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PubMed1993

[Three case reports of the use of stellate ganglion block for the climacteric psychosis].

There are many reports of the use of stellate ganglion block (SGB) for the climacteric psychosis, which is considered to be sympathicotonic response to stress. We experienced three cases of the SGB therapy for the climacteric psychosis. We performed SGB three times per week by 1% lidocaine 5 ml, and observed improvements of the symptoms after doing SGB for five times. The patients reported psychological relaxation after receiving SGB therapy. We examined the changes of the serum concentrations of ACTH, LH, FSH, and catecholamines (epinephrine, norepinephrine) before and after SGB in 8 patients who were suffering from climacteric psychosis, because we wanted to know the endocrinological response to SGB. We observed a significant decrease in norepinephrine concentration after SGB, which is reasonable considering the sympathetic blockage. There were no significant changes of ACTH, LH, FSH, and epinephrine. We conclude that SGB therapy must be effective for the climacteric psychosis because of sympathetic blockade. But we could not clarify the influence of endocrinological response to SGB.

Aged↗
PubMed1995

Trazodone: a non-hormonal alternative for neurovegetative climacteric symptoms.

Hormone replacement therapy (HRT) is the treatment of choice for neurovegetative climacteric symptoms. In some women, however, HRT may either be contraindicated, or the patients themselves may prefer a non-hormonal form of treatment. Trazodone is a drug that acts a weak, but specific, inhibitor of the uptake of 3H-serotonin and is generally used for its antidepressant effects. In this study we have observed the efficacy of oral Trazodone (75 mg/day) in the treatment of the climacteric symptoms in 25 menopausal patients recruited at the Menopause Clinic of Ferrara University Hospital. The symptoms were scored from 0 to 3 according to presence and intensity. The patients were all complaining of climacteric neurovegetative symptoms (average symptom score 2.43). Symptoms scores were recorded before starting treatment and then again after 3 months. The appeared to be particularly effective on the intensity of anxiety (OR: 0.08, CI: 0-0.080), insomnia (OR: 0.15, CI: 0.02-0.71), and irritability (OR: 0.29, CI: 0.04-1.48). The intensity of hot flushes appeared reduced but was not statistically significant (OR: 0.52, CI: 0.08-1.87). However, the average total score of symptoms appearing in the Kupperman scale was reduced (-14%) after treatment. Trazodone should be kept in mind as a possible alternative to HRT. This drug can be particularly useful for those patients whose climacteric symptoms have a marked connotation of anxiety rather than for hot flushes or when HRT are contraindicated.

Anti-Anxiety Agents↗
PubMed1984

Plasma androstenedione and oestrone levels in the climacteric syndrome.

Plasma androstenedione (A) and oestrone (E1) levels were measured by radioimmunoassay in a group of 78 healthy women who had undergone a natural menopause. Of this total, 23 were symptomless (Group 1), 39 presented with a moderate climacteric syndrome (Group 2) and 16 had a severe climacteric syndrome (Group 3). The average body weight was found to be significantly higher in Groups 2 (P less than 0.01) and 3 (P less than 0.05), than in Group 1, but the age distribution and number of years since the menopause were similar in all three groups. Nevertheless, significantly lower levels of A (0.75 +/- 0.06 ng/ml, P less than 0.01, in Group 2; 0.24 +/- 0.05 ng/ml, P less than 0.001, in Group 3) and E1 (20.80 +/- 2.18 pg/ml, P less than 0.05, in Group 2; 12.22 +/- 1.65 pg/ml, P less than 0.001, in Group 3) were observed in the women with climacteric symptoms than in those with no symptoms (A = 1.08 +/- 0.08 ng/ml, E1 = 27.73 +/- 2.22 pg/ml in Group 1). Since, after the menopause, the concentrations of A and E1 in the plasma represent the most important source of oestrogens, these results suggest that climacteric symptoms are related to oestrogen deficiency which is secondary to low A production.

Aged↗
PubMed2001

Climacteric vasomotor symptoms do not predict nocturnal breathing abnormalities in postmenopausal women.

