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Journal of Mid-life Health 2022Perimenopause phase of a woman's life is featured by decline in the ovarian activity, predisposing her to several health consequences. The signs and symptoms of thyroid...
INTRODUCTION
Perimenopause phase of a woman's life is featured by decline in the ovarian activity, predisposing her to several health consequences. The signs and symptoms of thyroid disorders simulate those of menopausal features which may go unnoticed and can cause untoward complications in these women.
AIMS AND OBJECTIVE
The primary objective is to screen women of perimenopausal age for thyroid disorders. The secondary objective is to examine the variations in thyroid hormone levels in these women with advancing age.
MATERIALS AND METHODS
One hundred and forty-eight apparently healthy women between the age group of 46 and 55 years were study subjects. They were divided into, Group I which constituted women between 46 and 50 years and Group II consisted of women between 51 and 55 years. Thyroid profile comprising serum thyroid-stimulating hormone (TSH), serum total triiodothyronine (T), and serum total thyroxine (T) were estimated for all the women recruited in the study.
RESULTS
Subclinical hypothyroidism (SCH) and overt hypothyroidism (OH) were detected in 22 and 8 women who constituted 14.9% and 5.4%, respectively, of the total women populace. In Group I, it was noted that 17.1% and 1.8% of women were suffering from SCH and OH, respectively. In Group II, while 8.1% of the women had SCH, 16.2% of women had progressed to OH. TSH levels were significantly higher ( = 0.002) in women of Group II than in Group I, suggesting increase in TSH levels with advancing age.
CONCLUSION
Screening of perimenopausal women for thyroid disorders will assure timely detection and proper management which will aid in reducing the morbidity and associated complications.
PubMed: 37324792
DOI: 10.4103/jmh.jmh_67_22 -
Social Science & Medicine (1982) May 2015This scoping review synthesizes existing research on two major transitions in females' lives: puberty and perimenopause. These two periods of vast physiological change... (Review)
Review
This scoping review synthesizes existing research on two major transitions in females' lives: puberty and perimenopause. These two periods of vast physiological change demarcate the beginning and the end of the reproductive life cycle and are associated with major neuroendocrine reorganization across two key systems, the hypothalamic-pituitary-gonadal (HPG) axis the hypothalamus-pituitary-adrenal (HPA) axis. Despite growing evidence suggesting that the timing and experience of puberty and perimenopause are related to various physical and mental health outcomes (e.g., mood disorders, metabolism, cardiovascular health, autoimmune conditions, and cancer), these two processes are rarely examined together. In this paper, we bridge these disparate literatures to highlight similarities, isolate inconsistencies, and identify important areas for future research in women's health.
Topics: Age Factors; Autoimmune Diseases; Cardiovascular Diseases; Female; Health Status; Hormones; Humans; Hypothalamo-Hypophyseal System; Mental Health; Mortality; Neoplasms; Perimenopause; Pituitary-Adrenal System; Puberty; Sexual Maturation; Women's Health
PubMed: 25797100
DOI: 10.1016/j.socscimed.2015.03.031 -
American Journal of Physiology. Heart... Jun 2020There is a sharp rise in cardiovascular disease (CVD) risk and progression with the onset of menopause. The 4-vinylcyclohexene diepoxide (VCD) model of menopause...
