... blood clots, you have liver disease. In some women, Menopause Hormone Therapy may increase risks of serious side effects including blood clots, heart attacks, strokes, breast cancer, and gall bladder disease. Menopause Hormone Therapy should ...
... 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 ...
... 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 ...
Chromosomal abnormalities are reported in. 10‑20% of cases involving X sex chromosomes.. Genetic causes of premature menopause: • Examples of Chromosomal abnormalities. ‑ Turner's syndrome. ‑ Pure gonadal dysgenesis. ‑ Familial. ‑ Trisomy 18 and Trisomy 13. Metabolic. • 17 alpha‑hydroxylase deficiency.
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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 ...
... 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 ...
... Video Series-2016 Video Series-2017 Commercial Supporters Advertise in Menopause NAMS Corporate Liaison Council Outreach Opportunities ... menopause source Menopause Guidebook Sexual Health Module MenoPro Mobile App Hormone Therapy MenoNote NAMS Video Series Homepage ...
Reid, Robert; Abramson, Beth L; Blake, Jennifer; Desindes, Sophie; Dodin, Sylvie; Johnston, Shawna; Rowe, Timothy; Sodhi, Namrita; Wilks, Penny; Wolfman, Wendy
To provide updated guidelines for health care providers on the management of menopause in asymptomatic healthy women as well as in women presenting with vasomotor or urogenital symptoms and on considerations related to cardiovascular disease, breast cancer, urogynaecology, and sexuality. Lifestyle interventions, prescription medications, and complementary and alternative therapies are presented according to their efficacy in the treatment of menopausal symptoms. Counselling and therapeutic strategies for sexuality concerns in the peri- and postmenopausal years are reviewed. Approaches to the identification and evaluation of women at high risk of osteoporosis, along with options for prevention and treatment, are presented in the companion osteoporosis guideline. Published literature was retrieved through searches of PubMed and The Cochrane Library in August and September 2012 with the use of appropriate controlled vocabulary (e.g., hormone therapy, menopause, cardiovascular diseases, and sexual function) and key words (e.g., hormone therapy, perimenopause, heart disease, and sexuality). Results were restricted to clinical practice guidelines, systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Results were limited to publication dates of 2009 onwards and to material in English or French. Searches were updated on a regular basis and incorporated in the guideline until January 5, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, national and international medical specialty societies, and clinical practice guideline collections.
... 6663) • Hormone Health Network information about menopause —— www.hormone.org/Menopause —— www.hormone.org/MenopauseMap • MedlinePlus (National Institutes of ... in Spanish at www.hormone.org/Spanish . Bioidentical Hormones and Menopause Fact Sheet www.hormone.org
... MenoNotes MenoPro Mobile App MenoPause Blog Sexual Health & Menopause Online Changes at Midlife How to Navigate This Online Resource ... on the left. We start by reviewing midlife changes related to menopause and aging. We then discuss common sexual problems ...
Stuhr, Robyn M.
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…
Al-Safi, Zain A; Polotsky, Alex J
Over the recent decades, the prevalence of obesity in the United States has increased to epidemic proportions to more than 35% of adults, along with an increased risk of a number of health conditions, including hypertension, adverse lipid concentrations, and type 2 diabetes. The relationships between menopausal transition, weight gain, and obesity are reported but incompletely understood. The association between menopause and these measures has been the subject of many studies, along with examining their effect on reproductive hormones and menopausal symptoms. The purpose of this review is to summarize what is published in the literature on this subject and examine it through: (1) the possible impact of obesity on the timing of menopause; (2) the effect of obesity on menopausal symptoms and reproductive hormones around the time of menopause; and (3) the effect of menopause on obesity, weight gain, and body composition. Copyright © 2014 Elsevier Ltd. All rights reserved.
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…
Vellanki, Kavitha; Hou, Susan
Most women with dialysis-dependent chronic kidney disease (CKD) stage 5 (CKD stage 5D) are in the postmenopausal age group. Early menopause is reported for all CKD stages (stages 3-5D). The traditional definition of menopause is not applicable in CKD stage 5(D) because menses can resume with hormone replacement therapy or kidney transplantation. Treatment of vasomotor symptoms continues to be the primary indication for hormone replacement therapy, with no dosing studies done specifically for CKD or kidney transplantation populations. Similarly, the risk for cardiovascular disease and osteoporosis in menopause is well described in healthy women, but the role that menopause plays in accelerating the risk further in CKD/kidney transplantation is yet to be explored. Lack of data and specific guidance on management make the long-term effects of menopause one of the most under-recognized and neglected patient problems in clinical nephrology. The efficacy and side effects of widely available therapeutic options in healthy women for menopause-related clinical manifestations, be it hormone replacement therapy for vasomotor symptoms or antiresorptive agents for osteoporosis, are to be tested in kidney transplantation and CKD populations. Longitudinal clinical trials are in need to define menopause in CKD and determine the role that CKD plays in menopause transition and menopause on CKD manifestations. Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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
Pragya A Nair
Full Text Available Menopause is defined as permanent irreversible cessation of menses brought by decline in ovarian follicular activity. Hormonal alteration results in various physical, psychological, and sexual changes in menopausal women. Associated dermatological problems can be classified as physiological changes, age-related changes, changes due to estrogen deficiency and due to hormone replacement therapy. Dermatosis seen due to estrogen deficiency includes Atrophic Vulvovaginitis, Vulvar Lichen Sclerosus, Dyaesthetic Vulvodynia, Hirsutism, Alopecia, Menopausal Flushing, Keratoderma Climactericum, Vulvovaginal Candidiasis. Dermatologists and gynecologists need to be familiar with the problems of menopausal women, as with increase in life expectancy, women passing through this phase is rising.
Bacon, Janice L
A clear understanding of the physiology of the menopausal transition, clinical symptoms, and physical changes is essential for individualized patient management, maximizing benefits and minimizing risks for the present and the future. Menopause, defined by amenorrhea for 12 consecutive months, is determined retrospectively and represents a permanent end to menses. Many physical changes occur during the menopausal transition and beyond. Knowledge of symptoms and findings experienced by women undergoing the menopausal transition allow individualized care- improving quality of life and enhancing wellbeing for years to come. Copyright © 2017 Elsevier Inc. All rights reserved.
Duarte, Gleison V; Trigo, Ana Cm; Paim de Oliveira, Mária de Fátima
Menopause is the cessation of menstrual periods due to the loss of ovarian function. Among the various phases of a woman's life, menopause has the greatest impact on health and has been one of the most neglected areas of research. Hormonal changes caused by menopause can lead to problems in the skin and its annexes, and despite the high frequency of dermatologic signs and symptoms, studies on this topic are limited. In this article, we review the skin disorders that result from the hormonal changes of menopause and other common dermatoses observed during this period and assess possible therapeutic approaches.
Stachowiak, Grzegorz; Pertyński, Tomasz; Pertyńska-Marczewska, Magdalena
Metabolic disorders occurring in menopause, including dyslipidemia, disorders of carbohydrate metabolism (impaired glucose tolerance - IGT, type 2 diabetes mellitus - T2DM) or components of metabolic syndrome, constitute risk factors for cardiovascular disease in women. A key role could be played here by hyperinsulinemia, insulin resistance and visceral obesity, all contributing to dyslipidemia, oxidative stress, inflammation, alter coagulation and atherosclerosis observed during the menopausal period. Undiagnosed and untreated, metabolic disorders may adversely affect the length and quality of women's life. Prevention and treatment preceded by early diagnosis should be the main goal for the physicians involved in menopausal care. This article represents a short review of the current knowledge concerning metabolic disorders (e.g. obesity, polycystic ovary syndrome or thyroid diseases) in menopause, including the role of a tailored menopausal hormone therapy (HT). According to current data, HT is not recommend as a preventive strategy for metabolic disorders in menopause. Nevertheless, as part of a comprehensive strategy to prevent chronic diseases after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered (after balancing benefits/risks and excluding women with absolute contraindications to this therapy). Life-style modifications, with moderate physical activity and healthy diet at the forefront, should be still the first choice recommendation for all patients with menopausal metabolic abnormalities.
Full Text Available 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.
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…
Gupta, Rina; Assalman, Iyas; Bottlender, Ronald
We have come a long way from our understanding of the menopause as it was described in the 11th century by Trotula of Salerno, a female gynaecologist who said 'there are older women who give forth blood matter especially as menopause approaches them'. Yet very little is known about the impact menopause has on the mental health of women especially severe and enduring illnesses like schizophrenia. A lot of research has shown that estrogen acts as a protective factor due to its antidopaminergic properties, thus providing an explanation for the increase in risk of a new psychotic disorder during the menopause. This has further led to the hypothesis of hormone replacement therapy providing benefits in the management of these disorders in menopausal women. This review article highlights the importance of a clear understanding of this phase of life in patients suffering from or who present with a risk of developing schizophrenia.
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
Shulman, L P
The cessation of ovarian sex steroidigenesis, either as result as surgical extirpation, certain medical therapies or the gradual cessation of ovarian function, leads to menopause with all its associated physiological, physical and lifestyle changes. The changing hormonal milieu of menopause is most commonly associated with declining levels of estrogens. However, ovarian senescence also results in declining levels of androgens. Indeed, it is the loss of physiological levels of estrogens and androgens that result in the varied signs and symptoms of menopause including vasomotor symptoms, bone mineral density loss, reduced interest in sex, alterations in mood and energy and hair loss, among others. This paper will provide a review of the role of androgens in the menopause and assess the potential of androgen therapies in the management of the menopause.
Watt, Fiona E
Hand osteoarthritis (OA) is one of the commonest musculoskeletal conditions, primarily affecting women over the age of 50, typically around the age of the menopause. Symptomatic disease can give rise to substantial pain, impairment of hand function and quality of life, leading to significant socioeconomic cost. There is currently no disease-modifying therapy, representing a huge unmet clinical need. The evidence for a relationship between hand OA and the menopause is summarised. Whether there is evidence for an effect of menopausal hormonal therapy on the incidence, prevalence or severity of symptomatic hand OA is critically reviewed, and gaps in our knowledge identified. Lastly, the potential mechanisms by which estrogen, or newer agents such as SERMs, might act to interfere with disease pathogenesis are overviewed. The need for specifically designed, controlled trials of agents in cohorts with symptomatic hand OA, refractory to standard symptomatic management is highlighted. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
El Khoudary, Samar R
To summarize recent provocative findings on conventional and novel metrics of HDL including HDL-C, HDL subclasses and HDL cholesterol efflux capacity as related to menopause. Pattern of menopause-related changes in HDL-C are not consistent, suggesting a complex relationship between HDL and menopause. Growing body of literature indicates that higher levels of HDL-C may not be consistently cardio-protective in midlife women, suggesting a potential change in other metrics of HDL that could not be captured by the static metric HDL-C. It is also possible that higher HDL-C at certain conditions could be a marker of HDL metabolism dysfunctionality. Significant alterations in other metrics of HDL have been reported after menopause and found to be related to estradiol. The impact of changes in novel metrics of HDL over the menopausal transition on cardiovascular disease (CVD) risk later in life is not clear in women. Much of our understanding of how the menopausal transition may impact HDL metrics comes from cross-sectional studies. Future longitudinal studies are needed to evaluate other metrics of HDL shown to better reflect the cardio-protective capacities of HDL, so that the complex association of menopause, HDL and CVD risk could be characterized.
... or supplements. Eat high calcium foods, such as cheese, leafy green vegetables, low-fat milk and other ... unable to manage your symptoms of menopause with home care only. Also call if you have any ...
... 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 ...
Jouyandeh, Zahra; Nayebzadeh, Farnaz; Qorbani, Mostafa; Asadi, Mojgan
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...
D. A. Anichkov
Full Text Available A role of menopause as a cardiovascular risk factor is reviewed. Menopause influence on the cardiovascular system may be mediated by body fat re-allocation, metabolic, hemodynamic and pro-inflammatory changes. Besides, estrogen deprivation has a direct effect on the arterial wall. Lifestyle modification, lipid-lowering and antihypertensive treatment should be considered for cardiovascular risk reduction in postmenopausal women.
Schneider, Berit; van Trotsenburg, Michael; Hanke, Gunda; Bigenzahn, Wolfgang; Huber, Johannes
Menopause rating scales still do not regard voice impairment as a genuine climacteric symptom, although voice changes are frequently reported. The purpose of this study was both to register and differentiate voice alterations and disorders in menopausal women. A total of 107 women between 37 and 71 years of age who were rated as postmenopausal according to their hormonal status answered a questionnaire on voice changes and vocal discomfort. Of this group, 49 women mentioned voices changes, and 35 of those women associated these changes with subjective discomfort, whereas 58 women mentioned neither voice changes nor discomfort. Sixteen of the women who mentioned voice changes and eight who did not participated in a comprehensive investigation, which included completion of the Klimax questionnaire, a head and neck examination, videostroboscopy, perceptual evaluation of voice sound, voice range profile measurements, and voice dysfunction index determination. Voice changes during menopause might be a common problem seen in clinical practice. Therefore, an additional systematic registration of voice impairment in future menopause rating scales should be considered if further studies confirm our findings of a high prevalence of voice complaints associated with menopause. Severe menopausal voice impairments, even without other climacteric symptoms, should be regarded as an indication for phoniatric examination.
Brzezinski, Amnon; Brzezinski-Sinai, Noa A; Seeman, Mary V
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.
Legendre, G; Fritel, X; Ringa, V; Lesavre, M; Fernandez, H
The aim of this review was to examine the relationship between menopause and urinary incontinence (UI). Our work is based on a review of the literature on the epidemiology of UI in women and the effects of hormone therapy on symptoms of urinary leakage. A search of the Medline database between January 2000 and April 2012 was performed by crossing the keywords "urinary incontinence, stress urinary incontinence (SUI), urge incontinence, over active bladder, menopause, estrogen therapy". Twenty-nine articles over the 482 articles were initialy selected. The UI was a common symptom during menopause, with a prevalence of 15 to 30% and an annual incidence of 5 to 10%. The association between UI and menopause was controversial. Indeed, although underpinned by pathophysiological mechanisms such as the sensitivity of tissues of the urogenital sinus to estrogen, the epidemiological data available were contradictory and should be interpreted, if possible, depending on the type of UI. Thus, it remained difficult to distinguish the effect of menopause of the aging. The effects of estrogen on IU differed depending on the route of administration and of the type of UI. Randomized trials showed that oral administration of estrogen after menopause increased the occurrence of UI or SUI. However a vaginal administration of estrogen improved urge urinary incontinence (UUI) and overactive bladder. The data of this review were consistent with the French and European guidelines. Copyright © 2012 Elsevier Masson SAS. All rights reserved.
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
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
Menopause is one area that has been shrouded in myths and taboos especially as related to the behaviour of women. The study therefore examined the perception of menopause and the adjustment practices adopted by menopausal women in Nigeria. The study involved both Quantitative and Qualitative method.
Discusses research dealing with the study of menopause. Underscores the problems with the case study method. Discusses two population-based studies and the problems of age adjustment and measurement in menopause research. Highlights alternate research strategies. (MK)
Maki, Pauline M
Midlife women frequently report memory problems during the menopausal transition. Recent studies validate those complaints by showing significant correlations between memory complaints and performance on validated memory tasks. Longitudinal studies demonstrate modest declines in verbal memory during the menopausal transition and a likely rebound during the postmenopausal stage. Clinical studies that examine changes in memory following hormonal withdrawal and add-back hormone therapy (HT) demonstrate that estradiol plays a critical role in memory. Although memory changes are frequently attributed to menopausal symptoms, studies show that the memory problems occur during the transition even after controlling for menopausal symptoms. It is well established that self-reported vasomotor symptoms (VMS) are unrelated to objective memory performance. However, emerging evidence suggests that objectively measured VMS significantly correlate with memory performance, brain activity during rest, and white matter hyperintensities. This evidence raises important questions about whether VMS and VMS treatments might affect memory during the menopausal transition. Unfortunately, there are no clinical trials to inform our understanding of how HT affects both memory and objectively measured VMS in women in whom HT is indicated for treatment of moderate to severe VMS. In clinical practice, it is helpful to normalize memory complaints, to note that evidence suggests that memory problems are temporary, and to counsel women with significant VMS that memory might improve with treatment. Copyright © 2015. Published by Elsevier Ireland Ltd.
Full Text Available Menopause is associated with a large number of symptoms ranging from physical to psychological. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to be aware of the symptoms and health care needs of peri-menopausal/menopausal/postmenopausal women. This article attempts to provide an insight into the multifarious oral manifestations at menopause along with the relevant prosthodontic implications.
Brady, Carla W
There are numerous physiologic and biochemical changes in menopause that can affect the function of the liver and mediate the development of liver disease. Menopause represents a state of growing estrogen deficiency, and this loss of estrogen in the setting of physiologic aging increases the likelihood of mitochondrial dysfunction, cellular senescence, declining immune responses to injury, and disarray in the balance between antioxidant formation and oxidative stress. The sum effect of these changes can contribute to increased susceptibility to development of significant liver pathology, particularly nonalcoholic fatty liver disease and hepatocellular carcinoma, as well as accelerated progression of fibrosis in liver diseases, as has been particularly demonstrated in hepatitis C virus liver disease. Recognition of the unique nature of these mediating factors should raise suspicion for liver disease in perimenopausal and menopausal women and offer an opportunity for implementation of aggressive treatment measures so as to avoid progression of liver disease to cirrhosis, liver cancer and liver failure.
Kaunitz, Andrew M.; Manson, JoAnn E.
Most menopausal women experience vasomotor symptoms, with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms, with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women’s Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen affected all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appears to represent a sound strategy for optimizing the benefit: risk profile and safety of hormone therapy. Systemic HT should not be arbitrarily stopped at age 65; instead treatment duration should be individualized based on patients’ risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely impacts the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit: risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms. PMID:26348174
Kaunitz, Andrew M; Manson, JoAnn E
Most menopausal women experience vasomotor symptoms with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women's Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen increased all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appear to represent a sound strategy for optimizing the benefit-risk profile and safety of HT. Systemic HT should not be arbitrarily stopped at age 65 years; instead treatment duration should be individualized based on patients' risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely affects the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low-dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit-risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms.
Hall, Janet E
In women, age-related changes in ovarian function begin in the mid-30s with decreased fertility and compensatory hormonal changes in the hypothalamus-pituitary-gonadal axis that maintain follicle development and estrogen secretion in the face of a waning pool of ovarian follicles. The menopause transition is characterized by marked variability in follicle development, ovulation, bleeding patterns, and symptoms of hyper- and hypoestrogenism. The menopause, which is clinically defined by the last menstrual period, is followed by the consistent absence of ovarian secretion of estradiol. Copyright © 2015 Elsevier Inc. All rights reserved.
Ameratunga, D; Goldin, J; Hickey, M
Sleep disturbance during menopause is a common and important complaint faced by many women. There are many factors that may play a role in this problem, including vasomotor symptoms and changing hormone levels, circadian rhythm abnormalities, exacerbation of primary insomnia, mood disorders, coexistent medical conditions as well as lifestyle factors. Sleep can be measured both objectively and subjectively; however, correlation between the two measures is not high. Most of the menopause-related sleep disturbances have been reported as qualitative in nature; however, there have also been studies showing changes in objective measures. This discrepancy has implications with regard to evaluation of research in sleep and menopause, as well as application in the clinical setting. Investigations of inadequate sleep and sleep problems during the menopausal period and obtaining a thorough understanding of the factors contributing to these problems are essential in formulating treatment strategies. Such strategies can vary from hormonal treatment and medications to lifestyle and behavioural modification. © 2012 The Authors. Internal Medicine Journal © 2012 Royal Australasian College of Physicians.
del Ghianda, S; Tonacchera, M; Vitti, P
Thyroid dysfunction is common in the general population especially in women. All thyroid diseases are in fact more common in women than in men and may interfere with the reproductive system. Thyroid function and the gonadal axes are related throughout the woman's fertile period. The relationship between the two glands is mutual. In particular, thyroid hormones affect the reproductive function both directly and indirectly through several actions. Studies on the relationship between menopause and thyroid function are few and do not allow to clarify whether menopause has an effect on the thyroid regardless of aging. With aging, the main changes regarding thyroid physiology and function are: a reduction of thyroid iodine uptake, free thyroxine and free triiodothyronine synthesis and catabolism of free thyroxine while reverse triiodothyronine increases; the level of thyroid stimulating hormone remains normal with sometimes a tendency to higher limits. These changes are present in both sexes without distinction between males and females. The complexity of the relationships can be summarized in three aspects: thyroid status does not influence significantly the climacteric syndrome; menopause may modify the clinical expression of some thyroid diseases, particularly the autoimmune ones; thyroid function is not directly involved in the pathogenesis of the complications of menopause. However, coronary atherosclerosis and osteoporosis may be aggravated in the presence of hyperthyroidism or hypothyroidism. The effects of postmenopausal estrogen replacement on thyroxine requirements in women with hypothyroidism should be considered.
manifested in the oral cavity. The teeth and gums are more affected by the hormonal changes occurring before menopause, which decrease the body's ability to fight minor infections or maintain a healthy balance of useful and harmful bacteria within the oral environment. The dentist needs to be aware of oral ...
Hadya Gorga; Putri Sri Lasmini; Arni Amir
AbstrakMenopause merupakan waktu penghentian menstruasi secara permanen yang terjadi setelah hilangnya aktivitas ovarium. Saat ini jumlah wanita usia menopause meningkat seiring dengan peningkatan usia harapan hidup. Studi tentang menopause sangat penting, terutama terkait akibat yang akan terjadi pasca menopause seperti penyakit kardiovaskuler dan osteoporosis. Tujuan penelitian ini adalah menentukan usia menopause alami dan menganalisis hubungannya terhadap jumlah paritas pada wanita di Kel...
Kanapathipillai, Rupa; Hickey, Martha; Giles, Michelle
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.
Meirelles, Ricardo M R
The incidence of cardiovascular disease increases considerably after the menopause. One reason for the increased cardiovascular risk seems to be determined by metabolic syndrome, in which all components (visceral obesity, dyslipidemia, hypertension, and glucose metabolism disorder) are associated with higher incidence of coronary artery disease. After menopause, metabolic syndrome is more prevalent than in premenopausal women, and may plays an important role in the occurrence of myocardial infarction and other atherosclerotic and cardiovascular morbidities. Obesity, an essential component of the metabolic syndrome, is also associated with increased incidence of breast, endometrial, bowel, esophagus, and kidney cancer. The treatment of metabolic syndrome is based on the change in lifestyle and, when necessary, the use of medication directed to its components. In the presence of symptoms of the climacteric syndrome, hormonal therapy, when indicated, will also contribute to the improvement of the metabolic syndrome.
Circadian rhythm is an internal biological clock which initiates and monitors various physiological processes with a fixed time-related schedule. The master circadian pacemaker is located in the suprachiasmatic nucleus in the hypothalamus. The circadian clock undergoes significant changes throughout the life span, at both the physiological and molecular levels. This cyclical physiological process, which is very complex and multifactorial, may be associated with metabolic alterations, atherosclerosis, impaired cognition, mood disturbances and even development of cancer. Sex differences do exist, and the well-known sleep disturbances associated with menopause are a good example. Circadian rhythm was detected in the daily pattern of hot flushes, with a peak in the afternoons. Endogenous secretion of melatonin decreases with aging across genders, and, among women, menopause is associated with a significant reduction of melatonin levels, affecting sleep. Although it might seem that hot flushes and melatonin secretion are likely related, there are not enough data to support such a hypothesis.
Al-Azzawi, Farook; Palacios, Santiago
Ovarian senescence occurs gradually during the fourth and fifth decades of life, leading to menopause at an average age of about 51 years. This senescence results in a changing hormonal milieu, with decreases in the levels of estrogens and androgens. Similar changes may be induced by surgical menopause (bilateral oophorectomy) or ovarian failure resulting from cancer treatment. The declining levels of estrogens and androgens affect many tissues of the body and can produce a variety of signs and symptoms, including vasomotor symptoms, decreased bone density, changes in mood and energy, loss of pubic hair and changes in the genital tissues, and effects on sexual function. Accurate measurement of testosterone levels in postmenopausal women requires methods that are validated in the lower ranges of testosterone level observed in this population.
Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly af...
Yum, Sun Kyoung; Kim, Tak
The average middle aged woman goes through a volatile period of endocrine fluctuations as she passes through menopause and the stages that precede and follow it. Ovarian hormones are steroid hormones. They readily cross the cell and nuclear membranes and influence transcription of numerous genes. Such influences are tissue specific and state specific. In short, changes in ovarian hormones mean that a women will experience changes in her entire body systems. When an individual woman's constitu...
Kaunitz, Andrew M.; Manson, JoAnn E.
Most menopausal women experience vasomotor symptoms, with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms, with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women’s Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with...
... 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 ...
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 ...
... 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 ...
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.
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.
Torella, M; La Rezza, F; Labriola, D; Ammaturo, F P; Ambrosio, D; Zarcone, R; Trotta, C; Schettino, M T; De Franciscis, P
Menopause is the interruption of menstrual and reproductive capacity, therefore, that occurs naturally in all women between 48 and 55 years, due to a lower production of gonadal steroids. The period becomes progressively irregular and lack of ovulation and menstrual flow decrease, and finally disappears. The time between the first symptoms and the cessation of the menstrual cycle is called menopause. With the onset of menopause the woman undergoes a series of changes related to estrogen deficiency, which occur in all tissues of the body. In this period one can distinguish an early stage, characterized by hot flashes, mood swings, night sweats and insomnia, and a late phase in which we highlight more symptoms related to the interruption of hormonal such as osteoporosis, obesity, at urogenital and increased incidence of cardiovascular disease. In Italy, only 5.2% of women aged 45-64 years used hormone replacement therapy, and only 20-30% follow a therapy for more than two years, both for psychological reasons, and for fear of side effects. Not surprisingly, therefore, phytoestrogens are given a high importance, as they are considered a natural alternative tank to to their plant origin. Interest in phytoestrogens was born from the observation that postmenopausal women who live in the East have a lower incidence of symptoms, cardiovascular disease, cancer and osteoporosis hormone use, compared to Western women.
menopause and the prevalence rates of depression fall post- menopause.“ Genazzani', Spinetti, Gallo, et ... previous history of poor physical and psychosocial health at age 36 also reported more symptoms at 47 ..... Hammer M, Berg G and Hindgren R: Does physical exercise inﬂuence the frequency ofpostmenopausal hot ...
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…
Hargarten, Kathleen M.
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)
Patterson, Marilyn M.; Lynch, Ann Q.
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…
Evarts, Barbara Kess; Baldwin, Cynthia
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)
Davies, K M; Heaney, R P; Recker, R R; Barger-Lux, M J; Lappe, J M
To determine total body weight change occurring in women at mid-life, specifically with respect to occurrence of menopause and use of estrogen. Retrospective analysis of body weight measurements accumulated in two cohorts of healthy women participating in studies of skeletal metabolism. Cohort 1: 191 healthy nuns enrolled in a prospective study of osteoporosis risk, aged 35-45 in 1967; cohort 2: 75 women aged 46 or older and still menstruating, enrolled in 1988 in a study of bone cell dynamics across menopause. Roughly one-third of each group received hormone replacement after menopause. Body weight and height, age, menstrual status and use of estrogen replacement. Cohort 1: 608 measurements at 5 y intervals spanning a period from 17 y before to 22 y after menopause; cohort 2: 1180 measurements at 6-month intervals spanning a period from 5 y prior to 5 y after menopause. In cohort 1 weight rose as a linear function of age (both chronological and menopausal), both before and after cessation of ovarian function, at a rate of approximately 0.43% y(-1). Neither the menopausal transition nor the use of estrogen had an appreciable effect on this rate of gain. In cohort 2 the rate of gain seemed to diminish slightly at menopause. As with cohort 1, hormone replacement (or its absence) had no appreciable effect on weight. The long-term, total body weight trajectory at mid-life is not influenced appreciably by either cessation of ovarian function or by hormone replacement.
Lucija Vrabič Dežman
The studies could not decisively confirm the effectiveness of various phytoestrogens inamelioration of climacteric symptoms. Most studies have proven the effectiveness of thenatural medication made of Cimicifuga racemosa and its safe short-term use. Gynecologists should be familiar with the basics of phytotherapy and the results of clinical studiesin this field in order to confidently advise women to use the natural medications in caseswhere despite the climacteric symptoms they cannot or will not use HRT, consequentlygreatly reducing the quality of their lives. In cases where climacteric symptoms are mild tomoderate, some menopausal societies around the globe suggest trying natural medicationfirst, and only later implementing HRT
Menopause diartikan sebagai suatu proses dimana wanita tidak mengalami menstruasi lagi. Usia rata - rata seorang wanita mengalami menopause adalah 51 tahun. Pada masa menjelang menopause, ovarium mulai mengalami penuaan sehingga produksi hormon estrogen menurun dan terjadi gangguan keseimbangan hormon. Kekurangan hormon estrogen ini menyebabkan keluhan keluhan yang dikenal sebagai sindroma defisiensi estrogen. Wanita menopause sering disertai dengan penyakit – penyakit sistemik seperti o...
Fitriyani Fitriyani; Ratna Djuwita
Menopause merupakan menstruasi yang berhenti secara permanen yang disebabkan kehilangan fungsi folikel sel-sel telur. Wanita yang memasuki menopause mengalami penurunan hormon estrogen yang mengganggu aktivitas sehari-hari, bahkan menurunkan kualitas hidup. Penggunaan kontrasepsi pil berhubungan dengan penundaan usia dan keluhan menopause. Penelitian ini bertujuan mengetahui hubungan antara penggunaan kontrasepsi pil terhadap usia menopause. Penelitian ini menggunakan desain potong lintang. P...
Full Text Available Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here.
Menopause is a physiological process related to the increasing insufficiency of the hypothalamic-hypophyseal-ovarian axis. The pool of ovarian follicles capable of synthesizing female sex hormones becomes gradually depleted. In response to the sequence of endocrine changes of premenopause, perimenopause, and postmenopause, systemic somatic and emotional disturbances appear. Skin is the target organ for sex hormones. In women, the trophicity and appearance of the skin are most significantly affected by female sex hormones, estrogens and progesterone. However, this review also emphasizes the influences of other hormones on the skin and subcutaneous tissue. During menopause, a low estrogen concentration is responsible for increased vascular permeability and decreased vascular tone, which lead to microcirculation impairment and are important factors predisposing to the development of cellulite. The effects of estrogen deficiency on the skin connective tissue include a decreased production and topical content of both type I and III collagen and elastin fibers, which also contributes to cellulite. This paper presents diagnostic methods and clinical types of cellulite, as well as principal instrumental and manual treatments used for the reduction of the condition. Preparations containing ingredients which help to improve the metabolism of subcutaneous fat and enhance blood and lymphatic circulation, applied in cosmetology and esthetic medicine practice, have been reviewed. Furthermore, we provide an array of opinions regarding the effectiveness of treatment modalities presented here.
Rocca, Walter A.; Grossardt, Brandon R.; Miller, Virginia M.; Shuster, Lynne T.; Brown, Robert D.
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
Foldspang, Anders; Mommsen, Søren
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...
Lobo, R A; Davis, S R; De Villiers, T J; Gompel, A; Henderson, V W; Hodis, H N; Lumsden, M A; Mack, W J; Shapiro, S; Baber, R J
Women may expect to spend more than a third of their lives after menopause. Beginning in the sixth decade, many chronic diseases will begin to emerge, which will affect both the quality and quantity of a woman's life. Thus, the onset of menopause heralds an opportunity for prevention strategies to improve the quality of life and enhance longevity. Obesity, metabolic syndrome and diabetes, cardiovascular disease, osteoporosis and osteoarthritis, cognitive decline, dementia and depression, and cancer are the major diseases of concern. Prevention strategies at menopause have to begin with screening and careful assessment for risk factors, which should also include molecular and genetic diagnostics, as these become available. Identification of certain risks will then allow directed therapy. Evidence-based prevention for the diseases noted above include lifestyle management, cessation of smoking, curtailing excessive alcohol consumption, a healthy diet and moderate exercise, as well as mentally stimulating activities. Although the most recent publications from the follow-up studies of the Women's Health Initiative do not recommend menopause hormonal therapy as a prevention strategy, these conclusions may not be fully valid for midlife women, on the basis of the existing data. For healthy women aged 50-59 years, estrogen therapy decreases coronary heart disease and all-cause mortality; this interpretation is entirely consistent with results from other randomized, controlled trials and observational studies. Thus. as part of a comprehensive strategy to prevent chronic disease after menopause, menopausal hormone therapy, particularly estrogen therapy may be considered as part of the armamentarium.
Davis, S R; Castelo-Branco, C; Chedraui, P; Lumsden, M A; Nappi, R E; Shah, D; Villaseca, P
The aim of this review was to summarize the literature regarding the impact of the menopause transition on body weight and body composition. We conducted a search of the literature using Medline (Ovid, 1946-present) and PubMed (1966-2012) for English-language studies that included the following search terms: 'menopause', 'midlife', 'hormone therapy' or 'estrogen' combined with 'obesity', 'body weight' or 'body composition'. Whereas weight gain per se cannot be attributed to the menopause transition, the change in the hormonal milieu at menopause is associated with an increase in total body fat and an increase in abdominal fat. Weight excess at midlife is not only associated with a heightened risk of cardiovascular and metabolic disease, but also impacts adversely on health-related quality of life and sexual function. Animal and human studies indicate that this tendency towards central abdominal fat accumulation is ameliorated by estrogen therapy. Studies mostly indicate a reduction in overall fat mass with estrogen and estrogen-progestin therapy, improved insulin sensitivity and a lower rate of development of type 2 diabetes. The hormonal changes across the perimenopause substantially contribute to increased abdominal obesity which leads to additional physical and psychological morbidity. There is strong evidence that estrogen therapy may partly prevent this menopause-related change in body composition and the associated metabolic sequelae. However, further studies are required to identify the women most likely to gain metabolic benefit from menopausal hormone therapy in order to develop evidence-based clinical recommendations.
Khan, Aliya; Fortier, Michel
To provide guidelines for the health care provider on the prevention, diagnosis, and clinical management of postmenopausal osteoporosis. Strategies for identifying and evaluating high-risk individuals, the use of bone mineral density (BMD) and bone turnover markers in assessing diagnosis and response to management, and recommendations regarding nutrition, physical activity, and the selection of pharmacologic therapy to prevent and manage osteoporosis. Published literature was retrieved through searches of PubMed and The Cochrane Library on August 30 and September 18, 2012, respectively. The strategy included the use of appropriate controlled vocabulary (e.g., oteoporosis, bone density, menopause) and key words (e.g., bone health, bone loss, BMD). Results were restricted to systematic reviews, practice guidelines, randomized and controlled clinical trials, and observational studies published in English or French. The search was limited to the publication years 2009 and following, and updates were incorporated into the guideline to March 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.
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....
... 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 ...
... on Aging) Also in Spanish Living With Healthy Lifestyle: Women's Health (Mayo Foundation for Medical Education and Research) Also ... Spanish Perimenopausal Bleeding and Bleeding After Menopause (American College of Obstetricians and Gynecologists) ... (North American Menopause Society) What You ...
Stuenkel, C A
Over the past three decades, the prevalence of diabetes has increased four-fold. Coupled with the global obesity epidemic and aging of the world's population, a perfect metabolic storm is brewing. The influence of menopause and exogenous estrogen and progestogens must be included in this equation. In this review, criteria for diagnosing diabetes and recommendations for screening are described. The reported effects of menopause on diabetes risk in healthy women are reviewed as well as the relationship between established diabetes and the timing of menopause. The effects of menopausal hormone therapies (MHT) on glucose control in women with diabetes and the effect of MHT on diabetes risk in menopausal women without diabetes are described. Evidence-based strategies to prevent diabetes in midlife women are highlighted. The augmenting effect of diabetes on chronic health concerns of aging women, such as cardiovascular disease, osteoporosis, and cancer, along with current recommendations for screening and prevention are presented. Given the current demographics of today's world, the content of this review may apply to as many as one-third of the average practitioner's postmenopausal patient population.
Shanley, Daryl P; Sear, Rebecca; Mace, Ruth; Kirkwood, Thomas B L
Why do women cease fertility rather abruptly through menopause at an age well before generalized senescence renders child rearing biologically impossible? The two main evolutionary hypotheses are that menopause serves either (i) to protect mothers from rising age-specific maternal mortality risks, thereby protecting their highly dependent younger children from death if the mother dies or (ii) to provide post-reproductive grandmothers who enhance their inclusive fitness by helping to care and provide for their daughters' children. Recent theoretical work indicates that both factors together are necessary if menopause is to provide an evolutionary advantage. However, these ideas need to be tested using detailed data from actual human life histories lived under reasonably 'natural' conditions; for obvious reasons, such data are extremely scarce. We here describe a study based on a remarkably complete dataset from The Gambia. The data provided quantitative estimates for key parameters for the theoretical model, which were then used to assess the actual effects on fitness. Empirically based numerical analysis of this nature is essential if the enigma of menopause is to be explained satisfactorily in evolutionary terms. Our results point to the distinctive (and perhaps unique) role of menopause in human evolution and provide important support for the hypothesized evolutionary significance of grandmothers.
Hormone replacement therapy can ease the symptoms of the menopause. The National Institute of Health and Care Excellence (NICE) is developing guidelines on the diagnosis and management of menopause, which are due for release in October 2015. This welcome development acknowledges the impact that menopause-related symptoms can have on an individual. NICE (2013) identify menopause as the ending of menstruation resulting from a failure in ovarian follicular activity. Changes in hormone levels can...
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....
Siregar, Muhammad Fidel Ganis
Menopause adalah hal yang normal, fase alami yang terjadi pad a wanita. Selama masa transisi dari tahun reproduktif .ke masa menopause dan sesudahnya, wanita mengalami banyak perubahan fisiko Walaupun banyak wanita menopause asimptomatik dan berhubungan dengan gangguan kecil hidup normal dan kesejahteraan, banyak wan ita mengalami gejala terkadang berat sehingga mempengaruhi kualitas kehidupan mereka .. Salah satunya adalah perubahan siklus menstruasi, hot flashes, gangguan ...
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.
Full Text Available In 2010, nearly 400 million women worldwide were of menopause age (45-54. Although many women transition through menopause with ease, some experience distress and a subsequent decrease in quality of life. The purpose of this qualitative study was to examine the experiences of distress in women during the menopause transition. A narrative analysis methodology was used maintaining participants’ complete narratives when possible. In-person interviews of 15 midlife women were digitally audio recorded and transcribed verbatim. Women shared narratives of distress related to menstrual changes, emotional instability, vaginal dryness, and decreased libido affected by their relationships with self, partners, work, and family. Some experiences were presented against a backdrop of the past and influenced by concerns for the future. Detailed stories illuminated the effect that distressful symptoms had on quality of life and captured how intricately woven symptoms were with the women’s interpersonal and social lives.
Kanovitch, D; Klotz, H P
The authors recall the antagonism between estradiol and parathormone. Estradiol tends to lower serum calcium and fix calcium in the bones as shown by one of us 25 years ago. The mechanism of this action of estrogen on calcium metabolism has been determined by numerous authors but some points are still not clear, e.g. the interferences between estrogen and calcitonin. Classically, parathormone is known to increase bony reabsorption and raise serum calcium. After the menopause the gradual reduction in estradiol secretion leads to post-menopausal osteoporosis. It is better to administer estrogens prophylactically to women after the menopause provided a cervical smear and mammography have been carried out to eliminate latent carcinoma of the breast or uterine cervix.
Pelcastre-Villafuerte, B; Garrido-Latorre, F; de León-Reyes, V
To characterize the meanings attributed to menopause, as a first approximation to the representational world of this event. A qualitative study was conducted between September and October 1998, in twenty women aged 45-65 years, residents of Cuernavaca and Emiliano Zapata, municipalities of Morelos state, Mexico. Twenty in-depth interviews were conducted using a guide, to collect data on sociodemographic variables, diagnosis, feelings and emotions, changes in life style, and physiological changes. Findings show that menopause is represented as the end of fertility and the beginning of old age. Characterization of menopause is related to womanhood, body, and sexuality representations. This paper analyzes women's practices related to life experiences such as medical visits. Implications of these findings are discussed using the social construction of meanings framework.
Muhleisen, Alicia L; Herbst-Kralovetz, Melissa M
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.
