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Frontiers in Neuroendocrinology Oct 2020Menopause, an inevitable event in a woman's life, significantly increases risk of bone resorption and diseases such as Alzheimer's, vascular dementia, cardiac arrest,... (Review)
Review
Menopause, an inevitable event in a woman's life, significantly increases risk of bone resorption and diseases such as Alzheimer's, vascular dementia, cardiac arrest, and stroke. The sole role of bones, as traditionally regarded, is to provide structural support for skeletal muscles and allow for ambulation, however this concept is becoming quickly outdated. New literature has emerged that suggests the bone cell-derived hormone osteocalcin (OCN) plays a pivotal role in cognition. OCN levels are correlated with bone mass density and bone turnover, and thus are strongly influenced by the changes associated with menopause. The goal of the current review is to discuss potential gaps in our knowledge of OCN and cognition, discrepancies in methods of OCN quantification, and therapies to enhance circulating OCN. A discussion on implementing exercise or low frequency vibration interventions at the menopausal transition to reduce risk and severity of neurological diseases and associated cognitive decline is included.
Topics: Brain; Cognition; Cognitive Dysfunction; Female; Humans; Menopause; Osteocalcin; Ovary
PubMed: 32781196
DOI: 10.1016/j.yfrne.2020.100861 -
Maturitas Jan 2020The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during... (Review)
Review
The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during the menopause. Nevertheless, the majority of women cope adequately with this reproductive transition phase and thus appear to be resilient. We assert that a variety of psychological factors influence the menopausal transition and result in an individual state on a continuum from successful adjustment to maladjustment. The purpose of this review is to offer a conceptual framework of resilience factors during the menopausal transition and to reveal which dimensions of resilience have already been verified for a healthy menopausal transition. We searched the databases PubMed and PsycINFO for studies investigating resilience factors during the menopausal transition which influence psychological and physical adjustment or maladjustment. A total of 23 articles were included. Altogether, we identified 15 different resilience factors, assessed with 23 different questionnaires. These factors can be grouped into six categories: core resilience, spirituality, control, optimism, emotion and self-related resilience. They are associated with a better adjustment to menopausal symptoms, milder physical symptoms, a better quality of and satisfaction with life, better well-being, less perceived stress and fewer depressive symptoms compared with women with lower levels of the respective resilience factors. Our conceptual framework includes resilience factors which have already been verified by empirical data. Further research is needed to determine whether these resilience factors can be assigned to a common factor and to incorporate biological resilience markers.
Topics: Adaptation, Psychological; Adult; Anxiety; Cross-Sectional Studies; Depression; Female; Humans; Longitudinal Studies; Menopause; Middle Aged; Perimenopause; Prevalence; Resilience, Psychological; Surveys and Questionnaires
PubMed: 31787147
DOI: 10.1016/j.maturitas.2019.10.015 -
Climacteric : the Journal of the... Jun 2023Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal...
Women frequently experience sleep disturbances, particularly night-time awakenings, as they transition menopause and enter postmenopause. Sleep is essential for optimal functioning and health. Persistent and distressing sleep disturbances across menopause can negatively impact daytime functioning and productivity, and increase risk for mental and physical health conditions. While multiple factors can disturb sleep, two unique factors in the context of menopause are vasomotor symptoms and the changing reproductive hormone environment. Vasomotor symptoms are associated with sleep disturbances and contribute significantly to awakenings and amount of time spent awake during the night. Even after accounting for vasomotor and depressive symptoms, lower estradiol and higher follicle stimulating hormone levels, indicative of menopause, are associated with sleep disturbance, particularly awakenings, suggesting that the hormone environment may directly affect sleep. Management strategies for clinically significant menopausal sleep disturbances include cognitive behavioral therapy for insomnia, which is effective and durable in treating menopausal insomnia. Hormone therapy alleviates sleep disturbances, particularly in the presence of disruptive vasomotor symptoms. Sleep disturbances have a significant impact on women's functioning and health, and there is a need for further research of the underlying mechanisms to advance effective preventative and treatment strategies that ensure optimal health and well-being of midlife women.
Topics: Female; Humans; Sleep Initiation and Maintenance Disorders; Hot Flashes; Menopause; Sleep; Estradiol; Sleep Wake Disorders
PubMed: 37011660
DOI: 10.1080/13697137.2023.2173569 -
Nursing Open Jan 2024The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well-being for staff experiencing perimenopausal and... (Review)
Review
AIM
The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well-being for staff experiencing perimenopausal and menopausal symptoms at work.
DESIGN
It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541-548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization.
METHODS
CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study.
RESULTS
The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in-depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person-centred support mechanisms and an organizational approach for all employees.
