Onset Of Menopause Research Articles

Margery Kempe’s Spiritual Medicine: Suffering, Transformation and the Life-Course

Margery Kempe’s Spiritual Medicine: Suffering, Transformation and the Life-Course

Margery Kempe’s Spiritual Medicine: Suffering, Transformation and the Life-Course

Margery Kempe’s Spiritual Medicine: Suffering, Transformation and the Life-Course

A Hot Flash about Menopause Hormone Therapy

Hormone therapy (HT) for vasomotor and genitourinary symptoms associated with menopause has been an effective treatment for relief of these symptoms and the prevention of bone loss and fracture, but does entail potential risks for which our understanding continually evolves with additional studies. Risks of HT are likely to be minimized if started within 10 years of menopause onset. HT, types of HT, dose, route of application, and duration of use should be individualized taking into account age, personal health risks, time since menopause, and individual preferences and quality of life issues to minimize risks and maximize benefits

Hodgkin Lymphoma and Female Fertility: A Multicenter Study of Fertility in Women Treated with Doxorubicin, Bleomycin, Vinblastine and Dacarbazine

Background: Hodgkin Lymphoma (HL) is a curable lymphoid malignancy affecting a young population of child-bearing age. Many young women are cured and face long-term complications. Among them, infertility holds an important place and the preservation of fertility has become a growing issue. First-line chemotherapy with ABVD (Doxorubicin, Bleomycin, Vinblastine, and Dacarbazine) appears to have low gonadotoxicity, but this toxicity has been rarely studied.Objective: To provide a new assessment of female fertility by measuring the number of pregnancies and births after ABVD in young women treated for HL compared to an unexposed population.Patients and Methods: Patients 18 to 40 years of age with HL treated in Angers, Nantes and Poitiers in the trials POF81, MH90 and MH97 conducted from 1981 to 2005 were contacted. The main treatment was ABVD. Two healthy controls were assigned to each patient and matched on age, tobacco consumption and body mass index. Fertility was assessed by the number of pregnancies after HL treatment and the number of births. Data were collected by paper questionnaires.Results: Sixty-seven patients were included. The median age at diagnosis was 24.4 years (15.6-43.1). Forty-six patients received “standard” intensity treatment: 37 patients were treated with ABVD and 9 patients with EBVM (epirubicin, bleomycin, vinblastine and methotrexate). Twenty-one patients received “enhanced” intensity treatment, 8 of them with autologous stem cells transplantation. All but one received radiotherapy. Fifty-four percent of ABVD-treated patients achieved pregnancy and 82.3% of patients who desired children had at least one birth. In the group of patients, 36 (53.7%) started at least one pregnancy after treatment versus 73 controls (54.5%) (p = 0.92). The median time to pregnancy did not differ between groups [4.8 years (3.1-6.6) in the patients vs. 6.8 years (5-8.7) in the controls, p = 0.214]. Similarly, there was no difference in the use of medically assisted procreation [7 (10.4%) patients vs 7 (5.2%) controls, p = 0.125]. The age at onset of menopause was 44.4 years (36-55) in patients vs 51.5 years (36.2-59) in controls (p = 0.006) without impact on the number of pregnancies. Thirty-six patients (53.7%) wanted to have children after HL treatment: 30 (83.3%) had at least one pregnancy and all but one had at least one birth (80.5% %). There were few premature births in patients (4%) and few neonatal complications [1 failure to thrive (2%)].Conclusion: In our study, the number of pregnancies and births in young women treated with ABVD for HL is similar to that of the general population, reflecting the low gonadotoxicity of ABVD. DisclosuresLeleu:Merck: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Pierre Fabre: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees.

Searching for female reproductive aging and longevity biomarkers.

Female reproductive aging is, in a way, a biological phenomenon that develops along canonical molecular pathways; however, it has particular features. Recent studies revealed complexity of the interconnections between reproductive aging and aging of other systems, and even suggested a cause-effect uncertainty between them. It was also shown that reproductive aging can impact aging processes in an organism at the level of cells, tissues, organs, and systems. Women at the end of their reproductive lives are characterized by the accelerated incidence of age-related diseases. Timing of the onset of menarche and menopause and variability in the duration of reproductive life carry a latent social risk: not having enough information about the reproductive potential, women keep on postponing childbirth. Identification and use of the most accurate and sensitive aging biomarkers enable the prediction of menopause timing and quantification of the true biological and reproductive ages of an organism. We discuss current views on reproductive aging and peculiarities of using available biomarkers of aging. We also consider latest advances in the search for potential genetic markers of reproductive aging. Finally, we posit the importance of determining the female biological age and highlight potential research directions in this area.

