Menopausal Symptoms Research Articles

Medicinal plants used to treat and manage menopausal symptoms in Grand-Lahou and Katiola Districts, Cote d'Ivoire

Medicinal plants used to treat and manage menopausal symptoms in Grand-Lahou and Katiola Districts, Cote d'Ivoire

8131 A Rare Case of Autoimmune Polyendocrine Syndrome; a Menopause Despite Replacement Therapy

Abstract Disclosure: M.E. Chacon Cruz: None. M. Sanchez Cordero: None. R.M. Roman Torres: None. G. Guerra Velazquez: None. Polyendocrinopathy is a heterogeneous group of disorders leading to dysfunction of multiple endocrine glands and other tissues. The syndromes can occur in patients from early infancy to old age and new components of a given syndrome can appear throughout life. APS can be classified into APS type 1 and APS2-4. APS-1 is a rare monogenic autosomal recessive autoimmune disorder consisting of the triad of chronic mucocutaneous candidiasis, hypoparathyroidism and adrenal insufficiency. APS2 require presence of Addison disease, autoimmune thyroid disorder and type 1 diabetes. APS 3 requires presence of Thyroid autoimmune disease associated with other autoimmune diseases. APS4 is a combination of organ specific autoimmune disease non included in a previous group. Autoimmune oophoritis is found in approximately 4 percent of females who presented with spontaneous primary ovarian insufficiency and may occur in type I and II syndromes of polyglandular autoimmune failure. This is the case of 44 year old female patient with history of hypertension, hypoparathyroidism diagnose at the age of 9 year old, vitiligo and premature ovarian failure diagnose at the age of 16 year old. Patient reported that started with multiple episodes of watery non bloody diarrhea and arthralgia. Patient went to her Pediatrician and they found hypocalcemia hyperphospathemia. Patient mineral was replaced with medication and then followed by pediatric endocrinologist. Patient continues with normal life, but menstrual periods had not started even at age 16th. Laboratory work up was done and premature ovarian failure was diagnosed after that, patient started with progesterone and estrogen to induce menstrual periods. Menstrual periods began regularly and monthly. Patient continues taking medication regularly, phoslo, calcitriol, progestin and estradiol without problem until this year that despite regular medication, started with signs and symptoms of menopause with irregular menstrual periods, palpitations hot flashes, sweating, anxiety and sleep problems. Patient met criteria for APS4 due to combination of organ specific autoimmune disease such premature ovarian failure, vitiligo and hypoparathryroidism. This case is extremely important since despite the fact that there is no family history of either endocrinological or autoimmune diseases, our patient debuts throughout her life with several autoimmune diseases, such as premature ovarian failure and vitiligo. Patient had Schedule appointment with gynecologist who increased the dose of progestin and estradiol. This case highlights the importance of being vigilant about new components of a syndrome developing at different times though a patient's life. As described, autoimmune diseases commonly are related to other diseases, but without a good clinical history and physical examination could be misdiagnosed affecting the quality of life of those patients. Presentation: 6/2/2024