Szpak, Rafał; Folwarczny, Wiesław; Drozdzol, Agnieszka; Szuścik, Adam; Skrzypulec, Agnieszka; Skrzypulec, Violetta
Evaluation of partner relationships in menopausal period. A questionnaire study was performed in a group of 67 women (age: 45-55 years) and their partners. The inclusion criteria were: presence of climacteric symptoms, stable partnership, consent to research. 40 women and their spouses were included into the final study group. The investigative tool was based on 3 scales: Marriage Bond Scale (SWM); Scale of Attractiveness (SKAT); GREEN Scale evaluating intensification of menopausal symptoms and a set of additional questions concerning socio-demographical data, marital sexuality and substitute hormonal therapy. Mean age of respondents was 52 years. Most of the women demonstrated an amenorrhea (90%). Climacteric symptoms such as: hot flush, stress, depressive moods (87.5% each), musculoarticular pain (80%) occurred in various degree. 97.5% of women did not use a substitute hormonal treatment. The mean result of SWM for women and their partners scored 237 which is 79% of the total value. A correlation between exacerbation of menopausal signs and SWM score was not found. The co-attractiveness ratio counted on the basis of SKAT scale scored 30 points on average, which constitutes 74% of the maximum. Approximately 58% of the men accepted symptoms related to menopause in their partners; they tolerated changes appearing in the climacteric period, however; 100% of men did not talk about menopausal problems with their partners and did not support them in this difficult time. Men find their partners attractive in the perimenopausal period, accepting their partners and problems related to menopause. Most of the male respondents understand changes occurring in their partners, however, they do not help them to deal with them.
Ide, Saburo; Hirota, Yoshio; Hotokebuchi, Takao; Takasugi, Shin-ichiro; Sugioka, Yoichi; Hayabuchi, Hitomi
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
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.
Daan, Nadine M P; Fauser, Bart C J M
Reproductive ageing in women is characterized by a decline in both the quantity and quality of oocytes. Menopause is reached upon exhaustion of the resting primordial follicle pool, occurring on average at 51 years of age (range 40-60 years). The mean global age at natural menopause (ANM) appears robust, suggesting a distinct genetic control. Accordingly, a strong correlation in ANM is observed between mothers and daughters. Few specific genetic determinants of ANM have been identified. Substantial efforts have been made to predict ANM by using anti-Müllerian hormone (AMH) levels. AMH serum concentrations at reproductive age predict ANM, but precision is currently limited. Early ANM is associated with early preceding fertility loss, whereas late menopause is associated with reduced morbidity and mortality later in life. Menopause affects various women's health aspects, including bone density, breast, the cardiovascular system, mood/cognitive function and sexual well-being. If the current trend of increasing human life expectancy persists, women will soon spend half their life postmenopause. Unfortunately, increased longevity does not coincide with an equal increase in years spend in good health. Future research should focus on determinants of long term health effects of ANM, and efforts to improve women's postmenopausal health and quality of life. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Full Text Available AbstrakMenopause merupakan waktu penghentian menstruasi secara permanen yang terjadi setelah hilangnya aktivitas ovarium. Saat ini jumlah wanita usia menopause meningkat seiring dengan peningkatan usia harapan hidup. Studi tentang menopause sangat penting, terutama terkait akibat yang akan terjadi pasca menopause seperti penyakit kardiovaskuler dan osteoporosis. Tujuan penelitian ini adalah menentukan usia menopause alami dan menganalisis hubungannya terhadap jumlah paritas pada wanita di Kelurahan Bandar Buat Padang. Penelitian ini merupakan studi analitik cross-sectional terhadap wanita usia 45-60 tahun yang berada di Kelurahan Bandar Buat Padang. Pengumpulan data dilakukan melalui wawancara dengan menggunakan kuesioner di rumah atau di tempat kerja mereka. Hasil penelitian menunjukan 69 wanita yang diteliti didapatkan rata-rata jumlah paritas adalah 3,663 dengan jumlah paritas 1 dan terbanyak memiliki 10 orang anak. Rata-rata usia menopause responden dalam penelitian ini adalah usia 50,65 tahun dengan usia termuda 46 tahun dan tertua 58 tahun. Terdapat hubungan yang signifikan antara jumlah paritas dan usia menopause di Kelurahan Bandar Buat dengan hasil p< 0,01.Kata kunci: menopause, jumlah paritas, penyakit kardiovaskuler, osteoporosis AbstractMenopause is the permanent cessation of menstruation period that occurs after the loss of ovarian activity. Currently, the number of women of menopausal age increases as the increase in life expectancy. The study of menopause is very important, especially related to the consequences that will occur after the menopause such as cardiovascular disease and osteoporosis. The objective of this study was to determine the age of natural menopause and analyze its relationship on the amount of parity in the Village Bandar Buat Padang. This study was a cross-sectional analytic study to women aged 45-60 years in the Village of Bandar Buat Padang. Data collected through interviews using a
Vitiello, Danielle; Naftolin, Frederick; Naftoilin, Frederick; Taylor, Hugh S
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.
Full Text Available Progestogens share one common effect: the ability to convert proliferative endometrium to its secretory form. In contrast, their biological activity is varied, depending on the chemical structure, pharmacokinetics, receptor affinity and different potency of action. Progestogens are widely used in the treatment of menstrual cycle disturbances, various gynaecological conditions, contraception and menopausal hormone therapy. The administration of progestogen in menopausal hormone therapy is essential in women with an intact uterus to protect against endometrial hyperplasia and cancer. Progestogen selection should be based on the characteristics available for each progestogen type, relying on the assessment of relative potency of action in experimental models and animal models, and on the indirect knowledge brought by studies of the clinical use of different progestogen formulations. The choice of progestogen should involve the conscious use of knowledge of its benefits, with a focus on minimizing potential side effects. Unfortunately, there are no direct clinical studies comparing the metabolic effects of different progestogens.
Dewi Elliana; Anita Murniwati
Latar belakang : Menopause terjadi akibat dari penurunan produksi hormon estrogen yang dihasilkan oleh kelenjar endokirin dimana pada usia sekitar 45-55 tahun ditandai dengan keluhan haid yang mulai tidak teratur. Berdasarkan studi pendahuluan terhadap 10 wanita yang berumur 45-55 tahun di Kelurahan Bendanduwur Kecamatan Gajahmungkur kota Semarang, didapatkan bahwa 7 dari 10 wanita menopause (70%) berstatus gizi baik dan 2 orang wanita menopause (20%) telah mengalami perubahan fisik menopause...
... but excess pounds aren't inevitable. To minimize menopause weight gain, step up your activity level and ... In fact, many women gain weight around the menopause transition. Menopause weight gain isn't inevitable, however. ...
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 ...
Sievert, Lynnette Leidy; Hautaniemi, Susan I
Comparisons of age at menopause are made difficult by the different methodologies applied across populations. This study extended an opportunity to apply different methodologies to the same data to draw some preliminary conclusions about age at menopause in Puebla, Mexico. Among 755 women aged 28 to 70 interviewed in the capital city of Puebla, Mexico, 447 (59.6%) were naturally or surgically postmenopausal. Mean recalled age at natural menopause in Puebla (46.7 years) appears to be similar to mean recalled age at menopause in Mexico City (46.5 years), suggesting that age at menopause is similar in urban Mexican populations. However, median age at menopause computed by probit analysis was later in the city of Puebla (49.6 years) compared to the median age computed by the same method in the capital city of León, Guanajuato, Mexico (48.2 years). Median age at menopause computed by Kaplan-Meier survival analysis suggests that age at menopause in Puebla (50.0 years) is older still, and close to that of the United States (51.1 years). The differences in median ages at menopause in Puebla are solely due to methodological choices and highlight the difficulty inherent in making inferences across studies of age at menopause between biological and/or cultural groups. Factors associated with age at menopause offer another avenue for comparing and understanding variation in this basic biological process. In Puebla, smoking, low levels of education, and nulliparity are associated with an earlier age at menopause.
Gannon, L; Stevens, J
This examination of menopause as presented by the popular print media was conducted in the context of furthering our understanding of the development of attitudes toward menopause. All articles indexed under "menopause" in the Reader's Guide in the years 1981, 1982, 1985, 1986, 1989, 1990, 1993, and 1994 were located and examined. The data revealed that, although there has been an increase in the frequency of articles on menopause in the last 15 years, the media's portrayal of menopause is problematic in several respects: (a) in spite of the increased attention, the information available on menopause through the popular media is minimal and insufficient; (b) there was little variability in terms of perspective, discipline, or focus; almost all were focused on menopause as a negative experience or disease and in need of medical treatment; (c) there was considerable contradiction and inconsistency among the articles with respect to descriptions of menopause and intervention advice for menopausal women; (d) aging, stress, life-style factors, race and ethnicity, exercise and diet were, with few exceptions, ignored or trivialized.
Siham Khalifa Abd Allah; Mohamed Abedelrahman Syid; Areeg Alsail Mohmmed; Raian Bakhet Yassein; Nosiba Abdelmajid Alballah; Nada Omer Alseedig
Menopause is very important turning phase in the life of a female and is associated with hormonal changes. These hormones affect the overall personality however menopause is also associated with varied menopausal symptoms. Menopause women are a high risk group for iron level disturbance in your bodies. This was descriptive cross-sectional study aimed to determine the serum iron level in menopause women. Following informed consent, fifty subjects in menopause period, and sex matched fifty heal...
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.
Williams, Jac; Currie, Heather; Foster, Adele; Anderson, Julia
The menopause should be diagnosed based on age, menstrual history and clinical symptoms, and as such, follicle stimulating hormone testing may be considered inappropriate when diagnosing the menopause or peri-menopause in women aged 45 and over. As part of a demand optimisation programme, the number of follicle stimulating hormone tests requested to diagnose the menopause in this age group was quantified and educational interventions were implemented to reduce inappropriate testing. The number of follicle stimulating hormone tests requested to diagnose the menopause in women aged 45 and over was successfully and sustainably reduced. © The Author(s) 2016.
Kontrasepsi hormonal merupakan suatu metode untuk mencegah kehamilan dengan cara pemberian hormon steroid. Menopause merupakan suatu fase dalam kehidupan wanita dimana masa kesuburan sudah berakhir yang ditandai dengan berhentinya siklus haid sekurang-kurangnya selama 1 tahun. Penggunaan kontrasepsi hormonal dapat menyebabkan pergeseran usia menopause menjadi lebih tua. Desain penelitian yang digunakan adalah deskriptif korelasi yang bertujuan mengidentifikasi hubungan pengg...
Sammaritano, Lisa R
Menopause represents a time of significant clinical and hormonal change. Given the incompletely understood interrelationship between gonadal hormones and the immune system, it is possible that menopause may affect, or be affected by, the presence of autoimmune disease. Menopause has significant effects on a number of organ systems including the cardiovascular, skeletal, central nervous and genitourinary systems. Premature ovarian failure is related to autoimmune factors in a proportion of cases, but is not generally associated with systemic autoimmune disorders unless secondary to treatment with alkylating agents such as cyclophosphamide. Gonadal hormones have been suggested to relate to both onset and activity in certain autoimmune diseases. For patients with systemic lupus erythematosus, disease activity is lower, and damage accrual higher, in the postmenopausal years, but the mechanisms responsible may relate to age, duration of disease, menopause changes, long-term effects of therapy, or some combination of these factors. Early menopause is a risk factor for rheumatoid arthritis, and post-menopausal status in RA is associated with greater damage and disability. Systemic sclerosis and giant cell arteritis may also be adversely affected by onset of menopause. Importantly, autoimmune disease and menopause may have an additive effect on risk for common comorbidities such as cardiovascular disease and osteoporosis. Copyright © 2011 Elsevier B.V. All rights reserved.
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 ...
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.
Calleja-Agius, J; Brincat, M P
The major cause of urogenital atrophy in menopausal women is estrogen loss. The symptoms are usually progressive in nature and deteriorate with time from the menopausal transition. The most prevalent urogenital symptoms are vaginal dryness, vaginal irritation and itching. The genitourinary syndrome of menopause includes vulvovaginal atrophy and the postmenopausal modifications of the lower urinary tract. Dyspareunia and vaginal bleeding from fragile atrophic skin are common problems. Other urogenital complaints include frequency, nocturia, urgency, stress urinary incontinence and urinary tract infections. Atrophic changes of the vulva, vagina and lower urinary tract can have a large impact on the quality of life of the menopausal woman. However, hormonal and non-hormonal treatments can provide patients with the solution to regain the previous level of function. Therefore, clinicians should sensitively question and examine menopausal women, in order to correctly identify the pattern of changes in urogenital atrophy and manage them appropriately.
Farahmand, M; Ramezani Tehrani, F; Bahri Khomami, M; Noroozzadeh, M; Azizi, F
Menopausal status exposes women to increased risk of cardiovascular disease. This study was performed to compare the effect of menopausal types, including surgical and natural, on metabolic syndrome and other metabolic disorders 3 years before and after menopause. Of 437 postmenopausal women, who participated in the Tehran Lipid and Glucose Study, 13 women with surgical menopause and 39 age-matched controls with natural menopause were selected. During the follow-up period, changes in metabolic and biochemical profiles were compared between surgical and natural menopause women. Odds of incidence of metabolic syndrome in surgical menopause women, compared to natural menopause women, was 9.7 (95 % CI 1.8-51.8). Metabolic disturbances after menopause are highly influenced by type of menopause and are more prevalent in those undergoing surgical menopause.
Results of the study revealed that (I) currently menopausal women experienced a significantly higher level of depression and a lower level of life satisfaction than non-menopausal and post menopausal women. (ii) women who experienced late menopause were more depressed and less satisfied with life than women who ...
Ana Mª Rivas Hidalgo
Full Text Available Taking into account that climacteric constitutes a physiological state in woman’s life, which covers a large stage of her life cycle, it is important that nursery professionals will develop an Action Plan, whose main objective will be health. Covering, then, this stage from a multidisciplinary and holistic field is going to contribute to both: the adoption of healthy life habits and the repercussions that symptoms and physiological processes associated with menopause have on women. Another objective for nurses there must be to provide all our knowledge in a detailed and focused on the individual needs that may come up way. That way, we lay the foundations for facing climacteric with the minimum deterioration of the quality of life and well being.This article is an analysis of the etiology of every one of the most prevalent menopause problems, the predisposing factors to suffer them or to make them get worse, and the habits that are going to prevent larger spill-over effects of those problems. Furthermore, a revision about how nutrition, exercise, toxic substances consumption, etc. have repercussions on musculoskeletal problems, vascular symptoms, urogenital problems, psychological alterations, and gynaecological and breast cancer is made.
Ripa, Patrizia; Ornello, Raffaele; Degan, Diana; Tiseo, Cindy; Stewart, Janet; Pistoia, Francesca; Carolei, Antonio; Sacco, Simona
Evidence suggests that migraine activity is influenced by hormonal factors, and particularly by estrogen levels, but relatively few studies have investigated the prevalence and characteristics of migraine according to the menopausal status. Overall, population-based studies have shown an improvement of migraine after menopause, with a possible increase in perimenopause. On the contrary, the studies performed on patients referring to headache centers have shown no improvement or even worsening of migraine. Menopause etiology may play a role in migraine evolution during the menopausal period, with migraine improvement more likely occurring after spontaneous rather than after surgical menopause. Postmenopausal hormone replacement therapy has been found to be associated with migraine worsening in observational population-based studies. The effects of several therapeutic regimens on migraine has also been investigated, leading to nonconclusive results. To date, no specific preventive measures are recommended for menopausal women with migraine. There is a need for further research in order to clarify the relationship between migraine and hormonal changes in women, and to quantify the real burden of migraine after the menopause. Hormonal manipulation for the treatment of refractory postmenopausal migraine is still a matter of debate. PMID:26316824
Burger, Henry G; Dudley, Emma C; Robertson, David M; Dennerstein, Lorraine
The menopause is the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is heralded by the menopausal transition, a period when the endocrine, biological, and clinical features of approaching menopause begin. A common initial marker is the onset of menstrual irregularity. The biology underlying the transition to menopause includes central neuroendocrine changes as well as changes within the ovary, the most striking of which is a profound decline in follicle numbers. Follicle-stimulating hormone (FSH) is an established indirect marker of follicular activity. In studies of groups of women, its concentration, particularly in the early follicular phase of the menstrual cycle, begins to increase some years before there are any clinical indications of approaching menopause. The rise in FSH is the result of declining levels of inhibin B (INH-B), a dimeric protein that reflects the fall in ovarian follicle numbers, with or without any change in the ability of the lining granulosa cells to secrete INH-B. Estradiol levels remain relatively unchanged or tend to rise with age until the onset of the transition and are usually well preserved until the late perimenopause, presumably in response to the elevated FSH levels. During the transition, hormone levels frequently vary markedly - hence, measures of FSH and estradiol are unreliable guides to menopausal status. Concentrations of testosterone have been reported to fall by about 50% during reproductive life, between the ages of 20 and 40. They change little during the transition and, after menopause, may even rise. Dehydroepiandrosterone (DHEA) and DHEAS, its sulphate, on the other hand, decline with age, without any specific influence of the menopause. Symptoms of the menopause can be interpreted as resulting primarily from the profound fall in estradiol, occurring over a 3- to 4-year period around final menses, a fall that presumably contributes importantly to the beginning, in the
Pimenta, Filipa; Leal, Isabel; Maroco, João; Ramos, Catarina
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.
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Ceylan, Burcu; ?zerdo?an, Nebahat
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 menopau...
Hachul, Helena; Bittencourt, Lia Rita Azeredo; Soares, José Maria; Tufik, Sergio; Baracat, Edmund Chada
The aim of this study was to evaluate the differences in sleep between women of early and late post-menopause. Thirty post-menopausal women who came to the climacteric service of their own volition were selected. Fourteen were in early post-menopause (less than 5 years after menopause), and sixteen were in late post-menopause (more than 5 years since menopause). None of the women were suffering from any other clinical diseases. Participants had no previous history of hormone therapy or hypnotic drug use. These patients were not previously selected with regard to any sleep complaints. All participants answered a sleep questionnaire and underwent a polysomnography recording. Subjective complaints included body pain, bruxism, anxiety, depression, lack of concentration, and sleepiness (measured by the Epworth Sleepiness Scale). These complaints were more frequent in the late post-menopause group. In contrast, complaints of memory impairment were more frequent in the early post-menopause group (psleep were higher in the late post-menopausal group.
Nappi, Rossella E; Sances, Grazia; Detaddei, Silvia; Ornati, Alessandra; Chiovato, Luca; Polatti, Franco
In this review, we underline the importance of linking migraine to reproductive stages for optimal management of such a common disease across the lifespan of women. Menopause has a variable effect on migraine depending on individual vulnerability to neuroendocrine changes induced by estrogen fluctuations and on the length of menopausal transition. Indeed, an association between estrogen 'milieu' and attacks of migraine is strongly supported by several lines of evidence. During the perimenopause, it is likely to observe a worsening of migraine, and a tailored hormonal replacement therapy (HRT) to minimize estrogen/progesterone imbalance may be effective. In the natural menopause, women experience a more favourable course of migraine in comparison with those who have surgical menopause. When severe climacteric symptoms are present, postmenopausal women may be treated with continuous HRT. Even tibolone may be useful when analgesic overuse is documented. However, the transdermal route of oestradiol administration in the lowest effective dose should be preferred to avoid potential vascular risk.
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.
Chaveli López, Begonya; Sarrión Pérez, María Gracia; Jiménez Soriano, Yolanda
The present study offers a literature review of the main oral complications observed in women during pregnancy and menopause, and describes the different dental management protocols used during these periods and during lactation, according to the scientific literature. To this effect, a PubMed-Medline search was made, using the following key word combinations: “pregnant and dentistry”, “lactation and dentistry”, “postmenopausal and dentistry”, “menopausal and dentistry” and “oral ...
Sveinsson, Olafur; Tomson, Torbjörn
Being a woman with epilepsy is not the same as being a man with the disease. There is a complex multidirectional interaction between sex hormones, seizures and antiepileptic drugs (AEDs) with gender-specific implications. Estrogen can be a potent proconvulsant, whereas progesterone is an anticonvulsant in experimental models. It is well established that women with epilepsy can have changes in seizure propensity related to their menstrual cycle (catamenial epilepsy). There is good evidence that the gonadotropin-releasing hormone cell population in the hypothalamus can be affected by seizures originating in the limbic system, possibly leading to anovulatory menses, possibly contributing to lower fertility, and earlier menopause among women with epilepsy. Data on the effects of menopause on epilepsy are scarce. In general, menopause appears to have limited effects on seizure control, with the possible exception of women with catamenial epilepsy who may experience an increase in seizure frequency during perimenopause and a decrease after menopause. Hormone replacement therapy has the potential to increase seizure frequency and thus cannot be recommended for women with epilepsy. Of particular relevance for menopause is the adverse effect on bone mineral density caused by enzyme inducers and other AEDs. In general, there is a remarkable shortage of studies on the impact of menopause on epilepsy and on its implications for epilepsy treatment.
Baker, Fiona C; Willoughby, Adrian R; Sassoon, Stephanie A; Colrain, Ian M; de Zambotti, Massimiliano
The menopausal transition is marked by increased prevalence in disturbed sleep and insomnia, present in 40-60% of women, but evidence for a physiological basis for their sleep complaints is lacking. We aimed to quantify sleep disturbance and the underlying contribution of objective hot flashes in 72 women (age range: 43-57 years) who had (38 women), compared to those who had not (34 women), developed clinical insomnia in association with the menopausal transition. Sleep quality was assessed with two weeks of sleep diaries and one laboratory polysomnographic (PSG) recording. In multiple regression models controlling for menopausal transition stage, menstrual cycle phase, depression symptoms, and presence of objective hot flashes, a diagnosis of insomnia predicted PSG-measured total sleep time (p insomnia had, on average, 43.5 min less PSG-measured sleep time (p insomnia reported more WASO (p = 0.002), more night-to-night variability in WASO (p insomnia in the approach to menopause have a measurable sleep deficit, with almost 50% of the sample having less than 6h of sleep. Compromised sleep that develops in the context of the menopausal transition should be addressed, taking into account unique aspects of menopause like hot flashes, to avoid the known negative health consequences associated with insufficient sleep and insomnia in midlife women. Copyright © 2015 Elsevier Ltd. All rights reserved.
Trutnovsky, Gerda; Rojas, Rodrigo Guzman; Mann, Kristy Pamela; Dietz, Hans P
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.
Nosek, Marcianna; Kennedy, Holly Powell; Beyene, Yewoubdar; Taylor, Diana; Gilliss, Catherine; Lee, Kathryn
As part of a longitudinal study of midlife women, the aim of this investigation was to describe the intensity of menopausal symptoms in relation to the level of perceived stress in a woman's life and her attitudes toward menopause and aging. Data were collected on 347 women between 40 and 50 years of age in Northern California who began the study while premenopausal. Women self-identified as African American, European American, or Mexican/Central American. Data collected over three time points in the first 12 months were used for this analysis. An investigator-developed tool for the perception of specific types of stress was used. Attitudes toward menopause and aging were measured using the Attitudes Toward Menopause and Attitude Toward Aging scales. Attitudes toward aging and menopause, perceived stress, and income were related to intensity of symptoms. There was no ethnic group difference in perceived stress or attitude toward menopause. However, European and African Americans had a more positive attitude toward aging than Mexican/Central Americans. A lower income, higher perceived stress, a more negative attitude toward aging, and a more positive attitude toward menopause influenced menopausal symptom experience. Copyright 2010 American College of Nurse-Midwives. Published by Elsevier Inc. All rights reserved.
Charbonneau, Deborah Hile
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…
Huang, Tianyi; Lin, Brian M; Redline, Susan; Curhan, Gary C; Hu, Frank B; Tworoger, Shelley S
Despite established sex differences and longstanding hypotheses of sex hormones in obstructive sleep apnea (OSA) etiology, no studies have evaluated type of menopause and age at menopause, which affect postmenopausal hormonal milieu, in relation to OSA risk in women. We followed 50,473 postmenopausal women from the Nurses' Health Study (NHS) between 2002-2012 and 53,827 postmenopausal women from the NHSII between 1995-2013, with 1,712 and 2,560 incident OSA diagnoses, respectively. Compared with natural menopause, the pooled HR for OSA was 1.27 (95% CI: 1.17, 1.38) for surgical menopause by hysterectomy/oophorectomy. The association remained the same after further accounting for age at menopause (HR=1.26; 95% CI: 1.15, 1.38). The risk associated with surgical menopause was higher in non-obese women as well as women who never used hormone therapy (P-interactionmenopause was associated with higher OSA risk prior to adjustment for type of menopause (HR comparing menopause was independently associated with higher OSA risk in postmenopausal women. Our results provide additional evidence for a role of sex hormones, particularly abrupt hormonal changes, in modulating OSA risk. © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: email@example.com.
Ceylan, Burcu; Özerdoğan, Nebahat
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.
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.
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
Yim, Gyeyoon; Ahn, Younjhin; Chang, Yoosoo; Ryu, Seungho; Lim, Joong-Yeon; Kang, Danbee; Choi, Eun-Kyung; Ahn, Jiin; Choi, Yuni; Cho, Juhee; Park, Hyun-Young
The present study investigated the prevalence and severity of menopause symptoms experienced by Korean women aged 44 to 56 years and their associated factors. A cross-sectional study was performed on 2,201 women aged 44 to 56 years in health checkup centers between November 2012 and March 2013. The 29-item Menopause-Specific Quality of Life Questionnaire was used to assess vasomotor, psychosocial, physical, and sexual symptoms related to menopause. The guidelines for the classification of reproductive aging stages proposed at the Stages of Reproductive Aging Workshop were used. Multivariable linear regression analyses were performed to identify factors associated with severity of menopause symptoms. Among participants, 42.6% were premenopausal, 36.7% were perimenopausal, and 20.7% were postmenopausal. Although physical symptoms were the most severe menopause symptoms experienced by premenopausal and perimenopausal women, postmenopausal women reported sexual symptoms as the most bothersome. The mean scores for each domain increased from the premenopausal period through the postmenopausal period (P for trend 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.
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.
Sibero, Jitasari Tarigan
Menopause is the cessation of menstruation. At menopause there is a change of physical and psychological. The number of grievances felt women during menopause can cause high stress. Menopausal women will experience emotional instability if they are difficult to adjust to changes that occur during menopause. The totality of self adjustment ability of menopausal women on menopause and social environment influenced by the the self concept. When individuals are experiencing menopause have a posit...
Guidozzi, Franco; Alperstein, A; Bagratee, J S; Dalmeyer, P; Davey, M; de Villiers, T J; Hirschowitz, S; Kopenhager, T; Moodley, S P; Roos, P; Shaw, A; Shimange, O; Smith, T; Thomas, C; Titus, J; van der Spuy, Z; van Waart, J
The South African Menopause Society (SAMS) consensus position statement on menopausal hormone therapy (HT) 2014 is a revision of the SAMS Council consensus statement on menopausal HT published in the SAMJ in May 2007. Information presented in the previous statement has been re-evaluated and new evidence has been incorporated. While the recommendations pertaining to HT remain similar to those in the previous statement, the 2014 revision includes a wider range of clinical benefits for HT, the inclusion of non-hormonal alternatives such as selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors for the management of vasomotor symptoms, and an appraisal of bioidentical hormones and complementary medicines used for treatment of menopausal symptoms. New preparations that are likely to be more commonly used in the future are also mentioned. The revised statement emphasises that commencing HT during the 'therapeutic window of opportunity' maximises the benefit-to-risk profile of therapy in symptomatic menopausal women.
Hvas, Lotte; Gannik, Dorte Effersøe
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...
Age of menopause is a very important biomarker of not only the loss of fertility but also an increased risk for various mid-life diseases and problems. Many of these diseases can be prevented by timely intervention of lifestyle modification, menopausal hormone therapy, or other supplementations such as calcium, Vitamin D, and micronutrients. In India age of menopause is less than our counterparts in the Western world. This means that the fertility potential of Indian women starts compromising early, so we need to start with the preventive measures much early. Earlier studies in India have been done on a limited population, and small sample size and not all the determinants of menopause age were considered. Survey was conducted in 21 chapters of Indian Menopause Society and all regions South, West, East and North were covered. There were 23 Medical practitioners who participated. Consent was taken and inclusion and exclusion criteria was set. Set questions were asked The questionnaire comprised of identification of the participants' religion, education, and various socioeconomic parameters. They were also inquired about their marital and parity status, abortion, or contraceptive use. The menopausal women were asked their menopause age and whether it was natural or surgical. The perimenopausal women were asked to enlist the date of their last period. All women with <1 year to menopause were classified as perimenopausal. The height, weight, and waist circumference were noted for all the women, and body mass index (BMI) was calculated. The women were also inquired about their food habits and social habits including alcohol consumption or smoking. Hence, this study was planned as a PAN India study. Average age of menopause of an Indian woman is 46.2 years much less than their Western counter parts (51 years). A definite rural and urban division was also seen. There was a correlation between the age of menopause and social and economic status, married status, and parity
Tawfik, Hebatullah; Kline, Jennie; Jacobson, Judith; Tehranifar, Parisa; Protacio, Angeline; Flom, Julie D; Cirillo, Piera; Cohn, Barbara A; Terry, Mary Beth
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.
Full Text Available Patrizia Ripa,1 Raffaele Ornello,1 Diana Degan,1 Cindy Tiseo,1 Janet Stewart,2 Francesca Pistoia,1 Antonio Carolei,1 Simona Sacco1 1Department of Applied Clinical Sciences and Biotechnology, Institute of Neurology, University of L’Aquila, L’Aquila, Italy; 2Psychology Division, School of Natural Sciences, University of Stirling, Scotland, UK Abstract: Evidence suggests that migraine activity is influenced by hormonal factors, and particularly by estrogen levels, but relatively few studies have investigated the prevalence and characteristics of migraine according to the menopausal status. Overall, population-based studies have shown an improvement of migraine after menopause, with a possible increase in perimenopause. On the contrary, the studies performed on patients referring to headache centers have shown no improvement or even worsening of migraine. Menopause etiology may play a role in migraine evolution during the menopausal period, with migraine improvement more likely occurring after spontaneous rather than after surgical menopause. Postmenopausal hormone replacement therapy has been found to be associated with migraine worsening in observational population-based studies. The effects of several therapeutic regimens on migraine has also been investigated, leading to nonconclusive results. To date, no specific preventive measures are recommended for menopausal women with migraine. There is a need for further research in order to clarify the relationship between migraine and hormonal changes in women, and to quantify the real burden of migraine after the menopause. Hormonal manipulation for the treatment of refractory postmenopausal migraine is still a matter of debate. Keywords: headache, female, menstrual cycle, sex hormones
Henderson, Victor W; Sherwin, Barbara B
Women who undergo both natural and surgical menopause experience the loss of cyclic ovarian production of estrogen, but hormonal and demographic differences distinguish these two groups of women. Our objective was to review published evidence on whether the premature cessation of endogenous estrogen production in women who underwent a surgical menopause has deleterious consequences for cognitive aging and to determine whether consequences differ for women if they undergo natural menopause. Studies of estrogen-containing hormone therapy are relevant to this issue. We reviewed evidence-based research, including the systematic identification of randomized clinical trials of hormone therapy with cognitive outcomes that included an objective measure of episodic memory. As inferred from very small, short-term, randomized, controlled trials of high-dose estrogen treatment, surgical menopause may be accompanied by cognitive impairment that primarily affects verbal episodic memory. Observational evidence suggests that the natural menopausal transition is not accompanied by substantial changes in cognitive abilities. For initiation of hormone therapy during perimenopause or early postmenopause when the ovaries are intact, limited clinical trial data provide no consistent evidence of short-term benefit or harm. There is stronger clinical trial evidence that initiation of hormone therapy in late postmenopause does not benefit episodic memory or other cognitive skills. Further research is needed on the long-term cognitive consequences of surgical menopause and long-term cognitive consequences of hormone therapy initiated near the time of surgical or natural menopause. A potential short-term cognitive benefit might be weighed when a premenopausal woman considers initiation of estrogen therapy at the time of, or soon after, hysterectomy and oophorectomy for benign conditions, although data are still quite limited and estrogen is not approved for this indication. Older
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.
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.
Mesalić, Lejla; Tupković, Emir; Kendić, Sulejman; Balić, Devleta
It is widely accepted that menopause leads to changes in hormonal status, metabolism and lipid profile. The aim of this study was to analyze the influence of menopause on the concentrations of lipids, lipoproteins and, the influence of estradiol, progesterone, FSH, LH on lipid profile in menopausal women as well. The menopausal women had higher but non-significant (p>0,05) concentrations of total cholesterol, VLDL, LDL, and triglycerides than women with regular menstruation. The concentration of HDL was significantly lower in menopausal women than in women with regular menstruation (pmenopausal women (p0,05). Estrogen concentration has significant negative correlation with VLDL and triglycerides (pmenopausal women. Progesterone concentration has shown no correlation with concentrations of lipids and lipoproteins in menopause. We can conclude that menopause leads to changes in lipid profile by reducing HDL, and elevating apolipoprotein B levels, thus increasing the risk for cardiovascular disease. These changes were caused by reduction of estrogen concentrations in menopause.
... These medications can be given during or after menopause. Hormone Therapy to Prevent Chronic Conditions Many women take ... a recommendation. Click Here to Learn More About Menopause and Hormone Therapy Postmenopausal Hormone Therapy: Information for the Public ( ...
Mešalić, Lejla; Tupković, Emir; Kendić, Sulejman; Balić, Devleta
It is widely accepted that menopause leads to changes in hormonal status, metabolism and lipid profile. The aim of this study was to analyze the influence of menopause on the concentrations of lipids, lipoproteins and, the influence of estradiol, progesterone, FSH, LH on lipid profile in menopausal women as well. The menopausal women had higher but non-significant (p>0,05) concentrations of total cholesterol, VLDL, LDL, and triglycerides than women with regular menstruation. The concentration of HDL was significantly lower in menopausal women than in women with regular menstruation (pmenopausal women (p0,05). Estrogen concentration has significant negative correlation with VLDL and triglycerides (pmenopausal women. Progesterone concentration has shown no correlation with concentrations of lipids and lipoproteins in menopause. We can conclude that menopause leads to changes in lipid profile by reducing HDL, and elevating apolipoprotein B levels, thus increasing the risk for cardiovascular disease. These changes were caused by reduction of estrogen concentrations in menopause. PMID:18498273
... What's the connection? Is there a connection between menopause and high blood pressure? Answers from Shannon K. ... Tommaso, M.D. Blood pressure generally increases after menopause. Some doctors think this increase suggests that hormonal ...
Dodkhoeva, M.F.; Djonova, B.Yu.; Barieva, L.S.; Djonbekova, P.A.
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
... possible effects on menopausal symptoms than have other botanicals. The evidence base on efficacy for black cohosh ... treatment of menopausal hot flashes. Annals of Internal Medicine. 2016;164(3):1-24. Borud E, White ...
Leite, R D; Prestes, J; Pereira, G B; Shiguemoto, G E; Perez, S E A
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.
Martin, Kathryn Ann; Manson, Joann E
Many women experience menopausal symptoms during the menopausal transition and postmenopausal years. Hot flashes, the most common symptom, typically resolve after several years, but for 15-20% of women, they interfere with quality of life. For these women, estrogen therapy, the most effective treatment for hot flashes, should be considered. The decision to use hormone therapy involves balancing the potential benefits of hormone therapy against its potential risks. Accumulating data suggest that initiation of estrogen many years after menopause is associated with excess coronary risk, whereas initiation soon after menopause is not. Therefore, most now agree that short-term estrogen therapy, using the lowest effective estrogen dose, is a reasonable option for recently menopausal women with moderate to severe symptoms who are in good cardiovascular health. Short-term therapy is considered to be not more than 4-5 yr because symptoms diminish after several years, whereas the risk of breast cancer increases with longer duration of hormone therapy. A minority of women may need long-term therapy for severe, persistent vasomotor symptoms after stopping hormone therapy. However, these women should first undergo trials of nonhormonal options such as gabapentin, selective serotonin reuptake inhibitors, or serotonin norepinephrine reuptake inhibitors, returning to estrogen only if these alternatives are ineffective or cause significant side effects. Low-dose vaginal estrogens are highly effective for genitourinary atrophy symptoms, with minimal systemic absorption and endometrial effects.
Yazdkhasti, Mansoureh; Simbar, Masoumeh; Abdi, Fatemeh
Context: 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 ...
Mešalić, Lejla; Tupković, Emir; Kendić, Sulejman; Balić, Devleta
It is widely accepted that menopause leads to changes in hormonal status, metabolism and lipid profile. The aim of this study was to analyze the influence of menopause on the concentrations of lipids, lipoproteins and, the influence of estradiol, progesterone, FSH, LH on lipid profile in menopausal women as well. The menopausal women had higher but non-significant (p>0,05) concentrations of total cholesterol, VLDL, LDL, and triglycerides than women with regular menstruation. The concentration...
Menopause, a normal midlife transition for women remains poorly understood. This study examined the attitudes of women to menopause. A total of 300 married female teachers made up the sample for the study. Data was collected using the modified Attitude Towards Menopause (ATM) checklist. The responses of the ...
A.E. Hak (Liesbeth); G.C. Curhan (Gary); F. Grodstein (Francine); H.K. Choi (Hyon)
textabstractObjective: To prospectively study the relation between menopause, postmenopausal hormone use and risk of gout, since female sex hormones have been postulated to decrease gout risk among women. Methods: In the Nurses' Health Study, the association between menopause, age at menopause,
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.
Palacios, S; Mejía, A; Neyro, J L
The vagina, vulva, vestibule, labia majora/minora, and bladder trigone have a high concentration of estrogen receptors; therefore, they are a sensitive biological indicator of serum levels of these hormones in women. The estrogen loss in postmenopausal women produces a dysfunction called genitourinary syndrome of menopause. The principal therapeutic goal in the genitourinary syndrome of menopause is to relieve symptoms. Treatment options, as well as local and systemic hormonal treatment are changes in lifestyle and non-hormonal treatments mainly based on the use of moisturizers and lubricants. New treatments that have recently appeared are ospemifeme, the first selective hormone receptor modulator for dyspareunia and vulvovaginal atrophy treatment, and the use of vaginal laser. This review has been written with the intention of giving recommendations on the prevention and treatment of genitourinary syndrome of menopause.
Pollycove, Ricki; Naftolin, Frederick; Simon, James A.
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
Pollycove, Ricki; Naftolin, Frederick; Simon, James A
Contemporary women have long life expectancy (81 y, United States), especially relative to the age at menopause (51 y, United States). 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 illnesses after menopause (ie, late postmenopausal osteoporosis, cardiovascular disease, and cognitive decline). Specifically, the similar hypoestrogenic hormonal milieu present during postpartum lactation provides biologic advantages (fitness) to both mother and newborn. These precepts of evolutionary medicine encourage a reassessment of hormone therapy, and on the basis of data presented the authors propose additional opportunities for disease prevention and morbidity reduction in postmenopausal women.
Ruddy, Kathryn J; Partridge, Ann H
The impact of oncologic treatments on fertility and menopausal symptoms is often significant for patients with cancer. Surgery, radiation, and chemotherapy can all damage the reproductive organs or the hypothalamic pituitary axis that controls them, impairing fertility and causing hormonally mediated symptoms such as hot flashes. Understanding these risks and strategies to mitigate them may substantially improve cancer survivorship care. For both female and male patients who desire a future biologic child, there are a variety of fertility preservation techniques that should be considered. For cancer survivors who experience menopausal symptoms, lifestyle changes may be beneficial, and hormonal and nonhormonal pharmacologic agents are well proven to reduce symptom burden.
Santoro, Nanette; Randolph, John F
The hormonal correlates of reproductive aging and the menopause transition reflect an initial loss of the follicle cohort, while a responsive ovary remains, and an eventual complete loss of follicle response, with persistent hypergonadotropic amenorrhea. The physiology of the process is described, along with key findings of relevant studies, with an emphasis on SWAN, the Study of Women’s Health Across the Nation. A clinical framework is provided to help clinicians forecast the major milestones of the menopausal transition and to predict potential symptoms or disease. PMID:21961713
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.
Full Text Available Background Depression is the commonest psychiatric disorder in women. Menopausal symptoms include hot flashes, sleep disturbance, irritability, and vaginal dryness, which can give rise to depression in postmenopausal women. Objectives This study aimed to determine the factors affecting and associated with depression in postmenopausal women. Patients and Methods In this descriptive analytical research, 250 postmenopausal women who referred to health centers in Ahvaz were selected through an easy sampling method and studied. The beck depression inventory, the menopause rating scale (MRS Questionnaire, and demographic information sheets were used to collect data. The collected data were analyzed with Pearson correlation coefficients, Spearman, chi-square, and one-way ANOVA. Results The mean depression score was 12.17 ± 8. The total MRS mean in this study is 13.04 ± 8.01. The somatic dimension had the highest score, the mean of which was 5.48 ± 3.28. We found a significant relationship between depression score and MRS scores in all three dimensions (P 0.05. However, the level of education was significantly associated with depression (P < 0.001. Conclusions Increase in menopausal symptoms is associated with a higher severity of depression. Diagnosis and treatment of menopausal symptoms is therefore recommended to reduce depression.
