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PubMed2004

Relationship between climacteric symptoms and serum galanin levels in post-menopausal women.

OBJECTIVES: The aim of the study was to evaluate the possible relationship between climacteric symptoms and serum galanin concentrations in post-menopausal women. MATERIALS AND METHODS: We studied 38 women who attended the Department of Gynecological Endocrinology in Poznan because of climacteric complaints. The control group comprised 16 women [mean age 22.2 yr (SD+/-0.9 yr), range 18-24 yr] who were menstruating regularly and had normal body mass index. We evaluated the severity of climacteric symptoms using the Kupperman scale and we measured 17beta-estradiol, FSH and galanin serum concentrations by radioimmunoassay. RESULTS: The mean serum galanin concentration was 18.7 pg/ml (SD+/-16.1 pg/ml) in the study group and 21.9 pg/ml (SD+/-9.4 pg/ml) in the control group. The difference was not statistically relevant. The mean serum galanin concentration was 15.9 pg/ml (SD+/-12.6 pg/ml) in the group of patients with mild and moderate climacteric symptoms and 29.5 pg/ml (SD+/-23.3 pg/ml) in the group of patients with severe climacteric symptoms. The difference between the two groups was statistically significant (Student t-test: p<0.05). Climacteric patients with nervousness had lower serum galanin concentration than patients without this symptom (Student t-test: p<0.05). CONCLUSIONS: a) Serum galanin concentration in post-menopausal women is related to severity of climacteric syndrome; b) the presence of nervousness in post-menopausal women is related to lower serum galanin level.

Adult↗
PubMed1985

Child-rearing, marital, recreational and work role integration and climacteric symptoms in midlife women.

This study investigated relationships between the roles women enact during midlife and the frequency and severity of symptoms they report at the climacteric. A sample of 185 healthy, middle-aged women completed measures assessing climacteric symptoms, adjustment to the marital role, and degree of participation in child-rearing, recreational, and work roles. Findings indicated that the more roles women enact, the less likely they are to experience climacteric symptoms. Adjustment to the marital role and an active recreational role were the best predictors of infrequent and mild climacteric symptoms. The number of hours worked was negatively related to recreational involvement and marital role adjustment but did not relate to climacteric symptoms. The child-rearing role was not related to symptoms. These findings indicate that successful marital adaptation and active role participation may be significantly related to diminished climacteric symptoms formation of midlife women.

Adaptation, Psychological↗
PubMed1994

The view of women aged 45-65 and their partners on aspects of the climacteric phase of life.

OBJECTIVE: to make an inventory of the opinions and attitudes of the Dutch female population (aged 45-65) and their partners on the climacteric period. DESIGN: Data were collected as part of a weekly computer assisted questionnaire filled in by a representative panel composed of 234 women aged 45-65 and their partners. SETTING: A random sample of the population of The Netherlands. RESULTS: 12% of the women were current users of hormone replacement therapy (HRT), 21% had been hysterectomized, 32% were smokers. Although the prevalence of climacteric symptoms was as expected, only 1 out of 3 peri- and post-menopausal women were really troubled by the symptoms and had consulted a physician. The attitude towards HRT was neutral. Most women preferred a natural approach as a solution to the problems. Information on the climacteric was mostly obtained via the media, but in general the self-assessed level of knowledge was regarded by the panel as very low, even in current HRT users. Women on HRT were more positive toward treatment, and less confident about the spontaneous disappearance of the problems. Nearly all women, including current HRT users, regarded the absence of menstruation as a relief. Partners of climacteric women had the same opinion as their wives on all items. CONCLUSION: There is a lack of information on the climacteric and on the use of HRT. The Dutch female population tends to a natural approach of the climacteric without medication, but the general attitude can be regarded as neutral.

Aged↗
PubMed1994

Climacteric and menopause in seven South-east Asian countries.

