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1.
BMC Complement Med Ther ; 23(1): 388, 2023 Oct 27.
Article in English | MEDLINE | ID: mdl-37891531

ABSTRACT

BACKGROUND: Hot flashes are the common and debilitating symptom among prostate cancer (PCa) patients undergoing androgen deprivation therapy (ADT). Strong evidence from multiple rigorously designed studies indicated that pharmacological option such as venlafaxine provides partial relief, but the tolerability is poor when dose is not tapered. Hence, alternative therapy is needed. Previous studies reported that acupuncture may be helpful in the management of hot flashes. However, the insufficient randomized controlled trial limited the quality of evidence. METHODS: Five hospitals will recruit 120 acupuncture naïve patients with moderate-to-severe hot flashes after prostate cancer received ADT in China from February 2023 to December 2024. Participants will be randomly 2:1:1 allocated to the 18 sessions of verum acupuncture at true acupuncture points plus usual care, 18 sessions of non-penetrating sham acupuncture at non-acupuncture points plus usual care, or usual care alone over 6 weeks. The primary outcome measure is the change of mean weekly hot flashes symptom severity score (HFSSS) at the end of treatment compared with baseline. EXPECTED RESULTS AND CONCLUSION: We will be able to measure the effectiveness of acupuncture for patients with PCa suffering from ADT-induced hot flashes and whether acupuncture is superior to sham acupuncture and usual care. The proposed acupuncture treatment might provide an alternative option for those patients. TRIAL REGISTRATION: Clinicaltrials.gov (NCT05069467).


Subject(s)
Acupuncture Therapy , Prostatic Neoplasms , Male , Humans , Hot Flashes/etiology , Hot Flashes/therapy , Androgen Antagonists/adverse effects , Prostatic Neoplasms/drug therapy , Acupuncture Therapy/methods , Acupuncture Points , Randomized Controlled Trials as Topic
2.
Menopause ; 30(6): 573-590, 2023 06 01.
Article in English | MEDLINE | ID: mdl-37252752

ABSTRACT

OBJECTIVE: To update the evidence-based Nonhormonal Management of Menopause-Associated Vasomotor Symptoms: 2015 Position Statement of The North American Menopause Society. METHODS: An advisory panel of clinicians and research experts in women's health were selected to review and evaluate the literature published since the Nonhormonal Management of Menopause-Associated Vasomotor Symptoms: 2015 Position Statement of The North American Menopause Society. Topics were divided into five sections for ease of review: lifestyle; mind-body techniques; prescription therapies; dietary supplements; and acupuncture, other treatments, and technologies. The panel assessed the most current and available literature to determine whether to recommend or not recommend use based on these levels of evidence: Level I, good and consistent scientific evidence; Level II, limited or inconsistent scientific evidence, and Level III, consensus and expert opinion. RESULTS: Evidence-based review of the literature resulted in several nonhormone options for the treatment of vasomotor symptoms. Recommended: Cognitive-behavioral therapy, clinical hypnosis, selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors, gabapentin, fezolinetant (Level I); oxybutynin (Levels I-II); weight loss, stellate ganglion block (Levels II-III). Not recommended: Paced respiration (Level I); supplements/herbal remedies (Levels I-II); cooling techniques, avoiding triggers, exercise, yoga, mindfulness-based intervention, relaxation, suvorexant, soy foods and soy extracts, soy metabolite equol, cannabinoids, acupuncture, calibration of neural oscillations (Level II); chiropractic interventions, clonidine; (Levels I-III); dietary modification and pregabalin (Level III). CONCLUSION: Hormone therapy remains the most effective treatment for vasomotor symptoms and should be considered in menopausal women within 10 years of their final menstrual periods. For women who are not good candidates for hormone therapy because of contraindications (eg, estrogen-dependent cancers or cardiovascular disease) or personal preference, it is important for healthcare professionals to be well informed about nonhormone treatment options for reducing vasomotor symptoms that are supported by the evidence.


