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Planta Medica Jun 2024, which contains isoflavones and prenylated derivatives, has analgesic and anti-inflammatory properties and is an ingredient in traditional Thai medicine for...
, which contains isoflavones and prenylated derivatives, has analgesic and anti-inflammatory properties and is an ingredient in traditional Thai medicine for perimenopause and menopause. However, the estrogenic activity of has not yet been explored. Therefore, this study aimed to examine the estrogenic activity of the stem extract of and its isoflavone derivatives. In this study, we conducted a proliferation assay in MCF-7 cells, and used quantitative reverse transcription polymerase chain reaction to assess gene expression. We found that the relative cell proliferation of the compounds (1 µM) was ranked in the following order as compared to 0.1 nM 17-estradiol (100%): genistein (97.84%) > derrisisoflavone A (83.17%) > genistein-7--[-rhamnopyranosyl-(1 → 6)-glucopyranoside] (69.55%) > 6,8-diprenylgenistein (51.91%) > lupalbigenin (18.72%). Furthermore, cotreatment with 1 µM lupalbigenin and 0.1 nM 17-estradiol was performed, which decreased cell proliferation to 80.38%. results suggest that lupalbigenin has an estrogen-antagonistic effect. At a dose of 1 µM, genistein had the strongest efficacy in increasing the expression of human estrogen receptor by 4.0-fold compared to the control. Furthermore, genistein-7--[-rhamnopyranosyl-(1 → 6)]--glucopyranoside augmented the gene expression of human estrogen receptor and human estrogen receptor by 1.5- and 3.4-fold, respectively. Prenylated derivatives of genistein (derrisisoflavone A, 6,8-diprenylgenistein, and lupalbigenin) significantly suppressed the gene expression of the human androgen receptor. The administration of the crude extract at 10 µg/mL significantly suppressed human androgen receptor (0.6-fold) and transmembrane protease serine 2 (0.1-fold) expression but did not significantly affect human estrogen receptor and human estrogen receptor gene expression. This herbal medicine may be safe for estrogen-exposed breast cancer patients.
PubMed: 38749481
DOI: 10.1055/a-2328-2750 -
Journal of Affective Disorders Aug 2024An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this includes women in perimenopause and postmenopause).
METHODS
PubMed, Web of Science, Embase, and PsycINFO databases were systematically searched from database inception until March 1, 2024. Studies with validated methods for assessing the prevalence of depression in perimenopausal and postmenopausal women were included. Two authors independently extracted relevant data. Random effects meta-analysis and Meta-regression analysis were performed using Stata software.
RESULTS
Total of 55 studies (76,817 participants) were included in the review. A random effects model was used to calculate pooled prevalence. The pooled depression prevalence in menopausal women was 35.6 % (95 % CI: 32.0-39.2 %), with 33.9 % (95 % CI: 27.8-40.0 %) in perimenopausal women, and 34.9 % (95 % CI: 30.7-39.1 %) in postmenopausal women. Subgroup analyses indicated that region, screening tool, study design, and setting moderated the prevalence of depression. Meta-regression indicated that smaller sample sizes and poorer study quality were significantly associated with a higher prevalence.
LIMITATIONS
There was a high degree of heterogeneity across the included studies. Only articles published in English were included. There was significant publication bias in this meta-analysis. There is insufficient information about many risk factors of menopausal depression in current meta-analysis.
CONCLUSIONS
Depression is common among menopausal women worldwide. To reduce the negative impact of depression on health outcomes in menopausal women, regular screening and the availability of effective prevention and treatment measures should be made available for this population.
