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Patient characteristics and outcomes of an interdisciplinary menopause clinic: a retrospective chart review
178
Abstracts / Maturitas 81 (2015) 144–190
P93 Quality of life in postmenopausal women: clinical effects of drospirenone–estradiol administration versus placebo Novella Russo Demetra Menopause Clinic, Gottaferrata, Italy Objectives: To evaluate the effect of low dose HRT on quality of life. Blood pressure, BMI, joint pain and vaginal lubrication. Methods: Postmenopausal symptomatic women untreated with HRT in the previous 12 months were randomized to Calcium Carbonate (1200 mg/day) + Colecalciferol (800 U.I./day) supplementation or to 17-Beta Estradiol (1 mg/day) plus Drospirenone (2 mg/day). Quality of life, Blood Pressure and BMI measurements, joint pain and vaginal lubrication were evaluated before and after 12 weeks of treatment. Results: Quality of life evaluated by the Women’s Health Questionnaire (WHQ) showed a significant improvement in the group of women treated with low dose HRT when compared to the calcium treated group. Joint pain as referred by patients was improved but did not reach the statistic significance. BMI was unchanged. Vaginal lubrication increased as referred by patients and confirmed by evaluating the vaginal cell maturation index. Women with high-normal systolic blood pressure (130–139 mmHg) showed a significant decrease while diastolic blood pressure values were unmodified. The calcium – vitamin D treated group showed no statistically significant improvement in all the parameters analyzed. Conclusion: Postmenopausal symptomatic women are responsive to treatment with E2-DRSP as confirmed by the positive effect on their quality of life and in particular, this treatment is to be considered the gold standard in situations of increased systolic blood pressure values from normal to high normal or in presence of a family history of hypertension. http://dx.doi.org/10.1016/j.maturitas.2015.02.228 P94 The quality of life for women in a period of menopause Sergey V. Nedogoda ∗ , Irina N. Barykina, Alla S. Salasyuk, Viktoria O. Smirnova, Ekaterina A. Popova Volgograd State Medical University, Therapy and Endocrinology, Volgograd, Russian Federation Currently, there is noted a steady trend of increasing life expectancy of women all over the world. At the same time age of menopause remains rather stable and averages 49–50 years. Pathological course of menopause leads to a significant reduction in quality of life. Materials and methods: We examined 120 women (mean age 51.5 ± 2.8 years, duration of menopause from 1 to 4.5 years). Physical examination was conducted. To assess the quality of life standard questionnaires (Zung Self-Rating Depression Scale, Teilor’s Manifest Anxiety Scale, SCL-90-R Symptom Check List90-Revised, asthenia scale MFI-20 The Multidimensionae Fatigue Inventory), Kerdo index was used. To determine the severity of climacteric syndrome MMI (modified menopausal index) was calculated. Results: Based on the assessment of MMI there had been identified: neurovegetative violation weak severity in 67.9%, moderate severity in 32.1%, endocrine and metabolic disorders moderate
severity in 86%, average psycho-emotional disorders in 35.7%, mildin 64.3%. In assessing the SCL-90-R depression in 14% of women, elevated levels of somatization and obsession in 7% were identified. Kerdo Index figures: excitatory influence in the activity of the ANS dominated in 29% of women, inhibitory influences in 71%. In assessing the scale of depression a mild form was noted in 39%. According to the scale of anxiety average level of severity with a tendency to high in 72%, and 4% of responders had a high level of anxiety. Total asthenia score according to MFI-20: 31–60 points in 36%, higher than 60 points in 64% of women. Conclusion: According to the results all surveyed women had severe fatigue, high levels of anxiety, increase of somatization and obsession. Inhibitory influences in the activity of the ANS dominated. There were noted moderately or weakly expressed prevalence of menopausal syndrome. http://dx.doi.org/10.1016/j.maturitas.2015.02.229 P95 Patient characteristics and outcomes of an interdisciplinary menopause clinic: a retrospective chart review Beate C. Sydora 1,∗ , Nicole Veltri 1 , Christoph P. Sydora 1 , Justin Marillier 1 , Lori Battochio 2 , Nese Yuksel 3 , Tami Shandro 2 , Sue J. Ross 1 1
University of Alberta, Obstetrics and Gynecology, Edmonton, Canada 2 Women’s Health Program (LHHW), Alberta Health Services, Edmonton, Canada 3 University of Alberta, Faculty of Pharmacy and Pharmaceutical Sciences, Edmonton, Canada
