Perimenopausal Symptoms Research Articles

Identifying Perimenopausal Symptoms in Women Diagnosed With Depression: A Focused Audit at a Tertiary Care Hospital

Identifying Perimenopausal Symptoms in Women Diagnosed With Depression: A Focused Audit at a Tertiary Care Hospital

Cognitive shadows in perimenopause: linking subjective cognitive decline (SCD) to menopausal symptom severity.

As women approach perimenopause, the incidence of Subjective Cognitive Decline (SCD) rises. This study aims to investigate the association between SCD and the severity of perimenopausal symptoms. Conducted at The Affiliated Hospital of Guizhou Medical University Menopause Clinic from November 2022 to June 2023. Participants, aged 40-55 years, were classified as perimenopausal using the STRAW + 10 criteria. SCD was assessed separately using the Chinese version of the SCD-Q9 scale and the SCD International Working Group (SCD-I) conceptual framework, while perimenopausal symptoms were evaluated with the Modified Kupperman Index (MKI). Linear relationships between MKI scores and SCD-Q9 scores were clarified using both univariate and multivariate linear regression analyses. Additionally, a multivariate Logistic regression analysis was conducted to examine the association between MKI scores and SCD classification based on SCD-I criteria. The primary outcomes were the Modified Kupperman Index scores, SCD-Q9 questionnaire scores, and the diagnosis of SCD based on SCD-I criteria. Among 101 participants, the average MKI score was 18.90 ± 9.74, and the average SCD-Q9 score was 4.57 ± 2.29. Both univariate and multivariate linear regressions demonstrated a positive correlation between these scores. A multivariate Logistic regression analysis, using MKI as the independent variable and SCD-I criteria classification as the dependent variable, revealed a significant positive association. A notable association exists between SCD and perimenopausal symptoms severity. This underscores the potential clinical importance of addressing perimenopausal symptoms to mitigate SCD risks in women. Further studies should focus on clarifying the causality between these factors.

Onset and resolution of ovarian toxicity with nirogacestat treatment in females with desmoid tumors: Updated safety analyses from the DeFi phase 3 study.

Nirogacestat is a targeted gamma secretase inhibitor approved in the United States for adults with progressing desmoid tumors. In the phase 3 DeFi study (NCT03785964) of nirogacestat, ovarian toxicity (OT) was identified as a safety signal among females of reproductive potential (FORP). This analysis further describes the incidence, presentation, and resolution of OT. Patients were randomized to twice-daily oral nirogacestat (150 mg) or placebo, taken in continuous 28-day cycles. Investigator-identified OT in FORP was based on abnormal reproductive hormone values or perimenopausal symptoms (or both). Adverse event follow-up was conducted to assess OT resolution. Post hoc analyses included return of menstruation and return of follicle-stimulating hormone (FSH) to within normal limits (WNL) (≤20.4 mIU/mL). Of 92 randomized females, 73 in the safety population were FORP (n=36 nirogacestat, n=37 placebo). OT was identified in 75% (27 of 36) receiving nirogacestat and 0% (0 of 37) receiving placebo. As of October 24, 2022, investigators reported OT resolution in 78% (21 of 27) of patients, with median OT duration of 19.1 weeks. Off-treatment resolution was reported in all 11 patients (100%) who stopped nirogacestat treatment; of these, all nine with available menstruation information experienced return of menstruation and eight had FSH WNL at last reported assessment. Resolution was reported in 10 of 14 (71%) while on nirogacestat; of these, all 10 experienced return of menstruation and seven had FSH WNL. Two patients were lost to follow-up. Most FORP treated with nirogacestat experienced OT, with the majority resolving, including all who stopped treatment, suggesting that OT is transient.

