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Medicina (Kaunas, Lithuania) Sep 2019The aim of this review is to provide an overview of genitourinary health in peri- and postmenopause, particularly of vulvovaginal atrophy (VVA), which is part of... (Review)
Review
The aim of this review is to provide an overview of genitourinary health in peri- and postmenopause, particularly of vulvovaginal atrophy (VVA), which is part of genitourinary syndrome (GSM). This condition has a high prevalence among post-menopausal women and negatively affects a woman's quality of life. Epidemiology, signs, symptoms, diagnostic criteria of VVA and target treatments for restoring vaginal health are discussed in light of the most recent literature. Issues related to this condition in menopausal women are under-diagnosed, lack objective diagnostic criteria, and consequently under-treated. Over the years, many treatments have been developed but their long-term effectiveness and safety have yet to be clearly defined. Patients are often dissatisfied and stop treatment, suggesting the need for a more personalized and tailored approach to achieve better compliance and thereby effectiveness. The aim of this paper is to provide an overview of the most recent literature on VVA in order to help the gynecologist in the management of this condition.
Topics: Administration, Intravaginal; Atrophy; Emollients; Female; Hormone Replacement Therapy; Humans; Laser Therapy; Lubricants; Perimenopause; Postmenopause; Vagina; Vaginal Diseases
PubMed: 31547180
DOI: 10.3390/medicina55100615 -
International Journal of Sports Medicine Jun 2023Midlife women experience changes in cardiometabolic, physical, and psychosocial health during menopause that negatively impacts their overall quality of life. Factors... (Review)
Review
Midlife women experience changes in cardiometabolic, physical, and psychosocial health during menopause that negatively impacts their overall quality of life. Factors that contribute to these increases in cardiometabolic risk include weight gain as well as increases in fat mass (particularly abdominal adiposity), insulin resistance, and vascular dysfunction. Other deleterious changes in physical health (e. g. reduced sleep health, bone density, and balance) as well as changes in psychosocial health (e. g. mood, anxiety, and depression) often coincide and are linked to these increases in cardiometabolic risk. Physical activity and exercise are important lifestyle components that have been demonstrated to improve cardiometabolic, physical, and psychosocial health, yet physical activity and exercise is known to decline during perimenopause and into the postmenopausal years. In this narrative review, we summarize these changes in overall health during menopause as well as how declining physical activity contributes to these changes. Additionally, we discuss how incorporating physical activity and exercise during menopause can potentially ameliorate health declines. We conclude that there exists a significant, positive impact of physical activity on cardiometabolic, physical, and psychological health among midlife women, particularly if undertaken during the perimenopausal and postmenopausal years.
Topics: Female; Humans; Quality of Life; Menopause; Perimenopause; Exercise; Cardiovascular Diseases
PubMed: 36807278
DOI: 10.1055/a-2003-9406 -
CMAJ : Canadian Medical Association... Jul 2023
Topics: Female; Humans; Perimenopause
PubMed: 37524397
DOI: 10.1503/cmaj.148952-l -
Obstetrics and Gynecology Clinics of... Sep 2011Loss of ovarian function has a profound impact on female skeletal health. Bone mineral density findings from the Study of Women's Health Across the Nation demonstrate an... (Review)
Review
Loss of ovarian function has a profound impact on female skeletal health. Bone mineral density findings from the Study of Women's Health Across the Nation demonstrate an accelerated rate of bone loss during the menopausal transition. The greatest reduction occurs in the year before the final menstrual period and the first 2 years thereafter. Clinical management includes maintenance of adequate dietary calcium and vitamin D intake, attention to modifiable risk factors, and osteoporosis screening. Indications, benefits, and risks of pharmacologic osteoporosis therapy should be assessed individually; there are currently no established guidelines addressing the treatment and prevention of osteoporosis in perimenopausal women.
Topics: Absorptiometry, Photon; Bone Density; Female; Fractures, Bone; Hormones; Humans; Osteoporosis, Postmenopausal; Perimenopause
PubMed: 21961717
DOI: 10.1016/j.ogc.2011.07.001 -
Nursing Open Jan 2024The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well-being for staff experiencing perimenopausal and... (Review)
Review
AIM
The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well-being for staff experiencing perimenopausal and menopausal symptoms at work.
DESIGN
It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541-548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization.
METHODS
CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study.
RESULTS
The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in-depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person-centred support mechanisms and an organizational approach for all employees.
