Dysfunction In Postmenopausal Women Research Articles

The impact of uninterrupted sitting on central and peripheral cardiovascular function in pre-menopausal and post-menopausal women.

Independently, both prolonged uninterrupted sitting and the onset of menopause negatively impact markers of cardiovascular risk. Whether their combination augment these responses additively remains unknown. This study assessed whether prolonged uninterrupted sitting causes greater central and peripheral cardiovascular dysfunction in post-menopausal women compared to pre-menopausal women. To address this, 23 healthy women (13 pre-menopausal [43.77 ± 4.30years] and 10 post-menopausal [57.20 ± 8.55years]) sat uninterrupted for 2-h. Carotid-femoral pulse wave velocity (cf-PWV), pulse wave analysis (PWA), lower limb venous pooling (HHb), and calf circumference were assessed pre-and post-sitting using general linear mixed models, with age as a covariate. Changes in MAP over time (both between and within groups) was assessed using a two-way repeated-measures-ANOVA. There were no significant interactions for any outcome measures. However, for cf-PWV, there was a significant main effect of group (Δ = 0.854 ± 0.354m s-1; p = 0.026, ηp2 = 0.707). For PWA, only heart rate (HR) and pressure forwards (Pf) showed significant main effects 13 of time [Δ = 6 ± 1 bts-min-1, p < 0.001, ηp2 = 0.861] and group [Δ = 3.893 ± 1.450mmHg, p = 0.016, ηp2 = 0.271], respectively. Both HHb (Δ = 2.737 ± 0.952, p = 0.009, ηp2 = 0.742) and calf circumference (Δ = 0.812 ± 0.128cm, p < 0.001, ηp2 = 0.863) significantly increased over time. Whilst post-menopausal women demonstrated greater overall arterial stiffness (increased cf-PWV at baseline), there was no difference in cardiovascular response (central or peripheral) to 2-h of prolonged sitting between the pre- and post-menopausal women.

Effect of ferric citrate on hippocampal iron accumulation and widespread molecular alterations associated with cognitive disorder in an ovariectomized mice model.

Nowadays, the prevalence of cognitive impairment in women has gradually increased, especially in postmenopausal women. There were few studies on the mechanistic effects of iron exposure on neurotoxicity in postmenopausal women. The aim of this study is to investigate the effect of iron accumulation on cognitive ability in ovariectomized mice and its possible mechanism and to provide a scientific basis for the prevention of cognitive dysfunction in postmenopausal women. Female C57BL/6N ovariectomized model mice were induced with ferric citrate (FAC). The mice were randomly divided into 5 groups: control, sham, ovariectomized (Ovx), Ovx + 50 mg/kg FAC (Ovx + l), and Ovx + 100 mg/kg FAC (Ovx + h). The impact of motor and cognitive function was verified by a series of behavioral tests. The levels of serum iron parameters, malondialdehyde, and superoxide dismutase were measured. The ultrastructure of mice hippocampal microglia was imaged by transmission electron microscopy. The differential expression of hippocampal proteins was analyzed by Tandem Mass Tag labeling. Movement and cognitive function in Ovx + l/Ovx + h mice were significantly decreased compared to control and Sham mice. Then, iron exposure caused histopathological changes in the hippocampus of mice. In addition, proteomic analysis revealed that 29/27/41 proteins were differentially expressed in the hippocampus when compared by Ovx vs. Sham, Ovx + l vs. Ovx, as well as Ovx + h vs. Ovx + l groups, respectively. Moreover, transferrin receptor protein (TFR1) and divalent metal transporter 1 (DMT1) protein expression were significantly increased in the iron accumulation mice model with ovariectomy. Iron exposure could cause histopathological damage in the hippocampus of ovariectomised mice and, by altering hippocampal proteomics, particularly the expression of hippocampal iron metabolism-related proteins, could further influence cognitive impairment in ovariectomized mice.

