Search

Abstract In this triple-blind, randomized clinical trial, 60 menopausal women between the ages of 45 and 65 were randomized to receive 78% dark chocolate (12 g/day) or milk chocolate (12 g/day) for eight weeks. The primary outcome was depression scores. Secondary outcomes included sleep quality and anthropometric indices. ANCOVA with baseline adjustment showed that the mean depression score after the intervention in the group receiving dark chocolate was significantly reduced compared to the milk chocolate group (mean difference: -2.3; 95% confidence interval: -3.9 to -0.8; p = 0.003; Cohen’s d = -0.54). However, no statistically significant difference in the overall sleep quality score and its subdomains was observed between the two groups after the intervention (p > 0.05). Furthermore, after the intervention, there was no statistically significant difference between the two groups in terms of anthropometric indices, including weight (p = 0.075), BMI (p = 0.137), waist circumference (p = 0.463), and hip circumference (p = 0.114). The study suggests that consuming 78% dark chocolate for eight weeks may contribute to improvements in depression scores, but it does not appear to improve sleep quality or anthropometric indices. Trial registration: IRCT20220926056046N1; December 2022.

The number of mature and elderly women is increasing all over the world. According to the World Health Organization, in most countries of the world, the life expectancy of women after the age of 50 ranges from 27 to 32 years. Thus, approximately one third of a woman’s life is lived after menopause. Aim. To analyze and summarize scientific data on cardiovascular and metabolic risks in perimenopausal and menopausal women based on the use of scientometric databases. Menopause should be considered as a risk factor for the development of cardiovascular diseases (CVDs), which triggers a whole cascade of pathological changes in a woman’s body, including the development of arterial hypertension, dyslipidemia, abdominal obesity, insulin resistance, an increased sympathoadrenal tone, endothelial function disorders, and inflammatory vascular reactions. CVD is known to be the leading cause of death among postmenopausal women associated with the loss of estrogenic protective effect on the cardiovascular system. Women with premature menopause have a 33 % higher risk of heart failure and a 9 % higher risk of atrial fibrillation. Metabolic syndrome is more common in postmenopausal women than in premenopausal women. It is defined as a cluster of disorders characterized by impaired glucose metabolism, high blood pressure, central obesity, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol and triglycerides. It is the activity of low-density lipoproteins and an increase in the level of triglycerides that have serious consequences in the etiology of cardiovascular diseases and the development of atherosclerosis. Osteoporosis ranks fourth among non-communicable diseases after CVD, cancer and diabetes. Estrogen deficiency during menopause results in increased osteoclast resorptive activity, while osteoblast function remains relatively constant, ultimately resulting in bone loss. In the first postmenopausal years, a woman can lose up to 9–35 % of bone mass, postmenopausal osteoporosis affects between one third to a half of all women. Conclusions. Menopause is a difficult period in a woman’s life, during which the risk of developing cardiovascular diseases and metabolic disorders increases, as well as almost all somatic diseases are exacerbated. Therefore, proper assessment of such risks is mandatory to improve long-term CVD outcomes. Given this, it is the interdisciplinary interaction that is central to early detection of symptoms and diagnosis of climacteric disorders for the timely prescription of treatment. Physicians working with this contingent of women should apply a comprehensive approach to health care and quality of life preservation during the menopause transition, menopause and postmenopause.

Objective Postmenopausal changes in bone mass and structure compromise the mechanical properties of proximal humerus, predisposing it to low‐energy fractures with complex morphology. The aim of the study is to investigate associations of bone quality and estimated bone strength of the surgical neck with age after menopause. Methods A total of 122 healthy postmenopausal women were recruited from December 2016 to December 2022 and assigned to three groups: the 50–59 years group, the 60–69 years group, and the older than 70 years group. Bone properties of the surgical neck, including volumetric bone mineral density (vBMD), cortical thickness (CTh), the periosteal and medullary size, and estimated indices of bone strength were evaluated by quantitative computed tomography. Results Compared to the 50–59 years group, postmenopausal women aged over 70 years were characterized by lower cortical thickness (13.9%) and vBMD (6.65%), as well as reduced strength indices including the minimum and maximum section modulus (Zmin 18.11%, Zmax 21.71%), polar section modulus (Zpol 20.21%), and the minimum and maximum second moments of area (Imax 21.01%, Imin 21.43%). Meanwhile, the difference in periosteal diameter and perimeter, total area in three groups did not reach statistical significance. Both cortical thickness and vBMD value were inversely associated with age, showing 10.56% and 23.92% decline. Imax showed the greatest age‐related decrease between age of 54 and 86 years (39.08%), followed by Zmax (−35.77%), Imin (−35.73%), Zpol (−34.90%) and Imin (−23.92%).The strength indices had stronger correlations with cortical thickness than with bone size or density. Conclusion In postmenopausal women, aging is associated with a significant decline in cortical bone thickness and mechanical strength of the proximal humerus, especially over the age of 70 years.

Abstract Background Obesity, and in particular abdominal obesity, is associated with an increased risk of developing a variety of chronic diseases. Obesity, aging, and menopause are each associated with differential shifts in the gut microbiome. Obesity causes chronic low-grade inflammation due to increased lipopolysaccharide (LPS) levels which is termed “metabolic endotoxemia.” We examined the association of visceral adiposity tissue (VAT) area, circulating endotoxemia markers, and the gut bacterial microbiome in a cohort of aged postmenopausal women. Methods Fifty postmenopausal women (mean age 78.8 ± 5.3 years) who had existing adipose measurements via dual x-ray absorptiometry (DXA) were selected from the extremes of VAT: n = 25 with low VAT area (45.6 ± 12.5 cm2) and n = 25 with high VAT area (177.5 ± 31.3 cm2). Dietary intake used to estimate the Healthy Eating Index (HEI) score was assessed with a food frequency questionnaire. Plasma LPS, LPS-binding protein (LBP), anti-LPS antibodies, anti-flagellin antibodies, and anti-lipoteichoic acid (LTA) antibodies were measured by ELISA. Metagenomic sequencing was performed on fecal DNA. Female C57BL/6 mice consuming a high-fat or low-fat diet were treated with 0.4 mg/kg diet-derived fecal isolated LPS modeling metabolic endotoxemia, and metabolic outcomes were measured after 6 weeks. Results Women in the high VAT group showed increased Proteobacteria abundance and a lower Firmicutes/Bacteroidetes ratio. Plasma LBP concentration was positively associated with VAT area. Plasma anti-LPS, anti-LTA, and anti-flagellin IgA antibodies were significantly correlated with adiposity measurements. Women with high VAT showed significantly elevated LPS-expressing bacteria compared to low VAT women. Gut bacterial species that showed significant associations with both adiposity and inflammation (anti-LPS IgA and LBP) were Proteobacteria (Escherichia coli, Shigella spp., and Klebsiella spp.) and Veillonella atypica. Healthy eating index (HEI) scores negatively correlated with % body fat and anti-LPS IgA antibodies levels. Preclinical murine model showed that high-fat diet-fed mice administered a low-fat diet fecal-derived LPS displayed reduced body weight, decreased % body fat, and improved glucose tolerance test parameters when compared with saline-injected or high-fat diet fecal-derived LPS-treated groups consuming a high-fat diet. Conclusions Increased VAT in postmenopausal women is associated with elevated gut Proteobacteria abundance and immunogenic metabolic endotoxemia markers. Low-fat diet-derived fecal-isolated LPS improved metabolic parameters in high-fat diet-fed mice giving mechanistic insights into potential pro-health signaling mediated by under-acylated LPS isoforms. Video Abstract

Abstract Background Women who reach menarche and menopause at earlier ages have been shown to be at increased risk for numerous conditions including cardiovascular disease, cancer, depression, and obesity; however, risk factors for earlier ages of menarche and menopause are not fully understood. Therefore, we aimed to perform a retrospective investigation of the associations between a personal birthweight and/or being born preterm and the age of and menarche and menopause and related events in the Women’s Health Initiative, a large, racially and ethnically diverse cohort of postmenopausal women. Methods At study entry, women reported their birthweight by category (

