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Llaneza-Suarez C, Garcia-Portilla P, Rodriguez-Vijande B, Carriles J, Sánchez-Prieto M, Coronado Martín PJ, Llaneza Coto ÁP, Sánchez-Borrego R. Rural residence and health-related quality of life in a sample of Spain perimenopausal women. Gynecol Endocrinol 2024; 40:2336335. [PMID: 38629396 DOI: 10.1080/09513590.2024.2336335] [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: 12/27/2023] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The prevalence and severity of perimenopausal symptoms are typically associated with multiple factors, including demographic characteristics. The sociodemographic characteristics of women living in rural areas differ from those residing in urban areas, and it has been suggested that these differences could potentially influence the prevalence of symptoms experienced during perimenopause. OBJECTIVES To evaluate if perimenopausal women living in Spanish rural areas have a higher prevalence of perimenopausal symptoms and assess their influence on health-related quality of life. METHODS A cross-sectional study was conducted in a sample of 270 perimenopausal women residing in rural and urban areas. The participants completed the Cervantes Scale Short Version and Beck Depression Inventory 2. RESULTS Perimenopausal women in rural areas reported a higher incidence of perimenopausal symptoms and a lower perception of health-related quality of life compared to those in urban areas, as evidenced by higher scores on the total Cervantes Scale Short Version scale (33.2 (±16.2) vs. 26.4 (±18.1), p = .001). No differences in the Beck Depression Inventory 2 score were detected. CONCLUSIONS Perimenopausal women residing in rural areas of Spain reported a higher prevalence of perimenopausal symptoms and experienced a poorer Health-Related Quality of Life compared to those living in urban areas of Spain.
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Mintziori G, Veneti S, Poppe K, Goulis DG, Armeni E, Erel CT, Fistonić I, Hillard T, Hirschberg AL, Meczekalski B, Mendoza N, Mueck AO, Simoncini T, Stute P, van Dijken D, Rees M, Duntas L, Lambrinoudaki I. EMAS position statement: Thyroid disease and menopause. Maturitas 2024; 185:107991. [PMID: 38658290 DOI: 10.1016/j.maturitas.2024.107991] [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] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Thyroid diseases are common in women in their late reproductive years; therefore, thyroid disease and menopause may co-exist. Both conditions may present with a wide range of symptoms, leading to diagnostic challenges and delayed diagnosis. Aim To construct the first European Menopause and Andropause Society (EMAS) statement on thyroid diseases and menopause. MATERIALS AND METHODS Literature review and consensus of expert opinion (EMAS executive board members/experts on menopause and thyroid disease). SUMMARY RECOMMENDATIONS This position paper highlights the diagnostic and therapeutic dilemmas in managing women with thyroid disease during the menopausal transition, aiming to increase healthcare professionals' awareness of thyroid disorders and menopause-related symptoms. Clinical decisions regarding the treatment of both conditions should be made with caution and attention to the specific characteristics of this age group while adopting a personalized patient approach. The latter must include the family history, involvement of the woman in the decision-making, and respect for her preferences, to achieve overall well-being.
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Affiliation(s)
- Gesthimani Mintziori
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
| | - Stavroula Veneti
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Kris Poppe
- University Hospital CHU St-Pierre UMC, Université libre de Bruxelles (ULB), Belgium
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Greece and Royal Free Hospital, London, United Kingdom
| | - C Tamer Erel
- Istanbul-Cerrahpaşa University, Cerrahpaşa School of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ivan Fistonić
- Faculty for Health Studies, University of Rijeka, Rijeka, Croatia
| | - Timothy Hillard
- Department of Obstetrics and Gynaecology, University Hospitals Dorset, Poole, UK
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Blazej Meczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Nicolás Mendoza
- Department of Obstetrics and Gynecology, University of Granada, Spain
| | - Alfred O Mueck
- Department of Women's Health, University Hospital Tuebingen, Germany; Beijing OB/GYN Hospital, Capital Medical University, China
| | - Tommaso Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy
| | - Petra Stute
- Department of Obstetrics and Gynecology, University Clinic Inselspital, Bern, Switzerland
| | - Dorenda van Dijken
- Department of Obstetrics and Gynecology, OLVG Hospital, Amsterdam, The Netherlands
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Leonidas Duntas
- Evgenideion Hospital, Unit of Endocrinology and Metabolism, National and Kapodistrian University, Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Greece
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Bonaccorsi G, Sciavicco G, Rinaudo L, Brigato A, Fiorella G, Carnevale A, Ulivieri FM, Messina C. Usefulness of DXA-based bone strain index in postmenopausal women with type 2 diabetes mellitus. Arch Osteoporos 2024; 19:54. [PMID: 38926167 DOI: 10.1007/s11657-024-01411-5] [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: 09/29/2023] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Bone Strain Index (BSI) is a new dual-energy x-ray absorptiometry (DXA)-based index. We retrospectively evaluated data from 153 postmenopausal women with a history of type 2 diabetes mellitus (T2DM). Lumbar spine and femoral Bone Strain Index (BSI) were sensitive to skeletal impairment in postmenopausal women suffering from T2DM. PURPOSE Bone Strain Index (BSI) is a new dual-energy X-ray absorptiometry (DXA)-based measurement. We evaluated the performance of BSI in predicting the presence of fragility fractures in type 2 diabetes mellitus (T2DM) postmenopausal women. METHODS We retrospectively evaluated data from a case-control study of 153 postmenopausal women with a history of at least 5 years of T2DM (age from 40 to 90 years). For each subject, we assessed the personal or familiar history of previous fragility fractures and menopause age, and we collected data about bone mineral density (BMD), BSI, and Trabecular Bone Score (TBS) measurements. Statistical analysis was performed having as outcome the history of fragility fractures. RESULTS Out of a total of 153 subjects, n = 22 (14.4%) presented at least one major fragility fracture. A negative correlation was found between lumbar BSI and lumbar BMD (r = - 0.49, p < 0.001) and between total femur BSI and total femur BMD (r = - 0.49, p < 0.001). A negative correlation was found between femoral neck BSI and femoral neck BMD (r = - 0.22, p < 0.001). Most DXA-based variables were individually able to discriminate between fractured and non-fractured subjects (p < 0.05), and lumbar BSI was the index with the most relative difference between the two populations, followed by femoral BSI. CONCLUSION Lumbar spine and femoral BSI are sensitive to skeletal impairment in postmenopausal women suffering from T2DM. The use of BSI in conjunction with BMD and TBS can improve fracture risk assessment.
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Affiliation(s)
- Gloria Bonaccorsi
- Department of Translational Medicine, Menopause and Osteoporosis Center, University of Ferrara, Ferrara, Italy
| | - Guido Sciavicco
- Department of Mathematics and Computer Science, University of Ferrara, Ferrara, Italy
| | - Luca Rinaudo
- Tecnologie Avanzate T.A. S.R.L, Lungo Dora Voghera 36/A, Turin, Italy
| | - Andrea Brigato
- Department of Mathematics and Computer Science, University of Ferrara, Ferrara, Italy
| | - Giuliana Fiorella
- Tecnologie Avanzate T.A. S.R.L, Lungo Dora Voghera 36/A, Turin, Italy
| | - Aldo Carnevale
- Department of Translational Medicine - Section of Radiology, University of Ferrara, Ferrara, Italy
| | | | - Carmelo Messina
- U.O.C. Radiodiagnostica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, 20122, Milan, Italy.
- Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Pascal, 36, Milan, Italy.
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Badenhorst CE. The Menstrual Health Manager (MHM): A Resource to Reduce Discrepancies Between Science and Practice in Sport and Exercise. Sports Med 2024:10.1007/s40279-024-02061-w. [PMID: 38904920 DOI: 10.1007/s40279-024-02061-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2024] [Indexed: 06/22/2024]
Abstract
Inadequate research on female health and performance; the complexity of the research; low menstrual health literacy of athletes, coaches, and support staff; and ethical and cultural sensitivities are all recognized as barriers to effective health monitoring for females in sports. Frameworks have been developed for academics to follow to help improve the quality of female-specific research. However, a similar resource that enables correct terminology, and use of health monitoring techniques has not been provided for sporting organizations, coaches, support staff or athletes. Therefore, this critical commentary presents a new resource, the Menstrual Health Manager. This resource may be used to determine the level of menstrual health monitoring detail that may be used by organisations, coaches or athletes, and specifies what reproductive health details the data will provide. This resource aims to provide organizations and coaches with a means of understanding the data that inform their decisions for female athletes. Utilization of this resource may aid in the consistent use of terminology and methods for female-specific health monitoring in both sports and research.
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Affiliation(s)
- Claire E Badenhorst
- School of Sport, Exercise and Nutrition, Massey University, Auckland, New Zealand.
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Amadou A, Giampiccolo C, Bibi Ngaleu F, Praud D, Coudon T, Grassot L, Faure E, Couvidat F, Frenoy P, Severi G, Romana Mancini F, Roy P, Fervers B. Multiple xenoestrogen air pollutants and breast cancer risk: Statistical approaches to investigate combined exposures effect. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 351:124043. [PMID: 38679129 DOI: 10.1016/j.envpol.2024.124043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 02/10/2024] [Accepted: 04/23/2024] [Indexed: 05/01/2024]
Abstract
Studies suggested that exposure to air pollutants, with endocrine disrupting (ED) properties, have a key role in breast cancer (BC) development. Although the population is exposed simultaneously to a mixture of multiple pollutants and ED pollutants may act via common biological mechanisms leading to synergic effects, epidemiological studies generally evaluate the effect of each pollutant separately. We aimed to assess the complex effect of exposure to a mixture of four xenoestrogen air pollutants (benzo-[a]-pyrene (BaP), cadmium, dioxin (2,3,7,8-Tétrachlorodibenzo-p-dioxin TCDD)), and polychlorinated biphenyl 153 (PCB153)) on the risk of BC, using three recent statistical methods, namely weighted quantile sum (WQS), quantile g-computation (QGC) and Bayesian kernel machine regression (BKMR). The study was conducted on 5222 cases and 5222 matched controls nested within the French prospective E3N cohort initiated in 1990. Annual average exposure estimates to the pollutants were assessed using a chemistry transport model, at the participants' residence address between 1990 and 2011. We found a positive association between the WQS index of the joint effect and the risk of overall BC (adjusted odds ratio (OR) = 1.10, 95% confidence intervals (CI): 1.03-1.19). Similar results were found for QGC (OR = 1.11, 95%CI: 1.03-1.19). Despite the association did not reach statistical significance in the BKMR model, we observed an increasing trend between the joint effect of the four pollutants and the risk of BC, when fixing other chemicals at their median concentrations. BaP, cadmium and PCB153 also showed positive trends in the multi-pollutant mixture, while dioxin showed a modest inverse trend. Despite we found a clear evidence of a positive association between the joint exposure to pollutants and BC risk only from WQS and QGC regression, we observed a similar suggestive trend using BKMR. This study makes a major contribution to the understanding of the joint effects of air pollution.
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Affiliation(s)
- Amina Amadou
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
| | - Camille Giampiccolo
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Fabiola Bibi Ngaleu
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France; Université Claude Bernard Lyon 1, Lyon, France
| | - Delphine Praud
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Thomas Coudon
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Lény Grassot
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France
| | - Elodie Faure
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Florian Couvidat
- National Institute for industrial Environment and Risks (INERIS), Verneuil-en-Halatte, France
| | - Pauline Frenoy
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France
| | - Gianluca Severi
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France; Department of Statistics, Computer Science and Applications (DISIA), University of Florence, Italy
| | - Francesca Romana Mancini
- Centre de Recherche en Epidémiologie et Santé des Populations (CESP, Inserm U1018), Facultés de Médecine, Université Paris-Saclay, UPS UVSQ, Gustave Roussy, Villejuif, France.
| | - Pascal Roy
- Université Claude Bernard Lyon 1, Lyon, France; Service de Biostatistique-Bioinformatique, Pole Sante Publique, Hospices Civils de Lyon, Lyon, France; Laboratoire de Biometrie Et Biologie Evolutive, CNRS UMR 5558, Villeurbanne, France
| | - Béatrice Fervers
- Department of Prevention Cancer Environment, Centre Léon Bérard, Lyon, France; Inserm U1296 Radiations: Défense, Santé, Environnement, Lyon, France.
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He X, Hou F, Shen X, Zhao D, Zhao X, Qi M, Li P. Individual and additive-effect relationships of menopausal symptoms and subjective cognitive decline among nurses during menopausal transition: a cross-sectional study. Menopause 2024:00042192-990000000-00336. [PMID: 38860940 DOI: 10.1097/gme.0000000000002368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE This study aimed to examine the individual and additive-effect relationships between menopausal symptoms and subjective cognitive decline among nurses during menopausal transition. METHODS Between February and September 2019, a convenience sampling strategy was used, involving 1,335 Chinese nurses undergoing menopausal transition. A general information survey that included the Subjective Cognitive Decline Scale and the Menopause Rating Scale was completed. Based on a cut-off point of the subjective cognitive decline score of 7.5, the overall sample was divided into mild and severe groups. Propensity score matching was performed to balance covariates of mild and severe subjective cognitive decline. The individual and cumulative effects of menopausal symptoms and subjective cognitive decline were analyzed using binary logistic regression and the Cochran-Armitage trend test, respectively. RESULTS After propensity score matching, none of the parameters showed significant differences between the groups. Logistic regression analysis revealed that four menopausal symptoms were closely associated with severe subjective cognitive decline. The Cochran-Armitage trend test indicated odds ratios linking the presence of these symptoms with increased severe subjective cognitive impairment. In addition, nurses simultaneously experiencing two or more core menopausal symptoms were over six times more likely to have severe subjective cognitive decline than nurses experiencing none or one core menopausal symptom during menopausal transition. CONCLUSIONS Individual and additive numbers of menopausal symptoms significantly influenced subjective cognitive decline in nurses during their menopausal transition. These findings suggest that interventions aimed at enhancing the cognitive performance of nurses experiencing menopause should consider menopausal symptoms.
