This review examines the mechanisms of anxiety and depression in menopausal syndrome from an integrated physiological to psychological perspective.Fluctuations in estrogen and progesterone levels during menopause affe...This review examines the mechanisms of anxiety and depression in menopausal syndrome from an integrated physiological to psychological perspective.Fluctuations in estrogen and progesterone levels during menopause affect neurotransmitter systems(including serotonin,norepinephrine,and dopamine),hypothalamic-pituitary-adrenal axis function,inflammatory processes,and neurotrophic factor expression,collectively diminishing the resilience of emotional regulation neural circuits.Simultaneously,vasomotor symptoms(such as hot flashes and night sweats),sleep disruption,genetic susceptibility,and epigenetic modifications interact with mood disorders,while psychosocial factors(such as midlife stressors and role transitions)and cognitive factors(including negative schemas about aging,attentional bias toward threats,and difficulties in emotional regulation)further shape women’s experiences of menopausal changes.Clinical practice should adopt a biopsychosocial model,employing personalized multimodal approaches through hormone therapy,antidepressants,psychotherapy,and lifestyle adjustments,while future research should focus on developing biomarkers,utilizing advanced technologies,and developing targeted interventions to support women’s psychological wellbeing during menopause.展开更多
The age at which a woman enters natural menopause has also been associated to death from any cause.Menopause is a natural component of aging that happens between the ages of 45 and 55,with the average menopausal age b...The age at which a woman enters natural menopause has also been associated to death from any cause.Menopause is a natural component of aging that happens between the ages of 45 and 55,with the average menopausal age being 51.Previous research has revealed the age at which women reach menopause,but there is no evidence to support the link between menopause and longevity.We made a study in assessing the limits of maximum lifespan at menopausal age in our previous article.In this paper,we aim to predict the maximum lifespan of women at mean menopausal age.展开更多
The concept of metabolically healthy obesity(MHO)has attracted growing attention,but its clinical relevance and association with future cardiovascular risk remain unclear.Estrogen deficiency,which signifies the menopa...The concept of metabolically healthy obesity(MHO)has attracted growing attention,but its clinical relevance and association with future cardiovascular risk remain unclear.Estrogen deficiency,which signifies the menopause phase,contributes to altered body composition and unfavorable metabolic processes.In this Editorial,we comment on the recent retrospective study by Pingili et al,which used a United States national in-patient population and observed significantly elevated odds of major adverse cardiac and cerebrovascular events in postmeno-pausal women with MHO compared with their age-matched non-obese counter-parts.Of note,disproportionately greater risks were particularly observed among Black patients.These findings along with previous literature data call into ques-tion the seemingly benign profile of the MHO state.Obese individuals who appear metabolically healthy present an elevated cardiovascular risk which may be exacerbated in older female populations.These findings emphasize the need for vigilance and improved approaches of risk stratification which would trans-late into the early application of preventive measures.展开更多
BACKGROUND Postmenopausal women with osteoporosis are at high risk of developing depre-ssive symptoms,necessitating specialized psychological nursing interventions.AIM To investigate factors influencing depressive sym...BACKGROUND Postmenopausal women with osteoporosis are at high risk of developing depre-ssive symptoms,necessitating specialized psychological nursing interventions.AIM To investigate factors influencing depressive symptoms in postmenopausal women with osteoporosis and develop targeted psychological nursing interven-tions.METHODS A total of 180 postmenopausal women with osteoporosis admitted to the Depar-tment of Orthopedics at the First Affiliated Hospital of Soochow University between October 2021 and October 2024 were selected as research participants.Information on age,duration of menopause,body mass index,education level,marital status,activity intensity,bone density,presence of chronic diseases,calcium supplement intake,sex hormone levels,and depressive symptoms were collected.The 24-item Hamilton Depression Scale was used for assessment.RESULTS Forty-eight patients had no depressive symptoms,and 132 patients had depre-ssive symptoms.Comprehensive univariate and multivariate logistic regression analyses showed that low bone density in the lumbar spine(L2-L4)and femoral neck,presence of chronic diseases,and low 5-hydroxytryptamine levels were independent risk factors for depressive symptoms,whereas calcium supplement intake and moderate to high-intensity activity were independent protective factors.CONCLUSION By implementing specialized psychological nursing interventions,and providing rehabilitation guidance,the incidence of depressive symptoms can be effectively reduced,improving the psychological health status and patient quality of life.展开更多
BACKGROUND Herbal supplements are increasingly used to manage menopausal symptoms.Physta®is a commercial herbal ingredient containing Eurycoma longifolia standardized water extract,traditionally used for vitality...BACKGROUND Herbal supplements are increasingly used to manage menopausal symptoms.Physta®is a commercial herbal ingredient containing Eurycoma longifolia standardized water extract,traditionally used for vitality.Its adaptogenic and anti-inflammatory properties promote hormonal balance,physical function,and sexual health,supporting its potential benefits for menopausal health.AIM To investigate Physta®’s role in improving menopausal quality of life,mood states,and overall safety profile compared with placebo.METHODS In this 12-week,randomized,double-blind,placebo-controlled trial,138 females aged 40-55 with menopausal symptoms were randomly assigned to receive Physta®50 mg,Physta®100 mg,or placebo.MENQOL and POMS were assessed at baseline,week 6,and week 12.Safety outcomes were evaluated through biochemical tests,vital signs,and female reproductive hormonal profile.RESULTS Physta®100 mg significantly reduced total MENQOL scores by 33.9%from baseline to week 12(P=0.049)with notable improvements in the physical(-36.4%,P=0.046)and sexual(-36.3%,P=0.043)domains.Total mood disturbance also declined more in the Physta®100 mg group(-38.6%)compared with placebo(-30.1%),although not statistically significant.No significant changes were observed in the vital signs and biochemical parameters,indicating the safety and tolerability of Physta®.No significant alterations were found in the female reproductive hormone profile,supporting its hormonal neutrality.CONCLUSION Physta®100 mg improved menopausal quality of life and mood without adverse effects,supporting its potential as a safe herbal therapy.Further studies with higher doses and longer durations are needed.展开更多
AIM To evaluate differences in capsule endoscopy(CE) performed in the setting of obscure gastrointestinal bleeding(OGIB) among premenopausal women(PMW) and menopausal women(MW).METHODS Retrospective, single-center stu...AIM To evaluate differences in capsule endoscopy(CE) performed in the setting of obscure gastrointestinal bleeding(OGIB) among premenopausal women(PMW) and menopausal women(MW).METHODS Retrospective, single-center study, including female patients submitted to CE in the setting of OGIB between May 2011 and December 2016. Patients were divided into 2 groups according to age, considering fertile age as ≤ 55 years and postmenopausal age as > 55 years. The diagnostic yield(DY), the rebleeding rate and the time to rebleed were evaluated and compared between groups. Rebleeding was defined as a drop of Hb > 2 g/dL or need for transfusional support or presence of melena/hematochezia.RESULTS A hundred and eighty three female patients underwent CE for OGIB, of whom 30.6%(n = 56) were PMW and 69.4%(n = 127) were MW. The DY was 30.4% in PMW and 63.8% in MW. The most common findings were angiodysplasias in both groups(PMW: 21.4%, MW: 44.9%)(P = 0.003). In PMW, only 1.8% required therapeutic endoscopy. In 17.3% of MW, CE findingsled to additional endoscopic treatment. Rebleeding at 1, 3 and 5 years in PMW was 3.6%, 10.2%, 10.2% and 22.0%, 32.3% and 34.2% in MW. Postmenopausal status was significantly associated with higher DY(P < 0.001), TY(P = 0.003), rebleeding(P = 0.031) and lower time to rebleed(P = 0.001).CONCLUSION PMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower.展开更多
