In the market of botanical dietary supplements, Cimicifuga heracleifolia (CH) has always been considered as an adulterated species of Cimicifuga racemosa (CR), a conventional American herb with promising benefits to counteract troubles arising from the menopause. However, the detailed comparison of their therapeutic effects is lacking. In present study, the pharmacological and metabolomics studies were comparatively conducted between CH and CR in ovariectomized (OVX) female rats. Specifically, estrogen-like, anti-hyperlipidemia and anti-osteoporosis effects were evaluated through measuring serum biochemical parameters, histopathological examination and micro computed tomography (Micro-CT) scanning. At the same time, a gas chromatography-mass spectrometry (GC-MS)-based serum metabolomics method was employed to profile the metabolite compositional changes. As a result, both CR and CH displayed anti-osteoporosis and anti-hyperlipemia on menopause syndrome. Meanwhile, their potentials in improving the OVX-induced metabolic disorders were discovered. In conclusion, these results demonstrated that CH is therapeutically similar to CR in relieving menopausal symptoms and CH could be considered as a promising alternative to CR instead of an adulterant in the market of botanical dietary supplements.
Animals ; Cimicifuga ; chemistry ; classification ; Dietary Supplements ; analysis ; Drug Evaluation, Preclinical ; Female ; Humans ; Menopause ; blood ; drug effects ; Metabolomics ; Osteoporosis ; blood ; drug therapy ; Ovariectomy ; adverse effects ; Phytotherapy ; Plant Extracts ; administration & dosage ; blood ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: This study is to compare the baseline characteristics and symptoms between groups with leiomyoma only (group M; myoma group), adenomyosis only (group A; adenomyosis group), and leiomyoma and adenomyosis together (group B; group for both disease). METHODS: Selected patients were who received total abdominal hysterectomy, laparoscopy-assisted vaginal hysterectomy, or total laparoscopic hysterectomy from January 2014 to December 2015, and whose pathology result showed leiomyoma (n=74), adenomyosis (n=27), or both (n=63). Baseline characteristics and symptoms were reviewed from the medical records. Researched characteristics included patients' age, degeneration of leiomyoma, endometrial hyperplasia, endometriosis, weight of the removed uterus, menopause before the surgery, method of the surgery, necessity for blood transfusion before and after the surgery, difference of hemoglobin level before and after the surgery, and number of gravida, para, and abortion. RESULTS: Eleven symptoms were checked. Thirty-eight point four percent of total subject had uterine leiomyoma and adenomyosis at the same time. Number of abortion was higher in the group B. The group B showed a tendency of presenting more menorrhagia, dysfunctional uterine bleeding, acute lower abdominal pain, and urinary frequency. Symptoms related to mass effect seem to be relative to uterine leiomyoma, and symptoms related to menorrhagia seems to be relative to adenomyosis. The group M showed suddenly growing mass symptoms, and was more likely to have massive hemorrhage during the surgery. It is hard to differentiate coexistence of uterine leiomyoma and adenomyosis from each disease. CONCLUSION: Coexistence of two disease exhibits mixed symptoms of each disease, but shows different tendency.
Abdominal Pain ; Adenomyosis ; Blood Transfusion ; Endometrial Hyperplasia ; Endometriosis ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Hysterectomy, Vaginal ; Leiomyoma ; Medical Records ; Menopause ; Menorrhagia ; Methods ; Metrorrhagia ; Myoma ; Pathology ; Retrospective Studies ; Uterus

