Loss Of Reproductive Function Research Articles

ASSOCIATION OF I/D POLYMORPHISM OF THE ACE GENE WITH THE PRESENCE/ABSENCE OF UTERINE BLEEDING AND THE CHARACTERISTICS OF LEIOMYOMATOUS NODES IN PATIENTS WITH A COMORBID COURSE OF UTERINE LEIOMYOMA AND GENITAL ENDOMETRIOSIS

Uterine leiomyoma (UL) is the most common benign tumor, which leads to reduced work capacity and loss of reproductive function in women of childbearing age.The aim of the study – to investigate the presence of probable associations of the polymorphic variant I/D of the angiotensin-converting enzyme (ACE) gene with the presence/absence of uterine bleeding and the characteristics of leiomyomatous nodes in patients with a comorbid course of intramural UL and genital endometriosis.Study methods. The molecular genetic study of the polymorphic variant I/D of the ACE gene was applied to 33 patients with a comorbid course of intramural UL and genital endometriosis and 30 patients with isolated intramural UL (at the same time, 5 patients had a medical history of cycles of controlled ovarian stimulation with the help of assisted reproductive technologies and a diagnosis of infertility) according to the standard operating procedure developed in the interdepartmental educational and research laboratory of the Ternopil State Medical University named after I.Ya. Horbachevskyi of the Ministry of Health of Ukraine. Study results. In patients with isolated intramural UL, uterine bleeding probably prevails in individuals with the DD genotype of the polymorphic variant of the ACE gene relative to individuals with the ID and II genotypes (χ2=7.07; p=0.029). At the same time, the presence of the D allele increases the risk of uterine bleeding by 5.8 times. Analysis of the dominant pattern of inheritance of the ACE gene showed that carriers of the D allele (genotype ID+DD) among patients with isolated intramural UL have a 6.3-fold increased risk of uterine bleeding. Analysis of the relationship between the maximum diameter of the leiomyomatous node in patients of the studied groups and the I/D polymorphism of the ACE gene in the group with isolated intramural UL revealed that the maximum diameter of the node in carriers of the DD genotype exceeds the corresponding indicator in carriers of the II genotype by 28.89% (p <0.001), and the maximum node diameter in ID genotype carriers exceeds the corresponding indicator in II genotype carriers by 9.43% (р=0.032). In addition, the maximum node diameter is 14.29% greater in carriers of the D allele than the corresponding indicator in carriers of the I allele. As for the relationship between the number of leiomyomatous nodes in the patients of the studied groups and the I/D polymorphism of the ACE gene, probable differences were established only in the group with a comorbid course of intramural UL and genital endometriosis. At the same time, the individuals with a solid node predominate among carriers of the II and ID genotypes, while the individuals with multiple nodes predominate among carriers of the DD genotype; the distribution of persons with a solid node or multiple nodes is even among carriers of the D allele, and a solid node was found in 72.41% of individuals (р=0.045) among carriers of the I allele. In addition, the presence of the D allele increases the risk of multiple nodes by 3.09 times. Conclusions. It was found for the first time in the Ukrainian population, that the I/D polymorphism of the ACE gene (the presence of the D allele (genotype ID+DD)) is probably associated with an increased risk of multiple leiomyomatous nodes in patients with a comorbid course of intramural UL and genital endometriosis and with an increased risk of uterine bleeding and the size of the leiomyomatous node in patients with isolated intramural UL. The results of the logistic regression analysis show that the presence of the DD genotype of the ACE gene is associated with the development of uterine bleeding and the occurrence of multiple leiomyomatous nodes in patients with intramural UL, regardless of the presence of comorbid genital endometriosis.

