Menopausal Population Research Articles

Supplementation with a Probiotic Formula Having β-Glucuronidase Activity Modulates Serum Estrogen Levels in Healthy Peri- and Postmenopausal Women.

Declines in estrogen levels occur in women transitioning to menopause. Estrogen hormones play important roles in multiple systems of the body, and estrogen loss is associated with a variety of symptoms that can decrease quality of life. The gut microbiota is involved in regulating endogenous estrogen levels. A portion of estrogen glucuronides can be reactivated in the gut by the microbial enzyme β-glucuronidase, and the resulting free estrogens can return to the bloodstream. Here, we carried out in vitro screening of β-glucuronidase activities for 84 strains belonging to 16 different species of lactic acid bacteria and bifidobacteria and found that one and three strains of Levilactobacillus brevis and Lacticasebacillus rhamnosus, respectively, can deconjugate estrogens. Among these strains, L. brevis KABP052 had the highest β-glucuronidase activity. Moreover, in an exploratory, randomized, double-blind, placebo-controlled trial, we demonstrated that serum estrogen levels in healthy peri- and postmenopausal women given a probiotic formula containing KABP052 were maintained over time, whereas levels significantly decreased in the group given a placebo. Significantly higher levels of estradiol (31.62 ± 7.97 pg/mL vs. 25.12 ± 8.17 pg/mL) and estrone (21.38 ± 8.57 pg/mL vs. 13.18 ± 8.77 pg/mL) were observed in the probiotic versus placebo group after 12 weeks of intervention. This clinical study demonstrated for the first time the estrogen modulation capacity of a probiotic formula containing a bacterial strain having β-glucuronidase activity in women during the menopausal transition and formed the basis for future investigations using probiotics in the menopausal population.

Lower Urinary Tract Symptoms in Greek Women After Menopause: The LADY Study.

The genitourinary syndrome of menopause (GSM), apart from symptoms related to vulvovaginal atrophy (VVA), also consists of lower urinary tract symptoms (LUTS). Based on the common embryological origin of the genital and lower urinary system, the presence of estrogen receptors, and the high prevalence of VVA and LUTS in the menopausal population, the two conditions can coexist. This study is aimed at investigating the prevalence and risk factors of LUTS in a sample of Greek peri- and postmenopausal women. Four hundred and fifty (450) women, aged 40-70 years, attending three outpatient gynecology clinics for routine examination, completed a structured interview and responded to a validated questionnaire (International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms, ICIQ-FLUTS). Urinary urgency or frequency affected 51.6% and dysuria 43.6% of the participants. Mild urgency or frequency was described by 25.6%, moderate by 14.4%, and severe by 11.6% of the women. Mild dysuria was reported by 26.26%, moderate by 5.8%, and severe by 11.6%. Age, weight, BMI, and number of pregnancies and abortions correlated with a higher ICIQ-FLUTS score. Women with moderate/severe symptoms of VVA, such as irritation, a burning sensation, and pruritus of the vulva or vagina, had a higher ICIQ-FLUTS score than women without such symptoms (beta coefficient 2.42, CI 1.204, 3.635, p < 0.001). Lower urinary tract symptoms are very common among peri- and postmenopausal women and are linked to symptoms of VVA. Our data support the need for prompt evaluation of women transitioning to menopause, as these symptoms compromise the quality of life.

Labial Adhesions

Labial adhesion is characterized by partial or complete fusion of labia minora or labia majora. It is rare in menopausal women. It is usually a triad of estrogen deficiency, inflammatory skin disorders and lack of sexual activity. Patients are mostly asymptomatic until labial fusion is complete. The most common symptoms are urinary retention and urinary tract infections and incontinence. It is usually diagnosed on examination of external genitalia. The treatment is not well established, owing to low prevalence in menopausal population. The most common methods of treatment are manual separation and surgical excision. Postoperative application of local estrogen cream is vital to prevent recurrence.

Evaluation of the Everyday Memory Questionnaire-Revised in a menopausal population: understanding the brain fog during menopause.

