BACKGROUND Postmenopausal women face an increased risk of cardiovascular disease(CVD)due to estrogen withdrawal,which exacerbates traditional cardiovascular risk factors such as dyslipidemia,glucose intolerance,and hy...BACKGROUND Postmenopausal women face an increased risk of cardiovascular disease(CVD)due to estrogen withdrawal,which exacerbates traditional cardiovascular risk factors such as dyslipidemia,glucose intolerance,and hypertension.Coronary Artery Calcium Score(CACS),a well-established marker of subclinical atherosclerosis,has emerged as a key predictor of adverse cardiovascular events.Despite the recognized association between menopause and heightened CVD risk,there remains a paucity of literature exploring the specific role of menopause in influencing CACS and its implications for cardiovascular morbidity and morta lity.AIM To examine the interplay between menopause,CACS,and cardiovascular health by synthesizing existing literature.METHODS A comprehensive literature search was conducted using PubMed and Google Scholar,focusing on studies that analyzed CACS in postmenopausal women,including the influence of factors such as hormone therapy,Triglyceride-Glucose index,bone mineral density,lipid metabolism,and type-1 diabetes.Data extraction and synthesis emphasized key patterns,metabolic influences,and potential mechanisms driving coronary calcification in menopause.RESULTS Findings suggest that menopause contributes to increased CACS through multiple pathways,including altered lipid metabolism,insulin resistance,and arterial stiffness.Additionally,premature menopause is associated with higher CACS and elevated CVD risk.While hormone replacement therapy(HRT)appears to have a protective effect against coronary calcification,further research is needed to clarify its long-term benefits and risks.CONCLUSION We introduce a novel framework combining CACS with metabolic and hormonal markers,and discuss estrogendriven mechanisms and HRT considerations in postmenopausal cardiovascular risk.This review underscores the need for targeted cardiovascular risk assessment in postmenopausal women,integrating CACS with other metabolic markers to improve early detection and prevention of CVD in this high-risk population.展开更多
Menopause is characterized by the cessation of menstruation and a decline in reproductive function,which is an intrinsic component of the aging process.However,it has been a frequently overlooked field of women’s hea...Menopause is characterized by the cessation of menstruation and a decline in reproductive function,which is an intrinsic component of the aging process.However,it has been a frequently overlooked field of women’s health.The oral and gut microbiota,constituting the largest ecosystem within the human body,are important for maintaining human health and notably contribute to the healthy aging of menopausal women.Therefore,a comprehensive review elucidating the impact of the gut and oral microbiota on menopause for healthy aging is of paramount importance.This paper presents the current understanding of the microbiome during menopause,with a particular focus on alterations in the oral and gut microbiota.Our study elucidates the complex interplay between the microbiome and sex hormone levels,explores microbial crosstalk dynamics,and investigates the associations between the microbiome and diseases linked to menopause.Additionally,this review explores the potential of microbiome-targeting therapies for managing menopause-related diseases.Given that menopause can last for approximately 30 years,gaining insights into how the microbiome and menopause interact could pave the way for innovative interventions,which may result in symptomatic relief from menopause and an increase in quality of life in women.展开更多
Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature ...Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature range—and women’s menopausal experiences. This study aims to interpret how these environmental factors influence the age of onset, severity of symptoms such as hot flushes and night sweats, and other long-term effects of menopause. Understanding these relationships addresses a significant gap in current knowledge and could guide future public health strategies. Methods: Through a comprehensive analysis of three cross-continental studies involving 1500 postmenopausal women from Spain, South American countries (Ecuador, Panama, Chile), various climates in Türkiye (Black Sea, Mediterranean, Continental), and the United Arab Emirates (UAE), this review evaluates diverse environmental impacts. Studies were selected based on their methodological rigor, geographical diversity, and focus on the unique and personal experiences of menopause. Data was collected via questionnaires and routine medical checkups, analyzing demographic, lifestyle, mood, symptom severity, and onset age variables. Results: Preliminary analysis indicates that 52.5% of participants from Spanish-speaking countries and the UAE reported vasomotor symptoms, with those in higher temperatures and lower altitudes experiencing exacerbated symptoms. Notably, Mediterranean climates were associated with an earlier menopause onset. Seasonal changes had minimal impact across all regions, suggesting lifestyle and other environmental factors play a more significant role. Conclusions: The findings highlight a clear link between climate-related geographical factors and the menopausal experience. Women in warmer, lower-altitude regions suffer more severe symptoms, while those in Mediterranean climates face earlier onset. The absence of significant seasonal variations across the studies underscores the predominance of lifestyle and environmental factors over purely climatic conditions. These insights pave the way for targeted interventions and support the need for further public health research into the complex interactions between climate change and menopause.展开更多
