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Introduction: Sexual instinct which is the cause of numerous changes in one’s life could be influenced by numerous factors such as menopause and aging. This study was focused on comparison of women’s sexual functioning disorders before and after menopause. Materials and Methods: This is an analytic cross sectional study in which data related to before and after menopause sexual activities of 174 married women (living with their spouses), referring to health centers in Isfahan in 2003 was collected and investigated. Data was collected by a self constructed sexual dysfunction inventory in which reliability and validity were reached by content validity and α chorenbach index. Findings were analysed through descriptive and inferential (MC-Nemar) statistics. Results: Findings showed that relative frequency of sexual functioning disorders in productive period was 38% and in menopausal period 72.4%. There was a significant association between sexual functioning disorders before and after menopausal period (P < 0.001). Frequency distribution of sexual functioning disorders in productive period of these women according to severity of disorders were: sexual desire disorder (49/2%), dyspareunia (34/3%), arousal dysfunction (26/8%), orgasmic dysfunction (23/8%), and vaginismus (16/4%). Frequency distribution of sexual functioning disorders in menopausal period of these women were: arousal dysfunction(75/3%), sexual disire disorder (62/6%), orgasmic dysfunction (56/3%), dyspareunia (34/9%) and vaginismus (15/8%).
Conclusion: As revealed by the findings of the study,a high percentage of women experience sexual functioning disorders in productive and menopausal periods. Menopause can be a cause to occur, or continue these disorders. The role of health care professinals in conselling and education is emphasized.

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Introduction: Menopause is a natural period of life. It means the permanent cessation of menstruation and the end of reproductive period which occurs between 45-52 years old. It also serves as an indicator of population health as the occurrence of menopause indicates the increased risk for the onset of several chronic diseases. In this study, the mean age of natural menopause among women in Arak (Central Iran) was investigated, considering their reproductive and socio-economic-demographic factors and their health behaviors. Materials and Methods: This study was an observational cross-sectional study on a population base, carried out in 2007 year. Interviews and questionnaires were used for gathering data from 458 women resident in Arak city, who had undergone a natural menopause. Sampling was multistaged using postal zones and selecting samples in each zone. Data was analyzed using variance analysis, multiple regression, T and correlation coefficient tests. Results: Findings showed that the mean age of menopause in our sample was 48.2±2.34 years (95% CI: 47.98- 48.41) and its median was 49 years. The mean age of menopause in women who were never married was less than married women (P= 0.015). Low income level (P= 0.003), having physical activity (P= 0.004), number of pregnancies (P<0.001), age of last pregnancy (P=0.026) and place of birth (P=0.003) were meaningfull factors in age of menopause. Conclusion: This phenomenon must be documented in Iran because of its strong link with mortality and morbidity of the growing number of women who are reaching advanced ages whose one forth of life is after menopause. Therefore health education as the best way for changing their lifestyle is suggested.

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Background: The aim of this study was to investigate the effect of BMI and reproductive histories (age, age at menarche, the number of parities, reproductive years and years since menopause, and serum levels of estradiol, testosterone and SHBG) on bone densitometry of spine and femur in healthy postmenopausal women. Materials and Methods: In a descriptive cross-sectional study, 190 healthy postmenopausal women, aged 40-64, who did not have a history of co-existing diseases, diseases affecting the quality of life, bone diseases, and using drugs affecting the bone metabolism, were randomly selected. Bone densitometry, T score, Z score, and bone marrow density (BMD) were determined by dual energy X-ray absorptiometry (DXA) at lumbar spine and femur. Correlation co-efficients were, then, measured for the relationship between bone density and the intended factors. Results: BMI presented significant positive relationships with T score and BMD of spine and BMD, T score, and Z score of femur, whereas age, the number of years since menopause, and the serum level of testosterone had negative relationships with T score and BMD of spine. The serum level of testosterone showed a negative relationship with Z score reduction in spine. The number of years since menopause had a positive relationship with reductions in Z score and BMD of femur. In addition, significant positive relationships were observed between the number of reproductive years and T score and BMD of spine. Conclusion: Bone loss in postmenopausal women is intensified with increases in age, the number of years since menopause, and the serum level of testosterone, whereas BMI has a bone-protective effect.

