Menopausal Phase Research Articles

MANAGEMENT OF MENOPAUSE (RAJONIVRITTI) THROUGH AYURVEDA: A REVIEW

Menstruation is unique to females. Menarche and menopause are two significant landmarks in the entire journey of a women’s life. Menarche traces the beginning of the reproductive life of a woman. Right from menarche, a woman undergoes several changes-behavioral and physical and finally attains a phase of complete cessation of menses known as menopause or rajonivritti. Rajonivritti or menopause is a natural and physiological phenomenon. However, various changes starting from physiological changes like depression, sleep disturbances, somatic changes like hot flushes, constipation etc., pathological changes like cardiac disorders, endometrial carcinoma etc., are very often found. By adopting a proper diet and regimen as per Ayurveda, all these changes developed in the pre-menopausal and menopausal phases can be prevented.

KLIMAKTERIUM

Background: Menopause is a condition in which women experience physiological failure of ovarian function, as a result of the loss of activity of the ovarian follicles. Menopause is the stage when a woman's menstrual bleeding stops. At the age of 50 years, women enter menopause so that there is a decrease or loss of the hormone estrogen which causes women to experience complaints or disorders that often interfere with daily activities and can even reduce their quality of life. Objectives: to determine risk factors, pathophysiology, clinical manifestations, diagnosis and management of climacteric. Methods: collecting and analyzing journals using pubmed search media, google scholar, NCBI, ScienceDirect with keywords Conclusion: The climacteric phase consists of premenopause, perimenopause, menopause and postmenopause phases. The premenopause phase is the period for 4-5 years before the onset of menopause. This phase begins when a woman is 40 years old, characterized by irregular, prolonged menstrual cycles, little or a lot of menstrual blood, and sometimes accompanied by pain. The perimenopause phase is a transitional phase between pre-menopausal and postmenopausal. This phase is characterized by irregular menstrual cycles and levels of Follicle Stimulating Hormone (FSH), luteinizing hormone (LH), and highly variable estrogen (normal, high, or low). The menopausal phase is the condition of women who have no longer menstruating calculated after 12 months from the last menstruation, which is characterized by blood FSH levels >35 mIU/ml and estradiol levels <30 pg/ml.

Eating disorders and their relationship with menopausal phases among a sample of middle-aged Lebanese women

ObjectivesThe objective of our study was to evaluate the association between the transition to menopause, body dissatisfaction, and abnormal eating habits (restrained eating, binge eating, and orthorexia nervosa) in a sample of middle-aged Lebanese women.MethodsA cross-sectional study conducted between July 2019 and January 2020 enrolled 1001 women aged 40 years and above from all Lebanese governorates. Data were collected by face-to-face interviews with all participants. The Body dissatisfaction subscale of the Eating Disorder Inventory‑second version was used to assess body dissatisfaction, whereas the Binge Eating Scale, Dutch Restrained Eating Scale, ORTO-15, Dusseldorf Orthorexia Scale (DOS), and Teruel Orthorexia Scale (TOS) were used to assess eating disorders (binge eating, restrained eating and orthorexia nervosa respectively. Multivariable analysis of covariance (MANCOVA) was used to compare multiple measures among the three menopausal phases, after adjustment over potential confounding variables (age, monthly income, body mass index, marital status, education level, and body dissatisfaction).ResultsPostmenopause was significantly associated with more orthorexia nervosa tendencies (lower ORTO-15 scores) than premenopause (β = − 1.87; p = 0.022). Perimenopause was associated with more binge eating (β = 1.56; p = 0.031), and less orthorexia nervosa (as measured by the DOS) than premenopause, with this association tending to significance (β = − 1.10; p = 0.051). Furthermore, higher body dissatisfaction was significantly associated with higher restrained eating (β = 0.02; p < 0.001), binge eating (β = 0.48; p < 0.001), and orthorexia nervosa as measured by ORTO-15 (β = − 0.17; p < 0.001) and TOS (β = 0.08; p = 0.002), but not DOS.ConclusionOur study showed that menopausal stages are associated with some disordered eating behaviors (binge eating and orthorexia nervosa) among middle-aged women. Those results may serve as a first step towards spreading awareness among women within this age group regarding eating attitudes. Moreover, healthcare professionals should screen for the presence of disordered eating during those women’s routine visits to the clinics.

