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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present study had two objectives: (1) to register the prevalence of a number of climacteric complaints in a Danish general population cohort and (2) retrospectively to test the validity of an association between climacteric complaints, menopausal development, occurrence of life events and social background. A postal questionnaire sent to the 51-year-old female population living in four Copenhagen suburbs, (N = 597, response rate = 88%) included information on menstrual pattern and change, hormonal treatment, socioeconomic data and a 4-year retrospective annual registration of prevalence of a number of climacteric complaints and life events. Logistic regression analyses performed on a restricted sample (women who experienced a natural menopausal development) revealed prevalence of hot flushes, moodiness and fatigue to be significantly associated with transitions in menopausal status. Fatigue, moodiness and depression were strongly associated with socio-economic variables. Life events were only occasionally associated with prevalence of the studied complaints.
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PMID:Climacteric complaints and their relation to menopausal development--a retrospective analysis. 813 90

Three sequential oestradiol valerate (E2V) and cyproterone acetate (CPA) combinations based on 11 days of oestrogen and 10 days of oestrogen-progestogen administration were investigated during hormone replacement therapy in two prospective, double-blind randomized trials. Treatment A comprised 2 mg E2V and 1 mg CPA, treatment B, 1 mg and 0.5 mg and treatment C, 2 mg and 2 mg, respectively. During treatment A hot flushes (P < 0.0001), night sweating (P < 0.0001), depression (P = 0.0001), dizziness (P = 0.0001) and insomnia (P = 0.003) decreased significantly. The only side effect was breast tenderness, which was experienced by 18% of the women. Weight and blood pressure, thyroid, adrenal, liver and kidney functions, parathyroid hormone and vitamin D, platelets and blood cell counts did not change during the 12 months of therapy. In the women who received treatment A the menstrual flow became less abundant during the early months of treatment (P < 0.0001), the menses being scanty in around 30% of the women, while some 10% had amenorrhoea. Spotting occurred in 10-20% of the subjects. Endometrial biopsies were atrophic in 10% of the women, whereas a normal secretory phase was observed in 45% and irregular secretion in 45%. After careful analysis using visual analog scales, these findings were interpreted as indicating a high-normal progestational effect. In comparison with the pattern observed in normal menstrual cycles the women who received treatment A had a more heterogenic glandular epithelium, with more papillae, larger stromal cells, a more pronounced decidual reaction and more fibrinoid material. No cases of hyperplasia were seen. Treatment B was less effective than treatment A in relieving climacteric complaints. Irregular bleeding was troublesome in over 20% of cases and amenorrhoea occurred in 50%. Endometrial biopsies were atrophic in 57% of the women. The effectiveness of treatment C in alleviating flushes, sweating, dizziness and depression was the same as that of treatment A. The decrease in menstrual flow during the early months and the incidence of amenorrhoea (approx. 10%) and atrophic endometria (approx. 10%) were comparable. Detailed analysis revealed that C had an even stronger progestational effect than A. It was concluded that A was the treatment of choice in comparison with B and C. It proved highly effective in treating climacteric complaints, had no side effects apart from breast tenderness, provided good cycle control and induced a physiological secretory transformation of the endometrium.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Endometrial effects during hormone replacement therapy with a sequential oestradiol valerate/cyproterone acetate preparation. 838 51

This study examines the symptoms after a natural menopause recalled by women aged 50-89 years. We determined the frequency and clustering of symptoms, the effect of age on symptoms, and the relation of symptoms to the use of estrogen therapy in a cross-sectional, community-based study of 589 Caucasian, middle- to upper-middle-class women from Rancho Bernardo, California. At the time of menopause, 55% of the women reported that they felt life was getting better and 57% were more cheerful. The most frequently recalled symptoms were hot flushes (74%), propensity to weight gain (45%), night sweats (35%), tiredness (32%), and insomnia (28%). Irritability was reported by one-fourth, depression by one-fifth. Nearly 11% reported anxiety about looking older. The recalled prevalence of hot flushes, irritability, weepiness and tiredness did not vary by current age, but younger women were significantly more likely than older women to have experienced night sweats, visible flushes, depression, anxiety about looking older and insomnia. Principal components factor analysis yielded four main independent factors: psychological symptoms (21% of the variance), vasomotor symptoms (14%), positive feelings (11%), and negative self-image (8%). The four symptom groupings suggest different causal mechanisms. Forty-two percent reported past, and 27% reported current use of estrogen therapy. Both past and current hormone users were significantly more likely to report menopause symptoms than non-users. Estrogen use was not associated with positive feelings or self-image at the time of menopause. Although three-quarters experienced symptoms, the majority of women reported positive feelings about menopause.
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PMID:A community-based study of menopause symptoms and estrogen replacement in older women. 853 87

