Postmenopausal Period Research Articles

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.

Oestrogen and Gastroesophageal Reflux Disease Dynamics in Premenopausal and Postmenopausal Women: A Cross-sectional Study

Introduction: Gastroesophageal Reflux Disease (GERD) is a common clinical disorder characterised by the reflux of stomach contents into the oesophagus, primarily due to the temporary relaxation of the Lower Oesophageal Sphincter (LES). The aetiology of GERD is multifactorial. The prevalence of GERD in females has been found to sharply increase throughout the postmenopausal period compared to the reproductive phase. Aim: To study the relationship between serum oestrogen levels in premenopausal and postmenopausal women with GERD. Materials and Methods: In this cross-sectional study, 60 patients with GERD were divided into 30 premenopausal and 30 postmenopausal groups. The study subjects underwent high-resolution oesophageal manometry. The Cobas e 411 immunoassay analyser was utilised to measure serum oestrogen levels through electrochemiluminescence. The independent, unpaired Student's t-test was employed to analyse the collected data. Results: The statistical analysis revealed that the mean reduced LES pressure of 9.76±3.80 mmHg and the mean reduced Oesophagogastric Junction Contractile Integral (EGJ-Cl) of 14.503±10.64 mmHg were lower in women with postmenopausal GERD who exhibited lower oestrogen levels compared to those with premenopausal GERD. An increase in LES pressure was also associated with an increase in EGJ-CI, demonstrating a statistically significant positive linear correlation between LES pressure and EGJ-CI. The p-value <0.05 was deemed highly statistically significant. Conclusion: Parameters such as basal LES pressure and EGJCl were observed to be reduced in postmenopausal women with GERD who had low oestrogen levels. This study suggests that oestrogen plays a crucial role in safeguarding the oesophageal epithelium against the reflux of gastric contents.

Psychophysical Problems of Peri– and Postmenopausal Women – an Urgent Public Health Challenge

The peri – and postmenopausal period is one-third of the average woman’s life. Despite its physiological nature, it is usually associated with a number of ailments that consequently weaken a woman’s psychophysical condition. The emergence of disorders in the psychological and somatic spheres can make it more difficult among women to perform social, domestic and professional functions, including those falling under labour law. The appearance of symptoms of anxiety and depression is much more common among women than men, and the duration of the COVID-19 epidemic has exacerbated health problems, often causing new difficulties especially in the aspect of mental health of postmenopausal women, creating a new and urgent challenge for state bodies responsible for prevention programs to create a comprehensive pilot project in this area of public health.

Using Maca (Lepidium Meyenii) to Treat Sexual Dysfunction in Menopausal Women: A Systematic Review

Background: With an increase in life expectancy and elderly population in the world, women experience a longer postmenopausal period and more menopausal symptoms. Maca belongs to the Cruciferous family and is cultivated in Peru. Maca plant is used to treat female sexual dysfunction. This systematic review aimed to determine the effects of maca on the treatment of sexual dysfunction during menopause.
 Methods: Key words lepidium meyenii, maca, lepidium meyenii and sexual dysfunction, lepidium meyenii and menopause, maca and sexual dysfunction, maca and menopause were searched in databases Web of Science, PubMed, Scopus, Cochrane and EBSCOhost and randomized controlled studies and quasi-experimental studies published in the English language between 2000 and 2022 were reviewed.
 Results: Three studies involving a total of 85 participants were reviewed. One study showed no effect of maca on sexual desire. However, another study revealed that it was effective in sexual desire. Maca was also reported to improve arousal and orgasm in another study.
 Conclusion: Although there are studies that the use of maca is effective in sexual dysfunctions; there is not enough data on how long this plant should be used, at what dose it can be given, and what the long-term results will be.

Advances in diagnosis and treatment of perimenopausal syndrome.

With the development and progress of society, people's average life expectancy has increased, and relevant literature reports that the number of postmenopausal women in China continues to increase. With lifespans extended, the transition period and post-menopause period have become the longest essential period in every woman's life. The life quality of women troubled by perimenopausal syndrome has been significantly reduced, which also places a burden on families and society. It is well known that hormone replacement therapy plays a vital role in improving women's menopause-related symptoms and is the most effective medical measure. With research ongoing into the treatment of menopausal symptoms in different patients, dose size, treatment duration, and medication regimens for hormones are still hot topics of discussion. This article reviews the definition, clinical diagnosis, staging, clinical manifestations, and treatment of menopause and explores the current diagnosis and treatment scenarios of perimenopausal syndrome.

