1
|
Glynne S, Reisel D, Kamal A, Neville A, McColl L, Lewis R, Newson L. The range and variation in serum estradiol concentration in perimenopausal and postmenopausal women treated with transdermal estradiol in a real-world setting: a cross-sectional study. Menopause 2024:00042192-990000000-00399. [PMID: 39689249 DOI: 10.1097/gme.0000000000002459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2024]
Abstract
OBJECTIVES The aims of the study are to explore the range and variation in serum estradiol concentration, and to estimate the prevalence of "poor absorption" (women using licensed estradiol doses with subtherapeutic levels), in perimenopausal and postmenopausal women using transdermal estradiol in the real world. METHODS This is a cross-sectional analysis in a specialist menopause clinic in the UK. RESULTS Serum samples were obtained from 1,508 perimenopausal and postmenopausal women. A total of 61.87% were using licensed doses. The median estradiol concentration was 355.26 pmol/L (interquartile range 198.44-646.15 pmol/L). A reference interval for the whole cohort was defined as 54.62-2,050.55 pmol/L. There was substantial interindividual variation across the dose range. Variance was greater in younger women (P = 0.002) and gel users (P = 0.002). There was a trend toward greater variance in women using higher doses, but the association failed to reach statistical significance (P = 0.074). One in four women (24.84%) using the highest licensed dose had subtherapeutic levels (<200 pmol/L). Older women (≥50 y) and patch users were more likely to have low levels (odds ratio 1.77, 95% confidence interval 1.22-2.62, P = 0.003; and odds ratio 1.51, 95% confidence interval 1.18-1.95, P = 0.001, respectively). CONCLUSIONS The reference interval for perimenopausal and postmenopausal women using on-label and off-label doses of transdermal estradiol in the real world is wide, and there is considerable interindividual variation. The number of estradiol users with low estradiol levels (<200 pmol/L) is higher than previously recognized. Measurement of serum estradiol can be helpful to identify women who may benefit from an off-label dose. Dose customization is key to ensure that all women can reap the benefits of HT.
Collapse
Affiliation(s)
- Sarah Glynne
- From the Portland Hospital, London, United Kingdom
| | - Daniel Reisel
- EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - Aini Kamal
- Newson Health, Stratford-upon-Avon, United Kingdom
| | - Amy Neville
- Newson Health, Stratford-upon-Avon, United Kingdom
| | | | | | | |
Collapse
|
2
|
Le Noan-Lainé M, Artaud F, Ozguler A, Cœuret-Pellicer M, Ringa V, Elbaz A, Canonico M. Association of Hormonal Exposures With Grip Strength in Women >45 Years: Data From the CONSTANCES Cohort Study. J Endocr Soc 2024; 8:bvae150. [PMID: 39290336 PMCID: PMC11406748 DOI: 10.1210/jendso/bvae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Indexed: 09/19/2024] Open
Abstract
Context Although biological findings show that estrogens are beneficial for muscular mass maintenance and bone resorption inhibition, the association of hormonal exposure with physical performance are controversial. Objective We investigated the association of reproductive history and exogenous hormone use with hand-grip strength (GS) in women. Methods Using the data from the CONSTANCES French prospective population-based cohort study, we ran linear mixed models to investigate the association of reproductive history and exogenous hormones use with maximal GS in 37 976 women aged 45 to 69 years recruited between 2012 and 2020. We used multiple imputation by chained equations to control missing values and corrections for multiple testing. Results The mean age of women was 57.2 years. Mean GS was 26.6 kg. After adjustment for age and confounders, GS increased with age at menarche (β+1 year = 0.14; 95% CI, 0.10-0.17) and duration of breastfeeding (β for ≥10 months vs <5 months = 0.39; 95% CI, 0.20-0.59; P for linear trend <.01). Compared to nonmenopausal women, postmenopausal women had significantly lower GS (β = -0.78; 95% CI, -0.98 to -0.58). GS was negatively associated with hormone therapy (HT) past use (β = -0.25; 95% CI, -0.42 to -0.07). Conclusion Our results suggested that menopausal transition was strongly associated with lower GS. However, despite our hypothesis, increased age at menarche and duration of breastfeeding were associated with higher GS and HT past users presented lower GS than HT never users. These findings could help identify women at high risk of poor physical performance.
Collapse
Affiliation(s)
| | - Fanny Artaud
- Inserm, Université Paris-Saclay, UVSQ, Gustave Roussy, CESP, Villejuif 94807, France
| | - Anna Ozguler
- Inserm, UMS011, Population-Based Epidemiologic Cohorts, Villejuif 94807, France
| | | | - Virginie Ringa
- Inserm, Université Paris-Saclay, UVSQ, Gustave Roussy, CESP, Villejuif 94807, France
| | - Alexis Elbaz
- Inserm, Université Paris-Saclay, UVSQ, Gustave Roussy, CESP, Villejuif 94807, France
| | - Marianne Canonico
- Inserm, Université Paris-Saclay, UVSQ, Gustave Roussy, CESP, Villejuif 94807, France
| |
Collapse
|
3
|
Memi E, Pavli P, Papagianni M, Vrachnis N, Mastorakos G. Diagnostic and therapeutic use of oral micronized progesterone in endocrinology. Rev Endocr Metab Disord 2024; 25:751-772. [PMID: 38652231 PMCID: PMC11294403 DOI: 10.1007/s11154-024-09882-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
Progesterone is a natural steroid hormone, while progestins are synthetic molecules. In the female reproductive system, progesterone contributes to the control of luteinizing hormone and follicle-stimulating hormone secretion and their pulsatility, via its receptors on the kisspeptin, neurokinin B, and dynorphin neurons in the hypothalamus. Progesterone together with estradiol controls the cyclic changes of proliferation and decidualization of the endometrium; exerts anti-mitogenic actions on endometrial epithelial cells; regulates normal menstrual bleeding; contributes to fertilization and pregnancy maintenance; participates in the onset of labor. In addition, it exerts numerous effects on other endocrine systems. Micronized progesterone (MP) is natural progesterone with increased bioavailability, due to its pharmacotechnical micronized structure, which makes it an attractive diagnostic and therapeutic tool. This critical literature review aims to summarize and put forward the potential diagnostic and therapeutic uses of MP in the field of endocrinology. During reproductive life, MP is used for diagnostic purposes in the evaluation of primary or secondary amenorrhea as a challenge test. Moreover, it can be prescribed to women presenting with amenorrhea or oligomenorrhea for induction of withdrawal bleeding, in order to time blood-sampling for diagnostic purposes in early follicular phase. Therapeutically, MP, alone or combined with estrogens, is a useful tool in various endocrine disorders including primary amenorrhea, abnormal uterine bleeding due to disordered ovulation, luteal phase deficiency, premenstrual syndrome, polycystic ovary syndrome, secondary amenorrhea [functional hypothalamic amenorrhea, premature ovarian insufficiency], perimenopause and menopause. When administrated per os, acting as a neurosteroid directly or through its metabolites, it exerts beneficial effects on brain function such as alleviation of symptoms of anxiety and depression, asw well as of sleep problems, while it improves working memory in peri- and menopausal women. Micronized progesterone preserves full potential of progesterone activity, without presenting many of the side-effects of progestins. Although it has been associated with more frequent drowsiness and dizziness, it can be well tolerated with nocturnal administration. Because of its better safety profile, especially with regard to metabolic ailments, breast cancer risk and veno-thromboembolism risk, MP is the preferred option for individuals with an increased risk of cardiovascular and metabolic diseases and of all-cause mortality.
Collapse
Affiliation(s)
- Eleni Memi
- Unit of Endocrinology, Diabetes mellitus, and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Vas. Sophias Av. 76, 11528, Athens, Greece
| | - Polina Pavli
- Unit of Endocrinology, Diabetes mellitus, and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Vas. Sophias Av. 76, 11528, Athens, Greece
| | - Maria Papagianni
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42100, Trikala, Greece
- Endocrine Unit, 3rd Department of Pediatrics, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642, Thessaloniki, Greece
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, Attikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Rimini Str. 1, 12462, Chaidari, Athens, Greece
- St George's NHS Foundation Trust Teaching Hospitals, St George's University of London, London, UK
| | - George Mastorakos
- Unit of Endocrinology, Diabetes mellitus, and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Vas. Sophias Av. 76, 11528, Athens, Greece.
| |
Collapse
|
4
|
Balan A, Moga MA, Neculau AE, Mitrica M, Rogozea L, Ifteni P, Dima L. Royal Jelly and Fermented Soy Extracts-A Holistic Approach to Menopausal Symptoms That Increase the Quality of Life in Pre- and Post-menopausal Women: An Observational Study. Nutrients 2024; 16:649. [PMID: 38474777 DOI: 10.3390/nu16050649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The objective of this study was to determine the effects of royal jelly and fermented soy extracts on menopausal symptoms and on quality of life in pre- and post-menopausal women. MATERIALS AND METHOD This prospective observational study was carried out in a Clinical Hospital of Brasov, Romania, during June 2020 and December 2021. Eighty pre- and post-menopausal women, aged between 45 and 60 years, were included in two groups. The first group (40 women) received a dietary supplement with fermented soy extract twice a day for eight weeks and the second group (40 women) received the same dietary supplement with fermented soy extracts and 1500 mg of royal jelly capsules for eight weeks. After the treatment, the MENQOL score, DASS-21 score, and the mean number and intensity of daily hot flushes were recorded and compared with baseline values. RESULTS After eight weeks of treatment, the score of the MENQOL questionnaire and all its domains' scores decreased in comparison with the baseline in both groups (p < 0.001). Also, the DASS-21 score (p < 0.001), depression score (p < 0.001), anxiety score (p < 0.001), and stress score (p < 0.001) improved. The mean number and the intensity of hot flushes decreased in both groups (p < 0.001). Comparing these variables after the treatment in both groups, we observed that the women who received dietary supplements with fermented soy extracts and royal jelly capsules recorded better scores for MENQOL (vasomotor, physical, and psychosocial domains) and a more reduced mean number of daily hot flushes. CONCLUSIONS This observational study suggests that both dietary fermented soy supplements and royal jelly capsules possess beneficial effects against menopausal symptoms, increase the quality of life in pre- and post-menopausal women, and that the effects might be significantly improved if those dietary supplements are administered in association.
Collapse
Affiliation(s)
- Andreea Balan
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500019 Brașov, Romania
| | - Marius Alexandru Moga
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transylvania University of Brasov, 500019 Brașov, Romania
| | - Andrea Elena Neculau
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500019 Brașov, Romania
| | - Maria Mitrica
- Department of Medical and Surgical Specialties, Faculty of Medicine, Transylvania University of Brasov, 500019 Brașov, Romania
| | - Liliana Rogozea
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500019 Brașov, Romania
| | - Petru Ifteni
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500019 Brașov, Romania
| | - Lorena Dima
- Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, Transilvania University of Brasov, 500019 Brașov, Romania
| |
Collapse
|
5
|
Pang C, Li JM, Wang Z, Luo YC, Cheng ZG, Han ZY, Liu FY, Yu XL, Liang F, Xi HQ, Zheng RQ, Cheng W, Wei Q, Yu SY, Li QY, He GZ, Yu J, Liang P. Age-Dependent Female Survival Advantage in Hepatocellular Carcinoma: A Multicenter Cohort Study. Clin Gastroenterol Hepatol 2024; 22:305-314. [PMID: 37659766 DOI: 10.1016/j.cgh.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) has a higher incidence in males, but the association of sex with survival remains controversial. This study aimed to examine the effect of sex on HCC survival and its association with age. METHODS Among 33,238 patients with HCC from 12 Chinese tertiary hospitals, 4175 patients who underwent curative-intent hepatectomy or ablation were analyzed. Cancer-specific survival (CSS) was analyzed using Cox regression and Kaplan-Meier methods. Two propensity score methods and multiple mediation analysis were applied to mitigate confounding. To explore the effect of estrogen, a candidate sex-specific factor that changes with age, female participants' history of estrogen use, and survival were analyzed. RESULTS There were 3321 males and 854 females included. A sex-related disparity of CSS was present and showed a typical age-dependent pattern: a female survival advantage over males appeared at the perimenopausal age of 45 to 54 years (hazard risk [HR], 0.77; 5-year CSS, 85.7% vs 70.6%; P = .018), peaked at the early postmenopausal age of 55 to 59 years (HR, 0.57; 5-year CSS, 89.8% vs 73.5%; P = .015), and was not present in the premenopausal (<45 y) and late postmenopausal groups (≥60 y). Consistent patterns were observed in patients after either ablation or hepatectomy. These results were sustained with propensity score analyses. Confounding or mediation effects accounted for only 19.5% of sex survival disparity. Female estrogen users had significantly longer CSS than nonusers (HR, 0.74; 5-year CSS, 79.6% vs 72.5%; P = .038). CONCLUSIONS A female survival advantage in HCC depends on age, and this may be associated with age-dependent, sex-specific factors.
