Women's midlife health最新文献

{"title":"Changes in androstenedione, dehydroepiandrosterone, testosterone, estradiol, and estrone over the menopausal transition.","authors":"Catherine Kim,&nbsp;Siobàn D Harlow,&nbsp;Huiyong Zheng,&nbsp;Daniel S McConnell,&nbsp;John F Randolph","doi":"10.1186/s40695-017-0028-4","DOIUrl":"https://doi.org/10.1186/s40695-017-0028-4","url":null,"abstract":"<p><strong>Background: </strong>Previous reports have noted that dehydroepiandrosterone-sulfate (DHEAS) increases prior to the final menstrual period (FMP) and remains stable beyond the FMP. How DHEAS concentrations correspond with other sex hormones across the menopausal transition (MT) including androstenedione (A4), testosterone (T), estrone (E1), and estradiol (E2) is not known. Our objective was to examine how DHEAS, A4, T, E1, and E2 changed across the MT by White vs. African-American (AA) race/ethnicity.</p><p><strong>Methods: </strong>We conducted a longitudinal observational analysis of a subgroup of women from the Study of Women's Health Across the Nation observed over 4 visits prior to and 4 visits after the FMP (<i>n</i> = 110 women over 9 years for 990 observations). The main outcome measures were DHEAS, A4, T, E1, and E2.</p><p><strong>Results: </strong>Compared to the decline in E2 concentrations, androgen concentrations declined minimally over the MT. T (β 9.180, p < 0.0001) and E1 (β 11.365, p < 0.0001) were higher in Whites than in AAs, while elevations in DHEAS (β 28.80, <i>p</i> = 0.061) and A4 (β 0.2556, <i>p</i> = 0.052) were borderline. Log-transformed E2 was similar between Whites and AAs (β 0.0764, <i>p</i> = 0.272). Body mass index (BMI) was not significantly associated with concentrations of androgens or E1 over time.</p><p><strong>Conclusion: </strong>This report suggests that the declines in E2 during the 4 years before and after the FMP are accompanied by minimal changes in DHEAS, A4, T, and E1. There are modest differences between Whites and AAs and minimal differences by BMI.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0028-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35736334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It is not just menopause: symptom clustering in the Study of Women's Health Across the Nation.","authors":"Siobán D Harlow,&nbsp;Carrie Karvonen-Gutierrez,&nbsp;Michael R Elliott,&nbsp;Irina Bondarenko,&nbsp;Nancy E Avis,&nbsp;Joyce T Bromberger,&nbsp;Maria Mori Brooks,&nbsp;Janis M Miller,&nbsp;Barbara D Reed","doi":"10.1186/s40695-017-0021-y","DOIUrl":"https://doi.org/10.1186/s40695-017-0021-y","url":null,"abstract":"<p><strong>Background: </strong>Patterns of symptom clustering in midlife women may suggest common underlying mechanisms or may identify women at risk of adverse health outcomes or, conversely, likely to experience healthy aging. This paper assesses symptom clustering in the Study of Women's Health Across the Nation (SWAN) longitudinally by stage of reproductive aging and estimates the probability of women experiencing specific symptom clusters. We also evaluate factors that influence the likelihood of specific symptom clusters and assess whether symptom clustering is associated with women's self-reported health status.</p><p><strong>Methods: </strong>This analysis includes 3289 participants in the multiethnic SWAN cohort who provided information on 58 symptoms reflecting a broad range of physical, psychological and menopausal symptoms at baseline and 7 follow-up visits over 16 years. We conducted latent transition analyses to assess symptom clustering and to model symptomatology across the menopausal transition (pre, early peri-, late peri- and post-menopausal). Joint multinomial logistic regression models were used to identify demographic characteristics associated with premenopausal latent class membership. A partial proportional odds regression model was used to assess the association between latent class membership and self-reported health status.</p><p><strong>Results: </strong>We identified six latent classes that ranged from highly symptomatic (LC1) across most measured symptoms, to moderately symptomatic across most measured symptoms (LC2), to moderately symptomatic for a subset of symptoms (vasomotor symptoms, pain, fatigue, sleep disturbances and physical health symptoms) (LC3 and LC5) with one class (LC3) including interference in life activities because of physical health symptoms, to numerous milder symptoms, dominated by fatigue and psychological symptoms (LC4), to relatively asymptomatic (LC6). In pre-menopause, 10% of women were classified in LC1, 16% in LC2, 14% in LC3 and LC4, 26% in LC5, and 20% in LC6. Intensity of vasomotor and urogenital symptoms as well as sexual desire) differed minimally by latent class. Classification into the two most symptomatic classes was strongly associated with financial strain, White race/ethnicity, obesity and smoking status. Over time, women were most likely to remain within the same latent class as they transitioned through menopause stages (range 39-76%), although some women worsened or improved. The probability of moving between classes did not differ substantially by menopausal stage. Women in the highly symptomatic classes more frequently rated their health as fair to poor compared to women in the least symptomatic class.