Subject(s)
Hot Flashes , Menopause , Female , Humans , Hot Flashes/drug therapy , Hot Flashes/etiology , Estrogens , Estrogen Replacement Therapy/methods , North America
3.
Gynecol Endocrinol ; 39(1): 2162035, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36591791

ABSTRACT

OBJECTIVE: Effective management of vasomotor symptoms (VMS) in patients undergoing treatment for breast cancer (BC) represents a critical but frequent unmet need. This review summarizes the epidemiology, pathophysiology, and clinical features of VMS in patients with BC and provides a synopsis of the complementary and alternative medicine (CAM) approaches in relieving VMS with a focus on purified cytoplasm of pollen (PCP). METHODS: The literature on VMS epidemiology, pathophysiology, clinical burden, and CAM treatment in healthy women and patients with BC was reviewed. RESULTS: VMS are common in patients with BC undergoing hormonal treatment and negatively impact quality of life, leading to treatment discontinuation in up to 25% of patients with detrimental impact on risk of BC recurrence and overall survival. CAM approaches to treat VMS in patients with BC include vitamin E, phytoestrogens, and black cohosh, even if there is a lack of solid evidence to guide clinicians in the choice of treatment. PCP, obtained according to standards of good manufacturing practice, has a definite pharmacological mechanism of action, is devoid of estrogen activity, and has shown clinical efficacy on menopause-associated symptoms with a favorable safety profile and high compliance. As such, it appears to represent a valid management option to improve quality of life in patients with pre- and postmenopausal BC. CONCLUSIONS: Physicians should actively investigate the presence and impact of VMS in patients receiving therapy for BC. Additional and appropriately sized randomized clinical trials are needed to provide clear evidence on how to best meet the needs of patients with BC suffering from menopause-associated symptoms.


Subject(s)
Breast Neoplasms , Female , Humans , Breast Neoplasms/therapy , Breast Neoplasms/drug therapy , Hot Flashes/drug therapy , Hot Flashes/etiology , Quality of Life , Neoplasm Recurrence, Local , Menopause/physiology , Cytoplasm , Pollen
4.
Gynecol Endocrinol ; 38(5): 379-384, 2022 May.
Article in English | MEDLINE | ID: mdl-35403534

ABSTRACT

OBJECTIVE: The increasing interest in Western countries regarding phytotherapy use to treat menopause-related symptoms has led the Spanish Menopause Society (AEEM) to update its position statement performed in 2009 on the role of black cohosh (Cimicifuga racemosa) for the treatment of menopausal symptoms. MATERIAL AND METHODS: A panel of experts from both clinical and research backgrounds were assembled to investigate the best available evidence. Selected studies were obtained by an electronic search, including the Internet search engines MEDLINE-Pubmed (1997-December 2021) and the Cochrane Controlled Trials Register. RESULTS: Most of the well-designed studies published in recent years have been conducted with the isopropanolic extract of black cohosh/C. racemosa. The most common dose is 40 mg/day capable of achieving a significant reduction in hot flushes (particularly in women with intense hot flushes) and an improvement in mood. Used at the recommended doses, C. racemose produces no significant adverse reactions. CONCLUSION: Black cohosh is an effective and safe treatment option for the relieving of vasomotor symptoms. Finally, further clinical trials with sufficient patient enrollment and longer study follow-up are needed.


Subject(s)
Cimicifuga , Cimicifuga/adverse effects , Female , Hot Flashes/drug therapy , Hot Flashes/etiology , Humans , Menopause , Phytotherapy , Plant Extracts/pharmacology , Plant Extracts/therapeutic use
5.
Support Care Cancer ; 30(6): 5063-5074, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35247073

