The Agency for Healthcare Research ...

The Agency for Healthcare Research and Quality (AHRQ) has released the eventuates of a systematic review forward managing menopause-related symptoms. The cloyed report, Evidence Report/Technology Assessment No. 120 "Management of Menopause-Related Symptoms," is available online at http://www ahrq.gov/clinic/epcsums/menosum.htm.

according to definition, menopause is the permanent cessation of mense caused on reduced ovarian hormone secretion. Menopause usually flash on the minds in women 40 to 58 years of age, and it may take several years to largely transition from onset to completion. During this time, many women experience symptoms that can cause reduc quality of life. general menopause-related symptoms include:

* violent flashes

* Vaginal dryness

* rest disturbance

* temper symptoms

* Cognitive disturbances

* Somatic complaints

* Urinary complaints

* Uterine bleeding

Many therapies exist to manage these symptoms, including hormone therapy, antidepressants and other physics behavioral interventions, and complementary and alternative medicine.

The AHRQ evidence report evaluates the benefits and harms of customary interventions to relieve menopause-related symptoms. The review included American women who were going end menopause and who presented with at least undivided of the above symptoms. A technical [i]connoisseur[/i] panel, which was made up of masters and clinicians in the field, and master reviewers provided input for this review.

Managing Menopausal Symptoms

ESTROGEN

Estrogen was the most numerous consistently effective intervention for vasomotor symptoms. The therapy also helped manage urogenital symptoms, along with drowse mood, sexual, and quality-of-life issues compared with placebo. The greatest in quantity common adverse effects of estrogen therapy were breast tendernes and uterine bleeding.

TESTOSTERONE AND ESTROGEN

The reviewers construct few trials evaluating testosterone therapy. However, individual trial showed no difference between combination testosterone and estrogen therapy and estrogen therapy alone for scalding;-very warm flashes, vaginal dryness, or be still problems. The results of pair trials showed that testosterone and estrogen therapy improved sexual symptoms better than estrogen alone or placebo. However, women receiving combination therapy had significantly more incidences of acne and hirsutism compared with those in the estrogen-only group

PROGESTIN

Trials showed varying eventuates regarding progestin in the management of vasomotor symptoms.

TIBOLONE

A not many trials of fair to serviceable quality showed that tibolone (Livial) helped manage vasomotor symptoms, be dead and somatic complaints compared with placebo. Tibolone was similar to estrogen in the management of an symptoms. Patients treated with tibolone experienced more uterine bleeding, visible form [i]or[/i] frame pain, weight gain, and headaches compared with patients who were treated with placebo.

SOY ISOFLAVONES AND OTHER ALTERNATIVE THERAPIES

Although inferences varied and more research is povertyed alternative therapies were beneficial in managing an nonvasomotor symptoms.

Conclusion

Trials evaluating therapies for the management of menopause-related symptoms were conclusive single for estrogen in the management of vasomotor and urogenital symptoms. After further research, other therapies may demonstrate beneficial results

LIMITATIONS

The trials included in this evidence review had the following limitations:

* Highly exquisiteed small sample groups

* Short duration

* Inadequate reporting of los to follow-up maintenance of comparable form into groupss contamination, methods of analysis, and adverse events

* one nonstandardized and nonvalidated measures and outcomes

* Unclear inclusion and exclusion criteria

* Industry sponsorship

FURTHER RESEARCH

Research is wanted to fill in the gaps of this evidence review. Researchers should focus forward determining optimal effective dosing, combination regimens, duration of use, and timing of therapy. Trials also should include head-to-head and placebo comparisons of estrogen alone and combined with other therapies, including nondrug interventions, as well as the best way to discontinue estrogen therapy after the symptoms subside.

COPYRIGHT 2005 American Academy of Family Physicians

COPYRIGHT 2005 Gale Group