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PubMed1995

Climacteric symptoms and control of the cycle in women aged 35 years or older taking an oral contraceptive with 0.150 mg desogestrel and 0.020 mg ethinylestradiol.

In a multicenter prospective trial, 58 healthy women aged between 35 and 49 years were studied for one year (639 cycles) while taking an oral contraceptive (OC) containing desogestrel 0.150 mg and ethinylestradiol (EE) 0.020 mg. Efficacy, control of the cycle, side effects, complaints, and climacteric symptoms were monitored after 3, 6, 9 and 12 cycles. No pregnancies occurred during the study period. Spotting gradually decreased from 29.3% in cycle 1 to 4.2% in cycle 12, while breakthrough bleeding (BTB) disappeared after cycle 7. One case of superficial thrombophlebitis and 3 cases of minor side effects were registered. With regard to the complaints, breast tenderness, headache, and depression gradually decreased during the study (basal vs. 12-month data: 50.9% vs. 31.2%, 48.3% vs. 18.7%, 39.6% vs. 20.8%, respectively), while nausea disappeared after three months. A significant treatment-dependent reduction of climacteric symptoms was obtained after cycle 3 and this tendency was maintained up to cycle 12. No changes were registered in body mass index (BMI) or blood pressure.

Adult↗
PubMed1981

Climacteric symptom formation: Donovan's contribution.

Engaged in evaluating the then newly introduced hormonal therapy of the climacteric syndrome, Donovan, late professor of obstetrics and gynaecology, of Rochester, NY, reached the conclusion that this complex of symptoms was only a clinical artifact. It was, he claimed, the result of the selective attention of doctors when securing medical histories. Though written 30 years ago, Donovan's paper is apparently still provocative enough to be regularly quoted. It has, however, never been closely examined. Looked at in a different light, Donovan's research appears even more interesting. The apparent paradoxes he reports disappear when it is remembered that symptoms are not data but means of communication. His perceptive picture of the influence of doctors on the formation of climacteric symptoms is especially convincing. Much of this is because the main conclusions of this research seem to have come almost as a surprise, forcing themselves on a worker engaged in a restricted field of his speciality. These circumstances probably also account for the relatives shown in drawing more general conclusions from it findings.

Climacteric↗
PubMed1981

Climacteric symptoms: a study in the Indian context.

The climacteric is a universal phenomenon which has received relatively little attention from psychiatrists, psychologists, sociologists, anthropologists and social workers all over the world, but almost no research on this subject has been carried out in the Third-World countries. This study, carried out in India, has been conducted for the purpose of unravelling the difficulties that Indian women have to face during the climacteric. 405 married women between 40 and 55 yr of age from the general population were contacted and interviewed. The results, obtained with the menopausal symptom checklist prepared by the authors, indicate (as do other recent surveys) that hot flushes, night sweats and insomnia seem to be clearly associated with the menopause. Also the incidence of other symptoms is described. Despite embarrassment or discomfort experienced from these symptoms by a majority of women, only 10% had apparently sought medical treatment. This study underlines the necessity of a multidisciplinary approach to the problems of menopause and ageing.

Adult↗
PubMed1982

Endocrinological features and endometrial morphology in climacteric women receiving hormone replacement therapy.

Prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), oestrone (E1), and oestradiol (E2) levels were determined in 204 women who were receiving hormone replacement therapy for their climacteric symptoms. The changes in these hormone levels and the endometrial morphology were studied in order to determine the effects of the replacement therapy. The women were divided into two groups: the first group of 120 women was treated with conjugated oestrogens administered cyclically, plus norethisterone acetate. The second group of 84 women received oral oestriol succinate, also administered cyclically but without additional progestogens. The oestrogen-progestogen therapy resulted in a disappearance of the climacteric symptoms and a significant decrease of FSH and LH levels. Oestriol therapy was less effective than the conjugated oestrogens as a replacement therapy. Oestriol therapy also resulted in a less remarkable decrease of gonadotrophin levels. There were no significant changes in prolactin levels in either group of women. The endometrial histology did not change significantly after either of the two hormone replacement therapies.

Climacteric↗
PubMed1984

Climacteric symptoms in an unselected sample of Swedish women.

