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The Journal of Clinical Endocrinology... Jan 2021Menopause, the permanent cessation of menses, reflects oocyte depletion and loss of gonadal steroids. It is preceded by a transition state, the perimenopause, which is... (Review)
Review
CONTEXT
Menopause, the permanent cessation of menses, reflects oocyte depletion and loss of gonadal steroids. It is preceded by a transition state, the perimenopause, which is characterized by the gradual loss of oocytes, altered responsiveness to gonadal steroid feedback, wide hormonal fluctuations, and irregular menstrual patterns. The goal of this mini-review is to discuss the basic pathophysiology of the menopausal transition and the hormonal and nonhormonal management of clinicopathology attributed to it.
EVIDENCE ACQUISITION
A Medline search of epidemiologic, population-based studies, and studies of reproductive physiology was conducted. A total of 758 publications were screened.
EVIDENCE SYNTHESIS
The reproductive hormonal milieu of the menopausal transition precipitates bothersome vasomotor symptoms, mood disruption, temporary cognitive dysfunction, genitourinary symptoms, and other disease processes that reduce the quality of life of affected women. The endocrine tumult of the menopause transition also exposes racial and socioeconomic disparities in the onset, severity, and frequency of symptoms. Hormone therapy (HT) treatment can be effective for perimenopausal symptoms but its use has been stymied by concerns about health risks observed in postmenopausal HT users who are older than 60 and/or women who have been postmenopausal for greater than 10 years.
CONCLUSIONS
The menopause transition is a disruptive process that can last for over a decade and causes symptoms in a majority of women. It is important for clinicians to recognize early signs and symptoms of the transition and be prepared to offer treatment to mitigate these symptoms. Many safe and effective options, including HT, are available.
Topics: Estrogen Replacement Therapy; Female; Gonadal Steroid Hormones; Hot Flashes; Humans; Menopause; Perimenopause; Quality of Life; Symptom Assessment; Vasomotor System
PubMed: 33095879
DOI: 10.1210/clinem/dgaa764 -
Best Practice & Research. Clinical... May 2022With life expectancy for women on the rise, most women will experience menopausal transition and spend a significant number of years of their life in the menopausal... (Review)
Review
With life expectancy for women on the rise, most women will experience menopausal transition and spend a significant number of years of their life in the menopausal phase. Menopausal transition involves a myriad of physical, endocrine, and psychological changes which are influenced by ethnic, psychological, and socio-cultural factors. Every woman's experience of the menopausal transition is unique, and a one-size-fits-all approach to the management of symptoms does not work. An understanding of the pathophysiology and severity of menopausal symptoms and the benefits and risks associated with both hormonal and non-hormonal treatments is important when individualising treatment options for menopausal symptoms.
Topics: Female; Humans; Menopause
PubMed: 35382992
DOI: 10.1016/j.bpobgyn.2022.03.003 -
Obstetrics and Gynecology Clinics of... Sep 2019Although American women spend approximately 30% to 40% of their lives in menopause, a state defined by the cessation of estrogen production by the ovaries, obstetricians... (Review)
Review
Although American women spend approximately 30% to 40% of their lives in menopause, a state defined by the cessation of estrogen production by the ovaries, obstetricians and gynecologists in North America receive little formal education about menopausal health. Hormonal therapy has been available for more than 75 years; however, controversies surrounding its use have impacted training of care providers in all specialties. This article offers updates on care for menopausal women, focusing on symptomatology and health issues that arise related to the decline in all reproductive hormones. Lifestyle adaptations and nonmedical approaches, and nonhormonal and hormonal medications are discussed.
