Onset Of Menopause Research Articles

Factors Affecting Age of Onset of Menopause

Background: Menopause is a natural process, occurring in women that marks the end of fertility among women. It is characterized by a cessation of menstruation, decline in ovarian activity and disturbances in periods along with vaginal dryness, mood swings and hot flashes. The age of menopause ranges in between 40 to 55 years. Although there are many factors affecting the age of menopause onset like metabolic syndrome, cytotoxic drugs, but there is no general agreement on them.
 Objectives: To explore the factors affecting age of onset of menopause among Pakistani women.
 Methodology: This cross-sectional-observation study was conducted on 139 women (aged at or above 40 years) presenting to the Outpatient Department of Obstetrics – Gynecology at Jinnah Medical College Hospital, Karachi – Pakistan from Nov 2020 to May 2021. Data was collected using a structured interview-based questionnaire containing inquiries pertaining to basic biodata, sociodemographic details, menstrual history, and probable factors affecting age of onset of menopause. Chi-square test was applied to check the association between the different factors and age of menopause.
 Results: The mean age of the participants was found to be 43.23 ± 4.11 SD years, while the mean age of onset of menopause was recorded to be 49.21 ± 3.83 SD years. The associations between the marital status, body mass index, use of OCP and socio-economic factors with age of onset of menopause, were found to be statistically significant.
 Conclusion: Menopausal age not only reflects the end of fertility era but also of aging as well. Age of menopause significantly effects physical and psychological health of women and is considered as a very important event in women’s lives. Controllable factors like obesity, tobacco use, use of OCP plays a significant role in age of onset of natural menopause.

Early menopause results from instead of causes premature general ageing

Recent genome-wide association studies have shown that the majority of genes involved in menopause are also instrumental in double-strand break repair and mismatch and base excision repair of DNA. Cumulative DNA damage causes cellular senescence resulting in exhaustion of somatic cell renewal capacity and cellular dysfunction, and eventually to accelerated cell death, generally called ageing. A similar erosion of the genome occurs within the germ cell line and thus in the ovaries. Subsequently, the systemic ‘survival’ response intentionally suppresses the sex-steroid hormone output, which in turn may contribute to the onset of menopause. The latter occurs in particular when age-dependent DNA damage accumulates. Both effects are expected to synergize to promote ovarian silencing resulting in menopause. Consequently, ageing of the soma seems to be a primary driver for the loss of ovarian function in women. Therefore menopause is the result rather than the cause of ageing.

Determinants of Early Onset of Menopause: An Empirical Study of Chittagong District in Bangladesh

Early onset of menopause results in the loss of fertility of women and creates many health complications. The aim of the study is to explore the determinants of the early onset of menopause of the women living in Chittagong district of Bangladesh. A total of 160 postmenopausal women over the age of 30 years participated in our cross-sectional study as respondents. In the study, the mean age of onset of menopause was observed to be 45.70 years. Chi-square test of association and binary logistic regression analyses were performed to reveal the predictors of early menopause. Crude odds ratio and adjusted odds ratio are obtained to find the likelihood of onset of menopause and to compare each category of the variable with the reference category. The result shows that age at marriage, use of contraceptives, regularity of period, type of food preferred, number of children in the family, and level of education of the respondents are significantly associated when crude odds ratios are obtained. On the other hand, adjusted odds ratio shows that use of contraceptives, regularity of period, level of education, and type of food preferred are significantly associated with early onset of menopause of the women of Chittagong district in Bangladesh.

A single dose of dietary nitrate supplementation protects against endothelial ischemia-reperfusion injury in early postmenopausal women.

The onset of menopause and accompanying changes to ovarian hormones often precedes endothelial dysfunction in women. In particular, accelerated impairments in macrovascular and microvascular function coincide with the loss of estrogen, as does impaired endothelial responses to ischemia-reperfusion (IR) injury. In healthy, early postmenopausal women (n=12; 3.9± 1.5 years since menopause) we tested the hypothesis that acute dietary nitrate (NO3-) supplementation would improve endothelial function and attenuate the magnitude of endothelial dysfunction following whole-arm IR in comparison with placebo. In this randomized, double-blind, placebo-controlled, crossover study we tested participants before and after NO3--rich (BRnitrate) and NO3--depleted (BRplacebo) beetroot juice (BR) consumption, as well as following IR injury, and 15min after IR to assess recovery. Analyses with repeated-measures general linear models revealed a condition× time interaction for brachial artery flow-mediated dilation (FMD; P=0.04), and no interaction effect was found for the near-infrared spectroscopy-derived reperfusion slope (P=0.86). Follow-up analysis showed a significant decline in FMD following IR injury with BRplacebo in comparison with all other timepoints (all, P<0.05), while this decline was not present with BRnitrate (all, P>0.05). Our findings demonstrate that a single dose of dietary NO3- minimizes IR-induced macrovascular endothelial dysfunction in healthy, early postmenopausal women, but does not improve resting macrovascular and microvascular function. Trial registration number: NCT03644472. Novelty: In healthy, early postmenopausal women, a single dose of NO3--rich BR can protect against IR-induced endothelial dysfunction. This protection may be due to nitric oxide bioactivity during IR rather than improved endothelial function prior to the IR protocol per se.

