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PubMed2005

The climacteric-like behaviour of young, mature and wounded citrus leaves.

Although leaves and other vegetative tissues are generally considered as non-climacteric, citrus leaves show a climacteric system II behaviour after detachment. Upon harvest, young, fully expanded 'Valencia' orange (Citrus sinensis) leaves ( approximately 60-d-old) exhibited two phases of ethylene production. The first phase, up to 6 d after detachment, was characterized by a low and constant ethylene production (system I pathway), associated with a constitutive expression of ACC synthase 2 (CsACS2), CsERS1, and CsETR1. ACC synthase 1 (CsACS1) was not expressed during this phase and autoinhibition of ethylene production was apparent following treatment with exogenous ethylene or propylene. The second phase, 7-12 d after detachment, was characterized by a climacteric rise in ethylene production, preceded by the induction of CsACS1 and ACC oxidase 1 (CsACO1) gene expression in the system II pathway. This induction was accelerated and augmented by exogenous ethylene or propylene, indicating an autocatalytic system II ethylene biosynthesis. Mature leaves (6-8-months-old) behaved similarly, except that the climacteric peak in ethylene production occurred earlier (day 5). Young and mature leaves varied in the timing of the climacteric ethylene rise and CsACS1 and CsACO1 induction. The two phases of ethylene production, system I and system II, were also detected in wounded leaf discs of both young and mature leaves. The first phase peaked 15 min after excision and the second phase peaked after 6 h.

Blotting, Northern↗
PubMed1970

The ribosomes of pear fruit. Their synthesis during the climacteric and the age-related compensatory response to ionizing radiation.

Maceration at liquid nitrogen temperatures, use of poly-vinylpyrrolidone, and careful pH control are essential to the isolation of ribosomes and polysomes from deciduous fruit tissue. Characteristics of the ribosomes and constituent RNA are described. The distribution of ribosomes among monomer and polymer forms remains relatively constant until fruit reach the climacteric peak, after which there is a notable decline in the polymeric forms. In contrast to the relative stability in size distribution there is a marked change in ribosomal turnover during the climacteric rise. A transitory increase in rate of ribosomal synthesis is followed by a rapid decline coincident with the final portion of the climacteric rise. No incorporation of radioactive base into ribosomes could be detected once fruit had reached the climacteric peak.Coincidence of radioactivity with the ribosomal RNA on methylated albumin-Kieselguhr chromatograms and complete inhibition of ribosomal RNA synthesis by actinomycin D confirm that radioactive nucleotide was incorporated into newly synthesized ribosomes. Data are presented to distinguish between a cellular response to injury, as may result from the preparation of tissue slices, and the effects of physiological age. Superimposed intracellular radiation injury stimulates the synthesis of new ribosomes and underscores a major transition in the dynamics of the ribosomal system coincident with the climacteric rise.

Aging↗
PubMed2005

Vaginal ring delivering estradiol and progesterone: a possible alternative to relieve climacteric symptoms.

BACKGROUND: Relief of climacteric symptoms is currently the main role of hormone therapy. However, vaginal bleeding complicating this therapy is among the leading causes for its early discontinuation. OBJECTIVES: To assess the effect of a vaginal ring delivering estradiol and progesterone in postmenopausal women and to determine whether continuous administration can relieve climacteric symptoms, produce an acceptable pattern of vaginal bleeding and control endometrial proliferation. METHODS: Twenty-nine postmenopausal women with an intact uterus were studied. All had climacteric symptoms. The vaginal rings contained 0.36 g estradiol and either 3.6 g progesterone (high dose progesterone) or 1.8 g (low dose progesterone), and were kept in place for 4-6 months. Serum progesterone, estradiol and estrone were measured and endometrial thickness determined. All women kept a daily diary of bleeding/spotting and completed a questionnaire on climacteric symptoms at monthly intervals. The low dose progesterone group comprised 14 women and the high dose progesterone group 15 women. RESULTS: A total of 18 patients (9 in each group) completed the study. Mean levels of estradiol, estrone and progesterone were at their peak after 2 to 4 weeks. All rings were effective in alleviating vasomotor symptoms, although there was evidence of "escape from effect" in month 6. Endometrial thickness increased in 6 of the 29 women but biopsy in each case showed no evidence of hyperplasia. Of the 18 women who completed the study, 5 had amenorrhea throughout, 7 had amenorrhea after 3 months, and the remainder had one or two bleeding episodes after 3 months. Therapy was discontinued in 11 women. CONCLUSIONS: A vaginal ring delivering estradiol and progesterone controlled climacteric symptoms, prevented endometrial proliferation, and provided an acceptable bleeding pattern. It should be viewed as a possible alternative for short-term estrogen-progesterone therapy.

