In contrast, likelihood of aches/stiffness has a nonlinear relationship with BMI, increasing to a threshold level.
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Affiliation(s)
| | - Brian W Whitcomb
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, MA
| | | | - Linda M Gerber
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY
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Acupuncture for hot flashes in hormone receptor-positive breast cancer, a coordinated multinational study: Rationale and design of the study protocol. Contemp Clin Trials 2022; 121:106885. [PMID: 35998768 DOI: 10.1016/j.cct.2022.106885] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/30/2022] [Accepted: 08/12/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Acupuncture has been reported to reduce hot flashes in patients with breast cancer undergoing adjuvant hormonal therapy. Although hot flashes are common, the prevalence varies among cultures, races, and ethnicities; the efficacy of acupuncture across cultures has not been investigated. METHODS This is a coordinated multinational study, including three parallel randomized trials with a planned analysis of individual patient data, to test the effectiveness of acupuncture on hot flash-related symptoms in hormone receptor-positive breast cancer patients on adjuvant endocrine therapy. Using a standardized acupuncture protocol (total across all three studies of n = 80) versus usual care (total n = 80), symptoms are assessed using changes in the Endocrine Symptom Subscale of Functional Assessment of Cancer Therapy-Endocrine Symptoms. Secondary outcomes include hot flash severity, quality of life, and sleep quality. Differences in response to acupuncture between participants in the three countries will also be explored. DISCUSSION Here we describe the design of a protocol for a coordinated multinational study, with attention to the complex considerations in developing a multinational research effort testing a non-pharmacologic intervention. This protocol and approach provide guidance for future efforts to evaluate and test non-pharmacologic interventions across multinational populations. TRIAL REGISTRATION clinicaltrials.gov (Identifier: NCT00797732, registered on December 21, 2018), Chinese Clinical Trial Registry (ChiCTR2100045888), and The Clinical Research Information Service (CRIS) of Korea (Registration number: KCT0003618).
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Hossain MB, Kong Y, Posada-Quintero HF, Chon KH. Comparison of Electrodermal Activity from Multiple Body Locations Based on Standard EDA Indices' Quality and Robustness against Motion Artifact. SENSORS (BASEL, SWITZERLAND) 2022; 22:3177. [PMID: 35590866 PMCID: PMC9104297 DOI: 10.3390/s22093177] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 06/15/2023]
Abstract
The most traditional sites for electrodermal activity (EDA) data collection, palmar locations such as fingers or palms, are not usually recommended for ambulatory monitoring given that subjects have to use their hands regularly during their daily activities, and therefore, alternative sites are often sought for EDA data collection. In this study, we collected EDA signals (n = 23 subjects, 19 male) from four measurement sites (forehead, back of neck, finger, and inner edge of foot) during cognitive stress and induction of mild motion artifacts by walking and one-handed weightlifting. Furthermore, we computed several EDA indices from the EDA signals obtained from different sites and evaluated their efficiency to classify cognitive stress from the baseline state. We found a high within-subject correlation between the EDA signals obtained from the finger and the feet. Consistently high correlation was also found between the finger and the foot EDA in both the phasic and tonic components. Statistically significant differences were obtained between the baseline and cognitive stress stage only for the EDA indices computed from the finger and the foot EDA. Moreover, the receiver operating characteristic curve for cognitive stress detection showed a higher area-under-the-curve for the EDA indices computed from the finger and foot EDA. We also evaluated the robustness of the different body sites against motion artifacts and found that the foot EDA location was the best alternative to other sites.
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Su J, Jogamoto A, Yoshimura H, Yang LJ. Menopausal symptoms among Chinese and Japanese women: differences and similarities. Menopause 2021; 29:73-81. [PMID: 34812777 DOI: 10.1097/gme.0000000000001874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES This study aimed to identify the characteristics of menopausal symptoms among Japanese and Chinese women and to determine the correlation between menopausal symptoms and self-efficacy. METHODS We surveyed 40- to 59-year-old women, 329 of whom were from an urban area in Northwest China (Xi'an) and 310 were from an urban area in Western Japan (Ehime), using a menopausal symptoms inventory and a self-efficacy scale. Comparison analysis was conducted among pre-, peri-, and postmenopausal status, within and between the two cultural groups. Following a two-way ANOVA, multiple comparisons were performed using the Tukey-Kramer test. The correlation between severity of menopause symptoms and self-efficacy scores was evaluated using canonical correlation analysis. RESULTS The most frequently reported symptoms were fatigue (93.6%) among Japanese women and memory loss (76.6%) among Chinese women. Japanese women showed significantly higher severity scores across all factors than Chinese, sexual function: 19.58 (SE = 0.73) versus 15.04 (SE = 0.67); mental health condition: 35.44 (SE = 1.15) versus 27.12 (SE = 0.95); interpersonal anxiety: 27.45 (SE = 0.95) versus 21.92 (SE = 0.86); autonomic balance: 42.76 (SE = 1.27) versus 35.75 (SE = 1.17); other subjective symptoms: 39.68 (SE = 1.20) versus 33.07 (SE = 1.12) in the premenopausal group (P < 0.01); and mental health conditions 35.14 (SE = 1.41) versus 29.60 (SE = 1.25), interpersonal anxiety: 27.34 (SE = 1.18) versus 20.79 (SE = 1.02), autonomic balance factors: 45.81 (SE = 1.79) versus 38.05 (SE = 1.67) in the postmenopausal group (P < 0.01). No significant differences of the factors among menopausal stages within Japanese women were found. Among Chinese women, peri- and postmenopausal women showed significantly higher severity scores on sexual function, while perimenopausal women scored higher on mental health conditions and autonomic balance factors (P < 0.01). A negative correlation was found between menopausal symptoms and self-efficacy among both Japanese and Chinese women (P < 0.01). CONCLUSIONS Japanese women reported more severe symptoms compared with their Chinese counterparts, and for Chinese women, symptoms might be specifically associated with menopausal status. Menopausal experience is associated with self-efficacy and vice versa.
