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Maturitas Jan 2020Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70 % greater in women. The perimenopause is considered to be a time... (Review)
Review
INTRODUCTION
Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70 % greater in women. The perimenopause is considered to be a time of increased risk for the development of depressive symptoms and major depressive episodes.
AIM
The aim of this position statement is to provide a comprehensive model of care for the management of depressive symptoms in perimenopausal and early menopausal women, including diagnosis, treatment and follow-up. The model integrates the care provided by all those involved in the management of mild or moderate depression in midlife women.
MATERIALS AND METHODS
Literature review and consensus of expert opinion.
SUMMARY RECOMMENDATIONS
Awareness of depressive symptoms, early detection, standardized diagnostic procedures, personalized treatment and a suitable follow-up schedule need to be integrated into healthcare systems worldwide. Recommended treatment comprises antidepressants, psychosocial therapies and lifestyle changes. Alternative and complementary therapies, although widely used, may help with depression, but a stronger evidence base is needed. Although not approved for this indication, menopausal hormone therapy may improve depressive symptoms in peri- but not in postmenopausal women, especially in those with vasomotor symptoms.
Topics: Adult; Aged; Antidepressive Agents; Complementary Therapies; Depression; Depressive Disorder, Major; Europe; Female; Hormones; Humans; Life Style; Menopause; Middle Aged; Perimenopause; Postmenopause; Practice Guidelines as Topic; Societies, Medical; Treatment Outcome
PubMed: 31740049
DOI: 10.1016/j.maturitas.2019.11.002 -
Annals of Palliative Medicine Jul 2022The quality of life of women is seriously affected by perimenopausal symptoms and related diseases. Clinical nurses often suffer from job burnout due to high pressure...
BACKGROUND
The quality of life of women is seriously affected by perimenopausal symptoms and related diseases. Clinical nurses often suffer from job burnout due to high pressure and intensity of work and life, which is easy to induce and aggravate perimenopausal syndrome. Nursing occupational environment varies greatly in different economic regions, but relevant studies are limited to northern cities, and are often confined to the second and third grade hospitals or a hospital in a certain region, lacking multi-center studies on hospitals of different grades. Therefore, it is necessary to understand the occurrence of perimenopausal syndrome in clinical nurses in Chongqing and its influencing factors, so as to provide reference for managers to take targeted intervention measures.
METHODS
The investigation was conducted using the method of stratified random cluster sampling. A questionnaire survey was conducted among 933 clinical nurses aged from 40 to 55 in primary, secondary and tertiary hospitals. Kupperman's total symptom score ranged from 0 to 63, while a score of ≥7 can determine the existence of perimenopausal syndrome.
RESULTS
Among the 933 clinical nurses surveyed, 662 (70.95%) had perimenopausal syndrome, the results of the multivariate unconditional logistic regression analysis showed that The age ranges from 51 to 55 (OR =2.035, 95% CI: 1.070-3.872), the presence of chronic diseases (OR =1.659, 95% CI: 1.095-2.512), menopause (OR =1.989, 95% CI: 1.198-3.303), moderate family function impairment (OR =1.940, 95% CI: 1.356-2.776), severe family dysfunction weekly (OR =2.309, 95% CI: 1.178-4.524), never participation in sports (OR =3.328, 95% CI: 1.657-6.684) and exercising 1-5 times per week (OR =2.689, 95% CI: 1.516-4.768) were risk factors for perimenopausal syndrome in clinical nurses, basic security (OR =0.939, 95% CI: 0.887-0.994), and sufficient manpower (OR =0.915, 95% CI: 0.855-0.979) were protective factors for perimenopausal syndrome in clinical nurses.
CONCLUSIONS
The incidence of perimenopausal syndrome in clinical nurses at all levels of hospitals situated in Chongqing is relatively high. It is suggested that nursing managers should attach great importance to the physical and mental condition of this population and timely take targeted intervention measures to prevent or alleviate the occurrence and development of perimenopausal syndrome in clinical nurses.
Topics: Burnout, Professional; Cross-Sectional Studies; Female; Humans; Perimenopause; Quality of Life; Surveys and Questionnaires; Syndrome; Tertiary Care Centers
PubMed: 35927777
DOI: 10.21037/apm-22-563 -
Neuropsychology, Development, and... Mar 2022The aim of this study was to analyze the influence of reproductive aging on executive functions. We assessed executive functions in three groups of healthy women in the...
