Postmenopausal Group Research Articles

Study of Vulvovaginal Atrophy and Genitourinary Syndrome of Menopause and Its Impact on the Quality of Life of Postmenopausal Women in Central India.

Background Urogenital health is a necessary part of health for all women, especially in the postmenopausal age group. We suspected that the increased incidence of vulvovaginal atrophy (VVA) had some or other effects on the quality of life of older women. So, we aimed to study VVA/genitourinary syndrome of menopause (GSM) and its impact on the quality of life of postmenopausal women in Central India.Despite its significant prevalence and detrimental impact on women's health, VVA/GSM is underdiagnosed and undertreated. In view of the feminization of aging, VVA management is becoming increasingly crucial. This study contributes to postmenopausal women's understanding that keeping their urogenital and sexual longevity is a critical step towardhealthy living and gender equality. Given its relationship with urogynecological conditions, this study will help to evaluate both subjectively and objectively the incidence of symptoms related to VVA and its effects on the quality of life of postmenopausal women. This will eventually help to understand the need to address this issue while making postmenopausal women health-related policies. Potential remedies to overcome the obstacles currently preventing patient-HCP interactions addressing sexual health include providing communication tools to facilitate the "uncomfortable" conversation, educating women, and providing enough training for healthcare professionals. Methods The current study was conducted at a rural tertiary healthcare center in Central India and is a cross-sectional study. The study population taken into consideration were all the postmenopausal women between the age group 45and 75 years with at least one vulvovaginal symptom attending the Outpatient Department (OPD). The total study sample size was 100 women. Further study was conducted by interview method using a questionnaire by the principal investigator. Data was gathered with the help of a pretested questionnaire in the patient's language. Symptoms related to GSM were studied by the vaginal symptom Bothersomeness Scale. Further, a gynecological clinical examination for the confirmation of VVA was carried out, which included a gynecological physical examination. The Vaginal Health Index (VHI) was calculated for each female using the score scale. Assessment of the quality of life of postmenopausal females using the Day-to-Day Impact of Vaginal Aging (DIVA) Questionnaire was performed. Results The majority of females (34%) who presented with the symptoms were in the category of 55-60 years followed by 22% in the age group of 61-65 years. The most common symptoms experienced by females were vaginal dryness (77%) followed by vaginal discharge (74%). Our study confirmed that 79% of the total females included in the study have a VHI score of less than 15, i.e., they suffer from VVA, thuspresenting our incidence at 79%. Conclusion According to the surveys discussed in this research, a significant portion of postmenopausal women have symptoms linked to VVA that have a negative impact on their quality of life, including their sexual relationships and self-esteem.

Severity of Coronary Artery Disease by Friesinger Score Among Women With Acute Coronary Syndrome in a Tertiary Care Hospital in Bangladesh.

The chance of coronary artery disease (CAD) is much higher in women who have gone through menopause than in those who have not, owing to hormonal defense against atherosclerosis. More advanced CADand several comorbidities were observed in postmenopausal women. Nevertheless, there is a paucity of information comparing the angiographic severity of acute coronary syndrome (ACS) in premenopausal and postmenopausal women of different ages. This research sought to determine the Friesinger score's use in evaluating the degree of CAD in premenopausal and postmenopausal women with ACS. A total of 145 female patients with ACS were included in this cross-sectional observational research. Depending on the stage of menopause, they were categorized into two groups: group I (premenopausal) and group II (postmenopausal). The study examined the differences in clinical data and the severity of coronary angiographic features based on the Friesinger score between the premenopausal and postmenopausal ACS groups. A statistically significant difference (p = 0.001) was found in the mean age of premenopausal ACS patients, which was 41.53 ± 5.45 years, and postmenopausal ACS patients, which was 57.23 ± 7.45 years. Between the premenopausal group (31.4% vs. 17.1%; p = 0.04 and 31.4% vs. 15.7%; p = 0.002) and postmenopausal group (48.6% vs. 20%; p = 0.001), there was a greater prevalence of normal coronary angiography, single-vessel disease, and triple-vessel disease. Comparing the postmenopausal group to the premenopausal group, the high to intermediate Friesinger score (11-15) was found to be considerably higher (2.9% vs. 1.4%; 72.9% vs. 50%; p = 0.003). Prior to menopause, single-vessel disease and normal coronary angiography were more common, whereas postmenopausal individuals had triple-vessel disease.The postmenopausal group's CAD was found to be more severe than the premenopausal group's according to the Friesinger score used for severity evaluation.

