Physiological Menopause Research Articles

DXA Android-to-Gynoid Ratio and Cardiovascular Risk Assessment in Age and BMI Propensity-Matched Early Postmenopausal Women.

Background and Objectives: The literature suggests that physiological menopause (MP) seems linked with increased adiposity with a preference for intra-abdominal fat accumulation, greater than what can be attributed only by aging, which could magnify this period's increased cardiovascular risk. Materials and Methods: We retrospectively analyzed two age and body mass index (BMI) propensity-matched subgroups each formed of 90 clinically healthy, 40-60-year-old postmenopausal women, within the first 5 and 5-10 years of MP. The 10-year ASCVD risk was assessed using medical history, anthropometric data, and lipid profile blood tests. The android-to-gynoid (A/G) ratio was computed using Lunar osteodensitometry lumbar spine and hip scans. Results: The A/G ratio was significantly higher for the subgroup evaluated in years 5-10 of MP than in the first 5 years of MP, even after controlling for BMI (1.05 vs. 0.99, p = 0.005). While displaying a significant negative correlation with HDL cholesterol (r = 0.406), the A/G ratio also had positive correlations with systolic blood pressure (BP) values (r = 0.273), triglycerides (r = 0.367), and 10-year ASCVD risk (r = 0.277). After adjusting for smoking, hypertension treatment, and type 2 diabetes, the 10-year ASCVD risk became significantly different for women in the first 5 years (3.28%) compared to those in years 5-10 of MP (3.74%), p = 0.047. Conclusions: In women with similar age and BMI, the A/G ratio appears to vary based on the number of years since menopause onset and correlates with either independent cardiovascular risk parameters like BP, triglycerides, and HDL cholesterol or with composite scores, such as 10-year ASCVD risk.

Features of aging replicative and biochemical aspects among females with non-iatrogenic hypergonadotropic hypogonadism

Estrogenic deficiency is the basic condition of human ageing that leads to hypergonadotropic hypogonadism. The existence of correlation between hypergonadotropic hypogonadism, replicative (leukocyte telomere length) and biochemical data is widely supposed among females with physiological (menopausal) and pathological (primary ovarian insufficiency) estrogenic deficiency is not unreasonable. To evaluate features of replicative (telomere length) and biochemical (metabolic syndrome) ageing markers among females with physiological (menopausal) and pathological (primary ovarian insufficiency) estrogenic deficiency. Research has been provided in collaboration between Endocrinology Research Centre of the Russian Ministry of Health and Lomonosov Moscow State University Medical Research and Educational Centre in the period since 10.01.2021 until 01.08.2022.110 females (20-75y.o.) have participated in the present research.Group 1: 26 females receiving menopausal hormonal therapy (MHT) ≥ 5 years with 0,5; 1; 2 mg estrogenic component.Group 2: 27 females in physiological menopause without MHTGroup 3: 33 females with primary ovarian insufficiency and receiving sex-steroid replacement therapy.Group 4: 24 healthy reproductive age females without sex-steroid replacement therapy.Patients have undergone laboratory genetic (leucocyte telomere length), biochemical analyses.DNA extraction - with Qiagen DNA blood mini kit (Germany). Biological material was cito conserved with Ficoll solution. Leukocyte telomere length - with real-time polymerase chain reaction PCR (Flow-fish).Soft program IBM SPSS Statistics (version 26,0 for Windows) has been used for statical analysis. 1.Menopausal females receiving MHT were inclined to highest HDL-P levels (p<0,006).2.Females with primary ovarian insufficiency were inclined to relatively highest serum creatinine level (p<0,001).3.Reproductive age females had relatively highest telomere length (p<0,001).4.FSH level correlates negatively and moderately (ρ= - 0,434) leukocyte telomere length (р<0,001) among females. Females with premature ovarian insufficiency are most sensible to ageing due to features of replicative and biochemical markers.

Monoclonal anti-CGRP antibodies in post-menopausal women: a real-life study.

