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Vollrath S, Theis S, Kolokythas A, Janka H, Schleich S, Moreth J, Kiesel L, Stute P. Self-management eHealth solutions for menopause - a systematic scoping review. Climacteric 2024; 27:255-268. [PMID: 38685754 DOI: 10.1080/13697137.2024.2334035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/18/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVE The purpose of this scoping review was to highlight the current scientific evidence on eHealth-based information tools for menopause in terms of quality, requirements and previous intervention outcomes. METHODS We systematically searched electronic databases (Embase, CINAHL, Cochrane Library, Global Health Database [Ovid], Web of Science, ClinicalTrials.gov [NLM], LIVIVO Search Portal [ZB MED] and Google Scholar) from 1974 to March 2022 for relevant records. RESULTS Our search yielded 1773 records, of which 28 met our inclusion criteria. Thirteen of 28 selected studies were cross-sectional with qualitative content analysis of websites about menopause; 9 studies were cohort studies examining the impact of an eHealth intervention; two studies were randomized controlled trials comparing eHealth tools with conventional ones; and four studies were non-systematic literature reviews. CONCLUSION This scoping review highlights the potential of eHealth-based information tools for the management of menopause and shows that most eHealth-based information tools are inadequate in terms of readability and the balanced view on information. Providers of eHealth-based information tools should pay attention to a participatory design, readability, balance of content and the use of multimedia tools for information delivery to improve understanding.
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Affiliation(s)
- Sabrina Vollrath
- Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland
| | - Susanne Theis
- Department of Obstetrics and Gynecology, University Medical Center Mainz, Mainz, Germany
| | - Argyrios Kolokythas
- Department of Obstetrics and Gynecology, McGill University, Montreal, Canada
| | - Heidrun Janka
- Medical Library, University Library Bern, University of Bern, Switzerland
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | | | - Ludwig Kiesel
- Department of Gynecology and Obstetrics, University Hospital, Münster, Germany
| | - Petra Stute
- Department of Obstetrics and Gynecology, University of Bern, Bern, Switzerland
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Takatsuka D, Sawaki M, Hattori M, Yoshimura A, Kotani H, Kataoka A, Horisawa N, Ozaki Y, Endo Y, Nozawa K, Iwata H. Arthralgia induced by endocrine therapy with or without cyclin-dependent kinase 4/6 inhibitors in breast cancer: A systematic review and meta-analysis. Asia Pac J Clin Oncol 2023; 19:e175-e182. [PMID: 36085411 DOI: 10.1111/ajco.13840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 07/22/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
Cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in combination with endocrine therapy (ET) have been approved for breast cancer (BC) treatment. Several trials suggested that arthralgia was reduced in patients treated with ET plus CDK4/6i compared with that in those with ET-alone. We aimed to compare arthralgia rates in BC patients treated with/without CDK4/6i. We reviewed randomized controlled phase II/III trials investigating CDK4/6i with ET in hormone receptor-positive and epidermal growth factor 2-negative BC. Publications were retrieved from PubMed from January 2014 to April 2021. We compared arthralgia rates between patients who were administered ET plus CDK4/6i (CDK4/6i group) and those treated with ET-alone (control group). We reviewed 12 trials that reported data on adverse effects for arthralgia. These trials included 17,440 patients (9255 in the CDK4/6i group and 8185 in the control group). The arthralgia rate in the CDK4/6i group was significantly lower than that in the control group (27.6% vs. 34.8%, p < .001), especially in early BC (28.8% vs. 37.3%, p < .001). These suggested that the arthralgia rate in patients treated with ET plus CDK4/6i was lower than that in patients treated with ET-alone and that CDK4/6i may decrease the arthralgia rate in BC patients treated with ET, especially in early BC.
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Affiliation(s)
- Daiki Takatsuka
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Masataka Sawaki
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Masaya Hattori
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Akiyo Yoshimura
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Haruru Kotani
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Ayumi Kataoka
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Nanae Horisawa
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Yuri Ozaki
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Yuka Endo
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Kazuki Nozawa
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
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Pershad A, Morris JM, Shearer K, Pace D, Khanna P. Influencing factors on women's attitudes toward hormone therapy acceptance for menopause treatment: a systematic review. Menopause 2023; 30:1061-1069. [PMID: 37643393 DOI: 10.1097/gme.0000000000002243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
IMPORTANCE There is a paucity of data on recent attitudes and perceptions toward hormone therapy use, especially subsequent reanalysis and follow-up of Women's Health Initiative data. OBJECTIVE The aim of this systematic review was to assess the factors influencing women's attitudes and perceptions toward hormone therapy use for menopausal symptoms. EVIDENCE REVIEW We conducted a comprehensive search of several medical databases including PubMed, Web of Science, Google Scholar, and Scopus. Quality assessment was performed using the Strengthening the Reporting of Observational Studies in Epidemiology Statement for cross-sectional studies. A search was conducted for cross-sectional articles published from January 2012 to March 2023 in English medical databases (PubMed, Web of Science, Scopus, and Google Scholar). Search keywords included "hormone therapy," "acceptance," "menopause," "attitudes," "influence," "factor," "estrogen," "perimenopause," "postmenopause," and "climacteric." Studies evaluating factors that influenced women's attitudes toward hormone therapy were identified. FINDINGS A total of 1,280 articles were initially identified. Twenty-one articles were ultimately included in the review after screening studies based on inclusion and exclusion criteria. The studies were conducted between 2012 and 2023 and included a total of 40,226 participants. The most common positive factor included awareness of the existence and efficacy of hormone therapy. The most common negative factors included concern for general adverse effects and negative perception of hormone therapy from family and friends. The factors assessed in this review on women's attitudes toward hormone therapy acceptance for menopause treatment were categorized into three main themes: (1) demographic factors, (2) environmental/contextual factors, and (3) health care-related factors. CONCLUSIONS AND RELEVANCE Hormone therapy can be a safe and effective tool to improve the quality of life in perimenopausal and postmenopausal women with vasomotor and genitourinary symptoms. However, there are many complex factors that shape women's perceptions of the efficacy, safety, and accessibility of hormone therapy. Healthcare providers should seek to understand these factors to better discuss the benefits and risks with women and assist with decision making based on cultural, personal, and environmental factors.
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Affiliation(s)
- Anita Pershad
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
| | | | - Katie Shearer
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
| | - Diane Pace
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
| | - Pallavi Khanna
- From the Department of Obstetrics and Gynecology, University of Tennessee Health Science Center, Memphis, TN
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Shiozawa A, Thurston RC, Cook E, Yang H, King DD, Kristy RM, Mancuso S. Assessment of women's treatment preferences for vasomotor symptoms due to menopause. Expert Rev Pharmacoecon Outcomes Res 2023; 23:1117-1128. [PMID: 37650213 DOI: 10.1080/14737167.2023.2250916] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/14/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Several therapies for vasomotor symptoms (VMS) due to menopause are available. Treatment preferences and willingness-to-pay for VMS treatment among US women with VMS were evaluated. METHODS An online survey of women with perimenopausal or postmenopausal VMS was conducted (3/15/21-4/23/21). A discrete choice experiment quantified the impact of 7 treatment attributes on VMS treatment choice: VMS frequency/severity reduction, sleep improvement, risk of breast cancer/cardiovascular events in 6 years, risk of short-term side effects, and out-of-pocket costs. Preference weights (PWs) with 95% confidence intervals (CIs) were estimated and reported. RESULTS Among 467 women, 86.5% and 87.8% reported moderate to very severe VMS and sleep problems during the preceding month, respectively. Sleep improvement (PW: 0.843; 95% CI: 0.721, 0.965) and reduction in VMS frequency (PW: 0.658; 95% CI: 0.520, 0.796) and severity (PW: 0.628; 95% CI: 0.500, 0.756) most influenced treatment preference; risk of cardiovascular events (PW: 0.150; 95% CI: 0.069, 0.232) or breast cancer (PW: 0.401; 95% CI: 0.306, 0.496) in 6 years had lesser effect. Willingness-to-pay was an additional $35-$46/month for substantially improved sleep, 80% VMS frequency reduction, and reduction from severe to mild VMS. CONCLUSIONS Sleep improvement and reductions in VMS frequency/severity were the most important treatment attributes.
