Pub Date : 2024-07-30DOI: 10.1080/13697137.2024.2380364
Qi Yu, John C Stevenson, Tetiana Tatarchuk, Rossella E Nappi, Marcelo Graziano Custodio, Elke Kahler, Tommaso Simoncini, Junyi Yang, Mulan Ren
Objective: Among postmenopausal women, oral, ultra-low-dose continuous combined estradiol (E0.5 mg) plus dydrogesterone (D2.5 mg) reduces vasomotor symptoms (VMS).
Methods: This study was a post hoc analysis of data from two phase 3, double-blind studies. Postmenopausal women were randomized 2:1:2 to receive E0.5 mg/D2.5 mg, E1 mg/D5 mg (not included in this analysis) or placebo for 13 weeks (European study), or randomized 1:1 to receive E0.5 mg/D2.5 mg or placebo for 12 weeks (Chinese study). Endpoints assessed in ethnicity subgroups (European and Chinese) included changes from baseline in number of hot flushes, number of moderate-to-severe hot flushes and Menopause Rating Scale (MRS) score.
Results: Overall, 579 women were included in the analysis (E0.5 mg/D2.5 mg, n = 288; placebo, n = 291). European and Chinese women receiving E0.5 mg/D2.5 mg experienced greater reductions from baseline in mean daily number of hot flushes and mean daily number of moderate-to-severe hot flushes at week 4, week 8 and end of treatment versus those receiving placebo. Significant improvements in the 'hot flushes, sweating' MRS item score were reported in both European and Chinese women.
Conclusion: Oral, ultra-low-dose continuous combined 0.5 mg 17β-estradiol and 2.5 mg dydrogesterone improved VMS compared with placebo in European and Chinese postmenopausal women, with a positive impact on health-related quality of life.
{"title":"Ultra-low-dose estradiol and dydrogesterone for treatment of vasomotor symptoms in Europe and China.","authors":"Qi Yu, John C Stevenson, Tetiana Tatarchuk, Rossella E Nappi, Marcelo Graziano Custodio, Elke Kahler, Tommaso Simoncini, Junyi Yang, Mulan Ren","doi":"10.1080/13697137.2024.2380364","DOIUrl":"https://doi.org/10.1080/13697137.2024.2380364","url":null,"abstract":"<p><strong>Objective: </strong>Among postmenopausal women, oral, ultra-low-dose continuous combined estradiol (E0.5 mg) plus dydrogesterone (D2.5 mg) reduces vasomotor symptoms (VMS).</p><p><strong>Methods: </strong>This study was a <i>post hoc</i> analysis of data from two phase 3, double-blind studies. Postmenopausal women were randomized 2:1:2 to receive E0.5 mg/D2.5 mg, E1 mg/D5 mg (not included in this analysis) or placebo for 13 weeks (European study), or randomized 1:1 to receive E0.5 mg/D2.5 mg or placebo for 12 weeks (Chinese study). Endpoints assessed in ethnicity subgroups (European and Chinese) included changes from baseline in number of hot flushes, number of moderate-to-severe hot flushes and Menopause Rating Scale (MRS) score.</p><p><strong>Results: </strong>Overall, 579 women were included in the analysis (E0.5 mg/D2.5 mg, <i>n</i> = 288; placebo, <i>n</i> = 291). European and Chinese women receiving E0.5 mg/D2.5 mg experienced greater reductions from baseline in mean daily number of hot flushes and mean daily number of moderate-to-severe hot flushes at week 4, week 8 and end of treatment versus those receiving placebo. Significant improvements in the 'hot flushes, sweating' MRS item score were reported in both European and Chinese women.</p><p><strong>Conclusion: </strong>Oral, ultra-low-dose continuous combined 0.5 mg 17β-estradiol and 2.5 mg dydrogesterone improved VMS compared with placebo in European and Chinese postmenopausal women, with a positive impact on health-related quality of life.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-30DOI: 10.1080/13697137.2024.2380363
Vonda J Wright, Jonathan D Schwartzman, Rafael Itinoche, Jocelyn Wittstein
