Impact of bilateral ovariectomy on climacteric symptoms in post-menopausal women / 上海交通大学学报（医学版）

Objective To evaluate the impact of bilateral ovariectomy in post-menopausal women by comparison of climacteric symptoms before and after operation. Methods Post-menopausal women who received hysterectomy with concurrent bilateral ovariectomy on benign uterine indications were recruited.Climacteric symptoms before and after operation were accessed by a questionaire including modified Kupperman Index.Comparison was made after grouping the patients into early menopause group,whose menopausal period was no more than 5 years,and late menopause group,whose menopausal period was more than 5 years. Results Among a total of 95 individuals,8 had normal,46 had mild,34 had moderatc,and the other 7 had severe Kupperman Index scores before operation,while 5 had normal,28 had mild,48 had moderate,and the other 14 had severe Kupperman Index scores after operation,with more moderate and severe climacteric symptoms after operation than before operation(P<0.05).Women of early menopause group had higher total Kupperman Index scores and symptom scores of sweating,insomnia,depression,fatigue and headache than those of late menopause group before operation(P<0.05).Women of early menopause group had significantly higher Kupperman Index scores after operation than before operation(23.93±7.53 vs 17.63±8.07,P<0.05).However,there was no significant difference in total Kupperman Index scores in women of late menopause group before and after operation. Conclusion Bilateral ovariectomy may affect the climacteric symptoms in post-menopausal women,especially in early menopausal period.

The Effects of Meridian Massage on Climacteric Symptoms, BMD and Serum Hormone in Perimenopausal Women / 성인간호학회지

PURPOSE: We analyzed climacteric symptoms, bone mineral density (BMD), serum estradiol (E2) and follicle stimulating hormone (FSH) to identify the health benefits of meridian massage in perimenopausal women. METHODS: There were 16 women in the experimental group and 17 people in the control group. Meridian massage was performed for 4 weeks, 3 times a week for 20 minutes each session. The data were collected pre-treatment, posttreatment and 4 weeks after treatment. SPSS/WIN 11.5 was used for data analysis. RESULTS: After meridian massage, there were significant differences in climacteric symptoms (U = 65.50, p = .011) and BMD (U = 65.50, p = .011) between the two groups. The E2 level showed a significant difference between the two groups pre- and posttreatment (U = 75.00, p = .028). FSH showed a significant increase when measured at 4 weeks after the treatment as compared with the amount when measured post-treatment within the control group (z = -2.249, p = .025), experimental group showed a stable change in FSH. but there was no significant difference between the groups. CONCLUSION: In this study, we confirmed the effects of Meridian massage in decreasing climacteric symptoms, inhibiting the decrease of BMD and stabilizing serum hormone in perimenopausal women. Therefore, it can be considered for use as a nursing intervention for health management in perimenopausal women.

A Study on the Relationship between Climacteric Symptom, Depression and Coping among Middle-Aged Women / 農村醫學 地域保健

OBJECTIVES: The purpose of this study were to examine the level of climacteric symptom, coping and depression among middle-aged women and to identify the relationship between climacteric symptom, coping and depression. METHODS: A descriptive correlational study was conducted. The participants were 275 middle-aged women visiting obstetrics and gynecology hospital in one metropolitan city. Data were collected using a self-administered questionnaire. Descriptive statistics, ANOVA and Pearson correlation were used for data analysis. RESULTS: The mean climacteric symptom score was .54, the mean depression score was .74 and the mean coping score was .35. The level of climacteric symptom, depression and coping were slightly lower than those of other studies. There were positive relationships between climacteric symptom and depression and between climacteric symptom and coping. CONCLUSIONS: To promote physical and emotional health of middle-aged women, more attention is necessary to decrease their climacteric symptom and depression. These results can be used for nursing intervention and care programs for creating better quality of life for middle-aged women.