Adult↗
PubMed2004

Effects of isoflavone supplements on bone metabolic markers and climacteric symptoms in Japanese women.

A double-blind, placebo-controlled crossover study on the effects of 40~mg/d isoflavone supplements was carried out by 58 climacteric Japanese women. A questionnaire and an interview concerning climacteric symptoms, health status, dietary and exercise habit, and medical history were carried out, and the physical check-up and biochemical tests including sex-hormone analysis were made at baseline and after 4 and 8 weeks of treatment. Urinary isoflavones were separately measured from the frozen samples. Isoflavone treatment did not cause any adverse effects on anthropometric measures or blood chemistry. Urinary deoxypyridinoline, a marker of bone resorption decreased significantly with isoflavone treatment. This tendency was remarkable among equol producers. Plasma osteocalcin and bone mineral density did not change by the four-weeks treatment. As for climacteric symptoms, hot flash decreased significantly. Systolic and diastolic blood pressure of hypertensive participants decreased significantly after isoflavone treatment compared with baseline and the placebo treatment. Isoflavone supplementation offers benefits to reduce effectively on bone resorption enhanced by menopause. The treatment also showed an improvement of climacteric hot flash and hypertension. Equol producers showed better results.

Adult↗
PubMed2005

[Effect of compound recipe Gengniankang on senile sexual hormone and expression of estrogen receptor in bone of climacteric female rats].

OBJECTIVE: To compare the therapeutic effect of Compound Recipe Gengniankang ( GNK) with that of hormone replacement treatment (HRT) on climacteric female rats with osteoporosis, and to investigate the roles of estrogen and estrogen receptors in the mechanism of osteoporosis. METHODS: Climacteric female rats with osteoporosis were chosen and divided into three groups (GNK group, HRT group and control group). Apoptosis of ovarian granulose cells was measured by terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) assay. Serum level of estradiol (E(2)), follicle stimulating hormone (FSH), luteinizing hormone (LH) were determined by the method of radioimmunoassay (RIA). Reverse transcriptase polymerase chain reaction (RT-PCT) technology was used to evaluate the expression of estrogen receptor (ER) in bone. Bone mineral density (BMD) was measured by double energy X-ray absorption (DEXA). RESULTS: In the climacteric rats, BMD, serum E(2), ER mRNA expression in bone decreased remarkably, and serum FSH, LH and apoptosis of ovarian granulose cells increased obviously. After treating with GNK, all the indexes were reversed except serum E(2). The increase of E(2) was not significant. CONCLUSION: GNK is effective on climacteric osteoporosis female rats. Its role is performed not by increasing serum E(2) but by enhancing ER in the bone and inhibiting apoptosis of ovarian granulose cells. GNK can deter further exhaustion of ovarian function.

Age Factors↗
PubMed1980

The use of medroxyprogesterone acetate for relief of climacteric symptoms.

Climacteric symptoms in the menopausal woman are perplexing to the physician. Recent literature concerning the relationship of estrogen to carcinogenesis has caused many women to discontinue this medication; thus, there is a need for an alternative therapy for the relief of these symptoms. The drug medroxyprogesterone acetate (Depo-Provera) was assessed in a double-blind, randomized, placebo-controlled study involving 48 subjects. Only one of the placebo-treated patients claimed any relief from climacteric symptoms while only two of the patients who received the study drug noted little or no relief (P < 0.0001). Relief from climacteric symptoms began at 4 to 7 days after entry into the study and extended for 8 to 20 weeks. The only side effects were withdrawal bleeding and a slight, transient weight gain. Depo-Provera appears to be a reliable substitute for estrogen in the treatment of climacteric symptoms. Further investigations with this medication seem indicated.

