Menopozda Semptom Yönetimi ve Tamamlayıcı Tıp

Yıl 2023, Cilt: 3 Sayı: 2, 41 - 53, 29.07.2023

Habibe Yaşar Yetişmiş , Aytül Hadımlı , Birsen Karaca Saydam

Öz

Menopozda yaşanan vazomotor semptomlara yönelik uzun süreli hormonal tedavi kullanımına bağlı birçok hastalık riski ortaya çıkmakta ve bireyleri tamamlayıcı tıp yöntemlerini kullanmaya yöneltmektedir. Bu makalede, menopozda görülen semptomlar ve bunlara yönelik kullanılan tamamlayıcı tıp yöntemleri hakkında bilgilerin derlenmesi amaçlanmıştır.
Konu ile ilgili yapılan çalışmalarda, tamamlayıcı tıp yöntemi olarak kullanılan “klinik hipnoz”un tamamlayıcı tedavi olarak önerilebileceği; “gevşeme ve rahatlama programı”, “farkındalık bazlı stres azaltma pogramı” ve “akupunktur”un vazomotor semptomlar üzerinde etkisinin sınırlı olduğu; “diyet kaynaklarınınn kullanımı ve yaşam tarzı değişikliklerinin” semptomları azaltmanın yanı sıra kalp ve kas iskelet problemlerinde de yararlı olabileceği; “aromaterapi”nin özellikle de lavanta aromaterapisi kullanımının vazomotor semptomları azalttığı ve yaşam kalitesinin arttığı fakat kanıtların yetersiz olduğu; “homeopati”nin vazomotor semptomlar üzerine kanıtların yetersiz olduğu; vazomotor semptomların tedavisi için “egzersiz” ve “yoganın” önerilmemesi gerektiği; apiterapinin bilişsel ve kardiyovasküler problemlerde yararlı olduğu fakat kanıtların yetersiz olduğu belirtilmektedir. Sık kullanılan yöntemlerden biri olan “fitoterapi”de ise farklı bitkiler kullanılabilmektedir. Şerbetçi otu, çin melekotu, çuha çiçeği, karayılan otu, kedi otu ve sarı kantaron için klinik kanıtların sınırlı olduğu; soyanın dikkatli bir şekilde önerilebileceği; kırmızı yonca ve keten tohumunun klimakterik dönemde vazomotor semptomların hafifletilmesini desteklenmediği; mabet ağacının bilişsel sağlık üzerine faydalarının olduğu fakat kanıtların yetersiz olduğu; ginsengin menopoz semptomları azaltmada etkili olmadığı fakat kardiyovasküler hastalıklar üzerine olumlu etkilerinin olduğu bildirilmiştir. Ebelerin konu ile ilgili menopoz dönemindeki kadınlara farkındalık kazandırması ve bu konuda danışmanlık yapması önerilir.

