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STUDY QUESTION: What is the association between reproductive health history (e.g. age at menarche, menopause, reproductive lifespan) with abdominal adiposity in postmenopausal women? SUMMARY ANSWER: Higher visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) tissue levels were observed among women with earlier menarche, earlier menopause, and greater parity. WHAT IS KNOWN ALREADY: Postmenopausal women are predisposed to accumulation of VAT and SAT. Reproductive health variables are known predictors of overall obesity status in women, defined by BMI. STUDY DESIGN, SIZE, DURATION: This study is a secondary analysis of data collected from the baseline visit of the Womens Health Initiative (WHI). The WHI is a large prospective study of postmenopausal women, including both a randomized trial and observational study. There were 10 184 women included in this analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS: Data were collected from a reproductive health history questionnaire, dual-energy x-ray absorptiometry scans, and anthropometric measures at WHI baseline. Reproductive history was measured via self-report, and included age at menarche, variables related to pregnancy, and age at menopause. Reproductive lifespan was calculated as age at menopause minus age at menarche. Statistical analyses included descriptive analyses and multivariable linear regression models to examine the association between reproductive history with VAT, SAT, total body fat, and BMI. MAIN RESULTS AND THE ROLE OF CHANCE: Women who reported early menarche (15 years had 23 cm2 less VAT (95% CI: -31.4, -14.4) and 47 cm2 less SAT (95% CI: -61.8, -33.4) than women who experienced menarche at age 10 years or earlier. A similar pattern was observed for age at menopause: compared to women who experienced menopause 3 pregnancies) was also associated with VAT and SAT. For example, adjusted beta coefficients for VAT were 8.36 (4.33, 12.4) and 17.9 (12.6, 23.2) comparing three to four pregnancies with the referent, one to two pregnancies. LIMITATIONS, REASONS FOR CAUTION: The WHI reproductive health history questionnaire may be subject to poor recall owing to a long look-back window. Residual confounding may be present given lack of data on early life characteristics, such as maternal and pre-menarche characteristics. WIDER IMPLICATIONS OF THE FINDINGS: This study contributes to our understanding of reproductive lifespan, including menarche and menopause, as an important predictor of late-life adiposity in women. Reproductive health has also been recognized as a sentinel marker for chronic disease in late life. Given established links between adiposity and cardiometabolic outcomes, this research has implications for future research, clinical practice, and public health policy that makes use of reproductive health history as an opportunity for chronic disease prevention. STUDY FUNDING/COMPETING INTEREST(S): HRB and AOO are supported by the National Institute of Health National Institute of Aging (R01AG055018-04). JWB reports royalties from ACSMS Body Composition Assessment Book and consulting fees from the WHI. The remaining authors have no competing interests to declare. TRIAL REGISTRATION NUMBER: N/A.

PURPOSE OF REVIEW: Cardiovascular disease is a leading cause of death worldwide. Dyslipidemia is a critical modifiable risk factor for the prevention of cardiovascular disease. Dyslipidemia affects a large population of women and is especially pervasive within racial/ethnic minorities. RECENT FINDINGS: Dyslipidemia in pregnancy leads to worse outcomes for patients and creates increased cardiovascular risk for women at an older age. However, women remain underscreened and undertreated compared to men. Females also comprise a small portion of clinical trial participants for lipid lowering agents with increased disease prevalence compared to trial representation. However, recent lipid trials have shown different efficacies of therapies such as ezetimibe, inclisiran, and bempedoic acid with a greater relative benefit for women. SUMMARY: Pathophysiology of dyslipidemia varies between men and women and across a womans lifetime. While increased lipid levels or lipid imbalances are more common in postmenopausal women over age 50, conditions such as PCOS and FH produce higher cardiovascular risk for young women.Best practices for management of women with dyslipidemia include early screening with lifestyle intervention and pharmacotherapy with statin and non-statin agents to achieve guideline directed LDL-C thresholds.

IntroductionReproductive health history may contribute to cognitive aging and risk for Alzheimer's disease, but this is understudied among Hispanic/Latina women.MethodsParticipants included 2126 Hispanic/Latina postmenopausal women (44 to 75 years) from the Study of Latinos-Investigation of Neurocognitive Aging. Survey linear regressions separately modeled the associations between reproductive health measures (age at menarche, history of oral contraceptive use, number of pregnancies, number of live births, age at menopause, female hormone use at Visit 1, and reproductive span) with cognitive outcomes at Visit 2 (performance, 7-year change, and mild cognitive impairment [MCI] prevalence).ResultsYounger age at menarche, oral contraceptive use, lower pregnancies, lower live births, and older age at menopause were associated with better cognitive performance. Older age at menarche was protective against cognitive change. Hormone use was linked to lower MCI prevalence.DiscussionSeveral aspects of reproductive health appear to impact cognitive aging among Hispanic/Latina women.

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. [ABSTRACT FROM AUTHOR]

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. 7yVbQmTTfsF9b4Af3tznWN Video Abstract [ABSTRACT FROM AUTHOR]

Simple Summary: Menopause remains a complex challenge after breast cancer. Menopausal symptoms, whether iatrogenic or premature due to cancer treatment, significantly affect health and quality of life. Menopausal hormone therapy is currently deemed unsafe in hormone-sensitive breast cancer. Unfortunately, the alternative non-hormonal therapies are not as effective in controlling menopausal symptoms. The aim of our narrative review was to determine the risk of recurrence of breast cancer in breast cancer survivors taking menopausal hormone therapy. Data on this topic are of low quality and outdated. This review highlights the need for future research to help navigate this difficult path. Menopausal symptoms negatively impact quality of life in breast cancer survivors. The paucity of data on the impact of Menopausal Hormone Therapy (MHT) on oncological outcomes in these patients limits informed clinical discussion. Defining the risk of cancer recurrence with MHT is central to the appraisal of risk/benefit, particularly with low-risk disease (based on genomic profile). The aim of this review is to summarize the current data evaluating MHT in breast cancer patients. A systematic review of the literature was performed to evaluate the impact of MHT on oncological outcomes in breast cancer survivors. Three major databases (PubMed, EMBASE and Medline) were searched. The review included all prospective studies published in English. Four randomized control trials and four non-randomized prospective studies were identified. An increase in breast cancer recurrence with MHT was observed in the early randomized trials whilst no increased risk of recurrence was reported in the observational studies. There remains a need to quantify MHT-related recurrence risk in patients with molecularly favorable disease. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

