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Maturitas Dec 2023The huge impact of climate change on humankind is multidimensional, and includes direct and indirect challenges to the physical, psychological and socio-cultural... (Review)
Review
The huge impact of climate change on humankind is multidimensional, and includes direct and indirect challenges to the physical, psychological and socio-cultural wellbeing. Women may be more vulnerable to climate-sensitive diseases, but little attention has been paid to specific needs and challenges associated with the menopause transition. The increase in average and extreme temperatures may modulate the manifestation of vasomotor symptoms; in particular, environmental temperature and seasonality may affect hot flushes and night sweats. However, more research is needed to define the impact of climate-related factors among the determinants influencing the individual experience of menopause. In addition, increased exposure to environmental pollution and toxins may also have a role in the modulation of ovarian aging mechanisms, possibly influencing timing of menopause. Finally, both air pollution and menopause transition are associated with unfavorable modifications of cardio-metabolic, bone and cognitive health, and account should be taken of these in the evaluation of the individual woman's health vulnerabilities. Overall, the evidence reported in this narrative review supports the need for specific strategies aimed at reducing the burden of climate and environmental change on menopausal women. Healthcare providers should promote behavioral measures that reduce anthropogenic climate change and at the same time have a beneficial role on several domains of physical and psychological wellbeing. From this perspective, menopause represents a golden moment to implement virtuous behaviors that will benefit at the same time women's longevity and the planet.
Topics: Female; Humans; Menopause; Hot Flashes; Women's Health; Sweating
PubMed: 37634295
DOI: 10.1016/j.maturitas.2023.107825 -
Maturitas Jul 2024The experience of menopause is not "one size fits all." Instead, biologic, physiologic, and sociocultural factors strongly affect women's experiences of menopause... (Review)
Review
The experience of menopause is not "one size fits all." Instead, biologic, physiologic, and sociocultural factors strongly affect women's experiences of menopause symptoms and the ways in which they would like to manage their care. By providing culturally sensitive and patient-centered care, clinicians may be able to improve menopause experiences for all of their patients. However, a literature review revealed a lack of information about culturally responsive care for menopause. The first objective of this review is to discuss the ways in which sociocultural identity influences menopause care-seeking and management. The second objective is to introduce a framework of culturally responsive care for menopause.
Topics: Humans; Female; Menopause; Culturally Competent Care; Patient-Centered Care; Patient Acceptance of Health Care
PubMed: 38663163
DOI: 10.1016/j.maturitas.2024.107995 -
Journal of Neuroinflammation Jun 2024A significant decrease in estrogen levels puts menopausal women at high risk for major depression, which remains difficult to cure despite its relatively clear etiology.... (Review)
Review
A significant decrease in estrogen levels puts menopausal women at high risk for major depression, which remains difficult to cure despite its relatively clear etiology. With the discovery of abnormally elevated inflammation in menopausal depressed women, immune imbalance has become a novel focus in the study of menopausal depression. In this paper, we examined the characteristics and possible mechanisms of immune imbalance caused by decreased estrogen levels during menopause and found that estrogen deficiency disrupted immune homeostasis, especially the levels of inflammatory cytokines through the ERα/ERβ/GPER-associated NLRP3/NF-κB signaling pathways. We also analyzed the destruction of the blood-brain barrier, dysfunction of neurotransmitters, blockade of BDNF synthesis, and attenuation of neuroplasticity caused by inflammatory cytokine activity, and investigated estrogen-immuno-neuromodulation disorders in menopausal depression. Current research suggests that drugs targeting inflammatory cytokines and NLRP3/NF-κB signaling molecules are promising for restoring homeostasis of the estrogen-immuno-neuromodulation system and may play a positive role in the intervention and treatment of menopausal depression.