(066) EXPLORING THE IMPACT OF ALCOHOL ON SEXUAL FUNCTION IN PERIMENOPAUSAL WOMEN

Abstract Introduction Sexual well-being is an important quality of life component to women throughout life, and during menopausal transition and beyond. Female sexual response cycle includes desire, arousal, orgasm, and resolution phases. Female sexual dysfunction (FSD) encompasses all phases of sexual response cycle and can lead to distress for both the woman and her partner and warrant further investigation. Research has indicated both positive and negative associations between alcohol consumption and sexual health, our review goal is to further explore the relationship between alcohol consumption and sexual function in perimenopausal women. Objective We aim to review the current literature regarding the influence of alcohol use on sexual health during the menopausal transition and beyond. Methods The examination of alcohol consumption and its effects on sexual health in menopausal women was performed through reviewing existing literature. The literature search was completed in the Ovid MEDLINE database (1946- Present) in August 2023. 16 articles were identified in the initial search. 12 articles met our inclusion criteria and were independently reviewed by the authors. Results from these articles were summarized. The search was limited to the English language and the last 20 years (2003-current). Keywords included: menopause, pre-menopause, post menopause, perimenopause, alcohol use, alcohol related disorder, and sexual function. Results Seven out of 16 articles reviewed linked a negative association between alcohol consumption and female sexual function. Seven indicated a positive association between alcohol use and sexual function and 2 articles did not reveal an association. The findings of our review indicate a complex relationship of alcohol on women's sexual function. Studies indicating a positive association between mild alcohol consumption (equal or less than 0.21 FL oz. alcohol/day) and improved sexual function. This effect was theorized due to alcohol increasing endogenous estrogen or due to behavioral changes such as disinhibition, influencing sexual activities influenced by alcohol or subjective arousal due to drinking. Additionally, a positive association was seen between increased alcohol consumption and Female Sexual Function Index (FSFI) scores. However no significant influence on Female Sexual Distress Scale scoring was identified which is a key component to FSD. Other studies showed that excessive or prolonged alcohol consumption (more than 1.00 FL oz. alcohol per day) found to be associated with worsening sexual function and can impact all 6 domains on the FSFI (which include: desire, arousal, lubrication, orgasm, satisfaction, and pain) even after abstinence. These findings were reflected in another study that showed women (however not exclusively menopausal) who were seeking treatment for alcohol dependency diagnosis experienced low sexual desire, inability to achieve orgasm and less satisfaction. Initiating alcohol consumption at a younger age, along with an extended and more intense period of dependency, was correlated with a higher likelihood of experiencing increased sexual dysfunction. A meta-Analysis of 7 studies showed increased odds of sexual dysfunction with alcohol consumption. Another study showed that moderate alcohol consumption was found to be an independent risk factor for FSD and Genitourinary syndrome of menopause (GSM) which can lead to FSD. Conclusions The impact of alcohol on sexual health in postmenopausal women is multifaceted, based on varying levels of consumption influencing various aspects of sexual function. This relationship can also be influenced by other factors such as pre-existing sexual problems and the utilization of alcohol as a coping mechanism to reduce anxiety, release stress or to increase sexual behavior through enhancing arousal. A study indicated that menopausal symptoms may trigger a craving for alcohol, leading to increased alcohol consumption. Further research is essential to elucidate the direct and indirect effects of alcohol consumption on sexual dysfunction. In addition, the impact of abstinence from alcohol on sexual dysfunction in postmenopausal women needs to be further explored. Understanding the impact of alcohol consumption on sexual function of postmenopausal women is critical for healthcare professionals, to provide appropriate guidance and interventions. These findings highlight the need for further research and increased awareness regarding the impact of alcohol use on sexual health during in pre-menopausal, peri and postmenopausal women. Disclosure No.

Higher incidence of meibomian gland dysfunction in postmenopausal women with primary acquired nasolacrimal duct obstruction

PurposeThis study aimed to investigate the incidence of meibomian gland dysfunction (MGD) in postmenopausal women with primary acquired nasolacrimal duct obstruction (PANDO) and enables ophthalmologists to pay attention to ocular surface damage before surgery.Methods165 postmenopausal women with PANDO and 115 postmenopausal women with a normal lacrimal drainage system were enrolled in this prospective study. Based on the results of lacrimal duct irrigation and age, the participants were further subdivided. The incidence of different severities of MGD in different groups was calculated and analyzed by the chi-squared test.ResultsThe incidence of MGD in the PANDO group was 81.21%, and in the control group, it was 46.96%, which was significantly higher in the presence of PANDO (p < 0.001). The incidence of severe MGD in the complete and incomplete PANDO groups was higher than that in the control group (all p < 0.05), and no significant differences were observed between the complete and incomplete PANDO groups. The incidence of moderate MGD was significantly higher in the complete PANDO group than in the control group (p < 0.001). When age was considered an independent variable, the results revealed a significant value for patients aged < 70 years (p < 0.001).ConclusionsOur study revealed a prodominantly high incidence of MGD in postmenopausal women with PANDO, especially in a complete PANDO or aged < 70 years. Ophthalmologists need to pay close attention to MGD in postmenopausal women with PANDO.

