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PubMed1982

[Serum sex steroid hormones in women with aging, and in the patients of climacteric syndrome and squamous cell carcinoma of the uterus].

The endocrinological studies were conducted in 116 normal women with aging, 16 women with climacteric syndrome and 31 patients of cervical cancer. The levels of serum estrone, estradiol and estriol had a tendency of gradual decline after the age of 40, and decreased rapidly 3 years after menopause, but still remained in a certain level thereafter throughout the senile period. The serum progesterone tended to decrease after the age of 40. While the serum testosterone showed no particular change before menopause, began to decrease after menopause. Women with climacteric syndrome were found to have a significant low serum estrogen and testosterone than in normal women, while a relative low tendency of serum progesterone in the premenopausal women of climacteric syndrome were observed. There was a relative high serum progesterone and testosterone found in adult and premenopausal patients of cervical cancer than in normal women, but showed no any difference of estrogen between them. The serum estrogen/testosterone ratio in cervical cancer group, was higher than that in the normal. Serum estrogen from the ovarian plexus was found several ten times higher than that in the iliac artery. However, progesterone and testosterone were found a slightly higher in the former.

Adult↗
PubMed1995

[Psychosocial aspects of the climacteric].

Medicine has till now payed less attention to psychosocial aspects of the menopause than to the hormonal changes of woman in this period of life. The climacteric woman is characterized in the language of the organ-medicine by faulty terms. The lack of hormones is considered to be a disease which has to be treated. The tendency to medicalize the menopause is in contradiction to the results of recent prospective studies. These studies show that pre- and postmenopausal complaints are less severe than they are often described. Psychosocial risk factors before and during the climacteric phase favour the development of psychic and psychosomatic symptoms. The climacteric period of life has to be seen as a vulnerable time of life which should be considered in the treatment of menopausal women.

Climacteric↗
PubMed1993

[The psychiatric aspect of the climacteric syndrome: its clinical picture and treatment].

A total of 130 patients with the climacteric syndrome associated with mental disorders were examined by psychiatrists. Two groups of patients were distinguished. In Group 1 specific climacteric disorders ('flushes', excessive sweating, etc.) were the major components, whereas mental disorders (asthenic, phobic, hysterical, depressive) were just concomitant. In Group 2 the climacteric syndrome resulted in development of various mental diseases, mostly neuroses, depressions of various origins, superworship ideas. Recommendations on psychotropic therapy of these disorders were developed and contraindications against the use of hormonal therapy formulated.

Adult↗
PubMed1996

[The influence of pregnancy and delivery on the climacteric symptoms].

This study was undertaken to investigate the influence of past pregnancy and delivery on the perimenopausal status in 144 women (48-52 years of age). Individual interviews to ascertain the personal profile, medical history, events at pregnancy, delivery and puerperium, and the kind and severity of climacteric symptoms were held. The subjects were divided into two groups by means of a simplified menopausal index (SMI): group A had climacteric symptoms (SMI > 50) and those in group B had mild symptoms (SMI < or = 50). The analysis of the principal components, and the correlation among the variables revealed that three factors--the impression and events at past pregnancies and deliveries, reproductive functions, and the psycho-character properties--had a significant influence on the status at the perimenopause, but the social-environmental factors appeared to have no significant influence on the severity of climacteric symptoms.

Climacteric↗
PubMed1977

[Autonomic-vascular and visceral crises in patients with climacteric spondylopathy].

The paper deals with the results of observations over 62 patients (55 females and 7 males) from the age of 42-76 with climacteric spondilopathy. The following syndromes of the nervous system lesions were revealed: neuralgic syndrome, middle and lower thoracal radiculoneuritis, the syndrome of vegetative sympatoganglionitis, myelopathy. Special attetion was given to the specificity of the nervous system lesions in patients with climacteric spondilopathy which was characterized by a tendency to vegetative-visceral crises. The author recommends a scheme of a comprehensive treatment of patients with climacteric spondilopathy with vegetative-vascular and visceral crises. This treatment includes androgen-estrogen preparations, anabolic steroids, thyrocalcitonine and symptomatic treatment.

Adult↗
PubMed1997

[Postmenopausal hormone substitution and its effects on the climacteric syndrome, body weight and blood pressure].

