The Effect of Short-term Treatment with Fennel on Bone Density in Postmenopausal Women: A Randomized Controlled Trial

( Masumeh Ghazanfarpour ),( Elham Amini ),( Talat Khadivzadeh ),( Masoudeh Babakhanian ),( Bahareh Nouri ),( Hassan Rakhshandeh ),( Maliheh Afiat ) 대한폐경학회 2017 대한폐경학회지 Vol.23 No.2

Objectives: The goal of this study is to assess the effect of fennel on bone density. Methods: This was a double-blind, randomized, placebo-controlled trial, which studied sixty eligible postmenopausal women, who were randomly assigned to fennel and placebo groups. Then, the dual energy X-ray absorptiometry was utilized to measure bone mineral density (BMD) and bone mineral content (BMC) of the spine, femoral neck, intertrochanter, and trochanter at the baseline and after three-month follow-up. Results: The mean BMD and BMC at lumbar spine (P = 0.14, P = 0.504), total hip femoral (P = 0.427, P = 0.471), trochanter (P = 0.075, P = 0.07), intertrochanter, (P = 0.864, P = 0.932) and femoral neck (P = 0.439, P = 0.641) was not significantly different between the fennel and placebo groups. Conclusions: The results of this study did not approve the effect of fennel on bone density in post-menopausal women. However, to gain deeper insights, further studies with longer durations and larger sample sizes are recommended. (J Menopausal Med 2017;23:124-130)

Sexual Disharmony in Menopausal Women and Their Husband: A Qualitative Study of Reasons, Strategies, and Ramifications

( Masumeh Ghazanfarpour ),( Talat Khadivzadeh ),( Robab Latifnejad Roudsari ) 대한폐경학회 2018 대한폐경학회지 Vol.24 No.1

Objectives: The goal of this study was to explore perceptions and experiences of general practitioners and midwives during sexual dialogue with menopausal women. Methods: In a descriptive exploratory qualitative study, 13 midwives and 12 general practitioners were selected using a semi-structured interview and purposive sampling method. Data analysis was conducted using qualitative content analysis adopted by Graneheim and Lundman. Results: Through data analysis “sexual disharmony” emerged as a central theme, which included three categories of reasons, strategies, and ramifications of sexual disharmony. Reasons for sexual disharmony included subcategories of aging and health related-problems, marital problems, and stereotypical perceptions regarding menopause and sexuality and daily concerns. Strategies used by couples to address sexual disharmony consisted of changing roles and values, pretending to reach orgasm, suppressing sexual desire, meeting sexual needs of husbands in accordance with religious rules, seeking help of peers, seeking friends or traditional medicine and health providers, seeking a help charmer, engaging in sex with other women to fulfill sexual needs, pretending to be moody to alleviate sexual tension. Sexual disharmony may lead to spending money on a prostitute instead of engaging in sex out of wedlock or a surge in social pathologies such as sexually transmitted disease. Conclusions: Healthcare providers must be aware of various sexual behavior of menopausal women and their husbands when they detect sexual disharmony in their patients. Results of this study can facilitate development of restricted guidelines for sexual discussion with menopausal women. (J Menopausal Med 2018;24:41-49)

The Effect of Foeniculum Vulgare (Fennel) on Body Composition in Postmenopausal Women with Excess Weight: A Double-blind Randomized Placebo-controlled Trial

( Nafiseh Saghafi ),( Masumeh Ghazanfarpour ),( Talat Khadivzadeh ),( Masoudeh Babakhanian ),( Maliheh Afiat ) 대한폐경학회 2017 대한폐경학회지 Vol.23 No.3

