Menopausal Transition Research Articles

Ovarian tissue cryopreservation and transplantation as a natural means to delay menopause.

Ovarian tissue cryopreservation and transplantation (OTCT) offers hope for preserving fertility and endocrine functions in patients undergoing gonadotoxic treatments. Advancements in techniques for the procedure have transformed OTCT from an experimental procedure into a viable option. There is a growing interest in utilizing OTCT to delay menopause and alleviate associated health issues. Menopausal transition affects women globally, leading to symptoms and long- term health risks. OTCT has the potential to restore endocrine functions, reducing menopause-related symptoms while mitigating health consequences such as osteoporosis and cardiovascular diseases. Although the use of OTCT for delaying menopause is not clinically proven, the discussion around shows potential for future utilization. In essence, the remarkable advancements in OTCT have bestowed upon us the ability to safeguard fertility and sustain the delicate endocrine functions of the ovaries. However, it is the tantalizing prospect of utilizing this technique to postpone menopause and alleviate its associated symptoms that truly captivates the imagination. Further research is imperative to substantiate the clinical efficacy of OTCT; nonetheless, its potential in menopausal therapy is both promising and warrants comprehensive exploration. This review highlights advancements and the feasibility of OTCT to postpone menopause as an alternative approach to currently used conventional menopause therapy methods.

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.

Cut-off point development for the Everyday Memory Questionnaire – Revised in perimenopausal women

Objective Subjective cognitive complaints have been reported in women during perimenopause and the Everyday Memory Questionnaire – Revised (EMQ-R) has been recently evaluated as a standardized instrument to measure subjective cognitive changes. The purpose of this study was to identify potential cut-off points for the EMQ-R retrieval subscale and attentional subscale, and to assess the validity of these cut-off points in detecting objective cognitive changes associated with reported subjective cognitive complaints. Method After screening, 232 perimenopausal women were included in the analyses. The supervised classification and regression tree was applied to identify optimal cut-off points. Its performance was evaluated by the value of the receiver operating characteristics curve, sensitivity and specificity. Results Findings revealed that the optimal cut-off point for the attentional subscale was 7, and for the retrieval subscale was 13. Both cut-off points presented acceptable discrimination performance. An independent t-test indicated that both cut-off points were associated with significant differences in scores on neuropsychological measures of retrieval (episodic memory and verbal fluency) as well as neuropsychological measures of higher-level attention (working memory). Conclusion The identified cut-off points may be helpful for women to track or quantify their subjective experiences of brain fog or cognitive symptoms during the menopause transition.

Prevalence Of Metabolic Syndrome in Peri and Postmenopausal Women Aged 40- 65 Years in a Tertiary Care Centre

Metabolic syndrome (MetS) is a constellation of interrelated risk factors of metabolic origin— metabolic risk factors—that appear to directly promote the development of atherosclerotic cardio-vascular disease (ASCVD). Menopausal transition with its incidental hormonal changes is considered to contribute to the development of MetS. This was a hospital based cross sectional descriptive study conducted in the Obstetrics and Gynaecology department of Nepal Medical College Teaching Hospital, Attarkhel, Gokarneshwor-8, Kathmandu, from the 1st of September 2023 till the 29th of February 2024 after clearance from the IRC (Ref. No: 56-080/081). Convenience sampling was used among women who fulfilled the inclusion criteria. The aim of the study was to determine the prevalence of MetS among the peri and postmenopausal women and to determine which component of the diagnostic criteria of MetS was more strongly associated with MetS in our population. Women were evaluated to have MetS using both the International Diabetes Federation (IDF) and the National Cholesterol Education Program- Adult Treatment Panel III (NCEP-ATPIII criteria). The prevalence of MetS by the IDF criteria was 54% among the perimenopausal women and 61% among the postmenopausal women. Similarly, the prevalence of MetS according to NCEP-ATPIII was 53.5% among the perimenopausal and 65% among the postmenopausal women. All the MetS diagnostic markers showed a strong correlation with MetS (p<0.001). The prevalence of MetS is high in our population by both the IDF and NCEP-ATP III criteria, being higher in the postmenopausal population, though not statistically significant.

The Association Between Hypothyroidism and Cognitive Function Change in Women across the Menopause Transition: The Study of Women's Health Across the Nation.

