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Reproductive Sciences (Thousand Oaks,... Dec 2023Premature ovarian insufficiency (POI) is a condition in which a woman experiences premature decline in ovarian function before the age of 40 years, manifested by... (Review)
Review
Premature ovarian insufficiency (POI) is a condition in which a woman experiences premature decline in ovarian function before the age of 40 years, manifested by menstrual disorders, decreased fertility, and possibly postmenopausal symptoms such as insomnia, hot flashes, and osteoporosis, and is one of the predominant clinical syndromes leading to female infertility. Genetic, immunologic, iatrogenic and other factors, alone or in combination, have been reported to trigger POI, yet the etiology remains unknown in most cases. The main methods currently used clinically to ameliorate menopausal symptoms due to hypoestrogenemia in POI patients are hormone replacement therapy, while the primary methods available to address infertility in POI patients are oocyte donation and cryopreservation techniques, both of which have limitations to some degree. In recent years, researchers have continued to explore more efficient and safe therapies, and have achieved impressive results in preclinical trials. In this article, we will mainly review the three most popular therapies and their related signaling pathways published in the past ten years, with the aim of providing ideas for clinical applications.
Topics: Humans; Female; Adult; Primary Ovarian Insufficiency; Menopause, Premature; Infertility, Female; Cryopreservation; Oocyte Donation
PubMed: 37460850
DOI: 10.1007/s43032-023-01300-1 -
Climacteric : the Journal of the... Dec 2023Smoking is associated with an increased risk of multiple sclerosis (MS), and smoking and early menopause are related to poor outcomes in MS. Smoking is also associated...
Smoking is associated with an increased risk of multiple sclerosis (MS), and smoking and early menopause are related to poor outcomes in MS. Smoking is also associated with early menopause. To explore this intricate relationship between smoking status, age at menopause and disease course in MS, 137 women with MS and 396 age-matched controls were included in this case-control study. Age at menopause (median 49.0 vs. 50.0 years; = 0.79) and smoking status (40.3% vs. 47.6%; = 0.15) were similar among MS and control women. Relapsing MS onset was earlier in ever-smoker women with early menopause compared to the rest of the women (median 30.4 vs. 37.0 years; = 0.02) and also compared to ever-smoker women with normal age at menopause (median 30.4 vs. 41.0 years; = 0.008) and never-smoker women with early menopause (median 30.4 vs. 41.5 years; = 0.004). Progressive MS onset was also earlier in ever-smoker women with early menopause compared to ever-smoker women with normal age at menopause (median 41.1 vs. 49.4 years; = 0.05) and never-smoker women with early menopause (median 41.1 vs. 50.1 years; = 0.12). Our results suggest that smoking and menopause associate with MS disease course, including the onset of relapsing and progressive MS in women.
Topics: Humans; Female; Multiple Sclerosis; Case-Control Studies; Risk Factors; Smoking; Menopause, Premature; Menopause; Disease Progression
PubMed: 37387356
DOI: 10.1080/13697137.2023.2221381 -
Journal of Clinical Nursing Aug 2023To explore the international literature related to women's knowledge and experience of perimenopause and menopause and to inform future directions for research and... (Review)
Review
AIM
To explore the international literature related to women's knowledge and experience of perimenopause and menopause and to inform future directions for research and individualised healthcare delivery.
BACKGROUND
Menopause is a normal physiological process experienced by most women. Despite this, care and support is fragmented and the implication on women's long-term health is not sufficiently understood.
DESIGN
An integrative review of primary research on women's knowledge and experience of perimenopause and menopause.
METHOD
CINAHL, Medline, Wiley Online Library, SCOPUS, PubMed and Google Scholar were searched from 2011 to 2021.Quantitative and qualitative studies written in English exploring women's knowledge and experience of menopause were included. The search strategy for the review complied with PRISMA guidelines. The mixed methods appraisal tool was used to assess quality. Thematic analysis was employed to present a narrative synthesis of the data.
RESULTS
A total of 17 studies, comprising 10 quantitative, and seven qualitative studies met the inclusion criteria. The four themes regarding women's knowledge and experience of perimenopause and menopause identified in the literature were as follows: (1) Symptoms associated with perimenopause and menopause; (2) Strategies to manage symptoms; (3) Support and information (4) Attitudes, education and health literacy.
CONCLUSION
This integrative review of the international literature highlights that women's knowledge of perimenopause and menopause varies significantly globally and within countries. The experience of perimenopause and menopause for women is heterogenous and influenced by deeply embedded sociocultural patterns.
RELEVANCE FOR CLINICAL PRACTICE
This integrative review has shown that individualised support for women during perimenopause and menopause is critical to ensure the diverse needs of women are suitably addressed.
NO PATIENT OR PUBLIC CONTRIBUTION
As this was a review of the literature, no patients, service users, caregivers or members of the public were involved in this review.
