Natural Menopause Research Articles

Association of age at diabetes complication diagnosis with age at natural menopause in women with type 1 diabetes: The Pittsburgh Epidemiology of Diabetes Complications (EDC) Study.

Vascular damage is thought to have a role in premature ovarian aging. We thus assessed the association between the presence, and age at onset of, vascular diabetes complications and age at natural menopause in women with type 1 diabetes. Female participants of the Epidemiology of Diabetes Complications study with type 1 diabetes who experienced natural menopause and who never received hormone therapy during their menopausal transition were included in the analysis (n=105). Microalbuminuria (MA), overt nephropathy, proliferative retinopathy, confirmed distal symmetric polyneuropathy, and coronary artery disease, were assessed during biennial clinical exanimations for the first 10 years of follow-up and at year 18, 25 and 30. Menopausal status was determined via self-report and sex hormone data. For each complication, separate linear regression models were used to assess whether, compared with women without the complication of interest, an earlier age at complication development (i.e., <30 years of age) was associated with an earlier age at natural menopause. Although results from multivariable linear regression models suggested a similar age at menopause between women with normo-albuminuria and those diagnosed with MA after 30 years of age, menopause occurred 2.06 years earlier (β±SE=-2.06±1.08) among women diagnosed with MA before age 30 (p=0.06). No significant association was observed for other complications. Among women with type 1 diabetes, menopause appears to occur earlier in those diagnosed with MA before age 30 compared to those with normo-albuminuria, suggesting that vascular dysfunction associated with early microvascular disease may affect ovarian aging.

A comparative study of effects of surgical and natural menopause on menopausal symptoms and musculoskeletal complaints in menopausal women

Background: To decrease morbidity in patients undergoing hysterectomy for benign lesions, oophorectomy should not be done. Aims and Objectives: This study aims to compare the effects of surgical and natural menopause on menopausal symptoms and musculoskeletal complaints in menopausal women. Materials and Methods: This study was conducted in gynecology outpatient department from June 2019 to June 2020. A total of 200 postmenopausal women were selected between the age group of 40 and 55 years and then divided into two main groups – Group A (100), that is, natural menopause and Group B (100), that is, surgical menopause. Interviews were conducted about menopausal symptoms, using a standard questionnaire and were modified for yes or no response. The women were asked about symptoms such as hot flashes, sweating, vaginal dryness, dryness of skin, decreased libido, poor memory, depression, and musculoskeletal pain. Results: The study showed that menopausal symptoms and musculoskeletal pain were more common in women with surgical menopause as compared to women with natural menopause. The rate of hot flashes and sweating was more in surgical menopause group, that is, 81% and 82%, respectively, as compared to 52% and 50%, respectively, in natural menopause group. The musculoskeletal pain was more significant in Group B as compared to Group A, especially low back and upper back which were present in 55% and 42%, respectively, in Group B as compared to 43% and 41%, respectively, in Group A. Conclusion: As the menopausal symptoms and musculoskeletal pain are more common in patients with surgical menopause thereby increasing the morbidity, so oophorectomy should not be done in patients who are undergoing hysterectomy for benign lesions. Therefore, treatment of osteoporosis and hormone replacement therapy is recommended after surgery to decrease the menopausal and musculoskeletal symptoms within the 1st year of menopause.

Age of Natural Menopause Among Jordanian Women and Factors Related to Premature and Early Menopause.