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Affiliation(s)
- Xudong He
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Fangyan Hou
- Shandong Youth Political College, Jinan, Shandong, China
| | - Xiaona Shen
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Di Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Xiangyu Zhao
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Meiling Qi
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Ping Li
- From the School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
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Delgado Spicuzza JM, Gosalia J, Zhong L, Bondonno C, Petersen KS, De Souza MJ, Alipour E, Kim-Shapiro DB, Somani YB, Proctor DN. Seven-day dietary nitrate supplementation clinically significantly improves basal macrovascular function in postmenopausal women: a randomized, placebo-controlled, double-blind, crossover clinical trial. Front Nutr 2024; 11:1359671. [PMID: 38915856 PMCID: PMC11194363 DOI: 10.3389/fnut.2024.1359671] [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: 12/21/2023] [Accepted: 04/09/2024] [Indexed: 06/26/2024] Open
Abstract
Introduction Cardiovascular disease (CVD) is the leading cause of death in women, with increased risk following menopause. Dietary intake of beetroot juice and other plant-based nitrate-rich foods is a promising non-pharmacological strategy for increasing systemic nitric oxide and improving endothelial function in elderly populations. The purpose of this randomized, placebo-controlled, double-blind, crossover clinical trial was to determine the effects of short-term dietary nitrate (NO3 -) supplementation, in the form of beetroot juice, on resting macrovascular endothelial function and endothelial resistance to whole-arm ischemia-reperfusion (IR) injury in postmenopausal women at two distinct stages of menopause. Methods Early-postmenopausal [1-6 years following their final menstrual period (FMP), n = 12] and late-postmenopausal (6+ years FMP, n = 12) women consumed nitrate-rich (400 mg NO3 -/70 mL) and nitrate-depleted beetroot juice (approximately 40 mg NO3 -/70 mL, placebo) daily for 7 days. Brachial artery flow-mediated dilation (FMD) was measured pre-supplementation (Day 0), and approximately 24 h after the last beetroot juice (BR) dose (Day 8, post-7-day BR). Consequently, FMD was measured immediately post-IR injury and 15 min later (recovery). Results Results of the linear mixed-effects model revealed a significantly greater increase in resting FMD with 7 days of BRnitrate compared to BRplacebo (mean difference of 2.21, 95% CI [0.082, 4.34], p = 0.042); however, neither treatment blunted the decline in post-IR injury FMD in either postmenopausal group. Our results suggest that 7-day BRnitrate-mediated endothelial protection is lost within the 24-h period following the final dose of BRnitrate. Conclusion Our findings demonstrate that nitrate-mediated postmenopausal endothelial protection is dependent on the timing of supplementation in relation to IR injury and chronobiological variations in dietary nitrate metabolism. Clinical trial registration https://classic.clinicaltrials.gov/ct2/show/NCT03644472.
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Affiliation(s)
- Jocelyn M. Delgado Spicuzza
- Integrative Vascular Physiology Lab, Integrative and Biomedical Physiology, Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Jigar Gosalia
- Integrative Vascular Physiology Lab, Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Liezhou Zhong
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Catherine Bondonno
- Nutrition and Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, The University of Western Australia, Perth, WA, Australia
| | - Kristina S. Petersen
- Cardiometabolic Nutrition Research Lab, Department of Nutritional Sciences, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Mary Jane De Souza
- Integrative Vascular Physiology Lab, Integrative and Biomedical Physiology, Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, United States
- Women’s Health and Exercise Lab, Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Elmira Alipour
- Department of Physics, Wake Forest University, Winston-Salem, NC, United States
| | | | - Yasina B. Somani
- Faculty of Biological Sciences, Department of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - David N. Proctor
- Integrative Vascular Physiology Lab, Integrative and Biomedical Physiology, Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, United States
- Integrative Vascular Physiology Lab, Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
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Reeves AN, Lewis TT, Hood MM, Thurston RC, Avis NE, Burnett-Bowie SAM, Cortés YI, Neal-Perry G, Harlow SD. Does everyday discrimination account for the increased risk of vasomotor symptoms in Black women?: the Study of Women's Health Across the Nation (SWAN). Menopause 2024; 31:484-493. [PMID: 38595299 PMCID: PMC11126360 DOI: 10.1097/gme.0000000000002357] [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] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Vasomotor symptoms (VMS), including hot flashes and night sweats, are hallmark symptoms of the menopause transition. Previous research has documented greater frequency, duration, and severity of VMS in Black women compared with women from other racial/ethnic groups, even after accounting for other factors. This analysis examined the association between discrimination and VMS and the extent to which discrimination accounts for the disproportionate burden of VMS in Black women. METHODS Using available discrimination and VMS data from the SWAN cohort study (n = 2,377, 48% White, 32% Black, 6% Japanese, 4% Chinese, and 9% Hispanic women) followed approximately yearly in midlife from premenopause (42-52 y) through postmenopause (~20 y), we assessed concurrent associations between discrimination and VMS frequency in the past 2 weeks using weighted generalized mixed models. We also assessed associations between chronic discrimination across first four visits and VMS trajectories from premenopause to postmenopause using weighted multinomial logistic regression. Models were adjusted for known risk factors for VMS. RESULTS Higher levels of discrimination were associated with concurrent reporting of any (odds ratio [OR], 1.57 [1.31-1.89]) and frequent (≥6 d) VMS (OR, 1.55 [1.21-1.99]). After adjustment, associations remained significant for any (OR, 1.30 [1.09-1.54]) but not frequent VMS. For any VMS trajectories, chronic discrimination was associated with "continuously high" (OR, 1.69 [1.03-2.77]) and "high pre-FMP-decline post-FMP" (OR, 1.70 [1.01-2.88]) versus "FMP-onset low" trajectories. After adjusting for discrimination, odds of reporting any, frequent, and of being in the "continuously high" any VMS trajectory remained elevated for Black versus White women. CONCLUSIONS Discrimination is associated with greater concurrent risk of any (but not frequent) VMS, and chronic discrimination is associated with a continuously high reporting of any VMS over time, independent of known risk factors. Adjusting for discrimination attenuates but does not eliminate the increased risk of VMS for Black women.
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Affiliation(s)
- Alexis N Reeves
- Department of Epidemiology, School of Public Health, University of Michigan
- Epidemiology and Population Health, School of Medicine, Stanford University
| | - Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University
| | - Michelle M Hood
- Department of Epidemiology, School of Public Health, University of Michigan
| | - Rebecca C. Thurston
- Department of Psychiatry, University of Pittsburgh School of Medicine
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health
- Department of Psychology, University of Pittsburgh
| | - Nancy E. Avis
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
| | | | | | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina – Chapel Hill
| | - Siobán D. Harlow
- Department of Epidemiology, School of Public Health, University of Michigan
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Huang F, Fan Y, Tang R, Xie Z, Yang L, Ma X, Liang J, Chen R. Musculoskeletal pain among Chinese women during the menopausal transition: findings from a longitudinal cohort study. Pain 2024:00006396-990000000-00608. [PMID: 38787639 DOI: 10.1097/j.pain.0000000000003283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/28/2024] [Indexed: 05/26/2024]
Abstract
ABSTRACT The profiles of muscle and joint pain throughout the menopausal transition and the factors associated with these symptoms have not been determined. A total of 609 participants from a longitudinal cohort study conducted in an urban Chinese community were enrolled in this study. We assessed the prevalence of musculoskeletal symptoms at different menopausal stages and explored the factors associated with these symptoms. The prevalence and severity of muscle and joint pain increase as menopausal stages progress, and late menopausal transition may be a crucial timepoint that triggers the onset of musculoskeletal pain. The results of the multivariate analysis revealed that poor health status (OR = 2.245, 95% CI = 1.714-2.94, P < 0.001), body mass index (BMI) (OR = 1.046, 95% CI = 1.01-1.084, P = 0.011), the presence of anxiety (OR = 1.601, 95% CI = 1.211-2.117, P < 0.001), and depression (OR = 1.368, 95% CI = 1.143-1.639, P < 0.001) were independently associated with muscle and joint pain. In addition, the severity of musculoskeletal pain was related to poor health status (OR = 2.738, 95% CI = 1.91-3.924, P < 0.001) and depression (OR = 1.371, 95% CI = 1.095-1.718, P = 0.006). Musculoskeletal symptoms are frequent somatic symptoms experienced by Chinese middle-aged women. Women with poor health status, high BMI, anxiety, and depression were at heightened risk of experiencing musculoskeletal pain. The severity of pain increased over time.
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Affiliation(s)
- Feiling Huang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China
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Raczkiewicz D, Gujski M, Sarecka-Hujar B, Suski K, Pedrycz-Wieczorska A, Wdowiak A, Bojar I. Impact of Serum Vitamin D, B6, and B12 and Cognitive Functions on Quality of Life in Peri- and Postmenopausal Polish Women. Med Sci Monit 2024; 30:e943249. [PMID: 38769717 PMCID: PMC11127608 DOI: 10.12659/msm.943249] [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: 11/20/2023] [Accepted: 02/23/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Menopause initiates or accelerates health problems in a woman’s life, and affects cognitive processes and quality of life. We aimed to assess the quality of life, cognitive functions, and serum vitamin D, B6, and B12 concentrations in perimenopausal and postmenopausal Polish women. Also, we correlated the assessment of the quality of life with these vitamin concentrations and cognitive functions. MATERIAL AND METHODS The study was conducted in 287 perimenopausal and postmenopausal women. Serum levels of vitamin D, B6, and B12, cognitive functions using CNS Vital Signs software, and quality of life using WHO Quality of Life Brief were tested. RESULTS Almost all of the perimenopausal and postmenopausal women had normal concentrations of serum vitamin B12 (96%), 80% of them had normal B6 concentration, while only 9% had optimal serum vitamin D concentration. Postmenopausal women had lower Neurocognitive Index, psychomotor speed, motor speed, reaction time, and lower assessment of overall quality of life, physical health, and social relationships compared to perimenopausal women. In comparison to postmenopausal women, perimenopausal women had a lower serum vitamin B6 concentration, and the lower the concentration of this vitamin in serum they had, the lower they assessed their environment. Perimenopausal women assessed their social relationships the better, the better the visual memory, and the lower the processing speed they had. Postmenopausal women assessed the environment the better, the higher their Neurocognition Index was, and the better the reaction time they had. CONCLUSIONS Assessment of quality of life was associated with some cognitive functions in both perimenopausal and postmenopausal women.
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Affiliation(s)
- Dorota Raczkiewicz
- Department of Medical Statistics, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Suski
- Department of Medical Statistics, School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
| | | | - Artur Wdowiak
- Chair of Obstetrics and Gynecology, Faculty of Health Sciences, Medical University of Lublin, Poland
| | - Iwona Bojar
- Department of Women’s Health, Institute of Rural Health in Lublin, Lublin, Poland
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11
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Baudin J, Hernandez-Baixauli J, Quesada-Vázquez S, Mulero F, Puiggròs F, Arola L, Caimari A. Combined supplementation with hesperidin, phytosterols and curcumin decreases adiposity and improves metabolic health in ovariectomized rats. Food Funct 2024; 15:4905-4924. [PMID: 38598180 DOI: 10.1039/d3fo05122f] [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: 04/11/2024]
Abstract
In recent years many women have looked for alternative therapies to address menopause. Hesperidin, phytosterols and curcumin are bioactive compounds that can ameliorate some cardiovascular risk factors associated with menopause, although there are no data concerning the effects of their combined supplementation. We used ovariectomized (OVX) rats, a postmenopausal model with oestrogen deficiency, to evaluate whether supplementation with a multi-ingredient (MI) including hesperidin, phytosterols and curcumin for 57 days would display beneficial effects against fat mass accretion and metabolic disturbances associated with menopause. Twenty OVX rats were orally supplemented with either MI (OVX-MI) or vehicle (OVX). Furthermore, 10 OVX rats orally received the vehicle along with subcutaneous injections of 17β-oestradiol biweekly (OVX-E2), whereas 10 rats were sham operated and received oral and injected vehicles (control group; SH). MI supplementation partly counteracted the fat mass accretion observed in OVX animals, which was evidenced by decreased total fat mass, adiposity index, the weight of retroperitoneal, inguinal and mesenteric white adipose tissue (MWAT) depots and MWAT adipocyte hypertrophy. These effects were accompanied by a significant decrease in the circulating levels of leptin and the mRNA levels of the fatty acid uptake-related genes Lpl and Cd36 in MWAT. These results were very similar to those observed in OVX-E2 animals. OVX-MI rats also displayed a higher lean body mass, lean/fat mass ratio, adiponectin-to-leptin ratio and insulin sensitivity than their OVX counterparts. Our findings can pave the way for using this MI formulation as an alternative therapy to manage obesity and to improve the cardiometabolic health of menopausal women.
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Affiliation(s)
- Julio Baudin
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, 43204 Reus, Spain
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, 43007 Tarragona, Spain.
| | - Julia Hernandez-Baixauli
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, 43204 Reus, Spain
| | - Sergio Quesada-Vázquez
- Eurecat, Centre Tecnològic de Catalunya, Technological Unit of Nutrition and Health, 43204 Reus, Spain
| | - Francisca Mulero
- Molecular Imaging Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Francesc Puiggròs
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, 43204 Reus, Spain.
| | - Lluís Arola
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, 43007 Tarragona, Spain.
| | - Antoni Caimari
- Eurecat, Centre Tecnològic de Catalunya, Biotechnology Area, 43204 Reus, Spain.
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12
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Coslov N, Richardson MK, Woods NF. "Not feeling like myself" in perimenopause - what does it mean? Observations from the Women Living Better survey. Menopause 2024; 31:390-398. [PMID: 38531011 DOI: 10.1097/gme.0000000000002339] [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: 03/28/2024]
Abstract
OBJECTIVE This study aimed to understand the meaning of the phrase "not feeling like myself" (NFLM) when used by those on the path to menopause by exploring the relationship of symptoms reported to ratings of NFLM. METHODS Participants responded to the item "Many women report just not feeling like themselves during this phase of life. How often was this true for you over the past 3 months?" choosing from "none of the time" to "all of the time." They rated bother associated with 61 symptoms and provided demographic information. Individual symptoms and the symptom bother scale scores were correlated with NFLM. Symptom scale scores were then entered in a two-stage multiple regression model to identify symptoms associated significantly with NFLM. RESULTS Sixty-three percent (63.3%) of participants reported NFLM 50% of the time or more over the previous 3 months. Individual symptom ratings correlated with NFLM ( r > 0.300) included the following: fatigue ( r = 0.491); feeling overwhelmed/less able to cope ( r = 0.463); low feelings ( r = 0.440); anxiety, more nervousness ( r = 0.398); being irritable ( r = 0.380); harder time concentrating ( r = 0.378); difficulty making decisions ( r = 0.357); feeling like "I can't calm down on the inside" ( r = 0.333); being more forgetful ( r = 0.332); tearfulness/crying ( r = 0.306); and worrying more ( r = 0.302). A two-stage regression analysis revealed less education completed and greater overall stress ratings as significant predictors in stage 1. In stage 2, five symptom groups met the P < 0.001 criterion: anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. CONCLUSIONS NFLM was associated with anxiety/vigilance, fatigue/pain, brain fog, sexual symptoms, and volatile mood symptoms. Recognizing symptoms associated with NFLM may allow for more accurate expectations and improve perimenopause care.