There is a sharp rise in cardiovascular disease (CVD) risk and progression with the onset of menopause. The 4-vinylcyclohexene diepoxide (VCD) model of menopause recapitulates the natural, physiological transition through perimenopause to menopause. We hypothesized that menopausal female mice were more susceptible to CVD than pre- or perimenopausal females. Female mice were treated with VCD or vehicle for 20 consecutive days. Premenopausal, perimenopausal, and menopausal mice were administered angiotensin II (ANG II) or subjected to ischemia-reperfusion (I/R). Menopausal females were more susceptible to pathological ANG II-induced cardiac remodeling and cardiac injury from a myocardial infarction (MI), while perimenopausal, like premenopausal, females remained protected. Specifically, ANG II significantly elevated diastolic (130.9 ± 6.0 vs. 114.7 ± 6.2 mmHg) and systolic (156.9 ± 4.8 vs. 141.7 ± 5.0 mmHg) blood pressure and normalized cardiac mass (15.9 ± 1.0 vs. 7.7 ± 1.5%) to a greater extent in menopausal females compared with controls, whereas perimenopausal females demonstrated a similar elevation of diastolic (93.7 ± 2.9 vs. 100.5 ± 4.1 mmHg) and systolic (155.9 ± 7.3 vs. 152.3 ± 6.5 mmHg) blood pressure and normalized cardiac mass (8.3 ± 2.1 vs. 7.5 ± 1.4%) compared with controls. Similarly, menopausal females demonstrated a threefold increase in fibrosis measured by Picrosirus red staining. Finally, hearts of menopausal females (41 ± 5%) showed larger infarct sizes following I/R injury than perimenopausal (18.0 ± 5.6%) and premenopausal (16.2 ± 3.3, 20.1 ± 4.8%) groups. Using the VCD model of menopause, we provide evidence that menopausal females were more susceptible to pathological cardiac remodeling. We suggest that the VCD model of menopause may be critical to better elucidate cellular and molecular mechanisms underlying the transition to CVD susceptibility in menopausal women. Before menopause, women are protected against cardiovascular disease (CVD) compared with age-matched men; this protection is gradually lost after menopause. We present the first evidence that demonstrates menopausal females are more susceptible to pathological cardiac remodeling while perimenopausal and cycling females are not. The VCD model permits appropriate examination of how increased susceptibility to the pathological process of cardiac remodeling accelerates from pre- to perimenopause to menopause.
Topics: Angiotensin II; Animals; Atrial Remodeling; Blood Pressure; Cardiovascular Diseases; Cyclohexenes; Female; Menopause; Mice; Models, Animal; Vinyl Compounds
PubMed: 32383991
DOI: 10.1152/ajpheart.00555.2019 -
Journal of Traditional Chinese Medicine... Jun 2023To examine, dissect, and understand the molecular mechanisms and combinatorial effects of Zuogui (, ZGP) and Yougui pills (, YGP) in 4-vinyl cyclohexene diepoxide...
OBJECTIVE
To examine, dissect, and understand the molecular mechanisms and combinatorial effects of Zuogui (, ZGP) and Yougui pills (, YGP) in 4-vinyl cyclohexene diepoxide (4-VCD)-induced Perimenopausal syndrome (PMS).
METHODS
Using the 4-VCD-induced PMS mouse model, uterine and ovary index were measured, and serum sex steroidal hormone levels were evaluated after treatment with ZGP, YGP, ZGP + YGP, estradiol valerate (EV), and Gengnian An (gengnianan, GNA). Histopathological examinations, ingredient-target network predictions, western blotting, and real-time quantitative polymerase chain reaction (RT-qPCR) analyses were performed to ascertain the possible pharmacological effects and molecular mechanisms of ZYP and YGP.
RESULTS
Treatment with ZGP and YGP remarkably improves estrous cyclicity and prevents pathological damage to the uterus. Also, altered sex hormones, including AMH, E2, FSH, LH, P, and T, were restored to normal levels after ZGP and YGP administration. Ingredient-target network analysis showed that the 5 ingredients common to the ZGP and YGP formula modulate 53 targets shared with PMS. Pathway-enrichment analysis further predicted that ZGY and YGP likely regulate of apoptosis and other essential pathways during PMS. In-vivo studies showed that ZGP and YGP suppress PMS modulating apoptosis through decreasing Caspase-3 and Bcl-2-associated X (Bax) levels and increasing B-cell lymphoma-2 (Bcl-2)/Bax and Bcl-2 levels. Importantly, ZGP + YGP treatment modulation effects were somewhat or significantly better compared to ZGP or YGP alone treatment.
CONCLUSION
ZGP and YGP represent novel anti-PMS agents whose effects involve restoring altered hormonal levels, protecting the uterus, and regulating apoptosis.
