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Sports Medicine (Auckland, N.Z.) Jun 2024The purpose of this review is to delineate aspects of energy metabolism at rest and during exercise that may be subject to sex differences and the potential underlying... (Review)
Review
The purpose of this review is to delineate aspects of energy metabolism at rest and during exercise that may be subject to sex differences and the potential underlying mechanisms involved. It focuses on distinct aspects of female physiology with an oriented discussion following the reproductive life stages of healthy, eumenorrheic females, including premenopausal time frames, pregnancy, perimenopause, and menopause. Finally, this review aims to address methodological challenges surrounding sexual dimorphism in energy metabolism investigations and confounding factors in this field. During resting conditions, females tend to have higher rates of non-oxidative free fatty acid clearance, which could contribute to lower respiratory exchange ratio measures. At the same time, carbohydrate energy metabolism findings are mixed. In general, females favor lipid energy metabolism during moderate-intensity exercise, while men favor carbohydrate energy metabolism. Factors such as age, dietary intake, genetics, and methodological decisions confound study findings, including properly identifying and reporting the menstrual cycle phase when female subjects are eumenorrheic. Pregnancy presents a unique shift in physiological systems, including energy metabolism, which can be observed at rest and during exercise. Changes in body composition and hormonal levels during the post-menopausal period directly impact energy metabolism, specifically lipid metabolism. This change in physiological state factors into the evidence showing a reduction in our understanding of sex differences in lipid metabolism during exercise in older adults. This review reveals a need for a focused understanding of female energy metabolism that could help exercise and nutrition professionals optimize female health and performance across the lifespan.
PubMed: 38888855
DOI: 10.1007/s40279-024-02063-8 -
Menopause (New York, N.Y.) Jul 2024Brain fog, referring to menopause-related subjective cognitive difficulties, is common in midlife women. Longitudinal studies find small but reliable declines in...
Brain fog, referring to menopause-related subjective cognitive difficulties, is common in midlife women. Longitudinal studies find small but reliable declines in objective memory performance as women transition into perimenopause, and these are not explained by advancing age alone. When memory declines occur, performance levels remain within normal limits for all but a very small number of women. Women's experience of brain fog extends beyond memory complaints, reflecting the negative effect on a broad range of cognitive abilities. Clinicians can counsel women about how menopause symptoms, estrogen, hormone therapy, and modifiable risk factors (eg, hypertension, sedentary lifestyle) can influence cognitive health.
Topics: Female; Humans; Middle Aged; Cognition Disorders; Cognitive Dysfunction; Counseling; Estrogen Replacement Therapy; Memory Disorders; Menopause; Risk Factors
PubMed: 38888619
DOI: 10.1097/GME.0000000000002382 -
Maturitas Jun 2024For women under age 65, varying recommendations and the need to apply clinical risk calculators can lead to underscreening for osteoporosis. The resulting undertreatment... (Review)
Review
For women under age 65, varying recommendations and the need to apply clinical risk calculators can lead to underscreening for osteoporosis. The resulting undertreatment may lead to a risk of osteoporotic fractures with significant morbidity and impact on functional status. Factors that must be considered when deciding to screen a woman under age 65 include a history of fragility fractures, race, family history, body mass index, smoking, high alcohol use, and secondary causes of osteoporosis. Secondary causes of osteoporosis are much more common in younger women. These include common conditions such as glucocorticoid use, hyperthyroidism, hypogonadism, chronic kidney disease, diabetes, anticonvulsant use, rheumatoid arthritis, malabsorption, and a history of anorexia nervosa. The reasons why these conditions confer an increased risk of osteoporosis are discussed. Recommendations are provided for the clinician to be aware of when screening women under age 65 for osteoporosis and initiating treatment when indicated.
PubMed: 38885594
DOI: 10.1016/j.maturitas.2024.108044 -
International Journal of Gynaecology... Jun 2024This study aimed to explore the relationship between urogenital symptom frequency and severity, perception of vaginal treatment burden, and female sexual desire,...
OBJECTIVE
This study aimed to explore the relationship between urogenital symptom frequency and severity, perception of vaginal treatment burden, and female sexual desire, arousal, and satisfaction.
METHODS
A cross-sectional study was conducted with a sample of 326 patients from three tertiary care hospitals in the United Arab Emirates. The frequency and severity of urogenital symptoms, emotional and physical functioning, and treatment burden were assessed using the validated genitourinary syndrome of menopause symptoms and vaginal treatments acceptability questionnaire (GSM-SVATQ). To examine the mediating roles of emotional and physical functioning, as well as the perceived treatment burden on sexual functioning, a partial least squares-structural equation model was developed using the SmartPLS 4 Software.