Topics: Female; Humans; Middle Aged; Depression; Global Health; Menopause; Perimenopause; Postmenopause; Prevalence
PubMed: 38735578
DOI: 10.1016/j.jad.2024.05.051 -
Fertility and Sterility Jul 2024Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large... (Review)
Review
Uterine fibroids (UFs) are the most common female benign pelvic tumors, affecting >60% of patients aged 30-44 years. Uterine fibroids are asymptomatic in a large percentage of cases and may be identified incidentally using a transvaginal ultrasound or a magnetic resonance imaging scan. However, in approximately 30% of cases, UFs affect the quality of life and women's health, with abnormal uterine bleeding and heavy menstrual bleeding being the most common complaints, along with iron deficiency (ID) and ID anemia. Medical treatments used for UFs-related abnormal uterine bleeding include symptomatic agents, such as nonsteroidal antiinflammatory drugs and tranexamic acid, and hormonal therapies, including combined oral contraceptives, gonadotropin-releasing hormone agonists or antagonists, levonorgestrel intrauterine systems, selective progesterone receptor modulators, and aromatase inhibitors. Nevertheless, few drugs are approved specifically for UF treatment, and most of them manage the symptoms. Surgical options include fertility-sparing treatments, such as myomectomy, or nonconservative options, such as hysterectomy, especially in perimenopausal women who are not responding to any treatment. Radiologic interventions are also available: uterine artery embolization, high-intensity focused ultrasound or magnetic resonance-guided focused ultrasound, and radiofrequency ablation. Furthermore, the management of ID and ID anemia, as a consequence of acute and chronic bleeding, should be taken into account with the use of iron replacement therapy both during medical treatment and before and after a surgical procedure. In the case of symptomatic UFs, the location, size, multiple UFs, or coexistent adenomyosis should guide the choice with a shared decision-making process, considering long- and short-term treatment goals expected by the patient, including pregnancy desire or wish to preserve the uterus independently of reproductive goals.
Topics: Humans; Female; Leiomyoma; Uterine Neoplasms; Uterine Hemorrhage; Treatment Outcome; Uterine Myomectomy; Uterine Artery Embolization; Adult
PubMed: 38723935
DOI: 10.1016/j.fertnstert.2024.04.041 -
Cardiovascular Diabetology May 2024The association between iron biomarkers and cardiovascular disease risk factors (CVD-RFs) remains unclear. We aimed to (1) evaluate the cross-sectional and longitudinal... (Comparative Study)
Comparative Study
Cross-sectional and longitudinal associations of Iron biomarkers and cardiovascular risk factors in pre- and postmenopausal women: leveraging repeated measurements to address natural variability.
BACKGROUND
The association between iron biomarkers and cardiovascular disease risk factors (CVD-RFs) remains unclear. We aimed to (1) evaluate the cross-sectional and longitudinal associations between iron biomarkers (serum ferritin, transferrin saturation (TSAT), transferrin) and CVD-RFs among women, and (2) explore if these associations were modified by menopausal status.
METHOD
Cross-sectional and longitudinal analyses including 2542 and 1482 women from CoLaus cohort, respectively. Multiple linear regression and multilevel mixed models were used to analyse the associations between Iron biomarkers and CVD-RFs. Variability of outcomes and iron markers between surveys was accessed using intraclass correlation (ICC).
RESULTS
After multivariable adjustment, elevated serum ferritin levels were associated with increased insulin and glucose levels, while higher transferrin levels were linked to elevated glucose, insulin and total cholesterol, and systolic and diastolic blood pressure (p < 0.05). No association was observed between CVD-RFs and TSAT (p > 0.05). Iron biomarkers demonstrated low reliability across reproductive stages but exhibited stronger associations in the perimenopausal group. In longitudinal analysis, we found association only for transferrin with lower glucose levels [β = - 0.59, 95% CI (- 1.10, - 0.08), p = 0.02] and lower diastolic blood pressure [β = - 7.81, 95% CI (- 15.9, - 0.56), p = 0.04].
CONCLUSION
In cross-sectional analysis, transferrin was associated with several CVD-RFs, and the associations did not change according to menopausal status. Conversely, in the longitudinal analyses, changes in transferrin were associated only with lower glucose and diastolic blood pressure levels. These differences might stem from the substantial longitudinal variation of iron biomarkers, underscoring the need for multiple iron measurements in longitudinal analyses.
Topics: Humans; Female; Biomarkers; Cross-Sectional Studies; Middle Aged; Ferritins; Longitudinal Studies; Cardiovascular Diseases; Transferrin; Heart Disease Risk Factors; Postmenopause; Risk Assessment; Adult; Iron; Time Factors; Brazil; Aged; Blood Glucose; Reproducibility of Results; Age Factors
PubMed: 38715055
DOI: 10.1186/s12933-024-02242-x -
Journal of Menopausal Medicine Apr 2024This study aimed to assess sexual health status and associated factors in menopausal women.
OBJECTIVES
This study aimed to assess sexual health status and associated factors in menopausal women.
METHODS
The study employed a descriptive, cross-sectional design. It included 420 menopausal women aged 40-65 years from Ilesa West Local Government Area of Osun State. A structured questionnaire was used, and the data were analyzed using descriptive and inferential statistics.