Background: Severe cases of menopause may be treated at specialized multidisciplinary menopause clinics. The menopause clinic at the Lois Hole Hospital for Women (LHHW) in Edmonton provides care for women referred by their general practitioner and includes a range of disciplines (specialized physician, pharmacist, dietician, and nurses). Objective: We wished to characterize patients attending the clinic and to evaluate the treatment outcomes at the LHWH Menopause Clinic. Methods: We conducted a retrospective chart review of a convenience sample of 200 patients who attended the LHHW clinic during 2008–2013. Data from clinic charts were entered into REDCap database and analyzed to describe patient demographics, menopause symptoms, medical conditions, and treatments provided. Menopause symptom severity questionnaires were used to compare severity scores ranging from 1 to 4 (none, mild, moderate, severe) from the first and follow-up visits. Results: At initial consultation, women’s age was mean 52 years (range 30–68) with 65% being postmenopausal; 22% had experienced surgical menopause. At presentation, the most common self-reported menopause symptoms were sleep dysfunction (46%), hot flashes (35%), and mood symptoms (32%). 97% of women reported at least one additional medical problem. Hormone Therapy was the primary treatment recommended (79%). Of the 138 patients with follow-ups, symptom severity scores were reduced between the first and last visit for 104 patients (75%), unchanged for 7 patients (5%), and increased for 27 (20%). Conclusion: Women seeking help at the LHHW Menopause Clinic present with complex medical issues in addition to a variety of menopause symptoms. We cannot rule out change over time in this study, but it appears that care received has a positive impact
Abstracts / Maturitas 81 (2015) 144–190
on patient outcomes as judged by reduced menopause scores over time of follow-up visits. Ethics approval: HREB (EDM)/Pro00041189. Funding: Women and Children’s Health Research Institute. http://dx.doi.org/10.1016/j.maturitas.2015.02.230 P96
179
P97 A randomised controlled trial on climacteric symptoms management and quality of life improvement of Nigella sativa seeds powder in menopausal women Saadat Parhizkar 1,∗ , Leila Manzouri 2 1
Correlation between the quality of life and sleep quality with the body mass index in Colombian women in climacteric Alvaro Monterrosa-Castro 1,∗ , Katherin ˜ 2 Portela-Buelvas 2 , Liezel Ulloque-Caamano 1 Grupo de Investigación Salud de la Mujer, Universidad de Cartagena, Cartagena, Colombia 2 Grupo de Investigación Salud de la Mujer, Cartagena, Colombia
Objective: To estimate the correlation between quality of life, sleep quality with the body mass index (BMI) in Colombian women. Methods: Cross-sectional study carried out in women aged between 40 and 59 years, residents in areas located in the Caribbean and Pacific coasts of Colombia, belonging to Hispanic, Afro-descendant and Indigenous ethnic groups. They participated willingly, in their own communities, anonymously and with informed consent. Hysterectomized and pregnant women were excluded. And a socio-demographic survey, the Athens Insomnia Scale (AIS), Pittsburgh Sleep Index (PSQI) and the Menopause Rating Scale (MRS) were applied. The BMI was calculated measuring participants’ weight and height. Data is presented in median and interquartile range. The three scales showed an adequate Cronbach’s alpha. The Spearman (rs ) correlation coefficient was calculated with the statistical program SPSS-15. A p value <0.05 was considered significant. Results: 3525 women were involved. Average age: 48.0 [IR:8] years old, number of children born: 3 [IR:2], education level: 11.0 [IR:7] years, diabetic women: 7.7%, women with Arterial Hypertension: 15.5%, usual coffee use: 71.4%, actual smokers: 8.4%, weight: 68 [IR:15] kg, BMI: 25.6 [IR:5.6], underweight: 2.7%, Normal: 41.2%, overweight: 39.1%, obesity-I: 12.4%, obesity-II: 3.8%, obesity-III: 0.6% and hormone therapy use: 11.5%. According to the menopause status: premenopause: 32.3%, perimenopause: 19.4%, postmenopause: 48.2%. A weak positive correlation was noticed between BMI and somatic-vegetative (rs = 0.20), psychological (rs = 0.17) and urogenital deterioration (rs = 0.15) and quality of life (rs = 0.2). p < 0.001. The correlation between BMI and sleep quality (rs = 0.020) and insomnia (rs = 0.004) were not significant. Conclusion: In a Colombian women group, the BMI had a weak positive correlation with quality of life and the domains of the MRS. However, neither quality of sleep nor insomnia had a significant correlation with the BMI. http://dx.doi.org/10.1016/j.maturitas.2015.02.231