Collapse
Affiliation(s)
- Chuan Pang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China; Department of General Surgery, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jian-Ming Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhen Wang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Feng Liang
- Department of General Surgery, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hong-Qing Xi
- Department of General Surgery, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Rong-Qin Zheng
- Department of Medical Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wen Cheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin City, China
| | - Qiang Wei
- Department of Ultrasound, The Second Hospital of Nanjing, Nanjing, China
| | - Song-Yuan Yu
- Department of Wuhan University of Science and Technology, Tianyou Hospital, Wuhan, China
| | - Qin-Ying Li
- Department of Ultrasound, Puyang Hospital of Traditional Chinese Medicine of Henan Province, Puyang, China
| | - Guang-Zhi He
- Department of Ultrasound, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.
| |
Collapse
|
6
|
Cui L, Chen Z, Zeng F, Jiang X, Han X, Yuan X, Wu S, Feng H, Lin D, Lu W, Liu X, Peng X, Yu B. Impact of sex on treatment-related adverse effects and prognosis in nasopharyngeal carcinoma. BMC Cancer 2023; 23:1146. [PMID: 38007428 PMCID: PMC10676584 DOI: 10.1186/s12885-023-11564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/24/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND In nasopharyngeal cancer (NPC), women have a lower incidence and mortality rate than men. Whether sex influences the prognosis of NPC patients remains debatable. We retrospectively examined the influence of sex on treatment-related side effects and prognosis in NPC. METHODS Clinical data of 1,462 patients with NPC treated at the Southern Hospital of Southern Medical University from January 2004 to December 2015 were retrospectively examined. Statistical analysis was performed to assess differences in overall survival (OS), distant metastasis-free survival (DMFS), local recurrence-free survival(LRFS), and progression-free survival(PFS), as well as treatment-related adverse effects, including myelosuppression, gastrointestinal responses, and radiation pharyngitis and dermatitis, between men and women. RESULTS Women had better 5-year OS (81.5% vs. 87.1%, P = 0.032) and DMFS (76.2% vs. 83.9%, P = 0.004) than men. Analysis by age showed that the prognoses of premenopausal and menopausal women were better than those of men, whereas prognoses of postmenopausal women and men were not significantly different. Additionally, women had a better prognosis when stratified by treatment regimen. Furthermore, chemotherapy-related adverse effects were more severe in women than in men; however, the incidences of radiation laryngitis and dermatitis were not significantly different between the sexes. Logistic regression analysis revealed that the female sex was an independent risk factor for severe myelosuppression and gastrointestinal reactions. CONCLUSIONS Chemotherapy-related side effects are more severe but the overall prognosis is better in women with NPC than in men with NPC. Patients may benefit from a personalized treatment approach for NPC. TRIAL REGISTRATION This study was approved by the Medical Ethics Committee of Nanfang Hospital of the Southern Medical University (NFEC-201,710-K3).
Collapse
Affiliation(s)
- Linchong Cui
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Zilu Chen
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Fangfang Zeng
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Xiaolan Jiang
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Xiaoyan Han
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Xiaofei Yuan
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Shuting Wu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Huiru Feng
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Danfan Lin
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Wenxuan Lu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China
| | - Xiong Liu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China.
| | - Xiaohong Peng
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China.
| | - Bolong Yu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, PR China.
| |
Collapse
|
7
|
Franco F, Borau Zamora C, Campana DM, Berli ME. Computational Analysis of the Influence of Menopause and Ageing on Bone Mineral Density, Exploring the Impact of Bone Turnover and Focal Bone Balance-A Study on Overload and Underload Scenarios. Life (Basel) 2023; 13:2155. [PMID: 38004295 PMCID: PMC10672644 DOI: 10.3390/life13112155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
This study aims to investigate the impact of hormonal imbalances during menopause, compounded by the natural ageing process, on bone health. Specifically, it examines the effects of increased bone turnover and focal bone balance on bone mass. A three-dimensional computational bone remodeling model was employed to simulate the response of the femur to habitual loads over a 19-year period, spanning premenopause, menopause, and postmenopause. The model was calibrated using experimental bone mineral density data from the literature to ensure accurate simulations. The study reveals that individual alterations in bone turnover or focal bone balance do not fully account for the observed experimental outcomes. Instead, simultaneous changes in both factors provide a more comprehensive explanation, leading to increased porosity while maintaining the material-to-apparent density ratio. Additionally, different load scenarios were tested, demonstrating that reaching the clinical osteoporosis threshold is independent of the timing of load changes. However, underload scenarios resulted in the threshold being reached approximately 6 years earlier than overload scenarios. These findings hold significant implications for strategies aimed at delaying the onset of osteoporosis and minimizing fracture risks through targeted mechanical stimulation during the early stages of menopause.
Collapse
Affiliation(s)
- Feliciano Franco
- Instituto de Bioingeniería y Bioinformática, Universidad Nacional de Entre Ríos, Consejo Nacional de Investigaciones Científicas y Técnicas, Ruta 11, Km 10, Oro Verde 3100, Argentina;
- Facultad de Ingeniería, Universidad Nacional de Entre Ríos, Ruta 11, Km 10, Oro Verde 3100, Argentina;
| | - Carlos Borau Zamora
- Multiscale in Mechanical and Biological Engineering, Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain;
- Centro Universitario de la Defensa de Zaragoza, 50090 Zaragoza, Spain
| | - Diego Martín Campana
- Instituto de Bioingeniería y Bioinformática, Universidad Nacional de Entre Ríos, Consejo Nacional de Investigaciones Científicas y Técnicas, Ruta 11, Km 10, Oro Verde 3100, Argentina;
- Facultad de Ingeniería, Universidad Nacional de Entre Ríos, Ruta 11, Km 10, Oro Verde 3100, Argentina;
| | - Marcelo Eduardo Berli
- Facultad de Ingeniería, Universidad Nacional de Entre Ríos, Ruta 11, Km 10, Oro Verde 3100, Argentina;
| |
Collapse
|
8
|
Xiong J, Kang SS, Wang M, Wang Z, Xia Y, Liao J, Liu X, Yu SP, Zhang Z, Ryu V, Yuen T, Zaidi M, Ye K. FSH and ApoE4 contribute to Alzheimer's disease-like pathogenesis via C/EBPβ/δ-secretase in female mice. Nat Commun 2023; 14:6577. [PMID: 37852961 PMCID: PMC10584868 DOI: 10.1038/s41467-023-42282-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 10/05/2023] [Indexed: 10/20/2023] Open
Abstract
Alzheimer's disease (AD) is the most common dementia. It is known that women with one ApoE4 allele display greater risk and earlier onset of AD compared with men. In mice, we previously showed that follicle-stimulating hormone (FSH), a gonadotropin that rises in post-menopausal females, activates its receptor FSHR in the hippocampus, to drive AD-like pathology and cognitive impairment. Here we show in mice that ApoE4 and FSH jointly trigger AD-like pathogenesis by activating C/EBPβ/δ-secretase signaling. ApoE4 and FSH additively activate C/EBPβ/δ-secretase pathway that mediates APP and Tau proteolytic fragmentation, stimulating Aβ and neurofibrillary tangles. Ovariectomy-provoked AD-like pathologies and cognitive defects in female ApoE4-TR mice are ameliorated by anti-FSH antibody treatment. FSH administration facilitates AD-like pathologies in both young male and female ApoE4-TR mice. Furthermore, FSH stimulates AD-like pathologies and cognitive defects in ApoE4-TR mice, but not ApoE3-TR mice. Our findings suggest that in mice, augmented FSH in females with ApoE4 but not ApoE3 genotype increases vulnerability to AD-like process by activating C/EBPβ/δ-secretase signalling.
Collapse
Affiliation(s)
- Jing Xiong
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Seong Su Kang
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Mengmeng Wang
- Faculty of Life and Health Sciences, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China
| | - Zhihao Wang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Yiyuan Xia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Jianming Liao
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Xia Liu
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Shan-Ping Yu
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Zhaohui Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China
| | - Vitaly Ryu
- Mount Sinai Bone Program, Department of Medicine and Department of Orthopedics, Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Tony Yuen
- Mount Sinai Bone Program, Department of Medicine and Department of Orthopedics, Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Mone Zaidi
- Mount Sinai Bone Program, Department of Medicine and Department of Orthopedics, Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Keqiang Ye
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA.
- Faculty of Life and Health Sciences, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, 518055, China.
| |
Collapse
|
9
|
Kim NY, Yoo SK, Jin JC, Han S, Hong JS, Kim SM. Development and verification of the Menopause Emotional Symptom Questionnaire. Menopause 2023; 30:961-968. [PMID: 37490658 DOI: 10.1097/gme.0000000000002224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVE A detailed, well-validated scale for measuring emotional symptoms in menopausal women is lacking. We aimed to develop the Menopause Emotional Symptom Questionnaire (MESQ) and to confirm its reliability and validity among Koreans. METHODS Eighteen primary items based on previous research results were selected using exploratory factor analysis and confirmatory factor analysis (CFA). New data, including answers to the novel MESQ, Menopause Rating Scale, Kupperman Index, Beck Depression Inventory-II, and Beck Anxiety Inventory, were collected from 200 perimenopausal women and 100 young men through a research company. Exploratory factor analysis and CFA were performed again to determine whether the MESQ accurately measures emotional symptoms in perimenopausal women. Receiver operating characteristic curve and k-means cluster analyses were used to identify the most appropriate cutoff value. RESULTS The MESQ showed high internal consistency (Cronbach α = 0.926), and the CFA revealed that the factor structure comprised two subscales: nine items for mood/anxiety symptoms and four items for sleep symptoms. A high correlation between the total MESQ score and total scores of the existing scales was confirmed, indicating high convergence validity. Comparison of the mean MESQ scores between men and women showed significant sex difference, indicating secure known-group validity. The cutoff point of the total MESQ score between the high-risk and low-risk groups was 26. CONCLUSIONS The novel MESQ has high validity and reliability, and this study confirmed that the MESQ is a valid tool for screening for and measuring emotional symptoms in menopausal women in Korea.
Collapse
Affiliation(s)
- Na Yeon Kim
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Seo-Koo Yoo
- School of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | - Jae-Chan Jin
- School of Social Welfare, Soongsil University, Seoul, Republic of Korea
| | - Seunga Han
- Department of Political Science, Vanderbilt University, Nashville, TN
| | - Ji Sun Hong
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| | - Sun Mi Kim
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
| |
Collapse
|
10
|
Prior JC, Cameron A, Fung M, Hitchcock CL, Janssen P, Lee T, Singer J. Oral micronized progesterone for perimenopausal night sweats and hot flushes a Phase III Canada-wide randomized placebo-controlled 4 month trial. Sci Rep 2023; 13:9082. [PMID: 37277418 PMCID: PMC10241804 DOI: 10.1038/s41598-023-35826-w] [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: 09/12/2022] [Accepted: 05/24/2023] [Indexed: 06/07/2023] Open
Abstract
This study tested progesterone for perimenopausal hot flush ± night sweat (vasomotor symptom, VMS) treatment. It was a double-blind, randomized trial of 300 mg oral micronized progesterone@bedtime versus placebo for 3-months (m) after a 1-m untreated baseline during 2012/1-2017/4. We randomized untreated, non-depressed, screen- and baseline-eligible by VMS, perimenopausal women (with flow within 1-year), ages 35-58 (n = 189). Participants aged 50 (± SD = 4.6) were mostly White, educated, minimally overweight with 63% in late perimenopause; 93% participated remotely. The 1° outcome was 3rd-m VMS Score difference. Participants recorded VMS number and intensity (0-4 scale)/24 h on a VMS Calendar. Randomization required VMS (intensity 2-4/4) of sufficient frequency and/or ≥ 2/week night sweat awakenings. Baseline total VMS Score (SD) was 12.2 (11.3) without assignment difference. Third-m VMS Score did not differ by therapy (Rate Difference - 1.51). However, the 95% CI [- 3.97, 0.95] P = 0.222, did not exclude 3, a minimal clinically important difference. Women perceived progesterone caused decreased night sweats (P = 0.023) and improved sleep quality (P = 0.005); it decreased perimenopause-related life interference (P = 0.017) without increased depression. No serious adverse events occurred. Perimenopausal night sweats ± hot flushes are variable; this RCT was underpowered but could not exclude a minimal clinically important VMS benefit. Perceived night sweats and sleep quality significantly improved.
Collapse
Affiliation(s)
- Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology, University of British Columbia (UBC), 2775 Laurel Street, Suite 4111, Vancouver, BC, Canada.
