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Frontiers in Endocrinology 2024We aimed to evaluate the clinical efficacy of five traditional Chinese fitness exercises (Baduanjin, Taijiquan, Wuqinxi, Yijinjing, and Liuzijue), as well as their... (Meta-Analysis)
Meta-Analysis
UNLABELLED
We aimed to evaluate the clinical efficacy of five traditional Chinese fitness exercises (Baduanjin, Taijiquan, Wuqinxi, Yijinjing, and Liuzijue), as well as their efficacy when combined with drug therapy, in the treatment of decreased bone mineral density in postmenopausal women.
METHODS
This study strictly followed the evaluation guidelines of PRISMA and followed the "PICOS" principle outlined in the Cochrane Handbook. We performed a systematic search on Web of Science, Springer Link, Scopus, EMBASE, EBSCO, PubMed, the Cochrane Library, CNKI, Wanfang, CBMdisc, and the VIP Database, and we targeted RCTs studying the effect of TCE on BMD in postmenopausal women published prior to September 2023. The quality of the literature and the risk of bias of the included studies were assessed according to ROB2 and GRADE criteria, and data analysis was performed using Stata 14.
RESULTS
A total of 33 RCTs (3658 post-menopausal women) were included. Network meta-analysis showed that Taiji (SMD=0.72, 95% CI: 0.22, 1.21, P<0.01) and Yijinjing (SMD=0.51, 95% CI: 0.03, 0.99, P<0.05) were significantly superior to conventional rehabilitation in lumbar BMD. In terms of improvement of femoral neck BMD, Baduanjin (SMD=1.63, 95% CI: -3.58, 6.85, P<0.001) and Taiji (SMD=0.46, 95% CI: 0.14, 0.79, P<0.05) had statistically different outcomes to conventional rehabilitation. Regarding Ward's triangle BMD, Taiji (SMD= 0.32, 95% CI: 0.14, 0.50, P< 0.05) had statistically different outcomes to conventional rehabilitation. The results of the SUCRA probability ranking showed that Baduanjin + drug interventions achieved the most significant improvement in lumbar BMD (SUCRA=83.6%) and femoral neck BMD (SUCRA=90.2%). Taiji + drug interventions most effectively improved Ward's triangle BMD (SUCRA=86.0%). In terms of traditional Chinese fitness exercises alone, Taiji was the most effective in improving lumbar BMD (SUCRA=64.4%) and Ward's triangle BMD (SUCRA=46.8%), and Baduanjin was the most effective in treating femoral neck BMD (SUCRA=89.9%).
CONCLUSION
Traditional Chinese fitness exercises can significantly improve the BMD levels of postmenopausal women. Taiji, Yijinjing, and Baduanjin combined with medication showed better intervention effects overall. However, due to the limitations of the number of studies and sample sizes of individual interventions, definitive conclusions need to be verified by more high-quality studies.
Topics: Female; Humans; Bone Density; Network Meta-Analysis; Postmenopause; Randomized Controlled Trials as Topic; China
PubMed: 38390196
DOI: 10.3389/fendo.2024.1323595 -
Preventive Medicine Apr 2024Based on past epidemiological investigations, the cardiovascular role of estrogen replacement therapy (ERT) in postmenopausal women has always been controversial. The... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Based on past epidemiological investigations, the cardiovascular role of estrogen replacement therapy (ERT) in postmenopausal women has always been controversial. The real efficacy of ERT for heart failure (HF) among postmenopausal women remains to be further investigated. This article is based on research into European and American populations.
PURPOSE
To determine the impact of estrogen replacement therapy on HF using meta-analysis.
METHODS AND MATERIAL
Electronic literature was searched on Web of Science, PubMed, and Embase databases to identify randomized controlled trials (RCTs) comparing the hospitalization for heart failure between ERT users and non-users among postmenopausal women. Pairs of reviewers screened eligible articles independently, extracted data, and evaluated the risk of bias. Summary relative risks were estimated for the composite endpoint of first hospitalized heart failure and admission to the hospital for heart failure.
RESULTS
A pooled study of five randomized controlled trials found that estrogen replacement therapy had no significant effect on the composite endpoint in postmenopausal women, with a relative risk of 1.02 (95% CI 0.94-1.10).
CONCLUSION
This systematic review demonstrated that estrogen replacement therapy did not significantly change the risk of first hospitalized heart failure and admission to the hospital for heart failure in postmenopausal women.
