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Background: Compared to older adults with breast cancer (BC), adolescents and young adults (AYAs) develop more aggressive disease necessitating more intensive therapy with curative intent, which is disruptive to planned life trajectories. The burden of unmet needs among AYA BC survivors exists in two domains: (1) symptoms (e.g., sexual problems, anxiety, fatigue, stress, hot flashes) and (2) AYA concerns (e.g., fertility, genetics, relationships, economic attainment). Improved attention to concerns and symptoms may improve symptom management and quality of life. The Young, Empowered and Strong (YES) trial tests the efficacy of a 9-month, multicomponent digital health intervention that includes monthly assessments of prevalent symptoms, a chat room, and journal to engage and support AYAs with BC by providing tailored information, resources, and support outside of the clinical setting. Methods: YES is a multicenter, randomized controlled trial across three academic institutions in the United States with 400 participants randomized to either the YES intervention or usual care arm. Inclusion criteria include biologically female; 15–39 years of age at diagnosis of stage 0-III BC; within 3 years of diagnosis; no known evidence of recurrence; no prior history of new malignancy since initial BC diagnosis; and ability to access medical records from treatment site. All participants complete REDCap surveys at baseline, and at 3, 6, and 9 months post-enrollment. The primary outcome is quality of life as measured by the Quality of Life in Adult Cancer Survivors Scale (QLACS), with changes from baseline to 6-months in QLACS scores, compared by arm. Secondary outcomes include patient reported AYA concerns/needs, emotional symptoms, general health, physical symptoms, and health behaviors, Discussion: Study findings will provide valuable insight into the ability of the YES digital health intervention to address symptoms and concerns of AYA BC survivors and assist them to track and self-manage their own symptoms, concerns, and needs related to their cancer outside of the clinic. Trial registration: Clinicaltrials.gov, NCT04906200, registered May 13, 2021. [ABSTRACT FROM AUTHOR]

The article explores the characteristics of prostate cancer patients seeking integrative medicine at an academic cancer center. The study found that patients sought integrative oncology services primarily for guidance on diet and nutrition, counseling on herbs and supplements, and specific integrative therapies like acupuncture. Common symptoms reported included fatigue, hot flashes, and trouble sleeping. The study highlights the need for further research to address the needs of this patient population and improve coordination of integrative services with traditional cancer care. [Extracted from the article]

Objective: This research was conducted to assess the therapeutic advantage of combined letrozole and clomiphene citrate versus monotherapy for polycystic ovarian syndrome (PCOS) patients. Study Design: Five databases were searched using the search string: (letrozole and clomiphene) AND (clomiphene OR clomiphene citrate OR CC) AND (letrozole OR LE) AND (ovulation induc* OR fertility induc* OR fertility preserv*) AND (polycystic ovarian syndrome OR PCOS). All statistical analyses were conducted in Review Manager 5.4.1. Random effect-effect model was used to pool risk ratio (RR), mean difference (MD), and odds ratio (OR) and their corresponding 95% confidence interval (CI). Moreover, qualitative analysis was conducted to qualitatively analyze ovulation, secondary outcomes, and cycle characteristics. Results: One clinical trial and three randomized clinical trials (RCTs) were used in the study. Two studies were used in a quantitative analysis showing that combination was superior for ovulation induction (RR = 1.86 [1.37, 2.53]; p < 0.0001; I2 = 0%), but the number of follicles ≥15 mm was significantly associated with the combination (MD = 0.40[0.14, 0.66]; p = 0.002; I2 = 0%). On subgroup analysis, only hot flushes were significantly associated with the combination (RR = 2.67[1.12, 6.36]; p = 0.03; I2 = 0%). The meta-analysis of two studies reported a significantly higher ovulation rate and number of dominant follicles in the combination therapy group compared with the LE alone arm but no significant difference in pregnancy rate, endometrial thickness, and adverse events. Conclusion: Our study demonstrates a significant effect of the combination on ovulation induction. The combination yielded a better chance of conception and viable pregnancy. Further studies are needed to determine the live birth rate. Highlights: Combined Letrozole and Clomiphene is superior to either of these drugs alone for ovulation induction in PCOS. Our results conclude that the combination results in better ovulation, cycle characteristics, and secondary changes. Only the incidence of hot flushes as an adverse effect is increasingly reported in combination. [ABSTRACT FROM AUTHOR]

