Atema, Vera; van Leeuwen, Marieke; Oldenburg, Hester S A; Retèl, Valesca; van Beurden, Marc; Hunter, Myra S; Aaronson, Neil K
Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive behavioral therapy (CBT) is effective in alleviating menopausal symptoms in women with breast cancer. However, compliance with face-to-face CBT programs can be problematic. A promising approach is to use the Internet to make this form of CBT more accessible and feasible for patients. This study is evaluating the efficacy and cost-effectiveness of an Internet-based CBT program, with or without therapist guidance, in alleviating or reducing the severity of menopausal symptoms. In a multicenter, randomized controlled trial we are evaluating the efficacy of two Internet-based CBT programs in alleviating or reducing the impact of menopausal symptoms, and particularly hot flushes and night sweats, in breast cancer survivors who have experienced a treatment-induced menopause. Secondary outcomes include sexual functioning, sleep quality, hot flush frequency, psychological distress, health-related quality of life and cost-effectiveness. We will recruit 248 women who will be randomized to either a therapist guided or a self-management version of the 6-week Internet-based CBT program, or to a usual care, waiting list control group. Self-administered questionnaires are completed at baseline (T0), and at 10 weeks (T1) and 24 weeks (T2) post-randomization. Internet-based CBT is a potentially useful treatment for reducing menopausal symptoms in breast cancer survivors. This study will provide evidence on the efficacy and cost-effectiveness of such an Internet-based CBT program, with or without therapist support. If demonstrated to be efficacious and cost-effective, the availability of such structured supportive intervention programs will be a welcome addition to standard medical treatment offered
Atema, Vera; van Leeuwen, Marieke; Oldenburg, Hester S. A.; Retel, Valesca; van Beurden, Marc; Hunter, Myra S.; Aaronson, Neil K.
Background: Menopausal symptoms are common and may be particularly severe in younger women who undergo treatment-induced menopause. Medications to reduce menopausal symptoms are either contra-indicated or have bothersome side effects. Previous studies have demonstrated that face-to-face cognitive
Parton, Chloe; Ussher, Jane M; Perz, Janette
Many women experience premature menopause following cancer treatment, accompanied by psychological distress, and poor health-related quality of life. In this qualitative study, we examined how women construct their gendered subjectivities - their sense of self as a woman - in the context of premature menopause after cancer. We analysed data from open-ended survey items and semi-structured interviews with women who had experienced cancer. Six hundred and ninety-five women completed the online survey and 61 took part in a semi-structured interview. A thematic decomposition was conducted to identify the subject positions associated with menopause taken up by the women. Three overall themes were identified: 'The Incomplete Woman,' 'The Abject, Asexual Woman' and 'Out of Time and Social Isolation.' Menopause was predominantly constructed as a negative experience, similar to older post-menopausal women and dissimilar to peers, contributing to experiences of social isolation. Menopause also signified the presence of a medically diagnosed cancer condition, and uncertainty around cancer prognosis. It is important for cancer support group leaders and other service providers to be sensitive to women's negotiation of menopause following cancer, in the context of broader cultural constructions, in order to provide appropriate information and support.
Włodarczyk, Małgorzata; Dolińska-Zygmunt, Grażyna
The aim of the study was to test differences in self-esteem and strength of the body self, body image, comfort with closeness with others and body protection among women reporting high and low intensity of psychological, vasomotor and somatic symptoms of menopause. The sample included 201 women aged 45-55 years. The Menopause Symptom List was used to test the intensity of menopausal symptoms, the Body Self Questionnaire was used to diagnose the body self, and the Rosenberg Self-Esteem Scale was used to examine participants'levels of self-esteem. Differences between women experiencing high and low intensity of symptoms were analyzed using Student's t-test for independent samples. Women experiencing high-intensity psychological, vasomotor and somatic symptoms of menopause showed significantly lower self-esteem and poorer body-self functioning in all its dimensions except for body protection. Women experiencing high-intensity psychological, vasomotor and somatic symptoms of menopause demonstrated poorer functioning of the body self and lower self-esteem.
Im, Eun-Ok; Ko, Young; Chee, Eunice; Chee, Wonshik
The transition due to immigration from one country to another country (referred to as immigration transition henceforth) is inherently stressful, placing an additional dimension of stress to midlife women in the menopausal transition. However, few studies have examined the association of immigration to sleep-related symptoms experienced by midlife women in the menopausal transition. The authors' purpose for this study was to explore the associations of immigration to sleep-related symptoms among four major racial/ethnic groups of 1,054 midlife women in the United States. This was a secondary analysis of data from two national surveys that were collected from 2005 to 2013. The instruments included questions on background characteristics, health and menopausal status, immigration transition, and the Sleep Index for Midlife Women. The data were analyzed using t-tests, chi-square tests, correlation analyses, and hierarchical multiple regression analyses. Immigrants reported fewer total numbers of and lower total severity scores of sleep-related symptoms than non-immigrants (p < .01). Yet, when background characteristics and health and menopausal status were controlled, self-reported racial/ethnic identity was the only significant factor associated with sleep-related symptoms (ΔR2 = 0.02, p < .01). Health-care providers need to consider self-reported racial/ethnic identity as a factor significantly related to sleep-related symptoms during the menopausal transition.
... for you. Menopause and Hormones: Common Questions La menopausia y las hormonas: Preguntas más frecuentes Menopause: Medicines ... PDF - 1.3MB) Menopause and Hormones Card La menopausia y las hormonas tarjeta (PDF - 1.6MB) Order ...
de Salis, Isabel; Owen-Smith, Amanda; Donovan, Jenny L; Lawlor, Debbie A
We investigated the experience and perspectives of menopause among 48 UK mothers through qualitative in-depth interviews. Interviews were analyzed thematically then explored using social science theories. Three interdependent narratives emerged: menopause as a normal, biological process, distinct from self and social transitions; menopause as struggle, an "idiom of distress" expressing upset, identity loss, shame, and social upheaval; and menopause as transformative and liberating, arising from biopsychic and relational changes. Some women followed a predictable "rite of passage" trajectory with transformation emerging from distress, but not all: Menopause arises from a complex interplay of personal predicament, somatic change, and sociocultural context.
Full Text Available Abstract Background The present study describes Complementary and Alternative Medicine (CAM use amongst Italian women transitioning through menopause. Popularity and perceived effectiveness of CAM treatments, use of pharmaceutical medications, characteristics of CAM users, the extent of communication between medical practitioners and women about their use of CAM, and variables associated with CAM use were also investigated. Methods Women, aged 45-65 years attending Family Planning and Women's Health clinics or Menopause Centres in Bologna were invited to complete a voluntary, anonymous, self administered questionnaire, which was used in a previous study in Sydney. The questionnaire was translated and adapted for use amongst Italian women. Data on general demographic and health characteristics, menopause related symptoms and the use of CAM and pharmaceutical treatments during the previous 12 months were collected. Results In total, 1,203 women completed the survey, of which 1,106 were included in the final sample. Of women who had symptoms linked with menopause and/or used remedies to alleviate symptoms, 33.5% reported to have used CAM. Among these, 23.5% had consulted one or more practitioners and 24% had used at least one CAM product. Approximately nine out of ten respondents reported medical practitioners did not seek information about their use of CAM; while one third of CAM users did not disclose the use of CAM to their physician. Nevertheless, medical practitioners were the most popular source of information. From the multivariate analysis, variables associated with CAM use were: professional employment, time since the last natural menses, use of CAM for conditions other than menopause, and presence of some severe symptoms. Conclusions The relatively high prevalence of CAM use by women transitioning through menopause should encourage research initiatives into determining which CAM treatments are the safest and effective. The increasing and
Okeke, Tc; Anyaehie, Ub; Ezenyeaku, Cc
Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to achieve pregnancy and mother a baby in those women at risk. Review of the pertinent literature on premature menopause, selected references, internet services using the PubMed and Medline databases were included in this review. In the past, pregnancy in women with premature menopause was rare but with recent advancement in oocyte donation, women with premature menopause now have hoped to mother a child. Hormone replacement therapy is beneficial to adverse consequences of premature menopause. Women with premature menopause are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. Public enlightenment and education is important tool to save those at risk.
therapy is beneficial to adverse consequences of premature menopause. Women ....  Maternal aging and oestrogen deficiency as a result of .... The pathology of female genital tuberculosis. Obstet Gynecol 1979;53:422‑8. 17. Jick A, Porter J, Morrison AS. The relationship between smoking and age of natural menopause.
Menopause is a period in the life of women who have experienced ceasation ... concerns such as lower estrogen level, cardiovascular disease, osteoporosis, ... began menstruation. However, she realized that 255 of the women polled had a positive attitude towards menopause, especially because it signified end of.
The study examined menopausal status, timing of menopause and their influence on experience of depression and life satisfaction among 188 working women. The participants were drawn from organizations in Lagos and Ibadan. Results of the study revealed that (I) currently menopausal women experienced a ...
... Consumer Information by Audience For Women Menopause and Hormones: Common Questions Share Tweet Linkedin Pin it More ... reproduction and distribution. Learn More about Menopause and Hormones Menopause--Medicines to Help You Links to other ...
Reid, Robert; Abramson, Beth L; Blake, Jennifer; Desindes, Sophie; Dodin, Sylvie; Johnston, Shawna; Rowe, Timothy; Sodhi, Namrita; Wilks, Penny; Wolfman, Wendy
To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor or urogenital symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality. Lifestyle interventions, prescription medications, and complementary and alternative therapies are presented according to their efficacy in the treatment of menopausal symptoms. Counselling and therapeutic strategies for sexuality concerns in the peri- and postmenopausal years are reviewed. Approaches to the identification and evaluation of women at high risk of osteoporosis, along with options for prevention and treatment, are presented in the companion osteoporosis guideline. Published literature was retrieved through searches of PubMed and The Cochrane Library in August and September 2012 with the use of appropriate controlled vocabulary (e.g., hormone therapy, menopause, cardiovascular diseases, and sexual function) and key words (e.g., hormone therapy, perimenopause, heart disease, and sexuality). Results were restricted to clinical practice guidelines, systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Results were limited to publication dates of 2009 onwards and to material in English or French. Searches were updated on a regular basis and incorporated in the guideline until January 5, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, national and international medical specialty societies, and clinical practice guideline collections.
Boughton, Maureen; Halliday, Lesley
This paper reports on a qualitative study designed to examine (i) possible explanations for difficulties young Australian women (under 40 years) encountered in the process of gaining a diagnosis of premature menopause and (ii) to address issues underpinning this aspect of menopause. Drawing on hermeneutic phenomenology, face-to-face interviews were carried out with 35 women who consented to share their experiences of 'being diagnosed' with premature menopause. The participants responded to an advertisement in a newspaper article, a radio announcement or through a menopause support centre. While all participants were located in Australia, larger numbers were from the metropolitan areas of Sydney, New South Wales, and Perth, Western Australia. This research reports that the process of finding an explanation for the physical and emotional symptoms the women were experiencing was very complex. The findings varied regarding the psychological and physical symptoms experienced, described feelings, and reasons that led to a diagnosis of menopause. This paper suggests that the age of the women and the non-specific symptoms experienced by them contributed significantly to the delay and uncertainty surrounding the experience of being diagnosed with premature menopause. There was uncertainty of the origin of symptoms, which led the women to feel as though they were 'going insane' or that it was 'all in their heads'. This frequently led to symptoms of menopause being attributed (by health professionals) to a psychiatric basis and menopause being overlooked for varying lengths of time.
Yim, Gyeyoon; Ahn, Younjhin; Chang, Yoosoo; Ryu, Seungho; Lim, Joong-Yeon; Kang, Danbee; Choi, Eun-Kyung; Ahn, Jiin; Choi, Yuni; Cho, Juhee; Park, Hyun-Young
The present study investigated the prevalence and severity of menopause symptoms experienced by Korean women aged 44 to 56 years and their associated factors. A cross-sectional study was performed on 2,201 women aged 44 to 56 years in health checkup centers between November 2012 and March 2013. The 29-item Menopause-Specific Quality of Life Questionnaire was used to assess vasomotor, psychosocial, physical, and sexual symptoms related to menopause. The guidelines for the classification of reproductive aging stages proposed at the Stages of Reproductive Aging Workshop were used. Multivariable linear regression analyses were performed to identify factors associated with severity of menopause symptoms. Among participants, 42.6% were premenopausal, 36.7% were perimenopausal, and 20.7% were postmenopausal. Although physical symptoms were the most severe menopause symptoms experienced by premenopausal and perimenopausal women, postmenopausal women reported sexual symptoms as the most bothersome. The mean scores for each domain increased from the premenopausal period through the postmenopausal period (P for trend obesity (for vasomotor and physical symptoms) were significantly associated with severity of menopause symptoms (P menopause than inactive women. Postmenopausal women experience the most severe symptoms. Obesity and physical activity are the main modifiable factors associated with symptom severity. Further studies are needed to examine the effects of physical activity promotion and weight control interventions on preventing menopause symptoms in Korean women.
... Clinical Evaluation and Counseling Chapter 6: Complementary and Alternative Medicine Chapter 7: Nonprescription Options Chapter 8: Prescription Therapies Professional Publications Menopause Journal Contents Position Statements & Other Reports Menopause Practice ...
... Clinical Evaluation and Counseling Chapter 6: Complementary and Alternative Medicine Chapter 7: Nonprescription Options Chapter 8: Prescription Therapies Professional Publications Menopause Journal Contents Position Statements & Other Reports Menopause Practice ...
The word 'menopause' is derived from men and pausis and is a direct description of the psychological and physical events in women where menstruation ceases to occur. It is the time in a woman's life when she has experienced the last menstrual bleed. Menopause is not a disease per se but a condition associated with ...
Nair, Pragya A
.... Dermatosis seen due to estrogen deficiency includes Atrophic Vulvovaginitis, Vulvar Lichen Sclerosus, Dyaesthetic Vulvodynia, Hirsutism, Alopecia, Menopausal Flushing, Keratoderma Climactericum...
Background: Although 27% of women will be premenopausal at diagnosis; treatment for BC may cause menopause/menopausal symptoms in up to 80% of these women. Both short term symptoms and long term health problems such as osteoporosis and heart disease are associated with early menopause (EM). Menopausal symptoms have a major negative impact on quality of life, sexual dysfunction and changes in body image and self-esteem in BC women. Overseas studies indicate that 2/3 of postmenopausal w...
Al-Safi, Zain A; Polotsky, Alex J
Over the recent decades, the prevalence of obesity in the United States has increased to epidemic proportions to more than 35% of adults, along with an increased risk of a number of health conditions, including hypertension, adverse lipid concentrations, and type 2 diabetes. The relationships between menopausal transition, weight gain, and obesity are reported but incompletely understood. The association between menopause and these measures has been the subject of many studies, along with examining their effect on reproductive hormones and menopausal symptoms. The purpose of this review is to summarize what is published in the literature on this subject and examine it through: (1) the possible impact of obesity on the timing of menopause; (2) the effect of obesity on menopausal symptoms and reproductive hormones around the time of menopause; and (3) the effect of menopause on obesity, weight gain, and body composition. Copyright © 2014 Elsevier Ltd. All rights reserved.
Al-Safi, Zain A; Santoro, Nanette
A majority of women will experience bothersome symptoms related to declining and/or fluctuating levels of estrogen during their menopausal transition. Vasomotor symptoms, vaginal dryness, poor sleep, and depressed mood have all been found to worsen during the menopausal transition. While vasomotor symptoms gradually improve after menopause, the time course can be many years. Vaginal dryness does not improve without treatment, while the long-term course of sleep and mood deterioration is not clearly defined at this time. A small minority of women have vasomotor symptoms that persist throughout the remainder of their lives. These common menopausal symptoms all improve with estrogen treatment. Over the last 10 years, we have witnessed a dramatic reduction in enthusiasm for menopausal hormone therapy, despite its high efficacy relative to other treatments. We have also seen the emergence of sound, evidence-based clinical trials of non-hormonal alternatives that can control the common menopausal symptoms. Understanding the natural history of menopausal symptoms, and the risks and benefits of both hormonal and non-hormonal alternatives, helps the clinician individualize management plans to improve quality of life. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Vaze, Nirmala; Joshi, Sulabha
With increased life expectancy, today, women spend one-third of their life after menopause. Thus more attention is needed towards peri- and post-menopausal symptoms. Estrogen replacement therapy is the most effective treatment, however, it has its own limitations. The present need is to explore new options for the management of menopausal symptoms. Yogic life style is a way of living which aims to improve the body, mind and day to day life of individuals. The most commonly performed Yoga prac...
Full Text Available Metabolic disorders occurring in menopause, including dyslipidemia, disorders of carbohydrate metabolism (impaired glucose tolerance – IGT, type 2 diabetes mellitus – T2DM or components of metabolic syndrome, constitute risk factors for cardiovascular disease in women. A key role could be played here by hyperinsulinemia, insulin resistance and visceral obesity, all contributing to dyslipidemia, oxidative stress, inflammation, alter coagulation and atherosclerosis observed during the menopausal period. Undiagnosed and untreated, metabolic disorders may adversely affect the length and quality of women’s life. Prevention and treatment preceded by early diagnosis should be the main goal for the physicians involved in menopausal care. This article represents a short review of the current knowledge concerning metabolic disorders (e.g. obesity, polycystic ovary syndrome or thyroid diseases in menopause, including the role of a tailored menopausal hormone therapy (HT. According to current data, HT is not recommend as a preventive strategy for metabolic disorders in menopause. Nevertheless, as part of a comprehensive strategy to prevent chronic diseases after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered (after balancing benefits/risks and excluding women with absolute contraindications to this therapy. Life-style modifications, with moderate physical activity and healthy diet at the forefront, should be still the first choice recommendation for all patients with menopausal metabolic abnormalities.
Full Text Available The digest has been prepared to review available clinical evidence on herbs used in treatment of menopause symptoms. Effectiveness of Humulus lupulus, Vitex agnus-castus, Dioskorea vilosa, Linum usitatissimum, Pinus pinaster, cruciferous vegetables, Cimicifuga racemosa L., Angelica sinensis, Oenothera biennis L., Hypericum perforatum L., Panax ginseng, Ginkgo biloba, Glycine soja, Trifolium pratense and Piper methysticum herbs were assessed for treatment of menopausal symptoms in the studies. Herbs used as alternative supplementary treatment for menopause symptoms have been found to have a limited effect. Thus more studies are warranted to assess effectiveness of herbal treatments for menopausal symptoms. [Archives Medical Review Journal 2015; 24(4.000: 520-530
Jurgenson, Janelle R; Jones, Emma K; Haynes, Emma; Green, Charmaine; Thompson, Sandra C
Despite extensive literature demonstrating differing experiences in menopause around the world, documentation of the experience of menopause in Australian Aboriginal women is scarce, and thus their menopausal experience is relatively unknown. This study aimed to understand Australian Aboriginal women's understanding and experience of menopause and its impact on their lives. The study was an exploratory qualitative study. Twenty-five Aboriginal women were recruited from a regional centre in the Mid-West region of Western Australia using opportunistic and snowballing sampling. Interviews and focus group discussions were undertaken from February 2011 to February 2012 using open-ended questioning with a yarning technique. Thematic analysis was undertaken of the transcribed interviews. A number of themes were revealed. These related to the language used, meanings and attitudes to menopause, symptoms experienced, the role of men, a lack of understanding, coping mechanisms and the attribution of menopausal changes to something else. The term "change of life" was more widely recognised and signified the process of ageing, and an associated gain of respect in the local community. A fear of menopausal symptoms or uncertainty about their origin was also common. Overall, many women reported insufficient understanding and a lack of available information to assist them and their family to understand the transition. There are similarities between Aboriginal and non-Aboriginal experiences of menopause, including similar symptom profiles. The current language used within mainstream health settings may not be appropriate to this population if it fails to recognise the importance of language and reflect the attributed meaning of menopause. The fear of symptoms and uncertainty of their relationship to menopause demonstrated a need for more information which has not adequately been supplied to Australian Aboriginal women through current services. While this study is with a select
Opinions of the women were sought on socio-cultural differences in the perception of menstruation, causes and consequences of menopause, sexual intercourse after menopause, social support networks for menopausal women, and types of care and treatment for women in menopause. The participants in the FGDs used ...
Full Text Available Menopause, especially the symptoms and complications, is always an interesting topic to be discussed. It is actually a normal part of woman's life entering ages of 50. The symptoms of menopause are highly individual to each woman. Some may experience multiple physical and psychological symptoms that may continue to social impacts. Misinterpretation as other disease symptoms could happen and lead to incorrect treatment. Many studies have been done to learn more about the menopause physiological process, symptoms, complication, and treatment. So many preventive and treatment options are offered, including hormone therapy and practicing healthy life style. By understanding the menopause, it is expected that symptoms could be controlled and complications could be avoided. Key words : Woman, Menstrual Period, Menopause, Healthy
O'Brien, Kylie A; Varigos, Euhna; Black, Catherine; Komesaroff, Paul A
Acupuncture is commonly used to treat menopausal symptoms and other gynecological conditions. Laser acupuncture, more accurately named "laser acupoint stimulation," has the advantages of being noninvasive, reproducible, and convenient. A few studies of conventional acupuncture have suggested a beneficial effect in treating menopausal symptoms. This study sought to investigate the effectiveness of laser acupoint stimulation in relieving symptoms associated with menopause. A double-blind, randomized, placebo-controlled study was conducted in 40 women experiencing active symptoms of menopause. Outcome variables were numbers of diurnal and nocturnal flushes and symptom score, determined using a previously validated scale. A laser acupoint stimulation device was altered to produce identical flashing lights whether or not the laser was operating to allow for a placebo ("laser off") control. Participants received either active or placebo treatment on a fortnightly basis for 12 weeks. The acupoint selection in both groups was individualized to each participant, selected from a set of 10 acupoints. There were no significant differences between the active and placebo treatment groups in numbers of diurnal or nocturnal flushes or in nonflushing symptom scores. Laser acupoint stimulation chosen from a fixed set of acupoints is no more efficacious than manual stimulation with an inert laser probe in altering menopausal symptoms.
Beigi, Marjan; Fahami, Fariba
Background: Sexual instinct which is the cause of numerous changes in an individual’s life could be influenced by different factors such as menopause and ageing. This study was designed to compare sexual dysfunction before and after menopause. Materials and Methods: This was a cross-sectional study. Participants were 174 menopausal women who referred to medical health centers of Isfahan, Iran. Data were collected through self constructed sexual dysfunctions questionnaire in relation to their sexual activities before and after menopause. The reliability and validity of this questionnaire was determined by content validity and Cronbach’s alpha coefficient. Findings: Findings showed that the relative frequency of sexual dysfunctions was 38% in the productive period and 72.4% in the menopause period. There was a significant association between sexual dysfunctions before and after the menopause period (p vaginismus, respectively. Conclusions: A considerable percentage of women experienced sexual dysfunctions in productive and menopause periods, and menopause could be a factor to maintain or intensify sexual dysfunctions. PMID:23833604
Seidl, M. M.; Stewart, D. E.
OBJECTIVE: To describe women's experiences with alternative treatments for symptoms attributed to menopause. DESIGN: Descriptive qualitative study. SETTING: Personal interviews and focus groups were conducted in private rooms at the Toronto Hospital; telephone interviews were conducted at mutually convenient times. PARTICIPANTS: Thirteen perimenopausal women with a mean age of 52.6 +/- 2.6 years who were experiencing symptoms attributed to menopause and were using alternative therapies partic...
McKee, Julie; Warber, Sara L
Menopause is a transitional time for women. This gives practitioners an opportunity to focus on recommending healthy life-style changes. Hormone replacement therapy (HRT) has been the mainstay of therapy for menopausal symptoms. With recent research findings, women and their physicians are seeking alternatives that do not carry the risks associated with HRT. Exercise has been shown to help some women with symptoms of hot flashes, as have relaxation techniques and deep breathing. Dietary changes to incorporate whole foods and soy are thought by some to help with menopausal symptoms, and are recommended because of a positive impact on heart disease and obesity; soy isoflavones may also help with menopausal symptoms. Botanicals such as black cohosh and red clover have been shown in some studies to decrease severity and frequency of hot flashes. We recommend that HRT be prescribed when other measures have failed to adequately control symptoms. Bioidentical hormones are preferred in our practice.
... up bone loss. After menopause your ovaries stop producing the hormone estrogen, which helps to keep your ... you minimize and treat bone loss? Diet and lifestyle can help prevent and treat bone loss. Successful ...
... Endocrinologist Search Featured Resource Menopause Map™ View Bioidentical Hormones January 2012 Download PDFs English Espanol Editors Howard ... take HT for symptom relief. What are bioidentical hormones? Bioidentical hormones are identical to the hormones that ...
Legendre, G; Fritel, X; Ringa, V; Lesavre, M; Fernandez, H
The aim of this review was to examine the relationship between menopause and urinary incontinence (UI). Our work is based on a review of the literature on the epidemiology of UI in women and the effects of hormone therapy on symptoms of urinary leakage. A search of the Medline database between January 2000 and April 2012 was performed by crossing the keywords "urinary incontinence, stress urinary incontinence (SUI), urge incontinence, over active bladder, menopause, estrogen therapy". Twenty-nine articles over the 482 articles were initialy selected. The UI was a common symptom during menopause, with a prevalence of 15 to 30% and an annual incidence of 5 to 10%. The association between UI and menopause was controversial. Indeed, although underpinned by pathophysiological mechanisms such as the sensitivity of tissues of the urogenital sinus to estrogen, the epidemiological data available were contradictory and should be interpreted, if possible, depending on the type of UI. Thus, it remained difficult to distinguish the effect of menopause of the aging. The effects of estrogen on IU differed depending on the route of administration and of the type of UI. Randomized trials showed that oral administration of estrogen after menopause increased the occurrence of UI or SUI. However a vaginal administration of estrogen improved urge urinary incontinence (UUI) and overactive bladder. The data of this review were consistent with the French and European guidelines. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
Monaci, G.; Braspenning, R.A.C.; Meerbeek, B.W.; Bingley, P.; Rajagopalan, R.; Triki, M.
This report describes the activities carried out in the first part of the Experiencing Control project (2008-324). The guiding idea of the project is to make control part of the experience, exploring new interaction solutions for complex, engaging interactions with Philips devices in the living
Hoga, Luiza; Rodolpho, Juliana; Gonçalves, Bruna; Quirino, Bruna
Evidence shows than an estimated one billion women have experienced menopause worldwide. The experience of menopause is influenced by beliefs and values prevalent in the sociocultural setting, the background of the women, and the ways in which the women approach changes in this phase of life. Independently of the circumstances involved, women experiencing menopause need to have their care needs and corresponding support identified based on their personal and contextual perspectives. Although it is essential to provide appropriate support to women experiencing menopause, no systematic reviews have so far been conducted that focus on menopause experienced by women worldwide. The objective of this review is to identify the best available evidence related to how women experience menopause worldwide. This review considered studies that included menopausal women aged between 40 and 65 years, who have lived the transition from reproductive years through menopause and beyond. This review included only studies whose participants have lived the experience of natural menopause. Women who have had induced menopause, or with premature menopause were excluded from this review. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: This review considered studies that investigate women's experiences of natural menopause under the scope of different social and cultural settings. TYPES OF STUDIES: This review considered studies that have a descriptive and interpretive approach, conducted using qualitative methodology. Qualitative studies that focus on program evaluation were excluded from this review. Qualitative data including, but not limited to, study designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion in this review. TYPES OF OUTCOMES: This review considered studies that include the following outcome measures: all aspects related both directly and indirectly to the experience of menopause, as concretely lived
Full Text Available Na vida das mulheres existem marcos concretos e objetivos que sinalizam diferentes fases ou passagens de suas vidas, tais como a menarca, o rompimento do hímen, a última menstruação. São marcos visíveis no corpo físico e cada cultura os investe de sua rubrica. Na nossa cultura, historicamente, associam-se à menopausa inúmeras afecções (físicas e psíquicas. A partir do trabalho de Robert Wilson, publicado no livro Eternamente Feminina (1966, a menopausa adquire o estatuto de doença e a sua prevenção, tratamento e cura vinculam-se à terapia de reposição hormonal (TRH. Os diferentes discursos que circulam sobre a menopausa em nossa cultura não só contribuem para que tal associação seja mantida, como partem do pressuposto que as questões relacionadas à menopausa e envelhecimentos se apresentam igualitariamente às mulheres, independentemente de sua condição física, psíquica, social, econômica e cultural. O estudo tem como objetivo abordar alguns aspectos da construção da menopausa em nossa cultura e simultaneamente mostrar o quanto este evento deve ser percebido em seu caráter particular e relativo, e não como sendo da ordem do universal ou padronizado.There are concrete and objective signs in women's lives that mark different phases or passages of their lives such as the menarche, the breaking of the hymen, the last period. These are visible marks in the physical body and each culture invests them with its seal. Historically in our culture, countless diseases (physic and psychic are associated with the menopause. Starting with Robert Wilson's studies, published in the book Feminine Forever (1966, the menopause acquires the statute of disease and its prevention, treatment and cure are linked to the Hormonal Replacement Therapy (HRT. The different discourses that circulate on the menopause in our culture not only contribute to the maintenance of such an association, but also assume that the subjects related to
Kobayashi, Sofie; Berge, Maria; Grout, Brian William Wilson
This study contributes towards a better understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction between supervisors and PhD students, using the notion of experiencing variation as a key to learning. Empirically, we have bas...... were discussed, created more complex patterns of variation. Both PhD students and supervisors can learn from this. Understanding of this mechanism that creates learning opportunities can help supervisors develop their competences in supervisory pedagogy....
Vaze, Nirmala; Joshi, Sulabha
With increased life expectancy, today, women spend one-third of their life after menopause. Thus more attention is needed towards peri- and post-menopausal symptoms. Estrogen replacement therapy is the most effective treatment, however, it has its own limitations. The present need is to explore new options for the management of menopausal symptoms. Yogic life style is a way of living which aims to improve the body, mind and day to day life of individuals. The most commonly performed Yoga practices are postures (asana), controlled breathing (pranayama), and meditation (dhyana). Yoga has been utilized as a therapeutic tool to achieve positive health and control and cure diseases. The exact mechanism as to how Yoga helps in various disease states is not known. There could be neuro-hormonal pathways with a selective effect in each pathological situation. There have been multiple studies that have combined the many aspects of Yoga into a general Yoga session in order to investigate its effects on menopausal symptoms. Integrated approach of Yoga therapy can improve hot flushes and night sweats. There is increasing evidence suggesting that even the short-term practice of Yoga can decrease both psychological and physiological risk factors for cardiovascular disease (CVD). Studies conclude that our age old therapy, Yoga, is fairly effective in managing menopausal symptoms.
Full Text Available Abstract Background Menopausal symptoms can be assessed by several tools, and can be influenced by various socio-demographic factors. Objectives To determine the commonly reported menopausal symptoms among Sarawakian women using a modified Menopause Rating Scale (MRS. Methods By using modified MRS questionnaire, 356 Sarawakian women aged 40-65 years were interview to document of 11 symptoms (divided into somatic, psychological and urogenital domain commonly associated with menopause. Results The mean age of menopause was 51.3 years (range 47 - 56 years. The most prevalent symptoms reported were joint and muscular discomfort (80.1%; physical and mental exhaustion (67.1%; and sleeping problems (52.2%. Followed by symptoms of hot flushes and sweating (41.6%; irritability (37.9%; dryness of vagina (37.9%; anxiety (36.5%; depressive mood (32.6%. Other complaints noted were sexual problem (30.9%; bladder problem (13.8% and heart discomfort (18.3%. Perimenopausal women (n = 141 experienced higher prevalence of somatic and psychological symptoms compared to premenopausal (n = 82 and postmenopausal (n = 133 women. However urogenital symptoms mostly occur in the postmenopausal group of women. Conclusions The prevalence of menopausal symptoms using modified MRS in this study correspond to other studies on Asian women however the prevalence of classical menopausal symptoms of hot flushes, sweating was lower compared to studies on Caucasian women.
Interpretation & conclusions: Associations of natural menopause with sociocultural, family planning and demographic variables were noted. Most importantly, there was an association with poverty that would require further investigation as to causality. The proportion of women experiencing early menopause may represent a useful overall indicator of women's health. The data are reassuring with regard to possible late effects of sterilization on ovarian function.
Kaunitz, Andrew M; Manson, JoAnn E
Most menopausal women experience vasomotor symptoms with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women's Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen increased all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appear to represent a sound strategy for optimizing the benefit-risk profile and safety of HT. Systemic HT should not be arbitrarily stopped at age 65 years; instead treatment duration should be individualized based on patients' risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely affects the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low-dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit-risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms.
Castelo-Branco, C; Rostro, F
Menopause signifies the permanent cessation of ovarian function and the end of a woman's reproductive potential. A universal experience in women's aging, it is the culmination of many years of reproductive aging; a process that unfolds as a continuum from birth through ovarian senescence to the menopausal transition and the postmenopause. The menopausal transition is known to play a major role in the etiology of many symptoms common in middle age and may contribute to chronic conditions and disorders of aging such as osteoporosis, cardiovascular diseases and cancer. Recent data suggest an unacceptable increase in morbidity in a number of women using hormone therapy (HT). Thus, during the past few years, many women and doctors have revised their opinions on HT for menopause-related symptoms, and a substantial number of individuals have discontinued its use because of concerns about side-effects, owing to this, numerous alternatives to HT are promoted, and researches have pointed out the interest in a group of molecules such as selective estrogen receptor modulators (SERMs) (i.e. raloxifene) and phytoestrogens. Further studies may open a new panorama in patient-specific management of postmenopausal health. Careful assessment of the midlife woman allows for individualized risk-benefit analysis with the formulation of a specific health management plan.
Honour, John W
The life of a human female is characterized from teenage years by monthly menstruation which ceases (the menopause) typically between the age of 40 and 60 years. The potential for reproduction declines and ceases as the ovaries become depleted of follicles. A transition period in mid-life, for 2 to 10 years, when menstruation is less regular is called the perimenopause. The menopause is associated with a significant decline in plasma concentrations of sex hormones, an increase in the concentrations of the gonadotrophins and changes in other hormones such as the inhibins. These changes are superimposed with effects of aging, social and metabolic factors, daily activity and well-being. Although the menopause is entirely natural, in some cases ovarian failure can occur earlier than usual; this is pathological and warrants careful biochemical investigations to distinguish it from conditions causing infertility. Elderly females are affected by a range of clinical disorders including endocrine, cardiovascular, skeletal, urogenital tract and immunological systems, body mass, vasomotor tone, mood and sleep pattern. Reference intervals for many diagnostic biochemical tests for the menopause need to be used when interpreting results in clinical investigations for patient management. The standardization and harmonization of assays are being addressed. Many women now choose to develop their career before bearing children, and the health service has had to change services around this. This review does not cover screening for and tests during pregnancy. The review is timely since the population is aging and there will be more demand on healthcare services.
Background: The term 'menopause' is derived from the Greek words men (month) and pausis (a cessation, a pause). It is a direct description of the psychological and physical events in women where menstruation ceases to occur. It is the time in a woman's life when she has experienced her last menstrual bleed.
The menopause is physiological changes in women that give rise to adaptive changes at both systemic and oral level. As we all begin to reach an older age, dental health and hygiene becomes a major concern. The dentist is often the first person to appreciate numerous changes that are experienced throughout the body ...
Meirelles, Ricardo M R
The incidence of cardiovascular disease increases considerably after the menopause. One reason for the increased cardiovascular risk seems to be determined by metabolic syndrome, in which all components (visceral obesity, dyslipidemia, hypertension, and glucose metabolism disorder) are associated with higher incidence of coronary artery disease. After menopause, metabolic syndrome is more prevalent than in premenopausal women, and may plays an important role in the occurrence of myocardial infarction and other atherosclerotic and cardiovascular morbidities. Obesity, an essential component of the metabolic syndrome, is also associated with increased incidence of breast, endometrial, bowel, esophagus, and kidney cancer. The treatment of metabolic syndrome is based on the change in lifestyle and, when necessary, the use of medication directed to its components. In the presence of symptoms of the climacteric syndrome, hormonal therapy, when indicated, will also contribute to the improvement of the metabolic syndrome.
Pavón de Paz, I; Alameda Hernando, C; Olivar Roldán, J
Menopause is one of the critical periods of a woman's life during which weight gain and onset or worsening of obesity are favoured. It is at this period when obesity prevalence is the highest. There are several causes for this disorder, ones clearly related with hypo-oestrogenism and others depend on age favouring increased food intake and decreased energy waste. This weight gain is related to adverse health effects that get worse due to changes in fat distribution observed during menopause. The increase in visceral fat favours the development of insulin resistance and its clinical consequences such as carbohydrate metabolism impairments and type 2 diabetes, arterial hypertension, and dyslipidaemia, leading to increased cardiovascular risk, among other complications.
Kaunitz, Andrew M.; Manson, JoAnn E.
Most menopausal women experience vasomotor symptoms, with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms, with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women’s Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with...
Bensaleh, H; Belgnaoui, F Z; Douira, L; Berbiche, L; Senouci, K; Hassam, B
Important changes related to declining level of several hormones occur during menopause: vasomotor instability, bone loss, anxiety, sexual dysfunction, skin aging... Our objective was a review of the literature concerning the histological and clinical changes seen in post menopausal skin, and also an analysis of the effect of hormonal replacement therapy in slowing down the aging process. Decline in progesterone increases the impact of androgen on the sebaceous glands and hair. Decreased estrogen slows down mitotic activity in the epidermal basal layer, reduces the synthesis of collagen and contributes to thickening of the dermo-epidermal junction. This hypoestrogenemia may be spontaneously attenuated by local synthesis of oestradiol in peripheral target tissues according to the intracrine process. This new hormonal pattern is associated with skin atrophy, hyperseborrhea, increased pilosity on the cheeks and upper lip, loss of scalp hair, increase in degeneration of elastic tissue, atrophy and dryness of the vaginal mucosa. Estrogen treatment in post menopausal women has been shown to increase collagen content, dermal thickness and elasticity. Biophysical properties are also significantly improved for the parameters reflecting hydration and sebum secretion. However, numerous side effects such as increased incidence of cancer and cardiovascular morbidity limit the use of this treatment. So non hormonal alternatives are proposed. Laser and lifting remain the most important options.
Full Text Available Abstract Background The metabolic syndrome is defined as an assemblage of risk factors for cardiovascular diseases, and menopause is associated with an increase in metabolic syndrome prevalence. The aim of this study was to assess the prevalence of metabolic syndrome and its components among postmenopausal women in Tehran, Iran. Methods In this cross-sectional study in menopause clinic in Tehran, 118 postmenopausal women were investigated. We used the adult treatment panel 3 (ATP3 criteria to classify subjects as having metabolic syndrome. Results Total prevalence of metabolic syndrome among our subjects was 30.1%. Waist circumference, HDL-cholesterol, fasting blood glucose, diastolic blood pressure ,Systolic blood pressure, and triglyceride were significantly higher among women with metabolic syndrome (P-value Conclusions Our study shows that postmenopausal status is associated with an increased risk of metabolic syndrome. Therefore, to prevent cardiovascular disease there is a need to evaluate metabolic syndrome and its components from the time of the menopause.
Elavsky, Steriani; McAuley, Edward
Many women experience detriments in mental health during the menopausal transition. Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist. This study examined the effects of a 4-month randomized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women (M age = 49.9; SD = 3.6). Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month randomized controlled exercise trial with three arms: walking, yoga, control. The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect. Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes. Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness. Physical activity appears to enhance mood and menopause-related QOL during menopause, however, other aspects of mental health may be affected only as a result of reduction in menopausal symptoms. Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms.
Leach, Matthew J; Moore, Vivienne
Menopause can be a distressing and disruptive time for many women, with many experiencing hot flushes, night sweats, vaginal atrophy and dryness. Postmenopausal women are also at increased risk of osteoporosis. Interventions that decrease the severity and frequency of these menopausal symptoms are likely to improve a woman's well-being and quality of life. Hormone therapy has been shown to be effective in controlling the symptoms of menopause; however, many potentially serious adverse effects have been associated with this treatment. Evidence from experimental studies suggests that black cohosh may be a biologically plausible alternative treatment for menopause; even so, findings from studies investigating the clinical effectiveness of black cohosh have, to date, been inconsistent. To evaluate the clinical effectiveness and safety of black cohosh (Cimicifuga racemosa or Actaea racemosa) for treating menopausal symptoms in perimenopausal and postmenopausal women. Relevant studies were identified through AARP Ageline, AMED, AMI, BioMed Central gateway, CAM on PubMed, CINAHL, CENTRAL, EMBASE, Health Source Nursing/Academic edition, International Pharmaceutical Abstracts, MEDLINE, Natural medicines comprehensive database, PsycINFO, TRIP database, clinical trial registers and the reference lists of included trials; up to March 2012. Content experts and manufacturers of black cohosh extracts were also contacted. All randomised controlled trials comparing orally administered monopreparations of black cohosh to placebo or active medication in perimenopausal and postmenopausal women. Two review authors independently selected trials, extracted data and completed the 'Risk of bias' assessment. Study authors were contacted for missing information. Sixteen randomised controlled trials, recruiting a total of 2027 perimenopausal or postmenopausal women, were identified. All studies used oral monopreparations of black cohosh at a median daily dose of 40 mg, for a mean duration of
Yunus, Fakir Md; Rahman, Musarrat Jabeen; Alam, Md Zahidul; Hore, Samar Kumar; Rahman, Mahfuzar
Chronic exposure to arsenic is associated with neoplastic, cardiovascular, endocrine, neuro-developmental disorders and can have an adverse effect on women's reproductive health outcomes. This study examined the relationship between arsenic skin lesions (a hallmark sign of chronic arsenic poisoning) and age of natural menopause (final menopausal period) in populations with high levels of arsenic exposure in Bangladesh. We compared menopausal age in two groups of women--with and without arsenic skin lesions; and presence of arsenic skin lesions was used as an indicator for chronic arsenic exposure. In a cross-sectional study, a total of 210 participants were randomly identified from two ongoing studies--participants with arsenic skin lesions were identified from an ongoing clinical trial and participants with no arsenic skin lesions were identified from an ongoing cohort study. Mean age of menopause between these two groups were calculated and compared. Multivariable linear regression was used to estimate the relationship between the status of the arsenic skin lesions and age of natural menopause in women. Women with arsenic skin lesions were 1.5 years younger (p arsenic skin lesions. After adjusting with contraceptive use, body mass index, urinary arsenic level and family history of premature menopause, the difference between the groups' age at menopause was 2.1 years earlier (p arsenic skin lesions. The study showed a statistically significant association between chronic exposure to arsenic and age at menopause. Heavily exposed women experienced menopause two years earlier than those with lower or no exposure.
menopause and the prevalence rates of depression fall post- menopause.“ Genazzani', Spinetti, Gallo, et ... previous history of poor physical and psychosocial health at age 36 also reported more symptoms at 47 ..... Hammer M, Berg G and Hindgren R: Does physical exercise inﬂuence the frequency ofpostmenopausal hot ...
Vanwesenbeeck, [No Value; Vennix, P; van de Wiel, H
This study investigated the relative importance of psychosocial factors as opposed to menopausal status in relation to so-called 'menopausal symptoms' among a large sample of premenopausal, perimenopausal and (naturally and surgically) postmenopausal women (n = 4308) in The Netherlands. The
... in the area of non-hormonal therapies for menopause? In 2002, the WHI found that there were harms in hormone therapy and there was a compelling need for women to have alternatives. Taking oral estrogen around menopause or after was ...
Daan, Nadine M P; Fauser, Bart C J M
Reproductive ageing in women is characterized by a decline in both the quantity and quality of oocytes. Menopause is reached upon exhaustion of the resting primordial follicle pool, occurring on average at 51 years of age (range 40-60 years). The mean global age at natural menopause (ANM) appears
Micronutrient and herbal/phytochemical supplements are of increasing interest as potential alternatives to using estrogen therapy in treating menopausal symptoms. This article provides an overview of the questionnaires that assess menopausal symptoms and research efforts to better standardize symptom assessment. The reported rate of symptoms varies by ethnicity, stage of menopause, hormonal therapy and the measurement method. The use of estrogen therapy has declined sharply after the Women's Health Initiative (WHI) Hormone Trial was stopped early because the potential risks outweighed potential benefits. There is a limited research base that addresses the efficacy of supplements in controlling menopausal symptoms. The generalizability of several studies is limited because the study participants experiences menopause as the results of treatment for breast cancer. The article concludes with a review of guidelines and of issues that need to be addressed in future research studies with emphasis on questions related to clinical practice.
Lucija Vrabič Dežman
The studies could not decisively confirm the effectiveness of various phytoestrogens inamelioration of climacteric symptoms. Most studies have proven the effectiveness of thenatural medication made of Cimicifuga racemosa and its safe short-term use. Gynecologists should be familiar with the basics of phytotherapy and the results of clinical studiesin this field in order to confidently advise women to use the natural medications in caseswhere despite the climacteric symptoms they cannot or will not use HRT, consequentlygreatly reducing the quality of their lives. In cases where climacteric symptoms are mild tomoderate, some menopausal societies around the globe suggest trying natural medicationfirst, and only later implementing HRT
Cohen, Lee S; Soares, Claudio N; Joffe, Hadine
Recent census data indicate that, in the United States, an increasing number of women--almost 1.5 million each year--are reaching menopause. The menopausal transition is marked by intense hormonal fluctuations, and may be accompanied by vasomotor complaints, sleep disturbances, changes in sexual function, and increased risk for osteoporosis and cardiovascular disease. In addition, there is evidence of increased risk for developing depression, even among women who never experienced depressive symptoms before. Thus depression during the perimenopause may have a substantial impact on personal, family, and professional spheres of life. A challenge to clinicians and health professionals lies in the identification of the most tolerable treatments to manage depression and improve quality of life in an aging population. Any treatment strategy should take into account not only the spectrum of side effects that may complicate treatment but also other menopause-related factors (e.g., vasomotor symptoms, psychosocial stressors) that may modulate risk for the development of mood disturbance. This article reviews the current literature on the prevalence and risk factors associated with depression during the menopausal transition. The benefits and risks of using hormonal and nonhormonal strategies for the management of depression and other menopause-related somatic symptoms are critically reviewed.
Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here. PMID:26327870
Full Text Available Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here.
Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here.
Wright, Cheryl L; Aickin, Mikel
Hypothesis Studies indicate that menopausal symptoms are relieved by acupuncture. Additional studies have suggested that acupuncture may affect heart rate variability (HRV). This paper reports a pilot study that investigated whether menopausal symptoms responded to acupuncture, and if changes in the spectral analysis of HRV, either suppression of low frequency or augmentation of high frequency bands, corresponded with symptom report. Methods/interventions 12 healthy menopausal subjects were enrolled in this feasibility study. At baseline, subjects were experiencing moderately distressing menopausal symptoms, scoring at least 22 of a possible 44 points on the Menopausal Rating Scale. 10 traditional Chinese medicine-based, protocol acupuncture treatments were administered over a 4 week period, three times a week for 2 weeks, followed by twice a week for 2 weeks. Outcome measures Menopausal Rating Scale questionnaire, 11 menopausal symptoms were evaluated on a zero to four severity scale via self-administered daily checklist for 4 weeks. Dynamic measures of HRV (autoregressive model) were captured before, during and after acupuncture at each session. Spectral analysis of the heart rate was used to compute power in the low frequency and high frequency bands, and their ratio. All subjects complied fully with the protocol without any reported adverse events. While all 11 symptoms showed significant improvement, and one HRV measure changed, on average over the study period, there was essentially no support for a relationship between HRV, menopausal symptom report and acupuncture intervention.
de Pommerol, M; Hessamfar, M; Lawson-Ayayi, S; Neau, D; Geffard, S; Farbos, S; Uwamaliya, B; Vandenhende, M-A; Pellegrin, J-L; Blancpain, S; Dabis, F; Morlat, P
The aim of the paper is to describe the characteristics of postmenopausal HIV-infected women and to investigate the factors associated with an earlier onset of menopause in a hospital-based cohort. Information was collected using a self-administered questionnaire. A Cox model was used to determine factors associated with menopause. Among the 404 women who completed the questionnaire, 69 were naturally postmenopausal at the time of the study (median age at onset: 49 years, premature menopause <40 years: 12%). The onset of menopause was studied among the 41 women still menstruating at the enrollment in the cohort, and who experienced menopause during follow-up. African origin (hazard ratio [HR] = 8.16; 95% confidence interval [CI] = 2.23-29.89) and history of injecting drug use (IDU) (HR = 2.46; 95% CI = 1.03-5.85) were associated with an increased risk of earlier menopause. Women with a CD4 cell count <200 cells/mm(3) tended to reach menopause earlier (HR = 2.25; 95% CI = 0.94-5.39). Earlier occurrence of menopause seems to be associated with factors already reported in HIV-negative women (IDU, ethnicity) and with HIV-related immunodeficiency.
Peng, Wenbo; Sibbritt, David W; Hickman, Louise; Adams, Jon
To examine the association between self-prescribed complementary and alternative medicine use and menopause-related symptoms, stratified by menopausal status. Data were obtained from a cross-sectional survey of a nationally representative sample of 10,011 menopausal women from the Australian Longitudinal Study on Women's Health, conducted in 2010. Multivariable logistic regression models were applied to identify if the use of selected self-prescribed complementary and alternative medicine was significantly associated with a range of menopause-related symptoms. Vitamins/minerals were more likely to be used by natural menopausal women experiencing anxiety (adjusted OR=1.20) and/or stiff/painful joints (adjusted OR=1.16). Yoga/meditation was more likely to be used by women with hysterectomy (adjusted OR=1.76) or natural menopausal women (adjusted OR=1.38) experiencing anxiety. Herbal medicines were more likely to be used by natural menopausal women experiencing anxiety (adjusted OR=1.22), tiredness (adjusted OR=1.20), and/or stiff/painful joints (adjusted OR=1.17), and by women with oophorectomy experiencing tiredness (adjusted OR=1.45). Aromatherapy oils were more likely to be used by natural menopausal women experiencing night sweats (adjusted OR=1.25) and by women with hysterectomy experiencing anxiety (adjusted OR=2.02). Chinese medicines were more likely to be used by women with oophorectomy experiencing stiff/painful joints (adjusted OR=4.06) and/or palpitations (adjusted OR=3.06). Our study will help improve the patient-provider communication regarding complementary and alternative medicine use for menopause, and we conclude that menopausal status should be taken into account by providers for menopause care. The women's experience and motivations of such use warrant further research. Copyright © 2015 Elsevier Ltd. All rights reserved.
Chiu, Hsiao-Yean; Pan, Chieh-Hsin; Shyu, Yuh-Kae; Han, Bor-Cheng; Tsai, Pei-Shan
This meta-analysis aims to evaluate the effects of acupuncture on hot flash frequency and severity, menopause-related symptoms, and quality of life in women in natural menopause. We systematically searched PubMed/Medline, PsychINFO, Web of Science, Cochrane Central Register of Controlled Trials, and CINAHL using keywords such as acupuncture, hot flash, menopause-related symptoms, and quality of life. Heterogeneity, moderator analysis, publication bias, and risk of bias associated with the included studies were examined. Of 104 relevant studies, 12 studies with 869 participants met the inclusion criteria and were included in this study. We found that acupuncture significantly reduced the frequency (g = -0.35; 95% CI, -0.5 to -0.21) and severity (g = -0.44; 95% CI, -0.65 to -0.23) of hot flashes. Acupuncture significantly decreased the psychological, somatic, and urogenital subscale scores on the Menopause Rating Scale (g = -1.56, g = -1.39, and g = -0.82, respectively; P Acupuncture improved the vasomotor subscale score on the Menopause-Specific Quality of Life questionnaire (g= -0.46; 95% CI, -0.9 to -0.02). Long-term effects (up to 3 mo) on hot flash frequency and severity (g = -0.53 and g = -0.55, respectively) were found. This meta-analysis confirms that acupuncture improves hot flash frequency and severity, menopause-related symptoms, and quality of life (in the vasomotor domain) in women experiencing natural menopause.
Although estrogen has been clinically available for more than six decades, women have been confused by different opinions regarding the risks and benefits of menopausal hormone therapy (HT), estrogen therapy (ET...
Although improvement in long-term health is no longer an indication for menopausal hormone therapy, evidence supporting fewer adverse events in younger women, combined with its high overall effectiveness, has reinforced its usefulness for short-term treatment of menopausal symptoms. Menopausal therapy has been provided not only by commercially available products but also by compounding, or creation of an individualized preparation in response to a health care provider's prescription to create a medication tailored to the specialized needs of an individual patient. The Women's Health Initiative findings, coupled with an increase in the direct-to-consumer marketing and media promotion of compounded bioidentical hormonal preparations as safe and effective alternatives to conventional menopausal hormone therapy, have led to a recent increase in the popularity of compounded bioidentical hormones as well as an increase in questions about the use of these preparations. Not only is evidence lacking to support superiority claims of compounded bioidentical hormones over conventional menopausal hormone therapy, but these claims also pose the additional risks of variable purity and potency and lack efficacy and safety data. The Committee on Gynecologic Practice of the American College of Obstetricians and Gynecologists and the Practice Committee of the American Society for Reproductive Medicine provide an overview of the major issues of concern surrounding compounded bioidentical menopausal hormone therapy and provide recommendations for patient counseling. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Davis, S R; Castelo-Branco, C; Chedraui, P; Lumsden, M A; Nappi, R E; Shah, D; Villaseca, P
The aim of this review was to summarize the literature regarding the impact of the menopause transition on body weight and body composition. We conducted a search of the literature using Medline (Ovid, 1946-present) and PubMed (1966-2012) for English-language studies that included the following search terms: 'menopause', 'midlife', 'hormone therapy' or 'estrogen' combined with 'obesity', 'body weight' or 'body composition'. Whereas weight gain per se cannot be attributed to the menopause transition, the change in the hormonal milieu at menopause is associated with an increase in total body fat and an increase in abdominal fat. Weight excess at midlife is not only associated with a heightened risk of cardiovascular and metabolic disease, but also impacts adversely on health-related quality of life and sexual function. Animal and human studies indicate that this tendency towards central abdominal fat accumulation is ameliorated by estrogen therapy. Studies mostly indicate a reduction in overall fat mass with estrogen and estrogen-progestin therapy, improved insulin sensitivity and a lower rate of development of type 2 diabetes. The hormonal changes across the perimenopause substantially contribute to increased abdominal obesity which leads to additional physical and psychological morbidity. There is strong evidence that estrogen therapy may partly prevent this menopause-related change in body composition and the associated metabolic sequelae. However, further studies are required to identify the women most likely to gain metabolic benefit from menopausal hormone therapy in order to develop evidence-based clinical recommendations.
Lobo, R A; Davis, S R; De Villiers, T J; Gompel, A; Henderson, V W; Hodis, H N; Lumsden, M A; Mack, W J; Shapiro, S; Baber, R J
Women may expect to spend more than a third of their lives after menopause. Beginning in the sixth decade, many chronic diseases will begin to emerge, which will affect both the quality and quantity of a woman's life. Thus, the onset of menopause heralds an opportunity for prevention strategies to improve the quality of life and enhance longevity. Obesity, metabolic syndrome and diabetes, cardiovascular disease, osteoporosis and osteoarthritis, cognitive decline, dementia and depression, and cancer are the major diseases of concern. Prevention strategies at menopause have to begin with screening and careful assessment for risk factors, which should also include molecular and genetic diagnostics, as these become available. Identification of certain risks will then allow directed therapy. Evidence-based prevention for the diseases noted above include lifestyle management, cessation of smoking, curtailing excessive alcohol consumption, a healthy diet and moderate exercise, as well as mentally stimulating activities. Although the most recent publications from the follow-up studies of the Women's Health Initiative do not recommend menopause hormonal therapy as a prevention strategy, these conclusions may not be fully valid for midlife women, on the basis of the existing data. For healthy women aged 50-59 years, estrogen therapy decreases coronary heart disease and all-cause mortality; this interpretation is entirely consistent with results from other randomized, controlled trials and observational studies. Thus. as part of a comprehensive strategy to prevent chronic disease after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered as part of the armamentarium.
