Hormone Replacement Research Articles

Gonadal Hormone Changes with Aging and Their Impact on Chronic Pain

Chronic pain, pain that lasts beyond three months, is a common finding in the elderly. It is often due to musculoskeletal conditions but can be precipitated by other factors as well. While physiological systems decline with aging, chronic pain is influenced by changes in hormone profiles as men and women enter into andropause and menopause, respectively. Research on gonadal hormones is limited, especially when it comes to their relationship with chronic pain. Women tend to experience less pain with aging compared to their premenopausal years, and this is partially explained by the fact that estrogen enhances pain sensitivity and its decline during menopause decreases it. However, hormone replacement therapy (HRT) seems to increase pain tolerance post-menopause. There is some evidence that testosterone plays a protective factor in pain perception. Men on the other hand, have higher pain tolerance as testosterone is considered to be a protective factor. With aging and decreasing testosterone, older men tend to be less tolerant to pain. This paper explores how hormonal changes with aging impact pain perception in both men and women, highlighting several pain conditions influenced by hormones. Although research remains limited, the potential of HRT as a treatment for common pain conditions is examined.

Evaluating the Efficacy of Combined Intravaginal Estriol Therapy and Kegel Exercises in Managing Menopausal Atrophic Vulvovaginitis

Background: This is a prospective study. Atrophic vulvovaginitis (VVA), a prevalent condition resulting from estrogen deficiency after the menopause, is characterized by symptoms such as vaginal dryness, itching, burning, dyspareunia, and urinary discomfort. Standard treatment involves systemic estrogen replacement therapy (HRT) and localized estrogen treatments, such as estriol. However, many women with moderate-to-severe VVA may not fully benefit from estrogen therapy alone. Non-hormonal adjunctive treatments, such as pelvic floor exercises (e.g., Kegel exercises), are being explored to enhance clinical outcomes. Objectives: This study investigates the combined effect of local estriol therapy and Kegel exercises in improving VVA symptoms in postmenopausal women. Methods: Fifty postmenopausal women diagnosed with VVA were enrolled and divided into three severity groups: mild, moderate, and severe. All participants received estriol therapy (0.5 mg vaginal tablets daily for 10 days each month) for the first three months. Following this, Kegel exercises were introduced for an additional three-month period, alongside continued estriol therapy. Symptom improvement was evaluated after six months, with outcomes categorized as complete remission, partial remission, or no remission. Results: Significant improvements in symptom remission were observed, particularly in the moderate and severe groups. In the mild VVA group, 81.82% achieved complete remission with combined therapy compared to 68.18% with estriol alone. In the severe group, complete remission was observed in 40% of patients receiving combined therapy compared to 20% with estriol therapy alone. These findings suggest that Kegel exercises enhance the effectiveness of estriol by improving local blood circulation, which facilitates better estrogen absorption and distribution. Conclusions: The addition of Kegel exercises to local estriol therapy significantly improves symptom remission rates, especially in moderate and severe VVA cases. This approach offers a promising strategy for managing postmenopausal VVA, particularly in cases that do not fully respond to estrogen therapy alone.

Macular, choroidal and disc associations across women’s reproductive life stages: a scoping review from menarche to post-menopause

Abstract Oestrogen and progesterone fluctuate cyclically in women throughout their adult lives. Although these hormones cross the blood-retinal barrier and bind to intraocular receptors, their effects remain unclear. We present the first review to date on associations between posterior pole structures—specifically the macula, choroid, and optic disc—and both the menstrual cycle and post-menopausal period, utilising multimodal imaging techniques in healthy adult non-pregnant women. We excluded studies on contraception and hormonal replacement therapy, focusing solely on physiological associations. Despite the comprehensive scope of our review, limited data and inconsistent reporting among studies prevented the establishment of meaningful trends. Across menstrual cycle phases, choroidal thickness (CHT) was the most consistently reported parameter, with thinning during the luteal phase compared to the follicular phase. Conversely, no significant differences were observed in macular or disc morphology across the cycle, likely reflecting a preserved structure despite potential fluctuations in blood flow and perfusion. Studies comparing pre- and post-menopausal associations, after adjusting for age or body mass index (BMI), failed to reveal meaningful trends, highlighting the difficulty in separating the effect of age from hormonal declines in older women. Understanding how hormonal cycles impact the posterior pole in women is crucial for addressing sex differences in various ocular pathologies. Research on female-specific factors is still sparse, and interestingly, the majority of affiliations in the reviewed articles did not originate from regions with the highest biomedical research funding and publication rates. We encourage further studies focusing on female-specific variables and provide recommendations for future designs.