Brain fog (ie, memory complaints and concentration difficulties) is frequently reported during the menopausal transition. There is lack of standardized scales available to measure brain fog across the menopausal transition. This study aimed to evaluate the factor structure of the Everyday Memory Questionnaire-Revised (EMQ-R) and to determine the most commonly reported everyday cognitive symptoms in a menopausal population. Four hundred seventeen eligible women aged from 40 to 60 years (107 premenopausal, 149 perimenopausal, and 161 early postmenopausal) were recruited from the general community and were included in the analyses. Confirmatory factor analysis was conducted to test the model fit of the bifactor structure (ie, 4-item attentional subscale ranged 0-16, 7-item retrieval subscale ranged 0-28) of the 13-item EMQ-R (ranged 0-52) in a menopausal populations. Typical items in the retrieval subscale include "difficulty finding words," the attentional subscale include "difficulty following the thread of a story," and analysis of variance and multivariate analysis of covariance were used to investigate the group differences of individual items and two subscales. Confirmatory factor analysis indicated the bifactor structure of the EMQ-R has a good fit in all three groups. A significant difference was identified in the mean retrieval scores (pre: 11.8, peri: 13.6, early post: 11.7) but not in the mean attentional scores (pre: 4.53, peri: 5.01, early post: 4.65). The EMQ-R retrieval subscale may serve as a potential instrument to assess memory retrieval symptoms that contribute to "brain fog" in menopause. Increased memory retrieval complaints reported by the perimenopausal group suggests a transition-related memory retrieval dysfunction during menopausal transition.

Cytomorphological Variations in Pap Smears amongst Postmenopausal Women Reporting at a Tertiary Care Centre, Tamil Nadu, India

Introduction: In developing countries, cervical cancer is the leading cause of death amongst women. Since women spend one third of their lives in the postmenopausal period, which is most neglected phase, needs a technically simple, non invasive and, cost-effective screening tool for cervical cancer detection and the exact answer is the Pap smear screening test. This simple screening test when performed at regular intervals in post menopausal population, can detect precursor lesions there by reducing cervical cancer morbidity and mortality. Aim: This study was undertaken to evaluate the cytomorphological variations in Pap smears amongst postmenopausal women. Materials and Methods: In this prospective study, a total of 138 satisfactory smears were considered for study amongst 146 postmenopausal women from August 2020 to July 2022 at Bhaarath Medical College and Hospital and then evaluated and categorised based on Bethesda system for reporting cervical cytology 2014. {Reporting elements include specimen type, specimen adequacy, general categorisation, interpretation/result includes general categories of negative for Intraepithelial Lesion or Malignancy (NILM), epithelial cell abnormalities and other malignancies. Results: Out of 138 satisfactory cases, 78.26% (108 cases) 14.5% (20 cases) and 7.24% (10 cases) were diagnosed as of inflammatory/benign conditions, epithelial abnormalities and normal cytology respectively. The mean age for inflammatory/ benign lesions was 57.5 years and majority presenting with postmenopausal bleeding and white discharge. Amongst epithelial abnormalities Atypical Squamous Cells of Undetermined Significance (ASCUS) and Low-grade Squamous Intraepithelial Lesions (LSIL) were commonest. The incidence of ASCUS 7.27% (10 cases), and incidence of LSIL 2.89% (4 cases). The mean age was 57.5 years and majority of patients presented with postmenopausal bleeding and mass per vaginum. Incidence of High grade Squamous Intraepithelial Lesion (HSIL) was 2.17% (3cases), the mean age was 65.5 years and presented with white discharge and postmenopausal bleeding. Incidence of SCC was 2.17% (3 cases) and the mean age was 70.5 years, presented with, postmenopausal bleeding and white discharge. Conclusion: Pap smear is a simple, cheap, safe and gold standard diagnostic tool for screening postmenopausal women for all cervical abnormalities in particular pre-invasive and invasive lesions.

Hormone replacement therapy prescribing in menopausal women in the UK: a descriptive study.