Fifty-one percent of humans are born with ovaries. As the ovarian production of estrogen diminishes in midlife and ultimately stops, it is estimated that more than 47 million women worldwide enter the menopause transition annually. More than 70% will experience musculoskeletal symptoms and 25% will be disabled by them through the transition from perimenopause to postmenopause. This often-unrecognized collective of musculoskeletal symptoms, largely influenced by estrogen flux, includes arthralgia, loss of muscle mass, loss of bone density and progression of osteoarthritis, among others. In isolation, it can be difficult for clinicians and patients to adequately appreciate the substantial role of decreasing estrogen, anticipate the onset of related symptoms and actively treat to mitigate future detrimental processes. Thus, in this review we introduce a new term, the musculoskeletal syndrome of menopause, to describe the collective musculoskeletal signs and symptoms associated with the loss of estrogen. Given the significant effects of these processes on quality of life and the associated personal and financial costs, it is important for clinicians and the women they care for to be aware of this terminology and the constellation of musculoskeletal processes for which proper risk assessment and prophylactic management are of consequence.
{"title":"The musculoskeletal syndrome of menopause.","authors":"Vonda J Wright, Jonathan D Schwartzman, Rafael Itinoche, Jocelyn Wittstein","doi":"10.1080/13697137.2024.2380363","DOIUrl":"https://doi.org/10.1080/13697137.2024.2380363","url":null,"abstract":"<p><p>Fifty-one percent of humans are born with ovaries. As the ovarian production of estrogen diminishes in midlife and ultimately stops, it is estimated that more than 47 million women worldwide enter the menopause transition annually. More than 70% will experience musculoskeletal symptoms and 25% will be disabled by them through the transition from perimenopause to postmenopause. This often-unrecognized collective of musculoskeletal symptoms, largely influenced by estrogen flux, includes arthralgia, loss of muscle mass, loss of bone density and progression of osteoarthritis, among others. In isolation, it can be difficult for clinicians and patients to adequately appreciate the substantial role of decreasing estrogen, anticipate the onset of related symptoms and actively treat to mitigate future detrimental processes. Thus, in this review we introduce a new term, the musculoskeletal syndrome of menopause, to describe the collective musculoskeletal signs and symptoms associated with the loss of estrogen. Given the significant effects of these processes on quality of life and the associated personal and financial costs, it is important for clinicians and the women they care for to be aware of this terminology and the constellation of musculoskeletal processes for which proper risk assessment and prophylactic management are of consequence.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-25DOI: 10.1080/13697137.2024.2380009
Youjie Zeng, Si Cao, Yuan Yuan
Objectives: Observational studies have suggested an association between age at natural menopause (ANM) and ventricular structure and function. Nevertheless, the causal relationship remains unclear. This study aimed to evaluate the causal effects of ANM on ventricular structure and function by Mendelian randomization (MR) analysis.
Methods: Genome-wide association summary statistics for ANM and 16 ventricular structures and functions were obtained. The inverse variance weighted (IVW) method was the primary MR approach for assessing causal associations. In addition, three additional MR methods (MR-Egger, weighted median and weighted mode) were performed to complement the IVW method. Furthermore, various sensitivity tests were conducted to evaluate the reliability of the MR results.
Results: The IVW method identified no causal association between ANM and all 16 ventricular structures or functions (p > 0.05). Three additional MR methods yielded parallel results to the IVW approach (p > 0.05). Various sensitivity tests revealed stability of the MR results, indicating no heterogeneity or horizontal pleiotropy.
Conclusion: The present MR study indicated that ANM would not causally affect ventricular structure or function. Therefore, the correlation between ANM and ventricular characteristics in previous observational studies might be attributed to shared upstream cardiovascular risk factors or unidentified genetic mutations that simultaneously affect both ANM and ventricular structure and function.