The menopause is universal, but what about the climacteric? In an attempt to answer this question, a study was conducted in seven south-east Asian countries, namely, Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore and Taiwan. Samples of approximately 400 women in each country were questioned about a number of climacteric complaints, incontinence and dyspareunia, consultation of a physician, menopausal status and several background characteristics. Special care was taken to overcome linguistic and cultural problems, and the data collected were kept as objective as possible. From the results obtained we were able to show that the climacteric was indeed experienced in south-east Asian countries, although in a mild form. The prevalence of hot flushes and of sweating was lower than in western countries, but was nevertheless not negligible. The percentages of women who reported the more psychological types of complaint were similar to those in western countries. The occurrence of climacteric complaints affected perceived health status. A physician was consulted for climacteric complaints by 20% of the respondents, although this was most frequently associated with the occurrence of psychological complaints and less so with that of hot flushes and sweating. The median age at menopause (51.09) appeared to be within the ranges observed in western countries. Ethnic background and age at menarche were found to have a significant influence on age at menopause. The study clearly demonstrated that climacteric complaints occur in south-east Asia. The findings suggest, however, that vasomotor-complaint-related distress might be 'translated' into psychological complaints, which are more frequently considered to warrant consulting a physician.

Adult↗
PubMed2003

The effect of a novel vaginal ring delivering oestradiol acetate on climacteric symptoms in postmenopausal women.

OBJECTIVE: Evaluate the efficacy and acceptability of a novel vaginal ring delivering oestradiol acetate (Menoring) versus oral oestradiol for relief of climacteric symptoms in postmenopausal women. DESIGN: Prospective, multicentre, randomised, double-blind, comparator-controlled, parallel group study. SETTING: Twenty-one centres in the United Kingdom. POPULATION: Postmenopausal women, aged <65 years experiencing > or =20 hot flushes/night sweats per week for two consecutive weeks. METHODS: Patients received a vaginal ring releasing oestradiol acetate at a rate equivalent to 50 microg/day in addition to placebo tablets (vaginal ring group) or oral oestradiol 1 mg/day in addition to placebo vaginal ring (oral group) for 24 weeks. For patients with inadequate control of vasomotor symptoms, dosage was doubled at 12 weeks. Non-hysterectomised women received norethisterone 1 mg/day for 12 days in each 28 day cycle. MAIN OUTCOME MEASURES: Efficacy was assessed by change in climacteric symptoms measured by the Greene Climacteric Scale, as well as mean change in frequency of hot flushes/night sweats. RESULTS: A total of 159 patients were enrolled (84 vaginal ring, 75 oral). Significant improvement (P < 0.05) in mean total Greene Climacteric Scale scores in both treatment groups was observed at 12 and 24 weeks and for every subscale score including anxiety, depression and sexual dysfunction (P < 0.05). In both groups, frequency of hot flushes/night sweats was significantly reduced (P < 0.001) at 12 and 24 weeks. No significant between-group differences were noted at 12 or 24 weeks. CONCLUSIONS: The oestradiol vaginal ring significantly improved climacteric symptoms as measured by Greene Climacteric Scale scores and reduced the frequency of hot flushes/night sweats. Efficacy and safety of vaginal ring oestradiol were comparable with those of oral therapy. Patient evaluations of oestradiol vaginal ring tolerability and acceptability were excellent.

Administration, Intravaginal↗
PubMedDate not supplied

[Effect of socioeconomic factors on timing of menopause and the course of climacteric].

The influence of several socioeconomic factors on age at menopause as well as on the mode of climacteric have been investigated in 142 postmenopausal women, originating from Eastern Austria. A significant correlation between socioeconomic factors and the age at menopause could not be observed. Unlike the age at menopause, significant correlations between socioeconomic factors and the degree of severity of climacteric syndrome could be made, resp., the education level, the marital status, total number of children and number of children not living in the parents household correlated significantly with the degree of severity of several symptoms of climacteric syndrome. The socioeconomic factors influenced only the somatic symptoms, which are mainly caused by hormonal changes during the climacteric. According to the results of the present study, psychosocial stress may influence sex hormone levels during the climacteric and postmenopause and, thus, the mode of climacteric.