Background: Patients treated for hypothyroidism with levothyroxine (LT4) monotherapy may present with persistent hypothyroidism symptoms, including cognitive symptoms, despite having a normal thyroid stimulating hormone (TSH) level. It remains unclear whether LT4 monotherapy is sufficient to normalize cognitive function outcomes over time. Methods: This is a multisite longitudinal study of a diverse group of women during midlife representing 5 ethnic/racial groups from 7 enrollment sites across the United States in the Study of Women's Health Across the Nation. Women were screened for a history of thyroid disease and the use of LT4. The study consisted of two primary groups: women with LT4-treated hypothyroidism and control women without thyroid disease. Each participant completed up to 9 cognitive assessments over the study period testing processing speed, working memory, and episodic memory (immediate and delayed recall). Multivariable generalized linear mixed models of scores for each cognitive assessment were developed to determine the association between LT4-treated hypothyroidism and cognitive function trajectories. Covariates included sociodemographic, clinical characteristics, and menopausal status (pre/early peri, late peri, and surgical/post). Sensitivity analyses were conducted to assess the impact of abnormal TSH levels and practice effects (i.e., improvements in scoring after repeated testing). Results: Of the 2033 women who were included in the study, 227 (11.2%) met criteria for LT4-treated hypothyroidism. At baseline, both processing speed and working memory scores were higher in LT4-treated women (mean processing speed scores: 56.5 vs 54.4; p value = 0.006; mean working memory scores: 6.8 vs 6.4; p value = 0.018). However, when considering the effect of LT4-treated hypothyroidism over time, there were no significant differences in the rate of cognitive decline (in any measure) between the hypothyroidism and control groups with or without covariate adjustment. The results were similar when considering LT4-treated women with abnormal TSH levels or after minimizing practice effects. Conclusions: We observed no difference in cognitive decline between women with LT4-treated hypothyroidism and women without thyroid disease. For similar aged patients with cognitive complaints, if thyroid function testing is normal, clinicians should consider causes other than inadequate thyroid hormone treatment to explain these symptoms.

Menopausal stage transitions and their associations with overall and individual sleep quality in middle-aged Korean women

BackgroundUnderstanding the association between the menopausal transition and declining sleep quality can guide optimal timing for preventive interventions in transitioning women. However, studies lack representation of Asian women and sufficient data on the progression of menopausal stages and sleep quality changes over time in this population. MethodsThis study included 3305 women in the pre-menopause stage at baseline. The sleep quality and its components were assessed using the Pittsburgh Sleep Quality Index (PSQI). Menopausal stages were classified as pre-menopause, early transition, late transition, and post-menopause according to the Stages of Reproductive Aging Workshop+10 (STRAW+10) criteria. We estimated the longitudinal association between menopausal stage changes over time and the PSQI score, and examined the effect of being overweight. ResultsThe trends in the PSQI scores and its components according to the menopausal stage changes over time showed that with the exception of sleep duration and habitual sleep efficiency, an overall decline was noted in sleep health during late transition and post-menopause compared to pre-menopause. These associations were independent of time-variant annual chronological aging, which was not significantly associated with sleep deterioration. Additionally, although the associations between menopausal stages and sleep quality did not significantly differ by adiposity level, the overweight group exhibited worse PSQI scores and components than did the non-overweight group. LimitationSleep quality and menopausal stage were assessed using self-reported questionnaires without objective measures. ConclusionOur study underscores the importance of screening for sleep quality deterioration and implementing appropriate measures for women experiencing menopausal transition.

A 2-year follow-up to a randomized controlled trial on resistance training in postmenopausal women: vasomotor symptoms, quality of life and cardiovascular risk markers