{"title":"Menopausal age does not affect ventricular structure and function: a Mendelian randomization study.","authors":"Youjie Zeng, Si Cao, Yuan Yuan","doi":"10.1080/13697137.2024.2380009","DOIUrl":"https://doi.org/10.1080/13697137.2024.2380009","url":null,"abstract":"<p><strong>Objectives: </strong>Observational studies have suggested an association between age at natural menopause (ANM) and ventricular structure and function. Nevertheless, the causal relationship remains unclear. This study aimed to evaluate the causal effects of ANM on ventricular structure and function by Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>Genome-wide association summary statistics for ANM and 16 ventricular structures and functions were obtained. The inverse variance weighted (IVW) method was the primary MR approach for assessing causal associations. In addition, three additional MR methods (MR-Egger, weighted median and weighted mode) were performed to complement the IVW method. Furthermore, various sensitivity tests were conducted to evaluate the reliability of the MR results.</p><p><strong>Results: </strong>The IVW method identified no causal association between ANM and all 16 ventricular structures or functions (<i>p</i> > 0.05). Three additional MR methods yielded parallel results to the IVW approach (<i>p</i> > 0.05). Various sensitivity tests revealed stability of the MR results, indicating no heterogeneity or horizontal pleiotropy.</p><p><strong>Conclusion: </strong>The present MR study indicated that ANM would not causally affect ventricular structure or function. Therefore, the correlation between ANM and ventricular characteristics in previous observational studies might be attributed to shared upstream cardiovascular risk factors or unidentified genetic mutations that simultaneously affect both ANM and ventricular structure and function.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-22DOI: 10.1080/13697137.2024.2376190
Luis Fernando Vidal-Neira, José Luis Neyro, Genessis Maldonado, Osvaldo Daniel Messina, Mario Moreno-Alvarez, Carlos Ríos
Fibromyalgia (FM) and climacteric conditions share common epidemiological and clinical features, with FM symptoms often beginning during menopause. Musculoskeletal pain, arthralgia, myalgia and other symptoms are frequently seen in both conditions. Some research suggests a link between the cessation of sex hormones and FM symptoms. Women with FM tend to experience more severe symptoms after menopause, and the severity of FM symptoms can worsen in women who have had a hysterectomy with or without oophorectomy. Despite these similarities, it is essential to treat FM and climacteric conditions separately and follow established guidelines for management. However, it is also important to recognize that both conditions can coexist in the same patient. It is crucial to note that there is limited evidence supporting the effectiveness of menopausal hormone therapy for primary FM management. Therefore, menopausal hormone therapy should not be recommended for FM unless the patient also has climacteric syndrome.
纤维肌痛(FM)和更年期症状具有共同的流行病学和临床特征,更年期症状通常始于更年期。肌肉骨骼疼痛、关节痛、肌痛和其他症状经常出现在这两种疾病中。一些研究表明,性激素的停止与调频症状之间存在联系。患有 FM 的女性在绝经后往往会出现更严重的症状,而切除或未切除子宫的女性 FM 症状的严重程度也会加重。尽管存在这些相似之处,但必须将 FM 和更年期症状分开治疗,并遵循既定的治疗指南。不过,同样重要的是,要认识到这两种病症可以在同一患者身上同时存在。值得注意的是,支持更年期激素治疗对治疗原发性 FM 有效的证据有限,这一点至关重要。因此,除非患者同时患有更年期综合征,否则不应建议对 FM 进行更年期激素治疗。
{"title":"Climacteric and fibromyalgia: a review.","authors":"Luis Fernando Vidal-Neira, José Luis Neyro, Genessis Maldonado, Osvaldo Daniel Messina, Mario Moreno-Alvarez, Carlos Ríos","doi":"10.1080/13697137.2024.2376190","DOIUrl":"https://doi.org/10.1080/13697137.2024.2376190","url":null,"abstract":"<p><p>Fibromyalgia (FM) and climacteric conditions share common epidemiological and clinical features, with FM symptoms often beginning during menopause. Musculoskeletal pain, arthralgia, myalgia and other symptoms are frequently seen in both conditions. Some research suggests a link between the cessation of sex hormones and FM symptoms. Women with FM tend to experience more severe symptoms after menopause, and the severity of FM symptoms can worsen in women who have had a hysterectomy with or without oophorectomy. Despite these similarities, it is essential to treat FM and climacteric conditions separately and follow established guidelines for management. However, it is also important to recognize that both conditions can coexist in the same patient. It is crucial to note that there is limited evidence supporting the effectiveness of menopausal hormone therapy for primary FM management. Therefore, menopausal hormone therapy should not be recommended for FM unless the patient also has climacteric syndrome.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-22DOI: 10.1080/13697137.2024.2376185
