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Nutrients Dec 2023Menopause is associated with an increased prevalence of obesity, metabolic syndrome, cardiovascular diseases, and osteoporosis. These diseases and unfavorable laboratory... (Review)
Review
Menopause is associated with an increased prevalence of obesity, metabolic syndrome, cardiovascular diseases, and osteoporosis. These diseases and unfavorable laboratory values, which are characteristic of this period in women, can be significantly improved by eliminating and reducing dietary risk factors. Changing dietary habits during perimenopause is most effectively achieved through nutrition counseling and intervention. To reduce the risk factors of all these diseases, and in the case of an already existing disease, dietary therapy led by a dietitian should be an integral part of the treatment. The following review summarizes the recommendations for a balanced diet and fluid intake, the dietary prevention of cardiovascular diseases, the role of sleep, and the key preventive nutrients in menopause, such as vitamin D, calcium, vitamin C, B vitamins, and protein intake. In summary, during the period of perimenopause and menopause, many lifestyle factors can reduce the risk of developing all the diseases (cardiovascular disease, insulin resistance, type 2 diabetes mellitus, osteoporosis, and tumors) and symptoms characteristic of this period.
Topics: Female; Humans; Perimenopause; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Menopause; Vitamins; Osteoporosis
PubMed: 38201856
DOI: 10.3390/nu16010027 -
Medicina (Kaunas, Lithuania) Sep 2019Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and... (Review)
Review
Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.
Topics: Atrophy; Central Nervous System Agents; Estrogen Replacement Therapy; Estrogens; Female; Humans; Menopause; Sexual Dysfunction, Physiological; Sexual Health; Vagina
PubMed: 31480774
DOI: 10.3390/medicina55090559 -
Maturitas Dec 2016Depression is one of the leading causes of disease-related disability in women, and they are nearly twice as likely as men to suffer from an episode of depression. The... (Review)
Review
Depression is one of the leading causes of disease-related disability in women, and they are nearly twice as likely as men to suffer from an episode of depression. The difference begins in early life and persists through to mid-life, and as such, these reproductive years have been labelled by some as a 'window of vulnerability'. The prevalence has been reported to be particularly high during the menopausal transition, but there is no consensus supporting a direct association with reproductive status. This may be partly due to methodological limitations and inconsistencies in the available studies, resulting from a large number of confounding factors. In addition, relationships between sex hormones and the neurotransmitters purported to be responsible for depression are complex. What appears to be universally accepted is that treatment, with oestrogen, for low mood in women during midlife years may be beneficial, and should be considered.
Topics: Adult; Depression; Depressive Disorder; Estrogens; Female; Humans; Menopause; Middle Aged; Prevalence
PubMed: 27823736
DOI: 10.1016/j.maturitas.2016.09.004 -
Menopause (New York, N.Y.) Oct 2019Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The... (Review)
Review
OBJECTIVE
Our initial understanding of the menopause transition (MT) has been framed by clinical samples of women seeking treatment rather than by population-based studies. The Study of Women's Health Across the Nation (SWAN) initiated in 1996 with an overall goal to define the MT, to characterize its biological and psychosocial antecedents and sequelae in an ethnically and racially diverse sample of midlife women.
METHODS
This review summarizes the central findings of SWAN to date that can inform women and their healthcare providers about the impact of the MT and midlife aging on overall health and well-being.
RESULTS
SWAN characterized changes in reproductive axis and menstrual cycle patterns that informed the development of the reproductive aging staging system Staging of Reproductive Aging Workshop+10; MT-related symptoms and mental health (vasomotor symptoms, sleep complaints, psychological symptoms, cognitive performance, and urogenital and sexual health); and physiological systems and functions (cardiovascular and cardiometabolic health, bone health, physical function performance) that are influenced by the MT. SWAN demonstrated substantial interrelations among these changes and significant racial/ethnic differences in the rate and magnitude of change in multiple health indictors in midlife women. The findings point to midlife as a critical stage for adopting healthy behavior and preventive strategies.
CONCLUSIONS
Over the past 23 years, SWAN has advanced our understanding of the impact of the MT and midlife aging on health and well-being in women. SWAN will be instrumental to determine whether MT-related changes during midlife are related to unfavorable health and well-being in early old age.
Topics: Adult; Aged; Aging; Ethnicity; Female; Health Status; Hot Flashes; Humans; Menopause; Mental Health; Middle Aged; Racial Groups; Research Report; Sexual Health; Women's Health
PubMed: 31568098
DOI: 10.1097/GME.0000000000001424 -
Obstetrics and Gynecology Clinics of... Dec 2018Vasomotor symptoms (VMS) are the primary menopausal symptoms, occurring in up 80% of women and peaking around the final menstrual period. The average duration is... (Comparative Study)
Comparative Study Review
Vasomotor symptoms (VMS) are the primary menopausal symptoms, occurring in up 80% of women and peaking around the final menstrual period. The average duration is 10 years, longer in women with an earlier onset. Compared with non-Hispanic white women, black and Hispanic women are more likely and Asian women are less likely to report VMS. Risk factors include greater body composition (in the early stage of menopausal transition), smoking, anxiety, depression, sensitivity to symptoms, premenstrual syndrome, lower education, and medical treatments, such as hysterectomy, oophorectomy, and breast cancer-related therapies. VMS patterns over time and within higher-risk subgroups are heterogeneous across women.