Anahtar Kelimeler

Tamamlayıcı Tıp, Vazomotor Semptomlar., Ebelik, Menopoz

Destekleyen Kurum

Yoktur

Proje Numarası

Yoktur

Teşekkür

Makalede ismi geçen ve emeği olan tüm yazarlara teşekkür ediyorum

Kaynakça

• 1. Sussman M, Trocio J, Best C, Mirkin S, Bushmakin AG, Yood R, Louie M. (2015). Prevalence of menopausal symptoms among mid-life women: findings from electronic medical records. BMC women's health,15(1),58.
• 2. Johnson A, Roberts L, Elkins G. (2019). Complementary and alternative medicine for menopause. Journal of evidence-based integrative, 24,1-14 doi: https://doi.org/10.1177/2515690X19829380
• 3. Pinkerton JV, Conner EA, Kaunitz AM. (2019). Management of Menopause and the Role For Hormone Therapy. Clinical obstetrics and gynecology, 62(4),677-686.
• 4. Kilci Ş, Ertem G. (2019). Menopozda Semptom Yönetiminde Kullanılan Kanıta Dayalı Uygulamalar. Sakarya Üniversitesi Holistik Sağlık Dergisi, 2(3),36-54.
• 5. Akarsu RH. (2017). Menapozal Sıcak Basması Kontrolünde Kullanılan Nonfarmakolojik Yöntemler. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6(2):104-112.
• 6. Demirci H. Menopoz. Saydam B,K. (Ed.), Olgularda jinekolojik hastalarda bakım (2019). İçinde (s.204-11). 2. Baskı, Ankara: Nobel Tıp Kitapevleri.
• 7. Çelik AS, Pasinlioğlu T. (2013). Klimakterik dönemde yaşanan semptomlar ve hemşirenin rolü. ERÜ Sağlık Bilimleri Fakültesi Dergisi. 1(1),50-56.
• 8. Delamater L, Santoro N. (2018). Management of the Perimenopause. Clin Obstet Gynecol, 61(3),419–432. doi:10.1097/GRF.0000000000000389
• 9. Santoro N, Epperson CN, Mathews SB. (2015). Menopausal Symptoms and Their Management. Endocrinology and metabolism clinics of North Americ,44(3),497-515. doi: 10.1016/j.ecl.2015.05.001
• 10. Babakhanian M, Ghazanfarpour M, Kargarfard L, Roozbeh N, Darvish L, Khadivzadeh T, et. (2018). Effect of Aromatherapy on the Treatment of Psychological Symptoms in Postmenopausal and Elderly Women: A Systematic Review and Meta-analysis. J Menopausal Med, 24(2),127–132. doi:10.6118/jmm.2018.24.2.127
• 11. Asltoghiri M, Ghodsi Z. (2012). The effects of Reflexology on sleep disorder in menopausal women. Procedia-Social and Behavioral Sciences, 31,42-246.
• 12. Körükcü Ö, Kukulu K. (2013). Beden-Zihin-Ruh Bütünlüğünü Korumaya Yönelik Bir Program: Farkındalık Temelli Stres Azaltma Programı. Psikiyatride Güncel Yaklaşımlar, 7(1),68-80.
• 13. Özcan H, Oskay Ü. (2013). Menopoz döneminde semptom yönetiminde kanıta dayalı uygulamalar. Göztepe Tıp Dergisi, 28(4),157-163, doi:10.5222/J.GOZTEPETRH.2013.157
• 14. Moore TR, Franks RB, Fox C. (2017). Review of efficacy of complementary and alternative medicine treatments for menopausal symptoms. Journal of midwifery & women's health, 62(3),286-297.
• 15. Guo PP, Li P, Zhang XH, Liu N, Wang J, Chen DD, Zhang W. (2019). Complementary and alternative medicine for natural and treatment-induced vasomotor symptoms: An overview of systematic reviews and meta-analyses. Complementary Therapies in Clinical Practice, 36,181–194.
• 16. Ulusoy, E. (2012). Bal ve apiterapi. Uludağ Arıcılık Dergisi. 12(3),89-97.
• 17. Othman Z, Shafin N, Zakaria R, Hussain NH, Mohammad WM. (2011). Improvement in immediate memory after 16 weeks of tualang honey (Agro Mas) supplement in healthy postmenopausal women. Menopause, 18(11),1219-1224.
• 18. Ab Wahab SZ, Hussain NHN, Zakaria R, Kadir AA, Mohamed N, Tohit NM, Hassan II. (2018). Long-term effects of honey on cardiovascular parameters and anthropometric measurements of postmenopausal women. Complementary therapies in medicine, 41,154-160.
• 19. WHO. Traditional, Complementary and Integrative Medicine. 2020.[Erişim tarihi:28.06.2020]. Erişim adresi: https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1 .
• 20. Villiers TJ, Gass ML, Haines CJ, et al. (2013). Global consensus statement menopausal hormone therapy. Climacteric, 16(2),203-204.
• 21. Shifren, J. L., Gass, M. L., & NAMS Recommendations for Clinical Care of Midlife Women Working Group. (2014). The North American Menopause Society recommendations for clinical care of midlife women. Menopause, 21(10), 1038-1062.
• 22. Carpenter J, Gass ML, Maki PM, Newton KM, Pinkerton JV, Taylor M, Shifren JL. (2015) Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause, 22(11),1155-1174.
• 23. Jenabi E, Shobeiri F, Hazavehei S, Roshanaei G. (2018). The effect of Valerian on the severity and frequency of hot flashes: A triple-blind randomized clinical trial. Women & health, 58(3),297–304.doi: https://doi.org/10.1080/03630242.2017.1296058
