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Sample records for menopause prospective analysis

  1. Menopause

    Science.gov (United States)

    ... 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 ...

  2. Diabetes and onset of natural menopause: results from the European Prospective Investigation into Cancer and Nutrition.

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    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

    2015-06-01

    Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89-1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10-20 years: HR = 1.43; 95% CI 1.02-2.01, France); German Cancer Aid, German Cancer Research Center (DKFZ) and Federal Ministry of Education and Research (BMMF) (Germany); Ministry of Health and Social Solidarity, Stavros Niarchos Foundation and Hellenic Health Foundation (Greece); Italian Association for Research on Cancer (AIRC) and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); ERC-2009-AdG 232997 and Nordforsk, Nordic Centre of Excellence programme on Food, Nutrition and Health (Norway); Health Research Fund (FIS), Regional Governments of Andaluc

  3. Manufacturing Menopause: An Analysis of the Portrayal of Menopause and Information Content on Pharmaceutical Web Sites

    Science.gov (United States)

    Charbonneau, Deborah Hile

    2010-01-01

    Consumer-targeted prescription drug advertising serves as an interesting lens through which we can examine the portrayal of menopause in online drug advertisements. The aim of this study was to explore the portrayal of menopause on web sites sponsored by pharmaceutical companies for hormone therapies (HT). To unravel this question, a qualitative…

  4. Menopause-related brain activation patterns during visual sexual arousal in menopausal women: An fMRI pilot study using time-course analysis.

    Science.gov (United States)

    Kim, Gwang-Won; Jeong, Gwang-Woo

    2017-02-20

    The aging process and menopausal transition are important factors in sexual dysfunction of menopausal women. No neuroimaging study has assessed the age- and menopause-related changes on brain activation areas associated with sexual arousal in menopausal women. The purpose of this study was to evaluate the time course of regional brain activity associated with sexual arousal evoked by visual stimulation in premenopausal and menopausal women, and further to assess the effect of menopause on the brain areas associated with sexual arousal in menopausal women using functional magnetic resonance imaging (fMRI). Thirty volunteers consisting of 15 premenopausal and 15 menopausal women underwent the fMRI. For the activation condition, volunteers viewed sexually arousing visual stimulation. The brain areas with significantly higher activation in premenopausal women compared with menopausal women included the thalamus, amygdala, and anterior cingulate cortex (ACC) using analysis of covariance adjusting for age (psexual arousal. These findings might help elucidate the neural mechanisms associated with sexual dysfunction in menopausal women. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  5. Diabetes and onset of natural menopause : Results from the European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    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.

    2015-01-01

    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

  6. Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials.

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    Chiu, Hsiao-Yean; Pan, Chieh-Hsin; Shyu, Yuh-Kae; Han, Bor-Cheng; Tsai, Pei-Shan

    2015-02-01

    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 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.

  7. Menopausal hormone therapy and breast cancer risk : impact of different treatments. The European Prospective Investigation into Cancer and Nutrition

    NARCIS (Netherlands)

    Bakken, Kjersti; Fournier, Agnes; Lund, Eiliv; Waaseth, Marit; Dumeaux, Vanessa; Clavel-Chapelon, Francoise; Fabre, Alban; Hemon, Bertrand; Rinaldi, Sabina; Chajes, Veronique; Slimani, Nadia; Allen, Naomi E.; Reeves, Gillian K.; Bingham, Sheila; Khaw, Kay-Tee; Olsen, Anja; Tjonneland, Anne; Rodriguez, Laudina; Sanchez, Maria-Jose; Amiano Etxezarreta, Pilar; Ardanaz, Eva; Tormo, Maria-Jose; Peeters, Petra H.; van Gils, Carla H.; Steffen, Annika; Schulz, Mandy; Chang-Claude, Jenny; Kaaks, Rudolf; Tumino, Rosario; Gallo, Valentina; Norat, Teresa; Riboli, Elio; Panico, Salvatore; Masala, Giovanna; Gonzalez, Carlos A.; Berrino, Franco

    2011-01-01

    Menopausal hormone therapy (MHT) is characterized by use of different constituents, regimens and routes of administration. We investigated the association between the use of different types of MHT and breast cancer risk in the EPIC cohort study. The analysis is based on data from 133,744

  8. Relationship between lower limb position and pelvic floor muscle surface electromyography activity in menopausal women: a prospective observational study

    Directory of Open Access Journals (Sweden)

    Halski T

    2017-01-01

    Full Text Available Tomasz Halski,1 Kuba Ptaszkowski,2 Lucyna Słupska,1 Robert Dymarek,3 Małgorzata Paprocka-Borowicz2 1Department of Physiotherapy, Opole Medical School, Opole, 2Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, 3Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Objectives: In physiotherapeutic practice, special attention is being given to the reciprocal anatomical, physiological, and biomechanical relationship of the pelvis and the structures connected to it. However, the scientific literature shows mainly the theoretical information about their mutual connections. The lack of information about these relations from a practical aspect coupled with the paucity of scientific papers on the impact of posture changes on the pelvic floor led the authors to conduct this study. The primary aim of this study was to compare the resting and functional bioelectrical activities of pelvic floor muscles (PFMs depending on three different positions of the lower limbs (positions A, B, and C in the supine position.Materials and methods: This was a prospective observational study evaluating resting and functional activities of the PFM depending on the position of the lower limbs. The study was carried out at the Department and Clinic of Urology, University Hospital in Wroclaw, Poland and the target group were women in the menopausal period. Bioelectrical activity of PFM was recorded using a surface electromyographic instrument in the supine position. Results of the values obtained in A, B, and C positions were compared using a one-way analysis of variance.Results: In position A, the average resting surface electromyography (sEMG activity of PFM was 6.9±2.6 µV; in position B, the result was 6.9±2.5 µV and in position C, the resting sEMG activity was 5.7±1.8 µV (P=0.0102. The results of the functional bioelectrical activity of PFM were as follows: position A – 20.3

  9. GP registrar consultations addressing menopause-related symptoms: a cross-sectional analysis.

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    De Giovanni, Jasmine M; Tapley, Amanda; Druce, Penny L; Davey, Andrew R; van Driel, Mieke L; Henderson, Kim M; Catzikiris, Nigel F; Mulquiney, Katie J; Morgan, Simon; Spike, Neil A; Kerr, Rohan H; Magin, Parker J

    2018-05-01

    To investigate the prevalence and associations of general practitioner registrars' (trainees') management of women with menopause-related symptoms. A cross-sectional analysis from the Registrar Clinical Encounters in Training (ReCEnT) cohort study. In ReCEnT registrars collected data of 60 consecutive consultations on three occasions during training. The outcome factor was menopause-related problems/diagnoses (compared with other problems/diagnoses). Associations of registrar, patient, practice, and consultation-independent variables were assessed by univariate and multivariable logistic regression. In all, 1,333 registrars conducted 189,774 consultations involving 295,017 problems/diagnoses. Of these, there were 1,291 problems/diagnoses (0.44% of all problems/diagnoses) relating to menopause. Significant multivariable independent associations of a problem being menopause-related were registrar female sex (odds ratio [OR] 2.74, 95% confidence interval [CI] 2.30-3.26) and registrars working part-time (OR 0.84, 95% CI 0.72-0.98 for full-time work). Consultation-related associations included an increased number of problems addressed in the consultation (OR 1.29, 95% CI 1.21-1.37), and menopause-related problems/diagnoses not being new (OR 0.75, 95% CI 0.66-0.86). Significant educational associations were increased odds of recourse to in-consultation sources of information or assistance (OR 2.09, 95% CI 1.80-2.44) and of generating learning goals (OR 3.15, 95% CI 2.66-3.72). Registrars seek more assistance and further knowledge about menopause compared with other problems. Thus, they may find the area particularly challenging and could benefit from further education regarding managing menopause. Our findings may help inform the design of measures aimed at improving the delivery of menopause training for general practice registrars.

  10. Meta-analysis of loci associated with age at natural menopause in African-American women

    Science.gov (United States)

    Chen, Christina T.L.; Liu, Ching-Ti; Chen, Gary K.; Andrews, Jeanette S.; Arnold, Alice M.; Dreyfus, Jill; Franceschini, Nora; Garcia, Melissa E.; Kerr, Kathleen F.; Li, Guo; Lohman, Kurt K.; Musani, Solomon K.; Nalls, Michael A.; Raffel, Leslie J.; Smith, Jennifer; Ambrosone, Christine B.; Bandera, Elisa V.; Bernstein, Leslie; Britton, Angela; Brzyski, Robert G.; Cappola, Anne; Carlson, Christopher S.; Couper, David; Deming, Sandra L.; Goodarzi, Mark O.; Heiss, Gerardo; John, Esther M.; Lu, Xiaoning; Le Marchand, Loic; Marciante, Kristin; Mcknight, Barbara; Millikan, Robert; Nock, Nora L.; Olshan, Andrew F.; Press, Michael F.; Vaiyda, Dhananjay; Woods, Nancy F.; Taylor, Herman A.; Zhao, Wei; Zheng, Wei; Evans, Michele K.; Harris, Tamara B.; Henderson, Brian E.; Kardia, Sharon L.R.; Kooperberg, Charles; Liu, Yongmei; Mosley, Thomas H.; Psaty, Bruce; Wellons, Melissa; Windham, Beverly G.; Zonderman, Alan B.; Cupples, L. Adrienne; Demerath, Ellen W.; Haiman, Christopher; Murabito, Joanne M.; Rajkovic, Aleksandar

    2014-01-01

    Age at menopause marks the end of a woman's reproductive life and its timing associates with risks for cancer, cardiovascular and bone disorders. GWAS and candidate gene studies conducted in women of European ancestry have identified 27 loci associated with age at menopause. The relevance of these loci to women of African ancestry has not been previously studied. We therefore sought to uncover additional menopause loci and investigate the relevance of European menopause loci by performing a GWAS meta-analysis in 6510 women with African ancestry derived from 11 studies across the USA. We did not identify any additional loci significantly associated with age at menopause in African Americans. We replicated the associations between six loci and age at menopause (P-value < 0.05): AMHR2, RHBLD2, PRIM1, HK3/UMC1, BRSK1/TMEM150B and MCM8. In addition, associations of 14 loci are directionally consistent with previous reports. We provide evidence that genetic variants influencing reproductive traits identified in European populations are also important in women of African ancestry residing in USA. PMID:24493794

  11. Estimation of natural age of menopause in Iranian women: A meta-analysis study

    Directory of Open Access Journals (Sweden)

    Abdolreza Rajaeefard

    2011-10-01

    Full Text Available Introduction: The mean age of menopause have been reported at the age of 51 in the world and regarding the increase in life expectancy in many countries more than a third of the life time of women i s in menopause period. The importance of menopause is due to its relationship with various diseases and quality of life. The present study was conducted to estimate the average natural age of menopause in women based on a meta-analysis study. Material and Methods: In a meta-analysis study on all the existing articles in the natural age o f menopause in Iran, 21 articles were selected based on inclusion criteria. Begg and Egger tests fo r publication bias and Cochrane test were used to determine the heterogeneity among samples. ???? estimate of mean calculated based on Random effect model in Stata11 software. Results: The publication bias assumption was rejected by Begg and Egger tests with significant value s equal to 0.174 and 0.446 respectively. There was a heterogeneity among samples (Q=4626.3, df=20 , P<0.001. So based on random effect model the mean age of menopause was calculated as 48.183 with 95 % CI=47.457-48.91. Conclusion: The average age of natural menopause in Iranian women is favorable to some places of Middle East, but is less compared with developed countries and the world mean. Because of the importance of this period in women, educational programs seem to be necessary.

  12. Age at natural menopause and risk of type 2 diabetes : A prospective cohort study

    NARCIS (Netherlands)

    T. Muka (Taulant); E. Asllanaj (Eralda); N. Avazverdi (Naim); L. Jaspers (Loes); N. Stringa (Najada); J. Milic (Jelena); S. Ligthart (Symen); M.K. Ikram (Kamran); J.S.E. Laven (Joop); M. Kavousi (Maryam); A. Dehghan (Abbas); O.H. Franco (Oscar)

    2017-01-01

    markdownabstract__Aims/hypothesis__ In this study, we aimed to examine the association between age at natural menopause and risk of type 2 diabetes, and to assess whether this association is independent of potential mediators. __Methods__ We included 3639 postmenopausal women from the

  13. Menopause Map

    Science.gov (United States)

    ... alone. Learn more about your personal journey with menopause. The Menopause Map™ will help you: Understand the stages of ... About It! Start your Journey Your journey through menopause is unique and we understand that. Answer a ...

  14. Quantitative bias analysis for epidemiological associations of perfluoroalkyl substance serum concentrations and early onset of menopause.

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    Ruark, Christopher D; Song, Gina; Yoon, Miyoung; Verner, Marc-André; Andersen, Melvin E; Clewell, Harvey J; Longnecker, Matthew P

    2017-02-01

    An association between increased serum concentrations of perfluoroalkyl substances (PFAS) such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) and early menopause has been reported (Knox et al., 2011; Taylor et al., 2014). This association may be explained by the fact that women who underwent menopause no longer excrete PFAS through menstruation. Our objective was to assess how much of the epidemiologic association between PFAS and altered timing of menopause might be explained by reverse causality. We extended a published population life-stage physiologically-based pharmacokinetic (PBPK) model of PFOS and PFOA characterized by realistic distributions of physiological parameters including age at menopause. We then conducted Monte Carlo simulations to replicate the Taylor population (Taylor et al., 2014) and the Knox population (Knox et al., 2011). The analysis of the simulated data overall showed a pattern of results that was comparable to those reported in epidemiological studies. For example, in the simulated Knox population (ages 42-51) the odds ratio (OR) for menopause in the fifth quintile of PFOA compared to those in the first quintile was 1.33 (95% CI 1.26-1.40), whereas the reported OR was 1.4 (95% CI 1.1-1.8). Using our model structure, a substantial portion of the associations reported can be explained by pharmacokinetics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Isoflavones, calcium, vitamin D and inulin improve quality of life, sexual function, body composition and metabolic parameters in menopausal women: result from a prospective, randomized, placebo-controlled, parallel-group study.

    Science.gov (United States)

    Vitale, Salvatore Giovanni; Caruso, Salvatore; Rapisarda, Agnese Maria Chiara; Cianci, Stefano; Cianci, Antonio

    2018-03-01

    Menopause results in metabolic changes that contribute to increase risk of cardiovascular diseases: increase in low density lipoprotein (LDL) and triglycerides and decrease in high density lipoprotein (HDL), weight gain are associated with a correspondent increase in incidence of hypertension and diabetes. The aim of this study was to evaluate the effect of a preparation of isoflavones, calcium vitamin D and inulin in menopausal women. We performed a prospective, randomized, placebo-controlled, parallel-group study. A total of 50 patients were randomized to receive either oral preparations of isoflavones (40 mg), calcium (500 mg) vitamin D (300 UI) and inulin (3 g) or placebo (control group). Pre- and post-treatment assessment of quality of life and sexual function were performed through Menopause-Specific Quality of Life Questionnaire (MENQOL) and Female Sexual Function Index (FSFI); evaluations of anthropometric indicators, body composition through bioelectrical impedance analyser, lumbar spine and proximal femur T-score and lipid profile were performed. After 12 months, a significant reduction in MENQOL vasomotor, physical and sexual domain scores ( p 0.05) were found in the same group. According to our data analysis, isoflavones, calcium, vitamin D and inulin may exert favourable effects on menopausal symptoms and signs.

  16. Methodological issues related to studies of lead mobilization during menopause

    Directory of Open Access Journals (Sweden)

    Berkowitz Gertrud S.

    1999-01-01

    Full Text Available While there has been a substantial decline in lead exposure in the United States during the past two decades, mobilization of existing lead stored in bone potentially represents an important endogenous source of exposure for menopausal women. It has been hypothesized that lead may be mobilized from skeletal stores during conditions of high bone turnover, such as during menopause. However, such mobilization has not been documented in prospective studies. This discussion is focussed on some of the methodological difficulties to be anticipated in longitudinal studies of lead mobilization specific to menopause and the issues that need to be taken into account when evaluating the results of such studies. To evaluate whether lead mobilization occurs during menopause, a prospective repeated measures design is needed using X-ray fluorescence analysis of lead in bone and serial measurements of blood lead. Potential confounders and effect modifiers also need to be taken into account in the statistical analysis.

  17. Dietary flavonoid and lignan intake and breast cancer risk according to menopause and hormone receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study

    DEFF Research Database (Denmark)

    Zamora-Ros, Raul; Ferrari, Pietro; González, Carlos A.

    2013-01-01

    Evidence on the association between dietary flavonoids and lignans and breast cancer (BC) risk is inconclusive, with the possible exception of isoflavones in Asian countries. Therefore, we investigated prospectively dietary total and subclasses of flavonoid and lignan intake and BC risk according...... to menopause and hormonal receptor status in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 334,850 women, mostly aged between 35 and 70 years from ten European countries. At baseline, country-specific validated dietary questionnaires were used. A flavonoid...

  18. Bone mineral density and fractures after surgical menopause : systematic review and meta-analysis

    NARCIS (Netherlands)

    Fakkert, I. E.; Teixeira, N.; Abma, E. M.; Slart, R. H. J. A.; Mourits, M. J. E.; de Bock, G. H.

    Background Oophorectomy is recommended for women at increased risk for ovarian cancer. When performed at premenopausal age oophorectomy induces acute surgical menopause, with unwanted consequences. Objective To investigate bone mineral density (BMD) and fracture prevalence after surgical menopause.

  19. Premature menopause.

    Science.gov (United States)

    Okeke, Tc; Anyaehie, Ub; Ezenyeaku, Cc

    2013-01-01

    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.

  20. Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study.

    Science.gov (United States)

    Damle, Rajshri P; Dravid, N V; Suryawanshi, Kishor H; Gadre, Arundhati S; Bagale, Priya S; Ahire, Neelam

    2013-12-01

    Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. The study included prospective analysis of 119 cases of endometrial samples in patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and H&E stained slides were studied. Patients were categorized into peri-menopausal (40-49 years) and post-menopausal (> 50 years) age group. A total of 119 specimens of endometrium were analyzed. Maximum number (73.94%) of cases were from peri-menopausal age group. The most common presenting complaint was menorrhagia (48.86%) followed by post-menopausal bleeding (26.05%). In peri-menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endometrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post-menopausal age group. Three cases of endometrial carcinoma were reported in post-menopausal age group only. A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above the age of 40 years to find out organic lesions. Careful screening can detect early cancer of endometrium which has excellent prognosis and it will help in further management.

  1. Aromatherapy for Sexual Problems in Menopausal Women: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Khadivzadeh, Talat; Najafi, Mona Najaf; Irani, Morvarid; Dizavandi, Fatemeh Rajab; Shariati, Khatereh

    2018-01-01

    Objectives The aim of the present systematic review and meta-analysis is the exploration of the potential evidence of the effectiveness of aromatherapy products on the sexual function of menopausal women. Methods From inception to December 2017, the search process was performed using the MEDLINE and Scopus databases and the Cochrane Library regarding the trials on the effectiveness of herbal-medicine aromatherapy on the sexual function of menopausal women. Results Three of the trials comprise suitable data for inclusion in the meta-analysis. According to the meta-analysis, it is possible to improve the standardized mean difference (SMD) of the sexual desire up to 0.56 in the aromatherapy group compared with the control group (SMD = 0.56; P aromatherapy with neroli oil or lavender (monopreparation) and combined-oil aromatherapy with lavender, fennel, geranium, and rose significantly improved human sexual function; however, a significant change of the serum-estrogen level was not detected. The findings of the present review should be presented cautiously because of the corresponding limitations such as the lack of a standardized tool, the lack of intention-to-treat reporting, the low study amount, and the short-term follow-up. PMID:29765928

  2. A cost-effectiveness analysis of hormone replacement therapy in the menopause.

    Science.gov (United States)

    Cheung, A P; Wren, B G

    1992-03-02

    To evaluate the cost-effectiveness of hormone replacement therapy in the menopause with particular reference to osteoporotic fracture and myocardial infarction. The multiple-decrement form of the life table was the mathematical model used to follow women of age 50 through their lifetime under the "no hormone replacement" and "hormone replacement" assumptions. Standard demographic and health economic techniques were used to calculate the corresponding lifetime differences in direct health care costs (net costs in dollars) and health effects ("net effectiveness" in terms of life expectancy and quality, in "quality-adjusted life-years"). This was then expressed as a cost-effectiveness ratio or the cost ($) per quality-adjusted life-year (QALY) for each of the chosen hormone replacement regimens. All women of age 50 in New South Wales, Australia (n = 27,021). The analysis showed that the lifetime net increments in direct medical care costs were largely contributed by hormone drug and consultation costs. Hormone replacement was associated with increased quality-adjusted life expectancy, a large percentage of which was attributed to a relief of menopausal symptoms. Cost-effectiveness ratios ranged from under 10,000 to over a million dollars per QALY. Factors associated with improved cost-effectiveness were prolonged treatment duration, the presence of menopausal symptoms, minimum progestogen side effects (in the case of oestrogen with progestogen regimens), oestrogen use after hysterectomy and the inclusion of cardiac benefits in addition to fracture prevention. Hormone replacement therapy for symptomatic women is cost-effective when factors that enhance its efficiency are considered. Short-term treatment of asymptomatic women for prevention of osteoporotic fractures and myocardial infarction is an inefficient use of health resources. Cost-effectiveness of hormone replacement in asymptomatic women is dependent on the magnitude of cardiac benefits associated with hormone

  3. Effect of acupuncture on hot flush and menopause symptoms in breast cancer- A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Tsai-Ju Chien

    Full Text Available Many breast cancer patients suffer from hot flush and medical menopause as side effects of treatment. Some patients undergo acupuncture, rather than hormone therapy, to relieve these symptoms, but the efficacy of acupuncture is uncertain. This meta-analysis evaluated the efficacy of acupuncture on hot flush and menopause symptoms in women with breast cancer.A literature search was performed, following the PRISMA Statement and without language restrictions, of 7 databases from inception through March 2017. All selected studies were randomized clinical trials (RCTs that examined the effect of needle acupuncture on hot flush and menopause symptoms in patients with breast cancer. The methodological quality of these trials was assessed using Cochrane criteria, and meta-analysis software (RevMan 5.2 was used to analyze the data.We examined 844 breast cancer patients (average age: 58 years-old from 13 RCTs. The trials had medium-to-high quality, based on the modified Jadad scale. The meta-analysis showed that acupuncture had no significant effect on the frequency and the severity of hot flush (p = 0.34; p = 0.33, but significantly ameliorated menopause symptoms (p = 0.009. None of the studies reported severe adverse events.Acupuncture significantly alleviated menopause symptoms, but had no effect on hot flush. Breast cancer patients concerned about the adverse effects of hormone therapy should consider acupuncture. Further large-scale studies that also measure biomarkers or cytokines may help to elucidate the mechanism by which acupuncture alleviates menopause symptoms in patients with breast cancer.

  4. Body mass index and age at natural menopause: a meta-analysis.

    Science.gov (United States)

    Tao, Xingyong; Jiang, Anran; Yin, Liping; Li, Yingchun; Tao, Fangbiao; Hu, Huaqing

    2015-04-01

    There is no universal consensus on the relationship between body mass index (BMI) and age at natural menopause (ANM). The primary bias was confounding by cigarette smoking because smoking was a strong confounding factor related to lower BMI and earlier menopause. This meta-analysis was conducted to estimate the effect of BMI on ANM. Medline and EMBASE databases were searched for relevant studies up to December 2013. Studies were selected for analysis based on certain inclusion and exclusion criteria. Hazard ratios (HRs) with 95% CI were extracted to assess the association between BMI and early ANM. Nine studies were selected for this meta-analysis. The HR of early ANM was 1.08 (95% CI, 1.03-1.14; P < 0.01) in underweight women compared with women of normal BMI. Compared with women of normal BMI, overweight women (HR, 0.93; 95% CI, 0.91-0.96; P < 0.001) and obese women (HR, 0.95; 95% CI, 0.79-1.15; P = 0.59) were associated with late ANM. In addition, the HRs of early ANM in overweight and obese women were 0.92 (95% CI, 0.90-0.94; P < 0.001) and 0.88 (95% CI, 0.82-0.95; P < 0.001), respectively, compared with underweight women. A separate meta-analysis indicated that the results (HR, 0.85; 95% CI, 0.81-0.90; P < 0.001) changed markedly in the comparison of obese versus normal-weight women in studies that controlled for smoking. The results of our study indicate that increased BMI modestly associates with later ANM. The relationship between BMI and ANM needs further clarification in well-designed studies, especially studies well-controlled for smoking status.

  5. Early or Premature Menopause

    Science.gov (United States)

    ... email updates Enter email Submit Early or premature menopause Menopause that happens before age 40 is called ... What is the difference between early and premature menopause? Early or premature menopause happens when ovaries stop ...

  6. Menopause accelerates biological aging

    Science.gov (United States)

    Levine, Morgan E.; Lu, Ake T.; Chen, Brian H.; Hernandez, Dena G.; Singleton, Andrew B.; Ferrucci, Luigi; Bandinelli, Stefania; Salfati, Elias; Manson, JoAnn E.; Quach, Austin; Kusters, Cynthia D. J.; Kuh, Diana; Wong, Andrew; Teschendorff, Andrew E.; Widschwendter, Martin; Ritz, Beate R.; Absher, Devin; Assimes, Themistocles L.; Horvath, Steve

    2016-01-01

    Although epigenetic processes have been linked to aging and disease in other systems, it is not yet known whether they relate to reproductive aging. Recently, we developed a highly accurate epigenetic biomarker of age (known as the “epigenetic clock”), which is based on DNA methylation levels. Here we carry out an epigenetic clock analysis of blood, saliva, and buccal epithelium using data from four large studies: the Women's Health Initiative (n = 1,864); Invecchiare nel Chianti (n = 200); Parkinson's disease, Environment, and Genes (n = 256); and the United Kingdom Medical Research Council National Survey of Health and Development (n = 790). We find that increased epigenetic age acceleration in blood is significantly associated with earlier menopause (P = 0.00091), bilateral oophorectomy (P = 0.0018), and a longer time since menopause (P = 0.017). Conversely, epigenetic age acceleration in buccal epithelium and saliva do not relate to age at menopause; however, a higher epigenetic age in saliva is exhibited in women who undergo bilateral oophorectomy (P = 0.0079), while a lower epigenetic age in buccal epithelium was found for women who underwent menopausal hormone therapy (P = 0.00078). Using genetic data, we find evidence of coheritability between age at menopause and epigenetic age acceleration in blood. Using Mendelian randomization analysis, we find that two SNPs that are highly associated with age at menopause exhibit a significant association with epigenetic age acceleration. Overall, our Mendelian randomization approach and other lines of evidence suggest that menopause accelerates epigenetic aging of blood, but mechanistic studies will be needed to dissect cause-and-effect relationships further. PMID:27457926

  7. Association of Vasomotor and Other Menopausal Symptoms with Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Taulant Muka

    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

  8. Menopausal Estrogen Therapy Benefits and Risks Vary by Age, WHI Analysis Suggests

    Science.gov (United States)

    Long-term follow-up data from the Women’s Health Initiative (WHI) provide new information about the potential risks and benefits of hormone therapy to treat symptoms related to menopause, including its effect on breast cancer risk,

  9. Investigating how menopausal factors and self-compassion shape well-being: An exploratory path analysis.

    Science.gov (United States)

    Brown, Lydia; Bryant, Christina; Brown, Valerie; Bei, Bei; Judd, Fiona

    2015-06-01

    A large body of work has investigated the relationship between menopausal factors and negative well-being (e.g. anxiety and depressive symptoms), but less is known about positive well-being and its correlates among midlife women. This study tests two models with both positive and negative well-being indices as outcomes: the first included menopausal factors as predictors; the second model expanded the first by adding self-compassion, a protective trait, as a predictor and moderator. Cross-sectional study based on self-report questionnaires from 206 women aged 40-60, currently experiencing hot flushes. Hot flush interference ratings, emotional balance, satisfaction with life, eudaimonic well-being and depressive symptoms. In model one, menopausal stage and hot flush frequency were independent of well-being outcomes. Beliefs about perceived control over menopause was the strongest predictor of well-being (β range: .22-.32), followed by hot flush interference ratings (β range: .15-.33). In model two, self-compassion was the strongest predictor of well-being indices (β range: .20-.39), followed by beliefs about control (β range: .16-.20) and interference ratings (β range: .17-.26). Psychological aspects of the menopause appear more strongly linked to well-being than physiological aspects such as menopausal stage and hot flush frequency. Specifically, self-compassion, feeling in control of menopause and low interference ratings are three factors that are associated with well-being among midlife women. These aspects could be considered in tandem, as a means to support well-being in the context of menopause. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Menopause, postmenopausal hormone use and risk of incident gout

    NARCIS (Netherlands)

    A.E. Hak (Liesbeth); G.C. Curhan (Gary); F. Grodstein (Francine); H.K. Choi (Hyon)

    2010-01-01

    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,

  11. Large Prospective Study of Ovarian Cancer Screening in High-risk Women: CA125 Cut-point Defined by Menopausal Status

    Science.gov (United States)

    Skates, Steven J.; Mai, Phuong; Horick, Nora K.; Piedmonte, Marion; Drescher, Charles W.; Isaacs, Claudine; Armstrong, Deborah K.; Buys, Saundra S.; Rodriguez, Gustavo C.; Horowitz, Ira R.; Berchuck, Andrew; Daly, Mary B.; Domchek, Susan; Cohn, David E.; Van Le, Linda; Schorge, John O.; Newland, William; Davidson, Susan A.; Barnes, Mack; Brewster, Wendy; Azodi, Masoud; Nerenstone, Stacy; Kauff, Noah D.; Fabian, Carol J.; Sluss, Patrick M.; Nayfield, Susan G.; Kasten, Carol H.; Finkelstein, Dianne M.; Greene, Mark H.; Lu, Karen

    2011-01-01

    Background Previous screening trials for early detection of ovarian cancer in postmenopausal women have used the standard CA125 cut-point of 35 U/mL, the 98th percentile in this population yielding a 2% false positive rate, while the same cut-point in trials of premenopausal women results in substantially higher false positive rates. We investigated demographic and clinical factors predicting CA125 distributions, including 98th percentiles, in a large population of high-risk women participating in two ovarian cancer screening studies with common eligibility criteria and screening protocols. Methods Baseline CA125 values and clinical and demographic data from 3,692 women participating in screening studies conducted by the NCI-sponsored Cancer Genetics Network and Gynecologic Oncology Group were combined for this pre-planned analysis. Due to the large effect of menopausal status on CA125 levels, statistical analyses were conducted separately in pre- and postmenopausal subjects to determine the impact of other baseline factors on predicted CA125 cut-points based on the 98th percentile. Results The primary clinical factor affecting CA125 cut-points was menopausal status, with premenopausal women having a significantly higher cut-point of 50 U/mL while in postmenopausal subjects the standard cut-point of 35 U/mL was recapitulated. In premenopausal women, current oral contraceptive (OC) users had a cut-point of 40 U/mL. Conclusions To achieve a 2% false positive rate in ovarian cancer screening trials and in high-risk women choosing to be screened, the cut-point for initial CA125 testing should be personalized primarily for menopausal status (~ 50 for premenopausal women, 40 for premenopausal on OC, 35 for postmenopausal women). PMID:21893500

  12. Myeloperoxidase polymorphism, menopausal status, and breast cancer risk: an update meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xue Qin

    Full Text Available Myeloperoxidase (MPO is a metabolic/oxidative lysosomal enzyme secreted by reactive neutrophils at the sites of inflamed organs and tissues during phagocytosis. MPO has been either directly or indirectly linked to neoplasia, which is a well-established risk factor for many types of cancer. A large number of studies have reported the role of MPO G-463A polymorphism regarding breast-cancer risk. However, the published findings are inconsistent. Therefore, we conducted a meta-analysis to determine more precise estimations for the relationship. Eligible studies were identified by searching several electronic databases for relevant reports published before June 2012. According to the inclusion criteria and exclusion criteria, a total of five eligible studies were included in the pooled analyses. When the five eligible studies concerning MPO G-463A polymorphism were pooled into this meta-analysis, there was no evidence found for a significant association between MPO G-463A polymorphism and breast-cancer risk in any genetic model. We also categorized by ethnicity (Caucasian or Asian for subgroup analysis; according to this subgroup analysis, we found no significant association between MPO G-463A polymorphism and breast-cancer risk in any genetic model. However, in the stratified analysis for the premenopausal group, women carrying the AA genotype were found to have a significantly reduced risk (OR = 0.56, 95% CI 0.34-0.94, p = 0.027. Under the recessive model, there was a significant association between MPO G-463A polymorphism and breast-cancer risk (OR = 0.57, 95% CI 0.34-0.93, p = 0.025. We conclude that MPO-G463A polymorphism might not be a good predictor of breast-cancer risk, though menopausal status modified women's risk of developing breast cancer.

  13. Aromatherapy for managing menopausal symptoms: A protocol for systematic review and meta-analysis.

    Science.gov (United States)

    Choi, Jiae; Lee, Hye Won; Lee, Ju Ah; Lim, Hyun-Ja; Lee, Myeong Soo

    2018-02-01

    Aromatherapy is often used as a complementary therapy for women's health. This systematic review aims to evaluate the therapeutic effects of aromatherapy as a management for menopausal symptoms. Eleven electronic databases will be searched from inception to February 2018. Randomized controlled trials that evaluated any type of aromatherapy against any type of control in individuals with menopausal symptoms will be eligible. The methodological quality will be assessed using the Cochrane risk of bias tool. Two authors will independently assess each study for eligibility and risk of bias and to extract data. This study will provide a high quality synthesis of current evidence of aromatherapy for menopausal symptoms measured with Menopause Rating Scale, the Kupperman Index, the Greene Climacteric Scale, or other validated questionnaires. The conclusion of our systematic review will provide evidence to judge whether aromatherapy is an effective intervention for patient with menopausal women. Ethical approval will not be required, given that this protocol is for a systematic review. The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. PROSPERO CRD42017079191.

  14. Feeling an Invisible Wall: The Experience of Iranian Women's Marital Relationship After Surgical Menopause: A Qualitative Content Analysis Study.

    Science.gov (United States)

    Abadi, Om Salimeh Roudi Rasht; Cheraghi, Mohammad Ali; Tirgari, Batool; Nayeri, Nahid Dehaghan; Rayyani, Masoud

    2018-02-16

    Sexual relationships after surgical menopause matter when talking about sex is taboo and marriage is the only justified way to meet sexual needs. In this qualitative research study, 22 surgical menopausal women shared their experiences of sexual/marital relationship after surgery through in-depth, face-to-face, semi-structured interviews. Qualitative content analysis technique was used for data analysis. An overarching theme entitled "feeling an invisible wall" reflected this experience. It comprised three categories: (1) declined marital intimacy, (2) disarming, and (3) transformation of societal norms into concerns. This study proposed new contextual information about the marital relationship of Iranian women after surgical menopause that was not openly articulated before and which may be applicable for others in such contexts. Women's main concern was the emotional separation because of the sexual consequences of the surgery. Healthcare providers should be aware of women's concerns, which may alter their marital relationship. They must provide individualized care, education, and support for couples to make thoughtful decisions about rebuilding their sexual relationship. Results may also have implications for psychiatrists, sex/marital therapists, and probably clergy who have the authority to openly address this important issue to the public.

  15. Hubungan Pengetahuan dengan Sikap Ibu Tentang Menopause

    Directory of Open Access Journals (Sweden)

    Nopi Anggista Putri

    2016-06-01

    Full Text Available Abstrak: Menopause merupakan fase dalam kehidupan seorang wanita yang ditandai dengan berhentinya masa subur. Menopause diikuti dengan gejala yang sering timbul pada tiga hingga sepuluh tahun sebelum datangnya menopause dengan berbagai keluhan, baik keluhan fisik maupun psikologis. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan dengan sikap ibu tentang menopause di Desa Tambahrejo Kecamatan Gadingrejo Kabupaten Pringsewu. Desain penelitian ini adalah penelitian survey analitik. Populasi dalam penelitian ini adalah seluruh ibu menopause yang ada di Desa Tambahrejo yang berjumlah 148 orang, dengan sampel berjumlah 60 orang. Analisis data dalam penelitian ini menggunakan analisis uji chi-square. Kesimpulan penelitian ini adalah Ada hubungan yang bermakna antara pengetahuan dengan sikap ibu tentang menopause. Kata Kunci: pengetahuan, sikap, menopause   CORRELATION BETWEEN KNOWLEDGE WITH THE ATTITUDE OF MOTHER ABOUT MENOPAUSE Abstract: Menopause is a phase in the life a woman that is marked with the stopping the fertile. Menopause is followed by symptoms that often arise on three up to ten years before the arrival of menopause with a variety complaints, either physical or psychological complaints. This research aims to know the relationship of knowledge with the attitude of mothers about menopause in the village of Tambahrejo sub-district og Gadingrejo Regency Pringsewu. Design research is survey analytical research. The population in this research is the mother of menopause in the village Tambahrejo totalled 148 people with a sample 60 people. Data analysis inthis study uses chi-square formula. Conclusion this study is there is a meaningful relationship between maternal attitudes kowledge about menopause. Keyword: knowledge, attitude, menopause

  16. Menopause and Hormones

    Science.gov (United States)

    ... 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 ...

  17. Cancer treatment - early menopause

    Science.gov (United States)

    Premature menopause; Ovarian insufficiency - cancer ... Cancer treatments that can cause early menopause include: Surgery. Having both ovaries removed causes menopause to happen right away. If you are age 50 or younger, your provider may ...

  18. North American Menopause Society

    Science.gov (United States)

    ... Other Meetings Publications Clinical Care Recommendations Chapter 1: Menopause Chapter 2: Midlife Body Changes Chapter 3: Clinical ... Nonprescription Options Chapter 8: Prescription Therapies Professional Publications Menopause Journal Contents Position Statements & Other Reports Menopause Practice ...

  19. Menopause and Heart Disease

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Menopause and Heart Disease Updated:Jun 23,2017 Heart ... can become more evident after the onset of menopause. Menopause does not cause cardiovascular diseases . However, certain ...

  20. Hubungan Penggunaan Kontrasepsi Pil dengan Usia Menopause

    Directory of Open Access Journals (Sweden)

    Fitriyani Fitriyani

    2013-11-01

    this study was all menopausal women in integrated training post (Posbindu, Depok. The sample was menopausal women among 45 - 60 years old. Sample was 407 menopausal women taken purposive sampling. The data was analysed by cox’s proportional hazard analysed. The longer use of oral contraceptive was not associated with age at menopause before and after adjusted for confounding variable (education. However, another similar studies was still needed with prospective kohort study design to know temporality causal of longer use of oral contraceptive and age at menopause.

  1. Free androgen index as a determinant of arterial stiffness in menopause: a mediation analysis.

    Science.gov (United States)

    Lambrinoudaki, Irene; Georgiopoulos, Georgios A; Athanasouli, Fani; Armeni, Elena; Rizos, Demetrios; Augoulea, Areti; Chatzidou, Sofia; Koutli, Evangelia; Makris, Nikolaos; Kanakakis, Ioannis; Stamatelopoulos, Kimon

    2017-06-01

    Associations of endogenous androgens in menopause with blood pressure (BP) and indices of arterial stiffness are reported, but directional relationships are not clear. Structural equation modeling is a contemporary statistical method, which allows assessment of such relationships and improves pathway understanding. We recruited 411 consecutive apparently healthy postmenopausal women who underwent noninvasive vascular evaluation. This included pulse wave analysis (aortic pressures and arterial wave reflections [augmentation index]), measurement of aortic stiffness by pulse wave velocity (PWV), stiffness index (SI), and flow-mediated dilatation. A cumulative marker combining PWV and SI (combined local and aortic arterial stiffness [CAS]) was also assessed. Free androgen index (FAI) was calculated from circulating total testosterone and sex hormone-binding globulin. FAI was an independent determinant of systolic BP (SBP) (P = 0.032), SI (P = 0.042), and PWV (P = 0.027). Under structural equation modeling analysis, FAI was a direct predictor for PWV (beta = 0.149, P = 0.014), SI (beta = 0.154, P = 0.022), and CAS (beta = 0.193, P = 0.02), whereas SBP was a parallel mediator of androgen's vascular effects on PWV (beta = 0.280, P stiffness via flow-mediated dilatation was not established. FAI was not a determinant of augmentation index. In healthy postmenopausal women, FAI was directly associated with PWV, SI, and CAS. FAI also directly correlated with SBP, which in turn concurrently increased PWV and CAS. The directional correlations found herein, imply that endogenous androgens may be causally associated with indices of arterial stiffness both directly and indirectly. This hypothesis should be confirmed in further studies with causal design.

  2. Chemotherapy-Related Amenorrhea and Menopause in Young Chinese Breast Cancer Patients: Analysis on Incidence, Risk Factors and Serum Hormone Profiles

    Science.gov (United States)

    Liem, Giok S.; Mo, Frankie K. F.; Pang, Elizabeth; Suen, Joyce J. S.; Tang, Nelson L. S.; Lee, Kun M.; Yip, Claudia H. W.; Tam, Wing H.; Ng, Rita; Koh, Jane; Yip, Christopher C. H.; Kong, Grace W. S.; Yeo, Winnie

    2015-01-01

    Purpose In this prospective cross-sectional study on young premenopausal breast cancer patients, the objectives were to: determine the incidences of chemotherapy-related amenorrhea (CRA) and menopause (CRM); identify associated factors; and assess plasma levels of estradiol (E2) and follicular stimulating hormone (FSH) among patients who developed menopause. Methods Eligibility criteria include Chinese stage I-III breast cancer patients, premenopausal, age ≤45 at breast cancer diagnosis, having received adjuvant chemotherapy, within 3–10 years after breast cancer diagnosis. Detailed menstrual history prior to and after adjuvant treatment was taken at study entry. Patients’ background demographics, tumor characteristics and anti-cancer treatments were collected. The rates of CRA and CRM were determined. Analysis was conducted to identify factors associated with CRM. For postmenopausal patients, levels of E2 and FSH were analyzed. Results 286 patients were recruited; the median time from breast cancer diagnosis to study entry was 5.0 years. 255 patients (91.1%) developed CRA. Of these, 66.7% regained menstruation. At the time of study entry, 137 (48.9%) had developed CRM, amongst whom 84 were age ≤45. On multivariate analysis, age was the only associated factor. Among patients with CRM, the median FSH was 41.0 IU/L; this was significantly lower in those who were taking tamoxifen compared to those who were not (20.1 vs. 59.7 IU/L, p<0.0001). The E2 level was <40 pmol/L; there was no difference between those who were still on tamoxifen or not. Conclusion After adjuvant chemotherapy, the majority of young Chinese breast cancer patients developed CRA; ~50% developed CRM, with 61% at age ≤45. Age at diagnosis is the only factor associated with CRM. FSH level may be affected by tamoxifen intake. PMID:26485568

  3. Black women in menopausal transition.

    Science.gov (United States)

    Im, Eun-Ok; Lee, Seung Hee; Chee, Wonshik

    2010-01-01

    To describe the experience of menopausal symptoms of midlife Black women in the United States. Qualitative online forum using a feminist perspective. Internet communities for midlife women and Blacks. Twenty midlife Black women recruited using a quota sampling method. A 6-month online forum was conducted with seven discussion topics on menopausal symptoms. The discussion topics were posted sequentially on the forum site, and the women posted messages at their convenience over 6 months. The data were analyzed using thematic analysis. The identified themes were raised to be strong, accepting a natural aging process, silent and without knowledge, and our own experience. The women tried to be strong during their menopausal transitions while dealing with other important family matters. The women did not report their menopausal symptoms and were silent about or downplayed their symptoms, but many emphasized the importance of education about menopausal symptoms and highlighted their own lack of knowledge. These women generally did not talk about their symptoms because they believed that nobody except other Black midlife women could understand their menopausal experience. Health care providers need to develop a mechanism to deliver the necessary knowledge about menopausal symptoms and management strategies to Black midlife women in their health care practices.

  4. The effects of yoga and self-esteem on menopausal symptoms and quality of life in breast cancer survivors-A secondary analysis of a randomized controlled trial.

    Science.gov (United States)

    Koch, Anna K; Rabsilber, Sybille; Lauche, Romy; Kümmel, Sherko; Dobos, Gustav; Langhorst, Jost; Cramer, Holger

    2017-11-01

    Previous research has found that yoga can enhance quality of life and ease menopausal symptoms of breast cancer survivors. The study examined whether self-esteem mediated the effects of yoga on quality of life, fatigue and menopausal symptoms, utilizing validated outcome measures. This is a secondary analysis of a randomized controlled trial comparing the effects of yoga with those of usual care in 40 breast cancer survivors who suffered from menopausal symptoms. All participants completed all 3 assessments (week 0, week 12, and week 24) and provided full data. Outcomes were measured using self-rating instruments. Mediation analyses were performed using SPSS. Self-esteem mediated the effect of yoga on total menopausal symptoms (B=-2.11, 95% BCI [-5.40 to -0.37]), psychological menopausal symptoms (B=-0.94, 95% BCI [-2.30 to -0.01]), and urogenital menopausal symptoms (B=-0.66, 95% BCI [-1.65 to -0.15]), quality of life (B=8.04, 95% BCI [3.15-17.03]), social well-being (B=1.80, 95% BCI [0.54-4.21]), emotional well-being (B=1.62, 95% BCI [0.70-3.34]), functional well-being (B=1.84, 95% BCI [0.59-4.13]), and fatigue (B=4.34, 95% BCI [1.28-9.55]). Self-esteem had no effect on somatovegetative menopausal symptoms (B=-0.50, 95% BCI n.s.) or on physical well-being (B=0.79, 95% BCI n.s.). Findings support the assumption that self-esteem plays a vital role in the beneficial effect of yoga and that yoga can have long-term benefits for women diagnosed with breast cancer and undergoing menopausal transition. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Reporting on post-menopausal hormone therapy: an analysis of gynaecologists' web pages.

    Science.gov (United States)

    Bucksch, Jens; Kolip, Petra; Deitermann, Bernhilde

    2004-01-01

    The present study was designed to analyse Web pages of German gynaecologists with regard to postmenopausal hormone therapy (HT). There is a growing body of evidence, that the overall health risks of HT exceed the benefits. Making one's own informed choice has become a central concern for menopausal women. The Internet is an important source of health information, but the quality is often dubious. The study focused on the analysis of basic criteria such as last modification date and quality of the HT information content. The results of the Women's Health Initiative Study (WHI) were used as a benchmark. We searched for relevant Web pages by entering a combination of key words (9 x 13 = 117) into the search engine www.google.de. Each Web page was analysed using a standardized questionnaire. The basic criteria and the quality of content on each Web page were separately categorized by two evaluators. Disagreements were resolved by discussion. Of the 97 websites identified, basic criteria were not met by the majority. For example, the modification date was displayed by only 23 (23.7%) Web pages. The quality of content of most Web pages regarding HT was inaccurate and incomplete. Whilst only nine (9.3%) took up a balanced position, 66 (68%) recommended HT without any restrictions. In 22 cases the recommendation was indistinct and none of the sites refused HT. With regard to basic criteria, there was no difference between HT-recommending Web pages and sites with balanced position. Evidence-based information resulting from the WHI trial was insufficiently represented on gynaecologists' Web pages. Because of the growing number of consumers looking online for health information, the danger of obtaining harmful information has to be minimized. Web pages of gynaecologists do not appear to be recommendable for women because they do not provide recent evidence-based findings about HT.

  6. Promotional tone in reviews of menopausal hormone therapy after the Women's Health Initiative: an analysis of published articles.

    Directory of Open Access Journals (Sweden)

    Adriane Fugh-Berman

    2011-03-01

    Full Text Available BACKGROUND: Even after the Women's Health Initiative (WHI found that the risks of menopausal hormone therapy (hormone therapy outweighed benefit for asymptomatic women, about half of gynecologists in the United States continued to believe that hormones benefited women's health. The pharmaceutical industry has supported publication of articles in medical journals for marketing purposes. It is unknown whether author relationships with industry affect promotional tone in articles on hormone therapy. The goal of this study was to determine whether promotional tone could be identified in narrative review articles regarding menopausal hormone therapy and whether articles identified as promotional were more likely to have been authored by those with conflicts of interest with manufacturers of menopausal hormone therapy. METHODS AND FINDINGS: We analyzed tone in opinion pieces on hormone therapy published in the four years after the estrogen-progestin arm of the WHI was stopped. First, we identified the ten authors with four or more MEDLINE-indexed reviews, editorials, comments, or letters on hormone replacement therapy or menopausal hormone therapy published between July 2002 and June 2006. Next, we conducted an additional search using the names of these authors to identify other relevant articles. Finally, after author names and affiliations were removed, 50 articles were evaluated by three readers for scientific accuracy and for tone. Scientific accuracy was assessed based on whether or not the findings of the WHI were accurately reported using two criteria: (1 Acknowledgment or lack of denial of the risk of breast cancer diagnosis associated with hormone therapy, and (2 acknowledgment that hormone therapy did not benefit cardiovascular disease endpoints. Determination of promotional tone was based on the assessment by each reader of whether the article appeared to promote hormone therapy. Analysis of inter-rater consistency found moderate agreement

  7. Promotional tone in reviews of menopausal hormone therapy after the Women's Health Initiative: an analysis of published articles.

    Science.gov (United States)

    Fugh-Berman, Adriane; McDonald, Christina Pike; Bell, Alicia M; Bethards, Emily Catherine; Scialli, Anthony R

    2011-03-01

    Even after the Women's Health Initiative (WHI) found that the risks of menopausal hormone therapy (hormone therapy) outweighed benefit for asymptomatic women, about half of gynecologists in the United States continued to believe that hormones benefited women's health. The pharmaceutical industry has supported publication of articles in medical journals for marketing purposes. It is unknown whether author relationships with industry affect promotional tone in articles on hormone therapy. The goal of this study was to determine whether promotional tone could be identified in narrative review articles regarding menopausal hormone therapy and whether articles identified as promotional were more likely to have been authored by those with conflicts of interest with manufacturers of menopausal hormone therapy. We analyzed tone in opinion pieces on hormone therapy published in the four years after the estrogen-progestin arm of the WHI was stopped. First, we identified the ten authors with four or more MEDLINE-indexed reviews, editorials, comments, or letters on hormone replacement therapy or menopausal hormone therapy published between July 2002 and June 2006. Next, we conducted an additional search using the names of these authors to identify other relevant articles. Finally, after author names and affiliations were removed, 50 articles were evaluated by three readers for scientific accuracy and for tone. Scientific accuracy was assessed based on whether or not the findings of the WHI were accurately reported using two criteria: (1) Acknowledgment or lack of denial of the risk of breast cancer diagnosis associated with hormone therapy, and (2) acknowledgment that hormone therapy did not benefit cardiovascular disease endpoints. Determination of promotional tone was based on the assessment by each reader of whether the article appeared to promote hormone therapy. Analysis of inter-rater consistency found moderate agreement for scientific accuracy (κ=0.57) and substantial

  8. Association between physical activity and menopausal symptoms in perimenopausal women.

    Science.gov (United States)

    Kim, Min-Ju; Cho, Juhee; Ahn, Younjhin; Yim, Gyeyoon; Park, Hyun-Young

    2014-10-03

    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

  9. Chinese and Indian women's experience with alternative medications for menopause related symptoms: A qualitative analysis.

    Science.gov (United States)

    Ohn Mar, Saw; Malhi, Fatehpal Singh; Syed Rahim, Syed Hamid; Soe, Myint Myint

    2017-09-15

    To explore women's rationalization for using alternative medications, their experience and view on safety of long-term use. Two focus group discussions, involving 5 participants each for Chinese and Indian groups, were conducted separately. Participant's personal information was collected anonymously. The discussion covered 5 areas: determinants for taking medications; reason for choosing alternative medications rather than hormone replacement therapy (HRT); how these medications help them; their view on cost-effectiveness and concerns over long-term use. The discussions were audio-taped, transcribed and analyzed. Chinese participants took supplements for controlling symptoms while Indian participants used herbs as a preventive measure during menopause according to their tradition. Women of both groups mentioned that they did not take HRT because of fear of side effects. Chinese group mentioned that medications remarkably improved their symptoms whereas Indian participants appreciated their herbals more for improvement in general wellbeing than for specific symptoms. All members agreed that using alternative medication was cost-effective. Both Chinese and Indian participants were quite confident in saying that long-term use will not be associated with any side effects. However, Indian group emphasized that proper preparation of herbal compound using different types of leaves, is essential in order to avoid untoward effects. Chinese and Indian women used alternative medicine in prevention and treatment of menopause-related problems even as they were avoiding HRT because of the fear of side effects. They believed that their supplements were effective, safe and cost-beneficial even with long-term use.

  10. Sexual Health and Menopause

    Science.gov (United States)

    ... pass through menopause and discover its effects on sexuality. And that’s something we can all be grateful for, since our understanding of how menopause and aging affect sexual health has grown a lot in ...

  11. Alternative Menopause Treatments

    Science.gov (United States)

    ... menopausal symptoms. These include estrogen—still the most effective treatment for many menopausal symptoms—non-estrogen prescription drugs, and complementary and alternative medicine (CAM). What is CAM? CAM refers to practices ...

  12. Menopause and Bone Loss

    Science.gov (United States)

    Fact Sheet & Menopause Bone Loss How are bone loss and menopause related? Throughout life your body keeps a balance between the ... lose bone faster than it can be replaced. Menopause—the time when menstrual periods end, which usually ...

  13. Menopause and breast cancer

    OpenAIRE

    Sayakhot, Padaphet

    2017-01-01

    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...

  14. The demography of menopause.

    Science.gov (United States)

    Hill, K

    1996-03-01

    Menopause marks a time of dramatic hormonal and often social change for women. Both risk factors and health needs are likely to change as women pass through menopause. This paper examines the demographic characteristics of the world population of menopausal and post-menopausal women, and also examines the implication of menopause for mortality risks. The numbers of women involved are large. Using age 50 as a proxy for menopause, about 25 million women pass through menopause each year, and we estimate that in 1990 there were 467 million post-menopausal women in the world, with an average age of about 60 years. By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion, with 47 million new entrants each year. The mortality implications of menopause are also substantial. Ratios of female to male mortality risks from all causes and from all major cause groups except neoplasms decline to low levels around menopause or shortly thereafter, and then rise again to near unity. This pattern is taken as evidence that the female reproductive period is broadly protective of health, but that this protection disappears after menopause. The main protective effect is through reduced risk of cardiovascular disease mortality, partially offset by increased risks of cancer mortality, particularly of the breast and endometrium.

  15. Exercise through Menopause.

    Science.gov (United States)

    Stuhr, Robyn M.

    2002-01-01

    Menopause is associated with many different health effects and symptoms. This paper explains that regular exercise can play a critical role in protecting health and battling the increased risk of cardiovascular disease, osteoporosis, pelvic floor atrophy, and joint stiffness associated with menopause. Exercise programs for menopausal women should…

  16. Association of alcohol consumption with the onset of natural menopause : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Taneri, Petek Eylul; Kiefte-de Jong, Jessica C.; Bramer, Wichor M.; Daan, Nadine M P; Franco, Oscar H.; Muka, Taulant

    2016-01-01

    Background: Early onset of menopause is associated with long-term health risks, including cardiovascular disease and premature death. Although alcohol intake has been suggested to affect the age at which natural menopause occurs, results from observational studies are not consistent. Objective and

  17. Menopause and Rheumatic Disease.

    Science.gov (United States)

    Talsania, Mitali; Scofield, Robert Hal

    2017-05-01

    Menopause occurs naturally in women at about 50 years of age. There is a wealth of data concerning the relationship of menopause to systemic lupus erythematosus, rheumatoid arthritis, and osteoarthritis; there are limited data concerning other rheumatic diseases. Age at menopause may affect the risk and course of rheumatic diseases. Osteoporosis, an integral part of inflammatory rheumatic diseases, is made worse by menopause. Hormone replacement therapy has been studied; its effects vary depending on the disease and even different manifestations within the same disease. Cyclophosphamide can induce early menopause, but there is underlying decreased ovarian reserve in rheumatic diseases. Published by Elsevier Inc.

  18. Distress During the Menopause Transition

    Directory of Open Access Journals (Sweden)

    Marcianna Nosek

    2012-07-01

    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.

  19. The Menopause Time of Life.

    Science.gov (United States)

    National Inst. on Aging (DHHS/NIH), Bethesda, MD.

    This pamphlet examines menopause and the changes associated with it. Menopause is briefly described, surgical menopause is explained, and the relationship between menopause and the reproductive cycle is discussed. Signs of menopause are described, including hot flashes and vaginal and urinary tract changes. Postmenopausal osteoporosis is explained…

  20. Women's perspectives toward menopause: A phenomenological study in Iran.

    Science.gov (United States)

    Hakimi, Sevil; Simbar, Masoumeh; Ramezani Tehrani, Fahimeh; Zaiery, Farid; Khatami, Shiva

    2016-01-01

    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.

  1. The role of sleep difficulties in the vasomotor menopausal symptoms and depressed mood relationships: an international pooled analysis of eight studies in the InterLACE consortium.

    Science.gov (United States)

    Chung, Hsin-Fang; Pandeya, Nirmala; Dobson, Annette J; Kuh, Diana; Brunner, Eric J; Crawford, Sybil L; Avis, Nancy E; Gold, Ellen B; Mitchell, Ellen S; Woods, Nancy F; Bromberger, Joyce T; Thurston, Rebecca C; Joffe, Hadine; Yoshizawa, Toyoko; Anderson, Debra; Mishra, Gita D

    2018-02-12

    Many women experience both vasomotor menopausal symptoms (VMS) and depressed mood at midlife, but little is known regarding the prospective bi-directional relationships between VMS and depressed mood and the role of sleep difficulties in both directions. A pooled analysis was conducted using data from 21 312 women (median: 50 years, interquartile range 49-51) in eight studies from the InterLACE consortium. The degree of VMS, sleep difficulties, and depressed mood was self-reported and categorised as never, rarely, sometimes, and often (if reporting frequency) or never, mild, moderate, and severe (if reporting severity). Multivariable logistic regression models were used to examine the bi-directional associations adjusted for within-study correlation. At baseline, the prevalence of VMS (40%, range 13-62%) and depressed mood (26%, 8-41%) varied substantially across studies, and a strong dose-dependent association between VMS and likelihood of depressed mood was found. Over 3 years of follow-up, women with often/severe VMS at baseline were more likely to have subsequent depressed mood compared with those without VMS (odds ratios (OR) 1.56, 1.27-1.92). Women with often/severe depressed mood at baseline were also more likely to have subsequent VMS than those without depressed mood (OR 1.89, 1.47-2.44). With further adjustment for the degree of sleep difficulties at baseline, the OR of having a subsequent depressed mood associated with often/severe VMS was attenuated and no longer significant (OR 1.13, 0.90-1.40). Conversely, often/severe depressed mood remained significantly associated with subsequent VMS (OR 1.80, 1.38-2.34). Difficulty in sleeping largely explained the relationship between VMS and subsequent depressed mood, but it had little impact on the relationship between depressed mood and subsequent VMS.

  2. Herbal Treatment in Menopause

    Directory of Open Access Journals (Sweden)

    Cigdem Gun

    2015-12-01

    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

  3. Metabolic disorders in menopause

    Directory of Open Access Journals (Sweden)

    Grzegorz Stachowiak

    2015-04-01

    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.

  4. The influence of unilateral oophorectomy on the age of menopause

    DEFF Research Database (Denmark)

    Rosendahl, M; Simonsen, M K; Kjer, J J

    2017-01-01

    OBJECTIVE: To determine the age of menopause after premenopausal unilateral oophorectomy (UO) and to establish whether UO at a young age leads to menopause at a younger age than if UO occurs at an older age. METHODS: A cohort of 28 731 women, of whom 17 781 (62%) were menopausal, was investigated....... Information on menopause was obtained from self-reported questionnaires. Surgical data were obtained from the National Patient Register to avoid recollection bias. Age of menopause after UO/not UO was determined using Kaplan-Meier curves. Cox regression was used to identify factors of importance for early...... menopause. RESULTS: UO was performed in 1148 women. Women with UO after the age of 45 years, premenopausal hysterectomy, bilateral oophorectomy and cancer were excluded, leaving 236 in the analysis. Menopause occurred 1.8 years earlier after UO compared to women with two intact ovaries (mean 49.5 vs. 51...

  5. "Is it menopause or bipolar?": a qualitative study of the experience of menopause for women with bipolar disorder.

    Science.gov (United States)

    Perich, Tania; Ussher, Jane; Parton, Chloe

    2017-11-16

    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.

  6. Application of Behavioral Analysis Phase of PRECEDE Model on Women’s Psychological Well-being in the Menopausal Period

    Directory of Open Access Journals (Sweden)

    Mahdi Moshki

    2015-08-01

    Full Text Available Background and Aims Positive psychology introduce mental health as a positive psychological functioning and represent it as wellbeing psychology and having positive characteristics such as self-esteem, positive social relationships, and life satisfaction. The purpose of this study was to investigate the psychological wellbeing of postmenopausal women based on the behavioral analysis phase of PRECEDE model. Materials and Methods This study is a cross-sectional survey and carried out through random sampling in the case of 110 postmenopausal women at Ferdows city, Iran in 2014. The psychological wellbeing variable was studied by Ryff test, including 84 questions and six components containing autonomy, purposeful in life, dominance on environment, personal development, positive relationships with others, and self-acceptance. The collected data were analyzed by SPSS v.20 using descriptive statistics and analytic statistics through correlation and ANOVA. Results The mean age of participants and the average number of their children were 51.62 ± 4.26 and 3.42 ± 1.38, respectively. 61.80 percent of participants had primary education. Pearson correlation test indicated a positive and significant relationship between psychological wellbeing and predisposing factors (knowledge, attitude toward menopause, environmentalbehavioral factors, enabling factors and reinforcing factors (P < 0.01. Conclusion The results indicated that increasing awareness, creating positive attitude and promoting healthy behaviors are the effective steps to improve the psychological wellbeing in postmenopausal women. * Corresponding Author: Gonabad University of Medical Sciences, Faculty of Public Health. Email: Fpf357@gmail.com

  7. Menopause and Methodological Doubt

    Science.gov (United States)

    Spence, Sheila

    2005-01-01

    Menopause and methodological doubt begins by making a tongue-in-cheek comparison between Descartes' methodological doubt and the self-doubt that can arise around menopause. A hermeneutic approach is taken in which Cartesian dualism and its implications for the way women are viewed in society are examined, both through the experiences of women…

  8. Measuring bothersome menopausal symptoms

    DEFF Research Database (Denmark)

    Lund, Kamma Sundgaard; Siersma, Volkert Dirk; Christensen, Karl Bang

    2018-01-01

    BACKGROUND: The experience of menopausal symptoms is common and an adequate patient-reported outcome measure is crucial in studies where women are treated for these symptoms. The aims of this study were to identify a patient-reported outcome measure for bothersome menopausal symptoms and, in the ...

  9. SELUK BELUK MENOPAUSE

    Directory of Open Access Journals (Sweden)

    Lannywati Ghani

    2012-09-01

    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

  10. Maternal menopause as a predictor of anti-Mullerian hormone level and antral follicle count in daughters during reproductive age

    DEFF Research Database (Denmark)

    Bentzen, J G; Forman, J L; Larsen, E C

    2013-01-01

    this prospective cohort whose mothers' age at natural menopause was known. PARTICIPANTS, SETTING AND METHODS: Participants were recruited from female health care workers aged 20-40 years employed at Copenhagen University Hospital, Rigshospitalet, and were enrolled in the study between September 2008 and February...... an internet-based questionnaire. We used an analysis of covariance model with serum-AMH and AFC as outcomes, age as the quantitative predictor and onset of maternal menopause as the categorical predictor, with further adjustments for BMI, use of oral contraceptives, participants' smoking habits and prenatal...

  11. HUBUNGAN ANTARA SINDROM MENOPAUSE DENGAN KUALITAS HIDUP PEREMPUAN MENOPAUSE DI PUSKESMAS SUKAHAJI KABUPATEN MAJALENGKA

    Directory of Open Access Journals (Sweden)

    Ruri Yuni Astari

    2015-01-01

    Full Text Available AbstractMenopause is a natural phase experienced by every woman, a reproduction process characterized by the end of the fertile period of a woman because the ovaries are no longer produce estrogen and progesterone, and may cause menopausal complaints which are referred to as menopausal syndrome. Problems or changes experienced by menopause women may lead to a crisis that will affect the quality of life. This study aims to analyze the correlation between menopausal syndrome and the quality of life. The study method was analytic observational with cross sectional design. The population were women who had experienced menopause for 1-2 years in Sukahaji Majalengka Primary Health Center area and met the study criteria such as were still have a husband, had no menstruation experience for 1-2 years and were able to read. Sampling technique was performed by total sampling, conducted in February until March 2013. Menopausal syndrome was measured by using MSQ (Menopause Symptom Questionnaire and quality of life was measured by using The World Health Organization Quality Of Life questionnaire (WHOQOL - BREF. Data was analyzed with univariate, bivariate and multivariate statistical analysis. The results presented strong negative correlation between physiological and psychological menopausal syndrome aspects in quality of life (r = -0.786, p = 0.000 and r = -0.706, p = 0.000, a negative correlation was simultaneouly strong in physiological and psychological aspects of menopausal syndrome and the quality of life of women (r = -0.772, p = 0.000, a significant correlation between income and education and quality of life (r = -0.313 p = 0.011 and r = -0.359 p = 0.003. Parity was not significantly associated with quality of life of menopause women. Conclusion: menopausal syndrome had impacts on the quality of life of menopause women. Social support, self-confidence and positive attitude towards the complaints of the menopause women to accept menopause as a gift

  12. Menopause and postmenopausal hormone therapy and risk of hearing loss.

    Science.gov (United States)

    Curhan, Sharon G; Eliassen, A Heather; Eavey, Roland D; Wang, Molin; Lin, Brian M; Curhan, Gary C

    2017-09-01

    Menopause may be a risk factor for hearing loss, and postmenopausal hormone therapy (HT) has been proposed to slow hearing decline; however, there are no large prospective studies. We prospectively examined the independent relations between menopause and postmenopausal HT and risk of self-reported hearing loss. Prospective cohort study among 80,972 women in the Nurses' Health Study II, baseline age 27 to 44 years, followed from 1991 to 2013. Baseline and updated information was obtained from detailed validated biennial questionnaires. Cox proportional-hazards regression models were used to examine independent associations between menopausal status and postmenopausal HT and risk of hearing loss. After 1,410,928 person-years of follow-up, 18,558 cases of hearing loss were reported. There was no significant overall association between menopausal status, natural or surgical, and risk of hearing loss. Older age at natural menopause was associated with higher risk. The multivariable-adjusted relative risk of hearing loss among women who underwent natural menopause at age 50+ years compared with those aged less than 50 years was 1.10 (95% confidence interval [CI] 1.03, 1.17). Among postmenopausal women, oral HT (estrogen therapy or estrogen plus progestogen therapy) was associated with higher risk of hearing loss, and longer duration of use was associated with higher risk (P trend menopause and longer duration of postmenopausal HT are associated with higher risk of hearing loss.