The origin of menopause

The origin of menopause is mysterious and difficult to explain in terms of evolutionary theory. Menopause is described in humans and in four cetacean species. Natural selection cannot act on a trait that appears after the end of reproduction; therefore, it cannot be formed by the classical selection mechanism. All the proposed theories of the onset of menopause, adaptive and non-adaptive, can explain the benefits of menopause, but are completely untenable from the point of view of the theory of evolution and do not answer the main question - how did it arise. We propose a hypothesis based on the assertion that menopause is a byproduct of the rapid increase in the size of the cerebral cortex during the formation of Homo sapiens. Genes associated with the development of congenital microcephaly, which are responsible for the development of the cerebral cortex, were identified, and clear traces of natural selection were found in them, and a powerful evolutionary process continues up to the present. Most products of these genes are associated with the process of formation of the cell division spindle, both in the process of mitosis and meiosis. We hypothesize that the rapid evolutionary process that led to the growth of the cerebral cortex in humans, as a side effect, led to the formation of a high frequency of aneuploidy in oocytes. A similar process has also led to the formation of menopause in cetaceans.

Residential green space and age at menarche in German and Australian adolescent girls: A longitudinal study.

A large multicentre European study reported later onset of menopause among women residing in greener areas. This influence on the timing of a reproductive event like menopause, raises the question whether similar associations can be observed with timing of menarche. We investigated whether exposure to residential green space was related to the age at menarche in German and Australian adolescent girls. The analytic samples comprised of 1706 German and 1474 Australian adolescent girls. Percentage of green space was calculated in 1000m buffers around a residential address or its surrogate at the previous follow-up. Mixed effects Cox proportional hazard models were used to explore the associations. The survival object was the occurrence of menarche at the time of follow-up (15-year follow-up of the German cohorts and the study wave at 14-15 years in the Australian cohort) and number of years since baseline (10-year follow-up in the German cohort and the study wave at 10-11 years in the Australian cohort). Participants who did not reach menarche were included as censored observations. A greener residence was not associated with the age at menarche. Null findings were consistent in the general population and in analyses stratified by socioeconomic status or urbanicity in both countries. Urban residents were more likely to have earlier menarche, and this association was consistent across Germany and Australia. The results of our analysis do not support the hypothesis that residing in places with more green space can influence timing of menarche. However, given the limitations of our study, researchers should not be discouraged to further explore environmental risk factors of early menarche.

Abstract P152: The Association Between Menopause Age And Carotid Plaque In The Multi-Ethnic Study Of Atherosclerosis (MESA)

Background: The menopause transition is associated with an accelerated rise in cardiovascular disease (CVD) risk among women. Early-onset menopause is associated with incident CVD events. Detection of subclinical atherosclerosis may be an opportunity to institute preventive efforts before the onset of clinical CVD. We assessed whether menopause age was associated with carotid plaque, a marker of subclinical atherosclerosis, in a multiethnic cohort. Methods: We studied post-menopausal women in MESA free of CVD who had age of menopause onset ascertained by questionnaire and carotid plaque measured by B-mode ultrasound at baseline. Menopause age was categorized as &lt;45, 45-&lt;50, 50-&lt;55 (ref) and ≥55 yrs. Multivariable logistic and linear regression models were performed to evaluate the association of menopause age with carotid plaque presence (yes/no) and extent (carotid plaque score (CPS)), respectively. Results: Of the 2,297 women included, 38% were White, 28% Black, 12% Chinese, and 22% Hispanic with a mean age (SD) of 64 (9) yrs. The distribution of menopause age was 22.7% at age &lt;45, 28.8% at age 45-49, 36.1% at age 50-54, 12.5% at age ≥55. Overall, carotid plaque was present in 52%. The association of carotid plaque presence/absence and CPS are shown in the Table . There was no statistically significant association of menopause age with carotid plaque presence. Compared to women with menopause age 50-55, menopause before age 45 was significantly associated with a 9% greater CPS [percent difference 9 (95% CI 2, 17) after adjusting for demographics. This was attenuated and no longer statistically significant after further adjustment for CVD risk factors. Conclusion: In a multiethnic cohort of women, a younger age of onset of menopause was associated with a greater extent of carotid plaque, which appears to be mediated through traditional CVD risk factors. Further studies are needed to evaluate the association between the age of onset of menopause and atherosclerotic risk.

