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Menopause (New York, N.Y.) Aug 2023Insomnia is common in midlife women. The efficacy and safety of lemborexant (LEM), a competitive dual orexin receptor antagonist, was assessed for 12 months in a... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
Insomnia is common in midlife women. The efficacy and safety of lemborexant (LEM), a competitive dual orexin receptor antagonist, was assessed for 12 months in a subgroup of midlife women (age, 40-58 y) from Study E2006-G000-303 (Study 303; SUNRISE-2).
METHODS
This was a randomized, double-blind, placebo (PBO)-controlled (first 6 mo) study of adults with insomnia disorder ( N = 949). During treatment period 1 (TP1), participants received PBO or LEM 5 mg (LEM5) or 10 mg (LEM10). During TP2 (second 6 mo), LEM participants continued their assigned dose; PBO participants were rerandomized to LEM5 or LEM10. Assessments included patient-reported sleep- and fatigue-related measures and treatment-emergent adverse events.
RESULTS
The midlife female subgroup comprised 280 of 949 participants (TP1: PBO, n = 90 of 318 [28.3%]; LEM5, n = 82 of 316 [25.9%]; LEM10, n = 108 of 315 [34.3%]). At 6 months, median changes from baseline in subjective sleep-onset latency (in minutes) were -17.9, -20.7, and - 30.4 for PBO, LEM5, and LEM10 (vs PBO: LEM5, P = not significant; LEM10, P = 0.0310). At 6 months, mean changes from baseline in subjective wake after sleep onset (in minutes) were -37.0 (59.6), -50.1 (74.5), and -54.5 (65.4) for PBO, LEM5, and LEM10 (vs PBO: LEM5 and LEM10, P = not significant), with benefits sustained through 12 months. Greater decreases from baseline (improvement) in Insomnia Severity Index total score and Fatigue Severity Scale total score were seen with LEM versus PBO at 6 months; benefits continued through 12 months. Most treatment-emergent adverse events were mild to moderate in severity.
CONCLUSIONS
Consistent with the total population, subjective sleep parameters improved, and improvement was sustained over time in midlife women. LEM was well tolerated, suggesting that LEM may be a potential treatment option for midlife women with insomnia.
Topics: Adult; Female; Humans; Middle Aged; Double-Blind Method; Pyridines; Pyrimidines; Sleep Initiation and Maintenance Disorders; Treatment Outcome; Menopause; Perimenopause
PubMed: 37339396
DOI: 10.1097/GME.0000000000002209 -
BMC Women's Health May 2022The perimenopausal period is associated with a higher risk of various mood disorders. Similarly, although resting-state electroencephalogram (rsEEG) brain oscillatory...
BACKGROUND
The perimenopausal period is associated with a higher risk of various mood disorders. Similarly, although resting-state electroencephalogram (rsEEG) brain oscillatory activity has been associated with various neuropsychological disorders and behaviours, these issues have not been assessed in perimenopausal women. This study aimed to evaluate quantitative relationships between psychometric properties and rsEEG rhythms (delta, theta, alpha, beta and gamma powers) in perimenopausal women.
METHODS
A cross-sectional correlational descriptive study was conducted to quantitatively analyze the correlations between rsEEG low-to-high band activities (delta, theta, alpha, beta, and gamma powers) and psychometric properties in 14 perimenopausal women. Participants completed a psychological inventory comprising the State Anxiety Inventory (SAI), Depression Inventory (DI), Behavioural Inhibition Scale (BIS) and short-form UPPS Impulsive Behaviour Scale (IS) before EEG recording.
RESULTS
Results showed that impulsivity was positively related to the beta power, symmetrical at most channels (frontal, temporal, central, parietal and occipital regions; p < .05); but did not related to the delta, theta, alpha and gamma powers. The brainwave low-to-high bands, delta, theta, alpha, beta and gamma power were not associated with DI, SAI or BIS scores.
