Clinical efficacy of gamma-oryzanol combined with Femoston for perimenopausal syndrome

BACKGROUND Perimenopausal syndrome(PMS)is a chronic disease associated with estrogen deficiency.Because of the unsatisfactory outcomes of current conventional treatments for this condition,its treatment must be continuously explored and optimized.AIM To assess the clinical effectiveness ofγ-oryzanol in combination with Femoston for PMS.METHODS A total of 119 patients with PMS were selected from June 2023 to December 2023,which included 59 and 60 patients in the control and observation group,respectively.The control and observation groups were treated with Femoston andγ-oryzanol+Femoston,respectively.Comparative analyses were performed in terms of clinical effectiveness,safety(dizziness and headache,nausea and vomiting,and breast tenderness),sex hormones[estradiol(E2),luteinizing hormone(LH),and follicle-stimulating hormone(FSH)],lumbar spine(L1-4)and bilateral femoral bone mineral density(BMD),and sleep quality(sleeping time and frequency of awakenings from sleep).RESULTS Compared with the control group,the observation group had statistically higher total effective rates of treatment;lower overall incidence of adverse events;higher post-treatment E2 levels and L1-4 and bilateral femoral BMD;and lower LH and FSH levels,sleeping time,and frequency of awakenings from sleep after treatment.CONCLUSION Therefore,for the treatment of PMS,γ-oryzanol combined with Femoston is significantly better than Femoston alone in terms of clinical effectiveness,exhibiting more pronounced clinical advantages in improving safety,sex hormone levels,BMD,and sleep quality.

Comparing the effectiveness of pattern differentiation treatment and fixed formula treatment for perimenopausal syndrome with Chinese herbal medicine:A study protocol

Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Federation of Trade Unions Workers'Medical Clinics,Hong Kong Baptist University Chinese Medicine Clinic cum Training and Research Centre(Hong Kong,China).One hundred Chinese women,aged 45-55 years,will be recruited.The participants will be randomized into 2 groups.The intervention group will be administered medication,based on pattern differentiation,by qualified traditional Chinese medicine(TCM)practitioners.After each evaluation,TCM practitioners will evaluate and revise the prescription,based on the participants'patterns.The control group will be given the standard formula,i.e.,the Erxian decoction,which contains 6 herbs.The treatment period and the follow-up period will be 8 weeks each.The primary assessment outcome measure will be the Kupperman Index,and the secondary outcome measure will be the Menopause-specific Quality of Life Questionnaire score.Conclusion:Pattern-differentiated treatment is the basic principle of TCM to understand and treat diseases.The study will show the pattern-differentiated treatment is effectiveness than the fixed prescription.

Study on the Molecular Mechanism of Danggui Buxue Decoction in Intervention of Perimenopausal Syndrome Based on Network Pharmacology and Molecular Docking

[Objectives]This study was conducted to explore the intervention mechanism of Danggui Buxue Decoction in perimenopausal syndrome based on network pharmacology and molecular docking.[Methods]The chemical components and targets of Danggui Buxue Decoction were acquired through the TCMSP database,and the main targets of perimenopausal syndrome were obtained through the GeneCards database.The component targets and disease targets were intersected,and combining with active components and Chinese herbs in the decoction,a traditional Chinese medicine-component-target network was constructed using Cytoscape 3.7.1 software.The STRING platform was employed for protein-protein interaction analysis.The DAVID analysis platform was used to conduct target GO and KEGG enrichment analysis,so as to predict the action mechanism Danggui Buxue Decoction.Finally,an active component-disease target-signal pathway network diagram was constructed.[Results]Twenty two components in Danggui Buxue Decoction related to perimenopausal syndrome and 120 corresponding targets were obtained,including active components such as 1,7-dihydroxy-3,9-dimquercetin and kaempferol,and key targets such as TNF,ESR1 and PPARG.The results of GO analysis and KEEG analysis indicated that Danggui Buxue Decoction might regulate the transcription of RNA polymerase II promoter,DNA templating,gene expression,signal transduction,hypoxia response and other biological processes by regulating multiple signal pathways such as chemical carcinogenesis-receptor activation,cancer pathways,lipid and atherosclerosis,tryptophan metabolism,malaria,steroid hormone biosynthesis and chemical carcinogenesis-DNA adduct.[Conclusions]Danggui Buxue Decoction intervenes in perimenopausal syndrome through multiple components,targets and pathways,providing a basis for elucidating the intervention mechanism of Danggui Buxue Decoction and expanding its clinical application.