TRANSFORMING PERIMENOPAUSAL HEALTH: NUTRITIONAL AND MOVEMENT-BASED INTERVENTIONS

Perimenopause, a transitional phase preceding menopause, signifies a decline in estrogen levels, often manifesting in one's 40s or even 30s, with associated symptoms such as irregular menstrual cycles, hot flashes, mood swings, and altered body composition. These symptoms not only affect quality of life but also pose long-term health risks, including cardiovascular disease, hypertension and osteoporosis. Given the complex hormonal changes during perimenopause, effective interventions are imperative. This study in Ambala, Haryana, aimed to assess the impact of dietary and physical activity interventions on perimenopausal women's health. Fifty women aged 35 to 50, self-reporting perimenopause, underwent a three-month intervention. The experimental group received tailored nutrition and movement guidance, while the control group maintained their usual lifestyle. Noteworthy enhancements were observed in dietary habits, anthropometric measurements, and biochemical parameter in the experimental group. These improvements included increased intake of nutrient-rich foods, reduction in weight, BMI, WC, HC, WHR and improvements in perimenopausal symptoms and related biochemical marker like hypertension. These findings underscore the efficacy of personalized interventions in mitigating perimenopausal symptoms and improving overall health, emphasizing the importance of lifestyle modifications during this transitional phase. This study investigates the effects of dietary and exercise interventions on physical health markers, dietary habits, physical activity levels, BMI and biochemical assessment of perimenopausal women. By exploring the impact of lifestyle modifications, the research aims to alleviate symptoms, enhance quality of life and reduce the risk of lifestyle diseases during this transitional phase.

Effect of Shatavarichinnaruhadi Ksheerakasaya in Perimenopausal Symptoms

Menopause is referred to as Rajakshaya in Ayurveda, which is the body's transition from a Pitta- to a Vata-dominant condition. It comes under Swabhavika vyadhi and occurs in Jara pakwa sareera, which causes Dhatus to gradually deteriorate. Treatment of perimenopausal symptoms may benefit from medications with Rasayana, Medhya, Balya, Dahasamana, Vayasthapaka, and Rasarakthaprasadaka characteristics. A 44-year-old woman who sought treatment for hot flushes, excessive sweating, particularly at night, irritability, mood swings, numbness in the extremities, sleep disturbances, and vaginal itching is presented here. Assessment was done using Greene Climacteric Scale. Among all the symptoms, hot flushes and night sweats were the most distressing one for the subject. Shatavari chinnaruhadiksheerakasaya mentioned in Chikitsamanjari in Vataraktha context possess Vatapittapradhana Tridoshasamana, Rasarakthapradhaka, Dahasamana, Rasayana, Medhya, Balya like properties which can be beneficial in reducing the most wretched vasomotor symptoms. Apart from these, the formulation exhibits anti-oxidant, free radical scavenging, phytoestrogenic and anti-stress activity. Ksheera is Vata pitta samana, Rasayana, Sheeta veerya, Vrishya, Ojasyam, Dhatuvardhaka, and Jeevaneeya. For thirty days, 48ml of Shatavarichinnaruhadi ksheerakasaya was administered twice daily, one hour before food. The severity of symptoms particularly hot flushes and night sweats were considerably reduced after treatment. Thirty days after quitting the drug, a follow-up was conducted, and this time the severity of the symptoms was also less severe than it had been before therapy. From this case report, it is evident that Shatavarichinnaruhadi ksheerakasaya is effective for the management of perimenopausal symptoms especially the most disturbing vasomotor symptoms

Perimenopause: Review Article

The perimenopause is the period that precedes the menopause and is a term used synonymously with “menopausal transition”. Stages -1 and -2 according of the STRAW+10 Staging System for Reproductive Aging in Women are included under it [1]. This is a crucial phase in the lives of women where they are juggling between peak stages of their career and taking care of family, both parents and children in most scenarios. This period is impeded by a wide range of perimenopausal symptoms like vasomotor, psychiatric, sleep, sexual, genitourinary, cognitive, and somatic symptoms [2]. This article reveals the impact of perimenopausal symptoms on the quality of life of women and the possible modalities of management.

Knowledge, Awareness, Attitudes and Practices toward Perimenopausal Symptoms among Saudi Females.