Arthralgia in midlife Singaporean women: the Integrated Women’s Health Program (IWHP)

Objective Arthralgia is a common menopausal complaint in midlife women, and its causes remain unclear. We examined the prevalence of menopausal arthralgia with various factors including sleep quality, depression/anxiety, muscle strength and physical performance among midlife Singaporean women. Methods The Integrated Women’s Health Program (IWHP) comprised 1120 healthy, community-dwelling women of Chinese, Malay or Indian ethnicities (aged 45–69 years) attending well-women clinics at the National University Hospital, Singapore. Sociodemographic, menopausal, reproductive and health data were obtained with validated questionnaires. Muscle strength, physical performance and dual-energy X-ray absorptiometry were measured. Women with moderate to very severe symptoms using the Menopause Rating Scale were classified as having arthralgia. Multivariable logistic regression analyses examined risk factors for arthralgia. Results One-third of the participants reported arthralgia, and 12.7%, 16.2% and 71.2% were in the premenopausal, perimenopausal and postmenopausal period, respectively. Menopausal symptoms, such as vaginal dryness (adjusted odds ratio [aOR]: 2.64, 95% confidence interval [CI]: 1.64, 4.24) and physical/mental exhaustion (aOR: 2.83, 95% CI: 1.79, 4.47), were independent risk factors for arthralgia. Poor muscle strength (aOR: 2.20, 95% CI: 1.29, 3.76), obesity (aOR: 1.94, 95% CI: 1.13, 3.32) and rheumatoid arthritis (aOR: 7.73, 95% CI: 4.47, 13.36) were also independently associated with arthralgia after adjustment for confounders. Conclusions Arthralgia in midlife Singaporean women was associated with menopausal symptoms of vaginal dryness and physical and mental exhaustion. Women with poor muscle strength were more likely to experience menopausal arthralgia.

Aged and induced-premature ovarian failure mouse models affect diestrus profile and ovarian features

Sex hormones exert a wide influence on several systems of the human body, especially in women, who undergo intense changes in the trans and postmenopausal periods. Different experimental models are used to mimic these conditions; however, the impact on hormonal profile may be different. This study aimed to analyze and compare vaginal cytology of different post-estropausal mice models, along with their microscopical ovarian features. Forty-six C57BL/6J female mice with the ages of 4, 6 and 18 months at the beginning of the experiment, weighing about 25–28 grams, constituted five groups: NC–(negative control) animals with no treatment, OVX-SHAM—sham ovariectomized, OVX–ovariectomized, VCD–medicated with 160 mg/kg/day of 4-vinylcyclohexene diepoxide via IP for 20 consecutive days, and Aged–senescent mice under physiological estropause. Euthanasia was performed at different periods for the removal of the ovaries, and after diestrus was confirmed by vaginal cytology for 10 consecutive days. For daily vaginal cytology, morphological and histomorphometric microscopic analyzes were performed. Aged mice presented significant increased neutrophils when compared to VCD group, as well as increased cornified epithelial cells when compared to OVX mice, and also increased nucleated epithelial cells when compared to VCD and OVX. NC and OVX-SHAM ovaries presented innumerous follicles at different stages of development, while VCD showed marked follicular atresia, depleted of primordial or developing follicles and a predominance of interstitial cells. The ovaries of aged mice were predominantly constituted by corpus luteum degenerated into corpus albicans, with rare antral follicles. All analyzed models led to different permanent diestrus profiles caused by each model, as indicated by ovarian features. This should be carefully considered when choosing a post-estropausal experimental model, in order to better correlate this challenging phase of female’s life with physiological/pathological conditions.

Sexual experiences of postmenopausal women in China: a qualitative study.