• 24. Kargozar R, Azizi H, Salari R. (2017). A review of effective herbal medicines in controlling menopausal symptoms. Electronic physician, 9(11),5826–5833. https://doi.org/10.19082/5826 25. Chiu HY, Pan CH, Shyu YK, Han BC, Tsai PS. (2015). Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause, 22,234-244.
• 26. Stefanopoulou E, Grunfeld EA. (2017). Mind–body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review. Journal of Psychosomatic Obstetrics & Gynecology, 38(3),210-225.
• 27. Elkins, G. R., Fisher, W. I., Johnson, A. K., Carpenter, J. S., & Keith, T. Z. (2013). Clinical hypnosis in the treatment of postmenopausal hot flashes: a randomized controlled trial. Menopause (New York, N.Y.), 20(3), 291–298. https://doi.org/10.1097/gme.0b013e31826ce3ed
• 28. Roozbeh N, Ghazanfarpour M, Khadivzadeh T, Kargarfard L, Dizavandi FR, Shariati K. (2019). Effect of Lavender on Sleep, Sexual Desire, Vasomotor, Psychological and Physical Symptom among Menopausal and Elderly Women: A Systematic Review. J Menopausal Med, 25(2),88-93. doi:10.6118/jmm.18158
• 29. Elhosary E, Ewidea MM, Ahmed H, El Khatib A. (2018). Effect of aerobic exercises versus laser acupuncture in treatment of postmenopausal hot flushes: a randomized controlled trial. Journal of physical therapy science, 30(2),328–331. https://doi.org/10.1589/jpts.30.328
• 30. Carmody JF, Crawford S, Salmoirago-Blotcher E, Leung K, Churchill L, Olendzki N. (2011). Mindfulness training for coping with hot flashes: results of a randomized trial. Menopause (New York, N.Y.), 18(6),611–620. https://doi.org/10.1097/gme.0b013e318204a05c
• 31. Gözüyesil E, Baser M. (2016). The effect of foot reflexology applied to women aged between 40 and 60 on vasomotor complaints and quality of life. Complement Ther Clin Pract, 24,78-85. doi:10.1016/j.ctcp.2016.05.011
• 32. Shorey S, Ang L, Lau Y. (2020). Efficacy of mind-body therapies and exercise-based interventions on menopausal-related outcomes among Asian perimenopause women: A systematic review, meta-analysis, and synthesis without a meta-analysis. Journal of advanced nursing, 76(5), 1098–1110. https://doi.org/10.1111/jan.14304
• 33. Aghamiri V, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, et al. (2015). The effect of Hop (Humulus lupulus L.) on early menopausal symptoms and hot flashes: a randomized placebo-controlled trial. Complement Ther Clin Pract, 23,130-135
• 34. Abdi F, Kazemi F, Ramezani Tehrani F, Roozbeh N. (2016). Protocol for systematic review and meta-analysis: hop (Humulus lupulus L.) for menopausal vasomotor symptoms. BMJ open, 6(4). e010734. https://doi.org/10.1136/bmjopen-2015-010734
• 35. Şahin G, ErbilenSÜ. (2012). Türkiye’de Yetiştirilen Keyf Bitkiler İçerisinde Özel Bir Tür: Şerbetçiotu (Humulus lupulus L.). ZfWT, 4(3):237-258.
• 36. Haines CJ, Lam PM, Chung TK, Cheng KF, Leung PC. (2008). A randomized, double-blind, placebo-controlled study of the effect of a Chinese herbal medicine preparation (Dang Gui Buxue Tang) on menopausal symptoms in Hong Kong Chinese women. Climacteric.The journal of the International Menopause Society, 11(3),244–251. https://doi.org/10.1080/13697130802073029
• 37. Wang CC, Cheng KF, Lo WM, Law C, Li L, Leung PC, Chung TK, Haines CJ. (2013). A randomized, double-blind, multiple-dose escalation study of a Chinese herbal medicine preparation (Dang Gui Buxue Tan for moderate to severe menopausal symptoms and quality of life in postmenopausal women. Menopause (New York, N.Y.), 20(2),223–231. https://doi.org/10.1097/gme.0b013e318267f64e
• 38. Wei WL, Zeng R, Gu CM, Qu Y, Huang LF. (2016). Angelica sinensis in China-A review of botanical profile, ethnopharmacology, phytochemistry and chemical analysis. Journal of ethnopharmacology, 190,116-141.
• 39. Farzaneh F, Fatehi S, Sohrabi MR, Alizadeh K. (2013). The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Arch Gynecol Obstet, 288(5),1075-1079. doi:10.1007/s00404-013-2852-6
• 40. Mahboubi M. (2019). Evening Primrose (Oenothera biennis) Oil in Management of Female Ailments. Journal of menopausal medicine, 25(2),74–82. https://doi.org/10.6118/jmm.18190
• 41. Nahas EA, Nahas-Neto J, Orsatti FL, Carvalho EP, Oliveira ML, Dias R. (2007). Efficacy and safety of a soy isoflavone extract in postmenopausal women: a randomized, double-blind, and placebo-controlled study. Maturitas, 58(3),249–258. https://doi.org/10.1016/j.maturitas.2007.08.012