[Objectives]To investigate the mechanism of action of glyasperin A(GAA)in intervening menopause using network pharmacology and molecular docking technology.[Methods]All target names of the active ingredients were scre...[Objectives]To investigate the mechanism of action of glyasperin A(GAA)in intervening menopause using network pharmacology and molecular docking technology.[Methods]All target names of the active ingredients were screened using TCMSP,3D model molecules converted into SMILES online tool,Swiss target prediction and literature search.The relevant target genes corresponding to menopause were identified using the Genecards database.Venn 2.1.0 was then used to generate the corresponding Venn diagram.Finally,the protein-protein interaction(PPI)network was constructed using Cytoscape 3.9.1 software.The core targets that were screened underwent enrichment and analysis using the Gene Ontology(GO)biological process and KEGG pathways with the assistance of the DAVID database and bioinformatics.The molecular docking was then verified using AutoDock and Pymol software on the core targets.[Results]This study screened 100 target genes of active ingredients.In the PPI network,ESR1 and AKT1 were found to have a higher degree.The GO and KEGG enrichment analyses revealed that the biological processes primarily involved platelet activation,regulation of circadian rhythms,and regulation of mRNA stability.The signalling pathways included hepatitis B,cytotoxicity,and gastric cancer.The molecular docking results indicated that the key active ingredients and proteins bound well,as evidenced by their small binding energies.[Conclusions]Using a systematic network pharmacology approach,this study predicts the basic pharmacological effects and potential mechanisms of GAA in intervening menopause,which provides a foundation for further research on its pharmacological mechanisms.展开更多
Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, a...Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.展开更多
Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling...Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling the inclusion criteria from February 2014 to July 2014. This research was taken in the Endocrinology Clinic, Department of Obstetrics and Gynecology, Hasan Sadikin Hospital and Unpad’s Pharmacokinetic Laboratory. All objects were interviewed using menopause rating scale (MRS) questionnaire. Their urine samples were analyzed using high performance liquid chromatography (HPLC). Then the results of questionnaire and HPLC test were evaluated. Results: The result is 97 objects (98%) detected having menopausal symptoms, produced equol. There is significant correlation between the level of equol in post-menopausal women that showed correlation (-0.71) which mean the higher the equol level, the lower the MRS score (p < 0.001) that mean the symptom is milder. Conclusion: Equol level in menopause women urine is a good predictor to identify the level of menopause symptoms.展开更多
Objectives:To relate the symptoms of menopause and the use of medicinal plants.Methods:it was carried out a study that applied the qualitative method,by means of a bibliographical and documental revision in sources of...Objectives:To relate the symptoms of menopause and the use of medicinal plants.Methods:it was carried out a study that applied the qualitative method,by means of a bibliographical and documental revision in sources of digital data of wide reach(Google,SciELO,DOAJ,Latindex and SCOPUS).It was kept in mind the quality and the present time.Conclusions:It was based on the search of articles in Virtual the Library in Health(Spanish:BVS)and using the key words:menopause,medicinal plants,phytotherapy,menopause symptoms.展开更多
Menopause is one of the key physiological events in the female life and can increase the risk for a number of complex autoimmune, neurodegenerative, metabolic, and cardiovascular disorders. Circulating monocytes can d...Menopause is one of the key physiological events in the female life and can increase the risk for a number of complex autoimmune, neurodegenerative, metabolic, and cardiovascular disorders. Circulating monocytes can differentiate into various cell types and play an important role in tissue morphogenesis and immune response. We studied gene expression profiles of peripheral blood monocytes in healthy pre- and postmenopausal women using Affymetrix Human U133A GeneChip array that contains probes for -14,500 genes. Comparative analyses between the samples showed that 20 genes were up- and 20 were down-regulated. Of these genes, 28 were classified into six major GO categories relevant to such biological processes as the cell proliferation, immune response, cellular metabolism, and the others. The remaining 12 genes have yet unidentified biological functions. Our results support the hypothesis that functional state of circulating monocytes is indeed affected by menopause, and resulting changes may be determined through the genomewide gene expression profiling. Several differentially expressed genes identified in this study may be candidates for further studies of menopause-associated systemic autoimmune, neurodegenerative, and cardiovascular disorders. Our study is only the first attempt in this direction, but it lays a basis for further research.展开更多
Women gradually lose bone from the age of〜35 years,but around menopause,the rate of bone loss escalates due to increasing bone resorption and decreasing bone formation levels,rendering these individuals more prone to ...Women gradually lose bone from the age of〜35 years,but around menopause,the rate of bone loss escalates due to increasing bone resorption and decreasing bone formation levels,rendering these individuals more prone to developing osteoporosis.The increased osteoclast activity has been linked to a reduced estrogen level and other hormonal changes.However,it is unclear whether intrinsic changes in osteoclast precursors around menopause can also explain the increased osteoclast activity.Therefore,we set up a protocol in which CD14f blood monocytes were isolated from 49 female donors(40-66 years old).Cells were differentiated into osteoclasts,and data on differentiation and resorption activity were collected.Using multiple linear regression analyses combining in vitro and in vivo data,we found the following:(1)age and menopausal status correlate with aggressive osteoclastic bone resorption in vitro;(2)the type I procollagen N-terminal propeptide level in vivo inversely correlates with osteoclast resorption activity in vitro;(3)the protein level of mature cathepsin K in osteoclasts in vitro increases with age and menopause;and(4)the promoter of the gene encoding the dendritic cell-specific transmembrane protein is less methylated with age.We conclude that monocytes are"reprogrammed"in vivo,allowing them to"remember"age,the menopausal status,and the bone formation status in vitro,resulting in more aggressive osteoclasts.Our discovery suggests that this may be mediated through DNA methylation.We suggest that this may have clinical implications and could contribute to understanding individual differences in age-and menopause-induced bone loss.展开更多