</p><p><strong>Conclusion: </strong>Clear patterns of symptom clustering were present early in midlife, tended to be stable over time, and were strongly associated with self-perceived health. Notably, vasomotor symptoms tended to cluster with sleep disturbances and fatigue","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"3 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-017-0021-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35730994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Seattle Midlife Women's Health Study: a longitudinal prospective study of women during the menopausal transition and early postmenopause.","authors":"Nancy Fugate Woods,&nbsp;Ellen Sullivan Mitchell","doi":"10.1186/s40695-016-0019-x","DOIUrl":"https://doi.org/10.1186/s40695-016-0019-x","url":null,"abstract":"<p><strong>Background: </strong>The need for longitudinal, population-based studies to illuminate women's experiences of symptoms during the menopausal transition motivated the development of the Seattle Midlife Women's Health Study.</p><p><strong>Methods: </strong>Longitudinal, population-based study of symptoms women experienced between the Late Reproductive stage of reproductive aging and the early postmenopause. Data collection began in 1990 with 508 women ages 35-55 and continued to 2013. Entry criteria included age, at least one period in past 12 months, uterus intact and at least 1 ovary. Women were studied up to 5 years postmenopause. Data collection included yearly health questionnaires, health diaries, urinary hormonal assays, menstrual calendars and buccal cell smears.</p><p><strong>Results: </strong>Contributions of the study included development of a method for staging the menopausal transition; development of bleeding criteria to differentiate bleeding episodes from intermenstrual bleeding from menstrual calendars; identification of hormonal changes associated with menopausal transition stages; assessment of the effects of menopausal transition factors, aging, stress-related factors, health factors, social factors on symptoms, particularly hot flashes, depressed mood, pain, cognitive, sexual desire, and sleep disruption symptoms, and urinary incontinence symptoms; identification of naturally occurring clusters of symptoms women experienced during the menopausal transition and early postmenopause; and assessment of gene polymorphisms associated with events such as onset of the early and late menopausal transition stages and symptoms.</p><p><strong>Conclusions: </strong>Over the course of the longitudinal Seattle Midlife Women's Health Study, investigators contributed to understanding of symptoms women experience during the menopausal transition and early postmenopause as well as methods of staging reproductive aging.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"2 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2016-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-016-0019-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cohort profile: Women's Healthy Ageing Project (WHAP) - a longitudinal prospective study of Australian women since 1990.","authors":"Cassandra Szoeke,&nbsp;Melissa Coulson,&nbsp;Stephen Campbell,&nbsp;Lorraine Dennerstein","doi":"10.1186/s40695-016-0018-y","DOIUrl":"https://doi.org/10.1186/s40695-016-0018-y","url":null,"abstract":"<p><strong>Background: </strong>The cohort was commenced to examine women's health from midlife (45-55 years) before the menopausal transition and into ageing.</p><p><strong>Methods: </strong>Randomised selection and assessment of 2,001 women living in the Melbourne metropolitan area was conducted by the Roy Morgan Centre in 1990/91. Of the 779 women who met the entry criteria for the longitudinal follow-up (aged 45-55 years, menstruating, having a uterus and at least one ovary and not taking hormone therapy) 438 agreed to be seen annually across the menopausal transition from 1992 to 1999. Longitudinal prospective follow-up since 2000 has continued intermittently (2002/03, 2004/05, 2012/13, 2014/15). Data collection has included fasting biomarkers in each year since 1992, clinical assessment, lifestyle and quality of life data, physical measures and validated questionnaire data. Participants have consented to data linkage and, to date, mammogram and BioGrid data have been accessed. Biobank storage including serum, deoxyribonucleic acid (DNA) storage and PAXgene tubes are maintained.</p><p><strong>Discussion: </strong>The WHAP has contributed to over 200 published research findings, several books, and book chapters in a variety of areas, including: health and wellbeing; mental and cognitive health; bone health; lifestyle, vascular risk and prevention; women's health and hormonal transition; and cross-cultural research.With all participants now aged over 70 years, the cohort is ideally placed to answer key questions of healthy ageing in women. With more than 25 years of longitudinal prospective follow-up this Australian dataset is unique in its duration, breadth and detail of measures including clinical review and specialized disease-specific testing and biomarkers. Ongoing follow-up into older ages for this long-running cohort will enable the association between mid to late-life factors and healthy ageing to be determined. This is particularly valuable for the examination of chronic diseases which have a 20-30 year prodrome and to provide knowledge on multiple morbidities. The dataset has a unique opportunity to improve our understanding of temporal relationships and the interactions between risk factors and comorbidities.