BackgroundMost women experience vasomotor symptoms (VMS) during the menopausal transition. A 15-week resistance training intervention (RTI) significantly reduced moderate-to-severe VMS (MS-VMS) and improved health-related quality of life (HRQoL) and cardiovascular risk markers in postmenopausal women. Whether a short RTI could have long-term effects is unknown. We aimed to investigate whether there were intervention-dependent effects two years after a 15-week RTI on MS-VMS frequency, HRQoL, and cardiovascular risk markers in postmenopausal women.MethodsThis observational prospective cohort study is a follow-up to a randomized controlled trial (RCT) on a 15-week RTI in postmenopausal women (n = 57). The control group had unchanged low physical activity during these first 15 weeks. At the follow-up contact two years post-intervention, 35 women agreed to participate in an additional physical visit at the clinic with clinical testing, blood sampling, and magnetic resonance imaging, identical to the protocol at the baseline visit at the start of the RCT.ResultsAlthough all women showed reduced MS-VMS and increased moderate-to-vigorous physical activity (MVPA) over the 2-year follow-up compared to baseline, the groups from the original RCT (intervention group; IG, control group; CG) changed differently over time (p < 0.001 and p = 0.006, respectively) regarding MS-VMS. The IG maintained a significantly lower MS-VMS frequency than the CG at the 6-month follow-up. At the 2-year follow-up, there was no significant difference between the original RCT groups. No significant changes over time or differences between groups were found in HRQoL or cardiovascular risk markers. However, significant interactions between original RCT groups and time were found for visceral adipose tissue (p = 0.041), ferritin (p = 0.045), and testosterone (p = 0.010).ConclusionsA 15-week resistance training intervention reduced MS-VMS frequency up to six months post-intervention compared to a CG, but the effect was not maintained after two years. The RTI did neither contribute to preserved improvements of cardiovascular risk markers nor improved HRQoL after two years compared to a CG.Trial registrationClinical trials.gov registered ID: NCT01987778, trial registration date 2013–11-19.

The development and evaluation of a fact sheet resource for women managing menopausal-related cognitive complaints.

Cognitive symptoms are frequently reported by women during the menopause transition years. The aim of this research was to codesign and evaluate a fact sheet resource to help women understand and manage cognitive symptoms that may occur during menopause. This study adopted a codesign approach involving women during the menopause transition years as well as professionals to develop and evaluate a fact sheet, with a focus on acceptability and safety. Four phases (discover, define, develop, deliver) were conducted to develop, refine, and evaluate the fact sheet using a mixed-methods approach of focus groups, interviews, and surveys. The discover phase identified a need for online educational resources for women in premenopause, perimenopause, and postmenopause to learn about menopause-related topics. The define and develop phases, relying on focus group sessions with perimenopausal and postmenopausal women, revealed common themes related to the experience of cognitive symptoms and a desire for management tips to optimize cognitive functioning. Structured interviews with professionals highlighted a desire for more concrete examples of cognitive symptoms. The results of the deliver phase found strong acceptability for the fact sheet, alongside requests for additional information on menopausal hormone therapy from premenopausal, perimenopausal, and postmenopausal women. The study reported a wide range of cognitive symptoms among women during the menopause transition years. This study showed broad agreement on the fact sheet's acceptability and safety in addressing menopausal cognitive symptoms. Feedback on menopausal hormone therapy and management tips underscores the demand for more research on effective interventions.

Disordered eating behaviours during the menopausal transition: a systematic review.

Disordered eating refers to a range of eating behaviours and attitudes towards weight and food that can negatively influence physical and psychosocial well-being. The menopausal transition could be a vulnerable period for disordered eating due to major hormonal fluctuations, menopausal symptoms, common body composition shifts, and an increased risk of psychological challenges. This systematic review aimed to summarize evidence on the associations between the menopausal transition and disordered eating. Records published before October 2023 were identified through MEDLINE, PsycINFO, Scopus, Embase, and CINAHL. Studies investigating associations between menopausal status, menopausal symptoms, or reproductive hormone levels, and disordered eating during the menopausal transition were sought. A total of 1301 non-duplicate records were screened, with 10 studies deemed eligible for inclusion. Most included studies used a cross-sectional design (n=9). Findings include potentially higher levels of binge eating during the perimenopausal stage, whereas restrictive eating behaviours appeared more common during postmenopause compared to premenopause. Both studies investigating menopausal symptoms found strong positive associations with disordered eating. Nonetheless, findings are equivocal with contrasting results and limited methodological quality across studies. Further research is needed to verify these findings and better assist health professionals in supporting healthy eating behaviours in menopausal women during this complex transition. (PROSPERO ID: CRD42021290736).

Exploring menopausal symptoms, attitudes, and behaviors among menopausal women in China: an online research perspective.

