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  • 1.
    Brynhildsen, Jan
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Nedstrand, Elizabeth
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Wyon, Yvonne
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Motion motverkar menopausens minus. Gynnsamma effekter på både kropp och själ [Exercise counteracts the negative effects of menopause. Positive effects on both body and soul]1994In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 91, no 23, p. 2323-5Article in journal (Refereed)
  • 2.
    Dahle, L. O.
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Forsberg, Pia
    Linköping University, Department of Molecular and Clinical Medicine, Infectious Diseases. Linköping University, Faculty of Health Sciences.
    Hård af Segerstad, Helene
    Linköping University, Department of Behavioural Sciences, Studies in Adult, Popular and Higher Education. Linköping University, Faculty of Educational Sciences.
    Wyon, Yvonne
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Problem-based medical education: development of a theoretical foundation and a science-based professional attitude1997In: Medical Education, ISSN 0308-0110, E-ISSN 1365-2923, Vol. 31, no 6, p. 416-424Article in journal (Refereed)
    Abstract [en]

    Problem-based learning, combined with early patient contact, integration between different subject areas, elements of multiprofessional education, and special emphasis on the development of communications skills has become the basis for the medical curriculum at the Faculty of Health Sciences in Linköping. Critics have questioned the depth of the scientific and theoretical aspects of the curriculum. Through a series of specific measures in the organization of the curriculum and examinations, and due to the pedagogical principles involved per se, our claim is that students graduating at Linköping do possess the required theoretical knowledge and a scientific attitude to the practice of medicine, at least equivalent to that obtained in a more conventional medical curriculum. One such specific measure is that all students perform one field study and two scientific studies during the course of the curriculum. An investigation of student opinions regarding the value of performing scientific projects of their own have shown that these projects have had a positive impact on the students' general scientific attitude and their willingness to engage in future scientific work. The specific skills acquired, as confirmed by oral examinations, were largely determined by the scientific nature of the chosen field of study. Our graduates have not yet progressed far enough in their careers for comparisons to be made on the basis of the Swedish Licensing Board Internship Examinations, but continuing evaluations of students, graduates and licensed doctors emerging from the curriculum will provide future evi-dence as to whether our present evaluation is correct.

  • 3.
    Hammar, Mats
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Ekblad, S
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Lönnberg, Barbro
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Berg, Göran
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Lindgren, R
    Wyon, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Postmenopausal women without previous or current vasomotor symptoms do not flush after abruptly abandoning estrogen replacement therapy. 1999In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 31, p. 117-122Article in journal (Refereed)
  • 4.
    Hammar, Mats
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Frisk, Jessica
    Linköping University, Department of health and environment. Linköping University, Faculty of Health Sciences.
    Grimsås, Ö
    Department of Surgery, County Hospital, Ludvika, Sweden.
    Höök, M
    Department of Surgery, County Hospital, Ludvika, Sweden.
    Spetz, Anna-Clara
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Wyon, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Acupuncture treatment of vasomotor symptoms in men with prostatic carcinoma: A pilot study1999In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 161, no 3, p. 853-856Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Most men who undergo castration therapy for prostatic carcinoma will have vasomotor symptoms that usually persist for years. Vasomotor symptoms are elicited from the thermoregulatory center, possibly due to a decrease in hypothalamic opioid activity induced by low sex steroid concentrations. Acupuncture treatment in women, which stimulates hypothalamic opioid activity, alleviates vasomotor symptoms. We report on men treated with acupuncture for relief of vasomotor symptoms after castration therapy.

    MATERIALS AND METHODS: We asked 7 men with vasomotor symptoms due to castration therapy to receive acupuncture treatment 30 minutes twice weekly for 2 weeks and once a week for 10 weeks. Effects on flushes were recorded in logbooks.

    RESULTS: Of the 7 men 6 completed at least 10 weeks of acupuncture therapy and all had a substantial decrease in the number of hot flushes (average 70% after 10 weeks). At 3 months after the last treatment the number of flushes was 50% lower than before therapy. Therapy was discontinued after 10 weeks because of a femoral neck fracture in 1 man and after 3 weeks due to severe back pain in 1.

    CONCLUSIONS: Acupuncture may be a therapeutic alternative in men with hot flushes after castration therapy and merits further evaluation.