ObjectiveThe aim of this study was to assess factors related to the onset of premature/early natural menopause among Jordanian women.MethodsA cross-sectional study was conducted in early 2016. Subjects were enrolled based on random drop-off technique to the Obstetrics and Gynecology clinics at the Jordan University Hospital. Women 18 years of age and above were initially eligible to enroll, and women who had surgically induced menopause or specific disease were excluded from the analysis. Relevant data were collected using a questionnaire that included 30 questions. The following variables were collected: socio-demographic, body mass index, chronic conditions, diseases, reproductive characteristics, and health status. Hormone indicators of menopause were tested by measuring estrogen (E2) and follicle-stimulating hormone (FSH) levels. Age at natural menopause (ANM) was self-reported retrospectively and considered an independent variable against BMI, smoking, hormone therapy, and concomitant diseases. Association analysis and multinomial logistic regression were used to examine the associated factors of ANM with adjusted odds ratios (ORs), and their 95% confidence intervals (CIs) were reported.ResultsA total of 409 women were included in the analysis, aged between 20−75 years. The mean ANM in our sample was 48.5±5.0, with 2.7% of the women experienced premature menopause (ANM <40) and 7.8% early menopause (ANM 40–44). Within the menopause women (n=242), the percentage of women who had premature menopause was 4.5%, 13.6% with early menopause, and 21.1% with late menopause (ANM >52). Smoking was the major risk factor for premature/early menopausal age among Jordanian women with an OR of 2.46 (95% CI: 1.08–5.59, p<0.05). On the other hand, women with occasional arthritis symptoms and diseases such as hypertension, diabetes, dyslipidemia, and their combination were associated with average (45–52 years) or late menopause (>52 years).ConclusionSmoking is the main contributor of premature/early menopause in Jordanian women. Increased awareness and public health policy about the adverse effects of smoking on women’s reproductive health are needed.

Menopause and Haematological Changes: a case control study

Background: Menopause is the natural cessation or stopping of a woman’s menstrual cycle and marks the end of fertility. Ovarian function declines can lead to undesirable alterations in metabolism, vascular endothelium function, fibrinolytic and coagulative properties of blood. Menopause may enhance risk for ischemic heart disease in women due to such altered properties of blood and vascular function.Aims and Objectives: To compare some haematological values in pre- and post-menopausal women to know the risk of vascular and ischemic heart disease in postmenopausal women.Materials and Methods: Blood samples were drawn in 50 women who have attained menopause and have weight of 55–60 kg and height of 150–160 cm and 50 control subjects who were disease-free women aged 35–40 years with matching weight and height. These women had natural menopause and were not subjected to any hormonal or surgical intervention. The vital parameters were recorded, and general examination was done.Results: There was a statistically significant increase in hematocrit, and there was no statistically significant change in platelet count, activated partial thromboplastin time (APTT), and prothrombin time (PT).Conclusion: A higher viscosity of blood can enhance the risk of coronary artery disease by elevating platelet aggregability and adhesiveness to sub-endothelium. However, the above effect may partially be offset by unchanged APTT and PT.

The Czech version of the Utian Quality of Life Scale questionnaire assessing women's quality of life during menopause.

IntroductionMenopause is a physiological process, forming a part of a lifetime that most women go through. This period of life is briefly described by experts as a triple transformation: biological, social, and psychological. For menopausal women, health care professionals can use one of 10 specific questionnaires to assess health-related quality of life and its symptoms. The authors herein speak about the preparation of a Czech version of one such questionnaire – the Utian Quality of Life Scale (UQOL).Material and methodsA Czech version of the UQOL was created by repeated and backward translation. It was validated on a sample of 204 women after natural menopause (45–65 years old). We judged the reliability of the Czech version of UQOL using Cronbach’s a. We assessed the instrument’s validity by means of confirmation factor analysis.ResultsThe authors modified the original version of the UQOL. The Czech version has 4 new domains with 18 items. This form was created using the results of confirmation factor analysis.ConclusionsThe Utian Quality of Life Scale questionnaire is completed by the women themselves, thus meeting the golden rule of all quality-of-life research stating that the primary source should be data from the client him/herself. However, this requirement raises some methodological problems.

The effect of low-dose combined hormone therapy (oestradiol and norethindrone acetate) on serum C-reactive protein levels and life quality in natural menopause women.

IntroductionTo assess the effect of low-dose combined oestradiol and norethindrone acetate hormone therapy (HT) on serum C-reactive protein (CRP) levels and life quality in natural menopause women.Material and methodsForty-five natural menopause women admitted to the clinic during a 1-year period and diagnosed as menopause, who planned to have HT for menopausal symptoms, were enrolled in this prospective study. The serum CRP levels were measured, and vasomotor symptoms scores were graded according to the Blatt-Kupperman menopause index, and life quality scores according to the Menopause-Specific Quality of Life Questionnaire (MENQOL) were recorded before and after (3 months later) hormone therapy.ResultsThe Blatt-Kupperman menopause index and MENQOL scores were significantly decreased after 3 months of low-dose treatment. No significant difference was found between white blood cell counts and serum CRP levels before and after 3 months of hormone therapy.ConclusionsConsidering all HT types and biochemical effects, low-dose HT, which had positive results in terms of quality of life, was a safe treatment and could be preferred to conventional-dose preparations in cases without contraindications. Low-dose combined HT containing oestradiol and norethindrone acetate did not alter the serum CRP level in postmenopausal cases.

