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Chronic pain and menopausal symptoms. Menopause 2019; 26:694-695. [PMID: 30994575 DOI: 10.1097/gme.0000000000001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Che Y, Sugita N, Yoshihara A, Iwasaki M, Miyazaki H, Nakamura K, Yoshie H. MAEA rs6815464 polymorphism and periodontitis in postmenopausal Japanese females: A cross-sectional study. Arch Oral Biol 2019; 102:128-134. [PMID: 31005685 DOI: 10.1016/j.archoralbio.2019.04.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/11/2019] [Accepted: 04/12/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Macrophage erythroblast attacher (MAEA) is a membrane protein that regulates the development of mature macrophages by mediating attachment with erythroblasts. A polymorphism rs6815464 (C/G) in MAEA gene was reported to be associated with type II diabetes. Along with diabetes, osteoporosis shows an increased prevalence in postmenopausal females, and both diseases have been reported to be associated with periodontitis. Therefore, we explored the relevance of the MAEA polymorphism to periodontitis, bone mineral density (BMD) and haemoglobin A1c (HbA1c). DESIGN This was a cross-sectional study with the final sample comprised of 344 postmenopausal Japanese females. Probing pocket depth (PPD) and clinical attachment level (CAL) were measured. Genotype was determined by TaqMan assay. Blood biochemical parameters and BMD of the lumbar spine were evaluated. RESULTS No differences were found in age, body mass index, HbA1c, BMD, number of teeth, bone metabolism parameters between the genotypes. Mean CAL and percentage of sites with PPD or CAL ≥ 5 mm were higher in the G-allele carriers than in the non-carriers. Multiple logistic regression analyses revealed that G-allele carriage was associated with severe periodontitis (odds ratio = 3.73, 95% CI = 1.36-10.19). CONCLUSION Our results suggested that the MAEA gene polymorphism was independently associated with severe periodontitis.
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Affiliation(s)
- Yulan Che
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan; Department of Stomatology, The Fourth Affiliated Hospital, Harbin Medical University, Harbin, China.
| | - Noriko Sugita
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - Akihiro Yoshihara
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - Masanori Iwasaki
- Division of Community Oral Health Development, Kyushu Dental University, 2-6-1, Manazuru, Kokura-kita, Kitakyushu, Fukuoka 803-8580, Japan.
| | - Hideo Miyazaki
- Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
| | - Kazutoshi Nakamura
- Division of Social and Environmental Medicine, Department of Community Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan.
| | - Hiromasa Yoshie
- Division of Periodontology, Department of Oral Biological Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Niigata 951-8514, Japan.
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Lizneva D, Rahimova A, Kim SM, Atabiekov I, Javaid S, Alamoush B, Taneja C, Khan A, Sun L, Azziz R, Yuen T, Zaidi M. FSH Beyond Fertility. Front Endocrinol (Lausanne) 2019; 10:136. [PMID: 30941099 PMCID: PMC6433784 DOI: 10.3389/fendo.2019.00136] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 02/13/2019] [Indexed: 12/24/2022] Open
Abstract
The traditional view of follicle-stimulating hormone (FSH) as a reproductive hormone is changing. It has been shown that FSH receptors (FSHRs) are expressed in various extra-gonadal tissues and mediate the biological effects of FSH at those sites. Molecular, animal, epidemiologic, and clinical data suggest that elevated serum FSH may play a significant role in the evolution of bone loss and obesity, as well as contributing to cardiovascular and cancer risk. This review summarizes recent data on FSH action beyond reproduction.
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Affiliation(s)
- Daria Lizneva
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Alina Rahimova
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Se-Min Kim
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ihor Atabiekov
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Seher Javaid
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Bateel Alamoush
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Charit Taneja
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ayesha Khan
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Li Sun
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ricardo Azziz
- Academic Health and Hospital Affairs, State University of New York, Albany, NY, United States
| | - Tony Yuen
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Mone Zaidi
- The Mount Sinai Bone Program, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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204
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Wasilewski GB, Vervloet MG, Schurgers LJ. The Bone-Vasculature Axis: Calcium Supplementation and the Role of Vitamin K. Front Cardiovasc Med 2019; 6:6. [PMID: 30805347 PMCID: PMC6370658 DOI: 10.3389/fcvm.2019.00006] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 01/14/2019] [Indexed: 12/11/2022] Open
Abstract
Calcium supplements are broadly prescribed to treat osteoporosis either as monotherapy or together with vitamin D to enhance calcium absorption. It is still unclear whether calcium supplementation significantly contributes to the reduction of bone fragility and fracture risk. Data suggest that supplementing post-menopausal women with high doses of calcium has a detrimental impact on cardiovascular morbidity and mortality. Chronic kidney disease (CKD) patients are prone to vascular calcification in part due to impaired phosphate excretion. Calcium-based phosphate binders further increase risk of vascular calcification progression. In both bone and vascular tissue, vitamin K-dependent processes play an important role in calcium homeostasis and it is tempting to speculate that vitamin K supplementation might protect from the potentially untoward effects of calcium supplementation. This review provides an update on current literature on calcium supplementation among post-menopausal women and CKD patients and discusses underlying molecular mechanisms of vascular calcification. We propose therapeutic strategies with vitamin K2 treatment to prevent or hold progression of vascular calcification as a consequence of excessive calcium intake.
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Affiliation(s)
- Grzegorz B Wasilewski
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands.,Nattopharma ASA, Hovik, Norway
| | - Marc G Vervloet
- Department of Nephrology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Leon J Schurgers
- Department of Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University, Maastricht, Netherlands
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Abstract
Menopause, the permanent cessation of the menstrual cycle, marks the end of a woman's reproductive lifespan. In addition to changes in sex hormone levels associated with menopause, its timing is another predictor of future health outcomes such as duration of the presence of vasomotor symptoms (VMS) and the risk of hormone-related cancers. With ageing of the population, it is estimated that worldwide 1·2 billion women will be menopausal by the year 2030. Previously the effects of reproductive factors (e.g. parity, age at menarche, pregnancy) and socio-demographic factors on intermediate and long-term health outcomes of menopause have been widely documented. However, little is known about whether diet could have an impact on these. Therefore, we review current evidence on the associations of diet with menopause, presence of VMS and the risk of hormone-related cancers such as ovarian, endometrial and breast cancer. Dietary factors could influence the lifespan of the ovaries and sex-hormones levels, hence the timing of natural menopause. Few studies reported an association between diet, in particular soya consumption, and a reduced risk of VMS. Sustained oestrogen exposure has been associated with a higher risk of hormone-related cancers and thus high-fat and meat diets have been linked with an increased risk of these cancers. However, to better understand the mechanistic pathways involved and to make stronger conclusions for these relationships, further studies investigating the associations of dietary intakes and dietary patterns with menopause, presence of VMS and the risk of hormone-related cancers are required.
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206
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Anagnostis P, Siolos P, Gkekas NK, Kosmidou N, Artzouchaltzi AM, Christou K, Paschou SA, Potoupnis M, Kenanidis E, Tsiridis E, Lambrinoudaki I, Stevenson JC, Goulis DG. Association between age at menopause and fracture risk: a systematic review and meta-analysis. Endocrine 2019; 63:213-224. [PMID: 30203119 DOI: 10.1007/s12020-018-1746-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/03/2018] [Indexed: 12/13/2022]
Abstract
PURPOSE Early menopause (EM, age at menopause < 45 years) and premature ovarian insufficiency (POI, age at menopause < 40 years) are associated with an increased risk of osteoporosis. However, their association with increased fracture risk has not been established, with studies yielding conflicting results. The primary aim of this systematic review and meta-analysis was to synthesize studies evaluating the association between age at menopause and fracture risk. The secondary aim was to evaluate this effect concerning the site of fractures. METHODS A comprehensive search was conducted in PubMed, CENTRAL and Scopus, up to 31 January 2018. Data were expressed as odds ratio (OR) with 95% confidence intervals (CI). The I2 index was employed for quantifying heterogeneity. RESULTS Eighteen studies were included in the qualitative and quantitative analysis (462,393 postmenopausal women, 12,130 fractures). Compared with women with age at menopause > 45 years, women with EM demonstrated higher fracture risk (OR 1.36, 95% CI 1.11-1.66, p < 0.002, I² 81.5%). Women with POI did not display any difference in fracture risk compared either with women with age at menopause > 40 (OR 1.23, 95% CI 0.72-2.09, p = 0.436, I² 62.5%) or >45 years (OR 0.54, 95% CI 0.22-1.29, p = 0.17, I2 0%). No difference was evident when a separate analysis was performed for vertebral, non-vertebral and hip fractures. CONCLUSIONS This is the first meta-analysis showing that EM is associated with increased fracture risk compared with normal age at menopause, without any distinct effect on the site of the fracture.
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Affiliation(s)
- Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
- Police Medical Center of Thessaloniki, Thessaloniki, Greece.