Predictive value of technetium-99m sodium pertechnetate thyroid scintigraphy in determining the permanence of congenital hypothyroidism

Objectives: We aim to investigate the predictive value of [99mTc] pertechnetate thyroid scintigraphy in determining the permanence of congenital hypothyroidism (CH). Material and Methods: A retrospective analysis of [99mTc] pertechnetate thyroid scans performed for evaluation of CH at the Nuclear Medicine Unit of a hospital in Hong Kong between January 1, 2008, and December 31, 2018, was conducted. Scintigraphic findings and parameters at diagnosis, including thyroid stimulating hormone (TSH), free thyroxine (fT4), gender, and gestational age, were reviewed. The need for lifelong thyroxine replacement therapy was reviewed. Results: The study included 85 subjects, with 74 (87.1%) presenting with eutopic thyroid and 11 (12.9%) showing thyroid dysgenesis. Patients with scintigraphic evidence of thyroid dysgenesis required permanent thyroid hormone replacement therapy. Among the patients with eutopic thyroid, a higher TSH level was associated with the need for lifelong thyroid hormone replacement therapy (cutoff TSH value 18.72 mIU/L, sensitivity 77.3% and specificity 53.8%). Gender, gestational age, and fT4 did not show significant differences between the transient and permanent CH groups in patients with eutopic thyroid. Conclusion: Scintigraphic findings of thyroid dysgenesis indicate a high prevalence of permanent CH. In patients with eutopic thyroid, higher TSH levels predict the requirement for lifelong thyroid hormone replacement therapy. These results provide insights into the prediction of CH and aid in individualized treatment decisions for patients with CH.

Endocrine Adverse Events in Patients Treated with Immune Checkpoint Inhibitors: A Comprehensive Analysis

Background and Objectives: Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy, but their use is associated with a spectrum of immune-related adverse events (irAEs), including endocrine disorders. This study aims to investigate the incidence, timing, treatment modalities, and impact of ICI-related endocrine side effects in cancer patients. Materials and Methods: This retrospective study analyzed 139 cancer patients treated with ICIs between 2016 and 2022. Data regarding endocrine irAEs, including hypothyroidism, hyperthyroidism, hypophysitis, and diabetes mellitus, were collected. The study examined the timing of irAE onset, management approaches, and the association between irAEs and treatment outcomes. Results: The most common endocrine irAE was hypothyroidism (65.5%), followed by hyperthyroidism (2.3%), hypophysitis (8.6%), and diabetes mellitus (0.7%). These disorders typically emerged within the first six months of ICI therapy. Most cases were managed conservatively or with hormone replacement therapy. Patients who developed endocrine irAEs exhibited a higher objective response rate (ORR) and clinical benefit rate (CBR) compared to those without irAEs. Conclusions: Endocrine dysfunction is a significant toxicity of ICI therapy. Early recognition, prompt diagnosis, and appropriate management are crucial to minimize their impact on patient health and quality of life. This study highlights the potential association between irAEs and improved clinical outcomes. Further research is needed to elucidate the underlying mechanisms and identify predictive biomarkers for irAE development.

The relationship between sexual health literacy and sexual function of women with diabetes mellitus: a cross-sectional study.