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Background: Sex life is one of the most important aspects of quality of life which is affected by a multitude of factors which can disrupt it. This study compares the effects of two different hormonal therapeutic regimens on sexual performance of postmenopausal women. Materials and Methods: In this randomized clinical trial, a total of 111 healthy postmenopausal women with no absolute contraindication for hormone replacement therapy (HRT) were divided into two groups that received GI-Tibolone 2.5mg/day (N=57) and GII-continuous conjugated estrogen (CE) 0.625mg/day plus medroxyprogestrone acetate (MPA) 2.5mg/day (N=54) for six months. At baseline and after 6 months of treatment, blood samples were collected for determining sexual hormones level. Sexual function was assessed by Female Sexual Function Index (FSFI). Data were analyzed using Spss 16. Results: Of all the participants, 45 women in the tibolone group and 32 women in HRT completed the study. Compared with the baseline values, the tibolone group significantly improved on all the six FSFI domains however, in the HRT group, just two of the six domains, lubrication and pain, got improved. The increase in mean total score and the score of each domain of FSFI except for satisfaction domain in the tibolone group was significantly greater than the HRT group (p<0.05). In the tibolone group, testosterone (p=0.003), FTI (p=0.002), and FEI (p=0.021) increased in comparison to the baseline, whereas SHBG decreased (p<0.001). In GII group, SHBG (p=0.001) significantly increased and tibolone was tolerated better than HRT. Conclusion: In post menopausal women, tibolone is more effective than HRT in improving sexual function scores, especially the desire, arousal, and orgasm domains. Its side effects are also much more acceptable.

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Background: Vasomotor disorders are one of the most painful menopausal complications that negatively affect the quality of life in menopausal women. This study investigated the effects of omega3 fatty acid on vasomotor disorders in menopausal women. Materials and Methods: This randomized, double-blind, placebo-controlled clinical trial study was done on 83 menopausal women aged 45-60 years that had met the inclusion criteria. The participants were randomly assigned to omega3 or placebo groups. Fish oil capsules (containing 300 mg of omega3) or placebo capsules were prescribed to the participants one capsule a day for 8 weeks. Of the 83 patients enrolled, 68 completed the study (omega3 supplement, n=34 placebo n=34). Data collection was done through demographic questionnaire, daily self report, and food frequency questionnaire (FFQ). Data were analyzed by t-test, Chi square, Fiedman, and Mann-Whitney tests using SPSS software version 18. Results: After 8 weeks of intervention, there was a significant difference in HF frequency (p=0.003) and nightsweats frequency (p=0.001) between the two groups. There was no significant difference in HF intensity between the two groups (p=0.2) but reduction of nightsweats intensity was significant between the two groups (p=0.003). Conclusion: Omega3 affected the reduction of HF frequency and nightsweats frequency and intensity but it did not have a significant effect on the severity of HF.

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Background: Menopause is associated with changes in body composition in postmenopausal women. The aim of this study was to compare the effects of tibolone and continuous combined hormone therapy (HT) on body composition in postmenopausal women. Materials and Methods: In this randomized clinical trial, 120 menopausal women were randomly selected and divided into three groups. Of these, 40 women received 2.5 mg tibolone plus one Cal+D tablet (500 mg carbonate calcium with 200 IU vitamin D) daily, 40 women received 0.625 mg conjugated estrogen combined with 2.5 mg medroxy progesterone acetate plus one Cal+D tablet daily and the rest 40 (the control group) only received one Cal+D tablet daily. All regimes continued for nine months. Body composition was evaluated with measurements of waist to hip ratio (WHR), fat mass (FM), fat-free mass (FFM), body mass index (BMI), and weight before and after intervention. Fat mass and fat free mass were assessed by measurement of skin-fold thickness. Data were analyzed by SPSS software. Results: In the tibolone group, FFM, BMI, and weight significantly increased compared to the baseline (p<0.05). In the HT group, only weight and BMI significantly increased (p<0.05). In the control group, however, BMI, FM, and weight did not significantly increase in comparison with the other groups. Overall, tibolone group showed a more significant increase in comparison with the other groups (p<0.01) Conclusion: From these results, it can be concluded that tibolone can be used in treating menopausal changes in menopausal women as an alternative to continuous combined hormone therapy.