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Affiliation(s)
- Jing Su
- Department of Nursing, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Akiko Jogamoto
- Department of Fundamental and Clinical Nursing Program for Nursing and Health Science, Ehime University, Shitsukawa, Toon, Ehime, Japan
| | - Hiroyuki Yoshimura
- University of Human Environments, Hanazonomachi, Matsuyama, Ehime, Japan
| | - Lu Jun Yang
- Research Center for Translational Medicine, The Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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Fouad S, El Shebini SM, Abdel-Moaty M, Ahmed NH, Hussein AMS, Essa HA, Tapozada ST. Menopause Anxiety and Depression; How Food Can Help? Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5555] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Anxiety and depression are reported as two major frequent and chief complaints among peri-menopausal women in several societies.
AIM: The objective of the study was to study the effect of using two dietary supplements to beat depression and anxiety associated with menopause.
SUBJECTS AND METHODS: Sixty-six volunteers’ menopausal women participated on the study for 8 weeks, 35 subjects consumed daily cookies prepared mainly from soya flour and flaxseed, and 31 females consumed daily a blend composed mainly of raw unroasted peanut and raw sesame. Follow-up was performed with menopause rating scale, anxiety score, depression score, and biochemical parameters.
RESULTS: Soya cookies were rich in plant-based protein and total phenols while blend was a good source of unsaturated fatty acid. Blend consumers showed significant percentage reduction in beck anxiety score and beck depression score after intervention, more than cookies consumers group. The anthropometrics parameters were statistical significant changed on both groups, more on the group who consumed the soya cookies. Soya cookies demonstrated an anti-inflammatory effect, while blend had an antioxidant and anti-inflammatory effects as was shown on the serum assay of interleukin-6 and malondialdehyde as an inflammatory marker and an antioxidant marker, respectively.
CONCLUSION: From the results, it can be concluded that the supplementation of products enriched with unsaturated fatty acid was more beneficial to slow down the psychological menopause symptoms than natural estrogen rich product consumption.
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Kim H, Kim Y, Mahmood M, Kwon S, Zavanelli N, Kim HS, Rim YS, Epps F, Yeo W. Fully Integrated, Stretchable, Wireless Skin-Conformal Bioelectronics for Continuous Stress Monitoring in Daily Life. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2020; 7:2000810. [PMID: 32775164 PMCID: PMC7404159 DOI: 10.1002/advs.202000810] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 04/22/2020] [Indexed: 05/21/2023]
Abstract
Stress is one of the main causes that increase the risk of serious health problems. Recent wearable devices have been used to monitor stress levels via electrodermal activities on the skin. Although many biosensors provide adequate sensing performance, they still rely on uncomfortable, partially flexible systems with rigid electronics. These devices are mounted on either fingers or palms, which hinders a continuous signal monitoring. A fully-integrated, stretchable, wireless skin-conformal bioelectronic (referred to as "SKINTRONICS") is introduced here that integrates soft, multi-layered, nanomembrane sensors and electronics for continuous and portable stress monitoring in daily life. The all-in-one SKINTRONICS is ultrathin, highly soft, and lightweight, which overall offers an ergonomic and conformal lamination on the skin. Stretchable nanomembrane electrodes and a digital temperature sensor enable highly sensitive monitoring of galvanic skin response (GSR) and temperature. A set of comprehensive signal processing, computational modeling, and experimental study provides key aspects of device design, fabrication, and optimal placing location. Simultaneous comparison with two commercial stress monitors captures the enhanced performance of SKINTRONICS in long-term wearability, minimal noise, and skin compatibility. In vivo demonstration of continuous stress monitoring in daily life reveals the unique capability of the soft device as a real-world applicable stress monitor.