Women with HIV transitioning through menopause: Insights from the Swiss HIV Cohort Study (SHCS).

ObjectivesWe aimed to assess prevalence and age at menopause, identify factors associated with early menopause and explore the provision and utilization of healthcare in women living with HIV in Switzerland.MethodsThis was a retrospective Swiss HIV Cohort Study analysis from January 2010 to December 2018. Descriptive statistics to characterise the population and menopause onset. Logistic regression analysis to identify risk factors for early menopause.ResultsOf all women in the SHCS, the proportion of postmenopausal women tripled from 11.5% (n = 274) in 2010 to 36.1% (n = 961) in 2018. The median age at menopause was 50 years. Early menopause (< 45 years) occurred in 115 (10.2%) women and premature ovarian insufficiency (POI) (< 40 years) in 23 (2%) women. Early menopause was associated with black ethnicity (52.2% vs. 21.6%, p < 0.001), but not with HIV acquisition mode, CDC stage, viral suppression, CD4 cell count, hepatitis C, smoking or active drug use. While 92% of the postmenopausal women underwent a gynaecological examination during the 36 months before menopause documentation, only 27% received a bone mineral density measurement within 36 months after the last bleed and 11% were on hormone replacement therapy at the time of menopause documentation.ConclusionsThe median age of women living with HIV at menopause is around 2 years lower than that reported for HIV‐negative women in Switzerland. HIV care providers need to adapt their services to the requirements of the increasing number of women living with HIV transitioning through menopause. They should be able to recognize menopause‐associated symptoms and improve access to bone mineral density measurement as well as hormone replacement therapy.

Menopausal experiences of South Asian immigrant women: a scoping review.

South Asians make up a significant portion of global immigration. Immigrants often face challenges when navigating the healthcare system, which can influence their experience during the menopausal transition. The purpose of this scoping review is to summarize the existing literature on South Asian immigrant women's menopausal experience. Various electronic databases were systematically searched to identify research articles. The menopausal experiences of South Asian immigrant women were examined. A total of 11 studies were included in this scoping review. A variety of physical symptoms were reported, including vasomotor symptoms, musculoskeletal symptoms, somatic symptoms, and early onset of menopause. Psychosocial symptoms included anxiety, depression, and decreased memory/concentration. Cultural experiences were both positive and negative, depending on the connotations surrounding menopause. Individual facilitators for a healthy transition included education and employment. Familial barriers included a lack of knowledge and support. Community and societal factors were both positive and negative, depending on the level of acculturation. Self-management was the most widely used intervention. Findings of this scoping review can help guide the development and evaluation of menopause interventions for South Asian immigrant women. Culturally sensitive care, increased discussion on sexual health, support networks, and reduction of socioeconomic barriers are needed to address the health needs of South Asian immigrant women. Further research is needed to better understand South Asian immigrant women's menopausal needs and help guide intervention design.

The effect of micronutrient supplementation on serum anti-Mullerian hormone levels: a retrospective pilot study

Background The anti-Müllerian-hormone (AMH) is secreted by the granulosa cells of the oocytes and can be used as a marker of the ovarian reserve; helpful to estimate female fertility or the menopause onset. Although various factors may influence AMH levels, the correlation with nutritional factors needs more research. Objective To evaluate the effect of a micronutrient supplementation on female AMH levels. Methods This retrospective analysis includes a total of 244 women, who attended the Karl Landsteiner Institute, Korneuburg, Austria from January 2013 to June 2019 due to an unfulfilled desire for a child. All women were treated with an oral micronutrient preparation consisting the dosage of one soft capsule and one tablet per day for 3 months. The soft capsule contains omega-3 fatty acids and the tablet is a standardized combination of coenzyme Q10, vitamin E, folic acid, selenium, catechins from green tea extract, and glycyrrhizin from licorice extract. Serum AMH levels before and after 3 months were compared. In addition, available clinical data such as ovulation frequency, endometrium thickness, and luteal phase duration were analyzed. Results The mean age of the women was 37.3 ± 1.8 years, the mean body mass index of 24.3 ± 4.6 k/m2. The mean serum AMH levels and endometrial thickness values were significantly higher after micronutrient supplementation as compared to baseline (1.42 ± 0.86 versus 1.86 ± 0.82 ng/mL and 6.10 ± 1.76 versus 7.29 ± 1.65 mm, respectively). In addition, ovulation frequency and luteal phase duration significantly improved in more than 60%. Conclusion Proposed micronutrient supplementation had a positive effect on serum AMH levels, endometrial thickness, ovulation frequency, and luteal phase duration. It could be a simple, risk-free therapeutic option to improve female fertility. More research is warranted to prove this effect.

