Yoga for menopausal symptoms: a systematic review

Lee, Myeong Soo,Kim, Jong-In,Ha, Jeong Yong,Boddy, Kate,Ernst, Edzard The North American Menopause Society 2009 Menopause Vol.16 No.3

OBJECTIVE:: The aim of this study was to assess the effectiveness of yoga as a treatment option for menopausal symptoms. METHODS:: We searched the literature using 14 databases from their inception to July 2008 and included all types of clinical studies regardless of their design. The methodological quality of all studies was assessed using a modified Jadad score. RESULTS:: Seven studies met our inclusion criteria. Two randomized clinical trials compared the effects of yoga with those of walking or physical exercise. The meta-analysis of these data failed to show specific effects of yoga on menopausal complaints including psychological, somatic, and vasomotor symptoms. Two randomized clinical trials found no effects of yoga on total menopausal symptoms compared with wait-list control or no treatment. The remaining studies were either non-randomized (n = 1) or uncontrolled clinical trials (n = 3). They reported favorable effects of yoga on menopausal symptoms. These data collectively show that the results of rigorous studies of the effects of yoga for menopausal symptoms are unconvincing. CONCLUSION:: The evidence is insufficient to suggest that yoga is an effective intervention for menopause. Further research is required to investigate whether there are specific benefits of yoga for treating menopausal symptoms.

Moxibustion for treating menopausal hot flashes: a randomized clinical trial

Park, Ji-Eun,Lee, Myeong Soo,Jung, Soyoung,Kim, Aeran,Kang, Kyungwon,Choi, Junyong,Park, Jongbae,Choi, Sun-Mi The North American Menopause Society 2009 Menopause Vol.16 No.4

OBJECTIVE:: A hot flash is a general postmenopausal symptom experienced by approximately 75% of climacteric women. Women often turn to complementary and alternative medicines to relieve hot flashes. Moxibustion is one such medication. The aim of this study was to evaluate the effect of moxibustion on hot flashes in perimenopausal and postmenopausal women. METHODS:: Fifty-one participants were randomly assigned into three groups, namely, moxibustion 1, moxibustion 2, and waiting list (control). The moxibustion groups received 14 sessions of moxibustion treatment for 4 weeks at acupuncture points. Our protocol was supported by evidence from clinical experts (Moxa 1) or published literature (Moxa 2), and we followed all participants for an additional 2 weeks after the end of the study. Our primary outcome measures were frequency and severity of hot flashes. Secondary outcome parameters included quality of life (Menopausal-Specific Quality of Life Scale) and Menopause Rating Scale. RESULTS:: Fifty-one women participated in our study. By week 4, the difference in severity and frequency of hot flashes had become statistically significant between the treatment groups and the control participants. In addition, there was a statistically significant difference in Menopausal-Specific Quality of Life Scale scores between treatment group 2 and the other groups. CONCLUSIONS:: Our results suggest that moxibustion reduces both the frequency and severity of menopausal hot flashes as compared with those in control participants. We would recommend further studies with larger samples and possibly including placebo controls.

Prevalence and severity of menopause symptoms and associated factors across menopause status in Korean women

Yim, Gyeyoon,Ahn, Younjhin,Chang, Yoosoo,Ryu, Seungho,Lim, Joong-Yeon,Kang, Danbee,Choi, Eun-Kyung,Ahn, Jiin,Choi, Yuni,Cho, Juhee,Park, Hyun-Young by The North American Menopause Society. 2015 Menopause Vol.22 No.10

OBJECTIVE:: The present study investigated the prevalence and severity of menopause symptoms experienced by Korean women aged 44 to 56 years and their associated factors. METHODS:: A cross-sectional study was performed on 2,201 women aged 44 to 56 years in health checkup centers between November 2012 and March 2013. The 29-item Menopause-Specific Quality of Life Questionnaire was used to assess vasomotor, psychosocial, physical, and sexual symptoms related to menopause. The guidelines for the classification of reproductive aging stages proposed at the Stages of Reproductive Aging Workshop were used. Multivariable linear regression analyses were performed to identify factors associated with severity of menopause symptoms. RESULTS:: Among participants, 42.6% were premenopausal, 36.7% were perimenopausal, and 20.7% were postmenopausal. Although physical symptoms were the most severe menopause symptoms experienced by premenopausal and perimenopausal women, postmenopausal women reported sexual symptoms as the most bothersome. The mean scores for each domain increased from the premenopausal period through the postmenopausal period (P for trend < 0.001). The regression model revealed that age (for vasomotor and sexual symptoms) and obesity (for vasomotor and physical symptoms) were significantly associated with severity of menopause symptoms (P < 0.05). Physically active women had fewer severe physical symptoms related to menopause than inactive women. CONCLUSIONS:: Postmenopausal women experience the most severe symptoms. Obesity and physical activity are the main modifiable factors associated with symptom severity. Further studies are needed to examine the effects of physical activity promotion and weight control interventions on preventing menopause symptoms in Korean women.

