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Indian Journal of Obstetrics and Gynecology Research


Combination therapy to target the neuronal origin of menopausal symptoms


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Author Details: Dhanasekar Karukkupalayam Ramasamy,Gomathy Nachimuthu,Trayambak Dutta*

Volume : 6

Issue : 1

Online ISSN : 2394-2754

Print ISSN : 2394-2746

Article First Page : 83

Article End Page : 86


Abstract

Menopausal syndrome is marked by an array of psychosomatic as well as vasomotor symptoms such as hot flushes and night sweats. Amongst vasomotor symptoms of menopause, hot flushes are the most common. It consists of sudden sweating and periodic flushing with palpitations, chills, anxiety, choking and nausea. Depletion of estrogen is in part a cause for these symptoms, but not entirely. Neuronal origin of menopausal symptoms is gaining significance for better understanding the pathophysiology of vasomotor symptoms. There is significant change that occurs in the thermoregulation due to menopause. An important neuronal theory is narrowing of thermoneutral zone due to elevated central sympathetic activation. The first line therapy such as lifestyle changes, either alone or combination with dietary isoflavones, do not effectively control the vasomotor symptoms in severe cases. In such individual hormone therapy is inevitable, albeit it’s higher risk for coronary artery disease, breast carcinoma and pulmonary embolism. Therefore, it is imperative that the therapeutic target should be directed towards the central origin of symptoms and it should be devoid of these adverse effects. Medicinal plants and complimentary therapies have proved to be of great therapeutic advantage for patients with menopausal syndrome. Amongst medicinal plants studied extensively so far for reduction of menopausal symptoms, Valeriana Officinalis, Passiflora incarnata and Humulus lupulus are particularly important. Valeriana Officinalis binds to the beta subunit of the GABA-A receptor which leads to chloride channel mediated anxiolysis. It also decreases the metabolism of GABA thereby potentiating its effect. Passiflora incarnata acts by increasing the level of serotonin via modulating the content of mono-amine oxidases. Humulus lupulus increases the level of GABA thereby exerting its sedative and anxiolytic effect in menopause. The GABA mimetic action of these three ingredients controls the psychosomatic and vasomotor symptoms of menopause mediated by central sympathetic action. Clinical trials with these three herbs in European post menopausal women have led to active control and reduction in menopausal symptoms. This review delineates their role in the management of menopausal syndrome.

Keywords: Valeriana officinalis, Passiflora incarnata, Humulus lupulus, Menopause.

Doi :-https://doi.org/10.18231/2394-2754.2019.0018