Association between depressive mood and body image and menopausal symptoms and sexual function in perimenopausal women

BACKGROUND Perimenopausal is the period when women's ovarian function begins to decline before and after menopause.During this period,women experience a series of mental state changes,such as decreased hormone levels,decreased libido,and even female sexual dysfunction(FSD)in severe cases,which reduces their quality of life.Factors affecting the occurrence of FSD include physiological and nonphysiological factors,among which physiological factors are uncontrollable.Therefore,it is particularly important to ascertain the related non-physiological factors that affect the occurrence of FSD for improving the quality of sexual life of perimenopausal women.AIM To investigate the mediating effect of depressive mood and body image on menopausal symptoms and sexual function in perimenopausal women.METHODS A total of 186 perimenopausal women were enrolled between January 2019 and January 2021 and divided into the FSD(134 cases)and control(52 cases)groups based on the presence and absence of FSD.Clinical data were compared between the two groups.FSD-related factors were analyzed using logistic regression analysis.Hamilton Depression Scale(HAMD),Body Image Scale(BIS),and Menopause Rating Scale(MRS)scores were compared among women with different FSD scores.The correlation of the MRS score with the BIS and HAMD scores and the mediating effect of the BIS and HAMD scores on the MRS score and female sexual function index(FSFI)were analyzed.RESULTS The HAMD and BIS scores were higher in the FSD group than in the control group,and the difference in monthly income between the two groups was statistically significant(all P<0.05).Monthly income of<2000 yuan[odds ratio(OR)=26.586,P=0.000],BIS score(OR=1.590,P=0.000),and HAMD score(OR=1.884,P=0.000)were independent risk factors for FSD.MRS scores were positively correlated with BIS and HAMD scores(r=0.358 and 0.244,P=0.000 and 0.001,respectively)and negatively correlated with FSFI scores(r=-0.433,P=0.000).Body image and depressive mood had partial mediating effects,accounting for 39.90%of the total effect.CONCLUSION Depression and body image play mediating roles between menopausal symptoms and sexual function in perimenopausal women.

Xiaoyao pill for treatment of functional dyspepsia in perimenopausal women with depression

AIM: To evaluate the efficacy and safety of the Xiaoyao pill for treatment of functional dyspepsia (FD) associated with perimenopausal depression.

The Efficacy and Safety of Modified Xiaoyao San for Perimenopausal Syndrome (PMS): A Systematic Review and Meta-Analysis

Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese Biomedical Literature Database, Wan Fang Database, and VIP Database up to December 2018. Hand search for further references was conducted. Study selection, data extraction, quality assessment, and data analyses were performed as request of the Cochrane standards. Results: Nine publications in total were suitable for inclusion. There was evidence that modified XYS was tested to be more effective in improving overall symptoms compared with HRT (odds ratio 3.50, 95% CI 2.56 to 4.78). Whereas HRT was more sensitive and direct in decreasing FSH (WMD 6.69, 95% CI 5.60 to 9.52) and LH (WMD 7.00, 95% CI, 5.75 to 8.25) in comparison with XYS group. It was also strongly supported that XYS had less adverse effect than HRT (odds ratio 0.07, 95% CI 0.05 to 0.10). Conclusion: Modified XYS might be more effective and safer in treatment of perimenopausal syndrome. However, due to poor methodological quality in the majority of included studies, the potential benefit and safety about XYS need to be confirmed in rigorously designed, multi-centre, and large-scale trials.

Subjective sleep quality in perimenopausal women and its related factors

Objective： To evaluate the sleep quality and its related factors among perimenopausal women. Methods： A self-designed questionnaire was administered to 506 perimenopausal women. The questionnaire included the influencing factors on the sleep quality, the Pittsburgh Sleep Quality Index （PSQI）, the Zung Self-Rating Depression Scales （SDS）, the Zung Self-Rating Anxiety （SAS） and the Modified Kupperman Index （KI）. Data were analyzed by SPSSll.5. Results： The mean PSQI was 5.97±4.30. Twenty-four percent of perimenopausal women reported poor sleep. Age and perimenopausal symptoms were significantly correlated with sleep quality. The sleep quality of the 45～49 age group was the poorest and the 40～44 age group was the best. The women who had higher Kupperman index were more likely to be poor sleepers. There was no significant correlation between occupation and sleep quality. Night sweat, depression, anxiety, hot flash, stressful life event, and regular exercise were significantly and independently related with sleep quality. Among them, regular exercise was a protective factor of sleep quality. Conclusion： High incidence of poor sleep quality exists among perimenopausal women. Some effective interventions Should be taken to improve the sleep quality of perimenopausal women.