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Affiliation(s)
| | | | - Nancy Fugate Woods
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA
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13
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Pan A, Crowder KD, Cedars MI, Bleil ME. Association between neighborhood poverty and ovarian reserve: the ovarian aging study. Menopause 2024; 31:372-380. [PMID: 38442312 PMCID: PMC11052688 DOI: 10.1097/gme.0000000000002331] [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] [Indexed: 03/07/2024]
Abstract
OBJECTIVE This study aimed to examine the association between neighborhood poverty and ovarian reserve. METHODS Among 1,019 healthy premenopausal women in the Ovarian Aging Study, aggregate exposure to neighborhood poverty was examined in relation to biomarkers of ovarian reserve, antimüllerian hormone (AMH) and antral follicle count (AFC). Specifically, the interaction of age-x-neighborhood poverty was assessed cross-sectionally to determine whether AMH and AFC declines across women may be greater in women exposed to more neighborhood poverty. Neighborhood poverty was assessed by geocoding and linking women's residential addresses in adulthood to US Census data. RESULTS Independent of covariates, a significant interaction term showed the association between age and AMH varied by degree of exposure to neighborhood poverty in adulthood ( b = -0.001, P < 0.05). AMH declines increased progressively across women exposed to low, medium, and high levels of neighborhood poverty. In addition, main effects showed that higher neighborhood poverty was related to higher AMH in the younger women only ( b = 0.022, P < 0.01). Results related to AFC were all nonsignificant ( P > 0.05). CONCLUSIONS Across women, greater aggregate exposure to neighborhood poverty in adulthood was related to lower ovarian reserve, indexed by AMH. In addition, there was a positive association between neighborhood poverty and AMH in younger women that attenuated in the older women. Together, results suggest that neighborhood disadvantage may have detrimental impacts that manifest as initially higher AMH, resulting in greater ovarian follicle loss over time. However, it remains unclear whether these results examining differences across women may replicate when AMH declines by neighborhood poverty are examined longitudinally.
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Affiliation(s)
- Anwesha Pan
- Department of Anthropology, University of Washington, Seattle, WA 98195 USA
| | - Kyle D. Crowder
- Department of Sociology, University of Washington, Seattle, WA 98195, USA
| | - Marcelle I. Cedars
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California San Francisco, San Francisco, CA 94143, USA
| | - Maria E. Bleil
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, WA 98195 USA
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14
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Di Giuseppe J, Delli Carpini G, Giannella L, Terenzi T, Fichera M, Ragno F, Campanati A, Boero V, Caia C, Pesce E, Vercellini P, Gardella B, Dominoni M, Spinillo A, Sopracordevole F, Clemente N, Del Fabro A, Rossi R, Corazza M, Borghi A, Martinello R, Greco P, Rizzo G, Criscuolo AA, Mappa I, Matteini E, Botti E, Campione E, Bianchi L, Ciavattini A. A Longitudinal Multiinstitutional Study of Vulvar Lichen Sclerosus: From Childhood to Perimenopause. J Low Genit Tract Dis 2024:00128360-990000000-00110. [PMID: 38661348 DOI: 10.1097/lgt.0000000000000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The main outcome of this study was the evaluation of clinical characteristics, comorbidities, and therapeutic approaches in patients with vulvar lichen sclerosus (VLS) aged from childhood to perimenopause. Secondly, it was intended to compare these characteristics according to the menarchal status. METHODS Patients less than 45 years of age with a diagnosis of VLS from January 2002 to June 2022 in 10 referral centers were included in this retrospective longitudinal study. The univariate analysis compared the dependent variables according to menarchal status. RESULTS One hundred eighty-six patients met the inclusion criteria. At diagnosis, between 25% and 40% of premenarchal patients reported signs related to subepithelial hemorrhage. A significantly greater presence of bleeding (p < .005), easy bruising (p = .028), fissures (p = .008), petechiae/splinter hemorrhages (p < .001), and bleeding/blistering or open sores (p = .011) was observed in premenarchal patients with respect to the postmenarchal group. The perineum (p = .013) and the perianal region (p < .001) were significantly more involved in the premenarchal group. Topical calcineurin inhibitors were more used in the premenarchal population (p = .004), whereas vitamin E oil and moisturizers were more used in the postmenarchal population (p = .047). CONCLUSIONS Vulvar lichen sclerosus is a chronic condition that can cause vulvar changes that result in severe morbidity and affects sexual function and quality of life, even before menopause. Vulvar lichen sclerosus continues to be misdiagnosed in this population. This may lead to an average delay from symptom onset to diagnosis. Evaluating clinical manifestations of VLS in premenarchal and postmenarchal age allowed us to find different clinical characteristics between the 2 periods suggestive of the diagnosis.
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Affiliation(s)
- Jacopo Di Giuseppe
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Giovanni Delli Carpini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Giannella
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Tomas Terenzi
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Mariasole Fichera
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Federica Ragno
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Anna Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Veronica Boero
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlotta Caia
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Pesce
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Vercellini
- Academic Center for Research on Adenomyosis and Endometriosis, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Arsenio Spinillo
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Francesco Sopracordevole
- Gynecological Oncology Unit, IRCCS CRO - Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Nicolò Clemente
- Gynecological Oncology Unit, IRCCS CRO - Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Anna Del Fabro
- Gynecological Oncology Unit, IRCCS CRO - Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Riccardo Rossi
- Preventive Gynecological Oncology Section, European Medical Center, Florence, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ruby Martinello
- Obstetrics and Gynaecology Clinic, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pantaleo Greco
- Obstetrics and Gynaecology Clinic, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome Italy
| | - Anna Angela Criscuolo
- Department of Obstetrics and Gynecology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome Italy
| | - Ilenia Mappa
- Department of Obstetrics and Gynecology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome Italy
| | - Enrico Matteini
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Elisabetta Botti
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Elena Campione
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Luca Bianchi
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Andrea Ciavattini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
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15
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Memi E, Pavli P, Papagianni M, Vrachnis N, Mastorakos G. Diagnostic and therapeutic use of oral micronized progesterone in endocrinology. Rev Endocr Metab Disord 2024:10.1007/s11154-024-09882-0. [PMID: 38652231 DOI: 10.1007/s11154-024-09882-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [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.
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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.
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Abelman RA, Schneider MF, Cox C, Messerlian G, Cohen M, Gustafson D, Plankey M, Sharma A, Price J, Grunfeld C, Tien PC. Association of Androgen Hormones, Sex Hormone-Binding Globulin, and the Menopausal Transition With Incident Diabetes Mellitus in Women With and Without HIV. J Acquir Immune Defic Syndr 2024; 95:486-493. [PMID: 38180885 PMCID: PMC10947917 DOI: 10.1097/qai.0000000000003380] [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: 08/24/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND HIV is associated with alterations in androgen hormone levels and sex hormone-binding globulin (SHBG) in women. Higher SHBG has been associated with a lower risk of diabetes in the general population, but the contribution of HIV, androgen hormones, SHBG, and menopausal phase to diabetes is unclear. METHODS From April 2003 through February 2020, 896 women with HIV (WWH) and 343 women without HIV (WWOH) from the Women's Interagency HIV Study with morning total testosterone, dehydroepiandrosterone sulfate (DHEAS), and SHBG levels were followed to assess for incident diabetes. Parametric regression models were used with age as the time scale and relative times (RT) as the measure of association of hormone level and menopausal phase with incident diabetes. Analyses incorporated time-dependent androgen hormone, SHBG levels, and menopausal phase and were adjusted for race/ethnicity, enrollment year, smoking status, BMI, hepatitis C virus status, and HIV-related factors. RESULTS In total, 128 (14%) WWH and 47 (14%) WWOH developed diabetes. In WWH, a doubling of SHBG and DHEAS were associated with a 7% (RT = 1.07 [95% CI: 0.82 to 1.40] and 15% (RT = 1.15 [95% CI: 0.95 to 1.39]) longer time to diabetes, respectively; in WWOH, a doubling of SHBG and DHEAS were associated with 84% (RT = 1.84 [95% CI: 0.89 to 3.82]) and 41% (RT= 1.41 [95% CI: 0.82 to 2.44]) longer times to diabetes. Total testosterone was not associated. In WWH, later menopausal phase was associated with shorter times to diabetes. CONCLUSIONS Despite alterations in androgen hormone and SHBG levels in HIV, regardless of HIV status, higher SHBG and DHEAS were associated with nonstatistically significant slower progression to diabetes. The menopausal transition may be a better hormonal indicator of diabetes risk in WWH.
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Affiliation(s)
- Rebecca A Abelman
- Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Michael F Schneider
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christopher Cox
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Geralyn Messerlian
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI
| | - Mardge Cohen
- Department of Medicine, Stroger Hospital, Cook County Health, Chicago, IL
| | - Deborah Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, NY
| | - Michael Plankey
- Department of Medicine, Georgetown University Medical Center, Washington, DC
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY; and
| | - Jennifer Price
- Department of Medicine, University of California San Francisco, San Francisco, CA
| | - Carl Grunfeld
- Department of Medicine, University of California San Francisco, San Francisco, CA
- Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA
| | - Phyllis C Tien
- Department of Medicine, University of California San Francisco, San Francisco, CA
- Medical Service, Department of Veteran Affairs Medical Center, San Francisco, CA
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17
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Wang Y, Miao X, Viwattanakulvanid P. Effects of a therapeutic lifestyle modification intervention on cardiometabolic health, sexual functioning and health-related quality of life in perimenopausal Chinese women: protocol for a randomised controlled trial. BMJ Open 2024; 14:e082944. [PMID: 38626978 PMCID: PMC11029459 DOI: 10.1136/bmjopen-2023-082944] [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] [Received: 12/07/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Perimenopause is a critical transitional period in reproductive ageing. A set of physiological and psychological changes can affect perimenopausal women's quality of life and further threaten their older adult health conditions. In China, less than one-third of midlife women with menopausal symptoms have actively sought professional healthcare. Regarding the public health significance of comprehensive menopause management, the current study aims to investigate the effects of a therapeutic lifestyle modification (TLM) intervention on cardiometabolic health, sexual functioning and health-related quality of life among perimenopausal Chinese women. METHOD AND ANALYSIS A randomised controlled trial with two parallel arms will be conducted at the gynaecology outpatient department of Yunnan Provincial Hospital of Traditional Chinese Medicine in China. 94 eligible perimenopausal women aged between 40 and 55 years will be recruited for the study. The TLM intervention consists of four elements: menopause-related health education, dietary guidance, pelvic floor muscle training and Bafa Wubu Tai Chi exercise. Participants will be randomly assigned (1:1) to receive either the 12-week TLM intervention or routine care via stratified blocked randomisation. The primary outcome is quality of life; secondary outcomes of interest include sexual functioning and cardiometabolic health. The outcome measures will be assessed at baseline and post-intervention. To explore the effects of the intervention, linear mixed models will be applied to test the changes between the two groups over time in each outcome based on an intention-to-treat analysis. ETHICS AND DISSEMINATION The Research Ethics Review Committee of Chulalongkorn University (COA No 178/66) and the Medical Ethics Committee of Yunnan Provincial Hospital of Traditional Chinese Medicine (IRB-AF-027-2022/02-02) approved the study protocol. Written informed consent will be obtained from all participants. Results will be published in peer-reviewed journals and disseminated through conferences. TRIAL REGISTRATION NUMBER ChiCTR2300070648.
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Affiliation(s)
- Yuru Wang
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Xiaoling Miao
- Yunnan University of Chinese Medicine, Kunming, People's Republic of China
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18
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Barth C, Galea LA, Jacobs EG, Lee BH, Westlye LT, de Lange AMG. Menopausal hormone therapy and the female brain: leveraging neuroimaging and prescription registry data from the UK Biobank cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.08.24305450. [PMID: 38645009 PMCID: PMC11030497 DOI: 10.1101/2024.04.08.24305450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Background and Objectives Menopausal hormone therapy (MHT) is generally thought to be neuroprotective, yet results have been inconsistent. Here, we present a comprehensive study of MHT use and brain characteristics in middle- to older aged females from the UK Biobank, assessing detailed MHT data, APOE ε4 genotype, and tissue-specific gray (GM) and white matter (WM) brain age gap (BAG), as well as hippocampal and white matter hyperintensity (WMH) volumes. Methods A total of 19,846 females with magnetic resonance imaging data were included (current-users = 1,153, 60.1 ± 6.8 years; past-users = 6,681, 67.5 ± 6.2 years; never-users = 12,012, mean age 61.6 ± 7.1 years). For a sub-sample (n = 538), MHT prescription data was extracted from primary care records. Brain measures were derived from T1-, T2- and diffusion-weighted images. We fitted regression models to test for associations between the brain measures and MHT variables including user status, age at initiation, dosage and duration, formulation, route of administration, and type (i.e., bioidentical vs synthetic), as well as active ingredient (e.g., estradiol hemihydrate). We further tested for differences in brain measures among MHT users with and without a history of hysterectomy ± bilateral oophorectomy and examined associations by APOE ε4 status. Results We found significantly higher GM and WM BAG (i.e., older brain age relative to chronological age) as well as smaller left and right hippocampus volumes in current MHT users, not past users, compared to never-users. Effects were modest, with the largest effect size indicating a group difference of 0.77 years (~9 months) for GM BAG. Among MHT users, we found no significant associations between age at MHT initiation and brain measures. Longer duration of use and older age at last use post menopause was associated with higher GM and WM BAG, larger WMH volume, and smaller left and right hippocampal volumes. MHT users with a history of hysterectomy ± bilateral oophorectomy showed lower GM BAG relative to MHT users without such history. Although we found smaller hippocampus volumes in carriers of two APOE ε4 alleles compared to non-carriers, we found no interactions with MHT variables. In the sub-sample with prescription data, we found no significant associations between detailed MHT variables and brain measures after adjusting for multiple comparisons. Discussion Our results indicate that population-level associations between MHT use, and female brain health might vary depending on duration of use and past surgical history. Future research is crucial to establish causality, dissect interactions between menopause-related neurological changes and MHT use, and determine individual-level implications to advance precision medicine in female health care.