Menopausal Syndrome - an Overview

Menopause is the natural cessation of a woman’s menstrual cycle, and marks the end of fertility. Most women experience menopause by the average age of 52, but pelvic or ovarian damage may cause sudden menopause earlier in life. Genetics or any disease conditions may also lead to early onset of menopause. Perimenopause and post menopause are the two different stages of menopause. The beginning of irregular menses to the first 12 months of amenorrhea is perimenopause and the period after menopause is post menopause. Women experience various physiological and psychological changes during their menopausal period which will affect their quality of life and health. The main objective of this review was to assess the literature concerning the various postmenopausal symptoms and prevalence. In many research they reported that the most common symptoms in menopausal women are somatic symptoms such as hot flushes, heart discomfort, sleep problem, muscle and joint pain. The psychological symptoms like depression, anxiety, irritability, physical and mental exhaustion, sexual problem, bladder problem and dryness of vagina are the urogenital symptoms. The menopause in women is stressful and produces many changes in vital parameters. The low intakes of dietary iron and calcium are common in menopausal women. As a conclusion of this study proper diet, improved life style, self-care, medical support and awareness program can help to reduce the postmenopausal symptoms and increase their quality of life.

Estrogens still represent an attractive therapeutic approach for Alzheimer's disease.

Estrogens still represent an attractive therapeutic approach for Alzheimer's disease.

Associations of long-term exposure to environmental noise and outdoor light at night with age at natural menopause in a US women cohort.

Premenopausal women from the Nurses' Health Study II (NHS II) were followed from age 40 through 2015. Median daytime and nighttime anthropogenic noise and outdoor LAN exposure were measured from a geospatial prediction model and satellite images, respectively, at residential addresses throughout the follow-up. Time-varying Cox proportional hazard models were used to calculate the hazard ratios and 95% confidence intervals, adjusting for individual lifestyle, reproductive history, and neighborhood socioeconomic factors. Possible effect modification by region, smoking status, body mass index, race/ethnicity, history of rotating shift work, and census tract population density and median income was examined. A total of 63,380 of 105,326 women self-reported natural menopause during 1,043,298 person-years of follow-up. No associations were found for noise (both daytime and nighttime) and outdoor LAN exposure with age at natural menopause (hazard ratios = 0.99-1.00) in the fully adjusted models. Sensitivity analyses showed similar null associations. No meaningful effect modification was found for region, smoking status, body mass index, race/ethnicity, history of rotating shift work, and census tract socioeconomic measures in stratified analyses. No associations were found between environmental noise and outdoor LAN exposure in mid-adulthood and menopausal age in this cohort of US women.

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

BackgroundTo estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45–60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS).MethodsWomen were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression.ResultsOf 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45–50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38–6.55 and 2.63; 1.44–4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13–4.14) and urogenital symptoms (2.54; 1.42–4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74–13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups.ConclusionsWomen living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women.

Abstract MP31: Early Age At Menopause And The Association With Incident Heart Failure In The Southern Community Cohort Study