Topics: Female; Mice; Animals; Perimenopause; bcl-2-Associated X Protein; Drugs, Chinese Herbal; Gonadal Steroid Hormones; Apoptosis
PubMed: 37147748
DOI: 10.19852/j.cnki.jtcm.20220507.001 -
Journal of Translational Medicine Mar 2022Osteoporosis is a disease threatening the health of millions of individuals. Melatonin is found to be a potential anti-osteoporosis drug. However, whether melatonin...
BACKGROUND
Osteoporosis is a disease threatening the health of millions of individuals. Melatonin is found to be a potential anti-osteoporosis drug. However, whether melatonin plays a role against osteoporosis at different stages of the menopause and the underlying mechanisms are unknown.
METHODS
Ovariectomy was utilized as a model of perimenopausal and postmenopausal osteoporosis. A total of 100 mg/kg melatonin, or solvent alone, was added to the drinking water of the rats over 8 weeks. Perimenopausal rats immediately received intervention following ovariectomy while postmenopausal rats received intervention 8 weeks after ovariectomy. All rats underwent overdose anesthesia following intervention after which blood samples and femurs were collected for further analysis. Rat femurs were scanned using micro-CT and examined histologically. The serum levels of melatonin and osteogenic biochemical markers were measured and the expression of osteogenesis-associated genes (Runx2, Sp7) were quantified by real-time quantitative PCR. Alkaline phosphatase (ALP) activity and the gene expression (Col1a1, Runx2, Alpl, and Bglap) were measured after bone marrow mesenchymal stem cells (BMSCs) were osteogenically induced, both with and without melatonin in vitro. ALP staining and Alizarin Red S staining were used to identify osteogenesis.
RESULTS
Analysis by micro-CT and histological staining demonstrated that bone mass decreased and bone microarchitecture deteriorated over time after ovariectomy. Intervention with melatonin increased bone mass in normal, perimenopausal, and postmenopausal osteoporotic rats. Serum levels of ALP continuously increased after ovariectomy while osteocalcin levels initially rose, then decreased. Melatonin increased the serum levels of ALP and osteocalcin and mRNA expression levels of Runx2 and Sp7 in normal and postmenopausal rats, the opposite of the markers in perimenopausal rats. In vitro study demonstrated that 100 μmol/L melatonin increased the mRNA expression of Col1a1, Runx2, and Alpl three and/or seven days after intervention, and Alpl and Bglap 14 d after intervention. Melatonin increased ALP activity and the extent of ALP and matrix mineralization in the late stage of osteogenesis.
CONCLUSIONS
Bone mass continuously decreased after ovariectomy, while melatonin increased bone mass and ameliorated bone metabolism in normal, perimenopausal, and postmenopausal osteoporotic rats due to the induction of osteogenic differentiation in BMSCs.
Topics: Animals; Female; Melatonin; Mesenchymal Stem Cells; Osteogenesis; Perimenopause; Postmenopause; Rats
PubMed: 35296324
DOI: 10.1186/s12967-022-03341-7 -
Menopause (New York, N.Y.) Jun 2018HIV-infected women are burdened by depression and anxiety, which may impact adherence to antiretroviral therapy and overall quality of life. Yet, little is known about...
OBJECTIVE
HIV-infected women are burdened by depression and anxiety, which may impact adherence to antiretroviral therapy and overall quality of life. Yet, little is known about the scope of psychological symptoms in the growing number of HIV-infected women reaching menopause, when affective symptoms are more prevalent in the general population. We conducted a longitudinal study to compare affective symptoms between perimenopausal HIV-infected and non-HIV-infected women.
METHODS
The Center for Epidemiologic Studies Depression Scale (CES-D), and the Generalized Anxiety Disorder scale (GAD-7) were completed at baseline and 12 months among 33 HIV-infected and 33 non-HIV-infected perimenopausal women matched by race, age, menstrual patterns, and BMI. Linear regression models estimated the relationship of baseline GAD-7 and CES-D scores with clinical factors.
