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Shukla R, Singh S, Kamath S, Shah U, Patel S, Kherajani K, Gupta A, Shaw P, Unnithan V, Kaithathara S, Gharde P. Interplay Between Diabetes Mellitus and the Occurrence of Osteoarthritis and Associated Conditions in Women of Menopausal Age. Cureus 2024; 16:e58502. [PMID: 38765429 PMCID: PMC11101597 DOI: 10.7759/cureus.58502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Osteoarthritis (OA) and diabetes mellitus (DM) have long-term deleterious chronic effects and are among the most prevalent chronic disorders. DM and its associated factors, such as hyperglycemia, have a significant contribution to the pathophysiology of OA, particularly in post-menopausal women. Women who have uncontrolled diabetes (DM) are more prone to develop osteoarthritis (OA), which may be exacerbated by poor glycemic control. Furthermore, this category of female patients with DM has an increased risk of developing fractures, even in those with initially normal bone density scores, further illustrating the correlation between DM and bone health. Additionally, multiple risk factors, including obesity, metabolic syndrome, hypertension, estrogen-based hormone therapy, and hyperuricemia, in menopausal women can lead to the development and exacerbation of OA. It is discovered that these variables have a direct or indirect impact, frequently causing inflammation and hormonal changes, which contribute to the intricate interaction between DM and OA. The management of OA and DM in women thus calls for a multi-faceted management plan including glycemic control, weight control, exercise, and specialized pain management methods catering to the specific requirements of the patients. Regularly screening for OA should be implemented for menopausal women with DM and utmost care should be provided by healthcare professionals. Regular monitoring of joint health and early management, encouraging interdisciplinary cooperation, putting preventative measures into place, and creating individualized treatment programs are essential. A thorough understanding of the link between DM and OA will ultimately lead to improved health outcomes and a better future for these individuals.
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Affiliation(s)
- Rushikesh Shukla
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shailja Singh
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shruthi Kamath
- Medicine, Kasturba Medical College, Mangalore, Mangalore, IND
| | - Urmil Shah
- Medicine, Rajiv Gandhi Medical College, Thane, IND
| | - Siddhi Patel
- Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | | | - Ananya Gupta
- Medicine, Kasturba Medical College, Mangalore, Mangalore, IND
| | - Priya Shaw
- Medicine, Burdwan Medical College and Hospital, Bardhaman, IND
| | - Vishnu Unnithan
- Nuclear Medicine, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, IND
| | | | - Pankaj Gharde
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Blanken A, Gibson CJ, Li Y, Huang AJ, Byers AL, Maguen S, Inslicht S, Seal K. Racial/ethnic disparities in the diagnosis and management of menopause symptoms among midlife women veterans. Menopause 2022; 29:877-882. [PMID: 35796560 PMCID: PMC9884100 DOI: 10.1097/gme.0000000000001978] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Racial/ethnic disparities in menopause symptoms and hormone therapy management remain understudied among women served by the Veteran's Health Administration, despite the unique racial/ethnic diversity of this population. Thus, we determined racial/ethnic disparities in medical record-documented menopause symptoms and prescribed menopausal hormone therapy among women veterans. METHODS We conducted cross-sectional analyses of national Veteran's Health Administration electronic health record data from 2014 to 2015. We used logistic regression models to compare medical-record documented menopause symptoms and treatment (eg, vaginal estrogen or systemic hormone therapy) by self-identified race/ethnicity, adjusting for age, body mass index, and depression. Models examining hormone treatment