1
|
Sievert LL, Shreyer S, Witkowski S, Brown DE. Brown Adipose Tissue Activity and Childhood Exposure to Cold Are Associated With Hot Flashes at Menopause. Am J Hum Biol 2024:e24148. [PMID: 39230250 DOI: 10.1002/ajhb.24148] [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: 03/12/2024] [Revised: 08/13/2024] [Accepted: 08/14/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVE Hot flashes (HFs) are experienced as sudden sensations of heat. We hypothesized that brown adipose tissue (BAT) activation could increase the likelihood of HFs in winter. The aim of this study was to test whether women with more BAT activity were more likely to experience self-reported or biometrically measured HFs. METHODS Women aged 45-55 years (n = 270) participated in face-to-face interviews and anthropometric and ambulatory measures. Level of BAT activity was estimated from the difference in supraclavicular skin temperature measured by infrared thermography before and after cooling. Logistic regressions were applied to examine whether bothersome HFs (yes/no) during the past 2 weeks were associated with BAT activity, adjusting for menopausal status, childhood exposure to cold, waist/hip ratio, and self-reported health. Linear regressions were used to examine the frequency of self-reported and biometrically measured HFs during the study period and BAT activity, adjusting for potential confounders. RESULTS Menopausal status, childhood exposure to cold, waist-to-hip ratio (WHR), and self-reported health were associated with both BAT activity and HFs. After adjusting for potential confounders, an increase in BAT activity almost tripled the likelihood of bothersome HFs (OR 2.84, 95% CI 1.26-6.43). In linear regressions, BAT activity was not associated with frequency of subjective or objective HFs during the study period, but childhood exposure to cold was associated with subjective HF report (β = 0.163, p = 0.010). CONCLUSION To our knowledge, this is the first study of BAT activation and HFs. Our results support a role for BAT activity in HF experience. Therefore, we encourage further examination of the role of BAT, as well as childhood exposure to cold, in HFs.
Collapse
Affiliation(s)
| | - Sofiya Shreyer
- Department of Anthropology, UMass Amherst, Amherst, Massachusetts, USA
| | - Sarah Witkowski
- Exercise & Sport Studies, Smith College, Northampton, Massachusetts, USA
| | - Daniel E Brown
- Department of Anthropology, University of Hawaii at Hilo, Hilo, Hawaii, USA
| |
Collapse
|
2
|
Jahangirifar M, Islam RM, Davis SR, Fooladi E. The prevalence and severity of vasomotor and sexual symptoms among refugee women in Australia. Climacteric 2024; 27:398-405. [PMID: 39022922 DOI: 10.1080/13697137.2024.2376183] [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: 03/05/2024] [Revised: 05/15/2024] [Accepted: 06/30/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE This study aimed to document the prevalence and severity of vasomotor symptoms (VMS) and sexual symptoms among refugee women in Melbourne, Australia. METHODS This cross-sectional study included refugee women, aged 18-63 years, recruited from community centers and social media between February and July 2023. The Menopause-specific Quality of Life (MENQOL) questionnaire measured VMS and sexual symptoms. The scores were compared between different menopausal states. RESULTS Of 333 participants, 62.8% were premenopausal, 8.0% perimenopausal and 29.2% postmenopausal, with a median age of 40 years (range 18-63 years). Moderate-severe VMS was most prevalent amongst perimenopausal (20.8%; 95% confidence interval [CI]: 8.9-41.4%) versus postmenopausal (9.5%; 95% CI: 5.0-17.3%) and premenopausal (0%) women. Moderate-severe sexual symptoms affected 15.8% (95% CI: 5.2-39.3%) of perimenopausal and 16.9% (95% CI: 10.4-26.1%) of postmenopausal women versus 1.4% (95% CI: 0.3-5.3%) of premenopausal women. Perimenopausal and postmenopausal women had higher VMS and sexual symptom scores than premenopausal women (both p < 0.0001); the scores were also higher in perimenopausal women than postmenopausal women (p = 0.016 and p = 0.013, respectively). CONCLUSION While perimenopausal and postmenopausal VMS and sexual symptoms are not uncommon amongst refugee women, these symptoms were less prevalent in postmenopausal refugees than in the non-refugee population. Further research is warranted to confirm and expand on these findings.
Collapse
Affiliation(s)
| | - Rakibul M Islam
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Susan R Davis
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ensieh Fooladi
- Monash Nursing and Midwifery, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
3
|
Herrera-Pérez JJ, Hernández-Hernández OT, Flores-Ramos M, Cueto-Escobedo J, Rodríguez-Landa JF, Martínez-Mota L. The intersection between menopause and depression: overview of research using animal models. Front Psychiatry 2024; 15:1408878. [PMID: 39081530 PMCID: PMC11287658 DOI: 10.3389/fpsyt.2024.1408878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 06/28/2024] [Indexed: 08/02/2024] Open
Abstract
Menopausal women may experience symptoms of depression, sometimes even progressing clinical depression requiring treatment to improve quality of life. While varying levels of estrogen in perimenopause may contribute to an increased biological vulnerability to mood disturbances, the effectiveness of estrogen replacement therapy (ERT) in the relief of depressive symptoms remains controversial. Menopausal depression has a complex, multifactorial etiology, that has limited the identification of optimal treatment strategies for the management of this psychiatric complaint. Nevertheless, clinical evidence increasingly supports the notion that estrogen exerts neuroprotective effects on brain structures related to mood regulation. Indeed, research using preclinical animal models continues to improve our understanding of menopause and the effectiveness of ERT and other substances at treating depression-like behaviors. However, questions regarding the efficacy of ERT in perimenopause have been raised. These questions may be answered by further investigation using specific animal models of reduced ovarian function. This review compares and discusses the advantages and pitfalls of different models emulating the menopausal stages and their relationship with the onset of depressive-like signs, as well as the efficacy and mechanisms of conventional and novel ERTs in treating depressive-like behavior. Ovariectomized young rats, middle-to-old aged intact rats, and females treated with reprotoxics have all been used as models of menopause, with stages ranging from surgical menopause to perimenopause. Additionally, this manuscript discusses the impact of organistic and therapeutic variables that may improve or reduce the antidepressant response of females to ERT. Findings from these models have revealed the complexity of the dynamic changes occurring in brain function during menopausal transition, reinforcing the idea that the best approach is timely intervention considering the opportunity window, in addition to the careful selection of treatment according to the presence or absence of reproductive tissue. Additionally, data from animal models has yielded evidence to support new promising estrogens that could be considered as ERTs with antidepressant properties and actions in endocrine situations in which traditional ERTs are not effective.