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Affiliation(s)
- Aki Shiozawa
- Medical Affairs US, Astellas Pharma, Inc, Northbrook, IL, USA
| | - Rebecca C Thurston
- Departments of Psychiatry, Psychology, Clinical and Translational Science and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erin Cook
- Analysis Group, Inc, Boston, MA, USA
| | | | - Deanna D King
- Medical Affairs US, Astellas Pharma, Inc, Northbrook, IL, USA
| | - Rita M Kristy
- Medical Affairs US, Astellas Pharma, Inc, Northbrook, IL, USA
| | - Shayna Mancuso
- Medical Affairs US, Astellas Pharma, Inc, Northbrook, IL, USA
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Lycke A, Brorsson A. Swedish women's experiences of menopausal transition: A focus group study. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 35:100807. [PMID: 36528995 DOI: 10.1016/j.srhc.2022.100807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/07/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to examine women's experience of menopausal transition and their expectations and wishes for support from healthcare. Further, to examine their knowledge about menopause and thoughts about current attitudes in healthcare and in society generally. METHODS Data was collected through three focus group interviews with 14 women experiencing menopausal symptoms. The qualitative analysis was transacted through systematic text condensation, where categories were derived from data. RESULTS The women in this study told us about being inadequately prepared for menopause through having insufficient knowledge of the menopausal transition. They experienced lack of clarity about where in the health care system they could get help and that knowledge of menopause varied among healthcare staff. The attitudes to menopause experienced by women in this study were both positive and negative, but they often equated menopause with getting old. To be better prepared for the climacteric transition, the women wanted information from health care professionals and they wanted menopausal care to be easily accessible and local. If needed, it should be possible to access clinics providing specialist care. CONCLUSION This work indicates that women want more and improved information about menopause in order to be better prepared. Advice and treatment for menopausal healthcare care should be easily accessible for women. Improved education and care guidelines for menopausal problems can be helpful for healthcare staff.
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Affiliation(s)
- Anette Lycke
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Clinical Research Center, Box 50332, 20213 Malmö, Sweden.
| | - Annika Brorsson
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Clinical Research Center, Box 50332, 20213 Malmö, Sweden.
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Pompei LM, Bonassi-Machado R, Steiner ML, Pompei IM, de Melo NR, Nappi RE, Fernandes CE. Profile of Brazilian climacteric women: results from the Brazilian Menopause Study. Climacteric 2022; 25:523-529. [PMID: 35801642 DOI: 10.1080/13697137.2022.2088276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE This study aims to understand the epidemiological characteristics of Brazilian menopausal women, and their view on menopause hormone therapy (MHT). METHODS A national cross-sectional study with 1500 women between 45 and 65 years old was carried out through questionnaires. RESULTS The overall median age of participants was 52 [47-56] years, and 55 [52-59] years for the postmenopausal subgroup. Menstrual irregularity started at median age 46 [44-49] years. Median menopause age was 48 [45-51] years with no differences between socioeconomic classes. The prevalence of any climacteric symptoms was 87.9% and hot flashes started at median age 47 [45-50] years. Among women in menopause/menopausal transition, 52.1% received any medical prescription, and MHT was recommended for 22.3%. Among those who started MHT, 45.4% were still using the treatment and the median duration of use was 8 months, but different among socioeconomic classes (24 months for class A against 3 months for class D/E). CONCLUSIONS In this first Brazilian national population-based study on menopause and MHT, it was observed that, in spite of being symptomatic when entering menopause around 48 years of age, only a small part of Brazilian women started MHT and the median duration of treatment was less than 1 year, but the duration was higher for higher socioeconomic class.
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Affiliation(s)
- L M Pompei
- Obstetric and Gynecology Department, Faculdade de Medicina do ABC, Santo André, Brazil
| | - R Bonassi-Machado
- Obstetric and Gynecology Department, Faculdade de Medicina de Jundiaí, Jundiaí, Brazil
| | - M L Steiner
- Obstetric and Gynecology Department, Faculdade de Medicina do ABC, Santo André, Brazil
| | - I M Pompei
- Medicine Student, Faculdade de Medicina de Jundiaí, Jundiaí, Brazil
| | - N R de Melo
- Obstetric and Gynecology Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - R E Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS San Matteo Foundation, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - C E Fernandes
- Obstetric and Gynecology Department, Faculdade de Medicina do ABC, Santo André, Brazil
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Bullington BW, Edmonds A, Ramirez C, Rahangdale L, Neal-Perry G, Konkle-Parker D, Weiss DJ, Moran C, Golub ET, Cejtin H, Seidman D, Kassaye S, Wilson TE, Sharma A, Adimora AA, Knittel AK. Premature and early menopause among US women with or at risk for HIV. Menopause 2022; 29:741-747. [PMID: 35324546 PMCID: PMC9177513 DOI: 10.1097/gme.0000000000001964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Little is known about the prevalence and treatment of premature and early menopause among people with HIV. We described premature and early menopause and subsequent hormonal treatment in a longitudinal cohort of women living with or at risk for HIV in the US. METHODS Data from the Women's Interagency HIV Study between 2008 and 2020 were analyzed to describe premature and early menopause among cohort participants under the age of 51. RESULTS Of 3,059 eligible women during the study period, 1% (n = 35) underwent premature menopause before age 41, 3% (n = 101) underwent menopause between ages 41 and 46, and 21% (n = 442) underwent menopause between ages 46 and 50, inclusive. Of participants who experienced menopause before age 41, between age 41 and 45, and between ages 46 and 50, 51%, 24%, and 7% (respectively) received either menopausal hormone therapy or hormonal contraception. CONCLUSION These findings suggest that disparities in receipt of recommended hormone therapy for premature and early menopause may contribute, in part, to evident health disparities, such as cardiovascular disease, osteoporosis, and overall mortality. They also suggest a substantial need for education among people experiencing early menopause and their providers, with the goal of improving access to hormone therapy based on guidelines to address health disparities and minimize future health consequences.
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Affiliation(s)
- Brooke W Bullington
- From the department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Andrew Edmonds
- From the department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Catalina Ramirez
- Institute for Global Health & Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lisa Rahangdale
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Deborah Konkle-Parker
- Department of Medicine, Division of Infectious Diseases, University of Mississippi Medical Center, Jackson, MS
| | - Deborah Jones Weiss
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Caitlin Moran
- Department of Medicine, Division of Infectious Disease, Emory University, Atlanta, GA
| | - Elizabeth Topper Golub
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Helen Cejtin
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, John H. Stroger Jr. Hospital of Cook County, Chicago, IL
| | - Dominika Seidman
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA
| | - Seble Kassaye
- Division of Infectious Diseases, Department of Medicine, Georgetown University, Washington DC
| | - Tracey E Wilson
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Adaora A Adimora
- From the department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Institute for Global Health & Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Andrea K Knittel
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Baquedano L, Fasero M, Gabasa L, Coronado P, Presa J, Mendoza N. What do Spanish women know about menopause? COMEM study. J OBSTET GYNAECOL 2022; 42:1448-1454. [PMID: 35019792 DOI: 10.1080/01443615.2021.1998892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of the study was to evaluate the level of knowledge that women have about menopause and to analyse whether sociodemographic aspects can influence it. For this, a multi-centre observational study was conducted in Spain using a survey including 2500 women between 35 and 75 years. Participants were administered a 10-question questionnaire with a maximum score of 45 points. The responses of 2355 women were analysed. The median age was 52 years (IQR 45-59) and the median of knowledge score was 22 points (IQR 16-27). Age (p < .001), menopausal status (p = .030), early menopause (p = .001), educational level (p < .001), type of healthcare (p < .001) and sources of information on menopause (p < .001) were factors related to the score on the questionnaire. We conclude that Spanish women have limited knowledge about menopause and it is urgent to implement training programs that can improve it.IMPACT STATEMENTWhat is already known on this subject? The knowledge and attitudes about menopause among women can vary across countries and also according to sociocultural context. It also seems that negative attitudes towards menopause and poor knowledge of the physiology and the most frequent symptoms have an increasing effect on the severity of the specific symptoms of menopause that cause further discomfort.What do the results of this study add? There are very few available reports or research on the issue of postmenopausal health in Spain. We believe that it is appropriate to explore the level of knowledge of women in our country. We have verified that the level of knowledge of Spanish women is low and that some sociodemographic aspects can influence itWhat are the implications of these findings for clinical practice and/or further research? Taking into account our results, it is a priority to implement health training programs to improve knowledge about menopause in Spanish women and overcome false myths and wrong beliefs.