Topics: Female; Humans; Estrogen Replacement Therapy; Postmenopause; Heart Failure; Randomized Controlled Trials as Topic
PubMed: 38382766
DOI: 10.1016/j.ypmed.2024.107909 -
Journal of Ovarian Research Feb 2024This study aims to investigate the effects of natural products on animal models of premature ovarian failure (POF). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aims to investigate the effects of natural products on animal models of premature ovarian failure (POF).
METHODS
We conducted comprehensive literature searches and identified relevant studies that examined the protective effects of natural products on experimental POF. We extracted quantitative data on various aspects such as follicular development, ovarian function, physical indicators, oxidative stress markers, inflammatory factors, and protein changes. The data was analyzed using random-effects meta-analyses, calculating pooled standardized mean differences and 95% confidence intervals. Heterogeneity was assessed using the I statistic, and bias was estimated using the SYRCLE tool.
RESULTS
Among the 879 reviewed records, 25 articles met our inclusion criteria. These findings demonstrate that treatment with different phytochemicals and marine natural products (flavonoids, phenols, peptides, and alkaloids, etc.) significantly improved various aspects of ovarian function compared to control groups. The treatment led to an increase in follicle count at different stages, elevated levels of key hormones, and a decrease in atretic follicles and hormone levels associated with POF. This therapy also reduced oxidative stress (specifically polyphenols, resveratrol) and apoptotic cell death (particularly flavonoids, chrysin) in ovarian granulosa cells, although it showed no significant impact on inflammatory responses. The certainty of evidence supporting these findings ranged from low to moderate.
CONCLUSIONS
Phytochemicals and marine natural product therapy (explicitly flavonoids, phenols, peptides, and alkaloids) has shown potential in enhancing folliculogenesis and improving ovarian function in animal models of POF. These findings provide promising strategies to protect ovarian reserve and reproductive health. Targeting oxidative stress and apoptosis pathways may be the underlying mechanism.
Topics: Female; Humans; Animals; Primary Ovarian Insufficiency; Menopause, Premature; Flavonoids; Phenols; Peptides; Alkaloids
PubMed: 38378652
DOI: 10.1186/s13048-024-01369-5 -
Journal of Affective Disorders May 2024Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to evaluate the effectiveness of psychosocial interventions on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Menopause, a crucial transitioning stage for women, can significantly impact mood and wellbeing. We aimed to evaluate the effectiveness of psychosocial interventions on non-physiological symptoms of menopause (depression, anxiety, cognition, and quality of life) through systematic review and meta-analysis.
METHODS
Five databases were searched from inception to August 2023 for randomized controlled trials. Pre- and post-test means and standard deviations for groups were extracted and used to calculate effect sizes. The effectiveness of Cognitive Behavioral Therapy (CBT) and Mindfulness-Based Interventions (MBI) on depression and anxiety were examined by subgroup analysis.
RESULTS
Thirty studies comprising 3501 women were included. From meta-analysis, mood symptoms significantly benefited from CBT (anxiety: d = -0.22, 95 % CI = -0.35, -0.10; depression: d = -0.33, 95 % CI = -0.45, -0.21) and MBI (anxiety: d = -0.56, 95 % CI = -0.74, -0.39; depression: d = -0.27, 95 % CI = -0.45, -0.09). Psychosocial interventions were also found to significantly improve cognition (d = -0.23, 95 % CI = -0.40, -0.06) and quality of life (d = -0.78, 95 % CI = -0.93, -0.63). Mean total therapy hours ('dose') was lower for CBT (11.3) than MBI (18.6), indicating reduced costs and burden for women.
LIMITATIONS
Data regarding menopausal status were not collected, limiting our ability to identify the optimal timing of interventions. Potential longer-term, effects of interventions were not investigated.
CONCLUSION
Our review highlighted the value of psychosocial interventions in improving non-physiological symptoms (particularly depression and anxiety) during menopause, noting the heterogeneity of findings and importance of implementing effective interventions.
Topics: Humans; Female; Quality of Life; Psychosocial Intervention; Cognitive Behavioral Therapy; Anxiety; Menopause; Depression
PubMed: 38364979
DOI: 10.1016/j.jad.2024.02.048 -
BMC Complementary Medicine and Therapies Feb 2024Evening primrose oil (EPO), extracted from the seeds of Oenothera biennis, has gained attention for its therapeutic effects in various inflammatory conditions.