Levonorgestrel-releasing intrauterine device plus metformin, or megestrol acetate plus metformin for fertility-sparing treatment of atypical endometrial hyperplasia and early endometrial carcinoma: a prospective, randomized, blind-endpoint design trial protocol

BackgroundEndometrial adenocarcinoma (EC) is the fifth most common cancer in women worldwide, standard treatment for EC includes hysterectomy, but it results in the loss of reproductive function. Thus, conservative treatment for these patients is strongly demanded, progestin therapy is widely accepted as the main fertility-sparing treatment for young women with endometrial hyperplasia with atypia (EHA) and well-differentiated endometrioid endometrial cancer. This trial will investigate the effectiveness of conservative treatment for obese women with early-stage EC.Method and designThis will be an open-label, 2-armed, randomized, phase-II single-center trial of LNG-IUD plus metformin or megestrol acetate (MA) plus metformin. A total of 88 participants will be randomly assigned into 2 treatment arms in a 1:1 ratio. Clinical, laboratory, ultrasound and radiology data, will be collected at baseline, and then at 3, 6, 9, 12, 18, and 24 months. EC biomarkers will be collected at baseline. The primary aim is to determine the efficacy of a levonorgestrel-releasing intrauterine device (LNG-IUD) plus metformin, or megestrol acetate (MA) plus metformin in achieving pathological complete response (pCR) at 12 months, as well as post-treatment pregnancy outcomes and recurrence rate. The secondary aims are to predict the response to an LNG-IUD plus metformin and MA plus metformin via clinical, blood, and tissue predictive biomarkers.ConclusionsProspective evidence for conservative treatment of EC is limited. New methods to achieve better CR rates with fewer side effects are needed. This trial will investigate the effectiveness of LNG-IUD plus metformin, and MA plus metformin, in obese women with early-stage EC, providing a non-surgical treatment option for these patients.Trial registration ChiCTR2200055624. The trial was registered at http://www.chictr.org.cn/listbycreater.aspx on January 15, 2022

Novel Approaches Used in Ovarian Tissue Transplantation for Fertility Preservation: Focus on Tissue Engineering Approaches and Angiogenesis Capacity.

Due to the impact of the modern lifestyle, female infertility has been reduced because of different reasons. For example, in combined chemotherapeutic therapies, a small fraction of cancer survivors has faced different post-complications and side effects such as infertility. Besides, in modern society, delayed age of childbearing has also affected fertility. Nowadays, ovarian tissue cryopreservation and transplantation (OTC/T) is considered one of the appropriate strategies for the restoration of ovarian tissue and bioactivity in patients with the loss of reproductive function. In this regard, several procedures have been considered to improve the efficacy and safety of OTT. Among them, a surgical approach is used to transplant ovaries into the optimal sites, but the existence of ischemic changes and lack of appropriate revascularization can lead to bulk follicular atresia. Besides, the role of OTC/T is limited in women of advanced maternal age undergoing lifesaving chemo-radiation. As a correlate, the development of de novo approaches with efficacious regenerative outcomes is highly welcomed. Tissue engineering shows high therapeutic potentialities to restore fertility in males and females using the combination of biomaterials, cells, and growth factors. Unfortunately, most synthetic and natural materials are at the experimental stage and only the efficacy has been properly evaluated in limited cases. Along with these descriptions, strategies associated with the induction of angiogenesis in transplanted ovaries can diminish the injuries associated with ischemic changes. In this review, the authors tried to summarize recent techniques, especially tissue engineering approaches for improving ovarian function and fertility by focusing on angiogenesis and neovascularization.

0309 A multidisciplinary initiative for screening and treating sleep disorders in menopause: experience in a tertiary center