Menopause transition: Physiology and symptoms.

With life expectancy for women on the rise, most women will experience menopausal transition and spend a significant number of years of their life in the menopausal phase. Menopausal transition involves a myriad of physical, endocrine, and psychological changes which are influenced by ethnic, psychological, and socio-cultural factors. Every woman's experience of the menopausal transition is unique, and a one-size-fits-all approach to the management of symptoms does not work. An understanding of the pathophysiology and severity of menopausal symptoms and the benefits and risks associated with both hormonal and non-hormonal treatments is important when individualising treatment options for menopausal symptoms.

CLIMATE AND MENOPAUSE

Introduction: Climacteric and menopause is defined by the World Health Organization as a biological phase of a woman’s life and not a pathological process. have the most severe symptoms. Primary Health Care is the most comprehensive unit in care and women tend to look for the service, for this it is essential that the nursing professional knows signs and symptoms of climacteric and menopause so that a service of assistance to climacteric women can be traced. aiming to guarantee the quality of life in the female aging process. Objective: To identify in the literature the assistance and strategies carried out by nursing in Primary Health Care regarding the care of women in the climacteric and menopause period. Methodology: This is an integrative literature review of a descriptive-exploratory nature, carried out in the scientific databases of the electronic libraries SCIELO, MEDLINE, LILACS and BDENF. Results and Discussions: For this assistance to happen effectively, it is essential that the nursing professional act in the reception of climacteric women who seek the service. Nurses need to adopt care strategies according to the female demand index, as well as health education actions on this climacteric and menopause phase and their respective forms of treatment. Conclusion: There is a need for nursing consultations in PHC aimed at early screening of climacteric and menopause, as well as promoting health education on the aforementioned phases.

Effects of Obesity on Severity of Menopausal Symptoms in Urban and Rural Women.

According to the WHO, obesity is an epidemic and is quantified by obesity indices. Menopause is a crucial period with a tendency toward weight gain and has profound implications on the morbidity and mortality of women. This study provides a greater insight into the aggravating adverse effects of obesity on the lifestyles of urban and rural women during their menopausal phase. Hence, this cross-sectional study aims at analyzing the effects of obesity indices on the severity of menopausal symptoms in urban and rural women. 1. To compare the obesity indices in rural and urban women and to study the severity of menopausal symptoms in them. 2. To assess the influence of the area and body mass index (BMI) on menopausal symptoms. This cross-sectional study comprised 120 women, of which 60 healthy women volunteers between the age group of 40 and 55 years from the urban area and 60 age-matched healthy women volunteers from the rural area were recruited. The sample size was calculated based on stratified random sampling. After obtaining informed consent anthropometric measurements were recorded and the Menopausal Rating Scale was used for assessing the severity of menopausal symptoms. A positive correlation was observed between the severity of menopausal symptoms and BMI as well as waist circumference in urban women. The problems related to menopausal symptoms were milder in rural women. Our study concludes that obesity worsens the severity of several menopausal symptoms which is greater among obese urban women owing to the urban lifestyle and increased stress levels.

The Impact of Soy Isoflavone Supplementation on the Menopausal Symptoms in Perimenopausal and Postmenopausal Women.