7497 Association between Plasma Prolactin Levels and Menopausal Vasomotor Symptoms

Abstract Disclosure: F. Galbiati: None. J. Kang: None. D.J. Cote: None. J.E. Manson: None. U.B. Kaiser: None. Background: High prolactin (PRL) levels inhibit gonadotropin-releasing hormone (GnRH), causing hypogonadism. GnRH release is regulated by neurokinin B (NKB) and kisspeptin. NKB antagonists are used in treatment of menopausal hot flashes and vasomotor symptoms (VMS). In mice and humans with hyperprolactinemic anovulation, kisspeptin restored ovarian cyclicity and LH pulsatility. However, the interplay between kisspeptin and PRL is not fully understood. In two menopausal women with hyperprolactinemia and central hypogonadism, treatment with bromocriptine led to PRL normalization and new-onset VMS, suggesting that hyperprolactinemia inhibited VMS associated with hypogonadism. We aimed to investigate the association between PRL and menopausal VMS in women from the Nurses’ Health Study I and II (NHS, NHSII). We hypothesized that women with higher PRL levels would have a lower frequency/severity of menopausal VMS. Methods: We conducted a cohort study of 2618 females enrolled in NHS (n=1692) and NHSII (n=926) in whom blood samples were collected between 1989-99, were not pregnant or on hormonal therapy, and were either pre or post-menopausal as of blood draw. Subjects were free of breast, ovarian and other cancers, and provided complete data on VMS at menopause as well as in the past 4 weeks (assessed in 2008 in NHS and 2009, 2013, 2017 in NHSII). Plasma PRL was measured as part of 28 case-control studies of various health outcomes. We evaluated the presence and severity of VMS at menopause and 4 weeks prior to the questionnaire, as well as duration (in years) of VMS. We used multiple logistic regression, adjusting for covariates to estimate multivariable-adjusted relative risks (MVRRs) and 95% confidence intervals (CIs). Results: Women were aged 33-65 years at blood draw; range for years from blood draw to menopause was -10 to 10 (median=1.8) years; range for years from blood draw to report of VMS (both at menopause and current VMS) was 9.8 to 22 years. Mean PRL (SD; range) was 14.7ng/mL (10.1; 0.08-246). Women with the highest PRL levels were likely to be younger and less likely to be current smokers or obese. 77.4% of women reported VMS at menopause and 47.6% in recent 4 weeks; 52.3% reported moderate-to-severe VMS at menopause and 32.0% reported VMS in recent 4 weeks. Overall, PRL was not associated with duration of VMS or moderate-to-severe VMS at menopause or in the past 4 weeks; compared to the lowest quintile (≤8.0ng/mL), those in the highest PRL quintile (≥18.2ng/mL) had MVRR of 1.23(95%CI=0.94,1.60) for moderate-to-severe menopausal VMS and 1.03(95%CI=0.67,1.59) for recent VMS. Menopausal status did not affect the association between prolactin levels and VMS. Conclusion: PRL levels were not associated with occurrence, severity, or duration of menopausal VMS in a large cohort of women. Presentation: 6/1/2024

8648 Association of isoflavone intake and age at natural menopause

Abstract Disclosure: M. Mitsunami: None. E.R. Bertone-Johnson: None. A. Eliassen: None. J.E. Chavarro: None. Introduction: Isoflavones, a type of phytoestrogens found mainly in soy and legumes, are structurally similar to estrogens and are consumed at a relatively high rate by Asian populations with an average intake of approximately 15-40 mg/d for isoflavone. They have been reported to alleviate menopausal symptoms, such as hot flashes, suggesting that isoflavones may be biologically active in a low-estrogen environment. Previous studies have reported inconsistent associations between the intake of soy and isoflavones and age at natural menopause. Therefore, our aim was to test the hypothesis that higher isoflavone intake is related to higher age at natural menopause. Methods: We followed 85,810 premenopausal women (mean [SD], 36.5 [4.7] year) who completed a previously validated food frequency questionnaire, had not been diagnosed with cancer, and did not undergo any menopausal hormone therapy as of 1991. Diet was assessed every 4 years. Isoflavone intake was estimated from these reports. Participants self-reported their menopausal status and the type of menopause (natural, surgical, and radiation or chemotherapy) every 2 years. We used proportional hazard regression models with age in months to evaluate the relation of isoflavone intake with age at natural menopause where natural menopause was the study outcome and menopause due to surgery, radiation, or chemotherapy were censoring events. We used restricted cubic splines to assess the possibility of non-linear relations between isoflavone intake and age at menopause using the U.S. average isoflavone intake (0.8mg/d) as a reference while adjusting for potential confounders, including age at menarche, BMI, race/ethnicity, smoking status, physical activity, parity, breastfeeding, time to regular menstrual cycle, energy intake, and two dietary factors identified by principal component analysis. Results: Over 1,079,608 person-years, we observed 37,438 cases of natural menopause. Soy products contributed approximately half of isoflavone intake. There was a non-linear association between isoflavone intake and age at natural menopause (p<0.001). Women with isoflavone intakes below the U.S. national average were more likely to experience earlier onset menopause. Conversely, in women with intakes above the national average, the risk of menopause decreased with increasing isoflavone intakes, albeit plateauing at intakes of approximately 3-4mg/d (90-95th percentile of observed distribution). There was a suggestion of a positive association between isoflavone intake and earlier onset menopause for intakes above the 99th percentile of the observed distribution (∼14 mg/d). Conclusion: This study suggests a non-linear relation between isoflavone intake and age at natural menopause with a potential later onset of menopause at intake levels higher than typical in the US diet but lower than those typically observed in East Asia. Presentation: 6/2/2024

Traditional Chinese Medicine Herbs for Breast Cancer Prevention and Survival: A Narrative Review of Epidemiological Studies from Taiwan.