Sociodemographic, Clinical and angiographic Overview of Women with Acute Coronary Syndrome: A Current Prospective Hospital Based Study in Bangladesh

Background: Women’s life cycles are more complex than men’s, and because female sex hormone shields premenopausal women from overt atherosclerosis, their risk of coronary events is lower. Postmenopausal women experience various comorbidities and more severe cases of coronary artery disease (CAD). Nevertheless, there is a paucity of information comparing pre- and postmenopausal women with acute coronary syndrome (ACS) in terms of their sociodemographic profiles, risk factors, clinical features, and angiographic severity of coronary artery disease. The purpose of this study was to evaluate the sociodemographic, clinical and angiographic aspects of premenopausal and postmenopausal women with ACS. Methods: In this cross sectional observational study a total of 140 female patients with acute coronary syndrome were enrolled. They were divided in group-I (premenopausal) and group-II (postmenopausal) on the basis of the state of menopause. The sociodemographic profile, clinical data and coronary angiographic characteristics severity were compared between the premenopausal and postmenopausal ACS groups. Results: The mean age of ACS patients who were premenopausal was 41.53 ± 5.45 years, while that of postmenopausal patients was 57.23 ± 7.45 years. These differences were statistically significant (p= 0.001). Most of the patient among both the groups didn’t complete their secondary school certificate (42.9% vs 65.7%). Premenopausal individuals had a considerably higher family history of early CAD (50% vs. 32.9%; p=0.017) than postmenopausal individuals. In the postmenopausal group, DM and smokeless tobacco were more common (68.6% vs. 40%; p=0.001 and 20% vs. 2.9%; p=0.002). In the premenopausal group, atypical presentations were more common (30% vs. 12.9%; p=0.013). The majority of patients in both groups initially had unstable angina, then STEMI and NSTEMI. The postmenopausal group had a lower mean left ventricular ejection fraction (50.71 ± 8.38% vs. 53.74 ± 7.46%; p=0.026) and RWMA (55.7% vs 62.9%; p=0.390) than the premenopausal group. In the premenopausal group, normal coronary angiography and single vessel disease were more common (31.4% vs 17.1%; p=0.04 and 31.4% vs 15.7%; p=0.002), while triple vessel disease was more common in the postmenopausal group (48.6% vs 20%; p=0.001). The postmenopausal group’s most often affected vascular was the left anterior descending artery (95.7% vs. 85.7%; p=0.04). In the postmenopausal group, the mean Gensini score was greater than in the premenopausal group (56.1 ± 43.4 vs. 33.5 ± 36.9; p=0.001). Conclusion: Premenopausal ACS patients were more likely to have a family history of early CAD and an unusual presentation, while postmenopausal patients were more likely to have diabetes and smokeless tobacco. Both the groups didn’t complete their secondary school certificate. In the premenopausal group, normal coronary angiography and single vessel disease were more common, whereas in the postmenopausal group, triple vessel disease was more common. CAD in the postmenopausal group was more severe.

Comparative Study of Serum Calcium Level Between Postmenopausal and Premenopausal Women

In postmenopausal women, more significant bony consequences are associated with low blood calcium levels. A observational cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College, Dhaka from July 2014 to June 2015. Serum calcium levels were compared between postmenopausal women as cases and premenopausal women as controls. The study sample size was 100 of which 50 were postmenopausal, and 50 were premenopausal. Mean (±SD) of serum calcium level was significantly higher in the premenopausal group than in the postmenopausal group. Serum calcium level was 8.66±0.43 mg/dL in postmenopausal women and 9.12±0.59mg/dL in premenopausal women. Both the values were within the normal reference range, but the difference was statistically significant with a p-value of 0.001. By this research work, it is observed that postmenopausal women are more prone to develop osteoporosis with a decreased serum calcium concentration. Routine check-up of this biochemical parameter may provide valuable information for preventing osteoporotic fractures in postmenopausal women.
 Bangladesh J Med Biochem 2019; 12(1): 1-5

Serum iron and ferritin levels in female patients with gingivitis and periodontitis.