Objective: Malondialdehyde (MDA), a by-product of lipid peroxidation, is considered one of the biological markers for oxidative stress. Oxidative stress increases with age, especially after menopause. The aim is to evaluate the oxidative stress levels in pre-, peri-, and postmenopausal women by measuring salivary malondialdehyde levels. Methods: The study included 45 participants, who were categorized into premenopausal, perimenopausal, and postmenopausal groups. Salivary MDA levels were measured biochemically using the thiobarbituric acid method. Results: A statistically significant rise (P < .001) in the mean salivary MDA level was observed in postmenopausal women (0.94 ± 0.18 nmol/mL) when compared to perimenopausal (0.78 ± 0.08 nmol/mL) and premenopausal women (0.48 ± 0.09 nmol/mL). Salivary MDA levels were also positively correlated with the age of the participants (r = 0.79; P < .00) and the duration of menopause (r = 0.609; P = .015). Conclusion: Salivary MDA levels were highest in postmenopausal women, followed by perimenopausal and premenopausal women. The changes observed in salivary MDA levels could be probably due to the oxidative stress during menopause. [ABSTRACT FROM AUTHOR]

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 (< 6 lbs., 6–7 lbs. 15 oz, 8–9 lbs. 15 oz, or ≥ 10 lbs.) and preterm birth status (4 or more weeks premature). Ages at events related to menarche and menopause were also self-reported. Linear regression and logistic regression models were used to estimate unadjusted and adjusted effect estimates (β) and odds ratios (OR), respectively (n ≤ 86,857). Individuals born preterm were excluded from all birthweight analyses. Results: After adjustments, individuals born weighing < 6lbs. were more likely to reach natural menopause at an earlier age (adjusted β=-0.361, SE = 0.09, P = < 0.001) and have a shorter reproductive window (adjusted β = -0.287, SE = 0.10, p < 0.004) compared to individuals weighing 6–7 lbs. 15 oz. Individuals born preterm were also more likely to reach natural menopause at an earlier age (adjusted β=-0.506, SE = 0.16, P = 0.001) and have a shorter reproductive window (adjusted β = -0.418, SE = 0.17, p < 0.006). Conclusions: These findings raise concerns that, as more preterm and low birthweight individuals survive to adulthood, the prevalence of earlier-onset menarche and menopause may increase. Clinical counseling and interventions aimed at reducing the incidence of preterm and low birthweight births, as well as intensification of lifestyle modifications to reduce CVD risk among women with these early-life risk factors, should be prioritized. [ABSTRACT FROM AUTHOR]

