Onset Of Menopause Research Articles

The consequences of early menopause and menopause symptoms for labour market participation

Using a difference-in-difference estimator we identify the causal impact of early menopause and menopause symptoms on the time women spend in employment through to their mid-50s. We find the onset of early natural menopause (before age 45) reduces months spent in employment by 9 percentage points once women enter their 50s compared with women who do not experience early menopause. Early menopause is not associated with a difference in full-time employment rates. The number of menopause symptoms women face at age 50 is associated with lower employment rates: each additional symptom lowers employment rates and full-time employment rates by around half a percentage point. But not all symptoms have the same effects. Vasomotor symptoms tend not to be associated with lower employment rates, whereas the employment of women who suffer psychological problems due to menopause is adversely affected. Every additional psychological problem associated with menopause reduces employment and full-time employment rates by 1–2 percentage points, rising to 2–4 percentage points when those symptoms are reported as particularly bothersome.

Sexual Dysfunction in Postmenopausal Women

Nowadays, women have a longer menopausal duration due to the worldwide dramatic life expectancy increase. Sexual dysfunction is one of the most prevalent problems during menopause that affect women`s quality of life, mental health, and interpersonal relationship. This study aimed to investigate sexual dysfunction and its contributing factors amongst married postmenopausal women. This cross-sectional study was conducted among 164 postmenopausal women who attended the menopause clinic of the academic hospitals in Mashhad during 2017-2018. Data were collected using a checklist that included demographic and reproductive information and the validated Persian version of the Female Sexual Function Index questionnaire (FSFI). The mean age of participants was 53.55±6.25 years. The mean FSFI score was 20.06±6.66, and 65.2% of women had sexual dysfunction. The most disturbed sexual domains were; desire (86%, n: 141), arousal (82.3%, n: 135), lubrication (71.3%, n: 117) and sexual satisfaction (70.1%, n: 115), respectively. The partner`s age (P=0.01), time since menopause onset (P=0.01), age at marriage (P=0.02), and frequency of sexual intercourse (P˂0.0001) had a significant relationship with sexual function. The sexual function of postmenopausal women in this study was highly deteriorated. The associated factors were; older age of the spouse, younger age at marriage, longer time since menopause onset, and lower frequency of sexual intercourse. It is important to determine perimenopausal women who are at potential risk of sexual dysfunction and consult them for preventive programs and strategies.

Benefits and risks of hormonal replacement therapy

Menopause, defined as the permanent cessation of menstruation resulting from the loss of the ovarian function, has gradually become a fundamental health concern. Menopause hormonal replacement therapies (HRT) were initially developed with the purpose to alleviate the estrogen deficiency induced symptoms. Currently, HRT is approved by the FDA (Food and Drug Association) for four indications: bothersome vasomotor symptoms (VMS); prevention of bone loss; hypoestrogenism caused by hypogonadism, castration, or premature ovarian failure and genitourinary symptoms. For patients younger than 60 years or within the first 10 years from menopause onset and without contraindications, the benefit-risk ratio should be favorable for treatment of VMS and for preventing bone loss and related fractures. For women who initiate HRT more than 10 / 20 years from menopause onset (or aged 60 years or older), the benefit-risk balance seems to be less favorable than for younger patients because of greater absolute risks of cardiovascular disease, stroke and VTE. Even though the management of menopausal symptoms through pharmacological and cognitive-behavioral therapy improves quality of life of affected women in the short term, there is a need for the development of strategies to modify menopausal health risks, in the long term.

The Relationship Between Psychosocial Factors and Adherence to Treatment in Men, Premenopausal and Menopausal Women with Type 2 Diabetes Mellitus.

