[Non-hormonal alternatives for the management of menopausal hot flushes. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. / Alternatives non hormonales de prise en charge des bouffées vasomotrices post-ménopausiques. RPC Les femmes ménopausées du CNGOF et du GEMVi.

One of the major symptoms of climacteric syndrome is hot flushes (HF). They are most often experienced as very disabling. Estrogen therapy is the most effective treatment. However, it may be contraindicated in some women. The aim of this article is to provide a review of the scientific literature on pharmacological and non-pharmacological alternatives in this context. Only randomized trials and meta-analyses of randomized trials were considered. This review shows that some treatments usually used in non-gynecological or endocrinological disease have significant effect in reducing the frequency and/or severity of HF. Hence, some selective serotonin reuptake inhibitors (paroxetine, citalopram and escitalopram), serotonin and norepinephrine reuptake inhibitors (venlafaxine, desvenlafaxine) gabapentin, pregabalin and clonidine have a statistically effect as compared with placebo in reducing, the frequency and/or severity of HF. Some phytoestrogens, such as genistein, may also reduce the frequency of HF. Regarding non-pharmacological interventions, hypnosis, acupuncture or yoga have been analyzed with significant beneficial results, even if their evaluation is difficult by the absence of a good placebo group in most trials. By contrast, other approaches, both pharmacological or non-pharmacological, appear to be ineffective in the management of HT. These include homeopathy, vitamin E, alanine, omega 3, numerous phytoestrogens (red clover, black cohosh…), primrose oil, physical activity. In women suffering from breast cancer, several additional problems are added. On the one hand because all phytoestrogens are contraindicated and on the other hand, in patients using tamoxifen, because the molecules, that interact with CYP2D6, are to be formally avoided because of potential interaction with this anti-estrogen treatment. In conclusion, several pharmacological and non-pharmacological alternatives have significant efficacy in the management of severe HF.

Multimorbidity After Surgical Menopause Treated with Individualized Classical Homeopathy: A Case Report.

Classical homeopathy was shown to be beneficial in climacteric syndrome in many studies, but the clinical effect is unclear. To inspect if individualized classical homeopathy has a role in treating complaints after surgical menopause through real world case, we present a case of a 54-year-old Russian woman treated with individualized classical homeopathy for multimorbid conditions after surgical menopause examined for changes from homeopathic treatment. We assessed changes in climacteric symptoms, changes in comorbidities, and the general well-being of the patient. The woman had severe climacteric syndrome, pelvic inflammatory disease, dyslipidemia, obesity, hepatic steatosis, pancreatic lipomatosis, gall bladder disease, and mild subclinical hypothyroidism to begin with. She was treated with individualized classical homeopathy and followed up for 31 months. She was relieved of the vasomotor symptoms and psychological disturbances of climacteric syndrome, her weight reduced, the ultrasound scan showed absence of lipomatosis/gall bladder disease/hepatic steatosis. Blood tests showed reduction of thyroid stimulating hormone and a balance in the lipid status. Individualized classical homeopathy may have a role in the climacteric syndrome and comorbidities after surgical menopause. The efficacy of homeopathic therapy in climacteric problems must be scientifically investigated further.

The use of homeopathy and flower therapy as an aid in the treatment of climacteric symptoms: an integrative review

Climacteric is characterized as the set of symptoms that usually start in the period of transition from the reproductive phase to female senility, and directly impacts woman's quality of life. Currently, the treatments approved by the FDA for this pathology mainly involve the use of antidepressants and hormone replacement, both having side effects. Clinical studies carried out in 2002, showed an increased risk of breast cancer, and other pathologies related to the prolonged use of these drugs. The impact ofthe studies resulted in a greater interest in complementary and alternative medicines (CAMs), such as the use of homeopathy and flower remedies for the treatment of climacteric symptoms. This abstract aims to present an integrative review on the use of homeopathy and flower remedies in the treatment of climacteric symptoms, in order to identify it main scientific evidence. For this, metodology consisted of research in the databases Web of Science, Google Scholar, HomeoIndex, LILACS and SciELO. The inclusion criteria were original human studies, totally available, and published in the last 10 years in Portuguese, English and Spanish, presenting the use of floral remedies or homeopathic treatment. The main homeopathic medicines used were Lachesis mutus, Belladona, Sepia officinalis, Sanguinaria canadensis and Sulfur. The main flower remedies were Cherry plum, Agrimony, Gentian, Walnut, Olive and Larch. The findings in this review demonstrate a positive outcome trend in favor of the effectiveness of these practices through the studies evaluated, encouraging the expansion of new designs and research that fully contemplate the principles of these practices. Thus, this work contributes to the advancement in the understanding of each one of these rationalities, making this work a source of consultation for health professionals and for future research, resulting in a strengthening of CAMs in the field of health.