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Pavlos Siolos
- Police Medical Center of Thessaloniki, Thessaloniki, Greece
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nifon K Gkekas
- Police Medical Center of Thessaloniki, Thessaloniki, Greece
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikoletta Kosmidou
- Police Medical Center of Thessaloniki, Thessaloniki, Greece
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini-Maria Artzouchaltzi
- Police Medical Center of Thessaloniki, Thessaloniki, Greece
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Christou
- Police Medical Center of Thessaloniki, Thessaloniki, Greece
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavroula A Paschou
- Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Potoupnis
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
- Academic Orthopaedic Unit, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Eustathios Kenanidis
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
- Academic Orthopaedic Unit, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Eleftherios Tsiridis
- Centre of Orthopedic and Regenerative Medicine Research (CORE), Center for Interdisciplinary Research and Innovation (CIRI), Aristotle University of Thessaloniki, Thessaloniki, Greece
- Academic Orthopaedic Unit, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece
| | - John C Stevenson
- National Heart and Lung Institute, Imperial College London, Royal Brοmpton and Harefield NHS Foundation Trust, London, SW3 6NP, UK
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Nappi RE, Martini E, Cucinella L, Martella S, Tiranini L, Inzoli A, Brambilla E, Bosoni D, Cassani C, Gardella B. Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women. Front Endocrinol (Lausanne) 2019; 10:561. [PMID: 31496993 PMCID: PMC6712495 DOI: 10.3389/fendo.2019.00561] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/31/2019] [Indexed: 12/23/2022] Open
Abstract
Vaginal health is an essential component of active and healthy aging in women at midlife and beyond. As a consequence of hormonal deprivation and senescence, the anatomy and function of urogenital tissues are significantly affected and vulvovaginal atrophy (VVA) may occur. In a high proportion of postmenopausal women, progressive and chronic VVA symptoms have a strong impact on sexual function and quality of life. The new definition of genitourinary syndrome of menopause (GSM) comprises genital symptoms (dryness, burning, itching, irritation, bleeding), sexual symptoms (dyspareunia and other sexual dysfunctions) and urinary symptoms (dysuria, frequency, urgency, recurrent urinary infections). Many variables (age, sexual activity and partnership status) influence the clinical impact VVA/GSM symptoms and attitudes of elderly women to consult for receiving effective treatments. Psychosocial factors play a critical role in sexual functioning, but the integrity of the urogenital system is as well important affecting many domains of postmenopausal women's health, including sexual function. Several international surveys have extensively documented the need to improve VVA/GSM management because of the strong impact on women's daily life and on couple's intimacy. Health care providers (HCPs) need to be proactive in the early recognition of VVA/GSM in order to preserve urogenital and sexual longevity, by using hormonal and non-hormonal strategies. The clinical diagnosis is based on genital examination to identify objective signs and on the use of subjective scales to rate most bothersome symptoms (MBS), especially vaginal dryness. Recent studies point to the importance of addressing VVA/GSM as a potential early marker of poor general health in analogy with vasomotor symptoms. Therefore, a standard of VVA/GSM care in elderly women is desirable to enhance physical, emotional and mental well-being.
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Affiliation(s)
- Rossella E. Nappi
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Rossella E. Nappi
| | - Ellis Martini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
| | - Laura Cucinella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Silvia Martella
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Lara Tiranini
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Alessandra Inzoli
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Emanuela Brambilla
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - David Bosoni
- Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Chiara Cassani
- Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Obstetrics and Gynecology Unit, IRCCS San Matteo Foundation, University of Pavia, Pavia, Italy
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208
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Shao T, Ke H, Liu R, Zhao S, Qin Y. Variation analysis of theTMEM150B gene in Chinese women with premature ovarian insufficiency. Reprod Biomed Online 2018; 38:407-412. [PMID: 30704953 DOI: 10.1016/j.rbmo.2018.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/18/2018] [Accepted: 12/11/2018] [Indexed: 02/03/2023]
Abstract
RESEARCH QUESTION The TMEM150B gene, which promotes cell survival under stress conditions by modulating autophagy, is closely associated with age at natural menopause, early menopause and premature ovarian insufficiency (POI) in European women. However, whether gene variants of TMEM150B contribute to the pathogenesis of POI needs to be determined. DESIGN A case-control genetic study in 408 Han Chinese women with non-syndromic POI, in which all exons and exon-intron boundaries of the TMEM150B gene were screened by Sanger sequencing; the results were analysed by statistics and bioinformatics. RESULTS Two novel variants located in the 3' untranslated region of the TMEM150B gene were identified, but bioinformation analyses showed that neither was potentially disease-causing. Six known single-nucleotide polymorphisms (SNP) were found, and they were not potentially causative for POI. The intronic SNP rs11668344 was also detected in the POI patients; no significant differences were found in either genotype or allele frequencies compared with the control population. CONCLUSION The results suggest that the perturbations in the TMEM150B gene are not a common explanation for POI in Chinese women. The role of autophagy in the pathogenic mechanism of POI needs further exploration.
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Affiliation(s)
- Tong Shao
- Centre for Reproductive Medicine, Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan 250021, China
| | - Hanni Ke
- Centre for Reproductive Medicine, Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan 250021, China
| | - Ran Liu
- Centre for Reproductive Medicine, Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan 250021, China
| | - Shidou Zhao
- Centre for Reproductive Medicine, Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan 250021, China.
| | - Yingying Qin
- Centre for Reproductive Medicine, Shandong University, National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, The Key Laboratory of Reproductive Endocrinology (Shandong University), Ministry of Education, Jinan 250021, China
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209
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Robison LS, Gannon OJ, Salinero AE, Zuloaga KL. Contributions of sex to cerebrovascular function and pathology. Brain Res 2018; 1710:43-60. [PMID: 30580011 DOI: 10.1016/j.brainres.2018.12.030] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 12/13/2022]
Abstract
Sex differences exist in how cerebral blood vessels function under both physiological and pathological conditions, contributing to observed sex differences in risk and outcomes of cerebrovascular diseases (CBVDs), such as vascular contributions to cognitive impairment and dementia (VCID) and stroke. Throughout most of the lifespan, women are protected from CBVDs; however, risk increases following menopause, suggesting sex hormones may play a significant role in this protection. The cerebrovasculature is a target for sex hormones, including estrogens, progestins, and androgens, where they can influence numerous vascular functions and pathologies. While there is a plethora of information on estrogen, the effects of progestins and androgens on the cerebrovasculature are less well-defined. Estrogen decreases cerebral tone and increases cerebral blood flow, while androgens increase tone. Both estrogens and androgens enhance angiogenesis/cerebrovascular remodeling. While both estrogens and androgens attenuate cerebrovascular inflammation, pro-inflammatory effects of androgens under physiological conditions have also been demonstrated. Sex hormones exert additional neuroprotective effects by attenuating oxidative stress and maintaining integrity and function of the blood brain barrier. Most animal studies utilize young, healthy, gonadectomized animals, which do not mimic the clinical conditions of aging individuals likely to get CBVDs. This is also concerning, as sex hormones appear to mediate cerebrovascular function differently based on age and disease state (e.g. metabolic syndrome). Through this review, we hope to inspire others to consider sex as a key biological variable in cerebrovascular research, as greater understanding of sex differences in cerebrovascular function will assist in developing personalized approaches to prevent and treat CBVDs.
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Affiliation(s)
- Lisa S Robison
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, 47 New Scotland Ave, Albany, NY 12208, United States.
| | - Olivia J Gannon
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, 47 New Scotland Ave, Albany, NY 12208, United States.
| | - Abigail E Salinero
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, 47 New Scotland Ave, Albany, NY 12208, United States.
| | - Kristen L Zuloaga
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, 47 New Scotland Ave, Albany, NY 12208, United States.
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210
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Mahjabeen S, Hatipoglu MK, Benbrook DM, Garcia-Contreras L. Pharmacokinetics and Pharmacodynamics of Escalating Doses of SHetA2 After Vaginal Administration to Mice. J Pharm Sci 2018; 107:3179-3186. [PMID: 30196041 PMCID: PMC6342475 DOI: 10.1016/j.xphs.2018.08.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 08/30/2018] [Accepted: 08/31/2018] [Indexed: 11/25/2022]
Abstract
SHetA2 is a novel compound with strong potential to treat cervical dysplasia, but its low aqueous solubility limits its oral bioavailability. A vaginal suppository achieved SHetA2 cervix concentrations that were severalfold above the predicted therapeutic levels. Thus, we aimed at determining the minimum dose that would achieve SHetA2 therapeutic levels while reducing cyclin D1 levels, the pharmacodynamic end point. The disposition of SHetA2 after vaginal administration of escalating SHetA2 doses and the corresponding reduction in cyclin D1 levels was compared to that after the conventional oral treatment. Vaginal administration of a 15-mg/kg dose achieved an area under the cervix concentration versus time curve (AUCcervix) that was ∼120 times larger than that after a 60 mg/kg administered orally. AUCcervix and Cmax-cervix did not increase proportionally with respect to the dose, with the 30-mg/kg dose resulting in higher AUCcervix and Cmax-cervix (1368.53 μg.mL/h and 155.38 μg/g, respectively) compared to the 15 mg/kg (334.98 μg.mL/h and 121.78 μg/g, respectively) or 60 mg/kg (1178.55 μg.mL/h and 410.38 μg/g, respectively). Likewise, the 30-mg/kg dose caused a larger reduction in cyclin D1 levels than the other doses. Thus, the 30-mg/kg dose was selected for future efficacy studies in a mouse model of cervical neoplasia.