  • 5.
    Hammar, Mats
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Hammar-Henriksson, MB
    Frisk, J
    Rickenlund, A
    Wyon, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Few oligo-amenorrheic athletes have vasomotor symptoms2000In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 34, no 3, p. 219-225Article in journal (Refereed)
    Abstract [en]

    Objective: To assess whether women with athletic oligo-amenorrhea have vasomotor symptoms. Material and methods: A mailed questionnaire was sent to 252 female athletes about vasomotor symptoms. Identical questions were also mailed to 1523 peri- and postmenopausal women. Results: The prevalence of vasomotor symptoms was low in female athletes with oligo- and amenorrhea and similar to that found in athletes with regular menstruations. The prevalence was significantly lower than in menopausal women. Although more than a third of the menopausal women had hormone replacement therapy, 30% of them still had vasomotor symptoms at least every week compared with only 2% of the oligo-amenorrheic athletes. Conclusion: Vasomotor symptoms are very uncommon in oligo-amenorrheic athletes, although many of them are hypoestrogenic. It was suggested that one factor contributing to these symptoms around menopause is low hypothalamic activity of ▀-endorphins, which makes the thermoregulatory centre labile. On the other hand, supraphysiological activity in hypothalamic ▀-endorphins may cause the oligo-amenorrhea in athletes, but may stabilise the thermoregulatory centre and thus prevent hot flushes. (C) 2000 Elsevier Science Ireland Ltd.

  • 6.
    Hammar, Mats
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Nedstrand, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wyon, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Få alternativ till östrogenbehandling vid vegetativa besvär efter menopaus.2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 18, p. 1612-1615Article in journal (Other academic)
  • 7.
    Lindh-Åstrand, Lotta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Nedstrand, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wyon, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Hammar, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomised to physical activity or estrogen therapy2004In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 48, no 2, p. 97-105Article in journal (Refereed)
    Abstract [en]

    Objective: To assess if regular physical exercise or oral oestradiol therapy decreased vasomotor symptoms and increased quality of life in previously sedentary postmenopausal women. Setting: A prospective, randomised trial at a University Hospital. Methods: 75 postmenopausal, sedentary women with vasomotor symptoms were randomised to: exercise three-times weekly over 12 weeks (15 women), oral oestradiol therapy for 12 weeks (15 women) and 45 women to three other treatment arms. Results from the exercise and oestradiol groups are presented here. The effects on vasomotor symptoms and wellbeing were assessed with logbooks and validated questionnaires. Results: Ten women fulfilled 12 weeks of exercise. The number of flushes was rather unchanged in five women and decreased to 28% (range 18-42%) of baseline in the other five women. Five of the ten women continued to exercise another 24 weeks, thus in all 36 weeks. The mean number of flushes decreased by about 50% in these five women (from 6.2/24 to 3.2 flushes/24 h at 36 weeks). In the same group a score made as the product of reduction in number and severity of flushes decreased by 92% at 12 weeks, 75% at 24 weeks and 72% at 36 weeks compared with baseline. In the estrogen group flushes decreased from 8.4 to 0.8 (P<0.001) after 12 weeks of therapy and remained at this level after 36 weeks. Well-being according to different measurements improved significantly in both groups, albeit more markedly in the estrogen group. Conclusions: Apart from many other health benefits regular physical exercise may decrease vasomotor symptoms and increase quality of life in postmenopausal women, but this has to be further evaluated scientifically. Exercise should be introduced gradually to ensure compliance.

  • 8.
    Nedstrand, Elisabeth
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Wyon, Yvonne
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women2005In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 51, no 2, p. 154-162Article in journal (Refereed)
    Abstract [en]

    Objective: The aim was to evaluate and compare the effects of applied relaxation and oral estradiol treatment on hot flushes, mood and psychological wellbeing in postmenopausal women.

    Patients and methods: In a prospective study, 30 postmenopausal women with vasomotor symptoms were randomized to applied relaxation or oral estradiol treatment during 12 weeks with 6 months follow-up. Number and severity of flushes were registered daily and Kupperman’s Index and a general estimate of climacteric symptoms, Mood Scale and Symptom Check List were completed at baseline, 4, 8 and 12 weeks of treatment, and 3 and 6 months after therapy.

    Results: After 12 weeks of treatment, the number of flushes/24 h decreased significantly over time in both treatment groups. In the group receiving applied relaxation, the mean number of flushes/24 h decreased from 6.0 (95% CI 4.5–7.6) to 3.0 (95% CI 2.1–3.9) after 12 weeks of treatment. The mean number of flushes/24 h was 1.7 (95% CI 0.7–2.5) at 6 months follow-up; i.e. a 72% decrease. In the estrogen group, the mean number of flushes/24 h decreased from 8.4 to 0.8; i.e a 90% decrease in the number of flushes after 12 weeks of treatment. The significant change in flushes reached after 12 weeks of treatment and remained to 6 months after end of treatment in both groups. Estrogen therapy reduced flushes significantly faster than applied relaxation. General climacteric symptoms according to the Visual Analogue Scale and the Kupperman’s Index decreased significantly over time in both groups. General mood (Mood Scale) increased significantly in the estrogen group, but not in the group receiving applied relaxation. Psychological wellbeing according to Symptom Checklist, increased significantly from baseline to 12 weeks in both groups.