Sexual dysfunction is common among postmenopausal women and can have a significant negative impact on quality of life. This study aimed to explore perceptions, experiences, and coping strategies related to sex among postmenopausal women in China. We used phenomenologic qualitative methods in this study. On the basis of purposive sampling and the data saturation principle, 21 volunteers from a community cohort study were selected for semistructured interviews. The data were analyzed and themes were extracted. Thematic codes pertaining to sexual experiences and coping strategies were defined and assessed in this study. Four themes and 12 subthemes were extracted from the interview data. The sexual concepts were relatively conservative for most of the Chinese women; the majority experienced physical and psychological distress with respect to sex, although negative and positive psychological experiences were described. The women often passively accepted and adapted to negative changes to their sex lives during the postmenopause period. This study highlights the importance of and need for effective dissemination of sexual health-related knowledge and the opening of appropriate communication channels. By using a qualitative approach, this study provides individuals with the opportunity to describe their cognition and attitudes toward sexuality. Limitations include limited generalizability, as is true for most qualitative research. Additionally, the study is based solely on the female perspective and cannot fully reflect the sex life of couples. The sexual experiences of our respondents exhibited distinct Chinese cultural characteristics. The interviews show the importance of paying attention to postmenopausal women's sexual health and providing relevant professional support and guidance to improve women's overall health-related quality of life.

Knowledge, Attitude, and Behavior Levels of Postmenopausal Women about Osteoporosis

Background: Osteoporosis can be delayed by providing accurate and adequate information to people at risk. Therefore, we aimed to determine the knowledge, attitude, and behavior levels of women in the postmenopausal period, which is the largest group at risk.Methods: The study was conducted in a tertiary Training and Research Hospital between 1 December 2018 and 1 May 2019 in 225 postmenopausal women who applied to the Family Medicine outpatient clinic and bone mineral density (BMD) outpatient clinics for BMD measurement or had previously had this measurement at least once. A questionnaire evaluating the knowledge, attitudes, and behavior levels related to osteoporosis was applied to all patients included in the study.Results: The mean age was 58.05±9.1 years. The median osteoporosis knowledge score was 7 out of 19 points. A total of 119 (52.9%) had low knowledge scores and 106 (47.1%) had higher knowledge scores. Of the individuals with high scores, 40 (37.7%) were smoking, 64 (60.4%) did not sunbathe, 89 (84%) did not consume the recommended daily amount of calcium, and 58 (54.7%) were not exercising in the recommended time. It was seen that those who were university graduates, who had previously learned about osteoporosis from a health professional, and who had a family history of osteoporosis had higher knowledge levels.Conclusions: Even in postmenopausal women who are aware that they are in the risk group and that they should have BMD, their knowledge, attitude, and behavior levels on osteoporosis were found to be quite low.

Bone density in patients with nonfunctional adrenal incidentaloma

Aims: Adrenal incidentalomas (AI) are adrenal masses that are detected incidentally in imaging studies performed for different reasons in people who do not have any complaints suggestive of adrenal gland disease. The overall prevalence, approximately just over 4%, increases with age. AI is detected in approximately 10% of people over the age of 70. In this context, we thought that CT imaging, which is already used in the diagnosis and follow-up of AI, can contribute to the evaluation of muscle and bone mass without creating additional costs. Methods: In this retrospective study, 39 patients who were followed up with NFAI by the endocrinology department and 30 healthy individuals with normal adrenal imaging in the abdominal CT examination as the control group were included. Patients with chronic diseases or drug use that may affect bone and muscle mass, and individuals in the postmenopausal period were excluded in this study. Endocrine tests performed to exclude autonomous cortisol secretion, pheochromocytoma and primary hyperaldosteronism; VMA and fractionated metanephrines in 24-hour urine, cortisol values after 1 mg dexamethasone suppression test, baseline serum dehydroepiandrosterone sulfate (DHEAS) levels and plasma aldosterone (ng/dl)/renin (ng/ml/hour) ratio were measured. Autonomous cortisol production was excluded in patients with serum cortisol below 1.8 mcg/dl after 1 mg dexamethasone suppression. Results: 39 patients with NFAI and 30 healthy volunteers participated in the study. In the NFAI group, 69.2% (n= 27) were female and 30.8% (n=12) were male. In the healthy control group 63.3% (n=19) of the people were female and 37.7% (n=11) were male. There was no statistically significant difference between the two groups in terms of gender (p=061). The mean age of the NFAI group is 43 and the mean age of the control group is 49, and there was no statistically significant difference in age between the two groups (p=0.06) Conclusion: No decrease was found in BMD and paravertebral muscle mass values in the measurements made at L1-3 vertebral level with CT in NAFI patients. Further studies are needed in a larger patient population where the results are evaluated together with the femur and vertebral BMD measurements by DXA method, and muscle strength and performance are evaluated in addition to muscle mass in terms of sarcopenia.