This paper documents health problems faced by menopausal and postmenopausal women. These women constitute a sizable proportion of India's population though there exist no health care programmes to cater their spec...This paper documents health problems faced by menopausal and postmenopausal women. These women constitute a sizable proportion of India's population though there exist no health care programmes to cater their specific health needs and health vulnerabilities arose due to menopausal transition. Researchers have generally tried to determine age at menopause and a few have explored psychosomatic problems experienced by them. Abrupt changes in hormone levels among women generally bring out several physical infirmities which have hardly been the interest of research. Studies on menopausal and postmenopausal health problems and their bio-cultural correlates are warranted. Efforts should be made to understand the process of aging among women in relation to menopausal transition. Cross-cultural differences in coping mechanisms to minimise the health problems arose due to menopausal transition are important to study. This review argues provision of culturally appropriate health care programs to facilitate easier menopausal transition and to ensure healthy postmenopausal life for women.展开更多
Objective: To explore the correlation of menopausal index with sex hormones, lipid metabolism and cytokines in perimenopausal women. Methods: A total of 208 perimenopausal women who were treated in this hospital betwe...Objective: To explore the correlation of menopausal index with sex hormones, lipid metabolism and cytokines in perimenopausal women. Methods: A total of 208 perimenopausal women who were treated in this hospital between September 2015 and March 2018 were selected as the perimenopausal group and 150 healthy young women (20-30 years old) who received physical examination in this hospital during the same period were selected as the control group. The differences in the levels of Kupperman menopausal index as well as the contents of sex hormones, lipid metabolism indexes and inflammatory factors were compared between the two groups. Results: Kupperman menopausal index of perimenopausal group was higher than that of control group;sex hormones E2, P and T contents were lower than those of control group whereas FSH content was higher than that of control group;lipid metabolism indexes TC and LDL-C contents were higher than those of control group whereas HDL-C content was lower than that of control group;inflammatory factors IL-1β, IL-2, IL-18 and IFN-γ contents were higher than those of control group;the Kupperman menopausal index of perimenopausal women was negatively correlated with E2, P, T and HDL-C contents, and positively correlated with FSH, TC, LDL-C, IL-1β, IL-2, IL-18 and IFN-γ contents. Conclusion: The Kupperman menopausal index in perimenopausal women abnormally increases, and the specific level is directly correlated with the female sex hormones, lipid metabolism disorder and systemic microinflammation.展开更多
Objective: To evaluate the performance of a sample of postmenopausal women complaining of decline of prospective memory, undergoing therapy with concentrated extract of soy (CES) for six months, through specific neuro...Objective: To evaluate the performance of a sample of postmenopausal women complaining of decline of prospective memory, undergoing therapy with concentrated extract of soy (CES) for six months, through specific neuropsychological assessment, developed for this purpose. Materials and Methods: A randomized and double-blind study was with 90 women, 12-month amenorrhea, 40 years to 65 years and body mass index (BMI) above 30 kg/m2, whose complaints were reduction of cognitive efficiency. The participants were randomly divided into two treatment groups: Group I— received one capsule of 150 mg extract of soy, with 60 mg isoflavones orally/day;Group II—received one capsule placebo, for six months. All participants underwent a detailed interview, the MMSE, depression scale, and as they were being included in the study, self-perception scales and neuropsychological tests before and after six months of treatment. For analysis purposes, we applied the ANOVA and t-student tests. Results: Our results suggest a possible positive effect regarding the improvement in verbal fluency and executive function tasks of planning and mental flexibility, in women undergoing therapy with concentrated extract of soy in postmenopause. There was no correlation between prospective memory and cognitive performance, and there were only intensity scores of the depressive symptoms. Conclusion: Isoflavones act favorably on the cognitive function, amongst all functions, only on verbal memory and executive function tasks of planning and mental flexibility. The others showed no signs of improvement. We concluded that concentrated extract acts only on some cognitive functions.展开更多
In the market of botanical dietary supplements, Cimicifuga heracleifolia(CH) has always been considered as an adulterated species of Cimicifuga racemosa(CR), a conventional American herb with promising benefits to cou...In the market of botanical dietary supplements, Cimicifuga heracleifolia(CH) has always been considered as an adulterated species of Cimicifuga racemosa(CR), a conventional American herb with promising benefits to counteract troubles arising from the menopause. However, the detailed comparison of their therapeutic effects is lacking. In present study, the pharmacological and metabolomics studies were comparatively conducted between CH and CR in ovariectomized(OVX) female rats. Specifically, estrogen-like, anti-hyperlipidemia and anti-osteoporosis effects were evaluated through measuring serum biochemical parameters, histopathological examination and micro computed tomography(Micro-CT) scanning. At the same time, a gas chromatography-mass spectrometry(GC-MS)-based serum metabolomics method was employed to profile the metabolite compositional changes. As a result, both CR and CH displayed anti-osteoporosis and anti-hyperlipemia on menopause syndrome. Meanwhile, their potentials in improving the OVX-induced metabolic disorders were discovered. In conclusion, these results demonstrated that CH is therapeutically similar to CR in relieving menopausal symptoms and CH could be considered as a promising alternative to CR instead of an adulterant in the market of botanical dietary supplements.展开更多
OBJECTIVE: To determine the therapeutic effect of Ziyin Jianghuo Ningxin Decoction(ZYJHNXD) plus dehydroepiandrosterone(DHEA) and menopausalhormone therapy(MHT) in patients suffering from menopausal symptoms identifie...OBJECTIVE: To determine the therapeutic effect of Ziyin Jianghuo Ningxin Decoction(ZYJHNXD) plus dehydroepiandrosterone(DHEA) and menopausalhormone therapy(MHT) in patients suffering from menopausal symptoms identified as, in terms of Traditional Chinese Medicine, symptom pattern of Yin deficiency with hyperactive fire.METHODS: Totally 180 postmenopausal women aged 40 to 60 years were assigned into four groups and accepted femoston, femoston with ZYJHNXD,femoston with DHEA, femoston with ZYJHNXD and DHEA therapies, respectively, for three months.Common questionnaire-based measure instruments included modified Kupperman index(MKI),Hamilton Rating Scale for Anxiety(HAMA), and Hamilton Rating Scale for Depression(HAMD). Follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), 5-hydroxyindole-3-acetic acid(5-HIAA), norepinephrine(NE), dopamine(DA),bone mineral density(BMD), and sleep quality were evaluated before and three months after the treatments.RESULTS: In all four groups, the scores of MKI, HAMA, HAMD and the levels of FSH, LH decreased significantly(P < 0.05) after the treatment, while the levels of E2, 5-HIAA, NE, and DA showed obvious elevation(P < 0.05). The group receiving ZYJHNXD and DHEA combined with femoston had superiority in the preservation of bone mineral density and improvement of total sleep time and nighttime sleep time over the other three groups.CONCLUSION: ZYJHNXD and DHEA combined with MHT therapy have a favorable outcome in managing menopausal symptoms, restoring hormone levels, preventing skeletal rarefaction or osteoporosis,and improving sleep quality for postmenopausal women.展开更多