Recent studies on the prescribing of hormone replacement therapy (HRT) medicines to treat symptoms of menopause are lacking. To describe the prescribing of HRT in a cohort of UK menopausal women. Population-based drug utilisation study using IQVIA Medical Research Database (IMRD-UK). Primary care data of women with recorded menopause and/or aged ≥50 years between January 2010 and November 2021 were extracted from the database. The incidence rate of women who received their first prescription for HRT was calculated annually using person-years-at-risk (PYAR) as the denominator. Incidence rates of HRT were estimated by type and route of administration. Relative changes in annual incidence rates were expressed as percentages and the average percentage change was assessed using linear regression. Annual prescribing prevalence per 100 women was calculated using mid-year menopausal population estimates. The incidence rate of prescribing of HRT increased from 5.01 in 2010 to 18.16 per 1000 PYAR in 2021, a relative increase of 13.64% (95% confidence interval [CI] = 6.97 to 20.30) per year. The incidence rate of fixed combinations of HRT increased from 3.33 to 12.23 per 1000 PYAR in 2010 and 2021, respectively. Transdermal formulations of HRT increased from 1.48 to 14.55 per 1000 PYAR in 2010 and 2021, respectively. The overall proportion of women in receipt of a prescription for HRT changed from 7.89% in 2010 to 6.86% in 2020. This study shows a steady increase in the number of women receiving their first prescription for HRT during the study period, which suggests regained acceptance of HRT medicines.

Use of Hormone Therapy in Women with Early Menopause and Premature Ovarian Insufficiency.

Women with early menopause or primary ovarian insufficiency (POI) experience a menopausal state a decade or more earlier than their peers. The health consequences for POI are vast and varied with detrimental effects seen on neurological, psychological, bone, and cardiovascular systems. The risk profile of POI patients requires special attention, as they differ from a typical menopausal population. This review will explore the health risks associated with POI and examine the various treatment options and also the risks associated with hormone therapy. Given the risks and benefits, POI patients should be strongly encouraged to start hormone therapy until the median age of menopause.

Attitude and knowledge for menopause management among health professionals in mainland China

Objective This study aims to understand the attitude of health-care professionals (HPs) in mainland China toward menopause management (MM) as well as the knowledge they have received regarding MM during training. Methods An anonymous survey recruited 3709 medical workers nationwide (including physicians, orthopedists, obstetricians and gynecologists, and general practitioners) through online surveys and on-site interviews at professional meetings. Results Of the 3709 questionnaires completed, 3426 questionnaires met the inclusion criteria. Of the participants, 1532 HPs had not received menopause management training (MMT) in nearly 1 year. Among the residents and physician assistants, 103 reported they were not familiar with MM. Satisfyingly, 98.3% of HPs considered it very important or essential to accept MM. Although most interviewees replied some correct menopausal knowledge, nearly half of them could not correctly identify the contraindications for menopause hormone therapy (MHT). Additionally, 73.1% of HPs would advise patients with premature ovarian insufficiency to receive hormone replacement therapy at least until the average age of menopause. Conclusion This survey indicated that HPs have some knowledge regarding MM, but a gap remains to master the basic theory of MHT. In order to manage the growing menopausal population in China, creating more in-depth educational MMT programs for HPs is necessary.

No association between postmenopausal time and the prevalence of newly discovered asymptomatic intracranial atherosclerotic stenosis: The APAC study

IntroductionAsymptomatic intracranial atherosclerotic stenosis (AICAS) is a common cause of stroke. Elderly women were more likely than men to develop AICAS, although it indicated that a lifelong exposure to estrogen could lower the risks of cardiovascular disease (CVDs). ObjectiveThe present study aims to ascertain whether postmenopausal time is a risk factor of AICAS. Fostering a correct perception of menopause is of great significance for the overall well-being of the elderly women. MethodsAll participants received a questionnaire, physical examination, laboratory testing and transcranial Doppler. The menopausal population (n = 701) was divided into three groups by tertiles of postmenopausal time. Two-tailed testing and trend test were used to reveal the relationship between postmenopausal time and newly discovered AICAS. Other potential risk factors were also analyzed to ascertain whether there was a relation between postmenopausal time and the newly discovered ICAS. ResultsBoth mean age and mean postmenopausal time were gradually increased from G0 to G2. The same trend occurred in hypertension, diabetes mellitus, total cholesterol, triglyceride, C-reactive protein and serum homocysteine. Adjusting for various confounding factors, postmenopausal time was not a risk factor for newly discovered AICAS. Multifactor analysis and stratifying analysis showed no correlation between newly discovered AICAS and postmenopausal time. ConclusionsPostmenopausal time is not an independent risk factor of AICAS. No relationship was detected between postmenopausal time and newly discovered AICAS, while vigorous control of body weight, blood pressure/glucose/lipids and smoke cessation are vital for preventing the occurrence of AICAS.