Topics: Female; Humans; Adult; Middle Aged; Menopause; Perimenopause; Case-Control Studies; Workforce; Research Design
PubMed: 38268277
DOI: 10.1002/nop2.2058 -
International Review of Psychiatry... May 2019Psychiatric symptoms that coincide with reproductive transitions are related to changes in sex steroids, but studies show that this relationship is governed by... (Review)
Review
Psychiatric symptoms that coincide with reproductive transitions are related to changes in sex steroids, but studies show that this relationship is governed by individual women's vulnerability to change rather than by differences in level. There is growing interest in the role of allopregnanolone (ALLO), a 3- reduced metabolite of progesterone and a strong allosteric modulator of the GABA receptor, in such symptoms, with enough evidence now across various times of reproductive transition to offer an overview of the role of this hormone in reproductive psychiatry. This review offers a brief overview, focusing on literature of the last 3 years, of the relationship between allopregnanolone and mood at menarche; in the menstrual cycle; in the peripartum; and in the menopausal transition. ALLO dysregulation is identified in all of these transitions and found to be associated with mood symptoms, although evidence of its exact role; its relationship to other systems; and directionality is not consistent.
Topics: Affect; Anxiety; Female; Humans; Menarche; Menstrual Cycle; Perimenopause; Pregnanolone; Psychiatry; Receptors, GABA-A; Reproductive Health
PubMed: 30701996
DOI: 10.1080/09540261.2018.1553775 -
Nursing ResearchMidlife perimenopausal and postmenopausal women with metabolic syndrome experience multiple symptoms concurrently.
BACKGROUND
Midlife perimenopausal and postmenopausal women with metabolic syndrome experience multiple symptoms concurrently.
OBJECTIVE
The study objectives were to examine the relationship among symptoms through network visualization and identify and compare symptom clusters and key symptoms across symptom occurrence and symptom severity dimensions in midlife perimenopausal and postmenopausal women with and without metabolic syndrome.
METHODS
Cross-sectional data from the Study of Women's Health Across the Nation (Visit 5) were used for analysis. A machine-learning-based network analysis and the Walktrap algorithm were used to fulfill the study objectives.
RESULTS
The number and types of symptom clusters differed between the groups. Midlife perimenopausal and postmenopausal women with metabolic syndrome experienced the psychological/somatic/genital cluster (key symptom: frequent mood change), the sleep/urinary cluster (sleep disturbance), and the vasomotor cluster (cold sweat) in the symptom occurrence dimension and the psychological/somatic/sexual cluster (anxiety), the sleep/urinary cluster (sleep disturbance), and the vasomotor/genital cluster (night sweat) in the symptom severity dimension. In contrast, midlife perimenopausal and postmenopausal women without metabolic syndrome experienced the psychological cluster (anxiety), the sleep/somatic/genitourinary cluster (sleep disturbance), and the vasomotor cluster (night sweat) in the symptom occurrence dimension and the psychological/somatic cluster (anxiety), the sleep/urinary cluster (sleep disturbance), the vasomotor cluster (night sweat), and the sexual/genital cluster (vaginal dryness) in the symptom severity dimension.
DISCUSSION
The study findings may serve as a knowledge basis for effective assessment and management of symptom clusters and key symptoms in clinical settings and provide directions for future development of targeted symptom management interventions.
Topics: Cross-Sectional Studies; Female; Hot Flashes; Humans; Metabolic Syndrome; Perimenopause; Postmenopause; Sleep Wake Disorders
PubMed: 35759720
DOI: 10.1097/NNR.0000000000000591 -
American Journal of Obstetrics and... Mar 2010Exacerbation of common medical and mental health disorders at specific phases of the menstrual cycle is a prevalent phenomenon. Although the precise cause is unclear,... (Review)
Review
Exacerbation of common medical and mental health disorders at specific phases of the menstrual cycle is a prevalent phenomenon. Although the precise cause is unclear, studies implicate complex interactions between the immune and neuroendocrine systems. The menstrual cycle also is a trigger for the onset of depressive disorders, including premenstrual dysphoric disorder, a disorder specific to the luteal phase of the menstrual cycle, and depression associated with the transition to menopause. This article discusses common mental health problems exacerbated by the menstrual cycle, with a particular focus on premenstrual dysphoric disorder and perimenopausal depression. Throughout the reproductive lifespan, routine screening and assessment for the presence of common psychiatric disorders are critical for accurate diagnosis and provision of effective treatment. Management options include referral or consultation with a primary care provider or psychiatrist; treatment options for premenstrual dysphoric disorder and perimenopausal depression include pharmacotherapy with antidepressant agents and/or psychotherapy. Hormones may be helpful.