Age Factors↗
PubMed1993

[The autonomic dystonia syndrome in pathological climacteric in women and cerebrovascular insufficiency].

The authors analyze some pathophysiologic mechanisms underlying the relationships between the vegetative dystonia syndrome running in the presence of the climacteric syndrome, on the one hand, and cerebrovascular insufficiency, on the other. A total of 82 women were examined, 62 of these with the climacteric syndrome and 20 with the normal climacteric (reference group). Among women with the climacteric syndrome patients with signs of cerebrovascular insufficiency (initial signs of cerebral circulation insufficiency and Stage I dyscirculatory encephalopathy) predominated. The severity of cerebrovascular insufficiency was higher in patients with the climacteric syndrome. The sympathetic tone of the autonomic nervous system clearly prevailed in the test group, and signs of inadequate autonomic supply were present. Electropolygraphic registration of the function of the nonspecific systems of the brain has shown marked signs of increased level of the ascending nonspecific activation of the brain in the main group as against the reference one. Basing on these findings, the authors analyze the specific features of the psychovegetative syndrome, conducive to the development of cerebrovascular dystonia in women with the pathologic course of the climacteric.

Autonomic Nervous System↗
PubMedDate not supplied

Medial frontal cortex perfusion abnormalities as evaluated by positron emission tomography in women with climacteric symptoms.

OBJECTIVE: To identify functional changes in the brains of women with climacteric symptoms. Images of regional cerebral blood flow (rCBF) were compared statistically between women with and women without symptoms to identify changes in rCBF. Results may provide a better understanding of the neural basis of the symptoms, which are divided into three symptom clusters: vasomotor, psychological, and somatic. DESIGN: The study participants consisted of 12 women with moderate to severe climacteric symptoms (age 47.5 +/- 5.9 years, mean +/- SD) and 7 women with no symptoms (control group; age 49.6 +/- 4.2 years, mean +/- SD). The study participants were patients at a menopause clinic, and the latter were healthy volunteer nurses and hospital staff. Climacteric symptoms were evaluated by an assessment of the severity of 17 symptoms immediately before positron emission tomography examination of rCBF. The symptoms had been used previously to generate the Kupperman Kohnenki Shogai Index, a modified Kupperman Menopausal Index adapted to Japanese women. rCBF was measured by positron emission tomography with the CO2 dynamic inhalation method. RESULTS: Reductions in relative rCBF in the patient group were observed in the bilateral rectal gyrus and in the left subcallosal gyrus on a voxel-by-voxel basis as compared with the control group. CONCLUSIONS: The present study revealed reductions in relative rCBF of the prefrontal cortex of Japanese women with moderate to severe climacteric symptoms. This area is close to that previously addressed in studies of familial bipolar depression and familial unipolar depression, although our participants did not satisfy criteria for depression. This reduction of rCBF may be related to the three climacteric symptom clusters, but further studies are needed for evaluation of its significance. Our results should stimulate investigations into the positron emission tomography rCBF change of these women as to the integration of multiple entities in climacteric symptoms.

Cerebrovascular Circulation↗
PubMed1968

Metabolic Changes in Excised Fruit Tissue. IV. Changes Occurring in Discs of Apple Peel During the Development of the Respiration Climacteric.

It is shown that a sequential development of a series of enzyme systems occurs in the peel of the apple as the respiration climacteric develops in the whole fruit. The sequence of development of these systems, i.e. acetate incorporation into lipid, production of ethylene, incorporation of amino acid into protein and, finally, the decarboxylation of added malate (malate effect) is the same as that shown earlier for the short term (24 hr) aging of peel discs from pre-climacteric apples. As these systems appear in the initial discs from fruit passing through the climacteric they gradually cease to increase during the 24 hour aging period. Uptake studies show that none of the changes in these systems can be due solely to changes in the permeability of the tissue over the climacteric period. On the basis of these results it is tentatively suggested that the aging of discs from pre-climacteric tissue might provide a model system for a detailed study of the physiological and biochemical changes occurring during the climacteric of apple fruits.