A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in me...A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in men.Based on this fact,hormonal factors likely contribute to cognitive decline.In this sense,cognitive complaints are more common near menopause,a phase marked by a decrease in hormone levels,especially estrogen.Additionally,a tendency toward worsened cognitive performance has been reported in women during menopause.Vasomotor symptoms(hot flashes,sweating,and dizziness),vaginal dryness,irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration.Hormone therapy(HT),based on estrogen with or without progestogen,is the treatment of choice to relieve menopausal symptoms.The studies conducted to date have reported conflicting results regarding the effects of HT on cognition.This article reviews the main aspects of menopause and cognition,including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function.We present and discuss the findings of the central observational and interventional studies on HT and cognition.展开更多
There is increasing attention about managing the adverse effects of adjuvant therapy(Chemotherapy and anti-estrogen treatment)for breast cancer survivors(BCSs).Vulvovaginal atrophy(VVA),caused by decreased levels of c...There is increasing attention about managing the adverse effects of adjuvant therapy(Chemotherapy and anti-estrogen treatment)for breast cancer survivors(BCSs).Vulvovaginal atrophy(VVA),caused by decreased levels of circulating estrogen to urogenital receptors,is commonly experienced by this patients.Women receiving antiestrogen therapy,specifically aromatase inhibitors,often suffer from vaginal dryness,itching,irritation,dyspareunia,and dysuria,collectively known as genitourinary syndrome of menopause(GSM),that it can in turn lead to pain,discomfort,impairment of sexual function and negatively impact on multiple domains of quality of life(QoL).The worsening of QoL in these patients due to GSM symptoms can lead to discontinuation of hormone adjuvant therapies and therefore must be addressed properly.The diagnosis of VVA is confirmed through patient-reported symptoms and gynecological examination of external structures,introitus,and vaginal mucosa.Systemic estrogen treatment is contraindicated in BCSs.In these patients,GSM may be prevented,reduced and managed in most cases but this requires early recognition and appropriate treatment,but it is normally undertreated by oncologists because of fear of cancer recurrence,specifically when considering treatment with vaginal estrogen therapy(VET)because of unknown levels of systemic absorption of estradiol.Lifestyle modifications and nonhormonal treatments(vaginal moisturizers,lubricants,and gels)are the first-line treatment for GSM both in healthy women as BCSs,but when these are not effective for symptom relief,other options can be considered,such as VET,ospemifene,local androgens,intravaginal dehydroepiandrosterone(prasterone),or laser therapy(erbium or CO2 Laser).The present data suggest that these therapies are effective for VVA in BCSs;however,safety remains controversial and a there is a major concern with all of these treatments.We review current evidence for various nonpharmacologic and pharmacologic therapeutic modalities for GSM in BCSs and highlight the substantial gaps in the evidence for safe and effective therapies and the need for future research.We include recommendations for an approach to the management of GSM in women at high risk for breast cancer,women with estrogen-receptor positive breast cancers,women with triplenegative breast cancers,and women with metastatic disease.展开更多
There are numerous physiologic and biochemical changes in menopause that can affect the function of the liver and mediate the development of liver disease. Menopause represents a state of growing estrogen deficiency, ...There are numerous physiologic and biochemical changes in menopause that can affect the function of the liver and mediate the development of liver disease. Menopause represents a state of growing estrogen deficiency, and this loss of estrogen in the setting of physiologic aging increases the likelihood of mitochondrial dysfunction, cellular senescence, declining immune responses to injury, and disarray in the balance between antioxidant formation and oxidative stress. The sum effect of these changes can contribute to increased susceptibility to development of significant liver pathology, particularly nonalcoholic fatty liver disease and hepatocellular carcinoma, as well as accelerated progression of fibrosis in liver diseases, as has been particularly demonstrated in hepatitis C virus liver disease. Recognition of the unique nature of these mediating factors should raise suspicion for liver disease in perimenopausal and menopausal women and offer an opportunity for implementation of aggressive treatment measures so as to avoid progression of liver disease to cirrhosis, liver cancer and liver failure.展开更多
OBJECTIVE: To investigate the effect of Jianpi Bushen(JPBS) formula on aromatase inhibitor(AI)-associated bone loss after menopause.METHODS: Six-month-old female rats were randomly divided into 6 groups: a sham group,...OBJECTIVE: To investigate the effect of Jianpi Bushen(JPBS) formula on aromatase inhibitor(AI)-associated bone loss after menopause.METHODS: Six-month-old female rats were randomly divided into 6 groups: a sham group, an ovariectomized(OVX) group, an OVX treated with exemestane and 3 OVX groups each treated with a different dose of JPBS formula. Bone mineral density(BMD) at the lumbar vertebrae, histology, bone markers and serum levels of estrogen were assessed. Furthermore, a cohort study was conducted in 130 postmenopausal women with breast cancer that had undergone treatment with AIs. The subjects were given JPBS + caltrate D or caltrate D only, administered orally. BMD at the lumbar vertebrae and femoral neck and bone markers were evaluated in both control and herbal treatment groups at baseline and 12 months.RESULTS: Experimental results indicated that a high dose of JPBS significantly increased the trabecular bone area percentage(Tb.Ar %) and broadened the trabecular thickness(Tb.Th). The JPBS formula enriched the carboxyterrninal propeptide of type ipmcollagen and increased serum estrogen level significantly. The clinical investigation revealed that bone loss was decreased in the group treated with JPBS vs control(BMD T score at lumbar vertebrae, 3.9% increased vs 14.58% decreased, respectively, P = 0.004 and BMD T score on femoral neck, 1.8% decreased vs 22.45% decreased, respectively, P = 0.008). Besides, JPBS formula elevated Nmiddle osteocalcin and decreased type Ⅰ collagen cross-linked C-terminal telopeptide.CONCLUSION: JPBS formula prevented aromatase-inhibitor-associated bone loss after menopause by inhibiting bone resorption and promoting bone formation.展开更多