Introduction:Approximately one-third of a woman's life is spent in the menopausal phase. The unpleasant menopausal symptoms are unacceptable as a part of routine life. Indications of menopausal hormone therapy (MHT) are for alleviation of vasomotor symptoms, prevention of osteoporosis, and genitourinary symptoms associated with menopause. MHT is associated with an increased risk of breast cancer, cerebrovascular accidents, and coronary heart disease. Soy isoflavones have been extensively used as an alternative treatment in patients who cannot take MHT. The evidence of the efficacy of isoflavones in the literature is equivocal.Aim:The aim of the study was to evaluate the efficacy of soy isoflavone supplementation on menopausal symptoms in perimenopausal and postmenopausal women and to evaluate the effect on blood pressure (BP) and body mass index (BMI).Materials and Methods:A questionnaire-based prospective observational study was undertaken involving 39 perimenopausal and 61 postmenopausal women, who were prescribed 40 mg soy isoflavone supplements twice daily for 12 weeks. Menopause Rating Scale questionnaire was given to the patients before starting soy isoflavone therapy and at the end of the treatment; BP and BMI were also noted.Results:The total score of both the groups was comparable at baseline. Among perimenopausal and postmenopausal women, the highest score was noted in symptoms of somatic domain. At the completion of our study, the total scores improved significantly by 38.6% and 33.3% in perimenopausal and postmenopausal women, respectively. The greatest improvement was seen in somatic subscale (42.5%) and psychological subscale (42.5%) and the least in urogenital subscale (16.1%) for perimenopausal women. For postmenopausal women, the greatest improvement was seen in psychological subscale (40.0%) and the least in urogenital subscale (14.2%).Conclusion:Soy isoflavone supplementation is beneficial in both perimenopausal and postmenopausal women, more so in perimenopausal women. There is no beneficial effect of soy isoflavone supplementation on lowering systolic BP and BMI.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Augmented Core Breathing Pelvic Floor Muscle Training for Patients with Genitourinary Syndrome in Different Phases of Menopause

Pelvic floor muscle has a role in core breathing for twenty-four hours and offers an influence to modulate the lumbar spine and pelvic floor. Several studies reported on pelvic floor muscle strength. Women with genitourinary syndrome do not seek care for their condition and are dismayed to speak with the health care provider about the condition. In the present work, we evaluated the efficiency of augmented core breathing in the genitourinary syndrome of menopause for pelvic floor muscle strength. We tested the role of augmented core breathing efficacy using pelvic floor muscle training in patients with the genitourinary syndrome. Our data revealed significant beneficial effects of core breathing with pelvic floor muscle training and Kegel’s exercise in patients with genitourinary syndrome in different phase of menopause. KEY WORDS: genitourinary syndrome; menopause; pelvic exerciser; pelvic floor muscle training; Utian quality of life scale.

ANALYSIS OF ANXIETY LEVEL OF PREMENOPAUSE IN KARAJAN BARAT VILLAGE OF CIKAMPEK BARAT DISTRICT OF KARAWANG REGENCY IN 2021

Development and growth in the human body process along with increasing age. The development and growth in the process will change gradually according to the stages. Most of these changes occur in women because in the aging process a phase occurs, namely the menopause phase. Many premenopausal women complain that with the arrival of menopause they will become anxious, they are anxious towards the end of their reproductive period and realize that they will grow old which means their beauty will fade and the function of their organs will decrease, thereby eliminating their pride as a woman This study aims to determine the factors associated with premenopausal anxiety levels in Karajan Barat Village of Cikampek Barat District of Karawang Regency in 2021. This study uses a correlational analytic study with a cross-sectional approach. The sample in this study amounted to 72 premenopausal women. The sampling technique used the purposive sampling technique. The research instrument consisted of a questionnaire about education level, knowledge level, financial material assets, family support, and socio-cultural support. This questionnaire has been tested for validity using Cronbach's alpha with an r table value of 0.514 and reliability testing with a value &gt;0.6. The anxiety questionnaire using Hamilton Rating Scale for Anxiety (HAR-S). The data were analyzed using the chi-square correlation test with a significant level of &lt;0.05 to determine the relationship between education level, knowledge level, financial material assets, family support, and socio-cultural support with premenopausal anxiety level. The results showed that the relationship between education level and anxiety obtained a p-value of 0.689 (p&gt;0.05). The relationship between the level of knowledge and anxiety obtained a p-value of 0.009 (p &lt;0.05). The relationship between financial material assets and anxiety has a p-value of 0.58 (p&gt;0.05). The relationship between family support and anxiety has a p-value of 0.001 (p &lt;0.05). The socio-cultural relationship between support and anxiety has a p-value of 0.000 (p&lt;0.05). The conclusion of this research is there is a significant relationship between the level of knowledge, family support, and socio-cultural support to the level of anxiety of premenopausal. There is no significant relationship between the level of education and financial material assets on the level of anxiety of premenopausal women. &#x0D; Keywords: Premenopausal, Education, Knowledge, Financial Material Assets, Family Support, Socio-Cultural Support, Anxiety.

