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.
MATERIALS AND METHODS: International and Thai databases were searched from inception to February 2017. Clinical trials investigating effects of PM menopausal or postmenopausal women were included. Outcomes were self-reported menopausal symptoms, serum reproductive hormones, urino-genital tract function, and bone surrogates. Methodological quality was assessed by Cochrane risk-of-bias v2.0, and a 22-parameter quality score based on the CONSORT checklist for herbal medicines.
RESULTS: Eight studies (9 articles) used data from 309 menopausal patients. Five-studies demonstrated that PM was associated with climacteric scores reduced by ~50% compared to baseline. Other PM studies using limited numbers of placebo participants suggested improved vaginal and other urogenital tract symptoms. Bone alkaline phosphatase halved (suggesting lowered bone turnover). Variable serum reproductive hormone levels suggested menopausal status differed between studies. PM active ingredients and sources were not defined. Adverse event rates (mastodynia, vaginal spotting, dizziness) were similar in all groups (PM, conjugated equine estrogen, and placebos) but serum C-reactive protein doubled. These studies had design and reporting deficiencies, high risks of biases, and low quality scores.
CONCLUSIONS: The efficacy of PM on menopausal symptoms remains inconclusive because of methodological short-comings especially placebo effects inherent in self-assessment/recall questionnaires and no PM standardization. PM efficacy and safety need a fundamental re-appraisal by: (i) cohort (retro- and prospective) studies on current users to define its traditional use for rejuvenation; (ii) tightly coupling long-term efficacy to safety of well-defined PM and multiple end-points; (iii) using study design related to current understanding of menopause progression and estrogen pharmacology (iv) robust pharmacovigilance.
OBJECTIVE: Previously published findings showed that phytoestrogens could relieve menopausal complaints, thus, the present review was aimed at assessing the effects of phytoestrogens on thermoregulatory mechanism during menopausal transition.
RESULTS: The molecular mechanisms underlying hot flashes are complex. Oestrogen fluctuations cause hypothalamic thermoregulatory centre dysfunction, which leads to hot flashes during menopause. The phytoestrogens of interest, in relation to human health, include isoflavones, lignans, coumestans, and stilbenes, which are widely distributed in nature. The phytoestrogens are capable of reducing hot flashes via their oestrogen-like hormone actions. The potential effects of phytoestrogens on hot flashes and their molecular mechanisms of action on thermoregulatory centre are discussed in this review.
CONCLUSION: The effects of phytoestrogens on these mechanisms may help explain their beneficial effects in alleviating hot flashes and other menopausal discomforts.