Topics: Adult; Cardiovascular Diseases; Estrogen Replacement Therapy; Female; Healthy Aging; Hot Flashes; Humans; Libido; Life Style; Menopause; Mental Health; Middle Aged; Osteoporosis, Postmenopausal; Women's Health
PubMed: 31378291
DOI: 10.1016/j.ogc.2019.04.008 -
Best Practice & Research. Clinical... May 2022Menopause is a major life event that can affect women in several ways. Its onset marks the end of the reproductive life cycle, and its impact can be both short and long... (Review)
Review
Menopause is a major life event that can affect women in several ways. Its onset marks the end of the reproductive life cycle, and its impact can be both short and long term. Menopause is often a gradual process, preceded by a transitional period known as perimenopause. The average age of menopause in the UK is 51. The clinical manifestations of menopause result from the eventual exhaustion of oocytes within the ovaries. This leads to a chronic hypo-estrogenic state, which in the short term causes menopausal symptoms and over a long term, has an impact on bone and cardiovascular health. There has been a steep drop in the prescription of hormone replacement therapy (HRT) following the publication of the Women's Health Initiative Study and the Million Women Study. It is currently estimated that approximately a million women in the UK are taking HRT for control of their menopausal symptoms. This review summarises the current recommendations for HRT use in menopausal women. The benefits of HRT in improving the symptoms of menopause are discussed as well as the potential role of HRT in managing long-term sequelae is covered. Evidence pertaining to the potential risks associated with HRT is also be reviewed.
Topics: Estrogen Replacement Therapy; Female; Hormone Replacement Therapy; Humans; Menopause; Perimenopause; Women's Health
PubMed: 35000809
DOI: 10.1016/j.bpobgyn.2021.12.001 -
Nutrients Jan 2020Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various... (Review)
Review
Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various lipid metabolic disorders due to hormonal changes, such as decreased levels of estrogens and increased levels of circulating androgens; these may lead to the development of metabolic syndromes including cardiovascular diseases and type 2 diabetes. Dysregulation of lipid metabolism affects the body fat mass, fat-free mass, fatty acid metabolism, and various aspects of energy metabolism, such as basal metabolic ratio, adiposity, and obesity. Moreover, menopause is also associated with alterations in the levels of various lipids circulating in the blood, such as lipoproteins, apolipoproteins, low-density lipoproteins (LDLs), high-density lipoproteins (HDL) and triacylglycerol (TG). Alterations in lipid metabolism and excessive adipose tissue play a key role in the synthesis of excess fatty acids, adipocytokines, proinflammatory cytokines, and reactive oxygen species, which cause lipid peroxidation and result in the development of insulin resistance, abdominal adiposity, and dyslipidemia. This review discusses dietary recommendations and beneficial compounds, such as vitamin D, omega-3 fatty acids, antioxidants, phytochemicals-and their food sources-to aid the management of abnormal lipid metabolism in postmenopausal women.
Topics: Adult; Aged; Estrogens; Fatty Acids, Omega-3; Female; Humans; Lipid Metabolism; Lipid Metabolism Disorders; Menopause; Middle Aged; Obesity; Phytochemicals; Postmenopause; Probiotics; Vitamin D
PubMed: 31941004
DOI: 10.3390/nu12010202 -
Molecules (Basel, Switzerland) Dec 2021Herbal products are often used as an alternative to pharmacological therapy. Menopausal symptoms and gynecological disorders (such as premenstrual syndrome and... (Review)
Review
Herbal products are often used as an alternative to pharmacological therapy. Menopausal symptoms and gynecological disorders (such as premenstrual syndrome and dysmenorrhea) are the indications where pharmacological therapy may have serious adverse events, hence many women prefer to use herbal products to help with these symptoms. Here, we reviewed plants and derived products, which are commonly used for the abovementioned indications, focusing on clinical data, safely profile and whether or not their use is justified. We noted that limited data are available on the use of some plants for alleviating the symptoms of menopause and gynecological disorders. While black cohosh () and red clover () were consistently shown to help reduce menopausal symptoms in clinical studies, currently available data do not fully support the use of fenugreek (), hops (), valerian (), and soybean ( and ) for this indication. For premenstrual syndrome and premenstrual dysphoric disorder, chaste tree () shows effectiveness, but more clinical studies are needed to confirm such effect upon the use of evening primrose ().
Topics: Dysmenorrhea; Female; Humans; Menopause; Phytotherapy; Plants, Medicinal; Premenstrual Syndrome
PubMed: 34946512
DOI: 10.3390/molecules26247421 -
Clinical Obstetrics and Gynecology Sep 2021Perimenopause and menopause are a time of great transition for women-physically, mentally, and emotionally. Symptoms of the menopause transition and beyond impact women... (Review)
Review
Perimenopause and menopause are a time of great transition for women-physically, mentally, and emotionally. Symptoms of the menopause transition and beyond impact women worldwide. Unfortunately, physician knowledge and comfort with addressing menopausal concerns vary greatly, limiting the support physicians provide to women in need. This review aims to increase physician understanding of the epidemiology, physiology, symptomology, and treatment options available for perimenopausal and menopausal women. Our goal is to empower physicians to educate and treat their patients to reduce the negative impact of perimenopausal changes and enhance overall well-being for women.