OBJECTIVE: To study the association of climacteric vasomotor symptoms and nocturnal breathing abnormalities in a sample of healthy postmenopausal women. METHODS: Out of 71 postmenopausal women who took part in a large sleep study, 65 women were included into the present study. Sleep was monitored with polysomnography and nocturnal breathing with a static-charge sensitive bed and a pulse oximeter. Climacteric vasomotor symptoms were scored daily for 14 days and levels of oestradiol and FSH were measured in the serum. RESULTS: Altogether 21 (32.3%) women had some degree of breathing abnormalities during the study night. The occurrence of clinically significant sleep apnoea was low (1.5%) and of moderate type (OP-2). In contrast, increased respiratory resistance pattern, typical for partial upper airway obstruction, was frequent (16.9%). Seventy-eight per cent of the women had arterial oxyhaemoglobin desaturation events, but only in 4.6% of the women these events occurred more than 5 times/h of time in bed. Older women had more simple periodic breathing (P-1) and lower mean arterial oxyhaemoglobin saturation (SaO(2)). Body mass index (BMI) correlated with the apnoea frequency (OP-2) and inversely with the mean SaO(2). The severity of climacteric vasomotor symptoms or serum oestradiol concentration did not correlate with nocturnal breathing abnormalities. CONCLUSIONS: Nocturnal breathing abnormalities, especially partial upper airway obstruction, are common in postmenopausal women, but climacteric vasomotor symptoms do not predict their occurrence or severity. Increasing age and high BMI are important determinants of nocturnal breathing abnormalities.

Age Factors↗
PubMed2003

Climacteric symptoms and knowledge about hormone replacement therapy among Hong Kong Chinese women aged 40-60 years.

OBJECTIVES: To evaluate the use of hormone replacement therapy (HRT), the prevalence of climacteric symptoms, and the knowledge about HRT. METHODS: A prospective study was conducted by telephone interview among a randomly selected population-based sample of 978 Hong Kong Chinese women aged 40-60 years. RESULTS: Of 414 women with a history of either natural or surgical menopause, 22 (5.3%) and 17 (4.1%), respectively, were either past or current users of HRT. The climacteric symptom scores of premenopausal women were significantly lower than those of perimenopausal women, but were comparable with those of postmenopausal women. The commonest climacteric symptom was 'muscle and joint pains' which was reported in 553 (56.6%) women, while only 228 (23.3%) and 151 (15.4%) women reported hot flushes and night sweating, respectively. Moreover, only 230 (23.5%) women realized that HRT could relieve menopausal symptoms and only 33 (3.4%) women were aware that HRT was protective against osteoporosis. In general, women with more climacteric symptoms, who had ever used HRT, and those with higher education level and higher family income, had better knowledge about HRT. CONCLUSIONS: Postmenopausal Hong Kong Chinese women have a low HRT usage rate and the majority of them are lacking of the knowledge about HRT.

Adult↗
PubMed2003

What do women think about menopause? A qualitative study of women's expectations, apprehensions and knowledge about the climacteric period.

AIM: To identify and describe expectations, apprehensions and knowledge about the menopausal period and climacteric symptoms. METHOD: Data were collected by semi-structured interviews/discussions with a convenience sample of 39 women, all 47 years of age. Data interpretation and analysis were based on content analysis, but influenced by a qualitative approach. FINDINGS: These included women's expectations and feelings of freedom. Apprehensions were described as different climacteric symptoms, which were well known to the women through their own or other's experiences. The women were, to some extent, aware of the physical and psychological changes that follow the menopause. However, the women lacked knowledge about these changes or self-care activities that could prevent problems or mitigate symptoms. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Discussions on health with premenopausal women can increase their knowledge about a natural phase of life, the climacteric period. The study showed that nurses/midwives who have regular contact with some women during their life have an important role to play in providing information, as well as in the treatment of climacteric symptoms.

Anxiety↗
PubMedDate not supplied

Efficacy of citalopram on climacteric symptoms.

OBJECTIVE: The aim of this study was to evaluate the efficacy of citalopram for climacteric symptoms and to assess the combined effect of citalopram and hormone therapy (HT) on climacteric symptoms in women inadequately responsive to HT alone. DESIGN: The study included 100 postmenopausal women who were allocated into one of four groups: (1) citalopram, (2) placebo, (3) citalopram+HT, or (4) placebo+HT. The women who were unable or unwilling to take HT were randomly placed in groups 1 and 2. The women who were inadequately responsive to HT were randomly placed in groups 3 and 4. The initial dose of citalopram was 10 mg/day in groups 1 and 3. After 1 week, the dose was increased to 20 mg/day. After starting the medication, follow-up visits took place during the fourth and eighth weeks of treatment. During the first and eighth weeks, women completed two questionnaires: a modified Kupperman index and the Menopause-Specific Quality of Life Questionnaire. RESULTS: Mean hot flash scores significantly improved in all groups (P<0.05). The reduction rates were 37% in group 1, 13% in group 2, 50% in group 3, and 14% in group 4. Psychosocial complaints and mean values on the Kupperman index significantly decreased in all groups (P<0.05). Physical well-being significantly improved in groups 1, 3, and 4 (P<0.05). The decrease in all scores was significantly greater in groups 1 and 3 compared to groups 2 and 4 (P<0.01). CONCLUSION: Citalopram is an effective alternative treatment option for patients who do not want to take HT for the alleviation of climacteric symptoms. Adjuvant treatment with a selective serotonin reuptake inhibitor increases the effectiveness of HT for the treatment of climacteric symptoms in women who had responded inadequately to HT.