BACKGROUND： Previous studies have indicated preventive acupuncture and moxibustion at the Guanyuan point have positive effects on the immune system of menopausal rats. OBJECTIVE： To observe the effects of preventive...BACKGROUND： Previous studies have indicated preventive acupuncture and moxibustion at the Guanyuan point have positive effects on the immune system of menopausal rats. OBJECTIVE： To observe the effects of preventive acupuncture or moxibustion at the Guanyuan point on interleukin-2 （IL-2） and its receptor （IL-2R mRNA） levels in hypothalamus, serum, and uterus of menopausal rats. DESIGN： Randomized control animal experiment. SETTING： School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine. MATERIALS： This study was performed at the Laboratory of Beijing University of Chinese Medicine from November 2004 to July 2005. The vaginal smear method was used to determine the estrus cycle of 9.5-month-old Sprague Dawley （SD） female rats. Three continuous estrus cycles were measured, and 160 rats with estrus cycle disorder, weighing （300 _＋ 20） g, were included in this study. The rats were randomly divided into four groups： preventive acupuncture group （n =48）, preventive moxibustion group （n =48）, model groups （n =48）, and 10-month-old group （n =16）. Sixteen 3.5-month-old healthy SD female rats, weighing （240 ± 20） g, were also assigned to the young group. All rats were clean grade and were purchased from the Laboratory Animal Center, Beijing University of Chinese Medicine. The experiment was in accordance with animal ethics standards. METHODS： Acupuncture was applied to the preventive acupuncture group at 10 months of age. The needle was inserted upward and perpendicularly two fen to a point that was two fen below the Guanyuan point. The rats freely moved around during needle retention （20 minutes）. Acupuncture was administered twice a week and continued for eight weeks. A moxa cone （small） moxibustion was applied to the preventive moxibustion group at 10 months of age. The rats were caught gently and kept at the same position as the preventive acupuncture group. The moxa cone was ignited and held to the Guanyuan point directly. Only one moxa cone was used each time. After moxibustion, the local skin turned slightly red. Moxibustion was used twice a week and continued for eight weeks. Nothing except gently catching and lying was administered to the model group and the young group. MAIN OUTCOME MEASURES： Radioimmunoassay, in situ hybridization, and similar methods were employed to detect IL-2 in serum and the uterus, as well as IL-2R mRNA expression in the hypothalamus and uterus arcuate nuclei, of the preventive acupuncture group, preventive moxibustion group, model groups （at 12, 14, and 16 months）, 10 month old group （at 10 months）, and the young group （at 4 months）. RESULTS： All 176 rats were included in the final analysis. （1） IL-2R mRNA： IL-2R mRNA expression decreased significantly in the uterus of 12-, 14-, and 16-month-old model groups and in the hypothalamus of 14- and 16-month-old model groups （P 〈 0.05-0.01）. Compared to the same month-aged model groups, the expression of IL-2R mRNA increased significantly in the hypothalamus and uterus of 16-month-old preventive acupuncture or moxibustion groups （P 〈 0.05-0.01）.（2） IL-2：IL-2 in serum of 12- and 14-month-old model groups and in the uterus of 12-, 14-, and 16-month-old model groups decreased significantly compared to the young group （P 〈 0.05-0.01）. IL-2 serum levels increased significantly in the 16-month-old group with preventive moxibustion; in addition, IL-2 expression levels increased significantly in the uterus of the 12-month-old group with preventive moxibustion, as well as the 12- and 16-month-old groups with preventive acupuncture （P 〈 0.05-0.01）. CONCLUSION： As a rat ages and becomes menopausal, IL-2R mRNA expression in the hypothalamus and uterus, as well as IL-2 levels in the serum and uterus, decrease. However, preventive acupuncture and preventive moxibustion can repress the decrease to some extent. This effect is even greater in the late stages of menopause （16-month-old rats）.展开更多
Menopausal metabolic syndrome(MMS) is a series of syndrome caused by ovarian function decline and hormone insufficiency, and is a high risk factor for cardiovascular diseases(CVD) and type II diabetes mellitus(T2DM). ...Menopausal metabolic syndrome(MMS) is a series of syndrome caused by ovarian function decline and hormone insufficiency, and is a high risk factor for cardiovascular diseases(CVD) and type II diabetes mellitus(T2DM). Erzhiwan(EZW),composed of Herba Ecliptae and Fructus Ligustri Lucidi, is a traditional Chinese herbal formula that has been used to treat menopausal syndrome for many years. We added Herba Epimedii, Radix Rehmanniae, and Fructus Corni into EZW, to prepare a new formula, termed Jiawei Erzhiwan(JE). The present study was designed to determine the anti-MMS effects of JE using ovariectomized(OVX) adult female rats that were treated with JE for 4 weeks, and β-tc-6 cells and INS cells were used to detected the protect effectiveness of JE. Our results showed JE could increase insulin sensitivity and ameliorated hyperlipidemia. Metabolomics analysis showed that the serum levels of branched and aromatic amino acids were down-regulated in serum by JE administration. Moreover, JE enhanced the function of islet βcells INS-1 and β-tc-6, through increasing the glucose stimulated insulin secretion(GSIS), which was abolished by estrogen receptor(ER)antagonist, indicating that JE functions were mediated by ER signaling. Additionally, JE did not induce tumorigenesis in rat mammary tissue or promoted proliferation of MCF-7 and Hela cells. In conclusion, our work demonstrated that JE ameliorated OVX-induced glucose and lipid metabolism disorder through activating estrogen receptor pathway and promoting GSIS in islet β cells, thus indicating that JE could be a safe and effective medication for MMS therapy.展开更多
Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. ...Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. Methods A total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women （PreM group, 94 patients, 12.7%） and the post-menopausal women （PostM group, 649 patients, 87.3%） were assessed. Results The patients in the PreM group were younger （P＆lt;0.001） and less likely to have hypertension （P＆lt;0.001） and diabetes （P=0.005） than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complica-tions related to AF ablation was similar in both groups （P=0.385）. After 43 （16-108） months of follow-up, the success rate of ablation was 54.3%in the PreM group and 54.2%in the PostM group （P=0.842）. The overall freedom from atrial tachyarrhythmia recurrence was simi-lar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia. Conclusions The long-term outcomes of single-procedure CA for AF are similar in pre-and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.展开更多
Objective: Carbohydrates, proteins, and fats are energy sources needed by the body for performing daily activities and generating primary energy substances. In women who have undergone menopause, the function of thyro...Objective: Carbohydrates, proteins, and fats are energy sources needed by the body for performing daily activities and generating primary energy substances. In women who have undergone menopause, the function of thyroid hormone in their body begins to decline and thus affects the ability of the body to produce energy. The purpose of this study was to determine the correlation between the intakes of carbohydrates, proteins, and fats and random blood sugar levels in menopausal women.Methods: This study was a correlational analytical research with a cross-sectional design, which was conducted in 72 menopausal women recruited by the purposive sampling technique. In this study, a 24-hour food recall form was used, and randomized blood sugar levels were measured using a glucometer. The analysis of the data was performed using a Pearson product moment and multiple linear regression.Results: Carbohydrates and fats together affected random blood sugar levels with an F-value of 25.810 and a p-value of 0.000.Meanwhile, adjusted R^2 showed the value of 0.411, indicating that the difference in the intake of carbohydrates and fats together affected random blood sugar levels by 41.1%.Conclusions: Intake of carbohydrates and fats affected random blood sugar levels, whereas the rest were influenced by other factors,and protein intake was unrelated to random blood sugar levels in menopausal women.展开更多
