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PubMed1985

[Circulatory system reaction to loading tests in patients with the climacteric syndrome in relation to the phase of the climacteric and the presence of cardialgia].

Female patients with the menopausal syndrome (MS) manifestations showed a steeper increment of diastolic arterial blood pressure (ABP) and heart rate, as compared to normal subjects, in both phases of the menopause, irrespective of whether cardialgia was present or not; moreover, half of the patients showed negative electrocardiographic dynamics. Hemodynamic shifts in response to bicycle ergometry were similar in both menopausal phases and showed steeper increments in ABP and heart rate, as compared to those of normal subjects. Excessive ABP rise in response to exercise is mostly associated with cardialgias. Exercise-related ECG can usually improve or return to normal in premenopausal patients, while ischemic ST depression is associated with postmenopausal conditions. Physical working capacity of premenopausal women is only impaired in the presence of cardialgias, whereas that of postmenopausal women is reduced in the absence of cardialgia as well.

Adult↗
PubMed1999

Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes.

OBJECTIVE: To evaluate the degree of psychological dysfunction and levels of stress hormones in postmenopausal women with climacteric syndromes and effect of Korean red ginseng (RG) on them. METHODS: ACTH, cortisol and DHEA-S in peripheral blood from 12 postmenopausal women with climacteric syndromes or 8 postmenopausal women without any climacteric syndrome were measured before and 30 days after treatment with daily oral administration of 6 g RG. Blood samples were collected in the early morning on the bed-rest. In postmenopausal women with climacteric syndromes such as fatigue, insomnia and depression, psychological tests using the Cornell Medical Index (CMI) and the State-Trait Anxiety Inventory (STAI) were performed before and 30 days after treatment with RG. RESULTS: CMI score as well as anxiety (A)-state in STAI score in postmenopausal women with climacteric syndromes was significantly higher than that without climacteric syndrome, while DHEA-S levels in postmenopausal women with climacteric syndromes were about a half of those without climacteric syndrome. Consequently, cortisol/DHEA-S (C/D) ratio was significantly higher in postmenopausal women with climacteric syndromes than in those without climacteric syndrome. When postmenopausal women with climacteric syndromes were treated with daily oral administration of 6 g RG for 30 days, CMI and STAI A-state scores decreased within normal range. Although the decreased DHEA-S levels were not restored to the levels in postmenopausal women without climacteric syndrome, the C/D ratio decreased significantly after treatment with RG. CONCLUSIONS: Improvement of CMI and STAI scores in postmenopausal women suffering climacteric syndromes, particularly fatigue, insomnia and depression, by RG seemed to be brought about in part by effects of RG on stress-related hormones as shown by a decrease in C/D ratio.

Adrenocorticotropic Hormone↗
PubMed2001

Climacteric complaints in the community.

BACKGROUND: At the onset of the climacteric, healthy middle-aged women present with a variety of complaints, especially in general practice. In these first years of entering the menopause, vaginal blood loss alters from irregular periods to complete amenorrhoea. According to these different menstrual patterns, we can distinguish a pre-, peri- and postmenopausal phase. It could be useful to know whether specific climacteric complaints are related to these different phases. OBJECTIVE: The aim of this study was to investigate the relationship between climacteric complaints and the menstrual pattern during the menopausal transition in a population-based cross-sectional survey of healthy middle-aged women. METHODS: All women aged 47-54 years, living in the city of Eindhoven, were invited to participate in the Eindhoven Osteoporosis Study (EPOS); 6648 (78%) agreed to participate. All women completed a questionnaire concerning climacteric complaints. Climacteric status was defined by menstrual history. Odds ratios (ORs) were obtained for the relationship between climacteric status and climacteric complaints. Multiple logistic regression analysis was carried out, with climacteric status as the dependent variable. RESULTS: Of the 27 items in the questionnaire concerning climacteric complaints, seven were significantly different between all three climacteric phases (P: < 0.1). After multiple logistic regression analysis, comparing peri- and premenopause, only flushing (OR 5.9) was significantly different. Between post- and perimenopause, seven symptoms appeared to be different: three urogenital complaints [vaginal dryness (OR 1.6), vaginal discharge (OR 0.4) and pain during intercourse (OR 1.9)], three vasomotor symptoms [daytime sweating (OR 1.4), night-time sweating (OR 0.7) and flushing (OR 1.9)] and, finally, insomnia (OR 1.3). When comparing post- and premenopause, flushing (OR 13.4), insomnia (OR 2.1) and depressed mood (OR 0.6) were significantly different, in addition to three urogenital symptoms: vaginal dryness (OR 2.6), vaginal discharge (OR 0.3) and pain during intercourse (OR 2.1). CONCLUSION: The major findings of the study are that flushing is strongly associated with the transition from pre- to perimenopause, while urogenital complaints, daytime sweating and insomnia are more prominent in the transition from peri- to postmenopause.

