No abstract
In a randomized, 2-group clinical study, acupuncture was used for the relief of menopausal hot flushes, sleep disturbances, and mood changes. The experimental acupuncture treatment consisted of specific acupuncture body points related to menopausal symptoms. The comparison acupuncture treatment consisted of a treatment designated as a general tonic specifically designed to benefit the flow of Ch'i (energy). Results from the experimental acupuncture treatment group showed a decrease in mean monthly hot flush severity for site-specific acupuncture. The comparison acupuncture treatment group had no significant change in severity from baseline over the treatment phase. Sleep disturbances in the experimental acupuncture treatment group declined over the study. Mood changes in both the experimental acupuncture treatment group and the comparison acupuncture treatment group showed a significant difference between the baseline and the third month of the study. Acupuncture using menopausal-specific sites holds promise for nonhormonal relief of hot flushes and sleep disturbances.
Although menopause is a normal developmental milestone through which all women pass, the transition has been long associated with chronic pain conditions that may be more accurately viewed as secondary to aging. Clinicians need to understand management of pain problems women may experience. This article examines pain syndromes including headache, back pain, osteoarthritis, pelvic pain, vulvo-vaginal pain, and burning mouth syndrome.
The issues of women and their work at the time of menopause are subjects of increasing interest and attention.' In today's world the majority of women in the United States and Western Europe are actively engaged in work activities outside the home when they reach the age of menopause. Despite the stress of work, the problem of male bosses who often fail to understand women's needs as well as their potential and the under-representation of women in positions of power in the professions and in industry, it has been shown that going to work, for most women, correlates with enhanced self-esteem, better health and less psychological stress. Work can and should be considered a major factor contributing to the quality of life especially during the mid-life years. When one recognizes that perhaps 20 or more years of potentially creative work activity lie ahead for the woman who has achieved her menopause, it is not surprising to read comments on work at mid-life such as those of the artist Kathe Kollwitz, who wrote in her diary "For the last third of life there remains only work. It alone is always stimulating, rejuvenating, exciting and ~atisfying."~ Unfortunately, Kollwitz's comment does not apply for a great many women. For those women menopause is a turbulent time, the stress of which can lead to compromise in adjustment to work conditions, loss of capability and sometimes, premature work termination. Essentially, the symptoms that many women experience can become a source of distraction, anxiety, and loss of confidence. A need exists for understanding the biology of menopause and its multisystem repercussions and for obtaining proper care to better cope with these changes. The biological effects of menopause on work capacity should be considered in the context of the many stresses that can affect a woman at mid-life. Health, finances, marital relations and the issues of children and parents are all part of the matrix in which the body experiences occur. For that reason it is not a simple matter to look separately at the biological changes and attribute psychological or social meanings to them. Still, it does appear that hormone changes at menopause such as sleep disturbance and hot flashes can directly interfere with work function: one does not function as well after a poor night's sleep as after an undisturbed rest or during a hot flash as compared to a more stable moment. Also, medical conditions such as heart disease and bone fracture, which have been related to hormone deficiency after menopause, can eventually compromise a woman's capacity to work in or out of the home. Thus there are both immediate as well as delayed effects of menopause to be considered, especially since hormone replacement or other treatment modalities can be used to help a woman cope and function optimally.
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