Associations Between Menopausal Symptoms with Socio-economic, Demographic and Lifestyle Variables among Postmenopausal Women of Assam, Northeast India.

Background: Menopausal health refers to the various biological, physiological, and psychological changes and imbalances that occur as a result of the severity of symptoms. However, low oestrogen production causes various changes and declinations in women, which manifest as menopausal symptoms. Objectives: Present study determines the prevalence of menopausal symptoms and associations between socio-economic, demographic and lifestyle variables among postmenopausal women in Assam, Northeast India. Methods: The study was undertaken on 300 postmenopausal women using stratified random sampling. A pre-structured interview schedule was used to collect relevant data on socioeconomic, demographic, and lifestyle variables, as well as menopausal symptoms and related self-reported diseases, through a household survey and interview methods. Results: The mean age of menopausal women was found to be 47.08±2.38 years. Change in sexual desire (96.33%), profuse sweating with hot flush (61.67%), hot flush (60.00%), pain during sexual intercourse (46.33%), difficulties sleeping (37.00%), and lack of energy (39.67%) were the most common menopausal symptoms. There were significant associations recorded between various menopausal symptoms and age, education, first pregnancy age, age at menarche, family size, family type, parity, age at menopause, physical weakness, family income, and house condition (p <0.05). Conclusion: Menopausal symptoms were found to be more prevalent, and to reduce the population's health-related threat, more awareness, knowledge dissemination, and assistance are required, particularly among rural women.

Prevalence of menopausal symptoms and its association with various factors among women in post menopausal age group: a cross-sectional study

Background: Menopause is an important time in women's life and it is a natural event in the process of aging. The onset of menopause heralds a time of diminished estrogen exposure, which may have both acute and chronic effect on health and quality of life.Methods: It was a cross sectional study, conducted for a period of 3months i.e. June to August 2018 among post menopausal women in 8 selected villages with a sample size of 247.Results: The common post- menopausal symptoms were joint and muscular discomfort, bladder problems, symptoms of dryness of vagina, physical and mental exhaustion. Factors like education, occupation, socio-economic status, marital status, parity, mode of delivery, age at menopause and BMI was related to one or more menopausal symptoms.  Conclusions: Proper and timely intervention among post menopausal women will help to reduce the symptoms and lead a better quality of life.

Prevalence, knowledge and attitudes of menopausal symptoms among women aged 40-60 years and their associated factors in a semi urban area, Matara district, Sri Lanka

Background: Menopause is naturally created milestone in a women’s life. Every woman experiences unique menopausal symptoms that may be physiological, psychological or both. The aim of this study was to determine the prevalence, knowledge and attitudes of menopausal symptoms among women aged 40-60 years and their associated factors in a semi urban area, Matara district, Sri Lanka.Methods: A descriptive cross-sectional community-based study was carried out among 212 women ages 40-60 years in three selected Grama Niladhari divisions Matara district, Sri Lanka. Data was collected using an interviewer administered questionnaire. A validated menopausal rating scale used to measure menopausal symptoms. Data was analysed using SPSS version 23. A probability of p<0.05 was considered significant.Results: The mean age of menopause of the study population was 47.84 years (SD=4.048). The most prevalent somatic symptoms were hot flushes 157 (74.1%), joint and muscular discomfort 138 (65.1%), sleeping problems 126 (59.5%) and heart discomfort 112 (52.9%). Majority (>50%) reported having psychological symptoms and minority reported urogenital symptoms. All menopausal symptoms were more prevalent and was statistically significant in post-menopausal stage for urogenital symptoms. According to the knowledge categorization, majority (>50%) of the respondents had good knowledge regarding menopause. Mean knowledge score was 68.4±18. Married women and more educated women had better knowledge regarding menopause (p<0.05). Public health midwives were the main source of knowledge.Conclusions: Education, creating awareness and providing suitable interventions can be done to improve the quality of life of women through menopausal transitional period.