The effect of laparoscopic ovarian drilling on timing of menopause in patients with polycystic ovary syndrome: 29 years of follow-up data

Background: Despite significantly improved rates of ovulation and pregnancy after laparoscopic ovarian drilling (LOD) in patients with polycystic ovary syndrome (PCOS), one should remain cautious of this procedure due to the associated risk of post-operative adhesions and a significant decrease in ovarian reserve markers. In this longitudinal follow-up study, we aimed to evaluate the long-term effects of LOD on the timing of menopause. Methods: A total of 83 patients were identified who had undergone LOD between December 1991 and December 1996. Of the 13 patients that we were able to reach, two had undergone unilateral LOD and were excluded, leaving 11 patients to be analysed. Results: The median age at the time of LOD was 25 (range 19–35) years. The median age at the time of the current analysis was 52 (range 46–64) years. Whereas two of these patients had surgical menopause at the age of 35 and 47 due to leiomyoma, four patients had natural menopause between the ages of 45 to 52 years. Although five patients were still having regular cycles at the age of 46 to 54 years at the time of the study, we do not have any biochemical data to evaluate their ovulatory status. With respect to fecundity, whereas nine out of 11 patients conceived spontaneously, two required assisted reproduction treatment. Discussion: According to the findings from a limited number of patients, LOD does not appear to have any negative effect on the timing of menopause.

Age at Natural Menopause; A Data Mining Approach (Data from the National Health and Nutrition Examination Survey 2013-2014).

The timing of the age at which menopause occurs varies among female populations. This variation is attributed to genetic and environmental factors. This study aims to investigate the determinants of early and late-onset menopause. We used data from the National Health and Nutrition Examination Survey 2013-2014 for 762 naturally menopause women. Data on sociodemographic, lifestyle, examination, and laboratory characteristics were examined. We used random forest (RF), support vector machine (SVM), and logistic regression (LR) to identify important determinants of early and late-onset menopause. We compared the performance of models using sensitivity, specificity, Brier score, and area under the receiver operating characteristic (AUROC). The top determinants were assessed by using the best performing models, using the mean decease in Gini. Random forest outperformed LR and SVM with overall AUROC 99% for identifying related factors of early and late-onset menopause (Brier score: 0.051 for early and 0.005 for late-onset menopause). Vitamin B12 and age at menarche were strongly related to early menopause. Also, methylmalonic acid (MMA), vitamin D, body mass index (BMI) were among the top highly ranked factors contributing to early menopause. Features such as age at menarche, MMA, sex hormone-binding globulin (SHBG), BMI, vitamin B12 were the most important covariate for late-onset menopause. Menarche age and BMI are among the important contributors of early and late-onset menopause. More research on the association between vitamin D, vitamin B12, SHBG, and menopause timing is required which will produce invaluable information for better prediction of menopause timing.

Development of a Chemical Reproductive Aging Model in Female Rats.