Sexual dysfunction (SD) is a complication of poorly managed diabetes mellitus (DM). To prevent SD, patients should develop sexual health literacy (SHL). This study investigated the relationship between SHL and SD in women with DM. This cross-sectional study was performed between 1 October 2023 and 1 June 2024. The sample comprised 400 participants. The inclusion criteria were (1) being 18-65years of age, (2) having been diagnosed with DM, and (3) having a sex partner. Data were collected using a personal information form, the Female Sexual Function Index (FSFI), and the Sexual Health Literacy Scale (SHLS). The data were analyzed using the Mann-Whitney test, Kruskal-Wallis H test, Spearman correlation coefficients, and binary logistic regression. Over half of the participants experienced SD (68,2%). Participants with higher education, those whose partners had higher education, those who did not have any chronic disease other than DM, and those who did not take hormone replacement therapy had a lower rate of SD (P < 0.05). Participants with higher income, those who used family planning, those with DM I, and non-menopausal participants had lower SD and higher SHL (P < 0.05). Insulin-only participants had higher SD and lower SHL than those who were on other types of medications (P < 0.05). There was a significant negative correlation between scale scores (FSFI and SHLS) and age (r = -0.388; P < 0.001 r = -0.326; P < 0.001, respectively), age of partner (r = -0.383; P < 0.001, r = -0.274; P < 0.001, respectively), duration of romantic relationship (r = -0.326; P < 0.001, r = -0.328; P < 0.001, respectively), number of children (r = -0.109; P < 0.001, r = -0.290; P < 0.001, respectively), and duration of DM (r = -0.254; P < 0.001, r = -0.125; P < 0.013, respectively). There was a significant positive correlation between scale scores (FSFI and SHLS) and number of sexual intercourse (r = 0,493; P < 0.001, r = 0.127; P < 0.011, respectively). A one-unit increase in DM duration resulted in a 3.7% increase in SD rate (OR = 1.037). A one-unit increase in the number of sexual intercourses reduced the SD rate by 35.5% (OR = 0.645). The data show that the prevalence of SD in diabetic women is directly affected by the number of sexual intercourses per week, menopausal status, and duration of DM. This is the first study to examine the relationship between SHL and SD in women with DM. Second, the results are sample-specific and cannot be generalized to all women with DM. Healthcare professionals should ensure that women with DM have high levels of SHL to prevent SD and improve their quality of sexual life.

Impact of the COVID-19 pandemic on cerebral venous sinus thrombosis in China: a comparative study

BackgroundCerebral venous sinus thrombosis (CVST) is a rare yet significant neurological disorder with high mortality. Understanding its evolving characteristics, risk factors, and outcomes, particularly in Chinese patients after the COVID-19 pandemic, is critical for developing effective preventive and therapeutic strategies.MethodsA retrospective analysis was conducted on 471 CVST cases from Xuanwu Hospital, comparing data before (2013–2017, n = 243) and after (2021–2023, n = 228) the COVID-19 pandemic. Data on demographics, clinical features, risk factors, and outcomes were evaluated, with subgroup analyses based on gender and age.ResultsThe mean patient age was 38 ± 14 years, with a female preponderance (55.0%). After the COVID-19 pandemic, significant changes in symptoms and neuroimaging findings were observed, including increased visual impairment and decreased headache, neurological deficits, and seizures. Infection emerged as a prominent risk factor, including eight cases related to COVID-19 or vaccination. At discharge, favorable outcomes (mRS 0–2) were noted in 86.6% of patients. Poor outcomes were associated with central nervous system (CNS) infection, oral contraceptive use or hormone replacement therapy (HRT), hematologic disorders, anemia, and prothrombotic conditions. Anemia was identified as an independent predictor of survival.ConclusionsThe pandemic has significantly altered the clinical and epidemiological profile of CVST in China. Infections have emerged as key risk factors, while anemia remains a critical prognostic indicator. These findings highlight the need for targeted clinical strategies to improve outcomes.Trial registrationThis study protocol was reviewed and approved by the ethics committee of Xuanwu Hospital, Capital Medical University (No. 2022-004, dated on November 20, 2022). The clinical trial was registered at Chinese Clinical Trial Registry (ChiCTR2200057621).