SIZE OF FIBROIDS AFFECTING THE POST MENOPAUSAL WOMEN

To evaluate the affects of sizes of fibroids in post-menopausal females. Material and method: Data for this article was extracted from google scholar and PubMed, including 28 articles published from 2003 to 2020. Conclusion: Uterine fibroids are benign tumors that affect women throughout their reproductive years, peaking in the perimenopausal years.In postmenopausal women, the incidence of Uterine fibroids reduces. Medical treatment of Uterine fibroids may provide symptom alleviation and serve as a transition into menopause.Although it is true that Uterine fibroids regress with the onset of menopause, this does not occur in all cases. The most successful treatment to date is hysterectomy.More study is needed to better understand the pathophysiology of Uterine fibroids and to identify risk factors.

The Effects of Environmental Contaminant Exposure on Reproductive Aging and the Menopause Transition.

Menopause marks the end of a woman's reproductive lifetime. On average, natural menopause occurs at 51years of age. However, some women report an earlier age of menopause than the national average. This can be problematic for women who delay starting a family. Moreover, early onset of menopause is associated with increased risk of cardiovascular disease, depression, osteoporosis, and premature death. This review investigates associations between exposure to endocrine-disrupting chemicals (EDCs) and earlier onset of menopause. Recent data suggest exposure to certain EDCs may accelerate reproductive aging and contribute to earlier onset of menopause. Human and rodent-based studies identify positive associations between exposure to certain EDCs/environmental contaminants and reproductive aging, earlier onset of menopause, and occurrence of vasomotor symptoms. These findings increase our understanding of the detrimental effects of EDCs on female reproduction and will help lead to thedevelopment of strategies for the treatment/prevention of EDC-induced reproductive aging.

The Impact of Sex on Strength Training in Adults With Cardiovascular Disease

Cardiovascular disease (CVD) is the leading killer of American males and females. Outcomes of treatment for CVD have historically been worse in females than in males. The inability to recover, may be, at least in part, due to lower levels of skeletal muscle mass in females; which is made worse with the onset of menopause and especially when a catabolic event like surgery and / or illness occurs. We theorize that while regaining cardiorespiratory fitness (CRF) after treatment for CVD is very important, it is only part of what is required for complete recovery. Regaining strength and muscle mass is just as important for healthy physiologic aging and recovery from illness. We outline a simply strategy for helping males and females train for strength while recovering from CVD.

Mediation effect of body mass index on the association between age at menopause and type 2 diabetes mellitus in postmenopausal Chinese women.

This study aimed to examine the association between age at menopause and type 2 diabetes mellitus (T2DM), and whether this association is mediated by body mass index (BMI) in postmenopausal Chinese women. This cross-sectional study enrolled 4,279 postmenopausal women. Binary logistic regression was used to estimate the association between age at menopause and T2DM. A multiple linear regression model was used to evaluate the relationships between age at menopause and fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPBG), homeostasis model assessment for insulin resistance (HOMA)-IR, and HOMA of ß-cell function (HOMA-ß). Mediation analysis was performed to investigate whether these associations were mediated by BMI. After full adjustment, women with a later age of menopause (>54 y) were more likely to have T2DM (odds ratio =1.401, 95% confidence interval [CI], 1.010-1.945; P = 0.044) than those in the reference group (4453 y). After multiple adjustments, each 1-year increase in the age at onset of menopause was associated with a 0.021 mmol/L increase in FPG (95% CI, 0.004-0.038; P = 0.014), 0.048 mmol/L increase in2hPBG (95% CI, 0.0060.090; P = 0.024), and 1.540 decrease in HOMA-ß (95% CI, -2.386 to -0.695; P < 0.001), but no changes in HOMA-IR. Later age of menopause was associated with overweight/general obesity (odds ratio = 1.416, 95% CI, 1.028-1.950; P = 0.015). BMI partially mediated the association between age at menopause and FPG and 2hPBG, and the proportion of the effect was 5.42% and 7.69%, respectively. Further, BMI suppressed the association between age at menopause and HOMA-ß, and the proportion of the suppressing effect was 9.54%. The later age of menopause was positively related to T2DM. BMI partially mediated the association between age at menopause and glucose status and suppressed the association between age at menopause and HOMA-ß. Prospective studies are warranted to confirm this association.