Genome-wide association studies and epistasis analyses of candidate genes related to age at menarche and age at natural menopause in a Korean population

Pyun, Jung-A.,Kim, Sunshin,Cho, Nam H.,Koh, InSong,Lee, Jong-Young,Shin, Chol,Kwack, KyuBum by The North American Menopause Society. 2014 Menopause Vol.21 No.5

OBJECTIVE: The aim of this study was to identify polymorphisms and gene-gene interactions that are significantly associated with age at menarche and age at menopause in a Korean population. METHODS: A total of 3,452 and 1,827 women participated in studies of age at menarche and age at natural menopause, respectively. Linear regression analyses adjusted for residence area were used to perform genome-wide association studies (GWAS), candidate gene association studies, and interactions between the candidate genes for age at menarche and age at natural menopause. RESULTS: In GWAS, four single nucleotide polymorphisms (SNPs; rs7528241, rs1324329, rs11597068, and rs6495785) were strongly associated with age at natural menopause (lowest P = 9.66 × 10). However, GWAS of age at menarche did not reveal any strong associations. In candidate gene association studies, SNPs with P < 0.01 were selected to test their synergistic interactions. For age at natural menopause, there was a significant interaction between intronic SNPs on ADAM metallopeptidase with thrombospondin type I motif 9 (ADAMTS9) and SMAD family member 3 (SMAD3) genes (P = 9.52 × 10). For age at menarche, there were three significant interactions between three intronic SNPs on follicle-stimulating hormone receptor (FSHR) gene and one SNP located at the 3&vprime; flanking region of insulin-like growth factor 2 receptor (IGF2R) gene (lowest P = 1.95 × 10). CONCLUSIONS: Novel SNPs and synergistic interactions between candidate genes are significantly associated with age at menarche and age at natural menopause in a Korean population.

Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women-a multicenter randomized clinical trial

Kim, Kun Hyung,Kang, Kyung Won,Kim, Dong Il,Kim, Hyung Jun,Yoon, Hyun Min,Lee, Jin Moo,Jeong, Jae Cheol,Lee, Myeong Soo,Jung, Hee Jung,Choi, Sun-Mi The North American Menopause Society 2010 Menopause Vol.17 No.2

OBJECTIVE:: The aim of this study was to evaluate the effectiveness of acupuncture plus usual care for relief of hot flashes and menopause-related symptoms compared with usual care alone in perimenopausal or postmenopausal women. METHODS:: A multicenter, randomized, controlled trial was conducted. Perimenopausal or postmenopausal women with average hot flash scores of 10 or higher during the week before the screening visit were enrolled and randomly divided into two groups. The treatment group received 12 sessions of acupuncture and maintained usual care for 4 weeks, whereas the control group underwent usual care alone. Hot flash scores were calculated by multiplying frequency by severity of hot flashes recorded in a daily diary. The primary outcome was the mean change in the average 24-hour hot flash score at week 4 from baseline. The secondary outcome was the mean change in menopause-related symptoms as estimated by the Menopause Rating Scale questionnaire at week 4. Follow-up assessment at week 8 was conducted in the treatment group only. RESULTS:: The mean change in the average 24-hour hot flash score was −16.57 in the treatment group (n = 116) and −6.93 in the control group (n = 59), a difference of 9.64 (P < 0.0001). The total Menopause Rating Scale score, as well as the subscale scores for the psychological, somatic, and urogenital dimensions of menopause, showed significant improvement in the acupuncture group compared with the control group (P < 0.001). The mean change in the treatment group in the primary outcome was −17.58 at week 8. CONCLUSIONS:: Our results suggest that acupuncture in addition to usual care is associated with marked clinical improvement in hot flashes and menopause-related symptoms in perimenopausal or postmenopausal women.

