Women Of Post-reproductive Age Research Articles

The diagnostic value of leptin for the detection of liver steatosis in postmenopausal obese women

Introduction. More than half of post-reproductive age women are overweight and obese, which puts them at high risk of developing non-alcoholic fatty liver disease (NAFLD). In the abdominal type of obesity, adipose tissue dysfunction and impaired leptin secretion develop.Aim. To evaluate the possibilities and diagnostic characteristics of leptin for the determination of liver steatosis in pre-obese and obese women in the early postmenopausal period.Materials and methods. 76 women in the early postmenopausal period were examined, including 63 patients with NAFLD and overweight and obesity with an average age of 50.50 ± 2.16 years and 13 practically healthy women with an average age of 49.29 ± 2.64 years, who underwent an ultrasound examination of the liver, calculation of the HSI index (Hepatic Steatosis Index) and determination of the level of leptin in the blood.Results. Abdominal type of obesity was detected in 84% of patients, the gynoid type was 16%, and the body mass index averaged 33.5 ± 1.3 kg/m2. According to the ultrasound examination and the HSI index, all patients had liver steatosis. Their leptin levels significantly exceeded the control data (p < 0.001) and directly correlated with the severity of steatosis according to the HSI index (r = 0.321; p = 0.010). The threshold value of the serum leptin level in patients with NAFLD was 13 ng/ml with sensitivity and specificity of 90.5% and 92.3%, respectively.Conclusion. Leptin is a highly informative marker of NAFLD in women with pre-obesity and obesity in the early postmenopausal period, the value of which is higher or equal to 13 ng/ml allows to verify steatosis, less than this value – to exclude it in this category of persons with high diagnostic effectiveness.

Changes in ageing women’s sexual subjectivity as seen from a life course perspective: security, caring, and desire

This article explores the sexual subjectivity of women of post-reproductive age who seek partners on dating apps. The existing literature highlights the sexual subjectivity and agency of older women as contested and not sufficiently investigated. Even less research has been conducted on changes in the sexual subjectivity of women born in the USSR in the 1960s, with the liberalisation of sexual behaviour. The study is based on 45 interviews with women aged 55 years and over, who were born in the USSR and who now live in Israel, Finland and Russia. In the article, we examine sexual subjectivity as presented in the interviews from a life course perspective. We explain theoretically and empirically how changes in sexual subjectivity are expressed in the light of age and socio-cultural context constraints. Three life stories highlight the accumulation of experience and turning points, such as divorce and migration. They illustrate very different pathways in changing sexual subjectivity, yet all contain three Leitmotifs: desire, security and caring. The expression of post-reproductive female desire can be related to the need to feel secure and enjoy mutual care in sexual relationships. We show that these Leitmotifs shape and are shaped by women’s identifications as both sexual objects and subjects, and explore how they relate to different sexual cultures and variations in the socio-sexual positioning of women in Israel, Finland, and Russia.

Association Between State-Level Access to Reproductive Care and Suicide Rates Among Women of Reproductive Age in the United States

Many states in the United States enforce restrictions to reproductive care, with access to abortion remaining a highly divisive issue. Denial of abortion is linked with heightened stress and anxiety among reproductive-aged women. However, no studies have tested whether access to reproductive care is linked to suicide. To evaluate whether state-level restrictions in access to reproductive care in the United States were associated with suicide rates among reproductive-aged women from 1974 to 2016. A longitudinal ecologic study with a difference-in-differences analysis assessed whether annual changes in the enforcement of state-level restrictions to reproductive care were related to annual state-level suicide rates vs rates of death due to motor vehicle crashes. Duration of follow-up varied between different states (range, 4-40 years), contingent on the first year that restrictions were implemented. Models controlled for year and state fixed effects and other relevant demographic and economic factors. Analyses were conducted between December 2021 and January 2022. Targeted Regulation of Abortion Providers (TRAP) laws index measuring state-year-level restrictions to reproductive care. Annual state-level suicide rates and motor vehicle crash death rates among reproductive-aged women (ages 20-34 years; target group) vs women of postreproductive age (ages 45-64 years; control group). Twenty-one US states enforced at least 1 TRAP law between 1974 and 2016. Annual rates of death by suicide ranged from 1.4 to 25.6 per 100 000 women of reproductive age to 2.7 to 33.2 per 100 000 women of postreproductive age during the study period (1974-2016). Annual motor vehicle crash death rates among women of reproductive age ranged from 2.4 to 42.9 per 100 000. Enforcement of TRAP laws was associated with higher suicide rates among reproductive-aged women (β = 0.17; 95% CI, 0.03 to 0.32; P = .02) but not women of postreproductive age (β = 0.06; 95% CI, -0.11 to 0.24; P = .47) nor to deaths due to motor vehicle crashes (β = 0.03, 95% CI, -0.04 to 0.11; P = .36). Among reproductive-aged women, the weighted average annual-state level suicide death rate when no TRAP laws were enforced was 5.5 per 100 000. Enforcement of a TRAP law was associated with a 5.81% higher annual rate of suicide than in pre-enforcement years. Findings remained significant when using alternative, broader indices of reproductive care access and different age categorizations. In this study with a difference-in-differences analysis of US women, restrictions on access to reproductive care from 1974 to 2016 were associated with suicide rates among reproductive-aged women. Given the limitations of the ecologic design of this study, further research is needed to assess whether current factors affecting access to reproductive care services are related to suicide risk among women of reproductive age and to inform suicide prevention strategies.