Urethral Prolapse in a Post-Menopausal Woman at the Sominé Dolo Hospital in Mopti (Mali)

Urethral mucosal prolapse is a rare and benign condition, which consists of a circular eversion of the distal urethral mucosa through the urinary meatus. It occurs most often in prepubertal and postmenopausal women for whom lack of estrogen and poor pelvic support remain the predisposing factors. Its presence in the post-menopausal period is rare. We report a case of urethral prolapse in a postmenopausal woman at the Sominé Dolo hospital in Mopti who presented with persistent urinary symptoms. We present a case of urethral prolapse observed in a 66-year-old woman referred to the urology consultation and who presented recurrent urinary symptoms with multiple treatments based on antibiotics and medicinal plants without success for a year. Physical examination noted a circular, non-reducible and non-painful swelling at the level of the urethral meatus with bleeding on contact, consistent with urethral prolapse. The option of surgical excision was discussed with the patient. The patient underwent surgery and the postoperative course was simple.

Severe mental illness and the perimenopause

Hormonal fluctuations in the perimenopause are associated with an array of physical and psychological symptoms. Those with pre-existing mental disorders may experience changes to their symptoms and response to treatment during the perimenopausal and postmenopausal periods and may also be at risk of poorer longer-term physical health outcomes in menopause. The transition towards menopause may be compounded by the oestradiol-suppressing effect of many psychotropics on the hypothalamopituitary–gonadal axis. A collaborative approach between primary care and secondary mental health services is an opportunity for proactive discussion of symptoms and support with management of the perimenopause. This may involve lifestyle measures and/or hormone replacement therapy, which can both lead to improvements in well-being and mental and physical health.

Effects of melatonin intake on depression and anxiety in postmenopausal women: a systematic review and meta-analysis of randomised controlled trials.

We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) evaluating the effects of melatonin intake on depression and anxiety in postmenopausal women. To identify RCTs examining the effect of melatonin supplementation on depression and anxiety scores in postmenopausal women, a comprehensive electronic search was conducted via the Cochrane Central Register of Controlled Trials, Science direct, Google Scholar, PubMed, Medline, Scopus and Web of Science databases using the keywords ("melatonin" OR "N-acetyl serotonin") AND ("menopause" OR "climacteric") AND ("depression" OR "anxiety"). The search strategy was applied to articles published between January 2000 and April 2023. The Cochrane tool was used to evaluate the bias risk in RCTs. For the meta-analysis, fixed effect models and random effect models were employed based on heterogeneity. Preferred Reporting Items for Systematic Reviews and Meta-Analysis in Our Study guidelines were followed. Five RCTs were included in the study, with a total sample size of 441 (experimental: 227 and control: 214). When the effect of melatonin use on depression in menopausal women was analysed, it was found that melatonin significantly reduced menopausal depression (SMD - 0.166, CI = - 0.288/ - 0.045, p < 0.05). When the effect of melatonin use on anxiety in postmenopausal women was analysed, it was found that melatonin significantly improved menopausal anxiety (SMD - 0.806, CI = 1.491/ - 0.120, p < 0.05). Melatonin is promising as a potential treatment to help depression and anxiety in the postmenopausal period. More high-quality studies are needed to determine their safety.