Collapse
Affiliation(s)
- José Jaime Herrera-Pérez
- Laboratorio de Farmacología Conductual, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Olivia Tania Hernández-Hernández
- Consejo Nacional de Humanidades, Ciencias y Tecnologías Research Fellow. Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mónica Flores-Ramos
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Jonathan Cueto-Escobedo
- Departamento de Investigación Clínica, Instituto de Ciencias de la Salud, Universidad Veracruzana, Xalapa-Enríquez, Mexico
| | | | - Lucía Martínez-Mota
- Laboratorio de Farmacología Conductual, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| |
Collapse
|
4
|
Meng C, Wei Q, Gu C, He S, Cai C, Lai D, Qiu Q. Prevalence and Risk Factors of Ocular Demodex at Ultra-High Altitude and Sea Level: A Cross-Sectional Study of Shigatse and Shanghai. J Ocul Pharmacol Ther 2024. [PMID: 38963788 DOI: 10.1089/jop.2024.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024] Open
Abstract
Purpose: Demodex infestation is a risk factor for several ocular surface diseases. However, the prevalence of ocular Demodex infection in the ultra-high altitude population is not clear. This study aimed to compare the prevalence and factors associated with Demodex in populations residing in ultra-high altitude region and sea level areas. Methods: Consecutive patients who visited Shigatse People's Hospital (> 4,000 m) and Shanghai Tongren Hospital (sea level) for eye complaints between January 2023 and January 2024 were included. Subjects were divided into ultra-high altitude and sea level groups. All subjects underwent eyelash epilation for ocular Demodex identification and counting. Demographic and lifestyle information was also collected. Results: A total of 517 subjects were eligible, including 255 subjects in the ultra-high-altitude group and 262 subjects in the sea level group. In the overall analysis, the prevalence of ocular Demodex infection was significantly different between the ultra-high-altitude and sea level groups (15.7% vs. 33.2%, P < 0.001). Multiple logistic regression showed that age, time spent outdoors, and makeup were associated with ocular Demodex infection in both groups. In addition, in the ultra-high-altitude group, people who wear sun hats outdoors were more likely to be infected with Demodex. Conclusion: The infection rate of ocular Demodex in the residents of ultra-high altitude area was significantly lower than that in the residents of sea level area, which may be related to lower ambient temperature, lower humidity, and higher solar radiation. Additionally, age, time spent outdoors, and makeup may be associated with ocular Demodex infection.
Collapse
Affiliation(s)
- Chunren Meng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Clinical Research Center for Eye Diseases, Shanghai, PR China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, PR China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, PR China
| | - Qingquan Wei
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, PR China
| | - Chufeng Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Clinical Research Center for Eye Diseases, Shanghai, PR China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, PR China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, PR China
| | - Shuai He
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Clinical Research Center for Eye Diseases, Shanghai, PR China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, PR China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, PR China
| | - Chunyang Cai
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Clinical Research Center for Eye Diseases, Shanghai, PR China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, PR China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, PR China
| | - Dongwei Lai
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Clinical Research Center for Eye Diseases, Shanghai, PR China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, PR China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, PR China
| | - Qinghua Qiu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
- Shanghai Clinical Research Center for Eye Diseases, Shanghai, PR China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, PR China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, PR China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, PR China
- Department of Ophthalmology, Shigatse People's Hospital, Shigatse, China
| |
Collapse
|
5
|
Witkowski S, White Q, Shreyer S, Garcia RL, Brown DE, Sievert LL. Acute increases in physical activity and temperature are associated with hot flash experience in midlife women. Menopause 2024; 31:600-607. [PMID: 38814193 PMCID: PMC11213681 DOI: 10.1097/gme.0000000000002373] [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: 05/31/2024]
Abstract
OBJECTIVE This study determined the association between acute changes in physical activity, temperature, and humidity and 24-hour subjective and objective hot flash experience. METHODS Data collection occurred during the cooler months of the year in Western Massachusetts (October-April). Women aged 45-55 across three menopause stages (n = 270) were instrumented with ambulatory monitors to continuously measure hot flashes, physical activity, temperature, and humidity for 24 hours. Objective hot flashes were assessed via sternal skin conductance, and subjective hot flashes were recorded by pressing an event marker and data logging. Physical activity was measured with wrist-worn accelerometers and used to define sleep and wake periods. Logistic multilevel modeling was used to examine the differences in physical activity, humidity, and temperature in the 10 minutes preceding a hot flash versus control windows when no hot flashes occurred. The odds of hot flashes were considered separately for objective and subjective hot flashes as well as for wake and sleep periods. RESULTS Data from 188 participants were included in the analyses. There was a significantly greater odds of a hot flash following acute increases in physical activity for objective waking hot flashes (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.17-1.47; P < 0.001) and subjective waking hot flashes (OR, 1.16; 95% CI, 1.0-1.33; P = 0.03). Acute increases in the actigraphy signal were associated with significantly higher odds of having an objective (OR, 1.17; 95% CI, 1.03-1.35; P < 0.01) or subjective (OR, 1.72; 95% CI, 1.52-2.01; P < 0.001) sleeping hot flash. Increases in temperature were significantly related to the odds of subjective sleeping hot flashes only (OR, 1.38; 95% CI, 1.15-1.62; P < 0.001). There was no evidence for a relationship between humidity and odds of experiencing any hot flashes. CONCLUSION These results indicate that acute increases in physical activity increase the odds of hot flashes that are objectively measured and subjectively reported during waking and sleeping periods. Temperature increases were only related to subjectively reported nighttime hot flashes.
