Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study II.

B. Harris, L. Lovett, R. G. Newcombe, G. F. Read, R. Walker, and D. Riad-Fahmy

Department of Psychological Medicine, University of Wales College of Medicine, Cardiff.

BMJ. 1994 April 9: 308(6934):949-953

Abstract

OBJECTIVES–To define relation between mood and concentrations of progesterone and cortisol during perinatal period to test hypothesis that rapid physiological withdrawal of steroid hormones after delivery is associated with depression. DESIGN–Prospective study of primiparous women from two weeks before expected date of delivery to 35 days postpartum. SETTING–Antenatal clinic in university hospital, obstetric inpatient unit, patients’ homes. SUBJECTS–120 of 156 primiparous women interviewed. Remainder excluded because of major marital, socioeconomic, or medical problems or because caesarean section required. MAIN OUTCOME MEASURES–Concentrations of progesterone and cortisol in saliva samples; women’s moods assessed by various scores for depression. RESULTS–Changes in salivary progesterone and cortisol concentrations were similar to those already characterised for plasma. Peak mean score for maternity blues (5.3 on Stein scale) was on day five postpartum (P < 0.02 compared with mean scores on other postpartum days). High postpartum scores for maternity blues were associated with high antenatal progesterone concentrations on day before delivery (P < 0.05), with high rate of rise of antenatal progesterone concentrations (P < 0.05), with decreasing progesterone concentrations from day of delivery to day of peak blues score (P > or = 0.01), and with low progesterone concentrations on day of peak blues score (P < 0.01). Seventy eight women were designated as having maternity blues (peak score > or = 8 on Stein scale) while 39 had no blues. Women with blues had significantly higher antenatal progesterone concentrations and lower postnatal concentrations than women without blues (geometric mean progesterone concentrations: one day before delivery 3860 pmol/l v 3210 pmol/l respectively, P = 0.03; ten days postpartum 88 pmol/l v 114 pmol/l, P = 0.048). Cortisol concentrations were not significantly associated with mood. CONCLUSION–Maternal mood in the days immediately after delivery is related to withdrawal of naturally occurring progesterone.

Licorice

Licorice belongs to a group of herbs known as adaptogens. They are herbs used during times of increased stress or convalescence to help the body cope with extreme changes. The effects of licorice in the body are diverse and include: antibacterial, anti-viral, demulcent or soothing qualities, antioxidant, and cholesterol and blood pressure-lowering. Glycerrhiza glabra, its more formal name, also mimics the action of cortisol in the body. Licorice has been combined with peony in a clinically studied formula that demonstrated testosterone-lowering and ovulation-inducing effects in women with PCOS. The study was published in the March/April 1994 issue of the International Journal of Fertility and Menopausal Studies, K. Takahashi.

Peony

The Chinese herb, Peonia lactiflora helps  in the treatment of gynecological conditions. Although frequently used and studied in China and Japan as an ingredient in complex traditional Chinese formulas, much of the herbs biological influence has been attributed to the constituent, paeoniflorin. Paeoniflorin is able to reduce levels of androgens, in a dose dependent manner. By reversing the body’s inhibition aromotase activity, in fat cells, the ovaries and hair follicles, peony can reduce the visible and systemic effects of excess testosterone. The aromatase enzyme is responsible for converting androgens into estrogens. It is widely distributed around the body, so by stimulating the activity of this enzyme, androgen levels are reduced and estrogen levels are increased. This can prove helpful in women with PCOS, as they are known to have lower than normal levels of estrogens as well.

Goat’s Rue

Goat’s rue, known more formally as Galega officinalis is the original source of the substance guanidine. Guanidine is the active ingredient in anti-diabetic drug class known as biguanides. Metformin, a drug belonging to the biguanide medication group, is commonly prescribed to women with PCOS. By controlling chronically high blood sugar levels, balancing insulin levels, and encouraging fat loss, Metformin consequently affects the levels of testosterone in women. The article, “Metformin,” published by Clifford Bailey, Ph.D., in the New England Journal of Medicine, details that goat’s rue was used to synthesize drugs like Metformin in the 1920′s. Goat’s Rue is still used by traditional herbalists today.

Rhonda K. Dailey, M.D., Anne Victoria Neale, Ph.D., M.P.H., Justin Northrup, M.P.T., Patricia West, Ph.D., R.N., Kendra L. Schwartz, M.D., M.S.P.H.

Abstract and Introduction

Abstract

Objectives: The four study objectives were to determine (1) the prevalence of use of four herbal product types promoted to reduce menopause symptoms (phytoestrogens, St. John’s wort, Ginkgo biloba, and ginseng) among primary care patients approaching or in menopause, (2) the extent to which women who use these types of herbal products report menopause related symptoms compared with herbal product nonusers, (3) the frequency of reported symptom reduction after use, and (4) if use was disclosed to their physicians.
Methods: A cross section of ethnically diverse women 40-55 years of age (35.5% African American, 60.2% Caucasian) who were recruited from eight primary care centers in Michigan to complete a self report survey. The questionnaire included demographic items, health history, recent use of four herbal product types purported to relieve menopause symptoms and perception of symptom improvement, and interest in additional herbal product information.
Results: Of 397 women, 24.9% reported taking, in the previous 6 months, at least one of the four study herbs. Herbal product use did not vary by patient demographics or health characteristics. Herbal product users reported more menopause symptoms than nonusers, and 68% of the users said that the herbs improved their symptoms; 56.4% said that their physician was aware of their herbal product use.
Conclusions: Primary care patients experiencing common menopausal symptoms are likely to use herbal products that are purported to provide menopause symptom relief, and many believe that these products improve their menopausal symptoms. Healthcare providers should be aware of patient’s positive attitude, use patterns, and lack of disclosure of use of herbal medicines. Inquiry of herbal product use is another way for physicians to learn about patient self medication of bothersome symptoms.