Geriatric gynecology: need and spectrum

Background: Geriatric gynaecology deals with gynaecological pathologies essential in post-menopausal women aged 65 years and above. The spectrum of geriatric gynaecological disorders in India differs from those in developed countries as there are no effective screening program for early detection of cancer and the burden of ignorance and taboos. In this study we aim to find the spectrum of gynaecological disorders in geriatric women and establish the need of dedicated geriatric unit.Methods: A cross-sectional comparative study was conducted on menopausal women of age 45 years or above who attended gynecology OPD for general counselling about menopause or treatment of menopausal problems over the period of 6 months duration. All these menopausal women attending OPD during this interval were evaluated on the basis of pretested questionnaire.Results: Out of 234 post-menopausal women who entered the study, 29% women belong to geriatric group. Post-menopausal bleeding due to both malignant and benign causes and pelvic organ prolapse are the major problems in geriatric women whereas somatic complaints like flushing, night sweats are more common in younger menopausal women.Conclusions: Where the medical science has successfully increased the life expectancy, focused approach to geriatric gynecology around us is our responsibility, where female still hesitate to come out. The need for dedicated geriatric gynecology unit in India on urgent basis is emphasized by this study wherein cancers can be screened in early stage and severe lifestyle hampering conditions like pelvic organ prolapse can be treated timely.

Menopausal symptoms and quality of life of hormone receptor positive breast cancer patients at different endocrine therapy time / 中华肿瘤杂志

Objective@#To explore the menopausal symptoms and quality of life of hormone receptor positive (HR+ ) breast cancer patients at different endocrine therapy time.@*Methods@#The HR+ breast cancer patients who were pathologically confirmed from 2011 to 2017 in the Sichuan Cancer Hospital were divided into three groups according to endocrine therapy time (<12 months, 12~36 months, >36 months) and analyzed by a cross-sectional study. The Menopausal symptoms and quality of life of these patients were measured using the modified Kupperman scale and the functional assessment of cancer therapy-breast cancer (FACT-B) scale. The differences of menopausal symptoms among different time groups and drug groups were analyzed by Chi-square test. The differences of quality of life and the effects of menopausal symptoms on quality of life were tested by covariance and multiple linear regression analyses.@*Results@#The average score of menopausal symptom of 167 patients was 14.5±7.6 and the prevalence rate was 87.4% (146/167). Among all of the menopausal symptoms, the prevalence rate of insomnia was the highest (73.7%, 123/167). Besides insomnia and excitement, hot flashes was more prevalent in selective estrogen receptor modulator (SERM) users (64.8%, 79/122) , while osteoarthritis was more prevalent in aromatase inhibitor (AI) users (62.2%, 28/45). The total score of FACT-B of Patients was 104.5±15.5, and the compliance rate was up to 89.8% (150/167). However, the condition of each dimension was different, the compliance rates of social/ family and functional dimension were lowest, which were 73.0% (122/167) and 50.9% (85/167), respectively. The menopausal symptoms of patients at different time groups were 15.0±1.3, 14.0±6.9, 14.5±7.4, respectively, and the total score of FACT-B of patients at different time groups were 102.7±17.8, 105.0±12.9, 105.6±16.7, respectively, without significant differences (both P>0.05). Multiple linear regression analysis showed that menopausal symptoms impaired the quality of life of SERM users during the endocrine therapeutic period. The standardized regression coefficients of three time groups were -0.67, -0.30, -0.50, respectively, with the lowest effect on 12~36 months group.@*Conclusion@#HR+ breast cancer patients will have a poor function recovery and social/ family return, who need more attention. Menopausal symptoms are common problems during endocrine therapy, and active measures should be taken to improve patients′ quality of life.

Hindi translated version of menopausal rating score questionnaire: a method to evaluate post menopausal symptoms in India

Background: There are large number of post menopausal patients in India deserving more care and attention than is given at present.MRS questionnaire in Hindi (MRS-H), a translated and validated version of original MRS Scale (MRS-E), self assessed by patients in their own native language. This tool can be used to assess and document current quality of life as well as improvement with treatment of severe post menopausal symptoms, in Indian population.Methods: 30 bilingual English and Hindi speaking postmenopausal patients were recruited for this study.MRS Questionnaire has 11 questions covering somatic, pschycological and genitourinary symptoms of menopause. The scoring system is simple. Hindi translation of MRS Questionare was done from English (MRS-E) to Hindi (MRS-H) by 4 independent translations using standard protocol. The MRS-H was tested for internal validity and also compared with MRS - E.Results: Quality of life is a subjective perception modified by the cultural habitat in which one lives. MRS-H showed high validity and good co-relation with MRS-E. The MRS-H possessed good convergent and discriminant validity. MRS-H showed anICC (Intraclass coefficient) was more than 0.5 and cronbach alpha more than0.5. There was found to be strong correlation between MRS-E and MRS-H questionnaire with all correlation value above 0.7.Conclusions: The authors recommend the use of the self assessed MRS-H in Hindi should be used to assess menopausal complaints and relief with treatment in India.

