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Journal of Nanobiotechnology Aug 2023The development of natural membranes as coatings for nanoparticles to traverse the blood-brain barrier (BBB) presents an effective approach for treating central nervous...
The development of natural membranes as coatings for nanoparticles to traverse the blood-brain barrier (BBB) presents an effective approach for treating central nervous system (CNS) disorders. In this study, we have designed a nanogel loaded with PACAP and estrogen (E2), sheathed with exosomes and responsive to reactive oxygen species (ROS), denoted as HA NGs@exosomes. The objective of this novel design is to serve as a potent drug carrier for the targeted treatment of perimenopausal depression. The efficient cellular uptake and BBB penetration of HA NGs@exosomes has been demonstrated in vitro and in vivo. Following intranasal intervention with HA NGs@exosomes, ovariectomized mice under chronic unpredictable mild stress (CUMS) have shown improved behavioral performance, indicating that HA NGs@exosomes produced a rapid-onset antidepressant effect. Moreover, HA NGs@exosomes exhibit notable antioxidant and anti-inflammatory properties and may regulate the expression of pivotal proteins in the PACAP/PAC1 pathway to promote synaptic plasticity. Our results serve as a proof-of-concept for the utility of exosome-sheathed ROS-responsive nanogel as a promising drug carrier for the treatment of perimenopausal depression.
Topics: Mice; Animals; Nanogels; Depression; Reactive Oxygen Species; Exosomes; Perimenopause; Pituitary Adenylate Cyclase-Activating Polypeptide; Drug Carriers
PubMed: 37553718
DOI: 10.1186/s12951-023-02005-y -
PloS One 2017After advanced age, female sex is the major risk factor for Alzheimer's disease (AD). The biological mechanisms underlying the increased AD risk in women remain largely...
After advanced age, female sex is the major risk factor for Alzheimer's disease (AD). The biological mechanisms underlying the increased AD risk in women remain largely undetermined. Preclinical studies identified the perimenopause to menopause transition, a neuroendocrine transition state unique to the female, as a sex-specific risk factor for AD. In animals, estrogenic regulation of cerebral glucose metabolism (CMRglc) falters during perimenopause. This is evident in glucose hypometabolism and decline in mitochondrial efficiency which is sustained thereafter. This study bridges basic to clinical science to characterize brain bioenergetics in a cohort of forty-three, 40-60 year-old clinically and cognitively normal women at different endocrine transition stages including premenopause (controls, CNT, n = 15), perimenopause (PERI, n = 14) and postmenopause (MENO, n = 14). All participants received clinical, laboratory and neuropsychological examinations, 18F-fluoro-deoxyglucose (FDG)-Positron Emission Tomography (PET) FDG-PET scans to estimate CMRglc, and platelet mitochondrial cytochrome oxidase (COX) activity measures. Statistical parametric mapping and multiple regression models were used to examine clinical, CMRglc and COX data across groups. As expected, the MENO group was older than PERI and controls. Groups were otherwise comparable for clinical measures and distribution of APOE4 genotype. Both MENO and PERI groups exhibited reduced CMRglc in AD-vulnerable regions which was correlated with decline in mitochondrial COX activity compared to CNT (p's<0.001). A gradient in biomarker abnormalities was most pronounced in MENO, intermediate in PERI, and lowest in CNT (p<0.001). Biomarkers correlated with immediate and delayed memory scores (Pearson's 0.26≤r≤0.32, p≤0.05). These findings validate earlier preclinical findings and indicate emergence of bioenergetic deficits in perimenopausal and postmenopausal women, suggesting that the optimal window of opportunity for therapeutic intervention in women is early in the endocrine aging process.
Topics: Adult; Aging; Alzheimer Disease; Blood Platelets; Brain; Brain Mapping; Electron Transport Complex IV; Energy Metabolism; Female; Fluorodeoxyglucose F18; Glucose; Humans; Memory; Middle Aged; Mitochondria; Neuropsychological Tests; Perimenopause; Phenotype; Positron-Emission Tomography; Postmenopause; Radiopharmaceuticals
PubMed: 29016679
DOI: 10.1371/journal.pone.0185926 -
Tijdschrift Voor Psychiatrie 2015Women are believed to be more vulnerable to depression during the perimenopause than during the premenopausal period. In clinical practice little attention has been...
