Menopausal Symptoms Research Articles

A Dedicated Menopausal After Cancer Clinic May Improve Adherence to Endocrine Therapy For Breast Cancer: A Population Based Study

PurposeTo examine utilization of a dedicated menopause symptoms after cancer clinic (MSAC) and to determine whether women referred to the MSAC for management of severe hot flush symptoms are more likely to adhere to endocrine therapy compare to those with severe symptoms not referred to MSAC. Patients and methodsBreast cancer patients prescribed endocrine therapy with a diagnosis of estrogen-receptor positive breast cancer between January 2003 and December 2011 were identified from the Royal Perth Hospital Breast Unit database. Details of breast cancer pathology, endocrine therapy, endocrine therapy related side effects, referral to MSAC and patient reported adherence to endocrine therapy for up to 4 years were ascertained from the database and medical records systems. For those with severe vasomotor symptoms, total duration of endocrine therapy was compared between women referred to MSAC and those who were not referred to MSAC. ResultsAbout 1275 women were identified from the database, with the cohort followed up until Dec 2016. Of these women, 120 (9.4%) were referred to MSAC and 1155 (90.1%) received usual care. In total, 147 reported severe vasomotor symptoms of whom almost half (71) were referred to MSAC. Women with severe vasomotor symptoms managed by MSAC were less likely to discontinue endocrine therapy (15.5%) compared with those managed with usual care (26.3%). However, this difference was not statistically significant (chi-square test statistic = 2.584, 1df, P = .1). ConclusionManagement of severe vasomotor symptoms at a dedicated menopause clinic may increase adherence to endocrine therapy for breast cancer.

Exploring Factors Related to Menopausal Symptoms in Middle-aged Women: A Study of Body Composition, Physical Fitness, and Physical Activity

Exploring Factors Related to Menopausal Symptoms in Middle-aged Women: A Study of Body Composition, Physical Fitness, and Physical Activity

Menopausal Symptoms and Quality of Life Among Women in Rural and Urban Communities of North-West Nigeria

Introduction: Menopause is a significant life milestone in women as they age. It affects Quality of Life, causing physical, cognitive, emotional, and social challenges. The aim of this study was to document Menopausal Symptoms and Quality of Life among menopausal Women in Kaduna, Northwest Nigeria. Materials and Methods: This was a cross-sectional study conducted among menopausal women using questionnaires to assess socio-demographics, reproductive histories, perceptions of symptoms and quality of life. The Utian QoL questionnaire (UQoL) and menopause rating scale (MRS) were used. Data was analyzed using IBM Statistical Product and Service Solution version 26.0. Results: Four hundred twenty women were recruited. Total MRS score was 15.38 ± 6.02 with mean scores of 5.61 ± 2.63 somatic, 5.23 ± 2.33 psychological, and 3.56 ± 2.47 sexual domains. Sleep problems (99.8%), physical and mental fatigue (85.2%), joint and muscular pain (82.4%) and sadness (82.1%) were the commonest symptoms. Linear regression of MRS indicated significant association with pregnancies and births (p = 0.011 and 0.022). The overall UQOL was 85.53 ± 12.77. Zero parity and no education were associated with lower UQOL score (p = 0.011 and p = 0.001 respectively). Marriage was associated with a greater UQOL (p = 0.001). Presence of Menstrual related symptoms predicted poor health and sexual UQOL. Conclusion: Prevalence of menstrual related symptoms was quite high and its presence predicted poor Qol. Menopausal women should receive information about symptoms, treatment options, and lifestyle adjustments from healthcare workers to improve their quality of life.

Examining The Relationship Between Menopausal Symptoms and Burnout Due To The COVID-19 Pandemic: A Cross-Sectional Study