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Background: Insomnia has major negative effects on quality of life in postmenopausal women and can reduce their physical, psychological and social function. About 64.8 percent of women prefer to use herbal supplements for sleep problems. The present study aimed to evaluate the satisfaction of taking Valerian on the improvement of sleep quality and sleep score in postmenopausal women during six month. Materials and Methods: In this clinical trial, satisfaction of taking Valerian and sleep score of 100 postmenopausal eligible women who were referred to health care centers of Tehran University of Medical Sciences were evaluated. Research tools had three part of personal caharctristictic, Pittsburg sleep Quality Scale, and for satisfaction Visual Analogue Scale (VAS 0-10). Data gathering were in tree phase immediately after intervention, one and six month after valerian withdrawal. Results: The difference between intervention and control group in satisfaction and sleep scores was significant only immediately after taking Valerian (p=0.001) and there was no statistically significant difference within valerian or placebo group in one and six month later. Also there was statistically significant difference in three times of evaluation and satisfaction and improvement in sleep score were reduced within the time. Conclusion: Valerian can improve the sleep quality in postmenopausal women in intervention duration and after withdrawal there is no difference between placebo and valerian group so continued use of this supplement is necessary for improving of sleep quality.

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Background: Urogenital atrophy is a common problem after menopause and quality of life in post-menopauseis seriously affected by the symptoms associated with vaginal atrophy. The aim of this study was to compare the effectiveness of the vaginal suppository of hyaluronic acid and vitamin E in atrophic vaginitis treatment. Materials and Methods: This randomized double-blind clinical trialwas carried out in Ahvaz (Iran) from August to December 2010. Forty postmenopausal women with symptoms of vaginal atrophy were randomly allocatedto two groups to take vaginal suppositories of either 5 mg hyaluronic acid sodium salt (n=20) or 1 mg vitamin E (n=20) for 8 weeks. The symptoms of vaginal atrophy were evaluated by a self-assessed 4-point scaleand the composite score was determined asnone, mild, moderate, and severe in four periods. Results: The results showed that the symptoms were relieved significantly in both groups (P<0.001).The relief of symptoms was significantly superior in the hyaluronic acid group compared with the vitamin E group (P<0.05). Conclusion: Although both hyaluronic acid and vitamin E relieved the vaginal symptoms, improvements were greater in the hyaluronic acid group. Therefore,hyaluronic acid vaginal suppository is suggested for women with vaginal atrophy who do not want to or cannot take local estrogen treatment.

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Background: Depression is one of the most commonly observed problems in menopausal women. This study was conducted to determine the effect of omega-3 fatty acids on menopausal depression in women referring to No. 1 Health Clinic of Ahvaz, Iran, in 2010.

Materials and Methods: This randomized double-blind clinical trial was done on 70 menopausal women experiencing various levels of depression. After administering the Hamilton Depression Rating Scale (HAM-D-21), the participants who met the inclusion criteria were randomly divided into intervention group (n=35) receiving a 2gr omega-3 capsules and control group (n=35) receiving 2 gr placebo capsules. After 8 weeks of intervention, data were collected and analyzed by Chi-square, independent t-test, and one-way ANOVA with repeated measures using SPSS software version 17.

Results: Mean depression scores decreased significantly (p<0.001) in the intervention group (13.36±2.23 to 8.72±3.71). Also, mean depression scores decreased (p>0.05) in the control group (13.25±2.04 to 11.78±2.93) however, it was not significant. The comparison of depression scores did not indicate a significant difference regarding the reduction of depression after intervention between the two groups (p=0.08).

Conclusion: According to the findings of this study, administration of omega-3 capsules (2gr/daily) for 8 weeks decreased menopausal depression. However, there was not a significant difference between omga-3 and placebo groups in this study. For a more precise observation of the effects, further studies with longer periods of intervention are needed.

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Background: Depression is one of the most common problems in postmenopausal women. Diosgenin present in fenugreek seeds present study the effects of menopause on depression in menopausal women took the city in 1390.