BACKGROUND
Women are believed to be more vulnerable to depression during the perimenopause than during the premenopausal period. In clinical practice little attention has been given to the relationship between the menopause and depression.
AIM
To provide an overview of the literature on the relationship between the perimenopause and the development of depression and to analyse the relationship between hormonal fluctuations and depression.
METHOD
We consulted the databases of PubMed, Web of Science and the Cochrane library, searching for epidemiologic studies on perimenopausal depression. We selected 22 studies relating to the prevalence of and the risk of depression during perimenopause.
RESULTS
Most of the 22 epidemiological studies selected suggest that the chances of developing depression during the perimenopause are higher than during during the premenopausal period. We found no unambiguous correlation between the fluctuation of hormones (e.g. oestrogen) and depression. A possible reason for this finding is that it is difficult to measure these hormones accurately.
CONCLUSION
The chances of developing depression seem to be higher during the perimenopause than during the premenopause. The difficulty in measuring the fluctuations of female hormones during the perimenopausal stage may be the reason why no correlation between depression and the fluctuations of hormones has yet been unambiguously established. Future studies and meta-analysis could provide a more accurate estimate of the risk of developing depression during the perimenopause and could give detailed information about the relationship between hormonal factors and perimenopausal depression.
Topics: Adult; Depressive Disorder; Estradiol; Female; Humans; Luteinizing Hormone; Middle Aged; Perimenopause
PubMed: 26552926
DOI: No ID Found -
Obstetrics and Gynecology Clinics of... Sep 2011Is there evidence for a perimenopausal sleep disorder? We address this question in our presentation of the Study of Women's Health Across the Nation (SWAN) "sleep... (Review)
Review
Is there evidence for a perimenopausal sleep disorder? We address this question in our presentation of the Study of Women's Health Across the Nation (SWAN) "sleep story," in which we summarize and discuss data addressing sleep quality, objective measures of sleep patterns, and sleep disorders that have been published to date by the SWAN and the ancillary SWAN Sleep Study. We describe what has been learned about sleep during the perimenopause. Analyses exploring racial/ethnic diversity and the role of hot flashes and mood disturbance in sleep-perimenopause associations are described. Implications for clinical practice are considered.
Topics: Cross-Sectional Studies; Female; Health Surveys; Hormones; Humans; Longitudinal Studies; Perimenopause; Self Report; Sleep; Sleep Wake Disorders; United States; Women's Health
PubMed: 21961720
DOI: 10.1016/j.ogc.2011.06.002 -
The Cochrane Database of Systematic... Jul 2014Since the time of publication of the Women's Health Initiative (WHI) study, menopausal symptom management has become more complex because of increased awareness of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Since the time of publication of the Women's Health Initiative (WHI) study, menopausal symptom management has become more complex because of increased awareness of the risks associated with hormone replacement therapy (HRT). Currently, a wide range of management options is available. Some women take prescription drugs, and others use self care strategies, including lifestyle modifications, over-the-counter preparations and complementary and alternative therapies, such as herbal preparations, exercise programmes and relaxation techniques. Relaxation techniques consist of a group of behavioural interventions. They are considered relatively harmless, but their effectiveness in treating vasomotor symptoms and sleep disturbances remains debatable.
OBJECTIVES
To determine the effectiveness of relaxation techniques as treatment for vasomotor symptoms and associated sleep disturbances in perimenopausal and postmenopausal women.
SEARCH METHODS
Searches of the following electronic bibliographic databases were performed in February 2014 to identify randomised controlled trials (RCTs): the Cochrane Menstrual Disorders and Subfertility Group Specialised Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, PsycINFO, Social Science Citation Index and CINAHL. Handsearches of trial registers, relevant journals and published conference abstracts were also performed.
SELECTION CRITERIA
RCTs were included if they compared any type of relaxation intervention with no treatment or other treatments (except hormones) for vasomotor symptoms in symptomatic perimenopausal/postmenopausal women.