Medicamentos homeopáticos en el tratamiento del climaterio y la menopausia: una revisión / Homeopathic medicinal products in the treatment of climateric and menopause: a review

RESUMEN Durante el climaterio y la menopausia debido a cambios hormonales pueden presentarse en las mujeres síntomas que afectan la calidad de vida y las relaciones interpersonales. La homeopatía puede ser utilizada como terapia alternativa o complementaria en el manejo de sus síntomas proporcionando múltiples beneficios, escasos efectos secundarios, ahorro de recursos y apertura de una nueva línea para investigar. La bibliografía sobre este tema es insuficiente y se encuentra dispersa lo que dificulta la consulta por parte de los profesionales que la necesitan. Se realizó una revisión bibliográfica con el objetivo de identificar y describir los principales medicamentos homeopáticos que pueden ser utilizados para tratar los síntomas durante el climaterio y la menopausia. Los artículos se identificaron básicamente a través de la búsqueda automatizada en las bases de datos Scielo, PubMed y EBSCO, entre los meses de enero de 2017 a mayo de 2018. Se revisaron aquellos libros y artículos que por su trascendencia fueron considerados como referentes en el tema. Se escogieron 26 referencias bibliográficas que se ajustaban a los objetivos de esta investigación. Fueron identificados y descritos 22 medicamentos homeopáticos susceptibles de ser utilizados en el tratamiento de los síntomas de climaterio y menopausia por lo que puede ser una fuente útil de consulta (AU).

ABSTRACT During the climacteric and menopause, due to hormonal changes, women may present symptoms affecting life quality and interpersonal relations. Homeopathy could be used as an alternative or complementary therapy in the management of those symptoms, providing several benefits, scarce secondary effects, saving resources and opening a new research field. There is not enough bibliography on this topic and it is dispersed, making it difficult for the professional to consult it when it is necessary. A bibliographic review was carried out with the objective of identifying and describing the main homeopathic medicinal products that could be used to treat the symptoms during the climacteric and menopause. The articles were identified mainly through an automated search in Scielo, PubMed and EBSCO databases, in the period from January 2017 and May 2018. Those books and articles considered as referents in the topic because of their transcendence were reviewed. 26 bibliographic references were chosen because they complied with the objective of this research. 20 homeopathic medicinal products capable of being used in the treatment of the climacteric and menopause symptoms were identified and described, being therefore a useful consultation source (AU).

Envelhecimento: combatê-lo ou compreendê-lo?: O climatério como exemplo / Aging: fight it or understand it?: The climacteric as an example

Enquanto aumenta a expectativa de vida, também cresce a preocupação com a qualidade de vida na velhice. Para muitos, o envelhecimento está associado a aspectos negativos como inatividade, doenças, necessidade de cuidados, além de não encontrarem significado nessa fase da vida. Rudolf Steiner considerava que as mesmas forças vitais empenhadas no crescimento e desenvolvimento orgânicos são as que dão sustentação ao pensamento. Assim, a antroposofia considera que há uma metamorfose das forças que promovem o crescimento em forças do pensamento. Da mesma forma, há uma metamorfose no processo do envelhecimento: as forças vitais se desprendem paulatinamente dos órgãos e ficam disponíveis para o desenvolvimento ou o fortalecimento de algumas habilidades. O exemplo do sentido da audição, metamorfoseado em percepção da verdade é citado. De modo marcante, as ondas de calor no climatério (fogachos) caracterizam forças vitais que se desprendem dos ovários e não encontram destino ou utilidade, causando mal-estar à mulher nessa fase da vida. Mas as mulheres descendentes dos maias, no Yucatán (México), não têm a experiência dos fogachos após a menopausa. Para essa sociedade, envelhecer significa evoluir, ganhar posição superior no status social. Além disso, elas tecem e bordam desde jovens e assim continuam a criar, mesmo após o término do período fértil, usando as forças vitais que se desprendem dos ovários. Ao usar a terapia de reposição hormonal, a mulher terá suas forças vitais artificialmente presas aos órgãos, impedindo que a metamorfose citada aconteça. Então, trata-se de uma necessidade de nossa época encontrar uma nova perspectiva para o envelhecimento, pautada pela compreensão da metamorfose das forças vitais no ser humano.(AU)