Objective: In the first five years of menopause, women experience menopausal symptoms intensely. During this period, many factors affect the menopause process. This study was conducted to examine the relationship between coronavirus burnout and women's menopausal symptoms in the COVID-19 pandemic. Methodology: The cross-sectional descriptive study was conducted between 20 April and 30 May 2021. The sample of the study consisted of 286 women who had entered menopause and had not completed their first five years. Data were collected using the “Menopause Symptoms Evaluation Scale” and “Coronavirus Burnout Scale”. The research was obtained using snowball sampling method and online questionnaires. Results: The mean age of the women participating in the study was 51.17±4.69, the age of menopause was 48.26±4.52, It was determined that the total score average of the Coronavirus Burnout Scale was 31.16±9.04, and the total score average of the Menopausal Symptoms Assessment Scale was 23.17±6.07. Coronavirus Burnout Scale mean total score and Menopause Symptoms Evaluation Scale (r=0.212, p=0.000), Somatic Complaints Sub-Dimension (r=0.188, p=0.001) and Psychological Complaints Sub-Dimension (r=0.222, p=0.000) was found to be positively correlated with the total score. Conclusion: It was found that the severity of corona virus-related burnout and menopausal symptoms of women during the pandemic period was above medium. It was observed that as the burnout due to the Coronavirus increased, the complaints of menopausal symptoms increased.

A study on prevalence of insomnia among middle aged women attending a tertiary care hospital, West Bengal

Background: Insomnia is one of the common but neglected conditions seen in family practice. During the menopausal transition, significant sleep disruptions are provoked by sleep disorders. Insomnia is estimated to affect up to 30% of the general population and women are almost twice as likely as men to develop it. Objective was to find the prevalence of insomnia among middle-aged women. Methods: This descriptive, cross-sectional study was done for 3 months at general OPDS and IPDs of a tertiary care hospital among 40-60-year-old women fulfilling inclusion criteria. The sampling technique was convenience sampling. Data were analyzed using Microsoft Office Excel and analyze by SPSS version 25. Results: Of 310 participants, 45% had insomnia based on AIS-8. The maximum number of study participants fall under the age group of 40-45 years (33.23%) and under the socio-economic group lower-middle class (25.81%) according to the modified B. G. Prasad scale. Conclusions: The study concludes a significant occurrence of insomnia in middle-aged women in addition to menopausal symptoms. Implementation of appropriate health educational programs for preventing insomnia in such women is necessary.

Brief Report: Under-Identification of Symptomatic Menopause in Publicly-Insured Autistic People.

Menopause is a normal part of aging and in the general population is associated with chronic conditions that impact health, mortality, and well-being. Menopause is experienced differently by autistic individuals, although no studies have investigated this topic in a large sample. The purpose of this study was to investigate rates of, and factors associated with symptomatic menopause among autistic individuals and to identify the prevalence of co-occurring conditions in symptomatic individuals.We included autistic females aged 35-70years enrolled for 10 + months in 2014-2016 Medicare and/or Medicaid (n = 26,904), excluding those with gender dysphoria. Those with symptomatic menopause were compared to a non-symptomatic reference group on demographic, enrollment characteristics, and co-occurring conditions through logistic regression.Approximately 4% of publicly-insured autistic females aged 46-70years had symptomatic menopause in their medical records. Intellectual disability was associated with a lower likelihood of symptomatic menopause, and being Medicare-enrolled or dual-enrolled was associated with higher likelihood of having symptomatic menopause recorded. In adjusted models, rates of ADHD, anxiety and depressive disorders, headache/migraine, altered sensory experiences, altered sexual function, and sleep disturbance were significantly higher in the symptomatic menopause sample compared to the reference group.More work to better support autistic women in discussing menopausal symptoms and co-occurring conditions with primary care providers is needed, particularly among those for whom self-report of symptoms are more challenging to ascertain. Factors associated with specific types of health care coverage warrant greater investigation to support better identification.

Impact of physical activity on menopausal symptoms and health in middle-aged women

The aim of this article is to review and analyze what is known about the effects of physical activity on the physical and mental health of menopausal women, and to summarize general recommendations for women at this time. Studies show that physical activity can lead to a reduction in the severity of symptoms associated with menopause. The enhanced quality of life is also due to the beneficial effects of physical activity on a woman's metabolism. Regular exercise leads to a normalization of lipid metabolism, a reduction in body fat, an improvement in bone density and, therefore, the avoidance of osteoporosis.

