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Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-seven women complaining of hot flushes, sweating and other menopausal symptoms were treated with clonidine. A double-blind crossover trial with placebo controls was undertaken. The clonidine dose was 2 X 0.025 mg/24 hours-0.075 mg/24 hours, increased if necessary at intervals of two weeks. The effect of clonidine did not differ significantly from placebo effect in the treatment of the symptoms. Side effects during clonidine management were slight and no difference was seen in their incidence compared with that in the patients treated with the placebo. A definitive placebo response was perceivable in the decreasing of symptoms.
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PMID:Clonidine in the treatment of menopausal symptoms. 3 14

In a double-blind study on the value of equine ("natural") oestrogens 30 patients presenting with menopausal symptoms in a group practice were monitored for possible adverse effects on blood clotting, weight, and blood pressure. The women were randomly allocated to two groups and given either three months' hormone treatment followed by three months' placebo or vice versa. An appreciable amelioration of all symptoms on placebo made it difficult to asses the genuine value of oestrogen treatment during the period of study. Both groups made a dramatic clinical improvement during the first three months. Nevertheless, the symptoms of the 15 women who received oestrogen first returned after the cross-over to placebo without any suggestion of a placebo response. In contrast, the other group who took placebo first did not deteriorate after changing to oestrogen. The menopausal index and the karyopyknotic index were not reliable guides to the need for oestrogen treatment. Hot flushes, however, were proportionately reduced on oestrogen and they seemed to be more readily eliminated in individual cases by oestrogen. The results of blood clotting studies indicated that natural oestrogen administration raised the levels of the extrinsic clotting factors VII and X and accelerated the prothrombin time. The findings were similar to those observed after three months synthetic oestrogen administration with oral contraception. Long-term studies and epidemiological surveys of the clinical incidence of thrombotic and other sequelae are needed before large-scale oestrogen replacement treatment can be recommended.
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PMID:Effects of "natural oestrogen" replacement therapy on menopausal symptoms and blood clotting. 17 81

The majority of women experience a variety of symptoms at the time of the menopause, but these are frequently regarded as being unworthy of management by their doctors. Recent reports of a possible association between exogenous oestrogens and endometrial carcinoma have increased professional reluctance to prescribe oestrogens for menopausal symptoms. This report describes the initial 50 patients who have attended a special clinic established to manage symptomatic menopausal women; common complaints included hot flushes, lack of energy, altered temperament, dyspareunia and headache. Oestrogen therapy was effective in the alleviation of symptoms and the practical aspects of oestrogen use are discussed. It is recommended that with due recognition of its potential complications, oestrogen therapy should be made available to symptomatic menopausal women, and that it requires further study in regard to its place in the long-term prophylaxis of osteoporosis.
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PMID:Oestrogens and menopausal and postmenopausal women. 19 65

Sixty-four patients with severe menopausal symptoms completed a four month double-blind placebo trial with conjugated equine oestrogens (premarin). Using a graphic rating scale system of assessment, a statistically significant improvement with premarin was observed in 12 psychological and symptomatic scores (Table 3). From a comparison between these results and the results of the 20 patients without vasomotor symptoms it would appear that many of these symptomatic improvements result from the relief of hot flushes (i.e. a domino effect). However, the improvement in memory and reduction of anxiety in these 20 patients suggest that oestrogens have a direct tonic effect on the mental state which is independent of vasomotor symptoms. Sixty-one patients with less severe menopausal symptoms completed the second twelve month double-blind placebo trial and, as assessed by graphic rating scales, a significant improvement with premarin was observed in five psychological and symptomatic scores (Table 3). In both the twelve and four month studies the marked placebo effect of "youthful skin appearance", and on skin greasiness in the twelve month study, indicate that no reliance can be placed on patient judgement of skin texture and appearance. Despite the lessening of the domino effect there was a slight improvement with premarin over placebo in 15 of the remaining 16 symptoms and it is likely that the cumulative effect of these small improvements results in an overall enhancement of well-being. The relief of atrophic vaginitis by premarin did not result in an improvement in libido and this suggests that the ability and the desire to have sexual intercourse are not related. The strength and duration of the placebo effect were well demonstrated in the three standard psychiatric scoring systems, the Beck score (for depression), the General Health Questionnaire and the Eysenck Personality Index (formula: see text) (for neuroticism). We observed a highly significant placebo effect extending for six months in all three, the improvement with premarin over placebo being non-significant. We must conclude that these tests are not sufficiently sensitive to assess psychological or symptomatic changes in menopausal women and that these changes are best assessed by the graphic rating scales. The number of side-effects and complications was assessed in the 61 patients in the long study. A higher incidence of minor side-effects was observed during premarin therapy; this was most marked in relation to leg cramps but radio-isotope scanning revealed no evidence of leg vein thrombosis in these patients or indeed in any patient in the study. Premarin caused no elevation of systolic or diastolic blood pressure; indeed there was a progressive fall in blood pressure throughout the study with no significant difference between premarin and placebo...
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PMID:Oestrogen therapy and the menopausal syndrome. 32 5

A prospective, double-blind, randomized comparison of propranolol, 40 mg three times daily, and matching placebo showed propranolol to be no more effective than placebo in controlling hot flushes in a group of 25 perimenopausal women. Other menopausal symptoms, such as insomnia and palpitations, were equally unaffected. However, a very close correlation was found between the daily atmospheric temperature and the number of flushes occurring in the group.
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PMID:A study of the effectiveness of propranolol in menopausal hot flushes. 35 Feb 62

