Pre-and Postmenopausal Women Research Articles

The effect of Ramadan intermittent fasting on anthropometric, hormonal, metabolic, inflammatory, and oxidative stress markers in pre-and post-menopausal women: a prospective cohort of Saudi women

BackgroundThe menopausal transition significantly affects cardiometabolic health, primarily due to changes in reproductive hormones, particularly decreased estrogen levels and relative androgen excess. Adult Muslim women, both pre-and post-menopausal, are mandated to observe Ramadan intermittent fasting (RIF) every year. Therefore, the current study was designed to investigate RIF’s effects on pre-menopausal (PRE-M) and post-menopausal (POST-M) healthy women’s cardiometabolic health markers. This study further evaluated the relationship between tested markers and the participant’s basic variables, such as BMI and body fatness. Due to differences in physiological and metabolic biomarkers between groups, RIF is likely to impact PRE-M and POST-M women differently.MethodsThis study included 62 healthy women (31 PRE-M, aged 21–42 years, and 31 POST-M, aged 43–68 years) who observed RIF. Anthropometrics, sex hormones, lipid profile, pro-inflammatory (TNF-α), anti-inflammatory (IL-10) cytokines, the oxidative stress markers malondialdehyde (MDA), total antioxidant capacity (TAC), superoxide dismutase (SOD), glutathione peroxidase (GPx), and aging biomarker insulin-like growth factor-1 (IGF-1); all were tested 1 week before and at the fourth week of Ramadan.ResultsBody weight, BMI, waist circumference, body fat percentage (BFP), fat mass, fat mass index, triglycerides, and diastolic blood pressure significantly (p < 0.05) decreased at the end of Ramadan in both groups in comparison to the pre-fasting period. Contrarily, HDL, SOD, GPx, and IL-10 significantly (p < 0.05) increased in both groups. Estrogen levels significantly (p < 0.05) decreased in PRE-M women, whereas significantly (p < 0.05) increased in POST-M women. The progesterone levels, TAC, MDA, and IGF-1 remained unchanged in both groups. TNF-α significantly decreased in both groups, but the magnitude of reduction was higher in PRE-M women. Sex hormones and some metabolic biomarkers, especially in POST-M women, variably exhibited positive or negative relationships to BMI and BFP. RIF may influence the levels of estrogen, TNF-α, and IL-10 through improvements in metabolic health, reductions in body fat, activation of autophagy, modulation of immune responses, and changes in hormonal regulation.ConclusionThe RIF was generally associated with improved anthropometric, metabolic, inflammatory, and oxidative stress markers in both PRE-M and POST-M healthy women. Adhering to healthy dietary and lifestyle guidelines by pre-and post-menopausal women during Ramadan may foster the health benefits gained.

Alcohol consumption trajectories and risk of breast cancer among postmenopausal women: a Danish cohort study.

Alcohol consumption is a risk factor for breast cancer (BC), yet little is known about longitudinal alcohol consumption patterns and risk of BC. This study aimed to investigate whether trajectory profiles of alcohol consumption across adulthood were associated with risk of first primary malignant BC in postmenopausal women. At baseline, 28,720 pre-and postmenopausal women aged 50-65 years from the Danish Diet, Cancer and Health Cohort reported their average alcohol intake over the past 12 months and their average alcohol intake at the ages of 20, 30, 40, and 50 years. Alcohol consumption trajectories were estimated using latent class mixed models. BC cases were identified through record linkage to the Danish Cancer Registry. To examine associations between alcohol consumption trajectories and BC, we fitted a proportional hazard model adjusted for potential confounding factors using data from 24,543 postmenopausal women without missing covariate information. We identified 4 alcohol consumption trajectory profiles. During a median follow-up of 16.5 years, 1,591 cases of BC occurred. A mean alcohol consumption trajectory of > 10g/day was associated with higher risk of BC (HR: 1.65, 95%CI: 1.35-2.03) compared to a mean alcohol consumption trajectory of < 6g/day. We found no association between trajectory profiles characterized by lower alcohol intakes in early adulthood followed by increasing consumption of alcohol in adulthood compared to a consistently low intake of alcohol. Postmenopausal women drinking consistently high amounts of alcohol throughout adulthood had a higher risk of BC compared to women with a consistently low intake of alcohol.