Global prevalence of sexual dysfunction among women with metabolic syndrome: a systematic review and meta-analysis.

Sexual dysfunction is a common disorder among women, especially during menopause. Metabolic syndrome is a multifactorial disease that, according to previous studies, there is a relationship between the metabolic syndrome and sexual dysfunction among women. The aim of this systematic review and meta-analysis is to obtain the prevalence of Female Sexual Dysfunction (FSD) among women with metabolic syndrome, and to analyze available related evidence. In this systematic review and meta-analysis, the keywords of MeSH, female sexual dysfunction, FSD, metabolic syndrome were searched in PubMed, Web of Science, Scopus, Science Direct and Google Scholar. The searches were conducted without a lower time limit and until May 2022. The prevalence of FSD among women with metabolic syndrome was found to be 39.3% (95% CI: 28.3-51.5). In the subgroup analysis and in the review of 4 studies, the prevalence of sexual dysfunction in postmenopausal women with metabolic syndrome was 49.8% (95% CI: 26.1-73.6). Analyzing the results of the meta-regression test in examining the effect of the three factors of sample size, year of the study, age, and BMI of the patients on the heterogeneity of the meta-analysis, showed that with the increase of the sample size, the prevalence of sexual dysfunction among women with metabolic syndrome decreases (p < 0.05). Moreover, the prevalence of sexual dysfunction among women with metabolic syndrome increases (p < 0.05) with the increase in the years of conducting studies and the mean of age of women with metabolic syndrome. Also, with increasing mean of BMI of female patients with metabolic syndrome, the prevalence of sexual dysfunction in these women also increases (p < 0.05). Female sexual dysfunction is a global health problem that can affect women's life to a great extent. Metabolic syndrome, which is a set of factors such as obesity, high blood pressure, and diabetes, affects sexual dysfunction in women. From this study, it can be concluded that there is a close relationship between metabolic syndrome and female sexual dysfunction.

#2647 MENOPAUSAL HORMONE THERAPY AND RISK OF DEMENTIA IN WOMEN WITH PRE-DIALYSIS CKD: A NATIONWIDE OBSERVATIONAL COHORT STUDY

Abstract Background and Aims The risk of dementia is increased in postmenopausal women. The incidences of premature menopause and dementia are increased in patients with chronic kidney disease (CKD). Therefore, the potential benefit of hormone replacement therapy (HRT) for cognitive function may be a more critical issue in CKD patients. Method Menopausal women over 40 years with or without HRT were identified through the National Health Screening questionnaire in 2009. Among the subjects, those newly diagnosed with CKD between 2009 and 2013 were enrolled. HRT was used as an exposure variable and was followed from the day when CKD was diagnosed to December 2019. The hazard ratio (HR) of dementia was evaluated using a Cox proportional hazards regression analysis. Results We included 755,426 postmenopausal women with CKD. The median follow-up period was 7.3 (IQR, 5.8-8.7) years. All-cause dementia occurred in 107,848 (14.3%), Alzheimer's disease in 87,833 (11.6%), and vascular dementia in 10,245 (1.4%). HRT was significantly associated with a lower risk of dementia in the adjusted Cox regression model (all-cause dementia: hazard ratio [HR] 0.796, 95% confidence interval [95% CI] 0.776-0.816, P &amp;lt; 0.001; Alzheimer's disease: HR 0.795, 95% CI 0.773-0.818, P &amp;lt; 0.001; vascular dementia: HR 0.803, 95% CI 0.743-0.868, P &amp;lt; 0.001). Conclusion HRT was significantly associated with a lower risk of CKD-related cognitive dysfunction in postmenopausal women. Prospective studies on whether HRT lowers the risk of dementia in menopausal women with CKD are needed.

Aromatherapy Improves Olfactory Acuity and Sexual Dysfunction In Postmenopausal Women.

The Article Abstract is not available.