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Affiliation(s)
- Hojoong Kim
- George W. Woodruff School of Mechanical EngineeringInstitute for Electronics and NanotechnologyGeorgia Institute of TechnologyAtlantaGA30332USA
- School of Intelligent Mechatronics EngineeringSejong UniversitySeoul05006Republic of Korea
| | - Yun‐Soung Kim
- George W. Woodruff School of Mechanical EngineeringInstitute for Electronics and NanotechnologyGeorgia Institute of TechnologyAtlantaGA30332USA
| | - Musa Mahmood
- George W. Woodruff School of Mechanical EngineeringInstitute for Electronics and NanotechnologyGeorgia Institute of TechnologyAtlantaGA30332USA
| | - Shinjae Kwon
- George W. Woodruff School of Mechanical EngineeringInstitute for Electronics and NanotechnologyGeorgia Institute of TechnologyAtlantaGA30332USA
| | - Nathan Zavanelli
- George W. Woodruff School of Mechanical EngineeringInstitute for Electronics and NanotechnologyGeorgia Institute of TechnologyAtlantaGA30332USA
| | - Hee Seok Kim
- Department of Mechanical EngineeringUniversity of South AlabamaMobileAL36608USA
| | - You Seung Rim
- School of Intelligent Mechatronics EngineeringSejong UniversitySeoul05006Republic of Korea
| | - Fayron Epps
- Nell Hodgson Woodruff School of NursingEmory UniversityAtlantaGA30322USA
| | - Woon‐Hong Yeo
- George W. Woodruff School of Mechanical EngineeringInstitute for Electronics and NanotechnologyGeorgia Institute of TechnologyAtlantaGA30332USA
- Wallace H. Coulter Department of Biomedical EngineeringParker H. Petit Institute for Bioengineering and BiosciencesInstitute for MaterialsNeural Engineering CenterInstitute for Robotics and Intelligent MachinesGeorgia Institute of Technology and Emory UniversityAtlantaGA30332USA
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Sievert LL, Huicochea-Gómez L, Cahuich-Campos D, Brown DE. Hot Flashes Associated with Menopause in the State of Campeche, Mexico: Biometric Measurement and Self-Reported Experience. CURRENT ANTHROPOLOGY 2019. [DOI: 10.1086/703144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bashar MI, Ahmed K, Uddin MS, Ahmed F, Emran AA, Chakraborty A. Depression and Quality of Life among Postmenopausal Women in Bangladesh: A Cross-sectional Study. J Menopausal Med 2017; 23:172-181. [PMID: 29354617 PMCID: PMC5770527 DOI: 10.6118/jmm.2017.23.3.172] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/22/2017] [Accepted: 08/19/2017] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aims of the research are to examine the problems of abnormal menopausal women: the relationship between depression and menopausal-specific quality of life (MENQOL)-symptoms among postmenopausal women; the association of MENQOL-symptoms between pre- and postmenopausal female society in Bangladeshi real community. METHODS This cross sectional study was conducted on 435 women of Tangail, aged (≥ 17) years, using a structured questionnaire where is inaacluded the information of MENQOL and one of the main outcomes "depression" is measured by beck depression inventory. RESULTS Menopausal status and MENQOL symptoms (except pain) are significantly (P < 0.05) associated. By using post-hoc analysis, the proportion of menopausal women, classified as having a depressive mood of early menopause is significantly higher than natural-menopause. Among postmenopausal women, there is a significant correlation between "concentration problem" and "depression". Here mean depression score (29.40 ± 6.42) of menopausal women who have any difficulty in concentrating is higher than mean depression score (20.89 ± 6.64) of menopausal women who have no difficulty in concentrating. Another six factors (osteoporosis, heart-beating, fatigue, pressure, tingling, headaches) of MENQOL-symptoms were significantly correlated with depression and P-values are 0.000, 0.000, 0.000, 0.033, 0.006, and 0.002, respectively. Finally the presence of "difficulty in concentrating" and "fatigue" are strongly associated factors with depression score (P < 0.001). CONCLUSIONS The early postmenopausal women have to face more psychological problems (e.g., depression) compare to others. Among postmenopausal women, there is no significant relation between depression and vasomotor symptom (e.g., hot-flashes) perspective to menopausal female society of Bangladesh.
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Affiliation(s)
- Mamun Ibn Bashar
- Department of Statistics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
- Group of Bio-photomatiχ, Tangail, Bangladesh
| | - Kawsar Ahmed
- Group of Bio-photomatiχ, Tangail, Bangladesh
- Department of Information and Communication Technology, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Muhammad Shahin Uddin
- Group of Bio-photomatiχ, Tangail, Bangladesh
- Department of Information and Communication Technology, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Farzana Ahmed
- Department of Mathematics and Natural Science, BRAC University, Dhaka, Bangladesh
- University of Queensland Diamantina Institute, Translational Research Institute, University of Queensland, Queensland, Australia
| | - Abdullah-Al Emran
- Department of Biotechnology and Genetic Engineering, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
- Dermatology Research Center, University of Queensland Diamantina Institute, Translational Research Institute, University of Queensland, Queensland, Australia
| | - Aditi Chakraborty
- Department of Statistics, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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The time has come for a safe, effective way to relieve menopausal symptoms. Menopause 2017; 24:1113-1115. [DOI: 10.1097/gme.0000000000000966] [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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Sturdee DW, Hunter MS, Maki PM, Gupta P, Sassarini J, Stevenson JC, Lumsden MA. The menopausal hot flush: a review. Climacteric 2017; 20:296-305. [DOI: 10.1080/13697137.2017.1306507] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- D. W. Sturdee
- Department of Gynaecology, Solihull Hospital, Birmingham, UK
| | - M. S. Hunter
- Unit of Psychology, Institute of Psychiatry (at Guy's), King's College London, London, UK
| | - P. M. Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - P. Gupta
- Women's Unit, Solihull Hospital, Birmingham Heartlands & Solihull NHS Trust, Birmingham, UK
| | - J. Sassarini
- Department of Obstetrics & Gynaecology, University of Glasgow, College of Medicine, Western Infirmary, Glasgow, UK
| | - J. C. Stevenson
- National Heart & Lung Institute, Royal Brompton Hospital, London, UK
| | - M. A. Lumsden
- Reproductive and Maternal Medicine, University of Glasgow, Glasgow, UK
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13