- School of Population and Public Health, UBC, Vancouver, Canada.
- British Columbia Women's Health Research Institute, Vancouver, Canada.
- Endocrinology and Metabolism, Department of Medicine, UBC, Vancouver, BC, Canada.
| | - Andrea Cameron
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology, University of British Columbia (UBC), 2775 Laurel Street, Suite 4111, Vancouver, BC, Canada
| | - Michelle Fung
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology, University of British Columbia (UBC), 2775 Laurel Street, Suite 4111, Vancouver, BC, Canada
- Etobicoke General Hospital, William Osler Health System, Etobicoke, ON, Canada
| | - Christine L Hitchcock
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology, University of British Columbia (UBC), 2775 Laurel Street, Suite 4111, Vancouver, BC, Canada
- Hitchcock Consulting, Oakville, ON, Canada
| | - Patricia Janssen
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology, University of British Columbia (UBC), 2775 Laurel Street, Suite 4111, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, Canada
- British Columbia Women's Health Research Institute, Vancouver, Canada
| | - Terry Lee
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| | - Joel Singer
- School of Population and Public Health, UBC, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
| |
Collapse
|
11
|
Carson MY, Thurston RC. Vasomotor symptoms and their links to cardiovascular disease risk. CURRENT OPINION IN ENDOCRINE AND METABOLIC RESEARCH 2023; 30:100448. [PMID: 37214424 PMCID: PMC10198127 DOI: 10.1016/j.coemr.2023.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Hot flashes and night sweats, also known as vasomotor symptoms (VMS), are common and bothersome symptoms of the menopause transition. In addition to negatively impacting quality of life, VMS have been associated with multiple indicators of cardiovascular disease (CVD) risk, including an unfavorable CVD risk factor profile, increased subclinical CVD, and elevated risk of CVD events. Several facets of VMS have been associated with CVD risk, including the frequency, timing, duration, and severity of VMS. VMS may signify poor or degrading cardiovascular health among midlife women and indicate women who warrant focused CVD prevention efforts.
Collapse
Affiliation(s)
- Mary Y. Carson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rebecca C. Thurston
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| |
Collapse
|
12
|
Arafah M, Aldawood N, Alrezaki A, Nahdi S, Alwasel S, Mansour L, Harrath AH. Prenatal exposure to acrylamide differently affected the sex ratio, aromatase and apoptosis in female adult offspring of two subsequent generations. Physiol Res 2023; 72:59-69. [PMID: 36545876 PMCID: PMC10069810 DOI: 10.33549/physiolres.934975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
In the present study, we investigated the effect of acrylamide (ACR) exposure during pregnancy on the ovary of female adult offspring of two subsequent generations. Sixty-day-old Wistar albino female rats were given different doses of ACR (2.5 and 10 mg/kg/day) from day 6 of pregnancy until giving birth. Females from the first generation (AF1) were fed ad libitum, and thereafter, a subgroup was euthanized at 8 weeks of age and ovary samples were obtained. The remaining females were maintained until they reached sexual maturity (50 days old) and then treated in the same way as the previous generation to obtain the second generation of females (AF2). The histopathological examination indicated a high frequency of corpora lutea along with an increased number of antral follicles that reached the selectable stage mainly at a dose of 2.5 mg/kg/day. Interestingly, ACR exposure significantly increased the mRNA levels of CYP19 gene and its corresponding CYP19 protein expression in AF1 females. The TUNEL assay showed a significantly high rate of apoptosis in stromal cells except for dose of 2.5 mg/kg/day. However, in AF2 females, ACR exposure significantly increased the number of degenerating follicles and cysts while the number of growing follicles was reduced. Moreover, in both ACR-treated groups, estradiol-producing enzyme CYP19A gene and its corresponding protein were significantly reduced, and an excessive apoptosis was produced. We concluded that the ovarian condition of AF1 females had considerable similarity to the typical early perimenopausal stage, whereas that of AF2 females was similar to the late perimenopausal stage in women.
Collapse
Affiliation(s)
- M Arafah
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia; Department of Zoology, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | | | | | | | | | | | | |
Collapse
|
13
|
Zhao FY, Zheng Z, Fu QQ, Conduit R, Xu H, Wang HR, Huang YL, Jiang T, Zhang WJ, Kennedy GA. Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial. Front Public Health 2023; 11:1120567. [PMID: 36815166 PMCID: PMC9939459 DOI: 10.3389/fpubh.2023.1120567] [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: 12/13/2022] [Accepted: 01/11/2023] [Indexed: 02/09/2023] Open
Abstract
Background and objective Whilst acupuncture is widely used for treating psychosomatic diseases, there is little high-quality evidence supporting its application in comorbid perimenopausal depression (PMD) and insomnia (PMI) which are common complaints during climacteric. This feasibility, patient-assessor-blinded, randomized, sham-controlled clinical trial addresses this gap by investigating the efficacy and safety of acupuncture on depressed mood and poor sleep in women with comorbid PMD and PMI. Methods Seventy eligible participants were randomly assigned to either real-acupuncture (RA) or sham-acupuncture (SA) groups. Either RA or SA treatment were delivered in 17 sessions over 8 weeks. The primary outcomes for mood and sleep were changes on 17-items Hamilton Depression Rating Scale (HAM-D17) and Pittsburgh Sleep Quality Index (PSQI) scores, from baseline to 16-week follow-up. Secondary outcome measures involved anxiety symptoms, perimenopausal symptoms, quality of life, participants' experience of and satisfaction with the acupuncture treatment. Blood samples were taken to measure reproductive hormone levels. Intention-To-Treat and Per-Protocol analyses were conducted with linear mixed-effects models. The James' and Bang's blinding indices were used to assess the adequacy of blinding. Results Sixty-five participants completed all treatment sessions, and 54 and 41 participants completed the eight- and 16-week follow-ups, respectively. At post-treatment and 8-week follow-up, the RA group showed a significantly greater reduction in PSQI scores than the SA group did; although the reduction of HAM-D17 scores in RA group was significant, the change was not statistically different from that of SA. There were no significant mean differences between baseline and 16-week follow-up in either HAM-D17 or PSQI in either group. There were no significant between-group differences in serum reproductive hormone levels. All treatments were tolerable and no serious adverse events were reported, and the blinding was successful. Conclusion Acupuncture is safe and can contribute to clinically relevant improvements in comorbid PMD and PMI, with satisfactory short-and medium-term effects. Whether the anti-depressive benefit of acupuncture is specific or non-specific remains to be determined. No evidence was found for any longer-term benefit of acupuncture compared to sham at 16 weeks. Further research is required to elucidate mechanisms underlying the short to medium term effects of acupuncture.
Collapse
Affiliation(s)
- Fei-Yi Zhao
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia,Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, China
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia,*Correspondence: Zhen Zheng ✉
| | - Qiang-Qiang Fu
- Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia,Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
| | - Hong Xu
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui-Ru Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yu-Ling Huang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ting Jiang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wen-Jing Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Wen-Jing Zhang ✉
| | - Gerard A. Kennedy
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia,Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia,Institute of Health and Wellbeing, Federation University, Mount Helen, VIC, Australia
| |
Collapse
|
14
|
Nakamura A, Aida Y, Okamoto M, Maeda A, Nagao A, Kitatani K, Takekoshi S, Fujisawa A, Yamamoto Y, Kashiba M. Transferrin, insulin, and progesterone modulate intracellular concentrations of coenzyme Q and cholesterol, products of the mevalonate pathway, in undifferentiated PC12 cells. J Clin Biochem Nutr 2023; 72:199-206. [DOI: 10.3164/jcbn.22-115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/04/2023] [Indexed: 03/19/2023] Open
Affiliation(s)
| | - Yukina Aida
- School of Bionics, Tokyo University of Technology
| | | | - Ayaka Maeda
- School of Bionics, Tokyo University of Technology
| | - Ayaka Nagao
- School of Bionics, Tokyo University of Technology
| | | | | | | | | | | |
Collapse
|
15
|
Peycheva D, Sullivan A, Hardy R, Bryson A, Conti G, Ploubidis G. Risk factors for natural menopause before the age of 45: evidence from two British population-based birth cohort studies. BMC Womens Health 2022; 22:438. [DOI: 10.1186/s12905-022-02021-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 10/22/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Menopause that occurs before the age of 45 and is not medically induced (referred to here as ‘early natural menopause’) affects around one in 10 women and has serious health consequences. These consequences include increased risk of all-cause mortality, cardiovascular disease, osteoporosis, and type 2 diabetes.
Methods
We investigate risk factors for the onset of natural menopause before the age of 45 in two population-based prospective cohort studies in Britain: the 1958 cohort following 8959 women and the 1970 cohort following 8655 women. These studies follow women from birth to adulthood, and we use harmonized data on birth and early life characteristics, reproductive health, health behaviour, and socioeconomic characteristics for 6805 women who were pre-menopausal, peri-menopausal or had undergone natural menopause. Of these 6805 women, 3614 participated in the 1958 cohort (of which 368 had early menopause) and 3191 participated in the 1970 cohort (of which 206 had early menopause). Taking a life course approach, we focus on three distinct life stages - birth/early life, childhood, and early adulthood - to understand when risk factors are most harmful. Respecting the temporal sequence of exposures, we use a series of multivariable logistic regression models to estimate associations between early menopause and each potential risk factor adjusted for confounders.
Results
We find that early menopause is influenced by circumstances at birth. Women born in lower social class families, whose mother smoked during the pregnancy or who were breastfed 1 month or less were more likely to undergo early menopause. Early menopause is also associated with poorer cognitive ability and smoking in childhood. Adult health behaviour also matters. Smoking is positively correlated with early menopause, while regular exercise and moderate frequency of alcohol drinking in women’s early thirties are associated with reduced risk of early menopause. The occurrence of gynaecological problems by women’s early thirties is also linked to early menopause.
Conclusions
We demonstrate that characteristics at different periods of life are associated with early menopause. Some of these associations relate to modifiable behaviours and thus the risks of early menopause and the adverse health outcomes associated with it may be preventable.
Collapse
|
16
|
Yin MT, Hoover DR, Shi Q, Tien PC, Cohen MH, Kassaye S, Gustafson D, Adimora A, Weitzmann MN, Bolivar H, Warriner A, Bares SH, Sharma A. Hormone therapy and fractures in postmenopausal women. AIDS 2022; 36:1683-1688. [PMID: 35730385 PMCID: PMC9444941 DOI: 10.1097/qad.0000000000003292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Fracture rates have been reported to be higher among older women living with HIV (WLWH) than HIV- women. Hormone therapy with estrogen can reduce vasomotor symptoms (VMS) associated with menopause and prevent fractures. As data are limited on the benefits of hormone therapy use in WLWH, we examined associations of hormone therapy, use and fractures. METHODS A prospective study of 1765 (1350 WLWH and 415 HIV-) postmenopausal Women's Interagency HIV Study (WIHS) participants was performed, including self-reported hormone therapy, use and fracture data from 2003 to 2017. Proportional hazard models determined predictors of new fractures at any site or at typical fragility fracture sites (hip, spine, wrist). RESULTS At the first postmenopausal visit, the median (IQR) age of WLWH was slightly younger than HIV- women [49.8 (46.4-53) vs. 50.7 (47.5-54), P = 0.0002] and a smaller proportion of WLWH reported presence of VMS (17% vs. 26%, P < 0.0001). A greater proportion of WLWH than HIV- women reported hormone therapy use (8% vs. 4%, P = 0.007) at the first postmenopausal visit. In multivariate analyses, white race and smoking were significant predictors of incident fracture at any site but hormone therapy ( P = 0.69) and HIV status ( P = 0.53) were not. CONCLUSION Our study did not find evidence of benefit or harm with regards to fracture outcomes in postmenopausal WLWH receiving hormone therapy. Further research is needed to determine whether hormone therapy has benefits beyond treatment of VMS, such as prevention of adverse aging-associated outcomes.