IntroductionType 2 Diabetes Mellitus (T2DM) is a chronic disease that begins in adulthood, and is caused by multiple factors. The onset of menopause involves changes that predispose women to the development of T2DM, which can worsen if the adherence to treatment is inadequate due to psychosocial factors or medications. The present study aims to describe the psychosocial factors that may affect adherence to treatment among men and premenopausal and menopausal women with T2DM.MethodsThis was a cross-sectional study of 96 patients with T2DM, who were divided into three groups: 1) men (n=32); 2) premenopausal women (n=32); and 3) menopausal women (n=32). Somatometric and metabolic control data were obtained. Adherence to treatment and psychosocial factors were evaluated: social support, belief in conventional medicine, disease denial, and depressive symptoms.ResultsAdherence to medication had a negative correlation with depressive symptoms in men (p <0.001) and menopausal women (p <0.021). Dietary adherence had a positive correlation with belief in conventional medicine in men (p <0.037) and premenopausal women (p <0.029).ConclusionMedication adherence in men and menopausal women was correlated with fewer depressive symptoms. Adherence to diet in men and premenopausal women was correlated with greater belief in conventional medicine. The results show the diversity of psychosocial factors among the groups that must be addressed in order to improve adherence.

Age at menopause in women living with HIV: a systematic review.

With improved HIV care, more women living with HIV (WLWH) are aging and entering menopause. Understanding any increased risk conferred by a potentially earlier menopause transition is important for the care of these women. There is conflicting literature regarding the association between HIV and an earlier onset of menopause. We conducted a systematic review to summarize the literature on the association between HIV and age at menopause. A search of Ovid MEDLINE, EMBASE, and Web of Science identified 894 articles. We included cohort studies that assessed age at menopause, primary ovarian insufficiency (POI), or early menopause among WLWH and used the World Health Organization definition of menopause as ≥12 months of amenorrhea. Nine studies were included and eight reported on age at menopause. Across studies, the age at menopause for WLWH fell between 46 and 50 years. Five of seven studies reported that WLWH had an earlier menopausal transition than HIV negative controls/the general population. Six studies reported on the prevalence of POI or early menopause among WLWH, with all studies demonstrating an increased prevalence of both among WLWH. Our systematic review summarizes the literature around HIV and age at menopause. Many studies reported a high prevalence of POI and early menopause among WLWH; a factor that may partially account for the observed lower age at menopause. As only one study included biochemical confirmation of menopause, it remains unclear whether individuals with early menopause or POI were truly menopausal or had prolonged amenorrhea due to other causes. Overall, our findings highlight the need for further investigation with studies that include an HIV negative control group and biochemical confirmation of menopause to better understand whether menopause truly is occurring earlier among WLWH.

The impacts of menopause on a mouse model of co‐morbid metabolic syndrome and Alzheimer’s disease

Alzheimer's disease (AD) is the leading cause of disability and 5th cause of death in people over 65 years of age. Approximately 2/3 of AD patients are women, most of whom are postmenopausal. Menopause is linked with cognitive changes in women: younger age at menopause is associated with worse cognitive outcomes. Moreover, menopause accelerates mid-life risk factors for dementia, by increasing risk for cardiovascular and cerebrovascular disease and metabolic disease which is by itself a risk factor for dementia. We have previously shown that female 3xTg-AD mice are more greatly impacted cognitively and metabolically by a high fat diet when compared to males. We therefore hypothesized that menopause would exacerbate both metabolic and cognitive impairment and pathology in a mouse model of AD. Female App NL-F mice were placed on either low fat (LF; 10% fat) or high fat (HF; 60% fat; metabolic disease model) diet for 7 months. An accelerated ovarian failure model of menopause (4-vinylcyclohexene diepoxide) was used at diet onset and female estrus cycles were monitored to determine menopause onset. Metabolic status was assessed by tracking weight gain and assessing glucose tolerance. Mice were then subjected to a battery of behavioral tests before being euthanized and brains and serum were collected. Menopausal mice tended to be more metabolically impaired (worse glucose tolerance) regardless of diet. Cognitive impairment differences between groups were investigated using several behavioral tests. Neither menopause nor HF diet affected anxiety-like behavior (open field testing), however HF diet decreased general activity levels. Novel object recognition testing demonstrated that menopause, regardless of diet, impaired episodic-like memory. Additionally, HF diet, regardless of menopause, impaired spatial learning (assessed via Barnes maze testing). We are currently evaluating the underlying pathology in the brain that could mediate these cognitive deficits (i.e. Amyloid pathology, white matter damage and neuroinflammation). We hope that this work will highlight the need to model endocrine aging in animal models of dementia and will contribute to further understanding of the interaction between metabolic disease and menopause in the scope of AD.