Abstract Background Premenopausal, high-risk, hormone receptor-positive breast cancer patients are often treated with ovarian suppression in combination with aromatase inhibitors (AI). This combination has important adverse effects, particularly in sexual function, such as vaginal dryness and loss of libido. There is no effective therapy for reduced sexual function in this setting. Our study aimed to determine the efficacy and safety, particularly regarding sexual function, of a low-dose, topical testosterone gel administration. Methods This is a pilot, single-center study, designed to evaluate the efficacy of topical testosterone gel (3 mg/day) in improving sexual function in 29 premenopausal patients on ovarian suppression in combination with an AI. The primary safety endpoint was to assess serum estradiol elevation. The primary efficacy endpoint was sexual function improvement, assessed by the Female Sexual Function Index questionnaire. Results We report the results on 29 patients. Twenty-two patients (75%) completed the 3-month treatment, and seven discontinued treatment before completion, mostly due to logistical difficulties related to the COVID-19 pandemic. All patients maintained the value of baseline mass spectrometry assay for estradiol of less than 2.7 pg/mL during the undertaken measurements. We observed a significant improvement in Female Sexual Function Index measures over the visits, with an increase from a mean of 11.7 at baseline to 19.1 in the third month (p

Abstract Background Rheumatoid arthritis (RA) is a chronic inflammatory condition primarily affecting the joints. The higher prevalence of RA among females, combined with the known effects of sex hormones on immune function, has led researchers to investigate the potential relationship between menopausal status and the risk, severity, or progression of RA. This systematic review and meta-analysis aimed to determine the association between menopause and rheumatoid arthritis. Methods In 2023, we conducted a comprehensive search across multiple databases, including Google Scholar, Scopus, PubMed/MEDLINE, Science Direct, Web of Science, EMBASE, Springer, and ProQuest. The search aimed to identify studies exploring the association between menopause and rheumatoid arthritis. Results Our analysis revealed that post-menopausal women had a higher risk of developing rheumatoid arthritis compared to pre-menopausal women, with an estimated odds ratio of 1.35 (95% CI: 1.04–1.67). Additionally, women who experienced early menopause (defined as onset before age 45) showed significantly higher odds of developing RA, with an odds ratio of 2.97 (95% CI: 1.73–4.22). Conclusion These findings highlight the importance of considering menopausal status when assessing the risk of RA development in women. The results suggest that post-menopausal women, particularly those who experience early menopause, may be at higher risk for developing RA. Further research in this area could provide valuable insights into potential preventive measures and targeted interventions for high-risk individuals.

Red clover (Trifolium pratense L.) is found in southeast Europe and Anatolia. Its primary traditional medicinal use includes the treatment of various conditions of the upper respiratory tract. In recent years, its isoflavones have become the focus of research aimed at developing treatments to alleviate menopausal symptoms. Reduced levels of circulating estrogen due to reduced ovarian function can cause short-term symptoms such as hot flashes, palpitations, difficulty sleeping, headaches, fatigue, mood disorders and reduced concentration but also long-term chronic conditions, such as cardiovascular disease, accelerated weight and bone mass loss, atrophic vaginitis, osteoporosis, and cognitive impairment. The aim of this narrative review was to analyze the effects of commercially available and standardized red clover extracts on menopausal women. Eight randomized controlled trials on a total of 8769 menopausal women (aged 40 to 65 years) evaluated the effect of red clover isoflavone extract on menopausal symptoms. In all studies, isoflavone extract treatment showed improvement in all menopausal symptoms, including some common comorbidities, namely, hot flashes (1487 women, 25%), blood lipids (1155 women, 19%), atherosclerosis (6938 women, 79%), risk of breast cancer and endometrial cancer (428 women, 5%), osteoporosis and osteopenia (555 women, 6%), and menopause-related cognitive impairment (3530 women, 40%).

Abstract The vaginal microbiome of trans men and menopausal women is suspected to be similar due to a lack of estrogen leading to the absence of lactobacilli. However, data are scarce. We performed an analysis of the vaginal microbiome of trans men (n = 25) in comparison to that of menopausal (n = 25) and premenopausal women (n = 25). The vaginal microbiome of trans men and menopausal women showed a higher alpha diversity than that of premenopausal women. Various beta diversity indices (e.g., Bray‒Curtis (Un-)Weigthed Unifrac), showed significant differences in community composition between trans men and premenopausal (p

Abstract Background Menopause significantly impacts the immune system. Postmenopausal women are more susceptible to infection. Nonetheless, the pattern of change in peripheral white blood cell counts around the menopause remains poorly understood. Methods We conducted a prospective longitudinal cohort study with repeated measurements using Kailuan cohort study of 3632 Chinese women who participated in the first checkup (2006–2007) and reached their final menstrual period (FMP) by the end of the seventh checkup (2018–2020). Peripheral WBC count indicators included total white blood cells (TWBC), neutrophils (NEUT), lymphocytes (LYM), and monocytes (MON). Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of WBC count indicators as a function of time before or after the final menstrual period (FMP). Interaction and subgroup analysis were used to explore the effects of age and body mass index (BMI) on changes in WBC indicators around FMP. Results WBC count indicators decreased before the FMP, and the reduction in TWBC, NEUT, and MON continued for 2 years following the FMP. LYM and NEUT declined during < -1 years and − 4 ∼ + 2 years relative to FMP, respectively. A reduction in MON was observed pre-FMP, extending continuously through the two-year period post-FMP. TWBC declined from − 3 to + 2 years relative to FMP, but both MON and TWBC increased during > + 2 years. The baseline age had an interaction effect on changes in WBC indicators during specific menopausal stages, except for TWBC. Individuals in different age subgroups showed distinct trajectories for NEUT, LYM and MON around the FMP. High baseline BMI had a synergistic effect on changes in specific menopause segments for TWBC, LYM, and MON. The impact of menopause on TWBC and LYM was postponed or counterbalanced in high BMI individuals. Individuals in three BMI subgroups experienced similar MON changes around FMP, and there were slight variations during < -4 years. Conclusions Menopause was associated with count changes of peripheral WBC. The trajectories of various WBC types differ around menopause. Age and BMI affected WBC trajectory around menopause. The menopause period may represent a window of opportunity to promote immune health in middle-aged women.

Abstract Background women post-menopause, are faced with various physical, emotional, and relational challenges. One such aspect that tends to be overlooked is the impact of menopause on sexual well-being. This study aimed to elucidate the concept of enriching the sexual life of women post-menopause. Methods A qualitative research strategy was adopted using a conventional content analysis approach. Data collection was conducted through semi-structured interviews with 24 participants (17 women post-menopause and 7 experts), using purposive sampling. Results The data analysis resulted in the extraction of 341 codes, 24 subcategories, and 8 categories. Ultimately, the following three themes emerged: “maintaining and enhancing the position of sexual relationships,” “deepening sexual relationships and expanding intimacy,” and “improving communication skills with the spouse “. Conclusion Enriching the sexual life of women post-menopause, as suggested by the themes, involves nurturing their relationships, keeping these connections strong and valued, deepening intimacy, and promoting effective communication to ensure a fulfilling and enjoyable experience during this phase of life. This leads to a sense of security, health, and tranquility, ultimately manifesting positive repercussions on the couple’s and family’s health.