ABSTRACT

PURPOSE: While clinical trials provide valuable data about efficacy of interventions, findings often do not translate into clinical settings. We report real world clinical outcomes of a 15-year service offering breast cancer survivors auricular acupuncture to manage hot flushes and night sweats (HFNS) associated with adjuvant hormonal treatments. This service evaluation aims to (1) assess whether usual practice alleviates symptoms in a clinically meaningful way and (2) compare these results with scientific evidence. METHODS: Data were analysed from 415 referrals to a service offering women eight standardised treatments using the National Acupuncture Detoxification Association (NADA) protocol. Outcome measures administered at baseline, end of treatment (EOT), and 4 and 18 weeks after EOT included hot flush diaries, hot flush rating scale (HFRS) and women's health questionnaire (WHQ). RESULTS: Over 2285 treatments were given to 300 women; 275 (92.3%) completed all eight treatments. Median daily frequency of HFNS reduced from 9.6 (IQR 7.3) to 5.7 (IQR 5.8) at EOT and 6.3 (IQR 6.5) 18 weeks after EOT. HFRS problem rating showed a clinically meaningful reduction of ≥ 2 points at all measurement points. WHQ showed improvements in several symptoms associated with the menopause. Two adverse events were reported, neither were serious. Results are comparable to published research. CONCLUSION: This first analysis of a long-term auricular acupuncture service compares favourably with outcomes of other studies for reducing HFNS frequency and associated menopausal symptoms. In day-to-day clinical practice, NADA appears to be a safe effective intervention for breast cancer survivors.


Subject(s)
Acupuncture Therapy , Acupuncture, Ear , Breast Neoplasms , Cancer Survivors , Female , Humans , Male , Acupuncture Therapy/methods , Breast Neoplasms/complications , Breast Neoplasms/drug therapy , Hot Flashes/etiology , Hot Flashes/therapy , Menopause , Sweat , Sweating
6.
Acupunct Med ; 40(4): 333-338, 2022 08.
Article in English | MEDLINE | ID: mdl-34892982

ABSTRACT

BACKGROUND: People have been teaching self-acupuncture (SA) in the United Kingdom since 1977. More recently, a small body of research has been conducted on SA. However, detailed guidelines on teaching and delivery of SA have so far, to our knowledge, not been developed. METHODS: Acupuncturists were invited to participate in an online survey about their experiences of teaching SA. Data from the survey were extracted, analysed using descriptive statistics and translated into SA teaching guidelines. RESULTS: One hundred thirty-eight acupuncturists completed the survey. Nineteen percent of participants had taught SA. The most common symptoms for which acupuncturists taught SA were pain, nausea, anxiety, hot flushes, headaches/migraines and breathlessness. The six most commonly taught traditional acupuncture point locations were LI4, ST36, SP6, PC6, LR3 and TE5. No participants had received reports of adverse effects from their patients. CONCLUSION: Acupuncturists who teach SA find it to be an acceptable and safe option for patients. The presented data have important implications for guiding the practice of SA.


Subject(s)
Acupuncture Therapy , Acupuncture , Acupuncture/education , Acupuncture Points , Acupuncture Therapy/adverse effects , Hot Flashes/etiology , Humans , Surveys and Questionnaires
7.
Expert Opin Drug Saf ; 21(2): 215-221, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34304686

ABSTRACT

INTRODUCTION: Menopausal complaints are a critical aspect of women's lives. In particular vasomotor symptoms, such as hot flashes, may seriously impact quality of life and are considered the most bothersome complaint by patients. Although Menopausal Hormone Therapy (MHT) is considered the best option, women increasingly ask for a natural and more tailored treatment approach. AREAS COVERED: Nutraceutical compounds represent the most widespread alternative therapy for vasomotor symptoms, and their use is somewhat increasing. In this review, the authors analyzed the mechanism of action and the related safety of non-hormonal treatments, including new approaches and future aspects. EXPERT OPINION: MHT represents the traditional therapy for menopausal complaints, especially for severe and moderate symptoms; however, evidence has not defined a safety profile for all patients. To address this issue, nutraceuticals could represent a compelling and useful non-hormonal approach in selected patients.


Subject(s)
Dietary Supplements/adverse effects , Hot Flashes/therapy , Menopause , Animals , Female , Hormone Replacement Therapy/adverse effects , Hormone Replacement Therapy/methods , Hot Flashes/etiology , Humans , Quality of Life
8.
Biomed Res Int ; 2021: 9979511, 2021.
Article in English | MEDLINE | ID: mdl-34825005