Menopause and Hyperuricemia in Women in the Russian Population (Results of the ESSE-RF Study)

Aims. To evaluate the relationship of menopause and its features with hyperuricemia in Russian women. Methods. In this study, we used data from the cross-sectional phase of the epidemiological study Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation (ESSE-RF) conducted in 20132014, in 13 regions of Russia. The final random sample size was 12 781 women. According to the interviews, the fact of menopause and the features of climacteric were identified. Hyperuricemia was defined as a serum uric acid concentration greater than 360 mol/L. Age, behavioral risk factors and indicators of health status were assessed as covariates. Logistic regression analysis was used for multivariate assessment of associations. Apart from the assessment of the general sample, the analysis of the groups stratified by obesity, diabetes mellitus and the characteristics of climacteric was carried out. The results of logistic regression analysis are presented as odds ratios (OR) and 95% confidence intervals (CI). Results. In the general sample, after adjusting for covariates, menopause was directly associated with hyperuricemia (OR = 1.17; 95% CI 1.061.28), the association of hyperuricemia with age was not statistically significant. Menopause was more consistently associated with hyperuricemia in obese compared to non-obese women. In diabetic women, menopause is directly and significantly associated with hyperuricemia, whereas in non-diabetic women there was not the association between menopause and hyperuricemia. Taking into account the features of climacteric, menopause was directly associated with hyperuricemia only in the 410 years after the onset of menopause (OR = 1.13; 95% CI 1.021.26), in natural menopausal women (OR = 1.18; 95% CI 1.071.30) and who were taking hormone replacement therapy (OR = 1.23; 95% CI 1.061.43). Conclusions. The results of the study indicate the direct association of hyperuricemia with menopause, but not with the age of women. The stratified analysis has made it possible to identify some features of the association between hyperuricemia and menopause in women with metabolic disorders, as well as to assess the influence of the features of climacteric.

The smoking behavior of women of reproductive age in Nepal

Smoking, the leading cause of preventable deaths worldwide, which is more detrimental to women not only increases the chances of infertility and miscarriage, but hastens the onset of menopause and causes women to be more susceptible to depression, decreased bone density, cataracts, and skin diseases. This paper investigates the smoking behavior and factors influencing smoking among women of reproductive age in Nepal. The study used secondary data from the 2016 Nepal Demographic and Health Survey. A total of 12,862 women of the reproductive age group were covered in the survey. The association between smoking and the explanatory variables was first assessed in bivariate analysis using the Chi-square test. The associations were further explored using multivariate logistic analysis. Nearly two-fifths (38%) of women were aged 15-24 years. Overall, 8% of women used tobacco products (smoking/chewing). Multivariate analysis showed that women aged 35 and above were almost seven times (aOR=6.52, CI=4.75-8.94) to be smokers than younger women. Separated/divorced/widowed women were nearly twice (aOR=1.86, CI=1.14-3.01) as likely to be smokers than their counterparts. Education is a significant predictor of smoking as women having primary (aOR=0.65, CI=0.54-0.78) and secondary/higher education (aOR=0.21, CI=0.16-0.26) were less likely to smoke than women with no education. Dalit women were nearly two times more likely to be smokers than higher caste Brahmin/Chhetri. Similarly, the richest and richer women were less likely to smoke than the poorest women. Age, education, marital status, caste/ethnicity, and wealth index were significant determinants of smoking among women. Hence, tobacco control interventions need to be focused on women of higher age groups and uneducated and poorer women.