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Affiliation(s)
- Sanjida Mahjabeen
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73126-0901
| | - Manolya Kukut Hatipoglu
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73126-0901
| | - Doris M Benbrook
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73126-0901; Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73126-0901
| | - Lucila Garcia-Contreras
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73126-0901.
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211
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MC Rodrigues G, DB Borges B, Gabriela Q Moreira L, Aparecida G Rossete É, de Castro Franca S. Effects of estrogen-like plant compounds on the vaginal epithelium pituitary, adrenal glands, and uterus of rats. Exp Biol Med (Maywood) 2018; 243:1173-1184. [PMID: 30509138 PMCID: PMC6384445 DOI: 10.1177/1535370218817503] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/06/2018] [Indexed: 12/13/2022] Open
Abstract
Plant species with recognized estrogenic activity and widely used by Brazil’s female population to prevent the unpleasant symptoms of menopause were investigated in this work to demonstrate if constituents of taro-inhame (Colocasia esculenta ), cumaru (Dipteryx odorata ), and camapu (Physalis angulata ) have the ability to mimic or interfere with the action of estrogens. Moreover, their potential use as natural sources of estrogen-like substances for hormone replacement therapy was evaluated. (a) In vivo pharmacological assays were conducted to determine the estrogenic effects of D. odorata isoflavone-rich extract, P. angulata physalin-rich extract, and C. esculenta flavonoid glycoside-rich fraction (FG) on endocrine glands and reproductive organs of female rats at three different stages of the life cycle. The protocols consisted of uterotrophic assays and cytological evaluation of vaginal smears to detect mucosa cell alterations correlated with changes in hormone levels in each phase of the estrous cycle of female rats. The results indicated that C. esculenta FG exhibited estrogenic activity in prepubescent, pubescent, and adult ovariectomized female rats, while D. odorata isoflavones only promoted a weight increase in the pituitary gland of prepubescent rats after prolonged treatment and P. angulata physalins induced a weight increment in the adrenal glands of ovariectomized rats. Additionally, C. esculenta exerted a significant effect on the opening of the vaginal canal in prepubescent rats and on vaginal epithelium. Prolonged treatment of ovariectomized rats with FG altered the proportion of different types of vaginal epithelial cells in these animals, suggesting an interference of FG with estrogen levels. Colocasia esculenta FG induced hypertrophy of the uterus and pituitary in ovariectomized rats similar to estradiol. To elucidate the mechanism of action of FG, its effects were compared to those of estradiol and of the selective estrogen receptor modulator raloxifene. The results suggest that the efficacy of C. esculenta FG is mediated by binding to selective estrogen receptors present in each organ and that raloxifene inhibits the mechanism of action of FG in the same way as it inhibits the effects of estradiol. The overall findings indicate that C. esculenta FG mimics the action of estrogens, with reduced harmful effects on specific tissues.
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Affiliation(s)
- Gismar MC Rodrigues
- Unidade de Biotecnologia, Universidade de Ribeirão Preto – UNAERP, Ribeirão Preto, SP 14096-900, Brazil
| | - Bruno DB Borges
- Departamento de Ciências da Saúde, Universidade Federal de Lavras – UFLA, Lavras, MG 37200-000, Brazil
| | | | - Érica Aparecida G Rossete
- Unidade de Biotecnologia, Universidade de Ribeirão Preto – UNAERP, Ribeirão Preto, SP 14096-900, Brazil
| | - Suzelei de Castro Franca
- Unidade de Biotecnologia, Universidade de Ribeirão Preto – UNAERP, Ribeirão Preto, SP 14096-900, Brazil
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212
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O'Brien Z, Cass A, Cole L, Finfer S, Gallagher M, McArthur C, McGuiness S, Myburgh J, Bellomo R, Mårtensson J. Sex and mortality in septic severe acute kidney injury. J Crit Care 2018; 49:70-76. [PMID: 30388491 DOI: 10.1016/j.jcrc.2018.10.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 10/08/2018] [Accepted: 10/20/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate the relationship between sex and mortality and whether menopause or the intensity of renal replacement therapy (RRT) modify this relationship in patients with severe septic acute kidney injury (AKI). MATERIALS AND METHODS Post-hoc analysis of patients with sepsis included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial. RESULTS Of 724 patients, 458 (63.3%) were male and 266 (36.7%) were female. The mean delivered effluent flow rate was 25.6 ± 7.4 ml/kg/h (80 ± 15% of prescribed dose) in males and 27.4 ± 7.6 ml/kg/h (83 ± 15% of prescribed dose) in females (p = .01). A total of 237 (51.7%) males and 118 (44.5%) females died within 90 days of randomization (p = .06). The adjusted hazard ratio (HR) for 90-day mortality was significantly decreased in females as compared with males (HR 0.74, 95% CI 0.57 to 0.96, p = .02). The relationship between sex and mortality was not significantly altered by menopausal status (adjusted P value for interaction 0.99) or by RRT intensity allocation (adjusted P value for interaction 0.27). CONCLUSIONS In a cohort of patients with sepsis and severe AKI, female sex was associated with improved survival. The relationship between sex and survival was not altered by menopausal status or RRT intensity.
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Affiliation(s)
- Zachary O'Brien
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Winnellie, NT, Australia
| | - Louise Cole
- Department of Intensive Care, Nepean Hospital, Sydney, Australia
| | - Simon Finfer
- The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia
| | - Martin Gallagher
- The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia
| | - Colin McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Shay McGuiness
- Cardiovascular Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
| | - John Myburgh
- The George Institute for Global Health, University of Sydney, Level 13, Sydney, NSW, Australia; St George Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia; Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Johan Mårtensson
- Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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213
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Associations of birth characteristics with perimenopausal disorders: a prospective cohort study. J Dev Orig Health Dis 2018; 10:246-252. [PMID: 30296955 DOI: 10.1017/s204017441800065x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Perimenopausal disorders (PDs) are prevalent and importantly affect quality of life among middle-aged women. Yet, very little is known about the developmental origins of these disorders. The objective of this study was to investigate the associations of birth characteristics with PDs. This cohort study is based on archived birth records for birth weight and gestational age, and followed prospectively in Swedish inpatient and outpatient registers for 8 years (n=3212). The main outcomes were menopausal and climacteric states (e.g. flushing, sleeplessness), perimenopausal bleeding and other PDs (e.g. atrophic vaginitis). Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) for three subtypes of PDs separately. During the follow-up, 218 women had PDs, among whom 125 had menopausal and climacteric states, 61 had perimenopausal bleeding and 58 had other PDs as first recorded disorder. Birth weight was linearly associated with incidence rate of menopausal and climacteric states [HR=1.66 per 1 kg increase, 95% confidence interval (95% CI)=1.14-2.41]. Gestational age (rather than birth weight) was associated with incidence rate of other PDs (HR=0.87 per 1 week increase, 95% CI=0.79-0.95). Neither birth weight nor gestational age was associated with perimenopausal bleeding. Similar results were found after adjustment for other early-life and adult socio-demographic characteristics. This observational study provides, for the first time, evidence regarding the developmental origins of PDs. Future research is required to investigate the underlying causal mechanisms, which may shed further light on the etiology of this class of disorders.
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214
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Doren A, Vecchiola A, Aguirre B, Villaseca P. Gynecological–endocrinological aspects in women carriers of BRCA1/2 gene mutations. Climacteric 2018; 21:529-535. [DOI: 10.1080/13697137.2018.1514006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- A. Doren
- Obstetrics and Gynecology Department, Faculty of Medicine, Universidad Católica del Maule, Talca, Chile
| | - A. Vecchiola
- Endocrinology Department, Faculty of Medicine, Millenium Institute of Immunology and Immunotherapy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - B. Aguirre
- Breast Imaging, Radiology Service, Clínica Las Condes, Santiago, Chile
| | - P. Villaseca
- Endocrinology Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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215
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Neuroendocrine aging precedes perimenopause and is regulated by DNA methylation. Neurobiol Aging 2018; 74:213-224. [PMID: 30497015 DOI: 10.1016/j.neurobiolaging.2018.09.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 09/21/2018] [Accepted: 09/21/2018] [Indexed: 11/22/2022]
Abstract
Perimenopause marks initiation of female reproductive senescence. Age of onset is only 47% heritable suggesting that additional factors other than inheritance regulate this endocrine aging transition. To elucidate these factors, we characterized transcriptional and epigenomic changes across endocrine aging using a rat model that recapitulates characteristics of the human perimenopause. RNA-seq analysis revealed that hypothalamic aging precedes onset of perimenopause. In the hypothalamus, global DNA methylation declined with both age and reproductive senescence. Genome-wide epigentic analysis revealed changes in DNA methylation in genes required for hormone signaling, glutamate signaling, and melatonin and circadian pathways. Specific epignetic changes in these signaling pathways provide insight into the origin of perimenopause-associated neurological symptoms such as insomnia. Treatment with 5-aza-2'-deoxycytidine, a DNA-methyltransferase-1 inhibitor, accelerated transition to reproductive senescence/ whereas supplementation with methionine, a S-adenosylmethionine precursor, delayed onset of perimenopause and endocrine aging. Collectively, these data provide evidence for a critical period of female neuroendocrine aging in brain that precedes ovarian failure and that DNA methylation regulates the transition duration of perimenopause to menopause.