Abstract Background Most women experience vasomotor symptoms (VMS) during the menopausal transition. A 15-week resistance training intervention (RTI) significantly reduced moderate-to-severe VMS (MS-VMS) and improved health-related quality of life (HRQoL) and cardiovascular risk markers in postmenopausal women. Whether a short RTI could have long-term effects is unknown. We aimed to investigate whether there were intervention-dependent effects two years after a 15-week RTI on MS-VMS frequency, HRQoL, and cardiovascular risk markers in postmenopausal women. Methods This observational prospective cohort study is a follow-up to a randomized controlled trial (RCT) on a 15-week RTI in postmenopausal women (n = 57). The control group had unchanged low physical activity during these first 15 weeks. At the follow-up contact two years post-intervention, 35 women agreed to participate in an additional physical visit at the clinic with clinical testing, blood sampling, and magnetic resonance imaging, identical to the protocol at the baseline visit at the start of the RCT. Results Although all women showed reduced MS-VMS and increased moderate-to-vigorous physical activity (MVPA) over the 2-year follow-up compared to baseline, the groups from the original RCT (intervention group; IG, control group; CG) changed differently over time (p

Abstract Background The onset of menopause leads to diminished estrogen exposure, resulting in a high morbidity burden related to menopausal symptoms. Menopausal hormonal therapy is an effective therapy that offers more advantages than disadvantages for women aged less than 60 years or who have had menopause for less than 10 years. Objective This study aimed to assess the prevalence of menopausal symptoms, identify factors associated with menopausal symptoms, and assess the use of menopausal hormone therapy among women aged 40–60 who visited the gynecological clinics of three hospitals in Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study was conducted from January 2022 to June 2022 at Gandhi Memorial Hospital, Tikur Anbessa Hospital, and Zewditu Memorial Hospital on 296 middle-aged women. Data were collected using an interviewer-administered structured questionnaire and analyzed for sociodemographic factors, utilization of menopausal hormone therapy, and prevalence of menopausal symptoms using the menopause rating scale. Data were analyzed using SPSS version 25. Bivariate and multivariate logistic regression analyses were performed to identify independent predictors of each subscale of menopausal symptoms. The strength of the association was measured using odds ratios with 95% confidence intervals, and statistical significance was set at a value of P

Abstract Aims The impact of life-course different adiposity indices on diabetes mellitus (DM) is poorly understood. We aimed to do trajectory analysis with repeated measurements of adiposity indices in the development of DM among women across the lifespan. Methods This study prospectively investigated the 1,681 population of Tehran Lipid and Glucose Study. At baseline, all individuals were free of diabetes. Trajectory analysis was used to identify homogeneous distinct clusters of adiposity indices trajectories and assign individuals to unique clusters. Results Of the 1681 healthy women, 320 progressed to the DM. Three distinct body mass index (BMI) trajectories and 2 distinct trajectories of other adiposity indices (waist circumstance (WC), conicity index (C-index), and body roundness index (BRI)) were chosen as the best fitting of the latent class growth mixture model. In the adjusted model, total participants [HR (CI 95%): 2.83 (2.05, 3.91); p

Masahiko Ayaki, Akiko Hanyuda, Kazuno Negishi Department of Ophthalmology, Keio University School of Medicine, Tokyo, JapanCorrespondence: Masahiko Ayaki; Kazuno Negishi, Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan, Email mayaki@olive.ocn.ne.jp; kazunonegishi@keio.jpPurpose: Risk factors for presbyopia have not been fully determined although previous studies suggested presbyopia was associate with age, dry eye, and retinal ganglion cell complex thickness (GCC). We accessed these signs and common ocular symptoms in the middle-aged population focusing on sex differences when women have drastic hormonal change.Methods: This cohort study consecutively enrolled 2743 patients aged 36– 45 years (n=1000), 46– 55 years (n=1000), and 56– 65 years (n=743). All underwent ocular surface tests and had near add power and GCC measured. Common ocular symptoms were asked using questionnaire.Results: Among female participants, visual symptoms (eye strain and photophobia) were more prevalent in the age group 46– 55, whereas non-visual symptoms (dryness, irritation, and pain) were not. We identified symptomatic presbyopia (near add power ≥ 1.5D) in 14.4%, 73.8%, and 97.8%, positive corneal staining in 29.1%, 23.8%, and 23.9%, and a mean GCC of 98.2 μm, 105.3 μm, and 89.6 μm in the age groups 36– 45, 46– 55, and 56– 65, respectively. Mean tear break-up time were 3.3, 3.5, and 3.3 seconds, respectively. Results indicated a large progression of presbyopia (P< 0.01) from the period of 36– 45 years onward and significantly increased GCC (P< 0.01) in women of age group 46– 55. No notable tendency was observed in symptoms and GCC for male participants.Conclusion: Visual symptoms in women were worse between 46 and 55 years than before or after these ages. The increase of symptomatic presbyopia and GCC may be contributing to visual symptoms in addition to menopausal transition symptoms in this age group.Keywords: presbyopia, sex difference, near add power, menopause, eye strain

Korean Red Ginseng (KRG) has long been used not only as a food supplement but also as a treatment for various diseases. Ginseng originated in South Korea, which later spread to China and Japan, has a wide range of pharmacological activities including immune, endocrine, cardiovascular, and central nervous system effects. KRG is produced by repetitions of steaming and drying of ginseng to extend preservation. During this steaming process, the components of ginseng undergo physio-chemical changes forming a variety of potential active constituents including ginsenoside-Rg3, a unique compound in KRG. Pandemic Coronavirus disease 2019 (COVID-19), has affected both men and women differentially. In particular, women were more vulnerable to COVID-related distress which in turn could aggravate menopause-related disturbances. Complementary and alternative medicinal plants could have aided middle-aged women for several menopause-related symptoms during and post COVID-19 pandemic. This review aimed to explore the beneficial effects of KRG on menopausal symptoms and gynecological cancer.

Cardiovascular (CV) disease remains the leading cause of death in women, with multifactorial causes. In women, traditional CV risk factors are associated with an increased risk of CV events, and there are also risk factors that are unique to women. CV risk increases further during menopause. In addition to hormonal changes, menopause is accompanied by adverse metabolic changes, such as the development of an atherogenic lipid profile, weight gain, visceral and epicardial and paracardial fat deposition. Menopausal body composition changes, increased visceral adipose tissue, decreased muscle mass, increased inactivity and adverse atherogenic lipid shifts alter the metabolic profile of the individual and significantly increase CV risk. Therefore, increased attention is recommended regarding lifestyle during menopause. The well-known Mediterranean-type diet can be beneficial in overcoming adverse metabolic changes. Maintaining physical fitness and muscle mass and strength through adequate amounts of exercise is a focus of attention. Hormone therapy may be recommended in selected cases.

Skeletal muscle function is vital for locomotion, posture, and metabolism, significantly impacting overall health and preventing falls, morbidity, and mortality, especially in elderly populations. This systematic review investigates the influence of hormonal fluctuations on skeletal muscle function across different life stages in women, including adolescence, the reproductive years, and menopause. A comprehensive literature search was conducted using databases such as PubMed, Scopus, and Web of Science to identify relevant studies. This review includes 45 studies that met the inclusion criteria, examining the roles of estrogen, progesterone, and other hormones in muscle metabolism, strength, and recovery. The findings highlight significant stage-specific hormonal impacts on muscle function, revealing how puberty, menstrual cycles, pregnancy, and menopause uniquely affect muscle health. Effective hormonal and non-hormonal interventions tailored to each life stage were identified, offering insights for optimizing muscle function and health management in women. This synthesis aims to bridge the gaps in understanding the hormonal regulation of muscle function, providing a foundation for future research and guiding clinical practices.

The assessment of endothelial dysfunction and free radical homeostasis parameters were performed in 92 women, aged 45 to 69 years, divided into the following groups: women without COVID-19 (unvaccinated, no antibodies, control); women with acute phase of COVID-19 infection (main group, COVID-19+); 12 months post COVID-19+; women with anti-SARS-CoV-2 IgG with no symptoms of COVID-19 in the last 12 months (asymptomatic COVID-19). Compared to the control, patients of the main group had lower glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities, decreased advanced glycation end products (AGEs) level, higher glutathione reductase (GR) activity, and higher glutathione S transferases pi (GSTpi), thiobarbituric acid reactants (TBARs), endothelin (END)-1, and END-2 concentrations (all p ≤ 0.05). The group with asymptomatic COVID-19 had lower 8-OHdG and oxidized glutathione (GSSG) levels, decreased total antioxidant status (TAS), and higher reduced glutathione (GSH) and GSH/GSSG levels (all p ≤ 0.05). In the group COVID-19+, as compared to the group without clinical symptoms, we detected lower GPx and SOD activities, decreased AGEs concentration, a higher TAS, and greater GR activity and GSTpi and TBARs concentrations (all p ≤ 0.05). The high content of lipid peroxidation products 12 months post COVID-19+, despite decrease in ENDs, indicates long-term changes in free radical homeostasis. These data indicate increased levels of lipid peroxidation production contribute, in part, to the development of free radical related pathologies including long-term post COVID syndrome.