Mugwort has many traditional uses around the world. The Chumash Indians of California use it to treat imbalances that women may suffer such as premenstrual syndrome, dysmenorrhea and menopausal symptoms. The plant con...Mugwort has many traditional uses around the world. The Chumash Indians of California use it to treat imbalances that women may suffer such as premenstrual syndrome, dysmenorrhea and menopausal symptoms. The plant contains a sesquiterpene that appears to work through a serotonergic mechanism and may be beneficial for women. Mugwort therapy is safer for menopausal women than hormone replacement therapy. Children affected by attention deficit hyperactivity disorder benefit from mugwort therapy. There is no doubt that mugwort therapy is safer for these children than methylphenidate or amphetamine.展开更多
Menopause is one of the natural stages of life of women that is associated with instability of vasomotor, flushing, sweating, anxiety and depression, urogenital atrophy and urinary problems. The age range of physiolog...Menopause is one of the natural stages of life of women that is associated with instability of vasomotor, flushing, sweating, anxiety and depression, urogenital atrophy and urinary problems. The age range of physiological event is between 48 - 55 years old. With regard to the role of genetics, nutrition and geographical conditions of the age of menopause in Iranian women is lower than and among 46 - 53 years. With the increase in life expectancy in recent decades, duration of menopause is increased and almost involved a third of the life of women so special issues of this era have had more attention. Since menopause is not the end of the life of a woman and keep her physical and mental health and problems resulting from the process of menopause such as urinary problems and incontinence will lead to improve the quality of life in this period. Many studies have tried to find a therapy for postmenopausal women with stress urinary incontinence using hormone. So this article seeks to examine the effect of conjugated estrogen in stress urinary incontinence of menopausal women with using the library method. The survey showed that by starting menopause, decreasing estrogen causes atrophy of mucosa of urogenital and the lining of the urethra and bladder, estrogen causes to maintain muscle tonicity. Also sacral nerves are also rich in estrogen receptors and by estrogen deficiency, elasticity of the urinary system decreases. Estrogen deficiency causes excitability of nerves and frequency of urine. So estrogen can increase the resistance of the urethra, bladder sensory threshold and sensitivity in Adorno in smooth muscles of the urethra and the rest of detrusor.展开更多
The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affec...The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.展开更多
The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit （BMU） activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mech...The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit （BMU） activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mechanical- biological factors at BMU level was integrated with finite element analysis to simulate the changes of trabecular bone structure during menopause. Mechanical disuse and changes in the BMU activation threshold were applied to the model for the period from 4 years before to 4 years after menopause. The changes in bone volume fraction, trabecular thickness and fractal dimension of the trabecular structures were used to quantify the changes of trabecular bone in three different cases associated with mechanical disuse and BMU activation threshold. It was found that the changes in the simulated bone volume fraction were highly correlated and consistent with clinical data, and that the trabecular thickness reduced signi-ficantly during menopause and was highly linearly correlated with the bone volume fraction, and that the change trend of fractal dimension of the simulated trabecular structure was in correspondence with clinical observations. The numerical simulation in this paper may help to better understand the relationship between the bone morphology and the mecha-nical, as well as biological environment; and can provide a quantitative computational model and methodology for the numerical simulation of the bone structural morphological changes caused by the mechanical environment, and/or the biological environment.展开更多
We here review principal literature data about sleep disorders in menopause and we compared it with data obtained from a systematical screening of a sample of 161 menopausal women through questionnaires and clinical e...We here review principal literature data about sleep disorders in menopause and we compared it with data obtained from a systematical screening of a sample of 161 menopausal women through questionnaires and clinical evaluation. Our data reveal high occurrence of sleep disorders in this group of women if compared to literature data about general population, in the absence of statistically significant differences among the three menopausal stages: we find only a trend toward a higher risk of OSAS (Obstructive Sleep Apnea Syndrome) in PM versus early PM and MT. However, none of women in our survey underwent PSG (polysomnography), essential to confirm the diagnosis of OSAS and none was diagnosed with RLS (Restless Legs Syndrome) (prior to our survey) by the Gynecologist or General Pratictioner: these data reveal the issue of too low attention towards sleep disorders in this contest. Generic “sleep complaints” are clearly associated with depressed mood and worse-quality life along the menopausal process. In our sample, a non-specific definition of insomnia shows a peculiar relationship with a mood disorder: it is only variable not associated with higher BDI and KI scores, in fact. This might suggest that the conditions linked to depression of these women could be more specific sleep disturbances, such as RLS and OSAS.展开更多
