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The transition from the
reproductive to the
non-reproductive stage
of life, known as the
climacteric, adversely
affects the quality of
life of most women. Some
of the most common
menopausal symptoms
experienced by women are
hot flashes, sweating,
heart palpitations,
fatigue, depression,
decreased libido, and
cognitive impairment. In
recent years there has
been a shift from a
broad to a more
conservative use of
hormone replacement
therapy (HRT)
and further to the use
of alternative medicines
or lifestyle changes to
ameliorate these
symptoms. This trend has
resulted because of the
serious adverse effects
associated with the
long-term use of
estrogens. Pycnogenol®,
(Horphag Research Ltd;
Geneva, Switzerland) a
standardized extract
from the bark of Pinus
pinaster, has been shown
in animal and clinical
studies to improve
cognitive function,
improve the elasticity
of the skin, stimulate
the
endothelial production
of nitric oxide,
alleviate menstrual
pain, and reduce
hyperactivity. On
the basis of these
findings, this study was
undertaken to evaluate
the efficacy of
Pycnogenol
in treating climacteric
symptoms in
peri-menopausal women in
Taiwan.
Over a 3.5-year period
(from January 2002 to
July 2005), 200
peri-menopausal women,
aged 45-55 years, were
allocated to receive
100-mg capsules of
Pycnogenol or placebo
twice daily (at
breakfast and dinner)
for 6 months in a
double-blind manner.
Both capsules
were prepared by
Wide-Doctor Int.,
Taiwan. To be eligible
for inclusion, the women
had to
have serum estrogen E2
concentrations <20 pg/mL
and follicle-stimulating
hormone (FSH)
concentrations >30
IU/mL; exclusion
criteria included
systematic or acute
disease, the use
of hormones or
contraceptives,
illiteracy, or a history
of oophorectomy or
hysterectomy.
The participants were
interviewed to determine
lifestyle habits and
socioeconomic status at
the first visit. Blood
pressure and body mass
index (BMI) were
determined and blood was
drawn for the
measurement of lipid and
hormone concentrations
at baseline and at 1, 3,
and
6 months. Total
antioxidant status was
also evaluated. The
36-item Women's Health
Questionnaire was used
to evaluate the
climacteric symptoms
experienced by subjects
throughout the study.
One hundred fifty-five
participants (n = 80 in
the Pycnogenol group and
75 in the placebo
group) completed all of
the questionnaires and
investigations. Blood
pressure decreased in
both groups, with no
significant difference
between groups. High
density lipoprotein
(HDL)
cholesterol increased
and low density
lipoprotein (LDL)
cholesterol decreased
significantly
from baseline with
Pycnogenol treatment. No
significant differences
in HDL cholesterol
were observed between
groups; however, the
decrease in LDL
cholesterol was
significantly
greater in the
Pycnogenol group than in
the placebo group. The
atherosclerotic index
(ratio
of HDL to LDL
cholesterol) and total
antioxidant status were
favorably altered by
Pycnogenol. All
climacteric symptoms
evaluated (depression,
somatic and vasomotoric
symptoms, memory,
attractiveness, anxiety,
sexual symptoms, sleep,
and menstrual
symptoms) improved
significantly (P <
0.001) with Pycnogenol
treatment, as early as 1
month after initiation
of treatment. Most
climacteric symptoms
also improved with
placebo,
but not significantly
so. No unwanted side
effects were reported.
Pycnogenol treatment
resulted in the
improvement of all
climacteric symptoms
evaluated
and improved total
antioxidant status and
the atherosclerotic
index. The authors
conclude
that, "Supplementation
with Pycnogenol® clearly
reduced the frequency as
well as the
severity of climacteric
symptoms." Pycnogenol
may offer an alternative
to HRT for the
amelioration of
menopausal symptoms.
—Brenda Milot, ELS
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