Abstract Introduction Menopause is a time of adaptation and transition to a new biological situation that implies the loss of reproductive function. The onset of menopause coincides with the onset of other symptoms related to hypertension, weight gain, hormonal changes, osteoporosis, and vascular disease. These hormonal changes could be responsible for some sleep disorders. It is well documented that the prevalence of sleep disorders is higher in post-menopause, regardless of other factors such as aging. Methods As part of routine care for patients in a gynecology outpatient clinic, all patients with menopause were screened for sleep disorders using the following clinical tools: the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-9), the STOP-BANG Questionnaire, and the Epworth Scale.A full clinical history was also taken, focusing on sleep habits and risk factors that could contribute to sleep difficulties.Patients that presented with any sleep disorders were assessed and continued their treatment depending on these results. Results Between August 2021 and December 2021, a total of 60 patients going through menopause that attended the gynecology outpatient clinic for other reasons were screened for sleep disorders.Using the PSQI we identified 51 patients with low quality sleep (defined as a score of 5 or higher using this tool).Depression was also identified in a total of 43 patients, none of which were receiving treatment. All these patients also reported low-quality sleep and other problems such as hypersomnia, which in turn was identified in 15 patients using the Epworth Scale.Thirty-five patients were identified as having at least 3 risks factors for obstructive sleep apnea with the STOP-BANG questionnaire and were ordered a polysomnography. Conclusion Sleep disorders are highly prevalent in menopause. With this initiative, we present our experience and results incorporating routine screening for these disorders in a clinical setting outside of a sleep clinic.Integrating this information can be helpful for working in multidisciplinary teams aimed at reducing chronic diseases and mortality in these patients. This is a multidisciplinary approach that will continue in our institution. Support (If Any)

Integrated Transcriptome and Multiple Activated Pathways in Endometrial Cancer

Because the incidence of endometrial cancer is notably increasing worldwide, it has become the leading gynecologic cancer in the United States. Standard treatment results in the loss of reproductive function in women of childbearing age. Furthermore, advanced cancer stages are associated with poor overall survival. The aim of this study was to explore the abnormal expression profile of genes during the development of endometrial cancer, which is essential to provide a better understanding of the mechanisms involved. Five pairs of endometrial cancer tissues and normal endometrial tissues were subjected to next-generation transcriptome sequencing technology. Quantitative real-time PCR (RT-qPCR) was performed to validate the expression profile of key differentially expressed genes (2.0-fold change, adj. p < 0.05) (DEGs) identified in the RNA-seq result. GO and KEGG pathways were used for bioinformatic analyses. The transcriptomic sequencing results showed 1153 DEGs, including 673 upregulated and 480 downregulated genes, in the EC specimens. Decreased expression of ID1, IGF1, GDF7, SMAD9, TGF-beta and WNT4, as well as GDF5, INHBA and ERBB4 overexpression, were confirmed in EC using RT-qPCR. Additionally, EC tissue exhibited marked enrichment in genes promoting cellular adhesion, proliferation, migration and plasma membrane. KEGG analysis revealed changes in various pathways, such as the TGF-beta, PI3K-Akt, Wnt, and estrogen pathways. Our data describe the molecular events involved in the pathogenesis of EC, which may be potential diagnostic markers and targets of therapeutic interventions.

ASRM müllerian anomalies classification 2021

There are many proposed classification systems for müllerian anomalies. The American Fertility Society (AFS) Classification from 1988 has been the most recognized and utilized. The advantages of this iconic classification include its simplicity, recognizability, and correlation with clinical pregnancy outcomes. However, the AFS classification has been criticized for its focus primarily on uterine anomalies, with exclusion of those of the vagina and cervix, its lack of clear diagnostic criteria, and its inability to classify complex aberrations. Despite this classification and others, the wide range of müllerian anomalies is still largely unknown and confusing to many providers. Consequently, müllerian anomalies may go undiagnosed for extended periods, receive inappropriate or inadequate surgical interventions, and result in persistent issues such as pain or loss of reproductive function. The American Society for Reproductive Medicine Task Force on Müllerian Anomalies Classification was formed and charged with designing a new classification. The Task Force set goals for a new classification and chose to base it on the iconic AFS classification from 1988 because of its simplicity and recognizability, while expanding and updating it to include all categories of anomalies. In addition, this was recognized as an opportunity to raise awareness of this area of medicine, educate providers and learners, and promote patient advocacy. Presented here is the new American Society for Reproductive Medicine Müllerian Anomalies Classification2021.

The Interrelationship Between Female Reproductive Aging and Survival.