Homozygosity for a stop-gain variant in CCDC201 causes primary ovarian insufficiency

Age at menopause (AOM) has a substantial impact on fertility and disease risk. While many loci with variants that associate with AOM have been identified through genome-wide association studies (GWAS) under an additive model, other genetic models are rarely considered1. Here through GWAS meta-analysis under the recessive model of 174,329 postmenopausal women from Iceland, Denmark, the United Kingdom (UK; UK Biobank) and Norway, we study low-frequency variants with a large effect on AOM. We discovered that women homozygous for the stop-gain variant rs117316434(A) in CCDC201 (p.(Arg162Ter), minor allele frequency ~1%) reached menopause 9 years earlier than other women (P = 1.3 × 10−15). The genotype is present in one in 10,000 northern European women and leads to primary ovarian insufficiency in close to half of them. Consequently, homozygotes have fewer children, and the age at last childbirth is 5 years earlier (P = 3.8 × 10−5). The CCDC201 gene was only found in humans in 2022 and is highly expressed in oocytes. Homozygosity for CCDC201 loss-of-function has a substantial impact on female reproductive health, and homozygotes would benefit from reproductive counseling and treatment for symptoms of early menopause.

Neurokinin receptor antagonists as potential nonhormone treatments for vasomotor symptoms.

Managing menopause symptoms is challenging for women unable or unwilling to take hormone therapy. All nonhormone options thus far have shown less overall efficacy compared with hormone therapy and significant adverse events that limit their use. New science has identified the source of vasomotor symptoms, achieving relief of these bothersome symptoms by directly targeting the neurokinin 3 receptor and its related pathways. This Practice Pearl reviews the clinical data available on neurokinin receptor antagonists.

Study protocol for the ROLEX-DUO randomised placebo-controlled trial: ROmosozumab Loaded with EXercise – DUal effects on bone and muscle in postmenopausal Osteoporosis and Osteopenia

IntroductionNovel strategies are needed to address the rising burden of osteoporosis and fragility fractures. High-intensity resistance and impact (HiRIT) exercise has shown benefit in improving bone density in postmenopausal women...

Therapeutic Potential of Water Chestnut Fruit Extract (Trapa bicornis) against Ovariectomy-Induced Climacteric Symptoms in Mice

Climacteric symptoms, as well as postmenopausal estrogen deficiency, have been associated with many psychological problems and the risk of osteoporosis and heart disease. Therefore, in this study, we aimed to evaluate, for the first time, the dose-dependent effect of water chestnut (WC), also known as Trapa bicornis, a fruit extract, on ovariectomy (OVX)-induced menopause in ICR mice. After bilateral OVX surgery, 200, 100, and 50 mg/kg of WC and 200 mg/kg of pomegranate concentrate powder (PCP) were administered orally for 84 days from 4 weeks after OVX operation. Then, anti-climacteric activities were evaluated in five groups: (1) estrogenic, (2) anti-obesity, (3) hypolipidemic, (4) hepatoprotective, and (5) anti-osteoporosis effects. Different biochemical assays, histopathological and morphological inspections, and mRNA expression findings showed that OVX-induced estrogen deficiency-related AMPK decrease was associated with climacteric symptoms such as obesity, hyperlipidemia, hepatic steatosis, and osteoporosis in ICR mice. However, these climacteric effects were reversed in OVX rats by treating them with WC at a dose relative to the same dose of PCP in OVX-ICR mice (200 and 100 mg/kg). Water chestnut fruit extract demonstrated promise as a complementary treatment for menopausal symptoms, indicating possible uses in the health of women through supplements or prescription drugs.

Efficacy of cognitive behavioral therapy for menopausal symptoms and quality of life in Korean perimenopausal women: A pilot randomized controlled trial