CONCLUSIONS
This study's findings propose that significantly enhanced resting-state beta activity is a trait of impulsivity in perimenopausal women. Therefore, results have potential implications for the preclinical or clinical evaluation of these issues in perimenopausal women.
Topics: Anxiety; Cross-Sectional Studies; Electroencephalography; Female; Humans; Perimenopause; Psychometrics
PubMed: 35538572
DOI: 10.1186/s12905-022-01729-7 -
BMC Women's Health Mar 2021Menopausal transition exposes women to an early decline in muscle force and motor function. Changes in muscle quality and function, especially in lower limbs, are...
BACKGROUND
Menopausal transition exposes women to an early decline in muscle force and motor function. Changes in muscle quality and function, especially in lower limbs, are crucial, as they expose individuals to increased risk of falls. To elucidate some of the related neuromuscular mechanisms, we investigated cortical inhibition and peripheral muscle twitch force potentiation in women during the early and late stages of perimenopause.
METHODS
Participants were 63 women aged 48-55 years categorized as early (EP, n = 25) or late (LP, n = 38) perimenopausal according to serum follicle-stimulating hormone (FSH) levels and menstrual diaries. EP women had an irregular menstrual cycle and FSH < 25 IU/L, while LP women had an irregular cycle and > 25 IU/L. We examined motor evoked potential (MEP) and silent period (SP) elicited by transcranial magnetic stimulation (TMS), in the tibialis anterior muscle at 20%, 40%, and 60% of maximal voluntary contraction (MVC) levels, and twitch force potentiation in plantar flexors.
RESULTS
EP group showed a longer SP duration in 40% MVC condition and larger motor evoked potential amplitude in 20% MVC condition compared to the LP group. No group difference was detected in twitch force potentiation; however, it correlated negatively with FSH levels. Other factors, such as age, height, body mass index, or physical activity did not explain group differences.
CONCLUSIONS
Our preliminary results indicate subtle modulation in both TMS-induced inhibitory and excitatory mechanisms and twitch force potentiation in women already in the late perimenopausal stage. This suggests that the reduction of estrogens may have an accelerating role in the aging process of neuromuscular control.
Topics: Evoked Potentials, Motor; Female; Humans; Menopause; Muscle, Skeletal; Perimenopause; Transcranial Magnetic Stimulation
PubMed: 33789654
DOI: 10.1186/s12905-021-01275-8 -
Journal of Mid-life Health 2018Perimenopause and menopause is an integral part of every woman's life constituting about 30% of the Indian female population. Hypothyroidism is a condition that can...
INTRODUCTION
Perimenopause and menopause is an integral part of every woman's life constituting about 30% of the Indian female population. Hypothyroidism is a condition that can mimic menopausal symptoms very often. Therefore, routine screening of thyroid function in the climacteric and menopausal period to determine subclinical thyroid disease can be recommended.
MATERIALS AND METHODS
With this background, we conducted a prospective study in our institute, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, to evaluate the abnormal thyroid function tests in perimenopausal and postmenopausal women aged 40-80 years.
RESULTS AND OBSERVATIONS
Subclinical hypothyroidism status increases from the age group of 40-70 years and hypothyroidism increases in slow frequency from 40 to 70 years after that there is plateauing. Interestingly, the frequency of hyperthyroidism remains same in all the age groups.
CONCLUSION
Looking at the increased risks of thyroid disorders with age, screening of thyroid disorders can be started at the age of 40 years with estimation of serum levels of TSH. This gives us the opportunity to treat both subclinical and clinical hypothyroidism and hyperthyroidism women.
PubMed: 30294181
DOI: 10.4103/jmh.JMH_21_18 -
BMC Psychiatry Feb 2023Women in perimenopause are vulnerable to depressive symptoms, and physical activity was reported to be a potential protective factor. The trajectories of physical...
BACKGROUND
Women in perimenopause are vulnerable to depressive symptoms, and physical activity was reported to be a potential protective factor. The trajectories of physical activity and depressive symptoms over time and their longitudinal relationships in Chinese perimenopausal women have not been explored yet, leaving a research gap hindering us from better understanding and managing perimenopause depressive symptoms.