The link between survival and reproductive function is demonstrated across many species and is under both long-term evolutionary pressures and short-term environmental pressures. Loss of reproductive function is common in mammals and is strongly correlated with increased rates of disease in both males and females. However, the reproduction-associated change in disease rates is more abrupt and more severe in women, who benefit from a significant health advantage over men until the age of menopause. Young women with early ovarian failure also suffer from increased disease risks, further supporting the role of ovarian function in female health. Contemporary experiments where the influence of young ovarian tissue has been restored in postreproductive-aged females with surgical manipulation were found to increase survival significantly. In these experiments, young, intact ovaries were used to replace the aged ovaries of females that had already reached reproductive cessation. As has been seen previously in primitive species, when the young mammalian ovaries were depleted of germ cells prior to transplantation to the postreproductive female, survival was increased even further than with germ cell-containing young ovaries. Thus, extending reproductive potential significantly increases survival and appears to be germ cell and ovarian hormone-independent. The current review will discuss historical and contemporary observations and theories that support the link between reproduction and survival and provide hope for future clinical applications to decrease menopause-associated increases in disease risks.

Hormone replacement therapy: update and practical prescribing

Peri-menopause and menopause are a normal part of ageing. Nikki Noble gives an overview of hormone replacement therapy and practical prescribing tips Menopause is a physiological event of ovarian failure due to a loss of ovarian follicular activity. This leads to a lack of oestrogen, resulting in the cessation of menstruation and loss of reproductive function. This article discusses the symptoms of menopause and treatment with hormone replacement therapy. This includes practical prescribing, side effects and long-term benefits and risks. The current shortages of hormone replacement therapy are also addressed. The aim of this article is to enable health professionals to define menopause and gain an understanding of the symptoms associated with it. After reading this article you should be able to: describe when peri-menopause and menopause occur, describe the common symptoms that may be experienced during peri-menopause and menopause, understand of the hormones used in hormone replacement therapy, and understand the practical prescribing of hormone replacement therapy and the benefits, risks, contraindications and side-effects.

DEPRESSION IN WOMEN IN THE GENERATIVE PERIOD AFTER TOTAL EXTIRPATION OF THE UTERUS

The loss of the uterus after a hysterectomy has many negative psychological consequences for women who have undergone such an operation. Hysterectomy results in a loss of reproductive capacity, which is why in some countries the younger generation of women is not treated at all. Even for women who are sure that they do not want to have children in the future, the uterus as an organ is not seen as something that can be easily removed. Side effects of this surgery are loss of menstrual function, loss of reproductive function, impaired sexual function and distorted image of female identity. These changes can contribute to the development of negative emotional reactions, including depression. This paper presents research findings on the level of depression in women who enter the phase of removal of the uterus and women who have already undergone surgery, in order to gain insight into the psychological state of women who go through this process. Keywords: hysterectomy, depression, uterus

Современные подходы к терапии урогенитальных расстройств у женщин в перименопаузе

In modern gynecology, hormone-dependent pathology is one of the most significant problems. The importance of solving this problem is due to the significant prevalence of this pathology, its long-term recurrent course and the presence of a medico-social task of preserving the reproductive function of patients. The age of women who develop dyshormonal diseases is already 30–35 years old, which leads to premature loss of reproductive function, an increase in the frequency of surgical interventions. The systemic nature of the lesion in dyshormonal pathology is due to the common links of pathogenesis. The leading factor in the pathogenesis of hormone-dependent pathology is absolute or relative hyperestrogenism. Menstrual disorders (MD) is one of the most overlooked problems in modern gynecology. Over the past decade, an increase in the frequency of MD in women of reproductive age has been noted in the world by almost 11 times. In the structure of gynecological morbidity, according to most authors, MD s account for about 60% of all dyshormonal disorders, which often lead to an underestimation of future not only reproductive, but also general somatic problems: from miscarriage and infertility to the formation of both benign and malignant tumors in the female organism. Keywords: hormone-dependent pathology, menstrual disorders, estrogens, progesterone, treatment, indole-3-carbinol, rod extract, Agidol.