ObjectivesTherapeutic interventions are crucial for perimenopausal women, given the challenging physical and psychological symptoms they face. This study focused on the development and verification of the efficacy of a cognitive behavioral therapy (CBT) protocol designed specifically for Korean perimenopausal women. Study designA CBT protocol for perimenopausal women was newly developed based on theory and evidence. Forty menopausal women were randomly assigned to either the CBT group (n = 19) or treatment-as-usual (TAU) group (n = 21). Participants in the CBT group underwent 60-min weekly sessions for eight weeks. The TAU group received standard care from gynecologists. Main outcome measuresAt baseline and follow-up, participants completed the Menopausal Rating Scale (MRS), World Health Organization Quality of Life Brief Version (WHOQOL-BREF), Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 (PHQ-15), Menopause Emotional Symptom Questionnaire (MESQ), and Subjective Memory Complaints Questionnaire. ResultsThe CBT group showed significant changes in their MRS (F = 4.18, p = .048), WHOQOL-BREF (7.60, 0.009), GAD-7 (4.61, 0.038), PHQ-15 (5.49, 0.025), and MESQ scores (7.19, 0.011) compared to the TAU group. In the CBT group, changes in GAD-7 scores were correlated with PHQ-15 (ρ = 0.57, p < .05), MESQ (0.57, < 0.05), and WHOQOL-BREF scores (−0.53, < 0.05). ConclusionCBT prevents the worsening of menopausal and emotional symptoms, anxiety, and quality of life. CBT may have had a therapeutic effect through the following mechanisms: managing anxiety by changing perceptions of menopause through education and training for coping with various menopausal symptoms and improving self-efficacy in symptom management. Clinical trial registration numberKCT0007517.

Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause

Safe and effective nonhormonal treatments for menopausal vasomotor symptoms (VMS) are needed. To evaluate the efficacy and safety of elinzanetant, a selective neurokinin-1,3 receptor antagonist, for the treatment of moderate to severe menopausal vasomotor symptoms. Two randomized double-blind phase 3 trials (OASIS 1 and 2) included postmenopausal participants aged 40 to 65 years experiencing moderate to severe vasomotor symptoms (OASIS 1: 77 sites in the US, Europe, and Israel from August 27, 2021, to November 27, 2023, and OASIS 2: 77 sites in the US, Canada, and Europe from October 29, 2021, to October 10, 2023). Once daily oral elinzanetant, 120 mg, for 26 weeks or matching placebo for 12 weeks followed by elinzanetant, 120 mg, for 14 weeks. Primary end points included mean change in frequency and severity of moderate to severe vasomotor symptoms from baseline to weeks 4 and 12, measured by the electronic hot flash daily diary. Secondary end points included Patient-Reported Outcomes Measurement Information System Sleep Disturbance Short Form 8b total T score and Menopause-Specific Quality of Life questionnaire total score from baseline to week 12. Eligible participants (mean [SD] age, OASIS 1: 54.6 [4.9] years; OASIS 2: 54.6 [4.8] years) were randomized to elinzanetant (OASIS 1: n = 199; OASIS 2: n = 200) or placebo (OASIS 1: n = 197; OASIS 2: n = 200). A total of 309 (78.0%) and 324 (81.0%) completed OASIS 1 and 2, respectively. For the elinzanetant and placebo groups, the baseline mean (SD) VMS per 24 hours were 13.4 (6.6) vs 14.3 (13.9) (OASIS 1) and 14.7 (11.1) v 16.2 (11.2) (OASIS 2). Baseline VMS severity was 2.6 (0.2) vs 2.5 (0.2) (OASIS 1) and 2.5 (0.2) vs 2.5 (0.2) (OASIS 2). Elinzanetant significantly reduced VMS frequency at week 4 (OASIS 1: -3.3 [95% CI, -4.5 to -2.1], P < .001; OASIS 2: -3.0 [95% CI, -4.4 to -1.7], P < .001) and at week 12 (OASIS 1: -3.2 [95% CI, -4.8 to -1.6], P < .001; OASIS 2: -3.2 [95% CI, -4.6 to -1.9], P < .001). Elinzanetant also improved VMS severity at week 4 (OASIS 1: -0.3 [95% CI, -0.4 to -0.2], P < .001; OASIS 2: -0.2 [95 CI, -0.3 to -0.1], P < .001) and week 12 (OASIS 1: -0.4 [95% CI, -0.5 to -0.3], P < .001; OASIS 2: -0.3 [95% CI, -0.4 to -0.1], P < .001). Elinzanetant improved sleep disturbances and menopause-related quality of life at week 12, and the safety profile was favorable. Elinzanetant was well tolerated and efficacious for moderate to severe menopausal VMS. ClinicalTrials.gov Identifier: OASIS 1: NCT05042362, OASIS 2: NCT05099159.

