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  • 1.
    Brynhildsen, Jan
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Nedstrand, Elizabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. 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]1994Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 91, nr 23, s. 2323-5Artikel i tidskrift (Refereegranskat)
  • 2.
    Hammar, Mats
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Heijl, Anders
    Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Svedin, Carl Göran
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Scheer, Johan
    Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Frisk, Jessica
    Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Nedstrand, Elizabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Kliniskt arbete i Linköpings läkarutbildning. Moment i utbildningen ersätter vikariaten [Clinical work during medical education in Linköping. This item in education is a substitute to temporary employment].1995Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 92, nr 13, s. 1389-1390Artikel i tidskrift (Övrigt vetenskapligt)
  • 3.
    Hammar, Mats
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Nedstrand, Elisabeth
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wyon, Yvonne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Få alternativ till östrogenbehandling vid vegetativa besvär efter menopaus.2004Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, nr 18, s. 1612-1615Artikel i tidskrift (Övrigt vetenskapligt)
  • 4.
    Lindgren, Richard
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Berg, G.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Zuccon (Nedstrand), Elizabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Hormonal replacement therapy and sexuality in a population of Swedish postmenopausal women1993Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 72, nr 4, s. 292-297Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    All women (n = 2465) living in the community of Linköping, Sweden, aged 55, 57, 59 and 65 years were studied in a cross-sectional trial concerning the prevalence of vasomotor symptoms, hormonal replacement therapy (HRT) and sexual activities. After one reminder, answers were received from 1867 (76%) women. In all, 51% of the women reported vasomotor symptoms. Ten percent of the women used HRT at the time of the survey. Another 10% of the women had previously used oral HRT but had abandoned treatment. One third of these women reported no vasomotor symptoms when they abandoned treatment. One fifth ceased treatment after recommendation from their physician and another fifth because of ‘fear’ of hormonal treatment.

    Sixty-two percent of the women reported sexual activity. The most common reasons for not having a regular sex-life were lack of partner or lack of desire.

  • 5.
    Lindh-Astrand, Lotta
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Nedstrand, Elizabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Effects of applied relaxation on vasomotor symptoms in postmenopausal women: a randomized controlled trial2013Ingår i: Menopause: The Journal of the North American Menopause, ISSN 1072-3714, E-ISSN 1530-0374, Vol. 20, nr 4, s. 401-408Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: This work aimed to study the efficacy of group therapy with applied relaxation on vasomotor symptoms and health-related quality of life in postmenopausal women. less thanbrgreater than less thanbrgreater thanMethods: In this open, randomized controlled trial, 60 healthy postmenopausal women with at least seven moderate to severe hot flashes per 24 hours were randomized to either group therapy with applied relaxation (n = 33) or untreated control group (n = 27) for 12 weeks. A follow-up visit was scheduled 3 months after the end of therapy or participation in the control group. Salivary cortisol was measured three times during a 6-month period. Hot flashes were recorded in self-registered diaries, and health-related quality of life was assessed with the Womens Health Questionnaire. less thanbrgreater than less thanbrgreater thanResults: The number of hot flashes decreased by 5.0 per 24 hours in the applied relaxation group compared with 1.9 in the control group on the 12th week (P andlt; 0.001) and still remained at the same level at the 3-month follow-up (P andlt; 0.001). Health-related quality of life for vasomotor symptoms, sleep, and memory improved significantly on the 12th week measurement in the applied relaxation group compared with the control group. Salivary cortisol concentration was lowered markedly in the applied relaxation group on a single measurement but was otherwise mainly stable in both groups. less thanbrgreater than less thanbrgreater thanConclusions: Applied relaxation can be used to treat vasomotor symptoms in healthy postmenopausal women.

  • 6.
    Lindh-Åstrand, Lotta
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Nedstrand, Elisabeth
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wyon, Yvonne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Vasomotor symptoms and quality of life in previously sedentary postmenopausal women randomised to physical activity or estrogen therapy2004Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 48, nr 2, s. 97-105Artikel i tidskrift (Refereegranskat)
    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.