Эффективное фармакотерапевтическое влияние индол-3-карбинола и экстракт прутняка в составе препарата Агидол

In modern gynecology, hormone-dependent pathology is one of the most significant problems. The importance of solving this problem is due to the significant prevalence of this pathology, its long-term recurrent course and the presence of a medico-social task of preserving the reproductive function of patients. The age of women who develop dyshormonal diseases is already 30–35 years old, which leads to premature loss of reproductive function, an increase in the frequency of surgical interventions. The systemic nature of the lesion in dyshormonal pathology is due to the common links of pathogenesis. The leading factor in the pathogenesis of hormone-dependent pathology is absolute or relative hyperestrogenism. Menstrual disorders (MD) is one of the most overlooked problems in modern gynecology. Over the past decade, an increase in the frequency of MD in women of reproductive age has been noted in the world by almost 11 times. In the structure of gynecological morbidity, according to most authors, MD s account for about 60% of all dyshormonal disorders, which often lead to an underestimation of future not only reproductive, but also general somatic problems: from miscarriage and infertility to the formation of both benign and malignant tumors in the female organism. Keywords: hormone-dependent pathology, menstrual disorders, estrogens, progesterone, treatment, indole-3-carbinol, rod extract, Agidol.

Fertility issue in early stage endometrial cancer patients.

Endometrial cancer (EC) is the most common cancer of the female reproductive system in developed countries. The incidence of EC has been increasing in young women. Approximately 4% of cases are aged <40 years. These young women may wish to delay therapy until after they have children. Common complaints in patients with EC include irregular vaginal bleeding, pelvic pain, and enlarged uterus. Imaging techniques such as transvaginal ultrasound (TVUS) or magnetic resonance imaging (MRI) can be utilized in detecting EC. Although the recommended treatment of EC is hysterectomy and bilateral salpingo-oophorectomy with or without systemic lymph node dissection, loss of reproductive function is the primary limiting factor of this surgical approach. Some studies have reported favorable results with high-dose oral progestins or levonorgestrel-releasing intrauterine system or hysteroscopic tumor resection followed by treatment with high-dose oral progestins. The most widely utilized medical treatment regimens are medroxyprogesterone acetate (MPA) 250–600 mg/day or megestrol acetate (MA) 160–480 mg/day. However, there is still a lack of evidence to establish the optimal dose and duration of progestin treatment. Patients with complete remission (CR) who wish to conceive must be encouraged, and referral to a fertility clinic should be offered as soon as possible. The key aspect of fertility-sparing management in women with EC appears to be the selection of appropriate candidates. Owing to the rarity of this condition, management may often be suboptimal. The aim of this review is to assess the current approaches to management of young women with EC who wish to preserve their fertility.

Therapeutic Perspectives on the Modulation of G-Protein Coupled Estrogen Receptor, GPER, Function.

Estrogens exert their physiological and pathophysiological effects via cellular receptors, named ERα, ERβ, and G-protein coupled estrogen receptor (GPER). Estrogen-regulated physiology is tightly controlled by factors that regulate estrogen bioavailability and receptor sensitivity, while disruption of these control mechanisms can result in loss of reproductive function, cancer, cardiovascular and neurodegenerative disease, obesity, insulin resistance, endometriosis, and systemic lupus erythematosus. Restoration of estrogen physiology by modulating estrogen bioavailability or receptor activity is an effective approach for treating these pathological conditions. Therapeutic interventions that block estrogen action are employed effectively for the treatment of breast and prostate cancer as well as for precocious puberty and anovulatory infertility. Theoretically, treatments that block estrogen biosynthesis should prevent estrogen action at ERs and GPER, although drug resistance and ligand-independent receptor activation may still occur. In addition, blockade of estrogen biosynthesis does not prevent activation of estrogen receptors by naturally occurring or man-made exogenous estrogens. A more complicated scenario is provided by anti-estrogen drugs that antagonize ERs since these drugs function as GPER agonists. Based upon its association with metabolic dysregulation and advanced cancer, GPER represents a therapeutic target with promise for the treatment of several critical health concerns facing Western society. Selective ligands that specifically target GPER have been developed and may soon serve as pharmacological agents for treating human disease. Here, we review current forms of estrogen therapy and the implications that GPER holds for these therapies. We also discuss existing GPER targeted drugs, additional approaches towards developing GPER-targeted therapies and how these therapies may complement existing modalities of estrogen-targeted therapy.