Journal Article↗
PubMed1991

Involvement of wound and climacteric ethylene in ripening avocado discs.

Avocado (Persea americana Mill. cv Hass) discs (3 mm thick) ripened in approximately 72 hours when maintained in a flow of moist air and resembled ripe fruit in texture and taste. Ethylene evolution by discs of early and midseason fruit was characterized by two distinct components, viz. wound ethylene, peaking at approximately 18 hours, and climacteric ethylene, rising to a peak at approximately 72 hours. A commensurate respiratory stimulation accompanied each ethylene peak. Aminoethoxyvinyl glycine (AVG) given consecutively, at once and at 24 hours following disc preparation, prevented wound and climacteric respiration peaks, virtually all ethylene production, and ripening. When AVG was administered for the first 24 hours only, respiratory stimulation and softening (ripening) were retarded by at least a day. When AVG was added solely after the first 24 hours, ripening proceeded as in untreated discs, although climacteric ethylene and respiration were diminished. Propylene given together with AVG led to ripening under all circumstances. 2,5-Norbornadiene given continuously stimulated wound ethylene production, and it inhibited climacteric ethylene evolution, the augmentation of ethylene-forming enzyme activity normally associated with climacteric ethylene, and ripening. 2,5-Norbornadiene given at 24 hours fully inhibited ripening. When intact fruit were pulsed with ethylene for 24 hours before discs were prepared therefrom, the respiration rate, ethylene-forming enzyme activity buildup, and rate of ethylene production were all subsequently enhanced. The evidence suggests that ethylene is involved in all phases of disc ripening. In this view, wound ethylene in discs accelerates events that normally take place over an extended period throughout the lag phase in intact fruit, and climacteric ethylene serves the same ripening function in discs and intact fruit alike.

Journal Article↗
PubMed2004

A 12-week structured education and exercise program improved climacteric symptoms in middle-aged women.

In the present study, 40- to 60-year-old women with climacteric symptoms were placed on a 12-week structured education and exercise program to ascertain the effects of this program on climacteric symptoms, quality of life (QOL), and attitude towards exercise. A total of 35 women served as subjects. Twenty women were enrolled in an educational and exercise program that involved learning about menopause and participating in physical activity at least three times a week (Group E). For comparison, the other 15 women did not participate in this program and were instructed to refrain from exercising during study period (Group C). The effects of the 12-week interventional program on climacteric symptoms, QOL, and attitude towards exercise were thereby investigated. The program demonstrated significant effects on climacteric symptoms in terms of Kupperman index and psychosomatic symptoms, especially paresthesia and nervousness. In other words, climacteric symptoms improved significantly in Group E. Furthermore, scores for QOL and attitude towards exercise improved in Group E after the 12-week program; however, these trends did not reach statistical significance. Hence, the 12-week structured education and exercise program was shown to be effective in alleviating climacteric symptoms.

Adult↗
PubMed2003

Relationship between climacteric symptoms and serum serotonin levels in postmenopausal women.

OBJECTIVE: The aim of the study was to evaluate the possible relationship between climacteric symptoms and serum serotonin concentrations in postmenopausal women. MATERIALS AND METHODS: We studied 39 women who attended the Department of Gynecological Endocrinology in Poznan because of climacteric complaints. We evaluated climacteric symptom severity with the use of the Kupperman scale and we measured 17beta-estradiol, follicle stimulating hormone (FSH) and serotonin serum concentrations by radioimmunoassay. RESULTS: The mean serum serotonin concentration in the studied women was 48.9 ng/ml (standard deviation, SD +/- 24.1 ng/ml). The mean serum serotonin concentration in the group of patients with mild climacteric symptoms was 97.7 ng/ml (SD +/- 16.6 ng/ml), and in the group of patients with moderate and severe climacteric symptoms was 36.2 ng/ml (SD +/- 24.1 ng/ml). The difference between the two groups was statistically significant (Mann-Whitney test, p < 0.05). There was no difference in serum serotonin concentrations between patients with or without specific symptoms (Mann-Whitney test, p > 0.05). CONCLUSIONS: Serum serotonin concentrations in postmenopausal women are related to the severity of climacteric symptoms.

