-
Human Reproduction (Oxford, England) Sep 2023Are there associations between natural or surgical menopause and incident dementia by age at menopause?
STUDY QUESTION
Are there associations between natural or surgical menopause and incident dementia by age at menopause?
SUMMARY ANSWER
Compared to age at menopause of 46-50 years, earlier natural menopause (≤40 and 41-45 years) was related to higher risk of all-cause dementia, while a U-shape relationship was observed between age at surgical menopause and risk of dementia.
WHAT IS KNOWN ALREADY
Menopause marks the end of female reproductive period. Age at menopause reflects the length of exposure to endogenous estrogen. Evidence on the association between age at natural, surgical menopause, and risk of dementia has been inconsistent.
STUDY DESIGN, SIZE, DURATION
A population-based cohort study involving 160 080 women who participated in the UK Biobank study.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Women with no dementia at baseline, and had no missing data on key exposure variables and covariates were included. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs on the association of categorical menopause age with incident all-cause dementia, Alzheimer's disease (AD) and vascular dementia (VD). Restricted cubic splines were used to model the non-linear relationship between continuous age at natural, surgical menopause, and risk of dementia. In addition, we analyzed the interaction effect of ever-used menopausal hormone therapy (MHT) at baseline, income level, leisure activities, and age at menopause on risk of dementia.
MAIN RESULTS AND THE ROLE OF CHANCE
Compared to women with age at menopause of 46-50 years, women with earlier natural menopause younger than 40 years (1.36, 1.01-1.83) and 41-45 years (1.19, 1.03-1.39) had a higher risk of all-cause dementia, while late natural menopause >55 years was linked to lower risk of dementia (0.83, 0.71-0.98). Compared to natural menopause, surgical menopause was associated with 10% higher risk of dementia (1.10, 0.98-1.24). A U-shape relationship was observed between surgical menopause and risk of dementia. Women with surgical menopause before age 40 years (1.94, 1.38-2.73) and after age 55 years (1.65, 1.21-2.24) were both linked to increased risk of all-cause dementia. Women with early natural menopause without ever taking MHT at baseline had an increased risk of AD. Also, in each categorized age at the menopause level, higher income level or higher number of leisure activities was linked to a lowers risk of dementia.
LIMITATIONS, REASONS FOR CAUTION
Menopausal age was based on women's self-report, which might cause recall bias.
WIDER IMPLICATION OF THE FINDINGS
Women who experienced natural menopause or had surgical menopause at an earlier age need close monitoring and engagement for preventive health measures to delay the development of dementia.
STUDY FUNDING/COMPETING INTERESTS
This work was supported by the Start-up Foundation for Scientific Research in Shandong University (202099000066), Science Fund Program for Excellent Young Scholars of Shandong Provence (Overseas) (2022HWYQ-030), and the National Natural Science Foundation of China (82273702). There are no competing interests.
TRIAL REGISTRATION NUMBER
N/A.
Topics: Female; Humans; Middle Aged; Adult; Cohort Studies; Biological Specimen Banks; Menopause; Menopause, Premature; United Kingdom
PubMed: 37344154
DOI: 10.1093/humrep/dead130 -
Post Reproductive Health Dec 2023There remains great debate amongst health professionals, women and social media commentators about what the best menopause diet should be. There are areas of nutrition...
There remains great debate amongst health professionals, women and social media commentators about what the best menopause diet should be. There are areas of nutrition requiring specific attention in the menopause such as bone health and cardiovascular health. Many women experience weight gain during the menopause. This tool for clinicans has been written to cover current evidence based dietary advice for menopause health and provide practical tips on how to present this information to women and motivate them to make appropriate changes.
Topics: Female; Humans; Weight Gain; Menopause; Diet
PubMed: 37347716
DOI: 10.1177/20533691231180721 -
Post Reproductive Health Sep 2023
Topics: Female; Humans; Menopause
PubMed: 37619964
DOI: 10.1177/20533691231198295 -
Revue Medicale Suisse Sep 2023
Topics: Female; Humans; Menopause; Dementia; Hormones
PubMed: 37671765
DOI: 10.53738/REVMED.2023.19.840.1634 -
Nature Aging Dec 2023For many pathologies associated with aging, female patients present with higher morbidity and more frequent adverse events from treatments compared to male patients.... (Review)
Review
For many pathologies associated with aging, female patients present with higher morbidity and more frequent adverse events from treatments compared to male patients. While preclinical models are the foundation of our mechanistic understanding of age-related diseases, the most common models fail to recapitulate archetypical female aging trajectories. For example, while over 70% of the top age-related diseases are influenced by the systemic effects of reproductive senescence, we found that preclinical studies that include menopausal phenotypes modeling those seen in humans make up <1% of published aging biology research. The long-term impacts of pregnancy, birthing and breastfeeding are also typically omitted from preclinical work. In this Perspective, we summarize limitations in the most commonly used aging models, and we provide recommendations for better incorporating menopause, pregnancy and other considerations of sex in vivo and in vitro. Lastly, we outline action items for aging biology researchers, journals, funding agencies and animal providers to address this gap.