Women are born with an abundant but finite pool of ovarian follicles, which naturally and progressively decreased during their reproductive years until menstrual periods stop permanently (menopause). Perimenopause represents the transition from reproductive to non-reproductive life. It is usually characterized by neuroendocrine, metabolic and behavioral changes, which result from a follicular depletion and reduced number of ovarian follicles. During this period, around 45-50 years old, women are more likely to express mood disorders, anxiety, irritability and vasomotor symptoms. The current animal models of reproductive aging do not successfully replicate human perimenopause and the gradual changes that occur in this phase. While the traditional rat model of menopause involves ovariectomy or surgical menopause consisting of the rapid and definitive removal of the ovaries resulting in a complete loss of all ovarian hormones, natural or transitional menopause is achieved by the selective loss of ovarian follicles (perimenopause period). However, the natural aging rodent (around 18-24 months) model fails to reach very low estrogen concentrations and overlaps the processes of somatic and reproductive aging. The chronic exposure of young rodents to 4-vinylcyclohexene diepoxide (VCD) is a well-established experimental model for perimenopause and menopause studies. VCD induces loss of ovarian small follicles (primary and primordial) in mice and rats by accelerating the natural process of atresia (apoptosis). The VCD, ovary-intact or accelerated ovarian failure (AOF) model is the experimental model that most closely matches natural human progression to menopause mimicking both hormonal and behavioral changes typically manifested by women in perimenopause. Graphical abstract: The female reproductive system is regulated by a series of neuroendocrine events controlled by central and peripheral components. (A). The mechanisms involved in this control are extremely complex and have not yet been fully clarified. In female mammals whose ovulation (the most important event in a reproductive cycle) occurs spontaneously, reproductive success is achieved through the precise functional and temporal integration of the hypothalamus-pituitary-ovary (HPO) axis. (B). In women, loss of fertility appears to be primarily associated with exhaustion of ovarian follicles, and this process occurs progressively until complete follicular exhaustion marked by the final menstrual period (FMP). (C). While in female rodents, reproductive aging seems to begin as a neuroendocrine process, in which changes in hypothalamic/pituitary function appear independently of follicular atresia. The traditional rat model of menopause, ovariectomy or surgical menopause consists of the rapid and definitive removal of the ovaries resulting in a complete loss of all ovarian hormones. (D). The chronic exposure (15-30 days) to the chemical compound 4-vinylcyclehexene diepoxide (VCD) in young rodents accelerates gradual failure of ovarian function by progressive depletion of primordial and primary follicles, but retains residual ovarian tissue before brain alterations that occurs in women in perimenopause. Low doses of VCD cause the selective destruction of the small preantral follicles of the ovary without affecting other peripheral tissues.

Hormonal replacement therapy in women with a history of internal genital organ malignancy.

Sudden cessation of ovary activity as a result of bilateral oophorectomy or chemo- or radiotherapy in premenopausal women is linked with more serious consequences that bear no comparison to natural menopause – to name just a few: higher rate of mortality, higher rate of colorectal and lung cancer, circulatory system diseases, cognitive disorders, Parkinson’s disease, psychological disorders, osteoporosis, and sexual disorders. The prolonged period of estrogens deficit in premenopausal age is connected with worsened quality of life.The progress in oncological care means that in many malignant diseases, also in the case of gynaecological malignancies, the percentage of survivors increases. This makes improving the quality of life more and more important.The purpose of this review is to establish, based on EBM data, the answer to whether replacement hormonal therapy, being the most effective treatment of menopause symptoms, can be recommended for women who have undergone bilateral oophorectomy because of gynaecological cancer.On the basis of collected data, derived from meta-analysis, and studies which have been published within the last 20 years, it seems that the use of the appropriate type of hormonal replacement therapy (HRT) in properly selected gynaecological cancer survivors (epithelial ovarian cancer – EOC, endometrial cancer, squamous cell carcinoma of the cervix) is safe and effective.It seems that benefits connected with better quality of life that stem from the use of appropriate HRT in gynaecological cancer survivors predominate the unfounded fear of disease recurrence in selected patients’ groups.

Menopoz Tipi ve Süresinin Postmenopozal Kadınlarda Pre-Diyabet ve Diyabet Gelişimine Etkisi

Aim: The onset of menopause is an important factor determining quality of life in females. The aim of this study was to evaluate the effect of natural or surgical menopause, the duration of the menopausal period, and serum gonadotropin levels on the development of pre-diabetes mellitus (pre-DM) and diabetes mellitus (DM) in postmenopausal women. Material and Methods: This retrospective study included 140 postmenopausal women with pre-DM, 148 postmenopausal women with DM and 265 healthy postmenopausal women. The groups were compared in respect of menopause type, the duration of the menopausal period, and serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) levels. Statistical evaluations were made. Results: There was found to be no significant effect of natural or surgical menopause on the development of pre-DM or DM (p=0.393). Increased duration of menopause was mostly seen in women with DM and the difference was statistically significant compared to the controls (p=0.019). Serum decreased FSH and LH levels and increased E2 level were observed in the DM group and the difference was significant compared to the control group (respectively, p=0.001, p=0.001 and p=0.012). Conclusion: The onset of natural or surgical menopause does not affect the development of pre-DM and DM. Women with DM have a longer menopausal period. Women with pre-DM and DM have lower serum FSH and LH levels and higher serum E2 levels. This can be explained in part by adiposity and insulin resistance.