Menopausal symptoms and quality of life in women above 40 years in an urban resettlement colony of East Delhi

Background: Awareness of menopausal symptoms and their effects on the quality of life is extremely important for better management of symptoms. Objectives: The objectives of this study was to assess the prevalence of menopausal symptoms and its effect on the quality of life in women >40 years and determine the association of sociodemographic, obstetric, and other factors with menopause. Materials and Methods: A cross-sectional study was conducted in 105 women aged 40 years and above residing in an urban resettlement colony of Delhi. An interviewer-administered questionnaire was used to obtain information about sociodemographic and menstrual history. Quality of life related to menopause and its symptoms were measured using the menopause-specific quality of life questionnaire. Statistical analysis was done using SPSS 20.0. Results: Majority of the participants were married (70%), literate (50.5%), unemployed (92.4%), and belonged to upper-lower socioeconomic class (65.7%). The most prevalent symptom was decrease in physical strength in 85.7% of women. The prevalence (89%) and mean score of botheration (3.05 ± 0.917) for physical domain of symptoms was highest and it was significantly associated with the age of subjects and attainment of menopause (P < 0.05). Psychosocial domain was also significantly affected by the age of participants. Sexual domain of symptoms was least prevalent (11%) and had the least mean score of botheration (1.38 ± 1.134). Mean age of menopause was 44.6 years. Awareness regarding menopause was poor (1.9%). Conclusions: Physical symptoms are the most prevalent. Both physical and psychosocial symptoms are associated with age of participants, while only physical symptoms are associated with menopause attainment. The awareness of menopausal symptoms was very poor in the participants.

Prospective and retrospective study of weekly intermittent hormone (estrogen and progesterone) replacement therapy in hysterectomised women

Background: Estrogen therapy in younger postmenopausal women is associated with a decisive reduction in morbidity and mortality, but estrogen use in this population is low because of risk of side effects. Weekly intermittent therapy is a more patient friendly approach with reduced pill burden increasing compliance and adherence as well as reducing side effects. Therefore, authors wanted to study the effect of weekly intermittent fixed dose estrogen and progesterone (ultra-low dose) supplements in hysterectomised surgically menopaused women.Methods: The present study was prospective and retrospective study. For retrospective study authors records of 100 hysterectomised women up to 45years of age with severe post-menopausal symptoms treated in authors Medicine Department of Hospital with once weekly MALA-D tablets were studied. For prospective study, all consecutive hysterectomised patients with severe post-menopausal symptoms attending medicine OPD were given once weekly MALA-D which contains ethinylestradiol 0.03mg and levonorgestrel 0.15mg tablets and followed up monthly with outcomes measured by Modified Kuppermann Index, visual analogue scale, and women’s health questionnaires.Results: Present retrospective study showed moderate degree of postmenopausal symptoms as indicated by Modified Kuppermann index of 19.57. Prospective study showed significant improvement in postmenopausal symptoms with weekly intermittent hormone replacement therapy as indicated by outcomes measured by Modified Kupperman index and Visual analogue scale. Women’s health questionnaire also showed statistically significant improvement in 6 out of 8 dimensions.Conclusions: Authors concluded that weekly estrogen progesterone hormone replacement therapy with mala-D tablet (ultra-low dose therapy) was 100% effective in relieving vasomotor symptoms and it is very effective in improving psychosomatic symptoms, urinary symptoms and quality of life with no obvious side effects and greater adherence.