Localized brain metabolite changes during visual sexual stimulation in postmenopausal women: a pilot study using functional magnetic resonance spectroscopy

Kim, Tae-Hoon,Kang, Heoung-Keun,Park, Kwangsung,Jeong, Gwang-Woo by The North American Menopause Society. 2014 Menopause Vol.21 No.1

OBJECTIVE: Functional magnetic resonance spectroscopy was used to compare brain metabolite changes between nonpostmenopausal and postmenopausal women exposed to visual sexual stimulation with erotic video clips. METHODS: Twenty nonpostmenopausal women and 20 postmenopausal women were enrolled in this study. Menopause was defined as continuous amenorrhea for more than 12 months and a follicle-stimulating hormone level higher than 40 mIU/mL. Brain metabolite concentrations were measured from a localized voxel on the anterior cingulate gyrus, one of the most important areas associated with sexual arousal. Subjective sexual arousal and attention to visual stimulation were assessed using a 5-point scale. Functional magnetic resonance spectroscopy data were acquired from nonpostmenopausal and postmenopausal women during rest and activation conditions. RESULTS: Compared with nonpostmenopausal women, postmenopausal women showed significantly lower levels of both &bgr;&ggr;-glutamate/glutamine and lipid during the “rest” period but had lower levels of &bgr;&ggr;-glutamate/glutamine only during the “activation” period (P < 0.05). CONCLUSIONS: This study finds differential brain metabolite changes during visual sexual arousal in nonpostmenopausal and postmenopausal women. These findings would be helpful in understanding the neural mechanism of visual sexual arousal in connection with brain metabolite changes after menopause.

Duration of ovarian hormone exposure and atherosclerotic cardiovascular disease in Korean women: the Korean Heart Study

Jung, Keum Ji,Kim, Mee-Ran,Yun, Young Duk,Kim, Hyeon Chang,Jee, Sun Ha by The North American Menopause Society. 2016 Menopause Vol.23 No.1

<P>Objective: Although reproductive and hormonal factors, such as menarche and menopause, have been reported as independent risk factors for atherosclerotic cardiovascular disease (ASCVD), few studies have examined these factors in East Asian populations. In the Korean Heart Study, ASCVD risk related to duration of ovarian hormone exposure was examined in a cohort of 66,104 Korean women. Methods: Study members were recruited from participants of routine health examinations at health promotion centers across South Korea in 1996-2004. Ovarian hormone exposure was defined as duration between menarche and menopause. Incidence rates for ASCVD, stroke, and ischemic heart disease were examined in relation to ovarian hormone exposure. Results: The mean duration of ovarian hormone exposure at study baseline was 33.7 years, and risk for ASCVD was negatively associated with duration. Women with shorter ovarian hormone exposure (<30 y) had a higher risk of developing ASCVD (hazard ratio [HR], 1.30; 95% CI, 1.01-1.68) than women with longer ovarian hormone exposure (35-35 y). In similar comparison groups, women with ovarian hormone exposure shorter than 30 years were at increased risk for developing total stroke (HR, 1.18; 95% CI, 1.00-1.38), thrombotic stroke (HR, 1.30; 95% CI, 1.05-1.61), ischemic heart disease (HR, 1.40; 95% CI, 1.19-1.63), and acute myocardial infarction (HR, 1.73; 95% CI, 1.08-2.47). Conclusions: Our study provides further confirmation of increased cardiovascular risk with shorter reproductive years. Therefore, women with reduced lifetime ovarian hormone exposure should focus on minimizing ASCVD risk by lifestyle modifications such as smoking avoidance or increased physical activities.</P>

Protective effect of egg yolk peptide on bone metabolism

Kim, Hye Kyung,Lee, Sena,Leem, Kang-Hyun The North American Menopause Society 2011 Menopause Vol.18 No.3

