Menopausal Syndrome Research Articles

Study on gut microbiota and metabolomics in postmenopausal women.

Menopausal syndrome, occurring during the menopausal stage in women, manifests as symptoms stemming from decreased estrogen levels, such as hot flashes, insomnia, mental disorders (anxiety, depression), and osteoporosis. The bulk of studies have indicated alterations in the gut microbiota of those experiencing menopause syndrome compared to healthy women. However, This article focuses on the alterations in gut microbiota in perimenopausal women. Our study utilized 16s rRNA sequencing to determine the differences in the gut microbiota and metabolites among 44 menopausal syndrome women. The distribution of gut microbiota in postmenopausal women varies based on the level of follicle stimulating hormone, with changes in gut microbiota abundance taking precedence over symptom onset. Fecal metabolites reveal changes in several metabolites, including Amino acid metabolism (Tyrosine, Tryptophan), Lipid metabolism (Alpha linolenic acid metabolism), and other metabolites. Disturbances in lipid metabolism, triggered by hormonal level fluctuations, can contribute to the development of osteoporosis.

Hu's AnGeng Decoction combined with Femostom for treating Menopausal syndrome: a randomized trial and network pharmacology study

Hu's AnGeng Decoction combined with Femostom for treating Menopausal syndrome: a randomized trial and network pharmacology study

Use of radiofrequency ablation of the vaginal canal for genitourinary syndrome of menopause.

Genitourinary syndrome of menopause (GSM) is a prevalent condition with a constellation of symptoms including burning, dryness, dyspareunia, and irritative lower urinary tract symptoms that result from vulvovaginal atrophic changes. Though hormonal therapy is a mainstay of treatment in GSM, some patients may pursue nonhormonal therapies. To determine the efficacy of radiofrequency ablation of the vaginal canal with the MorpheusV applicator in reducing the symptoms of GSM. We conducted a multicenter prospective case series of women with GSM as confirmed by Vaginal Health Index Score (VHIS). Subjects received 3 treatments of radiofrequency ablation ~4weeks apart with follow-up to 6-month posttreatment. The primary endpoint was VHIS at 6-month posttreatment. Secondary endpoints were VHIS at 3 months, Visual analog scale (VAS) pain with each treatment, 3- and 6-month measurements of urogenital distress inventory-6 (UDI-6), and female sexual function index (FSFI) questionnaires. From 2021 to 2023, 71 women were enrolled in the study with 51 followed to the 6-month follow-up time point. Treatments were found to be low in VAS pain score with mean values of 2.13 ± 2.1, 2.55 ± 2.38, and 2.18 ± 2.14 at treatments 1, 2, and 3 respectively. An improvement in VHIS score was seen from baseline to 3 months after the last treatment (15.00 ± 5.37 vs. 19.62 ± 4.44) and sustained at 6 months (20.23 ± 4.12) (P < .001). Significant improvements in both UDI-6 and FSFI were also noted. Between baseline and 6 months after treatment (FSFI: 18.81 ± 9.57 vs. 22.81 ± 10.34, P < 0.001; UDI-6: 39.58 ± 15.98 vs. 22.42 ± 14.03, P < 0.001). No adverse events were encountered by any subject during this study. A therapy that is safe and effective in the treatment of both GSM and lower urinary tract symptoms without the use of hormonal methods is clinically impactful for the many patients who cannot receive or do not desire to receive these medications. Strengths of this study include the utilization of 3 treatment sessions, with follow-up of subjects to 6-month posttreatment with a comprehensive assessment of patient symptoms. Limitations include the unblinded nature of the study and the lack of a comparator group. The data from this study suggests that radiofrequency ablation of the vaginal canal by the MorpheusV applicator is a safe and effective intervention for GSM. It also shows subjective improvements in stress urinary incontinence, urge urinary incontinence, and sexual function.