Topics: Humans; Female; Menopause; Estrogens; Animals; Depression; NLR Family, Pyrin Domain-Containing 3 Protein; Signal Transduction; Cytokines
PubMed: 38898454
DOI: 10.1186/s12974-024-03152-1 -
Taiwanese Journal of Obstetrics &... Nov 2023
Topics: Female; Humans; Menopause; Postmenopause; Uterine Diseases; Endometrium; Ultrasonography
PubMed: 38008495
DOI: 10.1016/j.tjog.2023.09.015 -
Best Practice & Research. Clinical... May 2022Vasomotor symptoms (VMS) affect 2 out of 3 women during menopause and are highly disruptive and intolerable. They exert a negative impact on a woman's physical and... (Review)
Review
Vasomotor symptoms (VMS) affect 2 out of 3 women during menopause and are highly disruptive and intolerable. They exert a negative impact on a woman's physical and mental well-being and are considered a high clinical priority requiring effective treatment. Although hormone therapy remains the gold-standard treatment for hot flushes, it is associated with several side effects and contraindications. Furthermore, alternative treatments for VMS are currently less efficacious and have limited availability; therefore, a new medication to treat VMS would benefit millions of women worldwide. Neurokinin 3 receptor (NK3R) antagonists have recently been developed as novel therapeutic agents for the amelioration of VMS through their action on NK3 receptors within the hypothalamus and consequent regulation of the thermoregulatory centre. So far, three NK3R antagonists have been studied in menopausal women, which have demonstrated significant reductions in VMS frequency and severity and have shown their ability to transform patients' quality of life.
Topics: Female; Hot Flashes; Humans; Menopause; Quality of Life; Treatment Outcome
PubMed: 34965909
DOI: 10.1016/j.bpobgyn.2021.10.010 -
Frontiers in Neuroendocrinology Oct 2020Menopause, an inevitable event in a woman's life, significantly increases risk of bone resorption and diseases such as Alzheimer's, vascular dementia, cardiac arrest,... (Review)
Review
Menopause, an inevitable event in a woman's life, significantly increases risk of bone resorption and diseases such as Alzheimer's, vascular dementia, cardiac arrest, and stroke. The sole role of bones, as traditionally regarded, is to provide structural support for skeletal muscles and allow for ambulation, however this concept is becoming quickly outdated. New literature has emerged that suggests the bone cell-derived hormone osteocalcin (OCN) plays a pivotal role in cognition. OCN levels are correlated with bone mass density and bone turnover, and thus are strongly influenced by the changes associated with menopause. The goal of the current review is to discuss potential gaps in our knowledge of OCN and cognition, discrepancies in methods of OCN quantification, and therapies to enhance circulating OCN. A discussion on implementing exercise or low frequency vibration interventions at the menopausal transition to reduce risk and severity of neurological diseases and associated cognitive decline is included.
Topics: Brain; Cognition; Cognitive Dysfunction; Female; Humans; Menopause; Osteocalcin; Ovary
PubMed: 32781196
DOI: 10.1016/j.yfrne.2020.100861 -
Journal of Women's Health (2002) Dec 2017The clinical update serves as a brief review of recently published, high-impact, and potentially practice changing journal articles summarized for our readers. Topics... (Review)
Review
The clinical update serves as a brief review of recently published, high-impact, and potentially practice changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected four recent high-impact publications related to endocrine issues in women. We have chosen to highlight research on subclinical hypothyroidism during pregnancy and adverse pregnancy outcomes, including cognitive outcomes in offspring; the progression of metabolic syndrome severity during the menopausal transition; and the association of diabetes and metformin use with cancer risk and mortality.
Topics: Cardiovascular Diseases; Contraception; Endocrine System Diseases; Female; Humans; Hypothyroidism; Menopause; Pregnancy; Pregnancy Complications; Women's Health
PubMed: 29111858
DOI: 10.1089/jwh.2017.6434 -
Maturitas Jan 2020The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during... (Review)
Review
The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during the menopause. Nevertheless, the majority of women cope adequately with this reproductive transition phase and thus appear to be resilient. We assert that a variety of psychological factors influence the menopausal transition and result in an individual state on a continuum from successful adjustment to maladjustment. The purpose of this review is to offer a conceptual framework of resilience factors during the menopausal transition and to reveal which dimensions of resilience have already been verified for a healthy menopausal transition. We searched the databases PubMed and PsycINFO for studies investigating resilience factors during the menopausal transition which influence psychological and physical adjustment or maladjustment. A total of 23 articles were included. Altogether, we identified 15 different resilience factors, assessed with 23 different questionnaires. These factors can be grouped into six categories: core resilience, spirituality, control, optimism, emotion and self-related resilience. They are associated with a better adjustment to menopausal symptoms, milder physical symptoms, a better quality of and satisfaction with life, better well-being, less perceived stress and fewer depressive symptoms compared with women with lower levels of the respective resilience factors. Our conceptual framework includes resilience factors which have already been verified by empirical data. Further research is needed to determine whether these resilience factors can be assigned to a common factor and to incorporate biological resilience markers.