Collapse
Affiliation(s)
- Michael T Yin
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - Donald R Hoover
- Department of Statistics and Institute for Health, Healthcare Policy and Aging Research, Rutgers University, Piscataway, NJ
| | - Qiuhu Shi
- School of Health Sciences and Practice, New York Medical College, Valhalla, NY
| | - Phyllis C Tien
- Department of Veterans Affairs Medical Center
- Department of Medicine, University of California San Francisco, San Francisco, CA
| | | | | | | | - Adaora Adimora
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill
| | - M Neale Weitzmann
- Department of Medicine, Emory University School of Medicine, Atlanta
- the Atlanta VA Medical Center, Decatur, GA
| | | | - Amy Warriner
- Department of Medicine, University of Alabama, Birmingham AL
| | - Sara H Bares
- Department of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| |
Collapse
|
17
|
Browne CJ, Fahey P, Sheeba SR, Sharpe MH, Rosner M, Feinberg D, Mucci V. Visual disorders and mal de debarquement syndrome: a potential comorbidity questionnaire-based study. Future Sci OA 2022; 8:FSO813. [PMID: 36248065 PMCID: PMC9540399 DOI: 10.2144/fsoa-2022-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
Aim: Mal de debarquement syndrome (MdDS) is a neurological condition characterized by a constant sensation of self-motion; onset may be motion-triggered (MT) or non-motion-triggered/spontaneous (NMT/SO). People with MdDS experience similar symptoms to those with vertical heterophoria, a subset of binocular visual dysfunction. Hence, we aimed to explore potential visual symptom overlaps. Methods: MdDS patients (n = 196) and controls (n = 197) completed a visual health questionnaire. Results: Compared with controls, the MdDS group demonstrated higher visual disorder scores and visual complaints. NMT/SO participants reported unique visual symptoms and a higher prevalence of mild traumatic brain injury. Conclusion: Our findings suggest visual disorders may coexist with MdDS, particularly the NMT/SO subtype. The difference in visual dysfunction frequency and medical histories between subtypes, warrants further investigation into differing pathophysiological mechanisms.
Collapse
Affiliation(s)
- Cherylea J Browne
- School of Science, Western Sydney University, Sydney, NSW 2560, Australia
- Translational Neuroscience Facility (TNF), School of Medical Sciences, UNSW Sydney, NSW, 2033, Australia
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, NSW, 2560, Australia
| | - Paul Fahey
- School of Health Sciences, Western Sydney University, Sydney, NSW, 2560, Australia
| | - Stella R Sheeba
- School of Science, Western Sydney University, Sydney, NSW 2560, Australia
- Brain Stimulation and Rehabilitation (BrainStAR) Lab, School of Health Sciences, Western Sydney University, Sydney, NSW, 2560, Australia
| | - Margie H Sharpe
- Dizziness & Balance Disorders Center, Adelaide, SA, 5000, Australia
| | - Mark Rosner
- NeuroVisual Medicine Institute, Bloomfield Hills, MI 48302, USA
| | - Debby Feinberg
- NeuroVisual Medicine Institute, Bloomfield Hills, MI 48302, USA
| | - Viviana Mucci
- School of Science, Western Sydney University, Sydney, NSW 2560, Australia
| |
Collapse
|
18
|
Mattick LJ, Bea JW, Singh L, Hovey KM, Banack HR, Wactawski-Wende J, Manson JE, Funk JL, Ochs-Balcom HM. Serum Follicle-Stimulating Hormone and 5-Year Change in Adiposity in Healthy Postmenopausal Women. J Clin Endocrinol Metab 2022; 107:e3455-e3462. [PMID: 35435955 PMCID: PMC9282244 DOI: 10.1210/clinem/dgac238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Evidence from animal studies suggests that the gradual rise in follicle-stimulating hormone (FSH) during reproductive senescence may contribute to the change in adiposity distribution characteristic of menopause. The potential independent role the interrelationships of FSH and estradiol (E2) may play in postmenopausal adiposity changes are not well studied. OBJECTIVE Our objective was to evaluate the associations of FSH and dual x-ray absorptiometry (DXA)-derived adiposity measures, with consideration of estradiol and postmenopausal hormone therapy use. METHODS In a sample of 667 postmenopausal women from the Women's Health Initiative Buffalo OsteoPerio Ancillary Study, we studied the associations of serum FSH and E2 levels with dual x-ray absorptiometry (DXA)-derived adiposity measures via cross-sectional and longitudinal analyses (5-year follow-up). RESULTS In cross-sectional analyses, FSH levels were inversely associated with all measures of adiposity in models adjusted for age, years since menopause, smoking status, pack-years, and hormone therapy (HT) use; these associations were not influenced by adjustment for serum E2. In longitudinal analyses, the subset of women who discontinued HT over follow-up (n = 242) experienced the largest increase in FSH (+33.9 mIU/mL) and decrease in E2 (-44.3 pg/mL) and gains in all adiposity measures in unadjusted analyses. In adjusted analyses, an increase in FSH was associated with a gain in percentage of total body fat, total body fat mass, and subcutaneous adipose tissue (SAT). CONCLUSION While cross-sectional findings suggest that FSH is inversely associated with adiposity, our longitudinal findings suggest that greater increases in FSH were associated with greater increases in percentage of total body fat, total body fat mass, and SAT. Future studies are needed to provide additional insight into FSH-adiposity mechanisms in larger samples.
Collapse
Affiliation(s)
- Lindsey J Mattick
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York 14214, USA
| | - Jennifer W Bea
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Department of Medicine, University of Arizona, Tucson, Arizona 85724, USA
| | - Lawanya Singh
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, New York 14203, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York 14214, USA
| | - Hailey R Banack
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York 14214, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York 14214, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts 02115, USA
| | - Janet L Funk
- Department of Medicine, University of Arizona, Tucson, Arizona 85724, USA
| | - Heather M Ochs-Balcom
- Correspondence: Heather Ochs-Balcom, PhD, Department of Epidemiology and Environmental Health, University at Buffalo, 270 Farber Hall, Buffalo, NY 14214-8001, USA.
| |
Collapse
|
19
|
Xiang ZF, Xiong HC, Hu DF, Li MY, Zhang ZC, Mao ZC, Shen ED. Age-Related Sex Disparities in Esophageal Cancer Survival: A Population-Based Study in the United States. Front Public Health 2022; 10:836914. [PMID: 35903385 PMCID: PMC9314568 DOI: 10.3389/fpubh.2022.836914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Background The association between sex and the survival of patients with esophageal cancer (EC) remains controversial. We sought to systematically investigate sex-based disparities in EC survival using the Surveillance, Epidemiology, and End Results (SEER) registry data from the United States. Methods Patients with EC diagnosed from 2004 to 2015 registered in the SEER database were selected. The association between sex and cancer-specific survival (CSS) was evaluated using survival analysis. The Inverse Probability Weighting (IPW) approach was applied to reduce the observed bias between males and females. Subgroup analyses were used to investigate the robustness of the sex-based disparity and to explore potential interaction effects with other variables. Results Overall, 29,312 eligible EC patients were analyzed, of whom 5,781 were females, and 23,531 were males. Females had higher crude CSS compared to males (10-year CSS: 24.5 vs. 21.3%; P < 0.001). Similar results were obtained after adjusting for selection bias using the IPW approach and multivariate regression. Subgroup analyses confirmed the relative robustness of sex as a prognostic factor. However, significant interactions were observed between sex and other variables, such as age, race, tumor grade, histology, and treatment modality. In particular, there was no survival advantage for premenopausal females compared to their male counterparts, but the association between sex and EC survival was prominent in 46-55-year-old patients. Conclusions Female EC patients had better long-term survival than males. The association between sex and EC survival vary according to age, race, tumor grade, histology, and treatment modality. Sex-based disparity in EC-specific survival was age-related in the United States population.
Collapse
Affiliation(s)
- Zhen-Fei Xiang
- Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Hua-Cai Xiong
- Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Dan-Fei Hu
- Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Ming-Yao Li
- Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Zhan-Chun Zhang
- Department of Radiation Oncology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Zheng-Chun Mao
- Department of Thoracic Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Er-Dong Shen
- Department of Oncology, Yueyang Central Hospital, Yueyang, China
| |
Collapse
|
20
|
Dysmenorrhea across the lifespan: a biopsychosocial perspective to understanding the dysmenorrhea trajectory and association with comorbid pain experiences. Pain 2022; 163:2069-2075. [PMID: 35420567 DOI: 10.1097/j.pain.0000000000002649] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/01/2022] [Indexed: 11/26/2022]
|
21
|
Sivarajah R. Hormonic Notes: Review of Endocrine Basis of Benign Breast Disease. Semin Roentgenol 2022; 57:149-159. [DOI: 10.1053/j.ro.2022.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 11/11/2022]
|
22
|
Abstract
PURPOSE OF REVIEW Vestibular disorders are gender distributed with a higher prevalence in women. Although research has increased in this field, the mechanisms underlying this unbalance is unclear. This review summarises recent advances in this research sphere, and briefly discusses sex hormone effects on various vestibular conditions and highlights some recent theories. RECENT FINDINGS Recent work has identified a direct link between aberrant gonadal hormone levels and vestibular dysfunction. Benign paroxysmal positional vertigo research suggests that the disorder may be linked to the rapid decrease in oestrogen, observed in menopausal women, which disrupts otoconial metabolism within the inner ear. A successful hormonal therapeutic intervention study has advanced our knowledge of hormonal influences in the inner ear in Ménière's disease. Also, several studies have focused on potential mechanisms involved in the interaction between Vestibular Migraine, Mal de Debarquement Syndrome, and gonadal hormones. SUMMARY In females, gonadal hormones and sex-specific synaptic plasticity may play a significant role in the underlying pathophysiology of peripheral and central vestibular disorders. Overall, this review concludes that clinical assessment of female vestibular patients requires a multifaceted approach which includes auditory and vestibular medicine physicians, gynaecologists and/or endocrinologists, in conjunction with hormonal profile evaluations.
Collapse
Affiliation(s)
- Viviana Mucci
- School of Science, Campbelltown Campus, Western Sydney University, NSW, Australia
| | | | - Yves Jacquemyn
- Antwerp University Hospital UZA, Drie Eikenstraat 655, 2650 Edegem Belgium and Antwerp University UA, ASTARC and GHI, Wilrijk, Belgium
| | - Cherylea J Browne
- School of Science, Campbelltown Campus, Western Sydney University, NSW, Australia
- Translational Neuroscience Facility, School of Medical Sciences, UNSW Sydney, NSW, Australia
| |
Collapse
|
23
|
Starrach T, Santl A, Seifert-Klauss VR. Perimenopausal Bone Loss Is Associated with Ovulatory Activity-Results of the PeKnO Study (Perimenopausal Bone Density and Ovulation). Diagnostics (Basel) 2022; 12:305. [PMID: 35204396 PMCID: PMC8871419 DOI: 10.3390/diagnostics12020305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND During the menopausal transition, around 25% of women experience a particularly accelerated loss of bone mineral density. These so-called "fast bone losers" represent a group of patients with an increased risk of osteoporosis. The precise mechanisms underlying this extraordinary level of bone mass reduction have not yet been conclusively elucidated. The PeKnO study (Perimenopausale Knochendichte und Ovulation; Perimenopausal Bone Density and Ovulation) was a 2-year prospective study investigating menstrual cycle changes, hormonal levels, markers of bone metabolism, and changes in bone mineral density (BMD) in perimenopausal women. The PeKnO study specifically focused on the questions of when the maximum of bone loss occurs, whether the decreasing number of ovulatory cycles correlates with increased bone density loss, and which hormones play a role during these processes. METHODS Healthy women aged ≥45 years with menstrual cycles of ≤42 days and without any exogenous hormonal intake continually self-assessed the lengths of their menstrual cycles and the occurrence of LH peaks with the help of a commercially available electronic fertility monitoring device. At baseline and at 6, 12, 18, and 24 months, hormones (LH, FSH, 17β-estradiol, progesterone, cortisol) and markers of bone metabolism (bone-specific alkaline phosphatase (BAP), osteocalcin (OC), and CTX (C-terminal telopeptide) were assessed during the luteal phase. Trabecular bone density was measured in the lumbar spine (vertebrae L1 through L3) by means of quantitative computed tomography (QCT) at the beginning and at the end of the 2-year study period. Patients were divided into 3 groups according to the changes in bone mineral density (BMD) that occurred within the period of 2 years: group I with an increase in BMD, group II with a decrease in BMD of ≤7%, and group III with a decline in BMD of >7%. Women in the latter group were defined as fast bone losers. RESULTS From a total of 72 recruited patients with an average age of 48.1 (±2.4) at baseline, complete 2-year data were available from 49 participants. Over the course of 24 months, mean bone mineral density decreased by -4.26 (±4.65). In the same time period, the proportion of ovulatory cycles declined from 67% to 33%. The decrease in the ovulatory rate significantly correlated with an enhanced BMD loss (r = 0.68; p < 0.05). Twelve of the forty-nine participants (24.3%) showed a BMD loss of >7% and were identified as fast bone losers. Levels of the luteal phase hormones LH, FSH, 17β-estradiol, and progesterone were significantly different between the three groups. CONCLUSION The PeKnO study confirms a marked decline of the ovulatory rate during perimenopause, which is associated with an increased bone density loss while estrogen levels are still adequate.
Collapse
Affiliation(s)
- Teresa Starrach
- Department of Gynecology, School of Medicine, Technical University of Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany; (T.S.); (A.S.)
