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Menopause (New York, N.Y.) Oct 2023This study aimed to determine the relationship between stages of the menopause transition (premenopausal, perimenopausal, and postmenopausal) on symptoms of...
OBJECTIVE
This study aimed to determine the relationship between stages of the menopause transition (premenopausal, perimenopausal, and postmenopausal) on symptoms of posttraumatic stress disorder (PTSD) and depression in trauma-exposed women.
METHODS
A cross-sectional study conducted between 2005 and 2017 recruited and enrolled an urban community sample (n = 6,093) from nonpsychiatric medical clinic waiting rooms of Grady Memorial Hospital, a public safety net hospital in Atlanta, Georgia. Participants were female, 18 to 65 years old, and predominantly Black/African American.
RESULTS
Of the 6,093 participants, 93.8% were Black/African American, 2.5% were White, and 3.8% were of all other races (Hispanic/Latino, Asian, multiracial). Participants younger than 40 years were categorized as premenopausal (n = 3,166), between 40 and 55 years of age were categorized as perimenopausal (n = 2,127), and older than 55 years were categorized as postmenopausal (n = 790). Menopause status was associated with total PTSD symptom severity ( F2,5416 = 9.61, P < 0.001), symptom severity within all three PTSD symptom clusters (avoidance/numbing symptoms: F2,5416 = 7.10, P < 0.001; intrusive symptoms: F2,5416 = 7.04, P < 0.001; hyperarousal symptoms: F2,5409 = 8.31, P < 0.001), and depression symptom severity ( F2,5148 = 11.4, P < 0.001). Compared with both premenopausal and postmenopausal women, perimenopausal women reported significantly worse total PTSD symptoms, symptoms in the hyperarousal cluster, and depressive symptoms.
CONCLUSIONS
The current cross-sectional data show that symptoms of PTSD and depression in women are associated with reproductive age, such that perimenopausal women show higher symptom severity than premenopausal and postmenopausal women. Future longitudinal studies can reveal how changes in hormones over the course of the menopause transition impact the symptoms, neurobiology, and psychophysiology of PTSD.
Topics: Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Aged; Male; Stress Disorders, Post-Traumatic; Depression; Cross-Sectional Studies; Perimenopause; Menopause
PubMed: 37610715
DOI: 10.1097/GME.0000000000002235 -
Maturitas Feb 2024During the perimenopause, estrogen concentrations gradually decrease, and this is associated with changes to women's energy expenditure and intake. These changes result... (Review)
Review
During the perimenopause, estrogen concentrations gradually decrease, and this is associated with changes to women's energy expenditure and intake. These changes result in weight gain and altered body fat distribution, with increased abdominal fat deposition and cardiometabolic risk via insulin resistance. Body composition analysis is a useful clinical tool in outpatient settings, as it is simple, not expensive and provides information on body mass index, skeletal mass, fat mass, fat percentage and basal metabolic rate. This review discusses body composition analysis as part of a health assessment for healthy women during the perimenopause and investigates the associations between body composition and cardiometabolic profile.
Topics: Humans; Female; Perimenopause; Body Composition; Weight Gain; Body Mass Index; Cardiovascular Diseases
PubMed: 38086169
DOI: 10.1016/j.maturitas.2023.107898 -
Journal of Nanobiotechnology Aug 2023The development of natural membranes as coatings for nanoparticles to traverse the blood-brain barrier (BBB) presents an effective approach for treating central nervous...
The development of natural membranes as coatings for nanoparticles to traverse the blood-brain barrier (BBB) presents an effective approach for treating central nervous system (CNS) disorders. In this study, we have designed a nanogel loaded with PACAP and estrogen (E2), sheathed with exosomes and responsive to reactive oxygen species (ROS), denoted as HA NGs@exosomes. The objective of this novel design is to serve as a potent drug carrier for the targeted treatment of perimenopausal depression. The efficient cellular uptake and BBB penetration of HA NGs@exosomes has been demonstrated in vitro and in vivo. Following intranasal intervention with HA NGs@exosomes, ovariectomized mice under chronic unpredictable mild stress (CUMS) have shown improved behavioral performance, indicating that HA NGs@exosomes produced a rapid-onset antidepressant effect. Moreover, HA NGs@exosomes exhibit notable antioxidant and anti-inflammatory properties and may regulate the expression of pivotal proteins in the PACAP/PAC1 pathway to promote synaptic plasticity. Our results serve as a proof-of-concept for the utility of exosome-sheathed ROS-responsive nanogel as a promising drug carrier for the treatment of perimenopausal depression.
