Perimenopausal Stage Research Articles

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

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

The unmet needs of menopausal women in primary care.

The average age for menopause is 51 years, this is preceded by a transitional perimenopausal stage, with vasomotor symptoms, muscular and joint pain, lowered libido and disordered sleep, impacting on mental health. In some women, the quality of life is considerably affected. This remains under-reported. There is no national screening service, or specialised clinics for menopausal services available in primary care. We undertook a survey of women in primary care as part of a needs assessment to understand the prevalence of peri- and menopausal symptoms, women's knowledge of these symptoms, and available treatment options. A questionnaire was sent to women aged 45-65 years registered with the practice. Of a total of 73 women, 78.1% complained of >4 symptoms. The most common symptoms were memory problems and brain fog (80.6%), sleep disturbance (72.1%) and muscle/joint pain (72.1%). Women were asked to rate their knowledge of therapy options on a self-reported scale of 0-10; a high proportion (64.3%) rated <4 points. They had better knowledge of symptoms, 79.3% rated >4 points. A high proportion (58.9%) rated inadequate support received from primary care and 75.3% felt they had no support at all. Our results of this preliminary study showed the vast majority of women were unaware of treatment options for their menopausal symptoms and felt they received inadequate to no support from primary care providers. The present ongoing study highlights lack of resource allocation to women's health and insufficient commissioning of services to address this health need.

Effect of Guggulu Tiktakam Kashayam in Uterine Fibroid

The most common benign uterine tumours affecting women in reproductive and perimenopausal stages are fibroids or leiomyomas. There is strong evidence that estrogen and progesterone promote the growth of fibroids, despite the fact that their exact aetiology is still unclear. This is because fibroids seldom arise before menarche and retreat after menopause. The most prevalent reason for hysterectomy is fibroids. Menorrhagia, polymenorrhoea, metrorrhagia, intermenstrual bleeding, infertility, repeated abortions, pain and pressure feelings, abdominal lumps, and vaginal discharge are a few of the symptoms they exhibit clinically. In Ayurveda there is no exact correlation for uterine fibroid. Fibroids can be considered as Mamsa Grandhis, one among the Grandhis described by Charaka and Vagbhata. They increase the surface area of the endometrial tissue in the uterus when present, causing excessive bleeding, pressure feelings, dysmenorrhea, and even infertility. Vata-Kapha predominant Tridoshas have a role in the aetiology of the Granthi Roga, necessitating the use of Vata-kaphahara medicines. As Granthi can also be caused by Mandagni, in Granthi chikitsa we can make use of Dravyas that are Deepana pachana. According to Acharya Susrutha, Sopha Chikitsa is included in the Apakwa Granthi chikitsa. In Mamsa granthi chikitsa, Shothagna, Lekhana, Chedhana, and Vatanulomana dravyas may be utilised. Asrigdara chikitsa and Raktapitta chiktsa can be used to treat fibroids when heavy, prolonged menstrual cycles are present. A 38 year old lady was presented with complaints of heavy, prolonged bleeding during menstruation along with lower abdomen pain. On USG she was diagnosed with uterine fibroids. Guggulu tikitakam kashayam was given for 3 months and after follow up symptoms were evaluated. She was relieved from prolonged heavy bleeding during menstruation and lower abdomen pain. From this case report, it is evident that Guggulu tiktakam kashayam is effective in uterine fibroids

Perimenopausal Stage: Perception, Benefit and Opinion of Husbands and Wives

Perimenopause or "menopause transition": Can begin eight to 10 years before menopause, when the ovaries gradually produce less estrogen. Females are not expected to discuss about this topic as it is considered taboo in society. The current study is based on the perception of husband’s (47-58 years) and wives (40-55 years) regarding perimenopausal stage, regarding perimenopause, signs and symptoms, challenges or difficulties, benefits, experiences and treatments. Aims of the study were: [1] To ascertain perception of Husband’s (47-58 years) and Wives (40-55 years) regarding: a) meaning b) physical symptoms c) discussion among couples. [2] To identify benefits of perimenopausal stage as observed by Husband’s (47-58 years) and Wives (40-55 years): a) finding sex more physically comfortable. b) feeling relief about not being pregnant and not taking contraceptives c) seeking medical treatment d) remedies for reducing the symptoms. [3] To develop or design a brochure/pamphlet for better understanding and knowledge regarding perimenopausal stage. Research design was exploratory and snowball sampling was implemented with a total sample of 200 participants (100 Husbands and 100 Wives) using a self-constructed tool (5 open and 15 closed ended items). Results revealed, (61%) discuss the changes faced during perimenopausal stage with their spouse while (39%) do not discuss. (42%) Neither agree nor disagree while (3%) Strongly agree finding sex more physically comfortable after perimenopause.

