WWW.ABSTRACT.XLIBX.INFO
FREE ELECTRONIC LIBRARY - Abstract, dissertation, book
 
<< HOME
CONTACTS



Pages:   || 2 |

«SC Biostandard 2007 SRL, Romania *Corresponding Author: Delia Mirela Țiț, Department of Pharmacy, Faculty of Medicine and Pharmacy, University of ...»

-- [ Page 1 ] --

PHARMACEUTICAL SCIENCE

Cronicon OPEN ACCESS

Research Article

The Treatment with Hormone Replacement Therapy and Phytoestrogens and The

Evolution of Urogenital Symptoms in Postmenopausal Women

Bungau S1, Tit DM1*, Fodor K1 and Purza L2

Department of Pharmacy, University of Oradea, Romania

SC Biostandard 2007 SRL, Romania

*Corresponding Author: Delia Mirela Țiț, Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29, N. Jiga St., 410028, Oradea, Romania.

Received: March 20, 2015; Published: May 21, 2015 Abstract The present study aims to optimize the treatment in menopause by replacing pharmaceutical preparations containing estroprogestatives with products containing phytoestrogens, with less contraindications and side effects. The objective of the study was to compare the in vivo effects of hormone therapy administered in small doses, with that of soy phytoestrogens, in the evolution of urogenital symptoms in postmenopausal women. The study represents a clinical-statistical research, conducted on 326 patients clinically diagnosed in post menopause with urogenital symptoms that have not been previously treated with hormone replacement therapy (HRT) or phytoestrogens. The patients were divided into three groups of which two with therapy: the first group received treatment in doses of 1 mg estradiol and 0.5 mg norethisterone acetate (NETA) p.o. daily (group of HRT); the second group - received an extract standardized at 40% containing 20 mg pure isoflavones (Genistein, Daidzein and Gliciteina) 40 mg p.o. daily (group of phytoestrogens) and a control group without therapy.

Symptom assessment was performed with a specific instrument, respectively a standardized questionnaire Menopause Rating Scale (MRS) initially at 6 months and at 12 months, after treatment initiation. It was found an improvement, statistically significant for all symptoms assessed both at 6 months and at 12 months - at the 2 treatment groups compared to the control group, without significant differences between the groups with therapy.

The study results are favorable evidence for the use of phytoestrogens derived from soy in the treatment of urogenital symptoms in postmenopausal women.

Keywords: Menopause; Urogenital symptoms; Hormone replacement therapy; Phytoestrogens Abbreviations: HRT: Hormone Replacement Therapy; MRS: Menopause Rating Scale; NETA: Norethisterone Acetate; CDC: Center of Disease Control and Prevention;

Depriving the body of estrogen due to the menopause causes symptomatic, histological and functional urogenital changes. These Introduction changes produce specific urogenital problems, including the urgent need to urinate, urinary incontinence, recurrent urinary tract infections [1] and discomfort symptoms, such as vaginal dryness and sexual dysfunction [2]. Along with the hot flashes and sleep disorders, vaginal dryness is considered a typical symptom of menopause [3-7], which is reported by 25% of women in the first year post menopause and their percentage increases to 47% in the third year post menopause [8]. Estrogen hormone therapy local or systemic significantly reduces the symptoms caused by urogenital atrophy [9]. However, systemic estrogen therapy is contraindicated for some women as it is associated with many risks (venothrombotic diseases, breast cancer, stroke and coronary disease) and imposes the need to assess Citation: Delia Mirela Țiț., et al. “The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women”. EC Pharmaceutical Science 1.3 (2015): 123-129.

The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women the benefits against the potential risks of the treatment [10]. According to recent studies HRT is administered in the lowest dose and for the shortest period necessary for symptom control [10]; with the reassessment of the need to continue hormone therapy at intervals of 6-12 months [11].

the benefits against the potential risks of the treatment [10]. According to recent studies HRT is administered in the lowest dose and for the shortest period necessary for symptom control [10]; with the reassessment of the need to continue hormone therapy at intervals of 6-12 months [11].

The present study aims to optimize the treatment of postmenopausal urogenital symptoms by replacing estroprogestative pharmaceutical preparations, with preparations containing phytoestrogens, with less contraindications and side effects. Thus the aim of this study was to compare the in vivo effectiveness of low-dose HRT and of phytoestrogens in improving urogenital symptoms in postmenopausal women.

The study was conducted over a period of 12 months, on three parallel groups, on a total of 326 women with characteristic menoMaterial and Methods pausal symptoms of mild to severe intensity. Menopausal status at recruitment into the study, according to menstrual history, was the postmenopausal with definitive cessation of the cycle, naturally for at least 12 months and no more than 5 years for all patients.

Inclusion criteria: natural menopausal women with specific symptoms, mild to severe; minimum one year and maximum 5 years of menopause; without hormonal therapy.