ABSTRACT

METHODS: The subjects included 13 PI patients from the Hubei Provincial Hospital of TCM, Hubei University of TCM, and Wuhan Traditional Chinese Medicine Hospital, and the corresponding noninsomniac spouses of the patients were selected as controls. TWBXG was continuously administered for 4 weeks. The feces of PI patients and their noninsomniac spouses before and after treatment with TWBXG were collected. The intestinal flora composition of each group was detected by metagenomic sequencing, and the efficacy of TWBXG was evaluated by the PSQI scale. RESULTS: Compared with the control group, the model group showed an increase in the abundance of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, and Blautia obeum, while those of Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii were decreased. Compared with pretreatment, the PSQI score was significantly reduced (P < 0.05), the abundance of Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii increased, and that of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, and Blautia obeum decreased after treatment. However, there was still a certain gap in the abundance of related flora in the treatment group compared with the control. CONCLUSION: PI is associated with disturbances in the intestinal flora and is mainly related to the disorders of Roseburia faecis, Ruminococcus, Prevotella copri, Fusicatenibacter saccharivorans, Blautia obeum, Bacteroides, fecal Bacteroidetes, and Faecalibacterium prausnitzii. TWBXG can effectively treat PI, and its effect may be achieved by regulating the disordered intestinal flora. Clinical Trials. The study was registered in the Chinese clinical trial registry and approved by the World Health Organization clinical trial registration platform (Effects of the modified Tianwang Buxin granule and modified Tianwang Buxin decoction pieces on insomnia: a randomized, controlled trial, ChiCTR-IPR-17011549).


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Gastrointestinal Microbiome/drug effects , Perimenopause , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/microbiology , Adult , Case-Control Studies , Drugs, Chinese Herbal/administration & dosage , Female , Gastrointestinal Microbiome/genetics , Hot Flashes/drug therapy , Hot Flashes/etiology , Hot Flashes/microbiology , Humans , Male , Middle Aged , Phytotherapy , Sleep Initiation and Maintenance Disorders/etiology
9.
Breast Cancer Res Treat ; 188(2): 343-350, 2021 Jul.
Article in English | MEDLINE | ID: mdl-34159473

ABSTRACT

PURPOSE: Vasomotor symptoms (VMS) such as hot flashes and night sweats are common in breast cancer patients and can affect both quality of life and treatment adherence. However, there is limited practical data to guide clinicians in the optimal selection of therapeutic strategies. A survey of health care providers was performed to better understand perspectives and prescribing practices for managing this problem. METHODS: Canadian health care providers who treat patients with early stage breast cancer (EBC) participated in an anonymous electronic survey. Participants provided their perspectives on the prevalence and severity of VMS among patients with EBC, outlined their management strategies, and provided feedback on the perceived efficacy of interventions for VMS. RESULTS: Responses were received from 65 providers including breast oncologists (36/65, 55%) and nurses with oncology expertise (29/65, 45%). Seventy-seven percent of participants reported regularly asking patients about VMS, and most indicated that bothersome VMS occurred in the majority of patients. Health care providers cited hot flash severity and sleep disruption as the most important issues for patients. The most common first- and second-line interventions recommended were lifestyle modifications (n = 32/65, 49.2%) and pharmacologic strategies (n = 27/65, 41.5%), respectively. Most respondents felt that interventions, including pharmacologic, over-the-counter, and complementary therapies, were only "somewhat effective". Overall, half of respondents (n = 35/65, 54%) reported being "confident" in managing VMS. CONCLUSION: Given the variability of treatment recommendations, and health care provider uncertainty around the benefits of therapies for VMS, more 'real-world' trials are needed to optimize patient care.


Subject(s)
Breast Neoplasms , Menopause , Breast Neoplasms/drug therapy , Breast Neoplasms/epidemiology , Canada , Female , Health Personnel , Hot Flashes/epidemiology , Hot Flashes/etiology , Hot Flashes/therapy , Humans , Quality of Life , Surveys and Questionnaires , Sweating
10.
Nutr Hosp ; 38(3): 568-574, 2021 Jun 10.
Article in Spanish | MEDLINE | ID: mdl-33752438