Materials and Methods: In a randomized controlled trial enrolled 60 women with complaints of depression caused by menopause. Beck Depression Inventory on a sample of postmenopausal women and the inclusion criteria were enrolled. The samples were divided randomly into two groups, Diosgenin (6 g Fenugreek seed daily containing 25 mg Diosgenin) and sorbitol (25 mg daily) for 8 weeks were placed before and after 8 weeks of intervention questionnaire, Beck completed SPSS software was used to test the statistical Paired test scores before and after treatment were compared.

Results: Mean depression score decreased after 8 weeks took Fenugreek containing Diosgenin and sorbitol as compared with before of intervention of this study and it was significant.The comparison did not indicate a significant difference between the two groups.

Conclusion: According to the finding of this study, administration of 6 g Fenugreek seed containing Diosgenin for 8 weeks decreased menopausal depression . The need for further studies with longer duration and higher doses before any recommendations can be felt.

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Background: One of the most common problems in Menopausal women is reduce of sexual satisfaction, which can affect their quality of life. The aim of the present study was the effect of Afrodit on sexual satisfaction in postmenopausal women.

Materials and Methods: In the triple blind clinical trial with the placebo group participated 80 healthy females 50-60 years that were referred to health centers affiliated to Tehran University of Medical Sciences. Participants were randomly assigned to two groups, Afrodit groups and placebo capsules for a month. Used tool in this study was Sabatsbrg. Part of which was to assess sexual satisfaction.

Results: After a month intervention, there is significant difference in the mean score for sexual satisfaction between two groups (p=0.01), Sexual satisfaction compared with pre-menopausal in two groups were compared. T-test results showed no significant difference. (p=0.16).

Conclusion: The results show Afrodit improves the sexual satisfaction in menopausal women. So it is essential that health providers are familiar with this herb supplement.

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Background: Regarding the importance of prevention of cardiovascular disease during menopause the purpose of present study was evaluating the influence of eight weeks progressive aquatic exercise on serum Apoproteins of A and B and lipoproteins in obese and normal weight menopause women.

Materials and Methods: This was a semi-experimental study in which 29 menopause women from Isfahan (age: 57.4 ±4.68 years) voluntarily participated in it. According to body mass index (BMI), participants were divided to obese (n=15, BMI= 30.21 ±3.90) or normal weight (n=14, BMI=22.44 ±2.25) groups. Subjects of both groups participated in 8 weeks aquatic exercise, three times a week, by progressive intensity of 50 to 70% of maximal heart rate and duration of 45 minutes.

Results: Findings of study indicated a significant influence of exercise on VLDL, Apo A and B and ApoB/ApoA in in obese group. In normal weight group, exercise caused significant changes in LDL, VLDL, Apo A and B and ApoB/ApoA, but there was no significaut difference between groups in none of study variables.

Conclusion: According to our findings, progressive aquatic aerobic exercise induces similar reduction of some cardiovascular risk factors especially ApoB and ApoB/ApoA and increasing ApoA in obese and normal weight menopause women.

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Background: The distal radius’ fracture is one of the most prevalent fractures in menopause women. Because of no delisery of an exact dosage by inhalation calcitonin, the effect of a systemic form such as parenteral on healing up of this area was investigated.

Materials and Methods: This study was a prospective cohort on 44 women 60 years-old with distal radius’ fracture divided into 2 equal groups of control and treatment (parenteral calcitonin, just after operation, 100 I.U/day during 10 days consecutive of each month for 3 months). The rate of improvement, hand ability and stiffness of joints of hand fingers and wrist according with physical examination, time of cortex healing up, level of alkaline phosphatase, calcium and phosphor serum levels and rate of osteoporosis accord to radiography indexes.

Results: The rate of osteoporosis and pain was less tham that of control group. Prevention of osteoporosiss and the cortex healirg was significaltly more than that of control group. The hard activity (Mayo Wrist index) and ability of ceetching of objects was better in calcitonin group. There were not any significant effects of calcitonin on level of alkalire phosphatose, calcium and phosphor us serum levels.

Conclusion: Calcitonin especially with calcium supplements can accelerate the improvement of distal radius’ fracture. Then patients will tolerate fewer problems at convalescence period.

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