DATA COLLECTION AND ANALYSIS
Two review authors selected studies, assessed quality and extracted data. Included studies were combined, if appropriate, by using a random-effects model to calculate pooled mean differences and 95% confidence intervals.
MAIN RESULTS
Four studies were eligible for inclusion (281 participants): Two studies compared relaxation with electroacupuncture or superficial needling, one study compared relaxation with paced respiration or placebo control (α-wave electroencephalographic biofeedback) and one study compared relaxation with no treatment.No evidence was found of a difference between relaxation and acupuncture or superficial needle insertion in the number of hot flushes per 24 hours (mean difference (MD) 0.05, 95% confidence interval (CI) -1.33 to 1.43, two studies, 72 participants, I(2) = 0%; very low-quality evidence). Nor did any evidence suggest a difference between the two interventions in hot flush severity, measured using the Kupperman Index (MD -1.32, 95% CI -5.06 to 2.43, two studies, 72 participants, I(2) = 0%; very low-quality evidence).The other two studies found no clear evidence of a difference in hot flush frequency between relaxation and paced respiration, placebo or no treatment. The data for these comparisons were unsuitable for analysis.None of these studies reported night sweats, sleep disturbances associated with night sweats or adverse effects as an outcome.The main limitations of identified evidence were lack of data, imprecision and failure to report study methods in adequate detail.
AUTHORS' CONCLUSIONS
Evidence is insufficient to show the effectiveness of relaxation techniques as treatment for menopausal vasomotor symptoms, or to determine whether this treatment is more effective than no treatment, placebo, acupuncture, superficial needle insertion or paced respiration.
Topics: Acupuncture Therapy; Electroacupuncture; Female; Hot Flashes; Humans; Middle Aged; Neurofeedback; Perimenopause; Postmenopause; Randomized Controlled Trials as Topic; Relaxation Therapy
PubMed: 25039019
DOI: 10.1002/14651858.CD008582.pub2 -
Obstetrics and Gynecology Clinics of... Sep 2011The concept that adrenal androgen production gradually declines with age has changed after analysis of longitudinal data from the Study of Women's Health Across the... (Review)
Review
The concept that adrenal androgen production gradually declines with age has changed after analysis of longitudinal data from the Study of Women's Health Across the Nation (SWAN). It is now recognized that 4 adrenal androgens rise during the menopausal transition in most women. Ethnic and individual differences in sex steroids are more apparent in circulating adrenal steroids than in either estradiol or cyclic ovarian steroid hormone profiles, particularly during the early and late perimenopause. Thus, adrenal steroid production may play a larger role in the occurrence of symptoms and the potential for healthier aging than previously recognized.
Topics: Adrenal Cortex Hormones; Adrenal Glands; Androgens; Androstenediol; Dehydroepiandrosterone Sulfate; Female; Humans; Perimenopause; Testosterone
PubMed: 21961714
DOI: 10.1016/j.ogc.2011.06.001 -
Actas Espanolas de Psiquiatria 2009Depressive symptoms and disorders are highly prevalent throughout life, particularly in the middle-aged. From adolescence, women have a 1.5-3 times higher risk than men... (Review)
Review
Depressive symptoms and disorders are highly prevalent throughout life, particularly in the middle-aged. From adolescence, women have a 1.5-3 times higher risk than men of suffering different depressive disorders. Traditionally, it has been assumed that transition to menopause, or perimenopause, is a period of higher depressive vulnerability, although there is some degree of controversy. This period seems to be associated with the appearance of both depressive symptoms and de novo depressive disorders, particularly if a background of depression exists. With regard to its etiopathogeny, genetic, hormonal, psychological and sociocultural factors have been suggested, but there are no solid data that support any of these explanations. Treatment basically depends on the severity of the disorder and includes antidepressants and/or psychotherapy. Maintained treatment with hormone replacement therapy (estrogens) is under discussion.
