Journal of Menopausal Medicine最新文献

Objectives: Many experimental studies have reported that female sex hormones involve thyroid cancer development because the incidence rate of thyroid cancer in women (TCW) is 3 times higher than in men. Three previous systematic reviews reporting no association between hormone replacement therapy (HRT) and TCW risk had the same search year of 2014. The aim was to reevaluate the association between HRT use and TCW risk using a meta-epidemiological study of prospective cohort studies.

Methods: The study preferentially used all studies selected by the existing systematic reviews and then secured an additional cohort from the list citing the studies. The selection criterion was defined as the prospective cohort study assessing the association between HRT and TCW risk by adjusted relative risk and its 95% confidence intervals (CI) from multivariate analysis. A random-effects model meta-analysis was applied to estimate summary relative risk (sRR) and its 95% CI. A publication bias was evaluated by Egger's test; moreover, the statistical significance level was set at 5%.

Results: Nine cohort studies were finally selected. The random-effect model was applied because of heterogeneity (I² = 64.3%). The sRR and its 95% CI from a random-effects model meta-analysis had no statistical significance in the association between HRT and TCW risk (sRR = 1.11; 95% CI, 0.98-1.26). Additionally, Egger's test revealed no statistical significance (P = 0.91).

Conclusions: HRT is not associated with TCW risk based on the random-effects model meta-analysis of prospective cohort studies published until now.

Objectives: Menopause is associated with a plethora of problems particularly hot flashes. This study aims to compare the effect of biofeedback and auriculotherapy on hot flashes in menopausal women in Kerman, Iran.

Methods: This study, a pilot clinical trial with a pretest-posttest control group design, was conducted on 39 postmenopausal women referring to the private offices of obstetricians and gynecologists in Kerman, Iran, in 2019. The participants were divided into 3 groups (n = 13 in each group) using simple random assignment. In the first and second intervention groups, the biofeedback program and auriculotherapy were conducted by the researcher 10 times in 45- and 30-min sessions twice a week, respectively. In the control group, routine care was provided. The participants completed the checklist of severity and frequency of hot flashes before, immediately, and 4 weeks postintervention.

Results: Immediate and 4-week postintervention biofeedback and auriculotherapy had a significant effect on reducing the severity and frequency of hot flashes (P < 0.001). However, the effect of auriculotherapy on mitigating the severity and frequency of hot flashes immediately and 4-week postintervention was more significant than that of biofeedback (P < 0.001).

Conclusions: Biofeedback and auriculotherapy may be effective in the treatment of hot flashes. Hence, they can be recommended as therapeutic methods for postmenopausal women.

Objectives: Menopause induces changes in neuronal transmission, leading to anxiety and depression. Changes in the brain's glutamate levels cause psychological behavior in postmenopausal women. Omega-3 has been studied to improve some of these behaviors.

Methods: Twenty-four female Wistar rats were divided into four groups: sham-operated treated with water (SO-W), sham-operated treated with omega-3 (SO-O), ovariectomized (OVX) treated with water (OVX-W), and bilateral OVX treated with omega-3 (OVX-O). These treatments were performed for 20 days via gavage, before and after surgery, totaling 40 days.

Results: In the forced swimming, elevated plus-maze, and open field tests to assess behaviors, such as depression and anxiety, omega-3 improved these behaviors in both treated groups. The levels of thiobarbituric acid reactive substances (TBARS) in the brain were not different between the groups; however, there was a significant decrease in the catalase activity in the SO-O group compared with the SO-W group (P < 0.05). The glutamate level in the cerebrospinal fluid (CSF) was elevated in the SO-O group (P < 0.001) but not in the OVX-W or OVX-O groups.

Conclusions: These results bring novel data when related to the glutamatergic system in the SO-O group. This has suggested that the action mechanism of omega-3 was not dependent on glutamate levels in the CSF of the OVX group, but it played a regulatory role in the sham-operated animals. To confirm this, more studies are needed to explore this field when relating to the estrogen and glutamate receptor changes in specific brain regions.

Objectives: During menopause, women may experience some physical changes that can affect their psychological status. Oxidative stress also increases with menopause, as decreasing levels of estrogen reinforce the deterioration of antioxidant status. To assess total antioxidative capacity, malondialdehyde, superoxide dismutase, and glutathione peroxidase and the correlation between psychological status and oxidative stress in postmenopausal women.

Methods: This cross-sectional study was undertaken on 100 postmenopausal women (40-59 years). Blood malondialdehyde, superoxide dismutase, glutathione peroxidase, and total antioxidative capacity were analyzed, and psychological status was assessed using Rosenberg's self-esteem test, Zung's self-rating anxiety scale, and Zung's self-rating depression scale.

Results: Of the women, 38.0% had mild to moderate symptoms of anxiety (mean ± standard deviation, 50.15 ± 4.89), 21.0% showed depression, and 19.0% had low self-esteem. Twelve percent of the study population had mild to moderate symptoms of all three disorders. A statistically significant difference was found in the scores of anxiety and self-esteem (P = 0.001 and P < 0.001 in women with and without psychological disturbances, respectively). With regard to oxidative stress parameters, only superoxide dismutase levels showed a statistically significant difference (P = 0.001), with lower levels found in women with psychological disturbance.