In the menopause transition, ovarian steroid production is gradually inhibited and around 35% of women will seek medical help for postmenopausal symptoms. The hot flush is a characteristic manifestation occurring in about 70% of women; it is associated with oestrogen withdrawal and disappears with oestrogen-based hormone replacement therapy. The exact mechanism behind it is still unclear but is probably related to heat loss mechanisms. The flush often occurs in parallel to changes in skin temperature, blood flow, pulse rate and pulses of luteinizing hormone (LH). These are probably secondary to a disturbance in the thermoregulatory centre of the CNS, which is anatomically close to neurons containing gonadotropin-releasing hormone. Depression is no more frequent in the menopausal transition than at other times in life. After surgical menopause, however, oestrogen improves low mood over placebo. In women with premenstrual syndrome, an increased feeling of well-being is associated with the pre-ovulatory oestrogen peak. Progestogens are associated with negative mood changes during the menstrual cycle, oral contraception and postmenopausal replacement therapy. Certain progesterone metabolites are anaesthetic and have anti-epileptic and anxiolytic properties, effects which are mediated via the type A gamma-aminobutyric acid (GABAA) receptor. Oestrogen is associated with increased sensory perception, locomotory activity, limb coordination and balance: this may help explain the increased frequency of bone fractures in the early postmenopausal period. Oestrogen improves memory and performance in patients with mild Alzheimer's dementia and increases epileptic activity in patients with partial epilepsy. These effects can be related to amplifying effects of oestrogen on excitatory amino acids in the CNS.
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PMID:Symptoms related to the menopause and sex steroid treatments. 858 96

Many researchers have noted a direct correlation between sexual difficulties and E2 level, when E2 < 50 pg/ml. But sexual behavior also interferes with sexuality. In Bachmann and coll. study, sexually active women ranging from 60 to 70, without HRT had higher mean levels of E2 and T than sexually inactive women. Of course the numerous complaints of that period (hot flushes, asthenia, tachycardia...) are creating physical and psychological conditions rather damaging for sexuality. They may also induce a state of true suffering with a loss of self esteem resulting in a more introverted way of life. In other cases, it is the psychological context in it self (depression, anxiety, relational difficulty with the partner or even male sexual problems) which is interfering. An actual amelioration of sexual life can be obtained with HRT plus or a minima percutaneous androgenotherapy in some cases. The treatment is indeed an asset for the therapeutic support, even from the psychotherapeutic point of view.
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PMID:[Menopause and sexuality]. 893 58

The specific aim of this study was to investigate the efficacy of elicitation of the relaxation response for the treatment of menopausal hot flashes and concurrent psychological symptoms. The volunteer sample consisted of 33 women, between the ages of 44 and 66 years, who were in general good health, with a minimum of 6 months without a menstrual period, experiencing at least five hot flashes per 24-h, and not using hormone replacement therapy. The setting was an outpatient clinic in a tertiary care teaching hospital. The interventions used were relaxation response training and an attention-control group and a daily symptom diary measuring both the frequency and intensity of hot flashes, the Spielberger State-Trait Anxiety Inventory (STAI), and the Profile of Mood Scale (POMS) were the measures used. This was a randomized, controlled, prospective study. Subjects were randomly assigned to one of three groups (relaxation response, reading, or control) for the 10-week study. The first 3 weeks of baseline measurement of frequency and intensity of hot flash symptoms, and the preintervention psychological scores were compared with the final 3 weeks measurement of frequency and intensity and the postintervention psychological scores for symptomatic improvement. The relaxation response group demonstrated significant reductions in hot flash intensity (p < 0.05), tension-anxiety (p < 0.05) and depression (p < 0.05). The reading group demonstrated significant reductions in trait-anxiety (p < 0.05) and confusion-bewilderment (p < 0.05). There were no significant changes for the control group. Daily elicitation of the relaxation response leads to significant reductions in hot flash intensity and the concurrent psychological symptoms of tension-anxiety and depression.
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PMID:The effects of relaxation response training on menopausal symptoms. 899 86