Migraine usually ameliorates after menopause. However, 10-29% of women still experience migraine attacks after menopause, especially if menopause is surgical. The use of monoclonal antibodies against the calcitonin gene-related peptide (CGRP) is changing the landscape of migraine treatment. This study aims to explore the effectiveness and safety of anti-CGRP monoclonal antibodies in women in menopause. Women affected by either migraine or chronic migraine and treated with an anti-CGRP monoclonal antibody for up to 1year. Visits were scheduled every 3months. Women in menopause displayed a similar response compared to women of childbearing age. Among women in menopause, the women experiencing surgical menopause seemed to exhibit a similar response compared to the ones experiencing physiological menopause. Erenumab and galcanezumab displayed similar effectiveness in women in menopause. No serious adverse events were registered. The effectiveness of anti-CGRP monoclonal antibodies is almost the same between women in menopause and women of childbearing age, without appreciable differences between the different antibodies.

Morphometric analysis of skin in ovariectomized mice of different ages

It is known that a deficiency of estrogens of any origin (physiological menopause, surgical removal of the ovaries, etc.) accelerates the aging processes of both the body in general and the skin in particular in women. Studies of the morphometric properties of skin caused by estrogen-deficient states may help in the development of more effective regenerative medicine approaches aimed at treating and preventing age-related skin changes. The purpose of the study is to determine the morphological changes in the skin of young and old SBA/Сa mice with estrogen deficiency on the ovariectomy model. Materials and methods. Skin samples from young (4 months) and old (16 months) mice two months after ovariectomy were compared with age-matched sham-operated mice. The thickness of the epidermis and dermis, the number of hair follicles, and sebaceous glands were determined on histological samples of the skin. Results and discussion. It was shown that the thickness of the epidermis was significantly smaller both in the group of young and in the group of old ovariectomized mice compared to the thickness of the epidermis of the control group of animals of the corresponding age. A significant increase in the thickness of the dermis was found in the group of young ovariectomized mice in comparison with the thickness of the dermis in the young control group, however, in the group of old ovariectomized mice, the thickness of the dermis did not differ significantly compared to the age-matched control group. No significant differences were found in the number of sebaceous glands and hair follicles in the studied groups. Conclusions. Ovariectomy, as a model of artificial estrogen deficiency, is accompanied by significant changes in the epidermis in young and old animals and the dermis in young ovariectomized animals, without affecting the number of sebaceous glands and hair follicles.

Порушення вуглеводного обміну та компоненти метаболічного синдрому в пацієнток із гіпертонічною хворобою на тлі фізіологічної та постхірургічної менопаузи

Мета — порівняння характеристик вуглеводного обміну, наявності інших компонентів метаболічного синдрому (МС) на тлі фізіологічної та постхірургічної менопаузи, а також оцінка можливого впливу замісної гормональної терапії (ЗГТ), призначеної для запобігання посткастраційним клімактеричним симптомам у жінок із гіпертонічною хворобою (ГХ) відповідних клінічних груп. Матеріал та методи. Обстежені 112 жінок із ГХ II ст. 1–2-го ступеня, середній вік яких становив 46,14 ± 1,60 року: I група — 37 хворих (середній вік — 45,70 ± 1,45 року) із ГХ II ст. і постхірургічною менопаузою в репродуктивному віці без ЗГТ; II група — 37 хворих (середній вік — 44,90 ± 1,82 року) із ГХ II ст. і постхірургічною менопаузою, яким призначалася комбінована ЗГТ; ІІІ група — 38 хворих (середній вік — 47,83 ± 1,70 року) із ГХ II ст. на тлі фізіологічної менопаузи без ЗГТ. Виявлення МС проводилося відповідно до Консенсусу Міжнародної діабетичної федерації (2009 р.). Результати. У жінок репродуктивного віку з постхірургічною менопаузою на тлі маніфестної гіпоестрогенемії без ЗГТ формуються порушення вуглеводного обміну, що проявляються вірогідним (р < 0,01) зростанням рівнів глюкози натще, у глікемічному профілі, характеристик інсулінорезистентності (ІР) за індексом НОМА та глікованого гемоглобіну, що асоціюється з мінімальним відсотком виявленої нормоглікемії (37,8 %), найбільшим відсотком ІР (89,2 %) і ЦД (29,7 %) на відміну від значно вищих показників нормоглікемії на тлі прийому ЗГТ (83,7 %) та ранньої фізіологічної менопаузи (63,1 %), нижчих відсотків ІР (70,3 та 65,8 %) і ЦД (2,7 та 0 %) у двох останніх групах хворих. Призначення ЗГТ жінкам репродуктивного віку з постхірургічною менопаузою оптимізує вуглеводний і ліпідний обмін, що проявляється майже вдвічі меншим числом випадків (45,9 проти 81,1 %) реєстрації МС та вірогідно (р < 0,01) меншою кількістю виявлених компонентів МС. Висновки. У жінок як із постхірургічною, так і з ранньою фізіологічною менопаузою на тлі гіпоестрогенемії присутні значні порушення вуглеводного обміну у вигляді гіперглікемії, ІР, ЦД, що асоціюються з кластером кардіометаболічних симптомів, які формують менопаузальний МС. Усі вищезгадані зрушення максимально маніфестують у хворих із пост-хірургічною менопаузою без ЗГТ, призначення якої в другій групі дозволило запобігти гіпоестрогенемії та уповільнити перебіг продіабетогенних змін вуглеводного обміну.