This review aims to describe the association of integrating traditional Chinese medicine (TCM) herbs into conventional medicine (CM) in preventing breast cancer and improving survival rates among breast cancer patients of Taiwan. Of 7 relevant studies, spanning 2014-2023, 4 investigated breast cancer risk in women with menopausal symptoms and other comorbidities. All 4 reported that TCM herbal use was associated with lower risks of developing breast cancer. Three studies investigated survival in newly-diagnosed breast cancer patients receiving CM. All reported that adjunctive TCM users had lower mortality rates than CM-only patients. However, the heterogeneity of study designs, populations, and interventions may limit the generalizability and robustness of the findings. TCM herbs may promote breast cancer prevention and survival when used alongside CM. More rigorous observational research and clinical trials in specific patient populations are needed to guide clinical decision-making.

Assessment of menopausal symptoms awareness among women in Bharatpur, Nepal

Assessment of menopausal symptoms awareness among women in Bharatpur, Nepal

Addressing menopause symptoms in the primary care setting: opportunity to bridge care delivery gaps.

Menopause symptoms affect quality of life and financial well-being but are often unaddressed in primary care clinics. Therefore, we evaluated the extent of menopause symptom documentation in electronic health records (EHRs) by primary health care professionals. We retrospectively reviewed adult women who reported moderate or higher vasomotor symptoms on a Mayo Clinic survey conducted from March 1, 2021, through June 30, 2021. We then assessed adequacy of menopause symptom documentation in the EHRs of these women who had primary care visits during the survey period. We reviewed the percentage of documented vasomotor symptoms from May 1, 2019, through May 1, 2021. In the Mayo Clinic Health System-Northwest Wisconsin Region, 229 women self-reported moderate or higher vasomotor symptoms in the Mayo Clinic survey. Although only 23% of these women had vasomotor symptoms listed in the EHR clinical problem lists, 60% of these women had vasomotor symptoms documented in their clinic notes from the primary care visit. Approximately 6% of women reported hormone therapy use for management of menopause symptoms, and nearly 15% reported use of nonhormone prescription therapies for vasomotor symptoms. A greater proportion of women in our study had EHR documentation of bothersome menopause symptoms than those reported in other studies, but vasomotor symptoms remain generally untreated. We need better methods for identifying midlife women with bothersome menopause symptoms in primary care clinics so that appropriate treatment options, including hormone therapy, can be discussed and offered.

Substance use and menopausal symptoms among people with and without HIV in the US, 2008-2020.

The aim of the study is to assess associations between substance use and menopausal symptoms among US people living with and without HIV in a longitudinal cohort. We analyzed self-reported menopausal symptoms and substance use from biannual Women's Interagency HIV Study (WIHS) visits from 2008-2020. Substance use since the last visit or lifetime cumulative use included tobacco, alcohol, marijuana, crack/cocaine, and opioids. Logistic regression quantified associations between each substance use and menopausal symptom frequency (vasomotor, mood, and musculoskeletal), adjusting for other substance use, HIV status, demographics, comorbidities, and trauma. A total of 1,949 participants contributed early perimenopausal, late perimenopausal, or postmenopausal study visits. Across reproductive-aging stages, based on menstrual history, and among participants with and without HIV, participants reported frequent vasomotor (range 22-43%), mood (18-28%), and musculoskeletal (25-34%) symptoms. Many reported ever using tobacco (72%), heavy alcohol (75%), marijuana (73%), crack (50%), and opioids (31%). Current heavy alcohol use (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.10-1.37), cumulative marijuana use (OR: 1.15, 95% CI: 1.01-1.32), and cumulative tobacco use (OR: 1.06, 95% CI: 1.01-1.12) were associated with a higher frequency of vasomotor symptoms; current heavy alcohol use (OR: 1.20, 95% CI: 1.04-1.39) and current opioid use (OR: 1.13; 95% CI: 1.01-1.25) were associated with mood symptoms; and current opioid use (OR: 1.11, 95% CI: 1.00-1.23) was associated with musculoskeletal symptoms. All other associations were found to be null. Current and prior substance use may independently affect symptoms experienced during the menopausal transition and may indicate potential to benefit from additional intervention and referral to menopause specialty care.