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Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Lourdes Gabasa
- Gynecology Department of Miguel, Servet University Hospital, Zaragoza, Spain
| | - Pluvio Coronado
- Women's Health Institute of the Hospital Clínico San Carlos, IdISSC, Complutense University, Madrid, Spain
| | - Jesus Presa
- Service of Obstetrics and Gynecology, University Hospital Jaén, Jaén, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Spain
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Murtaza F, Shirreff L, Huang LN, Jacobson M, Jarcevic R, Christakis MK. Quality and readability of online health information on menopausal hormone therapy in Canada: what are our patients reading? Menopause 2021; 29:54-62. [PMID: 34905747 DOI: 10.1097/gme.0000000000001881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the quality and readability of 24 of the most accessed menopause hormone therapy (MHT) websites by Canadian women. METHODS The top 24 websites from Google, Bing, and Yahoo were identified using the search term "hormone replacement therapy." Five menopause specialists assessed website content quality using the DISCERN Instrument, Journal of the American Medical Association (JAMA) benchmarks, and Abbott's Scale. Two reviewers assessed website credibility using the Health on the Net Foundation Code of Conduct certification, and website readability using the Simple Measure of Gobbledygook, Flesch-Kincaid Grade Level, and Flesch-Kincaid Read Ease formulae. RESULTS Scores for quality of information varied. The mean JAMA score was low at 2.3 ± 1.1 (out of 4). Only one website met all benchmarks. Fourteen websites (58%) had a good/excellent DISCERN score, while four (17%) had a poor/very poor score. For Abbott's Scale, both the mean authorship score at 2.2 ± 1.0 (out of 4) and mean content score at 45.9 ± 9.8 (out of 100) were low. Inter-rater reliability was high for all tools. Fifteen websites (63%) were Health on the Net Foundation Code of Conduct certified. The mean Flesch-Kincaid Read Ease was 42.7 ± 10.3, mean Flesch-Kincaid Grade Level was 12.3 ± 1.9, and mean Simple Measure of Gobbledygook grade level was 11.3 ± 1.5. Only one website presented content at a reading level recommended for the public. Websites meeting more JAMA benchmarks were significantly less readable (P < 0.05). CONCLUSION Although good quality MHT information exists online, several resources are inaccurate or incomplete. Overall, these resources are not considered comprehensible by the public. There is a need to disseminate accurate, comprehensive, and understandable MHT information online.
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Affiliation(s)
- Fahmeeda Murtaza
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lindsay Shirreff
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Lina N Huang
- Obstetrics & Gynaecology, Lakeshore General Hospital, Montreal, Quebec, Canada
- Department of Obstetrics and Gynaecology, McGill University, Montreal, Quebec, Canada
| | - Michelle Jacobson
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics & Gynaecology, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Radomir Jarcevic
- Obstetrics and Gynaecology, CIUSSS-de-l'Est-de-l'Île-de-Montréal, Montreal, Quebec, Canada
- Department of Obstetrics and Gynaecology, Université de Montréal, Montreal, Quebec, Canada
| | - Marie K Christakis
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- Obstetrics & Gynaecology, St. Michael's Hospital, Toronto, Ontario, Canada
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Menopausal hormone therapy: Characterising users in an Australian national cross-sectional study. PLoS One 2021; 16:e0253725. [PMID: 34379634 PMCID: PMC8357145 DOI: 10.1371/journal.pone.0253725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/05/2021] [Indexed: 11/19/2022] Open
Abstract
Menopausal hormone therapy (MHT) is effective for menopausal symptoms, however, its use is also associated with risks of serious health conditions including breast, ovarian and endometrial cancer, stroke and venous thromboembolism. MHT-related health risks increase with longer durations of use. In Australia, while overall MHT use fell when risk-related findings were published in 2002, a significant number of women continue using MHT long-term. We aimed to examine socio-demographic, health-related and lifestyle characteristics in relation to post-2002 MHT use, and to compare use for <5 and ≥5 years. Data from 1,561 participants from an Australian, national, cross-sectional survey of women aged 50–69 in 2013 were analysed. Odds ratios (ORs) were calculated using logistic regression for characteristics related to overall MHT use post-2002 and multinomial logistic regression for associations between MHT duration of use [never/<5 years/≥5 years] and personal characteristics, adjusting for sociodemographic, reproductive, health and lifestyle factors. Post-2002 MHT use was associated with increasing age (p-trend<0.001), hysterectomy versus no hysterectomy (OR:2.55, 95%CI = 1.85–3.51), bilateral oophorectomy vs no oophorectomy (OR:1.66, 95%CI = 1.09–2.53), and ever- versus never-use of therapies other than MHT for menopausal symptoms (OR:1.93, 95%CI = 1.48–2.57). Women with prior breast cancer (OR:0.35, 95%CI = 0.17–0.74) and with more children (p-trend = 0.034) were less likely than other women to use MHT. Prior hysterectomy was more strongly associated with MHT use for ≥5 years than for <5 years (p = 0.004). Ever-use of non-MHT menopausal therapies was associated with MHT use for <5 years but not with longer-term use (p = 0.004). This study reinforces the need for MHT users and their clinicians to re-evaluate continued MHT use on an ongoing basis.
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Dayaratna S, Sifri R, Jackson R, Powell R, Sherif K, DiCarlo M, Hegarty SE, Petrich A, Lambert E, Quinn A, Myers R. Preparing women experiencing symptoms of menopause for shared decision making about treatment. Menopause 2021; 28:1060-1066. [PMID: 34260477 DOI: 10.1097/gme.0000000000001807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To develop a decision support intervention that can be used with women experiencing menopausal symptoms to facilitate treatment shared decision making. METHODS Our research team contacted patients with reported menopausal symptoms by telephone to obtain consent and administer a baseline survey. Subsequently, we sent participants a booklet on the treatment of menopausal symptoms. A nurse educator then contacted participants by telephone to review the booklet and guide them through a structured decision counseling exercise designed to help clarify treatment preference. A 60-day endpoint telephone survey was completed. RESULTS Forty-eight consenting participants completed the baseline survey and 37 (77%) also completed a decision counseling session. At baseline, 19 of the women who had decision counseling were not being treated for menopausal symptoms and 18 were being treated. After decision counseling, 13 (68%) participants who were not being treated and 14 (78%) who were being treated identified a preferred treatment. Comparison of baseline and endpoint survey data showed that participant treatment knowledge increased (P = 0.007) and treatment decisional conflict decreased (P < 0.001). Furthermore, 71% of participants reported that they had received new information about treatment and 94% said they believed better prepared to discuss treatment with their healthcare provider. CONCLUSIONS Nurse-led decision counseling increased participant treatment knowledge, reduced treatment decisional conflict, and helped to clarify treatment preference. Implementation of this strategy could help to facilitate provider-patient shared decision making about the treatment of menopausal symptoms.
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Affiliation(s)
- Sandra Dayaratna
- Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA
| | - Randa Sifri
- Department of Family and Community Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Rebecca Jackson
- Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA
| | - Rhea Powell
- Division of Internal Medicine, Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Katherine Sherif
- Division of Women's Health, Department of Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Melissa DiCarlo
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Sarah E Hegarty
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA
| | - Anett Petrich
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Emily Lambert
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Anna Quinn
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
| | - Ronald Myers
- Division of Population Science, Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA
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Burla L, Kalaitzopoulos DR, Metzler JM, Scheiner D, Imesch P. Popularity of endocrine endometriosis drugs and limited alternatives in the present and foreseeable future: A survey among 1420 affected women. Eur J Obstet Gynecol Reprod Biol 2021; 262:232-238. [PMID: 34091158 DOI: 10.1016/j.ejogrb.2021.05.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/18/2021] [Accepted: 05/23/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Endocrine drugs represent an important cornerstone of endometriosis therapy. Pharmaceutical alternatives with similar efficacy remain out of sight in the near future. Aim of this study is to investigate attitudes and perceptions concerning endocrine therapies among affected women. STUDY DESIGN An online survey was distributed via social media in Austria, Germany, and Switzerland. Primary endpoints were satisfaction, attitudes and perceptions towards endocrine endometriosis drugs and secondary outcomes differences regarding demographic variables. RESULTS Of 1420 respondents, 63.5 % (n = 901) described their own attitude towards these drugs as rather negative. The most frequently reported unfavorable associations and experiences were sideeffects in general (85.5 %, n = 1181), change in libido (67.5 %, n = 932), hormone cycle disruptions (65.9 %, n = 910), and inefficiency at alleviating symptoms (38.2 %, n = 527). In total, 66.1 % (n = 935) were not satisfied with endocrine drugs for endometriosis. Age ≤ 30 years, living in a large city, and having an academic degree were significantly correlated to a more negative perception of these drugs and greater dissatisfaction with current endocrine endometriosis drugs. CONCLUSIONS Among women with endometriosis - and particularly among those aged ≤30 years, being large-city residents, or holding an academic degree - there appears to be a relevant degree of rejection and wariness towards endocrine endometriosis drugs. Given the prevalence of endometriosis and the few pharmaceutical alternatives on the horizon, these data point a growing need for further research and development of non-hormonal drugs for the treatment of endometriosis.