The aim of this study was to analyze the influence of reproductive aging on executive functions. We assessed executive functions in three groups of healthy women in the premenopausal (n = 45, mean age = 30.89, SD = 10.5), perimenopausal (n = 31, mean age = 50.06, SD = 3.6) and postmenopausal (n = 24, mean age = 63.39, SD = 6.5) phase. No differences between groups were observed in working memory, verbal fluency, inhibitory control, planning, and cognitive flexibility. However, when the analyses were repeated with participants with occupations with lower intellectual demands, perimenopausal and postmenopausal women performed worse than premenopausal women in semantic verbal fluency. This study provides important evidence to understand the effects of reproductive aging on cognitive performance in healthy women. Our findings indicate that cognitive reserve-related factors may be important to understand the differences in executive functions associated with reproductive aging.
Topics: Aging; Executive Function; Female; Humans; Perimenopause; Postmenopause; Premenopause
PubMed: 33307979
DOI: 10.1080/13825585.2020.1859083 -
Medicine Dec 2021This study aimed to investigate the correlation between homocysteine (HCY), C-reactive protein (CRP), lipid levels, and sleep quality in perimenopausal and...
This study aimed to investigate the correlation between homocysteine (HCY), C-reactive protein (CRP), lipid levels, and sleep quality in perimenopausal and postmenopausal women.We collected data from 217 patients (perimenopause and postmenopausal) who visited the gynecological endocrine outpatient department of our hospital between January 2017 and January 2019. The quality and patterns of sleep were measured using the Pittsburgh Sleep Quality Index, and relationships between HCY, CRP, lipid levels, and sleep quality were analyzed according to a Pittsburgh Sleep Quality Index ≥ 8.There were significant differences in age, education level, and occupation among patients with different levels of sleep quality (P < .05). HCY, CRP, total cholesterol, triglyceride, and low-density lipoprotein levels were significantly higher in patients with poor sleep quality than in those with good sleep quality (P < .05). Age, education level, occupation, HCY, CRP, and lipid levels (total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein) were all significant influencing factors for sleep quality in perimenopausal and postmenopausal women (all P < .05). After adjusting for age, education level, occupation, HCY, and CRP levels were all significant and independent risk factors for sleep quality in perimenopausal and postmenopausal women (all P < .05).Levels of HCY, CRP, and lipids were significantly correlated with sleep quality in perimenopausal and postmenopausal women. HCY and CRP were identified as independent risk factors for sleep quality in perimenopausal and postmenopausal women, thus providing theoretical support for the clinical improvement of sleep quality.
Topics: Adult; C-Reactive Protein; Cholesterol; Female; Homocysteine; Humans; Lipids; Middle Aged; Perimenopause; Postmenopause; Sleep Quality; Triglycerides
PubMed: 34941184
DOI: 10.1097/MD.0000000000028408 -
International Journal of Food Sciences... Sep 2022The effect of brown and golden flaxseeds on lipid profile, oxidative stress, intestinal permeability, endotoxemia, and fasting glycaemia of perimenopausal overweight... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect of brown and golden flaxseeds on lipid profile, oxidative stress, intestinal permeability, endotoxemia, and fasting glycaemia of perimenopausal overweight women was investigated in this clinical trial. Thirty participants were divided into control (CG), brown flaxseed (BF), and golden flaxseed (GF) groups. BF and GF received 40 g of brown and golden flaxseed for 12 weeks. Venous blood samples were collected at the beginning and at the end. Intestinal permeability analysis was performed by urinary excretion of lactulose and mannitol. There was significant reduction in intestinal permeability in flaxseed groups, with delta of lactulose/mannitol ratio smaller ( ≤ 0.05). LPS levels were reduced in the flaxseed groups, whereas low-density lipoproteins (LDL) was decreased in the GF group ( ≤ 0.05). Flaxseed consumption did not change oxidative stress markers and glycaemia. Flaxseed consumption, especially golden flaxseed, reduced intestinal permeability and improved the lipid profile, showing positive effects on metabolic changes caused by menopausal transition.HIGHLIGHTSBrown and golden flaxseeds show a high content of insoluble fibre and alpha-linolenic acid, and brown flaxseed presented higher antioxidant activity.Golden flaxseed improved the lipid profile.Brown and golden flaxseeds reduced intestinal permeability and endotoxemia.Brown and golden flaxseed can be a promising alternative for the prevention of metabolic changes caused by menopausal transition, and for the improvement of the intestinal health.