Hormone therapy for postmenopausal women

Hormone therapy is recommended for relief from hot flashes or night sweats in women younger than age 60 years or those who entered menopause within 10 years of seeking treatment. Hormone therapy also can reduce bone loss and the risk of fractures; offer a potential cardioprotective benefit; and alleviate the genitourinary symptoms of menopause, including dysfunction of the bladder and irritation of the vagina and vulva.For women with early menopause without contraindications, hormone therapy is recommended until at least the average age of natural menopause. Observational studies suggest that the risk of thromboembolism and stroke is lower with transdermal therapy than with oral hormone therapy. Compounded bioidentical hormone therapies that have not been approved by the Food and Drug Administration are not recommended owing to safety concerns. Hormone therapy is not recommended for primary or secondary prevention of coronary heart disease or dementia. Nonhormone therapies that have been shown to reduce hot flashes include low-dose selective serotonin-reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors, gabapentinoids, weight loss, hypnosis, and cognitive behavioral therapy. For women with only genitourinary symptoms, local vaginal hormone therapies are recommended.The treatment is not without its risks, including concerns about cognitive decline and breast cancer. More research is warranted, to determine the long-term benefits and risks of menopausal hormone therapy, to gauge the effects of prolonged use in women initiating therapy close to menopause, to inform the timing of and approach to hormone therapy discontinuation, and to answer additional unknowns. As scientists work to address these questions, technology can help identify women likely to benefit from hormone therapy. The MenoPro mobile app, backed by the North American Menopause Society, provides a free algorithm to flag the strongest candidates.

Cognitive function and associated factors among postmenopausal women with hypertension and natural menopause in Taiwan

Hypertension is prevalent among postmenopausal women worldwide and is a risk factor for cognitive impairment. This study examined the cognitive differences between Taiwanese postmenopausal women with and without hypertension after natural menopause and identified factors associated with cognitive function in hypertensive postmenopausal women. A two-group comparative design study of 171 Taiwanese postmenopausal participants (mean age = 64.8±6.6) was conducted in southern Taiwan. Cognitive performance on neuropsychological tests was evaluated, and demographic, health, menopausal, and disease related variables were assessed. Compared to the non-hypertensive group, women with hypertension showed significantly worse performance and a higher percentage of impairment in global cognitive functioning and memory. Fewer years of education and longer duration of hypertension were associated with lower global cognitive function, and increased age was associated with lower scores in delayed memory. Cognitive screening as well as training on global cognitive functioning and memory are needed for postmenopausal hypertensive women. (148 words)

Factors influencing age at natural menopause

Women who experience menopause before 45 years, have an increased risk for morbidity and mortality. We aimed to identify the factors influencing the age at natural menopause and to investigate whether tubal ligation alter age at natural menopause. This cross-sectional study was conducted on total 1660 women with natural menopause. The participants were divided into two groups as the ones having menopause before age of 45 years and after 45 years old. Positive family history, smoking and use of oral contraceptive were found to increase the risk of early menopause by 3.68, 1.34 and 1.04 times, respectively. First pregnancy at older age reduced the risk of early menopause by 0.97 and obesity reduced this risk by 0.65 (95% CI 0.47-0.90). There was no significant difference between menopausal age of patients who underwent BTL (47.46 ± 4.67 years old) and those who did not (47.68 ± 5.18 years old) (P:0.320; P > 0.05). The mean age at menopause of patients who had tubal ligation with laparoscopic cauterization and Pomeroy technique was 46.91 ± 4.07 and 47.55 ± 4.76 years old, respectively (P:0.503; P > 0.05). Besides, there was no significant difference between patients having tubal ligation at the time of cesarean section and those who did not regarding menopausal age (P:0.314; P > 0.05). We recommend identifying modifiable factors and informing women at risk of early menopause. Tubal ligation, when performed correctly, should not compromise ovarian function. If tubal ligation interferes with vascular supply to the ovaries, it may not be substantial enough to result in an earlier onset of menopause.

