Complications of menopause and the risks and benefits of estrogen replacement therapy

The Effect of Jazar Supplement on Quality of Life and Sexual Function in Postmenopausal Women: A Double-Blind, Randomized, Placebo-Controlled Trial

Background

Menopause is one of the most critical stages of a woman's life and is accompanied by symptoms including hot flashes, night sweats, mood swings, sexual dysfunction, mucus atrophy, and vaginal dryness. Women tend to use complementary and alternative medicine such as herbs rather than hormone replacement therapy to alleviate these symptoms. The purpose of this study is to examine the effects of Jazar supplement (herbal supplement comprising Vitex, fennel, and carrot seeds) on sexual function, quality of life, and vaginal atrophy in postmenopausal women.

Methods

This study was a randomized clinical trial conducted on ninety postmenopausal women. Participants were randomized to intervention/control groups using block randomization. The intervention group received four Jazar capsules (500 mg each) daily, while the control group received a placebo for eight weeks. Data were gathered using a socio-demographic questionnaire, the Female Sexual Function Index (FSFI), and the Menopause-Specific Quality of Life (MENQOL) before the intervention and at weeks 4, 8, and 10. Vaginal pH and vaginal maturation index (VMI) were measured before and at the end of the study.

Results

Eighty-four women completed the trial, and six women withdrew. There were no remarkable differences between the two groups in terms of quality of life, sexual function, VMI, and vaginal pH at baseline. At the end of the study, participants in the intervention group had a significantly lower score in terms of quality of life (P < 0.001) and vaginal pH (P=0.001), and a higher FSFI (P < 0.001) and VMI (P=0.030) score compared to the control group.

Conclusion

Based on the findings of the present study on menopausal women, the Jazar supplement significantly improved quality of life and sexual function and prevented or delayed vaginal atrophy.

Early Menopause in Type 2 Diabetes - A Study from a South Indian Tertiary Care Centre

INTRODUCTION

Menopause marks the end of ovarian function and it is called 'early' or 'premature' if it occurs before 45 years. Very little is known about the menopause transition in Diabetic women. Metabolic disorders like diabetes will accelerate the reproductive ageing and determine premature ovarian failure by various mechanisms. Early menopause along with diabetes has a synergistic effect over the incidence of cardiovascular diseases and other illnesses. There is no data regarding menopausal age in Indian population. Hence, present study was aimed at understanding the age of menopause in diabetic Indian women.

MATERIALS AND METHODS

This study was carried out at a tertiary care, teaching hospital in Southern India. Post-menopausal women who attended the Department of Medicine during August 2013 to August 2014, were included in the study. Six hundred patients were recruited by a systematic random sampling, 300 diabetic and 300 non-diabetic after obtaining their consents. They were all non-smokers, took mixed diet and other somatometric variables were similar in both the groups.

RESULTS

Average age of menopause among diabetic women was 44.65 years which is much earlier than the menopause in non-diabetic women (48.2 years). Out of the 600 women, 212 women had an early menopause (<45 yrs.). Among them, 54 were non-diabetic and 158 were diabetic. Present study also revealed a higher BMI among the diabetics than the non-diabetic women. This may be due to the changes in body composition and increase in abdominal fat after menopause. This change is more in diabetics due to the disturbances in insulin sensitivity and glucose metabolism.

CONCLUSION

The present study confirms that Type 2 Diabetes increases the risk of early menopause. The study reinforces the importance of early diagnosis and treatment of diabetes for a long term well being of a woman.

Postmenopausal bleeding: a practical approach

PURPOSE

To provide nurse practitioners (NPs) with a practical approach for the management of postmenopausal bleeding in office settings.

DATA SOURCES

Selected scientific literature and the author's own experience.

CONCLUSIONS

Postmenopausal bleeding should be considered cancer until proven otherwise, despite the fact that abnormal pathology is found in only 15% of endometrial biopsies.

IMPLICATIONS FOR PRACTICE

Post menopausal bleeding can be safely evaluated and managed by NPs using aspiration endometrial biopsies and/or transvaginal ultrasound. Hospitalization for dilation and curettage under anaesthesia can often be avoided.