RESULTS
The mean age of the study respondents was 54.74 ± 5.49 years. A little over half (52.4%) of the respondents exhibited good sexual health status, whereas 47.6% had poor sexual health status. Logistic regression analysis revealed that lack of financial resources ( = 0.01; odds ratio [OR], 4.00; 95% confidence interval [95% CI], 1.45-11.02), loss of partner ( = 0.01; OR, 9.18; 95% CI, 2.89-29.09), and limited communication with partner ( = 0.01; OR, 3.12; 95% CI, 1.51-6.46) were predictors of poor sexual health status.
CONCLUSIONS
This study provides insight into the determinants of the sexual health status of menopausal women, which may help health care providers and policymakers develop effective strategies to improve the sexual health of menopausal women.
PubMed: 38714493
DOI: 10.6118/jmm.22028 -
Cancer May 2024Nirogacestat is a targeted gamma secretase inhibitor approved in the United States for adults with progressing desmoid tumors. In the phase 3 DeFi study (NCT03785964) of...
INTRODUCTION
Nirogacestat is a targeted gamma secretase inhibitor approved in the United States for adults with progressing desmoid tumors. In the phase 3 DeFi study (NCT03785964) of nirogacestat, ovarian toxicity (OT) was identified as a safety signal among females of reproductive potential (FORP). This analysis further describes the incidence, presentation, and resolution of OT.
METHODS
Patients were randomized to twice-daily oral nirogacestat (150 mg) or placebo, taken in continuous 28-day cycles. Investigator-identified OT in FORP was based on abnormal reproductive hormone values or perimenopausal symptoms (or both). Adverse event follow-up was conducted to assess OT resolution. Post hoc analyses included return of menstruation and return of follicle-stimulating hormone (FSH) to within normal limits (WNL) (≤20.4 mIU/mL).
RESULTS
Of 92 randomized females, 73 in the safety population were FORP (n = 36 nirogacestat, n = 37 placebo). OT was identified in 75% (27 of 36) receiving nirogacestat and 0% (0 of 37) receiving placebo. As of October 24, 2022, investigators reported OT resolution in 78% (21 of 27) of patients, with median OT duration of 19.1 weeks. Off-treatment resolution was reported in all 11 patients (100%) who stopped nirogacestat treatment; of these, all nine with available menstruation information experienced return of menstruation and eight had FSH WNL at last reported assessment. Resolution was reported in 10 of 14 (71%) while on nirogacestat; of these, all 10 experienced return of menstruation and seven had FSH WNL. Two patients were lost to follow-up.
CONCLUSION
Most FORP treated with nirogacestat experienced OT, with the majority resolving, including all who stopped treatment, suggesting that OT is transient.
PubMed: 38703010
DOI: 10.1002/cncr.35324 -
Climacteric : the Journal of the... May 2024This study aimed to examine sex differences in factors associated with mood and anxiety in midlife men and women during the COVID-19 pandemic.
OBJECTIVE
This study aimed to examine sex differences in factors associated with mood and anxiety in midlife men and women during the COVID-19 pandemic.
METHODS
During a remote visit, 312 adults aged 40-60 years (167 female; 23.6% perimenopausal) from the Human Connectome Project in Aging completed PROMIS measures of depression, anxiety and anger/irritability; perceived stress; and questions about social support, financial stress and menopause stage. Multivariate linear regression models assessed sex differences in mental health and the association of social support, financial stress and menopause stage with mental health.
RESULTS
Anxiety was higher in women than in men ( = 2.39, = 0.02). For women only, decreased social support was associated with increased anxiety ( = -2.26, = 0.002), anger/irritability ( = -1.89, = 0.02) and stress ( = -1.67, = 0.002). For women only, not having close family was associated with increased depressive symptoms ( = -6.60, = 0.01) and stress ( = -7.03, < 0.001). For both sexes, having children was associated with lower depressive symptoms ( = -3.08, = 0.002), anxiety ( = -1.93, = 0.07), anger/irritability ( = -2.73, = 0.02) and stress ( = -1.44, = 0.07). Menopause stage was unrelated to mental health.
CONCLUSION
Social support, but not financial stress, influenced mental health during the COVID-19 pandemic at midlife, particularly for women.
