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Kingsberg SA, Schulze-Rath R, Mulligan C, Moeller C, Caetano C, Bitzer J. Global view of vasomotor symptoms and sleep disturbance in menopause: a systematic review. Climacteric 2023; 26:537-549. [PMID: 37751852 DOI: 10.1080/13697137.2023.2256658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/03/2023] [Indexed: 09/28/2023]
Abstract
Studies have shown racial/ethnic differences in the prevalence of vasomotor symptoms (VMS), sleep disturbance and VMS treatment in menopause. To assess the reproducibility of these differences, we systematically reviewed observational studies, published in 2000-2021, reporting the prevalence/incidence of VMS, sleep disturbance or treatment use in menopausal women stratified by race/ethnicity. We screened 3799 records from PubMed and Embase and included 27 papers (19 studies). No incidence data were found. Prevalence data varied widely, but some common patterns emerged. In all five studies comparing VMS between Black women and White, Hispanic and/or East Asian women, the prevalence was highest in Black women and lowest in East Asian women. The prevalence of sleep disturbance overall was compared among Black, White and East Asian women in two study populations, and was highest in White women in both papers. Sleep disturbance was more common than VMS in East Asian women. In all four studies comparing hormone therapy use between White women and Black and/or East Asian women, treatment use was more common in White women. These results highlight the need for individualized counseling and treatment, outreach to under-served minorities, and standardized definitions and outcome measures for VMS and sleep disturbance for future studies.
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Affiliation(s)
- S A Kingsberg
- Department of Obstetrics and Gynecology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - R Schulze-Rath
- Medical Affairs & Pharmacovigilance, Pharmaceuticals, Bayer AG, Berlin, Germany
| | - C Mulligan
- Evidence Synthesis, Beacon Medical Communications, Brighton, UK
| | - C Moeller
- Medical Affairs & Pharmacovigilance, Pharmaceuticals, Bayer AG, Berlin, Germany
| | - C Caetano
- Pharmaceuticals, Medical Affairs Women's Healthcare, Bayer AG, Basel, Switzerland
| | - J Bitzer
- Department of Obstetrics and Gynecology, University Hospital, University of Basel, Basel, Switzerland
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Greendale GA, Han W, Finkelstein JS, Burnett-Bowie SAM, Huang M, Martin D, Karlamangla AS. Changes in Regional Fat Distribution and Anthropometric Measures Across the Menopause Transition. J Clin Endocrinol Metab 2021; 106:2520-2534. [PMID: 34061966 PMCID: PMC8372653 DOI: 10.1210/clinem/dgab389] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Indexed: 01/28/2023]
Abstract
CONTEXT The relation between the menopause transition (MT) and changes in regional fat distribution is uncertain. OBJECTIVE To determine whether the MT is associated with the development of central adiposity. DESIGN Longitudinal analysis from the Study of Women's Health Across the Nation, spanning 1996-2013 (median follow-up 11.8 years). SETTING Community-based. PARTICIPANTS 380 women with regional body composition measures by dual energy X-ray absorptiometry. Mean baseline age was 45.7 years; racial/ethnic composition was 16% Black, 41% Japanese and 43% White. OUTCOMES Changes in android, gynoid and visceral fat and waist and hip circumferences. RESULTS Android fat increased by 1.21% per year (py) and 5.54% py during premenopause and the MT, respectively (each P < 0.05). Visceral and gynoid fat began increasing at the MT, annualized changes were 6.24% and 2.03%, respectively (each P < 0.05). Postmenopausal annual trajectories decelerated to 1.47% (visceral), 0.90% (android), and -0.87% (gynoid), (all non-zero, P < 0.05). Waist girth grew during premenopause (0.55% py), the MT (0.96% py), and postmenopause (0.55% py) (all non-zero, P < 0.05; not statistically different from each other). Hip girth grew during premenopause (0.20% py) and the MT (0.35% py) (each non-zero, P < 0.05; not statistically different from each other) and decelerated to zero slope in postmenopause. Results are for the White referent; there were statistically significant differences in some trajectories in Black and Japanese women. CONCLUSIONS The MT is associated with the development of central adiposity. Waist or hip circumferences are less sensitive to changes in fat distribution.
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Affiliation(s)
- Gail A Greendale
- Department of Medicine, Division of Geriatrics, UCLA, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA 90095, United States
- Correspondence: Gail A. Greendale, MD, UCLA, Los Angeles, CA, United States.