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Affiliation(s)
- Claudia Barth
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Liisa A.M. Galea
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emily G. Jacobs
- Psychological and Brain Sciences, University of California Santa Barbara, CA, USA
| | - Bonnie H. Lee
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lars T. Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- Centre for Precision Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ann-Marie G. de Lange
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
- Department of Psychiatry, University of Oxford, Oxford, UK
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Hemachandra C, Taylor S, Islam RM, Fooladi E, Davis SR. A systematic review and critical appraisal of menopause guidelines. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:122-138. [PMID: 38336466 DOI: 10.1136/bmjsrh-2023-202099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE AND RATIONALE To identify and appraise current national and international clinical menopause guidance documents, and to extract and compare the recommendations of the most robust examples. DESIGN Systematic review. DATA SOURCES Ovid MEDLINE, EMBASE, PsycINFO and Web of Science ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Practice guidance documents for menopause published from 2015 until 20 July 2023. Quality was assessed by the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument. RESULTS Twenty-six guidance papers were identified. Of these, five clinical practice guidelines (CPGs) and one non-hormonal therapy position statement met AGREE II criteria of being at least of moderate quality. The five CPGs listed symptoms associated with the perimenopause and menopause to be vasomotor symptoms (VMS), disturbed sleep, musculoskeletal pain, decreased sexual function or desire, and mood disturbance (low mood, mood changes or depressive symptoms). Acknowledged potential long-term menopause consequences were urogenital atrophy, and increased risks of cardiovascular disease and osteoporosis. VMS and menopause-associated mood disturbance were the only consistent indications for systemic menopausal hormone therapy (MHT). Some CPGs supported MHT to prevent or treat osteoporosis, but specific guidance was lacking. None recommended MHT for cognitive symptoms or prevention of other chronic disease. Perimenopause-specific recommendations were scant. A neurokinin 3B antagonist, selective serotonin/norepinephrine (noradrenaline) reuptake inhibitors and gabapentin were recommended non-hormonal medications for VMS, and cognitive behavioural therapy and hypnosis were consistently considered as being of potential benefit. DISCUSSION The highest quality CPGs consistently recommended MHT for VMS and menopause-associated mood disturbance, whereas clinical depression or cognitive symptoms, and cardiometabolic disease and dementia prevention were not treatment indications. Further research is needed to inform clinical recommendations for symptomatic perimenopausal women.
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Affiliation(s)
- Chandima Hemachandra
- Women's Health Research Program, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Sasha Taylor
- Women's Health Research Program, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Rakibul M Islam
- Women's Health Research Program, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Ensieh Fooladi
- Monash School of Nursing and Midwifery, Clayton, Victoria, Australia
| | - Susan R Davis
- Women's Health Research Program, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
- Endocrinology and Diabetes, Alfred Health, Melbourne, Victoria, Australia
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20
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Kim SM, Ko Y, Kim DS, Kim NY, Hwang HC, Han DH. Effects of sports therapy on improvement of menopausal symptoms, psychological status, and body morphology in perimenopausal women. Menopause 2024; 31:326-335. [PMID: 38442307 DOI: 10.1097/gme.0000000000002329] [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: 03/07/2024]
Abstract
OBJECTIVE The aim of this study was to increase the treatment rate of perimenopausal women by providing evidence-based nonpharmaceutical treatments through developing scientific evidence-based sports therapy and verifying its effectiveness. METHODS In a cross-over design, a total of 33 women were assigned to two different sequences of intervention: sports therapy and telephone intervention (n = 17) or telephone intervention and sports therapy (n = 16). A self-reported clinical symptom survey was conducted before and after the experimental and control periods using the following measures: the Menopause Rating Scale, Patient Health Questionnaire 9, and Patient Health Questionnaire 15. RESULTS There were significant differences in the changes in the scores for Menopause Rating Scale total (exercise phase, 17.8 ± 5.5 at baseline [B] and 13.5 ± 4.2 at follow-up [F]; control phase, 15.9 ± 6.0 [B] and 15.4 ± 5.3 [F]; P < 0.01), somatic symptoms (exercise phase, 9.5 ± 2.6 [B] and 6.6 ± 2.0 [F]; control phase, 8.5 ± 2.8 [B] and 8.0 ± 1.3 [F], P < 0.01), and urogenital symptoms (exercise phase, 4.9 ± 1.7 [B] and 4.1 ± 1.4 [F]; control phase, 4.3 ± 1.6 [B] and 4.4 ± 1.5 [F]; P < 0.01) between the exercise and control phases. There were also significant differences in the changes in the scores for PHQ-9 (exercise phase, 4.6 ± 4.4 [B] and 3.6 ± 3.3 [F]; control phase, 4.5 ± 3.8 [B] and 5.5 ± 4.6 [F]; P = 0.008) and PHQ-15 (exercise phase, 7.2 ± 4.4 [B] and 5.5 ± 3.5 [F]; control phase, 6.8 ± 4.4 [B] and 7.2 ± 4.9 [F]; P = 0.009) between the two phases. CONCLUSIONS Sports therapy would improve menopause symptoms, especially somatic and urogenital symptoms. In addition, sports therapy would improve depressive moods in perimenopausal women.
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Affiliation(s)
- Sun Mi Kim
- From the Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Republic of Korea
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Elavsky S, Burda M, Cipryan L, Kutáč P, Bužga M, Jandackova V, Chow SM, Jandacka D. Physical activity and menopausal symptoms: evaluating the contribution of obesity, fitness, and ambient air pollution status. Menopause 2024; 31:310-319. [PMID: 38377450 PMCID: PMC10959689 DOI: 10.1097/gme.0000000000002319] [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] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The menopausal transition is accompanied by transient symptoms that have been linked to subclinical cardiovascular disease (CVD); CVD has also been linked to air pollution. Physical activity (PA) reduces CVD, improves body composition, and can reduce menopausal symptoms. The purpose of this study was to assess the links between PA and menopausal symptoms and whether obesity, fitness, and air pollution status play a role in this relationship. METHODS Women (40-60 y; N = 243; mean [SD] age, 47.8 [5.6] y) from areas with high versus low air pollution enrolled in the Healthy Aging in Industrial Environment Program 4 prospective cohort study completed psychological, cardiorespiratory fitness, body composition, and menopausal status screening followed by a 14-day prospective assessment of menopausal symptoms (Menopause Rating Scale) using a mobile application. Daily PA was assessed objectively across 14 days via Fitbit Charge 3 monitor. General linear mixed models were conducted and controlled for age, menopausal status, day in the study, wear time, and neuroticism. RESULTS Peri/postmenopausal women ( β = 0.43, P < 0.001) and those residing in a high-air-pollution environment ( β = 0.45, P < 0.05) reported more somatovegetative symptoms. Hot flashes alone were associated with peri/postmenopausal status ( β = 0.45, P < 0.001), and for women residing in a high-air-pollution environment, lower reporting of hot flashes was observed on days when a woman was more physically active than usual ( β = -0.15, P < 0.001). No associations were found for cardiorespiratory fitness and visceral fat with any of the symptoms. CONCLUSIONS PA may enhance resilience to hot flashes, especially when residing in high-air-pollution environments where we also observed higher reporting of somatovegetative menopausal symptoms.
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Affiliation(s)
- Steriani Elavsky
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Michal Burda
- Institute for Research and Applications of Fuzzy Modeling, University of Ostrava, Czech Republic IT4Innovations
| | - Lukáš Cipryan
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Petr Kutáč
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
| | - Marek Bužga
- Department of Physiology and Pathophysiology, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Vera Jandackova
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
- Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Sy-Miin Chow
- Department of Human Development and Family Studies, College of Health and Human Development, Penn State University, USA
| | - Daniel Jandacka
- Department of Human Movement Studies, Faculty of Education, University of Ostrava, Czech Republic
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22
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Zhang Z, Hu Y, Cui X, Lu M, Zhang M, Li C. Menopausal age and cardiovascular disease risk in American women: evidence from the National Health and Nutrition Examination Survey. Climacteric 2024; 27:159-164. [PMID: 37921228 DOI: 10.1080/13697137.2023.2273526] [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: 07/03/2023] [Accepted: 10/10/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Cardiovascular disease (CVD) is a significant contributor to the deaths of females, and premature menopause adds to the risk of CVD in females. Therefore, our study aimed to investigate the age of menopause and CVD incidence in American females using data from the National Health and Nutrition Examination Survey (NHANES). METHOD We analyzed data from 6347 females to investigate the association between menopausal age and the risk of CVD using multivariate logistic regression analysis. RESULTS The study found that a later menopausal age reduces the risk of developing CVD (odds ratio [OR] = 0.74, 95% confidence interval [CI] = 0.63 - 0.88, p < 0.001). Moreover, females with early-onset CVD had an increased risk of premature menopause before the age of 40 years (OR = 2.44, 95% CI = 1.60 - 3.72, p < 0.001). CONCLUSION Menopausal age is associated with the risk of developing CVD in American females. Specifically, if menopause occurs earlier, there is an increased risk of CVD. Additionally, early-onset CVD significantly raises the risk of premature menopause, which in turn has important implications for female reproductive health.
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Affiliation(s)
- Z Zhang
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Y Hu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - X Cui
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - M Lu
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - M Zhang
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - C Li
- Innovation Research Institute of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
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Esperança TD, Stringhetta-Villar BP, Cavalcante DP, Douradinho LG, Fiais GA, Pereira R, Chaves-Neto AH, Lima FB, Dornelles RCM. Analysis of the cognitive and functional behavior of female rats in the periestropause after hormone therapy with estrogen. Behav Brain Res 2024; 462:114866. [PMID: 38232785 DOI: 10.1016/j.bbr.2024.114866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 01/11/2024] [Accepted: 01/11/2024] [Indexed: 01/19/2024]
Abstract
Perimenopause is a critical period, with severe cycle irregularity and lower estrogen secretion altering redox state biomarkers, leading to behavioral changes. The estrogen hormonal therapy (EHT) being commonly used to alleviate climacteric effects. Therefore, the aim of this study was to analyze anxiolytic profile, recognition memory (short and long term), ambulation, redox status, cell synaptic activity in locus coeruleus and hippocampus of Wistar rats in the periestropause after EHT. Forty rats participated in the study; 20 were treated with corn oil (group 21Mo/Veh; corn oil/0.2 mL/sc; 2x/week) and 20 were submitted to EHT (group 21Mo/E2; 17β-estradiol/15 μg/Kg/sc; 2x/week) for 120 days. Open field, elevated plus maze, object recognition (RO), and footprint tests were performed immediately before and at the end of the treatment period. From the decapitated brains, isolated hippocampus were destined for biochemical analysis, in turn, perfused brains were destined for histological analysis. The 21Mo/E2 group had a significantly greater total time in the central region and a significantly greater number of entries into the open arms compared to the 21Mo/Veh group, as in crossing, rearing and grooming behaviors, evidencing an anxiolytic profile. In the RO test, the 21Mo/Veh group decreased long-term memory, and the 21Mo/E2 group maintained the same index as at 17 months of age, in addition to a better balance of the hippocampal redox state, prevention of neuronal cell loss and better gait. Based on the results, it appears that exogenous E2 supplementation during periestropause may help preserve neurological functions and potentially prevent neuropsychological and neurodegenerative disorders.
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Affiliation(s)
- Thainá Daguane Esperança
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil; Aging Biology Research Group, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Beatriz Procópio Stringhetta-Villar
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil; Aging Biology Research Group, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Débora Prazias Cavalcante
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil; Aging Biology Research Group, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Luana Galante Douradinho
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil; Aging Biology Research Group, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Gabriela Alice Fiais
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil
| | - Rafael Pereira
- Integrative Physiology Research Center, Department of Biological Sciences, Universidade Estadual do Sudoeste da Bahia (UESB), Jequie 45210-506, Bahia, Brazil
| | - Antonio Hernandes Chaves-Neto
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil; Aging Biology Research Group, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | - Rita Cássia Menegati Dornelles
- Multicentric Graduate Program in Physiological Sciences- SBFis/UNESP, São Paulo State University, Araçatuba, São Paulo, Brazil; Aging Biology Research Group, Department of Basic Sciences, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil.
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24
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Liu H, Wu Y, Zhu H, Wang P, Chen T, Xia A, Zhao Z, He D, Chen X, Xu J, Ji L. Association between napping and type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1294638. [PMID: 38590820 PMCID: PMC10999583 DOI: 10.3389/fendo.2024.1294638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
As the incidence of type 2 diabetes mellitus (T2DM) is increasing rapidly and its consequences are severe, effective intervention and prevention, including sleep-related interventions, are urgently needed. As a component of sleep architecture, naps, alone or in combination with nocturnal sleep, may influence the onset and progression of T2DM. Overall, napping is associated with an increased risk of T2DM in women, especially in postmenopausal White women. Our study showed that napping >30 minutes (min) increased the risk of T2DM by 8-21%. In addition, non-optimal nighttime sleep increases T2DM risk, and this effect combines with the effect of napping. For nondiabetic patients, napping >30 min could increase the risks of high HbA1c levels and impaired fasting glucose (IFG), which would increase the risk of developing T2DM later on. For diabetic patients, prolonged napping may further impair glycemic control and increase the risk of developing diabetic complications (e.g., diabetic nephropathy) in the distant future. The following three mechanisms are suggested as interpretations for the association between napping and T2DM. First, napping >30 min increases the levels of important inflammatory factors, including interleukin 6 and C-reactive protein, elevating the risks of inflammation, associated adiposity and T2DM. Second, the interaction between postmenopausal hormonal changes and napping further increases insulin resistance. Third, prolonged napping may also affect melatonin secretion by interfering with nighttime sleep, leading to circadian rhythm disruption and further increasing the risk of T2DM. This review summarizes the existing evidence on the effect of napping on T2DM and provides detailed information for future T2DM intervention and prevention strategies that address napping.