Medicalization of menopause is a relatively recent phenomenon, originating from and shaped in the Northern American and Western European cultural context. This article, which is based on data from ethnographic research done in Istanbul between June 2006 and March 2007, explores how menopause is perceived and constructed in Turkey. Since the 1920s, Western science and technology has been accepted as the "guide" for the Turkish modernization project. Starting with the 1980s, neoliberalism and globalization brought structural changes, new notions, and practices in the health care sector as well as furthering and changing the modernization ideals. In this article I illustrate the interactions between modernization, globalization, femininity, and health by juxtaposing narratives of menopause as told by women and physicians. I argue that the ideals of modernity, especially the concept of "consciousness" (bilinç), provide a discursive basis for the adoption of the global medical discourse around menopause in the Turkish context.
The process of osteoporosis in women after menopause affected by such body mass index ( bmi ), parity and menopausal old.That was increasing every year, it because estogen not, resulting from the follicle but there is another source of estrogen that are produced by cells of adipose.Activity generated by network is smaller than for estrogen that is generated by a follicles and adalagi other factors reduce employment osteoblast.The process of osteoporosis be known by measuring its Bone Mineral ...
Carpenter, Janet S; Groves, Doyle; Chen, Chen X; Otte, Julie L; Miller, Wendy R
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.
Whayne, Thomas F; Mukherjee, Debabrata
Cardiovascular disease considerations are associated with the menopause. Despite a misconception that women have a minimal risk for coronary heart disease (CHD), it is the major cause of female deaths. This review highlights issues of hormone replacement therapy (HRT) and CHD in women. A woman under age 60, who suffers a myocardial infarction (MI), has a 2-year post-MI mortality of 28.9%; it is 19.6% in men. CHD and MI in women are subtle. In addition, female mortality from CHD increases after the menopause. The increased inflammatory risk factor status of women plays a role in development of atherosclerosis, before and after the menopause. Until after the menopause, women overall have a lower CHD mortality rate. Menopause is associated with unique symptoms, especially vasomotor ones; preexisting cardiovascular disease further exacerbates problems associated with the menopause. Use of HRT after the menopause is a major issue. Early menopause at age 39 years or younger and late menopause at age 56 years or older increase cardiovascular risk. HRT should not be prescribed for cardiovascular risk prevention, but when less than 10 years from menopause at a normal age, women can be reassured that cardiovascular risk from HRT is very low. Prescription of HRT should never be made only for cardiovascular risk reduction. However, when symptom-related and other indications are present, HRT is appropriate and well tolerated in the early years after menopause with onset at a normal age.
Vincent, A J
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.
Rosendahl, M; Simonsen, M K; Kjer, J J
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...
López-Alegría, Fanny; De Lorenzi, Dino Roberto Soares
During menopause the quality of life of women can be seriously deteriorated and influenced by lifestyles. To assess the prevalence of menopausal symptoms and their relationship with lifestyles and quality of life. The Menopause Rating Scale (MRS), a survey that measures menopausal symptoms and has questions related to lifestyles, was applied to 1023 women aged 54 ± 6 years (range 45 to 64 years), consulting in primary health care clinics. A multiple linear regression analysis was used to evaluate the association between menopausal symptoms and lifestyle. Fifty six percent of women did not have a paid work, 64% were nonsmokers and 90% did not perform any physical exercise. The most frequent menopausal symptoms referred were muscle and joint ailments (85%) followed by mental and physical exhaustion (80%). Sedentary women, smokers or those who did not to have time for leisure activities showed worst quality of life scores. Postmenopausal women with unhealthy lifestyles had the lower quality of life scores and more menopausal symptoms.
Geukes, Marije; van Aalst, Mariëlle P; Robroek, Suzan J W; Laven, Joop S E; Oosterhof, Henk
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 group, after adjustment for individual and lifestyle factors. Symptomatic women had significantly higher total GCS scores (mean 26.7 vs 14.2, t=10.8, Pvs 40.0, U=2380, Pgroup. They were 8.4 times more likely to report low 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.
Genazzani, Andrea R; Komm, Barry S; Pickar, James H
The majority of women experience bothersome symptoms postmenopause (e.g., hot flushes, vaginal symptoms). Estrogen receptor agonists remain the most effective options for ameliorating menopausal symptoms. However, use of hormonal therapies has declined in the wake of issues raised by the Women's Health Initiative trials. As a result, there is a need for new safe and effective alternatives to estrogen-progestogen hormone therapy. We review the efficacy and safety profile of hormonal menopausal therapies that are in Phase III clinical trials or recently approved. Investigational treatments discussed include two new vaginal estrogen products (TX-004HR, WC-3011); the first combination of estradiol and progesterone, and a novel combination of dehydroepiandrosterone and acolbifene. We also review a new selective estrogen receptor modulator (SERM), ospemifene, recently approved for treatment of dyspareunia related to menopause, and conjugated estrogens plus bazedoxifene, an estrogens/SERM combination, recently approved for moderate-to-severe vasomotor symptoms and prevention of osteoporosis. New and emerging hormonal treatments for managing menopausal symptoms may have improved safety and efficacy profiles compared with traditional estrogen-progestogen therapy; however, long-term safety data will be needed.
activity in the body system. Hence ... challenges such as anxiety, poor self-image, low self esteem, panic, ..... Husbands should encourage their wives during menopause and take them to social functions regularly so as to build up their self confidence. 5. There is need for Christian and Muslim leaders to introduce training.
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.
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 and ...
Richard A Morton
Full Text Available Human menopause is an unsolved evolutionary puzzle, and relationships among the factors that produced it remain understood poorly. Classic theory, involving a one-sex (female model of human demography, suggests that genes imparting deleterious effects on post-reproductive survival will accumulate. Thus, a 'death barrier' should emerge beyond the maximum age for female reproduction. Under this scenario, few women would experience menopause (decreased fertility with continued survival because few would survive much longer than they reproduced. However, no death barrier is observed in human populations. Subsequent theoretical research has shown that two-sex models, including male fertility at older ages, avoid the death barrier. Here we use a stochastic, two-sex computational model implemented by computer simulation to show how male mating preference for younger females could lead to the accumulation of mutations deleterious to female fertility and thus produce a menopausal period. Our model requires neither the initial assumption of a decline in older female fertility nor the effects of inclusive fitness through which older, non-reproducing women assist in the reproductive efforts of younger women. Our model helps to explain why such effects, observed in many societies, may be insufficient factors in elucidating the origin of menopause.
Ishunina, T.A.; Swaab, D.F.
In a series of studies we showed that menopause in women causes alterations not only in the neuronal expression of estrogen receptors (ER) alpha and beta, but also in local estrogen production in several brain areas and in the rate of neuronal metabolism. Although such changes are clearly brain
Vivian-Taylor, Josephine; Hickey, Martha
Depression is common and may have significant implications for the individual, their families and work and for the health care system. The menopause transition (MT) may be an 'at risk' time for the development of depression. This review aims to explore the relationship between depression and MT and the complex interaction between the biological, psychological and social factors that inform it. The literature on depressive disorders and MT is reviewed. Longitudinal studies have demonstrated an association between the menopause transition (MT) and an increase in depressive symptoms. A trend towards higher rates of depressive disorders during the MT, has also been shown, although not always reaching statistical significance. Risk factors for the development of depressive symptoms and depression in the MT include the presence of vasomotor symptoms (VMS), a personal history of depression (particularly depression that is related to pregnancy or hormonal changes through the menstrual cycle), surgical menopause, adverse life events, and negative attitudes to menopause and ageing. A treatment approach to depression during the MT exploits the biological as well as the psychosocial factors that are likely to be contributing in an individual. Crown Copyright © 2014. Published by Elsevier Ireland Ltd. All rights reserved.
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 ...
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 ...
Collaborative Group on Hormonal Factors in Breast Cancer; Bausch-Goldbohm, R.A.
BACKGROUND:Menarche and menopause mark the onset and cessation, respectively, of ovarian activity associated with reproduction, and affect breast cancer risk. Our aim was to assess the strengths of their effects and determine whether they depend on characteristics of the tumours or the affected
Hormes, Julia M; Rozin, Paul
About half of American women crave chocolate, and approximately half of the cravers crave it specifically around the onset of menstruation. This study examines whether the primary cause of this "perimenstrual" craving is a direct effect of hormonal changes around the perimenstrum, or rather if the craving is a general response in some individuals to stress or other notable events. Insofar as there is a direct hormonal effect, one would predict a substantial decrease of 38% in total chocolate craving in women post-menopause, corresponding to the proportion of women pre-menopause who report craving chocolate exclusively perimenstrually. Based on a survey of pre- and post-menopausal alumnae of the same University, we report a significant but small decrease in prevalence of chocolate cravings post-menopause. The decrease is only 13.4% and thereby much smaller than a 38% drop predicted by a purely hormonal explanation, suggesting that female reproductive hormones are not the principal cause of perimenstrual chocolate craving.
Menopause is a significant stage marking the end of a woman's reproductive life. Although this process is physiological, it is plagued by wide range of discomforting features which affects their quality of life. These symptoms includes years of hot flashes associated with episodes of sweating; sleep disturbances; joint pains; ...
Pearson, Quinn M.
The menopausal transition is associated with both first onset of depression and recurrent depression. Risk factors include vasomotor symptoms, a history of premenstrual dysphoria, postpartum depression, major depression, and sleep disturbances. Hormone replacement therapy, complementary and alternative medicine approaches, and counseling…
Llaneza, Plácido; García-Portilla, María P; Llaneza-Suárez, David; Armott, Begoña; Pérez-López, Faustino R
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
Madsen, Berit L.; Giudice, Linda; Donaldson, Sarah S.
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
Perich, Tania; Ussher, Jane; Parton, Chloe
Menopause can be a time of change for women and may be marked by disturbances in mood. For women living with a mental illness, such as bipolar disorder, little is known about how they experience mood changes during menopause. This study aimed to explore how women with bipolar disorder constructed mood changes during menopause and how this impacted on treatment decisions. Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with bipolar disorder. Data was analysed using thematic analysis guided by a social constructionist framework. Themes identified included 'Constructions of mood change: menopause or bipolar disorder?',' Life events, bipolar disorder and menopause coming together'; 'Treatment choices for mood change during menopause'. The accounts suggested that women related to the experience of mood changes during menopause through the lens of their existing framework of bipolar disorder, with implications for understanding of self and treatment choices.
Boonyanurak, Pongrak; Bunupuradah, Torsak; Wilawan, Kittisak; Lueanyod, Aksorn; Thongpaeng, Parawee; Chatvong, Duangjai; Sophonphan, Jiratchaya; Saeloo, Siriporn; Ananworanich, Jintanat; Chaithongwongwatthana, Surasith
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
Leach, Matthew J; Moore, Vivienne
Menopause can be a distressing and disruptive time for many women, with many experiencing hot flushes, night sweats, vaginal atrophy and dryness. Postmenopausal women are also at increased risk of osteoporosis. Interventions that decrease the severity and frequency of these menopausal symptoms are likely to improve a woman's well-being and quality of life. Hormone therapy has been shown to be effective in controlling the symptoms of menopause; however, many potentially serious adverse effects have been associated with this treatment. Evidence from experimental studies suggests that black cohosh may be a biologically plausible alternative treatment for menopause; even so, findings from studies investigating the clinical effectiveness of black cohosh have, to date, been inconsistent. To evaluate the clinical effectiveness and safety of black cohosh (Cimicifuga racemosa or Actaea racemosa) for treating menopausal symptoms in perimenopausal and postmenopausal women. Relevant studies were identified through AARP Ageline, AMED, AMI, BioMed Central gateway, CAM on PubMed, CINAHL, CENTRAL, EMBASE, Health Source Nursing/Academic edition, International Pharmaceutical Abstracts, MEDLINE, Natural medicines comprehensive database, PsycINFO, TRIP database, clinical trial registers and the reference lists of included trials; up to March 2012. Content experts and manufacturers of black cohosh extracts were also contacted. All randomised controlled trials comparing orally administered monopreparations of black cohosh to placebo or active medication in perimenopausal and postmenopausal women. Two review authors independently selected trials, extracted data and completed the 'Risk of bias' assessment. Study authors were contacted for missing information. Sixteen randomised controlled trials, recruiting a total of 2027 perimenopausal or postmenopausal women, were identified. All studies used oral monopreparations of black cohosh at a median daily dose of 40 mg, for a mean duration of
Mazhar, S.B.; Gul-e-Erum
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)
Full Text Available It is widely accepted that menopause leads to changes in hormonal status, metabolism and lipid profile. The aim of this study was to analyze the influence of menopause on the concentrations of lipids, lipoproteins and, the influence of estradiol, progesterone, FSH, LH on lipid profile in menopausal women as well. The menopausal women had higher but non-significant (p>0,05 concentrations of total cholesterol, VLDL, LDL, and triglycerides than women with regular menstruation. The concentration of HDL was significantly lower in menopausal women than in women with regular menstruation (p<0,05. Also, the concentration of apolipoprotein B was significantly higher in menopausal women (p<0,05, but the concentrations of apolipoprotein and lipoprotein (a were lower but without significance (p>0,05. Estrogen concentration has significant negative correlation with VLDL and triglycerides (p<0,05 and significant positive correlation with HDL (p<0,05 in menopausal women. Progesterone concentration has shown no correlation with concentrations of lipids and lipoproteins in menopause. We can conclude that menopause leads to changes in lipid profile by reducing HDL, and elevating apolipoprotein B levels, thus increasing the risk for cardiovascular disease. These changes were caused by reduction of estrogen concentrations in menopause.
Perich, Tania; Ussher, Jane; Meade, Tanya
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.
Bahri, Narjes; Yoshany, Nooshin; Morowatisharifabad, Mohammad Ali; Noghabi, Ali Delshad; Sajjadi, Moosa
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 menopausal health for spouses improves the quality of life in women during menopausal transition. We suggest integrating such educational programs in menopausal management programs.
Rosner, Bernard; Colditz, Graham A.
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
Chen, Ying; Lin, Shou-Qing; Wei, Yang; Gao, Hong-Lian; Wu, Zheng-Lai
The present study aimed to evaluate the satisfaction with quality of life of menopausal women living in an urban community of Beijing, People's Republic of China, using the Chinese version of the menopause-specific quality of life questionnaire (MENQOL). Menopause-related complaints were assessed for 353 women aged 40-60 years during their menopausal transition (MT) or postmenopause (PM) using MENQOL. The Kruskal-Wallis non-parametric test and Pearson correlation were used for statistical analysis. The mean age of the subjects was 51.20 +/- 4.62 years. The most frequent symptom was 'experiencing poor memory' (84.1%) and the least frequent was 'dissatisfaction with personal life' (26.9%). Mean scores of vasomotor and sexual symptoms in PM women were higher than in MT women (2.60 +/- 1.74 and 3.39 +/- 2.35 vs. 1.96 +/- 1.46 and 2.10 +/- 1.48, respectively; p = 0.0001). The prevalence of menopause-related symptoms varied between self-assessed health status groups (chi(2) = 29.12, p = 0.0001). In conclusion, MENQOL is a good self-administered tool in the assessment of climacteric complaints, with convenient application. The most frequent climacteric symptom of Chinese women living in an urban community was 'experiencing poor memory'. PM women seemed to suffer from more symptoms, especially in vasomotor and sexual domains, than did MT women. Symptom reports might be associated with self-assessed health status.
In both developed and developing countries osteoporosis is a growing health problem that is well recognized. This contributes greatly to the high costs of health care and mortality. Osteoporosis is a disease that is associated with fractures. This is a cause for worry solely because the results are lowered quality of life, people are no longer mobile, occurrences of disability and deaths. This bachelor thesis focuses on providing patient education on prevention of osteoporosis in menopaus...
Lasserre, A; Fournier, A
Estrogen-progestagen menopausal hormonal therapy (MHT) is recognized as carcinogenic to humans. The article presents the associations between MHT and breast, ovary and endometrial cancer risks, in particular according to treatment modalities. If MHT must be prescribed, it is recommended to use the lowest dose for the shortest possible duration. Discussing with the patient the benefits but also the risks and making regular gynecological follow-up are strongly encouraged. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Shaver, Joan L; Woods, Nancy F
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.
Arunima Chaudhuri; Nirmala G Borade
Menopause is associated with decreased heart rate variability, which is due to reduced parasympathetic or increased sympathetic outflow to the heart. Acute myocardial infarction may be accompanied by decreased heart rate variability. The causes of autonomic dysfunction in postmenopausal women may be multi-factorial i.e., dyslipidemia, increased body fat percentage, aging and loss of female sex hormones. The cardiac vagotonic and sympatholytic effects of estrogen can explain, at least in part,...
Acer, Semra; Pekel, Gökhan; Küçükatay, Vural; Karabulut, Aysun; Yağcı, Ramazan; Çetin, Ebru Nevin; Akyer, Şahika Pınar; Şahin, Barbaros
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...
Soheila Nazarpour; Masoumeh Simbar; Fahimeh Ramezani Tehrani
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 fa...
Rosano, G M C; Vitale, C; Marazzi, G; Volterrani, M
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.
Úbeda, Francisco; Ohtsuki, Hisashi; Gardner, Andy
Menopause is the transition from reproductive to non-reproductive life well before natural death. Rather than involving a smooth, rapid change, it is normally preceded by a long period of erratic hormonal fluctuation that is accompanied by a plethora of unpleasant symptoms. Here, we (1) suggest that this turbulent period owes to conflict, between a woman's maternally inherited (MI) and paternally inherited (PI) genes, over the trade-off between reproduction and communal care; (2) perform a theoretical analysis to show that this conflict is resolved either through silencing or fluctuating expression of one of the genes; (3) highlight which of the symptoms preceding menopause may result from antagonistic co-evolution of MI and PI genes; (4) argue that ecological differences between ancestral human populations may explain the variability in menopause among different ethnic groups; (5) discuss how these insights may be used to inform family planning and cancer risk assessment based on a woman's ancestral background. © 2013 The Authors. Ecology Letters published by John Wiley & Sons Ltd and CNRS.
Su, H. Irene; Freeman, Ellen W.
Summary The Menopausal Transition (MT) is the time in each woman’s reproductive life that precedes the final menstrual period (FMP). MT is associated with changes in bleeding pattern and hormone profiles. In recent years, research efforts have characterized changes in reproductive hormones over MT in order to elucidate the process of late reproductive aging and potentially identify predictors of time to menopause. Follicle stimulating hormone (FSH), anti-Mullerian hormone (AMH), inhibin B and estradiol represent the four primary hormone measures of these investigations. Current data show an increase in FSH and decreases in AMH, inhibin B and estradiol over MT (Table 1). AMH appears to be the first marker to change, followed by FSH and inhibin B. Estradiol declines in late MT. To date, there are no validated hormone cutpoints that predict the length of MT or FMP. There are very preliminary data on AMH as a predictor of menopause. Until further evidence identifies clinically useful hormone levels for predicting MT or FMP, diagnosis of MT and FMP should be based on clinical signs and symptoms only. PMID:19942836
Samir Ben Ali
Full Text Available Objectives. This study aimed to evaluate the effect of menopausal status on the risk of metabolic syndrome (MetS in Tunisian women. Methods. We analyzed a total of 2680 women aged between 35 and 70 years. Blood pressure, anthropometric indices, fasting glucose, and lipid profile were measured. The MetS was assessed by the modified NCEP-ATPIII definition. Results. The mean values of waist circumference, blood pressure, plasma lipids, and fasting glucose were significantly higher in postmenopausal than in premenopausal women, a difference that was no longer present when adjusting for age. Except for hypertriglyceridaemia, the frequency of central obesity, hyperglycemia, high blood pressure, and high total cholesterol was significantly higher in postmenopausal than in premenopausal women. After adjusting for age, the significance persisted only for hyperglycemia. The overall prevalence of MetS was 35.9%, higher in postmenopausal (45.7% versus 25.6% than in premenopausal women. A binary logistic regression analysis showed that menopause was independently associated with MetS (OR = 1.41, 95% CI 1.10–1.82 after adjusting for age, residence area, marital status, family history of cardiovascular disease, education level, and occupation. Conclusions. The present study provides evidence that the MetS is highly prevalent in this group of women. Menopause can be a predictor of MetS independent of age in Tunisian women.
Ogun, Oluwaseye Ayoola; Büki, Bela; Cohn, Edward S.; Janky, Kristen L.; Lundberg, Yunxia Wang
Objective This study was designed to examine the age and gender distribution and the effect of menopause in a large cohort of participants diagnosed with benign paroxysmal positional vertigo (BPPV). Methods We analyzed 1,377 BPPV patients and surveyed 935 women from this group, all diagnosed at Boys Town National Research Hospital (BTNRH) over the last decade. Results A detailed age- and gender- distribution analysis of BPPV onset showed that aging had a profound impact on BPPV occurrence in both genders, and that peri-menopausal women were especially susceptible to BPPV (3.2:1 female to male). The latter is a novel finding and was confirmed by a direct survey of female BPPV patients (168 participated). In addition, there was a pronounced female preponderance (6.8:1) for BPPV in the teenage group despite the low prevalence in this age group. Conclusions The data suggest that hormonal fluctuations (especially during menopause) may increase the tendency to develop BPPV. PMID:24496089
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.
Hale, G E; Burger, H G
This chapter describes current definitions of the climacteric, perimenopause, menopausal transition and menopause, and discusses the 2001 Stages of Reproductive Aging (STRAW) criteria in relation to more recently proposed categorization criteria for reproductive aging. Data from endocrine studies on women throughout the menopausal transition are discussed from earliest to most recent. The earlier studies focused on the changes in levels of steroid hormones and gonadotrophins, and established that follicle-stimulating hormone undergoes the first detectable change while menstrual cycles remain regular. Erratic and less predictable changes in steroid hormones follow, especially with the onset of irregular cycles. Later serum hormone studies on the inhibins and anti-Mullerian hormone established that diminishing ovarian follicle number contributes to the endocrine changes with advancing reproductive age. A classification system of cycle types incorporating all available endocrine data and their associated menstrual cycle patterns is proposed, and the application of biological markers as diagnostic tools for reproductive staging is discussed.
Full Text Available The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a woman’s life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patient’s needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska. For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.
Luisi, S; Orlandini, C; Biliotti, G; Scolaro, V; De Felice, G; Regini, C; Petraglia, F
Menopause is defined by world health organization (WHO) as the permanent cessation of menstruating resulting from a loss of ovarian follicular activity, after one year of amenorrhea. It signifies the last menstrual cycle and the end of women's fertile and reproductive life. The average age for a women to undergo menopause is 51 years; unlike menarche, whose average age has decreased over the past decades, the age of menopause has remained unchanged. We can distinguish: 1) premenopause, the time interval leading up to menopause; 2) climacteric, the time interval between the reproductive e non-reproductive life; 3) premature menopause, that occurs in 1% of women. Menopause can also be induced iatrogenically as a result of surgery, medical therapy, chemotherapy and radiotherapy. Beyond the life the number of oocytes falls until there are no more suitable follicles for reproduction and the menopause ensues. At the same time, the ability of the ovary to produce hormones falls, leading to an increasing pulsatile release of FSH in order to stimulate the ovary to produce oestrogens. Menopause is characterized by different symptoms such as hot flushes, night sweats, dispareunia, prolapse, vulval itching due to vaginal atrophy and dryness, urinary incontinence, dysuria, and also the psychological aspects don't should be underestimated because of many women suffer of depression, mood instability, insomnia, fatigue and decreased libido. Long term symptoms include osteoporosis, cardiovascular and neuro-degenerative diseases. The main aim of different treatments was symptoms relief. Pharmacological agents and psychological support represent the goal for menopause treatment.
Kargozar, Rahele; Azizi, Hoda; Salari, Roshanak
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
Caçapava Rodolpho, Juliana Reale; Cid Quirino, Bruna; Komura Hoga, Luiza Akiko; Lima Ferreira Santa Rosa, Patrícia
In this study, we explore men's perceptions, experiences, and attitudes toward wives experiencing natural menopause. We interviewed 20 men using the oral history method. Descriptive categories of experiences, such as misconceptions about menopause overcome through coexistence and recognition of women's perspectives; recognition of women's needs and efforts to provide support; coping with changes in marital relations and need to start a new time in couple's life; and existence of several needs as husbands of women experiencing menopause were explored. A better understanding by men about the changes experienced by menopausal women fosters the development of a better emotional support for their wives, which improves the quality of marital relations.
Yazdkhasti, Mansoureh; Simbar, Masoumeh; Abdi, Fatemeh
Menopause is described as a period of psychological difficulties that changes the lifestyle of women in multiple ways. Menopausal women require more information about their physical and psychosocial needs. Empowerment during the menopause can contribute to improving the perception of this stage and the importance of self-care. It is essential to increase women's awareness and adaptation to menopause, using empowerment programs. The aim of this study was to review the empowerment and coping strategies in menopause women. In this review, PubMed, EMBASE, ISI, and Iranian databases were scanned for relevant literature. A comprehensive search was performed, using the combinations of the keywords "empowerment, menopause, coping with" to review relevant literature and higher education journals. Most interventions for menopause women have focused on educational intervention, physical activity/exercise, healthy diet, stress management, healthy behaviors, preventing certain diseases and osteoporosis. Health education intervention strategy is one of the alternative strategies for improving women's attitudes and coping with menopause symptoms, identified as severalof the subcategories of health promotion programs. Empowerment of menopausal women will guarantee their health during the last third of their life. It will also help them benefit from their final years of reproductive life. The results of the present study can pave the way for future research about women's health promotion and empowerment.
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....
Barazzetti, Lidiane; Pattussi, Marcos Pascoal; Garcez, Anderson da Silva; Mendes, Karina Giane; Theodoro, Heloísa; Paniz, Vera Maria Vieira; Olinto, Maria Teresa Anselmo
This study investigated the association between minor psychiatric disorders and menopause symptoms and their associated factors. A cross-sectional study was conducted with 615 women aged 40 to 65 years treated in a public menopause and gynecological outpatient clinic in the South Region of Brazil. Minor psychiatric disorders were assessed using the Self-Reporting Questionnaire (SRQ-20) and menopause symptoms using the Menopause Rating Scale. Score for menopause symptoms was categorized into three levels of symptoms: mild, moderate, and severe. Multivariate analyses used ordinal logistic regression. The prevalence of mild, moderate, and severe menopause symptoms was 34.1% (95% CI 30.3-37.9), 29.6% (95% CI 25.8-33.1), and 36.3% (95% CI 32.4-40.0), respectively. The overall prevalence of minor psychiatric disorders was 66.6% (95% CI 62.8-70.3). After adjustment, the odds ratio (OR) of the occurrence of menopause symptoms were approximately eight times higher in women relating minor psychiatric disorders compared with those without such disorders (OR = 7.76; 95% CI 5.27-11.44). The following factors were also associated with the menopause symptoms: women older than 50 years, living with a partner, lower educational level, smokers, larger number of pregnancies, obese, and those using psychotropic and/or postmenopause medication. The minor psychiatric disorders exhibited strong association with the presence of menopause symptoms independently of sociodemographic, behavioral, and reproductive factors, and of use of psychotropic medication.
Chen, Y L; Voda, A M; Mansfield, P K
The purpose of this research was to discover and describe the meaning of and attitudes toward menopause in midlife Chinese women in Taiwan. How these women learned about menopause was also explored. Questionnaires were distributed to a convenience sample of 208 Chinese women aged 35 to 55 living in Taiwan; 168 responded. Qualitative data were analyzed using content analysis. Percentage and chi-square were used to examine the quantitative data. The findings revealed that 154 (91.7%) women perceived menopause as a natural phenomenon. No statistically significant differences in attitude toward menopause were found between women grouped by different menopausal levels, by use or not use of hormones, or by religious preference. Some women described menopause as, "no longer young, getting old." Others described menopause as, "wisdom and maturation," "a symbol of achievement," and "a time to start enjoying life." Sixty-eight (40.5%) of the sample indicated they obtained menopausal information from friends and printed materials such as books, newspapers, and magazines. Study findings indicate that Chinese women in Taiwan perceive menopause in a positive and holistic way. Culturally sensitized Western practitioners can utilize this study's findings to more appropriately individualize care for Chinese midlife women.
Full Text Available Introduction: Menopause woman has higher depression level than pre and postmenopause woman. Many woman who are getting menopause will feel lonely and don’t have any friends to talk, if this situation continue it can cause menopausal depression. Peer group support is one of group therapy which gives opportunity to menopause woman to get mutual support and help them to face the problem. This aimed of this study was to analyze the effect of peer group support in the menopause woman depression level. Method: A quasy experimental pre-post test design was used in this study. There were 16 menopause women taken from Cepokomulyo Kepanjen. The independent variable was peer group support and the dependent variable was the depression level. Data were analyzed by Wilcoxon Signed Rank Test and Mann Whitney U Test with the significance level α<0.05. Result: Result showed that there was an effect of peer group support in the menopause woman depression level with significance level p=0.011 (treatment group and p=0.23 (controlled group and the result of Mann Whitney U Test showed that p=0.02. Discussion: It can be concluded that peer group support can reduce the menopause woman depression level. It can be suggested to the institutional to practice peer group support to help menopause woman reduce their depression level.
Abdollahi, Ali Akbar; Qorbani, Mostafa; Asayesh, Hamid; Rezapour, Aziz; Noroozi, Mehdi; Mansourian, Morteza; Soleimani, Mohammad Ali; Ansari, Hossain
Considering the physical, emotional and psychological complications of early or delayed menopause on women's life, it is necessary to determine associated factors of menopause age. This study designed to determine menopausal age and associated factors in women of Gorgan, i.e. the capital of Golestan province in the north-east of Iran. In this cross-sectional study, 804 menopausal women in Gorgan were selected via two-stage sampling method in 2009. The study included only women who had undergone natural menopause and had their last menstrual bleeding at least one year before. Data were gathered through structured questionnaire that included individual characteristics, socioeconomic characteristics, menstrual and fertility characteristics and climacteric complaints. Socioeconomic status was defined using principal component analysis. Data were analyzed with T-student's and ANOVA tests using SPSS version 16 (SPSS Inc, Chicago, IL, USA) for Windows. The mean menopause age was 47.6±4.45 years with the median age of 48 years. The mean menopause age in women with first pregnancy before 30 years (47.58±4.47years), without pregnancy (46.26±4.90years) and without delivery (46.30±4.47 years) was significantly lower than others (p0.05). Socioeconomic status was not associated significantly with menopause age (p>0.05). This study illustrated that menstrual and fertility factors have influence on menopausal age while socioeconomic factors were not effective.
Hvas, Lotte; Gannik, Dorte Effersøe
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...
Remport, Júlia; Blázovics, Anna
In previous centuries many women did not even live until their menopause years due to poor economic conditions, deficiencies of medicine, epidemics and wars. Nowadays in the developed countries, people live until they are 75-80 years old, and with the expansion of average age, the number of people affected by menopause and the years spent in that state increase. Nowadays women spend one third of their lives in the menopausal stage. The only effective way to treat unpleasant symptoms for centuries was with the use of herbs, and the knowledge about them spread through oral tradition. In the 20th century, this therapeutic form was pushed into the background by the development of synthetic drug production and the introduction of hormone replacement therapy. Thanks to the influence of media in the 20th century, women began to have the social need for preserving their beauty and youth for as long as they could. Hormone replacement therapy enjoyed great popularity because women were temporarily relieved of their life quality-impairing menopausal symptoms, but years later it turned out that hormone replacement therapy could pose serious risks. A distinct advantage of herbal therapy is the more advantageous side-effect-profile opposite the used synthetics in hormone replacement therapy. Women are therefore happy to turn to valuable and well-tried natural therapies, which have been used for thousands of years. There is growing interest in herbal remedies. Studying the effects of phytoestrogens has now become an active area for research. However, the results of studies in animals and humans are controversial, some sources suggest that phytoestrogens are effective and safe, other authors claim that they are ineffective in menopause or they have particularly dangerous properties, and cannot be recommended to everyone. It is important to address this issue for the sake of health, mental health and safety of women, and so it is necessary to assess the benefits and the risks
Sánchez-Rodríguez, Martha A; Zacarías-Flores, Mariano; Arronte-Rosales, Alicia; Correa-Muñoz, Elsa; Mendoza-Núñez, Víctor Manuel
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.
Ballagh, Susan A
The vagina is an alternative delivery site of sex steroids for menopausal women. New ring technology provides continuous and consistent delivery of steroids for up to 3 months. Rings rest on the pelvic floor muscles in a nearly horizontal position and are usually imperceptible. Steroid is delivered directly into the systemic circulation which may result in less alteration of coagulation/fibrinolysis pathways as seen with transdermal hormone therapy. Fewer adverse effects are noted when progesterone is applied vaginally, possibly due to lower serum levels of metabolites such as alloprenanolone. Women often switch to a ring for the longer dosing interval but also appreciate the reduced messiness. Over 5700 healthy US women who evaluated an unmedicated ring as a drug delivery platform found it very acceptable independent of age or prior use of barrier contraceptives. Marketed rings in the US include: (i) a ring for systemic and vaginal menopausal therapy that provides average serum estradiol levels of 40.6 pg/mL for the 0.05 mg and 76 pg/mL for the 0.1 mg dose; (ii) a ring for urogenital menopausal symptoms only that minimally elevates serum estradiol, usually within the menopausal range, treating atrophic vaginitis and urethritis; and (iii) a ring labelled for contraception that provides ethinyl estradiol 15 microg and etonogestrel 120 microg appropriate for nonsmoking perimenopausal women. A ring for combination hormone therapy and another releasing progesterone for contraception in lactating women have been reported in the literature, but are not yet available commercially. These may offer future options for hormone therapy. Women with a uterus receiving estrogen, even in low doses, should be given progestogen to prevent endometrial hyperplasia or carcinoma. Even women who have had an endometrial ablation are likely to have some endometrial tissue remaining since long-term amenorrhoea is uncommon. Since no marketed combination ring product is available, other forms
Carturan, Paula; Scorcine, Claudio; Fragoso, Yara Dadalti
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...
Gracia, Clarisa R; Sammel, Mary D; Freeman, Ellen W; Lin, Hui; Langan, Elizabeth; Kapoor, Shiv; Nelson, Deborah B
Several menopausal staging definitions are currently being used in ongoing studies designed to identify changes occurring during menopause. The objective of this study was to determine which definition captures the earliest hormonal changes in the menopausal transition. In this prospective cohort study, women aged 35 to 47 years were followed for 5 years. Women were classified as premenopausal, early transition, late transition, and postmenopausal by 2 different menopausal staging systems defined by bleeding patterns. Definitions from the Study of Women Health Across the Nation (SWAN) and Stages of Reproductive Aging Workshop (STRAW) were compared. A new menopausal staging system (PENN-5) was also developed with five groups rather than four to distinguish among women with more subtle changes in cycle length. For each staging system, a linear regression model was created comparing mean hormone values (inhibin B, FSH, LH, E2) and menopausal stages at each assessment. Race, body mass index, cycle day, smoking, and follow-up time were included in the model. Statistically significant differences in mean inhibin B and FSH levels, but not estradiol levels, were detected between the earliest menopausal stages of each definition. Significant differences in LH values were detected among the earliest stages of the SWAN and STRAW definitions, but not the PENN-5 definition. Subtle changes in menstrual cycle length reflect significant changes in inhibin B and FSH levels during the menopausal transition. Therefore, it appears that subtle changes in bleeding pattern may be helpful in identifying the earliest hormonal changes during menopausal transition.
Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki
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
Hwang, K. H.; Choa, Won Sick; Yoon, Min Ki [Gachon Medical School, Gil Hospital, Incheon (Korea, Republic of)
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.
Jurgenson, Janelle R; Jones, Emma K; Haynes, Emma; Green, Charmaine; Thompson, Sandra C
Despite extensive literature demonstrating differing experiences in menopause around the world, documentation of the experience of menopause in Australian Aboriginal women is scarce, and thus their menopausal experience is relatively unknown. This study aimed to understand Australian Aboriginal women's understanding and experience of menopause and its impact on their lives. The study was an exploratory qualitative study. Twenty-five Aboriginal women were recruited from a regional centre in the Mid-West region of Western Australia using opportunistic and snowballing sampling. Interviews and focus group discussions were undertaken from February 2011 to February 2012 using open-ended questioning with a yarning technique. Thematic analysis was undertaken of the transcribed interviews. A number of themes were revealed. These related to the language used, meanings and attitudes to menopause, symptoms experienced, the role of men, a lack of understanding, coping mechanisms and the attribution of menopausal changes to something else. The term "change of life" was more widely recognised and signified the process of ageing, and an associated gain of respect in the local community. A fear of menopausal symptoms or uncertainty about their origin was also common. Overall, many women reported insufficient understanding and a lack of available information to assist them and their family to understand the transition. There are similarities between Aboriginal and non-Aboriginal experiences of menopause, including similar symptom profiles. The current language used within mainstream health settings may not be appropriate to this population if it fails to recognise the importance of language and reflect the attributed meaning of menopause. The fear of symptoms and uncertainty of their relationship to menopause demonstrated a need for more information which has not adequately been supplied to Australian Aboriginal women through current services. While this study is with a select
Li, Sixuan; Ho, Suzanne C; Sham, Aprille
This cross-sectional study aimed to explore the relationship between menopause status and attitude toward menopause, and also its relationship with quality of life (QoL) of Chinese midlife women in Hong Kong. Hong Kong Chinese women aged 40 to 59 years were recruited through computer-generated random telephone dialing. Information was obtained through telephone interviews based on a structured questionnaire. Women were classified into 3 groups: premenopausal, perimenopausal, and postmenopausal. Menopause Belief Scale and Utian Quality of Life Scale (QoL) were used to measure respondents' attitude toward menopause and their QoL. Information on social, health, and lifestyle factors was also collected. The mean age of the participants was 49.4 ± 5.2 years. Respondents generally had a positive attitude toward menopause. Compared with premenopausal women, postmenopausal women were noted to have significantly higher attitude score toward menopause. No significant differences in QoL score were noted among women of the 3 menopause statuses. Stepwise regression analysis showed that women with more positive attitude toward menopause tended to have higher QoL score. Furthermore, better self-reported health status, doing physical activities, higher education level, being married, and non-smoking status were associated with better QoL. Postmenopausal women tended to have more positive attitude toward menopause. Although menopause status did not seem to be associated with QoL, attitude toward menopause, self-reported health status, as well as social and lifestyle factors were associated with QoL in Chinese midlife women.
Conclusion: The majority of Chinese rural midlife women do not experience depression. The relationship between depression, VMS and sleep disturbances tends to change with menopausal status in Chinese rural midlife women. Keywords: depression, poor sleep, vasomotor symptoms, menopause, rural women ...
Full Text Available Menopause is an endocrinological transition that greatly affects health and disease susceptibility in middle-aged and elderly women. To gain new insights into the metabolic process of menopause, plasma metabolic profiles in 115 pre- and post-menopausal women were systematically analyzed by ultra-performance liquid chromatography/mass spectrometry in conjunction with univariate and multivariate statistical analysis. Metabolic signatures revealed considerable differences between pre- and post-menopausal women, and clear separations were observed between the groups in partial least-squares discriminant analysis score plots. In total, 28 metabolites were identified as potential metabolite markers for menopause, including up-regulated acylcarnitines, fatty acids, lysophosphatidylcholines, lysophosphatidylethanolamines, and down-regulated pregnanediol-3-glucuronide, dehydroepiandrosterone sulfate, p-hydroxyphenylacetic acid and dihydrolipoic acid. These differences highlight that significant alterations occur in fatty acid β-oxidation, phospholipid metabolism, hormone metabolism and amino acid metabolism in post-menopausal women. In conclusion, our plasma metabolomics study provides novel understanding of the metabolic profiles related to menopause, and will be useful for investigating menopause-related diseases and assessing metabolomic confounding factors.
van Asselt, Kristel M.; Kok, Helen S.; Peeters, Petra H. M.; Roest, Mark; Pearson, Peter L.; te Velde, Egbert R.; Grobbee, Diederick E.; van der Schouw, Yvonne T.
Objective: Smoking is consistently associated with a younger age for menopause. Although this may be because of the direct toxic effects of tobacco smoke on follicles, we hypothesize that there may also be a relationship between smoking and a vascular origin of early menopausal onset. Several
Overlie, Inger; Mørkrid, Lars; Andersson, Anna-Maria
A more direct and precise hormonal marker of the menopause has been required for some time. The aim of this study was to identify the most accurate marker of the menopause, based on analyses of inhibin A and B, FSH, LH and estradiol (E(2)), among 59 healthy women without hormonal treatment during...
Kok, Helen S.; van Asselt, Kristel M.; van der Schouw, Yvonne T.; van der Tweel, Ingeborg; Peeters, Petra H. M.; Wilson, Peter W. F.; Pearson, Peter L.; Grobbee, Diederick E.