Topics: Female; Humans; Adult; Middle Aged; Menopause; Perimenopause; Case-Control Studies; Workforce; Research Design
PubMed: 38268277
DOI: 10.1002/nop2.2058 -
Journal of Neuroendocrinology Jan 2020Biological sex and changes in sex hormones throughout life influence all aspects of health and disease. In women, changes in sex hormonal status reflect ovarian... (Review)
Review
Biological sex and changes in sex hormones throughout life influence all aspects of health and disease. In women, changes in sex hormonal status reflect ovarian function, pregnancy and the use of exogenous hormonal treatments. Longitudinal data from defined cohorts of women will help to identify mechanisms by which the hormonal milieu contributes to cerebrovascular ageing, brain structure and ultimately cognition. This review summarises the phenotypes of three cohorts of women identified through the medical records-linkage system of the Rochester Epidemiology Project and the Mayo Clinic Specialized Center of Research Excellence (SCORE) on Sex Differences: (i) menopausal women with histories of normotensive or hypertensive pregnancies; (ii) women who had bilateral oophorectomy ≤45 years of age; and (iii) women who experienced natural menopause and used menopausal hormone treatments for 4 years. Data from these cohorts will influence the design of follow-up studies concerning how sex hormonal status affects neurovascular ageing in women.
Topics: Adult; Aging; Blood Pressure; Brain; Female; Humans; Menopause; Middle Aged; Premenopause; Risk Factors
PubMed: 31397036
DOI: 10.1111/jne.12777 -
Menopause (New York, N.Y.) Aug 2020This narrative review addresses common clinical questions and concerns of both physicians and patients about migraine during and after the perimenopausal transition,... (Review)
Review
IMPORTANCE AND OBJECTIVES
This narrative review addresses common clinical questions and concerns of both physicians and patients about migraine during and after the perimenopausal transition, specifically (1) How does the perimenopausal transition affect migraine prevalence and does this vary by migraine type? (2) Does the magnitude of stroke risk associated with migraine increase with hormone therapy (HT)?, and (3) What are best practices as regards migraine treatment in perimenopausal women?
METHODS
We searched PubMed from 2010 through the present. Search terms included migraine, menopause, and HT. Articles were included if they were in English and had full text availability. In addition, key references identified in the search articles were included.
DISCUSSION AND CONCLUSION
Many women are informed that their migraines will disappear postmenopause; there are some data to support this, but a specific time frame has not been evidenced. Stroke risk in women with migraine with aura is small in absolute terms, but important at the population level, because migraine is so prevalent. The risk becomes clinically important in the context of additional stroke risk factors, which increase with aging such as hypertension. Estrogen in combined hormonal contraception increases the risk of an ischemic stroke, however, the lower amount of estrogen in HT may not contribute to a meaningful increase in stroke risk. HT is a preventative sex-specific treatment for female migraineurs for the menopausal transition. Sex differences for other conventional treatments outside their use in menstrual and menstrually related migraine have not been studied specifically in the menopausal transition.
Topics: Estrogens; Female; Humans; Male; Menopause; Menstruation; Migraine Disorders; Postmenopause
PubMed: 32796291
DOI: 10.1097/GME.0000000000001635 -
Multiple Sclerosis (Houndmills,... Feb 2022Sex hormones play a role in both the risk and the prognosis of multiple sclerosis (MS). Considering all stages of women's reproductive life, data regarding the influence... (Review)
Review
BACKGROUND
Sex hormones play a role in both the risk and the prognosis of multiple sclerosis (MS). Considering all stages of women's reproductive life, data regarding the influence of menopause on MS and vice versa are scarce.
OBJECTIVE
The aim of this study was to review the evidence addressing the relationship between menopause and MS.
METHODS
A literature search through PubMed was conducted, selecting studies that assessed (1) the influence of menopause in the MS course, (2) the influence of MS and disease-modifying drugs (DMD) on the development of menopause and (3) the effect of hormone replacement therapy (HRT) on symptoms of menopausal MS patients.
RESULTS
(1) Most studies suggest menopause may transitorily aggravate MS symptoms. Two studies found an inflexion point on the Expanding Disability Status Scale (EDSS) with clinical worsening during the menopausal transition. Another study considering full EDSS trajectories from clinically isolated syndrome to postmenopause did not find such an EDSS inflection; (2) MS and DMD do not seem to alter the age of menopause onset; and (3) HRT in menopausal MS patients has not shown consistent benefits.
CONCLUSION
Menopause seems to be associated with transient symptom worsening, but the existence of an inflection in disability progression is still controversial. Properly designed studies are necessary to achieve conclusive results.
Topics: Female; Hormone Replacement Therapy; Humans; Menopause; Multiple Sclerosis; Postmenopause; Prognosis
PubMed: 32856989
DOI: 10.1177/1352458520952022 -
The Relationship Between Menopause and Metabolic Syndrome: Experimental and Bioinformatics Analysis.Biochemical Genetics Dec 2021Menopausal hormonal changes have been associated with the emergence of the metabolic syndrome (MetS) and its consequences such as type 2 diabetes (T2D) and...