The aim of the study was to compare serum ferritin and iron levels and periodontal status in pre- and post-menopausal female patients. A total of 108 systemically healthy patients were included in the study, 63 patients in the pre-menopause group and 45 patients in the post-menopause group. The periodontal diagnosis was made according to the new periodontal disease classification of the American Academy of Periodontology and the European Federation of Periodontology Serum Iron (μg/dL) and Serum Ferritin (ng/mL) values were analysed in patients divided into groups according to menopausal status and periodontal status. The mean ferritin in pre-menopausal women (34.96 ± 27.87 ng/mL) was lower than the mean ferritin in post-menopausal women (64.24 ± 36.05 ng/mL), and this difference was found to be statistically significant (P<0.001). There was no statistically significant difference between the averages of iron and ferritin according to periodontal diagnosis in pre-menopausal women (P = 0.200 and P = 0.858). A statistically significant difference was found between serum ferritin averages according to periodontal diagnosis in post-menopausal women (P < 0.001). Serum ferritin at % Interdental bone loss = 0 in Post-M was 33.93 ± 8.65 ng/mL; 47.51 ± 16.17 ng/mL in Stage 1 periodontitis; 72.66 ± 18.12 ng/mL in Stage 2 periodontitis; It was found to be 87.4 ± 47.1 ng/mL in Stage 3-4 periodontitis. Serum ferritin values might vary depending on the presence or severity of periodontitis in post-menopausal women.

Body weight in childhood, adolescence, and young adulthood in relation to later risk of disabilities and early retirement among Danish female nurses.

Obesity is now the most common health problem in the younger population in Western societies and obesity rates are higher in lower socioeconomic status (SES) groups. We investigated whether overweight in childhood, independently of overweight in adulthood, influenced adult employment status and later risk of having disabilities. Using data from the Danish Female Nurse Cohort study, we examined associations between overweight in childhood/adolescence, and young adulthood and disabilities and early retirement in later adulthood (>44 years) and whether it was influenced by menopausal age (<or ≥52 years). We analysed data from 10,363 female nurses recruited in 1999, who reported whether they, as children, were larger or of similar weight size as their peers at any age below 13 years, between 13 and 19 years, their weights, and heights at 25 years, their current work situation and whether they had had disabilities for more than 6 months. Our results showed that overweight in childhood, adolescence and young adulthood was associated with an increased risk of disabilities and early retirement. Especially childhood overweight that did not persist into adulthood was associated with an increased risk of disabilities (OR = 1.82, 95% CI = 1.26-2.63) and early retirement (OR = 2.05, 95% CI = 1.38-3.03) in the postmenopausal group. A similar increased risk for disabilities (OR = 1.76, 95% CI = 1.26-2.47) was seen for adolescent overweight that did not persist into adulthood. The results show that in a well-educated population of women, overweight in childhood and/or adolescence had adverse socioeconomic consequences for later risk of disabilities and early retirement irrespective of weight status in adulthood.

Propulsive forces and muscle activation during gait: comparisons between premenopausal and postmenopausal midlife women.

The aim of this study was to investigate whether there is a reduction in propulsive force during gait in postmenopausal women compared with premenopausal women. Forty-four women (21 premenopausal and 23 postmenopausal women) aged 40 to 55 years were selected. The ability to reach peak propulsive forces was assessed during the step execution test. The test was performed at the usual speed on 2 nonconsecutive days, with two attempts per day, using a force platform. Four temporal parameters were defined and calculated: initiation phase, preparation phase, swing phase, and total time. Peak force (anteroposterior and vertical) and time to reach peak force were obtained in both preparation and swing phases. The rate of force development was defined as peak force divided by time to reach peak force. The postmenopausal women group presented a longer time in the preparation phase (540.6 ± 77 ms vs 482.5 ± 93 ms, P = 0.024) and consequently a longer total time in the step execution test (1,191 ± 106.4 ms vs 1,129 ± 114.3 ms, P = 0.045). There were differences between the groups for the rate of force development in the anteroposterior (postmenopausal women, 142.5 ± 38.1 N/s vs premenopausal women, 174.7 ± 70.5 N/s; P = 0.022) and vertical directions in the preparation phase (postmenopausal women, 102.7 ± 62.3 N/s vs premenopausal women, 145.3 ± 71 N/s; P = 0.012). No significant differences ( P > 0.05) were found in force, time to peak force, and rate of force development during the swing phase. In addition, there were no observed differences in surface electromyography of the medial and lateral gastrocnemius muscles during the preparation phase and swing phase of the step execution test between the two groups. Postmenopausal women exhibited lower ability to generate propulsive force rapidly (rates of force development) in both the anteroposterior and vertical directions during the preparation phase of gait compared with premenopausal women. This indicates that postmenopausal women experience a reduction in propulsive force during gait.