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An investigation of life circumstances associated with the experience of hot flashes in Campeche, Mexico. Menopause 2017; 24:52-63. [DOI: 10.1097/gme.0000000000000725] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Hart V, Sturgeon SR, Reich N, Sievert LL, Crawford SL, Gold EB, Avis NE, Reeves KW. Menopausal vasomotor symptoms and incident breast cancer risk in the Study of Women's Health Across the Nation. Cancer Causes Control 2016; 27:1333-1340. [PMID: 27680016 DOI: 10.1007/s10552-016-0811-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/24/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE Two case-control studies reported a 50 % decreased breast cancer risk among women who experienced menopausal vasomotor symptoms (VMS), but one cohort study found no association. VMS may be triggered by declining estrogen levels during menopause, whereas elevated estrogen levels have been associated with increased breast cancer risk. VMS may thus be indicative of lower susceptibility to breast cancer. METHODS We evaluated this relationship in the longitudinal Study of Women's Health Across the Nation (SWAN), using discrete survival analysis of approximately annual data on VMS and self-reported breast cancer occurrences for up to 13 years of follow-up in 3,098 women who were pre- or early perimenopausal at enrollment. RESULTS Over an average 11.4 years of follow-up, 129 incident breast cancer cases were self-reported, and approximately 50 % of participants experienced VMS. Symptomatic women had a reduced risk of breast cancer compared to non-symptomatic women (adjusted HR 0.63, 95 % CI 0.39, 1.00). The association was stronger in the subgroup of women who fully transitioned to postmenopause during follow-up (n = 67 cases, adjusted HR 0.45, 95 % CI 0.26, 0.77). CONCLUSION VMS appeared to be a marker of reduced breast cancer risk. Future research is needed to understand the biology underlying this relationship.
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Affiliation(s)
- Vicki Hart
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Susan R Sturgeon
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Nicholas Reich
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | | | - Sybil L Crawford
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Ellen B Gold
- Department of Public Health Sciences, School of Medicine, University of California School of Medicine, Davis, CA, USA
| | - Nancy E Avis
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Katherine W Reeves
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, 411 Arnold House, 715 North Pleasant Street, Amherst, MA, 01003, USA.
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Sievert LL, Begum K, Sharmeen T, Murphy L, Whitcomb BW, Chowdhury O, Muttukrishna S, Bentley GR. Hot flash report and measurement among Bangladeshi migrants, their London neighbors, and their community of origin. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:620-633. [DOI: 10.1002/ajpa.23062] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/26/2016] [Indexed: 12/16/2022]
Affiliation(s)
- L. L. Sievert
- Department of AnthropologyUniversity of MassachusettsAmherst Massachusetts
| | - K. Begum
- Department of AnthropologyUniversity College LondonLondon United Kingdom
| | - T. Sharmeen
- Department of AnthropologyUniversity College LondonLondon United Kingdom
| | - L. Murphy
- Department of AnthropologyUniversity of MassachusettsAmherst Massachusetts
| | - B. W. Whitcomb
- School of Public HealthUniversity of MassachusettsAmherst Massachusetts
| | | | - S. Muttukrishna
- Department of Obstetrics and GynecologyUniversity College CorkCork Ireland
| | - G. R. Bentley
- Department of AnthropologyDurham UniversityDurham United Kingdom
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Abstract
Most menopausal women experience vasomotor symptoms with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women's Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen increased all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appear to represent a sound strategy for optimizing the benefit-risk profile and safety of HT. Systemic HT should not be arbitrarily stopped at age 65 years; instead treatment duration should be individualized based on patients' risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely affects the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low-dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit-risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms.
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Islam MR, Gartoulla P, Bell RJ, Fradkin P, Davis SR. Prevalence of menopausal symptoms in Asian midlife women: a systematic review. Climacteric 2014; 18:157-76. [DOI: 10.3109/13697137.2014.937689] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dasgupta D, Ray S. Vasomotor and urogenital problems at midlife: a study on rural and urban women in India. Ann Hum Biol 2014; 42:268-75. [DOI: 10.3109/03014460.2014.941397] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Abstract
BACKGROUND Cross-cultural differences in attitudes and practices related to diabetes are well-known. Similar differences in symptom reporting of endocrine conditions such as menopause are well documented. Minimal literature is available on the cross-cultural variation in reporting of hypoglycemic symptoms. AIMS This cross-sectional study aimed to assess the symptoms of hypoglycemia encountered by diabetologists who deal with patients from different language groups from various states of North and West India and Nepal. MATERIALS AND METHODS Eighty three doctors from six Indian states and Nepal, attending a continuing medical education program were requested to fill a detailed, pre-tested, Likert scale based questionnaire which assessed the frequency and symptoms with which patients presented with hypoglycemia in their clinical practice. Data were analyzed based on geographic location of the diabetologists and language spoken by their patients (Hindi vs. Gujarati). RESULTS Gujarati-speaking patients tended to report to their doctors, a greater inability to work under pressure and a higher frequency of intense hunger during hypoglycemia. They were less likely to report specific adrenergic (inward trembling), neuroglycopenic (feeling down over nothing), and nocturnal (crumpled bedsheets upon waking up) symptoms. CONCLUSION Significant cross-cultural differences related to the symptomatology of hypoglycemia are noted. Indian diabetologists should be aware of the varying presentation of hypoglycemia based on language and ethnic background.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and B.R.I.D.E, Karnal, Haryana, India
| | | | - Ambrish Mithal
- Department of Endocrinology, Medanta Hospital, Gurgaon, India
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Morrison LA, Brown DE, Sievert LL, Reza A, Rahberg N, Mills P, Goodloe A. Voices from the Hilo Women's Health Study: talking story about menopause. Health Care Women Int 2013; 35:529-48. [PMID: 24134306 DOI: 10.1080/07399332.2013.829067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Our purpose in conducting this qualitative study was to examine how a multiethnic sample of women living in Hilo, Hawai'i, describe menopause. Interviews were conducted with 185 pre-, peri-, and post-menopausal women aged 45 to 55. We found that pre-menopausal women felt anxious compared with peri- and post-menopausal women's more affirmative attitudes of increasing confidence and freedom in this new cycle of life. A dominant theme was the construction of a post-menstrual identity. Peri-and post-menopausal women's attitudes were not biomedically oriented. Local culture and the island lifestyle may provide a positive atmosphere for women going through menopause.