Objectives: The goal of this study was to evaluate the effect of fennel on body composition. Methods: This study is a secondary analysis of a double-blind, randomized, placebo-controlled trial. Fifty-four out of 60 patients were able to successfully complete the original study. Seven out of 54 patients were excluded because they were not overweight and obese. Thus, 47 women were included in this secondary analysis. Of these 47 women, 22 were in the fennel group and 25 were in placebo group. Body weight, body mass index (BMI) as well as fat distribution was measured at the baseline and after a three-month follow-up. Results: Comparison of fennel and placebo groups did not reveal any significant effect in terms of body weight, BMI, waist and hip circumferences and fat distribution. Also, the results of paired t-test did not variation of these parameters across groups before and after 12-week treatment. Conclusions: Menopausal women in fennel group experienced a slight increase in body weight and fat distribution, which was not significant. Further studies with larger sample sizes are recommended to validate the results of this study. (J Menopausal Med 2017;23:166-171)

Cultural Barriers Influencing Midwives’ Sexual Conversation with Menopausal Women

( Talat Khadivzadeh ),( Masumeh Ghazanfarpour ),( Robab Latifnejad Roudsari ) 대한폐경학회 2018 대한폐경학회지 Vol.24 No.3

Objectives: The present study aimed to determine the barriers influencing the sexual conversation. Methods: In this descriptive cross-sectional study, 200 midwives were selected through convenience sampling method from private and public clinics in Mashhad, North East of Iran. A self-structured questionnaire was used to collect the study data. Results: The mean age of subjects was 39.58 ± 8.12 years with 13.49 ± 7.59 years of work experience. A number of cultural conditions act as an inhibitory force for the midwives to address sexual issues with menopausal women. Menopausal women visit a doctor at the acute stage when emotional and physical problems make sexual discussion difficult for the midwives (86.5%). Other related causes for not having proper sexual conversation were insufficient knowledge (51.4%), inadequate education provided via public media through health providers (83.5%), midwives or their patient’s shame (51.5%), and attempt to get help from traditional healers, friends, relatives and supplicants instead of midwifery staff (78.5%). Also, we found that sexual workshops, communication workshops, and work experiences had a significant influence in changing the views of midwives. Conclusions: Cultural barriers prevent the patients and providers from communicating effectively with each other, thus highlighting the need for sexual and communication workshops for the health care providers. (J Menopausal Med 2018;24:210-216)

Effect of Lavender on Sleep, Sexual Desire, Vasomotor, Psychological and Physical Symptom among Menopausal and Elderly Women: A Systematic Review

Nasibeh Roozbeh,Masumeh Ghazanfarpour,Talat Khadivzadeh,Leila Kargarfard,Fatemeh Rajab Dizavandi,Khatereh Shariati 대한폐경학회 2019 대한폐경학회지 Vol.25 No.2

Objectives: The present systematic review was conducted to compare the effect of lavender on the quality of sleep, sexual desire, and vasomotor, psychological and physical symptoms among menopausal and elderly women. Methods: There were five electronic databases which selected to search respective articles which included were Scopus, PubMed, Web of Science, Google Scholar, and the Cochrane Library without any language restriction since the study inception to March 10, 2018. The quality of studies was assessed in accordance with a jaded scale. Results: According to three trials, the lavender as utilized in a capsule form or aromatherapy could significantly improve the measured Pittsburgh Sleep Quality Index score (P < 0.05) in the menopausal and elderly women. The aromatherapy with lavender improved sexual function (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), and physical (P < 0.001) symptoms. Based on a trial, 66.7%, 70.0%, and 53.3% of subjects reported feelings of relaxation, happiness, and cleanness effects of having used lavender respectively. Conclusions: The results suggested the effectiveness of the use of lavender either in capsule form or aromatherapy on the improved quality of sleep, depression, anxiety, sexual desire, and psychological and physical symptoms. These results, however, should be interpreted with caution considering the limitations of the study.