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216
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Mahjabeen S, Hatipoglu MK, Benbrook DM, Kosanke SD, Garcia-Contreras D, Garcia-Contreras L. Influence of the estrus cycle of the mouse on the disposition of SHetA2 after vaginal administration. Eur J Pharm Biopharm 2018; 130:272-280. [PMID: 30064701 PMCID: PMC6092953 DOI: 10.1016/j.ejpb.2018.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/29/2018] [Accepted: 07/03/2018] [Indexed: 01/08/2023]
Abstract
SHetA2 is a novel compound with the potential to treat cervical dysplasia, but has poor water solubility. A vaginal suppository formulation was able to achieve therapeutic concentrations in the cervix of mice, but these concentrations were variable. Histological analysis indicated that mice in the same group were in different stages of their estrous cycle, which is known to induce anatomical changes in their gynecological tissues. We investigated the effects of these changes on the pharmacokinetics and pharmacodynamics of SHetA2 when administered vaginally. Mice were synchronized to be either in estrous or diestrus stage for administration of the SHetA2 suppository. Pharmacokinetic parameters were calculated from the SHetA2 concentrations vs. time data. The reduction in the expression of cyclin D1 protein in the cervix was used as pharmacodynamic endpoint. Mice dosed during diestrus had a larger AUCcervix (335 μg mL h-1), higher Cmax (121.8 ± 38.7 µg/g) and longer t1/2-cervix (30.3 h) compared to mice dosed during estrus (120 μg mL h-1, 44.6 ± 29.5 µg/g and 3.6 h respectively). Therapeutic concentrations of SHetA2 were maintained for 48 h in the cervix of mice dosed during diestrus and for only 12 h in the estrus group. The treatment reduced the expression of cyclin D1 protein in the cervix of mice in the estrus to a larger extent. These results indicate that the estrous cycle of mice influences significantly the disposition of SHetA2 after vaginal administration and may also influence its efficacy.
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Affiliation(s)
- Sanjida Mahjabeen
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Manolya Kukut Hatipoglu
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Doris M Benbrook
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Stanley D Kosanke
- College of Dentistry, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | | | - Lucila Garcia-Contreras
- Department of Pharmaceutical Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
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217
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Glisic M, Kastrati N, Musa J, Milic J, Asllanaj E, Portilla Fernandez E, Nano J, Ochoa Rosales C, Amiri M, Kraja B, Bano A, Bramer WM, Roks AJ, Danser AJ, Franco OH, Muka T. Phytoestrogen supplementation and body composition in postmenopausal women: A systematic review and meta-analysis of randomized controlled trials. Maturitas 2018; 115:74-83. [DOI: 10.1016/j.maturitas.2018.06.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/20/2018] [Accepted: 06/20/2018] [Indexed: 01/16/2023]
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218
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Frange C, Hachul H, Hirotsu C, Tufik S, Andersen ML. Insomnia with Musculoskeletal Pain in Postmenopause: Associations with Symptoms, Mood, and Quality of Life. J Menopausal Med 2018; 24:17-28. [PMID: 29765923 PMCID: PMC5949304 DOI: 10.6118/jmm.2018.24.1.17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/22/2018] [Accepted: 03/08/2018] [Indexed: 11/12/2022] Open
Abstract
Objectives To investigate the relationship between insomnia (INS) combined with chronic musculoskeletal pain (MSP) in postmenopausal women and its characteristics regarding MSP, menopausal and mood symptoms, sleep and quality of life (QOL). Methods A cross-sectional control study in 4 groups of postmenopausal women: control (n = 15), MSP (n = 15), INS (n =15) and INS + MSP (n = 17). Sixty-two participants completed questionnaires and had blood collected, and 43 underwent polysomnography. Results INS was associated with increased anxiety (P = 0.04) and sleep fragmentation (P = 0.02); worse MSP severity (P = 0.00), MSP interference with daily function (P = 0.00), higher pain intensity at midday (P = 0.02) and menopausal symptoms (P = 0.00); and reduced QOL (P = 0.00). MSP was associated with increased anxiety (P = 0.02) and menopausal symptoms (P = 0.00), and reduced QOL (P = 0.05). In the whole sample, depression symptoms were higher but no statistical differences were found between groups (P = 0.47). Worse QOL was associated with both higher depressive symptoms (P = 0.01) and worse pain interference (P = 0.02) Conclusions INS + MSP was related to higher menopausal and anxiety symptoms, more sleep fragmentation and complaints of MSP severity and interference, more pain sites and worse QOL. The presence of INS was associated to more MSP. Sleep management is essential in women who have developed chronic MSP.
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Affiliation(s)
- Cristina Frange
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Helena Hachul
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Gynecology, Universidade Federal de São Paulo, São Paulo, Brazil.,Department of Gynecology, Casa de Saúde Santa Marcelina, São Paulo, Brazil
| | - Camila Hirotsu
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Monica Levy Andersen
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
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219
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Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause - global prevalence, physiology and implications. Nat Rev Endocrinol 2018; 14:199-215. [PMID: 29393299 DOI: 10.1038/nrendo.2017.180] [Citation(s) in RCA: 287] [Impact Index Per Article: 47.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The symptoms of menopause can be distressing, particularly as they occur at a time when women have important roles in society, within the family and at the workplace. Hormonal changes that begin during the menopausal transition affect many biological systems. Accordingly, the signs and symptoms of menopause include central nervous system-related disorders; metabolic, weight, cardiovascular and musculoskeletal changes; urogenital and skin atrophy; and sexual dysfunction. The physiological basis of these manifestations is emerging as complex and related, but not limited to, oestrogen deprivation. Findings generated mainly from longitudinal population studies have shown that ethnic, geographical and individual factors affect symptom prevalence and severity. Moreover, and of great importance to clinical practice, the latest research has highlighted how certain menopausal symptoms can be associated with the onset of other disorders and might therefore serve as predictors of future health risks in postmenopausal women. The goal of this Review is to describe in a timely manner new research findings on the global prevalence and physiology of menopausal symptoms and their impact on future health.
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Affiliation(s)
- Patrizia Monteleone
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Giulia Mascagni
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
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220
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Papavagelis C, Avgeraki E, Augoulea A, Stamatelopoulos K, Lambrinoudaki I, Yannakoulia M. Dietary patterns, Mediterranean diet and obesity in postmenopausal women. Maturitas 2018; 110:79-85. [DOI: 10.1016/j.maturitas.2018.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 11/24/2022]
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221
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Impact of meal fatty acid composition on postprandial lipaemia, vascular function and blood pressure in postmenopausal women. Nutr Res Rev 2018; 31:193-203. [DOI: 10.1017/s0954422418000033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractCVD are the leading cause of death in women globally, with ageing associated with progressive endothelial dysfunction and increased CVD risk. Natural menopause is characterised by raised non-fasting TAG concentrations and impairment of vascular function compared with premenopausal women. However, the mechanisms underlying the increased CVD risk after women have transitioned through the menopause are unclear. Dietary fat is an important modifiable risk factor relating to both postprandial lipaemia and vascular reactivity. Meals rich in SFA and MUFA are often associated with greater postprandial TAG responses compared with those containing n-6 PUFA, but studies comparing their effects on vascular function during the postprandial phase are limited, particularly in postmenopausal women. The present review aimed to evaluate the acute effects of test meals rich in SFA, MUFA and n-6 PUFA on postprandial lipaemia, vascular reactivity and other CVD risk factors in postmenopausal women. The systematic search of the literature identified 778 publications. The impact of fat-rich meals on postprandial lipaemia was reported in seven relevant studies, of which meal fat composition was compared in one study described in three papers. An additional study determined the impact of a high-fat meal on vascular reactivity. Although moderately consistent evidence suggests detrimental effects of high-fat meals on postprandial lipaemia in postmenopausal (than premenopausal) women, there is insufficient evidence to establish the impact of meals of differing fat composition. Furthermore, there is no robust evidence to conclude the effect of meal fatty acids on vascular function or blood pressure. In conclusion, there is an urgent requirement for suitably powered robust randomised controlled trials to investigate the impact of meal fat composition on postprandial novel and established CVD risk markers in postmenopausal women, an understudied population at increased cardiometabolic risk.