A case report - Multidisciplinary approach to sexual dysfunction in post-menopausal women in Singapore

A case report - Multidisciplinary approach to sexual dysfunction in post-menopausal women in Singapore

Early diagnosis of subclinical left ventricular dysfunction in postmenopausal women with rheumatoid arthritis.

Heart failure is the most frequent cause of death among patients affected by rheumatoid arthritis(RA), in which high prevalence is independent of traditional risk factors. An early diagnosis of subclinical heart failure may be made by assessing left ventricular diastolic dysfunction (LVDD) by Doppler Echocardiography. Our study aims to early identify LVDD in RA patients. We enrolled 207 consecutive postmenopausal women (PMW) with normal electrocardiography and physical examination with a confirmed diagnosis of RA, for over one year, 200 PMW free from RA served as the control group (CG). All women underwent M-mode and two-dimensional Doppler echocardiography. A total of 72 women were affected by LVDD among 207 women with RA (34.8%), 46 among 200 women in the CG (23%), chi-squared 6.8, OR 1.8, confidence interval (CI) 95%, p < 0.009. For our RA women, the chance of being affected by LVDD has almost doubled. There were 70 women affected by LVDD among 72 hypertensive women with RA (97.2%). A total of 32 women were affected by LVDD among 98 hypertensive women in the CG (32.7%), chi-squared 72.1, OR 7.2, CI 95%, p < 0.009. Among hypertensive PMW in our population, the chance of being affected by LVDD has more than tripled. All LVDD subjects had abnormal diastolic function for all different degrees. We propose that PMW, affected by RA, have a significantly higher prevalence than CG of LVDD without clinical evidence of heart disease. Since the prevalence is even higher if they are hypertensive, we suggest a Doppler echocardiography examination for all women with a diagnosis of RA.

THYROID FUNCTION IN POSTMENOPAUSAL WOMEN IN WESTERN INDIA AND ITS IMPACT ON MENOPAUSAL SYMPTOMS, BMI, GLYCEMIC, LIPID AND CARDIAC PROFILE

Background Menopause is characterized by estrogen deciency and appearance of variety of menopausal symptoms like lethargy, hotushes, anxiety, sexual problems, tiredness, insomnia, weight gain and mood swings. Many of these symptoms are similar to symptoms of thyroid dysfunction and hence there is likelihood of symptoms of thyroid dysfunction in this age group being misinterpreted as menopausal symptoms and thyroid dysfunction remaining undetected. If thyroid dysfunction remains undetected and untreated, it can lead to health hazards like hyperlipidemia, atherosclerosis and heart disease.2Presently there are no clear cut guidelines about screening menopausal patients for thyroid function and existing studies on screening of menopausal women for thyroid disorders are not conclusive. Therefore this study was undertaken to look at thyroid functions in postmenopausal women and impact of thyroid dysfunction on their cardiovacular health through its action on their glycemic status, BMI and lipid prole. Aims And Objectives 1. To assess the basic thyroid functions in postmenopausal women. 2. To evaluate the effect of abnormal thyroid function on glycemic status, lipid prole, body weight and BMI in postmenopausal women. 3. To look for association of severity of menopause symptoms with the degree of thyroid dysfunction in postmenopausal women. Materials And Methods A cross-sectional observational study was carried out in the indoor and outdoor sections of Department of Medicine at SSG Hospital Vadodara for a period of one year from March 2015 to Feb 2016 in which 130 patients were enrolled. All patients were subjected to a standardized interview in which their symptoms were graded on the basis of the Simplied Menopausal Index , their BMI was calculated from their height and weight and investigations (Fasting thyroid prole, fasting blood sugar, fasting lipid prole, ECG) were carried out. Association between abnormalities in thyroid prole and severity of menopausal symptoms as well as abnormalities in BMI , fasting blood sugar, lipid prole and ECG were analyzed using appropriate statistical tests (Odd's ratio). A P value&lt;0.05 was considered statistically signicant. Thyroid dysfunction is Conclusion common in postmenopausal females and the symptoms of the two entities overlap but with a higher intensity in the former and the simplied menopausal index score can be used as an efcient tool to further increase the index of suspicion for thyroid dysfunction in postmenopausal women. Abnormal thyroid function is statistically associated with BMI with higher prevalence of hypothyroidism in overweight, preobese and obese postmenopausal subjects and hyperthyroidism in underweight postmenopausal subjects. Abnormal thyroid function is statistically associated with abnormal glucose metabolism with higher prevalence of fasting hyperglycemia at either end of the spectrum of thyroid disorders. Abnormal thyroid function is statistically associated with Dyslipidemia in the form of raised total cholesterol, LDL cholesterol and serum triglycerides with no signicant association with HDL cholesterol in postmenopausal women. There is no statistically signicant association between thyroid dysfunction and ischemic heart disease