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Affiliation(s)
- Lynn A Morrison
- a Department of Anthropology , University of Hawai'i at Hilo , Hilo , Hawai'i , USA
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Bhutani J, Kalra S, Bhutani S, Kalra B. Hypoglycemia perception: Cross-cultural differences in Punjabi and Hindi speaking postmenopausal women. Indian J Endocrinol Metab 2013; 17:S286-S288. [PMID: 24251188 PMCID: PMC3830334 DOI: 10.4103/2230-8210.119613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The cross cultural differences in perception of menopausal symptoms are well known and these differences in perception of hypoglycemic symptoms in Russian-speaking and Caucasian postmenopausal women have been reported. AIMS AND OBJECTIVES This study assessed cross - linguistic and cross - cultural differences in symptomatology of self reported hypoglycemia, between Punjabi and Hindi speaking diabetic post menopausal women. MATERIAL AND METHODS Thirty Punjabi speaking and 20 Hindi speaking diabetic postmenopausal women aged over 50 years, were recruited for this study. Each subject was asked, what happens to you when you have low sugar? in the language of her choice, and spontaneous answers were recorded verbatim. STATISTICAL ANALYSIS The data so obtained was analyzed by paper and pen method to obtain an understanding of the frequency of self reporting of various symptoms and then analyzed using Statistical Package for Social Science ver.19.0. RESULTS Symptoms of hollowness, cold sweats and headache correlated significantly (P < 0.0001, P = 0.0001 and P = 0.03 respectively). One difference was noted in women from rural vs. urban background: Inability to concentrate was more frequent in urban women (4/23) vs rural women (0/27) (P < 0.0001). DISCUSSION To our knowledge, this is the first exploratory work highlighting the differences in self reported hypoglycemia symptomatology, based on linguistic background. In India and other countries with multi ethnic, multi linguistic societies, linguistic competence in hypoglycemia history taking is important. LIMITATIONS Incidence of hypoglycemia in the subjects enrolled was not assessed. Many of the subjects in the Punjabi speaking cohort were bilingual. Some symptoms of hypoglycemia may have been missed or over-reported by participants. CONCLUSION Diabetes care professionals should be aware that persons with diabetes from varying linguistic backgrounds may report symptoms of hypoglycemia differently.
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Affiliation(s)
- Jaikrit Bhutani
- Post Graduate Institute of Medical Sciences Rohtak, Karnal, Haryana, India
| | - Sanjay Kalra
- Department of Endocrinology, BRIDE, Karnal, Haryana, India
| | - Sukriti Bhutani
- Maharaja Agarsen Institute of Medical Research and Education, Agroha, Hissar, Haryana, India
| | - Bharti Kalra
- Department of Obstetrics and Gynaecology, BRIDE, Karnal, Haryana, India
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Sievert LL. Subjective and objective measures of hot flashes. Am J Hum Biol 2013; 25:573-80. [DOI: 10.1002/ajhb.22415] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 04/30/2013] [Accepted: 05/07/2013] [Indexed: 12/11/2022] Open
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Ferrand F, Hajri S, Benzineb S, Draoui DM, Hassoun D, Delanoë D, Zins M, Ringa V. Comparative study of the quality of life associated with menopause in Tunisia and France. Menopause 2013; 20:609-22. [DOI: 10.1097/gme.0b013e318278b0ce] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ziv-Gal A, Flaws JA. Factors that may influence the experience of hot flushes by healthy middle-aged women. J Womens Health (Larchmt) 2013; 19:1905-14. [PMID: 20831431 DOI: 10.1089/jwh.2009.1852] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Interest in menopausal symptoms in general and hot flushes (HFs) in particular has grown in recent years. This is mostly due to increased awareness and the vast impact these symptoms have on women's lives. Despite the high prevalence of women who experience HFs, a definitive etiology for HFs is yet to be found. Our objective was to review the current literature dealing with associated factors for experiencing HFs and to provide a synthesized overview on this common and often debilitating condition. METHODS We systematically searched the English-language literature in the PubMed database using relevant key words and included only those articles that contained information on associated factors for HFs in generally healthy midlife women. RESULTS Both conflicting scientific results between studies documenting factors that influence HFs and the lack of validated measuring tools make it difficult to truly pinpoint associated factors for HFs. Nonetheless, we identified the following clusters of associated factors: the menopausal stages, sex steroid hormones, other endocrine agents, genetic polymorphisms, race/ethnicity, body mass index (BMI) and obesity, mood disorders, smoking, soy isoflavones and phytoestrogens, alcohol consumption, and physical activity. CONCLUSIONS No single associated factor was consistently identified as having a major role in experiencing HFs. More resources should be directed to develop a unified study system along with multivariable analyses to get a better understanding of this condition, which often imposes a tremendous social and personal toll on the women who experience it.