Topics: Endotoxemia; Female; Flax; Humans; Lactulose; Lipoproteins, LDL; Mannitol; Overweight; Perimenopause; Permeability
PubMed: 35311432
DOI: 10.1080/09637486.2022.2052820 -
Diabetes & Metabolism Journal Jul 2021Cardiovascular disease is the primary cause of mortality in women and men with diabetes. Due to age and worsening of risk factors over the menopausal transition, risk of... (Review)
Review
Cardiovascular disease is the primary cause of mortality in women and men with diabetes. Due to age and worsening of risk factors over the menopausal transition, risk of coronary heart disease events increases in postmenopausal women with diabetes. Randomized studies have conflicted regarding the beneficial impact of estrogen therapy upon intermediate cardiovascular disease markers and events. Therefore, estrogen therapy is not currently recommended for indications other than symptom management. However, for women at low risk of adverse events, estrogen therapy can be used to minimize menopausal symptoms. The risk of adverse events can be estimated using risk engines for the calculation of cardiovascular risk and breast cancer risk in conjunction with screening tools such as mammography. Use of estrogen therapy, statins, and anti-platelet agents can be guided by such calculators particularly for younger women with diabetes. Risk management remains focused upon lifestyle behaviors and achieving optimal levels of cardiovascular risk factors, including lipids, glucose, and blood pressure. Use of pharmacologic therapies to address these risk factors, particularly specific hypoglycemic agents, may provide some additional benefit for risk prevention. The minimal benefit for women with limited life expectancy and risk of complications with intensive therapy should also be considered.
Topics: Cardiovascular Diseases; Diabetes Mellitus; Female; Heart Disease Risk Factors; Humans; Perimenopause
PubMed: 34352986
DOI: 10.4093/dmj.2020.0262 -
BMC Women's Health Nov 2023To measure symptoms and health-related quality of life in a cross-sectional cohort of menopausal-aged women in China.
OBJECTIVE
To measure symptoms and health-related quality of life in a cross-sectional cohort of menopausal-aged women in China.
METHOD
A cross-sectional survey was conducted in a general population cohort of 2,000 Chinese females over the age of 45 years. Patients completed the Chinese version of the EuroQol-5D five level (EQ5D5L) health-related quality of life instrument via Personal Digital Assistant. Raw scores were converted to utility tariffs using value sets for China. Statistical analysis included Pearson's chi-square test, z test for multiple comparisons with adjustment by the Bonferroni method, independent-sample t-test, ANOVA, and adjustment by the Tukey method for multiple comparison. Results were considered statistically significant when p < 0.05 and the study was reported according to the STROBE recommendations.
RESULTS
In a cohort of 2000 women, 732 (37%) were premenopausal, 798 (40%) were perimenopausal and 470 (23%) were postmenopausal. Perimenopausal women reported significantly more symptoms (91%) compared to premenopausal (77%) and postmenopausal (81%) women. Health-related quality of life was significantly lower in symptomatic perimenopausal women compared to premenopausal (0.919, p < 0.05) and postmenopausal (0.877, p < 0.05) women. Within each group there was a statistically significant difference between the health-related quality of life of women with symptoms compared to without symptoms.
CONCLUSION
The perimenopausal phase of menopause is associated with significantly more symptoms and significantly lower HRQoL compared to premenopausal and postmenopausal phases.
Topics: Humans; Female; Aged; Middle Aged; Male; Cross-Sectional Studies; Perimenopause; Quality of Life; Menopause; Premenopause
PubMed: 37915020
DOI: 10.1186/s12905-023-02728-y -
Fertility and Sterility Nov 2019Fractures and their consequences are the clinically important manifestation of osteoporosis; preventing fractures is the primary goal of management. Effective management... (Review)
Review
Fractures and their consequences are the clinically important manifestation of osteoporosis; preventing fractures is the primary goal of management. Effective management is achievable given present knowledge and tools but is seldom prescribed. This review will cover the individual and social burden of fracture, essential information about fracture risk and its estimation, an approach to patient care emphasizing specific information to elicit and therapeutic strategies to pursue, and existing gaps in knowledge and important questions for future research.
Topics: Adult; Bone Density; Disease Management; Female; Fractures, Bone; Humans; Middle Aged; Perimenopause; Postmenopause; Risk Factors
PubMed: 31731932
DOI: 10.1016/j.fertnstert.2019.09.038 -
Trials Feb 2023The perimenopausal transition is accompanied by psychiatric symptoms in over 10% of women. Symptoms commonly include depressed mood and anhedonia and less commonly...
