The role of diet in managing menopausal symptoms: A narrative review

Pain during menopause

Menopause is a biological process marking the end of a woman's reproductive years, typically occurring between the ages of 45 and 55. While often associated with hot flashes, mood swings, and hormonal changes, pain is a frequently overlooked and under-addressed aspect of the menopausal experience. This review article explores the multifaceted nature of pain during menopause, and sheds light on its various manifestations and the factors contributing to its prevalence and severity. Pain during menopause may include musculoskeletal discomfort, headaches or migraines, and vulvovaginal pain. The etiology of these is intricate, involving hormonal fluctuations, psychosocial factors, and genetic predispositions. Fluctuations in estrogen and progesterone levels play a pivotal role in musculoskeletal pain and joint stiffness, and increase susceptibility to conditions such as osteoarthritis. Furthermore, mood disorders, stress, and sleep disturbances may exacerbate the perception of pain. Gender norms, as well as changes in reproductive capacity and societal views on aging, may adversely the impact the self-esteem of individuals undergoing menopause. These symptoms can significantly impact a woman's quality of life, underscoring the need for early identification and appropriate management strategies. This review article highlights the factors contributing to pain during menopause, evaluates the effects of hormones on menopausal pain, and investigates management strategies for pain during menopause, including both pharmacological and non-pharmacological approaches. It also emphasizes the need for further research to better understand the interplay of factors contributing to pain during menopause, in order to allow for more tailored and effective interventions. In understanding and addressing this often-neglected aspect of menopause, healthcare providers can enhance the overall wellbeing and quality of life for women transitioning through this natural life stage.

Nutrition information and the menopause: An online survey of perimenopausal and menopausal women

OBJECTIVE

This study aimed to explore where perimenopausal and menopausal women get their nutrition information from, and how reliable they perceive these sources to be.

STUDY DESIGN

This was a cross-sectional study that used an online survey to collect data about nutrition information seeking habits. The survey was generated using the Qualtrics software and promoted via social media. The convenience sample included women over the age of 40 years living in the UK. Main outcome measures: Quantitative data.

RESULTS

Two hundred and sixty-nine responses were analysed. The majority of respondents were over the age of 50, and from a white British background. Online sources were most commonly used by women to access nutrition information, namely official websites such as the British Menopause Society (BMS) and National Health Service (NHS) websites. The majority of participants believed that these, along with research papers, were the most reliable sources. However, receiving nutrition information from healthcare professionals was most likely to cause women to change their behaviour towards nutrition. The majority of women were interested in receiving targeted menopausal nutrition information, and this would ideally be from official websites or their healthcare professionals.

CONCLUSIONS

Findings from this study suggest that women predominantly rely on online sources for information about nutrition, perceiving official websites as reliable sources. There is a demand among women for tailored nutritional guidance during the menopausal transition, emphasising the importance of providing accessible and targeted resources to support women's health needs during this life stage.

Uptake of Risk-Reducing Salpingo-Oophorectomy and Gynaecologic Surveillance Among Germline BRCA Pathogenic Variants Carriers

INTRODUCTION

Risk-reducing salpingo-oophorectomy (RRSO) is recommended by international guidelines in women with BRCA1/2 germline pathogenic variants (PV) to prevent ovarian cancer. Despite the solid recommendation, women frequently refuse surgery and uptake rates reported in the literature are diverse. This study analyses the uptake rate of RRSO in BRCA 1/2 PV-carriers referred to a specialised referral centre for first counselling and investigate personal factors linked to the decision.

METHODS

This is a single-centre prospective study of BRCA1/2 PV-carriers referred for the first counselling to IRCCS Fondazione San Gerardo de' Tintori (Monza, Italy) between January 2010 and May 2023. Depending on individual characteristics, women were either proposed RRSO or surveillance, consisting of transvaginal ultrasound and CA125 measurement twice per year according to Regional guidelines. Women within the centre have access to a clinical psychologist, a nutritional consult and treatment of menopausal atrophy with diode vaginal laser. The primary endpoint of the study was the uptake rate of RRSO. The secondary objective was to evaluate the main reasons for refusing surgery.

RESULTS

Among the 287 women included, surgery was proposed to 205 women either at first counselling or during surveillance and was accepted by 197, with an uptake rate of 96.1%. 17.25% of women met the psychologist before or after surgery. The main reasons for refusing RRSO were fear of iatrogenic menopause and childbearing desire.