Objectives: To estimate the age at natural menopause and the frequency of climacteric symptoms in Chinese women.Design: A cross-sectional study of randomly recruited 788 women, aged 45 to 55 years in Beijing.Results: ...Objectives: To estimate the age at natural menopause and the frequency of climacteric symptoms in Chinese women.Design: A cross-sectional study of randomly recruited 788 women, aged 45 to 55 years in Beijing.Results: The mean age at natural menopause was 48. 2 years. there was a trend that women with more parities, more babies breast fed or longer duration of breastfeeding had a delayed age at natural menopause. Higher socio-economic status was related to a later cessetion of menstruation. Vasomotor and psychological symptoms increased during menopause transition. However, psychological disorders tended to decrease after the menopause. Bone-joint problems were inversely associated with daily activi-ty or physical exercise. Perimenopausal women experienced the most frequent climacteric symptoms.Conclusion: The menopausal age was influenced by reproductive factors and socio-economic status-Vasomotor and psychological symptoms were associated with the menopausal status. However, bone-joint problems was not.展开更多
文摘BACKGROUND Postmenopausal women face an increased risk of cardiovascular disease(CVD)due to estrogen withdrawal,which exacerbates traditional cardiovascular risk factors such as dyslipidemia,glucose intolerance,and hypertension.Coronary Artery Calcium Score(CACS),a well-established marker of subclinical atherosclerosis,has emerged as a key predictor of adverse cardiovascular events.Despite the recognized association between menopause and heightened CVD risk,there remains a paucity of literature exploring the specific role of menopause in influencing CACS and its implications for cardiovascular morbidity and morta lity.AIM To examine the interplay between menopause,CACS,and cardiovascular health by synthesizing existing literature.METHODS A comprehensive literature search was conducted using PubMed and Google Scholar,focusing on studies that analyzed CACS in postmenopausal women,including the influence of factors such as hormone therapy,Triglyceride-Glucose index,bone mineral density,lipid metabolism,and type-1 diabetes.Data extraction and synthesis emphasized key patterns,metabolic influences,and potential mechanisms driving coronary calcification in menopause.RESULTS Findings suggest that menopause contributes to increased CACS through multiple pathways,including altered lipid metabolism,insulin resistance,and arterial stiffness.Additionally,premature menopause is associated with higher CACS and elevated CVD risk.While hormone replacement therapy(HRT)appears to have a protective effect against coronary calcification,further research is needed to clarify its long-term benefits and risks.CONCLUSION We introduce a novel framework combining CACS with metabolic and hormonal markers,and discuss estrogendriven mechanisms and HRT considerations in postmenopausal cardiovascular risk.This review underscores the need for targeted cardiovascular risk assessment in postmenopausal women,integrating CACS with other metabolic markers to improve early detection and prevention of CVD in this high-risk population.
基金supported by Science&Technology Fundamental Resources Investigation Program(2022FY100800)the CAMS Innovation Fund for Medical Sciences(CIFMS)(2021-12M-1-023/2023-12M-C&T-B-005)+1 种基金Funding for Reform and Development of Beijing Municipal Health Commissionthe National High Level Hospital Clinical Research Funding(2022-PUMCH-B-094).
文摘Menopause is characterized by the cessation of menstruation and a decline in reproductive function,which is an intrinsic component of the aging process.However,it has been a frequently overlooked field of women’s health.The oral and gut microbiota,constituting the largest ecosystem within the human body,are important for maintaining human health and notably contribute to the healthy aging of menopausal women.Therefore,a comprehensive review elucidating the impact of the gut and oral microbiota on menopause for healthy aging is of paramount importance.This paper presents the current understanding of the microbiome during menopause,with a particular focus on alterations in the oral and gut microbiota.Our study elucidates the complex interplay between the microbiome and sex hormone levels,explores microbial crosstalk dynamics,and investigates the associations between the microbiome and diseases linked to menopause.Additionally,this review explores the potential of microbiome-targeting therapies for managing menopause-related diseases.Given that menopause can last for approximately 30 years,gaining insights into how the microbiome and menopause interact could pave the way for innovative interventions,which may result in symptomatic relief from menopause and an increase in quality of life in women.
文摘Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature range—and women’s menopausal experiences. This study aims to interpret how these environmental factors influence the age of onset, severity of symptoms such as hot flushes and night sweats, and other long-term effects of menopause. Understanding these relationships addresses a significant gap in current knowledge and could guide future public health strategies. Methods: Through a comprehensive analysis of three cross-continental studies involving 1500 postmenopausal women from Spain, South American countries (Ecuador, Panama, Chile), various climates in Türkiye (Black Sea, Mediterranean, Continental), and the United Arab Emirates (UAE), this review evaluates diverse environmental impacts. Studies were selected based on their methodological rigor, geographical diversity, and focus on the unique and personal experiences of menopause. Data was collected via questionnaires and routine medical checkups, analyzing demographic, lifestyle, mood, symptom severity, and onset age variables. Results: Preliminary analysis indicates that 52.5% of participants from Spanish-speaking countries and the UAE reported vasomotor symptoms, with those in higher temperatures and lower altitudes experiencing exacerbated symptoms. Notably, Mediterranean climates were associated with an earlier menopause onset. Seasonal changes had minimal impact across all regions, suggesting lifestyle and other environmental factors play a more significant role. Conclusions: The findings highlight a clear link between climate-related geographical factors and the menopausal experience. Women in warmer, lower-altitude regions suffer more severe symptoms, while those in Mediterranean climates face earlier onset. The absence of significant seasonal variations across the studies underscores the predominance of lifestyle and environmental factors over purely climatic conditions. These insights pave the way for targeted interventions and support the need for further public health research into the complex interactions between climate change and menopause.
基金Supported by Project of Science and Technology Department of Guizhou Province ([2019]1401)Guizhou Administration of Traditional Chinese Medicine (QZYY-2021-03)Guizhou Provincial Health Commission (gzwkj2021-464).