Analysis of Characteristics of Endometrial Carcinoma in Peri- and Postmenopausal Women with Abnormal Uterine Bleeding.

To analyze the menstrual characteristics of endometrial carcinoma and investigate whether abnormal uterine bleeding in the perimenopausal period differs from postmenopausal bleeding. We conducted a retrospective analysis of 928 cases of endometrial carcinoma in patients admitted from January 2016 to December 2022. We gathered fundamental clinical data and analyzed distinct clinical risk factors between the perimenopausal and postmenopausal groups. Furthermore, we computed the statistical variances in menarche, regular menstrual cycles, and the duration of abnormal uterine bleeding. Perimenopausal patients with endometrial carcinoma exhibit similar factors to postmenopausal patients, especially if they have a history of menstrual cycles lasting more than 30 years, hypertension, abnormal uterine bleeding for over 1 year, and a high risk of endometrial carcinoma. Early intervention for abnormal uterine bleeding during the perimenopausal stage can prevent up to 80% of women from developing endometrial carcinoma. Perimenopause women experiencing abnormal uterine bleeding should be mindful of the risk of endometrial carcinoma, as this awareness can substantially decrease the occurrence of the disease.

Menopause-Associated Depression: Impact of Oxidative Stress and Neuroinflammation on the Central Nervous System-A Review.

Perimenopausal depression, occurring shortly before or after menopause, is characterized by symptoms such as emotional depression, anxiety, and stress, often accompanied by endocrine dysfunction, particularly hypogonadism and senescence. Current treatments for perimenopausal depression primarily provide symptomatic relief but often come with undesirable side effects. The development of agents targeting the specific pathologies of perimenopausal depression has been relatively slow. The erratic fluctuations in estrogen and progesterone levels during the perimenopausal stage expose women to the risk of developing perimenopausal-associated depression. These hormonal changes trigger the production of proinflammatory mediators and induce oxidative stress, leading to progressive neuronal damage. This review serves as a comprehensive overview of the underlying mechanisms contributing to perimenopausal depression. It aims to shed light on the complex relationship between perimenopausal hormones, neurotransmitters, brain-derived neurotrophic factors, chronic inflammation, oxidative stress, and perimenopausal depression. By summarizing the intricate interplay between hormonal fluctuations, neurotransmitter activity, brain-derived neurotrophic factors, chronic inflammation, oxidative stress, and perimenopausal depression, this review aims to stimulate further research in this field. The hope is that an increased understanding of these mechanisms will pave the way for the development of more effective therapeutic targets, ultimately reducing the risk of depression during the menopausal stage for the betterment of psychological wellbeing.

Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia.

Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016-2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.

Histopathological patterns of abnormal uterine bleeding in endometrial biopsies: a retrospective study in Najran Region, Saudi Arabia

Objective: This retrospective study aimed to elucidate the histopathological patterns of endometrial biopsies in women presented with abnormal uterine bleeding (AUB) across various age groups in Najran, Saudi Arabia. Methods: A total of 365 subjects, spanning perimenarchal to perimenopausal stages, were included in the study, conducted at the Maternity and Children Hospital in Najran, Saudi Arabia. The study period extended from October, 2020 to September, 2022. Histopathological patterns were analyzed in relation to age, parity, bleeding patterns, cause, and management of AUB. Results: The predominant age group was 40-50 years (40.5%), with proliferative endometrium being the most prevalent histopathological pattern. Menorrhagia was the most common bleeding pattern (34.0%), and functional causes accounted for 46.0% AUB cases. Surgical treatment was the primary management approach (50.7%). Multinomial logistic regression highlighted the unique contributions of age, parity, bleeding patterns, cause, and management of AUB to endometrial histopathology (p &amp;lt; 0.001). Conclusion: The current study findings provided a comprehensive understanding of the complex interplay between demographic and clinical factors in shaping endometrial histopathology in women with AUB in Najran, Saudi Arabia. Tailoring diagnostic and management strategies based on these factors can enhance personalized care for this diverse patient population.

