Information Sources Consulted by Women in African Countries to Manage Menopausal Symptoms:A Systematic Review and Meta-Analysis

Background: Despite an abundance of information regarding menopausal women in western society, African menopausal women have been overlooked in menopausal research, particularly, where they find information regarding menopause. Since inadequate health-related knowledge on menopause negatively affects the understanding of and coping with menopause and related symptoms, it is important to determine where women in Africa obtain their information about menopause. Aim: To conduct a systematic review to identify and analyse information sources consulted by menopausal women in the African region regarding the management of menopausal symptoms. Method: PubMed, Embase (OVID), Google Scholar, Medline (OVID), Medline in Process (OVID), Scopus, https://www.africabib.org/, African Index Medicus;http://indexmedicus.afro.who. int/,and African Journals Online (AJOL) were searched for publications from January 2000 to April 2017. Fourteen studies met the eligibility criteria. Twelve were quantitative while two were qualitative. Studies were independently appraised by two researchers using checklists from the Centre for Evidence-Based Management. Results: Meta-analysis explored the prevalence of different information sources reported with friends being the highest (44%, 95% CI: [0.35, 0.54]) followed by relatives (35%, 95% CI: [0.22, 0.50]) with medical providers being sources of information for only 30% of participants (95% CI: [0.15, 0.50]). Conclusion: Information regarding menopause among African women emanated primarily from friends and relatives, suggesting that women perceive menopause as a natural process whereby information is the best gleaned from informal sources. However, health care should aim to increase public awareness of menopause education and strengthen efforts to provide accurate, timely and helpful information for women and their friends and families.

Hormone replacement therapy for menopausal mood swings and sleep quality:The current evidence

Marked alterations in the normal female hormonal milieu in the perimenopausal period significantly affect women’s health,leading to decreased well-being,psychological distress,and impaired quality of life.Common menopausal symp-toms include hot flashes,sleep and mood changes,fatigue,weight gain,and urogenital disturbances.Clinicians often neglect mood swings and disrupted sleep,although those can significantly limit the productivity of women and impair their cognitive function and mental health.Evidence-based management should include a personalized,holistic approach to alleviate symptoms and careful consideration of the risks vs benefits of hormone replacement therapy(HRT),with due consideration of personal preferences.A research paper in the recent issue of the World Journal of Psychiatry by Liu et al investigated the role of HRT in altering mood changes and impaired sleep quality in menopausal women,which helps us to understand the benefits of this treatment approach.

Menopausal Symptoms and Sleep Quality During Menopausal Transition and Postmenopause

Background： Menopausal symptoms and sleep difficulty were physiological processes that were affected by genetic and other factors. This study was to investigate the prevalence of menopausal symptoms and sleep quality in menopausal transition （MT） and postmenopause （PM） women in Taiyuan, Shanxi. Methods： A community-based survey of women＇s menopausal symptoms and sleep quality was conducted between July 2012 and May 2013 at six municipal districts of Taiyuan, Shanxi. A sample of 2429 women aged 40-59 years was divided into four groups： early MT, late MT, early PM, and late PM. Sleep quality in the past 2 weeks before the interview was recorded. The data were analyzed using SPSS 16.0. Results： The prevalence of menopausal symptoms was 49.8%. Mild, moderate, and severe symptoms were observed in 28.9%, 18.5%, and 2.5% of participants, respectively. The highest prevalence of menopausal symptoms occurred in the early postmenopausal stage; the subsequences were the late postmenopausal stage and the early MT stage. Interestingly, among the 13 items of modified Kupperman index, the five most common symptoms were fatigue, arthralgia and myalgia, decreased libido, insomnia, and nervousness. Meanwhile, 55% perimenopausal women had poor sleep. Conclusions： Menopausal symptoms are common but mild among women in Taiyuan, Shanxi during MT and PM. In these stages, the prevalence of poor sleep is high.

Perspectives in Clinical Research of Acupuncture on Menopausal Symptoms

Seventy percentage of perimenopausal and early postmenopausal women will experience menopause symptoms. Primary menopause symptoms in Westem countries included hot flashes, insomnia, somatic pain, depression, and fatigue. Hot flashes were most commonly treated. Menopausal hormone replacement therapy （HRT） continues to have a clinical role in the management of vasomotor symptoms, but since 2002 there has been a marked global decline in its use due to concerns about the risks and benefits of HRT; consequently many women with menopause symptoms are now seeking alternatives including acupuncture. Acupuncture has a long tradition of use for the treatment of different menopause symptoms. Its effectiveness has been studied for natural menopause or chemical and surgery induced menopause. Here we provide an update on recent advances in the field for clinicians. The recent systematic reviews on acupuncture in menopausal symptoms suggest that acupuncture is aneffective and valuable option for women suffering from menopause. However, the science of acupuncture therapies is still inadequate to sufficiently support the benefits of acupuncture therapies. Finally, we discuss our points of view on clinical trials of acupuncture for menopause symptoms.

Complementary and Alternative Medicine in the Treatment of Menopausal Symptoms

A large number of women will pass through menopause each year. Women in menopausal transition experience a variety of menopausal symptoms. Although hormonal therapy remains the most effective treatment, side effects have been reported by several large studies. An increased number of women seek the use of complementary and alternative medicine （CAM） for treating menopausal symptoms. This review analyzes the evidence from systematic reviews, randomized controlled trials and epidemiological studies of using herbal medicine （Black cohosh, Dong quai, St John＇s wart, Hops, Wild yam, Ginseng, and evening primrose oil） and acupuncture for the treatment of menopausal symptoms. Evidence supporting the efficacy and safety of most CAM for relief of menopausal symptoms are limited. Future larger and better controlled studies testing the effectiveness of these treatments are needed.

Women at the Change of Life——Comparisons of Menopausal Symptoms of Women in Urban and Rural Areas

IT is very important to talk about women’s life quality when they approach the age of menopause. The results of a research investigation on the "Mental and Health Condition of Rural/Urban Women at Menopause" and the "Common Mental and Health Problems of Women at Menopause and its Treatment in Nanjing," reveal that the incidence

Correlation of Equol (7-Hydroxy-3-(4-Hydroxyphenyl)Chroman) in Woman Urine with the Symptoms of Menopause

Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling the inclusion criteria from February 2014 to July 2014. This research was taken in the Endocrinology Clinic, Department of Obstetrics and Gynecology, Hasan Sadikin Hospital and Unpad’s Pharmacokinetic Laboratory. All objects were interviewed using menopause rating scale (MRS) questionnaire. Their urine samples were analyzed using high performance liquid chromatography (HPLC). Then the results of questionnaire and HPLC test were evaluated. Results: The result is 97 objects (98%) detected having menopausal symptoms, produced equol. There is significant correlation between the level of equol in post-menopausal women that showed correlation (-0.71) which mean the higher the equol level, the lower the MRS score (p < 0.001) that mean the symptom is milder. Conclusion: Equol level in menopause women urine is a good predictor to identify the level of menopause symptoms.

Application of Medicinal Plants on Menopause Symptoms

Objectives:To relate the symptoms of menopause and the use of medicinal plants.Methods:it was carried out a study that applied the qualitative method,by means of a bibliographical and documental revision in sources of digital data of wide reach(Google,SciELO,DOAJ,Latindex and SCOPUS).It was kept in mind the quality and the present time.Conclusions:It was based on the search of articles in Virtual the Library in Health(Spanish:BVS)and using the key words:menopause,medicinal plants,phytotherapy,menopause symptoms.