Health Of Perimenopausal Women Research Articles

The effects of Tai Chi Rouli ball exercise on bone mineral content and bone metabolism indicators in perimenopausal women

Background Perimenopause is associated with a decline in estrogen levels, leading to decreased bone mineral density (BMD) and altered bone metabolism, increasing the risk of osteoporosis. Tai Chi Rouli Ball, a traditional Chinese sport, is thought to have beneficial effects on physical health, but its impact on bone health in perimenopausal women is not well understood.Methods This study involved a randomized controlled trial with 52 perimenopausal women aged 45–55 years from community senior centers. Participants were divided into two groups: the Tai Chi Rouli Ball group and the control group. Baseline assessments of bone density, bone mineral content (BMC), and bone metabolism markers, including estrogen levels, were conducted. The Tai Chi Rouli Ball group underwent regular training for a specific period, while the control group did not receive any intervention. Post-experiment assessments were then compared to the baseline.Results Post-intervention, the Tai Chi Rouli Ball group showed a significant increase in spine bone density and BMC in various body parts, including the whole body, trunk/torso, and spine, compared to the control group. Bone metabolism indicators also improved, with increased levels of estrogen and a decrease in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Calcium levels showed a significant increase, while other markers like alkaline phosphatase (ALP), phosphorus (P), and magnesium (Mg) had non-significant changes.Conclusions Tai Chi Rouli Ball exercise may positively influence bone health by improving bone density, BMC, and altering bone metabolism markers in perimenopausal women. These findings suggest that Tai Chi Rouli Ball could be a viable non-pharmacological approach to prevent osteoporosis in this demographic.

The pathogenic pathways of cardiovascular disease in perimenopausal women.

Menopause is associated with disturbed cardiovascular health. The objective of the study was to compare the effect of hormonal replacement therapy (HRT) and its combination with diet, L-arginine, and xylitol solutions on metabolic processes and cardiovascular health in perimenopausal women. In total 106 women were enrolled in the cross-sectional study. The 36 patients of Group II received HRT. 35 women who had been prescribed additionally to HRT a diet, L-arginine, and also xylitol were included in Group III. 35 healthy reproductive-aged women were included in Group I (control). The variables body mass index (BMI), heart rate (HR), blood pressure (BP), lipid and carbohydrate metabolism and C-reactive protein, and menopausal Cooperman's score were determined before and after the 3-month program. The obtained results showed the homogeneity of average age, BMI, HR, BP, and Cooperman's score in Group II and Group III before inclusion in the study. But several variables changed significantly after a 3-month period. The study showed the effect of the 3-month program on BMI and Cooperman's score. We also found the restoration of the lipid profiles in Group III. The patients of perimenopausal age featured elevated levels of insulin and C-RP (C-reactive protein). The restoration of levels of insulin and CRP occurred in the process of the 3-month program. The use of a 3-month program including diet, xylitol, and L-arginine solutions contributed to the reduction of Cooperman's score, chronic inflammation, and restoration of lipid and carbohydrate metabolism.

Iron deficiency in peri-menopausal women: Clinical considerations from an expert consensus

Iron deficiency (ID) and iron deficiency anaemia (IDA) are usually anticipated to occur during and after pregnancy. Peri-menopausal women are at risk of ID/IDA & warrant attention as the symptoms of ID can be misinterpreted or overlooked. Scientific literatures convey iron deficiency to be considered as a major health problem for perimenopausal women. However, Indian evidence on ‘Iron deficiency in peri-menopausal women’ is scarce.The aim of this article is to understand the impact of iron deficiency on health of peri-menopausal women in India and to understand its important clinical considerations. Developing an expert consensus towards diagnosis & management of iron deficiency and iron deficiency anaemia in this population is the need of the hour.A 3-step modified Delphi method was used to build up the consensus. Nine experts representing gynaecology and endocrinology were invited to participate in the panel discussion. Session was being moderated by a senior gynaecologist. In round 1 – the prevalence of iron deficiency anemia in perimenopausal women and risk factors of iron deficiency anemia were discussed. The panel members asked polling questions and each member’s response to the poll question was recorded. The same voting method was used in round 2 and 3, which discussed the diagnosis and management, respectively. In round 1, round 2 and round 3 statements reached consensus. Consensus was attained for eleven statements representing four different domains: prevalence, risk factors, diagnosis, and treatment. This consensus guideline will help to standardize care, provide guidance on screening and treatment of iron deficiency anemia in perimenopausal women. This will also assist in clinical decision-making for all healthcare professionals.

Dietary and exercise interventions for metabolic health in perimenopausal women in Beijing.