Association between menopause and suicidal ideation in mothers of adolescents: A longitudinal study using data from a population-based cohort

BackgroundMidlife suicide among women has attracted increasing research attention. This study aimed to investigate the longitudinal association between menopause and suicidal ideation among middle-aged women. MethodsOur data were derived from the Tokyo Teen Cohort, a population-based survey of early adolescents (N = 3171) and their primary caregivers (typically, mothers) in Japan. A total of 2944 mothers (baseline mean age = 44.0 years) were included in the analysis. The baseline assessment in this study was performed at second-wave survey from July 2014 to January 2017. A follow-up assessment was conducted at fourth-wave survey from February 2019 to September 2021. Suicidal ideation at baseline and follow-up was assessed using the Suicidal Ideation subscale of the 28-item General Health Questionnaire. Menopausal stage was classified based on self-report at fourth-wave survey. ResultsParticipants who started the perimenopausal stage after baseline were significantly more likely to have suicidal ideation at follow-up than those who did not have experienced menopausal transition yet. Participants with greater social support were less likely to report suicidal ideation at follow-up, even after adjusting for baseline suicidal ideation. LimitationsThis study was based on self-report regarding menopausal stage and only included mothers of adolescents from Japan. An exact length of time from the onset to the presence of suicidal ideation was unavailable. ConclusionsWomen who have experienced the onset of menopausal transition presented an increased risk of suicidal ideation. Psychosocial interventions to increase social support may be beneficial in preventing mental health inequalities during menopausal transitions.

Borderline ovarian tumors: epidemio-clinical characteristics and prognoses

Introduction: Borderline ovarian tumors are common ovarian tumors at the limit of the malignancy and have generally a good clinical outcome. these ovarian neoplasms affect mostly young women and in the peri-menopausal stage. Borderline ovarian neoplasms can be suspected pre-operatively but the diagnosis is mostly made on stage of cystectomy or adnexectomy.

Prenatal exposure to acrylamide differently affected the sex ratio, aromatase and apoptosis in female adult offspring of two subsequent generations.

In the present study, we investigated the effect of acrylamide (ACR) exposure during pregnancy on the ovary of female adult offspring of two subsequent generations. Sixty-day-old Wistar albino female rats were given different doses of ACR (2.5 and 10 mg/kg/day) from day 6 of pregnancy until giving birth. Females from the first generation (AF1) were fed ad libitum, and thereafter, a subgroup was euthanized at 8 weeks of age and ovary samples were obtained. The remaining females were maintained until they reached sexual maturity (50 days old) and then treated in the same way as the previous generation to obtain the second generation of females (AF2). The histopathological examination indicated a high frequency of corpora lutea along with an increased number of antral follicles that reached the selectable stage mainly at a dose of 2.5 mg/kg/day. Interestingly, ACR exposure significantly increased the mRNA levels of CYP19 gene and its corresponding CYP19 protein expression in AF1 females. The TUNEL assay showed a significantly high rate of apoptosis in stromal cells except for dose of 2.5 mg/kg/day. However, in AF2 females, ACR exposure significantly increased the number of degenerating follicles and cysts while the number of growing follicles was reduced. Moreover, in both ACR-treated groups, estradiol-producing enzyme CYP19A gene and its corresponding protein were significantly reduced, and an excessive apoptosis was produced. We concluded that the ovarian condition of AF1 females had considerable similarity to the typical early perimenopausal stage, whereas that of AF2 females was similar to the late perimenopausal stage in women.