were adjusted for menopause symptoms. RESULTS Among 200,901 women veterans (mean age 54.3, SD 5.4 y; 58% non-Hispanic/Latinx White, 33% non-Hispanic/Latinx Black, 4% Hispanic/Latinx, and 4% other), 5% had documented menopause symptoms, 5% were prescribed vaginal estrogen, and 5% were prescribed systemic hormone therapy. In fully adjusted multivariable models, non-Hispanic/Latinx Black women veterans had lower odds of documented menopause symptoms relative to non-Hispanic/Latinx White women (OR 0.82, 95% CI: 0.78-0.86). Moreover, non-Hispanic/Latinx Black women (OR 0.74, 95% CI: 0.70-0.77), as well as Hispanic/Latinx women (OR 0.68, 95% CI: 0.61-0.77), had lower likelihood of systemic hormone therapy prescription. Hispanic/Latinx women had higher odds of vaginal estrogen prescription (OR 1.12 95% CI: 1.02-1.24) than non-Hispanic/Latinx White women. Non-Hispanic/Latinx Black women had lower likelihood of estrogen use (OR 0.78 95% CI: 0.74-0.81) than non-Hispanic/Latinx White women. CONCLUSION Despite evidence suggesting higher menopause symptom burden among Black women in community samples, documented menopause symptoms and hormone therapy were less common among Black, compared with White, women veterans. Additionally, Hispanic/Latinx women veterans had lower odds of prescribed systemic menopause therapy and yet higher odds of prescribed vaginal estrogen, despite no difference in documented symptoms. These findings may signal important disparities in symptom reporting, documentation, and/or treatment for minority women veterans.
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Affiliation(s)
- Anna Blanken
- San Francisco VA Health Care System
- University of California, San Francisco
| | - Carolyn J. Gibson
- San Francisco VA Health Care System
- University of California, San Francisco
| | - Yongmei Li
- San Francisco VA Health Care System
- University of California, San Francisco
| | | | - Amy L. Byers
- San Francisco VA Health Care System
- University of California, San Francisco
| | - Shira Maguen
- San Francisco VA Health Care System
- University of California, San Francisco
| | - Sabra Inslicht
- San Francisco VA Health Care System
- University of California, San Francisco
| | - Karen Seal
- San Francisco VA Health Care System
- University of California, San Francisco
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Abstract
OBJECTIVE Women are more likely than men to suffer chronic pain, with the highest rates seen in midlife. The symptoms that characterize menopause broadly affect health and well-being, but their contribution to chronic pain risk during this period is poorly understood. To address this gap in knowledge, we examined relationships between indicators of menopause symptoms and chronic pain among midlife women veterans, a population with prevalent chronic pain diagnoses and elevated risk for bothersome menopause symptoms. METHODS This is a cross-sectional analysis of national Veterans Health Administration medical and pharmacy records. Using national medical and pharmacy records from women veterans aged 45 to 64 with at least one VA encounter during 2014 and/or 2015 (n = 200,901), we developed multivariable logistic regression models to examine associations between menopause symptoms (defined by menopause symptom-related diagnoses on ≥2 encounters and/or menopause hormone therapy use) and chronic pain outcomes, adjusting for age, race, body mass index, mental health diagnoses, and substance use disorders. RESULTS In this national sample of midlife women veterans (mean age 54.3 ± 5.4), 13% had menopause symptoms, 52% had chronic pain, and 22% had ≥2 distinct chronic pain diagnoses. In multivariable analyses, women with menopause symptoms had nearly two-fold odds of chronic pain (odds ratio 1.84, 95% confidence interval 1.79-1.90, P < 0.001) and multiple chronic pain diagnoses (odds ratio 1.79, 95% confidence interval 1.74-1.83, P < 0.001). CONCLUSIONS These findings raise the possibility within this vulnerable critical period, midlife women with a higher menopause symptom burden may be most vulnerable for chronic pain.