Objective: evaluate the efficacy and tolerability of PureCyTonin against hot flashes (HF) in breast cancer survivors (BCS). Methods: a prospective, multicenter, randomized, double-blind placebo-controlled trial was conducted in Italy. Interventions: administration of PureCyTonin or placebo, for 3 months. Effectiveness was investigated through the compilation of a daily diary for HF and of validated questionnaires (Menopause Rating Scale (MRS), Pittsburgh Sleep Quality Index (PSQI), Visual Analogical Scales (VAS) for HF, sweating, irritability, fatigue, sleep, quality of life), carried out before starting the treatment (T0), after 1 month (T1) and after 3 months (T2). Any side effects and HF diary were recorded at each visit. Results: 19 women were randomized to receive PureCyTonin and 20 to placebo. At T2 compared to T0, in the PureCyTonin group, we found a reduction in the number of HF (p = 0.02) measured by daily diary. An improvement in the subjective perception of women regarding HF intensity (p = 0.04), sweat nuisance (p = 0.02), irritability (p = 0.03) and fatigue (p = 0.04) was observed through VAS scale measurement at T2 compared to T0.The total MRS score was significantly better in the PureCyTonin group at T1 (p = 0.03) compared to T0. Conclusions: PureCyTonin significantly reduces HF number after 3 months of therapy in BCS and it is well-tolerated. [ABSTRACT FROM AUTHOR]

• We expanded on the number of patients and research. • We discovered an improvement in fibroid size with mifepristone treatment. • The benefits of using mifepristone prior to surgery are examined. • To investigate the improvement of fertility in patients with fibroids by mifepristone. To systematically assess the safety and effectiveness of mifepristone at doses of 2.5 mg, 5 mg, 10 mg, 25 mg, and 50 mg in the treatment of uterine fibroids. The protocol is registered with INPLASY (registration number is INPLASY202460075). Computer retrieval PubMed, the Cochrane Library, Embase database related (mifepristone group) compared to placebo and mifepristone or conventional treatment (control group) in the treatment of uterine fibroids randomized controlled trial (RCT), retrieve the time limit for a Library to in October 2023, Refer to the Cochrane faced the quality evaluation of the literature of included in the 6.0 and uses the RevMan 5.4.1 software Meta-analysis and sensitivity analysis. There were 18 studies with a total of 2066 patients as participants. A meta -analysis found that the patients in the mifepristone group had lower uterine volume or uterine fibroid volume than the control group, with a statistically significant difference. Mifepristone treatment for 3 months uterine volume smaller is better than 6 months the difference is statistically significant. Compared with the control group, mifepristone can improve pelvic pain, pelvic pressure, bladder pressure, urinary symptoms, lower back pain, dyspareunia, rectal pain, menorrhagia, hypermenorrhea, and other clinical symptoms. The Mifepristone group had hot flashes, endometrium thickness increases, the incidence of hepatic transaminases associated is significantly higher than the control group, the patients in the 10 mg/d mifepristone group had endometrial thickness that was greater than those in the 5 mg/d mifepristone group. Mifepristone reduces fibroid volume and improves clinical symptoms, and 5 mg/day of mifepristone for three months may be the optimal clinical regimen. [ABSTRACT FROM AUTHOR]

Women going through menopause frequently experience vasomotor symptoms such as hot flashes, night sweats, and sleep disturbances, significantly influencing their quality of life. Hormonal therapy has been demonstrated to be beneficial in treating VMS. However, due to specific restrictions, it is not recommended for every woman. Fezolinetant, a neurokinin 3 antagonist and non-hormonal treatment for severe to moderate VMS, functions by inhibiting neuronal impulses originating from the hypothalamic thermoregulatory center. Current Skylight 2 and 4 trials statistically demonstrate the safety and acceptability of fezolinetant, with relatively few adverse effects reported. Fezolinetant has been shown great potential for treating menopausal-related VMS, supporting its further advancement. However, further investigation is required to thoroughly evaluate its safety, effectiveness, and its impact on sleep patterns. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship of dyslipidemia and menopausal symptoms in Chinese menopausal women. Material and methods: A total of 989 eligible participants with menopausal syndrome were recruited from outpatient clinics in several cities in China. Menopausal symptoms were assessed using the Chinese Menopause Rating Scale (CMRS), the Self-rating Depression Scale (SDS), and the Self-rating Anxiety Scale (SAS). Serum lipid profile was measured using enzyme colorimetry. The relationship between lipid profile and menopausal symptoms was assessed using Student's t test/nonparametric Mann–Whitney U test, Spearman's correlation test, and binary logistic regression analysis. Results: Among the 989 patients, 527 had dyslipidemia while 462 did not. Patients with dyslipidemia had significantly higher Self-rating Anxiety Scale (SAS) scores than those without (p < 0.001), while there was no significant difference in Self-rating Depression Scale (SDS) scores. Patients without dyslipidemia had higher scores on the Chinese Menopause Rating Scale (CMRS) vascular dimension compared to those with dyslipidemia (p = 0.003). The correlation test revealed that variables associated with dyslipidemia included age (p = 0.031), CMRS hot flashes dimension score (P = 0.003), and SAS score (p < 0.001). Regression analysis demonstrated that BMI (OR: 1.08, 95% CI: 1.01–1.16, p = 0.027), SAS scores (OR = 1.10, 95% CI = 1.07–1.13), vasomotor dimension (OR = 0.89, 95% CI = 0.83–0.95), physical dimension (OR = 0.96, 95% CI = 0.93–1.00), and social dimension (OR = 0.84, 95% CI = 0.74–0.95) were independently associated with an increased risk of dyslipidemia. Conclusions: This study showed that anxiety was associated with an unfavorable lipid profile, and menopausal depression seemed to have no relationship with lipid profile, while vasomotor symptoms appeared to be a favorable factor for dyslipidemia in Chinese menopausal women. [ABSTRACT FROM AUTHOR]