Sex and menopause impact 31P-Magnetic Resonance Spectroscopy brain mitochondrial function in association with 11C-PiB PET amyloid-beta load

Increasing evidence implicates sex and endocrine aging effects on brain bioenergetic aging in the greater lifetime risk of Alzheimer’s disease (AD) in women. We conducted 31Phosphorus Magnetic Resonance Spectroscopy (31P-MRS) to assess the impact of sex and menopause on brain high-energy phosphates [adenosine triphosphate (ATP), phosphocreatine (PCr), inorganic phosphate (Pi)] and membrane phospholipids [phosphomonoesters/phosphodiesters (PME/PDE)] in 216 midlife cognitively normal individuals at risk for AD, 80% female. Ninety-seven participants completed amyloid-beta (Aβ) 11C-PiB PET. Women exhibited higher ATP utilization than men in AD-vulnerable frontal, posterior cingulate, fusiform, medial and lateral temporal regions (p < 0.001). This profile was evident in frontal cortex at the pre-menopausal and peri-menopausal stage and extended to the other regions at the post-menopausal stage (p = 0.001). Results were significant after multi-variable adjustment for age, APOE-4 status, midlife health indicators, history of hysterectomy/oophorectomy, use of menopause hormonal therapy, and total intracranial volume. While associations between ATP/PCr and Aβ load were not significant, individuals with the highest Aβ load were post-menopausal and peri-menopausal women with ATP/PCr ratios in the higher end of the distribution. No differences in Pi/PCr, Pi/ATP or PME/PDE were detected. Outcomes are consistent with dynamic bioenergetic brain adaptations that are associated with female sex and endocrine aging.

Ameliorative Effect of Tocotrienols on Perimenopausal-Associated Osteoporosis-A Review.

Osteoporosis, or bone loss, is a disease that affects many women globally. As life expectancy increases, the risk of osteoporosis in women also increases, too, and this will create a burden on the healthcare and economic sectors of a country. Osteoporosis was once thought to be a disease that would occur only after menopause. However, many studies have shown that osteoporosis may develop even in the perimenopausal stage. Due to the erratic levels of estrogen and progesterone during the perimenopausal stage, studies suggest that women are exposed to the risk of developing osteoporosis even at this stage. The erratic hormonal changes result in the production of proinflammatory mediators and cause oxidative stress, which leads to the progressive loss of bone-building activities. Tocotrienols, members of vitamin E, have many health-promoting properties. Due to their powerful anti-oxidative and anti-inflammatory properties, tocotrienols have shown positive anti-osteoporotic properties in post-menopausal studies. Hence, we propose here that tocotrienols could also possibly alleviate perimenopausal osteoporosis by discussing in this review the connection between inflammatory mediators produced during perimenopause and the risk of osteoporosis. Tocotrienols could potentially be an anti-osteoporotic agent, but due to their low bioavailability, they have not been as effective as they could be. Several approaches have been evaluated to overcome this issue, as presented in this review. As the anti-osteoporotic effects of tocotrienols were mostly studied in post-menopausal models, we hope that this review could pave the way for more research to be done to evaluate their effect on peri-menopausal models so as to reduce the risk of osteoporosis from an earlier stage.

The impact of sexual hormones on depressive symptoms and alcohol use in a woman with delusional disorder at the perimenopausal stage: case report and review of recent works

IntroductionThe influence of sexual hormones on mental disorders have been extensively reported. In fact, recent studies suggest that sex hormones may play a relevant role in the pathophysiology of psychosis, may be a precipitant when exogenously administered or even be used as a treatment agent of psychotic disorders.ObjectivesTo describe the case of a patient with a recent diagnosis of delusional disorder (DD) with an onset in the perimenopausal period.MethodsCase report and narrative review focused on the impact of sexual hormones on depressive symptoms and alcohol use comorbidity during perimenopause in DD women by using PubMed database.ResultsCase report: A 48-year-old woman diagnosed with DD. The clinical assessment of climacteric symptoms, as well as the gonadotropins (elevated levels of follicle-stimulating hormone -FSH- and luteinizing hormone -LH-) and estrogen levels monitoring (variations on 17-β-estradiol -E2-) enabled to link the endocrine changes with the onset and course of the psychiatric disorder. During the development of the disease, the patient also presented comorbid depressive symptoms and alcohol use disorder. Review: Estrogen depletion seems to increase the risk of psychosis, while scientific literature is not conclusive in establishing a definitive relationship between depressive symptoms and hormonal imbalance in DD. Alcohol use disorder is a common comorbidity in both perimenopausal women and patients with DD.ConclusionsMultiaxial management of the case helped clinicians to achieve clinical stabilization. Sex differences as well as hormonal pattern disturbances should receive special attention due to the seminal implications in pharmacotherapy and clinical outcomes.DisclosureNo significant relationships.