A Cross-Sectional Study to Assess the Quality of Life of Perimenopausal and Post menopausal Women in Rural Etawah, Uttar Pradesh, India.

Background:Perimenopause is the period in a woman's life during which she passes from the reproductive to the nonreproductive stage. According to the 2008 estimates, the number of menopausal women in India was 43 million. Projected values in 2026 depict the menopausal population at 103 million. Due to the increasing life expectancy, improved quality of life is imperative to decrease the disability and frailty of a society.Objectives:To study the quality of life of perimenopausal women in rural areas of Etawah district, Uttar Pradesh, and the various factors associated with it.Materials and Methods:This is a community-based cross-sectional study conducted in 4 villages in the Saifai block of Etawah district, Uttar Pradesh, India. One hundred and ninety-nine healthy, perimenopausal women of the age group 45–55 years were included in the study. Data were collected on sociodemographic variables, and Menopause Specific Quality of Life Questionnaire - Intervention version questionnaire was used to assess the quality of life.Results:The mean age of attainment of menopause was 45.38 ± 3.58 years. Majority of the women experienced physical (100%) and psychosocial (94.5%) symptoms; the most common symptom being “decrease in physical strength” (86.4%) and being able to “accomplish less than previously” (80.4%). Women who handled stress poorly showed severe vasomotor (P = 0.047) and psychosocial (P = 0.014) symptoms. Postmenopausal women who regularly exercised were 52.6% less likely to have vasomotor symptoms (odd's ratio OR 0.474 (0.235–0.960), P = 0.038).Conclusion:The quality of life among the study population was affected by the physical and psychosocial problems they experienced. By taking appropriate preventive measures, these can be ameliorated, and further deterioration can be checked.

Tea Seed Oil Prevents Obesity, Reduces Physical Fatigue, and Improves Exercise Performance in High-Fat-Diet-Induced Obese Ovariectomized Mice.

Menopause is associated with changes in body composition (a decline in lean body mass and an increase in total fat mass), leading to an increased risk of metabolic syndrome, nonalcoholic fatty liver disease, and heart disease. A healthy diet to control body weight is an effective strategy for preventing and treating menopause-related metabolic syndromes. In the present study, we investigated the effect of long-term feeding of edible oils (soybean oil (SO), tea seed oil (TO), and lard oil (LO)) on female ovariectomized (OVX) mice. SO, TO, and LO comprise mainly polyunsaturated fatty acids (PUFA), monounsaturated fatty acids (MUFA), and saturated fatty acids (SFA), respectively. However, there have been quite limited studies to investigate the effects of different fatty acids (PUFA, MUFA, and SFA) on physiological adaption and metabolic homeostasis in a menopausal population. In this study, 7-week-old female Institute of Cancer Research (ICR) mice underwent either bilateral laparotomy (sham group, n = 8) or bilateral oophorectomy (OVX groups, n = 24). The OVX mice given a high-fat diet (HFD) were randomly divided into three groups: OVX+SO, OVX+TO, and OVX+LO. An HFD rich in SO, TO, or LO was given to the OVX mice for 12 weeks. Our findings revealed that the body weight and relative tissues of UFP (uterus fatty peripheral) and total fat (TF) were significantly decreased in the OVX+TO group compared with those in the OVX+SO and OVX+LO groups. However, no significant difference in body weight or in the relative tissues of UFP and TF was noted among the OVX+SO and OVX+LO groups. Furthermore, mice given an HFD rich in TO exhibited significantly decreased accumulation of liver lipid droplets and adipocyte sizes of UFP and brown adipose tissue (BAT) compared with those given an HFD rich in SO or LO. Moreover, replacing SO or LO with TO significantly increased oral glucose tolerance. Additionally, TO improved endurance performance and exhibited antifatigue activity by lowering ammonia, blood urea nitrogen, and creatine kinase levels. Thus, tea seed oil (TO) rich in MUFA could prevent obesity, reduce physical fatigue, and improve exercise performance compared with either SO (PUFA)- or LO(SFA)-rich diets in this HFD-induced obese OVX mice model.