Duff, Putu K; Money, Deborah M; Ogilvie, Gina S; Ranville, Florence; Kestler, Mary; Braschel, Melissa C; Pick, Neora; Shannon, Kate
Although more women living with HIV (WLWH) are entering midlife, the experiences of perimenopausal and menopausal WLWH, including the effects of menopausal symptoms severity, remain understudied. This study longitudinally investigated the correlates of antiretroviral therapy (ART) adherence among perimenopausal and menopausal WLWH from Metro Vancouver. Analyses drew on longitudinal data (2014-2017) from Sexual health and HIV/AIDS: Women's Longitudinal Needs Assessment, an ongoing community-based cohort of WLWH, aged 14+, from Metro Vancouver, Canada. At baseline and biannually, participants completed an interviewer-administered questionnaire. Bivariate and multivariable logistic regression with generalized estimating equations were used to identify the correlates of self-reported <95% ART adherence. The sample included 109 perimenopausal and menopausal WLWH (233 observations), with a median age of 49 years (IQR 44-53). Whereas most (68.8%) participants experienced menopausal symptoms, only 17% had received treatment (eg, antidepressants, hormone therapy) at baseline. In multivariable analysis, severe menopausal symptoms (adjusted odds ratio [AOR] 1.03, 95% confidence interval [CI] 1.00-1.06), injection drug use (AOR 2.86, 95% CI 1.44-5.55), and physical/sexual violence (AOR 2.33, 95% CI 1.02-5.26) independently and positively correlated with <95% adherence. These findings suggest that menopausal symptoms may undermine ART adherence, with overlapping vulnerabilities such as injection drug use and sexual/physical violence further exacerbating poor ART adherence. Women-centred, trauma-informed care approaches to detect menopause and treat menopausal symptoms are urgently needed. Such approaches should holistically address the intersecting barriers to adherence and link WLWH to peripheral health and social services, including trauma counseling and evidence-based harm reduction services.
Rocca, Walter A.; Grossardt, Brandon R.; Shuster, Lynne T.
The neuroprotective effects of estrogen have been demonstrated consistently in cellular and animal studies but the evidence in women remains conflicted. We explored the window of opportunity hypothesis in relation to cognitive aging and dementia. In particular, we reviewed existing literature, reanalyzed some of our data, and combined results graphically. Current evidence suggests that estrogen may have beneficial, neutral, or detrimental effects on the brain depending on age at the time of treatment, type of menopause (natural versus medically or surgically induced), or stage of menopause. The comparison of women who underwent bilateral oophorectomy with referent women provided evidence for a sizeable neuroprotective effect of estrogen before age 50 years. Several case-control studies and cohort studies also showed neuroprotective effects in women who received estrogen treatment (ET) in the early postmenopausal stage (most commonly at ages 50–60 years). The majority of women in those observational studies had undergone natural menopause and were treated for the relief of menopausal symptoms. However, recent clinical trials by the Women’s Health Initiative showed that women who initiated ET alone or in combination with a progestin in the late postmenopausal stage (ages 65–79 years) experienced an increased risk of dementia and cognitive decline regardless of the type of menopause. The current conflicting data can be explained by the window of opportunity hypothesis suggesting that the neuroprotective effects of estrogen depend on age at the time of administration, type of menopause, and stage of menopause. Therefore, women who underwent bilateral oophorectomy before the onset of menopause or women who experienced premature or early natural menopause should be considered for hormonal treatment until approximately age 51 years. PMID:20965156
Unalan Pemra C
Full Text Available Abstract Background While bio-medically, menopause could be treated as an illness, from a psychosocial and cultural perspective it could be seen as a "natural" process without requiring medication unless severe symptoms are present. Our objective is to explore the perceptions of Turkish women regarding menopause and Hormone Therapy (HT to provide health care workers with an insight into the needs and expectations of postmenopausal women. Methods A qualitative inquiry through semi-structured, in-depth interviews was used to explore the study questions. We used a purposive sampling and included an equal number of participants who complained about the climacteric symptoms and those who visited the outpatient department for a problem other than climacteric symptoms but when asked declared that they had been experiencing climacteric symptoms. The interview questions focused on two areas; 1 knowledge, experiences, attitudes and beliefs about menopause and; 2 menopause-related experiences and ways to cope with menopause and perception of HT. Results Most of the participants defined menopause as a natural transition process that one should go through. Cleanliness, maturity, comfort of not having a period and positive changes in health behaviour were the concepts positively attributed to menopause, whereas hot flushes, getting old and difficulties in relationships were the negatives. Osteoporosis was an important concern for most of the participants. To deal with the symptoms, the non-pharmacological options were mostly favoured. Conclusion To our knowledge, this is the first qualitative study which focuses on Turkish women's menopausal experiences. Menopause was thought to be a natural process which was characterised by positive and negative features. Understanding these features and their implications in these women's lives may assist healthcare workers in helping their clients with menopause.
Hamid, Saima; Al-Ghufli, Fatma Rashid; Raeesi, Hanan Ali; Al-Dliufairi, Khawla Mohammed; Al-Dhaheri, Noura Salem; Al-Maskari, Fatma; Blair, Iain; Shah, Syed Mahboob
Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms like vasomotor symptoms, sleep disturbances, mood alteration, depression, urinary tract infection, vaginal atrophy and increased health risks for osteoporosis, cardiovascular diseases and loss of cognitive function. This study was conducted to determine knowledge, attitude and practice toward menopause among women in UAE. A clinic-based cross-sectional study was carried out among women of age 40 and above. Study subjects were recruited from four Primary Health Care centres in Al Ain city. The participants were administered a questionnaire in Arabic and English, which included 33 items; socio-demographic variables, and questions related to knowledge, attitude and practices regarding menopause and HRT. Out of 177 study subjected selected, 150 (85%) completed the survey. Almost half of the participants (51%) had already experienced menopause. A substantial number of women had poor know knowledge about menopause (67%) and HRT (73%). Sixty percent of women had positive attitude towards menopause. Of the fifty three percent of women with symptoms, 35% of them did not use anything to relieve their symptoms. Knowledge about menopause varied significantly (pattitude towards menopause and HRT was found to be statistically significant. Women with reported symptoms that were bothersome had positive attitude towards HRT uptake. The study indicated that there is poor knowledge about menopause and HRT among the participants. Level of knowledge was associated with the level of education. There was a positive attitude towards menopause, with women suffering the most from menopausal symptoms showing positive attitude towards HRT.
Bitner, Diana L; Wild, Robert A
Central obesity is a risk factor for cardiovascular disease and diabetes. Women commonly increase central fat deposition during the menopausal transition. The purpose of this demonstration project was to determine whether a personalized sex-specific intervention, WAIPointes (WAI stands for Who Am I), could reduce central obesity in women undergoing perimenopausal transition. Eighty-three of 103 women aged 35 to 55 years and experiencing symptoms of the menopausal transition completed a 6-month WAIPointes demonstration project; 75 consented to data review.Sex-specific history was obtained on visit 1; directed physical examination for body mass index, body fat percentage, waist circumference, and blood pressure were performed at each of four or five subsequent monthly visits. Other tests were ordered as necessary to determine risk stratification.Participants were assessed for menopause status, and they reported activity and menopausal symptoms at each visit. Personalized strategies for health improvement were developed in partnership. Women served as their own controls. Data from visit 2 were compared with data from visit 4. The intervention reduced waist circumference and diastolic blood pressure and improved self-reported menopausal symptoms and physical activity levels. Although further study is needed, findings suggest that the WAIPointes program offers potential as an effective office-based clinical intervention to reduce cardiovascular risk factors and symptoms of menopause in women during the menopausal transition.
Full Text Available Menopausal symptoms have been suggested to be an indicator of better prognosis among patients treated for breast cancer, because women who experience these symptoms usually have a lower level of estrogen. We tested this hypothesis in a population-based, prospective cohort study involving 4,842 women with stage 0 to III primary breast cancer who were enrolled in the Shanghai Breast Cancer Survival Study between March 2002 and April 2006, were aged 20 to 75 years, and were recruited 6 months post-diagnosis. They were followed-up by in-person surveys and record linkages with the vital statistics registry. Cox regression analysis was used to evaluate the association of menopausal symptoms at baseline with breast cancer recurrence. Approximately 56% of patients experienced at least one menopausal symptom, including hot flashes, night sweats, and/or vaginal dryness at baseline. During a median follow-up period of 5.3 years, 720 women had a recurrence. Experiencing hot flashes or having ≥2 menopausal symptoms was associated with lower risk of recurrence among premenopausal women (hazard ratio [HR]=0.77, 95% confidence interval [CI]: 0.62-0.96 for hot flashes; 0.73, 0.56-0.96 for ≥2 menopausal symptoms. Lower recurrence risk in relation to hot flashes was also observed among women who were not overweight/obese (HR=0.78, 95% CI: 0.64-0.99, those with relatively low waist-to-hip ratio (WHR (HR=0.77, 95% CI: 0.61-0.97, and those who used tamoxifen (HR=0.75, 95% CI: 0.58-0.98. Consistently experiencing multiple menopausal symptoms was associated with lower recurrence risk among women with low WHR or who used tamoxifen. This large, population-based cohort study of women with breast cancer confirms that experiencing menopausal symptoms is an indicator of favorable breast cancer prognosis.
... Clinical Evaluation and Counseling Chapter 6: Complementary and Alternative Medicine Chapter 7: Nonprescription Options Chapter 8: Prescription Therapies Professional Publications Menopause Journal Contents Position Statements & Other Reports Menopause Practice ...
As a part of a larger study, "Menopause described from the woman's perspective", it has been the aim to explore whether women have any positive experiences in relation to menopause, and if so, the nature of these experiences....
This paper aims to describe menopausal women's positive experience of growing older and becoming middle-aged.......This paper aims to describe menopausal women's positive experience of growing older and becoming middle-aged....
Stuenkel, C A
Over the past three decades, the prevalence of diabetes has increased four-fold. Coupled with the global obesity epidemic and aging of the world's population, a perfect metabolic storm is brewing. The influence of menopause and exogenous estrogen and progestogens must be included in this equation. In this review, criteria for diagnosing diabetes and recommendations for screening are described. The reported effects of menopause on diabetes risk in healthy women are reviewed as well as the relationship between established diabetes and the timing of menopause. The effects of menopausal hormone therapies (MHT) on glucose control in women with diabetes and the effect of MHT on diabetes risk in menopausal women without diabetes are described. Evidence-based strategies to prevent diabetes in midlife women are highlighted. The augmenting effect of diabetes on chronic health concerns of aging women, such as cardiovascular disease, osteoporosis, and cancer, along with current recommendations for screening and prevention are presented. Given the current demographics of today's world, the content of this review may apply to as many as one-third of the average practitioner's postmenopausal patient population.
Soares, Claudio N
The menopausal transition may impose a challenge to clinicians and health professionals who are invested in improving women's quality of life; after all, this period in life is commonly marked by significant hormone fluctuations accompanied by bothersome vasomotor symptoms (e.g., hot flushes and night sweats) and other somatic complaints. In addition, more recent epidemiologic data demonstrate that some women transitioning to menopause may be at higher risk for developing depression when compared with their risk during premenopausal years; this increased risk appears to be true even among those who had never experienced depression before. In this article, putative contributing factors for this window of vulnerability for depression during the menopausal transition are critically reviewed. Hormonal and nonhormonal factors that may contribute to the occurrence of physical and/or psychiatric complaints during the menopausal transition are discussed. Lastly, existing evidence-based treatment strategies are summarized.
Every year 30% of individuals above age 65 fall, and falls are the principal cause of bone fractures. To reduce fracture incidence requires both prevention of falls and maintenance of bone strength. PubMed searches were performed, for studies of the epidemiology of fractures, bone physiology, endocrine effects, osteoporosis measurement, genetics, prevention and effectiveness. Topic summaries were presented to the Workshop Group and omissions or disagreements were resolved by discussion. Ageing reduces bone strength in post-menopausal women because estrogen deficiency causes accelerated bone resorption. Bone mineral density (BMD) decreased more than 2.5 standard deviation below the mean of healthy young adults defines osteoporosis, a condition associated with an increased risk of fractures. Risk factors such as age and previous fracture are combined with BMD for a more accurate prediction of fracture risk. The most widely used assessment tool is FRAX™ which combines clinical risk factors and femoral neck BMD. General preventive measures include physical exercise to reduce the risk of falling and vitamin D to facilitate calcium absorption. Pharmacological interventions consist mainly in the administration of inhibitors of bone resorption. Randomized controlled trials show treatment improves BMD, and may reduce the relative fracture risk by about 50% for vertebral, 20-25% for non-vertebral and up to 40% for hip fractures although the absolute risk reductions are much lower. Although diagnosis of osteoporosis is an important step, the threshold for treatment to prevent fractures depends on additional clinical risk factors. None of the presently available treatment options provide complete fracture prevention.
Full Text Available In 2010, nearly 400 million women worldwide were of menopause age (45-54. Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.
Kanovitch, D; Klotz, H P
The authors recall the antagonism between estradiol and parathormone. Estradiol tends to lower serum calcium and fix calcium in the bones as shown by one of us 25 years ago. The mechanism of this action of estrogen on calcium metabolism has been determined by numerous authors but some points are still not clear, e.g. the interferences between estrogen and calcitonin. Classically, parathormone is known to increase bony reabsorption and raise serum calcium. After the menopause the gradual reduction in estradiol secretion leads to post-menopausal osteoporosis. It is better to administer estrogens prophylactically to women after the menopause provided a cervical smear and mammography have been carried out to eliminate latent carcinoma of the breast or uterine cervix.
Zilberman, J M
Hypertension is the main cardiovascular risk factor affecting 25% of women. Hormone changes and hypertension after menopause may lead to higher target organ damage and cardiovascular disease such as increased arterial stiffness, coronary diseases, chronic heart failure and stroke. The physiopathological mechanisms involved in the development of hypertension and cardiovascular diseases in menopausal women are controversial. There are pharmacokinetic and pharmacodynamic differences in both sexes, the women have more coughing when using the converting-enzyme inhibitors, more cramps when using thiazide diuretics and more oedema in the inferior limbs when using calcium antagonists. The aim of this review is to analyse possible physiopathological mechanisms involved in hypertension after menopause and to gain a better understanding of the biological effects mediated by vascular ageing in women when the level of oestrogen protective effect decreases over the vascular system. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.
Gloria N. Makuwa
Full Text Available Background: The majority of South African aging population are women, who spend late adulthood experiencing natural menopause. Despite the government spending billions of rand on different services for ageing women, menopausal challenges to African women still receive little attention.Objectives: The aim of the study was to explore and describe the perceptions of African women regarding natural menopause, in order to propose recommendations for health and social support systems for women in Mamelodi, Tshwane district.Method: A qualitative, exploratory, descriptive and contextual design was used to conduct the study. The population of the study consisted of menopausal women, between the ages 45 and 60 years or more, visiting the clinics for collection of chronic medication and othe rhealth assessment. Individual face-to-face interviews were conducted, using a semi-structured interview guide to collect data. Tesch’s method of qualitative data analysis was used in the study.Results: The main theme that emerged from the study was ‘attitude toward menopause’, which was supported by cultural beliefs and experience. The African menopausal women expressed the importance of health support systems that will meet their needs within their context.Conclusion: Women’s health programs and educational health information at facilities should include menopausal education to promote and improve health of all African menopausal women during their adulthood. There is a need to establish a women’s health support group network within communities to share menopausal experiences with peers. The training and education curriculum of healthcare providers should include detailed menopause in order to provide comprehensive, congruent care.
Woman's sexuality encompasses sexual identity, sexual function, and sexual relationships. It is modulated throughout life by life and reproduction-related events, health, relationships, and sociocultural variables. The aging process and menopause are two potent contributors to female sexual dysfunction. The earlier the menopause, the more severe and complex the impact on sexuality is. The younger the woman, the less she realizes the different key goals of her life cycle (falling in love, having a satisfying sexual life, forming a stable couple, getting married, having a family) and the more pervasive the consequences on her sexual identity, sexual function, and sexual relationship can be. Premature menopause is an amplified paradigm of the complex impact menopause can have on women's and couple's sexuality. This paper will focus on biologically based sexual issues, namely desire, arousal, orgasm, and pain disorders, as well as key questions encountered in infertility. The concepts of "symptom inducer" and "symptom carrier" will also be addressed. © 2010 New York Academy of Sciences.
Dhillon, Hardip Kaur; Singh, Harbindar Jeet; Shuib, Rashidah; Hamid, Abdul Manaf; Mohd Zaki Nik Mahmood, Nik
The aim of the study was to document the prevalence of 16 symptoms commonly associated with menopause, in women living in Kelantan. After verification, a semi-structured questionnaire in the Malay language was administered to 326 naturally menopaused healthy women in Kelantan (mean age of 57.1+/-6.58 (S.D.) years) to assess the prevalence of 16 common symptoms, which had been identified through focus group discussions and those that have been repeatedly reported in the literature. Mean age at menopause was 49.4+/-3.4 (S.D.) years while both the mode and median were 50 years. Of these, 75% were within the first 10 years of menopause and the rest were within the range of 11 to more than 20 years postmenopause. The mode for the number of symptoms complained by each woman was 8 (range 0-16). The prevalence of atypical symptoms was as follows: tiredness (79.1%), reduced level of concentration (77.5%), musculo-skeletal aches (70.6%) and backache (67.7%). Night sweats (53%), headache (49.4%) and hot flushes (44.8%) were the typical vasomotor symptoms, whereas mood swings (51%), sleep problems (45.1%), loneliness (41.1%), anxiety (39.8%) and crying spells (33.4%) were the main psychological symptoms. Uro-genital symptoms such as vaginal discomfort (45.7%), occasional stress incontinence (40%), weak bladder control (24%) and urinary tract infection (19.3%) were also reported. The symptoms are somewhat similar to those experienced by postmenopausal women elsewhere, albeit at different frequencies. There was a tendency for the women to admit to having more of the atypical symptoms, the prevalence of some which increased with increasing menopausal status, and lesser of the vasomotor and psychological symptoms.
Gass, M L; Taylor, M B
Today, 42% of Americans use alternative nonprescription therapies to treat medical conditions; 46% of nonprescription alternative use for principal medical conditions is done without consulting either a medical doctor or a nonphysician practitioner of alternative therapy. Many nontraditional alternatives are used to treat the hot flashes and somatic complaints of menopause, for which options such as hormone replacement therapy and other prescription and over-the-counter drugs are also available. To date, no one agent treats all menopausal symptoms as effectively as estrogen. Selective estrogen-receptor modulators can help prevent osteoporosis but do not relieve menopausal symptoms. However, some women are unwilling or unable to take hormone replacement therapy, and some decide to discontinue therapy. Evidence supporting the use of some nonprescription alternatives for conditions related to menopause is limited. Patients need to be aware of the potential for drug interactions when these alternative therapies are used concomitantly with prescription drugs. The current evidence to support use of hormone replacement therapy, selective estrogen-receptor modulators, and nontraditional alternatives is reviewed here.
Foldspang, Anders; Mommsen, Søren
the year of final menstruation. The findings suggest perimenopausal processes rather than the menopause in general to be responsible for an increased risk of developing UI. The elevation of UI prevalence in the perimenopause may reflect the adjustment of the female continence mechanism to function...
Friedlander, Arthur H
Approximately 36 million women in the United States are in the postmenopausal phase of life. The vast majority of these women experienced spontaneous cessation of menses between the ages of 47 and 55 years when the production of estrogen decreased because of an inadequate number of functioning follicles within their ovaries. Fewer women entered menopause after surgical removal of both ovaries. This procedure usually is performed prophylactically to prevent ovarian cancer in conjunction with a hysterectomy, which is required to treat abnormal bleeding, endometriosis or pelvic inflammatory disease. The physiological changes associated with spontaneous or surgical menopause cause some women to experience uncomfortable symptoms such as hot flashes, night sweats and vaginal dryness. In addition, estrogen deprivation arising from menopause in association with age-related factors disproportionately increases the risk of developing cardiovascular disease (that is, myocardial infarct, stroke), osteoporosis, Alzheimer's disease and oral disease. Hormone replacement therapy, or HRT (estrogen or estrogen and progestin), often is prescribed on a short-term basis to alleviate the uncomfortable symptoms associated with estrogen deficiency and on a long-term basis to prevent some of the chronic illnesses common to postmenopausal women. Dentists who treat women entering menopause need to consider the stressful phase of life their patients are experiencing. Clinical findings of postmenopausal problems on dental examination may include a paucity of saliva, increased dental caries, dysesthesia, taste alterations, atrophic gingivitis, periodontitis and osteoporotic jaws unsuitable for conventional prosthetic devices or dental implants. Panoramic dental radiographs may reveal calcified carotid artery atheromas. Dentists have an opportunity to refer women who are not under the care of a gynecologist for an evaluation to determine the appropriateness of HRT for its systemic and oral
Li, Lin; Wu, Jie; Pu, Danhua; Zhao, Yang; Wan, Chunhua; Sun, Lihua; Shen, Cai-e; Sun, Weihua; Yuan, Zhimin; Shen, Qin; He, Xiaoyan; Jiang, Jian; Luo, Naimei; He, Ya; Qian, Qiuju; Cai, Peiqin; Zhang, Mei
To investigate the factors associated with the age of natural menopause and menopausal symptoms in a large population of Chinese middle-aged women. In this cross-sectional study, a total of 20,275 women (40-65 years) attending health screening in Jiangsu Province of China were enrolled. A structured questionnaire was used to collect data of demographics, menopausal status, chronic diseases, reproductive history, etc. Also we evaluated the severity of menopausal symptoms by Kupperman menopause index (KMI). Menopausal age and scorings of Kupperman menopause index. The overall median age at natural menopause was 50 years. Lower educational level, poor economic status, lower body mass index (BMI), age at menarche less than 14 years, nulliparity and smoking were associated with earlier onset of natural menopause (PKMI scores (P<0.05). The study provided an estimate of median age at natural menopause in Chinese women. The main factors contributing to earlier onset of menopause and severity of menopausal symptoms were lower educational level, poor economic status, and smoking. Thus, this study provides important insights for physicians to prevent and treat menopause related symptoms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Czarnecka-Iwańczuk, Marta; Stanisławska-Kubiak, Maja; Mojs, Ewa; Wilczak, Maciej; Samborski, Włodzimierz
.... Moreover, they also influence the quality of life and self-esteem. Aim of the study: The aim of survey was to analyze the level of self-esteem and life satisfaction in the context of menopausal symptoms experienced by women in this period of life...
Jeng, Chii; Yang, Shun-Hsuan; Chang, Pi-Chen; Tsao, Lee-Ing
Menopausal women are at high risk for cardiovascular diseases and osteoporosis. However, for so long, women have devoted much of their time and energy to family, children, and work such that they could not regularly exercise. There are few studies addressing the experiences of Taiwanese women who regularly exercise. The aim of this study was to explore the experiences of regularly exercising, defined as thoughts or actions by menopausal women who did not regularly exercise before menopause, but who now exercise regularly. A grounded theory research design was used. In-depth interviews were undertaken with a purposive sampling of 12 menopausal women who began to do regular exercises after menopause and who have continued exercising for more than 6 months. The constant comparative method was used to analyse the interview data. 'Perceiving Continuous Power' was the core category during the process of regularly exercising. Every participating woman perceived that her body and mind were filled with continuous power including the subcategories of 'Overcoming the initial discomfort', 'Experiencing Benefits to Body and Mind' and 'Broadening' during the process. 'Awareness of Health Crisis', which included the subcategories of 'Cureless Chronic Disease', 'Mood Swings', and 'Conflict on Medication', was identified as occurring when these women first began regularly exercising. Throughout the process of perceiving continuous power, women experienced the following interactive behaviour categories: 'Exercise Selection' with subcategories of 'Self-Evaluation', 'Seeking and Fitting', 'Comparing' and 'Health Becoming' with the subcategories of 'Releasing Health Crisis', 'Regaining Flowering Life', and 'Self-Fulfilling'. Regular exercises provided continuous power for menopausal women. The experiences with exercise we uncovered in this study can provide a reference for nurses to guide menopausal women with their regular exercise plans.
Full Text Available Progestogens share one common effect: the ability to convert proliferative endometrium to its secretory form. In contrast, their biological activity is varied, depending on the chemical structure, pharmacokinetics, receptor affinity and different potency of action. Progestogens are widely used in the treatment of menstrual cycle disturbances, various gynaecological conditions, contraception and menopausal hormone therapy. The administration of progestogen in menopausal hormone therapy is essential in women with an intact uterus to protect against endometrial hyperplasia and cancer. Progestogen selection should be based on the characteristics available for each progestogen type, relying on the assessment of relative potency of action in experimental models and animal models, and on the indirect knowledge brought by studies of the clinical use of different progestogen formulations. The choice of progestogen should involve the conscious use of knowledge of its benefits, with a focus on minimizing potential side effects. Unfortunately, there are no direct clinical studies comparing the metabolic effects of different progestogens.
González Torres, Maribel; Domingo, Cristina
After analyzing the causes of hot flashes caused by menopause according to the theories of Traditional Chinese Medicine, the author describe nine clinical case studies and their corresponding diagnoses according to the five basic elements: water, wood, fire, land and metal. In virtually every case study, once the corresponding treatment of choice was applied, an improvement in the patient's symptoms was observed along with a positive evaluation on behalf of these patients.
Moreno Saavedra, E; Rovira Magariños, M J; Rodríguez Liz, G A; López Eimil, T
In this article, the authors analyze the pathological alterations which women suffer in which menopause is assumed to be a risk factor leading to the outbreak of these pathologies. Taken together, all of these alterations present some clear nutritional considerations; therefore, adequate dietetical care, followed by women during this phase, could help in their prevention and control. These alterations are: osteoporosis, obesity, arterial hypertension, arteriosclerosis and cardiovascular diseases.
BACKGROUND: Vasomotor Symptoms are the most common and distressing menopausal complaint, for which women seek advice from their physician. OBJECTIVE: To review menopausal associated vasomotor symptoms and options available in its management. METHODS: Pertinent literature on menopause associated ...
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Full Text Available Elena M Umland, Laura FalconieriJefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USAAbstract: Vasomotor symptoms (VMS, including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical health of women experiencing VMS, leading to their pursuance of treatment to alleviate these symptoms. Management of VMS includes lifestyle modifications, some herbal and vitamin supplements, hormonal therapies including estrogen and tibolone, and nonhormonal therapies including clonidine, gabapentin, and some of the serotonin and serotonin–norepinephrine reuptake inhibitors. The latter agents, including desvenlafaxine, have been the focus of increased research as more is discovered about the roles of serotonin and norepinephrine in the thermoregulatory control system. This review will include an overview of VMS as they relate to menopause. It will discuss the risk factors for VMS as well as the proposed pathophysiology behind their occurrence. The variety of treatment options for VMS will be discussed. Focus will be given to the role of desvenlafaxine as a treatment option for VMS management.Keywords: menopause, vasomotor symptoms, hot flashes, vasomotor symptom treatment, desvenlafaxine
Soares Claudio N
Full Text Available Abstract There is little doubt that women experience a heightened psychiatric morbidity compared to men. A growing body of evidence suggests that, for some women, the menopausal transition and early postmenopausal years may represent a period of vulnerability associated with an increased risk of experiencing symptoms of depression, or for the development of an episode of major depressive disorder. Recent research has begun to shed some light on potential mechanisms that influence this vulnerability. At the same time, a number of studies and clinical trials conducted over the past decade have provided important data regarding efficacy and safety of preventative measures and treatment strategies for midlife women; some of these studies have caused a shift in the current thinking of how menopausal symptoms should be appropriately managed. Essentially, most women will progress from premenopausal into postmenopausal years without developing significant depressive symptoms. However, those with prior history of depression may face a re-emergence of depression during this transition while others may experience a first episode of depression in their lives. Here I provide an overview of what is known about risk factors for depression and the risk posed by the menopausal transition, its associated symptoms, and the underlying changes in the reproductive hormonal milieu, discussing the evidence for the occurrence of mood symptoms in midlife women and the challenges that face clinicians and health professionals who care for this population.
Morelli, Vincent; Naquin, Christopher
With growing concern about the use of hormone replacement therapy, some women are looking for alternative treatments for menopausal symptoms and preventing postmenopausal cardiovascular disease and osteoporosis...
... FSH (Follicle-Stimulating Hormone) Test (American Association for Clinical Chemistry) Hot Flashes (Mayo Foundation for Medical Education and Research) Signs of the Menopausal Transition (National Institute on ...
Gannon, L; Stevens, J
This examination of menopause as presented by the popular print media was conducted in the context of furthering our understanding of the development of attitudes toward menopause. All articles indexed under "menopause" in the Reader's Guide in the years 1981, 1982, 1985, 1986, 1989, 1990, 1993, and 1994 were located and examined. The data revealed that, although there has been an increase in the frequency of articles on menopause in the last 15 years, the media's portrayal of menopause is problematic in several respects: (a) in spite of the increased attention, the information available on menopause through the popular media is minimal and insufficient; (b) there was little variability in terms of perspective, discipline, or focus; almost all were focused on menopause as a negative experience or disease and in need of medical treatment; (c) there was considerable contradiction and inconsistency among the articles with respect to descriptions of menopause and intervention advice for menopausal women; (d) aging, stress, life-style factors, race and ethnicity, exercise and diet were, with few exceptions, ignored or trivialized.
, religion and socio-economic level ... women's psychosocial adjustment needs on the basis of marital status. (Cal.t=0.42; P>0.05), .... psychological health and sexual satisfaction using 32 post menopausal and 13 non-menopausal women and ...
Full Text Available The global population in the 21st century has reached 6.2 billion people, by the year 2025 it is to be around 8.3-8.5 billion, and will increase further. Elderly people are expected to grow rapidly than other groups. The fastest increase in the elderly population will take place in Asia. Life expectancy is increasing steadily throughout developed and developing countries. For many menopausal women, increased life expectancy will accompanied by many health problems. The consequences of estrogen deficiency are the menopausal symptoms. The treatment of menopause related complaints and diseases became an important socioeconomic and medical issue. Long term symptoms, such as the increase in osteoporosis fractures, cardio and cerebrovascular disesses and dementia, created a large financial burden on individuals and society. All these health problems can be lreated or prevented by hormone replacement therapy (HRT. Natural HRT is usually prefened. Synthetic estrogen in oral contraceptives (oc are not recommended for HRT. Many contra-indications for oc, but now it is widely usedfor HRT. The main reasons for discontinuing HRT are unwanted bleeding, fear of cancer, and negative side effects. Until now there are sill debates about the rebrtonship between HRT and the incidence of breast cancer. Many data showed that there were no clear relationship between the use of HRT and breast cancer. ThereÎore, nwny experts advocate the use of HRTfrom the first sign of climacteric complaints until death. (Med J Indones 2001;10: 242-51Keywords: estrogen deficiency, climacteric phases, tibolone.
Booth-LaForce, Cathryn; Thurston, Rebecca C; Taylor, Mary R
To assess the feasibility and efficacy of a yoga treatment for menopausal symptoms. Both physiologic and self-reported measures of hot flashes were included. A prospective within-group pilot study was conducted. Participants were 12 peri- and post-menopausal women experiencing at least 4 menopausal hot flashes per day, at least 4 days per week. Assessments were administered before and after completion of a 10-week yoga program. Pre- and post-treatment measures included: Severity of questionnaire-rated menopausal symptoms (Wiklund Symptom Check List), frequency, duration, and severity of hot flashes (24-h ambulatory skin-conductance monitoring; hot-flash diary), interference of hot flashes with daily life (Hot Flash Related Daily Interference Scale), and subjective sleep quality (Pittsburgh Sleep Quality Index). Yoga classes included breathing techniques, postures, and relaxation poses designed specifically for menopausal symptoms. Participants were asked to practice at home 15 min each day in addition to weekly classes. Eleven women completed the study and attended a mean of 7.45 (S.D. 1.63) classes. Significant pre- to post-treatment improvements were found for severity of questionnaire-rated total menopausal symptoms, hot-flash daily interference; and sleep efficiency, disturbances, and quality. Neither 24-h monitoring nor accompanying diaries yielded significant changes in hot flashes. The yoga treatment and study procedures were feasible for midlife women. Improvement in symptom perceptions and well being warrant further study of yoga for menopausal symptoms, with a larger number of women and including a control group.
Baker, Fiona C; de Zambotti, Massimiliano; Colrain, Ian M; Bei, Bei
A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs) and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment approaches and management options, including combination treatments, ranging from cognitive behavioral therapy for insomnia to hormonal and nonhormonal pharmacological options. Emerging studies suggest that the impact of severe insomnia symptoms could extend beyond immediate health care usage and quality of life issues to long-term mental and physical health, if left untreated in midlife women. Appropriate treatment, therefore, has immediate benefit as well as advantages for maintaining optimal health in the postmenopausal years.
Kanadys, Katarzyna; Wiktor-Stoma, Anna; Lewicka, Magdalena; Sulima, Magdalena; Wiktor, Henryk
The peri-menopausal period is the time of many biological, psychological and social changes. The quality of life of women in this period may be conditioned by many factors, and analysis of these factors may indicate the optimum directions of prophylactic and educational actions. Analysis of selected predictive factors of the quality of life of women in the peri-menopausal period. The study covered 268 peri-menopausal women. The qualification criteria were: age 45-55, lack of mental disorders and diseases requiring hospitalization during the period of study. The study was conducted using standardized instruments: Women's Health Questionnaire - WHQ, Beck Depression Inventory (BDI) and an author-constructed questionnaire. The presented study of the quality of life showed that the women examined felt physically unattractive, lacking the full joy of life, and frequently experienced somatic complaints. Nevertheless, the respondents enjoyed life, had no constant feeling of anxiety and concern. Multi-factor analysis showed that the quality of life in the group of women in the study was affected by the following factors: level of depression, self-reported state of health, occurrence of menopausal symptoms, education level, and marital status. The quality of life of the peri-menopausal women examined was the highest with respect to depressive mood (DEP) and anxiety/depressed mood (ANX), while it was the lowest with respect to the sense of attractiveness (ATT), and somatic symptoms (SOM). In addition, in the group of women in peri-menopausal period the quality of life was conditioned: level of depression, self-reported state of health, occurrence of menopausal symptoms, education level, and marital status.
Chair, Sek Ying; Wang, Qun; Cheng, Ho Yu; Lo, Sally Wai-Sze; Li, Xiao Mei; Wong, Eliza Mi-Ling; Sit, Janet Wing-Hung
Menopause is an inevitable stage affecting every middle-aged woman. China has a large and increasing group of post-menopausal women. Most post-menopausal women suffer from increased risks for cardiovascular diseases (CVD) and sleep problems. Previous studies have demonstrated the associations between sleep disorders and increased CVD risks in general population. The current study is to examine the relationship between sleep quality and CVD risks among Chinese post-menopausal women. This study was a sub-study nested in a cross-sectional study that investigated the sleep quality of community-dwelling adults in Xian, Shaanxi Province, China. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) and the Framingham 10-year risk score (FRS) were used to measure sleep quality and CVD risk among 154 Chinese post-menopausal women. Multivariate regression and logistic regression were used to determine the association between sleep quality and CVD risk. The participants (age: 63.65 ± 4.47 years) experienced poor sleep quality (mean score of global PSQI = 8.58) and a 10-year risk of CVD of 12.54%. The CVD risk was significantly associated with sleep duration (β = - 0.18, p = 0.04) and sleep disturbance (β = 0.33, p 10%) (odds ratio = 0.51, p = 0.04). Poor sleep quality might increase the CVD risk in post-menopausal women. Interventions to promote the cardiovascular health of Chinese post-menopausal women may need to include sleep promotion strategies.
Avis, Nancy E; Coeytaux, Remy R; Levine, Beverly; Isom, Scott; Morgan, Timothy
To examine the trajectories of responses to acupuncture treatment for menopausal vasomotor symptoms (VMS) and the characteristics of women in each trajectory. Two hundred nine perimenopausal and postmenopausal women aged 45 to 60 years experiencing at least four VMS per day were recruited and randomized to receive up to 20 acupuncture treatments within 6 months or to a waitlist control group. The primary outcome was percent change from baseline in the mean daily VMS frequency. Finite mixture modeling was used to identify patterns of percent change in weekly VMS frequencies over the first 8 weeks. The Freeman-Holton test and analysis of variance were used to compare characteristics of women in different trajectories. Analyses revealed four distinct trajectories of change in VMS frequency by week 8 in the acupuncture group. A small group of women (11.6%, n = 19) had an 85% reduction in VMS. The largest group (47%, n = 79) reported a 47% reduction in VMS frequency, 37.3% (n = 65) of the sample showed only a 9.6% reduction in VMS frequency, and a very small group (4.1%, n = 7) had a 100% increase in VMS. Among women in the waitlist control group, 79.5% reported a 10% decrease in VMS frequency at week 8. Baseline number of VMS, number of acupuncture treatments in the first 8 weeks, and traditional Chinese medicine diagnosis were significantly related to trajectory group membership in the acupuncture group. Approximately half of the treated sample reported a decline in VMS frequency, but identifying clear predictors of clinical response to acupuncture treatment of menopausal VMS remains challenging.
Avis, Nancy E.; Coeytaux, Remy R.; Levine, Beverly; Isom, Scott; Morgan, Timothy
Objective To examine the trajectories of responses to acupuncture treatment for menopausal vasomotor symptoms (VMS) and the characteristics of women in each trajectory. Methods 209 perimenopausal and postmenopausal women aged 45-60 years experiencing ≥4 VMS per day were recruited and randomized to receive up to 20 acupuncture treatments within 6 months or to a waitlist control group. The primary outcome was percent change from baseline in the mean daily VMS frequency. Finite mixture modeling was used to identify patterns of percent change in weekly VMS frequencies over the first 8 weeks. The Freeman-Holton test and ANOVA were used to compare characteristics of women in different trajectories. Results Analyses revealed four distinct trajectories of change in VMS frequency by week 8 in the acupuncture group. A small group of women (11.6%, n=19) had an 85% reduction in VMS. The largest group (47%, n=79) reported a 47% reduction in VMS frequency, 37.3% (n=65) of the sample showed only a 9.6% reduction in VMS frequency, and a very small group (4.1%, n=7) had a 100% increase in VMS. Among women in the waitlist control group, 79.5% reported a 10% decrease in VMS frequency at week 8. Baseline number of VMS, number of acupuncture treatments in the first 8 weeks, and traditional Chinese medicine diagnosis were significantly related to trajectory group membership in the acupuncture group. Conclusions Approximately half of the treated sample reported a decline in VMS frequency, but identifying clear predictors of clinical response to acupuncture treatment of menopausal VMS remains challenging. PMID:27676631
Yi, Sang-Wook; Odongua, Nemekhee; Nam, Chung Mo; Sull, Jae Woong; Ohrr, Heechoul
The association between body mass index and mortality caused by subtypes of stroke among postmenopausal women in terms of smoking status and age at menopause remains controversial. The data were derived from a cohort study of 3321 with 17.8 years of follow-up (1985 to 2002). Hazard ratios (HRs) and 95% CIs for strokes as related to body mass index were estimated by Cox proportional hazard models adjusted for age, hypertension, smoking, drinking, occupation, education, self-reported health, and age at menopause. A stratified analysis was conducted by age at menopause and smoking status. The obese group (body mass index >or=27.5 kg/m(2)) had higher risks of total stroke mortality (HR, 1.59; 95% CI, 1.05 to 2.42) and hemorrhagic stroke mortality (HR, 2.91; 95% CI, 1.37 to 6.19) than the normal weight group (18.5or=50. For the obese group of the former, the HR of total stroke was 2.04 (95% CI, 1.25 to 3.34) and that of hemorrhagic stroke 6.46 (95% CI, 2.42 to 17.25). In this prospective study, obesity raised the risks of total stroke mortality and hemorrhagic stroke mortality among Korean menopausal women. It was more evident with women who experienced menopause at age <50. The obese group of ever smokers was at an increased risk of ischemic stroke mortality.
Berner Andrée Sandoval-Ramírez
Full Text Available Beer is one of the most frequently consumed fermented beverages in the world, and it has been part of the human diet for thousands of years. Scientific evidence obtained from the development of new techniques of food analysis over the last two decades suggests that polyphenol intake derived from moderate beer consumption may play a positive role in different health outcomes including osteoporosis and cardiovascular risk and the relief of vasomotor symptoms, which are commonly experienced during menopause and are an important reason why women seek medical care during this period; here, we review the current knowledge regarding moderate beer consumption and its possible effects on menopausal symptoms. The effect of polyphenol intake on vasomotor symptoms in menopause may be driven by the direct interaction of the phenolic compounds present in beer, such as 8-prenylnaringenin, 6-prenylnaringenin, and isoxanthohumol, with intracellular estrogen receptors that leads to the modulation of gene expression, increase in sex hormone plasma concentrations, and thus modulation of physiological hormone imbalance in menopausal women. Since traditional hormone replacement therapies increase health risks, alternative, safer treatment options are needed to alleviate menopausal symptoms in women. The present work aims to review the current data on this subject.
Sandoval-Ramírez, Berner Andrée; M. Lamuela-Raventós, Rosa; Estruch, Ramon; Sasot, Gemma; Doménech, Monica
Beer is one of the most frequently consumed fermented beverages in the world, and it has been part of the human diet for thousands of years. Scientific evidence obtained from the development of new techniques of food analysis over the last two decades suggests that polyphenol intake derived from moderate beer consumption may play a positive role in different health outcomes including osteoporosis and cardiovascular risk and the relief of vasomotor symptoms, which are commonly experienced during menopause and are an important reason why women seek medical care during this period; here, we review the current knowledge regarding moderate beer consumption and its possible effects on menopausal symptoms. The effect of polyphenol intake on vasomotor symptoms in menopause may be driven by the direct interaction of the phenolic compounds present in beer, such as 8-prenylnaringenin, 6-prenylnaringenin, and isoxanthohumol, with intracellular estrogen receptors that leads to the modulation of gene expression, increase in sex hormone plasma concentrations, and thus modulation of physiological hormone imbalance in menopausal women. Since traditional hormone replacement therapies increase health risks, alternative, safer treatment options are needed to alleviate menopausal symptoms in women. The present work aims to review the current data on this subject. PMID:28904736
Ana Mª Rivas Hidalgo
Full Text Available Taking into account that climacteric constitutes a physiological state in woman’s life, which covers a large stage of her life cycle, it is important that nursery professionals will develop an Action Plan, whose main objective will be health. Covering, then, this stage from a multidisciplinary and holistic field is going to contribute to both: the adoption of healthy life habits and the repercussions that symptoms and physiological processes associated with menopause have on women. Another objective for nurses there must be to provide all our knowledge in a detailed and focused on the individual needs that may come up way. That way, we lay the foundations for facing climacteric with the minimum deterioration of the quality of life and well being.This article is an analysis of the etiology of every one of the most prevalent menopause problems, the predisposing factors to suffer them or to make them get worse, and the habits that are going to prevent larger spill-over effects of those problems. Furthermore, a revision about how nutrition, exercise, toxic substances consumption, etc. have repercussions on musculoskeletal problems, vascular symptoms, urogenital problems, psychological alterations, and gynaecological and breast cancer is made.
Huntley, A L
Grape flavonoids are members of a larger group of plant compounds called polyphenols. Epidemiological evidence relating to the traditional Mediterranean diet, which is high in polyphenols, derived from vegetables and red wine, suggests that dietary polyphenols are of benefit to health and reduce the incidence of cardiovascular disease. Overall, the evidence is promising for the benefit of grape flavonoids in the form of red wine, red grape juice and related preparations for cardiovascular risk factors. There are data to suggest a reduction in platelet activation, inflammation and low-density lipoprotein oxidation, and improvement of endothelial function with grape flavonoids. The evidence for grape flavonoids and renal function, cognition and cancer is less clear. However, it is important to note that much of this research has been carried out in animal and cell models; relatively little work has been done in humans and specifically on the health of menopausal women. There are no general safety concerns with ingestion of grape products. Obviously, consumption of red wine should be within recommended limits and it should be noted that grape juice has high sugar content. Grape flavonoids are also available as a supplement. In conclusion, it is likely that grape flavonoids do benefit the menopausal women. Further research is needed on the mode and dosage of application to maximize these benefits.
Lee, Myeong Soo; Kim, Jong-In; Ha, Jeong Yong; Boddy, Kate; Ernst, Edzard
The aim of this study was to assess the effectiveness of yoga as a treatment option for menopausal symptoms. We searched the literature using 14 databases from their inception to July 2008 and included all types of clinical studies regardless of their design. The methodological quality of all studies was assessed using a modified Jadad score. Seven studies met our inclusion criteria. Two randomized clinical trials compared the effects of yoga with those of walking or physical exercise. The meta-analysis of these data failed to show specific effects of yoga on menopausal complaints including psychological, somatic, and vasomotor symptoms. Two randomized clinical trials found no effects of yoga on total menopausal symptoms compared with wait-list control or no treatment. The remaining studies were either non-randomized (n = 1) or uncontrolled clinical trials (n = 3). They reported favorable effects of yoga on menopausal symptoms. These data collectively show that the results of rigorous studies of the effects of yoga for menopausal symptoms are unconvincing. The evidence is insufficient to suggest that yoga is an effective intervention for menopause. Further research is required to investigate whether there are specific benefits of yoga for treating menopausal symptoms.
Warren, Michelle P; Shortle, Barbara; Dominguez, Jennifer E
Hormone replacement therapy has traditionally been used to treat the accompanying symptoms of oestrogen deficiency in menopause. However, not all women can, or prefer to, receive this treatment and alternatives should be considered to reduce the increased risk of osteoporosis and heart disease in menopausal women. This chapter reviews the current literature on the efficacy of phyto-oestrogens in preventing cardiovascular disease, various cancers and osteoporosis, as well as treating the vasomotor and other menopause-related symptoms. Select herbal therapies, as well as selective oestrogen receptor modulators, are also considered. Copyright 2002 Elsevier Science Ltd.
Zdanowicz, Nicolas; Jacques, Denis; Tordeurs, David; Schepens, Pierre; Reynaert, Christine
Aim: Until the 1980s, due largely to prejudice, post-menopausal women were believed to experience significantly less sexual desire and thus to have sexual intercourse less often than before menopause. Since the 1990s, this type of prejudices seems to have decreased. The aim of our study is to examine the sexuality of post-menopausal women by comparing it to same aged men’s sexual behaviour and the importance of sexuality in their life. Methods: A sample of 1,526 women and 1,151 men aged 55 an...
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... begins. Try taking 6 breaths a minute. Try yoga, tai chi, or meditation. Other tips: Dress lightly ... been linked to some long-term effects, including: Bone loss and osteoporosis in some women Changes in ...
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Purwo Nugroho, Yuyus
Hubungan Antara Stadium Menopause Dengan Perubahan Seksual Wanita Menopause Di Posyandu Lansia Srikandi Kelurahan Sumbersari Kota MalangCorrelation between Stadium of Menopause with the Alteration of Menopause Women'ssexuality in Posyandu of Srikandi's Elderly Sumbersari MalangYuyus Purwo NugrohoPerawat Rumah Sakit Port Health Center (PHC)Jl. Prapat Kurung Selatan No. 1 Tanjung Perak Surabaya 60165Email : Menopause memilki 4 stadium atau tahapan dalam perkembanga...
Daley, Amanda; Stokes-Lampard, Helen; Thomas, Adèle; MacArthur, Christine
Evidence suggests that many perimenopausal and early postmenopausal women will experience menopausal symptoms; hot flushes are the most common. Symptoms caused by fluctuating levels of oestrogen may be alleviated by hormone therapy (HT), but a marked global decline in its use has resulted from concerns about the risks and benefits of HT. Consequently, many women are seeking alternatives. As large numbers of women are choosing not to take HT, it is increasingly important to identify evidence-based lifestyle modifications that have the potential to reduce vasomotor menopausal symptoms. To examine the effectiveness of any type of exercise intervention in the management of vasomotor symptoms in symptomatic perimenopausal and postmenopausal women. Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials (RCTs): Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Wiley Internet interface), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), the Science Citation Index and the Social Science Citation Index (Web of Science), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (Ovid) and SPORTDiscus. Searches include findings up to 3 March 2014. RCTs in which any type of exercise intervention was compared with no treatment/control or other treatments in the management of menopausal vasomotor symptoms in symptomatic perimenopausal/postmenopausal women. Five studies were deemed eligible for inclusion. Two review authors independently selected the studies, and three review authors independently extracted the data. The primary review outcome was vasomotor symptoms, defined as hot flushes and/or night sweats. We combined data to calculate standardised mean differences (SMDs) with 95% confidence intervals (CIs). Statistical heterogeneity was assessed using the I(2) statistic. We assessed the overall quality of the
Full Text Available Menopausal symptoms experienced by women vary widely, and while many women transition through menopause with manageable symptoms, others experience severe symptoms, which may impair their quality of life. The purpose of this study was to determine the effect of Tribulus terrestris , ginger, saffron, and Cinnamomum on menopausal symptoms. A randomised, triple-blind, controlled trial design was used for this study. The participants were 80 postmenopausal women aged 50–60 years. A demographic data form and the Menopause Rating Scale were used to collect data. The women were randomly divided into two groups, each of which received either an Aphrodit capsule or a placebo twice a day for four weeks. The two bottles looked exactly the same, so that the investigator and the participants were not aware of the contents of the bottles. Each Aphrodit capsule contained 40 mg of Tribulus terrestris , 12.27 mg of Zingiber officinale, 3 mg of Crocus sativus extract, and 11 mg of Cinnamomum zeylanicum, while the placebo capsules contained 50 mg of starch. Descriptive and inferential statistics were used to analyse the data. A statistically significant change was reported in the menopausal symptoms of the intervention group compared with the placebo group. The results of the study demonstrate that the Aphrodit capsule was effective in reducing menopausal symptoms.
Taavoni, Simin; Ekbatani, Neda Nazem; Haghani, Hamid
Menopausal symptoms experienced by women vary widely, and while many women transition through menopause with manageable symptoms, others experience severe symptoms, which may impair their quality of life. The purpose of this study was to determine the effect of Tribulus terrestris , ginger, saffron, and Cinnamomum on menopausal symptoms. A randomised, triple-blind, controlled trial design was used for this study. The participants were 80 postmenopausal women aged 50-60 years. A demographic data form and the Menopause Rating Scale were used to collect data. The women were randomly divided into two groups, each of which received either an Aphrodit capsule or a placebo twice a day for four weeks. The two bottles looked exactly the same, so that the investigator and the participants were not aware of the contents of the bottles. Each Aphrodit capsule contained 40 mg of Tribulus terrestris , 12.27 mg of Zingiber officinale , 3 mg of Crocus sativus extract, and 11 mg of Cinnamomum zeylanicum , while the placebo capsules contained 50 mg of starch. Descriptive and inferential statistics were used to analyse the data. A statistically significant change was reported in the menopausal symptoms of the intervention group compared with the placebo group. The results of the study demonstrate that the Aphrodit capsule was effective in reducing menopausal symptoms.
Full Text Available Objective. This study was designed to determine the effects of different short-term exercise programs on menopausal symptoms, psychological health, and quality of life in postmenopausal women. Material and Methods. Forty-two women were chosen from volunteering postmenopausal women presenting to the Department of Obstetrics and Gynecology of Bayındır Hospital between March and December 2009. The women aged 45–60 years and experiencing menopause naturally were included in the study. They were randomly divided into aerobic (=18 and resistance (=18 exercise groups. The women exercised 3 days per week for 8 weeks under the supervision of a physiotherapist. Aerobic exercise training was performed through a bicycle ergometer. Before and after the training, lipid profiles were measured and menopausal symptoms, psychological health, depression, and the quality of life were assessed through questionnaires. Results. In both exercise groups, no significant changes in lipid profiles were observed. In the resistance exercise group, excluding the urogenital complaints, there were significant improvements in all subscales of Menopausal Rating Scale (MRS. In the resistance exercise group, excluding the phobic anxiety, there were significant improvements in all subscales of The Symptom Checklist. Depression levels significantly decreased in both groups. Improvements were observed in all subscales of menopause-specific quality of life questionnaire in both groups except for sexual symptoms. Conclusion. Resistance exercise and aerobic exercise were found to have a positive impact on menopausal symptoms, psychological health, depression, and quality of life.
Joshi, Sulabha; Khandwe, Rambhau; Bapat, Dinesh; Deshmukh, Ujwala
To observe the effect of yoga on menopausal symptoms using a prospective, randomized, controlled and interventional study. Main outcome measures Total Menopause Rating Scale (MRS) score and three subscale scores (somatovegetative, psychological and urogenital) were measured on day 1 and day 90 in the study group which performed yoga (asana, pranayam and meditation) under supervision for three months, and were compared with the control group that did not perform yoga. MRS has been designed to measure health-related quality of life of ageing women. It consists of 11 symptoms and three subscales. It was observed that on day 1 the scores in both the groups were comparable. On day 90, the scores in the yoga group showed a reduction in score on all the subscales, which was statistically significant. No significant difference was noted in the control group. Yoga is effective in reducing menopausal symptoms and should be considered as alternative therapy for the management of menopausal symptoms.
... does not change the risk of contracting a sexually transmitted disease . In addition, getting a good night's sleep can sometimes be difficult for menopausal women. Whether sleep is disrupted due to night sweats ...
... body practice with historical origins in ancient Indian philosophy. Various styles of yoga typically combine physical postures ... nia.nih.gov/health/publication/menopause-time-change/introduction on February 17, 2016. National Institute on Aging. ...
Many women report gaining weight as they transition through menopause. For most, the weight gain is modest and can be reduced with a conscious effort to limit energy intake and increase energy expenditure. However, many women who are already overweight and obese will gain more weight as they approach menopause. The aims of this paper are to explain the reasons for menopausal weight gain and to detail a method for achieving and sustaining a substantial weight loss. Weight gain during menopause is predominantly due to a reduction in spontaneous activity. For women who are lean, advice about controlling energy intake and increasing physical activity may be all that is required to prevent weight gain. For women who are overweight and obese rapid weight loss is best achieved with the help of a very low energy diet. This must be followed by lifelong behaviour modification with or without the help of hunger-suppressing pharmacotherapy.
Helena Meden Vrtovec
Last decade in the field of menopausal medicine is characterized by discussions aboutbenefits and risks of HRT. The experts reached consensual position statement that benefitsovercome risks of HRT when introduced in early postmenopause
Geller, Stacie E; Studee, Laura
Every year, millions of women begin the peri-menopause and may experience a number of symptoms related to this transition. Many women are reluctant to use exogenous hormone therapy for treatment of menopausal symptoms and are turning to botanical and dietary supplements (BDS) for relief. This paper reviews the literature on alternatives to plant estrogens for relief of menopausal symptoms. The MEDLINE database was searched for clinical trials of non-estrogenic plant extracts for menopausal symptoms. To be included, studies had to include peri- or postmenopausal women as subjects. All clinical trials (randomized-controlled trials, open trials, and comparison group studies) were included for this review. Black cohosh appears to be one of the most effective botanicals for relief of vasomotor symptoms, while St. John's wort can improve mood disorders related to the menopausal transition. Many other botanicals have limited evidence to demonstrate safety and efficacy for relief of symptoms related to menopause. A growing body of evidence suggests that some botanicals and dietary supplements could result in improved clinical outcomes. Health care providers should discuss these issues with their patients so they can assist them in managing these alternative therapies through an evidence-based approach.
Baker, Fiona C; Willoughby, Adrian R; Sassoon, Stephanie A; Colrain, Ian M; de Zambotti, Massimiliano
The menopausal transition is marked by increased prevalence in disturbed sleep and insomnia, present in 40-60% of women, but evidence for a physiological basis for their sleep complaints is lacking. We aimed to quantify sleep disturbance and the underlying contribution of objective hot flashes in 72 women (age range: 43-57 years) who had (38 women), compared to those who had not (34 women), developed clinical insomnia in association with the menopausal transition. Sleep quality was assessed with two weeks of sleep diaries and one laboratory polysomnographic (PSG) recording. In multiple regression models controlling for menopausal transition stage, menstrual cycle phase, depression symptoms, and presence of objective hot flashes, a diagnosis of insomnia predicted PSG-measured total sleep time (p insomnia had, on average, 43.5 min less PSG-measured sleep time (p insomnia reported more WASO (p = 0.002), more night-to-night variability in WASO (p insomnia in the approach to menopause have a measurable sleep deficit, with almost 50% of the sample having less than 6h of sleep. Compromised sleep that develops in the context of the menopausal transition should be addressed, taking into account unique aspects of menopause like hot flashes, to avoid the known negative health consequences associated with insufficient sleep and insomnia in midlife women. Copyright © 2015 Elsevier Ltd. All rights reserved.