Abstract 11711: Quantification of Atherosclerotic Coronary Artery Disease in the Pre/Peri-Menopausal Female Using Cardiac CTA

Introduction: Coronary Artery Disease (CAD) occurs equally in males and females and is the most common cause of death in both genders worldwide. The pre/peri-menopausal female is believed to have minimal coronary atherosclerosis based primarily on non-invasive techniques, with limited coronary angiography data. Cardiac computed tomography angiography (CCTA) is a more sensitive, non-invasive anatomical diagnostic tool for quantifying coronary atherosclerosis, but pre/peri-menopausal women have been underrepresented and underdiagnosed. The goal of this study was to quantify coronary atherosclerosis in this population. Methods: We conducted a retrospective chart review on 510 females aged 35-60 presenting with atypical chest pain and shortness of breath. These were consecutive admissions in which CCTA was performed from January 2014 to December 2019. The degree of coronary atherosclerosis was quantified using the CAD-RADS scoring system. Results: Analysis showed 68.82% of patients had no evidence of coronary atherosclerosis. 4.31% had minimal CAD, 18.24% had mild CAD, 6.47% had moderate CAD and 2.16% were found to have severe CAD. Each category of stenosis typically had multiple vessels involved. Over 65% of patients were Non-Hispanic White, 27% Hispanic, 8% African American and 4% Asian. Less than 5% of patients were discharged with statin therapy. Conclusions: This is the first study to quantify coronary atherosclerosis in the pre/peri-menopausal female. Quantification was based on coronary angiograms obtained by CCTA, currently the most sensitive diagnostic imaging technique. Despite the perceived protective nature of the premenopausal state in women, 30% of patients had detectable CAD by CCTA. 10% had greater than 50% stenosis (moderate to severe CAD), suggesting the potential for future ischemic heart disease. So few patients were discharged on statin therapy, showing the paucity of guideline therapy used in this population. These results suggest targeting preventative therapy, even late in the pre or peri-menopausal stage, such as favorable lifestyle changes and reducing known modifiable cardiac risk factors, should significantly prevent the progression of coronary atherosclerosis and its subsequent sequelae in menopause.

Acupuncture: A Promising Approach for Comorbid Depression and Insomnia in Perimenopause.

Comorbid depression and insomnia are ubiquitous mental complaints among women going through the perimenopausal stage of life and can result in major decline in quality of life. Antidepressive agents combined with/without hypnotics, and/or hormone therapy are currently the most common treatment for perimenopausal depression (PMD) and insomnia (PMI). Balancing the benefits of these pharmacotherapies against the risk of adverse events (AEs) is a difficult task for both clinicians and women. There has been a growing body of research regarding the utilization of acupuncture for treatment of PMD or PMI, whereas no studies of acupuncture for comorbid PMD and PMI have appeared. In this review, we summarize the clinical and preclinical evidence of acupuncture as a treatment for PMD or PMI, and then discuss the potential mechanisms involved and the role of acupuncture in helping women during this transition. Most clinical trials indicate that acupuncture ameliorates not only PMD/PMI but also climacteric symptoms with minimal AEs. It also regulates serum hormone levels. The reliability of trials is however limited due to methodological flaws in most studies. Rodent studies suggest that acupuncture prolongs total sleep time and reduces depression-like behavior in PMI and PMD models, respectively. These effects are possibly mediated through multiple mechanisms of action, including modulating sex hormones, neurotransmitters, hypothalamic-pituitary-adrenal axis/hypothalamic-pituitary-ovary axis, oxidative stress, signaling pathways, and other cellular events. In conclusion, acupuncture is a promising therapeutic strategy for comorbid depression and insomnia during perimenopause. Neuroendocrine modulation is likely to play a major role in mediating those effects. High-quality trials are required to further validate acupuncture’s effectiveness.

Preface: Understanding Women’s Lives and Trauma Through Narrative Research and Analysis

Preface: Understanding Women’s Lives and Trauma Through Narrative Research and Analysis

Negative affect symptoms, anxiety sensitivity, and vasomotor symptoms during perimenopause.