The Effect of Complementary and Alternative Treatment Methods Applied by Women in Postmenopausal Period on Their Menopausal Symptoms and Quality of Life

The Effect of Complementary and Alternative Treatment Methods Applied by Women in Postmenopausal Period on Their Menopausal Symptoms and Quality of Life

Real-world evaluation of treatment utilization by women experiencing vasomotor symptoms associated with menopause in the United States and Europe: Findings from the REALISE study

ObjectivesDespite the profound impact of menopausal symptoms on women, treatment utilization is low, and many seek alternative therapies. The REALISE study aimed to evaluate the treatment landscape – that is, pharmacological treatment, lifestyle changes (LC), and use of over-the-counter (OTC) products – for women from six high-income countries experiencing vasomotor symptoms (VMS) and receiving healthcare. Study designAnalysis of a secondary dataset, the Adelphi Real World Disease Specific Programme™, a large, cross-sectional, point-in-time survey conducted in the United States and five European countries (February–October 2020). Physicians provided demographic, clinical, and treatment data; women were stratified by VMS severity (mild; moderate-severe) and presence of concomitant sleep/mood symptoms. Women completed forms on VMS severity, concomitant symptoms, LC, and OTC product use. Two subgroups were identified: VMS-only and VMS + sleep/mood. Main outcome measuresPrescription treatment, LC, and OTC product utilization. ResultsPhysicians (n = 233) provided data on 1767 women; 825 (46.7 %) completed a self-completion form. Physicians rated 60 % of women with moderate-severe VMS, of whom 709 (66.8 %) were currently prescribed pharmacological treatment; 27.1 % had never been prescribed. Hormone therapy was most frequently prescribed in the moderate-severe group (overall, 49.8 %; VMS-only, 57.4 %; VMS + sleep/mood, 47.3 %), followed by serotonergic antidepressants (15.7 %; 9.7 %; 17.6 %, respectively). Most women (78.3 %) with moderate-severe VMS adopted LC, and 57.6 % used at least one OTC product for VMS relief. ConclusionsNearly a third of women with moderate-severe VMS had never received treatment despite access to healthcare. This, combined with the prevalent use of LC/OTC products, suggests an unmet need for new treatment options to manage VMS and concomitant sleep/mood symptoms.

Systemic inflammation and menopausal symptomatology: insights from postmenopausal women.

This study aims to investigate the association between systemic inflammation, measured by the systemic immune-inflammatory index (SII), and menopausal symptoms in postmenopausal women. A cross-sectional study was conducted with 702 postmenopausal women recruited from a tertiary hospital. Participants completed the Menopause Rating Scale (MRS) to assess somatic, psychological, and urogenital symptoms. Blood samples were collected to calculate SII. Statistical analyses included correlation, univariate regression, and multivariate regression to determine the association between SII and menopausal symptoms. The most commonly reported symptoms were muscle and joint problems (75.9%), hot flashes and sweating (72.5%), sleeping problems (71.2%), and depressive mood (69.9%). Women with higher total and somatic subscale scores had significantly elevated SII levels compared with those with lower scores. SII was the most associated variable for high total MRS (odds ratio, 4.77; 95% CI, 3.36-6.78; P < 0.001) and somatic subscale scores (odds ratio, 6.32; 95% CI, 4.45-8.99; P < 0.001). Exercise and gravidity were negatively associated with high total MRS and somatic subscale scores. Conversely, no significant associations were observed between SII and the urogenital or psychological subscale scores. Elevated SII levels were found associated with higher somatic subscale and total MRS scores, suggesting that inflammation may contribute to worsened somatic menopausal symptoms in this group. These findings suggest that exploring inflammatory pathways could be beneficial in managing menopausal symptoms and enhancing quality of life for postmenopausal women.

Unraveling the core and bridge menopausal symptoms of perimenopausal women: a network analysis.