Aims and Objective: To validate calf circumference as a reliable clinical tool for measuring muscle mass in postmenopausal women. Materials and Methods: A cross sectional study done at Ram Manohar Lohia Hospital, New Delhi from February 2023 to September 2023. Thirty postmenopausal women were enrolled for this study. Women with surgical menopause, premature ovarian failure, chronic debilitating illness and morbid obesity were excluded. In these women, muscle mass was measured using calf circumference. Also, Appendicular skeletal muscle index (ASMI), a measure of muscle mass was calculated using DEXA scan (Gold standard). The muscle mass was taken as a parameter by both methods to detect sarcopenia. The collected data was analysed and statistically evaluated to clinically validate calf circumference as a reliable tool for measuring muscle mass in Indian postmenopausal women. Results: In our study, the values at different cut offs of calf circumference was compared to ASMI scoring using gold standard investigation DEXA Scan. The better accuracy was found for the cut off point 32 cm of calf circumference with sensitivity of 100%, specificity of 60%, positive predictive value of 71.4%, negative predictive value of 100% and accuracy of 80%. The prevalence of sarcopenia was found to be 70%. Conclusion: Calf circumference can be used as reliable clinical tool to assess sarcopenia as a measure of muscle mass in Indian postmenopausal women.

Abstract Background Remnant cholesterol (RC) exert a significant influence on atherosclerotic cardiovascular disease development. However, the prognostic implications of RC in menopausal women received percutaneous coronary intervention (PCI) who experiencing acute coronary syndrome (ACS) remain uncertain. Methods RC was derived by subtracting the sum of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol from the total cholesterol. Kaplan-Meier survival and Cox regression analysis were employed for assessing the correlation between continuous RC levels and composite and individual adverse events in Q1-Q4 quartiles. Receiver operator characteristic (ROC) curves, derived from Cox regression, were employed for analyzing the relationship between RC and both composite and individual adverse events. Results 1505 consecutive menopausal women who underwent PCI and diagnosed with ACS were included. Kaplan-Meier survival analysis demonstrated a progressive reduction in composite adverse event survival rates across the four groups, observed in both the general population and among diabetic individuals, as RC values increased (Log-rank P

Abstract Background Menopausal women should learn self-care practices to enjoy a healthy lifestyle, positive health behaviors, and health status. In addition, the lack of self-care knowledge can lead to unhealthy attitudes and lifestyles, resulting in many complications. Improved self-care knowledge can foster positive attitudes, leading to healthier lifestyles as a beneficial cycle. However, menopausal women have limited knowledge about self-care and evaluation tools. Therefore, this study aimed to develop and investigate the validity and reliability of the Women’s Self-care Knowledge and Attitude Questionnaire (WSKAQ) in Iranian menopausal women. Methods This cross-sectional study was conducted on 249 menopausal women, aged between 45 and 65 years and at least one year post-menopause, with a minimum literacy level of elementary education. Validation properties included construct validity, exploratory (EFA), and discriminant validity. Reliability was further established through Cronbach’s α and McDonald’s Omega. PASS 15 and SPSS 27 software were used to select centers, calculate sample size and analyze the data, respectively. Results The initial stage of construct validity involved the Kolmogorov–Smirnov test and EFA, resulting in a 6-item self-care knowledge subscale, 47.29% of the total data variance, and 7-item self-care attitude subscale, 55.50% of the total data variance. Independent t-test indicated that menopausal women with education level equal to or higher than diploma have significantly higher self-care attitude scores than those with lower than diploma (p = 0.007). Additionally, significant correlations were observed between self-care knowledge and attitude (r:0.30). Cronbach’s α and McDonald’s Omega coefficients of the 13-item WSKAQ were 0.77 and 0.78, respectively. Conclusions Based on the results, the WSKAQ, consisting of 13 items, was validated and reliable for assessing the self-care knowledge and attitude of Iranian menopausal women.

Abstract The proportion of women experiencing premature menopause is on the rise in India, particularly in the age groups of 30–39 years. Consequently, there is a need to understand the factors influencing the prevalence of premature menopausal status among women. Our study uses the data from 180,743 women gathered during the latest Indian version of the Demography Health Survey (National Family Health Survey-5). Our results suggest that close to 5% of women in rural areas and 3% of women in urban areas experience premature menopause, and this figure varies across Indian States. The regression results show that surgical menopause, lower levels of education, poorer wealth index, rural residence, female sterilization, and insurance coverage are key drivers of premature menopause. One of the striking factors is that the prevalence of premature menopause among those with the lowest levels of education (6.85%) is around seven times higher than those with the highest level of education (0.94%). We conducted a decomposition analysis to delve into the factors contributing to this inequality. The results show that undergoing a hysterectomy (surgical menopause) account for 73% of the gap in premature menopausal rates between women with the lowest and highest levels of education. This indicates that women with poor education are more likely to undergo hysterectomy at a younger age. This finding warrants further exploration as we would expect that women from lower socio-economic background would have limited access to surgical care, however, our results suggest otherwise. This perhaps indicates a lack of awareness, lack of alternative treatment options, and over-reliance on surgical care while neglecting conservative management. Our results have implications for addressing the diverse needs of the increasing number of women in their post-menopause phase and for focusing on conservative treatment options for these women.

The increased proportion of women in the workplace and the labor force aging have been demanding investigations of the link between menopause and occupational health issues, especially in healthcare settings. Evidence on the association between menopause and occupational burnout in healthcare settings is still inconclusive. Therefore, we aimed to evaluate the association between menopause and burnout among clinical and non-clinical workers in different occupational health environments. A multi-center, cross-sectional study, applying the Oldenburg Burnout Inventory (OBI) was conducted from September 2021 to March 2023 in University Medical Center (UMC) hospitals in Astana, Kazakhstan. The study involved 125 physicians and nurses and 82 non-clinical administrative and service staff. We found that 63.9% of respondents had disengagement and 61.7% had exhaustion. The affiliated clinical setting was associated with disengagement (p = 0.034), with the highest prevalence among employees in surgical departments (76.9%), while a higher prevalence of exhaustion was found in individuals with different work experience (p = 0.023) and among those who were dissatisfied with their work environment (74.3%). While burnout was identified in almost two-thirds of respondents, the self-reported menopause status of participants was not significantly related to either disengagement (p = 0.34) or exhaustion (p = 0.73), even though a higher prevalence of both was revealed among the postmenopausal group. We propose that healthcare management should understand the importance of burnout among postmenopausal healthcare workers and facilitate open communication and a supportive work environment.

Background Previous studies have found associations between monocyte count, high-density lipoprotein cholesterol (HDL-C), and thyroid-stimulating hormone (TSH) with acute coronary syndrome (ACS). However, research on the correlation between the monocyte count to high-density lipoprotein cholesterol ratio (MHR) and the onset of ACS is limited. The association between MHR, TSH, and the onset of ACS in postmenopausal women remains unclear. Objective To explore the predictive value of MHR and TSH for the onset of ACS in postmenopausal women and to investigate the correlation between these indicators and the degree of coronary artery stenosis in patients. Methods A total of 325 postmenopausal women hospitalized in the Department of Cardiology at Northern Jiangsu People's Hospital, from 2020 to 2021 and who underwent coronary angiography were selected as the study subjects. Patient general information was collected through the electronic medical record system. Venous blood was collected upon admission to measure monocyte count, total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C), and TSH. Left ventricular ejection fraction (LVEF) was measured using the biplane Simpson method, and coronary artery lesions were observed through coronary angiography. The Gensini scoring system was used to uniformly measure the extent of coronary artery lesions. Patients meeting the diagnostic criteria for ACS were classified as the ACS group (n=184), and non-ACS patients as the control group (n=141). The ACS group was further divided into subgroups based on the tertiles of the Gensini score: ≤36.5 as the low-risk subgroup (n=59), 36.6-66.5 as the moderate-risk subgroup (n=64), and >66.5 as the high-risk subgroup (n=61). Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of ACS. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of TSH, MHR, and combined detection for ACS and to calculate the area under the curve (AUC). Spearman's rank correlation analysis was used to explore the correlation between TSH, MHR, and combined detection indicators with the Gensini score. Results The baseline data of patients in the ACS and control groups showed that BMI, smoking rate, hypertension, diabetes, LDL-C, monocytes, TSH, and MHR in the ACS group were higher than in the control group, while LVEF and HDL-C were lower (P