Incidence and characteristics of &lt;em&gt;de novo&lt;/em&gt; stress urinary incontinence after pelvic organ prolapse vaginal repair

BACKGROUND Some patients who undergo pelvic floor reconstruction for pelvic organ prolapse (POP) may experience a de novo stress urinary incontinence (SUI) postoperatively. We aimed to investigate the incidence and characteristics of de novo SUI in patients who underwent pelvic floor reconstruction at the national referral hospital in Indonesia.&#x0D; METHODS This cross-sectional study evaluated 108 patients who underwent pelvic floor reconstruction due to POP between January 2016 and December 2017. Per the inclusion criteria, 75 women were enrolled using a consecutive sampling. The incidence of de novo SUI was determined 6–12 months postoperatively using the Indonesian version of the questionnaire for urinary incontinence diagnosis and objectively using the cough stress test during gynecologic examination after a negative preoperative prolapse reduction stress test.&#x0D; RESULTS The average age, parity, body mass index, and years since menopause onset were 56.17 (4.67) years, 3.17 (1.07), 28.58 (5.18) kg/m2, and 12.8 (7.0) years, respectively. De novo SUI was seen in 8.0% (6 of 75) patients at 6–7 months postoperatively, with 3 (50.0%) had severe POP and 3 (50.0%) had a mild POP. Most of these patients (4 of 6, 66.7%) had undergone procedures other than colpocleisis for POP reconstruction.&#x0D; CONCLUSIONS The incidence of de novo SUI after gynecologic surgery for POP at a national referral hospital in Indonesia is 8%. Most patients were aged &lt;60 years, had a parity of &lt;4, were nonobese, were menopausal, and had diabetes.

Abstract 10496: Cardiac Function in Postmenopausal Women Are Unaltered by Two Decades of Different Physical Activity Levels

Rationale: In women, the risk of coronary heart disease increases significantly after the onsetof menopause. Exercise and active lifestyle have known benefits such as a significantly reducedrisk of heart failure. To date, most of the knowledge on physical activity induced changes incardiac function in older individuals are based on males and with a sparsity of data from healthypostmenopausal women with differing physical activity and fitness. Aim: The aim was to determine the impact of more than twenty years of differing physicalactivity levels and maximal oxygen consumption on cardiac morphology and function inpostmenopausal women. Method: The study design was cross-sectional with age-matched non-smoking, non-medicatedhealthy women divided in to three groups based on their self-reported physical activity levelwith regard to intensity and volume over the past two decades. Forty-one women was included(age of 61 ± 1 years; 11 ± 2 postmenopausal years; body mass index 23 ± 3 kg • m 2 ) and dividedinto groups based on activity level categorized as sedentary (SED; ≤1 h exercise weekly; n=14);Moderate (MOD; ≥2 ≤6h low/moderate intensity exercise weekly; n=12) and high (HIGH; &lt;4h of moderate/high intensity exercise weekly; n=15). Cardiac function and dimensions wereassessed with transthoracic echocardiography and maximal pulmonary oxygen uptake wasdetermined by graded bike ergometer exercise to exhaustion. Results: The three groups displayed significantly different levels of maximum oxygen uptake(24.9 ± 5.8; 30.5 ± 5.8; 38.4 ± 4.4 ml/kg, for SED, MOD and HIGH respectively) (p &lt; 0.01).No differences were observed in resting left ventricular (LV) morphology (LVmass, LVmassindex) systolic function (EF%, GLS and mitral valve S′), diastolic function (E/A ratio, IVRT)or right ventricular function (TAPSE and tricuspid annular velocity S’) between the threegroups. Conclusions: These data show that the level of lifelong physical activity and correspondingdifferences in maximal oxygen consumption, may have less impact on left ventricularmorphology and systolic/diastolic function in healthy postmenopausal women than previouslyexpected.

Factors Associated With Changes In Bone-Mass Density In Post Menopause Female Patients With Osteopenia

Background: Many factors can cause changes in bone mass density (BMD) in women with postmenopausal osteopenia. Aim: Determine factors associated with changes in BMD in postmenopausal women with osteopenia with the most influential risk factors within 1 year.Methods: Survey was conducted on 38 patients who were included in the inclusion criteria with a cross-sectional study analysis and had BMD data for the last 2 years, body mass index, and conducted interviews for physical activity, age of menopause, and duration of menopause. Blood samples were also taken to check total calcium levels, vitamin D levels and estrogen levels. Finally, patients are followed for up to 1 week for daily nutrition records. The relationship between these factors and changes in BMD was analyzed using Pearson's or Spearman's test. The analysis result was considered significant if p&lt;0.05.Results: There was no significant relationship between body mass index, menopause duration, physical activity, dietary calcium, serum calcium levels and serum estradiol levels on changes in BMD with p value &gt; 0.05. However, there was a significant relationship between menopause onset and changes in ward mass density (r = 0,321, p = 0,04) and lumbal 1 (r = 0,333, p = 0,04), serum vitamin D levels and changes in great trochanter mass density (r = 0,336, p = 0,036), physical activity score and changes in ward mass density (r = -0,522, p &lt; 0,01).Conclusion: Â menopause onset, vitamin D and physical activity are significantly associated with changes in BMD in female patients with postmenopausal osteopenia.