Topics: Mice; Animals; Nanogels; Depression; Reactive Oxygen Species; Exosomes; Perimenopause; Pituitary Adenylate Cyclase-Activating Polypeptide; Drug Carriers
PubMed: 37553718
DOI: 10.1186/s12951-023-02005-y -
Expert Opinion on Pharmacotherapy Oct 2019: Although postnatal depression is now well recognized, there is also a risk of depressive symptoms during perimenopause. The mechanisms underlying perimenopausal... (Review)
Review
: Although postnatal depression is now well recognized, there is also a risk of depressive symptoms during perimenopause. The mechanisms underlying perimenopausal depression are still poorly understood; however, there are available treatment options. : This review describes: the current pharmacotherapeutic approaches for perimenopausal depression, their strengths and weakness, and provides recommendations on how current treatment can be improved in the future. An electronic search identified specific guidelines for the treatment of perimenopausal depression released in 2018, as well as recent clinical studies on the subject. : The 2018 guidelines recommend selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) as front-line medications for perimenopausal depression, but SSRIs and SNRIs are not always effective. The efficacy of estrogen in perimenopausal depression is well documented, but estrogen is not FDA-approved to treat mood disturbances in perimenopausal women. Clinical practice guidelines currently recommend to restrict hormone therapy to the symptomatic treatment of menopause (not for the prevention of chronic diseases). Research with new estrogenic compounds is under way to improve their benefit/risk ratio in perimenopausal depression.
Topics: Depression; Female; Humans; Perimenopause; Selective Serotonin Reuptake Inhibitors
PubMed: 31355688
DOI: 10.1080/14656566.2019.1645122 -
Medicine Aug 2023The issues related to the treatment of perimenopausal depression (PMD) are the side effects of antidepressants and hormone replacement therapy. The aim of this study was... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The issues related to the treatment of perimenopausal depression (PMD) are the side effects of antidepressants and hormone replacement therapy. The aim of this study was to assess the efficiency and safety of acupuncture and moxibustion in PMD patients.
METHODS
Databases, namely PubMed, Cochrane Library, Web of Science, EMBASE, CNKI, CBM, VIP, and WanFang, were reviewed for related randomized controlled trials dated between database inception and November 22, 2022. The primary outcomes were the efficacy rate and the Hamilton Depression Scale score. The secondary outcomes were the levels of follicle-stimulating hormone, luteinizing hormone, and estradiol and the Kupperman score. Odds ratios (ORs) were generated as the effect size for dichotomous outcomes, while the standard mean difference (SMD) ± standard deviation was used for continuous outcomes. Matrices were developed to demonstrate pairwise comparisons of regimens related to each endpoint. Utilizing Review Manager (RevMan) 5.3, Stata 16.0 and SPSS 21, data were analyzed.
RESULTS
In total, 27 studies involving 2269 PMD patients and 8 therapeutic measures were incorporated into the network meta-analysis (NMA). The NMA showed that warm acupuncture (OR = 1.55, 95% CI: 1.00-2.44), electroacupuncture (OR = 1.34, 95% CI: 1.00-1.8), abdominal acupuncture (OR = 1.19, 95% CI: 0.73-1.96), and common acupuncture (OR = 1.4, 95% CI: 0.9-2.17) were more effective than fluoxetine + menopausal hormone treatment in the treatment of PMD. The NMA also showed that, based on the Hamilton Depression Scale score, warm acupuncture was more effective than the other 4 acupuncture-related treatments, i.e., electroacupuncture (SMD = -1.22, 95% CI: -2.34 to -0.09), thread embedding (SMD = -1.31, 95% CI: -2.21 to -0.40), abdominal acupuncture (SMD = -1.33, 95% CI: -2.42 to -0.24), and common acupuncture (SMD = -1.46, 95% CI: -2.26 to -0.66). The cumulative ranking probability (SUCRA) showed that warm acupuncture (99.6%) was the best treatment method.
CONCLUSIONS
The findings of this network meta-analysis may help patients and therapists choose the best acupuncture therapy for treating perimenopausal depression patients and furnish reliable evidence for guidelines.
Topics: Humans; Network Meta-Analysis; Depression; Perimenopause; Adjuvants, Immunologic; Adjuvants, Pharmaceutic; Acupuncture Therapy
PubMed: 37603500
DOI: 10.1097/MD.0000000000034694 -
Maturitas Sep 2023In addition to a range of physiological and psychological symptoms, menopause causes a decrement to balance performance and risk of falls. This review aimed to determine... (Meta-Analysis)
Meta-Analysis Review
The comparative effect of exercise interventions on balance in perimenopausal and early postmenopausal women: A systematic review and network meta-analysis of randomised, controlled trials.