Menopausal Status Impact on the Quality of Life in Kazakhstani Healthcare Workers: A Cross-sectional Study.

Menopausal quality of life (MenQoL) is a common concern that primary healthcare workers often encounter. Menopause has a significant impact on women's health, but studies examining its effect on the MenQoL of menopausal healthcare employees have produced conflicting results. The aim of this study was to compare the quality of life related to menopausal status (pre-, peri-, or postmenopausal) in healthcare workers from various clinical settings in Kazakhstan. This was a cross-sectional study. In total, 222 menopausal healthcare workers (physicians, nurses/midwives, administrative staff, and cleaners) were enrolled from hospitals affiliated with the University Medical Center (UMC) in Kazakhstan. The outcome variable was assessed using the Menopausal Quality of Life Questionnaire (MENQOL), which evaluates MenQoL across four domains of menopausal symptoms: physical, psychological, vasomotor, and sexual. The most frequently reported menopausal symptoms were physical ones, such as feeling tired or worn out (70.7%), followed by feeling a lack of energy (65.3%) and dry skin (64.1%). The postmenopause group had the highest mean MenQoL score in the vasomotor domain (mean 3.46 ± 1.84). There was a borderline statistical significance when comparing postmenopause and perimenopause groups in the physical domain. The pairwise comparison of mean sexual scores revealed that postmenopause women had the highest average score (3.3 ± 2.36) compared to both premenopause (mean 2.3 ± 1.82) and perimenopause (mean 2.22 ± 1.58) groups (p < 0.05). Menopausal status has influence on the MenQoL of healthcare workers. The study findings could have important implications for policymakers as they provide insight into the factors influencing the quality of life of menopausal healthcare employees. Creating a more menopause-friendly work environment may not only enhance the well-being of healthcare personnel but also improve their overall job satisfaction and performance.

Menopause-Associated Changes in Mandibular Bone Microarchitecture Are Site-Specific

BackgroundThere are conflicting reports on the effects of decreased estrogen levels on mandibular bone microarchitecture, and whether these effects are consistent throughout the mandible is unclear and may have important implications for treatment planning. PurposeThe goal of this study was to evaluate trabecular and cortical bone microstructure in the mandibular condyle and the mandibular basal bone and compare these sites between premenopausal and postmenopausal women. Study Design, Setting, SampleParticipants were recruited for a cross-sectional cohort study at Columbia University Irving Medical Center. Each participant had CBCT taken of their mandibular condyles and of the basal bone. Exclusion criteria for the population included a) current chemo- or immunotherapy; b) history of bisphosphonate or other osteoporosis therapy; and c) currently pregnant, nursing, or on hormonal birth control. Independent VariableThe predictor variables are menopausal status (before or after menopause) and mandibular region of interest (condyle/basal bone). Outcome VariableParameters of interest included the following indicators of bone quality: trabecular bone volume fraction (BVF), trabecular thickness, trabecular number, trabecular separation, cortical BVF, cortical thickness, and cortical porosity. CovariatesCovariates included demographic variables such as age, estrogen levels, and ethnicity. AnalysesQuantitative microstructure analyses were conducted on CBCT images, and differences between groups for continuous measures (including age) were assessed with unpaired t-test, and demographic variables were assessed by Chi-square. Statistical significance was recorded at p<0.05. ResultsThe premenopausal and postmenopausal groups each had 31 participants, with the following average age: premenopausal= 43.9±6.9 vs. postmenopausal = 57.5±7.6 years old; p<0.001, and estrogen levels: premenopausal =91.77±80.13 pg/ml vs. postmenopausal= 41.44±61.62 pg/ml; p <0.01). Postmenopausal women had significantly greater condylar trabecular separation (0.61±0.18 vs 0.47±0.11 mm; p<0.001) and lower trabecular number (1.03±0.18 vs 1.21±0.19 1/mm; p<0.001) compared to premenopausal women. There were no significant differences in the basal bone microarchitectural parameters between the menopausal groups. Conclusion and RelevanceMenopause is associated with mandibular condylar trabecular bone loss but has minimal effects on the mandibular basal bone. This may have important ramifications for treatment planning in advanced age individuals.

Correlation between physical activity, appetite, and body composition during menopausal transition and postmenopause in Iranian women.