BACKGROUND
Evening primrose oil (EPO), extracted from the seeds of Oenothera biennis, has gained attention for its therapeutic effects in various inflammatory conditions.
METHOD
We performed a systematic search in multiple databases and defined the inclusion criteria based on the following PICOs: P: Patients with a form of inflammatory condition, I: EPO, C: Placebo or other therapeutic interventions, O: changes in inflammatory markers or patients' symptoms; S: randomized controlled trials. The quality of the RCTs was evaluated using Cochrane's RoB tool.
RESULTS
Several conditions were investigated in the literature. In rheumatoid arthritis, mixed results were observed, with some studies reporting significant improvements in symptoms while others found no significant impact. EPO showed some results in diabetes mellitus, atopic eczema, menopausal hot flashes, and mastalgia. However, it did not demonstrate effectiveness in chronic hand dermatitis, tardive dyskinesia, psoriatic arthritis, cystic fibrosis, hepatitis B, premenstrual syndrome, contact lens-associated dry eyes, acne vulgaris, breast cyst, pre-eclampsia, psoriasis, or primary Sjogren's syndrome. Some results were reported from multiple sclerosis after EPO consumption. Studies in healthy volunteers indicated no significant effect of EPO on epidermal atrophy, nevertheless, positive effects on the skin regarding hydration and barrier function were achieved.
CONCLUSION
Some evidence regarding the potential benefits of EPO in inflammatory disorders were reported however caution is due to the limitations of the current survey. Overall, contemporary literature is highly heterogeneous and fails to provide strong recommendations regarding the efficacy of EPO on inflammatory disorders. Further high-quality studies are necessitated to draw more definite conclusions and establish O. biennis oil effectiveness as an assuring treatment option in alleviating inflammatory conditions.
Topics: Pregnancy; Female; Humans; Oenothera biennis; gamma-Linolenic Acid; Linoleic Acids; Plant Oils
PubMed: 38360611
DOI: 10.1186/s12906-024-04378-5 -
BMC Pediatrics Feb 2024Preterm labor (PTL) is a common and serious pregnancy disorder that can cause long-term neurological issues in the infant. There are conflicting studies concerning... (Meta-Analysis)
Meta-Analysis
Efficient administration of a combination of nifedipine and sildenafil citrate versus only nifedipine on clinical outcomes in women with threatened preterm labor: a systematic review and meta-analysis.
BACKGROUND
Preterm labor (PTL) is a common and serious pregnancy disorder that can cause long-term neurological issues in the infant. There are conflicting studies concerning whether sildenafil citrate (SC) reduces preterm labor complications. Therefore, the meta-analysis aimed to examine the clinical outcomes in women with threatened PTL who received nifedipine plus SC therapy versus only nifedipine.
METHODS
For the original articles, six databases were searched using relevant keywords without restriction on time or language until January 13, 2024. The Cochrane risk-of-bias tool for randomized trials (RoB) and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) were both used to assess the risk of bias in randomized and non-randomized studies, and GRADE determined the quality of our evidence. Meta-analysis of all data was carried out using Review Manager (RevMan) version 5.1.
RESULTS
Seven studies with mixed quality were included in the meta-analysis. The study found that combining nifedipine and SC resulted in more prolongation of pregnancy (MD = 6.99, 95% CI: 5.32, 8.65, p < 0.00001), a lower rate of delivery in the 1st to 3rd days after hospitalization (RR = 0.62, 95% CI: 0.50, 0.76, p < 0.00001), a higher birth weight (252.48 g vs. nifedipine alone, p = 0.02), and the risk ratio of admission to the neonatal intensive care unit (NICU) was significantly lower (RR = 0.62, 95% CI: 0.50, 0.76, p < 0.00001) compared to nifidepine alone. The evidence was high for prolongation of pregnancy, delivery rate 24-72 h after admission, and NICU admission, but low for newborn birth weight.
CONCLUSIONS
Given the effectiveness of SC plus nifedipine in increased prolongation of pregnancy and birth weight, lower delivery in the 1st to 3rd days after hospitalization, and NICU admission, Gynecologists and obstetricians are suggested to consider this strategy for PTL management, although additional article rigor is required to improve the quality of the evidence.