Topics: Anxiety; Cigarette Smoking; Depression; Educational Status; Ethnicity; Female; Hot Flashes; Humans; Menopause; Premenstrual Syndrome; Risk Factors; Vasomotor System; Women's Health
PubMed: 30401547
DOI: 10.1016/j.ogc.2018.07.005 -
EBioMedicine Nov 2022The menopause transition is associated with unfavourable alterations in health. However, postprandial metabolic changes and their mediating factors are poorly understood.
BACKGROUND
The menopause transition is associated with unfavourable alterations in health. However, postprandial metabolic changes and their mediating factors are poorly understood.
METHODS
The PREDICT 1 UK cohort (n=1002; pre- n=366, peri- n=55, and post-menopausal females n=206) assessed phenotypic characteristics, anthropometric, diet and gut microbiome data, and fasting and postprandial (0-6 h) cardiometabolic blood measurements, including continuous glucose monitoring (CGM) data. Differences between menopausal groups were assessed in the cohort and in an age-matched subgroup, adjusting for age, BMI, menopausal hormone therapy (MHT) use, and smoking status.
FINDINGS
Post-menopausal females had higher fasting blood measures (glucose, HbA1c and inflammation (GlycA), 6%, 5% and 4% respectively), sugar intakes (12%) and poorer sleep (12%) compared with pre-menopausal females (p<0.05 for all). Postprandial metabolic responses for glucose and insulin were higher (42% and 4% respectively) and CGM measures (glycaemic variability and time in range) were unfavourable post- versus pre-menopause (p<0.05 for all). In age-matched subgroups (n=150), postprandial glucose responses remained higher post-menopause (peak 4%). MHT was associated with favourable visceral fat, fasting (glucose and insulin) and postprandial (triglyceride) measures. Mediation analysis showed that associations between menopause and metabolic health indicators (visceral fat, GlycA and glycaemia (peak)) were in part mediated by diet and gut bacterial species.
INTERPRETATION
Findings from this large scale, in-depth nutrition metabolic study of menopause, support the importance of monitoring risk factors for type-2 diabetes and cardiovascular disease in mid-life to older women to reduce morbidity and mortality associated with oestrogen decline.
FUNDING
Zoe Ltd.
Topics: Female; Humans; Aged; Blood Glucose; Blood Glucose Self-Monitoring; Menopause; Insulin; Life Style
PubMed: 36270905
DOI: 10.1016/j.ebiom.2022.104303 -
Medicina (Kaunas, Lithuania) Aug 2019Menopause is a normal physiological change occurring at a woman's mid-life. During this time, women experience vasomotor, physical and physiological problems, which...
Menopause is a normal physiological change occurring at a woman's mid-life. During this time, women experience vasomotor, physical and physiological problems, which reduce their quality of life. Many women are searching for different, alternative methods to reduce the severity of menopausal symptoms. Physical activity (PA) is one of the recommended methods to reduce menopausal symptoms. The purpose of this study was to investigate the association between specific domains (physical activity during leisure time, at work, during transportation and household activities) and the menopausal symptoms. We included 305 women aged 40-65 in the study. All participants were divided into three groups according to menopausal status. The research tools used were the International Physical Activity Questionnaire (IPAQ) to assess physical activity level in four domains and the Menopause Rating Scale (MRS) to assess the severity of menopausal symptoms. The data analysis was performed by Chi-square test and analysis of variance (ANOVA) with post hoc Tuckey test. Menopausal stage was significantly associated with the total MRS score ( < 0.001) and specifically the urogenital and somato-vegetative subscores ( < 0.001). Physical activity was significantly associated ( < 0.001) with leisure time (according to IPAQ domains). Most postmenopausal women had high PA level (59.66%). Significantly less women with high PA levels had severe urogenital symptoms: 10.82% of participant with a low PA level, 11.15% with a moderate PA level and 4.26% with a high PA level ( = 0.046). Physical activity during leisure time is associated to menopausal symptoms in Polish women. Women with high and moderate PA levels have less severe menopausal symptoms compared to inactive women. Middle-aged women with low PA levels at work suffer from more severe somato-vegetative symptoms.