Hormone fluctuations in women are accompanied by an increase in obesity. Although obesity has various causes, the interaction between obesity and menopausal status remains unclear. This study aimed to investigate the interaction between lifestyle physical activities (PAs), such as occupational and household activities, and purposeful exercise, such as sports, with appetite and their correlation with body composition during the menopausal transition (MT) and postmenopausal (PM) phases. This was a descriptive cross-sectional design. Women aged 42-62 years, in the MT or PM phases, were included. PA and appetite were measured using the validated Beacke questionnaire and the Simplified Nutritional Appetite Questionnaire, respectively. Body weight, height, waist circumference, and hip circumference were measured to estimate the body mass index (BMI) and waist-to-hip ratio (WHR). A total of 101 women were included in the study. A significant positive relationship was found between appetite and PA in the MT group (r = 0.55, p < 0.001). In the MT group, PA (β = -0.38, p = 0.009) and appetite (β = 0.42, p = 0.004) predicted 16% of the BMI, while PA and appetite predicted 16% of the WHR. Only PA contributed significantly to the prediction of WHR (β = -0.33, p = 0.0.02). In the PM group, PA and appetite predicted 15% of the WHR (p = 0.030), and PA was a significant predictor of the WHR (β = -0.29, p = 0.0.03). There was no significant difference between the BMI and WHR in active women who regularly performed purposeful exercise compared to inactive women during the PM phase (p > 0.05). However, the appetite of active women was higher than of inactive women (p = 0.003). Menopausal status was effective on obesity indices, appetite, and PA. Lifestyle PA was superior to appetite in predicting obesity indices during the MT and PM phases, and particularly during PM; hence, PA was more important than exercise in determining obesity.

Histopathological spectrum of endometrial biopsies in abnormal uterine bleeding at tertiary care centre, Jodhpur

Introduction: Abnormal uterine bleeding (AUB) shows spectrum of patterns on histopathology and pathologist plays a vital role in reporting of endometrial biopsies and helps in differentiating nonneoplastic lesion from neoplastic lesions, early detection of the precursor lesions and exclusion of malignancy. Aim - The aim of this study is to study the spectrum of endometrial patterns in women with AUB and to correlate it with the different age groups. Materials and Methods: 200 samples of endometrial biopsies with AUB were received from the gynecology department, processed and stained with hematoxylin &amp; eosin and subjected to histopathological examination. Results: The peak incidence is observed in the age group of 41-50 years. The predominant histological pattern observed is secretory and proliferative pattern and disordered endometrium (68%) followed by endometrial hyperplasia (10%) and the least common pattern is atrophic endometrium (1%). 2% cases are of endometrial carcinoma found in our study. Conclusion: AUB significantly affects the quality life of women and leads to anemia. Hence histopathological examination should be considered which plays a critical role in early diagnosis of endometrial pathology and to provide appropriate gynecological management. Endometrial sampling is an effective diagnostic tool and it needs to be considered in all patients from peri- and post-menopausal age groups with AUB so to provide appropriate management.

Sex differences in coronary atherosclerosis during the pre- and postmenopausal period: The Tampere Sudden Death Study

Background and aimsWomen are believed to be protected from coronary heart disease (CHD) by the effects of estrogen but detailed studies on the vessel wall level are missing. We aimed to measure sex differences in atherosclerosis during the premenopausal and postmenopausal periods directly at the coronary arteries. MethodsWe analyzed statistics for sex differences in CHD mortality in Finland in 2020. Coronary atherosclerosis was measured using computer-assisted morphometry in 10-year age groups of 185 white Caucasian women and 515 men from the Tampere Sudden Death Study. ResultsCHD mortality was rare in both women and men before 50 years of age. After 50 years of age, male mortality increased rapidly, with women reaching equal levels in the oldest age groups. In the autopsy series, there were no differences in fatty streak, fibrotic or calcified plaque areas, nor in the plaque area or stenosis percentage in coronary arteries between premenopausal women and men in the same age group. The plaque area remained 25 % smaller in both coronaries in postmenopausal women aged 51–70 years compared to men. In the oldest postmenopausal group (≥70 years), plaque area reached the level of men. In the postmenopausal period, coronary stenosis in the left anterior descending (LAD) artery remained lower among women. ConclusionWe did not detect any major sex-difference in coronary atherosclerosis in the premenopausal period when women are considered to be protected from CHD. However, in line with CHD mortality statistics, postmenopausal women showed a slower speed of coronary atherosclerosis development compared to men.