    Conclusions: We suggest that applied relaxation may be used as an alternative treatment of vasomotor symptoms for postmenopausal women but should be further evaluated.

  • 9.
    Nedstrand, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Wyon, Yvonne
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study2005In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 8, no 3, p. 243-250Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the effect of applied  relaxation and electro-acupuncture on vasomotor symptoms in women treated for breast cancer.

    Methods: Thirty-eight postmenopausal women with  breast cancer and vasomotor symptoms were randomized to treatment with electro-acupuncture (n = 19) or applied relaxation (n = 19) during 12 weeks. The number of hot flushes was registered daily in a logbook before and during treatment and after 3 and 6 months of follow-up.

    Results: Thirty-one women completed 12 weeks of treatment and 6  months of follow-up. After 12 weeks of applied relaxation, the number of flushes/24 h had decreased from 9.2 (95% confidence interval (CI) 6.6-11.9) at baseline to 4.5 (95% CI 3.2-5.8) and to 3.9 (95% CI 1.8-6.0) at 6 months follow-up (n = 14). The flushes/24 h were reduced from 8.4 (95% CI 6.6-10.2) to 4.1 (95% CI 3.0-5.2) after 12 weeks of treatment with electro-acupuncture and to 3.5 (95% CI 1.7-5.3) after 6 months follow-up (n = 17). In both groups, the mean Kupperman Index score was significantly reduced after treatment and remained unchanged 6 months after end of treatment.

    Conclusion: We suggest that applied relaxation and  electro-acupuncture should be further evaluated as possible treatments for vasomotor symptoms in postmenopausal women with breast cancer.

  • 10.
    Nedstrand, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wyon, Yvonne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Hammar, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wijma, Klaas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine .
    Psychological well-being improves in women with breast cancer after treatment with applied relaxation or electro-acupuncture for vasomotor symptom2006In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 27, no 4, p. 193-199Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the effect of applied relaxation and electro-acupuncture (EA) on psychological well-being in breast cancer-treated women with vasomotor symptoms. Thirty-eight breast cancer-treated postmenopausal women with vasomotor symptoms were included in the study. They were randomized to either treatment with electro-acupuncture (EA) (N = 19, three of them with tamoxifen) or applied relaxation (AR) (n = 19, five of them with tamoxifen) over a 12-week study period with six months follow-up. Vasomotor symptoms were registered daily. A visual analog scale was used to assess climacteric symptom, estimation of general well-being was made using the Symptom Checklist, and mood using the Mood Scale. These were applied during treatment and at follow-up. In total 31 women completed 12 weeks of treatment and six months of follow-up. Hot flushes were reduced by more than 50%. Climacteric symptoms significantly decreased during treatment and remained so six months after treatment in both groups. Psychological well-being significantly improved during therapy and at follow-up visits in both groups. Mood improved significantly in the electro-acupuncture treated group. In conclusion psychological well-being improved in women with breast cancer randomized to treatment with either AR or EA for vasomotor symptoms and we therefore suggest that further studies should be performed in order to evaluate and develop these alternative therapies. © 2006 Informa UK Ltd.

  • 11.
    Nedstrand, Elizabeth
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Wyon, Yvonne
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptomsManuscript (preprint) (Other academic)
    Abstract [en]

    The aim of this study was to evaluate effects of applied relaxation and electro-acupuncture on psychological wellbeing in breast cancer treated women with vasomotor symptoms. Thirty-eight postmenopausal women with breast cancer and vasomotor symptoms were included in the study. They were randomized between treatment with elcctro-acupuncture (n=19, three of them with tamoxifen) or applied relaxation (n=19, five of them with tamoxifen) during 12 weeks with six months follow-up. Vasomotor symptoms were registered daily and a visual analogue scale on climacteric symptoms as well as estimates of general wellbeing using the Symptom Checklist and mood by the Mood Scale, were completed during treatment and follow-up.

    Totally 31 women completed 12 weeks of treatment and 6 months of follow-up. Hot flushes were reduced by more than 50 percent. Climacteric symptoms significantly decreased after treatment and remained so 6 months after treatment in both groups. Simultaneously with the decrease of flushes, psychological wellbeing was significantly ameliorated throughout the study period in both groups. Mood changed significantly in the acupuncture treated group.