Оптимизация вторичной профилактики переломов костей при остеопорозе у менопаузальных женщин и роль коморбидного метаболического синдрома

Актуальность. Остеопороз (ОП) характеризуется хрупкостью скелета и подверженностью людей переломам, обусловленным уменьшением костной массы и ухудшением микроархитектуры кости. У неменструирующих женщин ломкость костей более выражена, а остеопоротические переломы встречаются втрое чаще. Ухудшает течение ОП у менопаузальных женщин наличие коморбидного метаболического синдрома (МС) и его тяжесть, что требует совершенствования лечебных мероприятий у таких больных. Цель исследования: повысить эффективность лечения ОП у менопаузальных женщин с МС и качество вторичной профилактики у них костных переломов. Материалы и методы. В течение двух лет под наблюдением находились 28 неменструирующих женщин с ОП в возрасте от 37 до 72 лет (в среднем 50 лет). Во всех случаях наступила физиологическая менопауза. Минеральную плотность кости оценивали по Т-индексу остеоденситограмм, рентгенологическим индексам Барнетта — Нордина, Рохлина и клиновидности. В сыворотке крови исследовали показатели, которые отражали состояние костного метаболизма и МС. ­Результаты. У менопаузальных женщин, страдающих ОП, переломы бедренной кости, позвоночника, костей запястья и ІІ плюсневой диагностированы в 39 % случаев. Остеофрактуры были прямо связаны с возрастом больных, параметром остеоденситометрического индекса, наличием и тяжестью течения коморбидного МС, составляющих его факторов (IV типа гиперлипидемии и сахарного диабета второго типа), с наличием диабетической нейропатии, а также с исходными концентрациями в крови Mg, Mn, Pb и Se. Разработана оптимальная вторичная профилактика костных переломов у менопаузальных женщин с коморбидными ОП и МС, основанная на индивидуальных подходах к длительному назначению препаратов Са, Se, Zn, бисфосфонатов, ранелата Sr, фибратов и урикодепрессоров с учетом характера и тяжести течения МС. Выводы. Предложенная медицинская технология лечения ОП у неменструирующих женщин с МС позволила сократить число остеофрактур в 10 раз, уменьшить активность в крови щелочной фосфатазы и показатель остеоденситометрического индекса.

Medical Treatment for Endometriosis: Tolerability, Quality of Life and Adherence.

Endometriosis is associated with painful symptoms, infertility, sexological difficulties, and psychological suffering. All these symptoms have a negative impact on the overall quality of life of women with the disease, with significant personal, social and economic costs. Several medical options are available to manage symptomatic endometriosis. The pharmacological treatment for endometriosis-related pain may be necessary for decades, or at least until there is a desire for pregnancy or physiologic menopause occurs. In this perspective, clinicians should consider not only the efficacy, but also side effects, tolerability, and costs, along with women's preferences toward different treatments. In this mini-review, we analyzed the pros and cons of the available drugs for the medical therapy of endometriosis, such as estrogen-progestins, progestins, GnRH agonist and GnRH antagonists.