Гинекологические аспекты сексуальной дисфункции в постменопаузальном периоде

Sexuality is defined as a physical, emotional, psychological, and social welfare state associated with sexual desires. The prevalence of sexual dysfunction among postmenopausal women is estimated to be 68% to 87%. The most significant causes of sexual disorders in this period are physiological changes of female body, psychological problems, lack of special knowledge, and male health status. Sexual function is linked to the complex neurotransmitter-hormone interaction both at the central and peripheral levels. The major cause of sexual dysfunction in postmenopausal women is genitourinary menopausal syndrome. Most commonly, gynecologist becomes a first contact physician dealing with female sexual disorders. Sexual dysfunction diagnosis in postmenopause includes the use of validated questionnaires, the assessment of the type and severity of menopausal disorders, the impact of somatic diseases and psychological issues, as well as a thorough physical examination. As sexual dysfunction in postmenopausal women is caused by multiple factors and has a complex pathogenesis, it is necessary to set up a multidisciplinary approach to problem solving. According to the biopsychosocial model, gynecologist has a wide range of therapeutic options for dealing with sexual disorders — pharmacotherapy (hormonal and non-hormonal agents), rational psychotherapy, and multimodal treatment methods. KEYWORDS: sexual dysfunction, postmenopause, sexual hormones, estrogens, androgens, genitourinary menopausal syndrome, biopsychosocial model of healthcare. FOR CITATION: Sandakova E.A., Zhukovskaya I.G. Gynecological aspects of sexual dysfunction in the postmenopausal women. Russian Journal of Woman and Child Health. 2023;6(1):26–30 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-26-30.

Objective evaluation of thyroid function in postmenopausal women

Background: Thyroid dysfunction is more prevalent among elderly female. Assessment of thyroid dysfunction in the postmenopausal women is difficult due to their age, associated comorbidities, and ongoing treatment. Aims and Objectives: The aim of the study was to evaluate the thyroid status, presence of relative estrogen dominance and correlation of thyroid status with reproductive hormones in postmenopausal women. Materials and Methods: This cross-section study consists 40 postmenopausal women between age group 45 and 55 years. All participants were subjected to measure serum thyroid stimulating hormone (TSH) levels. Based on TSH levels, subjects were divided into normal thyroid function group (n = 12) and abnormal thyroid function group (n = 12). Serum was assayed for thyroxin binding globin (TBG), thyroid peroxidase antibody (TPO), estrogen, progesterone, and progesterone to estrogen ratio (P: E) in subjects of both the groups. Results: Around, 12 (30%) postmenopausal women had TSH values outside the range of 0.3–6.5 μIU/mL. TPO was positive only in one subject and 12.5% showed elevated TBG levels in abnormal thyroid group. Mean estrogen levels were significantly high, mean progesterone levels were significantly low and P: E was low in abnormal thyroid level group. A significant difference (P &lt; 0.05) was observed on comparing the mean values of serum estrogen, progesterone, and P: E ratio among the groups. A significant positive correlation between TSH and serum estrogen, progesterone, and P: E and inverse correlation between estrogen and P: E was observed in abnormal thyroid level group. Conclusion: The thyroid dysfunction in postmenopausal women is associated with estrogen dominance. Therefore, menopausal women should be routinely screened for thyroid dysfunction, as part of their annual examination.