Medicinal Plants Research Centre, Yasuj University of Medical Sciences (YUMS), Yasuj, Islamic Republic of Iran 2 Yasuj University of Medical Sciences (YUMS), Social Determinant of Health Research Centre, Yasuj, Islamic Republic of Iran Objectives: This study was conducted to assess the effects of Nigella sativa on post menopausal symptoms and quality of life among yasujian menopausal women. Methods: In a randomized, double-blind, placebo-controlled clinical trial, 61 menopausal women were randomly allocated to receive either placebo or 2 g of Nigella sativa for 12 weeks. After getting informed consent, the participants were interviewed using Short Form Questionnaire (SF-36) before and after intervention to assess their quality of life before the treatment and at the end of the study. Greene Climacteric Scale (GCS) also was completed in order to assess the clinical effect on climacteric symptoms before and after intervention. Hormonal level including estradiol (E2) and follicle stimulating hormone (FSH) were measured at baseline and at the end of study. Results: The finding revealed that total SF-36 scores and its components including mental component summary (MCS) and physical component summary (PCS) of the SF-36 improved significantly (p < 0.05) compared to control group. A highly significant improvement was observed in the total GCS and its sub-scales (p < 0.01). Significant increment in serum E2 and reduction in FSH level were observed following three months treatment (p < 0.01). Conclusion: The results of this study indicated the potential of Nigella sativa as an alternative to hormone replacement therapy in management of menopausal symptoms. Keywords: Menopausal symptom; Quality of life; SF 36; Greene Climacteric Scale http://dx.doi.org/10.1016/j.maturitas.2015.02.232 P98 Influence of drugs on sexuality among Slovenian menopausal women
Lucija Vrabic Dezman 1,∗ , Mateja Legan 2 , Ksenija Gerˇsak 2 1 2
Health Center Kranj, Kranj, Slovenia University Medical Center, Ljubljana, Slovenia
Introduction: Sexuality significantly affects quality of women’s lives even after menopause. Age, sexual hormone levels, illness and certain drugs have adverse effects on sexuality. Objectives: Gynaecologists decided to conduct a pilot study titled ‘Let’s Discuss Sexuality’. Aim: To receive more data about the impact of drugs and some risk factors on sexual life. Methods: We gathered data from menopausal women visiting the outpatient clinics by using an anonymous survey. We collected data about factors and drugs, which might have an impact on sexual life. Data was gathered in 2007 in primary gynaecological outpatient clinics. We gathered 1657 surveys; out of which 1506 were suitable for statistical analysis.
Abstracts / Maturitas 81 (2015) 144–190
P93 Quality of life in postmenopausal women: clinical effects of drospirenone–estradiol administration versus placebo Novella Russo Demetra Menopause Clinic, Gottaferrata, Italy Objectives: To evaluate the effect of low dose HRT on quality of life. Blood pressure, BMI, joint pain and vaginal lubrication. Methods: Postmenopausal symptomatic women untreated with HRT in the previous 12 months were randomized to Calcium Carbonate (1200 mg/day) + Colecalciferol (800 U.I./day) supplementation or to 17-Beta Estradiol (1 mg/day) plus Drospirenone (2 mg/day). Quality of life, Blood Pressure and BMI measurements, joint pain and vaginal lubrication were evaluated before and after 12 weeks of treatment. Results: Quality of life evaluated by the Women’s Health Questionnaire (WHQ) showed a significant improvement in the group of women treated with low dose HRT when compared to the calcium treated group. Joint pain as referred by patients was improved but did not reach the statistic significance. BMI was unchanged. Vaginal lubrication increased as referred by patients and confirmed by evaluating the vaginal cell maturation index. Women with high-normal systolic blood pressure (130–139 mmHg) showed a significant decrease while diastolic blood pressure values were unmodified. The calcium – vitamin D treated group showed no statistically significant improvement in all the parameters analyzed. Conclusion: Postmenopausal symptomatic women are responsive to treatment with E2-DRSP as confirmed by the positive effect on their quality of life and in particular, this treatment is to be considered the gold standard in situations of increased systolic blood pressure values from normal to high normal or in presence of a family history of hypertension. http://dx.doi.org/10.1016/j.maturitas.2015.02.228 P94 The quality of life for women in a period of menopause Sergey V. Nedogoda ∗ , Irina N. Barykina, Alla S. Salasyuk, Viktoria O. Smirnova, Ekaterina A. Popova Volgograd State Medical University, Therapy and Endocrinology, Volgograd, Russian Federation Currently, there is noted a steady trend of increasing life expectancy of women all over the world. At the same time age of menopause remains rather stable and averages 49–50 years. Pathological course of menopause leads to a