METHODS
A multi-center prospective longitudinal study was conducted in four cities in Sichuan Province, China. Depressive symptoms and physical activity in perimenopausal women were collected in March 2019, June 2019, September 2019, and December 2019, respectively. Multivariable linear regression by generalized estimation equation was used to identify the relevant factors associated with depressive symptoms and physical activity. A four-wave autoregressive and cross-lagged panel model was performed to explore their longitudinal relationships.
RESULTS
A total of 1875 women who completed the four-wave data collection were included in the data analysis. Depressive symptoms exacerbated over time and were associated with women's age, monthly income, marital status, chronic disease, and negative life events. Physical activity decreased over time and was associated with educational background and monthly income. According to the cross-lagged panel model, perimenopausal women with more severe depressive symptoms tended to be less physically active, and similarly, perimenopausal women with less physical activity were more prone to report more severe depressive symptoms.
CONCLUSION
The cross-lagged panel model disclosed longitudinal bidirectional relationships between depressive symptoms and physical activity in perimenopausal women. Appropriate physical activity should be recommended for perimenopausal women to improve their mental well-being. Tailored physical activity duration and maintenance measures should be proposed based on different sociodemographic statuses.
Topics: Female; Humans; Perimenopause; Depression; Longitudinal Studies; Prospective Studies; Independent Living; Exercise; Surveys and Questionnaires
PubMed: 36750920
DOI: 10.1186/s12888-023-04591-5 -
Annals of Palliative Medicine Jul 2022The quality of life of women is seriously affected by perimenopausal symptoms and related diseases. Clinical nurses often suffer from job burnout due to high pressure...
BACKGROUND
The quality of life of women is seriously affected by perimenopausal symptoms and related diseases. Clinical nurses often suffer from job burnout due to high pressure and intensity of work and life, which is easy to induce and aggravate perimenopausal syndrome. Nursing occupational environment varies greatly in different economic regions, but relevant studies are limited to northern cities, and are often confined to the second and third grade hospitals or a hospital in a certain region, lacking multi-center studies on hospitals of different grades. Therefore, it is necessary to understand the occurrence of perimenopausal syndrome in clinical nurses in Chongqing and its influencing factors, so as to provide reference for managers to take targeted intervention measures.
METHODS
The investigation was conducted using the method of stratified random cluster sampling. A questionnaire survey was conducted among 933 clinical nurses aged from 40 to 55 in primary, secondary and tertiary hospitals. Kupperman's total symptom score ranged from 0 to 63, while a score of ≥7 can determine the existence of perimenopausal syndrome.
RESULTS
Among the 933 clinical nurses surveyed, 662 (70.95%) had perimenopausal syndrome, the results of the multivariate unconditional logistic regression analysis showed that The age ranges from 51 to 55 (OR =2.035, 95% CI: 1.070-3.872), the presence of chronic diseases (OR =1.659, 95% CI: 1.095-2.512), menopause (OR =1.989, 95% CI: 1.198-3.303), moderate family function impairment (OR =1.940, 95% CI: 1.356-2.776), severe family dysfunction weekly (OR =2.309, 95% CI: 1.178-4.524), never participation in sports (OR =3.328, 95% CI: 1.657-6.684) and exercising 1-5 times per week (OR =2.689, 95% CI: 1.516-4.768) were risk factors for perimenopausal syndrome in clinical nurses, basic security (OR =0.939, 95% CI: 0.887-0.994), and sufficient manpower (OR =0.915, 95% CI: 0.855-0.979) were protective factors for perimenopausal syndrome in clinical nurses.
CONCLUSIONS
The incidence of perimenopausal syndrome in clinical nurses at all levels of hospitals situated in Chongqing is relatively high. It is suggested that nursing managers should attach great importance to the physical and mental condition of this population and timely take targeted intervention measures to prevent or alleviate the occurrence and development of perimenopausal syndrome in clinical nurses.