Background/Objectives: Hormonal alterations during menopause result in substantial physiological changes. Although hormone replacement therapy (HRT) is widely used as a treatment strategy for these changes, its use remains controversial due to its associated risks. Plant isoflavones are phytoestrogens that are considered a potential alternative therapy for postmenopausal syndrome. We aimed to investigate the efficacy of ethanolic extracts from Styphnolobium japonicum fruit (SJF) and germinated soybean embryo (GSE) in alleviating prominent menopausal symptoms. Methods: A cell model (MCF7 human breast cancer cells) was used to investigate estrogen-like activity. A rat ovariectomy model was used to simulate estrogen depletion after menopause and to evaluate the efficacy of the SJF–GSE complex extract at ratios of 1:1, 1:2, and 2:1. Results: Treatment with the SJF–GSE extract elicited estrogen-like effects, raising pS2 and estrogen receptor α expression in MCF7 cells. The extract was found to contain 48–72 mg/g sophoricoside and 8–12 mg/g soyasaponin 1, identified as active compounds. In ovariectomized rats, the extract effectively reduced body weight and fat content, alleviated vasomotor symptoms, improved vaginal mucosal health, and exerted osteoprotective effects by enhancing bone density and structure, reducing bone-resorption markers and positively altering estradiol levels and lipid profiles. Conclusions: The SJF–GSE extract, working synergistically, provides a safe and effective alternative to HRT for managing postmenopausal symptoms and enhancing bone health, without adverse effects. These findings support the inclusion of SJF and GSE in health-functional foods and underscore the importance of further research into plant-based therapies for menopause. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia, characterized by muscle mass decline due to aging or other causes, is exacerbated by decreased estrogen levels after menopause in women. Isoflavones, a class of flavonoids acting on estrogen receptors, may have beneficial effects on metabolic disorders. We examined these effects in ovariectomized mice fed a high-fat, high-sucrose diet (HFHSD). Methods: At 7 weeks old, female C57BL6/J mice (18–20 g, n = 12) underwent bilateral ovariectomy (OVX), and were then fed a high-fat, high-sucrose diet starting at 8 weeks of age. Half of the mice received isoflavone water (0.1%). Metabolic analyses, including glucose and insulin tolerance tests, were conducted. Muscle analysis involved grip strength assays, next-generation sequencing, quantitative RT–PCR, and western blotting of skeletal muscle after euthanizing the mice at 14 weeks old. Additionally, 16S rRNA gene sequence analysis of the gut microbiota was performed. Results: The results demonstrated that isoflavone administration did not affect body weight, glucose tolerance, or lipid metabolism. In contrast, isoflavone-treated mice had higher grip strength. Gene expression analysis of the soleus muscle revealed decreased Trim63 expression, and western blotting showed inactivation of muscle-specific RING finger protein 1 in isoflavone-treated mice. Gut microbiota analysis indicated higher Bacteroidetes and lower Firmicutes abundance in the isoflavone group, along with increased microbiota diversity. Gene sets related to TNF-α signaling via NF-κB and unfolded protein response were negatively associated with isoflavones. Conclusions: Isoflavone intake alters gut microbiota and increases muscle strength, suggesting a potential role in improving sarcopenia in menopausal women. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of death globally, with women at higher risk after menopause. This increased risk is attributed to both aging and hormonal changes. Prior research has established a link between CVD risk perception and adopting healthy behaviors to prevent CVD. This study aimed to assess the accuracy of self-perceived CVD risk in perimenopausal and postmenopausal women, and to identify factors that predict CVD risk underestimation among them. Methods: A cross-sectional study was conducted in the administrative sectors of Suez Canal University campus in Ismailia, Egypt, over a period of eight months starting in July 2022. A total of 390 eligible women (employees and workers) were randomly selected. Participants were interviewed to obtain data on demographics, medical history, self-perceived risk of CVD, self-perceived general health, awareness of factors that increase the risk of developing CVD, perceived stress, health literacy, numeracy, and self-perceived 10-year risk of developing major cardiovascular events. They also underwent measurements of blood pressure, weight, and height. The updated 2019 WHO/CVD risk non-laboratory-based prediction chart for the North Africa and Middle East Region was used to predict the 10-year risk of major cardiovascular events for the study participants. Risk accuracy was measured by comparing self-perceived CVD risk with predicted CVD risk. Results: The ratio of self-perceived to predicted moderate/high CVD risk was 27.7% to 44.3%, respectively. The accuracy of CVD risk perception was 68.2%. Kappa analysis results showed fair and significant agreement between self-perceived and predicted CVD risk (kappa ± SE = 35.9 ± 4.1%, p < 0.001). The proportion of women who underestimated their risks was 24.1%. Of those in the high-risk group, 93.3% underestimated their CVD risk, compared to 50.6% in the moderate-risk group. Factors that significantly predicted CVD risk underestimation included being married (aOR 14.5; 95% CI 1.4-149.9), low income (aOR 2.321; 95% CI 1.09-4.909), high BMI (aOR 4.78; 95% CI 1.9-11.9), hypertension (aOR 3.5; 95% CI 2-6.2), and old age (aOR 1.46; 95% CI 1.3-1.6). Conclusions: Approximately one-third of our study participants misperceived their CVD risk; of those who did, 75.8% underestimated it. Marital status, old age, low income, high BMI, and hypertension strongly predicted CVD risk underestimation. These findings identified the menopausal women subgroups that could benefit from targeted health interventions designed to reduce CVD risk underestimation and improve risk accuracy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between circulating receptor activator of nuclear factor-kappa B ligand (RANKL) levels and marrow adipose tissue in postmenopausal females. Methods: A total of 164 postmenopausal females were included in the study. Serum levels of osteoprotegerin (OPG) and RANKL were measured using ELISA kits. Body composition and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry. Complex-based chemical shift imagingbased MRI was employed to evaluate the vertebral marrow proton density fat fraction (PDFF). A multivariate linear regression model was utilized to analyze the predictive effects of PDFF and BMD on circulating levels of OPG and RANKL. Results: Simple regression analysis showed significant associations among the marrow PDFF, BMD at either site, serum RANKL, and the RANKL/OPG ratio. In multivariate linear regression models, marrow PDFF was found to have a positive correlation (b = 3.15, 95% CI 2.60 to 3.70) and BMD had negative correlations (b = -0.200, 95% CI -0.348 to -0.051 for vertebral BMD; b = -0.383, 95% CI -0.589 to -0.177 for total hip BMD; and b =-0.393, 95% CI -0.598 to -0.188 for femoral neck BMD, all p < 0.01) with circulating soluble RANKL levels after adjusting for age, body mass index, physical activity, total fat mass, android/gynoid ratio, and lean mass. Similar results were observed for the RANKL/OPG ratio. Additionally, multivariate linear regression analyses revealed that marrow PDFF was a significant independent contributor of circulating soluble RANKL (b = 1.34, 95% CI 1.10 to 1.58, p < 0.001) after further controlling for BMD. However, marrow PDFF or BMD had no associations with circulating levels of OPG after adjusting for all potential confounders mentioned above. Conclusions: Vertebral marrow fat fraction is independently associated with circulating soluble RANKL levels in postmenopausal females. [ABSTRACT FROM AUTHOR]

Since CD4+ T cells are essential for regulating adaptive immune responses and for long lasting mucosal protection, changes in CD4+ T cell numbers and function are likely to affect protective immunity. What remains unclear is whether CD4+ T cell composition and function in the female reproductive tract (FRT) changes as women age. Here we investigated the changes in the composition and function of CD4+ T cells in the endometrium (EM), endocervix (CX), and ectocervix (ECX) with aging. We observed a significant decrease in both the total number and percentage of CD4+ T cells in the EM with increasing age, particularly in the years following menopause. CD4+ T cells within the FRT predominantly expressed CD69. The proportion of CD69+CD4+ T cells increased significantly with increasing age in the EM, CX and ECX. The composition of T helper cell subsets within the EM CD4+ T cell population also showed age-related changes. Specifically, there was a significant increase in the proportion of Th1 cells and a significant decrease in Th17 and Treg cells with increasing age. Furthermore, the production of IFNg by CD4+ T cells in the EM, CX, and ECX significantly decreased with increasing age upon activation. Our findings highlight the complex changes occurring in CD4+ T cell frequency, phenotype, and function within the FRT as women age. Understanding these age-related immune changes in the FRT is crucial for enhancing our knowledge of reproductive health and immune responses in women. [ABSTRACT FROM AUTHOR]