Developing an Instrument to Measure Climacteric Symptoms among Korean and Japanese Women / 간호학회지

PURPOSE: The purpose of this study was to construct a measurement instrument for climacteric symptoms among Korean and Japanese women. METHODS: From Dec. 1st of 2003 to March 30th of 2004, in-depth interviews were made with 26 women (15 in Jinju, Korea and 11 in Nagasaki, Japan) aged from 45 to 59 years who had not taken hormone replacement therapy to relieve the climacteric symptoms. A draft questionnaire with 45 items was constructed on the basis of the interview data and literature review. Three obstetricians, three PhDs in nursing science, and a chief nurse who was exclusively in charge of the climacteric management, examined the draft questionnaire to evaluate content validity. After deletions 39 items remained for a preliminary questionnaire. A survey was conducted by using a convenient sampling method in Jinju of Korea and Nagasaki of Japan during the period from April 1st, 2004 to July 10th, 2005. RESULTS: Factor analysis identified 4 factors, which were "mental and psychological symptoms", "physical symp-toms", "loss of autonomic nervous system symptoms", "sexual symptoms". These four factors explained 46.9% of total variance. CONCLUSIONS: The results demonstrated that climacteric symptom scale was multidimensional, and the reliability and validity of the scale was supported.

The Effect of black cohosh with St. John's wort (Feramin-Q(R)) on climacteric symptoms: multicenter randomized double-blind placebo-controlled trial / 대한산부인과학회지

OBJECTIVE: Results of several recent randomized clinical trials and epidemiological studies casted many doubts about the validity and safety of conventional hormone therapy for postmenopausal women. More and more women want to try more natural and safe ways of treating their climacteric symptoms. Black cohosh combined with St. John's wort may be effective in climacteric symptoms alternative to hormone therapy. This multicenter randomized double-blind placebo-controlled prospective clinical trial was carried out to evaluate the effect of the combined preparation of black cohosh and St. John's wort, Feramin-Q(R), on the general climacteric symptoms, hot flushes and climacteric depression. METHODS: Total of 80 postmenopausal women having moderate to severe degree of climacteric symptoms were randomly allocated to receive Feramin-Q(R) (n=40) or placebo (n=40) daily for 12 weeks. Fifty eight subjects completed this clinical study. The primary endpoint, the relief of general climacteric symptom and hot flushes were evaluated by measuring Kupperman index and the secondary endpoint, the relief of climacteric depression by Beck Depression Inventory at 4 and 12 weeks of treatment. RESULTS: After 4 and 12 weeks of treatment, Feramin-Q(R) and placebo groups showed significant decline of Kupperman index and BDI scores compared with baseline scores, but Kupperman index and BDI scores between the groups were not significantly different at 12 weeks. The changes of BDI scores between the groups were different at borderline significant level (p=0.07). Hot flush scores of Feramin-Q(R) groups were significantly decreased after 12 weeks of therapy, which showed significantly different at borderline level (p=0.07) from that of placebo. There was no statistical difference in change of hot flush scores from the baseline between the groups after 12 weeks. Among the 45 postmenopausal women with moderate to severe hot flush, Feramin-Q(R) group showed significant decrease of hot flush scores, which was significantly different compared with placebo group at 12 weeks of therapy. There were more patients (86.4%) in Feramin-Q(R) group, who had much more improvement of hot flushes compared with placebo group (54.6%) (P=0.04). CONCLUSION: There were no significant differences between placebo and Feramin-Q(R) groups concerning the effect on general climacteric symptoms and depression but Feramin-Q(R) was significantly more effective than placebo in relieving of hot flush in postmenopausal women with moderate to severe hot flushes. Therefore Feramin-Q(R) seems to be effective alternative for moderate to severe hot flushes.