The effect of 0.6 mg conjugated equine estrogens in combination with sequential medrogestone (5 mg from day 11 to 21) on climacteric symptoms, blood pressure and weight were investigated in 46 postmenopausal women. The climacteric symptoms were quantified by a modified Kuppermann-Index. After a 3 months' treatment the index decreased from 20.58 to 8.47 (p < 0.001). 28 patients (65%) showed a 50% and more reduction of climacteric symptoms. 40 patients (93%) reported an improvement of their complaints. The body weight remained stable. One patient had to interrupt the treatment due to a cerebral ischemic disease (PRIND). The systolic blood pressure was decreased by 7% and the diastolic by 16% under treatment (p < 0.001). 11 patients with borderline or not treated hypertension returned to normal ranges. 3 of the 4 patients treated with antihypertensiva came off the medicines.

Blood Pressure↗
PubMed1997

Climacteric complaints of paramedical personnel.

This study was conducted from October 1995 to January 1996, to assess the prevalence of climacteric complaints of paramedical personnel in Chulalongkorn Hospital. Data collection was performed using a standardized questionnaire, comprised of population characteristics, items and severity of climacteric complaints. All the participants filled up the questionnaire by themself after receiving a clear explanation of the meaning of each symptom. Two hundred and ninety women aged 40-59 years participated in the study. Their mean age was 47.72 +/- 4.77 years. Forty six per cent of the study population were classified as premenopausal, i.e. having regular vaginal bleeding during the last 12 months, 18 per cent were perimenopausal, i.e. having irregular vaginal bleeding during the last 12 months and 35 per cent were postmenopausal, i.e. having no vaginal bleeding during the last 12 months. The mean time since menopause of the last group was 4.71 +/- 3.75 years. The results revealed that the prevalence of vasomotor symptoms, urogenital symptoms and other symptoms i.e. numbness, forgetfulness, etc, were reported at a significantly higher rate in the postmenopause than in the perimenopause and premenopause women respectively (P < 0.05). However, there was no significant difference in the prevalence of psychological symptoms among the three groups (P > 0.05). In conclusion, except for psychological symptoms, the reported prevalence of climacteric complaints in paramedical personnel was associated with menopausal status.

Adult↗
PubMed2002

Urodynamics in climacteric women with urinary incontinence: correlation with route of delivery.

The aim of this study was to compare the urodynamic findings among climacteric women complaining of urinary incontinence who had only vaginal deliveries with those who had only cesarean sections. The study group comprised 30 climacteric women with complaints of urinary incontinence consulting at the Menopause Outpatient Clinic, State University of Campinas, submitted to anamneses and complete urodynamic testing. Nineteen women had had only vaginal deliveries and 11 were delivered only by cesarean section. Vaginal delivery was significantly associated with a reduced normal and strong desire to void and maximum cystometric capacity compared to women who delivered only by Cesarean section. Detrusor instability was four to five times more frequent among women who had had only vaginal deliveries. There was no difference between the two groups concerning uroflowmetry parameters. Climacteric women with urinary incontinence who had had only vaginal deliveries are at a higher risk of urodynamic abnormalities.

Adult↗
PubMed1993

Influence of the climacteric on the bone mass of the spine and femur.

OBJECTIVE: To determine the correlation between the bone mass of the lumbar spine and the neck of the femur in Spanish climacteric women. METHOD: Bone mass was measured using quantitative digital radiology in 200 climacteric women who had no record of receiving hormone replacement therapy. RESULT: A statistically significant correlation (P < 0.05) is observed between the bone mineral density and content of the lumbar spine and the femur in all the groups of climacteric women, although only in the postmenopausal women does it approach 70%. A direct relationship is observed between the loss of bone mass and the onset of the menopause, as well as with the patients' body mass index. CONCLUSION: When the different parameters are analyzed, the results show that measurement of the lumbar spine is essential, and measurement of the femur should not be used as a substitute, but rather in addition to it.

Adult↗
PubMed2004

Relationship between psychological complaints and vasomotor symptoms during climacteric.