Menopause

The female reproductive system matures in a continuous, natural process from menarche to menopause as the finite numbers of oocytes produced during fetal development are gradually lost to ovulation and senescence. Menopause is defined as the permanent cessation of menses; by convention, the diagnosis of menopause is not made until the individual has had 12 months of amenorrhea. Menopause is thus characterized by the menstrual changes that reflect oocyte depletion and subsequent changes in ovarian hormone production. However, hormonal changes, rather than the cessation of menstruation itself, cause the manifestations that occur around the time of menopause. Therefore, a woman who has undergone a hysterectomy but who retains her ovaries can experience normal menopausal symptoms as oocyte depletion leads to changes in estrogen levels, even though cessation of menstruation occurred with surgery. This review covers definitions, natural menopause, menopausal transition and postmenopausal symptom management, and premature ovarian insufficiency. Figures show stages of reproductive aging, serum concentrations of hormones during menopausal transition and postmenopause, hormonal changes associated with reproductive aging, symptoms of menopausal transition and menopause, treatment algorithm(s), and Women’s Health Initiative findings: risks and benefits of estrogen alone and estrogen plus progestin by age group: 50 to 59, 60 to 69, and 70 to 79 years. Tables list target tissues, physical manifestations, and menopausal symptoms; selective estrogen receptor modulators used in postmenopausal women; differential diagnosis and evaluation of common menopausal symptoms; estrogen doses; progestogen dosing for endometrial protection; nonhormonal pharmaceutical hot flash therapies; and pharmacologic therapy for genitourinary atrophy. This review contains 6 figures, 8 tables, and 122 references.

Long-term exposure to particulate matter and roadway proximity with age at natural menopause in the Nurses' Health Study II Cohort.

Evidence has shown associations between air pollution and traffic-related exposure with accelerated aging, but no study to date has linked the exposure with age at natural menopause, an important indicator of reproductive aging. In this study, we sought to examine the associations of residential exposure to ambient particulate matter (PM) and distance to major roadways with age at natural menopause in the Nurses' Health Study II (NHS II), a large, prospective female cohort in US. A total of 105,996 premenopausal participants in NHS II were included at age 40 and followed through 2015. Time-varying residential exposures to PM10, PM2.5-10, and PM2.5 and distance to roads was estimated. We calculated hazard ratios (HR) and 95% confidence intervals (CIs) for natural menopause using Cox proportional hazard models adjusting for potential confounders and predictors of age at menopause. We also examined effect modification by region, smoking, body mass, physical activity, menstrual cycle length, and population density. There were 64,340 reports of natural menopause throughout 1,059,229 person-years of follow-up. In fully adjusted models, a 10μg/m3 increase in the cumulative average exposure to PM10 (HR: 1.02, 95% CI: 1.00, 1.04), PM2.5-10 (HR: 1.03, 95% CI: 1.00, 1.05), and PM2.5 (HR: 1.03, 95% CI: 1.00, 1.06) and living within 50m to a major road at age 40 (HR: 1.03, 95%CI: 1.00, 1.06) were associated with slightly earlier menopause. No statistically significant effect modification was found, although the associations of PM were slightly stronger for women who lived in the West and for never smokers. To conclude, we found exposure to ambient PM and traffic in midlife was associated with slightly earlier onset of natural menopause. Our results support previous evidence that exposure to air pollution and traffic may accelerate reproductive aging.

Navigation ability before and after menopause

AbstractBackgroundCognitive decline is a common complaint in menopause. Alzheimer disease(AD) has higher incidence in women and early menopause increases risk for AD. Studies of cognitive change at menopause have had mixed results. Navigational ability declines early in the course of AD. No studies have looked at changes in navigational ability around menopause. Objective: Determine the effect of menopause on navigation.MethodParticipants were 200,999 persons aged 35‐65 who downloaded the Sea Hero Quest app and completed enough levels to analyze navigation. Measures of navigation examined included distance traveled and time spent to complete levels as well as accuracy in determining one’s starting point after completing a maze. These scores were normalized based on early, simple levels in order to control for video game ability. Each measure was analyzed by splitting male and female participants into ages 35‐45 and ages 55‐65 in order to look at persons before and after menopause. Groups were analyzed using a 2‐way ANOVA with gender and age as independent variables. Additionally, piecewise linear modeling was applied to the entire population aged 35 to 65 to test whether there was a significant change in the slope of decline in navigational ability at age 51, the average age of menopause.ResultFemale gender and advancing age were both predictive of worse performance on all measures. ANOVA found significant(p&lt;0.001) but small effect sizes for an age by gender interaction with partial eta2 for distance = 0.002, duration &lt; 0.001 and flare accuracy &lt;0.001. Piecewise linear modeling found small but significant (p&lt;0.001) changes in slope of worsening scores in distance, duration and flare accuracy at age 51. The increased rate of worsening performance was actually greater in men than women.ConclusionWhile men had better navigational performance than women at all ages, there is not a substantial change in this gap following menopause. Additionally, the relative rate of decline in female performance actually decreased relative to males at the typical age of menopause. This study suggests that natural menopause is unlikely to have a significant negative effect on navigational ability.

