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Zhongguo Zhen Jiu = Chinese Acupuncture... Jun 2022To observe the clinical effect of acupuncture for perimenopausal early-wake insomnia. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To observe the clinical effect of acupuncture for perimenopausal early-wake insomnia.
METHODS
A total of 60 patients with perimenopausal early-wake insomnia were randomly divided into an observation group (30 cases, 3 cases dropped off) and a control group (30 cases, 2 cases dropped off, 2 cases were removed). In the observation group, acupuncture was applied at Baihui (GV 20), Yintang (GV 24), Anmian (Extra), Hegu (LI 4), Shenmen (HT 7), Taichong (LR 3), Taixi (KI 3), etc., once every other day, 3 times a week. In the control group, oryzanol tablets were taken orally, 20 mg each time, 3 times a day. Both groups were treated for 4 weeks. Before and after treatment, the sleep actigraphy (ACT) was used to measure the effective sleep time, sleep quality, wake-up time, wake-up frequency, each wake-up time, and the Pittsburgh sleep quality index (PSQI) score and early-wake score were compared in the two groups, and the clinical effect was assessed.
RESULTS
After treatment, compared before treatment, the effective sleep time was prolonged and the sleep quality was improved (<0.05), the wake-up time, each wake-up time were shortened and wake-up frequency was decreased (<0.05), the PSQI score and early-wake score were decreased (<0.05) in the observation group. After treatment, the wake-up frequency, PSQI score and early-wake score were decreased in the control group (<0.05). The effective sleep time, sleep quality, wake-up time, wake-up frequency, each wake-up time, PSQI score and early-wake score after treatment in the observation group were superior to the control group (<0.05). The total effective rate was 88.9% (24/27) in the observation group, which was higher than 38.5% (10/26) in the control group (<0.05).
CONCLUSION
Acupuncture can increase the effective sleep time and improve sleep quality in patients with perimenopausal early-wake insomnia.
Topics: Acupuncture Points; Acupuncture Therapy; Humans; Perimenopause; Sleep Initiation and Maintenance Disorders; Treatment Outcome
PubMed: 35712942
DOI: 10.13703/j.0255-2930.20211009-k0004 -
Depression and Anxiety Aug 2015Controversy regarding the antidepressant efficacy of hormone replacement therapy (HRT) stems almost from its inception and reflects the same methodological... (Review)
Review
BACKGROUND
Controversy regarding the antidepressant efficacy of hormone replacement therapy (HRT) stems almost from its inception and reflects the same methodological inconsistencies that have compromised efforts to determine whether the perimenopause is accompanied by an increase in mood symptoms or depression. Methodologic differences of note (other than study design) include menopausal state (perimenopause vs. postmenopause), determination of state (earlier studies used age as a proxy measure), baseline symptomatology (asymptomatic vs. depressive symptoms vs. syndromic depression), route of hormone administration (transdermal vs. oral), and symptom or syndrome measure. Zweifel and O'Brien's 1997 meta-analysis included 26 studies of the effects of menopausal HRT on depressed mood and revealed an overall effect size of 0.68. This moderate to large effect size, showing lower ratings of depressed mood in treated patients compared with controls, implicated HRT as a potential treatment of or prophylactic for depression in menopausal women. Since this publication, multiple studies have aimed to discern the relationship between HRT and menopausal mood.
METHODS
The purpose of this systematic review is to examine the findings and quality of the evidence amassed since Zweifel and O'Brien's meta-analysis.
RESULTS
Of the 24 studies meeting criteria for review, only five RCTs examined depressed subjects, and only two of the study samples were solely perimenopausal.
CONCLUSIONS
One can generalize from the studies reviewed here only with great caution, but there is little evidence to support the use of estradiol to improve mood in nondepressed patients (not surprisingly) and some evidence to support the antidepressant efficacy of estradiol in perimenopausal but not postmenopausal women.
Topics: Depression; Estradiol; Estrogens; Female; Hormone Replacement Therapy; Humans; Middle Aged; Perimenopause
PubMed: 26130315
DOI: 10.1002/da.22391 -
Journal of Obstetrics and Gynaecology :... Oct 2022This cross-sectional study focussed on perimenopausal Mongolian women and aimed to determine the quality of life (QOL) and risk factors in this population. We collected...