Retrospective Investigator-Initiated Trial on Tocopherol Acetate Vaginal Administration in Pre-and Postmenopausal Women.

Menopause, a natural phase in a woman's life, often adversely affects physical, mental, sexual, and emotional well-being due to low estrogen levels. This study examines the impact of vaginal ovules with tocopherol acetate (Filme Gyno-V® ovules, manufactured by Panin Srl and distributed by Hulka Srl, Italy), 500 mg per ovule, on vaginal health in pre- and menopausal women. Fifty women aged 50-70 were divided into menopausal (28) and premenopausal (22) cohorts and treated with the ovules for two weeks, with assessments before and after treatment. The findings showed that distressing symptoms of vaginal atrophy, such as dryness, itching, and pain during intercourse, were resolved post-treatment. A molecular analysis revealed a reduction in Escherichia coli in both cohorts and an increase in three species of Lactobacillus in premenopausal patients. This study concludes that Filme Gyno-V ovules may benefit vaginal health by alleviating atrophy symptoms and promoting healthy vaginal microbiota.

Strut and radio-morphometric analysis of mandibular trabecular structure in pre-and post-menopausal women to aid in the diagnosis of osteoporosis

PurposeThe purpose of the study is to evaluate the mandibular trabecular pattern in pre- and postmenopausal age women. By analysing the strut, fractal, grey level co-occurrence matrix, and radio-morphometric indices in the panoramic radiograph. MethodPanoramic radiographs from 2019 to 2022 were used to assess pre- and postmenopausal women's bone mineral density. A total of 272 panoramic radiographs, which exhibited clear visibility of the mental foramen on both sides without any blurring, motion artefacts, surgical errors, overlapping hyoid bone, or inferior mandibular cortex, were divided into two groups. Group A (136 premenopausal women) and Group B (136 postmenopausal women). It is a retrospective study that is non-interventional/observational in design. Strut features, fractal dimensions, a grey-level co-occurrence matrix, and radio morphometric indices were used to investigate bone texture in an image processing program. The mean difference between group variables was calculated using an independent sample t-test/unpaired t-test. ResultsPre-menopausal women had a mean age of 38.83 ± 6.01 years, while postmenopausal women had a mean age of 68.26 ± 8.31 In the postmenopausal group Four regions of interest exhibited fractal dimensions with a P value of less than 0.01 and GLCM features including contrast (0.812), correlation (0.230), energy (0.215), and homogeneity (0.322). Strut features of the four regions showed that 15 of 19 characteristics were significantly different. ConclusionOrthopantomogram is useful in screening for osteoporosis. Strut, radio-morphometric indices, and fractal analysis can assess bone texture and quality. Future research incorporating artificial intelligence can revolutionize image analysis and support clinical decision-making.

Comparison of Inflammatory Markers in Pre and Post-Menopausal Women During First and Second Waves of COVID-19

Background The COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 SARS-CoV-2 has had profound global effect. Certain populations including post-menopausal women have shown increased susceptibility to severe outcomes. This study explored the association between menopausal status and COVID-19 outcomes focusing on inflammatory markers. Elevated markers like Interleukin-6 IL-6 ferritin and C-Reactive Protein CRP have been linked to severe COVID-19 and could be influenced by hormonal changes during menopause.Methodology Data from Abhaya Hospital in Bengaluru Karnataka covering the period between March 2020 and September 2021 were analyzed retrospectively. Pre-and post-menopausal women aged 12 years and above who tested positive for COVID-19 via RTPCR were included. Inflammatory markers IL-6 ferritin Erythrocyte Sedimentation Rate ESR C-Reactive Protein CRP Creatine Phosphokinase CPK Lactate Dehydrogenase LDH D-Dimer were compared between the two groups using appropriate laboratory methods. Statistical analysis was conducted using SPSS version 19.Results Post-menopausal women exhibited significantly higher levels of IL-6 P0.03 ferritin P0.034 and CRP P0.004 compared to pre-menopausal women during both waves of COVID-19. ESR showed a notable increase P0.1 in post-menopausal women although not statistically significant. No significant differences were observed in CPK P0.07 LDH P0.2 or D-Dimer P0.12 levels between the two groups.Conclusion The study revealed that post-menopausal women have a pro-inflammatory profile characterized by elevated IL-6 ferritin and CRP levels which are associated with severe COVID-19 outcomes. These findings underscore the importance of considering menopausal status in COVID-19 management and highlight the need for personalized healthcare strategies for this vulnerable group. Further research should investigate underlying mechanisms and potential interventions.