Adult↗
PubMed2003

[Relationship between climacteric symptoms and serum neuropeptide Y level in postmenopausal women].

UNLABELLED: The aim of this study was to determine circulating levels of neuropeptide Y (NPY) in postmenopausal women with climacteric symptoms in comparison with regularly menstruating women in reproductive age and to assess the relationship between serum NPY levels and the presence of climacteric symptoms in postmenopausal women. MATERIALS AND METHODS: We studied 41 postmenopausal patients attending the Clinic of Gynecological Endocrinology, University of Medical Sciences, Poznań because of climacteric complaints. The controls were 20 regularly menstruating women in reproductive age. In the study group the severity of climacteric symptoms was assessed using the Kupperman index. Serum 17 beta-estradiol, follicle stimulating hormone (FSH) and NPY concentrations were measured by radioimmunoassay in both groups. RESULTS: The mean value of the Kupperman index in the study group was 23.4 points (SD +/- 10.4 points); 17 beta-estradiol serum concentration was lower than 0.014 ng/ml in 30 women from the study group and the mean serum estradiol level for the remaining group was 0.023 ng/ml (SD +/- 0.03 ng/ml); the mean serum FSH concentration in the study group was 98.2 Ul/l (SD +/- 11.8 IU/l), the mean serum NPY concentration in the study group was 18.4 ng/ml (SD +/- 8.3 ng/ml). The mean serum NPY concentration in the control group was 12.9 ng/ml (SD +/- 6.3 ng/ml) and was lower than in the study group (t-test: p < 0.05). The difference between serum NPY concentration in patients with a particular climacteric symptom and patients without was not statistically significant for any symptom (t-test: p > 0.05). CONCLUSION: Serum NPY level is higher in postmenopausal women than regularly menstruating women in reproductive age an may be responsible for climacteric symptoms presence.

Adult↗
PubMed1991

How age conditions the relationship between climacteric status and health symptoms in African American women.

The purpose of this investigation was to evaluate the relationship between climacteric status and health symptoms across age cohorts in 522 African American women aged 25-75. Data were collected through home interviews and subjected to hierarchical regression analyses. In the overall sample a direct relationship was found between climacteric status and physical health symptoms but not mental health symptoms. A direct relationship between climacteric status and both physical and mental health symptoms was found for the younger age cohort 25-34. There was a direct relationship between climacteric status and physical health symptoms but not mental health symptoms for the 35-44 age cohort. The relationship between climacteric status and physical and mental health symptoms held despite controls for education, income, marital status, and body mass.

Adult↗
PubMed1990

Urinary excretion of prostacyclin and thromboxane metabolites in climacteric women: effect of estrogen-progestin replacement therapy.

To study the role of vasodilatory prostacyclin and vasoconstrictory thromboxane A2 in climacteric vascular instabilities, overnight urine samples were collected from sixteen women suffering from hot flushes and sweating before, during and after the six months' cyclic estradiol-desogestrel therapy as well as from ten non-climacteric control women. The urine was assayed for 6-keto-PGF1a and 2,3-dinor-6-keto-PGF1a (metabolites of prostacyclin) as well as for thromboxane B2 and 2,3-dinor-thromboxane B2 (metabolites of thromboxane A2) by means of HPLC and radioimmunoassay. No difference was seen in baseline prostaroid output between the climacteric and non-climacteric study groups. Furthermore, no relation was observed between individual prostanoid excretion and severity of vasomotor symptoms before replacement therapy. The replacement therapy abolished or markedly alleviated hot flushes and sweating, but prostanoid output did not change. Our data imply that climacteric symptoms are not accompanied by changes in the production of prostacyclin and thromboxane A2.

