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Menopause leads to decreased estradiol levels affecting tissue health and causing local inflammation in the genital organs and urinary tract. The rise of blood C-reactive protein (CRP) levels in menopausal women may indicate systemic inflammation associated with estradiol decline. The aim of this study was to determine the relationship between serum estradiol and CRP levels on genitourinary syndrome in menopausal women. A cross-sectional study was conducted among menopausal women who had not experienced menstruation for at least 12 consecutive months at Prof. dr. Chairuddin P. Lubis Hospital, Medan, Indonesia, in 2023. Estradiol and CRP levels were measured using enzyme-linked immunosorbent assay (ELISA) and the presence of genitourinary syndrome was assessed using the Menopause-Specific Quality of Life (MENQOL) questionnaire. The mean levels of estradiol and CRP were compared to menopausal women with and without genitourinary syndrome with the Mann-Whitney test. To assess the correlation between estradiol and CRP levels, and between their levels with the presence of genitourinary symptoms, the Spearman correlation test was used. The genitourinary syndrome was reported in 25% of the total included menopausal women. Our data indicated that the mean estradiol levels were not significantly different between menopausal women with and without genitourinary syndrome (9.13±2.47 pg/mL vs 18.96±31.23 pg/mL, p =0.881). The mean serum CRP level of menopausal women with genitourinary syndrome (9.72±6.30 mg/L) was higher than that of women without the syndrome (2.09±1.26 mg/L) with p <0.001. In addition, serum CRP level, not estradiol, was correlated with the symptom score of genitourinary syndrome. This study highlights that to identify and manage genitourinary syndrome, monitoring of CRP levels is essential in menopausal women., Competing Interests: The authors declare that there is no conflict of interest., (© 2024 The Author(s).)

Postmenopausal women often experience hormonal changes and shifts in fat composition, affecting weight gain and obesity. Understanding the link between hormones, especially estrogen and leptin, is key to managing weight and lowering disease risk in menopausal women. The aim of this study was to compare the levels of leptin and estrone in menopausal women with normal weight and obesity. A cross-sectional study was conducted on menopausal women, either normal body mass index (BMI) or obese, at H. Adam Malik General Hospital, Medan, Indonesia. Blood samples were collected to measure leptin and estrone levels using the enzyme-linked immunosorbent assay (ELISA) method. The differences in leptin levels between groups were analyzed using the Wilcoxon test, while the correlation between BMI and leptin was examined using the Pearson correlation test. The disparity in estrone levels in both groups was analyzed using the Mann-Whitney test and the correlations between variables were assessed using the Spearman or Pearson correlation tests as appropriate. The mean leptin levels in normal BMI and obesity groups were 17.73±4.96 and 25.46±12.95 ng/mL, respectively, and were statistically different ( p =0.006). The mean estrone levels in menopausal women with normal BMI and obesity were 943.23±391.79 and 851.38±282.23 ng/mol, respectively and were not statistically different ( p =0.564). A significant positive correlation was found between BMI and leptin level ( r =0.59; p <0.001), while BMI and estrone were not significantly correlated ( r =0.083; p =0.559). In conclusion, leptin level was significantly different between BMI groups and had a strong positive correlation with BMI. This finding could be an important insight in body weight management and disease risk prevention in menopausal women., Competing Interests: All authors affirm that they have no conflicts of interest., (© 2024 The Author(s).)

Musculoskeletal pain is one of the common symptoms of menopause syndrome throughout the world. Estradiol is the most potent and abundant derivative of estrogen and is associated with musculoskeletal pain, stiffness, and depressed mood during the menopausal transition. C-telopeptide is a molecule released during osteoclastic bone resorption and degradation of type I collagen, which is reported to have higher levels in individuals with musculoskeletal pain. An observational analytical study with a cross-sectional design was used in this research. Estradiol and C-telopeptide levels were measured in this study using enzyme-linked immunosorbent assay (ELISA). Musculoskeletal pain was assessed using the Nordic Musculoskeletal Questionnaire (NMQ) and the Menopause Quality of Life Questionnaire (MENQOL). Musculoskeletal pain was determined if the participant answered "yes" on questions number 12, 14 and 25 on the MENQOL. Data analysis was performed using the independent Student t-test for normally distributed data and the Mann-Whitney test for non-normally distributed data. A correlation test was performed using the Pearson correlation test for normally distributed data and the Spearman correlation test for non-normally distributed data. The results showed a non-significant relationship between estradiol and C-telopeptide levels with musculoskeletal pain assessed using the NMQ or MENQOL questionnaires. The correlation test also showed no correlation between estradiol and C-telopeptide levels in women with and without musculoskeletal pain., Competing Interests: All the authors declare that there are no conflicts of interest., (© 2024 The Author(s).)

Osteoporosis is a common condition associated with an increased risk of bone fractures due to fragility. Bone mineral density (BMD) is lower in menopausal women due to estrogen deficiency, age-related decline in osteoblast function, decreased calcium absorption, and reduced synthesis of vitamin D, which lead to osteoporosis. The aim of this study was to determine the correlation between serum vitamin D levels and BMD assessed using radiofrequency echographic multi-spectrometry technology (REMS) in menopausal women. A cross-sectional study was conducted at Prof. Dr. Chairuddin P. Lubis Hospital of Universitas Sumatera Utara, Medan, Indonesia, from May 2023 to August 2023. Consecutive sampling method was employed to sample menopausal women with no history of hysterectomy or oophorectomy (unilateral or bilateral), and no history of hormone replacement therapy or vitamin D supplementation. Interviews and physical examinations were conducted to obtain the characteristics of the subjects (age, duration of menopause, and body mass index). The 25(OH)D level was measured using immunoassay and REMS examination was conducted to assess BMD. The Spearman correlation test was used to assess the correlation between serum vitamin D levels and BMD. A total of 32 menopausal women were included in this study with the average vitamin D level was 18.05±5.81 ng/mL, and the mean BMD level was -2.13±1.23. The data showed a significant positive correlation between serum vitamin D levels and BMD in menopausal women ( r =0.710; p =0.020). This study highlights that REMS could be useful as an alternative to dual-energy x-ray absorptiometry (DXA) to assess DMD in postmenopausal women., Competing Interests: The authors declare that there is no conflict of interest., (© 2024 by the authors.)

Aim Vulvovaginal candidiasis (VVC) is a disease mostly caused by Candida albicans and affects the quality of life of women especially in the form of chronic recurrent vulvovaginal candidiasis(RVVC). Nigella sativa is known to have several effects such as antimicrobial, anti-inflammatory, immune stimulation and anticancer properties. The aim of this study was to evaluate the effect of Nigella sativa on vulvovaginal candidiasis. Methods This study is a true experimental design, we used 28 Wistar strain rats divided into 4 groups, all groups were conditioned in a pseudoestrus state. Candida albicans was inoculated into the rats' vagina for 3 consecutive days. All groups were observed every 24 hours, 48 hours and 72 hours to evaluate the number of Candida albicans colonies, IgG and IgM anti Candida. Results After administration of intervention, there was a significant difference in the amount of fungal colonization after the treatment in each group (p<0.001). There was no significant difference in the effectiveness of Nigella sativa and fluconazole in supressing Candida albicans colonies after 72 hours (p=0.101). The administration of Nigella sativa showed a significant difference in the increase in IgM levels compared to the others group (p<0.001), while the IgG level did not show a significant difference (p=0.423). Conclusion Nigella sativa provides a therapeutic effect by decreasing the number of fungal colonies and increasing IgM levels., (Copyright© by the Medical Assotiation of Zenica-Doboj Canton.)