Collapse
Affiliation(s)
| | - Quinn White
- Statistical & Data Sciences, Smith College, Northampton, MA
| | - Sofiya Shreyer
- Department of Anthropology, University of Massachusetts, Amherst, MA
| | - Randi L Garcia
- Statistical & Data Sciences, Smith College, Northampton, MA
| | - Daniel E Brown
- Department of Anthropology, University of Hawaii at Hilo, Hilo, HI
| | | |
Collapse
|
6
|
Mateikaitė-Pipirienė K, Jean D, Paal P, Horakova L, Kriemler S, Rosier AJ, Andjelkovic M, Beidleman BA, Derstine M, Hefti JP, Hillebrandt D, Keyes LE. Menopause and High Altitude: A Scoping Review-UIAA Medical Commission Recommendations. High Alt Med Biol 2024; 25:1-8. [PMID: 37922458 DOI: 10.1089/ham.2023.0039] [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: 11/05/2023] Open
Abstract
Mateikaitė-Pipirienė, Kastė, Dominique Jean, Peter Paal, Lenka Horakova, Susi Kriemler, Alison J. Rosier, Marija Andjelkovic, Beth A. Beidleman, Mia Derstine, Jacqueline Pichler Hefti, David Hillebrandt, and Linda E. Keyes for the UIAA MedCom writing group on Women's Health in the Mountains. Menopause and high altitude: A scoping review-UIAA Medical Commission Recommendations. High Alt Med Biol. 25:1-8, 2024. Background: Older people are an important fraction of mountain travelers and climbers, many of them postmenopausal women. The aim of this work was to review health issues that older and postmenopausal women may experience at high altitude, including susceptibility to high-altitude illness. Methods: We performed a scoping review for the UIAA Medical Commission series on Women's Health in the mountains. We searched PubMed and Cochrane libraries and performed an additional manual search. The primary search focused on articles assessing lowland women sojourning at high altitude. Results: We screened 7,165 potential articles. The search revealed three relevant articles, and the manual search another seven articles and one abstract. Seven assessed menopausal low-altitude residents during a high-altitude sojourn or performing hypoxic tests. Four assessed high-altitude residents. We summarize the results of these 11 studies. Conclusions: Data are limited on the effects of high altitude on postmenopausal women. The effects of short-term, high-altitude exposure on menopause symptoms are unknown. Menopause has minimal effect on the physiological responses to hypoxia in physically fit women and does not increase the risk of acute mountain sickness. Postmenopausal women have an increased risk of urinary tract infections, which may be exacerbated during mountain travel. More research is needed on the physiology and performance of older women at high altitude.
Collapse
Affiliation(s)
- Kastė Mateikaitė-Pipirienė
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Diaverum Clinics, Elektrėnai Division, Lithuania
| | - Dominique Jean
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Paediatrics, Infectious Diseases and Altitude Medicine, Grenoble, France
| | - Peter Paal
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelesus Medical University, Salzburg, Austria
| | - Lenka Horakova
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Alison J Rosier
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
| | - Marija Andjelkovic
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- Pharmacy, Singidunum University, Belgrade, Serbia
| | - Beth A Beidleman
- US Army Research Institute of Environmental Medicine, Military Performance Division, Natick MA
| | - Mia Derstine
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| | | | - David Hillebrandt
- Medical Commission of the International Climbing and Mountaineering Federation (UIAA), Bern, Switzerland
- General Medical Practitioner, Holsworthy, Devon, United Kingdom
| | - Linda E Keyes
- Department of Emergency Medicine, University of Colorado, Aurora, Colorado, USA
| |
Collapse
|
7
|
Jalali R, Romaszko J, Dragańska E, Gromadziński L, Cymes I, Sokołowski JB, Poterała M, Markuszewski L, Romaszko-Wojtowicz AM, Jeznach-Steinhagen A, Glińska-Lewczuk K. Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia. PLoS One 2024; 19:e0296412. [PMID: 38165960 PMCID: PMC10760728 DOI: 10.1371/journal.pone.0296412] [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: 08/24/2023] [Accepted: 12/12/2023] [Indexed: 01/04/2024] Open
Abstract
Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016-2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.
Collapse
Affiliation(s)
- Rakesh Jalali
- Department of Emergency Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jerzy Romaszko
- Department of Family Medicine and Infectious Diseases, School of Medicine, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Ewa Dragańska
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Leszek Gromadziński
- Department of Cardiology and Internal Medicine, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Iwona Cymes
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | | | - Magdalena Poterała
- Department of Medicine, Faculty of Medical Sciences and Health Science, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Leszek Markuszewski
- Department of Medicine, Faculty of Medical Sciences and Health Science, Kazimierz Pulaski University of Technology and Humanities in Radom, Radom, Poland
| | - Anna Maria Romaszko-Wojtowicz
- Department of Pulmonology, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | | | - Katarzyna Glińska-Lewczuk
- Department of Water Management and Climatology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| |
Collapse
|
8
|
Todorova L, Bonassi R, Guerrero Carreño FJ, Hirschberg AL, Yuksel N, Rea C, Scrine L, Kim JS. Prevalence and impact of vasomotor symptoms due to menopause among women in Brazil, Canada, Mexico, and Nordic Europe: a cross-sectional survey. Menopause 2023; 30:1179-1189. [PMID: 37847872 DOI: 10.1097/gme.0000000000002265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
OBJECTIVE This study investigated the prevalence and impact of moderate to severe vasomotor symptoms (VMS), related treatment patterns, and experiences in women. METHODS The primary objective was to assess the prevalence of moderate to severe menopause-related VMS among postmenopausal women aged 40 to 65 years in Brazil, Canada, Mexico, and four Nordic European countries (Denmark, Finland, Norway, and Sweden) using an online survey. Secondary objectives assessed impact of VMS among perimenopausal and postmenopausal women with moderate to severe VMS using the Menopause-Specific Quality of Life questionnaire, Work Productivity and Activity Impairment questionnaire, Patient-Reported Outcomes Measurement Information System sleep disturbances assessment, and questions regarding treatment patterns and attitudes toward symptoms and available treatments. RESULTS Among 12,268 postmenopausal women, the prevalence of moderate to severe VMS was about 15.6% and was highest in Brazil (36.2%) and lowest in Nordic Europe (11.6%). Secondary analyses, conducted among 2,176 perimenopausal and postmenopausal women, showed that VMS affected quality of life across all domains measured and impaired work activities by as much as 30%. Greater symptom severity negatively affected sleep. Many women sought medical advice, but most (1,238 [56.9%]) were not receiving treatment for their VMS. The majority (>70%) considered menopause to be a natural part of aging. Those treated with prescription hormone therapy and nonhormone medications reported some safety/efficacy concerns. CONCLUSIONS Among women from seven countries, moderate to severe menopause-related VMS were widespread, varied by region, and largely impaired quality of life, productivity, and/or sleep.
