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Hot Flashes/Hot Flushes/Menopausal Symptoms
Published in Charles Theisler, Adjuvant Medical Care, 2023
Hot flashes are intense waves of heat felt over the face, neck, and chest. Hot flashes and sweating, especially night sweats, are the most common symptoms of menopause and perimenopause. Mood and sleep disturbances are also frequent complaints. Menopause marks the end of the menstrual cycles and is diagnosed after a woman has gone 12 months without a menstrual period. Some hot flashes pass in a few seconds, while others may last for more than 10 minutes. Overall, episodes of hot flashes can last several months or years. African American and Hispanic women tend to experience hot flashes for more years than white and Asian women. Researchers do not know the exact causes of hot flashes.
Survival Analysis
Published in Marcello Pagano, Kimberlee Gauvreau, Heather Mattie, Principles of Biostatistics, 2022
Marcello Pagano, Kimberlee Gauvreau, Heather Mattie
However, when the individuals enrolled in the clinical trial are separated into two distinct subpopulations – premenopausal women versus postmenopausal women – treatment does appear to have an effect on survival. As shown in Figure 20.9, treatment A improves survival for premenopausal women. The product-limit survival curve for women receiving treatment A lies above the survival curve for those receiving treatment B; at any point in time following diagnosis, the estimated probability of survival is higher for women receiving treatment A. The log-rank test p-value is 0.052. In contrast, Figure 20.10 suggests that treatment B is more effective in prolonging survival for postmenopausal women. In this case, the survival curve for women receiving treatment B lies above the curve for those receiving treatment A. The log-rank p-value for this comparison is 0.086. Since the treatment effects are going in opposite directions in the two different subpopulations, they cancel each other out when the groups are combined. This serves as a reminder that care must be taken not to ignore not only important confounding variables, but also important interactions.
Menopause transition
Published in Barry G. Wren, Progress in the Management of the Menopause, 2020
The wide range of symptoms attributed to menopause onset and progression affects most body systems. These symptoms can be clustered into broad categories of vasomotor instability, cardiopulmonary, skeletal, respiratory, digestive, general somatic symptoms, mood and behavioral changes3,5,19. While many of the complaints are reported by women whose menstrual cycles are still continuing, the magnitude of symptoms seems to increase throughout the transition from premenopause to postmenopause, with the perimenopausal phase as the most symptomatic. From the large studies world-wide, similar symptom profiles across the transition have been reported and complaints seem to be directly linked to women’s changing menstrual status, which is underpinned by the shifting hormonal milieu.
Phyto-progestins for the treatment of abnormal uterine bleeding without organic cause in women at high risk for breast cancer and breast cancer survivors: a prospective, pilot study
Published in Gynecological Endocrinology, 2023
Giovanni Grandi, Fabio Facchinetti, Chiara Melotti, Alice Sgandurra
Last, but not least, we observed satisfaction regarding symptoms related to PMS, especially in the youngest women included (<40 years old). Progesterone is probably the causal factor of the mood symptoms experienced by the women with PMS. In particular, synthetic progestins are the cause for the changes in mood that have been noticed by some users of synthetic CHCs [25]. In this view, it could be possible that phyto-progestins can act in different ways compared to synthetic progestins, that result in beneficial improvements to luteal mood changes. In relation to premenstrual migraines, Warhurst et al. conducted a meta-analysis showing that progestin-only pills (POP) reduced the number of migraine attacks in a month, but the small effect size may reflect the variability in treatment response between women [26]. With regard to climacteric symptoms, progestins are also components of the hormonal replacement therapy (HT), but perimenopausal premenstrual symptoms (that can be identified as the ones that occur in perimenopause) can be caused by exogenous progesterone [27]. The fruit extract Vitex Agnus Castus is the only phytotherapy which has shown a beneficial action for controlling irritability and mood swings in placebo-controlled trials [28]. Our limited results obtained in premenopausal women do not allow us to state that this preparation can improve mood swings, but more than half of the women in this study experienced a promising amelioration in terms of depression and headache.
Optimizing sleep across the menopausal transition
Published in Climacteric, 2023
Associations between vasomotor symptoms and objective sleep disturbance (PSG or actigraphy) are less consistent [23]. Several studies have not found an association between vasomotor symptoms and overall objective sleep quality [43,47,62–65]. Another study that examined hot flash events and PSG awakenings showed a time of night effect: physiological hot flashes (measured with sternal skin conductance) were more likely to precede PSG awakenings in the first half of the night but awakenings were more likely to precede hot flashes in the second half of the night [66]. Others, including our own work, have found that the majority of nocturnal physiological hot flash events are linked with PSG awakenings, regardless of time of night, and/or with more WASO [67–69]. For example, we found that 69% of nocturnal hot flashes were associated with an awakening/arousal (Figure 2) and wake time associated with hot flashes contributed an average of 27% to total WASO [68]. Similarly, in an experimental model of new-onset hot flashes in young premenopausal women treated with a gonadotropin-releasing hormone agonist that simulates menopause, 66% of objectively measured vasomotor symptoms were associated with an awakening [69]. The strong overlap in timing between many hot flash events and awakenings suggests there may be a common mechanism within the central nervous system in response to estrogen withdrawal, although further work is needed to investigate this possibility.
Efficacy of minodronic acid for the prevention of osteoporosis in premenopausal women with gynaecologic disease who undergo bilateral oophorectomy: a single-centre, non-randomised controlled, experimental study
Published in Journal of Obstetrics and Gynaecology, 2022
Asumi Okumura, Eiji Kondo, Michiko Kubo-Kaneda, Kenta Yoshida, Tomoaki Ikeda
We included patients with a performance status of 0 or 1, who were aged 20–50 years at enrolment (premenopausal at enrolment) and underwent scheduled b-OVX for premenopausal gynaecologic disease between 2010 and 2013 at the Department of Obstetrics and Gynaecology at Mie University Hospital (Japan). We excluded patients with serious complications (cardiac disease, uncontrolled diabetes, or complications that were judged to seriously interfere with study performance), history of severe drug hypersensitivity or drug allergy, or concurrent HT, in addition to patients considered unsuitable to receive safe treatment by the physician in charge. Premenopausal status was defined as having a last menstrual period of 12 months or less. There were no entry criteria related to recent pregnancy, lactation, BMD, or fracture.