Factors influencing endometrial receptivity in women with recurrent implantation failure

BackgroundEmbryo implantation involves two key elements: a good quality embryo and receptive endometrium. Endometrial receptivity abnormalities are known as one of the possible causes of recurrent implantation failure (RIF), especially when the embryo is euploid. This study was aimed to evaluate the impact of age and other clinical factors on endometrial receptivity in women with RIF.Methods68 women with RIF (defined as at least three unsuccessful transfers of good quality embryo of at least 1BB category of blastocysts) and 49 controls (women undergoing IVF treatment because of idiopathic infertility or male factor) were included to the study. After preparation of the endometrium by the hormone replacement therapy endometrial biopsies were taken from each patient and sequenced with beREADY test TAC targeting 67 biomarker genes for endometrial receptivity. Depending on the test result patients were classified into one of four different groups: pre-receptive (n = 16), early-receptive (n = 54), receptive (n = 44) and late-receptive (n = 3).ResultsIn women with RIF pre-receptive endometrium has been detected substantially more often than in controls − 13 (19,1%) vs. 3 (6,1%) patients (p = 0,043). Early-receptive endometrium was diagnosed in the majority of patients with idiopathic infertility − 12 (66.7%) vs. 6 (33.3%) women (p = 0.042) and with polycystic ovary syndrome (PCOS) − 12 (70,6%) vs. 3 (17.7%) women (p = 0,0447). We found significant association between abnormal endometrial receptivity and patient’s age and duration of infertility. Young women were diagnosed significantly more often as normal or late-receptive, whereas older women with longer history of infertility as early-receptive and pre-receptive.ConclusionsIn patients with RIF in comparison to other women undergoing IVF procedures, patient’s age and infertility duration are the most important factors related to endometrial receptivity abnormalities, indicating that older women with a longer history of infertility may benefit the most from endometrial receptivity testing.Trial registrationNot applicable.

Predicting in vivo concentrations of dietary hop phytoestrogens by physiologically based kinetic modeling.

Hop extracts containing prenylated polyphenols such as 8-prenylnaringenin (8-PN) and its precursor isoxanthohumol (iXN) are popular among women seeking natural alternatives to hormone therapy for postmenopausal symptoms. Due to structural similarities with estrogens, these compounds act as estrogen receptor agonists. Especially 8-PN, described as the most potent phytoestrogen known to date, poses a potential risk for endocrine disruption. Therefore, its use as a hormone replacement raises concerns for human health. However, a significant challenge in assessing the potential endocrine-disruptive effects of hop polyphenols is the lack of data on their toxicokinetics. Particularly, information on in vivo concentrations in target tissues is lacking. To address this gap, we developed a physiologically based kinetic (PBK) model tailored to female physiology. The model was used to predict the levels of hop polyphenols in human blood and target tissues under realistic exposure scenarios. The predictions suggest that iXN and 8-PN concentrations in target tissues reach the low nanomolar range after dietary supplementation. This study enhances our understanding of internal concentrations of iXN and 8-PN after dietary consumption and is of direct applicability for respective risk assessment.

Freezing Time and Preserving Hope: Ovarian Tissue Cryopreservation for Girls with Turner Syndrome

Turner syndrome is a chromosomal abnormality that affects 1 in every 2500 live female births. Most patients with Turner syndrome experience primary ovarian insufficiency, often becoming infertile at a young age. Among all of the consequences associated with the illness, infertility is one of the most concerning issues for patients with Turner syndrome. We examine the treatment options that are currently available to aid in preserving patients’ fertility until they are ready to have children. Hormone replacement therapy and oocyte cryopreservation are the most standard procedures performed to preserve the fertility of patients with Turner syndrome, but they are not impactful options for patients who are likely to experience primary ovarian insufficiency before puberty. One novel treatment patients could potentially pursue prior to reaching puberty is ovarian tissue cryopreservation. Currently a well-established procedure to preserve fertility in patients with cancer, ovarian tissue cryopreservation has the potential to help patients with Turner syndrome have spontaneous pregnancies safely and successfully, without the adverse effects associated with other fertility preservation techniques. Additional research and funding should be directed towards ovarian tissue cryopreservation in patients with Turner syndrome specifically, so that efficacy, selection criteria, and safety guidelines can be established.