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Affiliation(s)
- Ayelet Ziv-Gal
- Department of Veterinary Biosciences, University of Illinois, Urbana, Illinois 61802, USA
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Lorizio W, Wu AHB, Beattie MS, Rugo H, Tchu S, Kerlikowske K, Ziv E. Clinical and biomarker predictors of side effects from tamoxifen. Breast Cancer Res Treat 2012; 132:1107-18. [PMID: 22207277 PMCID: PMC3335925 DOI: 10.1007/s10549-011-1893-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 11/19/2011] [Indexed: 12/28/2022]
Abstract
Tamoxifen decreases breast cancer recurrence, mortality, and breast cancer risk in high-risk women. Despite these proven benefits, tamoxifen use is often limited due to side effects. We identified predictors of tamoxifen-induced side effects based on clinical variables and serum tamoxifen metabolite biomarkers in a cross-sectional study of patients taking tamoxifen. We enrolled 241 women and collected data on demographics, tamoxifen use and side effects, as well as potential clinical and serum predictors. We used logistic regression models and adjusted for age, body mass index, ethnicity, education, prior post-menopausal hormone therapy (HT), tamoxifen duration, and endoxifen levels to identify factors associated with side effects. Common tamoxifen attributed side effects were hot flashes (64%), vaginal dryness (35%), sleep problems (36%), weight gain (6%), and depression, irritability or mood swings (6%). In multi-variate models, tamoxifen duration, age, prior post-menopausal HT, and endoxifen levels all predicted side effects. Women who had been on tamoxifen for >12 months were less likely to report side effects (OR 0.15, 95% CI 0.04-0.58) or severe side effects (OR 0.05, 95% CI 0.005-0.58) compared to women on tamoxifen for <12 months. Compared to women younger than 50, women who were age 60-70 and older than 70 were less likely to report side effects (OR 0.22, 95% CI 0.03-1.35; OR 0.13, 95% CI 0.01-0.99; respectively). Women who previously took post-menopausal HT were more likely to report severe side effects. Women with higher endoxifen levels were more likely to report side effects (OR 1.67, 95% CI 1.01-2.77 per standard deviation increase in endoxifen). Clinicians should consider closely monitoring adherence in women taking tamoxifen, especially in younger women, and women who previously took HT. The association between endoxifen levels and side effects is consistent with the data that suggest that endoxifen is the most highly active metabolite of tamoxifen.
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Affiliation(s)
- Wendy Lorizio
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
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van Dooren M, de Vries JJGGJ, Janssen JH. Emotional sweating across the body: comparing 16 different skin conductance measurement locations. Physiol Behav 2012; 106:298-304. [PMID: 22330325 DOI: 10.1016/j.physbeh.2012.01.020] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 01/19/2012] [Accepted: 01/30/2012] [Indexed: 11/30/2022]
Abstract
Skin conductance (SC) is one of the most commonly used measures in psychophysiological studies involving emotional arousal and is traditionally measured at the fingers or the palms (i.e., the palmar locations) of the hand. Palmar skin conductance recording positions are, however, not always preferred for ambulatory recordings in real-life situations. This study quantifies the responsiveness and similarity with the finger of 16 different recording positions of skin conductance while watching emotional film fragments. Findings indicated foot, fingers and shoulders being most responsive, whereas arm, back, armpit, and thighbone were least responsive. The measurements at the foot were most similar with those of the finger. In contrast, arm, back, and armpit traces differed most from the finger trace. Taken together, foot and shoulders are the best alternatives to the finger for ambulatory measurement of skin conductance to reflect emotional arousal. These findings can help new applications using skin conductance, like automated emotion measurements, to come to fruition.
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Affiliation(s)
- Marieke van Dooren
- Philips Research Europe, High Tech Campus 34, 5656 AE Eindhoven, The Netherlands.