Topics: Adaptation, Psychological; Adult; Anxiety; Cross-Sectional Studies; Depression; Female; Humans; Longitudinal Studies; Menopause; Middle Aged; Perimenopause; Prevalence; Resilience, Psychological; Surveys and Questionnaires
PubMed: 31787147
DOI: 10.1016/j.maturitas.2019.10.015 -
Climacteric : the Journal of the... Jun 2023Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal...
Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal functioning and health. Persistent and distressing sleep disturbances across menopause can negatively impact daytime functioning and productivity, and increase risk for mental and physical health conditions. While multiple factors can disturb sleep, two unique factors in the context of menopause are vasomotor symptoms and the changing reproductive hormone environment. Vasomotor symptoms are associated with sleep disturbances and contribute significantly to awakenings and amount of time spent awake during the night. Even after accounting for vasomotor and depressive symptoms, lower estradiol and higher follicle stimulating hormone levels, indicative of menopause, are associated with sleep disturbance, particularly awakenings, suggesting that the hormone environment may directly affect sleep. Management strategies for clinically significant menopausal sleep disturbances include cognitive behavioral therapy for insomnia, which is effective and durable in treating menopausal insomnia. Hormone therapy alleviates sleep disturbances, particularly in the presence of disruptive vasomotor symptoms. Sleep disturbances have a significant impact on women's functioning and health, and there is a need for further research of the underlying mechanisms to advance effective preventative and treatment strategies that ensure optimal health and well-being of midlife women.
Topics: Female; Humans; Sleep Initiation and Maintenance Disorders; Hot Flashes; Menopause; Sleep; Estradiol; Sleep Wake Disorders
PubMed: 37011660
DOI: 10.1080/13697137.2023.2173569 -
Obstetrics and Gynecology Oct 2015Most menopausal women experience vasomotor symptoms with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective... (Review)
Review
Most menopausal women experience vasomotor symptoms with bothersome symptoms often lasting longer than one decade. Hormone therapy (HT) represents the most effective treatment for these symptoms with oral and transdermal estrogen formulations having comparable efficacy. Findings from the Women's Health Initiative and other recent randomized clinical trials have helped to clarify the benefits and risks of combination estrogen-progestin and estrogen-alone therapy. Absolute risks observed with HT tended to be small, especially in younger women. Neither regimen increased all-cause mortality rates. Given the lower rates of adverse events on HT among women close to menopause onset and at lower baseline risk of cardiovascular disease, risk stratification and personalized risk assessment appear to represent a sound strategy for optimizing the benefit-risk profile and safety of HT. Systemic HT should not be arbitrarily stopped at age 65 years; instead treatment duration should be individualized based on patients' risk profiles and personal preferences. Genitourinary syndrome of menopause represents a common condition that adversely affects the quality of life of many menopausal women. Without treatment, symptoms worsen over time. Low-dose vaginal estrogen represents highly effective treatment for this condition. Because custom-compounded hormones have not been tested for efficacy or safety, U.S. Food and Drug Administration (FDA)-approved HT is preferred. A low-dose formulation of paroxetine mesylate currently represents the only nonhormonal medication FDA-approved to treat vasomotor symptoms. Gynecologists and other clinicians who remain abreast of data addressing the benefit-risk profile of hormonal and nonhormonal treatments can help menopausal women make sound choices regarding management of menopausal symptoms.
Topics: Estrogen Replacement Therapy; Female; Female Urogenital Diseases; Hot Flashes; Humans; Menopause; Middle Aged; Vasomotor System
PubMed: 26348174
DOI: 10.1097/AOG.0000000000001058