Patterns of clinical presentation of climacteric syndrome and total body composition in women with menopausal metabolic syndrome

Introduction. Modern gynecological endocrinology widely discusses various disorders accompanying the onset of menopause. Metabolic disorders are one of the leading risk factors for the development of ischemic heart disease and vascular dystonia in menopausal women. That is why the drugs prescribed as part of menopausal hormone therapy are contraindicated for patients with severe metabolic disorders and predisposition to thrombosis. Women with a normal body mass index may develop the menopausal metabolic syndrome, since its presentations largely depend on the total body composition and the specific gravity of visceral adipose tissue.Aim. To assess the patterns of clinical presentation of menopause in women with metabolic menopausal syndrome.Materials and methods. In the furtherance of that aim, we examined 184 women who were in menopause 1 to 5 years at the age of 52 to 57 years (average age 54.2 ± 0.5 years). Of these, 87 were diagnosed with metabolic syndrome – they were included in the main group. The comparison group included 97 menopausal women without metabolic disorders.Results and discussion. We assessed the severity of clinical presentations and the total body composition of the patients in the selected groups. It has been established that the body mass index cannot serve as a criterion for evaluation of metabolic processes, despite the sufficient simplicity of its computation.Conclusions. The authentic view of the risks of metabolic disorders in menopausal women requires the study of total body composition.

Causal and observational evidence on the role of early menopause in hypertension

Abstract Introduction Blood pressure has been suggested as potential factor contributing to the increased risk of cardiovascular disease observed in women experiencing early menopause (&amp;lt;45 years). However, whether the association between early menopause and hypertension is causal remains unclear (1,2). Purpose To evaluate the observational and causal association between age at natural menopause (ANM) and blood pressure (BP) traits in Caucasian women. Methods Cross-sectional and one-sample Mendelian randomization (MR) study was conducted in 4451 postmenopausal women from two different cohort studies. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg, and/or diastolic BP (DBP) ≥90 mmHg, and/or the use of antihypertensive medication. Multivariable linear and logistic regressions were implemented in the observational analysis. We calculated a weighted genetic risk score with 54 variants associated with ANM (GRS-ANM) (3). The genetic variants were previously identified in a genome wide association study (4), after that we implemented two-stage least squares in the one-sample MR. Estimates from all cohorts were pooled through meta-analysis Results The pooled analysis across cohorts showed early menopause, compared to menopause between 50–54 years, to be associated with lower DBP (β=−1.31 mmHg, 95% CI: −2.43; −0.18), while no association was found between other ANM categories and DBP. Similarly, the pooled analysis of both cohorts did not show an association of ANM with SBP, neither as a continuous variable nor by category. One year of later onset of menopause was associated with higher odds of developing hypertension (Odds ratio (OR): 1.02, 95% CI: 1:00; 1.04) while no association was found for the ANM categories and hypertension (Table 1). Results of the evaluation of MR assumption, supported their compliance, the GRS-ANM was associated with observed ANM and explained between 1.4% and 3.4% of the ANM variance in the included cohorts, F statistic values were among 11.15 and 40.63 (Figure 1). We found no association between GRS-ANM and SBP, DBP or hypertension (Table 1). Conclusion The present study does not support the hypothesis that early onset of menopause is associated with higher BP. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): The CoLaus study was and is supported by research grants from GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, and the Swiss National Science Foundation (grants 33CSCO-122661, 33CS30-139468 and 33CS30-148401).Zayne M. Roa-Díaz has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 801076, through the SSPH+ Global PhD Fellowship Programme in Public Health Sciences (GlobalP3HS) of the Swiss School of Public Health.

