Climacteric最新文献

Maintaining fitness throughout menopause is crucial for sustaining functional capacity and supporting healthy aging. Declines in physical activity and changes in physiology threaten cardiovascular health in menopause. Aerobic capacity is an indicator of current health status that can be measured directly, by maximal rate of oxygen uptake (V̇O_{2 max}), or using submaximal predictive methods that require fewer resources. This study aimed to establish the validity of these predictive methods for midlife women. Forty-four women (age 52 ± 4 years) completed three predictive cycle ergometer protocols (YMCA, Astrand-rhyming and Ekblom-Bak) and an incremental cycle ergometer V̇O_{2 max} test. Predicted V̇O_{2 max} scores were compared for agreement with directly measured V̇O_{2 max}. All methods evidenced moderate correlations with V̇O_{2 max}. The mean V̇O_{2 max} value derived from the YMCA (35.6 ± 9.7 ml·kg-¹·min-¹) and Astrand-Rhyming (35.5 ± 8.8 ml·kg-¹·min-¹) tests was no different to measured V̇O_{2 max} (34.5 ± 7.2 ml·kg-¹·min-¹), but the Ekblom-Bak test (37.5 ± 7.2 ml·kg-¹·min-¹, p < 0.01) overpredicted V̇O_{2 max}. All methods showed wide limits of agreement, suggesting variability in the accuracy of predictions. When measuring aerobic capacity or prescribing exercise using these predictive methods, the results should be interpreted with caution. Where possible, direct measurement of aerobic capacity should be utilized for prescription of exercise intensity in menopausal women.

Objectives: Low bone mineral density (LBMD) significantly contributes to global morbidity and mortality, especially in postmenopausal women. However, its burden in premenopausal women remains underrecognized. This study evaluated the global burden, temporal trends and future projections of LBMD-related outcomes.

Methods: Data were obtained from the Global Burden of Disease 2021 dataset covering 204 countries. Premenopausal and postmenopausal women from 1990 to 2021 were included. Incidence, mortality and disability-adjusted life years (DALYs) were extracted, and age-standardized rates were calculated. The study explored demographic and epidemiologic changes, applied inequality indices and employed a Bayesian Markov chain Monte Carlo model to forecast trends through 2035.

Results: Between 1990 and 2021, LBMD-related mortality rose by 27.39% (95% uncertainty interval [UI] 16.83-39.69) among premenopausal women and 138.73% (95% UI 98.45-186.25) among postmenopausal women. In 2021, the postmenopausal age-standardized rate (27.92 per 100,000) was 63.5 times higher than that of premenopausal women (0.44 per 100,000). By 2035, although rates may decline, overall deaths and DALYs will likely increase due to population growth and aging.

Conclusion: Despite decreasing standardized rates, the absolute burden of LBMD continues to grow. Early screening and targeted prevention, especially for postmenopausal and underrecognized premenopausal women, is crucial to lessen its global impact.

Objective: This study aimed to determine whether live birth affects the age at menopause (AAM), explore the relationship between different characteristics and AAM, and develop a model to project the AAM in middle-aged women.

Method: A cross-sectional study was conducted with 630 postmenopausal women in Cyprus between January 2022 and June 2022. Postmenopausal women between ages 40 and 90 years completed a 90-question questionnaire that assessed reproductive, socio-demographic, familial, lifestyle and newborn/childhood parameters. Linear regression analysis was used to determine the associations related to AAM, which was questioned in the questionnaire. Multiple linear regression analysis was applied to determine the effect of potential associations on AAM.

Results: The mean AAM was 48.7 years. In univariate analysis, the strongest associations observed were the positive correlation between AAM and the number of grown-up children and live births. Other reproduction-related parameters were mildly correlated with AAM. In the multivariable analysis, the effect of reproduction became less critical, including live birth. The strongest associations with AAM were the years of marriage before the AAM, relationship quality with the partner, the participant's mother's AAM and the average AAM of any sisters. A formula including parameters strongly associated with AAM contributed to a 26.7% variation in AAM between women (p < 0.001).

Conclusions: As the AAM can be determined to an extent, we can separate early and late AAM groups and prepare for the high-risk conditions related to later or earlier AAM to increase longevity.

Objective: Climacteric symptoms can significantly impair quality of life. Although various non-pharmacological interventions have been explored, the mid-term and long-term effects of yoga remain insufficiently investigated. This study aimed to evaluate the impact of Shivam Yoga practice on climacteric symptoms and hormone levels over 6, 12 and 24 months.

Method: In this quasi-experimental controlled trial, 373 women aged 40-65 years were assigned to either a yoga or control group. Symptoms and hormone levels were assessed at baseline, 6, 12 and 24 months.

Results: A total of 182 women completed at least 6 months of follow-up. The yoga group showed a significant reduction in the frequency of moderate-to-severe symptoms (Kupperman Index >19) across all time points. Median Kupperman scores decreased by 12 points (p < 0.001) at 6 months, 12 points (p = 0.008) at 12 months and 16.5 points (p = 0.027) at 24 months. Improvements were observed in hot flashes, insomnia, nervousness, depressive symptoms, fatigue, arthralgia/myalgia, headache, palpitations and tinnitus. After 24 months, the yoga group also showed significantly higher estrogen and total testosterone levels than the control group.

Conclusion: Regular Shivam Yoga practice significantly reduced climacteric symptoms over 24 months. These benefits may be mediated by hormonal changes, positioning Shivam Yoga as a promising complementary therapy for menopausal symptoms.

Objective: The aim of this study was to explore the independent and combined effects of age at menarche (AAM) and age at natural menopause (ANM) on postmenopausal women's mental health and to evaluate healthy life expectancy (HLE) in different AAM and ANM groups based on mental disease dimensions.