Lipid changes during endocrine therapy in early-stage breast cancer patients: A real-world study

BackgroundEndocrine drugs may affect lipid metabolism in breast cancer (BC) patients. This study explores lipid changes in early-stage BC patients taking different endocrine drugs.MethodsThe changing trend of blood lipid during endocrine therapy in 2756 BC patients from January 2013 to December 2021 was retrospectively analyzed. The changes in four lipid parameters were assessed by the Generalized Linear Mixed Model, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C). These parameters were quantified at baseline and at 6, 12, 18, 24, 36, 48, 60, and 72 months after endocrine therapy initiation. Furthermore, a subgroup analysis according to menopausal status or medication types was conducted.ResultsA total of 1201 patients taking aromatase inhibitors (AIs), including anastrozole (ANA), letrozole (LET), or exemestane (EXE), and 1555 patients taking toremifene (TOR) were enrolled. TC and TG levels showed a significantly elevated trend during 5 years of treatment (P < 0.05). HDL-C levels increased from baseline in the TOR group (P < 0.05). Compared with the postmenopausal AI group, the increasing trends of TC, TG, and LDL-C in the premenopausal AI group were more evident with the extension of time (β = 0.105, 0.027, 0.086, respectively). Within 3 years, TC, TG, and LDL-C levels in the ANA and LET groups were significantly higher than baseline (P < 0.05). Moreover, the levels of TG in the EXE group were significantly lower than that in the ANA or LET group (P < 0.05), but this significant difference disappeared after 3 years.ConclusionsAIs significantly influenced lipid profiles more than TOR. AIs had a greater effect on blood lipids in premenopausal patients. Steroidal AIs (EXE) may affect lipid levels less than nonsteroidal AIs (ANA and LET).

Pelvic floor muscle strength and influencing factors based on vaginal manometry among healthy women at different life stages: A multicentre cross-sectional study.

To assess pelvic floor muscle (PFM) strength and influencing factors among healthy women at different life stages. Multicentre cross-sectional study. Fourteen hospitals in China. A total of 5040 healthy women allocated to the following groups (with 1680 women per group): premenopausal nulliparous, premenopausal parous and postmenopausal. The PFM strength was evaluated by vaginal manometry. Multivariate logistic regression was used to determine the influencing factors for low PFM strength. Maximum voluntary contraction pressure (MVCP). The median MVCP values were 36, 35 and 35 cmH2O in premenopausal nulliparous (aged 19-51 years), premenopausal parous (aged 22-61 years), and postmenopausal (aged 40-86 years) women, respectively. In the premenopausal nulliparous group, physical work (odds ratio, OR 2.05) was the risk factor for low PFM strength, which may be related to the chronic increased abdominal pressure caused by physical work. In the premenopausal parous group, the number of vaginal deliveries (OR 1.28) and diabetes (OR 2.70) were risk factors for low PFM strength, whereas sexual intercourse (<2 times per week vs. none, OR 0.55; ≥2 times per week vs. none, OR 0.56) and PFM exercise (OR 0.50) may have protective effects. In the postmenopausal group, the number of vaginal deliveries (OR 1.32) and family history of pelvic organ prolapse (POP) (OR 1.83) were risk factors for low PFM strength. Physical work, vaginal delivery, diabetes and a family history of POP are all risk factors for low PFM strength, whereas PFM exercises and sexual life can have a protective effect. The importance of these factors varies at different stages of a woman's life.

Association of serum vitamin D, IL-6 levels, and bone mineral density in pre- and post-menopausal women suffering from osteoporosis before and after vitamin D3 supplementation therapy