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222
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Collins FL, Rios-Arce ND, Atkinson S, Bierhalter H, Schoenherr D, Bazil JN, McCabe LR, Parameswaran N. Temporal and regional intestinal changes in permeability, tight junction, and cytokine gene expression following ovariectomy-induced estrogen deficiency. Physiol Rep 2018; 5:5/9/e13263. [PMID: 28468850 PMCID: PMC5430124 DOI: 10.14814/phy2.13263] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 03/29/2017] [Accepted: 04/03/2017] [Indexed: 12/12/2022] Open
Abstract
Estrogen deficiency that occurs during menopause is associated with wide‐ranging consequences, including effects on the gastrointestinal system. Although previous studies have implicated a role for estrogen in modulating colonic permeability and inflammatory gene expression, the kinetics of these changes following loss of estrogen and whether they are intestinal region specific are unknown. To test this, we performed sham or ovariectomy (OVX) surgery in BALB/c mice and examined permeability (in vivo and ex vivo) and gene expression changes in the duodenum, jejunum, ileum, and colon at 1, 4, and 8 weeks postsurgery. In vivo permeability, assessed by FITC‐dextran gavage and subsequent measures of serum levels, indicated that OVX significantly increased whole intestinal permeability 1 week postsurgery before returning to sham levels at 4 and 8 weeks. Permeability of individual intestinal sections, measured ex vivo by Ussing chambers, revealed specific regional and temporal responses to OVX, with the most dynamic changes exhibited by the ileum. Analysis of gene expression, by qPCR and by mathematical modeling, revealed an OVX‐specific effect with tight junction and inflammatory gene expression elevated and suppressed with both temporal and regional specificity. Furthermore, ileal and colonic expression of the tight junction protein occludin was found to be significantly correlated with expression of TNFα and IL‐1β. Together, our studies reveal previously unappreciated effects of estrogen deficiency in specific intestinal segments and further demonstrate temporal links between estrogen deficiency, inflammatory genes, and intestinal permeability.
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Affiliation(s)
- Fraser L Collins
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Naiomy D Rios-Arce
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Shelby Atkinson
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Hayley Bierhalter
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Daniel Schoenherr
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Jason N Bazil
- Department of Physiology, Michigan State University, East Lansing, Michigan
| | - Laura R McCabe
- Department of Physiology, Michigan State University, East Lansing, Michigan .,Department of Radiology, Michigan State University, East Lansing, Michigan.,Biomedical Imaging Research Centre, Michigan State University, East Lansing, Michigan
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223
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Rathnayake KM, Weech M, Jackson KG, Lovegrove JA. Meal Fatty Acids Have Differential Effects on Postprandial Blood Pressure and Biomarkers of Endothelial Function but Not Vascular Reactivity in Postmenopausal Women in the Randomized Controlled Dietary Intervention and VAScular function (DIVAS)-2 Study. J Nutr 2018; 148:348-357. [PMID: 29546297 DOI: 10.1093/jn/nxx042] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 11/13/2017] [Indexed: 12/21/2022] Open
Abstract
Background Elevated postprandial triacylglycerol concentrations, impaired vascular function, and hypertension are important independent cardiovascular disease (CVD) risk factors in women. However, the effects of meal fat composition on postprandial lipemia and vascular function in postmenopausal women are unknown. Objective This study investigated the impact of sequential meals rich in saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), or n-6 (ω-6) polyunsaturated fatty acids (PUFAs) on postprandial flow-mediated dilatation (FMD; primary outcome measure), vascular function, and associated CVD risk biomarkers (secondary outcomes) in postmenopausal women. Methods A double-blind, randomized, crossover, postprandial study was conducted in 32 postmenopausal women [mean ± SEM ages: 58 ± 1 y; mean ± SEM body mass index (in kg/m2): 25.9 ± 0.7]. After fasting overnight, participants consumed high-fat meals at breakfast (0 min; 50 g fat, containing 33-36 g SFAs, MUFAs, or n-6 PUFAs) and lunch (330 min; 30 g fat, containing 19-20 g SFAs, MUFAs, or n-6 PUFAs), on separate occasions. Blood samples were collected before breakfast and regularly after the meals for 480 min, with specific time points selected for measuring vascular function and blood pressure. Results Postprandial FMD, laser Doppler imaging, and digital volume pulse responses were not different after consuming the test fats. The incremental area under the curve (iAUC) for diastolic blood pressure was lower after the MUFA-rich meals than after the SFA-rich meals (mean ± SEM: -2.3 ± 0.3 compared with -1.5 ± 0.3 mm Hg × 450 min × 103; P = 0.009), with a similar trend for systolic blood pressure (P = 0.012). This corresponded to a lower iAUC for the plasma nitrite response after the SFA-rich meals than after the MUFA-rich meals (-1.23 ± 0.7 compared with -0.17 ± 0.4 μmol/L × 420 min P = 0.010). The soluble intercellular adhesion molecule 1 (sICAM-1) time-course profile, AUC, and iAUC were lower after the n-6 PUFA-rich meals than after the SFA- and MUFA-rich meals (P ≤ 0.001). Lipids, glucose, and markers of insulin sensitivity did not differ between the test fats. Conclusion Our study showed a differential impact of meal fat composition on blood pressure, plasma nitrite, and sICAM-1, but no effect on postprandial FMD or lipemia in postmenopausal women. This trial was registered at www.clinicaltrials.gov as NCT02144454.
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Affiliation(s)
- Kumari M Rathnayake
- Hugh Sinclair Unit of Human Nutrition, Institute for Food, Nutrition and Health and Institute for Cardiovascular and Metabolic Research, University of Reading, Whiteknights, United Kingdom.,Department of Applied Nutrition, Faculty of Livestock, Fisheries and Nutrition, Wayamba University of Sri Lanka, Makandura, Sri Lanka
| | - Michelle Weech
- Hugh Sinclair Unit of Human Nutrition, Institute for Food, Nutrition and Health and Institute for Cardiovascular and Metabolic Research, University of Reading, Whiteknights, United Kingdom
| | - Kim G Jackson
- Hugh Sinclair Unit of Human Nutrition, Institute for Food, Nutrition and Health and Institute for Cardiovascular and Metabolic Research, University of Reading, Whiteknights, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition, Institute for Food, Nutrition and Health and Institute for Cardiovascular and Metabolic Research, University of Reading, Whiteknights, United Kingdom
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224
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Longitudinal analysis of changes in weight and waist circumference in relation to incident vasomotor symptoms: the Study of Women's Health Across the Nation (SWAN). Menopause 2018; 24:9-26. [PMID: 27749738 DOI: 10.1097/gme.0000000000000723] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Greater body mass index (BMI) and body fat are associated with vasomotor symptoms (VMS). Thus, weight loss may prevent VMS. We analyzed whether concurrent BMI or waist circumference and/or changes in weight or waist circumference predicted incident VMS and whether these relations differed by menopause stage or race/ethnicity. METHODS Data from 10 follow-up visits for 1,546 participants in the Study of Women's Health Across the Nation who reported no VMS at baseline were modeled for time to first symptomatic visit in relation to concurrent BMI and waist circumference and change in weight and waist circumference during early and late menopause using discrete survival analyses, adjusting for covariates. RESULTS Greater concurrent BMI and waist circumference were significantly related to greater any and frequent (≥6 d in the last 2 wk) incident VMS in early menopause and lower VMS risk in late menopause. Percentage weight change since baseline and since the prior visit was unrelated to incident any VMS in either menopause stage. Percentage weight change since baseline had a significant shallow U-shaped association with incident frequent VMS in early menopause (P = 0.02), a shallow inverse U-shape in late menopause (P = 0.02), and a significant interaction with menopause stage (P = 0.004) but not with race/ethnicity. Recent weight change was unassociated with incident VMS in either menopause stage. Results were similar for waist change. CONCLUSIONS Concurrent BMI and waist circumference were positively related to incident VMS in early menopause and negatively related in late menopause. Maintaining healthy weight in early menopause may help prevent VMS.
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Monteiro NE, Queirós LD, Lopes DB, Pedro AO, Macedo GA. Impact of microbiota on the use and effects of isoflavones in the relief of climacteric symptoms in menopausal women – A review. J Funct Foods 2018. [DOI: 10.1016/j.jff.2017.12.043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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226
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Solomon D, Sabin CA, Mallon PW, Winston A, Tariq S. Cardiovascular disease in women living with HIV: A narrative review. Maturitas 2018; 108:58-70. [DOI: 10.1016/j.maturitas.2017.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022]
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227
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Affiliation(s)
- Kathy Abernethy
- Senior nurse specialist, Northwick Park Hospital, London North West Healthcare NHS Trust; director, The Menopause Course
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228
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Lambrinoudaki I, Kazani A, Armeni E, Rizos D, Augoulea A, Kaparos G, Alexandrou A, Georgiopoulos G, Kanakakis I, Stamatelopoulos K. The metabolic syndrome is associated with carotid atherosclerosis and arterial stiffness in asymptomatic, nondiabetic postmenopausal women. Gynecol Endocrinol 2018; 34:78-82. [PMID: 28675704 DOI: 10.1080/09513590.2017.1344208] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The menopause transition is associated with adverse changes in cardiometabolic risk factors. We aimed to examine the association of the metabolic syndrome (MS) and its features with indices of vascular structure and function in a population of asymptomatic postmenopausal women. A total of 473 informed-consenting, nondiabetic postmenopausal women were included in the study. The MS was defined according to the Joint Definition. We evaluated the association between the presence of MS and indices of vascular structure (carotid artery intima-media thickness (IMT); atherosclerotic plaques) and function (flow-mediated dilatation (FMD); pulse wave velocity (PWV)). The mean age of women was 56.4 ± 6.7 and the mean menopausal age was 7.91 ± 6.31. The MS was present in 17.3% of our population. Mean values of PWV increased linearly with the accumulation of features of the MS. IMT was higher in women with the MS compared to women without the MS (0.78 ± 0.12 mm vs. 0.74 ± 0.11, p = .003). Multivariate analysis showed that the presence of the MS was independently associated with common carotid artery IMT (b = 0.149, p = .001), PWV (b = 0.114, p = .012) as well as central systolic and diastolic blood pressure (b = 0.293, p < .001 and b = 0.163, p < .001 respectively). The presence of the MS is associated with subclinical atherosclerosis already in the first postmenopausal decade of this sample of asymptomatic, nondiabetic women. Additional evidence is required to support the causative effect of these associations.