Assessment of the general condition and quality of life of women of post-reproductive age after asymptomatic COVID-19 and 12 months after moderate COVID-19

The aim. To assess the general condition, laboratory parameters, quality of life of women of post-reproductive age after asymptomatic COVID-19 and 12 months after moderate COVID-19. Material and methods. We examined 47 women (45–69 years old), divided into 3 groups: those who did not have COVID-19, not vaccinated (group 1 – control; n = 15); women 12 months after moderate COVID-19, accompanied by pneumonia (group 2; n = 19); women with IgG in their blood who deny any symptoms of COVID-19 (group 3; n = 13). Results and discussion. An assessment of the general condition of women in post-reproductive age was carried out. In women 12 months after COVID-19 we found a lower level of total bilirubin compared to the group with asymptomatic COVID-19 (p = 0.004). An increase in thrombin time was determined in the groups of patients with symptomatic (p = 0.014) and asymptomatic (p = 0.025) COVID-19 course compared with the control group. Patients with asymptomatic COVID-19 course had a higher level of high-density lipoprotein cholesterol compared with the control group (p = 0.016) and the group 2 (p = 0.006). Compared with the control group, the group 2 had lower scores for general health (p = 0.006), vital activity (p = 0.013), general physical well-being (p = 0.039), physical functioning (p = 0.046); and the group 3 had higher scores in role functioning due to physical condition (p = 0.049). When comparing groups 2 and 3, lower scores in the group of women who recovered from the moderate COVID-19 were found in physical functioning (p = 0.002), pain intensity (p = 0.034), role functioning due to physical condition (p = 0.049), general health (p = 0.003), vital activity (p = 0.018), general physical well-being (p = 0.001). Conclusion. 12 months after moderate COVID-19, there is a pronounced deterioration in physical and emotional health; and in asymptomatic patients, better protective functions of an organism can be assumed.

Sexual Health after Menopause: A Qualitative Study

Background: Menopause has been associated with decline in sexual well-being among women. The quality of sexual interactions in heterosexual relationship are increasingly being considered as an important indicator of positive health and quality of life. Objectives: This article describes the sexual health status of menopausal women and the challenges preventing them from having a fulfilling sexual life. Method: This was an exploratory qualitative interview. Seventeen (17) menopausal women were interviewed individually and face-to-face using semi-structured interview guide. The interviews were analyzed using content and thematic analysis. Results: The analysis yielded two themes for sexual health status; (a) good sexual health status and (b) poor sexual health status. Majority of the study participants claimed to have poor sexual health status. The challenges to having a fulfilling sexual life yielded four themes; (a) fear (b) lack of sexual partner (c) ageing process and (c) being breadwinner of the family. Conclusion: The study concludes that majority of the women in the study have poor sexual health status and diverse challenges to having a fulfilling sexual life. This article offers a premise for healthcare providers to see the necessity to inquire about sexual health from post-reproductive age women and to provide necessary support that can help improve their sexual health.