    In conclusion psychological wellbeing ameliorates in women with breast cancer randornized to treatment with applied relaxation or acupuncture for vasomotor symptoms.

  • 12.
    Sandberg, Margareta
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Pain and Rehabilitation Centre.
    Wijma, Klaas
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences.
    Wyon, Yvonne
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
    Nedstrand, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Effects of electro-acupuncture on psychological distress in postmenopausal women2002In: Complementary Therapies in Medicine, ISSN 0965-2299, Vol. 10, no 3, p. 161-169Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate effects of electro–acupuncture (EA) on general psychological distress and relate to experience of climacteric symptoms in 30 postmenopausal women.

    Design: A randomised single-blind controlled design was used to evaluate effects of EA and extremely superficial needle insertion, with the latter serving as a near-placebo control.

    Settings: The Linköping University Hospital in Sweden. Interventions: Fourteen treatments during 12 weeks with follow-ups at 3 and 6 months.

    Outcome measures: General psychological well-being, mood and experience of climacteric symptoms. Results: Mood Scale improved only in EA group and not until 12 weeks compared to baseline, from 110 to 129 (P=0.01), and to 120 at 3-month follow-up (P=0.04). Mood was significantly better than control at 8 (P=0.05) and 12 weeks (P=0.01). Visual analogue scale estimation of climacteric symptoms was decreased at 4 weeks in both groups, and lasted throughout the study period, in EA group from 5 to 2 (P=0.04) and in control group from 5 to 3 (P=0.02) at 6-month follow-up. Well-being was ameliorated from 4 weeks in EA and from 8 weeks in control group until end of study (P=0.01, P=0.03). No significant differences on climacteric symptoms or well-being existed between the groups.

    Conclusions: This study does not show that EA is better than superficial needle insertion for the amelioration of general psychological distress and experience of climacteric symptoms in women with vasomotor symptoms after menopause. However, the more pronounced effect on mood suggests that EA might have additional effects compared with superficial needle insertion.

  • 13.
    Wyon, Yvonne
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Vasomotor symptoms in postmenopausal women: the role of acupuncture and calcitonin gene-related peptide2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A majority of postmenopausal women experience vasomotor symptoms, which have a significant impact on the women's quality of life. Estrogens are the treatment of choice but can for different reasons not be used by all women. There is therefore a great need for viable alternative treatments. The patophysiology behind hot flushes and sweatings is so far not fully understood. Several studies have concluded that low levels of estrogens after menopause will lead to instability in the thermoregulatory center in the hypothalamus probably due to low [ß-endorphin levels. Since acupuncture is known to increase central [ß-endorphin activity, we wanted to evaluate if this treatment could ameliorate vasomotor symptoms which, to our knowledge, has not been scientifically evaluated previously. We also aimed to reveal if the vasoactive neuropeptides Calcitonin Gene-related peptide (CGRP), neuropeptide Y (NPY), neurokinin A, and substance P were involved in the mechanisms behind these symptoms.

    Results: Electro-acupuncture decreased flushes by 50 %, and superficial needle insertion by 30 %. The difference in reduction between the groups was not significant. Along with the decrease of flushes we found a significant reduction of the 24h urinary excretion of the neuropeptide CGRP, which is one of the most potent vasodilators known. When we later compared electro-acupuncture (EA), superficial needle insertion (SNI) and estrogen treatment, we found a significant reduction of 24h flushes by almost 60 % after EA and SNI. However, about 20% were non-responders in both groups. The responders in the EA group reduced their flushes and sweatings by 82 % and in the SNI group the reduction was 68%. We found no significant difference in effect between the acupuncture groups. Estrogen was the most effective treatment with a 91% reduction of flushes (range 58-100 %). We found a higher excretion of CGRP/24h urine in postmenopausal women with vasomotor symptoms, than in women without symptoms. Furthermore we found a 73 % elevation of CGRP in plasma, along with a 34% increase ofNPY concentration, during flushes in postmenopausal women.

    Conclusion: The results indicate that acupuncture is as a viable alternative or complement to traditional pharmacological treatments in postmenopausal women with vasomotor symptoms. The vasoactive neuropeptide CGRP is most likely involved in the mechanisms of vasomotor symptoms, probably as an executor or mediator of the skin vasodilatation and sweating that occur during the hot flush.