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Yang YL, Chee W, Im EO. Type 2 Diabetes and Musculoskeletal Symptoms Among Midlife Women. DIABETES EDUCATOR 2019; 45:520-528. [PMID: 31486342 DOI: 10.1177/0145721719872558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE The purpose of this study was to describe the association between type 2 diabetes and musculoskeletal symptoms among midlife women from 4 major racial/ethnic groups in the United States. METHODS This is a secondary data analysis using the data from 164 participants aged 40 to 60 years of 2 larger survey studies (62 with type 2 diabetes and 102 without type 2 diabetes). In the original studies, the participants completed multiple questionnaires on background characteristics, health status, menopausal status, and musculoskeletal symptoms. The Musculoskeletal Symptom Index for Midlife Women was used to determine the number and severity of musculoskeletal symptoms. For data analysis, independent t tests, Mann-Whitney U tests, and multiple regression analyses were used. RESULTS The mean number of musculoskeletal symptoms was significantly higher in women with vs without type 2 diabetes as was the mean severity score. In subgroup analyses, among each menopausal stage and non-Hispanic white women, there were significant differences in the numbers and total severity scores between those with type 2 diabetes and without type 2 diabetes. When background characteristics, health status, and menopausal status were controlled, having diagnosis of type 2 diabetes was positively associated with the numbers and total severity scores of musculoskeletal symptoms. CONCLUSION Study findings supported significant associations of type 2 diabetes with musculoskeletal symptoms among midlife women. Further studies are recommended to confirm relationships in larger populations.
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Affiliation(s)
- You Lee Yang
- School of Nursing, Duke University, Durham, North Carolina
| | - Wonshik Chee
- School of Nursing, Duke University, Durham, North Carolina
| | - Eun-Ok Im
- School of Nursing, Duke University, Durham, North Carolina
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Danan ER, Krebs EE, Ensrud K, Koeller E, MacDonald R, Velasquez T, Greer N, Wilt TJ. An Evidence Map of the Women Veterans' Health Research Literature (2008-2015). J Gen Intern Med 2017; 32:1359-1376. [PMID: 28913683 PMCID: PMC5698220 DOI: 10.1007/s11606-017-4152-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 06/08/2017] [Accepted: 07/27/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Women comprise a growing proportion of Veterans seeking care at Veterans Affairs (VA) healthcare facilities. VA initiatives have accelerated changes in services for female Veterans, yet the corresponding literature has not been systematically reviewed since 2008. In 2015, VA Women's Health Services and the VA Women's Health Research Network requested an updated literature review to facilitate policy and research planning. METHODS The Minneapolis VA Evidence-based Synthesis Program performed a systematic search of research related to female Veterans' health published from 2008 through 2015. We extracted study characteristics including healthcare topic, design, sample size and proportion female, research setting, and funding source. We created an evidence map by organizing and presenting results within and across healthcare topics, and describing patterns, strengths, and gaps. RESULTS We identified 2276 abstracts and assessed each for relevance. We excluded 1092 abstracts and reviewed 1184 full-text articles; 750 were excluded. Of 440 included articles, 208 (47%) were related to mental health, particularly post-traumatic stress disorder (71 articles), military sexual trauma (37 articles), and substance abuse (20 articles). The number of articles addressing VA priority topic areas increased over time, including reproductive health, healthcare organization and delivery, access and utilization, and post-deployment health. Three or fewer articles addressed each of the common chronic diseases: diabetes, hypertension, depression, or anxiety. Nearly 400 articles (90%) used an observational design. Eight articles (2%) described randomized trials. CONCLUSIONS Our evidence map summarizes patterns, progress, and growth in the female Veterans' health and healthcare literature. Observational studies in mental health make up the majority of research. A focus on primary care delivery over clinical topics in primary care and a lack of sex-specific results for studies that include men and women have contributed to research gaps in addressing common chronic diseases. Interventional research using randomized trials is needed.