Collapse
Affiliation(s)
- Lora Todorova
- From the Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Addlestone, United Kingdom
| | - Rogerio Bonassi
- Department of Gynecology and Obstetrics, Jundiaí School of Medicine, Jundiaí, São Paulo, Brazil
| | | | | | - Nese Yuksel
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Carol Rea
- Brand & Integrated Research Solutions, IQVIA, London, United Kingdom
| | - Ludmila Scrine
- From the Health Economics and Outcomes Research, Astellas Pharma Europe Ltd, Addlestone, United Kingdom
| | - Janet S Kim
- Data Science, Astellas Pharma Global Development, Inc, Northbrook, IL
| |
Collapse
|
9
|
Cucinella L, Tiranini L, Nappi RE. Impact of climate and environmental change on the menopause. Maturitas 2023; 178:107825. [PMID: 37634295 DOI: 10.1016/j.maturitas.2023.107825] [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: 06/18/2023] [Revised: 07/29/2023] [Accepted: 08/10/2023] [Indexed: 08/29/2023]
Abstract
The huge impact of climate change on humankind is multidimensional, and includes direct and indirect challenges to the physical, psychological and socio-cultural wellbeing. Women may be more vulnerable to climate-sensitive diseases, but little attention has been paid to specific needs and challenges associated with the menopause transition. The increase in average and extreme temperatures may modulate the manifestation of vasomotor symptoms; in particular, environmental temperature and seasonality may affect hot flushes and night sweats. However, more research is needed to define the impact of climate-related factors among the determinants influencing the individual experience of menopause. In addition, increased exposure to environmental pollution and toxins may also have a role in the modulation of ovarian aging mechanisms, possibly influencing timing of menopause. Finally, both air pollution and menopause transition are associated with unfavorable modifications of cardio-metabolic, bone and cognitive health, and account should be taken of these in the evaluation of the individual woman's health vulnerabilities. Overall, the evidence reported in this narrative review supports the need for specific strategies aimed at reducing the burden of climate and environmental change on menopausal women. Healthcare providers should promote behavioral measures that reduce anthropogenic climate change and at the same time have a beneficial role on several domains of physical and psychological wellbeing. From this perspective, menopause represents a golden moment to implement virtuous behaviors that will benefit at the same time women's longevity and the planet.
Collapse
Affiliation(s)
- Laura Cucinella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Lara Tiranini
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Rossella E Nappi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy; Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, 27100 Pavia, Italy.
| |
Collapse
|
10
|
An J, Li L. Urban-rural differences in epidemiology and risk factors of menopause syndrome in middle-aged Chinese women. Menopause 2023; 30:306-316. [PMID: 36728551 DOI: 10.1097/gme.0000000000002135] [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: 02/03/2023]
Abstract
OBJECTIVE To compare the prevalence and severity of menopausal symptoms and investigate their associated factors among rural and urban middle-aged Chinese women. METHODS A descriptive, cross-sectional study of 4,580 urban and 2,729 rural randomly sampled participants aged 40 to 55 years in Gansu Province, China, was conducted. Questionnaires assessing the sociodemographic information and menstrual and reproductive histories of the participants were administered. The modified Kupperman scale was used to assess the presence and severity of menopausal symptoms. Binary and ordinal logistic regression analyses were performed to identify factors associated with the occurrence and severity of menopausal syndrome, respectively, according to the modified Kupperman Menopausal Index score rank. RESULTS The natural menopausal age of the rural women was significantly lower than that of the urban women (rural: 47.22, urban: 47.98; P < 0.05). Furthermore, rural women had a higher prevalence (rural: 56.35%, urban: 43.47%) and severity (rural: 11.40%, urban: 6.61%) of menopausal syndrome than the urban women ( P < 0.05). For both the urban and rural women, the prevalence and severity of most menopausal symptoms increased as menopause progressed. The three most prevalent symptoms in both the urban and rural women were fatigue (rural: 70.43%, urban: 68.19%), muscle/joint pain (rural: 62.84%, urban: 59.32%), and vertigo (rural: 57.42%, urban: 47.44%). Positive associations between menopausal symptoms and age, residence, body mass index, level of education, time of pregnancy, menstrual cycle, and presence of chronic diseases were observed. CONCLUSIONS Rural women experience more frequent and severe menopausal syndrome than do urban women.
Collapse
Affiliation(s)
- Junxia An
- From the College of Life Sciences, Northwest Normal University, Anning, Lanzhou, Gansu, People's Republic of China
| | - Lifei Li
- The Reproductive Medicine Special Hospital of The First Hospital of Lanzhou University, Chengguan, Lanzhou, Gansu, People's Republic of China
| |
Collapse
|
11
|
Fonseca CS, Aquino NSS, Goncalves GKN, Drummond LR, Hipolito LTM, Silva JF, Silva KSC, Henriques PC, Domingues TE, Lacerda ACR, Guatimosim S, Coimbra CC, Szawka RE, Reis AM. Norepinephrine modulation of heat dissipation in female rats lacking estrogen. J Neuroendocrinol 2022; 34:e13188. [PMID: 36306200 DOI: 10.1111/jne.13188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/10/2022] [Accepted: 07/15/2022] [Indexed: 11/27/2022]
Abstract
Postmenopausal hot flushes are caused by lack of estradiol (E2) but their neuroendocrine basis is still poorly understood. Here, we investigated the interrelationship between norepinephrine and hypothalamic neurons, with emphasis on kisspeptin neurons in the arcuate nucleus (ARC), as a regulatory pathway in the vasomotor effects of E2. Ovariectomized (OVX) rats displayed increased tail skin temperature (TST), and this increase was prevented in OVX rats treated with E2 (OVX + E2). Expression of Fos in the hypothalamus and the number of ARC kisspeptin neurons coexpressing Fos were increased in OVX rats. Likewise, brainstem norepinephrine neurons of OVX rats displayed higher Fos immunoreactivity associated with the increase in TST. In the ARC, the density of dopamine-ß-hydroxylase (DBH)-immunoreactive (ir) fibers was not altered by E2 but, importantly, DBH-ir terminals were found in close apposition to kisspeptin cells, revealing norepinephrine inputs to ARC kisspeptin neurons. Intracerebroventricular injection of the α2-adrenergic agonist clonidine (CLO) was used to reduce central norepinephrine release, confirmed by the decreased 3-methoxy-4-hydroxyphenylglycol/norepinephrine ratio in the preoptic area and ARC. Accordingly, CLO treatment in OVX rats reduced ARC Kiss1 mRNA levels and TST to the values of OVX + E2 rats. Conversely, CLO stimulated Kiss1 expression in the anteroventral periventricular nucleus (AVPV) and increased luteinizing hormone secretion. These findings provide evidence that augmented heat dissipation in OVX rats involves the increase in central norepinephrine that modulates hypothalamic areas related to thermoregulation, including ARC kisspeptin neurons. This neuronal network is suppressed by E2 and its imbalance may be implicated in the vasomotor symptoms of postmenopausal hot flushes.