OBJECTIVE:: Osteoporosis is a major health problem worldwide, and most current therapy used in osteoporosis treatment acts by either increasing bone formation or decreasing bone resorption. However, the adverse effects of these therapies may preclude their long-term use. We examined the effects of egg yolk water-soluble peptide (YPEP) on bone metabolism as an alternative to current therapeutic agents in ovariectomized (OVX) rats. METHODS:: In the first step, the in vitro effects of YPEP on bone loss were determined. The proliferation, collagen content, and alkaline phosphatase activity of preosteoblastic MC3T3-E1 cells and osteoclastogenesis from bone marrow-derived precursor cells were measured. The in vivo experiment confirmed the positive effect of YPEP on bone tissue. Three-month-old female Sprague-Dawley rats were either sham operated or ovariectomized and fed commercial chow diet or 0.1% YPEP-supplemented diet for 3 month. RESULTS:: YPEP increased preosteoblastic MC3T3-E1 cell proliferation and alkaline phosphatase activity in a dose-dependent manner. Collagen content was also increased by YPEP treatment. Furthermore, YPEP potently suppressed osteoclastogenesis from bone marrow-derived precursor cells. YPEP (100 μg/mL) abolished the formation of osteoclasts positive for tartrate-resistant acid phosphatase. OVX rats supplemented with YPEP showed an osteoprotective effect, as the bone mineral density and cortical thickness in the tibia were increased compared with the OVX controls. Moreover, histological data indicate that YPEP prevented the cancellous bone loss induced by ovariectomy. None of these protective effects were observed in casein-treated rats. CONCLUSIONS:: The present study suggests that YPEP is a promising alternative to current therapeutic agents for the management of osteoporosis.

Combined exercise reduces arterial stiffness, blood pressure, and blood markers for cardiovascular risk in postmenopausal women with hypertension

Son, Won-Mok,Sung, Ki-Dong,Cho, Jae-Min,Park, Song-Young by The North American Menopause Society. 2017 Menopause Vol.24 No.3

<P>Conclusions: These findings indicate that 12 weeks of combined exercise training improves arterial stiffness, BP, ET-1, blood nitrite/nitrate, functional capacity, and body composition in postmenopausal women with stage 1 hypertension. Thus, this study provides evidence that combined exercise training is a useful therapeutic method to improve cardiovascular health which can reduce cardiovascular disease risk in postmenopausal women with hypertension.</P>

Insulin resistance independently influences arterial stiffness in normoglycemic normotensive postmenopausal women

Park, Jong Suk,Nam, Ji Sun,Cho, Min Ho,Yoo, Jeong Seon,Ahn, Chul Woo,Jee, Sun Ha,Lee, Hong Soo,Cha, Bong Soo,Kim, Kyung Rae,Lee, Hyun Chul The North American Menopause Society 2010 Menopause Vol.17 No.4

OBJECTIVE:: Cardiovascular disease risk increases after menopause, which may be related to insulin resistance, and arterial stiffness is a significant predictor of atherosclerosis. We investigated the relationships among insulin resistance, adiponectin, and arterial stiffness in normoglycemic normotensive postmenopausal women. METHODS:: From 9,555 participants who had routine health checkups, 455 normoglycemic normotensive postmenopausal women were enrolled. Serum concentrations of glucose, total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) and adiponectin were measured. Insulin resistance was estimated by the insulin resistance index of homeostasis model assessment (HOMA-IR). Pulse wave velocity (PWV) was evaluated to assess arterial stiffness. RESULTS:: The women were stratified into three groups according to their HOMA-IR values, and comparisons were made among the three groups. There were significant differences in metabolic parameters between the groups. The mean age, body mass index, waist circumference, fasting plasma glucose, TG, systolic blood pressure (SBP), diastolic blood pressure (DBP), aortic PWV, and peripheral PWV increased sequentially with the degree of insulin resistance. Meanwhile, HDL-C and adiponectin levels decreased with the worsening of insulin resistance. Age, body mass index, fasting plasma glucose, TG, insulin, SBP, HOMA-IR, aortic PWV, and peripheral PWV were significantly higher in women with central obesity, and HDL-C and adiponectin were significantly lower in women with central obesity. Aortic PWV and peripheral PWV were significantly correlated with age, waist circumference, total cholesterol, SBP, DBP, insulin, and HOMA-IR, but adiponectin was not associated with PWV. The results of multiple regression analysis indicated that SBP, DBP, and insulin resistance were independently correlated with PWV. CONCLUSIONS:: Insulin resistance was independently associated with PWV in normoglycemic normotensive postmenopausal women.