Ovarian reserve is the basis of female fertility. The main markers of ovarian reserve are the level of anti-Mullerian hormone and the number of antral follicles. In addition to the natural age-related loss of follicles, many women experience a premature diminished ovarian reserve associated with a number of factors. This can be caused by both various diseases and environmental factors, lifestyle, and social aspects.The aim of this review was to examine the influence of external factors on the ovarian reserve and women fertility. A systematic analysis of data from modern scientific literature, domestic and foreign sources was carried out. The search involved such resources as PubMed, MEDLINE, Science Direct, eLibrary, Scopus, Cyberleninka. A detailed analysis of the influence of environmental pollution, lifestyle (sleep, nutrition, physical activity), previous surgeries, bad habits, obesity, psychological and social factors on the ovarian reserve and reproductive function of women was carried out. Significantly diminished ovarian reserve was noted with low sleep quality, excessive physical activity, and an unbalanced diet poor with animal proteins. Regular consumption of alcohol, smoking and exposure to certain chemical environmental pollutants cause premature follicle apoptosis and the onset of menopause. Circadian dysrhythmia, chronic stress and obesity can lead to the ovarian menstrual cycle disorders and the development of infertility in women. Previous parovarium surgeries are a significant risk factor for diminished ovarian reserve. Further population-based studies are needed to determine the precise mechanisms of influence of various factors on female fertility.

Background: Menopause is a significant period in the life of a female; many hormonal and lifestyle changes occur, which can have a catastrophic effect on their health and well-being. Amongst these changes is the loss of muscle mass and strength. Resistance training is recommended for post-menopausal women; however, the role of protein in muscle mass and strength in this population is unclear. Methods: This narrative review discusses the research evidence regarding daily protein needs, dose and timings of intake, and protein quality. Results: Observational and interventional studies suggest post-menopausal females should ingest at least the RDA 0.8 g·kg−1·d−1 of protein, the dosing at each meal maybe important. Both whey and soy protein may provide some benefit to muscle strength. Conclusions: Overall, there is limited evidence and not of high quality, making it difficult to make inferences about the protein needs of post-menopausal females.

While the exercise-induced responses of circulated biomarkers related to inflammation and brain health are well documented in humans, little is known about the effect of menopausal status on these responses. This study compared the responses of inflammatory cytokines and brain-derived neurotrophic factor (BDNF) to high-intensity exercise between pre- and postmenopausal middle-aged females. Eight premenopausal (44 ± 3 years) and seven postmenopausal (57 ± 2 years) females performed a high-intensity interval training (HIIT) session consisting of 10 × 1 min running intervals (90% maximum heart rate) separated by 1 min passive recovery intervals. Blood samples were collected at baseline (fasted), pre-exercise (postprandial), and at 0, 30, and 90 min post-HIIT and analyzed for interleukin (IL-6) and 10 (IL-10), tumour necrosis factor-alpha (TNF-α), and BDNF. IL-6 significantly increased from pre-exercise to 0 min post-HIIT in postmenopausal (+40%, p = 0.01) and to 30 min post-HIIT in premenopausal females (+60%, p = 0.02). IL-6 remained elevated at 90 min post-HIIT in premenopausal (+104%, p = 0.05) and to a higher degree in postmenopausal females (+385%, p < 0.001). IL-10 showed no response. TNF-α increased from pre- to 0 min post-HIIT (+10%, p = 0.05), then decreased to below pre-exercise at 30 min (−10%, p = 0.02) and 90 min (−5%, p = 0.04) in both groups. BDNF increased immediately post-HIIT in premenopausal (+60%, p < 0.001) but not postmenopausal females. The differences in IL-6 and BDNF responses to HIIT between pre- and postmenopausal females provide evidence of the role of female reproductive hormones in the regulation of these exercise-induced responses.

During menopause, a woman will experience physical and psychological changes which often cause various complaints. There are several factors that are thought to be the cause of these complaints, such as education, use of hormonal contraceptives, and psycholog. The purpose of this study was to determine the severity of menopausal symptoms in terms of history of contraceptive use. This type of research is descriptive quantitative with cross sectional data collection using the Menopause Rating Scale questionnaire, with sampling techniques using non probability consecutive sampling techniques. inclusion criteria women aged 45 - 59 years and have stopped menstruating, have a history of using hormonal contraceptives, willing to be a respondent conducted in March 2024 until the number of respondents was obtained 30 people. Univariate analysis test with frequency distribution. The results showed that the severity of menopausal symptoms in women using contraceptives was none 3%, mild 33%, moderate 37%, and severe 27%. Conclusion of this study is the severity of menopausal symptoms in women who use hormonal contraceptives on average have moderate severity. The severity of menopausal symptoms is not only influenced by contraceptive use, but there are other factors such as education and psychological conditions.

Abstract Background The attention on improving health literacy (HL) for self-management at the population level in many countries has been increasing. Although self-management among middle-aged women in the menopausal transition are important public health issues, few studies have developed the menopausal HL intervention reflecting the multidimensional aspects of HL. We aimed to generate consensus from an expert panel on the core contents of the menopausal HL intervention for middle-aged women based on the HL conceptual framework of the European Health Literacy Survey. Methods The panel comprised 20 experts from multiple disciplines (nursing, medicine, public health, and food and nutrition). We conducted the e-Delphi process in three rounds, asking the panel to evaluate and prioritize the appropriateness of the core contents and provide open-ended responses to additional comments about the menopausal HL intervention. The e-Delphi questionnaire was developed based on the HL framework, integrating health and HL domains. Results The experts reached a consensus on 38 components of the intervention. Among the 19 components of the four health domains, health topics in healthcare and disease prevention were more appropriate than those in health promotion. For the 19 HL competency components, strengthening the ability to access, appraise, and apply health information was more important than strengthening the ability to understand information. Finally, a consensus was achieved on the 12 priorities for intervention content by HL domains integrated with health domains. For example, contents included proper access to reliable information resources, understanding the definition and process of menopause, judging abnormal health symptoms, and performing the health checkups necessary for menopausal women. Conclusions Our findings provide evidence for HL skills that nurses and other health professionals can consider when developing interventions to improve self-management among middle-aged women. Future research should focus on incorporating the core contents of multidimensional HL skills into menopausal HL interventions to improve self-management among middle-aged women.

Kadriye Erdo&gbreve;an,1 Nevin Sanlier2 1Department of Obstetrics and Gynecology, Health Sciences University, Etlik Zübeyde Han&inodot;m Women’s Health Training and Research Hospital, Ankara, Turkey; 2Department of Nutrition and Dietetics, Ankara Medipol University, Ankara, TurkeyCorrespondence: Kadriye Erdo&gbreve;an, Email opdrkerdogan@gmail.comPurpose: This study was undertaken to investigate the impact of menopause duration on the risk factors and components of metabolic syndrome (MetS).Patients and Methods: Women aged between 45 and 60 years participated in the study. Participants were split into two groups based on the duration of menopause. Women who had been menopausal for 1 to ≤ 5 years constituted Group 1, while women with 6– 10 years of menopause duration formed Group 2.Results: Significant differences were observed between the two groups for various factors associated with MetS, including anthropometric measurements, biochemical markers, and blood pressure. The conicity index, weight-to-hip ratio, waist-to-height ratio, visceral adiposity index (VAI), and menopause duration were associated with increased risk of MetS. Our multivariate logistic regression model showed that women with elevated VAI had a 2.073-fold (95% CI: 1.73– 2.48, p< 0.001) increased risk of MetS, while women with menopause duration more than 5 years had a 6.44-fold (95% CI: 3.336– 12.45, p< 0.001) increased risk of MetS.Conclusion: The duration of menopause was found to be linked to a higher risk of MetS. Our results emphasize the importance of monitoring and managing metabolic health in women during the menopausal period, particularly those with extended menopause duration.Keywords: metabolic syndrome, menopause, anthropometric measurements

Introduction: Physical exercises, in conjunction with Tribulus supplementation, can serve as an alternative to prevent complications associated with menopause. This study investigated the impact of combined exercises and Tribulus supplementation on the sex hormones estrogen, testosterone, and the testosterone-to-cortisol ratio in overweight postmenopausal women.Methods: In this study, 60 inactive postmenopausal women were selected based on voluntary entry criteria and were randomly divided into four groups of 15 individuals: combined exercise, supplement, combined exercise with supplement, and control. The combined training consisted of 10 weeks of aerobic and resistance training. The participants took a Tribulus supplement in the form of 500 mg capsules twice a day for ten weeks. The estradiol, cortisol, testosterone, and testosterone-to-cortisol ratios were measured before and after the training protocol. Data analysis was performed using SPSS version 25 software and repeated measures analysis of variance test.Results: The results showed a significant decrease in cortisol levels in the three experimental groups (P=0.001). There was also a significant increase in the total testosterone-to-cortisol ratio among the three experimental groups and the control group (P=0.001). This significant increase was also observed between the exercise and supplement group (P=0.001) and between the supplement group and the combined exercise + supplement group (P=0.001). No significant difference was observed in follicle-stimulating hormone, estradiol, and dehydroepiandrosterone (P>0.05).Conclusion: According to the results of this study, it is possible to use combined exercises with Tribulus supplement as an effective intervention to improve sex hormones in overweight postmenopausal women.