Eleven women with menopausal symptoms were treated with 150 micrograms Clonidine (dixarit) daily. Before and during therapy, plasma estradiol-17 beta, LH, FSH and prolactin levels were measured by specific radio-immunoassays. In addition, each patient recorded the number of hot flushes a day and symptoms were monitored by the Kupperman-index. A highly significant fall in the number of hot flushes by day and night occurred during therapy (p less than 0.001) and the Kupperman-index similarly improved. Significant pulse and blood pressure changes were not noted and plasma hormone concentrations remained unaltered. Medication was well tolerated. Clonidine therapy would appear to be the treatment of choice for menopausal symptoms if estrogens are contraindicated.
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PMID:Studies with clonidine (dixarit) in menopausal women. 51 36

The most controversial issue related to prolonged estrogen therapy is the possible relationship of this therapy to the etiology and pathogenesis of breast and uterine cancer. The imprecise nature of the relevant data does not allow full definition of the rish. To maintain proper perspective, smoking 20 cigarettes a day increases the risk of death from lung cancer 17 times; the risk from estrogens is less than that. There is no controversy over the use of estrogens for short-term relief of menopausal symptoms. The Mulley and Mitchell paper referred to was opinion based on no direct research and an inadequate knowledge of the literature. The early symptoms of estrogen dificiency, hot flushes and atrophic vaginitis, respond to short-term estrogen therapy, which in addition, provides a "mental tonic" effect. It is not justifiable to withhold such therapy from the normal informed patient requesting it, provided no contraindications exist. The patient should be reevaluated at frequent intervals, and the proper selection of drug, dosage, and therepeutic regimen administered. This can be accomplished, including research, through a menopause clinic.
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PMID:Oestrogen therapy and endometrial cancer. 89 Apr 29

In a review of mental health aspects of menopause, emphasis is laid on the psychiatric morbidity that precedes any somatic menopausal symptoms. Only sweating and hot flushes are directly related to the menopause. Complaints such as irritability, headaches, fatigue, depression, and ''mental imbalance'' increase prior to the menopause and decrease after it. Various situational factors have been considered as possible precipitants of emotional disturbances: a child marrying, or having 3 or more children. However, studies indicate that women in the year of the menopause were less likely to develop an episode of mental illness requiring admission to a hospital than at other times. Estrogens do improve symptoms of flushes, dryness and sweats. Changes in emotional imbalance are less clear. Women who come for treatment of menopausal symptoms may frequently be suffering from depression which makes toleration of these symptoms more difficult.
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PMID:Mental health aspects. 95 92

Micronized 17beta-estradiol (E2) was used as oral replacement therapy in 369 patients with estrogen deficiency and related menopausal symptoms. Over 95 percent of 319 patients evaluable for efficacy gained satisfactory relief of their symptoms from cyclic (on 21 days/off 7 days) E2 therapy. Approximately 77 percent required no adjustment of their initial daily dose, viz, 1 mg (5 or less hot flushes per day) or 2 mg (6 or more flushes daily). In addition, 80 percent (58/72) of the patents who did not obtain adequate control from their starting dose were successfully titrated, either upward to a maximum of 4 mg/day or downward for maintenance. Overall, a higher percentage of patients were treated successfully with 2 mg daily (209/319; 66 percent) than with 1 mg/day (22 percent). About 8 percent of the patients required 3 or 4 mg daily, while 4 percent failed to derive adequate benefit from micronized E2. Oral E2 therapy was well tolerated; hence, the attrition rate due to side effects or lack of control was only 6 percent (22/369). Moreover, all laboratory fingings were within normal limits, even in patients treated with E2 for over 12 months. Coincidental endometrial changes were found in 9 patients, all of whom had received long-term (9 months-3 years) estrogen therapy prior to entering this study. Thus, the stste of the endometrium should be determined before any estrogens are given for the monopause. It is concluded that micronized E2 is highly efficacious, well accepted, and safe for oral estrogen-replacement therapy in menopausal women.
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PMID:Micronized 17 beta-estradiol for oral estrogen therapy in menopausal women. 115 35

Between February and October 1990, researchers analyzed data on 110 postmenopausal women attending the university women's clinic in Vienna, Austria to determine whether a relationship exists between fertility, body shape, and menopause. Fertility incorporated number of pregnancies and births and age at each birth and induced and spontaneous abortions. They did not find a significant correlation between fertility and age at menopause. Yet there was a slight positive correlation between age at individual pregnancies and age at menopause regardless of whether it was the 1st or last pregnancy. The more pregnancies a woman experienced the larger her body shape became (p.01-.05). Thus multiparous women had more subcutaneous fat. In fact, fat distribution increases sex hormone levels which, along with the changes in hormone levels induced by pregnancy, probably delayed menopause. In addition, fertility was also positively associated with severity of menopause symptoms (p.01-.05). These symptoms included hot flushes, weakness, breast tension, urine loss, mood changes, headache, palpitation, vaginal dryness, sleeplessness, and loss of libido. Even though higher numbers of pregnancies increase estrogen secretion during menopause, many menopausal symptoms should not be very severe in theory since the higher estrogen levels abate severity. Yet the somatic and psychological stress of large family size appears to offset any advantages of higher estrogen levels induced by subcutaneous fat. Obese women face greater psychological stress than slender women since they do not conform to the cultural definition of beauty.
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PMID:Relations between fertility, body shape and menopause in Austrian women. 142 82


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