STop OVarian CAncer (STOPOVCA) young: Protocol for a multicenter follow-up study to determine the long-term effects of opportunistic salpingectomy on age at menopause

BackgroundOpportunistic salpingectomy comprises additional bilateral salpingectomy during abdominal surgery as a prophylactic method to reduce the risk of ovarian cancer. However, opportunistic salpingectomy may potentially damage (micro)blood circulation to the ovaries, resulting in earlier onset of menopause. Primary objectiveTo evaluate the long-term effects of opportunistic salpingectomy on the onset of menopause in women who underwent sterilization through salpingectomy compared with a control group who underwent sterilization by tubal ligation or no surgery at all. Study hypothesisOpportunistic salpingectomy does not lower the mean age at onset of menopause. Trial designIn a multicenter observational noninferiority study, we will prospectively compare the age at menopause of women initially aged 35–45 who underwent sterilization through opportunistic salpingectomy with a similarly aged control group who underwent sterilization by tubal ligation or no sterilization. Participants will be asked to complete an annual questionnaire on onset of menopause to eventually determine whether there is more than a one-year decrease in mean age at onset of menopause in the opportunistic salpingectomy group. Follow-up will last until determination of menopause, with a maximum of 15 years. Major inclusion/exclusion criteriaInclusion criteria: pre-menopausal; age between 35 and 45; intact ovaries. Exclusion criteria: post-menopausal; previous bilateral salpingectomy or oophorectomy; previous hysterectomy; abnormal karyotype; previous or current chemotherapy or pelvic radiation. Primary endpoint(s)Determination of age of menopause measured by annual questionnaire. Sample size1200 (400 intervention group; 800 control group). Estimated dates for completing accrual and presenting resultsIt is estimated that recruitment will be completed by 2023 and results will be published by 2039. ClinicalTrials.gov identifier: NCT04757922 Protocol version: Version 1, February 2021

Trajectories of Blood Pressure in Midlife Women: Does Menopause Matter?

Whether changes in blood pressure (BP) over women's midlife are more driven by chronological aging or the menopause transition has been debated. We sought to determine whether women can be classified into distinct trajectory groups based on pattern and level of systolic BP (SBP), diastolic BP, pulse pressure (PP), and mean arterial pressure (MAP) over the menopause transition, and to assess whether menopause-related factors predict the group and level of BP measures. Participants were from the SWAN (Study of Women's Health Across the Nation). Group-based trajectory modeling was used to identify women who shared distinct BP trajectories over time relative to menopause onset and to assess associations of menopause-related factors with trajectory group and level of BP measures. An accelerated rise relative to menopause onset suggests a menopause contribution. The study included 3302 multiracial and multiethnic women with BP measures over 17 follow-up visits (baseline age [SD]: 46.3 [2.7]). Women were classified into either low, medium, or high trajectory group in each BP measure. The low SBP, PP, and MAP trajectories (in 35%, 53%, and 28% of the cohort, respectively) were rising slowly before menopause but showed a significant accelerated rise 1 year after menopause, indicating a menopause contribution. The remaining BP trajectories were rising up until menopause and either continued with the same rise or declined after menopause. A younger menopause age predicted the low SBP, PP, and MAP trajectories. A greater follicle-stimulating hormone level predicted lower SBP and PP levels, while vasomotor symptoms occurrence predicted higher SBP, PP, and MAP levels over time. Estradiol did not predict trajectory or level of any BP measure. Distinct BP trajectories over the menopause transition exist that revealed a group of women whose SBP, PP, and MAP trajectories are consistent with a menopause contribution. Our findings support frequent monitoring of BP during the menopause transition.

