What is black cohosh used for?
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To alleviate menopausal symptoms.
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What is black cohosh used for?
To alleviate menopausal symptoms.
What was the conclusion of the systematic review regarding phytoestrogen treatments for menopausal symptoms?
There was no evidence that phytoestrogen treatments helped to relieve menopausal symptoms.
What is evening primrose oil rich in?
Gamma-linolenic and linolenic acid.
What effect does low-intensity exercise like yoga have on menopausal symptoms?
It may reduce vasomotor symptoms and improve psychological wellbeing.
What did early trials of oral clonidine reveal about its effectiveness?
They showed no evidence for hot flush reduction.
What is stellate ganglion blockade and its purpose?
A technique involving local anesthetic injection to treat hot flushes and sweating, especially when HRT is contraindicated.
What are the EU studies examining the role of phytoestrogens in health?
PHYTOS, ISOHEART, and PHYTOPREVENT.
What was the outcome of sham-controlled trials regarding acupuncture for menopausal hot flushes?
The authors failed to show beneficial effects of acupuncture over placebo.
What were the findings of the randomized trial involving reflexology for menopausal symptoms?
Both reflexology and nonspecific foot massage groups showed symptom reduction, but no significant difference between them.
What interactions have been reported with Dong quai?
Interactions with warfarin, increasing the risk of bleeding and photosensitisation.
What are progestogens used for in menopausal symptom management?
As an alternative to combined HRT for women with contraindications to estrogen.
What is the biochemical impossibility related to wild yam extract?
Steroids in yams cannot be converted to progesterone in the human body.
What was the outcome of short-term treatment with topical wild yam extract?
It appears to have little effect on menopausal symptoms.
What should clinicians consider when discussing menopause treatment options?
The range of options available, their advantages and disadvantages, and the patient's specific risk factors.
What is the primary aim of reflexology?
To relieve stress or treat health conditions through pressure application to specific points.
What is clonidine and its role in treating vasomotor symptoms?
Clonidine is a centrally active alpha-2 agonist that has been used as an alternative treatment, but evidence for its efficacy is limited.
What is the concern regarding high-dose progestogens?
They carry a thromboembolic risk.
What is needed to confirm the efficacy and long-term safety of alternative treatments?
Well-designed, prospective, randomised controlled trials.
What is known about Agnus Castus (chasteberry) in relation to menopausal symptoms?
Limited data exist, but a combination herbal product including it reduced vasomotor symptoms in a randomized controlled trial.
What type of exercise is suggested to improve menopausal symptoms?
Aerobic exercise.
What lifestyle changes can help reduce the severity of vasomotor symptoms?
Avoidance or reduction of alcohol and caffeine intake.
Which SNRI has shown the most convincing data for treating vasomotor symptoms?
Venlafaxine at a dosage of 37.5 mg twice daily.
What is the status of Kava kava in the UK?
It has been banned due to reports of liver damage.
What dietary component is associated with lower rates of menopausal symptoms in populations like the Japanese?
Isoflavones.
What is the effect of the soy-derived preparation DT56a on hot flushes?
It has been shown to have an effect on hot flush reduction.
What should clinicians avoid using as first-line therapy in women with estrogen/progesterone-dependent tumors?
Phytoestrogens and progestogens/progesterone.
What is a concern regarding paroxetine in breast cancer treatment?
It may reduce tamoxifen’s effectiveness by inhibiting its bioactivation by CYP2D6.
Why should phytoestrogens be used cautiously in breast cancer patients?
Their safety is unknown and should be confined to specialist centres and clinical trials.
What are two prescribed options for vaginal dryness in the UK?
ReplensMD™ and Sylk.
What is the efficacy of Dong quai for treating menopausal symptoms?
It has not been found to be superior to placebo in a randomized trial, but may be effective when combined with other herbs.
What is the efficacy comparison between alternative preparations and traditional HRT?
Alternatives provide 50-60% symptom reduction compared to 80-90% with traditional HRT.
What effect does DHEA have on hot flushes according to preliminary studies?
An uncontrolled pilot study showed a modest reduction in hot flushes with DHEA.
What class of drugs is commonly used for alleviating menopause symptoms as an alternative to HRT?
Selective serotonin and noradrenaline reuptake inhibitors (SSRIs and SNRIs).
What have studies shown about ginseng's efficacy for vasomotor symptoms?