Effectiveness of lifestyle related interventions to improve quality of life among postmenopausal women in selected slums of Bhubaneswar: A community based quasi experimental study

BACKGROUND: Postmenopausal women considered as risk population, due to estrogen deficiency, 80% of women reduce physical and mental well-being in their menopausal years. Menopausal symptoms are not always reasons for any life-intimidating situations, but it disturbs quality of life (QoL) of middle-aged women. MATERIALS AND METHODS: This non-randomized control trial was conducted among slum women in the age group of 40 to 60 years who were in their postmenopausal period (within 5 years). Study group was intervened by lifestyle-related interventional module about concept of menopause, symptoms, health issues, dietary habit for reducing menopausal symptoms with a practical demonstration of yoga, exercises and pranayama, group and individual counseling to the participants. Independent t-test, paired t-test, Chi-squared test, and Fisher's exact test were analyzed by SPSS software version 28 licensed to the institute. RESULTS: The mean age of the participants was 51.02 ± 2.94 years ranging from 47 to 58 years. As per anthropometric and blood pressure measurements data, significant differences were found in weight (P &lt; 0.02), body mass index (P &lt; 0.001), waist/Hip Ratio (P &lt; 0.001), SBP (P &lt; 0.001) and DBP (P &lt; 0.001) between both the groups. Comparing the mean difference score of vasomotor, psychosocial, physical and sexual domains of the MENQOL questionnaire pre- and post-intervention found that, there was significant reduction of QoL score in study group. CONCLUSION: The lifestyle related interventions as an alternative therapy are safe, free from side effects, cost-effective and government program may be implemented for the betterment of the menopausal women.

Trabecular bone score, bone mineral density and fracture risk in women with rheumatoid arthritis (pilot study)

The aim – to assess bone mineral density (BMD) and microarchitecture, as well as the risk of fractures in postmenopausal women with rheumatoid arthritis (RA). Materials and methods: 95 postmenopausal women (mean age 62.3±8.1 years) with a confirmed RA were included. All patients underwent a questionnaire, clinical and laboratory examination, dual-energy X-ray absorptiometry (DXA) of the lumbar spine (L1–L4), proximal femur, and trabecular bone score (TBS) assessment. The 10-year probability of osteoporotic fracture was calculated using the FRAX tool without including femoral neck (FN) BMD (BMD–), with FN BMD (BMD +) and additionally adjustment for TBS (BMD + TBS). Results. Osteoporosis (OP) was found in 41 (43.2%) patients: in L1–L4 – in 26,3%, in FN – in 22.1%, and in the total hip (TH) – in 11.6% persons. Degraded microarchitecture according to TBS was found in 38.9% of patients, partially degraded – in 25.3%, and normal – in 35.8% of women with RA. A high risk of fracture according to FRAX BMD– was detected in 49.5% of patients. TBS correlated with age (r=–0.30; p=0.003), duration of postmenopausal period (r=–0.26; p=0.014), cumulative dose of glucocorticoids (GCs) (r=–0.34; p=0.045), FRAX BMD– (r=–0.24; p&lt;0.05) and FRAX BMD+ (r=–0.21; p&lt;0.05); L1–L4 BMD (r=0.43; p&lt;0.001), FN BMD (r=0.21; p=0.038), TH BMD (r=0.23; p=0.02). Low TBS was significantly more often detected in people with a history of fractures compared to people without them (p&lt;0.05). Among RA patients with normal L1–L4 BMD 9.5% of persons had degraded microarchitecture of bone tissue according to TBS. The inclusion of TBS in FRAX increased the risk of fractures to high in 9.5% of patients and reduced it to low in 7.4% of women, due to which the total number of people with RA who had a high risk of fractures became 54.7%. Conclusion. OP was diagnosed in 43.2%, and degraded microarchitecture of bone tissue according to TBS – in 38.9% of postmenopausal women with RA. A high risk of fractures according to FRAX was found in 49.5%. TBS negatively correlated with age, duration of postmenopause, cumulative GCs dose, FRAX fracture risk, and positively correlated with BMD in all measurement sites. The FRAX adjustment by TBS redistributed patients in risk groups, as a result of which 54.7% of RA patients needed anti-osteoporotic treatment.

Up-regulation of plasma miRNA-21 and miRNA-422a in postmenopausal osteoporosis.