Collapse
Affiliation(s)
- Cristina S Fonseca
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Nayara S S Aquino
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gleisy K N Goncalves
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucas R Drummond
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Laisa T M Hipolito
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Juneo F Silva
- Centro de Microscopia Eletronica, Departamento de Ciencias Biologicas, Universidade Estadual de Santa Cruz, Ilheus, Brazil
| | - Kaoma S C Silva
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Patricia C Henriques
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Talita E Domingues
- Faculdade de Ciencias Biologicas e da Saude, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Ana C R Lacerda
- Faculdade de Ciencias Biologicas e da Saude, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Silvia Guatimosim
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Candido C Coimbra
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Raphael E Szawka
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adelina M Reis
- Departamento de Fisiologia e Biofisica, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| |
Collapse
|
12
|
Bayanjargal O, Namsrai Z, Sievert LL. The menopausal transition in Mongolia. Menopause 2021; 29:96-100. [PMID: 34668884 DOI: 10.1097/gme.0000000000001877] [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: 11/26/2022]
Abstract
OBJECTIVE The purpose of this cross-sectional pilot study was to develop a preliminary understanding of how menopause is experienced by Mongolian women. Our goals were to collect symptoms associated with the end of menstruation and to understand the language used and meaning of menopause in everyday life. METHODS We carried out interviews using a semistructured questionnaire with open-ended questions (n = 17). In the capital city of Ulaanbaatar, we carried out two focus groups of five women each in a community center and an artisan factory, along with five separate interviews in a second community center and a coffee shop. We also administered the questionnaire by phone to two women residing in rural villages. RESULTS The most common symptoms associated with the end of menstruation were hot flashes (71%), anger (47%), and stress (29%). Other symptoms included shortness of breath, fatigue, crying, and badairakh (tingling) on the face. Women used the words tsevershilt and tsevershikh to describe cleansing. Menstruation was thought to rid the body of "bad" blood, so with menopause the body has been "cleaned." Conversely, some women attributed a decline in health, including varicose veins, diabetes, and negative psychological changes, to the retention of "bad" blood after menopause. CONCLUSIONS The topic of menopause is not taboo, and the prevalence and experience of hot flashes is similar to experiences described across the world. However, there are specific words and concepts, such as tsevershikh and tsevershilt, that are uniquely applied to the menopausal transition in Mongolia.
Collapse
|
13
|
Jaeger MDB, Miná CS, Alves S, Schuh GJ, Wender MC, Manfro GG. Negative affect symptoms, anxiety sensitivity, and vasomotor symptoms during perimenopause. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:277-284. [PMID: 33053044 PMCID: PMC8136388 DOI: 10.1590/1516-4446-2020-0871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 06/20/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Vasomotor symptoms affect 60-80% of women during the menopausal transition. Anxiety, depression, and anxiety sensitivity can have an important role in the distressful experience of vasomotor symptoms. Our aim was to evaluate the prevalence and association of vasomotor and negative affect symptoms. METHODS A cross-sectional study was conducted with 89 perimenopausal women aged 45-55 years. Broad psychiatric and clinical evaluations were carried out. The primary outcome was the vasomotor symptom problem rating and the main study factor was anxiety sensitivity. Linear regression analyses were conducted to examine the associations between the study factors and the primary outcome, and a multiple regression model was created to assess which variables were independently associated with vasomotor symptom problem rating. RESULTS The prevalence of anxiety, depression, and vasomotor symptoms were 58, 62, and 73%, respectively. Negative affect symptoms were positively associated with vasomotor symptom problem rating. The association of anxiety sensitivity and vasomotor symptom problem rating remained significant after controlling for perimenopausal stage, thyrotropin, follicle-stimulating hormone levels, and psychotropic medication use (β = 0.314, p = 0.002). CONCLUSION A better understanding of the experience of vasomotor symptoms is needed, especially the role of negative affect symptoms and anxiety sensitivity. New strategies focusing on related thoughts and behaviors could improve the quality of life of perimenopausal women.
Collapse
Affiliation(s)
- Marianna de B. Jaeger
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Camila S. Miná
- Programa de Pós-Graduação em Neurociências, Instituto de Ciências Básicas da Saúde (ICBS), UFRGS, Porto Alegre, RS, Brazil
| | - Sofia Alves
- Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brazil
| | | | - Maria C. Wender
- Programa de Pós-Graduação em Ciências da Saúde: Ginecologia e Obstetrícia, UFRGS, Porto Alegre, RS, Brazil
| | - Gisele G. Manfro
- Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
14
|
Neutzling AL, Leite HM, Paniz VMV, de Bairros FS, Dias da Costa JS, Olinto MTA. Association between common mental disorders, sleep quality, and menopausal symptoms: a population-based study in Southern Brazil. ACTA ACUST UNITED AC 2020; 27:463-472. [DOI: 10.1097/gme.0000000000001524] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Yun H, Lee B, Lee SJ, Park CY. Marine Healing, but Not Additional Intake of Undaria pinnatifida, Benefits Physical and Emotional Exhaustion Symptoms of Menopause. Clin Nutr Res 2020; 9:1-10. [PMID: 32095443 PMCID: PMC7015728 DOI: 10.7762/cnr.2020.9.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/29/2019] [Accepted: 11/29/2019] [Indexed: 11/19/2022] Open
Abstract
Menopausal symptoms can persist or worsen even years after menopause and affect women's quality of life. We investigated whether menopausal symptoms were alleviated through a marine healing program and if sea mustard intake additionally benefits these symptoms. A total of 42 menopausal women self-selected to participate as the marine (n = 22) or city group (n = 20). The marine group participated in a 5-day marine healing program consisting of a balanced diet, exercise, and mind-body practices using ocean resources. The city group continued one's daily routine without any intervention. Within the marine group, participants were randomly assigned to consume sea mustard (Undaria pinnatifida) (15.4 g dry weight/day; n = 11) or control (n = 11). Changes in menopausal symptoms were measured using the Menopause Rating Scale (MRS) before, immediately after, and 2 weeks after the end of the marine healing program. The city group completed the MRS at baseline and on day 20. Within subject differences of menopausal symptoms between baseline and immediately after the marine healing program were assessed using paired t-test. Intervention effects were assessed by mixed analysis of variance. Somatic, psychological, and urogenital symptoms were immediately alleviated after the marine healing program. No effect of sea mustard was detected in the marine group. After 2 weeks, the effect of marine healing persisted in physical and mental exhaustion only. A 5-day integrated marine healing program, but not additional sea mustard intake, temporarily alleviated menopausal symptoms. The reduction in physical and mental exhaustion after marine healing can be maintained for 2 weeks. Trial Registration Clinical Research Information Service Identifier: KCT0004025.