Does the Anti-Mullerian Hormone Decline Rate Improve the Prediction of Age at Menopause?

ObjectivesThere are controversial studies investigating whether multiple anti-Mullerian hormone (AMH) measurements can improve the individualized prediction of age at menopause in the general population. This study aimed to reexplore the additive role of the AMH decline rate in single AMH measurement for improving the prediction of age at physiological menopause, based on two common statistical models for analysis of time-to-event data, including time-dependent Cox regression and Cox proportional-hazards regression models.MethodsA total of 901 eligible women, aged 18–50 years, were recruited from the Tehran Lipid and Glucose Study (TLGS) population and followed up every 3 years for 18 years. The serum AMH level was measured at the time of recruitment and twice after recruitment within 6-year intervals using the Gen II AMH assay. The added value of repeated AMH measurements for the prediction of age at menopause was explored using two different statistical approaches. In the first approach, a time-dependent Cox model was plotted, with all three AMH measurements as time-varying predictors and the baseline age and logarithm of annual AMH decline as time-invariant predictors. In the second approach, a Cox proportional-hazards model was fitted to the baseline data, and improvement of the complex model, which included repeated AMH measurements and the logarithm of the AMH annual decline rate, was assessed using the C-statistic.ResultsThe time-dependent Cox model showed that each unit increase in the AMH level could reduce the risk of menopause by 87%. The Cox proportional-hazards model also improved the prediction of age at menopause by 3%, according to the C-statistic. The subgroup analysis for the prediction of early menopause revealed that the risk of early menopause increased by 10.8 with each unit increase in the AMH annual decline rate.ConclusionThis study confirmed that multiple AMH measurements could improve the individual predictions of the risk of at physiological menopause compared to single AMH measurements. Different alternative statistical approaches can also offer the same interpretations if the essential assumptions are met.

Restoration and preservation of the vaginal ecosystem in postmenopausal women

The article is devoted to the problem of restoring the physiological conditions of vaginal contents with improving the degree of vaginal cleanliness and reducing atrophic manifestations of the vagina in postmenopausal patients, which reduces the recurrence of vaginal infections and improves the quality of life of menopausal women. The use of a combination of low concentrations of estriol and acidophilic lactobacilli, after the main etiotropic therapy allows to restore the vaginal ecosystem and reduce the manifestations of atrophic vaginitis in menopause.The objective: saving and recovering of the vaginal ecosystem after anti-inflammatory therapy and prevention of vaginal disorders in women in menopause; establishment of clinical effects of complex treatment of sexually transmitted infections, followed by normalization of vaginal flora using a combination of low doses of estriol with lactobacilli and lactose in the form of vaginal suppositories at menopause.Materials and methods. During the examination and treatment of women were divided as follows: I — the main group — 58 women with physiological menopause, who after a comprehensive treatment of colpitis with vaginal suppositorium with a combination of a minimum dose of estriol with lactobacilli and lactose (1 time per day for 12 days, then — 1 time per week for six weeks); ІІ — comparative — 29 patients who underwent only etiotropic therapy with no further correction of vaginal biocenosis.Results. The first control was performed 3–5 days after the end of the main therapy, the second control was performed two months later. After our proposed treatment, the percentage of women with pathological secretions in group I was 12% (7), in II — 66% (19). After 2 months in the main group there was no atrophic changes of the vagina in 39 (67,2%) patients, insignificant — 12 (20,7%), moderate — 6 (10,4%), pronounced — only in 1 (1,7%), and the absence of high atrophy. In the comparison group, the indicators remained unchanged. Conclusions. The combination of low doses of estriol, acidophilic lactobacilli and lactose contributes to sufficient population and maintenance of healthy vaginal flora, as well as the restoration of physiological properties of the vaginal mucosa in women during menopause, as evidenced by the reverse dynamics of atrophic disorders in the main group.