Topics: Adult; Depression; Female; Humans; Middle Aged; Perimenopause
PubMed: 19927235
DOI: No ID Found -
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 -
BMC Women's Health Apr 2024More than 2 billion women are experiencing the menopausal transition in China, and some of these women have hypertension. Limited studies has focused on perimenopausal...
BACKGROUND
More than 2 billion women are experiencing the menopausal transition in China, and some of these women have hypertension. Limited studies has focused on perimenopausal syndrome and hypertension in a specific population, so we aimed to investigate the prevalence of perimenopausal syndrome and hypertension and to analyse their relationships and risk factors in perimenopausal women in South China.
METHODS
This cross-sectional study included 3553 women aged 40 to 60 years from South China. We collected medical report, lifestyle, blood sample, general condition questionnaire, and modified Kupperman index (mKMI) data. Multivariate logistic regression analysis was performed to identify risk factors for perimenopausal syndrome and hypertension during perimenopause.
RESULTS
The prevalence of hypertension in perimenopause patients was 16.58%, and the prevalence of perimenopausal syndrome was 9.9%. Compared with women without hypertension during perimenopause, women with HTN during perimenopause had an increased risk of perimenopausal syndrome (26.4% vs. 8.7%, P < 0.001). Lipid levels and urinary tract infections were risk factors for hypertension and perimenopausal syndrome, in addition to the presence of breast nodules, the intake of snacks at night, high-salt diets, red meat and sugar-sweetened beverages, and a history of smoking and drinking for perimenopausal syndrome and the presence of gestational hypertension and diabetes for hypertension.
CONCLUSION
We concluded that perimenopausal syndrome and HTN are common in perimenopausal women in South China, and the associations between them are strong and positive. Perimenopausal syndrome shares some common risk factors with HTN during perimenopause, such as BMI and dyslipidaemia. Therefore, gynaecological endocrinologists in China should consider screening for perimenopausal syndrome in hypertensive perimenopausal women, and appropriate management of perimenopause is needed to alleviate these conditions.
Topics: Female; Humans; Perimenopause; Prevalence; Cross-Sectional Studies; Risk Factors; Hypertension; China
PubMed: 38570811
DOI: 10.1186/s12905-024-03056-5 -
The British Journal of General Practice... Jul 2023Each woman's experience of the perimenopause and/or menopause is individual and unique. Research shows women from ethnic minorities often have different experiences from...
BACKGROUND
Each woman's experience of the perimenopause and/or menopause is individual and unique. Research shows women from ethnic minorities often have different experiences from their White peers, and these are not being considered in conversations about the menopause. Women from ethnic minorities already face barriers to help-seeking in primary care, and clinicians have expressed challenges in cross cultural communication including the risk that women from ethnic minorities' perimenopause and/or menopause health needs are not being met.
AIM
To explore primary care practitioners' experiences of perimenopause and/or menopause help-seeking among women from ethnic minorities.
DESIGN AND SETTING
A qualitative study of 46 primary care practitioners from 35 practices across 5 regions of England, with patient and public involvement (PPI) consultations with 14 women from three ethnic minority groups.
METHOD
Primary care practitioners were surveyed using an exploratory approach. Online and telephone interviews were conducted and the data were analysed thematically. The findings were presented to three groups of women from ethnic minorities to inform interpretation of the data.
RESULTS
Practitioners described a lack of awareness of perimenopause and/or menopause among many women from ethnic minorities, which they felt impacted their help-seeking and communication of symptoms. Cultural expressions of embodied experiences could offer challenges to practitioners to 'join the dots' and interpret experiences through a holistic menopause care lens. Feedback from the women from ethnic minorities provided context to practitioner findings through examples from their individual experiences.
CONCLUSION
There is a need for increased awareness and trustworthy information resources to help women from ethnic minorities prepare for the menopause, and clinicians to recognise their experiences and offer support. This could improve women's immediate quality of life and potentially reduce future disease risk.
Topics: Female; Humans; Perimenopause; Ethnic and Racial Minorities; Ethnicity; Quality of Life; Minority Groups; Menopause; Qualitative Research; Primary Health Care
PubMed: 37130614
DOI: 10.3399/BJGP.2022.0569