ABSTRACT

INTRODUCTION: Introduction: in women with breast cancer and gynecologic cancer, as well as in men with prostate carcinoma, hot flashes, asthenia, and insomnia are common and bothersome symptoms that impair quality of life. Objective: to evaluate the effectiveness of tryptophan intake as a treatment for hot flushes, asthenia, and insomnia in patients with prostate, breast, and uterine cervical cancer. Materials and methods: intervention study without a control group at the HUCA Radiation Oncology Service, from July 2018 to July 2019. A total of 60 patients with prostate, breast, or uterine cervical cancer who had received treatment with radiotherapy and hormone therapy, and who presented with hot flushes, asthenia, and insomnia were included. L-tryptophan was administered at a dose of 3 g per day. Results: a significant increase in serum tryptophan levels at the end of the study (p < 0.001) and a significant decrease in the scores of the study symptoms were reported. Although statistical significance was not found, a significant improvement in each symptom was observed, as well as an improvement in quality of life (p < 0.001). Conclusions: the study suggests that, in patients with breast, prostate, or uterine cervical cancer, and symptoms such as hot flushes, asthenia, and insomnia, the administration of tryptophan as a nutritional supplement is well tolerated, improves quality of life, and is associated with improvement in the scale scores of the symptoms of interest, although no statistically significant relationship with increased blood tryptophan levels was found.


INTRODUCCIÓN: Introducción: tanto en las mujeres con cáncer de mama y cáncer ginecológico como en los hombres con carcinoma prostático, los sofocos, la astenia y el insomnio son síntomas frecuentes y molestos que alteran la calidad de vida. Objetivo: evaluar la eficacia del aporte de triptófano como tratamiento de los sofocos, la astenia y el insomnio en pacientes con cáncer de próstata, de mama y cervicouterino. Materiales y métodos: estudio de intervención sin grupo de control en el Servicio de Oncología Radioterápica del HUCA, en el período de julio de 2018 a julio de 2019. Se incluyeron en total 60 pacientes con cáncer de próstata, de mama y cervicouterino que habían recibido tratamiento con radioterapia y hormonoterapia, y que presentaban sofocos, astenia e insomnio. Se administraron 3 g de L-triptófano al día. Resultados: se reportan un aumento significativo del valor del triptófano sérico al final del estudio (p < 0,001) y una disminución significativa de las puntuaciones de los síntomas estudiados; aunque no hemos hallado ninguna significación estadística entre ellos, sí se aprecia una mejoría significativa de cada uno de los síntomas, así como una mejoría de la calidad de vida (p < 0,001). Conclusiones: el estudio actual sugiere que, en los pacientes con cáncer de mama, de próstata o cervicouterino y síntomas de sofocos, astenia e insomnio, el aporte de triptófano como suplemento nutricional se tolera bien, mejora la calidad de vida y puede asociarse a una mejoría de los valores obtenidos en las escalas de los síntomas referidos, aunque no se demuestra ninguna relación estadísticamente significativa con la elevación del triptófano en sangre.


Subject(s)
Asthenia/drug therapy , Asthenia/etiology , Breast Neoplasms/complications , Dietary Supplements , Hot Flashes/drug therapy , Hot Flashes/etiology , Prostatic Neoplasms/complications , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/etiology , Tryptophan/therapeutic use , Uterine Cervical Neoplasms/complications , Female , Humans , Male , Quality of Life , Treatment Outcome
12.
Climacteric ; 24(2): 128-138, 2021 04.
Article in English | MEDLINE | ID: mdl-33112163

ABSTRACT

Despite literature pointing to a relation between dietary intake and menopausal symptoms, most studies have evaluated either only supplements or only specific nutrients or foods. Therefore, this study aimed to provide a systematic review of the literature regarding the association between dietary intake and menopausal symptoms in postmenopausal women. A systematic search was conducted across PubMed/Medline, Web of Science, Scopus, and Embase to identify studies published between 2009 and 2019. We identified 3828 studies; after screening, 73 studies were reviewed and 19 of these investigated nutrient and food intake and eating patterns associated with the intensity of menopausal symptoms. Studies evaluating diet quality or dietary patterns showed an association between lower intensity of psychological symptoms, sleep disorders, and vasomotor, urogenital, and somatic symptoms and higher consumption of vegetables, whole grains, and unprocessed foods. Also, the intensity of these symptoms is associated with high-processed foods, saturated fats, and sugars. Regarding nutrient and/or specific food, the studies indicated an association between caffeine intake and type of fat intake and the intensity of menopausal symptoms. Dietary intake was found to be associated with the severity of menopausal symptoms; however, evidence for the association between dietary intake and menopausal symptoms is inconsistent and inconclusive, and is provided by a small number of studies.