Clinical and histomorphometric evaluation of the vagina following treatment with CO2 laser, radiofrequency, and promestriene for genitourinary syndrome of menopause in breast cancer survivors on adjuvant therapy

Clinical and histomorphometric evaluation of the vagina following treatment with CO2 laser, radiofrequency, and promestriene for genitourinary syndrome of menopause in breast cancer survivors on adjuvant therapy

Vaginal LASER and estrogen comparison in Genitourinary Syndrome of Menopause

Aim:This study aims to compare the efficacy of CO2 fractionated laser therapy and topical estrogen treatment in managing Genitourinary Syndrome of Menopause (GSM). Materials and Methods:A total of 88 patients diagnosed with GSM were included in this retrospective study. Of these, 39 received CO2 fractionated laser treatment, while 49 were treated with topical estrogen. Patients whose treatment was completed 1 to 1.5 months prior and had pre-treatment Vaginal Health Index (VHI) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) scored recorded were included in the study. These patients were invited for a follow-up visit, during which post-treatment VHI and ICIQ-SF scores were assessed by a physician. Results:Both the laser and estrogen groups showed significant improvements in VHI and ICIQ-SF scores after treatment (p < 0.00001 for both groups). No statistically significant difference was found between the post-treatment VHI and ICIQ-SF scores of the two groups (p < 0.923 and p < 0.579, respectively). Conclusion:Although there was no significant difference in the treatment efficacy between estrogen and CO2 fractionated laser therapy, there was a considerable difference in cost, with CO2 fractionated, with laser treatment being 23–24 times more expensive. Therefore, CO2 fractionated laser therapy, which shows similar short-term efficacy to topical estrogen, may be more suitable for patients where hormone therapy is contraindicated.

Genitourinary Syndrome of Menopause (GSM) and its impact on Quality of Life (QoL) among Midlife Women in Accra, Ghana

Introduction: Genitourinary syndrome of menopause (GSM) is a chronic, progressive, vulvovaginal, sexual, and lower urinary tract condition characterized by a broad spectrum of signs and symptoms. It is a consequence of the hypoestrogenic state associated with reproductive aging and impacts the quality of life of affected women. Even though the condition mainly affects postmenopausal women, it is seen in many premenopausal women as well This study sought to determine the prevalence, associated factors and quality of life impact associated with GSM among midlife women reporting for cervical routine screening in a tertiary hospital. Method: A cross-sectional study of 400 women aged 40 to 60 years who had a routine cervical smear at the Korle Bu Teaching Hospital (KBTH) from February 2022 to September 2022. GSM was defined by using three parameters: one symptom of GSM, one physical sign of vaginal atrophy and vaginal pH &gt; 5. Quality of life was determined using the Day-to Day Impact on Vaginal Aging (DIVA) Questionnaire. Multiple logistic regression was used to assess significant association and 95% confidence intervals calculated around the estimates generated. Results: The prevalence of GSM was 46.8%. The most common symptom and sign was vaginal dryness (57%) and vaginal pallor (85%) respectively. Age, frequency of sexual activity and anogenital index were significantly associated with GSM. Participants with GSM had higher mean DIVA scores as well as higher scores for the sexual dysfunction and self-perception domains. Conclusion: The study found a high prevalence of GSM significantly associated with increasing age, frequency of sexual activity and high anogenital index. As GSM negatively impacted the QoL of the women. It is important to screen and intervene early to improve QoL

Efficacy and Safety of Non-Ablative Dual Wavelength Diode Laser Therapy for Genitourinary Syndrome of Menopause: A Single-Center Prospective Study.

This study evaluates the efficacy and safety of non-ablative diode laser therapy for genitourinary syndrome of menopause (GSM) in post-menopausal women unable to use hormonal therapies. A pilot prospective study was conducted from September 2023 to April 2024, involving 22 post-menopausal women aged 45-73years. Participants underwent three sessions of diode laser treatment with the Leonardo® dual-wavelength Diode laser. Assessments were made at baseline, 3months, and 6months post-treatment. Main outcome measures included Visual Analog Scale (VAS) scores for GSM symptoms, Vaginal Health Index Score (VHIS), and sexual function evaluated using the Female Sexual Function Index (FSFI-6), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), and Sexual Quality of Life-Female (SQOL-F) questionnaire. Significant improvements were observed in VHIS, increasing from 12 to 19.27 at 6months (p<0.001). GSM symptoms improved significantly: vaginal dryness scores decreased from 7.72±2.37 to 3.72±2.53, burning sensation scores dropped from 6.00±3.22 to 1.90±1.81, and dyspareunia scores reduced from 8.09±2.11 to 3.90±2.58 (all p<0.016). Sexual function improved, indicated by FSFI-6 scores increasing from 12.27±7.29 to 19.30±6.24 (p<0.016) and SQOL-F scores rising from 63.18±22.93 to 71.45±23.31. No adverse events were reported. Non-ablative diode laser therapy is effective and safe for managing GSM symptoms in post-menopausal women, offering significant symptom relief and enhancing sexual health without serious side effects. Further research with a larger cohort and extended follow-up is needed to confirm these findings. Clinical Trials ID NCT06503003.