Menopausal hormone therapy(MHT)has been widely used for the clinical treatment of symptoms associated with menopause in women.However,the exact nature of the relationship between MHT and the increased risk of breast c...Menopausal hormone therapy(MHT)has been widely used for the clinical treatment of symptoms associated with menopause in women.However,the exact nature of the relationship between MHT and the increased risk of breast cancer has not been fully elucidated.The results of the Women’s Health Initiative’s randomized controlled clinical studies showed that estrogen monotherapy was associated with a lower incidence of breast cancer as compared to estrogen-progesterone combined therapy,with an elevated risk of breast cancer.The evidence currently available from randomized trials and observational studies is based on data from different populations,drug formulations,and routes of administration.Even though the risks of MHT and breast cancer have received a great deal of attention,information regarding the unpredictable toxicological risks of estrogen and progestogen metabolism needs to be further analyzed.Furthermore,the diversity and complexity of the metabolic pathways of estrogen and different progestogens as well as the association of the different estrogen and progestogen metabolites with the increased risk of breast cancer need to be adequately studied.Therefore,this review aimed to describe the biological effects of estrogen,progesterone,and their metabolites on the proliferation of breast cancer cells,based on relevant basic research and clinical trials,to improve our understanding of the biological functions of estrogen and progestogen as well as the safety of MHT.展开更多
In the present study, we aimed to retrospectively analyze the medication prescriptions of menopausal women diagnosed with menopausal syndrome in our hospital from 2015 to 2018, and compare the retention rate of estrog...In the present study, we aimed to retrospectively analyze the medication prescriptions of menopausal women diagnosed with menopausal syndrome in our hospital from 2015 to 2018, and compare the retention rate of estrogen and progesterone sequential therapy and hormone continuous therapy in menopausal women. The rational drug management system of Ningbo Women and Children’s hospital was used to screen the prescriptions of menopausal syndrome in 4 years. After the age, year included in the study, and prescription cost were adjusted, Kaplan-Meier regression analysis was performed to compare the prescription retention rates of the two drug regimens. The distribution of the two HRT regimens in the 4 years showed an increasing trend year by year, and the age groups of the two HRT regimens were mainly distributed between 41 and 60 years old, accounting for 97.1% and 87.06%, respectively. The cost distribution for the other two HRT regimens was approximately the same. Compared with the two HRT regimens, the drug retention rate of hormone continuous regimens was higher than that of hormone sequential regimens within 4 years. Kaplan-Meier regression analysis showed that the trend was significant(Tarone-Ware, Chi-square value = 3.857, P = 0.050). This study found that the median retention time of HRT therapy in menopausal women in our hospital was about half a year, which was significantly lower than that reported in previous studies of 1 year or longer. In addition, the present study found that compared with Femoston, the tibolone regimen significantly increased retention time in the treatment of menopausal syndrome.展开更多
Breast cancer is not one disease,but can be categorized into four major molecular subtypes according to hormone receptor [estrogen receptor(ER) and progesterone receptor(Pg R)] and human epidermal growth factor recept...Breast cancer is not one disease,but can be categorized into four major molecular subtypes according to hormone receptor [estrogen receptor(ER) and progesterone receptor(Pg R)] and human epidermal growth factor receptor type 2(HER2) expression status. Ki67 labeling index and/or multigene assays are used to classify ERpositive,HER2-negative breast cancer into luminal A and luminal B(HER2-negative) subtypes. To date,most studies analyzing predictive or prognostic factors in ER-positive breast cancer have been performed in postmenopausal women,mainly using patients and samples in adjuvant aromatase inhibitor trials. In contrast,even the clinical roles of Pg R and Ki67 have been little analyzed so far in premenopausal women. Pg R is one of the estrogen-responsive genes,and it has been reported that plasma estradiol levels are related to expression levels of estrogen-responsive genes including PGR in ER-positive breast cancer. In this article,biological differences,especially differences in expression of Pg R and Ki67 in ER-positive breast cancer between pre- and postmenopausal women are discussed. Clinical roles of Pg R and Ki67 in ER-positive breast cancer differ between pre- and postmenopausal women. We suggest that the mechanisms of development and estrogen-dependent growth of ER-positive breast cancer might differ according to menopausal status.展开更多
Objective: To evaluate the effect of domestic human menopausal gonadotropin (HMG) in treat-ment of anovulatory infertility Method:Sequential regimen with HMG and hCG were used in 110 cases with a total of 198 treat-me...Objective: To evaluate the effect of domestic human menopausal gonadotropin (HMG) in treat-ment of anovulatory infertility Method:Sequential regimen with HMG and hCG were used in 110 cases with a total of 198 treat-ment cycles, average 1. 8 cycles per patent and 33. 8 ampules of HMG per cycle. The dosage of hCG for induction of ovulation was divided into three groups: 10 000IU, 15 000IU, and 25 000IU. Methods used for monitoring ovulation were BBT,cervical mucus score,ultrasonography and hormone assays.Results: The ovulation rate per case was 99. 1 % and percycle was 94%; the pregnancy rate per case was 50% (37% for primary amenorrhea and 58% for secondary amenorrhea) and per cycle was 27%.Among the 55 pregnant women 44 delivered and 11 aborted. There were 8 twin pregnancies The compli-caton of ovarian hyperstimulation syndrome (OHSS) was encountered in 38 cases (34% ): mild in 12 (10.9%), moderate in 21 (19.0%) and severe in 5 (4. 5%).Conclusion:Domestic HMG showed satisfactory results in the treatment of hypogonadotrophic a-menorrhea or anovulatory infertility.展开更多
Menopausal hormone therapy(MHT)is used to treat menopausal complaints including the genitourinary syndrome of menopause,to prevent osteoporosis,and to treat bleeding problems.Since these can be the indications also in...Menopausal hormone therapy(MHT)is used to treat menopausal complaints including the genitourinary syndrome of menopause,to prevent osteoporosis,and to treat bleeding problems.Since these can be the indications also in young women,especially with POI(premature ovarian insufficiency)or with surgical menopause(bilateral oophorectomy),also the old term"Hormone Replacement Therapy(HRT)”is still used.The effective component is the estrogen component without relevant difference in the efficacy of the various MHT-preparations.Additional preventive benefits are reduction of cardiovascular disease(including prevention of diabetes mellitus and metabolic syndrome),reduction of colon cancer,and perhaps also Alzheimer's disease,if started within a Kwindow of opportunity",i.e.in perimenopause or within 6-10 years after menopause.Primary indication for progestogen addition is to avoid the development of estrogen-dependent endometrial cancer,i.e.addition not recommended in hysterectomized women.Two main schedules,sequential-or continuous-combined estrogen/progestogen regimens,are used for treatment of bleeding problems.For this and for optimizing menstrual regulation detailed recommendations are given including proposed dosages for the available different progestogens if added to oral or transdermal estradiol in different estrogen dosages.The WHI-study demonstrated the main risks using MHT within a“worst-case scenario",i.e.start of MHT in old women with high risk for breast cancer and cardiovascular diseases,whereby only^conjugated equine estro-gens”and^medroxprogesterone acetate”have been tested.One main result was that the progestogen component is decisive for the risk of breast cancer,which according to own experimental research and observational studies may be reduced using the physiological progesterone or its isomer dydrogesterone.In addition we propose to push forward research for screening patients with increased breast cancer risk like we have done in the past decade demonstrating that certain membrane-bound receptors in breast cancer tissue or blood can increase this risk.To reduce the risk of venous thromboembolism and stroke,transdermal estradiol(gels,patches,)should be used,in free combination with progesterone or dydrogesterone as"golden standard"in patients with increased risk.To increase the compliance in our patients without special risks we mostly use the available fix-combinations of estradiol/dydrogesterone getting strong efficacy,good menstrual regulation or amenorrhea,respectively,but also other combinations may be indicated to take advantage of for example androgenic or antiandrogenic progestogens.展开更多
基金Supported by Zhejiang Provincial Medical and Health Science and Technology Program,No.2025KY196.