Subject(s)
Diet/adverse effects , Eating , Postmenopause , Diet Surveys , Female , Hot Flashes/etiology , Humans , Middle Aged , Severity of Illness Index
13.
Rev Esc Enferm USP ; 54: e03609, 2020 Sep 07.
Article in Portuguese, English | MEDLINE | ID: mdl-32901659

ABSTRACT

OBJECTIVE: To analyze scientific evidence in the literature on the use of auriculotherapy to relieve symptoms related to cancer and/or its treatment. METHOD: An integrative literature review based on: MEDLINE, CINAHL, LILACS, SCOPUS and COCHRANE in the last five years in English, Portuguese and Spanish. Inclusion criteria primary studies with the central theme. Exclusion criteria opinion articles, reviews and experience reports. RESULTS: The search resulted in 435 publications, but only 11 remained after applying four selection stages. An analysis of the study designs showed that three of them (27.5%) had a high level of evidence, three (27.5%) had moderate, four (36%) had low and one (9%) had a very low level. The evaluated outcomes were related to the following symptoms: pain, constipation, nausea and vomiting, hot flashes, dyspnea, fatigue and insomnia. Moreover, 100% of the publications exposed positive effects of auriculotherapy in oncology. CONCLUSION: Auriculotherapy in cancer patients improves symptoms, and this practice was considered a safe and acceptable intervention. However, it is necessary to expand studies to obtain more favorable evidence since only 3 studies presented a high level of evidence.


Subject(s)
Auriculotherapy , Neoplasms/therapy , Cancer Pain , Constipation/etiology , Dyspnea/etiology , Fatigue/etiology , Hot Flashes/etiology , Humans , Nausea/etiology , Neoplasms/complications , Sleep Initiation and Maintenance Disorders/etiology , Vomiting/etiology
15.
Oncol Nurs Forum ; 47(4): 374-399, 2020 Jul 01.
Article in English | MEDLINE | ID: mdl-32555554

ABSTRACT

PURPOSE: Hot flashes are a common and troublesome side effect of surgery or endocrine therapy. They may lead to physical and psychological distress and negatively affect quality of life. This clinical practice guideline presents evidence-based recommendations for pharmacologic, behavioral, and natural health product interventions for treatment-related hot flashes in patients with breast or prostate cancer. METHODOLOGIC APPROACH: An interprofessional panel of healthcare professionals with patient representation prioritized clinical questions and patient outcomes for the management of hot flashes. Systematic reviews of the literature were conducted. The GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach was used to assess the evidence and make recommendations. FINDINGS: The panel agreed on 14 pharmacologic, behavioral, and natural health recommendations. IMPLICATIONS FOR NURSING: Conditional recommendations include the use of antidepressants rather than no treatment, physical activity rather than no treatment, and the avoidance of gabapentin and dietary supplements in the treatment of hot flashes. SUPPLEMENTARY MATERIAL CAN BE FOUND AT&NBSP;HTTPS: //onf.ons.org/ons-guidelines-hot-flashes-supplementary-material.


Subject(s)
Antidepressive Agents/standards , Biological Products/standards , Breast Neoplasms/complications , Exercise Therapy/standards , Hot Flashes/etiology , Hot Flashes/therapy , Practice Guidelines as Topic , Prostatic Neoplasms/complications , Adult , Aged , Aged, 80 and over , Antidepressive Agents/therapeutic use , Biological Products/therapeutic use , Female , Humans , Male , Middle Aged
16.
PLoS One ; 14(9): e0222383, 2019.
Article in English | MEDLINE | ID: mdl-31536531