  13. Life Course Exposure to Smoke and Early Menopause and Menopausal Transition

    Science.gov (United States)

    Tawfik, Heba; Kline, Jennie; Jacobson, Judith; Tehranifar, Parisa; Protacio, Angeline; Flom, Julie D.; Cirillo, Piera; Cohn, Barbara A.; Terry, Mary Beth

    2015-01-01

    Objective Early age at menopause is associated with increased risk of cardiovascular disease, stroke, osteoporosis and all-cause mortality. Cigarette smoke exposure in adulthood is an established risk factor for earlier age at natural menopause and may be related to age at menopausal transition. Using data from two U.S. birth cohorts, we examined the association between smoke exposure at various stages of the life course (prenatal, childhood exposure to parental smoking and adult smoke exposure) with menopause status in 1,001 women aged 39 – 49 years at follow-up. Methods We used logistic regression analysis, adjusting for age at follow-up, to estimate odds ratios (ORs) and 95% confidence intervals (CI) relating smoke exposure to natural menopause and menopausal transition. Results The magnitudes of the associations for natural menopause were similar, but not statistically significant after adjustment for confounders for i) women with prenatal smoke exposure who did not smoke at adult follow-up (OR= 2.7 [95% CI 0.8, 9.4]) and ii) current adult smokers who were not exposed prenatally (OR= 2.8 [95% CI 0.9, 9.0]). Women who had been exposed to prenatal smoke and were current smokers had three times the risk of experiencing natural menopause (adjusted OR=3.4 [95% CI 1.1, 10.3]) compared to women without smoke exposure in either time period. Only current smoking of long duration (>26 years) was associated with the timing of the menopausal transition. Conclusion Our data suggest that exposure to smoke both prenatally and around the time of menopause accelerates ovarian aging. PMID:25803667

  14. Life course exposure to smoke and early menopause and menopausal transition.

    Science.gov (United States)

    Tawfik, Hebatullah; Kline, Jennie; Jacobson, Judith; Tehranifar, Parisa; Protacio, Angeline; Flom, Julie D; Cirillo, Piera; Cohn, Barbara A; Terry, Mary Beth

    2015-10-01

    Early age at menopause is associated with increased risk of cardiovascular disease, stroke, osteoporosis, and all-cause mortality. Cigarette smoke exposure in adulthood is an established risk factor for earlier age at natural menopause and may be related to age at the menopausal transition. Using data from two US birth cohorts, we examined the association between smoke exposure at various stages of the life course (prenatal exposure, childhood exposure to parental smoking, and adult smoke exposure) and menopause status in 1,001 women aged 39 to 49 years at follow-up. We used logistic regression analysis (adjusting for age at follow-up) to estimate odds ratios (ORs) and 95% confidence intervals (CI) relating smoke exposure to natural menopause and the menopausal transition. The magnitudes of the associations for natural menopause were similar but not statistically significant after adjustment for confounders among (i) women with prenatal smoke exposure who did not smoke on adult follow-up (OR, 2.7; 95% CI, 0.8-9.4) and (ii) current adult smokers who were not exposed prenatally (OR, 2.8; 95% CI, 0.9-9.0). Women who had been exposed to prenatal smoke and were current smokers had three times the risk of experiencing earlier natural menopause (adjusted OR, 3.4; 95% CI, 1.1-10.3) compared with women without smoke exposure in either period. Only current smoking of long duration (>26 y) was associated with the timing of the menopausal transition. Our data suggest that exposure to smoke both prenatally and around the time of menopause accelerates ovarian aging.

  15. Length of FMR1 repeat alleles within the normal range does not substantially affect the risk of early menopause

    Science.gov (United States)

    Ruth, Katherine S.; Bennett, Claire E.; Schoemaker, Minouk J.; Weedon, Michael N.; Swerdlow, Anthony J.; Murray, Anna

    2016-01-01

    STUDY QUESTION Is the length of FMR1 repeat alleles within the normal range associated with the risk of early menopause? SUMMARY ANSWER The length of repeat alleles within the normal range does not substantially affect risk of early menopause. WHAT IS KNOWN ALREADY There is a strong, well-established relationship between length of premutation FMR1 alleles and age at menopause, suggesting that this relationship could continue into the normal range. Within the normal range, there is conflicting evidence; differences in ovarian reserve have been identified with FMR1 repeat allele length, but a recent population-based study did not find any association with age at menopause as a quantitative trait. STUDY DESIGN, SIZE, DURATION We analysed cross-sectional baseline survey data collected at recruitment from 2004 to 2010 from a population-based, prospective epidemiological cohort study of >110 000 women to investigate whether repeat allele length was associated with early menopause. PARTICIPANTS/MATERIALS, SETTING, METHOD We included 4333 women from the Breakthrough Generations Study (BGS), of whom 2118 were early menopause cases (menopause under 46 years) and 2215 were controls. We analysed the relationship between length of FMR1 alleles and early menopause using logistic regression with allele length as continuous and categorical variables. We also conducted analyses with the outcome age at menopause as a quantitative trait as well as appropriate sensitivity and exploratory analyses. MAIN RESULTS AND THE ROLE OF CHANCE There was no association of the shorter or longer FMR1 allele or their combined genotype with the clinically relevant end point of early menopause in our main analysis. Likewise, there were no associations with age at menopause as a quantitative trait in our secondary analysis. LIMITATIONS, REASONS FOR CAUTION Women with homozygous alleles in the normal range may have undetected FMR1 premutation alleles, although there was no evidence to suggest this. We

  16. Decision analysis with cumulative prospect theory.

    Science.gov (United States)

    Bayoumi, A M; Redelmeier, D A

    2000-01-01

    Individuals sometimes express preferences that do not follow expected utility theory. Cumulative prospect theory adjusts for some phenomena by using decision weights rather than probabilities when analyzing a decision tree. The authors examined how probability transformations from cumulative prospect theory might alter a decision analysis of a prophylactic therapy in AIDS, eliciting utilities from patients with HIV infection (n = 75) and calculating expected outcomes using an established Markov model. They next focused on transformations of three sets of probabilities: 1) the probabilities used in calculating standard-gamble utility scores; 2) the probabilities of being in discrete Markov states; 3) the probabilities of transitioning between Markov states. The same prophylaxis strategy yielded the highest quality-adjusted survival under all transformations. For the average patient, prophylaxis appeared relatively less advantageous when standard-gamble utilities were transformed. Prophylaxis appeared relatively more advantageous when state probabilities were transformed and relatively less advantageous when transition probabilities were transformed. Transforming standard-gamble and transition probabilities simultaneously decreased the gain from prophylaxis by almost half. Sensitivity analysis indicated that even near-linear probability weighting transformations could substantially alter quality-adjusted survival estimates. The magnitude of benefit estimated in a decision-analytic model can change significantly after using cumulative prospect theory. Incorporating cumulative prospect theory into decision analysis can provide a form of sensitivity analysis and may help describe when people deviate from expected utility theory.

  17. Urinary incontinence: the role of menopause.

    Science.gov (United States)

    Trutnovsky, Gerda; Rojas, Rodrigo Guzman; Mann, Kristy Pamela; Dietz, Hans P

    2014-04-01

    This study aims to explore the effects of menopause and hormone therapy on the symptoms and signs of stress urinary incontinence and urge urinary incontinence. Records of women who attended a tertiary urogynecological unit were reviewed retrospectively. A standardized interview included evaluations of symptoms, menopause age (ie, time since last menstrual period or onset of menopausal symptoms), current or previous hormone use, and visual analogue scales for bother. Multichannel urodynamics, including urethral pressure profilometry and determination of abdominal leak point pressure, was performed. Of 382 women seen during the inclusion period, 62% were postmenopausal. Current systemic or local hormone use was reported by 7% and 6%, respectively. Two hundred eighty-eight women (76%) reported symptoms of stress urinary incontinence, with a mean bother of 5.7, and 273 women (72%) reported symptoms of urge urinary incontinence, with a mean bother of 6.4. On univariate analysis, symptoms and bother of urge incontinence were significantly related to menopause age, whereas this relationship was not found for stress incontinence. After calendar age was controlled for, length of menopause showed no significant relationship with any symptom or sign of urinary incontinence. Hormone deficiency after menopause is unlikely to play a major role in urinary incontinence.

  18. Bioidentical Hormones and Menopause

    Science.gov (United States)

    ... 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 ...

  19. Metabolic syndrome and menopause

    OpenAIRE

    Jouyandeh, Zahra; Nayebzadeh, Farnaz; Qorbani, Mostafa; Asadi, Mojgan

    2013-01-01

    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 t...

  20. Treating schizophrenia during menopause.

    Science.gov (United States)

    Brzezinski, Amnon; Brzezinski-Sinai, Noa A; Seeman, Mary V

    2017-05-01

    The aim of this review is to examine three questions: What are the risks and benefits of treating women with schizophrenia with hormone therapy (HT) at menopause? Should the antipsychotic regimen be changed at menopause? Do early- and late-onset women with schizophrenia respond differently to HT at menopause? MEDLINE databases for the years 1990 to 2016 were searched using the following interactive terms: schizophrenia, gender, menopause, estrogen, and hormones. The selected articles (62 out of 800 abstracts) were chosen on the basis of their applicability to the objectives of this targeted narrative review. HT during the perimenopause in women with schizophrenia ameliorates psychotic and cognitive symptoms, and may also help affective symptoms. Vasomotor, genitourinary, and sleep symptoms are also reduced. Depending on the woman's age and personal risk factors and antipsychotic side effects, the risk of breast cancer and cardiovascular disease may be increased. Antipsychotic types and doses may need to be adjusted at menopause, as may be the mode of administration. Both HT and changes in antipsychotic management should be considered for women with schizophrenia at menopause. The question about differences in response between early- and late-onset women cannot yet be answered.

  1. Age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: the Hilo Women's Health Study.

    Science.gov (United States)

    Sievert, Lynnette Leidy; Murphy, Lorna; Morrison, Lynn A; Reza, Angela M; Brown, Daniel E

    2013-12-01

    A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii. Participants aged 40-60 years (n=898) were drawn from a larger, randomly generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause. History of hysterectomy, age at menopause. Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause. Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Prospective analysis. Nuclear deterrence in 2030

    International Nuclear Information System (INIS)

    Tertrais, B.

    2006-12-01

    This study is a prospective analysis of the long-term future of nuclear weapons, and particularly the future of French nuclear deterrence after 2015. The selected time period is 2025-2030. The principal objective is to reflect on what the nuclear world might look like during the first part of the 21 st century, beyond the modernization decisions already planned or envisaged, and to draw conclusions for the future of the French deterrent. (author)

  3. [Cost-effectiveness analysis of adjuvant anastrozol in post-menopausal women with breast cancer].

    Science.gov (United States)

    Sasse, Andre Deeke; Sasse, Emma Chen

    2009-01-01

    Carry out an economic analysis of the incorporation of anastrozole as adjuvant hormone therapy in postmenopausal women with breast cancer in a Brazilian setting. The cost-effectiveness estimate comparing anastrozole to tamoxifen was made from the perspectives of the patient, private health insurance, and government. A Markov model was designed based on data from ATAC trial after 100 months follow-up in a hypothetical cohort of 1000 postmenopausal women in Brazil, using outcomes projections for a 25-year period. Resource utilization and associated costs were obtained from preselected sources and specialists' opinions. Treatment costs varied according to the perspective used. The incremental benefit was inserted in the model to obtain the cost of quality-adjusted life-year gained (QALY). Benefit extrapolations for a 25-year time line showed an estimate of 0.29 QALY gained with anastrozole compared to tamoxifen. The cost-effectiveness ratio per QALY gained depended on which perspective was used. There was an increment of R$ 32.403,00/QALY in the public health system/government, R$ 32.230,00/QALY for private health system, and R$ 55.270,00/QALY for patients. The benefit from adjuvant anastrozole in postmenopausal patients with breast cancer is associated to major differences in cost-effectiveness ratio and varies with the different perspectives. According to current WHO parameters, the increment is considered acceptable under public and private health system perspectives, but not from that of the patient.

  4. Menopause perception and care of menopausal women in Nigeria ...

    African Journals Online (AJOL)

    The study involved both Quantitative and Qualitative method. For quantitative method the researchers designed a cross-sectional study, using ... after menopause, social support networks for menopausal women, and types of care and ...

  5. Neutron activation analysis in minerals prospecting

    International Nuclear Information System (INIS)

    Gomez, H.; Duque O, J.

    1988-01-01

    One method multielemental analysis in geological samples has been developed by neutron activation analysis without using standards and by eliminating many of the error sources of the absolute method. It uses the ratio of the activities induced by mass unit, between the element in the sample and one cobalt monitor. The detection limits are good for more than thirty elements in many prospecting programs, with a standard deviation less than 7%. The neutron flux used is 2x10 11 nxcm -2 .S -1 and the HPGE detector has a relative efficiency of 20% and an energy resolution of 1.9 KeV in 1332 KeV photopeak

  6. Yoga and menopausal transition.

    Science.gov (United States)

    Vaze, Nirmala; Joshi, Sulabha

    2010-07-01

    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.

  7. Association of collagen type I alpha1 (COLIA1) Sp1 polymorphism with osteoporotic fracture in Caucasian post-menopausal women: a meta-analysis.

    LENUS (Irish Health Repository)

    Ji, G-R

    2012-01-06

    This study was designed to summarize quantitatively the evidence for a relationship between collagen type I alpha1 (COLIA1) Sp1 polymorphism and osteoporotic fracture risk in Caucasian post-menopausal women. This meta-analysis included 16 studies, which analysed 2294 patients with fractures and 10 285 controls. The combined results showed that there was a significant difference in genotype distribution (SS odds ratio [OR] 0.72; Ss OR 1.18; ss OR 1.97) between patients with fractures and controls. When stratifying by the fracture site, it was found that: (i) patients with vertebral fractures had a significantly higher frequency of the Ss genotype and a lower frequency of the SS genotype than controls; and (ii) patients with non-vertebral fractures had a significantly higher frequency of the ss genotype and a lower frequency of the SS genotype than controls. This meta-analysis suggests that the COLIA1 Sp1 polymorphism may be associated with osteoporotic fracture in Caucasian post-menopausal women.

  8. Menopause: Medicines to Help You

    Science.gov (United States)

    ... For Consumers Consumer Information by Audience For Women Menopause--Medicines to Help You Share Tweet Linkedin Pin ... Email Print Print and Share (PDF 375 KB) Menopause (sometimes called “the change of life”) is a ...

  9. Age of Menopause and Fracture Risk in Post-Menopausal Women Randomized to Calcium + Vitamin D, Hormone Therapy, or the combination: Results from the Women’s Health Initiative Clinical Trials

    Science.gov (United States)

    Sullivan, Shannon D.; Lehman, Amy; Nathan, Nisha K.; Thomson, Cynthia A.; Howard, Barbara V.

    2016-01-01

    OBJECTIVE We previously reported that in the absence of hormone therapy (HT) or calcium/vitamin D (Ca/D) supplementation, earlier menopause age was associated with decreased bone mineral density (BMD) and increased fracture risk in healthy post-menopausal women. Treatment with HT and Ca/D are protective against fractures after menopause. In this analysis, we asked if age of menopause onset alters fracture risk in healthy post-menopausal women receiving HT, Ca/Vit D, or the combination. METHODS Hazard ratios (HR) for any fracture among 21,711 healthy post-menopausal women enrolled in the Women’s Health Initiative Clinical Trial (WHI-CT), who were treated with HT, Ca/Vit D, or HT + Ca/D, and who reported age of non-surgical menopause of menopause menopause 40-49 or ≥50, regardless of treatment intervention [HR (95% CI): menopause menopause menopause age (menopause ages. The effect of menopause age on fracture risk was not altered by any of the treatment interventions (HT, Ca/D, HT+Ca/D), suggesting that early age of menopause is an independent contributor to postmenopausal fracture risk. PMID:27801706

  10. Metabonomic Analysis Reveals Efficient Ameliorating Effects of Acupoint Stimulations on the Menopause-caused Alterations in Mammalian Metabolism

    Science.gov (United States)

    Zhang, Limin; Wang, Yulan; Xu, Yunxiang; Lei, Hehua; Zhao, Ying; Li, Huihui; Lin, Xiaosheng; Chen, Guizhen; Tang, Huiru

    2014-01-01

    Acupoint stimulations are effective in ameliorating symptoms of menopause which is an unavoidable ageing consequence for women. To understand the mechanistic aspects of such treatments, we systematically analyzed the effects of acupoint laser-irradiation and catgut-embedding on the ovariectomy-induced rat metabolic changes using NMR and GC-FID/MS methods. Results showed that ovariectomization (OVX) caused comprehensive metabolic changes in lipid peroxidation, glycolysis, TCA cycle, choline and amino acid metabolisms. Both acupoint laser-irradiation and catgut-embedding ameliorated the OVX-caused metabonomic changes more effectively than hormone replacement therapy (HRT) with nilestriol. Such effects of acupoint stimulations were highlighted in alleviating lipid peroxidation, restoring glucose homeostasis and partial reversion of the OVX-altered amino acid metabolism. These findings provided new insights into the menopause effects on mammalian biochemistry and beneficial effects of acupoint stimulations in comparison with HRT, demonstrating metabonomics as a powerful approach for potential applications in disease prognosis and developments of effective therapies.

  11. Women's experience of being well during peri-menopause: a phenomenological study.

    Science.gov (United States)

    Mackey, Sandra

    2007-01-01

    A research study was conducted to investigate women's experience of being well during the peri-menopause because much of the research investigating the experience of menopause has concentrated on its problematic and pathological aspects. For the majority of western women the reproductive transition of menopause is not problematic, however, the nature of the unproblematic or healthy menopause has not been investigated. The aim in conducting this research was to enhance understanding of the experience of being healthy or well during menopause. In so doing, recognition of the diversity of menopausal experiences may be strengthened. The research was approached from the disciplinary perspective of nursing, and was grounded in the methodology of Heideggerian interpretive phenomenology. Data was collected via unstructured, in-depth interviews and analysis was conducted utilising the repetitive and circular process developed by van Manen. The phenomenon of being healthy or well during menopause was expressed in the form of three major themes. These were the continuity of menstrual experience, the embodiment of menopausal symptoms, and the containment of menopause and menopausal symptoms. The experience of health and well being during menopause can accommodate the experience of symptoms when the experience of symptoms does not disrupt embodied existence and the continuity of menstrual patterns. Menopause is widely studied, yet only partly understood. While much is now known about the nature and influence of ovarian hormones, the physiology of menopausal changes, and the treatment of menopausal symptoms, little is known and understood about the experience of menopause. Research that has investigated the experience of menopause has largely focused on the problematic experiences. It is now known that the majority of women, regardless of cultural background, do not experience menopause in a problematic way (Utian 1977; Porter et al. 1996). However, the nature of such experience

  12. Functional and molecular neuroimaging of menopause and hormone replacement therapy

    DEFF Research Database (Denmark)

    Comasco, Erika; Frøkjær, Vibe; Sundström-Poromaa, Inger

    2014-01-01

    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 fluctuat......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. The present review summarizes the findings of thirty-five studies of human brain function, including functional magnetic resonance imaging, positron and single-photon computed emission tomography studies, in peri......-controlled multi-modal prospective neuroimaging studies as well as investigation on the related molecular mechanisms of effects of menopausal hormonal variations on the brain....

  13. Relationship between menopause status, attitude toward menopause, and quality of life in Chinese midlife women in Hong Kong.

    Science.gov (United States)

    Li, Sixuan; Ho, Suzanne C; Sham, Aprille

    2016-01-01

    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.

  14. Risk of chronic liver disease in post-menopausal women due to body mass index, alcohol and their interaction: a prospective nested cohort study within the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS

    Directory of Open Access Journals (Sweden)

    Paul M Trembling

    2017-06-01

    Full Text Available Abstract Background We investigated the risk of chronic liver disease (CLD due to alcohol consumption and body mass index (BMI and the effects of their interaction in a prospective cohort study of women recruited to the UKCTOCS trial. Methods 95,126 post-menopausal women without documented CLD were stratified into 12 groups defined by combinations of BMI (normal, overweight, obese and alcohol consumption (none, <1–15, 16–20 and ≥21 units/week, and followed for an average of 5.1 years. Hazard ratios (HR were calculated for incident liver-related events (LRE. Results First LREs were reported in 325 (0.34% participants. Compared to women with normal BMI, HR = 1.44 (95% CI; 1.10–1.87 in the overweight group and HR = 2.25 (95% CI; 1.70–2.97 in the obese group, adjusted for alcohol and potential confounders. Compared to those abstinent from alcohol, HR = 0.70 (95% CI; 0.55–0.88 for <1–15 units/week, 0.93 (95% CI; 0.50–1.73 for 16–20 units/week and 1.82 (95% CI; 0.97–3.39 for ≥21 units/week adjusted for BMI and potential confounders. Compared to women with normal BMI drinking no alcohol, HR for LRE in obese women consuming ≥21 units/week was 2.86 (95% CI; 0.67–12.42, 1.58 (95% CI; 0.96–2.61 for obese women drinking <1–15 units/week and 1.93 (95% CI; 0.66–5.62 in those with normal BMI consuming ≥21 units/week after adjustment for potential confounders. We found no significant interaction between BMI and alcohol. Conclusion High BMI and alcohol consumption and abstinence are risk factors for CLD in post-menopausal women. However, BMI and alcohol do not demonstrate significant interaction in this group. Trial registration UKCTOCS is registered as an International Standard Randomised Controlled Trial, number ISRCTN22488978 . Registered 06/04/2000.

  15. Do stages of menopause affect the outcomes of pelvic floor muscle training?

    Science.gov (United States)

    Tosun, Özge Çeliker; Mutlu, Ebru Kaya; Tosun, Gökhan; Ergenoğlu, Ahmet Mete; Yeniel, Ahmet Özgur; Malkoç, Mehtap; Aşkar, Niyazi; İtil, İsmail Mete

    2015-02-01

    The purpose of our study is to determine whether there is a difference in pelvic floor muscle strength attributable to pelvic floor muscle training conducted during different stages of menopause. One hundred twenty-two women with stress urinary incontinence and mixed urinary incontinence were included in this prospective controlled study. The participants included in this study were separated into three groups according to the Stages of Reproductive Aging Workshop staging system as follows: group 1 (n = 41): stages -3 and -2; group 2 (n = 32): stages +1 and -1; and group 3 (n = 30): stage +2. All three groups were provided an individual home exercise program throughout the 12-week study. Pelvic floor muscle strength before and after the 12-week treatment was measured in all participants (using the PERFECT [power, endurance, number of repetitions, and number of fast (1-s) contractions; every contraction is timed] scheme, perineometry, transabdominal ultrasound, Brink scale, pad test, and stop test). Data were analyzed using analysis of variance. There were no statistically significant differences in pre-exercise training pelvic floor muscle strength parameters among the three groups. After 12 weeks, there were statistically significant increases in PERFECT scheme, Brink scale, perineometry, and ultrasound values. In contrast, there were significant decreases in stop test and 1-hour pad test values observed in the three groups (P = 0.001, dependent t test). In comparison with the other groups, group 1 demonstrated statistically significant improvements in the following postexercise training parameters: power, repetition, speed, Brink vertical displacement, and stop test. The lowest increase was observed in group 2 (P menopause with pelvic floor muscle training, but the rates of increase vary according to the menopausal stage of the participants. Women in the late menopausal transition and early menopause are least responsive to pelvic floor muscle strength training

  16. Age at menopause and incident heart failure: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Ebong, Imo A; Watson, Karol E; Goff, David C; Bluemke, David A; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G

    2014-06-01

    This study aims to evaluate the associations of early menopause (menopause occurring before age 45 years) and age at menopause with incident heart failure (HF) in postmenopausal women. We also explored the associations of early menopause and age at menopause with left ventricular (LV) measures of structure and function in postmenopausal women. We included 2,947 postmenopausal women, aged 45 to 84 years without known cardiovascular disease (2000-2002), from the Multi-Ethnic Study of Atherosclerosis. Cox proportional hazards models were used to examine the associations of early menopause and age at menopause with incident HF. In 2,123 postmenopausal women in whom cardiac magnetic resonance imaging was obtained at baseline, we explored the associations of early menopause and age at menopause with LV measures using multivariable linear regression. Across a median follow-up of 8.5 years, we observed 71 HF events. There were no significant interactions with ethnicity for incident HF (Pinteraction > 0.05). In adjusted analysis, early menopause was associated with an increased risk of incident HF (hazard ratio, 1.66; 95% CI, 1.01-2.73), whereas every 1-year increase in age at menopause was associated with a decreased risk of incident HF (hazard ratio, 0.96; 95% CI, 0.94-0.99). We observed significant interactions between early menopause and ethnicity for LV mass-to-volume ratio (LVMVR; Pinteraction = 0.02). In Chinese-American women, early menopause was associated with a higher LVMVR (+0.11; P = 0.0002), whereas every 1-year increase in age at menopause was associated with a lower LVMVR (-0.004; P = 0.04) at baseline. Older age at menopause is independently associated with a decreased risk of incident HF. Concentric LV remodeling, indicated by a higher LVMVR, is present in Chinese-American women who experienced early menopause at baseline.

  17. Age at menopause and menopause-related symptoms in human immunodeficiency virus-infected Thai women.

    Science.gov (United States)

    Boonyanurak, Pongrak; Bunupuradah, Torsak; Wilawan, Kittisak; Lueanyod, Aksorn; Thongpaeng, Parawee; Chatvong, Duangjai; Sophonphan, Jiratchaya; Saeloo, Siriporn; Ananworanich, Jintanat; Chaithongwongwatthana, Surasith

    2012-07-01

    There are limited data for age at menopause (AM) and menopause-related symptoms in human immunodeficiency virus (HIV)-infected Asian women. We investigated AM and menopause-related symptoms in HIV-infected Thai women. HIV-infected Thai women 40 years or older who did not receive any hormone therapy in the 8-week period preceding the study were enrolled. Participants completed the Menopause-Specific Quality of Life survey for their symptoms in the past 30 days. Menopause was defined as having the last menstrual period more than 1 year ago. Multivariate Cox proportional hazard regression analysis was used to identify factors associated with menopause. Two hundred sixty-eight HIV-infected women were enrolled; their median age was 44.6 (41.8-48.7) years, and the ratio of their Centers for Disease Control and Prevention clinical classifications (A:B:C) was 53%:34%:13%; 95% were using highly active antiretroviral therapy. The median (interquartile range [IQR]) CD4 count was 575 (437-758) cells/μL, and 93% had HIV-RNA of less than 1.7log10 copies/mL. Among the 55 women who had reached menopause, the mean (SD) AM was 47.3 (5.1) years. The mean (SD) AM in our study was earlier than the previous report of 49.5 (3.6) years in non-HIV-infected Thai women (difference, -2.2 y; 95% CI, -3.2 to -1.2, P menopause were Centers for Disease Control and Prevention clinical classification B or C (hazard ratio, 1.7; 95% CI, 1.0-3.03, P = 0.04), and no sexual act in the past month (hazard ratio, 4.9; 95% CI, 1.5-16.0, P = 0.01). No associations of later age of menarche, parity, marital status, educational level, income, body mass index, CD4 count, and HIV-RNA with menopause were found. AM in HIV-infected Thai women was 47.3 years, which is significantly earlier than the findings of a previous AM report on non-HIV-infected women. Postmenopausal HIV-infected women had more vasomotor and sexual symptoms. More studies are needed to investigate the cause and appropriate interventions for

  18. Human immunodeficiency virus and menopause.

    Science.gov (United States)

    Kanapathipillai, Rupa; Hickey, Martha; Giles, Michelle

    2013-09-01

    This article aims to review currently available evidence for women infected with human immunodeficiency virus (HIV) and menopause and to propose clinical management algorithms. Key studies addressing HIV and menopause have been reviewed, specifically age of menopause onset in HIV-infected women, frequency of menopausal symptoms, comorbidities associated with HIV and aging (including cardiovascular disease and bone disease), treatment of menopausal symptoms, and prevention of comorbidities in HIV-infected women. Studies suggest an earlier onset of menopause in HIV-infected women, with increased frequency of symptoms. Cardiovascular disease risk may be increased in this population, with combination antiretroviral therapy (cART) and chronic inflammation associated with HIV, contributing to increased risk. Chronic inflammation and cART have been independently implicated in bone disease. No published data have assessed the safety and efficacy of hormone therapy in relation to symptoms of menopause, cardiovascular risk, and bone disease among HIV-infected women. Few studies on menopause have been conducted in HIV-infected women compared with HIV-uninfected women. Many questions regarding age of menopause onset, frequency of menopausal symptoms and associated complications such as bone disease and cardiovascular disease, and efficacy of treatment among HIV-infected women remain. The incidence and severity of some of these factors may be increased in the setting of HIV and cART.

  19. Vascular dysfunction across the stages of the menopausal transition is associated with menopausal symptoms and quality of life.

    Science.gov (United States)

    Hildreth, Kerry L; Ozemek, Cemal; Kohrt, Wendy M; Blatchford, Patrick J; Moreau, Kerrie L

    2018-04-09

    The menopausal transition is associated with somatic symptoms and increased rates of depression, which can impair quality of life (QOL) and increase cardiovascular disease (CVD) risk. This period is also associated with accelerated vascular aging (arterial stiffening and endothelial dysfunction), an antecedent to CVD. This secondary analysis sought to explore associations between depression, menopausal symptoms and QOL, and vascular aging across menopause stages. Arterial stiffness (carotid artery compliance), endothelial function (brachial artery flow-mediated dilation [FMD]), menopausal symptoms (Menopausal Symptom List [MSL]), depression (Center for Epidemiologic Studies Depression Scale [CES-D]), and QOL (Utian QOL Scale [UQOL]) were measured in 138 women (19-70 years) classified as premenopausal (n = 41, 34 ± 8 years; mean ± SD), early (n = 25, 49 ± 3 years), or late perimenopausal (n = 26, 50 ± 4 years), or early (n = 22, 55 ± 4 years) or late postmenopausal (n = 24, 61 ± 5 years). Differences across menopause stages were determined using one-way analysis of variance; associations between vascular measures and MSL, CES-D, and UQOL were tested using Pearson's correlation analyses. Menopausal symptoms, depression, and QOL worsened across menopause stages, particularly in late perimenopausal women. Vasosomatic symptom frequency, and general somatic symptom frequency and severity were inversely correlated with carotid artery compliance and FMD (r = -0.27 to -0.18, all P stages of menopause was associated with greater frequency and severity of menopausal symptoms, and lower QOL, but not depression. Mechanisms underlying these associations (eg, inflammation, oxidative stress) should be explored.

  20. [Menopause and metabolic syndrome].

    Science.gov (United States)

    Meirelles, Ricardo M R

    2014-03-01

    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.

  1. Working women and the menopause.

    Science.gov (United States)

    Kopenhager, T; Guidozzi, F

    2015-06-01

    Women are living longer, working more and retiring later. About 45% of the over 50-year-old workforce in virtually all forms of employment are women, all of whom will experience the menopause and its symptoms, which in some women will be mild to moderate, whilst in others they may be severe and debilitating. About half of these women will find it somewhat, or fairly difficult, to cope with their work, about half will not be affected and only about 5% will be severely compromised. Poor concentration, tiredness, poor memory, depression, feeling low, lowered confidence, sleepiness and particularly hot flushes are all cited as contributing factors. As with any longstanding health-related condition, the need for support and understanding from line management is crucial and can make a major difference to how a woman will deal with the adverse impact the menopausal symptoms may have on her productivity, her job satisfaction and her efficiency. A number of plausible strategies have been proposed that can be realistically implemented in the workplace and which could certainly make a significant difference. Careful thought, planning, consideration and effort may be required but, if instituted, they will, in the final analysis, benefit both employer and employee.

  2. Menopause: Prevention and Health Promotion

    Directory of Open Access Journals (Sweden)

    Ana Mª Rivas Hidalgo

    2009-01-01

    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.

  3. The association between recent abuse and menopausal symptom bother: results from the Data Registry on Experiences of Aging, Menopause, and Sexuality (DREAMS).

    Science.gov (United States)

    Vegunta, Suneela; Kuhle, Carol; Kling, Juliana M; Files, Julia A; Kapoor, Ekta; David, Paru S; Rullo, Jordan; Sood, Richa; Thielen, Jacqueline M; Jatoi, Aminah; Schroeder, Darrell R; Faubion, Stephanie S

    2016-05-01

    The aim of the study was to determine whether there is an association between current menopausal symptom bother and a history of abuse (physical, sexual, or emotional/verbal) in the last year. A cross-sectional survey was completed using the Data Registry on Experiences of Aging, Menopause, and Sexuality and the Menopause Health Questionnaire. Data from the Menopause Health Questionnaire were collected from 4,956 women seen consecutively for menopause consultation in the Women's Health Clinic at Mayo Clinic (Rochester, MN) from January 1, 2006 through October 7, 2014. Data from 3,740 women were included in the analysis. Menopausal symptom ratings were compared between women reporting a history of abuse (physical, sexual, or emotional/verbal) in the last year and those not using a two-sample t test. Analysis of covariance was used to assess whether abuse was associated with menopausal symptom bother after adjusting for baseline participant characteristics. Of the 3,740 women, 253 (6.8%) reported experiencing one or more forms of abuse in the last year, the majority (96%) of which was verbal/emotional abuse. Those reporting abuse in the last year had higher (P menopausal symptom bother scores. Consistent findings were obtained from multivariable analyses adjusting for all demographic and substance use characteristics. In the present study from the Data Registry on Experiences of Aging, Menopause, and Sexuality, menopausal symptom bother scores were directly associated with recent self-reported abuse.

  4. Analysis of Amygdalar-Cortical Network Covariance During Pre- versus Post-menopausal Estrogen Levels: Potential Relevance to Resting State Networks, Mood, and Cognition

    Science.gov (United States)

    Ottowitz, William E.; Derro, David; Dougherty, Darin D.; Lindquist, Martin A.; Fischman, Alan J.; Hall, Janet E.

    2014-01-01

    Objectives 1.) Expand the scope of neuroendocrine applications of functional neuroimaging techniques. 2.) Compare the covariance of amygdalar activity with that of the rest of the brain during pre- and post-menopausal levels of estrogen (E2). Based on the distribution of cortical E2 receptors and the neocortical regions where E2 has been shown to preferentially accumulate, we predict that E2 infusion will increase covariance of amygdalar activity with that of the temporal and frontal cortices. Design This basic physiology study employed a within-subject design. All participants were post-menopausal women (n =7). Analysis of covariance between whole brain and amygdalar regional cerebral glucose consumption (CMRglc) was conducted in a voxel-wise manner by means of the basic regression option in SPM2 and was applied to FDG-PET scans acquired at baseline and after a 24 hour graded E2 infusion. Setting an academic medical center; Massachusetts General Hospital, Boston, Massachusetts. Results E2 levels (mean ± sem) were significantly greater at 24 hours (257.9 pg/mL ± 29.7) than at 0 hours (28.1 pg/mL ± 3.4). Right amygdalar CMRglc showed a significant covariance with activity of three different regions of the temporal cortex during E2 infusion, but none at baseline. In addition, right amygdalar CMRglc covaried with that of the right medial and superior frontal gyri only during E2 infusion. Conclusions In addition to suggesting changes in amygdalar-cortical network connectivity as a result of short-term E2 exposure, these analyses provide evidence that basic neuroendocrine research may benefit from further use of FDG-PET and other functional neuroimaging modalities for network level analyses. PMID:18766152

  5. Vaginal microbiota in menopause

    Directory of Open Access Journals (Sweden)

    Martinus Tarina

    2016-12-01

    Full Text Available The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of menopause. Vulvovaginal atrophy is often found in postmenopausal women, and dominated by L. iners, Anaerococcus sp, Peptoniphilus sp, Prevotella sp, and Streptococcus sp. The normal vaginal microbiota’s imbalance in menopause will cause diseases such as bacterial vaginosis, and recurrent vulvovaginal candidiasis due to hormonal therapies. Changes in the vaginal microbiota due to bacterial vaginosis are characterized by decrease in H2O2-producing Lactobacillus. They are also caused by the increase in numbers and concentration of Gardnerella vaginalis, Mycoplasma hominis, and other anaerob species such as Peptostreptococci, Prevotella spp, and Mobiluncus spp.

  6. Metabolic syndrome and menopause

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    Jouyandeh Zahra

    2013-01-01

    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.

  7. Perimenopausal Bleeding and Bleeding After Menopause

    Science.gov (United States)

    ... Patients About ACOG Perimenopausal Bleeding and Bleeding After Menopause Home For Patients Search FAQs Perimenopausal Bleeding and ... 2011 PDF Format Perimenopausal Bleeding and Bleeding After Menopause Gynecologic Problems What are menopause and perimenopause? What ...

  8. Diabetes and Menopause: A Twin Challenge

    Science.gov (United States)

    Diabetes and menopause: A twin challenge Diabetes and menopause may team up for varied effects on your body. Here's what to ... to stay in control. By Mayo Clinic Staff Menopause — and the years leading up to it — may ...

  9. Menopause 101: A Primer for the Perimenopausal

    Science.gov (United States)

    ... Abstracts Media Award Recipients Media Policy Media Requests Menopause 101: A primer for the perimenopausal The information ... about 2 years earlier. Common Body Changes at Menopause Each woman’s experience of menopause is different. Many ...

  10. Menopause: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish What is Menopause? (National Institute on Aging) Topic Image MedlinePlus Email Updates Get Menopause updates by ... test Menopause Types of hormone therapy Related Health Topics Hormone Replacement Therapy Menstruation Premature Ovarian Failure National ...

  11. Transparent meta-analysis of prospective memory and aging.

    Directory of Open Access Journals (Sweden)

    Bob Uttl

    Full Text Available Prospective memory (ProM refers to our ability to become aware of a previously formed plan at the right time and place. After two decades of research on prospective memory and aging, narrative reviews and summaries have arrived at widely different conclusions. One view is that prospective memory shows large age declines, larger than age declines on retrospective memory (RetM. Another view is that prospective memory is an exception to age declines and remains invariant across the adult lifespan. The present meta-analysis of over twenty years of research settles this controversy. It shows that prospective memory declines with aging and that the magnitude of age decline varies by prospective memory subdomain (vigilance, prospective memory proper, habitual prospective memory as well as test setting (laboratory, natural. Moreover, this meta-analysis demonstrates that previous claims of no age declines in prospective memory are artifacts of methodological and conceptual issues afflicting prior research including widespread ceiling effects, low statistical power, age confounds, and failure to distinguish between various subdomains of prospective memory (e.g., vigilance and prospective memory proper.

  12. HISTOPATHOLOGY OF MARGINAL SUPERFICIAL PERIODONTIUM AT MENOPAUSE

    Directory of Open Access Journals (Sweden)

    A. Georgescu

    2012-03-01

    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.

  13. Age at menopause and measuring symptoms at midlife in a community in Babol, Iran.

    Science.gov (United States)

    Delavar, Mouloud Agajani; Hajiahmadi, Mahmoud

    2011-11-01

    The aim of the present study was to determine age at menopause and the prevalence of menopausal symptoms among women in a community in Babol, Iran, and then identify the factors associated with these symptoms and age. A retrospective, descriptive, epidemiological study was conducted on the characteristics of perimenopausal and postmenopausal women. A total of 1,397 individuals aged 45 to 63 years were selected using a standard cluster sampling technique. The questionnaire used included menopausal symptoms, menopause status, causes of menopause, use of hormones, reproductive history, and sociodemographic factors. A standard questionnaire named Symptom ScoreCard was used to assess the frequency and severity of menopausal symptoms. The data were analyzed by χ2 analysis, t test, analysis of variance, and adjusted odds ratios with their 95% CIs. Recalled mean ± SD age at natural menopause was 47.7 ± 4.9 years. No significant difference by age at menopause was observed in sociodemographic data, smoking status, reproductive history, and oral contraceptive use. The most prevalent symptoms were irritability (72.1%), joint pain (70.6%), and depression (59.7%) during the previous 2 weeks. An increase in the percentage of occurrence and severity of some symptoms with transition to menopause was observed. The total score for menopausal symptoms was 13.0 ± 7.7. High economic situation (odds ratio, 1.89; 95% CI, 1.37-2.58) was a factor significantly associated with a total menopausal score of higher than 15. This study shows a high prevalence of menopausal symptoms and an earlier mean age at menopause (47.7 y) for women in a community in Babol, Iran. It would be beneficial to establish a menopausal clinic in primary healthcare centers for the clinical staff to monitor postmenopausal women.

  14. Cost-effectiveness of diagnostic strategies for the management of abnormal uterine bleeding (heavy menstrual bleeding and post-menopausal bleeding): a decision analysis

    NARCIS (Netherlands)

    Cooper, Natalie A. M.; Barton, Pelham M.; Breijer, Maria; Caffrey, Orla; Opmeer, Brent C.; Timmermans, Anne; Mol, Ben W. J.; Khan, Khalid S.; Clark, T. Justin

    2014-01-01

    Heavy menstrual bleeding (HMB) and post-menopausal bleeding (PMB) together constitute the commonest gynaecological presentation in secondary care and impose substantial demands on health service resources. Accurate diagnosis is of key importance to realising effective treatment, reducing morbidity

  15. Menopause affects pain depending on pain type and characteristics.

    Science.gov (United States)

    Meriggiola, Maria Cristina; Nanni, Michela; Bachiocco, Valeria; Vodo, Stellina; Aloisi, Anna M

    2012-05-01

    Women are more affected than men by many chronic pain conditions, suggesting the effect of sex-related mechanisms in their occurrence. The role of gonadal hormones has been studied but with contrasting results depending on the pain syndrome, reproductive status, and hormone considered. The aim of the present study was to evaluate the pain changes related to the menopausal transition period. In this observational study, postmenopausal women were asked to evaluate the presence of pain in their life during the premenopausal and postmenopausal periods and its modification with menopause. One hundred one women were enrolled and completed questionnaires on their sociodemographic status, pain characteristics, and evolution. The most common pain syndromes were headache (38%), osteoarticular pain (31%), and cervical/lumbar pain (21%). Pain was present before menopause in 66 women, ceased with menopause in 17, and started after menopause in 18. Data were used for cluster analysis, which allowed the division of participants into four groups. In the first, all women experienced headaches that disappeared or improved with menopause. The second group included osteoarticular pain; the pain improved in half of these women and remained stable in the other half. The third group had cervical/lumbar pain, which disappeared or improved with menopause in all. The fourth group presented different kinds of moderate pain, which worsened in all. The present study provides preliminary data suggesting that menopause can affect pain depending on the painful condition experienced by the woman. This underlines the different interactions of menopause-related events with body structures involved in pain.

  16. Menopause, a Self Care Manual.

    Science.gov (United States)

    Lopez, Maria Cristina; And Others

    Written for women from the three main cultural groups in New Mexico (Native American, Hispanic, and Anglo), this pamphlet discusses the causes and symptoms, some remedies for the symptoms of menopause, and presents ideas for organizing support groups to help middle-aged women and their families deal with menopausal problems. Explanations of the…

  17. Menopause. How Exercise Mitigates Symptoms.

    Science.gov (United States)

    Hargarten, Kathleen M.

    1994-01-01

    During menopause and the climacteric, women experience many changes that can affect nearly every organ system and cause psychological symptoms. This article reviews the specific changes and explains how exercise can address each symptom; outlines a practical approach physicians can use to help menopausal patients improve their quality of life. (SM)

  18. Menopause: Salient Issues for Counselors.

    Science.gov (United States)

    Patterson, Marilyn M.; Lynch, Ann Q.

    1988-01-01

    Discusses issues surrounding menopause, with the idea that counselors are in an ideal position to help change attitudes toward viewing menopause as a time of positive change rather than a time of psychological distress. Reviews historical, sociological, psychological, and attitudinal factors that account for negative responses associated with…

  19. Menopause: A Life Cycle Transition.

    Science.gov (United States)

    Evarts, Barbara Kess; Baldwin, Cynthia

    1998-01-01

    Family therapists need to address the issue of menopause proactively to be of benefit to couples and families during this transitional period in the family life cycle. Physical, psychological, and psychosocial factors affecting the menopausal woman and her family, and ways to address these issues in counseling are discussed. (Author/EMK)

  20. Age at menopause and determinants of hysterectomy and menopause in a multi-ethnic community: The Hilo Women’s Health Study

    Science.gov (United States)

    Sievert, Lynnette Leidy; Murphy, Lorna; Morrison, Lynn; Reza, Angela; Brown, Daniel E.

    2013-01-01

    Objectives A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii. Study design Participants aged 40–60 years (n=898) were drawn from a larger, randomly-generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause. Main outcome measures History of hysterectomy, Age at menopause Results Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause. Conclusions Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause. PMID:24054435

  1. MENOPAUSE AND NATURAL HEALING

    Directory of Open Access Journals (Sweden)

    Lucija Vrabič Dežman

    2008-12-01

    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

  2. Analysis of the Relationship between Estradiol and Follicle-Stimulating Hormone Concentrations and Polymorphisms of Apolipoprotein E and LeptinGenes in Women Post-Menopause

    Directory of Open Access Journals (Sweden)

    Aleksandra Rył

    2016-05-01

    Full Text Available Background: Menopause is the permanent cessation of menstruation due to loss of ovarian follicular activity. A review of the available literature indicates that correlations between the changes that take place in a woman’s body after menopause and different genetic variants are still being sought. Methods: The study was conducted in 252 women who had completed physiological menopause. The women were divided into groups according to the time elapsed since menopause. The total concentrations of estradiol and follicle-stimulating hormone were determined by means of electrochemiluminescence. The apolipoprotein E (APOE and lepitn (LEP genotypes were determined by real-time PCR and polymerase chain reaction–restriction fragment length polymorphism, respectively. Results: We observed that people with the APOE3/E3 genotype entered menopause insignificantly later compared to other genotypes. Additionally, in the group of patients with the APOE3/E3 genotypes, differences in the E2 concentration were significantly related to the time since their last menstruation. There is no association found in the literature between these polymorphisms of the LEP gene and hormones. Conclusions: To date, attempts to formulate a model describing the association between E2 and FSH concentration with the polymorphisms of various genes of menopause in women have not been successful. This relationship is difficult to study because of the number of nongenetic factors. Environmental factors can explain variation in postmenopausal changes in hormone levels.

  3. Improving the effectiveness of geological prospecting with neutron activation analysis

    International Nuclear Information System (INIS)

    Fardy, J.J.

    1984-01-01

    Two examples of the use of neutron activation analysis to improve the effectiveness of geological prospecting are examined. The first is application to the direct hydrogeochemical prospecting for gold in surface waters. The second shows how multielement data banks produced by NAA for a geological formation provide a powerful method for the classification of ore bodies and sedimentary materials

  4. Correlative analysis of plasma and urine neopterin levels in the pre- and post-menopausal women with periodontitis, following nonsurgical periodontal therapy

    Directory of Open Access Journals (Sweden)

    Jammula Surya Prasanna

    2017-01-01

    Full Text Available Context: Periodontitis is an inflammatory condition which is distinguished by the devastation of the supported tooth structures. In such inflammatory conditions, some biomarkers such as neopterin will be secreted and elevated in the body fluids, which can be used as a diagnostic marker for the present and future disease activity. Aims: Assessment of the neopterin as a biomarker in inflammatory conditions such as menopause and periodontitis. Settings and Design: A cross-sectional interventional study. Materials and Methods: Sixty female individuals with a mean age of 40–60 years with chronic periodontitis were included in this study. All were categorized into two groups of thirty each, depending on their menstrual history: Group I – thirty premenopausal women and Group II – thirty postmenopausal women. Urine and plasma were collected from both groups to estimate neopterin levels. ELISA kit was used to assess the neopterin levels at baseline and after 3 months of nonsurgical periodontal therapy (NSPT. Statistical Analysis Used: IBM SPSS version 21 software. Results: A significant depreciation in the mean values of all the parameters from baseline to 3 months (P < 0.001, in the intragroup analysis, was observed. Plasma (0.006 and urine (0.004 reduction was seen. Conclusions: In both the groups, in 3 months after NSPT, decreased neopterin levels were found, suggesting that the NSPT is the definitive therapy. Further, suggesting that, neopterin levels in the plasma and urine can be used as an index to identify the periodontal inflammation and destruction.

  5. Vitamin D and calcium intake and risk of early menopause.

    Science.gov (United States)

    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

    2017-06-01

    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

  6. Carotid artery distensibility and hormone therapy and menopause: the Los Angeles Atherosclerosis Study.

    Science.gov (United States)

    Shufelt, Chrisandra; Elboudwarej, Omeed; Johnson, B Delia; Mehta, Puja; Bittner, Vera; Braunstein, Glenn; Berga, Sarah; Stanczyk, Frank; Dwyer, Kathleen; Merz, C Noel Bairey

    2016-02-01

    Observational studies have suggested that arterial distensibility decreases during menopause; however, its relationship with hormone therapy use remains controversial. We prospectively studied distensibility and hormone therapy use at different menopause stages. One hundred sixty-one women (aged between 42 and 61 y) without cardiovascular disease underwent carotid artery measurements by ultrasound to calculate distensibility index at baseline and 3 years later. Menopause stage was classified at each visit as premenopausal, perimenopausal, and postmenopausal. Across 3 years of prospective observation, women were classified as remaining premenopausal, remaining postmenopausal, or transitioning (defined as change from premenopausal to perimenopausal, from premenopausal to postmenopausal, from perimenopausal to perimenopausal, or from perimenopausal to postmenopausal). Distensibility declined across time at all menopause stages (P menopausal transition is associated with reduced vascular compliance. Hormone therapy is associated with better arterial distensibility only during the menopausal transition. Additional prospective studies are needed to confirm these findings and to determine whether hormone therapy use beyond the menopausal transition is related to distensibility.

  7. Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS).

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M; Brinton, Eliot A; Budoff, Mathew J; Cedars, Marcelle I; Hodis, Howard N; Lobo, Rogerio A; Manson, Joann E; Merriam, George R; Miller, Virginia M; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S Mitchell; Taylor, Hugh S

    2013-04-01

    To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Cross-sectional analysis. Multicenter, randomized controlled trial. Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). None. Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E2 levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E2, CAC, and CIMT were assessed. In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E2. Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. NCT00154180. Published by Elsevier Inc.

  8. Self-Reported Menopausal Symptoms, Coronary Artery Calcification and Carotid Intima-Media Thickness in Recently Menopausal Women Screened for the Kronos Early Estrogen Prevention Study (KEEPS)

    Science.gov (United States)

    Wolff, Erin Foran; He, Yunxiao; Black, Dennis M.; Brinton, Eliot A.; Budoff, Mathew J.; Cedars, Marcelle I.; Hodis, Howard N.; Lobo, Rogerio A.; Manson, JoAnn E.; Merriam, George R.; Miller, Virginia M.; Naftolin, Fredrick; Pal, Lubna; Santoro, Nanette; Zhang, Heping; Harman, S. Mitchell; Taylor, Hugh S.

    2012-01-01

    Objective To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis. Setting Multi-center, randomized controlled trial. Patients Recently menopausal women (n=868) screened for the Kronos Early Estrogen Prevention Study (KEEPS). Design Cross sectional analysis. Interventions None Main Outcome Measures Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum estradiol (E2) levels and measures of atherosclerosis were assessed. Atherosclerosis was quantified using Coronary Artery Calcium (CAC) Agatston scores (n=771) and Carotid Intima-Media Thickness (CIMT). Logistic regression model of menopausal symptoms and E2 was used to predict CAC. Linear regression model of menopausal symptoms and E2 was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, estradiol (E2), CAC, and CIMT were assessed. Results In early menopausal women screened for KEEPS, neither E2 nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations (p=0.09) and depression (p=0.07) approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E2 predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness and E2. Conclusions Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine if baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease. PMID:23312232

  9. A prospective toxicology analysis in alcoholics

    DEFF Research Database (Denmark)

    Thomsen, Jørgen Lange; Simonsen, Kirsten Wiese; Felby, Søren

    1997-01-01

    A prospective and comprehensive investigation was done on 73 medico–legal autopsies in alcoholics. The results of the toxicology analyses are described. Alcohol intoxication was the cause of death in 8%, combined alcohol/drug intoxication in 15% and drugs alone in 19%. Alcoholic ketoacidosis...

  10. Exploring Black-White Differences in the Relationship Between Inflammation and Timing of Menopause.

    Science.gov (United States)

    Nowakowski, Alexandra C H; Graves, Katelyn Y

    2017-06-01

    Understanding the biosocial context of menopausal timing offers insight into social and health inequalities. Prior research on inflammatory chronic conditions suggests that inflammation may predict how early women experience menopause. We explore the ability of black race to moderate the overall relationship between chronic inflammation and timing of menopause. We use data from the National Social Life, Health, and Aging Project on inflammation, age of last menstruation, and race as well as relevant social and medical covariates. We conduct event history modeling to predict age at menopause by inflammatory biomarker levels. Using interaction analysis, we investigate whether being black may shape the overall relationship between inflammation status and menopause timing. Our analyses find no significant statistical interactions between black race and inflammation in predicting menopausal onset. However, we do identify independent correlational relationships between inflammation and black race (r = 0.136) and between menopausal timing and black race (r = -0.129) as well as inflammation (r = -0.138) that emerge as significant in corresponding regression models. We conclude that race probably does not moderate associations between inflammation and menopause. Yet, we also note that the original parameter estimate for black race's impact on menopausal onset (HR = 1.29, p menopause relationship and recommend future research using mediation modeling.

  11. [Menopause-related symptoms in middle-aged women residing in the Zaragoza Province].

    Science.gov (United States)

    Pérez-Roncero, Gonzalo Ramón; Martínez-Dearth, Rebeca; López-Baena, María Teresa; Ornat-Clemente, Lía

    2013-01-01

    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.

  12. Quality of the relationship and menopausal symptoms of menopausal women

    Directory of Open Access Journals (Sweden)

    Karolina Jarecka

    2016-10-01

    Full Text Available Background The aim of this study was to evaluate the occurrence and intensity of menopausal symptoms, taking into account the length of one’s relationship, its nature and one’s assessment of it. Participants and procedure The study included 200 women between the ages of 45 and 68, with secondary or higher education, married or in cohabiting relationships. Women were divided into three groups depending on the experience related to menopause: premenopause (46 respondents, perimenopause (75 respondents, and postmenopause (79 respondents. The study used a survey of self-design, the “Women’s Health” Questionnaire (WHQ by M. Hunter, and the “Partner Relations Questionnaire” (PFB by K. Hahlweg. Results Most menopausal symptoms – including those of the greatest severity – are experienced by women in perimenopausal and postmenopausal phases, but one’s own relationship’s assessment is the lowest in postmenopausal women. In this group of women, relevant and significant relations between the dimensions of the quality of the relationship and the menopausal symptoms are the most numerous. The most essential assessment was the one relating to intimacy – its poor evaluation is accompanied by higher intensity of experienced depression symptoms, somatic symptoms, and disorders of memory and concentration, sex and sleep, and also the sum of menopausal symptoms is higher. In all three groups, no significant differences in the severity of menopausal symptoms were observed between women in marital and cohabiting relationships. In women in the perimenopausal phase, the shorter the length of the relationship (its seniority, the greater is the severity of sexual dysfunction symptoms, whereas in women in the postmenopausal stage, along with the length of the relationship, the severity of psychological and somatic symptoms increases. Conclusions One should find that the perimenopausal and postmenopausal phases are particularly difficult for women

  13. Menopausal hormone use and ovarian cancer risk

    DEFF Research Database (Denmark)

    Beral, V; Gaitskell, K; Hermon, C

    2015-01-01

    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....... Adjusted Poisson regressions yielded relative risks (RRs) versus never-use. FINDINGS: During prospective follow-up, 12 110 postmenopausal women, 55% (6601) of whom had used hormone therapy, developed ovarian cancer. Among women last recorded as current users, risk was increased even with

  14. Premature menopause or early menopause and risk of ischemic stroke

    Science.gov (United States)

    Rocca, Walter A.; Grossardt, Brandon R.; Miller, Virginia M.; Shuster, Lynne T.; Brown, Robert D.

    2011-01-01

    Objective The general consensus has been that estrogen is invariably a risk factor for ischemic stroke (IS). We reviewed new observational studies that challenge this simple conclusion. Methods This was a review of observational studies of the association of premature or early menopause with stroke or IS published in English from 2006 through 2010. Results Three cohort studies showed an increased risk of all stroke in women who underwent bilateral oophorectomy compared with women who conserved their ovaries before age 50 years. The increased risk of stroke was reduced by hormonal therapy (HT) in one of the studies, suggesting that estrogen deprivation is involved in the association. Four additional observational studies showed an association of all stroke or IS with the early onset of menopause or with a shorter lifespan of ovarian activity. In three of the seven studies, the association was restricted to IS. Age at menopause was more important than type of menopause (natural vs induced). Conclusions The findings from seven recent observational studies challenge the consensus that estrogen is invariably a risk factor for IS and can be reconciled by a unifying timing hypothesis. We hypothesize that estrogen is protective for IS before age 50 years and may become a risk factor for IS after age 50 years or, possibly, after age 60 years. These findings are relevant to women who experienced premature or early menopause, or to women considering prophylactic bilateral oophorectomy before the onset of natural menopause. PMID:21993082

  15. Menopausal Hormone Therapy and Cancer

    Science.gov (United States)

    ... study may also apply to younger women. However, women in the study were not using MHT to relieve symptoms of menopause. In addition, the WHI trials tested single-dose strengths of one estrogen-only medication (Premarin) ...

  16. The menopause and urinary incontinence

    DEFF Research Database (Denmark)

    Foldspang, Anders; Mommsen, Søren

    1994-01-01

    The objective was to study the possible role of the menopause in adult female urinary incontinence (UI) etiology, using a cross-sectional population study comprising a random sample of adult females and self-reported data based on postal questionnaires. The study group comprised 915 women who...... prevalence in 1987 of episodes of stress and urge urinary incontinence; prevalence of menopause and exposure to childbirth, gynecologic surgery, cystitis and obesity as indicated by body mass index more than 29; prevalence relative risks, as indicated by odds ratio of UI conditional on menopause and other...... 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...

  17. Post-menopausal breast abscess.

    OpenAIRE

    Raju, G. C.; Naraynsingh, V.; Jankey, N.

    1986-01-01

    Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma. Although the usual treatment of an abscess is incision and drainage, in post-menopausal women, excision of the lesion is helpful for accurate histological diagnosis.

  18. Post-menopausal breast abscess.

    Science.gov (United States)

    Raju, G. C.; Naraynsingh, V.; Jankey, N.

    1986-01-01

    Thirty post-menopausal women with breast abscess were treated at Port of Spain General Hospital, Trinidad, between 1976 and 1980. In this age group, breast abscess can be confused with cancer due to a lack of inflammatory features. History and physical examination are often not helpful in differentiating an abscess from carcinoma. Although the usual treatment of an abscess is incision and drainage, in post-menopausal women, excision of the lesion is helpful for accurate histological diagnosis. PMID:3628144

  19. Menopause and Metabolic Syndrome in Tunisian Women

    Directory of Open Access Journals (Sweden)

    Samir Ben Ali

    2014-01-01

    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.

  20. Increased menopausal symptoms among Afro-Colombian women as assessed with the Menopause Rating Scale.

    Science.gov (United States)

    Monterrosa, Alvaro; Blumel, Juan E; Chedraui, Peter

    2008-02-20

    Increased frequency and severity of menopausal symptoms have been associated to black race. However, this situation has not been described in any Latin American population. Compare frequency and severity of menopausal symptoms among Afro and non-Afro Hispanic Colombian climacteric women. In this cross-sectional study, healthy Afro and non-Afro-Colombian women aged 40-59 years were asked to fill out the Menopause Rating Scale (MRS) questionnaire in order to compare symptom frequency and intensity. A total of 578 women were surveyed (201 Afro-Colombian and 377 non-Afro-Colombian). Mean age of the whole sample was 47.9+/-5.9 years (median 47), with no differences among studied groups in terms of age, parity, and hormone therapy (HT) use. Intensity of menopausal symptoms, assessed with the total MRS score, was found to be significantly higher among Afro-Colombian women (10.6+/-6.7 vs. 7.5+/-5.7, p=0.0001), which was due to higher somatic and psychological subscale scores. In this group, the frequency of somatic symptoms, heart discomfort and muscle and joint problems, was found to be higher than in non-Afro-Colombian women (38.8% vs. 26.8% and 77.1% vs. 43.5%, respectively, pColombian ones presented more bladder problems (24.9% vs. 14.9%, p=0.005). After adjusting for confounding factors, logistic regression analysis determined that black race increased the risk for presenting higher total MRS scorings (OR: 2.31; CI 95%: 1.55-3.45, p=0.0001). Despite the limitations of this study, as determined with the MRS Afro-Colombian women exhibited more impaired quality of life (QoL) when compared to non-Afro-Colombian ones, due to a higher rate and severity of menopausal somatic and psychological symptoms.

  1. Menarche, menopause, and breast cancer risk: individual participant meta-analysis, including 118 964 women with breast cancer from 117 epidemiological studies

    DEFF Research Database (Denmark)

    Beral, V.; Bull, D.; Pirie, K.

    2012-01-01

    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 w...

  2. Sleep During Menopausal Transition: A 6-Year Follow-Up.

    Science.gov (United States)

    Lampio, Laura; Polo-Kantola, Päivi; Himanen, Sari-Leena; Kurki, Samu; Huupponen, Eero; Engblom, Janne; Heinonen, Olli J; Polo, Olli; Saaresranta, Tarja

    2017-07-01

    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. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  3. Surgical menopause and nonvertebral fracture risk among older US women.

    Science.gov (United States)

    Vesco, Kimberly K; Marshall, Lynn M; Nelson, Heidi D; Humphrey, Linda; Rizzo, Joanne; Pedula, Kathryn L; Cauley, Jane A; Ensrud, Kristine E; Hochberg, Marc C; Antoniucci, Diana; Hillier, Teresa A

    2012-05-01

    The aim of this study was to determine whether older postmenopausal women with a history of bilateral oophorectomy before natural menopause (surgical menopause) have a higher risk of nonvertebral postmenopausal fracture than women with natural menopause. We used 21 years of prospectively collected incident fracture data from the ongoing Study of Osteoporotic Fractures, a cohort study of community-dwelling women without previous bilateral hip fracture who were 65 years or older at enrollment, to determine the risk of hip, wrist, and any nonvertebral fracture. χ(2) and t tests were used to compare the two groups on important characteristics. Multivariable Cox proportional hazards regression models stratified by baseline oral estrogen use status were used to estimate the risk of fracture. Baseline characteristics differed significantly among the 6,616 women within the Study of Osteoporotic Fractures who underwent either surgical (1,157) or natural (5,459) menopause, including mean age at menopause (44.3 ± 7.4 vs 48.9 ± 4.9 y, P menopause, even among women who had never used oral estrogen (hip fracture: hazard ratio [HR], 0.87; 95% CI, 0.63-1.21; wrist fracture: HR, 1.10; 95% CI, 0.78-1.57; any nonvertebral fracture: HR, 1.11; 95% CI, 0.93-1.32). These data provide some reassurance that the long-term risk of nonvertebral fracture is not substantially increased for postmenopausal women who experienced premenopausal bilateral oophorectomy, compared with postmenopausal women with intact ovaries, even in the absence of postmenopausal estrogen therapy.