Tokin, S; Bjelajac, P; Dobrić, V
This study deals with the occurrence of menopause in women of Novi Sad during 1996 and 1997 in ambulatory-care services for women of the Health Center Novi Sad. This retrospective study included 640 women, 42-82 years of age. The mean age at menopause is 49.05 +/- 3.51 years, and median 50.05 +/- 0.17. Menopause in women under the age of 40 has been referred to as premature and it occurred in 16 women (2.49%). In regard to a longer time interval, in 585 women (91.41%) menopause occurred between 45-55 years of age. In our previous study of menarche in Novi Sad, we found that the mean age was 13.07 +/- 1.1 whereas the average reproductive period lasted 35.98 years. In order to perform relevant comparison of data in regard to menopause, it is necessary to establish a unified methodology. Foundation of Counseling Centers for menopausal women is desirable in the aim of better understanding their numerous problems during premenopausal and postmenopausal periods.
Ziv-Gal, Ayelet; Gallicchio, Lisa; Chiang, Catheryne; Ther, Sara N; Miller, Susan R; Zacur, Howard A; Dills, Russell L; Flaws, Jodi A
During the menopausal transition, a woman's reproductive capacity declines, her hormone milieu changes, and her risk of hot flashes increases. Exposure to phthalates, which can be found in personal care products, can also result in altered reproductive function. Here, we investigated the associations between phthalate metabolite levels and midlife hot flashes. Eligible women (45-54 years of age) provided detailed information on hot flashes history and donated urine samples (n=195). Urinary phthalate metabolite levels were measured by HPLC-MS/MS. A higher total sum of phthalate metabolites commonly found in personal care products was associated with an increased risk of ever experiencing hot flashes (odds ratio (OR)=1.45; 95% confidence interval (CI)=1.07-1.96), hot flashes in the past 30days (OR=1.43; 95%CI=1.04-1.96), and more frequent hot flashes (OR=1.47; 95%CI=1.06-2.05). These data suggest that some phthalate exposures from personal care products are associated with menopausal hot flashes in women. Copyright © 2016 Elsevier Inc. All rights reserved.
Umland, Elena M; Falconieri, Laura
Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical health of women experiencing VMS, leading to their pursuance of treatment to alleviate these symptoms. Management of VMS includes lifestyle modifications, some herbal and vitamin supplements, hormonal therapies including estrogen and tibolone, and nonhormonal therapies including clonidine, gabapentin, and some of the serotonin and serotonin-norepinephrine reuptake inhibitors. The latter agents, including desvenlafaxine, have been the focus of increased research as more is discovered about the roles of serotonin and norepinephrine in the thermoregulatory control system. This review will include an overview of VMS as they relate to menopause. It will discuss the risk factors for VMS as well as the proposed pathophysiology behind their occurrence. The variety of treatment options for VMS will be discussed. Focus will be given to the role of desvenlafaxine as a treatment option for VMS management.
Results: Average age of menopause of an Indian woman is 46.2 years much less than their Western counter parts (51 years. A definite rural and urban division was also seen. There was a correlation between the age of menopause and social and economic status, married status, and parity status.
Guidozzi, Franco; Alperstein, A; Bagratee, J S; Dalmeyer, P; Davey, M; de Villiers, T J; Hirschowitz, S; Kopenhager, T; Moodley, S P; Roos, P; Shaw, A; Shimange, O; Smith, T; Thomas, C; Titus, J; van der Spuy, Z; van Waart, J
The South African Menopause Society (SAMS) consensus position statement on menopausal hormone therapy (HT) 2014 is a revision of the SAMS Council consensus statement on menopausal HT published in the SAMJ in May 2007. Information presented in the previous statement has been re-evaluated and new evidence has been incorporated. While the recommendations pertaining to HT remain similar to those in the previous statement, the 2014 revision includes a wider range of clinical benefits for HT, the inclusion of non-hormonal alternatives such as selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors for the management of vasomotor symptoms, and an appraisal of bioidentical hormones and complementary medicines used for treatment of menopausal symptoms. New preparations that are likely to be more commonly used in the future are also mentioned. The revised statement emphasises that commencing HT during the 'therapeutic window of opportunity' maximises the benefit-to-risk profile of therapy in symptomatic menopausal women.
Gambacciani, Marco; Biglia, Nicoletta; Cagnacci, Angelo; DI Carlo, Costantino; Caruso, Salvatore; Cicinelli, Ettore; DE Leo, Vincenzo; Farris, Manuela; Gambera, Alessandro; Guaschino, Secondo; Lanzone, Antonio; Paoletti, Anna M; Russo, Novella; Vicariotto, Franco; Villa, Paola; Volpe, Annibale
In the last decade the risk benefits ratio of HRT has been reevaluated mainly in tens of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausel Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society). The aim of these Recommendations is to provide a simple and updated reference on postmenopausal HRT. The term HRT typically includes estrogen replacement therapy (ERT) and estrogen- progestogen therapy (EPT). EPT can be sequential (Seq) when progestogen is added to ERT for 10-14 days a month, or continuous combined (CC) when progestogen is administered continuously every day along with a fixed amount of estrogen, In the everyday language, HRT includes also Tibolone and the Tissue Selective Estrogen Complex (TSEC).
Full Text Available Menopause is a physiological process typically occurring in the fifth decade of life. One of the most annoying oral symptoms in this age group is the burning mouth syndrome (BMS, which may be defined as an intraoral burning sensation occurring in the absence of identifiable oral lesion or laboratory findings. Pain in burning mouth syndrome may be described as burning, tender, tingling, hot, scalding, and numb sensation in the oral mucosa. Multiple oral sites may be involved, but the anterior two-third part and the tip of tongue are most commonly affected site. There is no definite etiology for BMS other than the precipitating causative factors, and it is still considered idiopathic. Various treatment options like use of benzodiazepine, anti-depressants, analgesics, capsaicin, alpha lipoic acids, and cognitive behavioral therapy are found to be effective, but definite treatment is still unknown. The present article discusses some of the recent concepts of etiopathogenesis of BMS as well as the role of pharmacotherapeutic management in this disorder.
Dahl, Michael Slavensky; Reichstein, Toke
. We also find that spin-offs from parent companies that exit are less likely to survive than either spin-offs from surviving parents or other start-ups. These findings support the theoretical arguments that organizational heritage is important for the survival of new organizations. We found no similar...... ranked members of start-ups prior to their founding, and follow the fate of these firms. More specifically, we compare the survival of spin-offs from surviving parents, spin-offs from exiting parents, and other start-ups. Moreover, we investigate whether firms managed and founded by more experienced...... teams with higher levels of industry-specific experience are more likely to survive. Distinguishing between survivors and firms that have been acquired, we find that spin-offs from a surviving parent company combined with and industry-specific experience, positively affects the likelihood of survival...
... NICHD Research Information Find a Study More Information Preeclampsia and Eclampsia About NICHD Research Information Find a ... Facebook Twitter Pinterest Email Print What are the treatments for other symptoms of menopause? Menopause is a ...
Conclusion: Findings revealed high percentage of sexual desire disorder and sexual arousal disorder in menopausal women. Therefore, we should have emphasis on counseling and education about sexual activities during the menopause period.
Martin, Kathryn Ann; Manson, Joann E
Many women experience menopausal symptoms during the menopausal transition and postmenopausal years. Hot flashes, the most common symptom, typically resolve after several years, but for 15-20% of women, they interfere with quality of life. For these women, estrogen therapy, the most effective treatment for hot flashes, should be considered. The decision to use hormone therapy involves balancing the potential benefits of hormone therapy against its potential risks. Accumulating data suggest that initiation of estrogen many years after menopause is associated with excess coronary risk, whereas initiation soon after menopause is not. Therefore, most now agree that short-term estrogen therapy, using the lowest effective estrogen dose, is a reasonable option for recently menopausal women with moderate to severe symptoms who are in good cardiovascular health. Short-term therapy is considered to be not more than 4-5 yr because symptoms diminish after several years, whereas the risk of breast cancer increases with longer duration of hormone therapy. A minority of women may need long-term therapy for severe, persistent vasomotor symptoms after stopping hormone therapy. However, these women should first undergo trials of nonhormonal options such as gabapentin, selective serotonin reuptake inhibitors, or serotonin norepinephrine reuptake inhibitors, returning to estrogen only if these alternatives are ineffective or cause significant side effects. Low-dose vaginal estrogens are highly effective for genitourinary atrophy symptoms, with minimal systemic absorption and endometrial effects.
Stewart, Donna E
To explore any feelings and symptoms surrounding menopause among Mayan women in three ethnolinguistic groups in highland Guatemala and compare these with previous reports from Mexico. This was a qualitative exploratory study of the experiences around menopause of eight middle aged women and one local key informant in each of three villages in western highland Guatemala (n=27). Individual interviews were conducted in women with irregular menses or whose menses has ceased in the last 3 years. Field notes were kept and then an analysis undertaken by the author. Twenty-four Mayan women, aged 38-55, and three Mayan key informants (all women over age 50) were interviewed. Most women reported some symptoms, including hot flashes, night sweats, changes in libido, irritability, moodiness, abdominal cramps and menstrual clots occurring at some stage during the last 3 years. Although women reported symptoms, they mostly accepted them with equanimity; and rejoiced at the cessation of their periods. Highland Guatemalan Mayan women reported symptoms that were not reported in Mayan women in Yucatan, Mexico in the years surrounding menopause. The reasons for this disparity are unclear but may reflect differences in body weight and diet. Despite these symptoms, Mayan women looked forward to menopause and their newfound freedom and status. Symptoms in women in the years around menopause must be interpreted in geographical, nutritional, biological, psychological and cultural context.
Melby, Melissa K; Lock, Margaret; Kaufert, Patricia
The purpose of the present paper is to review recent research on the relationship of culture and menopausal symptoms and propose a biocultural framework that makes use of both biological and cultural parameters in future research. Medline was searched for English-language articles published from 2000 to 2004 using the keyword 'menopause' in the journals--Menopause, Maturitas, Climacteric, Social Science and Medicine, Medical Anthropology Quarterly, Journal of Women's Health, Journal of the American Medical Association, American Journal of Epidemiology, Lancet and British Medical Journal, excluding articles concerning small clinical samples, surgical menopause or HRT. Additionally, references of retrieved articles and reviews were hand-searched. Although a large number of studies and publications exist, methodological differences limit attempts at comparison or systematic review. We outline a theoretical framework in which relevant biological and cultural variables can be operationalized and measured, making it possible for rigorous comparisons in the future. Several studies carried out in Japan, North America and Australia, using similar methodology but different culture/ethnic groups, indicate that differences in symptom reporting are real and highlight the importance of biocultural research. We suggest that both biological variation and cultural differences contribute to the menopausal transition, and that more rigorous data collection is required to elucidate how biology and culture interact in female ageing.
Kim, Min-Ju; Cho, Juhee; Ahn, Younjhin; Yim, Gyeyoon; Park, Hyun-Young
Background Physical activity may be an effective way of preventing or attenuating menopause-related symptoms, and it has been shown to improve quality of life in menopausal women. However, there have been some inconsistencies regarding between exercise and menopausal symptoms, and study investigating this association has been scarce in Korea. In this study, the association between physical activity and menopausal symptoms in perimenopausal women in Korea was assessed. Methods This cross-secti...
Age of menopause is a very important biomarker of not only the loss of fertility but also an increased risk for various mid-life diseases and problems. Many of these diseases can be prevented by timely intervention of lifestyle modification, menopausal hormone therapy, or other supplementations such as calcium, Vitamin D, and micronutrients. In India age of menopause is less than our counterparts in the Western world. This means that the fertility potential of Indian women starts compromising early, so we need to start with the preventive measures much early. Earlier studies in India have been done on a limited population, and small sample size and not all the determinants of menopause age were considered. Survey was conducted in 21 chapters of Indian Menopause Society and all regions South, West, East and North were covered. There were 23 Medical practitioners who participated. Consent was taken and inclusion and exclusion criteria was set. Set questions were asked The questionnaire comprised of identification of the participants' religion, education, and various socioeconomic parameters. They were also inquired about their marital and parity status, abortion, or contraceptive use. The menopausal women were asked their menopause age and whether it was natural or surgical. The perimenopausal women were asked to enlist the date of their last period. All women with food habits and social habits including alcohol consumption or smoking. Hence, this study was planned as a PAN India study. Average age of menopause of an Indian woman is 46.2 years much less than their Western counter parts (51 years). A definite rural and urban division was also seen. There was a correlation between the age of menopause and social and economic status, married status, and parity status.
Carturan, Paula; Scorcine, Claudio; Fragoso, Yara Dadalti
.... Only those with non-surgical menopause and no hormone replacement therapy were included. Prevalence and characterization of headaches were assessed, as well as the burden of migraine, traits of anxiety and depression, and menopausal symptomatology...
Menopause, a normal midlife transition for women remains poorly understood. This study examined the attitudes of women to menopause. A total of 300 married female teachers made up the sample for the study. Data was collected using the modified Attitude Towards Menopause (ATM) checklist. The responses of the ...
reproductive life of women. It refers to a woman's last menstrual period and a woman can be said ... changes occurring in years immediately surrounding menopause.. The quality of life of perimenopausal and .... during the years immediately before and after menopause. Earlier studies on menopausal women in Ibadan ...
A.E. Hak (Liesbeth); G.C. Curhan (Gary); F. Grodstein (Francine); H.K. Choi (Hyon)
textabstractObjective: To prospectively study the relation between menopause, postmenopausal hormone use and risk of gout, since female sex hormones have been postulated to decrease gout risk among women. Methods: In the Nurses' Health Study, the association between menopause, age at menopause,
Cohen, Susan M; Rousseau, Mary Ellen; Carey, Bonnie L
In a randomized, 2-group clinical study, acupuncture was used for the relief of menopausal hot flushes, sleep disturbances, and mood changes. The experimental acupuncture treatment consisted of specific acupuncture body points related to menopausal symptoms. The comparison acupuncture treatment consisted of a treatment designated as a general tonic specifically designed to benefit the flow of Ch'i (energy). Results from the experimental acupuncture treatment group showed a decrease in mean monthly hot flush severity for site-specific acupuncture. The comparison acupuncture treatment group had no significant change in severity from baseline over the treatment phase. Sleep disturbances in the experimental acupuncture treatment group declined over the study. Mood changes in both the experimental acupuncture treatment group and the comparison acupuncture treatment group showed a significant difference between the baseline and the third month of the study. Acupuncture using menopausal-specific sites holds promise for nonhormonal relief of hot flushes and sleep disturbances.
Westerink, M. D. N. L.; Nuver, J.; Lefrandt, J. D.; Vrieling, A. H.; Gietema, J. A.; Walenkamp, A. M. E.
Increasing numbers of long-term cancer survivors face important treatment related adverse effects. Cancer treatment induced metabolic syndrome (CTIMetS) is an especially prevalent and harmful condition. The aetiology of CTIMetS likely differs from metabolic syndrome in the general population, but
Im, Eun-Ok; Ko, Young; Chee, Eunice; Chee, Wonshik
The purpose of this study was to explore the associations of immigration transition to cardiovascular symptoms among 4 major racial/ethnic groups of 1054 midlife women in the United States. This was a secondary analysis of the data from 2 large national survey studies. The instruments included questions on background characteristics and immigration transition and the Cardiovascular Symptom Index for Midlife Women. The data were analyzed using inferential statistics including hierarchical multiple regressions. Immigrants reported fewer numbers (t = 5.268, P < .01) and lower severity scores (t = 5.493, P < .01) of cardiovascular symptoms compared with nonimmigrants. Self-reported racial/ethnic identify was a significant factor influencing cardiovascular symptoms (P < .01).
Chiu, Hsiao-Yean; Shyu, Yuh-Kae; Chang, Pi-Chen; Tsai, Pei-Shan
Evidence regarding the effects of acupuncture on hot flashes in breast cancer survivors is conflicting. Little is known about the intermediate-term effects of acupuncture on hot flashes and other menopause-related symptoms in breast cancer survivors. The objective of this study was to evaluate the short-term and intermediate-term effects of acupuncture on menopause-related symptoms and particularly on hot flashes in breast cancer survivors. Electronic databases including EMBASE, PubMed, PsycINFO, Web of Science, CINAHL, Wanfang Data Chinese Database, and China Knowledge Resource Integrated Database from inception until June 15, 2014, were searched. Randomized controlled trials in which acupuncture was compared with sham controls or other interventions according to the reduction of hot flashes or menopause-related symptoms in breast cancer survivors were included. We analyzed 7 studies involving 342 participants. Acupuncture significantly reduced the frequency of hot flashes and severity of menopause-related symptoms (g = -0.23 and -0.36, respectively) immediately after the completion of treatment. In comparison with sham acupuncture, effects of true acupuncture on the frequency and severity of hot flashes were not significantly different. At 1 to 3 months' follow-up, the severity of menopause-related symptoms remained significantly reduced (g = -0.56). Acupuncture yielded small-size effects on reducing hot-flash frequency and the severity of menopause-related symptoms. Acupuncture may be used as a complementary therapy for breast cancer survivors experiencing hot flashes and other menopause-related symptoms; however, whether acupuncture exerts specific treatment effects other than needling or placebo effects needs to be further evaluated.
Conclusions: Menopausal transition brings about anomalies in total body composition characterized by an increased body fat mass and central adiposity. This creates a compatible atmosphere for abnormal metabolism and aggravated cardio metabolic risk factors. Thus, menopausal status and associated obesity is the major predictor of metabolic aberrations over age in menopausal women.
Memon, Fouzia R; Jonker, Leon; Qazi, Roshan A
To determine knowledge levels, and attitudes and perceptions towards, menopause among highly educated Asian women in their midlife. A cross-sectional survey. Five teaching institutions in Hyderabad, Pakistan. In total, 200 out of 225 (89% response rate) teachers, lecturers and professors, aged 40-59 years, were surveyed in 2013 using a self-administered questionnaire. The mean age of responders was 48 years. Premenopausal and perimenopausal women attributed for 58%, whereas 42% were postmenopausal. All women had a masters degree; 15% had a PhD degree. Forty-six percent of responders thought they had sufficient knowledge about the menopause and 87% had positive perceptions about it, with 76% feeling life was easier and calmer as a result of it. Reported negative perceptions included 30% of women experiencing feelings of grumpiness, irritability, altered work capability and loss of femininity. Health professionals were an information resource. of 60% of cases, only 5% of participants knew about hormone replacement therapy and none knew about available alternative therapies. Despite the fact that the majority of women felt well informed and exhibited a positive attitude towards menopause, a strong urge for more knowledge was expressed. Public health care systems should mobilize resources and take measures to improve women's awareness and knowledge about menopause-related changes through a variety of educational tools and media, including the Internet. A recommendation would be for physicians to provide more information about menopausal symptoms and also therapies to alleviate these symptoms, regardless of the patient's socioeconomic background. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Hakimi, Sevil; Simbar, Masoumeh; Ramezani Tehrani, Fahimeh; Zaiery, Farid; Khatami, Shiva
This study explores the attitude and feelings toward menopause among Azeri menopausal women using hermeneutic phenomenology based on Van Manen's approach. A total of 18 menopausal women who were attended in urban health centers of Tabriz, Iran, were recruited using a purposive sampling method. Data were gathered through semistructured interviews. Each interview was transcribed verbatim and analyzed simultaneously. Data analysis led to the emergence of five main themes: positive attitude, neutral attitude, negative attitude, positive feelings, and negative feelings. Participants had different feelings and attitude. Acceptance of menopause as a natural process helps women to have a neutral attitude toward menopause.
Carrasquilla, Germán D; Berglund, Anita; Gigante, Bruna; Landgren, Britt-Marie; de Faire, Ulf; Hallqvist, Johan; Leander, Karin
This study aims to assess whether the timing of menopausal hormone therapy initiation in relation to onset of menopause and hormone therapy duration is associated with myocardial infarction risk. This study was based on the Stockholm Heart Epidemiology Program, a population-based case-control study including 347 postmenopausal women who had experienced a nonfatal myocardial infarction and 499 female control individuals matched for age and residential area. Odds ratios (with 95% CIs) for myocardial infarction were calculated using logistic regression. Early initiation of hormone therapy (within 10 y of onset of menopause or before age 60 y), compared with never use, was associated with an odds ratio of 0.87 (95% CI, 0.58-1.30) after adjustments for lifestyle factors, body mass index, and socioeconomic status. For late initiation of hormone therapy, the corresponding odds ratio was 0.97 (95% CI, 0.53-1.76). For hormone therapy duration of 5 years or more, compared with never use, the adjusted odds ratio was 0.64 (95% CI, 0.35-1.18). For hormone therapy duration of less than 5 years, the odds ratio was 0.97 (95% CI, 0.63-1.48). Neither the timing of hormone therapy initiation nor the duration of therapy is significantly associated with myocardial infarction risk.
Li, Lin; Wu, Jie; Jiang, Xiao-qing; Pu, Dan-hua; Zhao, Yang
To investigate the epidemiologic factors associated with the age of natural menopause and menopausal symptoms in a large population at age of 40 to 65 years in Jiangsu Province. From May 2010 to Oct.2011, a total of 20 275 women (40 to 65 years) attending health examination in Jiangsu Province were enrolled in this cross-sectional study. A structured questionnaire was used to collect data of demographics, menopausal status, chronic diseases, reproductive history. Also the menopausal symptoms were evaluated by Kupperman menopause index (KMI). Cox proportional hazards regression model and Logistic regression were performed to identify risk factors for earlier age of natural menopause and menopausal symptoms, respectively. The overall median age at natural menopause in Jiangsu women was 50 years.Lower educational level, poor economic status, lower body mass index (BMI), age at menarche less than 14 years, nulliparity and smoking were associated with earlier onset of natural menopause (P < 0.05). The most frequently symptoms in perimenopausal women were fatigue (46.84%, 1880/4014), insomnia (44.67%, 1793/4014) and muscle/joint pain (43.80%, 1758/4014), while sexual problems (57.06%, 3463/6070), muscle/joint pain (53.30%, 3235/6070) and insomnia (51.03%, 3097/6070) were predominant symptoms in postmenopausal women. After adjusting for confounding factors, it was revealed that women with poor educational background, low income, divorce, higher BMI, higher parity, and smoking presented positive correlation with menopausal symptoms (P < 0.05). The study suggested that an estimate of median age at natural menopause were 50 years in Jiangsu women. The main factors contributing to earlier onset of menopause and menopausal symptoms were lower educational level, poor economic status, and smoking. Moreover, there were different menopausal symptoms between perimenopausal and postmenopausal women, which provided the important insights for physicians to prevent and treat menopause
Full Text Available Fiona C Baker,1,2 Massimiliano de Zambotti,1 Ian M Colrain,1,3 Bei Bei4,5 1Center for Health Sciences, SRI International, Menlo Park, CA, USA; 2Brain Function Research Group, University of the Witwatersrand, Johannesburg, South Africa; 3Melbourne School of Psychological Sciences, University of Melbourne, 4Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 5Centre for Women’s Mental Health, Department of Psychiatry, University of Melbourne, Royal Women’s Hospital, Melbourne, VIC, Australia Abstract: A substantial number of women experience sleep difficulties in the approach to menopause and beyond, with 26% experiencing severe symptoms that impact daytime functioning, qualifying them for a diagnosis of insomnia. Here, we review both self-report and polysomnographic evidence for sleep difficulties in the context of the menopausal transition, considering severity of sleep complaints and links between hot flashes (HFs and depression with poor sleep. Longitudinal population-based studies show that sleep difficulties are uniquely linked with menopausal stage and changes in follicle-stimulating hormone and estradiol, over and above the effects of age. A major contributor to sleep complaints in the context of the menopausal transition is HFs, and many, although not all, HFs are linked with polysomnographic-defined awakenings, with HF-associated wake time contributing significantly to overall wakefulness after sleep onset. Some sleep complaints may be comorbid with depressive disorders or attributed to sleep-related breathing or movement disorders, which increase in prevalence especially after menopause, and for some women, menopause, age, and environmental/behavioral factors may interact to disrupt sleep. Considering the unique and multifactorial basis for sleep difficulties in women transitioning menopause, we describe clinical assessment
Genazzani, Andrea R; Komm, Barry S; Pickar, James H
The majority of women experience bothersome symptoms postmenopause (e.g., hot flushes, vaginal symptoms). Estrogen receptor agonists remain the most effective options for ameliorating menopausal symptoms. However, use of hormonal therapies has declined in the wake of issues raised by the Women's Health Initiative trials. As a result, there is a need for new safe and effective alternatives to estrogen-progestogen hormone therapy. We review the efficacy and safety profile of hormonal menopausal therapies that are in Phase III clinical trials or recently approved. Investigational treatments discussed include two new vaginal estrogen products (TX-004HR, WC-3011); the first combination of estradiol and progesterone, and a novel combination of dehydroepiandrosterone and acolbifene. We also review a new selective estrogen receptor modulator (SERM), ospemifene, recently approved for treatment of dyspareunia related to menopause, and conjugated estrogens plus bazedoxifene, an estrogens/SERM combination, recently approved for moderate-to-severe vasomotor symptoms and prevention of osteoporosis. New and emerging hormonal treatments for managing menopausal symptoms may have improved safety and efficacy profiles compared with traditional estrogen-progestogen therapy; however, long-term safety data will be needed.
who attended Gynecology out patient department (OPD) for treatment of menopausal complaints were assessed using the. MRS questionnaire before starting therapy. ... which in turn is caused by aging of the ovaries.[4‑6]. Studies have shown that the frequency ... and occupational background. Section B dealt with detailed.
Collaborative Group on Hormonal Factors in Breast Cancer; Bausch-Goldbohm, R.A.
BACKGROUND:Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected
Cisplatin is one of the most effective chemotherapeutic agents used in the treatment of cancer cells including testicular cancer. Human Menopausal Gonadotropin (HMG) is a natural hormone necessary for human reproduction. This hormone is a leading modality of treatment for infertility as it contains equal amount of ...
Pearson, Quinn M.
The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling…
Full Text Available Premises: Sexual hormones may affect the general health condition of women, as early as puberty, continuing during pregnancy and also after menopause. Variations of the hormonal levels may cause different – either local or general – pathological modifications. Sexual hormones may also affect periodontal status, favourizing gingival inflammations and reducing periodontal resistance to the action of the bacterial plaque. Scope: Establishment of the correlations between the debut or the manifestation of menopause and the modifications produced in the superficial periodontium. Materials and method: Clinical and paraclinical investigations were performed on female patients with ages between 45 and 66 years, involving macroscopic, microscopic and radiological recording of the aspect of the superificial periodontium (gingiva. Results: Analysis of the histological sections evidenced atrophic and involutive modifications in the marginal superficial periodontium of female patients at menopause. Conclusions: Sexual hormones intervene in the histological equilibrium of the marginal superficial periodontium, influencing the periodontal health status, which explains the correlation between the subjective symptomatology specific to menopause and the histopatological aspect at epithelial level.
Perich, Tania; Ussher, Jane; Parton, Chloe
Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Themes identified included 'Constructions of mood change: menopause or bipolar disorder?',' Life events, bipolar disorder and menopause coming together'; 'Treatment choices for mood change during menopause'. The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices.
Baumelou, Alain; Liu, Bingkai; Wang, Xiao-Yun; Nie, Guang-Ning
Seventy percentage of perimenopausal and early postmenopausal women will experience menopause symptoms. Primary menopause symptoms in Western countries included hot flashes, insomnia, somatic pain, depression, and fatigue. Hot flashes were most commonly treated. Menopausal hormone replacement therapy (HRT) continues to have a clinical role in the management of vasomotor symptoms, but since 2002 there has been a marked global decline in its use due to concerns about the risks and benefits of HRT; consequently many women with menopause symptoms are now seeking alternatives including acupuncture. Acupuncture has a long tradition of use for the treatment of different menopause symptoms. Its effectiveness has been studied for natural menopause or chemical and surgery induced menopause. Here we provide an update on recent advances in the field for clinicians. The recent systematic reviews on acupuncture in menopausal symptoms suggest that acupuncture is an effective and valuable option for women suffering from menopause. However, the science of acupuncture therapies is still inadequate to sufficiently support the benefits of acupuncture therapies. Finally, we discuss our points of view on clinical trials of acupuncture for menopause symptoms.
Carson, James W; Carson, Kimberly M; Porter, Laura S; Keefe, Francis J; Seewaldt, Victoria L
Breast cancer survivors have limited options for the treatment of hot flashes and related symptoms. Further, therapies widely used to prevent recurrence in survivors, such as tamoxifen, tend to induce or exacerbate menopausal symptoms. The aim of this preliminary, randomized controlled trial was to evaluate the effects of a yoga intervention on menopausal symptoms in a sample of survivors of early-stage breast cancer (stages IA-IIB). Thirty-seven disease-free women experiencing hot flashes were randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. The primary outcome was daily reports of hot flashes collected at baseline, posttreatment, and 3 months after treatment via an interactive telephone system. Data were analyzed by intention to treat. At posttreatment, women who received the yoga program showed significantly greater improvements relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor. At 3 months follow-up, patients maintained their treatment gains in hot flashes, joint pain, fatigue, symptom-related bother, and vigor and showed additional significant gains in negative mood, relaxation, and acceptance. This pilot study provides promising support for the beneficial effects of a comprehensive yoga program for hot flashes and other menopausal symptoms in early-stage breast cancer survivors.
Full Text Available Objective: To determine the prevalence of sexual problems in Iranian women and association of sexual dysfunction with menopausal symptoms.Materials and methods: In this cross-sectional study, 151 married women with the age of 40-60 yearsold who were referred for treatmentto Department of Gynecology in Vali-e-Asr Hospital (Tehran, Iran from April to July 2012, were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI questionnaire.Menopause rating scale (MRS was developed for the diagnosis and quantification of climacteric symptoms.Results: Total frequency of sexual dysfunction was 53% with the domains of lubrication, arusal and desire being commonly affected 62%, 70% and 98.5% of cases respectively. There is a relationship between severity of somatic and urogenital symptoms with sexual dysfunction (p = 0.03, p = 0.00 respectively.Conclusion: A considerable percentage of women experienced sexual dysfunctions in this period. Somatic and urogenital symptoms during the menopausal period could be a factor to maintain or intensity of sexual dysfunctions.
Cedars, Marcelle I
In this Views and Reviews section, the authors present the most updated information on menopausal hormone therapy (MHT) and an individualized treatment approach. Care of women through the menopausal transition and post-menopausally requires physicians to integrate multi-organ implications of MHT and understand the full-range of treatment alternatives. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
increased bone turnover and net bone loss. Fortunately, only 25-30% of post-menopausal women will develop vertebral fractures – the hallmark of post...At the onset of menopause, lack of estrogen and other sex steroids results in increased bone turnover and net bone loss. However, only 25-30% of...women develop post-menopausal osteoporosis? Page | 8 Liver Histology Method: Sections of the livers were removed and fixed in 10% neutral
Pirotta, Marie; Ee, Carolyn; Teede, Helena; Chondros, Patty; French, Simon; Myers, Stephen; Xue, Charlie
Hot flushes and night sweats (vasomotor symptoms) are common menopausal symptoms, often causing distress, sleep deprivation and reduced quality of life. Although hormone replacement therapy is an effective treatment, there are concerns about serious adverse events. Non-hormonal pharmacological therapies are less effective and can also cause adverse effects. Complementary therapies, including acupuncture, are commonly used for menopausal vasomotor symptoms. While the evidence for the effectiveness of acupuncture in treating vasomotor symptoms is inconclusive, acupuncture has a low risk of adverse effects, and two small studies suggest it may be more effective than non-insertive sham acupuncture. Our objective is to assess the efficacy of needle acupuncture in improving hot flush severity and frequency in menopausal women. Our current study design is informed by methods tested in a pilot study. This is a stratified, parallel, randomised sham-controlled trial with equal allocation of participants to two trial groups. We are recruiting 360 menopausal women experiencing a minimum average of seven moderate hot flushes a day over a seven-day period and who meet diagnostic criteria for the Traditional Chinese Medicine diagnosis of Kidney Yin deficiency. Exclusion criteria include breast cancer, surgical menopause, and current hormone replacement therapy use. Eligible women are randomised to receive either true needle acupuncture or sham acupuncture with non-insertive (blunt) needles for ten treatments over eight weeks. Participants are blinded to treatment allocation. Interventions are provided by Chinese medicine acupuncturists who have received specific training on trial procedures. The primary outcome measure is hot flush score, assessed using the validated Hot Flush Diary. Secondary outcome measures include health-related quality of life, anxiety and depression symptoms, credibility of the sham treatment, expectancy and beliefs about acupuncture, and adverse events
Borud, Einar; White, Adrian
Acupuncture is one of the complementary therapies that are increasingly used by women with menopausal hot flushes. Acupuncture can be understood as a form of neurological stimulation. Clinical trials of acupuncture use different control groups according to whether they wish to provide practical information on the role of acupuncture in health care, or theoretical information on the specific needle effect. Controls for the latter research question are highly problematic, and no convincingly inert 'placebo' needle has yet been designed. For natural menopause, one large study has shown acupuncture to be superior to self-care alone in reducing the number of hot flushes and improving the quality of life; five small studies have been unable to demonstrate that the effect of acupuncture is limited to any particular points, as traditional theory would suggest; and one study showed acupuncture was superior to blunt needle for flash frequency but not intensity. For flushes associated with induced menopause, clearly acupuncture is useful for reducing flushes in clinical practice, but there is mixed evidence on the nature of the effect: one trial found genuine acupuncture superior to control needling, but another showed no significant difference between acupuncture and blunt needle. The possible mechanisms of acupuncture for hot flushes are discussed. Current evidence clearly justifies further research into the most cost effective form of acupuncture for treating hot flushes. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background: Sleep is necessary in life and approximately 1/3 of human life is devoted to sleep. One of the most common problems in menopausal women is sleep disturbance. The aim of this study was to determine frequency of sleep disorders and its related factors in 50 – 60 years old women Methods: A cross-sectional, descriptive study was conducted on 200 eligible women who referred to selected health centers of Tehran University of Medical Sciences (TUMS. Demographic form, ten-point slide to review sexual satisfaction and Pittsburg Sleep Quality Index Questioner (PSQI were used for data collection. Data was analyzed using ANOVA, t-test, and Pearson correlation tests.Results: The mean age of women was 53.6±3.6 year, menopause age 47.8±4, number of children 4.76±2 and partner age was 57.99±6.6. 34.5% of women were satisfied from their sexual relationship and their score was 8-10. Rate of sleep disturbances in this group was about 70%. The results showed that between four variables: economical status, occupation, partner occupation and educational status were significantly associated with sleep disturbance (P=0.002. There was not significant difference between other demographic information and sleep disturbance.Conclusion: The results show high prevalence of sleep disturbance symptoms among menopausal women. According to the relationship between some personal characters and sleep disturbance, health care providers need to consider these variables.
Samir Ben Ali
Full Text Available Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS in Tunisian women. Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition. Results. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6% than in premenopausal women. A binary logistic regression analysis showed that menopause was independently associated with MetS (OR = 1.41, 95% CI 1.10–1.82 after adjusting for age, residence area, marital status, family history of cardiovascular disease, education level, and occupation. Conclusions. The present study provides evidence that the MetS is highly prevalent in this group of women. Menopause can be a predictor of MetS independent of age in Tunisian women.
Ben Ali, Samir; Belfki-Benali, Hanen; Aounallah-Skhiri, Hajer; Traissac, Pierre; Maire, Bernard; Delpeuch, Francis; Achour, Noureddine; Ben Romdhane, Habiba
This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS) in Tunisian women. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6%) than in premenopausal women. A binary logistic regression analysis showed that menopause was independently associated with MetS (OR = 1.41, 95% CI 1.10-1.82) after adjusting for age, residence area, marital status, family history of cardiovascular disease, education level, and occupation. The present study provides evidence that the MetS is highly prevalent in this group of women. Menopause can be a predictor of MetS independent of age in Tunisian women.
Yazdkhasti, Mansoureh; Simbar, Masoumeh; Abdi, Fatemeh
Menopause is described as a period of psychological difficulties that changes the lifestyle of women in multiple ways. Menopausal women require more information about their physical and psychosocial needs. Empowerment during the menopause can contribute to improving the perception of this stage and the importance of self-care. It is essential to increase women's awareness and adaptation to menopause, using empowerment programs. The aim of this study was to review the empowerment and coping strategies in menopause women. In this review, PubMed, EMBASE, ISI, and Iranian databases were scanned for relevant literature. A comprehensive search was performed, using the combinations of the keywords "empowerment, menopause, coping with" to review relevant literature and higher education journals. Most interventions for menopause women have focused on educational intervention, physical activity/exercise, healthy diet, stress management, healthy behaviors, preventing certain diseases and osteoporosis. Health education intervention strategy is one of the alternative strategies for improving women's attitudes and coping with menopause symptoms, identified as severalof the subcategories of health promotion programs. Empowerment of menopausal women will guarantee their health during the last third of their life. It will also help them benefit from their final years of reproductive life. The results of the present study can pave the way for future research about women's health promotion and empowerment.
Teede, H J; Lombard, C; Deeks, A A
The prevalence of obesity is rising dramatically, impacting adversely on health and well-being at the menopause and across the lifespan. With menopause, abdominal adiposity selectively increases. The impact of obesity and abdominal adiposity on chronic disease, including diabetes and cardiovascular disease, is significant and quality of life is adversely affected. Yet accurate perception of the weight-related health-risk profile is lacking and there is inadequate focus on prevention and treatment of obesity and its complications. Research aimed at prevention and management of obesity at menopause is limited. Accurate risk perception, education and translation programs highlighting obesity risks and supporting sustainable lifestyle changes are needed, particularly around menopause.
Barazzetti, Lidiane; Pattussi, Marcos Pascoal; Garcez, Anderson da Silva; Mendes, Karina Giane; Theodoro, Heloísa; Paniz, Vera Maria Vieira; Olinto, Maria Teresa Anselmo
This study investigated the association between minor psychiatric disorders and menopause symptoms and their associated factors. A cross-sectional study was conducted with 615 women aged 40 to 65 years treated in a public menopause and gynecological outpatient clinic in the South Region of Brazil. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20) and menopause symptoms using the Menopause Rating Scale. Score for menopause symptoms was categorized into three levels of symptoms: mild, moderate, and severe. Multivariate analyses used ordinal logistic regression. The prevalence of mild, moderate, and severe menopause symptoms was 34.1% (95% CI 30.3-37.9), 29.6% (95% CI 25.8-33.1), and 36.3% (95% CI 32.4-40.0), respectively. The overall prevalence of minor psychiatric disorders was 66.6% (95% CI 62.8-70.3). After adjustment, the odds ratio (OR) of the occurrence of menopause symptoms were approximately eight times higher in women relating minor psychiatric disorders compared with those without such disorders (OR = 7.76; 95% CI 5.27-11.44). The following factors were also associated with the menopause symptoms: women older than 50 years, living with a partner, lower educational level, smokers, larger number of pregnancies, obese, and those using psychotropic and/or postmenopause medication. The minor psychiatric disorders exhibited strong association with the presence of menopause symptoms independently of sociodemographic, behavioral, and reproductive factors, and of use of psychotropic medication.
Full Text Available The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman’s life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient’s needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska. For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.
Dørmænen, Annbjørg; Heimdal, Marte Rye
The aim of this study was to compare the effectiveness of individualized acupuncture and self-care versus self-care only on hot flashes, health related quality of life (HR-QoL) and depression in postmenopausal women, experiencing a high frequency of hot flashes. The study also aimed to shed light on the question about an association between menopause and depression. It was conducted on a subsample from the Acuflash-study (Borud et al., in press) and involved a pragmatic, randomized, controlle...
Remport, Júlia; Blázovics, Anna
In previous centuries many women did not even live until their menopause years due to poor economic conditions, deficiencies of medicine, epidemics and wars. Nowadays in the developed countries, people live until they are 75-80 years old, and with the expansion of average age, the number of people affected by menopause and the years spent in that state increase. Nowadays women spend one third of their lives in the menopausal stage. The only effective way to treat unpleasant symptoms for centuries was with the use of herbs, and the knowledge about them spread through oral tradition. In the 20th century, this therapeutic form was pushed into the background by the development of synthetic drug production and the introduction of hormone replacement therapy. Thanks to the influence of media in the 20th century, women began to have the social need for preserving their beauty and youth for as long as they could. Hormone replacement therapy enjoyed great popularity because women were temporarily relieved of their life quality-impairing menopausal symptoms, but years later it turned out that hormone replacement therapy could pose serious risks. A distinct advantage of herbal therapy is the more advantageous side-effect-profile opposite the used synthetics in hormone replacement therapy. Women are therefore happy to turn to valuable and well-tried natural therapies, which have been used for thousands of years. There is growing interest in herbal remedies. Studying the effects of phytoestrogens has now become an active area for research. However, the results of studies in animals and humans are controversial, some sources suggest that phytoestrogens are effective and safe, other authors claim that they are ineffective in menopause or they have particularly dangerous properties, and cannot be recommended to everyone. It is important to address this issue for the sake of health, mental health and safety of women, and so it is necessary to assess the benefits and the risks
T. Jayadeepa; Dr. P. Muthulakshmi; P. Padmavathi
Menopause is one of the women’s most important life stages. Objectives: to assess the effectiveness of STP and Yoga therapy on menopausal symptoms among menopausal women. Design: A Quasi experimental research where pre and post test with control group design. Sample: Menopausal women with menopausal symptoms in Namakkal (Dt). Sampling Technique: Snowball sampling technique was used to select the sample. Data collection: A Structured interview questionnaire used to assess the knowledge on...
Dørmænen, Annbjørg; Heimdal, Marte Rye; Wang, Catharina Elisabeth Arfwedson; Grimsgaard, Anne Sameline
The current study was conducted on a subsample of postmenopausal women with a high frequency of hot flashes who participated in the Norwegian Acupuncture on Hot Flushes Among Menopausal Women study. The purpose of this study was to examine the prevalence of depressive symptoms, as measured by the Beck Depression Inventory; the effect of acupuncture therapy for menopausal hot flashes on depressive symptoms; and the associations between depressive symptoms and hot flashes, sleep disturbances, and self-reported health. The Acupuncture on Hot Flushes Among Menopausal Women study was a multicenter, pragmatic, randomized controlled trial. The present subsample consisted of 72 women who were randomized to two groups: self-care only and acupuncture in addition to self-care for a period of 12 weeks. The prevalence of depressive symptoms was 30.6% at baseline, decreased similarly in both study groups during the study period, and was 14.1% at the end of the intervention. Depressive symptoms were significantly associated with sleep disturbances and self-reported health, but not with frequency of hot flashes. Postmenopausal women experiencing a high frequency of hot flashes reported a high prevalence of depressive symptoms compared with the general female population. Study results lend support to previous findings of an increased risk for depression during menopause, at least in women with severe hot flashes. Results further indicate that symptoms of depression in postmenopausal women may be alleviated with limited resources.
Li, Sixuan; Ho, Suzanne C; Sham, Aprille
This cross-sectional study aimed to explore the relationship between menopause status and attitude toward menopause, and also its relationship with quality of life (QoL) of Chinese midlife women in Hong Kong. Hong Kong Chinese women aged 40 to 59 years were recruited through computer-generated random telephone dialing. Information was obtained through telephone interviews based on a structured questionnaire. Women were classified into 3 groups: premenopausal, perimenopausal, and postmenopausal. Menopause Belief Scale and Utian Quality of Life Scale (QoL) were used to measure respondents' attitude toward menopause and their QoL. Information on social, health, and lifestyle factors was also collected. The mean age of the participants was 49.4 ± 5.2 years. Respondents generally had a positive attitude toward menopause. Compared with premenopausal women, postmenopausal women were noted to have significantly higher attitude score toward menopause. No significant differences in QoL score were noted among women of the 3 menopause statuses. Stepwise regression analysis showed that women with more positive attitude toward menopause tended to have higher QoL score. Furthermore, better self-reported health status, doing physical activities, higher education level, being married, and non-smoking status were associated with better QoL. Postmenopausal women tended to have more positive attitude toward menopause. Although menopause status did not seem to be associated with QoL, attitude toward menopause, self-reported health status, as well as social and lifestyle factors were associated with QoL in Chinese midlife women.
... Evidence Base The evidence base on efficacy of acupuncture for menopause consists of many randomized controlled trials and several ... for hot flashes related to natural or induced menopause. The studies that the ... to acupuncture studies performed using needles stimulated by hand or ...
Daley, A J; Stokes-Lampard, H J; Macarthur, C
Many women are reluctant to consider HRT as a therapeutic option for menopausal symptoms and are keen to use non-pharmacological treatments. Evidence from randomised controlled trials (RCTs) concerning the effects of aerobic exercise on vasomotor and other menopausal symptoms is limited but what evidence we do have suggests that aerobic exercise can improve psychological health and quality of life in vasomotor symptomatic women. In addition, several RCTs of middle-aged/menopausal-aged women have found that aerobic exercise can invoke significant improvements in several common menopause-related symptoms (e.g. mood, health-related QoL and insomnia), relative to non-exercise comparison groups. There is some evidence that alternative forms of low intensity exercise such as yoga are beneficial in reducing vasomotor symptoms and improving psychological well-being in menopausal women. Collectively, these RCTs highlight the broader potential that exercise could have for women during the menopause transition. Whilst both the Royal College of Obstetricians and Gynaecologists in the UK and the North American Menopause Society have recommended that women be advised to consider aerobic exercise as a treatment for vasomotor menopausal symptoms, to make any evidence-based conclusions regarding the effectiveness of exercise in managing these symptoms, more high quality research is needed.
Results: 37.4% of women were determined to use alternative methods to reduce their menopausal symptoms. In the consequence of statistical analysis, a significant relation was found between the menopausal complaints such as hot flashes, night sweats and sleeping problem and the use of alternative methods in order to ...
Griffiths, Amanda; Ceausu, Iuliana; Depypere, Herman; Lambrinoudaki, Irene; Mueck, Alfred; Pérez-López, Faustino R; van der Schouw, Yvonne T; Senturk, Levent M; Simoncini, Tommaso; Stevenson, John C; Stute, Petra; Rees, Margaret
Women form a large part of many workforces throughout Europe. Many will be working throughout their menopausal years. Whilst the menopause may cause no significant problems for some, for others it is known to present considerable difficulties in both their personal and working lives. During the
Background: The association between depression, anxiety, and stress among Arab menopause and postmenopausal women have been explored in detailed. Aim: The objective of this study was to determine the correlation between depression, anxiety, and stress in menopausal and postmenopausal women and shedding ...
Overlie, Inger; Mørkrid, Lars; Andersson, Anna-Maria
A more direct and precise hormonal marker of the menopause has been required for some time. The aim of this study was to identify the most accurate marker of the menopause, based on analyses of inhibin A and B, FSH, LH and estradiol (E(2)), among 59 healthy women without hormonal treatment during...
Freedom from monthly bleeding (50.7%) was the most commonly reported advantage of menopause. Only thirty nine (7.3%) were aware of hormone replacement therapy (HRT) and none were on /ever had HRT. Conclusion: Although menopause is well-tolerated by women in our environment, it needs further investigation.
Conclusion: The majority of Chinese rural midlife women do not experience depression. The relationship between depression, VMS and sleep disturbances tends to change with menopausal status in Chinese rural midlife women. Keywords: depression, poor sleep, vasomotor symptoms, menopause, rural women ...
Data from the FGD were recorded on audio-tapes, transcribed and subjected to content analysis. Descriptive and Chi-square test statistics ... effects associated with menopause. There are gaps in knowledge, wrong perceptions and use of inappropriate palliative measures regarding menopause among the participants.
Menopause evolved in humans and whales, presumably because older females can help their kin. But how do they help? New research shows that post-menopausal female killer whales lead foraging groups. This leadership is most significant when food is scarce. Copyright © 2015 Elsevier Ltd. All rights reserved.
According to a January 28, 2011 article in the Journal of the National Cancer Institute, women who start taking menopausal hormone therapy around the time of menopause have a higher risk of breast cancer than women who begin taking hormones a few years later.
Background: As life expectancy increases,most women spent a larger part of their lives in the post-menopausal state,with part of this during the peak of their career for working class women. Perception, attitude and experience of the menopause and its transitional period may differ from one female population to the other.
Pinkerton, JoAnn V; Stovall, Dale W; Kightlinger, Rebecca S
Vasomotor symptoms and vaginal atrophy are both common menopausal symptoms. Hormone therapy is currently the only FDA-approved treatment for hot flashes. Current recommendations are to use the lowest dose of hormone therapy for the shortest period that will allow treatment goals to be met. Although the reanalysis of the WHI in 2007 by Roussow et al. provided evidence of coronary heart safety for users of hormone therapy under the age of 60 years and within 10 years of the onset of menopause, not all women desire or are candidates for hormone therapy. In this review we present an evidence-based discussion considering the effectiveness of hormonal and nonhormonal therapies for the relief of vasomotor symptoms and vaginal atrophy. Concern exists regarding systemic absorption of vaginal estrogen and possible adverse effects on the breast and uterus. Selective estrogen receptor modulators and estrogen agonists offer benefits through targeted estrogen agonist/antagonistic effects and are being evaluated with and without estrogen for symptomatic menopausal women. Centrally acting nonhormonal therapies that are effective for the relief of vasomotor symptoms include various antidepressants, gabapentin and clonidine. A limited number of clinical trials have been conducted with nonprescription remedies, including paced respiration, yoga, acupuncture, exercise, homeopathy and magnet therapy, and some, but not all of these, have been found to be more effective than placebo. Dietary herbal supplements, such as soy and black cohosh, have demonstrated mixed and inconclusive results in placebo-controlled trials. Potential therapies for vasomotor symptoms and vaginal atrophy require randomized, placebo-controlled trials of sufficient duration to establish efficacy and safety. Agents under investigation for vasomotor symptoms relief include neuroactive agents, such as gabapentin and desvenlafaxine; an estrogen receptor-beta-targeted herbal therapy, MF-101; and the selective estrogen
Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert
INTRODUCTION: Around 75% of menopausal women experience hot flushes (HF) and 10-20% of all postmenopausal women find this very distressing. The aim of this study is to evaluate the efficacy of acupuncture on moderate-to-severe menopausal symptoms in general and HF in particular. METHODS: An un...... acupuncturists will be medical doctors educated in acupuncture. The primary outcome is change in HF from baseline to week 6 measured by the HF scale from the MenoScores Questionnaire (MSQ). Secondary outcomes are change in other menopausal symptoms, in particular day and night sweats and menopausal......: In the ACOM study, we explore the potential benefits of acupuncture on moderate-to-severe meno-pausal symptoms. The cross-over design offers the possi-bility of examining the legacy effect of acupuncture. FUNDING: The Idella Foundation, the University of Copenhagen and the Research Foundation of General...
Rodrigo Ramirez Campillo
Full Text Available Obesity-related complications may be compounded by the detrimental consequences of menopause. Strength training programs may have an impact on this relationship. Our objective was to examine strength (1RM and kinanthropometric alterations for overweight/obese pre- and menopausal women who participated in a strength program. Methods: 35 women were separated into: overweight premenopausal (n=8,obese premenopausal (n=9, overweight menopausal (n=8 and obese menopausal (n=10categories. Participants attended a strength program for 8 weeks. Kinanthropometric characteristics and 1RM were determined at baseline, week 4 (except 1RM and week 8. Results: All groups reduced (p< 0.05 body weight, body mass index (BMI, skinfolds and waist circumference. Furthermore, all groups achieved an increase (p< 0.05 in 1RM. When grouped per menopausal state or BMI, a more significant increase in strength was seen in menopausal and obese subjects. A significant correlation was observed for menopausal state, BMI and strength. The strength changes were significantly superior vs. kinanthropometric changes. Within kinanthropometric changes, skinfolds exhibit amore significant reduction vs. body weight, BMI and waist circumference. Conclusions: all groups showed changes in strength and kinanthropometric parameters. Strength adaptations were superior in menopausal and obese women. The strength adaptations exhibit a superior magnitude vs. kinanthropometric changes. In short term, a strength program may lead.
Park, Mi Kyong; Satoh, Noriaki; Kumashiro, Masaharu
The aim of this study is to examine the relationship between mental workload and occurrence of hot flashes. Twelve women with moderate to severe menopausal hot flashes participated in the study. Subjects participated in both a mental arithmetic task (Task) and control (Non-task) experiments. We measured heart rate, heart rate variability, blood pressure, near infrared spectroscopy, skin temperature, and skin potential level. The incidence of hot flashes was greater in Task than in Non-task. No significant differences between before, during and after hot flashes emerged for the percentage of correct responses and reaction time. However, the percentage of correct responses for two subjects among the ten who experienced hot flashes in Task substantially declined during hot flashes. Chest skin temperatures increased in both Task and Non-task during hot flashes, and regional oxygen saturation was significantly higher in Non-task than in Task. The present study suggested that mental workload under time pressure might be a risk factor for menopausal hot flashes, and the performance of most people who experienced hot flashes was not affected by hot flashes, however, work-related difficulties due to cognitive disturbance during hot flashes might arise in some people.
Full Text Available The aim of this study was to determine the properties of women in pre or post menopausal period and their conception of calcium source foods. We interviewed randomly selected, aged over 40 years, 390 women with high school or higher education level in Diyarbakir. Body mass indexes (BMI of the women were also calculated by measuring height and weight. 28,72% of the study population were postmenopausal. Of the postmenopausal women, 18,75 % had experienced a surgical or medical intervention causing menopause. Average menopausal age was 45,63±4,60 for natural menopause. According to BMI 37,44% of the women was with over weight and 8,21% of them was with obesity. Prevalence of overweight was higher in post menopausal women than others (16,10% - 5,00% (p: 000. Only 24,62 % of the women attended to a physician for medical counseling. 14,61% of them were using calcium supplementary drugs and 6,41% of them were using estrogen regularly. Although most of the women (82,31% had information bout increasing calcium requirement during postmenopausal period but 35,13% of them were consuming calcium source foods sufficiently. This result showed that knowledge on good nutrition was not reflected to their nutritional habits, and health education programmes should be conducted on this manner.
Aso, Takeshi; Uchiyama, Shigeto; Matsumura, Yasuhiro; Taguchi, Makoto; Nozaki, Masahiro; Takamatsu, Kiyoshi; Ishizuka, Bunpei; Kubota, Toshiro; Mizunuma, Hideki; Ohta, Hiroaki
The objective of this clinical trial was to examine the efficacy of a supplement containing natural S-(-)equol, a daidzein metabolite, in reducing menopausal symptoms. In this multicenter, double-blind placebo-controlled trial, 160 equol nonproducing, postmenopausal Japanese women who experienced at least 1 hot flush/day were randomly assigned to consume 10 mg/day S-(-)equol (n=77 women) or placebo (n=83 women) for 12 weeks. Participants completed a standardized menopausal symptom checklist and rated five common menopause symptoms by a visual analog scale at baseline, week 12, and week 18 (6-week postintervention). Physical, blood, and urine examinations were conducted. One hundred twenty-six women completed the study. At baseline, daily hot flush frequency was 2.9±2.1 for the S-(-)equol group and 3.2±2.4 for the placebo group. After the 12-week intervention, the S-(-)equol group had a greater decrease from baseline in hot flush frequency compared with the placebo group (-1.9±1.8/day, -58.7%, vs. -1.0±2.0/day, -34.5%, p=0.009). The severity of hot flushes and neck or shoulder muscle stiffness significantly decreased in the S-(-)equol group compared with the placebo group. No changes in clinical parameters or serious adverse effects were reported. This is the first trial to show beneficial effects of a 10-mg natural S-(-)equol supplement consumed daily for 12 weeks on major menopausal symptoms, specifically, hot flushes and neck or shoulder muscle stiffness, in postmenopausal Japanese women. This supplement offers a promising alternative for management of menopausal symptoms.