Factors associated with use of hormone therapy after preventive oophorectomy in BRCA mutation carriers

Bilateral salpingo-oophorectomy (oophorectomy) is recommended to women with a germline BRCA1 or BRCA2 mutation before natural menopause to prevent ovarian and fallopian tube cancer. The adverse effects of early surgical menopause are well established. Although many of the side effects can be ameliorated by the use of hormone therapy (HT); use of HT in this group of predominantly young patients remains suboptimal. The goal of this study was to identify the frequency of HT use, as well as predictors of HT uptake in BRCA mutation carriers who underwent preventive oophorectomy before natural menopause. Eligible participants were identified from a longitudinal study of BRCA mutation carriers. We included premenopausal women with no personal history of cancer who underwent oophorectomy before age 50 and who had a minimum of 2 years of follow-up. Detailed information on HT use and other important variables was collected by a research questionnaire every 2 years. Descriptive statistics were used to evaluate the use of HT in various subgroups. A total of 793 women with a BRCA1 or BRCA2 mutation were included in this analysis. The mean age at oophorectomy was 42 years (range 28-49). Sixty-one percent of the women reported using HT after oophorectomy. Factors associated with HT use included young age at surgery, a high level of education and preventive mastectomy. The uptake of HT after oophorectomy in women with a BRCA1 or BRCA2 mutation varies by age, education, and surgical history. Clinician and patient awareness may lead to better utilization of HT in women who undergo oophorectomy at an early age to help mitigate the adverse effects associated with surgical menopause.

TMEM150B is dispensable for oocyte maturation and female fertility in mouse

Premature ovarian insufficiency (POI) refers to severe decline of ovary function in females which usually leads to infertility. It has been reported that the TMEM150B gene is mostly associated with age at natural menopause, early menopause and POI, but its role in female reproduction remains unknown. In this study, we found Tmem150b was highly expressed in mouse oocytes, but its deletion had no obvious effect on meiotic maturation of oocytes indicated by first polar body emission and spindle morphology. There were also no obvious differences in follicle development and corpus luteum formation between knockout and wild type mice. Finally, knockout of Tmem150b did not affect female fertility and sexual hormone levels. In summary, our results suggest that TMEM150B is not essential for female fertility in mice.

Longitudinal changes in reproductive hormones through the menopause transition in the Avon Longitudinal Study of Parents and Children (ALSPAC)

We characterised changes in reproductive hormones—LH, FSH, SHBG and AMH—by chronological age and time around the menopause (reproductive age) in mid-life women and explored their associations with lifestyle and reproductive factors. We used data from 1608 women from a UK cohort who had repeat hormone measures and experienced a natural menopause. Multilevel models were used to assess: (i) changes in hormones (outcomes) by reproductive age and chronological age (these age variables being the key exposures) and (ii) associations of body mass index (BMI), smoking, alcohol intake, parity and age at menarche with changes in hormones by reproductive age. Both LH and FSH increased until ~ 5 and 7 years postmenopause, respectively, after which they declined, but not to premenopausal levels. SHBG decreased slightly until ~ 4 years postmenopause and increased thereafter. AMH decreased markedly before menopause and remained low subsequently. For all hormones, the best fitting models included both reproductive and chronological age. BMI, smoking and parity were associated with hormone changes; e.g., higher BMI was associated with slower increase in LH and FSH and decrease in AMH. Reproductive and chronological age contribute to changes in LH, FSH, SHBG and AMH across mid-life in women, and BMI, smoking and parity are associated with these hormone changes.