A questionnaire on climacteric symptoms was sent to every woman living in the city of Linköping, Sweden (120,000 inhabitants) who was born in 1928 or 1930. Of the 1246 women concerned, 1118 (90%) responded. At the time of the survey, 252 women (23%) were pre-menopausal. In the total sample, 10% had undergone hysterectomy and/or bilateral oophorectomy. The median age at natural menopause was 51 yr. Climacteric symptoms were reported by 75% of the women, the predominating complaints being sweating attacks and hot flushes. Vaginal dryness and tenderness were experienced by 30% of the post-menopausal women, the discomfort tending to become more common as the duration of the post-menopausal period lengthened. After the menopause, every third women experienced periods of depression more often than previously. Depression was positively correlated to the severity of the vasomotor symptoms. Fifty percent of the women expressed interest in receiving oestrogen treatment, although only 7% were using oestrogens at the time of the survey. This discrepancy is probably due to widespread apprehension in Swedish society - shared by the doctors - in regard to 'hormonal treatment'.

Climacteric↗
PubMed1984

Comparison of a triphasic oestradiol/norethisterone acetate preparation with and without an oestriol component in the treatment of climacteric complaints.

This study was undertaken to evaluate the effects of oestriol in combination with oestradiol in the treatment of women with climacteric complaints. Forty-three post-menopausal women were randomly allocated to two groups on a double-blind basis. Over a 28-day cycle 23 of the women were treated sequentially for 12 days with 1 tablet containing 17 beta-oestradiol 2 mg plus oestriol 1 mg, then for 10 days with 1 tablet containing the same oestrogens plus norethisterone acetate 1 mg, thereafter for 6 days with 1 tablet containing 17 beta-oestradiol 1 mg plus oestriol 0.5 mg. The other 20 women received the same treatment but without the oestriol. No clinical, laboratory or histological differences were seen between the two groups. Both treatments were found to be equally effective in alleviating climacteric symptoms, with few side effects. It may be stated in conclusion that, on the basis of routine clinical and laboratory parameters no differences were found between the two preparations.

Adult↗
PubMed1984

Effect of prostaglandin inhibitor and oestrogen on climacteric symptoms and serum free fatty acids.

Oestradiol and naproxen were compared in a double-blind, cross-over study of 20 women suffering from climacteric symptoms. Subjective symptoms were assessed before and after treatment. In addition, serum levels of prostaglandin precursors and of certain other free fatty acids were determined. Oestradiol was found to have a slightly more pronounced effect than naproxen on symptoms and on fatty acid levels. Nevertheless, a large number of the patients reported significant alleviation of their symptoms on naproxen. Some of the climacteric symptoms may thus be mediated by prostaglandins. In most patients the fatty acid levels decreased after treatment with both substances, but there were two exceptions. It is suggested that there may be two separate types of metabolic response to these drugs.

Climacteric↗
PubMed1984

The effects of subcutaneous hormone implants during climacteric.

Climacteric symptoms in 120 women were treated with a total of 469 hormone implants (oestradiol 50 mg and testosterone 100 mg) over a period of four years. All patients with a uterus were given an oral progestogen to prevent endometrial hyperplasia. There was a marked response to treatment, hot flushes being improved in all patients, depression in 99% and loss of libido in 92%. Patient acceptability of this type of treatment was good and there were few side effects or complications. After therapy, the serum oestradiol exceeded the serum oestrone but remained within normal limits. When climacteric symptoms returned and re-implantation occurred the serum levels of oestrone, oestradiol, luteinising hormone (LH), follicle stimulating hormone (FSH) and testosterone were within the normal range for the reproductive age. This indicates that the return of symptoms is due to a change in the hormone levels rather than absolute hypo- oestrogenism .

Adult↗
PubMed1984

Relationship between biological changes and symptoms and health behaviour during the climacteric.

The object of this investigation was to assess the impact of biological (hormonal) changes during the climacteric on self-reported health status and health behaviour in a group of middle-aged women. The central research question was whether or not the menopausal phase (pre, peri, post) affects the number and frequency of the symptoms a women reports, the frequency of her visits to the primary-care clinic and her perception of her general state of health. The subjects comprised a random sample of 47 women aged 48-53 yr who were judged by their family doctors to be healthy or to be suffering from a chronic disease which was inactive at the time the study was carried out. The women were chosen from among a population of married couples under investigation in a larger study. The sample was homogeneous both ethnically (all subjects born in North Africa) and in terms of social class (lower to lower-middle class). No relationships were found between menopausal phase and any of the health criteria considered. The number and frequency of symptoms was low for all the women. Only a small number of women (2-10%) reported a frequent occurrence even of symptoms that are considered to be direct consequences of hormonal changes. These findings conflict with those deriving from studies of women attending gynaecological clinics, but confirm those of other community (non-clinic) studies. The results of this study bear out the general theoretical conclusion that climacteric symptoms are 'psychological and cultural artifacts' rather than consequences of biological changes.

Attitude to Health↗
PubMed1985

High blood pressure and 'ischaemic' ECG patterns in climacteric women.