Impact of sex hormones on pheochromocytomas, paragangliomas, and gastroenteropancreatic neuroendocrine tumors

Abstract Objective The effects of sex hormones remain largely unexplored in pheochromocytomas and paragangliomas (PPGLs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Methods We evaluated the effects of estradiol, progesterone, Dehydroepiandrosterone sulfate (DHEAS), and testosterone on human patient-derived PPGL/GEP-NET primary culture cell viability (n = 38/n = 12), performed next-generation sequencing and immunohistochemical hormone receptor analysis in patient-derived PPGL tumor tissues (n = 36). Results In PPGLs, estradiol and progesterone (1 µm) demonstrated overall significant antitumor effects with the strongest efficacy in PPGLs with NF1 (cluster 2) pathogenic variants. Estrogen receptor alpha (ERα) positivity was detected in 11/36 PPGLs, including 4/4 head-and-neck paragangliomas (HNPGLs). ERα–positive tumors responded with a significant cell viability decrease to estradiol. DHEAS and testosterone (1 µm) displayed no effects, but higher doses of testosterone (10 µm) demonstrated significant antitumor effects, including a pheochromocytoma lung metastasis with strong androgen receptor positivity (30%). Driven by the antitumor effects of estrogen, we evaluated G-protein-coupled estrogen receptor (GPER) agonist G-1 as a potential therapeutic option for PPGLs and found strong significant antitumor potential, with the strongest efficacy in tumors with NF1 pathogenic variants. Moreover, we detected sex-related differences—tumors from male patients showed significantly stronger responsivity to G-1 compared with tumors from female patients. In GEP-NETs, sex hormones showed overall no effects, especially no tumor growth-promoting effects. Conclusion We provide novel data on the effects of elevated sex hormone levels, potentially seen during pregnancy or hormone replacement therapy, on PPGL/GEP-NET tumor growth. G-1 might offer a novel therapeutic approach for some PPGLs depending on patient’s sex and the individual tumor’s genetic/molecular background. All HNPGLs showed ERα positivity.

Gonadotropin Releasing Hormone Agonists Combined with Hormone Replacement Therapy Significantly Improves Reproductive Outcomes for Patients with Thin Endometrium and Intramural Fibroids in Frozen Embryo Transfer Cycles.

Both intramural myomas and thin endometrium exert a detrimental influence on the outcomes of assisted reproductive technology (ART). The downregulation of gonadotropin releasing hormone agonists (GnRH-a) is regarded as an effective approach to reducing the size of intramural fibroids and enhancing endometrial receptivity. Consequently, we conducted this study to assess whether the GnRH-a combined with hormone replacement therapy (GnRH-a-HRT) can improve reproductive outcomes in frozen embryo transfer cycles for patients with a thin endometrium (≤7 mm) and intramural fibroids. This retrospective cohort study encompassed 360 patients who underwent frozen embryo transfer following in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles. Patients were stratified into three groups based on the endometrial preparation protocol: the natural cycle (NC) group (n=96), the hormone replacement therapy (HRT) group (n=180), and the GnRH-a-HRT group (n=84). The live birth rate (LBR) was designated as the primary outcome, while clinical pregnancy rate (CPR), miscarriage rate, and ectopic pregnancy rate were classified as secondary outcomes. The LBR and CPR in the GnRH-a-HRT group were significantly higher than those in both the HRT group and the NC group (both P < 0.0001). A logistic regression model indicated that the LBR was significantly higher in the GnRH-a-HRT group compared to both the HRT group (odds ratio, 0.269; 95% confidence interval, 0.114-0.637; P = 0.003) and the NC group (odds ratio, 0.524; 95% confidence interval, 0.457-0.956; P = 0.023). Subgroup analyses based on the number and dimension of fibroids demonstrate the positive efficacy of the GnRH-a-HRT regimen. Compared to NC and HRT protocol, improved reproductive outcomes were observed in the GnRH-a-HRT group. These findings provide valuable insights for exploration of the underlying mechanisms by which the GnRH-a-HRT protocol enhances reproductive outcomes in patients of thin endometrium with intramural fibroids.

Decompensated Cirrhosis with Hepatopulmonary Syndrome in a Patient with Interrupted Treatment for Hypopituitarism: A Case Report.

