Exploring Non-Hormonal Strategies for Improving Hemoglobin Levels in Women During the Perimenopausal Transition

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DOI: 10.21522/TIJPH.2013.13.02.Art099

Authors : C. Muthulakshmi

Abstract:

This research aims to investigate the efficacy of non-hormonal interventions in ameliorating hemoglobin levels among perimenopausal women. Specifically, the study examines the impact of incorporating soya supplementation alongside structured health education on hemoglobin levels among perimenopausal women exhibiting altered Hb levels. Conducted in a rural locale in southern India, this single-blinded quasi-experimental study enrolled 54 perimenopausal women aged between 40 and 55 years. The participants were divided into two groups: Group A received structured health education alone, while Group B received both structured health education and a dietary intervention comprising 50 grams of soya meal curry every other day for three days a week over 16 weeks. The primary outcome measure assessed was blood hemoglobin levels. Analysis of inter-group hemoglobin values at various intervals elucidated the comparative efficacy of interventions. Group B, which received both education and the dietary intervention, exhibited significantly superior improvements in hemoglobin levels compared to Group A. Within each group, significant enhancements were noted in various biomarkers, particularly in Group B, indicating the effectiveness of the combined intervention. Although the improvements in Group B were most pronounced initially, a sustained, overall highly significant improvement was observed throughout the study period. The findings underscore the potential of non-hormonal interventions, specifically incorporating soya meals alongside structured health education, as a viable approach to enhancing hemoglobin levels among perimenopausal women. This suggests a promising avenue for addressing altered Hb levels in this demographic.

References:

[1].   Ayers, B., Forshaw, M., & Hunter, M. S., 2010, The impact of attitudes towards the menopause on women’s symptom experience: A systematic review. Maturitas, 65(1):28–36. https://doi.org/10.1016/j.maturitas.2009.10.016

[2].   Badenhorst, C. E., Forsyth, A. K., & Govus, A. D., 2022, A contemporary understanding of iron metabolism in active premenopausal females. Frontiers in Sports and Active Living, 4, 903937. https://doi.org/10.3389/fspor.2022.903937

[3].   Biglia, N., Bounous, V. E., De Seta, F., Lello, S., Nappi, R. E., & Paoletti, A. M., 2019, Non-hormonal strategies for managing menopausal symptoms in cancer survivors: An update. Ecancermedicalscience, 13, 909. https://doi.org/10.3332/ecancer.2019.909

[4].   Boardman, H. M. P., Hartley, L., Eisinga, A., Main, C., Roqué i Figuls, M., Bonfill Cosp, X., Gabriel Sanchez, R., & Knight, B., 2015, Hormone therapy for preventing cardiovascular disease in post-menopausal women. The Cochrane Database of Systematic Reviews: 3, CD002229. https://doi.org/10.1002/14651858.CD002229.pub4

[5].   Chakrabarty, M., Singh, A., Singh, S., & Chowdhury, S., 2023, Is the burden of anaemia among Indian adolescent women increasing? Evidence from Indian Demographic and Health Surveys (2015-21): PLOS Global Public Health, 3(9), e0002117. https://doi.org/10.1371/journal.pgph.0002117

[6].   Chen, L.-R., & Chen, K.-H., 2021, Utilization of Isoflavones in Soybeans for Women with Menopausal Syndrome: An Overview. International Journal of Molecular Sciences. 22(6): 3212. https://doi.org/10.3390/ijms22063212

[7].   Chen, L.-R., Ko, N.-Y., & Chen, K.-H., 2019, Isoflavone Supplements for Menopausal Women: A Systematic Review. Nutrients. 11(11): 2649. https://doi.org/10.3390/nu11112649

[8].   Dasgupta, I., Thomas, G. N., Clarke, J., Sitch, A., Martin, J., Bieber, B., Hecking, M., Karaboyas, A., Pisoni, R., Port, F., Robinson, B., & Rayner, H., 2019, Associationsbetween Hemodialysis Facility Practices to Manage Fluid Volume and Intradialytic Hypotension and Patient Outcomes. Clinical Journal of the American Society of Nephrology: CJASN. 14(3):385–393. https://doi.org/10.2215/CJN.08240718