Perimenopause is the period from the early menopausal transition to 12 months after the final menstrual period. The clustering of menopausal symptoms poses a challenge for perimenopausal management. Core symptoms are targets for interventions that can alleviate other related symptoms. Bridge symptoms are connectors that link related symptom clusters and can improve the effectiveness of interventions. This study aims to construct a network structure of menopausal symptoms and to identify core and bridge symptoms as a reference for future management. Two hundred forty-two Chinese perimenopausal women were included in the survey. The structure and associations of the menopausal symptoms assessed by the Greene Climacteric Scale were analyzed using a network analysis. We generated the network structure graph using R software and checked its accuracy and stability. In the menopausal transition, the most prevalent symptoms were feeling tired or lacking in energy, excitability, and irritability. Sexual dysfunction was common among early postmenopausal women. Irritability (S = 7.16, C = 0.0167, B = 8) was a core symptom of the network. The depressive symptom cluster was a core symptom cluster, most of which have high centrality indices. Excitability (B = 6) was a bridge symptom connecting the anxiety and depressive symptom clusters. Our study has highlighted the crucial significance of irritability and excitability in perimenopausal management. Overcoming the challenges of perimenopausal management requires the public to ameliorate the prejudice and stigma associated with emotional symptoms.

Menopausal Vasomotor Symptoms and Subclinical Atherosclerotic Cardiovascular Disease: A Population-Based Study.

Menopausal vasomotor symptoms (VMS) are increasingly emphasized as a potentially important cardiovascular risk factor, but their role is still unclear. We assessed the association between VMS and subclinical atherosclerotic cardiovascular disease in peri- and postmenopausal women. Using a cross-sectional study design, questionnaire data were collected from a population-based sample of women aged 50 to 64. The questionnaire asked whether menopause was/is associated with bothersome VMS. A 4-point severity scale was used: (1) never, (2) mild, (3) moderate, and (4) severe. The VMS duration and time of onset were also assessed. Associations with subclinical atherosclerotic cardiovascular disease, detected via coronary computed tomography angiography, coronary artery calcium score, and carotid ultrasound were assessed using the outcome variables "any coronary atherosclerosis," "segmental involvement score >3," "coronary artery calcium score >100," and "any carotid plaque," using logistic regression. Covariate adjustments included socioeconomic, lifestyle, and clinical factors. Of 2995 women, 14.2% reported ever severe, 18.1% ever moderate, and 67.7% ever mild/never VMS. Using the latter as reference, ever severe VMS were significantly associated with coronary computed tomography angiography-detected coronary atherosclerosis (multivariable adjusted odds ratio, 1.33 [95% CI, 1.02-1.72]). Corresponding results for ever severe VMS persisting >5 years or beginning before the final menstrual period were 1.50 (95% CI, 1.07-2.11) and 1.66 (95% CI, 1.10-2.50), respectively. No significant association was observed with segmental involvement score >3, coronary artery calcium score >100, or with any carotid plaque. Ever occurring severe, but not moderate, VMS were significantly associated with subclinical coronary computed tomography angiography-detected atherosclerosis, independent of a broad range of cardiovascular risk factors and especially in case of long durations or early onset.

Isoflavone as a Mainstream Menopausal Symptom Therapy: A Systematic Review to Unravel Ambiguities and Overcoming Challenges for Wider Acceptance

Isoflavone as a Mainstream Menopausal Symptom Therapy: A Systematic Review to Unravel Ambiguities and Overcoming Challenges for Wider Acceptance

The Effects of Prolonged Indoor Inhalation of Nature-Derived Odors on Menopausal Women.

This study aimed to investigate the effects of prolonged inhalation of nature-derived odors indoors on humans. Twenty-six women participated in this study. Heart rate variability, heart rate, blood pressure, pulse rate, estradiol, testosterone, and cortisol were used as indicators of autonomic nervous system and endocrine system activities. Profile of mood state, state-trait anxiety inventory, menopause rating scale and general sleep disturbance scale were used as psychological indicators. The order was as follows: After the participants relaxed in a chair for 5 min, their heart rate variability and heart rate were measured for 3 min with their eyes closed. Subsequently, blood pressure and pulse rate were measured, salivary samples were collected for estradiol, testosterone, and cortisol analyses, and a subjective assessment was conducted. The participants received a diffuser containing fir essential oil and were instructed on its usage and precautions. Subsequently, they returned home and inhaled the fir oil for a week. After 7 days, participants revisited the laboratory for posttest measurements, conducted at the same time as the pretest. Prolonged inhalation of the fir essential oil resulted in increased estradiol concentration, decreased systolic and diastolic blood pressure, relief of menopausal symptoms, reduced anxiety levels, improved sleep quality and mood states. Prolonged inhalation of the fir essential oil induced physiological and psychological relaxation on menopausal women.