significant reduction in quality of life. Materials and methods: We examined 120 women (mean age 51.5 ± 2.8 years, duration of menopause from 1 to 4.5 years). Physical examination was conducted. To assess the quality of life standard questionnaires (Zung Self-Rating Depression Scale, Teilor’s Manifest Anxiety Scale, SCL-90-R Symptom Check List90-Revised, asthenia scale MFI-20 The Multidimensionae Fatigue Inventory), Kerdo index was used. To determine the severity of climacteric syndrome MMI (modified menopausal index) was calculated. Results: Based on the assessment of MMI there had been identified: neurovegetative violation weak severity in 67.9%, moderate severity in 32.1%, endocrine and metabolic disorders moderate
severity in 86%, average psycho-emotional disorders in 35.7%, mildin 64.3%. In assessing the SCL-90-R depression in 14% of women, elevated levels of somatization and obsession in 7% were identified. Kerdo Index figures: excitatory influence in the activity of the ANS dominated in 29% of women, inhibitory influences in 71%. In assessing the scale of depression a mild form was noted in 39%. According to the scale of anxiety average level of severity with a tendency to high in 72%, and 4% of responders had a high level of anxiety. Total asthenia score according to MFI-20: 31–60 points in 36%, higher than 60 points in 64% of women. Conclusion: According to the results all surveyed women had severe fatigue, high levels of anxiety, increase of somatization and obsession. Inhibitory influences in the activity of the ANS dominated. There were noted moderately or weakly expressed prevalence of menopausal syndrome. http://dx.doi.org/10.1016/j.maturitas.2015.02.229 P95 Patient characteristics and outcomes of an interdisciplinary menopause clinic: a retrospective chart review Beate C. Sydora 1,∗ , Nicole Veltri 1 , Christoph P. Sydora 1 , Justin Marillier 1 , Lori Battochio 2 , Nese Yuksel 3 , Tami Shandro 2 , Sue J. Ross 1 1
University of Alberta, Obstetrics and Gynecology, Edmonton, Canada 2 Women’s Health Program (LHHW), Alberta Health Services, Edmonton, Canada 3 University of Alberta, Faculty of Pharmacy and Pharmaceutical Sciences, Edmonton, Canada
Background: Severe cases of menopause may be treated at specialized multidisciplinary menopause clinics. The menopause clinic at the Lois Hole Hospital for Women (LHHW) in Edmonton provides care for women referred by their general practitioner and includes a range of disciplines (specialized physician, pharmacist, dietician, and nurses). Objective: We wished to characterize patients attending the clinic and to evaluate the treatment outcomes at the LHWH Menopause Clinic. Methods: We conducted a retrospective chart review of a convenience sample of 200 patients who attended the LHHW clinic during 2008–2013. Data from clinic charts were entered into REDCap database and analyzed to describe patient demographics, menopause symptoms, medical conditions, and treatments provided. Menopause symptom severity questionnaires were used to compare severity scores ranging from 1 to 4 (none, mild, moderate, severe) from the first and follow-up visits. Results: At initial consultation, women’s age was mean 52 years (range 30–68) with 65% being postmenopausal; 22% had experienced surgical menopause. At presentation, the most common self-reported menopause symptoms were sleep dysfunction (46%), hot flashes (35%), and mood symptoms (32%). 97% of women reported at least one additional medical problem. Hormone Therapy was the primary treatment recommended (79%). Of the 138 patients with follow-ups, symptom severity scores were reduced between the first and last visit for 104 patients (75%), unchanged for 7 patients (5%), and increased for 27 (20%). Conclusion: Women seeking help at the LHHW Menopause Clinic present with complex medical issues in addition to a variety of menopause symptoms. We cannot rule out change over time in this study, but it appears that care received has a positive impact
Abstracts / Maturitas 81 (2015) 144–190
on patient outcomes as judged by reduced menopause scores over time of follow-up visits. Ethics approval: HREB (EDM)/Pro00041189. Funding: Women and Children’s Health Research Institute. http://dx.doi.org/10.1016/j.maturitas.2015.02.230 P96
179
P97 A randomised controlled trial on climacteric symptoms management and quality of life improvement of Nigella sativa seeds powder in menopausal women Saadat Parhizkar 1,∗ , Leila Manzouri 2 1
Correlation between the quality of life and sleep quality with the body mass index in Colombian women in climacteric Alvaro Monterrosa-Castro 1,∗ , Katherin ˜ 2 Portela-Buelvas 2 , Liezel Ulloque-Caamano 1 Grupo de Investigación Salud de la Mujer, Universidad de Cartagena, Cartagena, Colombia 2 Grupo de Investigación Salud de la Mujer, Cartagena, Colombia