This cross-sectional study focussed on perimenopausal Mongolian women and aimed to determine the quality of life (QOL) and risk factors in this population. We collected data on 392 women using a predesigned questionnaire and classified the participants according to menopausal status. We used The Menopause Rating Scale (MRS) and the World Health Organisation Quality of Life (WHOQOL)-BREF. Blood pressure ( = .003) and body mass index ( = .02) were significantly high, whereas sexual activity was significantly decreased in postmenopausal women ( = .001). In perimenopausal women, somatovegetative ( = .003) and psychological ( = .025) symptoms were significantly severe, and menopausal symptom severity was significantly higher ( = .017). Menopausal symptoms ( = .02) and monthly sexual activity ( = .005) significantly influenced overall QOL. Sexuality had a significantly negative effect on psychological health ( = .03). Age, occupation, menopausal stage and somatovegetative symptoms have significant effects on health-related QOL (< .05). Our findings showed that menopausal symptoms and sexual activity significantly affect QOL in middle-aged Mongolian women.Impact Statement Women experience physiological changes at the onset of menopause. However, as their oestrogen levels decline, many women also experience physical, psychological and somatovegetative symptoms. Postmenopausal health has been the main issue affecting middle-aged women, until recently. Here, we showed that menopausal transition is a turning point for middle-aged women and suggest that more attention should be paid to the health of perimenopausal women in Mongolia. The study results showed that perimenopausal women had a higher prevalence of health-related problems than postmenopausal women, including weight gain, cardiovascular symptoms and vasomotor symptoms. The prevalence of genitourinary health problems increased with age. General practitioners and gynaecologists in Mongolia should acquire a better understanding of the physiological changes that occur during menopause and pay greater attention to genitourinary issues as they affect general, health-related quality of life.
Topics: Middle Aged; Female; Humans; Perimenopause; Quality of Life; Cross-Sectional Studies; Menopause; Risk Factors; Surveys and Questionnaires; Hot Flashes
PubMed: 36052870
DOI: 10.1080/01443615.2022.2106829 -
Menopause International Jun 2012
Topics: Female; Hormone Replacement Therapy; Humans; Perimenopause; Premenstrual Syndrome; Terminology as Topic
PubMed: 22611219
DOI: 10.1258/mi.2012.012012 -
Menopause (New York, N.Y.) Jan 2021To evaluate the effects of sex hormones on amplitude of low-frequency fluctuation (ALFF) in brain regions related to cognition in perimenopausal women.
OBJECTIVE
To evaluate the effects of sex hormones on amplitude of low-frequency fluctuation (ALFF) in brain regions related to cognition in perimenopausal women.
METHODS
This cross-sectional study involved 25 perimenopausal women and 25 premenopausal women who underwent behavioral evaluations, sex hormone level measurements, and functional magnetic resonance imaging (fMRI). All data and ALFF analyses were preprocessed using the Data Processing Assistant for Resting-State fMRI. Statistical analyses were performed using the Resting-State fMRI Data Analysis Toolkit to explore the differences in ALFF between perimenopausal and premenopausal women. The gray matter volume (GMV) values extracted from brain regions (regions of interest) with significantly different ALFF values between the perimenopausal and premenopausal groups were compared. We analyzed the correlations of the ALFF and GMV values of these regions of interest with the results of behavioral evaluations and sex hormone levels in the two groups.
RESULTS
Compared with the premenopausal group, the perimenopausal group showed significant ALFF increase in the left gyrus rectus. Regions with decreased ALFF in the perimenopausal group included the left superior temporal gyrus, left inferior frontal gyrus, and left insula. The GMV values of the left gyrus rectus and left superior temporal gyrus were reduced in perimenopausal women. Furthermore, the estradiol level was negatively correlated with the ALFF value of the left gyrus rectus in perimenopausal women.
CONCLUSIONS
The ALFF and GMV values of certain brain regions related to cognitive function were changed in perimenopausal women. Such functional brain alterations may provide more information regarding the mechanism of cognitive dysfunction in perimenopausal women.
Topics: Brain; Cross-Sectional Studies; Female; Gonadal Steroid Hormones; Humans; Magnetic Resonance Imaging; Perimenopause
PubMed: 33438891
DOI: 10.1097/GME.0000000000001720 -
BMC Women's Health May 2022The perimenopausal period is associated with a higher risk of various mood disorders. Similarly, although resting-state electroencephalogram (rsEEG) brain oscillatory...
BACKGROUND
The perimenopausal period is associated with a higher risk of various mood disorders. Similarly, although resting-state electroencephalogram (rsEEG) brain oscillatory activity has been associated with various neuropsychological disorders and behaviours, these issues have not been assessed in perimenopausal women. This study aimed to evaluate quantitative relationships between psychometric properties and rsEEG rhythms (delta, theta, alpha, beta and gamma powers) in perimenopausal women.