  4. Carotid Artery Distensibility and Hormone Therapy and Menopause: The Los Angeles Atherosclerosis Study (LAAS)

    Science.gov (United States)

    Shufelt, Chrisandra; Elboudwarej, Omeed; Johnson, B. Delia; Mehta, Puja; Bittner, Vera; Braunstein, Glenn; Berga, Sarah; Stanczyk, Frank; Dwyer, Kathleen; Merz, C. Noel Bairey

    2015-01-01

    Objective Observational studies suggest that arterial distensibility decreases during menopause; however, the relation to hormone therapy use is controversial. We prospectively studied distensibility and hormone therapy use during different menopause stages. Methods 161 women between 42–61 years of age without cardiovascular disease had carotid artery measurements by ultrasound to calculate the distensibility index at baseline and 3 years later. Menopause stage was classified at each visit as premenopausal, perimenopausal, and postmenopausal. Over 3 years of prospective observation, women were classified as remaining premenopausal, remaining postmenopausal, or transitioning, defined as change from premenopausal-to-perimenopausal, premenopausal-to-postmenopausal, perimenopausal-to-perimenopausal, or perimenopausal-to-postmenopausal. Results Distensibility declined over time in all menopause stages (pmenopause transition is associated with reduced vascular compliance. Hormone therapy is associated with better arterial distensibility only during menopause transition. Additional prospective studies are needed to confirm these findings and to determine if hormone therapy use beyond menopause transition is related to distensibility. PMID:26308234

  5. Menopause characteristics and subjective symptoms in women with and without spinal cord injury.

    Science.gov (United States)

    Kalpakjian, Claire Z; Quint, Elisabeth H; Bushnik, Tamara; Rodriguez, Gianna M; Terrill, Melissa Sendroy

    2010-04-01

    To examine menopause transition characteristics and symptom bother in women with spinal cord injury (SCI). Prospective cohort (4 data collection periods across 4 years). Community. Women (n=62) with SCI (injury levels C6-T12, nonambulatory, >36mo postinjury; 86.1% retention) and women without SCI (n=66; 92.9% retention) with intact ovaries, not using hormone therapy, and between the ages of 45 and 60 years volunteered. A total of 505 observations were collected and analyzed. None. Age at final menstrual period (FMP), transitions through menopause status classifications, and menopause symptom bother (vasomotor, somatic, psychologic symptoms). The number of women transitioning through a menopause status classification over the course of the study did not significantly vary by group (P=.263), nor did age at FMP (P=.643). Women with SCI experienced greater bother of somatic symptoms (a subscale, P<.001), bladder infections (P<.001), and diminished sexual arousal (P=.012). Women without SCI had significantly greater bother of vasomotor symptoms (P=.020). There were no significant group by menopause status interactions; main effects for menopause status were significant only for vasomotor symptoms and vaginal dryness. Results suggested that women with SCI experience greater symptom bother in certain areas, but that patterns of symptom bother across menopause, transition through menopause, and age at FMP are similar to those of their peers. Larger studies are needed to examine menopause outcomes with respect to level of injury and completeness of injury. These findings provide a framework that women with SCI and their health care providers can use to address the menopause transition and highlight the importance of multidisciplinary involvement to maximize health and well being during this transition. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Association of menopause age and N-terminal pro brain natriuretic peptide: the Multi-Ethnic Study of Atherosclerosis.

    Science.gov (United States)

    Ebong, Imo A; Watson, Karol E; Goff, David C; Bluemke, David A; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G

    2015-05-01

    Menopause age can affect the risk of developing cardiovascular disease (CVD). The purpose of this study was to investigate the associations of early menopause (menopause occurring before age 45 y) and menopause age with N-terminal pro brain natriuretic peptide (NT-proBNP), a potential risk marker of CVD and heart failure. Our cross-sectional study included 2,275 postmenopausal women, aged 45 to 85 years and without clinical CVD (2000-2002), from the Multi-Ethnic Study of Atherosclerosis. Participants were classified as having or not having early menopause. NT-proBNP was log-transformed. Multivariable linear regression was used for analysis. Five hundred sixty-one women had early menopause. The median (25th-75th percentiles) NT-proBNP value was 79.0 (41.1-151.6) pg/mL for all participants, 83.4 (41.4-164.9) pg/mL for women with early menopause, and 78.0 (40.8-148.3) pg/mL for women without early menopause. The mean (SD) age was 65 (10.1) and 65 (8.9) years for women with and without early menopause, respectively. No significant interactions between menopause age and ethnicity were observed. In multivariable analysis, early menopause was associated with a 10.7% increase in NT-proBNP levels, whereas each 1-year increase in menopause age was associated with a 0.7% decrease in NT-proBNP levels. Early menopause is associated with greater NT-proBNP levels, whereas each 1-year increase in menopause age is associated with lower NT-proBNP levels, in postmenopausal women.

  7. Aromatherapy for managing menopausal symptoms

    Science.gov (United States)

    Choi, Jiae; Lee, Hye Won; Lee, Ju Ah; Lim, Hyun-Ja; Lee, Myeong Soo

    2018-01-01

    Abstract Background: Aromatherapy is often used as a complementary therapy for women's health. This systematic review aims to evaluate the therapeutic effects of aromatherapy as a management for menopausal symptoms. Methods: Eleven electronic databases will be searched from inception to February 2018. Randomized controlled trials that evaluated any type of aromatherapy against any type of control in individuals with menopausal symptoms will be eligible. The methodological quality will be assessed using the Cochrane risk of bias tool. Two authors will independently assess each study for eligibility and risk of bias and to extract data. Results: This study will provide a high quality synthesis of current evidence of aromatherapy for menopausal symptoms measured with Menopause Rating Scale, the Kupperman Index, the Greene Climacteric Scale, or other validated questionnaires. Conclusions: The conclusion of our systematic review will provide evidence to judge whether aromatherapy is an effective intervention for patient with menopausal women. Ethics and dissemination: Ethical approval will not be required, given that this protocol is for a systematic review. The systematic review will be published in a peer-reviewed journal. The review will also be disseminated electronically and in print. Systematic review registration: PROSPERO CRD42017079191. PMID:29419673

  8. What Are the Symptoms of Menopause?

    Science.gov (United States)

    ... Pinterest Email Print What are the symptoms of menopause? Perimenopause begins with a change in a woman's ... longer than a week. A common symptom of menopause is the appearance of hot flashes (sometimes called ...

  9. Menopausal women's positive experience of growing older

    DEFF Research Database (Denmark)

    Hvas, Lotte

    2006-01-01

    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....

  10. Positive aspects of menopause: a qualitative study

    DEFF Research Database (Denmark)

    Hvas, L

    2001-01-01

    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.......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....

  11. Fractal dimension analysis in digital periapical radiographs: A diagnostic indicator of osteoporosis in post-menopausal women

    Directory of Open Access Journals (Sweden)

    Mathivanan Kavitha

    2017-01-01

    Full Text Available Objectives: To assess the alveolar bone density by fractal dimension (FD analysis in radiovisiograph of postmenopausal women of mandibular posterior region and to correlate FD values with t-scores of quantitative ultrasound of the calcaneus bone. Materials and Methods: This study, approved by the institutional review board, included 40 participants, aged 45–60 years divided into two groups. Twenty postmenopausal women with osteoporosis comprised group 1, and 20 postmenopausal women without osteoporosis comprised group 2 based on bone mineral density assessment of ultrasound of the calcaneus bone. Digital dental radiograph of mandibular first molar were obtained and used for assessing alveolar bone density by FD analysis and were correlated with t-scores of ultrasound of calcaneus bone. Results: The mean FD values were evaluated using SPSS 14 version software, and were found to be 1.738 and 1.867 for group 1 and group 2, respectively, which was statistically significant (P 0.05. Conclusion: FD analysis using direct digital periapical radiographs is a novel method, which can be used for early diagnosis of osteoporosis in the alveolar bone.

  12. [Menopause: Hypertension and vascular disease].

    Science.gov (United States)

    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.

  13. Comparison of the effects of surgical and natural menopause on carotid intima media thickness, osteoporosis, and homocysteine levels.

    Science.gov (United States)

    Özkaya, Enis; Cakir, Evrim; Okuyan, Erhan; Cakir, Caner; Ustün, Gülnihal; Küçüközkan, Tuncay

    2011-01-01

    Menopause is associated with increased cardiovascular risk factors. We designed this study to compare common carotid artery intima media thickness (IMT) and homocysteine level between women who had natural menopause and those who had surgical menopause and to correlate IMT, bone mineral density (BMD), and homocysteine level with time since menopause. Ninety healthy postmenopausal women aged 50 to 78 years who were not on hormone therapy (45 women who did not have a prior hysterectomy or oophorectomy and 45 women who had undergone hysterectomy with bilateral oophorectomy) were included in the study. B-mode ultrasonography of the carotid artery, BMD, and serum homocysteine level analysis were completed to evaluate the relationship between type of menopause, time since menopause, and subclinical atherosclerosis. Mean ± SD carotid artery IMT measurements were 0.72 ± 0.002 mm among women experiencing natural menopause and 0.88 ± 0.003 mm among women having bilateral oophorectomy (P = 0.002). After adjusting for time since menopause and age, the mean IMT also differed between the two groups: 0.76 ± 0.003 mm in the natural menopause group and 0.84 ± 0.003 mm in the bilateral oophorectomy group (P = 0.038). The age-adjusted carotid IMT was significantly positively associated with years since menopause (P = 0.001). Mean homocysteine measurements were 10.3 ± 5 μmol/L among women experiencing natural menopause and 9.1 ± 4 μmol/L among women who had bilateral oophorectomy (P = 0.216). Age-adjusted femur total, trochanter, and shaft BMDs were significantly lower in the surgical menopause group (P = 0.041, P = 0.034, and P = 0.046, respectively). Oophorectomy before natural menopause increases IMT but not homocysteine levels independent of age and time since menopause and is associated with lower BMD values after adjustment for age.

  14. Genetic variants of age at menopause are not related to timing of ovarian failure in breast cancer survivors.

    Science.gov (United States)

    Homer, Michael V; Charo, Lindsey M; Natarajan, Loki; Haunschild, Carolyn; Chung, Karine; Mao, Jun J; DeMichele, Angela M; Su, H Irene

    2017-06-01

    To determine if interindividual genetic variation in single-nucleotide polymorphisms (SNPs) related to age at natural menopause is associated with risk of ovarian failure in breast cancer survivors. A prospective cohort of 169 premenopausal breast cancer survivors recruited at diagnosis with stages 0 to III disease were followed longitudinally for menstrual pattern via self-reported daily menstrual diaries. Participants were genotyped for 13 SNPs previously found to be associated with age at natural menopause: EXO1, TLK1, HELQ, UIMC1, PRIM1, POLG, TMEM224, BRSK1, and MCM8. A risk variable summed the total number of risk alleles in each participant. The association between individual genotypes, and also the risk variable, and time to ovarian failure (>12 months of amenorrhea) was tested using time-to-event methods. Median age at enrollment was 40.5 years (range 20.6-46.1). The majority of participants were white (69%) and underwent chemotherapy (76%). Thirty-eight participants (22%) experienced ovarian failure. None of the candidate SNPs or the summary risk variable was significantly associated with time to ovarian failure. Sensitivity analysis restricted to whites or only to participants receiving chemotherapy yielded similar findings. Older age, chemotherapy exposure, and lower body mass index were related to shorter time to ovarian failure. Thirteen previously identified genetic variants associated with time to natural menopause were not related to timing of ovarian failure in breast cancer survivors.

  15. Menopause and the vaginal microbiome.

    Science.gov (United States)

    Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M

    2016-09-01

    For over a century it has been well documented that bacteria in the vagina maintain vaginal homeostasis, and that an imbalance or dysbiosis may be associated with poor reproductive and gynecologic health outcomes. Vaginal microbiota are of particular significance to postmenopausal women and may have a profound effect on vulvovaginal atrophy, vaginal dryness, sexual health and overall quality of life. As molecular-based techniques have evolved, our understanding of the diversity and complexity of this bacterial community has expanded. The objective of this review is to compare the changes that have been identified in the vaginal microbiota of menopausal women, outline alterations in the microbiome associated with specific menopausal symptoms, and define how hormone replacement therapy impacts the vaginal microbiome and menopausal symptoms; it concludes by considering the potential of probiotics to reinstate vaginal homeostasis following menopause. This review details the studies that support the role of Lactobacillus species in maintaining vaginal homeostasis and how the vaginal microbiome structure in postmenopausal women changes with decreasing levels of circulating estrogen. In addition, the associated transformations in the microanatomical features of the vaginal epithelium that can lead to vaginal symptoms associated with menopause are described. Furthermore, hormone replacement therapy directly influences the dominance of Lactobacillus in the microbiota and can resolve vaginal symptoms. Oral and vaginal probiotics hold great promise and initial studies complement the findings of previous research efforts concerning menopause and the vaginal microbiome; however, additional trials are required to determine the efficacy of bacterial therapeutics to modulate or restore vaginal homeostasis. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Osteoporosis and years since menopause

    International Nuclear Information System (INIS)

    Ide, Saburo; Hirota, Yoshio; Hotokebuchi, Takao; Takasugi, Shin-ichiro; Sugioka, Yoichi; Hayabuchi, Hitomi

    1999-01-01

    In Fukuoka Prefecture, in south-western Japan, a regional screening program for osteoporosis was conducted from 1994 to 1995. The screening level in the bone mineral density (BMD) at the distal non-dominant radius was equal to or less than two standard deviations below age-specific mean (≤ -2.0 SD). In 1177 examinees with natural menopause (mean age: 61.4, range: 42-88), 56 of those who were screened were subsequently radiologically confirmed by orthopedic specialists to have osteoporosis (case group). They were then compared with 802 normal BMD (≥ -1.0 SD) women (reference group) with their lifestyle and reproductive characteristics. The adjusted odds ratio (OR) and its 95% confidence interval (CI) were calculated using a logistic regression model. A significant increase in the ORs for osteoporosis based on the number of years since menopause was observed for 7-13 years since menopause (OR=2.3; 95% CI: 1.0-5.4) compared with <7 years, however, no increasing trend in risk was evident in 14+ years since menopause (OR=1.4; 95% CI: 0.4-5.1). Thus, the elevated risk continued up to around 10 years since menopause. These findings are consistent with previous studies that reported an alternation in the calcium metabolism and bone loss related to the length of time after menopause. Both the childhood and current milk consumption were also associated with a decreased risk: ORs were 0.4 (95% CI: 0.2-0.9) and 0.5 (95% CI: 0.3-1.0), respectively

  17. Prospective analysis. Nuclear deterrence in 2030; Essai de prospective. La dissuasion nucleaire en 2030

    Energy Technology Data Exchange (ETDEWEB)

    Tertrais, B

    2006-12-15

    This study is a prospective analysis of the long-term future of nuclear weapons, and particularly the future of French nuclear deterrence after 2015. The selected time period is 2025-2030. The principal objective is to reflect on what the nuclear world might look like during the first part of the 21 st century, beyond the modernization decisions already planned or envisaged, and to draw conclusions for the future of the French deterrent. (author)

  18. [Hypertension in women after menopause].

    Science.gov (United States)

    Beaufils, Michel

    2006-06-01

    Menopause coincides with an increase in the incidence of hypertension in women. A direct role of estrogen deprivation in this increased blood pressure remains a topic of debate. Menopause probably accelerates the arterial changes related to aging. Hormone replacement therapy does not influence blood pressure significantly and is not contraindicated in hypertensive women. The effect of hormone replacement treatment on cardiovascular risk was recently the object of controversy. It does not increase risk except in cases of late treatment in older women who already have atherosclerosis. Hypertension management in women is otherwise similar to management in men.

  19. The impact of menopausal symptoms on work ability.

    Science.gov (United States)

    Geukes, Marije; van Aalst, Mariëlle P; Nauta, Mary C E; Oosterhof, Henk

    2012-03-01

    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.

  20. The menopause transition experiences of Chinese Singaporean women: an exploratory qualitative study.

    Science.gov (United States)

    Lim, Hui-Koon; Mackey, Sandra

    2012-06-01

    Menopause, a developmental occurrence that takes place in midlife, marks the end of a woman's fertile phase. Cultural norms, social influences, and personal perceptions related to menopause may influence its meaning and how each woman experiences this transition. Little is known about the menopausal experiences of Asian women. This study explores the menopause transition experiences of ethnic Chinese women in Singapore. Using a qualitative design, the researchers conducted audio-taped interviews in 2010 with 14 menopausal and postmenopausal Chinese Singaporean women aged 40-60 years. Thematic analysis was used to analyze interviews. Two main themes were identified: (a) experiencing symptoms and (b) managing symptoms during menopause transition. The most commonly reported symptoms were abnormal bleeding, hot flushes, and emotional changes. Most participants described their transition to be uneventful and ordinary and reported two significant symptoms at most. The strategies women used to manage their transition included using Western and traditional Chinese medical interventions and seeking support from family and friends. This study provides new insights into how ethnic Chinese women in Singapore experience menopause transition. Findings can assist nurses and healthcare workers in the local context to better understand menopausal women's needs and guide nurses to implement suitable health promotional strategies for women under their care in both hospital and community settings. Although ethnicity is not necessarily a determinant of symptom experience during menopause transition, health education for menopausal women should be based on knowledge of culture-specific practices. Nurses caring for menopausal women in hospital and community settings in Singapore should evaluate the use of medications prescribed by Western and Chinese herbal medical professionals as well as those that are self-prescribed.

  1. Exploring Australian Aboriginal Women’s experiences of menopause: a descriptive study

    Science.gov (United States)

    2014-01-01

    Background 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. Methods 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. Results 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. Conclusion 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

  2. Reproductive factors, menopausal hormone therapies and primary liver cancer risk: a systematic review and dose-response meta-analysis of observational studies.

    Science.gov (United States)

    Zhong, Guo-Chao; Liu, Yan; Chen, Nan; Hao, Fa-Bao; Wang, Kang; Cheng, Jia-Hao; Gong, Jian-Ping; Ding, Xiong

    2016-12-01

    A striking gender disparity in the incidence and outcome of primary liver cancer (PLC) has been well recognized. Mounting evidence from basic research suggests that hormonal factors may be involved in the gender disparity of PLC. Whether hormonal exposures in human subjects are associated with PLC risk is largely unknown. Whether reproductive factors and use of menopausal hormone therapies (MHTs) in women are associated with PLC risk remains controversial. We conducted this study to clarify this issue. PubMed and EMBASE were searched to July, 2016 for studies published in English or Chinese. Observational studies (cohort, nested case-control and case-control) that provided risk estimates of reproductive factors, MHTs and PLC risk were eligible. The quality of included studies was determined based on the Newcastle-Ottawa quality assessment scale. Summary risk ratios (RRs) were calculated using a random-effects model. Dose-response analysis was conducted where possible. Fifteen peer-reviewed studies, involving 1795 PLC cases and 2 256 686 women, were included. Overall meta-analyses on parity and PLC risk did not find any significant associations; however, when restricting to studies with PLC cases ≥100, increasing parity was found to be significantly associated with a decreased risk of PLC [RR for the highest versus lowest parity 0.67, 95% CI 0.52, 0.88; RR for parous versus nulliparous 0.71, 95% CI 0.53, 0.94; RR per one live birth increase 0.93, 95% CI 0.88, 0.99]. A J-shaped relationship between parity and PLC risk was identified (P non-linearity  Parity is associated with PLC risk in a J-shaped dose-response pattern. Late age at menarche and ever use of MHT are associated with a reduced risk of PLC, whereas there is no association of ever use of ET and EPT, age at first birth, or spontaneous and induced abortion with PLC risk. Compared to women with no history of oophorectomy, those with a history of oophorectomy are at an increased risk of PLC. Our findings

  3. Exploring the breast cancer patient journey: do breast cancer survivors need menopause management support?

    Science.gov (United States)

    Tanna, Nuttan; Buijs, Helene; Pitkin, Joan

    2011-12-01

    Breast cancer survivors can be expected to suffer from menopause symptoms with estrogen deprivation due to cancer treatments, in addition to natural menopause-related estrogen loss. To gain an understanding of what support breast cancer patients have when they suffer from menopausal symptoms, and utilize findings to further inform National Health Service (NHS) care provision for breast cancer survivors. Qualitative study with focus group sessions targeting Caucasian and Asian women with breast cancer. Patient stories, with women describing their breast cancer journey and speaking about support received for any menopausal symptoms. Thematic data analysis of transcription. Breast cancer patients were not sure if they had menopausal symptoms or whether this was due to their breast cancer condition or treatment. Patients had an attitude of acceptance of menopausal symptoms and reported trying to cope with these by themselves. This research identifies a need for more information that is culturally sensitive on managing menopause symptoms, both as side-effects of breast cancer treatments as well as for affect on quality of life during the survivorship phase. Our work also gives insight into cultural remedies used for hot flushes by Asian patients, which they consider as 'cooling' foods. Breast cancer patients want to know whether side-effects of cancer treatment persist long term and how these can be managed. There is a need for improved patient support within any new NHS service models that are developed along breast cancer patient pathways, and inclusion of personalized advice for menopause symptoms.

  4. Life course effects on age at menopause among Bangladeshi sedentees and migrants to the UK.

    Science.gov (United States)

    Murphy, Lorna; Sievert, Lynnette; Begum, Khurshida; Sharmeen, Taniya; Puleo, Elaine; Chowdhury, Osul; Muttukrishna, Shanthi; Bentley, Gillian

    2013-01-01

    To assess how different variables experienced across the life course, but particularly during early life, might affect age at menopause among 174 Bangladeshi migrants to London by comparing them to 157 nonmigrant sedentees and 154 women of European descent in London. Participants were aged 35-59 years, with no exogenous hormone use in the past three months, not pregnant or lactating, with no history of hysterectomy or oophorectomy. Face-to-face interviews and anthropometric measures were carried out. In addition to mean recalled age at natural menopause, median age was computed by probit analysis. Ages at menopause were examined by bivariate and Cox regression analyses in relation to demographic, reproductive, and lifestyle variables, and in relation to potential exposure to cyclones in early childhood. Ages at menopause were significantly earlier among Bangladeshi sedentees and immigrants compared to Londoners of European origin. Ages at menopause were earlier among sedentees compared to immigrants. Urban birthplace, more infectious diseases during childhood, and lower levels of education increased the risk of an earlier menopause. Changes in environmental conditions during adulthood appeared to modify age at menopause among Bangladeshi immigrants in London compared to women living in Bangladesh; however, Bangladeshi immigrants still experienced an earlier age at menopause compared with their London neighbors of European descent. Copyright © 2012 Wiley Periodicals, Inc.

  5. The impact of menopausal symptoms on quality of life, productivity, and economic outcomes.

    Science.gov (United States)

    Whiteley, Jennifer; DiBonaventura, Marco daCosta; Wagner, Jan-Samuel; Alvir, Jose; Shah, Sonali

    2013-11-01

    The aim of this study was to investigate the impact of menopausal symptoms and menopausal symptom severity on health-related quality of life (HRQoL), work impairment, healthcare utilization, and costs. Data from the 2005 United States National Health and Wellness Survey were used, with only women 40-64 years without a history of cancer included in the analyses (N=8,811). Women who reported experiencing menopausal symptoms (n=4,116) were compared with women not experiencing menopausal symptoms (n=4,695) on HRQoL, work impairment, and healthcare utilization using regression modeling (and controlling for demographics and health characteristic differences). Additionally, individual menopausal symptoms were used as predictors of outcomes in a separate set of regression models. The mean age of women in the analysis was 49.8 years (standard deviation,±5.9). Women experiencing menopausal symptoms reported significantly lower levels of HRQoL and significantly higher work impairment, and healthcare utilization than women without menopausal symptoms. Depression, anxiety, and joint stiffness were symptoms with the strongest associations with health outcomes. Menopausal symptoms can be a significant humanistic and economic burden on women in middle age.

  6. Age of menopause and fracture risk in postmenopausal women randomized to calcium + vitamin D, hormone therapy, or the combination: results from the Women's Health Initiative Clinical Trials.

    Science.gov (United States)

    Sullivan, Shannon D; Lehman, Amy; Nathan, Nisha K; Thomson, Cynthia A; Howard, Barbara V

    2017-04-01

    We previously reported that in the absence of hormone therapy (HT) or calcium/vitamin D (Ca/D) supplementation, earlier menopause age was associated with decreased bone mineral density and increased fracture risk in healthy postmenopausal women. Treatment with HT and Ca/D is protective against fractures after menopause. In this analysis, we asked if the age of menopause onset alters fracture risk in healthy postmenopausal women receiving HT, Ca/D, or a combination. Hazard ratios (HRs) for any fracture among 21,711 healthy postmenopausal women enrolled in the Women's Health Initiative Clinical Trial, who were treated with HT, Ca/D, or HT + Ca/D, and who reported age of nonsurgical menopause of menopause menopause 40 to 49 or ≥50 years, regardless of treatment intervention (HR [95% CI]: menopause menopause menopause age (menopause ages. The effect of menopause age on fracture risk was not altered by any of the treatment interventions (HT, Ca/D, HT + Ca/D), suggesting that early age of menopause is an independent contributor to postmenopausal fracture risk.

  7. Type and Timing of Menopause and Later Life Mortality Among Women in the Iowa Established Populations for the Epidemiological Study of the Elderly Cohort

    Science.gov (United States)

    Cooper, Rachel; Wallace, Robert B.; Guralnik, Jack M.

    2012-01-01

    Abstract Background The relationship between menopausal characteristics and later life mortality is unclear. We tested the hypotheses that women with surgical menopause would have increased all-cause and cardiovascular mortality compared with women with natural menopause, and that women with earlier ages at natural or surgical menopause would have greater all-cause and cardiovascular mortality than women with later ages at menopause. Methods Women who participated in the Iowa cohort of the Established Populations for the Epidemiologic Study of the Elderly (n=1684) reported menopausal characteristics and potential confounding variables at baseline and were followed up for up to 24 years. Participants were aged 65 years or older at baseline and lived in rural areas. We used survival analysis to examine the relationships between menopausal characteristics and all-cause and cardiovascular mortality. Results A total of 1477 women (87.7% of respondents) died during the study interval. Women with an age at natural menopause ≥55 years had increased all-cause and cardiovascular disease mortality compared with women who had natural menopause at younger ages. Type of menopause and age at surgical menopause were not related to mortality. These patterns persisted after adjustment for potential confounding variables. Conclusions Among an older group of women from a rural area of the United States, later age at natural menopause was related to increased all-cause and cardiovascular mortality. Monitoring the cardiovascular health of this group of older women may contribute to improved survival times. PMID:21970557

  8. Common diseases as determinants of menopausal age.

    Science.gov (United States)

    Li, Jingmei; Eriksson, Mikael; Czene, Kamila; Hall, Per; Rodriguez-Wallberg, Kenny A

    2016-12-01

    Can the diagnosis of common diseases before menopause influence age at natural menopause (ANM) onset? Polycystic ovary syndrome (PCOS) and depression were observed to delay menopause. It has been observed that women who undergo early menopause experience a higher burden of health problems related to metabolic syndromes, heart disease and depression, but whether ANM can be influenced by common adult diseases has not been studied extensively. All women attending mammography screening or clinical mammography at four hospitals in Sweden were invited to participate in the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA) study. Between January 2011 and March 2013, 70 877 women were recruited. Information from the baseline questionnaire filled out upon enrollment was used in this cross-sectional analysis on predictors of ANM onset. We limited our analyses to 61 936 women with complete data on ANM and covariates and a follow-up time (from birth to menopause or censoring) of at least 35 years. Premenopausal diagnoses of depression, anorexia, bulimia, PCOS, ovarian cyst, heart failure, myocardial infarction, angina pectoris, stroke, preeclampsia, diabetes, hypertension and hyperlipidemia were examined as time-dependent variables in multivariable Cox regression analyses, adjusting for reproductive factors (age at menarche, menstrual cycle regularity in adult life, number of children and premenopausal oral contraceptive use) and risk factors of common diseases (education, physical activity at 18 years and information at the time of questionnaire including BMI, ever smoking and alcohol consumption). Women with PCOS and depression were independently associated with later menopause (hazard ratio (95% CI): 0.44 (0.28-0.71) and 0.95 (0.91-1.00), respectively), compared to women with no such histories. The associations remained significant in a subset of women who had never received gynecological surgery or hormone treatment (n = 32313, 0.21 (0

  9. Class, gender and culture in the experience of menopause. A comparative survey in Tunisia and France.

    Science.gov (United States)

    Delanoë, Daniel; Hajri, Selma; Bachelot, Annie; Mahfoudh Draoui, Dorra; Hassoun, Danielle; Marsicano, Elise; Ringa, Virginie

    2012-07-01

    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

  10. Physical performance in relation to menopause status and physical activity.

    Science.gov (United States)

    Bondarev, Dmitriy; Laakkonen, Eija K; Finni, Taija; Kokko, Katja; Kujala, Urho M; Aukee, Pauliina; Kovanen, Vuokko; Sipilä, Sarianna

    2018-05-21

    The aim of this study was to examine differences in physical performance (muscle power, muscle strength, aerobic capacity, and walking speed) across menopausal stages and potential of leisure physical activity (PA) to modify the impact of menopause on physical performance. In this cross-sectional study, women aged 47 to 55 were randomly selected from the Finnish National Registry and categorized as premenopausal (n = 233), perimenopausal (n = 381), or postmenopausal (n = 299) based on serum concentrations of follicle-stimulating hormone and bleeding diary. Physical performance was measured by knee extension force, handgrip force, vertical jumping height, maximal walking speed, and 6-minute walking distance. PA level was assessed by self-report and categorized as low, moderate, or high. Multivariate linear regression modeling was used for data analysis. After including fat mass, height, PA, and education in the model, the postmenopausal women showed 12.0 N weaker (P women. There was no significant interaction between menopausal stage and PA on physical performance. The peri- and postmenopausal women with a high PA, however, showed better performance in the maximal knee extension strength and 6-minute walking test, and showed greater lower body muscle power than those with a low PA. Menopause status is associated with muscle strength and power, whereas the association between menopause status and mobility/walking is clearly weaker. A high leisure PA level provides more capacity to counteract the potential negative influence of menopausal factors on muscle function.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

  11. Prospective Analysis of Nursing Management from the Students Voices

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Camejo Giménez

    2017-08-01

    Full Text Available This scientific article was intended to study management in nursing from a prospective analysis, interpret the meanings and meanings that social actors grant to the future of nursing management and unveil the importance of nursing management from prospectivity. The paradigm was interpretative under a qualitative approach, where the phenomenological method based on hermeneutics was applied. We selected 05 students from the first semester of nursing and 05 from the eighth for a total of 10 social actors. As a technique for obtaining the information I used as resources the in-depth interview, notes, photographs and recordings. The following categories emerged from the findings: Service management: training, administration and functions; Prospectivity: profile and futuristic scenario. The emerging categories triangulated and I can say that every bachelor who enters the career must know the functions of nursing. The contribution of the theoretician Michel Godet, among others, was considered. Finally, as a main finding, it was known that most nursing students do not know the future of the career and UCLA in the Deanery under study does not apply prospective management to determine cognitive and mental indicators in future Nursing graduates.

  12. Laboratory Computerization: The Case for a Prospective Analysis

    OpenAIRE

    Hurdle, John F.; Schwamm, Harry A.

    1982-01-01

    The argument is made that computerization of a laboratory should be preceeded by a thorough prospective analysis of laboratory operations. Points to be pondered include complementation of retrospective data, system cost justification, system performance justification, post-installation personnel adjustments, improved system utilization, improved manual performance, and insight into “how much” system to buy. A brief, general outline is offered describing how to approach such a study.

  13. No sweat: managing menopausal symptoms at work.

    Science.gov (United States)

    Hickey, Martha; Riach, Kathleen; Kachouie, Reza; Jack, Gavin

    2017-09-01

    Menopause usually occurs between the ages of 45 and 55, a time when women are likely to be in the paid workforce. Most women have menopausal symptoms and these may impact on daytime function and work performance. This study examines the relationship between reproductive stage, menopausal symptoms and work, and advises how employers can best support menopausal women. An online and paper-based survey was completed in 2015-16 by 1092 women (22% response rate) aged 40 years plus employed in three hospitals in metropolitan Australia. Survey questions examined demographics, health and lifestyle variables, menopausal symptom reporting, and work-related variables. Reproductive stage was determined using modified STRAW +10 principal and descriptive criteria. Reproductive stage was not significantly associated with work engagement, organizational commitment, job satisfaction, work limitations and perceived supervisor support. Postmenopausal women had lower intention to leave their organizations than pre- and peri-menopausal women. While sleep problems were the most commonly reported menopausal symptom by peri-menopausal women, for postmenopausal women it was joint and muscular discomfort. Only hot flushes and vaginal dryness were significantly more frequent in peri- and post, compared to pre-menopausal women. In general, women rated their work performance as high and did not feel that menopausal symptoms impaired their work ability. Most women would appreciate greater organizational support, specifically temperature control, flexible work hours and information about menopause for employees and managers. Most women did not believe that menopausal symptoms negatively impacted on their work. Organizational changes may reduce the burden of menopausal symptoms in the workplace.

  14. Changes in Australian women's perception of the menopause and menopausal symptoms before and after the climacteric.

    Science.gov (United States)

    Abraham, S; Llewellyn-Jones, D; Perz, J

    1994-12-01

    The symptoms and perceptions of menopause of 60 Australian women were studied, by questionnaire, when they were premenopausal and 10 years later when they were postmenopausal. Menopausal symptoms expected and experienced by the women were compared, fewer women experiencing hot flushes, headache, depression and nervousness and more experiencing insomnia, increase in appetite, abdominal fullness, numbness and muscular problems. The symptoms women thought were due to hormonal changes at menopause were compared. In 1993 more women cited osteoporosis, insomnia, loss of libido, obesity and loss of muscle tone as due to hormone change while fewer cited depression. The premenstrual symptoms and their severity experienced by a woman when she was premenopausal significantly predicts the type and severity of the menopausal symptoms experienced by the woman. The expected menopausal symptoms and their severity cited by a woman also significantly predicts the type of severity of the menopausal symptoms experienced. More premenstrual symptoms predict the menopausal symptoms than those menopausal symptoms the women expected. The expectation menopause will be 'a relief' or 'a nuisance' significantly predicted the overall menopause experience described by the women. Their negative attitudes about doctors' understanding and information available about menopause remained unchanged but they forget menstrual cycle problems over the 10 years. The results suggest a possible physiological basis for premenstrual and menopausal symptoms. Assistance for women with their premenstrual and menstrual cycle symptoms may improve their quality of life at menopause.

  15. Effects of early age at natural menopause on coronary heart disease and stroke in Chinese women.

    Science.gov (United States)

    Shen, Lijun; Song, Lulu; Liu, Bingqing; Li, Hui; Zheng, Xiaoxuan; Zhang, Lina; Yuan, Jing; Liang, Yuan; Wang, Youjie

    2017-08-15

    Menopause is identified as a risk factor for cardiovascular disease because of the change of estrogen. The objective of the study was to explore the associations between early age at natural menopause (menopause at an age≤45years) and the presence of CHD and stroke. The study subjects were from the first follow-up survey of the Dongfeng-Tongji cohort study. A total of 16,515 postmenopausal women were included for the analysis. Logistic regression models were used to examine the associations between age at natural menopause (≤45, 45-52, >52years) and the presence of CHD and stroke adjusted for sociodemographic characteristics, lifestyle, reproductive history and metabolic factors. In the fully adjusted model, for each 1-year delay in menopausal age, the prevalence of CHD and stroke was reduced by 3% (OR, 0.97; 95% CI, 0.95-0.98) and 5% (OR, 0.95; 95% CI, 0.92-0.98), respectively. Women with early menopause (≤45years) had a higher prevalence of CHD (OR, 1.33; 95% CI, 1.13-1.57) compared with those with menopause at ages 45-52years. Similarly, women with early menopause (≤45years) was associated with higher prevalence of stroke (OR, 1.69; 95% CI, 1.25-2.30) compared with those with menopause at ages 45-52years. Early age at natural menopause is significantly associated with the presence of CHD and stroke among Chinese women. Copyright © 2017. Published by Elsevier B.V.

  16. Differences in age at death according to smoking and age at menopause.

    Science.gov (United States)

    Bellavia, Andrea; Wolk, Alicja; Orsini, Nicola

    2016-01-01

    Younger age at menopause is associated with overall mortality, and cigarette smoking is the only lifestyle factor influencing this association. However, the combined effects of age at menopause and smoking have never been quantified in terms of survival time. Our aim was to evaluate, in a large cohort of Swedish women, differences in age at death according to age at menopause and smoking status. Age at menopause and smoking were assessed, using a self-administered questionnaire, in a population-based cohort of 25,474 women aged 48 to 83 years. Laplace regression was used to calculate differences in median age at death (50th percentile difference [PD]) according to smoking and age at menopause. Across 16 years of follow-up, 5,942 participants died. The difference in median age at death between women with menopause at 40 years and women with menopause at 60 years was 1.3 years (50th PD, 1.3; 95% CI, 0.3-2.2). Compared with current smokers, former smokers and never smokers had older median age at death-2.5 years (50th PD, 2.5; 95% CI, 1.9-3.1) and 3.6 years (50th PD, 3.6; 95% CI, 3.1-4.1), respectively. When analysis was restricted to current smokers, the difference in age at death between women with menopause at 40 years and women with menopause at 60 years increased to 2.6 years (50th PD, 2.6; 95% CI, 0.8-4.5). No association among never smokers was observed. Younger age at menopause is linearly associated with shorter survival. This association tends to be stronger among current smokers.

  17. Cross-cultural study: experience, understanding of menopause, and related therapies in Australian and Laotian women.

    Science.gov (United States)

    Sayakhot, Padaphet; Vincent, Amanda; Teede, Helena

    2012-12-01

    The aim of this study was to investigate and compare symptom experiences, beliefs, attitudes, and understanding of menopause and menopausal therapies in Australian and Laotian women. This was a cross-cultural, questionnaire-based study involving 108 women (56 Australian women and 52 Laotian women aged 40-65 y) attending outpatient clinics in Australia and Laos. Descriptive statistics and univariate analysis were conducted using Student's t test or Mann-Whitney U test, where appropriate. Psychological symptoms, depression, vasomotor symptoms, and sexual dysfunction were significantly higher in Australian women compared with Laotian women (P menopause as aging (57%), whereas most Laotian women reported not knowing what menopause meant to them (81%). Australian women's fears about menopause included weight gain (43%), aging (41%), and breast cancer (38%), whereas Laotian women reported not knowing about potential menopausal problems (85%). Exercise (55%), education and awareness (46%), and improving lifestyle (41%) were reported by Australian women as being effective in alleviating menopausal symptoms, with only 21% reporting not knowing what was effective compared with 83% of Laotian women. Many women reported not knowing the risks/benefits of hormonal therapies (50% of Australian women and 87% of Laotian women) and herbal therapies (79% of Australian women and 92% of Laotian women). General practitioners were the most common source of menopause information for both Australians (73%) and Laotians (67%). Sociocultural factors influence women's perception of menopause. Psychological symptoms, sexual dysfunction, and vasomotor symptoms are more commonly reported by Australian women than by Laotian women. Women have a limited understanding of the risks/benefits of menopausal therapies, and culturally appropriate education is needed.

  18. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis

    Science.gov (United States)

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Khadivzadeh, Talat; khorsand, Imaneh; Afiat, Maliheh; Esmaeilizadeh, Mahdi

    2016-01-01

    Objective: In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women Materials and Methods: We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used “menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. Results: Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. Conclusion: The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review. PMID:27462550

  19. Effects of flaxseed and Hypericum perforatum on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women: a systematic review and meta-analysis.

    Science.gov (United States)

    Ghazanfarpour, Masumeh; Sadeghi, Ramin; Latifnejad Roudsari, Robab; Khadivzadeh, Talat; Khorsand, Imaneh; Afiat, Maliheh; Esmaeilizadeh, Mahdi

    2016-01-01

    In this study, we aimed at evaluation of the efficacy of Hypericum perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers in menopausal women. We searched MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials (RCT) to explore trials that assessed the effectiveness of H. perforatum and flaxseed on hot flash, vaginal atrophy and estrogen-dependent cancers. In this regard, the following terms were used "menopause AND H. perforatum OR flaxseed OR Linum usitatissimum. Only randomized controlled trials were included in the study. Nine RCTs were included in this systematic review. Based on the literature, flaxseed showed beneficial effect on hot flash frequency and intensity, which was not statistically significant. According to two trials, flaxseed showed estrogenic effects; however, no conclusion regarding cancer promoting or protecting effects can be made. The evidence of the efficacy of the flaxseed on alleviating vaginal atrophy was also limited due to inconsistent findings in this regard. One trial declared that Vitex agnus-castus and H. perforatum showed comparable decrease in the frequency of hot flashes. The results of our systematic review suggest beneficial effect on vasomotor symptom with both of flaxseed and H. perforatum. Consistent conclusion regarding estrogen-dependent cancers and maturation value is limited due to small number of trials related to flaxseed. Further trials are still needed to confirm the results of our systematic review.

  20. Menopause: developing a rational treatment plan.

    Science.gov (United States)

    Vitiello, Danielle; Naftolin, Frederick; Naftoilin, Frederick; Taylor, Hugh S

    2007-12-01

    In recent years, growing importance has been afforded to assisting women in coping with the menopausal transition. Menopause is a normal stage of development and a woman's attitude toward this transition embodies biological, psychological and social influences. An enlarging body of conflicting data concerning menopausal hormone therapy (MHT) demands reassessment of established paradigms of disease prevention and menopausal health. Currently, a woman's decision to participate in or abstain from menopausal HT is personal. It involves not only consideration of risk stratification of potential harm and benefit, but also involves her expectations and attitudes toward perceived physical and emotional changes associated with this change. Through the use of extensive patient history, quality-of-life questionnaires and powerful biological profiling, we may be able to develop a rational approach to menopausal HT that safely guides our patients through this transition.

  1. An overview of menopause associated Vaso Motor Symptoms and ...

    African Journals Online (AJOL)

    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 ...

  2. What Are the Treatments for Other Symptoms of Menopause?

    Science.gov (United States)

    ... What are the treatments for other symptoms of menopause? Menopause is a normal part of aging and ... Treatment for Osteoporosis and Bone Loss Related to Menopause Because bone loss increases in the first two ...

  3. Menopause Treatments | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Menopause: A Woman's Change of Life Menopause Treatments Past Issues / Spring 2013 Table of Contents ... you should use hormones to help relieve some menopause symptoms. It's hard to know what to do, ...

  4. Associations of physical activity and diet with the onset of menopause in Japanese women.

    Science.gov (United States)

    Nagata, Chisato; Wada, Keiko; Nakamura, Kozue; Tamai, Yuya; Tsuji, Michiko; Shimizu, Hiroyuki

    2012-01-01

    Prospective studies on physical activity and diet and the onset of natural menopause are scarce. The aim of this study was to examine the association of physical activity and dietary factors potentially related to endogenous estrogen levels such as fats, dietary fiber, soy isoflavones, and alcohol with the onset of menopause in a cohort of premenopausal women. Study participants were 3,115 premenopausal Japanese women aged 35 to 56 years derived from the participants in the Takayama Study. Physical activity was assessed by a validated questionnaire at baseline, and the metabolic equivalent score was calculated. The dietary intakes were estimated by a validated food frequency questionnaire at baseline and adjusted for total energy. Menopause status was defined as the absence of menstruation for 12 months or more. The Cox proportional hazard model was used to estimate the hazard ratio of the occurrence of menopause after controlling for age, parity, body mass index, smoking status, years of education, and lifelong irregular menstrual cycle. During the 10-year follow-up, 1,790 women experienced natural menopause. A high physical activity level and a high intake of polyunsaturated fat were moderately but significantly associated with the earlier onset of menopause; the hazard ratios for the highest versus lowest quartile were 1.17 (95% CI, 1.02-1.34) for physical activity and 1.15 (95% CI, 1.01-1.31) for polyunsaturated fat intake. Total fat, other types of fat, dietary fiber, soy isoflavones, and alcohol were not associated with the onset of menopause. These data suggest that high levels of physical activity and polyunsaturated fat intake are associated with earlier onset of menopause.

  5. Risk of long-term hot flashes after natural menopause: evidence from the Penn Ovarian Aging Study cohort.

    Science.gov (United States)

    Freeman, Ellen W; Sammel, Mary D; Sanders, Richard J

    2014-09-01

    This study aims to estimate the risk of hot flashes relative to natural menopause and to evaluate the associations of hormone levels, behavioral variables, and demographic variables with the risk of hot flashes after menopause. We performed annual assessment of 255 women who were premenopausal at baseline and reached natural menopause within 16 years of follow-up. The prevalence of moderate/severe hot flashes increased in each premenopausal year, reaching a peak of 46% in the first 2 years after the final menstrual period (FMP). Hot flashes decreased slowly after menopause and did not return to premenopausal levels until 9 years after the FMP. The mean (SD) duration of moderate/severe hot flashes after the FMP was 4.6 (2.9) years (for any hot flashes, 4.9 [3.1] y). One third of women at 10 years or more after menopause continued to experience moderate/severe hot flashes. African-American women (obese and nonobese) and obese white women had significantly greater risks of hot flashes compared with nonobese white women (interaction, P = 0.01). In multivariable analysis, increasing follicle-stimulating hormone levels before the FMP (P menopause; more than one third of women observed for 10 years or more after menopause have moderate/severe hot flashes. Continuation of hot flashes for more than 5 years after menopause underscores the importance of determining individual risks/benefits when selecting hormone or nonhormone therapy for menopausal symptoms.

  6. Knowledge, attitudes, and practices associated with menopause: a multi-ethnic, qualitative study in Singapore.

    Science.gov (United States)

    Mackey, Sandra; Teo, Stephanie Swee Hong; Dramusic, Vesna; Lee, Hwee Khim; Boughton, Maureen

    2014-05-01

    We explored knowledge, attitudes, and practices associated with the menopause transition particular to women in the multi-ethnic cultural context of Singapore. Fifty-eight Chinese, Malay, and Indian Singaporean women participated in interviews that were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Women from all three ethnicities described an attitude of acceptance surrounding menopause and the changes associated with it. While they thought it was important to be informed, they did not seek out information about menopause and did not view health professionals as useful sources of information. Management practices were diverse and rarely involved accessing health professionals.

  7. Differential genetic basis for pre-menopausal and post-menopausal salt-sensitive hypertension.

    Directory of Open Access Journals (Sweden)

    Victoria L M Herrera

    Full Text Available Essential hypertension affects 75% of post-menopausal women in the United States causing greater cardiovascular complications compared with age-matched men and pre-menopausal women. Hormone replacement and current anti-hypertensive therapies do not correct this post-menopausal increased risk suggesting a distinct pathogenic framework. We investigated the hypothesis that distinct genetic determinants might underlie susceptibility to salt sensitive hypertension in pre-menopausal and post-menopausal states. To determine whether distinct genetic loci contribute to post-menopausal salt-sensitive hypertension, we performed a genome-wide scan for quantitative trait loci (QTLs affecting blood pressure (BP in 16-month old post-menopausal F2 (Dahl S×R-intercross female rats characterized for blood pressure by radiotelemetry. Given identical environments and high salt challenge, post-menopausal BP levels were significantly higher than observed in pre-menopausal (post-menopausal versus pre-menopausal SBP, P<0.0001 and ovariectomized (post-menopausal versus ovariectomized SBP, P<0.001 F2-intercross female rats. We detected four significant to highly significant BP-QTLs (BP-pm1 on chromosome 13, LOD 3.78; BP-pm2 on chromosome 11, LOD 2.76; BP-pm3 on chromosome 2, LOD 2.61; BP-pm4 on chromosome 4, LOD 2.50 and two suggestive BP-QTLs (BP-pm5 on chromosome 15, LOD 2.37; BP-f1 on chromosome 5, LOD 1.65, four of which (BP-pm2, BP-pm3, BP-pm4, BP-pm5 were unique to this post-menopausal cohort. These data demonstrate distinct polygenic susceptibility underlying post-menopausal salt-sensitive hypertension providing a pathway towards the identification of mechanism-based therapy for post-menopausal hypertension and ensuing target-organ complications.

  8. Differential genetic basis for pre-menopausal and post-menopausal salt-sensitive hypertension.

    Science.gov (United States)

    Herrera, Victoria L M; Pasion, Khristine A; Moran, Ann Marie; Ruiz-Opazo, Nelson

    2012-01-01

    Essential hypertension affects 75% of post-menopausal women in the United States causing greater cardiovascular complications compared with age-matched men and pre-menopausal women. Hormone replacement and current anti-hypertensive therapies do not correct this post-menopausal increased risk suggesting a distinct pathogenic framework. We investigated the hypothesis that distinct genetic determinants might underlie susceptibility to salt sensitive hypertension in pre-menopausal and post-menopausal states. To determine whether distinct genetic loci contribute to post-menopausal salt-sensitive hypertension, we performed a genome-wide scan for quantitative trait loci (QTLs) affecting blood pressure (BP) in 16-month old post-menopausal F2 (Dahl S×R)-intercross female rats characterized for blood pressure by radiotelemetry. Given identical environments and high salt challenge, post-menopausal BP levels were significantly higher than observed in pre-menopausal (post-menopausal versus pre-menopausal SBP, P<0.0001) and ovariectomized (post-menopausal versus ovariectomized SBP, P<0.001) F2-intercross female rats. We detected four significant to highly significant BP-QTLs (BP-pm1 on chromosome 13, LOD 3.78; BP-pm2 on chromosome 11, LOD 2.76; BP-pm3 on chromosome 2, LOD 2.61; BP-pm4 on chromosome 4, LOD 2.50) and two suggestive BP-QTLs (BP-pm5 on chromosome 15, LOD 2.37; BP-f1 on chromosome 5, LOD 1.65), four of which (BP-pm2, BP-pm3, BP-pm4, BP-pm5) were unique to this post-menopausal cohort. These data demonstrate distinct polygenic susceptibility underlying post-menopausal salt-sensitive hypertension providing a pathway towards the identification of mechanism-based therapy for post-menopausal hypertension and ensuing target-organ complications.

  9. Effect of lavender aromatherapy on menopause hot flushing: A crossover randomized clinical trial.

    Science.gov (United States)

    Kazemzadeh, Rafat; Nikjou, Roya; Rostamnegad, Masoumeh; Norouzi, Hosein

    2016-09-01

    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.

  10. RISK FACTOR ASSESSMENT AND CLINICOPATHOLOGICAL ANALYSIS OF BREAST DISEASES IN A TERTIARY CENTER- A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Abhishek Jina

    2017-08-01

    Full Text Available BACKGROUND Breast is modified sebaceous gland. It is an organ of female beauty and pride. From puberty to death, the breast is subjected to constant physical and physiological alterations that are related to menses, pregnancy and menopause. The breast problem could be as simple as breast abscess to as ominous as cancer. Both benign and malignant diseases occur in men and women of all ages but benign lesion tend to occur more commonly at younger age than cancer. Benign breast diseases (BBD are common with estimate of over half of the female population at some times in life seeking medical advice for breast problem. This prospective study was done on patients attending OPD for breast complaints in 1 year period, to do the risk factors assessment & clinical analysis of patients presented with breast complaints. MATERIALS AND METHODS Total 200 patients who have attended OPD with breast related complaints and given consent for study, were studied in a period of 1 year duration from at Nehru Hospital, B.R.D Medical College, Gorakhpur. RESULTS Benign breast diseases are more common in the population than malignant one, Fibroadenoma, Breast abscesses and Fibrocystic disease and ANDI are the most common cause of mass seen in middle ages. Malignant lesion of the breast is major concern and the second most commonly diagnosed cancer in our region as seen in study. Incidence is high in western industrialized countries and relatively low in developing countries in Asia and other parts of the world, predisposing factors for BBD are age, sex, race, inverted nipple, retracted nipple, cracked nipple, improper feeding due to lack of knowledge about breast-feeding and endogenous hormonal factors. CONCLUSION BBD is the most frequent type of lesion found in the present study in surgery OPD in BRD medical college, Gorakhpur. Among BBD, fibroadenoma was the commonest, followed by breast abscess, ANDI and gynecomastia. In this study, breast abscess was second most

  11. Age at menopause, reproductive history and venous thromboembolism risk among postmenopausal women

    Science.gov (United States)

    Canonico, Marianne; Plu-Bureau, Geneviève; O’Sullivan, Mary Jo; Stefanick, Marcia L.; Cochrane, Barbara; Scarabin, Pierre-Yves; Manson, JoAnn E.

    2013-01-01

    Objectives To investigate VTE risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy and time since menopause, as well as any interaction with randomized HT assignment among postmenopausal women. Methods Using pooled data from the Women’s Health Initiative HT clinical trials including 27,035 postmenopausal women ages 50 to 79 years with no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy and time since menopause by Cox proportional hazard models. Linear trends, quadratic relationships and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. Results During the follow-up, 426 women reported a first VTE, including 294 nonprocedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected and there was any significant association of VTE with age at menarche, age at menopause, parity, oophorectomy or time since menopause. However, analyses restricted to nonprocedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (pmenopause, those with early menopause (agemenopause (age>55 years) had a significant increased VTE risk (HR=1.8;95%CI:1.2–2.7 and HR=1.5;95%CI:1.0–2.4, respectively). Conclusion Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for nonprocedure-related VTE. PMID:23760439

  12. Prevalence and predictors of severe menopause symptoms among HIV-positive and -negative Nigerian women.

    Science.gov (United States)

    Agaba, Patricia A; Meloni, Seema T; Sule, Halima M; Ocheke, Amaka N; Agaba, Emmanuel I; Idoko, John A; Kanki, Phyllis J

    2017-11-01

    We compared the prevalence of menopause symptoms between women living with HIV to their HIV-negative peers and determined predictors of severe menopause symptoms in Jos, Nigeria. This descriptive cross-sectional study included 714 women aged 40-80 years. We compared prevalence and severity of menopause symptoms using the menopause rating scale (MRS). Logistic regression analysis was used to determine the predictors of severe symptoms. Six-hundred and seven (85.0%) were HIV-positive, with a mean duration of infection of 5.6 ± 2.7 years. The mean age of the cohort was 46 ± 5 years. The most prevalent menopause symptoms were hot flushes (67.2%), joint and muscle discomfort (66.2%), physical/mental exhaustion (65.3%), heart discomfort (60.4%), and anxiety (56.4%). The median MRS score was higher for HIV-positive compared to HIV-negative women (p = 0.01). Factors associated with severe menopause symptoms included HIV-positive status (aOR: 3.01, 95% CI: 1.20-7.54) and history of cigarette smoking (aOR: 4.18, 95% CI: 1.31-13.26). Being married (aOR: 0.49, 95% CI: 0.32-0.77), premenopausal (aOR: 0.60, 95% CI: 0.39-0.94), and self-reporting good quality of life (aOR: 0.62. 95% CI: 0.39-0.98) were protective against severe menopause symptoms. We found HIV infection, cigarette smoking, quality of life, and stage of the menopause transition to be associated with severe menopause symptoms. As HIV-positive populations are aging, additional attention should be given to the reproductive health of these women.

  13. The perceptions of African women regarding natural menopause in Mamelodi, Tshwane district

    Directory of Open Access Journals (Sweden)

    Gloria N. Makuwa

    2015-12-01

    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.

  14. Menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Ali Baziad

    2001-12-01

    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.

  15. The Menopausal Transition: Guidelines for Researchers.

    Science.gov (United States)

    Mansfield, Phyllis Kernoff; And Others

    1989-01-01

    Research guidelines are presented to encourage sound research on the menopausal transition. Included is a review of current literature covering three aspects of menopausal transition: age span, changes in menstrual bleeding during the transition, and other psychological and somatic changes during premenopausal stages. (IAH)

  16. Psychosocial Adjustment Needs of Menopausal Women | Dimkpa ...

    African Journals Online (AJOL)

    The purpose of this study was to examine the psychosocial adjustment needs of menopausal women. The population of the study consisted of 623 menopausal women who were out-patients in Federal Medical Centre and a private hospital in Yenagoa Local Government Area, Bayelsa State of. Nigeria. The sample ...

  17. Prospective analysis of delayed colorectal post-polypectomy bleeding.

    Science.gov (United States)

    Park, Soo-Kyung; Seo, Jeong Yeon; Lee, Min-Gu; Yang, Hyo-Joon; Jung, Yoon Suk; Choi, Kyu Yong; Kim, Hungdai; Kim, Hyung Ook; Jung, Kyung Uk; Chun, Ho-Kyung; Park, Dong Il

    2018-01-17

    Although post-polypectomy bleeding is the most frequent complication after colonoscopic polypectomy, only few studies have investigated the incidence of bleeding prospectively. The aim of this study was to investigate the incidence of delayed post-polypectomy bleeding and its associated risk factors prospectively. Patients who underwent colonoscopic polypectomy at Kangbuk Samsung Hospital from January 2013 to December 2014 were prospectively enrolled in this study. Trained nurses contacted patients via telephone 7 and 30 days after polypectomy and completed a standardized questionnaire regarding the development of bleeding. Delayed post-polypectomy bleeding was categorized as minor or major and early or late bleeding. Major delayed bleeding was defined as a > 2-g/dL drop in the hemoglobin level, requiring hospitalization for control of bleeding or blood transfusion; late delayed bleeding was defined as bleeding occurring later than 24 h after polypectomy. A total of 8175 colonoscopic polypectomies were performed in 3887 patients. Overall, 133 (3.4%) patients developed delayed post-polypectomy bleeding. Among them, 90 (2.3%) and 43 (1.1%) patients developed minor and major delayed bleeding, respectively, and 39 (1.0%) patients developed late delayed bleeding. In the polyp-based multivariate analysis, young age ( 10 mm (OR 2.45; 95% CI 1.38-4.36) were significant risk factors for major delayed bleeding, while young age (< 50 years; OR 2.6; 95% CI 1.35-5.12) and immediate bleeding (OR 3.3; 95% CI 1.49-7.30) were significant risk factors for late delayed bleeding. Young age, aspirin use, polyp size, and immediate bleeding were found to be independent risk factors for delayed post-polypectomy bleeding.

  18. Age at menopause, reproductive history, and venous thromboembolism risk among postmenopausal women: the Women's Health Initiative Hormone Therapy clinical trials.

    Science.gov (United States)

    Canonico, Marianne; Plu-Bureau, Geneviève; O'Sullivan, Mary Jo; Stefanick, Marcia L; Cochrane, Barbara; Scarabin, Pierre-Yves; Manson, Joann E

    2014-03-01

    This study aims to investigate venous thromboembolism (VTE) risk in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause, as well as any interaction with randomized hormone therapy (HT) assignment, among postmenopausal women. Using pooled data from the Women's Health Initiative HT clinical trials including 27,035 postmenopausal women aged 50 to 79 years who had no history of VTE, we assessed the risk of VTE in relation to age at menopause, age at menarche, parity, bilateral oophorectomy, and time since menopause by Cox proportional hazards models. Linear trends, quadratic relationships, and interactions of reproductive life characteristics with HT on VTE risk were systematically tested. During follow-up, 426 women reported a first VTE, including 294 non-procedure-related events. No apparent interaction of reproductive life characteristics with HT assignment on VTE risk was detected, and there was not a significant association between VTE and age at menarche, age at menopause, parity, oophorectomy, or time since menopause. However, analyses restricted to non-procedure-related VTE showed a U-shaped relationship between age at menopause and thrombotic risk that persisted after multivariable analysis (P menopause, those who had early menopause (age menopause (age >55 y) had a significantly increased VTE risk (hazard ratio [95% CI]: 1.8 [1.2-2.7] and 1.5 [1.0-2.4], respectively). Reproductive life characteristics have little association with VTE and do not seem to influence the effect of HT on thrombotic risk among postmenopausal women. Nevertheless, early and late onset of menopause might be newly identified risk factors for non-procedure-related VTE.

  19. Vitamin D and calcium intake and risk of early menopause12

    Science.gov (United States)

    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

    2017-01-01

    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

  20. Effective Factors on Urinary Incontinence in Natural Menopausal Women

    OpenAIRE

    Shohani; V Carson; Sayehmiri; Shohani

    2015-01-01

    Background Urinary tract infections and urinary incontinence are common urogenital problems affecting 7 - 10% of menopausal women. Objectives The primary objective of this study was to quantify effective factors on urinary incontinence in a cohort of menopausal women. Patients and Methods A sample of 150 menopausal women (natural menopause for at least 12 months) were recruited fro...

  1. Macro-regional variation in attitudes toward and experiences of vulvar and vaginal atrophy among Italian post-menopausal women: a post hoc analysis of REVIVE survey data.

    Science.gov (United States)

    Nappi, Rossella E; Particco, Martire; Biglia, Nicoletta; Cagnacci, Angelo; Di Carlo, Costantino; Luisi, Stefano; Paoletti, Anna Maria

    2017-05-01

    Italian participants in the European REVIVE survey reported that vaginal and vulvar atrophy (VVA) impaired various aspects of their lives, notably the ability to enjoy sex. The aim of the present study was to explore regional differences in knowledge, experiences, and treatment of VVA in the Italian REVIVE sample (n = 1000), which was analyzed according to region of residence. While many respondents were unfamiliar with the VVA condition, most could relate their VVA symptoms to the menopause. The rate of diagnosis of VVA was twice as high in Central Italy as in the North-East. For individual VVA symptoms, 25.4-41.6% of respondents judged that the symptom had worsened over time. There were no significant regional differences for symptoms in terms of reported rate, change in severity, impact on sexual activity, or health-care visits. Testosterone cream and OTC medication based on hyaluronic acid showed significant regional differences in lifetime rates of use. In Italy, there are modest regional differences in knowledge, diagnosis, and treatment of VVA, some of which may be explained by inter-regional differences in health care. Further efforts are needed to ensure that Italian women are properly informed about VVA and have access to appropriate health care and treatments.

  2. Menopause

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Amenorrhea About NICHD Research Information Find a Study More ... What are common symptoms? » Related A-Z Topics Amenorrhea Menstruation and Menstrual Problems Women's Health NICHD News ...

  3. Menopause

    Science.gov (United States)

    ... Peer Support Resources Diseases and Conditions Adrenal Disorders Osteoporosis and Bone Health Children and Teen Health Diabetes Heart Health Men's Health Rare Diseases Pituitary Disorders Thyroid Disorders Transgender Health Obesity and Weight Management Women's Health You and Your ...

  4. Menopausal symptoms: do life events predict severity of symptoms in peri- and post-menopause?

    Science.gov (United States)

    Pimenta, Filipa; Leal, Isabel; Maroco, João; Ramos, Catarina

    2012-08-01

    Hormonal changes during menopausal transition are linked to physical and psychological symptoms' emergence. This study aims to explore if life events predict menopausal symptoms. This cross-sectional research encompasses a community sample of 992 women who answered to socio-demographic, health, menopause-related and lifestyle questionnaires; menopausal symptoms and life events were assessed with validated instruments. Structural equation modeling was used to build a causal model. Menopausal status predicted only three symptoms: skin/facial hair changes (β=.136; p=.020), sexual (β=.157; p=.004) and, marginally, vasomotor symptoms (β=.094; p=.054). Life events predicted depressive mood (β=-.391; p=.002), anxiety (β=-.271; p=.003), perceived cognitive impairment (β=-.295; p=.003), body shape changes (β=-.136; p=.031), aches/pain (β=-.212; p=.007), skin/facial hair changes (β=-.171; p=.021), numbness (β=-.169; p=.015), perceived loss of control (β=-.234; p=.008), mouth, nails and hair changes (β=-.290; p=.004), vasomotor (β=-.113; p=.044) and sexual symptoms (β=-.208; p=.009). Although women in peri- and post-menopausal manifested higher symptoms' severity than their pre-menopausal counterparts, only three of the menopausal symptoms assessed were predicted by menopausal status. Since the vast majority of menopausal symptoms' severity was significantly influenced by the way women perceived their recent life events, it is concluded that the symptomatology exacerbation, in peri- and post-menopausal women, might be due to life conditions and events, rather than hormonal changes (nonetheless, the inverse influence should be investigated in future studies). Therefore, these should be accounted for in menopause-related clinical and research settings. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  5. Is the age at menopause a cause of sexual dysfunction? A Brazilian population-based study.

    Science.gov (United States)

    Lett, Caio; Valadares, Ana L R; Baccaro, Luiz F; Pedro, Adriana O; Filho, Jeffrey L; Lima, Marcelo; Costa-Paiva, Lucia

    2018-01-01

    The aim of the study was to evaluate the association between age at menopause and sexual dysfunction and the components of sexual function in postmenopausal women. In this cross-sectional population-based study, data of 540 women aged 45 to 60 years regarding the age they were when they achieved menopause and its association with sexual dysfunction (evaluated using the Short Personal Experiences Questionnaire) were obtained through interviews. We assessed the data for associations between age at menopause and sexual dysfunction and demographic, behavioral, and clinical characteristics. Age at menopause was not associated with sexual dysfunction. Arousal (dysfunction) was the only component of sexual function that was associated with premature ovarian insufficiency (POI) and early menopause (P = 0.01). It was reported by 64.2% of women with POI (women 45 years, respectively (P = 0.04). In women with POI or early menopause, Poisson regression analysis showed that having a partner with sexual problems (prevalence ratio [PR] = 6.6; 95% CI: 3.3-13,2; P POI. The major factors affecting this association were having a partner with sexual problems, dyspareunia, and no satisfaction with the partner as a lover. These findings highlight the importance of evaluating partner problems and improving lubrication in these groups of women.