Abstract Background Menopause, characterized by various physical and mental changes, is primarily caused by hormonal fluctuations, resulting in numerous complications. Recently, herbal treatments have gained significant attention for their minimal side effects compared to chemical drugs. This study aimed to investigate the effects of oral capsules containing Ocimum basilicum leaf extract (OBLE) on menopausal symptoms. Methods This placebo-controlled clinical trial study was conducted in 2020. The research focused on 60 menopausal women referred to Mashhad health centers. Eligible participants were administered either an OBLE 500 mg capsule or a placebo daily for 1 month. Menopause symptoms were evaluated using the Menopause Rating Scale (MRS) before, two weeks, and one month after the intervention. Data were analyzed using SPSS21, independent t, Mann–Whitney, and Friedman tests. A significance level of p

Significant progress has been made in the molecular diagnosis of cancer. It provides personalized medicine, including cancer diagnosis, prognosis, targeted therapy, and risk detection. These advances allow physicians to identify patients at risk for cancer before it develops and offer them an opportunity to prevent its development. Mutations in breast cancer susceptibility genes 1 and 2 (BRCA1 and 2) are one of the most well-known cancer-related gene mutations since actor Angelina Jolie shared her experience with genetic mutations and risk-reducing surgery in the media. In Korea, tests for germline BRCA1/2 mutations have been covered by insurance since May 2012 and the number of women of BRCA1/2 mutations has continued to increase over the past decade. Most carriers of BRCA1/2 mutations consider risk-reducing salpingo-oophorectomy (RRSO) resulting in early menopause and want to know the lifetime risks and benefits of RRSO. However, despite the increasing number of carriers of BRCA1/2 mutations, the counseling and management of patients requiring RRSO varies among physicians. This article provides basic knowledge on RRSO to help physicians comprehensively assess its risks and benefits and manage at-risk women.

Abstract Background Women experiencing problematic menopausal symptoms report lower health-related quality of life and greater healthcare use than women without symptoms. Not all women want to or are able to take hormone replacement therapy. Strengthening the evidence for menopause symptom-management options, including physical activity, improves agency for women. Aim This overview assesses effectiveness of physical activity and exercise interventions targeting women experiencing menopause symptoms. Methods Medline, Embase, CINAHL, Scopus, The Cochrane Database of Systematic Reviews and Social Science Citation Index were searched (June 2023) for systematic reviews of physical activity and exercise interventions targeting women experiencing menopause. Reviews were assessed using AMSTAR-2 and a best-evidence approach to synthesis without meta-analysis (SWIM) was adopted. The protocol was registered on PROSPERO (CRD42022298908). Results Seventeen reviews included 80 unique relevant primary studies with 8983 participants. There is evidence showing improvement of physical, urogenital, and total symptoms following yoga interventions. Evidence for vasomotor and psychological symptoms was inconclusive. Findings for aerobic exercise were inconclusive although there were some examples of beneficial effects on total and vasomotor symptoms. Evidence was very limited for other types of physical activity and impact on physical, sexual and urogenital symptoms. Conclusion There is some evidence that yoga, and to lesser extent, aerobic exercise may be beneficial for some menopause symptoms, but there is insufficient evidence to recommend a particular form of exercise. Current reviews categorise women on menopause status; broadening this to include ethnicity, income status, employment and other factors will allow better understanding of context for successful interventions.

Aim: The aim of this study is to determine the age and symptoms in menopausal women and providing hormonal treatment. Materials and Methods: This study was a community based cross sectional, descriptive, observational study conducted among 400 rural women living in and around Vijayapur. Women aged 40 to 55 years who attained natural menopause and cessation of menses for one year were included in the study. The study was carried out from November 2022 to October 2023. Ethical clearance has been taken for this study. The participants were interviewed on one-to-one basis using a self-constructed semi structured questionnaire. Results: A total of 400 women belonging to the age group of 40 to 55 years participated in the study. The mean age of the participants was 52.01 ± 2.89 years. The mean age of attaining menopause was 45.67 ± 3.9 years. The least age of attaining menopause was 37years and the maximum age noted was 54 years. Most women (55%) attained menopause in the age group of 45 to 49 years. The incidence of premature menopause was 4.6%. In women with hysterectomy Estrogen alone therapy is beneficial and in women with intact uterus, estrogen progesterone therapy is recommended. Conclusion: Almost majority of women are affected by menopausal symptoms and due to sociocultural factors, economic factors adversely affecting the women health. Better to initiate women with hormonal therapy in women with severe symptoms.

Abstract Background Women at middle age are puzzled by a series of menopausal disturbances, can be distressing and considerably affect the personal, social and work lives. We aim to estimate the global prevalence of nineteen menopausal symptoms among middle-aged women by performing a systematic review and meta-analysis. Methods Comprehensive search was performed in multiple databases from January, 2000 to March, 2023 for relevant studies. Random-effect model with double-arcsine transformation was used for data analysis. Results A total of 321 studies comprised of 482,067 middle-aged women were included for further analysis. We found varied prevalence of menopausal symptoms, with the highest prevalence of joint and muscular discomfort (65.43%, 95% CI 62.51–68.29) and lowest of formication (20.5%, 95% CI 13.44–28.60). Notably, South America shared dramatically high prevalence in a sort of menopausal symptoms including depression and urogenital symptoms. Besides, countries with high incomes (49.72%) had a significantly lower prevalence of hot flashes than those with low (65.93%), lower-middle (54.17%), and upper-middle (54.72%, p

Introduction: Considering the relatively high importance and complications of endometrial malignancies, especially during menopause, and considering that the role of endocrine hormones was not fully clarified, this study was performed with aim to determine the relationship between estradiol levels and the clinical characteristics of postmenopausal women with bleeding and endometrial malignancy. Methods: This analytical cross-sectional study was conducted in 2023 on 54 patients with postmenopausal bleeding suffering from endometrial malignancy who referred to Imam Hossein (AS) hospital. Demographic and clinical (signs and symptoms) characteristics and serum estradiol levels of patients were collected. Data were analyzed by SPSS software (version 23) and Man-Whitney and Chi-square tests. P

Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder affecting women across various life stages, presenting a wide array of symptoms that differ markedly during adolescence, reproductive age, and menopause. In adolescence, the overlap of PCOS symptoms with normal pubertal changes complicates diagnosis, with common presentations including menstrual irregularities, acne, and hirsutism. During the reproductive years, PCOS is often associated with infertility, menstrual dysfunction, and metabolic complications such as insulin resistance and type 2 diabetes. In menopausal women, reproductive symptoms diminish, but the risk of cardiovascular disease, persistent hyperandrogenism, and metabolic syndrome becomes more pronounced. This review aims to define the distinct clinical presentations of PCOS across these life stages, highlighting the diagnostic and management challenges inherent to its heterogeneous nature. By understanding the age-specific manifestations and complications of PCOS, healthcare providers can develop more effective, individualized therapeutic strategies, ultimately improving patient outcomes and quality of life.