  • 7.
    Lindh-Åstrand, Lotta
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Spetz, Anna-Clara
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Sydsjö, Gunilla
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Sweden.
    Carlbring, Per
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Psykologi. Linköpings universitet, Filosofiska fakulteten. Department of Psychology, Stockholm University, Sweden..
    Nedstrand, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Internet-delivered applied relaxation for vasomotor symptoms in postmenopausal women: Lessons from a failed trial.2015Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 80, nr 4, s. 432-434Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Internet-delivered therapies have a short history and promising results have been shown for several health problems, particularly for psychiatric conditions. This study was a first attempt to evaluate whether Internet-delivered applied relaxation for hot flushes in postmenopausal women may be useful. Due to a high drop-out rate the study was prematurely terminated after inclusion of approximately two thirds of calculated women. The Internet-delivered applied relaxation must probably be modified for such populations and settings before it can be used further. This article will discuss the benefits and pitfalls to learn in order to meet the challenges of future studies.

  • 8.
    Nedstrand, Elisabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Applied relaxation as treatment of vasomotor symptoms in postmenopausal women2005Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Vasomotor symptoms often disturb the night sleep and may lead to tiredness and mood disturbances. Many women who suffer from vasomotor symptoms ask for medical help and are often prescribed hormonal treatment. During the last years the popularity of HRT among women and doctors has decreased, probably because of the findings of long-term risks of HRT on breast cancer and the fact that the positive effects on cardiovascular health has not been confirmed in prospective randomized studies. The most effective treatment for hot flushes is HR T but for various reasons there is a need for developing alternative treatments. Relaxation therapy and behavioral therapies have been suggested for vasomotor symptoms but there are few randomized, controlled studies in this field, especially in women with breast cancer.

    The general aim of this thesis was to evaluate a technique in behavior therapy, applied relaxation, as a possible treatment of vasomotor symptoms in healthy women and women treated for breast cancer.

    The specific aims were:

    • to assess if stress coping differed between postmenopausal women, who wanted therapy for vasomotor symptoms and postmenopausal women without symptoms and to assess if stress coping changed when women with vasomotor symptoms received estrogen therapy. 18 women were recruited to the target group and 17 women to the comparison group

    • to evaluate if training applied relaxation for 12 weeks would decrease the number ofvasomotor symptoms and to evaluate if applied relaxation for 12 weeks would affect wellbeing in postmenopausal women seeking medical advice for vasomotor symptoms. 30 postmenopausal women were recruited and randomized to applied relaxation or estrogen therapy. In this study we also aimed to compare applied relaxation and estradiol as treatment of vasomotor symptoms in healthy postmenopausal women and also to compare the effects of applied relaxation and estradiol on wellbeing in healthy postmenopausal women

    • to evaluate if applied relaxation or electro-acupuncture for 12 weeks would decrease the number of vasomotor symptoms in postmenopausal women treated for breast cancer and to evaluate if applied relaxation or electro-acupuncture for 12 weeks would affect wellbeing in postmenopausal women treated for breast cancer. 38 women with breast cancer and with moderate to sever vasomotor symptoms were recruited.

    The main results were: Postmenopausal women bothered by vasomotor symptoms had significant lower stress coping ability measured with SCI, than women without symptoms.

    Eleven out of 12 healthy postmenopausal women randomised to treatment with applied relaxation had a mean decrease of flushes about 77% six months after end of therapy. The reduction was significant and persisted six months after end of therapy. General psychological wellbeing and mood were significantly ameliorated in healthy postmenopausal women treated with applied relaxation.

    Ten out of 14 breast cancer treated women randomised to treatment with applied relaxation had a mean decrease of flushes with 78 %. General psychological wellbeing was significantly ameliorated and this phenomenon appeared after the flushes were significantly reduced. Both the significant reduction of flushes and significantly ameliorated wellbeing persisted 6 months after end of therapy.