Citalopram↗
PubMed1971

The climacteric in ripening tomato fruit.

Phosphofructokinase is identified as the regulator reaction activated at the onset of the climacteric rise in respiration of the ripening tomato fruit (Lycopersicon esculentum Mill). The concentration of ATP in the fruit increases to a maximum value after the climacteric peak of respiration is past. Orthophosphate is proposed as the most probable activator of phosphofructokinase in the ripening fruit.Fifteen hours after infiltrating tomato fruit with orthophosphate, the rate of respiration increased and remained high until the end of the experiment, 45 hours after infiltration. In experiments where tomato plants were grown at various nutrient levels of P, the rate of respiration when fruit harvested at the mature-green stage reached the respiratory climacteric was correlated with the concentration of orthophosphate in the fruit at the end of the experiment. These results are consistent with the hypothesis that stimulation of phosphofructokinase through increasing concentration of orthophosphate in the cytoplasm of the fruit contributes to the climacteric rise in respiration.

Journal Article↗
PubMed1991

Glycolysis at the climacteric of bananas.

This work was carried out to investigate the relative roles of phosphofructokinase and pyrophosphate-fructose-6-phosphate 1-phosphotransferase during the increased glycolysis at the climacteric in ripening bananas (Musa cavendishii Lamb ex Paxton). Fruit were ripened in the dark in a continuous stream of air in the absence of ethylene. CO2 production, the contents of glucose 6-phosphate, fructose 6-phosphate, fructose 1,6-bisphosphate, phosphoenolpyruvate and PPi; and the maximum catalytic activities of pyrophosphate-fructose-6-phosphate 1-phosphotransferase, 6-phosphofructokinase, pyruvate kinase and phosphoenolpyruvate carboxylase were measured over a 12-day period that included the climacteric. Cytosolic fructose-1,6- bisphosphatase could not be detected in extracts of climacteric fruit. The peak of CO2 production was preceded by a threefold rise in phosphofructokinase, and accompanied by falls in fructose 6-phosphate and glucose 6-phosphate, and a rise in fructose 1,6-bisphosphate. No change in pyrophosphate-fructose-6-phosphate 1-phosphotransferase or pyrophosphate was found. It is argued that phosphofructokinase is primarily responsible for the increased entry of fructose 6-phosphate into glycolysis at the climacteric.

Carbon Dioxide↗
PubMed2003

[Influencing factors of climacteric women's depression].

PURPOSE: This study was conducted to define the main factors influencing depression of climacteric women. METHOD: The data was analyzed using a SAS 6.12 PC+ program for descriptive statistics, Pearson correlation coefficients and stepwise multiple regression. Two hundred seventy climacteric women between 40 and 59 years old were recruited from 6 areas in Korea from Oct. 5, 2002 to Dec. 13, 2002. The reliability of the 7 instruments were tested with Cronbach's alpha which ranged from.82 to.95. RESULT: The results were as follows : The mean depression score was 14.17, which was slightly high. The depression was influenced significantly by occupation, economic status, and menopause status. There were significant correlations between all the predictive variables and the depression(r=.73~ -.17, p <.05). Stepwise multiple regression analysis showed that 59% of the variance in depression was significantly accounted by stress(53%), climacteric symptoms(3%), marital adjustment (2%), and health promotion behavior(1%). CONCLUSION: In reducing the climacteric women's depression, the above major influencing factors should be considered.

English Abstract↗
PubMed2005

[Clinical study of recombinant human growth hormone for male climacteric syndrome].

OBJECTIVE: To evaluate the effect and safety of the recombinant human growth hormone (rhGH) in the treatment of male climacteric syndrome and to investigate the specificity and sensitivity of insulin-like growth factor-1 (IGF-1) and serum total testosterone as the curative effect index. METHODS: Forty patients aged 40-75 with male climacteric syndrome were divided into two groups randomly and injected with rhGH 4 IU (Group A) or 8 IU (Group B). The patients were followed up for about 12 weeks after 12-week treatment and then asked the questions of the assessed index of male climacteric syndrome at the 4th, 8th and 12th week of the treatment and 12 weeks after the treatment. The serum IGF-1, total testosterone (TT) and prostatic specific antigen(PSA) were measured before and after the treatment. The data were analysed by the software of SPSS 12.0 for Windows. RESULTS: The scores of the 4th, 8th and 12th week and the follow-up significantly declined compared with the baseline (P < 0.01), but did not differ significantly between Groups A and B (P > 0.05). After the treatment, serum total testosterone, PSA and prostate volume had no obvious change (P > 0.05), and the IGF-1 level was markedly higher than the baseline and the normal public. No obvious side effect was found during the treatment and follow-up. CONCLUSION: Small dosage of rhGH(4 IU/week) for 12 weeks can effectively treat male climacteric syndrome. The value of IGF-1 was parallel with the treatment effects. Short-time and small-dosage treatment with rhGH is safe and has little side effect.