Conclusions: Women with depression, anxiety, and low self-esteem are in an oxidative challenge, which might be associated with estrogen depletion. A lower superoxide dismutase level is associated with higher depression and anxiety scores in postmenopausal women.

Menopause is not a high-risk period for psychiatric illness but can cause psychological issues; the most common of which are anxiety and depression, which can impair coping and reduce women's quality of life. Thus, many women have leaned toward complementary and alternative medicine (CAM) for the relief of menopause-related symptoms. No rigorous study exists in the literature on the effects of CAMs on the psychological symptoms of menopause despite this growing patient interest. This systematic review aimed to assess the efficacy of CAM interventions on psychological symptoms of menopause. Databases (PubMed, Web of Science, Scopus, Cochrane Library, and Google Scholar) were searched from January 2000 to May 2021 using the keywords: menopause, menopausal symptoms, psychological symptoms, and complementary and alternative medicine. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT) for randomized clinical trials. Of the 704 articles found, 33 articles with 3,092 participants entered the final review. Aromatherapy, massage, yoga, and acupuncture, as well as some dietary and herbal supplements improved psychological symptoms during menopause based on the findings of the current study. However, the effectiveness of reflexology and exercise was debatable. However, necessary precautions should be taken when using them in clinical settings despite the positive effect of various CAM interventions on reducing psychological symptoms. More studies with a higher methodology quality are required to make better decisions about the effect of various CAM interventions on the psychological symptoms of menopause.

Objectives: This study compared serum anti-Mullerian hormone (AMH) levels in endometriotic cysts (ECs) with those in non-ECs and analyzed changes thereof after single-port laparoscopic (SPL) ovarian cyst enucleation using vasopressin injection.

Methods: In total, 180 patients (EC group, n = 112; non-EC group, n = 68) who underwent SPL ovarian cyst enucleation were retrospectively reviewed. Their AMH levels were checked preoperatively, on postoperative day 10 (POD10), and on postoperative month 3 (POM3). Changes in AMH levels were analyzed according to tumor type and vasopressin use.

Results: The median initial and postoperative serum AMH levels in the EC group were significantly lower than those in the non-EC group (preoperation: 2.0 vs 3.8 ng/mL, P < 0.001; POD10: 1.0 vs 3.2 ng/mL, P < 0.001; POM3: 1.2 vs 3.6 ng/mL, P < 0.001). The postoperative decrease in AMH levels was higher in the EC group than the non-EC group on POD10 (0.8 vs 0.5 ng/mL, P = 0.011) but not on POM3 (0.7 vs 0.5 ng/mL, P = 0.164). Vasopressin injection during EC enucleation had no significant effect on the decrease in AMH levels on POD10 (vasopressin group vs non-vasopressin group: 1.0 vs 0.8 ng/mL, P = 0.253) and POM3 (vasopressin group vs nonvasopressin group: 1.4 vs 1.1 ng/mL, P = 0.242).

Conclusions: AMH levels were lower at baseline and had higher decreasing rates after SPL surgery in the EC group relative to the non-EC group. Vasopressin injection might not protect the ovary from the postoperative decrease in AMH levels.

Objectives: This study aims to examine the clinical outcomes of women who underwent a midurethral sling surgery for stress urinary incontinence and compare postoperative urinary symptoms among different body mass index (BMI) groups.

Methods: A retrospective cohort study on results after midurethral sling surgery according to BMI was conducted at the institution of the current study from January 2010 to December 2019. The study population was classified into three groups according to patients' BMI (in kg/m²) during surgery: normal weight (BMI < 23.0 kg/m²), overweight (BMI, 23.0-24.9 kg/m²), and obese (BMI ≥ 25.0 kg/m²). The primary outcome was the recurrence of urinary symptoms after surgery. The secondary outcomes were operation time, estimated blood loss, length of hospital stay, and postoperative complications.

Results: This study included 376 patients (normal weight, 148; overweight, 74; and obese women, 154) who underwent midurethral sling surgery. No significant difference was noted in urinary symptom recurrence after midurethral sling surgery. Of the patients, 6.8% (n = 10), 9.5% (n = 7), and 7.8% (n = 12) were normal weight, overweight, and obese women, respectively (P = 0.775). Moreover, operation time (P = 0.589), blood loss (P = 0.138), and complication rate (P = 0.865) showed no significant difference.

Conclusions: Midurethral sling surgery is effective regardless of BMI. Even when midurethral sling surgery was performed as a concomitant surgery, no significant difference in urinary symptom recurrence, operation time, intraoperative blood loss, and complication rate was noted among different BMI groups.

Menopause is a normal phenomenon in a woman's life cycle involving multiple health-related issues that contribute to physical instability. Changes in the immune system in postmenopausal women are caused by estrogen deprivation along with age. Increased proinflammatory serum marker levels, cytokine responses in body cells, decreased CD4 T and B lymphocyte levels, and natural killer cell cytotoxic activity are also observed during postmenopause. Moreover, vitamin D, in addition to its classical effects on calcium homeostasis and bone density, plays an important role. Current evidence indicates that vitamin D regulates innate and adaptive immune responses; however, vitamin D deficiency is linked to increased autoimmune activity and infection susceptibility. This review provides an overview of the consequences of immune alterations as an outcome of aging in postmenopausal women and the benefit of vitamin D supplementation.