    In summary: This thesis shows that that behavioral therapy with applied relaxation significantly decreases flushes and ameliorates general psychological wellbeing in postmenopausal women bothered by climacteric symptoms. Therefore we suggest that applied relaxation is a viable alternative treatment of vasomotor symptoms in healthy postmenopausal women and in women treated for breast cancer.

    Delarbeten
    1. The relationship between stress-coping and vasomotor symptoms in postmenopausal women
    Öppna denna publikation i ny flik eller fönster >>The relationship between stress-coping and vasomotor symptoms in postmenopausal women
    1998 (Engelska)Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 31, nr 1, s. 29-34Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: The objective was to assess whether menopausal women with vasomotor symptoms had a lower stress-coping than menopausal women without symptoms and if stress-coping changed when vasomotor symptoms had been effectively treated with estrogens. The objective was also to assess whether menopausal women, effectively treated for vasomotor symptoms, had a higher neuroticism score than women without such symptoms.

    Methods: Two groups of physically and mentally healthy postmenopausal women were recruited from the outpatient clinic at the Department of Obstetrics and Gynaecology, University Hospital of Linköping, Sweden. Sixteen women with vasomotor symptoms (target group) were treated with oral 17β-estradiol, 2 mg/day during 3 months. A comparison group was formed comprising 17 women without vasomotor symptoms. The Kupperman Index was used to cover menopausal characteristics in all women at baseline as well as at the second visit after 3 months. Stress-coping was measured by means of the Stress Coping Inventory, which is an instrument developed to measure of the individual's appraisal of having adaptive resources for handling stressful situations. At the second visit all women were also asked to complete the Eysenck Personality Inventory.

    Results: Women in the target group had a significantly lower stress-coping than women in the comparison group at baseline as well as after 3 months. Stress-coping did not change after estrogen therapy, although the vasomotor symptoms had virtually disappeared. Women in the target group successfully treated for vasomotor symptoms, had a significantly higher neuroticism score compared to the comparison group.

    Conclusions: Differences in behaviour patterns and personality are probably two reasons why some women report or seek advice due to vasomotor symptoms and some women do not. Stress-coping in women with moderate to severe vasomotor symptoms is unaffected by estrogens.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-83011 (URN)10.1016/S0378-5122(98)00058-9 (DOI)
    Tillgänglig från: 2012-10-02 Skapad: 2012-10-02 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    2. Treatment of menopausal symptoms with applied relaxation: a pilot study
    Öppna denna publikation i ny flik eller fönster >>Treatment of menopausal symptoms with applied relaxation: a pilot study
    1997 (Engelska)Ingår i: Journal of Behavior Therapy and Experimental Psychiatry, ISSN 0005-7916, E-ISSN 1873-7943, Vol. 28, nr 4, s. 251-261Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Applied relaxation (AR) was tested in a series of six women with postmenopausal hot flushes. The AR program consisted of group instructions I hour per week over a 12 week duration. The number of flushes were registered from 1 month before to 6 months after training AR. Menopausal symptoms (Kupperman Index), psychological well-being (Symptom Checklist), and mood (MOOD Scale) were measured at various moments during the study. For the six patients the number of flushes decreased from the baseline period to 6 months follow-up with 59, 61, 62, 67, 89 and 100% respectively, in mean 73%. While the scores on the Kupperman Index and the Symptom Checklist followed the pattern of the flushes, a similar trend was not seen for the scores on the MOOD Scale.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-83012 (URN)10.1016/S0005-7916(97)00030-X (DOI)
    Tillgänglig från: 2012-10-02 Skapad: 2012-10-02 Senast uppdaterad: 2017-12-07Bibliografiskt granskad
    3. Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women
    Öppna denna publikation i ny flik eller fönster >>Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women
    2005 (Engelska)Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 51, nr 2, s. 154-162Artikel i tidskrift (Refereegranskat) Published
    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.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-29369 (URN)10.1016/j.maturitas.2004.05.017 (DOI)14701 (Lokalt ID)14701 (Arkivnummer)14701 (OAI)
    Tillgänglig från: 2009-10-09 Skapad: 2009-10-09 Senast uppdaterad: 2017-12-13Bibliografiskt granskad
    4. Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study
    Öppna denna publikation i ny flik eller fönster >>Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study
    2005 (Engelska)Ingår i: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 8, nr 3, s. 243-250Artikel i tidskrift (Refereegranskat) Published
    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.