The number of perimenopausal women in China is rising, but the population's concept of menopausal hormone therapy (MHT) is still relatively outdated. In this study, we used the Knowledge-Attitude-Practice (KAP) theory and collected online questionnaires from 1,100 women aged 40 to 60 years nationwide to find out their menopausal symptom profiles; to learn about their perceptions, attitudes, and behaviors toward menopause and MHT; to explore the factors influencing the acceptance of hormone treatments; and to look for better ways to promote the dissemination of menopausal knowledge. The results revealed that among women aged 40 to 60 years, 82.36% experienced possible menopausal symptoms, with hot flushes/sweating, sleep disorders, mood disorders, and fatigue being the most prevalent; 55.90% reported moderate to severe symptoms, but only 46.99% of them sought healthcare services. Among those who sought medical care, 16.00% had their first visit to climacteric clinics/gynecological endocrinology, and 5.66% accepted MHT. Furthermore, 77.82% of participants never heard of MHT or were unaware of its existence. The healthcare-seeking behavior of menopausal women in response to symptoms and their willingness to accept MHT were found to be closely associated with their level of self-care. The prevalence of menopausal symptoms is higher in China than previous research findings, but due to a lack of relevant knowledge, the rate of seeking treatment from the appropriate medical department and accepting MHT is relatively low. Enhancing physicians' knowledge of the menopausal transition and using Internet tools might help improve Chinese women's knowledge of menopause and help them pass through this period smoothly.

Depressive symptoms over the final menstrual period: Study of Women's Health Across the Nation (SWAN)

BackgroundWomen may be vulnerable to elevated depressive symptoms during the menopause transition (MT). Studies generally have not considered premenopausal depressive symptom history or examined symptoms in relation to the final menstrual period (FMP). ObjectiveTo identify specific time points in relation to the FMP when depressive symptoms increase or decrease. MethodsParticipants were 1582 multiracial/ethnic women from the longitudinal Study of Women's Health Across the Nation (SWAN). Biological, psychosocial, and depressive symptom data were collected approximately annually. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CESD) scale. ResultsWomen with high baseline depressive symptoms (CES-D ≥ 16) declined in symptoms (M = −1.04/yr., 95 % CI = −1.58, −0.50) until 4 years before the FMP, followed by a smaller decrease (M = −0.50/yr., 95 % CI = −0.72, −0.28) until 18 months after the FMP. Depressive symptoms increased (M = 0.21/yr., 95 % CI = 0.11, 0.30) in those with low baseline symptoms until 1 year before the FMP, and decreased (M = −0.06/yr., 95 % CI = −0.11, −0.008) going forward. Greater social support, higher levels of follicle stimulating hormone and estradiol, and less sleep disturbance contributed to greater decline in depressive symptoms among those with high baseline depressive symptoms. Anxiety, experiencing stressful life events, lower body mass index, and poor role-physical function contributed to an increase in depressive symptoms among those with low baseline symptoms. LimitationsExcluded women had higher baseline CES-D scores. Lacked pre-MT depression for pre/early perimenopausal women at baseline. ConclusionAccounting for baseline depressive symptom level and focusing on the FMP more precisely characterize depressive symptom change over the MT.

Impact of Real-life Environmental Exposures on Reproduction: Endocrine-disrupting chemicals, reproductive aging, and menopause.

This review article highlights the associations between endocrine-disrupting chemicals, reproductive aging, and menopause. Collectively, the current literature indicates that phthalates, bisphenols, parabens, per- and poly-fluoroalkyl substances, polychlorinated biphenyls, dioxins, and pesticides are associated with reproductive aging in women and animal models. Menopause marks the end of a woman's reproductive lifetime and can have a significant effect on a woman's quality of life. Menopause naturally occurs at 51 years of age on average, but recent literature suggests that endocrine-disrupting chemicals (EDCs) in our environment can accelerate reproductive aging, causing women to reach menopause at earlier ages. This is concerning as menopause can significantly alter a woman's quality of life and is associated with increased risks of conditions such as depression, osteoporosis, and cardiovascular disease. EDC exposures have also been associated with more intense menopausal symptoms, making the menopausal transition more difficult for some women. This review highlights the associations between EDC exposure, early menopause, and reproductive aging, using both epidemiological and experimental studies.