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Affiliation(s)
- Hongyi Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Yingxin Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Hui Zhu
- Department of Internal Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Penghao Wang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Tao Chen
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Anyu Xia
- Department of Clinical Medicine, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Zhijia Zhao
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
| | - Da He
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, China
| | - Xiang Chen
- Department of Obstetrics and Gynecology, Yinzhou District Maternal and Child Health Care Institute, Ningbo, Zhejiang, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, Health Science Center, Ningbo University, Ningbo, China
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Health Science Center, Ningbo University, Ningbo, Zhejiang, China
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25
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Brown L, Hunter MS, Chen R, Crandall CJ, Gordon JL, Mishra GD, Rother V, Joffe H, Hickey M. Promoting good mental health over the menopause transition. Lancet 2024; 403:969-983. [PMID: 38458216 DOI: 10.1016/s0140-6736(23)02801-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/01/2023] [Accepted: 12/11/2023] [Indexed: 03/10/2024]
Abstract
The potential risk for mental health conditions over the menopause transition shapes women's expectations and informs putative physiological mechanisms regulating women's mental health. We review evidence from prospective studies reporting on associations between mental health conditions and the menopause transition. Major depressive disorder and the more prevalent subthreshold depressive symptoms are the most common conditions studied. We reviewed 12 prospective studies reporting depressive symptoms, major depressive disorder, or both over the menopause transition and found no compelling evidence for a universal increased risk for either condition. However, specific subgroups of participants, primarily defined by menopause-related risk factors (ie, vasomotor symptoms that are severe or disturb sleep, a long duration of the transition, or reproductive hormone dynamics) and psychosocial risk factors (eg, stressful life events), were vulnerable to depressive symptoms. The increased risk of major depressive disorder over the menopause transition appears predominantly in individuals with previous major depressive disorder. Greater focus on recognising risk factors in primary care is warranted. On the basis of scarce data, we found no compelling evidence that risk of anxiety, bipolar disorder, or psychosis is universally elevated over the menopause transition. Potential misattribution of psychological distress and psychiatric disorders to menopause could harm women by delaying accurate diagnosis and the initiation of effective psychotropic treatments, and by creating negative expectations for people approaching menopause. A paradigm shift is needed. We conclude with recommendations for the detection and treatment of depressive symptoms or major depressive disorder and strategies to promote good mental health over the menopause transition, while responsibly preparing and supporting those at risk.
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Affiliation(s)
- Lydia Brown
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia; Academic Research Collaborative in Health, La Trobe University, Bundoora, VIC, Australia; Healthscope Hospitals, Melbourne, VIC, Australia.
| | - Myra S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Rong Chen
- Department of Obstetrics and Gynaecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China
| | - Carolyn J Crandall
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | | | - Gita D Mishra
- NHMRC Centre for Research Excellence in Women and NCDs, School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Viktoria Rother
- Inner West Area Mental Health Service, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology and Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha Hickey
- Department of Obstetrics, Gynaecology and Newborn Health, University of Melbourne and the Royal Women's Hospital, Melbourne, VIC, Australia
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Zhao J, Ji Y, Zuo Y, Zhang L, Ku C, Wang W, Wang P, Yang Y, Kang Y, Wang F. Association of Oxidative Stress and Proinflammation with Insomnia in Perimenopause. J Womens Health (Larchmt) 2024; 33:379-387. [PMID: 38394165 DOI: 10.1089/jwh.2023.0316] [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] [Indexed: 02/25/2024] Open
Abstract
Background: The levels of oxidative stress and proinflammatory factors in perimenopausal females increased, and they were also deeply troubled by insomnia. The occurrence of insomnia is related to the changes of oxidative stress and inflammation levels in the body. Perimenopausal insomnia may be related to mild systemic inflammation, and oxidative stress can promote chronic inflammation. However, the underlying mechanism behind the phenomenon is still unclear. Objective: The aim was to investigate whether the occurrence of perimenopausal insomnia disorder is related to higher levels of oxidative stress and inflammation in the body, and to explore the role of inducible nitric oxide synthase (iNOS) in perimenopausal insomnia. Methods: A total of 127 perimenopausal participants were recruited in this study. Participants with global scores of the Pittsburgh sleep quality index (PSQI) >7 were diagnosed with insomnia (n = 54). The patient health questionnaire-9 (PHQ-9) and generalized anxiety disorder-7 (GAD-7) were evaluated, and sociodemographic data were obtained. The serum concentrations of iNOS, interleukin 6 (IL6), and tumor necrosis factor α (TNFα) were measured using commercial assays. Results: In the insomnia group, IL6 levels were positively correlated with scores of component 5 and component 7 of PSQI, respectively. PHQ-9 and GAD-7 were positively correlated with the global score of PSQI component 7 and PSQI, respectively; PHQ-9 was positively correlated with the global score of PSQI component 1. Finally, PHQ-9, iNOS, and IL6 were found to be independent predictors of perimenopausal insomnia using logistic regression. Conclusions: Moderate oxidative stress caused by a certain concentration of iNOS plays a protective role in perimenopausal insomnia, while proinflammation and depression are potential risk factors.
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Affiliation(s)
- Jing Zhao
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
- Department of Basic Medical Teaching and Research, Ordos Institute of Technology, Ordos, China
| | - Yubo Ji
- Department of Medical Psychology, Inner Mongolia Medical University, Huhhot, China
| | - Yanni Zuo
- Physical Examination Center, Beijing Changping Hospital of Chinese Medicine, Beijing, China
| | - Long Zhang
- Department of Gynaecology and Obstetrics, the First Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China
| | - Congwen Ku
- Dongzhimen Hospital, the First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Wenyan Wang
- School of Pharmacy, Yantai University, Yantai, China
| | - Pengxiang Wang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Yan Yang
- Urumqi Fourth People's Hospital, Urumqi, China
| | - Yimin Kang
- Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, China
| | - Fan Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
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Thurston RC, Maki P, Chang Y, Wu M, Aizenstein HJ, Derby CA, Karikari TK. Menopausal vasomotor symptoms and plasma Alzheimer disease biomarkers. Am J Obstet Gynecol 2024; 230:342.e1-342.e8. [PMID: 37939982 PMCID: PMC10939914 DOI: 10.1016/j.ajog.2023.11.002] [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: 07/20/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Identifying risk factors for Alzheimer disease in women is important as women compose two-thirds of individuals with Alzheimer disease. Previous work links vasomotor symptoms, the cardinal menopausal symptom, with poor memory performance and alterations in brain structure, function, and connectivity. These associations are evident when vasomotor symptoms are monitored objectively with ambulatory skin conductance monitors. OBJECTIVE This study aimed to determine whether vasomotor symptoms are associated with Alzheimer disease biomarkers. STUDY DESIGN Between 2017 and 2020, the MsBrain study enrolled 274 community-dwelling women aged 45 to 67 years who had a uterus and at least 1 ovary and were late perimenopausal or postmenopausal status. The key exclusion criteria included neurologic disorder, surgical menopause, and recent use of hormonal or nonhormonal vasomotor symptom treatment. Women underwent 24 hours of ambulatory skin conductance monitoring to assess vasomotor symptoms. Plasma concentrations of Alzheimer disease biomarkers, including amyloid β 42-to-amyloid β 40 ratio, phosphorylated tau (181 and 231), glial fibrillary acidic protein, and neurofilament light, were measured using a single-molecule array (Simoa) technology. Associations between vasomotor symptoms and Alzheimer disease biomarkers were assessed via linear regression models adjusted for age, race and ethnicity, education, body mass index, and apolipoprotein E4 status. Additional models adjusted for estradiol and sleep. RESULTS A total of 248 (mean age, 59.06 years; 81% White; 99% postmenopausal status) of enrolled MsBrain participants contributed data. Objectively assessed vasomotor symptoms occurring during sleep were associated with significantly lower amyloid β 42/amyloid β 40, (beta, -.0010 [standard error, .0004]; P=.018; multivariable), suggestive of greater brain amyloid β pathology. The findings remained significant after additional adjustments for estradiol and sleep. CONCLUSION Nighttime vasomotor symptoms may be a marker of women at risk of Alzheimer disease. It is yet unknown if these associations are causal.
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Affiliation(s)
- Rebecca C Thurston
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA; Department of Psychology, University of Pittsburgh, Pittsburgh, PA.
| | - Pauline Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; Department of Psychology, University of Illinois at Chicago, Chicago, IL; Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL
| | - Yuefang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | | | - Carol A Derby
- Departments of Neurology and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
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Oppermann K, Spritzer PM. Prevalence and risk factors associated with diabetes mellitus among middle-aged women in southern Brazil: a population-based study. Menopause 2024; 31:225-230. [PMID: 38385732 DOI: 10.1097/gme.0000000000002320] [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: 02/23/2024]
Abstract
OBJECTIVES To investigate prevalence and clinical factors associated with diabetes among middle-aged women. METHODS In this cross-sectional population-based study, clinical and laboratory examinations were collected from 298 women. Participants wore a digital pedometer for 7 days to assess habitual physical activity. Abdominal computed tomography scans were performed to measure total fat area and visceral fat area. RESULTS Mean age was 57.1 years (SD, 5.4 y); 78.7% of women were postmenopausal. The prevalence of diabetes was 17.1%. Women with diabetes were older (P = 0.02); worked fewer hours per week in the past month (P = 0.04); had an earlier age at menarche (P = 0.03); were more frequently inactive (P = 0.01); had higher body mass index (P = 0.01), higher waist circumference (P < 0.01), higher visceral (P < 0.01), and higher total fat (P < 0.01) but not subcutaneous fat (P = 0.14); and had higher systolic blood pressure (BP) (P < 0.01). There was a prevalence of 19.5% of current smoking, 32.5% of alcohol use, and 16.1% of current hormone therapy use, prevalence similar among the groups of women. There was a higher prevalence of metabolic syndrome (P < 0.01) and statin use (P < 0.01) in women with diabetes. A higher prevalence ratio of diabetes was associated with physical inactivity (prevalence ratio, 2.137; 95% CI, 1.056-4.325; P < 0.03). The odds of having diabetes increased by 12% for each year of earlier menarche and by 1.4% for each millimeter of mercury increase in systolic BP. CONCLUSION The prevalence of diabetes was 17.1%. Age, physical inactivity, early age at menarche, and systolic BP were independently associated with higher prevalence of diabetes in this unselected population of middle-aged women.
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Affiliation(s)
- Karen Oppermann
- From the Medicine School, Universidade de Passo Fundo, Passo Fundo, Brazil
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Oh MR, Park JH, Park SK, Park SH. Efficacy of plant-derived dietary supplements in improving overall menopausal symptoms in women: An updated systematic review and meta-analysis. Phytother Res 2024; 38:1294-1309. [PMID: 38189863 DOI: 10.1002/ptr.8112] [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: 06/14/2023] [Revised: 10/06/2023] [Accepted: 12/16/2023] [Indexed: 01/09/2024]
Abstract
This updated systematic review and meta-analysis aims to confirm the effectiveness of plant-based supplements in improving overall menopausal symptoms and vasomotor symptoms. A systematic review of the literature was conducted by searching the PubMed/MEDLINE, Web of Science, EMBASE, and CENTRAL databases up to June 2022. Randomized placebo-controlled clinical trials that evaluated the effects of dietary supplements on menopausal symptoms were included. Outcome measures included daily hot flash frequency, Kupperman's index, Menopause Rating Scale, and Greene Climacteric Scale. Pooled data were analyzed using a fixed-effects model and expressed as a weighted mean difference with a 95% confidence interval for continuous outcomes. For qualitative assessment, 67 studies were selected. For quantitative assessment, 54 reports were obtained from 61 studies. The study participants were peri- or postmenopausal women aged 38-85, most of whom experienced hot flashes as a menopausal symptom. The investigational products included 28 soy-derived, 6 red clover-derived, and 28 other plant-derived supplements. Qualitative assessment revealed that approximately 76% of the studies were generally of fair or good quality, whereas 24% were of low quality. Meta-analysis results indicated significant improvements in all questionnaire scores, including hot flash frequency, in the dietary supplement group compared with the placebo group. Comprehensive evaluation using different questionnaire tools showed that the various plant-derived dietary supplements can significantly alleviate menopausal symptoms. However, further rigorous studies are needed to determine the association of plant-derived dietary supplements with menopausal health because of the general suboptimal quality and heterogeneous nature of current evidence.
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Affiliation(s)
- Mi Ra Oh
- Clinical Trial Center for Functional Foods, Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Jae Ho Park
- Food Functionality Research Division, Korea Food Research Institute, Wanju, Republic of Korea
| | - Seon Kyeong Park
- Food Functionality Research Division, Korea Food Research Institute, Wanju, Republic of Korea
| | - Soo Hyun Park
- Food Functionality Research Division, Korea Food Research Institute, Wanju, Republic of Korea
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Spets DS, Cohen JE, Konishi K, Aroner S, Misra M, Lee H, Goldstein JM. Impact of sex and reproductive status on the default mode network in early midlife: implications for aging of memory circuitry and function. Cereb Cortex 2024; 34:bhae088. [PMID: 38494419 PMCID: PMC10944696 DOI: 10.1093/cercor/bhae088] [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: 08/21/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024] Open
Abstract
Alterations to the resting-state default mode network (rsDMN) are early indicators of memory decline and Alzheimer's disease (AD). Brain regions shared by the rsDMN and memory circuitry are highly sexually dimorphic. However, data are limited regarding the impact of sex and reproductive status on rsDMN connectivity and memory circuitry and function. In the current investigation, rsDMN connectivity was assessed in 180 early midlife adults aged 45 to 55 by sex and reproductive status (87 women; 93 men). Associations between left and right hippocampal connectivity of rsDMN and verbal memory encoding circuitry were examined using linear mixed models, controlled for age and parental socioeconomic status, testing interactions by sex and reproductive status. Relative to men, women exhibited greater rsDMN connectivity between the left and right hippocampus. In relation to rsDMN-memory encoding connectivity, sex differences were revealed across the menopausal transition, such that only postmenopausal women exhibited loss of the ability to decrease rsDMN left-right hippocampal connectivity during memory encoding associated with poorer memory performance. Results demonstrate that sex and reproductive status play an important role in aging of the rsDMN and interactions with memory circuitry/function. This suggests the critical importance of sex and reproductive status when studying early midlife indicators of memory decline and AD risk.