Активное долголетие женщины: теломеразная теория старения в основе ведения менопаузального периода

The concept of women’s long-term health and longevity implies maintaining the quality of life, including a discussion of the role of hormone replacement therapy within the ‘therapeutic window’. Aging is a complex multi-step process. It is believed that women begin to experience the effects of aging at the age of 40. The processes of age-related changes in the body are being actively studied these days and include markers, models, systems, but there is no unified concept yet. In recent decades, there has been an increase in life expectancy for women, hence there are more women in menopause, and an increase in the incidence of age-related diseases can be expected. With the onset of menopause and age-related changes, women may experience metabolic disorders, cardiovascular diseases, endothelial dysfunction, disorders of both the central and peripheral nervous systems, musculoskeletal disrders and mental health problems. Over past decades, attention has been paid to cellular markers of aging, and the telomere theory has been most developed. It is associated with shortening of telomeres – the end regions of chromosomes. Many studies in recent years have examined the mechanisms influencing the length of these regions, the activity of the telomerase enzyme, and the processes of reproductive aging associated with this theory. In the 20th and 21st centuries, the possible effect of exogenously administered estrogen on telomere length as part of hormone replacement therapy has been under active consideration. Key words: insulin resistance, menopause, telomeres, telomerase, type 2 diabetes, aging, hormone replacement therapy

The influence of body mass index and smoking on the age of onset of menopause in women in Bosnia and Herzegovina: a cross-sectional multicentric study.

IntroductionMenopause is the last physiological menstrual period and is a complex process involving the following: endocrine, genitourinary, cardiovascular, and locomotor system, and it leads to vasomotor symptoms and psychological complaints. This study aims to investigate the influence of smoking and body mass index (BMI) as risk factors on the age of onset of menopause in women in Bosnia and Herzegovina.Material and methodsThis study included 460 women in natural menopause. The study was conducted in 2 phases: interview and measurement of BMI. Each patient underwent an interview based on the questionnaire, following the verbal consent of the patient, who had previously been explained the nature of the research.ResultsThe age at which menopause occurs increases with the BMI increase, and it can be described by the regression equation: age = 0.096 × BMI + 45.7, which has statistical significance. The mean age of menopause occurrence in current smokers was lower (47.5 ±0.4 years) than in non-smokers (48.8 ±0.2 years) (p = 0.010).ConclusionsOur study confirmed the statistically significant correlation between smoking, BMI, and age of onset of menopause.

Estrogen rapid effects: a window of opportunity for the aging brain?

Estrogen produces several beneficial effects in healthy neurological tissues and exhibits cardioprotective effects. Hormone therapy has been widely used to treat menopausal estrogen deficiency for more than 80 years. Despite high initial expectations of cardioprotective effects, there has been substantial distrust following important randomized clinical trials, such as the Women’s Health Initiative. Subsequently, the timing of treatment in relation to the onset of menopause came under consideration and led to the proposal of the timing hypothesis, that early initial treatment is important, and benefits are lost as the timing since menopause becomes prolonged. Subsequent analyses of the Women’s Health Initiative data, together with more recent data from randomized and observational trials, consistently show reductions in coronary heart disease and mortality in younger menopausal women. Regarding cognitive function, the timing hypothesis is consistent with observations from basic and animal studies. There is some clinical evidence to support the benefits of hormonal therapy in this context, though skepticism remains due to the paucity of clinical trials of substantial length in younger menopausal women. It is likely that the effects of estrogens on cognitive performance are due to rapid mechanisms, including mechanisms that influence Ca2+ homeostasis dynamics, provide protection in a hostile environment and reduce inflammatory signals from neural tissues. In the future, inflammatory profiles accounting for early signs of pathological inflammation might help identify the ‘window of opportunity’ to use estrogen therapy for successful cognitive protection.

Menopause and oral health

At menopause, a woman's body undergoes radical hormonal changes, which predisposes to damage of the oral cavity. The onset of menopause is a series of morpho functional physiological adaptive changes with systemic and oral action in women. Oral health is closely related to dental hygiene, a major concern in menopause. The addressability of women to dental services tends to increase due to perimenopausal changes that occur in the gums and teeth and the oral microbiome. These changes have a hormonal substrate that significantly influences the evolution of oral health. The purpose of this review is to understand the occurrence and evolution of oro-dental complications in menopause and the systematization of therapeutic regimens. The PubMed and Web Of Science databases searched identified approximately 21 eligible articles. Periodontal damage is the most common, followed by dryness and burning sensation in the mouth. The role of hormone replacement therapy is controversial in terms of prophylaxis or the obvious therapeutic aspect of menopausal women with oral symptoms. The lack of extensive research, at least for the time being, does not establish clear therapeutic protocols to resolve these dental conditions.