Adult↗
PubMed1994

The climacteric ovary as a functional gonadotropin-driven androgen-producing gland.

OBJECTIVE: To assess the hypothesis that the climacteric ovary is a functional endocrine gland. DESIGN: Review of the English-speaking literature as it relates to the physiology and pathophysiology of the climacteric ovary. RESULTS: By several accounts, the climacteric ovary appears to be a gonadotropin-dependent androgen-producing gland. Although the estrogen-producing potential of the climacteric ovary remains a matter of controversy, most studies would suggest limited aromatase activity. CONCLUSIONS: [1] The climacteric ovary is not a defunct endocrine organ. [2] The climacteric ovary is a site of gonadotropin reception and action. [3] The climacteric ovary contributes few if any estrogens to the circulating pool by way of direct production. [4] Circulating estrogens are derived virtually exclusively from the extraglandular conversion of androgens, a proportion of which are of ovarian origin. [5] The climacteric ovary contributes 40% and 20% of the total production rates of T and androstenedione, respectively. [6] Androgen biosynthesis by the climacteric ovary is partially gonadotropin-dependent.

Androgens↗
PubMed1997

The prevalence and severity of climacteric symptoms and the use of different treatment regimens in a Swedish population.

OBJECTIVES: To determine (i) the prevalence and severity of climacteric symptoms, and (ii) the prevalence of treatment for climacteric complaints, in a population based, random sample of Swedish women aged 46-62 years. MATERIAL AND METHODS: A random sample of 5990 women from the birth cohorts 1946, 1942, 1938, 1934 and 1930, resident in the city of Göteborg, was obtained from the population register. The women were invited by letter to complete a questionnaire concerning general health, reproductive history, climacteric symptoms (severity graded on a scale 0,1,2,3) and the treatment of climacteric complaints. The overall response rate was 76%. RESULTS: The prevalence of climacteric symptoms was as follows: vasomotor symptoms 53%, depression/irritability 57%, sleeping disturbance 52%, muscle/joint pain 57%, loss of libido 37% and vaginal dryness 21%. Hormone replacement therapy (HRT) with medium potency estrogens was currently being used by 13.4% and 7.7% were using low potency estrogens. Medium potency estrogens had previously been used by 14% and 6% had used low potency estrogens. HRT was reported to be effective against the most common climacteric complaints in 70%-90%. Non-hormonal treatment regimens had been used by 45% of the women and 31-63% reported a positive effect on climacteric symptoms. CONCLUSIONS: Although the majority of peri- and postmenopausal women reported suffering from climacteric complaints only 21% were current users of estrogens. Non-hormonal treatment modalities had been used by 45% of the women and were reported to have a good effect on climacteric symptoms in 45% compared to up to 90% of the HRT users.

Aged↗
PubMed2004

[A correlative study of the uncertainty in the climacteric women].

The purpose of this study was to explore the relationship between climacteric symptoms, knowledge, and uncertainty in climacteric women. A cross-sectional correlational research design was used. Data were collected by face-to-face interview. The Greene Climacteric Scale, Health Knowledge about Menopause Scale, and Perceived Uncertainty Scale were used to assess data. A convenience sampling approach was used to enlist 70 female subjects who were mothers of students in a nursing college located in southern Taiwan and were in perimenopause or post-menopause. The results of the study indicated that levels of uncertainty on the part of the subjects toward the climacteric state were moderate. Subjects in the perimenopause period had significantly higher levels of uncertainty about the climacteric state than those in the post-menopause period. The levels of uncertainty were significantly negatively correlated with socio-economic status. The frequency and disturbance levels of climacteric symptoms among subjects were between "not at all" and "a little". The levels of uncertainty were significantly positively correlated with frequency of and disturbance caused by the symptoms. The score on the knowledge about menopause was below average and was significantly negatively correlated with uncertainty. The degree of disturbance caused by the symptoms, menopause status, and knowledge explain 34% of the variance in uncertainty. The findings of the study support the view that climacteric women who had fewer symptoms and more knowledge had lower levels of uncertainty. Nurses can develop interventions to reduce uncertainty in climacteric women.