Endometrial Evaluation by Transvaginal Ultrasonography Saline Infusion Sonohysterography, Hysteroscopy versus Endometrial Office Bipsy in Perimenopausal Bleeding: A Comparative Study

Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and Gynecology at University Hospitals and included 176 patients with perimenopausal bleeding who attended a patient clinic during the period from January 2017 to May 2019. All patients were subjected to transvaginal ultrasound, saline sonohysterography and out-patient endometrial sampling using pipelle;all the results were compared to histopathology obtained by hysteroscopic guided biopsy and/or hysterectomy. Result: In comparing the validity of TVS and SHG we found highly significant decrease in malignancy assessment in the TVS method compared to hysteroscopic-guided biopsy. According to the validity of pipelle in detection of malignant lesion, it was found to detect 80 cases out of 88 cases of malignancy with sensitivity 90.9%, specificity 100% and 95.45% accuracy with respect to histopathology by hysteroscopy guided biopsy and/or hysterectomy. Combination tests were done between SHG and pipelle and we found that the validity of combination tests in detecting malignancy improves the sensitivity and specificity in detection of malignancy sensitivity = 100% and specificity = 100% and this was found to be as an effective method in detection of malignancy. Conclusion: When SHG combined to outpatient endometrial sampling “pipelle”, the results were the same as hysteroscopy.

Advances in the Pathogenesis of Perimenopausal Syndrome

Perimenopause syndrome refers to the syndrome of the disorders of multiple systems of women around menopause caused by the reduction in secreted estrogen and is also known as menopause syndrome.Its pathogenesis involves increasing age,the abatement of ovarian function,and psychological change caused by the increasing life pressure.The above factors lead to physical and mental changes in postmenopausal women.This paper summarizes the pathogenesis of perimenopause from the perspective of gene studies and existing experimental studies and provide some ideas for clinical treatment and research.

Research on the Effects of the Extract of Polygala fallax Hemsl on Sex Hormones andβ-EP in Perimenopausal Rat Models

Objective:To study the effects of the ethnic medicine Polygala fallax Hemsl with Guangxi characteristics on the sex hormones andβ-EP in research objective perimenopausal rat models.Methods:40 female SPF rats were randomly divided into 4 groups,including the normal,model,high-dose and lowdose groups.Rats of three groups except for the normal one were treated with perimenopausal modelling through the method of subcutaneous injection of compound 4-VCD for 15 consecutive days.Rats of the normal and model group were normally fed without any treatment.Rats of the high-dose and low-dose groups were administered by high-and low-dose intragastric administration of the extract of Polygala fallax Hemsl.According to the menstrual cycle of the vaginal smear of the rat,each menstrual cycle is a course of treatment and 6 consecutive courses of treatment would be given.The indexes of serum sex hormones(E2,FSH,LH)andβ-EP of rats in each group were observed after treatment.Results:After the treatment of 6 cycles,for the levels ofβ-EP and E2,the model group was lowest(P<0.05),the normal group was highest(P<0.05);and the high-dose group was higher than the low-dose group;For the levels of FSH and LH,the normal group was lowest(P<0.05),the model group was highest(P<0.05),and the high-dose group was lower than the low-dose group.Conclusion:Guangxi characteristic national medicine Polygala fallax Hemsl can effectively improve the levels of serum sex hormones andβ-EP in perimenopausal rat models and relieve the related symptoms with a certain dose-effect relationship.

Effects of Soy Isoflavones on the Sex Hormone Level and Pathological Changes in the Perimenopausal Syndrome Animal Model

[Objectives] To observe the effect of soy isoflavones on the perimenopausal syndrome model of female rats,and to find its mechanism,in order to provide experimental evidence for the clinical treatment of menopausal syndrome. [Methods]50 female SD rats were randomly divided into five groups,with 10 rats in each group,respectively,for the normal control group,sham operation group,model group,diethylstilbestrol group,soy isoflavone treated group,except the normal control group and sham operation group,the other groups were ovariectomized rats,the formation model of perimenopausal rats treated with normal saline,diethylstilbestrol,soy isoflavone by gavage,normal control group and sham operation group were given the same dose of normal saline and soy isoflavone by gavage. After 6 weeks of continuous treatment,abdominal aorta was taken blood,the serum was isolated,and radioimmunoassay method to measure E_2( Eestradiol),P( Progesterone),T( Testosterone). And removal of the pituitary gland,uterine and adrenal prepared pathological section,experimental effect was observed by light microscopy,using immunohistochemical method to observe the brain pituitary FSH( Follicle-Stimulating Hormone) and LH( Luteinizing Hormone) levels. [Results] Radiation immune analysis results showed that soy isoflavone could significantly improve serum E_2 level in ovariectomized rats,compared with the model group,the statistical analysis showed significant difference( P < 0. 05),but the serum P and T level had little effect. The pathological results showed that( i) uterus: the uterine wall and endometrial thickness of soy isoflavone group was between that of model group and sham operation group,the surface epithelium was columnar,glands increased;( ii) pituitary gland: soy isoflavone ovariectomized group cells were between model group and normal group;( iii) adrenal gland: soy isoflavone group adrenal tissue did not change significantly. Immunohistochemical results showed that soy isoflavone group pituitary tissues of FSH and LH cells compared with the model group decreased significantly. [Conclusions] The soy isoflavones could make the uterus wall and endometria of perimenopausal syndrome animal model thicken,improve the serum level of E_2 in ovariectomized rats,and decrease the level of FSH and LH,but had little effect on the adrenal tissues,level of T and P.