Introduction: Reproductive factors might have an effect on the development of heart failure (HF). Early age at menopause has been linked with increased risk of cardiovascular disease; however, there is limited evidence on the relationship between early menopause and HF. Hypothesis: We assessed the hypothesis that earlier age at menopause is associated with increased risk of incident HF among women in the southeastern United States. Methods: The Southern Community Cohort Study enrolled ~86,000 low-income black and white adults in 12 southeastern states (2002-2009). Participants for this analysis were 11,948 women who were postmenopausal at enrollment, had no history of HF, and were using Centers for Medicare or Medicaid Services (CMS). HF events were ascertained using International Classification of Diseases , Ninth Revision, codes 428.x via linkage of the cohort with CMS Research Identifiable Files through December 31, 2016. Early menopause was defined as self-reported age at menopause less than 45 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were computed from multivariable Cox regression models, overall and by race, adjusting for demographic, lifestyle, and reproductive factors, including reason for menopause. Results: At baseline, median age was 58 years and 65% of participants were black. Among women with early menopause, 76% (n=4,836) had menopause due to hysterectomy or oophorectomy. In women with later menopause, 74% (n=4,102) reported natural menopause. During a median follow-up of 9.5 years (interquartile range 6.0-11.8), 3,808 incident HF events occurred. Compared to women with later onset of menopause, those with early menopause had increased HF risk (HR: 1.13, 95% CI: 1.04-1.23). Risk of HF associated with early menopause differed between white and black women (p-value for interaction: 0.02). In stratified analyses, white women with early menopause had an increased risk of HF compared to those with later onset of menopause (HR: 1.26, 95% CI: 1.11-1.43), although there was no association between early age at menopause and risk of HF in black women (HR: 1.07, 95% CI: 0.98-1.18). Conclusions: In conclusion, in this largely low-income population, early menopause is associated with an increased risk of developing HF and associations differ by race. Women with early menopause represent a potential target population for future interventions aimed to decrease risk of HF and cardiovascular risk factors.

Could hormonal and follicular rearrangements explain timely menopause in unilaterally oophorectomized women?

Does unilateral oophorectomy modify the relationship between serum anti-Müllerian hormone (AMH) levels and antral follicle count (AFC)? No altered 'per-ovary' and 'per-follicle' AMH production and antral follicle distribution was evident in unilaterally oophorectomized women compared to matched controls. The age of menopause onset is relatively unchanged in patients having undergone unilateral oophorectomy. Mechanisms that occur to preserve and maintain ovarian function in this context remain to be elucidated. Forty-one infertile women, with no polycystic ovary syndrome (PCOS) and no endometriosis, aged 19-42 years old, having undergone unilateral oophorectomy (One Ovary group; average time since surgery: 23.8 ± 2.2 months) were retrospectively age-matched (±1 year) with 205 infertile women having two intact ovaries and similar clinical features (Control group). Serum AMH levels, 3-4 mm AFC, 5-12 mm AFC, and total AFC (3-12 mm) were assessed on cycle Day 3 in both groups. Hormonal and ultrasonographic measurements obtained from patients in the Control group (i.e. having two ovaries) were divided by two to be compared with measurements obtained from patients of the One Ovary group (i.e. having one single remaining ovary). To estimate per-follicle AMH production, we calculated the ratio between serum AMH levels over 3-4 mm AFC, 5-12 mm AFC, and total AFC (3-12 mm), and the strength of the correlation between serum AMH levels and total AFC. The main outcome measure was to assess Day 3 AMH/Day 3 AFC ratio and hormonal-follicular correlation. As expected, before correction, mean serum AMH levels (1.46 ± 0.2 vs 2.77 ± 0.1 ng/ml, P < 0.001) and total AFC (7.3 ± 0.6 vs 15.1 ± 0.4 follicles, P < 0.0001) were lower in the One Ovary group compared to the Control group, respectively. Yet, after correction, per-ovary AMH levels (1.46 ± 0.2 vs 1.39 ± 0.1 ng/ml) and total AFC (7.3 ± 0.6 vs 7.5 ± 0.2 follicles) values were comparable between the two groups. Consistently, per-follicle AMH levels (3-4 mm, 5-12 mm, and total) were not significantly different between the two groups (0.39 ± 0.05 vs 0.37 ± 0.02 ng/ml/follicle; 0.69 ± 0.12 vs 0.59 ± 0.05 ng/ml/follicle, and 0.23 ± 0.03 vs 0.19 ± 0.01 ng/ml/follicle; respectively). In addition, the prevalence of 3-4 mm follicles was comparable between the two groups (66.7% for One Ovary group vs 58.8% for Control group, respectively). Finally, the correlation between serum AMH levels and total AFC was similar for patients in the One Ovary group (r = 0.70; P < 0.0001) compared to those in the Control group (r = 0.68; P < 0.0001). The retrospective character of the analysis might lead to potential bias. The present investigation did not provide evidence of altered 'per-ovary' and 'per-follicle' AMH production and antral follicle distribution in unilaterally oophorectomized women compared to matched controls. Further studies are warranted to support the hypothesis that follicle-sparing mechanisms are clearly at stake in remaining ovaries after unilateral oophorectomy to explain their long-lasting function and timely menopausal onset. The authors have no funding or competing interests to declare. N/A.