CONCLUSION

This study shows a high uptake rate of RRSO in BRCA PV-carriers. We believe that the presence of a dedicated outpatient clinic with a multidisciplinary team contributes decisively to our results. Gynaecologic surveillance, as though not beneficial in terms of oncological prevention, may play a significant role in encouraging women with BRCA PV to opt for risk-reducing surgery.

A review on daidzein as food supplement: Exploring its phytopharmacological and preclinical status

A natural product is a compound or substance originating from a living organism and found in nature. Daidzein belongs to the class of bioflavonoids, which are plant‐derived compounds with various biological activities. Predominantly exists in soybeans and several legumes in either glycoside or aglycone forms. Its primary chemical constituents include metabolites like equol and trihydroxy isoflavone, generated through the influence of intestinal bacteria. Daidzein has exhibited pharmacological impacts on different ailments, including cardiovascular disease, cancer, diabetes, skin disorders, osteoporosis, and neurodegenerative disorders. Daidzein's mechanisms of action involve interactions with estrogen receptors, as well as its antioxidant and anti‐inflammatory properties, along with its ability to regulate apoptosis and the cell cycle. In efforts to enhance its solubility, stability, bioavailability, and targeting, daidzein has been innovatively formulated into novel dosage forms, including nanoparticles, liposomes, microemulsions, and nanosuspensions. As a promising nutraceutical, daidzein presents multiple health benefits and holds potential for various clinical applications. Additional investigation is required to comprehend the molecular mechanisms of this phenomenon and assess its safety. The purpose of this review is to provide a short description of the therapeutic properties, chemical composition, traditional use, toxicology profile, new insights on the dosage form, and future prospects of daidzein.

A Life-Stage Approach to Precision Nutrition: A Narrative Review

The concept of precision nutrition highlights the customization of nutrition to specific needs, emphasizing that a one-size-fits-all approach is not sufficient for either optimal nutrition or optimal health. Precision nutrition encompasses a range of factors, from broad strata of age and sex categories to personal characteristics such as lifestyle to an individual's unique genotype. This breadth of scope requires us to consider how precision nutrition can be implemented in an inclusive and appropriate way for individuals and groups within real-life populations. In this narrative review, we explore the potential of precision nutrition through a life-stage approach that emphasizes age- and gender-specific nutritional needs as these change across the lifespan. Focusing on adult life stages, we delineated trends in age-related conditions and health needs among Korean adults based on national-level survey data (KNHANES 2019-2021). We also reviewed the intake of nutrients associated with these health needs to better understand how life-stage guided approaches to nutrition and supplementation could support optimal health. Looking beyond preventing deficiency or disease, we discuss how tailored supplementation of essential vitamins, minerals, and certain bioactive substances could promote healthy functioning. Finally, we discuss the complexities and challenges of developing multivitamin/multimineral supplements (MVMS) to support life-stage appropriate nutrition while maximizing adherence. Future prospects include leveraging advancements in intelligent technologies and dietary assessments for tracking nutrient intake and health indicators and using these to optimize MVMS formulations in ways that are sensitive to a person's needs and priorities/preferences at different life stages. By adopting a life-stage guided approach to nutrition, we can better support health and well-being across the lifespan.

Menopause Hot Flashes and Molecular Mechanisms Modulated by Food-Derived Nutrients

The causes of vasomotor symptoms, including hot flashes, are not fully understood, may be related to molecular factors, and have a polygenic architecture. Nutrients and bioactive molecules supplied to the body with food are metabolized using various enzymatic pathways. They can induce molecular cell signaling pathways and, consequently, activate effector proteins that modulate processes related to hot flashes in menopausal women. In this review, we analyzed the literature data from the last 5 years, especially regarding genome-wide association study (GWAS) analysis, and selected molecular factors and cell signaling pathways that may potentially be related to hot flashes in women. These are the kisspeptin-GnRH pathway, adipocyte-derived hormones, aryl hydrocarbon receptor signaling, catechol estrogens and estrogen sulfotransferase, inflammatory and oxidative stress biomarkers, and glucose availability. Then, single compounds or groups of food ingredients were selected that, according to experimental data, influence the course of the discussed molecular pathways and thus can be considered as potential natural therapeutic agents to effectively reduce the troublesome symptoms of menopause in women.