Andropause↗
PubMed1977

Correlation between climacteric symptoms and serum levels of estradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone.

Correlation between the climacteric symptoms and serum levels of estradiol. progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) was studied in 191 premenopausal and postmenopausal women. Significant correlation was obtained between the climacteric symptoms represented by the menopausal index of Kupperman and associates and serum levels of estradiol as well as LH in a subgroup of the premenopausal women, ages 35 to 39 years. The symptoms were shown to be significantly related in serum levels of LH and inversely related to estradiol. These results confirmed that climacteric symptoms, at least in premenopausal women 35 to 39 years of age, could result from a low output of ovarian estrogen and a high production of pituitary gonadotropin.

Adult↗
PubMed1995

Transdermal estrogen with a levonorgestrel-releasing intrauterine device for climacteric complaints: clinical and endometrial responses.

OBJECTIVE: Our purpose was to study the effects of intrauterine release of a daily dose of 20 micrograms levonorgestrel by an intrauterine device on climacteric symptoms, bleeding pattern, and endometrial histologic features in postmenopausal women receiving transdermal estrogen replacement therapy. STUDY DESIGN: Forty parous postmenopausal women were randomly allocated into two groups for 1 year: 20 women receiving a continuous transdermal daily dose of 50 micrograms of estradiol had a levonorgestrel-releasing intrauterine contraceptive device inserted, and the control group of 20 women received a continuous oral dose of 2 mg of estradiol valerate and 1 mg of norethisterone acetate daily. The climacteric symptoms, bleeding patterns, endometrial thickness, and endometrial changes in biopsy samples were analyzed. Serum levels of estradiol in both groups and levonorgestrel levels in the intrauterine device group were also determined. RESULTS: Both treatment regimens effectively relieved climacteric symptoms. Spotting was more common in the intrauterine contraceptive device group than in the oral therapy group for the first 3 months. After that, the proportion of women without any bleeding was similar in both groups. Two patients in each group dropped out because of bleeding. CONCLUSION: These preliminary findings suggest that the levonorgestrel-releasing intrauterine contraceptive device is a useful alternative mode of progestin administration for certain selected women receiving estrogen replacement therapy.

Administration, Cutaneous↗
PubMed1981

What's in a name? Some linguistic aspects of the climacteric.

Examining such terms as climacteric or menopause and utilizing supportive historical data, an attempt is made to trace the development of these concepts, their time of inception and their spread. It is suggested that the persistence of popular terminology of the climacteric, especially in England, until late in the last century is due to the association of female popular healers with its management. In France, where medical men were long involved in this field, the terminology had been of a completely different character for over two centuries. Latin literature, as reflected in M.D. theses, goes back even further to the beginning of the 18th century. Only cultures which, because of their social structure and views of ageing regard the climacteric as a critical period, describe it in ominous terms. These terms in turn perpetuate the views and attitudes which spawned them. A warning is sounded against an objectification of abstract terms like the "biological menopause" which may lead to misrepresentation and distortion. The objectification of symptoms, essentially means of communication, as data has already led to many difficulties in research. Finally, the confusion produced through lack of a suitable approach to minor behavioural disorders, and their consequent inclusion under the label of "menopause", is very briefly reviewed.

Aged↗
PubMed1983

Dose-response and withdrawal effects on climacteric symptoms after hormonal replacement therapy. A placebo-controlled therapeutic trial.

Out of a sample of 162 early post-menopausal women, aged 45-54 yr, 131 completed a placebo-controlled study to investigate the effect of sex hormones on mild climacteric symptoms with special reference to the dose-response relationship and withdrawal effects. The women were followed up for 42 mth under four different study programmes. All the women were examined every 3 mth and a blind assessment made of the menopausal index estimated according to Kupperman et al. The data revealed a highly significant reduction in climacteric symptoms in the hormone-treated women as compared with the placebo group (P less than 0.001), a highly significant dose relationship between climacteric symptoms and treatment with 4, 2 and 1 mg oestradiol, respectively (P less than 0.001), a highly significant and dose-dependent rebound phenomenon after withdrawal of hormone treatment (P less than 0.001)--which levelled off after 6 mth following withdrawal--and complete relief of hot flushes with the two highest doses of oestradiol (4 and 2 mg oestradiol). It is concluded that sex hormones have a beneficial effect in post-menopausal women with even mild symptoms.