Background: Estrogen deficiency and vitamin D deficiency simultaneously stimulate surge of cytokine production leads to increase osteoclastogenesis cause bone resorption. Treatment with vitamin D strongly stimulates calcium resorption and decreases bone turnover. Vitamin D also decreases interleukin-6 (IL-6) levels, which further decreases the activity of osteoclast, which helps in regaining bone mineral density (BMD). Aims and Objectives: To assess and evaluate the link between serum vitamin D levels, BMD, and IL-6 levels in osteoporotic pre- and post-menopausal women. Materials and Methods: Three categories are formed among 36 female patients within the age group 30–55 years with osteoporosis: Group-1: Patients within age group 30–40 years; Group-2: Pre-menopausal patients within age group 40–55 years; and Group-3: Postmenopausal patients within age group 40–55 years. Serum 25-hydroxy vitamin D levels, IL-6 levels, and BMD scans were also done at baseline (day 0) before vitamin D supplementation and after 6 months of oral vitamin D therapy. Results: The comparison between mean values of IL-6, serum 25-hydroxy vitamin D level, and BMD at baseline and at 24th week was highly significant for all three groups, which showed that the post-menopausal group, i.e., Group-3, had the lowest vitamin D levels and the lowest bone mass as compared to the pre-menopausal groups, i.e., Group-2 and Group-1. It was observed that mean values of 25-hydroxy vitamin D and BMD at the 24th week significantly increased and IL-6 values significantly decreased in all the women after 24 weeks of Vitamin D therapy. Conclusion: There is a straight link between vitamin D and BMD in post-menopausal women and an opposite correlation between vitamin D and IL-6.

Features of the clinical picture of affective disorders in women during the menopausal transition and early postmenopause

To determine the clinical and psychopathological features of affective disorders in women in the perimenopausal and early postmenopausal periods. The study included 90 female patients receiving inpatient psychiatric care for affective disorders, among them 41 patients were perimenopausal (group 1) and 49 were early postmenopausal (group 2). Clinical and psychopathological, psychometric (the Hospital Anxiety and Depression Scale - HADS, the Hamilton Depression and Anxiety Scales - HAM-D and HAM-A, the Hypomania Checklist-32 - HCL-32, the Bipolarity Index (BI), the Insomnia Severity Index - ISI, the Pittsburgh Sleep Quality Index - PSQI) and statistical methods were used. Symptoms of atypical (63.4%) and anxious (87.8%) depression predominated among perimenopausal patients, and melancholic depression (59.2%) prevailed in early postmenopause. Patients in group 1 had higher anxiety scores on HADS and HAM-A compared to group 2 (p=0.003 and p=0.01). At the same time, early postmenopausal women had higher depression scores on the HADS and HAM-D (p=0.001). ISI and PSQI scores in postmenopause were significantly higher than in perimenopause (p=0.001 and p=0.009). The clinical features of affective disorders as well as severity and nature of the accompanying sleep disturbances vary depending on the stage of menopause, which must be considered when prescribing additional methods for examination and treatment of these disorders.

Association of ABO/Rh Blood Group with Hypertension in Pre and Postmenopausal Libyan women

BACKGROUND AND AIM: Hypertension is a prevalent and significant public health issue worldwide, affecting a substantial portion of the population. While various risk factors have been implicated in the development of hypertension, including genetics, lifestyle, and hormonal changes, the role of ABO/Rh blood groups in hypertension remains underexplored, particularly in different stages of Libyan women’s life. This research study aimed to investigate the potential association between ABO/Rh blood groups and hypertension in both pre- and post-menopausal Libyan women. METHODOLOGY: A cross sectional study was conducted over a four-month period on a diverse cohort of women aged 35 to 75 years. It involved a total of 200 hypertensive women divided into pre- (n=100) and post-menopausal (n=100) groups. It took place at Tripoli University Hospital, Tajoura Heart Centre and Total Care Clinic. Data were collected through structured interviews, clinical examinations, and blood sample analyses. Blood pressure (BP) measurements and blood group typing were performed using standard medical procedures. A statistical analysis was performed using SPSS program version 26.0. RESULTS: The distribution of ABO blood groups shows that blood group O is the most prevalent blood group among samples (58% in the pre-menopausal and 41% in post-menopausal hypertensives), whereas blood group AB is the least prevalent (only 9% in the pre-menopausal and 7% in post-menopausal hypertensives). One hundred and eighty-one (90.5%) were Rh +ve. Analysis of data revealed significant differences in age distribution as well as in the percentages of Rh +ve and Rh -ve blood groups among pre- and post-menopausal women (p&lt;0.05). However, there was no statistically significant difference in the mean values of BP indices between ABO/Rh blood groups (p&gt;0.05).CONCLUSION: This study showed that ABO/Rh blood group system does not significantly affect BP indices among the pre-menopausal and post-menopausal women. Findings of present study also illustrated that age could potentially influence the connection between blood groups and hypertension. Additionally, among ABO/Rh blood groups, the most observed type was 'O.' However, further investigation is necessary to validate these initial results and better understand the underlying mechanisms behind this relationship