This descriptive study was conducted to examine the genital hygiene, quality of life, and urinary incon-tinence awareness of post-menopausal women aged 55 and older living in the earthquake region after the disaster. The study was carried out between 07.07.2023 and 20.01.2024, with the participation of women who were 55 years old or older, lived in the Arsuz District of Hatay City, and met the inclusion criteria. Socio-demographic data form, Urinary Incontinence Awareness and Attitude Scale, The Utian Quality of Life Scale, and Genital Hygiene Behaviour Scale were used to evaluate the participants in the study. The average age of the participants in the study was 64.05± 8.04. 55% of the participants were illiterate, and 42% were primary school graduates. 55% of the participants were diagnosed with incon-tinence before the disaster, and 31 participants (%9.68) stated that the frequency of incontinence increased after the disaster. In the study, it was revealed that participants had lower quality of life due to the disaster (X̄±SS=64.41±10.06). Additionally, they were aware of urinary incontinence as a health problem (X̄±SS=35.76±4.10) and experienced fear of urinary leakage due to incontinence (X̄±SS=10.76±2.95). In addition, in the urinary incontinence awareness assessment, it was shown that the participants had high health motivation regarding urinary incontinence, which they perceived as a health problem. However, some participants have reported an increase in urinary incontinence follow-ing the earthquake. This situation especially suggests that post-earthquake living conditions may negatively affect hygiene practices and reduce the quality of life by causing health problems. Therefore, the hygiene and health problems experienced by women in disaster situations need to be considered.

Background : AMP-activated protein kinase (AMPK) is a key enzyme for cellular energy homeostasis and improves metabolic disorders. Brown and beige adipose tissues exert thermogenesis capacities to dissipate energy in the form of heat. Here, we investigated the beneficial effects of the antioxidant alpha-lipoic acid (ALA) in menopausal obesity and the underlying mechanisms. Methods : Female Wistar rats (8 weeks old) were subjected to bilateral ovariectomy (Ovx) and divided into four groups: Sham (n=8), Ovx (n=11), Ovx+ALA2 (n=10), and Ovx+ALA3 (n=6) (ALA 200 and 300 mg/kg/day, respectively; gavage) for 8 weeks. 3T3-L1 cells were used for in vitro study. Results : Rats receiving ALA2 and ALA3 treatment showed significantly lower levels of body weight and white adipose tissue (WAT) mass than those of the Ovx group. ALA improved plasma lipid profiles including triglycerides, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol. Hematoxylin & eosin staining of inguinal WAT showed that ALA treatment reduced Ovx-induced adipocyte size and enhanced uncoupling protein 1 (UCP1) expression. Moreover, plasma levels of irisin were markedly increased in ALA-treated Ovx rats. Protein expression of brown fat-specific markers including UCP1, PRDM16, and CIDEA was downregulated by Ovx but markedly increased by ALA. Phosphorylation of AMPK, its downstream acetyl-CoA carboxylase, and its upstream LKB1 were all significantly increased by ALA treatment. In 3T3-L1 cells, administration of ALA (100 and 250 μM) reduced lipid accumulation and enhanced oxygen consumption and UCP1 protein expression, while inhibition of AMPK by dorsomorphin (5 μM) significantly reversed these effects. Conclusion : ALA improves estrogen deficiency-induced obesity via browning of WAT through AMPK signaling.

Abstract Background Dementia is associated with older adults; however, it can also affect younger individuals, known as young-onset dementia (YOD), when diagnosed before the age of 65 years. We aimed to conduct a retrospective cohort study involving middle-aged women to investigate the association between premorbid depression and YOD development. Methods We included 1.6 million women aged 40–60 years who underwent health checkups under the Korean National Health Insurance Service and investigated the association between depression and YOD. Results Women with depression had a significantly higher risk of developing YOD than women without depression. Among premenopausal women, those with depression had a 2.67-fold increased risk, whereas postmenopausal women with depression had a 2.50-fold increased risk. Late age at menarche (> 16 years) and young age at menopause (

Abstract Background Hormone therapy (HT) use among menopausal women declined after negative information from the 2002 Women’s Health Initiative (WHI) HT study. The 2017 post-intervention follow-up WHI study revealed that HT did not increase long-term mortality. However, studies on the effects of the updated WHI findings are lacking. Thus, we assessed the impact of the 2017 WHI findings on HT use in Taiwan. Methods We identified 1,869,050 women aged 50–60 years, between June and December 2017, from health insurance claims data to compare HT use in the 3 months preceding and following September 2017. To address the limitations associated with interval-censored data, we employed an emulated repeated cross-sectional design. Using logistic regression analysis, we evaluated the impact of the 2017 WHI study on menopausal symptom-related outpatient visits and HT use. In a scenario analysis, we examined the impact of the 2002 trial on HT use to validate our study design. Results Study participants’ baseline characteristics before and after the 2017 WHI study were not significantly different. Logistic regressions demonstrated that the 2017 study had no significant effect on outpatient visits for menopause-related symptoms or HT use among women with outpatient visits. The scenario analysis confirmed the negative impact of the 2002 WHI trial on HT use. Conclusions The 2017 WHI study did not demonstrate any impact on either menopause-related outpatient visits or HT use among middle-aged women in Taiwan. Our emulated cross-sectional study design may be employed in similar population-based policy intervention studies using interval-censored data.

When postmenopausal women are under stress conditions, this exacerbates mood disorders and issues with neuroimmune systems. The porcine placenta is known to relieve menopausal depression in clinical trials, but its underlying mechanisms for depression and anti-inflammatory functions remain poorly defined. The present study was designed to examine the anti-inflammatory effects of enzymatic porcine placenta hydrolysate (EPPH) on LPS-induced levels of nitric oxide (NO), prostaglandin E2 (PGE2), corticosterone (CORT), and pro-inflammatory cytokine interleukin-1 beta (IL-1β) in RAW 264.7 macrophage cells. In addition, the neurite outgrowth of PC12 cells was evaluated to examine the effects of EPPH on neurite growth. To mimic the symptoms of women with menopause-related depression, a stressed ovariectomized (OVX) female mouse model was used to evaluate the antidepressant effects of EPPH. The female mice were randomly divided into five groups: (1) the sham-operated (Sham) group, (2) the OVX + repeated stress + saline-treated (OVX + ST) group, (3) the OVX + repeated stress + estradiol (0.2 mg/kg)-treated (positive control) group, (4) the OVX + repeated stress + EPPH (300 mg/kg)-treated (300) group, and (5) the OVX + repeated stress + EPPH (1500 mg/kg)-treated (1500) group. Female mice were OVX and repeatedly immobilization-stressed for 2 weeks (2 h/day). A tail suspension test was conducted on the 13th day, followed by the forced swimming test on the 14th day to assess the antidepressant effects of EPPH. After the behavioral tests, the levels of CORT, PGE2, and IL-1β were evaluated. In addition, c-Fos expression in the paraventricular nucleus (PVN) was evaluated using immunohistochemistry. The concentrations of NO, PGE2, and IL-1β stimulated by LPS were significantly reduced via the addition of EPPH to RAW 264.7 cells. EPPH significantly promoted neurite outgrowth in PC12 cells compared to that of the controls. In the tail suspension test, the duration of immobility was reduced in mice treated with EPPH 1500 compared to the OVX + ST group. The EPPH 1500 group had significantly decreased levels of c-Fos-positive neurons in the PVN and reduced levels of CORT and IL-1β in the serum of the Sham group. These results suggested that the high dose of EPPH administration induced the antidepressant-like effect in the ovariectomized mice with repeated stress via downregulating the levels of CORT, IL-1β, and PGE2 in the serum through reducing the expression of c-Fos in the PVN regions.