[9].   Erdélyi, A., Pálfi, E., Tűű, L., Nas, K., Szűcs, Z., Török, M., Jakab, A., & Várbíró, S., 2023, The Importance of Nutrition in Menopause and Perimenopause-A Review. Nutrients, 16(1): 27. https://doi.org/10.3390/nu16010027

[10].  Fukushima, T., Nakano, J., Ishii, S., Natsuzako, A., Kawachi, H., Sakamoto, J., Miyazaki, Y., & Okita, M., 2019, Influence of Hemoglobin Level on Muscle and Physical Functions, Activities of Daily Living, and Quality of Life in Patients with Hematological Malignancies. Integrative Cancer Therapies, 18, 1534735419842196. https://doi.org/10.1177/1534735419842196

[11].  Johnson-Wimbley, T. D., & Graham, D. Y., 2011, Diagnosis and management of iron deficiency anemia in the 21st century. Therapeutic Advances in Gastroenterology. 4(3): 177–184. https://doi.org/10.1177/1756283X11398736

[12].  Koyuncu, T., Unsal, A., & Arslantas, D., 2018, Evaluation of the Effectiveness of Health Education on Menopause Symptoms and Knowledge and Attitude in Terms of Menopause. Journal of Epidemiology and Global Health. 8(1–2): 8–12. https://doi.org/10.2991/j.jegh.2018.08.103

[13].  Leon-Ferre, R. A., Novotny, P. J., Wolfe, E. G., Faubion, S. S., Ruddy, K. J., Flora, D., Dakhil, C. S. R., Rowland, K. M., Graham, M. L., Le-Lindqwister, N., Smith, T. J., & Loprinzi, C. L., 2020, Oxybutynin vs Placebo for Hot Flashes in Women With or Without Breast Cancer: A Randomized, Double-Blind Clinical Trial (ACCRU SC-1603). JNCI Cancer Spectrum., 4(1): pkz088. https://doi.org/10.1093/jncics/pkz088

[14].  Madsen, T. E., Sobel, T., Negash, S., Shrout Allen, T., Stefanick, M. L., Manson, J. E., & Allison, M., 2023, A Review of Hormone and Non-Hormonal Therapy Options for the Treatment of Menopause. International Journal of Women’s Health., 15, 825–836 https://doi.org/10.2147/IJWH.S379808

[15].  Marengo-Rowe, A. J., 2006, Structure-function relations of human hemoglobins. Proceedings (Baylor University. Medical Center): 19(3): 239–245. https://doi.org/10.1080/08998280.2006.11928171

[16].  Nakada, D., Oguro, H., Levi, B. P., Ryan, N., Kitano, A., Saitoh, Y., Takeichi, M., Wendt, G. R., & Morrison, S. J., 2014, Oestrogen increases haematopoietic stem-cell self-renewal in females and during pregnancy: Nature, 505(7484): 555–558 https://doi.org/10.1038/nature12932

[17].  Noroozi, E., Dolatabadi, N. K., Eslami, A. A., Hassanzadeh, A., & Davari, S., 2013, Knowledge and attitude toward menopause phenomenon among women aged 40-45 years: Journal of Education and Health Promotion., 2, 25. https://doi.org/10.4103/2277-9531.112701

[18].  North American Menopause Society. 2011, The role of soy isoflavones in menopausal health: Report of The North American Menopause Society/Wulf H. Utian Translational Science Symposium in Chicago, IL (October 2010). Menopause (New York, N.Y.), 18(7),732–753. https://doi.org/10.1097/gme.0b013e31821fc8e0

[19].  Panjeta, M., Tahirović, I., Sofić, E., Ćorić, J., & Dervišević, A., 2017, Interpretation of Erythropoietin and Haemoglobin Levels in Patients with Various Stages of Chronic Kidney Disease. Journal of Medical Biochemistry., 36(2):145–152. https://doi.org/10.1515/jomb-2017-0014