Healthy Management of Menopause: Exploring Issues and User Requirements for Mobile Intervention

Designing and developing a mobile health intervention that focuses on menopausal symptom management and emotional support for women should be grounded by some knowledge about their problems and needs. Therefore, to gather information about the issues surrounding women in their menopausal phase, review of literatures pertaining to the topic was conducted, followed by a brief preliminary investigation (PI) using online survey method which was administered to Malaysian women for two weeks. The purpose of PI was to examine their awareness about menopause, namely its phases and symptoms management, as well as methods of information searching on menopause. Respondents were also inquired about their requirements from mobile app to support management of menopause. A total of 30 respondents answered the survey, with majority of them were between the ages of 40 and 59 years old. It was discovered that menopausal women had experienced variety of symptoms, some could be intense more often than the others, and they use diary or book to record these symptoms, which is deemed ineffective. It is imperative to help Malaysian women to manage this unavoidable phase of their lives in a more convenient approach. Therefore, a mobile app that supports symptoms management, and provides educational and motivational tips in Malay language is proposed.

A Review: Shed Light on Ayurvedic Description of Menopause

Menarche and Menopause are the two important landmarks of reproductive life cycle of woman's life. Menopause is the most significant event that brings physical and mental transformation in the body. It is a natural phenomenon occurs at the age 45-55 years. This phase is associated with manifestation of aging process along with other symptoms such as irregular menstruation, hot flashes, vaginal dryness, urinary problems, changes in appearance, GIT related problems, mood swings, sleep disturbances, palpitations, changes in sexual desire, osteoporosis, heart disease. The group of signs and symptoms associated with the menopausal phase are termed as menopausal syndrome. In Ayurvedic classics, Menopause is the termed as ‘Rajonivrutti’ and menopausal syndrome as ‘Rajonivrutti anubandhaja vyadhies’. Acharyas described as it is normal physiological state. In Ayurveda, Menopausal symptoms are regarded as imbalance of the Tridosha, Dhatukshaya and disturbance in Agni which occurs naturally as consequence of aging process. Modern medicine treat this condition with Hormone Replacement Therapy (HRT) which results in various complications, but it is effective therapy for a short term use. Considering the limitations of treatment with modern medicine, Ayurveda provides excellent solution &amp; effective medicament for transition period i.e. menopause. Ayurvedic treatment for menopause involves correcting hormonal imbalance with proper diet, lifestyle modification, Shamana, Shodhan chikitsa, Rasayan therapy.

Menopause and its Implications

Abstract It is a consequence that many women are unaware or are not able to identify the emotional consequences of menopause. It is likely that this ignorance must be associated with factors which, in fact, aggravate their physical and emotional state. Emotional manifestations are controversial and scarce in the psychoanalytic literature, a fact that motivates a deeper exploration of the theme. A literature review was carried out, examining books by authors of psychoanalysis that address this subject in a part of their work, among which we mention Freud and Laznik. This article contemplated some hypotheses about the psychic factors that could arise during the menopause phase. The influence of the Oedipus complex and the incestuous ghosts that may appear in some women during this period was discussed, in addition to the question of women facing their finitude. It also raised the importance of the look of another on a woman who experiences menopause and how it can be restorative and fundamental for her narcissism. It should be noted that the menopause process will take place in a singular way according to each experience and with the different ways each woman has to deal with a new situation.

