The effect of different progestogens on sleep in postmenopausal women: a randomized trial

Leeangkoonsathian, Ekachai; Pantasri, Tawiwan; Chaovisitseree, Somsak; Morakot, Nuntana

doi:10.1080/09513590.2017.1333094

Cited by 20 publications

(12 citation statements)

References 26 publications

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“…80,[82][83][84][85] Hormonal and nonhormonal therapies directed at vasomotor symptoms have been shown to improve subjective sleep quality. [85][86][87] Actigraphy and polysomnography confirm sleep fragmentation, increased wake after sleep onset chestjournal.org (WASO), and poor sleep efficiency associated with vasomotor symptoms. When vasomotor activity is measured objectively by using skin conductance, similar findings of objective sleep disturbances are found.…”

Section: Vasomotor Symptoms and Sleepmentioning

confidence: 99%

Sleep in Women Across the Life Span

Pengo

Won

Bourjeily

2018

Chest

209

133

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There are many ways in which women experience sleep differently from men. Women contending with distinct sleep challenges respond differently to sleep disorders, as well as sleep deprivation and deficiency, and face particular health outcomes as a result of poor sleep. Idiosyncrasies, including changes that occur with the biological life cycles of menstruation, pregnancy, and menopause, make the understanding of sleep in women an important topic to study. Each phase of a woman's life, from childhood to menopause, increases the risk of sleep disturbance in unique ways that may require distinct management. Indeed, new research is unraveling novel aspects of sleep pathology in women and the fundamental role that sex hormones play in influencing sleep regulation and arousals and possibly outcomes of sleep conditions. Moreover, studies indicate that during times of hormonal change, women are at an increased risk for sleep disturbances such as poor sleep quality and sleep deprivation, as well as sleep disorders such as OSA, restless legs syndrome, and insomnia. This article reviews sleep changes in female subjects from neonatal life to menopause.

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Section: Vasomotor Symptoms and Sleepmentioning

confidence: 99%

Sleep in Women Across the Life Span

Pengo

Won

Bourjeily

2018

Chest

209

133

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“…Four RCTs could not be included in the quantitative analysis due to the absence of outcomes in the placebo group. Leeangkoonsathia et al 30 reported that both EV combined with micronized progesterone and dydrogesterone improved sleep quality, whereas no significant difference between the two groups. Shulman et al 34 demonstrated that both t-17β-E 2 monotherapy and three doses of combined 17β-E 2 /levonor-gestrel transdermal system improved sleep quality, whereas no significant difference among those groups.…”

Section: Resultsmentioning

confidence: 99%

Different regimens of menopausal hormone therapy for improving sleep quality: a systematic review and meta-analysis

et al. 2022

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Importance: Long-term sleep disturbances in menopausal women are closely related to cardiovascular disorders, metabolic disorders, and cognitive impairment. At present, hormone therapy (HT) is a standard treatment for menopausal symptoms. However, it remains unclear whether HT can improve sleep quality. Objective: We did a systematic review and meta-analysis to assess the effects of different HT regimens on menopausal sleep quality. Evidence Review: We systematically searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and Web of Science for randomized controlled trials of menopausal HT on sleep disturbances up to June 14,2021. Information about ongoing and unpublished trials was collected by searching WHOICTRP and ClinicalTrials.gov. Our primary outcome was sleep quality with objective measurements. We estimated the standardized mean difference (SMD) using random-effects models. Findings: We identified a total of 3,059 studies and finally included 15 studies in the meta-analysis. Compared with placebo, HT improved self-reported sleep outcomes (SMD = –0.13; 95% CI, –0.18 to -0.08, P < 0.00001 and I 2 = 41%), but not sleep parameters measured by polysomnography. Subgroup analyses according to the regimen of HT showed that 17β-estradiol (17β-E 2 ) (SMD = –0.34; 95% CI, –0.51 to -0.17, P < 0.0001, and I 2 = 0%) and conjugated equine estrogens (SMD = –0.10; 95% CI, −0.12 to −0.07, P < 0.00001, and I 2 = 0%) improved sleep quality. Moreover, transdermal administration (SMD = −0.35; 95% CI, −0.64 to −0.06, and P = 0.02) was more beneficial than oral (SMD = −0.10; 95% CI, −0.14 to −0.07, and P < 0.00001). In addition, the combination of estrogen and progesterone had a positive effect on sleep disturbance (SMD = −0.10; 95% CI, −0.13 to −0.07, P < 0.00001, and I 2 = 0%), while estrogen monotherapy did not. The results showed that estrogen/micronized progesterone (SMD = −0.22; 95% CI, −0.37 to −0.06, P = 0.007, and I 2 = 0%) and estrogen/medroxyprogesterone acetate (SMD = −0.10; 95% CI, −0.13 to −0.07, P < 0.00001, and I 2 = 0%) could alleviate sleep disturbance. Conclusions and Relevance: HT has a beneficial effect on sleep disturbance to some extent, and the formulations and routes of administration of hormonal agents influence the effect s...