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum Großhadern, Marchioninistr. 15, 81377 Munich, Germany
| | - Anita Santl
- Department of Gynecology, School of Medicine, Technical University of Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany; (T.S.); (A.S.)
- Hausärztliche Gemeinschaftspraxis Peissenberg, Teaching Practice of the TUM, 82380 Peißenberg, Germany
| | - Vanadin Regina Seifert-Klauss
- Department of Gynecology, School of Medicine, Technical University of Munich (TUM), Ismaninger Str. 22, 81675 Munich, Germany; (T.S.); (A.S.)
| |
Collapse
|
24
|
King EM, Kaida A, Prior J, Albert A, Frank P, Abdul-Noor R, Kwaramba G, Gormley R, de Pokomandy A, Loutfy M, Murray MCM. Resilience and psychosocial factors linked to symptom experience during the menopause transition for women living with HIV. Menopause 2022; 29:430-439. [PMID: 35357366 DOI: 10.1097/gme.0000000000001926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Women living with HIV (WLWH) are commonly symptomatic during perimenopause and menopause (≥1 y without menstruation), however, little is known of risks for symptoms and their timing. We analyzed these unwanted experiences to inform care. METHODS WLWH (≥40 y) in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study rated midlife experiences for seven symptoms and a symptom composite (from 0 to 21). Timing was categorized into four phases: i) perimenopause (flow in the last year), ii) 1-2 years from final menstrual period (FMP), iii) 2-5 years post-FMP; and iv) >5 years post-FMP. Resilience (standardized out of 100) was assessed based on Wagnild's Resilience Scale. Univariable/multivariable mixed effects linear regression assessed correlates of symptom intensity by composite score. RESULTS Among 457 peri-/menopausal women mean age 54.7 (±6.6) over two time points (703 observations), 88% experienced ≥1 mild symptom; 75% were of moderate and 55% severe intensity. The most frequently reported symptoms were joint/muscle stiffness (67%), depressed mood (67%), and hot flashes (57%). After adjusting for reproductive phase, we found that women with greater resilience had fewer/lower intensity symptoms (symptom score 1.37 [2.30 to 0.44] lower; P = 0.004); those with depressive symptoms and recreational drug use (respectively) had more/higher intensity symptoms (scores 1.71 [0.61 to 2.82] [P = 0.002]; 2.89 [2.09 to 3.77] [P<0.001] higher). Symptoms were most intense in perimenopause and declined with increasing menopausal years (P = 0.03). CONCLUSIONS WLWH experiences a high burden of midlife symptoms, decreased by resilience and most intense during perimenopause. Unwanted experiences were linked to psychosocial and behavioral factors. These data encourage HIV providers to adopt a bio-psychosocial approach to midlife management.
Collapse
Affiliation(s)
- Elizabeth M King
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, BC, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
- Department of Medicine, Division of Endocrinology, UBC, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, BC, Canada
- Independent Researcher
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- McGill University Health Center, Montreal, QC, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada; and
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | - Angela Kaida
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, BC, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
- Department of Medicine, Division of Endocrinology, UBC, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, BC, Canada
- Independent Researcher
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- McGill University Health Center, Montreal, QC, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada; and
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | - Jerilynn Prior
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, BC, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
- Department of Medicine, Division of Endocrinology, UBC, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, BC, Canada
- Independent Researcher
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- McGill University Health Center, Montreal, QC, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada; and
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | - Arianne Albert
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
| | - Peggy Frank
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | | | - Rebecca Gormley
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, BC, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
- Department of Medicine, Division of Endocrinology, UBC, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, BC, Canada
- Independent Researcher
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- McGill University Health Center, Montreal, QC, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada; and
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | | | - Mona Loutfy
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, BC, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
- Department of Medicine, Division of Endocrinology, UBC, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, BC, Canada
- Independent Researcher
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- McGill University Health Center, Montreal, QC, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada; and
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| | - Melanie C M Murray
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, BC, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Menstrual Cycle and Ovulation Research, UBC, Vancouver, BC, Canada
- Department of Medicine, Division of Endocrinology, UBC, Vancouver, BC, Canada
- School of Population and Public Health, UBC, Vancouver, BC, Canada
- Independent Researcher
- BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- McGill University Health Center, Montreal, QC, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada; and
- Oak Tree Clinic, BC Women's Hospital, Vancouver, BC, Canada
| |
Collapse
|
25
|
Prior JC. Adaptive, reversible, hypothalamic reproductive suppression: More than functional hypothalamic amenorrhea. Front Endocrinol (Lausanne) 2022; 13:893889. [PMID: 36339445 PMCID: PMC9626525 DOI: 10.3389/fendo.2022.893889] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 09/26/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jerilynn C. Prior
- Endocrinology and Metabolism, Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- BC Women's Health Research Institute, Vancouver, British Columbia, Canada
- *Correspondence: Jerilynn C. Prior,
| |
Collapse
|
26
|
Rodrigues-Santos I, Kalil-Cutti B, Anselmo-Franci JA. Low Corticosterone Response to Stress in a Perimenopausal Rat Model Is Associated with the Hypoactivation of PaMP Region of the Paraventricular Nucleus and Can Be Corrected by Exogenous Progesterone Supplementation. Neuroendocrinology 2022; 112:467-480. [PMID: 34348338 DOI: 10.1159/000518336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 06/30/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The transition to menopause is characterized by mood, behavioral and metabolic changes. However, little is known about the changes in adrenal response to stress. AIMS The aim of the study was to evaluate, in an animal model of perimenopause induced by 4-vinylcyclohexene diepoxide (VCD), (1) the endocrine and neuronal stress system activity in response to acute restraint stress and (2) the effect of hormonal therapy in this response. METHODS Prepubertal female Wistar rats received daily injections (s.c) of oil or VCD (160 mg/kg) for 15 days. On 56th-66th days after treatment onset, the groups to be stressed received s.c implants containing placebo (PL), 17β-estradiol (E2), progesterone (P4), or E2P4. At 80 ± 5 days after VCD/oil injections, stress was applied for 30 min. Blood samples were collected immediately after and 60 min after the end of stress session from the tail tip followed by transcardial perfusion with PFA 4% for the assessment of c-Fos expression in the medial and posterior parvocellular (PaMP and PaPo) subdivisions of the paraventricular nucleus (PVN) and c-Fos/tyrosine hydroxylase in the locus coeruleus (LC) using immunohistochemistry. Control groups were not stressed nor received hormone therapy. RESULTS While basal corticosterone levels were similar between VCD-periestropausal and control rats, the secretion in response to stress in the VCD group was lower. This effect was prevented by P4 therapy. Inversely, basal levels of P4 were lower in VCD-periestropausal rats than in the controls, and no differences were found in response to stress between the groups. As expected, 30-min restraint stress increased c-Fos immunoreactivity in all brain areas studied in both control and VCD-periestropausal rats. However, the c-Fos increase in the PaMP region was attenuated. In all areas examined, there were no significant differences in the number of c-Fos-positive neurons across hormonal therapies. DISCUSSION/CONCLUSION This is the first study to demonstrate in a perimenopausal rat model that reproductive aging is accompanied by inadequate secretion of corticosterone in response to acute stress in association with the hypoactivation of the PaMP region of the PVN, while adrenal P4 response is preserved. Moreover, P4 therapy was shown to attenuate the effects of progressive ovarian failure on adrenal functioning during stress.
Collapse
Affiliation(s)
- Isabelle Rodrigues-Santos
- Department of Physiology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil,
| | - Bruna Kalil-Cutti
- Department of Physiology, Institute of Biomedical Science, Federal University of Alfenas, Alfenas, São Paulo, Brazil
| | - Janete Aparecida Anselmo-Franci
- Department of Basic and Oral Biology of Dentistry School of Ribeirão Preto, Laboratory of Neuroendocrinology, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| |
Collapse
|
27
|
Cvetkovic A, King E, Skerritt L, Loutfy M, Tseng A, Murray M, van Schalkwyk J, Boucoiran I, Marcotte S, Hankins C, Savoie É, de Pokomandy A, Pick N, Tkachuk S, Rowe T, Smaill F, Walmsley S. A practical clinical guide to counselling on and managing contraception, pre-conception planning, and menopause for women living with HIV. JOURNAL OF THE ASSOCIATION OF MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE CANADA = JOURNAL OFFICIEL DE L'ASSOCIATION POUR LA MICROBIOLOGIE MEDICALE ET L'INFECTIOLOGIE CANADA 2021; 6:278-295. [PMID: 36338461 PMCID: PMC9629258 DOI: 10.3138/jammi-2021-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 06/16/2023]
Abstract
Background Women represent one quarter of the population living with HIV in Canada and are an increasingly important sector of the HIV community. While some women's health issues such as cervical cancer screening and management are well addressed in HIV management guidelines, others are not. These include sexual and reproductive health factors such as contraception, pre-conception planning, and menopause. Existing literature has shown that while women living with HIV in Canada receive good HIV care based on HIV care cascade indicators, their women's health and sexual and reproductive health care needs are not being met. Methods In this article, we present a clinical guide for clinicians providing care for women living with HIV on three key women's health topics that are under-discussed during HIV care visits: (1) contraception, (2) pre-conception planning, and (3) menopause. Results We have summarized the most pertinent clinical factors on each topic to support straightforward counselling and present important considerations in the context of HIV-related diseases and treatment. Finally, when relevant, we have provided practical stepwise approaches for addressing each of these women's health care topics when seeing a patient during a visit. Conclusions It is important that HIV specialists stay well-versed in the complex clinical interactions between HIV treatment and management of women's health issues.
Collapse
Affiliation(s)
- Anna Cvetkovic
- Department of Medicine, Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada
| | - Elizabeth King
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, British Columbia, Canada
| | - Lashanda Skerritt
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Mona Loutfy
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Alice Tseng
- Immunodeficiency Clinic, University Health Network, Toronto, and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Melanie Murray
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women’s Hospital, Vancouver, British Columbia, Canada
| | - Julie van Schalkwyk
- Oak Tree Clinic, BC Women’s Hospital, Vancouver, British Columbia, Canada
- Department of Obstetrics and Gynecology, UBC, Vancouver, British Columbia, Canada
| | - Isabelle Boucoiran
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montréal, Québec, Canada
| | - Suzanne Marcotte
- Department of Pharmacy, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Catherine Hankins
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, Québec, Canada
| | - Édénia Savoie
- McGill University Health Centre, Montréal, Québec, Canada
| | | | - Neora Pick
- Department of Medicine, Division of Infectious Diseases, University of British Columbia (UBC), Vancouver, British Columbia, Canada
- Oak Tree Clinic, BC Women’s Hospital, Vancouver, British Columbia, Canada
| | - Stacey Tkachuk
- Oak Tree Clinic, BC Women’s Hospital, Vancouver, British Columbia, Canada
| | - Timothy Rowe
- Department of Obstetrics and Gynecology, UBC, Vancouver, British Columbia, Canada
| | - Fiona Smaill
- Department of Medicine, Division of Infectious Diseases, McMaster University, Hamilton, Ontario, Canada
| | - Sharon Walmsley
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
28
|
Rogowska MD, Pena UNV, Binning N, Christians JK. Recovery of the maternal skeleton after lactation is impaired by advanced maternal age but not by reduced IGF availability in the mouse. PLoS One 2021; 16:e0256906. [PMID: 34469481 PMCID: PMC8409645 DOI: 10.1371/journal.pone.0256906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/17/2021] [Indexed: 01/23/2023] Open
Abstract
Background Lactation results in substantial maternal bone loss that is recovered following weaning. However, the mechanisms underlying this recovery, and in particular the role of insulin-like growth factor 1 (IGF-I), is not clear. Furthermore, there is little data regarding whether recovery is affected by advanced maternal age. Methods Using micro-computed tomography, we studied bone recovery following lactation in mice at 2, 5 and 7 months of age. We also investigated the effects of reduced IGF-I availability using mice lacking PAPP-A2, a protease of insulin-like growth factor binding protein 5 (IGFBP-5). Results In 2 month old mice, lactation affected femoral trabecular and cortical bone, but only cortical bone showed recovery 3 weeks after weaning. This recovery was not affected by deletion of the Pappa2 gene. The amount of trabecular bone was reduced in 5 and 7 month old mice, and was not further reduced by lactation. However, the recovery of cortical bone was impaired at 5 and 7 months compared with at 2 months. Conclusions Recovery of the maternal skeleton after lactation is impaired in moderately-aged mice compared with younger mice. Our results may be relevant to the long-term effects of breastfeeding on the maternal skeleton in humans, particularly given the increasing median maternal age at childbearing.