  6. Distinguishing benign from malignant pelvic mass utilizing an algorithm with HE4, menopausal status, and ultrasound findings

    Science.gov (United States)

    Chan, Karen KL; Chen, Chi-An; Nam, Joo-Hyun; Ochiai, Kazunori; Aw, Tar-Choon; Sabaratnam, Subathra; Hebbar, Sudarshan; Sickan, Jaganathan; Schodin, Beth A; Charakorn, Chuenkamon; Sumpaico, Walfrido W

    2015-01-01

    Objective The purpose of this study was to develop a risk prediction score for distinguishing benign ovarian mass from malignant tumors using CA-125, human epididymis protein 4 (HE4), ultrasound findings, and menopausal status. The risk prediction score was compared to the risk of malignancy index and risk of ovarian malignancy algorithm (ROMA). Methods This was a prospective, multicenter (n=6) study with patients from six Asian countries. Patients had a pelvic mass upon imaging and were scheduled to undergo surgery. Serum CA-125 and HE4 were measured on preoperative samples, and ultrasound findings were recorded. Regression analysis was performed and a risk prediction model was developed based on the significant factors. A bootstrap technique was applied to assess the validity of the HE4 model. Results A total of 414 women with a pelvic mass were enrolled in the study, of which 328 had documented ultrasound findings. The risk prediction model that contained HE4, menopausal status, and ultrasound findings exhibited the best performance compared to models with CA-125 alone, or a combination of CA-125 and HE4. This model classified 77.2% of women with ovarian cancer as medium or high risk, and 86% of women with benign disease as very-low, low, or medium-low risk. This model exhibited better sensitivity than ROMA, but ROMA exhibited better specificity. Both models performed better than CA-125 alone. Conclusion Combining ultrasound with HE4 can improve the sensitivity for detecting ovarian cancer compared to other algorithms. PMID:25310857

  7. Menopausal Symptoms and Complementary Health Practices

    Science.gov (United States)

    ... with historical origins in ancient Indian philosophy. Various styles of yoga typically combine physical postures and movement, ... Obstetricians and Gynecologists. ACOG Practice Bulletin No. 141: management of menopausal symptoms. Obstetrics and Gynecology. 2014;123( ...

  8. Psychosocial Adjustment Needs of Menopausal Women

    African Journals Online (AJOL)

    User

    The sample consisted of 226 menopausal women selected through the random sampling technique. .... The research design adopted was the descriptive survey. It involves both quantitative and qualitative methods. This method was preferred ...

  9. The emergence of the menopause in India.

    Science.gov (United States)

    Sengupta, A

    2003-06-01

    A total of 130 million Indian women are expected to live beyond the menopause into old age by 2015. The menopause is emerging as an issue owing to rapid globalization, urbanization, awareness and increased longevity in urban middle-aged Indian women, who are evolving as a homogeneous group. Improved economic conditions and education may cause the attitude of rural working women to be more positive towards the menopause. However, most remain oblivious of the short- and long-term implications of the morbid conditions associated with middle and old age, simply because of lack of awareness, and the unavailability or ever-increasing cost of the medical and social support systems. Evidence-based medicine is accessible to still only a few Indian women. Most menopausal women go untreated or use unproven alternative therapies.

  10. Relationship between major dietary patterns and sarcopenia among menopausal women.

    Science.gov (United States)

    Mohseni, Reza; Aliakbar, Sima; Abdollahi, Afsoun; Yekaninejad, Mir Saeed; Maghbooli, Zhila; Mirzaei, Khadijeh

    2017-12-01

    Dietary habits have been associated with the prevalence of the sarcopenia and limited data are available in this field for menopausal women. This study focused on the relationship between dietary patterns and prevalence of the sarcopenia in menopausal women. This cross-sectional study was done in 250 menopausal women 45 years old or older. Dietary data were collected using a food-frequency questionnaire and physical activity was assessed by International Physical Activity Questionnaire (IPAQ). Height, weight, skeletal muscle mass, hand grip, and gait speed were measured and sarcopenia was defined based on European Working Group on Sarcopenia in Older People (EWGSOP) guidelines. Using factor analysis, two major dietary patterns were found: a Western pattern (high in commercial beverage, sugar and dessert, snacks, solid fat, potato, high fat dairy, legume, organ meat, fast food, and sweets) and a Mediterranean pattern (high in olive, low-fat dairy, vegetable, fish, nut, and vegetable oil). After adjusting for confounding variables, for the highest vs the lowest tertiles, the Odds Ratio (OR) for sarcopenia was 1.06 [95% confidence interval (CI), 0.47-2.37] in the Western pattern and 0.40 [95% confidence interval (CI), 0.17-0.89] in the Mediterranean pattern. Our findings suggest that Mediterranean dietary pattern has a favorable role in the prevention of sarcopenia.

  11. Functional and molecular neuroimaging of menopause and hormone replacement therapy

    Directory of Open Access Journals (Sweden)

    Erika eComasco

    2014-12-01

    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

  12. Age of menopause and determinants of menopause age: A PAN India survey by IMS

    Directory of Open Access Journals (Sweden)

    Maninder Ahuja

    2016-01-01

    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.

  13. Factors affecting age of onset of menopause and determination of quality of life in menopause

    Directory of Open Access Journals (Sweden)

    Burcu Ceylan

    2015-03-01

    Full Text Available Menopause is a process in the climacteric period, characterized by a reduction in ovarian activity, a fall in the fertility rate, and a range of symptoms including irregular menstruation intervals. Most women enter menopause in their 40s, but this can vary from one individual to another. Although there are many factors affecting the age of menopause onset, there is no general agreement on them. Studies have shown many factors to affect the age of menopause, such as the mother’s age at menopause, the age at menarche, gestational age, use of oral contraceptives, irregular menstrual cycle, number of pregnancies, body mass index, use of tobacco and alcohol, physical activity, unilateral oophorectomy, serum lead levels, consumption of polyunsaturated fat, socioeconomic status and educational level. During this period, hormonal and biochemical changes give rise to various symptoms in the woman’s body. In menopause period, physical, psychological, social and sexual changes have a negative effect on quality of life in women. Recently, different measures have been used to assess women’s quality of life in this period of change. The purpose of this review was to examine the factors affecting the onset age of menopause and the measures of quality of life related to menopause.

  14. Current smoking at menopause rather than duration determines the onset of natural menopause

    NARCIS (Netherlands)

    van Asselt, Kristel M.; Kok, Helen S.; van der Schouw, Yvonne T.; Grobbee, Diederick E.; te Velde, Egbert R.; Pearson, Peter L.; Peeters, Petra H. M.

    2004-01-01

    Background: Smoking has frequently been associated with early menopause. However, studies of this association have been inconclusive with regard to duration and intensity of smoking. A major problem in analyzing the effect of smoking duration on menopausal age is that both exposure and outcome are

  15. Prevalence and severity of menopause symptoms and associated factors across menopause status in Korean women.

    Science.gov (United States)

    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

    2015-10-01

    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 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.

  16. Breast cancer and menopause: perceptions of diagnosis, menopausal therapies and health behaviors.

    Science.gov (United States)

    Sayakhot, P; Vincent, A; Teede, H

    2012-02-01

    The aim of this study was to investigate the perception and experience of menopause diagnosis and therapies, the information provided and health behaviors in younger women with breast cancer. The questionnaire study was completed by 114 women, aged 40-51 years, with non-metastatic breast cancer. Women were recruited from outpatient clinics and the community. Descriptive statistics were completed. Most women were satisfied with the manner in which they were informed of the breast cancer (69%) and the menopause (59%) diagnoses. Although 80% of women were given breast cancer information, only 54% were given menopause information at diagnosis. Women were least satisfied (26%) with information regarding the long-term complications of menopause. Women perceived exercise (68%) and improving lifestyle (61%) as most effective in alleviating symptoms of menopause. The majority of women reported that they did not understand the risks/benefits of 'bioidentical' hormones (79%) and herbal therapies (78%), while 58% perceived hormone replacement therapies as associated with an increased risk of breast cancer. Most women reported weight gain (68%) and osteoporosis (67%) as the most common problems/fears regarding menopause. However, regarding health behaviors, only 56% reported having relevant tests including a blood sugar test or a bone density test. While information needs regarding breast cancer appear well met in younger women, unmet information needs regarding menopause after breast cancer persist. Further education and support are required for these women to optimize health screening and prevention behaviors and to ensure informed decision-making regarding menopause treatment options.

  17. Discourses on menopause--Part II: How do women talk about menopause?

    DEFF Research Database (Denmark)

    Hvas, Lotte; Gannik, Dorte Effersøe

    2008-01-01

    The aim of this article is to describe which of the different available discourses women relate to as revealed in the way they talk about menopause. We use a discourse analytic approach, which implies that meaning is ascribed to things according to how we talk about them. Twenty-four menopausal...... women from Denmark were interviewed. They were selected to cover a broad spectrum of Danish women with different menopausal experiences and social background factors. Seven previously identified discourses could be found in the interviews, though to varying degrees from woman to woman. Nearly all women...... the menopause was talked about almost became kaleidoscopic when images speedily changed from the decrepit osteoporotic woman or a woman with lack of vitality and sex-appeal to a healthy and strong woman with control over her body and self. Since many women contact doctors in relation to menopause, and since...

  18. Muscle performance after the menopause.

    Science.gov (United States)

    Sirola, Joonas; Rikkonen, Toni

    2005-06-01

    The timing of the menopause transition has remained fairly constant throughout history. It represents a milestone in female health and, after passing through it, women experience increased musculoskeletal and cardiovascular morbidity. Muscle performance is an important determinant of functional capacity and quality of life among the elderly and is also involved in the maintenance of balance. Therefore, good muscle strength can prevent fragility fractures and lessen the burden of osteoporosis. Muscle strength begins to decline during the perimenopausal years and this phenomenon seems to be partly estrogen dependent. Randomized controlled trials have indicated that hormone replacement therapy may prevent a decline in muscle performance, although the exact mechanism of estrogen-dependent sarcopenia remains to be clarified. Exercises have been shown to improve postmenopausal muscle performance and hormone replacement therapy may also potentiate these beneficial effects. Improvement or maintenance of muscle strength alone, however, may not be considered as a primary indication for long-term hormone replacement therapy in view of current knowledge of its risks and benefits. Work history and educational background may be associated with postmenopausal muscle performance, which itself has unique associations with skeletal and cardiovascular diseases.

  19. Burning mouth syndrome and menopause

    Directory of Open Access Journals (Sweden)

    Parveen Dahiya

    2013-01-01

    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.

  20. Burning Mouth Syndrome and Menopause

    Science.gov (United States)

    Dahiya, Parveen; Kamal, Reet; Kumar, Mukesh; Niti; Gupta, Rajan; Chaudhary, Karun

    2013-01-01

    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. PMID:23411996

  1. Evaluation of Salivary Flow Rate, pH and Buffer in Pre, Post & Post Menopausal Women on HRT.

    Science.gov (United States)

    D R, Mahesh; G, Komali; K, Jayanthi; D, Dinesh; T V, Saikavitha; Dinesh, Preeti

    2014-02-01

    Climateric is considered to be a natural phase of life which by definition is the period of life starting from decline in ovarian activity until after the end of ovarian function. It is accompanied by various health consequences that include the changes in saliva too. This study was carried out to evaluate the salivary flow rate, pH, buffering capacity in pre-menopausal, post-menopausal and post-menopausal women on HRT. (1) To evaluate the salivary flow rate, pH of resting saliva and stimulated saliva and buffer capacity of stimulated saliva in pre-menopausal, post-menopausal and post-menopausal women on Hormone Replacement Therapy (HRT). (2) To compare the above salivary findings between pre-menopausal, post-menopausal and post-menopausal women on HRT. The study was carried out on 60 patients. These patients were divided into three groups of 20 patients: Group 1: Pre-menopausal women (control), Group 2: post-menopausal women (case), Group 3: post-menopausal women on HRT (case). The control group consisted of 20 women volunteers, having regular ovulatory menstrual cycles with no known systemic illness and deleterious habits and Group 2 consists of 20 post-menopausal women and Group 3 will consist of 20 post-menopausal women on HRT. After clearing the mouth by swallowing, stimulated saliva was collected after chewing paraffin for 10 mins in to a glass centrifuge tube graded in 0.1 mL increments up to 10mL.in rare cases the collection time will be reduced or extended (5-15 min), salivary flow rate will be determined as ml/min, immediately after collection, pH was determined by dipping pH test paper directly into the sample of oral fluid, salivary buffer capacity was determined by using saliva check buffer kit (GC corporation). The data obtained was statistically evaluated using chi-square test, fisher exact test ANOVA analysis. In our study we found salivary flow rate significantly lower in the post-menopausal women in comparison with the menstruating women and also

  2. Menopause: highlighting the effects of resistance training.

    Science.gov (United States)

    Leite, R D; Prestes, J; Pereira, G B; Shiguemoto, G E; Perez, S E A

    2010-11-01

    The increase in lifespan and in the proportion of elderly women has increased the focus on menopause induced physiological alterations. These modifications are associated with the elevated risk of several pathologies such as cardiovascular disease, diabetes, obesity, hypertension, dyslipidemia, non-alcoholic fat liver disease, among others. Because of estrogen levels decline, many tissue and organs (muscular, bone, adipose tissue and liver) are affected. Additionally, body composition suffers important modifications. In this sense, there is a growing body of concern in understanding the physiological mechanisms involved and establishing strategies to prevent and reverse the effects of menopause. The hormone reposition therapy, diet and physical exercise have been recommended. Among the diverse exercise modalities, resistance training is not commonly used as a therapeutic intervention in the treatment of menopause. Thus, the aim of this review was to analyze the physiological alterations on several organs and systems induced by menopause and ovariectomy (experimental model to reproduce menopause), as well as, to study the effects of resistance training in preventing and reverting these modifications. In conclusion, resistance training promotes beneficial effects on several organs and systems, mainly, on muscular, bone and adipose tissue, allowing for a better quality of life in this population.

  3. The ultrasound research's results of the peri menopausal women's genitals

    International Nuclear Information System (INIS)

    Dodkhoeva, M.F.; Djonova, B.Yu.; Barieva, L.S.; Djonbekova, P.A.

    2007-01-01

    The results of ultrasound research of the peri menopausal women's genitals revealed that the sizes of the ovaries of women with the climacteric syndrome are smaller that the size of ovaries of the women with the physiologic menopause

  4. Sexual function among married menopausal women in Amol (Iran

    Directory of Open Access Journals (Sweden)

    Shabnam Omidvar

    2011-01-01

    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.

  5. Methodological issues related to studies of lead mobilization during menopause Consideraciones metodológicas relacionadas con estudios sobre movilización de plomo durante la menopausia

    Directory of Open Access Journals (Sweden)

    Gertrud S. Berkowitz

    1999-11-01

    Full Text Available While there has been a substantial decline in lead exposure in the United States during the past two decades, mobilization of existing lead stored in bone potentially represents an important endogenous source of exposure for menopausal women. It has been hypothesized that lead may be mobilized from skeletal stores during conditions of high bone turnover, such as during menopause. However, such mobilization has not been documented in prospective studies. This discussion is focussed on some of the methodological difficulties to be anticipated in longitudinal studies of lead mobilization specific to menopause and the issues that need to be taken into account when evaluating the results of such studies. To evaluate whether lead mobilization occurs during menopause, a prospective repeated measures design is needed using X-ray fluorescence analysis of lead in bone and serial measurements of blood lead. Potential confounders and effect modifiers also need to be taken into account in the statistical analysis.Mientras que la exposición a plomo ha declinado sustancialmente en Estados Unidos durante las dos décadas pasadas, la mobilización del plomo almacenado en los huesos representa potencialmente una importante fuente de exposición endógena en mujeres menopáusicas. No obstante, tal movilización no ha sido documentada por estudios prospectivos. La presente discusión se enfoca en algunas de las dificultades metodológicas a se anticipadas en estudios longitudinales de mobilización de plomo específicamente en la menopausia, y los aspectos que necesitan ser considerados cuando se evalúan los resultados de tales estudios. Para evaluar si durante la menopausia el plomo es mobilizado, se requiere de un diseño prospectivo con mediciones repetidas utilizando análisis de fluorescencia de rayos-X para determinar el plomo en hueso y una serie de mediciones de plomo en sangre. Los potenciales confusores y modificadores del efecto también deben tomarse

  6. Physical activity, menopause, and quality of life: the role of affect and self-worth across time.

    Science.gov (United States)

    Elavsky, Steriani

    2009-01-01

    Physical activity has been shown to enhance quality of life (QOL); however, few investigations of these effects exist in women undergoing the menopausal transition. The present study examined the long-term effects of physical activity on menopause-related QOL and tested the mediating effects of physical self-worth and positive affect in this relationship. Middle-aged women previously enrolled in a 4-month randomized controlled trial involving walking and yoga, and a control group completed a follow-up mail-in survey 2 years after the end of the trial. The survey included a battery of psychological and physical activity measures, including measures of menopausal symptoms and menopause-related QOL. Longitudinal linear panel analysis was conducted within a covariance modeling framework to test whether physical self-worth and positive affect mediated the physical activity-QOL relationship over time. At the end of the trial, physical activity and menopausal symptoms were related to physical self-worth and positive affect, and in turn, greater levels of physical self-worth and positive affect were associated with higher levels of menopause-related QOL. Analyses indicated that increases in physical activity and decreases in menopausal symptoms over the 2-year period were related to increases in physical self-worth (betas = 0.23 and -0.52, physical activity and menopausal symptoms, respectively) and, for symptoms, also to decreased positive affect (beta = -0.47), and both physical self-worth (beta = 0.34) and affect (beta = 0.43) directly influenced enhancements in QOL (R = 0.775). The findings support the position that the effects of physical activity on QOL are mediated, in part, by intermediate psychological outcomes and that physical activity can have long-term benefits for women undergoing the menopausal transition.

  7. Estrogen and progestogen use in postmenopausal women: July 2008 position statement of The North American Menopause Society

    Science.gov (United States)

    2009-01-01

    Objective To update for both clinicians and the lay public the evidence-based position statement published by The North American Menopause Society (NAMS) in March 2007 regarding its recommendations for menopausal hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at various times through menopause and beyond. Design An Advisory Panel of clinicians and researchers expert in the field of women’s health was enlisted to review the March 2007 NAMS position statement, evaluate new evidence through an evidence-based analysis, and reach consensus on recommendations. The Panel’s recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement. The document was provided to other interested organizations to seek their endorsement. Results Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered. This paper lists all these areas along with explanatory comments. Conclusions that vary from the 2007 position statement are highlighted. Addenda include a discussion of risk concepts, a new component not included in the 2007 paper, and a recommended list of areas for future HT research. A suggested reading list of key references is also provided. Conclusions Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both. The benefit-risk ratio for menopausal HT is favorable close to menopause but decreases with aging and with time since menopause in previously untreated women. PMID:18580541

  8. What do working menopausal women want? A qualitative investigation into women's perspectives on employer and line manager support.

    Science.gov (United States)

    Hardy, Claire; Griffiths, Amanda; Hunter, Myra S

    2017-07-01

    To explore women's perspectives on what employers and managers should and should not do in relation to women going through the menopause. An online questionnaire was used to collect qualitative data in a cross-sectional study of working women. Three open-ended questions asked peri- and post-menopausal women, aged 45-65 years: (i) what they thought employers could do, or should do, to help menopausal women who may be experiencing difficult menopausal symptoms at work; (ii) how managers should behave; and (iii) how managers should not behave towards women going through the menopause. 137 women responded to the open questions in the survey. An inductive thematic analysis was conducted and three overarching themes emerged. Theme 1 related to employer/manager awareness, specifically to knowledge about the menopause and awareness of how the physical work environment might impact on menopausal women. Theme 2 related to employer/manager communication skills and behaviors, specifically those considered helpful and desired and those considered unhelpful and undesired. Theme 3 described employer actions, involving staff training and raising awareness, and supportive policies such as those relating to sickness absence and flexible working hours. The menopause can be difficult for some women to deal with at work, partly due to the working environment. To our knowledge, this is the first study to explore women's descriptions of how they would like to be treated by employers/managers, and what would be helpful and unhelpful. The results have clear implications for communication about menopause at work and for employer-level policy and practice. Copyright © 2017. Published by Elsevier B.V.

  9. Neutron activation analysis of gold and prospectiveness of its application

    International Nuclear Information System (INIS)

    Tong Chunhan.

    1988-01-01

    NAA of gold is a method of high sensitivity and high percision, especially when epithermal neutron activation is applied. NAA is particularly emphasized in the process of gold reference standards preparation. In addition to the pure instrumental NAA, the NAA with pre-enrichment before sctivation is developed. This technque has been successfully used in assessment of micro and fine grained Au-Ag-phlymetal ores in Guixian, Guangxi. Through this example, prospectiveness of NAA application in Au-Ag-prospecting, fast assessment and trace element geochemistry investigation is seen

  10. Managing menopause: a critical feminist engagement.

    Science.gov (United States)

    Guillemin, M N

    1999-12-01

    Feminist critiques of menopause have been beneficial in opening up important public health debates around menopause. One of the most contentious public health issues concerns the use of Hormone Replacement Therapy (HRT) for the prevention of osteoporosis, heart disease and, more recently, Alzheimer's disease, in postmenopausal women. For preventive purposes, it is recommended that women should take HRT for 10-15 years and preferably remain on the therapy for the remainder of their lives. This is despite reported increased cancer risks associated with HRT, side effects and considerable cost of the therapy. Various studies have shown that up to 50% of women stop taking HRT after 9-12 months. These figures are used in the medical literature as an indication of women's non-compliance. Extending earlier feminist critiques around menopause and HRT, this paper discusses a critical feminist engagement around issues of women's perceived non-compliance with HRT.

  11. [Hypertension in women (contraception and menopause].

    Science.gov (United States)

    Beaufils, M

    2000-11-01

    There are three circumstances where hypertension develops specifically in women: oral contraception, pregnancy, and menopause. Oral contraception usually shifts the blood pressure moderately upwards, but hypertension appears in less than 5% of women. Still it may (rarely) be very severe. Hypertension is poorly related to the dosage of the estrogenic compound, but rather to the nature and dosage of the progestive part. This hypertension does not significantly increase the cardiovascular risk of these women. The role of menopause itself in the trigging of hypertension remains uncertain. It seems however that confounding factors such as age, body weight, sodium balance and so on explain the increased incidence of hypertension after menopause. The latter is also associated with an increase of cardiovascular risk, which requires adequate treatment. Hormone replacement therapy is not contra-indicated, even in hypertensive patients.

  12. The evolutionary origin and significance of Menopause

    Science.gov (United States)

    Pollycove, Ricki; Naftolin, Frederick; Simon, James A.

    2010-01-01

    Contemporary human females have long life expectancy (81y US), especially relative to age at menopause (51y US). Menopause is a consequence of reproductive aging and follicular depletion (ovarian failure), yielding very low circulating estrogen* serum concentrations and biologically disadvantageous metabolic alterations. Stated in terms of antagonistic pleiotropy, the ongoing hypoestrogenic endocrine environment, beneficial during lactation, results in acceleration of several age-related health conditions following menopause (i.e. late postmenopausal osteoporosis, cardiovascular disease and cognitive decline). In contrast, the complex hypoestrogenic hormonal milieu present during postpartum lactation provides biologic advantages to both mother and newborn. The lactational hormonal milieu causes symptoms similar to those of the late perimenopause and early postmenopause, prompting theories for their biologic selective advantage. The precepts of evolutionary medicine encourage a reassessment of hormone therapy. Based on data presented, the authors propose additional opportunities for disease prevention and morbidity reduction in postmenopausal women. PMID:21252729

  13. Menopausal Status, Depression, and Life-Satisfaction among some ...

    African Journals Online (AJOL)

    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 ...

  14. Perspectives on menopause and women with HIV

    Directory of Open Access Journals (Sweden)

    Andany N

    2016-01-01

    Full Text Available Nisha Andany,1 V Logan Kennedy,2 Muna Aden,2 Mona Loutfy1,2 1Department of Medicine, University of Toronto, Toronto, ON, Canada; 2Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada Abstract: Since the implementation of effective combination antiretroviral therapy, HIV infection has been transformed from a life-threatening condition into a chronic disease. As people with HIV are living longer, aging and its associated manifestations have become key priorities as part of HIV care. For women with HIV, menopause is an important part of aging to consider. Women currently represent more than one half of HIV-positive individuals worldwide. Given the vast proportion of women living with HIV who are, and will be, transitioning through age-related life events, the interaction between HIV infection and menopause must be addressed by clinicians and researchers. Menopause is a major clinical event that is universally experienced by women, but affects each individual woman uniquely. This transitional time in women’s lives has various clinical implications including physical and psychological symptoms, and accelerated development and progression of other age-related comorbidities, particularly cardiovascular disease, neurocognitive dysfunction, and bone mineral disease; all of which are potentially heightened by HIV or its treatment. Furthermore, within the context of HIV, there are the additional considerations of HIV acquisition and transmission risk, progression of infection, changes in antiretroviral pharmacokinetics, response, and toxicities. These menopausal manifestations and complications must be managed concurrently with HIV, while keeping in mind the potential influence of menopause on the prognosis of HIV infection itself. This results in additional complexity for clinicians caring for women living with HIV, and highlights the shifting paradigm in HIV care that must accompany this aging and evolving population

  15. Does menopause influence nocturnal awakening with headache?

    Science.gov (United States)

    Lucchesi, L M; Hachul, H; Yagihara, F; Santos-Silva, R; Tufik, S; Bittencourt, L

    2013-06-01

    The aim of the present study was to assess whether menopausal status influences the occurrence of nocturnal awakening with headache (NAH) in the female population of Sao Paulo, Brazil. We also examined the relationship of this complaint to sociodemographic determinants, hot flushes, sleep quality and parameters, anxiety and depressive symptoms, somnolence and fatigue according to menopausal status. The female population of the Sao Paulo Epidemiologic Sleep Study (EPISONO) (n = 576) was divided according to menopausal status (pre-, peri-, early and late menopause) based on questionnaires and hormonal blood measures. The complaint of waking up because of a headache at least once a week was assessed by the UNIFESP Sleep questionnaire. Additionally, hot flushes, sleep complaints, anxiety and depressive symptoms, somnolence and fatigue were assessed by specific questionnaires. A full-night polysomnography assessed sleep parameters. The prevalence of NAH in women in the Sao Paulo population was 13.3%. Perimenopause was associated with a higher risk of having NAH (odds ratio 13.9; 95% confidence interval 4.3-45.2). More complaints of NAH were observed in obese women. All the groups with NAH showed more hot flushes, worse subjective sleep quality, more complaints of insomnia, anxiety symptoms and fatigue. We observed a constellation of symptoms in women according to menopausal status and NAH that included hot flushes, sleep complaints, more anxiety symptoms and fatigue. Moreover, some of these symptoms were more frequent in perimenopausal women with NAH. Therefore, we concluded that menopausal status influences NAH and the women in perimenopause presented a high risk of having this complaint.

  16. Cigarettes, genetic background, and menopausal timing: the presence of single nucleotide polymorphisms in cytochrome P450 genes is associated with increased risk of natural menopause in European-American smokers.

    Science.gov (United States)

    Butts, Samantha F; Sammel, Mary D; Greer, Christine; Rebbeck, Timothy R; Boorman, David W; Freeman, Ellen W

    2014-07-01

    This study aims to evaluate associations between variations in genes involved in the metabolism of environmental chemicals and steroid hormones and risk of menopause in smokers. Survival analysis was performed on 410 eligible participants from the Penn Ovarian Aging study (ongoing for 14 years), a cohort study of late-reproductive-age women. Single nucleotide polymorphisms at the following loci were studied: COMT Val158Met, CYP1B1*4 Asn452Ser, CYP1B1*3 Leu432Val, and CYP3A4*1B. Significant interactions between smoking and single nucleotide polymorphisms were observed in European-American carriers of CYP3A4*1B and CYP1B1*3, supporting a greater risk of menopause entry compared with those not carrying these alleles. Among CYP1B1*3 carriers, smokers had a greater risk of menopause entry than nonsmokers (adjusted hazard ratio [HR], 2.26; 95% CI, 1.4-3.67; median time to menopause, 10.42 and 11.07 y, respectively). No association between smoking and menopause was identified in CYP1B1 wild types. Among CYP3A4*1B carriers, smokers were at greater risk for menopause entry than nonsmokers (adjusted HR, 15.1; 95% CI, 3.31-69.2; median time to menopause, 11.36 and 13.91 y, respectively). Risk of menopause entry in CYP3A4 wild types who smoked was far lower (adjusted HR, 1.59; 95% CI, 1.03-2.44). Heavily smoking CYP1B1*3 carriers (adjusted HR, 3.0; 95% CI, 1.54-5.84; median time to menopause, 10.41 y) and heavily smoking CYP3A4*1B carriers (adjusted HR, 17.79; 95% CI, 3.21-98.65; median time to menopause, 5.09 y) had the greatest risk of menopause entry. Our finding that the risk of menopause entry in European-American smokers varies depending on genetic background represents a novel gene-environment interaction in reproductive aging.

  17. Chinese herbal medicine for menopausal symptoms

    Science.gov (United States)

    Zhu, Xiaoshu; Liew, Yuklan; Liu, Zhao Lan

    2016-01-01

    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

  18. Notes on nervios: a disorder of menopause.

    Science.gov (United States)

    Barnett, E A

    1989-01-01

    The condition of nerves among women in the small Peruvian town of Puente Piedre is described. Both nervios (a symptom) and Nervios (a disorder) describe a woman's difficulty with nerves. In Puente Piedre, the identification of an anxiety condition among women depends only on the women's age. Younger women with anxiety symptoms are diagnosed as nervios, a temporary condition ascribed to a single episode of high blood pressure. Menopausal women with similar symptoms, on the other hand, are thought to have a specific disorder, Nervios. In Puente Piedre, Nervios clearly is a folk illness limited to women of menopausal age.

  19. Video Games and Youth Violence: A Prospective Analysis in Adolescents

    Science.gov (United States)

    Ferguson, Christopher J.

    2011-01-01

    The potential influence of violent video games on youth violence remains an issue of concern for psychologists, policymakers and the general public. Although several prospective studies of video game violence effects have been conducted, none have employed well validated measures of youth violence, nor considered video game violence effects in…

  20. Beer Polyphenols and Menopause: Effects and Mechanisms—A Review of Current Knowledge

    Science.gov (United States)

    Sandoval-Ramírez, Berner Andrée; M. Lamuela-Raventós, Rosa; Estruch, Ramon; Sasot, Gemma; Doménech, Monica

    2017-01-01

    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

  1. Differences in clinician understanding and management of early menopause after breast cancer.

    Science.gov (United States)

    Sayakhot, P; Teede, H J; Gibson-Helm, M; Vincent, A

    2013-08-01

    Investigation of clinicians' understanding of early menopause diagnosis/management in women with breast cancer. A cross-sectional study of 176 randomly recruited Australian clinicians (35 gynecologists, 35 endocrinologists, 36 oncologists, 35 breast surgeons and 35 general practitioners (GPs)) involved in the care of women with breast cancer. This questionnaire study utilized an index case to assess understanding of early menopause diagnosis and management. Analysis involved descriptive statistics, χ² tests and Student's t-test. Significant differences between clinician groups regarding diagnostic criteria for early menopause were observed; gynecologists, endocrinologists and GPs selected amenorrhea > 12 months, whereas oncologists and breast surgeons selected elevated serum follicle stimulating hormone level (p breast surgeons (57%), gynecologists (54%) and endocrinologists (49%) compared to oncologists (28%) or GPs (9%) (p = 0.0001). Exercise (63%) and nutrition (66%) were selected by most gynecologists for treatment of hot flushes, whereas endocrinologists (91%), oncologists (94%), breast surgeons (69%) and GPs (63%) prescribed venlafaxine. Hormone therapy was mainly prescribed by breast surgeons (43%) compared to other groups (p = 0.001). Most clinicians reported that the main problem with menopausal therapies was failure to resolve hot flushes. Exercise, lifestyle and stress management were recommended by all clinician groups for treatment of anxiety/depression. This exploratory study demonstrated a lack of consensus between clinician groups in their investigation, diagnosis and management of early menopause in women with breast cancer, with implications for both diagnosis and treatment.

  2. Total bone calcium in normal women: effect of age and menopause status

    International Nuclear Information System (INIS)

    Gallagher, J.C.; Goldgar, D.; Moy, A.

    1987-01-01

    Bone density in different regions of the skeleton was measured in 392 normal women aged 20-80 years by dual photon absorpiometry. In premenopausal women, aged 25-50 years, multiple regression analysis of regional bone density on age, height, and weight showed a small significant decrease in total bone density (less than 0.01) but no significant change in other regions of the skeleton. In postmenopausal women there were highly significant decreases in all regions of the skeleton (p less than 0.001), and bone density in these areas decreased as a logarithmic function of years since menopause. Based on multiple regression analyses, the decrease in spine density and total bone calcium was 2.5-3.0 times greater in the 25 years after menopause than the 25 years before menopause. The largest change, however, occurred in the first five years after menopause. During this time the estimated annual change in spine density and total bone calcium was about 10 times greater than that in the premenopausal period. These results demonstrate the important effect of the menopause in determining bone mass in later life

  3. Relationship of serum and saliva calcium, phosphorus and alkaline phosphatase with dry mouth feeling in menopause.

    Science.gov (United States)

    Agha-Hosseini, Farzaneh; Mirzaii-Dizgah, Iraj; Moosavi, Mahdieh-Sadat

    2012-06-01

    The aim of this study was to compare serum and saliva calcium, phosphorus and alkaline phosphatase of menopausal women with/without dry mouth (DM) feeling. The composition of saliva in menopause women with/without DM feeling is different. Some of these differences are in hormones that are related to bone turnover. A case-control study was carried out on 60 selected menopausal women aged 45-79 years with or without DM feeling (30 as case, 30 as control), conducted at the Clinic of Oral Medicine, Tehran University of Medical Sciences. The phosphorus concentration was measured by photometrical measurement of the blue colour formed after the addition of ammonium molybdate and stannous chloride; calcium was measured by Arsenazo reaction; and alkaline phosphatase by the pNPP-AMP method. Statistical analysis of Student's t-test was used. The mean serum phosphorus and alkaline phosphatase, stimulated and unstimulated saliva calcium and alkaline phosphatase levels were significantly higher in the menopausal women suffering from DM. There were no significant differences between groups regarding saliva phosphorus and serum calcium concentration. Calcium, phosphorus and alkaline phosphatase appear associated with DM feeling in menopause. © 2012 The Gerodontology Society and John Wiley & Sons A/S.

  4. Menopause versus aging: The predictor of obesity and metabolic aberrations among menopausal women of Karnataka, South India

    Directory of Open Access Journals (Sweden)

    Shruti Dasgupta

    2012-01-01

    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.

  5. Anti-Mullerian hormone is a more accurate predictor of individual time to menopause than mother's age at menopause

    NARCIS (Netherlands)

    Dolleman, M.; Depmann, M.; Eijkemans, M.J.; Heimensem, J.; Broer, S.L.; Stroom, E.M. van der; Laven, J.S.E.; Rooij, I.A.L.M. van; Scheffer, G.J.; Peeters, P.H.M.; Schouw, Y.T. van der; Lambalk, C.B.; Broekmans, F.J.

    2014-01-01

    STUDY QUESTION: In the prediction of time to menopause (TTM), what is the added value of anti-Mullerian hormone (AMH) when mother's age at natural menopause (ANM) is also known? SUMMARY ANSWER: AMH is a more accurate predictor of individual TTM than mother's age at menopause. WHAT IS KNOWN ALREADY:

  6. Video games and youth violence: a prospective analysis in adolescents.

    Science.gov (United States)

    Ferguson, Christopher J

    2011-04-01

    The potential influence of violent video games on youth violence remains an issue of concern for psychologists, policymakers and the general public. Although several prospective studies of video game violence effects have been conducted, none have employed well validated measures of youth violence, nor considered video game violence effects in context with other influences on youth violence such as family environment, peer delinquency, and depressive symptoms. The current study builds upon previous research in a sample of 302 (52.3% female) mostly Hispanic youth. Results indicated that current levels of depressive symptoms were a strong predictor of serious aggression and violence across most outcome measures. Depressive symptoms also interacted with antisocial traits so that antisocial individuals with depressive symptoms were most inclined toward youth violence. Neither video game violence exposure, nor television violence exposure, were prospective predictors of serious acts of youth aggression or violence. These results are put into the context of criminological data on serious acts of violence among youth.

  7. Prospect theory: A parametric analysis of functional forms in Brazil

    Directory of Open Access Journals (Sweden)

    Robert Eugene Lobel

    2017-10-01

    Full Text Available This study aims to analyze risk preferences in Brazil based on prospect theory by estimating the risk aversion parameter of the expected utility theory (EUT for a select sample, in addition to the value and probability function parameter, assuming various functional forms, and a newly proposed value function, the modified log. This is the first such study in Brazil, and the parameter results are slightly different from studies in other countries, indicating that subjects are more risk averse and exhibit a smaller loss aversion. Probability distortion is the only common factor. As expected, the study finds that behavioral models are superior to EUT, and models based on prospect theory, the TK and Prelec weighting function, and the value power function show superior performance to others. Finally, the modified log function proposed in the study fits the data well, and can thus be used for future studies in Brazil.

  8. Cumulative prospect theory and mean variance analysis. A rigorous comparison

    OpenAIRE

    Hens, Thorsten; Mayer, Janos

    2012-01-01

    We compare asset allocations derived for cumulative prospect theory(CPT) based on two different methods: Maximizing CPT along the mean–variance efficient frontier and maximizing it without that restriction. We find that with normally distributed returns the difference is negligible. However, using standard asset allocation data of pension funds the difference is considerable. Moreover, with derivatives like call options the restriction to the mean-variance efficient frontier results in a siza...

  9. Menopause and big data: Word Adjacency Graph modeling of menopause-related ChaCha data.

    Science.gov (United States)

    Carpenter, Janet S; Groves, Doyle; Chen, Chen X; Otte, Julie L; Miller, Wendy R

    2017-07-01

    To detect and visualize salient queries about menopause using Big Data from ChaCha. We used Word Adjacency Graph (WAG) modeling to detect clusters and visualize the range of menopause-related topics and their mutual proximity. The subset of relevant queries was fully modeled. We split each query into token words (ie, meaningful words and phrases) and removed stopwords (ie, not meaningful functional words). The remaining words were considered in sequence to build summary tables of words and two and three-word phrases. Phrases occurring at least 10 times were used to build a network graph model that was iteratively refined by observing and removing clusters of unrelated content. We identified two menopause-related subsets of queries by searching for questions containing menopause and menopause-related terms (eg, climacteric, hot flashes, night sweats, hormone replacement). The first contained 263,363 queries from individuals aged 13 and older and the second contained 5,892 queries from women aged 40 to 62 years. In the first set, we identified 12 topic clusters: 6 relevant to menopause and 6 less relevant. In the second set, we identified 15 topic clusters: 11 relevant to menopause and 4 less relevant. Queries about hormones were pervasive within both WAG models. Many of the queries reflected low literacy levels and/or feelings of embarrassment. We modeled menopause-related queries posed by ChaCha users between 2009 and 2012. ChaCha data may be used on its own or in combination with other Big Data sources to identify patient-driven educational needs and create patient-centered interventions.

  10. Menarche menopause breast cancer risk individual

    NARCIS (Netherlands)

    Collaborative Group on Hormonal Factors in Breast Cancer; Bausch-Goldbohm, R.A.

    2012-01-01

    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

  11. Knowledge and Perception of Menopause and Climacteric ...

    African Journals Online (AJOL)

    Uche

    Abstract. Background: Menopause alters the physiological, biochemical and psychological environment of a woman. Thus the knowledge and perception of its symptomatology is invaluable to enable appropriate adjustment to this natural phenomenon. Objective: The objective of this study was to determine the knowledge ...

  12. Managing Depression during the Menopausal Transition

    Science.gov (United States)

    Pearson, Quinn M.

    2010-01-01

    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…

  13. Abrogation by human menopausal gonadotropin on testicular ...

    African Journals Online (AJOL)

    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 ...

  14. Management of menopause in women with breast cancer.

    Science.gov (United States)

    Vincent, A J

    2015-10-01

    Increasing breast cancer incidence and decreasing mortality have highlighted the importance of survivorship issues related to breast cancer. A consideration of the issues related to menopause is therefore of great importance to both women and clinicians. Menopause/menopausal symptoms, with significant negative effects on quality of life and potential long-term health impacts, may in women with breast cancer be associated with: (1) natural menopause occurring concurrently with a breast cancer diagnosis; (2) recurrence of menopausal symptoms following cessation of hormone replacement therapy; (3) treatment-induced menopause (chemotherapy, ovarian ablation/suppression) and adjuvant endocrine therapy. A variety of non-hormonal pharmacological and non-pharmacological therapies have been investigated as therapeutic options for menopausal symptoms with mixed results, and ongoing research is required. This review presents a summary of the causes, common problematic symptoms of menopause (vasomotor, genitourinary and sexual dysfunction), and longer-term consequences (cardiovascular disease and osteoporosis) related to menopause. It proposes an evidenced-based multidisciplinary approach to the management of menopause/menopausal symptoms in women with breast cancer.

  15. The impact of menopause on work ability in women with severe menopausal symptoms.

    Science.gov (United States)

    Geukes, Marije; van Aalst, Mariëlle P; Robroek, Suzan J W; Laven, Joop S E; Oosterhof, Henk

    2016-08-01

    To measure the impact of menopause on work ability in women with severe menopausal symptoms. This cross-sectional study compared the work ability of a sample of otherwise healthy employed Dutch women (n=205) with that of a sample of first-time attendees of a menopause clinic (n=60); both groups were aged 44-60 years. Self-reported questionnaire data assessing work ability (Work Ability Index; WAI) and menopausal symptoms (Greene Climacteric Scale; GCS) were used. Logistic regression analyses were used to examine whether women with severe menopausal symptoms were more likely to have low work ability (defined as a score work ability than their healthy counterparts: 76.7% versus 30.2% (OR 8.4, 95% CI 4.1-17.2). Over three-quarters of symptomatic menopausal women report serious problems in dealing with the physical and mental demands of their work (recorded here as low work ability); hence these women might be at risk of prolonged sickness absence from work. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Depression, Anxiety, and Stress Symptoms in Menopausal Arab Women: Shedding More Light on a Complex Relationship.

    Science.gov (United States)

    Bener, A; Saleh, N M; Bakir, A; Bhugra, D

    2016-01-01

    The association between depression, anxiety, and stress among Arab menopause and postmenopausal women have been explored in detailed. The objective of this study was to determine the correlation between depression, anxiety, and stress in menopausal and postmenopausal women and shedding more light on a complex relationship. A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the primary health care centers in Qatar. A representative sample of 1468 women aged 45-65 years were approached during July 2012 and May 2014 and 1101 women agreed to participate (75.0%) and responded to the study. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales 21. Data on body mass index (BMI), clinical and other parameters were used. Univariate, multivariate, and matrix correlation analysis were performed for statistical analysis. A total of 1101 women agreed to participate after informed consent was obtained. The mean age and standard deviation (SD) of the menopausal age were 49.55 (3.12), the mean and SD of postmenopausal age was 58.08 (3.26) ( P stress among menopause and postmenopause. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were a predictor for depression. Meanwhile, diastolic BP, occupation, and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation, and sheesha smoking habits were considered as the main risk factors associated with stress. A large number of factors were associated with experiencing menopausal and psycho-social problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety, and stress should be considered as important risk factors for osteoporosis.

  17. The relationships of multiple factors to menopausal symptoms in different racial/ethnic groups of midlife women: the structural equation modeling.

    Science.gov (United States)

    Im, Eun-Ok; Chang, Sun Ju; Chee, Eunice; Chee, Wonshik

    2018-04-09

    The purpose of the present study was to examine the relationships of multiple factors to menopausal symptoms in different racial/ethnic groups of midlife women. This secondary analysis was conducted with the data from 980 midlife women that were collected from 2005 to 2013 using the Midlife Women's Symptom Index. Structural equation modeling was used to analyze the data. The model had the highest fit indices for Non-Hispanic (NH) White midlife women, and prominent racial/ethnic differences were observed in the relationships of multiple factors to menopausal symptoms. In all racial/ethnic groups (except in Hispanic women), perceived health status was significantly associated positively with menopausal symptoms (β = -0.149 for NH African American; β = -0.207 for NH Asians; β = -0.162 for NH Whites). Body mass index was significantly positively associated with menopausal symptoms only in NH Asians (β = 0.118) and Hispanics (β = 0.210). The racial/ethnic differences in the relationships of multiple factors to menopausal symptoms could have resulted from the different cultural contexts in which women undergo during their menopausal transitions. Further cultural studies on the associations of racial/ethnic-specific factors with menopausal symptoms would help in understanding possible causes for racial/ethnic differences in the factors significantly associated with menopausal symptoms.

  18. [Urinary tract infection in pregnancy and menopause].

    Science.gov (United States)

    Broseta Rico, Enrique; Jiménez Cruz, Juan Fernando

    2002-11-01

    To review the topic of urinary tract infections (UTI) during pregnancy and menopause. UTI during pregnancy and menopause have great relevance in the field of urologic infections; during pregnancy because of the particularities involved in its diagnosis and treatment and potential consequences to the fetus and mother; menopausal UTI because this group of women is numerous and represents a growing section of the general population pyramid, due to the aging of population in developed countries associated with longer life expectancies and grater demand for quality of life. We performed a bibliographic review combined with our personal experience. During pregnancy there are several functional and anatomical changes that condition not only a higher risk of UTI, but also an additional treatment difficulty due to antimicrobial pharmacokinetics alterations and potential damage to the fetus. Despite efforts to find an easy, fast and reliable test for bacteriuria detection, urine culture continues to be the first diagnostic test for its detection and follow up during pregnancy. Penicillin derivates and cephalosporins continue to be the first choice because their lack of adverse effects on either fetus or mother. Alternative options like phosphomicin and aztreonam although they show low toxicity there is need for more studies supporting their suitability for the treatment of pregnancy UTIs. Menopausal female UTI have their different features from those in younger women. Hormonal alterations derived from gonadal atrophy associate functional changes in the vaginal ecosystem, making it prone to enterobacteriaceae colonization as a first step up to the urinary tract. This associated with genitourinary tract anatomical alterations inherent t aging make UTI extraordinary prevalent in this growing segment of population. Treatment lines focus on hormonal alteration correction and proper antimicrobial prophylaxis and vaccines in a close future. UTIs during pregnancy and menopause have

  19. Premature menopause linked to CVD and osteoporosis.

    Science.gov (United States)

    Park, Claire; Overton, Caroline

    2010-03-01

    Premature menopause affects 1% of women under the age of 40, the usual age of the menopause is 51. Most women will present with irregular periods or no periods at all with or without climacteric symptoms. Around 10% of women present with primary amenorrhoea. A careful history and examination are required. It is important to ask specifically about previous chemotherapy or radiotherapy and to look for signs of androgen excess e.g. polycystic ovarian syndrome, adrenal problems e.g. galactorrhoea and thyroid goitres. Once pregnancy has been excluded, a progestagen challenge test can be performed in primary care. Norethisterone 5 mg tds po for ten days or alternatively medroxyprogesterone acetate 10 mg daily for ten days is prescribed. A withdrawal bleed within a few days of stopping the norethisterone indicates the presence of oestrogen and bleeding more than a few drops is considered a positive withdrawal bleed. The absence of a bleed indicates low levels of oestrogen, putting the woman at risk of CVD and osteoporosis. FSH levels above 30 IU/l are an indicator that the ovaries are failing and the menopause is approaching or has occurred. It should be remembered that FSH levels fluctuate during the month and from one month to the next, so a minimum of two measurements should be made at least four to six weeks apart. The presence of a bleed should not exclude premature menopause as part of the differential diagnosis as there can be varying and unpredictable ovarian function remaining. The progestagen challenge test should not be used alone, but in conjunction with FSH, LH and oestradiol. There is no treatment for premature menopause. Women desiring pregnancy should be referred to a fertility clinic and discussion of egg donation. Women not wishing to become pregnant should be prescribed HRT until the age of 50 to control symptoms of oestrogen deficiency and reduce the risks of osteoporosis and CVD.

  20. Radiation-induced premature menopause: a misconception

    International Nuclear Information System (INIS)

    Madsen, Berit L.; Giudice, Linda; Donaldson, Sarah S.

    1995-01-01

    Purpose: To disprove the common view that women who have undergone irradiation to fields excluding the pelvis are at risk for radiation-induced premature menopause, we reviewed menstrual function and fertility among women treated with subtotal lymphoid irradiation for Hodgkin's Disease. Methods and Materials: Treatment and follow-up records of all women less than age 50 at the time of diagnosis of Stage I or II supradiaphragmatic Hodgkin's Disease, treated with subtotal lymphoid irradiation alone and enrolled in radiotherapy trials from 1967 to 1985, were reviewed. In addition, patients were surveyed regarding their menstrual status and fertility history. Results: Thirty-six women, aged 10 to 40 years, with normal menstrual function at the time of Hodgkin's diagnosis, were identified. Mean follow-up was 14 years, with a range of 1.25-22.75 years. The average radiation dose to mantle and paraaortic fields was 40-44 Gy; the calculated scatter radiation dose to the pelvis at the ovaries was 3.2 Gy. There were 38 pregnancies in 18 women; all offspring are normal. One of 36 women (2.7%) experienced premature menopause. The reported rate of premature menopause in women who have not undergone irradiation is 1-3%; not significantly different than the rate in our study. There is a syndrome whereby antibodies to several endocrine organs occur (including the ovary), which is associated with premature ovarian failure. This syndrome may be associated with prior radiation to the thyroid, such as that given by mantle-irradiation for Hodgkin's Disease. We report such a case. Conclusion: There is little risk of premature menopause in women treated with radiation fields that exclude the pelvis. Women with presumed radiation-induced premature menopause warrant an evaluation to exclude other causes of ovarian failure, such as autoimmune disorders

  1. Depressive disorders and the menopause transition.

    Science.gov (United States)

    Llaneza, Plácido; García-Portilla, María P; Llaneza-Suárez, David; Armott, Begoña; Pérez-López, Faustino R

    2012-02-01

    Depressive disorders and symptoms are common among middle-aged women. The effects of hormones on depression remain unclear. This review aims to clarify the nature of depressive disorders during the menopause transition as well as their links with climacteric syndrome, sexuality, cardiovascular risk and cognitive function. The recent literature on depressive disorders and menopause is reviewed. Women are more vulnerable than men to depressive disorders. Endocrine influences have been postulated but differences in, for example, coping style and response to stress may also contribute to the gender difference in the prevalence of depressive disorders. Gender differences in socialization may lead to higher rates of depression in women. There are data top suggest that menopause and depression are associated, although there is not a common clear causative factor. Women with climacteric symptoms (hot flushes, night sweats, vaginal dryness and dyspareunia) are more likely to report anxiety and/or depressive symptoms. Bothersome vasomotor symptoms could be associated with sleep disturbances, which in turn can increase reports of anxiety and depressive symptoms. Biopsychosocial and partner factors have a significant influence on middle-aged women's sexuality and depressive disorders, and most antidepressants can have a negative effect on sexual response. Lastly, studies have consistently shown that women with high levels of depressive symptoms are at greater cardiovascular risk and have poorer cognitive function than non-depressed women. At present, a direct relationship between psychiatric symptoms and hormonal changes such as estrogen decrease has not been clearly found. Stress, educational level, ethnicity, socioeconomic factors and partner status may influence the prevalence and clinical course of both menopause symptoms and depressive disorders. Since in many cases depression is a lifelong condition, and is associated with severe comorbid conditions, further studies are

  2. [Survey on menopausal age and menstruation span in women in Pudong district of Shanghai].

    Science.gov (United States)

    Chen, Hua; Feng, You-ji; Shu, Hui-min; Lu, Tian-mei; Zhu, Hong-mei; Yang, Bin-lie; Xiong, Miao

    2010-06-01

    To investigate natural spontaneous menopausal age, menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai. From Jan 2007 to Jul 2008, 15 083 spontaneous menopause women undergoing cervical cancer screening were enrolled in this study. The questionnaire included menarche age, parity, spontaneous menopausal age and menstruation span. Those women were divided into four groups based on age, which were group of 56 - 60, 61 - 65, 66 - 70 and more than 70.Analysis of variance (ANOVA) was used for comparing difference between menopausal age and menstruation span. Multiple factor regressions was used to analyze the relationship between menarche age, parity and menopausal age and menstruation span. (1) Spontaneous menopausal age: the minimum was 29 years old, the maximum was 61 years old, and the mean age was (50.6 ± 3.7) years old. The mean spontaneous menopause age were (50.9 ± 3.4), (50.7 ± 3.7), (50.0 ± 4.1), (49.6 ± 4.0) years in groups of 56 - 60, 61 - 65, 66 - 70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menopausal age were observed, which the difference of 1.36 year was shown between groups of 56 - 60 and more than 70 years. (2) Menstruation span: the mean of menstruation span was (34.3 ± 4.1) years, which the minimal age of 12 years and maximal age of 48 years were recorded. (34.6 ± 3.8), (34.3 ± 4.1), (33.9 ± 4.6), (33.2 ± 4.5) were observed in groups of 56 - 60, 61 - 65, 66 - 70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menstruation span were observed, which the difference of 1.41 year was shown between groups of 56 - 60 and more than 70 years. (3) The impact of menarche age on menopausal age and menstruation span: there was no correlation between menarche age and menopausal age (r = 0.02); however, menstruation span was found to be negatively correlated with the menarche age (r = -0.43). (4) The impact

  3. DNA adducts and cancer risk in prospective studies: a pooled analysis and a meta-analysis

    DEFF Research Database (Denmark)

    Veglia, Fabrizio; Loft, Steffen; Matullo, Giuseppe

    2008-01-01

    in which bulky DNA adducts have been measured in blood samples collected from healthy subjects (N = 1947; average follow-up 51-137 months). In addition, we have performed a meta-analysis by identifying all articles on the same subject published up to the end of 2006, including case-control studies......). The association was evident only in current smokers and was absent in former smokers. Also the meta-analysis, which included both lung and bladder cancers, showed a statistically significant association in current smokers, whereas the results in never smokers were equivocal; in former smokers, no association......Bulky DNA adducts are biomarkers of exposure to aromatic compounds and of the ability of the individual to metabolically activate carcinogens and to repair DNA damage. Their ability to predict cancer onset is uncertain. We have performed a pooled analysis of three prospective studies on cancer risk...

  4. Reflux esophagitis revisited: Prospective analysis of radiologic accuracy

    International Nuclear Information System (INIS)

    Ott, D.J.; Gelfand, D.W.; Wu, W.C.

    1981-01-01

    A prospective radiologic-endoscopic study of the esophagogastric region in 266 patients, including 206 normals and 60 with esophagitis, is reported. The endoscopic classification grading severity of esophagitis was grade 1-normal; grades 2. 3. and 4-mild, moderate, and severe esophagitis, respectively. Radiology detected 22% of patient with mild esophagitis, 83% with moderate esophagitis, and 95% with severe esophagitis. Although hiatal hernia was present in 40% of normals and 89% with esophagitis, absence of radiographic hiatal hernia excluded esophagitis with 95% accuracy. The implications of this study regarding the role of radiology in evaluating patient with suspected reflux esophagitis are discussed. (orig.) [de

  5. Analysis of North Korea's Nuclear Tests under Prospect Theory

    International Nuclear Information System (INIS)

    Lee, Han Myung; Ryu, Jae Soo; Lee, Kwang Seok; Lee, Dong Hoon; Jun, Eunju; Kim, Mi Jin

    2013-01-01

    North Korea has chosen nuclear weapons as the means to protect its sovereignty. Despite international society's endeavors and sanctions to encourage North Korea to abandon its nuclear ambition, North Korea has repeatedly conducted nuclear testing. In this paper, the reason for North Korea's addiction to a nuclear arsenal is addressed within the framework of cognitive psychology. The prospect theory addresses an epistemological approach usually overlooked in rational choice theories. It provides useful implications why North Korea, being under a crisis situation has thrown out a stable choice but taken on a risky one such as nuclear testing. Under the viewpoint of prospect theory, nuclear tests by North Korea can be understood as follows: The first nuclear test in 2006 is seen as a trial to escape from loss areas such as financial sanctions and regime threats; the second test in 2009 was interpreted as a consequence of the strategy to recover losses by making a direct confrontation against the United States; and the third test in 2013 was understood as an attempt to strengthen internal solidarity after Kim Jong-eun inherited the dynasty, as well as to enhance bargaining power against the United States. Thus, it can be summarized that Pyongyang repeated its nuclear tests to escape from a negative domain and to settle into a positive one. In addition, in the future, North Korea may not be willing to readily give up its nuclear capabilities to ensure the survival of its own regime

  6. Prenatal famine, birthweight, reproductive performance and age at menopause: the Dutch hunger winter families study.

    Science.gov (United States)

    Yarde, F; Broekmans, F J M; van der Pal-de Bruin, K M; Schönbeck, Y; te Velde, E R; Stein, A D; Lumey, L H

    2013-12-01

    Is there an association between acute prenatal famine exposure or birthweight and subsequent reproductive performance and age at menopause? No association was found between intrauterine famine exposure and reproductive performance, but survival analysis showed that women exposed in utero were 24% more likely to experience menopause at any age. Associations between prenatal famine and subsequent reproductive performance have been examined previously with inconsistent results. Evidence for the effects of famine exposure on age at natural menopause is limited to one study of post-natal exposure. This cohort study included men and women born around the time of the Dutch famine of 1944-1945. The study participants (n = 1070) underwent standardized interviews on reproductive parameters at a mean age of 59 years. The participants were grouped as men and women with prenatal famine exposure (n = 407), their same-sex siblings (family controls, n = 319) or other men and women born before or after the famine period (time controls, n = 344). Associations of famine exposure with reproductive performance and menopause were analysed using logistic regression and survival analysis with competing risk, after controlling for family clustering. Gestational famine exposure was not associated with nulliparity, age at birth of first child, difficulties conceiving or pregnancy outcome (all P> 0.05) in men or women. At any given age, women were more likely to experience menopause after gestational exposure to famine (hazard ratio 1.24; 95% CI 1.03, 1.51). The association was not attenuated with an additional control for a woman's birthweight. In this study, there was no association between birthweight and age at menopause after adjustment for gestational famine exposure. Age at menopause was self-reported and assessed retrospectively. The study power to examine associations with specific gestational periods of famine exposure and reproductive function was limited. Our findings support

  7. Genetic modifiers of menopausal hormone replacement therapy and breast cancer risk

    DEFF Research Database (Denmark)

    Rudolph, Anja; Hein, Rebecca; Lindström, Sara

    2013-01-01

    Women using menopausal hormone therapy (MHT) are at increased risk of developing breast cancer (BC). To detect genetic modifiers of the association between current use of MHT and BC risk, we conducted a meta-analysis of four genome-wide case-only studies followed by replication in 11 case...

  8. [Retrospectively experiencing the menopause in Germany and in Papua New Guinea: a comparative report].

    Science.gov (United States)

    Kowalcek, I; Rotte, D; Painn, K; Schmidt-Müller, A; Diedrich, K

    2003-11-01

    The objective of this study was to examine the experience of menopause in postmenopausal women from Germany and in postmenopausal women from Papua New Guinea. Experience of menopause were assessed by formation of symptom groups (e. g. hot flushes, cardiac or sleeping trouble, depression, touchiness, drop in performance, vaginal dryness, painful joints or muscles), following the Menopause Rating Scale (MRS). Apart from the translated English version a questionaire in Pidgin English was offered. Questions about positive and negative experience of menopause and the acceptance of hormonal replacement therapy were included. Statistical analysis was performed both descriptively and for the group analyses the Chi-squared-test and the Mann Whitney's U test. 40 postmenopausal German women and 41 postmenopausal women from Papua New Guinea were asked about their experience of menopause. The German women were 58.7 years old (range from 52 to 62) and had two children on average (range from 0 to 4). 87.7 % had experience of symptoms. In Papua New Guinea mean age was 55.2 years (range from 48 to 70), parity six (range from 2 to 12). 76.9 % had experience of symptoms. There were significant intercultural differences between the experience of depressive mood, general drop of performance, sexual experience and the vaginal dryness and we found no significant intercultural differences between the experiences of hot flushes, cardiac trouble, sleeping trouble, nervousness and urological symptoms. 50 % of the German women take hormonal replacement therapy and nobody of Papua New Guinea. The experience of menopause as seen in the developed countries does not exist in the developing countries. The perception about illness and well-being are formed by culturally produced patterns.

  9. Is an unfavourable cardiovascular risk profile a risk factor for vasomotor menopausal symptoms? Results of a population-based cohort study.

    Science.gov (United States)

    van den Berg, M J; Herber-Gast, G C M; van der Schouw, Y T

    2015-08-01

    Evidence suggests an association between vasomotor menopausal symptoms (VMSs), i.e. hot flushes and night sweats, and cardiovascular disease. However, the causal pathway is unclear. We investigated whether an unfavourable cardiovascular risk profile is a risk factor for VMS later in life. Retrospective cohort study. Women aged 50-70 from the general population. The Prospect-European Prospective Investigation into Cancer and Nutrition (Prospect-EPIC) cohort is a population-based cohort of women who enrolled between 1993 and 1997. Follow-up questionnaires were sent at 5-year intervals for 15 years. Women who returned the third questionnaire, answered questions regarding lifetime VMS and did not report VMS prior to baseline were included in this study (n = 1295). At baseline, the Framingham Risk Score (FRS) was determined. We used logistic regression analysis to calculate odds ratios (ORs) for the association between baseline FRS and incident VMS. Incident VMS. At baseline (mean age ± standard deviation, 52.2 ± 3.6 years), 21.2% had a FRS > 10%. During follow-up, 40.2% of women reported the onset of VMS. Adjusted for body mass index, physical activity, education and alcohol consumption, each point increase in FRS was associated with a decreased incidence of VMS [OR, 0.94 (95% CI, 0.91-0.97)]. Additional adjustment for menopausal status attenuated the OR to null [OR, 0.98 (95% CI, 0.95-1.01)]. None of the separate FRS variables were associated with VMS after adjustment for age. In our cohort, an unfavourable cardiovascular risk profile was not associated with VMS, and therefore we found no evidence for the involvement of a vascular mechanism in the etiology of VMS. © 2014 Royal College of Obstetricians and Gynaecologists.

  10. Employment conditions and work-related stressors are associated with menopausal symptom reporting among perimenopausal and postmenopausal women.

    Science.gov (United States)

    Bariola, Emily; Jack, Gavin; Pitts, Marian; Riach, Kathleen; Sarrel, Philip

    2017-03-01

    While many women undergo menopausal transition while they are in paid employment, the effect of poor working conditions on women's experience of the menopause has received scant empirical attention. We examined associations between employment conditions, work-related stressors, and menopausal symptom reporting among perimenopausal and postmenopausal working women. Data were drawn from an online survey conducted between 2013 and 2014 involving 476 perimenopausal and postmenopausal women working in the higher education sector in Australia. Survey questions assessed demographics; health-related variables; menopausal symptom reporting; employment status; presence of flexible working hours; presence of temperature control; job autonomy; and supervisor support. A forced entry multivariable regression analysis revealed that high supervisor support (β = -0.10, P = 0.04), being employed on a full-time basis (β = -0.11, P = 0.02), and having control over workplace temperature (β = -0.11, P = 0.02) were independently associated with lower menopausal symptom reporting. These findings may help inform the development of tailored occupational health policies and programs that cater for the needs of older women as they transition through menopause in the workplace.

  11. Knowledge and attitude of older women towards menopause

    International Nuclear Information System (INIS)

    Mazhar, S.B.; Gul-e-Erum

    2003-01-01

    Objective: To determine the knowledge and attitude towards menopause among postmenopausal women seeking gynecological treatment. Results: The mean age of respondents was 54.4 years. Fifty-two (74.3%) women knew about menopause, 39 (55.7%) were aware of symptomatology while only 7(10%) knew sequelae of menopause. Fifty-three (75.5%) women were satisfied with cessation of menstruation and only 17 (24.3%) desired to continue menstruation. Twenty-four (34.3%) respondents were unhappy with their menopausal status. Thirty-two (45.7%) women were content with their present sexual relations, 18 (25.7%) were dissatisfied and 20 (28.6%) had no sexual activity. Fifty-two (74.3%) women felt a need for health education on menopause in educational institutions. Thirty-three (47.1%) considered treatment of menopause necessary. Four (5.7%) were aware of any treatment of menopause and 55 (78.6%) desired to learn more about menopause. Conclusion: Women have different views about menopause, few see it as a medical condition requiring treatment, whereas majority consider it is a natural transition. There was breath of knowledge regarding significance of menopause. (author)

  12. Menopause and illness course in bipolar disorder: A systematic review.

    Science.gov (United States)

    Perich, Tania; Ussher, Jane; Meade, Tanya

    2017-09-01

    Menopause may be a time of increased mood symptoms for some women. This systematic review aimed to examine the severity of symptoms and prevalence of mood changes in women with bipolar disorder during peri-menopause and post-menopause. A systematic review was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The two primary outcomes assessed were relapse rates and symptom severity during menopause. Databases searched were MEDLINE, EMBASE, PsychInfo, CINAHL and SCOPUS from January 1980 until December 2016. Nine studies, including a total of 273 participants diagnosed with bipolar disorder and who reported menopause, were included in the narrative synthesis. Menopause was reported to be associated with increased symptoms overall, and with depression in particular (range of 46%-91%). The collection of self-reported retrospective data was the most commonly used method to record menopause status. The impact of menopause on illness course for women with bipolar disorder is largely under-explored. Preliminary evidence suggests that it may be associated with increased bipolar symptoms. Further work is needed to explore how menopause may interact with bipolar disorder over time and the nature of these symptom changes, and if and how menopause may differ from other reproductive stages. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Renewable energy sources cost benefit analysis and prospects for Italy

    International Nuclear Information System (INIS)

    Ariemma, A.; Montanino, G.