文摘This review examines the mechanisms of anxiety and depression in menopausal syndrome from an integrated physiological to psychological perspective.Fluctuations in estrogen and progesterone levels during menopause affect neurotransmitter systems(including serotonin,norepinephrine,and dopamine),hypothalamic-pituitary-adrenal axis function,inflammatory processes,and neurotrophic factor expression,collectively diminishing the resilience of emotional regulation neural circuits.Simultaneously,vasomotor symptoms(such as hot flashes and night sweats),sleep disruption,genetic susceptibility,and epigenetic modifications interact with mood disorders,while psychosocial factors(such as midlife stressors and role transitions)and cognitive factors(including negative schemas about aging,attentional bias toward threats,and difficulties in emotional regulation)further shape women’s experiences of menopausal changes.Clinical practice should adopt a biopsychosocial model,employing personalized multimodal approaches through hormone therapy,antidepressants,psychotherapy,and lifestyle adjustments,while future research should focus on developing biomarkers,utilizing advanced technologies,and developing targeted interventions to support women’s psychological wellbeing during menopause.
文摘The age at which a woman enters natural menopause has also been associated to death from any cause.Menopause is a natural component of aging that happens between the ages of 45 and 55,with the average menopausal age being 51.Previous research has revealed the age at which women reach menopause,but there is no evidence to support the link between menopause and longevity.We made a study in assessing the limits of maximum lifespan at menopausal age in our previous article.In this paper,we aim to predict the maximum lifespan of women at mean menopausal age.
基金Supported by Program“MEDICUS”of the University of Patras,No.82869,3419/15.01.2024.
文摘The concept of metabolically healthy obesity(MHO)has attracted growing attention,but its clinical relevance and association with future cardiovascular risk remain unclear.Estrogen deficiency,which signifies the menopause phase,contributes to altered body composition and unfavorable metabolic processes.In this Editorial,we comment on the recent retrospective study by Pingili et al,which used a United States national in-patient population and observed significantly elevated odds of major adverse cardiac and cerebrovascular events in postmeno-pausal women with MHO compared with their age-matched non-obese counter-parts.Of note,disproportionately greater risks were particularly observed among Black patients.These findings along with previous literature data call into ques-tion the seemingly benign profile of the MHO state.Obese individuals who appear metabolically healthy present an elevated cardiovascular risk which may be exacerbated in older female populations.These findings emphasize the need for vigilance and improved approaches of risk stratification which would trans-late into the early application of preventive measures.
文摘BACKGROUND Postmenopausal women with osteoporosis are at high risk of developing depre-ssive symptoms,necessitating specialized psychological nursing interventions.AIM To investigate factors influencing depressive symptoms in postmenopausal women with osteoporosis and develop targeted psychological nursing interven-tions.METHODS A total of 180 postmenopausal women with osteoporosis admitted to the Depar-tment of Orthopedics at the First Affiliated Hospital of Soochow University between October 2021 and October 2024 were selected as research participants.Information on age,duration of menopause,body mass index,education level,marital status,activity intensity,bone density,presence of chronic diseases,calcium supplement intake,sex hormone levels,and depressive symptoms were collected.The 24-item Hamilton Depression Scale was used for assessment.RESULTS Forty-eight patients had no depressive symptoms,and 132 patients had depre-ssive symptoms.Comprehensive univariate and multivariate logistic regression analyses showed that low bone density in the lumbar spine(L2-L4)and femoral neck,presence of chronic diseases,and low 5-hydroxytryptamine levels were independent risk factors for depressive symptoms,whereas calcium supplement intake and moderate to high-intensity activity were independent protective factors.CONCLUSION By implementing specialized psychological nursing interventions,and providing rehabilitation guidance,the incidence of depressive symptoms can be effectively reduced,improving the psychological health status and patient quality of life.
基金Supported by Biotropics Malaysia Berhad,Malaysia,NN-2021-016.
文摘BACKGROUND Herbal supplements are increasingly used to manage menopausal symptoms.Physta®is a commercial herbal ingredient containing Eurycoma longifolia standardized water extract,traditionally used for vitality.Its adaptogenic and anti-inflammatory properties promote hormonal balance,physical function,and sexual health,supporting its potential benefits for menopausal health.AIM To investigate Physta®’s role in improving menopausal quality of life,mood states,and overall safety profile compared with placebo.METHODS In this 12-week,randomized,double-blind,placebo-controlled trial,138 females aged 40-55 with menopausal symptoms were randomly assigned to receive Physta®50 mg,Physta®100 mg,or placebo.MENQOL and POMS were assessed at baseline,week 6,and week 12.Safety outcomes were evaluated through biochemical tests,vital signs,and female reproductive hormonal profile.RESULTS Physta®100 mg significantly reduced total MENQOL scores by 33.9%from baseline to week 12(P=0.049)with notable improvements in the physical(-36.4%,P=0.046)and sexual(-36.3%,P=0.043)domains.Total mood disturbance also declined more in the Physta®100 mg group(-38.6%)compared with placebo(-30.1%),although not statistically significant.No significant changes were observed in the vital signs and biochemical parameters,indicating the safety and tolerability of Physta®.No significant alterations were found in the female reproductive hormone profile,supporting its hormonal neutrality.CONCLUSION Physta®100 mg improved menopausal quality of life and mood without adverse effects,supporting its potential as a safe herbal therapy.Further studies with higher doses and longer durations are needed.
文摘AIM To evaluate differences in capsule endoscopy(CE) performed in the setting of obscure gastrointestinal bleeding(OGIB) among premenopausal women(PMW) and menopausal women(MW).METHODS Retrospective, single-center study, including female patients submitted to CE in the setting of OGIB between May 2011 and December 2016. Patients were divided into 2 groups according to age, considering fertile age as ≤ 55 years and postmenopausal age as > 55 years. The diagnostic yield(DY), the rebleeding rate and the time to rebleed were evaluated and compared between groups. Rebleeding was defined as a drop of Hb > 2 g/dL or need for transfusional support or presence of melena/hematochezia.RESULTS A hundred and eighty three female patients underwent CE for OGIB, of whom 30.6%(n = 56) were PMW and 69.4%(n = 127) were MW. The DY was 30.4% in PMW and 63.8% in MW. The most common findings were angiodysplasias in both groups(PMW: 21.4%, MW: 44.9%)(P = 0.003). In PMW, only 1.8% required therapeutic endoscopy. In 17.3% of MW, CE findingsled to additional endoscopic treatment. Rebleeding at 1, 3 and 5 years in PMW was 3.6%, 10.2%, 10.2% and 22.0%, 32.3% and 34.2% in MW. Postmenopausal status was significantly associated with higher DY(P < 0.001), TY(P = 0.003), rebleeding(P = 0.031) and lower time to rebleed(P = 0.001).CONCLUSION PMW with suspected OGIB are less likely to have significant findings in CE. In MW DY, need for endoscopic treatment and rebleeding were significantly higher while time to rebleed was lower.
