The effect of different progestogens on sleep in postmenopausal women: a randomized trial.

BACKGROUND: While progesterone affects sleep, different types of it might affect sleep differently. METHODS: One hundred Thai women, who complained of insomnia, visited the Menopause Clinic at Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand from February 2014 to March 2015, and were divided randomly into two groups. Both groups received daily hormonal treatment that included estradiol valerate (progynova) at 1 mg. The first group also received dydrogesterone (duphaston®) at 10 mg and the second group micronized progesterone (utrogestran®) at 100 mg. The clinical symptoms and Pittsburgh Sleep Quality Index (PSQI) were recorded for three consecutive months after treatment. This study was registered with clinicaltrial.gov (code number NCT02086032). RESULTS: Sleep quality improved in both groups (10.52 ± 4.27 to 4.91 ± 3.15 in the dydrogesterone group and 10.16 ± 3.60 to 6.27 ± 3.04 in the micronized progesterone group, p value 0.08). Women in the micronized progesterone group had fewer overall side effects than those in the dydrogesterone group. CONCLUSION: Sleep quality of peri-postmenopausal women with insomnia improved dramatically after the first month of hormonal treatment. However, more participating patients are necessary to ascertain the differences in sleep quality from dydrogesterone and micronized progesterone treatment.

Validate of clinical risk index for osteoporosis in Thai women at Phramongkutklao Hospital.

BACKGROUND: Osteoporosis is a common problem found in elderly people and the cost of treatment with its complications is much higher than the cost of diagnosis and prevention. However diagnosis of osteoporosis is hindered by an unavailability of dual energy x-ray absorptiometry (DXA). Many clinical risk index-scoring systems were developed to help prediction of osteoporosis such as Khon Kaen Osteoporosis Study (KKOS). The KKOS is one among those scoring systems based on the Thai population database. The objectives of the present study were to validate KKOS for prediction of osteoporosis in Thai women at Gynecologic Clinic of Phramongkutklao Hospital and to study the prevalence of women with osteoporosis diagnosed with KKOS. MATERIAL AND METHOD: Four hundred forty six Thai women, aged 40 years or more attending the Gynecologic Clinic of Phramongkutklao Hospital, and had Bone mineral density (BMD) result were enrolled in the present study. The results of BMD were measured at the lumbar spine and femoral neck by DXA and KKOS. The score was evaluated and compared. RESULTS: Sensitivity and specificity of KKOS for prediction of osteoporosis were 48.6% and 68.1%, respectively. Prevalence of osteoporosis using KKOS was 23% while 32% were diagnosed with DXA. CONCLUSION: KKOS had low sensitivity and specificity for diagnosed osteoporosis in Thai women at Gynecologic Clinic of Phramongkutklao Hospital.