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Affiliation(s)
- Laurin Burla
- Department of Gynecology, University Hospital Zurich, Zurich, Switzerland.
| | | | | | - David Scheiner
- Department of Gynecology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Imesch
- Department of Gynecology, University Hospital Zurich, Zurich, Switzerland
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Grandi G, Boggio Sola V, Cortesi L, Toss A, Giuliani GA, Del Savio MC, Facchinetti F. BRCA mutation carriers' perceptions on postmenopausal hormone therapy: An Italian study. Psychooncology 2021; 30:1711-1719. [PMID: 34002428 PMCID: PMC8518789 DOI: 10.1002/pon.5714] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/30/2021] [Accepted: 05/07/2021] [Indexed: 11/23/2022]
Abstract
Objective To evaluate the actual perceptions of postmenopausal hormone therapy (HT) in BRCA mutation carriers (BRCAmc) in comparison with women from the general population. Methods Questionnaire‐based study of 83 BRCAmc and a control group of 89 women without a genetic mutation. Perceptions were evaluated by specific questions and Likert scales (−5–+5). Results Present and past users of HT were more frequent in the control group (p = 0.01), with a longer time of use (p = 0.03). The preferred route of administration of HT was ‘oral’ (54.6%). The most frequently reported adverse effect of HT was venous thrombosis (0.8), while a protective effect on bone health was reported. No noticeable beneficial effects of HT have been recognised for hot flushes (0.2) and vaginal dryness (0.1). The most frequently perceived beneficial and adverse effects of HT were not significantly different between BRCA mutation carriers and controls. The greatest oncological fear was breast cancer (1.0). The protective role of HT on colorectal cancer was not known (0.1). These oncological impacts were mostly overestimated in BRCAmc, however this was not significant. Few BRCAmc would think of taking HT after risk‐reducing surgeries. Conclusions Knowledge of the effects of HT on BRCAmc is relatively poor and they are likely to overstate its negative effects and underestimate its health benefits; however, this is not significant in comparison to the general population. More and better information should be given to BRCAmc to allow them to make informed decisions about the use of HT, especially before undergoing risk‐reducing surgeries.
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Affiliation(s)
- Giovanni Grandi
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Valentina Boggio Sola
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Laura Cortesi
- Department of Oncology, Haematology and Respiratory Disease, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Angela Toss
- Department of Oncology, Haematology and Respiratory Disease, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - Giulia Andrea Giuliani
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Maria Chiara Del Savio
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Fabio Facchinetti
- Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
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Kanadys W, Barańska A, Błaszczuk A, Polz-Dacewicz M, Drop B, Kanecki K, Malm M. Evaluation of Clinical Meaningfulness of Red Clover ( Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2021; 13:nu13041258. [PMID: 33920485 PMCID: PMC8069620 DOI: 10.3390/nu13041258] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 12/18/2022] Open
Abstract
The meta-analysis presented in this article covered the efficacy of red clover isoflavones in relieving hot flushes and menopausal symptoms in perimenopausal and postmenopausal women. Studies were identified by MEDLINE (PubMed), Embase, and the Cochrane Library searches. The quality of the studies was evaluated according to Cochrane criteria. A meta-analysis of eight trials (ten comparisons) demonstrated a statistically significant reduction in the daily incidence of hot flushes in women receiving red clover compared to those receiving placebo: weighted mean difference (WMD—weighted mean difference) −1.73 hot flushes per day, 95% CI (confidence interval) −3.28 to −0.18; p = 0.0292. Due to 87.34% homogeneity, the performed analysis showed substantive difference in comparisons of postmenopausal women with ≥5 hot flushes per day, when the follow-up period was 12 weeks, with an isoflavone dose of ≥80 mg/day, and when the formulations contained a higher proportion of biochanin A. The meta-analysis of included studies assessing the effect of red clover isoflavone extract on menopausal symptoms showed a statistically moderate relationship with the reduction in the daily frequency of hot flushes. However, further well-designed studies are required to confirm the present findings and to finally determine the effects of red clover on the relief of flushing episodes.
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Affiliation(s)
- Wiesław Kanadys
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
| | - Agnieszka Barańska
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
- Correspondence:
| | - Agata Błaszczuk
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-093 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Bartłomiej Drop
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Warsaw Medical University, 02-007 Warsaw, Poland;
| | - Maria Malm
- Department of Informatics and Medical Statistics, Medical University of Lublin, 20-090 Lublin, Poland; (W.K.); (B.D.); (M.M.)
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Baquedano L, Espiau A, Fasero M, Ortega S, Ramirez I, Mendoza N. Beliefs, knowledge and the impact of COVID19 on menopause therapies in Spanish women: COMEM-treatment study. BMC Womens Health 2020; 20:277. [PMID: 33371883 PMCID: PMC7768270 DOI: 10.1186/s12905-020-01151-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/14/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To study what women think about menopause treatments and assess their knowledge about them. To analyze adherence to treatment during COVID-19 confinement as a secondary objective. METHODS A multi-center cross-sectional observational study was conducted using a survey of 2500 women between January and June 2019. This was administered following a non-probability sampling procedure including women between 35 and 75 years. An extension study was conducted during the coronavirus pandemic, between March and June 2020. RESULTS The responses of 2355 surveyed women were analyzed. Of this sample, 42% knew about menopause hormone therapy (MHT). The most frequently identified indication was the treatment of hot flashes (65.6%). The MHT risks most frequently perceived were weight gain (24.2%) and breast cancer (21.7%); the main reason for rejecting MHT was a lack of information (96.1%). Comparative analyses were conducted according to age, menopausal status, type of menopause, place of residence, type of health care and level of education. During the coronavirus confinement period, 85 women using MHT were located, of which 84.7% continued it. CONCLUSIONS Women hold certain false beliefs about menopause, and their knowledge of the available treatments is somewhat limited. Adherence to MHT during the COVID-19 confinement in Spain has been high.
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Affiliation(s)
- Laura Baquedano
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain.
| | - Andrea Espiau
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - María Fasero
- Service of Obstetrics and Gynecology, Hospital Sanitas La Zarzuela, Madrid, Spain
| | - Silvia Ortega
- Gynecology Department of Miguel, Servet University Hospital, Paseo Isabel La Católica 1-3, 50009, Zaragoza, Spain
| | - Isabel Ramirez
- Sexual and Reproductive Health Service, UGC Dr Cayetano Roldan San Fernando Health Centre, Cadiz, Spain
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
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16
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Moon SA, Bae J, Kim K, Cho SY, Kwon G, Lee R, Ko SH, Lim S, Moon C. EEG Revealed That Fragrances Positively Affect Menopausal Symptoms in Mid-life Women. Exp Neurobiol 2020; 29:389-401. [PMID: 33154200 PMCID: PMC7649086 DOI: 10.5607/en20036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/18/2020] [Accepted: 09/28/2020] [Indexed: 11/19/2022] Open
Abstract
During mid-life, women experienced not only physical but also neurological transition. Because of this, many women suffer from physiological and/or psychological menopausal symptoms. Although hormone therapy (HT) was broadly used to alleviate menopausal symptoms, HT showed inconsistent effects in case of psychological symptoms. Moreover, mid-life women’s brains have distinct characteristics than in other periods of life, it is needed to study psychological symptoms in shifted brain network of mid-life women. As an alternative, inhalation of fragrances may alleviate psychological menopausal symptoms. To characterize the alleviation mechanism by fragrances, we tested the effect of fragrances on menopausal symptoms using electroencephalographic (EEG) methods. We hypothesized that fragrance could restore mid-life women’s brain response to stressful situations. We tested six fragrance conditions, including no-odor condition (solvent only) in twenty-eight mid-life women (49.75 years±3.49). Our results showed that fragrances increased alpha power and decreased β/α ratio depending on the severity of menopausal symptoms in a stressful situation. Our study would be helpful in psychological menopausal symptom alleviation as well as fragrance screening for well-being in mid-life.