What is new on peri- and postmenopause?

Menopause is an increasingly discussed topic in recent years. More women are demanding consultancy and help from their doctors via different channels, be it online or in menopause centers.The term genitourinary syndrome of menopause (GSM) comprises vaginal and urological symptoms such as mucosal dryness, itching and burning, dysuria or bleeding and pain during sexual intercourse. GSM can strongly affect quality of life, is common if estrogen deficiency has lasted for 3 months and can be treated locally with very low doses of the weak estrogen estriol."Not feeling like myself anymore" - symptomatic perimenopause may present with sleep disturbances, mastalgia, mood swings, palpitations, panic attacks, but also entail joint pain, vertigo, headache, and brain fog - even years before menopause and in the presence of still adequate estrogen levels. In an online study, 20% of women in the menopausal transition reported symptoms which they could not explain, and which may cause fears of serious illness. This can lead to extensive medical work-ups if the possibility of perimenopause as the cause is disregarded.(Peri-)menopausal complaints last much longer than previously thought: The Study of women's health across the nation (SWAN) reported longer duration of vasomotor symptoms (median: 11,8 years) in women who were already affected in early perimenopause, while those in whom VMS started only after menopause experienced a shorter duration of symptoms (median: 3,4 years).Female hormones protect women from fatty streaks and hypertension, but menopausal hormone therapy (MHT) has positive effects only if started in the first decade after menopause. The interaction with stress, aging and lifestyle factors is complex.For the treatment of VMS, German and international guidelines list both drug and non-drug or non-prescription options, although there is no clear data on their effectiveness.Fezolinetant, a Neurokinin-3 receptor antagonist, is now available in Germany for the treatment of vasomotor symptoms in postmenopausal women with contraindications or aversion against steroid hormones. It modulates the thermoregulation center in the hypothalamus by blocking the KNDy-neurons. Studies on Elinzanetant, another representative of this class of drugs, are still ongoing.

Effects and Mechanisms of Lactobacillus Probiotics in Maintaining Women’s Vaginal Health: A Review

Probiotics are beneficial living microorganisms. They are useful to vaginal health when consumed in suitable doses. The dominant species included in probiotics are Lactobacillus. We can get these microbes naturally or commercially utilize them as functional food. Lactobacillus species form 70% of inhabitant bacteria in females compared to other warm-blooded animals. The prevalent Lactobacillus species are L. crispatus, L. gasseri, L. iners and L. jensenii. Because of the development of antibiotic resistance mechanisms, the beneficial relationship between humans and probiotics has been discussed for several years. Lactobacillus prevents the attachment of pathogens by using several mechanisms, for example, by increasing estrogen levels, production of lactic acid, lowering pH 4.0-4.5 to provide an acidic environment, release of hydrogen peroxide, bacteriocins and bacteriocins-like substances, adhesion and colonization properties. Lactobacillus prevent the entry and attachment of pathogenic bacteria, thus not only helping to control and manage different gynecological conditions like bacterial vaginosis, endometriosis, vulvovaginal candidiasis and genitourinary syndrome of menopause but also infections that can spread through sexual contacts such as gonorrhea, chlamydia, genital herpes, Human papillomavirus infections (HPV). Overall, the use of probiotics in improving vaginal health is beneficial, easy and cost-effective but the use of probiotics in HPV clearance is not quite beneficial. So, more work should be done on HPV preventive vaccines.

The Link Between Menopause and Urinary Incontinence: A Systematic Review.