    1992-01-01

    In light of Italy's over-dependency on imported oil, and due to this nation's commitment to the pursuit of the strict environmental protection policies of the European Communities, ENEL (the Italian National Electricity Board) has become actively involved in research efforts aimed at the commercialization of renewable energy sources - photovoltaic, wind, biomass, and mini-hydraulic. Through the use of energy production cost estimates based on current and near- future levels of technological advancement, this paper assesses prospects for the different sources. The advantages and disadvantages of each source in its use as a suitable complementary energy supply satisfying specific sets of constraints regarding siting, weather, capital and operating costs, maintenance, etc., are pointed out. In comparing the various alternatives, the paper also considers environmental benefits and commercialization feasibility in terms of time and outlay

  14. Texture analysis of clinical radiographs using radon transform on a local scale for differentiation between post-menopausal women with and without hip fracture

    Science.gov (United States)

    Boehm, Holger F.; Körner, Markus; Baumert, Bernhard; Linsenmaier, Ulrich; Reiser, Maximilian

    2011-03-01

    Osteoporosis is a chronic condition characterized by demineralization and destruction of bone tissue. Fractures associated with the disease are becoming an increasingly relevant issue for public health institutions. Prediction of fracture risk is a major focus research and, over the years, has been approched by various methods. Still, bone mineral density (BMD) obtained by dual-energy X-ray absorptiometry (DXA) remains the clinical gold-standard for diagnosis and follow-up of osteoporosis. However, DXA is restricted to specialized diagnostic centers and there exists considerable overlap in BMD results between populations of individuals with and without fractures. Clinically far more available than DXA is conventional x-ray imaging depicting trabecular bone structure in great detail. In this paper, we demonstrate that bone structure depicted by clinical radiographs can be analysed quantitatively by parameters obtained from the Radon Transform (RT). RT is a global analysis-tool for detection of predefined, parameterized patterns, e.g. straight lines or struts, representing suitable approximations of trabecular bone texture. The proposed algorithm differentiates between patients with and without fractures of the hip by application of various texture-metrics based on the Radon-Transform to standard x-ray images of the proximal femur. We consider three different regions-of-interest in the proximal femur (femoral head, neck, and inter-trochanteric area), and conduct an analysis with respect to correct classification of the fracture status. Performance of the novel approach is compared to DXA. We draw the conclusion that performance of RT is comparable to DXA and may become a useful supplement to densitometry for the prediction of fracture risk.

  15. Longitudinal analysis of associations between women's consultations with complementary and alternative medicine practitioners/use of self-prescribed complementary and alternative medicine and menopause-related symptoms, 2007-2010.

    Science.gov (United States)

    Peng, Wenbo; Adams, Jon; Hickman, Louise; Sibbritt, David W

    2016-01-01

    This study aims to determine associations between consultations with complementary and alternative medicine (CAM) practitioners/use of self-prescribed CAM and menopause-related symptoms. Data were obtained from the Australian Longitudinal Study on Women's Health. Generalized estimating equations were used to conduct longitudinal data analyses, which were restricted to women born in 1946-1951 who were surveyed in 2007 (survey 5; n = 10,638) and 2010 (survey 6; n = 10,011). Women with menopause-related symptoms were more likely to use self-prescribed CAM but were not more likely to consult a CAM practitioner. Overall, CAM use was lower among women who had undergone hysterectomy or women who had undergone oophorectomy, compared with naturally postmenopausal women, and decreased with increasing age of postmenopausal women. Weak associations between CAM use and hot flashes were observed. Women experiencing hot flashes were more likely to consult a massage therapist (odds ratio, 1.09; 95% CI, 1.00-1.20) and/or use self-prescribed herbal medicines (odds ratio, 1.13; 95% CI, 1.03-1.23) than women not experiencing hot flashes. Consultations with CAM practitioners and use of self-prescribed CAM among naturally or surgically postmenopausal women are associated with menopause-related symptoms. Our study findings should prompt healthcare providers, in particular family medicine practitioners, to be cognizant of clinical evidence for CAM typically used for the management of common menopause-related symptoms in their aim to provide safe, effective, and coordinated care for women.

  16. Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies.

    Science.gov (United States)

    Pizot, Cécile; Boniol, Mathieu; Mullie, Patrick; Koechlin, Alice; Boniol, Magali; Boyle, Peter; Autier, Philippe

    2016-01-01

    Lower risk of breast cancer has been reported among physically active women, but the risk in women using hormone replacement therapy (HRT) appears to be higher. We quantified the association between physical activity and breast cancer, and we examined the influence that HRT use and other risk factors had on this association. After a systematic literature search, prospective studies were meta-analysed using random-effect models applied on highest versus lowest level of physical activity. Dose-response analyses were conducted with studies reporting physical activity either in hours per week or in hours of metabolic equivalent per week (MET-h/week). The literature search identified 38 independent prospective studies published between 1987 and 2014 that included 116,304 breast cancer cases. Compared to the lowest level of physical activity, the highest level was associated with a summary relative risk (SRR) of 0.88 (95% confidence interval [CI] 0.85, 0.90) for all breast cancer, 0.89 (95% CI 0.83, 0.95) for ER+/PR+ breast cancer and 0.80 (95% CI 0.69, 0.92) for ER-/PR- breast cancer. Risk reductions were not influenced by the type of physical activity (occupational or non-occupational), adiposity, and menopausal status. Risk reductions increased with increasing amounts of physical activity without threshold effect. In six studies, the SRR was 0.78 (95% CI 0.70, 0.87) in women who never used HRT and 0.97 (95% CI 0.88, 1.07) in women who ever used HRT, without heterogeneity in results. Findings indicate that a physically inactive women engaging in at least 150 min per week of vigorous physical activity would reduce their lifetime risk of breast cancer by 9%, a reduction that might be two times greater in women who never used HRT. Increasing physical activity is associated with meaningful reductions in the risk of breast cancer, but in women who ever used HRT, the preventative effect of physical activity seems to be cancelled out. Copyright © 2015 Elsevier Ltd. All

  17. Evaluation of Dietary Intake of Various Vitamins in Menopausal Women with Hot Flashes

    Directory of Open Access Journals (Sweden)

    Aytekin Tokmak

    2014-12-01

    Full Text Available Aim: Menopausal hot flashes affect the majority of women. Hormone replacement therapy to reduce the severity of hot flashes is the most effective method. Today, however, due to a number of side effects of hormone therapy more women are seeking alternative treatments such as vitamin pills and herbal products. Previously, various vitamins, minerals and trace elements were studied for this purpose. In this study, our aim was to determine the level of dietary intake of various vitamins in women with hot flashes and to compare them with women who had no complaints. Material and Method: One hundred and seven consecutive women who attended the menopause clinic of our hospital for routine follow up were included in this study. All of the participants were asked about the occurrence of specific menopausal symptoms and completed 92-itm antioxidant nutrient questionnaire developed by Satia. The main parameters recorded for each woman were; age, obstetrical characteristics, body mass index, smoking status, educational level, type of menopause (surgical or natural, duration of menopause, menopausal symptoms, and number and duration of hot flashes. According to the computerized analysis of questionnaire, dietary intake of water-soluble vitamins; B complex and vitamin C, and fat-soluble vitamins; vitamin, A D, E, K were calculated. Results: Patients were divided into two groups with regard to presence of hot flashes, those with hot flashes constituted the study groups (n:75, and others without hot flashes constituted the control group (n:32. The mean age of patients was statistically significantly lower in the study group (p<0,001. The mean duration of menopause was also lower in this group (p<0,001. There were no statistically significant differences between groups in terms of obstetrical characteristics, body mass index, smoking status, educational level, type of menopause (p>0,05. Night sweats and sleep disorders were more common in women with hot flashes

  18. Evaluation of Dietary Intake of Various Vitamins in Menopausal Women with Hot Flashes

    Directory of Open Access Journals (Sweden)

    Aytekin Tokmak

    2016-11-01

    Full Text Available Aim: Menopausal hot flashes affect the majority of women. Hormone replacement therapy to reduce the severity of hot flashes is the most effective method. Today, however, due to a number of side effects of hormone therapy more women are seeking alternative treatments such as vitamin pills and herbal products. Previously, various vitamins, minerals and trace elements were studied for this purpose. In this study, our aim was to determine the level of dietary intake of various vitamins in women with hot flashes and to compare them with women who had no complaints. Material and Method: One hundred and seven consecutive women who attended the menopause clinic of our hospital for routine follow up were included in this study. All of the participants were asked about the occurrence of specific menopausal symptoms and completed 92-itm antioxidant nutrient questionnaire developed by Satia. The main parameters recorded for each woman were; age, obstetrical characteristics, body mass index, smoking status, educational level, type of menopause (surgical or natural, duration of menopause, menopausal symptoms, and number and duration of hot flashes. According to the computerized analysis of questionnaire, dietary intake of water-soluble vitamins; B complex and vitamin C, and fat-soluble vitamins; vitamin, A D, E, K were calculated. Results: Patients were divided into two groups with regard to presence of hot flashes, those with hot flashes constituted the study groups (n:75, and others without hot flashes constituted the control group (n:32. The mean age of patients was statistically significantly lower in the study group (p<0,001. The mean duration of menopause was also lower in this group (p<0,001. There were no statistically significant differences between groups in terms of obstetrical characteristics, body mass index, smoking status, educational level, type of menopause (p>0,05. Night sweats and sleep disorders were more common in women with hot flashes

  19. Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry.

    Science.gov (United States)

    Liu, Qingyu; Liu, Junling; Ren, Chengda; Cai, Wenting; Wei, Qingquan; Song, Yi; Yu, Jing

    2017-01-01

    The purpose of this study was to investigate whether acupuncture is effective at treating dry eye disease among postmenopausal women and to identify the possible mechanisms. Twenty-eight postmenopausal women with dry eye disease were randomly divided into two groups: an acupuncture plus artificial tears (AC + AT) group and an artificial tears (AT) only group. After baseline examination of clinical parameters and tear sample collection, each patient received the designated modality of topical therapy for 2 months. Post-treatment documentation of clinical parameters was recorded, and tear samples were collected. Tear samples from the AC + AT group were subjected to two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry (2D nano-LC-MS/MS). Western blot analysis was also performed on tear samples from both groups. After treatment, the Ocular Surface Disease Index scores, symptom assessment scores, scores of sign assessment, and tear break-up time were significantly improved in both groups ( P =0.000). Symptom assessment scores were significantly improved in the AC + AT group ( P =0.000) compared with the AT group. 2D nano-LC-MS/MS identified 2,411 proteins, among which 142 were downregulated and 169 were upregulated. After combined AC + AT treatment, the abundance of secreted proteins was increased, whereas that of cytoplasmic proteins decreased (Pearson's χ 2 test, P =0.000, P =0.000, respectively). Proteins involved in immunity and regulation were also more abundant (Pearson's χ 2 test, P =0.040, P =0.016, respectively), while components and proliferation-related proteins were downregulated (Pearson's χ 2 test, P =0.003, P =0.011, respectively). AC + AT treatment increased protein synthesis and secretion, and improved clinical symptoms. These results indicate that acupuncture may be a complimentary therapy for treating postmenopausal dry eye disease.

  20. The effects of menopausal health training for spouses on women's quality of life during menopause transitional period.

    Science.gov (United States)

    Bahri, Narjes; Yoshany, Nooshin; Morowatisharifabad, Mohammad Ali; Noghabi, Ali Delshad; Sajjadi, Moosa

    2016-02-01

    Spouses' support during menopausal transition has an important role for improving the quality of life in postmenopausal women. Since the first step in providing support is having adequate knowledge, this study aimed to investigate the effects of an educational program on menopause health for spouses on women's quality of life during the menopausal transition. This clinical trial was conducted in Yazd, Iran. A hundred healthy women aged 45 to 60 years were recruited by random sampling. The spouses in the intervention group (n = 50) attended three training sessions about the management and health of menopausal transition. The spouses in the control group (n = 50) did not receive any intervention. Knowledge and performance about menopausal health were assessed in all spouses before and 3 months after intervention. All women were assessed by the Menopause Rating Scale, and the Menopause Quality of Life questionnaire before and 3 months after educational intervention. Analyses were carried out using SPSS 16 software. The level of significance was set at P less than 0.05. The knowledge and performance of spouses in the intervention group were significantly higher 3 months after intervention (P women in the intervention group was higher 3 months after intervention (P training of menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.

  1. Age at menopause: imputing age at menopause for women with a hysterectomy with application to risk of postmenopausal breast cancer

    Science.gov (United States)

    Rosner, Bernard; Colditz, Graham A.

    2011-01-01

    Purpose Age at menopause, a major marker in the reproductive life, may bias results for evaluation of breast cancer risk after menopause. Methods We follow 38,948 premenopausal women in 1980 and identify 2,586 who reported hysterectomy without bilateral oophorectomy, and 31,626 who reported natural menopause during 22 years of follow-up. We evaluate risk factors for natural menopause, impute age at natural menopause for women reporting hysterectomy without bilateral oophorectomy and estimate the hazard of reaching natural menopause in the next 2 years. We apply this imputed age at menopause to both increase sample size and to evaluate the relation between postmenopausal exposures and risk of breast cancer. Results Age, cigarette smoking, age at menarche, pregnancy history, body mass index, history of benign breast disease, and history of breast cancer were each significantly related to age at natural menopause; duration of oral contraceptive use and family history of breast cancer were not. The imputation increased sample size substantially and although some risk factors after menopause were weaker in the expanded model (height, and alcohol use), use of hormone therapy is less biased. Conclusions Imputing age at menopause increases sample size, broadens generalizability making it applicable to women with hysterectomy, and reduces bias. PMID:21441037

  2. Prospective Safety Analysis and the Complex Aviation System

    Science.gov (United States)

    Smith, Brian E.

    2013-01-01

    Fatal accident rates in commercial passenger aviation are at historic lows yet have plateaued and are not showing evidence of further safety advances. Modern aircraft accidents reflect both historic causal factors and new unexpected "Black Swan" events. The ever-increasing complexity of the aviation system, along with its associated technology and organizational relationships, provides fertile ground for fresh problems. It is important to take a proactive approach to aviation safety by working to identify novel causation mechanisms for future aviation accidents before they happen. Progress has been made in using of historic data to identify the telltale signals preceding aviation accidents and incidents, using the large repositories of discrete and continuous data on aircraft and air traffic control performance and information reported by front-line personnel. Nevertheless, the aviation community is increasingly embracing predictive approaches to aviation safety. The "prospective workshop" early assessment tool described in this paper represents an approach toward this prospective mindset-one that attempts to identify the future vectors of aviation and asks the question: "What haven't we considered in our current safety assessments?" New causation mechanisms threatening aviation safety will arise in the future because new (or revised) systems and procedures will have to be used under future contextual conditions that have not been properly anticipated. Many simulation models exist for demonstrating the safety cases of new operational concepts and technologies. However the results from such models can only be as valid as the accuracy and completeness of assumptions made about the future context in which the new operational concepts and/or technologies will be immersed. Of course that future has not happened yet. What is needed is a reasonably high-confidence description of the future operational context, capturing critical contextual characteristics that modulate

  3. Sleep and menopause: a narrative review.

    Science.gov (United States)

    Shaver, Joan L; Woods, Nancy F

    2015-08-01

    Our overall aim-through a narrative review-is to critically profile key extant evidence of menopause-related sleep, mostly from studies published in the last decade. We searched the database PubMed using selected Medical Subject Headings for sleep and menopause (n = 588 articles). Using similar headings, we also searched the Cochrane Library (n = 1), Embase (n = 449), Cumulative Index to Nursing and Allied Health Literature (n = 163), Web of Science (n = 506), and PsycINFO (n = 58). Articles deemed most related to the purpose were reviewed. Results were articulated with interpretive comments according to evidence of sleep quality (self-reported) and sleep patterns (polysomnography and actigraphy) impact as related to reproductive aging and in the context of vasomotor symptoms (VMS; self-reported), vasomotor activity (VMA) events (recorded skin conductance), depressed mood, and ovarian hormones. Predominantly, the menopausal transition conveys poor sleep beyond anticipated age effects. Perceptions of sleep are not necessarily translatable from detectable physical sleep changes and are probably affected by an emotional overlay on symptoms reporting. Sleep quality and pattern changes are mostly manifest in wakefulness indicators, but sleep pattern changes are not striking. Likely contributing are VMS of sufficient frequency/severity and bothersomeness, probably with a sweating component. VMA events influence physical sleep fragmentation but not necessarily extensive sleep loss or sleep architecture changes. Lack of robust connections between perceived and recorded sleep (and VMA) could be influenced by inadequate detection. There is a need for studies of women in well-defined menopausal transition stages who have no sleep problems, accounting for sleep-related disorders, mood, and other symptoms, with attention to VMS dimensions, distribution of VMS during night and day, and advanced measurement of symptoms and physiologic manifestations.

  4. Sleep disturbance associated factors in menopausal women

    Directory of Open Access Journals (Sweden)

    Hamid Haghani

    2011-09-01

    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.

  5. Menopause and cardiovascular disease: the evidence.

    Science.gov (United States)

    Rosano, G M C; Vitale, C; Marazzi, G; Volterrani, M

    2007-02-01

    Menopause is a risk factor for cardiovascular disease (CVD) because estrogen withdrawal has a detrimental effect on cardiovascular function and metabolism. The menopause compounds many traditional CVD risk factors, including changes in body fat distribution from a gynoid to an android pattern, reduced glucose tolerance, abnormal plasma lipids, increased blood pressure, increased sympathetic tone, endothelial dysfunction and vascular inflammation. Many CVD risk factors have different impacts in men and women. In postmenopausal women, treatment of arterial hypertension and glucose intolerance should be priorities. Observational studies and randomized clinical trials suggest that hormone replacement therapy (HRT) started soon after the menopause may confer cardiovascular benefit. In contrast to other synthetic progestogens used in continuous combined HRTs, the unique progestogen drospirenone has antialdosterone properties. Drospirenone can therefore counteract the water- and sodium-retaining effects of the estrogen component of HRT via the renin-angiotensin-aldosterone system, which may otherwise result in weight gain and raised blood pressure. As a continuous combined HRT with 17beta-estradiol, drospirenone has been shown to significantly reduce blood pressure in postmenopausal women with elevated blood pressure, but not in normotensive women. Therefore, in addition to relieving climacteric symptoms, drospirenone/17beta-estradiol may offer further benefits in postmenopausal women, such as improved CVD risk profile.

  6. Placental methylome analysis from a prospective autism study.

    Science.gov (United States)

    Schroeder, Diane I; Schmidt, Rebecca J; Crary-Dooley, Florence K; Walker, Cheryl K; Ozonoff, Sally; Tancredi, Daniel J; Hertz-Picciotto, Irva; LaSalle, Janine M

    2016-01-01

    Autism spectrum disorders (ASD) are increasingly prevalent neurodevelopmental disorders that are behaviorally diagnosed in early childhood. Most ASD cases likely arise from a complex mixture of genetic and environmental factors, an interface where the epigenetic marks of DNA methylation may be useful as risk biomarkers. The placenta is a potentially useful surrogate tissue characterized by a methylation pattern of partially methylated domains (PMDs) and highly methylated domains (HMDs) reflective of methylation patterns observed in the early embryo. In this study, we investigated human term placentas from the MARBLES (Markers of Autism Risk in Babies: Learning Early Signs) prospective study by whole genome bisulfite sequencing. We also examined the utility of PMD/HMDs in detecting methylation differences consistent with ASD diagnosis at age three. We found that while human placental methylomes have highly reproducible PMD and HMD locations, there is a greater variation between individuals in methylation levels over PMDs than HMDs due to both sampling and individual variability. In a comparison of methylation differences in placental samples from 24 ASD and 23 typically developing (TD) children, a HMD containing a putative fetal brain enhancer near DLL1 was found to reach genome-wide significance and was validated for significantly higher methylation in ASD by pyrosequencing. These results suggest that the placenta could be an informative surrogate tissue for predictive ASD biomarkers in high-risk families.

  7. Antimicrobial usage in an intensive care unit: a prospective analysis.

    LENUS (Irish Health Repository)

    Conrick-Martin, I

    2012-01-31

    Antimicrobial therapies in the Intensive Care Unit (ICU) need to be appropriate in both their antimicrobial cover and duration. We performed a prospective observational study of admissions to our semi-closed ICU over a three-month period and recorded the indications for antimicrobial therapy, agents used, duration of use, changes in therapy and reasons for changes in therapy. A change in therapy was defined as the initiation or discontinuation of an antimicrobial agent. There were 51 patients admitted during the three-month study period and all received antimicrobial therapy. There were 135 changes in antimicrobial therapy. 89 (66%) were made by the ICU team and 32 (24%) were made by the primary team. Changes were made due to a deterioration or lack of clinical response in 41 (30%) cases, due to the completion of prescribed course in 36 (27%) cases, and in response to a sensitivity result in 25 (19%) cases. Prophylactic antibiotic courses (n=24) were of a duration greater than 24 hours in 15 (63%) instances. In conclusion, the majority of changes in antimicrobial therapy were not culture-based and the duration of surgical prophylaxis was in excess of current recommended guidelines.

  8. Prospects of Organic Farming in Bhutan: A SWOT Analysis

    Directory of Open Access Journals (Sweden)

    Sonam Tashi

    2016-01-01

    Full Text Available A study was conducted to investigate the prospects of organic agriculture (OA in Bhutan from the experts’ perspective, particularly the SWOT (strength, weakness, opportunity, and threat aspect. Thirty-five Bhutanese experts were interviewed. The strengths of OA were (i good alignment of the principles of OA with Bhutan’s development philosophy, (ii strong policy and political support, (iii pristine environment, (iv OA practices similar to traditional farming, and (v compatibility of OA with the local farming knowledge. The major weaknesses were (i a lack of awareness of the benefits of OA, (ii lack of incentives, (iii shortage of farm labor, (iv small and irregular supply of organic product, (v lack of clarity in policy, (vi limited plant protection materials, and (vii a lack of coordination between agencies. Opportunities were (i a huge regional and global organic market, (ii promoting healthy lifestyle, (iii sustainable use of resources, (iv lowering dependence on food and input imports, (v development of local organic manure suppliers, (vi creating seed sovereignty, (vii conserving local crops, (viii building soil fertility, (ix introducing premium price for organic products, and (x addressing unemployment. Threats included (i increasing incidences of pests and diseases, (ii decline in sources of organic manure, and (iii limited sources of organic manures and fertilizers.

  9. Prospective Analysis of Risk for Hypothyroidism after Hemithyroidectomy

    Directory of Open Access Journals (Sweden)

    Virgilijus Beisa

    2015-01-01

    Full Text Available Objectives. To evaluate risk factors and to develop a simple scoring system to grade the risk of postoperative hypothyroidism (PH. Methods. In a controlled prospective study, 109 patients, who underwent hemithyroidectomy for a benign thyroid disease, were followed up for 12 months. The relation between clinical data and PH was analyzed for significance. A risk scoring system based on significant risk factors and clinical implications was developed. Results. The significant risk factors of PH were higher TSH (thyroid-stimulating hormone level and lower ratio of the remaining thyroid weight to the patient’s weight (derived weight index. Based on the log of risk factor, preoperative TSH level greater than 1.4 mU/L was assigned 2 points; 1 point was for 0.8–1.4 mU/L. The derived weight index lower than 0.8 g/kg was assigned 1 point. A risk scoring system was calculated by summing the scores. The incidences of PH were 7.3%, 30.4%, and 69.2% according to the risk scores of 0-1, 2, and 3. Conclusion. Risk factors for PH are higher preoperative TSH level and lower derived weight index. Our developed risk scoring system is a valid and reliable tool to identify patients who are at risk for PH before surgery.

  10. Validity and reliability of menopause attitude assessment scale: a study in women aged 40-64 in Eskisehir-Mahmudiye

    Directory of Open Access Journals (Sweden)

    Tugce Koyuncu

    2015-12-01

    Full Text Available Background: According to studies, related to symptoms of menopause, women's attitudes about menopause is an effective variable on the frequency and severity of menopausal symptoms. The most common method to assess attitudes about menopause is the attitude scale. The main purpose of the study is to expose reliability and validity of and ldquo;menopause attitudes assessment scale and rdquo; developed for assessing attitudes of menopause on middle age women. Methods: This is a methodological study conducted 8-15 November 2013 on middle age women living in the district center of Mahmudiye. In the first of the two stage s of the study, items pool was generated and items were assessed by experts for content validity. In the second stages, exploratory factor analysis was performed for construct validity and Cronbach alpha (Cra was calculated for reliability analysis. Result: According to the factor analysis, items, whose factor loadings were less than 0.40, were removed from the scale. The remaining 13 items were classified into four factors. Four factors explain 61.82% of variance. Factors were named as positive emotional, negative emotional, family relationships, behavioral. For this scale, which is consists of 13 items, Cra is 0.744. Factors' Cra are between 0.682 to 0.828. Conclusion: According to the results of validity and reliability study, Menopause Attitude Assessment Scale, which is consists of 13 items and four subscales, was found to be suitable to measure middle-aged women's attitudes about menopau se. [TAF Prev Med Bull 2015; 14(6.000: 448-452

  11. EMAS recommendations for conditions in the workplace for menopausal women

    OpenAIRE

    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

    2016-01-01

    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 menopausal transition women report that fatigue and difficulties with memory and concentration can have a negative impact on their working lives. Furthermore, hot flushes can be a source of embarrassme...

  12. Oxidative stress of crystalline lens in rat menopausal model

    OpenAIRE

    Acer, Semra; Pekel, Gökhan; Küçükatay, Vural; Karabulut, Aysun; Yağcı, Ramazan; Çetin, Ebru Nevin; Akyer, Şahika Pınar; Şahin, Barbaros

    2016-01-01

    ABSTRACT Purpose: To evaluate lenticular oxidative stress in rat menopausal models. Methods: Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1). From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2), 10 were administered a daily injection of methylprednisolone until the end of the study (Gro...

  13. A review of effective herbal medicines in controlling menopausal symptoms

    Science.gov (United States)

    Kargozar, Rahele; Azizi, Hoda; Salari, Roshanak

    2017-01-01

    Background Acute menopausal syndrome especially hot flashes, is one of the most common gynecological problems during menopause. Due to the side effects of hormone therapy, herbal and complementary medicines are always of immense interest to people in the treatment and management of the symptoms and complications of menopause. Objective The aim of this study was to investigate the mechanisms and effects of medicinal plants employed in the treatment of menopausal symptoms. Methods This review article was carried out by examining clinical trial studies between the period of 1994 and 2016. The keywords, which include menopause, climacteric, hot flushes, flashes, herb and phytoestrogens were used to search for herbal medicines used in clinical trials for the treatment of menopausal symptoms using databases such as PubMed, Medline, Scopus, Google scholar, SID and Magiran. Results The results of the study showed that the medicinal plants, which include Sage herb (Salvia officinalis), Lemon balm (Melissa officinalis), Valerina officinalis, Black cohosh (Cimicifuga racemosa), Fenugreek (Trigonella foenum-graecum), Black cumin (Nigella sativa), Vitex (Vitex agnus-castus), Fennel (Foeniculum vulgare), Evening primrose (Oenothera biennis), Ginkgo biloba, Alfalfa (Medicago sativa), Hypericum perforatum, Panax ginseng, Pimpinella anisum, Licorice (Glycyrrhiza glabra), Passiflora incarnata, Red clover (Trifolium pratense), and Glycine soja were effective in the treatment of acute menopausal syndrome with different mechanisms. Conclusion Medicinal plants can play an imperative role in the treatment of acute menopausal syndrome; however, further studies are required to buttress their efficacy in the treatment of acute menopausal syndrome. PMID:29403626

  14. Empowerment and coping strategies in menopause women: a review.

    Science.gov (United States)

    Yazdkhasti, Mansoureh; Simbar, Masoumeh; Abdi, Fatemeh

    2015-03-01

    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.

  15. Parity and age at menopause in a Danish sample

    DEFF Research Database (Denmark)

    Jeune, B

    1986-01-01

    A random sample of 151 Danish women who had undergone natural menopause reported the age at which this occurred and answered a questionnaire. A significant association was found between parity and age at menopause after correction for the effects of age at the first and last births, weight, smoking...... 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...... and age at menopause....

  16. Psychiatric disorders and menopause symptoms in Brazilian women.

    Science.gov (United States)

    Barazzetti, Lidiane; Pattussi, Marcos Pascoal; Garcez, Anderson da Silva; Mendes, Karina Giane; Theodoro, Heloísa; Paniz, Vera Maria Vieira; Olinto, Maria Teresa Anselmo

    2016-04-01

    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.

  17. Menopausal Symptoms and Complementary Health Practices: What the Science Says

    Science.gov (United States)

    ... effects on the body. Mind and Body Practices Hypnotherapy and Mindfulness Meditation There is some evidence suggesting that clinical hypnotherapy and mindfulness meditation may help improve certain menopausal ...

  18. Discourses on menopause--Part I: Menopause described in texts addressed to Danish women 1996-2004

    DEFF Research Database (Denmark)

    Hvas, Lotte; Gannik, Dorte Effersøe

    2008-01-01

    To understand Danish women's very different ways of interpreting menopausal experiences and the way they construct meaning relating to menopause, it is necessary to include the context in which meaning is constructed as well as the background of cultural attitudes to menopause existing...... in the Danish society. Using documentary material, the aim of this article was to describe different discourses on menopause in Denmark that present themselves to menopausal women, and to discuss how these discourses may affect women's identity and constitute their scope of action. One hundred and thirty......-two pieces of text under the heading or subject of 'menopause' or 'becoming a middle-aged woman', published from 1996 to 2004, were included. All material was addressed to Danish women, and consisted of booklets and informational material, articles from newspapers and magazines and popular science books...

  19. Menopause as risk factor for oxidative stress.

    Science.gov (United States)

    Sánchez-Rodríguez, Martha A; Zacarías-Flores, Mariano; Arronte-Rosales, Alicia; Correa-Muñoz, Elsa; Mendoza-Núñez, Víctor Manuel

    2012-03-01

    The aim of this study was to determine the influence of menopause (hypoestrogenism) as a risk factor for oxidative stress. We carried out a cross-sectional study with 187 perimenopausal women from Mexico City, including 94 premenopausal (mean ± SD age, 44.9 ± 4.0 y; estrogen, 95.8 ± 65.7 pg/mL; follicle-stimulating hormone, 13.6 ± 16.9 mIU/mL) and 93 postmenopausal (mean ± SD age, 52.5 ± 3.3 y; estrogen, 12.8 ± 6.8 pg/mL; follicle-stimulating hormone, 51.4 ± 26.9 mIU/mL) women. We measured lipoperoxides using a thiobarbituric acid-reacting substance assay, erythrocyte superoxide dismutase and glutathione peroxidase activities, and the total antioxidant status with the Randox kit. An alternative cutoff value for lipoperoxide level of 0.320 μmol/L or higher was defined on the basis of the 90th percentile of young healthy participants. All women answered the Menopause Rating Scale, the Athens Insomnia Scale, and a structured questionnaire about pro-oxidant factors, that is, smoking, consumption of caffeinated and alcoholic beverages, and physical activity. Finally, we measured weight and height and calculated body mass index. The lipoperoxide levels were significantly higher in the postmenopausal group than in the premenopausal group (0.357 ± 0.05 vs 0.331 ± 0.05 μmol/L, P = 0.001). Using logistic regression to control pro-oxidant variables, we found that menopause was the main risk factor for oxidative stress (odds ratio, 2.62; 95% CI, 1.35-5.11; P menopause rating score, insomnia score, and lipoperoxides, and this relationship was most evident in the postmenopausal group (menopause scale, r = 0.327 [P = 0.001]; insomnia scale, r = 0.209 [P < 0.05]). Our findings suggest that the depletion of estrogen in postmenopause could cause oxidative stress in addition to the known symptoms.

  20. [Phytoestrogens in the treatment of menopause].

    Science.gov (United States)

    Remport, Júlia; Blázovics, Anna

    2017-08-01

    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

  1. Analysis and prospects of the green certificates market

    International Nuclear Information System (INIS)

    Allegri, S.; Zorzoli, G.B.

    2000-01-01

    This paper presents an analysis on the possible development of electric energy production from renewable sources in Italy, in relation to financial incentives provided by Bersani Decree. The value of green certificates has been analysed and determined [it

  2. Migraine in the post-menopausal period is associated with higher levels of mood disorders, disability, and more menopausal symptoms

    OpenAIRE

    Carturan, Paula; Scorcine, Claudio; Fragoso, Yara Dadalti

    2016-01-01

    ABSTRACT Objective To assess the prevalence of headache in post-menopausal women. Methods Women attending gynecology outpatient services in the coastal region of the state of Sao Paulo, Brazil were invited to participate in this study. 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. Results...

  3. Towards ICF implementation in menopause healthcare: a systematic review of ICF application in Switzerland.

    Science.gov (United States)

    Zangger, Martina; Poethig, Dagmar; Meissner, Florian; von Wolff, Michael; Stute, Petra

    2017-12-28

    To present a systematic literature review on the application and degree of implementation of the International Classification of Functioning, Disability and Health (ICF) across different health conditions and regions in Switzerland in order to develop an ICF classification of the climacteric syndrome in the medium term. A systematic literature search was conducted through Embase and Medline covering the period between 2011 and August 2016. Inclusion criteria were the term ICF in title or abstract and Switzerland as the workplace of the first author. Identified publications were analysed as descriptive statistics. A total of 83 articles were included in the analysis. Forty-seven different first authors from 24 different institutions were identified. The majority of publications were from Swiss Paraplegic Research (68.7%) and focused on neurology (31.3%). Forty-six cohort studies were identified. In most of them, the ICF was used to set up a general language for comparing patients' information (82.9%). Only one paper from the medical specialty gynaecology was identified; this was on breast cancer. No paper on the menopause was found. In Switzerland, the ICF is actively used in various areas of healthcare, especially in the field of neurology and rehabilitation. There is a need for ICF core sets in other medical fields, such as menopause healthcare, in order to accomplish the goal of the European Menopause and Andropause Society, which is a healthcare model for healthy menopause and aging.

  4. Assessment of sleep quality and correlates in a large cohort of Colombian women around menopause.

    Science.gov (United States)

    Monterrosa-Castro, Alvaro; Marrugo-Flórez, Martha; Romero-Pérez, Ivette; Fernández-Alonso, Ana M; Chedraui, Peter; Pérez-López, Faustino R

    2013-04-01

    The aim of this study was to determine the relationship between self-reported sleep quality, menopausal symptom intensity, and correlates (including ethnicity) among middle-aged women. The present cross-sectional study involved 1,078 Colombian women aged 40 to 59 years who completed the Pittsburgh Sleep Quality Index (PSQI), the Menopause Rating Scale (MRS), and a general questionnaire exploring sociodemographic data. The median [interquartile range] age of the whole sample was 49.0 [9.0] years. Among the participants, 45.4% were postmenopausal, 57.2% had increased body mass index values, 13.9% were black, 20.7% had hypertension, 74.1% had a stable partner, and 3.8% used hormone therapy. The prevalence of poor sleep quality was 57.1% (PSQI global score ≥5). Significant correlations between PSQI global scores and MRS total and subscale scores were found. Multiple linear regression analysis found that higher PSQI scores (poorer quality of sleep) correlated with higher MRS psychological and somatic subscale scores (more severe symptoms), smoking habit, and hypertension. Menopause status and black ethnicity were excluded from the final regression model. Despite study limitations, poor sleep quality is highly prevalent in this large middle-aged Colombian female sample and is related to menopausal symptom severity, tobacco use, and presence of hypertension.

  5. Influence of the menopause in the sexual standard: opinion of women

    Directory of Open Access Journals (Sweden)

    Rosália Teixeira de Araújo

    2007-01-01

    Full Text Available In this study we objectify: to inquire the physiological modifications of the menopause that influence the sexual standard of the woman; to know if the frequency of the sexual activity changed the menopause after and to investigate the factors aggravations or extenuating circumstances in the sexual life during this phase. One is about a study of quanti-qualitative nature, had as scene the Center of Health Almerinda Lomanto, having as informing 16 women. The data had been collected using the form. The data had been submitted to the Technique of Analysis of Content of Bardin, of where categories and subcategorias had emerged: Changes observed in the sexual relationship after the menopause (Reduction of the libido, Incompreensão of the friend, did not have alteration, positive Change; Reasons that had favored the changes (physiological Alterations in the sexual act, menorragia Chronic headache nauseas fogacho/, Lack or psychological reduction of the pleasure, Alterations. We conclude that during the climatério and after the menopause, can occur physiological modifications that influence the standard of the sexual act, fits professional we while of health, to search to promote attitudes and behaviors that aim at the disruption of myths and taboos and the promotion of the sexual health.

  6. Comparison of myocardial function between post-menopausal and pre-menopausal women: evaluation by gated myocardial SPECT

    International Nuclear Information System (INIS)

    Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki

    2005-01-01

    In addition to inhibiting coronary atherosclerosis, estrogen is expected to have protective effects on cardiac myocytes. We investigated the difference in myocardial functional parameters evaluated by gated myocardial SPECT after adenosine-stress between post-menopausal and pre-menopausal healthy women. This study included 22 healthy post-menopausal women (mean age: 53.0 yr) and 20 pre-menopausal women (mean age: 43.0 yr) who performed Tc-99m tetrofosmin gated myocardial SPECT after adenosine-stress. Measured hemodynamic parameters, EDV, ESV, stroke volume, EF, cardiac output and cardiac index were compared between the two groups. For comparison, similar-aged two male groups with matched numbers were also studied. There was no significant difference in hemodynamic parameters. EDV, ESV, stroke volume, EF, or cardiac output between the post-menopausal and pre-menopausal women. However, post-menopausal women have a smaller cardiac index (mean: 1.95 L/min/m2 vs 2.20 L/min/m2; p=0.045) and adenosine-induced HR increase (mean : 80.5/min vs 89.7/min ; p=0.03), compared to the pre-menopausal women. On the contrary, the two male groups of the same age range and numbers with the women groups showed no significant difference in any myocardial parameters. These results suggest that menopause may be correlated with reduced increase in cardiac index and HR increase after adenosine-stress

  7. Comparison of myocardial function between post-menopausal and pre-menopausal women: evaluation by gated myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki [Gachon Medical School, Gil Hospital, Incheon (Korea, Republic of)

    2005-07-01

    In addition to inhibiting coronary atherosclerosis, estrogen is expected to have protective effects on cardiac myocytes. We investigated the difference in myocardial functional parameters evaluated by gated myocardial SPECT after adenosine-stress between post-menopausal and pre-menopausal healthy women. This study included 22 healthy post-menopausal women (mean age: 53.0 yr) and 20 pre-menopausal women (mean age: 43.0 yr) who performed Tc-99m tetrofosmin gated myocardial SPECT after adenosine-stress. Measured hemodynamic parameters, EDV, ESV, stroke volume, EF, cardiac output and cardiac index were compared between the two groups. For comparison, similar-aged two male groups with matched numbers were also studied. There was no significant difference in hemodynamic parameters. EDV, ESV, stroke volume, EF, or cardiac output between the post-menopausal and pre-menopausal women. However, post-menopausal women have a smaller cardiac index (mean: 1.95 L/min/m2 vs 2.20 L/min/m2; p=0.045) and adenosine-induced HR increase (mean : 80.5/min vs 89.7/min ; p=0.03), compared to the pre-menopausal women. On the contrary, the two male groups of the same age range and numbers with the women groups showed no significant difference in any myocardial parameters. These results suggest that menopause may be correlated with reduced increase in cardiac index and HR increase after adenosine-stress.

  8. Analysis Of Japans Economy Based On 2014 From Macroeconomics Prospects

    Directory of Open Access Journals (Sweden)

    Dr Mohammad Rafiqul Islam

    2015-02-01

    Full Text Available Abstract Japan is the worlds third largest economy. But currently economic situations of Japan are not stable. It is not increasing as expected. Since 2013 it was world second largest economy but Japan loosed its placed to China in 2014 due to slow growth of important economic indicators. By using the basic Keynesian model we will provide a detailed analysis of the short and long run impacts of the changes for Japans real GDP rate of unemployment and inflation rate. We demonstrated a detailed use of the 45-degree diagram or the AD-IA model and other economic analysis of the macroeconomic principles that underlie the model and concepts. Finally we will recommend the government with a change in fiscal policy what based on the analysis by considering what might be achieved with a fiscal policy response and the extent to which any impact on the stock of public debt might be a consideration

  9. Direct renin inhibitors – new approaches in the treatment of patients with arterial hypertension associated with obesity, diabetes mellitus, menopause and kidneys’ disorders

    OpenAIRE

    Syvolap, V. V.; Gerasko, M. P.

    2013-01-01

    In this review composed on the data of multicentred randomized investigations the advantages of direct renin inhibitors for patients with arterial hypertension are discussed. The prospects of using direct renin inhibitors in the cases of arterial hypertension associated with obesity, diabetes mellitus, menopause and kidneys’ disorders are studied.

  10. Prospects for accelerator neutron sources for large volume minerals analysis

    International Nuclear Information System (INIS)

    Clayton, C.G.; Spackman, R.

    1988-01-01

    The electron Linac can be regarded as a practical source of thermal neutrons for activation analysis of large volume mineral samples. With a suitable target and moderator, a neutron flux of about 10 10 n/cm/s over 2-3 kg of rock can be generated. The proton Linac gives the possibility of a high neutron yield (> 10 12 n/s) of fast neutrons at selected energies. For the electron Linac, targets of W-U and W-Be are discussed. The advantages and limitations of the system are demonstrated for the analysis of gold in rocks and ores and for platinum in chromitite. These elements were selected as they are most likely to justify an accelerator installation at the present time. Errors due to self shielding in gold particles for thermal neutrons are discussed. The proton Linac is considered for neutrons generated from a lithium target through the 7 Li(p, n) 7 Be reaction. The analysis of gold by fast neutron activation is considered. This approach avoids particle self-absorption and, by appropriate proton energy selection, avoids potentially dominating interfering reactions. The analysis of 235 U in the presence of 238 U and 232 Th is also considered. (author)

  11. Efficiency aspects of design and analysis of prospective cohort studies on diet, nutrition and cancer

    NARCIS (Netherlands)

    Kaaks, R.J.

    1994-01-01

    This thesis presents and analyzes methodological approaches to improve the design and analysis of prospective cohort studies on the relations between diet, nutritional status and cancer. The first chapters discuss methods to optimize the measurement of the individuals' habitual dietary

  12. A New Method of Measuring Online Media Advertising Effectiveness: Prospective Meta-Analysis in Marketing

    NARCIS (Netherlands)

    G. Liberali (Gui); G.L. Urban (Glen); B.G.C. Dellaert (Benedict); C. Tucker (Catherine); Y. Bart (Yakov); S. Stremersch (Stefan)

    2016-01-01

    textabstractThe authors introduce a new method, prospective meta-analysis in marketing (PMM), to estimate consumer response to online advertising on a large and adaptive scale. They illustrate their approach in a field study in the U.S., China and the Netherlands, covering equivalent ad content on

  13. Model-based human reliability analysis: prospects and requirements

    International Nuclear Information System (INIS)

    Mosleh, A.; Chang, Y.H.

    2004-01-01

    Major limitations of the conventional methods for human reliability analysis (HRA), particularly those developed for operator response analysis in probabilistic safety assessments (PSA) of nuclear power plants, are summarized as a motivation for the need and a basis for developing requirements for the next generation HRA methods. It is argued that a model-based approach that provides explicit cognitive causal links between operator behaviors and directly or indirectly measurable causal factors should be at the core of the advanced methods. An example of such causal model is briefly reviewed, where due to the model complexity and input requirements can only be currently implemented in a dynamic PSA environment. The computer simulation code developed for this purpose is also described briefly, together with current limitations in the models, data, and the computer implementation

  14. Symptomatic menopausal transition and subsequent bipolar disorder among midlife women with major depression: a nationwide longitudinal study.

    Science.gov (United States)

    Chen, Li-Chi; Yang, Albert C; Su, Tung-Ping; Bai, Ya-Mei; Li, Cheng-Ta; Chang, Wen-Han; Chen, Tzeng-Ji; Tsai, Shih-Jen; Chen, Mu-Hong

    2017-06-01

    Previous studies suggested that menopausal transition played an important role in the clinical course of major depression and bipolar disorder. However, the role of symptomatic menopausal transition in diagnostic conversion from major depression to bipolar disorder was still unknown. Using the Taiwan National Health Insurance Research Database, 50,273 midlife women aged between 40 and 60 years in 2002∼2008 with major depression were enrolled in our study and divided into two subgroups based on the presence (n = 21,120) or absence (n = 29,153) of symptomatic menopausal transition. Subjects who had subsequent bipolar disorder during the follow-up were identified. Midlife women with major depression and symptomatic menopausal transition had a higher incidence of the diagnostic conversion to bipolar disorder (7.3 vs. 6.6%, p = 0.003) than those with major depression alone. Cox regression analysis after adjusting for demographic data and psychiatric comorbidities further showed that symptomatic menopausal transition was associated with an increased risk of developing bipolar disorder (HR 1.14, 95% CI 1.07∼1.23) among midlife women with major depression. Sensitivity test after excluding the 1-year and 3-year observation exhibited the consistent findings (HR 1.18, 95% CI 1.09∼1.28; HR 1.20, 95% CI 1.08∼1.34). Midlife women with the dual diagnoses of major depression and symptomatic menopausal transition had an increased risk of the diagnostic conversion to bipolar disorder compared to those with major depression alone. Further studies may be required to investigate the underlying mechanisms among menopausal transition and the diagnostic conversion from major depression to bipolar disorder.

  15. Transparent meta-analysis: does aging spare prospective memory with focal vs. non-focal cues?

    Directory of Open Access Journals (Sweden)

    Bob Uttl

    Full Text Available BACKGROUND: Prospective memory (ProM is the ability to become aware of a previously-formed plan at the right time and place. For over twenty years, researchers have been debating whether prospective memory declines with aging or whether it is spared by aging and, most recently, whether aging spares prospective memory with focal vs. non-focal cues. Two recent meta-analyses examining these claims did not include all relevant studies and ignored prevalent ceiling effects, age confounds, and did not distinguish between prospective memory subdomains (e.g., ProM proper, vigilance, habitual ProM (see Uttl, 2008, PLoS ONE. The present meta-analysis focuses on the following questions: Does prospective memory decline with aging? Does prospective memory with focal vs. non-focal cues decline with aging? Does the size of age-related declines with focal vs. non-focal cues vary across ProM subdomains? And are age-related declines in ProM smaller than age-related declines in retrospective memory? METHODS AND FINDINGS: A meta-analysis of event-cued ProM using data visualization and modeling, robust count methods, and conventional meta-analysis techniques revealed that first, the size of age-related declines in ProM with both focal and non-focal cues are large. Second, age-related declines in ProM with focal cues are larger in ProM proper and smaller in vigilance. Third, age-related declines in ProM proper with focal cues are as large as age-related declines in recall measures of retrospective memory. CONCLUSIONS: The results are consistent with Craik's (1983 proposal that age-related declines on ProM tasks are generally large, support the distinction between ProM proper vs. vigilance, and directly contradict widespread claims that ProM, with or without focal cues, is spared by aging.

  16. Female reproductive factors, menopausal hormone use, and Parkinson’s disease

    Science.gov (United States)

    Liu, Rui; Baird, Donna; Park, Yikyung; Freedman, Neal D.; Huang, Xuemei; Hollenbeck, Albert; Blair, Aaron; Chen, Honglei

    2014-01-01

    Objective To examine the associations of reproductive factors and exogenous hormone use with risk of Parkinson’s disease (PD) among postmenopausal women. Methods The study comprised 119,166 postmenopausal women ages 50–71 years in the NIH-AARP Diet and Health Study, who completed a baseline questionnaire in 1995–1996 and a follow-up survey in 2004–2006. A total of 410 self-reported PD diagnoses were identified between 1995 and 2006. Multivariate odds ratios (OR) and 95% confidence intervals (CI) were derived from logistic regression models. Results PD risk was not significantly associated with female reproductive factors including age at menarche, age at first live birth, parity, and age at menopause. For example, compared with women with natural menopause at ages 50–54 years, the ORs were 1.18, (95% CI 0.78–1.79) for women with natural menopause at ages <45, 1.19 (0.88–1.61) for ages 45–49, and 1.33 (0.91–1.93) for ages 55 or later. We found that oral contraceptive use for ≥10 years (vs. never use) was associated with lower PD risk (OR=0.59; 0.38–0.92) but shorter use showed no association. Use of menopausal hormone therapy showed inconsistent results. Compared with non-hormone users at baseline, current hormone users of <5 years showed a higher risk of PD (OR=1.52; 1.11–2.08). However, no associations were observed for past hormone users or current users of ≥5 years. Conclusions Overall, this large prospective study provides little support for an association between female reproductive factors and PD risk. Our findings on long-term oral contraceptive use and current hormone therapy warrant further investigations. PMID:24352877

  17. Menopause and menopausal hormone therapy in women: cardiovascular benefits and risks

    Directory of Open Access Journals (Sweden)

    Anna Svatikova

    2018-01-01

    Full Text Available The last decade has brought many challenges and uncertainties regarding the use of menopausal hormone therapy in women. Two early key studies, the Heart and Estrogen/Progestin Replacement Study (HERS and the Women's Health Initiative (WHI failed to prove beneficial effects of exogenous estrogen, and estrogen combined with progestin, in cardiovascular prevention. More recent studies, however, introduced the concept of a possible “window-of-opportunity” for hormonal therapy, in which menopausal hormone therapy is used early after the onset of menopause, and may lead to more favorable, cardio-protective outcomes. Despite the increasing wealth of clinical data, menopausal hormone therapy is not currently recommended for primary or secondary prevention of coronary heart disease in women. Further research is needed to understand the risk-benefit balance of menopausal hormone therapy. Resumen: La última década ha traído muchos retos e incertidumbres respecto al uso de la terapia hormonal en la menopausia en mujeres. Dos estudios tempranos clave, el Heart and Estrogen/Progestin Replacement Study (HERS [Estudio del Corazón y Reemplazo de Estrógeno/Progestina] y la Womeńs Health Initiative (WHI [Iniciativa de Salud de la Mujer] no pudieron demostrar los efectos benéficos del estrógeno exógeno y el estrógeno combinado con la progestina, en la prevención cardiovascular. Sin embargo, estudios más recientes han introducido el concepto de una posible “ventana de oportunidad” para la terapia hormonal, en donde la terapia hormonal en la menopausia se emplea tempranamente luego del inicio de la menopausia, y que puede llevar a resultados más favorables y cardioprotectores. A pesar de la creciente riqueza en datos clínicos, en la actualidad no se recomienda la terapia hormonal en la menopausia para la prevención primaria o secundaria de la enfermedad coronaria en mujeres. Se requiere m

  18. Assessment of Prospective Physician Characteristics by SWOT Analysis.

    Science.gov (United States)

    Thira, Woratanarat; Patarawan, Woratanarat

    2012-01-01

    Thailand is one of the developing countries encountering medical workforce shortage. From the national registry in 2006, there were 33 166 physicians: 41.5% worked in the government sector, 21.6% worked in the private sector, and the remaining worked in non-medical fields. There is no current data to confirm the effectiveness of the national policy to increase physician production. We demonstrate our findings from the strength, weakness, opportunity, and threat (SWOT) analysis in medical students and the potential impact on national workforce planning. We introduced SWOT analysis to 568 medical students during the 2008-2010 academic years, with the objective of becoming "a good physician in the future". Pertinent issues were grouped into 4 categories: not wanting to be a doctor, having inadequate medical professional skills, not wanting to work in rural or community areas, and planning to pursue training in specialties with high salary/low workload/low risk for lawsuit. The percentages of medical students who described themselves as "do not want to be a doctor" and "do not want to work in rural or community areas" increased from 7.07% and 25.00% in 2008 to 12.56% and 29.65% in 2010, respectively. Further intervention should be considered in order to change the medical students attitudes on the profession and their impact on Thai health system.

  19. Perception and experience of menopause among primary school ...

    African Journals Online (AJOL)

    Objective: The objective of this study was to determine the perception and experience of menopause among a group of educated Nigerian career women, and how menopausal symptoms affect their family relationship and work performance. Method: This was a cross sectional study.Two hundred and twenty five post ...

  20. Heritability of menopausal age in mothers and daughters

    NARCIS (Netherlands)

    van Asselt, Kristel M.; Kok, Helen S.; Pearson, Peter L.; Dubas, Judith S.; Peeters, Petra H. M.; te Velde, Egbert R.; van Noord, Paulus A. H.

    2004-01-01

    Objective: To determine the heritability of age at natural menopause from mother-daughter pairs. Design: Two-generation families were selected to study heritability of menopausal age. Setting: Subjects were drawn from a population-based study. Patient(s): One hundred sixty-four mother-daughter pairs

  1. EMAS recommendations for conditions in the workplace for menopausal women

    NARCIS (Netherlands)

    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

    2016-01-01

    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

  2. Longitudinal changes in abdominal fat distribution with menopause.

    Science.gov (United States)

    Franklin, Ruth M; Ploutz-Snyder, Lori; Kanaley, Jill A

    2009-03-01

    Increases in abdominal fat have been reported with menopause, but the impact of menopause on abdominal fat distribution (visceral vs subcutaneous) is still unclear. The objective of the study was to determine if abdominal fat content (volume) or distribution is altered with menopause. Magnetic resonance imaging was used to quantify total abdominal, subcutaneous, and visceral fat in 8 healthy women, both in the premenopausal state and 8 years later in the postmenopausal state. Physical activity (PA) and blood lipids were also measured. Body weight and waist circumference did not change with menopause (pre- vs postmenopause: body weight, 63.2 +/- 3.1 vs 63.9 +/- 2.5 kg; waist circumference, 92.1 +/- 4.6 vs 93.4 +/- 3.7 cm); however, total abdominal fat, subcutaneous fat, and visceral fat all significantly (P fat distribution was not significantly different after menopause (pre- vs postmenopause: subcutaneous, 73% +/- 3% vs 71% +/- 3%; visceral, 26% +/- 3% vs 28% +/- 3%). Lean mass, fat mass, and PA, along with total cholesterol and triglyceride levels, did not change with menopause. High-density lipoprotein and low-density lipoprotein both increased (P abdominal fat content increased with menopause despite no change in PA, body weight, or waist circumference; however, menopause did not affect the relative abdominal fat distribution in these women.

  3. A Comparative study on sexual dysfunctions before and after menopause

    Science.gov (United States)

    Beigi, Marjan; Fahami, Fariba

    2012-01-01

    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

  4. The Use Of Alternative Methods In Reducing Menopausal ...

    African Journals Online (AJOL)

    Background: Millions of women experience menopause every year, therefore the aim of this study is to determine the rates of application of alternative methods applied by women in order to reduce their complaints caused by menopause and alternative application methods. Materials and Methods: This study was carried ...

  5. A pastoral evaluation of menopause in the African context | Baloyi ...

    African Journals Online (AJOL)

    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 ...

  6. Starting Hormone Therapy at Menopause Increases Breast Cancer Risk

    Science.gov (United States)

    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.

  7. Inhibin A and B as markers of menopause

    DEFF Research Database (Denmark)

    Overlie, Inger; Mørkrid, Lars; Andersson, Anna-Maria

    2005-01-01

    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...

  8. Assessing menopausal status in women aged 40 - 49 using depot ...

    African Journals Online (AJOL)

    Background. Determining symptoms of menopause in older users of hormonal injectable contraceptives may be challenging, owing to method-induced amenorrhoea, suppression of follicle-stimulating hormone (FSH) and vasomotor symptoms. Objective. To investigate menopausal symptoms in women aged 40 - 49 using ...

  9. Pectin: cell biology and prospects for functional analysis.

    Science.gov (United States)

    Willats, W G; McCartney, L; Mackie, W; Knox, J P

    2001-09-01

    Pectin is a major component of primary cell walls of all land plants and encompasses a range of galacturonic acid-rich polysaccharides. Three major pectic polysaccharides (homogalacturonan, rhamnogalacturonan-I and rhamnogalacturonan-II) are thought to occur in all primary cell walls. This review surveys what is known about the structure and function of these pectin domains. The high degree of structural complexity and heterogeneity of the pectic matrix is produced both during biosynthesis in the endomembrane system and as a result of the action of an array of wall-based pectin-modifying enzymes. Recent developments in analytical techniques and in the generation of anti-pectin probes have begun to place the structural complexity of pectin in cell biological and developmental contexts. The in muro de-methyl-esterification of homogalacturonan by pectin methyl esterases is emerging as a key process for the local modulation of matrix properties. Rhamnogalacturonan-I comprises a highly diverse population of spatially and developmentally regulated polymers, whereas rhamnogalacturonan-II appears to be a highly conserved and stable pectic domain. Current knowledge of biosynthetic enzymes, plant and microbial pectinases and the interactions of pectin with other cell wall components and the impact of molecular genetic approaches are reviewed in terms of the functional analysis of pectic polysaccharides in plant growth and development.

  10. Menopause and myocardial infarction risk among employed women in relation to work and family psychosocial factors in Lithuania.

    Science.gov (United States)

    Malinauskiene, Vilija; Tamosiunas, Abdonas

    2010-05-01

    To assess the relationship between menopause and age at menopause and the risk of the first non-fatal myocardial infarction taking into account the possible influence of psychosocial job characteristics, marital stress, level of social support, educational level, occupation, age and traditional ischemic heart disease risk factors. Population-based case-control study among 35-61 years old employed women in Kaunas, Lithuania. Totally 122 myocardial infarction cases and 371 controls were interviewed in 2001-2004. The logistic regression analysis was performed. Younger age at menopause (women was 1.15; 95% CI 0.48-2.75. The association between low job control and myocardial infarction showed step increase, women in the lowest quartile of job control had the highest myocardial infarction risk (OR=4.51; 95% CI 1.90-10.75), while those in the second and third quartiles showed modest risk. Marital stress was an independent myocardial infarction risk factor for employed women (adjusted OR=2.36; 95% CI 1.07-5.19). Menopausal status and younger age at menopause showed only a tendency for increase in myocardial infarction risk among the employed women in Kaunas, Lithuania. Adverse psychosocial job characteristics as low job control, as well as marital stress play more important role in the development of the first myocardial infarction. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  11. An approach to prospective consequential life cycle assessment and net energy analysis of distributed electricity generation

    International Nuclear Information System (INIS)

    Jones, Christopher; Gilbert, Paul; Raugei, Marco; Mander, Sarah; Leccisi, Enrica

    2017-01-01

    Increasing distributed renewable electricity generation is one of a number of technology pathways available to policy makers to meet environmental and other sustainability goals. Determining the efficacy of such a pathway for a national electricity system implies evaluating whole system change in future scenarios. Life cycle assessment (LCA) and net energy analysis (NEA) are two methodologies suitable for prospective and consequential analysis of energy performance and associated impacts. This paper discusses the benefits and limitations of prospective and consequential LCA and NEA analysis of distributed generation. It concludes that a combined LCA and NEA approach is a valuable tool for decision makers if a number of recommendations are addressed. Static and dynamic temporal allocation are both needed for a fair comparison of distributed renewables with thermal power stations to account for their different impact profiles over time. The trade-offs between comprehensiveness and uncertainty in consequential analysis should be acknowledged, with system boundary expansion and system simulation models limited to those clearly justified by the research goal. The results of this approach are explorative, rather than for accounting purposes; this interpretive remit, and the assumptions in scenarios and system models on which results are contingent, must be clear to end users. - Highlights: • A common LCA and NEA framework for prospective, consequential analysis is discussed. • Approach to combined LCA and NEA of distributed generation scenarios is proposed. • Static and dynamic temporal allocation needed to assess distributed generation uptake.

  12. Fruits, vegetables and breast cancer risk: a systematic review and meta-analysis of prospective studies.

    Science.gov (United States)

    Aune, D; Chan, D S M; Vieira, A R; Rosenblatt, D A Navarro; Vieira, R; Greenwood, D C; Norat, T

    2012-07-01

    Evidence for an association between fruit and vegetable intake and breast cancer risk is inconclusive. To clarify the association, we conducted a systematic review and meta-analysis of the evidence from prospective studies. We searched PubMed for prospective studies of fruit and vegetable intake and breast cancer risk until April 30, 2011. We included fifteen prospective studies that reported relative risk estimates and 95 % confidence intervals (CIs) of breast cancer associated with fruit and vegetable intake. Random effects models were used to estimate summary relative risks. The summary relative risk (RR) for the highest versus the lowest intake was 0.89 (95 % CI: 0.80-0.99, I (2) = 0 %) for fruits and vegetables combined, 0.92 (95 % CI: 0.86-0.98, I (2) = 9 %) for fruits, and 0.99 (95 % CI: 0.92-1.06, I (2) = 20 %) for vegetables. In dose-response analyses, the summary RR per 200 g/day was 0.96 (95 % CI: 0.93-1.00, I (2) = 2 %) for fruits and vegetables combined, 0.94 (95 % CI: 0.89-1.00, I (2) = 39 %) for fruits, and 1.00 (95 % CI: 0.95-1.06, I (2) = 17 %) for vegetables. In this meta-analysis of prospective studies, high intake of fruits, and fruits and vegetables combined, but not vegetables, is associated with a weak reduction in risk of breast cancer.

  13. [Menopause and ultrasonographic measurements of calcaneus].

    Science.gov (United States)

    López-Caudana, Alma Ethelia; Castillo-Calderón, María Griselda; Ávila-Jiménez, Laura

    2014-01-01

    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.

  14. Deconstructing the genitourinary syndrome of menopause.

    Science.gov (United States)

    Vieira-Baptista, Pedro; Marchitelli, Claudia; Haefner, Hope K; Donders, Gilbert; Pérez-López, Faustino

    2017-05-01

    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.

  15. Menopausal status dependence of the timing of breast cancer recurrence after surgical removal of the primary tumour

    International Nuclear Information System (INIS)

    Demicheli, Romano; Bonadonna, Gianni; Hrushesky, William JM; Retsky, Michael W; Valagussa, Pinuccia

    2004-01-01

    Information on the metastasis process in breast cancer patients undergoing primary tumour removal may be extracted from an analysis of the timing of clinical recurrence. The hazard rate for local-regional and/or distant recurrence as the first event during the first 4 years after surgery was studied in 1173 patients undergoing mastectomy alone as primary treatment for operable breast cancer. Subset analyses were performed according to tumour size, axillary nodal status and menopausal status. A sharp two-peaked hazard function was observed for node-positive pre-menopausal patients, whereas results from node-positive post-menopausal women always displayed a single broad peak. The first narrow peak among pre-menopausal women showed a very steep rise to a maximum about 8–10 months after mastectomy. The second peak was considerably broader, reaching its maximum at 28–30 months. Post-menopausal patients displayed a wide, nearly symmetrical peak with maximum risk at about 18–20 months. Peaks displayed increasing height with increasing axillary lymph node involvement. No multi-peaked pattern was evident for either pre-menopausal or post-menopausal node-negative patients; however, this finding should be considered cautiously because of the limited number of events. Tumour size influenced recurrence risk but not its timing. Findings resulting from the different subsets of patients were remarkably coherent and each observed peak maintained the same position on the time axis in all analysed subsets. The risk of early recurrence for node positive patients is dependent on menopausal status. The amount of axillary nodal involvement and the tumour size modulate the risk value at any given time. For pre-menopausal node-positive patients, the abrupt increase of the first narrow peak of the recurrence risk suggests a triggering event that synchronises early risk. We suggest that this event is the surgical removal of the primary tumour. The later, broader, more symmetrical risk

  16. Development of A Mouse Model of Menopausal Ovarian Cancer

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    Elizabeth R. Smith

    2014-02-01

    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.

  17. Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis.

    Science.gov (United States)

    Larsson, Susanna C; Åkesson, Agneta; Gigante, Bruna; Wolk, Alicja

    2016-07-01

    To examine whether chocolate consumption is associated with a reduced risk of ischaemic heart disease, we used data from a prospective study of Swedish adults and we performed a meta-analysis of available prospective data. The Swedish prospective study included 67 640 women and men from the Cohort of Swedish Men and the Swedish Mammography Cohort who had completed a food-frequency questionnaire and were free of cardiovascular disease at baseline. Myocardial infarction (MI) cases were ascertained through linkage with the Swedish National Patient and Cause of Death Registers. PubMed and EMBASE databases were searched from inception until 4 February 2016 to identify prospective studies on chocolate consumption and risk of ischaemic heart disease. The results from eligible studies were combined using a random-effects model. During follow-up (1998-2010), 4417 MI cases were ascertained in the Swedish study. Chocolate consumption was inversely associated with MI risk. Compared with non-consumers, the multivariable relative risk for those who consumed ≥3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for trend =0.04). Five prospective studies on chocolate consumption and ischaemic heart disease were identified. Together with the Swedish study, the meta-analysis included six studies with a total of 6851 ischaemic heart disease cases. The overall relative risk for the highest versus lowest category of chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity among studies (I(2)=24.3%). Chocolate consumption is associated with lower risk of MI and ischaemic heart disease. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  18. Menopause management: a cardiovascular risk-based approach.

    Science.gov (United States)

    Haines, C J; Farrell, E

    2010-08-01

    Hormone replacement therapy (HRT) remains the gold standard for the management of menopausal symptoms; however, HRT use has declined due to concerns over possible adverse side-effects. Approaches to menopause management are continually being revised and these extend beyond the control of recognized menopausal symptoms to encompass wider aspects of menopausal women's health. Hypertension and associated cardiovascular risk are particularly important unmet needs in postmenopausal women, especially in the Asia-Pacific region which has a rapidly aging population and bears around half of the global burden of cardiovascular disease, two-thirds of which has been attributed to elevated blood pressure. As first point of contact for women with menopausal symptoms, gynecologists play a gatekeeper role in assessing women's health, providing appropriate lifestyle counseling, and, where appropriate, implementing treatment or referral to relevant specialists. This paper, with contributions by gynecologists and cardiologists from Asia Pacific and beyond, summarizes available evidence and provides a treatment algorithm that employs a flexible blood pressure classification strategy to assist physicians in their decision-making for the individualized management of menopausal symptoms in women with low, moderate and high cardiovascular risk, and also for women with diabetes. Individualized HRT according to cardiovascular risk may yield improvements in cardiovascular health, as well as managing menopausal symptoms.

