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Menopause (New York, N.Y.) Nov 2020Vasomotor symptoms (VMS) are associated with a poorer cardiovascular risk profile. Although the mechanisms underlying this relationship are poorly understood,...
OBJECTIVE
Vasomotor symptoms (VMS) are associated with a poorer cardiovascular risk profile. Although the mechanisms underlying this relationship are poorly understood, alterations of the hypothalamic-pituitary-adrenal (HPA) stress axis have been hypothesized to play a role. This study examined the within- and between-subject relationship between VMS and cortisol in a sample of healthy perimenopausal women.
METHODS
A total of 101 perimenopausal women, ages 45 to 55 years, were included in the study. Once a week for 12 weeks, participants completed a 24-hour hot flash diary assessing frequency and severity of VMS. They also provided two saliva samples for the measurement of the cortisol awakening response (CAR) - immediately upon waking and 30 minutes postwaking - and collected a urine sample for the measurement of a urinary metabolite of estradiol and progesterone: estrone-3-glucuronide and pregnanediol glucuronide, respectively. General linear models examined the between-subject relationship between mean VMS symptoms and mean CAR, whereas multilevel modeling was used to examine the relationship between within-person weekly changes on weekly CAR.
RESULTS
Within-subject weekly change in VMS bother, frequency, and severity were not significantly related to weekly CAR. Several significant between-subject effects of VMS on the CAR were, however, observed such that total number of hot flashes, overall VMS severity, and VMS bother, were each associated with a blunted CAR. Results remained significant despite statistically adjusting for levels of estrone-3-glucuronide, pregnanediol glucuronide, and self-reported sleep quality.
CONCLUSION
Findings suggest that women who suffer from more severe and bothersome perimenopausal VMS exhibit alterations in HPA axis activity. Within an individual, short-term changes in VMS are, however, not associated with concurrent changes in HPA axis functioning. Further research investigating the role of the HPA axis in linking VMS and increased cardiovascular disease risk is warranted. : Video Summary:http://links.lww.com/MENO/A607.
Topics: Female; Hot Flashes; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Middle Aged; Perimenopause; Pituitary-Adrenal System
PubMed: 33110049
DOI: 10.1097/GME.0000000000001588 -
Frontiers in Psychiatry 2023Females in the perimenopausal period are susceptible to mood disorders. Perimenopausal panic disorder (PPD) is characterized by repeated and unpredictable panic attacks...
INTRODUCTION
Females in the perimenopausal period are susceptible to mood disorders. Perimenopausal panic disorder (PPD) is characterized by repeated and unpredictable panic attacks during perimenopause, and it impacts the patient's physical and mental health and social function. Pharmacotherapy is limited in the clinic, and its pathological mechanism is unclear. Recent studies have demonstrated that gut microbiota is strongly linked to emotion; however, the relation between PPD and microbiota is limitedly known.
METHODS
This study aimed to discover specific microbiota in PPD patients and the intrinsic connection between them. Gut microbiota was analyzed in PPD patients ( = 40) and healthy controls ( = 40) by 16S rRNA sequencing.
RESULTS
The results showed reduced α-diversity (richness) in the gut microbiota of PPD patients. β-diversity indicated that PPD and healthy controls had different intestinal microbiota compositions. At the genus level, 30 species of microbiota abundance had significantly different between the PPD and healthy controls. In addition, HAMA, PDSS, and PASS scales were collected in two groups. It was found that Bacteroides and Alistipes were positively correlated with PASS, PDSS, and HAMA.
DISCUSSION
Bacteroides and Alistipes dysbiosis dominate imbalanced microbiota in PPD patients. This microbial alteration may be a potential pathogenesis and physio-pathological feature of PPD. The distinct gut microbiota can be a potential diagnostic marker and a new therapeutic target for PPD.
PubMed: 37304433
DOI: 10.3389/fpsyt.2023.1139992 -
Menopause (New York, N.Y.) Sep 2022Expanding access to legal cannabis has dovetailed with increased interest in medical cannabis (MC) use; however, there is a paucity of research examining MC use to...
OBJECTIVE
Expanding access to legal cannabis has dovetailed with increased interest in medical cannabis (MC) use; however, there is a paucity of research examining MC use to alleviate menopause-related symptoms. This survey study assessed patterns of MC use in perimenopausal and postmenopausal individuals.
METHODS
Participants (perimenopausal, n = 131; postmenopausal, n = 127) completed assessments of menopause-related symptomatology and cannabis use, including modes of use, type of use, and menopause-related symptoms addressed by MC use.