OBJECTIVES: The purpose of this study was to investigate the correlation of periodontitis with metabolic syndromes and menopause status. METHODS: The 2013 Korea National Health and Nutrition Examination Survey data of 645 postmenopausal and 663 premenopausal women were analyzed using the Pearson's chi-squared test and multiple regression analysis with the Statistical Package for the Social Sciences (PASW statistics) software version 21.0. Metabolic syndromes and community periodontal index (CPI) were analyzed. RESULTS: CPI 3, CPI 4 (P<0.001), and the prevalence of periodontal disease were significantly higher in the postmenopausal group (P<0.001). Periodontal disease was significantly higher (P<0.001) in postmenopausal women not using dental floss (2.69 times), hypertensive postmenopausal women (1.60 times), and premenopausal women with high blood glucose levels (1.67 times). In the multiple logistic regression analysis, after adjusting for age, smoking habit, and alcohol consumption, significant risk factors for periodontal disease were the lack of dental floss use (odds ratio [OR]: 1.83; 95% confidence interval [CI]: 1.26–2.67), menopause (OR: 1.71; 95% CI: 1.22–2.41), and number of metabolic syndromes (when 1 or 2, OR: 2.22 and 95% CI: 1.50–3.29; when 3 or more, OR: 2.22 and 95% CI: 1.58–3.13). CONCLUSIONS: In summary, menopause status is associated with periodontal disease. Therefore, oral health programs for middle-aged women with menopause and metabolic syndromes should be conducted to improve their oral health-related quality of life.
Alcohol Drinking ; Blood Glucose ; Dental Devices, Home Care ; Female ; Humans ; Korea ; Logistic Models ; Menopause ; Nutrition Surveys ; Oral Health ; Periodontal Diseases ; Periodontal Index ; Periodontitis ; Prevalence ; Quality of Life ; Risk Factors ; Smoke ; Smoking ; Social Sciences

The purpose of the present overview of meta-analysis is to summarize and critically assess the effect of isoflavones and genistein on glucose metabolism among the peri- and post-menopausal women. Two independent authors searched the databases of MEDLINE, Scopus and Cochrane Library for meta-analysis. Three databases were searched from inception to January 2018. Methodological quality of each meta-analysis of randomized controlled trials was evaluated using the AMSTAR (a measurement tool used to assess systematic reviews). Four meta-analyses were included to the current overview. Fasting insulin levels and homeostatic model assessment of insulin resistance (HOMA-IR) values were significantly lower in peri-menopausal and postmenopausal. Two meta-analyses showed that treatment with isoflavones could not alter fasting blood glucose. However, one meta-analysis depicted that isoflavones significantly improved blood glucose levels in non-Asian postmenopausal women. Treatment with genistein could have significant beneficial effects on fasting insulin, blood glucose and HOMA-IR in comparison to the control group. Regardless of the population, the treatment with genistein is effective in improving fasting insulin, HOMA-IR and glucose levels. Nevertheless, the high heterogeneity among studies and poor methodology of reviews made it difficult to draw a definite conclusion on the positive impacts of soy on glucose metabolism.
Blood Glucose ; Fasting ; Female ; Genistein ; Glucose Metabolism Disorders ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Insulins ; Isoflavones ; Menopause ; Metabolism ; Population Characteristics

BACKGROUND: Serum uric acid (UA) has been found to be associated with hypertension, obesity, dyslipidemia, and metabolic syndrome; however, its role as an independent risk factor of cardiovascular disease (CVD) is still controversial. There have been very few studies reporting an association between UA levels and carotid intima-media thickness (CIMT), especially in women.METHODS: The study included 245 subjects whose CIMT was evaluated between February 2016 and December 2017 at a health promotion center. We divided the population into two groups on the basis of menopausal status: premenopausal women (n=78) and postmenopausal women (n=167). We measured blood pressure, serum lipid profile, fasting blood glucose (FBG), and creatinine and UA levels. CIMT was measured using high-resolution B-mode ultrasonography.RESULTS: UA levels and CIMT were higher in postmenopausal women (P=0.029, P < 0.001). In premenopausal women, age (r=0.438), body mass index (r=0.373), UA (r=0.205), and FBG (r=0.336) were associated with CIMT, whereas in postmenopausal women, age (r=0.326), body mass index (r=0.167), UA (r=0.166), systolic blood pressure (r=0.200), and HDL-cholesterol (r=−0.140) were associated with CIMT. The UA level was independently associated with CIMT in premenopausal women (β=0.208, P=0.031), whereas age was the only factor independently associated with CIMT in postmenopausal women (β=0.253, P=0.002). Women in the highest tertile of uric acid level exhibited a higher CIMT than did those in the lowest tertile after age adjustment (P for trend < 0.001).CONCLUSION: UA may be an independent risk factor for CIMT, suggesting that UA is a risk factor for the early detection of CVD, especially in premenopausal women.
Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; Carotid Intima-Media Thickness ; Creatinine ; Dyslipidemias ; Fasting ; Female ; Health Promotion ; Humans ; Hypertension ; Menopause ; Obesity ; Risk Factors ; Ultrasonography ; Uric Acid

