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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 -
Calcified Tissue International Nov 2020In this sub-analysis of a comprehensive meta-analysis, we aimed to determine the effect of different types of exercise on (areal) bone mineral density (BMD) in... (Meta-Analysis)
Meta-Analysis Review
In this sub-analysis of a comprehensive meta-analysis, we aimed to determine the effect of different types of exercise on (areal) bone mineral density (BMD) in postmenopausal women. A systematic review of the literature according to the PRISMA statement included (a) controlled trials, (b) with at least one exercise and one control group, (c) intervention ≥ 6 months, (d) BMD assessments at lumbar spine (LS), femoral neck (FN) or total hip (TH), (e) in postmenopausal women. Eight electronic databases were scanned without language restrictions up to March 2019. The present subgroup analysis was conducted as a mixed-effect meta-analysis with "type of exercise" as the moderator. The 84 eligible exercise groups were classified into (a) weight bearing (WB, n = 30) exercise, (b) (dynamic) resistance exercise (DRT, n = 18), (c) mixed WB&DRT interventions (n = 36). Outcome measures were standardized mean differences (SMD) for BMD-changes at LS, FN and TH. All types of exercise significantly affect BMD at LS, FN and TH. SMD for LS average 0.40 (95% CI 0.15-0.65) for DRT, SMD 0.26 (0.03-0.49) for WB and SMD 0.42 (0.23-0.61) for WB&DRT. SMD for FN were 0.27 (0.09-0.45) for DRT, 0.37 (0.12-0.62) for WB and 0.35 (0.19-0.51) for WB&DRT. Lastly, SMD for TH changes were 0.51 (0.28-0.74) for DRT, 0.40 (0.21-0.58) for WB and 0.34 (0.14-0.53) for WB&DRT. In summary, we provided further evidence for the favorable effect of exercise on BMD largely independent of the type of exercise. However, in order to generate dedicated exercise recommendations or exercise guideline, meta-analyses might be a too rough tool.
Topics: Bone Density; Exercise; Female; Femur Neck; Humans; Lumbar Vertebrae; Osteoporosis, Postmenopausal; Postmenopause; Resistance Training; Weight-Bearing
PubMed: 32785775
DOI: 10.1007/s00223-020-00744-w -
BioMed Research International 2020Osteoporosis is a chronic disease that seriously affects human health and quality of life. This study is aimed at determining whether swimming had an effect on the bone... (Meta-Analysis)
Meta-Analysis
Osteoporosis is a chronic disease that seriously affects human health and quality of life. This study is aimed at determining whether swimming had an effect on the bone mineral density (BMD) of the spine and femoral neck in postmenopausal and premenopausal osteoporosis patients. We retrieved relevant literature and analyzed data from randomized controlled trials to assess the effect of swimming on BMD in postmenopausal and premenopausal women. Relevant studies, with no language restrictions, from inception to September 2019, were retrieved from the PubMed, Cochrane, EMBASE, and EBSCO databases independently by two investigators. The keywords used for the literature search were "osteoporosis" and "swimming." The main results included BMD and -score. We searched 256 relevant articles and finally screened five articles, including 263 participants. Lumbar spine density was mentioned in three articles. Although the heterogeneity of lumbar vertebral density is moderate, the analysis of swimmers to nonswimmers shows that the lumbar vertebral density in swimmers is improved [heterogeneity: chi = 5.16, df = 2 ( = 0.08); = 61%]. We analyzed the following heterogeneous subgroups: subgroup 1 (3-6 hours) and subgroup 2 (<3 hours). The BMD in subgroup 1 was significantly higher than that in the placebo, while no effect on BMD was found in subgroup 2 [heterogeneity: chi = 0.15, df = 3 ( = 0.70); = 0%]. According to the current evidence, swimming may improve the BMD of postmenopausal women participants, if the swimming time is between 3 and 6 hours, especially in long-term swimmers. However, the effectiveness of swimming does require further investigation.
Topics: Adult; Bone Density; Exercise Therapy; Female; Femur Neck; Humans; Lumbar Vertebrae; Middle Aged; Osteoporosis; Osteoporosis, Postmenopausal; Postmenopause; Premenopause; Swimming
PubMed: 32509864
DOI: 10.1155/2020/6210201 -
Disease Markers 2022To systematically evaluate the differences in intestinal flora before and after menopause. To provide a possible mechanism for perimenopausal syndrome and provide a... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To systematically evaluate the differences in intestinal flora before and after menopause. To provide a possible mechanism for perimenopausal syndrome and provide a basis for probiotics as adjuvant therapy.
METHODS
MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CNKI, Wanfang, and VIP databases were searched. The included studies were case-control studies.
RESULTS
Three case-control studies were included, with a total of 156 people. At the phylum level, there were no differences between premenopausal and postmenopausal women. At the genus level, the relative abundances of A. odoratum and B. cholerae were higher in postmenopausal women than in premenopausal women, with no differences among other genera. The Shannon diversity index increased after menopause, but no differences were found. Only one study found a positive association of estradiol with Gammaproteobacteria and Myxococcales and a negative association with Prevotellaceae.