    List of papers
    1. Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women
    Open this publication in new window or tab >>Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women
    1995 (English)In: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 2, no 1, p. 3-12Article in journal (Refereed) Published
    Abstract [en]

    Most perimenopausal women suffer from vasomotor symptoms. Changes in central opioid activity have been proposed to be involved in the mechanisms of hot flushes after menopause. Because acupuncture increases central opioid activity, it may affect postmenopausal hot flushes. The aim was to study if and to what extent two different kinds of acupuncture affected postmenopausal hot flushes, urinary excretion of certain neuropeptides, and quality of life in a group of postmenopausal women. Twenty-four women with natural menopause and hot flushes were included. Twenty-one women completed the study. One group was randomized to electroacupuncture at 2 Hz, whereas the other group was treated with another form of acupuncture (i.e., superficial needle insertion) for a total of 8 weeks. All women daily registered the number and severity of flushes from 1 month before to 3 months after treatment. They completed Quality of Life questionnaires before, during, and after treatment. Twenty-four-hour urine was sampled before, during, and after treatment and analyzed for neuropeptides using radioimmunoassay methods. The number of flushes decreased significantly by >50% in both groups and remained decreased in the group receiving electroacupuncture, whereas in the superficial-needle-insertion group, the number of flushes increased again during the 3 months after treatment. The Kupperman Index decreased significantly in both groups during and after treatment. The excretion of the potent vasodilating neuropeptide calcitonin gene-related peptide-like immunoreactivity decreased significantly during treatment. Acupuncture significantly affects hot flushes and sweating episodes after menopause, with effects persisting at least 3 months after the end of treatment. Changes in calcitonin gene-related peptide, which is a very potent vasodilator, could be involved in the mechanisms behind hot flushes.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81633 (URN)
    Available from: 2012-09-19 Created: 2012-09-19 Last updated: 2017-12-07Bibliographically approved
    2. Postmenopausal women with vasomotor symptoms have increased urinary excretion of calcitonin gene-related peptide
    Open this publication in new window or tab >>Postmenopausal women with vasomotor symptoms have increased urinary excretion of calcitonin gene-related peptide
    Show others...
    1998 (English)In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 30, no 3, p. 289-294Article in journal (Refereed) Published
    Abstract [en]

    Objectives: To establish whether 24 h urinary excretion of the potent vasodilator calcitonin gene-related peptide (CGRP) was higher in postmenopausal women with vasomotor symptoms compared to the level in women without symptoms. We also wanted to establish whether urinary excretion of CGRP changed during the menstrual cycle in women of fertile age.

    Material and methods: Thirteen postmenopausal women with and 13 women without vasomotor symptoms were included. Urine was collected over 24 h and CGRP excretion was measured utilizing radio-immuno assay technique. Twenty-four hour CGRP excretion was also measured in ten fertile women with regular cycles in early follicular, preovulatory and midluteal phase.

    Results: Twenty-four hour urinary excretion of CGRP was significantly higher in women with vasomotor symptoms compared to non-flushing women (median 7.16 vs 5.15 pmol/24h; P=0.028). CGRP concentrations were stable throughout the ovulatory cycles.

    Conclusion: The 24 h urinary excretion of CGRP is higher in women with vasomotor symptoms than in women without these symptoms. CGRP may be the mediator of vasodilator signals originating from the thermoregulatory center.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-81634 (URN)10.1016/S0378-5122(98)00047-4 (DOI)
    Available from: 2012-09-19 Created: 2012-09-19 Last updated: 2017-12-07Bibliographically approved
    3. Concentrations of Calcitonin Gene-Related Peptide and Neuropeptide Y in Plasma Increase During Flushes in Postmenopausal Women
    Open this publication in new window or tab >>Concentrations of Calcitonin Gene-Related Peptide and Neuropeptide Y in Plasma Increase During Flushes in Postmenopausal Women
    2000 (English)In: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 7, no 1, p. 25-30Article in journal (Refereed) Published
    Abstract [en]

    Objective: To assess whether the plasma concentrations of calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), or neurokinin A (NKA) increase during hot flushes in postmenopausal women with vasomotor symptoms.

    Design: Eight postmenopausal women (age range = 49-63 years) with vasomotor symptoms were included. During 1 day, repeated blood samples were taken between and during flushes; four samples were taken during each flush. The samples were analyzed for CGRP, NPY, and NKA using radioimmunoassay technique.

    Results: The serum concentrations of CGRP and NPY increased significantly-73% and 34%, respectively-during the flushes (p = 0.018; p = 0.028), whereas the concentrations of NKA did not change significantly.