Topics: Female; Humans; Perimenopause; Menopause; Women's Health; Delivery of Health Care; Qualitative Research
PubMed: 36336832
DOI: 10.1111/jocn.16568 -
Maturitas Oct 2023Menopause is linked to a higher risk of cardiovascular disease. However, it is unclear whether premature menopause (defined as menopause before the age of 40 years) or... (Meta-Analysis)
Meta-Analysis Review
OBJECT
Menopause is linked to a higher risk of cardiovascular disease. However, it is unclear whether premature menopause (defined as menopause before the age of 40 years) or early menopause (defined as menopause before the age of 45 years) is associated with an increased risk of heart failure or atrial fibrillation. This study aimed to examine the most reliable evidence on the relationship between early menopause and the risk of heart failure and atrial fibrillation.
METHODS
A comprehensive literature search was performed in three online databases, Embase, Web of Science, and PubMed, from database establishment to April 1, 2023. The results were presented as hazard ratios with 95 % confidence intervals. The I statistic was employed to assess heterogeneity, and the Egger's test was used to determine publication bias.
RESULTS
Nine cohort studies were included in the analysis, with a total of 6,255,783 postmenopausal women. Women with premature and early menopause had an increased risk of heart failure (HR: 1.39, 95 % CI: 1.31-1.47; HR: 1.23, 95 % CI: 1.10-1.37, respectively) and atrial fibrillation (HR: 1.15, 95 % CI: 1.01-1.31; HR: 1.08, 95 % CI: 1.04-1.13, respectively) when compared with women who had undergone menopause after the age of 45 years. Subgroup analysis showed that, compared with early menopause, premature menopause has a stronger association with an increased risk of heart failure and atrial fibrillation.
CONCLUSIONS
Women who undergo premature menopause or early menopause have a higher risk of heart failure and atrial fibrillation compared with women who undergo menopause in the normal age range. These reproductive factors need to be considered for measures that might reduce the risk of heart failure and atrial fibrillation.
Topics: Humans; Female; Atrial Fibrillation; Menopause, Premature; Heart Failure; Menopause; Cohort Studies; Risk Factors
PubMed: 37454569
DOI: 10.1016/j.maturitas.2023.107784 -
American Journal of Obstetrics and... Apr 2024Although phenotypic associations between female reproductive characteristics and uterine leiomyomata have long been observed in epidemiologic investigations, the shared... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although phenotypic associations between female reproductive characteristics and uterine leiomyomata have long been observed in epidemiologic investigations, the shared genetic architecture underlying these complex phenotypes remains unclear.
OBJECTIVE
We aimed to investigate the shared genetic basis, pleiotropic effects, and potential causal relationships underlying reproductive traits (age at menarche, age at natural menopause, and age at first birth) and uterine leiomyomata.
STUDY DESIGN
With the use of large-scale, genome-wide association studies conducted among women of European ancestry for age at menarche (n=329,345), age at natural menopause (n=201,323), age at first birth (n=418,758), and uterine leiomyomata (n/n=35,474/267,505), we performed a comprehensive, genome-wide, cross-trait analysis to examine systematically the common genetic influences between reproductive traits and uterine leiomyomata.
RESULTS
Significant global genetic correlations were identified between uterine leiomyomata and age at menarche (r, -0.17; P=3.65×10), age at natural menopause (r, 0.23; P=3.26×10), and age at first birth (r, -0.16; P=1.96×10). Thirteen genomic regions were further revealed as contributing significant local correlations (P<.05/2353) to age at natural menopause and uterine leiomyomata. A cross-trait meta-analysis identified 23 shared loci, 3 of which were novel. A transcriptome-wide association study found 15 shared genes that target tissues of the digestive, exo- or endocrine, nervous, and cardiovascular systems. Mendelian randomization suggested causal relationships between a genetically predicted older age at menarche (odds ratio, 0.88; 95% confidence interval, 0.85-0.92; P=1.50×10) or older age at first birth (odds ratio, 0.95; 95% confidence interval, 0.90-0.99; P=.02) and a reduced risk for uterine leiomyomata and between a genetically predicted older age at natural menopause and an increased risk for uterine leiomyomata (odds ratio, 1.08; 95% confidence interval, 1.06-1.09; P=2.30×10). No causal association in the reverse direction was found.
CONCLUSION
Our work highlights that there are substantial shared genetic influences and putative causal links that underlie reproductive traits and uterine leiomyomata. The findings suggest that early identification of female reproductive risk factors may facilitate the initiation of strategies to modify potential uterine leiomyomata risk.
Topics: Female; Humans; Genome-Wide Association Study; Phenotype; Menopause; Risk Factors; Leiomyoma
PubMed: 38191017
DOI: 10.1016/j.ajog.2023.12.040 -
The Journal of Clinical Endocrinology... Oct 2023
Topics: Female; Humans; Menopause; Heterocyclic Compounds, 2-Ring; Thiadiazoles
PubMed: 37097747
DOI: 10.1210/clinem/dgad209 -
Viruses Dec 2023The objectives of this study were to describe the trajectories of bone mineral density (BMD) and trabecular bone score (TBS) changes throughout pre-menopause... (Observational Study)
Observational Study
OBJECTIVE
The objectives of this study were to describe the trajectories of bone mineral density (BMD) and trabecular bone score (TBS) changes throughout pre-menopause (reproductive phase and menopausal transition) and post-menopause (early and late menopause) in women with HIV (WWH) undergoing different antiretroviral therapies (ARTs) and explore the risk factors associated with those changes.