文摘This paper documents health problems faced by menopausal and postmenopausal women. These women constitute a sizable proportion of India's population though there exist no health care programmes to cater their specific health needs and health vulnerabilities arose due to menopausal transition. Researchers have generally tried to determine age at menopause and a few have explored psychosomatic problems experienced by them. Abrupt changes in hormone levels among women generally bring out several physical infirmities which have hardly been the interest of research. Studies on menopausal and postmenopausal health problems and their bio-cultural correlates are warranted. Efforts should be made to understand the process of aging among women in relation to menopausal transition. Cross-cultural differences in coping mechanisms to minimise the health problems arose due to menopausal transition are important to study. This review argues provision of culturally appropriate health care programs to facilitate easier menopausal transition and to ensure healthy postmenopausal life for women.
文摘Objective: To explore the correlation of menopausal index with sex hormones, lipid metabolism and cytokines in perimenopausal women. Methods: A total of 208 perimenopausal women who were treated in this hospital between September 2015 and March 2018 were selected as the perimenopausal group and 150 healthy young women (20-30 years old) who received physical examination in this hospital during the same period were selected as the control group. The differences in the levels of Kupperman menopausal index as well as the contents of sex hormones, lipid metabolism indexes and inflammatory factors were compared between the two groups. Results: Kupperman menopausal index of perimenopausal group was higher than that of control group;sex hormones E2, P and T contents were lower than those of control group whereas FSH content was higher than that of control group;lipid metabolism indexes TC and LDL-C contents were higher than those of control group whereas HDL-C content was lower than that of control group;inflammatory factors IL-1β, IL-2, IL-18 and IFN-γ contents were higher than those of control group;the Kupperman menopausal index of perimenopausal women was negatively correlated with E2, P, T and HDL-C contents, and positively correlated with FSH, TC, LDL-C, IL-1β, IL-2, IL-18 and IFN-γ contents. Conclusion: The Kupperman menopausal index in perimenopausal women abnormally increases, and the specific level is directly correlated with the female sex hormones, lipid metabolism disorder and systemic microinflammation.
基金supported by CNPq,National Council for Scientific and Technological Development
文摘Objective: To evaluate the performance of a sample of postmenopausal women complaining of decline of prospective memory, undergoing therapy with concentrated extract of soy (CES) for six months, through specific neuropsychological assessment, developed for this purpose. Materials and Methods: A randomized and double-blind study was with 90 women, 12-month amenorrhea, 40 years to 65 years and body mass index (BMI) above 30 kg/m2, whose complaints were reduction of cognitive efficiency. The participants were randomly divided into two treatment groups: Group I— received one capsule of 150 mg extract of soy, with 60 mg isoflavones orally/day;Group II—received one capsule placebo, for six months. All participants underwent a detailed interview, the MMSE, depression scale, and as they were being included in the study, self-perception scales and neuropsychological tests before and after six months of treatment. For analysis purposes, we applied the ANOVA and t-student tests. Results: Our results suggest a possible positive effect regarding the improvement in verbal fluency and executive function tasks of planning and mental flexibility, in women undergoing therapy with concentrated extract of soy in postmenopause. There was no correlation between prospective memory and cognitive performance, and there were only intensity scores of the depressive symptoms. Conclusion: Isoflavones act favorably on the cognitive function, amongst all functions, only on verbal memory and executive function tasks of planning and mental flexibility. The others showed no signs of improvement. We concluded that concentrated extract acts only on some cognitive functions.
基金supported by the National Natural Science Foundation of China(Nos.81773993 and 81130068)the National Key R&D Program of China(No.2018YFC-1707905)
文摘In the market of botanical dietary supplements, Cimicifuga heracleifolia(CH) has always been considered as an adulterated species of Cimicifuga racemosa(CR), a conventional American herb with promising benefits to counteract troubles arising from the menopause. However, the detailed comparison of their therapeutic effects is lacking. In present study, the pharmacological and metabolomics studies were comparatively conducted between CH and CR in ovariectomized(OVX) female rats. Specifically, estrogen-like, anti-hyperlipidemia and anti-osteoporosis effects were evaluated through measuring serum biochemical parameters, histopathological examination and micro computed tomography(Micro-CT) scanning. At the same time, a gas chromatography-mass spectrometry(GC-MS)-based serum metabolomics method was employed to profile the metabolite compositional changes. As a result, both CR and CH displayed anti-osteoporosis and anti-hyperlipemia on menopause syndrome. Meanwhile, their potentials in improving the OVX-induced metabolic disorders were discovered. In conclusion, these results demonstrated that CH is therapeutically similar to CR in relieving menopausal symptoms and CH could be considered as a promising alternative to CR instead of an adulterant in the market of botanical dietary supplements.
基金Supported by the National Natural Science Foundation of China(No.31571196)the Science and Technology Commission of Shanghai Municipality 2015 YIXUEYINGDAO project(No.15401932200)+3 种基金the FY2008 JSPS Postdoctoral Fellowship for Foreign Researchers P08471the National Natural Science Foundation of China(No.30801502)the Shanghai Pujiang Program(No.11PJ1401900)Development Project of Shanghai Peak Disciplines-Integrative Medicine(No.20150407)
文摘OBJECTIVE: To determine the therapeutic effect of Ziyin Jianghuo Ningxin Decoction(ZYJHNXD) plus dehydroepiandrosterone(DHEA) and menopausalhormone therapy(MHT) in patients suffering from menopausal symptoms identified as, in terms of Traditional Chinese Medicine, symptom pattern of Yin deficiency with hyperactive fire.METHODS: Totally 180 postmenopausal women aged 40 to 60 years were assigned into four groups and accepted femoston, femoston with ZYJHNXD,femoston with DHEA, femoston with ZYJHNXD and DHEA therapies, respectively, for three months.Common questionnaire-based measure instruments included modified Kupperman index(MKI),Hamilton Rating Scale for Anxiety(HAMA), and Hamilton Rating Scale for Depression(HAMD). Follicle-stimulating hormone(FSH), luteinizing hormone(LH), estradiol(E2), 5-hydroxyindole-3-acetic acid(5-HIAA), norepinephrine(NE), dopamine(DA),bone mineral density(BMD), and sleep quality were evaluated before and three months after the treatments.RESULTS: In all four groups, the scores of MKI, HAMA, HAMD and the levels of FSH, LH decreased significantly(P < 0.05) after the treatment, while the levels of E2, 5-HIAA, NE, and DA showed obvious elevation(P < 0.05). The group receiving ZYJHNXD and DHEA combined with femoston had superiority in the preservation of bone mineral density and improvement of total sleep time and nighttime sleep time over the other three groups.CONCLUSION: ZYJHNXD and DHEA combined with MHT therapy have a favorable outcome in managing menopausal symptoms, restoring hormone levels, preventing skeletal rarefaction or osteoporosis,and improving sleep quality for postmenopausal women.