Peyman Hadji, Jens-Olaf Schmeißer, Klaus Peters, Erwin Göckeler-Leopold
Objective: This study aimed to investigate the effectiveness, tolerability and application of estradiol metered-dose transdermal spray (EMDTS) in postmenopausal women during real-world use.
Methods: This was a prospective, non-interventional, multicenter, observational phase IV cohort study. The Menopause Rating Scale II (MRS II) was used to assess symptoms and clinical response. Safety was assessed by the occurrence of adverse events and adverse drug reactions (ADRs).
Results: A total of 451 postmenopausal women were enrolled at 52 gynecological practices across Germany; 383 patients were evaluated for effectiveness and 430 patients for safety. Mean age was 54.3 ± 7.4 years. In total, 228 patients (59.5%) received EMDTS monotherapy and 155 patients (40.5%) received EMDTS plus progestogens. Significant improvements (p < 0.0001) from baseline in symptom severity were recorded for all 11 items of the MRS II at 3, 6 and 12 months of treatment. At 12 months, 81.4% of patients reported improvement in hot flushes/sweating. At final visit, 73% of patients and 77% of physicians were 'satisfied/very pleased' with EMDTS. Most common ADRs were headache (n = 6), nausea (n = 4), dizziness (n = 4) and pruritus (n = 3).
Conclusions: EMDTS is an effective, well tolerated and easily applied hormone replacement therapy for women experiencing postmenopausal symptoms.
{"title":"Use of an estradiol transdermal spray in women with menopausal symptoms: a non-interventional study.","authors":"Peyman Hadji, Jens-Olaf Schmeißer, Klaus Peters, Erwin Göckeler-Leopold","doi":"10.1080/13697137.2024.2376185","DOIUrl":"https://doi.org/10.1080/13697137.2024.2376185","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effectiveness, tolerability and application of estradiol metered-dose transdermal spray (EMDTS) in postmenopausal women during real-world use.</p><p><strong>Methods: </strong>This was a prospective, non-interventional, multicenter, observational phase IV cohort study. The Menopause Rating Scale II (MRS II) was used to assess symptoms and clinical response. Safety was assessed by the occurrence of adverse events and adverse drug reactions (ADRs).</p><p><strong>Results: </strong>A total of 451 postmenopausal women were enrolled at 52 gynecological practices across Germany; 383 patients were evaluated for effectiveness and 430 patients for safety. Mean age was 54.3 ± 7.4 years. In total, 228 patients (59.5%) received EMDTS monotherapy and 155 patients (40.5%) received EMDTS plus progestogens. Significant improvements (<i>p</i> < 0.0001) from baseline in symptom severity were recorded for all 11 items of the MRS II at 3, 6 and 12 months of treatment. At 12 months, 81.4% of patients reported improvement in hot flushes/sweating. At final visit, 73% of patients and 77% of physicians were 'satisfied/very pleased' with EMDTS. Most common ADRs were headache (<i>n</i> = 6), nausea (<i>n</i> = 4), dizziness (<i>n</i> = 4) and pruritus (<i>n</i> = 3).</p><p><strong>Conclusions: </strong>EMDTS is an effective, well tolerated and easily applied hormone replacement therapy for women experiencing postmenopausal symptoms.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1080/13697137.2024.2376189
Salvatore Giovanni Vitale, Stefano Angioni, Maurizio Nicola D'Alterio, Carlo Ronsini, Stefania Saponara, Pasquale De Franciscis, Gaetano Riemma
Objective: This study aimed to evaluate characteristics of endometrial surveillance in women treated for breast cancer to build a clinical prediction model.