The Effects Of Baduanjin On Menopausal Symptoms In Patients With Breast Cancer Treated With Aromatase Inhibitors

The Effects Of Baduanjin On Menopausal Symptoms In Patients With Breast Cancer Treated With Aromatase Inhibitors

Association of insurance type with unmet need for menopause care in Oregon.

To determine unmet need for menopause care in Oregon and evaluate if insurance type is associated with receipt of care. We conducted a cross-sectional survey of patients using an Oregon Listserv. Our primary outcome was use of medication for the treatment of moderate or severe symptoms of menopause. We used the Menopause Rating Scale to evaluate respondents' symptoms: 0-4 none or little symptoms; 5-8 mild symptoms; 9-16 moderate symptoms; and 17+ severe symptoms. We abstracted demographic and clinical information including age, rurality, race, ethnicity, primary language, and insurance type. We used a regression model to determine the association between public insurance and treatment for moderate to severe menopause symptoms. We examined reasons for nonuse of therapy. Our sample included 845 perimenopausal or postmenopausal individuals who were predominantly White (93.0%), aged 45-49 (32.8%) or 50-54 years (39.1%), and privately insured (81.3%). Overall, 62.4% of individuals with moderate and severe symptoms of menopause were not receiving any therapy. After adjustment for age and rurality, public insurance was associated with an average of 47% increased odds of nontreatment for moderate or severe menopause symptoms (adjusted odds ratio: 1.47, 95% CI: 0.99-2.19). The most common reasons for nontreatment in both groups were "therapy was not recommended by a provider" (43%) and worries about safety or side effects (40%). Even in well-insured persons, the majority of people with moderate and severe symptoms of menopause are not receiving treatment. People who are publicly insured are more likely to go untreated than privately insured individuals.

Clinical Pharmacology Of Selective Oestrogen Receptor Modulators In The Prevention Of Breast Cancer, Osteoporosis, Coronary Heart Disease, Alzheimer's Disease, Use In Hormone Replacement Therapy, Cholesterol Metabolism

Oestrogen is the key regulatory hormone for the development and maintenance of reproductive functions and affects various physiological systems, including the skeletal, cardiovascular, and central nervous systems. oestrogen replacement therapy (ERT) is highly effective in postmenopausal women, addressing menopausal symptoms and providing beneficial effects on osteoporosis and coronary heart disease. However, ERT is associated with significant side effects, such as an increased risk of breast cancer. To mitigate these risks, selective oestrogen receptor modulators (SERMs) have been developed. SERMs are a growing class of synthetic nonsteroidal compounds that act as oestrogen receptor agonists or antagonists in a tissue-specific manner. They can selectively activate or inhibit oestrogen receptors in different tissues throughout the body. SERMs are used to treat a variety of conditions, including ER-positive breast cancer, osteoporosis, coronary heart disease, Alzheimer’s disease, and cholesterol metabolism disorders in postmenopausal women. Specific SERMs are employed for different conditions: raloxifene for osteoporosis, tamoxifen and toremifene for breast cancer, clomiphene for the induction of ovulation, and ormeloxifene for oral contraception. Arzoxifene is used for altering cholesterol metabolism. Each SERM forms a unique complex with oestrogen receptors, influencing target tissues and resulting in a tissue-selective pharmacological profile. This unique mechanism of action translates into specific safety and efficacy profiles for each SERM. The surprising pharmacology of SERMs has sparked interest in developing new selective medications, allowing for precise treatment of various diseases. This article reviews the pharmacological properties of SERMs and explains how they differ from oestrogen in their actions.