Adult↗
PubMed1993

Dutch general practitioners' attitudes towards the climacteric and its treatment.

In order to obtain insight into general practitioners' (GPs) point of view regarding climacteric problems and possible treatment, a survey was conducted among 195 GPs in the Limburg Province in the Netherlands. Ultimately, 159 GPs participated (response-rate 82%). The GPs were either members of the Society for the Improvement of the Expertise of GPs, or filled out the questionnaire previous to participation in a medical training course. The climacteric and its typically related complaints were generally well recognized by the surveyed GPs. Ninety-five percent of the GPs were of the opinion that women with climacteric complaints need some kind of medical help, and 62% were found to prescribe medication, mainly hormone replacement therapy (HRT). Remarkably, 75% of all GPs were of the opinion that prescribing HRT for climacteric complaints is a form of medicalization. Twelve percent of the GPs stated they never prescribe HRT for solely preventive purposes. In case of preventive treatment merely 32% of the GPs prescribed HRT for a period longer than 5 years.

Adult↗
PubMed1996

The climacteric in The Netherlands: a review of Dutch studies on epidemiology, attitudes and use of hormone replacement therapy.

The climacteric has been the subject of research in the Netherlands for several decades. The incidence of climacteric symptoms has not changed since the pioneerwork of Jaszmann in 1967; nevertheless the number of contacts with a physician decreased by a factor of three during the 1970s and early 1980s. A rise in the number of contacts has occurred since 1987-1988 and nowadays the same number is reached as was 20 years ago. In 1970 psychopharmacons were the first choice of therapy. Nowadays 90% of the prescriptions for climacteric complaints are hormones. Twelve percent of women aged 45-60 years are current users of HRT. The mean duration of HRT use is only 7 months. The positive attitude of most women towards the climacteric is an explanation for this very short duration of use. Women receive their information on HRT use mainly through women's magazines and TV programmes and not through physicians. The determinants of longer duration of use are a positive attitude to treatment, younger age and the support of the GP. Physicians claim that they prescribe progestogens for 51% of oestrogen users, but the data give a figure of only 20% of prescription of progestogens with oestrogens. One explanation for this difference is the practice of many doctors to prescribe progestogens only once in 3 months.

Attitude↗
PubMed1985

Climacteric in women: an evolutionary defect?

This is a theoretical paper. Climacteric in women has two basic consequences: (i) Sterility, which is interpreted here as a positive feature, because it protects the older woman from the hardships of pregnancy. (ii) Hormonal deficiency, which is interpreted here as a negative feature, because it leads to deleterious changes in various parts of the body. Can these negative features be regarded as evolutionary defects? The answer is no, if the following points are considered. Through human innovations, women's natural lifespan of less than 30 years has been extended to almost 80 years. Had the lifespan not been manipulated, most women would not reach climacteric, which normally does not begin before the fourth decade of life. When interpreting climacteric as a phenomenon precipitated by man rather then by Nature, it follows that the negative features of climacteric should not be regarded as evolutionary defects.

Adult↗
PubMed1981

On the calculation of climacteric symptoms.

Survey techniques, which are widely used to estimate the prevalence of climacteric symptoms, are generally unable to distinguish symptoms which relate to physiological changes from those which may be attributable to other factors. New data collection techniques developed in a study of menopause among a group of American Indians are reported here, which permit the evaluation of the cause of the reported symptoms. Two classes of complaints were than calculated: "gross" symptoms and "climacteric" symptoms. It was found that differences between prevalence, as estimated by the two classes of complaints, were smallest for vasomotor symptoms and greatest for psychological complaints, reflecting presumed physiological relationships. Further, climacteric-related symptoms demonstrated a clearer relationship to factors hypothesized by other researchers as affecting the experience of climacteric symptoms. While not feasible for all studies, these techniques demonstrate that more accurate estimates of symptom experience are possible.

Climacteric↗
PubMed1994

A study on the use of medication for climacteric complaints in western Europe--II.