Using X-ray diffraction in characterization of bone remodeling and nanocomposites in ovariectomized rats osteopenia model

Abstract Sedentary lifestyle and physiological menopause are among the risk factors of osteopenia, especially in elderly people. However, bone mineral density decrease can also be observed in young individuals, for instance, due to deficiency of female sex hormones after surgical interventions, particularly ovariectomy. Our research enabled us to assess the efficacy of whole-body vibration in preventing the loss of bone mineral density in the ovariectomy rat osteopenia model. Thus, whole-body vibration with acceleration level 0.3 g and frequency 50 Hz was used on young female rats, which had been subjected to ovariectomy (n = 18). It had been conducted for 24 weeks, exposure time – 30 minutes per day, 5 times a week. Assessment of mineral component loss of the tibia was performed by means of X-ray diffraction. Bone remodeling was assessed by determining hormones: parathyroid hormone and calcitonin, Ca and P in the blood. X-ray diffraction is an effective method, which enables the evaluation a nanocomposites structure of the bone tissue in the experiment. In the article, we applied this method to determine the loss of bone mineral mass after ovariectomy and the impact of whole-body vibration under such conditions. In the ovariectomy group, the volume of a mineral component significantly decreased starting already from the 16th week (р<0.05) versus control. However, in the group with ovariectomy + whole-body vibration, the loss of a mineral component was insignificant during 8-16 weeks of the investigation, compared with the control group. On the 24th day, the spectrums almost did not differ from ovariectomized rats group. Meanwhile, hormone levels changed in ovariectomized rats group. It should be emphasized that the aforementioned whole-body vibration parameters do not cause severe bone damage or further negative consequences.

Augmentation of the Female Reproductive System Using Honey: A Mini Systematic Review.

Phytochemical contents of honey are presumed to be beneficial to the female reproductive system (FRS). However, the biological effects of honey supplementation (HS) in vivo on the FRS remain unclear. This review aims to investigate the current literature on the effects of HS on the FRS, particularly on the sex hormone profile and reproductive organs (uterus and vagina). A systematic literature search using Scopus, MEDLINE via Ovid and Cochrane Library databases was conducted. Records were screened and identified for preclinical and clinical studies addressing the effects of HS on the FRS. Data on populations, interventions, outcomes and methodological quality were extracted. Studies were synthesised using tables and written summaries. Of the 198 identified records, six fulfilled the inclusion criteria. All six records were used for data extraction: two experimental studies using rats as the model organism and four human clinical studies of honey on female reproductive health. HS elevated the progesterone levels, restrained body weight increase, prevented uterine and vaginal atrophies in ovariectomised rats, attenuated symptoms of candidiasis and improved oxidative status in patients. Current evidence shows that short-term HS following surgical or physiological menopause exerts an oestrogenic, antioxidant and anti-inflammatory effect on the FRS. However, insufficient long-term studies preclude any definitive conclusions.

Factors of mineral homeostasis impairment and bone mineral density loss in women with central hypogonadism

Objective The aims of the study were to estimate markers of mineral turnover and bone mineral density (BMD) in young women with central hypogonadism (CH) in comparison with healthy young and postmenopausal women, and to reveal the possible impact of different factors on BMD. Method We examined 73 patients with CH (mean age 25 [21.2; 30.5] years, mean duration of amenorrhea 5 [2.3; 10.1] years), 47 young healthy women (mean age 24 [23.1; 28.0] years) and 50 healthy women in natural postmenopause (mean age 56 [53; 58] years, mean duration of 6 [2; 10] years since last menstrual period). Women with CH were examined before and after 12 months of treatment with 17β-estradiol 2 mg and dydrogesterone 10 mg in continuous sequential fashion. Results Levels of calcium, alkaline phosphatase, and C-terminal telopeptide of type I collagen were statistically higher in women with CH without treatment than in young healthy women but did not differ from those in postmenopausal women. Prevalence of T-score ≤−2.5 standard deviations was higher in CH than in postmenopause both in lumbar vertebrae and total femur. Factors that were responsible for lower BMD in young women with CH included the duration of hypoestrogenism, primary amenorrhea, and hypoandrogenism. Conclusion Central hypogonadism at a young age poses a higher risk of bone metabolism impairment than physiological menopause.