Collapse
Affiliation(s)
- Hyunju Yun
- Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea
| | - Bora Lee
- Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea
| | - Sung Jae Lee
- Department of Integrative Medicine, Korea University College of Medicine, Seoul 02841, Korea
| | - Clara Yongjoo Park
- Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea
| |
Collapse
|
16
|
Costanian C, Zangiabadi S, Bahous SA, Deonandan R, Tamim H. Reviewing the evidence on vasomotor symptoms: the role of traditional and non-traditional factors. Climacteric 2020; 23:213-223. [DOI: 10.1080/13697137.2019.1711051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- C. Costanian
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - S. Zangiabadi
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
| | - S. A. Bahous
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - R. Deonandan
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - H. Tamim
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
| |
Collapse
|
17
|
Harlow SD, Elliott MR, Bondarenko I, Thurston RC, Jackson EA. Monthly variation of hot flashes, night sweats, and trouble sleeping: effect of season and proximity to the final menstrual period (FMP) in the SWAN Menstrual Calendar substudy. Menopause 2020; 27:5-13. [PMID: 31567864 PMCID: PMC6934911 DOI: 10.1097/gme.0000000000001420] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Although reproductive function is influenced by season, few studies have evaluated seasonal effects on menopausal symptoms. We assessed the impact of season and proximity to the final menstrual period (FMP) on frequency of symptom reporting. METHODS In all, 955 participants in the Study of Women's Health Across the Nation recorded whether or not they had experienced menopausal symptoms on a monthly menstrual calendar over a 10-year period. We modeled the log-odds of presence of a given symptom each month using a logistic mixed-effects model, assuming a third-order polynomial before the FMP and a different third-order polynomial after the FMP. We assumed sine and cosine functions for month of the year. RESULTS Five to 10 years before the FMP, ∼20% of women reported hot flashes and night sweats, whereas ∼40% reported trouble sleeping. Prevalence rose ∼4 years before the FMP with a sharp jump in hot flash (∼60%) and night sweats (∼40%) prevalence coincident with the FMP. Peaks in hot flashes and trouble sleeping were observed in July with troughs in January. The peak and trough in night sweats occurred about 1 month earlier. Odds of hot flashes, night sweats, and trouble sleeping were 66%, 50%, and 24% greater, respectively, at the seasonal peak versus the seasonal minimum. CONCLUSION Menopausal symptoms exhibit seasonal variation associated with the summer and winter equinoxes. Seasonal increases in night sweats precede increases in hot flashes. Prospectively recorded monthly symptom data demonstrate that hot flashes and night sweats increase notably coincident with the FMP. : Video Summary:http://links.lww.com/MENO/A476.
Collapse
Affiliation(s)
- Siobán D Harlow
- Department of Epidemiology, University of Michigan, Ann Arbor, MI
| | | | - Irina Bondarenko
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | | | | |
Collapse
|
18
|
Seasonality and symptoms. Menopause 2019; 27:1-2. [PMID: 31880676 DOI: 10.1097/gme.0000000000001470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
19
|
Richalet JP, Lhuissier F, Jean D. Ventilatory Response to Hypoxia and Tolerance to High Altitude in Women: Influence of Menstrual Cycle, Oral Contraception, and Menopause. High Alt Med Biol 2019; 21:12-19. [PMID: 31855465 DOI: 10.1089/ham.2019.0063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Introduction: Tolerance to high altitude in women might be influenced by hormonal status since female hormones modulate ventilation. Methods: Our objectives were (i) to explore in 1060 women, the influence of the phase of menstrual cycle, oral contraception, and menopause with or without hormonal treatment, on hypoxic ventilatory response at exercise (HVRe) and hypoxic cardiac response at exercise (HCRe) measured during a routine hypoxia exercise test, before an exposure to high altitude; (ii) to determine in 260 women exposed to high altitude, the influence of menopause and oral contraceptive and other drug use, on the prevalence of severe acute mountain sickness (sAMS). Four groups were defined: premenopausal with or without oral contraception and postmenopausal with or without hormonal treatment. Results: In premenopausal women without contraception, HVRe was higher in the early luteal/midluteal phase than in the early follicular phase (0.89 ± 0.37 vs. 0.75 ± 0.27 mL/[min · kg], p = 0.03). HVRe was similar in postmenopausal versus premenopausal women. HCRe was lower in postmenopausal women (p < 0.001), due to aging. HVRe decreased from second to fourth decade of age and increased from fourth to eighth decade, while HCRe consistently decreased with aging. Oral contraception or hormonal treatment had no effect on responses to hypoxia. The prevalence of sAMS was similar in all groups. Severe high-altitude illness score was higher and HVRe lower in women with sAMS. Conclusion: (i) physiological responses to hypoxic exercise depend on the ovarian cycle phase and menopause status, (ii) oral contraception and hormonal treatment have no influence on the tolerance to high altitude, and (iii) independent of hormonal status, aging modulates physiological responses to hypoxia.