Samples of about 300 women aged 40-69 were interviewed in Denmark and the Netherlands about consultations with a physician for climacteric complaints, awareness regarding the menopause and hormone replacement therapy (HRT), and use of medication. Twenty percent of Danish and 13% of Dutch respondents had consulted a physician. Fifty percent of Danish and 16% of Dutch respondents were informed about the menopause, and 46% of Danish and 10% of Dutch respondents were informed about HRT, the mass media being the most important information source. In Denmark and the Netherlands HRT use rates were 12% and 4%, respectively, those for non-hormonal treatment being 6% and 2%, and for tranquillizers 11% and 7%. Pooling of the data with those from a similar study conducted in Italy, the United Kingdom, West Germany and France [6] revealed that consultation for climacteric complaints was a universal phenomenon in all six countries which correlated mainly with perimenopausal status. Awareness of the menopause and HRT, and actual use of HRT were predominantly associated with the individual countries. These findings suggest that HRT prescription and use for climacteric complaints depend greatly on country-specific reservations about HRT among both physicians and women. Surprisingly, these appeared more prevalent in the countries where GPs played a predominant role in climacteric counselling.

Adult↗
PubMed1994

Climacteric Filipino women: a preliminary survey in the Philippines.

In a survey of 500 Filipino women aged 40-50 years, of various professions and residing mostly in Metropolitan Manila, the average age of menopause was estimated at 48 years. The climacteric symptoms were seen to affect 83% of the respondents. Sixty-three percent reported menopause-related circulatory or vasomotor disorders and 79% mentioned psychological disorders. The incidence and frequency of climacteric symptoms were highest among the perimenopausals. Headache was the most common climacteric symptom, while the hot flush was the least prevalent. Only 31% consulted a physician for menopause-related ailments. Eighty-six percent of those who consulted were prescribed medication, however, only 52% of these followed the prescription. Eleven percent reported dyspareunia and only 36% consulted a doctor. Thirty-one percent suffered from urinary stress incontinence and only 16% consulted a doctor. The findings of this study suggest that the average Filipino woman has an attitude of forbearance towards the climacteric syndrome. This attitude is shaped by her Asian culture and Third World circumstances.

Adult↗
PubMed2006

The basal and TRH stimulated levels of prolactin in low risk climacteric patients with increased breast density: a matched pair case control trial.

OBJECTIVE: To detect any significant alteration of basal and TRH stimulated circulating prolactin levels in those with an extremely dense breast composition as compared to ones with a fatty pattern in mammography in climacteric patients with a low risk probability for developing invasive breast cancer within five years according to a validated risk model. MATERIALS AND METHOD: In this matched pairs case-control trial a total of 67 climacteric patients with an extremely dense breast composition were compared to a control group of 71 climacteric patients with an almost entirely fat pattern composition in terms of basal and TRH stimulated circulating prolactin levels. All participants in the study had an estimated 5 years breast cancer risk less than 1.67% according to the validated model of Gail. Subgroup analysis was done according to menopausal status (premenopausal versus postmenopausal) and according to the hormone replacement therapy (HRT) in postmenopausal patients (current users of HRT versus never used HRT). RESULTS: We did not detect any statistically relevant differences between groups or subgroups in terms of basal, stimulated and Delta levels (stimulated-basal) of prolactin (ng/ml). The differences between groups of extremely dense composition versus almost fatty pattern in terms of DeltaPRL (ng/ml) (+/-S.D.) were not statistically significant (68.1+/-34.5 versus 69.1+/-43.0; unpaired t test, Welch corrected p=0.88, 95% CI -12.1 to 14.0). CONCLUSION: Our results do not suggest a contribution of circulating prolactin to increased mammographic density in climacteric patients with low risk probability to develop breast cancer. A study of similar kind is warranted in high risk patients.

Breast↗
PubMed2004

A longitudinal population study of climacteric symptoms and their treatment in a random sample of Swedish women.