In addition to a range of physiological and psychological symptoms, menopause causes a decrement to balance performance and risk of falls. This review aimed to determine the effects of exercise interventions on balance in perimenopausal and early postmenopausal women. Web of Science, PubMed, CINAHL, SPORTDiscus and Cochrane Central Register of Controlled Trials databases were searched. Randomised, controlled trials of exercise interventions in perimenopausal or early postmenopausal populations with an average age of 65 years or younger reporting balance measures were included. Risk of bias was assessed using Cochrane RoB 2. A random effects model network meta-analysis was performed to assess the effect of exercise on balance. Standardised mean differences with 95 % confidence intervals were used as the measure of effect. Twenty-six studies were included after screening. Network meta-analyses were conducted for 5 balance variables. Whole-body vibration (standardised mean difference: 2.25, confidence interval: 0.08; 4.43), balance (standardised mean difference: 1.84, confidence interval: 0.15; 3.53), balance + nutrition (standardised mean difference: 3.81, confidence interval: 1.57; 6.05) and resistance (standardised mean difference: 1.43, confidence interval: 0.41; 2.46) exercise improved Berg balance scale performance. Resistance + aerobic + balance exercise improved one-leg stance (standardised mean difference: 0.80, confidence interval: 0.39; 1.22) and whole-body vibration improved anterior-posterior (standardised mean difference: -0.89, confidence interval: -1.48; -0.31), medio-lateral (standardised mean difference: -0.58, confidence interval: -1.15; -0.01) postural sway and falls indices (standardised mean difference: -0.75, confidence interval: -1.45; -0.04). Exercise improved all balance measures and should be considered as an adjunct therapy in perimenopausal and postmenopausal women. Whole-body vibration was most frequently the highest ranked intervention; resistance and balance training also improved balance.
Topics: Humans; Female; Aged; Network Meta-Analysis; Postmenopause; Perimenopause; Exercise; Exercise Therapy; Randomized Controlled Trials as Topic
PubMed: 37343343
DOI: 10.1016/j.maturitas.2023.107790 -
Nursing ResearchMidlife perimenopausal and postmenopausal women with metabolic syndrome experience multiple symptoms concurrently.
BACKGROUND
Midlife perimenopausal and postmenopausal women with metabolic syndrome experience multiple symptoms concurrently.
OBJECTIVE
The study objectives were to examine the relationship among symptoms through network visualization and identify and compare symptom clusters and key symptoms across symptom occurrence and symptom severity dimensions in midlife perimenopausal and postmenopausal women with and without metabolic syndrome.
METHODS
Cross-sectional data from the Study of Women's Health Across the Nation (Visit 5) were used for analysis. A machine-learning-based network analysis and the Walktrap algorithm were used to fulfill the study objectives.
RESULTS
The number and types of symptom clusters differed between the groups. Midlife perimenopausal and postmenopausal women with metabolic syndrome experienced the psychological/somatic/genital cluster (key symptom: frequent mood change), the sleep/urinary cluster (sleep disturbance), and the vasomotor cluster (cold sweat) in the symptom occurrence dimension and the psychological/somatic/sexual cluster (anxiety), the sleep/urinary cluster (sleep disturbance), and the vasomotor/genital cluster (night sweat) in the symptom severity dimension. In contrast, midlife perimenopausal and postmenopausal women without metabolic syndrome experienced the psychological cluster (anxiety), the sleep/somatic/genitourinary cluster (sleep disturbance), and the vasomotor cluster (night sweat) in the symptom occurrence dimension and the psychological/somatic cluster (anxiety), the sleep/urinary cluster (sleep disturbance), the vasomotor cluster (night sweat), and the sexual/genital cluster (vaginal dryness) in the symptom severity dimension.
DISCUSSION
The study findings may serve as a knowledge basis for effective assessment and management of symptom clusters and key symptoms in clinical settings and provide directions for future development of targeted symptom management interventions.
Topics: Cross-Sectional Studies; Female; Hot Flashes; Humans; Metabolic Syndrome; Perimenopause; Postmenopause; Sleep Wake Disorders
PubMed: 35759720
DOI: 10.1097/NNR.0000000000000591 -
Menopause (New York, N.Y.) Nov 2023Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and...
OBJECTIVES
Weight gain and unfavorable body composition are prevalent among midlife/older women throughout menopause. These shifts may negatively impact health, well-being, and longevity. Efforts to attenuate weight and body composition changes are traditionally driven by manipulation of diet and/or exercise; however, sustained results are limited, possibly because the full spectrum of biobehavioral systems is not addressed by diet and exercise alone. We propose a biobehavioral model detailing mechanisms of body composition decline among perimenopausal women and the associated components of Meditative Movement (ie, tai chi, qigong, yoga) that address each of these factors.
METHODS
Based on our previous work and extensive review of the literature, we developed a multifactorial and multidimensional biobehavioral model including factors that most directly relate to body composition among perimenopausal women: 1) psychological (ie, stress and mood, mindfulness and self-compassion, body awareness), 2) behavioral (ie, sleep, physical activity, eating behaviors), and 3) physiological (ie, cortisol, estrogen). Relationships between each factor, Meditative Movement practice components, and predicted effects on body composition were explored in detail.