TEMPORARY REMOVAL: Effect of soy isoflavones on measures of estrogenicity: A systematic review and meta-analysis of randomized controlled trials

BackgroundDespite recommendations to increase plant food consumption for public and planetary health and the role that soy foods can play in plant-predominant diets, controversies around the effects of soy foods and especially soy isoflavones, are a barrier to their intake. Given their cardioprotective effects and ability to alleviate menopausal symptoms, addressing these concerns is particularly relevant to women. ObjectiveThis systematic review and meta-analysis of randomized controlled trials aimed to determine the effect of soy isoflavones on measures of estrogenicity in postmenopausal women. MethodsMEDLINE, Embase, and Cochrane Library were searched through August 2024 for randomized trials 3-months investigating soy isoflavones versus non-isoflavone controls in postmenopausal women. Outcomes included endometrial thickness (ET), vaginal maturation index (VMI), follicle-stimulating hormone (FSH), and estradiol. Independent authors extracted data and assessed risk of bias. GRADE (grading of recommendations assessment, development, and evaluation) was used to assess certainty of evidence. ResultsWe included 40 trials (52 trial comparisons, n=3285) assessing the effect of a median reported dose of 75mg/day of soy isoflavones in substitution for non-isoflavone controls over a median of 24 weeks. Soy isoflavones had no statistically significant effect on any measure of estrogenicity; ET (mean difference, -0.22mm [95% confidence interval, -0.45, 0.01mm], PMD=0.059), VMI (2.31 [-2.14, 6.75], PMD=0.310), FSH (-0.02IU/L [-2.39, 2.35IU/L], PMD=0.987), and estradiol (1.61pmol/L [-1.17, 4.38pmol/L], PMD=0.256). The certainty of evidence was high-to-moderate for all outcomes. ConclusionsCurrent evidence suggests that soy isoflavones do not exhibit estrogenic effects compared to non-isoflavone controls on 4 measures of estrogenicity in postmenopausal women. This synthesis supports that soy isoflavones likely act as selective estrogen receptor modulators, differing clinically from the hormone estrogen. Addressing public health concerns may promote soy foods as high-quality plant protein sources with low environmental impact and cost, particularly benefiting postmenopausal women, and aligning with sustainable dietary patterns and guidelines. RegistrationPROSPERO (CRD42023439239)

Letter to Editor: Relieving menopausal symptoms through yoga practice

Letter to Editor: Relieving menopausal symptoms through yoga practice

Transdermal Carboxytherapy for Treating Vulvovaginal Atrophy: A Pilot Study

Objective: Genitourinary syndrome of menopause (GSM) is a prevalent disorder that can negatively impact the overall health, sexual function, and quality of life of affected women; however, available data do not support specific treatment protocols. A novel product enables the noninvasive transdermal administration of carboxytherapy with a topical gel (CO2Lift®, Lumisque, Inc.; Weston, FL). The following randomized, placebo-controlled pilot study assessed the safety and efficacy of the transdermal carboxytherapy gel for treating GSM-related vulvovaginal changes. Methods: Menopausal or postmenopausal women 40 to 70 years old with signs or symptoms of vulvovaginal atrophy and Female Sexual Dysfunction were randomized to receive topical carboxytherapy gel (n=40) or placebo gel (n=10) in a randomized, double-blind fashion. The assigned treatments were placed into the vagina and on the vulva for 45 minutes before removal. Treatment was applied daily for 5 days, stopped for 2 days, then continued for 5 additional days. Subjects completed four validated pre- and posttreatment questionnaires to assess female sexual function, sexual health, and genital self-image. Additionally, control (n=10) and treatment subjects (n=10) were randomized to undergo 3 mm pre- and posttreatment punch biopsies of vulva and vaginal tissue. Results: Overall, carboxytherapy-treated subjects achieved significant improvements in Female Sexual Function Index scores with strong positive correlations between sexual desire and arousal, arousal and sexual satisfaction, and sexual satisfaction and desire. The Day-to-Day Impact of Vaginal Aging Questionnaire results demonstrated a significant difference in mean pre- and posttreatment values for each assessment among subjects receiving topical carboxytherapy. Biopsy improvements included hyperplasia of the keratinized squamous epithelium, discrete hyperplasia of the basal layer and neovascularization, and increased thickness of mucous squamous epithelium. There were no adverse events. Conclusion: Transdermal carboxytherapy represents a safe, noninvasive means of treating the genitourinary syndrome of menopause symptoms and is suitable for home use. Additional research on this treatment is warranted.