Incidence, Characteristics, Risk Factors, and Outcomes of Takotsubo Cardiomyopathy With and Without Ventricular Arrhythmia

Takotsubo cardiomyopathy (TC) is a medical entity mimicking an acute coronary syndrome (ACS). Ventricular arrhythmia (VA) in TC has been reported in small studies, leading to uncertain knowledge of its incidence. We sought to describe the characteristics, incidence, predictive factors, and outcomes of VA in patients presenting with TC. Over a 12-year period, we reviewed all patients (n= 5,484) referred to our coronary care unit for a suspicion of ACS. TC was diagnosed in 90 patients according to the Mayo Clinic criteria. Incidence of VA among TC was 10%. In multivariate analysis, the factors significantly associated with an increased risk of VA were syncope (p= 0.007), age <55years (p= 0.008), atypical TC (p= 0.04), a troponin I peak >7μg/L (p= 0.04), and dobutamine use during hospitalization (p= 0.04). During follow-up, there was no significant difference in mortality rate between patients with or without VA. In conclusion, VA occurred in 10% of patients at the acute phase of TC and independent predictive factors of VA were syncope, atypical pattern of TC, high troponin peak, dobutamine use, and a relatively young age in a female and menopausal population. During the acute phase, identification of high-risk patients with VA allows better management, with electrocardiographic monitoring and therapeutic intervention in the coronary care unit.

Circulating Serotonin as Bone Remodelling Marker in Women

The bone remodelling represents a physiological reparative process which is constant into the human body. The underlying aspects include osteoclasts activity (for instance areas of bone are resorbed) and osteoblasts activity that fill with new bone the resorbed zones (bone formation). Normally there is a balance between these two mechanisms. By this continuum a major contribution to the quality of bone is achieved[1,2]. The bone turnover is influenced by age: in time resorption become more pronounced that bone formation causing a net loss of bone, and thus damaging the skeleton integrity. In women a secondary factor is essential: the timing of menopause and the consecutive exposure to estrogens deficiency[2,3]. Overall the bone quality suffers by affecting the micro-architecture, decreasing the mineralisation and increasing the cortical porosity[3,4]. The process of remodelling is best assessed by bone markers levels. They are biochemical parameters with blood or urinary assay that offer to the clinician a rapid and facile clue regarding the bones turnover status (see Figure 1)[5,6]. They predict the fracture risk especially in some menopausal population but the references levels still vary so a specific pattern cannot actually be predicted[5,6]. Some persons with menopausal osteoporosis may have normal bone markers while others display a high status of bone turnover bio-markers. The data regarding the correlation to bone mineral density as assessed by central DXA (Dual Energy X-Ray Absorptiometry) are heterogeneous but usually in subjects with osteoporosis higher bone resorbtion markers are found compare to control group[7]. Overall the biochemical markers are not recommended for the diagnosis of osteoporosis by any guideline. They may become useful in follow-up the patients who started anti-osteoporotic drugs especially if they had a high values at the beginning of therapy[5,6,7]. An extended usefulness is seen in clinical trials in order to express the medication effects. However the routine use in not recommended and the intra-individual variations are difficult to “translate” in everyday practice[5,6,7].

Marketing and its Role in Competitive Menopause Market: A Review

Marketing plays a key role in enhancing business performance. Even an unimpeded condition like Menopause has not been able to be free from marketing influence. Menopause is the most striking event occurring during the middle age in women. It can be defined as the time when there has been no menstrual period for 12 consecutive months and no other biological or physiological cause can be identified. It is the end of fertility, the end of childbearing years. Menopause has wider implications than simply loss of fertility. It sets the stage for ageing. Menopause indicates that ovaries are no more functional & hence results in low Estrogen levels in the women’s body. Pharma Companies are, hence, utilising this gap of “low Estrogen levels” to market various Estrogen Brands. The total Estrogen market stands at 38 Cr & there is a growth spurt with introduction of newer brands in the last 2 years. The social shift from viewing Menopause as a natural period to adjustment to one of the deficient conditions can be attributed to Estrogen or Menopause Marketing. The number of menopausal women in India is around 43 million. In 2026 experts have estimated the population in India will be around 1.4 billion, people over 60 years will be 173 million, and the menopausal population will be 103 million. This population estimate indicates that Estrogen Marketing can be the next big thing even in Country like India where Menopause has always been a hidden, un-discussed phase of women’s life.