    Ort, förlag, år, upplaga, sidor
    Institutionen för klinisk och experimentell medicin, 2005
    Nyckelord
    Vasomotor symptoms; Menopause; Breast cancer; Applied relaxation; Acupuncture
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-11901 (URN)10.1080/13697130500118050 (DOI)
    Anmärkning
    Original publication: E. Nedstrand, K. Wijma, Y. Wyon, M. Hammar, Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study, 2005, Climacteric, (8), 3, 243-250. http://dx.doi.org/10.1080/13697130500118050. Copyright © Taylor & Francis Group, an informa businessTillgänglig från: 2008-05-23 Skapad: 2008-05-23 Senast uppdaterad: 2017-12-13
    5. Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptoms
    Öppna denna publikation i ny flik eller fönster >>Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptoms
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    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.

    Nyckelord
    Vasomotor symptoms, menopause, breast cancer, applied relaxation, acupuncture
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-83191 (URN)
    Tillgänglig från: 2012-10-02 Skapad: 2012-10-02 Senast uppdaterad: 2012-10-02Bibliografiskt granskad
  • 9.
    Nedstrand, Elisabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Applied relaxation and oral estradiol treatment of vasomotor symptoms in postmenopausal women2005Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 51, nr 2, s. 154-162Artikel i tidskrift (Refereegranskat)
    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.

  • 10.
    Nedstrand, Elisabeth
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Vasomotor symptoms decrease in women with breast cancer randomized to treatment with applied relaxation or electro-acupuncture: a preliminary study2005Ingår i: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 8, nr 3, s. 243-250Artikel i tidskrift (Refereegranskat)
    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.

  • 11.
    Nedstrand, Elisabeth
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wyon, Yvonne
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wijma, Klaas
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin.
    Psychological well-being improves in women with breast cancer after treatment with applied relaxation or electro-acupuncture for vasomotor symptom2006Ingår i: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 27, nr 4, s. 193-199Artikel i tidskrift (Refereegranskat)
    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.

  • 12.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Ekseth, Ulrika
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Lindgren, Richard
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    The climacteric among South-American women, who immigrated to Sweden and age-matched Swedish women1995Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 21, nr 1, s. 3-6Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Forty-nine immigrated South-American (SA) and 48 Swedish women, aged 42-67 years, were studied in a comparative semi-structured interview survey, concerning the climacteric and its treatment. The mean age at natural menopause was 47 for the South-American women and 50 for the Swedish women. The prevalence of moderate to severe vasomotor symptoms at the time of the survey did not differ significantly between the non-treated, non-operated, postmenopausal South-American and Swedish women (36% and 21%; N.S.). One reason for the trend towards a higher prevalence among South-American women could be that a greater number of Swedish women used hormone replacement treatment compared to South-American women (11 vs. 4). The general attitude to hormone replacement therapy was more positive among South-American women, although they did not use hormone therapy, as could be expected from their symptoms. These results are probably an illustration of the difficulties in getting access to treatment for the immigrated SA women.

  • 13.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Pertl, J.
    Department of Obstetrics and Gynaecology, County Hospital of Kladno, Kladno, Czech Republic.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, BKC - Barn och kvinnocentrum, KK - Kvinnokliniken.
    Climacteric symptoms in a postmenopausal Czech population1996Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 23, nr 1, s. 85-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To assess the prevalence of climacteric symptoms and the use of hormone replacement therapy in a former eastern European country. All 55-, 57-, 59- and 61-year-old women in Kladno in the Czech Republic were asked to participate in the study.

    METHOD: In 1993, 1505 women in Kladno of the Czech Republic were sent a postal questionnaire concerning age at menopause and their climacteric symptoms.

