Climacteric最新文献

{"title":"Prevalence, impact and management of postmenopausal symptoms among postmenopausal women in Rwanda.","authors":"B Sitini, P Ntihinyurwa, D Ntirushwa, L Mafende, M Small, S Rulisa","doi":"10.1080/13697137.2023.2246887","DOIUrl":"10.1080/13697137.2023.2246887","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed at evaluating the prevalence and management of postmenopausal symptoms among Rwandan women.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted at the four largest Rwandan referral hospitals from August 2017 to March 2018 among postmenopausal women. Data on postmenopausal symptoms were collected using the Modified Blatt-Kupperman Menopausal Index and score ranges of 0-6, 7-15, 16-30 and >30 were used to rate the degree of severity as none, mild, moderate, and severe, respectively.</p><p><strong>Results: </strong>Six hundred participants were recruited. The mean age at natural menopause was 51.7 ± 5.6 years. Common symptoms were hot flushes (82%), sexual complaints (66%) and headache (61%). The mean Blatt-Kupperman index score was 21.2 (1-58). Participants' symptoms were classified as severe (35.8%), moderate (49.0%), mild (11.3%) and none (3.8%). Among 41.2% who had sought medical care, 1.7% were given hormonal replacement and 36% were given only pain medications. Age >50 years and lack of a male partner were significantly associated with higher scores.</p><p><strong>Conclusions: </strong>Postmenopausal symptoms remain a burden among Rwandan women and little consideration is given for optimal management. There is a need for health managers to consider this inevitable phase of life on the health policy agenda for equitable healthy aging.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"613-618"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156275","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}

{"title":"'Vaginal Laser Therapy for GSM/VVA: Where We Stand Now - A Review by the EUGA Working Group on Laser'.","authors":"F G Li, J A Abbott","doi":"10.1080/13697137.2023.2259791","DOIUrl":"10.1080/13697137.2023.2259791","url":null,"abstract":"","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"638"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142568","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}

{"title":"Women with mood disorders and couples conflict: menopause symptom improvement, after group therapy.","authors":"D Y Conklin, G Karakurt","doi":"10.1080/13697137.2023.2223922","DOIUrl":"10.1080/13697137.2023.2223922","url":null,"abstract":"<p><strong>Objective: </strong>Although a public health crisis, intimate partner violence (IPV) has been understudied for middle-aged women with mood disorders during their perimenopausal and postmenopausal years. The aims of this study were to examine the relationship between IPV and hot flashes/night sweats (HF/NS) frequency and severity among women with mood disorders and to test whether the effect of cognitive behavioral group therapy on menopausal symptoms differs between those with and without IPV at baseline and post-test.</p><p><strong>Methods: </strong>Of 59 participants from a mood disorders outpatient clinic enrolled in the parent study, 24 experienced IPV. This study analyzed pretreatment and post-treatment data from the Revised Conflict Tactic Scale - Short Form-2, and HF/NS frequency and severity ratings on the Hot Flash Daily Diary using the McNemar chi-square test.</p><p><strong>Results: </strong>The presence of any type of violence at pretreatment was significantly (<i>p</i> < 0.01) linked to improvements in HF/NS frequency and severity. Women who showed improvements in negotiation skills had better outcomes in menopausal symptoms. Sexual coercion increased from one to three women.</p><p><strong>Conclusions: </strong>Negotiation skills may help women with mood disorders to reduce HF/NS frequency and severity. More studies need to be conducted with a special focus on helping women in this population.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"565-570"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10074804","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}

{"title":"Lack of evidence that progesterone in ovulatory cycles causes breast cancer.","authors":"A Gompel, V Seifert-Klauss, J A Simon, J C Prior","doi":"10.1080/13697137.2023.2249813","DOIUrl":"10.1080/13697137.2023.2249813","url":null,"abstract":"<p><p>A recent Perspective article asserted that progesterone secretion during ovulatory cycles is the cause of breast cancer. However, we challenge most of the evidence developed in this publication. First, there is a lack of evidence that progesterone is mutagenic for breast cells. Cause of a cancer should mean initiation by mutation, as opposed to promotion. Second, subclinical ovulatory disturbances occur rather frequently in normal-length menstrual cycles. Third, the authors attribute a potential carcinogenic effect to progesterone secreted during menstrual cycles but not to progesterone during pregnancy. They did not discuss breast cancer evidence from progesterone/progestin therapeutics. They argue that in genetic primary amenorrhea, a hypothetic lower risk of breast cancer could be due to the lack of progesterone, despite the progesterone/progestin in hormone replacements these women receive. Fourth, they advocate a regulatory effect of progesterone on several genes potentially involved in cancer genesis. In particular, they attribute a lower risk of breast cancer in women with Mayer-Rokitansky-Küster-Hauser syndrome to a defect in the progesterone-stimulated Wnt4 gene. However, this defect is only present in a small subset. Thus, the postulated progesterone breast cancer risk is unconvincing, which we discuss point by point in this commentary.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"634-637"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164920","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}