Collapse
Affiliation(s)
- Jean-Paul Richalet
- INSERM U1272 Hypoxie et Poumon, Université Paris 13, Bobigny, France.,Département Médical, Institut National de l'Expertise et de la Performance, Paris, France
| | - François Lhuissier
- INSERM U1272 Hypoxie et Poumon, Université Paris 13, Bobigny, France.,Assistance Publique Hôpitaux de Paris, Hôpital Jean-Verdier, Bondy, France
| | - Dominique Jean
- CHU Grenoble-Alpes, Centre Pluridisciplinaire de Diagnostic Prénatal, Grenoble, France
| |
Collapse
|
20
|
Padilla SL, Johnson CW, Barker FD, Patterson MA, Palmiter RD. A Neural Circuit Underlying the Generation of Hot Flushes. Cell Rep 2019; 24:271-277. [PMID: 29996088 DOI: 10.1016/j.celrep.2018.06.037] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 05/24/2018] [Accepted: 06/08/2018] [Indexed: 12/15/2022] Open
Abstract
Hot flushes are a sudden feeling of warmth commonly associated with the decline of gonadal hormones at menopause. Neurons in the arcuate nucleus of the hypothalamus that express kisspeptin and neurokinin B (Kiss1ARH neurons) are candidates for mediating hot flushes because they are negatively regulated by sex hormones. We used a combination of genetic and viral technologies in mice to demonstrate that artificial activation of Kiss1ARH neurons evokes a heat-dissipation response resulting in vasodilation (flushing) and a corresponding reduction of core-body temperature in both females and males. This response is sensitized by ovariectomy. Brief activation of Kiss1ARH axon terminals in the preoptic area of the hypothalamus recapitulates this response, while pharmacological blockade of neurokinin B (NkB) receptors in the same brain region abolishes it. We conclude that transient activation of Kiss1ARH neurons following sex-hormone withdrawal contributes to the occurrence of hot flushes via NkB release in the rostral preoptic area.
Collapse
Affiliation(s)
- Stephanie L Padilla
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Christopher W Johnson
- Graduate Program in Neuroscience, University of Washington, Seattle, WA 98195, USA; Departments of Biochemistry and Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Forrest D Barker
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Michael A Patterson
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA
| | - Richard D Palmiter
- Howard Hughes Medical Institute, University of Washington, Seattle, WA 98195, USA; Departments of Biochemistry and Genome Sciences, University of Washington, Seattle, WA 98195, USA.
| |
Collapse
|
21
|
Monteleone P, Mascagni G, Giannini A, Genazzani AR, Simoncini T. Symptoms of menopause - global prevalence, physiology and implications. Nat Rev Endocrinol 2018; 14:199-215. [PMID: 29393299 DOI: 10.1038/nrendo.2017.180] [Citation(s) in RCA: 303] [Impact Index Per Article: 50.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The symptoms of menopause can be distressing, particularly as they occur at a time when women have important roles in society, within the family and at the workplace. Hormonal changes that begin during the menopausal transition affect many biological systems. Accordingly, the signs and symptoms of menopause include central nervous system-related disorders; metabolic, weight, cardiovascular and musculoskeletal changes; urogenital and skin atrophy; and sexual dysfunction. The physiological basis of these manifestations is emerging as complex and related, but not limited to, oestrogen deprivation. Findings generated mainly from longitudinal population studies have shown that ethnic, geographical and individual factors affect symptom prevalence and severity. Moreover, and of great importance to clinical practice, the latest research has highlighted how certain menopausal symptoms can be associated with the onset of other disorders and might therefore serve as predictors of future health risks in postmenopausal women. The goal of this Review is to describe in a timely manner new research findings on the global prevalence and physiology of menopausal symptoms and their impact on future health.
Collapse
Affiliation(s)
- Patrizia Monteleone
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Giulia Mascagni
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, University of Pisa, Via Savi 10, Pisa 56126, Italy
| |
Collapse
|
22
|
Sturdee DW, Hunter MS, Maki PM, Gupta P, Sassarini J, Stevenson JC, Lumsden MA. The menopausal hot flush: a review. Climacteric 2017; 20:296-305. [DOI: 10.1080/13697137.2017.1306507] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- D. W. Sturdee
- Department of Gynaecology, Solihull Hospital, Birmingham, UK
| | - M. S. Hunter
- Unit of Psychology, Institute of Psychiatry (at Guy's), King's College London, London, UK
| | - P. M. Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - P. Gupta
- Women's Unit, Solihull Hospital, Birmingham Heartlands & Solihull NHS Trust, Birmingham, UK
| | - J. Sassarini
- Department of Obstetrics & Gynaecology, University of Glasgow, College of Medicine, Western Infirmary, Glasgow, UK
| | - J. C. Stevenson
- National Heart & Lung Institute, Royal Brompton Hospital, London, UK
| | - M. A. Lumsden
- Reproductive and Maternal Medicine, University of Glasgow, Glasgow, UK
| |
Collapse
|
23
|
Sriprasert I, Pantasri T, Piyamongkol W, Suwan A, Chaikittisilpa S, Sturdee D, Gupta P, Hunter MS. An International Menopause Society study of vasomotor symptoms in Bangkok and Chiang Mai, Thailand. Climacteric 2017; 20:171-177. [DOI: 10.1080/13697137.2017.1284782] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- I. Sriprasert
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Ma, Thailand
| | - T. Pantasri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Ma, Thailand
| | - W. Piyamongkol
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Ma, Thailand
| | - A. Suwan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S. Chaikittisilpa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - D. Sturdee
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - P. Gupta
- Heart of England NHS Foundation Trust, Birmingham, UK
| | - M. S. Hunter
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| |
Collapse
|
24
|
Sievert LL, Begum K, Sharmeen T, Murphy L, Whitcomb BW, Chowdhury O, Muttukrishna S, Bentley GR. Hot flash report and measurement among Bangladeshi migrants, their London neighbors, and their community of origin. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 161:620-633. [DOI: 10.1002/ajpa.23062] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 07/26/2016] [Indexed: 12/16/2022]
Affiliation(s)
- L. L. Sievert
- Department of AnthropologyUniversity of MassachusettsAmherst Massachusetts
| | - K. Begum
- Department of AnthropologyUniversity College LondonLondon United Kingdom
| | - T. Sharmeen
- Department of AnthropologyUniversity College LondonLondon United Kingdom
| | - L. Murphy
- Department of AnthropologyUniversity of MassachusettsAmherst Massachusetts
| | - B. W. Whitcomb
- School of Public HealthUniversity of MassachusettsAmherst Massachusetts
| | | | - S. Muttukrishna
- Department of Obstetrics and GynecologyUniversity College CorkCork Ireland
| | - G. R. Bentley
- Department of AnthropologyDurham UniversityDurham United Kingdom
| |
Collapse
|
25
|
Chedraui P, Pérez-López FR, Sánchez H, Sánchez P, Miranda O, Quispe P, Madero-Trelles T, Hidalgo L, Arboleda D, López G, Quintero JC. Application of the 10-item Cervantes Scale among mid-aged Ecuadorian women for the assessment of menopausal symptoms. Maturitas 2014; 79:100-5. [PMID: 25085706 DOI: 10.1016/j.maturitas.2014.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Revised: 06/27/2014] [Accepted: 06/28/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The majority of instruments used to evaluate menopausal symptoms are long and complex. In this sense, more simple tests are being designed to rapidly obtain a snapshot of the global clinical picture. OBJECTIVE To assess menopausal symptoms in mid-aged women using the short 10 item version of the original menopause Cervantes Scale (CS-10). METHOD This was a cross sectional study in which a total of 451 Ecuadorian women (40-59 years) were surveyed with the CS-10 and a general socio-demographic questionnaire containing personal and partner data. RESULTS Median age of the whole sample was 48 years. A 41.2% were postmenopausal, 44.3% abdominally obese (waist circumference >88cm), 6% diabetic, 16.9% hypertense, 11.5% smoked, 6.9% currently used hormone therapy, 9.5% phytoestrogens and 6.7% psychotropic drugs. For the entire sample, median [interquartile range] CS-10 global scores were 10.0 [9.5], and for pre-, peri- and postmenopausal women: 5.0 [7.0], 11.0 [9.0] and 13.5 [8.0], respectively. The CS-10 displayed good internal consistency (Cronbach's alpha 0.87). According to the CS-10, the three most prevalent menopausal symptoms were: muscle and joint pains (88.5%), hot flushes (77.6%) and skin dryness (71.4%). Multiple linear regression analysis found that postmenopausal status, parity, unhealthy perceived status, psychotropic drug use, partner erectile dysfunction, lower coital frequency and living at high altitude were related to higher CS-10 global scores. CONCLUSION In this mid-aged Ecuadorian female sample severity of menopausal symptoms, as determined by the CS-10, were related to environmental and female/partner personal and socio-demographical aspects.