Women's knowledge about perimenopause plays a crucial role in shaping their perception of related illnesses, influencing coping strategies, treatment adherence, and the overall management of this life stage. This cross-sectional study assessed the awareness, knowledge, attitudes, and practices regarding perimenopause among 409 Saudi women attending primary healthcare centers. Participants completed a structured questionnaire addressing demographic data, awareness, knowledge, attitudes, and practices related to perimenopause. While 75.3% of the participants were aware of perimenopause, only 17.4% could identify more than 10 out of 20 perimenopause symptoms. Commonly recognized symptoms included menstrual irregularity (67.7%), mood swings (66.0%), and mood fluctuations (50.4%). Only 23.0% had optimal knowledge about perimenopause complications. Additionally, 73.3% had not consulted a doctor for perimenopause-related issues. An analysis of the overall knowledge score showed a mean (SD) = 14.82 (5.64) out of 34. The level of knowledge was independently associated with a higher educational level, more frequent perimenopause symptoms, and regular doctor visits. This study reveals high awareness but insufficient knowledge among Saudi women regarding perimenopause symptoms and complications associated with higher perimenopause morbidity and a lack of engagement with healthcare professionals. It underscores the need for early and continued education on perimenopause, improved doctor-patient communication, and specific interventions to boost knowledge and attitudes toward perimenopause.

A Contemporary View of Menopausal Hormone Therapy.

Enthusiasm for the use of hormones to ameliorate symptoms of perimenopause and menopause has waxed and waned over the years. Both treatment for symptoms and training of women's health care practitioners in the management of menopause have sharply declined since publication of the Women's Health Initiative initial results in 2002. Findings from that trial, which treated a population of older, asymptomatic patients, have been extrapolated over the past 21 years to all estrogen products, all menopausal women, and all delivery mechanisms. Our patients deserve a more nuanced, individualized approach. Conjugated equine estrogens and medroxyprogesterone acetate are no longer the predominant medications or medications of choice available for management of menopausal symptoms. All hormones are not equivalent any more than all antiseizure medications or all antihypertensives are equivalent; they have different pharmacodynamics, duration of action, and affinity for receptors, among other things, all of which translate to different risks and benefits. Consideration of treatment with the right formulation, at the right dose and time, and for the right patient will allow us to recommend safe, effective, and appropriate treatment for people with menopausal symptoms.

Nocturia in Menopausal Women: The Link Between Two Common Problems of the Middle Age.

The aim of this review is to discuss the link between menopause and nocturia and to give an overview of the increasing prevalence, risk factors, causative factors, treatment needs and options for nocturia in peri-menopausal women. This opinion article is a narrative review based on the expertise and consensus of a variety of key opinion leaders, in combination with an extensive literature review.This literature search included a thorough analysis of potential publications on both the PubMed Database and the Web of Science and was conducted between November 2022 and December 2022. The following key words were used "nocturia" and "menopause" or "nocturnal frequency and menopause." Moreover, key words including "incidence," "prevalence," "insomnia," "estrogen therapy," "metabolic syndrome," and "hot flushes" were used in combination with the aforementioned key words. Last, the reference lists of articles obtained were screened for other relevant literature. The perimenopause can be a trigger for inducing nocturia. Typically, obesity, body mass index (BMI), and waist circumference are risk factors for developing peri-menopausal nocturia. Presumably the development of peri-menopausal nocturia is multifactorial, with interplay among bladder, sleep, and kidney problems due to estrogen depletion after the menopause. First, impaired stimulation of estrogen receptors in the urogenital region leads to vaginal atrophy and reduced bladder capacity. Moreover, menopause is associated with an increased incidence of overactive bladder syndrome. Second, estrogen deficiency can induce salt and water diuresis through blunted circadian rhythms for the secretion of antidiuretic hormone and the activation of the renin-angiotensin-aldosterone system. Additionally, an increased incidence of sleep disorders, including vasomotor symptoms and obstructive sleep apnea signs, is observed. Oral dryness and a consequent higher fluid intake are common peri-menopausal symptoms. Higher insulin resistance and a higher risk of cardiovascular diseases may provoke nocturia. Given the impact of nocturia on general health and quality of life, bothersome nocturia should be treated. Initially, behavioral therapy should be advised. If these modifications are inadequate, specific treatment should be proposed. Systemic hormone replacement is found to have a beneficial effect on nocturia, without influencing sodium and water clearance in patients with nocturnal polyuria. It is presumed that the improvement in nocturia from hormonal treatment is due to an improvement in sleep disorders.

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.

How do women feel cold water swimming affects their menstrual and perimenopausal symptoms?

This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms. An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed. Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms. 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement. Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings.