OBJECTIVES The purpose of this study was to investigate whether a harmful cardiovascular risk profile accelerates menopause. BACKGROUND Women with an early menopause are at an increased risk of cardiovascular disease. Although increased cardiovascular risk has been proposed as consequence of
Background: As life expectancy increases,most women spent a larger part of their lives in the post-menopausal state,with part of this during the peak of their career for working class women. Perception, attitude and experience of the menopause and its transitional period may differ from one female population to the other.
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 ...
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 ...
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.
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 ...
Li, Jingmei; Eriksson, Mikael; Czene, Kamila; Hall, Per; Rodriguez-Wallberg, Kenny A
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
Pinkerton, JoAnn V; Stovall, Dale W; Kightlinger, Rebecca S
Vasomotor symptoms and vaginal atrophy are both common menopausal symptoms. Hormone therapy is currently the only FDA-approved treatment for hot flashes. Current recommendations are to use the lowest dose of hormone therapy for the shortest period that will allow treatment goals to be met. Although the reanalysis of the WHI in 2007 by Roussow et al. provided evidence of coronary heart safety for users of hormone therapy under the age of 60 years and within 10 years of the onset of menopause, not all women desire or are candidates for hormone therapy. In this review we present an evidence-based discussion considering the effectiveness of hormonal and nonhormonal therapies for the relief of vasomotor symptoms and vaginal atrophy. Concern exists regarding systemic absorption of vaginal estrogen and possible adverse effects on the breast and uterus. Selective estrogen receptor modulators and estrogen agonists offer benefits through targeted estrogen agonist/antagonistic effects and are being evaluated with and without estrogen for symptomatic menopausal women. Centrally acting nonhormonal therapies that are effective for the relief of vasomotor symptoms include various antidepressants, gabapentin and clonidine. A limited number of clinical trials have been conducted with nonprescription remedies, including paced respiration, yoga, acupuncture, exercise, homeopathy and magnet therapy, and some, but not all of these, have been found to be more effective than placebo. Dietary herbal supplements, such as soy and black cohosh, have demonstrated mixed and inconclusive results in placebo-controlled trials. Potential therapies for vasomotor symptoms and vaginal atrophy require randomized, placebo-controlled trials of sufficient duration to establish efficacy and safety. Agents under investigation for vasomotor symptoms relief include neuroactive agents, such as gabapentin and desvenlafaxine; an estrogen receptor-beta-targeted herbal therapy, MF-101; and the selective estrogen
Full Text Available Introduction: In the gynecological profession Pelvic Inflammatory Disease (PID has a significant role due to its frequency, many complications and high costs of treatment Aim: The aim of this study was to investigate frequency and complications caused by these diseases, and used methods of treatment. Methods: The research was conducted in Clinic of Obstetrics and Gynecology 'Narodni Front', Belgrade, and included all consecutive patients diagnosed with PID during the period from year 2007 to 2010. The diagnosis of PID was set on the basis of: gynecological examination, test analysis (leucocytes, sedimentation, platelets, CRP, CA125, and ultrasound examination. A clinical criterion is divided into minimal and additional. The study included 112 patients. There were 33.93% of women in perimenopause/menopause (experimental group, while the control group consisted of 66.07% female subjects. Results: The frequency of surgically treated patients in experimental and control group was: 44.74% : 39.19% (χ2 test; p > 0.05. Women in experimental group used Intrauterine Device (IUD more than other patients 57.89% : 13.15% (χ2 test; p = 0.0001. A link was established between the use of intrauterine devicela in (χ2 test; p = 0.0516, patients’ irregular control of IUD (χ2 test; p = 0.0114 and surgical treatments of women in experimental group. The conservative treatment usually applies dual antibiotic therapy. Costs of surgically treated patients are around 1300 and conservatively treated around 210 €. Conclusion: Women in perimenopause and menopause are not exposed to higher risks of contracting PID. Women in perimenopause and menopause which use intrauterine device and don’t have regular controls, have higher risk of surgical treatments in case of pelvic inflammatory disease. Costs of treatment are 6-7 times in lower with conservatively treated patients compared to operatively treated ones.
Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert
INTRODUCTION: Around 75% of menopausal women experience hot flushes (HF) and 10-20% of all postmenopausal women find this very distressing. The aim of this study is to evaluate the efficacy of acupuncture on moderate-to-severe menopausal symptoms in general and HF in particular. METHODS: An un...... acupuncturists will be medical doctors educated in acupuncture. The primary outcome is change in HF from baseline to week 6 measured by the HF scale from the MenoScores Questionnaire (MSQ). Secondary outcomes are change in other menopausal symptoms, in particular day and night sweats and menopausal......: In the ACOM study, we explore the potential benefits of acupuncture on moderate-to-severe meno-pausal symptoms. The cross-over design offers the possi-bility of examining the legacy effect of acupuncture. FUNDING: The Idella Foundation, the University of Copenhagen and the Research Foundation of General...
Lasley, Bill L; Crawford, Sybil; McConnell, Daniel S
The concept that adrenal androgen production gradually declines with age has changed after analysis of longitudinal data from the Study of Women's Health Across the Nation (SWAN). It is now recognized that 4 adrenal androgens rise during the menopausal transition in most women. Ethnic and individual differences in sex steroids are more apparent in circulating adrenal steroids than in either estradiol or cyclic ovarian steroid hormone profiles, particularly during the early and late perimenopause. Thus, adrenal steroid production may play a larger role in the occurrence of symptoms and the potential for healthier aging than previously recognized.
Full Text Available Menopause is associated with decreased heart rate variability, which is due to reduced parasympathetic or increased sympathetic outflow to the heart. Acute myocardial infarction may be accompanied by decreased heart rate variability. The causes of autonomic dysfunction in postmenopausal women may be multi-factorial i.e., dyslipidemia, increased body fat percentage, aging and loss of female sex hormones. The cardiac vagotonic and sympatholytic effects of estrogen can explain, at least in part, why premenopausal women compared with postmenopausal women have a lower coronary heart disease incidence and mortality rate.
Freeman, Ellen W; Sammel, Mary D; Boorman, David W; Zhang, Rongmei
An increased risk of depressive symptoms has been associated with the transition to menopause, but the risk of depressive symptoms in the early postmenopausal years has not been well characterized. To identify within-woman changes in depressive symptoms during a 14-year period around menopause, determine associations of a history of depression with the pattern of depressive symptoms, and evaluate the rate of change in reproductive hormones as predictors of depressive symptoms following menopause. A randomly identified, population-based sample in Philadelphia County, Pennsylvania, of 203 late-reproductive-age women who were premenopausal at baseline and reached natural menopause. Center for Epidemiologic Studies Depression Scale. The prevalence of high scores on the Center for Epidemiologic Studies Depression Scale decreased from 10 years before to 8 years after the final menstrual period (FMP), with a decrease of approximately 15% of baseline per year (odds ratio, 0.85; 95% CI, 0.81-0.89; P menopause compared with women with no depression history. Among women who first experienced depressive symptoms approaching menopause, the risk of depressive symptoms declined after the FMP, with a significantly lower risk the second year after menopause. The risk of depressive symptoms after menopause decreased by 35% for each unit (SD) increase before the FMP in the log rate of change of follicle-stimulating hormone (odds ratio, 0.65; 95% CI, 0.46-0.91; P = .01). The FMP was pivotal in the overall pattern of decreasing depressive symptoms in midlife women, with higher risk before and lower risk after the FMP. A history of depression strongly increased the risk both before and after menopause. Women who had no history of depression before the menopause transition had a low risk of depressive symptoms 2 or more years after the FMP.
Full Text Available The problem of menopause attracts attention for many decades of not only gynecologists, but urologists, cardiologists, psychiatrists and other doctors. This is related to systemic complications of estrogen deficiency. The objective of our work is to establish clinical and hormonal changes in women of menopausal age with physiological menopause and after ovariectomy and also assess the effectiveness of the offered treatment. During the examination and treatment the women were divided as follows: I – main group – 48 women with physiological menopause: Ia (n=27 – within three months received a complex of non-hormonal treatment, Ib (n=21 – hormone replacement therapy (HRT; II group – 34 women after total ovariectomy: IIa (16 with therapeutic purpose received a complex of non-hormonal treatment for three months, IIb (18 – HRT. The offered complex of non-hormonal treatment included Cimicifuga, Menopace, Noophen. This treatment was used in women with early menopause who have contraindications to HRT or refused to take hormones. The degree of severity of menopausal syndrome was judged according to the menopausal index of Kuperman. In the study of hormonal status the determination of a set of hormones by immunochemical method was performed. During study we obtained results that indicate the inverse dynamics of menopausal disorders in both study groups. For the prevention and treatment of individual selection of treatment of climax manifestations it is appropriate the dynamic definition of hormonal mirrors of the patients.
Full Text Available 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 One hundred and three women were included in the study. Migraine affected 14.7% of them. Some previous type of headache was reported by 86.2% of the women, most of whom improved during menopause but still presented with headache attacks. There was a correlation between higher migraine disability and depressive traits. Conclusions Many women believe that their headaches, particularly migraine, will end after menopause. This is, unfortunately, not the case for many of them.
Meema, S; Meema, H E
Throughout adult life the bone mineral mass of the radius is greater in males than in females. In males, it decreases after 60 years of age, while in females, it decreases earlier, at approximately 50 years, and the loss is greater. At the average age of 67 years, one half of the normal white female population has less than the normal amount of bone in the radius. Premenopausal women over the age of 50 do not show any decline of bone mineral mass, while in postmenopausal women, regardless of age, there is a loss of bone mass related to the number of years after menopause. Castrated women have significantly less bone mass than premenopausal women of the same average age. No decrease in cortical thickness of the radius was found in oophorectomized women treated with estrogens after castration. In a long-term, follow-up study, untreated postmenopausal women (after a natural or an artifical menopause) showed a significant loss of bone mass, while estrogen-treated, postmenopausal women showed no such loss. Estrogen treatment thus appears to prevent postmenopausal bone loss.
Lerner, U H
Bone mass in the skeleton is dependent on the coordinated activities of bone-forming osteoblasts and bone-resorbing osteoclasts in discrete bone multi-cellular units. Remodeling of bone in these units is important not only for maintaining bone mass, but also to repair microdamage, to prevent accumulation of too much old bone, and for mineral homeostasis. The activities of osteoblasts and osteoclasts are controlled by a variety of hormones and cytokines, as well as by mechanical loading. Most importantly, sex hormones are very crucial for keeping bone mass in balance, and the lack of either estrogen or testosterone leads to decreased bone mass and increased risk for osteoporosis. The prevalence of osteoporotic fractures is increasing dramatically in the Western part of the world and is a major health problem in many countries. In the present review, the cellular and molecular mechanisms controlling bone remodeling and the influence of sex hormones on these processes are summarized. In a separate paper in this issue, the pathogenesis of post-menopausal osteoporosis will be compared with that of inflammation-induced bone remodeling, including the evidence for and against the hypothesis that concomitant post-menopausal osteoporotic disease influences the progression of periodontal disease.
Vieira-Baptista, Pedro; Marchitelli, Claudia; Haefner, Hope K; Donders, Gilbert; Pérez-López, Faustino
The concept of genitourinary syndrome of menopause (GSM) was recently introduced and has been gaining widespread use. While some justifications for its introduction are straightforward, others may be questionable. Numerous unspecific symptoms and signs were included in the definition of the syndrome, but the minimum number required for diagnosis was not established. While the GSM definition is designed to facilitate identifying vulvovaginal and urinary estrogen-deprivation-associated symptoms and signs, several concerns have evolved: (1) the syndrome may result in the underdiagnosis of vulvar and urinary pathology; and (2) serious conditions (e.g., high-grade squamous intraepithelial lesions of the vulva or vulvar intraepithelial neoplasia, differentiated type) may be missed while others may not receive appropriate treatment (e.g., lichen sclerosus, overactive bladder). In addition, the transformation of urogenital symptoms and signs into a syndrome may create an iatrogenization of menopause, which, consequently, can lead to demand for (and offer of) a panacea of treatments. This can be detrimental to the care of women who require focused therapy rather than global treatment addressing a variety of genitourinary conditions, not all of which even require any form of intervention. Women's needs may be better served by having a more precise urogenital diagnosis.
Lindh-Åstrand, L; Hoffmann, M; Järvstråt, L; Fredriksson, M; Hammar, M; Spetz Holm, A-C
Are Swedish women age 40-44 years with assumed early menopause 'undertreated' by hormone therapy (HT)? Many women with probable early menopause discontinue their HT after a short period of time. Thus, they fail to complete the recommended replacement up to age 51-52 years, the average age of menopause. Spontaneous early menopause occurs in ∼5% of women age 40-45 years. Regardless of the cause, women who experience hormonal menopause due to bilateral oophorectomy before the median age of spontaneous menopause are at increased risk of cardiovascular disease, neurological disease, osteoporosis, psychiatric illness and even death. The study is descriptive, and epidemiological and was based on the use of national registers of dispensed drug prescriptions (HT) linking registers from the National Board of Health and Welfare and Statistics Sweden from 1 July 2005 until 31 December 2011. The study population consisted of 310 404 women, 40-44 years old on 31 December 2005 who were followed from 1 July 2005 until 31 December 2011. Only 0.9% of women 40-44 years old started HT during the study period. A majority of these women used HT menopause was the main reason. Because of the study design-making a retrospective study of registers-we can only speculate on the reasons for most of the women in this group discontinuing HT. Another limitation of this study is that we have a rather short observation time. However, we have up to now only been able to collect and combine the data since July 2005. As the occurrence of spontaneous early menopause in women age 40-45 is reported to be ∼5%, the fact that menopause may have used combined contraceptives as supplementation therapy, but in Sweden HT is the recommended treatment for early menopause so any such women are not following this recommendation. Women who experience early menopause are at increased risk for overall morbidity and mortality, and can expect to benefit from HT until they have reached at least the median age of
Damle, Rajshri P; Dravid, N V; Suryawanshi, Kishor H; Gadre, Arundhati S; Bagale, Priya S; Ahire, Neelam
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.
Hildreth, Kerry L; Ozemek, Cemal; Kohrt, Wendy M; Blatchford, Patrick J; Moreau, Kerrie L
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.
Haines, C J; Farrell, E
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.
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.
Santen, Richard J; Stuenkel, Cynthia A; Burger, Henry G; Manson, Joann E
After publication of the Women's Health Initiative study in 2002, use of menopausal hormone therapy (HT) has declined by nearly 80% worldwide and internists now play only a limited role in menopause management. Over the past decade, new data have increased our knowledge of the multiple effects and mechanisms of HT. Existing literature was reviewed. A consensus has emerged that the benefits of HT outweigh the risks for the relief of symptoms in women who have recently undergone menopause and are not at excess risk of breast cancer and cardiovascular disease. Non-hormonal agents, selective estrogen receptor modulators (SERMs), and tibolone are also useful in management. Factors entering into the decision-making process regarding menopause management are increasingly complex and involve consideration of effects on multiple systems and potential disease-related events. These considerations suggest that internists trained to evaluate and integrate factors influencing multiple organ systems should re-engage in menopause management. Most internists currently lack the core competencies and experience necessary to address menopausal issues and meet the needs of women who have completed their reproductive years. We believe that this situation is detrimental to women's health, leads to fragmented care, and should change. We propose that the multidimensional expertise that characterizes the internist may provide the most comprehensive approach to menopause management. For the internist to meet this need, a set of core competencies must be attained, which will require new didactic programs to be developed for medical students, residents and practicing physicians.
Curhan, Sharon G; Eliassen, A Heather; Eavey, Roland D; Wang, Molin; Lin, Brian M; Curhan, Gary C
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.
Hayatbakhsh, Mohammad R; Najman, Jake M; O'Callaghan, Michael J; Williams, Gail M; Paydar, Anita; Clavarino, Alexandra
There is a lack of evidence about whether menopausal status influences the effect of smoking on lung function. This study examined the association between smoking and menopausal status and lung function independent of each other. Data were from a cohort of women attending the 21-year follow-up of the Mater University of Queensland Study of Pregnancy. The study was based on 2020 women who provided data on respiratory function, smoking, and menopausal status. A Spirobank G spirometer system was used to measure forced vital capacity (FVC), forced expiratory volume in first second (FEV(1)), and forced expiratory flow between 25 and 75% of forced vital capacity (FEF(25-75)). Smoking and menopausal status were assessed by self-report. Respiratory function was associated with cigarette smoking, menopausal status, and hormone replacement therapy. Regardless of smoking status, postmenopausal women had poorer lung function when compared with premenopausal women. In multivariate analysis, cigarette smoking was associated with lower FVC, FEV(1), and FEF(25-75), with the magnitude of effect being stronger for women who were postmenopausal. The data suggest that the impact of smoking intensifies after menopause. It seems plausible that effective quit-smoking programs, particularly after menopause, may lead to better lung function and reduced morbidity and mortality in women.
Fabbrini, Monica; AricÃ, Irene; Tramonti, Francesco; Condurso, Rosaria; Carnicelli, Luca; De Rosa, Anna; Di Perri, Caterina; Bonsignore, Maria Rosaria; Zito, Anna; Russo, Giovanna; Pagliarulo, Maria Giovanna; Guarnieri, Biancamaria; Cerroni, Gianluigi; Mennuni, Gianfranco; Della Marca, Giacomo; Bonanni, Enrica; Silvestri, Rosalia
Menopause in the female life cycle is a special period due to important hormonal, physical and psychological changes. Sleep disruption represents a common complaint for midlife and menopausal women, related to primary sleep disorders, including insomnia, sleep disordered breathing, restless legs syndrome (RLS), mood and anxiety disorder, other medical illness, hormonal-related vasomotor symptoms, and aging per se. Aims of our study were to evaluate the prevalence of sleep disorders in a sample of pre and post menopausal women, and to investigate the relationship between sleep and other medical disorders, and life habits. Among workers in the six participant centers, we enrolled 334 women, aged between 40 and 60 years, that completed a questionnaire that included screening on menarche, menstrual cycle, fertility, parity, menopause, life habits, personal medical and sleep history and related treatment, and self-administered scales for sleep quality (PSQI), excessive daytime sleepiness [Epworth Sleepiness Scale (ESS)], mood disorder [Beck Depression Inventory (BDI)], Berlin Questionnaire for sleep disordered breathing (SDB), IRLS diagnostic interview and Rating Scale. Menopausal and perimenopausal women showed an increased prevalence of poor sleep, high risk of SDB, and mood disorder; menopausal women also reported increased RLS severity. Mood disorder had a significant impact on night sleep measures and excessive daytime sleepiness, as well as on RLS severity, and had a greater prevalence in hypertensive women. Sleep disturbances are frequent in menopausal women. Their aetiology is unclear, but probably multifactorial, and many factors contribute to the sleep disruption. Our data suggest the importance of correctly investigate and address sleep problems associated with menopause, through sleep history, and a sleep study could be obtained if clinically warranted. Pharmacological and behavioural treatment strategies should then be aimed at improving sleep and life
Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen
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.
Meriggiola, Maria Cristina; Nanni, Michela; Bachiocco, Valeria; Vodo, Stellina; Aloisi, Anna M
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.
Menopause is the cessation of a woman's reproductive ability caused by the depletion of the hormones of estrogens and progesterone marked by the expiration of menstrual cycle. During menopause, physical and psychological changes occur. Experiences during menopause periods are individual and culture-influenced. In Minangkabau culture, Minangnese women revealed that they did not feel any changes during menopause periods but instead they took menopause as an interesting matter, yet there is only...
Robinson, Dudley; Cardozo, Linda
The urogenital tract and lower urinary tract are sensitive to the effects of oestrogen and progesterone throughout adult life. Epidemiological studies have implicated oestrogen deficiency in the aetiology of lower urinary tract symptoms occurring following the menopause. Although to date the role of oestrogen replacement therapy in the management of post-menopausal urinary incontinence remains controversial, its use in the management of women complaining of urogenital atrophy is now well established. This aim of this chapter is to review the recent evidence regarding the urogenital effects of hormone therapy with a particular emphasis on the management of post-menopausal urinary incontinence, recurrent lower urinary tract infections and urogenital atrophy.
Maas, A H E M; Franke, H R
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.).
Messina, Giovanni; Viggiano, Andrea; De Luca, Vincenzo; Messina, Antonietta; Chieffi, Sergio; Monda, Marcellino
Menopause is a period of significant physiological changes that may be associated with increased body weight and obesity-related diseases. Many researches were conducted to assess the contribution of factors such as estrogen depletion, REE decline, and aging to weight gain. An increase in orexin-A plasma levels, paralleling lower estrogen levels, was found during menopause. Orexins are hypothalamic neuropeptides recently discovered, involved in the regulation of feeding behaviour, sleep-wakefulness rhythm, and neuroendocrine homeostasis. Orexins might offer the missing link between postmenopausal hypoestrogenism and other manifestations of the menopausal syndrome, including appetite and weight changes and increase in cardiovascular risk.
Singh, Savita; van Herwijnen, Ineke; Phillips, Christian
Currently, 25% of women seek the advice of a medical professional for symptoms related to the menopause. However, with an increasingly ageing and medically aware population, it is likely this proportion will grow. The main symptoms related to the menopause are systemic vasomotor and localized urogenital symptoms. Numerous forms of estrogen have been used to alleviate these symptoms. Further problems that increase during the menopause include incontinence, pelvic organ prolapse and recurrent urinary tract infections. This article reviews the process by which estrogen affects the tissues of the urogenital tract, what symptoms occur during this period and what modalities of treatments are available.
Hoga, Luiza; Rodolpho, Juliana; Gonçalves, Bruna; Quirino, Bruna
Evidence shows than an estimated one billion women have experienced menopause worldwide. The experience of menopause is influenced by beliefs and values prevalent in the sociocultural setting, the background of the women, and the ways in which the women approach changes in this phase of life. Independently of the circumstances involved, women experiencing menopause need to have their care needs and corresponding support identified based on their personal and contextual perspectives. Although it is essential to provide appropriate support to women experiencing menopause, no systematic reviews have so far been conducted that focus on menopause experienced by women worldwide. The objective of this review is to identify the best available evidence related to how women experience menopause worldwide. This review considered studies that included menopausal women aged between 40 and 65 years, who have lived the transition from reproductive years through menopause and beyond. This review included only studies whose participants have lived the experience of natural menopause. Women who have had induced menopause, or with premature menopause were excluded from this review. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST: This review considered studies that investigate women's experiences of natural menopause under the scope of different social and cultural settings. TYPES OF STUDIES: This review considered studies that have a descriptive and interpretive approach, conducted using qualitative methodology. Qualitative studies that focus on program evaluation were excluded from this review. Qualitative data including, but not limited to, study designs such as phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion in this review. TYPES OF OUTCOMES: This review considered studies that include the following outcome measures: all aspects related both directly and indirectly to the experience of menopause, as concretely lived
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
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.
Neyro, José Luis; Franco, Ricardo; Rodríguez, Esteban; Carrero, Ariany; Palacios, Santiago
Fibromyalgia constitutes today, in the western world, an important problem of health that affects fundamentally in women from 45 years. The studies on the influence of the hormones on the symptomatology of the patients with fibromyalgia have not managed to establish a link of causal union between the hormonal climacteric decline and the development of the painful syndrome. Nevertheless, there are studies that relate the pain, the anxiety and the depression to the level of sexual steroids. It is our aim to check these associations. We will have to expect to the development of the intracrinology and, possibly, to know more the relationship between sexual steroids and neurotransmitters to be able to know the exact relation between fibromyalgia and menopause.
Lasley, B L; Crawford, S L; McConnell, D S
Observations over the past decade using longitudinal data reveal a gender-specific shift in adrenal steroid production. This shift is represented by an increase in the circulating concentrations of delta 5 steroids in 85% of all women and is initiated only after the menopausal transition has begun. While the associated rise in the major adrenal androgen, dehydroepiandrosterone sulfate (DHEAS), is modest, the parallel rises in dehydroepiandrosteone (DHEA) and androstenediol (Adiol) are much more robust. These increases in circulating steroid concentrations are qualitatively similar on average between ethnicities but quantitatively different between individual women. Both circulating testosterone (T) and androstenedione (Adione) also rise concomitantly but modestly by comparison. This phenomenon presents a new and provocative aspect to the endocrine foundations of the menopausal transition and may provide important clues to understanding the fundamentals of mid-aged women's healthy aging, particularly an explanation for the wide diversity in phenotypes observed during the MT as well as their different responses to hormone replacement therapies. Experimental studies using the nonhuman primate animal model show an acute adrenal response to human chorionic gonadotropin (hCG) challenge as well as the presence of luteinizing hormone receptors (LHR) in their adrenal cortices. These experimental results support the concept that LHRs are recruited to the adrenal cortices of mid-aged women that subsequently function to respond to increasing circulating LH to shunt pregnenolone metabolites towards the delta 5 pathway. Future investigations are required to determine the relationship of these changes in adrenal function to symptoms and health outcomes of mid-aged women.
The Women's Health Initiative randomised controlled trials that were mainly of relatively older postmenopausal women, reported that menopausal hormone therapy (MHT) has adverse consequences including an increased risk of breast cancer, coronary heart disease (CHD), venous thromboembolism (VTE) and stroke.
Lund, Kamma Sundgaard; Brodersen, John; Siersma, Volkert
INTRODUCTION: Around 75% of menopausal women experience hot flushes (HF) and 10-20% of all postmenopausal women find this very distressing. The aim of this study is to evaluate the efficacy of acupuncture on moderate-to-severe menopausal symptoms in general and HF in particular. METHODS: An un......-blinded randomised trial (cross-over) with 1:1 allocation to early (intervention) versus late (control) acupuncture. The included women suffer from moderate-to-severe HF and will receive a weekly treatment during five consecutive weeks in the following predefined acupuncture points: CV-3, CV-4, LR-8, SP-6, SP-9. All...... acupuncturists will be medical doctors educated in acupuncture. The primary outcome is change in HF from baseline to week 6 measured by the HF scale from the MenoScores Questionnaire (MSQ). Secondary outcomes are change in other menopausal symptoms, in particular day and night sweats and menopausal...
Full Text Available Abstract Menopausal health is important since this stage of life is not to be avoided. A recent article in BMC Women's Health from the Estonian Postmenopausal Hormone Therapy trial has concluded that quality of life is not related to hormonal therapy use. The commentary article discusses this finding and considers other factors related to symptoms and quality of life during menopause. Important factors known to affect hot flushes and quality of life are smoking and high body weight. Since both these factors are modifiable, menopause is a suitable area for health promotion. However, evidence concerning lifestyle changes in symptom relief or increase of quality of life is weak. More trials in this area are needed before women may consider non-pharmacological treatment of symptoms as a reliable option for menopausal symptom cure.
Comasco, Erika; Frøkjær, Vibe; Sundström-Poromaa, Inger
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....
Kim, Gwang-Won; Jeong, Gwang-Woo
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 (pchanges in the amygdala while viewing erotic video were positively correlated with estrogen levels in the two groups. Our findings suggest that reduced brain activity of the thalamus, amygdala, and ACC in menopausal women may be associated with menopause-related decrease in sexual 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.
Triebner, Kai; Matulonga, Bobette; Johannessen, Ane; Suske, Sandra; Benediktsdóttir, Bryndís; Demoly, Pascal; Dharmage, Shyamali C; Franklin, Karl A; Garcia-Aymerich, Judith; Gullón Blanco, José Antonio; Heinrich, Joachim; Holm, Mathias; Jarvis, Debbie; Jõgi, Rain; Lindberg, Eva; Moratalla Rovira, Jesús Martínez; Muniozguren Agirre, Nerea; Pin, Isabelle; Probst-Hensch, Nicole; Puggini, Luca; Raherison, Chantal; Sánchez-Ramos, José Luis; Schlünssen, Vivi; Sunyer, Jordi; Svanes, Cecilie; Hustad, Steinar; Leynaert, Bénédicte; Gómez Real, Francisco
Menopause is associated with changes in sex hormones, which affect immunity, inflammation, and osteoporosis and may impair lung function. Lung function decline has not previously been investigated in relation to menopause. To study whether lung function decline, assessed by FVC and FEV 1 , is accelerated in women who undergo menopause. The population-based longitudinal European Community Respiratory Health Survey provided serum samples, spirometry, and questionnaire data about respiratory and reproductive health from three study waves (n = 1,438). We measured follicle-stimulating hormone and luteinizing hormone and added information on menstrual patterns to determine menopausal status using latent class analysis. Associations with lung function decline were investigated using linear mixed effects models, adjusting for age, height, weight, pack-years, current smoking, age at completed full-time education, spirometer, and including study center as random effect. Menopausal status was associated with accelerated lung function decline. The adjusted mean FVC decline was increased by -10.2 ml/yr (95% confidence interval [CI], -13.1 to -7.2) in transitional women and -12.5 ml/yr (95% CI, -16.2 to -8.9) in post-menopausal women, compared with women menstruating regularly. The adjusted mean FEV 1 decline increased by -3.8 ml/yr (95% CI, -6.3 to -2.9) in transitional women and -5.2 ml/yr (95% CI, -8.3 to -2.0) in post-menopausal women. Lung function declined more rapidly among transitional and post-menopausal women, in particular for FVC, beyond the expected age change. Clinicians should be aware that respiratory health often deteriorates during reproductive aging.
Rahayu, Dwi Estuning; Indah Rahmaningtyas, Indah Rahmaningtyas; Diana Sulistyo Rini, Diana Sulistyo Rini
Menopause adalah haid terakhir yang dialami oleh wanita yang masih dipengaruhi oleh hormon reproduksi yang terjadi pada usia menjelang/memasuki usia lima puluh tahunan, pada masa ini banyak terjadi Perubahan-Perubahan pada diri wanita menopause, salah satunya adalah berhentinya siklus menstruasi yang dirasakan sebagai hilangnya sifat inti kewanitaannya karena sudah tidak dapat melahirkan anak lagi, Akibat lebih jauh adalah timbulnya perasaan tak berharga, tidak berarti dalam hidup. Perasaan i...
Messina, Giovanni; Viggiano, Andrea; De Luca, Vincenzo; Messina, Antonietta; Chieffi, Sergio; Monda, Marcellino
Menopause is a period of significant physiological changes that may be associated with increased body weight and obesity-related diseases. Many researches were conducted to assess the contribution of factors such as estrogen depletion, REE decline, and aging to weight gain. An increase in orexin-A plasma levels, paralleling lower estrogen levels, was found during menopause. Orexins are hypothalamic neuropeptides recently discovered, involved in the regulation of feeding behaviour, sleep-wakef...
Berent-Spillson, Alison; Marsh, Courtney; Persad, Carol; Randolph, John; Zubieta, Jon-Kar; Smith, Yolanda
Disturbances of emotion regulation and depressive symptoms are common during the menopause transition. Reproductive hormone levels are not directly correlated with depressive symptoms, and other factors may influence mood symptoms during menopause. In this study, we sought to determine the role of metabolic function in mood symptoms during menopause, hypothesizing an association with menopause status and long-term glucose load. We studied 54 women across three menopause transition stages (15 premenopause, 11 perimenopause, and 28 postmenopause), examining effects of age, hormones, and metabolism on mood and neural activation during emotional discrimination. We assessed participants using behavioral and functional MRI measures of negative emotion and emotion discrimination, and glycated hemoglobin A1c, to assess long-term glucose load. We found that emotionally unpleasant images activated emotion regulation (amygdala) and cognitive association brain regions (prefrontal cortex, posterior cingulate, temporal-parietal-occipital (TPO) junction, hippocampus). Cognitive association region activity increased with menopause stage. Perimenopausal women had left TPO junction activation, and postmenopausal women had prefrontal cortex, posterior cingulate, and TPO junction activation. Negative affect was associated with decreased amygdala activation, while depression symptoms and negative mood were associated with increased TPO junction activation. Hemoglobin A1c was associated with negative interpretation bias of neutral images and cognitive region recruitment during emotion discrimination. FSH levels, indicating menopause stage, were associated with negative mood. Age was not associated with any behavioral measures or activation patterns during the emotion task. Our results suggest that an interaction between metabolic and hormonal factors may influence emotion regulation, leading to increased risk for depression during menopause. Copyright © 2016 Elsevier Ltd. All rights
AWARD NUMBER: W81XWH-13-1-0307 TITLE: Why Do Only Some Women Develop Post- Menopausal Osteoporosis ? PRINCIPAL INVESTIGATOR: Marc D...Only Some Women Develop Post-Menopausal Osteoporosis ? 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-13-1-0307 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...proposed project addresses a novel and potentially important mechanism of osteoporosis which may determine which women suffer the disease. Confirmation
Tao, M F; Sun, D M; Shao, H F; Li, C B; Teng, Y C
Whether sleep problems of menopausal women are associated with vasomotor symptoms and/or changes in estrogen levels associated with menopause or age-related changes in sleep architecture is unclear. This study aimed to determine if poor sleep in middle-aged women is correlated with menopause. This study recruited women seeking care for the first time at the menopause outpatient department of our hospital. Inclusion criteria were an age ≥40 years, not taking any medications for menopausal symptoms, and no sleeping problems or depression. Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), modified Kupperman Index (KI), and Menopause Rating Scale (MRS). A PSQI score of menopausal. Follicle-stimulating hormone and estradiol levels were similar between the groups. Patients with a sleep disorder had a significantly higher total modified KI score and total MRS score (both, Pmenopausal and non-menopausal women. These results do not support that menopause per se specifically contributes to sleep problems.
Martínez Pérez, J A; Palacios, S; Chavida, F; Pérez, M
To assess whether the severity of menopausal symptoms is related to increased cardiovascular and osteoporosis risk factors, and to determine whether women with more severe menopausal symptoms present a greater percentage of osteoporosis disease. This was a cross-sectional, descriptive study encompassing women aged 45-65 years in the whole Spanish territory. The study population sample was collected through random sampling. A total of 10 514 women were included. Their sociodemographic, medical history and lifestyle data were assessed by means of a survey. The Kupperman Index was used to assess the severity of menopausal symptoms. Bone mineral density was measured by the dual X-ray absorptiometry method. The prevalences of risk factors for osteoporosis and cardiovascular disease were 67.6% and 74.8%, respectively. Women with a higher intensity of symptoms also had a greater percentage of cardiovascular (p osteoporosis (p osteoporosis disease (p menopausal symptoms were: arterial hypertension (odds ratio (OR) 2.14; 95% confidence interval (CI) 1.49-2.79; p osteoporosis disease (OR 3.71; 95% CI 2.9-4.52; p menopausal symptoms had a greater prevalence of cardiovascular and osteoporosis disease risk factors and suffered more from osteoporosis disease compared to those who had milder or no menopausal symptoms.
Legendre, Guillaume; Ringa, Virginie; Fauconnier, Arnaud; Fritel, Xavier
Whether there is any association between urinary incontinence and menopause is the subject of debate, partly due to the fact it is difficult to tell the difference between the effects of menopause and those of ageing. For some time it was hoped that hormonal treatment for menopause would be beneficial for urinary incontinence because there are hormonal receptors in the urinary tract. The goal of this survey of current knowledge on the subject is to explore thoroughly the relationship between menopause and urinary incontinence. Our study is based on a review of the literature dealing with the epidemiology of urinary incontinence in women aged between 45 and 60, and the effects of hormonal treatment with respect to the symptoms of involuntary loss of urine. Analysis of the epidemiological data drawn from large cohorts shows that on the one hand, the menopause has little if any impact on the risk of urinary incontinence, and on the other hand that the effects of oestrogen medication on urinary incontinence vary according to how it is administered and the type of incontinence. The effect of oral hormone treatments for menopause is rather negative with respect to stress incontinence. Vaginal treatment appears to be beneficial for overactive bladder symptoms. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Yakoot, Mostafa; Salem, Amel; Omar, Abdel-Mohsen
Lady 4 is a combination of 4 natural components (evening primrose oil, damiana, ginseng, royal jelly) with a known history of traditional use for menopausal symptoms. To study efficacy and safety of Lady 4 in women suffering from menopausal syndrome. 120 women with menopausal symptoms were randomised into an experimental group treated with 2 capsules of Lady 4 daily and a control group treated with placebo. The outcome was measured by the Menopause Rating Scale II (MRS-II). There was a statistically significant improvement in the MRS-II score in both groups after 2 and 4 weeks of treatment, but the improvement was significantly better in the Lady 4 group (p < 0.001). 86.7% in the Lady 4 group and 56.7% in the placebo group rated the therapy success as 'much improved' or 'very much improved'. Lady 4 may be beneficial in the treatment of menopausal syndrome and can be used as a safe natural promoter of health and well-being in women during the menopausal transition. Copyright © 2011 S. Karger AG, Basel.
de Vries, Heather F.; Northington, Gina M.; Kaye, Elise M.; Bogner, Hillary R.
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
Khalid, M. M. M.
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
Bassuk, Shari S; Manson, JoAnn E
The Women's Health Initiative (WHI), a landmark randomized trial of menopausal hormone therapy (HT) for prevention of chronic disease in postmenopausal women aged 50-79, established that such therapy neither prevents coronary heart disease (CHD) nor yields a favorable balance of benefits and risks in such women as a whole. However, a nuanced look at the data from this trial, considered alongside other evidence, suggests that timing of HT initiation affects the relation between such therapy and coronary risk, as well as its overall benefit-risk balance. Estrogen may have a beneficial effect on the heart if started in early menopause, when a woman's arteries are likely to be relatively healthy, but a harmful effect if started in late menopause, when those arteries are more likely to show signs of atherosclerotic disease. However, even if HT-associated relative risks are constant across age or time since menopause onset, the low absolute risk of CHD in younger or recently menopausal women translates into low attributable risks in this group. Thus, HT initiation for relief of moderate to severe vasomotor symptoms in early menopausal patients who have a favorable coronary profile remains a viable option. Copyright © 2016 Elsevier Inc. All rights reserved.
María Isabel Capote Bueno
Full Text Available La experiencia de la menopausia es diferente para cada mujer y entre mujeres de diferentes culturas o procedencias. La menopausia no es el final de la vida, sino el comienzo de una etapa que ocupa casi la tercera parte de la vida femenina; por otra parte, se plantea que el climaterio no es el cese de la existencia, sino la etapa que deja abierta las puertas al disfrute de una nueva forma que debe cursar con menos tensión, con menos carga. Según los conceptos de salud, salud mental y salud sexual de la Organización Mundial de la Salud, nada puede impedir que la mujer climatérica sea capaz de ser mental y sexualmente sana; por lo que el profesional de la salud debe estar actualizado en todos aquellos elementos que redunden en un mejor desempeño y en la expresión de la plenitud de las posibilidades físicas, psíquicas y sociales de la mujer en esta etapa. En este artículo se profundiza en los aspectos históricos y conceptuales del climaterio y la menopausia, los elementos esenciales relacionados con los principales síntomas y signos del climaterio, los factores de riesgo en esta etapa, así como en la conducta terapéutica que se debe tener en cuenta para su adecuado manejo, en la atención integral, por los profesionales de la salud.The experience of menopause for each woman is different and among women of different cultures or origin. Menopause is not the end of the life, but the onset of a stage occupying almost the third part of the female life; by other hand, it is proposed that climateric is not the final of existence, but the stage leaving open the doors for the enjoyment of a new way that must to take place with less stress and with less burden. According to the concepts of health, mental health and sexual health from the World Health Organization, nothing may to prevent that climateric woman be able to has a mentally and sexually life; thus, the health professional must to be updated on all those elements having an effect on a
Campbell, S; Whitehead, M
Sixty-four patients with severe menopausal symptoms completed a four month double-blind placebo trial with conjugated equine oestrogens (premarin). Using a graphic rating scale system of assessment, a statistically significant improvement with premarin was observed in 12 psychological and symptomatic scores (Table 3). From a comparison between these results and the results of the 20 patients without vasomotor symptoms it would appear that many of these symptomatic improvements result from the relief of hot flushes (i.e. a domino effect). However, the improvement in memory and reduction of anxiety in these 20 patients suggest that oestrogens have a direct tonic effect on the mental state which is independent of vasomotor symptoms. Sixty-one patients with less severe menopausal symptoms completed the second twelve month double-blind placebo trial and, as assessed by graphic rating scales, a significant improvement with premarin was observed in five psychological and symptomatic scores (Table 3). In both the twelve and four month studies the marked placebo effect of "youthful skin appearance", and on skin greasiness in the twelve month study, indicate that no reliance can be placed on patient judgement of skin texture and appearance. Despite the lessening of the domino effect there was a slight improvement with premarin over placebo in 15 of the remaining 16 symptoms and it is likely that the cumulative effect of these small improvements results in an overall enhancement of well-being. The relief of atrophic vaginitis by premarin did not result in an improvement in libido and this suggests that the ability and the desire to have sexual intercourse are not related. The strength and duration of the placebo effect were well demonstrated in the three standard psychiatric scoring systems, the Beck score (for depression), the General Health Questionnaire and the Eysenck Personality Index (formula: see text) (for neuroticism). We observed a highly significant placebo effect
Purdue-Smithe, Alexandra C; Whitcomb, Brian W; Szegda, Kathleen L; Boutot, Maegan E; Manson, JoAnn E; Hankinson, Susan E; Rosner, Bernard A; Troy, Lisa M; Michels, Karin B; Bertone-Johnson, Elizabeth R
Background: Early menopause, defined as the cessation of ovarian function before the age of 45 y, affects ∼10% of women and is associated with higher risk of cardiovascular disease, osteoporosis, and other conditions. Few modifiable risk factors for early menopause have been identified, but emerging data suggest that high vitamin D intake may reduce risk. Objective: We evaluated how intakes of vitamin D and calcium are associated with the incidence of early menopause in the prospective Nurses' Health Study II (NHS2). Design: Intakes of vitamin D and calcium from foods and supplements were measured every 4 y with the use of a food-frequency questionnaire. Cases of incident early menopause were identified from all participants who were premenopausal at baseline in 1991; over 1.13 million person-years, 2041 women reported having natural menopause before the age of 45 y. We used Cox proportional hazards regression to evaluate relations between intakes of vitamin D and calcium and incident early menopause while accounting for potential confounding factors. Results: After adjustment for age, smoking, and other factors, women with the highest intake of dietary vitamin D (quintile median: 528 IU/d) had a significant 17% lower risk of early menopause than women with the lowest intake [quintile median: 148 IU/d; HR: 0.83 (95% CI: 0.72, 0.95); P -trend = 0.03]. Dietary calcium intake in the highest quintile (median: 1246 mg/d) compared with the lowest (median: 556 mg/d) was associated with a borderline significantly lower risk of early menopause (HR: 0.87; 95% CI: 0.76, 1.00; P -trend = 0.03). Associations were stronger for vitamin D and calcium from dairy sources than from nondairy dietary sources, whereas high supplement use was not associated with lower risk. Conclusions: Findings suggest that high intakes of dietary vitamin D and calcium may be modestly associated with a lower risk of early menopause. Further studies evaluating 25-hydroxyvitamin D concentrations, other
Tepper, Ping G.; Brooks, Maria M.; Randolph, John F.; Crawford, Sybil L.; El Khoudary, Samar R.; Gold, Ellen B.; Lasley, Bill L.; Jones, Bobby; Joffe, Hadine; Hess, Rachel; Avis, Nancy E.; Harlow, Sioban; McConnell, Daniel S.; Bromberger, Joyce T.; Zheng, Huiyong; Ruppert, Kristine; Thurston, Rebecca C.