CHARACTERISTICS OF THE INTERRELATION OF VASOMOTOR SYMPTOMS WITH BODY MASS INDEX

The mechanisms of the emergence of "hot flashes" are actively considered, but still insufficiently studied. A woman's body weight is a modifiable risk factor, that is, amenable to both non-drug and drug correction. Therefore, the relevance of studying this risk factor for hot flashes is high. The purpose of this study is to study the relationship between vasomotor symptoms and body mass index in women. The study included 228 women with vasomotor complaints in the early postmenopausal period. The average age at the onset of menopause was 51.6 years (47.2; 53.4), while the median duration of menopause was 4.1 years (2.2; 5.0). Our results indicate the possibility of hot flashes in women with different body mass index. In obese women, severe menopausal syndrome (MS) is less common (5.7%) than in women with overweight (8.3%) or normal body weight (6.1%); while the average degree of MS is most often observed in patients with normal body weight (21.5%), less often with obesity (14.9%) and overweight (10.1%); mild MS is most often observed in patients with normal body weight (18%), less often with obesity (10.1%) and overweight (5.3%). It was found that in women with obesity, the severity of the initial signs of MS is not high (on average, up to 5-6 hot flashes per day), severe MS is less common than in women with overweight or normal body weight. Thus, hot flashes occur in women regardless of the woman's body weight and "obesity" is not able, as previously thought, to "protect" a woman from the appearance of hot flashes.

An epidemiological study on knowledge, attitude and practice of married women about menopause and hormone replacement therapy

Background: Women all over the world now have to spend almost 1/3rd of their lives in menopausal years. Therefore, menopause now is a concerning matter to maintain and improve women’s health. Hormone replacement therapy (HRT) is an effective treatment for menopausal symptoms. This study was conducted to determine knowledge, attitude and practice toward menopause HRT among women. Objective of the study was to determine the level of knowledge, attitude, and practice related to menopause and HRT among women.Methods: This cross-sectional study was carried out in May 2020 to July 2020 in a rural area of Ernakulam district of Kerala, India. 150 women were interviewed using a predesigned, pretested questionnaire.Results: In the present study, 42.6% of menopausal women had knowledge of menopausal symptoms. 31.3%, 38% and 26% knew that menopause increases risk of cardiovascular, osteoporosis and breast cancer respectively. 16.6% think menopausal women should consult a physician, only 42% of menopausal women are aware of HRT. 60.6% think menopausal symptoms affect quality of life. 50.6% think that menopause means end of sexual life. 42.6% think that absence of menstruation is a relief. 48.6% think physical changes of menopause are inevitable, hence acceptable. 35.3% had consulted a physician at the onset of menopause. 80% preferred natural approaches when compared to HRT. 76% and 86% think that HRT has many complications and side effects hence should be avoided respectively.Conclusions: The study concluded that the knowledge and attitude of the participants towards menopause and HRT was poor in the study population.

Continuous combined low-dose hormone replacement therapy in perimenopause: an algorithm of choice

In the age of broad medical options, women’s health has received sufficient attention. The different periods of a woman’s life are characterised by specific physiological changes, based on the age-related characteristics of the reproductive system. The onset of menopause can have a negative impact on health in varying degrees. Clinicians have a clear understanding of the effects of estrogen deficiency and the therapeutic options for managing it with menopausal hormone therapy (MHT) and alternative methods of treatment. However, to date, methods for optimising and individualising the correction of menopausal disorders continue to improve. The individualization of MHT is aimed at increasing the efficacy of menopausal management and minimizing possible adverse events. Individualization is based on the selection of a hormone drug taking into account age, menopausal status, somatic health of the woman and her main complaints against the background of estrogen deficiency. The next stage of transformation of MHT concerned the composition of the drugs and the doses of their components. The evolution of the estrogenic component began with the use of conjugated estrogens, whose metabolism is not fully clarified, and stopped at the production of bioidentical estrogens (17p-estradiol and estradiol valerate), which in their structure are as close as possible to ovarian estradiol. The type, dose and combination of estrogens and progestogens determine the severity and specificity of the effect of the hormone. This article will present a clinical case study of the low- and ultra-low-dose combination of 17p-estradiol and dydrogesterone (E/DG).