Thyroid Dysfunction in Postmenopausal Women: Across Section Study

This study was conducted on postmenopausal women who went to internal medicine and gynaecological outpatient clinics for various purposes during the period from 1/3/2021 to 1/2/2022. The aim of this work was to study possible relationship between thyroid disorders and menopause. Our study included 80 women who were postmenopausal. Patient with history of thyroid disorders, autoimmune diseases, liver disease, renal disease and patient on amiodarone or other drugs that affect thyroid function were excluded from the study.All cases were subjected to the following: History , examination , Routine investigations and Thyroid gland hormones (TSH, free T3 and free T4) and thyroid autoantibodies (TPO and TG).The result of this study showed that: Among our post-menopausal women there was 17.5% of them had thyroid disorders. The frequency of different thyroid disorders in our post-menopausal women was as follow: 10 women out of 80 (representing 12.5%) were overt hypothyroid, 4 women (5%) had subclinical hypothyroidism and 22 women (27.5%) classified as non-thyroidal illness syndrome. While 44 women (55%) were euthyroid. Thyroid auto antibodies were detected in 15% in cases of the study distributed as follow: 5% were overt hypothyroid, 2.5% had subclinical hypothyroidism and 7.5% were euthyroid women. Conclusion: Thyroid disorders are common in women in postmenopausal age. Overt hypothyroidism is the most common thyroid disorder in them, followed by subclinical hypothyroidism and thyroid autoantibodies are present in high percentage of women whether they have thyroid disorders or are euthyroid.

High-normal diastolic blood pressure as a risk factor for left ventricular diastolic dysfunction in healthy postmenopausal women.

Left ventricular (LV) diastolic dysfunction is associated with heart failure with preserved ejection fraction, and metabolic syndrome (MetS) is a risk factor. However, there is limited knowledge regarding the metabolic factors that contribute to LV dysfunction in postmenopausal women without comorbidities. This study aimed to analyze the relationship between LV diastolic dysfunction and MetS, as well as other cardiovascular risk factors, and to determine risks for LV diastolic dysfunction. Postmenopausal women without hypertension, diabetes mellitus, LV systolic dysfunction, or other heart diseases underwent physical examinations, including echocardiography. The study participants were diagnosed with LV diastolic dysfunction based on several echocardiographic parameters. Logistic regression analyses of LV diastolic dysfunction and cardiovascular risk factors were performed. Of the 269 postmenopausal women examined, 29 (10.7%) and 40 (14.9%) had MetS and LV diastolic dysfunction, respectively. Abnormal diastolic blood pressure (odds ratio, 3.6; 95% confidence interval, 1.16-10.9; P < 0.05) and age (odds ratio, 1.1; 95% confidence interval, 1.07-1.19; P < 0.01) were predictors of LV diastolic dysfunction. In healthy postmenopausal women, high-normal diastolic blood pressure was the only independent risk factor for LV diastolic dysfunction, and it thus may be a useful predictor of diastolic heart failure during routine physical examinations.

Effect of Short‐Term Estradiol Exposure on Endothelin‐B Receptor‐Mediated Vasodilation in Postmenopausal Women

Endothelin (ET)‐1 contributes to endothelial dysfunction in postmenopausal women (PMW) via the ETB receptor. We have previously shown that the ETB receptor mediates vasodilation in young women, an effect that is lost in PMW. However, it is unclear if ETB receptor‐mediated dilation can be restored in PMW exposed to E2.PURPOSETo test the hypothesis that E2 exposure restores ETB receptor‐mediated vasodilation in PMW.METHODSWe tested 9 PMW (55±2 yrs, 24±3 kg/m2, 91±5 mmHg) who self‐reported natural menopause and were at least 1 year without menses. We measured vasodilation in the cutaneous microcirculation via local heating using laser Doppler flowmetry coupled with intradermal microdialysis during perfusions of lactated Ringer’s (control), ETB receptor antagonist (BQ‐788, 300nM) and ETA receptor antagonist (BQ‐123, 500nM). Cutaneous vascular conductance (CVC) was calculated during the plateau phase of local heating (42°C), and normalized to maximal vasodilation achieved by perfusion of sodium nitroprusside (28mM) and heating to 43°C. All women were tested at baseline (BL) and after 7 days of E2 (Vivelle‐Dot, 0.1mg/day, transdermal patch) administration (+E2). A two‐way repeated measures ANOVA was performed to compare %CVCmax in PMW before and after E2 exposure. Data presented are mean ± standard deviation.RESULTSE2 administration increased serum estradiol (BL: 45±29 vs +E2: 71±42 pg/mL, P&lt;0.01) and reduced follicle stimulating hormone (BL: 71±13 vs +E2: 57±17 pg/mL, P&lt;0.01), but there were no changes in serum progesterone (BL: 0.57±0.93 vs +E2: 0.53±0.88 pg/mL, P=0.14) nor plasma ET‐1 (BL: 1.62±0.66 vs +E2: 1.54±0.54 pg/mL, P=0.42). E2 administration had no effect on cutaneous microvascular responses (Time P=0.41, Drug P=0.17, Interaction P=0.71). At BL, vasodilatory responses to local heating were not different during control and ETB receptor antagonism (control: 83±8 vs. BQ‐788: 88±6 %CVCmax). Similarly, vasodilation was not altered at BL during ETA receptor antagonism in a subset of women (n=6, control: 83±8 vs. BQ‐123: 87±8 %CVCmax). E2 administration did not improve vasodilation in the control site (BL: 83±8 vs. +E2 85±13 %CVCmax). Furthermore, there was no effect of E2 exposure on cutaneous vasodilatory responses during perfusion of ETB (BL: 88±6 vs. +E2: 89±6 %CVCmax) nor ETA (n=6, BL: 87±8 vs +E2: 92±7 %CVCmax) receptor antagonists.CONCLUSIONThese preliminary data suggest that short‐term E2 exposure does not modulate ETB receptor function in PMW. These findings are in contrast to our observations in young women demonstrating that ETB receptors mediate vasodilation in the presence of E2. The role of alternative therapies to modulate ETB receptor function should be considered in future studies.