    Conclusions: CGRP and NPY may be involved in the mechanisms that cause vasomotor symptoms.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-25426 (URN)9871 (Local ID)9871 (Archive number)9871 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
    4. A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women
    Open this publication in new window or tab >>A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women
    2004 (English)In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 7, no 2, p. 153-164Article in journal (Refereed) Published
    Abstract [en]

    Objective To compare the effects of electro-acupuncture with oral estradiol and superficial needle insertion on hot flushes in postmenopausal women.

    Material and methods  Forty-five postmenopausal women with vasomotor symptoms were randomized to electro-acupuncture, superficial needle insertion or oral estradiol treatment during 12 weeks, with 6 months' follow-up. The number and severity of flushes were registered daily and the Kupperman index and a general estimate of climacteric symptoms were completed before, during and after therapy.

    Results In the electro-acupuncture group, the mean number of flushes/24 h decreased from 7.3 to 3.5 (ANOVA, p  < 0.001). Eleven of the 15 women had at least a 50% decrease in number of flushes (with a mean decrease of 82%). Superficial needle insertion decreased the number of flushes/24 h from 8.1 to 3.8 (p  < 0.001). In seven out of 13 women, the number of flushes decreased by at least 50% (mean decrease 83%). In the estrogen group, the number of flushes decreased from 8.4 to 0.8 (p < 0.001). The decrease in number of flushes persisted during the 24-week follow-up period in all treatment groups. The Kupperman index and the general climacteric symptom score decreased, and remained unchanged 24 weeks after treatment in all groups (p < 0.001). Electro-acupuncture decreased the number of flushes/24 h significantly over time, but not to the same extent as the estrogen treatment. No significant difference in effect was found between electro-acupuncture and the superficial needle insertion.

    Conclusion We suggest that acupuncture is a viable alternative treatment of vasomotor symptoms in postmenopausal women and cannot recommend superficial needle insertion as an inactive control treatment.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-22013 (URN)10.1080/13697130410001713814 (DOI)1041 (Local ID)1041 (Archive number)1041 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
  • 14.
    Wyon, Yvonne
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Frisk, Jessica
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Lundeberg, Thomas
    Department of Pharmacology and Physiology, Karolinska lnstitutet, Stockholm, Sweden.
    Theodorsson, Elvar
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Postmenopausal women with vasomotor symptoms have increased urinary excretion of calcitonin gene-related peptide1998In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 30, no 3, p. 289-294Article in journal (Refereed)
    Abstract [en]

    Objectives: To establish whether 24 h urinary excretion of the potent vasodilator calcitonin gene-related peptide (CGRP) was higher in postmenopausal women with vasomotor symptoms compared to the level in women without symptoms. We also wanted to establish whether urinary excretion of CGRP changed during the menstrual cycle in women of fertile age.

    Material and methods: Thirteen postmenopausal women with and 13 women without vasomotor symptoms were included. Urine was collected over 24 h and CGRP excretion was measured utilizing radio-immuno assay technique. Twenty-four hour CGRP excretion was also measured in ten fertile women with regular cycles in early follicular, preovulatory and midluteal phase.

    Results: Twenty-four hour urinary excretion of CGRP was significantly higher in women with vasomotor symptoms compared to non-flushing women (median 7.16 vs 5.15 pmol/24h; P=0.028). CGRP concentrations were stable throughout the ovulatory cycles.

    Conclusion: The 24 h urinary excretion of CGRP is higher in women with vasomotor symptoms than in women without these symptoms. CGRP may be the mediator of vasodilator signals originating from the thermoregulatory center.

  • 15.
    Wyon, Yvonne
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Lindgren, R.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Lundeberg, T.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women1995In: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 2, no 1, p. 3-12Article in journal (Refereed)
    Abstract [en]

    Most perimenopausal women suffer from vasomotor symptoms. Changes in central opioid activity have been proposed to be involved in the mechanisms of hot flushes after menopause. Because acupuncture increases central opioid activity, it may affect postmenopausal hot flushes. The aim was to study if and to what extent two different kinds of acupuncture affected postmenopausal hot flushes, urinary excretion of certain neuropeptides, and quality of life in a group of postmenopausal women. Twenty-four women with natural menopause and hot flushes were included. Twenty-one women completed the study. One group was randomized to electroacupuncture at 2 Hz, whereas the other group was treated with another form of acupuncture (i.e., superficial needle insertion) for a total of 8 weeks. All women daily registered the number and severity of flushes from 1 month before to 3 months after treatment. They completed Quality of Life questionnaires before, during, and after treatment. Twenty-four-hour urine was sampled before, during, and after treatment and analyzed for neuropeptides using radioimmunoassay methods. The number of flushes decreased significantly by >50% in both groups and remained decreased in the group receiving electroacupuncture, whereas in the superficial-needle-insertion group, the number of flushes increased again during the 3 months after treatment. The Kupperman Index decreased significantly in both groups during and after treatment. The excretion of the potent vasodilating neuropeptide calcitonin gene-related peptide-like immunoreactivity decreased significantly during treatment. Acupuncture significantly affects hot flushes and sweating episodes after menopause, with effects persisting at least 3 months after the end of treatment. Changes in calcitonin gene-related peptide, which is a very potent vasodilator, could be involved in the mechanisms behind hot flushes.