Topics: Pregnancy; Infant, Newborn; Female; Humans; Nifedipine; Premature Birth; Sildenafil Citrate; Tocolytic Agents; Birth Weight; Obstetric Labor, Premature
PubMed: 38341578
DOI: 10.1186/s12887-024-04588-3 -
Role of Alternate Therapies to Improve the Quality of Life in Menopausal Women: A Systematic Review.Journal of Mid-life Health 2023Middle aged women in majority undergoing menopausal symptoms are unaware of the physiological changes happening in their body, necessary lifestyle changes and alternate... (Review)
Review
Middle aged women in majority undergoing menopausal symptoms are unaware of the physiological changes happening in their body, necessary lifestyle changes and alternate therapies to overcome the symptoms. All major electronic sources of relevant information were systematically searched and collected data were pooled under specific subheadings. From the reviewed papers, the awareness on symptoms and related complications of menopause in the middle aged women were consolidated. Studies helped to identify alternative therapies replacing or in parallel with the Hormone Replacement Therapy to overcome the menopausal symptoms. Reduced oestrogen and progesterone level causes physiological, psychological, and genitourinary symptoms. Prolonged consequences cause libido, osteoporosis, and cardio vascular diseases. Hypo-estrogenic status is well managed with alternative therapies including dietary intervention, acupuncture, aromatherapy, exercise, and yoga. Dietary interventions involving foods like Fennel, Soy, Black Cohash, St. John Wort, Red Clover and Date Pollen were found to be managing vasomotor symptoms and sexual dysfunction. Non-Hormonal and Non-Pharmacological impact behind acupuncture treatment was well accepted. Various studies proved inhaling and massaging with Lavender, Neroli oil, Fennel, Rose, and Geranium essential oils balance cortisol hormone and reduce stress and anxiety. Impact of yoga therapy on neurohormonal pathways reduce both psychological and physiological symptoms. Reviews summarizes various symptoms and complications during menopausal transition and alternate ways of better management with dietary intervention, yoga, exercise, aromatherapy, and acupuncture to improve the quality of menopausal women's life.
PubMed: 38312763
DOI: 10.4103/jmh.jmh_222_22 -
International Journal of Reproductive... Nov 2023The quality of life of a person and her sexual partner is impacted by sexual function. Sexual function disorders have a significant prevalence in society. There are... (Review)
Review
The quality of life of a person and her sexual partner is impacted by sexual function. Sexual function disorders have a significant prevalence in society. There are different treatments for sexual disorders, including herbal therapies. This study aimed to do a comparison of phytoestrogens and non-phytoestrogens medicinal plant's effects on sexual health in pre- and postmenopausal women. This systematic review and meta-analysis was performed to identify relevant articles in electronic databases such as Web of Science, Scopus, PubMed, Cochrane Library, Google Scholar, and SID for English- and Persian-language articles published up to December 2021. The Cochrane collaboration tool was used to assess the risk of bias. Heterogeneity was assessed using I statistics. Of 5428 records retrieved by searching the databases, after removing duplicate and irrelevant articles, 39 articles were included based on the inclusion criteria in the study. Finally, 18 articles with 1299 participants were included in the meta-analysis. 18 randomized clinical trial studies of phytoestrogens (n = 13) and non-phytoestrogens (n = 5) plants that used the female sexual function index questionnaire and reported the mean difference (MD) and standard deviation were included in the meta-analysis. The effects of phytoestrogens and non-phytoestrogens plants on the sexual health of postmenopausal women appear to differ significantly from one another, according to the meta-analysis (MD = 7.59; 95% CI = 4.56-10.60 and MD = 3.19; 95% CI = 1.25-5.13, respectively) but this difference was not observed in premenopausal women. The effect of phytoestrogens plants is more in menopausal women, and they can be advised to use these herbs.
PubMed: 38292511
DOI: 10.18502/ijrm.v21i11.14652 -
BMC Women's Health Jan 2024Menopause hormone therapy (MHT), as an effective method to alleviate the menopause-related symptoms of women, its benefits, risks, and potential influencing factors for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Menopause hormone therapy (MHT), as an effective method to alleviate the menopause-related symptoms of women, its benefits, risks, and potential influencing factors for the cardiovascular system of postmenopausal women are not very clear.
OBJECTIVES
To evaluate cardiovascular benefits and risks of MHT in postmenopausal women, and analyze the underlying factors that affect both.
SEARCH STRATEGY
The EMBASE, MEDLINE, and CENTRAL databases were searched from 1975 to July 2022.
SELECTION CRITERIA
Randomized Clinical Trials (RCTs) that met pre-specified inclusion criteria were included.