Correction of sexual dysfunction in postmenopausal women

Annotation. In the postmenopausal age, the quality of sexual life deteriorates significantly. To date, there are no effective methods for correcting sexual dysfunction (SD) in women of this age. The aim of the study was to compare the clinical efficacy of traditional drugs for menopausal hormone therapy (MHT) – tibolone and a complex drug containing 1 mg of estradiol and 5 mg of dydrogesterone for SD in postmenopausal women. 69 postmenopausal women with SD were monitored: 37 – the main group (MG), 32 – the comparison group (CG). MG women were treated a drug’s containing tibolone, 1 pill once a day. Women with CG were prescribed traditional menopausal hormone therapy (MHT) with a drug containing 1 mg of estradiol and 5 mg of dydrogesterone. The quality of sexual life was determined before treatment and 1 month after treatment using a specially designed questionnaire and menopause rating scale (MRS). Statistics were processed using LibreOffice Calc (Mozilla Public License v 2.0). Quantitative data from the two related groups (before and after treatment) were compared using the Wilcoxon signed rank test. When considering the results in an alternative form (the presence or absence of a certain feature used Fisher's angular transformation. Pairwise comparisons of groups were performed using the Mann-Whitney test at p &lt;0,05. In the treatment of SD in women with MG there was a reduction of all symptoms; in patients with CG - improvement of only one indicator was observed. In MG, after 1month treatment of SD, the number of women satisfied with their sexual life increased 2.4 times (p&lt;0.05), and in CG – 1.4 times (p&gt;0.05). Significant reduction in most menopausal symptoms was observed in both groups of women after treatment. According to psychoneurological indicators and atrophic changes of the vagina, the difference between MG and CG after treatment was not detected (p&gt;0.05). Besides, the best correction of climacteric vegetative disorders in CG was found in comparison with MG (p&lt;0.05). In MG has been noted significant improvement in physical and mental health disorders and joint and muscle discomfort compared with СG (p &lt;0.05). Recovery of urinary disorders during a month of therapy with MHT drugs was not observed in any group of studied women. Thus, the drug based on tibolone can be recommended for the correction of sexual dysfunction in postmenopausal women.

Cognitive disorders and dementia in postmenopausal women

Cognitive dysfunction in postmenopausal women reduces their quality of life, social and family adaptation and can lead to complications such as dementia including Alzheimer's disease. Results of the studies on the potential of hormone replacement therapy in prevention of this group of disorders are controversial and require further investigation. However, following healthy lifestyle, certain diets as well as regular physical and mental activity can minimize the risks of dementia and ensure normal mental performance in old age.

Impact of metabolic syndrome and systemic inflammation on endothelial function in postmenopausal women.