КЛИНИЧЕСКАЯ ЭФФЕКТИВНОСТЬ НЕГОРМОНАЛЬНЫХ МЕТОДОВ ТЕРАПИИ ПАТАЛОГИЧЕСКОГО КЛИМАКТЕРИЧЕСКОГО СИНДРОМА У ЖЕНЩИН

The purpose of the study is to study the clinical effectiveness of the dietary supplement "Menophen" in comparison with β-alanine in the treatment of menopausal symptoms in women in the perimenopausal, menopausal and postmenopausal periods. Menopausal syndrome is a complex of vegetative-vascular, psycho-emotional, metabolic-endocrine, vaginal, sexual and other disorders. According to domestic authors, vasomotor disorders such as hot flashes, lability of blood pressure and pulse, increased sweating, chills, which significantly reduce the quality of life of patients and disrupt the circadian sleep-wake rhythm, come to the fore. Today, menopausal women continue to work actively, but hot flashes and sleep disturbances significantly reduce their level of performance and increase the number of absences from sick leave by 82%, compared to women without hot flashes. At the same time, 87.5% of women refuse to use and prescribe MHT, expressing doubts about the safety of their use; the main fears of patients are weight gain and the development of oncological pathology. Treatment with the dietary supplement Menofen leads to a decrease in the number and severity of psycho-emotional, metabolic-endocrine and neurovegetative disorders in menopausal women.

CAUSES, DIAGNOSTICS AND PSYCHOLOGICAL IMPACT OF PREMATURE OVARIAN INSUFFICIENCY- REVIEW OF LITERATURE

Premature ovarian insufficiency (POI) before the age of 35 occurs in 1 in 250 women. It can develop on a genetic basis, but also may be a consequence of iatrogenic interventions, such as surgery, radiation or chemotherapy. The patients with impaired ovarian endocrine function may experience disruptive menopausal symptoms. Estrogens deficiency consequences include increased risk of osteoporotic fractures and cardiovascular events. Lack of folliculogenesis and ovulation results in infertility. Detailed review of the literature was conducted to summarize current knowledge about causes, diagnostics, psychological impact and novel therapeutic methods in POI. Review of the literature was conducted by searching the PubMed database and Google Scholar. Checking the literature was carried out by the following keywords: ‘premature ovarian insufficiency’, ‘POI’, ‘etiology’, ‘symptomatology’, ‘treatment’, ‘pathogenesis’, ‘genes’, ‘mutations’, ‘psychological effects’, ‘oncofertility’. The multifactorial aetiology of POI, including genetic, autoimmune, iatrogenic, and environmental factors, highlights the complexity of this condition and the need for a multidisciplinary approach to diagnosis and treatment. Progress in molecular methods of genetic diagnostics, such as whole-genome sequencing, may help identify causative mutations in a larger proportion of idiopathic cases. Hormonal replacement therapy is the gold standard for alleviating menopausal symptoms, maintaining bone density, and reducing cardiovascular risk. The psychological impact of POI cannot be underestimated, with many patients experiencing significant emotional distress and dissatisfaction with the manner in which their diagnosis is delivered. Healthcare providers must prioritize sensitive and informative communication, while also referring patients to appropriate sources of emotional support.

Styphnolobium japonicum Fruit and Germinated Soybean Embryo Complex Extract for Postmenopausal-Symptom Relief.

Hormonal alterations during menopause result in substantial physiological changes. Although hormone replacement therapy (HRT) is widely used as a treatment strategy for these changes, its use remains controversial due to its associated risks. Plant isoflavones are phytoestrogens that are considered a potential alternative therapy for postmenopausal syndrome. We aimed to investigate the efficacy of ethanolic extracts from Styphnolobium japonicum fruit (SJF) and germinated soybean embryo (GSE) in alleviating prominent menopausal symptoms. A cell model (MCF7 human breast cancer cells) was used to investigate estrogen-like activity. A rat ovariectomy model was used to simulate estrogen depletion after menopause and to evaluate the efficacy of the SJF-GSE complex extract at ratios of 1:1, 1:2, and 2:1. Treatment with the SJF-GSE extract elicited estrogen-like effects, raising pS2 and estrogen receptor α expression in MCF7 cells. The extract was found to contain 48-72 mg/g sophoricoside and 8-12 mg/g soyasaponin 1, identified as active compounds. In ovariectomized rats, the extract effectively reduced body weight and fat content, alleviated vasomotor symptoms, improved vaginal mucosal health, and exerted osteoprotective effects by enhancing bone density and structure, reducing bone-resorption markers and positively altering estradiol levels and lipid profiles. The SJF-GSE extract, working synergistically, provides a safe and effective alternative to HRT for managing postmenopausal symptoms and enhancing bone health, without adverse effects. These findings support the inclusion of SJF and GSE in health-functional foods and underscore the importance of further research into plant-based therapies for menopause.