Dynamics of natural selection in two generations (on the example of the population of the Kirovograd region)

Aim. In connection with the success of modern medicine, the pressure of natural selection in various civilized human populations is weakening, which leads to the accumulation of a genetic load. The purpose of this work was to trace the change in the intensity of natural selection among population of the Kirovograd region in two successive generations. Methods. The collection of material was carried out in 2020 and 2021. Anonymous questionnaires were conducted and medical histories of women of post-reproductive age of the Kirovograd region were studied. The first generation included 40 women born in 1937–1959; the second generation consists of 273 women born in 1960–1981. Results. The total selection index was 0.27 in the first generation, and 0.37 in the second generation. The percentage of women who have not had pregnancies increased from the first generation to the second from 2.5 to 3.7, respectively. Conclusions. The index of total selection in the Kirovograd region population for one generation increased by almost one and a half times (from 0.27 to 0.37), as well as the index of differential fertility (from 0.25 to 0.35).
 Keywords: reproductive characteristics, Kirovograd population, Crow's index, selection, generations.

Mammographic density as marker of increased risk of breast cancer

‘Mammographic density’ (MD) is a concept that has entered medical practice since 2017. as a marker of breast cancer risk factor (BC) according to the international classifiation of NCCN. The term reflcts the degree of severity of benign diffuse breast dysplasia in women of post-reproductive age. MD is determined by the ratio of stromal, epithelial, and adipose tissue. According to the literature, in young women, high MD limits the possibilities of X-ray mammography, reducing its effectiveness in oncomammoscreening, leading to the detection of advanced forms of breast cancer. Post-reproductive women with high MD are more likely to develop breast cancer than those with low MD. In this regard, MD is of particular interest for studying its role in oncogenesis. Recent molecular genetic studies of the differences between high and low MD explain the main biological reasons why post-reproductive women with dense breast structure are at a higher risk of developing breast cancer. The aim is to identify the factors that inflence the relationship of MD with the risk of developing breast cancer based on a comparative analysis of molecular genetic studies and radiological manifestations of MD of different severity and to identify the factors that contribute to the formation of MD variants.

Assessment of the urogynaecology patient in primary care and when to refer.

Urogynaecological symptoms are commonly encountered problems in women of post-reproductive age, which have a major impact on quality of life in affected women. This review summarises a standardised approach to common urogynaecological problems in primary care, which focuses on making the correct diagnosis, assessing impact, evaluating for other relevant lifestyle and medical factors and indications for referral into secondary care.

Crow’s index in ethnic and social groups of urban population

Aim. According to the data characterizing reproductive behavior of women, assess an impact of ethnicity and level of education on the intensity of selection in the urbanized multinational population of Kharkiv city. Methods. Data from obstetric history of 532 post-reproductive age women was studied. Results. For indicators of the number of pregnancies with favorable and unfavorable outcomes, universally valid statistical indicators were calculated. Crow’s indexes were calculated as indicators of the intensity of selection. The total selection index for Ukrainians living in Kharkiv equal 0.26, for Russians it is 0.32, and for the group formed from representatives of rare nationalities this index is 0.75. In a group of women with secondary education total selection index is 0.26, in a group with highest education it is 0.35. Conclusions. Ethnicity and level of education of women affects reproductive behavior and determine number of pregnancies and their outcomes. Selection indexes differ in ethnic groups and in groups with different levels of education.
 Keywords: reproductive characteristics, Kharkiv population, Crow's index, selection, nationality, education.

95 Role of Papanicolaou Screening Test in Diagnosis of Glandular Lesions in Women of Postreproductive Age: Retrospective Analysis With Histological or Cytological Follow-Up

95 Role of Papanicolaou Screening Test in Diagnosis of Glandular Lesions in Women of Postreproductive Age: Retrospective Analysis With Histological or Cytological Follow-Up

Maintaining the quality of life and social activity of women in the post-reproductive period