RESULTS
Most participants reported current cannabis use (86.1%) and endorsed using MC for menopause-related symptoms (78.7%). The most common modes of use were smoking (84.3%) and edibles (78.3%), and the top menopause-related symptoms for MC use were sleep disturbance (67.4%) and mood/anxiety (46.1%). Relative to postmenopausal participants, perimenopausal participants reported significantly worse menopause-related symptomatology on the vasomotor and psychosocial subscales of the Menopause-Specific Quality of Life Questionnaire ( P s ≤ 0.04), including greater burden of anxiety ( P = 0.01) and hot flash ( P = 0.04) symptoms. In addition, perimenopausal participants reported higher incidence of depression ( P = 0.03) and anxiety diagnoses ( P < 0.01), as well as increased use of MC to treat menopause-related mood/anxiety symptoms relative to postmenopausal participants ( P = 0.01).
CONCLUSIONS
Results suggest that many individuals are currently using MC as an adjunctive treatment for menopause-related symptoms, particularly sleep disturbance and mood/anxiety. Future research should examine the impact of different MC use characteristics (e.g., cannabinoid profiles) on the efficacy of MC use for menopause-related symptoms. Increased severity and prevalence of mood and anxiety symptoms in perimenopausal participants suggest promising targets for clinical trials of cannabinoid-based therapies.
Topics: Cannabinoids; Female; Hot Flashes; Humans; Medical Marijuana; Perimenopause; Postmenopause; Quality of Life; Surveys and Questionnaires
PubMed: 35917529
DOI: 10.1097/GME.0000000000002018 -
Journal of Obstetrics and Gynaecology :... Oct 2022This cross-sectional study focussed on perimenopausal Mongolian women and aimed to determine the quality of life (QOL) and risk factors in this population. We collected...
This cross-sectional study focussed on perimenopausal Mongolian women and aimed to determine the quality of life (QOL) and risk factors in this population. We collected data on 392 women using a predesigned questionnaire and classified the participants according to menopausal status. We used The Menopause Rating Scale (MRS) and the World Health Organisation Quality of Life (WHOQOL)-BREF. Blood pressure ( = .003) and body mass index ( = .02) were significantly high, whereas sexual activity was significantly decreased in postmenopausal women ( = .001). In perimenopausal women, somatovegetative ( = .003) and psychological ( = .025) symptoms were significantly severe, and menopausal symptom severity was significantly higher ( = .017). Menopausal symptoms ( = .02) and monthly sexual activity ( = .005) significantly influenced overall QOL. Sexuality had a significantly negative effect on psychological health ( = .03). Age, occupation, menopausal stage and somatovegetative symptoms have significant effects on health-related QOL (< .05). Our findings showed that menopausal symptoms and sexual activity significantly affect QOL in middle-aged Mongolian women.Impact Statement Women experience physiological changes at the onset of menopause. However, as their oestrogen levels decline, many women also experience physical, psychological and somatovegetative symptoms. Postmenopausal health has been the main issue affecting middle-aged women, until recently. Here, we showed that menopausal transition is a turning point for middle-aged women and suggest that more attention should be paid to the health of perimenopausal women in Mongolia. The study results showed that perimenopausal women had a higher prevalence of health-related problems than postmenopausal women, including weight gain, cardiovascular symptoms and vasomotor symptoms. The prevalence of genitourinary health problems increased with age. General practitioners and gynaecologists in Mongolia should acquire a better understanding of the physiological changes that occur during menopause and pay greater attention to genitourinary issues as they affect general, health-related quality of life.
Topics: Middle Aged; Female; Humans; Perimenopause; Quality of Life; Cross-Sectional Studies; Menopause; Risk Factors; Surveys and Questionnaires; Hot Flashes
PubMed: 36052870
DOI: 10.1080/01443615.2022.2106829 -
Antioxidants (Basel, Switzerland) Nov 2022Osteoporosis, or bone loss, is a disease that affects many women globally. As life expectancy increases, the risk of osteoporosis in women also increases, too, and this... (Review)
Review
Osteoporosis, or bone loss, is a disease that affects many women globally. As life expectancy increases, the risk of osteoporosis in women also increases, too, and this will create a burden on the healthcare and economic sectors of a country. Osteoporosis was once thought to be a disease that would occur only after menopause. However, many studies have shown that osteoporosis may develop even in the perimenopausal stage. Due to the erratic levels of estrogen and progesterone during the perimenopausal stage, studies suggest that women are exposed to the risk of developing osteoporosis even at this stage. The erratic hormonal changes result in the production of proinflammatory mediators and cause oxidative stress, which leads to the progressive loss of bone-building activities. Tocotrienols, members of vitamin E, have many health-promoting properties. Due to their powerful anti-oxidative and anti-inflammatory properties, tocotrienols have shown positive anti-osteoporotic properties in post-menopausal studies. Hence, we propose here that tocotrienols could also possibly alleviate perimenopausal osteoporosis by discussing in this review the connection between inflammatory mediators produced during perimenopause and the risk of osteoporosis. Tocotrienols could potentially be an anti-osteoporotic agent, but due to their low bioavailability, they have not been as effective as they could be. Several approaches have been evaluated to overcome this issue, as presented in this review. As the anti-osteoporotic effects of tocotrienols were mostly studied in post-menopausal models, we hope that this review could pave the way for more research to be done to evaluate their effect on peri-menopausal models so as to reduce the risk of osteoporosis from an earlier stage.