基金the National Nature Science Foundation of China, No. 90209026Natural Science Foundation of Beijing, No. 7052037
文摘BACKGROUND： Previous studies have indicated preventive acupuncture and moxibustion at the Guanyuan point have positive effects on the immune system of menopausal rats. OBJECTIVE： To observe the effects of preventive acupuncture or moxibustion at the Guanyuan point on interleukin-2 （IL-2） and its receptor （IL-2R mRNA） levels in hypothalamus, serum, and uterus of menopausal rats. DESIGN： Randomized control animal experiment. SETTING： School of Acupuncture and Moxibustion, Beijing University of Chinese Medicine. MATERIALS： This study was performed at the Laboratory of Beijing University of Chinese Medicine from November 2004 to July 2005. The vaginal smear method was used to determine the estrus cycle of 9.5-month-old Sprague Dawley （SD） female rats. Three continuous estrus cycles were measured, and 160 rats with estrus cycle disorder, weighing （300 _＋ 20） g, were included in this study. The rats were randomly divided into four groups： preventive acupuncture group （n =48）, preventive moxibustion group （n =48）, model groups （n =48）, and 10-month-old group （n =16）. Sixteen 3.5-month-old healthy SD female rats, weighing （240 ± 20） g, were also assigned to the young group. All rats were clean grade and were purchased from the Laboratory Animal Center, Beijing University of Chinese Medicine. The experiment was in accordance with animal ethics standards. METHODS： Acupuncture was applied to the preventive acupuncture group at 10 months of age. The needle was inserted upward and perpendicularly two fen to a point that was two fen below the Guanyuan point. The rats freely moved around during needle retention （20 minutes）. Acupuncture was administered twice a week and continued for eight weeks. A moxa cone （small） moxibustion was applied to the preventive moxibustion group at 10 months of age. The rats were caught gently and kept at the same position as the preventive acupuncture group. The moxa cone was ignited and held to the Guanyuan point directly. Only one moxa cone was used each time. After moxibustion, the local skin turned slightly red. Moxibustion was used twice a week and continued for eight weeks. Nothing except gently catching and lying was administered to the model group and the young group. MAIN OUTCOME MEASURES： Radioimmunoassay, in situ hybridization, and similar methods were employed to detect IL-2 in serum and the uterus, as well as IL-2R mRNA expression in the hypothalamus and uterus arcuate nuclei, of the preventive acupuncture group, preventive moxibustion group, model groups （at 12, 14, and 16 months）, 10 month old group （at 10 months）, and the young group （at 4 months）. RESULTS： All 176 rats were included in the final analysis. （1） IL-2R mRNA： IL-2R mRNA expression decreased significantly in the uterus of 12-, 14-, and 16-month-old model groups and in the hypothalamus of 14- and 16-month-old model groups （P 〈 0.05-0.01）. Compared to the same month-aged model groups, the expression of IL-2R mRNA increased significantly in the hypothalamus and uterus of 16-month-old preventive acupuncture or moxibustion groups （P 〈 0.05-0.01）.（2） IL-2：IL-2 in serum of 12- and 14-month-old model groups and in the uterus of 12-, 14-, and 16-month-old model groups decreased significantly compared to the young group （P 〈 0.05-0.01）. IL-2 serum levels increased significantly in the 16-month-old group with preventive moxibustion; in addition, IL-2 expression levels increased significantly in the uterus of the 12-month-old group with preventive moxibustion, as well as the 12- and 16-month-old groups with preventive acupuncture （P 〈 0.05-0.01）. CONCLUSION： As a rat ages and becomes menopausal, IL-2R mRNA expression in the hypothalamus and uterus, as well as IL-2 levels in the serum and uterus, decrease. However, preventive acupuncture and preventive moxibustion can repress the decrease to some extent. This effect is even greater in the late stages of menopause （16-month-old rats）.
基金supported by the Funds for Creative Research Groups of China,National Natural Science Foundation of China(No.81421005)the New Century Excellent Talents in University(NCET-12-0976)+1 种基金the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)the Fundamental Research Funds for the Central Universities(No.ZD2014YW0030)
文摘Menopausal metabolic syndrome(MMS) is a series of syndrome caused by ovarian function decline and hormone insufficiency, and is a high risk factor for cardiovascular diseases(CVD) and type II diabetes mellitus(T2DM). Erzhiwan(EZW),composed of Herba Ecliptae and Fructus Ligustri Lucidi, is a traditional Chinese herbal formula that has been used to treat menopausal syndrome for many years. We added Herba Epimedii, Radix Rehmanniae, and Fructus Corni into EZW, to prepare a new formula, termed Jiawei Erzhiwan(JE). The present study was designed to determine the anti-MMS effects of JE using ovariectomized(OVX) adult female rats that were treated with JE for 4 weeks, and β-tc-6 cells and INS cells were used to detected the protect effectiveness of JE. Our results showed JE could increase insulin sensitivity and ameliorated hyperlipidemia. Metabolomics analysis showed that the serum levels of branched and aromatic amino acids were down-regulated in serum by JE administration. Moreover, JE enhanced the function of islet βcells INS-1 and β-tc-6, through increasing the glucose stimulated insulin secretion(GSIS), which was abolished by estrogen receptor(ER)antagonist, indicating that JE functions were mediated by ER signaling. Additionally, JE did not induce tumorigenesis in rat mammary tissue or promoted proliferation of MCF-7 and Hela cells. In conclusion, our work demonstrated that JE ameliorated OVX-induced glucose and lipid metabolism disorder through activating estrogen receptor pathway and promoting GSIS in islet β cells, thus indicating that JE could be a safe and effective medication for MMS therapy.
文摘Objectives To address whether menopause affects outcome of catheter ablation （CA） for atrial fibrillation （AF） by comparing the safety and long-term outcome of a single-procedure in pre-and post-menopausal women. Methods A total of 743 female patients who underwent a single CA procedure of drug-refractory AF were retrospectively analyzed. The differences in clinical presentation and outcomes of CA for AF between the pre-menopausal women （PreM group, 94 patients, 12.7%） and the post-menopausal women （PostM group, 649 patients, 87.3%） were assessed. Results The patients in the PreM group were younger （P＆lt;0.001） and less likely to have hypertension （P＆lt;0.001） and diabetes （P=0.005） than those in the PostM group. The two groups were similar with regards to the proportion of concomitant mitral valve regurgitation coronary artery disease, left atrium dimensions, and left ventricular ejection fraction. The overall rate of complica-tions related to AF ablation was similar in both groups （P=0.385）. After 43 （16-108） months of follow-up, the success rate of ablation was 54.3%in the PreM group and 54.2%in the PostM group （P=0.842）. The overall freedom from atrial tachyarrhythmia recurrence was simi-lar in both groups. Menopause was not found to be an independent predictive factor of the recurrence of atrial tachyarrhythmia. Conclusions The long-term outcomes of single-procedure CA for AF are similar in pre-and post-menopausal women. Results indicated that CA of AF appears to be as safe and effective in pre-menopausal women as in post-menopausal women.
文摘Objective: Carbohydrates, proteins, and fats are energy sources needed by the body for performing daily activities and generating primary energy substances. In women who have undergone menopause, the function of thyroid hormone in their body begins to decline and thus affects the ability of the body to produce energy. The purpose of this study was to determine the correlation between the intakes of carbohydrates, proteins, and fats and random blood sugar levels in menopausal women.Methods: This study was a correlational analytical research with a cross-sectional design, which was conducted in 72 menopausal women recruited by the purposive sampling technique. In this study, a 24-hour food recall form was used, and randomized blood sugar levels were measured using a glucometer. The analysis of the data was performed using a Pearson product moment and multiple linear regression.Results: Carbohydrates and fats together affected random blood sugar levels with an F-value of 25.810 and a p-value of 0.000.Meanwhile, adjusted R^2 showed the value of 0.411, indicating that the difference in the intake of carbohydrates and fats together affected random blood sugar levels by 41.1%.Conclusions: Intake of carbohydrates and fats affected random blood sugar levels, whereas the rest were influenced by other factors,and protein intake was unrelated to random blood sugar levels in menopausal women.