Insilico Analysis of the Potential Phytoestrogens of Selected Alkaloid from ‎Soursop (Annona muricata) Leaves

Estrogen is an important hormone in the female reproductive system, as well as other systems in men and women. The decrease of estrogen levels mainly occurs in the menopause phase. The decrease of estrogen is one indication of the presence of various diseases such as cardiovascular disease. Decreased levels of estrogen can be treated by administering exogenous estrogen such as Estradiol-17β. However, long-term administration of estradiol plays an important role in tumor cell growth. Phytoestrogens are plant-basedpolyphenolic compounds that have a structure and biological activity similar to the estrogen. Phytoestrogens can be derived from alkaloid compounds, one of which is found in the soursop (Annona muricata) leaves. The purpose of this study was to analysis the potential phytoestrogens of selected alkaloid in the A. muricata leaves. The analysis was carried out using the insilico approach using molecular docking methods, pharmacokinetic analysis and druglikeness. The molecular docking results showed that the ligands could bind to the receptors on the specific binding site with the lowest binding affinity value approaching the control ligands, namely the Anonaine compound of -8.6 kcal / mol, followed by Xylopine compound of -7.8 kcal / mol and Annonamine of -7.0 kcal / mol. The results of pharmacokinetic and druglikeness showed that all ligand compounds have a good ability to be absorbed in the gastrointestine and have a good bioavalaibility as an oral drug.

Levels of Advanced Oxidation Protein Products in Blood Plasma of Peri- and Postmenopausal Women with Insomnia

Background. Insomnia occurs in more than half of menopausal women. These disorders can contribute to a change in the prooxidant-antioxidant balance, causing the damage to structural cellular elements. Currently, there is a lack of research on this issue.Aim. To carry out a comparative analysis of the level of advanced oxidation protein products in in periand postmenopausal women with insomnia.Materials and methods. The study included peri(n = 30) and postmenopausal (n = 60) women, who were divided into 2 groups (control and main groups) in each menopausal phase after being questioned using special sleep questionnaires: Insomnia Severity Index; Epworth Sleepiness Scale; Munich Chronotype Questionnaire. The advanced oxidation protein products (AOPP) levels was determined by immunoenzymatic assay using ImmunDiagnostik (German) kits on a BioTek EL×808 (USA) analyzer. Statistical analysis was performed using Mann – Whitney test.Results. Comparative analysis of the AOPP levels in control groups, depending on the menopausal periods, showed an increase in their levels in the postmenopausal period as compared to perimenopause (p &lt; 0.05). When comparing the AOPP levels between the control and the main group in different menopausal periods, statistically significant differences were revealed only in the perimenopausal period towards a higher content in women with insomnia (p &lt; 0.05). The presence of insomnia in postmenopausal women is accompanied by a higher AOPP levels as compared to the perimenopausal women (p &lt; 0.05).Conclusion. The obtained results indicate the association between insomnia and oxidative proteins modification only in the perimenopausal period.

Thickened Endometrium: When to Intervene? A Clinical Conundrum.

The endometrium is a dynamic target organ in a woman's reproductive life. It undergoes cyclical change regulated by the fine balance between oestrogen and progesterone. The endometrial thickness (ET) varies according to the phases of the menstrual cycle. Endometrium contains both oestrogen and progesterone receptors, which respond to above hormones, irrespective of whether the woman is in reproductive or menopausal phase. Abundance of oestrogen leads to endometrial hyperplasia, and paucity causes endometrial atrophy. The initial best modality of assessing ET or aberration is high resolution transvaginal ultrasonogram. Thickened endometrium is always a clinical conundrum. Dilemma does remain as to the thickness of endometrium which requires intervention, mostly in symptomatic pre and perimenopausal women. In post-menopausal women with bleeding, the cut-off of ET that warrants investigation is almost defined. However, the cut-off value of ET in asymptomatic postmenopausal women; beyond which intervention is required, is still debated. Dilemma also exists about the cut-off of ET in both symptomatic and asymptomatic women on HRT and Tamoxifen. This article will discuss the above issues and reach at some consensus about the cut-off of ET after critical analysis of evidence and experience and will help clinicians in arriving at a proper decision in dealing with such clinically confounding situations.