    RESULTS: Answers were received from 799 women (53%); 98% were postmenopausal. The median age at spontaneous menopause was 50 years, 49.5 years among women smoking at least 5 cigarettes/day and 51.0 years among non-smokers (P < 0.05). About every fifth woman smoked. Totally 22% of the women had undergone hysterectomy and/or oophorectomy and 3% had been treated for a gynaecological malignancy. The majority of the women (58%) reported ongoing vasomotor symptoms; half of them had moderate to severe vasomotor symptoms. In all, 79% of the women reported ever having vasomotor symptoms. Only 3% of the women had ever tried hormone replacement therapy (HRT) and one woman had current treatment. Dysuria was reported by 22% and 4% had recurrent urinary tract infections; 70% of the women had a partner and 50% were sexually active. Reasons for not being sexually active were mostly lack of a partner, loss of sexual desire or partner's disease or impotence.

    CONCLUSION: Climacteric symptoms including vasomotor and urogenital symptoms had the same prevalence in the Czech Republic as previously reported in other Western Countries. Only a few women had tried HRT. Smokers had a slightly earlier menopause.

  • 14.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Lindgren, Monica
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    The relationship between stress-coping and vasomotor symptoms in postmenopausal women1998Ingår i: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 31, nr 1, s. 29-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The objective was to assess whether menopausal women with vasomotor symptoms had a lower stress-coping than menopausal women without symptoms and if stress-coping changed when vasomotor symptoms had been effectively treated with estrogens. The objective was also to assess whether menopausal women, effectively treated for vasomotor symptoms, had a higher neuroticism score than women without such symptoms.

    Methods: Two groups of physically and mentally healthy postmenopausal women were recruited from the outpatient clinic at the Department of Obstetrics and Gynaecology, University Hospital of Linköping, Sweden. Sixteen women with vasomotor symptoms (target group) were treated with oral 17β-estradiol, 2 mg/day during 3 months. A comparison group was formed comprising 17 women without vasomotor symptoms. The Kupperman Index was used to cover menopausal characteristics in all women at baseline as well as at the second visit after 3 months. Stress-coping was measured by means of the Stress Coping Inventory, which is an instrument developed to measure of the individual's appraisal of having adaptive resources for handling stressful situations. At the second visit all women were also asked to complete the Eysenck Personality Inventory.

    Results: Women in the target group had a significantly lower stress-coping than women in the comparison group at baseline as well as after 3 months. Stress-coping did not change after estrogen therapy, although the vasomotor symptoms had virtually disappeared. Women in the target group successfully treated for vasomotor symptoms, had a significantly higher neuroticism score compared to the comparison group.

    Conclusions: Differences in behaviour patterns and personality are probably two reasons why some women report or seek advice due to vasomotor symptoms and some women do not. Stress-coping in women with moderate to severe vasomotor symptoms is unaffected by estrogens.

  • 15.
    Nedstrand, Elizabeth
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Psychological wellbeing ameliorates in women with breast cancer randomized to treatment with applied relaxation or acupuncture for vasomotor symptomsManuskript (preprint) (Övrigt vetenskapligt)
    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.

  • 16.
    Sandberg, Margareta
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Rehabiliteringsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Smärt- och rehabiliteringscentrum.
    Wijma, Klaas
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Genus och medicin. Linköpings universitet, Hälsouniversitetet.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Nedstrand, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Effects of electro-acupuncture on psychological distress in postmenopausal women2002Ingår i: Complementary Therapies in Medicine, ISSN 0965-2299, Vol. 10, nr 3, s. 161-169Artikel i tidskrift (Refereegranskat)
    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.