OBJECTIVES: To assess, first, the prevalence and severity of symptoms associated with the climacteric period and their treatment and, second, the prevalence of exercise, smoking and body weight in a population-based sample of Swedish women. MATERIAL AND METHODS: Prospective, longitudinal cohort study, initiated in 1992, in women aged 46, 50, 54, 58 and 62 years with a follow-up 6 years later. Information was obtained from the same women (n=3816) on both occasions using a postal questionnaire regarding sociodemographic variables, general and reproductive health, the occurrence of climacteric symptoms and their severity, and the use of hormone replacement therapy (HRT). RESULTS: The prevalences of climacteric symptoms were as follows (1992/1998): vasomotor symptoms, 52%/62%; depression/irritability, 57%/65%; sleeping disturbances, 51%/69%; muscle/joint pain, 55%/70%; and loss of libido, 38%/57%. HRT with medium-potency estrogens was currently being used by 34% (1992: 14%), and 12% (1992: 8%) were using low-potency estrogens. The maximum prevalence of HRT (medium-potency estrogens) use was found in the 56-year-old group, at 46% (1992: 25% in the 54-year-old group). Body mass for the whole group had increased from 66.3 to 68.9 kg. Exercise was more frequent in all age groups in 1998 compared to 1992. There was a decrease in current smokers from 32 to 26% between the two periods. Compared with 1992, the women in all five birth cohorts considered themselves to be less healthy and quality of life had decreased for the whole group. CONCLUSIONS: The prevalence of symptoms associated with the climacteric period and the use of HRT had increased markedly in this longitudinal study of the same women followed between 1992 and 1998. During the same period, smoking decreased, while body weight and exercise frequency increased.

Age Distribution↗
PubMed2006

Climacteric symptoms among Japanese women and men: comparison of four symptom checklists.

OBJECTIVES: To explore whether Japanese kōnenki (climacteric) symptoms are unique to women or are experienced by men, to compare common symptom indices, and to explore the relationship between symptoms and soy intake. METHODS: Two-week recall of 54 symptoms, an eight-item food frequency questionnaire, and views about kōnenki were collected from 60 individuals in Kanazawa, Japan. Factor analysis identified kōnenki-associated symptom groupings; Blatt-Kupperman, Simplified Menopausal Index, Lock, and Kanazawa symptom scores were calculated; and sex and kōnenki status differences were tested. RESULTS: Thirty-two women and 22 men (mean age 48.7 years) provided complete questionnaires. Although males had higher prevalence of stress, irritability, and nervousness (p < 0.05), no men reported having kōnenki. Four of eight female symptom factors exhibited significant correlations with kōnenki status. All symptom index scores were lower in pre-kōnenki women than in peri-kōnenki women, but scores for men and women did not differ. Soy intake and Lock score were negatively correlated among women. CONCLUSIONS: Several symptoms commonly associated with kōnenki in Japan are not unique to women and have higher prevalence in men. Inclusion of men in climacteric studies may permit identification of male climacteric symptoms and assessment of the specificity of many typical female climacteric symptoms, thus refining and standardizing symptom checklists.

Adult↗
PubMed2006

Black cohosh and St. John's wort for climacteric complaints: a randomized trial.

OBJECTIVE: To investigate the efficacy of the fixed combination of black cohosh (Cimicifuga racemosa) and St. John's wort (Hypericum perforatum) extracts in women with climacteric complaints with a pronounced psychological component. METHODS: In this double-blind randomized placebo-control study, 301 women experiencing climacteric complaints with psychological symptoms were treated with ethanolic St. John's wort extract and isopropanolic black cohosh extract or a matched placebo for 16 weeks. Climacteric complaints were evaluated by means of the Menopause Rating Scale mean score, and psychological complaints were evaluated using the Hamilton Depression Rating Scale sum score. RESULTS: The mean (+/- standard deviation) Menopause Rating Scale score decreased 50% (0.46 +/- 0.13 to 0.23 +/- 0.13) in the treatment group and 19.6% (0.46 +/- 0.14 to 0.37 +/- 0.15) in the placebo group. The Hamilton Depression Rating Scale total score decreased 41.8% in the treatment group (18.9 +/- 2.2 to 11.0 +/- 3.8 points), and 12.7% in the placebo group (18.9 +/- 2.1 to 16.5 +/- 4.3). The treatment was significantly (P < .001) superior to placebo in both measures. There were no relevant group differences regarding adverse events, laboratory values, or tolerability. CONCLUSION: This fixed combination of black cohosh and St. John's wort is superior to placebo in alleviating climacteric complaints, including the related psychological component. LEVEL OF EVIDENCE: I.