Chronic renal insufficiency can cause early anemia: A cross-sectional study

Background: Chronic renal insufficiency has emerged as a global health issue, causing significant morbidity and mortality. Anybody can develop anemia but it is very common in people with chronic kidney disease (CKD). Renal anemia develops as a result of CKD, and its prevalence rises as the disease progresses. The WHO defines anemia as a hemoglobin level &lt;13 gm/dl for males as well as women in the post-menopausal age group and ˂12 gm/dl for women in the pre-menopausal age group. Aim and Objectives: This study was done to assess whether a correlation exists between the grades of anemia and various stages of chronic renal insufficiency. Materials and Methods: The authors conducted a cross-sectional study involving 145 subjects with diabetes mellitus and CKD. The primary aim was to investigate the various grades of anemia in different stages of CKD patients. We classified the CKD patients into 5 stages based on GFR rates, as defined by guidelines of the national kidney foundation. Results: This study shows that out of 145 subjects having diabetic nephropathy with CKD, 59 subjects had mild anemia, 60 subjects had moderate anemia, and 26 subjects had severe anemia. Data were analyzed using the SPSS 16.0 version. The qualitative results were presented in frequency, percentages, and graphs. Baseline characteristic cases were compared with grades of anemia. For the correlation between two variables, Pearson and Spearman correlation coefficients were applied. The majority of patients with Grade 2 and Grade 3 CKD had mildto-moderate grades of anemia which worsened as the stage of CKD progressed and came out to be highly significant. Conclusion: This study concludes that anemia is a consistent finding in patients of CKD; the severity of anemia progresses as the kidney function is compromised.

Cervical carcinoma and diabetes mellitus among women in Southern India.

Cervical carcinoma is the second commonest malignancy among females worldwide. In India, about 365.71 million women aged over 15 years are more vulnerable to cervical carcinoma. Risk factors may include immunodeficiency diseases, herpes, smoking and oral contraceptives. Scientific literature has documented that type 2 diabetes mellitus (T2DM) could aggravate the risk of some malignancies (hepatic, pancreatic, endometrial). This study aimed to evaluate the potential association between cervical carcinoma and diabetes mellitus in women. Patients with cervical carcinoma, with or without diabetes, were assigned to two groups based on attainment of menopause. SPSS version 11.5 was used for data analysis. Odds ratios were calculated, and the chi-square test was used. P-values ≤ 0.05 were considered statistically significant. It was observed that 29% of patients with cervical cancer were sixty to seventy years old, with a majority (40%) of them being multiparous. Though the association of body mass index as a risk factor for diabetic patients with cervical carcinoma was not significant in pre- and post-menopausal age groups, T2DM in cervical carcinoma is a useful prognostic indicator. Diabetic females after attaining menopause have a higher risk of developing cervical carcinoma and therefore should mandatorily receive routine screening. Future research with a longer timeframe is needed in order to generalize the results.

Natural vs. Surgical Postmenopause and Psychological Symptoms Confound the Effect of Menopause on Executive Functioning Domains of Cognitive Experience.

The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study investigated whether potential confounders, including natural vs. surgical postmenopause and menopause-related psychological symptoms, influence whether executive dysfunction persists into postmenopause. A cross-sectional sample of women aged 35-65 years (N = 1971) in one of four groups, premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were surveyed. Participants self-reported executive functioning with the Brown Attention Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for Epidemiologic Studies Depression Scale (CES-D). We analyzed the association between group and BADDS scores using linear regression models - first, by controlling for age, education, and self-reported attention deficit hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling for current difficulty sleeping, anxiety, and depression (Model #2). In both models, BADDS scores were significantly elevated (indicating more difficulties in executive function) among women in the perimenopausal and surgical postmenopausal groups compared with those in the premenopausal group. Likewise, the perimenopausal and surgical postmenopausal groups had the highest proportions of participants who reported difficulty sleeping and clinical levels of anxiety and depression. BADDS scores were significantly higher in natural postmenopausal vs. premenopausal women without controlling for difficulty sleeping, anxiety, and depression (Model #1), but not when adjusting for these variables (Model #2). The type of menopause and psychological symptoms are important confounders of the relationship between the menopause transition and executive dysfunction, and help explain whether executive dysfunction persists or recovers in postmenopause.Reprinted from Maturitas 2023; 170:64-73, with permission from Elsevier. Copyright © 2023.