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Affiliation(s)
- Sun Ae Moon
- Department of Brain and Cognitive Sciences, Graduate School, Daegu Gyeungbuk Institute of Science and Technology, Daegu 42988, Korea
| | - Jisub Bae
- Department of Brain and Cognitive Sciences, Graduate School, Daegu Gyeungbuk Institute of Science and Technology, Daegu 42988, Korea
| | - Kwangsu Kim
- Department of Brain and Cognitive Sciences, Graduate School, Daegu Gyeungbuk Institute of Science and Technology, Daegu 42988, Korea
| | | | - Gusang Kwon
- AMOREPACIFIC R&D Center, Yongin 17074, Korea
| | - Ran Lee
- AMOREPACIFIC R&D Center, Yongin 17074, Korea
| | - Seung Ho Ko
- AMOREPACIFIC R&D Center, Yongin 17074, Korea
| | - Soyeon Lim
- AMOREPACIFIC R&D Center, Yongin 17074, Korea
| | - Cheil Moon
- Department of Brain and Cognitive Sciences, Graduate School, Daegu Gyeungbuk Institute of Science and Technology, Daegu 42988, Korea.,Convergence Research Advanced Centre for Olfaction, Daegu Gyeungbuk Institute of Science and Technology, Daegu 42988, Korea.,Convergence Brain Research Department, Korea Brain Research Institute (KBRI), Daegu 41062, Korea
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Alshogran OY, Mahmoud FM, Alkhatatbeh MJ. Knowledge and awareness toward menopause and hormone therapy among premenopausal women in Jordan. Climacteric 2020; 24:171-178. [PMID: 32914657 DOI: 10.1080/13697137.2020.1813099] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Menopause is a natural important transition in women's life. Having adequate knowledge and perception about menopause at a young age is critical for women to cope better with its associated consequences and improve their well-being. OBJECTIVE This study evaluated the awareness, knowledge, and perception of menopause and menopause hormone therapy (MHT) among premenopausal females from Jordan. METHODS A cross-sectional study including females aged 20-40 years (n = 450) was conducted from November 2018 to March 2019 in two hospitals in Irbid, Jordan. A structured questionnaire was developed based on previous literature and using the Green Climacteric Scale to assess participants' knowledge and awareness of signs and symptoms of menopause and MHT. Data were collected by face-to-face interview. Factors associated with the degree of menopausal knowledge were identified. RESULTS The mean ± standard deviation age of participants was 29.1 ± 6.3 years. More than half of participants were knowledgeable about several aspects of menopause. Education to college or more was significantly and positively associated with knowledge about menopause (β = 0.504, p = 0.005). The majority of participants did not know the roles, benefits, and risks of MHT. There was an almost equal distribution for participants' positive (47.6%) and negative (50%) attitudes toward menopause. CONCLUSIONS The findings suggest that premenopausal females in Jordan are knowledgeable about various aspects of menopause. Nevertheless, there is still a need to develop educational programs and implement proper counseling to improve young females' awareness about menopause, particularly its health implications and treatment options.
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Affiliation(s)
- O Y Alshogran
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - F Mz Mahmoud
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - M J Alkhatatbeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
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Hormone Replacement Therapy: Lebanese Women's Awareness, Perception, and Acceptance. Obstet Gynecol Int 2020; 2020:5240932. [PMID: 32607105 PMCID: PMC7315264 DOI: 10.1155/2020/5240932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 05/07/2020] [Accepted: 05/15/2020] [Indexed: 11/30/2022] Open
Abstract
Objectives Hormone replacement therapy (HRT) had been the gold standard for the treatment of menopausal symptoms until the publication of the World Health Initiative (WHI) study. After the WHI study, the use of HRT changed among the physicians and patients all over the world despite newer more reassuring data. This study aimed to investigate the knowledge and attitudes of women towards HRT and the factors affecting it for better counseling. Study design. A clinic-based cross-sectional study using a survey was offered to women aged 40 years and above coming to the women's health center at the American University of Beirut Medical Center (AUBMC) from October 1st, 2017, till March 31st, 2018. The questionnaire included questions about demographics and menopausal symptoms in addition to knowledge and attitudes towards menopause and HRT. Main outcome measures. Our main hypothesis was that women would be aware of HRT as a treatment modality; however, the majority would have a negative attitude towards its usage. Results The response rate was 87.8%. Seventy-three percent of the respondents had already heard about HRT with 57.9% supporting the use of HRT; however, 47.9% did not know when to use it. The significant predictor for having heard about HRT and a positive attitude towards HRT were having HRT prescribed as a part of treatment and employment status, respectively. Conclusions Lebanese women are aware of HRT as a treatment option; however, a lack of both proper information and positive attitude towards HRT use was noted.
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Depypere H, Timmerman D, Donders G, Sieprath P, Ramael S, Combalbert J, Hoveyda HR, Fraser GL. Treatment of Menopausal Vasomotor Symptoms With Fezolinetant, a Neurokinin 3 Receptor Antagonist: A Phase 2a Trial. J Clin Endocrinol Metab 2019; 104:5893-5905. [PMID: 31415087 DOI: 10.1210/jc.2019-00677] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/07/2019] [Indexed: 02/13/2023]
Abstract
CONTEXT The thermoregulatory center in the hypothalamus is stimulated by neurokinin 3 receptor (NK3R) activation and inhibited by estrogen-negative feedback. This balance is disrupted in menopause, producing vasomotor symptoms (VMSs). OBJECTIVE To evaluate safety and efficacy of the NK3R antagonist fezolinetant in menopausal VMSs. DESIGN Twelve-week, double-blind, randomized, placebo-controlled study. SETTING Eight Belgian centers from September 2015 to October 2016. PARTICIPANTS Generally healthy menopausal women aged 40 to 65 years with moderate/severe VMSs. INTERVENTIONS Subjects were randomized (1:1) to 90 mg of fezolinetant twice daily or placebo for 12 weeks. MAIN OUTCOME MEASURES Subjects captured VMS severity and frequency using an electronic diary. The primary outcome was change from baseline to week 12 in total VMS score with fezolinetant vs placebo. Secondary outcomes included timing of changes in frequency and severity of moderate/severe VMSs and quality-of-life assessments at weeks 4, 8, and 12. Pharmacodynamic and pharmacokinetic effects were assessed, as were safety and tolerability. RESULTS Of 122 subjects screened, 87 were randomized and 80 (92%) completed the study. At week 12, fezolinetant significantly reduced total VMS score vs placebo (-26.5 vs -12.2, P < 0.001) and decreased mean frequency of moderate/severe VMSs by five episodes per day vs placebo. Severity and frequency of moderate/severe VMSs were reduced from the first day of treatment. Improvements were achieved in all quality-of-life measures. Fezolinetant was well tolerated. The most common fezolinetant-related adverse event was gastrointestinal disorder (n = 6). CONCLUSIONS Fezolinetant rapidly and significantly reduced moderate/severe VMSs, supporting its potential as an effective nonhormonal treatment option for menopausal women.
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Affiliation(s)
- Herman Depypere
- Breast and Menopause Clinic, University Hospital, Ghent, Netherlands
| | - Dirk Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Harder H, Starkings RM, Fallowfield LJ, Menon U, Jacobs IJ, Jenkins VA. Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis. Menopause 2019; 26:1100-1009. [PMID: 31290761 PMCID: PMC6791508 DOI: 10.1097/gme.0000000000001377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Sexual well-being can contribute significantly to the overall quality of women's lives. This qualitative study aimed to examine sexual activity, functioning, and satisfaction in a large sample of postmenopausal women from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) METHODS:: Thematic analysis was used to evaluate the free-text data of the Fallowfield Sexual Activity Questionnaire (FSAQ) completed by UKCTOCS participants at baseline before annual screening. RESULTS A total of 24,305 women completed the baseline FSAQ and 4,525 (19%) provided free-text data, with 4,418 comments eligible for analysis. Median age was 64 years; 65% had a partner and 22.5% were sexually active. Four interrelated themes were derived: partner availability, physical and sexual health, mental well-being, and interpersonal relationships. Primary reason for absence of sexual activity was lack of a partner, mainly due to widowhood (n = 1,000). Women discussed how partner's medical condition (27%) or sexual dysfunction (13.5%), their own physical health (18%) or menopause-related symptoms (12.5%), and prescribed medication (7%) affected sexual activity. Impact of low libido in self (16%) or partner (7%), relationship problems (10.5%) or logistics (6%), and perceptions of ageing (9%) were also mentioned. Few (3%) referred to positive sexual experiences or had sought medical help for sexual problems (6%). CONCLUSIONS This qualitative analysis explored postmenopausal women's perspective on their sexual functioning. Having an intimate partner and good physical health are key factors for continuation of sexual activity and satisfaction. Further sexual education for healthcare professionals is needed to raise awareness about sexuality and sexual difficulties in later life. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A426.
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Affiliation(s)
- Helena Harder
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Rachel M.L. Starkings
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Lesley J. Fallowfield
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, United Kingdom
| | - Ian J. Jacobs
- EGA Institute for Women's Health, University College London, London, United Kingdom
- University of New South Wales, Sydney, Australia
| | - Valerie A. Jenkins
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
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Cipriani C, Pepe J, Minisola S, Lewiecki EM. Adverse effects of media reports on the treatment of osteoporosis. J Endocrinol Invest 2018; 41:1359-1364. [PMID: 29761280 DOI: 10.1007/s40618-018-0898-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/05/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE The review focused on the role that media reporting plays in the level of public awareness about osteoporosis and its influence on osteoporosis treatment decisions. METHODS We reviewed the literature on the role of media on three main aspects influencing patient adherence to osteoporosis treatment: the awareness of osteoporosis as a major health problem, the perception of the effectiveness of osteoporosis medications, and the fear of adverse effects with osteoporosis medications. RESULTS A review of the literature confirmed what is routinely observed in clinical practice-that media report can strongly influence the level of awareness of osteoporosis and fracture risk. Inadequate and/or incorrect information on osteoporosis in the media are associated with a low level of awareness of the disease. High-risk patients may have a poor understanding of the need for treatment. Alarming information in the media over the last 2 decades regarding effectiveness and safety of long-term osteoporosis treatment is associated with reduction in the use of osteoporosis medications. CONCLUSIONS There is a gap between the application of clinical recommendations and patient perceptions of osteoporosis and its treatment. There is a need for better education of patients and practitioners aimed at recognizing the serious consequences of fractures and understanding the expected benefits and potential risks of treatment. Media reports that disseminate evidence-based information on the balance of benefits and risks could help to reduce the osteoporosis treatment gap and mitigate the crisis in osteoporosis care.