Data on the impact of metabolic syndrome (MetS) and systemic inflammation on endothelial function remains scarce. In this study, we aimed to investigate the combined effects of MetS and systemic inflammation on endothelial function in postmenopausal women. We identified 423 postmenopausal women from February 2019 through July 2020. MetS was diagnosed according to the International Diabetes Federation (IDF) criteria, and high sensitivity C-reaction protein (hs-CRP) was measured to assess the degree of underlying inflammation. The measurement of endothelial function was using digital arterial tonometry by assessing reactive hyperemia-induced vasodilation in one arm and adjusting for changes in the contralateral arm (reactive hyperemia index, RHI). There were 156 patients with MetS and 267 without MetS. Compared to the group without MetS, patients with MetS had significantly lower natural logarithmic RHI (0.66±0.29 versus 0.91±0.31; p<0.001), but higher levels of hs-CRP (0.98 [0.31, 3.54] versus 0.53 [0.20, 2.14]; p<0.001). In sequential multivariable analysis, the presence of hs-CRP (ΔR2=0.047, p=0.004) had a significant and independent influence on natural logarithmic RHI. Furthermore, the interaction of hs-CRP*MetS was synergistically associated with endothelial dysfunction even in the fully adjusted model (β=-0.107, 95% CI [-0.161~-0.053], p=0.009). MetS and systemic inflammation are synergistically associated with endothelial dysfunction in postmenopausal women. Postmenopausal women with both these conditions appear to be at a significantly higher risk for adverse cardiovascular events.

Alterations in pro- and anti-inflammatory mediators are involved in microvascular dysfunction in postmenopausal women with type 2 diabetes mellitus.

Evidence has shown that women with type 2 diabetes mellitus (T2DM) have a greater risk of cardiovascular complications compared with men, but this sex difference is not clearly understood. This study assessed the microvascular function and circulatory biomarkers in postmenopausal women (PMW) with T2DM compared with diabetic men and their non-diabetic counterparts. Sixty participants were divided into nondiabetic PMW, PMW with T2DM, non-diabetic men, and diabetic men. Microvascular function was assessed using non-invasive equipment (EndoPAT®) and reported as reactive hyperemia index (RHI). Anthropometric and cardiovascular parameters were also measured. Two-way ANOVA was performed using sex (women or men) and T2DM (non-diabetic and diabetic) as the two factors. RHI impairment (1.97±0.14) was detected in diabetic PMW compared with women without T2DM (2.5±0.13) accompanied by lower adiponectin levels (T2DM: 9.3±1.2 and CTL: 13.8±1.8 ug/mL, P<0.05). An increase in the Nε-carboxymethyllysine (CML), nitrate/nitrite, and C-reactive protein (CRP) levels were observed in diabetic PMW compared to the other groups. Although a poor glycemia control was seen in diabetic men, neither RHI nor circulatory biomarkers were affected by T2DM. Multiple linear regression stratified by sex and T2DM identified some variables with RHI only in PMW with T2DM: HbA1c (P=0.003), body mass index (P=0.029), CML (P=0.032), and CRP (P=0.006). Diabetic PMW were more susceptible to the deleterious effects of hyperglycemia than men, showing microvascular dysfunction with high levels of pro-inflammatory mediators (CML and CRP) and a lower adiponectin concentration.

Sexual Dysfunction in Postmenopausal Women

Nowadays, women have a longer menopausal duration due to the worldwide dramatic life expectancy increase. Sexual dysfunction is one of the most prevalent problems during menopause that affect women`s quality of life, mental health, and interpersonal relationship. This study aimed to investigate sexual dysfunction and its contributing factors amongst married postmenopausal women. This cross-sectional study was conducted among 164 postmenopausal women who attended the menopause clinic of the academic hospitals in Mashhad during 2017-2018. Data were collected using a checklist that included demographic and reproductive information and the validated Persian version of the Female Sexual Function Index questionnaire (FSFI). The mean age of participants was 53.55±6.25 years. The mean FSFI score was 20.06±6.66, and 65.2% of women had sexual dysfunction. The most disturbed sexual domains were; desire (86%, n: 141), arousal (82.3%, n: 135), lubrication (71.3%, n: 117) and sexual satisfaction (70.1%, n: 115), respectively. The partner`s age (P=0.01), time since menopause onset (P=0.01), age at marriage (P=0.02), and frequency of sexual intercourse (P˂0.0001) had a significant relationship with sexual function. The sexual function of postmenopausal women in this study was highly deteriorated. The associated factors were; older age of the spouse, younger age at marriage, longer time since menopause onset, and lower frequency of sexual intercourse. It is important to determine perimenopausal women who are at potential risk of sexual dysfunction and consult them for preventive programs and strategies.