Management of women with infertility and uterine leiomyoma in assisted reproductive technology programs

In the structure of female infertility, one of the important causes is the uterine factor of infertility, namely, uterine leiomyoma, which is diagnosed in 13.3–24.0% of cases and leads to loss of reproductive function and pregnancy pathology.Aim of research: to increase the incidence of pregnancy in infertile women with uterine leiomyoma by analyzing the main factors in the development of this pathology and optimizing the treatment and prevention complex.Material and research methods. A randomized clinical trial was performed among 175 (29.0%) women of reproductive age with a UL diagnosis, and the control group (CG) of 32 somatically healthy women with normal menstrual and reproductive functions, who were divided into the following groups: Main Group A (MG) – 137 women with UL, who were further divided into subgroups for evaluation of the treatment: subgroup A1 – 55 women with UL after laparoscopy and hysteroscopy with the proposed treatment complex (TC), subgroup A2 – 45 women with UL after hysteroscopy and TC, subgroup A3 – 37 women with UL and the proposed drug treatment without surgical removal of UL; comparison group B – 38 women with UL and conventional treatment.Results. The age of the examined patients was (33.9 ± 7.8) years (26–42 years), BMI - (23.5 ± 5.2) kg / m², AMH – 1.8 ng / ml (0.4–5), 2 ng / ml). The duration of infertility was 2–15 years on average (5.4 ± 0.5 years). Primary infertility was diagnosed in 43 patients (24.5%), and secondary – in 132 women (75.5%). 93 (53.7%) women developed hypermenorrhea, of which one in three indicated a history of anemia. 31 (17.7%) women complained of algodysmenorrhea; in 43 (24.6%) women, dysmenorrhea occurred after the appearance of uterine fibroids, and 23 women (13.2%) had irregular menstruation.During hysteroresectoscopy, single submucosal nodes “on the pedicle”, which had clear contours, a rounded shape, a dense consistency, and deformed the uterine cavity, were found in 71 (40.8%) patients. Of these, 51 (71.8%) nodes were whitish in color with isolated small hemorrhages, and in the remaining 20 (28.2%) cases, the nodes were covered with a lace of stretched and altered blood vessels.Analysis of the location and size of the nodes revealed that in every third patient (25 patients, 35.2%) the size of the node was about2.5 cm, in every fourth (19 patients, 26.7%) nodes were up to4 cm, in other patients (27 patients, 38.0%) the nodes were up to5 cmand greater in sizeInterstitial-submucosal myomas with a combination of subserous nodes were diagnosed in 104 (59.2%) of the examined women and visualized as a bulge of one of the uterine walls.During hysteroresectoscopy, we visualized endometrial hyperplasia in 89 (50.8%) patients, which was subsequently confirmed histologically in 67 (38.3%) women, and secretory transformation of the endometrium in the remaining 22 (12.5%). In 22 (12.6%) patients, we observed hysteroscopic signs of chronic endometritis; this diagnosis was also confirmed morphologically, which was manifested by uneven thickening of the endometrium and micropolyps.The use of our improved algorithm of rehabilitation measures allowed to reduce the period of menstrual bleeding in 42 (48.8%) women in group A2, which was 1.3 times more effective than in the comparison group and 1.4 times more effective than in patients of group A3. Menstrual discharge was 1.9-fold and 1.8-fold lower compared to A1 women who refused surgery and 1.2-fold lower than in the comparison group. The effectiveness of the proposed treatment was analyzed, and the frequency of pregnancy was evaluated; findings indicate that the highest efficiency was observed in women of group A2 – 31.1% of cases, which was 2 times higher than the comparison group and 2.3 times higher than in group A3.Conclusion. Uterine leiomyoma is mainly the cause of infertility due to a mechanical factor. Laparo- and hysteroresectoscopy is the optimal method of pre-pregnancy treatment for women with uterine leiomyoma who are undergoing infertility treatment with assisted reproductive technologies. Laparo- and hysteroresectoscopy is an organ-sparing operation that has a number of advantages: easy postoperative period, no adhesions, which, in turn, increases the frequency of pregnancy and reduces premature delivery.

