Supervisors info:
Χρούσος Π. Γεώργιος, Καθηγητής Παιδιατρικής, Ιατρική Σχολή, ΕΚΠΑ
Λαμπρινουδάκη Β. Ειρήνη, Αναπληρώτρια Kαθηγήτρια Γυναικολογικής Eνδοκρινολογίας, Ιατρική Σχολή, ΕΚΠΑ
Ζέρβας Μ. Ιωάννης, Καθηγητής Ψυχιατρικής, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Abstract
Introduction
Stress and psychology may affect the climacteric symptoms experienced by women during the menopausal transition and accordingly these in turn may affect stress levels. We assumed therefore, that by implementing a stress – reducing intervention in this population, climacteric symptoms can be managed without medical treatment.
Aim
The main purpose of this study was to evaluate the effectiveness of a stress management program to reduce stress and climacteric symptoms in recently postmenopausal Greek women. Secondary objectives were: 1) to describe health indicators, medical history, daily routine and quality of life in this population 2) to assess the effectiveness of the intervention on self-esteem of women and 3) to identify which menopause - related factors contribute to stress occurrence.
Population and methods
This is a randomized clinical study performed for the first time, as far as we know, in a population of peri- and postmenopausal women. The study was conducted in the Menopause Clinic of the 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Medical School, Aretaieio Hospital. The study included 61 women aged 40-65 years, who were either perimenopausal or within the 1st decade of menopause and presented with climacteric and stress symptoms. Women were randomly assigned either in the intervention group (31 people) or the control group (30 people). Both groups answered the same questionnaire at baseline. The intervention group attended eight sessions of a stress management program (1 per week) on the benefits of regular exercise, healthy diet, cognitive restructuring-positive thinking. Women were taught relaxation techniques such as diaphragmatic breathing, progressive neuromuscular relaxation and guided visualization. The control received only advise after the completion of the baseline questionnaire on diet, exercise and relaxation. At the end of the 8 week study period, both groups completed the original questionnaire to determine whether changes have been made in their responses. After the completion of the study, women in the control group were offered the same stress – reducing intervention which had been implemented in the study.
Results
The intervention group was significantly improved with regard to all parameters compared with the initial responses (stress before intervention Mean: 8,10, SD: 4,735, stress after intervention Mean: 5,03 SD: 3,886, p-value:0,001<0,05, climacteric symptoms before intervention Mean: 4,3226, SD: 2,39982, climacteric symptoms after intervention Mean: 1,2581 SD: 1,12451, p-value: 0,000<0,05) and compared with those in control responses (stress in Control Group after 8 weeks Mean: 13,8000, SD: 4,90882, stress in Intervention Group after 8 weeks Mean: 5,0323 SD: 3,88573, p-value: 0,000<0,05, climacteric symptoms in Control Group after 8 weeks Mean: 2,8667, SD: 2,09652, climacteric symptoms in Intervention Group after 8 weeks Mean: 1,2581 SD: 1,12451, p-value: 0,001<0,05). Reduction of stress levels, anxiety, depressive and climacteric symptoms were significant in the intervention group and non-significant in the control group. Furthermore, statistically significant improvements of sleep quality, spiritual and religious well-being and life satisfaction were observed only in the intervention group. Finally, self-esteem, healthy lifestyle and cognitive skills improved in both groups, the magnitude of the effect, however, was stronger in the intervention group.
Conclusions
In this study, both groups had similar descriptive characteristics in terms of age, marital status, number of children, education level, body mass index and years in menopause.
The homogeneity of the two study group indicates that stress management alone can improve climacteric symptomatology and quality of life of peri- and postmenopausal women. This may prove an alternative non-pharmacological approach for the management of menopausal symptoms.