RESULTS
Our model describes select psychological, behavioral, and physiological factors, and potential mechanistic pathways of Meditative Movement practice driving improved changes in body composition and weight outcomes for perimenopausal women.
CONCLUSIONS
The proposed model details a novel, evidence-supported means to reduce the risk of deleterious shifts in body composition throughout perimenopause and menopause thereafter. We suggest that these changes may occur directly and/or indirectly through psychological, behavioral, and physiological mechanisms that facilitate the desired changes in body composition.
Topics: Aged; Female; Humans; Biobehavioral Sciences; Body Composition; Menopause; Perimenopause; Tai Ji; Middle Aged
PubMed: 37788427
DOI: 10.1097/GME.0000000000002262 -
BMC Women's Health Apr 2022In women with endometriosis, the association between ovarian function, hormones, and bone mineral density (BMD) is unclear. Therefore, this study aimed to elucidate the...
BACKGROUND
In women with endometriosis, the association between ovarian function, hormones, and bone mineral density (BMD) is unclear. Therefore, this study aimed to elucidate the association between changes in bone mineral density (BMD) and clinical data, such as ovarian reserves, in perimenopausal women with endometriosis.
METHODS
In this prospective study, we evaluated 207 female patients who visited the Department of Obstetrics and Gynecology at the University of Tokyo Hospital between December 2015 and December 2020. We included patients aged ≥ 40 years with a history of endometriosis or who presented with endometriosis lesions. Patients with a history of smoking, steroid administration, autoimmune diseases, dyslipidaemia, and heart disease were excluded. During the study period, patients who underwent two tests, an initial and a follow-up test (n = 142, average age: 45.02 years, average BMD: 1.16 g/cm), were evaluated at regular intervals based on the annual rate of change in BMD.
RESULTS
There was a weak negative correlation between the follicle-stimulating hormone (FSH) and BMD and a weak positive correlation between the anti-Müllerian hormone (AMH) and BMD. The annual rate of change in BMD showed a very weak correlation with thyroid-stimulating hormone (TSH) levels. A large decline in BMD was associated with high TSH levels and higher average age at menopause. Patients with higher TSH exhibited a higher rate of decrease in BMD than those without.
CONCLUSIONS
High FSH or low AMH levels are associated with decreased BMD. Decreased ovarian reserve is associated with decreased BMD in perimenopausal women with endometriosis. High TSH levels increase the risk of BMD loss. This finding may suggest that women with endometriosis should undergo bone scanning to rule out the possibility of reduced bone mass and subsequent increased risk of fracture.
Topics: Bone Density; Endometriosis; Female; Follicle Stimulating Hormone; Humans; Middle Aged; Perimenopause; Prospective Studies; Thyroid Gland; Thyrotropin
PubMed: 35477494
DOI: 10.1186/s12905-022-01711-3 -
Climacteric : the Journal of the... Oct 2022Regional homogeneity (ReHo) was used to evaluate the changes of brain function and the relationship with cognitive function in perimenopausal women.
OBJECTIVE
Regional homogeneity (ReHo) was used to evaluate the changes of brain function and the relationship with cognitive function in perimenopausal women.
METHODS:
The cross-sectional study recruited 25 perimenopausal women and 25 postmenopausal women who underwent sex hormone level measurements, clinical and neuropsychological assessments, and magnetic resonance imaging (MRI) scans. ReHo was measured based on the resting-state functional MRI (rs-fMRI) data and the differences in ReHo between the perimenopausal and postmenopausal groups were compared. Gray matter volume (GMV) values of brain regions with differences (region of interest [ROI]) in ReHo were extracted and the differences of GMV between the two groups were compared. We analyzed the correlations of the ReHo and GMV values of these ROIs with the results of sex hormone levels, clinical and neuropsychological assessments in the two groups.
RESULTS
ReHo values in the left lingual gyrus and the right precentral gyrus increased in perimenopause, whereas ReHo values in the left inferior temporal gyrus and bilateral putamen decreased. Correlation analysis showed that the ReHo values of the left inferior temporal gyrus positively correlated with the reaction time of the Stroop color word test in perimenopausal women.
CONCLUSIONS
Changes in abnormal patterns of the ReHo in perimenopausal women affect cognitive function. These changes in brain function may provide more insights and information on the neural mechanisms of cognitive dysfunction in perimenopausal women.
Topics: Brain; Cognition; Cross-Sectional Studies; Female; Humans; Magnetic Resonance Imaging; Perimenopause
PubMed: 34994285
DOI: 10.1080/13697137.2021.2014808