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Castelo-Branco C. The effect of soy isoflavone on bone mineral density. Climacteric 2011; 15:95-6. [PMID: 22201242 DOI: 10.3109/13697137.2012.640818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Concordance between self-reported and sternal skin conductance measures of hot flushes in symptomatic perimenopausal and postmenopausal women: a systematic review. Menopause 2011; 18:709-22. [PMID: 21326119 DOI: 10.1097/gme.0b013e318204a1fb] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Sternal skin conductance is considered the gold standard in hot flush and night sweat measurement, but results sometimes differ from women's own self-reports. To date, there has been no systematic review of concordance between sternal skin conductance and self-report measures. An exploratory meta-analysis was conducted to quantify concordance between these measures and to explore the reasons for discordance between them. METHODS A search of Medline, EMBASE, Web of Science, and PsychInfo from inception to December 2009 was conducted. Studies that measured self-reported hot flushes and/or night sweats and sternal skin conductance concurrently in symptomatic perimenopausal and postmenopausal women were retained for data extraction. Studies were included if data on concordance between the two measures were available. RESULTS Concordance rates overall were 29%, but variability between studies was too broad to identify a single typical concordance rate. However, concordance rates for ambulatory monitoring were more homogeneous and also had a 29% concordance rate. Nonambulatory studies tended to result in more concordant hot flushes (54%) than ambulatory studies did, and night sweats tended to be under-reported more often than over-reported (46% and 22%, respectively). CONCLUSIONS Concordance rates were typically lower than early reports of sternal skin conductance measures but were highly variable between studies. Possible measurement error and study conditions might partly explain the discordance and variation in study findings, but further exploration of the effects of symptom perception is warranted. Use of both measures concurrently is likely to achieve more reliable and valid measurement of hot flushes and night sweats than either measure alone.
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Methods used in cross-cultural comparisons of vasomotor symptoms and their determinants. Maturitas 2011; 70:110-9. [DOI: 10.1016/j.maturitas.2011.07.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 07/13/2011] [Accepted: 07/14/2011] [Indexed: 11/23/2022]
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Methods used in cross-cultural comparisons of somatic symptoms and their determinants. Maturitas 2011; 70:127-34. [DOI: 10.1016/j.maturitas.2011.07.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 07/15/2011] [Accepted: 07/16/2011] [Indexed: 11/24/2022]
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Melby MK, Sievert LL, Anderson D, Obermeyer CM. Overview of methods used in cross-cultural comparisons of menopausal symptoms and their determinants: Guidelines for Strengthening the Reporting of Menopause and Aging (STROMA) studies. Maturitas 2011; 70:99-109. [DOI: 10.1016/j.maturitas.2011.07.011] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 07/13/2011] [Accepted: 07/14/2011] [Indexed: 11/27/2022]
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A comparative study of menopausal hot flashes and their psychosocial correlates in Taiwan and the United States. Maturitas 2010; 67:171-7. [DOI: 10.1016/j.maturitas.2010.06.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 06/11/2010] [Accepted: 06/11/2010] [Indexed: 11/21/2022]
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Kronenberg F. Menopausal hot flashes: a review of physiology and biosociocultural perspective on methods of assessment. J Nutr 2010; 140:1380S-5S. [PMID: 20505017 DOI: 10.3945/jn.109.120840] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Hot flashes continue to be a troublesome problem for menopausal women the world over. After >50 y of research, we still do not understand the etiology and mechanism of hot flashes, nor do we know how estrogen, the major pharmaceutical treatment, works to reduce hot flashes. We are gaining insight into sociocultural complexities that may affect how and whether women report hot flashes. And we are becoming more sophisticated in our research tools (be it questionnaires, physiological monitors, or brain imaging techniques). New aspects of hot flash research, including neuroimaging and the study of genetic polymorphisms, when combined with increasingly nuanced ways of asking questions of culturally distinct populations, provide challenges but rich complexity from which a better understanding will emerge.
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Affiliation(s)
- Fredi Kronenberg
- Clayman Institute for Gender Research, Stanford University, Stanford, CA 94305, USA.
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Morrison LA, Sievert LL, Brown DE, Rahberg N, Reza A. Relationships between menstrual and menopausal attitudes and associated demographic and health characteristics: the Hilo Women's Health Study. Women Health 2010; 50:397-413. [PMID: 20853216 PMCID: PMC2947147 DOI: 10.1080/03630242.2010.507721] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The objective of this study was to examine the relation of menstrual attitudes to menopausal attitudes and the demographic and health characteristics associated with each. This cross-sectional study consisted of a randomly selected sample of 1,824 respondents aged 16 to 100 years in multi-ethnic Hilo, Hawai'i. Women completed questionnaires for demographic and health information, such as age, ethnicity, education, residency in Hawai'i, menopausal status, exercise, and attitudes toward menstruation and menopause. Women more often chose positive terms, such as "natural," to describe menstruation (60.8%) and menopause (59.4%). In bivariate analyses, post-menopausal women were significantly more likely to have positive menstrual and menopausal attitudes than pre-menopausal women. Factor analyses were used to cluster attitudes followed by linear regression to identify demographic characteristics associated with factor scores. Asian-American ethnicity, higher education, reporting more exercise, and growing up outside of Hawai'i were associated with positive menstrual attitudes. Higher education, older age, post-menopausal status, growing up outside of Hawai'i and having hot flashes were associated with positive menopausal attitudes. Bivariate correlation analyses suggested significant associations between factor scores for menstrual and menopausal attitudes. Both negative and positive menstrual attitudes were positively correlated with the anticipation of menopause, although negative attitudes toward menstruation were negatively correlated with menopause as a positive, natural life event. Demographic variables, specifically education and where one grows up, influenced women's attitudes toward menstruation and menopause and should be considered for inclusion in subsequent multi-ethnic studies. Further research is also warranted in assessing the relationship between menstrual and menopausal attitudes.