• 42. Coon JT, Pittler MH, Ernst E. (2007). Trifolium pratense isoflavones in the treatment of menopausal hot flushes: a systematic review and meta-analysis. Phytomedicine: international journal of phytotherapy and phytopharmacology, 14(2-3),153–159. https://doi.org/10.1016/j.phymed.2006.12.009
• 43. Aygün C, Olgun M. (2016). Çayır üçgülünde (Trifolium pratense L.) karakterizasyon çalışmaları. Artvin Çoruh Üniversitesi Orman Fakültesi Dergisi, 16(2),164-175.
• 44. Lipovac M, Chedraui P, Gruenhut C, Gocan A, Kurz C, Neuber B, Imhof M. (2012). The effect of red clover isoflavone supplementation over vasomotor and menopausal symptoms in postmenopausal women. Gynecological endocrinology: the official journal of the International Society of Gynecological Endocrinology, 28(3),203–207. https://doi.org/10.3109/09513590.2011.593671
• 45. Ghazanfarpour M, Sadeghi R, Latifnejad Roudsari R, Khadivzadeh T, Khorsand I, Afiat M, Esmaeilizadeh M. (2016a). Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis. Avicenna journal of phytomedicine, 6(3),273–283.
• 46. Ghazanfarpour M, Sadeghi R, Abdolahian S, Latifnejad Roudsari R. (2016b) The efficacy of Iranian herbal medicines in alleviating hot flashes: A systematic review. International journal of reproductive biomedicine,14(3),155–166.
• 47. İşleroğlu H, Yıldırım, Z, Yıldırım M. (2005). Fonksiyonel bir gıda olarak keten tohumu. GOÜ. Ziraat Fakültesi Dergisi, 22 (2),23-30
• 48. Mehrpooya M, Rabiee S, Larki-Harchegani A, Fallahian AM, Moradi A, Ataei S, Javad MT. (2018). A comparative study on the effect of "black cohosh" and "evening primrose oil" on menopausal hot flashes. Journal of education and health promotion, 7,36. https://doi.org/10.4103/jehp.jehp_81_17
• 49. Gün Ç, Demirci N. (2015). Menopozda bitkisel tedavi kullanımı. Arşiv Kaynak Tarama Dergisi, 24(4),520-530.
• 50. Eatemadnia A, Ansari S, Abedi P, Najar S. (2019). The effect of Hypericum perforatum on postmenopausal symptoms and depression: A randomized controlled trial. Complementary therapies in medicine, 45;109–113. https://doi.org/10.1016/j.ctim.2019.05.028
• 51. Liu YR, Jiang YL, Huang RQ, Yang JY, Xiao BK, Dong JX. (2014). Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety. Climacteric: the journal of the International Menopause Society, 17(4),325–335. https://doi.org/10.3109/13697137.2013.861814
• 52. Ceylan A, Bayram E, Arabacı O, Marquard RA, Nazan ÖZAY, Geren H. (2005). Ege Bölgesi Florası Kantaron (Hypericum perforatum L.) Populasyonlarında Uygun Kemotiplerin Belirlenmesi ve Islahı. Ege Üniversitesi Ziraat Fakültesi Dergisi, 42(3),33-44.
• 53. Lee HW, Choi J, Lee Y, Kil KJ, Lee MS. (2016). Ginseng for managing menopausal woman's health: A systematic review of double-blind, randomized, placebo-controlled trials. Medicine, 95(38),4914. https://doi.org/10.1097/MD.0000000000004914
• 54. Oh KJ, Chae MJ, Lee HS, HongHD, Park K. (2010). Effects of Korean red ginseng on sexual arousal in menopausal women: placebo-controlled, double-blind crossover clinical study. The journal of sexual medicine, 7(4),1469–1477. https://doi.org/10.1111/j.1743-6109.2009.01700.x
• 55. Hartley DE, Heinze L, Elsabagh S, File SE. (2003). Effects on cognition and mood in postmenopausal women of 1-week treatment with Ginkgo biloba. Pharmacology, biochemistry, and behavior, 75(3),711–720. https://doi.org/10.1016/s0091-3057(03)00123-0
• 56. Clement YN, Onakpoya I. Hung SK, Ernst E. (2011). Effects of herbal and dietary supplements on cognition in menopause: a systematic review. Maturitas, 68(3),256–263. https://doi.org/10.1016/j.maturitas.2010.12.005 57. Taşdemir A, Yaman AM. (2017). Ginsengin özellikleri ve sağlık üzerine etkileri. Sağlık Akademisi Kastamonu, Sağlık Akademisi Kastamonu, 2(3),211-222.
• 58. Münstedt, K., Männle, H. (2020). Apitherapy for menopausal problems. Archives of Gynecology and Obstetrics, 302(6), 1495-1502. https://doi.org/10.1007/s00404-020-05692-2
• 59. Pilkington K, Kirkwood G, Rampes H, Fisher P, Richardson J. (2005). Homeopathy for depression: a systematic review of the research evidence. Homeopathy, 94,153-
• 60. McCarthy M. (2005). Critics slam draft WHO report on homoeopathy. The Lancet, 366(9487),705-706.
• 61. Thompson EA, Relton C. (2009). Designing clinical trials of homeopathy formenopausal symptoms: a review of the literature. Menopause Int, 15,31–4.
• 62. Befus D, Coeytaux RR, Goldstein KM, et al. (2018). Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. J Altern Complement Med, 24(4),314-323. doi:10.1089/acm.2016.0408.