Association of diet with the onset of natural menopause: a systematic review and meta-analysis

Background: Onset of natural menopause (ONM) is associated with an increased risk of cardiovascular diseases (CVDs) and overall mortality. Diet intake has been suggested to play an important role in determining at which age of natural menopause occurs, but the current results are not consistent.

Assessment of Risk Scoring Model for Prediction of Endometrial Cancer Among Symptomatic Postmenopausal Women (A Prospective Cohort Study)

Abstract Background Endometrial carcinoma is the most common gynecological malignancy in the developed countries and the third common gynecological malignancy in Egypt after breast and ovarian cancers. Aim of the Work to evaluate this risk scoring model on Egyptian patients and to study the effect of adding other patient characteristics (DM, BMI and relevant family history) on the sensitivity and specificity of RHEA scoring model. Patients and Methods The current study was conducted in Ain Shams University Maternity Hospital in the period between September 2017 and December 2018. A total of 100 women with postmenopausal bleeding and endometrial thickness &amp;gt; 4mm were included in the study. Results Histological examination revealed that benign pathology (n = 65) (73%) was found to be: most common cause was endometrial hyperplasia without atypia (20.3%) followed by chronic endometritis (13.5%), then endometrial polyp (11.3%), cystic atrophy of endometrium (8.9%), proliferative endometrium (8.9%), endometrial hyperplasia with atypia (6.7%) and lastly mucous polyp (3.4%) while malignant histopathology(n = 24)(27%) which is significantly higher than the international rates showed: Endometriod adenocarcinoma (n = 19)(21.3%), papillary serous carcinoma (n = 4)(4.5%) and undifferentiated carcinoma (n = 1)(1.1%). The current study showed that RHEA score performs in our study population with a comparable validity to that reported by its inventors with sensitivity 79.2% (57.8% - 92.9%) vs. 87.5% and specificity 84.6% (73.5% - 92.4%) vs. 80.1% respectively. In results of the current study it was found that the time since onset of menopause rather than age was associated with endometrial cancer with the optimum cut-off for postmenopausal duration was estimated to be 9 years achieving a sensitivity of 87.5% and a specificity of 60.0%, but it needs multivariate analysis on larger and more representative sample size to confirm this association, A statistically significant regression model was including only postmenopausal duration, recurrent bleeding and endometrial thickness. None of age, BMI, family history or hypertension proved a statistically significant predictive effect after adjustment for other predictive variables. Conclusion Taking in consideration the higher prevalence of endometrial carcinoma in the sample of the current study, the wide 95% confidence intervals for the different validity indices for the RHEA scores derived from this study, it seems that RHEA score performs in this study population with a comparable validity to that reported by its inventors.

Age at natural menopause and body mass index: longitudinal analysis

Background: Early onset of menopause has been considered a risk factor for cardiovascular diseases, an association that could be mediated by factors such as obesity secondary to menopause. However, the timing of menopause on body mass index (BMI) remains unclear.

MHT: How and how long in healthy women above 65?

MHT: How and how long in healthy women above 65? Abstract. In Europe, women spend more than one third of their lifetime in the postmenopause which is characterized by chronic estrogen deficiency. About 80 % of them suffer from vasomotor symptoms which can last for up to twelve years or more. Menopausal hormone therapy (MHT) with sexual steroids is the most effective treatment resulting in a reduction of hot flushes and an improvement of quality of life. Today, a large proportion of women is not treated adequately as demonstrated by a marked decline of MHT-prescriptions. The postmenopause is not only associated with climacteric symptoms, but also with long-term risks, such as cardiovascular events, osteoporosis, cognitive dysfunction or diabetes mellitus. Numerous studies have shown beneficial effects of MHT on many of these diseases and on mortality, provided that treatment has been initiated close to the onset of menopause. Accordingly, some investigators have postulated a possible role of MHT in primary prevention. However, concerning long-term beneficial effects of MHT in women beyond the age of 65 years, the optimal duration of MHT is still unknown. Consequently, the duration of MHT should always be planned individually after thorough consideration of potential benefits and risks in agreement with the patient. Especially with advancing age transdermal application of estrogens seems to be the best option because of less vascular risks. There is no apodictic limitation of maximal duration of MHT.