PREVENTION AND TREATMENT OF MENOPAUSAL DISORDERS WITH THE USE OF PHYTOPREPARATIONS

The purpose of our work is to evaluate the clinical manifestations of menopausal disorders in the primary treatment of women and after the proposed complex of non-hormonal treatment. Clinical and laboratory examination of patients of menopausal age was conducted to determine neurovegetative, psycho-emotional, and metabolic-endocrine disorders. The patients were divided into groups as follows: Group I - main, 48 women with physiological menopause up to three years who received a complex of herbal remedies within six months; Group II was a control, 34 women receiving symptomatic treatment for menopausal disorders. The results of the clinical manifestations of climax before and after the use of non-hormonal drugs for six months are presented. Thus, the level of personal anxiety in patients of group I decreased to 30.3 ± 2.8 points (p <0.05), while in group II remained almost at the same level of 40.2 ± 2.5 points (p> 0.05). After the treatment we offered, the percentage of women with climacteric disorders of moderate severity decreased in group I from 54.2% to 18.8%, in II - from 44.1% to 29.4%. The slightly higher rates of physiological menopause in group II women are explained by the fact that patients with severe climax were not included in the treatment group. The effectiveness of this therapy as an alternative method of relief of menopausal manifestations has been established.

PREVENTION AND TREATMENT OF MENOPAUSAL DISORDERS WITH THE USE OF PHYTOPREPARATIONS

The purpose of our work is to evaluate the clinical manifestations of menopausal disorders in the primary treatment of women and after the proposed complex of non-hormonal treatment. Clinical and laboratory examination of patients of menopausal age was conducted to determine neurovegetative, psycho-emotional, and metabolic-endocrine disorders. The patients were divided into groups as follows: Group I - main, 48 women with physiological menopause up to three years who received a complex of herbal remedies within six months; Group II was a control, 34 women receiving symptomatic treatment for menopausal disorders. The results of the clinical manifestations of climax before and after the use of non-hormonal drugs for six months are presented. Thus, the level of personal anxiety in patients of group I decreased to 30.3 ± 2.8 points (p <0.05), while in group II remained almost at the same level of 40.2 ± 2.5 points (p> 0.05). After the treatment we offered, the percentage of women with climacteric disorders of moderate severity decreased in group I from 54.2% to 18.8%, in II - from 44.1% to 29.4%. The slightly higher rates of physiological menopause in group II women are explained by the fact that patients with severe climax were not included in the treatment group. The effectiveness of this therapy as an alternative method of relief of menopausal manifestations has been established.

Early Ovarian Hormone Deprivation Increases Cardiac Contractility In Old Female Rats - Role Of Physical Training

Physiological menopause occurs around 51 years of age. However, in some cases, menopause can happen early, that is, before the age of 40. Of the main consequences of early ovarian hormones deprivation or early menopause, one of the most alarming is the increased risk of cardiovascular diseases, contributing to an increase in the morbidity and mortality rate in these women. Our hypothesis is that early deprivation of ovarian hormones, when associated with the aging process, promotes more adverse cardiac remodeling and greater damage to cardiac function related to physiological ovarian failure. Thus, aerobic physical training is fundamental to attenuate these deleterious effects. PURPOSE: The objective of the present study was to investigate the effects of early deprivation of ovarian hormones on cardiac morphological and functional parameters in 82 week-old female rats subjected to ovariectomy at 10 weeks of age, as well as to evaluate the application of aerobic training as a non-pharmacological therapeutic tool. METHODS: Female Wistar rats (N = 48) were divided into two groups, at 10 weeks of life: early ovarian hormones deprivation by ovariectomy (OVX; N=24) and sham (SHAM; N=24).Between weeks 62 and 82, 12 animals of each group underwent aerobic training (OVX-T and SHAM-T, N=12). At the end of week 82, all were evaluated by echocardiography, cardiac function (Langendorff technique) and cardiac β-adrenergic receptor expression quantification. RESULTS: Echocardiography showed slight changes in morphology between OVX and SHAM. OVX (Δ= 101 ± 4.7 mmHg) showed higher values for maximal left intraventricular pressure in response to dobutamine, when compared to SHAM (Δ= 55 ± 11.8 mmHg).Both OVX-T (Δ= 70 ± 4.0 mmHg) and SHAM-T (Δ= 22 ± 6.6 mmHg) showed a reduction in this response. While, β-adrenergic receptor expression was not different between the sedentary groups, SHAM-T (0.23 ± 0.02AU) and OVX-T (0.29 ± 0.01AU) showed decreased expression of these receptors when compared to their respectively sedentary groups. CONCLUSIONS: Early ovarian hormones deprivation associated with aging, promotes discrete changes in cardiac morphology, increasing cardiac contractility. Aerobic training decreases β-adrenergic receptors expression, influencing the cardiac contractility. Supported by FAPESP Grant 01937-9