Design: A multicentric retrospective cohort study was conducted at two tertiary-care university hospitals from January 2020 to June 2023. Perimenopausal and postmenopausal women treated for breast cancer were categorized into two groups: patients with and without diagnosis of endometrial malignancy (endometrial carcinoma) or premalignancy (atypical endometrial hyperplasia). Characteristics of breast cancer and ultrasonographic and hysteroscopic examinations were compared. A prediction model for endometrial malignancy was built using logistic regression. Predictive accuracy was assessed using the receiver operating characteristic (ROC) curve and goodness of fit using the Hosmer-Lemeshow test.
Results: One hundred and thirty-two (28 with premalignancy or malignancy and 104 without malignancy) women were analyzed. A nomogram was produced for prediction model development utilizing the presence and duration in months of abnormal uterine (BL)eeding, ultrasound (US) vascular pattern and echogenicity and (H)ysteroscopic appearance of endometrium (BLUSH) as determined by logistic regression. Sensitivity and specificity were 79.17% and 95.19%, respectively, with an area under ROC curve of 0.965, indicating good accuracy. Good goodness of fit and prediction stability were indicated by the calibration curve and Hosmer-Lemeshow test (χ2 = 26.36; p = 0.999).
Conclusions: Breast cancer survivors undergoing endometrial surveillance might benefit from a potentially useful prediction model based on hysteroscopic appearance, ultrasonographic uniformity of endometrium, Doppler flow and presence of abnormal uterine bleeding.
{"title":"Risk of endometrial malignancy in women treated for breast cancer: the BLUSH prediction model - evidence from a comprehensive multicentric retrospective cohort study.","authors":"Salvatore Giovanni Vitale, Stefano Angioni, Maurizio Nicola D'Alterio, Carlo Ronsini, Stefania Saponara, Pasquale De Franciscis, Gaetano Riemma","doi":"10.1080/13697137.2024.2376189","DOIUrl":"https://doi.org/10.1080/13697137.2024.2376189","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate characteristics of endometrial surveillance in women treated for breast cancer to build a clinical prediction model.</p><p><strong>Design: </strong>A multicentric retrospective cohort study was conducted at two tertiary-care university hospitals from January 2020 to June 2023. Perimenopausal and postmenopausal women treated for breast cancer were categorized into two groups: patients with and without diagnosis of endometrial malignancy (endometrial carcinoma) or premalignancy (atypical endometrial hyperplasia). Characteristics of breast cancer and ultrasonographic and hysteroscopic examinations were compared. A prediction model for endometrial malignancy was built using logistic regression. Predictive accuracy was assessed using the receiver operating characteristic (ROC) curve and goodness of fit using the Hosmer-Lemeshow test.</p><p><strong>Results: </strong>One hundred and thirty-two (28 with premalignancy or malignancy and 104 without malignancy) women were analyzed. A nomogram was produced for prediction model development utilizing the presence and duration in months of abnormal uterine (BL)eeding, ultrasound (US) vascular pattern and echogenicity and (H)ysteroscopic appearance of endometrium (BLUSH) as determined by logistic regression. Sensitivity and specificity were 79.17% and 95.19%, respectively, with an area under ROC curve of 0.965, indicating good accuracy. Good goodness of fit and prediction stability were indicated by the calibration curve and Hosmer-Lemeshow test (<i>χ</i><sup>2</sup> = 26.36; <i>p</i> = 0.999).</p><p><strong>Conclusions: </strong>Breast cancer survivors undergoing endometrial surveillance might benefit from a potentially useful prediction model based on hysteroscopic appearance, ultrasonographic uniformity of endometrium, Doppler flow and presence of abnormal uterine bleeding.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1080/13697137.2024.2376193
M M S Bem, C M S Paraizo-Horvath, P S Freitas, T R P Brito
Objective: Knowing the important repercussions of menopause for women's health and that female longevity can be better understood through studies based on aging biomarkers, studies on the relationship between menopause and telomere shortening may help to better understand this stage of life. This study aimed to analyze what research has been produced regarding the relationship between menopause and telomere length.