Influence of Work on Andropause and Menopause: A Systematic Review.

Aging is associated with gender-specific hormonal changes that progressively lead to gonadal insufficiency, a condition which characterizes a minority of men and all women. Work-related factors, such as stress and pollutant exposure, affect gonadal function and can interfere with reproduction in both genders. A systematic review of the PubMed, SCOPUS and EMBASE databases was conducted, according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement to investigate the effect of occupational factors on andropause and menopause. A total of 26 studies met the inclusion and exclusion criteria: 9 studies evaluated the effects of work on andropause symptoms, 8 studies examined its effects on age at menopause onset, and 9 studies addressed its effects on menopausal symptoms. Work-related factors, such as psychological stress, physical effort, and sleep disorders, showed a significant correlation with andropause manifestations, whereas age at menopause and severity of menopausal symptoms were both influenced by factors such as pesticide exposure, high job strain, and repetitive work. Since work accompanies men and women for most of their lives, it is essential to identify and prevent the risk factors that may affect reproductive health.

Age at Natural Menopause and Blood Pressure Traits: Mendelian Randomization Study.

Observational studies suggest that early onset of menopause is associated with increased risk of hypertension. Whether this association is causal or due to residual confounding and/or reverse causation remains undetermined. We aimed to evaluate the observational and causal association between age at natural menopause (ANM) and blood pressure traits in Caucasian women. A cross-sectional and one-sample Mendelian randomization (MR) study was conducted in 4451 postmenopausal women from the CoLaus and Rotterdam studies. Regression models were built with observational data to study the associations of ANM with systolic and diastolic blood pressure (SBP/DBP) and hypertension. One-sample MR analysis was performed by calculating a genetic risk score of 54 ANM-related variants, previously identified in a genome-wide association study (GWAS) on ANM. In the two-sample MR analysis we used the estimates from the ANM-GWAS and association estimates from 168,575 women of the UK Biobank to evaluate ANM-related variants and their causal association with SBP and DBP. Pooled analysis from both cohorts showed that a one-year delay in menopause onset was associated with 2% (95% CI 0; 4) increased odds of having hypertension, and that early menopause was associated with lower DBP (β = −1.31, 95% CI −2.43; −0.18). While one-sample MR did not show a causal association between ANM and blood pressure traits, the two-sample MR showed a positive causal association of ANM with SBP; the last was driven by genes related to DNA damage repair. The present study does not support the hypothesis that early onset of menopause is associated with higher blood pressure. Our results suggest different ANM-related genetic pathways could differently impact blood pressure.

The association of parity and breastfeeding with anti-Müllerian hormone levels at two time points

ObjectiveTo evaluate the association between parity and breastfeeding and anti-Müllerian hormone levels (AMH) and change in AMH levels over time. Furthermore, we examined whether AMH levels mediate the relation of parity and breastfeeding with age at menopause. Study designObservational, prospective cohort study. Main outcome measuresAMH levels were assessed in a subset of premenopausal participants in the Nurses’ Health Study II, including 1619 women who provided a blood sample in 1996-1999 and an additional 800 women who provided a second premenopausal sample in 2010-2012. ResultsIn multivariable linear regression models adjusted for parity, body mass index, smoking, and other factors, mean log AMH levels in 1996-1999 were 39% higher in women reporting ≥25 months of total breastfeeding vs. <1 month (P for trend = 0.009). Parity was not associated with AMH levels after adjustment for breastfeeding. Neither parity nor breastfeeding was associated with decline in AMH levels over 11 to 15 years. Breastfeeding duration was positively associated with age at menopause (P for trend = 0.01), with evidence that the association was mediated via AMH. ConclusionsOur results suggest that breastfeeding is associated with higher AMH levels and later onset of menopause, and support the hypothesis that observed relations of parity with AMH levels and menopause timing may be largely attributable to breastfeeding.