  19. The effect of soy intake on menopausal symptoms

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    Andrea Pérez-Rovira

    2014-05-01

    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.

  20. Validity and reliability of menopause rating scale in colombian indigenous population

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    Álvaro Monterrosa-Castro

    2017-01-01

    Full Text Available The Menopause Rating Scale (MRS measures quality of life in menopausal women. It compounds of three dimensions that assess somatic, psychological and urogenital menopausal-related symptoms. However, the validity of the scales may vary according to population characteristics, and there are no validations to date of MRS in American indigenous population. To assess the validity of MRS in Indigenous Colombian women during menopause. A research was done a sample of 914 indigenous women, 507 postmenopausal women and 407 premenopausal. They were between 40-49 years-old, with a mean age of 59.3 ± 5.9years. MRS was applied to all enrolled women. Cronbach's alpha was applied for the original proposed dimensions, and the dimensions from the results of factor analysis and maximum likelihood methods. A Promax rotation was applied to analysis. MRS showed a Cronbach's alpha: 0.86. The somatic dimension: 0.63, the psychological dimension: 0.75, and urogenital: 0.84. Score was greater in postmenopausal compared to premenopausal, 14.4 (±SD, 6.4 versus 8.4 (±SD, 5.9 (P<0.001. The factor analysis showed two dimensions. The first dimension included items 1,7,8,9,10,11; and accounted for 39.9% of variance. The second dimension included items 2,3,4,5,6; explaining 14.2% of variance. Cronbach's alpha was 0.86 for the first dimension and 0.81 for the second dimension. MRS showed high internal consistency and adequate nomological validity. The factor analysis resulted in two dimensions. These results evidence the need to better assess the validity of the instruments in different populations.

  1. Menopause education: needs assessment of American obstetrics and gynecology residents.

    Science.gov (United States)

    Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen

    2013-11-01

    This study aims to understand the current teaching of menopause medicine in American obstetrics and gynecology residency programs. A Web-based survey was e-mailed to all American obstetrics and gynecology residency directors, with a request that they forward it to their residents. Of 258 residency program directors contacted, 79 (30.6%) confirmed forwarding the survey. In all, 1,799 people received the survey, with 510 completions, for a response rate of 28.3%. Most residents reported that they had limited knowledge and needed to learn more about these aspects of menopause medicine: pathophysiology of menopause symptoms (67.1%), hormone therapy (68.1%), nonhormone therapy (79.0%), bone health (66.1%), cardiovascular disease (71.7%), and metabolic syndrome (69.5%). Among fourth-year residents who will be entering clinical practice soon, a large proportion also reported a need to learn more in these areas: pathophysiology of menopause symptoms (45.9%), hormone therapy (54.2%), nonhormone therapy (69.4%), bone health (54.2%), cardiovascular disease (64.3%), and metabolic syndrome (63.8%). When asked to rate the most preferred modalities for learning about menopause, the top choice was supervised clinics (53.2%), followed by case presentations (22.2%), formal lectures (21.3%), small groups (14.7%), Web-based learning (7.8%), and independent reading (5.2%). Only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and 16.3% had a defined menopause clinic as part of their residency. It seems that some American residency programs do not fulfill the educational goals of their residents in menopause medicine. A curriculum would be beneficial for increasing knowledge and clinical experience on menopause issues.

  2. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation.

    Science.gov (United States)

    Avis, Nancy E; Brockwell, Sarah; Randolph, John F; Shen, Shunhua; Cain, Virginia S; Ory, Marcia; Greendale, Gail A

    2009-01-01

    Sexual functioning is an important component of women's lives. The extent to which the menopausal transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopausal transition is associated with changes in sexual functioning. This was a prospective, longitudinal cohort study of women aged 42 to 52 years at baseline recruited at seven US sites (N = 3,302) in the Study of Women's Health Across the Nation (SWAN). Cohort-eligible women had an intact uterus, had at least one ovary, were not currently using exogenous hormones, were either premenopausal or early perimenopausal, and self-identified as one of the study's designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; and degree of emotional satisfaction and physical pleasure. With adjustment for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause but declined during postmenopause. The menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. With adjustment for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional

  3. Environment, human reproduction, menopause, and andropause.

    Science.gov (United States)

    Vermeulen, A

    1993-07-01

    As the hypothalamic gonadotropin-releasing hormone (GnRH) pulse generator is an integrator of hormonal, metabolic, and neural signals, it is not surprising that the function of the hypothalamogonadal axis is subject to the influence of a large array of environmental factors. Before puberty, the central nervous system (CNS) restrains the GnRH pulse generator. Undernutrition, low socioeconomic status, stress, and emotional deprivation, all delay puberty. During reproductive life, among peripheral factors that effect the reproductive system, stress plays an important role. Stress, via the release of corticotropin-releasing factor (CRF), eventually triggered by interleukin 1, inhibits GnRH release, resulting in hypogonadism. Effects of CRF are probably mediated by the opioid system. Food restriction and underweight (anorexia nervosa), obesity, smoking, and alcohol all have negative effects on the GnRH pulse generator and gonadal function. Age and diet are important determinants of fertility in both men and women. The age-associated decrease in fertility in women has as a major determinant chromosomal abnormalities of the oocyte, with uterine factors playing a subsidiary role. Age at menopause, determined by ovarian oocyte depletion, is influenced by occupation, age at menarche, parity, age at last pregnancy, altitude, smoking, and use of oral contraceptives. Smoking, however, appears to be the major determinant. Premature menopause is most frequently attributable to mosaicism for Turner Syndrome, mumps ovaritis, and, above all, total hysterectomy, which has a prevalence of about 12-15% in women 50 years old. Premature ovarian failure with presence of immature follicles is most frequently caused by autoimmune diseases or is the consequence of irradiation or chemotherapy with alkylating cytostatics. Plasma estrogens have a physiological role in the prevention of osteoporosis. Obese women have osteoporosis less frequently than women who are not overweight. Early menopause

  4. Coffee Consumption and Risk of Gastric Cancer: A Large Updated Meta-Analysis of Prospective Studies

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    Feiyue Xie

    2014-09-01

    Full Text Available The potential role of coffee consumption in the development of various types of cancer has been extensively investigated in epidemiologic studies. How coffee consumption may modulate risk of gastric cancer, however, remains a subject open for investigation. To better quantify this relation, we quantitatively summarized evidence from prospective studies. Eligible studies were identified on PubMed and Embase databases. The summary risk estimates were obtained using the random-effects model. Subgroup, sensitivity and dose-response analyses were conducted. The present meta-analysis included 12 prospective cohort studies. A pooled analysis of these studies suggested that coffee consumption (highest vs. lowest consumption was not associated with risk of gastric cancer (RR = 1.12, 95% CI = 0.93–1.36. In the subgroup analysis, significant increased risk was detected in the U.S. studies (RR = 1.36, 95% CI = 1.06–1.74 and in the studies with <10 years of follow-up (RR = 1.24, 95% CI = 1.00–1.54, and the greatest increase in risk was observed in those studies without adjustment for smoking (RR = 1.48, 95% CI = 1.13–1.93. There was some evidence of publication bias (P for Egger’s test = 0.03. Cumulative evidence from prospective studies suggests that coffee consumption is not associated with risk of gastric cancer. The observed positive results may be confounded by smoking and need further investigation.

  5. Women's health in menopause with a focus on hypertension.

    Science.gov (United States)

    Maas, A H E M; Franke, H R

    2009-02-01

    In menopause transition many women have vasomotor symptoms which may affect their normal daily activities. With the decline in oestrogen levels, risk factors for coronary heart disease (CHD) become more apparent, especially hypertension. The onset of hypertension can cause a variety of complaints that are often attributed to the menopause. Risk factor identification is poorly managed in middle-aged women and should be the first step in the evaluation and treatment of women with perimenopausal symptoms. In women at low risk for CHD, there is still a window of opportunity for safe hormone prescription in the first years proximal to menopause. (Neth Heart J 2009;17:68-72.).

  6. Women's experience of menopause: a systematic review of qualitative evidence.

    Science.gov (United States)

    Hoga, Luiza; Rodolpho, Juliana; Gonçalves, Bruna; Quirino, Bruna

    2015-09-16

    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

  7. Risk Assessment: Factors Contributing to Discomfort for Menopausal Women in Workplace

    OpenAIRE

    Jafari, Mehdi; Seifi, Bahar; Heidari, Mohammad

    2017-01-01

    The purpose of this study was to review the Factors contributing to discomfort for menopausal women in workplace and the perceived effects of working conditions on menopausal symptoms, and to produce recommendations for managers and women. This study was a review article. We searched PubMed and Science Direct for articles related to menopause and workplace. Keywords included: menopause AND workplace OR occupational health or menopausal women AND managers. Because we aimed to update the litera...

  8. Assessment of menopausal symptoms using modified Menopause Rating Scale (MRS among middle age women in Kuching, Sarawak, Malaysia

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    Rahman Syed

    2010-02-01

    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.

  9. A depressed post-menopausal woman.

    Science.gov (United States)

    Lutwak, Nancy; Dill, Curt

    2012-11-01

    Post-menopausal women are at significant risk for coronary artery disease, have increased rates of depression compared to their male counterparts, and often present atypically with coronary insufficiency. The symptoms of depression and coronary ischemia overlap greatly. Complaints like fatigue, body aches, and sleep disturbance reported by a depressed elderly woman may be cardiac related and need to be investigated seriously without physician bias. To ensure that clinicians are cautious when evaluating older women with a history of depression who are presenting with atypical complaints. A 61-year-old woman with history of depression presented to the Emergency Department with multiple complaints atypical for acute coronary syndrome. She had an immediate electrocardiogram and troponin-T Biosite point-of-care test (Biosite Incorporated, San Diego, CA) performed, which were positive for cardiac ischemia and myocardial infarction. The patient underwent immediate cardiac catheterization, which revealed occlusion of the mid left circumflex. After aspiration of thrombus and balloon dilatation of the site, a bare metal stent was deployed, restoring excellent flow. The patient did well medically but her depression worsened after the procedure and continues despite psychiatric intervention. For years there have been gender differences in medical treatment of coronary artery disease, and often women's complaints are not investigated aggressively. Post-menopausal women are at great risk for cardiac ischemia and depression, and their symptoms, which are often atypical, may not be diagnosed as anginal equivalents. In addition, depression is an independent risk factor for cardiovascular disease and, if it occurs after myocardial infarction, may lead to poor quality of life and increased morbidity and mortality. Patients who have had a coronary event must be thoroughly evaluated for signs of depression and receive the necessary treatment. Published by Elsevier Inc.

  10. Positive Effekte eines Kuraufenthaltes auf menopausale Beschwerden // Positive Effects of Health Cure on Menopausal Complaints

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    Foisner W

    2016-01-01

    Full Text Available 100 patients in menopause were recruited in an open duo-centre study during a health cure for musculoskeletal system to investigate if health cure is able to achieve additive effects on menopausal afflictions. Patients were differentiated in pre-, periand postmenopausal stadium due to their hormonal state (TSH, estradiol, LH, FSH. Survey dates were admission, discharge, 3, 6, 9, 12 months. MRS (Menopause Rating Scale and HADS-D (Hospital Anxiety and Depression Scale – German version were used as main outcome parameters.brThe analysis revealed that beside the total score also the subscale of both questionnaires improved during the cure. This “success of cure” lasted over a period of 6 months. Afterwards the values approached to the initial situation. Indeed all subscales stayed beyond baseline during the whole study.brThe results of the present investigation may be concluded as a temporary improvement of discomforts, life quality and psyche of peri- and postmenopausal women due to inpatient health cure. p bKurzfassung/b: Während eines Kurheilverfahrens zu Beschwerden des Stütz- und Bewegungsapparates wurden in einer offenen Duo-Center-Studie 100 Patientinnen in der Menopause rekrutiert, um zu untersuchen, ob der Kuraufenthalt additive Effekte auf menopausale Beschwerden besitzt. Anhand eines Hormonstatus (TSH, Estradiol, LH, FSH wurden die Patientinnen in die Menopause-Stadien prä-, peri- und postmenopausal eingeteilt. Erhebungszeitpunkte: Aufnahme, Entlassung, 3, 6, 9 und 12 Monate. Die „Menopause Rating Scale“ (MRS und die „Hospital Anxiety and Depression Scale – deutsche Version“ (HADS-D wurden als Haupt-Outcomeparameter herangezogen.brDie Auswertung ergab, dass sich neben dem Gesamtscore auch die Teilskalen der beiden Fragebögen während des Kuraufenthaltes verbesserten. Dieser „Kurerfolg“ hielt über einen Zeitraum von 6 Monaten an, danach näherten sich die Werte wieder der Ausgangssituation. Alle Teilscores blieben über dem

  11. Menopause status and attitudes in a Turkish midlife female population: an epidemiological study

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    Arslan Gul

    2010-01-01

    Full Text Available Abstract Background It is a well accepted status that socio-cultural characteristics may affect the onset of menopause and its characteristics. The aims of this study were to describe the prevalence rates of menopausal symptoms and these symptoms related factors, and to assess the women's attitudes towards some climacteric issues. Methods This survey was conducted between Jan., 1st 2008 and March, 31st 2008 to research the menopause status of the female population in a city of western Turkey. The study group consisted of 1551 women selected with a multistage area sampling method: a random sample of individuals aged 40-65 years. The questionnaire included questions pertaining to women's sociodemographic characteristics, women's menopausal status, some statements about the climacteric, use of hormones at menopause or before menopause, and some climacteric myths. The data was analyzed by Chi-square (x2 analysis and percent (% ratios with a significant value of P Results The mean age of the women was 49.1 years. Over 90% of the women were of the negative opinion that the climacteric is "the end of youth", "the end of fecundity", and "the end of unclean days". Most women said that cessation of menstrual periods was the most positive thing because they do not have to wait for monthly bleedings, use sanitary equipment, or take birth control methods. There were significant connections between age groups and nearly all the items, with the exception of the items "the end of life" and "the end of fecundity". Among the women, hot flushes were the most common complaint occurring in 96.5% of women: being severe in 32.9%, moderate in 43.1% and mild in 20.4%. This was followed by low backache or muscle pain 95.0% (25.9% severe, 46.0% moderate and mild 23.1%, headache 91.7% (21.9% severe, 34.9% moderate and 34.9% mild and feeling tired 91.0% (15.3% severe, 38.6% moderate and 37.1% mild. Conclusions Most of the women in this study had mixed ideas of opinions

  12. The use of complementary and alternative medicine by women experiencing menopausal symptoms in Bologna

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    Lombardo Flavia

    2010-02-01

    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

  13. The use of Complementary and Alternative Medicine by women experiencing menopausal symptoms in Bologna.

    Science.gov (United States)

    Cardini, Francesco; Lesi, Grazia; Lombardo, Flavia; van der Sluijs, Corinne

    2010-02-27

    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. 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. 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. 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 likely concomitant use of CAM with HRT and other pharmaceuticals

  14. Symptoms experienced during menopausal transition: Korean women in South Korea and the United States.

    Science.gov (United States)

    Im, Eun-Ok

    2003-10-01

    This article reports on cultural influences on symptoms experienced during menopausal transition of Korean women in South Korea and Korean immigrant women in the United States. Data from independent studies of two groups of Korean women were triangulated and analyzed using descriptive and inferential statistics. The analysis indicated that Korean women in South Korea tended to report more symptoms than Korean immigrant women in the United States. Types and severity of prevalent symptoms were also found to be different between the two groups. The findings suggest that recent introduction of menopausal industries in South Korea and contextual influences on Korean women's work and immigration in the United States would be the reason for differences. Based on the findings, implications for future research are proposed.

  15. Analysis of teacher relations with teaching in classroom with prospects to be inclusive.

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    Angela Meneghello Passos

    2015-12-01

    Full Text Available This article presents a proposal for the analysis of teaching relationships in the classroom with prospects of being inclusive, having as theoretical support an instrument called 3x3 matrix. This matrix enables us to understand the actions of the teacher in the classroom based on the relationship with knowledge, teaching and learning in epistemic, personal and social dimensions. The main question that guided this research was: What teacher relationships is possible to see in a classroom with prospects of being inclusive? The methodological procedures were based on discursive textual analysis. Among other, results provided by this research are: the evidence that there is an increase in teaching tasks in the classroom with prospects to be inclusive; the need to expand the 3x3 matrix to accommodate the new teacher relations; and that the presence of the student with disabilities changes the classroom setting and stimulates the concern of the teacher with learning leading him to pay attention to the social dimension of the relationship with knowledge.

  16. Blood pressure and kidney cancer risk: meta-analysis of prospective studies.

    Science.gov (United States)

    Hidayat, Khemayanto; Du, Xuan; Zou, Sheng-Yi; Shi, Bi-Min

    2017-07-01

    Globally, kidney cancer is the twelfth most common cancer, accounting for 337 860 cases recorded in 2012. By 2020, this number has been estimated to reach 412 929 or increase by 22%. Over the past few decades, a number of prospective studies have investigated the association between blood pressure (BP) and risk of kidney cancer, using either recorded BP levels or reported hypertension as the principal exposure variable. However, the relation of BP to kidney cancer remains incompletely understood, and the data on sex-specific differences in risk estimates have been inconsistent. PubMed and Web of Science databases were searched for studies assessing the association between BP and kidney cancer through July 2016. The summary relative risk with 95% confidence intervals was calculated using a random-effects model. A total of 18 prospective studies with 8097 kidney cancer cases from 3 628 479 participants were included in our meta-analysis. History of hypertension was associated with 67% increased risk of kidney cancer. Significant heterogeneity and evidence of publication bias were observed. However, the results remain unchanged after introducing the trim and fill method to correct the publication bias. Accordingly, each 10-mmHg increase in SBP and DBP was associated with 10 and 22% increased risk of kidney cancer. Collectively, the present meta-analysis of 18 prospective studies provides further support for a positive association between hypertension and kidney cancer risk.

  17. Preliminary study of Songa-Wayaua geothermal prospect area using volcanostratigraphy and remote sensing analysis

    Science.gov (United States)

    Asokawaty, Ribka; Nugroho, Indra; Satriana, Joshua; Hafidz, Muhamad; Suryantini

    2017-12-01

    Songa-Wayaua geothermal prospect area is located on Bacan Island, Northern Molluca Province. Geothermal systems in this area associated with three Quartenary volcanoes, such as Mt. Pele-pele, Mt. Lansa, and Mt. Bibinoi. Based on literature study, five surface manifestations such as hot springs and alteration occurred within this area. The active manifestations indicate that Songa-Wayaua area has potential geothermal resource. This study objective is to evaluate Songa-Wayaua geothermal system on preliminary study stage by using volcanostratigraphy and remote sensing analysis to delineate the boundary of geothermal system area. The result of this study showed that Songa-Wayaua prospect area has four heat sources potential (e.g. Pele-pele Hummock, Lansa Hummock, Songa Hummock, and Bibinoi Hummock), controlled by geological structure presented by Pele-pele Normal Fault, and had three places as the recharge and discharge area which are very fulfilling as a geothermal system.

  18. A histerectomia simples realizada no menacme e a densidade mineral óssea da mulher na pós-menopausa Pre-menopausal simple hysterectomy and post-menopausal female bone mineral density

    Directory of Open Access Journals (Sweden)

    João Daniel Hobeika

    2002-12-01

    Full Text Available O objetivo foi avaliar a densidade mineral óssea de mulheres na pós-menopausa, com o antecedente de histerectomia com conservação ovariana bilateral, realizada no menacme, comparadas a um grupo de mulheres com menopausa natural, não histerectomizadas. Tratou-se de um estudo de corte transversal, com trinta mulheres na pós-menopausa e histerectomizadas no menacme e 102 mulheres menopausadas naturalmente, comparando-se as respectivas densitometrias ósseas, em nível do fêmur e coluna lombar. A análise mostrou que as variáveis idade e índice de massa corporal estavam fortemente associadas à densidade mineral óssea do fêmur e da coluna lombar, sendo o índice de massa corporal diretamente e a idade inversamente associados. Posteriormente, as trinta mulheres histerectomizadas, foram pareadas por idade e índice de massa corporal, com trinta mulheres não-histerectomizadas, não apresentando diferenças estatisticamente significantes da densidade mineral óssea. Esses resultados sugerem que a histerectomia com conservação ovariana bilateral, realizada em mulheres no menacme, não parece ocasionar redução adicional da massa óssea, quando avaliadas na pós-menopausa.This study aimed to evaluate the bone mineral density (BMD of post-menopausal women with previous pre-menopausal hysterectomy including bilateral ovarian conservation compared to a group of non-hysterectomized women with natural menopause. Data from a cross-sectional study of 30 pre-menopausally hysterectomized women evaluated in the post-menopause were compared with 102 naturally post-menopausal women, analyzing their respective bone densitometry, measuring the femoral and lumbar spinal BMD. Multiple regression analysis of the 132 women showed that age and body mass index (BMI were heavily associated with femoral and lumbar spinal BMD, BMI directly associated, and age inversely associated with BMD. In addition, 30 hysterectomized women were matched by age and BMI to the

  19. The efficacy of acupuncture on menopausal symptoms (ACOM study)

    DEFF Research Database (Denmark)

    Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert

    2017-01-01

    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...

  20. Features and perceptions of menopausal women in Benin City ...

    African Journals Online (AJOL)

    Ramakantb

    Research priorities include the influence of socio-cultural beliefs on sexuality at menopause and evaluation of HRT benefits. ... physiological manifestation of the aging process and do not seek ..... and oestrogen replacement in older women.

  1. Cross cultural adaptation of the menopause specific questionnaire ...

    African Journals Online (AJOL)

    Cross cultural adaptation of the menopause specific questionnaire into the Persian language. ... Annals of Medical and Health Sciences Research ... good internal consistency in vasomotor, physical and psychosocial domains, but not sexual.

  2. Depression, anxiety, and stress symptoms in menopausal arab women

    African Journals Online (AJOL)

    Depression, anxiety, and stress symptoms in menopausal arab women: Shedding ... and stress were measured using the Depression Anxiety Stress Scales 21. ... and which had negative effects on the quality of life among Arabian women.

  3. attitudes of women to menopause: implications for counselling

    African Journals Online (AJOL)

    Elizabeth

    conforms to society's standards of youth and beauty include low self- esteem, depression and anxiety. .... issue in understanding her attitudes or perception of menopause. Fifty- .... Lippert, L. (1997). Women at midlife: Implications for theories of.

  4. Saliva secretion difference before and after rinsing with baking soda on menopause women

    Directory of Open Access Journals (Sweden)

    Dewi Anggraeni

    2007-03-01

    Full Text Available Menopause women can experience a decrease in saliva secretion (decrease. To understand the clear picture about saliva secretion, the volume, flow rate, pH and viscosity were then measured. The aim of this research was to obtain a picture about the difference of saliva secretion before and after rinsing with baking soda on menopause women. The type of the research used was a laboratory quasi-experiment with comparative descriptive form. The technique used in this research is the survey method, and samples were taken using the multistage cluster random sampling method, and t-student statistical analysis. This research was conducted with the saliva collected with spitting method on 45 menopause women. The results show that the average volume, flow rate, pH and viscosity before rinsing with baking soda was 1.79 ml, 0.18 ml/minute, 7.40 and 0.81 mm2/second. The average volume, flow rate, pH and viscosity after rinsing with baking soda were 2.66 ml; 0.27 ml/minute; 8.67 and 0.78 mm2/second. Statistical analysis t-student on α = 0.05 shows volume changes, flow rate, pH and saliva viscosity before and after rinsing with baking soda was 0.873; 0.086; 1.273 and 0.037 respectively. The conclusion shows a significant difference between saliva secretion before and after rinsing with baking soda, and saliva secretion after rinsing with baking soda on menopause women.

  5. AB029. Meeting sexual health requirements in menopause

    OpenAIRE

    Srilatha, B.

    2015-01-01

    Many underlying psycho-physiological complexities can alter the normal manifestation of sexual responses in women. While these factors may be hormonal changes associated with pregnancy or lactation, medical or surgical debilitating illnesses, relationship issues or socio-cultural and environmental factors, a major hallmark along the life stages is menopause per se. The transition from reproductively active period to menopause is the key to a variety of physiological, psychological, functional...

  6. Sexual Functioning During Menopause: Schemas, Hormones, and Race

    Science.gov (United States)

    2010-10-08

    Spitznagel, E. L., Schootman, M., Bucholz, K. K., Peipert, J. F., . . . Bierut, L. J. (2009). Age of sexual debut among US adolescents . Contraception , 80(2...use different, non-comparable methods to calculate the average age that menopause ‘begins.’ Finally, it is unclear how oral contraceptives and... contraception use are related to a later age of menopause (Gold et al., 2001; Gold et al., 2006; Hardy, Kuh, & Wadsworth, 2000; Kato et al., 1998; Palmer

  7. The menopausal experience among indigenous women of Sarawak, Malaysia.

    Science.gov (United States)

    Syed Alwi, S A R; Lee, P Y; Awi, I; Mallik, P S; Md Haizal, M N

    2009-12-01

    To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia. A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause. The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual). The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.

  8. Sedentary behavior and incident cancer: a meta-analysis of prospective studies.

    Directory of Open Access Journals (Sweden)

    Dong Shen

    Full Text Available Sedentary behavior is ubiquitous in modern adults' daily lives and it has been suggested to be associated with incident cancer. However, the results have been inconsistent. In this study, we performed a systematic review and meta-analysis of prospective cohort studies to clarify the association between sedentary behavior and incident cancer.PubMed and Embase databases were searched up to March 2014. All prospective cohort studies on the association between sedentary behavior and incident cancer were included. The summary relative risks (RRs with 95% confidence intervals (CIs were estimated using random effect model.A total of 17 prospective studies from 14 articles, including a total of 857,581 participants and 18,553 cases, were included in the analysis for sedentary behavior and risk of incident cancer. The overall meta-analysis suggested that sedentary behavior increased risk of cancer (RR = 1.20, 95%CI = 1.12-1.28, with no evidence of heterogeneity between studies (I(2 = 7.3%, P = 0.368. Subgroup analyses demonstrated that there were statistical associations between sedentary behavior and some cancer types (endometrial cancer: RR = 1.28, 95% CI = 1.08-1.53; colorectal cancer: RR = 1.30, 95%CI = 1.12-1.49; breast cancer: RR = 1.17, 95%CI = 1.03-1.33; lung cancer: RR = 1.27, 95%CI = 1.06-1.52. However, there was no association of sedentary behavior with ovarian cancer (RR = 1.26, 95%CI = 0.87-1.82, renal cell carcinoma (RR = 1.11, 95%CI = 0.87-1.41 or non-Hodgkin lymphoid neoplasms (RR = 1.09, 95%CI = 0.82-1.43.The present meta-analysis suggested that prolonged sedentary behavior was independently associated with an increased risk of incident endometrial, colorectal, breast, and lung cancers, but not with ovarian cancer, renal cell carcinoma or non-Hodgkin lymphoid neoplasms.

  9. Quantitative ultrasound of the calcaneus with parametric imaging: correlation with bone mineral density at different sites and with anthropometric data in menopausal women

    International Nuclear Information System (INIS)

    Louis, O.; Kaufman, L.; Osteaux, M.

    2000-01-01

    Objective: To prospectively study the relationship of quantitative ultrasound of the calcaneus with anthromopometric variables and with bone mineral density (BMD) assessed at the level of the calcaneus as well as at other sites. Method: Osteosonography of the non-dominant calcaneus was performed in 135 menopausal women, using a DTU-one device with parametric imaging. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were assessed. BMD of the calcaneus (BMDcal) was measured using dual energy X-ray absorptiometry (DXA), in a subregion matched with the region of interest for osteosonography. BMD of the lumbar trabecular bone was measured using quantitative computed tomography (BMD QCT) while the non-dominant hip was studied using DXA, which provided the total bone mineral density (BMDhip) and that of the Ward triangle (BMDWard). Results: The Pearson correlation coefficients between BUA, SOS and the various measurements of BMD ranged from 0.305 (SOS versus BMDhip) to 0.717 (BUA versus BMDcal). BMD QCT and BMDWard were found to depend on age, but not on weight or height, while BUA, SOS, BMDcal, BMDhip were unrelated to age, but correlated with weight (SOS, BMDhip) or with weight and height (BUA, BMDcal). In a multiple stepwise regression analysis, age was a significant predictor for BMD QCT, BMD hip and BMDWard; BMD QCT, BMDWard and BMDhip admitted BUA as sole predictor, while BMDcal was significantly related to both BUA and SOS. Conclusion: BUA and SOS of the calcaneus, assessed in 135 menopausal women using a parametric imaging device, reflected BMDcal, measured with DXA at a matched region of interest, and did not decline significantly with age

  10. Quantitative ultrasound of the calcaneus with parametric imaging: correlation with bone mineral density at different sites and with anthropometric data in menopausal women

    Energy Technology Data Exchange (ETDEWEB)

    Louis, O.; Kaufman, L.; Osteaux, M

    2000-07-01

    Objective: To prospectively study the relationship of quantitative ultrasound of the calcaneus with anthromopometric variables and with bone mineral density (BMD) assessed at the level of the calcaneus as well as at other sites. Method: Osteosonography of the non-dominant calcaneus was performed in 135 menopausal women, using a DTU-one device with parametric imaging. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were assessed. BMD of the calcaneus (BMDcal) was measured using dual energy X-ray absorptiometry (DXA), in a subregion matched with the region of interest for osteosonography. BMD of the lumbar trabecular bone was measured using quantitative computed tomography (BMD QCT) while the non-dominant hip was studied using DXA, which provided the total bone mineral density (BMDhip) and that of the Ward triangle (BMDWard). Results: The Pearson correlation coefficients between BUA, SOS and the various measurements of BMD ranged from 0.305 (SOS versus BMDhip) to 0.717 (BUA versus BMDcal). BMD QCT and BMDWard were found to depend on age, but not on weight or height, while BUA, SOS, BMDcal, BMDhip were unrelated to age, but correlated with weight (SOS, BMDhip) or with weight and height (BUA, BMDcal). In a multiple stepwise regression analysis, age was a significant predictor for BMD QCT, BMD hip and BMDWard; BMD QCT, BMDWard and BMDhip admitted BUA as sole predictor, while BMDcal was significantly related to both BUA and SOS. Conclusion: BUA and SOS of the calcaneus, assessed in 135 menopausal women using a parametric imaging device, reflected BMDcal, measured with DXA at a matched region of interest, and did not decline significantly with age.

  11. Passive smoking and risk of type 2 diabetes: a meta-analysis of prospective cohort studies.

    Directory of Open Access Journals (Sweden)

    Ying Wang

    Full Text Available BACKGROUNDS/OBJECTIVE: The prevalence of diabetes is increasing rapidly all over the world. However, studies on passive smoking and type 2 diabetes have not been systematically assessed. Therefore, we conducted a meta-analysis to explore whether an association exists between passive smoking and risk of type 2 diabetes. METHODS: We searched PubMed, EMBASE, Cochrane library and Web of Science up to April 9(th, 2013, to identify prospective cohort studies that assessed passive smoking and risk of type 2 diabetes. The fixed-effect model was used to calculate the overall relative risk (RR. RESULT: 4 prospective cohort studies were included for analysis, with a total of 112,351 participants involved. The pooled RR was 1.28 (95% confidence interval (CI 1.14 to 1.44 comparing those who were exposed to passive smoking with those who were not. Subgroup, sensitivity analysis and publication bias test suggested the overall result of this analysis was robust. CONCLUSIONS: Passive smoking is associated with a significantly increased risk of type 2 diabetes. Further well-designed studies are warranted to confirm this association.

  12. The Analysis of the Chosen Internal Condition and Prospects of Romania’s Energy Security

    Directory of Open Access Journals (Sweden)

    Rutka Michał

    2017-03-01

    Full Text Available In the age of high pace of technological, economic and social development, stable and uninterrupted energy supply is one of the key components determining the economic sovereignty of the state, its position in international relations, and the quality of human life. Every economy around the world is heavily dependent on its energy sector. Consequently, ensuring energy security is currently one of the most important determinant of every country’s national security and the purpose of its security policy. In this article we focus on Romania’s energy security internal condition and prospects. Our main goal is to present actual state and prospects of Romanian energy sector. In order to achieve that goal, we decided to use various methods, such as descriptive analysis, document analysis and comparative analysis. The article has two parts. The first part consists of a description of energy sources and infrastructure used by Romanian economy. The second part is an analysis of possible chances and threats for both energy sector and energy security level.

  13. Comparative study of the quality of life associated with menopause in Tunisia and France.

    Science.gov (United States)

    Ferrand, Farida; Hajri, Selma; Benzineb, Sarah; Draoui, Dorra Mahfoudh; Hassoun, Danielle; Delanoë, Daniel; Zins, Marie; Ringa, Virginie

    2013-06-01

    Because the experience of menopause varies by ethnic group, society, and social class, we sought to compare quality of life (QoL) at menopause between Tunisian and French women. This secondary analysis of existing data collected in two independent, cross-sectional surveys (the French GAZEL cohort and a representative sample of Tunisian women) compared both samples for six dimensions of the Women's Health Questionnaire while taking into account social and demographic characteristics and menopause status with multivariate logistic models. Comparison of 1,040 Tunisian women aged 45 to 64 years with 774 French women aged 48 to 53 years showed that Tunisian women had a significantly lower QoL than the French women in every dimension (low QoL for Tunisian vs French, odds ratio [95% CI]: somatic symptoms, 2.1 [1.6-2.7]; depressed mood, 3.6 [2.8-4.7]; anxiety, 2.4 [1.8-3.3]; vasomotor symptoms, 1.7 [1.3-2.3]). QoL was also lower for working-class women, but associations were weaker than for country (low QoL for working class vs middle class, odds ratio [95% CI]: somatic symptoms: 1.9 [1.5-2.4]; depressed mood, 1.5 [1.2-1.8]; anxiety, 1.8 [1.5-2.3]; vasomotor symptoms, 1.7 [1.4-2.2]). Associations between country and QoL were stronger in the working class than in the middle class. This epidemiological study comparing France and a North African country sheds light on the major role of country of residence, social class, and their interaction in the experience of menopause. Levels of national wealth, human development, cultural constraints, and social and gender inequality are likely to explain how country and class affect QoL.

  14. Hypericum perforatum with Vitex agnus-castus in menopausal symptoms: a randomized, controlled trial.

    Science.gov (United States)

    van Die, M Diana; Burger, Henry G; Bone, Kerry M; Cohen, Marc M; Teede, Helena J

    2009-01-01

    To evaluate the effectiveness of a phytotherapeutic intervention comprising a combination of Hypericum perforatum (St. John's wort) and Vitex agnus-castus (Chaste tree/berry) in the management of menopausal symptoms. A double-blind, randomized, placebo-controlled, parallel trial was performed over 16 weeks in 100 eligible late-perimenopausal or postmenopausal women experiencing hot flushes and other menopausal symptoms. Herbal combination therapy or placebo tablets were administered twice daily. The primary endpoint was hot flush episodes. Secondary endpoints included Greene Climacteric Scale scores, Hamilton Depression Inventory scores, and Utian Quality of Life Scale scores. Ninety-three women completed the study. Data analysis on an intent-to-treat basis found no significant differences between the two groups for any of the endpoints. Analyses performed at interim data time points revealed no significant differences at week 4, 8, or 12 for daily weighted flushes or scores on the Greene Climacteric Scale or Hamilton Depression Inventory. However, significant improvements across the treatment phase were observed in both the placebo and active treatment groups for these endpoints. No significant change was found for either group on quality of life. The herbal combination of H. perforatum and V. agnus-castus was not found to be superior to placebo for the treatment of menopausal symptoms. The herbal combination was well tolerated with no significant adverse events noted in the short term. Robust findings from quality studies such as this are important for informing the community, healthcare providers, and regulatory authorities.

  15. Comparative study of transvaginal hysterosonography and biopsy for theevaluation of post-menopausal bleeding

    International Nuclear Information System (INIS)

    Abu-Ghazzeh, Y.; Sahkoury, Waheed A.; Barqawi, R.

    1999-01-01

    The aim of this prospective study was to evaluate transvaginalhysterosonography (TVHS) in post-menopausal bleeding (PMB) as an alternativeto endometrial biopsy. The study was conducted at the Zarka MilitaryHospital, Amman, Jordan, over a one year period from 1996 to 1997. The studycomprised 98 women presenting with post-menopausal bleeding who had beenlisted for diagnostic dilatation and curettage. Transvaginal sonography (TVS)and transvaginal hysterosonography were performed one week before operation.The mean age of the women was 75 years, and all of them had their menopausefor at least six months. Sixty-one women (62%) demonstrated endometrialthickness of more than 5mm by transvaginal sonography. All the women hadtransvaginal hysterosonography, except seven on whom hysterosonography couldnot be performed for technical reasons and who had to be excluded from thestudy, leaving a total 54 women. TVS confirmed the presence of endoluminalmass in 30 of 54 women (60%). Twenty-two of the 30 endoluminal mass caseswere pedunculated while eight were sessile. Sixteen of the pedunculated caseswere endometrial polyps while the remaining six were fibroid polyps. Five ofthe sessile cases were fibroid, two were endometrial hyperplasia, and thelast one endometrial carcinoma. The other 44 out of the 98 patients alsounderwent transvaginal hysterosonography. No pathology could be detected inthese patients, but they were noted to have atrophic endometrium afterdilatation and curettage. The combination of transvaginal sonography andtransvaginal hysterosonography is both sensitive and specific with regard todetecting and excluding endoluminal masses as the cause of post-menopausalbleeding. Diagnostic dilatation and curettage fails to detect a largepercentage of some lesions, so TVS in combination with TVHS should beconsidered as the initial examination in the evaluation of all women withpost-menopausal bleeding. (author)

  16. Assessment of the Effects of Tribulus Terrestris on Sexual Function of Menopausal Women.

    Science.gov (United States)

    Postigo, Sóstenes; Lima, Sônia Maria Rolim Rosa; Yamada, Silvia Saito; dos Reis, Benedito Fabiano; da Silva, Gustavo Maximiliano Dutra; Aoki, Tsutomu

    2016-03-01

    The aim of this study was to study the effects of Tribulus terrestris on sexual function in menopausal women. This was a prospective, randomized, double-blind, placebo-controlled clinical trial that included 60 postmenopausal women with sexual dysfunction. The women were divided into two groups, placebo group and Tribulus group, and evaluated by using the Sexual Quotient-female version (SQ-F) and Female Intervention Efficacy Index (FIEI) questionnaires. There was no significant difference between the groups in age, age at menopause, civil status, race, and religion. In the evaluation with the SQ-F questionnaire, there were significant differences between the placebo (7.6 ± 3.2) and Tribulus (10.2 ± 3.2) groups in the domains of desire and sexual interest (p ≤ 0.001), foreplay (3.3 ± 1.5 versus 4.2 ± 1.0) (p ≤ 0.01), arousal and harmonious interaction with the partner (5.7 ± 2.1 versus 7.2 ± 2.6) (p ≤ 0.01), and comfort in sexual intercourse (6.5 ± 2.4 versus 8.0 ± 1.9) (p ≤ 0.01). There was no significant difference between the placebo and Tribulus groups in the domains of orgasm and sexual satisfaction (p = 0.28). In the FIEI questionnaire, there was a significant improvement (p Tribulus terrestris to be effective in treating sexual problems among menopausal women. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  17. Endocrine identification of menopausal status of Sudanese women

    International Nuclear Information System (INIS)

    Khalid, M. M. M.

    2010-12-01

    This study was conducted in order to identify the menopausal statues of Sudanese women which is critically important in determining the treatment strategy for infertile patients. In this study samples were collected from two hundred Sudanese women, aged between 35 and 62. They were from different social classes and are not suffering any systemic or endocrine disease. They were not exposed to any surgical intervention by complete hysterectomy or partial removal of ovaries or thyroidectomy. Reproductive hormones were determined for these women. Immunoradiometric Assay (IRMA) was adopted for the measurement of serum prolactin, follicle stimulating hormone, and luteinizing hormone. Enzyme linked immunosorbent assay (ELISA) was used for the determination of estradiol and esterone, whereas, enzyme immunoassay (tube format) was used for the determination of serum testosterone. Average menopausal age for Sudanese women was determined in this study and found to be 43.0±4.2 which is lower than that of the neighboring countries. A new classification system was developed during this study which uses a combination of symptoms together with hormonal profile in order to identify the menopausal status of women. The three key tools of this system are FSH and LH level together with the absence of menstrual cycle during the last three months. The new classification scheme had successfully differentiated the early peri-menopausal women from pre-menopausal ones. The early peri-menopausal women according to the new classification scheme are suffering cycle irregularities and amenorrhea but with normal hormonal levels. The new classification scheme is now, clearly indicating that amenorrhea with normal hormonal levels may be an indication to the beginning of the peri-menopausal life. The big challenge faced during this study had been the sub-classification of the peri-menopausal stage as it is not a single homogeneous stage but a wide heterogenous and transitional stage extending from

  18. CHRONIC MEDICAL CONDITIONS AND REPRODUCIBILITY OF SELF-REPORTED AGE AT MENOPAUSE AMONG COMMUNITY DWELLING WOMEN

    Science.gov (United States)

    de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.

    2011-01-01

    OBJECTIVE To examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. METHOD Age at menopause was assessed in a population-based longitudinal survey of 240 women twice, in 1993 and 2004. Women who recalled age at menopause in 2004 within one year or less of the age at menopause recalled in 1993 (concordant) were compared with women who did not recall of age at menopause in 2004 within 1 year of age at menopause recalled in 1993 (discordant). Type of menopause (surgical or natural) and chronic medical conditions were assessed by self-report. RESULTS One hundred and forty three women (59.6%) reported surgical menopause and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) of women recalled age at menopause in 2004 within one year or less of recalled age at menopause in 1994 while 110 (45.8%) women did not recall age at menopause in 2004 within one year or less of recalled age at menopause in 1994. Among women with surgical menopause, women with three or more medical conditions were less likely to have concordant recall of age at menopause than women with less than three chronic medical conditions (adjusted odds ratio (OR) = 0.36, 95% confidence interval (CI) [0.15, 0.91]) in multivariate models controlling for potentially influential characteristics including cognition and years from menopause. CONCLUSIONS Among women who underwent surgical menopause, the presence of three or more medical conditions is associated with decreased reproducibility of self-reported age at menopause. PMID:21971208

  19. A Prospective Analysis of Dynamic Loss of Breast Projection in Tissue Expander-Implant Reconstruction

    Directory of Open Access Journals (Sweden)

    Lauren M Mioton

    2015-05-01

    Full Text Available BackgroundBreast projection is a critical element of breast reconstruction aesthetics, but little has been published regarding breast projection as the firm expander is changed to a softer implant. Quantitative data representing this loss in projection may enhance patient education and improve our management of patient expectations.MethodsFemale patients who were undergoing immediate tissue-expander breast reconstruction with the senior author were enrolled in this prospective study. Three-dimensional camera software was used for all patient photographs and data analysis. Projection was calculated as the distance between the chest wall and the point of maximal projection of the breast form. Values were calculated for final tissue expander expansion and at varying intervals 3, 6, and 12 months after implant placement.ResultsFourteen breasts from 12 patients were included in the final analysis. Twelve of the 14 breasts had a loss of projection at three months following the implant placement or beyond. The percentage of projection lost in these 12 breasts ranged from 6.30% to 43.4%, with an average loss of projection of 21.05%.ConclusionsThis study is the first prospective quantitative analysis of temporal changes in breast projection after expander-implant reconstruction. By prospectively capturing projection data with three-dimensional photographic software, we reveal a loss of projection in this population by three months post-implant exchange. These findings will not only aid in managing patient expectations, but our methodology provides a foundation for future objective studies of the breast form.

  20. Serum Lipids and Breast Cancer Risk: A Meta-Analysis of Prospective Cohort Studies.

    Directory of Open Access Journals (Sweden)

    Haibo Ni

    Full Text Available Epidemiologic studies exploring causal associations between serum lipids and breast cancer risk have reported contradictory results. We conducted a meta-analysis of prospective cohort studies to evaluate these associations.Relevant studies were identified by searching PubMed and EMBASE through April 2015. We included prospective cohort studies that reported relative risk (RR estimates with 95% confidence intervals (CIs for the associations of specific lipid components (i.e., total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], and triglycerides [TG] with breast cancer risk. Either a fixed- or a random-effects model was used to calculate pooled RRs.Fifteen prospective cohort studies involving 1,189,635 participants and 23,369 breast cancer cases were included in the meta-analysis. The pooled RRs of breast cancer for the highest versus lowest categories were 0.96 (95% CI: 0.86-1.07 for TC, 0.92 (95% CI: 0.73-1.16 for HDL-C, 0.90 (95% CI: 0.77-1.06 for LDL-C, and 0.93 (95% CI: 0.86-1.00 for TG. Notably, for HDL-C, a significant reduction of breast cancer risk was observed among postmenopausal women (RR = 0.77, 95% CI: 0.64-0.93 but not among premenopausal women. Similar trends of the associations were observed in the dose-response analysis.Our findings suggest that serum levels of TG but not TC and LDL-C may be inversely associated with breast cancer risk. Serum HDL-C may also protect against breast carcinogenesis among postmenopausal women.

  1. A study on relationship to risk factors according to menopausal status in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Han Sik [Wonkwang Health Science College, Iksan (Korea, Republic of)

    2000-06-01

    It is important to identify modifiable risk factors for breast cancer, because the breast cancer is one of the major cause of mortality among women. Some reported that obesity is a risk factor for breast cancer, but the results are not constant. Many risk factors are related to the duration of estrogenic stimulation of the breast. In general, early menarche and late menopause are positive risk factors. Human breast cancer has different characteristics according to the status of menopause (premenopause and postmenopause). In premenopausal women, about 60% of circulating estrogen is from the ovaries in the form of estradiol, and the remaining 40% is estrogen formed primarily in the adipose(fat) tissue via aromatization of androstenedion from the adrenal glands. After menopause this adipose cell production of estrone is the maon source of estrogens and the level of estrone is maintained approximately at premenopausal levels. This study was undertaken to determine the role of body size and body mass index by status of menopause in development of breast cancer using retrospective case/control study. From Mach 1991 to February 1997 at the Wonkwang University Hospital, the breast cancer cases(n=3D72) and controls(n=3D86) were selected. By statistical analysis method, regression analysis, paired T-test and multiple logistic regression were done to estimate the influenced factors same as height, weight, BMI, age at menarche and age at menopause. The following results were obtained: 1. In premenopausal women, age at menarche was showed comparatively high correlation coefficients and BMI was described prominently highly in postmenopause. 2. At the results of multiple regression analysis, age at menarch, BMI and weight were showed as significant variables. In this method, critical facor(R{sup 2}) was 0.054. 3. Paired samples T-test was undertaken to test mean difference between two groups of cases and controls. The result of test performance showed a significant difference. 4

  2. A study on relationship to risk factors according to menopausal status in breast cancer

    International Nuclear Information System (INIS)

    Yoon, Han Sik

    2000-01-01

    It is important to identify modifiable risk factors for breast cancer, because the breast cancer is one of the major cause of mortality among women. Some reported that obesity is a risk factor for breast cancer, but the results are not constant. Many risk factors are related to the duration of estrogenic stimulation of the breast. In general, early menarche and late menopause are positive risk factors. Human breast cancer has different characteristics according to the status of menopause (premenopause and postmenopause). In premenopausal women, about 60% of circulating estrogen is from the ovaries in the form of estradiol, and the remaining 40% is estrogen formed primarily in the adipose(fat) tissue via aromatization of androstenedion from the adrenal glands. After menopause this adipose cell production of estrone is the maon source of estrogens and the level of estrone is maintained approximately at premenopausal levels. This study was undertaken to determine the role of body size and body mass index by status of menopause in development of breast cancer using retrospective case/control study. From Mach 1991 to February 1997 at the Wonkwang University Hospital, the breast cancer cases(n=3D72) and controls(n=3D86) were selected. By statistical analysis method, regression analysis, paired T-test and multiple logistic regression were done to estimate the influenced factors same as height, weight, BMI, age at menarche and age at menopause. The following results were obtained: 1. In premenopausal women, age at menarche was showed comparatively high correlation coefficients and BMI was described prominently highly in postmenopause. 2. At the results of multiple regression analysis, age at menarch, BMI and weight were showed as significant variables. In this method, critical facor(R 2 ) was 0.054. 3. Paired samples T-test was undertaken to test mean difference between two groups of cases and controls. The result of test performance showed a significant difference. 4. In

  3. Sequential analysis of materials balances. Application to a prospective reprocessing facility

    International Nuclear Information System (INIS)

    Picard, R.

    1986-01-01

    This paper discusses near-real-time accounting in the context of the prospective DWK reprocessing plant. Sensitivity of a standard sequential testing procedure, applied to unfalsified operator data only, is examined with respect to a variety of loss scenarios. It is seen that large inventories preclude high-probability detection of certain protracted losses of material. In Sec. 2, a rough error propagation for the MBA of interest is outlined. Mathematical development for the analysis is given in Sec. 3, and generic aspects of sequential testing are reviewed in Sec. 4. In Sec. 5, results from a simulation to quantify performance of the accounting system are presented

  4. Electrocardiographic PR prolongation and atrial fibrillation risk: a meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Cheng, Min; Lu, Xiangfeng; Huang, Jianfeng; Zhang, Shu; Gu, Dongfeng

    2015-01-01

    Electrocardiographic PR interval prolongation is considered a benign condition, but recent studies have challenged the notion by demonstrating that prolonged PR interval is associated with an increased risk of atrial fibrillation (AF). The purpose of this study was to perform a meta-analysis of prospective cohort studies to evaluate the evidence supporting an association of prolonged PR interval with AF incidence. We searched the MEDLINE and EMBASE database (from inception to May 2014) supplemented by manual searches of references of relevant retrieved articles. Prospective cohort studies were included with hazard ratio (HR) of prolonged PR interval for incident AF. The search strategy yielded 6 cohort studies meeting eligibility criteria. A total of 328,932 participants were included, with 14,191 participants suffering from AF during follow-up. Pooled HRs of prolonged PR interval for incident AF was 1.30 (95% CI: 1.13 to 1.49) using random-effect model (I(2) = 30%). There was a significant difference of combined HRs between studies with and without adjustment for taking of AV nodal blocking agents in subgroup analysis. Sensitivity analysis supported the robustness of the results. Prolonged PR interval is not a totally benign condition but an independent risk factor for AF incidence. The mechanisms underlying the association of prolonged PR interval with AF incidence need further research. © 2014 Wiley Periodicals, Inc.

  5. Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies

    Science.gov (United States)

    LI, Xinli; XU, Jiuhong

    2014-01-01

    Epidemiological studies support a protective role of lycopene against stroke occurrence or mortality, but the results have been conflicting. We conducted a meta-analysis to assess the relationship between dietary or circulating lycopene and stroke risk (including stroke occurrence or mortality). Relevant papers were collected by screening the PubMed database through October 2013. Only prospective studies providing relative risk estimates with 95% confidence intervals for the association between lycopene and stroke were included. A random-effects model was used to calculate the pooled estimate. Subgroup analysis was conducted to investigate the effects of various factors on the final results. The pooled analysis of seven prospective studies, with 116,127 participants and 1,989 cases, demonstrated that lycopene decreased stroke risk by 19.3% (RR = 0.807, 95% CI = 0.680–0.957) after adjusting for confounding factors. No heterogeneity was observed (p = 0.234, I2 = 25.5%). Circulating lycopene, not dietary lycopene, was associated with a statistically significant decrease in stroke risk (RR = 0.693, 95% CI = 0.503–0.954). Lycopene could protect European, or males against stroke risk. Duration of follow-up had no effect on the final results. There was no evidence of publication bias. Lycopene, especially circulating lycopene, is negatively associated with stroke risk. PMID:24848940

  6. Voices from the Hilo Women's Health Study: talking story about menopause.

    Science.gov (United States)

    Morrison, Lynn A; Brown, Daniel E; Sievert, Lynnette L; Reza, Angela; Rahberg, Nichole; Mills, Phoebe; Goodloe, Amber

    2014-05-01

    Our purpose in conducting this qualitative study was to examine how a multiethnic sample of women living in Hilo, Hawai'i, describe menopause. Interviews were conducted with 185 pre-, peri-, and post-menopausal women aged 45 to 55. We found that pre-menopausal women felt anxious compared with peri- and post-menopausal women's more affirmative attitudes of increasing confidence and freedom in this new cycle of life. A dominant theme was the construction of a post-menstrual identity. Peri-and post-menopausal women's attitudes were not biomedically oriented. Local culture and the island lifestyle may provide a positive atmosphere for women going through menopause.

  7. STAMP model and its application prospect in DCS safety analysis of nuclear power plant

    International Nuclear Information System (INIS)

    Yang Xiaohua; Liu Jie; Liu Zhaohui; Liu Hua; Yu Tonglan

    2013-01-01

    The application of DCS (Digit Control System) is a certain trend for the development of nuclear power. DCS not only improves the control capability of nuclear power system, but also increases the complexity of the system. Traditional safety analysis techniques based on event-chain model are facing challenges. In order to improve the safety performance of nuclear power DCS, the latest research achievement in the field of safety engineering should be focused, studied and applied into nuclear power safety. This paper introduces a new safety analysis model named STAMP (Systems-Theoretic Accident Modeling and Processes) based on the system theory, analyzes its advantages and disadvantages compared with the traditional ones, and explains the basic steps of STPA (STAMP-Based Hazard Analysis) technology. Finally, according to the application status of STAMP at home and abroad, it prospects the development of STAMP in China's nuclear power safety. (authors)

  8. Preclosure safety analysis for a prospective Yucca Mountain conceptual design repository

    International Nuclear Information System (INIS)

    Ma, C.W.; Jardine, L.J.

    1989-12-01

    A preliminary probabilistic risk assessment was performed for the prospective Yucca Mountain conceptual design repository. A new methodology to quantify radioactive source terms was developed and applied in the analysis. The study identified 42 event trees comprising 278 accident scenarios. The maximum offsite dose evaluated in this study is about 1000 mrem. For the majority of the accident scenarios, either the offsite dose is less than 100 mrem or the probability of occurrence is less than 1 x 10 -9 /yr. Only 11 accident scenarios with a dose larger than 100 mrem and an associated probability greater than 1 x 10 -9 /yr were identified. A more detailed follow-on analysis for seismic events of various severity was also performed, and similar results were obtained. Therefore, based on the results of this analysis, no significant risk to the general public was identified during the preclosure period for the conceptual repository design. 13 refs., 4 figs., 2 tabs

  9. [Effects of Aromatherapy on Menopausal Symptoms, Perceived Stress and Depression in Middle-aged Women: A Systematic Review].

    Science.gov (United States)

    Kim, Shinmi; Song, Ji Ah; Kim, Mi Eun; Hur, Myung Haeng

    2016-10-01

    This study was a systematic review to evaluate the effects of aromatherapy on menopausal symptoms, perceived stress and depression in middle aged-women. Eight databases were searched from their inception September 8, 2015. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria. For analysis of the data, a meta-analysis of the studies was performed. From the electronic databases, 73 articles were selected, and 19 removed due to duplication. After two reviewers read the abstracts of 54 studies, 34 studies were selected. Complete papers for 34 original articles were read and, 12 studies which met selection criteria were reviewed and the effects of aromatherapy on menopausal symptoms, stress and depression analyzed using meta-analysis with RevMan. In the 2 studies which included Randomized Controlled Trials testing of aromatherapy on menopausal symptoms and comparison of control and placebo groups were done. Aromatherapy massage was favorably effective in reducing the menopausal symptoms compared to the control group (n=118, MD=-6.33; 95% CI -11.51 to -1.15), and compared to the placebo group (n=117, MD=-4.14; 95% CI -7.63 to -0.64). Also aromatherapy was effective in reducing stress (n=72, SMD=-0.64; 95% CI -1.12 to -0.17) and depression (n=158, MD=-5.63; 95% CI -10.04 to -1.22). There is limited evidence suggesting that aromatherapy for middle-aged women may be effective in controlling menopausal symptoms, perceived stress and depression.

  10. Migraine Management During Menstruation and Menopause.

    Science.gov (United States)

    MacGregor, E Anne

    2015-08-01

    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.

  11. Adiposity, insulin and lipid metabolism in post-menopausal women.

    Science.gov (United States)

    Lovegrove, J A; Silva, K D R R; Wright, J W; Williams, C M

    2002-04-01

    To investigate relationships between body fat and its distribution and carbohydrate and lipid tolerance using statistical comparisons in post-menopausal women. Sequential meal, postprandial study (600 min) which included a mixed standard breakfast (30 g fat) and lunch (44 g fat) given at 0 and 270 min, respectively, after an overnight fast. Twenty-eight post-menopausal women with a diverse range of body weight (body mass index (BMI), mean 27.2, range 20.5-38.8 kg/m2) and abdominal fat deposition (waist, mean 86.4, range 63.5-124.0 cm). Women with BMI 37 kg/m2, age > 80 y and taking hormone replacement therapy (HRT) were excluded. Anthropometric measurements were performed to assess total and regional fat deposits. The concentrations of plasma total cholesterol, high density lipoprotein (HDL) cholesterol, triacylglycerol (TAG), glucose, insulin (ins), non-esterified fatty acids (NEFA) and apolipoprotein (apo) B-48 were analysed in plasma collected at baseline (fasted state) and at 13 postprandial time points for a 600 min period. Insulin concentrations in the fasted and fed state were significantly correlated with all measures of adiposity (BMI, waist, waist-hip ratio (W/H), waist-height ratio (W/Ht) and sum of skinfold thickness (SSk)). After controlling for BMI, waist remained significantly and positively associated with fasted insulin (r=0.559) with waist contributing 53% to the variability after multiple regression analysis. After controlling for waist, BMI remained significantly correlated with postprandial (IAUC) insulin (r=0.535) contributing 66% of the variability of this measurement. No association was found between any measures of adiposity and glucose concentrations, although insulin concentration in relation to glucose concentration (glucose-insulin ratio) was significantly negatively correlated with all measures of adiposity. A significant positive correlation was found between fasted TAG and BMI (r=0.416), waist (r=0.393) and Ssk (r=0.457) and

  12. Lateral Epicondylitis and Physical Exposure at Work? A Review of Prospective Studies and Meta-Analysis.

    Science.gov (United States)

    Descatha, Alexis; Albo, Francesco; Leclerc, Annette; Carton, Matthieu; Godeau, Diane; Roquelaure, Yves; Petit, Audrey; Aublet-Cuvelier, Agnès

    2016-11-01

    In view of recent published studies, a meta-analysis was undertaken on prospective studies in order to assess any association between lateral epicondylitis and physical exposure at work. Using the key words "lateral epicondylitis" AND "occupational" AND ("cohort" OR "longitudinal," OR "incidence") without limitations on the language or year of publication, original prospective studies were selected from 4 databases (PubMed, Scopus, Web of Science, and Base de Données de Santé Publique) after 2 rounds (valid design, valid association reported, and valid work exposure). Relevant associations between physical exposure at work and incident lateral epicondylitis were extracted from the articles, and a meta-risk was calculated using the generic variance approach (meta-odds ratios [meta-ORs]). From 2001 to 2014, 5 prospective studies were included. Among 6,922 included subjects (and 3,449 who were followed), 256 cases of incident lateral epicondylitis were diagnosed 2.5-6 years after baseline. All the published studies found a significant estimation of relative risk for a positive association between combined biomechanic exposure involving the wrist and/or elbow and incidence of lateral epicondylitis. The overall meta-OR was 2.6 (95% confidence interval 1.9-3.5), with a low heterogeneity (Q = 1.4, P > 0.05). Funnel plots and Egger's test did not suggest major publication bias. The results of this meta-analysis strongly support the hypothesis of an association between biomechanic exposure involving the wrist and/or elbow at work and incidence of lateral epicondylitis. © 2016, American College of Rheumatology.

  13. Psychometric properties of the Chinese version of the Menopause-Specific Quality-of-Life questionnaire.

    Science.gov (United States)

    Nie, Guangning; Yang, Hongyan; Liu, Jian; Zhao, ChunMei; Wang, Xiaoyun

    2017-05-01

    The Menopause-Specific Quality-of-Life (MENQOL) questionnaire was developed as a specific tool to measure the health-related quality-of-life of postmenopausal women. Thus far, the Chinese version questionnaire has not been subjected to psychometric assessment with a large sample. This study aims to evaluate the validity and reliability of the Chinese version of the MENQOL specific to postmenopausal women in China. A total of 1,137 menopausal symptomatic and 491 menopausal asymptomatic women from eight cities in China were recruited using a convenience sampling method. Psychometric properties were evaluated by descriptive statistics, validity, and reliability. Reliability was assessed for each subscale of the MENQOL through internal consistency reliability with Cronbach's α and intersubscale correlations. Item-domain correlations, principal components analysis (PCA), and confirmatory factor analysis were performed to determine construct validity. t tests were used to compare the differences between the menopausal symptomatic and asymptomatic women and to evaluate the discriminate validity. Pearson correlation coefficients were calculated between MENQOL scores and the Kupperman index to assess criterion-related validity. The most common symptoms in Chinese menopausal symptomatic women were "experiencing poor memory" (94.4%), "feeling tired or worn out" (93.8%), "aching in muscle and joints" (89.4%), "low backache" (86.9%), "decrease in physical strength" (86.6%), "aches in back of neck or head" (86.2%), "difficulty sleeping" (83.6%), "accomplishing less than I used to" (83.4%), "feeling a lack of energy" (83.3%), "change in your sexual desire" (81%), and "hot flash" (80.7%) among others. The symptoms of "increased facial hair" were rarely seen (9.9%). The vasomotor domain, as well as psychosocial, physical, and sexual domains showed high reliability (Cronbach's α 0.84, 0.87, 0.89, and 0.86, respectively). Item-domain correlation analysis showed that all items

  14. Consumption of garlic and risk of colorectal cancer: an updated meta-analysis of prospective studies.

    Science.gov (United States)

    Hu, Ji-Yi; Hu, Yi-Wang; Zhou, Jiao-Jiao; Zhang, Meng-Wen; Li, Dan; Zheng, Shu

    2014-11-07

    To conduct an updated meta-analysis of prospective studies addressing the association between garlic consumption and colorectal cancer. Eligible cohort studies were identified by searching MEDLINE (PubMed) and screening the references of related articles published up to October 2013. Meta-analyses were conducted for colorectal cancer in relation to consumption of raw and cooked (RC) garlic and garlic supplements, separately. The summary relative risks (RR) with 95%CI were calculated using fixed-effects or random-effects model depending on the heterogeneity among studies. A total of 5 prospective cohort studies were identified. In contrast to the previous meta-analysis, no significant associations were found between consumption of RC garlic (RR: 1.06; 95%CI: 0.95-1.19) or garlic supplements (RR: 1.12; 95%CI: 0.96-1.31) and risk of colorectal cancer. A non-significant protective effect of garlic supplement intake against colorectal cancer was observed in females (RR: 0.84; 95%CI: 0.64-1.11), but the opposite was the case in males (RR: 1.24; 95%CI: 0.96-1.59). Consumption of RC garlic or garlic supplements is not significantly associated with reduced colorectal cancer risk.

  15. Chocolate Consumption and Risk of Heart Failure: A Meta-Analysis of Prospective Studies.

    Science.gov (United States)

    Gong, Fei; Yao, Shuyuan; Wan, Jing; Gan, Xuedong

    2017-04-20

    Epidemiological studies have shown inconsistent findings on the association between chocolate consumption and risk of heart failure (HF). We, therefore, performed a meta-analysis of prospective studies to determine the role of chocolate intake in the prevention of HF. We searched databases of PubMed, Web of Science, and Scopus through December 2016 and scrutinized the reference lists of relevant literatures to identify eligible studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were aggregated using random effect models. The dose-response relationship between chocolate consumption and incident HF was also assessed. This meta-analysis is registered with PROSPERO, number CRD42017054230. Five prospective studies with 106,109 participants were finally included. Compared to no consumption of chocolate, the pooled HRs (95% CIs) of HF were 0.86 (0.82-0.91) for low-to-moderate consumption (chocolate consumption and risk of HF ( p for nonlinearity = 0.005). Compared with non-consumption, the HRs (95% CIs) of HF across chocolate consumption levels were 0.92 (0.88-0.97), 0.86 (0.78-0.94), 0.93 (0.85-1.03), and 1.07 (0.92-1.23) for 1, 3, 7, and 10 servings/week, respectively. In conclusion, chocolate consumption in moderation may be associated with a decreased risk of HF.