PubMed: 36358550
DOI: 10.3390/antiox11112179 -
Journal of the National Cancer Institute Jan 2022
Topics: Aromatase Inhibitors; Breast Neoplasms; Female; Humans; Perimenopause; Tamoxifen
PubMed: 34396390
DOI: 10.1093/jnci/djab153 -
Menopause (New York, N.Y.) Dec 2021This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and...
OBJECTIVE
This study investigated whether (1) cognitive functions change after the transition from the perimenopausal to the postmenopausal stage, (2) cognitive functions and walking are associated in middle-aged women, and (3) cognitive functions assessed in perimenopause are associated with walking after reaching the postmenopause or vice versa.
METHODS
In total, 342 women, categorized as early (n = 158) or late perimenopausal (n = 184), were included in the study and followed up until postmenopausal. Psychomotor speed, executive functions related to set-shifting and updating, working memory, and visual memory were assessed. Walking was assessed with walking speed, walking distance, and dual-task cost in walking speed. Data was analyzed using the paired-samples t test, Wilcoxon signed rank test, multiple linear regression analysis, and structural equation modeling.
RESULTS
We found small but significant improvements in psychomotor speed (P = 0.01) and working memory (P < 0.001) among early perimenopausal and in psychomotor speed (P = 0.001), set-shifting (P = 0.02), visual memory (P = 0.002), and working memory (P < 0.001) among late perimenopausal women after the transition from peri- to postmenopause. Walking speed (β = 0.264, P = 0.001) and dual-task cost (β = 0.160, P = 0.03) were associated with updating, and walking distance was associated with updating and set-shifting (β = 0.198, P = 0.02, β=-0.178 P = 0.04 respectively) among the late perimenopausal women. We found no longitudinal associations between cognitive functions and walking.
CONCLUSION
Cognitive performance remained unchanged or improved after reaching postmenopause. Cognitive functions and walking were associated during the late perimenopause, but the association depended on the cognitive process and nature of the physical task. Cognitive performance was not associated with walking after reaching postmenopause or vice versa.
Topics: Cognition; Executive Function; Female; Humans; Memory, Short-Term; Middle Aged; Perimenopause; Walking
PubMed: 34930867
DOI: 10.1097/GME.0000000000001896 -
Climacteric : the Journal of the... Jun 2021This study aimed to evaluate dry eye disease (DED) symptoms and quality of life (QoL) in a group of perimenopausal and postmenopausal women, based on the Ocular Surface... (Observational Study)
Observational Study
OBJECTIVE
This study aimed to evaluate dry eye disease (DED) symptoms and quality of life (QoL) in a group of perimenopausal and postmenopausal women, based on the Ocular Surface Disease Index (OSDI) questionnaire.
METHODS
An observational study was performed in a group of 1947 perimenopausal and postmenopausal women, aged between 45 and 79 years. The personal data collected were age, menopause status, age at menopause, and OSDI score.
RESULTS
The mean age of the group was 54.18 ± 6.84 years, with a mean age at menopause of 49.45 ± 4.02 years. The average OSDI score was 29.20 ± 19.4. The overall prevalence of DED symptoms was 79%, increasing significantly in postmenopausal women, 76.4% vs. 80.5% ( = 0.029). In our group, 37.7% had severe DED symptoms. Ocular symptoms, vision-related functions, and environmental trigger scores were higher in postmenopausal women, leading to a lower QoL. The severity of OSDI score increases with age ( coefficient: 0.15 [95% confidence interval: 0.02; -0.28]), while the severity of OSDI score decreases with a later onset age of menopause ( coefficient: -0.27 [95% confidence interval: -0.55; -0.01]).
CONCLUSIONS
DED symptoms are highly prevalent in perimenopausal and postmenopausal women. Postmenopausal women had a higher prevalence of symptoms and higher OSDI scores than perimenopausal women. The severity of DED symptoms and vision-related functions leads to poorer QoL.