METHODS
A cross-sectional correlational descriptive study was conducted to quantitatively analyze the correlations between rsEEG low-to-high band activities (delta, theta, alpha, beta, and gamma powers) and psychometric properties in 14 perimenopausal women. Participants completed a psychological inventory comprising the State Anxiety Inventory (SAI), Depression Inventory (DI), Behavioural Inhibition Scale (BIS) and short-form UPPS Impulsive Behaviour Scale (IS) before EEG recording.
RESULTS
Results showed that impulsivity was positively related to the beta power, symmetrical at most channels (frontal, temporal, central, parietal and occipital regions; p < .05); but did not related to the delta, theta, alpha and gamma powers. The brainwave low-to-high bands, delta, theta, alpha, beta and gamma power were not associated with DI, SAI or BIS scores.
CONCLUSIONS
This study's findings propose that significantly enhanced resting-state beta activity is a trait of impulsivity in perimenopausal women. Therefore, results have potential implications for the preclinical or clinical evaluation of these issues in perimenopausal women.
Topics: Anxiety; Cross-Sectional Studies; Electroencephalography; Female; Humans; Perimenopause; Psychometrics
PubMed: 35538572
DOI: 10.1186/s12905-022-01729-7 -
Obstetrics and Gynecology Mar 2016To examine the association of acupuncture with sleep disturbances and serum sex hormone levels in perimenopausal and postmenopausal women and whether there are... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To examine the association of acupuncture with sleep disturbances and serum sex hormone levels in perimenopausal and postmenopausal women and whether there are associated changes in sex hormone levels.
DATA SOURCES
We systematically searched electronic databases (EMBASE, PubMed, PsycINFO, CINAHL, ClinicalTrials.gov, Wanfang Data Chinese Database, and China Knowledge Resource Integrated Database) and the reference lists of the identified studies.
METHODS OF STUDY SELECTION
Randomized controlled trials that examined the effects of acupuncture on sleep disturbances in perimenopausal and postmenopausal women were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was followed.
TABULATION, INTEGRATION, AND RESULTS
We identified 31 randomized controlled trials with 34 effect sizes involving a total of 2,433 participants. Acupuncture is associated with a significant reduction in the likelihood of sleep disturbances (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.14-0.31), a significant increase in the secretion of serum estradiol (pooled difference in means 7.56 pg/mL, 95% CI 4.03-11.08), and reduction in the secretion of serum follicle-stimulating hormone (-6.75 milli-international units/mL, 95% CI -12.16 to -1.34) and luteinizing hormone (-2.71 milli-international units/mL, 95% CI -4.22 to -1.20). Studies with a large effect size of acupuncture-associated changes in serum estradiol had a significantly lower odds of sleep disturbances than did those with a small-to-moderate effect sizes (ORs 0.07 and 0.36, P=.02).
CONCLUSION
Acupuncture is associated with a significant reduction in sleep disturbances in women experiencing menopause-related sleep disturbances. Our findings suggest that acupuncture should be adopted as part of a multimodal approach for improving sleep disturbances in perimenopausal and postmenopausal women.
Topics: Acupuncture Therapy; Female; Humans; Perimenopause; Postmenopause; Randomized Controlled Trials as Topic; Sleep Wake Disorders
PubMed: 26855097
DOI: 10.1097/AOG.0000000000001268 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Sep 2021To explore and analyze the effect and indication of hormone replacement therapy(HRT) in perimenopausal women with chronic tinnitus. The perimenopausal women with...
To explore and analyze the effect and indication of hormone replacement therapy(HRT) in perimenopausal women with chronic tinnitus. The perimenopausal women with chronic tinnitus were divided into mild group and moderate to severe group according to Kupperman score of menopause, and then were divided into treatment group and untreated group according to whether they received MHT treatment or not. The serum 5-HT level, tinnitus handicap inventory (THI) and Pittsburgh sleep quality index (PSQI) were compared before and after treatment. In moderate to severe perimenopausal tinnitus, the serum 5-HT level, THI and PSQI in the treatment group were statistically different before and after treatment(<0.05), and no significant difference was found in the untreated group. In mild perimenopausal tinnitus, there was no significant difference in 5-HT levels, THI and PSQI between the treated group and the untreated group before and after treatment. The 5-HT levels were correlated with THI. The lower the 5-HT level was, the more severe tinnitus was. HRT is helpful in the treatment of perimenopausal chronic tinnitus, especially in moderate to severe perimenopausal patients, and is recommended for clinical use.