Climacteric↗
PubMed1977

Succinoxidase Activity of Avocado Fruit Mitochondria in Relation to Temperature and Chilling Injury throughout the Climacteric Cycle.

Mitochondria were isolated from ;Fuerte' avocado fruit (Persea americana Mill.) at four different stages of the respiratory climacteric. Preclimacteric fruit had the highest rate of succinate oxidation and the postclimacteric mitochondria the lowest. Subsequently, successive additions of ADP increased the respiratory control ratio.Arrhenius plots of succinate oxidation of intact mitochondria from climacteric rise and climacteric peak fruit showed two transition temperatures, while only one was observed in preclimacteric fruit. The low temperature phase transition was at about 9 C, while the high one was at 20 C. In postclimacteric fruit, the low temperature transition decreased to between 5 and 2 C. The state 3 rate of succinate oxidation was highest for mitochondria from preclimacteric fruit and decreased for each later stage. The state 4 rates for preclimacteric and climacteric rise were the same, while both the climacteric peak and postclimacteric rates were about 40% lower than the preclimacteric O(2) uptake.The results indicate continuous changes in the mitochondrial membrane of the electron transport chain throughout the climacteric cycle. The change in the membrane influencing the phosphorylation system is greatest between climacteric rise and peak stages. Mitochondrial membranes of postclimacteric fruit are presumed to change from flexible disordered to solid ordered phase at a lower temperature than those of other climacteric stages.

Journal Article↗
PubMed1997

Climacteric symptoms do not impair cognitive performances in postmenopause.

OBJECTIVE: To investigate whether information processing and attention performances are affected by climacteric vasomotor symptoms. METHODS: The study group comprised 66 healthy hysterectomized postmenopausal women. The subjects were divided into two subgroups (high symptomatic and low symptomatic) according to the quantity of climacteric vasomotor symptoms. Information processing was examined using CogniSpeed, a reaction time software that separates, for example, pure controlled processing and working memory from perceptual and motor components. Attention was examined by using visual and auditory tasks. The role of climacteric depression as a determinant of cognitive performance was evaluated by the Beck Depression Inventory and dividing subjects according to self-reported climacteric mood symptoms. The effects of serum oestrogen level and ageing on cognitive performances were also studied. RESULTS: Cognitive performances were similar in high symptomatic and low symptomatic women. On the Verification test younger women had shorter reaction times (P = 0.002) and on the Subtraction test they had fewer errors (P = 0.015) than older women. These tests required working memory and decision making. Accuracy in the tests of sustained and auditory attention worsened slightly with age. Cognitive performances neither correlated with scores on the Beck Depression scale nor with serum oestrogen level. Climacteric mood symptoms did not impair cognitive performance. CONCLUSIONS: Despite subjective complaints of memory impairment in association with climacteric vasomotor symptoms, our results did not support a direct cause-and-effect relationship. Thus, the minor deficits found in cognitive processing efficiency seem to be related rather to age than climacteric symptoms.

Aging↗
PubMed1999

Efficacy on climacteric symptoms of a new estradiol transdermal patch with active matrix in comparison with a reference reservoir patch. Two long-term randomized multicenter parallel-group studies.