This study aims to investigate the effects of individualised dietary guidance and anti-resistance exercise intervention on blood pressure and metabolic indexes of perimenopausal women. Between June 2018 to August 2018, 78 perimenopausal women were recruited at the Gynaecological Outpatient Department of Beijing Pinggu District Hospital. After coding, they were randomly divided into three groups, A, B and C, by lottery. Group A was required to participate in educational seminars. Group B was required to participate in educational seminars and received individualised dietary guidance from professional nutritionists. Group C had the same intensive education classes and individualised dietary guidance as Group B, along with intensive resistance exercise. The difference in the various observation indexes was reviewed after three months of intervention. The number of patients with abnormal metabolic indexes in the diet and comprehensive groups decreased significantly after intervention, compared with the statistics before intervention. The number of patients with a waist circumference ≥80 cm in the diet and comprehensive groups decreased significantly, and the difference was statistically significant (χ2=5.976, p=0.014; χ2=4.433, p=0.035). Before and after observation, the control and diet groups had a higher incidence of HDL <1.29 mmol/L than the comprehensive group, and the difference was statistically significant (p<0.05). After intervention, TGs in the comprehensive group were significantly lower than the control group (≥1.7 mmol/L), and the difference was statistically significant. Individualised dietary intervention combined with anti-resistance exercise can significantly improve eating and exercise habits, correct metabolic disorders and reduce the occurrence of metabolic syndrome.

Dietary supplement for relieving menopausal symptoms in Egyptian perimenopausal women

BackgroundWomen experience various menopausal symptoms during the menopause; these symptoms can affect their quality of life and health. The aim of this study was to help females around this time to relief their symptoms by natural safe product.Subjects and methodsForty-two women participated as volunteers, who are suffering from different symptoms of menopause with mean age 45.36 ± 0.98 years. Full clinical examination, anthropometric parameters, dietary recalls, and Menopause Rating Scale evaluation were recorded. Blood sampling and biochemical analysis was done including important sex hormones. Participants daily consumed 45 g of supplement made from raw unsalted crashed peanut, raw sesame, dry coriander, and dry thyme that were made in the form of blend. Study period lasted for 8 weeks. Chemical composition of the blend was assessed.ResultsAll participants showed marked improvement in psychological, urogenital, and somatic symptoms after intervention.ConclusionData of this study showed that the blend had a beneficial impact on the physical, psychological, and mental health in perimenopausal women. So, functional foods must be considered in controlling different menopausal annoying symptoms; perimenopausal women can use this blend as a safe and effective food supplement.

Doctor, ask your perimenopausal patient about her physical fitness; association of self-reported physical fitness with cardiometabolic and mental health in perimenopausal women: the FLAMENCO project.

The aim of this study was to explore the association of self-reported physical fitness (PF) and its components with cardiometabolic and mental health in perimenopausal women. These cross-sectional analyses included 191 participants (53 ± 4 y old) from the FLAMENCO project. Self-reported PF was assessed with the International Fitness Scale (IFIS). Body mass index (BMI), fat mass (FM), waist circumference (WC), systolic and diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglycerides, C-reactive protein (CRP), and glucose were measured. The Beck's Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Life Orientation Test Revised, and Positive and Negative Affect Schedule were used to assess mental health. After adjusting for potential confounders, greater overall PF was associated with lower BMI, FM, WC (P < 0.001), DBP and CRP, and higher HDL-C (P < 0.05). Cardiorespiratory fitness (CRF), speed-agility, and flexibility were associated with lower BMI, WC, and FM (P < 0.001), and muscle strength (MS) with lower WC and FM (P < 0.05). In addition, CRF, MS, and speed-agility were associated with lower CRP (P < 0.01), and flexibility with enhanced triglycerides and HDL-C (P < 0.05). Overall PF and all its components were associated with lower depression, anxiety, and negative affect (P≤0.01), and greater positive affect (P≤0.05). Overall PF and MS were associated with better sleep quality (P < 0.05), and CRF, MS, and speed-agility with greater optimism (P≤0.05). Finally, overall PF showed evidence of significant association with less pharmaceutical expenditure (B = -7.2, β=-0.145, P = 0.08). Self-reported PF was associated with better cardiometabolic and mental health in perimenopausal women. The IFIS might be proposed as an inexpensive, quick, and easy tool in clinical settings.