RESULTS
All women were perimenopausal at baseline, and the vast majority remained perimenopausal throughout follow-up. HIV status was associated with higher baseline CES-D scores (median [interquartile range] 21 [12, 29] vs 10 [5, 14]; P = 0.03) and GAD-7 scores (7 [5, 15] vs 2 [1, 7]; P = 0.01), controlling for smoking, substance use, and antidepressant use. Depressive symptoms and anxiety remained significantly higher in the HIV-infected women at 12 months (P ≤ 0.01). Significant relationships of depressive symptoms (P = 0.048) and anxiety (P = 0.02) with hot flash severity were also observed.
CONCLUSIONS
Perimenopausal HIV-infected women experienced a disproportionately high level of affective symptom burden over a 12-month observation period. Given the potential for these factors to influence adherence to HIV clinical care and quality of life, careful assessment and referral for treatment of these symptoms is essential.
Topics: Antiretroviral Therapy, Highly Active; Cross-Sectional Studies; Depressive Disorder; Female; HIV Infections; Hot Flashes; Humans; Longitudinal Studies; Middle Aged; Patient Compliance; Perimenopause; Prospective Studies; Quality of Life; United States
PubMed: 29381662
DOI: 10.1097/GME.0000000000001058 -
Medicine Nov 2023Perimenopausal insomnia (PMI) is a relatively common menopausal symptom that can cause serious problems for the women themselves and their families. Today, the world is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Perimenopausal insomnia (PMI) is a relatively common menopausal symptom that can cause serious problems for the women themselves and their families. Today, the world is facing the trend and challenges of an aging population. It is reported that about 1.5 million women worldwide enter menopause every year, with sleep disorder identified as a core symptom. The efficacy of acupuncture combined with traditional Chinese medicine for treating PMI has been recognized by patients and doctors.
METHODS
We searched 8 databases to identify 15 randomized controlled trials evaluating the effects of acupuncture combined with traditional Chinese medicine on sleep in patients with PMI compared with Western medicine alone. Subsequently, data extraction and analysis were performed to assess the quality and risk of bias of the study method design, and a meta-analysis of the data was performed.
RESULTS
This study included 15 randomized controlled trials involving 1188 patients with PMI. The results show that acupuncture combined with traditional Chinese medicine seems to be more effective than Western medicine in the treatment of PMI: efficiency (RR: 1.18; 95% CI: 1.08, 1.29; P = .001); the Pittsburgh Sleep Quality Index (PSQI) (WMD: -2.77; 95% CI: 4.15-1.39; P < .0001); follicle-stimulating hormone (FSH) (WMD: -31.45; 95% CI: 42.7-20.2; P < .001) and the Hamilton Anxiety Score (HAMA) (WMD: -2.62, 95% CI: -3.93, -1.32; P < .0001). Compared with western medicine, E2 (WMD: 5.07; 95% CI: 5.78-15.92; P = .36) and LH (WMD: -4.86; 95% CI: 11.5-1.78; P = .151) had no difference.
CONCLUSION
The current analysis results show that acupuncture combined with Chinese medicine seems to have a more positive effect than western medicine alone in improving sleep and FSHF in PMI patients, but no difference has been found in improving E2 and LH. This study provides a basis for acupuncture combined with Chinese medicine to treat PMI. However, due to the higher risk of evaluation in included studies, more rigorous randomized controlled trials and higher quality studies are needed to validate included studies.
Topics: Humans; Female; Aged; Drugs, Chinese Herbal; Perimenopause; Sleep Initiation and Maintenance Disorders; Acupuncture Therapy; Medicine, Chinese Traditional; Randomized Controlled Trials as Topic
PubMed: 37960761
DOI: 10.1097/MD.0000000000035942 -
Frontiers in Endocrinology 2023The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different... (Review)
Review
The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.
Topics: Animals; Female; Humans; Depression; Hypothalamo-Hypophyseal System; Pituitary-Adrenal System; Menstrual Cycle; Premenstrual Dysphoric Disorder; Life Cycle Stages
PubMed: 38149098
DOI: 10.3389/fendo.2023.1295261 -
Psychiatry Investigation Jan 2023Menopause symptoms can vary in type, duration, and severity. The purpose of this study was to investigate the key factors predicting severe symptoms among Korean...