  • 16.
    Wyon, Yvonne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre for Medicine, Department of Dermatology and Venerology in Östergötland.
    Nedstrand, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Hammar, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Klimakteriebesvär: Mer forskning behövs om olika behandlingsformer - inklusive akupunktur.2005In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, p. 1664-1665Article in journal (Other academic)
  • 17.
    Wyon, Yvonne
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Spetz, Anna-Clara
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Theodorsson, Elvar
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Varenhorst, Eberhard
    Linköping University, Department of Biomedicine and Surgery, Urology. Linköping University, Faculty of Health Sciences.
    Urinary excretion of calcitonin gene-related peptide in males with hot flushes after castration for carcinoma of the prostate2001In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 35, no 2, p. 92-96Article in journal (Refereed)
    Abstract [en]

    Objective: The majority of men who undergo surgical or medical castration due to prostatic carcinoma develop vasomotor symptoms with hot flushes. The mechanisms behind these symptoms are poorly understood. One possible explanation is a release of the vasodilatory peptide calcitonin gene-related peptide (CGRP) from perivascular nerves, which seem to be involved in the mechanisms behind vasomotion and sweating in postmenopausal women. The aim of this report was to investigate whether CGRP is involved in vasomotion in men after castration therapy.

    Material and methods: Twenty-four hour urine excretion of CGRP was analysed in 15 men with prostatic carcinoma, using radioimmunoassay before and 3 months after surgical or medical castration.

    Results: Eleven of the 15 men developed hot flushes during the observation period of 3 months. Twenty-four hour urine excretion of CGRP did not change significantly after castration, either in the group as a whole or in those 11 men who developed hot flushes.

    Conclusions: Even though we did not observe any significant changes in 24-h urine excretion of the potent vasodilator CGRP after castration it is possible that serum levels of CGRP increase during hot flushes, without having an effect on the 24-h urine excretion of the peptide.

  • 18.
    Wyon, Yvonne
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Spetz, Anna-Clara
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Theodorsson, Elvar
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Concentrations of Calcitonin Gene-Related Peptide and Neuropeptide Y in Plasma Increase During Flushes in Postmenopausal Women2000In: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 7, no 1, p. 25-30Article in journal (Refereed)
    Abstract [en]

    Objective: To assess whether the plasma concentrations of calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), or neurokinin A (NKA) increase during hot flushes in postmenopausal women with vasomotor symptoms.

    Design: Eight postmenopausal women (age range = 49-63 years) with vasomotor symptoms were included. During 1 day, repeated blood samples were taken between and during flushes; four samples were taken during each flush. The samples were analyzed for CGRP, NPY, and NKA using radioimmunoassay technique.

    Results: The serum concentrations of CGRP and NPY increased significantly-73% and 34%, respectively-during the flushes (p = 0.018; p = 0.028), whereas the concentrations of NKA did not change significantly.

    Conclusions: CGRP and NPY may be involved in the mechanisms that cause vasomotor symptoms.

  • 19.
    Wyon, Yvonne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Synnerstad, Ingrid
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of dermatology and venereology. Östergötlands Läns Landsting, Centre for Medicine, Department of Dermatology and Venerology in Östergötland.
    Fredrikson, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Rosdahl, Inger
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of dermatology and venereology. Östergötlands Läns Landsting, Centre for Medicine, Department of Dermatology and Venerology in Östergötland.
    Spectrophotometric analysis of melanocytic naevi during pregnancy2007In: Acta Dermato-Venereologica, ISSN 0001-5555, E-ISSN 1651-2057, Vol. 87, no 3, p. 231-237Article in journal (Refereed)
    Abstract [en]