Abstract 191: BRAVE: Blood Pressure and Vascular Health Around Menopause

Background: Post-menopausal women are more likely to have uncontrolled hypertension and are at higher risk of cardiovascular disease compared with age-matched men. Blood pressure variability (BPV) has recently emerged as a predictor of adverse cardiovascular outcomes. It is unknown if there is a relationship between BPV and menopause and whether BPV can predict vascular health in perimenopausal women. Methods: BRAVE (Blood pRessure And Vascular hEalth around menopause) is an observational study recruiting perimenopausal healthy women, aimed at studying the relationship between BPV, the menopause transition and vascular health. A 24-hour blood pressure (BP) measurement [including 24-hour coefficient of variation, night dipping and maximum BP] was used to define the BPV. Menopausal status and cardiovascular risk factors were collected through questionnaires. Arterial stiffness, as a marker of vascular health status, was measured using pulse wave velocity. Multivariable models were performed to identify factors associated with BPV as well as those associated with arterial stiffness in perimenopausal women. Results: Fifty healthy women (mean age 52.9 ± 4.0, 62% post-menopausal) were recruited. There was a low prevalence of cardiovascular risk factors, except physical inactivity (60%). In around 40% of patients, we observed an abnormal pattern of BPV. However, all measures of BPV were similar between peri and post menopausal women. In the multivariable analysis, BMI was the only factor associated independently with maximum overnight BP (ß=1.95, p&lt;0.0001) and maximum daytime BP (ß=2.46, p=0.008). Furthermore, maximum overnight BP was found to significantly associated with the arterial stiffness measurement (ß=0.035, p=0.048) after adjusting for confounders, including mean BP and cardiovascular risk factors. Conclusion: An abnormal pattern of BPV is common in perimenopausal women with normal office BP measurement. Maximum overnight BP provides useful information on vascular health beyond mean blood pressure in this population. BPV measurements in normotensive perimenopausal women may therefore have additional clinical value in stratifying their cardiovascular risk.

Association of sedentary time and physical fitness with ideal cardiovascular health in perimenopausal women: The FLAMENCO project

IntroductionHealthier lifestyle behaviours might be related to a lower cardiometabolic risk predisposed by menopause transition. The objectives of the study were: 1) to examine the association of sedentary time (ST) and physical fitness with “Ideal Cardiovascular Health” (ICH) in perimenopausal women, and 2) to determine the capacity of ST and physical fitness tests to discriminate between the presence or absence of ICH status in this population. Study designObservational cross-sectional study. Main outcome measuresSedentary time and different levels of physical activity were objectively assessed using triaxial accelerometry (on 7 consecutive days). Physical fitness was assessed with the Senior Fitness Test battery, handgrip strength, and sit-and-reach tests. ICH status was created from the cut-off values of several health behaviours (smoking, body mass index, physical activity, and diet) and classical cardiometabolic markers (plasma total cholesterol and fasting glucose, and blood pressure). ResultsA total of 122 perimenopausal women (52.6 ± 4.2 years old) participated in this study. After adjusting for covariates, perimenopausal women with ICH status spent less time in sedentary behaviours and had higher scores on the 6-min-walk, 30-s-chair-stand, and back-scratch tests than women with a non-ICH status (all, P≤.03). Cut-off values of <460 min/day in ST and ≥−3 cm on the back-scratch test were associated with around threefold higher odds (95% confidence interval 0.14-0.71 and 1.47–7.01, respectively, all P <.01) of having ICH status. ConclusionReduced ST and greater cardiorespiratory fitness, upper-body flexibility, and lower-body muscular strength were associated with a better cardiovascular profile in perimenopausal women. Including ST and upper-body flexibility as complementary ICH metrics might facilitate early identification of perimenopausal women with a higher risk of cardiovascular disease. However, further studies evaluating the usefulness of these potential complementary diagnostic tools in perimenopausal women are warranted before they are implemented in clinical practice.

The Relationship between Follicle-stimulating Hormone and Bone Health: Alternative Explanation for Bone Loss beyond Oestrogen?

Bone loss in women commences before the onset of menopause and oestrogen deficiency. The increase of follicle-stimulating hormone (FSH) precedes oestrogen decline and may be a cause for bone loss before menopause. This review summarizes the current evidence on the relationship between FSH and bone derived from cellular, animal and human studies. Cellular studies found that FSH receptor (FSHR) was present on osteoclasts, osteoclast precursors and mesenchymal stem cells but not osteoblasts. FSH promoted osteoclast differentiation, activity and survival but exerted negligible effects on osteoblasts. Transgenic FSHR or FSH knockout rodents showed heterogenous skeletal phenotypes. Supplementation of FSH enhanced bone deterioration and blocking of FSH action protected bone of rodents. Human epidemiological studies revealed a negative relationship between FSH and bone health in perimenopausal women and elderly men but the association was attenuated in postmenopausal women. In conclusion, FSH may have a direct action on bone health independent of oestrogen by enhancing bone resorption. Its effects may be attenuated in the presence of overt sex hormone deficiency. More longitudinal studies pertaining to the effects of FSH on bone health, especially on fracture risk, should be conducted to validate this speculation.