Topics: Female; Humans; Hormone Replacement Therapy; Perimenopause; Tinnitus
PubMed: 34628834
DOI: 10.13201/j.issn.2096-7993.2021.09.009 -
The American Journal of Psychiatry Mar 2015In this conceptual review, the authors propose a novel mechanistic candidate in the etiology of depression with onset in the menopause transition ("perimenopausal... (Review)
Review
OBJECTIVE
In this conceptual review, the authors propose a novel mechanistic candidate in the etiology of depression with onset in the menopause transition ("perimenopausal depression") involving alterations in stress-responsive pathways, induced by ovarian hormone fluctuation.
METHOD
The relevant literature in perimenopausal depression, including prevalence, predictors, and treatment with estrogen therapy, was reviewed. Subsequently, the growing evidence from animal models and clinical research in other reproductive mood disorders was synthesized to describe a heuristic model of perimenopausal depression development.
RESULTS
The rate of major depressive disorder and clinically meaningful elevations in depressive symptoms increases two- to threefold during the menopause transition. While the mechanisms by which ovarian hormone fluctuation might impact mood are poorly understood, growing evidence from basic and clinical research suggests that fluctuations in ovarian hormones and derived neurosteroids result in alterations in regulation of the HPA axis by γ-aminobutyric acid (GABA). The authors' heuristic model suggests that for some women, failure of the GABAA receptor to regulate overall GABA-ergic tone in the face of shifting levels of these neurosteroids may induce HPA axis dysfunction, thereby increasing sensitivity to stress and generating greater vulnerability to depression.
CONCLUSIONS
The proposed model provides a basis for understanding the mechanisms by which the changing hormonal environment of the menopause transition may interact with the psychosocial environment of midlife to contribute to perimenopausal depression risk. Future research investigating this model may inform the development of novel pharmacological treatments for perimenopausal depression and related disorders, such as postpartum depression and premenstrual dysphoric disorder.
Topics: Depressive Disorder; Female; Gonadal Hormones; Humans; Hypothalamo-Hypophyseal System; Models, Biological; Models, Psychological; Ovary; Perimenopause; Pituitary-Adrenal System; Social Environment; gamma-Aminobutyric Acid
PubMed: 25585035
DOI: 10.1176/appi.ajp.2014.14070918 -
Menopause (New York, N.Y.) May 2024The increasing attention to the management of perimenopausal and postmenopausal women parallels the growth of the aging population. Although hormone therapy is commonly... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
The increasing attention to the management of perimenopausal and postmenopausal women parallels the growth of the aging population. Although hormone therapy is commonly used to alleviate menopausal symptoms, it carries a potential risk of cancer. Recently, mind-body exercises have emerged as innovative approaches for improving menopausal symptoms and bone health. However, research findings have needed to be more consistent, highlighting the significance of this study's systematic review of mind-body exercise effects on perimenopausal and postmenopausal women.
OBJECTIVE
This study aims to evaluate the impact of mind-body exercises, including tai chi, yoga, Pilates, qigong, baduanjin, and mindfulness-based stress reduction, on bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women.
EVIDENCE REVIEW
Four electronic databases-PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science-were systematically searched from inception until July 2023. The search focused exclusively on randomized controlled trials to examine the impact of mind-body exercise interventions on perimenopausal and postmenopausal women. The methodological quality of the included studies was evaluated using the Cochrane Bias Risk Assessment tool.
FINDINGS
A total of 11 randomized controlled trials, comprising 1,005 participants, were included in the analysis. Traditional meta-analysis indicated that mind-body exercise significantly enhanced bone mineral density in perimenopausal and postmenopausal women compared with control groups, with a standardized mean difference (SMD) of 0.41 (95% CI, 0.17 to 0.66; P = 0.001, I2 = 7%). In addition, significant improvements were observed in sleep quality (SMD, -0.48; 95% CI, -0.78 to -0.17; P = 0.002, I2 = 76%), anxiety reduction (SMD, -0.80; 95% CI, -1.23 to -0.38; P = 0.0002, I2 = 84%), depressive mood (SMD, -0.80; 95% CI, -1.17 to -0.44; P < 0.0001, I2 = 79%), and fatigue (SMD, -0.67; 95% CI, -0.97 to -0.37; P < 0.0001, I2 = 0%).
CONCLUSIONS AND RELEVANCE
The findings of this meta-analysis demonstrate that mind-body exercise positively influences bone mineral density, sleep quality, anxiety, depression, and fatigue among perimenopausal and postmenopausal women.
Topics: Humans; Female; Perimenopause; Postmenopause; Bone Density; Mind-Body Therapies; Middle Aged; Depression; Sleep Quality; Randomized Controlled Trials as Topic; Anxiety; Fatigue; Exercise; Tai Ji; Yoga
PubMed: 38669625
DOI: 10.1097/GME.0000000000002336