Objective:Vasomotor symptoms affect 60-80% of women during the menopausal transition. Anxiety, depression, and anxiety sensitivity can have an important role in the distressful experience of vasomotor symptoms. Our aim was to evaluate the prevalence and association of vasomotor and negative affect symptoms.Methods:A cross-sectional study was conducted with 89 perimenopausal women aged 45-55 years. Broad psychiatric and clinical evaluations were carried out. The primary outcome was the vasomotor symptom problem rating and the main study factor was anxiety sensitivity. Linear regression analyses were conducted to examine the associations between the study factors and the primary outcome, and a multiple regression model was created to assess which variables were independently associated with vasomotor symptom problem rating.Results:The prevalence of anxiety, depression, and vasomotor symptoms were 58, 62, and 73%, respectively. Negative affect symptoms were positively associated with vasomotor symptom problem rating. The association of anxiety sensitivity and vasomotor symptom problem rating remained significant after controlling for perimenopausal stage, thyrotropin, follicle-stimulating hormone levels, and psychotropic medication use (β = 0.314, p = 0.002).Conclusion:A better understanding of the experience of vasomotor symptoms is needed, especially the role of negative affect symptoms and anxiety sensitivity. New strategies focusing on related thoughts and behaviors could improve the quality of life of perimenopausal women.

Perimenopausal women show modulation of excitatory and inhibitory neuromuscular mechanisms

BackgroundMenopausal transition exposes women to an early decline in muscle force and motor function. Changes in muscle quality and function, especially in lower limbs, are crucial, as they expose individuals to increased risk of falls. To elucidate some of the related neuromuscular mechanisms, we investigated cortical inhibition and peripheral muscle twitch force potentiation in women during the early and late stages of perimenopause.MethodsParticipants were 63 women aged 48–55 years categorized as early (EP, n = 25) or late (LP, n = 38) perimenopausal according to serum follicle-stimulating hormone (FSH) levels and menstrual diaries. EP women had an irregular menstrual cycle and FSH < 25 IU/L, while LP women had an irregular cycle and > 25 IU/L. We examined motor evoked potential (MEP) and silent period (SP) elicited by transcranial magnetic stimulation (TMS), in the tibialis anterior muscle at 20%, 40%, and 60% of maximal voluntary contraction (MVC) levels, and twitch force potentiation in plantar flexors.ResultsEP group showed a longer SP duration in 40% MVC condition and larger motor evoked potential amplitude in 20% MVC condition compared to the LP group. No group difference was detected in twitch force potentiation; however, it correlated negatively with FSH levels. Other factors, such as age, height, body mass index, or physical activity did not explain group differences.ConclusionsOur preliminary results indicate subtle modulation in both TMS-induced inhibitory and excitatory mechanisms and twitch force potentiation in women already in the late perimenopausal stage. This suggests that the reduction of estrogens may have an accelerating role in the aging process of neuromuscular control.

The effects of life style modification versus food supplementation on menopausal symptoms

BackgroundNutrition and good health are two dependent parallel axes; female’s health at different ages in general and at the time of menopause in particular has received a lot of attention last several years. The objective of this experimental study was to evaluate the effect of consuming food supplement versus lifestyle modification in the dietary habit on menopausal symptoms in perimenopausal Egyptians females.ResultsForty seven females in the perimenopausal stage of life with mean age 46.04 ± 5.88 years participated on the food supplement consumption group, they consumed 75 g per day of a rusk (prepared from corn flour, wheat flour 72%, full cream milk powder, flaxseed oil, wheat germ, clove and cinnamon powder) for 2 months. They were compared with the control group (forty nine females with mean age 46.91 ± 5.39 years) who changed their foods habits to a healthy life style. Menopause rating scale and the biochemical analysis were comparable on day 1 and on day 60. The total menopause rating scale and its three subscales (psychological, urogenital and somatic), waist circumference, serum follicle stimulating hormone and estradiol in the corn rusk supplement group showed a statistically significant improvement. No significant difference was noted in the control group apart of the psychological subscale and waist circumference.ConclusionsCorn Rusk enriched with clove and cinnamon as a food supplement snake is promising to relief menopausal symptoms and should be considered on the diet of menopausal females.