文摘[Objectives]To investigate the mechanism of action of glyasperin A(GAA)in intervening menopause using network pharmacology and molecular docking technology.[Methods]All target names of the active ingredients were screened using TCMSP,3D model molecules converted into SMILES online tool,Swiss target prediction and literature search.The relevant target genes corresponding to menopause were identified using the Genecards database.Venn 2.1.0 was then used to generate the corresponding Venn diagram.Finally,the protein-protein interaction(PPI)network was constructed using Cytoscape 3.9.1 software.The core targets that were screened underwent enrichment and analysis using the Gene Ontology(GO)biological process and KEGG pathways with the assistance of the DAVID database and bioinformatics.The molecular docking was then verified using AutoDock and Pymol software on the core targets.[Results]This study screened 100 target genes of active ingredients.In the PPI network,ESR1 and AKT1 were found to have a higher degree.The GO and KEGG enrichment analyses revealed that the biological processes primarily involved platelet activation,regulation of circadian rhythms,and regulation of mRNA stability.The signalling pathways included hepatitis B,cytotoxicity,and gastric cancer.The molecular docking results indicated that the key active ingredients and proteins bound well,as evidenced by their small binding energies.[Conclusions]Using a systematic network pharmacology approach,this study predicts the basic pharmacological effects and potential mechanisms of GAA in intervening menopause,which provides a foundation for further research on its pharmacological mechanisms.
文摘Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.
文摘Objective: In order to identify the correlation between equol excreted through human urine and the symptom of menopause. Methods: The method used is cross sectional study examined to 99 postmenopausal women fulfilling the inclusion criteria from February 2014 to July 2014. This research was taken in the Endocrinology Clinic, Department of Obstetrics and Gynecology, Hasan Sadikin Hospital and Unpad’s Pharmacokinetic Laboratory. All objects were interviewed using menopause rating scale (MRS) questionnaire. Their urine samples were analyzed using high performance liquid chromatography (HPLC). Then the results of questionnaire and HPLC test were evaluated. Results: The result is 97 objects (98%) detected having menopausal symptoms, produced equol. There is significant correlation between the level of equol in post-menopausal women that showed correlation (-0.71) which mean the higher the equol level, the lower the MRS score (p < 0.001) that mean the symptom is milder. Conclusion: Equol level in menopause women urine is a good predictor to identify the level of menopause symptoms.
文摘Objectives:To relate the symptoms of menopause and the use of medicinal plants.Methods:it was carried out a study that applied the qualitative method,by means of a bibliographical and documental revision in sources of digital data of wide reach(Google,SciELO,DOAJ,Latindex and SCOPUS).It was kept in mind the quality and the present time.Conclusions:It was based on the search of articles in Virtual the Library in Health(Spanish:BVS)and using the key words:menopause,medicinal plants,phytotherapy,menopause symptoms.
文摘Menopause is one of the key physiological events in the female life and can increase the risk for a number of complex autoimmune, neurodegenerative, metabolic, and cardiovascular disorders. Circulating monocytes can differentiate into various cell types and play an important role in tissue morphogenesis and immune response. We studied gene expression profiles of peripheral blood monocytes in healthy pre- and postmenopausal women using Affymetrix Human U133A GeneChip array that contains probes for -14,500 genes. Comparative analyses between the samples showed that 20 genes were up- and 20 were down-regulated. Of these genes, 28 were classified into six major GO categories relevant to such biological processes as the cell proliferation, immune response, cellular metabolism, and the others. The remaining 12 genes have yet unidentified biological functions. Our results support the hypothesis that functional state of circulating monocytes is indeed affected by menopause, and resulting changes may be determined through the genomewide gene expression profiling. Several differentially expressed genes identified in this study may be candidates for further studies of menopause-associated systemic autoimmune, neurodegenerative, and cardiovascular disorders. Our study is only the first attempt in this direction, but it lays a basis for further research.
基金This study was financed by the Research Counsel of Lillebaelt Hospitalthe Region of Southern Denmark(15/24819)+3 种基金the Institute of Regional Health Research,University of Southern Denmarkthe Aase Ejnar Danielsen foundation(10-001835)the Fru Astrid Thaysens foundation(ATL 16/02)We particularly wish to thank Annette Ulv for her hard work recruiting the blood donors,Merete Villumsen for her excellent technical assistance on CTX and PINP measurements,and Hellen Kuasne for her kind support in primer selection for pyrosequencing.
文摘Women gradually lose bone from the age of〜35 years,but around menopause,the rate of bone loss escalates due to increasing bone resorption and decreasing bone formation levels,rendering these individuals more prone to developing osteoporosis.The increased osteoclast activity has been linked to a reduced estrogen level and other hormonal changes.However,it is unclear whether intrinsic changes in osteoclast precursors around menopause can also explain the increased osteoclast activity.Therefore,we set up a protocol in which CD14f blood monocytes were isolated from 49 female donors(40-66 years old).Cells were differentiated into osteoclasts,and data on differentiation and resorption activity were collected.Using multiple linear regression analyses combining in vitro and in vivo data,we found the following:(1)age and menopausal status correlate with aggressive osteoclastic bone resorption in vitro;(2)the type I procollagen N-terminal propeptide level in vivo inversely correlates with osteoclast resorption activity in vitro;(3)the protein level of mature cathepsin K in osteoclasts in vitro increases with age and menopause;and(4)the promoter of the gene encoding the dendritic cell-specific transmembrane protein is less methylated with age.We conclude that monocytes are"reprogrammed"in vivo,allowing them to"remember"age,the menopausal status,and the bone formation status in vitro,resulting in more aggressive osteoclasts.Our discovery suggests that this may be mediated through DNA methylation.We suggest that this may have clinical implications and could contribute to understanding individual differences in age-and menopause-induced bone loss.