OBJECTIVE
Menopause symptoms can vary in type, duration, and severity. The purpose of this study was to investigate the key factors predicting severe symptoms among Korean perimenopausal women with various demographic data, obstetric and psychiatric histories, and menopausal symptoms screening scale scores.
METHODS
Data were collected from 1,060 women, and 4 latent classes were identified using latent profile analysis, with 6 major categories of menopausal complaints. Among the 4 classes, we selectively used data from the "all unimpaired" and "all impaired" groups. Menopause rating scale (MRS), sociodemographic, obstetric, and psychiatric factors were assessed, and hierarchical logistic regression analyses were conducted with the "all impaired" group as a dependent variable.
RESULTS
Marital status and scores on the psychological and somatic subscales of the MRS were statistically related to being in the "all impaired" group. Otherwise, family history of menopausal symptoms, menarche age, and history of other psychiatric disorders were not statistically significant predictors of being in the "all impaired" group.
CONCLUSION
The psychological and somatic subscales of the MRS predict the severity of perimenopausal syndrome better than obstetric and psychiatric history do among Korean perimenopausal women. Psychological and somatic symptoms as well as genitourinary symptoms in menopausal patients should be closely evaluated.
PubMed: 36721882
DOI: 10.30773/pi.2022.0249 -
Frontiers in Psychiatry 2022The perimenopause is associated with an increased risk of developing a major depressive (MD) episode. The biological changes occurring during perimenopause responsible...
A comparative magnetic resonance spectroscopy study of GABA+ and glutamate referenced to creatine and phosphocreatine in the left dorsolateral prefrontal cortex of perimenopausal women and women of reproductive age.
OBJECTIVE
The perimenopause is associated with an increased risk of developing a major depressive (MD) episode. The biological changes occurring during perimenopause responsible for this increased risk of depression remain to be elucidated. Postmortem and magnetic resonance spectroscopy (MRS) studies have revealed decreased gamma-aminobutyric acid (GABA) and glutamate (Glu) levels in the dorsolateral prefrontal cortex (DLPFC) of MD patients. The objective of this study was to compare LDLPFC GABA+ and Glu ratios (referenced to creatine and phosphocreatine) in healthy reproductive-aged (RD) and perimenopausal (PM) women.
MATERIALS AND METHODS
Eighteen healthy PM and 20 RD women were included in the study. Our dependent variables, LDLPFC Glu and GABA+ ratios which include homocarnosine and macromolecules, were measured MRS, using a 3 Tesla magnet. Absence of current or past psychiatric diagnosis was confirmed a structured interview. RD participants were scanned during the early follicular phase of the menstrual cycle (MC). PM women were scanned outside of ovulatory cycles.
RESULTS
Mean LDLPFC GABA+ and Glu ratios were not statistically different between the PM group and RD group (PM mean = 0.10 ± 0.06, RD mean = 0.11 ± 0.04, = -0.383, = 36, = -0.13, = 0.70) (PM mean = 0.56 ± 0.06, RD mean = 0.57 ± 0.05, = -0.794, = 36, = -0.26, = 0.43), respectively. The perimenopause demarcates the end of the reproductive life. Unsurprisingly PM women were older than RD women (PM women: 48.8 ± 3.55 years, range 41-53 years old; RD women: 31.5 ± 9.66 years, range 18-47 years old) ( < 0.001). This inherent entanglement of group and age is a limitation of our study.
CONCLUSION
Contrary to our previous findings of decreased GABA+ and Glu in the medial prefrontal cortex in perimenopausal women, the perimenopause is not associated with decreased GABA+ or Glu ratios in the LDLPFC. This suggests that brain areas playing a role in MD display different sensitivity to the female hormones fluctuations associated with perimenopause.
PubMed: 36386999
DOI: 10.3389/fpsyt.2022.989050