6-Ketoprostaglandin F1 alpha↗
PubMed1984

Vasoconstrictory thromboxane A2 and vasodilatory prostacyclin in climacteric women: effect of oestrogen-progestogen therapy.

The production of vasoconstrictory thromboxane A2 (TxA2) and vasodilatory prostacyclin ( PG2 ) was studied in women suffering from climacteric vascular instabilities before and during the oestrogen-progestogen therapy. The serum concentrations of TxB2, a metabolite of TxA2, in climacteric patients were similar (170.5 +/- 25.5 ng/ml, mean +/- SE, n = 14) to those in control subjects (196.0 +/- 27.5 ng/ml n = 17) before the start of treatment, but rose to 209.3 +/- 24.5 ng/ml after 3 wk of treatment (P less than 0.01 in comparison with the pre-treatment level), to 227.2 +/- 44.1 ng/ml after 3 mth (P less than 0.05) and to 237.4 +/- 30.3 ng/ml after 6 mth (P less than 0.05). The plasma concentrations of 6-keto-prostaglandin F1a , a stable breakdown product of PG2 , were normal in climacteric (43.5 +/- 7.3 pg/ml as against 46.1 +/- pg/ml) and did not change during replacement therapy. It was concluded, firstly, that climacteric symptoms are not accompanied by changes in TxA2/ PG2 which can be detected in peripheral blood and, secondly, that the increase in the concentration of vasoconstrictory TxA2 induced by oestrogen-progestogen therapy may contribute to the disappearance of climacteric vascular instabilities.

6-Ketoprostaglandin F1 alpha↗
PubMed1995

The climacteric, osteoporosis and hormone replacement; views of women aged 45-49.

We report climacteric symptoms among women aged 45-49, and their attitudes towards HRT and osteoporosis prevention. Semi-structured questionnaires were administered to 481 women attending for bone density screening after random invitation. We recorded social class, menopausal status, history of HRT exposure and climacteric symptoms, awareness of HRT and osteoporosis, and potential willingness to consider HRT before and after bone densitometry. In total, 294 (61%) were from non-manual social classes; 338 (70%) were premenopausal, 68 (14%) postmenopausal and 75 (16%) uncertain; 101 (21%) were current/previous HRT users. Three or more climacteric symptoms were experienced by 189 (56%) of premenopausal women, compared to 64 (94%) of postmenopausal women. Most women had heard of HRT (96%) and osteoporosis (84%), usually from women's magazines or friends. HRT was usually prescribed for climacteric symptoms and, in one case, for osteoporosis prevention. Side effects were reported with most HRT preparations and affected 38% of all users. Of the 380 (79%) women who had never taken HRT, half had concerns about such treatment, and few wanted it at the menopause. However, 364 (96%) said they would consider HRT if their bone scan suggested increased osteoporosis risk. In conclusion, women around the menopause experience considerable climacteric morbidity, but are often anxious about HRT use. Better health education might improve HRT uptake, while long-term compliance might be enhanced by disclosure of fracture risk.

Bone Density↗
PubMed1994

The climacteric of Chinese factory workers.

Chinese factory workers (427) mainly of Fujian origin were found to have few climacteric symptoms. Of these, 65% and 50% reported having no circulatory and nervosity symptoms, respectively. Only 18% of women experienced hot flushes. The climacteric symptoms were more pronounced at the perimenopausal period (P < 0.001) when these women experienced more irregular menstruation. Low socio-economic status and educational level did not have adverse effects on the symptom reporting. High parity and employment may be positive factors in this period of change of life. A majority of women (74%) felt that the climacteric and menopause is a natural process which caused them no concern. Of those who were still menstruating 80% did not anticipate that they would have problems with the climacteric and menopause. These women's different climacteric pattern could be related to their introspective abilities to cope adequately or in an impersonal manner.

Adult↗