Comparative Assessment of the Effects of Hatha Yoga and Physical Exercise on Biochemical Functions in Perimenopausal Women.

Menopause is a transitional phase in which some women experience discomfort, while others may exhibit variety of symptoms. The power of yoga therapy in relieving stress, enhancing health, improving fitness and managing symptoms of a variety of disorders is remarkable. The current study was designed to study the effect of Hatha yoga therapy and regular physical exercise on the Fasting Blood Sugar (FBS), Glycated Haemoglobin (GHB), Thyroid Stimulating Hormone (TSH), serum cortisol and total plasma thiol levels in perimenopausal women. The study included 216 women with perimenopausal symptoms, 111 in test group (Hatha yoga) and 105 in control group (physical exercise). The duration of intervention was 45 minutes every day for 12 weeks. Blood samples were collected in the pre and post intervention period. Statistical significance was defined as p<0.05. FBS and GHB (p≤0.05) showed a significant decrease after yoga therapy. Cortisol levels significantly (p≤0.05) increased in the post intervention period in the control group. However, it is maintained in the test group between the two time periods. The total plasma thiols level showed a rise in the post intervention period, significant rise (p≤0.001) in control group but not significant in the test group. The TSH levels were not altered in any group. It is concluded that exercise helps in maintaining the sugar levels but calming effects of yoga practice is important in relieving stress and enhancing health in perimenopausal women.

Relationship between autonomic nervous system activity and bone mineral density in non-medicated perimenopausal women

The autonomic nervous system (ANS) has attracted attention as a regulator of bone remodeling and the effects of beta-blockers on the prevention of osteoporosis have been studied. However, results are as yet inconclusive and the physiological role of the ANS in bone metabolism has not been clarified. Thus, we investigated the relationship between bone mineral density (BMD) and ANS activity in non-medicated perimenopausal women. ANS activity was evaluated by power spectral analysis of heart rate variability, and overall ANS activity and the balance between sympathetic and parasympathetic nervous activities (SNS and PNS) were quantified. Pre- and postmenopausal subjects were divided into higher or lower overall ANS activity groups, and were also divided into SNS- and PNS-dominant groups. BMD (percentage of young adult mean) was significantly higher in the higher overall ANS group than in the lower group (112.2 ± 16.2 % vs 99.7 ± 14.8 %, p < 0.05) of premenopausal subjects, but not in postmenopausal subjects (91.5 ± 15.9 % vs 91.0 ± 14.9 %). BMD was significantly higher in the SNS-dominant group than in the PNS-dominant group (94.1 ± 16.3 % vs 88.4 ± 18.8 %, p < 0.05) of postmenopausal subjects, but not in the premenopausal subjects (103.5 ± 18.4 % vs. 107.2 ± 14.6 %). Our study revealed that ANS influences bone metabolism under physiological conditions. Thus, it appears to be worthwhile to introduce ANS activity evaluation into the management of bone health in perimenopausal women.

Peri- and Postmenopausal Uterine Bleeding Transvaginal Ultrasound with Hysterosonography and Diagnostic Correlation with Hysteroscopy

ABSTRACT The recent years have seen medical science and technology expand by leaps and bounds. We have shifted focus from correction of the problem to prevention of the problem. Abnormal uterine bleeding is an important cause of ill health in perimenopausal women. In the perimenopausal years, there is an increase in the incidence of bleeding irregularities. This is because of an increase in the prevalence of benign and malignant uterine lesions. There has also been a significant increase in the number of women presenting with postmenopausal bleeding. At transvaginal ultrasonography (TVS), the finding of a thickened central endometrial complex, with or without cystic changes, is often nonspecific and may be caused by an endometrial polyp, submucosal fibroid, endometrial hyperplasia, carcinoma or cystic atrophy. In addition, because of an increased prevalence of adenomyosis or adenomyosis-like changes in women around this age group, proper transvaginal sonographic assessment of endometrial thickness and abnormalities is of utmost importance but maybe difficult in some women. When TVS cannot accurately measure the endometrial thickness or when there is a nonspecific thickened central endometrial complex, hysterosonography can provide additional information and can help in the diagnosis and final treatment. Hysterosonography, as an adjunct to TVS, allows identification of intracavitary lesions and focal and diffuse endometrial abnormalities and helps determine the abnormality. Final diagnosis confirmed by hysteroscopy. In this review, we discuss these common abnormalities and the correlation of TVS and hysterosonographic findings with hysteroscopic evaluation.