BACKGROUND
The perimenopausal transition is accompanied by psychiatric symptoms in over 10% of women. Symptoms commonly include depressed mood and anhedonia and less commonly include psychosis. Psychiatric symptoms have been linked to the depletion and/or variability of circulating estradiol, and estradiol treatment reduces perimenopausal anhedonia and psychosis in some women. Estrogen fluctuations may disrupt function in the mesolimbic reward system in some women, leading to psychiatric symptoms like anhedonia or psychosis. The Perimenopausal Effects of Estradiol on Anhedonia and Psychosis Study (PEEPs) is a mechanistic clinical trial that aims to (1) identify relationships between perimenopausal-onset anhedonia and psychosis and neuromolecular markers of mesolimbic reward responses and (2) determine the extent to which estradiol treatment-induced changes in mesolimbic reward responses are associated with alleviation of perimenopausal onset anhedonia or psychosis.
METHODS
This study will recruit 100 unmedicated women ages 44-55 in the late-stage perimenopausal transition, sampling across the range of mild-to-high anhedonia and absent-to-moderate psychosis symptoms. Patients will be randomized to receive either estradiol or placebo treatment for 3 weeks. Clinical outcome measures will include symptoms of anhedonia (measured with Snaith-Hamilton Pleasure Scale; SHAPS) and psychosis (measured with Brief Psychiatric Rating Scale; BPRS psychosis subscale) as well as neural markers of mesolimbic reward system functioning, including reward-related fMRI activation and PET-derived measure of striatal dopamine binding. Pre-treatment associations between (1) SHAPS/BPRS scores and (2) reward-related striatal dopamine binding/BOLD activation will be examined. Furthermore, longitudinal mixed models will be used to estimate (1) symptom and neuromolecular trajectories as a function of estradiol vs. placebo treatment and (2) how changes in reward-related striatal dopamine binding and BOLD activation predict variability in symptom trajectories in response to estradiol treatment.
DISCUSSION
This clinical trial will be the first to characterize neural and molecular mechanisms by which estradiol treatment ameliorates anhedonia and psychosis symptoms during the perimenopausal transition, thus laying the groundwork for future biomarker research to predict susceptibility and prognosis and develop targeted treatments for perimenopausal psychiatric symptoms. Furthermore, in alignment with the National Institute for Mental Health Research Domain Criteria initiative, this trial will improve our understanding of a range of disorders characterized by anhedonia, psychosis, and reward system dysfunction.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05282277.
Topics: Female; Humans; Estradiol; Anhedonia; Dopamine; Perimenopause; Psychotic Disorders; Randomized Controlled Trials as Topic
PubMed: 36855177
DOI: 10.1186/s13063-023-07166-7 -
Journal of Mid-life Health 2021Menopause is associated with physical, physiological, psychological changes and may lead to sexual dysfunction (SD) effecting woman's health and well-being. Scientific...
BACKGROUND
Menopause is associated with physical, physiological, psychological changes and may lead to sexual dysfunction (SD) effecting woman's health and well-being. Scientific research in the area of female sexuality in India is scant. Therefore, this study aimed to investigate female sexual function at perimenopause and menopause and determine the association between sociodemographic and physiological factors with sexual function.
MATERIALS AND METHODS
This was a cross-sectional hospital-based study carried out in perimenopausal and menopausal women. Study participant's details were collected by gynecologists and clinical research professionals following the participant's informed consent. The case report and McCoy female sexuality questionnaire were used. The association between sociodemographic status and sexual function was determined. Data were summarized using descriptive statistics for portraying profile of the participants and -test for comparison.
RESULTS
A total of 129 women in the menopausal (SD - 3.26) and 112 in the premenopausal group (SD - 6.01) were enrolled. The sociodemographic parameters did not significantly affect the sexual function scores in both groups. In terms of vaginal atrophy, a significant increase in urgency was noted in the postmenopause group. The general domain of sexual function was significantly lower in menopausal than and perimenopausal with a < 0.001. Looking at individual domains of sexual function, for sexual interest, satisfaction, vaginal lubrication, and orgasm, the mean value of perimenopausal participants was significantly higher when compared to menopausal women; for a primary partner domain, no significant differences between the two groups were noted.
CONCLUSION
Overall, the sociodemographic profile did not impact sexual function in this study. Compared with menopausal women, perimenopausal women showed better, more complete sexual function based on McCoy's score except partner-related domain that is constant from perimenopause to menopause in a monogamous relationship.
PubMed: 34526750
DOI: 10.4103/jmh.jmh_95_21