Background: Guidelines recommend Menopausal Hormone Therapy (MHT) as the most effective treatment for menopausal symptoms. However, a local study found that the usage of MHT among menopausal women was low (8.1%), with one of the main reasons being it is not recommended by doctors. Therefore, the objectives of this study are to determine the prevalence of offering MHT in treating symptomatic menopausal women among primary care doctors (PCDs) and its associated factors. Methods: This cross-sectional study involved PCDs from the Federal Territory of Kuala Lumpur, the Federal Territory of Putrajaya and the state of Selangor. All PCDs provided services in government primary care clinics from the three states were invited through the doctor in charge of each clinic. An online survey links was provided for the participants to the self-administered questionnaire. The questionnaire included PCDs' demographics, their menopause management practices, attitudes towards MHT, perceived barriers in offering MHT, knowledge of related guidelines and received training on menopause management. The outcome variable was offering MHT which defined as either prescription of MHT or referral to hospital for MHT initiation. Multivariate logistic regression analysis was performed to determine the factors associated with offering MHT. Results: The response rate was 42.9% (559/1301). Of those who participated in the study, 77.8% of PCDs were female and 89.1% were medical officer. Although 66.9% of the participants reported offering MHT to their patients, the actual prescription rate was low (0.9%). Most PCDs (66%) would refer the patients to hospitals. 87.1% of PCDs (487/559) reported that MHT was not available in their clinic. In the past 12 months, 83% of PCDs had not received any related training. Female PCDs (AOR:2.5, CI: 1.51–4.13, p<0.001), perceiving MHT as preference treatment for menopause symptom (AOR:3.6, CI: 2.13–6.19, p < 0.001), having likelihood to recommend MHT to family and friends (AOR:3.0, CI: 1.87–4.83, p < 0.001), and receiving training on menopause management (AOR:2.7, CI: 1.30–5.56, p = 0.008) were the positive predictor of offering MHT. The negative predictors in offering MHT were no-experience in prescribing MHT (AOR: 0.4, CI: 0.15–0.87, p = 0.024) and lack of information regarding MHT for the patient (AOR: 0.4, CI:0.20–0.67, p < 0.001). Conclusion: The study revealed a low rate of MHT prescription among PCDs, with many relying on referrals to hospitals for managing menopausal symptoms. The findings underscore the need for strategies that includes fulfilling professional training gaps, improving MHT availability, and improving information dissemination for patient. [ABSTRACT FROM AUTHOR]

Elinzanetant is a potent and selective dual neurokin‐1 (NK‐1) and ‐3 (NK‐3) receptor antagonist that is currently developed for the treatment of women with moderate‐to‐severe vasomotor symptoms (VMS) associated with menopause. Here, we report the development of a population pharmacokinetic (popPK) model for elinzanetant and its principal metabolites based on an integrated dataset from 366 subjects (including 197 women with VMS) collected in 10 phase I or II studies. The pharmacokinetics of elinzanetant and its metabolites could be well described by the popPK model. Within the investigated dose range of 40–160 mg, the oral bioavailability of elinzanetant was dose independent and estimated to be 36.7%. The clearance of elinzanetant was estimated to be 7.26 L/h and the central and peripheral distribution volume were 23.7 and 168 L. No intrinsic or extrinsic influencing factors have been identified in the investigated population other than the effect of a high‐fat breakfast on the oral absorption of elinzanetant. The popPK model was then coupled to a pharmacodynamic model to predict occupancies of the NK‐1 and NK‐3 receptors. After repeated once‐daily administration of the anticipated therapeutic dose of 120 mg elinzanetant, the model‐predicted median receptor occupancies are >99% for NK‐1 and >94.8% for NK‐3 during day and night‐time, indicating sustained and near‐complete inhibition of both target receptors during the dosing interval. [ABSTRACT FROM AUTHOR]

The aim of this systematic review is to evaluate the impact of estrogen levels on the occurrence of temporomandibular disorders (TMDs) in humans. Searches were conducted in the same databases as follows: PubMed, the Cochrane Collaboration database, and the Scopus database. In accordance with the MeSH database and previous work, the following keywords were used: 'estrogens' and 'temporomandibular joint disorders'. Twelve studies were included in the review and were assessed for the quality of evidence. Estrogen levels are associated with pain modulation in the temporomandibular joint and the entire orofacial region. There is insufficient evidence to either confirm or refute the influence of estrogen on the occurrence of TMDs. The study was registered under the identifier: 10.17605/OSF.IO/BC7QF. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this review was to evaluate the effects of manual therapy for musculoskeletal pain in menopausal women. (2) Methods: A comprehensive search of manuscripts published from inception until 29 February 2024 was conducted on PubMed, EBSCO Information Services (EBSCOhost), Physiotherapy Evidence Database (Pedro), Web of Science, Scientific Electronic Library Online (SciELO), Cochrane Central Register of Controlled Clinical Trials, and Scopus using Medical Subject Headings (MeSH) and free terms. Randomized controlled trials (RCT) investigating the effects of manual therapy for musculoskeletal pain in postmenopausal women were included. Articles published in non-English or non-Portuguese languages, case reports, expert opinions, dissertations, conference papers, and gray literature were excluded. Studies were screened for population, musculoskeletal pain, intervention, and pain outcome by two independent reviewers using an ad hoc data extraction form. (3) Results: A total of 5 RCTs (4 with high risk of bias and 1 with low risk of bias) were included (total sample = 245), addressing thumb carpometacarpal osteoarthritis, thoracic kyphosis, chronic neck and backache, knee osteoarthritis, and sternocostal joint pain. The combined results of these studies showed improved musculoskeletal pain in menopausal women; duration of the follow-up was between 4 weeks to 6 months. Conclusions: The majority of studies included in this systematic review were effective in reducing musculoskeletal pain in menopausal women. These results come mainly from studies with a high risk of bias with small sample sizes, and the most representative follow-up period was short-term. Therefore, the results of this systematic review should be interpreted with caution. [ABSTRACT FROM AUTHOR]

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 < 0.001), with the greatest improvement observed between the second and third months. Conclusions: Our findings suggest that topical testosterone seems to be safe and may be effective in improving sexual function in patients on ovarian suppression and AI. Trial registration: The project was submitted and approved through the hospital's SGPP platform in 11/26/2019 (Project No. SGPP 393819) and CAAE (Research Ethics Committee) (CAAE No 25609719.5.0000.007). [ABSTRACT FROM AUTHOR]