Topics: Burnout, Professional; Cross-Sectional Studies; Female; Humans; Perimenopause; Quality of Life; Surveys and Questionnaires; Syndrome; Tertiary Care Centers
PubMed: 35927777
DOI: 10.21037/apm-22-563 -
Medicine Dec 2021This study aimed to investigate the correlation between homocysteine (HCY), C-reactive protein (CRP), lipid levels, and sleep quality in perimenopausal and...
This study aimed to investigate the correlation between homocysteine (HCY), C-reactive protein (CRP), lipid levels, and sleep quality in perimenopausal and postmenopausal women.We collected data from 217 patients (perimenopause and postmenopausal) who visited the gynecological endocrine outpatient department of our hospital between January 2017 and January 2019. The quality and patterns of sleep were measured using the Pittsburgh Sleep Quality Index, and relationships between HCY, CRP, lipid levels, and sleep quality were analyzed according to a Pittsburgh Sleep Quality Index ≥ 8.There were significant differences in age, education level, and occupation among patients with different levels of sleep quality (P < .05). HCY, CRP, total cholesterol, triglyceride, and low-density lipoprotein levels were significantly higher in patients with poor sleep quality than in those with good sleep quality (P < .05). Age, education level, occupation, HCY, CRP, and lipid levels (total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein) were all significant influencing factors for sleep quality in perimenopausal and postmenopausal women (all P < .05). After adjusting for age, education level, occupation, HCY, and CRP levels were all significant and independent risk factors for sleep quality in perimenopausal and postmenopausal women (all P < .05).Levels of HCY, CRP, and lipids were significantly correlated with sleep quality in perimenopausal and postmenopausal women. HCY and CRP were identified as independent risk factors for sleep quality in perimenopausal and postmenopausal women, thus providing theoretical support for the clinical improvement of sleep quality.
Topics: Adult; C-Reactive Protein; Cholesterol; Female; Homocysteine; Humans; Lipids; Middle Aged; Perimenopause; Postmenopause; Sleep Quality; Triglycerides
PubMed: 34941184
DOI: 10.1097/MD.0000000000028408 -
Diabetes & Metabolism Journal Jul 2021Cardiovascular disease is the primary cause of mortality in women and men with diabetes. Due to age and worsening of risk factors over the menopausal transition, risk of... (Review)
Review
Cardiovascular disease is the primary cause of mortality in women and men with diabetes. Due to age and worsening of risk factors over the menopausal transition, risk of coronary heart disease events increases in postmenopausal women with diabetes. Randomized studies have conflicted regarding the beneficial impact of estrogen therapy upon intermediate cardiovascular disease markers and events. Therefore, estrogen therapy is not currently recommended for indications other than symptom management. However, for women at low risk of adverse events, estrogen therapy can be used to minimize menopausal symptoms. The risk of adverse events can be estimated using risk engines for the calculation of cardiovascular risk and breast cancer risk in conjunction with screening tools such as mammography. Use of estrogen therapy, statins, and anti-platelet agents can be guided by such calculators particularly for younger women with diabetes. Risk management remains focused upon lifestyle behaviors and achieving optimal levels of cardiovascular risk factors, including lipids, glucose, and blood pressure. Use of pharmacologic therapies to address these risk factors, particularly specific hypoglycemic agents, may provide some additional benefit for risk prevention. The minimal benefit for women with limited life expectancy and risk of complications with intensive therapy should also be considered.
Topics: Cardiovascular Diseases; Diabetes Mellitus; Female; Heart Disease Risk Factors; Humans; Perimenopause
PubMed: 34352986
DOI: 10.4093/dmj.2020.0262 -
Cureus Jan 2023Introduction We aim to report the histotypes and reassess the anatomic distribution of benign ovarian tumors in perimenopausal and postmenopausal women. Methods Medical...