Analysis of Famous TCM Doctor Zan Qiang's Experience in the Treatment of Perimenopausal Osteoporosis

The purpose of this study was to analyze the clinical experience of Zan Qiang,a famous doctor of Traditional Chinese Medicine in Shaanxi province,in the treatment of perimenopausal osteoporosis.Zan believed that the main etiology and pathogenesis of perimenopausal osteoporosis were "deficiency of kidney essence,decreased marrow and bone",deficiency of liver and kidney"and"stasis caused by deficiency".Although it is a chronic physiological disease,and the pathological process is irreversible,the treatment groups of"tonifying kidney and filling essence","tonifying liver and tonifying kidney"and "tonifying deficiency and promoting blood circulation" can significantly improve the symptoms of patients,slow down the progress of the disease and improve the quality of life of patients.

Correlation of menopausal index with sex hormones, lipid metabolism and cytokines in perimenopausal women

Objective: To explore the correlation of menopausal index with sex hormones, lipid metabolism and cytokines in perimenopausal women. Methods: A total of 208 perimenopausal women who were treated in this hospital between September 2015 and March 2018 were selected as the perimenopausal group and 150 healthy young women (20-30 years old) who received physical examination in this hospital during the same period were selected as the control group. The differences in the levels of Kupperman menopausal index as well as the contents of sex hormones, lipid metabolism indexes and inflammatory factors were compared between the two groups. Results: Kupperman menopausal index of perimenopausal group was higher than that of control group;sex hormones E2, P and T contents were lower than those of control group whereas FSH content was higher than that of control group;lipid metabolism indexes TC and LDL-C contents were higher than those of control group whereas HDL-C content was lower than that of control group;inflammatory factors IL-1β, IL-2, IL-18 and IFN-γ contents were higher than those of control group;the Kupperman menopausal index of perimenopausal women was negatively correlated with E2, P, T and HDL-C contents, and positively correlated with FSH, TC, LDL-C, IL-1β, IL-2, IL-18 and IFN-γ contents. Conclusion: The Kupperman menopausal index in perimenopausal women abnormally increases, and the specific level is directly correlated with the female sex hormones, lipid metabolism disorder and systemic microinflammation.

Exploring the prevention and treatment of perimenopausal hypertension based on the theory of"Preventive Treatment of Disease"

"Preventive Treatment of Diseases"is an important theory of Traditional Chinese medicine(TCM)to prevent and treat diseases.This review explored the prevention and treatment of perimenopausal hypertension with the idea of"Preventive Treatment of Disease".Strengthening the health care awareness of perimenopausal women,carring community education activities,health education publicity,health screening,early screening and identification of high-risk groups play the important role in prevention of perimenopausal hypertension.TCM treatment has unique advantages in improving patients'anxiety,and other bad emotions,regulating patients'constitution,promoting the early arrival of the disease recovery period,and preventing recurrence after the disease;Western medicine can control blood pressure quickly and effectively in the stage of disease progression,and both TCM and Western medicine have their own advantages.Rational and effective application of combined TCM and Western medicine in clinical practice can significantly improve patients'symptoms,improve treatment effect,and prevent disease progression or recurrence.