  16. Chocolate Consumption and Risk of Heart Failure: A Meta-Analysis of Prospective Studies

    Science.gov (United States)

    Gong, Fei; Yao, Shuyuan; Wan, Jing; Gan, Xuedong

    2017-01-01

    Epidemiological studies have shown inconsistent findings on the association between chocolate consumption and risk of heart failure (HF). We, therefore, performed a meta-analysis of prospective studies to determine the role of chocolate intake in the prevention of HF. We searched databases of PubMed, Web of Science, and Scopus through December 2016 and scrutinized the reference lists of relevant literatures to identify eligible studies. Study-specific hazard ratios (HRs) and 95% confidence intervals (CIs) were aggregated using random effect models. The dose–response relationship between chocolate consumption and incident HF was also assessed. This meta-analysis is registered with PROSPERO, number CRD42017054230. Five prospective studies with 106,109 participants were finally included. Compared to no consumption of chocolate, the pooled HRs (95% CIs) of HF were 0.86 (0.82–0.91) for low-to-moderate consumption (chocolate consumption and risk of HF (p for nonlinearity = 0.005). Compared with non-consumption, the HRs (95% CIs) of HF across chocolate consumption levels were 0.92 (0.88–0.97), 0.86 (0.78–0.94), 0.93 (0.85–1.03), and 1.07 (0.92–1.23) for 1, 3, 7, and 10 servings/week, respectively. In conclusion, chocolate consumption in moderation may be associated with a decreased risk of HF. PMID:28425931

  17. Early Menopause Predicts Future Coronary Heart Disease and Stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

    Science.gov (United States)

    Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay

    2012-01-01

    Objective Cardiovascular disease is the number one killer of women. Identifying women at risk of cardiovascular disease has tremendous public health importance. Early menopause is associated with increased cardiovascular disease events in some predominantly white populations, but not consistently. Our objective was to determine if a self-reported early menopause (menopause at an age menopause (either natural menopause or surgical removal of ovaries at an age menopause. In survival curves, women with early menopause had worse coronary heart disease and stroke-free survival (log rank p=menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors. PMID:22692332

  18. Comparison of medical costs and healthcare resource utilization of post-menopausal women with HR+/HER2- metastatic breast cancer receiving everolimus-based therapy or chemotherapy: a retrospective claims database analysis.

    Science.gov (United States)

    Li, Nanxin; Hao, Yanni; Koo, Valerie; Fang, Anna; Peeples, Miranda; Kageleiry, Andrew; Wu, Eric Q; Guérin, Annie

    2016-01-01

    To analyze medical costs and healthcare resource utilization (HRU) associated with everolimus-based therapy or chemotherapy among post-menopausal women with hormone-receptor-positive, human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC). Patients with HR+/HER2- mBC who discontinued a non-steroidal aromatase inhibitor and began a new line of treatment with everolimus-based therapy or chemotherapy (index therapy/index date) between July 20, 2012 and April 30, 2014 were identified from two large claims databases. All-cause, BC-related, and adverse event (AE)-related medical costs (in 2014 USD) and all-cause HRU per patient per month (PPPM) were analyzed for both treatment groups across patients' first four lines of therapies for mBC. Adjusted differences in costs and HRU between the everolimus and chemotherapy treatment group were estimated pooling all lines and using multivariable generalized linear models, accounting for difference in patient characteristics. A total of 3298 patients were included: 902 everolimus-treated patients and 2636 chemotherapy-treated patients. Compared to chemotherapy, everolimus was associated with significantly lower all-cause (adjusted mean difference = $3455, p well as significantly lower HRU (emergency room incidence rate ratio [IRR] = 0.83; inpatient IRR = 0.74; inpatient days IRR = 0.65; outpatient IRR = 0.71; BC-related outpatient IRR = 0.57; all p chemotherapy.

  19. »CRIME AND PUNISHMENT« IN THE MENOPAUSAL HEALTH CARE

    Directory of Open Access Journals (Sweden)

    Ivan Fistonić

    2018-02-01

    Full Text Available Background. In the past thirty years, there has been a significant rise of public and private health institutions’ interest in the prediction and management of medical risks. The need of risk management is a direct consequence of the growing number of legal actions against medical malpractice. The concept of risk management involves three basic processes: risk identification, risk analysis, and risk management. Risk includes an evaluation of vulnerability and management of events that could potentially endanger the operation of a health institution, comprising a balance between the consequential costs of medical malpractice and the costs of risk reduction (anticipation. Thus the potential financial consequences of risk exposure are crucial in the formation of diagnostic and treatment protocols, whereas improvement of the quality of medical care as well as patient protection are the primary aims of risk management. Conclusions. Postmenopausal health care is not an exempt when considering possible erorrs in medication or medical process per se. On the orther hand menopausal medicine is not only hormonal replacement therapy but also bunch of complementary and alternative specialities involved in the healing process where error could be easily achieved.

  20. Premedication in Supravaginal Uterine Amputation in Menopausal Women

    Directory of Open Access Journals (Sweden)

    D. V Sadchikov

    2008-01-01

    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

  1. Attention problems and pathological gaming: resolving the 'chicken and egg' in a prospective analysis.

    Science.gov (United States)

    Ferguson, Christopher J; Ceranoglu, T Atilla

    2014-03-01

    Pathological gaming (PG) behaviors are behaviors which interfere with other life responsibilities. Continued debate exists regarding whether symptoms of PG behaviors are a unique phenomenon or arise from other mental health problems, including attention problems. Development of attention problems and occurrence of pathological gaming in 144 adolescents were followed during a 1-year prospective analysis. Teens and their parents reported on pathological gaming behaviors, attention problems, and current grade point average, as well as several social variables. Results were analyzed using regression and path analysis. Attention problems tended to precede pathological gaming behaviors, but the inverse was not true. Attention problems but not pathological gaming predicted lower GPA 1 year later. Current results suggest that pathological gaming arises from attention problems, but not the inverse. These results suggest that pathological gaming behaviors are symptomatic of underlying attention related mental health issues, rather than a unique phenomenon.

  2. A Theory for the Origin of Human Menopause.

    Science.gov (United States)

    Takahashi, Mike; Singh, Rama S; Stone, John

    2016-01-01

    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.

  3. Use of Chinese herbal medicine among menopausal women in Taiwan.

    Science.gov (United States)

    Chen, Lih-Chi; Wang, Bi-Ru; Chen, I-Chin; Shao, Chun-Hui

    2010-04-01

    To assess the patterns of use of Chinese herbal medicine (CHM) used by women in Taiwan to treat menopausal symptoms. A retrospective review of the records of women who received CHM therapies for menopausal symptoms at the Traditional Medicine Center, Veterans General Hospital, Taipei, between January 2003 and December 2006. The average number of therapies per prescription, dosage, and duration of the prescription were recorded. The most commonly prescribed herbs and formulae were also recorded. Data were analyzed using descriptive statistics. The records of 3432 women who were administered a total of 19370 CHMs to treat symptoms of the menopause were reviewed. The average number of drugs per prescription was 5.64. Most of the prescriptions (97.1%) were prescribed to be taken 3 times a day. The most commonly prescribed Chinese herb was Leonurus heterophyllus. Jia-Wey-Shiau-Yau-San was the most commonly prescribed Chinese herbal formula. CHM is commonly used in Taiwan for the treatment of menopausal symptoms. The efficacy and safety of CHM drugs used for the management of menopausal symptoms require further study. Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Effects of calci soya balance and vitagnus on menopausal symptoms.

    Science.gov (United States)

    Golian Tehrani, Shahnaz; Bazzazian, Shahin; Bakhtiarian, Azam; Ghobadzadeh, Maryam

    2014-10-01

    Menopause is a period of women's lives with changes and symptoms that affect their work, sleep and quality of life. Therefore, it is important to overcome these symptoms. The aim of the present study was to compare the effects of Calci soya balance and Vitagnus on menopausal symptoms. This double-blinded controlled trial study was performed in public health centers of Tehran University of Medical Sciences (2011-2012). Seventy postmenopausal women with menopausal symptoms were randomly divided into two groups of treatments with Vitagnus and Calci soya balance. Data were collected using interviews, answering Cooperman's index questionnaires before four and eight weeks after the treatment. Descriptive and analytic statistics were used for analyzing the data. In both groups, Wilcoxon test showed a significant decrease in the mean of Cooperman's menopausal index as well as after four and eight weeks of treatment (P = 0.000). Mann-Whitney test did not show any significant differences between the two groups, before and after four and eight weeks of treatment. The results showed that both Vitagnus and Calci soya balance were effective on reduction of menopausal symptoms to a similar extent and medical community can administer each of these two drugs based on patients' conditions and costs.

  5. Identifying the educational needs of menopausal women: a feasibility study.

    Science.gov (United States)

    Trudeau, Kimberlee J; Ainscough, Jessica L; Trant, Meredith; Starker, Joan; Cousineau, Tara M

    2011-01-01

    The goal of this project was to identify the educational needs of menopausal women and test the feasibility of an online self management program based on social learning theory. The four stages included 1) a needs assessment using a) focus groups with 24 women ages 40 to 55 and b) phone interviews with eight health experts; 2) the use of concept mapping methodology for quantifying qualitative data from stage 1 to identify the core programmatic concepts; 3) development of a demonstration program; and 4) a pilot study with 35 women and 9 health experts to assess knowledge gained and program satisfaction. Results show that women desire more information about normalcy of menopause and symptom management and found the program to meet a need for menopausal education otherwise perceived as unavailable. The women significantly increased their menopausal knowledge after brief exposure (t(34) = 3.64; p = .001). This project provides support for an online health education program for menopausal women and content ideas for inclusion in women's health education curriculum. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  6. Analysis and Interpretation of Avo Data in Buit-North Prospect of the Niger Delta Slope

    International Nuclear Information System (INIS)

    Oladapo, M.I.; Ojo, J. S.; Adetola, B.A.

    2003-01-01

    A qualitative analysis and interpretation of Amplitude Variations with Offset (AVO) data from Buit-North prospect in the Niger Delta Slope has been undertaken. Four horizons evaluated are AA (1900mm), BB (2345m), CC (2500m) and DD (2935). The work involved the comparison of AVO analysis of Buit-I well log and those of 3-D Pre-Stack Time Migrated (PSTM) seismic data acquired from the study area. Acoustic Impedance-Depth trend generated from Buit-1 Well demonstrates that AVO interpretation at depths between 2650m and .3300m (points of polynomial fit convergence) may be subdued due to nera zero impedance contrasts at contacts. Monte-Carlo models generated for the horizons using parameters measured from Buit. Zoeppritz (AVO) curves and seismic attributes crossplots were generated for all the horizons. AA horizon exhibit classes II and IV (falling AVO) while horizon BB reveal class III (classical bright spot) gas sand. Horizon CC exhibit class II (near zero impedance) gas sand while the seismic attributes crossplots show no distinct anomalous plots. The AVO response curves displayed at the upper level of horizon DD is characteristic of class IV response with the lower level exhibiting class II attribute. The seismic attributes crossplots for DD show plots on quandrants II, III and IV thus confirmation AVO analysis complexity within that depth window. Quantitative analysis and interpretation of AVO data is demonstrated in this study as a valuable emerging technology for appraising deep-water prospects for the delineation of probable hydrocarbon zones for further studies

  7. Anticipating the use of future things: towards a framework for prospective use analysis in innovation design projects.

    Science.gov (United States)

    Nelson, Julien; Buisine, Stéphanie; Aoussat, Améziane

    2013-11-01

    Anticipation of future product use is a persistent issue in User-Centered Design. In this paper, we argue that one obstacle to early integration of use analysis in innovation design is overreliance on retrospective use analysis, i.e. that which is based on clear references to existing products or activities. In contrast, innovation design projects are full of uncertainty, leading to a need for prospective analysis. After having described some limitations of prospective use analysis, we contend that creativity tools may be used to assist the anticipation of future product use, by allowing designers to approach the variability of situations of future use in a structured manner rather than by "muddling through". We illustrate the expected benefits of this approach with two case studies, and describe some prospects for future research and practice in ergonomics. Copyright © 2013. Published by Elsevier Ltd.

  8. Daytime napping and risk of type 2 diabetes: a meta-analysis of prospective studies.

    Science.gov (United States)

    Chen, Guo-Chong; Liu, Meng-Meng; Chen, Li-Hua; Xu, Jia-Ying; Hidayat, Khemayanto; Li, Fu-Rong; Qin, Li-Qiang

    2017-06-13

    Prospective studies reported inconsistent findings on the relationship between daytime napping and risk of type 2 diabetes (T2D). Categorized and dose-response meta-analyses were performed to quantify this relation. Potentially eligible studies were identified by searching PubMed and Embase databases. Dose-response effects were assessed by the generalized least squares trend estimation and study-specific summary relative risks (RRs) with 95% confidence intervals (CIs) were computed with a random-effects model. Seven prospective studies including one US, four European, and two Chinese cohorts involving 249,077 participants and 13,237 cases of T2D were included. The overall analyses showed a 17% increased risk of T2D when comparing habitual nappers with non-nappers (RR = 1.17, 95% CI 1.08-1.27). By region, the summary RR was 1.21 (95% CI 1.17-1.26), 1.15 (95% CI 1.03-1.30) and 1.23 (95% CI 0.87-1.73) for the US, European, and Chinese studies, respectively. Limiting to five studies that excluded subjects with known major chronic disorders yielded a summary RR of 1.16 (95% CI 1.03-1.30). A dose-response analysis suggested an 11% (95% CI 7-16%) increased T2D risk for each increment in daytime napping of 30 min/day and, despite no evidence for nonlinearity (P nonlinearity  = 0.65), the increased risk of T2D for short nap (napping is associated with an increased risk of T2D. Given the limited number of cohorts and inconsistency in terms of methodological and population characteristics across these cohorts, residual confounders and/or reverse causality cannot be fully addressed, and our findings should be interpreted with great caution. Future well-designed prospective studies are still warranted.

  9. Prospect Theory and the Risks Involved in Decision-Making: Content Analysis in ProQuest Articles

    Directory of Open Access Journals (Sweden)

    Sady Darcy da Silva-Junior

    2016-04-01

    Full Text Available In this study, the objective is to perform content analysis on articles of a reliable database, dealing with the prospect theory and the risks involved in the decision making process, evaluating some criteria for the theoretical and methodological approaches that allow a joint analysis and comparative. Therefore, a search in ProQuest database was performed which resulted in 15 articles that were submitted to content analysis process, based on the evaluation of nine factors identified by researchers. Among the results highlight the critical attitude to the prospect theory, in contrast to the assertion of his representative capacity of real situations and application in various situations.

  10. Menopausal Hot Flashes and White Matter Hyperintensities

    Science.gov (United States)

    Thurston, Rebecca C.; Aizenstein, Howard J.; Derby, Carol A.; Sejdić, Ervin; Maki, Pauline M.

    2015-01-01

    Objective Hot flashes are the classic menopausal symptom. Emerging data links hot flashes to cardiovascular disease (CVD) risk, yet how hot flashes are related to brain health is poorly understood. We examined the relationship between hot flashes - measured via physiologic monitor and self-report - and white matter hyperintensities (WMH) among midlife women. Methods Twenty midlife women ages 40-60 without clinical CVD, with their uterus and both ovaries, and not taking hormone therapy were recruited. Women underwent 24 hours of ambulatory physiologic and diary hot flash monitoring to quantify hot flashes; magnetic resonance imaging to assess WMH burden; 72 hours of actigraphy and questionnaires to quantify sleep; and a blood draw, questionnaires, and physical measures to quantify demographics and CVD risk factors. Test of a priori hypotheses regarding relations between physiologically-monitored and self-reported wake and sleep hot flashes and WMH were conducted in linear regression models. Results More physiologically-monitored hot flashes during sleep were associated with greater WMH, controlling for age, race, and body mass index [beta(standard error)=.0002 (.0001), p=.03]. Findings persisted controlling for sleep characteristics and additional CVD risk factors. No relations were observed for self-reported hot flashes. Conclusions More physiologically-monitored hot flashes during sleep were associated with greater WMH burden among midlife women free of clinical CVD. Results suggest that relations between hot flashes and CVD risk observed in the periphery may extend to the brain. Future work should consider the unique role of sleep hot flashes in brain health. PMID:26057822

  11. Benefits of Walking on Menopausal Symptoms and Mental Health Outcomes among Chinese Postmenopausal Women

    OpenAIRE

    Liang Hu; Li Zhu; Jiaying Lyu; Wenjun Zhu; Yaping Xu; Lin Yang

    2017-01-01

    Background: Menopausal transition is often associated with impaired satisfaction with life (SL). Exercise is promising in both managing menopausal symptoms and improving subjective well-being of women after menopause. Purpose: This study examined the effects of a 4-month randomized controlled walking trial on menopausal symptoms and SL in 80 community-dwelling postmenopausal Chinese women (M age = 53.38, SD = 3.41), and identified predictors of changes in SL across the intervention. Met...

  12. Predicting complication risk in spine surgery: a prospective analysis of a novel risk assessment tool.

    Science.gov (United States)

    Veeravagu, Anand; Li, Amy; Swinney, Christian; Tian, Lu; Moraff, Adrienne; Azad, Tej D; Cheng, Ivan; Alamin, Todd; Hu, Serena S; Anderson, Robert L; Shuer, Lawrence; Desai, Atman; Park, Jon; Olshen, Richard A; Ratliff, John K

    2017-07-01

    OBJECTIVE The ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort. METHODS The spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period. Prospectively collected data were used to compare the RAT to the Charlson Comorbidity Index (CCI) and the American College of Surgeons National Surgery Quality Improvement Program (ACS NSQIP) Surgical Risk Calculator. Study end point was occurrence and type of complication after spine surgery. RESULTS The authors identified 69 patients (73 procedures) who experienced a complication over the prospective study period. Cardiac complications were most common (10.2%). Receiver operating characteristic (ROC) curves were calculated to compare complication outcomes using the different assessment tools. Area under the curve (AUC) analysis showed comparable predictive accuracy between the RAT and the ACS NSQIP calculator (0.670 [95% CI 0.60-0.74] in RAT, 0.669 [95% CI 0.60-0.74] in NSQIP). The CCI was not accurate in predicting complication occurrence (0.55 [95% CI 0.48-0.62]). The RAT produced mean probabilities of 34.6% for patients who had a complication and 24% for patients who did not (p = 0.0003). The generated predicted values were stratified into low, medium, and high rates. For the RAT, the predicted complication rate was 10.1% in the low-risk group (observed rate 12.8%), 21.9% in the medium-risk group (observed 31.8%), and 49.7% in the high-risk group (observed 41.2%). The ACS NSQIP calculator consistently

  13. Prospect analysis for sandstone-type uranium mineralization in the northern margin of Qaidam basin

    International Nuclear Information System (INIS)

    Liu Lin; Song Xiansheng; Feng Wei; Song Zhe; Li Wei

    2010-01-01

    Affected by the regional geological structural evolution, a set of sedimentary structure, i.e. the construction of coal-bearing classic rocks which is in favor of the sandstone-type uranium mineralization has deposited in the northern margin of Qaidam Basin since Meso-Cenozoic. A NWW thrust nappe tectonic belt, i.e. the ancient tectonic belt which is the basis for the development of ancient interlayer oxidation zone formed by the tectonic reverse in late Jurassic and Cretaceous. The Mid and late Jurassic layer was buried by the weak extension in Paleogene and the depression in early Neogene. The extrusion reversal from late Neogene to Quaternary made the basin into the development era of the modern interlayer oxidation zone. It can be concluded that the layer of the northern margin of Qaidam Basin has the premise for the formation of sandstone-type uranium ore. Based on the analysis of the characteristics of the thrust belt, the structure of the purpose layer, the sand body, the hydrogeology, the interlayer oxidation zone and uranium mineralization, the results indicated that the ancient interlayer oxidation zone is the prospecting type of sandstone-type uranium ore. Beidatan and the east of Yuqia are the favorable prospective area of sandstone-type uranium mineralization. (authors)

  14. Can we predict age at natural menopause using ovarian reserve tests or mother's age at menopause? A systematic literature review.

    Science.gov (United States)

    Depmann, Martine; Broer, Simone L; van der Schouw, Yvonne T; Tehrani, Fahimeh R; Eijkemans, Marinus J; Mol, Ben W; Broekmans, Frank J

    2016-02-01

    This review aimed to appraise data on prediction of age at natural menopause (ANM) based on antimüllerian hormone (AMH), antral follicle count (AFC), and mother's ANM to evaluate clinical usefulness and to identify directions for further research. We conducted three systematic reviews of the literature to identify studies of menopause prediction based on AMH, AFC, or mother's ANM, corrected for baseline age. Six studies selected in the search for AMH all consistently demonstrated AMH as being capable of predicting ANM (hazard ratio, 5.6-9.2). The sole study reporting on mother's ANM indicated that AMH was capable of predicting ANM (hazard ratio, 9.1-9.3). Two studies provided analyses of AFC and yielded conflicting results, making this marker less strong. AMH is currently the most promising marker for ANM prediction. The predictive capacity of mother's ANM demonstrated in a single study makes this marker a promising contributor to AMH for menopause prediction. Models, however, do not predict the extremes of menopause age very well and have wide prediction interval. These markers clearly need improvement before they can be used for individual prediction of menopause in the clinical setting. Moreover, potential limitations for such use include variations in AMH assays used and a lack of correction for factors or diseases affecting AMH levels or ANM. Future studies should include women of a broad age range (irrespective of cycle regularity) and should base predictions on repeated AMH measurements. Furthermore, currently unknown candidate predictors need to be identified.

  15. EMAS recommendations for conditions in the workplace for menopausal women.

    Science.gov (United States)

    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

    2016-03-01

    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 menopausal transition women report that fatigue and difficulties with memory and concentration can have a negative impact on their working lives. Furthermore, hot flushes can be a source of embarrassment and distress. Some consider that these symptoms can impact on their performance. Greater awareness among employers, together with sensitive and flexible management can be helpful for women at this time. Particular strategies might include: fostering a culture whereby employees feel comfortable disclosing health problems, allowing flexible working, reducing sources of work-related stress, providing easy access to cold drinking water and toilets, and reviewing workplace temperature and ventilation. Copyright © 2016. Published by Elsevier Ireland Ltd.

  16. Menopausal symptoms and associated factors in HIV-positive women.

    Science.gov (United States)

    Lui-Filho, Jeffrey F; Valadares, Ana Lúcia R; Gomes, Debora de C; Amaral, Eliana; Pinto-Neto, Aarão M; Costa-Paiva, Lúcia

    2013-10-01

    To evaluate menopausal symptoms and their associated factors in HIV-positive women. A cross-sectional study was conducted with 537 women of 40-60 years of age, 273 of whom were HIV-positive and 264 HIV-negative. The women were interviewed to obtain data on their sociodemographic characteristics and menopausal symptoms. The mean age of the seropositive women was 47.7±5.8 years compared to 49.8±5.3 for the seronegative women (psymptoms in the seropositive group (p=0.009), specifically hot flashes (pHIV serological status and any of the menopausal symptoms. In this study, after controlling for confounding variables, HIV infection was not found to be associated with vasomotor, genitourinary or psychological symptoms or with insomnia. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Distribution of age at menopause in two Danish samples

    DEFF Research Database (Denmark)

    Boldsen, J L; Jeune, B

    1990-01-01

    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...... ages for the effect of differing ages at reporting. The corrected distribution of age at menopause differs from the normal distribution in the same way in both samples. Both distributions could be described by a mixture of two normal distributions. It appears that most of the parameters of the normal...... distribution mixtures remain unchanged over a 50-year time lag. The position of the distribution, that is, the mean age at menopause, however, increases slightly but significantly....

  18. The Critical Role of Estrogen in Menopausal Osteoporosis

    Directory of Open Access Journals (Sweden)

    Mrinali Sharma

    2017-12-01

    Full Text Available Osteoporosis is a bone disorder, which causes a reduction in the mass and density of bone tissue, and implants a greater possibility for skeletal fractures to occur. This bone disease is especially relevant for women suffering from menopause. Due to this general prevalence, osteoporosis requires continual intervention in the pharmacological and medicinal industry for better treatment alternatives for patients. A focal point for many scientific research studies for osteoporosis has been estrogen. As a hormone, estrogen exhibits a fluctuating capacity in the woman's body, and this has been proclaimed to be a qualifying explanation as to why women develop osteoporosis after menopause. The purpose of this paper is to interpret estrogen's capacity to treat menopausal osteoporosis. Thus, in this article, estrogen’s significance in bone health and different forms, derivatives, and the combinations of estrogen is examined in terms of efficiency in treating osteoporosis. [J Contemp Med 2017; 7(4.000: 418-427

  19. A comparison of two prospective risk analysis methods: Traditional FMEA and a modified healthcare FMEA.

    Science.gov (United States)

    Rah, Jeong-Eun; Manger, Ryan P; Yock, Adam D; Kim, Gwe-Ya

    2016-12-01

    To examine the abilities of a traditional failure mode and effects analysis (FMEA) and modified healthcare FMEA (m-HFMEA) scoring methods by comparing the degree of congruence in identifying high risk failures. The authors applied two prospective methods of the quality management to surface image guided, linac-based radiosurgery (SIG-RS). For the traditional FMEA, decisions on how to improve an operation were based on the risk priority number (RPN). The RPN is a product of three indices: occurrence, severity, and detectability. The m-HFMEA approach utilized two indices, severity and frequency. A risk inventory matrix was divided into four categories: very low, low, high, and very high. For high risk events, an additional evaluation was performed. Based upon the criticality of the process, it was decided if additional safety measures were needed and what they comprise. The two methods were independently compared to determine if the results and rated risks matched. The authors' results showed an agreement of 85% between FMEA and m-HFMEA approaches for top 20 risks of SIG-RS-specific failure modes. The main differences between the two approaches were the distribution of the values and the observation that failure modes (52, 54, 154) with high m-HFMEA scores do not necessarily have high FMEA-RPN scores. In the m-HFMEA analysis, when the risk score is determined, the basis of the established HFMEA Decision Tree™ or the failure mode should be more thoroughly investigated. m-HFMEA is inductive because it requires the identification of the consequences from causes, and semi-quantitative since it allows the prioritization of high risks and mitigation measures. It is therefore a useful tool for the prospective risk analysis method to radiotherapy.

  20. Poor sleep in relation to natural menopause: a population-based 14-year follow-up of midlife women.

    Science.gov (United States)

    Freeman, Ellen W; Sammel, Mary D; Gross, Stephanie A; Pien, Grace W

    2015-07-01

    This study aims to estimate the prevalence and predictors of moderate/severe poor sleep in relation to the final menstrual period (FMP) in midlife women. Annual assessments were conducted in a population-based cohort of 255 women. All were premenopausal at cohort enrollment and reached natural menopause during the 16-year follow-up. The outcome measure was severity of poor sleep, as reported by participants in annual interviews for 16 years and as evaluated in relation to the FMP. The annual prevalence of moderate/severe poor sleep largely ranged from about 28% to 35%, with no significant differences in any year relative to the FMP for the sample overall. When sleep status was stratified at premenopausal baseline, premenopausal sleep status strongly predicted poor sleep around the FMP. Women with moderate/severe poor sleep in premenopause were approximately 3.5 times more likely to have moderate/severe poor sleep around menopause than those with no poor sleep at baseline in adjusted analysis (odds ratio, 3.58; 95% CI, 2.50-5.11; P menopause (odds ratio, 1.57; 95% CI, 0.99-2.47; P = 0.053). There was no significant association between poor sleep and time relative to the FMP among women who had no poor sleep at premenopausal baseline. Hot flashes were significantly associated with poor sleep (odds ratio, 1.79; 95% CI, 1.44-2.21; P menopausal transition. Overall, poor sleep does not increase around the FMP and frequently occurs in the absence of hot flashes, indicating that sleep difficulties in the menopausal transition in generally healthy women are not simply associated with ovarian decline.

  1. It is not just menopause: symptom clustering in the Study of Women's Health Across the Nation.

    Science.gov (United States)

    Harlow, Siobán D; Karvonen-Gutierrez, Carrie; Elliott, Michael R; Bondarenko, Irina; Avis, Nancy E; Bromberger, Joyce T; Brooks, Maria Mori; Miller, Janis M; Reed, Barbara D

    2017-01-01

    Patterns of symptom clustering in midlife women may suggest common underlying mechanisms or may identify women at risk of adverse health outcomes or, conversely, likely to experience healthy aging. This paper assesses symptom clustering in the Study of Women's Health Across the Nation (SWAN) longitudinally by stage of reproductive aging and estimates the probability of women experiencing specific symptom clusters. We also evaluate factors that influence the likelihood of specific symptom clusters and assess whether symptom clustering is associated with women's self-reported health status. This analysis includes 3289 participants in the multiethnic SWAN cohort who provided information on 58 symptoms reflecting a broad range of physical, psychological and menopausal symptoms at baseline and 7 follow-up visits over 16 years. We conducted latent transition analyses to assess symptom clustering and to model symptomatology across the menopausal transition (pre, early peri-, late peri- and post-menopausal). Joint multinomial logistic regression models were used to identify demographic characteristics associated with premenopausal latent class membership. A partial proportional odds regression model was used to assess the association between latent class membership and self-reported health status. We identified six latent classes that ranged from highly symptomatic (LC1) across most measured symptoms, to moderately symptomatic across most measured symptoms (LC2), to moderately symptomatic for a subset of symptoms (vasomotor symptoms, pain, fatigue, sleep disturbances and physical health symptoms) (LC3 and LC5) with one class (LC3) including interference in life activities because of physical health symptoms, to numerous milder symptoms, dominated by fatigue and psychological symptoms (LC4), to relatively asymptomatic (LC6). In pre-menopause, 10% of women were classified in LC1, 16% in LC2, 14% in LC3 and LC4, 26% in LC5, and 20% in LC6. Intensity of vasomotor and

  2. Benefits of Walking on Menopausal Symptoms and Mental Health Outcomes among Chinese Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Liang Hu

    2017-09-01

    Conclusion: Walking could be recommended for post-menopausal women to manage menopausal symptoms and promote psychological well-being. Life satisfaction may be enhanced through the improvement of mental and physical parameters (e.g., menopausal symptoms, BMI and depression.

  3. Familial concordance for age at natural menopause: results from the Breakthrough Generations Study.

    Science.gov (United States)

    Morris, Danielle H; Jones, Michael E; Schoemaker, Minouk J; Ashworth, Alan; Swerdlow, Anthony J

    2011-09-01

    Existing estimates of the heritability of menopause age have a wide range. Furthermore, few studies have analyzed to what extent familial similarities might reflect shared environment, rather than shared genes. We therefore analyzed familial concordance for age at natural menopause and the effects of shared genetic and environmental factors on this concordance. Participants were 2,060 individuals comprising first-degree relatives, aged 31 to 90 years, and participating in the UK Breakthrough Generations Study. Menopause data were collected using a self-administered questionnaire and analyzed using logistic regression and variance-components models. Women were at an increased risk of early menopause (≤45 y) if their mother (odds ratio, 6.2; P menopause. Likewise, women had an increased risk of late menopause (≥54 y) if their relative had had a late menopause (mother: odds ratio, 6.1; P menopause age attributed to environmental factors shared by sisters. We confirm that early menopause aggregates within families and show, for the first time, that there is also strong familial concordance for late menopause. Both genes and shared environment were the source of variation in menopause age. Past heritability estimates have not accounted for shared environment, and thus, the effect of genetic variants on menopause age may previously have been overestimated.

  4. Genetics of ovarian ageing : genetic association studies on natural menopause and primary ovarian insufficiency

    NARCIS (Netherlands)

    Voorhuis, M.

    2013-01-01

    Menopause is the endpoint of a process referred to as ovarian ageing. The mean age at menopause is approximately 51 years, but varies widely between 40 to 60 years of age. Approximately 1% of all women experience menopause before the age of 40, which is a condition known as primary ovarian

  5. Genes Involved in Initial Follicle Recruitment May Be Associated with Age at Menopause

    NARCIS (Netherlands)

    Voorhuis, Marlies; Broekmans, Frank J.; Fauser, Bart C. J. M.; Onland-Moret, N. Charlotte; van der Schouw, Yvonne T.

    Context: Timing of menopause is largely influenced by genetic factors. Because menopause occurs when the follicle pool in the ovaries has become exhausted, genes involved in primordial follicle recruitment can be considered as candidate genes for timing of menopause. Objective: The aim was to study

  6. Influence Of Feminine Hormones On Some Biochemical Parameters In Early And Late Menopausal Status

    International Nuclear Information System (INIS)

    KAMAL, A.M.

    2009-01-01

    Forty two healthy Egyptian women were participated in this study to evaluate the effect of early and late menopause on some biochemical and hormonal parameters. The women were divided into three equal groups. The first was the pre-menopausal group with regular menstrual cycle, the second was the late menopausal group comprised the menopausal female less than 5 years and the third group consisted of women that became menopause since 5-9 years. The second and third groups had almost the same age and body weight. After clinical examination, fasting blood samples were collected from all volunteers. Regarding the pre-menopausal women, blood was withdrawn between the 3 rd and the 5 th day post-menstruation (follicular phase). Follicle stimulating hormone (FSH), leutinizing hormone (LH), progesterone, prolactin (PRL), testosterone, leptin and thyroxine (T4) in addition to hemoglobin (Hb), blood glucose, calcium (Ca), inorganic phosphorous (P), magnesium (Mg) and uric acid were determined. Both menopausal groups showed significant increase in FSH and LH and significant decrease in PRL and late menopausal group experienced also multiple significant correlations between FSH, LH and other tested parameters. Prolongation of menopause exhibited decrease in leptin being significant as compared to pre-menopausal women than that experienced menopause at younger age. Due to the relation between leptin hormone and osteoporosis, the results of this investigation denoted that early cessation of annulations (menopause) in Egyptian women may lead to disturbance in bone metabolism causing inhibiting osteoblastogenesis and decreasing bone mass.

  7. Effect of lavender aromatherapy on menopause hot flushing: A crossover randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Rafat Kazemzadeh

    2016-09-01

    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.

  8. Should symptomatic menopausal women be offered hormone therapy?

    Science.gov (United States)

    Lobo, Rogerio A; Bélisle, Serge; Creasman, William T; Frankel, Nancy R; Goodman, Neil E; Hall, Janet E; Ivey, Susan Lee; Kingsberg, Sheryl; Langer, Robert; Lehman, Rebecca; McArthur, Donna Behler; Montgomery-Rice, Valerie; Notelovitz, Morris; Packin, Gary S; Rebar, Robert W; Rousseau, MaryEllen; Schenken, Robert S; Schneider, Diane L; Sherif, Katherine; Wysocki, Susan

    2006-01-01

    Many physicians remain uncertain about prescribing hormone therapy for symptomatic women at the onset of menopause. The American Society for Reproductive Medicine (ASRM) convened a multidisciplinary group of healthcare providers to discuss the efficacy and risks of hormone therapy for symptomatic women, and to determine whether it would be appropriate to treat women at the onset of menopause who were complaining of menopausal symptoms. Numerous controlled clinical trials consistently demonstrate that hormone therapy, administered via oral, transdermal, or vaginal routes, is the most effective treatment for vasomotor symptoms. Topical vaginal formulations of hormone therapy should be preferred when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy. Data from the Women's Health Initiative indicate that the overall attributable risk of invasive breast cancer in women receiving estrogen plus progestin was 8 more cases per 10,000 women-years. No increased risk for invasive breast cancer was detected for women who never used hormone therapy in the past or for those receiving estrogen only. Hormone therapy is not effective for the treatment of cardiovascular disease and that the risk of cardiovascular disease with hormone therapy is principally in older women who are considerably postmenopause. Healthy symptomatic women should be offered the option of hormone therapy for menopausal symptoms. Symptom relief with hormone therapy for many younger women (at the onset of menopause) with menopausal symptoms outweighs the risks and may provide an overall improvement in quality of life. Hormone therapy should be individualized for symptomatic women. This involves tailoring the regimen and dose to individual needs.

  9. Musculoskeletal pain among women of menopausal age in Puebla, Mexico.

    Science.gov (United States)

    Sievert, Lynnette Leidy; Goode-Null, Susan K

    2005-06-01

    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.

  10. Menopause and risk of diabetes in the Diabetes Prevention Program.

    Science.gov (United States)

    Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

    2011-08-01

    The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

  11. Human ovarian reserve from conception to the menopause.

    Directory of Open Access Journals (Sweden)

    W Hamish B Wallace

    Full Text Available The human ovary contains a fixed number of non-growing follicles (NGFs established before birth that decline with increasing age culminating in the menopause at 50-51 years. The objective of this study is to model the age-related population of NGFs in the human ovary from conception to menopause. Data were taken from eight separate quantitative histological studies (n = 325 in which NGF populations at known ages from seven weeks post conception to 51 years (median 32 years were calculated. The data set was fitted to 20 peak function models, with the results ranked by obtained r2 correlation coefficient. The highest ranked model was chosen. Our model matches the log-adjusted NGF population from conception to menopause to a five-parameter asymmetric double Gaussian cumulative (ADC curve (r2 = 0.81. When restricted to ages up to 25 years, the ADC curve has r2 = 0.95. We estimate that for 95% of women by the age of 30 years only 12% of their maximum pre-birth NGF population is present and by the age of 40 years only 3% remains. Furthermore, we found that the rate of NGF recruitment towards maturation for most women increases from birth until approximately age 14 years then decreases towards the menopause. To our knowledge, this is the first model of ovarian reserve from conception to menopause. This model allows us to estimate the number of NGFs present in the ovary at any given age, suggests that 81% of the variance in NGF populations is due to age alone, and shows for the first time, to our knowledge, that the rate of NGF recruitment increases from birth to age 14 years then declines with age until menopause. An increased understanding of the dynamics of human ovarian reserve will provide a more scientific basis for fertility counselling for both healthy women and those who have survived gonadotoxic cancer treatments.

  12. Menopause in the workplace: What employers should be doing.

    Science.gov (United States)

    Jack, Gavin; Riach, Kathleen; Bariola, Emily; Pitts, Marian; Schapper, Jan; Sarrel, Philip

    2016-03-01

    Large numbers of women transition through menopause whilst in paid employment. Symptoms associated with menopause may cause difficulties for working women, especially if untreated, yet employers are practically silent on this potentially costly issue. This review summarises existing research on the underexplored topic of menopause in the workplace, and synthesises recommendations for employers. Longstanding scholarly interest in the relationship between employment status and symptom reporting typically (but not consistently) shows that women in paid employment (and in specific occupations) report fewer and less severe symptoms than those who are unemployed. Recent studies more systematically focused on the effects of menopausal symptoms on work are typically cross-sectional self-report surveys, with a small number of qualitative studies. Though several papers established that vasomotor (and associated) symptoms have a negative impact on women's productivity, capacity to work and work experience, this is not a uniform finding. Psychological and other somatic symptoms associated with menopause can have a relatively greater negative influence. Physical (e.g., workplace temperature and design) and psychosocial (e.g., work stress, perceptions of control/autonomy) workplace factors have been found to influence the relationship between symptoms and work. Principal recommendations for employers to best support menopausal women as part of a holistic approach to employee health and well-being include risk assessments to make suitable adjustments to the physical and psychosocial work environment, provision of information and support, and training for line managers. Limitations of prior studies, and directions for future research are presented. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Use of MR-based trabecular bone microstructure analysis at the distal radius for osteoporosis diagnostics: a study in post-menopausal women with breast cancer and treated with aromatase inhibitor.

    Science.gov (United States)

    Baum, Thomas; Karampinos, Dimitrios C; Seifert-Klauss, Vanadin; Pencheva, Tsvetelina D; Jungmann, Pia M; Rummeny, Ernst J; Müller, Dirk; Bauer, Jan S

    2016-01-01

    Treatment with aromatase inhibitor (AI) is recommended for post-menopausal women with hormone-receptor positive breast cancer. However, AI therapy is known to induce bone loss leading to osteoporosis with an increased risk for fragility fractures. The purpose of this study was to investigate whether changes of magnetic resonance (MR)-based trabecular bone microstructure parameters as advanced imaging biomarker can already be detected in subjects with AI intake but still without evidence for osteoporosis according to dual energy X-ray absorptiometry (DXA)-based bone mineral density (BMD) measurements as current clinical gold standard. Twenty-one postmenopausal women (62±6 years of age) with hormone-receptor positive breast cancer, ongoing treatment with aromatase inhibitor for 23±15 months, and no evidence for osteoporosis (current DXA T-score greater than -2.5) were recruited for this study. Eight young, healthy women (24±2 years of age) were included as controls. All subjects underwent 3 Tesla magnetic resonance imaging (MRI) of the distal radius to assess the trabecular bone microstructure. Trabecular bone microstructure parameters were not significantly (p>0.05) different between subjects with AI intake and controls, including apparent bone fraction (0.42±0.03 vs. 0.42±0.05), trabecular number (1.95±0.10 mm(-1) vs 1.89±0.15 mm(-1)), trabecular separation (0.30±0.03 mm vs 0.31±0.06 mm), trabecular thickness (0.21±0.01 mm vs 0.22±0.02 mm), and fractal dimension (1.70±0.02 vs. 1.70±0.03). These findings suggest that the initial deterioration of trabecular bone microstructure as measured by MRI and BMD loss as measured by DXA occur not sequentially but rather simultaneously. Thus, the use of MR-based trabecular bone microstructure assessment is limited as early diagnostic biomarker in this clinical setting.

  14. The efficacy of acupuncture on menopausal symptoms (ACOM study)

    DEFF Research Database (Denmark)

    Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert

    2017-01-01

    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......-specific sleeping problems, also measured by other scales from the MSQ. A total of 68 patients must be enrolled to detect a relevant clinical reduction on the above MSQ scales. Both intention-to-treat and per-protocol analyses will be conducted; four or more treatments are considered adequate adherence. CONCLUSIONS...

  15. Insulin-resistance and lipids metabolism in women at menopause

    Directory of Open Access Journals (Sweden)

    Marina Dmitrуina Gresko

    2018-01-01

    Full Text Available The article describes lipid metabolism in women during premenopausal and considered their relationship with the level of insulin sensitivity and abdominal obesity. Examined 20 women aged 46-48 years, with fixed transition to pre-menopause on the bases of menstrual cycle dysfunction or amenorrhea during a year as well as a decrease of visualized follicular reserve according to the results of ultrasonic examination of the organs of the small pelvis, were involved into investigation. Body mass increase with abdominal obese formation and disorders of the lipid metabolism against a background of insulin resistance is observed in women during pre-menopause against a background of sexual hormones deficiency.

  16. Analysis of gravity data beneath Endut geothermal prospect using horizontal gradient and Euler deconvolution

    Science.gov (United States)

    Supriyanto, Noor, T.; Suhanto, E.

    2017-07-01

    The Endut geothermal prospect is located in Banten Province, Indonesia. The geological setting of the area is dominated by quaternary volcanic, tertiary sediments and tertiary rock intrusion. This area has been in the preliminary study phase of geology, geochemistry, and geophysics. As one of the geophysical study, the gravity data measurement has been carried out and analyzed in order to understand geological condition especially subsurface fault structure that control the geothermal system in Endut area. After precondition applied to gravity data, the complete Bouguer anomaly have been analyzed using advanced derivatives method such as Horizontal Gradient (HG) and Euler Deconvolution (ED) to clarify the existance of fault structures. These techniques detected boundaries of body anomalies and faults structure that were compared with the lithologies in the geology map. The analysis result will be useful in making a further realistic conceptual model of the Endut geothermal area.

  17. Analysis of Praxis physics subject assessment examinees and performance: Who are our prospective physics teachers?

    Science.gov (United States)

    Shah, Lisa; Hao, Jie; Rodriguez, Christian A.; Fallin, Rebekah; Linenberger-Cortes, Kimberly; Ray, Herman E.; Rushton, Gregory T.

    2018-06-01

    A generally agreed upon tenant of the physics teaching community is the centrality of subject-specific expertise in effective teaching. However, studies which assess the content knowledge of incoming K-12 physics teachers in the U.S. have not yet been reported. Similarly lacking are studies on if or how the demographic makeup of aspiring physics educators is different from previously reported analyses of the actual high school physics teaching workforce. Here we present findings about the demographics and subject knowledge of prospective high school physics teachers using data from Praxis physics subject assessments administered between 2006 and 2016. Our analysis reveals significant variations in exam participation and performance between men and women, as well as those with different undergraduate majors and academic performance over the past decade. Findings from this work inform understandings and decisions about the quality, recruitment, and preparation of the high school physics teaching workforce.

  18. Economic-energy-environment analysis of prospective sugarcane bioethanol production in Brazil

    International Nuclear Information System (INIS)

    Lopes de Carvalho, Ariovaldo; Antunes, Carlos Henggeler; Freire, Fausto

    2016-01-01

    Highlights: • A Hybrid IO-MOLP model is formulated for energy-economic-environmental analysis. • Scenarios for sugarcane cultivation and 1st- and 2nd-generation bioethanol production. • Higher energy use and GHG emissions due to chemicals in 2G processes. • Lower overall employment level in the 1G + 2G scenarios compared to the 1G scenario. • Policies and technological choices should consider direct and indirect effects of 2G. - Abstract: Bioethanol from sugarcane can be produced using first-generation (1G) or second-generation (2G) technologies. 2G technologies can increase the capacity of production per sugarcane mass input and are expected to have a key role in future reductions of environmental impacts of sugarcane bioethanol. A hybrid Input-Output (IO) framework is developed for Brazil coupling the System of National Accounts and the National Energy Balance, which is extended to assess Greenhouse Gas (GHG) emissions. Life-cycle based estimates for two sugarcane cultivation systems, two 1G and eight 2G bioethanol production scenarios, are coupled in the IO framework. A multi-objective linear programming (MOLP) model is formulated based on this framework for energy-economic-environmental analysis of the Brazilian economic system and domestic bioethanol supply in prospective scenarios. Twenty-four solutions are computed: four “extreme” solutions resulting from the individual optimization of each objective function (GDP, employment level, total energy consumption and total GHG emissions - 1G scenario), ten compromise solutions minimizing the distance of the feasible region to the ideal solution (1G, 1G-optimized and prospective 1G + 2G scenarios), and ten solutions maximizing the total bioethanol production (1G, 1G-optimized and prospective 1G + 2G scenarios). Higher diesel oil and lubricants consumption in the mechanical harvesting process has counterbalanced the positive effects of more efficient trucks leading to higher energy consumption and GHG

  19. [Research progress and application prospect of near infrared spectroscopy in soil nutrition analysis].

    Science.gov (United States)

    Ding, Hai-quan; Lu, Qi-peng

    2012-01-01

    "Digital agriculture" or "precision agriculture" is an important direction of modern agriculture technique. It is the combination of the modern information technique and traditional agriculture and becomes a hotspot field in international agriculture research in recent years. As a nondestructive, real-time, effective and exact analysis technique, near infrared spectroscopy, by which precision agriculture could be carried out, has vast prospect in agrology and gradually gained the recognition. The present paper intends to review the basic theory of near infrared spectroscopy and its applications in the field of agrology, pointing out that the direction of NIR in agrology should based on portable NIR spectrograph in order to acquire qualitative or quantitative information from real-time measuring in field. In addition, NIRS could be combined with space remote sensing to macroscopically control the way crop is growing and the nutrition crops need, to change the current state of our country's agriculture radically.

  20. Using prospective hazard analysis to assess an active shooter emergency operations plan.

    Science.gov (United States)

    Card, Alan J; Harrison, Heidi; Ward, James; Clarkson, P John

    2012-01-01

    Most risk management activity in the healthcare sector is retrospective, based on learning from experience. This is feasible where the risks are routine, but emergency operations plans (EOP) guide the response to events that are both high risk and rare. Under these circumstances, it is important to get the response right the first time, but learning from experience is usually not an option. This case study presents the rationale for taking a proactive approach to improving healthcare organizations' EOP. It demonstrates how the Prospective Hazard Analysis (PHA) Toolkit can drive organizational learning and argues that this toolkit may lead to more efficient improvement than drills and exercises. © 2012 American Society for Healthcare Risk Management of the American Hospital Association.

  1. [Life satisfaction and self-esteem among women in the menopausal time].

    Science.gov (United States)

    Banaczek, Zbigniew; Saracen, Agnieszka

    2016-01-01

    The period of menopause is usually a long-lasting, running process, with strong hormone changes which are manifested with somatic disorders and the lability of the emotional state. The degree of severity of the occurence of these symptoms can be variously bolstered. These changes can affect the quality of life and ones self-esteem. To assess the level of self-esteem of biopsychosocial functioning women in the menopausal time and the impact of menopause on women's quality of life. A group of 90 women in perimenopausal aged 49-61 were enrolled in the study. Standardized psychological questionnaires (Kupperman Index, SES Rosenberg and WHOQoL-BREF) were used. Additional data was collected by using a questionnaire developed by the authors. In statistical analysis χ2, analysis of variance and Spearman's rank correlation models were used. A significant correlation relationship between level of education and the sphere of psychological evaluation (p life in the social (p 25 indicating the correct (in the normal or higher range) self-esteem. In the studied group, women believe that they have the correct (in the normal or higher range) self-esteem. The surveyed women found as good their quality of life, the highest rated was social and psychological sphere, the lowest score received sphere of physical functioning (somatic). A statistically significant correlations were achieved between home and professional activity, and the assessment of the quality of life in the social and environmental sphere. The analysis showed a significant association correlation between level of education of women and the sphere of psychological evaluation.

  2. Fruits and vegetables consumption and risk of stroke: a meta-analysis of prospective cohort studies.

    Science.gov (United States)

    Hu, Dan; Huang, Junqian; Wang, Yuchun; Zhang, Dongfeng; Qu, Yan

    2014-06-01

    We conducted a meta-analysis to summarize evidence from prospective cohort studies about the association of fruits and vegetables consumption with the risk of stroke. Pertinent studies were identified by a search of Embase and PubMed databases to January 2014. Study-specific relative risks with 95% confidence intervals were pooled using a random-effects model. Dose-response relationship was assessed by restricted cubic spline. Twenty prospective cohort studies were included, involving 16 981 stroke events among 760 629 participants. The multivariable relative risk (95% confidence intervals) of stroke for the highest versus lowest category of total fruits and vegetables consumption was 0.79 (0.75-0.84), and the effect was 0.77 (0.71-0.84) for fruits consumption and 0.86 (0.79-0.93) for vegetables consumption. Subgroup and meta-regression showed that the inverse association of total fruits and vegetables consumption with the risk of stroke was consistent in subgroup analysis. Citrus fruits, apples/pears, and leafy vegetables might contribute to the protection. The linear dose-response relationship showed that the risk of stroke decreased by 32% (0.68 [0.56-0.82]) and 11% (0.89 [0.81-0.98]) for every 200 g per day increment in fruits consumption (P for nonlinearity=0.77) and vegetables consumption (P for nonlinearity=0.62), respectively. Fruits and vegetables consumption are inversely associated with the risk of stroke. © 2014 American Heart Association, Inc.

  3. Prospective analysis agriculture energy 2030. Agriculture and the challenges of energy - Synthesis

    International Nuclear Information System (INIS)

    Vert, Julien; Portet, Fabienne; Even, Marie-Aude; Herault, Bruno; Laisney, Celine; Mahe, Thuriane

    2010-01-01

    The present overview document contains the main results of the Agriculture Energy 2030 prospective study, based on the work of the group led by the CEP [Centre d'etudes et de prospective/Centre for studies and strategic foresight] at the Ministry of Agriculture, Food, Fisheries, Rural Affairs and Spatial Planning. Energy in agriculture is all too often seen as a purely cyclical problem whereas it is a major issue for the future due to its economic consequences for agricultural holdings, its links with environmental and climatic issues, and its influence on food supply chains and spatial planning. Based on the scenario method, this analysis initially involved describing the whole range of links between agriculture and energy in France and organising them into a system of variables before going on to draw up an inventory of the knowledge available. Starting out from this diagnostic approach, the group constructed four scenarios over the period to 2030: 'Regionalization and sobriety to confront the crisis', 'Twin track agriculture and energy realism', 'Health Agriculture with no major energy constraints' and 'Ecological agriculture and energy savings'. These scenarios do not form an exhaustive panorama of all possible developments of the agriculture-energy system - they are rather formalised images of what the future might hold. However, quantification and comparison of the scenarios has led to the identification of major room for progress in energy efficiency in French farming. By helping gain greater awareness of future difficulties and issues or, conversely, opportunities to be grasped, these scenarios provided input for the strategic analysis phase, the concluding stage of this exercise, and the identification of general objectives and levers for public action. (authors)

  4. Inverse correlation between the standard deviation of R-R intervals in supine position and the simplified menopausal index in women with climacteric symptoms.

    Science.gov (United States)

    Yanagihara, Nobuyuki; Seki, Meikan; Nakano, Masahiro; Hachisuga, Toru; Goto, Yukio

    2014-06-01

    Disturbance of autonomic nervous activity has been thought to play a role in the climacteric symptoms of postmenopausal women. This study was therefore designed to investigate the relationship between autonomic nervous activity and climacteric symptoms in postmenopausal Japanese women. The autonomic nervous activity of 40 Japanese women with climacteric symptoms and 40 Japanese women without climacteric symptoms was measured by power spectral analysis of heart rate variability using a standard hexagonal radar chart. The scores for climacteric symptoms were determined using the simplified menopausal index. Sympathetic excitability and irritability, as well as the standard deviation of mean R-R intervals in supine position, were significantly (P standard deviation of mean R-R intervals in supine position and the simplified menopausal index score. The lack of control for potential confounding variables was a limitation of this study. In climacteric women, the standard deviation of mean R-R intervals in supine position is negatively correlated with the simplified menopausal index score.

  5. Histeroscopia na menopausa: análise das técnicas e acurácia do método Histeroscopy in menopause: analysis of the techniques and accuracy of the method

    Directory of Open Access Journals (Sweden)

    Hélio de Lima Ferreira Fernandes Costa

    2008-10-01

    non-invasive method, largely available and with high sensitivity, the transvaginal ultrasonography should be the initial investigative method. Though there is no consensus about the echographical endometrial thickness, above which the investigation is to proceed, diagnostic hysteroscopy should be the next step. The risk of neoplasia in endometriums with thickness under or equal to 3 mm is low enough to limit hysteroscopy to exceptional cases. Biopsy must be a necessary part of the hysteroscopy, because the diagnosis, made on visual basis, alone may lead to false results. Outpatient hysteroscopy can be done in more than 95% of the cases, even in menopausal women, rarely with severe complications. The adoption of "non-contact" examination techniques and the progressive reduction of the hysteroscope diameter have decreased the discomfort associated to small outpatient procedures.

  6. Functional analysis of concealment: a novel application of prospect and refuge theory.

    Science.gov (United States)

    Singh, Punya; Ellard, Colin G

    2012-09-01

    According to prospect-refuge theory, humans prefer environments that afford protection from threat (refuge), but also provide large fields of view (prospect). Prospect-refuge theory in the past has traditionally only been applied to humans, but many of the same contingencies governing spatial preference ought to also hold true in animals. The focus of this study was to examine if this phenomena also occurs in animals. Gerbils were placed in an arena containing three dome shaped refuges that varied in prospect-refuge levels. A simulated predator was released during the trial to examine how contextual factors may influence the degree of prospect and refuge preferred. The results indicate a preference for the enclosed refuge at stimulus onset even though this was not reflective of what happened prior to predator release. The results suggest spatial preferences in animals are influenced by prospect-refuge considerations in certain contexts. Copyright © 2012 Elsevier B.V. All rights reserved.

  7. Prospective identification of adolescent suicide ideation using classification tree analysis: Models for community-based screening.

    Science.gov (United States)

    Hill, Ryan M; Oosterhoff, Benjamin; Kaplow, Julie B

    2017-07-01

    Although a large number of risk markers for suicide ideation have been identified, little guidance has been provided to prospectively identify adolescents at risk for suicide ideation within community settings. The current study addressed this gap in the literature by utilizing classification tree analysis (CTA) to provide a decision-making model for screening adolescents at risk for suicide ideation. Participants were N = 4,799 youth (Mage = 16.15 years, SD = 1.63) who completed both Waves 1 and 2 of the National Longitudinal Study of Adolescent to Adult Health. CTA was used to generate a series of decision rules for identifying adolescents at risk for reporting suicide ideation at Wave 2. Findings revealed 3 distinct solutions with varying sensitivity and specificity for identifying adolescents who reported suicide ideation. Sensitivity of the classification trees ranged from 44.6% to 77.6%. The tree with greatest specificity and lowest sensitivity was based on a history of suicide ideation. The tree with moderate sensitivity and high specificity was based on depressive symptoms, suicide attempts or suicide among family and friends, and social support. The most sensitive but least specific tree utilized these factors and gender, ethnicity, hours of sleep, school-related factors, and future orientation. These classification trees offer community organizations options for instituting large-scale screenings for suicide ideation risk depending on the available resources and modality of services to be provided. This study provides a theoretically and empirically driven model for prospectively identifying adolescents at risk for suicide ideation and has implications for preventive interventions among at-risk youth. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Prospective analysis of patient-reported late toxicity following pelvic radiotherapy for gynaecological cancer

    International Nuclear Information System (INIS)

    Barraclough, Lisa H.; Routledge, Jacqueline A.; Farnell, Damian J.J.; Burns, Meriel P.; Swindell, Ric; Livsey, Jacqueline E.; Davidson, Susan E.

    2012-01-01

    Background and purpose: As late radiotherapy toxicity impacts negatively on the quality-of-life of cancer survivors and is often under reported, a study was set up to prospectively collect patient-reported data in an unselected series of patients with gynaecological malignancy. Aim 1 – To provide 3 year results for the longitudinal study. Aim 2 – To improve the questionnaire used to collect data by identifying redundant items and modifying for use to collect Common Terminology Criteria for Adverse Events (CTCAE) data. Material and methods: Aim 1 – Patient reported outcome data were collected prospectively by 226 patients before and up to 3 years following radiotherapy for gynaecological cancer using a questionnaire developed to collect LENT subjective data. Aim 2 – A factor analysis was performed to identify which questions gave the most and least information. Results: Aim 1 – Faecal urgency and incontinence (all grades) peaked at 79% and 24%, respectively at 1 year then settled to 69% and 18% at 3 years, respectively. Urinary urgency (all grades) increased with time and was described in 75% at 3 years. Other symptoms reported at 3 years include diarrhoea in 12%, urinary incontinence in 27% and vaginal dryness in 29%. A third of patients did not feel their sex life had changed following treatment, while a quarter felt that it had. Aim 2 – some questions overlapped and others were non-specific. The questionnaire has subsequently been altered. Conclusions: The extent of late toxicity is substantial. This detailed information is important for both patients and clinicians in terms of treatment decisions and follow-up care. The LENT questionnaire provides a feasible tool for capture of this information in the clinic.

  9. Teaching Taboo Topics: Menstruation, Menopause, and the Psychology of Women

    Science.gov (United States)

    Chrisler, Joan C.

    2013-01-01

    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…

  10. Cross Cultural Adaptation of the Menopause Specific Questionnaire ...

    African Journals Online (AJOL)

    Cross Cultural Adaptation of the Menopause Specific. Questionnaire into the Persian Language. Ghazanfarpour M, Kaviani M1, Rezaiee M2, Ghaderi E3, Zandvakili F2. Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, 1Nursing and Midwifery College, Shiraz ...

  11. Effect of soy isoflavone supplementation on menopausal quality of life

    Science.gov (United States)

    Recent clinical trials have found an increased risk of health problems in women using menopausal hormone therapy. As a result, women are in search of alternative strategies to improve their quality of life. The purpose of this study was to assess the effect of soy isoflavone supplementation on quali...

  12. 1 Morpho-physiological features associated with menopause: recent ...

    African Journals Online (AJOL)

    oestrogen receptors such as bones, brain, blood vessels, central nervous system and the skin. But generally ... This article reviews the cell biology of menopause and the associated .... regeneration of the functional layer. .... 2001). Stem cell factor (SCF) and its receptors, which regulate mast cell proliferation and.

  13. Menopause, hormone replacement and RR and QT modulation during sleep

    Czech Academy of Sciences Publication Activity Database

    Lanfranchi, P. A.; Gosselin, N.; Kára, T.; Jurák, Pavel; Somers, V. K.; Denesle, R.; Petit, D.; Carrier, J.; Nadeau, R.; Montplaisir, J.

    2005-01-01

    Roč. 6, č. 6 (2005), s. 561-566 ISSN 1389-9457 R&D Projects: GA ČR(CZ) GA102/05/0402 Keywords : Sleep * Menopause * RR interval * QT interval * Gender * Hormones Subject RIV: FS - Medical Facilities ; Equipment Impact factor: 2.711, year: 2005

  14. Morpho-physiological features associated with menopause: recent ...

    African Journals Online (AJOL)

    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 the ...

  15. Perceptions of menopause and aging in rural villages of Limpopo ...

    African Journals Online (AJOL)

    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.

  16. Menopausal challenges as perceived by women in rural villages of ...

    African Journals Online (AJOL)

    The study explored the challenges of menopause as perceived by participants in rural villages of Vhembe District. A cross-sectional study involved a sample of 500 women between the ages of 40 years and above. A structured questionnaire was used to collect data and was analysed descriptively. The results indicated that ...

  17. Factors affecting sexual function in menopause: A review article

    Directory of Open Access Journals (Sweden)

    Soheila Nazarpour

    2016-08-01

    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.

  18. Factors affecting sexual function in menopause: A review article.

    Science.gov (United States)

    Nazarpour, Soheila; Simbar, Masoumeh; Tehrani, Fahimeh Ramezani

    2016-08-01

    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. Copyright © 2016. Published by Elsevier B.V.

  19. Perceptions of menopause and aging in rural villages of Limpopo ...

    African Journals Online (AJOL)

    2014-11-13

    Nov 13, 2014 ... cultures, because of cultural beliefs and the manner in which symptoms are .... Focus group interviews promoted self-disclosure and were able to discern what ... Participants were protected from all forms of harm resulting ..... symptoms among healthy middle aged women with the Menopause Rating Scale',.

  20. Menopause-related osteoporosis | Snyman | South African Family ...

    African Journals Online (AJOL)

    These measures are important to prevent osteopenia and osteoporosis by obtaining a maximum peak bone mineral density (BMD) and to maintain it by avoiding excessive bone loss. One year before the onset of menopause, however, as a result of oestrogen deficiency, there is an increase in osteoclastic activity without a ...

  1. Vitamin D levels and menopause-related symptoms.

    Science.gov (United States)

    LeBlanc, Erin S; Desai, Manisha; Perrin, Nancy; Wactawski-Wende, Jean; Manson, JoAnn E; Cauley, Jane A; Michael, Yvonne L; Tang, Jean; Womack, Catherine; Song, Yiqing; Johnson, Karen C; O'Sullivan, Mary J; Woods, Nancy; Stefanick, Marcia L

    2014-11-01

    This study aims to determine whether vitamin D levels are associated with menopause-related symptoms in older women. A randomly selected subset of 1,407 women, among 26,104 potentially eligible participants of the Women's Health Initiative Calcium and Vitamin D trial of postmenopausal women aged 51 to 80 years, had 25-hydroxyvitamin D [25(OH)D] levels measured at the Women's Health Initiative Calcium and Vitamin D trial baseline visit. Information about menopause-related symptoms at baseline was obtained by questionnaire and included overall number of symptoms and composite measures of sleep disturbance, emotional well-being, and energy/fatigue, as well as individual symptoms. After exclusions for missing data, 530 women (mean [SD] age, 66.2 [6.8] y) were included in these analyses. Borderline significant associations between 25(OH)D levels and total number of menopausal symptoms were observed (with P values ranging from 0.05 to 0.06 for fully adjusted models); however, the effect was clinically insignificant and disappeared with correction for multiple testing. No associations between 25(OH)D levels and composite measures of sleep disturbance, emotional well-being, or energy/fatigue were observed (P's > 0.10 for fully adjusted models). There is no evidence for a clinically important association between serum 25(OH)D levels and menopause-related symptoms in postmenopausal women.

  2. Physical activity, symptoms, esteem, and life satisfaction during menopause.

    Science.gov (United States)

    Elavsky, Steriani; McAuley, Edward

    2005-01-01

    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.

  3. Oxidative stress of crystalline lens in rat menopausal model.

    Science.gov (United States)

    Acer, Semra; Pekel, Gökhan; Küçükatay, Vural; Karabulut, Aysun; Yağcı, Ramazan; Çetin, Ebru Nevin; Akyer, Şahika Pınar; Şahin, Barbaros

    2016-01-01

    To evaluate lenticular oxidative stress in rat menopausal models. Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1). From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2), 10 were administered a daily injection of methylprednisolone until the end of the study (Group 3), and the remaining 10 rats were administered intraperitoneal streptozocin to induce diabetes mellitus (Group 4). Total oxidant status (TOS), total antioxidant capacity (TAC), and oxidative stress index (OSI) measurements of the crystalline lenses were analyzed. The mean OSI was the lowest in group 1 and highest in group 4. Nevertheless, the difference between the groups was not statistically significant in terms of OSI (p >0.05). The mean TOS values were similar between the groups (p >0.05), whereas the mean TAC of group 1 was significantly higher than that of the other groups (p <0.001). Our results indicate that menopause may not promote cataract formation.

  4. Oxidative stress of crystalline lens in rat menopausal model

    Directory of Open Access Journals (Sweden)

    Semra Acer

    Full Text Available ABSTRACT Purpose: To evaluate lenticular oxidative stress in rat menopausal models. Methods: Forty Wistar female albino rats were included in this study. A total of thirty rats underwent oophorectomy to generate a menopausal model. Ten rats that did not undergo oophorectomy formed the control group (Group 1. From the rats that underwent oophorectomy, 10 formed the menopause control group (Group 2, 10 were administered a daily injection of methylprednisolone until the end of the study (Group 3, and the remaining 10 rats were administered intraperitoneal streptozocin to induce diabetes mellitus (Group 4. Total oxidant status (TOS, total antioxidant capacity (TAC, and oxidative stress index (OSI measurements of the crystalline lenses were analyzed. Results: The mean OSI was the lowest in group 1 and highest in group 4. Nevertheless, the difference between the groups was not statistically significant in terms of OSI (p >0.05. The mean TOS values were similar between the groups (p >0.05, whereas the mean TAC of group 1 was significantly higher than that of the other groups (p <0.001. Conclusions: Our results indicate that menopause may not promote cataract formation.