Early Ovarian Hormone Deprivation Increases Cardiac Contractility in Old Female Rats‐ Role of Physical Training

Physiological menopause occurs around 51 years of age. However, in some cases, menopause can happen early, that is, before the age of 40. Of the main consequences of early ovarian hormones deprivation or early menopause, one of the most alarming is the increased risk of cardiovascular diseases, contributing to an increase in the morbidity and mortality rate in these women. Our hypothesis is that early deprivation of ovarian hormones, when associated with the aging process, promotes more adverse cardiac remodeling and greater damage to cardiac function related to physiological ovarian failure. Thus, aerobic physical training is fundamental to attenuate these deleterious effects.PURPOSEThe objective of the present study was to investigate the effects of early deprivation of ovarian hormones on cardiac morphological and functional parameters in 82 week‐old female rats subjected to ovariectomy at 10 weeks of age, as well as to evaluate the application of aerobic training as a non‐pharmacological therapeutic tool.METHODSFemale Wistar rats (N = 48) were divided into two groups, at 10 weeks of life: early ovarian hormones deprivation by ovariectomy (OVX; N=24) and sham (SHAM; N=24). Between weeks 62 and 82, 12 animals of each group underwent aerobic training (OVX‐T and SHAM‐T, N=12). At the end of week 82, all were evaluated by echocardiography, cardiac function (Langendorff technique) and cardiac β‐adrenergic receptor expression quantification.RESULTSEchocardiography showed slight changes in morphology between OVX and SHAM. OVX (D= 101 ± 4.7 mmHg) showed higher values for maximal left intraventricular pressure in response to dobutamine, when compared to SHAM (D= 55 ± 11.8 mmHg). Both OVX‐T (D= 70 ± 4.0 mmHg) and SHAM‐T (D= 22 ± 6.6 mmHg) showed a reduction in this response. While, β‐adrenergic receptor expression was not different between the sedentary groups, SHAM‐T (0.23 ± 0.02 AU) and OVX‐T (0.29 ± 0.01AU) showed decreased expression of these receptors when compared to their respectively sedentary groups.CONCLUSIONEarly ovarian hormones deprivation associated with aging, promotes discrete changes in cardiac morphology, increasing cardiac contractility. Aerobic training decreases β‐adrenergic receptors expression, influencing the cardiac contractility.Support or Funding InformationSupported by FAPESP Grant 01937‐9This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Diagnostics of genitourinary disorders and sexual dysfunctions in women in menopause

In complex clinical examination of 40 women with physiological menopause (group I) and 44 women with surgical menopause (group II) genitourinary disorders were revealed among 25 (62,5%) and 39 (88,6%) patients respectively. Atrophic colpitis was the first manifestation of genitourinary disorders. It was noted that the formation of genitourinary disorders and sexual dysfunctions in women in menopause took place at the background of reduction of nitrite azote and changes of blood flow in genitals, and worsened as menopause developed. In accordance with the results of earlier carried out research an algorithm of early diagnostics of sexual dysfunctions in women in menopause was developed.