This study aims to review the subsisting literature on the relationship between menopause and urinary incontinence (UI).To locate research that met the inclusion criteria, a thorough computerized search of relevant databases was carried out. A comprehensive search was carried out on PubMed, SCOPUS, Science Direct, Cochrane Library, and Web of Science to locate relevant material.Our data included 11 trials with 8547 post-menopausal women. The prevalence of UI among post-menopausal women ranged from 13.6% to 84.4%, with a total prevalence of 5394 (63.1%). Across studies, the mean age of menopause varies, with some studies reporting averages around 48 to 50 years. Several studies report that UI prevalence increases with age, particularly in the postmenopausal period. UI symptoms, such as burning micturition and mixed UI, are noted, often related to the genitourinary syndrome of menopause (GSM) and nocturia. These symptoms are linked to reduced quality of life and considerable morbidity.Among postmenopausal women, UI is still a common and complex problem that has a significant negative impact on well-being and life quality. There is no doubt that menopause, aging, and UI are related, but there is still much to learn about the underlying reasons and practical treatment options. The quality of care for postmenopausal women with UI can be improved by standardizing diagnostic procedures, emphasizing non-hormonal therapy, and addressing socioeconomic and lifestyle determinants. These and other initiatives will be addressed in future research and clinical practice.

The Effectiveness of Dry Carbon Dioxide Baths in Menopausal Syndrome: a Randomized Clinical Study

INTRODUCTION. Climacteric syndrome is characterized by significant disorders in the nervous, musculoskeletal, urinary and cardiovascular systems in women of the perimenopausal and postmenopausal periods. The main reason is a sharp decrease in estrogen levels. Menopausal hormone therapy is often used for treatment, but due to contraindications and complications, it does not always completely solve the problem. This has sparked interest in alternative treatments such as dry carbon dioxide baths. AIM. To study the effectiveness of using dry carbon dioxide baths in women with menopausal syndrome and evaluate their impact on the neurovegetative, metabolic and psycho-emotional state of these patients. MATERIALS AND METHODS. A prospective randomized study was conducted involving 70 patients with moderate climacteric syndrome aged from 48 to 60 years. Using a simple randomization method, the women were divided into 2 groups: 35 patients of the main group received 10 procedures of dry carbon dioxide baths with a CO2 concentration of 15–20 %, temperature 28–32 °C, lasting 15–20 minutes, 35 patients of the control group did not receive any treatment. To assess the effectiveness of treatment, a modified Kupperman-Uvarova menopausal index, an assessment of the effect of “hot flashes” on daily life on the HFRDIS scale, as well as daily blood pressure monitoring (SMAD) were used. RESULTS AND DISCUSSION. After treatment, patients in the main group observed a significantly significant (p 0.05) improvement in the patients’ condition in the form of a decrease in integral indicators of the modified menopausal index and an assessment of the impact of hot flashes on daily activity on the HFRDIS scale by 28.2 and 43.1 %, respectively, as well as in the form of a decrease in average daily systolic blood pressure by 13.7 %. CONCLUSION. The use of dry carbon dioxide baths is recommended for use in women with moderate climacteric syndrome, since this method significantly improves the quality of life of patients and is an effective non-drug that can reduce the drug load on the body of a woman suffering from neurovegetative disorders.

Influence of Mediterranean Diet on Sexual Function in People with Metabolic Syndrome: A Narrative Review

Metabolic syndrome (MS), a cluster of cardiometabolic disorders, and sexual dysfunction are two conditions that impact a large proportion of the general population. Although they can occur independently, they are frequently linked and significantly affect people’s quality of life. In recent years, research has increasingly focused on the importance of diet, particularly the Mediterranean diet (MD), in modulating sexual function due to its anti-inflammatory, antioxidant, and vasodilatory properties. In this narrative review, we examined the relationship between MS and sexual function in both men and women, with a special emphasis on the MD’s therapeutic efficacy in improving sexual dysfunction. In men, MD has been shown to ameliorate erectile dysfunction, as well as several sperm parameters, perhaps leading to improved fertility. On the other hand, adherence to MD has been demonstrated to partially recover several sexual dysfunctions in women, such as those related to their menstrual cycle, menopause, endometriosis, and polycystic ovary syndrome. These favorable effects of MD have been demonstrated in both sexes also among people affected by MS. However, more targeted studies are needed to validate these data for different dietary approaches as well.

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.