Exclusion criteria: induced menopause; hormonal therapy; onset of menopause for more than 5 years; patients with concomitant illness that would contraindicate HRT;





In the statistical processing entered 326 women divided into three study groups as follows: group I - 96 patients receiving hormone replacement therapy (1 mg estradiol and 0.5 mg norethisterone acetate (NETA) po daily); group II - 124 patients with phytoestrogens (extract standardized at 40%, containing 20 mg of pure isoflavones (Genistein, Daidzein and Gliciteina) 40 mg po daily); group III - control, 106 patients, who have not received any kind of treatment.

Isoflavones extract was purchased from pharmacies/natural food store in the form of capsules, manufactured by Organika Canada or IPRAD-France, and the dose administrated was established together with the doctor, taking into account the indications of the prospectus.

The division into groups of patients was made according to the historic, evaluation and diagnosis, risks and benefits of the proposed treatment.

Statistical analysis was done by using the EPIINFO, version 6.0, a program of the Center for Disease Control and Prevention - CDC (Center of Disease Control and Prevention) in Atlanta, adapted to processing from medical statistics. We calculated average parameters, frequency ranges, standard deviations, tests of statistical significance by the Student method (t test) and χ2. The distribution of tests is similar to the normal one, being used by hypotheses involving numerical data. The t test also called Student test takes into account the standard deviation of the sample.

Each patient included in the study was drawn up an informed consent form.

Evaluation was performed with a specific instrument Menopause Rating Scale (MRS), designed and standardized as a tool for selfassessment to evaluate symptoms/manifestations related to aging, under different conditions, of some groups of women; assessing symptom severity over time; assessing pre and post replacement therapy changes in menopause [14].

Citation: Delia Mirela Țiț., et al. “The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women”. EC Pharmaceutical Science 1.3 (2015): 123-129.

The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women This is comprised of 11 items, divided into three areas: somatic-vegetative, psychological and urogenital. On the urogenital field are evaluated: bladder problems (urinating difficulty, urinating often, having trouble to refrain from urinating); vaginal dryness (dryness or burning sensation in the vagina, difficulty in having intercourse) and sexual problems (changes in sexual desire, sexual activity and satisfaction).

The evaluation of the completed questionnaire follows a simple scheme. The score increases point by point with the increase of symptom severity, perceived subjectively, for each of the 11 items (severity is expressed from 0 to 4 points for each item). By completing the five possible boxes of “severity” for each item, the respondent gives his personal perception. MRS total score ranges from 0 (asymptomatic) to 44 (most severe symptoms). Scores minimum /maximum when urogenital symptoms varies between 0-12 points (three symptoms: sexual problems, urinary problems, vaginal dryness), and the total score is based on summing the scores for each item in the field [14,15].

The initial distribution of cases according with the severity of the symptoms does not interfere with the results. Initially there were Results and Discussion no significant differences between the three groups in terms of uro-genital symptoms (p = 0.782). In all three groups predominated the patients with moderate or severe symptoms, regardless of the type of symptoms (table 1). The comparative results on the evolution of the evaluated urogenital symptoms at 6 and at 12 months are shown in Table 2.

–  –  –

Table 1: Distribution of cases according to the severity of initial symptoms.

At 6 months, the disappearance of sexual problems was recorded at 28.23% in the group with phytotherapy, percentage insignifiSexual Problems cantly lower than the HRT group (31.58%) (p = 0.471), and significantly higher than the control group (19.81%) (p = 0.35).

In the control group, the disappearance of sexual problems was recorded at a percentage significantly lower than in the group with hormone therapy (19.81% vs 31.58%) (p = 0.003). Both in the phytoestrogens and in the THS group were recorded cases of worsening of the sexual problems (0.81% and 2.11%).

At 12 months, the disappearance of sexual problems was recorded at 33.06% in the group with phytotherapy, percentage insignificantly lower than the hormone therapy group (36.84%) (p = 0.433), and slightly higher than the control group (30.19%) (p = 0.532). At the control group the disappearance of sexual problems was recorded at a percentage insignificantly lower than the hormone therapy group (30.19% vs 36.84%) (p = 0.147). Both in the group with phytoestrogens and in the one with the hormone therapy were registered cases of worsening of the sexual problems at 12 months (0.81% and 2.11%).

At 6 months, the disappearance of the bladder problems was recorded at 21.77% in the group with phytotherapy, percentage insigProblems with the bladder nificantly lower than the hormone therapy group (24.21%) (p = 0.569), and slightly higher than the control group (17.92%) (p = 0.315).

In the control group, the disappearance of the bladder problems was recorded at a percentage significantly lower than in the group with hormone therapy (17.92% vs 24.21%) (p = 0.101). In all the three groups were registered cases of worsening of the bladder problems (4.03%, 4.21% respectively 2.83%).