The influence of anthropometric parameters on the concentration of globulin that binds sex hormones during the menopausal transition

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim &amp;lt;/strong&amp;gt;To determine the effect of body mass index (BMI) and waist-hip ratio (WHR) on the concentration of circulating sex hormone-binding globulin (SHBG) throughout the menopausal transition.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Methods &amp;lt;/strong&amp;gt;This cross-sectional study included 150 women divided into three groups: premenopausal (n=50), perimenopausal (n=50), and postmenopausal (n=50). The processing of the test women consisted of three phases: inter-view, blood sampling and determination of BMI and WHR. The SHBG concentration was determined from the blood, and BMI and WHR were measured.&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Results &amp;lt;/strong&amp;gt;The BMI and WHR of the post-menopausal women were significantly higher comparing to the other two groups, while the postmenopausal SHBG was significantly lower compared to the premenopausal con-centration. In all three groups, a significant negative correlation was found between SHBG and BMI (Rho= -0.385; p&amp;amp;lt;0.05), and between SHBG and WHR (Rho= -0.411; p&amp;amp;lt;0.05). By the univariate regression analysis model, it was determined that BMI (&amp;amp;beta;= -0.594; p&amp;amp;lt;0.001) and WHR (&amp;amp;beta;= -0.407; p=0.003) were independently negative predictors of SHBG in postmenopausal women, while in the multivariate regression analysis model only BMI as an independently negative predictor of SHBG in postmenopausal women was found (&amp;amp;beta;= -0.263; p=0.024).&amp;lt;br /&amp;gt;&amp;lt;strong&amp;gt;Conclusion &amp;lt;/strong&amp;gt;The value of SHBG during the menopausal transition decreases and women with higher BMI and WHR have lower values of SHBG regardless of the duration of menopause.&amp;amp;nbsp;&amp;lt;br /&amp;gt;Considering the connection between SHBG and anthropometric parameters, and the drop in its values upon entering and passing through the menopausal transition as such it can be used as a predictor for an increased risk of cardiovascular diseases and metabolic syndrome in a selected group of women.&amp;lt;/p&amp;gt;

Biopsychosocial factors intersecting with weekly sleep difficulties in the menopause transition

ObjectivesSleep difficulties are common in the menopause transition and increase risk for a variety of physical and psychological problems. The current study investigated potential interactions between psychosocial variables and within-person changes in ovarian hormones in predicting perimenopausal sleep problems as well as the potential interactions between poor sleep and psychosocial factors in predicting worsened mood, affect, and attention. Study designThe sample included 101 perimenopausal individuals. Participants completed 12 weekly assessments of self-reported sleep outcomes, depressive mood and affect, and attention function, and of estrone glucuronide (E1G) and pregnanediol glucuronide (PdG) levels (urinary metabolites of estradiol and progesterone, respectively); they also had 24-h tracking of vasomotor symptoms. Other psychosocial variables such as trauma history and stressful life events were assessed at baseline. ResultsA history of depression, baseline depressive symptoms, trait anxiety, and more severe and bothersome vasomotor symptoms predicted worsened sleep outcomes. Recent stressful life events, trauma history, and person-centred E1G and PdG changes did not predict sleep outcomes. However, there was an interaction whereby person-centred E1G decreases predicted lower sleep efficiency in those with higher baseline depressive symptoms. Higher baseline depression and trauma history also amplified the effect of vasomotor symptoms on sleep outcomes. In evaluating the effect of poor sleep on psychological and cognitive outcomes, stressful life events emerged as a moderating factor. Finally, trauma history and poor sleep interacted to predict worsened attention function. ConclusionsThe current study suggests that certain individuals may be at greater risk of perimenopausal sleep problems and the resulting negative effects on mood and cognition.