Taking into account the increase in the proportion of women in the post-reproductive age in society and the increase in the retirement age, it becomes necessary to preserve their professional and social activity. As of 2016, in the structure of the female population of Ukraine, women over 50 years are 46.7%, respectively, the number of women over 45 years is more than half. However, today the problems of women of post-reproductive age are paid insufficient attention both by society, and by the media and social organizations.The issue of maintaining the life quality and social activity of women in the post-reproductive period was discussed on April 5, 2017 in Kiev at an expert council meeting in which leading experts in obstetrics and gynecology, cardiology, family medicine and oncology participated. As noted at the meeting, the relevance of this topic is primarily due to the deterioration of the life quality due to the cessation of ovarian function and the appearance of symptoms of menopause, along with an increase in the incidence of cardiovascular diseases, oncological pathology, and type II diabetes at post-reproductive age.In this regard, at the meeting of the expert council it was proposed to implement the social and information project “Femininity of the future”, within the framework of which in the next 3 years (2017–2019) in 18 regions of Ukraine a number of measures aimed at preserving the life quality and social activity of women in the post-reproductive period. In particular, among them is the development of methods that reduce the risk of developing diseases, increase the level of knowledge of patients and doctors of different directions on modern approaches to the prevention, diagnosis and treatment of menopausal disorders in women, a large-scale educational program on the preservation of life quality, social activity of women in the post-reproductive period and with respect to methods for reducing the risk of cardiovascular pathology, oncological diseases.

Hormone replacement therapy affects iron status more than endometrial bleeding in older US women: A role for estrogen in iron homeostasis?

High iron levels in women of post-reproductive age may be related to their increased risk of chronic disease as they become older, but the causes of this rise in iron in late life is unclear. Recently estrogen has been implicated in non-human models of iron homeostasis. Studying iron in women who take hormone replacement therapy (HRT) may provide insight into the relationship between iron status and hormonal status in older women. This study examines the association between HRT and iron status in women aged 50+ who took part in the 1999–2000 National Health and Nutrition Examination Survey (NHANES). Data were analyzed using multiple imputation, which corrects for missing data, and complex survey regression, which adjusts for NHANES sampling. Current HRT use was associated with lower ferritin (β=−34.13, p=0.0002), controlling for potential breakthrough bleeding with a hysterectomy variable. HRT was associated with lower iron stores in women of post-reproductive in the absence of uterine blood loss, indicating potential homeostatic hormonal control of iron status. This research demonstrates the utility of studying clinical hormonal therapy to advance new understandings about the basic biology of iron homeostasis in women.

Crow’s index and reproductive characteristic of the Republic of Tatarstan population

On the basis of 1212 questionnaires filled up by women of postreproductive age living in five districts of the Republic of Tatarstan (Arsky, Atninsky, Kukmorsky, Buinsky, and Drozhzhanovsky), the basic reproductive characteristics and Crow's index and its components have been calculated. The rural population is characterized by expanded reproduction with a mean sibship size of 2.68; in district administrative centers, there is only simple reproduction. Crow's index and its components for the rural Tatar population are Im = 0.026, If = 0.172, Itot = 0.202. Graphic analysis of the mutual positions of some populations studied has been carried out.

Younger women incur excess risk of uxoricide by stabbing and other hands-on killing methods

Uxoricide is the killing of a woman by her husband. Younger, reproductively valuable women, relative to older women, are at an increased risk of uxoride. The purpose of the current research is to investigate in a sample of over 17,000 uxoricides whether the percentage of uxoricides by stabbing and other hands-on killing methods varies as a function of the wife’s reproductive status (as indexed by her age) and the husband’s age. The results indicate that, relative to older, post-reproductive age women, reproductive age women are more likely to be killed by hands-on killing methods. Competing explanations for the findings are examined in the discussion.

Racial and ethnic disparities in the incidence of invasive cervical cancer in Florida

Although cervical cancer incidence has declined in the past decade, considerable racial and ethnic differences remain. The objective of this study was to examine differences in incidence by histology and cancer stage in Florida stratified further by race, ethnicity, and 5-year time intervals. Women who were diagnosed with invasive cervical cancer in Florida between January 1985 and December 2004 were included in the analysis. Age-adjusted incidence rates by race and ethnicity were estimated for different histologic types and stages of cancer. The annual percentage of change in incidence also was calculated for each histologic type. Rate ratios were estimated by race and ethnicity using whites and non-Hispanics as the reference group. Overall, the incidence in Florida of cervical squamous cell carcinoma and transitional cell carcinoma declined significantly from 9.1 per 100,000 women in 1985 to 5.6 per 100,000 women in 2004 (P < .05), whereas the incidence of cervical adenocarcinoma remained stable (P > .05). The incidence of invasive cervical cancer was 9.6 per 100,000 women among whites and 13.13 per 100,000 women among African Americans from 2000 to 2004. African-American women were nearly 2 times more likely to be diagnosed at regional and distant cancer stages than white women for all periods examined. Furthermore, among African-American women aged >40 years, the age-specific incidence of invasive cervical cancer increased considerably, whereas the rates among other racial groups decreased. The increasing rate of invasive cervical cancer among African-American women aged >40 years in Florida, coupled with their diagnosis at a later stage of cancer, is of great concern. Most screening organizations recommend stopping screening at age 65 years. The observations from these analyses highlighted the need to focus prevention and screening efforts on African-American women living in Florida, and particularly on women of postreproductive age.