Introduction We aim to report the histotypes and reassess the anatomic distribution of benign ovarian tumors in perimenopausal and postmenopausal women. Methods Medical and pathology reports of women with histologically confirmed benign ovarian pathology were investigated. Data were collected, retrospectively between 2000 and 2020, and analyzed from perimenopausal and postmenopausal women with benign ovarian tumors, after bilateral salpingo-oophorectomy (BSO) with or without total abdominal hysterectomy (TAH). The ovarian masses histology and the distribution of locations were further evaluated. Results The total sample consisted of 1,355 women with benign ovarian tumors; 929 (68.6%) of the perimenopausal and 426 (31.4%) of the postmenopausal age. A dermoid cyst was prominent in the right ovary (52.8%), compared to the left side (41%) (p<0.01). Conversely, in patients with endometriomas and cysts of Morgagni, the observed proportion was more prominent in the left-sided ovary (61.8% vs 27%; p<0.001 and 52.3% vs 36.4%; p<0.01, respectively). Moreover, in the perimenopausal women, we mostly detected endometrioma (18.3%), dermoid cyst (15.5%) and cyst of Morgagni (4%) compared to postmenopausal women, where serous cysts (29.8%) and ovarian fibroids (8%) were the most common tumors. Conclusions Benign ovarian tumors are frequently seen in perimenopausal women and most histotypes present anatomical differences between the left and right ovaries. Serous cysts, followed by paraovarian, dermoid cysts and endometrioma present the commonest ovarian benign masses. Gynecologists should pay special attention to adnexal tumors in the postmenopausal period to choose the right operating setting for women at risk for ovarian cancer.
PubMed: 36824539
DOI: 10.7759/cureus.34059 -
American Journal of Physiology.... Nov 2016Endothelial dysfunction and inflammation are characteristics of subclinical atherosclerosis and may increase through progressive menopausal stages. Evaluating...
Endothelial dysfunction and inflammation are characteristics of subclinical atherosclerosis and may increase through progressive menopausal stages. Evaluating endothelial responses to acute exercise can reveal underlying dysfunction not apparent in resting conditions. The purpose of this study was to investigate markers of endothelial function and inflammation before and after acute exercise in healthy low-active perimenopausal (PERI) and late postmenopausal (POST) women. Flow-mediated dilation (FMD), CD31/CD42b and CD62E endothelial microparticles (EMPs), and the circulating inflammatory factors monocyte chemoattractant protein 1 (MCP-1), interleukin 8 (IL-8), and tumor necrosis factor-α (TNF-α) were measured before and 30 min after acute exercise. Before exercise, FMD was not different between groups (PERI: 6.4 ± 0.9% vs. POST: 6.5 ± 0.8%, P = 0.97); however, after acute exercise PERI tended to improve FMD (8.5 ± 0.9%, P = 0.09), whereas POST did not (6.2 ± 0.8%, P = 0.77). Independent of exercise, we observed transient endothelial dysfunction in POST with repeated FMD measures. There was a group × exercise interaction for CD31/CD42b EMPs (P = 0.04), where CD31/CD42b EMPs were similar before exercise (PERI: 57.0 ± 6.7 EMPs/μl vs. POST: 58.5 ± 5.3 EMPs/μl, P = 0.86) but were higher in POST following exercise (PERI: 48.2 ± 6.7 EMPs/μl vs. POST: 69.4 ± 5.3 EMPs/μl, P = 0.023). CD62E EMPs were lower in PERI compared with POST before exercise (P < 0.001) and increased in PERI (P = 0.04) but did not change in POST (P = 0.68) in response to acute exercise. After acute exercise, MCP-1 (P = 0.055), TNF-α (P = 0.02), and IL-8 (P < 0.001) were lower in PERI but only IL-8 decreased in POST (P < 0.001). Overall, these data suggest that perimenopausal and late postmenopausal women display different endothelial and inflammatory responses to acute exercise.
Topics: Cytokines; Endothelium, Vascular; Exercise; Female; Humans; Inflammation; Inflammation Mediators; Middle Aged; Perimenopause; Postmenopause
PubMed: 27534876
DOI: 10.1152/ajpregu.00189.2016