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Affiliation(s)
- Cristiana Cipriani
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - Jessica Pepe
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - E Michael Lewiecki
- New Mexico Clinical Research and Osteoporosis Center, 300 Oak St. NE, Albuquerque, NM, 87106, USA
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Geng L, Zheng Y, Zhou Y, Li C, Tao M. The prevalence and determinants of genitourinary syndrome of menopause in Chinese mid-life women: a single-center study. Climacteric 2018; 21:478-482. [PMID: 29734845 DOI: 10.1080/13697137.2018.1458832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to explore the prevalence and determinants of genitourinary syndrome of menopause (GSM) in Chinese mid-life women. METHODS A cross-sectional single-center study was performed among 40-65-year-old women who participated in physical examinations at Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2015 to December 2016. The participating women were questioned about their genitourinary symptoms, and the relationships between these symptoms and the women's demographic characteristics were evaluated. RESULTS The prevalence of GSM was 30.8%, the most frequent symptom was decreased sexual desire (18.4%), and the frequency of vulvovaginal symptoms and lower urinary tract symptoms was 17.5% and 14.8%, respectively. In addition, most of the symptoms were mild. In postmenopausal women, the prevalences of GSM and the three aforementioned symptoms were higher than those in perimenopausal women (p < 0.05). Based on binary logistic regression analysis, GSM was found to be associated with postmenopause (p = 0.007; odds ratio (OR) 1.52), at least two abortions (p = 0.035; OR 1.42), body mass index (BMI) ≥ 30 kg/m2 (p = 0.032; OR 1.91) and diabetes (p = 0.041; OR 1.94). CONCLUSIONS GSM is common in Chinese mid-life women, and associations between GSM and postmenopause, abortion, BMI and diabetes were identified. Health-care practitioners should actively discuss urogenital symptoms with middle-aged female patients and take appropriate interventions to improve the health of their urogenital tract and quality of life.
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Affiliation(s)
- L Geng
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Y Zheng
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - Y Zhou
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - C Li
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
| | - M Tao
- a Department of Gynecology & Obstetrics , Shanghai Jiao Tong University Affiliated Sixth People's Hospital , Shanghai , China
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Stanzel KA, Hammarberg K, Fisher J. Experiences of menopause, self-management strategies for menopausal symptoms and perceptions of health care among immigrant women: a systematic review. Climacteric 2018; 21:101-110. [PMID: 29345497 DOI: 10.1080/13697137.2017.1421922] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To systematically review the published literature relating to experiences of menopause, self-management strategies for menopausal symptoms and health-care needs among immigrant women. METHODS A systematic literature search of English-language publications was performed using Medline, Embase, PsychInfo, Cinahl and Scopus. Twenty-four papers reporting on 19 studies met our inclusion criteria and investigated immigrant women's experiences of menopause and/or their self-management strategies for menopausal symptoms and/or their perceptions of menopause-specific health care. FINDINGS Of the 19 studies, 15 reported symptoms experienced during the menopausal transition. Three studies included questions regarding self-management strategies for menopausal symptoms and four enquired about perceptions of menopause-specific health care. Although the heterogeneity of the studies makes comparison difficult, their findings are broadly consistent. Immigrant women reported more vasomotor symptoms and other physical symptoms and poorer mental health than non-immigrant women. The few studies that investigated self-management strategies for menopausal symptoms found that these were influenced by culture and those that assessed perceptions of menopause-specific health care found that they were mostly dissatisfied with the care they had received. CONCLUSION More research is needed to improve understanding of how immigrant women manage the menopausal transition and how to provide culturally relevant menopause-specific health care.
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Affiliation(s)
- K A Stanzel
- a School of Public Health and Preventive Medicine, Jean Hailes Research Unit , Monash University Faculty of Medicine Nursing and Health Sciences , Melbourne , VIC , Australia
| | - K Hammarberg
- a School of Public Health and Preventive Medicine, Jean Hailes Research Unit , Monash University Faculty of Medicine Nursing and Health Sciences , Melbourne , VIC , Australia
| | - J Fisher
- a School of Public Health and Preventive Medicine, Jean Hailes Research Unit , Monash University Faculty of Medicine Nursing and Health Sciences , Melbourne , VIC , Australia
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Thompson JJ, Ritenbaugh C, Nichter M. Why women choose compounded bioidentical hormone therapy: lessons from a qualitative study of menopausal decision-making. BMC Womens Health 2017; 17:97. [PMID: 28969624 PMCID: PMC5625649 DOI: 10.1186/s12905-017-0449-0] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 09/20/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In recent years, compounded bioidentical hormone therapy (CBHT) has emerged as a popular alternative to manufactured, FDA approved hormone therapy (HT)-despite concerns within the medical community and the availability of new FDA approved "bioidentical" products. This study aims to characterize the motivations for using CBHT in a U.S. sample of ordinary midlife women. METHODS We analyze data collected from 21 current and former users of CBHT who participated in a larger qualitative study of menopausal decision-making among U.S. women. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed thematically using an iterative inductive and deductive process. RESULTS Although women's individual motivations varied, two overarching themes emerged: "push motivations" that drove women away from conventional HT and from alternative therapies, and "pull motivations" that attracted women to CBHT. Push motivations focused on (1) fear and uncertainty about the safety of conventional HT, (2) an aversion to conjugated estrogens in particular, and (3) and overarching distrust of a medical system perceived as dismissive of their concerns and overly reliant on pharmaceuticals. Participants also voiced dissatisfaction with the effectiveness of herbal and soy supplements. Participants were attracted to CBHT because they perceive it to be (1) effective in managing menopausal symptoms, (2) safer than conventional HT, (3) tailored to their individual bodies and needs, and (4) accompanied by enhanced clinical care and attention. CONCLUSIONS This study finds that women draw upon a range of "push" and "pull" motivations in their decision to use CBHT. Importantly, we find that women are not only seeking alternatives to conventional pharmaceuticals, but alternatives to conventional care where their menopausal experience is solicited, their treatment goals are heard, and they are engaged as agents in managing their own menopause. The significance of this finding goes beyond understanding why women choose CBHT. Women making menopause treatment decisions of all kinds would benefit from greater shared decision-making in the clinical context in which they are explicitly invited to share their experiences, priorities, and preferences. This would also provide an opportunity for clinicians to discuss the pros and cons of conventional HT, CBHT, and other approaches to managing menopause.
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Affiliation(s)
- Jennifer Jo Thompson
- Department of Crop and Soil Sciences, University of Georgia, 3111 Miller Plant Sciences, Athens, GA 30602 USA
| | - Cheryl Ritenbaugh
- Department of Family and Community Medicine, University of Arizona, 1450 N. Cherry Ave, Tucson, AZ 85719 USA
| | - Mark Nichter
- School of Anthropology, University of Arizona, 1009 E. South Campus Drive, Tucson, AZ 85721 USA
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Ohn Mar S, Malhi FS, Syed Rahim SH, Soe MM. Chinese and Indian women's experience with alternative medications for menopause related symptoms: A qualitative analysis. Chin J Integr Med 2017:10.1007/s11655-017-2780-6. [PMID: 28914436 DOI: 10.1007/s11655-017-2780-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To explore women's rationalization for using alternative medications, their experience and view on safety of long-term use. METHODS Two focus group discussions, involving 5 participants each for Chinese and Indian groups, were conducted separately. Participant's personal information was collected anonymously. The discussion covered 5 areas: determinants for taking medications; reason for choosing alternative medications rather than hormone replacement therapy (HRT); how these medications help them; their view on cost-effectiveness and concerns over long-term use. The discussions were audio-taped, transcribed and analyzed. RESULTS Chinese participants took supplements for controlling symptoms while Indian participants used herbs as a preventive measure during menopause according to their tradition. Women of both groups mentioned that they did not take HRT because of fear of side effects. Chinese group mentioned that medications remarkably improved their symptoms whereas Indian participants appreciated their herbals more for improvement in general wellbeing than for specific symptoms. All members agreed that using alternative medication was cost-effective. Both Chinese and Indian participants were quite confident in saying that long-term use will not be associated with any side effects. However, Indian group emphasized that proper preparation of herbal compound using different types of leaves, is essential in order to avoid untoward effects. CONCLUSIONS Chinese and Indian women used alternative medicine in prevention and treatment of menopause-related problems even as they were avoiding HRT because of the fear of side effects. They believed that their supplements were effective, safe and cost-beneficial even with long-term use.