Analysis of reproductive and age-parameters in Kalmyk rural populations

Questionnaire data of 704 women of postreproductive age were used in this study. Questionnaire involved 462 Kalmyks, 119 Russians, 43 Kazakhs, 52 representatives of Northern Caucasus ethnic groups and, 28 other ethnic groups. The average number of pregnancies in Kalmyks was 5.49; the average number of live births was 3.21. The Crow index for Kalmyks was I(m) = 0.038, I(f) = 0.300, I(tot) = 0.350; and for Russians in Kalmykia, I(m) = 0.030, I(f) = 0.264, I(tot) = 0.302.

Genetic Analysis of Reproduction in the Buryat Populations

A complex anthropological survey based on population-genetic methods and a study of a wide spectrum of genetic systems (43 alleles from 17 independent loci) was undertaken among 450 Buryat women of post-reproductive age. The results obtained showed the influence of particular genetic markers and their complex on the formation of peculiarities in the reproduction structure of the Buryat population.A sharp increase in phenotype GC 2-2 frequency and the corresponding GC*2 allele of the group-specific component (GC) was established for women groups with burdened obstetric records. These groups are characterized also by a considerable decrease in the observed geterozygosity (Ho) as compared to its expected value (He). Samples including women with multiple pregnancies in the recorded obstetric anamnesis are characterized by a significant increase in the frequency of the rare alleles TF*C3 of the transferrin system and those of PI*Z belonging to the proteinase inhibitor system (a1-antitrypsin) as compared to the control group. The results obtained widened current knowledge about the influence of genetic and environmental components on reproduction processes in human populations.

Oocyte donation to postmenopausal women

The reported success of oocyte donation to older women makes pregnancy feasible in virtually any woman with a normal uterus, regardless of age or the absence of ovaries and ovarian function (1–3). A woman's reproductive age, once a dictate of nature, now has been artificially extended. Both women with premature ovarian failure and women of postreproductive age may give birth by using donated oocytes fertilized in vitro and transferred to their uteri.

Sexual behavior and condom practices among Los Angeles women

Background The sociodemographic correlates of the number of recent sexual partners and condom use are investigated in a population-based sample of 1,178 unmarried women living in Los Angeles County. Results Asian Americans, foreign born, and older women are less likely to be sexually active and that more educated and previously married women are more likely. Among the sexually active ( n = 909), Hispanic women and older women are less likely to have multiple partners, and younger and previously married women more are more likely. African-American women and younger women are more likely to use condoms; older and previously married women are less likely. Conclusions Results from this study indicate that women-centered primary and secondary prevention efforts may benefit from targeting women not previously considered, such as women of post-reproductive age and divorced women.

Understanding domestic violence against women: using evolutionary psychology to extend the feminist functional analysis.

Evolutionary psychologists such as Wilson and Daly (1993b) hypothesize that one goal of male-perpetrated domestic violence is control over female sexuality, including the deterrence of infidelity. According to this hypothesis, domestic violence varies with women's reproductive value or expected future reproduction, declining steeply as women age. We tested this hypothesis with a sample of 3,969 cases of male-perpetrated partner-abuse reported to a single police precinct in a large urban area over a 14-year period. Results show that (a) rates of domestic violence decrease as women age, (b) younger men are at greatest risk for perpetrating domestic violence, (c) younger, reproductive age women incur nearly 10 times the risk of domestic violence as do older, post-reproductive age women, and (d) the greater risk of domestic violence incurred by reproductive age women is not attributable solely to mateship to younger, more violent men. Discussion addresses theoretical implications of these findings and suggests a refinement of the feminist hypothesis of domestic violence against women.