A study to evaluate the prevalence of high blood pressure (HBP) and resting 'ischaemic' electrocardiogram (ECG) patterns in the climacteric was carried out in 494 outpatients aged up to 65 yr. The study group was made up of 91 pre-menopausal women, 235 natural post-menopausal women, 91 surgical post-menopausal women and 77 women of advanced reproductive age, who comprised the control group. High systolic and/or diastolic blood pressure values were seen in 26.6% of the overall climacteric group (C), i.e. in 23.1% of the pre-menopausal women (PM); 28.9% of the natural post-menopausal women (NMt); and 24.2% of the surgical post-menopausal women (SMt), these frequencies being statistically significant compared to that in the control group (K) (6.5%). 'Ischaemic' ECG patterns (according to the Minnesota Code definition) were observed in 20.3% of the C group, in 22.0% of the PM group and in 27.5% of the SMt group, these rates being statistically significant compared to that in the control group (9.1%). Minnesota Code 4:1 and 5: 1-2 patterns were present in 5.7%, and 4:2 and 5:3 patterns in 14.6% of the C group. A significant correlation was found between HBP (systolic and diastolic) and 'ischaemic' ECG patterns.

Blood Pressure↗
PubMed1986

A case-control study on climacteric symptoms and complaints of Japanese women by symptomatic type for psychosocial variables.

Postal questionnaires about psychosocial factors of climacteric symptoms and complaints were sent to 353 women (subjects) with such symptoms and complaints and to 1024 volunteers without such symptoms and complaints. Controls were selected from the latter. Both subjects and volunteers were inhabitants of Miyagi Prefecture, North-East Japan. Two hundred and eighty-two subjects (79.9%) and 829 volunteers (81.0%) returned completed questionnaires. Two hundred and sixteen of these 282 subjects, 40-59 yr of age, were selected. Each was matched at random with one of 639 volunteers, also 40-59 yr of age and within 1 yr of the subject's age. Thus, 216 matched pairs, each consisting of a case and control, were created. Significantly high relative risks of the following variables as estimated by McNemar's test were shown by this case-control study, and were of two types. Social variables were few intimate friends, low educational level, husband employed in unskilled labor, and subject employed in unskilled labor. Psychic variables were a feeling of poor health, low self-esteem, perceived lack of respect from people surrounding the subject, dissatisfaction with present life, anxiety about the future, and a feeling of being a burden to family and/or community. Moreover, correlations between all possible pairs of variables of the above two groups were examined by means of the chi-square test. Statistically significant correlations were found for the following two pairs of variables: few intimate friends and either low self-esteem or anxiety about the future, and low educational level and either dissatisfaction with present life or a feeling of poor health. These results suggest that climacteric symptoms and complaints are closely associated with a lack of potential social support characterized by few intimate friends, etc., especially in mild symptom-type cases, and also with low socioeconomic status related to low educational level, etc., particularly in severe symptom-type cases.

Adult↗
PubMed1987

Effect of Bellergal Retard on climacteric complaints: a double-blind, placebo-controlled study.

The effect of Bellergal Retard (BR) on climacteric complaints was evaluated versus a placebo in an 8-wk double-blind study, followed by a 4-wk open study in which only BR was used as medication. There was a marked decrease in complaints in both the BR and the placebo groups. Statistically significant differences were observed between the groups after 2 and 4 wk of treatment, indicating superior results with BR. After 8 wk of study however, these differences were no longer apparent. It was concluded that studies on medication for climacteric complaints should not only be placebo-controlled, but also be of at least 8 to 12 wk duration for proper evaluation.

Belladonna Alkaloids↗
PubMed1987

Use of Org OD 14 for the treatment of climacteric complaints.

The effects of treating climacteric complaints in post-menopausal women were studied in an open trial in which Org OD 14, a placebo and no treatment were compared. In addition to the symptomatic effects, clinical and laboratory parameters were also studied. One hundred and twenty-four women who had undergone a natural or surgical menopause completed 4 mth of randomized treatment; 35 received Org OD 14 (2.5 mg/day, per os), 46 a placebo, and 43 no treatment. The mean ages and time in years since menopause were comparable for each group. The parameters were assessed before treatment and after 4 mth. The results in the group treated with Org OD 14 were compared statistically with those for the other two groups using the chi 2 test, Student's t test or analysis of variance. A beneficial effect on clinical parameters was seen following Org OD 14 treatment. The results as regards hot flushes and sweating were significantly better statistically than those in the other groups. Org OD 14 was found to have no effect on the endometrium, breasts, body weight or blood pressure, while vaginal atrophy was slightly improved. Serum levels of total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and phosphate were slightly reduced by Org OD 14. Liver function tests, clotting factors and the other routine laboratory parameters were not affected by Org OD 14 treatment. It was concluded that Org OD 14 is an effective and safe compound for the treatment of climacteric syndrome.