Topics: Adult; Aged; Cross-Sectional Studies; Exercise; Exercise Therapy; Female; Humans; Menopause; Middle Aged; Surveys and Questionnaires; Syndrome
PubMed: 31405242
DOI: 10.3390/medicina55080466 -
Maturitas Sep 2022The aim of these recommendations is to set forth an individualized approach to the management of early postmenopausal women (i.e., within the first 10 years after... (Review)
Review
Management of postmenopausal women: Collège National des Gynécologues et Obstétriciens Français (CNGOF) and Groupe d'Etude sur la Ménopause et le Vieillissement (GEMVi) Clinical Practice Guidelines.
AIM
The aim of these recommendations is to set forth an individualized approach to the management of early postmenopausal women (i.e., within the first 10 years after natural menopause) covering all aspects of lifestyle and therapeutic management, with or without menopause hormone therapy (MHT).
MATERIALS AND METHODS
Literature review and consensus of French expert opinion. Recommendations were graded according to the HAS methodology and levels of evidence derived from the international literature, except when there was no good-quality evidence.
SUMMARY RECOMMENDATIONS
The beginning of menopause is an ideal time for each woman to evaluate her health status by assessing her bone, cardiovascular, and cancer-related risk factors that may be amplified by postmenopausal estrogen deficiency and by reviewing her lifestyle habits. Improving lifestyle, including nutrition and physical activity, and avoiding risk factors (notably smoking), should be recommended to all women. MHT remains the most effective treatment for vasomotor symptoms but it could be also recommended as first-line treatment for the prevention of osteoporosis in early postmenopausal women at low to moderate risk for fracture. The risks of MHT differ depending on its type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. There is reasonable evidence that using transdermal estradiol in association with micronized progesterone or dydrogesterone may limit both the venous thromboembolic risk associated with oral estrogens and the risk of breast cancer associated with synthetic progestins. Treatment should be individualized to each woman, by using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of its benefit-risk balance. For bothersome genitourinary syndrome of menopause (GSM) symptoms, vaginal treatment with lubricants and moisturizers is recommended as first-line treatment together with low-dose vaginal estrogen therapy, depending on the clinical course. No recommendation of an optimal duration of MHT can be made, but it must take into consideration the initial indication for MHT as well as each woman's benefit-risk balance. Management of gynecological side-effects of MHT is also examined. These recommendations are endorsed by the Groupe d'Etude sur la Ménopause et le Vieillissement hormonal (GEMVI) and the Collège National des Gynécologues-Obstétriciens Français (CNGOF).
Topics: Estrogen Replacement Therapy; Estrogens; Female; Humans; Menopause; Postmenopause; Practice Guidelines as Topic; Progestins
PubMed: 35717745
DOI: 10.1016/j.maturitas.2022.05.008 -
Roczniki Panstwowego Zakladu Higieny 2018Menopause, also referred to as climacterium, is a period of multiple changes in the structure and functions of a woman organism.
BACKGROUND
Menopause, also referred to as climacterium, is a period of multiple changes in the structure and functions of a woman organism.
OBJECTIVE
Determination of differences in body composition and fatty tissue distribution in women from groups discriminated based on their menstrual status.
MATERIAL AND METHODS
The survey covered 312 women aged 38-75 years. Menstrual status of the surveyed women was established according to WHO guidelines based on answers to a questionnaire, and three groups were discriminated: women in the premenopausal period (group 1), in the perimenopausal period (group 2), and in the postmenopausal period (group 3). The following anthropomological measurements were taken: body height, body mass, waist and hip circumference, and thickness of 6 skinfolds. Their results enabled evaluating the somatic built of women in the separated groups. Fatty tissue distribution was determined based on TER distribution index calculated as a ratio of the sum of trunk skinfolds (TSS) to the sum of extremity skinfolds (ESS). Body composition of the women, including percentage of body fat, lean body mass, soft tissue mass, and total body water, was assessed using an IOI 353 analyzer by JAWON MEDICAL. In addition, percentages of women with underweight, normal content of fatty tissue, and these with overweight and obesity were calculated. The WHR index was computed in the case of obese women.
RESULTS
The highest values of body mass, hip circumference and most of the skinfolds were determined in the perimenopausal group, whereas the postmenopausal women were characterized by the highest percentage of body fat (PBF) and by the lowest contents of lean tissue, soft tissue, and total water content in the body. The highest percentage of obese women was found in the postmenopausal group, including 40% of them having visceral type obesity. The occurrence of the menopause contributed to changes in fatty tissue distribution, causing its shift from extremities toward the trunk.
CONCLUSIONS
The study showed differences in the somatic built and body composition in groups of women distinguished based on their menstrual status.
Topics: Adipose Tissue; Adult; Age Factors; Aged; Anthropometry; Body Composition; Body Fat Distribution; Female; Humans; Menopause; Middle Aged; Postmenopause; Weight Gain; Women's Health
PubMed: 29519121
DOI: No ID Found -
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