Citation: Delia Mirela Țiț., et al. “The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women”. EC Pharmaceutical Science 1.3 (2015): 123-129.

The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women

–  –  –

Table 2: The evolution of urogenital symptoms on items.

At 12 months, the disappearance of the bladder problems was registered at 30.65% in the group with phytotherapy, percentage insignificantly lower than of the hormone therapy group (34.74%) (p = 0.390), and slightly higher than of the control group (29.25%) (p = 0.758). In the control group, the disappearance of the bladder problems was registered at a percentage insignificantly lower than in the hormone therapy group (29.25% vs 34.74%) (p = 0.227). In all three groups were registered cases of worsening of the bladder problems (3.23%, 4.21% and 4.72%).

At 6 months, the disappearance of the vaginal dryness was registered at 33.87% of the group with phytotherapy, percentage insigVaginal Dryness nificantly lower than of the hormone therapy group (37.89%) (p = 0.407), and significantly higher of the control group (21.70%) (p = 0.003). At the control group, the disappearance of the vaginal dryness was registered at a percentage significantly lower than in the group with hormone therapy (21.70% vs 37.89%) (p 0.001). In the groups with hormone therapy in the control group were registered cases of worsening of the vaginal dryness (3.16% and 1.89%).

At 12 months, the disappearance of the vaginal dryness was registered at 41.13% in the group with phytotherapy, percentage insignificantly lower than of the hormone therapy group (44.21%) (p = 0.535), and slightly higher than of the control group (36.79%) (p = 0.368). At the control group, the disappearance of the vaginal dryness was registered at a percentage slightly lower than in the group with hormone therapy (36.79% vs 41.13%) (p = 0.124). And at 12 months were registered cases of vaginal dryness worsening in the group with hormone therapy and in the control group (3.16% and 1.89%).

Regardless of the group favorable development (symptom disappearance or improvement) was recorded especially for the vaginal

dryness item:

Citation: Delia Mirela Țiț., et al. “The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women”. EC Pharmaceutical Science 1.3 (2015): 123-129.

The Treatment with Hormone Replacement Therapy and Phytoestrogens and The Evolution of Urogenital Symptoms in Postmenopausal Women a. At 6 months - 51.61% (33.87% absent, 17.74 ameliorated) in the group with phytotherapy, 54.74% (37.89% absent, 16.84% ameliorated) in the hormonotherapy group and 41.51% (21.70% absent, 19.81% ameliorated) in the control group;

b. At 12 months- 66.94% (41.13% absent, 25.81% ameliorated) in the group with phytotherapy, 69.47% (44.21% absent, 25.26% ameliorated) in hormonotherapy group and 51.88% (36.79% absent, 15.09% ameliorated) in the control group, followed by

sexual problems:



Pages:   || 2 |


Similar works:

«Resource List: Mental Health Services & Other Community Resources for Students and Families Newport News Public Schools Edited by Chrystal Bailey, MSW, David Carroll, MSW, and Mara Yoko, MSW Updated-December 2012 TABLE OF CONTENTS 1. Counseling/ Mental Health Services 3 2. Cultural Specializations 8 3. Housing/Rent/Food/ Clothing Assistance 9 4. Medical Services 11 5. Resources for Individuals with Disabilities 13 6. Parent Resources 14 7. Support for Military Families 14 8. State/ City...»

«Aus der Medizinischen Klinik und Poliklinik IV der Ludwig-Maximilians-Universität München Arbeitsgruppe Klinische Biochemie Vorstand: (Direktor: Prof. Dr. med. Martin Reincke) Characterization and Targeted Therapy of Stem Cell-Like Side Population Cells in Pancreatic Cancer and Esophageal Cancer Dissertation zum Erwerb des Doktorgrades der Naturwissenschaften (Dr. rer. nat.) an der medizinischen Fakultät der Ludwig-Maximilians-Universität zu München vorgelegt von Yue Zhao Aus Jiang Su,...»

«rWHO Model Prescribing Information Drugs used in Skin Diseases • World Health Organization Geneva Информация ВОЗ о примерном перечне лекарственных средств Лекарственные средства для лечения кожных болезней Выпущено издательством Медицина по поручению Министерств здравоохранения Российской Федерации, которому...»

«Talanta, Volume 88, 15 January 2012, Pages 14-29 Current Trends in Explosive Detection Techniques J. Sarah Caygilla, Frank Davisa and Seamus P. J. Higsona,* a Cranfield Health, Vincent Building, Cranfield University, Bedfordshire, MK43 0AL, United Kingdom * Corresponding author. Tel: +44(0)-1234-758516. Fax: +44(0)-1234-758380. Email address: s.p.j.higson@cranfield.ac.uk (S.P.J. Higson) Abstract The detection of explosives and explosive-related compounds has become a heightened priority in...»