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Affiliation(s)
- Irene Lambrinoudaki
- a 2nd Department of Obstetrics and Gynecology , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Aikaterini Kazani
- b Department of Therapeutics , University of Athens, Alexandra Hospital , Athens , Greece
| | - Eleni Armeni
- a 2nd Department of Obstetrics and Gynecology , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Demetrios Rizos
- c Hormonal and Biochemical Laboratory , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Areti Augoulea
- a 2nd Department of Obstetrics and Gynecology , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Georgios Kaparos
- c Hormonal and Biochemical Laboratory , University of Athens, Aretaieio Hospital , Athens , Greece
| | - Andreas Alexandrou
- d 1st Department of Surgery , National and Kapodestrian University of Athens, Medical School, Laiko General Hospital , Athens , Greece
| | - Georgios Georgiopoulos
- b Department of Therapeutics , University of Athens, Alexandra Hospital , Athens , Greece
| | | | - Kimon Stamatelopoulos
- b Department of Therapeutics , University of Athens, Alexandra Hospital , Athens , Greece
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Ciebiera M, Łukaszuk K, Męczekalski B, Ciebiera M, Wojtyła C, Słabuszewska-Jóźwiak A, Jakiel G. Alternative Oral Agents in Prophylaxis and Therapy of Uterine Fibroids-An Up-to-Date Review. Int J Mol Sci 2017; 18:ijms18122586. [PMID: 29194370 PMCID: PMC5751189 DOI: 10.3390/ijms18122586] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 01/18/2023] Open
Abstract
Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases.
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Affiliation(s)
- Michał Ciebiera
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Krzysztof Łukaszuk
- Department of Obstetrics and Gynecological Nursing, Faculty of Health Sciences, Medical University of Gdansk, 80-210 Gdansk, Poland.
- INVICTA Fertility and Reproductive Center, 80-172 Gdansk, Poland.
| | - Błażej Męczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, 60-513 Poznan, Poland.
| | - Magdalena Ciebiera
- Students' Scientific Association at the I Department of Obstetrics and Gynecology, Medical University of Warsaw, 02-015 Warsaw, Poland.
| | - Cezary Wojtyła
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Aneta Słabuszewska-Jóźwiak
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
| | - Grzegorz Jakiel
- Department of Obstetrics and Gynecology, The Centre of Postgraduate Medical Education, 00-416 Warsaw, Poland.
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Cianci A, Maiolino L, Giunta G, Rapisarda AMC, Di Mauro P, Caruso S. Neurovegetative disorders of perimenopausal women treated with docosahexaenoic acid (DHA, 625 mg). Gynecol Endocrinol 2017; 33:980-984. [PMID: 28562107 DOI: 10.1080/09513590.2017.1334200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The study evaluated the effect of DHA 625 mg in women who experience menopausal symptoms, on sexuality and quality of life (QoL), and on the auditory brainstem response (ABR). Forty-two perimenopausal women were enrolled. The Kupperman Index (KI) was used to evaluate menopause symptoms. The Short Form-36 (SF-36), Female Sexual Function Index (FSFI), and the Female Sexual Distress Scale (FSDS) were used to assess QoL, sexual function, and sexual distress, respectively. Auditory evoked potentials to measure the ABR. The study had one follow-up at 6 months. The women reported an improvement in the KI total score (p < .001). Moreover, women reported QoL improvements in all the psychological categories (p < .001), but not in physical categories (p = NS). FSFI and FSDS total scores increased (p < .01) and the FSDS score decreased (p < .01), mainly due to arousal (p < .03) and lubrication (p < .05) sexual aspects. The ABR wave latencies were lower than the baseline values (p < .05). DHA could be effective in modulating some perimenopausal symptoms in women and, consequently could contribute to improve their QoL and sexual life. Finally, DHA seems to have a direct activity on the neuronal conduction time into the audiological system.
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Affiliation(s)
- Antonio Cianci
- a Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology , University of Catania , Catania , Italy
| | - Luigi Maiolino
- b Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", ENT Section , University of Catania , Catania , Italy
| | - Giuliana Giunta
- a Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology , University of Catania , Catania , Italy
| | - Agnese Maria Chiara Rapisarda
- a Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology , University of Catania , Catania , Italy
| | - Paola Di Mauro
- b Department of Medical and Surgical Sciences and Advanced Technologies "G. Ingrassia", ENT Section , University of Catania , Catania , Italy
| | - Salvatore Caruso
- a Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, Research Group for Sexology , University of Catania , Catania , Italy
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Mulhall S, Andel R, Anstey KJ. Variation in symptoms of depression and anxiety in midlife women by menopausal status. Maturitas 2017; 108:7-12. [PMID: 29290217 DOI: 10.1016/j.maturitas.2017.11.005] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 11/01/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To examine the association between menopausal status and the risk of symptoms of depression and anxiety in a community-based sample of Australian midlife women. STUDY DESIGN Female participants (mean age 50.6±1.5) who were premenopausal (n=237), perimenopausal (n=249) or naturally postmenopausal (n=225) were drawn from the Personality and Total Health (PATH) Through Life Project, a longitudinal study. MAIN OUTCOME MEASURES Symptoms of depression and anxiety were measured using the Goldberg Depression Scale and Goldberg Anxiety Scale. Generalised linear regression models with a negative binomial log link were used. RESULTS Relative to premenopause and after adjusting for all relevant covariates, being perimenopausal was associated with increased risk of greater symptoms of depression (incidence rate ratio [IRR]=1.29, p=0.001), while being postmenopausal was associated with increased risk of greater symptoms of anxiety (IRR=1.15, p=0.041). Being perimenopausal or postmenopausal was associated with an increased risk of greater symptoms of depression (IRR=1.35, p=0.008; IRR=1.31, p=0.029) and anxiety (IRR=1.22, p=0.030; IRR=1.32, p=0.006) in women without a history of probable major depressive disorder or generalised anxiety disorder. Risk of symptoms did not differ with menopausal status in women with this history. CONCLUSIONS Menopausal status is associated with the risk of symptoms of depression and anxiety. There is a greater likelihood of increased symptoms of depression during perimenopause and symptoms of anxiety during postmenopause. In women without a history of depression or anxiety, the perimenopause and postmenopausal stages are associated with increased risk of greater symptoms of anxiety and depression relative to premenopause.
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Affiliation(s)
- Stephanie Mulhall
- The Australian National University, Centre for Research on Ageing, Health and Wellbeing, Canberra, ACT, Australia; The Australian National University, Research School of Psychology, Canberra, ACT, Australia.
| | - Ross Andel
- The Australian National University, Centre for Research on Ageing, Health and Wellbeing, Canberra, ACT, Australia; University of South Florida, School of Aging Studies, Tampa, FL, United States
| | - Kaarin J Anstey
- The Australian National University, Centre for Research on Ageing, Health and Wellbeing, Canberra, ACT, Australia
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Donaldson EK, Huang V, Ross S, Sydora BC. Experience of menopause in women with inflammatory bowel disease: pilot study. Climacteric 2017; 20:545-551. [DOI: 10.1080/13697137.2017.1360861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- E. Kaley Donaldson
- Department of Obstetrics & Gynecology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - V. Huang
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - S. Ross
- Department of Obstetrics & Gynecology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - B. C. Sydora
- Department of Obstetrics & Gynecology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Abstract
The rise of follicle-stimulating hormone (FSH) is a hallmark of menopause associated with osteoporosis and visceral adiposity. In Nature, Zaidi and colleagues (Liu et al., 2017) report that blocking FSH action reduces body fat by promoting brown/beige fat thermogenesis, potentially providing a new intervention for the treatment of menopause-related metabolic diseases.
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Affiliation(s)
- Carlos Henrique Sponton
- Diabetes Center and Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA; Obesity and Comorbidities Research Center-OCRC, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Shingo Kajimura
- Diabetes Center and Department of Cell and Tissue Biology, University of California, San Francisco, San Francisco, CA, USA.