Topics: Aged; Dry Eye Syndromes; Female; Humans; Middle Aged; Perimenopause; Postmenopause; Prevalence; Quality of Life; Severity of Illness Index; Surveys and Questionnaires
PubMed: 33283560
DOI: 10.1080/13697137.2020.1849087 -
Journal of Hypertension Jul 2023To evaluate the impact of sacubitril/valsartan on blood pressure (BP), ventricular structure, and myocardial fibrosis compared with valsartan in perimenopausal... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To evaluate the impact of sacubitril/valsartan on blood pressure (BP), ventricular structure, and myocardial fibrosis compared with valsartan in perimenopausal hypertensive women.
METHODS
This prospective, randomized, actively controlled, open-label study included 292 women with perimenopausal hypertension. They were randomly divided into two groups: sacubitril/valsartan 200 mg once daily and valsartan 160 mg once daily for 24 weeks. The relevant indicators of ambulatory BP, echocardiography, and myocardial fibrosis regulation were assessed at baseline and at 24 weeks.
RESULTS
The 24-h mean SBP after 24 weeks of treatment was 120.08 ± 10.47 mmHg in the sacubitril/valsartan group versus 121.00 ± 9.76 mmHg in the valsartan group ( P = 0.457). After 24 weeks of treatment, there was no difference in central SBP between the sacubitril/valsartan and valsartan groups (117.17 ± 11.63 versus 116.38 ± 11.58, P = 0.568). LVMI in the sacubitril/valsartan group was lower than that in the valsartan group at week 24 ( P = 0.009). LVMI decreased by 7.23 g/m 2 from the baseline in the sacubitril/valsartan group and 3.70 g/m 2 in the valsartan group at 24 weeks ( P = 0.000 versus 0.017). A statistically significant difference in LVMI between the two groups was observed at 24 weeks after adjusting for the baseline LVMI ( P = 0.001). The levels of α-smooth muscle actin (α-SMA), connective tissue growth factor (CT-GF) and transforming growth factor-β (TGF-β) were reduced in the sacubitril/valsartan group compared with the baseline ( P = 0.000, 0.005, and 0.000). LVMI between the two groups was statistically significant at 24 weeks after correcting for confounding factors 24-h mean SBP and 24-h mean DBP ( P = 0.005). The LVMI, serum TGF-β, α-SMA, and CT-GF remained statistically significant between the two groups after further correcting the factors of age, BMI, and sex hormone levels ( P < 0.05).
CONCLUSION
Sacubitril/valsartan could reverse ventricular remodeling more effectively than valsartan. The different effects of these two therapies on ventricular remodeling in perimenopausal hypertensive women might be because of their different effects on the down-regulation of fibrosis-related factors.
Topics: Female; Humans; Aminobutyrates; Biphenyl Compounds; Drug Combinations; Heart Failure; Hypertension; Perimenopause; Prospective Studies; Valsartan; Ventricular Remodeling
PubMed: 37071432
DOI: 10.1097/HJH.0000000000003430 -
BMC Women's Health Apr 2024More than 2 billion women are experiencing the menopausal transition in China, and some of these women have hypertension. Limited studies has focused on perimenopausal...
BACKGROUND
More than 2 billion women are experiencing the menopausal transition in China, and some of these women have hypertension. Limited studies has focused on perimenopausal syndrome and hypertension in a specific population, so we aimed to investigate the prevalence of perimenopausal syndrome and hypertension and to analyse their relationships and risk factors in perimenopausal women in South China.
METHODS
This cross-sectional study included 3553 women aged 40 to 60 years from South China. We collected medical report, lifestyle, blood sample, general condition questionnaire, and modified Kupperman index (mKMI) data. Multivariate logistic regression analysis was performed to identify risk factors for perimenopausal syndrome and hypertension during perimenopause.
RESULTS
The prevalence of hypertension in perimenopause patients was 16.58%, and the prevalence of perimenopausal syndrome was 9.9%. Compared with women without hypertension during perimenopause, women with HTN during perimenopause had an increased risk of perimenopausal syndrome (26.4% vs. 8.7%, P < 0.001). Lipid levels and urinary tract infections were risk factors for hypertension and perimenopausal syndrome, in addition to the presence of breast nodules, the intake of snacks at night, high-salt diets, red meat and sugar-sweetened beverages, and a history of smoking and drinking for perimenopausal syndrome and the presence of gestational hypertension and diabetes for hypertension.
CONCLUSION
We concluded that perimenopausal syndrome and HTN are common in perimenopausal women in South China, and the associations between them are strong and positive. Perimenopausal syndrome shares some common risk factors with HTN during perimenopause, such as BMI and dyslipidaemia. Therefore, gynaecological endocrinologists in China should consider screening for perimenopausal syndrome in hypertensive perimenopausal women, and appropriate management of perimenopause is needed to alleviate these conditions.
Topics: Female; Humans; Perimenopause; Prevalence; Cross-Sectional Studies; Risk Factors; Hypertension; China
PubMed: 38570811
DOI: 10.1186/s12905-024-03056-5