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 < 0.001) and menopausal women (p < 0.001). The vaginal microbiome of trans men is characterized by a loss of Lactobacillus and an increase in bacteria associated with the intestinal flora (e.g., Campylobacter, Anaerococcus, Dialister, Prevotella). The abundance of Dialister and Prevotella decreased with the length of hormonal therapy in trans men. The Nugent score, Pap smear and HPV status did not differ between the study groups. The vaginal microbiome of trans men differs from that of premenopausal women but shows similarities to that of menopausal women. The duration of hormonal therapy in trans men may have important impacts on the vaginal microbiome and thus possibly on the risk for STIs. [ABSTRACT FROM AUTHOR]

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 < 0.05. Result: The prevalence of menopausal symptoms was 89.9%. According to the menopausal rating scale, the frequency of reported symptoms was hot flushes (54.7%), muscle and joint pain (32.1%) on the somatic subscale; physical and mental exhaustion (55.1%), irritability (48.6%) on psychological subscale; and sexual problems (41.3%), bladder problems (39.2%) on urogenital subscale. This study also showed that the age of women [aOR: 0.317, 95%CI (0.102, 0.990)], and monthly family income [aOR = 0.182, 95% CI (0.041, 0.912)] were significantly associated with somatic menopausal symptoms. There was no utilization of menopausal hormonal therapy to treat menopausal symptoms and to prevent complications. Conclusion: The prevalence of menopausal symptoms is high; however, the utilization of individualized administration of menopausal hormone therapy according to symptoms is negligible. It appears essential for these institutions to work on service availability and delivery of menopausal hormone therapy for those in need of wider benefits for their clients. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

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 FROM AUTHOR]

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 < 0.001], and menopause [1.35 (1.10, 2.11); p = 0.001] and reproductive-age women [2.93 (1.80, 4.78); p = 0.003] of the high BMI trajectory compared to the ones in the low trajectory of BMI were more likely to develop DM. The high BRI in menopause had a significantly higher risk of DM compared to the low trajectory. In menopause (1.80 (1.26, 2.58)) and reproductive-age women (4.32 (2.49, 7.47)) with high trajectory of C-index, the DM risk decreased after adjustment. Conclusions: The risk of DM was greater for high BMI, WC, C-index, and BRI trajectories than for lower trajectories. Hence, the development of general, abdominal, and visceral obesity trajectories in the prevention of DM should be considered by clinicians. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests a connection between DNA methylation (DNAm) aging and reproductive aging. However, the causal relationship between DNAm and age at menopause remains uncertain. Methods: Employing established DNAm epigenetic clocks, such as DNAm Hannum age acceleration (Hannum), Intrinsic epigenetic age acceleration (IEAA), DNAm-estimated granulocyte proportions (Gran), DNAm GrimAge acceleration (GrimAgeAccel), DNAm PhenoAge acceleration (PhenoAgeAccel), and DNAm-estimated plasminogen activator inhibitor-1 levels (DNAmPAIadjAge), a bidirectional Mendelian randomization (MR) study was carried out to explore the potential causality between DNAm and menopausal age. The primary analytical method used was the inverse variance weighted (IVW) estimation model, supplemented by various other estimation techniques. Results: DNAm aging acceleration or deceleration, as indicated by Hannum, IEAA, Gran, GrimAgeAccel, PhenoAgeAccel, and DNAmPAIadjAge, did not exhibit a statistically significant causal effect on menopausal age according to forward MR analysis. However, there was a suggestive positive causal association between age at menopause and Gran (Beta = 0.0010; 95% confidence interval (CI): 0.0004, 0.0020) in reverse MR analysis. Conclusion: The observed increase in granulocyte DNAm levels in relation to menopausal age could potentially serve as a valuable indicator for evaluating the physiological status at the onset of menopause. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Hormone replacement therapy (HRT) is a treatment for acute climacteric syndrome, with the best effectivity. It also prevents bone loss and fractures. Ischemic heart disease prevention and cognitive function improvement have been observed with HRT, only when started early (critical window hypothesis). There is a large scale of complementary and alternative medicines for women in preference to non-hormonal treatment. Unfortunately, they do not always accompany reliable documentation of efficacy and safety from well-performed studies. [ABSTRACT FROM AUTHOR]

A randomised open clinical/laboratory study was performed to evaluate the safety and cosmetic efficacy of facial cosmetics for females during the menopausal period. The cosmetics contain active ingredients of meristem cells derived from the medicinal plants Leontopodium alpinum, Buddeleja davidii, Centella asiatica, and Echinacea angustifolia. Recently, the major bioactive molecules of these medicinal plants (leontopodic acid, verbascoside, asiaticoside, and echinacoside, respectively) have been thoroughly evaluated in vitro for molecular pathways and cellular mechanisms and their preventive/curative effects on human skin cells exposed to factors promoting premature skin ageing and cellular senescence. Nevertheless, clinical data on their safety/efficacy to ageing human skin are scarce. This clinical study enrolled 104 Caucasian females in pre-menopause, menopause, or post-menopause periods. They applied cosmetic serums daily for 1 month. Questionnaires and instrumental and biochemical methods were used to assess dermatological/ophthalmological safety and cosmetic efficacy through changes of the skin physiology markers characteristic of ageing/menopause (elasticity, barrier functions, moisture, sebum, ultrasonic properties, and collagen content and structure). Quantitative microbiological tests were carried out for skin microbiota fluctuations. Data showed that the cosmetics were safe, and they shifted the skin physiology parameters to a younger biological age, enhanced collagen synthesis, inhibited lipid peroxidation, and favoured normal microbiota. [ABSTRACT FROM AUTHOR]