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"2 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2016-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-016-0018-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic vulvar pain in a cohort of post-menopausal women: Atrophy or Vulvodynia?","authors":"S. Mitro, S. Harlow, J. Randolph, B. Reed","doi":"10.1186/s40695-016-0017-z","DOIUrl":"https://doi.org/10.1186/s40695-016-0017-z","url":null,"abstract":"","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-016-0017-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65743721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving toward a prevention strategy for osteoporosis by giving a voice to a silent disease","authors":"K. Jepsen, E. Bigelow, M. Ramcharan, Stephen H. Schlecht, C. Karvonen-Gutierrez","doi":"10.1186/s40695-016-0016-0","DOIUrl":"https://doi.org/10.1186/s40695-016-0016-0","url":null,"abstract":"","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-016-0016-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65743666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s Midlife Health reviewer acknowledgement 2015","authors":"S. Harlow","doi":"10.1186/s40695-016-0015-1","DOIUrl":"https://doi.org/10.1186/s40695-016-0015-1","url":null,"abstract":"","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-016-0015-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"65744105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods in a longitudinal cohort study of late reproductive age women: the Penn Ovarian Aging Study (POAS).","authors":"Ellen W Freeman,&nbsp;Mary D Sammel","doi":"10.1186/s40695-016-0014-2","DOIUrl":"https://doi.org/10.1186/s40695-016-0014-2","url":null,"abstract":"<p><strong>Background: </strong>This report describes the methods utilized in the Penn Ovarian Aging Study (POAS), which is a longitudinal cohort study of hormone dynamics and menopausal symptoms of women in the menopause transition.</p><p><strong>Methods/design: </strong>The cohort is a community-based sample of generally healthy women enrolled in the late reproductive years. The study population is a stratified random sample of African-American and Caucasian women, identified by random digit dialing.Of the 1427 women who were identified as potentially eligible, 578 women were eligible after full screening; 75 % of the eligible women enrolled in the study (436/578). At Period 14 (14 years after study enrollment), 67 % remained active and were fully evaluated (293/436). Attrition was non-differential with respect to the sample characteristics.The aims of the project overall are to 1) identify within-woman trends of reproductive hormones (estradiol, follicle stimulating hormone, hormone, lutinizing hormone, inhibin B, dehydroepiandrosterone, testosterone, and anti-mullerian hormone), cofactors such as race, body mass index (BMI), age, physical and behavioral symptoms, and their predictions of menopausal symptoms, and patterns around the final menstrual period; 2) identify associations of hormone dynamics with physical and behavioral symptoms that occur with ovarian aging and identify racial differences in these factors; 3) identify associations of genetic polymorphisms with levels and longitudinal trends in menopausal symptoms. The cohort consists of 436 late reproductive-age women at enrollment, and now has 18 years of approximately annual follow-up assessments. Menopausal stage based on concurrent menstrual dates is identified at each follow-up period.</p><p><strong>Discussion: </strong>Studies of the cohort have shown that hot flashes can occur well before menopause and extend 10 or more years beyond menopause for sizeable numbers of women; provide evidence for new-onset depressed mood in the menopause transition and show that the final menstrual period is pivotal in the increases in depressive symptoms prior to menopause and decreases postmenopausal; suggest that poor sleep is common in the late reproductive years but increases in relation to the final menstrual period in only a small proportion of women; and show effects of obesity on reproductive hormones in the menopause transition. To date, more than 50 studies of the cohort are published in medical journals, demonstrating the relevance of these data to the clinical care of mid-life women.