Many researchers focused on diverse miRNAs in the progression of osteoporosis in postmenopausal women. This study aimed to evaluate the association between plasma miRNA-21-5p and miRNA-422a with osteoporosis in postmenopausal women. This cross-sectional comparative study was performed on 126 randomly selected postmenopausal women aged 50-65, including 65 osteoporotic and 61 normal-bone mineral density (BMD) women. miRNA-21 and miRNA-422a were identified using qRT-PCR in these women. BMD was evaluated by the dual-energy X-ray absorptiometry method. A binary logistic regression model adjusted for confounders was used to evaluate the associations between plasma miRNAs' expression levels and osteoporosis. The Area Under Curve (AUC) was calculated to differentiate low BMD in the postmenopausal period using Receiver-Operator Characteristic (ROC) curves. miRNA-21 and miRNA-422a were significantly up-regulated in osteoporotic compared to non-osteoporotic postmenopausal women. The expression levels of miRNA-21 and miRNA-422a indicated a significant reverse correlation with both lumbar spine and femoral neck density. After adjusting the confounders, the likelihood of osteoporosis in the postmenopausal women with under the median plasma levels of miRNA-21 (OR = 0.025; 95% CI: 0.003 to 0.198, p<0.001) and miRNA-422a (OR = 0.037; 95% CI: 0.007 to 0.211, p<0.001) was significantly less than the women with the levels above the median. There were significant inverse correlations between miRNA-21 (p<0.001, r = -0.511) and miRNA-422a (p<0.001, r = -0.682) with BMD-lumbar spine as well as an inverse correlation between miRNA-21(p<0.001, r = -0.374) and miRNA-422a (p<0.001, r = -0.602) with BMD-femoral neck. The AUC (95%CI) for miRNA-21 and miRNA-422a was 0.84 (0.77 to 0.91) and 0.98 (0.96 to 0.99), respectively. ROC analysis illustrated that sensitivity and specificity values were 83.1% and 74%, respectively, for miRNA-21 at the cut-off point of 3.38. Also, at the cut-off point of 2.86, a sensitivity of 94% as well as a specificity of 89% was determined for miRNA-422a. This study indicated that the odds of osteoporosis in postmenopausal women increased with the higher expression of plasma miRNA-21 and miRNA-422a.

Arterial hypertension and stiffness in women of different age groups and reproductive status

Objective: study of the relationship between arterial hypertension and arterial stiffness in women to identify potential markers of target organ damage and therapeutic targets of antihypertensive therapy.Materials and methods: the study involved 161 women who were divided into three groups depending on age and reproductive function. Group 1 consisted of 52 women aged 18 to 30; group 2 – 54 women aged 31 years before menopause; 3rd group – 55 women in the postmenopausal period. All women were questioned, clinical examination, determination of anthropometric data, measurement of carotid-femoral pulse wave velocity, determination of arterial stiffness by volumetric sphygmography, 24-hour blood pressure monitoring with assessment of aortic stiffness and characteristics of the central pulse wave.Results: 24-hour blood pressure monitoring revealed arterial hypertension in 38 (34,8%) women: 15 (27,8%) women in the 2nd group and 23 (41,8%) women in the 3rd group. Correlation analysis revealed the most significant correlations between the presence of arterial hypertension (R=0,45-0,71; p&lt;&lt;0,01) with central aortic pressure, double product index and average daily aortic pulse wave velocity in the aorta (PWVao), regardless of the state reproductive function. For women of reproductive age with arterial hypertension, the ambulatory vascular stiffness index (AASI: R=0,36; p=0,01) is more significant, while in the menopausal period, the arterial stiffness index (ASI: R=0,33; p=0,01). Correlation analysis did not reveal significant relationships between carotid-femoral pulse wave velocity and cardio-ankle vascular index (CAVI) with arterial hypertension in women of the 2nd and 3rd groups. The relationship between carotid-femoral pulse wave velocity and arterial hypertension in women was confirmed by analysis of variance (p=0,007).Conclusion: Central aortic pressure, carotid-femoral pulse wave velocity, AASI, ASI, PWVao – direct and indirect indicators of arterial stiffness – are interconnected with the presence of arterial hypertension in women of reproductive and menopausal age. In this regard, these indicators are potential markers of target organ damage in arterial hypertension.