基金Supported by National Council for Scientific and Technological Development of Brazil(CNPq),No.312400/2018-7.
文摘A severe impairment of cognitive function characterizes dementia.Mild cognitive impairment represents a transition between normal cognition and dementia.The frequency of cognitive changes is higher in women than in men.Based on this fact,hormonal factors likely contribute to cognitive decline.In this sense,cognitive complaints are more common near menopause,a phase marked by a decrease in hormone levels,especially estrogen.Additionally,a tendency toward worsened cognitive performance has been reported in women during menopause.Vasomotor symptoms(hot flashes,sweating,and dizziness),vaginal dryness,irritability and forgetfulness are common and associated with a progressive decrease in ovarian function and a subsequent reduction in the serum estrogen concentration.Hormone therapy(HT),based on estrogen with or without progestogen,is the treatment of choice to relieve menopausal symptoms.The studies conducted to date have reported conflicting results regarding the effects of HT on cognition.This article reviews the main aspects of menopause and cognition,including the neuroprotective role of estrogen and the relationship between menopausal symptoms and cognitive function.We present and discuss the findings of the central observational and interventional studies on HT and cognition.
文摘There is increasing attention about managing the adverse effects of adjuvant therapy(Chemotherapy and anti-estrogen treatment)for breast cancer survivors(BCSs).Vulvovaginal atrophy(VVA),caused by decreased levels of circulating estrogen to urogenital receptors,is commonly experienced by this patients.Women receiving antiestrogen therapy,specifically aromatase inhibitors,often suffer from vaginal dryness,itching,irritation,dyspareunia,and dysuria,collectively known as genitourinary syndrome of menopause(GSM),that it can in turn lead to pain,discomfort,impairment of sexual function and negatively impact on multiple domains of quality of life(QoL).The worsening of QoL in these patients due to GSM symptoms can lead to discontinuation of hormone adjuvant therapies and therefore must be addressed properly.The diagnosis of VVA is confirmed through patient-reported symptoms and gynecological examination of external structures,introitus,and vaginal mucosa.Systemic estrogen treatment is contraindicated in BCSs.In these patients,GSM may be prevented,reduced and managed in most cases but this requires early recognition and appropriate treatment,but it is normally undertreated by oncologists because of fear of cancer recurrence,specifically when considering treatment with vaginal estrogen therapy(VET)because of unknown levels of systemic absorption of estradiol.Lifestyle modifications and nonhormonal treatments(vaginal moisturizers,lubricants,and gels)are the first-line treatment for GSM both in healthy women as BCSs,but when these are not effective for symptom relief,other options can be considered,such as VET,ospemifene,local androgens,intravaginal dehydroepiandrosterone(prasterone),or laser therapy(erbium or CO2 Laser).The present data suggest that these therapies are effective for VVA in BCSs;however,safety remains controversial and a there is a major concern with all of these treatments.We review current evidence for various nonpharmacologic and pharmacologic therapeutic modalities for GSM in BCSs and highlight the substantial gaps in the evidence for safe and effective therapies and the need for future research.We include recommendations for an approach to the management of GSM in women at high risk for breast cancer,women with estrogen-receptor positive breast cancers,women with triplenegative breast cancers,and women with metastatic disease.
文摘There are numerous physiologic and biochemical changes in menopause that can affect the function of the liver and mediate the development of liver disease. Menopause represents a state of growing estrogen deficiency, and this loss of estrogen in the setting of physiologic aging increases the likelihood of mitochondrial dysfunction, cellular senescence, declining immune responses to injury, and disarray in the balance between antioxidant formation and oxidative stress. The sum effect of these changes can contribute to increased susceptibility to development of significant liver pathology, particularly nonalcoholic fatty liver disease and hepatocellular carcinoma, as well as accelerated progression of fibrosis in liver diseases, as has been particularly demonstrated in hepatitis C virus liver disease. Recognition of the unique nature of these mediating factors should raise suspicion for liver disease in perimenopausal and menopausal women and offer an opportunity for implementation of aggressive treatment measures so as to avoid progression of liver disease to cirrhosis, liver cancer and liver failure.
基金Supported by a TCM Scientific and Technological Research Fund of Guangdong Provincial Hospital of Chinese Medicine,People's Republic of China(No.2011KT371)
文摘OBJECTIVE: To investigate the effect of Jianpi Bushen(JPBS) formula on aromatase inhibitor(AI)-associated bone loss after menopause.METHODS: Six-month-old female rats were randomly divided into 6 groups: a sham group, an ovariectomized(OVX) group, an OVX treated with exemestane and 3 OVX groups each treated with a different dose of JPBS formula. Bone mineral density(BMD) at the lumbar vertebrae, histology, bone markers and serum levels of estrogen were assessed. Furthermore, a cohort study was conducted in 130 postmenopausal women with breast cancer that had undergone treatment with AIs. The subjects were given JPBS + caltrate D or caltrate D only, administered orally. BMD at the lumbar vertebrae and femoral neck and bone markers were evaluated in both control and herbal treatment groups at baseline and 12 months.RESULTS: Experimental results indicated that a high dose of JPBS significantly increased the trabecular bone area percentage(Tb.Ar %) and broadened the trabecular thickness(Tb.Th). The JPBS formula enriched the carboxyterrninal propeptide of type ipmcollagen and increased serum estrogen level significantly. The clinical investigation revealed that bone loss was decreased in the group treated with JPBS vs control(BMD T score at lumbar vertebrae, 3.9% increased vs 14.58% decreased, respectively, P = 0.004 and BMD T score on femoral neck, 1.8% decreased vs 22.45% decreased, respectively, P = 0.008). Besides, JPBS formula elevated Nmiddle osteocalcin and decreased type Ⅰ collagen cross-linked C-terminal telopeptide.CONCLUSION: JPBS formula prevented aromatase-inhibitor-associated bone loss after menopause by inhibiting bone resorption and promoting bone formation.