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Affiliation(s)
- Dylan S Spets
- Clinical Neuroscience Laboratory for Sex Differences in the Brain, Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
| | - Justine E Cohen
- Clinical Neuroscience Laboratory for Sex Differences in the Brain, Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
| | - Kyoko Konishi
- Clinical Neuroscience Laboratory for Sex Differences in the Brain, Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
| | - Sarah Aroner
- Clinical Neuroscience Laboratory for Sex Differences in the Brain, Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
| | - Madhusmita Misra
- Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Department of Pediatrics, Division of Pediatric Endocrinology, Massachusetts General Hospital, 55 Fruit Street Boston, MA 02114, USA
| | - Hang Lee
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
- Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
- Biostatistics Center, Massachusetts General Hospital, 500 Staniford Street, Boston, MA 02114, USA
| | - Jill M Goldstein
- Clinical Neuroscience Laboratory for Sex Differences in the Brain, Department of Psychiatry, Massachusetts General Hospital, 149 13th Street, Boston, MA 02129, USA
- Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA
- Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02215, USA
- Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
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Fisher T, Powell E, Yuwono NL, Ford CE, Warton K. Circulating cell-free DNA is elevated in postmenopausal compared with pre- and perimenopausal women. Menopause 2024; 31:171-175. [PMID: 38385729 DOI: 10.1097/gme.0000000000002313] [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: 02/23/2024]
Abstract
OBJECTIVE With the rising use of circulating cell-free DNA (cirDNA) liquid biopsies for disease screening, it is important to understand biological differences that may impact the accuracy of cirDNA-based clinical tests. Although a number of biological factors have been researched, the relationship between menopause and cirDNA has not been thoroughly investigated. We aimed to compare plasma cirDNA concentration and DNA fragment integrity in healthy women pre- and postmenopause. METHODS Blood was collected from healthy female volunteers 40 years and older. cirDNA was extracted from plasma (n = 52) and quantified by quantitative polymerase chain reaction (n = 47; 26 premenopause, mean age-46 y; 21 postmenopause, mean age-59 y). cirDNA concentration was quantitated using an ALU repetitive sequence with a 115-base-pair (bp) product (ALU-115), and long cirDNA fragments were quantitated using an ALU repetitive sequence with a 247-bp product (ALU-247). cirDNA integrity was expressed as a ratio of ALU-247 over ALU-115. Mann-Whitney U test was used to compare pre- and postmenopause qPCR results, and a two-tailed, unpaired t test was undertaken to compare the integrity ratio between the two groups. RESULTS Postmenopause plasma samples were found to have a significantly higher cirDNA concentration (P < 0.0001, premenopause: mean, 3.10 ± 1.84 ng/mL; median, 2.90 ng/mL; postmenopause: mean, 5.28 ± 2.76 ng/mL; median, 4.56 ng/mL) and significantly higher concentration of long-stranded cirDNA fragments (P = 0.0033, premenopause: mean, 1.06 ± 0.48 ng/mL; median, 0.96 ng/mL; postmenopause: mean, 1.69 ± 0.89 ng/mL; median, 1.48 ng/mL). There was no significant difference in the integrity ratio between the groups (P = 0.1788). CONCLUSIONS Plasma cirDNA concentrations are higher in postmenopausal women. This has important implications in cirDNA liquid biopsy development and screening, especially for diseases such as cancer where the majority of cases are diagnosed postmenopause.
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Affiliation(s)
- Teagan Fisher
- From the Gynaecological Cancer Research Group, Adult Cancer Program, School of Clinical Medicine University of New South Wales, Sydney, Australia
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Fabunmi OA, Dludla PV, Nkambule BB. Effect of combined oral contraceptive on cardiorespiratory function and immune activation in premenopausal women involved in exercise: A systematic review protocol. PLoS One 2024; 19:e0298429. [PMID: 38394139 PMCID: PMC10889868 DOI: 10.1371/journal.pone.0298429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The use of combined oral contraceptive (COC) is common among women of reproductive age despite the potential risk of them developing thrombotic events. There is a need to understand how COC affects cardiorespiratory function and markers of immune activation in premenopausal women involved in exercise. This highlights a need for a systematic review to enhance our understanding of how the use of COC affects cardiovascular health in premenopausal women subjected to exercise. METHOD This systematic review protocol was prepared following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 statement. An extensive search of relevant literature by two independent reviewers will be conducted through the EBSCOhost interface to access databases such as MEDLINE, EMBASE, and CINAHL. Other health sources, including Cochrane CENTRAL, unpublished studies and grey literature, will also be searched. The search will include all studies that report the effect of COC on essential parameters of cardiorespiratory function and markers of immune activation in premenopausal women involved in exercise. All included studies will be appraised using appraisal tools, while appropriate extraction tools will be used for data extraction. Where possible, eligible studies will be pooled for meta-analysis. If statistical pooling is not feasible, our findings will be presented in a narrative format. The certainty of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation Assessment (GRADE) tool. TRIAL REGISTRATION PROSPERO registration number: CRD42021265257.
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Affiliation(s)
- Oyesanmi A. Fabunmi
- School of Laboratory Medicine and Medical Sciences (SLMMS), University of KwaZulu-Natal, Durban, South Africa
- Health-awareness, Exercise and Cardio-immunologic Research Unit (HECIRU), Department of Physiology, College of Medicine, Ekiti State University, Ado-Ekiti, Nigeria
| | - Phiwayinkosi V. Dludla
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa, South Africa
| | - Bongani B. Nkambule
- School of Laboratory Medicine and Medical Sciences (SLMMS), University of KwaZulu-Natal, Durban, South Africa
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Kim MJ, Kim S, Kim JJ, Kim YS, Song JH, Lee JE, Youn J, Yang SY. Dietary intake is associated with the prevalence of uterine leiomyoma in Korean women: A retrospective cohort study. PLoS One 2024; 19:e0291157. [PMID: 38359002 PMCID: PMC10868850 DOI: 10.1371/journal.pone.0291157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE Uterine leiomyoma (UL), the most prevalent benign gynecologic tumor among reproductive-aged women, lacks sufficient research on the potential association between dietary intake and its occurrence in Korean women. Addressing this research gap, this study aims to evaluate the potential link between dietary intake and the prevalence of UL in Korean women. METHODS In this cross-sectional study, a cohort of 672 women, aged 23 to 73, were enrolled, with 383 (57%) being premenopausal. Dietary intake was assessed using a validated food frequency questionnaire (FFQ), and UL presence was determined through ultrasonography. The analysis focused exclusively on items within ten categories, including vegetables/fruit, vegetables, fruits, red meat, processed meat, poultry, fish, dairy product, milk, and alcohol. Multiple logistic regression models were employed to explore the relationship between dietary intake and the prevalence of UL, calculating odds ratios (ORs) and 95% confidence intervals (CIs) while adjusting for confounding factors. RESULTS Within the total cohort, 220 (32.7%) women were diagnosed with UL. High intakes of fish and poultry showed an association with higher UL prevalence. Odds ratios (95% CIs) for the upper quartiles compared to the lower quartiles were 1.68 (1.01-2.81; p trend = 0.05) for fish intake and 1.87 (1.11-3.17; p trend = 0.06) for poultry intake. Conversely, an inverse relationship emerged between dairy product intake and UL prevalence, with an odds ratio of 0.58 (95% CI 0.35-0.96; p trend = 0.05). Stratifying the analysis by menopausal status revealed a parallel pattern, with heightened UL prevalence with fish intake and reduced prevalence with dairy product intake. However, the link between poultry intake and UL prevalence was primarily observed among postmenopausal women. Among premenopausal women, elevated vegetable intake was linked to a decreased UL prevalence (OR 0.45, 95% CI 0.21-0.97 for top vs. bottom quartiles; p trend = 0.01). CONCLUSION We found that high consumption of fish and poultry, coupled with low intake of dairy products, correlated with an elevated prevalence of UL. Furthermore, vegetable intake exhibited an inverse relationship with UL prevalence, particularly among premenopausal women.
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Affiliation(s)
- Min-Jeong Kim
- Department of Obstetrics and Gynecology, Division of Gynecology Oncology, CHA Hospital Ilsan Medical Center, Goyang-si, Gyonggi-do, Republic of Korea
| | - Sunmie Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Jin Ju Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Young Sun Kim
- Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Ji Hyun Song
- Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Jung Eun Lee
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
- Research Institute of Human Ecology, Seoul National University, Seoul, Korea
| | - Jiyoung Youn
- Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - Sun Young Yang
- Department of Internal Medicine and Healthcare Research Institute, Seoul National University Hospital, Healthcare System Gangnam Center, Seoul, Republic of Korea
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Atilla R, Kaya D, Akarsu RH, Köroğlu V. Relationship Between Menopausal Symptoms, Cancer Screening Behaviors, and Religion Attitudes of Women in the Climacteric Period: A Cross-Sectional Study. Niger J Clin Pract 2024; 27:280-288. [PMID: 38409159 DOI: 10.4103/njcp.njcp_676_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/12/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Although it is known that religion is used to cope with health problems, there is a lack of information about the effect of religion on menopausal symptoms and cancer screening attitudes of climacteric women. AIM This study was conducted to determine the relationship between the religious attitudes of women in the climacteric period and their attitudes toward menopausal symptoms and cancer screening. MATERIALS AND METHODS This was a cross-sectional study of 381 women in the climacteric period in the Central Anatolia region of Türkiye. Data collection form, the Menopause Rating Scale (MRS), OK-Religious Attitude Scale (ORAS), and attitude for cancer screening (short form) (ASCS) were used to collect data. Correlation analysis assessed the relationship between MRS, ORAS, and ASCS. RESULTS There was a low positive correlation between women's ORAS mean score (35.19 ± 4.80) and MRS mean score (12.68 ± 7.24) (r = 0.284, P < 0.001). There was no statistically significant relationship between the mean ORAS scores of the women and the mean ASCS scores (64.59 ± 10.47) (r = 0.089, P > 0.05). CONCLUSION Women who experienced more severe menopausal symptoms had stronger religious attitudes. Women's religious attitudes did not affect their attitudes toward cancer screening. It is therefore recommended that health professionals organize counseling and training activities to protect and improve the health of menopausal women and increase their participation in screening and treatment programs.
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Affiliation(s)
- R Atilla
- Department of Obstetrics and Gynecology Nursing, Nigde Zübeyde Hanım Faculty of Health Sciences, Nigde Omer Halisdemir University, Nigde, Türkiye
| | - D Kaya
- Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Nuh Naci Yazgan University, Kayseri, Türkiye
| | - R H Akarsu
- Department of Obstetrics and Gynecology Nursing, Faculty of Health Sciences, Bozok University, Yozgat, Türkiye
| | - V Köroğlu
- Department of Midwifery, Şehit Kenan Erdem Family Health Center, Nigde, Türkiye
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Rulu P, Bertone-Johnson ER, Kamilar J, Dhall M, Sievert LL. Midlife symptoms and household stress are associated with fingernail cortisol. Menopause 2024; 31:116-122. [PMID: 38166237 DOI: 10.1097/gme.0000000000002302] [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: 01/04/2024]
Abstract
OBJECTIVE This study investigates menopausal symptoms, household stressors, and ethnopolitical problems in relation to stress markers, including chronic stress measured by fingernail cortisol, perceived stress measured by the Perceived Stress Scale, and acute stress measured by blood pressure. METHODS Data from 151 women aged 40 to 55 years were collected from four regions in Nagaland, India, using opportunity sampling. A structured questionnaire was used to collect sociodemographic and lifestyle variables. Symptoms were grouped into emotional instability, vasosomatic symptoms, mood disturbances, and aches and pains using principal component analysis in a previous study, and stress markers included fingernail cortisol, perceived stress, and blood pressure. Community-level, household-level, and midlife symptoms were included to ascertain stressors from different sources. RESULTS Our results revealed a significant positive association between a composite measure of emotional instability and stress assessed by fingernail cortisol ( β = 0.46, P < 0.001). In addition, there was a positive association between mood disturbances and fingernail cortisol ( β = 0.24, P < 0.05). This relationship persisted after controlling for body mass index, socioeconomic status, and menopausal status. In addition, household problems were positively associated with fingernail cortisol ( β = 0.25, P = 0.01). CONCLUSIONS These findings highlight the potential health impacts of the psychosocial stress response associated with domestic stressors such as financial strain and concerns about children and health.
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Affiliation(s)
- Peteneinuo Rulu
- From the Department of Anthropology, University of Massachusetts Amherst, Amherst, MA
| | | | - Jason Kamilar
- From the Department of Anthropology, University of Massachusetts Amherst, Amherst, MA
| | - Meenal Dhall
- Department of Anthropology, University of Delhi, Delhi, India
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Lambrinoudaki I, Armeni E. Understanding of and clinical approach to cardiometabolic transition at the menopause. Climacteric 2024; 27:68-74. [PMID: 37224871 DOI: 10.1080/13697137.2023.2202809] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/19/2023] [Accepted: 02/28/2023] [Indexed: 05/26/2023]
Abstract
Cardiovascular disease (CVD) represents the leading cause of death and accounts for almost 50% of all deaths in women worldwide. The menopausal transition is associated with central body fat accumulation, a decrease in energy expenditure, weight gain, insulin resistance and a pro-atherogenic lipid profile. Moreover, menopause is independently associated with an adverse effect on functional and structural indices of subclinical atherosclerosis. Women with premature ovarian insufficiency have heightened CVD risk compared to women of natural age at menopause. Furthermore, women with severe menopausal symptoms may have a more adverse cardiometabolic profile than those without symptoms. We reviewed the latest evidence on the cardiovascular management of perimenopausal or postmenopausal women. Clinicians should aim for cardiovascular risk stratification, followed by dietary and lifestyle advice as required based on individual needs. The medical management of cardiometabolic risk factors at midlife should always be individualized, focusing on hypertension, diabetes and dyslipidemia. Menopausal hormone therapy, when prescribed for the management of bothersome menopausal symptoms or for the prevention of osteoporosis, has also a beneficial effect on cardiometabolic risk factors. This narrative review aims to summarize the cardiometabolic alternations occurring during the menopausal transition and to outline the appropriate prevention strategies to prevent future cardiovascular adverse outcomes.
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Affiliation(s)
- I Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
| | - E Armeni
- 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Aretaieio Hospital, Athens, Greece
- Royal Free Hospital NHS Foundation Trust, UCL Medical School, London, UK
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Graham EE, Michala L, Hachfeld A, Moseholm E. Collection of menopause data in studies of women living with HIV: A systematic literature review. HIV Med 2024; 25:174-187. [PMID: 37776176 DOI: 10.1111/hiv.13552] [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: 03/14/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES An increasing number of women living with HIV are transitioning through midlife and menopause. Women living with HIV may experience earlier menopause and a higher symptom burden than women without HIV, but more evidence is needed. Data collection on menopause in women living with HIV is scarce and often not standardized. We sought to assess how menopause data are collected in cohorts and studies of women living with HIV. METHODS This was a literature review conducted within the PubMed database. We included original studies and cohorts assessing menopause and/or menopausal symptoms in women living with HIV. Study characteristics and menopause data collection, including the definition of menopause, symptom assessment tools, and measurement of biomedical parameters, were noted and summarized systematically in data tables. RESULTS We included 40 articles describing 37 separate studies published between 2000 and 2023; 27 of these were conducted in high-income countries, the majority in the USA (n = 16). Ten studies were from low- and middle-income countries; four of these were conducted in Brazil. In 20 studies, menopause was defined according to the World Health Organization's definition of over 12 months of amenorrhea. Twelve studies used the Menopause Rating Scale to characterize menopausal symptoms, five studies used other specified symptom assessment tools, and 12 studies used a study-specific tool. CONCLUSIONS Menopause data collection in women living with HIV is heterogeneous. We propose that standardized tools should be used to enable comparisons between studies and countries, thereby improving the quality of research and clinical treatment. Further research into the validity of menopausal symptom scoring tools is warranted.