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"2 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2016-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s40695-016-0014-2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36954695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Passo Fundo Cohort Study: design of a population-based observational study of women in premenopause, menopausal transition, and postmenopause.","authors":"Karen Oppermann, Verônica Colpani, Sandra C Fuchs, Poli Mara Spritzer","doi":"10.1186/s40695-015-0013-8","DOIUrl":"10.1186/s40695-015-0013-8","url":null,"abstract":"<p><strong>Background: </strong>The Passo Fundo Cohort Study (PFS) is a population-based longitudinal observational study of pre-, peri-, and postmenopausal women that has been ongoing since 1995 in Passo Fundo, a city in southern Brazil. This paper describes the rationale and design of the PFS and summarizes objectives and procedures that have been updated during follow-up.</p><p><strong>Methods/design: </strong>Women in the PFS have been followed for a variety of diseases that are frequent in menopause. Sampling was conducted in 154 randomly selected census divisions (geographical subdivisions of the city as defined by the Brazilian Institute of Geography and Statistics). One block in each census division was chosen by lot and two women were randomly selected for interview in each block. The first cycle, conducted between 1995 and 1997, included a representative sample of 298 women aged 35 to 55 years. In the second cycle, conducted between 2001 and 2002, additional participants were enrolled based on the same sampling strategy used in 1995, for a final sample of 358 women. In 2010, a third follow-up was initiated, when all 358 participants or their relatives were located. Participants completed a standardized questionnaire on demographic and socioeconomic characteristics. They also answered questions about lifestyle, medical and reproductive characteristics, sexual life, hormone therapy and mental aspects by using validated instruments. Physical activity was assessed and anthropometric measurements, blood sampling and pelvic ultrasound examination were performed. In the third cycle, bone mineral density by dual-energy X-ray absorptiometry and abdominal fat and coronary artery calcium score by computed tomography were also determined.</p><p><strong>Discussion: </strong>The study findings provide relevant information to evaluate the association between menopausal status, female aging and the risk of cardiovascular diseases, and bone health aspects in a representative sample of women from southern Brazil.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"1 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2015-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6298002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36956102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of sexual dysfunction in breast cancer survivors: a systematic review.","authors":"Susan M Seav, Sally A Dominick, Boris Stepanyuk, Jessica R Gorman, Diana T Chingos, Jennifer L Ehren, Michael L Krychman, H Irene Su","doi":"10.1186/s40695-015-0009-4","DOIUrl":"10.1186/s40695-015-0009-4","url":null,"abstract":"<p><p>Female sexual dysfunction occurs frequently in midlife breast cancer survivors (BCS) and encompasses problems with sexual desire, interest, arousal, orgasm and genitopelvic pain. Although common, sexual problems are under-diagnosed and under-treated in BCS. The objective of this review was to assess primary studies that intervene on sexual dysfunction in BCS. In February 2015, PubMed, SCOPUS, CINAHL, COCHRANE and Web of Science databases were systematically searched for randomized controlled clinical trials (RCTs) of vaginal (lubricants, moisturizers, estrogens, dehydroepiandrosterone [DHEA], testosterone, vibrators, dilators), systemic (androgens, anti-depressants, flibanserin, ospemifene), physical therapy (physical activity, pelvic floor training), counseling and educational interventions on sexual function in BCS. Observational studies of vaginal interventions were also included due to the paucity of RCTs. The search yielded 1414 studies, 34 of which met inclusion criteria. Both interventions and outcomes, measured by 31 different sexual function scales, were heterogeneous, and therefore data were not pooled. The review found that regular and prolonged use of vaginal moisturizers was effective in improving vaginal dryness, dyspareunia, and sexual satisfaction. Educational and counseling interventions targeting sexual dysfunction showed consistent improvement in various aspects of sexual health. No consistent improvements in sexual health were observed with physical activity, transdermal testosterone or hot flash interventions. There was a lack of BCS-specific data on vaginal lubricants, vibrators, dilators, pelvic floor therapy, flibanserin or ospemifene. Overall, the quality of evidence for these studies was moderate to very low. Because each of the interventions with BCS data had limited efficacy, clinical trials to test novel interventions are needed to provide evidence-based clinical recommendations and improve sexual function in BCS.</p>","PeriodicalId":75330,"journal":{"name":"Women's midlife health","volume":"1 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2015-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36956100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}