A 32-year-old man presented with cirrhosis. At 8 years of age, he underwent resection of a craniopharyngioma, which resulted in panhypopituitarism. He underwent self-interrupted hormone replacement therapy at 20 years of age. Computed tomography revealed severe fatty liver and cirrhosis. An endocrinological evaluation revealed panhypopituitarism. Further assessment revealed a diagnosis of hepatopulmonary syndrome. Home oxygen therapy and hormone replacement therapy were initiated. Despite these efforts, poorly controlled hypothalamic obesity led to liver failure, and the patient is currently awaiting liver transplantation. Liver cirrhosis associated with long-term panhypopituitarism may have a poor prognosis even with hormone replacement therapy.

Menopausal symptoms in breast cancer survivors on adjuvant endocrine therapy compared with those of menopausal women.

To compare menopausal symptoms of breast cancer survivors on adjuvant endocrine therapy with those of menopausal women. In a retrospective nested case-control study menopausal symptoms were compared of breast cancer survivors in pre-, peri- or post-menopause at the time of diagnosis, on tamoxifen or an aromatase inhibitor, plus a gonadotrophin-releasing hormone analogue, if pre- or peri-menopausal, and age-matched control women either in the late peri-menopause, or in surgical or in physiological post-menopause on no hormone replacement therapy. Differences between women on tamoxifen and those on aromatase inhibitors were also evaluated. Weighted and non-weighted t-tests, chi-square tests, and linear or logistic regressions were applied as appropriate. Score on the Greene's Climacteric Scale and so of its subscales evaluating vasomotor, anxiety, depression, somatisation and sexuality symptoms. A total of 99 breast cancer survivors (45 on tamoxifen, 54 on aromatase inhibitors) and 554 controls (173 in late perimenopause, 353 in natural and 28 in surgical menopause) were enrolled. The score on the Greene's Climacteric Scale was similar in cases and controls (means±standard deviation) (21.3±10.4 vs. 22.8±11.5, p=0.199), as were the subscale scores for vasomotor symptoms, anxiety, and somatisation. The depression score was lower (4.63±3.3 vs. 5.98±3.8; p=0.001) in breast cancer survivors on adjuvant endocrine therapy, mainly due to a lower score of -2.132 (95% confidence interval-3.858/-0.407; p=0.016) for users of aromatase inhibitors. The sexuality score was higher (1.76±1.1 vs. 1.50±1.1, p=0.011) than in controls. Differences remained significant when corrected for age, menarche, body mass index, menopausal status (peri- or post-), type of menopause (natural, surgical), use of gonadotrophin-releasing hormone analogues, years of amenorrhea, smoking, alcohol use, and for breast radiotherapy, chemotherapy, tamoxifen or aromatase inhibitors. Among breast cancer survivors, women on aromatase inhibitors had lower scores for anxiety (5.75±2.5vs.5.75±2.5; p=0.045) and depression (3.89±2.5 vs. 5.13±3.6; p=0.046) than women on tamoxifen. In breast cancer survivors, adjuvant therapy induces symptoms similar in type and intensity to those of symptomatic menopausal women. Compared with menopausal women, breast cancer survivors, particularly those on aromatase inhibitors, appear to experience less severe depressive symptoms.