  5. Severity of menopausal symptoms and cardiovascular and osteoporosis risk factors.

    Science.gov (United States)

    Martínez Pérez, J A; Palacios, S; Chavida, F; Pérez, M

    2013-04-01

    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.

  6. Contextual Influences on Women's Health Concerns and Attitudes toward Menopause

    Science.gov (United States)

    Strauss, Judy R.

    2011-01-01

    Social factors that affect women's attitudes toward menopause were examined in a sample of 1,037 baby boomer women who took part in two waves of the Midlife in the United States survey. Survey data were collected in 1996 and 2005 from a nationally representative sample of women born between 1946 and 1964 residing in the United States. Women's…

  7. Reproductive Health Issues for Nigerian Women in Menopause ...

    African Journals Online (AJOL)

    A number of physical conditions were commonly associated with menopause, including weakness, internal heat, waist pains, 'false pregnancy', general body pain, headache, shrinking of the body, vaginal dryness, sweating, dizziness, restlessness and unhappiness. The perception concerning the degree of severity of ...

  8. Oral Health and Menopause: A Comprehensive Review on Current ...

    African Journals Online (AJOL)

    sensation of painful mouth (PM) due to various causes and less frequently ... It is a chronic condition ... [23] The occurrence of periodontitis was reported significantly greater ... [17] In a case‑control study of 38 post‑menopausal women, a ...

  9. Breast cancer and menopause: partners' perceptions and personal experiences--a pilot study.

    Science.gov (United States)

    Sayakhot, Padaphet; Vincent, Amanda; Teede, Helena

    2012-08-01

    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.

  10. Ten-year absolute risk of osteoporotic fractures according to BMD T score at menopause: the Danish Osteoporosis Prevention Study

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Vestergaard, Peter; Rud, Bo

    2006-01-01

    was 10.9% as opposed to an expected risk of 5.7%. Relative risk gradients were similar to those of the recent meta-analysis. CONCLUSIONS: In healthy women, examined in the first year or two after menopause, 10-year fracture risk was higher at each level of BMD T score than expected from the model...... by Kanis et al. Inclusion of HRT users in the cohorts used may have led to higher BMD values and lower absolute fracture risk in the Kanis model. These longitudinal data can be used directly in estimating absolute fracture risk in untreated north European women from BMD at menopause....

  11. Novel use of the ovarian follicular pool to postpone menopause and delay osteoporosis

    DEFF Research Database (Denmark)

    Andersen, Claus Yding; Kristensen, Stine Gry

    2015-01-01

    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...... menopause. Excision of ovarian tissue will advance menopause marginally and will not reduce natural fertility. Grafted tissue restores ovarian function with circulating concentrations of sex steroids for years in post-menopausal cancer survivors. Future developments may further utilize the enormous store...

  12. Biomarkers of vascular function in pre- and recent post-menopausal women of similar age

    DEFF Research Database (Denmark)

    Nyberg, Michael Permin; Seidelin, Kåre; Rostgaard Andersen, Thomas

    2014-01-01

    Menopause is associated with an accelerated decline in vascular function, however, whether this is an effect of age and/or menopause and how exercise training may affect this decline remains unclear. We examined a range of molecular measures related to vascular function in matched pre- and post-menopausal...... women before and after 12 weeks of exercise training. Thirteen pre-menopausal and ten recently post-menopausal (1.6±0.3 (mean±SEM) years after final menstrual period) women only separated by three years (48±1 vs. 51±1 years) were included. Before training, diastolic blood pressure, soluble intercellular...... adhesion molecule-1 (sICAM-1) and skeletal muscle expression of thromboxane A synthase were higher in the post-menopausal women compared to the pre-menopausal women, all indicative of impaired vascular function. In both groups, exercise training lowered diastolic blood pressure, the levels of sICAM-1...

  13. Impact of hormone therapy on quality of life after menopause.

    Science.gov (United States)

    Utian, Wulf H; Woods, Nancy Fugate

    2013-10-01

    Given the complexity of the literature on quality of life (QOL) and hormone therapy (HT) among women in the menopausal transition and postmenopause, the purposes of this integrative review were to (1) define QOL as a multidimensional construct; (2) review validated instruments for measurement of QOL; (3) review results of HT and QOL clinical trials that have used validated instruments; and (4) assess the effectiveness of HT on QOL, including health-related QOL (HRQOL), menopause-specific QOL (MSQOL), and global QOL (GQOL). The literature on HT and QOL was searched for definitions of QOL and validated instruments for measuring QOL, and the results were summarized. The purposes of this integrative review were to evaluate the effects of HT on HRQOL, differentiating the effects of HT on GQOL, HRQOL, and MSQOL. As a basis for this review, we searched for published controlled clinical trials in which the effects of HT on QOL were studied using validated QOL instruments, in particular menopause-specific validated instruments. Clear definitions are elucidated. Validated instruments for the measurements of HRQOL, GQOL, and MSQOL are summarized, and the necessity of their incorporation into future research and clinical practice is emphasized. The published effects on QOL of estrogens and progestogens administered to symptomatic and nonsymptomatic women in the menopausal transition and beyond are reviewed. The impact of various health state-related symptoms on HRQOL and GQOL is now an integral component of contemporary health care. Effects of HT include GQOL and HRQOL and should be menopause-specific. There is clearly a need for further studies on menopause and menopause-related therapies using appropriate and validated instruments. Literature review shows that HT provides a significant benefit for MSQOL in midlife women, mainly through relief of symptoms, but treatment also may result in a global increase in sense of well-being (GQOL). HRQOL benefits are contingent on

  14. Longitudinal Changes in Sexual Functioning as Women Transition Through Menopause: Results from the Study of Women’s Health Across the Nation (SWAN)

    Science.gov (United States)

    Avis, Nancy E.; Brockwell, Sarah; Randolph, John F.; Shen, Shunhua; Cain, Virginia S.; Ory, Marcia; Greendale, Gail A.

    2009-01-01

    Objective Sexual functioning is an important component of women’s lives. The extent to which the menopause transition is associated with decreased sexual functioning remains inconclusive. This study seeks to determine if advancing through the menopause transition is associated with changes in sexual functioning. Design A prospective, longitudinal cohort study of women aged 42–52 at baseline recruited at 7 US sites (N=3302) in the Study of Women’s Health Across the Nation (SWAN). Cohort eligible women had an intact uterus, at least one ovary, were not currently using exogenous hormones, were either pre- or early perimenopausal, and self-identified as one of the study’s designated racial/ethnic groups. Data from the baseline interview and six annual follow-up visits are reported. Outcomes are self-reported ratings of importance of sex; frequency of sexual desire, arousal, masturbation, sexual intercourse, and pain during intercourse; degree of emotional satisfaction and physical pleasure. Results Adjusting for baseline age, chronological aging, and relevant social, health, and psychological parameters, the odds of reporting vaginal or pelvic pain increased and desire decreased by late perimenopause. Masturbation increased at early perimenopause, but declined during postmenopause. Menopausal transition was unrelated to other outcomes. Health, psychological functioning, and importance of sex were related to all sexual function outcomes. Age, race/ethnicity, marital status, change in relationship, and vaginal dryness were also associated with sexual functioning. Conclusions Pain during sexual intercourse increases and sexual desire decreases over the menopausal transition. Masturbation increases during the early transition, but then declines in postmenopause. Adjusting for other factors, the menopausal transition was not independently associated with reports of the importance of sex, sexual arousal, frequency of sexual intercourse, emotional satisfaction with

  15. A PROSPECTIVE ANALYSIS OF RISK-FACTORS FOR THE DISCONTINUATION OF 2ND-LINE ANTIRHEUMATIC DRUGS

    NARCIS (Netherlands)

    WIJNANDS, MJ; VANTHOF, MA; VANLEEUWEN, MA; VANRIJSWIJK, MH; VANDEPUTTE, LBA; VANRIEL, PLCM

    1993-01-01

    Clinical and laboratory factors influencing the discontinuation of second-line antirheumatic drugs were prospectively studied using survival analysis in a consecutive series of 245 patients with recently diagnosed rheumatoid arthritis. A statistically significant influence of age, sex, serum IgA and

  16. The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

    NARCIS (Netherlands)

    Abbott, T. E. F.; Ahmad, T.; Phull, M. K.; Fowler, A. J.; Hewson, R.; Biccard, B. M.; Chew, M. S.; Gillies, M.; Pearse, R. M.; Pearse, Rupert M.; Beattie, Scott; Clavien, Pierre-Alain; Demartines, Nicolas; Fleisher, Lee A.; Grocott, Mike; Haddow, James; Hoeft, Andreas; Holt, Peter; Moreno, Rui; Pritchard, Naomi; Rhodes, Andrew; Wijeysundera, Duminda; Wilson, Matt; Ahmed, Tahania; Everingham, Kirsty; Hewson, Russell; Januszewska, Marta; Phull, Mandeep-Kaur; Halliwell, Richard; Shulman, Mark; Myles, Paul; Schmid, Werner; Hiesmayr, Michael; Wouters, Patrick; de Hert, Stefan; Lobo, Suzana; Fang, Xiangming; Rasmussen, Lars; Futier, Emmanuel; Biais, Matthieu; Venara, Aurélien; Slim, Karem; Sander, Michael; Koulenti, Despoina; Arvaniti, Kostoula; Chan, Mathew; Kulkarni, Atul; Chandra, Susilo; Tantri, Aida; Geddoa, Emad; Abbas, Muntadhar; Della Rocca, Giorgio; Sivasakthi, Datin; Mansor, Marzida; Luna, Pastor; Bouwman, Arthur; Buhre, Wolfgang; Beavis, Vanessa; Campbell, Douglas; Short, Tim; Osinaike, Tunde; Matos, Ricardo; Grigoras, Ioana; Kirov, Mikhail; Protsenko, Denis; Biccard, Bruce; Aldecoa, Cesar; Chew, Michelle; Hofer, Christoph; Hubner, Martin; Ditai, James; Szakmany, Tamas; Fleisher, Lee; Ferguson, Marissa; MacMahon, Michael; Cherian, Ritchie; Currow, Helen; Kanathiban, Kathirgamanathan; Gillespie, David; Pathmanathan, Edward; Phillips, Katherine; Reynolds, Jenifer; Rowley, Joanne; Douglas, Jeanene; Kerridge, Ross; Garg, Sameer; Bennett, Michael; Jain, Megha; Alcock, David; Terblanche, Nico; Cotter, Rochelle; Leslie, Kate; Stewart, Marcelle; Zingerle, Nicolette; Clyde, Antony; Hambidge, Oliver; Rehak, Adam; Cotterell, Sharon; Huynh, Wilson Binh Quan; McCulloch, Timothy; Ben-Menachem, Erez; Egan, Thomas; Cope, Jennifer; Fellinger, Paul; Haisjackl, Markus; Haselberger, Simone; Holaubek, Caroline; Lichtenegger, Paul; Scherz, Florian; Hoffer, Franz; Cakova, Veronika; Eichwalder, Andreas; Fischbach, Norbert; Klug, Reinhold; Schneider, Elisabeth; Vesely, Martin; Wickenhauser, Reinhart; Grubmueller, Karl Gernot; Leitgeb, Marion; Lang, Friedrich; Toro, Nancy; Bauer, Marlene; Laengle, Friedrich; Haberl, Claudia; Mayrhofer, Thomas; Trybus, Christoph; Buerkle, Christian; Forstner, Karin; Germann, Reinhard; Rinoesl, Harald; Schindler, Elke; Trampitsch, Ernst; Bogner, Gerhard; Dankl, Daniel; Duenser, Martin; Fritsch, Gerhard; Gradwohl-Matis, Ilse; Hartmann, Andreas; Hoelzenbein, Thomas; Jaeger, Tarkan; Landauer, Franz; Lindl, Gregor; Lux, Michael; Steindl, Johannes; Stundner, Ottokar; Szabo, Christian; Bidgoli, Jawad; Verdoodt, Hans; Forget, Patrice; Kahn, David; Lois, Fernande; Momeni, Mona; Prégardien, Caroline; Pospiech, Audrey; Steyaert, Arnaud; Veevaete, Laurent; de Kegel, Dirk; de Jongh, Karen; Foubert, Luc; Smitz, Carine; Vercauteren, Marcel; Poelaert, Jan; van Mossevelde, Veerle; Abeloos, Jacques; Bouchez, Stefaan; Coppens, Marc; de Baerdemaeker, Luc; Deblaere, Isabel; de Bruyne, Ann; Fonck, Kristine; Heyse, Bjorn; Jacobs, Tom; Lapage, Koen; Moerman, Anneliese; Neckebroek, Martine; Parashchanka, Aliaksandra; Roels, Nathalie; van den Eynde, Nancy; Vandenheuvel, Michael; Limmen, JurgenVan; Vanluchene, Ann; Vanpeteghem, Caroline; Wyffels, Piet; Huygens, Christel; Vandenbempt, Punitha; van de Velde, Marc; Dylst, Dimitri; Janssen, Bruno; Schreurs, Evelien; Aleixo, Fábia Berganton; Candido, Keulle; Batista, Hugo Dias; Guimarães, Mario; Guizeline, Jaqueline; Hoffmann, João; Lobo, Francisco Ricardo Marques; Nascimento, Vinícius; Nishiyama, Katia; Pazetto, Lucas; Souza, Daniela; Rodrigues, Rodrigo Souza; Vilela Dos Santos, Ana Maria; Jardim, Jaquelline; Sá Malbouisson, Luiz Marcelo; Silva, Joao; Nascimento Junior, Paulo do; Baio, Thalissa Hermínia; Pereira de Castro, Gabriel Isaac; Watanabe Oliveira, Henri Roger; Amendola, Cristina Prata; Cardoso, Gutemberg; Ortega, Daniela; Brotto, Ana Flavia; de Oliveira, Mirella Cristine; Réa-Neto, Álvaro; Dias, Fernando; Travi, Maria Eduarda; Zerman, Luiza; Azambuja, Pedro; Knibel, Marcos Freitas; Martins, Antonio; Almeida, William; Neto, Calim Neder; Tardelli, Maria Angela; Caser, Eliana; Machado, Marcio; Aguzzoli, Crisitiano; Baldisserotto, Sérgio; Tabajara, Fernanda Beck; Bettega, Fernanda; Rodrigues Júnior, La Hore Correa; de Gasperi, Julia; Faina, Lais; Nolasco, Marcos Farias; Ferreira da Costa Fischer, Bruna; Fosch de Campos Ferreira, Mariana; Hartmann, Cristina; Kliemann, Marta; Hubert Ribeiro, Gustavo Luis; Fraga, Julia Merladete; Netto, Thiago Motta; Pozza, Laura Valduga; Wendling, Paulo Rafael; Azevedo, Caroline; Garcia, Juliana; Lopes, Marcel; Maia, Bernardo; Maselli, Paula; Melo, Ralph; Mendes, Weslley; Neves, Matheus; Ney, Jacqueline; Piras, Claudio; Applewhaite, Christopher; Carr, Adrienne; Chow, Lorraine; Duttchen, Kaylene; Foglia, Julena; Greene, Michael; Hinther, Ashley; Houston, Kendra; McCormick, Thomas Jared; Mikhayel, Jennifer; Montasser, Sam; Ragan, Alex; Suen, Andrew; Woolsey, Adrianna; Yu, Hai Chuan; Funk, Duane; Kowalski, Stephen; Legaspi, Regina; McDonald, Heather; Siddiqui, Faisal; Pridham, Jeremy; Rowe, Bernadette; Sampson, Sonia; Thiessen, Barton; Zbitnew, Geoff; Bernard, Andre; George, Ronald; Jones, Philip; Moor, Rita; Siddiqui, Naveed; Wolfer, Alexandra; Tran, Diem; Winch, Denyse; Dobson, Gary; McCormick, Thomas; Montasser, Osama; Hall, Richard; Baghirzada, Leyla; Curley, Gerard; Dai, Si Yuan; Hare, Gregory; Lee, Esther; Shastri, Uma; Tsui, Albert; Yagnik, Anmol; Alvares, Danielle; Choi, Stephen; Dwyer, Heather; Flores, Kathrina; McCartney, Colin; Somascanthan, Priya; Carroll, Jo; Pazmino-Canizares, Janneth; Ami, Noam; Chan, Vincent; Perlas, Anahi; Argue, Ruth; Huang, Yang; Lavis, Katie; Mayson, Kelly; Cao, Ying; Gao, Hong; Hu, Tingju; Lv, Jie; Yang, Jian; Yang, Yang; Zhong, Yi; Zhou, Jing; Zou, Xiaohua; He, Miao; Li, Xiaoying; Luo, Dihuan; Wang, Haiying; Yu, Tian; Chen, Liyong; Wang, Lijun; Cai, Yunfei; Cao, Zhongming; Li, Yanling; Lian, Jiaxin; Sun, Haiyun; Wang, Sheng; Wang, Zhipeng; Wang, Kenru; Zhu, Yi; Du, Xindan; Fan, Hao; Fu, Yunbin; Huang, Lixia; Huang, Yanming; Hwan, Haifang; Luo, Hong; Qu, Pi-Sheng; Tao, Fan; Wang, Zhen; Wang, Guoxiang; Wang, Shun; Zhang, Yan; Zhang, Xiaolin; Chen, Chao; Wang, Weixing; Liu, Zhengyuan; Fan, Lihua; Tang, Jing; Chen, Yijun; Chen, Yongjie; Han, Yangyang; Huang, Changshun; Liang, Guojin; Shen, Jing; Wang, Jun; Yang, Qiuhong; Zhen, Jungang; Zhou, Haidong; Chen, Junping; Chen, Zhang; Li, Xiaoyu; Meng, Bo; Ye, Haiwang; Zhang, Xiaoyan; Bi, Yanbing; Cao, Jianqiao; Guo, Fengying; Lin, Hong; Liu, Yang; Lv, Meng; Shi, Pengcai; Song, Xiumei; Sun, Chuanyu; Sun, Yongtao; Wang, Yuelan; Wang, Shenhui; Zhang, Min; Chen, Rong; Hou, Jiabao; Leng, Yan; Meng, Qing-Tao; Qian, Li; Shen, Zi-Ying; Xia, Zhong-Yuan; Xue, Rui; Zhang, Yuan; Zhao, Bo; Zhou, Xian-Jin; Chen, Qiang; Guo, Huinan; Guo, Yongqing; Qi, Yuehong; Wang, Zhi; Wei, Jianfeng; Zhang, Weiwei; Zheng, Lina; Bao, Qi; Chen, Yaqiu; Chen, Yijiao; Fei, Yue; Hu, Nianqiang; Hu, Xuming; Lei, Min; Li, Xiaoqin; Lv, Xiaocui; Miao, Fangfang; Ouyang, Lingling; Qian, Lu; Shen, Conyu; Sun, Yu; Wang, Yuting; Wang, Dong; Wu, Chao; Xu, Liyuan; Yuan, Jiaqi; Zhang, Lina; Zhang, Huan; Zhang, Yapping; Zhao, Jinning; Zhao, Chong; Zhao, Lei; Zheng, Tianzhao; Zhou, Dachun; Zhou, Haiyan; Zhou, Ce; Lu, Kaizhi; Zhao, Ting; He, Changlin; Chen, Hong; Chen, Shasha; Cheng, Baoli; He, Jie; Jin, Lin; Li, Caixia; Li, Hui; Pan, Yuanming; Shi, Yugang; Wen, Xiao Hong; Wu, Shuijing; Xie, Guohao; Zhang, Kai; Zhao, Bing; Lu, Xianfu; Chen, Feifei; Liang, Qisheng; Lin, Xuewu; Ling, Yunzhi; Liu, Gang; Tao, Jing; Yang, Lu; Zhou, Jialong; Chen, Fumei; Cheng, Zhonggui; Dai, Hanying; Feng, Yunlin; Hou, Benchao; Gong, Haixia; Hu, Chun Hua; Huang, Haijin; Huang, Jian; Jiang, Zhangjie; Li, Mengyuan; Lin, Jiamei; Liu, Mei; Liu, Weicheng; Liu, Zhen; Liu, Zhiyi; Luo, Foquan; Ma, Longxian; Min, Jia; Shi, Xiaoyun; Song, Zhiping; Wan, Xianwen; Xiong, Yingfen; Xu, Lin; Yang, Shuangjia; Zhang, Qin; Zhang, Hongyan; Zhang, Huaigen; Zhang, Xuekang; Zhao, Lili; Zhao, Weihong; Zhao, Weilu; Zhu, Xiaoping; Bai, Yun; Chen, Linbi; Chen, Sijia; Dai, Qinxue; Geng, Wujun; Han, Kunyuan; He, Xin; Huang, Luping; Ji, Binbin; Jia, Danyun; Jin, Shenhui; Li, Qianjun; Liang, Dongdong; Luo, Shan; Lwang, Lulu; Mo, Yunchang; Pan, Yuanyuan; Qi, Xinyu; Qian, Meizi; Qin, Jinling; Ren, Yelong; Shi, Yiyi; Wang, Junlu; Wang, Junkai; Wang, Leilei; Xie, Junjie; Yan, Yixiu; Yao, Yurui; Zhang, Mingxiao; Zhao, Jiashi; Zhuang, Xiuxiu; Ai, Yanqiu; Du, Fang; He, Long; Huang, Ledan; Li, Zhisong; Li, Huijuan; Li, Yetong; Li, Liwei; Meng, Su; Yuan, Yazhuo; Zhang, Enman; Zhang, Jie; Zhao, Shuna; Ji, Zhenrong; Pei, Ling; Wang, Li; Chen, Chen; Dong, Beibei; Li, Jing; Miao, Ziqiang; Mu, Hongying; Qin, Chao; Su, Lin; Wen, Zhiting; Xie, Keliang; Yu, Yonghao; Yuan, Fang; Hu, Xianwen; Zhang, Ye; Xiao, Wangpin; Zhu, Zhipeng; Dai, Qingqing; Fu, Kaiwen; Hu, Rong; Hu, Xiaolan; Huang, Song; Li, Yaqi; Liang, Yingping; Yu, Shuchun; Guo, Zheng; Jing, Yan; Tang, Na; Wu, Jie; Yuan, Dajiang; Zhang, Ruilin; Zhao, Xiaoying; Li, Yuhong; Bai, Hui-Ping; Liu, Chun-Xiao; Liu, Fei-Fei; Ren, Wei; Wang, Xiu-Li; Xu, Guan-Jie; Hu, Na; Li, Bo; Ou, Yangwen; Tang, Yongzhong; Yao, Shanglong; Zhang, Shihai; Kong, Cui-Cui; Liu, Bei; Wang, Tianlong; Xiao, Wei; Lu, Bo; Xia, Yanfei; Zhou, Jiali; Cai, Fang; Chen, Pushan; Hu, Shuangfei; Wang, Hongfa; Xu, Qiong; Hu, Liu; Jing, Liang; Li, Bin; Liu, Qiang; Liu, Yuejiang; Lu, Xinjian; Peng, Zhen Dan; Qiu, Xiaodong; Ren, Quan; Tong, Youliang; Wang, Jin; Wen, Yazhou; Wu, Qiong; Xia, Jiangyan; Xie, Jue; Xiong, Xiapei; Xu, Shixia; Yang, Tianqin; Ye, Hui; Yin, Ning; Yuan, Jing; Zeng, Qiuting; Zhang, Baoling; Zheng, Kang; Cang, Jing; Chen, Shiyu; Fan, Yu; Fu, Shuying; Ge, Xiaodong; Guo, Baolei; Huang, Wenhui; Jiang, Linghui; Jiang, Xinmei; Liu, Yi; Pan, Yan; Ren, Yun; Shan, Qi; Wang, Jiaxing; Wang, Fei; Wu, Chi; Zhang, Xiaoguang; Christiansen, Ida Cecilie; Granum, Simon Nørgaard; Rasmussen, Bodil Steen; Daugaard, Morten; Gambhir, Rajiv; Brandsborg, Birgitte; Steingrímsdóttir, Guðný Erla; Jensen-Gadegaard, Peter; Olsen, Karsten Skovgaard; Siegel, Hanna; Eskildsen, Katrine Zwicky; Gätke, Mona Ring; Wibrandt, Ida; Heintzelmann, Simon Bisgaard; Wiborg Lange, Kai Henrik; Lundsgaard, Rune Sarauw; Amstrup-Hansen, Louise; Hovendal, Claus; Larsen, Michael; Lenstrup, Mette; Kobborg, Tina; Larsen, Jens Rolighed; Pedersen, Anette Barbre; Smith, Søren Hübertz; Oestervig, Rebecca Monett; Afshari, Arash; Andersen, Cheme; Ekelund, Kim; Secher, Erik Lilja; Beloeil, Helene; Lasocki, Sigismond; Ouattara, Alexandre; Sineus, Marlene; Molliex, Serge; Legouge, Marie Lim; Wallet, Florent; Tesniere, Antoine; Gaudin, Christophe; Lehur, Paul; Forsans, Emma; de Rudnicki, Stéphane; Maudet, Valerie Serra; Mutter, Didier; Sojod, Ghassan; Ouaissi, Mehdi; Regimbeau, Jean-Marc; Desbordes, Jacques; Comptaer, Nicolas; Manser, Diae El; Ethgen, Sabine; Lebuffe, Gilles; Auer, Patrick; Härtl, Christine; Deja, Maria; Legashov, Kirill; Sonnemann, Susanne; Wiegand-Loehnert, Carola; Falk, Elke; Habicher, Marit; Angermair, Stefan; Laetsch, Beatrix; Schmidt, Katrin; von Heymann, Christian; Ramminger, Axel; Jelschen, Florian; Pabel, Svenja; Weyland, Andreas; Czeslick, Elke; Gille, Jochen; Malcharek, Michael; Sablotzki, Armin; Lueke, Katharina; Wetzel, Peter; Weimann, Joerg; Lenhart, Franz-Peter; Reichle, Florian; Schirmer, Frederike; Hüppe, Michael; Klotz, Karl; Nau, Carla; Schön, Julika; Mencke, Thomas; Wasmund, Christina; Bankewitz, Carla; Baumgarten, Georg; Fleischer, Andreas; Guttenthaler, Vera; Hack, Yvonne; Kirchgaessner, Katharina; Männer, Olja; Schurig-Urbaniak, Marlen; Struck, Rafael; van Zyl, Rebekka; Wittmann, Maria; Goebel, Ulrich; Harris, Sarah; Veit, Siegfried; Andreadaki, Evangelia; Souri, Flora; Katsiadramis, Ioannis; Skoufi, Anthi; Vasileiou, Maria; Aimoniotou-Georgiou, Eleni; Katsourakis, Anastasios; Veroniki, Fotini; Vlachogianni, Glyceria; Petra, Konstantina; Chlorou, Dimitra; Oloktsidou, Eirini; Ourailoglou, Vasileios; Papapostolou, Konstantinos; Tsaousi, Georgia; Daikou, Panagoula; Dedemadi, Georgia; Kalaitzopoulos, Ioannis; Loumpias, Christos; Bristogiannis, Sotirios; Dafnios, Nikolaos; Gkiokas, Georgios; Kontis, Elissaios; Kozompoli, Dimitra; Papailia, Aspasia; Theodosopoulos, Theodosios; Bizios, Christol; Koutsikou, Anastasia; Moustaka, Aleaxandra; Plaitakis, Ioannis; Armaganidis, Apostolos; Christodoulopoulou, Theodora; Lignos, Mihail; Theodorakopoulou, Maria; Asimakos, Andreas; Ischaki, Eleni; Tsagkaraki, Angeliki; Zakynthinos, Spyros; Antoniadou, Eleni; Koutelidakis, Ioannis; Lathyris, Dimitrios; Pozidou, Irene; Voloudakis, Nikolaos; Dalamagka, Maria; Elena, Gkonezou; Chronis, Christos; Manolakaki, Dimitra; Mosxogiannidis, Dimitris; Slepova, Tatiana; Tsakiridou, Isaia-Sissy; Lampiri, Claire; Vachlioti, Anastasia; Panagiotakis, Christos; Sfyras, Dimitrios; Tsimpoukas, Fotios; Tsirogianni, Athanasia; Axioti, Elena; Filippopoulos, Andreas; Kalliafa, Elli; Kassavetis, George; Katralis, Petros; Komnos, Ioannis; Pilichos, Georgios; Ravani, Ifigenia; Totis, Antonis; Apagaki, Eymorfia; Efthymiadi, Andromachi; Kampagiannis, Nikolaos; Paraforou, Theoniki; Tsioka, Agoritsa; Georgiou, Georgios; Vakalos, Aristeidis; Bairaktari, Aggeliki; Charitos, Efthimios; Markou, George; Niforopoulou, Panagiota; Papakonstantinou, Nikolaos; Tsigou, Evdoxia; Xifara, Archontoula; Zoulamoglou, Menelaos; Gkioni, Panagiota; Karatzas, Stylianos; Kyparissi, Aikaterini; Mainas, Efstratios; Papapanagiotou, Ioannis; Papavasilopoulou, Theonymfi; Fragandreas, George; Georgopoulou, Eleni; Katsika, Eleni; Psarras, Kyriakos; Synekidou, Eirini; Verroiotou, Maria; Vetsiou, Evangelia; Zaimi, Donika; Anagnou, Athina; Apostolou, Konstantinos; Melissopoulou, Theodora; Rozenberg, Theophilos; Tsigris, Christos; Boutsikos, Georgios; Kalles, Vasileios; Kotsalas, Nikolaos; Lavdaiou, Christina; Paikou, Fotini; Panagou, Georgia-Laura; Spring, Anna; Botis, Ioannis; Drimala, Maria; Georgakakis, Georgios; Kiourtzieva, Ellada; Ntouma, Panagiota; Prionas, Apostolos; Xouplidis, Kyriakos; Dalampini, Eleftheria; Giannaki, Chrysavgi; Iasonidou, Christina; Ioannidis, Orestis; Lavrentieva, Athina; Lavrentieva, Athena; Papageorgiou, George; Kokkinoy, Maria; Stafylaraki, Maria; Gaitanakis, Stylianos; Karydakis, Periclis; Paltoglou, Josef; Ponireas, Panagiotis; Chaloulis, Panagiotis; Provatidis, Athanasios; Sousana, Anisoglou; Gardikou, Varvara Vanessa; Konstantivelli, Maria; Lataniotou, Olga; Lisari, Elisavet; Margaroni, Maria; Stamatiou, Konstantinos; Nikolaidis, Edouardos; Pnevmatikos, Ioannis; Sertaridou, Eleni; Andreou, Alexandros; Arkalaki, Eleni; Athanasakis, Elias; Chaniotaki, Fotini; Chatzimichali, Chatzimichali Aikaterini; Christofaki, Maria; Dermitzaki, Despina; Fiorentza, Klara; Frantzeskos, Georgios; Geromarkaki, Elisavet; Kafkalaki, Kalliopi; Kalogridaki, Marina; Karydi, Konstyllia; Kokkini, Sofia; Kougentakis, Georgios; Lefaki, Tatiana; Lilitsis, Emmanouhl; Makatounaki, Aikaterini; Malliotakis, Polychronis; Michelakis, Dimosthenis; Neonaki, Maria; Nyktari, Vasileia; Palikyra, Iliana; Papadakis, Eleftherios; Papaioannou, Alexandra; Sfakianakis, Konstantinos; Sgouraki, Maria; Souvatzis, Xenia; Spartinou, Anastasia; Stefanidou, Nefeli; Syrogianni, Paulina; Tsagkaraki, Georgia; Arnaoutoglou, Elena; Arnaoutoglou, Christina; Bali, Christina; Bouris, Vasilios; Doumos, Rodamanthos; Gkini, Konstantia-Paraskevi; Kapaktsi, Clio; Koulouras, Vasilios; Lena, Arian; Lepida, Dimitra; Michos, Evangelos; Papadopoulos, Dimitrios; Paschopoulos, Minas; Rompou, Vaia Aliki; Siouti, Ioanna; Tsampalas, Stavros; Ververidou, Ourania; Zilis, Georgios; Charlalampidoy, Alexandra; Christodoulidis, Gregory; Flossos, Andreas; Stamoulis, Konstantinos; Chan, Matthew; Tsang, Man Shing Caleb; Tsang, Man Shing; Lai, Man Ling; Yip, Chi Pang; Heymans Chan, Hey Man; Law, Bassanio; Li, Wing Sze; Chu, Hiu Man; Koo, Emily Gar Yee; Lam, Chi Cheong Joe; Cheng, Ka Ho; Lam, Tracy; Chu, Susanna; Lam, Wing Yan; Wong, Kin Wai Kevin; Kwok, Dilys; Hung, Ching Yue Janice; Chan, Wai Kit Jacky; Wong, Wing Lam; Chung, Chun Kwong Eric; Ma, Shu Kai; Kaushik, Shuchi; Shah, Bhagyesh; Shah, Dhiren; Shah, Sanjay; Ar, Praburaj; Muthuchellappan, Radhakrishnan; Agarwal, Vandana; Divatia, Jigeeshu; Mishra, Sanghamitra; Nimje, Ganesh; Pande, Swati; Savarkar, Sukhada; Shrivastava, Aditi; Thomas, Martin; Yegnaram, Shashikant; Hidayatullah, Rahmat; Puar, Nasman; Niman, Sumara; Indra, Imai; Hamzah, Zulkarnain; Yuliana, Annika; Abidin, Ucu Nurhadiat; Dursin, Ade Nurkacan; Kurnia, Andri; Susanti, Ade; Handayani, Dini; Alit, Mahaalit Aribawa; Arya, Aryabiantara; Senapathi, Tjokorda Gde Agung; Utara, Utara Hartawan; Wid, Widnyana Made; Wima, Semarawima; Wir, Wiryana Made; Jehosua, Brillyan; Kaunang, Jonathan; Lantang, Eka Yudha; Najoan, Rini; Waworuntu, Neil; Awad, Hadi; Fuad, Akram; Geddoa, Burair; Khalaf, Abdel Razzaq; Al Hussaini, Sabah; Albaj, Safauldeensalem; Kenber, Maithem; Bettinelli, Alessandra; Spadaro, Savino; AlbertoVolta, Carlo; Giancarlo, Luigi; Sottosanti, Vicari; Copetti, Elisa; Spagnesi, Lorenzo; Toretti, Ilaria; Alloj, Chiara; Cardellino, Silvano; Carmino, Livio; Costanzo, Eleonora; Fanfani, Lucia Caterina; Novelli, Maria Teresa; Roasio, Agostino; Bellandi, Mattia; Beretta, Luigi; Bignami, Elena; Bocchino, Speranza; Cabrini, Luca; Corti, Daniele; Landoni, Giovanni; Meroni, Roberta; Moizo, Elena; Monti, Giacomo; Pintaudi, Margherita; Plumari, Valentina Paola; Taddeo, Daiana; Testa, Valentina; Winterton, Dario; Zangrillo, Alberto; Cloro, Luigi Maria; Colangelo, Chiara; Colangelo, Antonio; Rotunno, Giuseppe; Paludi, Miguel Angel; Maria, Cloro Paolo; Pata, Antonio; Parrini, Vieri; Gatta, Alessandro; Nastasi, Mauro; Tinti, Carla; Baroselli, Antonio; Arrigo, Mario; Benevento, Angelo; Bottini, Corrado; Cannavo', Maurizio; Gastaldi, Christian; Marchesi, Alessandro; Pascazio, Angelantonio; Pata, Francesco; Pozzi, Emilio; Premoli, Alberto; Tessera, Gaetano; Boschi, Luca; D'Andrea, Rocco; Ghignone, Federico; Poggioli, Gilberto; Sibilio, Andrea; Taffurelli, Mario; Ugolini, Giampaolo; Ab Majid, Mohd Azuan; Ab Rahman, Rusnah; Joseph, James; Pathan, Furquan; Sybil Shah, Mohammad Hafizshah; Yap, Huey Ling; Cheah, Seleen; Chin, Im Im; Looi, Ji Keon; Tan, Siew Ching; Visvalingam, Sheshendrasurian; Kwok, Fan Yin; Lee, Chew Kiok; Tan, Tse Siang; Wong, Sze Meng; Abdullah, Noor Hairiza; Liew, Chiat Fong; Luxuman, Lovenia; Mohd Zin, Nor Hafizah; Norddin, Muhamad Faiz; Raja Alias, Raja Liza; Wong, Juan Yong; Yong, Johnny; Bin Mustapha, Mohd Tarmimi; Chan, Weng Ken; Dzulkipli, Norizawati; Kuan, Pei Xuan; Lee, Yew Ching; Alias, Anita; Guok, Eng Ching; Jee, Chiun Chen; Ramon, Brian Rhadamantyne; Wong, Cheng Weng; Abd Ghafar, Fara Nur Idayu; Aziz, Faizal Zuhri; Hussain, Nabilah; Lee, Hooi Sean; Sukawi, Ismawaty; Woon, Yuan Liang; Abd Hadi, Husni Zaeem; Ahmad Azam, Ummi Azmira; Alias, Abdul Hafiz; Kesut, Saiful Aizar; Lee, Jun May; Ooi, Dar Vin; Sulaiman, Hetty Ayuni; Lih, Tengku Alini Tengku; Veerakumaran, Jeyaganesh; Rojas, Eder; Resendiz, Gerardo Esteban Alvarez; Zapata, Darcy Danitza Mari; López, Julio Cesar Jesús Aguilar; Flores, Armando Adolfo Alvarez; Amador, Juan Carlos Bravo; Avila, Erendira Jocelin Dominguez; Aquino, Laura Patricia González; Rodriguez, Ricardo Lopez; Landa, Mariana Torres; Urias, Emma; Hollmann, Markus; Hulst, Abraham; Preckel, Benedikt; Koopman-van Gemert, Ankie; Buise, Marc; Tolenaar, Noortje; Weber, Eric; de Fretes, Jennifer; Houweling, Peter; Ormskerk, Patricia; van Bommel, Jasper; Lance, Marcus; Smit-Fun, Valerie; van Zundert, Tom; Baas, Peter; Donald de Boer, Hans; Sprakel, Joost; Elferink-Vonk, Renske; Noordzij, Peter; van Zeggeren, Laura; Brand, Bastiaan; Spanjersberg, Rob; ten Bokkel-Andela, Janneke; Numan, Sandra; van Klei, Wilton; van Zaane, Bas; Boer, Christa; van Duivenvoorde, Yoni; Hering, Jens Peter; van Rossum, Sylvia; Zonneveldt, Harry; Campbell, Doug; Hoare, Siobhan; Santa, Sahayam; Ali, Marlynn; Allen, Sara Jane; Bell, Rachel; Choi, Hyun-Min David; Drake, Matthew; Farrell, Helen; Hayes, Katia; Higgie, Kushlin; Holmes, Kerry; Jenkins, Nicole; Kim, Chang Joon; Kim, Steven; Law, Kiew Chai; McAllister, Davina; Park, Karen; Pedersen, Karen; Pfeifer, Leesa; Pozaroszczyk, Anna; Salmond, Timothy; Steynor, Martin; Tan, Michael; Waymouth, Ellen; Ab Rahman, Ahmad Sufian; Armstrong, John; Dudson, Rosie; Jenkins, Nia; Nilakant, Jayashree; Richard, Seigne; Virdi, Pardeep; Dixon, Liane; Donohue, Roana; Farrow, Mehreen; Kennedy, Ross; Marissa, Henderson; McKellow, Margie; Nicola, Delany; Pascoe, Rebecca; Roberts, Stephen John; Rowell, George; Sumner, Matthew; Templer, Paul; Chandrasekharan, Shardha; Fulton, Graham; Jammer, Ib; More, Richard; Wilson, Leona; Chang, Yuan Hsuan; Foley, Julia; Fowler, Carolyn; Panckhurst, Jonathan; Sara, Rachel; Stapelberg, Francois; Cherrett, Veronica; Ganter, Donna Louise; McCann, Lloyd; Gilmour, Fiona; Lumsden, Rachelle; Moores, Mark; Olliff, Sue; Sardareva, Elitza; Tai, Joyce; Wikner, Matthew; Wong, Christopher; Chaddock, Mark; Czepanski, Carolyn; McKendry, Patrick; Polakovic, Daniel; Polakovich, Daniel; Robert, Axe; Belda, Margarita Tormo; Norton, Tracy; Alherz, Fadhel; Barneto, Lisa; Ramirez, Alberto; Sayeed, Ahmed; Smith, Nicola; Bennett, Cambell; McQuoid, Shane; Jansen, Tracy-Lee; Nico, Zin; Scott, John; Freschini, David; Freschini, Angela; Hopkins, Brian; Manson, Lara; Stoltz, Deon; Bates, Alexander; Davis, Simon; Freeman, Victoria; McGaughran, Lynette; Williams, Maya; Sharma, Swarna Baskar; Burrows, Tom; Byrne, Kelly; English, Duane; Johnson, Robert; Manikkam, Brendon; Naidoo, Shaun; Rumball, Margot; Whittle, Nicola; Franks, Romilla; Gibson-Lapsley, Hannah; Salter, Ryan; Walsh, Dean; Cooper, Richard; Perry, Katherine; Obobolo, Amos; Sule, Umar Musa; Ahmad, Abdurrahman; Atiku, Mamuda; Mohammed, Alhassan Datti; Sarki, Adamu Muhammad; Adekola, Oyebola; Akanmu, Olanrewaju; Durodola, Adekunle; Olukoju, Olusegun; Raji, Victor; Olajumoke, Tokunbo; Oyebamiji, Emmanuel; Adenekan, Anthony; Adetoye, Adedapo; Faponle, Folayemi; Olateju, Simeon; Owojuyigbe, Afolabi; Talabi, Ademola; Adenike, Odewabi; Adewale, Badru; Collins, Nwokoro; Ezekiel, Emmanuel; Fatungase, Oluwabunmi Motunrayo; Grace, Anuforo; Sola, Sotannde; Stella, Ogunmuyiwa; Ademola, Adeyinka; Adeolu, Augustine A.; Adigun, Tinuola; Akinwale, Mukaila; Fasina, Oluyemi; Gbolahan, Olalere; Idowu, Olusola; Olonisakin, Rotimi Peter; Osinaike, Babatunde Babasola; Asudo, Felicia; Mshelia, Danladi; Abdur-Rahman, Lukman; Agodirin, Olayide; Bello, Jibril; Bolaji, Benjamin; Oyedepo, Olanrewaju Olubukola; Ezike, Humphrey; Iloabachie, Ikechukwu; Okonkwo, Ikemefuna; Onuora, Elias; Onyeka, Tonia; Ugwu, Innocent; Umeh, Friday; Alagbe-Briggs, Olubusola; Dodiyi-Manuel, Amabra; Echem, Richard; Obasuyi, Bright; Onajin-Obembe, Bisola; Bandeira, Maria Expedito; Martins, Alda; Tomé, Miguel; Costa, Ana Cristina Miranda Martins; Krystopchuk, Andriy; Branco, Teresa; Esteves, Simao; Melo, Marco António; Monte, Júlia; Rua, Fernando; Martins, Isabel; Pinho-Oliveira, Vítor Miguel; Rodrigues, Carla Maria; Cabral, Raquel; Marques, Sofia; Rêgo, Sara; Jesus, Joana Sofia Teixeira; Marques, Maria Conceição; Romao, Cristina; Dias, Sandra; Santos, Ana Margarida; Alves, Maria Joao; Salta, Cristina; Cruz, Salome; Duarte, Célia; Paiva, António Armando Furtado; Cabral, Tiago do Nascimento; Faria E Maia, Dionisio; Correia da Silva, Rui Freitas Mendonça; Langner, Anuschka; Resendes, Hernâni Oliveira; Soares, Maria da Conceição; Abrunhosa, Alexandra; Faria, Filomena; Miranda, Lina; Pereira, Helena; Serra, Sofia; Ionescu, Daniela; Margarit, Simona; Mitre, Calin; Vasian, Horatiu; Manga, Gratiela; Stefan, Andreea; Tomescu, Dana; Filipescu, Daniela; Paunescu, Marilena-Alina; Stefan, Mihai; Stoica, Radu; Gavril, Laura; Pătrășcanu, Emilia; Ristescu, Irina; Rusu, Daniel; Diaconescu, Ciresica; Iosep, Gabriel Florin; Pulbere, Dorin; Ursu, Irina; Balanescu, Andreea; Grintescu, Ioana; Mirea, Liliana; Rentea, Irina; Vartic, Mihaela; Lupu, Mary-Nicoleta; Stanescu, Dorin; Streanga, Lavinea; Antal, Oana; Hagau, Natalia; Patras, Dumitru; Petrisor, Cristina; Tosa, Flaviu; Tranca, Sebastian; Copotoiu, Sanda Maria; Ungureanu, Liviu Lucian; Harsan, Cristian Remus; Papurica, Marius; Cernea, Daniela Denisa; Dragoescu, Nicoleta Alice; CarmenVaida, Laura Aflori; Ciobotaru, Oana Roxana; Aignatoaie, Mariana; Carp, Cristina Paula; Cobzaru, Isabelle; Mardare, Oana; Purcarin, Bianca; Tutunaru, Valentin; Ionita, Victor; Arustei, Mirela; Codita, Anisoara; Busuioc, Mihai; Chilinciuc, Ion; Ciobanu, Cristina; Belciu, Ioana; Tincu, Eugen; Blaj, Mihaela; Grosu, Ramona-Mihaela; Sandu, Gigel; Bruma, Dana; Corneci, Dan; Dutu, Madalina; Krepil, Adriana; Copaciu, Elena; Dumitrascu, Clementina Oana; Jemna, Ramona; Mihaescu, Florentina; Petre, Raluca; Tudor, Cristina; Ursache, Elena; Kulikov, Alexander; Lubnin, Andrey; Grigoryev, Evgeny; Pugachev, Stanislav; Tolmasov, Alexander; Hussain, Ayyaz; Ilyina, Yana; Roshchina, Anna; Iurin, Aleksandr; Chazova, Elena; Dunay, Artem; Karelov, Alexey; Khvedelidze, Irina; Voldaeva, Olga; Belskiy, Vladislav; Dzhamullaev, Parvin; Grishkowez, Elena; Kretov, Vladimir; Levin, Valeriy; Molkov, Aleksandr; Puzanov, Sergey; Samoilenko, Aleksandr; Tchekulaev, Aleksandr; Tulupova, Valentina; Utkin, Ivan; Allorto, Nikki Leigh; Bishop, David Gray; Builu, Pierre Monji; Cairns, Carel; Dasrath, Ashish; de Wet, Jacques; Hoedt, Marielle den; Grey, Ben; Hayes, Morgan Philip; Küsel, Belinda Senta; Shangase, Nomcebo; Wise, Robert; Cacala, Sharon; Farina, Zane; Govindasamy, Vishendran; Kruse, Carl-Heinz; Lee, Carolyn; Marais, Leonard; Naidoo, Thinagrin Dhasarthun; Rajah, Chantal; Rodseth, Reitze Nils; Ryan, Lisa; von Rhaden, Richard; Adam, Suwayba; Alphonsus, Christella; Ameer, Yusuf; Anderson, Frank; Basanth, Sujith; Bechan, Sudha; Bhula, Chettan; Biccard, Bruce M.; Biyase, Thuli; Buccimazza, Ines; Cardosa, Jorge; Chen, James; Daya, Bhavika; Drummond, Leanne; Elabib, Ali; Abdel Goad, Ehab Helmy; Goga, Ismail E.; Goga, Riaz; Harrichandparsad, R.; Hodgson, Richard E.; Jordaan, J.; Kalafatis, Nicky; Kampik, Christian; Landers, A. T.; Loots, Emil; Madansein, Rajhmum; Madaree, Anil; Madiba, Thandinkosi E.; Manzini, Vukani T.; Mbuyisa, Mbali; Moodley, Rajan; Msomi, Mduduzi; Mukama, Innocent; Naidoo, Desigan; Naidoo, Rubeshan; Naidu, Tesuven K.; Ntloko, Sindiswa; Padayachee, Eneshia; Padayachee, Lucelle; Phaff, Martijn; Pillay, Bala; Pillay, Desigan; Pillay, Lutchmee; Ramnarain, Anupa; Ramphal, Suren R.; Ryan, Paul; Saloojee, Ahmed; Sebitloane, Motshedisi; Sigcu, Noluyolo; Taylor, Jenna L.; Torborg, Alexandra; Visser, Linda; Anderson, Philip; Conradie, Alae; de Swardt, Mathew; de Villiers, Martin; Eikman, Johan; Liebenberg, Riaan; Mouton, Johan; Paton, Abbey; van der Merwe, Louwrence; Wilscott-Davids, Candice; Barrett, Wendy Joan; Bester, Marlet; de Beer, Johan; Geldenhuys, Jacques; Gouws, Hanni; Potgieter, Jan-Hendrik; Strydom, Magdel; WilberforceTurton, Edwin; Chetty, Rubendraj R.; Chirkut, Subash; Cronje, Larissa; de Vasconcellos, Kim; Dube, Nokukhanya Z.; Gama, N. Sibusiso; Green, Garyth M.; Green-Thompson, Randolph; Kinoo, Suman Mewa; Kistnasami, Prenolin; Maharaj, Kapil; Moodley, Manogaran S.; Mothae, Sibongile J.; Naidoo, Ruvashni; Aslam F Noorbhai, M.; Rughubar, Vivesh; Reddy, Jenendhiran; Singh, Avesh; Skinner, David L.; Smith, Murray J.; Singh, Bhagwan; Misra, Ravi; Naidoo, Maheshwar; Ramdharee, Pireshin; Selibea, Yvonne; Sewpersad, Selina; Sham, Shailendra; Wessels, Joseph D.; Africander, Cucu; Bejia, Tarek; Blakemore, Stephen P.; Botes, Marisa; Bunwarie, Bimalshakth; Hernandez, Carlos B.; Jeeraz, Mohammud A.; Legutko, Dagmara A.; Lopez, Acela G.; de Meyer, Jenine N.; Muzenda, Tanaka; Naidoo, Noel; Patel, Maryam; Pentela, Rao; Junge, Marina; Mansoor, Naj; Rademan, Lana; Scislowski, Pawel; Seedat, Ismail; van den Berg, Bianca; van der Merwe, Doreen; van Wyk, Steyn; Govender, Komalan; Naicker, Darshan; Ramjee, Rajesh; Saley, Mueen; Kuhn, Warren Paul; Matos-Puig, Roel; Alberto Lisi, Zaheer Moolla; Perez, Gisela; Beltran, Anna Valle; Lozano, Angels; Navarro, Carlos Delgado; Duca, Alejandro; Ernesto, Ernesto Pastor Martinez; Ferrando, Carlos; Fuentes, Isabel; García-Pérez, Maria Luisa; Gracia, Estefania; Palomares, Ana Izquierdo; Katime, Antonio; Miñana, Amanda; Incertis, Raul Raul; Romero, Esther; Romero Garcia, Carolina Soledad; Rubio, Concepcion; Artiles, Tania Socorro; Soro, Marina; Valls, Paola; Laguarda, Gisela Alaman; Benavent, Pau; Cuenca, Vicente Chisbert; Cueva, Andreu; Lafuente, Matilde; Parra, Asuncion Marques; Rodrigo, Alejandra Romero; Sanchez-Morcillo, Silvia; Tormo, Sergi; Redondo, Francisco Javier; de Andrés Ibanez, José Antonio; Diago, Lorena Gómez; José Hernández Cádiz, Maria; Manuel, Granell Gil; Peris, Raquel; Saiz, Cristina; Vivo, Jose Tatay; Soto, Maria Teresa Tebar; Brunete, Tamara; Cancho, David; Delgado García, David R.; Zamudio, Diana; del Valle, Santiago Garcia; Serrano, M. Luz; Alonso, Eduardo; Anillo, Victor; Maseda, Emilio; Salgado, Patricia; Suarez, Luis; Suarez-de-la-Rica, Alejandro; Villagrán, María José; Alonso, José Ignacio; Cabezuelo, Estefania; Garcia-Saiz, Irene; Lopez del Moral, Olga; Martín, Silvia; Gonzalez, Alba Perez; Doncel, Ma Sherezade Tovar; Vera, Martin Agüero; José Ávila Sánchez, Francisco; Castaño, Beatriz; Moreira, Beatriz Castaño; Risco, Sahely Flores; Martín, Daniel Paz; Martín, Fernando Pérez; Poza, Paloma; Ruiz, Adela; Serna Martínez, Wilson Fabio; Vicente, Bárbara Vázquez; Dominguez, Saul Velaz; Fernández, Salvador; Munoz-López, Alfonso; Bernat, Maria Jose; Mas, Arantxa; Planas, Kenneth; Jawad, Monir; Saeed, Yousif; Hedin, Annika; Levander, Helena; Holmström, Sandra; Lönn, David; Zoerner, Frank; Åkring, Irene; Widmark, Carl; Zettergren, Jan; Liljequist, Victor Aspelund; Nystrom, Lena; Odeberg-Wernerman, Suzanne; Oldner, Anders; Fagerlund, Malin Jonsson; Reje, Patrik; Lyckner, Sara; Sperber, Jesper; Adolfsson, Anne; Klarin, Bengt; Ögren, Katrin; Barras, Jean-Pierre; Bührer, Thomas; Despotidis, Vasileios; Helmy, Naeder; Holliger, Stephan; Raptis, Dimitri Aristotle; Schmid, Roger; Meyer, Antoine; Jaquet, Yves; Kessler, Ulf; Muradbegovic, Mirza; Nahum, Solange R.; Rotunno, Teresa; Schiltz, Boris; Voruz, François; Worreth, Marc; Christoforidis, Dimitri; Popeskou, Sotirios Georgios; Furrer, Markus; Prevost, Gian Andrea; Stocker, Andrea; Lang, Klaus; Breitenstein, Stefan; Ganter, Michael T.; Geisen, Martin; Soll, Christopher; Korkmaz, Michelle; Lubach, Iris; Schmitz, Michael; Meyer Zu Schwabedissen, Moritz; Moritz, Meyer Zu Schwabedissen; Zingg, Urs; Hillermann, Thomas; Wildi, Stefan; Pinto, Bernardo Bollen; Walder, Bernhard; Mariotti, Giustina; Slankamenac, Ksenija; Namuyuga, Mirioce; Kyomugisha, Edward; Kituuka, Olivia; Shikanda, Anne Wesonga; Kakembo, Nasser; Tom, Charles Otim; Antonina, Webombesa; Bua, Emmanuel; Ssettabi, Eden Michael; Epodoi, Joseph; Kabagenyi, Fiona; Kirya, Fred; Dempsey, Ged; Seasman, Colette; Nawaz Khan, Raja Basit; Kurasz, Claire; Macgregor, Mark; Shawki, Burhan; Francis, Daren; Hariharan, Vimal; Chau, Simon; Ellis, Kate; Butt, Georgina; Chicken, Dennis-Wayne; Christmas, Natasha; Allen, Samantha; Daniel, Gayatri Daniel; Dempster, Angie; Kemp, Juliette; Matthews, Lewis; Mcglone, Philip; Tambellini, Joanne; Trodd, Dawn; Freitas, Katie; Garg, Atul; Gupta, Janesh Kumar; Karpate, Shilpaja; Kulkarni, Aditi; O'Hara, Chloe; Troko, Jtroko; Angus, Kirsty; Bradley, Jacqueline; Brennan, Emma; Brooks, Carolyn; Brown, Janette; Brown, Gemma; Finch, Amanda; Gratrix, Karen; Hesketh, Sue; Hill, Gillian; Jeffs, Carol; Morgan, Maureen; Pemberton, Chris; Slawson, Nicola; Spickett, Helen; Swarbrick, Gemma; Thomas, Megan; van Duyvenvoorde, Greta; Brennan, Andrew; Briscoe, Richard; Cooper, Sarah; Lawton, Tom; Northey, Martin; Senaratne, Rashmi; Stanworth, Helen; Burrows, Lorna; Cain, Helen; Craven, Rachael; Davies, Keith; Jonas, Attila; Pachucki, Marcin; Walkden, Graham; Davies, Helen; Gudaca, Mariethel; Hobrok, Maria; Arawwawala, Dilshan; Fergey, Lauren; Gardiner, Matthew; Gunn, Jacqueline; Johnson, Lyndsay; Lofting, Amanda; Lyle, Amanda; Neela, Fiona Mc; Smolen, Susan; Topliffe, Joanne; Williams, Sarah; Bland, Martin; Balaji, Packianathaswamy; Kaura, Vikas; Lanka, Prasad; Smith, Neil; Ahmed, Ahmed; Myatt, John; Shenoy, Ravikiran; Soon, Wai Cheong; Tan, Jessica; Karadia, Sunny; Self, James; Durant, Emma; Tripathi, Shiva; Bullock, Clare; Campbell, Debbie; Ghosh, Alison; Hughes, Thomas; Zsisku, Lajos; Bengeri, Sheshagiri; Cowton, Amanda; Khalid, Mohammed Shazad; Limb, James; McAdam, Colin; Porritt, Mandy; Rafi, M. Amir; Shekar, Priya; Adams, David; Harden, Catherine; Hollands, Heidi; King, Angela; March, Linda; Minto, Gary; Patrick, Abigail; Squire, Rosalyn; Waugh, Darren; Kumara, Paramesh; Simeson, Karen; Yarwood, Jamie; Browning, Julie; Hatton, Jonathan; Julian, Howes; Mitra, Atideb; Newton, Maria; Pernu, Pawan Kootelu; Wilson, Alison; Commey, Thelma; Foot, Helen; Glover, Lyn; Gupta, Ajay; Lancaster, Nicola; Levin, Jill; Mackenzie, Felicity; Mestanza, Claire; Nofal, Emma; Pout, Lauren; Varden, Rosanna; Wild, Jonathan; Jones, Stephanie; Moreton, Sarah; Pulletz, Mark; Davies, Charlotte; Martin, Matthew; Thomas, Sian; Burns, Karen; McArthur, Carol; Patel, Panna; Lau, Gary; Rich, Natalie; Davis, Fiona; Lyons, Rachel; Port, Beth; Prout, Rachel; Smith, Christopher; Adelaja, Yemi; Bennett, Victoria; Bidd, Heena; Dumitrescu, Alexandra; Murphy, Jacqui Fox; Keen, Abigail; Mguni, Nhlanhla; Ong, Cheng; Adams, George; Boshier, Piers; Brown, Richard; Butryn, Izabella; Chatterjee, Jayanta; Freethy, Alexander; Lockwood, Geoffrey; Tsakok, Maria; Tsiligiannis, Sophia; Peat, William; Stephenson, Lorraine; Bradburn, Mike; Pick, Sara; Cunha, Pedro; Olagbaiye, Olufemi; Tayeh, Salim; Packianathaswamy, Balaji; Abernethy, Caroline; Balasubramaniam, Madhu; Bennett, Rachael; Bolton, David; Martinson, Victoria; Naylor, Charde; Bell, Stephanie; Heather, Blaylock; Kushakovsky, Vlad; Alcock, Liam; Alexander, Hazel; Anderson, Colette; Baker, Paul; Brookes, Morag; Cawthorn, Louise; Cirstea, Emanuel; Clarkson, Rachel; Colling, Kerry; Coulter, Ian; Das, Suparna; Haigh, Kathryn; Hamdan, Alhafidz; Hugill, Keith; Kottam, Lucksy; Lisseter, Emily; Mawdsley, Matthew; McGivern, Julie; Padala, Krishnaveni; Phelps, Victoria; Ramesh Kumar, Vineshykaa; Stewart, Kirsten; Towse, Kayley; Tregonning, Julie; Vahedi, Ali; Walker, Alycon; Baines, Duncan; Bilolikar, Anjali; Chande, Shiv; Copley, Edward; Dunk, Nigel; Kulkarni, Raghavendra; Kumar, Pawan; Metodiev, Yavor; Ncomanzi, Dumisani; Raithatha, Bhavesh; Raymode, Parizade; Szafranski, Jan; Twohey, Linda; Watt, Philip; Weatherall, Lucie; Weatherill, J.; Whitman, Zoe; Wighton, Elinor; Abayasinghe, Chamika; Chan, Alexander; Darwish, Sharif; Gill, James; Glasgow, Emma; Hadfield, Daniel; Harris, Clair; Hopkins, Phil; Kochhar, Arun; Kunst, Gudrun; Mellis, Clare; Pool, Andrew; Riozzi, Paul; Selman, Andrew; Smith, Emma-Jane; Vele, Liana; Gercek, Yuksel; Guy, Kramer; Holden, Douglas; Watson, Nicholas; Whysall, Karen; Andreou, Prematie; Hales, Dawn; Thompson, Jonathan; Bowrey, Sarah; McDonald, Shara; Gilmore, Jemma; Hills, Vicky; Kelly, Chan; Kelly, Sinead; Lloyd, Geraint; Abbott, Tom; Gall, Lewis; Torrance, Hew; Vivian, Mark; Berntsen, Emer; Nolan, Tracey; Turner, Angus; Vohra, Akbar; Brown, Andrew; Clark, Richard; Coughlan, Elaine; Daniel, Conway; Patvardhan, Chinmay; Pearson, Rachel; Predeep, Sheba; Saad, Hesham; Shanmugam, Mohanakrishnan; Varley, Simon; Wylie, Katharine; Cooper, Lucy; Makowski, Arystarch; Misztal, Beata; Moldovan, Eliza; Pegg, Claire; Donovan, Andrew; Foot, Jayne; Large, Simon; Claxton, Andrew; Netke, Bhagyashree; Armstrong, Richard; Calderwood, Claire; Kwok, Andy; Mohr, Otto; Oyeniyi, Peter; Patnaik, Lisa; Post, Benjamin; Ali, Sarah; Arshad, Homa; Baker, Gerard; Brenner, Laura; Brincat, Maximilian; Brunswicker, Annemarie; Cox, Hannah; Cozar, Octavian Ionut; Cheong, Edward; Durst, Alexander; Fengas, Lior; Flatt, Jim; Glister, Georgina; Narwani, Vishal; Photi, Evangelos; Rankin, Adeline; Rosbergen, Melissa; Tan, Mark; Beaton, Ceri; Horn, Rachel; Hunt, Jane; Rousseau, Guy; Stancombe, Lucia; Absar, Mohammed; Allsop, Joanne; Drinkwater, Zoe; Hodgkiss, Tracey; Smith, Kirsty; Brown, Jamie; Alexander-Sefre, Farhad; Campey, Lorraine; Dudgeon, Lucy; Hall, Kathryn; Hitchcock, Rachael; James, Lynne; Smith, Kate; Winstone, Ulrika; Ahmad, Norfaizan; Bauchmuller, Kris; Harrison, Jonathan; Jeffery, Holly; Miller, Duncan; Pinder, Angela; Pothuneedi, Sailaja; Rosser, Jonathan; Sanghera, Sumayer; Swift, Diane; Walker, Rachel; Bester, Delia; Cavanagh, Sarah; Cripps, Heather; Daniel, Harvey; Lynch, Julie; Paton, Alison; Pyke, Shirley; Scholefield, John; Whitworth, Helen; Bottrill, Fiona; Ramalingam, Ganesh; Webb, Stephen; Akerman, Nik; Antill, Philip; Bourner, Lynsey; Buckley, Sarah; Castle, Gail; Charles, Rob; Eggleston, Christopher; Foster, Rebecca; Gill, Satwant; Lindley, Kate; Lklouk, Mohamed; Lowery, Tracey; Martin, Oliver; Milne, David; O'Connor, Patrick; Ratcliffe, Andrew; Rose, Alastair; Smith, Annie; Varma, Sandeep; Ward, Jackie; Barcraft-Barnes, Helena; Camsooksai, Julie; Colvin, Carolyn; Reschreiter, Henrik; Tbaily, Lee; Venner, Nicola; Hamilton, Caroline; Kelly, Lewis; Toth-Tarsoly, Piroska; Dodsworth, Kerry; Foord, Denise; Gordon, Paul; Hawes, Elizabeth; Lamb, Nikki; Mouland, Johanna; Nightingale, Jeremy; Rose, Steve; Schrieber, Joe; Al'Amri, Khalid; Aladin, Hafiz; Arshad, Mohammed Asif; Barraclough, James; Bentley, Conor; Bergin, Colin; Carrera, Ronald; Clarkson, Aisling; Collins, Michelle; Cooper, Lauren; Denham, Samuel; Griffiths, Ewen; Ip, Peter; Jeyanthan, Somasundaram; Joory, Kavita; Kaur, Satwant; Marriott, Paul; Mitchell, Natalie; Nagaiah, Sukumar; Nilsson, Annette; Parekh, Nilesh; Pope, Martin; Seager, Joseph; Serag, Hosam; Tameem, Alifia; Thomas, Anna; Thunder, Joanne; Torrance, Andrew; Vohra, Ravinder; Whitehouse, Arlo; Wong, Tony; Blunt, Mark; Wong, Kate; Giles, Julian; Reed, Isabelle; Weller, Debbie; Bell, Gillian; Birch, Julie; Damant, Rose; Maiden, Jane; Mewies, Clare; Prince, Claire; Radford, Jane; Reynolds, Tim; Balain, Birender; Banerjee, Robin; Barnett, Andrew; Burston, Ben; Davies, Kirsty; Edwards, Jayne; Evans, Chris; Ford, David; Gallacher, Pete; Hill, Simon; Jaffray, David; Karlakki, Sudheer; Kelly, Cormac; Kennedy, Julia; Kiely, Nigel; Lewthwaite, Simon; Marquis, Chris; Ockendon, Matthew; Phillips, Stephen; Pickard, Simon; Richardson, James; Roach, Richard; Smith, Tony; Spencer-Jones, Richard;