4. Discussion
sleep disorders, ovarian aging, age-related decline, Sleep disturbances
ADVERSE REACTION, DYSFUNCTION
An age-related decline in melatonin concentration was observed in aging healthy people, which might be bound up with pineal aging [As menopause approaches, women's ovarian function gradually degrades, resulting in a decreased sensitivity to gonadotropin and decreased estrogen levels [The Kupperman index and MENQOL scores may reflect the severity of climacteric symptoms and their impact on life in the perimenopausal and menopausal women. Significant lower scores in these two scales were observed in the study group than in the control group after melatonin treatment in the study. Besides, we also observed a notable decrease in the two scale scores in both groups before and after treatment. These may indicate that melatonin use can effectively relieve climacteric symptoms and improve their QoL in the perimenopausal women, and placebo may have positive implications for the participants as well. As mentioned before, ovarian aging and the fluctuation and imbalance of reproductive hormone levels are responsible for the dysfunction of the autonomic nervous system and further cause the occurrence of climacteric symptoms. In this study, we found that melatonin may have a stabilizing effect on the imbalance of reproductive hormones without adverse reaction, which may be the main reason for the improvement of climacteric symptoms. Obviously, it makes sense that the women in the study group experienced an improvement in their QoL as their symptoms diminished.Sleep disturbances is common during menopausal transition and postmenopausal state [The primary limitations of the study include a comparatively small sample size and certain heterogeneity of the sample. In addition, we did not measure nocturnal melatonin concentrations in the study to explore the effect of exogenous melatonin on reproductive hormones at night. Even so, we suggested that melatonin may be a suitable treatment for relieving climacteric symptoms while also improving sleep disorders, mood, and QoL in perimenopausal women. Our findings are promising for improving the symptoms in perimenopausal women and need to be confirmed in larger longitudinal studies.