Impact of Promoting a Healthy Lifestyle on Anthropometric Characteristics, Climacteric Symptoms, Sleep Quality and Quality of Life in Women During Menopausal Transition

Objective: The purpose of the study was to assess the effects of a lifestyle promotion based on the principles of the Mediterranean diet (MD) combined with regular physical exercise on climacteric symptoms, sleep quality, and quality of life in women in the menopausal transition. Methods: Among 100 perimenopausal women recruited, 80 (48 ± 2 years) with climacteric symptoms were eligible for the study and were randomized into two groups: an intervention group (n=40) that received nutritional counselling based on the principles of MD with the practice of regular activity during 8 weeks, and a control group (n=40). At baseline and 8 weeks after the initiation of nutritional intervention, we assessed daily energy expenditure and food intake, anthropometric characteristics, climacteric symptoms, sleep quality, and quality of life. Results: Results showed that in the intervention group, compared to the control group, after 8 weeks of nutritional counselling, a significant decrease was noted in somatic and psychologic (p&lt;0.01) symptoms. No significant difference was noted in urogenital symptoms. The quality of life was improved by the decrease of the Menopause Rating Score (-25%, p&lt;0.001). A decrease was observed in subjective sleep quality (-27%, p&lt;0.05), sleep duration (-39%, p&lt;0.05), habitual sleep efficiency (-43%, p&lt;0.05), and daytime dysfunction (-43%, p&lt;0.01). The score of PSQI was decreased by (-31%, p&lt;0.01), which meant that the quality of sleep improved. Conclusion: Anthropometric characteristics, climacteric symptoms, sleep quality and quality of life were improved in women on menopausal transition adopting a healthy lifestyle based on the principles of Mediterranean eating pattern combined with regular physical activity.

Presbyopia, Dry Eye, and Retinal Thickness in the Middle-Aged Population: Focusing on Sex Differences.

Risk factors for presbyopia have not been fully determined although previous studies suggested presbyopia was associate with age, dry eye, and retinal ganglion cell complex thickness (GCC). We accessed these signs and common ocular symptoms in the middle-aged population focusing on sex differences when women have drastic hormonal change. This cohort study consecutively enrolled 2743 patients aged 36-45 years (n=1000), 46-55 years (n=1000), and 56-65 years (n=743). All underwent ocular surface tests and had near add power and GCC measured. Common ocular symptoms were asked using questionnaire. Among female participants, visual symptoms (eye strain and photophobia) were more prevalent in the age group 46-55, whereas non-visual symptoms (dryness, irritation, and pain) were not. We identified symptomatic presbyopia (near add power ≥ 1.5D) in 14.4%, 73.8%, and 97.8%, positive corneal staining in 29.1%, 23.8%, and 23.9%, and a mean GCC of 98.2 μm, 105.3 μm, and 89.6 μm in the age groups 36-45, 46-55, and 56-65, respectively. Mean tear break-up time were 3.3, 3.5, and 3.3 seconds, respectively. Results indicated a large progression of presbyopia (P<0.01) from the period of 36-45 years onward and significantly increased GCC (P<0.01) in women of age group 46-55. No notable tendency was observed in symptoms and GCC for male participants. Visual symptoms in women were worse between 46 and 55 years than before or after these ages. The increase of symptomatic presbyopia and GCC may be contributing to visual symptoms in addition to menopausal transition symptoms in this age group.

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

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

Association of Hormonal Exposures With Grip Strength in Women >45 Years: Data From the CONSTANCES Cohort Study.

Although biological findings show that estrogens are beneficial for muscular mass maintenance and bone resorption inhibition, the association of hormonal exposure with physical performance are controversial. We investigated the association of reproductive history and exogenous hormone use with hand-grip strength (GS) in women. Using the data from the CONSTANCES French prospective population-based cohort study, we ran linear mixed models to investigate the association of reproductive history and exogenous hormones use with maximal GS in 37 976 women aged 45 to 69 years recruited between 2012 and 2020. We used multiple imputation by chained equations to control missing values and corrections for multiple testing. The mean age of women was 57.2 years. Mean GS was 26.6 kg. After adjustment for age and confounders, GS increased with age at menarche (β+1 year = 0.14; 95% CI, 0.10-0.17) and duration of breastfeeding (β for ≥10 months vs <5 months = 0.39; 95% CI, 0.20-0.59; P for linear trend <.01). Compared to nonmenopausal women, postmenopausal women had significantly lower GS (β = -0.78; 95% CI, -0.98 to -0.58). GS was negatively associated with hormone therapy (HT) past use (β = -0.25; 95% CI, -0.42 to -0.07). Our results suggested that menopausal transition was strongly associated with lower GS. However, despite our hypothesis, increased age at menarche and duration of breastfeeding were associated with higher GS and HT past users presented lower GS than HT never users. These findings could help identify women at high risk of poor physical performance.