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Affiliation(s)
- Emma Eileen Graham
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - Lina Michala
- 1st Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Hachfeld
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ellen Moseholm
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Zeber-Lubecka N, Kulecka M, Jagiełło-Gruszfeld A, Dąbrowska M, Kluska A, Piątkowska M, Bagińska K, Głowienka M, Surynt P, Tenderenda M, Mikula M, Ostrowski J. Breast cancer but not the menopausal status is associated with small changes of the gut microbiota. Front Oncol 2024; 14:1279132. [PMID: 38327745 PMCID: PMC10848918 DOI: 10.3389/fonc.2024.1279132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/03/2024] [Indexed: 02/09/2024] Open
Abstract
Background Possible relationships between gut dysbiosis and breast cancer (BC) development and progression have been previously reported. However, the results of these metagenomics studies are inconsistent. Our study involved 88 patients diagnosed with breast cancer and 86 cancer-free control women. Participants were divided into groups based on their menopausal status. Fecal samples were collected from 47 and 41 pre- and postmenopausal newly diagnosed breast cancer patients and 51 and 35 pre- and postmenopausal controls, respectively. In this study, we performed shotgun metagenomic analyses to compare the gut microbial community between pre- and postmenopausal BC patients and the corresponding controls. Results Firstly, we identified 12, 64, 158, and 455 bacterial taxa on the taxonomy level of phyla, families, genera, and species, respectively. Insignificant differences of the Shannon index and β-diversity were found at the genus and species levels between pre- and postmenopausal controls; the differences concerned only the Chao index at the species level. No differences in α-diversity indexes were found between pre- and postmenopausal BC patients, although β-diversity differed these subgroups at the genus and species levels. Consistently, only the abundance of single taxa differed between pre- and postmenopausal controls and cases, while the abundances of 14 and 23 taxa differed or tended to differ between premenopausal cases and controls, and between postmenopausal cases and controls, respectively. There were similar differences in the distribution of enterotypes. Of 460 bacterial MetaCyc pathways discovered, no pathways differentiated pre- and postmenopausal controls or BC patients, while two and one pathways differentiated cases from controls in the pre- and postmenopausal subgroups, respectively. Conclusion While our findings did not reveal an association of changes in the overall microbiota composition and selected taxa with the menopausal status in cases and controls, they confirmed differences of the gut microbiota between pre- and postmenopausal BC patients and the corresponding controls. However, these differences were less extensive than those described previously.
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Affiliation(s)
- Natalia Zeber-Lubecka
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Maria Kulecka
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Agnieszka Jagiełło-Gruszfeld
- Department of Breast Cancer & Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Michalina Dąbrowska
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anna Kluska
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Magdalena Piątkowska
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Katarzyna Bagińska
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Maria Głowienka
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Piotr Surynt
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Michał Tenderenda
- Department of Oncological Surgery and Neuroendocrine Tumors, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Michał Mikula
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Jerzy Ostrowski
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education, Warsaw, Poland
- Department of Genetics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Lawley SD, Sammel MD, Santoro N, Johnson J. Mathematical recapitulation of the end stages of human ovarian aging. SCIENCE ADVANCES 2024; 10:eadj4490. [PMID: 38215196 PMCID: PMC10786411 DOI: 10.1126/sciadv.adj4490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/15/2023] [Indexed: 01/14/2024]
Abstract
Ovarian aging in women can be described as highly unpredictable within individuals but predictable across large populations. We showed previously that modeling an individual woman's ovarian reserve of primordial follicles using mathematical random walks replicates the natural pattern of growing follicles exiting the reserve. Compiling many simulations yields the observed population distribution of the age at natural menopause (ANM). Here, we have probed how stochastic control of primordial follicle loss might relate to the distribution of the preceding menopausal transition (MT), when women begin to experience menstrual cycle irregularity. We show that identical random walk model conditions produce both the reported MT distribution and the ANM distribution when thresholds are set for growing follicle availability. The MT and ANM are shown to correspond to gaps when primordial follicles fail to grow for 7 and 12 days, respectively. Modeling growing follicle supply is shown to precisely recapitulate epidemiological data and provides quantitative criteria for the MT and ANM in humans.
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Affiliation(s)
- Sean D. Lawley
- Department of Mathematics, University of Utah, 155 S 1400 E, JWB 233, Salt Lake City, UT 84112, USA
| | - Mary D. Sammel
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, CO 80045, USA
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine (AMC) Building RC2, Room P15 3103, Aurora, CO 80045, USA
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine (AMC) Building RC2, Room P15 3103, Aurora, CO 80045, USA
| | - Joshua Johnson
- Department of Obstetrics and Gynecology, University of Colorado School of Medicine (AMC) Building RC2, Room P15 3103, Aurora, CO 80045, USA
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Medeiros de Morais MS, Macêdo SGGF, do Nascimento RA, Vieira MCA, Moreira MA, da Câmara SMA, Almeida MDG, Maciel ÁCC. Dissatisfaction with body image and weight gain in middle-aged women: A cross sectional study. PLoS One 2024; 19:e0290380. [PMID: 38206926 PMCID: PMC10783740 DOI: 10.1371/journal.pone.0290380] [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: 11/08/2022] [Accepted: 07/26/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES To investigate the relationship between weight gain and body image perception in in middle-aged women. METHODS Cross-sectional study with 453 women. Body image was assessed using the Stunkard scale, in which women were classified as: satisfied or dissatisfied (general, thinness or obesity). The identification of possible factors associated with body image dissatisfaction was performed using binary logistic regression analysis. RESULTS The mean age was 55.7 (±9.6) years; 80.8% were classified as dissatisfied with body image. As for body composition, women satisfied with their body image had lower values of body fat and higher values of lean mass. In the logistic regression, for general dissatisfaction and obesity, the associated variables were BMI, education and physical activity. As for "dissatisfaction with thinness", only BMI was associated. CONCLUSION Thus, the prevalence of body image dissatisfaction is high in women and part of associated factors are linked to lifestyle behaviors.
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Affiliation(s)
| | | | | | | | - Mayle Andrade Moreira
- Department of Federal University of Ceará, Physiotherapy Fortaleza, Fortaleza, CE, Brazil
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Kalpakjian CZ, Hanks R, Quint EH, Millis S, Sander AM, Lequerica AH, Bushnik T, Brunner R, Rapport L. Assessing menopause symptoms in women with traumatic brain injury: the development and initial testing of a new scale. Women Health 2024; 64:51-64. [PMID: 38097958 DOI: 10.1080/03630242.2023.2294969] [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: 08/16/2023] [Accepted: 12/09/2023] [Indexed: 12/30/2023]
Abstract
With greater survival rates after catastrophic injury, more women with traumatic brain injury (TBI) are living longer than ever. However, knowledge about this transition in these women is largely unexamined and there are no scales that have been developed to assess the experience of symptoms. To address this gap, we developed and tested a new scale of menopause symptoms in midlife women with TBI. We selected candidate items from two existing measures based on feedback from focus group discussions with seven women with TBI. Twenty candidate items were tested in cognitive interviews with six women with TBI/1 non-TBI. Then, these were field tested with 221 participants (TBI, n = 68; non-TBI, n = 153) recruited from registries. Rasch analysis and convergent validity testing were used to evaluate the new scale. Results of the Rasch analysis indicate that overall, the scale fits well the Rasch model with evidence for unidimensionality. Differential item functioning indicated that the scale performed equally well for women with and without TBI and distinguished pre- and post-menopausal states. Convergent validity was found in the expected directions. These findings support further development of the new scale to understand the experience of menopause symptoms among women with TBI.
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Affiliation(s)
- Claire Z Kalpakjian
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Robin Hanks
- Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Elisabeth H Quint
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA
| | - Scott Millis
- Department of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Angelle M Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine and the Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, USA
| | - Anthony H Lequerica
- Center for Traumatic Brain Injury Research, Kessler Foundation, West Orange, New Jersey, USA
| | - Tamara Bushnik
- Rusk Rehabilitation, NYU Langone Health, New York, NY, USA
| | - Robert Brunner
- Department of Physical Medicine and Rehabilitation, University of Alabama, Birmingham, Alabama, USA
| | - Lisa Rapport
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
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Jabbour G, Iancu HD. Anaerobic and aerobic contributions to repeated supramaximal cycling exercises and their adaptation to high-intensity interval training in obese perimenopausal and postmenopausal women. Menopause 2024; 31:39-45. [PMID: 38086015 DOI: 10.1097/gme.0000000000002284] [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: 12/30/2023]
Abstract
OBJECTIVE This study investigated the anaerobic and aerobic contributions to total energy release during repeated supramaximal cycling exercises (SCE) and their adaptation in response to 6 weeks of high-intensity interval training (HIIT) in obese perimenopausal and postmenopausal women. METHODS Nineteen perimenopausal women and 21 postmenopausal women with an average age of 50.1 years participated in the 6-week HIIT intervention. Before and after the training, the accumulated oxygen deficits (mL·min -1 ) and anaerobic and aerobic contributions (%) were measured in all groups via repeated SCE. RESULTS The results showed that, before training, the anaerobic contributions to repeated SCE did not differ between the perimenopausal and postmenopausal women for the first three repetitions. However, a higher decrease was reported for postmenopausal women at the fourth and fifth repetitions ( P < 0.01, respectively). After HIIT, anaerobic contributions increased significantly in both groups ( P < 0.01, respectively). Nevertheless, postmenopausal women still had significantly lower anaerobic contributions to repeated SCE compared with perimenopausal women ( P < 0.01, respectively). Multiple linear regression analysis indicated that menopause status was an independent predictor of anaerobic contribution, accounting for 17%, 21%, 15%, 19%, and 22% of variations (β = 0.28, P = 0.03; β = 0.29, P = 0.04; β = 0.18, P = 0.05; β = 0.22, P = 0.05; and β = 0.33, P = 0.03 for the first to the fifth repetitions consecutively for perimenopausal vs postmenopausal groups). CONCLUSIONS A 6-week HIIT intervention increased the anaerobic contributions to energy in response to repeated SCE in obese perimenopausal and postmenopausal women. However, postmenopausal women had lower anaerobic contributions at the fourth and fifth repetitions mainly due to the effects of menopause.
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Affiliation(s)
- Georges Jabbour
- From the Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Horia D Iancu
- School of Kinesiology and Leisure, University of Moncton, Moncton, New Brunswick, Canada
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Hsu S, Bove R. Hormonal Therapies in Multiple Sclerosis: a Review of Clinical Data. Curr Neurol Neurosci Rep 2024; 24:1-15. [PMID: 38102502 PMCID: PMC10774191 DOI: 10.1007/s11910-023-01326-7] [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] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE OF REVIEW Given the potential for exogenous hormones to influence risk and course of MS, this narrative review aims to summarize current knowledge from observational and interventional studies of exogenous hormones in humans with MS. RECENT FINDINGS Large randomized clinical trials for combined oral contraceptives and estriol both show modest effect on inflammatory activity, with the latter showing potential neuroprotective effect. After fertility treatment, large actively treated cohorts have not confirmed any elevated risk of relapse. Preclinical data suggest that androgens, selective estrogen receptor modulators (SERMs), and selective androgen receptor modulators (SARMs) may be neuroprotective but clinical data are lacking. Gender affirming treatment, particularly estrogen in trans-women, could possibly be associated with elevated risk of inflammation. For women with MS entering menopause, hormone therapy appears safe during the appropriate menopausal window, but its long-term effects on neuroprotection are unknown. Exogenous hormones, used in varied doses and for diverse indications, have variable effects on MS risk, inflammatory activity, and neuroprotection. Large randomized trials are needed before it is possible to determine the true effect of exogenous hormones in a condition as complex as MS.
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Affiliation(s)
- Stephanie Hsu
- UCSF Weill Institute for Neuroscience, Division of Neuroimmunology and Glial Biology, Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Riley Bove
- UCSF Weill Institute for Neuroscience, Division of Neuroimmunology and Glial Biology, Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
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Fernández‐Pena A, Navas‐Sánchez FJ, de Blas DM, Marcos‐Vidal L, Desco M, Carmona S. Previous pregnancies might mitigate cortical brain differences associated with surgical menopause. Hum Brain Mapp 2024; 45:e26538. [PMID: 38063284 PMCID: PMC10789212 DOI: 10.1002/hbm.26538] [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: 01/20/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 01/16/2024] Open
Abstract
Surgical menopause causes a sharp drop in estrogen levels in middle-aged women, thus preventing the gradual physiological adaptation that is characteristic of the perimenopause. Previous studies suggest that surgical menopause might increase the risk of dementia later in life. In addition, the transition to motherhood entails long-lasting endocrine and neuronal adaptations. We compared differences in whole-brain cortical volume between women who reached menopause by surgery and a group of women who reached spontaneous non-surgical menopause and determined whether these cortical differences were influenced by previous childbearing. Using surface-based neuroimaging techniques, we investigated cortical volume differences in 201 middle-aged women (134 women who experienced non-surgical menopause, 78 of whom were parous women; and 67 women who experienced surgical menopause, 39 of whom were parous women). We found significant atrophy in the frontal and temporal regions in women who experienced surgical menopause. Nulliparous women with surgical menopause showed significant lower cortical volume in the left temporal gyrus extending to the medial temporal lobe cortex, as well as in the precuneus bilaterally compared to parous women with surgical menopause; whereas our results revealed no significant differences between parous women with surgical menopause and both parous and nulliparous women who reached a non-surgical menopause. Furthermore, in the surgical menopause group, we found a negative correlation between cortical volume and age at first pregnancy in the temporal lobe. Our study suggests that the long-term brain remodeling of parity may mitigate the neural impact of the sudden drop in estrogen levels that characterizes surgical menopause.