Collapse
Affiliation(s)
- Monika D Rogowska
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Uriel N V Pena
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Nimrat Binning
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Julian K Christians
- Department of Biological Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,Centre for Cell Biology, Development and Disease, Simon Fraser University, Burnaby, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada.,BC Women's Hospital and Health Centre, Women's Health Research Institute, Vancouver, British Columbia, Canada
| |
Collapse
|
29
|
Zhang M, Wang Y, Huan Z, Liu Y, Zhang W, Kong D, Kong L, Xu J. FSH modulated cartilage ECM metabolism by targeting the PKA/CREB/SOX9 pathway. J Bone Miner Metab 2021; 39:769-779. [PMID: 33988757 DOI: 10.1007/s00774-021-01232-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 04/18/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Osteoarthritis (OA) is a common joint disease characterized by articular cartilage degeneration. The prevalence of OA is higher among women than men, and this prevalence is closely related to menopause. The classic view assumes that the underlying mechanism of postmenopausal OA is attributed to declining estrogen levels. Although follicle-stimulating hormone (FSH) levels become elevated in parallel, the effects of FSH on OA have been poorly explored. The present study aimed to study the effect of FSH on cartilage metabolism. METHODS Chondrocyte-like ATDC5 cells were treated with recombinant FSH protein. Then the cell viability was measured using cell counting kit-8 assay. Expressions of crucial factors involved in the extracellular matrix (ECM) metabolic and PKA-CREB-SOX9 pathway were analyzed by western blot, RT-qPCR, and immunofluorescence staining. Intracellular cAMP levels were assessed by ELISA assay. Experimental OA in mice was induced by destabilization of the medial meniscus (DMM) surgery. Adeno-associated virus expressing shRNA against FSHR (AAV-shFSHR) was intra-articular (IA) injected into the OA model animals to specifically knock down FHSR in cartilage. Histological staining and OARSI scores were used to assess the efficacy of AAV-shFSHR injections. RESULTS We found that FSH down-regulated the expression of ECM-related proteins in chondrocyte-like ATDC5 cells. The underlying mechanism is probably associated with regulating PKA/CREB/SOX9 pathway. Besides, blocking FSH signaling via shRNA-mediated downregulation of FSHR in joint tissues effectively delayed the development of posttraumatic OA in mice. CONCLUSIONS Our results collectively indicated that FSH plays an essential role in the pathogenesis of OA and acts as a crucial mediator.
Collapse
Affiliation(s)
- Mengqi Zhang
- School of Medicine, Shandong University, jinan, 250021, shandong, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
| | - Yan Wang
- School of Medicine, Shandong University, jinan, 250021, shandong, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
| | - Zhikun Huan
- School of Medicine, Shandong University, jinan, 250021, shandong, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
| | - Yaping Liu
- School of Medicine, Shandong University, jinan, 250021, shandong, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
- Department of Endocrinology, Jining No.1 People's Hospital, No.6 Health Road, Jining, 272011, China
| | - Wenwen Zhang
- School of Medicine, Shandong University, jinan, 250021, shandong, China
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China
- Scientific Center, Shandong Provincial Hospital Affiliated To Shandong University, Jinan, Shandong, China
| | - Dehuan Kong
- Department of Geriatrics, Taian City Central Hospital, Taian, Shandong, China
| | - Lei Kong
- School of Medicine, Shandong University, jinan, 250021, shandong, China.
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China.
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.
| | - Jin Xu
- School of Medicine, Shandong University, jinan, 250021, shandong, China.
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jina, 250021, Shandong, China.
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Shandong Provincial Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.
| |
Collapse
|
30
|
King EM, Prior JC, Pick N, van Schalkwyk J, Kestler M, Tkachuk S, Loutfy M, Murray MCM. Menopausal hormone therapy for women living with HIV. Lancet HIV 2021; 8:e591-e598. [PMID: 34384545 DOI: 10.1016/s2352-3018(21)00148-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/11/2021] [Accepted: 06/18/2021] [Indexed: 01/13/2023]
Abstract
People living with HIV are ageing, and a growing number of women living with HIV are entering menopause. Women living with HIV commonly have bothersome vasomotor symptoms and onset of menopause at earlier ages; both factors go on to affect quality of life and systemic health. Vasomotor symptoms and early menopause are both indications for menopausal hormone therapy; however, current evidence suggests that this therapy is seldom offered to women living with HIV. Additionally, women living with HIV have several risks to bone health and are likely to benefit from the bone-strengthening effects of menopausal hormone therapy. We present an assessment of the benefits and risks of menopausal hormone therapy in the context of HIV care and propose a practical approach to its prescription. If considered in the appropriate clinical context with discussion of risks and benefits, menopausal hormone therapy might provide substantial benefits to symptomatic menopausal women living with HIV and improve health-related quality of life.
Collapse
Affiliation(s)
- Elizabeth Marie King
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada.
| | - Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, BC, Canada; Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Neora Pick
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada; Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Julie van Schalkwyk
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada; Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Mary Kestler
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada; Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Stacey Tkachuk
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada; Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| | - Mona Loutfy
- Department of Medicine, University of Toronto, Toronto, ON, Canada; Dalla School of Public Health, University of Toronto, Toronto, ON, Canada; Women's College Research Institute, Toronto, ON, Canada
| | - Melanie C M Murray
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada; Women's Health Research Institute, British Columbia Women's Hospital, Vancouver, BC, Canada; Oak Tree Clinic, British Columbia Women's Hospital, Vancouver, BC, Canada
| |
Collapse
|
31
|
Effects of exogenous melatonin on sleep quality and menopausal symptoms in menopausal women: a systematic review and meta-analysis of randomized controlled trials. ACTA ACUST UNITED AC 2021; 28:717-725. [PMID: 33784263 DOI: 10.1097/gme.0000000000001757] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
IMPORTANCE Because of the bothersome symptoms during women's menopausal period and the severe side effects of hormone therapy, it is meaningful to find new breakthroughs in improving menopausal women's quality of life. OBJECTIVE We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating melatonin intake on the improvement of sleep quality, general menopausal symptom, mood states, as well as interaction of estradiol levels and body mass index (BMI) in menopausal women. EVIDENCE REVIEW We used the search terms "melatonin" together with "menopause" or "post-menopause" or "peri-menopause" in multiple databases online including PubMed, Web of Science, Embase, Clinical trial, Cochrane Library, and China National Knowledge Infrastructure from the first publication year to October 2020. Interesting data included characteristics of the study design, study participants, intervention, and outcome measures. Risk of biases in RCTs was evaluated with the Cochrane tool. Fixed-effect models and random-effect models were used for meta-analysis according to heterogeneity. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in our study. FINDINGS Eight cohorts (n = 812) evaluating the effects of melatonin in menopausal women were included. Melatonin was used in every study with differences existing in dose (1 mg - 5 mg) and duration (3 to 12 mo). Improved physical symptoms (standard mean difference [SMD] -0.376; 95% CI, -0.599 to -0.153, P = 0.001) merged in four RCTs. Melatonin treatment resulted in no benefits to sleep quality (SMD -0.659; 95% CI, -1.535 to 0.217, P = 0.141) and general menopause symptoms (SMD -0.625; 95% CI, -1.354 to 0.105, P = 0.093) in four and three RCTs, respectively. More specifically, melatonin did not solve the psychological (SMD -0.026; 95% CI, -0.372 to 0.321, P = 0.884, I2 = 70.3%), sexual (SMD -0.661; 95% CI, -1.416 to 0.093, P = 0.086) and vasomotor (SMD -0.256; 95% CI, -0.701 to 0.188, P = 0.258) issues. No significant changes were observed in anxiety (SMD 0.018; 95% CI, -0.519 to 0.556, P = 0.946), depression (SMD 0.133; 95% CI, -0.435 to 0.702, P = 0.646), BMI (weighted mean difference 0.029 kg/m2; 95% CI, -0.183 to 0.240, P = 0.790) or estradiol levels (weighted mean difference 0.016 pg/mL; 95% CI, -1.220 to 1.252, P = 0.980). CONCLUSIONS Melatonin seems to improve physical symptoms in menopausal women, but the general menopausal symptoms, sleep quality, mood state, estradiol levels, and BMI did not improve under melatonin intervention. However, multiple large-scale clinical randomized trials are needed to validate our conclusions.
Collapse
|
32
|
Li WZ, Lv SH, Liu GY, Liang H, Xia WX, Xiang YQ. Age-dependent changes of gender disparities in nasopharyngeal carcinoma survival. Biol Sex Differ 2021; 12:18. [PMID: 33516267 PMCID: PMC7847041 DOI: 10.1186/s13293-021-00361-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/20/2021] [Indexed: 12/24/2022] Open
Abstract
Background The mortality of nasopharyngeal carcinoma (NPC) is usually lower in females than in males, but the underlying mechanism remains largely unknown. We sought to describe the age-dependent patterns of gender disparities in NPC survival and explore the extent to which the confounder or mediation effects could explain these differences. Methods A total of 11,980 patients with NPC were reviewed. The effect of gender on cancer-specific survival (CSS) was assessed using Cox regression analyses. Two propensity score methods were conducted to control the confounding bias between genders. Restricted cubic spline regression was used to model the association of gender and age with mortality flexibly. Multiple mediation analysis was applied to estimate the direct or indirect effect of gender on CSS. Results Overall, 7026 males and 2320 females were analyzed. The crude CSS was significantly higher for females than males (10-year CSS 78.4% vs 70.3%; P < 0.001). Similar results were observed after adjusting for confounding bias. Gender disparities in NPC-specific mortality were age-dependent, where they would increase with age until peaking at age 55–60 years and decline rapidly afterward. Subgroup analyses revealed that females’ survival advantage was observed in the 18–45 age group and was more prominent in the 46–55 age group, but vanished in the > 55 age group. Either confounder or mediation effects only accounted for approximately 20% of the gender differences. Conclusions Gender disparities in cancer-specific mortality for patients with NPC were age-dependent. The differences mostly cannot be explained by confounder or mediation effects. Supplementary Information The online version contains supplementary material available at 10.1186/s13293-021-00361-8.
Collapse
Affiliation(s)
- Wang-Zhong Li
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Shu-Hui Lv
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Guo-Ying Liu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Hu Liang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China
| | - Wei-Xiong Xia
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
| | - Yan-Qun Xiang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China. .,Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, China.
| |
Collapse
|
33
|
Abstract
Uterine fibroids (UFs) are benign tumors that arise from a single genetically altered mesenchymal stem cell under the influence of gonadal hormones. UFs are the most common benign gynecologic tumors in premenopausal women worldwide. It is estimated that nearly 70% to 80% of women will develop UFs at some point during their lifetime. UFs often present with abnormal uterine bleeding (AUB), pelvic fullness, and may have deleterious effects on fertility. The natural regression of UFs begins in menopause. This is, however, a generality as this pathology may still be present in this age group. Many clinicians are concerned about hormone therapy (HT) because of UFs regrowth; nevertheless, research of this subject remains inconclusive. If UFs are present in perimenopause or menopause, they typically manifest as AUB, which represents up to 70% of all gynecological consultations in perimenopausal and postmenopausal women. As AUB is a broad symptom and may not be specific to UFs, a thorough evaluation is required for correct diagnosis and proper treatment accordingly. Understanding the unique characteristics of the available treatment modalities is crucial in deciding the appropriate treatment approach. Decision on treatment modality should be made based on selection of the least morbidity and lowest risk for each patient. Multiple modalities are available; however, surgery remains the method of choice, with the best cure rates. Various attempts to create an inexpensive, safe, and effective drug for the treatments of UFs are still in the early stages of the clinical trials with some showing great promise. Treatment options include tibolone, aromatase inhibitors, selective estrogen receptor modulators, uterine artery embolization, and selective progesterone receptor modulators.
Collapse
|
34
|
Ying Y, Qiu F, Huang Q, Li S, Liu H, Liu J. Follicular phase length has no influence on frozen-thawed embryo transfers in natural cycles. J Ovarian Res 2020; 13:87. [PMID: 32736647 PMCID: PMC7393903 DOI: 10.1186/s13048-020-00690-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Whether menstrual variability in women with regular and ovulatory cycle could affect embryo implantation remains controversial, with conflicting evidences presented in the literature. Thus, in this study, we evaluated the impact of prolonged follicular phase length (FPL) on the clinical pregnancy rate (CPR) after frozen–thawed embryo transfer (FET) in true natural cycles (NC). Methods This retrospective cohort study utilized data from a large university-affiliated reproductive medicine center. Women undergoing true NC-FET were grouped as per their FPL type: Prolonged FPL (n = 127) and Normal FPL (n = 737). The primary study outcome was CPR in these 2 groups. Results The FPL in the current cycle was significantly longer in the Prolonged FPL group (23.0 ± 2.4) than in the Normal FPL group (16.0 ± 2.2; p < 0.001). The crude CPR was significantly higher in the Prolonged FPL group (61.4%) than in the Normal FPL group (51.7%; p = 0.043). After adjusting for the results of potential confounders including the age, BMI, percent of optimal embryos transferred, and endometrial thickness, the difference in the CRP between the 2 groups disappeared (OR 1.28, 95% CI: 0.86–1.91, p = 0.232). No statistically significant difference was noted in the rates of implantation and miscarriage. Conclusions The current FET should not be cancelled if the ovulation time exceeds the predicted period based on the length of the previous menstrual cycle in the light of no negative effect on the pregnancy outcome.