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.

Surgical menopause and its management. Analysis of literature data and own data

The article presents the main clinical variants of the surgical menopause syndrome (SMS), provides modern views on the treatment of this pathology.The purpose of the study was to identify the features of the clinical course of SMS compared to the typical climacteric syndrome, to present modern views on its management, and to determine ways of prevention.To achieve this goal, a literature search and analysis was conducted in the PubMed scientometric database for the last 15 years, and domestic scientific publications related to the mechanisms of development, clinical course, and management of SMS were selected. At the current stage, there is a significant increase in the prevalence of uterine leiomyomas, as well as a tendency to increase the frequency of this pathology in young women. Given that 50% of uterine leiomyomas have symptomatic course, the number of surgical interventions for leiomyomas is also increasing.Hysterectomy occupies a significant place among operative interventions for benign tumors of the uterus and ovaries. As a result of hysterectomy (with or without oophorectomy) in women, SMS occurs. The main pathogenetic mechanism of SMS is hypoestrogeny. As a result, a symptom complex of menopausal disorders develops: vegetative-vascular, neuropsychic, metabolic and urogenital disorders. Compared to the classic climacteric syndrome, the clinical condition in surgical menopause is more acute and progresses faster.The management of SMS depends on the volume of surgical intervention, the age of the patient, and concomitant pathology. Treatment of SMS should be individualized and include the use of menopausal hormone therapy, herbal preparations, multivitamin complexes against the background of lifestyle modification.The prevention of SMS consists in the wide use of modern conservative and minimally invasive operations in the case of surgical treatment of benign tumors of the uterus and ovaries, a balanced approach to determining the volume of operations.

The Effects of Quercetin on the Expression of Collagen I, Collagen III and Elastin in Vaginal: An Experimental Animal Study

Background: Vulvovaginal atrophy is part of the genitourinary syndrome of menopause caused by hypoestrogenic changes. This pathophysiological mechanism alters the concentration of collagen and elastin, which modifies the vaginal mucosa and impairs the function of the pelvic floor muscles. Quercetin is one of the flavonols found in plants, fruits, and vegetables. Quercetin helps to improve the syndrome through a variety of actions and estrogen-like effects. This study aimed to analyze the impact of quercetin on collagen I, collagen III, and elastin in a vaginal menopausal rat model. Method: This study's research design was an in vivo randomized control group post-test. The research was conducted at the animal laboratory, Faculty of Medicine, Universitas Airlangga. Rattus norvegicus, used in the study, were divided into 5 groups: normal rat, menopausal model without treatment, menopausal model given 17-β estradiol valerate 0.18 mg/kg, quercetin 12.5 mg/kg, and quercetin 50 mg/kg. The effectiveness of therapy was assessed from the immunohistochemical expression of collagen I, collagen III, and elastin in vaginal tissue. Results: The standard group in this study had the highest average expression levels of collagen I and elastin. The group of menopausal models without treatment in the study had the highest average expression of collagen III. Collagen I expression (p &lt; 0.001), collagen III expression (p &lt; 0.001), and elastin expression (p &lt; 0.001) all showed significant differences. The menopausal rat model without treatment and the standard group showed the most differences in the expression of collagen I, collagen III, and elastin. Conclusions: The expression of collagen I, collagen III, and elastin in the vagina of the menopausal model was affected by the administration of quercetin at a level of 50 mg/kg. Thus, quercetin can be an alternative herbal treatment option to improve vulvovaginal atrophy in menopausal conditions.

Efficacy and safety of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause: A randomized double-blind placebo-controlled trial