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Affiliation(s)
- Alberto Fernández‐Pena
- Departamento de BioingenieríaUniversidad Carlos III de MadridMadridSpain
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- CIBER de Salud MentalInstituto de Salud Carlos IIIMadridSpain
| | | | - Daniel Martín de Blas
- Departamento de BioingenieríaUniversidad Carlos III de MadridMadridSpain
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- CIBER de Salud MentalInstituto de Salud Carlos IIIMadridSpain
| | - Luis Marcos‐Vidal
- Departamento de BioingenieríaUniversidad Carlos III de MadridMadridSpain
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- CIBER de Salud MentalInstituto de Salud Carlos IIIMadridSpain
| | - Manuel Desco
- Departamento de BioingenieríaUniversidad Carlos III de MadridMadridSpain
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- CIBER de Salud MentalInstituto de Salud Carlos IIIMadridSpain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC)MadridSpain
| | - Susanna Carmona
- Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
- CIBER de Salud MentalInstituto de Salud Carlos IIIMadridSpain
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Kastrati L, Groothof D, Quezada-Pinedo HG, Raeisi-Dehkordi H, Bally L, De Borst MH, Bakker SJL, Vidal PM, Eisenga MF, Muka T. Utility of iron biomarkers in differentiating menopausal status: Findings from CoLaus and PREVEND. Maturitas 2024; 179:107872. [PMID: 37952488 DOI: 10.1016/j.maturitas.2023.107872] [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: 02/23/2023] [Revised: 09/21/2023] [Accepted: 10/23/2023] [Indexed: 11/14/2023]
Abstract
AIM To examine the association of iron biomarkers with menopausal status and assess whether these biomarkers can help differentiate menopausal status beyond age. METHODS In this cross-sectional study we included 1679 women from the CoLaus and 2133 from the PREVEND cohorts, with CoLaus used as primary cohort and PREVEND for replication. Ferritin, transferrin, iron, and transferrin saturation (TSAT) were used to assess iron status. Hepcidin and soluble transferrin receptor were assessed only in PREVEND. Menopausal status was self-reported and defined as menopausal or non-menopausal. Logistic regressions were used to explore the association of these iron biomarkers with menopause status. Sensitivity, specificity, area under the receiver operating characteristic curves (AUC), positive and negative predictive values as well as cut-off points for the iron biomarkers were calculated. The model with the highest AUC was defined as the best. RESULTS In the CoLaus and PREVEND cohorts, respectively, 513 (30.6 %) and 988 (46.3 %) women were postmenopausal. Ferritin (OR, 2.20; 95 % CI 1.72-2.90), transferrin (OR, 0.03; 95 % CI 0.01-0.10), and TSAT (OR, 1.28; 95 % CI 1.06-1.54) were significantly associated with menopausal status in CoLaus, with the findings replicated in PREVEND. AUC of age alone was 0.971. The best model resulted from combining age, ferritin, and transferrin, with an AUC of 0.976, and sensitivity and specificity of 87.1 % and 96.5 %, respectively. Adding transferrin and ferritin to a model with age improved menopause classification by up to 7.5 %. In PREVEND, a model with age and hepcidin outperformed a model with age, ferritin, and transferrin. CONCLUSION Iron biomarkers were consistently associated with menopausal status in both cohorts, and modestly improved a model with age alone for differentiating menopause status. Our findings on hepcidin need replication.
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Affiliation(s)
- Lum Kastrati
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland; Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism UDEM, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Dion Groothof
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
| | - Hugo G Quezada-Pinedo
- The Generation R Study Group, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hamidreza Raeisi-Dehkordi
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Lia Bally
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism UDEM, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Martin H De Borst
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
| | - Stephan J L Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
| | - Pedro-Marques Vidal
- Department of Medicine, internal medicine, Lausanne university hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Michele F Eisenga
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, 9713, GZ, Groningen, the Netherlands
| | - Taulant Muka
- Epistudia, 3011 Bern, Switzerland; Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
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Frankenthal D, Karni-Efrati Z, Zatlawi M, Keinan-Boker L, Bromberg M. Menopausal symptoms and attitudes toward hormone replacement therapy among Israeli women. J Women Aging 2024; 36:1-13. [PMID: 37319035 DOI: 10.1080/08952841.2023.2222048] [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: 10/19/2021] [Revised: 02/12/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
Menopause occurs around midlife and is an inevitable component of women's aging. The study aimed to investigate the associations between the lifetime prevalence of menopausal symptoms and health-related characteristics among Israeli postmenopausal women aged 55-75 years. Additionally, this study aimed to estimate the use of hormone replacement therapy (HRT) and women's attitudes toward this treatment. Data for this study were extracted from a cross-sectional national telephone survey conducted in Israel between 2018 and 2020. For the current study, only postmenopausal women aged 55-75 years were included. Multivariate analyses were used to identify demographic and health-related characteristics associated with menopausal symptoms. The study included 688 participants. Most (68.8%) reported one or more menopausal symptoms, specifically vasomotor symptoms (50.4%). According to the multivariate logistic regression analysis, menopausal symptoms were associated with moderate-high anxiety and/or depression symptoms (OR = 2.01, 95% CI 1.12-3.58) and with osteoporosis (OR = 1.78, 95% CI 1.08-2.92). Although most (78.3%) symptomatic women were bothered by their symptoms, 29.1% received any treatment for symptom relief and only 12.6% reported current or past use of HRT. The findings show that menopausal symptoms were associated with a higher prevalence of anxiety and/or depression symptoms and osteoporosis in the years following menopause. Most symptomatic women did not receive any treatment and the majority were against HRT. Knowledge and awareness about menopause and treatment options should be increased among Israeli women. Additionally, the promotion of positive attitudes toward menopause and HRT use among women and healthcare providers is strongly recommended.
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Affiliation(s)
- Dvora Frankenthal
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel
| | - Ziv Karni-Efrati
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel
- Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel
| | - Miri Zatlawi
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel
| | - Lital Keinan-Boker
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel
- Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel
| | - Michal Bromberg
- Israel Center for Disease Control (ICDC), Ministry of Health, Ramat-Gan, Israel
- Sackler Faculty of Medicine, School of Public Health, Tel Aviv University, Tel Aviv, Israel
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Usselman CW, Lindsey ML, Robinson AT, Habecker BA, Taylor CE, Merryman WD, Kimmerly D, Bender JR, Regensteiner JG, Moreau KL, Pilote L, Wenner MM, O'Brien M, Yarovinsky TO, Stachenfeld NS, Charkoudian N, Denfeld QE, Moreira-Bouchard JD, Pyle WG, DeLeon-Pennell KY. Guidelines on the use of sex and gender in cardiovascular research. Am J Physiol Heart Circ Physiol 2024; 326:H238-H255. [PMID: 37999647 DOI: 10.1152/ajpheart.00535.2023] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/02/2023] [Accepted: 11/21/2023] [Indexed: 11/25/2023]
Abstract
In cardiovascular research, sex and gender have not typically been considered in research design and reporting until recently. This has resulted in clinical research findings from which not only all women, but also gender-diverse individuals have been excluded. The resulting dearth of data has led to a lack of sex- and gender-specific clinical guidelines and raises serious questions about evidence-based care. Basic research has also excluded considerations of sex. Including sex and/or gender as research variables not only has the potential to improve the health of society overall now, but it also provides a foundation of knowledge on which to build future advances. The goal of this guidelines article is to provide advice on best practices to include sex and gender considerations in study design, as well as data collection, analysis, and interpretation to optimally establish rigor and reproducibility needed to inform clinical decision-making and improve outcomes. In cardiovascular physiology, incorporating sex and gender is a necessary component when optimally designing and executing research plans. The guidelines serve as the first guidance on how to include sex and gender in cardiovascular research. We provide here a beginning path toward achieving this goal and improve the ability of the research community to interpret results through a sex and gender lens to enable comparison across studies and laboratories, resulting in better health for all.
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Affiliation(s)
- Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Merry L Lindsey
- School of Graduate Studies, Meharry Medical College, Nashville, Tennessee, United States
- Research Service, Nashville Veterans Affairs Medical Center, Nashville, Tennessee, United States
| | - Austin T Robinson
- Neurovascular Physiology Laboratory, School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Beth A Habecker
- Department of Chemical Physiology and Biochemistry and Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, United States
| | - Chloe E Taylor
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
| | - W David Merryman
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, United States
| | - Derek Kimmerly
- Autonomic Cardiovascular Control and Exercise Laboratory, Division of Kinesiology, School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeffrey R Bender
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale Cardiovascular Research Center, New Haven, Connecticut, United States
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States
| | - Judith G Regensteiner
- Divisions of General Internal Medicine and Cardiology, Department of Medicine, Ludeman Family Center for Women's Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
| | - Kerrie L Moreau
- Division of Geriatrics, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States
- Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, Colorado, United States
| | - Louise Pilote
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Megan M Wenner
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, United States
| | - Myles O'Brien
- School of Physiotherapy and Department of Medicine, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Timur O Yarovinsky
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale Cardiovascular Research Center, New Haven, Connecticut, United States
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, United States
| | - Nina S Stachenfeld
- John B. Pierce Laboratory, New Haven, Connecticut, United States
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Quin E Denfeld
- School of Nursing and Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, United States
| | - Jesse D Moreira-Bouchard
- Q.U.E.E.R. Lab, Programs in Human Physiology, Department of Health Sciences, Boston University College of Health and Rehabilitation Sciences: Sargent College, Boston, Massachusetts, United States
| | - W Glen Pyle
- IMPART Team Canada Network, Dalhousie Medicine, Saint John, New Brunswick, Canada
- Department of Biomedical Sciences, University of Guelph, Guelph, Ontario, Canada
| | - Kristine Y DeLeon-Pennell
- School of Medicine, Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, United States
- Research Service, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina, United States
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48
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Shi J, Wang X, Qi W, Wang S, Fu Y, Zhang Y, Zhang Q, Han L, Xu Y, Duan H, Liu J, Cong X, Zhou C, Zhao P, Wang J. Association between NTCP hepatic expression and inflammation/fibrosis as well as gender-specific differences in chronic HBV-infected patients. J Med Virol 2024; 96:e29428. [PMID: 38258306 DOI: 10.1002/jmv.29428] [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: 07/24/2023] [Revised: 01/09/2024] [Accepted: 01/14/2024] [Indexed: 01/24/2024]
Abstract
To investigate the relationship between the expression of hepatitis B virus (HBV) functional receptor sodium taurocholate cotransporting polypeptide (NTCP) with disease progression and gender-specific differences in chronic HBV-infected patients. Liver samples were collected from chronic HBV-infected patients who underwent percutaneous liver biopsy or liver surgery. HBV DNA levels and the mRNA and protein expression levels of NTCP in liver tissues were determined. The relationship between NTCP expression and HBV DNA levels, inflammatory activity, fibrosis, and gender-specific differences were analyzed. A total of 94 chronic HBV-infected patients were included. Compared with patients with a METAVIR score of A0-1 or F0-1, patients with score of A2 or F2/F3 had a relatively higher level of NTCP expression. NTCP levels were positively correlated with HBV DNA levels. The inflammatory activity scores and fibrosis scores of women <50 years were significantly lower than those of women ≥50 years and age-matched males. In patients with score A0-2 or F0-3, women <50 years have lower NTCP expression level compared to women ≥50 years and age-matched males. NTCP can promote the disease progression by affecting the viral load of HBV. The NTCP expression difference may be why male and postmenopausal women are more prone to disease progression than reproductive women.
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Affiliation(s)
- Jingyi Shi
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xu Wang
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Wenqian Qi
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Song Wang
- Department of Urology, The First Hospital of Jilin University, Changchun, China
| | - Yao Fu
- Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
| | - Yonggui Zhang
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Qian Zhang
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Liang Han
- Department of Pathology, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Yanhui Xu
- Department of Gastroenterology and Hepatology, People's Hospital of Zhengzhou University and Henan Provincial People's Hospital, Zhengzhou, China
| | - Honglei Duan
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jia Liu
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Xianling Cong
- Department of Biobank, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Changyu Zhou
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Ping Zhao
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
| | - Jiangbin Wang
- Department of Digestive, China-Japan Union Hospital of Jilin University, Changchun, China
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49
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Rifas-Shiman SL, Aris IM, Switkowski KM, Young J, Fleisch AF, James-Todd T, Zota AR, Perng W, Hivert MF, Rich-Edwards JW, Perez Capotosto M, Chavarro JE, Oken E. Cohort Profile Update: Project Viva mothers. Int J Epidemiol 2023; 52:e332-e339. [PMID: 37875013 PMCID: PMC10749767 DOI: 10.1093/ije/dyad137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Affiliation(s)
- Sheryl L Rifas-Shiman
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Karen M Switkowski
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Jessica Young
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Abby F Fleisch
- Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA
- Center for Interdisciplinary Population and Health Research, MaineHealth Institute for Research, Portland, ME, USA
| | - Tamarra James-Todd
- Department of Environmental Health, Harvard T H Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Ami R Zota
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Wei Perng
- Department of Epidemiology and the Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Janet W Rich-Edwards
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Jorge E Chavarro
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
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50
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Chen W, Chen M, Tang H, Wei W, Shao P, Dou S, Wu J, Lu B, Shi R, Chen J. Advances in diagnosis and treatment of perimenopausal syndrome. Open Life Sci 2023; 18:20220754. [PMID: 38152579 PMCID: PMC10751995 DOI: 10.1515/biol-2022-0754] [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: 02/25/2023] [Revised: 08/24/2023] [Accepted: 09/19/2023] [Indexed: 12/29/2023] Open
Abstract
With the development and progress of society, people's average life expectancy has increased, and relevant literature reports that the number of postmenopausal women in China continues to increase. With lifespans extended, the transition period and post-menopause period have become the longest essential period in every woman's life. The life quality of women troubled by perimenopausal syndrome has been significantly reduced, which also places a burden on families and society. It is well known that hormone replacement therapy plays a vital role in improving women's menopause-related symptoms and is the most effective medical measure. With research ongoing into the treatment of menopausal symptoms in different patients, dose size, treatment duration, and medication regimens for hormones are still hot topics of discussion. This article reviews the definition, clinical diagnosis, staging, clinical manifestations, and treatment of menopause and explores the current diagnosis and treatment scenarios of perimenopausal syndrome.
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Affiliation(s)
- Wanying Chen
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Mengjuan Chen
- Zhoukou Maternal and Child Health Hospital, Zhoukou, Henan, 466000, PR China
| | - Huimin Tang
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Weiwei Wei
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Panqiu Shao
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Shulan Dou
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Jia Wu
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Bingying Lu
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Ruxia Shi
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
| | - Jiming Chen
- Department of Gynecology, The Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, Jiangsu, 213003, PR China
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