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Affiliation(s)
- Lynn A. Morrison
- Department of Anthropology University of Hawai`i at Hilo 200 W. Kawili St. Hilo, HI 96720 Tel: 808-974-7697
| | - Lynnette L. Sievert
- Department of Anthropology Machmer Hall University of Massachussetts- Amherst Amherst, MA 01003
| | - Daniel E. Brown
- Department of Anthropology University of Hawai`i at Hilo 200 W. Kawili St. Hilo, HI 96720
| | - Nichole Rahberg
- Department of Anthropology University of Hawai`i at Hilo 200 W. Kawili St. Hilo, HI 96720
| | - Angela Reza
- Department of Anthropology Machmer Hall University of Massachussetts- Amherst Amherst, MA 01003
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Sievert LL, Reza A, Mills P, Morrison L, Rahberg N, Goodloe A, Sutherland M, Brown DE. Diurnal rhythm and concordance between objective and subjective hot flashes: the Hilo Women's Health Study. Menopause 2010; 17:471-9. [PMID: 20220538 PMCID: PMC2866775 DOI: 10.1097/gme.0b013e3181cbb3c6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aims of this study were to test for a diurnal pattern in hot flashes in a multiethnic population living in a hot, humid environment and to examine the rates of concordance between objective and subjective measures of hot flashes using ambulatory and laboratory measures. METHODS Study participants aged 45 to 55 years were recruited from the general population of Hilo, HI. Women wore a Biolog hot flash monitor (UFI, Morro Bay, CA), kept a diary for 24 hours, and also participated in 3-hour laboratory measures (n = 199). Diurnal patterns were assessed using polynomial regression. For each woman, objectively recorded hot flashes that matched subjective experience were treated as true-positive readings. Subjective hot flashes were considered the standard for computing false-positive and false-negative readings. True-positive, false-positive, and false-negative readings were compared across ethnic groups by chi analyses. RESULTS Frequencies of sternal, nuchal, and subjective hot flashes peaked at 1500 +/- 1 hours with no difference by ethnicity. Laboratory results supported the pattern seen in ambulatory monitoring. Sternal and nuchal monitoring showed the same frequency of true-positive measures, but nonsternal electrodes picked up more false-positive readings. Laboratory monitoring showed very low frequencies of false negatives. There were no ethnic differences in the frequency of true-positive or false-positive measures. Women of European descent were more likely to report hot flashes that were not objectively demonstrated (false-negative measures). CONCLUSIONS The diurnal pattern and peak in hot flash occurrence in the hot humid environment of Hilo were similar to results from more temperate environments. Lack of variation in sternal versus nonsternal measures and in true-positive measures across ethnicities suggests no appreciable effect of population variation in sweating patterns.
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Affiliation(s)
- Lynnette L Sievert
- Department of Anthropology, University of Massachusetts Amherst, Amherst, MA 01003-9278, USA.
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Ayranci U, Orsal O, Orsal O, Arslan G, Emeksiz DF. Menopause status and attitudes in a Turkish midlife female population: an epidemiological study. BMC WOMENS HEALTH 2010; 10:1. [PMID: 20064263 PMCID: PMC2822813 DOI: 10.1186/1472-6874-10-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2009] [Accepted: 01/11/2010] [Indexed: 11/10/2022]
Abstract
Background It is a well accepted status that socio-cultural characteristics may affect the onset of menopause and its characteristics. The aims of this study were to describe the prevalence rates of menopausal symptoms and these symptoms related factors, and to assess the women's attitudes towards some climacteric issues. Methods This survey was conducted between Jan., 1st 2008 and March, 31st 2008 to research the menopause status of the female population in a city of western Turkey. The study group consisted of 1551 women selected with a multistage area sampling method: a random sample of individuals aged 40-65 years. The questionnaire included questions pertaining to women's sociodemographic characteristics, women's menopausal status, some statements about the climacteric, use of hormones at menopause or before menopause, and some climacteric myths. The data was analyzed by Chi-square (x2) analysis and percent (%) ratios with a significant value of P < 0.05. Results The mean age of the women was 49.1 years. Over 90% of the women were of the negative opinion that the climacteric is "the end of youth", "the end of fecundity", and "the end of unclean days". Most women said that cessation of menstrual periods was the most positive thing because they do not have to wait for monthly bleedings, use sanitary equipment, or take birth control methods. There were significant connections between age groups and nearly all the items, with the exception of the items "the end of life" and "the end of fecundity". Among the women, hot flushes were the most common complaint occurring in 96.5% of women: being severe in 32.9%, moderate in 43.1% and mild in 20.4%. This was followed by low backache or muscle pain 95.0% (25.9% severe, 46.0% moderate and mild 23.1%), headache 91.7% (21.9% severe, 34.9% moderate and 34.9% mild) and feeling tired 91.0% (15.3% severe, 38.6% moderate and 37.1% mild). Conclusions Most of the women in this study had mixed ideas of opinions concerning the climacteric, and the majority was also suffering from climacteric complaints. This data could assist healthcare providers in the provision of culturally competent health care to midlife Turkish women.
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Affiliation(s)
- Unal Ayranci
- Kurtulus Aile Sagligi Merkezi, Vatan Cd, 12/A Eskişehir, Turkey.
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