RESULTS
The measurement model was successfully established. All constructs had a reliability of > 0.70 and discriminant validity of < 0.90. Emotional, physical and sexual functioning showed an adjusted R values of 0.377, 0.282 and 0.169, respectively.The multistep multiple mediator model revealed a full mediation effect of both emotional and physical functioning between symptom, treatment burden and sexual functioning. The model showed high predictive performance with all manifest variables showing lower mean absolute errors compared to the naiive benchmark model.
CONCLUSION
This study enhances our understanding of the relationships between urogenital symptoms, perceived treatment burden, emotional functioning, and sexual well-being. The findings emphasize the importance of addressing emotional well-being in managing urogenital symptoms and in addressing emotional factors associated with the use of vaginal treatments.
PubMed: 38874110
DOI: 10.1002/ijgo.15736 -
Radiology Case Reports Aug 2024Female genital tract tuberculosis presents a diagnostic challenge because of its variable clinical presentation and radiological manifestation. Most patients are present...
Female genital tract tuberculosis presents a diagnostic challenge because of its variable clinical presentation and radiological manifestation. Most patients are present with history of infertility, pain in the abdomen, vaginal discharge, and bleeding. These symptoms mimic those of gynecological cancer, such as endometrial carcinoma. Endometrial cancer typically manifests with vaginal bleeding in the post-menopausal age group; however, in less than 10% to 20% patients, it can occur in perimenopausal age groups, which makes it difficult to distinguish between malignancy and tuberculosis. We present a case report of a 40-year-old woman who complained of vaginal bleeding and lower abdominal pain. Her imaging findings favored the diagnosis of endometrial carcinoma but histopathology revealed tuberculosis.
PubMed: 38872740
DOI: 10.1016/j.radcr.2024.04.093 -
Reproductive Sciences (Thousand Oaks,... Jun 2024We explore the interaction between estrogen and PCSK9 and their collective impact on lipid metabolism, especially concerning the regulation of low-density lipoprotein...
We explore the interaction between estrogen and PCSK9 and their collective impact on lipid metabolism, especially concerning the regulation of low-density lipoprotein receptor levels. Utilizing both animal and cellular models, including ovariectomized mice and HepG2 cell lines, we demonstrate that estrogen deficiency leads to a disruption in lipid metabolism, characterized by elevated levels of total cholesterol and LDL-C. The study commences with mice undergoing ovariectomy, followed by a diet regimen comprising either high-fat diet or normal feed for a four-week duration. Key assessments include analyzing lipid metabolism, measuring PCSK9 levels in the bloodstream, and evaluating hepatic low-density lipoprotein receptor expression. We will also conduct correlation analyses to understand the relationship between PCSK9 and various lipid profiles. Further, a subset of ovariectomized mice on high-fat diet will undergo treatment with either estrogen or PCSK9 inhibitor for two weeks, with a subsequent re-evaluation of the earlier mentioned parameters. Our findings reveal that estrogen inhibits PCSK9-mediated degradation of low-density lipoprotein receptor, a process crucial for maintaining lipid homeostasis. Through a series of experiments, including immunohistochemistry and western blot analysis, we establish that PCSK9 is involved in lipid metabolism disorders caused by estrogen deficiency and that estrogen regulates PCSK9 and low-density lipoprotein receptor at post-transcriptional level. The study provides a mechanism for the involvement of PCSK9 in elucidating the disorders of lipid metabolism caused by estrogen deficiency due to perimenopause and ovarian decline.
PubMed: 38871967
DOI: 10.1007/s43032-024-01614-8 -
Alternative Therapies in Health and... Jun 2024To evaluate the clinical effects of five-element music therapy combined with auricular-plaster therapy for perimenopausal insomnia with anxiety. This study aimed to...
OBJECTIVE
To evaluate the clinical effects of five-element music therapy combined with auricular-plaster therapy for perimenopausal insomnia with anxiety. This study aimed to leverage the complementary effects of both approaches to provide patients with a more comprehensive and personalized therapeutic experience.
METHODS
In this experiment, 90 cases of perimenopausal insomnia patients were selected and randomly assigned to the treatment group (45 cases) and the control group (45 cases) using the random number table method. In the treatment group, except for 2 cases who withdrew, the remaining 43 cases were observed and treated with Five Elements Music combined with auricular acupressure therapy. In the control group, except 3 cases withdrew, 42 cases were observed and given alprazolam oral treatment. The treatment course of both groups was 4 weeks. Data such as Pittsburgh Sleep Quality Index (PSQI) and Hamilton Anxiety Scale (HAMA) scores were also recorded for all patients before and after treatment.
RESULTS
After treatment, the total effective rate was 93.02% in the treatment group and 88.10% in the control group. The PSQI and HAMA scores of the two groups after treatment improved compared to before treatment(P < .01). The curative effect in the treatment group was superior to that in the control group in terms of sleep quality and anxiety.