Statement of retraction: Greening the brain: A horticultural stress management program for perimenopausal symptoms

Statement of retraction: Greening the brain: A horticultural stress management program for perimenopausal symptoms

Ab. No. 68 Effect of Aerobic Exercise on Menopause Symptoms in Perimenopausal Housewives

Introduction: To find effect of four weeks of aerobic exercise on Menopausal Symptoms using Menopausal Rating Scale (MRS) in perimenopausal housewives. Women during perimenopause suffer from hot flashes, fatigue, and mood swings due to hormonal changes. These symptoms can disrupt daily life, work, and well-being. Housewives may have limited access to health information leading to a lack of awareness of symptoms, resulting in increased suffering and a lack of understanding of how to manage. Aerobic exercise, like walking, has been shown to reduce these symptoms and improve overall well-being in perimenopausal women. Method: 36 housewives aged between 40-55years with perimenopausal symptoms were randomized into an intervention group A or a control group B. Women with known conditions which affected walking, taking drugs to relieve perimenopausal symptoms, women with surgical menopause, and receiving any hormone therapy were excluded. An experimental study was conducted in community of Ahmedabad. Women in the intervention group were asked to perform walking at 11-13 RPE for 150 minutes/week with warm up and cool down, five times a week. Those in control group continued their usual routine. Outcome used was menopausal rating scale. Data analysis was performed using SPSSv.20. Wilcoxon signed rank test was used for within group analysis and Mann-Whitney U test for between group analyses. Level of Significance was 5%. Results: Study is ongoing. Within group analysis for group A(z=-3.187,p=0.001) and for group B(z=-1.890, p=0.059). Between group analysis U=13, p=0.0001. Conclusion: Aerobic exercise like walking reduces menopausal symptoms in perimenopausal housewives. Implication: Aerobic exercise has benefits on physical and mental health, including reduced hot flashes, improved sleep, and decreased depression, significantly contributing to improving quality of life and well-being during the perimenopausal phase in women undergoing the menopause transition. Housewives who may have reduced social peers to discuss these symptoms can benefit from structured walking programs.

Perimenopausal Symptoms and Their Effects on Quality of Life in Menopausal Women with Comorbidity Diabetes

Perimenopausal Symptoms and Their Effects on Quality of Life in Menopausal Women with Comorbidity Diabetes

Assessment of Relationship between Lifestyle Behaviors and Severity of Perimenopausal Symptoms among Women

Menopause is a stage of transition from a reproductive to a non-reproductive state in the life of a woman. The perimenopause transition is defined as the period immediately before the menopause. The most common symptoms of menopause can be broken down into vasomotor, physical, emotional, or sexual complaints. Lifestyle behaviors play a significant role in women's experiencing menopausal symptoms during the perimenopause. Aims:It aims to assess the relationship between women's lifestyle behaviors and the severity of perimenopausal symptoms. Methods:Adescriptive correlational study of 120 perimenopausal women using a purposive sample was conducted at gynecology outpatient clinics and general medicine outpatient clinics at Assuit University hospitals from the first of January to the end of June 2023. Three tools were used for this study: a structured interview questionnaire, a modified menopausal rating scale, and a health promotion lifestyle profile. Results:This study reveals that 85.8% of perimenopausal women's lifestyle was poor. Also, 31.6% of perimenopausal women reported moderate perimenopausal symptoms. Somatic symptoms were the most prevalent symptoms on the menopausal rating scale, followed by psychological symptoms and, lastly, urogenital symptoms. There has been a highly statistically significant difference as regards the relationship between the severity of perimenopausal symptoms and women's lifestyle behaviors (p>0.001). Conclusion:There has been an intense negative correlation between women's lifestyle behaviors and the severity of perimenopausal symptoms. So, women need to get health education from the nurse specialists during perimenopause and nurses should plan and implement educational programs for the perimenopausal women about the healthy life style behaviors to reduce and manage their menopausal symptoms. Recommendation: Plan and implement a necessary educational program for perimenopausal women about healthy lifestyle behaviors to manage menopausal symptoms.

Dietary Supplements for Vasomotor Symptoms of Perimenopause: An Updated Review

The experience of perimenopause is complex and varies from female to female. For some, the experience is benign, and changes feel subtle. For others, perimenopause is a time of confusion and frustration with disruptive physical and psychological symptoms. Either way, with the right guidance and support, the transition to postmenopause can be an enriching experience with great personal growth and acceptance. Nurse practitioners can foster a positive process by approaching a perimenopausal female’s care from a holistic, individualized perspective.