{"title":"What is the evidence for the effect of physical exercise on bone health in menopausal women? An umbrella systematic review.","authors":"D Y Fausto, J B B Martins, A C Machado, P S Saraiva, A Pelegrini, A C A Guimarães","doi":"10.1080/13697137.2023.2249819","DOIUrl":"10.1080/13697137.2023.2249819","url":null,"abstract":"<p><p>This study aimed to analyze the effects of physical exercise (PE) on bone health in menopausal women through an umbrella review and to assess the quality of systematic reviews (SRs) and meta-analyses (MAs) included. The review was registered in PROSPERO (CRD42020208130) and the Rayyan application was used. The methodological quality of the included studies was evaluated by A MeaSurement Tool to Assess Systematic Reviews (AMSTAR), and Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to assess the level of evidence of the results. The results showed that low-intensity jumping exercises with longer sessions proved to be efficient in the hip segment. Swimming requires further investigation, as it showed high heterogeneity. Aerobic and resistance exercises showed inconsistent results, requiring further studies with these modalities of PE. Concurrent training showed improvements in the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance exercises are effective in preserving bone mineral density (BMD) of the femoral neck and lumbar spine in postmenopausal women. In conclusion, jumping exercises were efficient in the hip, while aerobic and resistance exercises are still inconsistent. Concurrent training showed improvements in BMD of the lumbar spine, femoral neck, Ward's triangle and trochanter. Finally, combined resistance protocols are effective in preserving BMD of the femoral neck and lumbar spine in postmenopausal women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"550-559"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170554","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}

{"title":"Clinical practice: guidelines, position statements, recommendations and tool kits.","authors":"Rod Baber","doi":"10.1080/13697137.2023.2266255","DOIUrl":"10.1080/13697137.2023.2266255","url":null,"abstract":"","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":"26 6","pages":"515-516"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470016","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}

{"title":"Long-term clinical and histological safety and efficacy of the CO₂ laser for treatment of genitourinary syndrome of menopause: an original study.","authors":"A Casiraghi, A Calligaro, N Zerbinati, M Doglioli, A F Ruffolo, M Candiani, S Salvatore","doi":"10.1080/13697137.2023.2246886","DOIUrl":"10.1080/13697137.2023.2246886","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate histological modifications of the vaginal mucosa after repeated microablative fractional CO₂ laser treatments. As secondary objectives we evaluated the clinical effects associated with repeated microablative fractional CO₂ laser treatments using validated questionnaires.</p><p><strong>Methods: </strong>A prospective intervention study was performed in the Division of Gynecology and Obstetrics, Urogynecology Unit, IRCCS San Raffaele Scientific Institute with 15 postmenopausal women complaining of genitourinary syndrome of menopause symptoms. The cohort of patients was submitted to at least two previous laser treatment cycles in the past years. The Vaginal Health Index (VHI), visual analog scale (VAS), Female Sexual Function Index (FSFI), Urinary Distress Inventory-6 (UDI-6), International Consultation on Incontinence Questionnaire - Urinary Incontinence (ICIQ-UI) and 5-point Likert scale were used. Moreover, histological examinations were carried out on all samples.</p><p><strong>Results: </strong>At 4 weeks after the last treatment, the VHI score and all FSFI items were significantly increased compared with baseline. We observed a statistically significant decrease in both frequency and severity for all urinary symptoms after the follow<b>-</b>up. We observed a statistically significant increase in the number of epithelial cell layers with a consequent increase in epithelial thickness, in the number of glycogen<b>-</b>filled cells and in the number of papillae after the laser treatment. No signs of fibrosis were observed as neovascularization was observed in each woman.</p><p><strong>Conclusions: </strong>This is the first study demonstrating the histological persistency of efficacy in repeated annually laser treatment cycles, with tissue changes always leading to regenerative results without any sign of fibrosis.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov ID: NCT04868812 (release date: 27 April 2021).</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"605-612"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125055","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}