While the life expectancy increases, there is also a growing concern about the quality of life in old age. For many, aging is associated with negative aspects such as inactivity, illness, need for care and lack of meaning in this stage of life. Rudolf Steiner considered that the same vital forces engaged in organic growth and development, are those that support the thought. Thus, anthroposophy considers that there is a metamorphosis of growth forces into thinking forces. In the same way, there is a metamorphosis in the process of aging: the vital forces gradually detach from the organs and they become available for the development or the strengthening of some abilities. The example of the sense of hearing, metamorphosed into the perception of truth is cited. Significantly, the hot flushes in the climacteric characterize vital forces that are released from the ovaries and do not find a destiny or a utility, causing discomfort to the woman in this phase of life. But the women descendants of the Maya, in the Yucatán (Mexico), do not experience the hot flashes after the menopause. For this society, aging means to progress, to gain a superior position in social status. In addition, they weave and embroider since youth and thus they continue to create, even after the end of the fertile period, using the vital forces that are released from the ovaries. The hormone replacement therapy artificially attaches the vital forces to the organs, and impedes the event of the mentioned metamorphosis. Therefore, finding a new perspective for aging is a necessity of our time, based on the understanding of vital forces metamorphosis in the human being.(AU)

Un enfoque médico de la perimenopausia. Episodio importante de la vida femenina / A medical approach to perimenopause. An important episode in female life

Un artículo que data de hace 20 años le recuerda a la comunidad médica que hay una gran desinformación en torno a la perimenopausia, la menopausia y el climaterio, etapas en las que se encuentran millones de mujeres que enfrentan, por increíble que parezca, un estigma social generado a partir de algunos de los síntomas propios de la disminución hormonal en su organismo.No todo resuelve con las terapias de reemplazo hormonal ni con la indiscriminada administración de estrógenos, ya que la transición fisiológica de la mujer a partir del cese de la mestruación presenta una sintomatología individual, interpreta la doctora María Eugenia Pulido Álvarez, una de las investigadroas y catedráticas más prestigiadas en la historia de la medicina homeópata nacional e internacional.Este trabajo describe los efectos más frecuentes generados por los bajos niveles de estrógeneos y define cuáles son los tratamientos convencionales, al tiempo uqe enfatiza que la homeopatía puede se muy útil en esta etapa si forma parte de una "estrategia que comprenda, además de la medicación, una alimentación adecuada, así como actividades y ejercicio regular".La homeopatía, refiere la doctora Pulido Álvarez, es una excelente opción para equilibrar los síntomas psíquicos y somáticos, y es aplicable en microdosis de rango conocido a todas las mujeres sin que exista riesgo alguno para su salud.(AU)

An article dating back 20 yeras reminds the medical community that there is a great deal of disinformation about perimenopause, menopause and climateric stages in which millions of women face, as incredible as it may seem, a social stigma generated from some of the symptoms of the hormonal decline in their body.Not everything is solved with hormone replacement therapies or with the indiscriminate administration of estrogens, since the physiological transition of the woman form the cessation of menstruation presents an individual symptomatology, interprets Dr. María Eugenia Pulido Álvarez, one of the researchers and most prestigious professors in the history of national and international homeopathic medicine.This paper describes the most frequent effects generated by low estrogen leves and defines the conventional treatments, while emphasizing that homeopathy can be very useful at this stage if it is part of a "strategy that includes, in addition to medication, adequate food, as well as activities and regular exercise".Homeopathy, says Pulido Álvarez, is an excellent option to balance psychic and somatic symptoms,a nd iss applicable in microdosis of known range to all women without anu risk to their health.(AU)

Alternativas para o tratamento não hormonal de mulheres no climatério / Alternatives to non-hormonal treatment of climacteric women

Objetivo: Analisar as opções de tratamento não hormonal da mulher climatérica. Material e método: Estudo e análise dos trabalhos e capítulos de livro que mostrem avaliação adequada das opções de tratamento não hormonal das mulheres climatéricas, considerando as indicações, benefícios e tolerabilidade com os diferentes tratamentos. Resultados e conclusões: A revisão apresentou evidências de que medidas gerais (dieta, atividade física e ocupacional) são recomendáveis para todas as mulheres climatéricas. Para alívio dos sintomas vasomotores, o tratamento com mais índices de sucesso é realizado com antidepressivos, outras opções como cinarizina ou hipotensores podem beneficiar secundariamente as mulheres que devam utilizá-los por indicações clínicas. A fitoterapia, acupuntura e homeopatia ainda não apresentam evidências conclusivas...