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234
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Chandra RV, Sailaja S, Reddy AA. Estimation of tissue and crevicular fluid oxidative stress marker in premenopausal, perimenopausal and postmenopausal women with chronic periodontitis. Gerodontology 2017; 34:382-389. [PMID: 28568604 DOI: 10.1111/ger.12279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVES The aim of this study was to estimate tissue and gingival crevicular fluid (GCF) levels of the oxidative stress marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) in premenopausal, perimenopausal and postmenopausal women with chronic periodontitis. BACKGROUND Oxidative stress has been implicated in the etiopathogenesis of periodontitis and menopause induces oxidative stress. MATERIALS AND METHODS According to Stages of Reproductive Aging Workshop (STRAW) criteria, women diagnosed with periodontitis were subdivided into three groups of 31 participants each 1. Premenopausal 2. Perimenopausal and 3. Postmenopausal. GCF and gingival tissue samples were collected from sites with maximum probing depth. Tissue DNA was extracted from the gingival sample and 8-OHdG in the extracted DNA, and GCF samples were measured using ELISA. RESULTS There was a highly significant difference in the overall GCF 8-OHdG levels among the three groups with the pairwise difference being highly significant between the premenopausal-postmenopausal groups and perimenopausal-postmenopausal groups. However, no overall significant differences in tissue 8-OHdG levels were found among the three groups. Pairwise, highly significant differences were found between the premenopausal-postmenopausal groups and perimenopausal-postmenopausal groups for tissue 8-OHdG levels. No significant correlations were found between various measure of periodontal disease and GCF/tissue 8-OHdG levels among all the groups. CONCLUSION Premenopausal-postmenopausal and perimenopausal-postmenopausal transition resulted in significant increase in tissue and GCF 8-OHdG levels. However, no association was found between stages of reproductive ageing and tissue levels of 8-OHdG.
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Affiliation(s)
- Rampalli Viswa Chandra
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Sistla Sailaja
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
| | - Aileni Amarender Reddy
- Department of Periodontics, SVS Institute of Dental Sciences, Mahabubnagar, Telangana, India
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235
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Diamanti-Kandarakis E, Dattilo M, Macut D, Duntas L, Gonos ES, Goulis DG, Gantenbein CK, Kapetanou M, Koukkou E, Lambrinoudaki I, Michalaki M, Eftekhari-Nader S, Pasquali R, Peppa M, Tzanela M, Vassilatou E, Vryonidou A. MECHANISMS IN ENDOCRINOLOGY: Aging and anti-aging: a Combo-Endocrinology overview. Eur J Endocrinol 2017; 176:R283-R308. [PMID: 28264815 DOI: 10.1530/eje-16-1061] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/14/2017] [Accepted: 03/06/2017] [Indexed: 12/14/2022]
Abstract
Aging and its underlying pathophysiological background has always attracted the attention of the scientific society. Defined as the gradual, time-dependent, heterogeneous decline of physiological functions, aging is orchestrated by a plethora of molecular mechanisms, which vividly interact to alter body homeostasis. The ability of an organism to adjust to these alterations, in conjunction with the dynamic effect of various environmental stimuli across lifespan, promotes longevity, frailty or disease. Endocrine function undergoes major changes during aging, as well. Specifically, alterations in hormonal networks and concomitant hormonal deficits/excess, augmented by poor sensitivity of tissues to their action, take place. As hypothalamic-pituitary unit is the central regulator of crucial body functions, these alterations can be translated in significant clinical sequelae that can impair the quality of life and promote frailty and disease. Delineating the hormonal signaling alterations that occur across lifespan and exploring possible remedial interventions could possibly help us improve the quality of life of the elderly and promote longevity.
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Affiliation(s)
| | | | - Djuro Macut
- Clinic for EndocrinologyDiabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Leonidas Duntas
- Medical SchoolUniversity of Ulm, Ulm, Germany
- Endocrine ClinicEvgenidion Hospital, University of Athens, Athens, Greece
| | - Efstathios S Gonos
- National Hellenic Research FoundationInstitute of Biology, Medicinal Chemistry and Biotechnology, Athens, Greece
| | - Dimitrios G Goulis
- First Department of Obstetrics & GynecologyMedical School, Aristotle University of Thessaloniki, Unit of Reproductive Endocrinology, Thessaloniki, Greece
| | - Christina Kanaka Gantenbein
- First Department of Pediatrics Medical SchoolAghia Sophia Children's Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianna Kapetanou
- National Hellenic Research FoundationInstitute of Biology, Medicinal Chemistry and Biotechnology, Athens, Greece
| | | | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and GynecologyUniversity of Athens, Aretaieio Hospital, Athens, Greece
| | - Marina Michalaki
- Endocrine DivisionInternal Medicine Department, University Hospital of Patras, Patras, Greece
| | - Shahla Eftekhari-Nader
- Department of Internal MedicineMc Goven Medical School, The University of Texas, Houston, Texas, USA
| | | | - Melpomeni Peppa
- Second Department of Internal Medicine PropaedeuticResearch Institute and Diabetes Center, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | | | - Evangeline Vassilatou
- Endocrine Unit2nd Department of Internal Medicine, Attikon University Hospital, Athens, Greece
| | - Andromachi Vryonidou
- Department of EndocrinologyDiabetes and Metabolism, 'Red Cross Hospital', Athens, Greece
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Quiroga A, Larroy C, González-Castro P. Climacteric symptoms and their relation to feminine self-concept. Climacteric 2017; 20:274-279. [PMID: 28398825 DOI: 10.1080/13697137.2017.1310192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate women's subjective experiences in the climacteric transition, especially the impact of self-concept, quality of life and depression on the severity of climacteric symptoms. METHOD Non-experimental, cross-sectional study, purpose sampling. To analyze the results, we proposed a three-way interaction, in which the direct effect of depression on the severity of climacteric symptoms would be buffered by perceived sexual quality of life, and mediated by self-concept. RESULTS As hypothesized, depression significantly predicted self-concept, which in turn mediated the severity of climacteric symptoms. In a second stage of the model, sexual quality of life moderated the direct effect of depression on climacteric symptoms, such that women with a better sexual quality of life would perceive less severity of climacteric symptoms than those with a less favorable sexual quality of life. Physical quality of life did not significantly buffer the direct effect of depression on climacteric symptoms, nor did vasomotor or psychosocial quality of life. CONCLUSIONS Our study confirmed the impact of subjective factors such as satisfaction, self-concept, and quality of life on climacteric symptoms; specifically, we observed the moderating effect of the sexual quality of life on the previously established correlation between depression and aggravation of climacteric symptoms.
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Affiliation(s)
- A Quiroga
- a Departamento Académico de Psicología , Universidad of Monterrey , Garza García , Mexico
| | - C Larroy
- b Clinic Psychology Department , Universidad Complutense de Madrid , Madrid , Spain
| | - P González-Castro
- a Departamento Académico de Psicología , Universidad of Monterrey , Garza García , Mexico
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237
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Hengartner MP. Subtle Scientific Fallacies Undermine the Validity of Neuroendocrinological Research: Do Not Draw Premature Conclusions on the Role of Female Sex Hormones. Front Behav Neurosci 2017; 11:3. [PMID: 28144217 PMCID: PMC5239782 DOI: 10.3389/fnbeh.2017.00003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 01/05/2017] [Indexed: 11/13/2022] Open
Abstract
Major scientific flaws such as reporting and publication biases are well documented, even though acknowledgment of their importance appears to be lacking in various psychological and medical fields. Subtle and less obvious biases including selective reviews of the literature and empirically unsupported conclusions and recommendations have received even less attention. Using the literature on the association between transition to menopause, hormones and the onset of depression as a guiding example, I outline how such scientific fallacies undermine the validity of neuroendocrinological research. It is shown that in contrast to prominent claims, first, most prospective studies do not support the notion that the menopausal transition relates to increased risk for depression, second, that associations between hormone levels and depression are largely inconsistent and irreproducible, and, third, that the evidence for the efficacy of hormone therapy for the treatment of depression is very weak and at best inconclusive. I conclude that a direct and uniform association between female sex hormones and depression is clearly not supported by the literature and that more attention should be paid to the manifold scientific biases that undermine the validity of findings in psychological and medical research, with a specific focus on the behavioral neurosciences.
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Affiliation(s)
- Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences (ZHAW) Zurich, Switzerland
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238
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Wang X, Huang Y, Yuan S, Tamadon A, Ma S, Feng Y. The Role of Hippocampal Estradiol Receptor- α in a Perimenopausal Affective Disorders-Like Rat Model and Attenuating of Anxiety by Electroacupuncture. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:4958312. [PMID: 28044085 PMCID: PMC5156811 DOI: 10.1155/2016/4958312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 10/16/2016] [Accepted: 10/25/2016] [Indexed: 02/07/2023]
Abstract
Hormone replacement therapy is the principal treatment for perimenopausal affective disorders which can cause severe side effects. The present study compared the effects of electroacupuncture (EA) and estradiol treatment on perimenopausal affective disorders at the behavioral and cellular levels. In this randomized experimental in vivo study, adult female rats were divided into intact, ovariectomy, chronic unpredictable stress (CUS), and ovariectomy and CUS combination groups. After week 6, all groups were subdivided to three subgroups of control, EA, and estradiol treatment. The behavioral parameters in the open field and the elevated plus maze tests were assessed before and after treatments. Alterations of serum steroid hormones and changes of estradiol receptor-α (ER-α) immunofluorescence neurons in the hippocampus sections were evaluated. EA treatment caused more antianxiety effects than estradiol treatment in CUS group (P < 0.05). Notably, estradiol and EA treatments had better significant behavioral effects when the models were not estrogen-deficient. Importantly, within each group, compared to the control group, the numbers of ER-α-positive neurons were significantly larger in EA subgroups. Therefore, EA had antianxiety effects on perimenopausal affective disorders caused by CUS but not by estrogen deficiency and upregulation of hippocampus ER-α neurons may contribute to its mechanism of action.