CONCLUSION
The five-element music therapy combined with auricular-plaster therapy is effective in the treatment of perimenopausal insomnia with anxiety. Compared with traditional therapy, Chinese medicine non-drug therapy has the characteristics of green safety, simple effect, and low cost. It can avoid adverse reactions caused by long-term use of drugs, so It is a safe and reliable method, worthy of recommendation for clinical use.
PubMed: 38870496
DOI: No ID Found -
Cureus May 2024Giant fibroadenomas are common in young females and are rarely reported in perimenopausal or menopausal females. These fibroadenomas are observed as single, mobile,...
Giant fibroadenomas are common in young females and are rarely reported in perimenopausal or menopausal females. These fibroadenomas are observed as single, mobile, small to large, with distinct boundaries. These tumors are hyperplastic and characterized by their aberrant growth in both the epidermal and mesenchymal layers, which can be accompanied by pain in some instances. These tumors have similar clinical resemblances to other epithelial and stromal tumors, such as phyllodes tumors, except for the level of disease severity and malignancy. Treatment of giant fibroadenomas includes surgical resection. Surgical excision is done by complete excision of the fibroadenoma, with the rest of the breast tissue and the nipple-areolar complex preserved. Timely diagnosis can be helpful in the prevention of adverse outcomes. This is a case of a 40-year-old female who presented with a lump in her right breast, for which she underwent a wide local excision. On histopathology, it was found to be a giant fibroadenoma. Her postoperative recovery was uneventful.
PubMed: 38868246
DOI: 10.7759/cureus.60189 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2024Aim: The aim of the study was to determine the level of anxiety and depression in patients with endometrial hyperplastic processes and somatic pathology in the...
OBJECTIVE
Aim: The aim of the study was to determine the level of anxiety and depression in patients with endometrial hyperplastic processes and somatic pathology in the perimenopausal period.
PATIENTS AND METHODS
Materials and Methods: Overall, 150 women who were split into 2 groups, participated in this study and answered on questionnaires that were conducted according to the Hospital Anxiety and Depression Scale (HADS) to assess the degree of anxiety and depressive symptoms in patients. PHQ-2 and PHQ-9 questionnaires were used to study the level of anxiety and depression.
RESULTS
Results: Analysis of the results obtained using the HADS scale revealed that both anxiety and depressive symptoms in patients of the main group were more pronounced than in women of the control group. Identification of psycho-emotional disorders is the result of adverse effects of somatic diseases and gynecological pathology.
CONCLUSION
Conclusions: The results of the study indicate the need to correct psycho-emotional disorders and take them into account when choosing a method of treatment in such patients.
Topics: Humans; Female; Perimenopause; Middle Aged; Anxiety; Depression; Endometrial Hyperplasia; Adult; Surveys and Questionnaires
PubMed: 38865624
DOI: 10.36740/WLek202404112 -
Climacteric : the Journal of the... Jun 2024The phase II STARLIGHT study was conducted to investigate the efficacy/safety of fezolinetant in Japanese women and identify the optimal dose for future evaluation.
OBJECTIVE
The phase II STARLIGHT study was conducted to investigate the efficacy/safety of fezolinetant in Japanese women and identify the optimal dose for future evaluation.
METHOD
Participants were perimenopausal/postmenopausal women aged ≥40 to ≤65 years from 36 centers in Japan seeking treatment/relief for vasomotor symptoms (VMS) associated with menopause. After screening, participants were randomized 1:1:1, stratified by menopausal status, to receive fezolinetant 15 or 30 mg or placebo orally once daily for 12 weeks. Participants completed a daily VMS diary. The primary endpoint was mean change in frequency of VMS of any severity from baseline to week 8. Secondary endpoints included mean change in VMS frequency from baseline each week up to week 12 and frequency/severity of adverse events.
RESULTS
A total of 147 participants were randomized (placebo, = 47; fezolinetant 15 mg, = 53; fezolinetant 30 mg, = 47). Fezolinetant 15 and 30 mg demonstrated statistically significant reductions in mean VMS frequency at week 8 versus placebo. Least-squares mean estimates of mean change in frequency of VMS from baseline to week 8 were -7.04 for fezolinetant 15mg, -6.31 for fezolinetant 30mg, and -4.55 for placebo. The difference in least-squares mean estimates was -2.50 (95% CI: -4.03, -0.96), = 0.002 for fezolinetant 15mg and placebo, and was -1.76 (95% confidence interval [CI]: -3.35, -0.17), = 0.030 for fezolinetant 30mg and placebo. Reductions from baseline in mean VMS frequency versus placebo were seen after week 1 of treatment, maintained throughout 12 weeks. Fezolinetant was well tolerated, with no safety signals of concern for either dose to week 12.
CONCLUSION
Oral fezolinetant at once-daily doses of 15 or 30 mg was efficacious and well tolerated for treatment of mild, moderate and severe VMS associated with menopause in this Japanese study.
PubMed: 38864290
DOI: 10.1080/13697137.2024.2356854