Treatment of Menopausal Symptoms with Herbal Medicines: A Review

Background: Menopause refers to the natural process of the “cessation of the menstrual cycle.” This phase predominantly affects aged women and can lead to various symptoms such as hot flashes, insomnia, night sweats, and sexual dysfunction, among others. Unfortunately, many women remain unaware of this condition, and some even choose to overlook the symptoms. However, those who recognize the symptoms consult with a doctor, who may recommend Hormone replacement therapy (HRT). Initially, Hormone replacement therapy (HRT) can be effective, but prolonged use can result in side effects. To mitigate these effects, there is a need to explore and investigate herbal therapies as an alternative treatment for menopausal symptoms. Objective: The objective of this review is to explore and summarize various herbs used in managing menopausal symptoms as an alternative to hormone replacement therapy. Methods: For this review, we conducted a literature survey spanning from 1998 to 2023. We used keywords such as menopause, endocrinology, hormone replacement therapy, and herbs used for reducing menopausal symptoms to search databases such as Google Scholar, PubMed, and SciDirect. Relevant data were sourced from various journals like Plos One, JAMA, Frontier, Drug in Context, MDPI, Molecules, BMC Women's Health, Research Gate, Heliyon, Elsevier, Taylor &amp; Francis, Nutrients, JMM, Wiley, OXFORD, Hindawi, Clinical Phytoscience, Pharmaceuticals, Phytomedicine, and Menopause: The Journal of The North American Menopause Society. Results: The literature review encompassed 40 research articles and 200 review articles, including randomized controlled trials. The findings revealed that several herbal plants, including Curcuma longa, Zingiber officinale, Foeniculum vulgare, Trigonella foenum, Actaea racemosa, Glycyrrhiza glabra, Oenothera biennis, Trifolium pratense, Humulus lupulus, Vitex agnus-castus, Valeriana officinalis, Linum usitatissimum, Cannabis sativa, and Asparagus racemosus, have shown efficacy in treating menopausal symptoms. Conclusion: In conclusion, medicinal plants can play a significant role in managing acute menopausal syndrome. The intent of this review is to highlight the most recent research on estrogenic plants for medicinal purposes and their therapeutic impact on cognitive deficiencies brought on by estrogen shortage during menopause and aging.

Managing thyroid hormone replacement after total thyroidectomy: Guidance for family medicine

ABSTRACT Thyroid hormones are among the most prescribed medications to patients worldwide and are commonly used to treat hypothyroidism. Thyroxine is also indicated after total thyroidectomy for Graves’ disease or a multinodular goitre. In this commentary, we discuss and provide guidance for family medicine and primary care clinicians on how to navigate thyroid hormone replacement in patients after total thyroidectomy for cancer.

Hypertriglyceridemia and younger age are associated with effectiveness of growth hormone therapy on hepatic steatosis.

Adult growth hormone deficiency (AGHD) is often accompanied with metabolic dysfunction-associated steatotic liver disease (MASLD). Although some studies reported that MASLD is ameliorated by growth hormone replacement therapy (GHRT), the characteristics of AGHD that are associated with an improvement of hepatic steatosis by GHRT remain unknown. We aimed to investigate whether GHRT affects hepatic lipid accumulation as well as biochemical parameters, and investigated the association between these parameters (UMIN000044989). Thirty people with AGHD were recruited, and assigned to either the GHRT group or the non-GHRT group. Serum laboratory data were analyzed before and after GHRT. Hepatic lipid content was evaluated using magnetic resonance imaging-proton density fat fraction (MRI-PDFF). Correlations between MRI-PDFF and other clinical parameters were investigated. Twenty-nine people completed this study (19 in the GHRT group and 10 in the non-GHRT group). In the GHRT group, significant decreases in MRI-PDFF and serum levels of aspartate aminotransferase, alanine aminotransferase, and γ-glutamyl transpeptidase were observed after the treatment. The decrease in MRI-PDFF levels after GHRT significantly correlated with initial MRI-PDFF, triglyceride (TG), lactate dehydrogenase, and ALT levels, and age. Multiple regression analysis demonstrated that younger age and high serum TG levels were independent predictors of a decrease in MRI-PDFF levels. GHRT in people with AGHD significantly reduced lipid accumulation in the liver on MRI, and improved serum liver parameters. Age and serum TG levels were found to be associated with the effectiveness of GHRT.

Age and Menopausal Status in Idiopathic Subglottic Stenosis.