ABSTRACT

OBJECTIVES: This systematic review aimed to evaluate the therapeutic effects and safety of Chinese herbal medicine (CHM) formulae for managing menopausal hot flushes (MHF). METHODS: Seven English and Chinese databases were searched for studies from respective inceptions to February 2019. Randomized controlled trials investigating the clinical effects and safety of CHM formulae on MHF were considered for inclusion. The outcomes of subjective feelings (MHF and quality of life), objective changes (hormones and peripheral blood flow) and safety were analyzed. The most frequently prescribed formulae and herbs were summarized. RESULTS: Nineteen randomized clinical trials involving 2469 patients were included. When compared to menopausal hormone therapy, CHM had similar effects to menopausal hormone therapy on total effectiveness rate (OR 1.41, 95% CI 0.84 to 2.35) and total Kupperman index (KI) score (SMD -0.13, 95% CI -0.61 to 0.36), and could significantly reduce vasomotor symptom score (MD -0.43, 95% CI -0.55 to -0.31) and upper-body peripheral blood flow (MD -3.56, 95% CI -5.14 to -1.98 under the jaw, MD -7.10, 95% CI -11.01 to -3.19 in the fingertip). When compared to placebo, CHM could reduce MHF severity (MD -0.70, 95% CI-1.00 to -0.40) and improve total KI score (MD -12.61, 95% CI -15.21 to -10.01). However, no statistically significant changes to hormone levels were detected. Most commonly seen adverse events were mild gastrointestinal tract reactions. The most popularly studied formula was Kun Tai capsule and the most frequently prescribed herb was Bai shao (Paeoniae Radix Alba, Paeonia lactiflora Pall.). More than 50% included studies had low risks of bias in the domains of selection, performance, attrition and reporting. CONCLUSIONS: This review indicated that CHM formulae were safe to be applied in MHF females and able to improve MHF-related symptom scores as well as the peripheral blood flow. Further studies should focus on specific formulae.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Hot Flashes/drug therapy , Menopause/drug effects , Drugs, Chinese Herbal/adverse effects , Female , Hot Flashes/etiology , Humans , Menopause/physiology , Treatment Outcome
17.
Oncol Nurs Forum ; 46(4): E107-E118, 2019 07 01.
Article in English | MEDLINE | ID: mdl-31225840

ABSTRACT

PROBLEM IDENTIFICATION: To determine best practices for managing hot flashes associated with androgen deprivation therapy (ADT) in men with prostate cancer. LITERATURE SEARCH: The CINAHL®, Embase®, PsycINFO®, PubMed®, and Scopus® databases were used to identify randomized controlled trials (RCTs) and quasiexperimental studies published between January 1994 and June 2018. DATA EVALUATION: Using the Cochrane Handbook for Systematic Reviews of Interventions, the authors reviewed 15 studies examining the effects of pharmacologic or complementary and alternative medicine interventions on ADT-associated hot flashes in men with prostate cancer. SYNTHESIS: Pharmacologic interventions (e.g., cyproterone, medroxyprogesterone, megestrol acetate) showed some promise for reducing hot flashes but were associated with side effects and risks. Acupuncture demonstrated potential benefit in reducing hot flashes without side effects. IMPLICATIONS FOR RESEARCH: Evidence is insufficient to support interventions for ADT-associated hot flashes in men with prostate cancer. Future RCTs should be sufficiently powered, include a control group, and use standardized outcome measures.


Subject(s)
Androgen Antagonists/adverse effects , Androgen Antagonists/therapeutic use , Androgens/deficiency , Antineoplastic Agents, Hormonal/adverse effects , Hot Flashes/drug therapy , Hot Flashes/etiology , Prostatic Neoplasms/complications , Adult , Aged , Aged, 80 and over , Antineoplastic Agents, Hormonal/therapeutic use , Humans , Male , Middle Aged
18.
Integr Cancer Ther ; 18: 1534735419848494, 2019.
Article in English | MEDLINE | ID: mdl-31046489

ABSTRACT

BACKGROUND: Acupuncture is a recognized integrative modality for managing hot flashes. However, data regarding predictors for response to acupuncture in cancer patients experiencing hot flashes are limited. We explored associations between patient characteristics, including traditional Chinese medicine (TCM) diagnosis, and treatment response among cancer patients who received acupuncture for management of hot flashes. METHODS: We reviewed acupuncture records of cancer outpatients with the primary reason for referral listed as hot flashes who were treated from March 2016 to April 2018. Treatment response was assessed using the hot flashes score within a modified Edmonton Symptom Assessment Scale (0-10 scale) administered immediately before and after each acupuncture treatment. Correlations between TCM diagnosis, individual patient characteristics, and treatment response were analyzed. RESULTS: The final analysis included 558 acupuncture records (151 patients). The majority of patients were female (90%), and 66% had breast cancer. The median treatment response was a 25% reduction in the hot flashes score. The most frequent TCM diagnosis was qi stagnation (80%) followed by blood stagnation (57%). Older age ( P = .018), patient self-reported anxiety level ( P = .056), and presence of damp accumulation in TCM diagnosis ( P = .047) were correlated with greater hot flashes score reduction. CONCLUSIONS: TCM diagnosis and other patient characteristics were predictors of treatment response to acupuncture for hot flashes in cancer patients. Future research is needed to further explore predictors that could help tailor acupuncture treatments for these patients.