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Affiliation(s)
- Elisheva R Danan
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA. .,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
| | - Erin E Krebs
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kristine Ensrud
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Eva Koeller
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Roderick MacDonald
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Tina Velasquez
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Nancy Greer
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA
| | - Timothy J Wilt
- VA HSR&D Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, 1 Veterans Drive (152), Minneapolis, MN, 55417, USA.,Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
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Steels E, Steele M, Harold M, Coulson S. Efficacy of a ProprietaryTrigonella foenum-graecum L. De-Husked Seed Extract in Reducing Menopausal Symptoms in Otherwise Healthy Women: A Double-Blind, Randomized, Placebo-Controlled Study. Phytother Res 2017; 31:1316-1322. [DOI: 10.1002/ptr.5856] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 05/03/2017] [Accepted: 06/01/2017] [Indexed: 12/11/2022]
Affiliation(s)
- E. Steels
- Sydney Medical School; The University of Sydney; Sydney Australia
| | - M.L. Steele
- Institute of Health and Biomedical Innovation, School of Public Health; Queensland University of Technology; Brisbane Australia
- Hospital Havelhöhe; Research Institute Havelhöhe; Berlin Germany
| | - M. Harold
- The BRIDI Centre Pty. Ltd; Brisbane Australia
| | - S. Coulson
- Sydney Medical School; The University of Sydney; Sydney Australia
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Agaba PA, Meloni ST, Sule HM, Ocheke AN, Agaba EI, Idoko JA, Kanki PJ. Prevalence and predictors of severe menopause symptoms among HIV-positive and -negative Nigerian women. Int J STD AIDS 2017; 28:1325-1334. [PMID: 28409538 DOI: 10.1177/0956462417704778] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We compared the prevalence of menopause symptoms between women living with HIV to their HIV-negative peers and determined predictors of severe menopause symptoms in Jos, Nigeria. This descriptive cross-sectional study included 714 women aged 40-80 years. We compared prevalence and severity of menopause symptoms using the menopause rating scale (MRS). Logistic regression analysis was used to determine the predictors of severe symptoms. Six-hundred and seven (85.0%) were HIV-positive, with a mean duration of infection of 5.6 ± 2.7 years. The mean age of the cohort was 46 ± 5 years. The most prevalent menopause symptoms were hot flushes (67.2%), joint and muscle discomfort (66.2%), physical/mental exhaustion (65.3%), heart discomfort (60.4%), and anxiety (56.4%). The median MRS score was higher for HIV-positive compared to HIV-negative women (p = 0.01). Factors associated with severe menopause symptoms included HIV-positive status (aOR: 3.01, 95% CI: 1.20-7.54) and history of cigarette smoking (aOR: 4.18, 95% CI: 1.31-13.26). Being married (aOR: 0.49, 95% CI: 0.32-0.77), premenopausal (aOR: 0.60, 95% CI: 0.39-0.94), and self-reporting good quality of life (aOR: 0.62. 95% CI: 0.39-0.98) were protective against severe menopause symptoms. We found HIV infection, cigarette smoking, quality of life, and stage of the menopause transition to be associated with severe menopause symptoms. As HIV-positive populations are aging, additional attention should be given to the reproductive health of these women.
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Affiliation(s)
- Patricia A Agaba
- 1 Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.,2 APIN Centre, Jos University Teaching Hospital, Jos, Nigeria
| | - Seema T Meloni
- 3 Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Halima M Sule
- 1 Department of Family Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria.,2 APIN Centre, Jos University Teaching Hospital, Jos, Nigeria
| | - Amaka N Ocheke
- 4 Department of Obstetrics & Gynaecology, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - Emmanuel I Agaba
- 5 Department of Medicine, University of Jos/Jos University Teaching Hospital, Jos, Nigeria
| | - John A Idoko
- 6 National Agency for the Control of AIDS, Abuja, Nigeria
| | - Phyllis J Kanki
- 3 Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Ranasinghe GC, Piliang MP, Bergfeld WF. Prevalence of hormonal and endocrine dysfunction in patients with lichen planopilaris (LPP): A retrospective data analysis of 168 patients. J Am Acad Dermatol 2017; 76:314-320. [DOI: 10.1016/j.jaad.2016.05.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/28/2016] [Accepted: 05/25/2016] [Indexed: 12/19/2022]
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