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Affiliation(s)
- Xun Wang
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Institute of Acupuncture Research (WHO Collaborating Center for Traditional Medicine), Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai 200032, China
- 2008 Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Yongheng Huang
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Institute of Acupuncture Research (WHO Collaborating Center for Traditional Medicine), Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai 200032, China
- 2008 Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Shiwen Yuan
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Institute of Acupuncture Research (WHO Collaborating Center for Traditional Medicine), Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai 200032, China
- 2008 Clinical Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Amin Tamadon
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Institute of Acupuncture Research (WHO Collaborating Center for Traditional Medicine), Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai 200032, China
| | - Shulan Ma
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Institute of Acupuncture Research (WHO Collaborating Center for Traditional Medicine), Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai 200032, China
| | - Yi Feng
- Department of Integrative Medicine and Neurobiology, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Institute of Acupuncture Research (WHO Collaborating Center for Traditional Medicine), Institutes of Brain Science, Brain Science Collaborative Innovation Center, Fudan University, Shanghai 200032, China
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239
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Onstad MA, Schmandt RE, Lu KH. Addressing the Role of Obesity in Endometrial Cancer Risk, Prevention, and Treatment. J Clin Oncol 2016; 34:4225-4230. [PMID: 27903150 DOI: 10.1200/jco.2016.69.4638] [Citation(s) in RCA: 329] [Impact Index Per Article: 41.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In sharp contrast to many other cancer types, the incidence and mortality of endometrial cancer continue to grow. This unfortunate trend is, in no small part, a result of the worldwide obesity epidemic. More than half of endometrial cancers are currently attributable to obesity, which is recognized as an independent risk factor for this disease. In this review, we identify the molecular mechanisms by which obesity and adipose tissue contribute to the pathogenesis of endometrial cancer. We further discuss the impact of obesity on the clinical management of the disease and examine the development of rational behavioral and pharmaceutical interventions aimed at reducing endometrial cancer risk, improving cancer outcomes, and preserving fertility in an increasingly younger population of patients with endometrial cancer.
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Affiliation(s)
- Michaela A Onstad
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Karen H Lu
- All authors: The University of Texas MD Anderson Cancer Center, Houston, TX
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240
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Abstract
PURPOSE OF REVIEW Sexuality is an essential part of a healthy life. It can contribute significantly to the physical, psychological and social wellbeing of menopausal women, therefore, to their quality of life. This study is an overview of the most recent findings in the literature retrieved from searches of computerized databases. We extracted all notable information concerning definition, epidemiology, symptoms, diagnostic evaluation and management. RECENT FINDINGS The experience of sexuality in menopause is fundamentally shaped by the biological and psychological changes that occur on a substrate of modifications linked to the ageing process. Moreover, several additional factors, including effects of illness, medications and psychosocial stressors can contribute to sexual dysfunction. Patients should be educated about the causes of sexual dysfunction and available treatment. SUMMARY In recent years, the field of research in sexual dysfunctions has made great progress in many areas of investigation, from epidemiology to pathophysiology providing a better understanding of causes and promoting better care. However, the multifactorial nature of human sexuality still makes our ability to comprehensively treat sexual dysfunction quite difficult. An integrated approach is needed to recognize different aspects involved and to identify the proper intervention strategies for early prevention and promotion of a healthy sexuality in menopause.
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241
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Variation analysis of PRIM1 gene in Chinese patients with primary ovarian insufficiency. Reprod Biomed Online 2016; 33:587-591. [PMID: 27599756 DOI: 10.1016/j.rbmo.2016.08.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/24/2016] [Accepted: 08/18/2016] [Indexed: 11/23/2022]
Abstract
Insights into common genetic susceptibility between primary ovarian insufficiency (POI) and natural or early menopause have delivered an innovative way of assessing the genetic mechanisms involved in POI. PRIM1 plays a crucial role in DNA replication by synthesizing RNA primers for Okazaki fragments. It is closely associated with age at natural menopause, early menopause and POI in European women. In this study, we aimed to investigate whether mutations in PRIM1 contribute to POI in Chinese women. All exons and exon-intron boundaries of PRIM1 gene were sequenced in 192 Han Chinese women with non-syndromic POI. No plausible mutations were identified. The results suggest that the perturbations in PRIM1 gene are not a common explanation for POI in Chinese women.
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242
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Prevalence and severity of vasomotor symptoms and joint pain in women at midlife in Bangladesh: a population-based survey. Menopause 2016; 23:731-9. [DOI: 10.1097/gme.0000000000000615] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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243
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Rössler W, Ajdacic-Gross V, Riecher-Rössler A, Angst J, Hengartner MP. Does menopausal transition really influence mental health? Findings from the prospective long-term Zurich study. World Psychiatry 2016; 15:146-54. [PMID: 27265705 PMCID: PMC4911775 DOI: 10.1002/wps.20319] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
In the prospective long-term Zurich study, we re-examined the hypothesized association between mental health problems in women and the transition through menopausal stages. One hundred sixty-eight women from a population-based Swiss community cohort were prospectively followed up from age 21 to 50. At age 50, the occurrence of hot flushes/night sweats and sleep disturbances was significantly more frequent in peri- and post-menopausal women. Irritability/nervousness was increased only in peri-menopausal women, but that association was accounted for by neuroticism trait scores at age 30. Transitions to peri- or post-menopause were not related to changes in either the prevalence rates of DSM major depressive episode or anxiety disorders, or the course of psychopathological syndromes as assessed by the Symptom Checklist 90 - Revised. The null associations held when adjusting for duration of reproductive period or age at menopause. Preceding mental health problems between ages 21 and 41, increased neuroticism trait scores at age 30, and concurrent psychosocial distress were significantly related to mental health problems occurring between ages 41 and 50. Depending upon the cut-off point that was chosen, the arbitrary dichotomization of a continuous depression outcome produced spurious associations with the menopausal transition. We conclude that mental health problems between ages 41 and 50 are probably not directly related to the menopausal transition, and that previously reported associations could be false positives due to inadequate dichotomizations, reporting bias, undisclosed multiple adjustments or overfitting.
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Affiliation(s)
- Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
- Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of São Paulo, Brazil
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Anita Riecher-Rössler
- University of Basel Psychiatric Clinics, Center for Gender Research and Early Detection, Basel, Switzerland
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
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244
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Roberts H, Hickey M. Managing the menopause: An update. Maturitas 2016; 86:53-8. [DOI: 10.1016/j.maturitas.2016.01.007] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 01/12/2016] [Accepted: 01/13/2016] [Indexed: 02/07/2023]
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245
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Prior JC. Progesterone or progestin as menopausal ovarian hormone therapy: recent physiology-based clinical evidence. Curr Opin Endocrinol Diabetes Obes 2015; 22:495-501. [PMID: 26512775 DOI: 10.1097/med.0000000000000205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Provide evidence-based recent data on oral micronized progesterone (OMP) and progestins in menopausal hormonal therapy (MHT). RECENT FINDINGS Medroxyprogesterone acetate (MPA) increases breast cancer acting through the glucocorticoid receptor; progestins in MHT increase thrombosis more than oral estrogens; MPA, but not OMP or other progestins, increase monocyte cell endothelium adhesion; MPA and estradiol (E2)/MPA have negative brain effects, whereas E2/progesterone (P4) has neuroregenerative brain effects. The 'window of opportunity' cardiovascular disease hypothesis is not supported by a randomized controlled trial showing that transdermal estradiol with sequential OMP in early menopause does not prevent increased carotid intimal media thickness; P4 in the cardiac electrical system opposes E2 effects and prevents sudden death/long QT syndrome; transdermal estradiol/OMP does not increase venous thromboembolism in observational data. P4 decreases breast cell proliferation and improves prognosis through P4 receptor alteration of estrogen receptor α genetic effects; OMP with conjugated equine estrogen (CEE)/estrogen (E)/E2 does not increase breast cancer in two prospective cohorts, one population-based. Endometrial cancer is increased in MHT of CEE/E/E2+cyclic OMP at 200 mg/day. SUMMARY New data show CEE/E/E2+MPA/P mechanisms for negative breast cancer, venous thromboembolism, cardiovascular system, and brain effects. OMP/P4 counterbalances CEE/E/E2-related negative effects on breast cancer and long QT syndrome. OMP effectively treats vasomotor symptoms and sleep disturbances, and could safely be used alone for symptomatic menopause.
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Affiliation(s)
- Jerilynn C Prior
- Endocrinology and Metabolism, Centre for Menstrual Cycle and Ovulation Research (CeMCOR), Department of Medicine, School of Population and Public Health, University of British Columbia, Vancouver Coastal Health Research Institute, Vancouver, Canada
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Moderate-severely bothersome vasomotor symptoms are associated with lowered psychological general wellbeing in women at midlife. Maturitas 2015; 81:487-92. [DOI: 10.1016/j.maturitas.2015.06.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 06/03/2015] [Accepted: 06/04/2015] [Indexed: 11/21/2022]
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