Da Fonseca, Angela Maggio; Bagnoli, Vicente Renato; Souza, Marilene Alícia; Azevedo, Raymundo Soares; Couto, Euro De Barros; Soares, José Maria; Baracat, Edmund Chada
To assess the relationship of onset of menopause and body mass on the menopausal symptoms in post-menopausal Brazilian women. Observational study conducted by the selection and inclusion of 5968 Brazilian women after menopause. The following variables were analyzed in this study: time at menopause; the relationship between age at menarche and age at menopause; vasomotor symptoms compared with age at the time of menopause and the time of menopause; Kupperman menopausal index (KMI) versus total time of menopause; body mass index (BMI) compared to the time of menopause, vasomotor symptoms, and KMI total score. We used the Chi-square test, and the significance level was set at 5%. The age at natural menopause ranged from 41 to 62 years (mean 48.1 ± 4.07 years). A younger age at menopause was associated with a high intensity of vasomotor symptoms. These symptoms were more intense in the first 5 years of menopause and decreased with time. The KMI total also decreased with time after menopause, with the exception of arthralgia, myalgia, and insomnia, which did not tend to improve over time. In addition, the vasomotor symptoms and total KMI were more frequent with increasing BMI. Our results suggested that the age of menopause and BMI may influence the intensity of vasomotor symptoms.
Michaelson-Cohen, Rachel; Beller, Uziel
As the length of survival in patients with gynecological malignancies increases due to advances in early diagnosis and therapy, quality of life becomes a major issue for the survivors. These women frequently suffer symptoms following an iatrogenically induced menopause. Many gynecologists advise these patients against hormonal replacement therapy. This review attempts to provide the clinician with information based on current evidence. The most recent two prospective studies did not find an increase in the recurrence rates in endometrial cancer patients who used hormonal replacement therapy. To date, there are few studies on hormonal replacement therapy in patients with ovarian cancer but the available data suggest that there is no detriment to overall or disease-free survival. There are no data showing an association between poorer outcome and hormonal replacement therapy use in patients with cervical or vulvar cancers. There is no evidence showing hormones negatively influence survival after treatment for epithelial ovarian, squamous cervical or vulvar cancer. Their use can be considered in symptomatic patients with endometrial cancer, after weighing the benefits against the risk of recurrence. Gynecologic cancer survivors suffering from menopausal symptoms should be supported by advice about the alternatives to hormonal replacement therapy and by giving them nonbiased information on the present knowledge on the effects of hormonal use in women with a previous cancer. It is reasonable to prescribe hormonal replacement therapy to symptomatic, well informed patients.
Soffa, V M
This paper examines the controversy over estrogen therapies and shows how lifestyle interventions can be offered as a safe way to promote prevention and good health, without the risks and long-term side effects associated with hormone replacement drugs. Some researchers show that estrogen therapy may decrease osteoporosis and heart disease. Preventing these diseases has become the primary justification for recommending hormones to most menopausal women, whether the loss of estrogen is induced by surgical removal of the ovaries, hysterectomy, ovary radiation, chemotherapy, or is a result of the natural aging process. Prevention is the foremost reason that many clinicians tell their patients that the benefits outweigh the risks, and the reason women are advised to use this therapy for decades. More women may be requesting alternatives to the widely prescribed hormone replacement drugs as concern about the long-term risks and public understanding about the drug-free options for prevention grow. Beginning with providing information about the risks associated with both estrogen and the combination of estrogen and progestogen, this paper examines "natural" approaches to conditions commonly associated with menopause.
To describe women's experiences during decision making about hormonal and nonhormonal therapies during the menopausal transition. Transcripts from 21 semi-structured audio taped interviews with seven peri- and postmenopausal women who had a recently visited a nurse practitioner (NP) and were making a decision about menopausal management. Decision making was a nonlinear process in which women considered available options, weighed benefits and risks and likely outcomes. Reevaluation of the decision was ongoing. Both internal and external conditions influenced their decisions. Media reports of findings from the Women's Health Initiative study may have influenced some women's perceptions of the risk of using hormones for symptom relief. Women described caring and empowering consultations with the NPs. They appreciated provision of information, adequate time spent at the visit, and decision support. NPs have a critical role to play in providing women with current research findings about hormone therapy and alternatives for symptom relief, and assisting women with understanding risks and benefits of each possible choice. Both individual and group approaches for decision support should be available to women. The approach of a collaborative partnership in decision making is a model that is congruent with nursing practice. ©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.
López-Caudana, Alma Ethelia; Castillo-Calderón, María Griselda; Ávila-Jiménez, Laura
In Mexico, calcaneal ultrasound measurements -bone mineral density (BMD), broadband ultrasound attenuation (BUA), speed of sound (SOS), ultrasonic quantitative index (QUI)- and their differences in regards to menopause have not been documented. It was carried out a cross-sectional study in 862 women from 20 to 90 years old, incorporated through consecutive sample, who were users of the Sistema para el Desarrollo Integral de la Familia (DIF) in Morelos. Sociodemographic, reproductive and life style factors were identified. BMD, BUA, SOS and QUI were measured with quantitative ultrasound (QUS), using a Sunlight Omnisense 7000 S device. Adjusted differences in the mean of these measurements were estimated between pre and postmenopausal women through multiple linear regression. The medians were: BMD, 0.455 g/cm² (IQR, interquartile range = 0.378, 0.538); BUA, 66.0 dB/mHz (IQR = 54.3, 78.1); SOS, 1530.7 m/s (IQR = 1509.8, 1551.7); QUI = 83.7 units (IQR = 71.1, 96.6). In postmenopausal women, adjusted mean for BUA was -4.34 dB/mHz (CI 95 % = -8.23,-0.43); for SOS, -4.26 m/s (CI 95 % = -13.82, 5.30) ; for QUI, -4.42 units (CI 95 % = -8.64,-0.19). This report increases information about the clinical applicability of QUS. SOS in calcaneus does not reflect changes related with menopause.
Vieira-Baptista, Pedro; Marchitelli, Claudia; Haefner, Hope K; Donders, Gilbert; Pérez-López, Faustino
The concept of genitourinary syndrome of menopause (GSM) was recently introduced and has been gaining widespread use. While some justifications for its introduction are straightforward, others may be questionable. Numerous unspecific symptoms and signs were included in the definition of the syndrome, but the minimum number required for diagnosis was not established. While the GSM definition is designed to facilitate identifying vulvovaginal and urinary estrogen-deprivation-associated symptoms and signs, several concerns have evolved: (1) the syndrome may result in the underdiagnosis of vulvar and urinary pathology; and (2) serious conditions (e.g., high-grade squamous intraepithelial lesions of the vulva or vulvar intraepithelial neoplasia, differentiated type) may be missed while others may not receive appropriate treatment (e.g., lichen sclerosus, overactive bladder). In addition, the transformation of urogenital symptoms and signs into a syndrome may create an iatrogenization of menopause, which, consequently, can lead to demand for (and offer of) a panacea of treatments. This can be detrimental to the care of women who require focused therapy rather than global treatment addressing a variety of genitourinary conditions, not all of which even require any form of intervention. Women's needs may be better served by having a more precise urogenital diagnosis.
Santen, Richard J; Stuenkel, Cynthia A; Burger, Henry G; Manson, Joann E
After publication of the Women's Health Initiative study in 2002, use of menopausal hormone therapy (HT) has declined by nearly 80% worldwide and internists now play only a limited role in menopause management. Over the past decade, new data have increased our knowledge of the multiple effects and mechanisms of HT. Existing literature was reviewed. A consensus has emerged that the benefits of HT outweigh the risks for the relief of symptoms in women who have recently undergone menopause and are not at excess risk of breast cancer and cardiovascular disease. Non-hormonal agents, selective estrogen receptor modulators (SERMs), and tibolone are also useful in management. Factors entering into the decision-making process regarding menopause management are increasingly complex and involve consideration of effects on multiple systems and potential disease-related events. These considerations suggest that internists trained to evaluate and integrate factors influencing multiple organ systems should re-engage in menopause management. Most internists currently lack the core competencies and experience necessary to address menopausal issues and meet the needs of women who have completed their reproductive years. We believe that this situation is detrimental to women's health, leads to fragmented care, and should change. We propose that the multidimensional expertise that characterizes the internist may provide the most comprehensive approach to menopause management. For the internist to meet this need, a set of core competencies must be attained, which will require new didactic programs to be developed for medical students, residents and practicing physicians.
Full Text Available The menopause is characterized by a reduction in ovarian function and estrogen production. Altogether, these changes together lead to a series of disorders that may affect the woman’s life style. Currently, medicine, influenced by the pharmaceutical industry, is prone to act aggressively against any symptoms, resulting in. polymedicated population. Doctors usually prescribe treatments such as hormone replacement therapy (HRT, to help them manage menopause symptoms. However, recently, several studies have reported adverse effects associated with this treatment. The influence of diet on several chronic diseases in western societies is currently well known. Therefore, dietary therapies, including dietary soy and isoflavone supplements, have been proposed for the reduction of menopause symptoms. Several published studies have suggested isoflavones, which have a great estrogenic power, as an HRT alternative for the relief of menopause symptoms. However, our current understanding on the effects of isoflavone supplements on the menopause symptoms is limited, and scientific publications show heterogenous results. Due to those arguments, the objective of this review is to address some of the mechanisms of isoflavones and their role in the menopausal period, postulating that, as food supplements, they could be used as a complementary therapy for menopause symptoms.
Fernández-Alonso, Ana M; Cuadros, José L; Chedraui, Peter; Mendoza, Marcela; Cuadros, Angela M; Pérez-López, Faustino R
To assess the metabolic syndrome (METS) and its components in postmenopausal women using updated diagnostic criteria and explore their relation to menopausal symptom severity. Medical records of the first visit of 574 postmenopausal Caucasian Spanish women attending a menopause clinic were retrospectively reviewed. Recorded information included general demographic data, type of menopause, menopausal symptom intensity (Kupperman index) and baseline hormonal and metabolic parameters. METS was established if three or more of the following criteria were met: body mass index (BMI) >28.8 kg/m(2), fasting glycaemia ≥100 mg/dL, high-density lipoprotein cholesterol (HDL-C) menopause and 38.9% were obese. In all, 23.1% met diagnostic criteria for METS who were significantly older and displayed higher rates of being married, obesity and abnormal glucose, triglyceride, HDL-C, low-density lipoprotein cholesterol and blood pressure values, when compared with those without the syndrome. The mean Kupperman index score for the whole sample was 26.4±10.6, with 73.8% displaying moderate to severe scores (20 or more). Logistic regression analysis determined that obesity and marriage status were independent risk factors related to more severe menopausal symptoms (Kupperman index scores of 20 or more). Although METS was observed in a lower frequency than previous reports, obesity was associated with more severe menopausal symptoms among postmenopausal Spanish women.
Hayatbakhsh, Mohammad R; Najman, Jake M; O'Callaghan, Michael J; Williams, Gail M; Paydar, Anita; Clavarino, Alexandra
There is a lack of evidence about whether menopausal status influences the effect of smoking on lung function. This study examined the association between smoking and menopausal status and lung function independent of each other. Data were from a cohort of women attending the 21-year follow-up of the Mater University of Queensland Study of Pregnancy. The study was based on 2020 women who provided data on respiratory function, smoking, and menopausal status. A Spirobank G spirometer system was used to measure forced vital capacity (FVC), forced expiratory volume in first second (FEV(1)), and forced expiratory flow between 25 and 75% of forced vital capacity (FEF(25-75)). Smoking and menopausal status were assessed by self-report. Respiratory function was associated with cigarette smoking, menopausal status, and hormone replacement therapy. Regardless of smoking status, postmenopausal women had poorer lung function when compared with premenopausal women. In multivariate analysis, cigarette smoking was associated with lower FVC, FEV(1), and FEF(25-75), with the magnitude of effect being stronger for women who were postmenopausal. The data suggest that the impact of smoking intensifies after menopause. It seems plausible that effective quit-smoking programs, particularly after menopause, may lead to better lung function and reduced morbidity and mortality in women.
Suka, Machi; Taniuchi, Asako; Igarashi, Suguru; Yanagisawa, Hiroyuki; Ishizuka, Bunpei
This study proposed a method for assessing menopause-specific health literacy (knowledge and beliefs about menopausal symptoms which aid their recognition, assessment, and management) using a vignette methodology. A cross-sectional web-based survey was conducted in September 2015 among Japanese women aged 30-59 years. Of 1236 women surveyed, 1196 eligible participants who were not under treatment for menopausal symptoms were included. Participants were presented with a vignette describing a woman with menopausal symptoms and were then asked a series of questions to assess their recognition of menopausal symptoms, attitude, subjective norm, perceived behavior control, availability, and intention to seek medical care if they themselves had the problems described in the vignette. The majority (87%) of participants correctly labelled the vignette as menopausal symptoms and 60% expressed an intention to seek medical care if they had the symptoms presented. Logistic regression showed that attitude, subjective norm, and perceived behavior control were significant predictors of the intention to seek medical care. A structural equation model depicting these relationships with intention to seek medical care revealed acceptable fit indices: goodness of fit index (GFI)=0.948, adjusted goodness of fit index (AGFI)=0.913, comparative fit index (CFI)=0.883, and root mean square error of approximation (RMSEA)=0.089. Subjective norm had the greatest direct effect on intention to seek medical care. The assessment of menopause-specific health literacy may be useful for understanding why women hesitate to seek medical care for menopausal symptoms and for developing interventions to improve the coping behaviors of women with menopausal symptoms. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David
To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex- and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray, two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation.
Erpelding, Nathalie; Simons, Laura; Lebel, Alyssa; Serrano, Paul; Pielech, Melissa; Prabhu, Sanjay; Becerra, Lino; Borsook, David
To date, brain structure and function changes in children with complex regional pain syndrome (CRPS) as a result of disease and treatment remain unknown. Here, we investigated (a) gray matter (GM) differences between patients with CRPS and healthy controls and (b) GM and functional connectivity (FC) changes in patients following intensive interdisciplinary psychophysical pain treatment. Twenty-three patients (13 females, 9 males; average age ± SD = 13.3 ± 2.5 years) and 21 healthy sex-and age-matched controls underwent magnetic resonance imaging. Compared to controls, patients had reduced GM in the primary motor cortex, premotor cortex, supplementary motor area, midcingulate cortex, orbitofrontal cortex, dorsolateral prefrontal cortex (dlPFC), posterior cingulate cortex, precuneus, basal ganglia, thalamus, and hippocampus. Following treatment, patients had increased GM in the dlPFC, thalamus, basal ganglia, amygdala, and hippocampus, and enhanced FC between the dlPFC and the periaqueductal gray (PAG), two regions involved in descending pain modulation. Accordingly, our results provide novel evidence for GM abnormalities in sensory, motor, emotional, cognitive, and pain modulatory regions in children with CRPS. Furthermore, this is the first study to demonstrate rapid treatment-induced GM and FC changes in areas implicated in sensation, emotion, cognition, and pain modulation. PMID:25515312
Pitkin, Joan; Rees, Margaret C P; Gray, Sarah; Lumsden, Mary Ann; Stevenson, John; Williamson, Jennifer
The British Menopause Society Council aims to aid health professionals to inform and advise women about the menopause. The oestrogen plus progestogen arm of the Women's Health Initiative was stopped in July 2002. This guidance regarding hormone replacement therapy (HRT) use responds to the results and analysis that have been published since then. Because there are few effective alternatives to HRT for vasomotor and urogenital symptoms, oestrogen-based treatments still have a major role. HRT is also most effective for prevention of osteoporosis. Unopposed oestrogens are contraindicated in women with an intact uterus, and hence a range of oestrogen and progestogen combinations, with differing routes of delivery, now exists under the title of "HRT". Treatment choice should be based on up to date information and targeted to individual women's needs. Hormone replacement still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination.
Agrinier, N; Cournot, M; Ferrières, J
A high prevalence of cardiovascular risk factors is reported in postmenopausal women. The objective of this review was to determine whether the effect of the menopause on lipid profile remained after adjusting for age in middle age women. The results of 10 cross sectional studies and nine longitudinal studies added evidence of a worsening effect of the menopause on total cholesterol, LDL cholesterol and triglyceride plasmatic levels. This effect remained after adjustment for age. Menopausal estrogenic deficiency could be an explanation for those results, even if the hormonal replacement therapy effect on the lipid profile remains unclear.
Full Text Available Menopause is a period of significant physiological changes that may be associated with increased body weight and obesity-related diseases. Many researches were conducted to assess the contribution of factors such as estrogen depletion, REE decline, and aging to weight gain. An increase in orexin-A plasma levels, paralleling lower estrogen levels, was found during menopause. Orexins are hypothalamic neuropeptides recently discovered, involved in the regulation of feeding behaviour, sleep-wakefulness rhythm, and neuroendocrine homeostasis. Orexins might offer the missing link between postmenopausal hypoestrogenism and other manifestations of the menopausal syndrome, including appetite and weight changes and increase in cardiovascular risk.
Christensen, Amy; Pike, Christian J
Alzheimer's disease (AD) is a multifactorial neurodegenerative disorder, the development of which is regulated by several environmental and genetic risk factors. Two factors theorized to contribute to the initiation and/or progression of AD pathogenesis are age-related increases in inflammation and obesity. These factors may be particularly problematic in women. The onset of menopause in mid-life elevates the vulnerability of women to AD, an increased risk that is likely associated with the depletion of estrogens. Menopause is also linked with an abundance of additional changes, including increased central adiposity and inflammation. Here, we review the current literature to explore the interactions between obesity, inflammation, menopause and AD.
Anna Brończyk-Puzoń; Dariusz Piecha; Justyna Nowak; Aneta Koszowska; Karolina Kulik-Kupka; Anna Dittfeld; Barbara Zubelewicz-Szkodzińska
The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman’s life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and s...
Blume-Peytavi, Ulrike; Atkin, Stephen; Gieler, Uwe; Grimalt, Ramon
Menopause is defined by 12 months of amenorrhea after the final menstrual period. The reduction in ovarian hormones and increased androgen levels can manifest as hair and skin disorders. Although hirsutism, unwanted facial hair, alopecia, skin atrophy and slackness of facial skin are common issues encountered by post-menopausal women, these problems receive very little attention relative to other menopausal symptoms. The visibility of these disorders has been shown to cause significant anxiety and may impact on patients' self-esteem and quality of life, particularly given the strong association of hair and skin with a woman's femininity and beauty, which is demonstrated by extensive marketing by the cosmetic industry targeting this population and the large expenditure on these products by menopausal women. The proportion of the female population who are in the post-menopausal age group is rising. Therefore, the prevalence of these dermatological symptoms is likely to increase. Current therapies aim to rectify underlying hormonal imbalances and improve cosmetic appearance. However, there is little evidence to support treatment for these disorders specifically in post-menopausal women. This review discusses the assessment and treatment of both the physiological and psychological aspects of hair and skin disorders pertinent to the growing post-menopausal population.
Beral, V; Gaitskell, K; Hermon, C
BACKGROUND: Half the epidemiological studies with information about menopausal hormone therapy and ovarian cancer risk remain unpublished, and some retrospective studies could have been biased by selective participation or recall. We aimed to assess with minimal bias the effects of hormone therapy...... on ovarian cancer risk. METHODS: Individual participant datasets from 52 epidemiological studies were analysed centrally. The principal analyses involved the prospective studies (with last hormone therapy use extrapolated forwards for up to 4 years). Sensitivity analyses included the retrospective studies......-progestagen preparations, but differed across the four main tumour types (heterogeneity pdefinitely increased only for the two most common types, serous (RR 1·53, 95% CI 1·40-1·66; p
Avis, Nancy E; Legault, Claudine; Russell, Gregory; Weaver, Kathryn; Danhauer, Suzanne C
This study aims to obtain preliminary data on the efficacy of yoga for reducing self-reported menopausal hot flashes in a randomized study including an attention control group. We randomized 54 late perimenopausal women (2-12 mo of amenorrhea) and postmenopausal women (>12 mo of amenorrhea)--aged 45 to 58 years and who experienced at least four hot flashes per day, on average, for at least 4 weeks--to one of three groups: yoga, health and wellness education (HW), and wait list (WL). Yoga and HW classes consisted of weekly 90-minute classes for 10 weeks. All women completed daily hot flash diaries throughout the trial (10 wk) to track the frequency and severity of hot flashes. The mean hot flash index score is based on the number of mild, moderate, severe, and very severe hot flashes. Hot flash frequency declined significantly across time for all three groups, with the strongest decline occurring during the first week. There was no overall significant difference in hot flash frequency decrease over time by treatment groups, but the yoga and HW groups followed similar patterns and showed greater decreases than the WL group. On week 10, women in the yoga group reported an approximately 66% decrease in hot flash frequency, women in the HW group reported a 63% decrease, and women in the WL group reported a 36% decrease. The hot flash index showed a similar pattern. Results suggest that yoga can serve as a behavioral option for reducing hot flashes but may not offer any advantage over other types of interventions.
The Women's Health Initiative randomised controlled trials that were mainly of relatively older postmenopausal women, reported that menopausal hormone therapy (MHT) has adverse consequences including an increased risk of breast cancer, coronary heart disease (CHD), venous thromboembolism (VTE) and stroke.
Effective prescription medications are available to treat menopausal symptoms. However, due to adverse effects and risks associated with use, many women are seeking complementary and alternative options to treat their symptoms. Nonpharmacological options for the management of menopausal symptoms are widely available and frequently used. This article outlines the use of, and evidence for, nonprescription therapies and complementary therapies for menopausal symptom management. There are a large number of studies on complementary and alternative therapies for the management of menopausal symptoms. Lifestyle changes are beneficial and studies on relaxation training are revealing encouraging results. Studies of the benefits of yoga have mixed results. Current evidence from systematic reviews does not support the use of over-the-counter complementary therapies or acupuncture. A large placebo effect exists for the management of hot flushes, therefore further research against active controls is required. Management options should be collaboratively explored.
Full Text Available Abstract Menopausal health is important since this stage of life is not to be avoided. A recent article in BMC Women's Health from the Estonian Postmenopausal Hormone Therapy trial has concluded that quality of life is not related to hormonal therapy use. The commentary article discusses this finding and considers other factors related to symptoms and quality of life during menopause. Important factors known to affect hot flushes and quality of life are smoking and high body weight. Since both these factors are modifiable, menopause is a suitable area for health promotion. However, evidence concerning lifestyle changes in symptom relief or increase of quality of life is weak. More trials in this area are needed before women may consider non-pharmacological treatment of symptoms as a reliable option for menopausal symptom cure.
... fullstory_165588.html Timing of Menopause May Affect Heart Failure Risk Women whose periods end early and those ... gave birth might have an increased risk of heart failure, a new study suggests. Researchers analyzed data from ...
Erin L. Scott
Conclusion: Collectively, these studies partially explain the enhanced risk of dementia and mortality from neurological disorders seen in prematurely menopausal women and support timely initiation of E2 therapy to yield maximum neurological benefit.
Sampselle, Carolyn M; Harris, Vanessa; Harlow, Sioban D; Sowers, MaryFran
Little is known about factors that enhance midlife women's well-being and even less about whether these factors differ for African Americans and Caucasians. We conducted focus groups with 30 women, grouped by ethnicity and menopausal status. Women identified midlife as a time of opportunity for self-development. Pre/perimenopausal women expressed more fears about severe emotional changes than did their postmenopausal counterparts. These fears were in sharp contrast to the women's descriptions of enhanced self-esteem. Caucasian women were primarily concerned about menopause as a harbinger of physical aging and the ensuing disadvantage of divergence from society's ideal of a youthful appearance, while African American women viewed menopause as a normal, even welcome, part of life. A language of emancipation and awareness of gender bias were prominent in the women's stories regardless of menopausal status or race. Further study should assess the role that feminist insights may play in the well-being of midlife women.
Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert
INTRODUCTION: Around 75% of menopausal women experience hot flushes (HF) and 10-20% of all postmenopausal women find this very distressing. The aim of this study is to evaluate the efficacy of acupuncture on moderate-to-severe menopausal symptoms in general and HF in particular. METHODS: An un......-blinded randomised trial (cross-over) with 1:1 allocation to early (intervention) versus late (control) acupuncture. The included women suffer from moderate-to-severe HF and will receive a weekly treatment during five consecutive weeks in the following predefined acupuncture points: CV-3, CV-4, LR-8, SP-6, SP-9. All...... acupuncturists will be medical doctors educated in acupuncture. The primary outcome is change in HF from baseline to week 6 measured by the HF scale from the MenoScores Questionnaire (MSQ). Secondary outcomes are change in other menopausal symptoms, in particular day and night sweats and menopausal...
... necessarily cause menopause weight gain. Instead, the weight gain is usually related to aging, as well as lifestyle and genetic factors. For example, muscle mass typically diminishes with age, while fat increases. Loss ...
Jarosław Kozakowski; Małgorzata Gietka-Czernel; Dorota Leszczyńska; Agnieszka Majos
.... This paper presents an overview of current knowledge concerning the etiology of obesity related to menopause and about the mechanisms of its development, with particular regard to the hormonal...
Scheid, Volker; Tuffrey, Veronica; Weijburg, Thomas; Bovey, Mark; Ward, Trina
The aims of this pilot study were to evaluate treatment effects, ascertain safety and formulate best practice Chinese medicine protocols relevant for London women suffering from menopausal symptoms. This clinical pilot study employed a case series design within a wider action-based research project. 117 perimenopausal women between 45 and 55 years of age recruited from the general population were treated for menopausal symptoms by six experienced practitioners of Chinese medicine at the Polyclinic of the University of Westminster. Practitioners were instructed to treat as near to their usual practice style as possible. This involved using Chinese herbal medicine and/or acupuncture along with dietary and lifestyle advice. A maximum of 12 treatments over 6 months was allowed per patient. The menopause specific quality of life questionnaire (MenQoL), the Greene climacteric scale, and flushing diaries were used to evaluate treatment outcomes. Liver and kidney function tests were carried out at intake and after 1, 6 and 12 treatments to evaluate the safety particularly in relation to the use of herbal medicines. Patients showed significant improvement across all domains measured by the MenQoL and Greene climacteric scales. Reduction on the MenQoL scale between first and last visit was from 4.31 to 3.27 (p<0.001) and on the Green climacteric scale from 21.01 to 13.00 (p<0.001). Study participants did not reliably complete their flushing diaries. No adverse events or abnormal liver or kidney function values were observed during the course of the study. Further research that seeks to investigate the effects observed in more detail and to evaluate them against other forms of treatment and/or no-treatment controls is warranted. This could be achieved by way of a pragmatic randomized controlled trial that evaluated Chinese medicine against orthodox medical care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Richa Sood, Stephanie S Faubion, Carol S Kuhle, Jacqueline M Thielen, Lynne T Shuster Division of General Internal Medicine, Women's Health Clinic, Mayo Clinic, Rochester, MN, USA Abstract: The constantly changing landscape regarding menopausal hormone therapy (MHT has been challenging for providers caring for menopausal women. After a decade of fear and uncertainty regarding MHT, reanalysis of the Women's Health Initiative data and the results of recent studies have provided some clarity regarding the balance of risks and benefits of systemic MHT. Age and years since menopause are now known to be important variables affecting the benefit-risk profile. For symptomatic menopausal women who are under 60 years of age or within 10 years of menopause, the benefits of MHT generally outweigh the risks. Systemic MHT initiated early in menopause appears to slow the progression of atherosclerotic disease, thereby reducing the risk of cardiovascular disease and mortality. During this window of opportunity, MHT might also provide protection against cognitive decline. In older women and women more than 10 years past menopause, the risk-benefit balance of MHT is less favorable, particularly with regard to cardiovascular risk and cognitive impairment. For women entering menopause prematurely (<40 years, MHT ameliorates the risk of cardiovascular disease, osteoporosis, and cognitive decline. Nonoral administration of estrogen offers advantages due to the lack of first-pass hepatic metabolism, which in turn avoids the increased hepatic synthesis of clotting proteins, C-reactive protein, triglycerides, and sex hormone-binding globulin. The duration of combined MHT use is ideally limited to less than 5 years because of the known increase in breast cancer risk after 3–5 years of use. Limitations to use of estrogen only MHT are less clear, since breast cancer risk does not appear to increase with use of estrogen alone. For women under the age of 60 years, or
Ertunc, D; Tok, E C; Aytan, H; Gozukara, Y M
The aim of the study was to investigate the age at menopause in women exposed to passive smoking. The study was designed as a case-control study. The main outcome measure was to compare the age at menopause of women exposed to second-hand smoking to non-exposed women. The age at menopause in the group exposed to second-hand smoking was significantly lower than that of women in the non-exposed group (47.0 ± 4.7 vs. 48.1 ± 5.2 years, p = 0.002). In regression analyses, the age at menopause had an inverse correlation with second-hand smoking, and a positive correlation with the mother's age at menopause. We further stratified women according to their smoking status. Women exposed to second-hand smoking who had never smoked had a significantly lower age at menopause than the non-exposed women only when the duration of exposure exceeded 20 years (46.6 ± 5.6 vs. 48.4 ± 3.7 years, p = 0.008). Furthermore, women who had never smoked and who were exposed to ≥ 10 cigarettes per day had a significantly lower mean age at menopause than non-exposed women who had never smoked. These differences were not observed among women who had ever smoked. Our findings suggest that earlier age at menopause should be added to the negative effects of passive smoking, in addition to increased risks for overall, cardiovascular and cancer mortality as well as increased risk for osteoporosis.
Berent-Spillson, Alison; Marsh, Courtney; Persad, Carol; Randolph, John; Zubieta, Jon-Kar; Smith, Yolanda
Disturbances of emotion regulation and depressive symptoms are common during the menopause transition. Reproductive hormone levels are not directly correlated with depressive symptoms, and other factors may influence mood symptoms during menopause. In this study, we sought to determine the role of metabolic function in mood symptoms during menopause, hypothesizing an association with menopause status and long-term glucose load. We studied 54 women across three menopause transition stages (15 premenopause, 11 perimenopause, and 28 postmenopause), examining effects of age, hormones, and metabolism on mood and neural activation during emotional discrimination. We assessed participants using behavioral and functional MRI measures of negative emotion and emotion discrimination, and glycated hemoglobin A1c, to assess long-term glucose load. We found that emotionally unpleasant images activated emotion regulation (amygdala) and cognitive association brain regions (prefrontal cortex, posterior cingulate, temporal-parietal-occipital (TPO) junction, hippocampus). Cognitive association region activity increased with menopause stage. Perimenopausal women had left TPO junction activation, and postmenopausal women had prefrontal cortex, posterior cingulate, and TPO junction activation. Negative affect was associated with decreased amygdala activation, while depression symptoms and negative mood were associated with increased TPO junction activation. Hemoglobin A1c was associated with negative interpretation bias of neutral images and cognitive region recruitment during emotion discrimination. FSH levels, indicating menopause stage, were associated with negative mood. Age was not associated with any behavioral measures or activation patterns during the emotion task. Our results suggest that an interaction between metabolic and hormonal factors may influence emotion regulation, leading to increased risk for depression during menopause. Copyright © 2016 Elsevier Ltd. All rights
AWARD NUMBER: W81XWH-13-1-0307 TITLE: Why Do Only Some Women Develop Post- Menopausal Osteoporosis ? PRINCIPAL INVESTIGATOR: Marc D...Only Some Women Develop Post-Menopausal Osteoporosis ? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-13-1-0307 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...proposed project addresses a novel and potentially important mechanism of osteoporosis which may determine which women suffer the disease. Confirmation
Triebner, Kai; Matulonga, Bobette; Johannessen, Ane; Suske, Sandra; Benediktsdóttir, Bryndís; Demoly, Pascal; Dharmage, Shyamali C; Franklin, Karl A; Garcia-Aymerich, Judith; Gullón Blanco, José Antonio; Heinrich, Joachim; Holm, Mathias; Jarvis, Debbie; Jõgi, Rain; Lindberg, Eva; Moratalla Rovira, Jesús Martínez; Muniozguren Agirre, Nerea; Pin, Isabelle; Probst-Hensch, Nicole; Puggini, Luca; Raherison, Chantal; Sánchez-Ramos, José Luis; Schlünssen, Vivi; Sunyer, Jordi; Svanes, Cecilie; Hustad, Steinar; Leynaert, Bénédicte; Gómez Real, Francisco
Menopause is associated with changes in sex hormones, which affect immunity, inflammation, and osteoporosis and may impair lung function. Lung function decline has not previously been investigated in relation to menopause. To study whether lung function decline, assessed by FVC and FEV1, is accelerated in women who undergo menopause. The population-based longitudinal European Community Respiratory Health Survey provided serum samples, spirometry, and questionnaire data about respiratory and reproductive health from three study waves (n = 1,438). We measured follicle-stimulating hormone and luteinizing hormone and added information on menstrual patterns to determine menopausal status using latent class analysis. Associations with lung function decline were investigated using linear mixed effects models, adjusting for age, height, weight, pack-years, current smoking, age at completed full-time education, spirometer, and including study center as random effect. Menopausal status was associated with accelerated lung function decline. The adjusted mean FVC decline was increased by -10.2 ml/yr (95% confidence interval [CI], -13.1 to -7.2) in transitional women and -12.5 ml/yr (95% CI, -16.2 to -8.9) in post-menopausal women, compared with women menstruating regularly. The adjusted mean FEV1 decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) in post-menopausal women. Lung function declined more rapidly among transitional and post-menopausal women, in particular for FVC, beyond the expected age change. Clinicians should be aware that respiratory health often deteriorates during reproductive aging.
Bialek-Gosk, Katarzyna; Maskey-Warzechowska, Marta; Krenke, Rafal; Dabrowska, Marta; Paplinska-Goryca, Magdalena; Nejman-Gryz, Patrycja; Domagala-Kulawik, Joanna; Przybylowski, Tadeusz; Chazan, Ryszarda
Menopausal asthma is considered a distinct asthma phenotype. Our aim was to identify potential specific features of asthma in postmenopausal women in a cohort of Polish females. Asthma severity and control, pulmonary function, exhaled nitric oxide (FENO), peripheral blood and induced sputum (IS) differential cell count were compared in three groups: women with premenopausal asthma (group 1), menopausal women with pre-existing asthma (group 2A) and menopausal women with asthma onset in the perimenopausal or menopausal period (group 2B). We enrolled 27 women to group 1, 13 to group 2A and 16 to group 2B. Asthma severity and control, blood eosinophil count and FENO did not differ among the groups. Menopausal women had a higher incidence of irreversible airway obstruction (84.6% in group 2A and 56.2% in group 2B vs. 22.2% in group 1, p < 0.001 and p = 0.03, respectively). The proportion of patients with sputum eosinophilia was highest in menopausal women with pre-existing asthma, although the difference did not reach statistical significance (88.9% in group 2A vs. 66.7% in group 2B and 65.0% in group 1, respectively, p = 0.86). Menopausal women with asthma are characterized by an increased incidence of irreversible airway obstruction regardless of disease duration. This may indicate that age may contribute to pulmonary function impairment in asthmatic women independently of their hormonal status at the time of asthma diagnosis. Our results failed to confirm the presence of specific asthma features which would allow to distinguish the phenotype of menopausal asthma.
Ley, Sylvia H; Li, Yanping; Tobias, Deirdre K; Manson, JoAnn E; Rosner, Bernard; Hu, Frank B; Rexrode, Kathryn M
Although the timing of menarche and menopause may be associated with cardiovascular disease (CVD), the entire reproductive life span has not been considered comprehensively as risk for CVD. We investigate the associations of reproductive life span duration and ages at menarche and menopause, induced by natural means or surgical bilateral oophorectomy, with incident CVD in women. Prospective cohort study of 73 814 Nurses' Health Study following participants without CVD, defined as incident coronary heart disease or stroke, from 1980 through 2012. Duration of reproductive life span was generated by subtracting age at menarche from age at menopause. A shorter reproductive life span was associated with a higher risk of incident CVD after multivariable adjustment (relative risk, 1.32 [95% confidence interval, 1.16-1.49] comparing duration <30 with ≥42 years; P trend<0.0001). Early age at menopause was associated with higher multivariable-adjusted CVD risk (1.32 [1.16-1.51] comparing age <40 with 50 to <55 years; P trend<0.0001), with excess risk for both natural and surgical menopause. Compared with women with menarche at 13 years, the multivariable-adjusted CVD risk for early menarche at ≤10 years was 1.22 (1.09-1.36). The association between reproductive life span and CVD remained significant in sensitivity analyses excluding women who experienced extreme early age at menarche or who used hormone therapy. A shorter duration of reproductive life span is associated with a higher risk of CVD, which is likely driven by the timing of menopause induced either naturally or surgically. Extremely early age at menarche is also associated with a higher risk of CVD. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
Dasgupta, Shruti; Salman, Mohammed; Lokesh, S; Xaviour, D; Saheb, S Yaseen; Prasad, B V Ravi; Sarkar, Biswanath
Increased incidences of cardiovascular disorder and metabolic syndrome particularly after menopause have raised curiosity for the underlying factors. However, it is still a debate whether age or menopausal transition is a greater contributor. To elucidate the inter-relationships of age, menopause, and associated obesity and to assess their independent effects on aggravation of cardio metabolic risk factors in postmenopausal women. Four hundred two women aged between 30 and 75 years were recruited in a cross-sectional study from Southern India. Three hundred sixteen participants exempting exclusion criteria, comprising of 169 premenopausal and 147 postmenopausal women were finally included. Anthropometric measurements such as weight, height, waist circumference (WC), hip circumference (HC), fat percentage, basal metabolic rate (BMR), and blood pressure were taken. Fasting plasma glucose, postprandial glucose, glycated hemoglobin (HbA1c), lipid profile, and C-reactive protein (CRP) were also measured. Independent t-test, Analysis of covariates (ANCOVA), Pearson's correlation coefficients and multiple stepwise linear regression model analysis were done. A significant increase in physical and metabolic factors was observed in postmenopausal women compared to premenopausal women except WC and HbA1c. Contrastingly, high-density lipoprotein cholesterol (HDL) levels and BMR were significantly decreased. After adjusting for BMI and age, the significant differences in the variables through the menopausal transition persisted, including an increase in WC. Significant correlation was observed between age and measures of general obesity such as BMI (P obesity indices. Menopausal status and WC exerted an independent effect on most of the metabolic risk factors (P Menopausal transition brings about anomalies in total body composition characterized by an increased body fat mass and central adiposity. This creates a compatible atmosphere for abnormal metabolism and aggravated
Walaszek, Paweł; Mazur, Paweł; Płachta, Zenon; Adamiak, Aneta; Azizi, Ilir; Rechberger, Tomasz
The study was aimed to assess if the prevalence of female depressive disorders after menopause depends on their hormonal status (E2, FSH, testosterone, DHEAS) or psychosocial conditions, Moreover, the influence of HRT on female mood disorders was estimated. One hundred women (44=65 ys old) were included into the study. Ali patients were complaining of hot flushes for at least 6 months. Among these women 31% had depressive disorders at baseline. The hormonal status, psychosocial conditions and mood disorders (Beck's and Haniilton's scales) were assessed at the baseline and after 12 months in 50 women on HRT and in 20 control patients. After 1 year the depressive mood disappeared in 59% and worsened in 5,9% of women taking HRT, whereas in the control group 35% of patient experienced depression. Among women on HRT the significant increase of serum DHEAS was observed in patients with improvement of mood as well as in depressed ones. Serum testosterone, 17P-estradiol and FSH levels did not differ between both groups. The higher scores of Beck's and Hamilton's scales were not associated with hormonal status but correlated with worsening of psychosocial conditions. The female depressive disorders after menopause are associated with their psychosocial conditions but not with their hormonal status.
Kim, Jangseon; Kim, Mi Hye; Choi, You Yeon; Hong, Jongki; Yang, Woong Mo
Leonurus sibiricus, also called motherwort, is a well-known functional food and medicinal herb. It has been known to possess beneficial properties for women's health, especially for aged women. Estrogen deficiency in the menopause could induce lipid metabolic abnormalities in body fat, resulting in obesity. In this study, the inhibitory effects of L. sibiricus on obesity after the menopause were investigated. Female C57BL/6 mice were ovariectomized and fed high-fat diet (HFD) for 12 weeks. Following an induction period, aqueous extracts of L. sibiricus (LS) were orally administrated for 6 weeks. The body, uterine, and visceral fat weights were measured immediately after the animals were killed. Histological analysis was performed to monitor fat and liver. Serum levels of glucose, triglyceride, total cholesterol, and LDL-cholesterol were evaluated. In addition, the expression of lipases was analyzed. Total body weight was significantly decreased by LS treatment. Histological changes in adipocyte size were shown along with a decrease of visceral fat weight in the LS-treated group. In addition, the fat infiltration of liver was reduced by LS administration. LS-treated mice experienced decreases of serum triglyceride, total cholesterol, and LDL-cholesterol levels. The expression of HSL and ATGL was significantly increased by LS treatment. These results suggest that LS could regulate the lipid metabolism via an increase of lipases expression in ovariectomized and HFD-fed mice. LS might be a novel candidate for a functional food to inhibit weight gain after the menopause.
Full Text Available Vasomotor symptoms (hot flushes and night sweats and other symptoms, including depression, anxiety and panic attacks, are commonly experienced by menopausal women and have been associated with an unfavourable cardiovascular risk profile.To investigate whether presence of menopausal symptoms is associated with the development of cardiovascular disease (CVD.Five electronic databases (Medline, EMBASE and Web of Science were search until February 17th, 2015 to identify relevant studies. Observational cohort studies or randomised intervention studies were eligible for inclusion if they followed participants prospectively (at least 1 year of follow-up, and reported relevant estimates on the association of any vasomotor symptoms, or other menopausal symptoms, with risk of CVD, coronary heart disease (CHD, or stroke in perimenopausal, menopausal, or postmenopausal women. Data were extracted by two independent reviewers using a pre-designed data collection form. Separate pooled relative risks (RRs for age and non-established cardiovascular risk factors (e.g., education, ethnicity adjusted data and for established cardiovascular risk factors and potential mediators-adjusted data (e.g., smoking, body mass index, and hypertension were calculated.Out of 9,987 initially identified references, ten studies were selected, including 213,976 women with a total of 10,037 cardiovascular disease outcomes. The age and non-established cardiovascular risk factors adjusted RRs [95% confidence intervals] for development of CHD, Stroke and CVD comparing women with and without any menopausal symptoms were 1.34 [1.13-1.58], 1.30 [0.99-1.70], 1.48 [1.21-1.80] respectively, and the corresponding RRs adjusted for cardiovascular risk factors and potential mediators were 1.18 [1.03-1.35], 1.08 [0.89-1.32], 1.29 [0.98-1.71]. However, these analyses were limited by potential unmeasured confounding and the small number of studies on this topic.Presence of vasomotor symptoms and
Mathiasen, Niels Raabjerg; Bødker, Susanne
Security is experienced differently in different contexts. This paper argues that in everyday situations, users base their security decisions on a mix of prior experiences. When approaching security and interaction design from an experience approach, tools that help bring out such relevant...... experiences for design are needed. This paper reports on how Prompted exploration workshops and Acting out security were developed to target such experiences when iteratively designing a mobile digital signature solution in a participatory design process. We discuss how these tools helped the design process...... and illustrate how the tangibility of such tools matters. We further demonstrate how the approach grants access to non-trivial insights into people's security experience. We point out how the specific context is essential for exploring the space between experience and expectations, and we illustrate how people...
Ismail, Rita; Linder, Lauri A; MacPherson, Catherine Fiona; Fugate Woods, Nancy
To evaluate feasibility, including usability and utility, of the Computerized Symptom Capture Tool for Menopause (C-SCAT-M), a symptom heuristics application (app) for the iPad, with midlife women. Thirty midlife women aged 40-60 and experiencing symptoms they associated with menopause were recruited through flyers posted on a university campus, primary care and women's health clinics. The C-SCAT-M guided participants to identify symptoms they experienced, draw temporal and causal relationships between symptoms and identify symptom clusters. Women were encouraged to think aloud as they encountered questions or problems and their comments were audio recorded. After completing the C-SCAT-M, they completed a 22-item acceptability survey and a demographic survey. Data were downloaded from catalyst website and analyzed using SPSS. Women completed the C-SCAT-M with minimal difficulty, with most indicating that using the app was very/extremely easy and most (57%) preferred using the iPad app to paper. Most women stated that the final diagrams were very/extremely accurate depictions of their symptom clusters and relationships (77%). The C-SCAT-M demonstrated initial feasibility, including usability and utility, for collecting data about symptom clusters experienced by midlife women.
María Isabel Capote Bueno
Full Text Available La experiencia de la menopausia es diferente para cada mujer y entre mujeres de diferentes culturas o procedencias. La menopausia no es el final de la vida, sino el comienzo de una etapa que ocupa casi la tercera parte de la vida femenina; por otra parte, se plantea que el climaterio no es el cese de la existencia, sino la etapa que deja abierta las puertas al disfrute de una nueva forma que debe cursar con menos tensión, con menos carga. Según los conceptos de salud, salud mental y salud sexual de la Organización Mundial de la Salud, nada puede impedir que la mujer climatérica sea capaz de ser mental y sexualmente sana; por lo que el profesional de la salud debe estar actualizado en todos aquellos elementos que redunden en un mejor desempeño y en la expresión de la plenitud de las posibilidades físicas, psíquicas y sociales de la mujer en esta etapa. En este artículo se profundiza en los aspectos históricos y conceptuales del climaterio y la menopausia, los elementos esenciales relacionados con los principales síntomas y signos del climaterio, los factores de riesgo en esta etapa, así como en la conducta terapéutica que se debe tener en cuenta para su adecuado manejo, en la atención integral, por los profesionales de la salud.The experience of menopause for each woman is different and among women of different cultures or origin. Menopause is not the end of the life, but the onset of a stage occupying almost the third part of the female life; by other hand, it is proposed that climateric is not the final of existence, but the stage leaving open the doors for the enjoyment of a new way that must to take place with less stress and with less burden. According to the concepts of health, mental health and sexual health from the World Health Organization, nothing may to prevent that climateric woman be able to has a mentally and sexually life; thus, the health professional must to be updated on all those elements having an effect on a
Campbell, S; Whitehead, M
Sixty-four patients with severe menopausal symptoms completed a four month double-blind placebo trial with conjugated equine oestrogens (premarin). Using a graphic rating scale system of assessment, a statistically significant improvement with premarin was observed in 12 psychological and symptomatic scores (Table 3). From a comparison between these results and the results of the 20 patients without vasomotor symptoms it would appear that many of these symptomatic improvements result from the relief of hot flushes (i.e. a domino effect). However, the improvement in memory and reduction of anxiety in these 20 patients suggest that oestrogens have a direct tonic effect on the mental state which is independent of vasomotor symptoms. Sixty-one patients with less severe menopausal symptoms completed the second twelve month double-blind placebo trial and, as assessed by graphic rating scales, a significant improvement with premarin was observed in five psychological and symptomatic scores (Table 3). In both the twelve and four month studies the marked placebo effect of "youthful skin appearance", and on skin greasiness in the twelve month study, indicate that no reliance can be placed on patient judgement of skin texture and appearance. Despite the lessening of the domino effect there was a slight improvement with premarin over placebo in 15 of the remaining 16 symptoms and it is likely that the cumulative effect of these small improvements results in an overall enhancement of well-being. The relief of atrophic vaginitis by premarin did not result in an improvement in libido and this suggests that the ability and the desire to have sexual intercourse are not related. The strength and duration of the placebo effect were well demonstrated in the three standard psychiatric scoring systems, the Beck score (for depression), the General Health Questionnaire and the Eysenck Personality Index (formula: see text) (for neuroticism). We observed a highly significant placebo effect
Purdue-Smithe, Alexandra C; Whitcomb, Brian W; Szegda, Kathleen L; Boutot, Maegan E; Manson, JoAnn E; Hankinson, Susan E; Rosner, Bernard A; Troy, Lisa M; Michels, Karin B; Bertone-Johnson, Elizabeth R
Background: Early menopause, defined as the cessation of ovarian function before the age of 45 y, affects ∼10% of women and is associated with higher risk of cardiovascular disease, osteoporosis, and other conditions. Few modifiable risk factors for early menopause have been identified, but emerging data suggest that high vitamin D intake may reduce risk.Objective: We evaluated how intakes of vitamin D and calcium are associated with the incidence of early menopause in the prospective Nurses' Health Study II (NHS2).Design: Intakes of vitamin D and calcium from foods and supplements were measured every 4 y with the use of a food-frequency questionnaire. Cases of incident early menopause were identified from all participants who were premenopausal at baseline in 1991; over 1.13 million person-years, 2041 women reported having natural menopause before the age of 45 y. We used Cox proportional hazards regression to evaluate relations between intakes of vitamin D and calcium and incident early menopause while accounting for potential confounding factors.Results: After adjustment for age, smoking, and other factors, women with the highest intake of dietary vitamin D (quintile median: 528 IU/d) had a significant 17% lower risk of early menopause than women with the lowest intake [quintile median: 148 IU/d; HR: 0.83 (95% CI: 0.72, 0.95); P-trend = 0.03]. Dietary calcium intake in the highest quintile (median: 1246 mg/d) compared with the lowest (median: 556 mg/d) was associated with a borderline significantly lower risk of early menopause (HR: 0.87; 95% CI: 0.76, 1.00; P-trend = 0.03). Associations were stronger for vitamin D and calcium from dairy sources than from nondairy dietary sources, whereas high supplement use was not associated with lower risk.Conclusions: Findings suggest that high intakes of dietary vitamin D and calcium may be modestly associated with a lower risk of early menopause. Further studies evaluating 25-hydroxyvitamin D concentrations, other dairy
Wang, Qin; Ferreira, Diana L Santos; Nelson, Scott M; Sattar, Naveed; Ala-Korpela, Mika; Lawlor, Debbie A
Women who experience menopause are at higher cardiometabolic risk and often display adverse changes in metabolic biomarkers compared with pre-menopausal women. It remains elusive whether the changes in cardiometabolic biomarkers during the menopausal transition are due to ovarian aging or chronological aging. Well-conducted longitudinal studies are required to determine this. The aim of this study was to explore the cross-sectional and longitudinal associations of reproductive status, defined according to the 2012 Stages of Reproductive Aging Workshop criteria, with 74 metabolic biomarkers, and establish whether any associations are independent of age-related changes. We determined cross-sectional associations of reproductive status with metabolic profiling in 3,312 UK midlife women. In a subgroup of 1,492 women who had repeat assessments after 2.5 years, we assessed how the change in reproductive status was associated with the changes in metabolic biomarkers. Metabolic profiles were measured by high-throughput quantitative nuclear magnetic resonance metabolomics. In longitudinal analyses, we compared the change in metabolic biomarkers for each reproductive-status category change to that of the reference of being pre-menopausal at both time points. As all women aged by a similar amount during follow-up, these analyses contribute to distinguishing age-related changes from those related to change in reproductive status. Consistent cross-sectional and longitudinal associations of menopause with a wide range of metabolic biomarkers were observed, suggesting the transition to menopause induces multiple metabolic changes independent of chronological aging. The metabolic changes included increased concentrations of very small very low-density lipoproteins, intermediate-density lipoproteins, low-density lipoproteins (LDLs), remnant, and LDL cholesterol, and reduced LDL particle size, all toward an atherogenic lipoprotein profile. Increased inflammation was suggested via
Full Text Available Adriana Coutinho de Azevedo Guimarães1, Fátima Baptista2 1Physical Education Department, Health and Sport Sciences Center, State University of Santa Catarina, Santa Catarina, Brazil; 2Exercise and Health Laboratory, Faculty of Human Movement, Technical University of Lisbon, Lisbon, Portugal Aim: To analyze the influence of the duration of habitual physical activity (PA on the symptoms of climacterium/menopause and on several domains of the health-related quality of life (QOL in middle-aged women. Methods: One hundred and four 45- to 59-year-old women were placed into three groups: group A, subjects who maintained PA less than 30 minutes/day; group B, subjects who maintained or began to perform PA 30–60 minutes/day; and group C, subjects who maintained or increased PA to more than 60 minutes/day. Symptoms of menopause, QOL (physical, psychological, and social, and PA were assessed through the Kupperman Menopausal Index, World Health Organization Quality of Life Brief Version questionnaire, and International Physical Activity Questionnaire, respectively. Results: The analysis of covariance (ANCOVA results, adjusted for age, initial body mass index, schooling years, hormonal replacement therapy, and the number of diseases, indicated that the women who maintained or increased their total habitual PA to more than 60 minutes/day had reduced symptoms of climacterium/menopause (-5.4 ± 0.5; P = 0.001 and improved QOL in the psychological (4.4% ± 0.8%; P = 0.001 and social domains (2.0% ± 0.9%; P = 0.035. ANCOVA revealed a further improvement of approximately 5% in the psychological domain of QOL in group C, who also experienced decreased menopause symptoms (P = 0.001 and lost weight (P = 0.009. Conclusion: The habitual practice of at least moderate-intensity PA for 60 minutes/day has a favorable effect on climacterium/menopause symptoms and on QOL, particularly on its psychological and social domains. The influence of habitual PA at the
Zhu, Xiaoshu; Liew, Yuklan; Liu, Zhao Lan
Background Chinese herbal medicine (CHM) usage is expected to increase as women suffering from menopausal symptoms are seeking alternative therapy due to concerns from the adverse effects (AEs) associated with hormone therapy (HT). Scientific evidence for their effectiveness and safety is needed. Objectives To evaluate the effectiveness and safety of CHM in the treatment of menopausal symptoms. Search methods We searched the Gynaecology and Fertility Group’s Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), MEDLINE, Embase, CINAHL, AMED, and PsycINFO (from inception to March 2015). Others included Current Control Trials, Citation Indexes, conference abstracts in the ISI Web of Knowledge, LILACS database, PubMed, OpenSIGLE database, and China National Knowledge Infrastructure database (CNKI, 1999 to 2015). Other resources included reference lists of articles as well as direct contact with authors. Selection criteria Randomised controlled trials (RCTs) comparing the effectiveness of CHM with placebo, HT, pharmaceutical drugs, acupuncture, or another CHM formula in women over 18 years of age, and suffering from menopausal symptoms. Data collection and analysis Two review authors independently assessed 864 studies for eligibility. Data extractions were performed by them with disagreements resolved through group discussion and clarification of data or direct contact with the study authors. Data analyses were performed in accordance with Cochrane Collaboration guidelines. Main results We included 22 RCTs (2902 women). Participants were from different ethnic backgrounds with the majority of Chinese origin. When CHM was compared with placebo (eight RCTs), there was little or no evidence of a difference between the groups for the following pooled outcomes: hot flushes per day (MD 0.00, 95% CI −0.88 to 0.89; 2 trials, 199 women; moderate quality evidence); hot flushes per day assessed by an overall hot
Garcia, Marcelo Csermak; Pompéia, Sabine; Hachul, Helena; Kozasa, Elisa H; de Souza, Altay Alves L; Tufik, Sergio; Mello, Luiz Eugênio A M
Mindfulness has been defined as being intentionally aware of internal and external experiences that occur at the present moment, without judgment. Techniques that develop mindfulness, such as meditation, have positive effects on reducing insomnia, a sleep disorder that is common both during and after menopause. Our aim was to establish whether postmenopausal women with insomnia are less mindful than postmenopausal women without sleep disorders. Postmenopausal women aged 50 to 65 years who did not use hormone therapy were recruited for the study. The sample included 14 women with insomnia and 12 women without insomnia or any other sleep disorder. The groups were comparable in age, schooling, and anxiety level. To assess mindfulness, we used the validated Mindful Attention Awareness Scale and the attentiveness domain of the Positive and Negative Affect Schedule-Expanded Form. Participants with insomnia were less mindful than healthy women. The level of mindfulness was able to discriminate the group with insomnia from the healthy group, with 71.4% accuracy. Postmenopausal women with insomnia are less mindful than women without insomnia. Mindfulness-based interventions, such as meditation, may be beneficial for postmenopausal insomnia.