Influence of pilates method training on the balance of the elderly: a systematic review

Introduction: Getting older is a process characterized by physical changes, which include, among other, the loss of reproductive function and the decline of motor function and it is sometimes associated with chronic diseases. The aging process induces a natural functional decline, and considering this phenomenon, it is primordial research studies that indicate interventions that promote improvements in the health status of the elderly. Objective: To analyse, through a sistemic review, the effects of the pilates method on the static and dinamic balance in the elderly. Method: This systematic review followed the recommendations of the Preferred Reporting Itens for Systematic Reviews and Meta-Analyses (PRISMA) and the searches were carried out in database: IBECS, PubMed, LILACS, EMBASE, SCIELO e PEDro from descriptors “pilates, exercício físico e idosos”, and their names in english and spanish. Results: There were analysed 11 original articles about the theme and most of them showed positive results of the pilates method on the static and dinamic balance in the elderly. Conclusion: The pilates method showed significant results on the static and dinamic balance in the elderly, but there should be better quality studies to guarantee its effectiveness.

Невидимый дизонтогенез поколений X, Y, Z (трансформация черт социальной субъектности)

The article analyzes the causes of population dysontogenesis-a hidden process of loss of human subjectivity: the destruction of its psychophysiological and psychosocial qualities necessary for the normal activity of society. Violations caused by unformed structures of the child’s brain during the period of socialization in the family and school are hardly noticeable in a state of comfort, but they manifest themselves under normative and especially peak psychophysiological loads: deviant behaviors, educational failure, deterioration of health and loss of reproductive functions. The consolidation of dysontogenesis in generations X, Y, and Z occurs through international educational standards that simplify educational programs and reduce didactic requirements to a level beyond which pathophenomenes become barely noticeable, but continue to accumulate statistically at the lower limit of the norm. Compensation for impaired functions occurs at the expense of modern means of digital communication-there is a non-specific “swarm” subjectivity: emotionally unstable, easily suggestible representatives of generations Y and Z become the main resource base of extremist and terrorist organizations. The loss of basic social functions of goal-setting and control, empathy and passionarity in generations X, Y, Z, a simplified view of reality, increased lability and network conformism, decreased libido, and redirection of creative energy to the virtual-all this leads to the cessation of reproduction of the properties of society as a system structure. Restoration of systemogenetic development is possible only if the basic functions of the social state — science, education and upbringing-are provided.

Hormone replacement therapy: update and practical prescribing

Menopause is a physiological event of ovarian failure due to a loss of ovarian follicular activity. This leads to a lack of oestrogen, resulting in the cessation of menstruation and loss of reproductive function. This article discusses the symptoms of menopause and treatment with hormone replacement therapy. This includes practical prescribing, side effects and long term benefits and risks. The current shortages of hormone replacement therapy are also addressed. The aim of this article is to enable healthcare professionals to define menopause and gain an understanding of the symptoms associated with it. After reading this article you should be able to: describe when peri-menopause and menopause occur, describe the common symptoms that may be experienced during peri-menopause and menopause, understand of the hormones used in hormone replacement therapy, and understand the practical prescribing of hormone replacement therapy and the benefits, risks, contraindications and side-effects.

Effects of Methanolic Root Extract of Holarrhena floribunda on the Lipid Profile and Sex Hormones in Wistar Rats