Methods: This integrative literature review included searches in PubMed, CINAHL, LILACS, Web of Science and Scopus databases. Four studies were selected for the final sample.
Results: The findings of these studies indicate that older age for menopause and longer reproductive life (difference between age at menopause and menarche) are associated with longer telomeres, that is, with longevity.
Conclusion: The relationship between menopause and telomere length is uncertain. The small number of studies included in this review, and the fact that the results indicate that the relationship between menopause and telomere length may be dependent on the stage of the menopause and race/ethnicity, suggest that additional research focusing on these variables should be carried out.
研究目的鉴于更年期对女性健康的重要影响,以及通过基于衰老生物标志物的研究可以更好地了解女性的长寿,对更年期与端粒缩短之间关系的研究可能有助于更好地了解这一生命阶段。本研究旨在分析有关更年期与端粒长度之间关系的研究成果:这项综合性文献综述包括在PubMed、CINAHL、LILACS、Web of Science和Scopus数据库中进行检索。结果:这些研究结果表明,老年女性的雌激素水平较高,而雌激素水平较低的女性的雌激素水平较低:这些研究结果表明,绝经年龄越大、生育期越长(绝经年龄与月经初潮年龄之差)与端粒越长,即与长寿有关:结论:绝经与端粒长度之间的关系尚不确定。本综述中包含的研究数量较少,而且研究结果表明更年期与端粒长度之间的关系可能取决于更年期的阶段和种族/民族,这表明应针对这些变量开展更多的研究。
{"title":"Is it possible that menopause is associated with telomere length? Findings of an integrative review.","authors":"M M S Bem, C M S Paraizo-Horvath, P S Freitas, T R P Brito","doi":"10.1080/13697137.2024.2376193","DOIUrl":"https://doi.org/10.1080/13697137.2024.2376193","url":null,"abstract":"<p><strong>Objective: </strong>Knowing the important repercussions of menopause for women's health and that female longevity can be better understood through studies based on aging biomarkers, studies on the relationship between menopause and telomere shortening may help to better understand this stage of life. This study aimed to analyze what research has been produced regarding the relationship between menopause and telomere length.</p><p><strong>Methods: </strong>This integrative literature review included searches in PubMed, CINAHL, LILACS, Web of Science and Scopus databases. Four studies were selected for the final sample.</p><p><strong>Results: </strong>The findings of these studies indicate that older age for menopause and longer reproductive life (difference between age at menopause and menarche) are associated with longer telomeres, that is, with longevity.</p><p><strong>Conclusion: </strong>The relationship between menopause and telomere length is uncertain. The small number of studies included in this review, and the fact that the results indicate that the relationship between menopause and telomere length may be dependent on the stage of the menopause and race/ethnicity, suggest that additional research focusing on these variables should be carried out.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-02-06DOI: 10.1080/13697137.2024.2306892
J K K Mark, S Samsudin, I Looi, K H Yuen
The issue of vaginal dryness in genitourinary syndrome of menopause (GSM) and its pervasive impact on women's quality of life is often overlooked. Extensive surveys conducted worldwide reveal limited understanding of vaginal dryness among public and health-care providers. Physician knowledge on menopause medicine varies globally, highlighting the need for standardized training. Effective communication between physicians and patients plays a crucial role in diagnosing and treating GSM symptoms. There are multiple treatment options to improve vaginal lubrication, including hormonal and non-hormonal therapies, along with lifestyle modifications. Tailoring treatments to individual patient preferences is crucial for compliance. Overall, GSM is multifaceted, from the prevalence of vaginal dryness to the nuances of treatment preferences. The urgency of widespread education and awareness of this matter must be underscored to meet the aim of enhancing the well-being and quality of life for women.