BACKGROUND: It has been suggested that hormonal changes and environmental alterations during the climacteric period are important in the development of psychological symptoms. OBJECTIVE: To evaluate the role of biological and psycho-social factors in the prevalence of climacteric symptoms. DESIGN: Open, cross-sectional, observational and descriptive study. MATERIAL AND METHODS: A total of 300 women between 40 and 59 years of age were evaluated using Greene scale for climacteric symptoms, Cooper questionnaire for psychosomatic symptoms of stress, Smilkstein family apgar for family dysfunction, Duke-UNC questionnaire for social support and Israel scale for vital events. All these tests have been previously validated in Spanish. RESULTS: Postmenopausal women do not have higher prevalence of psychological symptoms, they only have more vasomotor symptoms. Premenopausal women with vasomotor symptoms have more psychological and somatic symptoms and stress, independently of the vital events, family dysfunction or poor social support. Vasomotor symptoms in the premenopause are associated with increased risk of anxiety (OR: 3.7, IC: 1.4-9.7; P<0.008), depression (OR: 8.1, IC: 2.5-26.4; P<0.0005), somatic symptoms (OR: 14.9, IC: 3.4-65.3; P<0.0003), sexual dysfunction (OR: 7.2, IC: 2.5-20.6; P<0.0002) and stress (OR: 7.5, IC: 3.5-15.9; P<0.0001). Negative vital events and family dysfunction increase in minor intensity the risk of anxiety, depression and stress. CONCLUSION: In conclusion, psychological symptoms are frequent in the premenopause and are associated to vasomotor symptoms. This observation links psychological symptoms with menopausal transition and might suggest an organic base in their origin. The negative psycho-social environment is a factor that favours the development of these symptoms.

Adult↗
PubMed2005

Climacteric medicine: European Menopause and Andropause Society (EMAS) 2004/2005 position statements on peri- and postmenopausal hormone replacement therapy.

In women experiencing distressing climacteric symptoms during the peri- and postmenopause there is conclusive evidence from abundant randomised controlled trials that systemic hormone replacement therapy (HRT) of any type affords symptom relief, with no alternative treatment producing similar effect. Though this evidence is accumulating, the question of how to provide best clinical practice in an attempt to both alleviate the menopausal symptoms and prevent the more long-term postmenopausal degenerative diseases is still under debate. When providing climacteric medicine, the dose and regimen of HRT needs to be individualised based on the principle of choosing the lowest appropriate dose in relation to severity of symptoms and on the menopausal age. However, few long-term data on different HRT formulations exist in symptomatic women, which also account for baseline risk of cardiovascular disease (CVD), breast cancer and osteoporosis. In most cases, an individualized prescription together with life-style management will sustain possibilities for net beneficial effects on climacteric symptoms, quality of life (QoL), sexuality and osteoporosis, with only rare risk of severe adverse effects. With the perspective provided by recent epidemiological findings, not least from the estrogen only arm of the Women's Health Initiative Study (WHI), European Menopause and Andropause Society (EMAS) supports research activities in symptomatic women with new HRT formulations in order to affect positively the balance of clinical benefit and risk, including specific information on QoL and also account for the traditional differences in treatment modalities between the US and Europe, and the difference in BMI, life-style and diet. In women experiencing an early menopause (<45 year) current data support a specific overall benefit of HRT. At present, more long-term systemic HRT may be considered in women at high risk of osteoporotic fractures, in particular when alternate therapies are either inappropriate or insufficiently effective, as benefits will outweigh any risks. In contrast, urogenital symptoms may be addressed efficiently and safely with long-term local estrogen therapy.

Adult↗
PubMed2006

The effect of tibolone versus 17beta-estradiol on climacteric symptoms in women with surgical menopause: a randomized, cross-over study.

OBJECTIVE: To compare the effectiveness of tibolone and 17beta-estradiol on climacteric symptoms, in a randomized, single-blind, cross-over study in surgically menopausal women. MATERIAL AND METHODS: Forty surgically menopausal women were divided randomly into two groups. Group A received treatment with tibolone for 6 months, while group B received 17beta-estradiol. After 3 weeks washout period, treatment protocols were exchanged for another 6 months. The climacteric symptoms were assessed with Greene Climacteric Scale at baseline, during washout and after the treatments. Statistical analysis was done with the Wilcoxon's Sign Rank test. RESULTS: Both treatments significantly improved the scores of all subscales with respect to baseline. However, the improvement in psychological, somatic and sexual subscales were significantly superior in the tibolone group compared with 17beta-estradiol group. Both treatments showed comparable improvements in the relief of vasomotor symptoms. CONCLUSION: Our findings suggest that tibolone may improve mood, libido and somatic symptoms in surgically menopausal women to a greater extent than estrogen therapy alone.

Adult↗
PubMed1998

Constructing a standard climacteric scale.

Issues relating to the design of scales and their psychometric properties are discussed in the context of constructing a standard measure of core climacteric symptoms. Seven factor analytic studies of climacteric symptoms are examined to determine whether or not there is sufficient consensus across studies to permit agreement on the symptom content and the structure of such a scale. It is argued that these factor analytic studies do indeed contain sufficient consensus on the basis of which a standard climacteric scale can be constructed. Such a scale is described.