Dietary quality index and the risk of breast cancer: a case-control study

BackgroundDiet quality is a significant determinant in the etiology of breast cancer (BrCa), but further studies are required to explore this relationship. Therefore, we tried to assess if diet quality, assessed using the Diet Quality Index-International (DQI-I), was related to BrCa among the Iranian population.MethodsIn the present case-control research, 134 women with a recent diagnosis of BrCa and 267 without BrCa were selected as case and control groups. Individual food intake data from a food frequency questionnaire was used to compute DQI-I. Also, the multivariable logistic regression models were utilized to evaluate the association between DQI-I and BrCa odds .ResultsWe found a significant association between the last tertile of DQI-I and BrCa odds in the fully adjusted model (odds ratio (OR) = 0.30; 95% confidence interval (CI): 0.15–0.56). The subgroup analysis based on menopausal status also showed a significant decrease in BrCa odds in pre-and post-menopausal women (pre-menopausal: OR = 0.27; 95% CI: 0.10–0.70 – post-menopausal status: OR = 0.35; 95% CI: 0.13–0.92).ConclusionsOur findings indicated that a higher DQI-I score was related to a lower chance of BrCa. According to our research, a healthy diet pattern is crucial for BrCa prevention.

(036) Characterizing flibanserin’s safety profile among postmenopausal women with HSDD: An Exploratory Analysis

Abstract Introduction Flibanserin is approved in the United States (US) for premenopausal women and in Canada for pre and naturally postmenopausal women, ≤60 years of age, to treat acquired, generalized hypoactive sexual desire disorder (HSDD). Clinical trials suggest that flibanserin's safety profile is similar among pre-and postmenopausal women. During a Phase 3 postmenopausal study, the most frequently reported adverse events (AEs) were dizziness (10%), somnolence (9%), nausea (8%), and headache (6%). This study explores postmarketing AEs received from postmenopausal women and their clinicians during flibanserin treatment. Objective The primary objective of this safety study is to further characterize flibanserin's safety profile among postmenopausal women with HSDD treated in a clinical setting. Methods This study is a retrospective exploratory analysis of AEs captured in a global safety database (August 15, 2015, to May 12, 2022). The database was queried for US reports of AEs in postmenopausal women using the Medical Dictionary for Regulatory Activities Search Strategy Version 21.1. Preferred Term (PT) “Product use in unapproved indication.” This PT was selected as postmenopausal use is an unapproved indication in the US. Reports were filtered to identify and exclude non-postmenopausal unapproved usages, such as use in males and premenopausal women with non-HSDD conditions. All reports stating postmenopausal use are included in this analysis. If reproductive status was not specified, age was used as an indicator. If age was unknown, the report was excluded. The age range used in this study was 51-75 years. Adverse events were categorized using PTs, and descriptive statistics were used to summarize the results. Dispensing data from a sample of 30,000 scripts filled over the past year at one pharmacy were used to estimate the percentage of flibanserin prescriptions filled by women ages &amp;gt;50 years. No incidence data were calculated as AE reporting is voluntary and true exposure is unknown. Results We identified 195 unique reports of postmenopausal use with at least one AE during the study period. There were 656 reported AEs, 16 (2.4%) were serious, and no fatalities. Adverse events occurring in ≥5 postmenopausal women excluding events not related to a body system are summarized in the Figure. Approximately 18% of scripts filled over the past year at one pharmacy were for women ages &amp;gt;50 years. It is important to acknowledge that this pharmacy’s findings may not represent all pharmacies. Conclusions The postmarketing safety profile of flibanserin among postmenopausal women is similar to that observed with premenopausal women and during clinical trials. Excluding PTs not related to a body system such as unapproved use and drug ineffective, the most frequently reported postmarketing AEs included dizziness, nausea, and insomnia. No safety signals specific to postmenopausal women have been identified to date. Although informative, the lack of information on medical history, concomitant medications, and other potential interacting products limit the ability to make inferences on causality in most reported cases. Disclosure Yes, this is sponsored by industry/sponsor: Sprout Pharmaceuticals, Inc Clarification: Industry initiated, executed and funded study Any of the authors act as a consultant, employee or shareholder of an industry for: Sprout Pharmaceuticals, Inc.