MacGregor, E Anne
Migraine is most prevalent in women during their reproductive years. An understanding of the effects of menstruation and menopause on migraine can enable neurologists to provide targeted and appropriate medical and hormonal strategies, enabling their patients to achieve better control of migraine and reduced disability. This article reviews the effects of hormonal events on migraine and summarizes the evidence-based options available for management. Estrogen "withdrawal" during the late luteal phase of the natural menstrual cycle and the hormone-free interval of combined hormonal contraceptives has long been implicated in the pathophysiology of menstrual migraine. However, more recent research suggests that other independent mechanisms may be relevant. Prostaglandin inhibitors used for management of dysmenorrhea are effective for associated menstrual migraine, suggesting a common pathophysiology. The interplay between serotonin and estrogen also deserves further research. Menstrual and perimenopausal migraine can be managed effectively using a variety of strategies, the choice of which depends on the efficacy of acute treatment, predictability and regularity of menstruation, use of contraception, and presence of menstrual disorders or perimenopausal vasomotor symptoms.
Palumbo, A R; Fasolino, C; Santoro, G; Gargano, V; Rinaldi, M; Arduino, B; Belli, M; Guida, M
Vulvar and vaginal atrophy (VVA), is a chronic medical condition experienced by postmenopausal women, with prevalence estimated ranging from 10% to 50% . VVA is characterized by a constellation of symptoms, that may affect daily activities, sexuality, relationships, and quality of life . Early recognition and effective treatment of VVA may enhance sexual health and the quality of life of women and their partners. Some vulvar conditions such as lichen sclerosus are more prevalent in the postmenopausal years. Lichen sclerosus has been suggested as a precursor of Vulvar squamous cell carcinoma. The vulvar exam in post-menopausal women plays an essential role in prevention of cancer because it allows to identify women who should undergo vulvar skin biopsy in order to early detect pre-neoplastic lesions for early diagnosis of cancer of the vulva.
D. V Sadchikov
Full Text Available Objective: to study the efficiency of using small-dose estrogens as a component of remedial premedication. Subjects and materials. A hundred and ninety menopausal women were examined. All the patients were divided into a study group and a control one. Group 1 included patients with uterine myoma and menopausal syndrome, which was further divided into two subgroups: Subgroup A comprised patients who as a remedial premedication, along with the standard therapy, received hormonal therapy with oral estradiol in a dose of 2 mg once daily for 7 days. There were no contraindications to the use of these drugs in all the women from this subgroup. Postoperative estrogen therapy was continued in the above doses for a year (as recommended by the International Menopause Committee. Subgroup B consisted of 40 women with menopausal syndrome who received the standard conventional premedication and postoperative therapy. Group 2 included 70 patients with physiological menopause and uterine myoma. Studies were made when remedial premedication was given just before surgery and on discharge from hospital on days 7—8. Results. In the patients with the menopausal syndrome, the level of follicle-stimulating hormone (FSH was ascertained to be higher than that in women with normal menopause, the level of estradiol was accordingly lower. The differences found in the levels of hormones in the patients depending on the clinical course of a menopausal period allowed the use of hormonal replacement therapy with estradiol in the remedial premedication regimen as both etiologically and pathogenetically founded. On admission, the first stage of psychoemotional testing before remedial premedication revealed impairments of memory, attention, and thinking, as well as high anxiety in all the patients with myoma and menopausal syndrome. There was a significant reduction in long-term memory and memorization. Seven days after preoperative preparation using estradiol, 2 mg/day, there
Full Text Available BACKGROUND: Hormone therapy (HT in the menopause is still a tricky question among healthcare providers, women and mass media. Informing women about hormone replacement therapy was a Consensus Conference (CC organized in 2008: the project Know the Menopause has been launched to shift out the results to women and healthcare providers and to assess the impact of the cc's statement. METHODS: And Findings: The project, aimed at women aged 45-60 years, was developed in four Italian Regions: Lombardy, Tuscany, Lazio, Sicily, each with one Local Health Unit (LHU as "intervention" and one as "control". Activities performed were: survey on the press; training courses for health professionals; educational materials for target populations; survey aimed at women, general practitioners (GPs, and gynaecologists; data analysis on HT drugs' prescription. Local activities were: training courses; public meetings; dissemination on mass media. About 3,700 health professionals were contacted and 1,800 participated in the project. About 146,500 printed leaflets on menopause were distributed to facilitate the dialogue among women and health care professionals. Training courses and educational cascade-process activities: participation ranged 25- 72% of GPs, 17-71% of gynaecologists, 14-78% of pharmacists, 34-85% of midwives. SURVEY: 1,281 women interviewed. More than 90% believed menopause was a normal phase in life. More than half did not receive information about menopause and therapies. HT prescription analysis: prevalence fell from 6% to 4% in five years. No differences in time trends before-after the intervention. Major limitations are: organizational difficulties met by LHU, too short time for some local activities. CONCLUSIONS: A huge amount of information was spread through health professionals and women. The issue of menopause was also used to discuss women's wellbeing. This project offered an opportunity to launch a multidisciplinary, multimodal approach to
Kim, Min-Ju; Cho, Juhee; Ahn, Younjhin; Yim, Gyeyoon; Park, Hyun-Young
Physical activity may be an effective way of preventing or attenuating menopause-related symptoms, and it has been shown to improve quality of life in menopausal women. However, there have been some inconsistencies regarding between exercise and menopausal symptoms, and study investigating this association has been scarce in Korea. In this study, the association between physical activity and menopausal symptoms in perimenopausal women in Korea was assessed. This cross-sectional observational study was conducted between November 2012 and March 2013. In total, 2,204 healthy women aged 44-56 years were recruited from a healthcare center at the Kangbuk Samsung hospitals for investigating women's attitudes towards menopause. To investigate the influence of physical activity on perimenopause-associated symptoms, 631 perimenopausal women were selected for this study. Their physical activity levels were assessed using the International Physical Activity Questionnaire (IPAQ) short form. The Menopause-specific Quality of Life (MENQOL) questionnaire was used to assess menopause-related symptoms. The study participants were, on average, 48.5 ± 2.7 years old and had a mean body mass index of 22.8 ± 3.1 kg/m2. The total MENQOL score and the psychosocial and physical subscores exhibited U-shaped trends in relation to the level of physical activity. Multiple linear regression analysis adjusted for confounding variables showed that perimenopausal women who performed moderate physical activity reported significantly lower psychosocial (β = -0.413, P = 0.012) and physical symptoms (β = -0.445, P = 0.002) than women who performed low physical activity. By contrast, a high level of physical activity did not influence the MENQOL total score and subscores relative to the low activity group. In addition, no associations were observed between physical activity and the vasomotor and sexual symptoms in any group. Moderate level of physical activity was associated
, more so in our ... indication that menopause is an independent risk factor for developing cardiovascular disease in our environment. Key Words: Menopause, Dyslipidemia, Cholesterol ... determinative influence on the concentration of.
Becht, M.C.; van Erp, C.F.; Teeuwisse, T.M.; van Heck, G.L.; van Son, M.J.; Pop, V.J.M.
Background: The relationship between menopause and depression is still rather unclear. Studies using different methodology especially those lacking a clear definition of depression are hardly comparable. Since the Edinburgh Depression Scale (EDS) is not influenced by (menopause-related) somatic
Shifren, Jan L; Schiff, Isaac
There are many options available to address the quality of life and health concerns of menopausal women. The principal indication for hormone therapy (HT) is the treatment of vasomotor symptoms, and benefits generally outweigh risks for healthy women with bothersome symptoms who elect HT at the time of menopause. Although HT increases the risk of coronary heart disease, recent analyses confirm that this increased risk occurs principally in older women and those a number of years beyond menopause. These findings do not support a role for HT in the prevention of heart disease but provide reassurance regarding the safety of use for hot flushes and night sweats in otherwise healthy women at the menopausal transition. An increased risk of breast cancer with extended use is another reason short-term treatment is advised. Hormone therapy prevents and treats osteoporosis but is rarely used solely for this indication. If only vaginal symptoms are present, low-dose local estrogen therapy is preferred. Contraindications to HT use include breast or endometrial cancer, cardiovascular disease, thromboembolic disorders, and active liver disease. Alternatives to HT should be advised for women with or at increased risk for these disorders. The lowest effective estrogen dose should be provided for the shortest duration necessary because risks increase with increasing age, time since menopause, and duration of use. Women must be informed of the potential benefits and risks of all therapeutic options, and care should be individualized, based on a woman's medical history, needs, and preferences.
Geukes, Marije; van Aalst, Mariëlle P; Nauta, Mary C E; Oosterhof, Henk
Menopause is an important life event that may have a negative influence on quality of life. Work ability, a concept widely used in occupational health, can predict both future impairment and duration of sickness absence. The aim of this study was to examine the impact of menopausal symptoms on work ability. This was a cross-sectional study that used a sample of healthy working Dutch women aged 44 to 60 years. Work ability was measured using the Work Ability Index, and menopausal symptoms were measured using the Greene Climacteric Scale. Stepwise multiple linear regression models were used to examine the relationship between menopausal symptoms and work ability. A total of 208 women were included in this study. There was a significant negative correlation between total Greene Climacteric Scale score and Work Ability Index score. Total Greene Climacteric Scale score predicted 33.8% of the total variance in the Work Ability Index score. Only the psychological and somatic subscales of the Greene Climacteric Scale were significant predictors in multiple linear regression analysis. Together, they accounted for 36.5% of total variance in Work Ability Index score. Menopausal symptoms are negatively associated with work ability and may increase the risk of sickness absence.
Full Text Available Menopause, with its physical and emotional changes, appears to be an inevitable road for women to travel. The moment of choice for women at menopause involves not only whether they will embrace the new self or try to cling to identities from earlier life but also how the society in which they live views women after menopause. Amongst other things, many African marriages face difficulties when the moment of menopause arrives. This situation is often characterised by a second marriage or a situation where husband and wife no longer share a room. Whenever this happens, it testifies to the idea that the sole purpose of marriage amongst African people is procreation – hence, when the period for that is passed, the bedroom setup changes. This is one of the ways in which senior women are deemed unfit for sexual encounters, a gender-equality concern. This article aims to unveil and discuss how some Africans use menopause as an excuse to exclude women from sexual intercourse, and how pastoral caregivers can help in such situations.
Full Text Available Sex hormones strongly influence body fat distribution and adipocyte differentiation. Estrogens and testosterone differentially affect adipocyte physiology, but the importance of estrogens in the development of metabolic diseases during menopause is disputed. Estrogens and estrogen receptors regulate various aspects of glucose and lipid metabolism. Disturbances of this metabolic signal lead to the development of metabolic syndrome and a higher cardiovascular risk in women. The absence of estrogens is a clue factor in the onset of cardiovascular disease during the menopausal period, which is characterized by lipid profile variations and predominant abdominal fat accumulation. However, influence of the absence of these hormones and its relationship to higher obesity in women during menopause are not clear. This systematic review discusses of the role of estrogens and estrogen receptors in adipocyte differentiation, and its control by the central nervous systemn and the possible role of estrogen-like compounds and endocrine disruptors chemicals are discussed. Finally, the interaction between the decrease in estrogen secretion and the prevalence of obesity in menopausal women is examined. We will consider if the absence of estrogens have a significant effect of obesity in menopausal women.
Takahashi, Mike; Singh, Rama S; Stone, John
A complete and compelling evolutionary explanation for the origin of human menopause is wanting. Menopause onset is defined clinically as the final menses, confirmed after 1 year without menstruation. The theory proposed herein explains at multiple levels - ultimately genetic but involving (1) behavioral, (2) life history, and (3) social changes - the origin and evolution of menopause in women. Individuals in Lower Paleolithic human populations were characterized by short lifespans with diminished late-age survival and fertility, similar to contemporary chimpanzees, and thence were subject to three changes. (1) A mating behavior change was established in which only young women reproduced, thereby rendering as effectively neutral female-specific late-onset fertility-diminishing mutations, which accumulated subsequently. (2) A lifespan increase was manifested adaptively, revealing the reproductive senescence phenotype encoded in late-onset fertility-diminishing mutation genotypes, which, heretofore, had been unexpressed in the shorter lifespan. (3) A social interaction change emerged exaptively, when older non-reproductive women exclusively started assisting in rearing grandchildren rather than giving birth to and caring for their own children, ultimately leading to menstrual cycle cessation. The changes associate in a one-to-one manner with existing, non-mutually exclusive hypotheses for the origin of human menopause. Evidence for each hypothesis and its associated change having occurred are reviewed, and the hypotheses are combined in a synthetic theory for the origin of human menopause. The new theory simultaneously addresses the main theoretical problem with each hypothesis and yields predictions for future testing.
Gonçalves, Jaqueline Teixeira Teles; Silveira, Marise Fagundes; Campos, Maria Cecília Costa; Costa, Lúcia Helena Rodrigues
This study aims to check the association between overweight and obesity and sociodemographic, behavioral and clinical factors in menopausal women. A cross-sectional study of a sample of 253 menopausal women who answered questions about socioeconomic and demographic factors, health in general, eating habits and behaviors. Body-mass index (BMI) was used to assess participant nutritional status. The Menopause Rating Scale (MRS) was used to assess quality of life. To assess sexual performance we used SQ-F (Sexual Quotient, Female Version). We used bivariate analysis and hierarchical multiple regression to identify the factors associated with being overweight during menopause. Using BMI we found that 30.8% of the sample was overweight and 35.2% obese, totaling 66% overweight women in the sample. In the multiple analysis, not owning a home, the severity of symptoms using MRS, use of continuous use medication and having been on any type of diet were associated with being overweight or obese. Nutritional intervention for weight control and changing behaviors could produce considerable benefits in terms of the health and quality of life of menopausal women.
Lizcano, Fernando; Guzmán, Guillermo
Sex hormones strongly influence body fat distribution and adipocyte differentiation. Estrogens and testosterone differentially affect adipocyte physiology, but the importance of estrogens in the development of metabolic diseases during menopause is disputed. Estrogens and estrogen receptors regulate various aspects of glucose and lipid metabolism. Disturbances of this metabolic signal lead to the development of metabolic syndrome and a higher cardiovascular risk in women. The absence of estrogens is a clue factor in the onset of cardiovascular disease during the menopausal period, which is characterized by lipid profile variations and predominant abdominal fat accumulation. However, influence of the absence of these hormones and its relationship to higher obesity in women during menopause are not clear. This systematic review discusses of the role of estrogens and estrogen receptors in adipocyte differentiation, and its control by the central nervous systemn and the possible role of estrogen-like compounds and endocrine disruptors chemicals are discussed. Finally, the interaction between the decrease in estrogen secretion and the prevalence of obesity in menopausal women is examined. We will consider if the absence of estrogens have a significant effect of obesity in menopausal women.
Maria Angela Boccara de Paula
Full Text Available OBJECTIVE: Identify the Social Representations (SR of ostomized people in terms of sexuality after the stoma. METHODS: An exploratory, descriptive, qualitative study using the Social Representation Theory with 15 ostomized people (8 females, mean age of 57.9 years, between August and September 2005. Data obtained from transcribed interviews were submitted to content analysis, resulting in the thematic unit "Giving new meaning to sexuality" and subthemes. RESULTS: The study demonstrated that the intestinal stoma interferes in the sexuality experience, showing that the meanings attributed to this experience are based on individual life stories, quality of personal relationships established in practice and perception of sexuality, despite the stoma. CONCLUSIONS: The Social Representations, in terms of experiencing sexuality after the stoma, are based on meanings attributed to the body, associated with daily life and present in the social imaginary. It is influenced by other factors, such as physiological changes resulting from the surgery and the fact of having or not a partner. Care taken during sexual practices provide greater security and comfort in moments of intimacy, resembling the closest to what ostomized people experienced before the stoma. The self-irrigation technique associated or not with the use of artificial occluder, has been attested by its users as a positive element that makes a difference in sexual practice after the stoma. The support to ostomized people should be comprehensive, not limited to technical care and disease, which are important, but not sufficient. The interdisciplinary health team should consider all aspects of the person, seeking a real meeting between subjects.OBJETIVO: Identificar as Representações Sociais (RS da pessoa estomizada intestinal sobre vivência da sexualidade após confecção do estoma. MÉTODOS: Estudo exploratório, descritivo, qualitativo do ponto de vista do referencial da Representa
Bener, A; Rizk, D E; Shaheen, H; Micallef, R; Osman, N; Dunn, E V
The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction questionnaire for the postmenopausal period, in the United Arab Emirates (UAE). A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires were used and face-to-face interviews were performed. The study was based in primary health-care clinics in Al Ain City, Sharjah and Dubai Emirates, UAE. A multistage sampling design was used, and a representative sample of 450 UAE females aged 45 years and above were included during January-April 1999. Of the 450 women living in both urban and rural areas, 390 women agreed to participate (86.7%) and responded to the study. The mean age and standard deviation (SD) of the subjects was 56.5 +/- 6.6 years, and the median age of natural menopause in the present study was 48 years (mean +/- SD 48.4 +/- 3.8). The rate of consanguinous marriages in the sample was found to be 47.2%. The most common disease was found to be diabetes mellitus (10.3%), followed by osteoarthritis (7.7%), hypertension (7.2%) and asthma (6.2%), but the majority of subjects (68.7%) had no specific disease. Out of 29 possible symptoms, the mean number of symptoms was 7.57 (range 0-24). The most frequent symptom was 'aches in the back of the neck or head' at 46.4% followed by 'aches in the muscles/joints' at 34.6%. The least reported symptom was 'facial hair' at 15.9%. Increasing education resulted in more symptoms reported, and increasing parity resulted in fewer symptoms reported. In the present study, it was found that employed women experienced more symptoms and disorders. Of the total sample, 28.5% of the subjects reported no symptoms. In the four domains, 69% reported physical symptoms, 58.7% reported psychosocial symptoms, 40% reported vasomotor symptoms and 37.9% reported sexual symptoms. Spearman's rank correlation coefficient indicated that
Gibbons, Christopher H; Freeman, Roy
Treatment-induced neuropathy in diabetes (also referred to as insulin neuritis) is considered a rare iatrogenic small fibre neuropathy caused by an abrupt improvement in glycaemic control in the setting of chronic hyperglycaemia...
Monterrosa-Castro, Álvaro; Durán-Méndez, Leidy Carolina; Salguedo-Madrid, Marlon
Introduction: the menopausal manifestations should be studied by ethnic considerations. Objective: to identify the most prevalent menopausal manifestations and to evaluate quality of life according to menstrual states. Methods: this study is a part of CAVIMEC [Quality of Life in Menopause and Colombian Ethnic Groups], performed with Cervantes Scale, which evaluates CV in menopause, in 646 Afro-Colombians, aged 40-59 years, living in populations of the Caribbean and Pacific. Results: mean age ...
Tal, Joshua Z.; Suh, Sooyeon A.; Dowdle, Claire L.; Nowakowski, Sara
Understanding sleep complaints among menopausal women is an emerging area of clinical and research interest. Several recent reviews have focused on mechanisms of menopausal insomnia and symptoms. In this review, we present a discussion on the most relevant and recent publications on the treatment of sleep disorders for menopausal women, with a focus on menopause-related insomnia, insomnia symptoms, and obstructive sleep apnea. We discuss both nonpharmacological and pharmacological treatments,...
Conclusion: This study indicated that the use of lavender aromatherapy reduced menopause flushing. Given the impact of stress on flushing and the undesirable effects of menopause symptoms on the quality of life, it would appear that this simple, noninvasive, safe, and effective method can be used by menopausal women with noticeable benefits.
Brand, J. S.; Onland-Moret, N. C.; Eijkemans, M. J C; Tjønneland, A.; Roswall, N.; Overvad, K.; Fagherazzi, G.; Clavel-Chapelon, F.; Dossus, L.; Lukanova, A.; Grote, V.; Bergmann, M. M.; Boeing, H.; Trichopoulou, A.; Tzivoglou, M.; Trichopoulos, D.; Grioni, S.; Mattiello, A.; Masala, G.; Tumino, R.; Vineis, P.; Bueno-De-Mesquita, H. B.; Weiderpass, E.; Redondo, M. L.; Sánchez, M. J.; Castaño, J. M Huerta; Arriola, L.; Ardanaz, E.; Duell, E. J.; Rolandsson, O.; Franks, P. W.; Butt, S.; Nilsson, P.; Khaw, K. T.; Wareham, N.; Travis, R.; Romieu, I.; Gunter, M. J.; Riboli, E.; Van Der Schouw, Y. T.
STUDY QUESTION Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate
Som, N; Roy, P; Ray, S
To find out the association of menopause-specific quality of life of women with menopausal status. In this cross-sectional study, we involved 250 Bengali-speaking women of Hindu ethnic group (118 perimenopausal and 132 postmenopausal), aged 40-65 years from urban areas of North 24 Paraganas, a district of West Bengal, India. The Menopause-Specific Quality of Life questionnaire (MENQOL) consisting of 29 menopausal symptoms, grouped under four menopausal domains (vasomotor, psychosocial, physical and sexual), was used to assess menopause-specific quality of life. Scores of four menopausal domains generated a composite score of 'Quality of Life'. Additionally, participants were also interviewed for their sociodemographic characteristics. Bivariate analyses showed significant difference in all the domains of menopause-specific quality of life (barring vasomotor domain) when compared for menopausal status. Results of ANCOVA showed that menopausal status was significantly associated only with the physical domain after removing the effects of sociodemographic characteristics. Menopausal status had a significant association with the physical domain of menopause-specific quality of life of women.
Will, Constance I; Fowles, Willa
Many women are turning to herbal, homeopathic, dietary, and other complementary therapies for relief of stressful aspects of menopause. Several questions related to complementary therapy use are not, however, well addressed in current research literature. Why do women seek out complementary therapies? Which therapies do they choose and why? What is the nature of their experiences using complementary therapies? In this qualitative study, 19 Caucasian women, who identified themselves as using or having used complementary therapies during menopause were interviewed in one of four focus groups. Findings revealed a wide variety of therapies, such as vitamin, mineral, and herbal preparations and lifestyle and behavioral initiatives, used to address distressing aspects of menopause. Also identified was lack of family and professional support for women who are seeking complements or alternatives to conventional treatment.
Sievert, Lynnette Leidy; Goode-Null, Susan K
Worldwide, complaints of musculoskeletal pain are more frequent than complaints of hot flashes amongst women of menopausal age. The purpose of this study was to examine musculoskeletal pain among women of menopausal age in the city of Puebla, Mexico. An opportunity sample was recruited from public parks and markets, with representation from all social classes (n=755). Mean age was 50.1 years, and the majority were employed as saleswomen in small businesses. Symptom frequencies were collected by open-ended interviews and with a structured symptom list that queried symptom experience during the two weeks prior to interview. In response to open-ended questions, "dolores de huesos" (bone pain) was volunteered by 47% of respondents as a symptom associated with menopause, second only to hot flashes (53%). From the structured symptom list, 55.8% and 55.6% reported back pain and joint stiffness during the two weeks prior to interview. Women with back pain and joint stiffness were less likely to report being active during their leisure time (p<.01). The results of backwards stepwise logistic regressions indicate that women with back pain were more likely to be older, with less education, a higher BMI, and ate less meat. Women with joint pain were more likely to be post-menopausal, with less education, more children, a higher BMI, and were likely to drink milk and coffee more than once/week but less than once/day. While menopause is not necessarily a risk factor for musculoskeletal pain, it is important to recognize the pervasiveness of this complaint among women of menopausal age.
Lampio, Laura; Polo-Kantola, Päivi; Himanen, Sari-Leena; Kurki, Samu; Huupponen, Eero; Engblom, Janne; Heinonen, Olli J; Polo, Olli; Saaresranta, Tarja
Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition. Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models. After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B -37.4, 95% confidence interval [CI] -71.5 to (-3.3)), lower sleep efficiency (B -6.5, 95%CI -12.7 to (-0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95%CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95%CI 12.5 to 63.0), awakenings per hour (B 1.8, 95%CI 0.8 to 2.8), and arousal index (B 2.3, 95%CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95%CI 0.01 to 0.16) after controlling for confounding factors. A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS.
Monterrosa-Castro, A; Blümel, J E; Portela-Buelvas, K; Mezones-Holguín, E; Barón, G; Bencosme, A; Benítez, Z; Bravo, L M; Calle, A; Chedraui, P; Flores, D; Espinoza, M T; Gómez, G; Hernández-Bueno, J A; Laribezcoa, F; Lima, S; Martino, M; Mostajo, D; Ojeda, E; Onatra, W; Sánchez, H; Navarro, D; Tserotas, K; Vallejo, M S; Witis, S; Zuñiga, M C
Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confidence interval (CI) 3.47-5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22-1.94), hormonal therapy (OR 1.46; 95% CI 1.11-1.92), ≥ 50 years of age (OR 1.48; 95% CI 1.17-1.86), overweight or obese (OR 1.47; 95% CI 1.15-1.89), and waist circumference ≥ 88 cm (OR 1.32; 95% CI 1.06-1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35-0.87), alcohol (OR 0.73; 95% CI 0.54-0.98) and living in cities > 2500 meters above sea level (OR 0.70; 95% CI 0.53-0.91) or with high temperatures (OR 0.67; 95% CI 0.51-0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age.
Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert
INTRODUCTION: Around 75% of menopausal women experience hot flushes (HF) and 10-20% of all postmenopausal women find this very distressing. The aim of this study is to evaluate the efficacy of acupuncture on moderate-to-severe menopausal symptoms in general and HF in particular. METHODS: An un......-blinded randomised trial (cross-over) with 1:1 allocation to early (intervention) versus late (control) acupuncture. The included women suffer from moderate-to-severe HF and will receive a weekly treatment during five consecutive weeks in the following predefined acupuncture points: CV-3, CV-4, LR-8, SP-6, SP-9. All...
Full Text Available The pineal hormone Melatonin plays an important role in the regulation of the circadian sleep/wake cycle, mood, and perhaps immune functions, carcinogensis and reproduction. The human circadian rhythm of melatonin release from the pineal gland is tightly synchronized with the habitual hours of sleep. Peri- and postmenopausal women often complain of difficulties initiating and/or maintaining sleep, with frequent nocturnal and early morning awakenings. In this review we discuss the pathophysiology of melatonin function as it relates to sleep disorders in menopausal women, highlighting the potential use of exogenous melatonin during the menopausal transition and beyond.
Full Text Available Background Polycystic ovary syndrome (PCOS is a relatively widespread disease and a main cause of fertility problems. The disease diagnosis is frequently related to changes in the value hierarchy. However, it can be treated as a “loss of/threat to” femininity. Similar aspects of the loss of part of femininity are connected with menopause and mastectomy. Participants and procedure One hundred and forty-five women were examined in total: 42 with the PCOS diagnosis, 20 after mastectomy, 42 in menopause and 41 healthy women (reference group. Standard measurement methods were used: the Value Crisis Questionnaire by P. Oleś and the IPAT Anxiety Scale – Self Analysis Form by R. B. Cattell. Results Women suffering from PCOS obtained significantly higher indexes of both crisis and anxiety compared to other groups, whereas women after mastectomy and in menopause did not differ between one another in tested variables, and they did not differ from healthy women either. It was noted that the most relationships between variables were observed in the group of women in menopause (significant correlations between almost all dimensions, while there are few relationships in women after mastectomy. In women with PCOS (a relatively small number of correlations relationships of the greatest strength relate to the relationships of negative self-esteem and guilt proneness with all dimensions of the value crisis. Conclusions Polycystic ovary syndrome, despite having a relatively non-threatening course, is experienced much more strongly by women compared to mastectomy and menopause. It is associated with strong internal anxiety and degradation of the value hierarchy.
Dasgupta, Shruti; Salman, Mohammed; Lokesh, S.; Xaviour, D.; Saheb, S. Yaseen; Prasad, B. V. Ravi; Sarkar, Biswanath
Context: Increased incidences of cardiovascular disorder and metabolic syndrome particularly after menopause have raised curiosity for the underlying factors. However, it is still a debate whether age or menopausal transition is a greater contributor. Aims: To elucidate the inter-relationships of age, menopause, and associated obesity and to assess their independent effects on aggravation of cardio metabolic risk factors in postmenopausal women. Settings and Design: Four hundred two women aged between 30 and 75 years were recruited in a cross-sectional study from Southern India. Three hundred sixteen participants exempting exclusion criteria, comprising of 169 premenopausal and 147 postmenopausal women were finally included. Materials and Methods: Anthropometric measurements such as weight, height, waist circumference (WC), hip circumference (HC), fat percentage, basal metabolic rate (BMR), and blood pressure were taken. Fasting plasma glucose, postprandial glucose, glycated hemoglobin (HbA1c), lipid profile, and C-reactive protein (CRP) were also measured. Statistical Analysis Used: Independent t-test, Analysis of covariates (ANCOVA), Pearson's correlation coefficients and multiple stepwise linear regression model analysis were done. Results: A significant increase in physical and metabolic factors was observed in postmenopausal women compared to premenopausal women except WC and HbA1c. Contrastingly, high-density lipoprotein cholesterol (HDL) levels and BMR were significantly decreased. After adjusting for BMI and age, the significant differences in the variables through the menopausal transition persisted, including an increase in WC. Significant correlation was observed between age and measures of general obesity such as BMI (P < 0.05) and fat percentage (P < 0.001) but not with central obesity indices. Menopausal status and WC exerted an independent effect on most of the metabolic risk factors (P < 0.001 or P < 0.01). Fat percentage was the predicting variable
Sayakhot, Padaphet; Vincent, Amanda; Teede, Helena
The aim of this study was to describe the partners' perceptions, understanding, and personal experiences of early menopause and menopausal therapy in women with breast cancer. A questionnaire study was completed by 50 partners of women with diagnoses of breast cancer, recruited via outpatient clinics and the community. Descriptive statistics and χ tests were applied. Most (68%) of the partners perceived hot flushes as the meaning of menopause. Most (60%) partners perceived that loss of sexuality was the key problem/fears about being menopausal. Partners perceived that exercise (72%) and reducing stress (64%) were most effective in alleviating symptoms of menopause. Most partners reported that they did not understand the risks/benefits of hormone therapy (50%), bioidentical hormones (90%), and herbal therapies (84%). The general practitioner was considered the best source of information on menopause (68%). Partners expected menopause to affect a women's everyday life and relationships with family and partner and, particularly, to cause intermittent stress on the relationship (66%) and to decrease libido or sexual interest (64%). Forty-four percent of partners reported that there was some difficulty in communication/discussion about menopause with family and partners. This pilot study highlights (1) the lack of understanding of menopause and menopausal therapies that partners of women with breast cancer have, (2) the personal experience of having a female partner with breast cancer, and (3) the partners' attitudes and responses toward menopause in women with breast cancer.
Rangel-Zuñiga, Oriol A; Cruz-Teno, Cristina; Haro, Carmen; Quintana-Navarro, Gracia M; Camara-Martos, Fernando; Perez-Martinez, Pablo; Garcia-Rios, Antonio; Garaulet, Marta; Tena-Sempere, Manuel; Lopez-Miranda, Jose; Perez-Jimenez, Francisco; Camargo, Antonio
Menopause is characterized by the depletion of estrogen that has been proposed to cause oxidative stress. Circadian rhythm is an internal biological clock that controls physiological processes. It was analyzed the gene expression in peripheral blood mononuclear cells and the lipids and glucose levels in plasma of a subgroup of 17 pre-menopausal women, 19 men age-matched as control group for the pre-menopausal women, 20 post-menopausal women and 20 men age-matched as control group for the post-menopausal women; all groups were matched by body mass index. Our study showed a decrease in the expression of the oxidative stress-related gene GPX1, and an increase in the expression of SOD1 as consequence of menopause. In addition, we found that the circadian rhythm-related gene PER2 decreased as consequence of menopause. On the other hand, we observed a decrease in the expression of the oxidative stress-related gene GPX4 and an increase in the expression of CAT as a consequence of aging, independently of menopause. Our results suggest that the menopause-induced oxidative stress parallels a disruption in the circadian clock in women, and part of the differences in oxidative stress observed between pre- and post-menopausal women was due to aging, independent of menopause. Clinical Trials.gov.Identifier: NCT00924937. Copyright © 2017 Elsevier B.V. All rights reserved.
Gracia, Clarisa R; Freeman, Ellen W; Sammel, Mary D; Lin, Hui; Nelson, Deborah B
Data are lacking on the effects of obesity and race on inhibin B levels during the menopause transition. The purpose of this study was to determine the relationship among inhibin B levels, body mass index (BMI), and race during the menopause transition. In the Penn Ovarian Aging Study, a prospective cohort study of reproductive aging, 436 women aged 35 to 47 years were followed up with serial hormones, anthropometric measures, and questionnaires for 6 years. Univariate and multivariable analyses were performed comparing mean log transformed inhibin B levels among menopause stages, age groups, BMI categories, races, and smoking groups. In the univariate analyses, mean inhibin B levels were negatively associated with menopause stage, age, and BMI, but not significantly with race or smoking. Interactions of menopause status and BMI were significant (P menopause stage. These data provide additional evidence that obesity influences hormones during the menopause transition.
To investigate menopausal symptoms in women aged 40 - 49 using injectable contraceptives depot-medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN) or combined oral contraceptives (COCs), compared with non-users of hormonal contraception. Methods. Women using DMPA (N=127), NET-EN ...
Lee, M S; Shin, B-C; Ernst, E
To assess the effectiveness of acupuncture as a treatment option for menopausal hot flushes. We have searched the literature using 17 databases from inception to October 10, 2008, without language restrictions. We included randomized clinical trials (RCTs) of acupuncture versus sham acupuncture. Their methodological quality was assessed using the modified Jadad score. In total, six RCTs could be included. Four RCTs compared the effects of acupuncture with penetrating sham acupuncture on non-acupuncture points. All of these trials failed to show specific effects on menopausal hot flush frequency, severity or index. One RCT found no effects of acupuncture on hot flush frequency and severity compared with penetrating sham acupuncture on acupuncture points that are not relevant for the treatment of hot flushes. The remaining RCT tested acupuncture against non-penetrating acupuncture on non-acupuncture points. Its results suggested favorable effects of acupuncture on menopausal hot flush severity. However, this study was too small to generate reliable findings. Sham-controlled RCTs fail to show specific effects of acupuncture for control of menopausal hot flushes. More rigorous research seems warranted.
different racial groups and cultures report differential attitudes towards menopause (Im, Lee, Chee, Dormire , & Brown, 2010; Sommer et al., 1999). There...Counseling & Development 83(1), 48 - 56. Im, E. O., Lee, B., Chee, W., Dormire , S., & Brown, A. (2010). A national multiethnic online forum study on
Reproductive Health is usually focused upon women in their reproductive years, but this does not include girls who have not begun procreation nor women who are past the age of reproduction. In this paper, we focus attention upon women in menopause, realizing that they form a significant proportion of the female ...
Nov 13, 2014 ... a condition designed by nature and regarded as a normal part of aging; it should not be taken as some sort of ... Objectives: The purpose of this study was to explore perceptions of menopause and aging amongst ...... consequences of estrogen deficiency, effects of hormone replacement therapy, treatment ...
The association of depression status with menopause symptoms among rural midlife women in China. Hongyan Zang1, Lianping He2 , Yan Chen2, Jianfeng Ge2, Yingshui Yao2. 1. Hongyan Zang, Women's health department, Yancheng Maternal and Child Health Hospital,. Yancheng 224400, Jiangsu, People's Republic ...
and occupation. However, there is no evidence that the age at menopause has fallen in recent decades, even though the average parity in developed populations has dropped dramatically over this period. It is therefore possible that potential fertility is a confounding variable in the relationship between parity...
Boldsen, J L; Jeune, B
We analyzed the distribution of reported age at natural menopause in two random samples of Danish women (n = 176 and n = 150) to determine the shape of the distribution and to disclose any possible trends in the distribution parameters. It was necessary to correct the frequencies of the reported ...
Elavsky, Steriani; McAuley, Edward
The present study examined the relationships among physical activity (PA), symptom reporting, self-esteem, and satisfaction with life (SWL) in 133 women (M age=51.12, S.D.=4.10) of varying menopausal status. Multivariate analyses of co-variance (MANCOVA) revealed that independent of menopausal status, women who were more physically active reported significantly less severe vaso-somatic and general somatic symptoms, and higher levels of physical self-worth (PSW). Subsequent hierarchical regression analyses indicated that expended MET-h/week, reported symptoms (frequency and severity, respectively), and PSW accounted for significant variance in SWL (R2 model=0.32, for symptom frequency, and 0.33, for symptom severity). Physical activity was significantly related to SWL through the mediation of PSW. However, both reported symptom frequency and severity retained significant association with SWL after controlling for PSW, although the original associations were significantly reduced. Finally, both symptoms and MET-h/week were independent contributors to the variance in PSW (R2 model=0.33 and 0.34). The results suggest that being physically active may reduce perceived severity of menopausal symptoms and enhance psychological well-being, and that the relationship between physical activity and QOL in mid-life women may be mediated by factors such as physical self-perceptions and menopausal symptoms.
Mishra, Nalini; Mishra, V N; Devanshi
With a significant number of women belonging to the status of menopause and beyond, it is imperative to plan a comprehensive health program for them, including lifestyle modifications. Exercise is an integral part of the strategy. The benefits are many, most important being maintenance of muscle mass and thereby the bone mass and strength. The exercise program for postmenopausal women should include the endurance exercise (aerobic), strength exercise and balance exercise; it should aim for two hours and 30 minutes of moderate aerobic activity each week. Every woman should be aware of her target heart rate range and should track the intensity of exercise employing the talk test. Other deep breathing, yoga and stretching exercises can help to manage the stress of life and menopause-related symptoms. Exercises for women with osteoporosis should not include high impact aerobics or activities in which a fall is likely. The women and the treating medical practitioner should also be aware of the warning symptoms and contraindications regarding exercise prescription in women beyond menopause. The role of exercise in hot flashes, however, remains inconclusive. Overall, exercising beyond menopause is the only noncontroversial and beneficial aspect of lifestyle modification and must be opted by all.
Mishra, Nalini; Mishra, V. N.; Devanshi
With a significant number of women belonging to the status of menopause and beyond, it is imperative to plan a comprehensive health program for them, including lifestyle modifications. Exercise is an integral part of the strategy. The benefits are many, most important being maintenance of muscle mass and thereby the bone mass and strength. The exercise program for postmenopausal women should include the endurance exercise (aerobic), strength exercise and balance exercise; it should aim for two hours and 30 minutes of moderate aerobic activity each week. Every woman should be aware of her target heart rate range and should track the intensity of exercise employing the talk test. Other deep breathing, yoga and stretching exercises can help to manage the stress of life and menopause-related symptoms. Exercises for women with osteoporosis should not include high impact aerobics or activities in which a fall is likely. The women and the treating medical practitioner should also be aware of the warning symptoms and contraindications regarding exercise prescription in women beyond menopause. The role of exercise in hot flashes, however, remains inconclusive. Overall, exercising beyond menopause is the only noncontroversial and beneficial aspect of lifestyle modification and must be opted by all. PMID:22408332
van Beek, André P.; de Ruijter-Heijstek, Florianne C.; Erkelens, D. Willem; de Bruin, Tjerk W.A.
Deficiency of endogenous estrogens has been associated with a higher incidence of coronary heart disease (CHD) in women. We investigated whether natural menopause is associated with reduced protection from postprandial lipemia, which represents a risk indicator of CHD. Twenty-three postmenopausal
Premature menopause affects 1% of women under the age of 40 years. The women are at risk of premature death, neurological diseases, psychosexual dysfunction, mood disorders, osteoporosis, ischemic heart disease and infertility. There is need to use simplified protocols and improved techniques in oocyte donation to ...
... menopause may mean making some changes in the way you live. Don't smoke. If you do use any type of tobacco, stop—it's never too late to benefit from quitting smoking. Eat a healthy diet, low in fat, high in fiber, with plenty of fruits, vegetables, ...
been translated into about 15 languages. This questionnaire has been used in several interventional and observational studies.[11-15] The MENQOL was modified by Lewis et al.,. Cross Cultural Adaptation of the Menopause Specific. Questionnaire into the Persian Language. Ghazanfarpour M, Kaviani M1, Rezaiee ...
Background: Postmenopausal bleeding is an alarming sign that may be associated with uterine malignancy. In recent years about 60% of women with post menopausal bleeding are said to have no organic cause in developed countries. There is no data concerning about this issue in Ethiopia. Objective: To determine ...
Oral health is an integral part of general health. Menopausal period has an important role in the reproductive life of a woman and gives rise to many physical and mental problems. The oral manifestations may vary for each patient in the form of burning mouth syndrome, xerostomia, mucosal changes, neurological disorders, ...
Martínez Pérez, J A; Palacios, S; Chavida, F; Pérez, M
To assess whether the severity of menopausal symptoms is related to increased cardiovascular and osteoporosis risk factors, and to determine whether women with more severe menopausal symptoms present a greater percentage of osteoporosis disease. This was a cross-sectional, descriptive study encompassing women aged 45-65 years in the whole Spanish territory. The study population sample was collected through random sampling. A total of 10 514 women were included. Their sociodemographic, medical history and lifestyle data were assessed by means of a survey. The Kupperman Index was used to assess the severity of menopausal symptoms. Bone mineral density was measured by the dual X-ray absorptiometry method. The prevalences of risk factors for osteoporosis and cardiovascular disease were 67.6% and 74.8%, respectively. Women with a higher intensity of symptoms also had a greater percentage of cardiovascular (p osteoporosis (p osteoporosis disease (p obesity (OR 2.23; 95% CI 1.55-2.91; p osteoporosis disease (OR 3.71; 95% CI 2.9-4.52; p osteoporosis disease risk factors and suffered more from osteoporosis disease compared to those who had milder or no menopausal symptoms.
Persian version of the MENQOL questionnaire from the original English language version. Subjects and Methods: This was a ... language and Iranian culture in different subgroups of age, marital status and educational level as well as in ..... estradiol/norethindrone acetate therapy for the management of menopausal signs ...
Full Text Available This study aimed to systematically review the articles on factors affecting sexual function during menopause. Searching articles indexed in Pubmed, Science Direct, Iranmedex, EMBASE, Scopus, and Scientific Information Database databases, a total number of 42 studies published between 2003 and 2013 were selected. Age, estrogen deficiency, type of menopause, chronic medical problems, partner's sex problems, severity of menopause symptoms, dystocia history, and health status were the physical factors influencing sexual function of menopausal women. There were conflicting results regarding the amount of androgens, hormonal therapy, exercise/physical activity, and obstetric history. In the mental–emotional area, all studies confirmed the impact of depression and anxiety. Social factors, including smoking, alcohol consumption, the quality of relationship with husband, partner's loyalty, sexual knowledge, access to health care, a history of divorce or the death of a husband, living apart from a spouse, and a negative understanding of women's health were found to affect sexual function; however, there were conflicting results regarding the effects of education, occupation, socioeconomic status, marital duration, and frequency of sexual intercourse.
Chrisler, Joan C.
The purpose of this article is (a) to consider reasons why women's reproductive processes receive so little attention in psychology courses and (b) to make an argument for why more attention is needed. Menstruation, menopause, and other reproductive events are important to the psychology of women. Reproductive processes make possible a social role…
As we all begin to reach an older age, dental health and hygiene .... periodontal disease.[23,24] Though, systemic bone loss may be a risk indicator for periodontal destruction, and augmented rates of bone mineral density loss after menopause are coupled .... Today the standard of dental treatment allows people to.
van der Stroom, Elizabeth M. C.; Konig, Tamar E.; van Dulmen-den Broeder, Eline; Elzinga, Wieteke S.; van Montfrans, Joris M.; Haadsma, Maaike L.; Lambalk, Cornelis B.
Objective: To investigate whether having a Down syndrome pregnancy at a relatively young age is associated with lower ovarian reserve as reflected by lower antimullerian hormone (AMH) levels and the occurrence of earlier menopause. Design: Retrospective, case control study. Setting: Not applicable.
Background: The menopause‑specific quality‑of‑life (MENQOL) was developed as a specific tool to measure the health‑related quality‑of‑life in menopausal women. Recently, it has been translated into about 15 languages. Aim: This study was performed to develop the Persian version of the MENQOL questionnaire from ...
Abstract: Menopause is the permanent cessation of menstruation resulting from loss of ovarian follicular activity which happens as a result of depletion of primary follicles which is basically an aging effect. Depletion of ovarian follicles is reflected as declined production of oestradiol which is currently known to be central to.
Bae, Jinju; Park, Susan; Kwon, Jin-Won
A regular menstrual cycle is an important indicator of a healthy reproductive system. Previous studies reported obesity, stress, and smoking as the factors that are associated with irregular menstruation and early menopause. However, the integrative effects of these modifiable risk factors have not been fully understood. This study aimed to investigate the modifiable risk factors of menstrual cycle irregularity and premature menopause, as well as their individual and combined effects among adult women in Korea. This study selected adult women aged 19 years and above who had been included in the 2007-2014 Korean National Health and Nutrition Examination Survey. We used a separate dataset to analyze the risk factors of menstrual cycle irregularity and menopause (pre- and postmenopausal women: n = 4788 and n = 10,697, respectively). Univariate and multiple logistic regression analyses were conducted to evaluate the effects of smoking, drinking, obesity, and perceived level of stress on the menstrual cycle and menopause. Both logit and linear models were used in the analyses of the association between smoking and menopausal age. Equivalized household income, marital status, and educational level were considered as covariates. The modifiable risk factor scores were also calculated to integrate the effect of smoking, drinking, and obesity in the analysis. Results showed that smoking status, pack-year, obesity, and perceived level of stress were significantly associated with irregular menstruation among premenopausal women. Especially, women demonstrating > 3 modifiable risk factor scores had 1.7 times higher risk of having irregular menstruation than those who had a 0 score. Meanwhile, early initiation of smoking (≤19 years) and high pack-year (≥5) were also significantly associated with premature menopause among postmenopausal women. This study demonstrated that modifiable risk factors, such as smoking, obesity, and stress, were significantly associated
He, L; Tang, X; Hu, Y H
To explore the associations of menopause with cardiovascular disease (CVD) and related metabolic disorders (including hypertension, diabetes or higher blood sugar, obesity, dyslipidemia) in Chinese females aged 45-59 years . Data were acquired from a national cross-sectional survey conducted in 2013, China, which was also the second follow-up survey of China Health and Retirement Longitudinal Study (CHARLS). In the study, 4 702 Chinese perimenopausal women aged 45-59 years were enrolled, including 1 769 premenopausal women and 2 933 postmenopausal women. Information was collected from questionnaires of health status and functioning and physical examination. General liner models were employed to calculate age-adjusted or age-and-body-mass-index-adjusted or multiple-factor-adjusted means and their 95% confidence intervals (95% CIs) of cardiovascular risk factors (CRFs). The comparisons of CVD and its risk factors according to menopausal status, and calculation of adjusted odds ratios (ORs) and their 95%CIs for the associations of menopause with CVD and its risk factors were performed by multivariate Logistic regression models separately. After adjustment for age and other confounders (including body mass index, marriage, education, current smoking, drink alcohol more than once per month), statistically significant associations of menopause with cardiovascular disease, which referred to having a history of heart disease or stroke in this study,were observed in the participants (OR=1.34,95%CI: 1.04-1.74); prevalence of hypertension (OR=1.42, 95%CI: 1.10-1.84), prevalence of CRFs clustering number≥2 (OR=1.31, 95%CI: 1.02-1.68) and average waist circumference level (87.11 cm, 95%CI: 86.81-87.42 cm in post-menopausal group vs. 86.41 cm, 95%CI: 85.99-86.84 cm in premenopausal group) were presented higher in postmenopausal group, compared with the premenopausal one. However, diabetes or higher blood sugar (OR= 0.96, 95%CI: 0.60-1.52), dyslipidemia (OR= 0.84, 95%CI: 0
Jones, Emma K; Jurgenson, Janelle R; Katzenellenbogen, Judith M; Thompson, Sandra C
There is great variation in experience of menopause in women around the world. The purpose of this study was to review current understanding of Australian Aboriginal and Torres Strait Islander (Indigenous) women's experiences of menopause. The literature pertaining to the perception, significance and experience of menopause from a number of cultural groups around the world has been included to provide context for why Indigenous women's experience might be important for their health and differ from that reported in other studies of Australian women and menopause. A search of databases including Ovid Medline, Pubmed, Web of Science, AUSThealth, AMED, EMBASE, Global Health and PsychINFO was undertaken from January 2011 to April 2011 using the search terms menopause, Indigenous, Aboriginal, attitudes, and perceptions and repeated in September 2012. Considerable research shows significant variation across cultures in the menopausal experience. Biological, psychological, social and cultural factors are associated with either positive or negative attitudes, perceptions or experiences of menopause in various cultures. Comparative international literature shows that neither biological nor social factors alone are sufficient to explain the variation in experiences of the menopausal transition. However, a strong influence of culture on the menopause experience can be found. The variation in women's experience of menopause indicates that different cultural groups of women may have different understandings and needs during the menopausal transition. While considerable literature exists for Australian women as a whole, there has been little investigation of Australian Indigenous women, with only two research studies related to Indigenous women's experiences of menopause identified. Differences in biocultural experience of menopause around the world suggest the importance of biocultural research. For the Indigenous women of Australia, the relative contribution of culture, social
Hill, D Ashley; Crider, Mark; Hill, Susan R
The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined estrogen/progestogen therapy, but not estrogen alone, increases the risk of breast cancer when used for more than three to five years. Therefore, in women with a uterus, it is recommended that physicians prescribe combination therapy only to treat menopausal symptoms such as vasomotor symptoms (hot flashes) and vaginal atrophy, using the smallest effective dosage for the shortest possible duration. Although estrogen is the most effective treatment for hot flashes, nonhormonal alternatives such as low-dose paroxetine, venlafaxine, and gabapentin are effective alternatives. Women with a uterus who are using estrogen should also take a progestogen to reduce the risk of endometrial cancer. Women who cannot tolerate adverse effects of progestogens may benefit from a combined formulation of estrogen and the selective estrogen receptor modulator bazedoxifene. There is no highquality, consistent evidence that yoga, paced respiration, acupuncture, exercise, stress reduction, relaxation therapy, and alternative therapies such as black cohosh, botanical products, omega-3 fatty acid supplements, and dietary Chinese herbs benefit patients more than placebo. One systematic review suggests modest improvement in hot flashes and vaginal dryness with soy products, and small studies suggest that clinical hypnosis significantly reduces hot flashes. Patients with genitourinary syndrome of menopause may benefit from vaginal estrogen, nonhormonal vaginal moisturizers, or ospemifene (the only nonhormonal treatment approved by the U.S. Food and Drug Administration for dyspareunia due to menopausal atrophy). The decision to use hormone therapy depends on clinical presentation, a thorough evaluation of the risks and
Ee, Carolyn; Xue, Charlie; Chondros, Patty; Myers, Stephen P; French, Simon D; Teede, Helena; Pirotta, Marie
Hot flashes (HFs) affect up to 75% of menopausal women and pose a considerable health and financial burden. Evidence of acupuncture efficacy as an HF treatment is conflicting. To assess the efficacy of Chinese medicine acupuncture against sham acupuncture for menopausal HFs. Stratified, blind (participants, outcome assessors, and investigators, but not treating acupuncturists), parallel, randomized, sham-controlled trial with equal allocation. (Australia New Zealand Clinical Trials Registry: ACTRN12611000393954). Community in Australia. Women older than 40 years in the late menopausal transition or postmenopause with at least 7 moderate HFs daily, meeting criteria for Chinese medicine diagnosis of kidney yin deficiency. 10 treatments over 8 weeks of either standardized Chinese medicine needle acupuncture designed to treat kidney yin deficiency or noninsertive sham acupuncture. The primary outcome was HF score at the end of treatment. Secondary outcomes included quality of life, anxiety, depression, and adverse events. Participants were assessed at 4 weeks, the end of treatment, and then 3 and 6 months after the end of treatment. Intention-to-treat analysis was conducted with linear mixed-effects models. 327 women were randomly assigned to acupuncture (n = 163) or sham acupuncture (n = 164). At the end of treatment, 16% of participants in the acupuncture group and 13% in the sham group were lost to follow-up. Mean HF scores at the end of treatment were 15.36 in the acupuncture group and 15.04 in the sham group (mean difference, 0.33 [95% CI, -1.87 to 2.52]; P = 0.77). No serious adverse events were reported. Participants were predominantly Caucasian and did not have breast cancer or surgical menopause. Chinese medicine acupuncture was not superior to noninsertive sham acupuncture for women with moderately severe menopausal HFs. National Health and Medical Research Council.
Maclennan, Alastair H
Background and Objective The highest level of scientific evidence available for each therapy for menopausal symptoms was sought, for example, systematic reviews of randomised controlled trials (RCTs). Results There is reasonable evidence that some symptoms are modified by lifestyle, for example, cessation of smoking, exercise, reduction of alcohol, diet and alleviation of psychosocial stress. No complementary medicine, for example, phytoestrogens, black cohosh, herbal or homeopathic medicines or complementary therapies, for example, acupuncture, yoga, chiropractic manipulation, reflexology or magnetic devices have a greater effect than the usual placebo effect seen in quality blinded RCTs. Some have potential side-effects. So-called 'bioidentical hormones' have no evidence-base and potential for harm. None of the above therapies have evidence of efficacy and long-term safety. Selective serotonin and noradrenaline re-uptake inhibitors ameliorate vasomotor symptoms and sometimes menopausal depression better than placebo. The most effective therapy for menopausal (oestrogen) deficiency symptoms is oestrogen which is the main component of hormone replacement therapies (HRT). Compared with placebo HRT is highly effective in relieving hot flushes, night sweats, dry vagina and dyspareunia. It also improved joint pains, sexuality and sleeplessness and reduced subsequent fractures in RCTs. The increased risk of oral HRT for thromboembolism is small around menopause, for those without thrombotic risk factors, and is not elevated with non-oral routes. Cardiovascular disease may be reduced when HRT is initiated near menopause. Breast cancer risk increases after several years with the use of oral HRT containing progestogens at an annual rate of 8/10 000 (<0.1%). No increase in breast cancer risk was seen with oestrogen-only HRT. © 2009 The Author. Journal Compilation © Blackwell Publishing Asia Pty Ltd.
Innes, Kim E; Selfe, Terry Kit; Vishnu, Abhishek
To systematically review the peer-reviewed literature regarding the effects of self-administered mind-body therapies on menopausal symptoms. To identify qualifying studies, we searched 10 scientific databases and scanned bibliographies of relevant review papers and all identified articles. The methodological quality of all studies was assessed systematically using predefined criteria. Twenty-one papers representing 18 clinical trials from 6 countries met our inclusion criteria, including 12 randomized controlled trials (N=719), 1 non-randomized controlled trial (N=58), and 5 uncontrolled trials (N=105). Interventions included yoga and/or meditation-based programs, tai chi, and other relaxation practices, including muscle relaxation and breath-based techniques, relaxation response training, and low-frequency sound-wave therapy. Eight of the nine studies of yoga, tai chi, and meditation-based programs reported improvement in overall menopausal and vasomotor symptoms; six of seven trials indicated improvement in mood and sleep with yoga-based programs, and four studies reported reduced musculoskeletal pain. Results from the remaining nine trials suggest that breath-based and other relaxation therapies also show promise for alleviating vasomotor and other menopausal symptoms, although intergroup findings were mixed. Most studies reviewed suffered methodological or other limitations, complicating interpretation of findings. Collectively, findings of these studies suggest that yoga-based and certain other mind-body therapies may be beneficial for alleviating specific menopausal symptoms. However, the limitations characterizing most studies hinder interpretation of findings and preclude firm conclusions regarding efficacy. Additional large, methodologically sound trials are needed to determine the effects of specific mind-body therapies on menopausal symptoms, examine long-term outcomes, and investigate underlying mechanisms. Copyright 2010 Elsevier Ireland Ltd. All
Full Text Available BACKGROUND: Breast cancer is the most common cancer worldwide. The incidence and mortality rate is increasing in developing countries as compare to developed countries. The aim of this study was to evaluate the breast cancer risk factors in premenopausal and post-menopausal women. METHODOLOGY: In the present study, two hundred breast cancer patients and one hundred age matched controls were taken to study breast cancer risk factors. The odd Ratio (ORs at 95% confidence interval (CIs was computed to study significance of risk factor on menopausal status. RESULTS: The mean age for menopause was 46.52±4.72 for breast cancer cases and 45.9±4.29 for control group was observed. The marital status, parity, age at menarche at =13 years was found to be associated with breast cancer risk in premenopausal age group. Early age at first full term pregnancy, number of children more than three and lactation duration of more than one year were observed to be protective factors in both pre and postmenopausal age groups A history of spontaneous abortion had no significant effect on the risk of breast cancer diagnosed before or after menopause. The positive association of breast cancer was observed for Height, weight and body mass index (BMI in postmenopausal women. CONCLUSION: In conclusion, present results suggest that changes in reproductive pattern, menstruation and anthropometric measurements contribute to the risk of breast cancer in both pre and post-menopausal women. Further genetic and hormonal relationship based studies have been suggested using a large cohort.