Artificial intelligence aided measurement of cervical squamous epithelial thickness and its correlation with cervical precancerous lesions

Objective: To study the thickness of cervical squamous epithelia and its correlation with cervical precancerous lesions. Methods: We selected 495 HE slides of 209 cervical biopsies from January 2020 to June 2020 in the Department of Pathology, the First and Seventh Medical Center of the PLA General Hospital, including 173 slides with low grade squamous intraepithelial lesion (LSIL) and 214 slides with high grade squamous intraepithelial lesion (HSIL). Artificial intelligence labeling software was used to assist in measuring the epithelial thickness of normal cervical squamous epithelium, LSIL and HSIL of each slide. The thickest, thinnest, and middle widths of epithelial thickness were measured, respectively. Average epithelial thickness was defined as the sum of the above three widths divided by 3. The correlation statistical analysis was performed by combining the data of age and pathological diagnosis. Results: The average thickness of normal cervical squamous mucosa was (245.83±91.40) μm, which was (222.42±81.22) μm and was (195.95±66.59) μm in LSIL and HISL epithelial respectively (F=27.09, P<0.01). The average cell layers of normal cervical squamous epithelium was (15.5±4.2) layers, which of LSIL was (14.8±4.8) layers, and that of HSIL was (15.8±4.8) layers. The differences among normal, LSIL and HSIL were not statistically significant (P>0.05). Further statistical analysis was stratified by age (≤30 years, 31-40 years, 41-50 years, 51-60 years, and >60 years), the results of Pearson correlation analysis showed that the thickness of normal cervical squamous epithelial gradually thinned with age (correlation coefficient r=-0.141 9, P<0.05), while LSIL and HSIL epithelial thickness had significant correlation with age (P>0.05). In the subgroup of ≤50 years old, the epithelial thickness of normal squamous epithelium was the thickest, followed by LSIL, and HSIL epithelial thickness was the thinnest. The differences were statistically significant (P<0.05). While in the subgroup of >50 years, the differences were not statistically significant (P>0.05). Conclusions: The cervical squamous epithelium gradually becomes thinner with the degree of precancerous lesions increasing among patients of ≤50 years old. However, after age of 50 years, with the onset of menopause, the normal mucosal epithelium is becoming atrophy, so that mucosal thickness is no longer correlated with the extent of the lesion. In addition, it is suggested that the cervical vinegar white test performance during colposcopy is related to the protein changes in the mucosal epithelial cells, but not directly related to the thickness of the epithelial layer.

Application of country‐specific Globorisk score to estimate next 10 years risk of cardiovascular diseases and its associated predictors among postmenopausal rural women of Bangladesh: A cross‐sectional study in a primary care setting

AbstractIntroductionRisk of cardiovascular disease (CVD) among postmenopausal Bangladeshi women has not yet been evaluated using a country‐specific tool. Hence, we prompted to estimate the risk and identify the predictors that were not typically included in any CVD risk assessment tool.MethodsThis cross‐sectional study used a web version of country‐specific lab‐based Globorisk calculator to estimate the risk of CVD among 265 postmenopausal women who visited a primary healthcare centre in a rural area of Bangladesh. The centre was selected purposively and the participants were recruited using a convenient sampling technique. Data were collected using a modified STEP‐wise approach to surveillance of non‐communicable disease risk factors questionnaire of the World Health Organization. The risk levels were presented using descriptive statistics and the associated predictors were identified using adjusted multiple linear regression analysis.ResultsOverall, 56.7% of the subjects were identified as ‘at risk’ of future CVD events. After adjusting the confounders, CVD risk factors including age of onset of menopause (β = 0.441, p &lt; 0.001), duration of menopause (β = 0.603, p &lt; 0.001), smokeless tobacco use (β = –1.047, p = 0.003), added salt intake (β = 1.081, p = 0.002), waist–hip ratio (β = 0.094, p = 0.03) and diastolic blood pressure (β = 0.145, p = 0.001) were identified as significant predictors of CVD risk.ConclusionThis finding suggests screening program among postmenopausal women for early detection of CVD risk and efforts to control the associated predictors.