Effect of Progressive Muscle Relaxation using Biofeedback on Perceived Stress, Stress Response, Immune Response and Climacteric Symptoms of Middle-Aged Women / 간호학회지

PURPOSE: This study was aimed to evaluate the effect of progressive muscle relaxation training using biofeedback on perceived stress, stress response, immune response and climacteric symptoms. METHOD: This was a crossover, pre-post test design. The study subjects are 36 middle-aged women who were selected at 2 public health centers. The independent variable was Biofeedback training for 4 weeks, twice a week and home training for 4 weeks. Dependent variables were perceived stress, stress response, immune response, and climacteric symptoms measured with Hildtch's scale (1996). RESULT: Progressive muscle relaxation training using biofeedback was not effective in reducing perceived stress, but it was shown to be effective in reducing physiological stress responses such as pulse rate and EMG. Though blood pressure and skin conductance were repeatedly down, and skin temperature slowly increased, there were no statistically significant differences. Progressive muscle relaxation training using biofeedback was not effective in reducing serum cortisol, enhancing immune responses, or decreasing climacteric symptoms. CONCLUSION: The findings point to a pressing need for further, well-controlled and designed research with consideration in selection of subjects and instruments, frequency of measurements, the sampling method, and intervention modalities.

The Effects of Estrogen Replacement Therapy on Blood Pressure, Heart Rate Variability, and Climacteric Symptoms in Postmenopausal Women / 여성건강간호학회지

PURPOSE: Estrogen replacement therapy is indicated for the relief of hot flushes and urogenital atrophy, the prevention of osteoporosis and the reduction in risk of cardiovascular disease. The present study assessed by blood pressure, heart rate variability, and climacteric symptoms in menopausal women before treatment and at 1 month during estrogen replacement therapy. METHODS: The study sample consisted of 16 healthy menopausal women (range 49 to 59 years, mean : 53.4 years) attending menopausal clinics for the complaint of climateric symptoms at S. hospital in Chunchoen. They were all non-smokers and no patient had symptoms or evidence of cardiovascular disease. They took estrogen replacement therapy (conjugated estrogen 0.625 mg with or without medroxy progesteron 2.5mg) for 1 month. Blood pressure, heart rate variability(heart period and vagal tone) through ECG, and climacteric symptom were measured in all subjects before treatment and at 1 month during treatment. Climacteric symptom questionnaire which was developed by Neugarten et al.(1963) was modified with 20 items of question(Cronbach's alpha = .88 -.89). The data was collected from Sept. 1. 2000 to July. 30. 2001. RESULTS: There was no significant difference in mean systolic and diastolic pressure between the baseline and at 1 month during treatment. The mean heart period and vagal tone were slightly increased, but difference of mean heart period and vagal tone were not statistically significant between the baseline and at 1 month during treatment. The score of climacteric symptoms decreased significantly from the baseline after treatment. CONCLUSIONS: Even though, this study did not show that estrogen replacement therapy led decrease of blood pressure and increase heart rate variability, climacteric symptoms reduced much in all subjects after taking drugs. These results suggest that there is need to repeat study with long term period.

A Study on the Climacteric Symptoms and Emotion of Korean Women Living in the United States and Korea / 기본간호학회지

The purpose of this study was to compare the climacteric symptoms and emotion of Korean women living in the United States and Korea. The 195 subjects consisted of 81 women who have lived for more than 10 years in the United States and 114 women who live in Korea. All the subjects were from 40 to 60 years of age. Data were collected by convenience sampling using a questionaire in the west and mid-west regions of the United States and in Kyungbuk province in Korea. The results of .this study are as follows: 1. Both subjects in the United States and Korea showed the highest negative emotions according to the following ; in the 50-54 years of age group, divorced, less than high school graduation, lower income level and Protestant in religion. So we concluded that the cultural differences between the United States and Korea did not exert an important influence on the women's emotional tendency, but personal characteristics and background did. 2. Emotional tendency of Korean women from 40 to 60 years of age living in United States and Korea was slight negative (Korean-American ; 3.97+/-.94, Korean ; 3.90+/-.71) 3. The emotions of women living in the United States showed a significant difference according to the state of health(F=3.7726, p<.05). The emotions of women living in Korea showed a significant difference according to marrital status(F=6.4733, p<.05). 4. There were negative correlations between the number of climacteric symptoms and emotions.