Women's Experiences of Intimate and Sexual Relationships During Menopause: A Qualitative Synthesis.

The aim of this literature review was to explore women's experiences of their intimate and sexual relationships during menopause. Evidence shows that the menopause transition can be a difficult time for women due to symptoms of menopause. There is little research evidence about how menopause-related symptoms impact women's intimate and sexual relationships. A qualitative synthesis was carried out on research published between May 2005 and July 2023 using five electronic databases: ASSIA, CINAHL, PubMed, PsycINFO and Web of Science. We also searched Google Scholar and used backward and forward chaining methods to identify results not listed in the databases and ensure that no relevant literature was omitted. Eighteen qualitative studies were included in this review. Six main themes were identified: the meaning of menopause to women in different cultures; factors affecting women's sexual lives; changes in sexual desire and orgasm; talking about sexual issues; women's attempts to overcome the impact of ageing and menopause on their sexual lives; and concerns about partner sexual satisfaction during the menopause. During the menopause transition, women can experience sexual difficulties that have an impact on their lives and intimate relationships. Qualitative studies showed that sexual changes associated with menopause can be difficult to manage and must be viewed in the social and cultural contexts of the women's lives. The results of this review will be of interest to nurses to assess patient needs while offering health services to women in menopause. In addition, the results can be used to inform education and support programmes for women. We have adhered to relevant EQUATOR guidelines and used the PRISMA-ScR reporting method. No patient or public contribution was required for this study.

Factors associated with uterine fibroids in women of reproductive age: A cross-sectional study

Background. Uterine fibroids is a benign monoclonal tumor originating from the smooth muscle layer of the uterus. Non-modifiable risk factors for the development of uterine fibroids, such as age, ethnicity, age at menarche, etc, have been studied quite extensively, while the role of many controllable factors remains debatable.The aim of the study. To identify the main modifiable factors associated with uterine fibroids in women of reproductive age living in the Baikal region, including certain ethnic groups.Materials and methods. We carried out a multicenter cross-sectional study in 2016–2019 in institutions of Irkutsk and Bokhan (Irkutsk region) and Ulan-Ude (Republic of Buryatia). The subjects of the study were women to have annual workplace medical examination. The study included 1,347 participants of reproductive age (34.33 ± 6.37 years) who met the inclusion criteria. Among all women included in the study, there were 867 (64.37 %) Caucasians, 361 (26.80 %) Asians, and 119 (8.83%) women of mixed (Caucasian-Asian), ethnicity. The research methods included a questionnaire, general clinical and gynecological examination, and pelvic ultrasound examination.Results. According to our study, the main non-modifiable factors associated with the presence of uterine fibroids were: Asian ethnicity; age at menarche 12–13 years; age of the study participant 40–44 years; menopausal symptoms; adenomyosis. The “controllable” factors included: city residency; body mass index over 40 kg/m2; history of abortions and miscarriages; metabolic syndrome; using combined oral contraceptives; lack of sexual activity; smoking; presence of anumber of occupational hazards.Conclusion. Our study identified the main controllable factors associated with the presence of uterine fibroids in a multiethnic population of women of reproductive age.

Menopausal Hormone Therapy in Breast Cancer Survivors.

Menopausal symptoms negatively impact quality of life in breast cancer survivors. The paucity of data on the impact of Menopausal Hormone Therapy (MHT) on oncological outcomes in these patients limits informed clinical discussion. Defining the risk of cancer recurrence with MHT is central to the appraisal of risk/benefit, particularly with low-risk disease (based on genomic profile). The aim of this review is to summarize the current data evaluating MHT in breast cancer patients. A systematic review of the literature was performed to evaluate the impact of MHT on oncological outcomes in breast cancer survivors. Three major databases (PubMed, EMBASE and Medline) were searched. The review included all prospective studies published in English. Four randomized control trials and four non-randomized prospective studies were identified. An increase in breast cancer recurrence with MHT was observed in the early randomized trials whilst no increased risk of recurrence was reported in the observational studies. There remains a need to quantify MHT-related recurrence risk in patients with molecularly favorable disease.