DATA COLLECTION AND ANALYSIS
Two reviewers extracted data independently. A meta-analysis of random effects was used to analyze data.
MAIN RESULTS
This systematic review identified 33 RCTs using MHT involving 44,639 postmenopausal women with a mean age of 60.3 (range 48 to 72 years). There was no significant difference between MHT and placebo (or no treatment) in all-cause death (RR = 0.96, 95%CI 0.85 to 1.09, I = 14%) and cardiovascular events (RR = 0.97, 95%CI 0.82 to 1.14, I = 38%) in the overall population of postmenopausal women. However, MHT would increase the risk of stroke (RR = 1.23, 95%CI 1.08 to 1.41,I = 0%) and venous thromboembolism (RR = 1.86, 95%CI 1.39 to 2.50, I = 24%). Compared with placebo, MHT could improve flow-mediated arterial dilation (FMD) (SMD = 1.46, 95%CI 0.86 to 2.07, I = 90%), but it did not improve nitroglycerin-mediated arterial dilation (NMD) (SMD = 0.27, 95%CI - 0.08 to 0.62, I = 76%). Compared with women started MHT more than 10 years after menopause, women started MHT within 10 years after menopause had lower frequency of all-cause death (P = 0.02) and cardiovascular events (P = 0.002), and more significant improvement in FMD (P = 0.0003). Compared to mono-estrogen therapy, the combination therapy of estrogen and progesterone would not alter the outcomes of endpoint event. (all-cause death P = 0.52, cardiovascular events P = 0.90, stroke P = 0.85, venous thromboembolism P = 0.33, FMD P = 0.46, NMD P = 0.27).
CONCLUSIONS
MHT improves flow-mediated arterial dilation (FMD) but fails to lower the risk of all-cause death and cardiovascular events, and increases the risk of stroke and venous thrombosis in postmenopausal women. Early acceptance of MHT not only reduces the risk of all-cause death and cardiovascular events but also further improves FMD, although the risk of stroke and venous thrombosis is not reduced. There is no difference in the outcome of cardiovascular system endpoints between mono-estrogen therapy and combination therapy of estrogen and progesterone.
Topics: Female; Humans; Middle Aged; Aged; Venous Thromboembolism; Postmenopause; Progesterone; Arteries; Stroke; Estrogens; Hormone Replacement Therapy; Venous Thrombosis; Risk Assessment
PubMed: 38263123
DOI: 10.1186/s12905-023-02788-0 -
Journal of Clinical Medicine Jan 2024(1) Background: Women in their middle years undergoing perimenopause encounter a range of physical and psychological alterations attributed to hormonal changes. The... (Review)
Review
(1) Background: Women in their middle years undergoing perimenopause encounter a range of physical and psychological alterations attributed to hormonal changes. The prominent symptoms among menopausal women are depressive symptoms and sleep-related problems. The aim of this study was to conduct a meta-analysis examining the effects of Cognitive Behavioral Therapy (CBT) on women going through menopause, specifically focusing on depressive symptoms and sleep problems. We analyzed studies conducted both within the country and across international settings over the last decade. (2) Methods: A search of the literature was conducted-a targeted search, exclusively considering randomized controlled trials (RCTs) that were published within the timeframe spanning from 15 June 2013 to 15 June 2023. (3) Findings: Upon reviewing nine studies that satisfied our inclusion criteria and involved a total of 923 participants, it was noted that four of these studies incorporated diverse cognitive-behavioral strategies. Among the nine studies, a total of four were included in the meta-analysis: two measured depressive symptoms, and two measured sleep quality. The combined effect size for depressive symptoms was found to be 3.55 (95% confidence interval: -5.48, -1.61; < 0.05), and for sleep quality, it was 0.78 (95% confidence interval: -1.32, -0.25; = 0.004). (4) Conclusions: Our review emphasizes the necessity for conducting larger-scale studies focused on the application of CBT for women experiencing menopausal symptoms. Additionally, it is recommended to approach the interpretation of these results with caution due to discrepancies in methodology and the overall quality of the studies. Further clinical trials are necessary to establish the ideal number of CBT sessions needed for the effective treatment of depression in menopausal women. Future studies should cover a wider range of geographical locations, including more countries, and focus on various outcomes such as depressive symptoms and sleep quality.
PubMed: 38256545
DOI: 10.3390/jcm13020412