The Role of Cosmetic Gynecology Treatments in Women in Perimenopausal Period

The conditions in which we live nowadays contribute to exposure of our bodies to harmful factors such as UV radiation, pollution, smoking, poor eating habits, low physical activity, stress, which thereafter lead to the acceleration of skin aging process. In women, the process is additionally dependent on the menopause, as a result of the disappearance of hormones, the process is faster. Physiological changes that occur in women’s body during perimenopausal and menopausal period affect their sexual function: pain during an intercourse, decreased libido, lack of agitation. Deficiency of hormones, besides skin changes, leads to vaginal dryness, accompanied by inflammation, often correlated with discharge and burning. As a result of the loss of hyaluronic acid labia become slack and less moisturized. In addition, there has been observed: a gradual loss of pigment and hair, involution of the clitoris, and involution and sticking of labia minora, lipoatrophy of labia majora with subsequent reduction in their volume and thinning the lining around the vaginal opening. This article presents processes of skin aging. It describes mechanisms of intrinsic and extrinsic aging. It also presents the mechanisms of accelerated aging in women in perimenopausal period—accelerated skin aging dependent on hormonal factors associated with the loss of ovarian function. The research presents how the hormonal loss influences woman’s body, her genitals—its functionality and aesthetic look. It also shows how using filler treatments in gynecology can restore the aesthetic appearance of female genital and improve their functionality.

Chief Physician Defen Wang’s Clinical Experience in Dialectical Treatment with Mediation Method of Perimenopausal Sweating

The objective of this paper is to outline Chief Physician Defen Wang’s clinical experience in perimenopausal sweating syndrome differentiation and treatment,to inherit Mr.Gao’s academic concept of mediation technique,and to integrate multiple prescriptions under Mr.Gao’s thinking.The deficiency is based on the deficiency of liver and kidney Yin,the weakness of spleen and stomach,and the standard is the imbalance of Ying and Wei,the imbalance of Qi,blood and body fluid,and the main method of treatment is nourishing liver and kidney,soothing liver and invigorating spleen,regulating Ying and Wei,as well as tonifying Qi and absorbing fluid.

Clinical Experience in Using Zishui Qinggan Decoction in the Treatment of Perimenopausal Gall Disease

Objective:To explore the clinical experience in using Zishui Qinggan decoction in the treatment of perimenopausal gall disease.Methods:By comparing the clinical effects of two groups of patients under different methods of treatment,100 patients with perimenopausal gall disease who visited the hospital from January 2022 to February 2022 were selected as the research subjects of this study.According to the methods of treatment,the patients were divided into two groups:the conventional group comprised of 50 patients who received conventional medication,whereas the Zishui Qinggan decoction group comprised of the other 50 patients who received Zishui Qinggan decoction.The overall clinical effects of the two groups were compared along with the time required for symptom relief Results:The time required for symptom relief in the Zishui Qinggan decoction group was significantly shorter than that in the conventional group(p<0.05).Conclusion:Zishui Qinggan decoction can effectively treat perimenopausal gall disease and reduce the time required for symptom(pain)relief.

Prevalence and Risk Factors of Stress Urinary Incontinence Among Perimenopausal Women and Its Influence on Daily Life in Women with Sexual Desire Problem

The prevalence of,and related factors to,stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated.In this study,1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area,and two impoverished,mountainous communities in Hubei province,and followed from April to October 2014.Detailed information about demographic characteristics,menstruation,pregnancy,sexual life and chronic diseases was collected.A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis.Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4,95% CI:1.92-6.04),vaginal delivery (OR=0.623,95% CI:0.45-0.87),low income (OR=0.063,95% CI:0.40-0.92),atrophic vaginitis (OR=1.4,95% CI:1.03-1.80),pelvic organ prolapse (OR=2.81,95% CI:1.36-5.80),chronic pelvic pain (OR=2.17,95% CI:1.90-4.03),constipation (OR=1.44,95% CI:1.07-1.93) and incontinence of feces (OR=3.32,95% CI:2.03-5.43).Moreover,the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1 %) or the ratio of mixed urinary incontinence (17.4%),and SUI had a greater impact on daily life among women with decreased sexual desire.In conclusion,SUI is a common disorder affecting over one third of the women surveyed,and has a severe impact on the daily life of perimenopausal women with declined sexual desire.Age,mode of delivery,and monthly income are major risk factors involved in the development of SUI.

Research progress in the treatment of perimenopausal abnormal uterine bleeding with traditional Chinese and western medicine

In order to fully understand the research progress of Chinese and Western medicine in the treatment of perimenopausal abnormal uterine bleeding,this paper reviews all kinds of research by referring to related literature reports at home and abroad.The results showed that western medicine mainly used hormone drugs,supplemented by surgery,but the clinical adverse reactions were more and the recurrence rate was higher;traditional Chinese medicine often obtained satisfactory results through the treatment of traditional Chinese medicine,syndrome differentiation,stage treatment,acupuncture and other treatment methods,with fewer adverse reactions and low recurrence rate,but the effect of sudden collapse and hemostasis was slower;the combination of Chinese and Western medicine can learn from each other and become The research focus in recent years is worthy of further discussion.