Objective: To estimate the correlation between quality of life, sleep quality with the body mass index (BMI) in Colombian women. Methods: Cross-sectional study carried out in women aged between 40 and 59 years, residents in areas located in the Caribbean and Pacific coasts of Colombia, belonging to Hispanic, Afro-descendant and Indigenous ethnic groups. They participated willingly, in their own communities, anonymously and with informed consent. Hysterectomized and pregnant women were excluded. And a socio-demographic survey, the Athens Insomnia Scale (AIS), Pittsburgh Sleep Index (PSQI) and the Menopause Rating Scale (MRS) were applied. The BMI was calculated measuring participants’ weight and height. Data is presented in median and interquartile range. The three scales showed an adequate Cronbach’s alpha. The Spearman (rs ) correlation coefficient was calculated with the statistical program SPSS-15. A p value <0.05 was considered significant. Results: 3525 women were involved. Average age: 48.0 [IR:8] years old, number of children born: 3 [IR:2], education level: 11.0 [IR:7] years, diabetic women: 7.7%, women with Arterial Hypertension: 15.5%, usual coffee use: 71.4%, actual smokers: 8.4%, weight: 68 [IR:15] kg, BMI: 25.6 [IR:5.6], underweight: 2.7%, Normal: 41.2%, overweight: 39.1%, obesity-I: 12.4%, obesity-II: 3.8%, obesity-III: 0.6% and hormone therapy use: 11.5%. According to the menopause status: premenopause: 32.3%, perimenopause: 19.4%, postmenopause: 48.2%. A weak positive correlation was noticed between BMI and somatic-vegetative (rs = 0.20), psychological (rs = 0.17) and urogenital deterioration (rs = 0.15) and quality of life (rs = 0.2). p < 0.001. The correlation between BMI and sleep quality (rs = 0.020) and insomnia (rs = 0.004) were not significant. Conclusion: In a Colombian women group, the BMI had a weak positive correlation with quality of life and the domains of the MRS. However, neither quality of sleep nor insomnia had a significant correlation with the BMI. http://dx.doi.org/10.1016/j.maturitas.2015.02.231
Medicinal Plants Research Centre, Yasuj University of Medical Sciences (YUMS), Yasuj, Islamic Republic of Iran 2 Yasuj University of Medical Sciences (YUMS), Social Determinant of Health Research Centre, Yasuj, Islamic Republic of Iran Objectives: This study was conducted to assess the effects of Nigella sativa on post menopausal symptoms and quality of life among yasujian menopausal women. Methods: In a randomized, double-blind, placebo-controlled clinical trial, 61 menopausal women were randomly allocated to receive either placebo or 2 g of Nigella sativa for 12 weeks. After getting informed consent, the participants were interviewed using Short Form Questionnaire (SF-36) before and after intervention to assess their quality of life before the treatment and at the end of the study. Greene Climacteric Scale (GCS) also was completed in order to assess the clinical effect on climacteric symptoms before and after intervention. Hormonal level including estradiol (E2) and follicle stimulating hormone (FSH) were measured at baseline and at the end of study. Results: The finding revealed that total SF-36 scores and its components including mental component summary (MCS) and physical component summary (PCS) of the SF-36 improved significantly (p < 0.05) compared to control group. A highly significant improvement was observed in the total GCS and its sub-scales (p < 0.01). Significant increment in serum E2 and reduction in FSH level were observed following three months treatment (p < 0.01). Conclusion: The results of this study indicated the potential of Nigella sativa as an alternative to hormone replacement therapy in management of menopausal symptoms. Keywords: Menopausal symptom; Quality of life; SF 36; Greene Climacteric Scale http://dx.doi.org/10.1016/j.maturitas.2015.02.232 P98 Influence of drugs on sexuality among Slovenian menopausal women
Lucija Vrabic Dezman 1,∗ , Mateja Legan 2 , Ksenija Gerˇsak 2 1 2
Health Center Kranj, Kranj, Slovenia University Medical Center, Ljubljana, Slovenia
Introduction: Sexuality significantly affects quality of women’s lives even after menopause. Age, sexual hormone levels, illness and certain drugs have adverse effects on sexuality. Objectives: Gynaecologists decided to conduct a pilot study titled ‘Let’s Discuss Sexuality’. Aim: To receive more data about the impact of drugs and some risk factors on sexual life. Methods: We gathered data from menopausal women visiting the outpatient clinics by using an anonymous survey. We collected data about factors and drugs, which might have an impact on sexual life. Data was gathered in 2007 in primary gynaecological outpatient clinics. We gathered 1657 surveys; out of which 1506 were suitable for statistical analysis.