Exploring women's perceptions and experiences of menopause among East Coast Malaysian women.

Menopause signifies the beginning of a non-reproductive phase from the reproductive period. Although it is considered a natural life transition, recent studies have indicated that a woman's menopausal experience may impact her quality of life. While studies have examined Malaysian women's knowledge and awareness of menopause, they have focused on the prevalence of menopausal symptoms and sociocultural aspects. These investigations also used a quantitative design that may have limited the information regarding the nature and experience of menopause. Objectives: This study explores women's perceptions and understanding of their menopausal experience. A total of 20 menopausal women were recruited using purposive sampling through social media in the state of Pahang, Malaysia. In-depth semi-structured interviews were used to explore how they perceived their menopausal experience. The data were then analyzed using thematic analysis. Three themes that emerged from the findings included perceptions of menopause, biopsychosocial changes and help-seeking behavior. For many Muslim women, menopause was perceived as a time for them to engage in religious commitment more than they had before. The study findings uncovered a knowledge gap and a lack of support for women impacted by menopause. Muslim women regarded their menopause phase as a time for them to engage in religious duty fully. These results indicate the need for a psychosocial intervention and educational program to ensure women a better transition throughout their menopausal phase.

Review of clinical studies on rajonivrutti avastha with special reference to menopausal syndrome

Menopausal symptoms are alarming call to more sincere attention to elderly women’s health. As lifespan is increased with developed medical facilities, women are living around 30 years in postmenopausal state with all the complaints of menopause and geriasis. In Ayurveda, menopause is depicted as “jarapakwa avastha” and rajonivrutti. Rajonivrutti janya laksana is a group of symptoms produced by degenerative changes in the body. Degenerative changes are dhatukshaya lakshana in Ayurveda. Vata dosha is dominant in the vridhha stage of life. Symptoms in menopausal phase like insomnia, anxiety, urinary symptoms, and osteoporotic changes are due to dominance of vata dosha. Along with that pitta dosha symptoms like hot flushes, irritability, etc are seen, during this phase. Thus, review and compilation of the work done at institute for post graduate teaching and research in ayurveda, Jamnagar on the topic was done to help future researchers to fulfil the lacunae and develop standard ayurvedic treatment protocol. The research work conducted on rajonivrutti avastha and its vyapada were collected and reviewed from Ayurvedic research data base, Jamnagar, Jamnagar Central Library and Department of Prasuti tantra and Stree roga, Jamnagar. Total 15 research works were conducted. Drugs having rasayana, deepana, pachana, medhya, balya, vayasthapana properties help in dhatukshaya janya lakshana pacification, vata- pitta doshhar, shrotoshodhana, and the process of formation of dhatu is benefited and ultimately resulting into delay aging process and related compilations. Menopausal syndrome can be well managed by ayurvedic treatment.

Using the novel pelvic organ prolapse histologic quantification system to identify phenotypes in uterosacral ligaments in women with pelvic organ prolapse