Objective To investigate the heterogeneity of temporal patterns of vasomotor symptoms (VMS) over the menopausal transition and to identify factors associated with these patterns in a diverse sample of women. Methods The Study of Women's Health Across the Nation is a multi-site longitudinal study of women from five racial/ethnic groups transitioning through the menopause. The analytic sample included 1455 women with non-surgical menopause and a median follow-up of 15.4 years. Temporal patterns of VMS and associations with serum estradiol and follicle stimulation hormone, race/ethnicity, body mass index (BMI), and demographic and psychosocial factors were examined using group-based trajectory modeling. Results Four distinct trajectories of VMS were found: onset early (11 years prior to the final menstrual period (FMP)) with decline after menopause (Early onset, 18.4%); onset near the FMP with later decline (Late onset, 29.0%), onset early with persistently high frequency (High, 25.6%); and persistently low frequency (Low, 27.0%). Relative to women with persistently Low frequency of VMS, women with persistently High and Early onset VMS had a more adverse psychosocial and health profile. Black women were overrepresented in the Late onset and High VMS subgroups relative to white women. Obese women were underrepresented in the Late onset subgroup. In multivariable models, the pattern of estradiol over the menopause was significantly associated with the VMS trajectory. Conclusions These data demonstrate distinctly heterogeneous patterns of menopausal symptoms which are associated with race/ethnicity, reproductive hormones, pre-menopause BMI and psychosocial characteristics. Early targeted intervention may have a meaningful impact on long-term VMS. PMID:27404029
Słopień, Radosław; Wichniak, Adam; Pawlak, Michał; Słopień, Agnieszka; Warenik-Szymankiewicz, Alina; Sajdak, Stefan
The objective of the study was to evaluate the prevalence of sleep continuity disorders in women during menopausal transition, to evaluate the relationship between disturbances of sleep continuity and the severity of menopausal syndrome and the occurrence of various symptoms of this syndrome, as well as to evaluate the association between the presence of sleep disturbances and serum concentrations of gonadotropins, prolactin and sex hormones. Consecutive 140 women (mean age 54.4 ± 4.7 years) searching for the treatment in the Clinic for Gynaecological Endocrinology who reported symptoms of menopausal syndrome were investigated. The type and severity of disturbances of sleep continuity were evaluated using a survey based on the sleep related questions from Hamilton Depression Rating Scale. The severity of symptoms of menopausal syndrome was assessed using the Kupperman Index. The concentration of the following hormones in blood serum was tested: FSH, LH, 17β-estradiol, PRL, total testosterone, DHEAS and SHBG. Disturbances of sleep continuity were a prevalent complaint in the studied group of women. Difficulties in falling asleep were found in 57.8% of women, difficulties in maintaining sleep in 70%, waking up too early in 60.7%. The severity of all three types of sleep continuity disturbances was related to the severity of menopausal syndrome as measured with Kupperman Index (Spearman correlation coefficient r = 0.63, r = 0.61, r = 0.52, respectively; p sleep were negatively correlated with the concentration of FSH (r = - 0.19; p Sleep continuity disturbances are frequently reported by women during the menopausal transition. Interventions aimed at reducing the symptoms of menopausal syndrome should be considered as important action to improve sleep quality in this population of patients.
Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay
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
Garcia, Marcelo Csermak; Pompéia, Sabine; Hachul, Helena; Kozasa, Elisa H; de Souza, Altay Alves L; Tufik, Sergio; Mello, Luiz Eugênio A M
Mindfulness has been defined as being intentionally aware of internal and external experiences that occur at the present moment, without judgment. Techniques that develop mindfulness, such as meditation, have positive effects on reducing insomnia, a sleep disorder that is common both during and after menopause. Our aim was to establish whether postmenopausal women with insomnia are less mindful than postmenopausal women without sleep disorders. Postmenopausal women aged 50 to 65 years who did not use hormone therapy were recruited for the study. The sample included 14 women with insomnia and 12 women without insomnia or any other sleep disorder. The groups were comparable in age, schooling, and anxiety level. To assess mindfulness, we used the validated Mindful Attention Awareness Scale and the attentiveness domain of the Positive and Negative Affect Schedule-Expanded Form. Participants with insomnia were less mindful than healthy women. The level of mindfulness was able to discriminate the group with insomnia from the healthy group, with 71.4% accuracy. Postmenopausal women with insomnia are less mindful than women without insomnia. Mindfulness-based interventions, such as meditation, may be beneficial for postmenopausal insomnia.
Full Text Available The need to use a dental prostheses in women increases with age. Low estrogen level is characteristic in post menopausal women, they are therefore more prone to severe osteoporosis than women at other ages. Osteoporosis is a disease characterized by low bone mass and the developemtn of fractures as a direct result of the low bone mass. In this preliminary study, five women aged between 53 - 62 years were observed. Bone density was determined by means of bone densitometry Lunar DPX-L and panoramic radiographs. The results showed that the tendency of osteopenie (L1, L2 and L3 was associated with the increase of age, while using panoramic radiography there were no mandible radiolucency among those under 60 years. In addition, based on densitometry and panoramic radiography, osteoporos was detected in subjects over 60 years of age. It can be concluded that the quality of the mandible in this study was relatively low among those over 60 years old.
Zhu, Xiaoshu; Liew, Yuklan; Liu, Zhao Lan
Background Chinese herbal medicine (CHM) usage is expected to increase as women suffering from menopausal symptoms are seeking alternative therapy due to concerns from the adverse effects (AEs) associated with hormone therapy (HT). Scientific evidence for their effectiveness and safety is needed. Objectives To evaluate the effectiveness and safety of CHM in the treatment of menopausal symptoms. Search methods We searched the Gynaecology and Fertility Group’s Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), MEDLINE, Embase, CINAHL, AMED, and PsycINFO (from inception to March 2015). Others included Current Control Trials, Citation Indexes, conference abstracts in the ISI Web of Knowledge, LILACS database, PubMed, OpenSIGLE database, and China National Knowledge Infrastructure database (CNKI, 1999 to 2015). Other resources included reference lists of articles as well as direct contact with authors. Selection criteria Randomised controlled trials (RCTs) comparing the effectiveness of CHM with placebo, HT, pharmaceutical drugs, acupuncture, or another CHM formula in women over 18 years of age, and suffering from menopausal symptoms. Data collection and analysis Two review authors independently assessed 864 studies for eligibility. Data extractions were performed by them with disagreements resolved through group discussion and clarification of data or direct contact with the study authors. Data analyses were performed in accordance with Cochrane Collaboration guidelines. Main results We included 22 RCTs (2902 women). Participants were from different ethnic backgrounds with the majority of Chinese origin. When CHM was compared with placebo (eight RCTs), there was little or no evidence of a difference between the groups for the following pooled outcomes: hot flushes per day (MD 0.00, 95% CI −0.88 to 0.89; 2 trials, 199 women; moderate quality evidence); hot flushes per day assessed by an overall hot
D. V Sadchikov
Full Text Available Objective: to study the efficiency of using small-dose estrogens as a component of remedial premedication. Subjects and materials. A hundred and ninety menopausal women were examined. All the patients were divided into a study group and a control one. Group 1 included patients with uterine myoma and menopausal syndrome, which was further divided into two subgroups: Subgroup A comprised patients who as a remedial premedication, along with the standard therapy, received hormonal therapy with oral estradiol in a dose of 2 mg once daily for 7 days. There were no contraindications to the use of these drugs in all the women from this subgroup. Postoperative estrogen therapy was continued in the above doses for a year (as recommended by the International Menopause Committee. Subgroup B consisted of 40 women with menopausal syndrome who received the standard conventional premedication and postoperative therapy. Group 2 included 70 patients with physiological menopause and uterine myoma. Studies were made when remedial premedication was given just before surgery and on discharge from hospital on days 7—8. Results. In the patients with the menopausal syndrome, the level of follicle-stimulating hormone (FSH was ascertained to be higher than that in women with normal menopause, the level of estradiol was accordingly lower. The differences found in the levels of hormones in the patients depending on the clinical course of a menopausal period allowed the use of hormonal replacement therapy with estradiol in the remedial premedication regimen as both etiologically and pathogenetically founded. On admission, the first stage of psychoemotional testing before remedial premedication revealed impairments of memory, attention, and thinking, as well as high anxiety in all the patients with myoma and menopausal syndrome. There was a significant reduction in long-term memory and memorization. Seven days after preoperative preparation using estradiol, 2 mg/day, there
Donati, Serena; Satolli, Roberto; Colombo, Cinzia; Senatore, Sabrina; Cotichini, Rodolfo; Da Cas, Roberto; Spila Alegiani, Stefania; Mosconi, Paola
Hormone therapy (HT) in the menopause is still a tricky question among healthcare providers, women and mass media. Informing women about hormone replacement therapy was a Consensus Conference (CC) organized in 2008: the project Know the Menopause has been launched to shift out the results to women and healthcare providers and to assess the impact of the cc's statement. And Findings: The project, aimed at women aged 45-60 years, was developed in four Italian Regions: Lombardy, Tuscany, Lazio, Sicily, each with one Local Health Unit (LHU) as "intervention" and one as "control". Activities performed were: survey on the press; training courses for health professionals; educational materials for target populations; survey aimed at women, general practitioners (GPs), and gynaecologists; data analysis on HT drugs' prescription. Local activities were: training courses; public meetings; dissemination on mass media. About 3,700 health professionals were contacted and 1,800 participated in the project. About 146,500 printed leaflets on menopause were distributed to facilitate the dialogue among women and health care professionals. Training courses and educational cascade-process activities: participation ranged 25- 72% of GPs, 17-71% of gynaecologists, 14-78% of pharmacists, 34-85% of midwives. 1,281 women interviewed. More than 90% believed menopause was a normal phase in life. More than half did not receive information about menopause and therapies. HT prescription analysis: prevalence fell from 6% to 4% in five years. No differences in time trends before-after the intervention. Major limitations are: organizational difficulties met by LHU, too short time for some local activities. A huge amount of information was spread through health professionals and women. The issue of menopause was also used to discuss women's wellbeing. This project offered an opportunity to launch a multidisciplinary, multimodal approach to menopause looking not only at pharmacological aspects, but
Berent-Spillson, Alison; Persad, Carol C; Love, Tiffany; Sowers, MaryFran; Randolph, John F; Zubieta, Jon-Kar; Smith, Yolanda R
Cognitive decline is prevalent in aging populations, and cognitive complaints are common during menopause. However, the extent of hormonal influence is unclear, particularly when considered independent of the aging process. We sought to determine differences in cognitive function attributable to menopause, hypothesizing that differences would be associated with reproductive rather than chronological age. In this cross-sectional study at a university hospital, we combined neuropsychological measures with functional magnetic resonance imaging to comprehensively assess cognitive function. Sixty-seven menopausal women, aged 42-61 yr, recruited from a population-based menopause study, grouped into menopause stages based on hormonal and cycle criteria (premenopause, perimenopause, and postmenopause), participated in the study. Neuropsychological and functional magnetic resonance imaging measures of verbal, visual, and executive cognitive function. We found age-independent menopause effects on verbal function. Menopause groups differed in phonemic verbal fluency (F = 3.58, P menopausal transition. Targeted intervention may preserve function of this critical cognitive domain.
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.
Full Text Available Sex hormones strongly influence body fat distribution and adipocyte differentiation. Estrogens and testosterone differentially affect adipocyte physiology, but the importance of estrogens in the development of metabolic diseases during menopause is disputed. Estrogens and estrogen receptors regulate various aspects of glucose and lipid metabolism. Disturbances of this metabolic signal lead to the development of metabolic syndrome and a higher cardiovascular risk in women. The absence of estrogens is a clue factor in the onset of cardiovascular disease during the menopausal period, which is characterized by lipid profile variations and predominant abdominal fat accumulation. However, influence of the absence of these hormones and its relationship to higher obesity in women during menopause are not clear. This systematic review discusses of the role of estrogens and estrogen receptors in adipocyte differentiation, and its control by the central nervous systemn and the possible role of estrogen-like compounds and endocrine disruptors chemicals are discussed. Finally, the interaction between the decrease in estrogen secretion and the prevalence of obesity in menopausal women is examined. We will consider if the absence of estrogens have a significant effect of obesity in menopausal women.
Baber, R J; Wright, J
Although some understanding of post-reproductive life dates back to Ancient Greece, the term 'menopause' was only introduced in the early 1800s by a French physician. Notwithstanding familiarity with the condition at that time, treatments were largely ineffective, often harmful and never evidence-based, and it was not until 100 years later with the identification and description of estrogen and progesterone that effective treatments became available. So efficacious were hormone therapies for menopausal symptoms that their prescription was often recommended for all postmenopausal women regardless of their needs, wishes or health status. For many there was benefit but for some there was harm. It was in this environment that a small group of clinicians determined to form an International Menopause Society (IMS) to conduct research into the appropriate use of hormone therapy in treating menopause symptoms, to hold regular congresses to educate colleagues and discuss research results and thus to improve the health and well-being of women in midlife and beyond. Formed in 1978, the IMS is now recognized as the global leader in its field, working towards these goals in collaboration with colleagues and other national and regional societies concerned with women's health. During that time, the IMS has been led by 13 Presidents and has conducted 15 World Congresses on the Menopause, all of which are reviewed in this paper.
Cohen, Lee S; Soares, Claudio N; Joffe, Hadine
Recent census data indicate that, in the United States, an increasing number of women--almost 1.5 million each year--are reaching menopause. The menopausal transition is marked by intense hormonal fluctuations, and may be accompanied by vasomotor complaints, sleep disturbances, changes in sexual function, and increased risk for osteoporosis and cardiovascular disease. In addition, there is evidence of increased risk for developing depression, even among women who never experienced depressive symptoms before. Thus depression during the perimenopause may have a substantial impact on personal, family, and professional spheres of life. A challenge to clinicians and health professionals lies in the identification of the most tolerable treatments to manage depression and improve quality of life in an aging population. Any treatment strategy should take into account not only the spectrum of side effects that may complicate treatment but also other menopause-related factors (e.g., vasomotor symptoms, psychosocial stressors) that may modulate risk for the development of mood disturbance. This article reviews the current literature on the prevalence and risk factors associated with depression during the menopausal transition. The benefits and risks of using hormonal and nonhormonal strategies for the management of depression and other menopause-related somatic symptoms are critically reviewed.
Trudeau, Kimberlee J; Ainscough, Jessica L; Trant, Meredith; Starker, Joan; Cousineau, Tara M
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.
2016 Background : Menopause is a normal biological changes in a women???s life. Age of menopause is about 40 - 60 years old and is characterized by the cessation of reproductive function permanently. During menopause, gingival epithelium becomes thinner, atrophic and more prone to inflammatory changes. Estrogen production that occurs in menopause is considered to be the main cause of primary osteoporosis, which also affects jawbones. Estrogens also interfere with other perio...
Ebong, Imo A; Watson, Karol E; Goff, David C; Bluemke, David A; Srikanthan, Preethi; Horwich, Tamara; Bertoni, Alain G
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.
Tal, Joshua Z.; Suh, Sooyeon A.; Dowdle, Claire L.; Nowakowski, Sara
Understanding sleep complaints among menopausal women is an emerging area of clinical and research interest. Several recent reviews have focused on mechanisms of menopausal insomnia and symptoms. In this review, we present a discussion on the most relevant and recent publications on the treatment of sleep disorders for menopausal women, with a focus on menopause-related insomnia, insomnia symptoms, and obstructive sleep apnea. We discuss both nonpharmacological and pharmacological treatments,...
Liang Hu; Li Zhu; Jiaying Lyu; Wenjun Zhu; Yaping Xu; Lin Yang
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...
Chair, Sek Ying; Wang, Qun; Cheng, Ho Yu; Lo, Sally Wai-Sze; Li, Xiao Mei; Wong, Eliza Mi-Ling; Sit, Janet Wing-Hung
Background Menopause is an inevitable stage affecting every middle-aged woman. China has a large and increasing group of post-menopausal women. Most post-menopausal women suffer from increased risks for cardiovascular diseases (CVD) and sleep problems. Previous studies have demonstrated the associations between sleep disorders and increased CVD risks in general population. The current study is to examine the relationship between sleep quality and CVD risks among Chinese post-menopausal women....
Matthews, Karen A.; And Others
Investigated psychological and symptom consequences of natural menopause in longitudinal study of 541 initially premenopausal healthy women. Findings 3 years later from 101 menopausal women and control group of 101 premenopausal women revealed that natural menopause led to few changes in psychological characteristics, with only decline in…
Praju Susiana Marga
Menopause adalah suatu masa berakhirnya reproduksi wanita yang disebabkan berkurangnya hormon estrogen dan progesteron yang ditandai dengan berhentinya haid. Pada masa menopause terjadi perubahan-perubahan fisik dan psikologis yang menimbulkan perubahan pada gambaran diri (body image). Perubahan ini menimbulkan stress tersendiri bagi ibu menopause, jika ibu tidak dapat beradaptasi, kondisi stress tersebut akan menyebabkan kecemasan. Penelitian deskriptif korelasi ini bertujuan untuk mengid...
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
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
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.
Lambert, Max Norman Tandrup; Thorup, Anne Cathrine Sønderstgaard; Søvsø Szocska Hansen, Esben
treatment to alleviate existing menopausal VMS, assessed for the first time by 24hour ambulatory skin conductance (SC) Methods and results We conducted a parallel, double blind, randomised control trial of 62 peri-menopausal women aged 40±65, reporting 5 hot flushes/day and follicle stimulating hormone 35...... in future studies on menopausal VMS....
Morris, Danielle H; Jones, Michael E; Schoemaker, Minouk J; Ashworth, Alan; Swerdlow, Anthony J
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.
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.
Brand, J. S.; Onland-Moret, N. C.; Eijkemans, M. J C; Tjønneland, A.; Roswall, N.; Overvad, K.; Fagherazzi, G.; Clavel-Chapelon, F.; Dossus, L.; Lukanova, A.; Grote, V.; Bergmann, M. M.; Boeing, H.; Trichopoulou, A.; Tzivoglou, M.; Trichopoulos, D.; Grioni, S.; Mattiello, A.; Masala, G.; Tumino, R.; Vineis, P.; Bueno-De-Mesquita, H. B.; Weiderpass, E.; Redondo, M. L.; Sánchez, M. J.; Castaño, J. M Huerta; Arriola, L.; Ardanaz, E.; Duell, E. J.; Rolandsson, O.; Franks, P. W.; Butt, S.; Nilsson, P.; Khaw, K. T.; Wareham, N.; Travis, R.; Romieu, I.; Gunter, M. J.; Riboli, E.; Van Der Schouw, Y. T.
STUDY QUESTION Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? SUMMARY ANSWER Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate
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.
Kwon, Jong Kyu; Kim, Jae Heon; Choi, Hoon; Chang, In Ho; Park, Bo Ra; Kwon, Soon-Sun; Lee, Eun Sil; Choi, Gyu Yeon; Lee, Jeong Jae; Lee, Im Soon
To characterize voiding symptoms during the peri- and post-menopausal periods and to investigate related hormonal changes. We enrolled a total of 55 patients between February 10, 2013, and August 15, 2013, to participate in this cross-sectional study. To characterize patients' voiding symptoms, we administered voiding questionnaires, including the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and Sandvik Severity Index. Measured hormones included E2, FSH, TSH, prolactin, progesterone, and testosterone. In the univariate analysis, there were significant intergroup differences for all of the hormones except progesterone. Among the voiding symptoms, straining (IPSS question 1), frequency (IPSS question 2), and SUI were significantly different between the two groups (p=0.039. 0.010, and 0.017, respectively). In the multivariate analysis, frequency (IPSS question 2) and SUI were significantly different between the two groups (p=0.020 and 0.011, respectively). Among the hormones, only testosterone was marginally different between the two groups (p=0.059). During the transition to menopause, voiding symptoms, such as frequency, can potentially worsen in the peri-menopausal period, and SUI is more prevalent in the post-menopausal period. Additionally, testosterone may have a role in voiding changes that occur during the menopausal transition. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Depmann, Martine; Broer, Simone L; van der Schouw, Yvonne T; Tehrani, Fahimeh R; Eijkemans, Marinus J; Mol, Ben W; Broekmans, Frank J
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.
Menopause is puzzling because life-history theory predicts there should be no selection for outliving one's reproductive capacity. Adaptive explanations of menopause offered thus far turn on women's long-term investment in offspring and grandoffspring, all variations on the grandmother hypothesis. Here, I offer a very different explanation. The patriarch hypothesis proposes that once males became capable of maintaining high status and reproductive access beyond their peak physical condition, selection favored the extension of maximum life span in males. Because the relevant genes were not on the Y chromosome, life span increased in females as well. However, the female reproductive span was constrained by the depletion of viable oocytes, which resulted in menopause.
Boldsen, J L; Jeune, B
We analyzed the distribution of reported age at natural menopause in two random samples of Danish women (n = 176 and n = 150) to determine the shape of the distribution and to disclose any possible trends in the distribution parameters. It was necessary to correct the frequencies of the reported...... 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....
Boldsen, J L; Jeune, B
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......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...... 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....
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, estrogens 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
The menopause is characterized by an array of changes to the female body caused by modulations which occur in the production of estrogens and androgens. The ovaries are important sites of testosterone production in the peri- and postmenopausal women, but the contribution of testosterone pro-hormones from the adrenal glands falls precipitously to the extent where the ovaries cannot correct the deficit. This results in a net decline in circulating testosterone levels. This paper gives an overview of this interesting subject area. Researchers have cogitated on the relationship between the physical effects of the menopause and the observed declines in testosterone levels, but it is now much clearer that falling testosterone levels cannot explain all of these changes. The cessation of follicular functioning results in a steep decline in the production of estrogens. This modulation is responsible for the physical manifestations of the menopause--hot flushes, sleep disturbances, mood changes, bleeding problems, local urogenital problems, vaginal changes, etc. A review of the pertinent literature was conducted to investigate hormonal changes around the menopause. A précis of the salient information is presented here. Although the most obvious and well-known effects of the menopause are due to the decline of estrogen levels, the effects of falling testosterone levels are subtle, but by no means less significant. Reductions in sexual motivation, sexual arousal, vaginal lubrication, etc. are all associated with plummeting androgen levels. Today, several options exist for the treatment of the endocrinological changes associated with the menopause. Estrogen deficiency can be corrected with hormone replacement therapy and topical preparations for the genitalia. A new transdermal system for the administration of testosterone shows a great deal of potential for the treatment of androgen deficiency.
Sánchez-Guerrero, Jorge; González-Pérez, Marisol; Durand-Carbajal, Marta; Lara-Reyes, Pilar; Jiménez-Santana, Luisa; Romero-Díaz, Juanita; Cravioto, María-del-Carmen
To evaluate the effects of menopause hormonal therapy on disease activity in women with systemic lupus erythematosus (SLE). We conducted a double-blind, randomized clinical trial involving 106 women with SLE who were in the menopausal transition or in early or late postmenopause. Patients received a continuous-sequential estrogen-progestogen regimen (n = 52) or placebo (n = 54). Disease activity was assessed at baseline and at 1, 2, 3, 6, 9, 12, 15, 18, 21, and 24 months, according to the SLE Disease Activity Index (SLEDAI). The primary outcome measure was global disease activity, estimated by measuring the area under the SLEDAI curve. Secondary outcome measures included maximum SLEDAI score, change in SLEDAI score, incidence of lupus flares, median time to flare, medication use, and adverse events. Results were studied using intent-to-treat analysis. At baseline, demographic and disease characteristics were similar in both groups. Mean +/- SD SLEDAI scores were 3.5 +/- 3.3 and 3.1 +/- 3.4 in the menopause hormonal therapy and placebo groups, respectively (P = 0.57). Disease activity remained mild and stable in both groups throughout the trial. There were no significant differences between the groups in global or maximum disease activity, incidence or probability of flares, or medication use. Median time to flare was 3 months in both groups. Thromboses occurred in 3 patients who received menopause hormonal therapy and in 1 patient who received placebo. One patient in each group died during the trial due to sepsis. Menopause hormonal therapy did not alter disease activity during 2 years of treatment. However, an apparently increased risk of thrombosis seems to be a real threat in women with SLE who receive menopausal hormone therapy.
Jack, Gavin; Riach, Kathleen; Bariola, Emily; Pitts, Marian; Schapper, Jan; Sarrel, Philip
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.
Monterrosa-Castro, A; Blümel, J E; Portela-Buelvas, K; Mezones-Holguín, E; Barón, G; Bencosme, A; Benítez, Z; Bravo, L M; Calle, A; Chedraui, P; Flores, D; Espinoza, M T; Gómez, G; Hernández-Bueno, J A; Laribezcoa, F; Lima, S; Martino, M; Mostajo, D; Ojeda, E; Onatra, W; Sánchez, H; Navarro, D; Tserotas, K; Vallejo, M S; Witis, S; Zuñiga, M C
Type II diabetes mellitus causes metabolic changes that may lead to early menopause and worsen climacteric symptoms. To determine the risk factors for type II diabetes mellitus and assess the impact of this disease on the age of menopause and on climacteric symptoms. A total of 6079 women aged between 40 and 59 years from 11 Latin American countries were requested to answer the Menopause Rating Scale and Goldberg Anxiety-Depression Scale. The prevalence of diabetes was 6.7%. Diabetes mellitus was associated with arterial hypertension (odds ratio (OR) 4.49; 95% confidence interval (CI) 3.47-5.31), the use of psychotropic drugs (OR 1.54; 95% CI 1.22-1.94), hormonal therapy (OR 1.46; 95% CI 1.11-1.92), ≥ 50 years of age (OR 1.48; 95% CI 1.17-1.86), overweight or obese (OR 1.47; 95% CI 1.15-1.89), and waist circumference ≥ 88 cm (OR 1.32; 95% CI 1.06-1.65). Factors associated with lower risk of diabetes were the use of hormonal contraceptives (OR 0.55; 95% CI 0.35-0.87), alcohol (OR 0.73; 95% CI 0.54-0.98) and living in cities > 2500 meters above sea level (OR 0.70; 95% CI 0.53-0.91) or with high temperatures (OR 0.67; 95% CI 0.51-0.88). In turn, diabetes tripled the risk of menopause in women under 45 years of age. Diabetes did not increase the risk of deterioration of quality of life due to climacteric symptoms. Menopause does not increase the risk of type II diabetes mellitus. Diabetes is associated with early menopause in women under 45 years of age.
Lampio, Laura; Polo-Kantola, Päivi; Himanen, Sari-Leena; Kurki, Samu; Huupponen, Eero; Engblom, Janne; Heinonen, Olli J; Polo, Olli; Saaresranta, Tarja
Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition. Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models. After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B -37.4, 95% confidence interval [CI] -71.5 to (-3.3)), lower sleep efficiency (B -6.5, 95%CI -12.7 to (-0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95%CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95%CI 12.5 to 63.0), awakenings per hour (B 1.8, 95%CI 0.8 to 2.8), and arousal index (B 2.3, 95%CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95%CI 0.01 to 0.16) after controlling for confounding factors. A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail firstname.lastname@example.org.
Sievert, Lynnette Leidy; Goode-Null, Susan K
Worldwide, complaints of musculoskeletal pain are more frequent than complaints of hot flashes amongst women of menopausal age. The purpose of this study was to examine musculoskeletal pain among women of menopausal age in the city of Puebla, Mexico. An opportunity sample was recruited from public parks and markets, with representation from all social classes (n=755). Mean age was 50.1 years, and the majority were employed as saleswomen in small businesses. Symptom frequencies were collected by open-ended interviews and with a structured symptom list that queried symptom experience during the two weeks prior to interview. In response to open-ended questions, "dolores de huesos" (bone pain) was volunteered by 47% of respondents as a symptom associated with menopause, second only to hot flashes (53%). From the structured symptom list, 55.8% and 55.6% reported back pain and joint stiffness during the two weeks prior to interview. Women with back pain and joint stiffness were less likely to report being active during their leisure time (p<.01). The results of backwards stepwise logistic regressions indicate that women with back pain were more likely to be older, with less education, a higher BMI, and ate less meat. Women with joint pain were more likely to be post-menopausal, with less education, more children, a higher BMI, and were likely to drink milk and coffee more than once/week but less than once/day. While menopause is not necessarily a risk factor for musculoskeletal pain, it is important to recognize the pervasiveness of this complaint among women of menopausal age.
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
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.
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
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.
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
Objective The study objective was to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopausal status modifies response to diabetes prevention interventions. Methods The study population included women in premenopause (n=708), natural postmenopause (n=328), and bilateral oophorectomy (n=201) in the Diabetes Prevention Program (DPP), 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 (HT) use. Results 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 (HR 0.19, 95% CI 0.04, 0.94), although observations were too few to determine if this was independent of HT 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). Conclusions 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 decreased diabetes risk. PMID:21709591
Collins Fantasia, Heidi; Sutherland, Melissa A
Many women will undergo menopause without incident, but others will experience bothersome effects resulting from declining estrogen levels. Vasomotor symptoms, which manifest as intense feelings of warmth, flushing, and perspiration, are the most common symptoms for which women seek treatment. Hormone therapy is indicated for the relief of vasomotor symptoms related to menopause. We review current Food Drug Administration-approved options for hormone therapy and discuss implications for practice and patient education. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
Full Text Available The purpose of this study was to explore how a small group of white South African men going through menopause attached meaning to this major event in their lives, and also how it affected the decisions they took as leaders in the financial sector. The findings indicated that menopause symptoms in particular (physical, psychological and sexual dimensions had a profound influence on the systemic male. A provisional substantive theory was developed – “work power trade-offs result in decreased decision-making power during the male menopause�? – and a number of recommendations were proposed
Castelo-Branco, Camil; Biglia, Nicoletta; Nappi, Rossella E; Schwenkhagen, Anne; Palacios, Santiago
Vulvovaginal atrophy (VVA), also known as genitourinary syndrome of menopause, exerts a negative impact on the sexuality, health and quality of life of post-menopausal women. A better understanding of post-menopausal women's profiles as defined by their attitude and behaviours in relation to their VVA symptoms may improve public health policies and will allow appropriate targeting of public health campaigns. These improvements may help women of middle and advanced age recover and maintain their quality of life. In this study, we analysed the attitudes of post-menopausal women, aged 45-74 years, with VVA symptoms from five European countries, with the aim of identifying profile markers to improve healthcare strategies. Two consecutive cross-sectional studies were conducted in five European countries (the UK, France, Spain, Germany and Italy). An initial exploratory study (n=69) was based on interviews and then an analytical study (n=749) was based on online surveys to validate women's profiles by means of a multi-level approach. We identified eight profiles: self-treater, pragmatic, vivacious, reserved, silent sufferer, expressive, stoic and sad. The percentage distribution varied among the countries. The 'pragmatic', 'vivacious' and 'expressive' women were the most proactive, talkative and open with their healthcare professional, whereas women with the 'reserved' and 'stoic' profiles showed less interest in searching for information about their VVA symptoms, either from their healthcare professional or from other sources. The attitudes and behaviours of post-menopausal women in relation to their VVA allow for the clear definition of a series of profiles with varying representation across countries. This study reveals the importance of identifying post-menopausal women's profiles to develop interventions to help them overcome barriers to the diagnosis, management and treatment of VVA. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Dilbar K. Najmutdinova
Full Text Available The aim of the present study was to determine whether an association exists between the duration of menopause and the age of menopause onset, and the differences in bone mineral density (BMD in postmenopausal women. Materials and Methods: We have reviewed medical records of 112 postmenopausal women who had not taken any anti-osteoporosis treatment and/or hormone replacement therapy at the time of BMD measurement. The mean age of the postmenopausal women was 53.5±1.1 years, and the mean menopausal period was 4.5 years. The women were evaluated according to the duration of menopause at the time of BMD measurement and age at menopause onset. BMD was measured anteroposteriorly at the L1–L4 level by the dual-energy X-ray absorptiometry method. Results: According to WHO criteria, osteoporosis and osteopenia were identified in 18(16.2% and 44(39.2% cases, respectively; overall, 50(44.6% women had normal BMD.At the time of BMD measurement, osteoporosis was determined in 10.3% and 29.1% of the women with menopause duration of 0–3 years and >7 years, respectively (P=0.047. The percentages for osteopenia were similar among the three different menopause durations (36.2%, 43.3% and 41.6% for 0-3 years, 4-7 years and >7 years, respectively. No differences were determined in the prevalence of osteopenia and osteoporosis in women with menopause duration of >7 years.Thirty-three percent of women with the age of menopause onset of 52 years, respectively. The frequency of osteopenia did not differ between the groups according to the age of menopause onset. Conclusion: According to our results, osteoporosis is related to the duration of menopause at the time of BMD measurement more than to the age of menopause onset among untreated postmenopausal women.
Perich, Tania; Ussher, Jane; Parton, Chloe
Background 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. Methods Semi-structured interviews were undertaken with fifteen women who reported they had been diagnosed with ...
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
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.
Rangel-Zuñiga, Oriol A; Cruz-Teno, Cristina; Haro, Carmen; Quintana-Navarro, Gracia M; Camara-Martos, Fernando; Perez-Martinez, Pablo; Garcia-Rios, Antonio; Garaulet, Marta; Tena-Sempere, Manuel; Lopez-Miranda, Jose; Perez-Jimenez, Francisco; Camargo, Antonio
Menopause is characterized by the depletion of estrogen that has been proposed to cause oxidative stress. Circadian rhythm is an internal biological clock that controls physiological processes. It was analyzed the gene expression in peripheral blood mononuclear cells and the lipids and glucose levels in plasma of a subgroup of 17 pre-menopausal women, 19 men age-matched as control group for the pre-menopausal women, 20 post-menopausal women and 20 men age-matched as control group for the post-menopausal women; all groups were matched by body mass index. Our study showed a decrease in the expression of the oxidative stress-related gene GPX1, and an increase in the expression of SOD1 as consequence of menopause. In addition, we found that the circadian rhythm-related gene PER2 decreased as consequence of menopause. On the other hand, we observed a decrease in the expression of the oxidative stress-related gene GPX4 and an increase in the expression of CAT as a consequence of aging, independently of menopause. Our results suggest that the menopause-induced oxidative stress parallels a disruption in the circadian clock in women, and part of the differences in oxidative stress observed between pre- and post-menopausal women was due to aging, independent of menopause. Clinical Trials.gov.Identifier: NCT00924937. Copyright © 2017 Elsevier B.V. All rights reserved.
Sayakhot, Padaphet; Vincent, Amanda; Teede, Helena
The aim of this study was to describe the partners' perceptions, understanding, and personal experiences of early menopause and menopausal therapy in women with breast cancer. A questionnaire study was completed by 50 partners of women with diagnoses of breast cancer, recruited via outpatient clinics and the community. Descriptive statistics and χ tests were applied. Most (68%) of the partners perceived hot flushes as the meaning of menopause. Most (60%) partners perceived that loss of sexuality was the key problem/fears about being menopausal. Partners perceived that exercise (72%) and reducing stress (64%) were most effective in alleviating symptoms of menopause. Most partners reported that they did not understand the risks/benefits of hormone therapy (50%), bioidentical hormones (90%), and herbal therapies (84%). The general practitioner was considered the best source of information on menopause (68%). Partners expected menopause to affect a women's everyday life and relationships with family and partner and, particularly, to cause intermittent stress on the relationship (66%) and to decrease libido or sexual interest (64%). Forty-four percent of partners reported that there was some difficulty in communication/discussion about menopause with family and partners. This pilot study highlights (1) the lack of understanding of menopause and menopausal therapies that partners of women with breast cancer have, (2) the personal experience of having a female partner with breast cancer, and (3) the partners' attitudes and responses toward menopause in women with breast cancer.
Bauld, Rosie; Brown, Rhonda F
Relatively few studies have evaluated relationships between stress, psychological distress, psychosocial factors and menopause symptoms, and none have evaluated emotional intelligence (EI) in relation to menopause. In this study, direct and indirect relationships were evaluated between stress, psychological distress, psychosocial factors (e.g. social support, coping, EI), menopause symptom severity and physical health in middle-aged women. One hundred and sixteen women aged 45-55 years were recruited through women's health centres and community organizations. They completed a short questionnaire asking about stress, psychological distress (i.e. anxiety, depression), EI, attitude to menopause, menopause symptoms and physical health. Low emotional intelligence was found to be related to worse menopause symptoms and physical health, and these associations were partly mediated by high stress, anxiety and depression, a negative attitude to menopause and low proactive coping. Women with high EI appear to hold more positive attitudes to menopause and experience less severe stress, psychological distress and menopause symptoms and better physical health. These results suggest that women who expect menopause to be a negative experience or are highly stressed or distressed may be more likely to experience a more negative menopause.
Andersen, Claus Yding; Kristensen, Stine Gry
Life expectancy has increased by more than 30 years during the last century and continues to increase. Many women already live decades in menopause deprived of naturally produced oestradiol and progesterone, leading to an increasing incidence of menopause-related disorders such as osteoporosis......, cardiovascular diseases and lack of general well-being. Exogenous oestradiol has traditionally been used to alleviate menopause-related effects. This commentary discusses a radical new method to postpone menopause. Part of the enormous surplus of ovarian follicles can now be cryostored in youth for use after...... 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...
Nyberg, Michael Permin; Seidelin, Kåre; Rostgaard Andersen, Thomas
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...
Streuli, I; Gaitzsch, H; Wenger, J-M; Petignat, P
Endometriosis is a hormone-dependent inflammatory disease that is usually characterized by infertility and pain symptoms. This disease mainly occurs during the reproductive years and is rarely diagnosed after menopause. We discuss the physiopathology of this condition after menopause as well as treatment options and the risk of malignant transformation. Occurrence or progression of postmenopausal endometriosis lesions could be related to extra-ovarian production of estrogen by endometriosis lesions and adipose tissue, which becomes the major estrogen-producing tissue after menopause. Postmenopausal women with symptomatic endometriosis should be managed surgically because of the risk of malignancy; medical treatments can be used in cases of pain recurrence after surgery. Aromatase inhibitors act by decreasing extra-ovarian estrogen production and by blocking the feed-forward stimulation loop between inflammation and aromatase within endometriosis lesions. The evidence is currently insufficient to support a conclusion about the optimal hormone replacement therapy for women with endometriosis. The question of malignant transformation of endometriosis in response to hormone replacement therapy in women with a history of endometriosis remains unanswered and needs a long-term follow-up study to evaluate the risk of an adverse outcome. Further studies should be performed to determine the optimal management of menopausal women with endometriosis.