Cimicifuga heracleifolia is therapeutically similar to black cohosh in relieving menopausal symptoms: evidence from pharmacological and metabolomics studies / 中国天然药物

In the market of botanical dietary supplements, Cimicifuga heracleifolia (CH) has always been considered as an adulterated species of Cimicifuga racemosa (CR), a conventional American herb with promising benefits to counteract troubles arising from the menopause. However, the detailed comparison of their therapeutic effects is lacking. In present study, the pharmacological and metabolomics studies were comparatively conducted between CH and CR in ovariectomized (OVX) female rats. Specifically, estrogen-like, anti-hyperlipidemia and anti-osteoporosis effects were evaluated through measuring serum biochemical parameters, histopathological examination and micro computed tomography (Micro-CT) scanning. At the same time, a gas chromatography-mass spectrometry (GC-MS)-based serum metabolomics method was employed to profile the metabolite compositional changes. As a result, both CR and CH displayed anti-osteoporosis and anti-hyperlipemia on menopause syndrome. Meanwhile, their potentials in improving the OVX-induced metabolic disorders were discovered. In conclusion, these results demonstrated that CH is therapeutically similar to CR in relieving menopausal symptoms and CH could be considered as a promising alternative to CR instead of an adulterant in the market of botanical dietary supplements.

Study on the predictors of the menopausal symptoms related quality of life in patients with breast cancer undergoing chemotherapy / 上海交通大学学报（医学版）

Objective • To survey the menopausal symptoms related quality of life in patients with breast cancer undergoing chemotherapy and its determinants, which provides theoretical basis on intervention. Methods • In this cross-sectional study, a questionnaire survey was conducted on 484 breast cancer patients undergoing chemotherapy in 9 hospitals nationwide recruited by convenience sampling approach, from July 2016 to December 2017. Descriptive statistics, ANOVA, Spearman correlation and multiple linear regression analyses were preformed to explore the risk factors of the menopausal symptoms related quality of life. Results • The mean score of the Menopause Rating Scale (MRS) was 9.580±6.174 with 75.8% larger than 4, which indicated poor quality of life. One-Way ANOVA results showed the effect of marital status, monthly income, and the change of menstrual status on the MRS score were statistically significant. Spearman correlation results showed that the MRS score was positive correlated with anxiety and depression score and chemotherapy symptoms score, but negative correlated with social support score. Three of the nine variables, chemotherapy symptoms, anxiety, and information and emotional support, were selected by the multiple linear stepwise regression analysis, and could explain 43.0% of total variance (P<0.01). Conclusion • Most breast cancer patients undergoing chemotherapy have poor menopausal symptoms related quality of life. The main determinants were chemotherapy symptoms, anxiety, and information and emotional support. Informational and emotional support should be actively provided and mental health interventions should be strengthened, which could effectively improve their quality of life.

Prevalence of menopausal symptoms, its effect to quality of life among Malaysian women and their treatment seeking behaviour

Introduction: This study aimed to determine the prevalence of menopausal symptoms, its effect to the quality of life and their treatment seeking behaviour in a multiracial community in Malaysia. Methods: This is a cross-sectional study involving postmenopausal women in Klang Valley, Malaysia. Data was obtained by face-to-face interview using standardised questionnaires on sociodemographic data, Menopause Rating Scale questionnaire, effect to quality of life and treatment sought. Results: A total of 258 women, including Malays (82%), Indians (14.1%) and Chinese (3.9%) were recruited. The median age was 58 (range 45-86) years old. Joint and muscular discomfort (73.3%) and fatigue (59.3%) were the most prevalent symptoms. Significant association with ethnicity were demonstrated with Malays was found to have 3.1 times higher incidence of sexual problems than Indians, (Odds Ratio (OR) 3.103; 95%CI 1.209, 7.967) and Indian had 2.6 times higher incidence of irritability compared to Malays (OR 2.598; 95%CI 1.126, 5.992). Fifty-two percent of women felt that menopausal symptoms affected their quality of life but there were only 2.7% who were severely affected. There were 24.8% of women who sought treatment and only 20.3% of those who took hormone replacement therapy. There was no significant association found between their treatment seeking behaviour in association with ethnicity, age, parity, marital and occupational status. Conclusion: Menopausal symptoms were prevalent among menopausal women, although only a small group of women who were severely affected. There was a lack of tendency in seeking treatment for menopausal symptoms among the women.