    Malignant melanoma is the most common cancer during pregnancy, but it is unknown whether melanocytic naevi in general are activated. A total of 381 melanocytic naevi in 34 Caucasian primigravidae were examined using spectrophotometric intracutaneous analysis (SIAscopy) technology in early pregnancy and prior to delivery. The Siagraphs of each naevus were then compared in order to evaluate changes over time. A total of 163 melanocytic naevi in 21 nulliparous women served as an additional control group. At the first visit none of the Siagraphs examined for the case or control groups aroused suspicion of dysplastic naevus or melanoma and no significant structural changes were noted during the observation period. However, 2.1% of the melanocytic naevi in the pregnant group increased and 1.3% decreased in size. Corresponding figures in the non-pregnant group were 1.8% and 0%, respectively. Only one naevus in a pregnant woman increased slightly in epidermal pigmentation, and a decrease in pigmentation was noted in 3.7% of the melanocytic naevi in the cases and 1.8% in the controls. None of the differences within or between the groups was statistically significant. We conclude that pregnancy does not influence the appearance of pigmented naevi. A changing naevus during pregnancy should be examined carefully and considered for excision and histopathology. © 2007 Acta Dermato-Venereologica.

  • 20.
    Wyon, Yvonne
    et al.
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Wijma, Klaas
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Nedstrand, Elisabeth
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    Hammar, Mats
    Linköping University, Department of Molecular and Clinical Medicine, Obstetrics and gynecology. Linköping University, Faculty of Health Sciences.
    A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women2004In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 7, no 2, p. 153-164Article in journal (Refereed)
    Abstract [en]

    Objective To compare the effects of electro-acupuncture with oral estradiol and superficial needle insertion on hot flushes in postmenopausal women.

    Material and methods  Forty-five postmenopausal women with vasomotor symptoms were randomized to electro-acupuncture, superficial needle insertion or oral estradiol treatment during 12 weeks, with 6 months' follow-up. The number and severity of flushes were registered daily and the Kupperman index and a general estimate of climacteric symptoms were completed before, during and after therapy.

    Results In the electro-acupuncture group, the mean number of flushes/24 h decreased from 7.3 to 3.5 (ANOVA, p  < 0.001). Eleven of the 15 women had at least a 50% decrease in number of flushes (with a mean decrease of 82%). Superficial needle insertion decreased the number of flushes/24 h from 8.1 to 3.8 (p  < 0.001). In seven out of 13 women, the number of flushes decreased by at least 50% (mean decrease 83%). In the estrogen group, the number of flushes decreased from 8.4 to 0.8 (p < 0.001). The decrease in number of flushes persisted during the 24-week follow-up period in all treatment groups. The Kupperman index and the general climacteric symptom score decreased, and remained unchanged 24 weeks after treatment in all groups (p < 0.001). Electro-acupuncture decreased the number of flushes/24 h significantly over time, but not to the same extent as the estrogen treatment. No significant difference in effect was found between electro-acupuncture and the superficial needle insertion.

    Conclusion We suggest that acupuncture is a viable alternative treatment of vasomotor symptoms in postmenopausal women and cannot recommend superficial needle insertion as an inactive control treatment.

  • 21.
    Zaborowska, Ewa
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Brynhildsen, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Damberg, Sara
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Fredriksson, Mats
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Lindh-Åstrand, Lotta
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Nedstrand, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wyon, Yvonne
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Hammar, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Effects of acupuncture, applied relaxation, estrogens and placebo on hot flushes in postmenopausal women – an analysis of two prospective, parallel, randomised studies2007In: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 10, no 1, p. 38-45Article in journal (Refereed)
    Abstract [en]

    Objective: To assess if transdermal or oral estrogens, acupuncture and applied relaxation decrease the number of menopausal hot flushes/24 h and improve climacteric symptoms, as assessed by the Kupperman index, more than transdermal placebo treatment.

    Setting: An outpatient clinic at a Swedish university hospital.

    Methods: A total of 102 postmenopausal women were recruited to two studies performed in parallel. In Study I, the women were randomized between transdermal placebo or estrogen treatment and, in Study II, between oral estrogens, acupuncture or applied relaxation for 12 weeks. Climacteric symptoms were measured with daily logbooks on hot flushes. Women completed the assessment questionnaire for the Kupperman index at baseline and after 12 weeks.

    Results: The number of flushes/24 h decreased significantly after 4 and 12 weeks in all groups except the placebo group. Both at 4 and 12 weeks, acupuncture decreased the number of flushes more (p < 0.05; p < 0.01, respectively) than placebo. At 12 weeks, applied relaxation decreased the number of flushes more (p < 0.05) than placebo. The Kupperman index score decreased in all groups except the placebo group. The decrease in score was significantly greater in all treatment groups than in the placebo group (p < 0.01).

    Conclusion: Acupuncture and applied relaxation both reduced the number of hot flushes significantly better than placebo and should be further evaluated as alternatives to hormone therapy in women with menopausal vasomotor complaints.

1 - 21 of 21
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