Effect of Circuit Training on Menopausal Symptoms and Quality of Life

Objective To determine the effect of an 8-week circuit training program on menopausal symptoms and quality of life (QOL). Study Design Pre- to posttest of convenience. Background Because of recent findings regarding the adverse effects of hormone therapy, nonpharmacological treatments are being explored for managing menopausal symptoms and decreased QOL associated with this transitional period. Several studies have demonstrated the benefits of aerobic or resistance exercises on the menopausal population. Methods and Measures Twelve perimenopause and postmenopausal women (mean age, 54.8 years) underwent an 8-week circuit training program at a local fitness center in southern New Jersey. Menopausal symptoms and QOL were monitored via pre- and posttest administration of the Menopause Specific Quality of Life Intervention Questionnaire (MENQOL-Intervention). Physical activity level was evaluated using Baecke's Questionnaire of Habitual Physical Activity. Muscular strength, endurance, and flexibility were evaluated using physical tests. Anthropometric measurements were recorded to assess body composition. Results Statistical significance was observed in the physical domain of the MENQOL-Intervention (P [SUPERSCRIPT EQUALS SIGN] .008) but not in the vasomotor, psychosocial, and sexual domains. An increase in muscle strength, endurance, and flexibility was observed post-circuit training for each of the modified Push-up Test (P [SUPERSCRIPT EQUALS SIGN] .04) and Sit and Reach Test (P [SUPERSCRIPT EQUALS SIGN] .006). However, statistical significance was not seen in the other physical tests: curl-up, body fat percentage, and Baecke's Questionnaire. Conclusion Circuit training may be a helpful strategy for menopausal women who experience menopausal symptoms and decreased QOL. Physical therapists treating menopausal women should consider circuit training as an intervention or lifestyle recommendation.

The Relationships Between Current and Past Physical Activity Participation and Low BMD in a Mixed Menopausal Population

The Relationships Between Current and Past Physical Activity Participation and Low BMD in a Mixed Menopausal Population

The prevalence and pattern of gastroesophageal reflux symptoms in perimenopausal and menopausal women

To determine the prevalence and describe the pattern of gastroesophageal reflux disease (GERD) symptoms in premenopausal-, perimenopausal-, and menopausal-age women. Three tools were used to collect data: the Menopause Rating Scale, a standardized, self-administered 11-item scale that assesses the presence of menopausal symptoms and their impact on quality of life; the Gastrointestinal Symptom Rating Scale, a standardized, self-administered 15-question survey that inquires about both lower and upper gastrointestinal (GI) symptoms; and the Reflux Disease Questionnaire (RDQ), a self-administered 14-question survey currently being evaluated in the United States as a specific diagnostic tool for GERD that specifically addresses upper GI symptoms of discomfort. Additionally, GERD were correlated with vasomotor, vaginal, genitourinary, and other menopausal symptoms using multiple regression analysis to assess the relationships between GERD and menopausal symptoms. Approximately 497 women between the ages of 25 and 60 years completed the surveys. The prevalence of GERD symptoms was high in this sample. Almost 42% of perimenopausal and 47% of menopausal participants complained of upper GI symptoms. Although perimenopausal and menopausal women had higher percentages of GERD diagnosis as compared to premenopausal women, 80% of the perimenopausal and menopausal groups had never been diagnosed with an upper GI disorder. A post hoc analysis of RDQ results demonstrated that patients with menopause had significantly more upper GI discomfort. Overall, this study found that menopausal women were 2.9 times more likely to have GERD symptoms. These findings are strongly suggestive of a hormonal link between perimenopausal and menopausal states and increasing GERD symptoms. Women of all ages should be screened for symptoms of GERD, especially in the perimenopausal and menopausal population of women because diagnosis of GERD is often not made or misdiagnosed. The impact on the quality of life of women experiencing GERD symptoms cannot be underestimated.