CONCLUSIONS
On the basis of previous studies, it was found that there was no significant difference at the phylum level between postmenopausal women and premenopausal women, but Odoribacter and Bilophila increased at the genus level in postmenopausal women. The class of Gammaproteobacteria may be positively correlated with estradiol. Limited by the number of included studies, more high-quality clinical studies are needed for validation.
Topics: Estradiol; Female; Gastrointestinal Microbiome; Humans; Menopause; Postmenopause; Premenopause
PubMed: 35923245
DOI: 10.1155/2022/3767373 -
Medicina (Kaunas, Lithuania) Sep 2019The history of hormone replacement therapy (HRT) started in the 1960s, with very high popularity in the 1990s. The first clinical trials on HRT and chronic... (Review)
Review
The history of hormone replacement therapy (HRT) started in the 1960s, with very high popularity in the 1990s. The first clinical trials on HRT and chronic postmenopausal conditions were started in the USA in the late 1990s. After the announcement of the first results of the Women's Health Initiative (WHI) in 2002, which showed that HRT had more detrimental than beneficial effects, HRT use dropped. The negative results of the study received wide publicity, creating panic among some users and new guidance for doctors on prescribing HRT. The clear message from the media was that HRT had more risks than benefits for all women. In the following years, a reanalysis of the WHI trial was performed, and new studies showed that the use of HRT in younger women or in early postmenopausal women had a beneficial effect on the cardiovascular system, reducing coronary disease and all-cause mortality. Notwithstanding this, the public opinion on HRT has not changed yet, leading to important negative consequences for women's health and quality of life.
Topics: Clinical Trials as Topic; Female; Global Health; History, 20th Century; History, 21st Century; Hormone Replacement Therapy; Humans; Postmenopause; United States; Women's Health
PubMed: 31540401
DOI: 10.3390/medicina55090602 -
Endocrinology Oct 2020Nonalcoholic fatty liver disease (NAFLD) prevalence in women is increasing worldwide. Women of reproductive age have lower rates of NAFLD compared with men; however,... (Review)
Review
Nonalcoholic fatty liver disease (NAFLD) prevalence in women is increasing worldwide. Women of reproductive age have lower rates of NAFLD compared with men; however, this protection is lost following the menopausal transition when NAFLD prevalence in postmenopausal women becomes similar to or surpasses that in age-matched male counterparts. Ongoing epidemiological, clinical, and experimental studies indicate greater NAFLD risk and higher rates of severe hepatic fibrosis in postmenopausal women relative to premenopausal women, and that older women with NAFLD experience greater mortality than men. Investigations involving ovariectomized animal models demonstrate a causal relationship between estrogen deficiency and heightened susceptibility to the development of fatty liver and steatohepatitis, although dietary factors may exacerbate this complex relationship. The accumulated findings suggest that a better understanding of the interplay among menopausal status, metabolic comorbidities, and sex steroids in NAFLD pathogenesis is needed. Further, the mechanisms underlying the difference in NAFLD risk between postmenopausal and premenopausal women remain incompletely understood. The goals of this review are to summarize studies of NAFLD risk in postmenopausal women, discuss results from animal models of estrogen deficiency, and explore the development of NAFD within the context of altered sex hormone profiles resulting from the menopausal transition. Potential implications for the prevention, diagnosis, and treatment of NAFLD in this relatively understudied cohort are also addressed.
Topics: Adult; Age of Onset; Animals; Diagnostic Techniques, Endocrine; Estrogens; Female; Humans; Middle Aged; Non-alcoholic Fatty Liver Disease; Postmenopause; Prevalence; Risk Factors
PubMed: 32776116
DOI: 10.1210/endocr/bqaa134 -
Revista Brasileira de Ginecologia E... Oct 2022To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women. (Review)
Review
OBJECTIVE
To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women.
DATA SOURCES
We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied.
SELECTION OF STUDIES
We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women.
DATA COLLECTION
Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors.
DATA SYNTHESIS
A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study).
CONCLUSION
We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).
Topics: Female; Humans; Postmenopause; Vagina; Exercise Therapy; Atrophy
PubMed: 36446564
DOI: 10.1055/s-0042-1756148 -
International Journal of Impotence... Nov 2022As women age, there is an overall decrease in androgen production due to decline of ovarian and adrenal function during menopause. Androgens have been demonstrated to... (Review)
Review
As women age, there is an overall decrease in androgen production due to decline of ovarian and adrenal function during menopause. Androgens have been demonstrated to play an important role in sexual motivation in women. As a result, many postmenopausal women experience Female Sexual Dysfunction (FSD) which are a group of disorders that pertain to sexual arousal, desire, orgasm, and pain. A prevalent manifestation of FSD is Hypoactive Sexual Desire Disorder (HSDD) or the absence of sexual fantasies, thoughts, and/or desire for or receptivity to sexual activity. There is gaining interest in the use of Testosterone Replacement Therapy (TRT) for the treatment of HSDD in postmenopausal women. This article reviews the literature on the relationship of androgen decline and HSDD, describes our methodology for evaluation, diagnosis of HSDD, and the use of TRT in treating postmenopausal women with HSDD. Our results conclude that testosterone is a vital hormone in women in maintaining sexual health and function. TRT is an effective treatment option for postmenopausal people with HSDD. There is still limited data on the effectiveness in premenopausal people with HSDD. Further research in the strengths and weaknesses for the long-term effect of TRT in women of all ages is needed.