Manual acupuncture versus electroacupuncture for menopausal syndrome:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical therapeutic effects and safety on menopausal symptoms between manual acupuncture (MA) and electroacupuncture (EA).</p><p><b>METHODS</b>Fifty patients were randomized into an MA group (25 cases) and an EA group (25 cases). In the MA group, the regular needling technique and pseudo-EA were used at Guanyuan (CV 4), Zigong (EX-CA 1), Tianshu (ST 25) and Sanyinjiao (SP 6). In the EA group, the acupoints were the same as the MA group and stimulated with EA and pseudo-MA (no manipulation applied in treatment), with disperse-dense wave, 10 Hz/50 Hz, 0.5 to 1.0 mA. In the two groups, the needles were retained for 30 min. The treatment was given once every two days, three times a week, totally for 8 consecutive weeks. The results of the menopause rating scale (MRS), the menopause-specific quality of life (MENQOL), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E) as well as adverse reactions were evaluated before treatment, in 4 and 8 weeks of treatment separately.</p><p><b>RESULTS</b>Compared with those before treatment, the scores of MRS, MENQOL, SAS and SDS were all reduced in the 4 and 8 weeks of treatment in the two groups (all<0.05). The results in 8 weeks of treatment were lower than those in 4 weeks of treatment in the two groups (all<0.05). The differen-ces were not significant statistically between the two groups (all>0.05). Compared with those before treatment, the levels of FSH and LH reduced and Eincreased after treatment in the two groups, without significant differences (all>0.05). The differences were not significant statistically between the two groups (all>0.05). The severe adverse reactions were not found in the treatment of the two groups.</p><p><b>CONCLUSIONS</b>Both manual acupuncture and electroacupuncture relieve the symptoms of depression and anxiety in menopausal syndrome,improve the living quality and do not induce apparent changes in serological sex hormones in the patients.</p>

Associations between Vasomotor Symptoms and Depression, Stress and Quality of Life in Midlife Women / 정신신체의학

OBJECTIVES: The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. METHODS: We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. RESULTS: 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory≥16), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. CONCLUSIONS: Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.

Factors associated with the severity of menopausal symptoms in post menopausal Brazilian women / Fatores associados com a intensidade dos sintomas menopausais em mulheres brasileiras na pós-menopausa

PURPOSES: To identify the socio-demographic and anthropometric profile and correlate them with the severity of menopausal symptoms in postmenopausal women. METHODS: Cross-sectional study with 201 postmenopausal women attended in a Gynecology Outpatient Department in Rio de Janeiro city (RJ, Brazil). A questionnaire was applied for collection of demographic, socioeconomic, clinical and lifestyle variables. The Blatt–Kupperman Menopausal Index was used to evaluate the menopausal symptoms. RESULTS: Women with moderate to severe symptoms ( ≥20) corresponded to 57.7% (116) of the sample. Obesity was not associated with the severity of menopausal symptoms (p < 0.90). Severe to moderate symptoms were inversely associated with age (PR 0.96; CI 95% 0.94–0.99;p < 0.01). Women within 6–10 years of menopause presented nearly 1.4 times higher prevalence of moderate to severe symptoms compared with those with more than 10 years of menopause. Unemployed women (PR 1.52; CI 95% 1.13–2.04; p < 0.01) and housewives (PR1.53; CI 95% 1.12–2.09; p < 0.01) presented higher prevalence of menopausal symptoms compared with working women. Tobaccoism was associated with higher prevalence of moderate to severe symptoms (p < 0.01). CONCLUSIONS: Age constituted a protection factor for moderate to severe symptoms, whereas having within 6–10 years of menopause, smoking and being unemployed or a housewife were factors related to higher prevalence of moderate to severe menopausal symptoms.

OBJETIVO: Identificar o perfil sociodemográfico e antropométrico e associá-los com a intensidade dos sintomas menopausais em mulheres na pós-menopausa.MÉTODOS: Estudo transversal com 201 mulheres na pós-menopausa atendidas em um ambulatório de ginecologia no Rio de Janeiro/RJ. Foi aplicado um questionário para coleta das variáveis demográficas, socioeconômicas, clínicas e hábitos de vida. O Índice Menopausal de Blatt–Kupperman (IMBK) foi utilizado para avaliar os sintomas menopausais.RESULTADOS: Mulheres com sintomas moderados a grave (≥20) corresponderam a 57,7% (116)da amostra. A obesidade não foi associada com a intensidade de sintomas menopausais (p < 0,90). Os sintomas moderados a intensos associaram-se inversamente com a idade (RP0,96; IC95% 0,94–0,99; p < 0,01). Mulheres com tempo de menopausa entre 6 e 10 anos apresentaram cerca de 1,4 vezes maior prevalência de sintomas moderados a intensos quando comparadas com aquelas com mais de 10 anos de menopausa. Mulheres desempregadas (RP 1,52; IC95% 1,13–2,04; p < 0,01) e donas de casa (RP 1,53; IC95% 1,12–2,09; p < 0,01) apresentaram maior prevalência de sintomas menopausais quando comparadas com mulheres trabalhando. O tabagismo foi associado a maior prevalência de sintomas moderados a intensos(p < 0,01). CONCLUSÕES: A idade constituiu fator de proteção para sintomas moderados a intensos. Enquanto que ter entre 6 à 10 anos de tempo de menopausa, ser tabagista e ser desempregada ou dona de casa foram fatores associados a uma maior prevalência de sintomas menopausais moderados a intensos.

