مجله زنان مامائی و نازائی ایران
سال نوزدهم شماره 211 (هفته دوم مهر 1395)

One of the most important challenges in women during menopausal period is disturbing symptoms of menopause and decision about the methods to treat them. With regard of increasing rate of menopausal women, evaluation of symptoms and disturbing signs is valuable. This study was performed with aim to investigate the various treatment options used for menopausal symptoms and related factors.
This cross-sectional study was done on 460 menopausal women who had at least one of the menopausal symptoms in Gonabad at 2016. The participants were selected by stratified sampling method and completed a demographic questionnaire and menopausal treatment options questionnaire. Data was analyzed using SPSS software (version 16) and analysis of variance and Chi-square test. P 229 cases (51.7%) had attempted to treat menopausal symptoms that among treatment methods, hormone replacement therapy (59.5%) and acupuncture (2.9%) had the highest and lowest frequency, respectively. Yoga, acupressure, and reflexology were not used at all. The gynecologists (59.5%) and the midwives (3.3%) had the highest and lowest participation, respectively. No significant difference was found between treatment methods and education, chronic diseases, and the source of information about menopause (P> 0.05).
Hormone replacement therapy was the most widely used method to treat menopausal symptoms. Complementary and alternative medicines were the least used method.

Vasomotor symptom is one of the most commonly problems of women during menopause and can negatively affect women’s quality of life. Humulus Lupulus L.) Hops) has powerful Phytoestrogenic compounds which are effective in the alleviation of menopausal symptoms. This systematic review and meta-analysis study was performed with aim to evaluate the effects of hops on vasomotor symptoms of menopause.
In this systematic review, databases of Medline, Embase, ProQuest, Web of Science, the Cochrane Central Register of Controlled Trials, PsycINFO, Scopus, Uptodate, Google Scholar, and CINAHL (EBSCO) were searched using the keywords of “menopause”, “hops”, “hot flash”, and “vasomotor symptoms” and all clinical trials published between 2000 to the end of December 2015 were included in the study. No limitation was imposed on the papers’ language. Finally, four articles were extracted and evaluated. Data was analyzed by Stata software (version 10). Publication bias was assessed by Egger tests and heterogeneity was assessed by chi-square and I2 index. Z-value and P-value were used for evaluation of the significance of mean differences.
Among 340 initially assessed papers, finally, 4 articles were entered to the study. Combining data from different studies based on random model indicated that hop alleviated vasomotor symptoms of menopause and reduced the frequency and duration of hot flushes and night sweats (P Hops can be used as an alternative treatment in the management of vasomotor symptoms of menopause.

Heterotopic pregnancy is a rare event. This type of pregnancy includes simultaneous intrauterine pregnancy and ectopic pregnancy. Because of the high risk of rupture of ectopic pregnancy in this case, the diagnosis of this life-threatening condition is most important. So, this study was performed with aim to introduce a case of heterotopic pregnancy.
Case report: In this article, a 20 years old pregnant woman at 18 weeks of pregnancy with clinical symptoms of pelvic mass with a presumptive diagnosis of malignant ovarian tumor is introduced. Surgical report of the frozen section of pelvic mass detected ectopic pregnancy and after surgery, intrauterine pregnancy continued until the delivery of a healthy baby.
Although heterotopic pregnancy is a rare event, but we should consider the risk of heterotopic pregnancy in all pregnant women. Heterotopic pregnancy in case of lack of attention and inappropriate treatment can lead to emergency and critical situation.