Effect of Aromatherapy on the Treatment of Psychological Symptoms in Postmenopausal and Elderly Women: A Systematic Review and Meta-analysis

( Masoudeh Babakhanian ),( Masumeh Ghazanfarpour ),( Leila Kargarfard ),( Nasibeh Roozbeh ),( Leili Darvish ),( Talat Khadivzadeh ),( Fatemeh Rajab Dizavandi ) 대한폐경학회 2018 대한폐경학회지 Vol.24 No.2

Objectives: To critically assess the effect of aromatherapy on the psychological symptoms as noted in the postmenopausal and elderly women. Methods: Three following databases were systematically searched: MEDLINE, Scopus and Cochrane Library (Cochrane Central Register of Controlled Trials) from inception to January 2018. The search keywords included ‘menopause’ AND (aromatherapy), without language restrictions. Results: In this study, 4 trials were included which fit into our systematic review. The findings demonstrated that the aromatherapy massage have significantly improved psychological symptoms in menopausal and elderly women as compared to the control group (standardized mean difference [SMD] = -1.24; 95% confidence interval, -0.188 to -0.606; P < 0.001 random effect model; 3 trials, moderate to high heterogeneity, I2 = 0.76; P = 0.028). According to 1 of the trials, the aromatherapy oil massage was no more effective than the untreated group regarding their experience of symptoms such as nervousness. Conclusions: The aromatherapy may be beneficial in attenuating the psychological symptoms that these women may experience, such as anxiety and depression, but it is not considered as an effective treatment to manage nervousness symptom among menopausal women. This finding should be observed in light of study limitations. (J Menopausal Med 2018;24:127-132)

Effect of Vitamin D on the Vaginal Health of Menopausal Women: A Systematic Review

Hedyeh Riazi,Masumeh Ghazanfarpour,Mahboubeh Taebi,Somayeh Abdolahian 대한폐경학회 2019 대한폐경학회지 Vol.25 No.3

Menopause is associated with the onset of climacteric symptoms due to low estradiol levels, which may cause insufficient maturation of the vaginal mucosa. Vitamin D may regulate the growth and differentiation of cells that are adversely affected due to low estradiol levels, thereby restoring vaginal health. The objective of this systematic review, the first on this subject, was to investigate the effect of vitamin D on the vaginal health of menopausal women. PubMed, Embase, Scopus, Web of Science, and Google Scholar databases and reference lists of hand-searched articles were searched for published studies from February 2000 to November 2018. The selection criteria were as follows: randomized or quasi-randomized trials that compared the effects of vitamin D or related compounds, alone or with calcium, on vaginal health (growth and differentiation of epithelial cells, dryness, acidity [pH]) outcomes in menopausal women. The methodological quality of these studies was examined using the Cochrane tool checklist by two independent investigators, following which the data were extracted. Of six examined studies, two showed that vitamin D administration improved the growth and differentiation of vaginal epithelial cells, improved vaginal pH, and decreased vaginal dryness in menopausal women. Although the level of evidence for the effects of vitamin D on vaginal health is low in our study, we concluded that vitamin D may improve the vaginal health of women, especially during menopause.

A Systematic Review and Meta-analysis on the Effect of Herbal Medicine to Manage Sleep Dysfunction in Periand Postmenopause

( Talat Khadivzadeh ),( Somayeh Abdolahian ),( Masumeh Ghazanfarpour ),( Leila Kargarfard ),( Fatemeh Rajab Dizavandi ),( Imaneh Khorsand ) 대한폐경학회 2018 대한폐경학회지 Vol.24 No.2

Objectives: Some conventional medications used to treat insomnia, such as benzodiazepine, non-benzodiazepine, and hormone therapy, are associated with side effects. Therefore, there is a growing interest in the use of herbal medicine. The aim of this systematic review is to assess the effects herbal medicines have on sleep disorders of peri- and postmenopausal women. Methods: Three databases were searched including MEDLINE, Scopus, and the Cochrane Library from inception to March 2018. Results: Six trials assessed the effect of soy on sleep disorders. Forrest plot for 2 studies showed that the standardized mean difference (SMD) of the sleep problems was lower in the soy group than the placebo group (SMD = -0.996; P < 0.001; 95% confidence interval, -1.42 to -0.563). Three trials showed soy had no significant effect on sleep disorders and one study showed a positive effect on sleep disorders. Accordingly, it is difficult to reach a definite conclusion regarding the effects of soy on sleep disorders based on these findings. According to a trial, significant beneficial effect associated with taking Schisandra chinensis. Findings suggested that some herbal medicines like red clover, lavender combined with bitter orange and pin bark extract had attenuating effects on sleep disorders. After intake of 530 mg of valerian twice a day for one month, statistically significant effects were observed regarding the quality of sleep of postmenopausal women. Conclusions: The present systematic review and meta-analysis found inadequate evidence to draw conclusions regarding the effectiveness of herbal medications, especially soy. (J Menopausal Med 2018;24:92-99)