It has not been found to be superior to placebo.
What do women perceive about complementary therapies compared to traditional hormone therapies?
They perceive them to be safer and more natural alternatives.
What is a major concern regarding herbal medicines?
They can cause unwanted effects and have potentially dangerous interactions with other medicines.
What is dehydroepiandrosterone (DHEA) and its initial use?
DHEA was initially used in the USA as a food supplement for its supposed anti-aging effects in postmenopausal women.
What concerns exist regarding phytoestrogens and hormone-sensitive tissues?
Safety concerns due to estrogenic actions and interactions with selective estrogen receptor modulators.
What is a concern regarding the long-term safety of black cohosh?
Potential liver toxicity.
What is a primary concern regarding traditional hormone replacement therapy (HRT)?
The purported risks to the breasts and cardiovascular system.
What has fueled interest in alternatives to HRT?
Concerns about the risks associated with traditional HRT.
What has the Women’s Health Initiative study indicated about progestogens?
It has raised concerns about the safety of progestogens due to an increased risk of breast cancer when combined with estrogen.
What vitamins and minerals are mentioned as being present in supplements for postmenopausal women?
Vitamins E and C, and minerals like selenium.
What is the current status of herbal preparations in the UK?
They must be registered with the Medicines and Healthcare products Regulatory Authority.
What was the outcome of the trial on Danggui Buxue Tang?
Benefit over placebo was found only for mild hot flushes.
How did gabapentin compare to vitamin E in treating hot flushes?
Gabapentin appeared to be more effective, with a favorable effect on sleep quality, while vitamin E had only a marginal effect.
What new technique is showing promise for refractory symptoms?
Stellate ganglion blockade.
What is the current understanding of homeopathy's effectiveness for menopausal symptoms?
The mechanisms are unclear, and while some data is encouraging, more research is needed.
What is the recommendation regarding natural progesterone cream?
It is not recommended for progestogenic opposition due to inconsistent data.
What are some common side effects associated with SSRIs and SNRIs?
High incidence of nausea, reduced libido, and sexual response.
What interactions are associated with St John’s wort?
It decreases blood concentrations of several medications and may cause breakthrough bleeding with oral contraceptives.
What is the evidence for the effectiveness of other herbs like Ginkgo biloba and valerian root on menopausal symptoms?
There is no good evidence that they have any effect on menopausal symptoms.
What is the current understanding of acupuncture's effectiveness for menopausal symptoms?
The evidence is conflicting, with difficulties in trial design, particularly with blinding to 'sham' acupuncture.
What is a potential best choice for therapy in women with estrogen/progesterone-dependent tumors?
An SNRI (Serotonin-Norepinephrine Reuptake Inhibitor).
Why might progestogens be inappropriate for women with an increased risk of breast cancer?
Because they can increase the risk of breast cancer, especially in women with progesterone-receptor-positive tumors.
What is the current evidence regarding magnet therapies for hot flushes?
There is no known mechanism of action or evidence of benefit for magnet therapies.
What is a potential risk associated with doses of progestogens used for vasomotor symptom control?
Increased risk of venous thromboembolism.
What is the primary function of lubricants for vaginal dryness?
To relieve vaginal dryness during intercourse.
What was the result of the trial investigating vitamin E for hot flushes in women with breast cancer?
A small statistically significant reduction in hot flush frequency was observed, but it may not be clinically significant.
What benefit has been shown for megestrol acetate in randomized studies?
A benefit over placebo for intractable vasomotor symptoms.
What caution should be taken when interpreting data on ginseng?
Caution is essential due to the use of the common name for multiple chemically different species.
What is the effect of St John’s wort on menopausal symptoms?
Its efficacy for vasomotor symptoms remains to be proved, but it has shown efficacy in mild to moderate depression.
What has research shown about gabapentin in relation to hot flushes?
Gabapentin has shown efficacy for hot flush reduction compared to placebo.
What are phytoestrogens and where are they commonly found?
Phytoestrogens are plant substances with estrogen-like effects, found in soybeans, chickpeas, and red clover.
What are some adverse effects of gabapentin?
Drowsiness, dizziness, and fatigue.
What are the major lignans associated with phytoestrogens?
Enterolactone and enterodiol.
What are the major isoflavones found in phytoestrogens?
Genistein and daidzein.