Calcium↗
PubMed1988

Climacteric symptoms among women aged 60-62 in Linköping, Sweden, in 1986.

By means of a simple postal questionnaire, all women aged 60, 61 and 62 (n = 2015) living in the community of Linköping, Sweden, were screened for vasomotor symptoms and local vaginal complaints. After one reminder, answers were received from 73% of the women. At the time of the survey (April 1986) all the women were post-menopausal, the median period since menopause being 11 yr. Slightly over one in four of the women (27%) were suffering from sweating and hot flushes. Ten percent (10%) of the women who were more than 15 yr post-menopausal still had moderate to severe climacteric symptoms. Vasomotor symptoms were significantly more common among oophorectomized women than among those whose ovaries were intact. Local vaginal symptoms were positively correlated with urinary problems, repeated urinary tract infections and a high risk of disturbance of sexual activity. It was concluded that climacteric symptoms often persist for more than 15 yr after the menopause.

Climacteric↗
PubMed1988

Body mass index distribution in climacteric women.

Body Mass Index (BMI) was calculated in 2481 climacteric women selected from among the outpatients attending the Menopause Clinic at Bologna University in absence of hormonal replacement therapy and diseases that could cause weight gain. Analysis of variance of the W/H2 (weight/height squared) distribution in different age and climacteric situations demonstrates that the pre-menopause is a weight-gain inducing state and that ageing seems to cause a progressive increase in W/H2.

Adult↗
PubMed1988

Beta-endorphin levels during the climacteric period.

Hot flushes are not caused by hypergonadotrophinaemia. This is apparent because peaks of gonadotrophin in the serum do not coincide with cutaneously measured hot flushes while such flushes still occur in hypophysectomized women. Gonadotrophin-releasing hormone and other neurotransmitters (possibly beta-endorphin) affect thermoregulation. The following hypothesis is advanced. During the climacteric period neurotransmitter changes, a decrease in catechol oestrogens, a decrease in alpha-2-adrenoceptor activity and cessation of ovarian steroid production may lead to alterations in endogenous opiate activity and thus to disturbances of thermoregulation, resulting in the occurrence of hot flushes. Low beta-endorphin levels in the peripheral plasma, which rise again following oestrogen treatment, are observed during the climacteric. On the other hand, women with severe hot flushes caused by a stress event show enormously increased beta-endorphin values, which are normalized by hormone substitution therapy acting via still unknown neuroendocrinological feedback mechanisms.

Body Temperature Regulation↗
PubMed1989

Analysis of the climacteric syndrome.

The climacteric syndrome (CS) was investigated in a large sample of women (over 4000) who spontaneously attended the Menopause Clinic at the University of Bologna between 1976 and 1986. The participants selected had received no hormonal replacement therapy for at least 6 mth or any other drug for at least 3 mth previously. They were all free from any disease that could influence any of the CS symptoms. The frequency of 12 symptoms considered typical of the CS was investigated. The interrelationships between these symptoms were determined as well as the frequency of the occurrence of individual symptoms in association with various climacteric complaints. The results indicated (a) that the CS is not uniform but both variable and individual, (b) that the frequency of its constituent symptoms remains high in advanced fertile age and the advanced postmenopause, (c) that the symptoms are preferentially interlinked, (d) that many, but not all, symptoms exhibit a differentiated pattern during the course of the natural and surgical menopause/age progression, and (e) that hot flushes and sweating, and to some extent insomnia and headache, are menopause-dependent.

Adult↗
PubMed1991

Ophthalmic complaints as a climacteric symptom.

The menopausal syndrome is characterized by a variety of emotional and physical symptoms of varying intensity. A total of 1287 women who attended the Outpatient Department for Climacteric Symptoms and Osteoporosis Prophylaxis (1st Department of Gynaecology and Obstetrics, University of Vienna Medical School) constituted the study population. These women, who were seeking relief from various complaints or for prophylactic assessment and treatment, visited the clinic over the period 1988-1989. We placed special emphasis on ophthalmic complaints as evidence of the incipient climacteric period. Of the 430 patients with eye complaints, 98 underwent ophthalmological investigation. Within our patient group, we analyzed the incidence and severity of menopausal eye complaints as well as therapeutic responses to hormone replacement therapy on an epidemiological scale. Potential endocrinological factors are discussed.

Climacteric↗