To evaluate the impact of age on disease recurrence in idiopathic subglottic stenosis (iSGS) patients. This was a retrospective chart review of iSGS patients treated with laser wedge excision. Patients did not have prior surgery. Survival rates free of recurrence were estimated using the Kaplan-Meier methods, and associations were evaluated using Cox Proportional Hazards models. Eighty-five female patients were included in the study. Most patients (68%) were postmenopausal, had first period at or before 13 years of age, had at least one full-term pregnancy (82%), were not undergoing hormone replacement therapy (93%), were not using hormonal birth control (88%), and were either partially or completely compliant with triple therapy regime (80%). There was a statistically significant average reduction in risk of recurrence of 5% for every additional year of age (p < 0.0001). When compared to patients older than 65 years of age, patients less than 35 were nearly 10 times more likely to recur (p = 0.002), and patients 55-65 and 45-55 years of age were 8 and 5 times more likely to recur, respectively (p = 0.003 and 0.009). Additionally, females on birth control showed decreased risk of recurrence of 74% compared with their counterparts (p = 0.04). This is the first study to demonstrate an inverse relationship between age and disease recurrence in patients with iSGS following surgery. Using age as a surrogate for menopausal status, these results suggest that increased age and/or birth control provide a protective effect through decreased recurrence rates, possibly mediated by decreased estrogen levels. 4 Laryngoscope, 135:198-205, 2025.

Utilizing a Combination of Supplements Comprising Boric Acid, Magnesium, Vitamin D3, and Extra Virgin Olive Oil to Improve Metabolism in Menopausal Ovariectomized Rats.

Metabolic syndrome during menopause can lead to diabetes, cardiovascular problems, and increased mortality rates. Hormone replacement therapy is recommended to manage climacteric complications, but it has serious adverse effects. This study, therefore, investigated the potential of supplementing some minerals, vitamins, and natural products like boric acid, magnesium, vitamin D3, and extra virgin olive oil on metabolic status of menopausal ovariectomized rats. Fourty-two female adult rats were randomly assigned to seven groups: a) Sham Control, b) Ovariectomized Control, c) Ovariectomized + Boric acid, d) Ovariectomized + Magnesium, e) Ovariectomized + Vitamin D3, f) Ovariectomized + Extra virgin olive oil, and g) Ovariectomized + Combined treatment groups. Serum inflammatory and oxidative stress markers, serum lipogram pattern, hepatic triglycerides, body weight, fasting blood glucose, serum insulin, leptin, and adiponectin, as well as hepatic insulin signaling cascade, IRS1/pAKT/GLUT4 were measured in each group to assess metabolic function. Results revealed a significant improvement in inflammation, oxidative stress, and metabolic parameters by individual and concomitant treating ovariectomized rats with boric acid, magnesium, vitamin D3, and extra virgin olive oil. Interestingly, the concurrent use of these supplements displayed a better impact than individual use, suggesting their valuable therapeutic potential for managing metabolic syndrome in menopausal women. However, the necessity of all four supplements for optimal therapeutic effects remains unsubstantiated.

Effects of growth hormone replacement therapy in childhood-onset craniopharyngioma: an updated systematic review and meta-analysis.

Craniopharyngiomas (CPs) often lead to growth hormone deficiency (GHD) in children. Growth hormone replacement therapy (GHRT) is essential for managing GHD but its impact on body mass index (BMI) and metabolic outcomes is controversial. Concerns exist that GHRT might contribute to tumor recurrence, with guidelines varying on when to start therapy post-surgery. This updated systematic review and meta-analysis explores the effects and timing of GHRT in children post-craniopharyngioma surgery. We systematically searched PubMed, Embase, and Cochrane Library databases. Included studies compared the effects of GHRT in childhood-onset craniopharyngioma patients who received GHRT versus those who did not. Random-effects meta-analyses were used to pool relative risk (RR) or mean difference (MD) for each outcome. Heterogeneity was assessed using the I² statistic. This study is registered with PROSPERO (CRD42024498082). We included 11 studies in the meta-analysis. No differences in tumor progression/recurrence were found between the GHRT and no GHRT groups (RR 0.77, 95% CI 0.56-1.05, p = 0.10). The impact of timing of GHRT is less clear because of limited data and high heterogeneity. There were no differences in BMI between the GHRT and no GHRT (MD -0.94, 95% CI -1.88,0.00, p = 0.05). Two studies reported that GHRT might improve lipid profiles. Our study suggests that GHRT does not increase the risk of tumor progression/recurrence in CP patients. GHRT can improve linear growth, but its effects on the BMI and lipid profiles remain inconclusive, requiring further studies.