Effects of topical DHEA on aging skin: A pilot study

Objectives Dehydroepiandrosterone (DHEA) is a steroid hormone involved in physiological aging. When administered by oral route, it has been shown to positively affect skin condition on aged people. The purpose of this pilot study was to observe the in vivo effects on skin aging of topical DHEA (1%). Methods The DHEA formulation (1%) or the vehicle was topically applied for 4 months to facial and hand skin, in two groups of 20 post-menopausal women. The efficacy of the treatment was evaluated on the basis of clinical and biophysical signs linked to skin aging. Results We showed that DHEA treatment increased the rate of sebum, which was perceived rather positively by a menopausal population usually affected with a declining sebum level. Topical DHEA tends to improve skin brightness, to counteract papery appearance of skin and epidermal atrophy, a characteristic feature of hormone-related skin aging. Topical DHEA could also act on skin process related to wrinkles, but this result remains to be confirmed. Conclusions This pilot study showed beneficial effects on skin characteristics that are rarely provided by topical treatments. It raised some interesting clues towards the treatment of skin aging.

Treatment of hot flushes in breast and prostate cancer

Hot flushes, the most common health problem reported by menopausal-age women, can lead to significant morbidity and affect the social life, ability to work and sleep pattern of the sufferer. Women treated for breast cancer and men receiving androgen ablation for prostate cancer experience hot flushes that are more frequent, severe and longer lasting than those experienced by the general menopausal population. In women with breast cancer, hot flushes can result from chemotherapy-induced menopause, hormonal therapy, or ovarian suppression. In men with prostate cancer, hot flushes occur after surgical or medical castration. Hormone replacement therapy with oestrogen-based compounds has been a mainstay of treatment for hot flushes during the perimenopausal period. However, recent studies have shown that, in healthy menopausal women, hormone replacement therapy is associated with an increased risk of breast cancer, myocardial infarction, thrombo-embolic events and stroke. Thus, identifying nonhormonal agents that can control hot-flush symptoms is essential to the quality of life of a growing population of cancer survivors. The most promising agents act on the CNS and include selective serotonin reuptake inhibitors, as well as venlafaxine and gabapentin.

Assessment of Insulin Sensitivity from Measurements in the Fasting State and during an Oral Glucose Tolerance Test in Polycystic Ovary Syndrome and Menopausal Patients

Polycystic ovary syndrome (PCOS) and menopausal subjects are characterized by an increased cardiovascular and type 2 diabetes mellitus risk, at least partially related to insulin disturbances. The evaluation of insulin resistance in these patients could be useful as primary prevention. The aim of the study was to verify the validity of several indexes of insulin sensitivity in PCOS and menopausal subjects by comparing the data obtained by these indexes to those of euglycemic-hyperinsulinemic clamp studies. One hundred PCOS and 110 menopausal subjects were analyzed; all subjects underwent an oral glucose tolerance test (75 g) and euglycemic-hyperinsulinemic clamp study. Seven PCOS patients and 13 menopausal subjects had impaired glucose tolerance or type 2 diabetes mellitus and were excluded from the study. After analysis of correlation coefficients between the evaluated indexes and the clamp studies, the sensitivity and specificity of different cut-off values for each parameter were analyzed by receiver operating characteristic (ROC) curves. The best correlation coefficients with clamp studies were obtained with the Avignon insulin sensitivity index (SiM) (R(s) = 0.7812) in PCOS patients and the Matsuda and De Fronzo index (R(s) = 0.6178) in menopausal patients. The best predictive index of insulin resistance in PCOS was a Avignon insulin sensitivity basal index (SibB) value of 62 or less (78% sensitivity, 95% specificity) and an insulin area under the curve (AUC) of 7,000 microIU/ml or more (>/=50,225 pmol/liter) x 120 min (83% sensitivity, 90% specificity). In the menopausal population, the best predictive performance was obtained by an insulin AUC of 10,000 microIU/ml or more (>/=71,750 pmol/liter) x 240 min (70% sensitivity, 88% specificity). The presence of high correlation coefficients does not necessarily mean that the indexes of insulin resistance have an optimal predictive performance; this is probably due to the presence of many borderline values. The simple evaluation of insulin AUC seems to effectively replace the euglycemic-hyperinsulinemic clamp in routine clinical practice, allowing results superimposable to those obtained by minimal model analysis.