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...
Depression, anxiety, and stress symptoms in menopausal arab women: Shedding more light on a complex relationship. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about ...
Lutter, Judy Mahle; And Others
Examines the results of a 1991 pilot study of the characteristics of the menopausal experience for women between the ages of 45 and 55. Specific items reported are physical health data and perceptions of factors affecting health status (diet, health characteristics, stress factors, and life changes). (GLR)
Freeman, Ellen W; Sammel, Mary D; Lin, Hui; Gracia, Clarisa R
The aim of this study was to estimate associations of obesity with reproductive hormone levels as women progress from premenopausal to postmenopausal status. This was a longitudinal study conducted in the population-based Penn Ovarian Aging Cohort (N = 436). At cohort enrollment, the women were premenopausal, ages 35 to 47 years, with equal numbers of African Americans and whites. Anthropometric measures, menopause status, and reproductive hormone measures were evaluated for 12 years. Associations of the anthropometric measures with estradiol, follicle-stimulating hormone, and inhibin B in the menopausal transition were estimated using generalized linear regression models for repeated measures. Associations between obesity and hormone levels differed by menopause status as indicated by significant interactions between each hormone and menopausal stage. Premenopausal obese and overweight women had significantly lower estradiol levels compared with nonobese women, independent of age, race, and smoking (obese: 32.8 pg/mL [95% CI, 30.6-35.2] vs nonobese: 39.8 pg/mL [95% CI, 37.0-42.8], P hormone levels were lowest in postmenopausal obese compared with nonobese women (P hormone dynamics independent of age, race, and smoking in midlife women, although the mechanisms remain unclear.
Oral health is an integral part of general health. Menopausal period has an important role in the reproductive life of a woman and gives rise to many physical and mental problems. The oral manifestations may vary for each patient in the form of burning mouth syndrome, xerostomia, mucosal changes, neurological disorders, ...
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 ...
Assadi, Seyedeh Negar
Workplace exposures as in clinical work can cause disorders. Some organ systems are at risk. This work may be a risk factor for early symptoms of menopause. The objective of this study was to compare the early symptoms of menopause between hospital personnel who work in clinical and office settings. This was a historical cohort study conducted on clinical and office workers of hospitals. The study was conducted using a flexible interview conducted with a questionnaire among personnel of age 40 years and above. According to their menopausal status, they were divided into three phases: premenopause, perimenopause, and postmenopause. Symptoms in 10 items were assessed and scored from 1 to 10, and were compared. Data were analyzed with SPSS 16, t-test, and Chi-square tests and were calculated considering P flashing and sweating was 1.879 (1.457-2.423) and in the office personnel, it was 0.192 (0.030-1.238). In the clinical group, the odds ratio for anxiety and irritability was 2.029 (1.660-2.481) and in the office personnel, it was 0.116 (0.017-0.779). Clinical personnel had higher risk for early menopausal symptoms such as flashing, sweating, anxiety, and irritability. Assessing the health of these personnel may help to improve their reproductive health. The person with reproductive risk factors is not suitable for clinical work.
Al-Saqi, Shahla H; Uvnäs-Moberg, Kerstin; Jonasson, Aino F
To explore the efficacy of local oxytocin for the treatment of post-menopausal vaginal atrophy. Double-blinded randomised controlled trial. Healthy post-menopausal women in Stockholm, Sweden. Sixty four post-menopausal women between February and June 2012 at the Karolinska University Hospital Huddinge/Sweden. The efficacy of oxytocin for treatment of vaginal atrophy after seven weeks and cytological evaluation. The percentage of superficial cells in the vaginal smears and the maturation values were significantly increased after seven weeks of treatment with vagitocin 400 IU (p = 0.0288 and p = 0.0002, respectively). The vaginal pH decreased significantly after seven weeks of treatment with vagitocin 100 IU (p = 0.02). The scores of vaginal atrophy, according to the histological evaluation, were significantly reduced after administration of vagitocin 100 IU (p = 0.03). The thickness of the endometrium did not differ between the treatment and placebo groups after seven weeks of treatment. The symptom experienced as the most bothersome was significantly reduced after seven weeks of treatment in the women receiving vagitocin 400 IU compared to women in the placebo group (p = 0.0089). Treatment with intravaginally applied oxytocin could be an alternative to local estrogen treatment in women with post-menopausal vaginal atrophy. © The Author(s) 2015.
Lanfranchi, P. A.; Gosselin, N.; Kára, T.; Jurák, Pavel; Somers, V. K.; Denesle, R.; Petit, D.; Carrier, J.; Nadeau, R.; Montplaisir, J.
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
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 ...
Jan 15, 2013 ... they will embrace the new self or try to cling to identities from earlier life but also how the society in ... animal, a boy or girl-child and 'a menopausal woman' would touch the animal's head while the elders ... (like Shangaans and other tribes with similar practices), in order to assist both pastoral caregivers.
Nov 13, 2014 ... Original Research http://www.hsag.co.za doi:10.4102/hsag.v19i1.771. Perceptions of menopause and aging in rural villages of. Limpopo Province, South ... churches, other community resources and health care services so that when women reach ..... that they felt that they had lost their self-esteem because.
The findings of the study indicated that the rural women in Mutale community had the common traditional understanding of the concept menopause, that blood is gone, old age, it was God' nature of doing things and that cessation of menstruation was a normal and natural transition. They could not attach cessation of ...
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
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.
Strauss, Judy R.
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…
Chrisler, Joan C.
The purpose of this article is (a) to consider reasons why women's reproductive processes receive so little attention in psychology courses and (b) to make an argument for why more attention is needed. Menstruation, menopause, and other reproductive events are important to the psychology of women. Reproductive processes make possible a social role…
Background: The term 'menopause' is derived from the Greek words men (month) and pausis (a cessation, a pause). It is a direct description of the psychological and physical events in women where menstruation ceases to occur. It is the time in a woman's life when she has experienced her last menstrual bleed.
The 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 ...
Reproductive Health is usually focused upon women in their reproductive years, but this does not include girls who have not begun procreation nor women who are past the age of reproduction. In this paper, we focus attention upon women in menopause, realizing that they form a significant proportion of the female ...
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.
Background: Postmenopausal bleeding is an alarming sign that may be associated with uterine malignancy. In recent years about 60% of women with post menopausal bleeding are said to have no organic cause in developed countries. There is no data concerning about this issue in Ethiopia. Objective: To determine ...
Elavsky, Steriani; McAuley, Edward
The present study examined the relationships among physical activity (PA), symptom reporting, self-esteem, and satisfaction with life (SWL) in 133 women (M age=51.12, S.D.=4.10) of varying menopausal status. Multivariate analyses of co-variance (MANCOVA) revealed that independent of menopausal status, women who were more physically active reported significantly less severe vaso-somatic and general somatic symptoms, and higher levels of physical self-worth (PSW). Subsequent hierarchical regression analyses indicated that expended MET-h/week, reported symptoms (frequency and severity, respectively), and PSW accounted for significant variance in SWL (R2 model=0.32, for symptom frequency, and 0.33, for symptom severity). Physical activity was significantly related to SWL through the mediation of PSW. However, both reported symptom frequency and severity retained significant association with SWL after controlling for PSW, although the original associations were significantly reduced. Finally, both symptoms and MET-h/week were independent contributors to the variance in PSW (R2 model=0.33 and 0.34). The results suggest that being physically active may reduce perceived severity of menopausal symptoms and enhance psychological well-being, and that the relationship between physical activity and QOL in mid-life women may be mediated by factors such as physical self-perceptions and menopausal symptoms.
Background/Objective: The features of menopause have always been assumed to occur only to a minor degree of .... Depression. 23. 4.3. Dyspareunia. 10. 1.9. Urine leakage. 4. 0.8. Table 1: Sociodemographic characteristics of respondents. Characteristics. Number. % ... 39 (7.3%) of the women, all of whom had post.
Background: The menopause‑specific quality‑of‑life (MENQOL) was developed as a specific tool to measure the health‑related quality‑of‑life in menopausal women. Recently, it has been translated into about 15 languages. Aim: This study was performed to develop the Persian version of the MENQOL questionnaire from ...
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 ...
Dobkin, Roseanne DeFronzo; Menza, Matthew; Bienfait, Karina L; Allen, Lesley A; Marin, Humberto; Gara, Michael A
Sleep disturbances have been reported to be one of the most troubling manifestations of menopause. While hormone replacement therapy (HRT) has historically been considered a first-line treatment for menopausal insomnia, many women are now seeking alternative treatments due to concerns about the risks and side-effects of HRT. The goal of this study was to evaluate the effect of ramelteon, a selective melatonin receptor agonist, for the treatment of menopausal insomnia. A total of 20 healthy peri- and postmenopausal women with insomnia participated in this six-week, prospective, open-label trial of ramelteon (8 mg) at an academic medical centre. Participants completed sleep-wake diaries on a daily basis for six weeks. Self-report measures of sleep impairment, daytime functioning, quality of life and mood were also completed on a bi-weekly basis. Significant improvements in latency to sleep onset, total sleep time and sleep efficiency were observed in diary data while gains in sleep quality, sleep impairment, daytime functioning, quality of life and mood were found in self-report measures. There was no evidence of tolerance or rebound over the course of the trial. Overall, results suggest that ramelteon is an effective non-hormonal approach for the treatment of insomnia in menopause. Randomized-controlled trials are needed to further evaluate the efficacy of this intervention.
Conclusion: 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. Keywords: Anxiety, Complex ...
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.
Acer, Semra; Pekel, Gökhan; Küçükatay, Vural; Karabulut, Aysun; Yağcı, Ramazan; Çetin, Ebru Nevin; Akyer, Şahika Pınar; Şahin, Barbaros
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.
Bae, Jinju; Park, Susan; Kwon, Jin-Won
A regular menstrual cycle is an important indicator of a healthy reproductive system. Previous studies reported obesity, stress, and smoking as the factors that are associated with irregular menstruation and early menopause. However, the integrative effects of these modifiable risk factors have not been fully understood. This study aimed to investigate the modifiable risk factors of menstrual cycle irregularity and premature menopause, as well as their individual and combined effects among adult women in Korea. This study selected adult women aged 19 years and above who had been included in the 2007-2014 Korean National Health and Nutrition Examination Survey. We used a separate dataset to analyze the risk factors of menstrual cycle irregularity and menopause (pre- and postmenopausal women: n = 4788 and n = 10,697, respectively). Univariate and multiple logistic regression analyses were conducted to evaluate the effects of smoking, drinking, obesity, and perceived level of stress on the menstrual cycle and menopause. Both logit and linear models were used in the analyses of the association between smoking and menopausal age. Equivalized household income, marital status, and educational level were considered as covariates. The modifiable risk factor scores were also calculated to integrate the effect of smoking, drinking, and obesity in the analysis. Results showed that smoking status, pack-year, obesity, and perceived level of stress were significantly associated with irregular menstruation among premenopausal women. Especially, women demonstrating > 3 modifiable risk factor scores had 1.7 times higher risk of having irregular menstruation than those who had a 0 score. Meanwhile, early initiation of smoking (≤19 years) and high pack-year (≥5) were also significantly associated with premature menopause among postmenopausal women. This study demonstrated that modifiable risk factors, such as smoking, obesity, and stress, were significantly associated
Utian, Wulf H; Woods, Nancy Fugate
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
Delavar, Mouloud Agajani; Hajiahmadi, Mahmoud
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.
Sullivan, Shannon D.; Lehman, Amy; Nathan, Nisha K.; Thomson, Cynthia A.; Howard, Barbara V.
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
Marta Teresa Makara-Studzińśka
Full Text Available Introduction : The age of menopause is a time of many changes in the psychophysical-social functioning of women, with reduced ovarian hormonal activity and estrogen levels. The most common, troublesome symptoms of menopause age include depressive disorders, sleep disorders, sexual dysfunction, discomfort associated with muscle pain, joint aches, osteoporosis and characteristic hot flashes. Aim of the study is to determine and compare the rate of menopausal symptoms among women living in continents of both Americas, Africa, Australia and Eurasia. Material and methods : The results of this work were obtained in 2014 on the basis of the data from a review of the 64 most important studies using the PubMed database. Research published in the period 2000-2014, from Africa, both Americas, Australia and Eurasia, were taken into account. Results : The prevalence of menopausal symptoms in African women is disconcertingly high. Women from South America complain about occurrence of depressive, sexual dysfunctions and discomfort associated with muscle pain and joint aches. Symptoms most reported by women in the United States are pains associated with muscles and joints. Women in Australia suffer mainly due to vasomotor symptoms and sexual dysfunction, while in the group of women surveyed in Asia there is observed an alarming increase in the proportion of women reporting depressive disorders. In Europe there was a much greater incidence of sleep disorders and depressive disorders. Conclusions : Women around the world suffer from ailments characteristic for the menopausal period regardless of ethnic origin, skin color or socio-demographic factors.
Full Text Available BACKGROUND: Breast cancer is the most common cancer worldwide. The incidence and mortality rate is increasing in developing countries as compare to developed countries. The aim of this study was to evaluate the breast cancer risk factors in premenopausal and post-menopausal women. METHODOLOGY: In the present study, two hundred breast cancer patients and one hundred age matched controls were taken to study breast cancer risk factors. The odd Ratio (ORs at 95% confidence interval (CIs was computed to study significance of risk factor on menopausal status. RESULTS: The mean age for menopause was 46.52±4.72 for breast cancer cases and 45.9±4.29 for control group was observed. The marital status, parity, age at menarche at =13 years was found to be associated with breast cancer risk in premenopausal age group. Early age at first full term pregnancy, number of children more than three and lactation duration of more than one year were observed to be protective factors in both pre and postmenopausal age groups A history of spontaneous abortion had no significant effect on the risk of breast cancer diagnosed before or after menopause. The positive association of breast cancer was observed for Height, weight and body mass index (BMI in postmenopausal women. CONCLUSION: In conclusion, present results suggest that changes in reproductive pattern, menstruation and anthropometric measurements contribute to the risk of breast cancer in both pre and post-menopausal women. Further genetic and hormonal relationship based studies have been suggested using a large cohort.
Jamin, C; Raccah-Tebeka, B; Chevallier, T; Micheletti, M-C
A survey entitled FEMME was conducted during 2002 in order to evaluate among French women doctors their own actual or future menopause perception and this before the WHI publication. The results of this American trial possibly modified the perception of these French women doctors. Therefore the same experts group conducted a new survey, from May to September 2003. The main aim of this survey was to evaluate the possible changes in the medical management of the actual or future menopause of these women, and secondarily to evaluate the changes in their patients' behaviour towards hormone replacement therapy (HRT). Postal auto administered questionnaires were sent to the same 10 000 French women doctors (GP or gynaecologist) whatever their menopausal status or their age. 1365 women doctors (respectively 18,5 or 11% of the gynaecologists or GPs contacted) were volunteers to participate in this survey. Among them, 1120 (84,9%) had already participated in the first part of this survey which took place before the WHI publication. 80% of these women doctors have been informed on WHI results principally by professional press or conferences. 70,9% changed their own actual or future menopause perception as follows. No additional selection of non hormonal treatment have been mentioned in comparison with the first part of the survey. On the other hand for HRT, selections of free estrogen plus progestin associations increased whereas those of fixed combinations decreased: this might be linked to the greater variety of estrogen doses, types of progestin and schedules of treatment (mostly with bleeding) offered by this kind of associations. Finally, duration of HRT is included between three and ten years in most cases. Thus, unlike most of their patients, these women's physicians always preferred hormonal treatment for their own actual or future menopause. Only the conditions of these treatments have changed.
Hill, D Ashley; Crider, Mark; Hill, Susan R
The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined estrogen/progestogen therapy, but not estrogen alone, increases the risk of breast cancer when used for more than three to five years. Therefore, in women with a uterus, it is recommended that physicians prescribe combination therapy only to treat menopausal symptoms such as vasomotor symptoms (hot flashes) and vaginal atrophy, using the smallest effective dosage for the shortest possible duration. Although estrogen is the most effective treatment for hot flashes, nonhormonal alternatives such as low-dose paroxetine, venlafaxine, and gabapentin are effective alternatives. Women with a uterus who are using estrogen should also take a progestogen to reduce the risk of endometrial cancer. Women who cannot tolerate adverse effects of progestogens may benefit from a combined formulation of estrogen and the selective estrogen receptor modulator bazedoxifene. There is no highquality, consistent evidence that yoga, paced respiration, acupuncture, exercise, stress reduction, relaxation therapy, and alternative therapies such as black cohosh, botanical products, omega-3 fatty acid supplements, and dietary Chinese herbs benefit patients more than placebo. One systematic review suggests modest improvement in hot flashes and vaginal dryness with soy products, and small studies suggest that clinical hypnosis significantly reduces hot flashes. Patients with genitourinary syndrome of menopause may benefit from vaginal estrogen, nonhormonal vaginal moisturizers, or ospemifene (the only nonhormonal treatment approved by the U.S. Food and Drug Administration for dyspareunia due to menopausal atrophy). The decision to use hormone therapy depends on clinical presentation, a thorough evaluation of the risks and
Akdeniz, Nurten; Akpolat, Veysi; Kale, Ahmet; Erdemoglu, Mahmut; Kuyumcuoglu, Umur; Celik, Yusuf
The aim of this study was to determine, how much the anthropometric measurements and age affect the femur and vertebra T-scores by using correlation and regression analysis in postmenopausal women. Data of 540 healthy postmenopausal women were included in this analysis. Bone mineral density was determined by dual energy X-ray absorptiometry (DXA). The data of the patients related to height, weight, age, age at menopause were obtained from records, and body mass index (BMI) was calculated (BMI = W (kg)/H(m(2))). Statistical analyses were performed with SPSS 15.0 for Windows (SPSS, Chicago, IL). Mean age and standard deviation of 540 postmenopausal women was 59.3 +/- 8.4 years. The correlation coefficients among femur, vertebra T-scores, weight, the time elapsed after the menopause onset, age, BMI and height were found as follows, from higher to lower values with 0.465, 0.453, 0.411, 0.382, 0.232, respectively, and were statistically significant (p osteoporosis from higher to lower influence as follows: weight, menopause age, age, BMI and height. Weight and menopause age of the patients were the major determinants for osteoporosis.
Damle, Rajshri P.; Dravid, N.V.; Suryawanshi, Kishor H.; Gadre, Arundhati S.; Bagale, Priya S.; Ahire, Neelam
Background: 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.
Darsareh, Fatemeh; Taavoni, Simin; Joolaee, Soodabeh; Haghani, Hamid
Menopause is a significant event in most women's lives because it marks the end of a woman's natural reproductive life. The purpose of this study was to determine the effect of aromatherapy massage on menopausal symptoms. A randomized placebo-controlled clinical trial was conducted at a menopausal clinic at a gynecology hospital in Tehran. The study population comprised 90 women who were assigned to an aromatherapy massage group, a placebo massage group, or a control group. Each participant in the aromatherapy massage group received 30-minute aromatherapy treatment sessions twice a week for 4 weeks with aroma oil, whereas participants in the placebo massage group received the same treatment with plain oil. No treatment was provided to participants in the control group. The outcome measures in this study were menopausal symptoms, as obtained through the Menopause Rating Scale. The mean baseline level of the menopausal score did not differ among all groups. However, after eight sessions of intervention, the Menopause Rating Scale score differed significantly among the three groups (P aromatherapy massage group and the placebo massage group had a lower menopausal score than the control group (P aromatherapy massage and the placebo massage groups were compared, the menopausal score for the aromatherapy massage group was found to be significantly lower (P aromatherapy massage were effective in reducing menopausal symptoms. However, aromatherapy massage was more effective than only massage.
Verhoeven, Marieke O; van der Mooren, Marius J; Teerlink, Tom; Verheijen, René H M; Scheffer, Peter G; Kenemans, Peter
To investigate the influence of physiological and surgical menopause on serum concentrations of coronary heart disease (CHD) risk markers and sex hormones. Physiological menopausal transition was investigated in two studies. In a longitudinal study, 16 women were followed from 2 years before until 2 years after physiological menopause. In a case-control study, 27 early postmenopausal women were compared with 27 age-matched late premenopausal women. Surgical menopause was investigated in 11 women undergoing a prophylactic bilateral salpingo-oophorectomy. The following parameters were measured: serum concentrations of estradiol, follicle-stimulating hormone, inhibin A, inhibin B, asymmetric dimethylarginine, lipids, leptin, homocysteine, C-reactive protein, and coenzyme Q10, as well as weight and body mass index. After physiological and surgical menopause, serum estradiol and inhibin A and B decreased, whereas follicle-stimulating hormone increased (all P values menopausal transition. Total and low-density lipoprotein cholesterol increased after surgical menopause (both P values = 0.01). None of the other parameters studied were influenced significantly by the menopausal transition. No difference in change in the various CHD risk markers investigated was observed between physiological and surgical menopause. The CHD risk profile was affected unfavorably by both physiological and surgical menopause. Changes in most CHD risk markers were small, despite the substantial changes in hormonal parameters.
Sievert, Lynnette Leidy
This work aims to consider how the discipline of anthropology contributes to the study of menopause through evolutionary, developmental, and comparative perspectives. This study was a review of skeletal and ethnographic evidence for menopause and postreproductive life in humans' distant past, hypotheses for the evolution of menopause and long postreproductive life, variation in age at menopause with focus on childhood environments, and the study of variation in symptom experience across populations. Longevity, rather than capacity for menopause, sets humans apart from other primates. Skeletal evidence demonstrates that some Neanderthals and archaic Homo sapiens lived to the age at menopause and that at least one third of women in traditional foraging populations live beyond menopause. The evolutionary reasons for why women experience a long postreproductive life continue to be debated. A developmental perspective suggests that early childhood may be a critical time for the environment to irreversibly influence the number of oocytes or rate of follicular atresia and, ultimately, age at menopause. A comparative perspective examines symptom experience at midlife through participant observation, qualitative interviews, and quantitative instruments to gain a holistic understanding of the meaning, experience, and sociocultural context of menopause. An evolutionary perspective suggests that menopause is not a recent phenomenon among humans. A developmental perspective focuses on the influence of early childhood on ovarian function. A comparative perspective expands clinical norms and provides knowledge about the range of human variations.
Nowakowski, Alexandra C H; Graves, Katelyn Y
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.
Pérez-Roncero, Gonzalo Ramón; Martínez-Dearth, Rebeca; López-Baena, María Teresa; Ornat-Clemente, Lía
The aim of this study was to assess menopausal symptoms and related sociodemographic conditions in middle-aged women from the Spanish province of Zaragoza. This was a cross-sectional study in which 241 women (40-59 years old) from the Zaragoza province completed the Menopause Rating Scale (MRS) and a sociodemographic questionnaire containing personal and partner data to assess symptoms associated with the menopause. The most prevalent symptoms were musculoskeletal, followed by hot flushes and perspiration. Somatic, psychological and urogenital symptoms were more severe in post-menopausal women. Somatic and urogenital symptoms worsen with age, body mass index, age at menopause, and partner age. Multiple linear regression analysis (MA) for somatic symptoms was related with the menopausal status, psychiatric treatment, problems with sexual relationships, and history of gender violence. The MA for psychological symptoms was associated with menopausal status, psychiatric treatment and a history of gender violence. The MA for urogenital symptoms was associated with menopausal status, problems with sexual relationships, urinary incontinence and partner alcohol abuse. A history of gender violence was reported by 11.6% of the women. In this sample of middle-aged women, menopausal symptoms were related to menopausal status, and other factors associated with their partner factors, including gender violence. Copyright © 2013 Elsevier España, S.L. All rights reserved.
Judd, Fiona K; Hickey, Martha; Bryant, Christina
Cross sectional and longitudinal studies have suggested that the menopausal transition is a period of vulnerability for the development of depressive symptoms in women. It has been proposed that depression at the time of transition to menopause is part of a distinct diagnostic group of 'reproductive-related depressive disorders'. Furthermore it is proposed that these disorders are so prevalent that that middle aged women should be routinely screened to improve detection. The aims of this paper were to explore key studies undertaken over the past three decades to examine what evidence exists to support the proposals that depression in midlife women occurs as a biological response to hormonal change and that it is so common that all middle aged women should be routinely screened for depression. A systematic search was carried out of electronic databases for original research using population-based studies examining the relationship between menopause and depression. Longitudinal change in menopausal status over time is associated with an increased risk of elevated depressive symptoms, independent of relevant demographic, psychosocial, behavioural and health factors. However, depressive symptoms have non-specific diagnostic significance, and even when severe do not always reflect a depressive syndrome. There is no clear evidence that depressive disorders occur more commonly in association with the menopause. Rather, it appears that the true rate of disorder is similar to that at other times in a woman's reproductive life. The studies identified here do not provide evidence for the delineation of depression at the menopausal transition as part of a distinctive diagnostic group of 'reproductive-related depressive disorders' which occur as a biological response to hormonal change. The most plausible explanation is a bio-psycho-socio-cultural model of the processes which might lead to a depressive disorder in midlife. Although depressive symptoms are common at this time
de Vries, Heather F; Northington, Gina M; Kaye, Elise M; Bogner, Hillary R
The aim of this study was to examine the association between chronic medical conditions and reproducibility of self-reported age at menopause among community-dwelling women. 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 1 year or less of age at menopause recalled in 1993 (concordant) were compared with women who did not recall 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. One hundred forty-three women (59.6%) reported surgical menopause, and 97 (40.4%) reported natural menopause. In all, 130 (54.2%) women recalled age at menopause in 2004 within 1 year or less of recalled age at menopause in 1994, whereas 110 (45.8%) women did not recall age at menopause in 2004 within 1 year or less of recalled age at menopause in 1994. Among the women with surgical menopause, the women with three or more medical conditions were less likely to have concordant recall of age at menopause than the women with less than three chronic medical conditions (adjusted odds ratio, 0.36; 95% CI, 0.15-0.91) in multivariate models controlling for potentially influential characteristics including cognition and years since menopause. 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.
Fayakun Nur Rohmah
Full Text Available ABSTRACT Background :Yogyakarta has an olderly population structure (pre-elderly and elderly women among most other provinces in Indonesia that means the majority number of women is in menopause . Every woman has different response and complaints that occurred before and after menopause. Good self-efficacy will help women to face the complaints toward menopause. Objectives : This research aimed to analyze the correlation between husband’s support and woman’s selfefficacy towards menopause from a female perspective. Methods : This research was a correlational study with cross sectional approach. The sample technique of this study was accidental sampling technique, with the number of 32 women in menopause as the samples. Data were analyzed with Chi-square. Result :As the result, p-value was 0.378 (p>0.05. Conclusion : There were no correlation between husband’s support and women’s self efficacy towards menopause.
Moreira, Ana C; Silva, Ana M; Santos, Maria S; Sardão, Vilma A
Menopause is characterized by an altered hormonal status and by a decrease in life quality due to the appearance of uncomfortable symptoms. Nowadays, with increasing life span, women spend one-third of their lifetime under menopause. Understanding menopause-associated pathophysiology and developing new strategies to improve the treatment of menopausal-associated symptoms is an important topic in the clinic. This review describes physiological and hormone alterations observed during menopause and therapeutic strategies used during this period. We critically address the benefits and doubts associated with estrogen/progesterone-based hormone replacement therapy (HRT) and discuss the use of phytoestrogens (PEs) as a possible alternative. These relevant plant-derived compounds have structural similarities to estradiol, interacting with cell proteins and organelles, presenting several advantages and disadvantages versus traditional HRT in the context of menopause. However, a better assessment of PEs safety/efficacy would warrant a possible widespread clinical use. Copyright © 2014 Elsevier Ltd. All rights reserved.
Paulo J. Oliveira
Full Text Available Menopause is a consequence of the normal aging process in women. This fact implies that the physiological and biochemical alterations resulting from menopause often blur with those from the aging process. It is thought that menopause in women presents a higher risk for cardiovascular disease although the precise mechanism is still under discussion. The postmenopause lipid profile is clearly altered, which can present a risk factor for cardiovascular disease. Due to the role of mitochondria in fatty acid oxidation, alterations of the lipid profile in the menopausal women will also influence mitochondrial fatty acid oxidation fluxes in several organs. In this paper, we propose that alterations of mitochondrial bioenergetics in the heart, consequence from normal aging and/or from the menopausal process, result in decreased fatty acid oxidation and accumulation of fatty acid intermediates in the cardiomyocyte cytosol, resulting in lipotoxicity and increasing the cardiovascular risk in the menopausal women.
Full Text Available Abstract: The purpose of this study is to identify the effectiveness ofendorphine massage on female sexual function during menopause inNgampel District of Kendal Regency. Sampling was done by samplingcriteria acsidental aged less than 60 years old, have a husband, in a healthycondition. Data processing was performed using the Wilcoxon test todetermine differences in sexual function before and after the interventionwhile endorphine effectiveness of massage performed by using MannWhitney.Hasil research: Wilcoxon test showed that there are significantdifferences in sexual function before and after being given endorphineMassage with p value 0.00. While Mann Whitney test showed p value of0.13 and the value of z score of -2.828, which means there is a stronginfluence among endorphine Massage to increased sexual function soendorphine Massage is effective for improving sexual function.Keyword: menopause, endorphin massage, sexual function
Hutchinson-Colas, Juana; Segal, Saya
Genitourinary syndrome of menopause is a common condition that left untreated can progress and negatively affect quality of life and sexual function. Laser therapy has a therapeutic role for several gynecologic conditions and most recently has gained interest as a non-hormonal treatment for genitourinary syndrome of menopause (GSM). The laser is well tolerated and may increase thickness of the squamous epithelium and improve vascularity of the vagina. These morphological changes presumably alleviate symptoms of dryness, dyspareunia, and irritation. However, the duration of therapeutic effects and safety of repeated applications at this point is not clear. Further research is needed in the form of controlled studies of the laser and other non-hormonal GSM therapies. The objective of this paper is to review the existing literature describing laser therapy for GSM. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Magyar, Zoltán; Fél, Tamás
Although the expected mean age of women increased significantly in the 20th century, the time of menopause has not changed (age of 50-51 years). Women's life span in Hungary is 77.2 years, which means, that one third of their lives is lived in menopause. Aging and the consequent lack of estrogen means a more and more serious problem on social level as well. In Hungary there are approximately 1.8 million women above the age of 50. Only an insignificant part of them is treated, which is about 5%, compared to other European countries, where this ratio is between 5 and 25%. Menopause-related symptoms can be divided into the following groups: vasomotor symptoms (sweating, hot flashes, palpitation), decreased psychic and physical functions (fatigue, depression, panic disease, cognitive problems, decreased libido), cardiovascular diseases (ischaemic heart disease), endometrial atrophy, bone and articular alterations (osteoporosis) and urogenital symptoms (vaginal dryness, incontinence, cystitis). The most frequent symptom is hot flashes, which is characteristic of more than 60% of women in menopause. Osteoporosis after the cardiovascular diseases is the second most serious problem on public health level. Approximately 9% of the Hungarian population suffers from osteoporotic problems, which concretely means 600.000 women and 300.000 men. The most frequent fractures are the hip and vertebral fractures. In 1999, 15.100 hip and 51.000 peripheric fractures occurred in Hungary. The above mentioned symptoms, even separately, may decrease the quality of life, therefore their treatment and the knowledge of all of the therapeutic possibilities are essential.
Morabia, Alfredo; Costanza, Michael C.
The occurrences and timing of reproduction-related events, such as menarche, first birth, and menopause, play major roles in a woman's life. There is a lack of comparative information on the overall patterns of the ages at and the timing between these events among different populations of the world. This study describes the variability in reproductive factors across populations in Europe, the Americas, Asia, Australia, and Africa. The study sample consisted of 18,997 women from 13 centers in ...
López-Marcos, Joaquín Francisco; García-Valle, Silvia; García-Iglesias, Angel Agustín
Currently, an important number of women use HRT to control their hormonal problems during menopause. A large percentage of these have problems at periodontal level. The present study aims at examining the effects that menopause, due to a decline in the synthesis of hormones, mainly of estrogens, can cause on the oral dental health of such women; in particular on the characteristics of the gingiva and periodontium, checking whether characteristics such as gingival recession, pain, tooth mobility and periodontal pocket formation might permit physicians to evaluate the degree of bone loss in menopausal woman. Menopausal women aged 40 to 58 years of age undergoing hormone replacement therapy that had gingival periodontal disturbances. The total population of the study comprised 210 patients, divided into two groups. One group received HRT administered in patches and the other group did not receive this therapy. Gynecologic and odonto-stomatologic protocols were established for data collection. In order to assess the efficacy of the treatment a descriptive statistical study for sociodemographic variables, analysis of variance, McNemar's test and the Stuart-Maxwell test were performed. The mean age of the patients studied was 49.6 years. HRT acts as a protective factor in dental pain and improves tooth mobility and depth of the probing of periodontal pockets. With respect to the variable gingival recession, no significant results were found either for the group not receiving HRT or for the group being treated with patches. The response to the HR therapy in periodontal disease is probably due to the existence of estrogen receptors localized in the gingiva and in the periodontal ligament.
Min, Lingfeng; Wang, Fang; Liang, Sudong; Yang, Junjun; Xu, Xingxiang
Abstract Background: Quantification of the association between menopausal status and risk of lung cancer is inconsistent. We carried out a meta-analysis of available studies to examine this issue. Methods: Relevant articles were identified by searching PudMed and Embase databases. Reference lists from selected papers were also reviewed. A random-effect model was used to calculate summary odds ratios (OR) and relative risk (RR) with 95% confidence interval (CI). Publication bias was estimated ...
Uml; EM; Falconieri L
Elena M Umland, Laura FalconieriJefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USAAbstract: Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical...
Whelan, Anne Marie; Jurgens, Tannis M.; Trinacty, Melanie
In the last decade, the use of bioidentical hormones (BHs) to treat menopause-related symptoms has become increasingly popular. However, the many different definitions of BHs have led to a great deal of confusion often making it difficult for health care providers to discuss this area with patients.Objective: The purpose of this paper was to produce a concise definition of bioidentical hormones, based on a review of the literature.Methods: Searches, using systematic review methodology, were c...
Savita Rani Singhal; Wansalan Kuru Shullai
Objective: This study was planned to compare the effects of gabapentin and isoflavones in menopausal vasomotor symptoms. Materials and Methods: This prospective comparative study was conducted on 100 patients with complaints of hot flashes, divided into two groups of 50 each. Group I received 900 mg of gabapentin and Group II received 60 mg of isoflavones daily for 3 months. The patients were interviewed to calculate hot flash, global and depression scores and were rescored after 2, 4, 8, and...
Liva Maita; Nurlisis Nurlisis; Risa Pitriani
Menopause merupakan fase terakhir dimana perdarahan haid seorang wanita berhenti sama sekali. Pada usia 50 tahun, perempuan memasuki masa menopause sehingga terjadi penurunan atau hilangnya hormon estrogen yang menyebabkan perempuan mengalami keluhan atau gangguan yang seringkali mengganggu aktivitas sehari-hari bahkan dapat menurunkan kualitas hidupnya. Penelitian ini dilakukan untuk mengetahui karakteristik wanita yang mengalami keluhan masa menopause di Puskesmas Rejosari. Penelitian ini ...
Full Text Available Background: Menopause is a natural event in the ageing process and signifies the end of reproductive years with cessation of cyclic ovarian function as manifested by cyclic menstruation. Lipid profile is altered in menopause because of various reasons. Objectives: The study was aimed to compare the lipid profile in women with normal body mass index (BMI = 18.9-24.9 and women with BMI = 25-29.9 in both pre- and post-menopausal group. Materials and Methods: Estimation of total cholesterol (TC by CHOD-PAP Cholesterol Oxidase - Peroxidase + Aminophenazone + Phenol method, triglyceride (TG by enzymatic calorimetric method, high density lipoprotein-cholesterol (HDL-C phosphotungstic acid method, low density lipoprotein-cholesterol (LDL-C by using Friedewald formula and very low density lipoprotein (VLDL was done by using the formula -VLDL = TG/5 in 30 women selected in each group. Results: Our study revealed that serum levels of TC, TG and LDL-C were significantly higher in post-menopausal women in comparison to their pre-menopausal counterparts, irrespective of BMI (P < 0.05. Similarly, HDL-C levels were significantly lower in post-menopausal women as compared with pre-menopausal women of similar BMI (P < 0.05. Conclusions: We found that serum levels of TC, TG and LDL-C were significantly higher in post-menopausal women in comparison to their pre-menopausal counterparts, irrespective of BMI. Similarly, HDL-C levels were significantly lower in post-menopausal women as compared to pre-menopausal women of similar BMI. Since we found similar changes in women of different BMIs, the difference in hormonal status is the probable cause of altered lipid profile. Hence, all post-menopausal women irrespective of body weight and BMI should be strongly counseled to have proper physical exercise and dietary habits to avoid the possible cardiovascular complications.
El Khoudary, Samar R.; Shields, Kelly J.; Janssen, Imke; Hanley, Carrie; Budoff, Matthew J.; Barinas-Mitchell, Emma; Everson-Rose, Susan A.; Powell, Lynda H.; Matthews, Karen A.
Copyright © 2015 by the Endocrine Society. Context: Cardiovascular risk increases in women after menopause. Mounting evidence demonstrates a role of cardiovascular fat (CF) in the pathogenesis of coronary heart disease, but no research has examined CF in relation to sex hormones or menopausal status in women. Objective: The objective was to determine the relationship between CF depots, menopausal status, and endogenous sex hormones. Design: Cross-sectional and longitudinal study designs were ...
Carwile, Jenny L.; Willett, Walter C.; Michels, Karin B.
Later menopause is a risk factor for breast and endometrial cancer, yet few studies have investigated dietary predictors of this potentially modifiable event. In particular, dairy contains hormones and growth factors that could potentially affect menopausal timing. We therefore assessed the association between regular consumption of dairy foods and related nutrients and age at natural menopause. We conducted a prospective analysis with up to 20 y of follow-up in 46,059 participants in the Nur...
Martínez Pérez, José Antonio; Palacios, Santiago; García, Felipe Chavida; Pérez, Maite
(1) To assess the prevalence of osteoporosis risk factors in Spanish menopausal women; (2) to detect medical and lifestyle risk factor differences between perimenopausal and postmenopausal women; (3) and to identify the main factors responsible for osteoporosis. Cross-sectional descriptive study encompassing women aged 45-65 across Spain. The study population sample was collected through random sampling and a total of 10,514 women were included. Socio-demographic, medical history, and lifestyle data were assessed. The prevalence of osteoporosis risk factors was 67.6%. The most common risk factors were physical inactivity (53.6%), use of medication related to osteoporosis risk (45.9%), and low calcium intake (30.1%). There were statistically significant differences between peri- and postmenopausal women in terms of smoking status, alcohol intake, personal history, poor dairy product intake, and medication use that could increase risk. Logistic regression analysis showed that osteoporosis was significantly associated with age, family history, age at onset of menopause, Kupperman Index, prolonged immobilization, weight loss, and other diseases that increase the probability of developing osteoporosis. A high prevalence of women taking osteoporosis risk-related medication was observed in our study. There was correlation between the menopausal symptoms' degree of severity and the risk of suffering from osteoporosis.
Full Text Available Dry eye disease (DED is a multifactorial ocular surface disease that causes symptoms of ocular pain, discomfort, and decreased visual acuity. It significantly affects quality of life of patients. It is more prevalent in the females and is being specifically in the menopausal and postmenopausal age group. This is believed to be due to the changes in balance of sex hormones. Sex hormones – estrogens and androgens – influence production of all components of the tear film including aqueous layer, lipid, and mucin. Various mechanisms such as decrease in hormonal levels, shift in feedback mechanisms, and changes in receptor receptivity interplay to alter the ocular surface homeostasis and subsequently result in DED. Several studies have suggested potential role of hormone replacement therapy in menopause-associated dry eye symptoms. The purpose of this review is to help the non ophthalmic physicians about DED encountered commonly in menopausal age group. It is important for primary care physicians to understand DED due to its high prevalence, often debilitating symptoms and the potentially preventable and treatable nature of the condition.
Soares Claudio N
Full Text Available Abstract There is little doubt that women experience a heightened psychiatric morbidity compared to men. A growing body of evidence suggests that, for some women, the menopausal transition and early postmenopausal years may represent a period of vulnerability associated with an increased risk of experiencing symptoms of depression, or for the development of an episode of major depressive disorder. Recent research has begun to shed some light on potential mechanisms that influence this vulnerability. At the same time, a number of studies and clinical trials conducted over the past decade have provided important data regarding efficacy and safety of preventative measures and treatment strategies for midlife women; some of these studies have caused a shift in the current thinking of how menopausal symptoms should be appropriately managed. Essentially, most women will progress from premenopausal into postmenopausal years without developing significant depressive symptoms. However, those with prior history of depression may face a re-emergence of depression during this transition while others may experience a first episode of depression in their lives. Here I provide an overview of what is known about risk factors for depression and the risk posed by the menopausal transition, its associated symptoms, and the underlying changes in the reproductive hormonal milieu, discussing the evidence for the occurrence of mood symptoms in midlife women and the challenges that face clinicians and health professionals who care for this population.
