P06.14
Purpose: Most women experience multiple co-occurring symptoms (clusters) during the menopausal transition (MT) and early postmenopause. Clinical trial reports of hot flash (HF) therapies often omit co-occurring symptoms as outcomes. Systematic reviews of therapeutics for symptoms have focused almost exclusively on a single symptom, HFs. Although most investigators have focused systematic reviews on hormonal therapy, an increasing number are studying non-hormonal therapies. The purpose of this project is to systematically review clinical trials of Traditional Chinese Medicine, black cohosh, soy/isoflavone preparations and mind-body therapies for managing symptom clusters during the MT and early postmenopause.
Methods: To date there are no published reviews of multiple co-occurring symptoms in the MT literature. An experienced librarian searched for randomized controlled trials reported in English between 2004 and 2012. The following databases were searched: PubMED/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch. Reports that met all inclusion criteria and no exclusion criteria were reviewed and data were extracted and summarized.
Results: 1193 abstracts were identified and 58 reports of trials examining the effectiveness of therapies on HFs and at least one additional symptom including mood, pain, sleep and cognitive concerns were reviewed. Statistically significant between-group change in HFs plus one or more symptoms were reported in: 8 of 12 trials of Traditional Chinese Medicine (TCM), 10 of 19 trials of herbal therapies, 8 of 19 trials of soy-isoflavones, and 3 of 8 trials of mind-body therapies.
Conclusion: The papers reviewed reported few harms. TCM and herbal therapies show promise. Most investigators didn't include symptom clusters in the design or use measures with homogeneous scales. Most studies included fewer than 100 participants. Investigators should be encouraged to measure and report treatment effects in ways that allow clinicians to consider symptom clusters when prescribing therapies.
Contact: Lisa Taylor-Swanson, ljts369@uw.edu