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Affiliation(s)
- Saw Ohn Mar
- Faculty of Medicine, University Kuala Lumpur, Royal College of Medicine Perak, Ipoh, 30450, Malaysia.
| | - Fatehpal Singh Malhi
- Faculty of Medicine, University Kuala Lumpur, Royal College of Medicine Perak, Ipoh, 30450, Malaysia
| | - Syed Hamid Syed Rahim
- Faculty of Medicine, University Kuala Lumpur, Royal College of Medicine Perak, Ipoh, 30450, Malaysia
| | - Myint Myint Soe
- Faculty of Medicine, University Kuala Lumpur, Royal College of Medicine Perak, Ipoh, 30450, Malaysia
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What you don't know can hurt you: more information and communication are needed regarding menopausal therapies. Menopause 2017; 24:1116-1117. [PMID: 28742628 DOI: 10.1097/gme.0000000000000963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mendoza N, Hernández C, Cornellana MJ, Carballo A, Llaneza P, Harvey X, Palacios S. Factors determining the use of hormonal therapy and phytotherapy in Spanish postmenopausal women. Climacteric 2016; 19:375-80. [DOI: 10.1080/13697137.2016.1183625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- N. Mendoza
- University of Granada, Obstetric & Gynaecology, Granada, Spain
| | - C. Hernández
- University of Granada, Obstetric & Gynaecology, Granada, Spain
| | | | | | - P. Llaneza
- University of Asturias, Obstetrics & Gynecologogy, Oviedo, Spain
| | - X. Harvey
- University of Granada, Obstetric & Gynaecology, Granada, Spain
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Jin F, Tao M, Teng Y, Shao H, Li C, Mills E. Knowledge and attitude towards menopause and hormone replacement therapy in Chinese women. Gynecol Obstet Invest 2014; 79:40-5. [PMID: 25277502 DOI: 10.1159/000365172] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To explore the knowledge and prevalence of menopausal symptoms as well as the use and attitude toward hormone replacement therapy (HRT) in Chinese women. METHODS A cross-sectional study was conducted between May 2011 and April 2012 in Shanghai, China. The structured questionnaire addressing sociodemographic characteristics, knowledge and prevalence of menopausal symptoms, and knowledge and attitude towards HRT and its use were investigated. RESULTS 3,619 women aged 40-65 years were included in the analysis. The majority of the women had knowledge of menopause. Symptoms were prevalent in 16.1% of premenopausal women and in 49.3% of peri-, post- and surgical-menopausal women. Back and joint pain, sleeplessness, fatigue and sweating/hot flushes were frequently reported. HRT awareness among women was 3.5% and was related to menopausal, working and marital status; 75 (2.1%) women had used or were using HRT, of which 57.3% used HRT with a doctor's prescription and 29.3% experienced side effects from the use of HRT. CONCLUSION Most Chinese women had knowledge of menopause and thought menopausal symptoms should not be treated. The awareness of HRT was poor and influenced by menopausal, working and marital status. Chinese health care providers have to assume responsibility for educating women about menopause and HRT use.
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Affiliation(s)
- Feng Jin
- Department of Gynecology, Affiliated Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China
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Lee EJ, Kim JL, Kim YH, Kang MK, Gong JH, Kang YH. Phloretin promotes osteoclast apoptosis in murine macrophages and inhibits estrogen deficiency-induced osteoporosis in mice. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2014; 21:1208-1215. [PMID: 24932975 DOI: 10.1016/j.phymed.2014.04.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Revised: 02/12/2014] [Accepted: 04/02/2014] [Indexed: 06/03/2023]
Abstract
Bone-remodeling imbalance induced by increased osteoclast formation and bone resorption is known to cause skeletal diseases such as osteoporosis. The reduction of estrogen levels at menopause is one of the strongest risk factors developing postmenopausal osteoporosis. This study investigated osteoprotective effects of the dihydrochalcone phloretin found in apple tree leaves on bone loss in ovariectomized (OVX) C57BL/6 female mice as a model for postmenopausal osteoporosis. OVX demoted bone mineral density (BMD) of mouse femurs, reduced serum 17β-estradiol level and enhanced serum receptor activator of NF-κB ligand (RANKL)/osteoprotegerin ratio with uterine atrophy. Oral administration of 10 mg/kg phloretin to OVX mice for 8 weeks improved such effects, compared to sham-operated mice. Phloretin attenuated TRAP activity and cellular expression of β3 integrin and carbonic anhydrase II augmented in femoral bone tissues of OVX mice. This study further examined that osteogenic activity of phloretin in RANKL-differentiated Raw 264.7 macrophages into mature osteoclasts. Phloretin at 1-20 μM stimulated Smac expression and capase-3 activation concurrently with nuclear fragmentation of multi-nucleated osteoclasts, indicating that this compound promoted osteoclast apoptosis. Consistently, phloretin enhanced bcl-2 induction but diminished bax expression. Furthermore, phloretin activated ASK-1-diverged JNK and p38 MAPK signaling pathways in mature osteoclasts, whereas it dose-dependently inhibited the RANKL-stimulated activation of ERK. Therefore, phloretin manipulated ASK-1-MAPK signal transduction leading to transcription of apoptotic genes. Phloretin was effective in preventing estrogen deficiency-induced osteoclastogenic resorption.
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Affiliation(s)
- Eun-Jung Lee
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Jung-Lye Kim
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Yun-Ho Kim
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Min-Kyung Kang
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Ju-Hyun Gong
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea
| | - Young-Hee Kang
- Department of Food Science and Nutrition, Hallym University, Chuncheon, Republic of Korea.
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Gibson-Helm M, Teede H, Vincent A. Symptoms, health behavior and understanding of menopause therapy in women with premature menopause. Climacteric 2014; 17:666-73. [PMID: 24742007 DOI: 10.3109/13697137.2014.913284] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To explore symptoms, understanding of menopausal therapies, medication use and health-related behavior in women with and without premature menopause. METHODS Cross-sectional, questionnaire-based study involving a community-based sample of 77 women in Australia: 23 premenopausal, 25 with premature ovarian failure (POF) and 29 with medically induced premature menopause (MIPM). RESULTS The median (interquartile range) age of each group was: premenopausal = 29 (13) years, POF = 36 (8.0) years and MIPM = 38 (4.0) years (p < 0.001). The reported frequency of menopausal symptoms differed across the groups for difficulty sleeping (premenopausal = 26%, POF = 44%, MIPM = 69%, p = 0.01), some depression symptoms (premenopausal = 4.4-22%, POF = 20-25%, MIPM = 38-59%, p < 0.05), hot flushes (premenopausal = 4.4%, POF = 28%, MIPM = 59%, p < 0.001), sweating at night (premenopausal = 4.4%, POF = 20%, MIPM = 52%, p < 0.001) and loss of interest in sex (premenopausal = 17%, POF = 52%, MIPM = 54%, p = 0.02). More women with premature menopause than premenopausal women reported taking prescription medication (premenopausal = 52%, POF = 92%, MIPM = 86%, p = 0.002), perceived that hormone therapy (HT) was associated with increased breast cancer risk (premenopausal = 43%, POF = 56%, MIPM = 79%, p = 0.03) and that HT prevented fractures (premenopausal = 13%, POF = 56%, MIPM = 39%, p = 0.01). Most women reported not knowing risks/benefits of bioidentical hormone therapy (premenopausal = 86%, POF = 56%, MIPM = 75%, p = 0.06). Regarding health-related behavior around prevention and screening, varying rates of bone densitometry (premenopausal = 4.4%, POF = 64%, MIPM = 59%, p < 0.001), blood glucose testing (premenopausal = 39%, POF = 67%, MIPM = 57%, p = 0.16) and cholesterol testing (premenopausal = 22%, POF = 71%, MIPM = 54%, p = 0.003) were reported. CONCLUSIONS Differences in understanding of menopausal therapies and health-related behavior exist among women with premature menopause of differing etiology and premenopausal women. While perceived understanding of HT was greater than other therapies, targeted education is needed regarding specific risks/benefits of menopausal therapies and regarding preventive health screening after premature menopause.