Climacteric↗
PubMed1984

Physiopathological aspects of body overweight in the female climacteric.

The correlation between overweight and the climacteric was studied in 550 menopause clinic patients by investigating certain clinical and sociocultural parameters (age, marital status, educational level, occupation and type of work, calorie intake, smoking habits, parity, blood pressure, previous hormonal therapy and climacteric symptoms), evaluating plasma levels of various hormones (17 beta-oestradiol, follicle-stimulating hormone (FSH), luteinizing (LH), testosterone, hydrocortisone, adrenocorticotrophic hormone (ACTH), triiodothyronine (T3), thyroxine (T4), growth hormone (GH) and insulin), glucose and various lipid fractions (total lipids, total cholesterol, nonesterified fatty acids (NEFA), triglycerides and phospholipids) and exploring the blood-clotting pattern ( Owren 's test, euglobulin lysis time, antithrombin III and prothrombin agglutination time (PAT). The subjects were classified as normal weight or overweight by reference to Broca's Index, as modified by Brusch , and the degree of overweight was determined by means of the Body Mass Index (BMI). Of the subjects examined, 49% were overweight and, in successive years following the menopause, there was a growing bipolarization of the weight increase. The correlation between overweight in the climacteric and the parameters considered was found to be significant only in regard to calorie intake, age and educational level. Post-menopausal gonadotrophin levels in blood were significantly lower in the overweight than in the normal-weight women. With the onset of menopause, the plasma level of testosterone fell in the normal-weight women, while it increased, along with that of hydrocortisone, in the overweight women. In the normal-weight women at menopause, it was found that there was a tendency towards a substantial increase in lipid fractions and glycaemia, as well as a state of hypercoagulability. In the overweight women, the tendency was towards an even more marked increase in both glycaemia and the various lipid fractions, and, besides the hypercoagulative state, there was an associated reduction in fibrinolytic activity. It is concluded that the menopause not only causes metabolic changes but also aggravates the metabolic and endocrine tendencies which characterize overweight subjects and thus, clinically, constitutes an obesity risk factor in those women who already demonstrate a tendency towards overweight in the pre-menopausal phase.

Adult↗
PubMed1984

Duration of the climacteric syndrome in women treated by hormonal substitution and in controls.

This study investigates the duration of symptoms occurring in vegetative climacteric syndrome in women treated by hormonal substitution and in untreated controls. The average duration of the problem in 97 women who refused hormone treatment and served as the control group was 4.5 yr. A mean duration of 5.4 yr was seen in 85 women treated with oral oestrogens, of 6.4 yr in 20 women treated with a combination of oestradiol and prasterone , and of 12.9 yr in 28 women receiving a combination of oestradiol and testosterone. All of these groups were practically identical as regards initiation of therapy, age, and 17 other case-history, sociological and clinical criteria. Although hormonal treatment of the climacteric syndrome can lengthen the duration of the symptoms, this is not necessarily always the case. The type of medication and the dose undoubtedly play an important role in this connection. It has been shown that oestradiol-testosterone combinations can prolong the period during which the symptoms of the climacteric syndrome occur beyond the period that their occurrence may be regarded as physiological.

Administration, Oral↗
PubMed1985

Surveys of climacteric semeiology in non-Western populations: a critique.

Traditionally regarded as limited to Western women, the menopausal syndrome has the characteristics of a culture-bound syndrome. Yet, pointing to the results of recent surveys in non-Western populations, several investigators claim that the latter are also affected. Despite faults in collection, the salient data of these surveys are acceptable. This does not mean that the conclusions drawn from them are invariably correct. Many, including the claims referred to, are contestable. Researchers have failed to distinguish between the spontaneous symptoms of women subject to climacteric disturbances and the sensations others admit to on questioning. They do not differentiate between symptoms and semeions. Lack of discrimination between the two categories also confounds Western surveys of climacteric semeiology, obscured by a cultural context where acceptance of the climacteric syndrome transforms semeions, sensations, into incipient symptoms. Once outside, among non-Western populations, the distinction becomes vividly apparent. This is of great theoretical importance, both in the structuring of medical surveys and in explaining symptom formation. It may also clarify the effects of cultural/personal attention on the level of physiological activity associated with symptoms.

Climacteric↗