<b>Four Cases of Menopausal Symptoms with Respiratory Complaints </b><b>Effectively Treated with Saikokeishikankyoto </b> / 日本東洋医学雑誌

We describe four cases of menopausal symptoms with respiratory complaints successfully treated with saikokeishikankyoto. Case 1 was a 49-year-old female who became easily tired and often caught colds, as well as suffered from cough, hot flushes and insomnia. Case 2 was a 47-year-old female who became easily fatigued and irritated, and suffered from dry cough. Case 3 was a 51-year-old female, who became easily exhausted and suffered from nasal congestion and swelling of the gums. Case 4 was a 53-year-old female, who suffered from sensations of coldness and hot flushes, insomnia, sore throat and dry cough. Although saikokeishikankyoto has been classically applied for diverse symptoms, respiratory signs are associated with the most preferable outcome. Saikokeishikankyoto could be a suitable herbal medicine for menopausal patients with a weak constitution, who present with respiratory symptoms caused by coldness, <i>qi </i>deficiency and <i>qi </i>stagnation.

The Relationship of Hot Flush to Other Menopausal Symptoms and Chronic Disease Related to Menopause / 대한폐경학회지

Hot flush is one of the most commonly reported symptoms during menopause and it is referred to as vasomotor symptoms along with night sweats. I have summarized the current available knowledge on the relationships between hot flush to other menopausal symptoms and the related chronic diseases to menopause in this article.

Evaluation of effect of isoflavone on thyroid economy & autoimmunity in oophorectomised women: A randomised, double-blind, placebo-controlled trial.

Background and objectives: The potential of soy isoflavones to interfere with thyroid function has been reported. However, there are limited data regarding their effect on thyroid function and autoimmunity in surgical menopausal women. The present study aimed to evaluate the effect of isoflavones on thyroid function and autoimmunity, menopausal symptoms, serum follicle stimulating hormone (FSH) and estradiol levels in oophorectomised women. Methods: A randomized, double blind, placebo-controlled trial was conducted in 43 oophorectomised women to evaluate the effect of soy isoflavones (75 mg/day for 12 wk) on serum thyroid profile (free T3 , free T4 , TSH, TBG and anti-TPO antibody titres) assessed at baseline, 6 and 12 wk after randomization. Assessment was also done for menopause symptom score (MSS) three weekly, and FSH and estradiol levels at baseline and at study completion. Results: There was a significant alteration in free T 3 levels in the group receiving isoflavones (4.05 ± 0.36, 4.12 ± 0.69 and 3.76 ± 0.55 pmol/l at baseline, 6 and 12 wk, respectively; P=0.02). However, the mean change in various thyroid parameters at 12 wk from baseline was not significantly different between the two groups. MSS was also significantly decreased at 9 and 12 wk from baseline with isoflavones (12.47 ± 8.15, 9.35 ± 5.23 and 9 ± 5.14 at baseline, 9 and 12 wk respectively; P=0.004) with significant improvement in urogenital symptoms compared to placebo. Isoflavones did not significantly affect other parameters during study period. There were no serious adverse events reported and the proportion of patients experiencing adverse events was similar between the two groups. Interpretation and conclusions: Modest reduction in serum free T3 levels in the isoflavone group in the absence of any effect on other thyroid parameters might be considered clinically unimportant.

Menopausal Symptoms:A Comparative Study in Rural and Urban Women.