Subject(s)
Hot Flashes/etiology , Hot Flashes/therapy , Neoplasms/complications , Acupuncture/methods , Acupuncture Therapy/methods , Female , Humans , Male , Medicine, Chinese Traditional/methods , Middle Aged , Retrospective Studies
19.
Exp Biol Med (Maywood) ; 244(3): 193-206, 2019 03.
Article in English | MEDLINE | ID: mdl-30722698

ABSTRACT

IMPACT STATEMENT: Menopausal symptoms impair the quality of life of many women, and although conventional treatments are often effective, their use is limited by adverse effects. Ojayeonjonghwan, OJa, is a traditional Oriental medicine that is used for both male and female reproductive health and has a long history of safe use. We evaluated the effectiveness of two variations of OJa (OJa1 and OJa2) for treating menopausal symptoms in ovariectomized (OVX) rats. Both OJa preparations were effective for relieving indicators of hot flashes and depression, and for preventing loss of bone mineral density and lean body mass. Only OJa 2 prevented memory dysfunction. These results show that the traditional Oriental medicine, Ojayeonjonghwan, has the potential to relieve menopausal symptoms in women and should be further evaluated in human clinical trials as an alternative to convention therapies in women for whom conventional therapies are not indicated or found to be ineffective.


Subject(s)
Drugs, Chinese Herbal/pharmacology , Menopause/drug effects , Animals , Bone Density/drug effects , Depression/etiology , Estrogens/deficiency , Female , Hot Flashes/etiology , Memory Disorders/etiology , Nervous System Diseases/etiology , Ovariectomy , Rats
20.
Medicine (Baltimore) ; 97(32): e11793, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30095640

ABSTRACT

BACKGROUND: Breast cancer survivors experience various symptoms associated with their cancer interventions, and the benefits of acupuncture for these symptoms have been evaluated in clinical trials worldwide. The purpose of this review was to discuss the current status of clinical research regarding the use of acupuncture as a part of traditional Korean medicine (KM) for various symptoms associated with breast cancer therapies. METHODS: We conducted a systematic review of the literature regarding the use of acupuncture as a part of traditional KM to treat symptoms associated with breast cancer therapies. The following databases were searched for content up to February 2017: MEDLINE, EMBASE, the Cochrane library, 4 Korean databases, and conference proceedings from major Korean medical societies. RESULTS: Among the 1228 identified articles, 8 observational studies (3 case series and 5 case reports), and 1 randomized controlled trial (RCT) were included in this review. Among these studies, 3 investigated lymphedema, 2 investigated chemotherapy-induced peripheral neuropathy, 1 investigated hot flushes, 1 investigated constipation, and 2 investigated miscellaneous symptoms in breast cancer survivors; all studies concluded that acupuncture can alleviate the symptom in question. However, we identified only 1 relevant RCT, and the included studies had limitations in terms of reporting quality. CONCLUSION: There is a lack of conclusive evidence regarding the benefits of acupuncture for the treatment of breast cancer survivors in Korea. More rigorous RCTs are necessary in the future to establish stronger clinical evidence regarding the use of acupuncture to better reflect the clinical context of Korea.


Subject(s)
Acupuncture Therapy/methods , Breast Neoplasms/complications , Cancer Survivors , Constipation/etiology , Constipation/therapy , Female , Hot Flashes/etiology , Hot Flashes/therapy , Humans , Lymphedema/etiology , Lymphedema/therapy , Pain Management/methods , Peripheral Nervous System Diseases/etiology , Peripheral Nervous System Diseases/therapy , Republic of Korea
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