There is accumulating evidence that vitamin D (VD) has important effects besides its well-known role in calcium and bone metabolism. Hypovitaminosis D is associated with cardiovascular disease, the metabolic syndrome, type 2 diabetes mellitus, cancer as well as with increased mortality. Further, VD deficiency is related to depression and impaired cognitive function. Increasing age and elevated body fat mass contribute to an increased risk of VD deficiency. Further, some studies report a relationship between VD and estrogen metabolism. During menopause, the decline of estrogens results in increased bone turnover, a decrease in bone mineral density and elevated fracture risk. Musculoskeletal discomfort might impair quality of life, mood disturbances do frequently occur and the risk of metabolic and cardiovascular disease increases. Moreover, body composition changes including increased fat mass and decreased lean mass, which results in an increased risk of VD deficiency. Conversely, VD deficiency might aggravate discomfort as well as diseases that occur during menopause. There are precise recommendations regarding a sufficient VD intake in order to prevent bone loss in peri- and postmenopausal women. Considering the fact that VD deficiency and menopause share risk factors beyond bone health such as cardiovascular, metabolic, cognitive and affective disorders, a sufficient VD status should be obtained in all peri- and postmenopausal women. This might be beneficial not only considering bone health but also regarding cognitive, affective, metabolic and cardiovascular health of women. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Stachenfeld, Nina S
Reproductive surgeries leave women more susceptible to postoperative hypervolemic hyponatremia because during this period women can retain water at an accelerated pace and much faster than they do sodium. This review proposes that estrogen and progestogen exposure play an important role in the increased risk of hyponatremia in menopausal women. Estrogen and progesterone exposure have important effects on both body fluid regulation and cardiovascular function and both of these reproductive hormones impact blood pressure responses to sodium loads. This article provides information on the effects of female reproductive hormones and hormone therapy (HT) on fluid regulation and cardiovascular function during menopause. Thirst- and fluid-regulating hormones respond to both osmotic and volume stimuli. Aging women maintain thirst sensitivity to osmotic stimuli but lose some thirst sensitivity to changes in central body fluid volume. Thus, older adults are more at risk of dehydration because they may replenish fluids at a slower rate. Estrogen therapy increases osmotic sensitivity for mechanisms to retain body water so may help menopausal women control body fluids and avoid dehydration. Some progestogens can mitigate estradiol effects on water and sodium retention through competition with aldosterone for the mineralocorticoid receptor and attenuating aldosterone-mediated sodium retention in the distal tubule. However, some progestogens can increase cardiovascular risks. Appropriate balance of these hormones within HT is important to avoid the negative consequences of body fluid and sodium retention, including edema and hypertension.
Qureshi, H.J.; Hussain, G.; Bashir, M.U.; Latif, N.; Riaz, Z.
Background: In postmenopausal women, the two major causes of bone loss are oestrogen deficiency after menopause and age related processes. Bone turnover increases to high levels and oestrogen deficiency may induce calcium loss by indirect effects on extra skeletal calcium homeostasis. Objective of this study was to evaluate calcium status in pre-menopausal and postmenopausal women. Methods: This cross sectional study was carried out in 34 premenopausal women and 33 postmenopausal women, in Department of Physiology, Services Institute of Medical Sciences, Lahore. Height and weight of each woman were taken to find out the body mass index (BMI). Serum calcium, parathyroid hormone and calcitonin levels of each subject were determined. Results: Premenopausal women were obese (BMI>30 Kg/m/sup 2/) while postmenopausal women were overweight (BMI>25 Kg/m/sup 2/). Serum calcium levels were significantly lower in postmenopausal women than in pre-menopausal women, while serum parathyroid hormone levels were significantly higher in postmenopausal woman. Serum calcitonin level was not significantly different in the two groups. Conclusion: Postmenopausal women are calcium deficient and have increased bone turnover as indicated by increased serum parathyroid hormone levels. (author)
Full Text Available Elena M Umland, Laura FalconieriJefferson School of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USAAbstract: Vasomotor symptoms (VMS, including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical health of women experiencing VMS, leading to their pursuance of treatment to alleviate these symptoms. Management of VMS includes lifestyle modifications, some herbal and vitamin supplements, hormonal therapies including estrogen and tibolone, and nonhormonal therapies including clonidine, gabapentin, and some of the serotonin and serotonin–norepinephrine reuptake inhibitors. The latter agents, including desvenlafaxine, have been the focus of increased research as more is discovered about the roles of serotonin and norepinephrine in the thermoregulatory control system. This review will include an overview of VMS as they relate to menopause. It will discuss the risk factors for VMS as well as the proposed pathophysiology behind their occurrence. The variety of treatment options for VMS will be discussed. Focus will be given to the role of desvenlafaxine as a treatment option for VMS management.Keywords: menopause, vasomotor symptoms, hot flashes, vasomotor symptom treatment, desvenlafaxine
Most menopausal women experience vasomotor symptoms, vulvar-vaginal atrophy, and/or bone loss. Although available estrogen and progestin therapies are effective in treating menopausal symptoms and preventing bone loss, some women may seek a therapy that provides symptom relief and has an improved tolerability profile. One option is a tissue-selective estrogen complex (TSEC), or the pairing of estrogen(s) with a selective estrogen receptor modulator (SERM) to achieve the benefits of each component with fewer side effects. The first TSEC in clinical development combines the SERM bazedoxifene (BZA) with conjugated estrogens (CEs). The purpose of this article is to review published data for BZA/CE. Data were obtained from phase 3 BZA/CE clinical trial study articles. Daily BZA 20 mg/CE 0.625 mg or 0.45 mg effectively relieved hot flushes, maintained or increased bone mineral density, treated vulvar-vaginal atrophy, and improved quality of life. Further, BZA prevented stimulation of the endometrium by CE, and resulted in rates of amenorrhea and breast pain similar to placebo. These results support the use of a TSEC consisting of BZA/CE as a promising therapy for managing the signs and symptoms from reduced estrogen levels associated with menopause. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.
Mohseni, Reza; Aliakbar, Sima; Abdollahi, Afsoun; Yekaninejad, Mir Saeed; Maghbooli, Zhila; Mirzaei, Khadijeh
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.
Full Text Available Background and aim: Menopause refers to the cessation of menstruation due to hormonal changes and ovarian inactivity in women. These changes in hormone levels lead to various health consequences. This period of physiological changes usually starts in women with 40-50 years of age, and is characterized by the reduction of estrogen level. The mortality rate of premenopausal women, due to cardiovascular diseases (CVDs, is one fifth of men, though it rapidly increases after the menopause. Therefore, this descriptive study was conducted in order to determine the cardiovascular risk factors for menopausal and non-menopausal women in comparison with men of the same age. Materials and Methods: The study sample included patients referring to the cardiovascular department of Imam Reza Hospital, Mashhad, Iran. The subjects were divided into 4 groups: non-menopausal women (n=35, men of the same age (as the non-menopausal women, n=35, menopausal women (n=50, and men of the same age (as the menopausal women, n=50. All criteria related to major cardiovascular risk factors including systolic and diastolic blood pressure (SBP and DBP, cholesterol, triglyceride (TG, and low and high-density lipoprotein (LDL and HDL were measured and compared in all four groups. In order to analyze the data, Fisher's exact test was carried out using SPSS version 16. Results: There was a significant difference between non-menopausal women and men of the same age with regard to high SBP and DBP, hypercholesterolemia, low HDL, and high LDL. However, no significant difference was observed among two groups, regarding high levels of TG. The menopausal women and men of the same age showed significant differences in terms of high SBP and low HDL. However, no differences were observed in DBP, hypercholesterolemia, hypertriglyceridemia, and high LDL. Conclusion: Both non-menopausal and menopausal women and men had significant differences in relation to high SBP and low HDL. But a
Andersen, Claus Yding; Kristensen, Stine Gry
Life expectancy has increased by more than 30 years during the last century and continues to increase. Many women already live decades in menopause deprived of naturally produced oestradiol and progesterone, leading to an increasing incidence of menopause-related disorders such as osteoporosis, cardiovascular diseases and lack of general well-being. Exogenous oestradiol has traditionally been used to alleviate menopause-related effects. This commentary discusses a radical new method to postpone menopause. Part of the enormous surplus of ovarian follicles can now be cryostored in youth for use after 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 of ovarian follicles. Currently, the main goal of ovarian cryopreservation is fertility preservation, but grafting of ovarian tissue may also serve endocrine functions as a physiological solution to prevent the massive medical legacy of osteoporosis and menopause-related conditions in the ageing population. This intriguing solution is now technically available; the question is whether this method qualifies for postponing menopause, perhaps initially for those patients who already have cryostored tissue? Copyright © 2015 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Tropeano, Giovanna; Amoroso, Sonia; di Stasi, Carmine; Vizzielli, Giuseppe; Bonomo, Lorenzo; Scambia, Giovanni
To determine whether uterine fibroid embolization before the age of 45 years advances the timing of natural menopause. Prospective cohort study. University tertiary-care center. Forty-three regularly cycling women aged 35-44 years who underwent embolization and 43 age-matched control subjects. Annual assessments of menopausal status using prospectively recorded menstrual diaries and hormonal (serum FSH and E(2)) and ultrasound measures (ovarian volume and antral follicle count). Women were followed for 7 years or until they reached menopause. Age at menopause as computed by subtracting the date of birth from the exact date of the last menstrual period. Over the study period, 9 patients (25%) and 12 control subjects (33%) became menopausal, 19 patients (53%) and 18 control subjects (50%) entered the menopausal transition (irregular cycles), and 8 patients (22%) and 6 control subjects (17%) continued to menstruate regularly. Mean menopausal age in the embolization group (48.94 ± 2.48 years) was not significantly different from that in the control group (49.52 ± 1.25 years). There was no significant difference of menopause occurrence between the groups. Longitudinal changes in hormonal and ultrasound measures were similar for the two groups. This long-term follow-up study found no evidence for fibroid embolization advancing the timing of menopause in women before the age of 45 years. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Mirmonsef, Paria; Modur, Sharada; Burgad, Derick; Gilbert, Douglas; Golub, Elizabeth T.; French, Audrey L.; McCotter, Kerrie; Landay, Alan L.; Spear, Greg T.
Objective Previous studies have suggested that glycogen expression in vaginal epithelium decreases at menopause, resulting in reduced levels of lactobacilli. However, free glycogen in genital fluids and its relationship to Lactobacillus levels has not been compared in pre- and post-menopausal women. Methods 82 cervico-vaginal lavage samples were collected at different phases of the menstrual cycle from 11 pre-menopausal (4 HIV-uninfected and 7 HIV-infected) and 12 post-menopausal (7 HIV-uninfected and 5 HIV-infected) women over a 1–3 month period. Free glycogen was quantified in genital fluid. Lactobacillus levels were quantified by real time PCR. Estrogen and progesterone levels in blood were determined by ELISA. Results Free glycogen was detected in both pre- and post-menopausal women. Across all samples, those from post-menopausal women had significantly lower levels of free glycogen than those from pre-menopausal women (median 0.002 vs. 0.065 µg/µl, respectively; p = 0.03). Lactobacillus levels correlated positively with free glycogen in both pre- (Spearman r=0.68, p Free glycogen was detected in both pre- and post-menopausal women and correlated with Lactobacillus in both groups. These results point to the complexity of the relationship between menopause and vaginal microbiota and indicate that more careful studies of the role played by glycogen are warranted. PMID:25535963
Lichtarowicz, A; Norman, C; Calcraft, B; Morris, J S; Rhodes, J; Mayberry, J
One hundred and ninety-six women with Crohn's disease from south-east Wales were asked to provide details of their menstrual cycles, age at menopause, history of surgery, smoking habits and use of oral contraceptives. One hundred and forty-six provided the information (response rate 77 per cent). Eighty-four were still menstruating, three were pregnant, 10 had undergone hysterectomy, one had a pharmacologically-induced menopause and 48 had had a physiological menopause. Of these 48 women, 33 were diagnosed as having Crohn's disease before the menopause. Twenty-five of these were smokers. The mean age at menopause was similar in smokers and non-smokers and in those diagnosed before and after the menopause. The mean age at menopause was between 46 and 47. A logistic analysis using the 'status quo' method showed that 50 per cent of women with Crohn's disease had the menopause at 47.6 years compared with 49.6 years in a group of healthy women from the same area. The two groups had similar smoking habits and it would seem that a premature menopause is associated with Crohn's disease.
INTRODUCTION A women up to 45 years old will have menopause phase. Many woman in menopause phase will be psycological changes. In 2013, total of menopause women in Indonesia (45-49 years old) are 17.511.166 womens. In 2014, Jambi has 28.516 woman (45-49 years old). METHOD This research was a descriptive research. The independent variables that researched are experiences and family supported, dependent variables is the psychological changes of menopause woman. The population are womens 50-...
Kim, Catherine; Nan, Bin; Kong, Shengchun; Harlow, Siobhan
No longitudinal studies have examined how iron measures change over menopause. Our objectives were to examine iron measures in individual women at premenopause and at postmenopause and, secondarily, to determine if any changes contributed to insulin resistance. In a subset of participants (n=70) in a longitudinal study of menopause, we measured ferritin, transferrin, and soluble transferrin receptor (sTfR) once in the premenopause and once in the postmenopause. We also examined associations between menopausal status and change in iron markers after adjustment for age at menopause, race/ethnicity, and waist circumference. In linear regression models, we examined associations between premenopause iron measures and changes in iron markers over menopause with homeostasis model assessment of insulin resistance (HOMA-IR) changes over menopause, before and after adjustment for age at menopause, race/ethnicity, changes in waist circumference, C-reactive protein (CRP), and sex hormone-binding globulin (SHBG) levels. Women had lower ferritin (pmenopause (changes in sTfR:ferritin β=13.6, 95% CI 0.93-26.3) were associated with larger increases in HOMA-IR. From premenopause to postmenopause, women on average have increases in measures of iron stores. Women who had the greatest changes in iron over menopause (lower measures of premenopausal iron and greater increases in iron measures over the menopause) had the strongest associations between changes in iron and changes in insulin resistance.
Full Text Available Introduction: - Menopause is a universal reproductive phenomenon. All the nutrients plays important role at the time of menopause and in prevention of diseases. Deficiency of vitamin D is one of the major contributory factors responsible for lower bone mineral density (BMD in menopausal women. Iron deficiency anemia is common among menopausal women. The present study was conducted to assess the views on importance of nutrition & intake of various food items during menopause.Methods: - Community based cross sectional study. A total of 100 women aged 45-55 years in post-menopausal phase were selected from urban areas of district Varanasi during 2012-13. Data were collected by pretested questionnaire cum interview method.Results: - In the present study half of respondent belonged to 40-45 years age group. When they were asked about importance of nutrition during menopause 70% respondent said that they paid attention on their diet during menopause. 79% women preferred food being cooked in their kitchen. 69% women took milk in their regular diet. 95% women’s took fruits and vegetables in their diet. Only 76% have knowledge of added requirement of iron & calcium but only 59% women had iron and calcium reach foods in their regular diet.Conclusion: - In the present study about three fourth respondents knew about nutritional importance during menopause.
Santonicola, Antonella; Iovino, Paola; Cappello, Carmelina; Capone, Pietro; Andreozzi, Paolo; Ciacci, Carolina
We evaluated menopause-associated disorders and fertile life span in women with celiac disease (CD) under untreated conditions and after long-term treatment with a gluten-free diet. The participants were 33 women with CD after menopause (untreated CD group), 25 celiac women consuming a gluten-free diet at least 10 years before menopause (treated CD group), and 45 healthy volunteers (control group). The Menopause Rating Scale questionnaire was used to gather information on menopause-associated disorders. The International Physical Activity Questionnaire was used to acquire information on physical activity. Untreated celiac women had a shorter duration of fertile life span than did the control women because of an older age of menarche and a younger age of menopause (P menopause causes a shorter fertile period in untreated celiac women compared with control women. A gluten-free diet that started at least 10 years before menopause prolongs the fertile life span of celiac women. The perception of intensity of hot flushes and irritability is more severe in untreated celiac women than in controls. Low physical exercise and/or poorer quality of life frequently reported by untreated celiac women might be the cause of reduced discomfort tolerance, thus increasing the subjective perception of menopausal symptoms.
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees.Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT.For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not
El Khoudary, Samar R; Santoro, Nanette; Chen, Hsiang-Yu; Tepper, Ping G; Brooks, Maria M; Thurston, Rebecca C; Janssen, Imke; Harlow, Sioban D; Barinas-Mitchell, Emma; Selzer, Faith; Derby, Carol A; Jackson, Elizabeth A; McConnell, Daniel; Matthews, Karen A
The purpose of this study was to assess associations between distinct patterns of circulating estradiol (E2) and follicle-stimulating hormone (FSH) over the menopause transition (MT) and subclinical measures of atherosclerosis after menopause. Four temporal patterns of E2 decline (Low: low before and after final menstrual period (FMP); Medium: medium before and high after FMP; High-early decline: high prior to FMP and early decline thereafter; High-late decline: high prior to FMP and late decline thereafter) and three of FSH rise (Low, Medium, High) over 9.6 years across FMP were identified and linked to carotid intima-media-thickness (IMT), adventitial diameter (AD), and presence of carotid plaque (cPlaque) measured after menopause at the 12th annual visit (visit 12). Participants were 856 women (age at visit 12 = 59.5 ± 2.7 years) from the Study of Women's Health Across the Nation (SWAN), who never reported a stroke or a heart attack. In models adjusted for visit 12 or baseline cardiovascular disease (CVD) risk factors, odds of having any cPlaque were ∼43% lower among women with the High-early decline E2 trajectory compared to women with the Low E2 trajectory. In contrast, women with the Medium E2 trajectory had significantly higher IMT than those with the Low E2 trajectory adjusting for visit 12 CVD risk factors. Interestingly, adjusting for baseline CVD risk factors attenuated this association. The Low FSH group had lower IMT than the Medium and High FSH groups (p ≤ 0.05) in all models. During MT, women are subjected to hormonal alterations that could potentially increase their risk of developing CVD after menopause. © The European Society of Cardiology 2015.
Collaris, Ron; Sidhu, Kiren; Chan, Joe M
Surgical menopause, in comparison with natural menopause, has traditionally been claimed to lead to faster onset of more severe menopausal symptoms. There is little prospective research to support this view. We aimed to evaluate the speed of onset and magnitude of climacteric symptoms after oophorectomy and whether they relate to serum hormone changes. This would aide in counseling women before surgery. The Greene Climacteric Scale (GCS) was used in a sample of women before either total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAHBSO) or hysterectomy with one or both ovaries preserved. After surgery, women filled out GCS questionnaires weekly until the final assessment 5 to 6 weeks after surgery. Follicle-stimulating hormone, leuteinizing hormone, and estradiol levels were determined preoperatively at day 10 and postsurgery at day 37. All study participants had high preoperative GCS scores. Scores were highest in the TAHBSO group, but by 5 to 6 weeks after surgery, ratings had returned to premenopausal levels, showing marked improvement of ratings for anxiety, depression, and somatic complaints. Vasomotor symptoms remained unchanged. Hormone levels dropped within 10 days to postmenopausal levels in women undergoing TAHBSO. Fewer than 25% of women considered themselves symptomatic, and their symptom ratings increased significantly only between 2 and 3 weeks after surgery. This study suggests that vasomotor and other symptoms do not manifest as rapidly and severely in our study population as claimed in the literature and that many women have minimal or no symptoms. Improved symptom rating may be caused by perceived improvement of overall quality of life after surgery. This supports the concept that menopausal complaints depend on a multitude of factors other than hormone levels alone.
Yazdkhasti, Mansoureh; Keshavarz, Maryam; Mahmoodi, Zohreh; Hosseini, Agha Fatemeh
One of the main criteria to verify the effectiveness of a health training program is to measure quality of life in menopausal women. Hence the aim of this review was to evaluate the effects of self-directed learning (SDL) on MENQOl. The present single blind field study was conducted in Saadatmandi Health Center of Robat Karim (Iran, Southwest of Tehran Province) from August to December 2010. One handred and ten menopausal women were selected using convenience sampling method and then divided into two experimental (Self-directed Learning) and control groups of 55 each. Four manuals were developed to guide the women in the experimental group containing practical ways to treat menopausal symptoms. They were distributed among the participants for four weeks on a specific day. Menopausal Specific Quality of Life Questionnaire (MENQOL) was used to determine and compare quality of life scores of these women (before and three months after intervention sessions). The control group did not receive any intervention. Statistical analysis was performed by SPSS/16 software using Kolmogorov-Sminov, ANOVA, independent paired t test and Chi-square test. There were significant statistical differences between two groups regarding the age of subjects; age of menopause; economic, educational and employment status; number of dead and living children; BMI and vasomotor, physical, sexual and psycho-social postmenopausal symptoms. The implementation of Self-directed Learning (SDL) model leads to a significant statistical difference in scores of vasomotor symptoms (16.32 ± 5.92 to 13.26 ± 5.31), psychosocial symptoms (34.8 ± 11 to 27.18 ± 10.83), physical symptoms (75.02 ± 18.07 to 61.42 ± 15.49), sexual symptoms (15.36 ± 6.10 to 12.00 ± 4.97) and the overall score for quality of life (141.5 ± 41.09 to 113.86 ± 36.6) (P self-directed learning provides a useful strategy that should be included in health intervention and national surveillance programs in order to improve health and
Full Text Available Introduction: Menopause is the absence of menses in the period longer that one year. It is widely accepted that menopause leads to changes in hormonal status, metabolism and lipid profi le. The aim of this study wasto analyze the infl uence of menopause on the concentrations of lipids, lipoproteins and also the influence of body mass index (BMI and waist-hip ratio (WHR on lipid profi le in post-menopausal women.Methods: Sixty post-menopausal women of average age of 52.82 years were compared to a group of 34 pre-menopausal women average age of 47.92 years.Results: Post-menopausal women had higher, but non signifi cant (p>0.05 concentrations of total cholesterol, very low density lipoproteins (VLDL, low density lipoproteins (LDL and triglycerides than pre-menopausal women. The concentration of high density lipoproteins (HDL was significantly lower in post-menopausal women than pre-menopausal (pbut without signifi cance (p>0.05. There was no difference between body mass index (BMI and waste-hip ratio (WHR, but the WHR has shown as a signifi cant predictor of the LDL and cholesterol concentrations inpost-menopausal women.Conclusion: We can conclude that menopause leads to changes in lipid profi le by lowering of HDL and increasing the levels of apolipoprotein B, that increases the risk for cardiovascular disease. The WHR is thesignifi cant predictor of cardiovascular risk in post-menopausal women.
Overlie, Inger; Mørkrid, Lars; Andersson, Anna-Maria; Skakkebaek, Niels E; Moen, Mette H; Holte, Arne
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 the perimenopause and early postmenopause. Fifty-nine women, aged 46-56 years (mean age 51.2 years), were examined annually for 5 years during the menopausal transition and had venous blood drawn simultaneously for later analyses of the above-mentioned hormones. Inhibin A showed a steady decline from at least 4 years before the final menstrual period (FMP) until 1 year before menopause, whereas inhibin B had a shorter lasting decline from year 3 to year 2 before menopause, concomitant with a rise in FSH and LH. The present study confirmed previous observations that inhibin A had a continuous decline starting before the decline of inhibin B, suggesting that an increasing part of the cycle was anovulatory. The fall in inhibin B and the increase in FSH constitute markers of ovarian aging. One year prior to menopause neither inhibin A nor inhibin B could be detected. The disappearance of these peptide hormones is an important predictor of the approaching menopause.
Chiu, Hsiao-Yean; Pan, Chieh-Hsin; Shyu, Yuh-Kae; Han, Bor-Cheng; Tsai, Pei-Shan
This meta-analysis aims to evaluate the effects of acupuncture on hot flash frequency and severity, menopause-related symptoms, and quality of life in women in natural menopause. We systematically searched PubMed/Medline, PsychINFO, Web of Science, Cochrane Central Register of Controlled Trials, and CINAHL using keywords such as acupuncture, hot flash, menopause-related symptoms, and quality of life. Heterogeneity, moderator analysis, publication bias, and risk of bias associated with the included studies were examined. Of 104 relevant studies, 12 studies with 869 participants met the inclusion criteria and were included in this study. We found that acupuncture significantly reduced the frequency (g = -0.35; 95% CI, -0.5 to -0.21) and severity (g = -0.44; 95% CI, -0.65 to -0.23) of hot flashes. Acupuncture significantly decreased the psychological, somatic, and urogenital subscale scores on the Menopause Rating Scale (g = -1.56, g = -1.39, and g = -0.82, respectively; P 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.
Full Text Available Background/Aim. The most common secondary manifestations of menopause are clinical manifestations of estrogen deficiency. They could be early and late. The aim of this study was to compare manifestations of somatic disturbances in early postmenopause in women after physiological and surgical menopause. Methods. This prospective study included 60 women, age 41-55 years, divided into two groups: physiological (30 of them and surgically induced menopause. For every subject a special evidence list, consisting of the disease history questions, physical and gynecology examination as well as dates about physiological variables (arterial tension, height, weight, and body-mass index and laboratory examination was formed. The values of arterial blood pressure, body height, body mass, body mass index (BMI, and lipid status were determined and gynecological examinations were performed in each patient. Results. The most frequent symptoms in both groups were vasomotor ones. Headache was the more intensive sign in the group after induced menopause. Extra systolic heart excursion was a common symptom in both study groups. Arterial tension, regardless of the type of menopause, was in the physiological range. The frequent organic signs of menopause, more intensive in the group after induced menopause, were genitourinary and skin atrophy. An analysis of the BMI showed that the women in both groups were obese (BMI > 25. The lipids analysis confirmed the predomination of hyperlipoproteinemia type IIa in the group with physiologic menopause and type IIb after induced menopause. Conclusion. The dominant signs of menopausal syndrome were vasomotor and bone-joint symptoms, more frequent in the group after induced menopause. There were no statistically significant differences between the study groups according to the genitourinary atrophy and other signs of aging. Menopausal hormonal changes, regardless of the way of menopause developing, increase the risk for
Gohari, Mahmood Reza; Ramezani Tehrani, Fahime; Chenouri, Shojaeddin; Solaymani-Dodaran, Masoud; Azizi, Fereidoun
The ability of antimüllerian hormone (AMH) to predict age at menopause has been reported in several studies, and a decrease in AMH level has been found to increase the probability of menopause. The rate of decline varies among women, and there is also a variability of decline between women's cycles. As a result, individualized evaluation is required to accurately predict time of menopause. To this end, we have used the AMH trajectories of individual women to predict each one's age at menopause. From a cohort study, 266 women (ages 20-50 y) who had regular and predictable menstrual cycles at the initiation of the study were randomly selected from among 1,265 women for multiple AMH measurements. Participants were visited at approximately 3-year intervals and followed for an average of 6.5 years. Individual likelihood of menopause was predicted by fitting the shared random-effects joint model to the baseline covariates and the specific AMH trajectory of each woman. In total, 23.7% of the women reached menopause during the follow-up period. The estimated mean (SD) AMH concentration at the time of menopause was 0.05 ng/mL (0.06 ng/mL), compared with 1.36 ng/mL (1.85 ng/mL) for those with a regular menstrual cycle at their last assessment. The decline rate in the AMH level varied among age groups, and age was a significant prognostic factor for AMH level (P menopause. Individualized prediction of time to menopause was obtained from the fitted model. Longitudinal measurements of AMH will enable physicians to individualize the prediction of menopause, thereby facilitating counseling on the timing of childbearing or medical management of health issues associated with menopause.
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
Christianson, Mindy S; Washington, Chantel I; Stewart, Katherine I; Shen, Wen
Previous work has shown American obstetrics and gynecology (OB/GYN) residents are lacking in menopause training. Our objective was to assess the effectiveness of a 2-year menopause medicine curriculum in improving OB/GYN residents' knowledge and self-assessed competency in menopause topics. We developed a menopause medicine-teaching curriculum for OB/GYN residents at our academic hospital-based residency program. The 2-year curriculum was composed of year 1: four 1-hour lectures and one 2-hour lab with cases presentations, and year 2: three 1-hour lectures and one 2-hour lab. Core topics included menopause physiology, hormone therapy, breast health, bone health, cardiovascular disease, and autoimmune disease. Pre- and posttests assessed resident knowledge and comfort in core topics, and a pre- and postcurriculum survey assessed utility and learning satisfaction. From July 2011 to June 2013, 34 OB/GYN residents completed the menopause curriculum annually with an average attendance at each module of 23 residents. Pre-/posttest scores improved from a mean pretest score of 57.3% to a mean posttest score of 78.7% (P menopause patients with 75.8% reporting feeling "barely comfortable" and 8.4% feeling "not at all comfortable." After the 2-year curriculum, 85.7% reported feeling "comfortable/very comfortable" taking care of menopause patients. The majority of residents (95.2%) reported the menopause curriculum was "extremely useful." A 2-year menopause medicine curriculum for OB/GYN residents utilizing lectures and a lab with case studies is an effective modality to improve resident knowledge required to manage menopause patients.
Steffen, Patrick R; Soto, Marilyn
Menopause represents an important life change, particularly for religious women whose identity is significantly related to family. Two competing hypotheses are examined: one, because religious women have their identity focused on family and child rearing, spirituality will be related to increased menopausal symptoms because menopause represents a loss of identity and purpose; and two, because spirituality can provide strength and comfort during difficult times, it will, therefore, be related to decreased menopausal symptoms. To test these competing hypotheses, questionnaires were administered to 218 women (average age 55, 35% premenopausal, 26% peri-menopausal, 39% postmenopausal) who were members of the Church of Jesus Christ of Latter Day Saints. Regression analyses indicated that higher levels of spiritual strength were related to decreased levels of reported menopausal symptoms. Spiritual strength was also related to increased benefit finding during menopause, decreased concern with body appearance, and increased use of adaptive coping strategies. We conclude that finding strength in spirituality may help religious women cope better with the life changes associated with menopause.
Lima, Aluísio Henrique Rodrigues de Andrade; Couto, Henrique Eduardo; Cardoso, Glêbia Alexa; Toscano, Lidiane Tavares; Silva, Alexandre Sérgio; Mota, Maria Paula Gonçalves
Arterial Hypertension (AH) is an aggravating condition for Metabolic Syndrome (MS), as well as being aggravated by it. Menopause can make hypertension treatment more difficult, as it favors the worsening of MS components. Although there is evidence that exercise training reduces blood pressure, whether menopause and SM affect the exercise-induced benefits is yet to be elucidated. To compare the effects of aerobic training on blood pressure in non-menopausal and menopausal women with MS METHODS: A total of 44 women were recruited and divided into four groups: non-menopausal control (NMC: 39.5 ± 3.6 years, n = 11); menopausal control (MC: 54.9 ± 5.9 years, n = 12), non-menopausal aerobics (NMA: 43.1 ± 6.8 years, n = 11) and menopausal aerobics (MA: 52.1 ± 5 years, n = 10). The exercise groups performed aerobic training for three months, five times a week, at an intensity between 60% and 70% of heart rate reserve. The resting blood pressure and blood pressure response after 60 minutes of exercise were measured before and after the training period. The two-way ANOVA test was used, considering a p value 0.05). Three months of aerobic training improved MS components, but did not alter resting blood pressure or the BP response after an acute exercise session in women with MS.
Stute, Petra; 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.; Rees, Margaret
Worldwide, the number of menopausal women is increasing. They present with complex medical issues that lie beyond the traditional scope of gynaecologists and general practitioners (GPs). The European Menopause and Andropause Society (EMAS) therefore provides a holistic model of care for healthy
Nappi, Rossella E; Lachowsky, Michèle
This article aims to summarise the available knowledge on the prevalence of sexual symptoms at the menopause and their impact on quality of life in elderly women. Sexual changes are analysed in the context of the menopause transition and beyond. The medical literature was searched (1990-2008) with regard to menopause and sexuality using several related terms. The prevalence of sexual symptoms at the menopause differs across studies depending on several factors such as sample size, design, hormonal status and country. The most common sexual complaints are reduced sexual desire, vaginal dryness and dyspareunia, poor arousal and orgasm and impaired sexual satisfaction. Age and declining oestradiol levels have significant detrimental effects on sexual functioning, desire and responsiveness (arousal, sexual pleasure and orgasm) across the normal menopause transition, while reduced androgens levels played a role in hypoactive sexual desire disorder (HSDD), a symptom frequently diagnosed in surgically menopausal women. Women attending menopause clinics are vulnerable to female sexual dysfunction (FSD) because of a complex interplay of individual factors variably affecting well-being. Surgically menopausal women may be more distressed by sexual symptoms. Giving women the opportunity to talk about sexual problems is a fundamental part of health care and may improve their quality of life.
Depmann, M.; Faddy, M. J.; Van Der Schouw, Y. T.; Peeters, P. H M; Broer, S. L.; Kelsey, T. W.; Nelson, S. M.; Broekmans, F. J M
Context: Menopause has been hypothesized to occur when the nongrowing follicle (NGF) number falls below a critical threshold. Age at natural menopause can be predicted using NGF numbers and this threshold. These predictions support the use of ovarian reserve tests, reflective of the ovarian follicle
Freeman, Ellen W.; Sammel, Mary D.; Sanders, Richard J.
Objectives To estimate the risk of hot flashes relative to natural menopause and evaluate associations of hormone levels, behavioral and demographic variables with the risk of hot flashes following menopause. Methods Annual assessments of 255 women who were premenopausal at baseline and reached natural menopause during 16 years of follow-up. Results The prevalence of moderate/severe hot flashes increased in each premenopausal year, reaching a peak of 46% in the first two years after the final menstrual period (FMP). Hot flashes decreased slowly following menopause and did not return to premenopausal levels until 9 years after FMP. The mean duration of moderate/severe hot flashes after FMP was 4.6 (SD2.9) years (4.9, SD3.1 years for any hot flashes). One-third of women at 10 or more years following menopause continued to experience moderate/severe hot flashes. African American women (obese and non-obese) and obese white women had significantly greater risk of hot flashes compared to non-obese white women (interaction P=0.01). In multivariable analysis, increasing FSH levels before FMP (Pmenopause; more than one- third of women observed for 10 or more years following menopause had moderate/severe hot flashes. Continuation of hot flashes for more than 5 years following menopause underscores the importance of determining individual risk/benefit when selecting hormone or non-hormonal therapy for menopausal symptoms. PMID:24473530
Honorato, Talita C; Haadsma, Maaike L; Land, Jolande A; Boezen, Marike H; Hoek, Annemieke; Groen, Henk
OBJECTIVE: Cigarette smoking is a risk factor for earlier menopause. Animal studies show that in-utero smoke exposure is toxic to developing ovaries. Our aim was to evaluate whether in-utero smoke exposed women reach menopause earlier compared with nonexposed women. METHODS: This is a cohort study
Hulsman, C. A.; Westendorp, I. C.; Ramrattan, R. S.; Wolfs, R. C.; Witteman, J. C.; Vingerling, J. R.; Hofman, A.; de Jong, P. T.
The authors examined the association between age at menopause and open-angle glaucoma among women aged > or = 55 years in the population-based Rotterdam Study (1990--1993). Information on age and type of menopause was obtained by interview. Subjects (n = 3,078) were stratified into three categories
Verhoeven, Marieke O.; van der Mooren, Marius J.; Teerlink, Tom; Verheijen, Rene H. M.; Scheffer, Peter G.; Kenemans, Peter
Objective: To investigate the influence of physiological and surgical menopause oil Serum concentrations of corollary heart disease (CHD) risk markers and sex hormones. Design: Physiological menopausal transition was investigated in two studies. In a longitudinal Study, 16 women were followed from 2
Lejsková, M; Alušík, S; Suchánek, M; Zecová, S; Pitha, J
The incidence of the metabolic syndrome (MS) in women rises rapidly during the menopause, substantially increasing their cardiovascular risk and mortality. The aim of the study was to analyze menopausal changes in individual MS components and the parameter of insulin resistance (HOMA-IR). A random population sample of 909 women aged 45-54 years, resident in Prague 4, was examined in an epidemiological study. After excluding women with gynecological hormone therapy or surgical therapy, the two groups of women were compared: women of reproductive age (REPRO, n = 245) vs. naturally postmenopausal women (POSTm, n = 149). The incidence of MS rose significantly in menopause (REPRO/POSTm 22.9 ± 2.6%/38.3 ± 4.0%; p menopause (REPRO/POSTm: low HOMA-IR 13.8%/18.7%, not significant; high HOMA-IR 30.9%/57.3%, p menopause, there was an increase in the clustered incidence (accompanying MS) of each of the five MS components at the expense of isolated incidence (not accompanying MS). The acceleration of MS incidence at the onset of menopause may be accompanied by an increase in insulin resistance only in the population at highest risk. Reproductive women entering the menopause with an isolated MS component are at high risk for developing additional risk factors during menopause.
Yarde, F.; van der Schouw, Y. T.; de Valk, H. W.; Franx, A.; Eijkemans, M. J. C.; Spierings, W.; Fauser, Bart; Broekmans, F. J. M.
STUDY QUESTION: Is type 1 diabetes a determinant of advanced ovarian ageing, resulting in an early age at natural menopause? SUMMARY ANSWER: No clear evidence was provided that type 1 diabetes is a determinant of accelerated ovarian ageing resulting in an early menopause. WHAT IS KNOWN ALREADY: The
Banas, Tomasz; Hajdyla-Banas, Iwona; Pitynski, Kazimierz; Niewegłowska, Dorota; Juszczyk, Grzegorz; Ludwin, Artur; Knafel, Anna; Ludwin, Inga
The aim of the study was to compare the natural menopause ages of healthy women with those of women with methotrexate (MTX)-treated rheumatoid arthritis (RA), and to specifically assess the effect of disease onset and activity and the use of MTX on the age of the last menstruation. We performed a retrospective review of medical records to identify the ages at which menopause occurred in women with premenopausal RA treated with MTX and in women with postmenopausal onset, irrespective of therapy. Natural menopause ages were also compared between participants with and without RA. Women with premenopausal onset of RA underwent menopause at a significantly younger age than did healthy women (P Menopause also occurred at younger ages in participants with postmenopausal disease onset than in healthy controls (P = 0.012). The study suggested that menopause age was positively correlated with the age at which RA was diagnosed (R = 0.51; P menopause (P = 0.008). The age at which menopause occurs in a patient with RA depends on the patient's age at the time of disease onset and its duration, but is not influenced by MTX treatment.
Wellons, Melissa; Ouyang, Pamela; Schreiner, Pamela J; Herrington, David M; Vaidya, Dhananjay
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 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 = 0.008 and P = 0.0158). In models adjusted for age, race/ethnicity, Multi-ethnic Study Atherosclerosis site, and traditional cardiovascular disease risk factors, this risk for coronary heart disease and stroke remained (hazard ratio, 2.08; 95% CI, 1.17-3.70; and hazard ratio, 2.19; 95% CI, 1.11-4.32, respectively). Early menopause is positively associated with coronary heart disease and stroke in a multiethnic cohort, independent of traditional cardiovascular disease risk factors.
Paula de Holanda Mendes
Full Text Available OBJECTIVES: cigarette smoking has been the modifiable risk factor most consistently associated with earlier menopause. This preliminary study based on cross-sectional data aimed to analyze the association between smoking status and age of onset of menopause in a Brazilian population. METHODS: a cross-sectional study was carried out with 1,222 female employees of Rio de Janeiro university campuses aged over 35 years who were at risk of natural menopause. A Cox proportional hazards model was used to investigate the association between smoking status and age at the onset of menopause, adjusting for education, parity and alcohol consumption. RESULTS: current smokers showed a 56% increase in the risk of menopause, being 1.8 years younger at menopause onset compared with women who had never smoked. However, no differences were observed between former smokers and women who had never smoked. The adjusted median age at menopause was 49.5 years for current smokers and 51.3 years for women who had never smoked (p<0.05. CONCLUSIONS: the results suggest a deleterious but potentially reversible effect of smoking on the age of onset of menopause, which should receive greater attention in tobacco control efforts. Longitudinal analyses of this association will be carried out in the future in a follow-up study of this population.
Løkkegaard, E; Andersen, Zorana Jovanovic; Heitmann, B L
Randomised clinical trials find no protection against development of ischaemic heart disease by use of Hormone Therapy (HT) after the age of 50 years. Observational studies suggest that early menopause is a risk factor for ischaemic heart disease. Yet, a clinical very relevant question is whether...... HT reduces this risk associated with early menopause....
Willis, Diane S.; Wishart, Jennifer G.; Muir, Walter J.