FEATURES OF MENOPAUSE MANAGEMENT AS AN AGING PREVENTION (review article)

Menopause is a physiological transition period in a woman’s life from the reproductive phase with regular ovulatory cycles and corresponding cyclic changes in the reproductive system to the postmenopausal state. The modern concept of female reproductive aging is to recognize the leading role of depletion of the ovarian follicular apparatus. Climacteric syndrome (CS) is the earliest and most common complication of the menopausal period. Most of the pathological manifestations that occur during peri- and postmenopausal periods are associated with an estrogen deficiency state and are subject to correction by hormone replacement therapy (HRT). In addition, in postmenopause the frequency of many diseases that reflect the biological aging of the body increases. Therefore, in order to develop optimal HRT regimens and understand the role of a rational lifestyle in the correction of these manifestations, it is necessary to consider the evolution of views on the menopause in general and HRT in particular. Until now, there has been no consensus regarding the tactics of a differentiated approach when prescribing HRT, taking into account existing systemic disorders in women with a history of “diseases of civilization.” Individualization of HRT in patients with a history of impaired reproductive function should be determined not only by the clinical variability of the manifestations of CS, but also taking into account the presence of extragenital pathology, which requires the implementation of our proposed diagnostic algorithm and the basis for the development of such a HRT strategy.

Diet and Depression during Peri- and Post-Menopause: A Scoping Review Protocol.

The aim of the proposed scoping review is to describe and summarize studies assessing the associations between diet-related variables and depression in peri- and post-menopausal women. Studies examining the associations between diet-related variables and mental health indicators in women undergoing menopausal transition or in the post-menopausal period will be systematically retrieved via Medline, EMBASE, PsycINFO, Web of Science, and Scopus databases. All articles identified through the database searches will be imported into Covidence. Following the removal of duplicates, two authors will independently perform title and abstract screening, as well as full-text assessment against eligibility criteria. Data will be extracted using tables developed for observational and experimental studies. The methodological quality of randomized trials, cohort and cross-sectional studies, and case-control studies, will be assessed using the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case-Control studies, respectively. Data extraction tables will be used to produce two tables summarizing the main characteristics and findings of the studies included in the review. In the proposed review, we will systematically identify and summarize the currently available evidence on the association between diet-related variables and depression in peri- and post-menopausal women. To our knowledge, this is the first review focusing on this subgroup of the population. Protocol registration: osf.io/b89r6.

Effect of Home-based Aerobic Exercise on Leukocyte TERT Gene Expression Without Altering DNA Oxidative Damage in Postmenopausal Women

Objectives: In middle-aged women, the postmenopausal period is associated with increased oxidative, inflammatory, and psychological stress. We intend to investigate the effect of home-based aerobic exercise (HAE) on serum levels of 8-hydroxy-2’-deoxyguanosine (8-C) and the expression of telomerase reverse transcriptase (TERT) in leukocytes of postmenopausal women. Methods: A total of 20 sedentary postmenopausal women who had at least 12 months passed since their last menstruation participated in the study voluntarily. Their Mean±SD age, height, weight, and body mass index (BMI) were respectively 52.4±3.8 years, 161.4±3.7 cm, 74.4±6.8 kg, and 28.6±3.4 kg/m2 . They were randomly divided into two groups: Home-based aerobic exercise (HAE, n=10) and inactive control (CON, n=10). HAE group undertook 4 weeks of home-based aerobic exercise (4 d/wk, intensity: 70%-80% maximal heart rate) with online supervision. Participants’ weight and fasting blood samples (12-h fasting state) were measured and taken before and 48 hours after the intervention. TERT expression in blood leukocytes and serum levels of 8-OHDG were assessed by real-time PCR and ELISA methods, respectively. The collected data were analyzed using mixed (2×2) repeated measure ANOVA and independent samples t-test in SPSS software. A significance level of P&lt;0.05 was considered for all tests. Results: The findings showed that 4 weeks of HAE increased TERT expression significantly compared to the CON (ES=0.40, P&lt;0.05). Although 8-OHDG serum level in the HAE group increased following training compared to pre-training (P&lt;0.05), no significant difference was observed between the CON and HAE groups (P&gt;0.05). Also, the interaction effect on 8-OHDG was not significant (ES=0.11, P&gt;0.05). In addition, after 4 weeks of HAE, body weight and BMI significantly decreased in the training group compared to the control (P&lt;0.05). Discussion: According to these findings, HEA effectively reduces telomere erosion and improves weight control in postmenopausal women.