This study involved 110 late peri menopausal and early postmenopausal women. All of them were initially experiencing around 5 or more moderate to severe hot flashes or night sweats daily.

After 5 months, women who received mindfulness-based stress reduction training reported a 21% reduction in ‘bother’ caused by hot flashes.

Even though the intensity of hot flashes did not change throughout the study, women with mindfulness training saw improvements in quality of life, subjective sleep quality, and perceived stress.

According to the researchers, mindfulness can help women cope with sleep problems, stress and anxiety.

What Is Mindfulness?

The concept of mindfulness is simple.

It means paying attention in a particular way, on purpose, in the present moment, and non-judgmentally.

For example, when you are experiencing a hot flash, instead of being driven crazy by the sudden heat and heart palpitation, you accept this experience with equanimity, observe the physical sensations and acknowledge your responses to those sensations.

Improve Your Menopause Experience With Simple Techniques

If you keep a positive attitude and take a little preparation, you can deal with menopause much better and minimize the side effects of menopause.

Here are some tips to help you go through menopause with ease:

First of all, educate yourself on this subject. Mystery and misconceptions only add stress to your experience. Menopause is a natural part of life, just like toddlerhood and puberty.

Keep a positive attitude. We are what we think. Once you acknowledge that menopause is natural, and all the symptoms are just your hormones having a wild dance, you may be less reactive and stressed about the emotional and physical changes.

Exercise. Exercise is very beneficial for menopausal women. Regular and moderate exercises can keep you fit, both mentally and physically.

Take mindfulness training. As the study above shows, meditation technique can help ease hot flashes, night sweats and sleeplessness. Learn simple techniques such as breathing and yoga, you may be surprised with the changes to your state of mind and health.

Check out www.yestechnique.com

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Menopause is a natural step in a woman’s life cycle. Yet several body changes that accompany menopause pose problems for many women. Fortunately, lifestyle choices may help women diminish common concerns, like weight gain and hot flashes.

Reuters

Experience among women varies, but studies show that menopause is often linked to weight gain and a movement of fat from the thighs and hips to the waistline. Some women blame hormone replacement therapy (HRT), but studies show the opposite. HRT seems to lessen the shift of fat to the waist.

Women are right to be concerned about weight gain. A recent Finnish study found that each two pounds of weight gained during menopause raises the risk of high blood pressure five percent. Menopausal weight gain also raises the risk of diabetes and heart disease. Excess weight and weight gain in adulthood are both strongly linked to risk of breast and other hormone-related cancers after menopause.

Exercise and nutrition are key
Research shows that weight gain at menopause can be prevented or minimized. Weight gain at this time is often related to a drop in exercise level. To counter weight gain and weight shifts, women should keep physically fit with regular exercise. Strength-training exercise may offer special help in maintaining muscle mass and controlling weight.

A low fat, mostly plant-based diet is another aid. The American Institute for Cancer Research’s brochure The New American Plate is an excellent approach to weight management that stresses both portion control and balanced food choices.

Studies confirm the ability of exercise and healthful eating to help control menopausal weight gain. A recent five-year exercise and diet study found that 55 percent of the menopausal women participants could maintain or even lose weight. The program involved a moderate exercise routine that burned 1,000 to 1,500 calories per week. Brisk walking for 30 to 45 minutes, five days a week is one way to fulfill this goal. The women also ate a low fat diet that kept total calories low.

Hot flashes (or “hot flushes” as doctors call them) are another common menopause concern. A new Swedish study suggests that a vigorous exercise program and other steps to limit weight gain may reduce the tendency for hot flashes as a side benefit.

Bruner-Tran KL, Osteen KG, Taylor HS, Sokalska A, Haines K, Duleba AJ.

Source

Women’s Reproductive Health Research Center, Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.

Abstract

Endometriosis is a common gynecologic disorder characterized by ectopic attachment and growth of endometrial tissues. Resveratrol is a natural polyphenol with antiproliferative and anti-inflammatory properties. Our objective was to study the effects of resveratrol on human endometriotic implants in a nude mouse model and to examine its impact on human endometrial stromal (HES) cell invasiveness in vitro. Human endometrial tissues were obtained from healthy donors. Endometriosis was established in oophorectomized nude mice by intraperitoneal injection of endometrial tissues. Mice were treated with 17β-estradiol (8 mg, silastic capsule implants) alone (n = 16) or with resveratrol (6 mg/mouse; n = 20) for 10-12 and 18-20 days beginning 1 day after tissue injection. Mice were killed and endometrial implants were evaluated. A Matrigel invasion assay was used to examine the effects of resveratrol on HES cells. We assessed number and size of endometriotic implants in vivo and Matrigel invasion in vitro. Resveratrol decreased the number of endometrial implants per mouse by 60% (P < 0.001) and the total volume of lesions per mouse by 80% (P < 0.001). Resveratrol (10-30 μM) also induced a concentration-dependent reduction of invasiveness of HES by up to 78% (P < 0.0001). Resveratrol inhibits development of endometriosis in the nude mouse and reduces invasiveness of HES cells. These observations may aid in the development of novel treatments of endometriosis.

Biol Reprod. 2011 Jan;84(1):106-12. Epub 2010 Sep 15.