Overall life expectancy for women with intellectual disabilities (ID) is now significantly extended, and many will live long enough to experience menopause. Little is known about how carers support women with ID through this important stage in their lives. This study investigated carer knowledge of how menopause affects women with ID under their…
Kuiper, S.; Gestel, A.M. van; Swinkels, H.L.; Boo, T.M. de; Silva, J.A. da; Riel, P.L.C.M. van
OBJECTIVE: To investigate the influences of the menopausal state, sex, and age on the course and outcome of rheumatoid arthritis (RA). METHODS: A cohort of patients with early RA (209 female, 123 male) was studied. Sex, age, and menopausal state at baseline, and disease activity, radiographic joint
Full Text Available Background. Subjective sleep disturbances increase during menopause. Some problems commonly encountered during menopause, such as hot flushes and sweating at night, can cause women to have difficulty in sleeping. These complaints can influence quality of life of menopausal women. Methods. This cross-sectional study was performed on menopausal women attending health centers in Qazvin for periodic assessments. We measured excessive daytime sleepiness by Epworth sleepiness scale (ESS, obstructive sleep apnea (OSA by the Berlin questionnaire, and insomnia by the insomnia severity index (ISI. We evaluate quality of life by the Menopause specific quality of life questionnaire (MENQOL. Results. A total of 380 menopausal women entered the study. Mean age of participated women was 57.6 ± 6.02. Mean duration of menopause was 6.3 ± 4.6. The frequency of severe and moderate insomnia was 8.4% (32 and 11.8% (45. Severe daytime sleepiness (ESS ≥ 10 was present in 27.9% (80 of the participants. Multivariate analytic results show that insomnia and daytime sleepiness have independent negative impact on each domain and total score of MENQOL questionnaire. Conclusion. According to our findings, EDS and insomnia are frequent in menopausal women. Both EDS and insomnia have significant quality of life impairment.
Murphy, Lorna; Sievert, Lynnette; Begum, Khurshida; Sharmeen, Taniya; Puleo, Elaine; Chowdhury, Osul; Muttukrishna, Shanthi; Bentley, Gillian
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.
Crowe, Marie; Burrell, Beverly; Whitehead, Lisa
This article is a report of a study that examined how women describe their decisions in relation to the use of menopausal hormone therapy following surgical menopause. Women who have had a surgically induced menopause generally experience more intense menopausal symptoms than natural menopause and are regularly prescribed menopausal hormone therapy. Since 2002 the risks associated with this therapy have been widely reported. This study is a qualitative analysis of semi-structured interviews between March and May 2009 with 30 participants who had experienced surgical menopause and were, or had in the past, taken menopausal hormone therapy. This was a community sample recruited in Christchurch, New Zealand. A risk management theoretical approach underpinned the analysis. The womens' descriptions of managing the risks associated with menopausal therapy fell into two main themes: Life has to go on and Waiting for someone to tell me. All these women had either made an active decision to continue on treatment because of the impact of menopausal symptoms or took their doctor's advice to continue. A less dominant theme but one that was also evident was Relying on my body to get me through in which the women had decided to discontinue treatment because they regarded it as unnatural. The study provided insights into how women utilize an experiential reasoning process to manage the health and lifestyle risks associated with taking menopausal hormone therapy. Nurses need to be aware of how this process influences women's reasoning processes when working with women following surgical menopause. © 2011 Blackwell Publishing Ltd.
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
Full Text Available Aim. The aim of this study was to assess serum levels of the key anti-inflammatory cytokines in women of reproductive age and in pre and postmenopausal women. Material and Method. 175 women were enrolled and were divided into 5 groups (1 – Fertile women; 2 – Pre- and perimenopausal women; 3 – Postmenopausal women; 4 – Surgically-induced menopause; 5 – Chronic inflammation. Multiplex cytokine kits were used to evaluate serum levels of interleukin-4, -10 and -13. We determined the serum levels of follicle stimulating hormone, of luteinizing hormone, 17β-estradiol, progesterone, dehydroepiandrosterone and dehydroepiandrosterone sulfate using sandwich ELISA. Results. IL-4, IL-10 and IL-17 present a statistically significant decrease (p=0.00, p=0.00, respectively p=0.0053 in women with natural or surgically induced menopause (groups 3 and 4, compared with fertile women and premenopausal women (Groups 1, 2 and 5. Serum levels of IL-4 and IL-10 are significantly higher in fertile patients with associated chronic inflammatory diseases (133.5±1.314 pg/ml, respectively 6.406±13.47 pg/ml than in fertile patients without chronic inflammatory diseases or premenopausal women (84.67±1.22 pg/ml, respectively 0.627±0.714. Conclusions. IL-4 and IL-10, together with IL-17, show significantly lower serum values in patients with natural or surgically induced menopause compared with patients of childbearing age or in premenopause. IL-4 and IL-10 show significantly higher serum values for patients of childbearing age presenting chronic inflammatory pathology compared with patients of childbearing age without chronic inflammatory pathology or premenopausal patients.
Fu, Cong; Zhao, Na; Liu, Zhen; Yuan, Lu-Hua; Xie, Chen; Yang, Wen-Jia; Yu, Xin-Tong; Yu, Huan; Chen, Yun-Fei
To evaluate the short-term efficacy of acupuncture for the treatment of peri-menopausal insomnia (PMI). Design: A randomized, participant-blind, placebo-controlled trial consisted of the acupuncture group (n = 38) and placebo-acupuncture group (n = 38). Setting: A tertiary teaching and general hospital. Participants: 76 peri-menopausal women with insomnia disorder based on the International Classification of Sleep Disorders, Third Edition. Interventions: A 10-session of acupuncture at bilateral Shenshu (BL 23) and Ganshu (BL 18) with unilateral Qimen (LR 14) and Jingmen (GB 25) or Streitberger needles at the same acupoints was performed for over 3 weeks. Measurements: Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) with over-night polysomnography (PSG) exam were completed at baseline and post-treatment. After the treatments, the decrease from baseline in PSQI score was 8.03 points in acupuncture group and 1.29 points in placebo-acupuncture group. The change from baseline in ISI score was 11.35 points in acupuncture group and 2.87 points in placebo-acupuncture group. In PSG data, acupuncture significantly improved the sleep efficiency and total sleep time, associated with less wake after sleep onset and lower percent stage 1 after the treatment. No significant differences from baseline to post-treatment were found in placebo-acupuncture group. Acupuncture can contribute to a clinically relevant improvement in the short-term treatment of PMI, both subjectively and objectively. Acupuncture for peri-menopause insomnia: a randomized controlled trial, http://www.chictr.org.cn/showproj.aspx?proj=12118 ChiCTR-IPR-15007199, China. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail email@example.com.
Palacios, Santiago; Mejias, Andrea
Vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) are recognized as the most frequent and bothersome symptoms associated with menopause. There are different treatments for both groups of symptoms, being necessary to individualize them. There are different therapies for VMS including hormonal treatments with estrogen, with and without progestins; the new alternative, tissue-selective estrogen complex (TSEC), tibolone, phytoestrogens and only progestins. Evidence also shows efficacy with selective serotonin reuptake inhibitors. Other nonhormonal alternatives exist as second-line treatments, all with not conclusive results. The GSM can be treated with nonhormonal treatments such as vaginal lubricants and moisturizers, other alternatives as vaginal laser needs to have more evidence. On the other hand, there is the possibility to use the hormonal treatments with systemic or local estrogen, which are the most effective treatment, the TSEC and the newest selective estrogen receptor modulator (SERM), ospemifene. Therapies with testosterone and dehydroepiandrosterone (DHEA) are still under study. The GSM can be treated with nonhormonal treatments such as vaginal lubricants and moisturizers, and other alternatives as vaginal laser need to have more evidence. On the other hand, there is the possibility to use the hormonal treatments with systemic or local estrogen, which are the most effective treatment, the TSEC and the newest SERM, ospemifene. Therapies with testosterone and DHEA are still under study. The increasing numbers of therapies for menopausal symptoms open up new options, but we must individualize treatments. New possibilities arise in patients who did not have them and which can improve compliance and is also important to design strategies using combined or sequential treatments.
Ghosh, Mimi; Rodriguez-Garcia, Marta; Wira, Charles R
With aging, a general decline in immune function is observed leading to immune-senescence. Several of these changes are gender specific affecting postmenopausal women. Menopause is a normal part of a woman's lifecycle and consists of a series of body changes that can last from one to ten years. It is known that loss of sex hormones due to aging results in a reduction of immune functions. However, there remains a major gap in our understanding regarding the loss of immune functions particularly in the female reproductive tract (FRT) following menopause and the role of menopausal hormone therapy (MHT) in protecting against immune senescence. The current review presents an overview of changes in the immune system due to aging, focusing on genital tract immunity in menopausal women and the risks and benefits of using MHT. This article is part of a Special Issue entitled 'Menopause'. Copyright © 2013 Elsevier Ltd. All rights reserved.
Muscelli, Elza; Kozàkovà, Michaela; Flyvbjerg, Allan
BACKGROUND: The mechanisms by which menopause may influence the systemic subclinical atherosclerosis are unexplained. The aim of this cross-sectional study was to evaluate the associations between early menopause, established cardiovascular (c-v) risk factors, metabolic parameters (insulin...... secretion and sensitivity, plasma adiponectin), and carotid intima-media thickness (IMT) in healthy women. METHODS: In 74 menopausal women (mean age = 51 +/- 3 years, mean duration of menopause = 2.9 +/- 1.2 years) and in 74 nonmenopausal women comparable for age and body mass index (BMI), common carotid...... by mathematical modeling. RESULTS: CCA diameter (5.55 +/- 0.46 vs. 5.21+/- 0.51 mm, P menopausal women, whereas CCA IMT/diameter ratio and IMT in other carotid...
Li Wenqi; Li Xin; Zhou Jiwen; Zhou Zhengli
Objective: To explore the clinical value of determination of serum PRL levels inpost-menopausal women. Methods: Serum PRL levels were determined with RIA in 596 post-menopausal women (age 45-59, mean 55). Results: The normal range of serum PRL level in this laboratory was 0-30 ng/ml. Among the 596 women tested, 77(13%) had their PRL levels above 30 ng/ml. Further investigation with CT and/or MRI revealed presence of micro-pituitary-adenoma in 31 of the Symptoms of menopausal syndrome and osteoporosis were much more severe in women with hyperprolactinemia then in those without. Conclusion: As hyperprolactinemia might be a high risk factor for development of breast cancer, hormone replacement therapy (HRT) in menopausal women with hyperprolactinemia should be applied very cautiously, even withheld at all. Determination of serum prolactin levels in post-menopausal women is of practical clinical value. (authors)
Yang Liu; Guo Hui; Duan Liusheng
In order to clarify the mechanism of osteogenesis and osteopenia of the menopausal women, serum [Ca 2+ ], [P 3+ ], AKP, sexual hormones and BGP level were investigated. The blood samples were taken from 177 female individuals who were divided into 5 groups based on different ages of menopause. Serum estradiol, testosterone and BGP were measured by RIA. Serum LH, FSH and PRL were determined by IRMA. Serum [Ca 2+ ], [P 3+ ], AKP were determined by biochemistry analytical methods. Results showed that serum E 2 and T levels in the menopausal women were lower than those in the normal, E 2 decreased significantly. Meanwhile, serum PRL level was only a little lower, but the menopausal female had the higher levels of LH and FSH. Conclusion: the most important cause of osteopenia for the menopausal women is the deficiency of estrogen and degeneration of ovarian function
Alexander, Jeanne Leventhal; Burger, Henry; Dennerstein, Lorraine; Woods, Nancy Fugate; Davis, Susan R; Kotz, Krista; Van Winkle, Julie; Richardson, Gregg; Ratka, Anna; Kessel, Bruce
This article aims to educate the nonpsychiatric as well as the psychiatric clinician on the impact of vasomotor symptoms in women with comorbid psychiatric problems and the challenges of treating vasomotor symptoms in these women. The pathophysiology, prevalence and common risk factors associated with disturbing hot flashes in the menopausal transition are reviewed. Hormonal, nonhormonal and behavioral treatment options of vasomotor symptoms for these women are discussed. Special pharmacokinetic implications for hormonal treatment of those women on anticonvulsant medications for the treatment of their mood disorders, on tamoxifen and/or with high or low sex hormone-binding globulin are examined. An in-depth discussion of mood and the menopausal transition, theoretical mechanisms for mood problems with the symptomatic menopause and the impact of stress on the symptomatic menopause are found elsewhere in this clinical review series on psychiatric illness, stress and the symptomatic menopause.
Cramer, Joyce A; Gordon, Jacki; Schachter, Steven; Devinsky, Orrin
Epilepsy is a multilayered disorder complicated by numerous comorbid conditions and hormonal changes. More than 1.5 million girls and women with epilepsy face side effects that are compounded at different ages by menstruation, fertility, pregnancy, fetal health, bone health, and other health issues. Changes in hormonal balance during maturation, from menarche through menopause, affect seizure thresholds and antiepileptic drugs, and vice versa. This overview provides physicians with a background on the multiple issues relevant to women of all ages in the reproductive years, including those planning to conceive and those who are pregnant, and beyond the childbearing years.
Full Text Available A 52-year-old patient presented with complaints of menorrhagia. Endometrial biopsy revealed simple hyperplasia of the endometrium. Total abdominal hysterectomy with bilateral oophorectomy was carried out. The ovaries looked grossly normal, but histopathology reported granulosa cell tumor of the right ovary. Granulosa cell tumors belong to the sexcord stromal category and account for approximately 2% of all ovarian tumors. We review the features and treatment of granulosa cell tumors and the importance of screening for ovarian tumors in a case of endometrial hyperplasia and delayed menopause.
Wei Tao; Ma Yongxiu; He Juan
Serum leptin, follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E 2 ) were measured by RIA in 138 peri-menopausal women in order to clear the relations between them. The results showed that serum levels of all the four circulating hormones are all changed significantly in all subgroups. Compared with the women of childbearing age group, it changed with P < 0.05; P < 0.01 respectively. All the changes indicate: As a circulating hormone, leptin plays an important role in woman's normal physiology developing process along ages
Allen, Caitlin; Evans, Ginger; Sutton, Eliza L
Female hormones play a significant role in the etiology and treatment of many women's health conditions. This article focuses on the common uses of hormonal therapy. When prescribing estrogen-containing regimens throughout the span of a woman's life, the risks are similar (ie, cardiovascular risk and venous thromboembolism), but the degree of risk varies significantly depending on a woman's particular set of risk factors and the details of the hormone regimen. In addition to estrogens and progestogens, this article also touches on the use of selective steroid receptor modulators in emergency contraception and in treatment of menopause symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.
Kozinoga, Mateusz; Majchrzycki, Marian; Piotrowska, Sylwia
Low back pain is a massive problem in modern population, both in social and economic terms. It affects large numbers of women, especially those aged 45-60. Going through a perimenopausal period is associated with many symptoms, including low back pain. This paper is a review of published research on the association between the perimenopausal age and low back pain. PubMed databases were investigated. After the search was narrowed to “menopausal status, back pain”, 35 studies were found. Se...
Unalan Pemra C
Full Text Available Abstract Background While bio-medically, menopause could be treated as an illness, from a psychosocial and cultural perspective it could be seen as a "natural" process without requiring medication unless severe symptoms are present. Our objective is to explore the perceptions of Turkish women regarding menopause and Hormone Therapy (HT to provide health care workers with an insight into the needs and expectations of postmenopausal women. Methods A qualitative inquiry through semi-structured, in-depth interviews was used to explore the study questions. We used a purposive sampling and included an equal number of participants who complained about the climacteric symptoms and those who visited the outpatient department for a problem other than climacteric symptoms but when asked declared that they had been experiencing climacteric symptoms. The interview questions focused on two areas; 1 knowledge, experiences, attitudes and beliefs about menopause and; 2 menopause-related experiences and ways to cope with menopause and perception of HT. Results Most of the participants defined menopause as a natural transition process that one should go through. Cleanliness, maturity, comfort of not having a period and positive changes in health behaviour were the concepts positively attributed to menopause, whereas hot flushes, getting old and difficulties in relationships were the negatives. Osteoporosis was an important concern for most of the participants. To deal with the symptoms, the non-pharmacological options were mostly favoured. Conclusion To our knowledge, this is the first qualitative study which focuses on Turkish women's menopausal experiences. Menopause was thought to be a natural process which was characterised by positive and negative features. Understanding these features and their implications in these women's lives may assist healthcare workers in helping their clients with menopause.
Shen, Lijun; Song, Lulu; Liu, Bingqing; Li, Hui; Zheng, Xiaoxuan; Zhang, Lina; Yuan, Jing; Liang, Yuan; Wang, Youjie
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.
Sayakhot, Padaphet; Vincent, Amanda; Teede, Helena
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.
Bellavia, Andrea; Wolk, Alicja; Orsini, Nicola
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.
Sievert, Lynnette Leidy; Espinosa-Hernandez, Graciela
To examine how attitudes toward menopause were associated with symptom frequencies after controlling for menopause status and level of education. Women aged 28-70 (n = 755) were interviewed from May, 1999 through August, 2000 in the city of Puebla, Mexico. Over 90% of the sample were aged 40-60. Participants were asked to select from a set of dichotomies to describe "how a woman feels during menopause." Symptom frequencies were assessed by a checklist of everyday complaints experienced during the two weeks before interview. Symptom presence or absence was examined in relation to attitudes while controlling for menopause status and level of education using binary logistic regression analyses. The majority of respondents said that a menopausal woman feels "insecure" and "unattractive" yet "complete," "necessary," and "successful." Pre-menopausal women and respondents who had undergone a hysterectomy were more likely to express negative attitudes. Post-menopausal women and women with fewer years of education were significantly more likely to report symptoms such as hot flashes, joint aches, and nervous tension. A range of negative attitudes were associated with nervous tension, feeling blue, and head aches; however, only a few negative attitudes were significantly predictive of estrogen-related symptoms (e.g., hot flashes). There is a high value placed on both external appearance and familial responsibility among menopausal women in Puebla, Mexico, and negative characterizations of menopause reflect these values. Negative attitudes were associated with more frequently reported symptoms compared with positive attitudes. The challenge remains to separate factors related to the hormonal changes of menopause from those not associated with hormonal changes to better understand symptom experience.
Atsalis, Sylvia; Margulis, Susan W
As our closest living relatives, great apes likely experience physiological patterns associated with reproductive aging that are similar to humans. We present results from a nationwide zoo-based study on female western lowland gorillas during which we evaluated concentrations of progestogens via daily fecal sampling in 30 gorillas, 22 of whom were geriatric (>or=30). Whereas control females cycled regularly, ca. 23% of geriatric females were acyclic (menopausal), and approximately 1/3 showed variable hormonal patterns suggestive of perimenopause. Patterns included increased cycle variability, low luteal phase rises of progestogens - possibly indicative of anovulatory cycling - and peak height variability of progestogens in the luteal phase of the cycle. We discovered a progressive trend toward increased variability in estrous cycle length and toward decreased concentrations of fecal progestogens when we compared control to geriatric cycling and to geriatric noncycling females. Noncycling females had significantly lower overall progestogen concentrations than the cycling females, though differences were not significant when cycle phase was incorporated. Preliminary analyses of follow-up data on 10 perimenopausal females indicated that subjects experienced age-related changes in reproductive function that mirrored those observed in aging human females including a female who transitioned from perimenopause to menopause. To date, maximum longevity in captive female gorillas is 52 years, with poor reproductive prognosis beginning from the age of 37 suggesting a postreproductive lifespan of >25%. Continued study of aging apes is warranted, with emphasis on longitudinal monitoring of aged subjects.
Jaouen, Klervia; Balter, Vincent
Iron (δ(56) Fe) and copper (δ(65) Cu) stable isotope compositions in blood of adult human include a sex effect, which still awaits a biological explanation. Here, we investigate the effect of menopause by measuring blood δ(56) Fe and δ(65) Cu values of aging men and women. The results show that, while the Fe and Cu isotope compositions of blood of men are steady throughout their lifetime, postmenopausal women exhibit blood δ(65) Cu values similar to men, and δ(56) Fe values intermediate between men and premenopausal women. The residence time of Cu and Fe in the body likely explains why the blood δ(65) Cu values, but not the δ(56) Fe values, of postmenopausal women resemble that of men. We suggest that the Cu and Fe isotopic fractionation between blood and liver resides in the redox reaction occurring during hepatic solicitation of Fe stores. This reaction affects the Cu speciation, which explains why blood Cu isotope composition is impacted by the cessation of menstruations. Considering that Fe and Cu sex differences are recorded in bones, we believe this work has important implications for their use as a proxy of sex or age at menopause in past populations. Copyright © 2013 Wiley Periodicals, Inc.
Nappi, Rossella E; Albani, Francesca; Santamaria, Valentina; Tonani, Silvia; Martini, Ellis; Terreno, Erica; Brambilla, Emanuela; Polatti, Franco
The present short review underlines the role of testosterone (T) in the motivational and satisfaction components of women's sexuality and critically discusses the strategies to treat hypoactive sexual desire disorder (HSDD), a condition of low desire associated with personal and/or interpersonal difficulties, which is more common in surgical menopausal women. There are multiple ways androgens target the brain regions (hypothalamic, limbic and cortical) involved in sexual function and behaviour. Even though circulating available androgens have been implicated in several domains of sexual response, they seem to be related weakly to symptoms, such as low sexual desire, poor sexual arousal, orgasm and diminished well-being in postmenopausal women. The possibilities of treating low sexual desire/HSDD are multifaceted and should include the combination of pharmacological treatments able to maximize biological signals driving the sexual response, and individualized psychosocial therapies in order to overcome personal and relational difficulties. Transdermal T has been shown to be effective at a dose of 300 µg/day both in surgically and naturally menopausal women replaced with estrogen or not, without any relevant side-effects. However, the decision to treat postmenopausal women with HSDD with T is mainly based on clinical judgement, after informed consent regarding the unknown long-term risks.
Hajirahimkhan, Atieh; Dietz, Birgit M.; Bolton, Judy L.
Menopausal women suffer from a variety of symptoms, including hot flashes and night sweats which can affect quality of life. Although hormone therapy (HT) has been the treatment of choice for relieving these symptoms, HT has been associated with increased breast cancer risk leading many women to search for natural, efficacious, and safe alternatives such as botanical supplements. Data from clinical trials suggesting that botanicals have efficacy for menopausal symptom relief, have been controversial and several mechanisms of action have been proposed including estrogenic, progestogenic, and serotonergic pathways. Plant extracts with potential estrogenic activities include soy, red clover, kudzu, hops, licorice, rhubarb, yam, and chasteberry. Botanicals with reported progestogenic activities are red clover, hops, yam, and chasteberry. Serotonergic mechanisms have also been proposed since women taking antidepressants often report reduction in hot flashes and night sweats. Black cohosh, kudzu, kava, licorice, and dong quai all either have reported 5-HT7 ligands or inhibit serotonin re-uptake, therefore have potential serotonergic activities. Understanding the mechanisms of action of these natural remedies used for women’s health, could lead to more efficacious formulations and to the isolation of active components which have the potential of becoming effective medications in the future. PMID:23408273
Full Text Available Abstract The importance of the results of some large, randomized controlled trials (RCTs on Hormone Replacement Therapy (HRT has modified the risk/benefit perception of HRT. Recent literature review supports a different management. The differences in age at initiation and the duration of HRT are key points. HRT appears to decrease coronary disease in younger women, near menopause; yet, in older women, HRT increases risk of a coronary event. Although HRT is a recognized method in the prevention and treatment of osteoporosis, it is not licensed for the prevention of osteoporosis as a first-line treatment. The effectiveness of low and ultra-low estrogen doses has been demonstrated for the treatment of vasomotor symptoms, genital atrophy and the prevention of bone loss, with fewer side-effects than the standard dose therapy. Further research, however, is needed to determine the effect both on fractures, as well as on cardiovascular and breast diseases. Newer progestins show effects that are remarkably different from those of other assays. The effectiveness of testosterone at improving both sexual desire and response in surgically and naturally postmenopausal women is shown by the testosterone patch. The intention, dose and regimen of HRT need to be individualized, based on the principle of choosing the lowest appropriate dose in relation to the severity of symptoms and the time and menopause age.
Fukuta, Hajime; Ito, Itsuo; Tateno, Amane; Nogami, Tsuyoshi; Taiji, Yasutomo; Arakawa, Ryosuke; Suhara, Tetsuya; Asai, Kunihiko; Okubo, Yoshiro
The aim of this study was to investigate the influences of menopause on brain morphological changes in schizophrenia using magnetic resonance imaging (MRI). Forty female schizophrenia patients, 20 premenopausal and 20 postmenopausal, and 50 female controls underwent cerebral MRI. Optimized voxel-based morphometry was performed with Statistical Parametric Mapping version 5. Compared with controls, regional gray matter reductions in schizophrenia patients were observed in the insula, superior temporal gyrus, anterior cingulate, parahippocampal gyrus, and thalamus. Direct comparison between the patient groups showed that the gray matter of postmenopausal patients was significantly smaller when compared with premenopausal patients in the left middle frontal gyrus, and no region had significantly lower gray matter volume in premenopausal patients relative to postmenopausal patients. Significant negative correlation between gray matter volume and the interval after menopause was found in the right superior frontal gyrus in the postmenopause patient group. Differential morphological alterations between postmenopausal and premenopausal schizophrenia patients were observed, suggesting that the female hormone plays a protective role against schizophrenia. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.
Chow, Erika T; Mahalingaiah, Shruthi
Cosmetics contain a vast number of chemicals, most of which are not under the regulatory purview of the Food and Drug Administration. Only a few of these chemicals have been evaluated for potential deleterious health impact: parabens, phthalates, polycyclic aromatic hydrocarbons, and siloxanes. A review of the ingredients in the best-selling and top-rated products of the top beauty brands in the world, as well as a review of highlighted chemicals by nonprofit environmental organizations, reveals 11 chemicals and chemical families of concern: butylated hydroxyanisole/butylated hydroxytoluene, coal tar dyes, diethanolamine, formaldehyde-releasing preservatives, parabens, phthalates, 1,4-dioxane, polycyclic aromatic hydrocarbons, siloxanes, talc/asbestos, and triclosan. Age at menopause can be affected by a variety of mechanisms, including endocrine disruption, failure of DNA repair, oxidative stress, shortened telomere length, and ovarian toxicity. There is a lack of available studies to make a conclusion regarding cosmetics use and age at menopause. What little data there are suggest that future studies are warranted. Women with chronic and consistent use of cosmetics across their lifespan may be a population of concern. More research is required to better elucidate the relationship and time windows of vulnerability and the effects of mixtures and combinations of products on ovarian health. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Azizi, Hoda; Feng Liu, Yan; Du, Lin; Hua Wang, Chao; Bahrami-Taghanaki, Hamidreza; Ollah Esmaily, Habib; Azizi, Hamideh; Ou Xue, Xiao
To compare the therapeutic effect of Chinese herbal medicine (CHM), acupuncture, and hormone therapy on menopause- related symptoms of peri- and postmenopausal women. Fifty-seven Chinese women completed 2 months of treatment with either CHM (5 g twice daily, n = 22), acupuncture plus CHM (Kun Bao Wan) 5 g twice daily plus sessions of acupuncture, n = 20), or hormone therapy (n = 15). Kupperman index score, levels of follicle-stimulating hormone (FSH) and estradiol, and the number of symptoms before and after treatment were the main outcome measures. CHM, acupuncture plus CHM, and hormone therapy significantly decreased Kupperman score (P acupuncture plus CHM and CHM with significantly better results by acupuncture plus CHM. Acupuncture plus CHM, as well as hormone therapy, significantly reduced the level of FSH (P .05). The mean difference in the level of FSH between baseline and 2 months among the three groups was significantly different (P = .02). This difference was only between CHM and hormone therapy with significantly better results by hormone therapy. The three treatments didn't make any significant increase in the level of E2 (P > .05). application of the combination of Chinese herbal medicine and acupuncture proved as effective as hormone therapy in the treatment of menopause-related symptoms, and it achieved better outcomes than herbal medicine alone.
Full Text Available Numerous concerns about menopause exist among women, and fear of an increase in body weight is one of the most important of them. This paper presents an overview of current knowledge concerning the etiology of obesity related to menopause and about the mechanisms of its development, with particular regard to the hormonal changes that occur during this period of life. The role of estrogens in the regulation of energy balance and the effect of sex hormones on metabolism of adipose tissue and other organs are presented. The consequence of the sharp decline in the secretion of estrogens with subsequent relative hyperandrogenemia is briefly discussed. The main intention of this review is to clarify what is inevitable and what perhaps results from negligence and unhealthy lifestyles. In the last part of the paper the possibilities of counteracting the progress of adverse changes in body composition, by promoting beneficial lifestyle modifications and the use of hormonal substitution treatment, in cases where it is reasonable and possible, are described.
Umland, Elena M; Falconieri, Laura
Vasomotor symptoms (VMS), including hot flashes and night sweats, occur in as many as 68.5% of women as a result of menopause. While the median duration of these symptoms is 4 years, approximately 10% of women continue to experience VMS as many as 12 years after their final menstrual period. As such, VMS have a significant impact on the quality of life and overall physical health of women experiencing VMS, leading to their pursuance of treatment to alleviate these symptoms. Management of VMS includes lifestyle modifications, some herbal and vitamin supplements, hormonal therapies including estrogen and tibolone, and nonhormonal therapies including clonidine, gabapentin, and some of the serotonin and serotonin-norepinephrine reuptake inhibitors. The latter agents, including desvenlafaxine, have been the focus of increased research as more is discovered about the roles of serotonin and norepinephrine in the thermoregulatory control system. This review will include an overview of VMS as they relate to menopause. It will discuss the risk factors for VMS as well as the proposed pathophysiology behind their occurrence. The variety of treatment options for VMS will be discussed. Focus will be given to the role of desvenlafaxine as a treatment option for VMS management.
Faubion, Stephanie S; Sood, Richa; Kapoor, Ekta
Genitourinary syndrome of menopause (GSM), previously known as atrophic vaginitis or vulvovaginal atrophy, affects more than half of postmenopausal women. Caused by low estrogen levels after menopause, it results in bothersome symptoms, including vaginal dryness, itching, dyspareunia, urinary urgency and increased frequency, and urinary tract infections. Even though women with GSM can have sexual dysfunction that interferes with partner relationships, women are often embarrassed to seek treatment, and health care professionals do not always actively screen for GSM. As a result, GSM remains underdiagnosed and undertreated. Several effective treatments exist, but low-dose vaginal estrogen therapy is the criterion standard. It is effective and safe for most patients, but caution is suggested for survivors of hormone-sensitive cancers. Newer treatment options include selective estrogen receptor modulators, vaginal dehydroepiandrosterone, and laser therapy. Nonprescription treatments include vaginal lubricants, moisturizers, and dilators. Pelvic floor physical therapy may be indicated for some women with concomitant pelvic floor muscle dysfunction. Sex therapy may be helpful for women with sexual dysfunction. This concise review presents a practical approach to the evaluation and management of GSM for the primary care physician. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Full Text Available Abstract Background To evaluate the impact of osteoporosis on the patients' quality of life, particularly in the absence of fractures. Methods 100 post-menopausal women (age 50-85 - 62 with uncomplicated primary osteoporosis and 38 with primary osteoporosis complicated by vertebral fractures; all already treated - were studied using two validated questionnaires: Qualeffo-41 for quality of life in osteoporosis, and Zung for depression. Data were compared to those of 35 controls of comparable age, affected by a different chronic disease (hypothyroidism. Results Family history of osteoporosis and T-score of spine were similar in the two subgroups of osteoporotic women. Body mass index, age at menopause and education level were similar in the two subgroups of osteoporotic women and in the control group. The patients affected by osteoporosis perceived it as a disease affecting their personal life with undesirable consequences: chronic pain (66% of women with fractures and 40% of women without fractures, impaired physical ability, reduced social activity, poor well-being (21% of women without fractures and depressed mood (42% of women irrespective of fractures. Overall, 41% of the women showed a reduced quality of life. On the contrary, in the control group only 11% reported a reduced quality of life. Conclusion The quality of life of osteoporotic patients should be investigated even before fractures, in order to develop appropriate counselling, support and care interventions to help patients develop efficient strategies for accepting the disease and coping with it.
Full Text Available Gestational Trophoblastic Neoplasms (GTN are group of diseases which are known as fertilization disorders and may appear as Complete hydatidiform mole, Mole partialis, Invasive mole, Placental site trophoblastic tumor, Choriocarcinoma. Malignant disease precedes in approxi mately 50% of patients. All cases of GTN must be registrated. The Followe up programme period may last 6 months to 2 years until three sequential beta hCG values are negative. The risk of repeated GTN is low but patient has to be informed that risk is 1 : 74. GTN can appear in perimenopausal or menopausal women. That is the reason why each rapid enlargement of uterus especially with uterine bleeding followed with multiple cystic formations (grape like cysts needs a serious examination on GTN. Patient can complain of nausea, vomiting, painful breasts or hiperthyoidism. Legal abortion can precede GTN in perimenopausal women. In the great number of women with GTN the last pregnancy was 5 or more than 5 years before GTN is diagnosed. During 5 year period from june 1999. till june 2004, 58 GTN cases were diagnosed on our Department. 7 women with confirmed GTN were in perimenopause or menopause. All cases were hystologicalu confirmed with clinical low clinical score. In 1999. (March-June unpowerishment Uranium was used during war in Former Yugoslavia. Potential effect on reproductive potential could be analyzed after collecting data from the whole territory of Serbia and Montenegro in next years. All GTN patients are clinically, laboratory and ultrasonographicaly examined and staged according to FIGO 2002. recommendations
Landgren, Britt-Marie; Collins, Aila; Csemiczky, Giorgy; Burger, Henry G; Baksheev, Lyrissa; Robertson, David M
To examine the hormonal characteristics of menstrual cycles in healthy women approaching menopause, serum hormone profiles were investigated annually in this longitudinal study of 13 healthy women between 4 and 9 yr before menopause and the year of the menopause. Serum FSH, LH, estradiol, progesterone, total inhibin, inhibins A and B, and prolactin were determined in blood samples collected annually three times weekly for 4 wk beginning with the onset of menses. Menstrual bleeding diaries covering this 4- to 9-yr period were also collected allowing the prospective identification of the final menstrual period. A change in serum hormone patterns was observed in cycles approaching menopause, exemplified by an increasing number of cycles of prolonged length with a prolonged follicular phase resulting in a failure to detect a luteal phase rise in serum progesterone within the 4-wk collection period. These prolonged cycles (designated B cycles based on a previous work) were analyzed separately and compared with the remaining ovulatory (D) cycles. No B cycles were identified in any women earlier than 27 cycles from menopause. The proportion of B cycles increased as menopause approached, reaching 62% in the last 10 cycles. The proportion of D cycles decreased accordingly. The B cycles during the initial 4-wk collection period were characterized by elevated FSH, LH, FSH/inhibin A and FSH/inhibin B ratios, and longer duration, although cycle length/subject was not significantly different presumably due to the small number of B cycles. The D cycles showed no changes in hormonal profiles over the 4- to 9-yr time period. These data indicate that there is a time-related change in the character of menstrual cycles as menopause approaches, with an increasing proportion of cycles observed with prolonged follicular phases that may either be delayed ovulatory cycles or anovulatory cycles. The increase in the proportion of B cycles with elevated early follicular phase FSH levels and
Im, Eun-Ok; Lee, Yaelim; Chee, Eunice; Chee, Wonshik
Advances in computer and Internet technologies have allowed health care providers to develop, use, and test various types of Web-based interventions for their practice and research. Indeed, an increasing number of Web-based interventions have recently been developed and tested in health care fields. Despite the great potential for Web-based interventions to improve practice and research, little is known about the current status of Web-based interventions, especially those related to menopause. To identify the current status of Web-based interventions used in the field of menopause, a literature review was conducted using multiple databases, with the keywords "online," "Internet," "Web," "intervention," and "menopause." Using these keywords, a total of 18 eligible articles were analyzed to identify the current status of Web-based interventions for menopause. Six themes reflecting the current status of Web-based interventions for menopause were identified: (a) there existed few Web-based intervention studies on menopause; (b) Web-based decision support systems were mainly used; (c) there was a lack of detail on the interventions; (d) there was a lack of guidance on the use of Web-based interventions; (e) counselling was frequently combined with Web-based interventions; and (f) the pros and cons were similar to those of Web-based methods in general. Based on these findings, directions for future Web-based interventions for menopause are provided. Copyright Â© 2016 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Background Domination of the biomedical approach to menopause may imply creation of negative attitudes to the phenomenon, and at the same time negatively affect women’s life satisfaction and behaviour in the family. It is assumed that physical activity may be a defensive factor, as this type of activity may reduce the intensity of menopause symptoms. The aim of the research was to determine the relation between menopause evaluation, life satisfaction and tactics of influence employed in marriage by women who differ in involvement in physical exercise. Participants and procedure The research was conducted among 90 women, at the age of 45-55: 45 physically active women and 45 women who do not engage in any physical activity. The following research methods were used: the Menopause Evaluation Scale, the Satisfaction With Life Scale (SWLS and the Questionnaire of Influence in Close Relations of Women and Men. Results Positive evaluation of menopause was related to involvement in physical exercise as well as to a stronger tendency to use positive strategies of exerting influence on one’s spouse. The research also showed a slight correlation between life satisfaction and involvement in physical exercise. Negative evaluation of menopause was related to avoiding physical activity. Conclusions Physical activity is more frequently related to a positive attitude towards menopause and the use of more positive tactics of exerting influence on one’s spouse, and slightly positively conducive to one’s life satisfaction level.
Full Text Available Post-menopausal women experience physiological hormonal changes that reduce bone density which leads to tooth loss and presumably affect masticatory function. Objective: This study aims to determine association between tooth loss and masticatory ability in post-menopausal women. Methods: Cross sectional study of 95 post-menopausal women at Posbindu Lansia Pergeri Depok, West Java was performed. Subjects answered questionnaires and intra oral examination was performed. Chi square analysis was conducted to relate age, menopausal period, education level, tooth loss and denture use with masticatory ability. Results: 47% subjects lost >10 teeth, 27% subjects lost 6-10 teeth and 26% subjects lost <6 teeth. Seventy-six percent of subjects did not wear dentures. Menopausal period, tooth loss, and age had significant correlation with masticatory ability (p<0.05. Conclusions: This study concludes that masticatory ability in post-menopausal women is significantly affected by length of menopausal period, tooth loss and age (p<0.05.
Simoncig-Netjasov, Aleksandra; Vujović, Svetlana; Ivović, Miomira; Tancić-Gajić, Milina; Drezgić, Milka
Hypoestrogenic status in the menopausal women shows a shift to a central android fat distribution and metabolic syndrome (MIS). Related metabolic changes and hypertension increase the risk for cardiovascular (CV) diseases. The aim of this study was to investigate the influence of duration of menopause, anthropometric and hormonal parameters on metabolic syndrome. 50 obese women were examined with BMI = 31.92 = 5.83 kg/m2, age 54.40 +/- 3.64, time since menopause 5.90 +/- 5.46 years. Control group consisted of 37 normal weight women with BMI = 23.50 +/- 2.13 kg/m2, age 53.92 +/- 3.95, time since menopause 5.96 +/- 4.92 years. Anthropometric characteristics and blood pressure were measured. Blood was taken at 8 am for: fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A (ApoA), apolipoprotein B (ApoB), lipoprotein(a) (Lp(a)), C-reactive protein (CRP), fibrinogen, FSH, LH, prolactin, estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG). In obese women significant negative correlations were found for: BMI anid HDL (p menopause and waist/hip ratio (p menopause and HDL (p menopausal endocrine changes cause metabolic and hemodynamic imbalances, which contribute to risk for cardiovascular diseases.
Baber, R J; Panay, N; Fenton, A
The International Menopause Society (IMS) has produced these new 2016 recommendations on women's midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.
Aydogan, B; Mirkin, S
Menopause is a relevant phase in a woman's reproductive life. Accurate estimation of the time of menopause could improve the preventive management of women's health. Reproductive hormones reflect the activity of follicle pools and provide information about ovarian aging. Anti-Mu llerian hormone (AMH) is secreted from small antral follicles and its level is correlated to the ovarian reserve. AMH declines with age, and data suggest that it can provide information on menopausal age and reproductive lifespan. Serum AMH levels become low approximately 5 years before the final menstrual period and are undetectable in postmenopausal women. The majority of studies indicate that AMH is relatively stable throughout the menstrual cycle; however, there are interindividual variabilites of serum AMH concentration under different conditions. AMH is an independent predictor of time to menopause. AMH coupled with age for menopause prediction provides stronger information than using age alone. Ongoing research is focused on constructing a multivariate model including AMH values, genes related to follicular recruitment and maternal age of menopause that would predict more precisily time to menopause.