基金This study was supported by grants from the National Natural Science Foundation of China(Grant Nos.61673024 and 81971348)the Clinical Medicine Plus X-Young Scholar Project,Peking University,and the Fundamental Research Funds for the Central University(Grant No.PKU2018LCXQ001).
文摘Menopausal hormone therapy(MHT)has been widely used for the clinical treatment of symptoms associated with menopause in women.However,the exact nature of the relationship between MHT and the increased risk of breast cancer has not been fully elucidated.The results of the Women’s Health Initiative’s randomized controlled clinical studies showed that estrogen monotherapy was associated with a lower incidence of breast cancer as compared to estrogen-progesterone combined therapy,with an elevated risk of breast cancer.The evidence currently available from randomized trials and observational studies is based on data from different populations,drug formulations,and routes of administration.Even though the risks of MHT and breast cancer have received a great deal of attention,information regarding the unpredictable toxicological risks of estrogen and progestogen metabolism needs to be further analyzed.Furthermore,the diversity and complexity of the metabolic pathways of estrogen and different progestogens as well as the association of the different estrogen and progestogen metabolites with the increased risk of breast cancer need to be adequately studied.Therefore,this review aimed to describe the biological effects of estrogen,progesterone,and their metabolites on the proliferation of breast cancer cells,based on relevant basic research and clinical trials,to improve our understanding of the biological functions of estrogen and progestogen as well as the safety of MHT.
基金Ningbo Public Welfare Science and Technology Plan(Grant No.2019C50089)。
文摘In the present study, we aimed to retrospectively analyze the medication prescriptions of menopausal women diagnosed with menopausal syndrome in our hospital from 2015 to 2018, and compare the retention rate of estrogen and progesterone sequential therapy and hormone continuous therapy in menopausal women. The rational drug management system of Ningbo Women and Children’s hospital was used to screen the prescriptions of menopausal syndrome in 4 years. After the age, year included in the study, and prescription cost were adjusted, Kaplan-Meier regression analysis was performed to compare the prescription retention rates of the two drug regimens. The distribution of the two HRT regimens in the 4 years showed an increasing trend year by year, and the age groups of the two HRT regimens were mainly distributed between 41 and 60 years old, accounting for 97.1% and 87.06%, respectively. The cost distribution for the other two HRT regimens was approximately the same. Compared with the two HRT regimens, the drug retention rate of hormone continuous regimens was higher than that of hormone sequential regimens within 4 years. Kaplan-Meier regression analysis showed that the trend was significant(Tarone-Ware, Chi-square value = 3.857, P = 0.050). This study found that the median retention time of HRT therapy in menopausal women in our hospital was about half a year, which was significantly lower than that reported in previous studies of 1 year or longer. In addition, the present study found that compared with Femoston, the tibolone regimen significantly increased retention time in the treatment of menopausal syndrome.
文摘Breast cancer is not one disease,but can be categorized into four major molecular subtypes according to hormone receptor [estrogen receptor(ER) and progesterone receptor(Pg R)] and human epidermal growth factor receptor type 2(HER2) expression status. Ki67 labeling index and/or multigene assays are used to classify ERpositive,HER2-negative breast cancer into luminal A and luminal B(HER2-negative) subtypes. To date,most studies analyzing predictive or prognostic factors in ER-positive breast cancer have been performed in postmenopausal women,mainly using patients and samples in adjuvant aromatase inhibitor trials. In contrast,even the clinical roles of Pg R and Ki67 have been little analyzed so far in premenopausal women. Pg R is one of the estrogen-responsive genes,and it has been reported that plasma estradiol levels are related to expression levels of estrogen-responsive genes including PGR in ER-positive breast cancer. In this article,biological differences,especially differences in expression of Pg R and Ki67 in ER-positive breast cancer between pre- and postmenopausal women are discussed. Clinical roles of Pg R and Ki67 in ER-positive breast cancer differ between pre- and postmenopausal women. We suggest that the mechanisms of development and estrogen-dependent growth of ER-positive breast cancer might differ according to menopausal status.
文摘Objective: To evaluate the effect of domestic human menopausal gonadotropin (HMG) in treat-ment of anovulatory infertility Method:Sequential regimen with HMG and hCG were used in 110 cases with a total of 198 treat-ment cycles, average 1. 8 cycles per patent and 33. 8 ampules of HMG per cycle. The dosage of hCG for induction of ovulation was divided into three groups: 10 000IU, 15 000IU, and 25 000IU. Methods used for monitoring ovulation were BBT,cervical mucus score,ultrasonography and hormone assays.Results: The ovulation rate per case was 99. 1 % and percycle was 94%; the pregnancy rate per case was 50% (37% for primary amenorrhea and 58% for secondary amenorrhea) and per cycle was 27%.Among the 55 pregnant women 44 delivered and 11 aborted. There were 8 twin pregnancies The compli-caton of ovarian hyperstimulation syndrome (OHSS) was encountered in 38 cases (34% ): mild in 12 (10.9%), moderate in 21 (19.0%) and severe in 5 (4. 5%).Conclusion:Domestic HMG showed satisfactory results in the treatment of hypogonadotrophic a-menorrhea or anovulatory infertility.
基金supported by National Natural Science Foundation of China(No.81671411)Beijing Municipal Administration of Hospitals’Ascent Plan of China(No.DFL20181401).
文摘Menopausal hormone therapy(MHT)is used to treat menopausal complaints including the genitourinary syndrome of menopause,to prevent osteoporosis,and to treat bleeding problems.Since these can be the indications also in young women,especially with POI(premature ovarian insufficiency)or with surgical menopause(bilateral oophorectomy),also the old term"Hormone Replacement Therapy(HRT)”is still used.The effective component is the estrogen component without relevant difference in the efficacy of the various MHT-preparations.Additional preventive benefits are reduction of cardiovascular disease(including prevention of diabetes mellitus and metabolic syndrome),reduction of colon cancer,and perhaps also Alzheimer's disease,if started within a Kwindow of opportunity",i.e.in perimenopause or within 6-10 years after menopause.Primary indication for progestogen addition is to avoid the development of estrogen-dependent endometrial cancer,i.e.addition not recommended in hysterectomized women.Two main schedules,sequential-or continuous-combined estrogen/progestogen regimens,are used for treatment of bleeding problems.For this and for optimizing menstrual regulation detailed recommendations are given including proposed dosages for the available different progestogens if added to oral or transdermal estradiol in different estrogen dosages.The WHI-study demonstrated the main risks using MHT within a“worst-case scenario",i.e.start of MHT in old women with high risk for breast cancer and cardiovascular diseases,whereby only^conjugated equine estro-gens”and^medroxprogesterone acetate”have been tested.One main result was that the progestogen component is decisive for the risk of breast cancer,which according to own experimental research and observational studies may be reduced using the physiological progesterone or its isomer dydrogesterone.In addition we propose to push forward research for screening patients with increased breast cancer risk like we have done in the past decade demonstrating that certain membrane-bound receptors in breast cancer tissue or blood can increase this risk.To reduce the risk of venous thromboembolism and stroke,transdermal estradiol(gels,patches,)should be used,in free combination with progesterone or dydrogesterone as"golden standard"in patients with increased risk.To increase the compliance in our patients without special risks we mostly use the available fix-combinations of estradiol/dydrogesterone getting strong efficacy,good menstrual regulation or amenorrhea,respectively,but also other combinations may be indicated to take advantage of for example androgenic or antiandrogenic progestogens.