[20].  Pinkerton, J. V., Joffe, H., Kazempour, K., Mekonnen, H., Bhaskar, S., & Lippman, J., 2015, Low-dose paroxetine (7.5 mg) improves sleep in women with vasomotor symptoms associated with menopause: Menopause (New York, N.Y.), 22(1), 50–58. https://doi.org/10.1097/GME.000000000000031

[21].  Pita-Rodríguez, G. M., Basabe-Tuero, B., Díaz-Sánchez, M. E., Alfonso-Sagué, K., Gómez Álvarez, A. M., Montero-Díaz, M., Valdés-Perdomo, S., Chávez-Chong, C., Rodríguez-Martinez, E., Díaz-Fuentes, Y., Llera-Abreu, E., Calzadilla-Cámbara, A., & Ríos-Castillo, I., 2023, Prevalence of Anemia and Iron Deficiency in Women of Reproductive Age in Cuba and Associated Factor: International Journal of Environmental Research and Public Health., 20(6): 5110. https://doi.org/10.3390/ijerph20065110

[22].  Portolés, J., Martín, L., Broseta, J. J., & Cases, A., 2021, Anemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments, to Future Agents. Frontiers in Medicine, 8, 642296. https://doi.org/10.3389/fmed.2021,642296

[23].  Ranjan, P., Vikram, N. K., Kumari, A., Chopra, S., Choranur, A., Pradeep, Y., Puri, M., Malhotra, A., Ahuja, M., Meeta, null, Batra, A., Balsarkar, G., Goswami, D., Guleria, K., Sarkar, S., Kachhawa, G., Verma, A., Kumari, M. K., Madan, J., Guleria, R., 2022, Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative: Journal of Family Medicine and Primary Care. 11(12): 7549–7601. https://doi.org/10.4103/jfmpc.jfmpc_51_22

[24].  Ruwan et al., 2015, Nonhormonal management of menopause-associated vasomotor symptoms: 2015, position statement of The North American Menopause Society: Menopause (New York., N.Y.), 22(11), 1155–1172; quiz 1173–1174. https://doi.org/10.1097/GME.0000000000000546

[25].  Santoro, N., 2016, Perimenopause: From Research to Practice. Journal of Women’s Health: (2002), 25(4), 332–339. https://doi.org/10.1089/jwh.2015.5556

[26].  Sharif, N., Das, B., & Alam, A., 2023, Prevalence of anemia among reproductive women in different social group in India: Cross-sectional study using nationally representative data: PloS One 18(2): e0281015. https://doi.org/10.1371/journal.pone.0281015

[27].  Todd, T., & Caroe, T., 2007, Newly diagnosed iron deficiency anaemia in a premenopausal woman: BMJ (Clinical Research Ed.)., 334(7587): 259. https://doi.org/10.1136/bmj.39003.602338.94

[28].  Rajasekaran, K., Renu, K., Sankaran, K., Priya Veeraraghavan, V., Rengasamy, G., Ronsivalle, V., Cicciù, M., & Minervini, G., 2024, Determination of red blood cell parameters for signs of iron deficiency anemia in patients with oral diseases. Minerva dental and oral science: 10.23736/S2724-6329.24.04907-6. Advance online publication., https://doi.org/10.23736/S2724-6329.24.04907

[29].  Mrs. Kavitha, Nisha D., Radhika K., 2023, Prevalence of Iron DeficiencyAnemia and Associated Risk Factors among Women: International Journal of Current ScienceResearch and Review., ISSN: 2581-8341 Volume 06 Issue 11 November 2023DOI:10.47191/ijcsrr/V6i11-23, Impact Factor: 6.789 IJCSRR.

[30].  Kirubamani, Hepzibah; Ahire, Prachi1; Stalin, C1., Evaluation of Efficacy and Safety of EstroG-100® in Alleviating Menopausal Symptoms in Postmenopausal Women in India: A Prospective, Single-center, Single-arm, Interventional Study: Journal of Mid-life Health., 14(4):p 285-290, Oct–Dec 202,. | DOI: 10.4103/jmh.jmh_220_23