Postmenopausal Symptoms and Management by Women in Delhi–NCR

Menopause is defined as the complete cessation of the menstrual cycle in women for twelve consecutive months. Although menopause is an important aspect of the female reproductive health cycle, it is often ignored. Women may experience different menopausal and postmenopausal symptoms ranging from mild to severe. In the present study, a cross-sectional survey of 200 women in their postmenopausal years was conducted across Delhi and the National Capital Region (NCR). A pretested questionnaire was given to a random population of postmenopausal women to record various postmenopausal symptoms and the coping strategies adopted by them. The mean age of menopause of the sample population was 47.48 years, and body mass index seemed to affect the age of onset of menopause. The majority of women experienced postmenopausal symptoms, with 95.28% experiencing more than one symptom, ranging from fatigue and sleep disturbances to severe symptoms such as anxiety attacks, palpitations and joint pains. Many women used different coping strategies, such as changes in lifestyle and social interaction with other women experiencing menopause. Very few women used hormone replacement therapy as a coping mechanism and most of them were ignorant about the same. Interestingly, both education and working status were observed to affect the adoption of coping strategies by women in Delhi–NCR. The results of the study emphasize the need of addressing the problems of the postmenopausal population and incorporating the same in the national healthcare programme.

Femininity Concerns and Feelings About Menstruation Cessation Among Lesbian, Bisexual, and Heterosexual Women: Implications for Menopause.

Background: Women differ in how they psychologically respond to the end of menstruation and onset of menopause; however, little empirical evidence exists for understanding how sexual orientation and gendered dynamics contribute to menstrual experiences in middle-to-late adulthood. We investigated if women's attitudes toward the cessation of menstruation vary by their sexual orientation. Methods: Using data from the Midlife in the United States Study (MIDUS, N = 3471), we examined the relationship between women's sexual orientation and attitudes toward menstruation cessation. We also assessed their femininity concerns, such as their worries about attractiveness and fertility in the context of aging. Results: Sexual minority (SM) women, compared with their heterosexual counterparts, expressed less regret of their menstrual periods ending. SM women also expressed lower concerns about femininity compared with heterosexual women, and concerns about femininity mediated the relationship between sexual orientation and regret. That is, SM women felt less regret about menstrual periods ending than heterosexual women, and this finding was partially explained through SM women's lower concerns about femininity (attractiveness and fertility). Conclusions: Our results contribute to a growing body of research on the psychological strengths of sexual minorities by highlighting SM women's potential strengths in an aging context. We propose implications for understanding aging stigma and women's health, and we discuss how menopause may be differently experienced by women based on sexual orientation.

Thick Hyperkeratotic Plaques on the Palms and Soles.

A 52-year-old woman with a history of rheumatoid arthritis presented with a rash on the palms and soles of 7 years' duration that started around the onset of menopause. Physical examination revealed thick hyperkeratotic plaques with multiple deep fissures on the palms and soles.

Effects of Menopause in Women With Multiple Sclerosis: An Evidence-Based Review.

Over two thirds of all individuals who develop multiple sclerosis (MS) will be women prior to the age of menopause. Further, an estimated 30% of the current MS population consists of peri- or postmenopausal women. The presence of MS does not appear to influence age of menopausal onset. In clinical practice, symptoms of MS and menopause can frequently overlap, including disturbances in cognition, mood, sleep, and bladder function, which can create challenges in ascertaining the likely cause of symptoms to be treated. A holistic and comprehensive approach to address these common physical and psychological changes is often suggested to patients during menopause. Although some studies have suggested that women with MS experience reduced relapse rates and increased disability progression post menopause, the data are not consistent enough for firm conclusions to be drawn. Mechanisms through which postmenopausal women with MS may experience disability progression include neuroinflammation and neurodegeneration from age-associated phenomena such as immunosenescence and inflammaging. Additional effects are likely to result from reduced levels of estrogen, which affects MS disease course. Following early retrospective studies of women with MS receiving steroid hormones, more recent interventional trials of exogenous hormone use, albeit as oral contraceptive, have provided some indications of potential benefit on MS outcomes. This review summarizes current research on the effects of menopause in women with MS, including the psychological impact and symptoms of menopause on disease worsening, and the treatment options. Finally, we highlight the need for more inclusion of MS patients from underrepresented racial and geographic groups in clinical trials, including among menopausal women.