| | - Weijuan Han
- Department of Medicine, Division of Geriatrics, UCLA, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA 90095, United States
| | - Joel S Finkelstein
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, 50 Blossom St, Boston, MA 02114, United States
| | - Sherri-Ann M Burnett-Bowie
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital, 50 Blossom St, Boston, MA 02114, United States
| | - MeiHua Huang
- Department of Medicine, Division of Geriatrics, UCLA, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA 90095, United States
| | - Deborah Martin
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 4420 Bayard Street, Suite 600, Pittsburgh, PA 15260, United States
| | - Arun S Karlamangla
- Department of Medicine, Division of Geriatrics, UCLA, 10945 Le Conte Ave, Suite 2339, Los Angeles, CA 90095, United States
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Woods R, Hess R, Biddington C, Federico M. Association of lean body mass to menopausal symptoms: The Study of Women's Health Across the Nation. Womens Midlife Health 2020; 6:10. [PMID: 32944260 PMCID: PMC7490966 DOI: 10.1186/s40695-020-00058-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
Background The purpose of this study was to examine the association of lean body mass (LBM) to the development of vasomotor symptoms (VMS) as women transition through menopause. Methods This study is a secondary use of data available for public use from follow up visits six through 10 for participants in the Study of Women’s Health Across the Nation. The study examined 2533 women, between the ages 42–52 years, each year over a10-year period. Data was modeled for associations of lean body mass and VMS. Changes in LBM since prior visit and since baseline were also modeled along with differences in means using binary logistic regression, adjusting for covariates. Results LBM was significantly associated to concurrent VMS (p = .036), percent change in LBM since prior visit (p = .003), percent change since baseline (p < .001), and overall means associations (p = .023). LBM was not significant for VMS at individual visit measures. In mixed regression modeling, time was significant (p < .0001) at all visits. The estimated probability of developing VMS decreases significantly as LBM increases. Conclusions Lean body mass is negatively associated with incident VMS. Our data suggests that maintaining higher levels of LBM during the menopausal transition may be protective against the development of VMS. Every woman will experience menopause in her life and the ability to potentially prevent the onset of specific symptoms through basic interventions, such as resistance training to increase lean body mass, may positively impact this large population.
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Affiliation(s)
- Rosanne Woods
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Rebecca Hess
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Carol Biddington
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
| | - Marc Federico
- Department of Exercise Science and Sport Studies, California University of Pennsylvania, 50 University Ave, California, PA 15419 USA
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Dugan SA, Lange-Maia B, Karavolos K, Kazlauskaite R, Hollings CS, Avery E, Nackers L, Lynch E, Ventrelle J, Normand P, Johnson T, Fullam F, Shipp-Johnson K, Wilbur J, Powell LH. Design of a lifestyle intervention to slow menopause-related progression of intra-abdominal adipose tissue in women: The Women in the Southside Health and Fitness (WISHFIT) study. Contemp Clin Trials Commun 2016; 4:74-83. [PMID: 29736471 PMCID: PMC5935904 DOI: 10.1016/j.conctc.2016.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/28/2016] [Accepted: 07/18/2016] [Indexed: 11/25/2022] Open
Abstract
Background Changes in reproductive hormones during menopause are associated with accumulation of intra-abdominal adipose tissue (IAAT), a subclinical indicator of cardiometabolic disease risk. Independent of reproductive hormones, unhealthy lifestyle contributes to IAAT gain. The Women in the Southside Health and Fitness (WISHFIT) Study aims to develop a lifestyle approach to slowing IAAT accumulation as women begin the menopausal transition. Methods The primary aim is to develop and conduct a proof-of-concept test of a multi-component, multi-level behavioral intervention targeting jointly physical activity, diet, and psychological well-being. Participants attend group sessions over 2 years to experiment with healthy living through both experiential and didactic learning, cultivate a health network, and draw on community resources to sustain change. The primary endpoint is 2-year IAAT progression, assessed using computerized tomography. Behavioral targets of treatment and secondary endpoints will be evaluated at 6, 12, 18 and 24 months. Change in social networks and community support will be assessed at 2 years. Results WISHFIT recruited 71 pre- and peri-menopausal Caucasian and African American women (mean ± SD age = 47.6 ± 3.4 yrs; BMI = 33.6 ± 7.3 kg/m2; 52% African American). Baseline IAAT was 2104.1 ± 1201.3 cm3. IAAT, physical activity, BMI, and self-reported family income and resilience differed by ethnicity at baseline. Conclusions WISHFIT is a multi-component, multi-level intervention aimed at producing a sustained improvement in physical activity, diet, and psychological well-being early in the menopausal transition to slow menopause-related accumulation of IAAT. It provides a model for the process of developing a behavioral treatment to manage a chronic disease.
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Affiliation(s)
- Sheila A Dugan
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States.,Department of Physical Medicine & Rehabilitation, Rush University Medical Center, Chicago, IL, United States
| | - Brittney Lange-Maia
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Kelly Karavolos
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Rasa Kazlauskaite
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States.,Department of Endocrinology, Rush University Medical Center, Chicago, IL, United States
| | - Chiquia S Hollings
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Elizabeth Avery
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Lisa Nackers
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison WI, United States
| | - Elizabeth Lynch
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Jennifer Ventrelle
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Patricia Normand
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Tricia Johnson
- Health Systems Management, Rush University Medical Center, Chicago, IL, United States
| | - Francis Fullam
- Strategic Planning, Marketing and Program Development, Rush University Medical Center, Chicago, IL, United States
| | - Karla Shipp-Johnson
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - JoEllen Wilbur
- College of Nursing, Rush University Medical Center, Chicago, IL, United States
| | - Lynda H Powell
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
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