  • 17.
    Sydsjö, Gunilla
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Lindell Pettersson, Malin
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Bladh, Marie
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Skoog Svanberg, Agneta
    Uppsala Univ, Sweden.
    Lampic, Claudia
    Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Nedstrand, Elizabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för barns och kvinnors hälsa. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Evaluation of risk factors’ importance on adverse pregnancy and neonatal outcomes in women aged 40 years or older2019Ingår i: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 19, artikel-id 92Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Women of advanced age (40 years or older) are generally, at risk for pregnancy and delivery related problems. In addition, there is limited knowledge on being of advanced age and having been given Assisted Reproductive Treatment (ART) and its association with negative obstetric outcomes. Therefore, data from the Swedish Medical Birth Register was used to investigate pregnancy and neonatal outcomes for women aged 40 or more who had given birth. The secondary aim was to compare the obstetric outcomes of women who had used ART and women who had not undergoneART while adjusting for marital status across the age groups.

    Method

    Women of advanced age who had given birth in Sweden during 2007–2012 formed the index group, n = 37,558; a reference group of women comprised 71,472 women under the age of 40. An additional subgroup of women aged 45 or older when giving birth was also formed, n = 2229. The obstetric and neonatal data for all the women was derived from national register data.

    Results

    Women of advanced age were more often single, had undergone ART, and more often experienced adverse obstetric outcomes than did younger women. The neonate’s health was also more often adversely affected expressed as being born with low birth weight and Small for Gestational Age (SGA), having lower Apgar scores, and having more health problems during the first week compared to the reference group.

    Conclusions

    Women who are approaching the upper limit of fecundity are at greater risk for having children who are preterm and SGA. The adverse effects of being preterm and SGA may have negative long-term effects, not only on the children but also on the mothers. This needs to be addressed more frequently in a clinical setting when advising women of all ages on pregnancy and ART treatment.

  • 18.
    Wijma, Klaas
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Melin, Annika
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Nedstrand, Elizabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Treatment of menopausal symptoms with applied relaxation: a pilot study1997Ingår i: Journal of Behavior Therapy and Experimental Psychiatry, ISSN 0005-7916, E-ISSN 1873-7943, Vol. 28, nr 4, s. 251-261Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Applied relaxation (AR) was tested in a series of six women with postmenopausal hot flushes. The AR program consisted of group instructions I hour per week over a 12 week duration. The number of flushes were registered from 1 month before to 6 months after training AR. Menopausal symptoms (Kupperman Index), psychological well-being (Symptom Checklist), and mood (MOOD Scale) were measured at various moments during the study. For the six patients the number of flushes decreased from the baseline period to 6 months follow-up with 59, 61, 62, 67, 89 and 100% respectively, in mean 73%. While the scores on the Kupperman Index and the Symptom Checklist followed the pattern of the flushes, a similar trend was not seen for the scores on the MOOD Scale.

  • 19.
    Wyon, Yvonne
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Medicincentrum, Hudkliniken i Östergötland.
    Nedstrand, Elisabeth
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Klimakteriebesvär: Mer forskning behövs om olika behandlingsformer - inklusive akupunktur.2005Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, s. 1664-1665Artikel i tidskrift (Övrigt vetenskapligt)
  • 20.
    Wyon, Yvonne
    et al.
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Wijma, Klaas
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Nedstrand, Elisabeth
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    Hammar, Mats
    Linköpings universitet, Institutionen för molekylär och klinisk medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet.
    A comparison of acupuncture and oral estradiol treatment of vasomotor symptoms in postmenopausal women2004Ingår i: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 7, nr 2, s. 153-164Artikel i tidskrift (Refereegranskat)
    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.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Brynhildsen, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Damberg, Sara
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Fredriksson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Lindh-Åstrand, Lotta
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Nedstrand, Elisabeth
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Wyon, Yvonne
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Hammar, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Obstetrik och gynekologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Kvinnokliniken i Linköping.
    Effects of acupuncture, applied relaxation, estrogens and placebo on hot flushes in postmenopausal women – an analysis of two prospective, parallel, randomised studies2007Ingår i: Climacteric, ISSN 1369-7137, E-ISSN 1473-0804, Vol. 10, nr 1, s. 38-45Artikel i tidskrift (Refereegranskat)
    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.

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