{"title":"Vaginal dryness: a review of current understanding and management strategies.","authors":"J K K Mark, S Samsudin, I Looi, K H Yuen","doi":"10.1080/13697137.2024.2306892","DOIUrl":"10.1080/13697137.2024.2306892","url":null,"abstract":"<p><p>The issue of vaginal dryness in genitourinary syndrome of menopause (GSM) and its pervasive impact on women's quality of life is often overlooked. Extensive surveys conducted worldwide reveal limited understanding of vaginal dryness among public and health-care providers. Physician knowledge on menopause medicine varies globally, highlighting the need for standardized training. Effective communication between physicians and patients plays a crucial role in diagnosing and treating GSM symptoms. There are multiple treatment options to improve vaginal lubrication, including hormonal and non-hormonal therapies, along with lifestyle modifications. Tailoring treatments to individual patient preferences is crucial for compliance. Overall, GSM is multifaceted, from the prevalence of vaginal dryness to the nuances of treatment preferences. The urgency of widespread education and awareness of this matter must be underscored to meet the aim of enhancing the well-being and quality of life for women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-02-06DOI: 10.1080/13697137.2024.2306269
A Monllor-Tormos, A García-Vigara, O Morgan, M-Á García-Pérez, J J Tarín, A Cano
Objective: The prevalence of frailty has been related to menopause. Our main objective was to investigate whether single nucleotide polymorphisms (SNPs) of the estrogen receptor (ER) ER and ER genes were related to the frailty phenotype in a population of community-dwelling postmenopausal women.
Methods: A cross-sectional study was performed in which we selected five SNPs, three in the ER gene and two in the ER. Linear regression was used to estimate the percentage of phenotypic variance after adjusting for confounding variables.
Results: A total of 470 women (mean ± standard deviation age 63.83 ± 8.16 years) were included, of whom 137 women were frail. The SNP rs3798577 of the ER gene was the only variant associated with frailty, but this significance faded in the multivariant analysis. Body mass index (p = 0.012), number of comorbidities (0 vs. ≥2, p = 0.002) and two reproductive variables, number of miscarriages (none vs. ≥2, p = 0.036) and of childbirths (one vs. ≥3, p = 0.008), were independently related to frailty.
Conclusion: The five SNPs of the ER and ER genes tested were not correlated with frailty. Other SNPs of the ER warrant analysis to clarify whether variance in the gene response affects frailty status.