BACKGROUND: Previous studies have reported that fasting insulin and blood glucose levels are higher in postmenopausal than in premenopausal women and that insulin resistance was more serious in postmenopausal women. The effects of menopause on glucose metabolism have been well studied, but it is unclear whether age at menopause onset is associated with fasting blood sugar and HbA1c levels. The purpose of this study is to determine the effect of menopause age on diabetes and prediabetes.METHODS: We retrospectively analyzed data from the Sixth Korea National Health and Nutrition Examination Survey (2013–2015). The participants were 2,156 naturally menopausal women, except diabetes, stroke, coronary artery disease and cancer patients. The study population was divided into four groups according to the age of natural menopause onset ( < 40, 40–44, 45–55, and ≥56 years). Diagnosis of diabetes and prediabetes was based on the American Diabetes Association guideline. The association between menopause age and diabetes or prediabetes was analyzed by multiple logistic regression.RESULTS: Women reaching menopause at 40–44 years were 4.901 times more likely to have diabetes (odds ratio [OR], 4.901; 95% confidence interval [95% CI], 1.353–17.756, P=0.016) than those who reached menopause at an age of ≥56 years. Women with menopause at age < 40 years were 2.839 times more likely to have diabetes or prediabetes (OR, 2.839; 95% CI, 1.012–7.968, P=0.047).CONCLUSION: Women with premature menopause (< 40 years) have high risk of developing diabetes or prediabetes, and women with a menopause age of 40–44 years have high risk of developing diabetes.
Blood Glucose ; Coronary Artery Disease ; Diabetes Mellitus ; Diagnosis ; Fasting ; Female ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Korea ; Logistic Models ; Menopause ; Menopause, Premature ; Metabolism ; Nutrition Surveys ; Prediabetic State ; Retrospective Studies ; Stroke

OBJECTIVETo compare the clinical efficacy differences between acupuncture at back- points of five , Geshu (BL 17), Shenmen (HT 7) and regular medication for the treatment of menopausal insomnia.

METHODSA total of 128 female patients of menopausal insomnia were randomly divided into an observation group and a control group, 64 cases in each one. Four patients in the observation group and 2 patients in the control group dropped out during the treatment. The patients in the observation group were treated with acupuncture at Feishu (BL 13), Xinshu (BL 15), Pishu (BL 20), Ganshu (BL 18), Shenshu (BL 23), Geshu (BL 17) and Shenmen (HT 7), once a day, and there was an interval of 2 days between every 5 days of treatment. The patients in the control group were treated with oral administration of alprazolam (0.4 mg or 0.8 mg) before sleep. Three-week treatment was taken as one course, and totally three courses were given in the two groups. Pittsburgh sleep quality index (PSQI), levels of estradiol (E), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were observed before treatment and 30 days after treatment; the efficacy was evaluated 30 days after treatment.

RESULTSEach item score and total score of PSQI 30 days after treatment were lower than those before treatment in the two groups (all <0.05), the scores in the observation group were lower than those in the control group (all <0.05). The levels of E 30 days after treatment were higher than those before treatment in the two groups (both <0.05), but the level of FSH and LH 30 days after treatment were lower than those before treatment in the two groups; the level in the observation group was superior to that in the control group (all <0.05). The total effective rate was 98.3% (59/60) in the observation group, which was better than 95.2% (59/62) in the control group (<0.05).

CONCLUSIONAcupuncture at Feishu (BL 13), Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Shenshu (BL 23), Geshu (BL 17), and Shenmen (HT 7) has better efficacy for menopausal insomnia than alprazolam.

Acupuncture Points ; Acupuncture Therapy ; Alprazolam ; therapeutic use ; Estradiol ; blood ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Luteinizing Hormone ; blood ; Menopause ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome

PURPOSE: The health risk of women increases after menopause. This study evaluated the effectiveness of a public health center-based nutrition education program for hypertension in women older than 50 years of age. METHODS: The program included 8-week nutrition education and 8-week follow-up with keeping a health diary and nutrition counseling. The program was evaluated three times: before and after the nutrition education, and after the follow-up. The subjects were classified into hypertensives (n = 44) or normotensives (n = 71). RESULTS: The rate of taking antihypertensive drugs in the hypertensive group was 86.4%. The systolic blood pressure decreased in the hypertensive and normotensive groups after nutrition education (p < 0.05). The body weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001), and percent body fat (p < 0.01) were also decreased after nutrition education in both groups. The hypertensive group showed an increase in HDL-cholesterol level (p < 0.001) and decreases in triglycerides (p < 0.01) and LDL-cholesterol (p < 0.05) levels after completion of the program. The normotensive group also displayed significant changes in HDL-cholesterol (p < 0.001) and triglycerides (p < 0.01). The dietary habits and nutrition knowledge on sodium and hypertension were improved in both groups (p < 0.001). The total score of dietary behavior related to the sodium intake was improved in the normotensive group (p < 0.001). The total score of the high sodium dish frequency questionnaire decreased in both groups after nutrition education and completion of the program compared to that before the program. Decreases in the consumption frequencies of noodles, pot stews and stews, Kimchi, and beverages were significant. The total self-efficacy score was increased in both groups by the program (p < 0.001). In particular, the hypertensive group showed improvement in all items. CONCLUSION: This public health center-based nutrition education program may contribute to the prevention and management of hypertension and chronic diseases in women over 50 years of age.
Adipose Tissue ; Antihypertensive Agents ; Beverages ; Blood Pressure ; Body Weight ; Chronic Disease ; Counseling ; Education* ; Female ; Follow-Up Studies ; Food Habits ; Humans ; Hypertension* ; Medical Records ; Menopause ; Public Health* ; Sodium ; Triglycerides ; Waist Circumference

OBJECTIVES: This study explored the association between a history of oligomenorrhea and onset of menopause and metabolic parameters. METHODS: The study population was 605 postmenopausal women who were patients at the Menopause Clinic, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand between February 2015 and December 2015. A questionnaire was used to ask all women about their history of oligomenorrhea. The study also collected medical data, including weight, height, waist circumference, blood pressure, and blood glucose and lipid profile. RESULTS: Of the 231 postmenopausal women with a complete data record, 31 had a history of oligomenorrhea and 200 did not. The age of onset of menopause was around 48 years in both groups. Prevalence of metabolic syndrome was 12.1%. More women with a waist circumference larger than 80 cm had a history of oligomenorrhea at the interview than women who had not, but a history of oligomenorrhea did not relate to other metabolic parameters. The adjusted odds ratio of a history of oligomenorrhea to waist circumference was 3.69 (95% confidence interval, 1.17–11.64). CONCLUSIONS: A history of oligomenorrhea did not affect the age at menopause, but was associated with waist circumference during menopause.
Age of Onset ; Anovulation ; Asian Continental Ancestry Group ; Blood Glucose ; Blood Pressure ; Female ; Humans ; Menopause ; Odds Ratio ; Oligomenorrhea ; Polycystic Ovary Syndrome ; Prevalence ; Thailand ; Waist Circumference

OBJECTIVES: The rate of metabolic syndrome (MetS) in women diagnosed as they age is one of the main concerns of health cares. Recently new strategies used to prevent progressions of MetS toward the diagnosis of diabetes have focused on plant flavonoids. This study was aimed to investigate the beneficial effects of flavonoids fraction of Mespilus germanica leaves (MGL) on MetS in ovariectomized (OVX) rats. METHODS: Twenty-four adult female Wistar rats, weighing 200 to 250 g, were divided into 3 groups: Sham surgery, OVX + Salin, or OVX + Flavonoid. Three weeks after ovariectomy, animals displayed MetS criteria received flavonoid injection (10 mg/kg, intraperitoneally) for 21 days. Then the body weight, body mass index, waist circumference, visceral fat, fasting blood glucose, serum insulin, lipid profiles and tumor necrosis factor-α (TNF-α) were measured. RESULTS: Treatment with flavonoids fraction of MGL significantly decreased serum level of insulin (P = 0.011), glucose (P = 0.024), TNF-α (P = 0.010), also MetS Z score (P = 0.020) and homeostasis model assessment of insulin resistance (P = 0.007). Lipid profiles and visceral fat showed insignificant reduction. CONCLUSIONS: Flavonoids of MGL attenuates some of the MetS components possibly via reduction in TNF-α inflammatory cytokine.
Adult ; Animals ; Blood Glucose ; Body Mass Index ; Body Weight ; Diagnosis ; Fasting ; Female ; Flavonoids ; Glucose ; Homeostasis ; Humans ; Insulin Resistance ; Insulin ; Intra-Abdominal Fat ; Menopause ; Necrosis ; Ovariectomy ; Plants ; Polyphenols ; Rats ; Rats, Wistar ; Waist Circumference