Full Text Available Background: Sexual dysfunction could be under the influence of some underlying medical problems. The purpose of this study is to examine the relationship between medical problems and sexual function in post-menopausal women. Methods: This is a community-based, descriptive-correlation study of 405 post-menopausal women residing in Chalus and Nowshahr cities, North of Iran, aged 40 to 65 years old from October 2013 to May 2014. A multistage, randomized sampling was conducted. The data was acquired through interviews using the Female Sexual Function Index (FSFI questionnaire and a researcher-made questionnaire, and was analyzed using descriptive and analytical tests such as multiple linear regression and logistic regression models. Results: 51.4% of the subjects had medical conditions. Cardiovascular disorders were the most common diseases among the subjects. 61% of the women were suffering from female sexual dysfunction (FSD. Sexual dysfunction in patients with medical conditions was significantly higher (P= 0.037. Scores of arousal (P= 0.000, orgasm (P= 0.018, and satisfaction (P= 0.026, as well as the FSFI total score (P= 0.005, were significantly lower in subjects with cardiovascular disorders. Scores of desire (P= 0.001, arousal (P= 0.006, lubrication (P= 0.010, orgasm (P= 0.004, and satisfaction (P= 0.022, as well as the FSFI total score (P= 0.017, were significantly lower in subjects with diabetes. Scores of pain were significantly lower in subjects with musculoskeletal disorders (P= 0.041, they experienced more pain during intercourse. In domains of arousal (P= 0.030, satisfaction (P= 0.040, and pain (P= 0.044, the scores of those taking antihypertensive medications were significantly lower than the scores of the rest of the subjects. Scores of desire (P= 0.001, arousal (P= 0.006, orgasm (P= 0.006, and satisfaction (P= 0.048, as well as the FSFI total score (P= 0.006, were significantly lower in those taking antidiabetic drugs. And lastly
Ee, Carolyn C; Thuraisingam, Sharmala; Pirotta, Marie V; French, Simon D; Xue, Charlie C; Teede, Helena J
Evidence on the impact of expectancy on acupuncture treatment response is conflicting. This secondary analysis of a randomized sham-controlled trial on acupuncture for menopausal hot flashes investigated whether treatment expectancy score was associated with hot flash score at end-of-treatment. Secondary analyses investigated whether there were associations between other pre-specified factors and hot flash score. Women experiencing moderately-severe hot flashes were randomized to receive 10 sessions of real or sham acupuncture over eight weeks. Hot flash score was collected using a seven-day hot flash diary, and expectancy using the modified Credibility and Expectancy Questionnaire immediately after the first treatment. Linear mixed-effects models with random intercepts were used to identify associations between expectancy score and hot flash score at end-of-treatment. Regression was also used to identify associations between pre-specified factors of interest and hot flash score. Because there was no difference between real and sham acupuncture for the primary outcome of hot flash score, both arms were combined in the analysis. 285 women returned the Credibility and Expectancy Questionnaire, and 283 women completed both expectancy measures. We found no evidence for an association between expectancy and hot flash score at end-of-treatment for individual cases in either acupuncture or sham group. Hot flash scores at end-of-treatment were 8.1 (95%CI, 3.0 to 13.2; P = 0.002) points lower in regular smokers compared to those who had never smoked, equivalent to four fewer moderate hot flashes a day. In our study of acupuncture for menopausal hot flashes, higher expectancy after the first treatment did not predict better treatment outcomes. Future research may focus on other determinants of outcomes in acupuncture such as therapist attention. The relationship between smoking and hot flashes is poorly understood and needs further exploration.
Carolyn C Ee
Full Text Available Evidence on the impact of expectancy on acupuncture treatment response is conflicting.This secondary analysis of a randomized sham-controlled trial on acupuncture for menopausal hot flashes investigated whether treatment expectancy score was associated with hot flash score at end-of-treatment. Secondary analyses investigated whether there were associations between other pre-specified factors and hot flash score.Women experiencing moderately-severe hot flashes were randomized to receive 10 sessions of real or sham acupuncture over eight weeks. Hot flash score was collected using a seven-day hot flash diary, and expectancy using the modified Credibility and Expectancy Questionnaire immediately after the first treatment. Linear mixed-effects models with random intercepts were used to identify associations between expectancy score and hot flash score at end-of-treatment. Regression was also used to identify associations between pre-specified factors of interest and hot flash score. Because there was no difference between real and sham acupuncture for the primary outcome of hot flash score, both arms were combined in the analysis.285 women returned the Credibility and Expectancy Questionnaire, and 283 women completed both expectancy measures. We found no evidence for an association between expectancy and hot flash score at end-of-treatment for individual cases in either acupuncture or sham group. Hot flash scores at end-of-treatment were 8.1 (95%CI, 3.0 to 13.2; P = 0.002 points lower in regular smokers compared to those who had never smoked, equivalent to four fewer moderate hot flashes a day.In our study of acupuncture for menopausal hot flashes, higher expectancy after the first treatment did not predict better treatment outcomes. Future research may focus on other determinants of outcomes in acupuncture such as therapist attention. The relationship between smoking and hot flashes is poorly understood and needs further exploration.
Thurston, Rebecca C; Chang, Yuefang; Barinas-Mitchell, Emma; Jennings, J Richard; Landsittel, Doug P; Santoro, Nanette; von Känel, Roland; Matthews, Karen A
There has been a longstanding interest in the role of menopause and its correlates in the development of cardiovascular disease (CVD) in women. Menopausal hot flashes are experienced by most midlife women; emerging data link hot flashes to CVD risk indicators. We tested whether hot flashes, measured via state-of-the-art physiologic methods, were associated with greater subclinical atherosclerosis as assessed by carotid ultrasound. We considered the role of CVD risk factors and estradiol concentrations in these associations. A total of 295 nonsmoking women free of clinical CVD underwent ambulatory physiologic hot flash assessments; a blood draw; and carotid ultrasound measurement of intima media thickness and plaque. Associations between hot flashes and subclinical atherosclerosis were tested in regression models controlling for CVD risk factors and estradiol. More frequent physiologic hot flashes were associated with higher carotid intima media thickness (for each additional hot flash: β [SE]=0.004 [0.001]; P=0.0001; reported hot flash: β [SE]=0.008 [0.002]; P=0.002, multivariable) and plaque (eg, for each additional hot flash, odds ratio [95% confidence interval] plaque index ≥2=1.07 [1.003-1.14]; P=0.04, relative to no plaque, multivariable] among women reporting daily hot flashes; associations were not accounted for by CVD risk factors or by estradiol. Among women reporting hot flashes, hot flashes accounted for more variance in intima media thickness than most CVD risk factors. Among women reporting daily hot flashes, frequent hot flashes may provide information about a woman's vascular status beyond standard CVD risk factors and estradiol. Frequent hot flashes may mark a vulnerable vascular phenotype among midlife women. © 2016 American Heart Association, Inc.
Sturdee, David W
variety of chemical pathways have been proposed involving serotonin, noradrenalin and dopamine. Trials of drugs that selectively inhibit the re-uptake of serotonin and noradrenalin have shown some beneficial effects, as also has gabapentin, but often the results have been disappointing, and certainly less than the response seen with oestrogen or tibolone. The prevalence of hot flushes varies considerably around the world and is less in the Far East than in the west. Differences in diet and in particular the intake of phytoestrogens has been implicated and many studies have tried to establish whether dietary supplementation with phytoestrogens might be a suitable alternative to conventional hormone replacement therapy (HRT). So far, the results are disappointing. Other lifestyle measures such as avoiding alcohol, caffeine and spicy foods, keeping the core body temperature cool, paced respiration, taking exercise and even acupuncture may help. Hot flushes remain a major cause of reduced quality of life in a large proportion of menopausal women, but perhaps because they are not fatal and are usually self-limiting, there has been rather limited research or clinical interest. However, for the increasing number of women being treated with tamoxifen for breast cancer, and for whom oestrogen will usually be contra-indicated or unsuitable, there is an urgent need to identify the underlying mechanism so that appropriate, specific and safe non-oestrogen therapy can be offered to improve their quality of life.
Johnson, Daniel C.; Matthews, Wendy K.
The purpose of this descriptive study was to explore experienced general music teachers' decision-making processes. Participants included seven experienced, American general music teachers who contributed their views during two phases of data collection: (1) responses to three classroom scenarios; and (2) in-depth, semi-structured, follow-up…
van den Heuvel, Wim J. A.; van Santvoort, Marc M.
This study analyses the experienced age discrimination of old European citizens and the factors related to this discrimination. Differences in experienced discrimination between old citizens of different European countries are explored. Data from the 2008 ESS survey are used. Old age is defined as
Darsareh, Fatemeh; Taavoni, Simin; Joolaee, Soodabeh; Haghani, Hamid
Menopause is a significant event in most women's lives because it marks the end of a woman's natural reproductive life. The purpose of this study was to determine the effect of aromatherapy massage on menopausal symptoms. A randomized placebo-controlled clinical trial was conducted at a menopausal clinic at a gynecology hospital in Tehran. The study population comprised 90 women who were assigned to an aromatherapy massage group, a placebo massage group, or a control group. Each participant in the aromatherapy massage group received 30-minute aromatherapy treatment sessions twice a week for 4 weeks with aroma oil, whereas participants in the placebo massage group received the same treatment with plain oil. No treatment was provided to participants in the control group. The outcome measures in this study were menopausal symptoms, as obtained through the Menopause Rating Scale. The mean baseline level of the menopausal score did not differ among all groups. However, after eight sessions of intervention, the Menopause Rating Scale score differed significantly among the three groups (P aromatherapy massage group and the placebo massage group had a lower menopausal score than the control group (P aromatherapy massage and the placebo massage groups were compared, the menopausal score for the aromatherapy massage group was found to be significantly lower (P aromatherapy massage were effective in reducing menopausal symptoms. However, aromatherapy massage was more effective than only massage.
Pérez-Roncero, Gonzalo Ramón; Martínez-Dearth, Rebeca; López-Baena, María Teresa; Ornat-Clemente, Lía
The aim of this study was to assess menopausal symptoms and related sociodemographic conditions in middle-aged women from the Spanish province of Zaragoza. This was a cross-sectional study in which 241 women (40-59 years old) from the Zaragoza province completed the Menopause Rating Scale (MRS) and a sociodemographic questionnaire containing personal and partner data to assess symptoms associated with the menopause. The most prevalent symptoms were musculoskeletal, followed by hot flushes and perspiration. Somatic, psychological and urogenital symptoms were more severe in post-menopausal women. Somatic and urogenital symptoms worsen with age, body mass index, age at menopause, and partner age. Multiple linear regression analysis (MA) for somatic symptoms was related with the menopausal status, psychiatric treatment, problems with sexual relationships, and history of gender violence. The MA for psychological symptoms was associated with menopausal status, psychiatric treatment and a history of gender violence. The MA for urogenital symptoms was associated with menopausal status, problems with sexual relationships, urinary incontinence and partner alcohol abuse. A history of gender violence was reported by 11.6% of the women. In this sample of middle-aged women, menopausal symptoms were related to menopausal status, and other factors associated with their partner factors, including gender violence. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Sievert, Lynnette Leidy
This work aims to consider how the discipline of anthropology contributes to the study of menopause through evolutionary, developmental, and comparative perspectives. This study was a review of skeletal and ethnographic evidence for menopause and postreproductive life in humans' distant past, hypotheses for the evolution of menopause and long postreproductive life, variation in age at menopause with focus on childhood environments, and the study of variation in symptom experience across populations. Longevity, rather than capacity for menopause, sets humans apart from other primates. Skeletal evidence demonstrates that some Neanderthals and archaic Homo sapiens lived to the age at menopause and that at least one third of women in traditional foraging populations live beyond menopause. The evolutionary reasons for why women experience a long postreproductive life continue to be debated. A developmental perspective suggests that early childhood may be a critical time for the environment to irreversibly influence the number of oocytes or rate of follicular atresia and, ultimately, age at menopause. A comparative perspective examines symptom experience at midlife through participant observation, qualitative interviews, and quantitative instruments to gain a holistic understanding of the meaning, experience, and sociocultural context of menopause. An evolutionary perspective suggests that menopause is not a recent phenomenon among humans. A developmental perspective focuses on the influence of early childhood on ovarian function. A comparative perspective expands clinical norms and provides knowledge about the range of human variations.
Gujski, Mariusz; Pinkas, Jarosław; Juńczyk, Tomasz; Pawełczak-Barszczowska, Adrianna; Raczkiewicz, Dorota; Owoc, Alfred; Bojar, Iwona
The analysis of the relationship between stress at work and results of cognitive functions amongst women, at peri- and post-menopausal age, performing intellectual work. The study group included women, aged 45-66 years old, employed as intellectual workers. Research instruments were: the Montreal Cognitive Assessment; computer tests of the CNS Vital Signs; the Subjective Work Characteristics Questionnaire, and a questionnaire designed by the author. The results were statistically analyzed. Nearly a half of respondents experienced high stress at the place of work; 1/3 - on the average level, on a low level - every fifth. The largest number of respondents experienced stress caused by social contacts. Among a half of the women, stress was caused by the lack of awards at work, followed by the lack of support. Slightly fewer of them experienced stress caused by the feeling of psychological load related to the complexity of work or the feeling of uncertainty caused by the organization of work. Every third woman experienced stress due to the sense of responsibility or the lack of control. The smallest number experienced stress caused by physical arduousness, the sense of threat and unpleasant working conditions. The examined women obtained the best results with respect to simple attention, the worst results - with respect to the reaction time. The results concerning the remaining 9 cognitive functions were ranked in the middle of the aforementioned results. The intensity of stress at work and factors which caused this stress, negatively correlated with simple attention of women in the early peri-menopausal period, while positively correlating with the psychomotor and processing speed of women in the late peri-menopausal period. Among the post-menopausal women, negative correlations were observed between the majority of cognitive functions and the intensity of stress at work, and the majority of factors which caused this stress. Cognitive functions of the examined women
Cumming, Grant P; Currie, Heather
The Internet was born in 1969; it was originally developed so that computers could share information on research and development in the scientific and military fields. The original Internet consisted of four university computers networked in the United States. Email became available two years later. The infant Internet initially required complex computing knowledge to be used. However, this was all to change with the development of the World Wide Web in the early 1990s, which made the Internet much more widely accessible. The Internet has since grown at a phenomenal rate and has evolved into a global communications tool. It is by nature anarchic, in that it is an unrestricted broadcast medium. Although this lack of censorship is a strength, it is also a weakness. The quality of information available on the Web is variable and discernment is required. With the growth of e-health, medicine and its allied specialties are faced with the challenges of providing their services in a novel way while maintaining the first principle of medicine, primum non nocere (first, do no harm). This provision of e-health care is in its infancy and this review explores issues arising from the use of the Internet as a medium for organizing menopausal health care in the third millennium.
Cody, June D; Jacobs, Madeleine Louisa; Richardson, Karen; Moehrer, Birgit; Hextall, Andrew
It is possible that oestrogen deficiency may be an aetiological factor in the development of urinary incontinence in women. This is an update of a Cochrane review first published in 2003 and subsequently updated in 2009. To assess the effects of local and systemic oestrogens used for the treatment of urinary incontinence. We searched the Cochrane Incontinence Group Specialised Register of trials (searched 21 June 2012) which includes searches of MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL) and handsearching of journals and conference proceedings, and the reference lists of relevant articles. Randomised or quasi-randomised controlled trials that included oestrogens in at least one arm in women with symptomatic or urodynamic diagnoses of stress, urgency or mixed urinary incontinence or other urinary symptoms post-menopause. Trials were evaluated for risk of bias and appropriateness for inclusion by the review authors. Data were extracted by at least two authors and cross checked. Subgroup analyses were performed by grouping participants under local or systemic administration. Where appropriate, meta-analysis was undertaken. Thirty-four trials were identified which included approximately 19,676 incontinent women of whom 9599 received oestrogen therapy (1464 involved in trials of local vaginal oestrogen administration). Sample sizes of the studies ranged from 16 to 16,117 women. The trials used varying combinations of type of oestrogen, dose, duration of treatment and length of follow up. Outcome data were not reported consistently and were available for only a minority of outcomes.The combined result of six trials of systemic administration (of oral systemic oestrogens) resulted in worse incontinence than on placebo (risk ratio (RR) 1.32, 95% CI 1.17 to 1.48). This result was heavily weighted by a subgroup of women from the Hendrix trial, which had large numbers of participants and a longer follow up of one year. All of the women had had a
Paulo J. Oliveira
Full Text Available Menopause is a consequence of the normal aging process in women. This fact implies that the physiological and biochemical alterations resulting from menopause often blur with those from the aging process. It is thought that menopause in women presents a higher risk for cardiovascular disease although the precise mechanism is still under discussion. The postmenopause lipid profile is clearly altered, which can present a risk factor for cardiovascular disease. Due to the role of mitochondria in fatty acid oxidation, alterations of the lipid profile in the menopausal women will also influence mitochondrial fatty acid oxidation fluxes in several organs. In this paper, we propose that alterations of mitochondrial bioenergetics in the heart, consequence from normal aging and/or from the menopausal process, result in decreased fatty acid oxidation and accumulation of fatty acid intermediates in the cardiomyocyte cytosol, resulting in lipotoxicity and increasing the cardiovascular risk in the menopausal women.
Alfhaily, F; Ewies, A A A
There is an increased interest amongst women in seeking alternatives for hormone replacement therapy because of their fear of side-effects. It is claimed that acupuncture is effective for curing menopausal symptoms, and to be a safe treatment in the hands of well-trained and qualified practitioners. About one million acupuncture treatments are given in the National Health Service and two million privately each year in England for various indications. However, because its mechanism of action is not fully understood in physiological terms, acupuncture is considered by many clinicians to be of no value. This article reviews the currently available evidence as regards the effectiveness and safety of acupuncture in treating menopausal symptoms.
The aim of this survey is to identify the representations of the menopause in general population and to identify socioculturals determinants of attitudes toward hormone replacement therapy (HRT). For this qualitative study 60 through interviews were performed with women aged between 40 and 65. Four representations were found: negative, ambivalent, neutral and positive. The negative pole, which is dominant, corresponds to the assignation of women to domestic and reproduction functions. The positive pole corresponds to access of women to some social autonomy. Thus, representations of the menopause form a major element of the symbolic domination on middle aged women. Medicalisation and cosmetic practices are the most strongly correlated variables with taking HRT. Three dimensions appear in the social uses of HRT: medical, cosmetic and symbolic, which intervene in various ways according different representations.
D'haeseleer, Evelien; Depypere, Herman; Claeys, Sofie; Van Lierde, Kristiane
The purpose of this study was to investigate the impact of menopause and hormone therapy on nasal resonance by comparing premenopausal women and postmenopausal women with and without hormone therapy. A total of 147 middle-aged Flemish (Dutch)-speaking women participated in the study and were divided into three groups: premenopausal women (n =42), and postmenopausal women with (n =63) and without (n =42) hormone therapy. Nasal resonance scores of isolated sounds and connected speech were measured using the Nasometer. For the isolated sounds as well as for the reading texts, no differences were found in nasal resonance scores between the three groups (ANCOVA). The results of this study indicate that menopause and hormone therapy do not have an impact on the nasal resonance in middle-aged women.
Cho, Seung-Hun; Whang, Wei-Wan
The aim of this study was to critically assess whether acupuncture therapy reduces vasomotor menopausal symptoms and to evaluate the adverse effects of acupuncture therapy on the basis of the results of randomized controlled trials (RCTs). Nineteen electronic databases, including English, Korean, Japanese, and Chinese databases, were systematically searched for RCTs in which acupuncture was used to reduce vasomotor menopausal symptoms before July 2008. There were no language restrictions. The methodological quality of the eligible studies was assessed using the categories provided by the Menstrual Disorders and Subfertility Review Group. Eleven studies, which included a total of 764 individual cases, were systematically reviewed. The methodological quality of the trials varied substantially. Six trials compared acupuncture treatment to sham or placebo acupuncture. Only one study using a nonpenetrating placebo needle found a significant difference in the severity outcomes of hot flashes between groups (mean difference, 0.48; 95% CI, 0.05-0.91). Five studies reported a reduced frequency of hot flashes within groups; however, none found a significant difference between groups. An analysis of the outcomes of the trials that compared acupuncture with hormone therapy or oryzanol for reducing vasomotor symptoms showed that acupuncture was superior. Three RCTs reported minimal acupuncture-related adverse events. There is no evidence from RCTs that acupuncture is an effective treatment in comparison to sham acupuncture for reducing menopausal hot flashes. Some studies have shown that acupuncture therapies are better than hormone therapy for reducing vasomotor symptoms. However, the number of RCTs compared with a nonpenetrating placebo control needle or hormone therapy was too small, and the methodological quality of some of the RCTs was poor. Further evaluation of the effects of acupuncture on vasomotor menopausal symptoms based on a well-controlled placebo trial is
Mishra, Nalini; Mishra, V. N.; Devanshi,
With a significant number of women belonging to the status of menopause and beyond, it is imperative to plan a comprehensive health program for them, including lifestyle modifications. Exercise is an integral part of the strategy. The benefits are many, most important being maintenance of muscle mass and thereby the bone mass and strength. The exercise program for postmenopausal women should include the endurance exercise (aerobic), strength exercise and balance exercise; it should aim for tw...
Uml; EM; Falconieri L
Elena M Umland, Laura FalconieriJefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USAAbstract: Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical...
Full Text Available Hypertension is a state of blood pressure ≥140 mmHg (systolic or ≥90 mmHg (diastolic. Incidence of women hypertension in Rejomulyo from January to November 2013 reached 28.4%, in which 87% were menopausal. Risk factors increased since early menopausal period. The aim of the study was to analyze risk factors of hypertension in menopausal women in Rejomulyo, Madiun. An observational analysis was conducted with cross-sectional study design. Samples were 90 menopausal women aged 50-80 years using stratified random sampling. Bivariate analysis showed association between obesity (p=0.023;CI: 1.4-116.8, abdominal obesity (p=0.002;CI: 1.8-24.9, family history suffering of hypertension (p=0.018;CI: 1.2-7.1, elderly age (p =0.028;CI: 1.2-12.9, high stress level (p=0.001;CI: 2.9-19.4 and often natrium consumption (p=0.001;CI: 2.4-15.2. Multivariate analysis showed that risk factors of hypertension were abdominal obesity (POR adj=9.2 CI: 1.7-50.9, elderly age or >65 years old (POR adj=8.6;CI: 1.6-45.1, high stress level (POR adj=8.6;CI: 2.6-28.3 and often natrium consumption (POR adj=6.4;CI: 1.9-20.5. This study found that risk factors of hypertension were abdominal obesity, elderly age (>65 years old, high stress level, and high natrium consumption. Tawangrejo Health Center should be in collaboration with relevant sectors such as the PKK and health cadres.
Netjasov, Aleksandra Simoncig; Vujović, Svetlana; Ivović, Miomira; Tancić-Gajić, Milina; Marina, Ljiljana; Barać, Marija
Menopause leads to the development of central adiposity, a more atherogenic lipid profile and increased incidence of metabolic syndrome independent of age and other factors. The aim of the study was to investigate the relationships between anthropometric characteristics, sex hormones, lipids and fasting glucose in menopausal women. The study included 87 menopausal women, who where divided into groups according to two criteria: BMI > or = 26.7 kg/m2 and BMI > or = 25 kg/m2. Anthropometric characteristics and blood pressure were measured. Blood was taken at 08.00 h for fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A, apolipoprotein B, lipoprotein(a) (Lp(a)), C-reactive protein, fibrinogen, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG). Significant differences between groups were found for weight, BMI, waist, hips circumference, waist/hip ratio (WHR), systolic and diastolic blood pressure, Lp(a), FSH, LH, PRL (for systolic blood pressure p obese and overweight women with BMI > or = 26.7 kg/m2 significant negative correlations were found for FSH and glucose, SHBG and LDL, SHBG and total cholesterol, SHBG and glucose, BMI and HDL, WC and HDL. In obese and overweight women with BMI > or = 25 kg/m2 significant negative correlations were found for BMI and HDL, waist circumference (WC) and HDL, WHR and HDL, FSH and glucose, SHBG and glucose; significant positive correlations were between BMI and glucose, WC and glucose and WHR with triglycerides. Gaining weight and decreased SHBG are related to dyslipidemia and increased fasting glucose confirming increased incidence of metabolic abnormalities in the menopause.
Freeman, Ellen W; Sammel, Mary D; Lin, Hui; Gracia, Clarisa R
The aim of this study was to estimate associations of obesity with reproductive hormone levels as women progress from premenopausal to postmenopausal status. This was a longitudinal study conducted in the population-based Penn Ovarian Aging Cohort (N = 436). At cohort enrollment, the women were premenopausal, ages 35 to 47 years, with equal numbers of African Americans and whites. Anthropometric measures, menopause status, and reproductive hormone measures were evaluated for 12 years. Associations of the anthropometric measures with estradiol, follicle-stimulating hormone, and inhibin B in the menopausal transition were estimated using generalized linear regression models for repeated measures. Associations between obesity and hormone levels differed by menopause status as indicated by significant interactions between each hormone and menopausal stage. Premenopausal obese and overweight women had significantly lower estradiol levels compared with nonobese women, independent of age, race, and smoking (obese: 32.8 pg/mL [95% CI, 30.6-35.2] vs nonobese: 39.8 pg/mL [95% CI, 37.0-42.8], P obese women having the highest estradiol levels (obese: 20.6 pg/mL [95% CI, 17.2-24.7] vs nonobese: 12.2 pg/mL [95% CI, 10.1-14.8], P obese compared with nonobese women but reversed in the late transition stage. Follicle-stimulating hormone levels were lowest in postmenopausal obese compared with nonobese women (P Obesity is an important factor in hormone dynamics independent of age, race, and smoking in midlife women, although the mechanisms remain unclear.
Nateri, Nafiseh Shams; Beigi, Marjan; Kazemi, Ashraf; Shirinkam, Fatemeh
Background: Paying attention to sexual dysfunction and its coping strategies is essential owing to its impact on mental health in postmenopausal women and their families. This study aimed to determine the relationship between women coping strategies toward the process of menopause and sexual dysfunction in menopausal women. Materials and Methods: This is a cross-sectional study in which 233 married menopausal women were sampled in the first 5 years after cessation of menstrual cycle using hea...
Martínez Pérez, José Antonio; Palacios, Santiago; García, Felipe Chavida; Pérez, Maite
(1) To assess the prevalence of osteoporosis risk factors in Spanish menopausal women; (2) to detect medical and lifestyle risk factor differences between perimenopausal and postmenopausal women; (3) and to identify the main factors responsible for osteoporosis. Cross-sectional descriptive study encompassing women aged 45-65 across Spain. The study population sample was collected through random sampling and a total of 10,514 women were included. Socio-demographic, medical history, and lifestyle data were assessed. The prevalence of osteoporosis risk factors was 67.6%. The most common risk factors were physical inactivity (53.6%), use of medication related to osteoporosis risk (45.9%), and low calcium intake (30.1%). There were statistically significant differences between peri- and postmenopausal women in terms of smoking status, alcohol intake, personal history, poor dairy product intake, and medication use that could increase risk. Logistic regression analysis showed that osteoporosis was significantly associated with age, family history, age at onset of menopause, Kupperman Index, prolonged immobilization, weight loss, and other diseases that increase the probability of developing osteoporosis. A high prevalence of women taking osteoporosis risk-related medication was observed in our study. There was correlation between the menopausal symptoms' degree of severity and the risk of suffering from osteoporosis.
There is accumulating evidence that vitamin D (VD) has important effects besides its well-known role in calcium and bone metabolism. Hypovitaminosis D is associated with cardiovascular disease, the metabolic syndrome, type 2 diabetes mellitus, cancer as well as with increased mortality. Further, VD deficiency is related to depression and impaired cognitive function. Increasing age and elevated body fat mass contribute to an increased risk of VD deficiency. Further, some studies report a relationship between VD and estrogen metabolism. During menopause, the decline of estrogens results in increased bone turnover, a decrease in bone mineral density and elevated fracture risk. Musculoskeletal discomfort might impair quality of life, mood disturbances do frequently occur and the risk of metabolic and cardiovascular disease increases. Moreover, body composition changes including increased fat mass and decreased lean mass, which results in an increased risk of VD deficiency. Conversely, VD deficiency might aggravate discomfort as well as diseases that occur during menopause. There are precise recommendations regarding a sufficient VD intake in order to prevent bone loss in peri- and postmenopausal women. Considering the fact that VD deficiency and menopause share risk factors beyond bone health such as cardiovascular, metabolic, cognitive and affective disorders, a sufficient VD status should be obtained in all peri- and postmenopausal women. This might be beneficial not only considering bone health but also regarding cognitive, affective, metabolic and cardiovascular health of women. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Villaverde Gutiérrez, Carmen; Ramírez Rodrigo, Jesús; Olmedo Alguacil, Maria Milagrosa; Sánchez Caravaca, Maria Angeles; Argente del Castillo Lechuga, Maria Josefa; Ruiz Villaverde, Alberto
the hormonal decline that is characteristic of the menopause, in conjunction with the associated weight gain, is considered a determinant factor of cardiovascular risk. to examine weight status in relation to clinical symptoms during the menopausal transition, in women referred from primary care to an endocrinology specialist, to determine potential cardiovascular risk profiles. observational analytic cross-sectional study, conducted with data from medical records created at time of referral. 805 women aged 40 years or older, a sufficient number of subjects and medical records for cardiovascular risk to be estimated. hierarchic cluster analysis distinguished four clusters. The prevalence of obesity in each one exceeded 60%. The highest mean cardiovascular risk was observed in women who were older and presented obesity and hypertension. In younger age groups, the risk was low, rising to levels similar to those of the older women by the age of 65 years. these results suggest that preventive and therapeutic monitoring of obesity and modifiable risk factors should be conducted during the menopausal transition, to reduce the risk attributable to these factors, a risk that increases with time. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.
Obermeyer, Carla Makhlouf; Sievert, Lynnette Leidy
This summary of the 3-day "Cross-Cultural Comparisons, Midlife, and Aging" workshop introduces 15 papers that examine menopause from biological, cultural, and health perspectives. The workshop was designed to critically examine the conceptual and methodological bases of cross-cultural studies and to make recommendations regarding future research on midlife and aging. This summary first reviews the comparative method with an emphasis on cross-cultural studies of menopause. Then the difference between etic and emic data is introduced. Etic data are collected by standardized instruments according to the interests of the investigator, whereas emic data reflect the concerns of individuals in the community studied. A brief review of cross-country studies concludes that there is a set of "core" menopausal symptoms but that the nuances of those symptoms seem to be culture-specific. The workshop concluded with a unanimous plea for the collection of similar information, both emic and etic data, to improve cross-cultural comparisons. This multidisciplinary collection of papers is an impressive commentary on what has been done in cross-cultural research and a compendium of suggestions for the future.
We conducted and evaluated a coaching intervention aimed at encouraging menopausal women's engagement in goal-oriented actions, self-efficacy enhancement, menopausal symptom alleviation, and quality of life improvement. The study was a randomized controlled trial comprising women aged 40-60 who were not receiving hormone therapy. The intervention group received leaflets and three monthly coaching sessions. Instruments included the Simplified Menopausal Index, Medical Outcome Study 36-Item Short Form Health Survey, and goal achievement scale. Participants were measured preintervention, immediately postintervention, and three months postintervention. A 3-month coaching intervention to enhance menopausal women's health increased their self-efficacy. This effect was not maintained 3 months postintervention.
Chirwa, Mimie; Ma, Richard; Guallar, Cristina; Tariq, Shema
Objective One in three women living with HIV (WLHIV) in the UK is aged 45-56, and therefore of potentially menopausal age. Little is known about the management of menopause in WLHIV in primary care. We aim to describe current knowledge and practice in the management of menopause in WLWH among primary care practitioners (PCPs). Methods A questionnaire-based study of 88 PCPs attending two sexual and reproductive health conferences. Results Almost all respondents (n = 87, 99%) routinely managed women with menopause-related symptoms; however, only 18 (20%) reported having managed menopause in WLHIV. Over 95% (n = 85) reported being confident in managing menopause in general, whereas less than half (n = 40) reported confidence in managing menopause in WLHIV ( p confidence in managing menopause-related symptoms in WLHIV. Nearly all PCPs had concerns about managing menopause-related symptoms in WLHIV, many stating that this should be managed outside primary care. Development of national guidance and specialised training, coupled with good liaison between HIV services and PCPs, may improve confidence in this area.
Andersen, Claus Yding; Kristensen, Stine Gry
Life expectancy has increased by more than 30 years during the last century and continues to increase. Many women already live decades in menopause deprived of naturally produced oestradiol and progesterone, leading to an increasing incidence of menopause-related disorders such as osteoporosis......, cardiovascular diseases and lack of general well-being. Exogenous oestradiol has traditionally been used to alleviate menopause-related effects. This commentary discusses a radical new method to postpone menopause. Part of the enormous surplus of ovarian follicles can now be cryostored in youth for use after...
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not
El Khoudary, Samar R; Santoro, Nanette; Chen, Hsiang-Yu; Tepper, Ping G; Brooks, Maria M; Thurston, Rebecca C; Janssen, Imke; Harlow, Sioban D; Barinas-Mitchell, Emma; Selzer, Faith; Derby, Carol A; Jackson, Elizabeth A; McConnell, Daniel; Matthews, Karen A
The purpose of this study was to assess associations between distinct patterns of circulating estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition (MT) and subclinical measures of atherosclerosis after menopause. Four temporal patterns of E2 decline (Low: low before and after final menstrual period (FMP); Medium: medium before and high after FMP; High-early decline: high prior to FMP and early decline thereafter; High-late decline: high prior to FMP and late decline thereafter) and three of FSH rise (Low, Medium, High) over 9.6 years across FMP were identified and linked to carotid intima-media-thickness (IMT), adventitial diameter (AD), and presence of carotid plaque (cPlaque) measured after menopause at the 12th annual visit (visit 12). Participants were 856 women (age at visit 12 = 59.5 ± 2.7 years) from the Study of Women's Health Across the Nation (SWAN), who never reported a stroke or a heart attack. In models adjusted for visit 12 or baseline cardiovascular disease (CVD) risk factors, odds of having any cPlaque were ∼43% lower among women with the High-early decline E2 trajectory compared to women with the Low E2 trajectory. In contrast, women with the Medium E2 trajectory had significantly higher IMT than those with the Low E2 trajectory adjusting for visit 12 CVD risk factors. Interestingly, adjusting for baseline CVD risk factors attenuated this association. The Low FSH group had lower IMT than the Medium and High FSH groups (p ≤ 0.05) in all models. During MT, women are subjected to hormonal alterations that could potentially increase their risk of developing CVD after menopause. © The European Society of Cardiology 2015.
Melby, Melissa K; Sievert, Lynnette Leidy; Anderson, Debra; Obermeyer, Carla Makhlouf
This paper reviews the methods used in cross-cultural studies of menopausal symptoms with the goal of formulating recommendations to facilitate comparisons of menopausal symptoms across cultures. It provides an overview of existing approaches and serves to introduce four separate reviews of vasomotor, psychological, somatic, and sexual symptoms at midlife. Building on an earlier review of cross-cultural studies of menopause covering time periods until 2004, these reviews are based on searches of Medline, PsycINFO, CINAHL and Google Scholar for English-language articles published from 2004 to 2010 using the terms "cross cultural comparison" and "menopause." Two major criteria were used: a study had to include more than one culture, country, or ethnic group and to have asked about actual menopausal symptom experience. We found considerable variation across studies in age ranges, symptom lists, reference period for symptom recall, variables included in multivariate analyses, and the measurement of factors (e.g., menopausal status and hormonal factors, demographic, anthropometric, mental/physical health, and lifestyle measures) that influence vasomotor, psychological, somatic and sexual symptoms. Based on these reviews, we make recommendations for future research regarding age range, symptom lists, reference/recall periods, and measurement of menopausal status. Recommendations specific to the cross-cultural study of vasomotor, psychological, somatic, and sexual symptoms are found in the four reviews that follow this introduction. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Alraek, Terje; Malterud, Kirsti
The aim of this study was to describe any changes in health experienced by postmenopausal women after having acupuncture treatment for hot flashes. Our sample was drawn from women participating in a randomized controlled trial (ACUFLASH) investigating the effect of acupuncture on menopausal hot flashes. One hundred and twenty-seven (127) women from the intervention group who had received a course of 10 acupuncture treatments were asked to make a written statement about any kind of change they had perceived that they considered could be related to the acupuncture treatment. Qualitative data were analyzed using systematic text condensation. Many women reported a substantial impact from the treatment with respect to a reduction in frequency and intensity of hot flashes both by night and by day. Changes related to improved sleep pattern were also reported, and a variety of different bodily and mental changes were described (i.e., feeling in a good mood, not so run down, and calmer). Several women were uncertain whether any changes had occurred. A few reported feeling worse. Our results describe a variety of health changes that may not be revealed by limited outcome measures in acupuncture studies. Further analysis of the relationship between such bodily experiences could lead to the development of hypotheses or models for how the acupuncture effect is mediated in complex bodily systems, and also contribute to development of outcome measures relevant for acupuncture studies.
Full Text Available Menopause is a natural event to be experienced by every woman and appears to be associated with increased risk for developing type 2 diabetes mellitus. It has been postulated that a diet high in legumes may be beneficial for the prevention of glycosuria. These unique components of soy have been shown to have beneficial effects on glucose and insulin homeostasis. The objective of the present study was to examine the possibility of an association between soy food consumption and risk of glycosuria in postmenopausal women. A cross-sectional study was conducted among 94 postmenopausal women attending Mampang Prapatan Health Center, Mampang Prapatan subdistrict, South Jakarta. Anthropometric measurements were taken using standard instruments and dietary intake was assessed with a validated food-frequency questionnaire. A dipstick semiquantitative assay for urinary glucose was used to define glycosuria (positive. The results showed that 12.8% of postmenopausal women had glycosuria and mean isoflavone intake was 69.5 ± 61.4 g/d. Intake of isoflavone was inversely associated with risk of glycosuria. Compared to women in the lowest quintile of isoflavone intake (Q1, postmenopausal women in the highest quintile (Q5 had a lower risk for glycosuria of 0.30 times that of Q1, which risk was however statistically not significant (OR = 0.30; 95% CI = 0.02 – 3.14. In conclusion, isoflavone may play a role in the prevention of glycosuria (an important indicator of diabetes among postmenopausal women.
Full Text Available Menopause is a natural event to be experienced by every woman and appears to be associated with increased risk for developing type 2 diabetes mellitus. It has been postulated that a diet high in legumes may be beneficial for the prevention of glycosuria. These unique components of soy have been shown to have beneficial effects on glucose and insulin homeostasis. The objective of the present study was to examine the possibility of an association between soy food consumption and risk of glycosuria in postmenopausal women. A cross-sectional study was conducted among 94 postmenopausal women attending Mampang Prapatan Health Center, Mampang Prapatan subdistrict, South Jakarta. Anthropometric measurements were taken using standard instruments and dietary intake was assessed with a validated food-frequency questionnaire. A dipstick semiquantitative assay for urinary glucose was used to define glycosuria (positive. The results showed that 12.8% of postmenopausal women had glycosuria and mean isoflavone intake was 69.5 ± 61.4 g/d. Intake of isoflavone was inversely associated with risk of glycosuria. Compared to women in the lowest quintile of isoflavone intake (Q1, postmenopausal women in the highest quintile (Q5 had a lower risk for glycosuria of 0.30 times that of Q1, which risk was however statistically not significant (OR = 0.30; 95% CI = 0.02 – 3.14. In conclusion, isoflavone may play a role in the prevention of glycosuria (an important indicator of diabetes among postmenopausal women.
Muñoz López, Alejandro
Full Text Available Purpose: to examine kinematic differences of instep soccer kick between experienced and non-experienced soccer players. Subjects: 17 men between 17 and 21 years old. Methodology: a 3D film system with 4 cameras was used. Maximum power instep kicks were executed. It was analyzed feet velocity in the impact, maximum hip extension, maximum knee flexion and kick phases duration. Results: were found significant differences in feet velocity with non-dominant leg in the impact moment (m/s (Experienced: 14.5±.52, Non-experienced: 12.5±.5; p<.001 and maximum hip extension (degrees (Experienced: 39.2 ± 1.3, Non-experienced: 34.28±3.2; p<.001. Also were significant differences in the second phase duration in both legs (p<.05. Conclusions: Maximum instep soccer kick show significant differences between groups of different level only in non-dominant leg.
Verhoeven, Marieke O.; van der Mooren, Marius J.; Teerlink, Tom; Verheijen, Rene H. M.; Scheffer, Peter G.; Kenemans, Peter
Objective: To investigate the influence of physiological and surgical menopause oil Serum concentrations of corollary heart disease (CHD) risk markers and sex hormones. Design: Physiological menopausal transition was investigated in two studies. In a longitudinal Study, 16 women were followed from 2
Steffen, Patrick R; Soto, Marilyn
Menopause represents an important life change, particularly for religious women whose identity is significantly related to family. Two competing hypotheses are examined: one, because religious women have their identity focused on family and child rearing, spirituality will be related to increased menopausal symptoms because menopause represents a loss of identity and purpose; and two, because spirituality can provide strength and comfort during difficult times, it will, therefore, be related to decreased menopausal symptoms. To test these competing hypotheses, questionnaires were administered to 218 women (average age 55, 35% premenopausal, 26% peri-menopausal, 39% postmenopausal) who were members of the Church of Jesus Christ of Latter Day Saints. Regression analyses indicated that higher levels of spiritual strength were related to decreased levels of reported menopausal symptoms. Spiritual strength was also related to increased benefit finding during menopause, decreased concern with body appearance, and increased use of adaptive coping strategies. We conclude that finding strength in spirituality may help religious women cope better with the life changes associated with menopause.
Paula de Holanda Mendes
Full Text Available OBJECTIVES: cigarette smoking has been the modifiable risk factor most consistently associated with earlier menopause. This preliminary study based on cross-sectional data aimed to analyze the association between smoking status and age of onset of menopause in a Brazilian population. METHODS: a cross-sectional study was carried out with 1,222 female employees of Rio de Janeiro university campuses aged over 35 years who were at risk of natural menopause. A Cox proportional hazards model was used to investigate the association between smoking status and age at the onset of menopause, adjusting for education, parity and alcohol consumption. RESULTS: current smokers showed a 56% increase in the risk of menopause, being 1.8 years younger at menopause onset compared with women who had never smoked. However, no differences were observed between former smokers and women who had never smoked. The adjusted median age at menopause was 49.5 years for current smokers and 51.3 years for women who had never smoked (p<0.05. CONCLUSIONS: the results suggest a deleterious but potentially reversible effect of smoking on the age of onset of menopause, which should receive greater attention in tobacco control efforts. Longitudinal analyses of this association will be carried out in the future in a follow-up study of this population.
Santonicola, Antonella; Iovino, Paola; Cappello, Carmelina; Capone, Pietro; Andreozzi, Paolo; Ciacci, Carolina
We evaluated menopause-associated disorders and fertile life span in women with celiac disease (CD) under untreated conditions and after long-term treatment with a gluten-free diet. The participants were 33 women with CD after menopause (untreated CD group), 25 celiac women consuming a gluten-free diet at least 10 years before menopause (treated CD group), and 45 healthy volunteers (control group). The Menopause Rating Scale questionnaire was used to gather information on menopause-associated disorders. The International Physical Activity Questionnaire was used to acquire information on physical activity. Untreated celiac women had a shorter duration of fertile life span than did the control women because of an older age of menarche and a younger age of menopause (P celiac women than in the control women (higher by 49.4%, 121.4%, and 58.6%, respectively; P celiac women compared with control women. A gluten-free diet that started at least 10 years before menopause prolongs the fertile life span of celiac women. The perception of intensity of hot flushes and irritability is more severe in untreated celiac women than in controls. Low physical exercise and/or poorer quality of life frequently reported by untreated celiac women might be the cause of reduced discomfort tolerance, thus increasing the subjective perception of menopausal symptoms.
Methodology: A total of 100 subjects were selected for this study which comprised 50 pre-menopausal (control) and 50 post-menopausal (test). The subjects were divided into different age categories and duration. Determination of the concentrations of trace elements was performed using the FS-240 atomic absorption ...
Willis, Diane S.; Wishart, Jennifer G.; Muir, Walter J.
Overall life expectancy for women with intellectual disabilities (ID) is now significantly extended, and many will live long enough to experience menopause. Little is known about how carers support women with ID through this important stage in their lives. This study investigated carer knowledge of how menopause affects women with ID under their…
Calvo-Pérez, Andrés; Campillo-Artero, Carlos
To explore demographic and epidemiological characteristics surrounding menopause among women of Majorca, estimate their health related quality of life (QOL), and ascertain wheather they differ from those of the mainland population of menopausal women. A cross-sectional population-based study was conducted with a sample of 428 women. The Cervantes questionnaire for measuring QOL during menopause was used. Among women in Majorca, the mean QOL is better than the national mean of the Spain reference population. It declines with age and levels off at menopause. In menopausal women, QOL improves slightly in tandem with educational level. 29% of menopausal women were on some form of therapy, most commonly a mix of estrogens and gestagens (36%). Only a weak association was detected between being menopausal and QOL. The Cervantes questionnaire allows periodic study sample cut-offs to determine whether changes in sociodemographic and disease-related variables are also accompanied by changes in self-perceived QOL. It is much better in menopausal women in Majorca than in those in the Spanish mainland.
Freeman, Ellen W.; Sammel, Mary D.; Sanders, Richard J.
Objectives To estimate the risk of hot flashes relative to natural menopause and evaluate associations of hormone levels, behavioral and demographic variables with the risk of hot flashes following menopause. Methods Annual assessments of 255 women who were premenopausal at baseline and reached natural menopause during 16 years of follow-up. Results The prevalence of moderate/severe hot flashes increased in each premenopausal year, reaching a peak of 46% in the first two years after the final menstrual period (FMP). Hot flashes decreased slowly following menopause and did not return to premenopausal levels until 9 years after FMP. The mean duration of moderate/severe hot flashes after FMP was 4.6 (SD2.9) years (4.9, SD3.1 years for any hot flashes). One-third of women at 10 or more years following menopause continued to experience moderate/severe hot flashes. African American women (obese and non-obese) and obese white women had significantly greater risk of hot flashes compared to non-obese white women (interaction P=0.01). In multivariable analysis, increasing FSH levels before FMP (Pmenopause; more than one- third of women observed for 10 or more years following menopause had moderate/severe hot flashes. Continuation of hot flashes for more than 5 years following menopause underscores the importance of determining individual risk/benefit when selecting hormone or non-hormonal therapy for menopausal symptoms. PMID:24473530
Kobayashi, Sofie; Berge, Maria; Grout, Brian W. W.; Rump, Camilla Østerberg
This study contributes towards a better understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction between supervisors and PhD students, using the notion of experiencing variation as a key to learning. Empirically, we have based the study on four video-recorded sessions, with…
Gadzella, Bernadette M.; And Others
This study was conducted to examine the types of stresses experienced by professionals. Subjects were 56 persons enrolled in graduate classes who completed the Tennessee Stress Scale-L, Work Related Stress Inventory for Professionals. Besides the Total stress score, the instrument produced three subscale scores: Stress Producers, Coping…
McCormick, Alister; Meijen, Carla; Marcora, Samuele
This study aimed to identify psychological demands that are commonly experienced by endurance athletes so that these demands could inform the design of performance-enhancement psychological interventions for endurance athletes. Focus group interviews were conducted with 30 recreational endurance athletes of various sports (running, cycling, and triathlon), distances, and competitive levels to explore the psychological demands of training, competition preparation, and competition participation...
Cite as: Urimubenshi G. Activity limitations and participation restrictions experienced by people with stroke in Musanze district in Rwanda. Afri Health ..... analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education To- day 2004, 24(2), 105–112. 20. Lincoln YS, Guba EA.
Perceived and experienced restrictions in participation and autonomy among adult survivors of stroke in Ghana. ... There were significant differences in two domains between survivors who received physiotherapy and those who received traditional rehabilitation. Over half of the survivors also perceived they would ...
Overlien, Carolina; Hyden, Margareta
The aim of this article is, by analysing children's discourses, to investigate their actions or absence of actions during a domestic violence episode. The empirical data are recorded group therapy sessions and individual interviews with children who have grown up experiencing their fathers' violence against their mothers. The analysis shows that…
Schillings, M.L.; Kalkman, J.S.; Janssen, H.M.; Engelen, B.G.M. van; Bleijenberg, G.; Zwarts, M.J.
OBJECTIVE: Fatigue has been described as a typical symptom of neurological diseases. It might be caused both by changes at the peripheral and at the central level. This study measured the level of experienced fatigue and physiological correlates of fatigue in three genetically defined neuromuscular
Okas, Anne; van der Schaaf, Marieke; Krull, Edgar
This article discusses teachers’ practical knowledge and beliefs of their profession based on reflective writings of twenty Estonian teachers.Ten novice and ten experienced teachers participated in the study. They put together their professional portfolios, which among other documents included
Fu, Cong; Zhao, Na; Liu, Zhen; Yuan, Lu-Hua; Xie, Chen; Yang, Wen-Jia; Yu, Xin-Tong; Yu, Huan; Chen, Yun-Fei
To evaluate the short-term efficacy of acupuncture for the treatment of peri-menopausal insomnia (PMI). Design: A randomized, participant-blind, placebo-controlled trial consisted of the acupuncture group (n = 38) and placebo-acupuncture group (n = 38). Setting: A tertiary teaching and general hospital. Participants: 76 peri-menopausal women with insomnia disorder based on the International Classification of Sleep Disorders, Third Edition. Interventions: A 10-session of acupuncture at bilateral Shenshu (BL 23) and Ganshu (BL 18) with unilateral Qimen (LR 14) and Jingmen (GB 25) or Streitberger needles at the same acupoints was performed for over 3 weeks. Measurements: Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) with over-night polysomnography (PSG) exam were completed at baseline and post-treatment. After the treatments, the decrease from baseline in PSQI score was 8.03 points in acupuncture group and 1.29 points in placebo-acupuncture group. The change from baseline in ISI score was 11.35 points in acupuncture group and 2.87 points in placebo-acupuncture group. In PSG data, acupuncture significantly improved the sleep efficiency and total sleep time, associated with less wake after sleep onset and lower percent stage 1 after the treatment. No significant differences from baseline to post-treatment were found in placebo-acupuncture group. Acupuncture can contribute to a clinically relevant improvement in the short-term treatment of PMI, both subjectively and objectively. Acupuncture for peri-menopause insomnia: a randomized controlled trial, http://www.chictr.org.cn/showproj.aspx?proj=12118 ChiCTR-IPR-15007199, China.
Full Text Available The level of gonadal hormones to which the female brain is exposed considerably changes across the menopausal transition, which in turn, is likely to be of great relevance for neurodegenerative diseases and psychiatric disorders. However, the neurobiological consequences of these hormone fluctuations and of hormone replacement therapy in the menopause have only begun to be understood. This review summarizes the findings of thirty-four studies of human brain function, including functional magnetic resonance imaging, positron and single-photon computed emission tomography studies, in peri- and postmenopausal women treated with estrogen, or estrogen-progestagen replacement therapy. Seven studies using gonadotropin-releasing hormone agonist intervention as a model of hormonal withdrawal are also included. Cognitive paradigms are employed by the majority of studies evaluating the effect of unopposed estrogen or estrogen-progestagen treatment on peri- and postmenopausal women’s brain. In randomized-controlled trials, estrogen treatment enhances activation of fronto-cingulate regions during cognitive functioning, though in many cases no difference in cognitive performance was present. Progestagens seems to counteract the effects of estrogens. Findings on cognitive functioning during acute ovarian hormone withdrawal suggest a decrease in activation of the inferior frontal gyrus, thus essentially corroborating the findings in postmenopausal women. Studies of the cholinergic and serotonergic systems indicate these systems as biological mediators of hormonal influences on the brain. More, hormonal replacement appears to increase cerebral blood flow in cortical regions. On the other hand, studies on emotion processing in postmenopausal women are lacking. These results call for well-powered randomized-controlled multi-modal prospective neuroimaging studies as well as investigation on the related molecular mechanisms of effects of menopausal hormonal
Palacios, Santiago; Mejias, Andrea
Vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) are recognized as the most frequent and bothersome symptoms associated with menopause. There are different treatments for both groups of symptoms, being necessary to individualize them. There are different therapies for VMS including hormonal treatments with estrogen, with and without progestins; the new alternative, tissue-selective estrogen complex (TSEC), tibolone, phytoestrogens and only progestins. Evidence also shows efficacy with selective serotonin reuptake inhibitors. Other nonhormonal alternatives exist as second-line treatments, all with not conclusive results. The GSM can be treated with nonhormonal treatments such as vaginal lubricants and moisturizers, other alternatives as vaginal laser needs to have more evidence. On the other hand, there is the possibility to use the hormonal treatments with systemic or local estrogen, which are the most effective treatment, the TSEC and the newest selective estrogen receptor modulator (SERM), ospemifene. Therapies with testosterone and dehydroepiandrosterone (DHEA) are still under study. The GSM can be treated with nonhormonal treatments such as vaginal lubricants and moisturizers, and other alternatives as vaginal laser need to have more evidence. On the other hand, there is the possibility to use the hormonal treatments with systemic or local estrogen, which are the most effective treatment, the TSEC and the newest SERM, ospemifene. Therapies with testosterone and DHEA are still under study. The increasing numbers of therapies for menopausal symptoms open up new options, but we must individualize treatments. New possibilities arise in patients who did not have them and which can improve compliance and is also important to design strategies using combined or sequential treatments.
Alexander, Jeanne Leventhal; Burger, Henry; Dennerstein, Lorraine; Woods, Nancy Fugate; Davis, Susan R; Kotz, Krista; Van Winkle, Julie; Richardson, Gregg; Ratka, Anna; Kessel, Bruce
This article aims to educate the nonpsychiatric as well as the psychiatric clinician on the impact of vasomotor symptoms in women with comorbid psychiatric problems and the challenges of treating vasomotor symptoms in these women. The pathophysiology, prevalence and common risk factors associated with disturbing hot flashes in the menopausal transition are reviewed. Hormonal, nonhormonal and behavioral treatment options of vasomotor symptoms for these women are discussed. Special pharmacokinetic implications for hormonal treatment of those women on anticonvulsant medications for the treatment of their mood disorders, on tamoxifen and/or with high or low sex hormone-binding globulin are examined. An in-depth discussion of mood and the menopausal transition, theoretical mechanisms for mood problems with the symptomatic menopause and the impact of stress on the symptomatic menopause are found elsewhere in this clinical review series on psychiatric illness, stress and the symptomatic menopause.
Liu, Mengfang; Wang, Ying; Li, Xu; Liu, Peihao; Yao, Chen; Ding, Yanming; Zhu, Sainan; Bai, Wenpei; Liu, Jun-E
To collect health information of Beijing middle-aged registered nurses during menopause. We distributed self-administered questionnaires to 2100 registered nurses aged 40-55 from 20 hospitals in Beijing. The objects of interest were selected by cluster sampling. A total of 1686 questionnaires met the criteria and were used for statistical analysis. The average natural menopause age was 48.68 ± 3.61 years old. We determined that 37.83% of the objects had modified Kupperman Menopausal Index (KMI) scores ≥ 15. The top three menopause symptoms were fatigue (82.72%), irritability (70.24%), and arthralgia/myalgia (69.55%); hot flashes ranked eleventh (30.83%). A total of 37.83% Beijing middle-aged registered nurses had menopause syndrome, and the top three symptoms were fatigue, irritability, and arthralgia/myalgia. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Pinkerton, J V; Santen, R
Women frequently chose alternatives to hormone replacement therapy (HRT) for treatment of menopause even though medical indications for estrogens may be present. Prior breast cancer or fear of breast cancer is a major consideration. This review of alternatives to estrogen discusses the evidence linking breast cancer to HRTs and compares potential risks and benefits of HRT to nonHRT alternatives for relief of vasomotor symptoms, vaginal atrophy, neurocognitive changes and prevention of heart disease and osteoporosis. Practical guidelines are suggested for use of alternatives for each problem.