目的虚弱的发生率与更年期有关。我们的主要目的是研究雌激素受体(ER)ERα和ERβ基因的单核苷酸多态性(SNPs)是否与社区绝经后妇女人群的虚弱表型有关:我们进行了一项横断面研究,选取了五个 SNPs,其中三个在 ERα 基因中,两个在 ERβ 基因中。在对混杂变量进行调整后,我们使用线性回归法估算了表型变异的百分比:共纳入 470 名妇女(平均 ± 标准差年龄为 63.83 ± 8.16 岁),其中 137 名妇女体弱。ERα基因的 SNP rs3798577 是唯一一个与体弱有关的变异,但在多变量分析中这一意义消失了。体重指数(p = 0.012)、合并症数量(0 vs. ≥2,p = 0.002)和两个生殖变量--流产次数(无 vs. ≥2,p = 0.036)和分娩次数(1 vs. ≥3,p = 0.008)--与虚弱有独立关系:结论:ERα和ERβ基因的5个SNP与体弱无关。结论:ERα和ERβ基因的5个SNPs与体弱无关,需要对ER的其他SNPs进行分析,以明确基因反应的差异是否会影响体弱状况。
{"title":"Allelic variants of the estrogen receptor genes and frailty phenotype in postmenopausal women.","authors":"A Monllor-Tormos, A García-Vigara, O Morgan, M-Á García-Pérez, J J Tarín, A Cano","doi":"10.1080/13697137.2024.2306269","DOIUrl":"10.1080/13697137.2024.2306269","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of frailty has been related to menopause. Our main objective was to investigate whether single nucleotide polymorphisms (SNPs) of the estrogen receptor (ER) <i>ER</i><math><mi>α</mi></math> and <i>ER</i><math><mrow><mi>β</mi></mrow></math> genes were related to the frailty phenotype in a population of community-dwelling postmenopausal women.</p><p><strong>Methods: </strong>A cross-sectional study was performed in which we selected five SNPs, three in the <i>ER</i><math><mrow><mi>α</mi></mrow></math> gene and two in the <i>ER</i><math><mrow><mi>β</mi></mrow></math>. Linear regression was used to estimate the percentage of phenotypic variance after adjusting for confounding variables.</p><p><strong>Results: </strong>A total of 470 women (mean ± standard deviation age 63.83 ± 8.16 years) were included, of whom 137 women were frail. The SNP rs3798577 of the <i>ER</i><math><mrow><mi>α</mi></mrow></math> gene was the only variant associated with frailty, but this significance faded in the multivariant analysis. Body mass index (<i>p</i> = 0.012), number of comorbidities (0 vs. ≥2, <i>p</i> = 0.002) and two reproductive variables, number of miscarriages (none vs. ≥2, <i>p</i> = 0.036) and of childbirths (one vs. ≥3, <i>p</i> = 0.008), were independently related to frailty.</p><p><strong>Conclusion: </strong>The five SNPs of the <i>ER</i><math><mrow><mi>α</mi></mrow></math> and <i>ER</i><math><mrow><mi>β</mi></mrow></math> genes tested were not correlated with frailty. Other SNPs of the ER warrant analysis to clarify whether variance in the gene response affects frailty status.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01Epub Date: 2024-01-30DOI: 10.1080/13697137.2024.2306272
R P Kauffman, E J MacLaughlin, L A Courtney, D D Vineyard
The use of compounded bioidentical hormone therapy (cBHT) continues to grow in popularity despite the availability of many US Food and Drug Administration-approved hormone products produced in different formulations and dosages. Numerous claims made by proponents of cBHT are not substantiated by properly designed studies. Valid concerns about purity, efficacy, bioavailability and safety of cBHT have been raised. Since patient welfare is the first duty of health professionals, promoting and prescribing cBHT as first-line therapy violates a number of ethical tenets of medical and pharmacy practice and should be discouraged without a compelling reason.
{"title":"An ethical assessment of compounded bioidentical hormone therapy.","authors":"R P Kauffman, E J MacLaughlin, L A Courtney, D D Vineyard","doi":"10.1080/13697137.2024.2306272","DOIUrl":"10.1080/13697137.2024.2306272","url":null,"abstract":"<p><p>The use of compounded bioidentical hormone therapy (cBHT) continues to grow in popularity despite the availability of many US Food and Drug Administration-approved hormone products produced in different formulations and dosages. Numerous claims made by proponents of cBHT are not substantiated by properly designed studies. Valid concerns about purity, efficacy, bioavailability and safety of cBHT have been raised. Since patient welfare is the first duty of health professionals, promoting and prescribing cBHT as first-line therapy violates a number of ethical tenets of medical and pharmacy practice and should be discouraged without a compelling reason.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139575015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}