文摘Mugwort has many traditional uses around the world. The Chumash Indians of California use it to treat imbalances that women may suffer such as premenstrual syndrome, dysmenorrhea and menopausal symptoms. The plant contains a sesquiterpene that appears to work through a serotonergic mechanism and may be beneficial for women. Mugwort therapy is safer for menopausal women than hormone replacement therapy. Children affected by attention deficit hyperactivity disorder benefit from mugwort therapy. There is no doubt that mugwort therapy is safer for these children than methylphenidate or amphetamine.
文摘Menopause is one of the natural stages of life of women that is associated with instability of vasomotor, flushing, sweating, anxiety and depression, urogenital atrophy and urinary problems. The age range of physiological event is between 48 - 55 years old. With regard to the role of genetics, nutrition and geographical conditions of the age of menopause in Iranian women is lower than and among 46 - 53 years. With the increase in life expectancy in recent decades, duration of menopause is increased and almost involved a third of the life of women so special issues of this era have had more attention. Since menopause is not the end of the life of a woman and keep her physical and mental health and problems resulting from the process of menopause such as urinary problems and incontinence will lead to improve the quality of life in this period. Many studies have tried to find a therapy for postmenopausal women with stress urinary incontinence using hormone. So this article seeks to examine the effect of conjugated estrogen in stress urinary incontinence of menopausal women with using the library method. The survey showed that by starting menopause, decreasing estrogen causes atrophy of mucosa of urogenital and the lining of the urethra and bladder, estrogen causes to maintain muscle tonicity. Also sacral nerves are also rich in estrogen receptors and by estrogen deficiency, elasticity of the urinary system decreases. Estrogen deficiency causes excitability of nerves and frequency of urine. So estrogen can increase the resistance of the urethra, bladder sensory threshold and sensitivity in Adorno in smooth muscles of the urethra and the rest of detrusor.
文摘The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.
基金The Hong Kong Polytechnic University Research Grants (1-BB 81 and G-YX64)the National Natural Science Foundation of China (10502021 and 10529202)
文摘The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit （BMU） activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mechanical- biological factors at BMU level was integrated with finite element analysis to simulate the changes of trabecular bone structure during menopause. Mechanical disuse and changes in the BMU activation threshold were applied to the model for the period from 4 years before to 4 years after menopause. The changes in bone volume fraction, trabecular thickness and fractal dimension of the trabecular structures were used to quantify the changes of trabecular bone in three different cases associated with mechanical disuse and BMU activation threshold. It was found that the changes in the simulated bone volume fraction were highly correlated and consistent with clinical data, and that the trabecular thickness reduced signi-ficantly during menopause and was highly linearly correlated with the bone volume fraction, and that the change trend of fractal dimension of the simulated trabecular structure was in correspondence with clinical observations. The numerical simulation in this paper may help to better understand the relationship between the bone morphology and the mecha-nical, as well as biological environment; and can provide a quantitative computational model and methodology for the numerical simulation of the bone structural morphological changes caused by the mechanical environment, and/or the biological environment.
文摘We here review principal literature data about sleep disorders in menopause and we compared it with data obtained from a systematical screening of a sample of 161 menopausal women through questionnaires and clinical evaluation. Our data reveal high occurrence of sleep disorders in this group of women if compared to literature data about general population, in the absence of statistically significant differences among the three menopausal stages: we find only a trend toward a higher risk of OSAS (Obstructive Sleep Apnea Syndrome) in PM versus early PM and MT. However, none of women in our survey underwent PSG (polysomnography), essential to confirm the diagnosis of OSAS and none was diagnosed with RLS (Restless Legs Syndrome) (prior to our survey) by the Gynecologist or General Pratictioner: these data reveal the issue of too low attention towards sleep disorders in this contest. Generic “sleep complaints” are clearly associated with depressed mood and worse-quality life along the menopausal process. In our sample, a non-specific definition of insomnia shows a peculiar relationship with a mood disorder: it is only variable not associated with higher BDI and KI scores, in fact. This might suggest that the conditions linked to depression of these women could be more specific sleep disturbances, such as RLS and OSAS.
文摘Objectives: To estimate the age at natural menopause and the frequency of climacteric symptoms in Chinese women.Design: A cross-sectional study of randomly recruited 788 women, aged 45 to 55 years in Beijing.Results: The mean age at natural menopause was 48. 2 years. there was a trend that women with more parities, more babies breast fed or longer duration of breastfeeding had a delayed age at natural menopause. Higher socio-economic status was related to a later cessetion of menstruation. Vasomotor and psychological symptoms increased during menopause transition. However, psychological disorders tended to decrease after the menopause. Bone-joint problems were inversely associated with daily activi-ty or physical exercise. Perimenopausal women experienced the most frequent climacteric symptoms.Conclusion: The menopausal age was influenced by reproductive factors and socio-economic status-Vasomotor and psychological symptoms were associated with the menopausal status. However, bone-joint problems was not.