METHODS
This was an observational longitudinal retrospective study in WWH with a minimum of two DEXA evaluations comprising BMD and TBS measurements, both in the pre-menopausal and post-menopausal periods. Menopause was determined according to the STRAW+10 criteria, comprising four periods: the reproductive period, menopausal transition, and early- and late-menopausal periods. Mixed-effects models were fitted to estimate the trajectories of the two outcomes (BMD and TBS) over time. Annualized lumbar BMD and TBS absolute and percentage changes were calculated in each STRAW+10 time window. A backward elimination procedure was applied to obtain the final model, including the predictors that affected the trajectories of BMD or TBS over time.
RESULTS
A total of 202 WWH, all Caucasian, were included. In detail, 1954 BMD and 195 TBS data were analyzed. The median number of DEXA evaluations per woman was 10 (IQR: 7, 12). The median observation periods per patient were 12.0 years (IQR = 8.9-14.4) for BMD and 6.0 years (IQR: 4.3, 7.9) for TBS. The prevalence of osteopenia (63% vs. 76%; < 0.001) and osteoporosis (16% vs. 36%; < 0.001) increased significantly between the pre-menopausal and post-menopausal periods. Both BMD (1.03 (±0.14) vs. 0.92 (±0.12) g/cm; < 0.001) and TBS (1.41 (IQR: 1.35, 1.45) vs. 1.32 (IQR: 1.28, 1.39); < 0.001) decreased significantly between the two periods. The trend in BMD decreased across the four STRAW+10 periods, with a slight attenuation only in the late-menopausal period when compared with the other intervals. The TBS slope did not significantly change throughout menopause. The delta mean values of TBS in WWH were lower between the menopausal transition and reproductive period compared with the difference between menopause and menopausal transition.
CONCLUSIONS
Both BMD and TBS significantly decreased over time. The slope of the change in BMD and TBS significantly decreased in the menopausal transition, suggesting that this period should be considered by clinicians as a key time during which to assess bone health and modifiable risk factors in WWH.
Topics: Female; Humans; Bone Density; Cancellous Bone; Retrospective Studies; Lumbar Vertebrae; Menopause; HIV Infections
PubMed: 38140615
DOI: 10.3390/v15122375 -
Menopause (New York, N.Y.) Jul 2024Brain fog, referring to menopause-related subjective cognitive difficulties, is common in midlife women. Longitudinal studies find small but reliable declines in...
Brain fog, referring to menopause-related subjective cognitive difficulties, is common in midlife women. Longitudinal studies find small but reliable declines in objective memory performance as women transition into perimenopause, and these are not explained by advancing age alone. When memory declines occur, performance levels remain within normal limits for all but a very small number of women. Women's experience of brain fog extends beyond memory complaints, reflecting the negative effect on a broad range of cognitive abilities. Clinicians can counsel women about how menopause symptoms, estrogen, hormone therapy, and modifiable risk factors (eg, hypertension, sedentary lifestyle) can influence cognitive health.
Topics: Female; Humans; Middle Aged; Cognition Disorders; Cognitive Dysfunction; Counseling; Estrogen Replacement Therapy; Memory Disorders; Menopause; Risk Factors
PubMed: 38888619
DOI: 10.1097/GME.0000000000002382 -
JAMA Jan 2024
Topics: Female; Humans; Dementia; Estrogen Replacement Therapy; Estrogens; Menopause; Postmenopause
PubMed: 38109125
DOI: 10.1001/jama.2023.23784 -
American Journal of Human Genetics Sep 2023There is currently little evidence that the genetic basis of human phenotype varies significantly across the lifespan. However, time-to-event phenotypes are understudied...
There is currently little evidence that the genetic basis of human phenotype varies significantly across the lifespan. However, time-to-event phenotypes are understudied and can be thought of as reflecting an underlying hazard, which is unlikely to be constant through life when values take a broad range. Here, we find that 74% of 245 genome-wide significant genetic associations with age at natural menopause (ANM) in the UK Biobank show a form of age-specific effect. Nineteen of these replicated discoveries are identified only by our modeling framework, which determines the time dependency of DNA-variant age-at-onset associations without a significant multiple-testing burden. Across the range of early to late menopause, we find evidence for significantly different underlying biological pathways, changes in the signs of genetic correlations of ANM to health indicators and outcomes, and differences in inferred causal relationships. We find that DNA damage response processes only act to shape ovarian reserve and depletion for women of early ANM. Genetically mediated delays in ANM were associated with increased relative risk of breast cancer and leiomyoma at all ages and with high cholesterol and heart failure for late-ANM women. These findings suggest that a better understanding of the age dependency of genetic risk factor relationships among health indicators and outcomes is achievable through appropriate statistical modeling of large-scale biobank data.
Topics: Humans; Female; Aging; Menopause; Age of Onset; Ovary; Risk Factors; Age Factors
PubMed: 37543033
DOI: 10.1016/j.ajhg.2023.07.006