Topics: Female; Humans; Menopause; Perimenopause
PubMed: 34323232
DOI: 10.1097/GRF.0000000000000639 -
BMJ (Clinical Research Ed.) Aug 2023Most women worldwide experience menopausal symptoms during the menopause transition or postmenopause. Vasomotor symptoms are most pronounced during the first four to... (Review)
Review
Most women worldwide experience menopausal symptoms during the menopause transition or postmenopause. Vasomotor symptoms are most pronounced during the first four to seven years but can persist for more than a decade, and genitourinary symptoms tend to be progressive. Although the hallmark symptoms are hot flashes, night sweats, disrupted sleep, and genitourinary discomfort, other common symptoms and conditions are mood fluctuations, cognitive changes, low sexual desire, bone loss, increase in abdominal fat, and adverse changes in metabolic health. These symptoms and signs can occur in any combination or sequence, and the link to menopause may even be elusive. Estrogen based hormonal therapies are the most effective treatments for many of the symptoms and, in the absence of contraindications to treatment, have a generally favorable benefit:risk ratio for women below age 60 and within 10 years of the onset of menopause. Non-hormonal treatment options are also available. Although a symptom driven treatment approach with individualized decision making can improve health and quality of life for midlife women, menopausal symptoms remain substantially undertreated by healthcare providers.
Topics: Female; Humans; Middle Aged; Perimenopause; Quality of Life; Sweating; Menopause; Hot Flashes
PubMed: 37553173
DOI: 10.1136/bmj-2022-072612 -
Nutrients Jun 2021Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can... (Review)
Review
Among the various aspects of health promotion and lifestyle adaptation to the postmenopausal period, nutritional habits are essential because they concern all women, can be modified, and impact both longevity and quality of life. In this narrative review, we discuss the current evidence on the association between dietary patterns and clinical endpoints in postmenopausal women, such as body composition, bone mass, and risk markers for cardiovascular disease. Current evidence suggests that low-fat, plant-based diets are associated with beneficial effects on body composition, but further studies are needed to confirm these results in postmenopausal women. The Mediterranean diet pattern along with other healthy habits may help the primary prevention of bone, metabolic, and cardiovascular diseases in the postmenopausal period. It consists on the use of healthy foods that have anti-inflammatory and antioxidant properties, and is associated with a small but significant decrease in blood pressure, reduction of fat mass, and improvement in cholesterol levels. These effects remain to be evaluated over a longer period of time, with the assessment of hard outcomes such as bone fractures, diabetes, and coronary ischemia.
Topics: Eating; Endpoint Determination; Female; Humans; Menopause; Nutritional Physiological Phenomena; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 34201460
DOI: 10.3390/nu13072149 -
Work (Reading, Mass.) 2022Menopause is part of working women's lives. In Western countries, labour market patterns are changing rapidly: women's labour participation has increased, the percentage... (Review)
Review
BACKGROUND
Menopause is part of working women's lives. In Western countries, labour market patterns are changing rapidly: women's labour participation has increased, the percentage of full-time working women is rising, and retirement age is increasing.
OBJECTIVE
This narrative literature study aims to provide an insight in the state of the art in the literature about the relationship between menopause, work and health and to identify knowledge gaps as input for further research.
METHODS
The search was conducted in PubMed, CINAHL, MEDLINE and ScienceDirect. The final set includes 36 academic articles, 27 additional articles related to the topic and 6 additional sources.
RESULTS
Research on menopause, work and health is scarce. Results are grouped thematically as follows: Menopause and (1) a lack of recognising; (2) sickness absence and costs; (3) work ability; (4) job characteristics; (5) psychosocial and cultural factors; (6) health; (7) mental health, and (8) coping and interventions. Work ability of women with severe menopausal complaints may be negatively affected.
CONCLUSIONS
Due to taboo, menopause remains unrecognised and unaddressed within an organisational context. New theoretical and methodological approaches towards research on menopause, work and health are required in order to match the variety of the work contexts world-wide.
Topics: Employment; Female; Humans; Menopause; Mental Health; Narration; Workplace
PubMed: 35570508
DOI: 10.3233/WOR-205214