Aim: This study aims to determine the effects of methanolic root extract of Holarrehna floribunda on the level of some serum sex hormones, follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, estradiol, progesterone and lipid profile in Wistar rats. &#x0D; Materials and Methods: Twenty- four male and female Wistar rats (150-250 g body weight) were randomly assigned into 4 groups of 6 rats each. Group 1 (control male) took normal rat chow and drinking water. Group 2 (control female) took normal rat chow and drinking water, Group 3(Male test group), was administered with 200 mg/kg of Holarrehna floribunda extract, Group 4(Female test group), was administered with 200 mg/kg of Holarrehna floribunda. The feeding regimens lasted for 5weeks.&#x0D; Results: The values for the lipid profile shows CHOL in Group 1 and Group 3 were 4.02±0.41 mmol/l and 5.75±0.09 mmol/l, Group 2 and Group 4 were 3.87±0.22 mmol/l and 5.80±0.10 mmol/l respectively, TRIG for Group 1 and Group 3 were 1.30±0.05 mmol/l and 2.11±0.15 mmol/l for Groups 2 and 4 were 1.15±0.03 mmol/l and (2.10±0.12 mmol/l,HDL-C for Groups 1 and 3 were 30.01±0.82 mg/dL and 39.88± 1.24mg/dL,for Groups 2 and 4 were 29.98± 0.77 mg/dL and 38.20± 1.83 mg/dL, LDL-C for Groups 1 and 3 were 2.26±0.37 mmol/L and 4.17±0.35 mmol/L respectively, for Groups 2 and 4 were 3.27±0.47 mmol/L and 4.06±0.21 mmol/L respectively, shows significant increase(p&lt;0.05) in HDL-C (mg/dL) in Groups 1,2,3 and 4.The values obtained showed significant increase (p&lt;0.05) in HDL-C (mg/dL) in Groups 1,2,3and 4The serum concentrations of FSH, Estradiol, LH and progesterone in the control Group 2 were 0.38 ±0.07mIU/mL, 7.83±0.35 mIU/mL, 15.50±0.15 Pg/mL and 0.86±0.03 ng/mL respectively, and in test Group 4 were 0.77±0.04mIU/mL, 8.75±0.17 mIU/mL, 21.09±0.79 Pg/Ml 0.33±0.05 ng/mL. Follicle stimulating hormone levels was significantly higher (p&lt;0.05) in test group compared with control. While in Group 1 and 3, the serum concentrations of FSH, LH, and testosterone in control Group 1 were (0.51 ±0.06) mIU/mL, (16.44±0.31) mIU/mL and (8.41±0.50) ng/mL respectively and in test Group 3 were 0.88±0.06 mIU/mL19.88±1.46mIU/mL and10.68±0.64 ng/mL, respectively.&#x0D; Conclusion: The extract improves the level of sex hormones in both the male and female rats. which could enhance reproductive functions in normal rats and those with loss of reproductive function.

Symptom management in women undergoing the menopause.

The menopause is a physiological event involving ovarian failure as a result of a loss of ovarian follicular activity, which leads to oestrogen deficiency, resulting in permanent cessation of menstruation and loss of reproductive function. Women undergoing the menopause are seen in a range of healthcare settings. It is important that all nurses, particularly those practising in primary care and women's health, have an understanding of the symptoms, treatment and long-term implications of the menopause on women's health and quality of life. This article outlines the symptoms of the menopause and the available treatments for these, including hormone replacement therapy, non-hormonal treatments and alternative therapies, and discusses how nurses can assist women undergoing the menopause to improve their health and quality of life during this often challenging time.

Gene expression changes in male accessory glands during ageing are accompanied by reproductive decline in Drosophila melanogaster.

Senescence is accompanied by loss of reproductive functions. Here, we studied reproductive ageing in Drosophila melanogaster males and asked whether the expected decline in male reproductive success is due to diminished functionality of the male accessory gland (AG). The male AG produces the majority of seminal fluid proteins (SFPs) transferred to the female at mating. SFPs induce female postmating changes and are key to male reproductive success. We measured age-dependent gene expression changes for five representative SFP genes in males from four different age groups ranging from 1 to 6weeks after eclosion. Simultaneously, we also measured male reproductive success in postmating traits mediated by transfer of these five SFPs. We found a decreased in male SFP gene expression with advancing age and an accompanying decline in male postmating success. Hence, male reproductive senescence is associated with a decline in functionality of the male AG. While overall individual SFP genes decreased in expression, our results point towards the idea that the composition of an ejaculate might change with male age as the rate of change was variable for those five genes.