Topics: Pregnancy; Animals; Humans; Male; Female; Aging; Menopause
PubMed: 38052933
DOI: 10.1038/s43587-023-00509-8 -
Maturitas Aug 2023
Topics: Female; Humans; Menopause; Social Media
PubMed: 36964011
DOI: 10.1016/j.maturitas.2023.02.006 -
Lancet (London, England) Mar 2024Menopause eventually happens to all people with typically functioning ovaries, and almost one billion women worldwide are postmenopausal. Although the biology of typical... (Review)
Review
Menopause eventually happens to all people with typically functioning ovaries, and almost one billion women worldwide are postmenopausal. Although the biology of typical menopause is ubiquitous, the experience varies substantially. Factors contributing to the experience include not only individual factors, such as the nature and severity of symptoms, but also psychological, social, and contextual considerations, many of which are modifiable. In this first paper in the Lancet Series on menopause, we argue for a new approach that goes beyond the treatment of specific symptoms, to encompass a broad model to support women transitioning this life stage, using the model of empowerment. WHO defines empowerment as an active process of gaining knowledge, confidence, and self-determination to self-manage health and make informed decisions about care. Rather than focusing on menopause as an endocrine deficiency, we propose an empowerment model that recognises factors modifying the experience, in which the patient is an expert in their own condition and the health-care worker supports the patient to become an equal and active partner in managing their own care.
Topics: Humans; Female; Menopause; Empowerment
PubMed: 38458214
DOI: 10.1016/S0140-6736(23)02799-X -
Best Practice & Research. Clinical... Jan 2024Vasomotor symptoms (VMS) are characteristic of menopause experienced by over 75% of postmenopausal women with significant health and socioeconomic implications. Although... (Review)
Review
Vasomotor symptoms (VMS) are characteristic of menopause experienced by over 75% of postmenopausal women with significant health and socioeconomic implications. Although the average duration of symptoms is seven years, 10% of women experience symptoms for more than a decade. Although menopausal hormone therapy (MHT) remains an efficacious and cost-effective treatment, its use may not be suitable in all women, such as those at an increased risk of breast cancer or gynaecological malignancy. The neurokinin B (NKB) signaling pathway, together with its intricate connection to the median preoptic nucleus (MnPO), has been postulated to provide integrated reproductive and thermoregulatory responses, with a central role in mediating postmenopausal VMS. This review describes the physiological hypothalamo-pituitary-ovary (HPO) axis, and subsequently the neuroendocrine changes that occur with menopause using evidence derived from animal and human studies. Finally, data from the latest clinical trials using novel therapeutic agents that antagonise NKB signaling are reviewed.
Topics: Animals; Female; Humans; Hot Flashes; Menopause; Neurokinin B; Hormone Replacement Therapy; Signal Transduction
PubMed: 37076317
DOI: 10.1016/j.beem.2023.101774 -
Best Practice & Research. Clinical... Jan 2024Premature ovarian insufficiency (POI) is a condition in which there is a decline in ovarian function in women who are younger than 40 years resulting in a... (Review)
Review
Premature ovarian insufficiency (POI) is a condition in which there is a decline in ovarian function in women who are younger than 40 years resulting in a hypo-oestrogenic state with elevated gonadotrophins and oligomenorrhoea/amenorrhoea. This leads to short term complications of menopausal symptoms and long-term effects on bone and cardiovascular health, cognition as well as the impact of reduced fertility and sexual function associated with this condition. It is managed by sex steroid replacement either with HRT or combined hormonal contraception until the age of natural menopause (51) and this can provide a beneficial role with both symptom control and minimising the long-term adverse effects associated with this condition. Women who undergo a menopause between 40 and 45 years are deemed to have an "early menopause". The limited data available for this group suggest that they also have an increased morbidity if not adequately treated with hormone therapy. As such, women who have an early menopause should be managed in a similar way to those with POI, with the recommendation that they should take HRT at least until the natural age of menopause. This is the same for induced menopause that is caused by medical or surgical treatment that impacts the ovaries. It is important to ensure early diagnosis and access to specialist care to help support and manage these patients to reduce the symptoms and risks of long-term complications. This review looks at the diagnosis, causes, short and long-term complications and management of POI, early and induced menopause.
Topics: Humans; Female; Primary Ovarian Insufficiency; Menopause, Premature; Menopause; Amenorrhea
PubMed: 37802711
DOI: 10.1016/j.beem.2023.101823 -
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