Collapse
Affiliation(s)
- Peter Chedraui
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador.
| | - Faustino R Pérez-López
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Hugo Sánchez
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Priscila Sánchez
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Octavio Miranda
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Paulina Quispe
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Teddy Madero-Trelles
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Luis Hidalgo
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Daniela Arboleda
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Gabriela López
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| | - Juan C Quintero
- Writing Group for the National Research Project sponsored by the Ecuadorian Climacteric and Menopause Society (SECLIM), Ecuador
| |
Collapse
|
26
|
Stefanopoulou E, Gupta P, Mostafa RM, Nosair N, Mirghani Z, Moustafa K, Al Kusayer G, Sturdee DW, Hunter MS. IMS study of Climate, Altitude, Temperature and vasomotor symptoms in the United Arab Emirates. Climacteric 2014; 17:425-32. [DOI: 10.3109/13697137.2014.898266] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
27
|
Ojeda E, Blümel JE, Vallejo MS, Lavín P. Climacteric symptoms in Quechua and Mestizo women from the Andean region of Cusco, Peru: Effects of altitude and ethnicity. Maturitas 2014; 77:356-60. [DOI: 10.1016/j.maturitas.2014.01.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 01/24/2014] [Accepted: 01/27/2014] [Indexed: 11/15/2022]
|
28
|
Worsley R, Bell R, Kulkarni J, Davis SR. The association between vasomotor symptoms and depression during perimenopause: A systematic review. Maturitas 2014; 77:111-7. [DOI: 10.1016/j.maturitas.2013.11.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 11/24/2013] [Indexed: 01/22/2023]
|
29
|
Stefanopoulou E, Shah D, Shah R, Gupta P, Sturdee DW, Hunter MS. An International Menopause Society study of Climate, Altitude, Temperature (IMS-CAT) and vasomotor symptoms in urban Indian regions. Climacteric 2013; 17:417-24. [DOI: 10.3109/13697137.2013.852169] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
30
|
Pérez-Roncero GR, Martínez-Dearth R, López-Baena MT, Ornat-Clemente L. Síntomas relacionados con el climaterio en mujeres residentes en la provincia de Zaragoza. ENFERMERIA CLINICA 2013; 23:252-61. [DOI: 10.1016/j.enfcli.2013.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 09/03/2013] [Accepted: 09/06/2013] [Indexed: 10/26/2022]
|
31
|
Pérez-López FR, Fernández-Alonso AM, Pérez-Roncero G, Chedraui P, Monterrosa-Castro Á, Llaneza P. Assessment of menopause-related symptoms in mid-aged women with the 10-item Cervantes Scale. Maturitas 2013; 76:151-4. [DOI: 10.1016/j.maturitas.2013.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Revised: 07/01/2013] [Accepted: 07/04/2013] [Indexed: 12/30/2022]
|
32
|
Hunter MS, Chilcot J. Testing a cognitive model of menopausal hot flushes and night sweats. J Psychosom Res 2013; 74:307-12. [PMID: 23497832 DOI: 10.1016/j.jpsychores.2012.12.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 12/05/2012] [Accepted: 12/09/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Hot flushes and night sweats (HFNS) are commonly experienced by women during the menopause transition and are particularly problematic for approximately 25% having negative impact on their quality of life. We previously developed a cognitive model of HFNS, which outlines potential predictors of HFNS. This study aims to test the model by investigating the relationships between personality characteristics, perceived stress, mood, HFNS beliefs and subjective and physiological measures of menopausal HFNS. METHODS 140 women (menopause transition or postmenopausal) who were experiencing at least 10 HFNS per week for at least a month, completed assessment interviews, including questionnaires assessing optimism, somatic amplification, perceived stress, depressed mood, anxiety, HFNS beliefs and HFNS frequency, problem-rating and 24-hour sternal skin conductance monitoring. Structural equation models (SEM) were used to investigate the optimum predictive model for HFNS Frequency and HFNS Problem-Rating. RESULTS On average 63 HFNS per week and moderately problematic HFNS were reported. The physiological measure of HFNS frequency was not associated with socio-demographic variables, personality or mood. The final SEM explained 53.2% of the variance in problem rating. Stress, anxiety and somatic amplification predicted HFNS problem rating but only via their impact on HFNS beliefs; HFNS frequency, smoking and alcohol intake also predicted HFNS problem rating. CONCLUSIONS Findings support the influence of psychological factors on experience of HFNS at the level of symptom perception and cognitive appraisal of HFNS.
Collapse
Affiliation(s)
- Myra S Hunter
- Institute of Psychiatry, King's College London, London, UK.
| | | |
Collapse
|