ObjectivesThis study evaluated the efficacy of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause. Study designRandomized, double-blind, placebo-controlled, multicenter clinical trial conducted across 28 Spanish sites involving specialists in gynecology, urology, and primary care. A total of 108 postmenopausal women were randomly assigned in a 1:1 ratio to receive 1 g of vaginal gel with 50 micrograms of estriol or an identical moisturizing vaginal gel without estriol. Main outcome measuresThe primary outcome was the number of episodes of urinary tract infection by the end of the 24-week treatment. Secondary measures encompassed percentage of patients without recurrence, time to first recurrence, use of antibiotic treatment, vaginal pH, safety, and tolerability, among others. ResultsThe incidence rate of urinary tract infections (new cases per 100 women-year) was 26 % lower in the group that received estriol vs. the group that received placebo (32.34 vs. 43.76 (RR = 0.74) p < 0.001). The frequency of urinary tract infections fell during treatment in all patients in the estriol group. Favorable pH changes from baseline were observed in the estriol arm at all follow-up visits. ConclusionsUltra-low-dose 0.005 % estriol vaginal gel is safe and effective in preventing recurrent urinary tract infections in postmenopausal women with genitourinary syndrome of menopause, reducing the incidence and potentially decreasing the susceptibility to urogenital infections by improving vaginal pH.Study registration N°: 2018-001481-42. Date of registration: 09-04-2018.

Unveiling proteomic targets in the hypothalamus of ovariectomized and estradiol-treated rats: Insights into menopausal syndrome mechanisms

BackgroundMenopausal syndrome profoundly affects the physical and mental health of many women, drawing increasing attention from the medical community. However, its pathogenesis remains unclear. These symptoms are primarily driven by hormonal fluctuation. The hypothalamus, a key regulator of hormonal balance, potentially playing a critical role in the manifestation of menopausal syndrome. MethodsWe simulated the low-estrogen menopausal state using ovariectomized rats, confirmed the success of ovariectomy via histological analysis of the uterus and vagina, followed by estrogen treatment. TMT-labeled quantitative proteomics, RTqPCR, targeted proteomics and Western blotting were used to identify differentially expressed proteins and their functions in the hypothalamus under low-estrogen conditions. ResultsOne-way ANOVA (p < 0.05) identified 295 differentially expressed proteins across the sham, ovariectomized and estrogen-treated groups. Post-ovariectomy, 103 differentially expressed proteins were upregulated and 93 were downregulated. Among these, 50 proteins were involved in hormones and neurotransmitters, immunity, metabolism and cardiovascular function. Notably, four proteins—Prkcg, Hsp90ab1, Ywhae, and Gad2—were identified as crucial regulators. ConclusionsThis study elucidates the central molecular mechanism of menopausal syndrome through bioinformatics analysis of differentially expressed proteins in the hypothalamus under low-estrogen conditions, providing novel targets for the treatment of related symptoms.

Sex-Specific Cardiovascular Risk Factors and Treatment in Females With T2DM and CVD: Developments and Knowledge Gaps

Abstract Purpose There are large disparities in the impact of diabetes on cardiovascular disease (CVD) risk and outcomes by sex and gender. Achieving health equity requires understanding risks and medication efficacy in female patients, especially now, as novel pharmacologic treatments are transforming the diabetes and CVD treatment landscape. This review examines 2 bodies of research that can inform sex differences in CVD in patients with diabetes: female-specific risk factors for CVD and sex-related limitations of clinical trial research in evaluating novel diabetes and CVD treatments. Methods Two literature searches were performed using Ovid Medline(R) All. The first retrieved manuscripts covering sex and gender differences related to CVD risk and therapies and diabetes. The second focused on randomized controlled trial data on sex/gender differences and GLP-1/SGLT-2/DPP-4 drugs. Results Female-specific risk factors for CVD include early menarche, premature or early menopause, irregular cycles and polycystic ovary syndrome; pregnancy; adverse pregnancy outcomes; history of breast cancer; and autoimmune diseases. Clinical trials of novel pharmacological treatments for diabetes and CVD have undersampled female populations, and clinical characteristics of male and female participants have differed significantly. Thus, evidence to evaluate potential sex differences in treatment efficacy and side effects has been lacking. Conclusion To improve health of female patients with diabetes, sex-specific cardiovascular risk factors should be taken into account in screening and treatment decisions. Further, studies of cardiovascular and diabetes medications must ensure adequate representation by sex and report participant characteristics and outcomes by sex.

Research status of hormone replacement therapy on mood and sleep quality in menopausal women

Menopausal syndrome is a common disease of clinical women, which refers to a series of physical and mental symptoms caused by the fluctuation or reduction of sex hormones before and after menopause. Many of these patients have sleep and mood abnormalities that affect their health and quality of life. At present, the understanding of it is gradually improving. This paper mainly analyzes its background and current treatment.