{"title":"COVID-19-related premature ovarian insufficiency: case report and literature review.","authors":"K Pankiewicz, E Chotkowska, B Nowakowska, M Gos, T Issat","doi":"10.1080/13697137.2023.2246878","DOIUrl":"10.1080/13697137.2023.2246878","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to present the case report of a 36-year-old woman developing premature ovarian insufficiency (POI) after COVID-19 and review the literature referring to the possible impact of SARS-CoV-2 infection on female reproduction.</p><p><strong>Methods: </strong>A 36-year-old nulligravida with normal menstrual cycles, non-smoker, with a normal body mass index and no pelvic surgery or oncological treatment in her medical history presented to the Infertility Center of the Institute of Mother and Child in Warsaw after a year of unsuccessful attempts to get pregnant. During diagnostic process she was affected by COVID-19 with a mild manifestation and thereafter she presented amenorrhea with intense hot flushes. Further diagnostic confirmed the diagnosis of POI.</p><p><strong>Results: </strong>There is a strong molecular basis for a possible effect of SARS-CoV-2 infection on the female reproductive system; however, the results of available research are conflicting. All of these aspects are discussed in detail.</p><p><strong>Conclusions: </strong>SARS-CoV-2 infection may cause serious complications that cast a long shadow on a patient's future life and health. Further research is needed to assess the real impact of SARS-CoV-2 infection on female reproductive health, as well as potential preventive and therapeutic strategies for women affected with COVID-19.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"601-604"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118815","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}

{"title":"Impact of overweight and obesity in postmenopausal women.","authors":"S Martínez-Vázquez, A Hernández-Martínez, R A Peinado-Molina, J M Martínez-Galiano","doi":"10.1080/13697137.2023.2228692","DOIUrl":"10.1080/13697137.2023.2228692","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between overweight and obesity in postmenopausal women and different aspects related to health such as quality of life, physical activity, sleep quality and level of physical activity.</p><p><strong>Methods: </strong>An observational cross-sectional study was carried out during 2021-2022 in Spain in postmenopausal women. Health-related quality of life was assessed using the 12-item short-form survey (SF-12). The Pittsburgh Sleep Quality Index (PSQI) was used to determine sleep quality, and the International Physical Activity Validated Questionnaire (IPAQ) was used for physical activity. A multivariate analysis was conducted using binary logistic regression to control the confounding bias.</p><p><strong>Results: </strong>A total of 395 postmenopausal women participated: 64.6% (<i>n</i> = 255) were overweight or obese. Obesity was associated with higher odds of having a lower quality of life (adjusted odds ratio [aOR] = 2.88; 95% confidence interval [CI]: 1.51-5.49), including alterations in physical role and function, pain and vitality. Postmenopausal women with overweight/obesity had higher odds of cardiovascular problems (aOR = 2.09; 95% CI: 1.04-4.19/aOR = 4.44; 95% CI: 2.12-9.31), and women with obesity were more likely to develop endocrine problems (aOR = 2.29; 95% CI: 1.10-4.75). Finally, women with obesity had higher odds of suffering urinary incontinence (aOR = 2.10; 95% CI: 1.10-4.01) or fecal incontinence (aOR = 2.70; 95% CI: 1.35-5.39), and pelvic pain (aOR = 2.33; 95% CI: 1.18-4.59).</p><p><strong>Conclusions: </strong>Obesity in postmenopausal women negatively affects perceived quality of life, sleep quality, physical activity, the development of cardiovascular problems and pelvic floor-related problems.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"577-582"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9841259","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}

{"title":"Postmenopausal hormone therapy in prior pre-eclamptic women: a nationwide cohort study in Finland.","authors":"M Venetkoski, O Ylikorkala, J M Joensuu, M Gissler, T S Mikkola, H Savolainen-Peltonen","doi":"10.1080/13697137.2023.2228687","DOIUrl":"10.1080/13697137.2023.2228687","url":null,"abstract":"<p><strong>Objective: </strong>We compared the trends of hormone therapy (HT) use among women with and without a history of pre-eclampsia.</p><p><strong>Methods: </strong>This national cohort study consisted of women with a pre-eclamptic pregnancy (<i>n</i> = 31,688) or a normotensive pregnancy (<i>n</i> = 91,726) (controls) during 1969-1993. The data on their use of HT during 1994-2019 were traced from the National Medicine Reimbursement Register.</p><p><strong>Results: </strong>Both women with a history of pre-eclampsia and controls initiated HT at a mean age of 49.9 years. Cumulative HT™ use during the total follow-up did not differ between the groups (31.1% vs. 30.6%, <i>p</i> = 0.066). However, HT use in previously pre-eclamptic women was less common in 1994-2006 (20.2% vs. 22.4%, <i>p</i> < 0.001) and more common in 2007-2019 (22.1% vs. 21.1%, <i>p</i> < 0.001) than in controls. This trend was also seen in the annual changes of HT starters. Women with a history of pre-eclampsia used HT for a shorter time (6.3 vs. 7.1 years, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>In contrast to controls, HT use in previously pre-eclamptic women increased during the last half of the follow-up. This may reflect the changes in the international recommendations, the increased awareness of pre-eclampsia-related cardiovascular risk later in life and the aim to diminish this risk with HT.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"571-576"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9848175","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}