Surveys consistently show that a significantly higher percentage of women with chronic medical conditions report use of complementary and integrative medicine (CIM) approaches compared with men. A total of 54.5% of women report use of at least one CIM approach specifically for obstetric or gynecologic problems. However, primary care providers remain an underutilized resource by patients for guidance in the safe and appropriate use of integrative therapies. This article provides a practical overview of the most appropriate integrative therapies to consider in the management of commonly seen women's health conditions: polycystic ovarian syndrome, menopause, and osteoporosis. Copyright © 2017 Elsevier Inc. All rights reserved.
Full Text Available A 52-year-old patient presented with complaints of menorrhagia. Endometrial biopsy revealed simple hyperplasia of the endometrium. Total abdominal hysterectomy with bilateral oophorectomy was carried out. The ovaries looked grossly normal, but histopathology reported granulosa cell tumor of the right ovary. Granulosa cell tumors belong to the sexcord stromal category and account for approximately 2% of all ovarian tumors. We review the features and treatment of granulosa cell tumors and the importance of screening for ovarian tumors in a case of endometrial hyperplasia and delayed menopause.
Kozinoga, Mateusz; Majchrzycki, Marian; Piotrowska, Sylwia
Low back pain is a massive problem in modern population, both in social and economic terms. It affects large numbers of women, especially those aged 45-60. Going through a perimenopausal period is associated with many symptoms, including low back pain. This paper is a review of published research on the association between the perimenopausal age and low back pain. PubMed databases were investigated. After the search was narrowed to “menopausal status, back pain”, 35 studies were found. Se...
Svejme, Ola; Ahlborg, Henrik G; Nilsson, Jan-Åke; Karlsson, Magnus K
Identify risk factors for fragility fractures and mortality in women aged 48. Prospective population-based observational study on 390 white north European women aged 48 at study start. At study start, we measured bone mineral density (BMD) by single-photon absorptiometry (SPA) in the distal forearm, anthropometry by standard equipment and registered menopausal status, health and lifestyle factors. Menopause before age 47 was defined as early menopause. Incident fragility fractures and mortality were recorded until the women reached age 82. Potential risk factors for fragility fracture and mortality were evaluated with Cox's proportional hazard regression analysis. Data are presented as risk ratios (RR) with 95% confidence intervals in brackets. Incidence of fragility fractures and mortality. In the univariate analysis, low BMD and early menopause predicted fractures. In the multivariate analysis, only BMD remained as an independent risk factor with a RR of 1.36 (1.15, 1.62) per standard deviation (SD) decrease in baseline BMD. In the univariate analysis, early menopause and smoking predicted mortality, and remained as independent risk factors in the multivariate analysis with RR 1.62 (1.09, 2.39) for early menopause and 2.16 (1.53, 3,06) for smoking. Low BMD at age 48 is an independent predictor for fragility fractures. The predictive ability of early menopause is at least partially attributed to other associated risk factors. Early menopause and smoking were found in this study to be independent predictors for mortality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Delanoë, Daniel; Hajri, Selma; Bachelot, Annie; Mahfoudh Draoui, Dorra; Hassoun, Danielle; Marsicano, Elise; Ringa, Virginie
The experience of menopause can vary strongly from one society to another: frequency of hot flushes, other somatic and psychological symptoms, and changes in family and social relations. Several studies have shown that country of residence, country of birth, ethnicity, and social class all play roles in these variations. But few comparative anthropological studies have analysed the social processes that construct the experience of menopause or considered menopausal women's social and financial autonomy. To study the impact of the social status accorded to menopausal women and their social resources, during 2007 and 2008 we conducted a series of 75 in-depth interviews with women in different sociocultural settings: Tunisian women in Tunisia, Tunisian women in France, and French women in France, all aged from 45 to 70 years. Our methodological approach to the data included content analysis, typology development and socio-demographic analysis. Quite substantial differences appeared, as a function of social class and cultural environment. We identified three principal experiences of menopause. Tunisian working class women, in Tunisia and France, experience menopause with intense symptoms and strong feelings of social degradation. Among Tunisian middle-class women in both countries, menopause was most often accompanied by a severe decline in aesthetic and social value but few symptoms. For most of the French women, menopause involved few symptoms and little change in their social value. The distribution of types of experiences according to social but not geographic or national factors indicates that, in the populations studied here, the differences in symptoms are not biologically determined. Different experiences of menopause are linked to social class and to the degree of male domination. A given level of independence and emancipation allows women an identity beyond their reproductive function and a status unimpaired by menopause. Copyright © 2012 Elsevier Ltd. All
Tariq, Shema; Anderson, Jane; Burns, Fiona; Delpech, Valerie; Gilson, Richard; Sabin, Caroline
As the life expectancy of people living with HIV improves as a result of antiretroviral therapy, increasing numbers of women living with HIV (WLHIV) are now reaching menopausal age. The menopause transition in WLHIV remains a relatively overlooked area in clinical HIV research. Whilst there is some evidence to suggest that WLHIV experience menopause at an earlier age and that they have more menopausal symptoms, there is no clear consensus in the literature around an impact of HIV infection on either timing or symptomatology of the menopause. Data are also conflicting on whether HIV-related factors such as HIV viral load and CD4 cell count have an impact on the menopause. Furthermore, menopausal symptoms in WLHIV are known to go under-recognised by both healthcare providers and women themselves. There is likely to be a burden of unmet health needs among WLHIV transitioning through the menopause, with significant gaps in the evidence base for their care. With this in mind, we have developed the PRIME study (Positive Transitions Through the Menopause). This mixed-methods observational study will explore, for the first time in the UK, the impact of the menopause on the health and wellbeing of 1500 ethnically diverse WLHIV. In establishing a cohort of women in their midlife and following them up longitudinally, we hope to develop a nuanced understanding of the gendered aspects of ageing and HIV, informing the provision of appropriate services for WLHIV to ensure that they are supported in maintaining optimal health and wellbeing as they get older.
Bærenholdt, Jørgen Ole
Experiences of place and mobility play central roles not only in what was traditionally understood as tourism, but also in the broader practices of travelling and visiting sites and sights. On the one hand, such experiences are performed to an extent where it is difficult to isolate the sites...... and movements experienced per se, since visitors and travellers take part in ‘doing’ places and mobility. On the other, experience sites and routes stand out with specific traces and characteristics affording some – and not other – experiences. This paper discusses conceptual understandings that may help...... to better analyse what it takes to perform tourist sites. Following a discussion of Walter Benjamin’s way of understanding experiences as Erlebnisse, I suggest that ideas about multiplicity and absence-presence in Actor-Network Theory can develop new insights into how place and mobility are experienced...
Keerus, Külli; Gjerris, Mickey; Röcklinsberg, Helena
Tom Regan encapsulated his principle of harm as a prima facie direct duty not to harm experiencing subjects of a life. However, his consideration of harm as deprivation, one example of which is loss of freedom, can easily be interpreted as a harm, which may not be experienced by its subject....... This creates a gap between Regan’s criterion for moral status and his account of what our duties are. However, in comparison with three basic paradigms of welfare known in nonhuman animal welfare science, Regan’s understanding coheres with a modified version of a feelings-based paradigm: not only the immediate...... feelings of satisfaction, but also future opportunities to have such feelings, must be taken into account. Such an interpretation is compatible with Regan’s understanding of harm as deprivation. The potential source of confusion, however, lies in Regan’s own possible argumentative mistakes....
Pitkin, Joan; Rees, Margaret C P; Gray, Sarah; Lumsden, Mary Ann; Marsden, Jo; Stevenson, John; Williamson, Jennifer
The British Menopause Society Council aims to help health professionals to inform and advise women about the menopause. The oestrogen plus progestogen arm of the Women's Health Initiative was stopped in July 2002. This guidance regarding hormone replacement therapy (HRT) use responds to the results and analysis that have been published since then, as well as the Million Women Study published in August 2003. Because there are few effective alternatives to HRT for vasomotor and urogenital symptoms, oestrogen-based treatments still have a major role. HRT is also most effective for the prevention of osteoporosis. Unopposed oestrogens are contraindicated in women with an intact uterus, and hence a range of oestrogen and progestogen combinations, with differing routes of delivery, now exists under the title of "HRT". Treatment choice should be based on up to date information and targeted to individual women's needs. Hormone replacement still offers the potential for benefit to outweigh harm, providing the appropriate regimen has been instigated in terms of dose, route and combination.
Attarian, Hrayr; Hachul, Helena; Guttuso, Thomas; Phillips, Barbara
Insomnia both as a symptom and as part of chronic insomnia disorder is quite common in menopause. Comorbid conditions, such as restless legs syndrome and obstructive sleep apnea, occur with high prevalence among perimenopausal women with insomnia. Insomnia in this population group is associated with adverse health outcomes, and there are no clear standards on how to treat it. Based on extensive literature search, 76 articles were identified. Two authors independently graded evidence according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. Evaluation and treatment of other comorbid sleep disorders are recommended, as is cognitive-behavioral therapy for insomnia. Hormone therapy, eszopiclone, escitalopram, gabapentin, isoflavones, valerian, exercise, and hypnosis are suggested. Zolpidem, quiteiapine XL, citalopram, mirtazapine followed by long-acting melatonin, ramelteon, Pycnogenol, Phyto-Female Complex, yoga, and massage may be considered. Kampo formulas are not recommended. Acupuncture may not be suggested, and cognitive-behavioral therapy that is not tailored for insomnia probably should not be considered. Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures.
Jaouen, Klervia; Balter, Vincent
Iron (δ(56) Fe) and copper (δ(65) Cu) stable isotope compositions in blood of adult human include a sex effect, which still awaits a biological explanation. Here, we investigate the effect of menopause by measuring blood δ(56) Fe and δ(65) Cu values of aging men and women. The results show that, while the Fe and Cu isotope compositions of blood of men are steady throughout their lifetime, postmenopausal women exhibit blood δ(65) Cu values similar to men, and δ(56) Fe values intermediate between men and premenopausal women. The residence time of Cu and Fe in the body likely explains why the blood δ(65) Cu values, but not the δ(56) Fe values, of postmenopausal women resemble that of men. We suggest that the Cu and Fe isotopic fractionation between blood and liver resides in the redox reaction occurring during hepatic solicitation of Fe stores. This reaction affects the Cu speciation, which explains why blood Cu isotope composition is impacted by the cessation of menstruations. Considering that Fe and Cu sex differences are recorded in bones, we believe this work has important implications for their use as a proxy of sex or age at menopause in past populations. Copyright © 2013 Wiley Periodicals, Inc.
Leptin a cytokine protein secreted by adipose tissue raises considerable interest as a potential mediator of the protective effects of fat mass on bone tissue. After menopause heavier women conserve bone mass better than those with lower body weight. The protective effect of obesity on bone mass has been ascribed to a high body fat content. As Leptin levels reflect the body fat content it has emerged as a possible mediator of these protective effects. A search of the available literature focused on the role of leptin on bone tissue. Both peripheral and central action of leptin on bone metabolism have been proposed. In vitro and in vivo evidence supports the hypothesis that leptin can act directly or indirectly on bone remodelling by modulating both osteoblast and osteoclast activities. However, studies in humans have not yet been able to confirm these actions possibly because of the shifting balance between stimulatory direct action and suppressive indirect action of leptin on bones via the hypothalamus. The effects of oestrogen decline and deficiency during natural or artificially induced menopause and administration of hormone replacement therapy has on leptin production remains controversial. Various studies have shown differences in leptin values in pre- and postmenopausal women. The existing clinical data on this issue are discordant. Larger clinical studies are necessary to clarify leptin's role in vivo and to assess the contribution of the central and peripheral role of leptin in the overall maintenance of bone turnover in human beings.
Schneider Hermann PG
Full Text Available Abstract Background Symptom scales for aging women have clinically been used for years and the interest in measuring health-related quality of life (HRQoL has increased in recent years. The Menopause Rating Scale (MRS is a formally validated scale according to the requirements for quality of life instruments. The aim of this paper is to review the current state of the instrument particularly concerning versions of the scale in different languages. MRS versions available The translations were performed following international methodological recommendations for the linguistic & cultural adaptation of HRQoL instruments. The first translation was done from the German original scale into English (UK & USA. The English version was used as the source language for the translations into French, Spanish, Swedish, Mexican/Argentine, Brazilian, Turkish, and Indonesian languages (attached as additional PDF files. Conclusion The MRS scale is obviously a valuable tool for assessing health related quality of life of women in the menopausal transition and is used worldwide. The currently available 9 language versions have been translated following international standards for the linguistic and cultural translation of quality of life scales. Assistance is offered to help interested parties in the translation process.
Full Text Available Gestational Trophoblastic Neoplasms (GTN are group of diseases which are known as fertilization disorders and may appear as Complete hydatidiform mole, Mole partialis, Invasive mole, Placental site trophoblastic tumor, Choriocarcinoma. Malignant disease precedes in approxi mately 50% of patients. All cases of GTN must be registrated. The Followe up programme period may last 6 months to 2 years until three sequential beta hCG values are negative. The risk of repeated GTN is low but patient has to be informed that risk is 1 : 74. GTN can appear in perimenopausal or menopausal women. That is the reason why each rapid enlargement of uterus especially with uterine bleeding followed with multiple cystic formations (grape like cysts needs a serious examination on GTN. Patient can complain of nausea, vomiting, painful breasts or hiperthyoidism. Legal abortion can precede GTN in perimenopausal women. In the great number of women with GTN the last pregnancy was 5 or more than 5 years before GTN is diagnosed. During 5 year period from june 1999. till june 2004, 58 GTN cases were diagnosed on our Department. 7 women with confirmed GTN were in perimenopause or menopause. All cases were hystologicalu confirmed with clinical low clinical score. In 1999. (March-June unpowerishment Uranium was used during war in Former Yugoslavia. Potential effect on reproductive potential could be analyzed after collecting data from the whole territory of Serbia and Montenegro in next years. All GTN patients are clinically, laboratory and ultrasonographicaly examined and staged according to FIGO 2002. recommendations
Full Text Available Numerous concerns about menopause exist among women, and fear of an increase in body weight is one of the most important of them. This paper presents an overview of current knowledge concerning the etiology of obesity related to menopause and about the mechanisms of its development, with particular regard to the hormonal changes that occur during this period of life. The role of estrogens in the regulation of energy balance and the effect of sex hormones on metabolism of adipose tissue and other organs are presented. The consequence of the sharp decline in the secretion of estrogens with subsequent relative hyperandrogenemia is briefly discussed. The main intention of this review is to clarify what is inevitable and what perhaps results from negligence and unhealthy lifestyles. In the last part of the paper the possibilities of counteracting the progress of adverse changes in body composition, by promoting beneficial lifestyle modifications and the use of hormonal substitution treatment, in cases where it is reasonable and possible, are described.
Azizi, Hoda; Feng Liu, Yan; Du, Lin; Hua Wang, Chao; Bahrami-Taghanaki, Hamidreza; Ollah Esmaily, Habib; Azizi, Hamideh; Ou Xue, Xiao
To compare the therapeutic effect of Chinese herbal medicine (CHM), acupuncture, and hormone therapy on menopause- related symptoms of peri- and postmenopausal women. Fifty-seven Chinese women completed 2 months of treatment with either CHM (5 g twice daily, n = 22), acupuncture plus CHM (Kun Bao Wan) 5 g twice daily plus sessions of acupuncture, n = 20), or hormone therapy (n = 15). Kupperman index score, levels of follicle-stimulating hormone (FSH) and estradiol, and the number of symptoms before and after treatment were the main outcome measures. CHM, acupuncture plus CHM, and hormone therapy significantly decreased Kupperman score (P acupuncture plus CHM and CHM with significantly better results by acupuncture plus CHM. Acupuncture plus CHM, as well as hormone therapy, significantly reduced the level of FSH (P .05). The mean difference in the level of FSH between baseline and 2 months among the three groups was significantly different (P = .02). This difference was only between CHM and hormone therapy with significantly better results by hormone therapy. The three treatments didn't make any significant increase in the level of E2 (P > .05). application of the combination of Chinese herbal medicine and acupuncture proved as effective as hormone therapy in the treatment of menopause-related symptoms, and it achieved better outcomes than herbal medicine alone.
Chow, Erika T; Mahalingaiah, Shruthi
Cosmetics contain a vast number of chemicals, most of which are not under the regulatory purview of the Food and Drug Administration. Only a few of these chemicals have been evaluated for potential deleterious health impact: parabens, phthalates, polycyclic aromatic hydrocarbons, and siloxanes. A review of the ingredients in the best-selling and top-rated products of the top beauty brands in the world, as well as a review of highlighted chemicals by nonprofit environmental organizations, reveals 11 chemicals and chemical families of concern: butylated hydroxyanisole/butylated hydroxytoluene, coal tar dyes, diethanolamine, formaldehyde-releasing preservatives, parabens, phthalates, 1,4-dioxane, polycyclic aromatic hydrocarbons, siloxanes, talc/asbestos, and triclosan. Age at menopause can be affected by a variety of mechanisms, including endocrine disruption, failure of DNA repair, oxidative stress, shortened telomere length, and ovarian toxicity. There is a lack of available studies to make a conclusion regarding cosmetics use and age at menopause. What little data there are suggest that future studies are warranted. Women with chronic and consistent use of cosmetics across their lifespan may be a population of concern. More research is required to better elucidate the relationship and time windows of vulnerability and the effects of mixtures and combinations of products on ovarian health. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background To evaluate the impact of osteoporosis on the patients' quality of life, particularly in the absence of fractures. Methods 100 post-menopausal women (age 50-85 - 62 with uncomplicated primary osteoporosis and 38 with primary osteoporosis complicated by vertebral fractures; all already treated - were studied using two validated questionnaires: Qualeffo-41 for quality of life in osteoporosis, and Zung for depression. Data were compared to those of 35 controls of comparable age, affected by a different chronic disease (hypothyroidism. Results Family history of osteoporosis and T-score of spine were similar in the two subgroups of osteoporotic women. Body mass index, age at menopause and education level were similar in the two subgroups of osteoporotic women and in the control group. The patients affected by osteoporosis perceived it as a disease affecting their personal life with undesirable consequences: chronic pain (66% of women with fractures and 40% of women without fractures, impaired physical ability, reduced social activity, poor well-being (21% of women without fractures and depressed mood (42% of women irrespective of fractures. Overall, 41% of the women showed a reduced quality of life. On the contrary, in the control group only 11% reported a reduced quality of life. Conclusion The quality of life of osteoporotic patients should be investigated even before fractures, in order to develop appropriate counselling, support and care interventions to help patients develop efficient strategies for accepting the disease and coping with it.
Obesity is a common problem and its health consequences depend on the phenotype of obesity. Clinical aspects of three phenotypes of obesity: upper body (visceral), lower body (healthy) and metabolic obesity with normal weight are discussed. The PolSenior study and other data show that the incidence of obesity increases during hormonal climacteric transformation with special emphasis on visceral (72%) and metabolic obesity with normal weight (16%). The etiology of menopausal obesity and fat redistribution with an increase incidence of menopausal metabolic syndrome is presented. The role of sex hormones and SHBG of fat mass and fat distribution in postmenopausal women is discussed on the basis of PolSenior study. The diagnostic-therapeutic algorithm for climacteric women is recommended according to cardiovascular diseases risk (CVD), elevated waist circumference, serum triglicerides, decreased HDL cholesterol, elevated fasting glucose, HOMA over 1.69 and BP over 130/80 mmHg. In women with CVD risk factors the metformin therapy is a golden standard.
Kozakowski, Jarosław; Gietka-Czernel, Małgorzata; Leszczyńska, Dorota; Majos, Agnieszka
Numerous concerns about menopause exist among women, and fear of an increase in body weight is one of the most important of them. This paper presents an overview of current knowledge concerning the etiology of obesity related to menopause and about the mechanisms of its development, with particular regard to the hormonal changes that occur during this period of life. The role of estrogens in the regulation of energy balance and the effect of sex hormones on metabolism of adipose tissue and other organs are presented. The consequence of the sharp decline in the secretion of estrogens with subsequent relative hyperandrogenemia is briefly discussed. The main intention of this review is to clarify what is inevitable and what perhaps results from negligence and unhealthy lifestyles. In the last part of the paper the possibilities of counteracting the progress of adverse changes in body composition, by promoting beneficial lifestyle modifications and the use of hormonal substitution treatment, in cases where it is reasonable and possible, are described.
Sowers, Maryfran R; Randolph, John F; Zheng, Huiyong; Jannausch, Mary; McConnell, Daniel; Kardia, Sharon R; Crandall, Carolyn J; Nan, Bin
Obesity and genetic variation in aromatase and type 1 17-β hydroxysteroid dehydrogenase (HSD) could influence the E2 trajectory of decline during the menopause transition. E2 trajectories during the menopause transition (phenotype) were identified using 5934 data points acquired annually from 681 women in Study of Women's Health across the Nation (SWAN), a multiethnic study of the mid-life. E2 trajectories were related to CYP19 and type I 17-βHSD single-nucleotide polymorphisms (SNPs) and obesity. (log) E2 trajectories began to decline precipitously 2 years before the final menstrual period (FMP). The trajectory of the (log) E2 decline varied with genotypes and obesity. (log) E2 rates of decline were greater in nonobese women than in obese women, P obesity groups. Within each obesity group, (log) E2 rate of decline was greater in heterozygous variants and much less in homozygotes (P Obese women with selected CYP19 and 17-β HSD gene variants had remarkably different E2 trajectories around the FMP, resulting in different postmenopausal E2 levels. The rate of the E2 decline and the subsequent postmenopausal E2 levels may be relevant to oestrogen-sensitive chronic diseases including cancers. © 2011 Blackwell Publishing Ltd.
Chow, Erika; Mahalingaiah, Shruthi
Short Narrative Abstract Cosmetics contain a vast number of chemicals, most of which are not under the regulatory purview of the Food and Drug Administration. Only a few of these chemicals have been evaluated for potential deleterious health impact – parabens, phthalates, polycyclic aromatic hydrocarbons, and siloxanes. A review of the ingredients in the best-selling and top rated products of the top beauty brands in the world, as well as a review of highlighted chemicals by non-profit environmental organizations reveal 11 chemicals and chemical families of concern: butylated hydroxyanisole/butylated hydroxytoluene, coal tar dyes, diethanolamine, formaldehyde releasing preservatives, parabens, phthalates, 1,4 dioxane, polycyclic aromatic hydrocarbons, siloxanes, talc/asbestos, and triclosan. Age at menopause can be affected by a variety of mechanisms, including endocrine disruption, failure of DNA repair, oxidative stress, shortened telomere length, and ovarian toxicity. There is a lack of available studies to make a conclusion regarding cosmetics use and age at menopause. What little data there is suggests future studies are warranted. Women with chronic and consistent use of cosmetics across their lifespan may be a population of concern. More research is required to better elucidate the relationship and time windows of vulnerability and the effects of mixtures and combinations of products on ovarian health. PMID:27545020
Colombo, Cinzia; Mosconi, Paola; Buratti, Maria Grazia; Liberati, Alessandro; Donati, Serena; Mele, Alfonso; Satolli, Roberto
To evaluate the information reported by Italian press articles about hormone replacement therapy (HRT) and menopause, in terms of completeness, clarity of language and transparency. In the framework of the Consensus Conference Informing women about hormone replacement therapy, 225 articles published from 2000 to 2007 in Italian lay press were evaluated. Health magazines, weekly news magazines, newspapers, women's magazines and medical practitioners' journals were selected. A form covering graphic layout, completeness of information, clarity of language and transparency was applied to each article by a reviewer. The form was tested in a pilot phase. HRT was recommended to treat menopausal symptoms in more than half of articles (56%) and was described as a preventive measure in almost half (48%). Risks related to HRT were under-reported (58% of the articles). Information on conflicts of interest was lacking (88%). Opinions of experts were the main source of information cited in the articles (66%). The information reported by the articles is lacking in several aspects. Many women are likely to receive unbalanced information from the press. Qualified sources of information delivered on the scientific knowledge available are needed, reporting advantages and disadvantages of HRT, pharmacological and non-pharmacological alternative treatments and their effectiveness. Scientific journalism needs to grow through training. The role of researchers and clinicians is discussed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Abstract The importance of the results of some large, randomized controlled trials (RCTs on Hormone Replacement Therapy (HRT has modified the risk/benefit perception of HRT. Recent literature review supports a different management. The differences in age at initiation and the duration of HRT are key points. HRT appears to decrease coronary disease in younger women, near menopause; yet, in older women, HRT increases risk of a coronary event. Although HRT is a recognized method in the prevention and treatment of osteoporosis, it is not licensed for the prevention of osteoporosis as a first-line treatment. The effectiveness of low and ultra-low estrogen doses has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss, with fewer side-effects than the standard dose therapy. Further research, however, is needed to determine the effect both on fractures, as well as on cardiovascular and breast diseases. Newer progestins show effects that are remarkably different from those of other assays. The effectiveness of testosterone at improving both sexual desire and response in surgically and naturally postmenopausal women is shown by the testosterone patch. The intention, dose and regimen of HRT need to be individualized, based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and the time and menopause age.
Thomas, Yvonne; Gray, M.; McGinty, S.
This paper reports findings of a study that utilised an occupational perspective to explore how wellbeing was achieved and sustained by the occupations of people experiencing homelessness in Australia. Thirty three in-depth qualitative interviews were conducted with homeless individuals in a regional city in Australia. Data from the interviews were thematically analysed to understand the relationship between wellbeing, as defined by the individual, and the occupations engaged in by people exp...
Paixão,Gilvânia Patrícia do Nascimento; Gomes,Nadirlene Pereira; Diniz,Normélia Maria Freire; Lira,Margaret Ollinda de Souza Carvalho e; Carvalho,Milca Ramaiane da Silva; Silva,Rudval Souza da
Objective: to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence. Method: qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011). Results: the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed vio...
Steven Freund; Dev Prasad; Frank Andrews
In this study, we examine the differences in the factors perceived to be significant in the security selection process between novice and experienced investors. We apply the direct inquiry approach to two distinct groups: One group is composed of students enrolled in traditional face-to-face introductory investments classes, while the other group consists of students enrolled in the online sections of the same course. The online students tend to be generally older part-time students with grea...
Full Text Available Burnout is a serious psychological syndrome that can affect not only an individual’s well-being, but also the functioning of whole organisations, such as schools. It is characterized by emotional exhaustion, depersonalization, and decreased personal accomplishment.The level of burnout among teachers in the field of education has a negative impact on student success. The present investigation examines the level of burn out among high and low experienced teachers. It focused on a group of English teachers from different nationalities: Iranian, and Malaysian at UPM to examine if there is any relation between burnout and experience level. The sample consisted of 30 English teachers. Two instruments namely, The Maslach Burnout Inventory and Demographic Questionnaire were used to collect data. Data analysis revealed that there is no significant difference in depersonalization and personal accomplishment scores between low and high experienced teachers. But the result of this study also revealed that there is a significant difference in Emotional Exhaustion scores between low and high experienced teachers. Further research is required to explore the roots and the causes of burnout.
Struch, Naomi; Levav, Itzhak; Shereshevsky, Yechiel; Baidani-Auerbach, Alona; Lachman, Max; Daniel, Noga; Zehavi, Tali
Mental health-related stigma causes suffering and interferes with care and social inclusion. This study explored stigma as experienced by mental health service users. Particular attention is given to their use of coping mechanisms. Interviews were held with 167 adults undergoing outpatient psychiatric treatment; two-thirds of them had previously been hospitalized. Examples of frequency of stigma-related situations included the following: Over half of service users expect people to refuse to have a person with a mental disorder as a co-worker or neighbor, or to engage in other types of social contact. A sizeable group acknowledged that they feared or had experienced rejection. A third of respondents reported they feared or had experienced inappropriate treatment by their doctor. Service users utilize several coping mechanisms to deal with stigma, among them: education, withdrawal, secrecy, and positive distinctiveness. Although we studied a convenience sample of service users, our findings provide sufficient basis to suggest different types of intervention, i.e., to address stigma in the course of treatment in the specialist settings, to promote the establishment of mutual support groups, and to raise family physicians' awareness with regard to the stigma that may be present when caring for persons with mental disorders.
Full Text Available Menopause is a natural part of the aging process in women and is defined as occurring 12 months after the last menstrual period marking the end of menstrual cycles. Menopause has a negative impact on the quality of life (QoL. Various generic and specific questionnaires have been used for assessing different dimensions of QoL in menopausal women. The purpose of this systematic review was to identify those general and specific instruments, and to determine the factors that affect QoL in menopausal women. We assessed eight specific and three general tools and found that some general and specific instruments, such as the 36-item short form (SF-36 and the Menopause Specific Quality of Life Questionnaire (MENQOL, were mostly used for assessment. The specific tools available were diverse. Employment status and a high educational level in menopausal women were considered to be protective factors in improving QoL. Identification of predicting factors of QoL, such as body mass index, race, age, duration of menopause, and social and occupational variables can help to improve the QoL of these women allowing planning of psychological consultations and practical interventions.
Vyas, Rashmi; Raval, Kanti V; Dikshit, Nirupama
Coronary artery disease is an important cause of death and disability among older women. Modification in lipid profile lowers the risk of coronary artery disease. It is claimed that yoga and transcendental meditation have a cholesterol lowering effect. This study was designed to assess the effect of raja yoga meditation of Brahmakumaris which is very simple to practice, on serum lipids in normal Indian women. 49 normal female volunteers were the subjects. They were divided into pre-menopausal (n=23) and post-menopausal (n=26) groups. They were further divided into non-meditators (who had never done any kind of meditation), short-term meditators (meditating for 6 months to 5 years) and long-term meditators (meditating for more than 5 years). Lipid profile was assessed using their respective reagent sets. Serum cholesterol, triglyceride and low-density lipoprotein-cholesterol in nonmeditators were significantly more in post-menopausal women as compared to pre-menopausal women. Serum cholesterol and low density lipoprotein-cholesterol were significantly lowered in both short and long term meditators as compared to non-meditators in post-menopausal women. No significant difference was observed in lipid profile in pre-menopausal women. Raja yoga meditation lowered serum cholesterol and low-density lipoprotein-cholesterol in post-menopausal women thus reducing the risk of coronary artery disease in them.
Campbell, Ian G; Bromberger, Joyce T; Buysse, Daniel J; Hall, Martica H; Hardin, Kimberly A; Kravitz, Howard M; Matthews, Karen A; Rasor, Marianne O'Neill; Utts, Jessica; Gold, Ellen
Women report increasing sleep difficulties during menopause, but polysomnographic measures do not detect sleep disturbances. We examined whether two spectral analysis sleep measures, delta and beta power, were related to menopausal status. The Study of Women's Health Across the Nation (SWAN) Sleep Study compared cross-sectionally spectral sleep measures in women in different stages of menopause. Sleep EEG was recorded in the participants' homes with ambulatory recorders. A multi-ethnic cohort of premenopausal and early perimenopausal (n = 189), late perimenopausal (n = 73), and postmenopausal (n = 59) women. EEG power in the delta and beta frequency bands was calculated for all night NREM and all night REM sleep. Physical, medical, psychological, and socioeconomic data were collected from questionnaires and diaries. Beta EEG power in NREM and REM sleep in late perimenopausal and postmenopausal women exceeded that in pre- and early perimenopausal women. Neither all night delta power nor the trend in delta power across the night differed by menopausal status. In a multivariate model that controlled for the physical, demographic, behavioral, psychological, and health-related changes that accompany menopause, beta power in both NREM and REM sleep EEG was significantly related to menopausal status. The frequency of hot flashes explained part but not all of the relation of beta power to menopausal status. Elevated beta EEG power in late perimenopausal and postmenopausal women provides an objective measure of disturbed sleep quality in these women. Elevated beta EEG activity suggests that arousal level during sleep is higher in these women.
Kazemzadeh, Rafat; Nikjou, Roya; Rostamnegad, Masoumeh; Norouzi, Hosein
Flushing is generally considered to be the primary symptom of menopause and is typically the most common complaint in menopausal women. Although flushing poses no danger to a woman's health, it decreases the quality of life. Thus, the purpose of this study was to determine the effect of lavender aromatherapy on menopause flushing. This double-blinded crossover clinical trial included 100 menopausal women 45-55 years of age who were referred to various health centers in Ardabil, Iran in 2013-2014. Samples were blocked randomly and divided into two intervention (lavender) and control (diluted milk) groups. Lavender aroma was smelled for 20 minutes twice a day, over a 12-week period. Data were collected using a demographic questionnaire, and flushing numbers were duly recorded. Data analysis was performed by SPSS version 16 (SPSS Inc., Chicago, IL, USA) using the Chi-square and t test. The results of our investigation showed that both groups had no significant difference according to demographic characteristics (p > 0.05). Additionally, the flushing number significantly decreased in the intervention group than in the control group (p aromatherapy reduced menopause flushing. Given the impact of stress on flushing and the undesirable effects of menopause symptoms on the quality of life, it would appear that this simple, noninvasive, safe, and effective method can be used by menopausal women with noticeable benefits. Copyright © 2016. Published by Elsevier Taiwan LLC.
Sergeant, Judith; Rizq, Rosemary
This study explores the impact of menopause on women's identity and considers the effect of sociocultural factors on their experience of this stage of life. Semi-structured interviews were conducted with 11 women and analysed following constructivist Grounded Theory methods. Women described uncertainty produced by their changing bodies. Menopause was interpreted as marking transition to another phase of life, which necessitated renegotiation of role and status in the face of menopause narratives questioning women's relevance, vigour, attractiveness and emotional stability. We discuss results with reference to what appears to be an unspoken social "rule" keeping menopause hidden, something that enables dismissive menopausal narratives to persist. Our study suggests this resulted in some sense of emotional strain for participants as they negotiated a continuing narrative of their lives through a period of change. However, results also indicate that menopause may provide an opportunity for women to refocus on their goals and wellbeing. We conclude by considering the implications of the study for healthcare professionals working with menopausal women.
Peng, W; Sibbritt, D W; Hickman, L; Kong, X; Yang, L; Adams, J
To provide the first critical review of traditional Chinese medicine (TCM) use amongst symptomatic menopausal women, drawing upon work examining the perspectives of both TCM users and TCM practitioners. A search was conducted in three English-language databases (MEDLINE, CINAHL and AMED) and three Chinese-language databases (CNKI, VIP and CBM Disc) for 2002-2013 international peer-reviewed articles reporting empirical findings of TCM use in menopause. A total of 25 journal articles reporting 22 studies were identified as meeting the review inclusion criteria. Chinese herbal medicine appears to be the most common therapy amongst symptomatic menopausal women, and vasomotor symptoms and emotional changes are the most frequent symptoms for which TCM is sought. However, evidence regarding the prevalence of TCM use and users' profile in menopause is limited. Existing studies are of varied methodological quality, often reporting low response rate, extensive recall bias and a lack of syndrome differentiation. This review provides insights for practitioners and health policy-makers regarding TCM care to symptomatic menopausal women. More nationally representative studies are required to rigorously examine TCM use for the management of menopausal symptoms. Syndrome differentiation of menopausal women is an area which also warrants further attention.
Simoncig-Netjasov, Aleksandra; Vujović, Svetlana; Ivović, Miomira; Tancić-Gajić, Milina; Drezgić, Milka
Hypoestrogenic status in the menopausal women shows a shift to a central android fat distribution and metabolic syndrome (MIS). Related metabolic changes and hypertension increase the risk for cardiovascular (CV) diseases. The aim of this study was to investigate the influence of duration of menopause, anthropometric and hormonal parameters on metabolic syndrome. 50 obese women were examined with BMI = 31.92 = 5.83 kg/m2, age 54.40 +/- 3.64, time since menopause 5.90 +/- 5.46 years. Control group consisted of 37 normal weight women with BMI = 23.50 +/- 2.13 kg/m2, age 53.92 +/- 3.95, time since menopause 5.96 +/- 4.92 years. Anthropometric characteristics and blood pressure were measured. Blood was taken at 8 am for: fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A (ApoA), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, FSH, LH, prolactin, estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG). In obese women significant negative correlations were found for: BMI anid HDL (p menopause and waist/hip ratio (p menopause and HDL (p menopausal endocrine changes cause metabolic and hemodynamic imbalances, which contribute to risk for cardiovascular diseases.
Im, Eun-Ok; Lee, Yaelim; Chee, Eunice; Chee, Wonshik
Advances in computer and Internet technologies have allowed health care providers to develop, use, and test various types of Web-based interventions for their practice and research. Indeed, an increasing number of Web-based interventions have recently been developed and tested in health care fields. Despite the great potential for Web-based interventions to improve practice and research, little is known about the current status of Web-based interventions, especially those related to menopause. To identify the current status of Web-based interventions used in the field of menopause, a literature review was conducted using multiple databases, with the keywords "online," "Internet," "Web," "intervention," and "menopause." Using these keywords, a total of 18 eligible articles were analyzed to identify the current status of Web-based interventions for menopause. Six themes reflecting the current status of Web-based interventions for menopause were identified: (a) there existed few Web-based intervention studies on menopause; (b) Web-based decision support systems were mainly used; (c) there was a lack of detail on the interventions; (d) there was a lack of guidance on the use of Web-based interventions; (e) counselling was frequently combined with Web-based interventions; and (f) the pros and cons were similar to those of Web-based methods in general. Based on these findings, directions for future Web-based interventions for menopause are provided. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Cramer, Holger; Rabsilber, Sybille; Lauche, Romy; Kümmel, Sherko; Dobos, Gustav
Breast cancer survivors have only very limited treatment options for menopausal symptoms. The objective of this trial was to evaluate the effects of a 12-week traditional Hatha yoga and meditation intervention on menopausal symptoms in breast cancer survivors. Patients were randomly assigned either to a 12-week yoga and meditation intervention or to usual care. The primary outcome measure was total menopausal symptoms (Menopause Rating Scale [MRS] total score). Secondary outcome measures included MRS subscales, quality of life (Functional Assessment of Cancer Therapy-Breast), fatigue (Functional Assessment of Chronic Illness Therapy-Fatigue), depression, and anxiety (Hospital Anxiety and Depression Scale). Outcomes were assessed at week 12 and week 24 after randomization. In total, 40 women (mean age ± standard deviation, 49.2 ± 5.9 years) were randomized to yoga (n = 19) or to usual care (n = 21). Women in the yoga group reported significantly lower total menopausal symptoms compared with the usual care group at week 12 (mean difference, -5.6; 95% confidence interval, -9.2 to -1.9; P = .004) and at week 24 (mean difference, -4.5; 95% confidence interval, -8.3 to -0.7; P = .023). At week 12, the yoga group reported less somatovegetative, psychological, and urogenital menopausal symptoms; less fatigue; and improved quality of life (all P menopausal symptoms. Short-term effects on menopausal symptoms remained significant when only women who were receiving antiestrogen medication (n = 36) were analyzed. Six minor adverse events occurred in each group. Yoga combined with meditation can be considered a safe and effective complementary intervention for menopausal symptoms in breast cancer survivors. The effects seem to persist for at least 3 months. © 2015 American Cancer Society.
Full Text Available Background: Sexual function can be affected by several factors. Menopause and its symptoms including somatic, psychological, and urogenital symptoms can be associated with sexual dysfunction during menopause. Objective: The aim of this study was to determine the effects of the severity of menopausal symptoms on sexual function in postmenopausal women. Methods: This analytical study was conducted in 405 postmenopausal women -40 to 60 years old- in Nowshahr and Chaloos during 2013 and 2014. Subjects were selected by multi-stage random sampling method. Data were collected using the Female Sexual Function Index (FSFI, the Menopause Rating Scale (MRS, and a researcher-made questionnaire. Data were analyzed using Pearson's correlation coefficient, Spearman correlation coefficient, T-test, multiple linear regression and logistic regression. Findings: Sixty one percent of the subjects had sexual dysfunction. The most severe menopausal symptoms were related to psychological domain and the lowest score was related to urogenital domain. All domains of MRS and the MRS total score had significantly negative correlation with the FSFI total score. The urogenital score (r=0.283, P<0.001 and the MRS total score (r=0.116, P=0.020 had significantly positive correlation with sexual dissatisfaction. Urogenital score and MRS total score were significantly higher in women with decreased sexuality and sexual relationship after menopause compared to others. The severity of menopausal symptoms was negative predictor of all domains of sexual function except for satisfaction and the FSFI total score. The MRS total score was a predictor of variation in sexuality and sexual relationship after menopause and satisfaction. Conclusion: The severity of menopausal symptoms could have a negative effect on sexual function. Controlling these symptoms should be noted to improve sexual function for women's health policy making.
Roubaud, Guilhem; Liaw, Bobby C; Oh, William K; Mulholland, David J
The increasing potency of therapies that target the androgen receptor (AR) signalling axis has correlated with a rise in the proportion of patients with prostate cancer harbouring an adaptive phenotype, termed treatment-induced lineage crisis. This phenotype is characterized by features that include soft-tissue metastasis and/or resistance to standard anticancer therapies. Potent anticancer treatments might force cancer cells to evolve and develop alternative cell lineages that are resistant to primary therapies, a mechanism similar to the generation of multidrug- resistant microorganisms after continued antibiotic use. Herein, we assess the hypothesis that treatment-adapted phenotypes harbour reduced AR expression and/or activity, and acquire compensatory strategies for cell survival. We highlight the striking similarities between castration-resistant prostate cancer and triple-negative breast cancer, another poorly differentiated endocrine malignancy. Alternative treatment paradigms are needed to avoid therapy-induced resistance. Herein, we present a new clinical trial strategy designed to evaluate the potential of rapid drug cycling as an approach to delay the onset of resistance and treatment-induced lineage crisis in patients with metastatic castration-resistant prostate cancer.
Roubaud, Guilhem; Liaw, Bobby C.; Oh, William K.; Mulholland, David J.
The increasing potency of therapies that target the androgen receptor (AR) signalling axis has correlated with a rise in the proportion of patients with prostate cancer harbouring an adaptive phenotype, termed treatment-induced lineage crisis. This phenotype is characterized by features that include soft-tissue metastasis and/or resistance to standard anticancer therapies. Potent anticancer treatments might force cancer cells to evolve and develop alternative cell lineages that are resistant to primary therapies, a mechanism similar to the generation of multidrug-resistant microorganisms after continued antibiotic use. Herein, we assess the hypothesis that treatment-adapted phenotypes harbour reduced AR expression and/or activity, and acquire compensatory strategies for cell survival. We highlight the striking similarities between castration-resistant prostate cancer and triple-negative breast cancer, another poorly differentiated endocrine malignancy. Alternative treatment paradigms are needed to avoid therapy-induced resistance. Herein, we present a new clinical trial strategy designed to evaluate the potential of rapid drug cycling as an approach to delay the onset of resistance and treatment-induced lineage crisis in patients with metastatic castration-resistant prostate cancer. PMID:27874061
Porzio, Giampiero; Trapasso, Tiziana; Martelli, Silvia; Sallusti, Elisa; Piccone, Caterina; Mattei, Antonella; Di Stanislao, Carlo; Ficorella, Corrado; Marchetti, Paolo
Fifteen patients were enrolled in a pilot study to evaluate the safety and efficacy of acupuncture for the treatment of menopausal symptoms in tamoxifen-treated patients. Patients were evaluated before treatment and after one, three and six months with the Greene Menopause Index and were treated according to the traditional Chinese medicine. Anxiety, depression, somatic and vasomotor symptoms were improved by the treatment; libido was not modified. Acupuncture seems to be safe and effective for the treatment of menopausal symptoms in women with previous breast cancer taking tamoxifen. Confirmatory studies with a larger number of patients and with a placebo-treated group are warranted.
Kuo Jennifer; Ganji Vijay
Abstract Background Cardiovascular disease is the leading cause of death in women and men. Psyllium, a soluble fiber has been known to reduce serum lipids. In this pilot study, we evaluated whether menopausal status would affect the serum lipid responses to psyllium fiber in women. Methods Eleven post-menopausal and eight pre-menopausal women with serum total cholesterol >200 mg/dL were included in the study. Subjects consumed their habitual diet and 15 g psyllium/d for 6 weeks. Psyllium was ...
Full Text Available Post-menopausal osteoporosis is a skeletal disease that can be asymptomatic and is sometimes underdiagnosed and undertreated. Post-menopausal osteoporosis can be associated with fractures and consequent impaired quality of life and increase of health care costs. Bisphosphonates are a therapeutic choice, because they proved to be effective in preventing bone loss. The current case report shows the efficacy of six-month risedronate administration in a post-menopausal woman affected by osteoporosis and inflammatory bowel disease in reducing biochemical bone turnover markers and increasing bone mineral density.
Jin, Feng; Shao, Hongfang; Tao, Minfang
To explore the factors affecting menarcheal age by investigating two groups of women differing in age by 10-15 years in Shanghai. Data on 5,207 women were collected from January 2011 to May 2012: 2,151 women of reproductive age from the Obstetrical Department and 3,056 women in menopause from the Medical Center of the Sixth Hospital of Shanghai City. General data and data on menarcheal age and medical history were collected. The two groups were divided into subgroups from menopause women (p menopausal women was significantly negatively correlated with their menarcheal age (r = -0.033, p obesity. © 2013 S. Karger AG, Basel.
Márcia Mendes Menezes
Full Text Available ABSTRACT The current study aimed to identify and analyze the prevalence of ethical conflicts experienced by medical students. This study is a cross-sectional and analytical research that was conducted in a public school in the state of Minas Gerais, Brazil. The instrument used for the data collection was a self-administered questionnaire. The data collected were presented in absolute and percentage values. For the analytical statistical treatment of the data, the level of significance was considered p <0.05. The outcome variables were: Experiences of ethical conflicts in interpersonal relations within the medical course and Ethical conduct in health care. The identification of the prevalence of ethical conflicts in the undergraduate program adopted the perspective of different interpersonal relations (academic-teaching, academic-academic, academic-employee, academic-patient, teacher-teacher, teacher-patient, teacher-employee and employee-patient. (Importance of identifying themselves to the health services user and requesting consent to perform the physical examination, assistance without the supervision of the teacher, issuance of health documents without the signature of the professional responsible and use of social networks to share data Of patient. It was verified the association of the outcome variables with sex, year of graduation and course evaluation. A total of 281 undergraduate students enrolled in all undergraduate courses in Medicine of both sexes, with a predominance of female (52.7%. The students reported having experienced conflicting situations in interpersonal relations with teachers (59.6%, provided assistance without proper supervision of a teacher (62.6%, reported having issued health documents without the accompaniment of teachers (18, 5%. The highest frequency was observed among those enrolled in the most advanced years of the undergraduate program (p <0.05. The use of social networks for the purpose of sharing patient
Borud, Einar Kristian; Alraek, Terje; White, Adrian; Grimsgaard, Sameline
The previously published Acupuncture on Hot Flashes Among Menopausal Women study compared the effectiveness of individualized acupuncture treatment plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women. This article reports on the observational follow-up results at 6 and 12 months. The Acupuncture on Hot Flashes Among Menopausal Women study was a pragmatic, multicenter randomized controlled trial with two parallel arms, conducted in 2006 to 2007. The 267 participants were postmenopausal women experiencing, on average, 12.6 hot flashes per 24 h. The acupuncture group received 10 individualized acupuncture treatments during 12 weeks and advice on self-care, whereas the control group received only advice on self-care. Hot flash frequency and intensity (0-10 scale) and hours of sleep per night were registered in a diary. Health-related quality of life was assessed by the Women's Health Questionnaire. From baseline to 6 months, the mean reduction in hot flash frequency per 24 hours was 5.3 in the acupuncture group and 5.0 in the control group, a nonsignificant difference of 0.3. At 12 months, the mean reduction in hot flash frequency was 6.0 in the acupuncture group and 5.8 in the control group, a nonsignificant difference of 0.2. Differences in quality-of-life scores were not statistically significant at 6 and 12 months. The statistically significant differences between the study groups found at 12 weeks were no longer present at 6 and 12 months. Acupuncture can contribute to a more rapid reduction in vasomotor symptoms and increase in health-related quality of life in postmenopausal women but probably has no long-term effects.
In 2009, Elena Long created the LGBT+ Physicists website (http://lgbtphysicists.x10hosting.com) as a warehouse for resources useful for sexual and gender minorities working in physics. This resource has grown to include networking resources, lists of LGBT-friendly universities and localities, recommendations for enacting positive change in physics communities, and out-reach to other STEM-oriented LGBT organizations. This has been possible in large part by the dynamic community of LGBT+ physicists and allies looking to make physics more welcoming towards our community. In 2011, Elena used hir position as Member at Large on the executive committee of the Forum of Graduate Student Affairs (FGSA) to conduct a climate survey that included, among other things, the first serious look at LGBT+ demographics in physics. The survey focused particularly on issues of language heard and harassment experienced by physicists and was broken down into categories based on race, physical and mental ability, gender, and sexuality. Furthermore, it examined the outcomes of experienced harassment and the reasons for when harassment was not reported. Due to the nature of the study, overlapping demographics, especially ``multiple minorities,'' were also explored. This talk will give a brief history of the LGBT+ Physicists resource as well as an overview of the FGSA study.
da Luz, Kely Regina; Vargas, Mara Ambrosina de Oliveira; Schmidtt, Pablo Henrique; Barlem, Edison Luiz Devos; Tomaschewski-Barlem, Jamila Geri; da Rosa, Luciana Martins
To know the ethical problems experienced by oncology nurses. Descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. For the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.
Kely Regina da Luz
Full Text Available Objective: to know the ethical problems experienced by oncology nurses. Method: descriptive and exploratory study with a qualitative approach, performed in inpatient units and in chemotherapy out-patients units that provide assistance to oncological patients in two capitals in the South region of Brazil. Eighteen nurses participated in this study, selected by snowball sampling type. For data collection, semi-structured interviews were carried out, which were recorded and transcribed, and then analyzed by thematic analysis. Results: two categories were established: when informing or not becomes a dilemma - showing the main difficulties related to oncological treatment information regarding health staff, health system, and infrastructure; to invest or not - dilemmas related to finitude - showing situations of dilemmas related to pain and confrontation with finitude. Conclusion: for the effective confrontation of the ethical problems experienced by oncology nurses to occur, it is important to invest in the training of these professionals, preparing them in an ethical and human way to act as lawyers of the patient with cancer, in a context of dilemmas related mainly to the possibility of finitude.
Van Someren, Eus J. W.; Dekker, Kim; Te Lindert, Bart H. W.; Benjamins, Jeroen S.; Moens, Sarah; Migliorati, Filippo; Aarts, Emmeke; van der Sluis, Sophie
ABSTRACT Individuals differ in thermosensitivity, thermoregulation, and zones of thermoneutrality and thermal comfort. Whereas temperature sensing and -effectuating processes occur in part unconsciously and autonomic, awareness of temperature and thermal preferences can affect thermoregulatory behavior as well. Quantification of trait-like individual differences of thermal preferences and experienced temperature sensitivity and regulation is therefore relevant to obtain a complete understanding of human thermophysiology. Whereas several scales have been developed to assess instantaneous appreciation of heat and cold exposure, a comprehensive scale dedicated to assess subjectively experienced autonomic or behavioral thermoregulatory activity has been lacking so far. We constructed a survey that specifically approaches these domains from a trait-like perspective, sampled 240 volunteers across a wide age range, and analyzed the emergent component structure. Participants were asked to report their thermal experiences, captured in 102 questions, on a 7-point bi-directional Likert scale. In a second set of 32 questions, participants were asked to indicate the relative strength of experiences across different body locations. Principal component analyses extracted 21 meaningful dimensions, which were sensitive to sex-differences and age-related changes. The questions were also assessed in a matched sample of 240 people with probable insomnia to evaluate the sensitivity of these dimensions to detect group differences in a case-control design. The dimensions showed marked mean differences between cases and controls. The survey thus has discriminatory value. It can freely be used by anyone interested in studying individual or group differences in thermosensitivity and thermoregulation. PMID:27227080
Innes, Kim E; Selfe, Terry Kit; Taylor, Ann Gill
Cardiovascular disease risk rises sharply with menopause, likely due to the coincident increase in insulin resistance and related atherogenic changes that together comprise the metabolic or insulin resistance syndrome, a cluster of metabolic and hemodynamic abnormalities strongly implicated in the pathogenesis and progression of cardiovascular disease. A growing body of research suggests that traditional mind-body practices such as yoga, tai chi, and qigong may offer safe and cost-effective strategies for reducing insulin resistance syndrome-related risk factors for cardiovascular disease in older populations, including postmenopausal women. Current evidence suggests that these practices may reduce insulin resistance and related physiological risk factors for cardiovascular disease; improve mood, well-being, and sleep; decrease sympathetic activation; and enhance cardiovagal function. However, additional rigorous studies are needed to confirm existing findings and to examine long-term effects on cardiovascular health.
The increasing proportion of the aged in the population is posing significant new challenges to politics, society and medicine as well. Gerontology and geriatrics are playing a role in all areas of preventive and curative medicine. Since the life expectancy of women is approximately eight years longer than that of men, gynecology draws special significance from the fact that the greater part of an aging society will primarily be comprise of women. The medical treatment and care of women in climacteric and postmenopause in the past is seriously inadequate by today's standards. The attitude in earlier years of not making any great investment of cost or personnel in patients over 75 can, in view of the vitality of modern-day senior citizens, no longer be justified or maintained. The necessity of establishing old-age gynecology becomes more and more clear and urgent. The decrease of ovarian function in menopause is without doubt an important turning point in the life of a woman. The first signs of aging are inescapable. Following these years a woman still has more than one third of life expectancy ahead of her which she would like to and should spend in good mental, spiritual and physical health. The principle of postmenopausal hormone replacement has shown itself to be amazingly successful in treating climacteric disorders and their effects on the entire organism. Treatment over many years with as board a spectrum as possible of preventive hormones to combat the long-term consequences of hormone deficiency, like osteoporosis-related fractures, heart attacks, or strokes, is one of the great medical advances of our time. Furthermore, the significance of preventing a number of genital concern manifestations through hormone replacement therapy cannot be overestimated. Gynecology has taken a remarkable step toward its goal of enabling aging women to spend the third part of their lives free of unnecessary diseases and suffering. In 1994, after consultation with
Cordingley, Lis; Mackie, Fiona; Pilkington, Andrea; Bundy, Christine
The menopause is an important transition point for women in terms of their experience of sex. Higher expectations of a longer, healthier lifespan means that access to health professionals with the skills to address sexual issues is more important than ever. This review of the literature considered four broad areas: the influence of patient and practitioner characteristics on consultations about sexual issues for peri- and postmenopausal women; perceived barriers to discussion of sexual issues; the role and effectiveness of communication training; and examples of good practice in the field. This is an under-researched area with few papers focusing on the specific needs of this group of patients or practitioners. In order to improve the quality of life of mid-life and older women, more high-quality research is needed that can inform both education and training for gynaecologists, and the development of high-quality services.
Carlos Enrique Escobar Gónima
Full Text Available Se hace un recuento histórico de cómo la cultura médica occidental ha percibido la menopausia, su transformación de condición fisiológica en una enfermedad y cómo a consecuencia de nuevas publicaciones relacionadas con las terapias de reemplazo hormonal se hace necesario reconsiderar muchas actitudes y prácticas médicas que se desarrollaron en los últimos años. This article presents a historic review about the recent ways in which medicine conceives menopause, the implications of the Women‘s Health Initiative Studies and the need to develop a critic attitude before adopting foreign doctrines, technologies and drug therapies.