Obstetric and psychiatric history as predictors for psychosomatic symptoms among Korean perimenopausal women.

Menopause presents various physical and psychological disturbances for women and comes at a high financial cost. Therefore, this study aimed to identify factors influencing menopause symptoms. Data of Korean perimenopausal women aged 40-60 (n=1060; mean age, 46.03±4.08) were collected by a research company. Participants were classified into a "functional" group (n=716) or a "dysfunctional" group (n=344) according to the severity of their perimenopausal psychosomatic symptoms. To investigate the association of obstetric and psychiatric history with membership of the "dysfunctional" group, a hierarchical logistic regression analysis was conducted. The outcomes of all three hierarchical logistic regression models presented significant overall model fit. Among the independent variables, family history of menopausal symptoms, menarcheal age, number of pregnancies, history of postpartum depression, postpartum psychosis, and other psychiatric disorders were positively associated with being in the "dysfunctional" group, whereas age and number of deliveries were negatively associated with being in the "dysfunctional" group. A short reproductive period and short exposure to estrogen due to late menarche and early menopausal transition may be related to severe perimenopausal symptoms. The relationship between the history of postpartum mental illness and severe perimenopausal symptoms may be associated with heightened sensitivity to hormonal triggers when a woman is exposed to fluctuating ovarian sex steroid levels. The relationship between parity or gravidity and the severity of menopausal symptoms in Korean women differed from that in studies conducted in other countries, possibly due to the low birth rate in Korea.

Minding menopause in patients with cognitive impairment: a patient’s perspective and reflections on clinical practice

Many women experience impairment in cognitive function during perimenopause. These symptoms are often not attributed to perimenopause by women themselves, by family and friends, or by healthcare professionals. In this article, we present a case in which perimenopausal complaints were attributed to early dementia and discuss mechanisms contributing to the low level of awareness of perimenopausal symptoms amongst patients and clinicians. Stigma amongst women and healthcare professionals impairs the recognition of perimenopausal complaints, and consideration of treatment options by clinicians. We advocate raising awareness in patients and physicians with more education, and the incorporation of potential menopause-related symptoms in general clinical guidelines.

Perimenopause symptoms: The impact on nurses’ mental health

Perimenopause symptoms: The impact on nurses’ mental health

Cognitive Problems in Perimenopause: A Review of Recent Evidence.

To review recent research regarding cognitive problems during perimenopause, including which menopause-related symptoms, demographic variables, stress exposures, and neural biomarkers are associated with cognitive problems and which interventions demonstrate efficacy at improving cognitive performance. Cognitive problems are common during perimenopause and have a significant impact on a substantial proportion of women. Evidence continues to indicate that verbal learning and verbal memory are the cognitive functions that are most negatively affected during perimenopause, and new research suggests that perimenopause may also be associated with deficits in processing speed, attention, and working memory. Recent research suggests that the cognitive profiles of women transitioning through perimenopause are heterogenous - with some showing strengths and others demonstrating weaknesses in particular cognitive domains. Depression, sleep problems, and vasomotor symptoms in perimenopause may be associated with cognitive difficulties. Recent neuroimaging studies are identifying changes in activity patterns within brain regions that correlate with cognitive performance in perimenopause, but future causal studies are needed to understand the neural mechanisms of cognitive problems during this time. Although clinical treatment studies for cognitive concerns have historically focused on postmenopause, some small trials in perimenopausal samples have been conducted recently but are frequently underpowered. Current guidelines from the North American Menopause Society do not support the use of hormone therapy at any age for cognitive problems. Animal research demonstrates that estradiol and levonorgestrel combined may alleviate working memory problems. Much progress has been made in understanding how perimenopause impacts cognition, and more research is needed to better identify who is at highest risk and how to meaningfully prevent and alleviate cognitive problems during this reproductive stage. Larger-scale randomized intervention trials specifically during perimenopause are urgently needed to address cognitive concerns in this population of women. More consistent reproductive staging, inclusion of covariates, and analyses examining perimenopause specifically would improve study quality and the ability to draw clear conclusions from this research.