The modern approach to the correction of menopausal disorders in women with physiological menopause and after ovariectomy

The problem of menopause attracts attention for many decades of not only gynecologists, but urologists, cardiologists, psychiatrists and other doctors. This is related to systemic complications of estrogen deficiency. The objective of our work is to establish clinical and hormonal changes in women of menopausal age with physiological menopause and after ovariectomy and also assess the effectiveness of the offered treatment. During the examination and treatment the women were divided as follows: I – main group – 48 women with physiological menopause: Ia (n=27) – within three months received a complex of non-hormonal treatment, Ib (n=21) – hormone replacement therapy (HRT); II group – 34 women after total ovariectomy: IIa (16) with therapeutic purpose received a complex of non-hormonal treatment for three months, IIb (18) – HRT. The offered complex of non-hormonal treatment included Cimicifuga, Menopace, Noophen. This treatment was used in women with early menopause who have contraindications to HRT or refused to take hormones. The degree of severity of menopausal syndrome was judged according to the menopausal index of Kuperman. In the study of hormonal status the determination of a set of hormones by immunochemical method was performed. During study we obtained results that indicate the inverse dynamics of menopausal disorders in both study groups. For the prevention and treatment of individual selection of treatment of climax manifestations it is appropriate the dynamic definition of hormonal mirrors of the patients.

Estrogen-progestins and progestins for the management of endometriosis.

Endometriosis is characterized by frequent recurrences of symptoms and lesions even after extirpative surgery. Because medical therapies control but do not cure the disease, long periods of pharmacologic management may be needed until pregnancy desire or, sometimes, physiologic menopause. Hormonal drugs suppress ovulation and menstruation and have similar beneficial effects against pain. However, only estrogen-progestins and progestins have safety/tolerability/cost profiles that allow long-term use. These compounds induce atrophy of eutopic and ectopic endometrium, have antiinflammatory and proapoptotic properties, and can be delivered via different modalities, including oral, transdermal, subcutaneous, intramuscular, vaginal, and intrauterine routes. At least two-thirds of symptomatic women are relieved from pain and achieve appreciable improvements in health-related quality of life. Progesterone resistance may cause nonresponse in the remaining one-third. When using estrogen-progestins continuously, individualized, tailored cycling should be explained to improve compliance. All combinations demonstrated a similar effect on dysmenorrhea, independently from progestin type. Estrogen-progestins with the lowest possible estrogen dose should be chosen to combine optimal lesion suppression and thrombotic risk limitation. Progestins should be suggested in women who do not respond or manifest intolerance to estrogen-progestins and in those with dyspareunia and/or deep lesions. Progestins do not increase significantly the thrombotic risk and generally may be used when estrogens are contraindicated. Estrogen-progestins and progestins reduce the incidence of postoperative endometrioma recurrence and show a protective effect against endometriosis-associated epithelial ovarian cancer risk.

Analysis of the Relationship between Estradiol and Follicle-Stimulating Hormone Concentrations and Polymorphisms of Apolipoprotein E and LeptinGenes in Women Post-Menopause.

Background: Menopause is the permanent cessation of menstruation due to loss of ovarian follicular activity. A review of the available literature indicates that correlations between the changes that take place in a woman’s body after menopause and different genetic variants are still being sought. Methods: The study was conducted in 252 women who had completed physiological menopause. The women were divided into groups according to the time elapsed since menopause. The total concentrations of estradiol and follicle-stimulating hormone were determined by means of electrochemiluminescence. The apolipoprotein E (APOE) and lepitn (LEP) genotypes were determined by real-time PCR and polymerase chain reaction–restriction fragment length polymorphism, respectively. Results: We observed that people with the APOE3/E3 genotype entered menopause insignificantly later compared to other genotypes. Additionally, in the group of patients with the APOE3/E3 genotypes, differences in the E2 concentration were significantly related to the time since their last menstruation. There is no association found in the literature between these polymorphisms of the LEP gene and hormones. Conclusions: To date, attempts to formulate a model describing the association between E2 and FSH concentration with the polymorphisms of various genes of menopause in women have not been successful. This relationship is difficult to study because of the number of nongenetic factors. Environmental factors can explain variation in postmenopausal changes in hormone levels.