Gestrinone (R-2323), or ethylnorgestrienone, is a synthetic steroid of the 19-nortestosterone group more commonly used as an oral, intravaginal, or subcutaneous implant for the treatment of endometriosis, contraception, and estrogen-dependent conditions such as hypermenorrhea, premenstrual dysphoria, and intense menstrual cramps. This review aims to reevaluate the routes, doses, and applicability proposed for using gestrinone, including its use in new conditions such as menopause, lipedema, and sarcopenia. Here, we present the possible application of gestrinone as a long-acting therapeutic possibility through hormonal implants and the benefits and potential risks. Available evidence on the safety of doses and routes is limited. Gestrinone appears to be effective compared to other progestins and may have some advantages in the treatment of estrogen-dependent pathologies. Future research must evaluate gestrinone's long-term safety and potential therapeutic indications. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Menopausal depression, often associated with hormonal fluctuations such as decreased estrogen levels, imposes significant mental health burdens. Despite the antidepressant biological properties of standardized rice bran supplement (RBS), its impact on menopausal depression and underlying mechanisms remains largely unexplored. In this study, we investigated the antidepressant effects of RBS in a mouse model of estrogen deficiency–induced depression. Ovariectomized (OVX) mice received oral doses of RBS (250 and 1000 mg/kg) and 17β estradiol over a 20-week period. RBS administration resulted in decreased immobility time in the tail suspension and forced swim tests, along with increased locomotor activity in the open field test. Furthermore, RBS enhanced nitric oxide production and neuronal nitric oxide synthase (nNOS) expression in the hippocampi of OVX mice. Additionally, RBS administration phosphorylated extracellular signal-regulated kinase (ERK), cAMP response element-binding protein (CREB), and tropomyosin receptor kinase B and increased the protein expression of brain-derived neurotrophic factor (BDNF) in the hippocampus. These findings suggest that RBS alleviated depressive behaviors in OVX mice by augmenting hippocampal nNOS expression and activating the ERK-CREB-BDNF signaling pathway. Therefore, based on these results, we propose that RBS is a promising agent to treat menopausal depression, a challenging condition. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study is to examine the effect of menopausal symptoms on general health status in postmenopausal women. Material and Methods: Our study is a descriptive type of study. It was conducted on 223 women aged 45-65 who applied to a family health center between October and November 2019 and at least 12 months had passed since their last menstrual period. A personal information form developed by the researcher, Menopause Symptom Scale (MSDS) and General Health Questionnaire-28 (GHQ-28) were distributed to women who agreed to participate in the study. Descriptive statistics are used for individual information during statistical analysis of data. Chi-square test was used to evaluate the data obtained by counting. Results: The mean MSDS score for women was 22.72. In the General Health Survey, it was determined that the subsections most affected by menopausal symptoms experienced by women were somatic symptoms, anxiety, sleep disorders and depression, social functioning and depression. Highly significant positive relationships were found between the Menopause Symptoms Assessment Scale and its subscales experienced by women and GHQ-28. Conclusion: Menopause symptoms seen in postmenopausal women affect the general health of women. Women registered at the family health center need to plan menopause education and train regularly. [ABSTRACT FROM AUTHOR]

Vaginal mucosa undergoes physiological changes across the lifespan, such as increased pH and reduced natural lubrication which are known to impact vaginal commensal microorganisms, hence increasing the chances of vaginal infections. An improved understanding of vaginal microbiome composition in different age groups and the effect of social behaviors, such as the use of personal lubricants, could facilitate the development of new strategies to maintain good vaginal health. The objective of this study was to assess the effect of water-based lubricants on the human vaginal microbiome. Fifty females from three age groups (18–29, 30–44, and 45–65 years) with mild-to-moderate vaginal dryness were randomized to one of five lubricants (four of which were formulated to meet expert guidance on osmolality and pH). Subjects entered the study at tolerance or treatment phase (vaginal intercourse minimum once a week using assigned lubricant). Four vaginal swabs per participant were sampled during pre-("baseline"), post-first ("2 h", "24 h") and post-last ("4 weeks") lubricant application to assess bacterial and fungal diversity via amplicon sequencing. Vaginal pH and relative humidity were measured at baseline, 2 h, and 24 h post-lubricant application. Relative bacteriome abundance was statistically compared between timepoints for each lubricant group. Vaginal moisture, age, BMI, and pH were correlated with bacteriome relative abundance. Lactobacilli and Gardnerella sp. Were predominant across participants. Repeated lubricant application did not significantly alter the vaginal bacteriome during 4 weeks of product use (p > 0.05) when measured by relative abundance and alpha-diversity index. Bacteriome diversity and abundance differed significantly between age groups at baseline whereas lactobacilli relative abundance was negatively associated with age and vaginal pH. [ABSTRACT FROM AUTHOR]

Background: There is an increased prevalence of cardiovascular and metabolic diseases in postmenopausal women. Estrogen plays an important role in the regulation of blood pressure (BP) and autonomic function. Various hormone therapies are widely used in postmenopausal women, especially combination therapy of low-dose estrogen and progesterone. Hormone therapy might be useful not only in alleviating menopausal symptoms but help in reducing cardiovascular risk factors and improving quality of life. Aims and Objectives: The aim of the study is to study the effect of combined estrogen and progesterone hormone therapy on BP and sympathetic overactivity in postmenopausal women. Materials and Methods: The study included two groups of 50 women each. Group I included postmenopausal women of age 45-55 years who were taking combined hormone therapy while Group II included postmenopausal women of the same age group who were not on any replacement therapy Heart rate and BP in resting state was noted in both the groups. Sympathetic function assessment was done by performing cold pressor test, handgrip test, and BP response to standing on all the participants. Statistical analysis was done using the student's t-test. Results: There was a statistically significant difference in resting heart rate, BP, and sympathetic function tests in both groups. Conclusion: There is a facilitatory role of combined estrogen and progesterone therapy in menopausal women in reducing BP and sympathetic system dysregulation. [ABSTRACT FROM AUTHOR]