Background: A low-fat vegan diet, supplemented with soybeans, has been shown effective in reducing postmenopausal hot flashes. This secondary analysis assessed the association of a plant-based index (PDI), healthful (hPDI), and unhealthful (uPDI), with changes in hot flashes in postmenopausal women. Methods: Participants (n = 84) were randomly assigned to a low-fat vegan diet supplemented with soybeans (n = 42) or a control group (n = 42) for 12 weeks. Three-day dietary records were analyzed and PDI indices were calculated. A repeated measures analysis of variance (ANOVA) was used for statistical analysis. Results: All three scores increased in the vegan group, compared with no change in the control group; the effect sizes were: PDI + 9.8 (95% CI + 5.8 to + 13.8; p < 0.001); hPDI + 10.9 (95% CI + 6.4 to + 15.3; p < 0.001); and uPDI + 3.6 (95% CI + 0.5 to + 6.6; p = 0.02). The change in all three scores negatively correlated with change in body weight (PDI: r=-0.48; p < 0.001; hPDI: r=-0.38; p = 0.002; and uPDI: r=-0.31; p = 0.01). The changes in PDI and uPDI were negatively associated with changes in severe hot flashes (r=-0.34; p = 0.009; and r=-0.43; p < 0.001, respectively), and associations remained significant after adjustment for changes in body mass index (r=-0.31; p = 0.02; and r=-0.41; p = 0.001, respectively). Conclusions: These findings suggest that minimizing the consumption of animal products and oil may be an effective strategy to reduce hot flashes in postmenopausal women, and that categorization of plant foods as "healthful" or "unhealthful" may be unwarranted. Trial registration: ClinicalTrials.gov, NCT04587154, registered on Oct 14, 2020. [ABSTRACT FROM AUTHOR]

Background: Menopause can be seen as a complex phenomenon influenced by an individual's cultural norms, belief systems, and lifestyle choices. In conservative societies such as Saudi Arabia, some women silently struggle with menopause due to cultural taboos and social stigma, making their experiences invisible and lowering their quality of life. The aim of this study was to explore in-depth the knowledge, attitudes, and experiences of middle-aged Saudi women with menopause. Methods: The study employed qualitative methods using semi-structured interviews with middle-aged women undergoing menopause in Saudi Arabia from February to May 2023. The interviews were conducted online in Arabic, recorded and transcribed verbatim. The data were analysed inductively using thematic analysis. Results: A total of twenty-nine women, aged 40–64 years, were interviewed. Three key themes were identified: mixed emotions towards menopause; experiencing biopsychosocial changes; and adapting to the transition. Overall, most participants had mixed perspectives on menopause. Negative aspects included feelings of uncertainty and the loss of fertility while positive aspects included a sense of relief from menstruation and the newfound freedom to engage in religious activities at any time. Notably, during the interviews, many participants reconsidered their initial negative views and voiced predominantly positive perspectives. Several women reported inconvenient menopausal symptoms, such as hot flashes, night sweats, disturbed sleep, and fatigue. Concerns about being perceived as less attractive led many to keep their symptoms private, and societal expectations played a significant role in influencing how women managed these symptoms and sought help. Many women opted to seek information discreetly online rather than seeking support from others. Self-care practices were favoured for managing menopause, with medical care being undervalued or at times deemed unsatisfactory. Conclusion: In Saudi Arabia, menopause is generally seen as a natural phase of life. Many women appreciate the positive aspects it brings, such as relief from menstrual pain and an enhanced ability to participate in religious practices. However, they also encounter challenges, including hot flashes and concerns about perceived decreases in attractiveness. A notable trend is the preference for self-care strategies over medical interventions or hormone replacement therapy (HRT). There is a need to raise awareness about menopausal symptoms to reduce negative perceptions and experiences and to develop health promotion and educational interventions to support and empower women during this transition. Future research with healthcare professionals would extend these findings. [ABSTRACT FROM AUTHOR]