Collapse
Affiliation(s)
- Ying Ying
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Fuman Qiu
- The State Key Lab of Respiratory Disease, Collaborative Innovation Center for Environmental Toxicity, The School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Qing Huang
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Sichen Li
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China
| | - Haiying Liu
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China.
| | - Jianqiao Liu
- Reproductive Medicine Center, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Liwan District, Guangzhou, China.
| |
Collapse
|
35
|
Li K, Urteaga I, Wiggins CH, Druet A, Shea A, Vitzthum VJ, Elhadad N. Characterizing physiological and symptomatic variation in menstrual cycles using self-tracked mobile-health data. NPJ Digit Med 2020; 3:79. [PMID: 32509976 PMCID: PMC7250828 DOI: 10.1038/s41746-020-0269-8] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 03/23/2020] [Indexed: 01/17/2023] Open
Abstract
The menstrual cycle is a key indicator of overall health for women of reproductive age. Previously, menstruation was primarily studied through survey results; however, as menstrual tracking mobile apps become more widely adopted, they provide an increasingly large, content-rich source of menstrual health experiences and behaviors over time. By exploring a database of user-tracked observations from the Clue app by BioWink GmbH of over 378,000 users and 4.9 million natural cycles, we show that self-reported menstrual tracker data can reveal statistically significant relationships between per-person cycle length variability and self-reported qualitative symptoms. A concern for self-tracked data is that they reflect not only physiological behaviors, but also the engagement dynamics of app users. To mitigate such potential artifacts, we develop a procedure to exclude cycles lacking user engagement, thereby allowing us to better distinguish true menstrual patterns from tracking anomalies. We uncover that women located at different ends of the menstrual variability spectrum, based on the consistency of their cycle length statistics, exhibit statistically significant differences in their cycle characteristics and symptom tracking patterns. We also find that cycle and period length statistics are stationary over the app usage timeline across the variability spectrum. The symptoms that we identify as showing statistically significant association with timing data can be useful to clinicians and users for predicting cycle variability from symptoms, or as potential health indicators for conditions like endometriosis. Our findings showcase the potential of longitudinal, high-resolution self-tracked data to improve understanding of menstruation and women's health as a whole.
Collapse
Affiliation(s)
- Kathy Li
- Department of Applied Physics and Applied Mathematics, Columbia University, New York, NY 10027 USA
- Data Science Institute, Columbia University, New York, NY 10027 USA
| | - Iñigo Urteaga
- Department of Applied Physics and Applied Mathematics, Columbia University, New York, NY 10027 USA
- Data Science Institute, Columbia University, New York, NY 10027 USA
| | - Chris H. Wiggins
- Department of Applied Physics and Applied Mathematics, Columbia University, New York, NY 10027 USA
- Data Science Institute, Columbia University, New York, NY 10027 USA
| | - Anna Druet
- Clue by BioWink GmbH, Adalbertstraße 7-8, 10999 Berlin, Germany
| | - Amanda Shea
- Clue by BioWink GmbH, Adalbertstraße 7-8, 10999 Berlin, Germany
| | - Virginia J. Vitzthum
- Clue by BioWink GmbH, Adalbertstraße 7-8, 10999 Berlin, Germany
- Kinsey Institute & Department of Anthropology, Indiana University, Bloomington, IN 47405 USA
| | - Noémie Elhadad
- Data Science Institute, Columbia University, New York, NY 10027 USA
- Department of Biomedical Informatics, Columbia University, New York, NY 10032 USA
| |
Collapse
|
36
|
Menopausal Symptoms and Perimenopausal Healthcare-Seeking Behavior in Women Aged 40-60 Years: A Community-Based Cross-Sectional Survey in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082640. [PMID: 32290565 PMCID: PMC7215590 DOI: 10.3390/ijerph17082640] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/03/2020] [Accepted: 04/07/2020] [Indexed: 11/20/2022]
Abstract
The aim of the study was to specify prevalence and severity of menopausal symptoms among middle-aged women and to understand the factors associated with women’s perimenopausal healthcare-seeking behavior in Shanghai, China. A community-based cross-sectional study was carried out involving 3147 participants aged 40–60 years. A combination of stratified sampling and quota sampling was used. Out of the total 16 districts in Shanghai, 7 were purposefully selected in consideration of covering both central and suburban areas, population distribution, and willingness to participate. Two communities were randomly selected in each of six districts. Four communities were randomly selected in the 7th district considering the relatively low coverage of central population in the sampling frame. Eligible women were recruited continuously according to the house number and invited to participate in the study until 200 participants were recruited in each community. A structured questionnaire was designed to collect information including sociodemographic data, menopausal symptoms, and experiences in seeking perimenopausal healthcare. The severity of menopausal symptoms was assessed with the modified Kupperman menopausal index (mKMI). The mean age of all the participants was 51 years. 33.13% of the participants were premenopausal, 14.52% were perimenopausal, and 52.35% were postmenopausal. The total prevalence of menopausal symptoms was 73.8%, while among the perimenopausal women, the symptoms were the most common (81.70%). The top three reported symptoms were fatigue (38.08%), hot flushes and sweating (33.65%), and joint ache (28.81%). Perimenopausal and postmenopausal participants had a higher score of the mKMI than premenopausal women (p < 0.01). Of the women who had symptoms, 25.97% had sought healthcare. A logistic regression model revealed that employment, menstruation status, and the mKMI were significantly associated with healthcare-seeking behaviors (p < 0.01). We concluded that prevalence of menopausal symptoms was relatively high among middle-aged women, with perimenopausal women showing the highest level. However, only a small percentage of the participants sought healthcare. Carrying out health education may be a measure to improve the healthcare-seeking behavior.
Collapse
|
37
|
Sivarajah R, Welkie J, Mack J, Casas RS, Paulishak M, Chetlen AL. A Review of Breast Pain: Causes, Imaging Recommendations, and Treatment. JOURNAL OF BREAST IMAGING 2020; 2:101-111. [PMID: 38424883 DOI: 10.1093/jbi/wbz082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Indexed: 03/02/2024]
Abstract
Over two-thirds of women will experience breast pain in their lifetime. As one of the leading breast symptoms for which women seek medical attention, breast pain is suspected to be underreported and under-studied. Cyclical breast pain is related to hormonal changes. Noncyclical breast pain is independent of the menstrual cycle and can be idiopathic and related to chronic pain syndromes, infections, ill-fitting bras, musculoskeletal abnormalities, pregnancy, perimenopause, and postsurgical causes. Breast pain can also present in transgender patients and may require additional considerations as to the underlying cause. Imaging of mastalgia depends upon the suspected etiology. Inappropriate imaging for breast pain is associated with significant utilization of health care resources. Cyclical breast pain does not require an imaging work-up. The work-up of focal, noncyclical breast pain includes ultrasound for women aged younger than 40 years, and mammography and ultrasound for women aged 40 years and older. Management of breast pain is often supportive, as most breast pain resolves spontaneously. If pain persists, imaging and management should follow a step-wise approach. If conservative measures fail, second-line therapy is topical nonsteroidal anti-inflammatory drugs. If breast pain is severe and resistant to conservative methods, additional third-line therapies can be added by breast care specialists with specific knowledge of the potential deleterious side effects of these medications. While the causes of mastalgia are overwhelmingly benign, breast pain can significantly impact quality of life, and the breast radiologist should be familiar with causes, management, and treatment recommendations from a multidisciplinary approach.
Collapse
Affiliation(s)
- Rebecca Sivarajah
- Penn State Health-Hershey Medical Center, Department of Radiology, Hershey, PA
| | - Janelle Welkie
- Penn State Health-Hershey Medical Center, Department of Radiology, Hershey, PA
- Penn State College of Medicine, Hershey, PA
| | - Julie Mack
- Penn State Health-Hershey Medical Center, Department of Radiology, Hershey, PA
| | - Rachel S Casas
- Penn State Health-Hershey Medical Center, Department of General Internal Medicine, Hershey, PA
| | - Melody Paulishak
- Penn State Health-Hershey Medical Center, Department of Surgery, Hershey, PA
| | - Alison L Chetlen
- Penn State Health-Hershey Medical Center, Department of Radiology, Hershey, PA
| |
Collapse
|
38
|
Takeuchi T, Tanaka Y, Higashitani C, Iwai M, Komatsu K, Akazawa R, Lademacher C. A phase 2a, randomized, double-blind, placebo-controlled trial of the efficacy and safety of the oral gonadotropin-releasing hormone antagonist, ASP1707, in postmenopausal female patients with rheumatoid arthritis taking methotrexate. Mod Rheumatol 2020; 31:53-60. [PMID: 32075475 DOI: 10.1080/14397595.2020.1733214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Many patients with rheumatoid arthritis (RA) are not able to achieve long-term disease remission. This phase 2a study (NCT02884635) evaluated the efficacy, safety, pharmacokinetics, and pharmacodynamics of the novel, oral, gonadotropin-releasing hormone antagonist, ASP1707, in combination with methotrexate (MTX) for treatment of RA. METHODS Postmenopausal women with RA who had been receiving MTX for ≥90 days were randomized to ASP1707 30 mg twice daily or placebo for 12 weeks. The primary endpoint was the American College of Rheumatology 20% improvement criteria (ACR20) response rate at week 12. Secondary endpoints included: ACR20, ACR50, and ACR70 response rates; disease activity score (DAS)28-CRP; DAS28-ESR; Tender or Swollen Joint Counts; and remission rates. RESULTS Of 105 patients screened, 72 were randomized to ASP1707 30 mg twice daily (n = 37) or placebo (n = 35). ASP1707 did not improve ACR20, ACR50, or ACR70 response rates at any time point and did not improve any secondary efficacy endpoint. Plasma luteinizing hormone (LH) concentration decreased >90% in >90% of patients receiving ASP1707, with a rapid decrease to <1 IU/L at week 1 that remained stable throughout the treatment. CONCLUSION In the current study, ASP1707 did not demonstrate a clinical benefit.
Collapse
Affiliation(s)
- Tsutomu Takeuchi
- Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Megumi Iwai
- Clinical Pharmacology and Exploratory Development, Astellas Pharma, Inc., Tokyo, Japan
| | - Kanji Komatsu
- Clinical Pharmacology, Astellas Pharma, Inc., Tokyo, Japan
| | - Rio Akazawa
- Data Science, Astellas Pharma, Inc., Tokyo, Japan
| | | |
Collapse
|
39
|
de Bakker CMJ, Burt LA, Gabel L, Hanley DA, Boyd SK. Associations Between Breastfeeding History and Early Postmenopausal Bone Loss. Calcif Tissue Int 2020; 106:264-273. [PMID: 31786624 DOI: 10.1007/s00223-019-00638-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/22/2019] [Indexed: 12/13/2022]
Abstract
This study aimed to evaluate associations of parity and breastfeeding history with postmenopausal bone loss. Early postmenopausal women from the Canadian Multicentre Osteoporosis Study were divided into three groups based on their reproductive histories: nulliparous (NP, n = 10), parous with < 6 months breastfeeding (P-NBF, n = 14), and parous with > 6 months breastfeeding (P-BF, n = 21). Women underwent dual X-ray absorptiometry and high-resolution peripheral quantitative computed tomography imaging at baseline and after 6 years to evaluate bone mineral density (BMD), bone microstructure, and finite element-estimated failure load. Average age at baseline was 57 years. Baseline density, microstructure, and failure load were not different among groups. In all women, total and cortical BMD decreased significantly at the tibia and radius. P-BF women only experienced a significant decline in tibial trabecular BMD, with a greater magnitude of change for P-BF than NP women (p = 0.002). Overall, results suggest that early postmenopausal bone health did not differ based on parity or breastfeeding history. Over the 6-year follow-up period, postmenopausal bone loss was evident in all women, with subtle differences in the rate of postmenopausal change among women with varying breastfeeding histories. Parous women who had breastfed for at least 6 months showed an elevated rate of trabecular BMD loss at the tibia. Meanwhile, correlation analyses suggest that longer durations of breastfeeding may be associated with reduced cortical bone loss at the radius. The lack of differences among groups in FE-derived failure load suggests that parity and breastfeeding history is unlikely to significantly affect postmenopausal risk of fracture.