Smith, Elizabeth R.; Wang, Ying; Xu, Xiang-Xi
Despite significant understanding of the genetic mutations involved in ovarian epithelial cancer and advances in genomic approaches for expression and mutation profiling of tumor tissues, several key questions in ovarian cancer biology remain enigmatic: the mechanism for the well-established impact of reproductive factors on ovarian cancer risk remains obscure; cell of origin of ovarian cancer continue to be debated; and the precursor lesion, sequence, or events in progression remain to be defined. Suitable mouse models should complement the analysis of human tumor tissues and may provide clues to these questions currently perplexing ovarian cancer biology. A potentially useful model is the germ cell-deficient Wv (white spotting variant) mutant mouse line, which may be used to study the impact of menopausal physiology on the increased risk of ovarian cancer. The Wv mice harbor a point mutation in c-Kit that reduces the receptor tyrosine kinase activity to about 1–5% (it is not a null mutation). Homozygous Wv mutant females have a reduced ovarian germ cell reservoir at birth and the follicles are rapidly depleted upon reaching reproductive maturity, but other biological phenotypes are minimal and the mice have a normal life span. The loss of ovarian function precipitates changes in hormonal and metabolic activity that model features of menopause in humans. As a consequence of follicle depletion, the Wv ovaries develop ovarian tubular adenomas, a benign epithelial tumor corresponding to surface epithelial invaginations and papillomatosis that mark human ovarian aging. Ongoing work will test the possibility of converting the benign epithelial tubular adenomas into neoplastic tumors by addition of an oncogenic mutation, such as of Tp53, to model the genotype and biology of serous ovarian cancer. Model based on the Wv mice may have the potential to gain biological and etiological insights into ovarian cancer development and prevention. PMID:24616881
Elizabeth R. Smith
Full Text Available Despite significant understanding of the genetic mutations involved in ovarian epithelial cancer and advances in genomic approaches for expression and mutation profiling of tumor tissues, several key questions in ovarian cancer biology remain enigmatic: the mechanism for the well-established impact of reproductive factors on ovarian cancer risk remains obscure; questions of the cell of origin of ovarian cancer continue to be debated; and the precursor lesion, sequence, or events in progression remain to be defined. Suitable mouse models should complement the analysis of human tumor tissues and may provide clues to these questions currently perplexing ovarian cancer biology.A potentially useful model is the germ cell-deficient Wv (white spotting variant mutant mouse line, which may be used to study the impact of menopausal physiology on the increased risk of ovarian cancer. The Wv mice harbor a point mutation in c-Kit that reduces the receptor tyrosine kinase activity to about 1-5% (it is not a null mutation. Homozygous Wv mutant females have a reduced ovarian germ cell reservoir at birth and the follicles are rapidly depleted upon reaching reproductive maturity, but other biological phenotypes are minimal and the mice have a normal life span. The loss of ovarian function precipitates changes in hormonal and metabolic activity that model features of menopause in humans. As a consequence of follicle depletion, the Wv ovaries develop ovarian tubular adenomas, a benign epithelial tumor corresponding to surface epithelial invaginations and papillomatosis that mark human ovarian aging. Ongoing work will test the possibility of converting the benign epithelial tubular adenomas into neoplastic tumors by addition of an oncogenic mutation, such as of Tp53, to model the genotype and biology of serous ovarian cancer.Model based on the Wv mice may have the potential to gain biological and etiological insights into ovarian cancer development and prevention.
Croft, Darren P; Johnstone, Rufus A; Ellis, Samuel; Nattrass, Stuart; Franks, Daniel W; Brent, Lauren J N; Mazzi, Sonia; Balcomb, Kenneth C; Ford, John K B; Cant, Michael A
Why females of some species cease ovulation prior to the end of their natural lifespan is a long-standing evolutionary puzzle [1-4]. The fitness benefits of post-reproductive helping could in principle select for menopause [1, 2, 5], but the magnitude of these benefits appears insufficient to explain the timing of menopause [6-8]. Recent theory suggests that the cost of inter-generational reproductive conflict between younger and older females of the same social unit is a critical missing term in classical inclusive fitness calculations (the "reproductive conflict hypothesis" [6, 9]). Using a unique long-term dataset on wild resident killer whales, where females can live decades after their final parturition, we provide the first test of this hypothesis in a non-human animal. First, we confirm previous theoretical predictions that local relatedness increases with female age up to the end of reproduction. Second, we construct a new evolutionary model and show that given these kinship dynamics, selection will favor younger females that invest more in competition, and thus have greater reproductive success, than older females (their mothers) when breeding at the same time. Third, we test this prediction using 43 years of individual-based demographic data in resident killer whales and show that when mothers and daughters co-breed, the mortality hazard of calves from older-generation females is 1.7 times that of calves from younger-generation females. Intergenerational conflict combined with the known benefits conveyed to kin by post-reproductive females can explain why killer whales have evolved the longest post-reproductive lifespan of all non-human animals. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Woods, N F; Mitchell, E S; Schnall, J G; Cray, L; Ismail, R; Taylor-Swanson, L; Thomas, A
Although most women experience symptom clusters during the menopausal transition and early postmenopause, investigators reporting clinical trial effects for hot flushes often omit co-occurring symptoms. Our aim was to review controlled clinical trials of mind-body therapies for hot flushes and at least one other co-occurring symptom from these groups: sleep, cognitive function, mood, and pain. An experienced reference librarian performed an extensive search of PubMed/Medline, CINAHL Plus, PsycInfo, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, AMED, and Alt-Health Watch for randomized controlled trials reported in English between 2004 and July 2011. Of 1193 abstracts identified, 58 trials examining effectiveness of therapies for hot flushes and at least one additional co-occurring symptom of interest were identified. Eight trials (ten publications) examined relaxation, yoga, or exercise. Physical activity/exercise trials (six) yielded mixed results; only one significantly reduced hot flushes and mood symptoms. Of two relaxation therapy trials, only mindfulness-based stress reduction training reduced sleep and mood symptoms and had within-group treatment effects on hot flushes. Yoga (one trial) significantly reduced hot flushes and improved cognitive symptoms more than exercise, and also had within-group effects on sleep and pain symptoms. Studies of mind-body therapies for hot flushes increasingly measure multiple symptom outcomes, but few report treatment effects in ways that allow clinicians to consider symptom clusters when prescribing therapies. Future studies need to measure and report results for individual symptoms or group like symptoms together into subscales rather than use subscales with mixed dimensions. Trials with larger numbers of participants are essential to allow evaluation of these therapies on multiple co-occurring symptoms.
Elavsky, Steriani; McAuley, Edward
The menopausal transition is characterized by increased reporting of various symptoms, however, little is known about what underlies individual differences in their reporting. The present study examined the contribution of personality factors to the reporting of menopausal symptoms in the context of a 4-month randomized controlled exercise trial. Symptomatic middle-aged women (N = 164 M age = 49.9, SD = 3.6) completed measures of menopausal symptoms, personality, physical activity, fitness and body composition assessment at the beginning and end of a 4-month randomized controlled trial involving walking and yoga. After controlling for baseline values, psychological symptoms at the end of the trial were associated with trait anxiety (beta = .47, p menopause however improvements in physical parameters such as fitness may reduce reported symptomatology.
... menopausal symptoms: Mind and body practices such as hypnosis, mindfulness meditation, and tai chi may help improve ... joint pain. There is also some evidence that hypnotherapy may help women manage hot flashes. Many natural ...
Modi, Mansi B; Donga, Shilpa B; Dei, Laxmipriya
... and psychological changes adjustments. The present clinical trial was designed as per Ayurveda clinical trials protocol to evaluate the efficacy of Ashokarishta, Ashwagandha Churna and Praval Pishti in the management of menopausal syndrome...
Jalambadani, Zeinab; Garmaroodi, Gholamreza; Yaseri, Mehdi; Tavousi, Mahmood; Jafarian, Koroush
More than half of the sexual problems in menopausal women are due to insufficient knowledge or false beliefs about sexual function. Theory of planned behavior (TPB) is one of the important theories that explain the main process of adopting healthy behaviors. This study investigates the effect of education based on TPB over sexual function of menopausal women in Sabzevar, Iran. In this quasi-experimental study, the data were collected through a survey. This study included 180 Iranian menopausal women from five health center of Sabzevar city in Iran from 2016 to 2017. Using a questionnaire, demographic, anthropometric, and TPB by SPSS version 22 software were measured and analyzed. After educational intervention, the average rates of knowledge, attitude, perceived behavioral control, and intention to sexual function in education group were increased meaningfully (sig subjective norms between two groups after intervention. According to the findings, it is proposed that TPB be used to improve sexual function in Iranian menopausal women.
Hur, Myung-Haeng; Yang, Yun Seok
This study investigated the effects of aromatherapy massage on menopausal symptoms in Korean climacteric women. Kupperman's menopausal index was used to compare an experimental group of 25 climacteric women with a wait-listed control group of 27 climacteric women. Aromatherapy was applied topically to subjects in the experimental group in the form of massage on the abdomen, back and arms using lavender, rose geranium, rose and jasmine in almond and primrose oils once a week for 8 weeks (eight times in total). The experimental group reported a significantly lower total menopausal index than wait-listed controls (P aromatherapy massage may be an effective treatment of menopausal symptoms such as hot flushes, depression and pain in climacteric women. However, it could not be verified whether the positive effects were from the aromatherapy, the massage or both. Further rigorous studies should be done with more objective measures. PMID:18830459
Tice, Jeffrey A
.... 47 pre-menopausal women with breast density ! 50% on mammography were randomized to either 25 mgld of soy protein containing 50 mg total isoflavones or 25 mglday of milk protein containing 0 mg of total isoflavones for 6 months...
Thouzeau, Valentin; Raymond, Michel
Menopause, the permanent cessation of ovulation, occurs in women well before the end of their expected life span. Several adaptive hypotheses have been proposed to solve this evolutionary puzzle, each based on a possible fitness benefit derived from an early reproductive senescence, but no consensus has emerged. The construction of a game theory model allowed us to jointly study the main adaptive hypotheses in emergence and maintenance of menopause. Four classical hypotheses on the benefits of menopause were considered (decreased maternal mortality, increased grandmothering, decreased conflict over reproductive resources between older and younger females, and changes in their relatedness) plus a fifth one derived from a possible pleiotropic trade-off. Interestingly, the conditions for the emergence of menopause are more restrictive than those for its maintenance due to the social and familial changes induced by the occurrence of non-reproductive older women. Copyright © 2017 Elsevier Ltd. All rights reserved.
Conclusion: With regard to life expectancy, women spend approximately one third of their life after menopause. Identification of factors associated with these issue particularly aspects of quality of life is important.
Cekmez, Yasemin; Torun, Fuat; Göçmen, Ahmet; Şanlıkan, Fatih
The relationship between depression and reproductive hormone changes in menopausal women is well konown but recent animal studies showed that depression can also cause changes in reproductive hormone levels...
Sénéchal, M; Arguin, H; Bouchard, D R; Carpentier, A C; Ardilouze, J L; Dionne, I J; Brochu, M
To examine the association between weight gain since menopause and weight regain after a weight loss program. Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.
Laakasuo, Michael; Palomäki, Jussi; Salmela, Mikko
Online poker and poker subcultures have become exceedingly popular. Previous studies assessing experience and skill in poker have revealed that proficiency in emotion regulation is a consequential factor in explaining financial success in the game. We assessed (N=478) the associations between poker players' (recruited from online poker forums) level of poker experience and HEXACO-PI-R personality traits. The results indicate that a predisposition for emotional stability-that is, lower scores on emotionality-is linked to high levels of poker experience. Thus, in order to become a successful and experienced poker player, it helps to be able to "keep cool" under pressure. Further exploratory analyses suggest that players who prefer live play to online play are more likely to be extroverted and open to experiences. The results contribute to the extant literature on individual differences in personality in poker players, and in particular help to fill the interdisciplinary gap between personality and gambling research.
Secchi, Davide; Seri, Raffaello
the applicant’s nationality is considered. In addition to its findings, the study (a) provides an original econometric model on a two-step procedure to test perceived discrimination and (b) suggests a method and approach that may constitute a point of reference for those willing to study perceived......This article proposes a framework for the analysis of experienced discrimination in home mortgages. It addresses the problem of home mortgage lending discrimination in one of the richest areas of northern Italy. Employees of a local hospital were interviewed to study their perception (or experience......) of discriminatory behavior related to home financing. The analysis follows two steps. The first evaluates self-selection (the probability that individuals apply) and the second focuses on the likelihood that applications are accepted by the bank. Findings show that discrimination is likely to appear when...
Full Text Available Gauteng, Province of South Africa is experiencing a decreasing number of registered and practising debt counsellors. This paper investigates and assesses the challenges that debt counsellors in Gauteng experiences. Fifteen debt counsellors from three municipalities of Gauteng were interviewed. Data was analysed using ATLAS ti. The paper concluded that though debt counsellors are complying with the regulations in rendering debt counselling service, they still had challenges regarding backlogs in debt review. The paper recommends that debt counsellors should be adequately trained and should restructure their rehabilitation methods on the one hand and the National Credit Regulator should monitor debt counsellors’ practices and assist them with their queries on the other hand.
Bechlioulis, Aris; Naka, Katerina K; Kalantaridou, Sophia N; Kaponis, Apostolos; Papanikolaou, Odysseas; Vezyraki, Patra; Kolettis, Theofilos M; Vlahos, Antonis P; Gartzonika, Konstantina; Mavridis, Anestis; Michalis, Lampros K
Menopause has been related to an increased atherosclerotic risk. Presence and severity of hot flushes in menopausal women have been associated with impaired endothelial function and advanced subclinical atherosclerosis. The objective of the study was to evaluate the effect of menopausal transition on vascular inflammation indices and investigate the association of hot flush severity with these indices in early menopausal women. This was a cross-sectional study that included 120 early menopausal women (age range 42-55 yr, women (controls). Serum high-sensitivity C-reactive protein, P-selectin, and soluble CD40 ligand (sCD40L) levels were measured. P-selectin and sCD40L were increased in early menopausal compared with control women (P = 0.006 and P = 0.02 respectively), whereas high-sensitivity C-reactive protein levels did not differ (P = 0.4) between the groups. Hot flush severity was the most important independent predictor of P-selectin levels (P = 0.011) in early menopausal women. Women with moderate/severe/very severe hot flushes had increased P-selectin compared with women with no/mild hot flushes or controls (P women with moderate/severe/very severe hot flushes compared with controls (P = 0.03) but did not differ significantly compared with women with no/mild hot flushes (P = 0.2). Increased indices of vascular inflammation in early menopausal compared with age-matched premenopausal women may indicate a higher atherosclerotic risk. Increased severity of hot flushes was associated with adverse changes in vascular inflammation, further supporting the emerging role of hot flushes in cardiovascular prognosis in these women.
Aragão, F R; Moreira, M H; Gabriel, R E; Abrantes, C G
Menopausal characteristics (i.e. the nature of menopause, hormone therapy, and time elapsed since menopause) are known to affect women's health-related quality of life. The purpose of this study was to determine whether menopausal characteristics affect the cardiorespiratory exercise response and which characteristics should be considered for exercise prescription. Fifty-eight postmenopausal women (60.21 ± 4.49 years of age; 66.26 ± 8.99 kg body weight; 157.09 ± 4.92 cm in height; 29.70 ± 4.79 ml·kg(-1)·min(-1) maximal oxygen uptake) participated in this study. A graded 25-W/min(2) cycle ergometer exercise protocol was applied to assess aerobic power and ventilatory thresholds. Participants' heart rates and gas-exchange variables were measured continuously using a COSMED K4b(2) portable gas analyzer system. The first and the second ventilatory thresholds were determined by the time-course curves of ventilation and oxygen and carbon dioxide ventilatory equivalents. Using age as a covariate, an analysis of covariance was performed to assess the effect of menopause characteristics upon the data. Regardless of the nature of menopause, use of hormone therapy, time elapsed since menopause, and the interaction between these characteristics, the participants presented no differences in maximal oxygen uptake values, neither on submaximal variables often used in evaluations of exercise prescription, such as percent of maximal oxygen uptake, maximal heart rate, and heart rate reserve, nor in respiratory exchange ratio and gas exchange energy expenditure at aerobic and anaerobic ventilatory thresholds. These data suggest that a personalized cardiorespiratory target zone for this population should be set according to the published literature, and that consideration of the individual menopausal characteristics seems to be unnecessary.
Grzegorz Stachowiak; Tomasz Pertyński; Magdalena Pertyńska-Marczewska
[b]Introduction[/b]. Despite the undeniably positive effect on the quality of life of menopausal women, menopausal hormone therapy (HT) also has negative side-effects, which include, among others, thromboembolic complications. [b]objective[/b]. To assess the effect of a popular type of this therapy – transdermal HT on platelet hemostasis, which plays a significant role in intravascular coagulation. [b]Materials and method[/b]. The study group consisted of 92 postmenopausal women: ...
Full Text Available Background: Menopause is a physiological event that occurs in women's life and result in physical, emotional and social changes which affects their quality of life. Because of controversial finding in previous researches and lack of such study in kashan city, this study investigated the quality of life in menopausal women and its related factors. Methods: A cross - sectional study was performed on 700 menopausal women aged 40-60 in Kashan city with cluster sampling. Menopausal Specific Quality of life questionnaire (MENQOL was used for estimation of QOL and related factor such as age, job, educational level, marital status, duration of menopause, child at home, income satisfaction, marital satisfaction, exercise, smoking and family smoking were examined with statistical tests. Results: The quality of life was high in 17.9%, intermediate in 68.9% and low in 13.3% of women. Most of women had intermediate quality of life at vasomotor domain (67.3 %, psychosomatic domain (67.4%, physical domain(46.3% and sexual domain (51.6%.Also there was a significant difference between quality of life and educational level (P=0.004, income satisfaction (P=0.01 and exercise (P=0.0001. Conclusions: Educational level, exercise and income satisfaction are related with quality of life in menopausal women. Based on our findings, we emphasis on teaching about menopause, its symptom and adverse effects. Also emphasizes the necessity use of non pharmacological methods such as exercise and change in life style and diet to improve quality of life in menopausal women.
Maasoumi, R; S Ziaei; Faghihzadeh, S.
Introduction & Objective: Urinary complications are a common disorder which affects the quality of life of women. The objective of this study was to compare the therapeutic effects of Tibolone and classic hormone replacement therapy (HRT) on the urinary complications of menopausal women. Materials and methods: This randomized controlled trial study was conducted at Tarbiat Modarres University in 2007-2008 on 100 menopausal women which were divided into two therapeutic groups. Women in th...
Pirotta, Marie; Ee, Carolyn; Teede, Helena; Chondros, Patty; French, Simon; Myers, Stephen; Xue, Charlie
Background Hot flushes and night sweats (vasomotor symptoms) are common menopausal symptoms, often causing distress, sleep deprivation and reduced quality of life. Although hormone replacement therapy is an effective treatment, there are concerns about serious adverse events. Non-hormonal pharmacological therapies are less effective and can also cause adverse effects. Complementary therapies, including acupuncture, are commonly used for menopausal vasomotor symptoms. While the evidence for th...
Soheila Nazarpour; Masoumeh Simbar; Fahimeh Ramezani Tehrani; Hamid Alavi Majd
Background: Sexual dysfunction could be under the influence of some underlying medical problems. The purpose of this study is to examine the relationship between medical problems and sexual function in post-menopausal women. Methods: This is a community-based, descriptive-correlation study of 405 post-menopausal women residing in Chalus and Nowshahr cities, North of Iran, aged 40 to 65 years old from October 2013 to May 2014. A multistage, randomized sampling was conducted. The data was a...
De Bruin, Marie L; Huisbrink, Jeannine; Hauptmann, Michael
We conducted a cohort-study among 518 female 5-year Hodgkin lymphoma (HL) survivors, aged 14 to 40 years (median: 25 years) at treatment (1965-1995). Multivariable Cox regression was used to quantify treatment effects on risk of premature menopause, defined as cessation of menses before age 40...... after treatment, the actuarial risk of premature menopause was 64% after high cumulative doses (> 8.4 g/m(2)) and 15% after low doses (
Wei, Yingying; Zhou, Dandan; Peng, Jing; Pan, Leiqing; Tu, Kang
To explore the effects of hot air (HA, 38 °C for 12 h) treatment on the phenylpropanoid metabolism in cherry tomatoes, phenylpropanoid metabolite levels and the activities and expression of key enzymes were analyzed in HA-treated fruit. HA treatment enhanced phenylpropanoid metabolism, as evidenced by elevated levels of phenolics and flavonoids, higher activities of phenylalanine ammonia-lyase and cinnamate-4-hydroxylase, and upregulated expression of LeCHS, LeCHI, LeF3H, and LeFLS. Levels of several phenylpropanoid metabolites were higher after HA treatment, including p-coumaric acid, caffeic acid, chlorogenic acid, isoquercitrin, quercetin, and rutin. These metabolic changes may be related to the reduced disease incidence and smaller lesion diameters observed in HA-treated fruit inoculated with Alternaria alternata (black mold) or Botrytis cinerea (gray mold). The results suggest that HA treatment induces disease resistance by activating the phenylpropanoid pathway in cherry tomato fruit.
Jurczak, Anna; Brodowski, Jacek; Grochans, Elżbieta; Karakiewicz, Beata; Szkup-Jabłońska, Małgorzata; Wieder-Huszla, Sylwia; Mroczek, Bożena; Włoszczak-Szubzda, Anna; Grzywacz, Anna
The level of trace elements is extremely important for the maintenance of normal functioning of the human body. The risk of disturbance of their balance increases especially dynamically during the period of menopause. The objective of the study was the effect of MHT on the levels of bioelements (Mg and Zn) in blood plasma, and toxic metals (Pb and Cd) in the whole blood in postmenopausal women. The study covered 323 women at postmenopausal age from the population of the West Pomeranian Region, in whom the levels of Mg, Zn, Pb and Cd were determined. The women were divided into two groups: study and control. The study group were 152 women who used menopausal hormone therapy (MHT). The control group were 171 women who did not use MHT, and had had their final menstrual period at least one year prior to inclusion in the study. The mean age of the women examined was 56±5. Significantly higher levels of the bioelements Mg, Zn were observed in women who used MHT, compared to the control group (p<0.05). The concentration of Pb in whole blood was significantly lower in the study than the control group: 16.09±7.33 µg/l and 20.18±9.01 µg/l, respectively. An elevated level of Cd in whole blood was found in both groups of women: 0.9±1.03 µg/l and 0.8±1.1 µg/l, respectively. It was noted that women who used MHT more frequently declared the presence of climacteric symptoms (p<0.05). 1) Higher levels of Mg and Zn were found in blood plasma of women who used MHT. 2) The mean concentration of Cd in the blood of women in both groups was similar. 3) In women who use MHT the level of Pb in whole blood was lower, compared to the rest of the women.
Maura Scanlon, Anne Blaes, Melissa Geller, Navneet S Majhail, Bruce Lindgren, Tufia Haddad
Full Text Available PURPOSE: Pre-menopausal women with cancer are at risk of therapy-associated infertility, premature menopause, and sexual dysfunction. However, it is unknown whether oncologists adequately address these risks during treatment planning. We conducted a study to evaluate physician-patient discussions addressing the impact of cancer treatment and actual treatment effects on fertility, menopause status, and general sexual health.METHODS: A questionnaire was administered in four oncology clinics specializing in breast, gynecologic, general hematology-oncology, and blood and marrow transplantation (BMT cancer care at a single institution. Eligible participants were pre-menopausal at the time of diagnosis and either actively receiving or within 24 months from completion of treatment. Participants completed the questionnaire at enrollment and at 1-year follow-up.RESULTS: Of the 104 eligible women, a majority were satisfied with the quality (68% and length (66% of reproductive health discussions, with the highest satisfaction levels in the gynecologic cancer clinic (85% and the lowest levels in the BMT clinic (53%. Fertility preservation was desired by 20% of women, including some >40 years old. Women were more interested in discussing treatment impact on menopause status and sexual health than fertility. Rates of discussions on treatment impact on sexual health were low despite 77% of women reporting severe sexual dysfunction at 1-year follow-up.CONCLUSIONS: One-third of women are dissatisfied with the quality and length of discussions regarding the impact of cancer treatment on reproductive health. There is notably inadequate counseling on the effect of treatment on fertility in women > 40 and on sexual function in all women. Oncologists must offer better resources and improve communication on the effect of treatment on reproductive health to pre-menopausal women with cancer.
Kolbasnikov, S V; Bakhareva, O N
To specify clinical, vegetative and cognitive disorders in hypertensive women depending on the type of menopause. A total of 195 hypertensive women were divided into three groups: group 1 (n = 50, age 45.6 +/- 4.5 years) consisted of premenopausal women, group 2 (n = 100, age 57.4 +/- 4.7 years) - of women with natural menopause, group 3 (n = 45, age 55.1 +/- 5.9 years)--with early and/or surgical menopause. Severity of the menopausal syndrome, anxiety, depression, alexitimia, mental performance, vegetative regulation of heart rhythm were examined. The premenopausal women were characterized by cardial and cerebral disorders, unaffected psychovegetative function and initial symptoms of lowering mental performance. Hypertensive women with natural menopause showed combination of cardial and cerebral symptoms with moderate anxio-depressive disorders, alexitimia, subnormal parasympathetic activity of the autonomic nervous system in high centralization of heart rhythm regulation and attention disturbances. Patients with surgical and/or early menopause had marked cardial and cerebral symptoms, moderate anxiodepressive disorders, alexitimia, inhibition of mental performance, vegetative dysfunction, overcentralization of heart rhythm control. With development of postmenopausal metabolic symptom complex, severity of hypertension grows with emergence of anxiodepressive disorders which combine with vegetative regulation disorders and attenuation of mental performance.
Mintziori, Gesthimani; Lambrinoudaki, Irene; Goulis, Dimitrios G; Ceausu, Iuliana; Depypere, Herman; Erel, C Tamer; Pérez-López, Faustino R; Schenck-Gustafsson, Karin; Simoncini, Tommaso; Tremollieres, Florence; Rees, Margaret
To review non-hormonal therapy options for menopausal vasomotor symptoms. The current EMAS position paper aims to provide to provide guidance for managing peri- and postmenopausal women who cannot or do not wish to take menopausal hormone therapy (MHT). Literature review and consensus of expert opinion. Non-hormonal management of menopausal symptoms includes lifestyle modifications, diet and food supplements, non-hormonal medications and application of behavioral and alternative medicine therapies. There is insufficient or conflicting evidence to suggest that exercise, supplements or a diet rich in phytoestrogens are effective for vasomotor menopausal symptoms. Selective serotonin-reuptake inhibitors (SSRIs), serotonin norepinephrine-reuptake inhibitors (SNRIs) and gabapentin could be proposed as alternatives to MHT for menopausal symptoms, mainly hot flushes. Behavioral therapies and alternative medicine interventions have been tried, but the available evidence is still limited. A number of interventions for non-hormonal management of menopausal vasomotor symptoms are now available. For women who cannot or do not wish to take estrogens, non-hormonal management is now a realistic option. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Lunny, Carole A; Fraser, Shawn N
Despite questionable efficacy and safety, many women use a variety of complementary and alternative medicine (CAM) therapies to relieve menopause symptoms. We examined the determinants and use of CAM therapies among a sample of menopausal-aged women in Canada by using a cross-sectional Web-based survey. Four hundred twenty-three women who were contacted through list serves, e-mail lists, and Internet advertisements provided complete data on demographics, use of CAM, therapies, and menopausal status and symptoms. Ninety-one percent of women reported trying CAM therapies for their symptoms. Women reported using an average of five kinds of CAM therapies. The most common treatments were vitamins (61.5%), relaxation techniques (57.0%), yoga/meditation (37.6%), soy products (37.4%), and prayer (35.7%). The most beneficial CAM therapies reported were prayer/spiritual healing, relaxation techniques, counseling/therapy, and therapeutic touch/Reiki. Demographic factors and menopausal symptoms contributed to 14% of the variance (P menopausal women have high user rates of CAM therapy and show that specific demographic factors and somatic symptomatology relate to use of CAM therapies. Health care providers can benefit from understanding the determinants and use of CAM by women during the menopause transition if they are to help and provide quality care for this population. Copyright 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.
Ayers, B; Hunter, M S
Despite a large body of research on menopause, there is little definitive evidence of the impact of vasomotor symptoms on health-related quality of life (HrQoL). Therefore, this study describes the HrQoL of menopausal women with hot flushes and night sweats and examines predictors of HrQoL. A total of 140 women reporting at least ten hot flushes/night sweats (vasomotor symptoms) a week for at least a month completed an assessment interview (including medical history, past and current physical and mental health and menopausal status) and questionnaires eliciting sociodemographic and help-seeking information, HrQoL and the Hot Flush Rating Scale. Women with vasomotor symptoms reported somewhat reduced HrQoL compared to SF-36 US norms and a general sample of UK menopausal women; 53% reported comorbid physical illness and 66% had current psychosocial concerns; 77% had visited their doctor about menopausal symptoms; 28% were past and 3% current users of hormone therapy. Overall, poor HrQoL was associated with having problematic hot flushes, current psychosocial concerns, (younger) age, (higher) body mass index and poor general health. This sample of relatively healthy mid-aged women with vasomotor symptoms reported reduced HrQoL compared to age-matched norms and a general sample of menopausal women. Problem rating, rather than frequency, of hot flushes was associated with reduced HrQoL, as were health and psychosocial factors.
Full Text Available Background: Menopause is a universal event in a women’s life occurring in the middle period causing a variety of physical, vasomotor, psychological and sexual symptoms. These symptoms generally tend to usually go underreported. Aims & Objectives: To find out the quality of life among the menopausal women and associations of menopausal symptom domains with their socio-demographic parameters. Material & Methods: The present cross-sectional study was undertaken in a slum of Chetla, Kolkata. Response to each question in the MENQOL questionnaire, was assigned a score and the composite scores assessed the quality of life and impact of menopause among the study population. Results: Out of a total of 100 women, psychosocial symptoms were the most prevalent with anxiety, loss of memory and nervousness to be 76%. Occurrence of vasomotor symptoms was average with 55% of them reporting hot flashes and 40% reporting sweating. Physical symptoms were highly variable and sexual symptoms were not prevalent. Psychosocial symptoms had the most associations and religion, literacy, marital status, and abortion all had significant associations. Conclusion: It is indeed imperative that quality of life among menopausal women is affected by the symptoms of menopause and measures should be taken for mitigation of the same
Lee, Myeong Soo; Shin, Byung-Cheul; Yang, Eun Jin; Lim, Hyun-Ja; Ernst, Edzard
Maca (Lepidium meyenii), an Andean plant of the brassica (mustard) family has been used for centuries in the Andes as an adaptogenic plant to manage anemia, infertility and female hormone balance. The aim of this review was to assess the evidence for and against the effectiveness of the maca plant as a treatment for menopausal symptoms. We searched 17 databases from their inception up to June 2011 and included all randomized clinical trials (RCTs) that compared any type of maca-based intervention to a placebo for the treatment of menopausal symptoms. All studies were assessed for methodological quality using the Cochrane 'risk of bias' assessment tool. Four RCTs met all inclusion criteria. These RCTs tested the effects of maca on menopausal symptoms in healthy perimenopausal, early postmenopausal, and late postmenopausal women. Using the Kupperman Menopausal Index and the Greene Climacteric Score, all RCTs demonstrated favorable effects of maca. There have been very few rigorous trials of maca for menopausal symptoms. The results of our systematic review provide limited evidence for the effectiveness of maca as a treatment for menopausal symptoms. However, the total number of trials, the total sample size, and the average methodological quality of the primary studies, were too limited to draw firm conclusions. Furthermore, the safety has not been proved yet. Therefore, the efficacy and safety should be tested in larger studies. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
King, Valencia [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Breast Imaging Section, New York, NY (United States); Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Gu, Yajia [Fudan University Shanghai Cancer Center, Department of Radiology, Shanghai (China); Fudan University, Department of Oncology, Shanghai Medical College, Shanghai (China); Kaplan, Jennifer B.; Morris, Elizabeth A. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, Breast Imaging Section, New York, NY (United States); Brooks, Jennifer D.; Pike, Malcolm C. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States)
To evaluate the effect of menopausal status on the background parenchymal enhancement (BPE) and amount of fibroglandular tissue (FGT) on breast MRI. Retrospective review identified 1,130 women who underwent screening breast MRI between July and November 2010. In 28 of these women, breast MRI was performed both at one time point while pre- and one time point while post-menopausal (median interval 49 months). Two independent readers blinded to menopausal status used categorical scales to rate BPE (minimal/mild/moderate/marked) and FGT (fatty/scattered/heterogeneously dense/dense). Consensus was reached when there was disagreement. The sign test was used to assess changes in rating categories, and the Spearman rank and Fisher's exact tests were used to measure correlations and associations between variables. Significant proportions of women demonstrated decreases in BPE and FGT on post-menopausal breast MRI (P = 0.0001 and P = 0.0009). BPE category was unchanged in 39 % (11/28) and decreased in 61 % (17/28) of women. FGT category was unchanged in 61 % (17/28) and decreased in 39 % (11/28) of women. Age, reason for menopause, or interval between MRIs had no significant impact on changes in BPE and FGT. On MRI, BPE, and FGT decrease after menopause in significant proportions of women; BPE decreases more than FGT. (orig.)
Rice, Valerie Montgomery
Menopause is a naturally occurring "equal opportunity" event that every woman who lives beyond the age of approximately 52 years will experience. During the next 20 years, approximately 3.5 million African American women, 2 million Latinas, and 1 million Asian American women will enter the menopause. How a woman approaches the menopausal transition depends on a number of factors, from educational level to socioeconomic status; health-related factors, including stress; and marital status. Increasingly, the roles of race and ethnicity, as they relate to menopausal symptoms, are being explored. Understanding similarities and differences among women of color in perceptions, attitudes, and expectations surrounding the menopause can help provide culturally appropriate care and promote lifestyles that may decrease symptoms and increase quality of life. For example, minority women are usually the gatekeepers for healthcare for themselves and their families and have a highly developed social support network, often including extended family, a church community, and involvement in sororal or social organizations. In the future, research on menopausal symptoms among women of different racial/ethnic groups should focus on exploring in greater detail the effect of dietary factors and body mass index, additional evaluation of pituitary sensitivity, and use of complementary and alternative medicines in symptom management, with a better understanding of the risks and benefits of such therapies.
El Khoudary, Samar R; Shields, Kelly J; Janssen, Imke; Hanley, Carrie; Budoff, Matthew J; Barinas-Mitchell, Emma; Everson-Rose, Susan A; Powell, Lynda H; Matthews, Karen A
Cardiovascular risk increases in women after menopause. Mounting evidence demonstrates a role of cardiovascular fat (CF) in the pathogenesis of coronary heart disease, but no research has examined CF in relation to sex hormones or menopausal status in women. The objective was to determine the relationship between CF depots, menopausal status, and endogenous sex hormones. Cross-sectional and longitudinal study designs were used. The setting included the Study of Women's Health Across the Nation (SWAN) Heart and Cardiovascular Fat Ancillary Study. A total of 456 women (mean age, 50.75 y); 62% premenopausal/early perimenopausal, and 38% late peri-/postmenopausal. Menopausal status, endogenous sex hormones measured simultaneously with CF volumes, and circulating estradiol available 4.80 years (median) before CF measures. Volumes of CF (epicardial adipose tissue [EAT], paracardial adipose tissue [PAT], total heart adipose tissue [TAT = EAT + PAT], and aortic perivascular adipose tissue [PVAT]). In final models, late peri-/postmenopausal women had 9.88% more EAT, 20.72% more PAT, and 11.69% more TAT volumes than pre-/early perimenopausal women (P menopausal status. In final models, lower estradiol concentrations were associated with greater volumes of PAT and TAT (P obesity, and other covariates. Endogenous sex hormones are associated with CF. Perhaps CF plays a role in the higher risk of coronary heart disease reported in women after menopause.
E S Sharanya Shre
Full Text Available Background: The symptoms of menopause have a negative impact on quality of life, especially in women transitioning to menopause and earlier transitions. This study was conducted with the objective of assessing the effect of obesity on the severity of menopausal symptoms and the clustering of symptoms in postmenopausal women in India. Methodology: The Menopausal Rating Scale (MRS was used to assess the severity of menopausal symptoms of postmenopausal women of Chennai, visiting Saveetha Medical College, Chennai, India. This cross-sectional study was conducted from August to November 2013 in Chennai, India. Sociodemographic characteristics, anthropometric measurements, blood pressure level, menopausal history, personal health history, and hormonal disorder issues were investigated. Results: The results have shown that 24% of the participants had complaint of mild to severe hot flushes, half of them had reported heart ailments (49%; n = 74, and disturbed sleep (48%; n = 72. The proportion of overweight/obese participants was higher in married (64% than widows (41%, and this difference was found statistically significant (P = 0.005. There were no significant differences in MRS scores of obese and nonobese postmenopausal participants. Conclusion: There is a need of developing interactive, user friendly, technology based education module for addressing the chronic ailments of postmenopausal women.
Leal Hernández, Mariano; García Sánchez, Francisco Alberto; Martínez Selva, José María; Abellán Alemán, José
To asses if the hot flushes during menopause are associated with an abnormal cardivascular reactivity to stress. We also aimed to evaluate the effect of hormone replacement therapy (HRT) on reactivity to stress in menopausal women. Experimental study including 28 healthy menopausal women with hot flushes (12 on HRT) and 20 without flushes (6 on HRT). Parameters evaluated included determination of systolic and diastolic blood pressure, heart rate, percentage of decrease of peripheral pulse volume, skin conductance level and frecuency of inespecific cutaneous responses. All studies were performed prior to and after 4-6 months under HRT therapy. Menopausal women reporting hot flashes showed the highest electrodermal activity in front of stress. HRT therapy led to a decreased physiological reactivity in menopausal women, especially reactivity to stressors. Hot flushes during menopause indicate an increased level of cardiovascular reactivity to stress situations, hence a higher cardiovascular risk.
Baker, William D; Pierce, Stuart R; Mills, Anne M; Gehrig, Paola A; Duska, Linda R
To assess the endometrial response rates to treatment with the levonorgestrel intrauterine device in post-menopausal women with atypical hyperplasia/endometrial intraepithelial neoplasia and grade 1 endometrioid (AH/EC) endometrial carcinoma who are not surgical candidates. Chart review was undertaken of patients with AH/EC who underwent levonorgestrel intrauterine device insertion by a gynecologic oncologist within two academic health systems between 2002 and 2013. When available, tissue blocks were evaluated with immunohistochemical staining for progesterone receptor expression. A total of 41 patients received treatment for AH/EC with the levonorgestrel intrauterine device. Follow up sufficient to assess response occurred in 36 women (88%). Complete response was documented in 18 of 36 women (50%), no response in 8 patients (22%), partial response in 3 women (8%) and progression of disease in 7 patients (19%). Four of 18 patients with complete response (22%) later experienced relapse of hyperplasia or cancer. Four patients (10%) died during the study period: none had evidence of metastatic disease and 1 of the 4 woman died of perioperative complications following hysterectomy for stage I disease. Patients responding to treatment had significantly lower progesterone receptor expression on post-treatment biopsies. Intrauterine levonorgestrel is a viable treatment option for post-menopausal women with AH/EC who are poor candidates for standard surgical management. The response rate in this series is similar to published reports in premenopausal patients and includes cases of disease recurrence following conversion to benign endometrium. Copyright © 2017 Elsevier Inc. All rights reserved.
Choi, Byoung-O; Lee, Yeon-Ji; Choi, Ji-Ho; Cho, Se-Wook; Im, Hyun-Jung; An, Jee-Eun
Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women. Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (β) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM. Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17±3.7 and 50.58±3.5 years, respectively), with a statistically significant correlation (Pstress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
Saliares, Ellen; Wilkerson, J Michael; Sieving, Renee E; Brady, Sonya S
Little research on adolescents has examined developmentally normative facets of sexuality that are not obviously linked to physical health. The purpose of this secondary data analysis was to qualitatively analyze adolescents' thoughts about and experiences with sexual pleasure. The study sample consisted of 56 sexually experienced, ethnically diverse, predominantly female adolescents who were participating in a Web-based intervention to promote healthy sexual decision making. Comments on one message board, "Sexual Pleasure: Does It Matter to You?," provided an opportunity to examine adolescents' thoughts about and experiences with sexual pleasure, as well as their communication with partners about that topic. Adolescents' comments demonstrated that they experience difficulties with pleasure in their sexual relationships. Adolescents generally believed that men are more likely than women to feel pleasure due to differences that include biology, understanding of one's body, and control over partnered sexual behavior. Adolescents defined inequality of received pleasure differently and discussed contexts in which inequality may be acceptable. Adolescents expressed motivation to communicate with partners about sexual pleasure. However, their statements suggested they often lack the skills to do so. Future prevention and intervention programs should equip adolescents with skills to communicate with partners about sexual pleasure.
Gilvânia Patrícia do Nascimento Paixão
Full Text Available Objective: to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence.Method: qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011.Results: the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mother's submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mother's submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence.Conclusion: investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.
Paixão, Gilvânia Patrícia do Nascimento; Gomes, Nadirlene Pereira; Diniz, Normélia Maria Freire; Carvalho e Lira, Margaret Ollinda de Souza; Carvalho, Milca Ramaiane da Silva; da Silva, Rudval Souza
to analyze the family relationship, in childhood and adolescence, of women who experience conjugal violence. qualitative study. Interviews were held with 19 women, who were experiencing conjugal violence, and who were resident in a community in Salvador, Bahia, Brazil. The project was approved by the Research Ethics Committee (N. 42/2011). the data was organized using the Discourse of the Collective Subject, identifying the summary central ideas: they witnessed violence between their parents; they suffered repercussions from the violence between their parents: they were angry about the mother's submission to her partner; and they reproduced the conjugal violence. The discourse showed that the women witnessed, in childhood and adolescence, violence between their parents, and were injured both physically and psychologically. As a result of the mother's submission, feelings of anger arose in the children. However, in the adult phase of their own lives, they noticed that their conjugal life resembled that of their parents, reproducing the violence. investment is necessary in strategies designed to break inter-generational violence, and the health professionals are important in this process, as it is a phenomenon with repercussions in health. Because they work in the Family Health Strategy, which focuses on the prevention of harm and illness, health promotion and interdepartmentality, the nurses are essential in the process of preventing and confronting this phenomenon.
Full Text Available Cistanche is the traditional and precious Chinese herbal, with two thousand years of use history in China. It has the effect on tonifying kidney, strong supplement to the liver and kidney, and replenishing essence and blood, known as the “desert ginseng”. Here, we explored the mechanism of Phenylethanoid Glycosides of Cistanche (PGC to the model mice of menopausal syndrome, as well as the therapeutic effect and characteristics of PGC to the menopausal syndrome. In this study, KM mice were reproduced by the complete resection of the ovaries on both sides of the back to establish the model mice of menopausal syndrome (MPS, and received distilled water or drugs, respectively. Model mice received distilled water. Mice received 200 mg/(kg day high doses of Phenylethanoid Glycosides of Cistanche (HPGC, and 100 mg/(kg day medium doses of Phenylethanoid Glycosides of Cistanche (MPGC, and 50 mg/(kg day low doses of Phenylethanoid Glycosides of Cistanche (LPGC. After 21 days, it could determine the number of independent activities and the number of standing, the latent period of first entering the dark room, and the electric number. It also calculated the viscera index of uterus, thymus, spleen, measured the levels of estradiol (E2, testosterone (T, luteinizing hormone (LH, and follicle-stimulating hormone (FSH in the serum. Furthermore, it observed the pathological changes of uterus, thymus, spleen and pituitary of mice. The results showed that behavioral indicators: Compared with the model group (MG, HPGC, MPGC, LPGC could increase the independent activities (P < 0.01; HPGC, MPGC could increase the number of standing, the latent period of first entering the dark room, and reduce the electric number (P < 0.01; LPGC could increase the number of standing (P < 0.05; Viscera index: Compared with MG, HPGC, MPGC could increase the viscera index of uterus, thymus, spleen (P < 0.01; LPGC could increase the viscera index of uterus (P < 0
•\tActivity in R posSTG decreased over time for CORR pictures while increasing over time for TR/PR pictures Discussion Short-term intensive treatment followed by a home practice program can produce enduring language improvements that provide rich opportunities for investigating treatment-induced neuroplasticity in aphasia. Given the high degree of individual variability in lesion location/extent, and the resulting variability in aphasia type/severity, it makes sense to examine treatment-induced changes in neural activity patterns within subjects where ‘signature’ patterns of activity are remarkably reliable across time.
Full Text Available Abstract Background Early onset of menopause is a risk factor for several health problems. The objective was primarily to investigate the association between early menopause and current, past active and passive smoking. A second aim was to investigate the association between coffee and alcohol consumption and early menopause. Methods The present population-based cross-sectional study included a sub-sample of 2123 postmenopausal women born in 1940–41 who participated in the Oslo Health Study. Early menopause was defined as menopause occurring at an age of less than 45 years. We applied logistic regression analyses (crude and adjusted odds ratio (OR to examine the association between early menopause and selected lifestyle factors. Results Current smoking was significantly associated with early menopause (adj. OR, 1.59; 95% CI, 1.11–2.28. Stopping smoking more than 10 years before menopause considerably reduced the risk of early menopause (adj. OR, 0.13; 95% CI, 0.05–0.33. Total exposure to smoking (the product of number of cigarettes per day and time as a smoker was positively related to early menopause and, at the highest doses, nearly doubled the odds (adj. OR, 1.93; 95% CI, 1.12–3.30. These data suggest a possible dose-response relationship between total exposure to smoking and early menopause, but no dose-response relationship was detected for the other variables examined. We found no significant association of coffee or alcohol consumption with early menopause. Of the lifestyle factors tested, high educational level (adj. OR, 0.50; 95% CI, 0.34–0.72 and high social participation (adj. OR, 0.60, 95% CI, 0.39–0.98 were negatively associated with early menopause. Conclusion This cross-sectional study shows an association between current smoking and early menopause. The data also suggest that the earlier a woman stops smoking the more protected she is from early menopause. Early menopause was not significantly associated with passive
Depypere, H; Pintiaux, A; Desreux, J; Hendrickx, M; Neven, P; Marchowicz, E; Albert, V; Leclercq, V; Van den Branden, S; Rozenberg, S
An internet survey was performed to obtain data on the current use in Belgium of hormone replacement therapy and alternative treatments for the alleviation of menopausal symptoms. A supplementary aim was to assess the use of opt-in internet opinion panels (TalkToChange, http://www.talktochange.com, and GMI, http://www.gmi-mr.com/global-panel) as a potential new way to obtain data on menopausal issues. Data were collected via an internet platform from 696 postmenopausal women aged 45-60 years. Respondents were asked questions about their socio-demographic profile, their experience of the menopause, the burden of the menopause, its impact on their quality of life and the treatment of menopausal symptoms (if any). The opt-in internet opinion panels proved a quick way (19days) to obtain reliable information with a low error margin (3.7%). The online survey collected detailed socio-demographic data. Almost all of the women (98%) had heard about the menopause before. Sixty-one percent perceived the menopause as a temporary phase (17% thought it lasted for one or two years and 44% thought it lasted for three to five years) and only 39% realized the menopause would last for the rest of their life. Twenty-three percent of the women reported any kind of impact of the menopause on their quality of life. However, for the other 77% the menopause had resulted in complaints. No differences according to the women's age, level of education or professional status were found in this respect. Sixty-nine percent of the women had 'ever' used some type of treatment for menopausal symptoms and 53% were currently using a treatment. Forty percent of those with more than three symptoms were currently untreated. Of those who were not on hormone replacement therapy (HRT), 61% would not consider taking it (54% were 'strongly opposed' and 7% simply 'opposed'), while 8% would consider asking their doctor for HRT. Among those women who were opposed to HRT, 25% indicated that they were afraid of
To provide health care providers, patients, and the general public with a responsible assessment of currently available data on the management of menopause-related symptoms. A non-DHHS, nonadvocate 12-member panel representing the fields of obstetrics and gynecology, general internal medicine, endocrinology, rheumatology, family and health psychology, geriatric medicine, health services research, demography, biochemistry, epidemiology, clinical research, and biostatistics. In addition, 26 experts in fields related to the conference topic presented data to the panel and to the conference audience. Presentations by experts and a systematic review of the medical literature prepared by the Oregon Evidence-based Practice Center, through the Agency for Healthcare Research and Quality's Evidence-based Practice Centers Program. Scientific evidence was given precedence over clinical anecdotal experience. Answering pre-determined questions, the panel drafted its statement based on scientific evidence presented in open forum and on the published scientific literature. The draft statement was read in its entirety on the final day of the conference and circulated to the audience for comment. The panel then met in executive session to consider the comments received, and released a revised statement later that day at http://consensus.nih.gov. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government. A final copy of this statement is available, along with other recent conference statements, at the same web address of http://consensus.nih.gov. Menopause is the permanent cessation of menstrual periods that occurs naturally in women, usually in their early 50s. Many women have few or no symptoms; these women are not in need of medical treatment. Premenopausal or perimenopausal women who have menopause induced by surgery, chemotherapy, or radiation are more likely to experience bothersome and even disabling symptoms. These
Full Text Available The field of pain medicine that once began as a supportive and compassionate care, adding value to the management of acute and chronic ailments, has now transformed into a vital and essential specialty with structured training programs and service units with professionals dedicating their careers to it. The expansion of understanding of the direct relationship of pain relief to the quality of life, uncovering of neuronal pathways, and technological advances in imaging as well as in interventional techniques have all contributed to this phenomenal growth. However, there is a growing concern whether the training programs and the specialized practitioners are gradually limiting their skilled inputs primarily within the sensory realm of the pain experience with sophisticated interventional techniques and relegating its subjective and emotional dimensions to perfunctory realms within the schema of service provision. While the specialty is still young, if we can understand the inherent aspect of these dimensions within the pain experience and acknowledge the gaps in service provision, it may be possible to champion development of truly comprehensive pain relief programs that responds effectively and ethically to a patient′s felt needs. This article attempts to position the subjectivity of pain experience in context and surface the need to design complete systems of pain relief services inclusive of this dimension. It presents authors′ review of literature on perspectives of ′unpleasant subjective emotional experiencing of the pain" to elucidate possible clinical implications based on the evidences presented on neuro-biology and neuro-psychology of the pain experience; the aim being to inspire systems of care where this dimension is sufficiently evaluated and managed.
Agrinier, N; Cournot, M; Dallongeville, J; Arveiler, D; Ducimetière, P; Ruidavets, J-B; Ferrières, J
The aim of our study was to determine the effect of the menopause on various coronary heart disease (CHD) risk factors and on the global risk of CHD in a population based sample of women, making the difference between menopause and age related effects. The Third French MONICA cross-sectional survey on cardiovascular risk included 1730 randomly selected women, aged 35-64 years, representative from the general population. Women were defined as post-menopausal (postM; n=696), peri-menopausal (periM; n=183) or pre-menopausal (preM; n=659) based on the date of last menses. Socio-demographic, clinical and biological data were collected. Analyses of variance were used to compare means. PostM women had significantly higher age-adjusted levels of total cholesterol (6.0mmol/L in postM vs. 5.7mmol/L in preM, p<0.05) and LDL cholesterol (3.9mmol/L vs. 3.6mmol/L, p<0.05). There was no difference in HDL cholesterol or triglyceride levels, glycemia or blood pressure. Further adjustment on body mass index and hormonal treatments did not modify the results. No risk factor was significantly different between periM and postM. However, the Framingham 10-year risk of CHD was higher in postM, as compared with periM (5.1% vs. 5.0%, p<0.05). In postM women, lipids and the Framingham risk were not associated with elapsed time since menopause. The CHD risk increases during the sixth decade could be explained not only by estrogen deprivation but also by an effect on lipid profile, which is likely to occur in the peri-menopause period. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Cintron, Dahima; Lipford, Melissa; Larrea-Mantilla, Laura; Spencer-Bonilla, Gabriela; Lloyd, Robin; Gionfriddo, Michael R; Gunjal, Shalak; Farrell, Ann M; Miller, Virginia M; Murad, Mohammad Hassan
Sleep complaints are reported by 40-60 % of menopausal women. Poor sleep is a risk factor for cardiovascular disease, diabetes, and obesity. The effect of menopausal hormone therapy on sleep quality is unclear. A systematic review and meta-analysis were conducted to summarize the efficacy of menopausal hormone therapy on self-reported sleep quality. Electronic databases (PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews CENTRAL, and PsycInfo) were searched from 2002 to October 2015. Randomized trials assessing the effect of menopausal hormone therapy with a minimum follow up of 8 weeks were included. Titles, abstracts, and full texts were screened independently and in duplicate. Primary outcome included sleep items within a questionnaire, scale or diary. Standardized mean differences across trials were pooled using random-effects models. The search identified 424 articles, from which 42 trials were included. Seven trials at a moderate to high risk of bias enrolling 15,468 women were pooled in meta-analysis. Menopausal hormone therapy improved sleep quality in women who had vasomotor symptoms at baseline [standardized mean difference -0.54 (-0.91 to -0.18), moderate quality evidence]. No difference was noted when women without such symptoms were analyzed separately or combined. Across 31 sleep quality questionnaires, daytime dysfunction was the most evaluated sleep domain. Menopausal hormone therapy improves sleep in women with concomitant vasomotor symptoms. Heterogeneity of trials regarding study population, formulations, and sleep scales; limit overall certainty in the evidence. Future menopausal hormone therapy trials should include assessment of self-reported sleep quality using standardized scales and adhere to reporting guidelines.
Luisetto, G; Zangari, M; Bottega, F; Peccolo, F; Galuppo, P; Nardi, A; Ziliotto, D
The aim of this study was to evaluate whether healthy women with early or late menopause have different rates of age- and menopause-related bone loss, and whether premature menopause really represents a risk factor for osteopenia. Healthy women aged from 27 to 84 years (n = 2204), with no history of fractures, were divided into two groups according to their age at menopause (AAM): group A with AAM or = 50 years. Bone mineral density (BMD) was measured in the distal non-dominant forearm by single-photon absorptiometry. Group B had a significantly lower average BMD than group A (group A, 0.430 +/- 0.074 g/cm2; group B, 0.419 +/- 0.081; p = 0.003); however, the average age of group A was significantly lower, and weight and height were significantly higher. When women older than 50 years of age were divided into five age-matched subgroups, BMD was significantly lower in women with AAM < or = 43 years up to 60 years; after that age this difference disappeared and, in the oldest subgroups, BMD was significantly lower in group B than in group A. Independent variables such as age, AAM and body mass index (BMI) explain about 30% of the variation of BMD, using a multiple linear regression analysis. In both groups age and BMI weighted more than AAM in determining BMD. When BMD was plotted versus either chronological age or years since menopause, women with late menopause showed a significantly faster bone loss than those with early menopause.(ABSTRACT TRUNCATED AT 250 WORDS)
Gibson, C J; Thurston, R C; El Khoudary, S R; Sutton-Tyrrell, K; Matthews, K A
The directional and temporal nature of relationships between overweight and obesity and hysterectomy with or without oophorectomy is not well understood. Overweight and obesity may be both a risk factor for the indications for these surgeries and a possible consequence of the procedure. We used prospective data to examine whether body mass index (BMI) increased more following hysterectomy with and without bilateral oophorectomy compared with natural menopause among middle-aged women. BMI was assessed annually for up to 10 years in the Study of Women's Health Across the Nation (SWAN (n=1962)). Piecewise linear mixed growth models were used to examine changes in BMI before and after natural menopause, hysterectomy with ovarian conservation and hysterectomy with bilateral oophorectomy. Covariates included education, race/ethnicity, menopausal status, physical activity, self-rated health, hormone therapy use, antidepressant use, age and visit before the final menstrual period (FMP; for natural menopause) or surgery (for hysterectomy/oophorectomy). By visit 10, 1780 (90.6%) women reached natural menopause, 106 (5.5%) reported hysterectomy with bilateral oophorectomy and 76 (3.9%) reported hysterectomy with ovarian conservation. In fully adjusted models, BMI increased for all women from baseline to FMP or surgery (annual rate of change=0.19 kg m(-2) per year), with no significant differences in BMI change between groups. BMI also increased for all women following FMP, but increased more rapidly in women following hysterectomy with bilateral oophorectomy (annual rate of change=0.21 kg m(-2) per year) as compared with following natural menopause (annual rate of change=0.08 kg m(-2) per year, P=0.03). In this prospective examination, hysterectomy with bilateral oophorectomy was associated with greater increases in BMI in the years following surgery than following hysterectomy with ovarian conservation or natural menopause. This suggests that accelerated weight