METHODS: Two randomized prospective multicentre parallel group studies were performed (one in Germany and the other in Italy) in symptomatic postmenopausal women. The goal was to assess the efficacy on climacteric symptoms and the safety of a new estradiol (CAS 50-28-2) transdermal patch with solid active matrix (SAM) in comparison to a conventional liquid reservoir (LR) type estradiol transdermal patch. Both patches released 50 micrograms/day estradiol. One group of patients received the SAM patch and the other the LR patch in 4-week cycles, with a twice-weekly application of the patches for 3 weeks, followed by one week without patches. Progestin opposition was achieved with medroxyprogesterone acetate 5 mg/day orally in the last 11 days of patch application in the German study and with 10 mg/day in the last 12 days of patch application in the Italian study. Both studies were divided into two Parts: Part 1 with three 4-week cycles for a total of 12 weeks and Part 2 for other ten 4-weeks cycles in which the patches could be applied also continuously. The total duration of the study was therefore 52 weeks. RESULTS: Germany study. 133 patients resulted randomized to the SAM group and 129 to the LR group. Both estradiol patches quickly relieved climacteric symptoms already during the first 3 weeks of patch application, as shown by the rapid decrease of the Kupperman Index. At the end of Part 1, in the SAM group 91% and in the LR group 96% of patients reported relief from climacteric symptoms. At the end of Part 2 the percentages were 98% and 95%, respectively. The two patches were therapeutically equivalent with a power greater than 99.7%. Both patches were systemically fairly well tolerated. Only 4.5% of patients in the SAM group and 3.9% in the LR group discontinued prematurely for possible adverse reactions related to estradiol. There was no significant difference between the two patches with regard to systemic tolerability. Conversely, with regard to local skin reactions, the SAM patch was significantly (p < 0.01) better tolerated than the LR patch. The adhesion to the skin of the SAM patches was better than that of the LR patches. RESULTS. Italian study. 139 patients resulted randomized to the SAM patch and 128 to the LR patch. Also in this study both types of patches relieved the climacteric symptoms already during the first 3 weeks of patch application, as shown by the rapid decrease of the visual analogue scale (VAS) recordings of severity of hot flushes and of sweats. At the end of Part 1 both patches relieved 95% of patients from climacteric symptoms. At the end of Part 2, i.e. after 52 weeks, 100% of patients were relieved from climacteric symptoms. Of these, 72% in the SAM group and 78% in the LR group reported complete disappearance of symptoms. Also in the Italian study, therefore, the two patches were found therapeutically equivalent. Both patches stopped or even reversed bone mineral loss in L2-L4 and had some favorable effects on lipid metabolism. Both patches were systemically equally fairly well tolerated with premature discontinuations for systemic adverse drug reactions in only 5.0% of patients in the SAM group and 3.9% in the LR group. Conversely, as in the German study, the SAM patches were significantly better tolerated by the skin (p < 0.0001). CONCLUSIONS: The two types of estradiol transdermal patches were equivalent in providing an effective and rapid relief from climacteric symptoms. Systemically both patches were fairly well tolerated. The SAM patches were significantly better tolerated by the skin. The better local tolerability combined with better adhesion and cosmetic properties render the SAM patches very patient friendly and improve the compliance in the long term estrogen replacement therapy required to reduce osteoporosis and cardiovascular risks.

Adhesiveness↗
PubMed2005

[From "anni climacterici" to "menopause". The historical roots of the concept of "climacteric"].

In modern language, the term "climacteric" refers to what is more popularly called the "change of life" in English or "Wechseljahre" in German. As this paper demonstrates, the concept of "clim acteric" has a long but largely forgotten history, however, in the course of which the concept changed fundamentally. Originally, the "climacterical years" were simply the 7th, 14th, 21st years and so forth in the life of men and women alike. These "climacterical years" were associated with a "critical" change in the whole body, which could lead towards a further stage of renewed vigour and health but also towards death, especially in the 63rd year, the so called "annus climactericus maximus". The concept was well-known and widely debated and commented upon in the 16th and 17th centuries. By the 18th century it had lost much of its scientific credibility but eventually term "climacteric", rather than coming out of use, acquired a new meaning. Decisive for this process was a new understanding of the female menopause. Leading physicians, especially in France, reframed widely held traditional notions of the dangers of a "cessation of the menses". They no longer saw them as initiating a period of increasing decline due to the accumulation of superfluous or impure matter in the bodies of postmenopausal women. Instead they distinguished a specific period of troubles and danger in female life around the time when the periods stopped, which they called "menopause". Once this period of menopause was over a stage of renewed health and vigour was said to follow. Around the same time, English physicians began to describe a "climacteric disease" which commonly occurred roughly between 50 and 75 years of age, primarily though not exclusively in men. They thus still used the term "climacteric" but it no longer referred to individual, particularly dangerous years but, like the new term "menopause" to a more or less extended period in life. The two concepts gradually seem to have merged in the course of the 19th century. In the end, rather than suggesting a cyclical structure of crisis and renewal in human life, the term "climacteric" became a single, more or less extended, frequently quite troublesome but rarely lethal period in the life of women.

Climacteric↗