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Affiliation(s)
- M Gibson-Helm
- * Women's Public Health Research, Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University , Clayton, Victoria
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Lindh-Åstrand L, Hoffmann M, Hammar M, Spetz Holm AC. Hot flushes, hormone therapy and alternative treatments: 30 years of experience from Sweden. Climacteric 2014; 18:53-62. [DOI: 10.3109/13697137.2014.915516] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Vélez Toral M, Godoy-Izquierdo D, Padial García A, Lara Moreno R, Mendoza Ladrón de Guevara N, Salamanca Ballesteros A, de Teresa Galván C, Godoy García JF. Psychosocial interventions in perimenopausal and postmenopausal women: A systematic review of randomised and non-randomised trials and non-controlled studies. Maturitas 2014; 77:93-110. [DOI: 10.1016/j.maturitas.2013.10.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 10/26/2022]
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34
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Effects of acupuncture and Chinese herbal medicine (Zhi Mu 14) on hot flushes and quality of life in postmenopausal women. Menopause 2014; 21:15-24. [DOI: 10.1097/gme.0b013e31829374e8] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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van Bekkum JE, Hilton S. Primary care nurses' experiences of how the mass media influence frontline healthcare in the UK. BMC FAMILY PRACTICE 2013; 14:178. [PMID: 24267614 PMCID: PMC4222829 DOI: 10.1186/1471-2296-14-178] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/19/2013] [Indexed: 11/18/2022]
Abstract
Background Mass media plays an important role in communicating about health research and services to patients, and in shaping public perceptions and decisions about health. Healthcare professionals also play an important role in providing patients with credible, evidence-based and up-to-date information on a wide range of health issues. This study aims to explore primary care nurses’ experiences of how mass media influences frontline healthcare. Methods In-depth telephone interviews were carried out with 18 primary care nurses (nine health visitors and nine practice nurses) working in the United Kingdom (UK). Interviews were recorded and transcribed. The data was analysed using thematic analysis, with a focus on constant comparative analysis. Results Three themes emerged from the data. First, participants reported that their patients were frequently influenced by controversial health stories reported in the media, which affected their perceptions of, and decisions about, care. This, in turn, impinged upon participants’ workloads as they had to spend additional time discussing information and reassuring patients. Second, participants also recalled times in their own careers when media reports had contributed to a decline in their confidence in current healthcare practices and treatments. Third, the participants in this study suggested a real need for additional resources to support and expand their own media literacy skills, which could be shared with patients. Conclusion In an ever expanding media landscape with greater reporting on health, nurses working in the primary care setting face increasing pressure to effectively manage media stories that dispute current health policies and practices. These primary care nurses were keen to expand their media literacy skills to develop critical autonomy in relation to all media, and to facilitate more meaningful conversations with their patients about their health concerns and choices.
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Buhling KJ, Daniels B, Studnitz FSG, Eulenburg C, Mueck AO. Attitude of German women towards hormone therapy: results of a lay survey. Gynecol Endocrinol 2013; 29:460-4. [PMID: 23362982 DOI: 10.3109/09513590.2012.754881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Hormone therapy (HT) use has experienced a substantial change since publication of Women's Health Initiative (WHI) controlled trial. We aimed to investigate the attitude towards HT in German women aged 45-60 years. STUDY DESIGN A questionnaire was sent to 9785 randomly selected women in Germany aged between 45 and 60 years. RESULTS Response rate was 19.3% (n = 1,893). Of those, 81% experienced climacteric symptoms. Vasomotor symptoms were most frequently reported (71.2%; n = 1332). Of the respondents, 19.7% (n = 369) used HT. The most frequently mentioned benefits of HT were the improvement of climacteric complaints (71.2%; n = 1346), followed by the relief of osteoporosis (37.2%; n = 697) and the "anti-aging" effect (16.3%; n = 305). Breast cancer was stated as the main risk (64.9%; n = 1215), closely followed by weight gain (53.4%; n = 1000) and thromboembolism (48%; n = 898). About 44% of the women who has been advised by gynaecologists choose a HT, whereas this rate dropped down to 14.3% and 11.3% for women who have been advised by friends or media. CONCLUSION German women were generally aware of the main risks and benefits of HT. "More informed" women appear to be more likely to use HT compared to "less informed" women. The media produces negative impression of HT.
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Affiliation(s)
- K J Buhling
- Clinic for Gynaecology, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
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Tao M, Shao H, Li C, Teng Y. Correlation between the modified Kupperman Index and the Menopause Rating Scale in Chinese women. Patient Prefer Adherence 2013; 7:223-9. [PMID: 23569361 PMCID: PMC3615846 DOI: 10.2147/ppa.s42852] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The severity of menopausal symptoms can vary according to ethnicity and geography. Two common menopausal symptom scales, the modified Kupperman Index (KI) and the Menopausal Rating Scale (MRS), are accepted internationally. In this study, we evaluated the correlation between these scales and their relevance to women in the People's Republic of China. METHODS We enrolled treatment-naïve women who visited the menopause outpatient department at a major teaching hospital in Shanghai, People's Republic of China. The women were required to complete two questionnaires, ie, the modified KI and the MRS. We assessed the correlation between the tools using a correlation analysis. RESULTS We enrolled 277 women of average age 51.5 ± 4.8 years. There was a strong positive correlation between total scores on the modified KI and the MRS (0.74, 95% confidence interval 0.69-0.79) and subscores for the somatic and psychological domains (0.74 and 0.77, respectively), with a moderate correlation for urogenital symptoms. According to the modified KI, 15 (5.4%) women were categorized as asymptomatic, and when using the MRS, 33 (11.9%) were categorized as asymptomatic. Women categorized as having none/minimal symptoms by the MRS were diagnosed as having mild to severe symptoms using the modified KI. The highest agreement (74%) was found when symptoms were moderate. CONCLUSION The modified KI and the MRS do correlate in Chinese women, but the modified KI is more likely to identify menopausal symptoms than the MRS in screening if there is doubt about the diagnosis of menopause.
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Affiliation(s)
| | | | | | - YinCheng Teng
- Correspondence: YinCheng Teng, Department of Gynecology, the Sixth Affiliated People’s Hospital of Shanghai Jiao Tong University, 600 Yi Shan Road Shanghai, People’s Republic of China 200233, Tel +11 8621 2405 8544, Fax +11 8621 6470 1361, Email
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Affiliation(s)
- Mary Ann Lumsden
- Head of Reproductive & Maternal Medicine, University of Glasgow, UK
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Shi HY, Lee HH, Tsai JT, Ho WH, Chen CF, Lee KT, Chiu CC. Comparisons of prediction models of quality of life after laparoscopic cholecystectomy: a longitudinal prospective study. PLoS One 2012; 7:e51285. [PMID: 23284677 PMCID: PMC3532431 DOI: 10.1371/journal.pone.0051285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 10/31/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Few studies of laparoscopic cholecystectomy (LC) outcome have used longitudinal data for more than two years. Moreover, no studies have considered group differences in factors other than outcome such as age and nonsurgical treatment. Additionally, almost all published articles agree that the essential issue of the internal validity (reproducibility) of the artificial neural network (ANN), support vector machine (SVM), Gaussian process regression (GPR) and multiple linear regression (MLR) models has not been adequately addressed. This study proposed to validate the use of these models for predicting quality of life (QOL) after LC and to compare the predictive capability of ANNs with that of SVM, GPR and MLR. METHODOLOGY/PRINCIPAL FINDINGS A total of 400 LC patients completed the SF-36 and the Gastrointestinal Quality of Life Index at baseline and at 2 years postoperatively. The criteria for evaluating the accuracy of the system models were mean square error (MSE) and mean absolute percentage error (MAPE). A global sensitivity analysis was also performed to assess the relative significance of input parameters in the system model and to rank the variables in order of importance. Compared to SVM, GPR and MLR models, the ANN model generally had smaller MSE and MAPE values in the training data set and test data set. Most ANN models had MAPE values ranging from 4.20% to 8.60%, and most had high prediction accuracy. The global sensitivity analysis also showed that preoperative functional status was the best parameter for predicting QOL after LC. CONCLUSIONS/SIGNIFICANCE Compared with SVM, GPR and MLR models, the ANN model in this study was more accurate in predicting patient-reported QOL and had higher overall performance indices. Further studies of this model may consider the effect of a more detailed database that includes complications and clinical examination findings as well as more detailed outcome data.
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Affiliation(s)
- Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hao-Hsien Lee
- Department of Surgery, Chi Mei Medical Center, Liouying, Taiwan
| | - Jinn-Tsong Tsai
- Department of Computer Science, National Pingtung University of Education, Pingtung, Taiwan
| | - Wen-Hsien Ho
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chieh-Fan Chen
- Emergency Department, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
- Department of Health Business Administration, Meiho University, Pigntung, Taiwan
| | - King-Teh Lee
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Hepatobiliary Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chong-Chi Chiu
- Department of Surgery, Chi Mei Medical Center, Liouying, Taiwan
- Department of General Surgery, Chi Mei Medical Center, Tainan, Taiwan
- Taipei Medical University, Taipei, Taiwan
- Chia Nan University of Pharmacy and Science, Tainan, Taiwan
- * E-mail:
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