Topics: Humans; Female; Androgens; Libido; Postmenopause; Sexual Dysfunctions, Psychological; Testosterone
PubMed: 36198811
DOI: 10.1038/s41443-022-00613-0 -
The Lancet. Global Health Aug 2020Breast cancer has distinct causes, prognoses, and outcomes and effects in patients at premenopausal and postmenopausal ages. We sought to assess the global burden and...
BACKGROUND
Breast cancer has distinct causes, prognoses, and outcomes and effects in patients at premenopausal and postmenopausal ages. We sought to assess the global burden and trends in breast cancer by menopausal status.
METHODS
We did a population-based analysis of global breast cancer incidence and mortality among premenopausal and postmenopausal women. Menopausal status was defined using age as a proxy, whereby breast cancer cases or deaths at age 50 years or older were regarded as postmenopausal. Age-standardised breast cancer incidence and mortality in 2018 were calculated using GLOBOCAN data. Incidence trends for 1998-2012 were assessed in 44 populations from 41 countries using the Cancer in Five Continents plus database, by calculating the annual average percent change.
FINDINGS
Approximately 645 000 premenopausal and 1·4 million postmenopausal breast cancer cases were diagnosed worldwide in 2018, with more than 130 000 and 490 000 deaths occurring in each menopausal group, respectively. Proportionally, countries with a low UNDP human development index (HDI) faced a greater burden of premenopausal breast cancer for both new cases and deaths compared with higher income countries. Countries with a very high HDI had the highest premenopausal and postmenopausal breast cancer incidence (30·6 and 253·6 cases per 100 000, respectively), whereas countries with low and medium HDI had the highest premenopausal and postmenopausal mortality, respectively (8·5 and 53·3 deaths per 100 000, respectively). When examining breast cancer trends, we noted significantly increasing age-standardised incidence rates (ASIRs) for premenopausal breast cancer in 20 of 44 populations and significantly increasing ASIRs for postmenopausal breast cancer in 24 of 44 populations. The growth exclusively at premenopausal ages largely occurred in high-income countries, whereas the increasing postmenopausal breast cancer burden was most notable in countries under transition.
INTERPRETATION
We provide evidence of a rising burden of both premenopausal and postmenopausal breast cancer worldwide. Although early diagnosis and access to treatment remain crucial in low-income and middle-income countries, primary prevention efforts seeking to decrease exposure to known breast cancer risk factors are warranted in all world regions to curb the future breast cancer burden.
FUNDING
None.
Topics: Breast Neoplasms; Female; Global Health; Humans; Incidence; Middle Aged; Postmenopause; Premenopause
PubMed: 32710860
DOI: 10.1016/S2214-109X(20)30215-1 -
JPMA. the Journal of the Pakistan... Oct 2022To determine the effects of high-intensity multimodal exercise training on bone mineral density and muscle performance in postmenopausal women. (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of high-intensity multi-modal exercise training (HIT-MMEX) on bone mineral density and muscle performance in postmenopausal women. A Pilot randomized controlled trial.
OBJECTIVES
To determine the effects of high-intensity multimodal exercise training on bone mineral density and muscle performance in postmenopausal women.
METHODS
The two-armed, parallel, pilot randomised controlled trial was conducted from November 2020 to July 2021 at Riphah Rehabilitation Centre, Rawalpindi, Pakistan, and comprised women aged 45-70 having been in the post-menopause phase for at least 3 years, with body mass index <30, community ambulant and willing to have exercise therapy. The subjects were randomised into two equal groups. The experimental group A received supervised high-intensity resistance, weight-bearing, balance and mobility training twice weekly for 8 months. The control group B received low-to-moderate intensity exercises. Femoral neck and lumbar spine bone mineral density (g/cm2) were taken through a dual-energy X-ray absorptiometry scan. Muscle performance was measured using 1 repetition maximum for leg and trunk extensors, and 30 sec sit to stand test. Data was analysed using SPSS 21.
RESULTS
Of the 101 women screened, 28(27.7%) were enrolled; 14(50%) in group A having mean age 53.36±6.28 years, and 14(50%) in group B having mean age 51.71±4.82 years (p>0.05). Group A showed significantly more improvement than group B both with respect to lumbar spine bone mineral density and muscle performance (p<0.05).
CONCLUSIONS
Supervised high-intensity multimodal exercise training protocol had a positive effect on lumbar spine bone mineral density and muscle performance in postmenopausal women.
CLINICAL TRIAL NUMBER
NCT04653350, Link https://clinicaltrials.gov/ct2/show/NCT04653350.
Topics: Female; Humans; Middle Aged; Bone Density; Postmenopause; Osteoporosis, Postmenopausal; Pilot Projects; Exercise; Muscles
PubMed: 36660974
DOI: 10.47391/JPMA.5394