The present study was carried out on 500 females in the age group of 40-60yrs to find out average age of menopause in rural and urban women and associated menopausal symptoms & its awareness & prevalence by predesigned questionnaire. We found out that , the percentage of all menopausal symptoms is more in urban women as compared to rural cases. Commonly observed symptoms' are hot flushes, joint & muscular discomfort and physical & mental exhaustion. However women don't come out with sexual problem much both in rural and urban.The symptoms are at peak during 45-55 years and after 55 years severity decreases. However the urinary symptoms and heart discomfort are more in > 55 years in urban women. Though the urban women are consulting physician for menopausal problems still percentage is very less. On the other hand rural women don't come out with their problems.

Menopausal Symptoms:A Comparative Study in Rural and Urban Women.

The present study was carried out on 500 females in the age group of 40-60yrs to find out average age of menopause in rural and urban women and associated menopausal symptoms & its awareness & prevalence by predesigned questionnaire. We found out that , the percentage of all menopausal symptoms is more in urban women as compared to rural cases. Commonly observed symptoms' are hot flushes, joint & muscular discomfort and physical & mental exhaustion. However women don't come out with sexual problem much both in rural and urban.The symptoms are at peak during 45-55 years and after 55 years severity decreases. However the urinary symptoms and heart discomfort are more in > 55 years in urban women. Though the urban women are consulting physician for menopausal problems still percentage is very less. On the other hand rural women don't come out with their problems.

Manifestaciones músculo-articulares, y no las oleadas de calor, es el síntoma más prevalente en mujeres climatéricas del Caribe colombiano / Joint and muscular discomfort, and not hot flashes, are the most frequent symptoms in middle-age menopause women from the Colombian Caribbean

Objetivo: Evaluar con Menopause Rating Scale la frecuencia y severidad de síntomas menopáusicos presentes en un conjunto global de mujeres saludables en edad media que son originarias y residen en distintas comunidades del Caribe colombiano. Materiales y métodos: Estudio transversal con formulario y escala MRS aplicada entre noviembre de 2006 y enero de 2009 a mujeres saludables entre 40 y 59 años de edad, tomadas de comunidades de la Costa Caribe colombiana: afrodescendientes, indígenas e hispánicas. Se determinó la frecuencia de presentación de los síntomas y su severidad. Resultados: Las molestias músculo-articulares fueron el síntoma más frecuente en un 72.9% de las mujeres, seguido de las oleadas de calor, en un 70.4%. La irritabilidad y el cansancio físico y mental fueron síntomas frecuentes, y se presentaron en más del 60% de las participantes. Las molestias músculo-articulares tienen la mayor puntuación promedio (1,6 +/-1,3), lo cual revela que contribuyen en mayor proporción al deterioro de la calidad de vida. Al considerar la severidad de los síntomas en quienes manifestaron molestias músculo-articulares, los síntomas fueron severos o muy severos en un 29.6%, seguido de los problemas de vejiga, con un 23.2%. Conclusión: Para mejorar la calidad de vida de la mujer en la menopausia es importante caracterizar los síntomas climatéricos en cada población para brindar una mejor atención en salud, descubrir estrategias para el manejo de los síntomas y promover estilos de vida que contribuyan a disminuir su incidencia y severidad.

Objective: Determine the frequency and severity of menopausal symptoms in a set of healthy middle aged women born and living in different communities of the Colombian Caribbean with menopause rating scale (MRS). Materials and Methods: Cross sectional study. Survey form and scale MRS were applied between November 2006 and January 2009 in healthy women between 40 and 59 years old, taken from communities in the Colombian Caribbean: Afro-descents, indigenous and Hispanic. We determined the frequency of symptoms and their severity. Results: Joint and muscular discomfort was the most frequent symptom in 72.9% of women, followed by hot flashes in 70.4%; irritability and physical and mental exhaustion were frequent, occurring in more than 60% of participants. Joint and muscular discomfort had the highest average score (1.6 + / -1.3), revealing that is a major contributor to a poorer quality of life. Considering severity of symptoms, joint and muscular discomfort was expressed as severe or very severe in 29.6%, followed by bladder problems in 23.2%. Conclusion: To improve the quality of life for women in menopause is important to characterize the climacteric symptoms in each population to provide better health care, discover strategies for managing symptoms, and promote lifestyles that help reduce its incidence and severity.