PubMed: 38695574
DOI: 10.1080/13697137.2024.2340476 -
Cureus Apr 2024[This corrects the article DOI: 10.7759/cureus.58081.].
Correction: Prevalence of High-Risk Human Papillomavirus Infection, Associated Risk Factors, and Relationship With Cervical Precancerous Lesions in Perimenopausal and Older Women in an Area With High Cervical Cancer Incidence in China.
[This corrects the article DOI: 10.7759/cureus.58081.].
PubMed: 38694638
DOI: 10.7759/cureus.c171 -
Focus (American Psychiatric Publishing) Jan 2024The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study...
OBJECTIVE
The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study investigated whether potential confounders, including natural vs. surgical postmenopause and menopause-related psychological symptoms, influence whether executive dysfunction persists into postmenopause.
STUDY DESIGN
A cross-sectional sample of women aged 35-65 years (N = 1971) in one of four groups, premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were surveyed. Participants self-reported executive functioning with the Brown Attention Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for Epidemiologic Studies Depression Scale (CES-D).
MAIN OUTCOME MEASURES
We analyzed the association between group and BADDS scores using linear regression models - first, by controlling for age, education, and self-reported attention deficit hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling for current difficulty sleeping, anxiety, and depression (Model #2).
RESULTS
In both models, BADDS scores were significantly elevated (indicating more difficulties in executive function) among women in the perimenopausal and surgical postmenopausal groups compared with those in the premenopausal group. Likewise, the perimenopausal and surgical postmenopausal groups had the highest proportions of participants who reported difficulty sleeping and clinical levels of anxiety and depression. BADDS scores were significantly higher in natural postmenopausal vs. premenopausal women without controlling for difficulty sleeping, anxiety, and depression (Model #1), but not when adjusting for these variables (Model #2).
CONCLUSIONS
The type of menopause and psychological symptoms are important confounders of the relationship between the menopause transition and executive dysfunction, and help explain whether executive dysfunction persists or recovers in postmenopause.Reprinted from , with permission from Elsevier. Copyright © 2023.
PubMed: 38694151
DOI: 10.1176/appi.focus.23021034 -
Phosphaturic mesenchymal tumor-induced bilateral osteomalacia femoral neck fractures: a case report.Frontiers in Endocrinology 2024Phosphaturic mesenchymal tumors (PMT) are rare and distinctive tumors that typically result in paraneoplastic syndrome known as tumor-induced osteomalacia (TIO). We...
Phosphaturic mesenchymal tumors (PMT) are rare and distinctive tumors that typically result in paraneoplastic syndrome known as tumor-induced osteomalacia (TIO). We report a case of bilateral osteoporotic femoral neck fracture caused by PMT. PMT was surgically resected, followed by sequential treatment of bilateral femoral neck fractures with total hip arthroplasty (THA). A 49-year-old perimenopausal woman experienced consistent bone pain with limb weakness persisting for over 2 years. Initially, she was diagnosed with early osteonecrosis of the femoral head and received nonsurgical treatment. However, from 2020 to 2022, her pain extended to the bilateral shoulders and knees with increased intensity. She had no positive family history or any other genetic diseases, and her menstrual cycles were regular. Physical examination revealed tenderness at the midpoints of the bilateral groin and restricted bilateral hip range of motion, with grade 3/5 muscle strength in both lower extremities. Laboratory findings revealed moderate anemia (hemoglobin 66 g/L), leukopenia (2.70 × 10/L), neutropenia (1.28 × 10/L), hypophosphatemia (0.36 mmol/L), high alkaline phosphatase activity (308.00 U/L), and normal serum calcium (2.22 mmol/L). After surgery, additional examinations were performed to explore the cause of hypophosphatemic osteomalacia. After definitive diagnosis, the patient underwent tumor resection via T11 laminectomy on August 6, 2022. Six months after the second THA, the patient regained normal gait with satisfactory hip movement function without recurrence of PMT-associated osteomalacia or prosthesis loosening. By providing detailed clinical data and a diagnostic and treatment approach, we aimed to improve the clinical understanding of femoral neck fractures caused by TIO.
Topics: Humans; Female; Osteomalacia; Middle Aged; Femoral Neck Fractures; Paraneoplastic Syndromes; Neoplasms, Connective Tissue; Hypophosphatemia; Arthroplasty, Replacement, Hip
PubMed: 38689735
DOI: 10.3389/fendo.2024.1373794