The Effect of Short-term Treatment with Fennel on Lipid Profile in Postmenopausal Women: A Randomized Controlled Trial

( Maliheh Afiat ),( Elham Amini ),( Masumeh Ghazanfarpour ),( Bahareh Nouri ),( Mahsa Sadat Mousavi ),( Masoudeh Babakhanian ),( Hassan Rakhshandeh ) 대한폐경학회 2018 대한폐경학회지 Vol.24 No.1

Objectives: The present trial aimed to assess the effects of Fennel (Foeniculum vulgare Mill.) on lipid profiles. Methods: In this double blind, randomized and placebo-controlled trial, sixty eligible postmenopausal women were randomly assigned into the fennel and placebo groups. Total blood cholesterol, cholesterol fractions, and triglycerides were tested at the baseline, and after three-month follow-up. Results: There was no significant difference in triglyceride (P = 0.679), total cholesterol (P = 0.103), low-density lipoprotein cholesterol (LDL-C; P = 0.146) and high-density lipoprotein cholesterol (HDL-C; P = 0.266) levels between the two groups. In addition, in both groups, a paired t-test showed no significant difference in all mentioned parameters, except for HDL-C, indicating significant borderline improvement (P = 0.052) in the fennel group. Conclusions: The fennel group revealed a very slight positive change in LDL-C, triglyceride and HDL-C. Further studies with longer durations, higher doses, and larger sample sizes are recommended to validate the results. (J Menopausal Med 2018;24:29-33)

The Beneficial and Adverse Effects of Raloxifene in Menopausal Women: A Mini Review

Imaneh Khorsand,Reyhaneh Kashef,Masumeh Ghazanfarpour,Elaheh Mansouri,Sareh Dashti,Talat Khadivzadeh 대한폐경학회 2018 대한폐경학회지 Vol.24 No.3

Objectives: The present mini review aimed to summarize the existing knowledge regarding the beneficial and adverse effects of raloxifene in menopausal women. Methods: This study is a review of relevant publications about the effects of raloxifene on sleep disorder, depression, venous thromboembolism, the plasma concentration of lipoprotein, breast cancer, and cognitive function among menopausal women.Results: Raloxifene showed no significant effect on depression and sleep disorder. Verbal memory improved with administration of 60 mg/day of raloxifene while a mild cognitive impairment risk reduction by 33% was observed with administration of 120 mg/ day of raloxifene. Raloxifene was associated with a 50% decrease in the need for prolapse surgery. The result of a meta-analysis showed a significant decline in the plasma concentration of lipoprotein in the raloxifene group compared to placebo (standardized mean difference, -0.43; 10 trials). A network meta-analysis showed that raloxifene significantly decreased the risk of breast cancer (relative risk, 0.572; 95% confidence interval, 0.327-0.881; P = 0.01). In terms of adverse effects of raloxifene, the odds ratio (OR) was observed to be 1.54 (P = 0.006), indicating 54% increase in the risk of deep vein thrombosis (DVT) while the OR for pulmonary embolism (PE) was 1.05, suggesting a 91% increase in the risk of PE alone (P = 0.03). Conclusions: Raloxifene had no significant effect on depression and sleep disorder but decreased the concentration of lipoprotein. Raloxifene administration was associated with an increased risk of DVT and PE and a decreased risk of breast cancer and pelvic organ prolapse in postmenopausal women.