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“…Supplementation with exogenous estrogen and progesterone can inhibit the release of FSH and restore follicular development and ovulation through a negative feedback mechanism. The Leeangkoonsathian et al [ 21 ]’ study suggested that estrogen and progesterone supplementation could improve the sleep quality of postmenopausal women.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, we found that treatment with Kuntai capsules combined with FMT was associated with improved menstruation, reduced menstruation, delayed menstruation, thick red discharge, dizziness and palpitations, sore waist and knees, insomnia and excessive dreaming, irritability, pudendal dryness, and other symptoms. The mechanisms may be related to the effects of FMT on regulating the hypothalamus-pituitary-ovary axis through negative feedback by supplementation with estrogen and progesterone to promote follicular development and ovulation[ 21 ]. Water extracts of cooked Rehmannia glutinosa in Kuntai capsules can regulate the response of the human body to gonadotropin and modulate endometrial receptivity.…”

Section: Discussionmentioning

confidence: 99%

Clinical observation of Kuntai capsule combined with Fenmotong in treatment of decline of ovarian reserve function

Lin

Chen

Wang

et al. 2021

WJCC

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BACKGROUND Decreased ovarian reserve function is an ovarian hypofunction disease that occurs in women before 40 years of age, leading to a decline in fertility and perimenopausal symptoms, such as irregular menstruation, amenorrhea, infertility, decreased libido, and autonomic nervous dysfunction. Fenmatong (FMT) is a compound mixture of estradiol tablets and estradiol didroxyprogesterone tablets, which can improve ovarian reserve function by supplementation of exogenous estrogen. However, this treatment has also been shown to cause breast pain, gastrointestinal discomfort, irregular vaginal bleeding, and changes in sexual desire. In severe cases, FMT can promote the development of breast cancer, endometrial cancer, and venous embolic disease. AIM To observe the effects of Kuntai capsules and FMT on endocrine indexes and uterine artery blood circulation in patients with decreased ovarian reserve function. METHODS Patients (130) with decreased ovarian reserve function, who were treated in our hospital from May 2018 to May 2020, were divided into two groups: The FMT group, in which patients were treated with FMT, and the observation group, in which patients were treated with Kuntai capsules. Chinese medicine symptom scores, uterine artery blood flow parameters, ovarian ultrasound test indexes, pictorial blood loss assessment chart (PBAC) scores, and hormone levels were recorded, and total effective rates were calculated for both groups. RESULTS The total effective rate in the observation group was higher than that in the FMT group ( P < 0.05).After treatment, primary symptoms, including low menstrual volume, delayed menstruation, red color and thick consistency of menses, dizziness, palpitation, weakness at the waist and knee, insomnia and excessive dreaming, irritability, and dryness and astringency of the pudendal canal in the observation group decreased, and scores for primary and secondary symptoms in the observation group were significantly lower than those in the FMT group ( P < 0.05).The systolic peak flow rate (PSV), end-diastolic flow rate (EDV), ovarian diameter, sinus follicle count, and resistance index (RI) of the uterine arteries in the observation group and FMT group increased after treatment. Notably, the PSV, EDV, ovarian diameter, and antral follicle count in the observation group were higher than those in the FMT group, whereas the RI in the observation group was lower than that in the FMT group ( P < 0.05).The PBAC scores in the observation and FMT groups increased after treatment, with that in the observation group becoming significantly higher than that in the FMT group ( P < 0.05). After treatment, estradiol (E2) and anti-Mullerian hormone (AMH) levels increased, whereas follicle-stimulating hormone (FSH) levels decreased in the observation group and FMT group; E2 and AMH levels beca...

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The effect of different progestogens on sleep in postmenopausal women: a randomized trial

Abstract: Sleep quality of peri-postmenopausal women with insomnia improved dramatically after the first month of hormonal treatment. However, more participating patients are necessary to ascertain the differences in sleep quality from dydrogesterone and micronized progesterone treatment.

Cited by 20 publications

References 26 publications

Sleep in Women Across the Life Span

Sleep in Women Across the Life Span

Different regimens of menopausal hormone therapy for improving sleep quality: a systematic review and meta-analysis

Clinical observation of Kuntai capsule combined with Fenmotong in treatment of decline of ovarian reserve function

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