Adult↗
PubMed1996

Is irregular regression of corpora lutea in climacteric women caused by age-induced alterations in the "tissue control system"?

PROBLEM: We have recently observed that the regression of corpora lutea (CL) in women during the reproductive period of life is accompanied by a diminution of Thy-1 differentiation protein release from vascular pericytes and an accumulation of T lymphocytes and activated macrophages among both degenerating granulosa lutein cells (GLC) and theca lutein cells. These data suggest that the immune system and other stromal factors, representing components of the "tissue control system," may play a role in regression of the CL. We investigated degenerating CL from climacteric women to address the possibility that the decline of immune functions with advancing age may result in incomplete regression of luteal tissue. This could contribute to the altered hormonal profiles and abnormal uterine bleeding that frequently occur during the climacteric. METHOD: Immunoperoxidase staining and image analysis were used to localize Thy-1 differentiation protein of vascular pericytes, cytokeratin staining of GLC, neural cell adhesion molecule expression by theca lutein cells, CD15 of neutrophils, CD4, CD14, CD68, and leukocyte common antigens of macrophages, and CD3 and CD8 determinants of T lymphocytes. We also investigated the expression of luteinizing hormone receptor (LH receptor) and mitogen activated protein kinases (MAP kinases) in luteal cells. Samples of regressing luteal tissue were obtained during the follicular phase from perimenopausal women (age 45-50) who exhibited prolonged or irregular cycles. For comparison, luteal tissues from women with regular cycles (age 29-45) and CL of pregnancy were also investigated. RESULTS: Corpora lutea of the climacteric women exhibited irregular regression of luteal tissue characterized by a lack of cytoplasmic vacuolization and nuclear pyknosis in GLC, and by a persistence of theca lutein cells exhibiting hyperplasia and adjacent theca externa layers. This was accompanied by a continuing release of Thy-1 differentiation protein from vascular pericytes. Persisting GLC lacked surface expression of macrophage markers (CD4, CD14, CD68 and leukocyte common antigen) as well as nuclear granules exhibiting CD15 of neutrophils, detected in regularly regressing GLC. In addition, such persisting GLC showed weak or no LH receptor expression, and retained the expression of cytokeratin. They also exhibited enhanced staining for MAP kinases. Strong cytoplasmic MAP kinase expression with occasional nuclear translocation was also detected in persisting theca lutein cells, indicating high metabolic activity of these cells. T lymphocytes, although occasionally present in luteal stroma within luteal convolutions, did not invade among persisting GLC and were virtually absent from layers of theca externa and theca lutein cells. CONCLUSIONS: These data indicate that the regressing CL in climacteric women may exhibit persistence of luteal cells, perhaps because of age-induced alterations of the immune system and other local stromal homeostatic mechanisms involved in the elimination of luteal cells. Persisting GLC and/or theca lutein cells may exhibit abnormal hormonal secretion that contributes to the alteration of target tissues, such as the endometrium, resulting in abnormal uterine bleeding, hyperplasia, and neoplasia.

Adult↗
PubMed2000

Stress vulnerability and climacteric symptoms: life events, coping behavior, and severity of symptoms.

To explore a possible association between climacteric symptoms and ways of coping with stress, a comparative study was conducted among 19 menopausal women who sought treatment for climacteric symptoms (the study group) and 44 healthy menopausal women (the control group). Life stress was assessed using a life event method in which factor analysis extracted four ways that women cope with stress: avoidance-oriented coping, consultation-oriented coping, aggression-expression coping, and problem-solving coping. The study group had a higher symptom score and was more prone to avoidance-oriented coping than the control group despite experiencing the same number of undesirable life events. The severity of climacteric symptoms correlated positively with the number of undesirable life events and the degree of avoidance-oriented coping and correlated negatively with the degree of aggression- expression coping for the study group. These results suggest that vulnerability to stress contributes to worsening climacteric symptoms caused by stress.

Adaptation, Psychological↗