Female↗
PubMed1999

Climacteric skin ageing of the face--a prospective longitudinal comparative trial on the effect of oral hormone replacement therapy.

BACKGROUND: It is still a matter of debate whether HRT improves the physical quality of sun damaged skin. OBJECTIVES: To compare in a prospective longitudinal study the effects of climacteric aging controlled or not by HRT upon the tensile properties of facial skin. METHOD: A total of 140 women aged 40-52 years were enrolled in the study. The HRT group comprised 90 volunteers and a control group encompassed 50 non recipient volunteers. Yearly measurements of tensile functions of facial skin were performed for 5 years. A computerized suction device equipped with a 2-mm diameter hollow probe derived tensile variables quantifying skin distensibility, viscosity and elasticity. RESULTS: Climacteric aging was characterized by increased skin distensibility (1.1% per year) and viscosity (1.3% per year) mirrored by a decrease in elasticity (1.5% per year). HRT helped mitigate such changes. However, the HRT efficacy was not similar in all volunteers. Groups of good and poor responders were clearly identified as far as benefit on skin elasticity was concerned. CONCLUSION: The beneficial effect of HRT upon climacteric skin aging of the face is confirmed, at least in a subgroup of menopausal women.

Adult↗
PubMed2005

Efficacy of Cimicifuga racemosa on climacteric complaints: a randomized study versus low-dose transdermal estradiol.

OBJECTIVE: To investigate, in a randomized clinical study, the efficacy of an isopropanolic aqueous extract of Cimicifuga racemosa (CR) on climacteric complaints in comparison with low-dose transdermal estradiol (TTSE2). Hormonal parameters, lipid profile and endometrial thickness were also evaluated. METHODS: Sixty-four postmenopausal women were enrolled and over the course of 3 months filled in a diary recording the number of hot flushes per day. Other climacteric symptoms (vasomotor and urogenital symptoms) as well as anxiety and depression, were evaluated at baseline and after 3 months. Gonadotropins (follicle-stimulating hormone (FSH), luetinizing hormone (LH)), prolactin (PRL), 17 beta-estradiol (17beta-E2) and cortisol, lipid profile (total cholesterol high-density lipoprotein (HDL)/low-density lipoprotein (LDL)-cholesterol, triglycerides, liver function (glutamic-oxalacetic transaminase, glutamic-pyruvic transaminase) and endometrial thickness were measured. Patients were randomly allocated to receive, for 3 months, either 40 mg isopropanolic aqueous CR extract daily or 25 microg TTSE2 every 7 days plus dihydrogesterone 10 mg/day for the last 12 days of the 3-month estradiol treatment. RESULTS: Both CR and low-dose TTSE2 significantly reduced the number of hot flushes per day (p < 0.001) and vasomotor symptoms (p < 0.001), starting at the first month of treatment. Such a positive effect was maintained throughout the 3 months of observation, without any significant difference between the two treatments. An identical effect was evident also for both anxiety (p < 0.001) and depression (p < 0.001) which were significantly reduced following 3 months of both CR and low-dose TTSE2. Total cholesterol was unchanged by CR treatment but significantly (p < 0.033) reduced by 3 months of low-dose TTSE2. A slight but significant increase of HDL-cholesterol (p < 0.04) was found only in women treated with CR, while LDL-cholesterol levels were significantly lowered by 3 months of both CR (p < 0.003) and low dose TTSE2 (p < 0.002). Triglycerides were not affected by both treatments, nor was liver function. FSH, LH and cortisol were not significantly affected after the 3-month treatment, while PRL (p < 0.005) and 17 beta-E2 (p < 0.001) were increased slightly only by low-dose TTSE2. Endometrial thickness was not affected by either CR or low-dose TTSE2. CONCLUSIONS: CR (40 mg/day) may be a valid alternative to low-dose TTSE2 in the management of climacteric complaints in those women who cannot be treated with or just refuse conventional strategies.

Administration, Cutaneous↗
PubMed2006

Short-term effects of a combination of isoflavones, lignans and Cimicifuga racemosa on climacteric-related symptoms in postmenopausal women: a double-blind, randomized, placebo-controlled trial.