Background. The rise in global obesity has worsened the prevalence of metabolic syndrome and related cardiovascular complications, particularly among post-menopausal women. Dysfunctions in thyroid hormone activity, critical for metabolic regulation, are often implicated in obesity and its associated conditions. This study evaluated the interactions between thyroid function, body composition, and cardiovascular health in post-menopausal women. Material and Methods. We conducted an observational, prospective, open-label clinical study, involving post-menopausal women, stratified into two groups based on weight changes after menopause: the Menopausal Weight Gain Group (MWGG) and the Menopausal Weight Maintenance Group (MWMG). We included 12 cases (MWGG) and 8 control (MWMG) women. Participants underwent cardio-metabolic assessments, including evaluations of thyroid function, blood pressure, arterial stiffness, body composition, and cardiovascular risk profiles. The statistical analysis employed t-tests and Pearson correlations. Results. The MWGG showed significant increases in both the Augmentation Index (AI@75) and adiposity markers (BMI, total fat mass, in percentage and kg, and lean–to–fat mass ratio) compared to the MWMG. A notable decrease in FT3 and the FT3/FT4 ratio was observed in the MWGG. Moreover, discrepancies in Cholesterol levels and insulinemia were reported between groups. Moreover, differences in cholesterol levels and insulinemia were reported between groups. We analyzed the correlation between blood pressure, cardiovascular stiffness, and body composition parameters; notably, there was a strong correlation between AI@75 and weight, BMI, and total fat mass, and a strong negative correlation with the lean–to–fat mass ratio. Conclusions. The MWGG presented a higher BMI, greater total fat mass (kg) and a higher percentage of total fat mass compared to the MWMG. Interestingly, we reported a significant difference in intramuscular adipose tissue between the groups. These results highlight the importance of further research to elucidate the mechanisms involved and to develop targeted interventions for managing menopause-related cardio-metabolic risks. [ABSTRACT FROM AUTHOR]

Climacteric symptoms, as well as postmenopausal estrogen deficiency, have been associated with many psychological problems and the risk of osteoporosis and heart disease. Therefore, in this study, we aimed to evaluate, for the first time, the dose-dependent effect of water chestnut (WC), also known as Trapa bicornis, a fruit extract, on ovariectomy (OVX)-induced menopause in ICR mice. After bilateral OVX surgery, 200, 100, and 50 mg/kg of WC and 200 mg/kg of pomegranate concentrate powder (PCP) were administered orally for 84 days from 4 weeks after OVX operation. Then, anti-climacteric activities were evaluated in five groups: (1) estrogenic, (2) anti-obesity, (3) hypolipidemic, (4) hepatoprotective, and (5) anti-osteoporosis effects. Different biochemical assays, histopathological and morphological inspections, and mRNA expression findings showed that OVX-induced estrogen deficiency-related AMPK decrease was associated with climacteric symptoms such as obesity, hyperlipidemia, hepatic steatosis, and osteoporosis in ICR mice. However, these climacteric effects were reversed in OVX rats by treating them with WC at a dose relative to the same dose of PCP in OVX-ICR mice (200 and 100 mg/kg). Water chestnut fruit extract demonstrated promise as a complementary treatment for menopausal symptoms, indicating possible uses in the health of women through supplements or prescription drugs. [ABSTRACT FROM AUTHOR]

Rice bran, which is abundant in dietary fiber and phytochemicals, provides multiple health benefits. Nonetheless, its effects on neuroinflammation and gut microbiota in postmenopausal conditions are still not well understood. This study investigated the effects of rice bran and/or tea seed oil supplementation in d-galactose-injected ovariectomized (OVX) old mice fed a fructose drink. The combination of d-galactose injection, ovariectomy, and fructose drink administration creates a comprehensive model that simulates aging in females under multiple metabolic stressors, including oxidative stress, estrogen deficiency, and high-sugar diets, and allows the study of their combined impact on metabolic disorders and related diseases. Eight-week-old and 6–8-month-old female C57BL/6 mice were used. The mice were divided into six groups: a sham + young mice, a sham + old mice, an OVX + soybean oil, an OVX + soybean oil with rice bran, an OVX + tea seed oil (TO), and an OVX + TO with rice bran diet group. The OVX groups were subcutaneously injected with d-galactose (100 mg/kg/day) and received a 15% (v/v) fructose drink. The rice bran and tea seed oil supplementation formed 10% of the diet (w/w). The results showed that the rice bran with TO diet increased the number of short-chain fatty acid (SCFA)-producing Clostridia and reduced the number of endotoxin-producing Tannerellaceae, which mitigated imbalances in the gut–liver–brain axis. Rice bran supplementation reduced the relative weight of the liver, levels of hepatic triglycerides and total cholesterol; aspartate transaminase and alanine aminotransferase activity; brain levels of proinflammatory cytokines, including interleukin-1β and tumor necrosis factor-α; and plasma 8-hydroxy-2-deoxyguanosine. This study concludes that rice bran inhibits hepatic fat accumulation, which mitigates peripheral metaflammation and oxidative damage and reduces neuroinflammation in the brain. [ABSTRACT FROM AUTHOR]

In this study, we aimed to compare metabolic risk factors, lipid indices, healthy eating index, and physical activity among premenopausal, menopausal, and postmenopausal women. In this cross-sectional study, a total of 4,732 women participating in the Hoveyzeh Cohort Study were placed into three groups of premenopausal (n=736), menopausal (n=396), and postmenopausal (n=917) women, according to the inclusion and exclusion criteria. The prevalence of metabolic syndrome was 43.3%, 55.6%, and 62.8% in premenopausal, menopausal, and postmenopausal women, respectively. After menopause, the prevalence of hypertension (50.2%), dyslipidemia (61.2%), diabetes (37.7%), and abdominal obesity according to the Iranian guidelines (75.9%) was higher than before menopause. Based on the results, cardiovascular disease had the highest prevalence after menopause (23%). The weight-adjusted waist index (WWI) had the highest odds ratio (OR) among indices, with values of 2.94 and 1.93 in menopausal and postmenopausal women, respectively (P<0.001). According to the Healthy Eating Index-2015 (HEI-2015), the total consumption of fruits, vegetables, seafood, and protein was higher in premenopausal women than in postmenopausal women, and the consumption of foods containing sugar was higher in menopausal women than in premenopausal women. The results showed that the level of physical activity was the highest and the lowest in premenopausal and postmenopausal women, respectively (P<0.001). Menopause leads to an increase in the prevalence of metabolic syndrome. The Atherogenic Index of Plasma (AIP), Triglyceride Glucose (TyG) index, WWI, and physical activity index increased in postmenopausal women compared to premenopausal women. The TyG index, WWI, and HEI-2015 did not show significant differences between the groups, based on the multiple regression analysis. [ABSTRACT FROM AUTHOR]