Menopausal hormonal changes have been associated with the emergence of the metabolic syndrome (MetS) and its consequences such as type 2 diabetes (T2D) and cardiovascular diseases (CVD). The common gene signature and the associated signaling pathways of MetS, T2D, CVD and menopause status have not been widely studied. We analyzed a total of 314 women aged between 35 and 75 years. The sample was divided into two groups: Group I, including women in the premenopausal period and Group II, comprising women in the post-menopausal period. The presence of MetS and its components were evaluated, as well as occurrence of T2D and CVD in both groups. We also exploited the translational bioinformatics approach to choose the common gene signatures for MetS, T2D, CVD and the menopause status. The frequency of the MetS was significantly higher in postmenopausal women than in premenopausal ones (67.1 vs. 27.2%, p < 0.001). Gene mining analysis revealed that a total of 47 genes were commonly associated with MetS, T2D, CVD and the menopausal changes. The gene enrichment analysis showed that these genes were markedly enriched in biological processes, including positive regulation of binding, positive regulation of leukocyte cell-cell adhesion, regulation of lipid localization. Furthermore, P53 signaling pathway, prolactin signaling pathway, parathyroid hormone synthesis, secretion and action were the top enriched pathways. Additionally, network analysis revealed TGFB1, SPP1, MMP2, MMP9, CCL2, IGF1, EGFR, ICAM1, TNF and IL6 as important hub genes with significant interacting partners. These hub genes identified in our study may play key role in menopausal changes and influence the risks of MetS, T2D and CVD.
Topics: Adult; Aged; Computational Biology; Diabetes Mellitus, Type 2; Female; Humans; Menopause; Metabolic Syndrome; Middle Aged; Postmenopause; Risk Factors
PubMed: 33973091
DOI: 10.1007/s10528-021-10066-7 -
Maturitas Dec 2022Dyslipidemia is an established risk factor for cardiovascular disease (CVD), which remains the leading cause of morbidity and mortality in women globally. The incidence... (Review)
Review
Dyslipidemia is an established risk factor for cardiovascular disease (CVD), which remains the leading cause of morbidity and mortality in women globally. The incidence of dyslipidemia increases over a woman's lifespan, with adverse changes around the time of menopause. Menopause, and the years leading up to the final menstrual period, is a time of estrogen fluctuation and ultimately estrogen deficiency, which has been associated with proatherogenic changes in the lipid profile. Independent of aging, menopausal status is associated with elevations in serum total cholesterol, LDL cholesterol, apolipoproteins, and triglycerides, and decreases in HDL cholesterol (HDL-C). Emerging research also suggests that after menopause there is a loss of functional HDL cardioprotective properties. Early initiation of menopausal hormone therapy (MHT) confers a favorable effect on lipid profile, though this does not translate into improved CVD outcomes and therefore guidelines do not indicate it for primary or secondary prevention of CVD. At the time of menopause, special consideration should be given to women with conditions more associated with CVD, including polycystic ovarian syndrome, premature menopause, early menopause, premature ovarian insufficiency, and familial hypercholesterolemia. Statins remain the mainstay of dyslipidemia therapy, though novel lipid-lowering agents are emerging. This review provides an overview of lipid alterations observed during the menopausal transition, summarizes the current evidence on the role of estrogen and progestogen on lipids, identifies special populations of women at especially high risk for lipid dysregulation at menopause, and describes approaches to the screening and treatment of midlife women.
Topics: Female; Humans; Menopause; Menopause, Premature; Estrogens; Cardiovascular Diseases; Triglycerides; Dyslipidemias
PubMed: 36027726
DOI: 10.1016/j.maturitas.2022.08.001 -
Social Science & Medicine (1982) Jan 2022Using a difference-in-difference estimator we identify the causal impact of early menopause and menopause symptoms on the time women spend in employment through to their...
Using a difference-in-difference estimator we identify the causal impact of early menopause and menopause symptoms on the time women spend in employment through to their mid-50s. We find the onset of early natural menopause (before age 45) reduces months spent in employment by 9 percentage points once women enter their 50s compared with women who do not experience early menopause. Early menopause is not associated with a difference in full-time employment rates. The number of menopause symptoms women face at age 50 is associated with lower employment rates: each additional symptom lowers employment rates and full-time employment rates by around half a percentage point. But not all symptoms have the same effects. Vasomotor symptoms tend not to be associated with lower employment rates, whereas the employment of women who suffer psychological problems due to menopause is adversely affected. Every additional psychological problem associated with menopause reduces employment and full-time employment rates by 1-2 percentage points, rising to 2-4 percentage points when those symptoms are reported as particularly bothersome.
Topics: Anxiety; Child, Preschool; Employment; Female; Humans; Menopause; Middle Aged
PubMed: 34953416
DOI: 10.1016/j.socscimed.2021.114676