This study was a cross-sectional survey of mid-aged Thai women with the following aims: to describe their experience of symptoms and attitudes to menopause and to examine the relationships between symptoms, attitudes to menopause, sociodemographic variables and menopausal status. The sample was 268 women aged between 40 and 59 y who had accompanied patients to the outpatients department of the Royal Irrigation Hospital. Mean age at menopause was 50.13 (SD 4.67) y. Fifty-one percent were premenopausal. 9% perimenopausal and 40% postmenopausal. The symptoms which showed strongest associations (P < 0.001) with menopausal status were: joint aches/pain, hot flushes, depression and insomnia. Women most likely to experience symptoms were: older than 50 years of age, had more children, peri- or post-menopausal, of little education, housewives or landowners and reported their health was not so good and required treatment.
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PMID:Menopausal experiences of Thai women. Part 1: Symptoms and their correlates. 903 40

Since 1952 the Kupperman index has served as an indicator for climacteric symptoms. This index, original at that time, has been widely criticized in recent years. After worldwide criticism it was finally reduced to two true symptoms, namely hot flushes and genital atrophy. The so-called psychosomatic symptoms which are essential for the quality of life, insomnia, nervousness and depression, were largely disregarded. In 1994, an expert group of German, Austrian and Swiss members published a new score (Menopause Rating Scale [MRS]) selectively adopting most of the symptoms of the Kupperman index and adding the missing symptoms such as alteration of libido, urological complaints and vaginal dryness. In contrast to the Kupperman index, the Menopause Rating Scale (MRS) presented here registers every single symptom individually in a numerical and graphic way without any multiplication factor. Thus, an individual profile of each patient can be established. This new score may be completed by the physician or by the patient. An improvement in therapy can be rapidly recognized by means of the score as well as by the graphic presentation.
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PMID:[A new rating scale for the climacteric syndrome (Menopause Rating Scale (MRS)]. 906 55

Postmenopausal estrogen deprivation is a major cause for vasomotor and psychic complaints and for urogenital dysfunction, it is also a risk factor for osteoporosis, hip fracture, cardiovascular disease and possibly dementia. Hormone replacement therapy is highly effective in improving hot flushes, insomnia, depression and genital atrophia, but it prevents bone mineral loss and coronary heart disease as well. The potential risk for thromboembolism remains small and there is no final proof for a significant increase of breast cancer. Hysterectomized women may be treated with unopposed estrogens, otherwise progestogens must be added in a cyclic or continuous manner in order to protect the endometrium. Natural estrogens are to be preferred, they may be administered orally, percutaneously or vaginally. Long acting subcutaneous implants are also gaining interest. Prolonged treatment for many years is essential in order to be preventive. Compliance by motivation and comprehensive care is therefore indispensable.
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PMID:[Hormone substitution in menopause]. 938 Oct 46

Little is known about the long-term effects of adjuvant therapy on quality of life, sexual functioning and symptoms in breast cancer survivors. Between January 1996 and June 1997, we surveyed 1098 women who had been diagnosed with early stage breast cancer between 1 and 5 years earlier. The breast cancer survivors were recruited in two large metropolitan centers in the USA. They completed a survey battery that contained standardized measures of health-related quality of life (HRQL), depression, body image, sexual functioning, and symptoms. A total of 1096 had usable responses for these analyses. In this sample, n = 356 had received tamoxifen (TAM) alone, n = 180 received chemotherapy (CHEM) alone, n = 395 received CHEM + TAM, and n = 265 received no adjuvant therapy (NO RX). There were significant differences in the mean age of each group, with the TAM group being the oldest (mean 62.6 years) and the CHEM group being the youngest (mean 46.8 years). Both age and time since diagnosis were controlled for in all statistical analyses. We found no significant differences in global quality of life among the four treatment groups. For the MOS-SF-36, there were no significant differences on the subscale scores except for the physical functioning subscale (p = 0.0002); the NO RX group had the highest functioning. There were no significant differences in depression scores among the four treatment groups. The MOS-SF-36 physical functioning composite score differed by treatment group (p = 0.012); the NO RX group had a physical functioning composite score that was at the mean for a normal healthy population of women, while those in the adjuvant treatment groups scored slightly lower. The mental health composite score was not significantly different among the four treatment groups and approximated scores from the normal population of healthy women. There were no differences in body image scores among the four treatment groups; however, sexual functioning scores did differ (p = 0.0078) with patients receiving chemotherapy (either alone or with tamoxifen) experiencing more problems. Hot flashes, night sweats, and vaginal discharge differed by treatment (p = 0.0001); all symptoms were reported more often in breast cancer survivors on tamoxifen. Vaginal dryness and pain with intercourse also differed significantly by adjuvant treatment, occurring more often in survivors treated with chemotherapy. Overall, breast cancer survivors function at a high level, similar to healthy women without cancer. However, compared to survivors with no adjuvant therapy, those who received chemotherapy have significantly more sexual problems, and those treated with tamoxifen experience more vasomotor symptoms.
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PMID:Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. 992 75


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