The present study aimed to evaluate the short-term effects of a combination of isoflavones, lignans and Cimicifuga racemosa on acute climacteric-related symptoms in postmenopausal women in a double-blind, randomized, placebo-controlled trial performed at the menopause clinic of our department. Eighty healthy postmenopausal women were randomly assigned to two treatment groups - one receiving the combination (group A, n = 40), the other receiving calcium supplements (group B, n = 40) - for three cycles of 28 days. Climacteric-related symptoms were evaluated by the Kupperman index (KI) at baseline and after the three cycles of treatment. At baseline no significant difference was detected in KI between groups A and B; however, after three cycles of treatment, KI was significantly (p < 0.05) lower in group A compared with baseline and with group B. We conclude that the administration of a combination of isoflavones, lignans and C. racemosa already reduces acute climacteric symptoms in postmenopausal women after 3 months of treatment. This prompt effect is probably due to the different pharmacokinetic properties of isoflavones and lignans; isoflavones are absorbed faster than lignans, while lignans are removed later. The combination of these molecules can guarantee a better reduction of postmenopausal symptoms over a 24-h period.

Cimicifuga↗
PubMed2005

Different ethylene receptors show an increased expression during the ripening of strawberries: does such an increment imply a role for ethylene in the ripening of these non-climacteric fruits?

Notwithstanding the economic importance of non-climacteric fruits like grape and strawberry, little is known about the mechanisms that regulate their ripening. Up to now no growth regulator has emerged with a primary role similar to that played by ethylene in the ripening of the climacteric fruits. Strawberries can produce ethylene, although in limited amounts. Two cDNAs coding for enzymes of the ethylene biosynthetic pathway (i.e. FaACO1 and FaACO2), and three cDNAs encoding different ethylene receptors have been isolated. Two receptors (i.e. FaEtr1 and FaErs1) belong to the type-I while the third (i.e. FaEtr2) belongs to the type-II group. The expression of both the ACO and the receptor-encoding genes has been studied in fruits at different stages of development and in fruits treated with hormones (i.e. ethylene and the auxin analogue NAA). All the data thus obtained have been correlated to the known data about ethylene production by strawberry fruits. Interestingly, a good correlation has resulted between the expression of the genes described in this work and the data of ethylene production. In particular, similarly to what occurs during climacteric fruit ripening, there is an increased synthesis of receptors concomitant with the increased synthesis of ethylene in strawberries as well. Moreover, the receptors mostly expressed in ripening strawberries are the type-II ones, that is those with a degenerate histidine-kinase domain. Since the latter domain is thought to establish a weaker link to the CTR1 proteins, even the little ethylene produced by ripening strawberries might be sufficient to trigger ripening-related physiological responses.

Amino Acid Oxidoreductases↗
PubMedDate not supplied

Effects of ospemifene, a novel SERM, on hormones, genital tract, climacteric symptoms, and quality of life in postmenopausal women: a double-blind, randomized trial.

OBJECTIVE: Ospemifene, a novel selective estrogen receptor modulator, shows a potential for prevention and treatment of osteoporosis in postmenopausal women. We studied the effects of ospemifene on hormone levels, genital tract organs, climacteric symptoms, and quality of life. DESIGN: A double-blinded study in which 160 postmenopausal women were randomly allocated to receive either ospemifene at three different daily doses (30, 60, or 90 mg) or placebo for 3 months. RESULTS: No significant differences were observed among the study groups in clinical characteristics or parameters reflecting estrogen action at baseline. Ospemifene reduced follicle-stimulating hormone and insulin-like growth factor I levels, whereas estradiol failed to change at all, and luteinizing hormone was reduced only in the 90-mg group of ospemifene. In the vast majority of participants, the endometrium remained atrophic after 3 months of treatment with ospemifene. Although the rate of proliferative endometrium slightly increased in all groups, including placebo, no hyperplasia or bleeding occurred in any participant. Ospemifene had no effect on the appearance of proliferation marker Ki-67 in the endometrium as compared with placebo, and endometrial thickness increased by mean 0.4 to 0.6 mm (P < 0.01, P < 0.05 and P < 0.05 for 30, 60 and 90 mg ospemifene, respectively). Uterine volume slightly increased (8.4%-14.7%) in the ospemifene groups (P > 0.05), perhaps as a result of increased uterine blood flow. The most conspicuous finding was the significant estrogenic effect on vaginal epithelium, as evidenced by an increase in intermediate and superficial cells in repeat Pap smears. Ospemifene was not observed to aggravate climacteric symptoms or cause adverse events, nor did it suppress climacteric symptoms. CONCLUSIONS: Ospemifene at daily doses of 30 to 90 mg did not stimulate endometrium or aggravate hot flashes but clearly had a rather strong estrogenic effect on the vaginal epithelium during a 3-month treatment period. Such effects would be advantageous if ospemifene were found to be effective in the long-term prevention of osteoporosis.

Aged↗