This paper reviews epidemiological data on primary hyperparathyroidism (PHPT). PHPT is an endocrine disease caused by a tumor or hyperplastic changes in the parathyroid glands (PTG); it leads to disturbances in calcium-phosphorus homeostasis and can cause organ dysfunction. The results of epidemiological studies in various countries indicate an "epidemic" of PHPT at the end of the 20th century. Currently, PHPT ranks as the third endocrine problem in the world. Its prevalence is about 0.86-1% in people under 50 and 2% in people over 50. It was found that PHPT occurs more often in people aged 40-60 years, with an increase in the frequency of its detection after 25 years of age, especially in women after menopause. The review emphasizes the importance of PHPT, which represents a severe medical and social problem. Regular screening and the introduction of modern diagnostic methods play a vital role in the timely detection and management of PHPT, which is of great importance for improving patients' quality of life and preventing severe complications. When compiling the literature review, we used the following databases: PubMed, Embase, Medline, ScienceDirect, Cochrane Library, eLibrary, and CyberLeninka. The literature search was carried out using the following keywords: "epidemiology of primary hyperparathyroidism", "prevalence", "incidence", "normocalcemic hyperparathyroidism", "parathyroid gland", and "parathyroid hormone". The search identified more than 1070 scientific papers, from which 48 studies were selected. These studies cover the epidemiological aspects (incidence and prevalence) of PHPT conducted in various countries. The selection was done without considering each study's specific period and volume of observations. The selection process focused on studies using automated blood calcium analyzers to evaluate the impact of regular screening on the effectiveness of detecting PHPT. Works presenting both global and regional data were also included in the analysis. Studies that did not meet the established selection criteria were excluded.

The increase in life expectancy implies a greater attention to the prophylaxis of pathology specific to geriatrics (cardiovascular, osteoarticular) Menopause, a natural process, involves hormonal changes such as insomnia, irritability and anxiety Methods: The batch of this study included 106 women who were divided into 2 groups: the study group (G1) with 54 patients, who followed a program of controlled physical exercises, on land and in water, and the control group (G2) with 52 people, who performed only controlled physical exercises on land. The parameters body mass, height, Body Mass Index), systolic blood pressure, diastolic blood pressure, heart rate) were evaluated. (3) Results: After performing physical exercises on land and in water, the systolic blood pressure improved by 11.46% in the G1 group compared to 1.14% in the G2 group, the diastolic blood pressure recorded a reduction of 14.78% in the G1 group and by 0.7% in the G2 group, and heart rate improved by 15.15% in the G1 group compared to 11.84% in the G2 group. (4) Conclusions: Anthropometric and hemodynamic parameters can be improved by regular physical exercises, on land and in water, performed by premenopausal and postmenopausal women. The improvement of blood pressure and heart rate values ​​is due to regular physical exercises, individualized and adapted to the age group and pathology.

Background. In recent decades, the frequency of surgical interventions on reproductive system organs has been steadily increasing. In gynecological practice, preference is given to minimally invasive surgery and precision treatments, especially involving ovaries. Despite the modern approach, it is not always possible to preserve this endocrine organ, which leads to post-surgical menopause (PSM). The relatively high incidence of total hysterectomy-associated PSM and primary hypothyroidism in late reproductive age often leads to their combination. Clinical manifestations aggravating each other form an unfavorable vicious circle. Aim. To study the features of the PSM course with concomitant primary hypothyroidism. Materials and methods. A prospective clinical study included 130 women aged 45 to 55 years with a history of PSM. The main group consisted of 70 patients with PSM with subclinical primary hypothyroidism. A control group included 60 PSM patients without thyroid disorders. We assessed the effect of hypothyroidism on the PSM course by comparing several indicators in the main and control groups. Results. It was found that in the main group patients, severe 26.5% and moderate 38.8% menopausal syndrome prevailed, while in the control group patients, such forms were twice as common. In the women of the main group, the levels of triglycerides were higher than those in the control group by 1.3 times (2.6±0.86 mmol/L and 1.43±0.33 mmol/L, respectively). The total serum alkaline phosphatase activity in patients in the study groups was 29.8% higher than in healthy women. Conclusion. It can be concluded that the severity of menopausal disorders depends on the thyroid status, with more severe in patients of the main group with hypothyroidism. In addition, in patients of the main group with hypothyroidism, dyslipidemia is more pronounced, which predisposes them to severe diseases in the future, in particular cardiovascular disorders, the unfavorable course of metabolic syndrome, and the development of postmenopausal osteoporosis.

Aim. To assess the functional state of the liver and endothelium in patients with menopausal metabolic syndrome, depending on the degree of obesity. Materials and methods. 70 patients with menopausal metabolic syndrome and obesity of varying degrees with an average age of 49.9±1.1 years and 30 practically healthy women without obesity and liver pathology with an average age of 47.3±2.6 years (comparison group) who were in the early postmenopausal period were examined. All women underwent biometric and laboratory-instrumental examination, including assessment of biometric indicators, determination of estradiol levels in the blood, biochemical markers of cytolysis and cholestasis, markers of endothelial dysfunction, assessment of microvascular tone reaction with calculation of the thermal vasodilation index, ultrasound examination of the liver and calculation of the Hepatic steatosis index (HSI). Results. All patients with menopausal metabolic syndrome had a genoid type of obesity and hypoestrogenism. The level of estradiol decreased more significantly during the transition to the 1st degree of obesity (p=0.001). According to ultrasound and the HSI index, signs of liver steatosis were found in all patients with menopausal metabolic syndrome. Functional liver tests were within the reference values, 13% had an increase in the level of alkaline phosphatase, more significant in the group with grade 3 obesity (p=0.034). Laboratory markers of endothelial dysfunction were significantly higher in patients with menopausal metabolic syndrome than in the comparison group. The muscular and neurogenic index of thermal vasodilation significantly decreased in women with grade 1 obesity compared to the group with “pre-obesity“ (p=0.041 and 0.047). The lowest endothelial response was observed at the transition to the 1st degree of obesity in comparison with women with excess body weight. Conclusion. For patients with menopausal metabolic syndrome to assess the condition of the liver, it is recommended to conduct a comprehensive instrumental laboratory examination, including ultrasound examination of the liver, biochemical parameters and calculation of the steatosis index.

Abstract Background This cross-sectional study aims to explore whether there exists an interaction between selenium and menopause concerning type 2 diabetes (T2D) prevalence and its related indicators such as fasting blood glucose (FBG) and homeostasis model assessment of insulin resistance (HOMA-IR). Methods 150 women aged 35–60 years old were finally analyzed in this study. Multivariate linear or logistic regression modeling was conducted to explore the association of selenium and the prevalence of T2D besides its related indicators. Subgroup analyses were conducted based on menopause status to assess the potential impact on the relationship. Results In the fully adjusted model, serum selenium was positively associated with FBG (β: 0.03, CI: 0.01–0.05) and the prevalence of T2D (OR: 1.04, CI: 1.00–1.08). After stratifying the data by menopause status, compared with the postmenopausal women group, as the serum selenium concentrations increased, the FBG concentrations were significantly higher in the premenopausal women group (p for interaction = 0.0020). Conclusions The present study found serum selenium was positively associated with FBG and the prevalence of T2D. Furthermore, the relationship between serum selenium and FBG was different in the premenopausal and postmenopausal women. More studies are still needed in the future to verify the relationship as well as to explore the specific mechanisms.

Introduction: The menstrual cycle (MC) reflects multifaceted hormonal changes influencing women’s metabolism, making it a key aspect of women’s health. Changes in hormonal levels throughout the MC have been demonstrated to influence various physiological parameters, including exhaled carbon dioxide (CO2). Lumen is a small handheld device that measures metabolic fuel usage via exhaled CO2. This study leverages exhaled CO2 patterns measured by the Lumen device to elucidate metabolic variations during the MC, which may hold significance for fertility management. Additionally, CO2 changes are explored in menopausal women with and without hormonal replacement therapy (HRT). Methods: This retrospective cohort study analyzed exhaled CO2 data from 3,981 Lumen users, including eumenorrheal women and menopausal women with and without HRT. Linear mixed models assessed both CO2 changes of eumenorrheal women during the MC phases and compared between menopausal women with or without HRT. Results: Eumenorrheic women displayed cyclical CO2 patterns during the MC, characterized by elevated levels during the menstrual, estrogenic and ovulation phases and decreased levels during post-ovulation and pre-menstrual phases. Notably, despite variations in cycle length affecting the timing of maximum and minimum CO2 levels within a cycle, the overall pattern remained consistent. Furthermore, CO2 levels in menopausal women without HRT differed significantly from those with HRT, which showed lower levels. Conclusion: This study reveals distinct CO2 patterns across MC phases, providing insights into hormonal influences on metabolic activity. Menopausal women exhibit altered CO2 profiles in relation to the use or absence of HRT. CO2 monitoring emerges as a potential tool for tracking the MC and understanding metabolic changes during menopause.