Pelvic organ prolapse is common, but the underlying etiologies are poorly understood, which limits our current prevention and treatment options. Our primary objective was to compare the uterosacral ligament histologic features in women with and without prolapse using the novel pelvic organ prolapse histologic quantification system. Our secondary aim was to determine whether composite histologic findings in uterosacral ligaments are associated with prolapse risk factors. This was a prospective cohort study in which paracervical uterosacral ligament biopsies were performed at the time of hysterectomy for primary prolapse or other benign gynecologic indications and processed for histologic evaluation. The pelvic organ prolapse quantification system was used to determine the prolapse stage. In this study, 9 prominent histologic features were semiquantitatively scored using the pelvic organ prolapse histologic quantification system in a blinded fashion and compared between prolapse and control groups. Unbiased principal component analysis of these scores was independently performed to identify potential relationships between histologic measures and prolapse risk factors. The histologic scores of 81 prolapse and 33 control ligaments were analyzed. Compared with the control group, women in the prolapse group were significantly older and more likely to be in the menopausal phase. There was no difference in the number of vaginal deliveries, body mass index, hormone use, or smoking status between the groups. To control for baseline differences, patients were also stratified by age over 40 years and menopausal status. Compared with the control group, the prolapse ligaments in the premenopausal group had significantly more loss of smooth muscle fibers within the fascicles (P<.001), increased inflammatory infiltrates of neutrophils within the tissue and perineural inflammatory cells (P<.01 and P=.04, respectively), and reduced neointimal hyperplasia (P=.02). Prolapse ligaments in the postmenopausal group exhibited elevated adipose content compared with that of the control group (P=.05). Amount of fibrillar collagen, total nonvascular smooth muscle, and muscle fiber vesicles of prolapse ligaments did not differ in either the premenopausal or postmenopausal group compared with that of the control group. Unbiased principal component analysis of the histologic scores separated the prolapse ligaments into 3 phenotypes: (1) increased adipose accumulation, (2) increased inflammation, and (3) abnormal vasculature, with variable overlap with controls. Posthoc analysis of these subgroups demonstrated a positive correlation between increasing number of vaginal deliveries and body mass index with increasing adipose content in the adipocyte accumulation and inflammatory phenotype and increasing neointimal hyperplasia in the vascular phenotype. However, only the relationship between vaginal delivery and adipocytes was significant in the adipose phenotype (R2=0.13; P=.04). Histologic phenotypes exist in pelvic support ligaments that can be distinguished using the pelvic organ prolapse histologic quantification system and principle component analysis. Vaginal delivery is associated with aberrant adipose accumulation in uterosacral ligaments. Our findings support a multifactorial etiology for pelvic organ prolapse contributing to altered smooth muscle, vasculature, and connective tissue content in crucial pelvic support structures. To confirm these associations and evaluate the biomechanical properties of histologic phenotypes of prolapse, larger studies are warranted. Closing this gap in knowledge will help optimize personalized medicine and help identify targets for prevention and treatment of this complex condition.

The Potential of Soy Isoflavones (Glycine max) and Magnetic Hydroxyapatite Nanoparticles as Osteoporosis Therapy for Menopausal Women

Background: Menopausal women experience amenorrhea for 12 consecutive months. In Indonesia, one of four women aged 50 – 80 years has a risk of osteoporosis. This age range is related to the menopause phase. Low estrogen levels in menopausal women cause decreased bone mineral density resulting in osteoporosis. Osteoporosis is a degenerative disease characterized by decreased bone density and bone strength that causes fractures. This literature review aims to determine the potential of soy isoflavones (Glycine max) and magnetic hydroxyapatite nanoparticles as alternative therapies for osteoporosis in menopausal women.&#x0D; Reviews: Soy isoflavones are phytoestrogens because they have estrogen-like structures and functions. Some studies explain that phytoestrogens have benefits in osteoporosis therapy by maintaining bone density through decreasing osteoclast resorption and stimulating osteoblasts. Consuming enough soy supplements everyday has been shown to increase bone mineral density. This effect is strengthened by coating the soy isoflavones with magnetic hydroxyapatite nanoparticles through two mechanisms, as a therapeutic agent and drug carrier. The magnetic field of the magnetic nanoparticles produces force and torque to increase the temperature until 42°C and trigger organelles movement, causing apoptosis of osteoclasts. Hydroxyapatite is a major component of bone mineral that replaces bone tissue deformity and has an osteoblastic effect in bone regeneration. Nano-sized hydroxyapatite will increase material properties and stability in high temperatures. However, hydroxyapatite has less magnetic activity so this function is completed by magnetic nanoparticles.&#x0D; Summary: Therefore, the combination of soy isoflavones and magnetic hydroxyapatite nanoparticles works synergistically as an alternative therapy for osteoporosis in menopausal women.