Collapse
Affiliation(s)
- Chantal M J de Bakker
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Lauren A Burt
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Leigh Gabel
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - David A Hanley
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Steven K Boyd
- Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada.
| |
Collapse
|
40
|
Association between FSH, E1, and E2 levels in urine and serum in premenopausal and postmenopausal women. Clin Biochem 2019; 73:105-108. [DOI: 10.1016/j.clinbiochem.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/06/2019] [Accepted: 08/15/2019] [Indexed: 01/01/2023]
|
41
|
Yang Y, Arnot M, Mace R. Current ecology, not ancestral dispersal patterns, influences menopause symptom severity. Ecol Evol 2019; 9:12503-12514. [PMID: 31788193 PMCID: PMC6875564 DOI: 10.1002/ece3.5705] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 12/21/2022] Open
Abstract
All human females who reach midlife experience menopause, however, it is currently unclear why women experience this period of infertility, and why it is accompanied by many unpleasant symptoms. Using primary data from four ethnic groups in China, we test an existing theory that age of menopause and its symptoms are the result of intragenomic conflict between maternally and paternally inherited genes, with the outcome of such conflict predicted to be contingent on the ancestral postmarital residence pattern of the female (Úbeda, Ohtsuki, & Gardner, Ecology Letters, 17, 2014, 165). The model predicts that being ancestrally patrilocal results in less intragenomic conflict, causing a shorter, less symptomatic perimenopause that terminates in a later menopause. Our findings show no support for this hypothesis and suggest current, rather than ancestral, residence patterns better predict aspects of the menopausal transition. Furthermore, current patrilocality when compared to duolocality is associated with more severe menopause symptoms, which may be due to sexual, rather than intragenomic, conflict. OPEN RESEARCH BADGES This article has earned an Open Data Badge for making publicly available the digitally-shareable data necessary to reproduce the reported results. The data is available at https://doi.org/10.5061/dryad.27s8k0p.
Collapse
Affiliation(s)
| | - Megan Arnot
- Department of AnthropologyUniversity College LondonLondonUK
| | - Ruth Mace
- Life SciencesLanzhou UniversityLanzhouChina
- Department of AnthropologyUniversity College LondonLondonUK
| |
Collapse
|
42
|
Fiacco S, Walther A, Ehlert U. Steroid secretion in healthy aging. Psychoneuroendocrinology 2019; 105:64-78. [PMID: 30314729 DOI: 10.1016/j.psyneuen.2018.09.035] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 01/16/2023]
Abstract
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
Collapse
Affiliation(s)
- Serena Fiacco
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland
| | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
| |
Collapse
|
43
|
Jung Y, Kim TH, Kim JY, Han S, An YS. The effect of sex hormones on normal breast tissue metabolism: Evaluation by FDG PET/CT. Medicine (Baltimore) 2019; 98:e16306. [PMID: 31277170 PMCID: PMC6635257 DOI: 10.1097/md.0000000000016306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated the effect of sex hormones on F-fluorodeoxyglucose (FDG) uptake in normal breast tissue.The retrospective study included 249 premenopausal women (median age, 45 years) who were diagnosed with unilateral breast cancer and underwent FDG positron emission tomography/computed tomography and hormone tests. The volume of interest was within the contralateral normal breast and the standardized uptake values (SUVs) were measured. The correlations of sex hormones (including estrogen, progesterone, testosterone, follicle-stimulating hormone [FSH] and luteinizing hormone [LH]) with the SUVs of the normal breast were analyzed.There was a weak negative correlation between age and breast FDG uptake (P = .012, Spearman coefficient = -.16 for the maximum standardized uptake values [SUVmax]), especially in the luteal phase group (P = .005, Spearman coefficient = -.27 for SUVmax). The SUVs of normal breast tissue were increased when progesterone levels were higher (P = .043, Spearman coefficient = .13 for SUVmax). In the irregular menstrual cycle group, FDG uptake in the breast decreased as FSH (P = .027, Spearman coefficient = -.42 for SUVmax) and LH (P = .048, Spearman coefficient = -.44 for SUVmax) increased.Glucose metabolism of normal breast tissue decreases with age, and progesterone weakly affects breast FDG uptake. Gonadotropins may affect breast FDG uptake in premenopausal women with irregular menstrual cycles.
Collapse
Affiliation(s)
| | | | | | | | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, South Korea
| |
Collapse
|
44
|
Samtani R, Saksena D. BRCA gene mutations: A population based review. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
45
|
Abstract
Menopause is defined as permanent cessation of menstrual periods, determined retrospectively after a woman has experienced 12 months of amenorrhea without any other obvious cause. Over the years, the discourse surrounding the Climacteric was mainly elicited as a "disease of the castrates", as opposed to the feminist views. There has been a large feminist contribution to both the debate of contraception and menopause in the last few years. Over the years, menopause has been treated in a uniform fashion, as a disease, excluding the different circumstances and lived experiences that patients go through during this sensitive period. Every primary care provider should be familiar with the menopausal process and be able to provide adequate care for these women, respecting patient's autonomy and decision making. A brief historical of menopause and hormone replacement therapy (HRT) will be reviewed in this paper. We will also discuss the different views of the menopausal discourse as well as the benefits and risks, compliance rates and reasons for discontinuation of HRT.
Collapse
Affiliation(s)
- Salam Chalouhi
- Department of OBGYN, 1104 University of New Mexico Hospital, Albuquerque, USA
| |
Collapse
|
46
|
Affiliation(s)
- J. C. Prior
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology and Metabolism, University of British Columbia, Vancouver, BC, Canada
- Associate to the School for Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- British Columbia Women’s Health Research Institute, Vancouver, BC, Canada
| |
Collapse
|
47
|
Abstract
Estradiol (E2) is women's dominant 'bone hormone' since it is essential for development of adolescent peak bone mineral density (BMD) and physiological levels prevent the rapid (3-week) bone resorption that causes most adult BMD loss. However, deceasing E2 levels trigger bone resorption/loss. Progesterone (P4) is E2's physiological partner, collaborating with E2 in every cell/tissue; its bone 'job' is to increase P4-receptor-mediated, slow (3-4 months) osteoblastic new bone formation. When menstrual cycles are normal length and normally ovulatory, E2 and P4 are balanced and BMD is stable. However, clinically normal cycles commonly have ovulatory disturbances (anovulation, short luteal phases) and low P4 levels; these are more frequent in teen and perimenopausal women and increased by everyday stressors: energy insufficiency, emotional/social/economic threats and illness. Meta-analysis shows that almost 1%/year spinal BMD loss occurs in those with greater than median (∼31%) of ovulatory disturbed cycles. Prevention of osteoporosis and fragility fractures requires the reversal of stressors, detection and treatment of teen-to-perimenopausal recurrent cycle/ovulatory disturbances with cyclic oral micronized progesterone. Low 'Peak Perimenopausal BMD' is likely the primary risk for fragility fractures in later life. Progesterone plus estradiol or other antiresorptive therapies adds 0.68%/year and may be a highly effective osteoporosis treatment. Randomized controlled trials are still needed to confirm progesterone's important role in women's bone formation.
Collapse
Affiliation(s)
- J C Prior
- a Centre for Menstrual Cycle and Ovulation Research, Department of Medicine, Division of Endocrinology , University of British Columbia , Vancouver , BC , Canada.,b School of Population and Public Health , University of British Columbia; BC Women's Health Research Network , Vancouver , BC , Canada
| |
Collapse
|
48
|
Women's Mid-Life Night Sweats and 2-Year Bone Mineral Density Changes: A Prospective, Observational Population-Based Investigation from the Canadian Multicentre Osteoporosis Study (CaMos). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061079. [PMID: 29861446 PMCID: PMC6025051 DOI: 10.3390/ijerph15061079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/14/2018] [Accepted: 05/19/2018] [Indexed: 11/17/2022]
Abstract
Women’s hot flushes and night sweats, collectively called vasomotor symptoms (VMS), are maximal (79%) in late perimenopause. The evidence describing whether VMS are associated with loss of areal bone mineral density (BMD) is mixed. We examined baseline and 2-year data for 1570 randomly selected women aged 43–63 in the Canadian Multicentre Osteoporosis Study (CaMos), a prospective Canada-wide study; we used linear regression to assess the relationship of night sweats (VMSn) with BMD and its changes. Clinically important VMSn occurred for 12.2%. Women with VMSn were slightly younger (54.5 vs. 55.3 years, p = 0.02) and less likely to use sex steroid therapies (39.8% vs. 51.4%, p < 0.05). BMD at the lumbar spine (L1-4), femoral neck (FN) and total hip (TH) were similar between those with/without VMSn. In adjusted models, we did not find a significant association between VMSn and 2-year change in L1-4, FN and TH BMD. Age, reproductive status, weight, sex steroid therapy and smoking status were associated with 2-year change in BMD. Incident fractures over 2 years also did not differ by VMSn. Our analyses were restricted to VMSn and may not truly capture the relationship between VMS and BMD. Additional research involving VMS, bone loss and fracture incidence is needed.
Collapse
|
49
|
Abstract
Osteoporosis is the most common bone metabolic disease with a very high morbidity, and women usually got a higher risk of osteoporosis than men. The high incidence rate of osteoporosis in women was mainly caused by (1) women having fewer skeletons and bone mass, (2) pregnancy consuming a large amount of calcium and other nutrients, and most importantly (3) the cease of estrogen secretion by ovaries after menopause. Along with ovarian aging, the follicle pool gradually declines and the oocyte quality reduced, accompanied with decline in serum estrogen. Estrogen deficiency plays an important role in the pathogenesis of postmenopausal osteoporosis; it is mainly a result of the recognition that estrogen regulates bone remodeling by modulating the production of cytokines and growth factors from bone marrow and bone cells. This review will summarize current knowledge concerning ovarian aging and postmenopause osteoporosis and also discuss clinical treatment and new ideas of drug development for osteoporosis.
Collapse
Affiliation(s)
- Liyuan Li
- MOE Key Laboratory of Protein Sciences, School of Pharmaceutical Sciences, Tsinghua University, Beijing, China
| | - Zhao Wang
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China.
| |
Collapse
|
50
|
Chen WY, Hsiao CH, Chen YC, Ho CH, Wang JJ, Hsing CH, Wang HY, Kan WC, Wu CC. Cisplatin Nephrotoxicity Might Have a Sex Difference. An analysis Based on Women's Sex Hormone Changes. J Cancer 2017; 8:3939-3944. [PMID: 29187868 PMCID: PMC5705995 DOI: 10.7150/jca.20083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 09/20/2017] [Indexed: 11/10/2022] Open
Abstract
Background: A sex difference in cisplatin-induced nephrotoxicity (CIN) has been reported in human and animal studies. We examined in humans whether it is associated with sex-hormone changes. Methods: In this retrospective nationwide cohort study, we used Taiwan's National Health Insurance Research Database (NHIRD) to identify patients with a history of malignancy and cisplatin treatment. Patients diagnosed with kidney disease before cisplatin treatment and those with sex-organ malignancies were excluded. A diagnosis of kidney disease within 90 days after the first administration of cisplatin was the study outcome. Risk factors were estimated using a Cox regression model. Subgroup analyses were performed based on different women's estrogen levels in phases of childbearing, perimenopause, and postmenopause. Results: A retrospective analysis of the records of 3973 men (mean age: 56.15 ± 12.85 years) and 1154 women (mean age: 56.31 ± 12.40 years) showed that 1468 (36.95%) men and 451 (39.08%) women had a new diagnosis of kidney disease. The risk factors were being > 55 years old, a high comorbidity score, and a history of aminoglycoside treatment. Only postmenopausal women had a significantly higher risk of kidney injury (hazard ratio: 1.28; 95% CI: 1.02-1.61) than did men. Conclusions: Perimenopausal women have a significantly higher risk of CIN than do men, which might be explained by women's higher levels of estrogen. Additional studies on the underlying mechanisms of the sex difference of CIN are needed.
Collapse
Affiliation(s)
- Wei-Yu Chen
- Department of Hematology and Oncology, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
| | - Ching-Hsing Hsiao
- Department of Ophthalmology, Chi Mei Hospital, Jiali District, Tainan, Taiwan
| | - Yi-Chen Chen
- Department of Medical Research, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Rende District, Tainan, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
| | - Chung-Hsi Hsing
- Department of Anesthesiology, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
- Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Hsien-Yi Wang
- Department of Nephrology, Department of Internal medicine, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
- Department of Sports Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Rende District, Tainan, Taiwan
| | - Wei-Chih Kan
- Department of Nephrology, Department of Internal medicine, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
- Department of Biological Science and Technology, Chung Hwa University of Medical Technology, Rende District, Tainan City 717, Taiwan
| | - Chia-Chun Wu
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Rende District, Tainan, Taiwan
- Department of Nephrology, Department of Internal medicine, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
| |
Collapse
|