Introduction. Globally, yoga has gained popularity as a health-promoting and disease-prevention discipline. The common health conditions prompting yoga use include musculoskeletal disorders, mental health conditions, asthma, fibromyalgia, arthritis, diabetes, and cancers. Although the therapeutic benefits of using yoga are well documented, little is known about the characteristics of yoga instructors (YIs) and yoga users (YUs) in New Zealand (NZ). Aim. This paper seeks to profile the characteristics of NZ YIs and YUs and explore reasons for yoga use. Methods. Online surveys for YIs and YUs were conducted to collect the sociodemographic characteristics of 84 YIs and 267 YUs. Descriptive statistics were used to determine trends. Results. The surveys were conducted between September 2020 and February 2021. The YIs were predominantly female (87.1%) with mean ± s.d. years of practice of 9.8 ± 0.8 (95% CI: 8.2, 11.4). YUs were most commonly female (86%), of NZ European descent (63%), aged 45–64 years (56%), not married (52.5%), and with a university or higher education qualification (61.5%). They use yoga to alleviate chronic health conditions like back pain (18%), menopausal symptoms (14.5%), anxiety (13.5%) and depression (11.5%). Discussion. Most YIs in NZ are females facilitating moderatesized yoga classes. YUs in NZ are disproportionately NZ European, female, middle-aged and tertiary educated. They use yoga to help manage long-term conditions, including mental ill-health and musculoskeletal disorders. The study findings could inform health professionals regarding the utilisation of yoga in NZ. Further research is required to gain insights into yoga use. [ABSTRACT FROM AUTHOR]

Background and Objectives: Proteomics encompasses the exploration of protein composition, regulation, function, and pathways. Its influence spans diverse clinical fields and holds promise in addressing various women's health conditions, including cancers, osteoporosis, and cardiovascular disorders. However, no comprehensive summary of proteomics and menopausal health exists. Our objective was to summarize proteomic profiles associated with diseases and disorders in peri- and postmenopausal women. Materials and Methods: We conducted a comprehensive search of databases including PubMed, Google Scholar, the Cochrane database, Elsevier, and ScienceDirect until 2022. A total of 253 studies were identified, and 41 studies met the inclusion criteria to identify data of interest. These included the study design, disease, and proteomics/proteins of significance, as described by the authors. Results: The 41 studies covered diverse areas, including bone disorders (10 studies), cardiovascular diseases (5 studies), oncological malignancies (10 studies), and various conditions, such as obesity, nonalcoholic liver disease, the effects of hormone replacement therapy, and neurological diseases (16 studies). The results of our study indicate that proteomic profiles correlate with heart disease in peri- and postmenopausal women, with distinct sex differences. Furthermore, proteomic profiles significantly differ between women with and without osteoporosis. Additionally, patients with breast, ovarian, and endometrial cancer exhibit notable variations in proteomic profiles compared to those without these conditions. Conclusions: Proteomics has the potential to enhance risk assessment and disease monitoring in peri- and postmenopausal women. By analyzing unique protein profiles, clinicians can identify individuals with heightened susceptibility to specific diseases or those already affected by established conditions. This review suggests that there is sufficient preliminary data related to proteomics in peri- and postmenopausal women for early identification of cardiovascular disease, osteoporosis, and cancers, disease monitoring, and tailoring individualized therapies. Rigorous validation studies involving large populations are essential before drawing definitive conclusions regarding the clinical applicability of proteomic findings. [ABSTRACT FROM AUTHOR]

Objective: The effects of hormonal therapy, estrogen-based hormone replacement therapy (HRT), and anti-tumor hormone therapy, such as tamoxifen, on the physiological uptake of the endometrium on 2-deoxy-2[18F]fluoro-d-glucose ([18F]F-FDG) positron emission tomography (PET) in postmenopausal women have not been determined. We explored the effect of hormone therapy, particularly HRT, on physiological uptake in the endometrium of postmenopausal women. Materials and methods: Postmenopausal women receiving hormone therapy who underwent cancer screening using PET/computed tomography (CT) between June 2016 and April 2023 were included in the hormone therapy group (n = 21). Postmenopausal women with no history of hormone therapy were included in the control group (n = 49). First, the physiological endometrial uptake at menopausal age and at least 1 year thereafter was compared quantitatively (SUVmax) and qualitatively (4-point scale) in the control group, to assess when the endometrium ceased to show significant physiological [18F]F-FDG uptake after menopause. Endometrial uptake was compared between the hormone therapy and control groups. The association between HRT duration (months) and endometrial uptake (SUVmax) was evaluated. Endometrial thickness, measured using transvaginal ultrasonography, was also compared between the two groups. Results: Endometrial uptake was significantly reduced both qualitatively and quantitatively (P < 0.05) at least 1 year after menopause in control patients, by which time most women (89.8%) no longer had significant endometrial uptake. The hormone therapy group (n = 21) showed higher FDG uptake in the endometrium compared to the control group (median SUVmax: 2.3 vs 1.9, P = 0.0011), as well as a higher visual score (P < 0.0001). HRT duration did not correlate with endometrial uptake (P = 0.097). Endometrial thickness in the hormone therapy group was significantly thicker than in the control group (median: 3.9 mm vs 1.8 mm, P = 0.002). Conclusion: Hormone therapy may affect physiological uptake in the endometrium in postmenopausal women. [ABSTRACT FROM AUTHOR]