Topics: Female; Humans; Mass Screening; Menstrual Cycle; Mental Disorders; Perimenopause; Premenstrual Syndrome; Referral and Consultation; Selective Serotonin Reuptake Inhibitors
PubMed: 20207238
DOI: 10.1016/j.ajog.2009.07.061 -
Skin Research and Technology : Official... Jul 2023The decline in estrogen levels from several years before (perimenopause) and during menopause has various negative effects, including skin specific issues, which often... (Observational Study)
Observational Study
Evaluation of adapted dermocosmetic regimens for perimenopausal and menopausal women using an artificial intelligence-based algorithm and quality of life questionnaires: An open observational study.
BACKGROUND
The decline in estrogen levels from several years before (perimenopause) and during menopause has various negative effects, including skin specific issues, which often receive less attention than other menopausal symptoms despite having a significant negative effect on quality of life (QoL). The objective of this study was to evaluate the effectiveness of anti-aging dermocosmetic products designed for women during the perimenopause and menopause.
MATERIALS AND METHODS
An open study of 101 perimenopausal women (no menstruation for 4-12 months or irregular menstruation for <5 years) and 101 menopausal women (no menstruation for >12 months), not taking hormone replacement therapy, was conducted. Adapted dermocosmetic regimens, specific to each group (day cream, night cream and serum), were applied for 56 days. Assessments included automatic artificial intelligence diagnostics of eight clinical facial signs, hydration and transepidermal water loss (TEWL), and a menopause skin QoL questionnaire.
RESULTS
Mean age was 50 ± 3.9 years (range 41-57) and 59 ± 3.8 years (range 50-66) for the perimenopause and menopause groups, respectively. Significant improvements in wrinkles and vascular signs, increases in hydration, decreases in TEWL, and a positive impact on QoL were observed after 56 days of application of the respective dermocosmetic regimens for both the perimenopause and menopause groups.
CONCLUSION
The anti-aging skin care products designed specifically for perimenopausal and menopausal women increased skin hydration and improved wrinkles with a positive impact on QoL.
Topics: Female; Humans; Adult; Middle Aged; Perimenopause; Quality of Life; Artificial Intelligence; Menopause; Surveys and Questionnaires; Algorithms
PubMed: 37522490
DOI: 10.1111/srt.13349 -
Journal of Healthcare Engineering 2023100 healthy perimenopausal women were recruited and randomly assigned to two groups, with 50 subjects in each group. In the control group, placebo was administrated... (Randomized Controlled Trial)
Randomized Controlled Trial
METHOD
100 healthy perimenopausal women were recruited and randomly assigned to two groups, with 50 subjects in each group. In the control group, placebo was administrated daily for 3 cycles (4 weeks of treatment for 1 cycle and drug withdrawals for 1 week). The study group received 3 mg oral melatonin treatment daily in the same period of time. All subjects completed the study. We compared the uterine volume, endometrial thickness, LH (luteinizing hormone), FSH (follicle generating hormone), E2 (estradiol), and melatonin levels during daytime between the two groups before and after the study. Moreover, perimenopause syndrome, sleep, mood, and QoL were analyzed at the baseline and 3 cycles by the questionnaires of the Kupperman index, the Pittsburgh sleep quality index (PSQI), the Hamilton anxiety scale (HAMA), and the Hamilton depression scale (HAMD), as well as menopausal QoL (MENQOL), respectively. Any adverse reactions experienced by the subjects were also compared in the study. Finally, 91 participants (92%) completed the whole study, 47 and 44 in the study and control groups, respectively, and their data were considered in subsequent analyses.
RESULTS
After therapy, the two groups were similar in the uterine volume and endometrial thickness. In contrast to the control group, the study group showed notably decreased LH and FSH levels. No notable difference was discovered in E2 and melatonin levels between the two groups in the study. Moreover, the study group exhibited a significantly lower score in the Kupperman index, PSQI, HAMA, HAMD, and MENQOL scale than the control group. Moreover, the two groups had no notable difference in adverse reactions.
CONCLUSION
Melatonin was a useful treatment to relieve climacteric symptoms and improve sleep, mood, and life quality in perimenopausal women without obvious adverse reactions.
Topics: Female; Humans; Perimenopause; Melatonin; Quality of Life; Sleep; Affect; Follicle Stimulating Hormone
PubMed: 37854169
DOI: 10.1155/2023/2198804