Method: Logistic regression was used to assess the associations of AAM and ANM with mental health. A period life table was used to calculate life expectancy, and HLE was calculated via the Sullivan method.

Results: A total of 11,908 postmenopausal women were included in this study. Compared with menarche at 12-15 years, multiple adjusted odds ratios (95% confidence intervals) for depression, anxiety and mental disorder were 2.313 (1.079, 4.960), 2.401 (1.161, 4.966) and 2.103 (1.051, 4.205) for menarche age <12 years and 1.219 (1.013, 1.468), 1.244 (1.039, 1.491) and 1.210 (1.029, 1.421) for menarche age >15 years; early menopause was associated with depression and anxiety compared to the normal range of ANM. The early AAM and ANM groups tended to have the lowest HLE.

Conclusion: Abnormal AAM and ANM are not only associated with increased risk of mental problems, but also affect mental HLE in postmenopausal women.

Objective: This study aimed to explore the needs and preferences of women and general practitioners (GPs) in relation to a menopause-related digital pre-consultation screening tool to be used in Australian general practice.

Method: The qualitative co-design design study brought together GPs and women with lived experience of menopause symptoms to develop a prototype for a digital pre-consultation screening tool for menopause symptoms.

Results: Twelve participants worked together to co-design a pre-consultation questionnaire. Themes highlighted the barriers around starting conversations about menopause, and the importance of normalizing these discussions. Participants envisioned that a well-designed pre-consultation tool could help address these needs. A prototype of the tool was successfully co-designed, receiving consensus agreement from all participants. Key elements of the tool include the use of signposting, clear language and logical sequencing of questions.

Conclusion: The tool will be trialed in a pilot implementation study in 10 general practice clinics over a period of 12 months. Qualitative interviews will focus on the tool's functionality and workflow in practice.

Objective: Menopause is associated with profound hormonal changes, including declines in estradiol and progesterone and increases in follicle stimulating hormone (FSH) and luteinizing hormone (LH), which contribute to elevated cardiovascular disease (CVD) risk. Digital twin frameworks offer a novel approach to simulate these complex dynamics.

Method: This study developed a semi-mechanistic digital twin model of menopause using 1000 simulated women (50% age ≥55 years, 50% age <55 years) followed over 90 days. Hormonal dynamics were modeled as cyclical in non-menopausal women and stable in postmenopausal women. Cardiovascular risk was assessed with linear mixed-effects models and generalized estimating equations, adjusting for age, body mass index and smoking.

Results: The model reproduced expected patterns, with estradiol and progesterone peaks at ovulation and luteal phases in non-menopausal women, and stable, low levels in postmenopausal women, alongside elevated gonadotropins. After adjustment, menopause remained significantly associated with hormonal changes and CVD risk (p < 0.001). CVD-related differences were more pronounced in non-menopausal women, where estradiol peaks and luteal progesterone amplitudes were attenuated.

Conclusion: This proof of concept highlights the potential of digital twin models to capture menopause-related hormonal dynamics and their cardiovascular implications. Future work should integrate real-world data, perimenopausal variability and ethical governance to enhance clinical translation.

Women in early midlife often experience specific health issues due to aging and the menopausal transition. Hormonal changes, systemic chronic inflammation and micronutrient deficiencies contribute to symptoms such as vasomotor disturbances, metabolic syndrome, neurocognitive decline and reduced mobility, which can adversely affect overall health and quality of life. However, the menopausal transition also offers opportunities for improving health and preventing diseases. Many women use dietary supplements as a form of complementary and alternative medicine (CAM) to manage these complex challenges during this life stage. Given the multifaceted nature of these health concerns, an integrated approach that combines dietary supplements with conventional medicine and harnesses nutrient synergy for enhanced benefits should be considered. This article examines current evidence on the use of multivitamins, minerals and dietary supplements (including those containing phytonutrients and other CAMs) for health issues during early midlife and the menopausal transition. Although current evidence suggests that multi-nutrient dietary supplementation combinations are promising, further research is needed to verify their effectiveness and evaluate potential interactions with standard treatments across diverse populations. The successful integration of dietary supplements alongside conventional medicine during the menopausal transition will also require personalized care, support from healthcare professionals and public education.

Objective: This study aimed to examine the 20-year incidence of cardiovascular disease (CVD) in menopausal women, exploring the interplay of traditional and menopause-specific risk factors.

Method: The ATTICA study is a prospective cohort survey established in 2001-2002, with three consecutive follow-ups performed in 2006, 2012 and 2022. A total of 1001 women with complete data for CVD evaluation comprised the sample of the current study. For the purposes of this analysis, women were classified according to their menopausal status (at menopause, 276 out of 1001 women [27.6%]).

Results: The 20-year cumulative CVD incidence was 321 cases among 1001 women (32%); 274 out of the 337 (81.3%) who were at menopause developed CVD, whereas 47 out of 664 at premenopause developed CVD (7.1%). Age-adjusted analysis revealed that postmenopausal women had 2.25 times (95% confidence interval: 1.20, 4.24) higher risk of CVD, compared to women not at menopause. The fully adjusted model revealed that history of diabetes and hypercholesterolemia were significant predictors for the 20-year-CVD events. Moreover, high-sensitivity C-reactive protein was a significant predictor for CVD events only in women aged above 52 years at menopause.

Conclusion: Postmenopausal women had an age-adjusted 2.25 times higher 20-year risk of CVD, as compared to women who were not at menopause. Prevailed hypercholesterolemia and diabetes were the most important determinants for long-term CVD events, whereas chronic systemic inflammation had significant predictive value only in women aged above 52 years at menopause.