Fundamental intersectionality of menopause and neurodivergence experiences at work

This investigation explores the complex interplay between menopause and neurodivergence in the workplace, employing thematic analysis of qualitative data from 43 participants across the United Kingdom and the United States. Findings reveal that menopause transitions intensify symptoms of neurodivergence, and can interrupt how women engage with paid work. By shining a light on these under-reported experiences at work, we demonstrate how employers can better support their neurodivergent employees during menopause. Applying the Demand-Control model, this research underscores the necessity for workplaces to adopt more inclusive practices and supportive adaptations that go beyond flexible work and that are focused on pressures faced by neurodivergent women during menopause. Participants were more likely to report a decrease in workplace experiences than work performance in response to the disruptive effects of menopause on neurodiversity. This is an important insight for people managers as experiences of work might be less closely monitored than performance. This study advocates for a unified approach of organisational support for the intersectional effects of menopause and neurodiversity.

Features of the course of menopause in women under chronic stress: An observational cohort study

Background. Functional processes in the female organism at the stage of reproductive function failure in menopause attract considerable interest of researchers. The paper presents a study of great medical, biological and social importance into reproductive function failure in women living in the territories with permanent military operations for a long time and, thus, suffering from post-traumatic syndrome, which significantly affects the character of menopause. Objectives. To identify the features of menopausal syndrome in women who have been living under chronic stress (6–8 years) in the zone of ongoing military operations, namely in the Donetsk and Luhansk People’s Republics, and in women from Rostov Oblast — the region free from active military operations.Methods. An observational cohort study involved 60 women (refugees), long-term residents of the territories with ongoing military operations and 60 long-term residents of the territories without military operations, aged 50–65 years, with clinical manifestations of menopausal syndrome; all women were patients of the Research Institute of Obstetrics and Pediatrics, Rostov State Medical University. In accordance with the Stages of Reproductive Aging Workshop (STRAW+10) classification and clinical manifestations of menopause, two clinical groups (n = 30) were formed from the representatives of each region of residence. Group I included 30 women, aged 50–55, from the Donetsk and Luhansk People’s Republics, who had late menopausal transition (stage -1 of STRAW+10) and menopausal syndrome. Group II involved 30 postmenopausal patients (stages +1 and +2 of STRAW+10), aged 60–65, with menopausal syndrome. Group 1 enrolled 30 residents of Rostov Oblast, aged 50–55, who had late menopausal transition (stage -1 of STRAW+10) and menopausal syndrome, group 2 included 30 postmenopausal patients (stages +1 and +2 of STRAW+10), aged 60–65, with menopausal syndrome. Modified menopausal index was considered as the main indicator of the study. Statistical data processing was carried out by means of Statistica 10.01 (StatSoft, USA), Microsoft Excel 2010 (Microsoft, USA), IBM SPSS 24.0 (IBM, USA), and MedCalc (MedCalc Software, Belgium).Results. Long-term female residents of the territories with ongoing military operations were reported to develop menopausal syndrome more often. Rostov Oblast female residents in the late menopausal transition revealed a statistically significant prevalence of a mild degree of menopausal syndrome in 63.3 % of cases compared to 36.7 % of a similar severity of menopausal syndrome in residents of the Donetsk and Luhansk People’s Republics. Meanwhile, women from the Donetsk and Luhansk People’s Republics were indicated with moderate menopausal syndrome in 50.0 % of cases in late menopausal transition and severe syndrome in 33.3 % in postmenopause versus 23.4 % and 10 % of women from Rostov Oblast, respectively. The intensity of neurovegetative and psycho-emotional disorders in women of both regions increases with the aging process of the reproductive system and appears most pronounced in the postmenopausal period.Conclusion. Residents of the Donetsk and Luhansk People’s Republics, who live in the war zone and are exposed to constant threat to life, develop post-traumatic syndrome which significantly intensifies and modulates the already existing functional and hormonal restructuring in the brain subsystems during perimenopause. Non-uniform functional shifts at different levels of the central nervous system under conditions of chronic stress lead to a significant change in intracerebral processes and to an increase in the occurrence and severity of various dysfunctional deviations.