«Journal of Rational-Emotive & Cognitive-Behavior Therapy, Vol. 24, No. 1, Spring 2006 (Ó 2006) DOI: 10.1007/s10942-006-0022-5 Published Online: June 20, 2006 MINDFULNESS AND SELF-ACCEPTANCE Shelley H. Carson Ellen J. Langer Harvard University, USA ABSTRACT: The present article will focus on the cognitive theory of mindfulness and its importance in achieving unconditional self-acceptance. The goal of the mindful perspective is to increase cognitive flexibility and to thereby increase...»

«February 9, 2012 Robin E. Jensen 1 CURRICULUM VITAE Robin E. Jensen Assistant Professor, Department of Communication University of Utah Languages and Communication Bldg, Room 2400 Telephone: (801) 581-6889 255 South Central Campus Drive Fax: (801) 585-6255 Salt Lake City, UT 84112 E-mail: r.e.jensen@utah.edu Education Ph.D. University of Illinois, Urbana-Champaign Communication Concentration: Rhetoric; Health Communication Graduate Minor: Gender and Women’s Studies Degree awarded: May 2007...»

«IBERIA, LÍNEAS AÉREAS DE ESPAÑA, S.A. MULTIRISK TRAVEL INSURANCE GENERAL CONDITIONS These General Conditions will allow you to be familiar in detail with the framework agreement that you are entering with AGA INTERNATIONAL SA Sucursal en España (hereinafter AGA INTERNATIONAL) when you take out this insurance. Please read this policy carefully, including the exclusions. Should you have any queries or claims, AGA INTERNATIONAL places its Telephone Helpline at your service, on 902 180 722, and...»

«The Unhealthy Truth The Unhealthy Truth: Obesity in the black population of Chicago An analysis and overview by Anthony V. Clark Research Specialist Chicago Urban League June 2005 The Unhealthy Truth The Unhealthy Truth INTRODUCTION Obesity has become the number one health issue of the 21st century. Both in the U.S. and abroad, people have become more overweight than ever before. Whether due to the proliferation of fast food choices or a decrease in exercise and healthful activities, Americans...»

«Toxins 2013, 5, 1180-1201; doi:10.3390/toxins5061180 OPEN ACCESS toxins ISSN 2072-6651 www.mdpi.com/journal/toxins Review Heparin-Binding Epidermal Growth Factor-like Growth Factor/Diphtheria Toxin Receptor in Normal and Neoplastic Hematopoiesis Fabrizio Vinante * and Antonella Rigo Department of Medicine, Section of Hematology, Cancer Research & Cell Biology Laboratory, University of Verona, Verona, Italy; E-Mail: antonella.rigo@univr.it * Author to whom correspondence should be addressed;...»

«Aus der Abteilung Allgemeinmedizin der Medizinischen Hochschule Hannover Wirksamkeit von Ayurveda bei chronischen Erkrankungen Systematische Reviews und Poweranalysen von klinischen Studien zu ayurvedischen Therapien bei Diabetes mellitus, Asthma bronchiale und Fettstoffwechselstörungen Dissertation zur Erlangung des Doktorgrades der Medizin an der Medizinischen Hochschule Hannover Vorgelegt von Christian H.S. Keßler aus Berlin Hannover, September 2006 Angenommen vom Senat der Medizinischen...»

«Suitability of the TEL-AML1 Chromosomal Translocation for Targeting by Adoptive T Cell Therapy of Leukemia: An Investigation in a Novel Humanized Mouse Model Dissertation zur Erlangung des akademischen Grades doctor rerum naturalium (Dr. rer. nat.) im Fachbereich Biologie, Chemie, Pharmazie eingereicht an der Freien Universität Berlin von Diplom-Molekularbiologin und -Physiologin Jelena Popović (geb. Tasić) aus Belgrad, Serbien Berlin, 2011 Die Arbeit wurde am Max-Delbrück-Centrum für...»

«Iranian Int. J. Sci. 2(1) 2001 Cytogenetic Biomonitoring of Workers Occupationally Exposed to Aromatic Solvents Hossein Mozdarani*, Ph.D. and Shirazeh Arghami, M.Sc *School of Medical Sciences, Tarbiat Modarres University, Tehran, Iran, P.O.Box, 14115-111 e-mail: mozdarah@Net1cs.modares.ac.ir Abstract It has long been shown that several organic solvents such as benzene are potent carcinogens. Because of long latency and no radical treatment of cancers, evaluation of the biological effects of...»





 
<<  HOME   |    CONTACTS
2016 www.abstract.xlibx.info - Free e-library - Abstract, dissertation, book

Materials of this site are available for review, all rights belong to their respective owners.
If you do not agree with the fact that your material is placed on this site, please, email us, we will within 1-2 business days delete him.