Object: Perimenopause depression disorder (PDD) is a very common problem in clinical practice and is characterized by depression and autonomic nervous symptoms, including hot flashes, palpitation, and night sweating. In addition, the comorbidity of menopause depression has long been an integral component of the estradiol (E2) shortage. Previous studies have suggested that the mechanisms underlying this comorbidity involved overlap of endocrine and cerebellar networks. Emerging evidence has shown that the endocrine–brain–gut–microbiota axis plays a key role in the regulation of affective disorders. Yangyin-ningshen formula (YYNS) is a traditional Chinese decoction tailored by Yijintang for menopausal depression intervention. Thus, we hypothesized that the YYNS may be involved in the menopause depression alleviation through the endocrine–brain–gut–microbiota axis. Methods: To verify this, we constructed a bilateral ovariectomy (OVX) mouse model to simulate menopausal-related depression. Subsequently, behavioral tests including the open field test (OFT) and the forced swimming test (FST) were conducted to examine the depression state post-OVX. With YYNS or E2 intervention, enzyme-linked immunosorbent assay (ELISA) was used to determine the serum sex hormones level. 16S rRNA gene sequencing and liquid chromatography-mass spectrometry (LC-MS) were used to analyze the microbiome of the colon samples collected from mice in the sham surgery group (CSH), the OVX model group (CMD), the OVX with E2 hormone intervention group (CHM), and the OVX with YYNS intervention group (CYYNS). One week after OVX, CMD, CHM, and CYYNS showed depression in OFT, FST. Three weeks post-OVX, CHM and CYYNS showed a notable relief of depression; CMD shaped the OTUs shrinkage; and OTUs were raised in the sham, CHM, and CYYNS group. The CMD group showed that the abundance of Actinobiota decreased but that of Bacteriodia increased. The relative abundance of the genus varied in each group. Moreover, functional correlation of changes in sex hormone and gut microbes between different groups showed that the PRL level was negatively correlated with Odoribacter. T level was positively correlated with Lachnospiraceae NK4A136 group and Odoribacter abundance (p < 0.05). Conclusion: Our results not only offer novel insights into the sex hormones and depression with OVX mice but also build an important basis for E2 or YYNS therapeutic efficacy on PDD, which provide for future research on this etiology through the endocrine–brain–gut–microbiota network. [ABSTRACT FROM AUTHOR]

Menopausal syndrome, occurring during the menopausal stage in women, manifests as symptoms stemming from decreased estrogen levels, such as hot flashes, insomnia, mental disorders (anxiety, depression), and osteoporosis. The bulk of studies have indicated alterations in the gut microbiota of those experiencing menopause syndrome compared to healthy women. However, This article focuses on the alterations in gut microbiota in perimenopausal women. Our study utilized 16 s rRNA sequencing to determine the differences in the gut microbiota and metabolites among 44 menopausal syndrome women. The distribution of gut microbiota in postmenopausal women varies based on the level of follicle stimulating hormone, with changes in gut microbiota abundance taking precedence over symptom onset. Fecal metabolites reveal changes in several metabolites, including Amino acid metabolism (Tyrosine, Tryptophan), Lipid metabolism (Alpha linolenic acid metabolism), and other metabolites. Disturbances in lipid metabolism, triggered by hormonal level fluctuations, can contribute to the development of osteoporosis. [ABSTRACT FROM AUTHOR]

Secondary adrenal insufficiency is a life-threatening condition that may arise in the setting of iatrogenic Cushing syndrome. Intra-articular corticosteroid injections (IACs) are a standard treatment for osteoarthritis, and they carry a high risk of secondary central adrenal suppression (SAI). We present the case of a 43-year-old woman who was referred to reproductive endocrinology for evaluation of abnormal uterine bleeding with a provisional diagnosis of perimenopause. She reported new-onset type 2 diabetes mellitus, abdominal striae, hot flashes, and irregular menses. Laboratory evaluation revealed iatrogenic Cushing syndrome and SAI attributable to prolonged use of therapeutic IACs for osteoarthritis. Treatment included hydrocortisone replacement and discontinuation of IACs followed by hydrocortisone taper over the following 16 months that resulted in the return of endogenous ovarian and adrenal function. This case demonstrates the many hazards of prolonged IAC use, including suppression of ovarian and adrenal function and iatrogenic SAI. [ABSTRACT FROM AUTHOR]