Vaginal and urinary evaluation of lactobacilli quantification by qPCR: Identifying factors that influence urinary detection and the quantity of Lactobacillus.

Vaginal colonization with lactobacilli has been linked to the health of the lower urinary tract in women. There is growing evidence that the bladder has its microbiome related closely to the vagina. In this study, we compared the three common vaginal Lactobacillus species (L. jensenii, L. iners and L. crispatus) in vaginal and urine samples to identify factors that influence urinary detection and the quantity of Lactobacillus. We used quantitative real-time PCR (qPCR) assays to measure the concentration of Lactobacillus jensenii, L. iners and L. crispatus in paired vaginal swabs and clean-catch urine samples from pre-and post-menopausal women. We compared demographic variables and vaginal Lactobacillus quantity between women with vaginal detection of at least one of the three species, detection in both vagina and urine, or urine only. We performed Spearman correlation between vaginal and urinary quantities of each species. We used multivariable logistic regression models to determine predictors of detectable Lactobacillus species in both samples (vs. vagina only or urine only). Models were adjusted for variables selected a priori: age, BMI, condom use, and recent sexual activity. Ninety-three paired vaginal fluid, and urine samples were included in the final analysis. 44 (47%) had no detectable Lactobacillus species in their urine samples, and 49 (53%) had at least one of the three Lactobacillus species (L. jensenii, L. iners and L. crispatus) detected in urine. Most women were white (91.4%), with a mean age of 39.8 ±13.8 years. The two groups were similar in demographics, gynecologic history, sexual history, recent use of antibiotics or probiotics within 7 days of sample collection, Nugent scores, and urine-specific gravity. Among the three Lactobacillus species, L. jensenii was more commonly detected in urine than the other two. For all three species, detection in the urine sample alone was infrequent. The concentrations of all three species were higher in vaginal samples than in urine samples. For all three Lactobacillus spp., vaginal abundance was associated with the urinary abundance of the same species even after adjusting for the Nugent score. In Spearman correlation analysis, urinary and vaginal Lactobacillus concentrations were positively correlated within the same species, with the most significant correlation coefficient for L. jensenii (R = 0.43, p<0.0001). Vaginal quantities were positively correlated between the three species, as were urinary quantities to a lesser extent. There was no meaningful correlation between the urinary quantity of one Lactobacillus sp. and the vaginal quantity of another species. In summary, the vaginal quantity of Lactobacillus was the most significant predictor of concurrent detection of the same species in the bladder, confirming the close relationship between these environments. Strategies to promote vaginal Lactobacillus colonization may also bring urinary colonization and the health of the lower urinary tract.

Comparison of intraocular pressure and retinal nerve fibre layer thickness in pre-menopausal and post-menopausal women attending outpatient department of BSMMU

In a menopausal lady, a reduced level of estrogen hormone leads to changes in the intraocular pressure (IOP) and retinal nerve fiber layer (RNFL) thickness in the eyes. This comparative study was carried out in the Outpatient Departments (OPD) of the Community Ophthalmology and Ophthalmology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from April 2017 to June 2019 to identify any difference in IOP and RNFL thickness in pre-menopausal and post-menopausal women aged 40-65 years. In this study, 60 pre-and post-menopausal women were included. Participants 40-50 years old with irregular menstruation were classified as group A, while those 51-65 years old with no menstruation for at least 12 months were classified as group B. More than one-fourth (26.7%) of participants had HTN in group A and 53.3% in group B. HTN was significantly associated with group B. The rise in menopausal age had a significant impact on the mean IOP and RNFL. The mean IOP in right eye (RE) was 11.80 (3.31) mm of Hg in Group A and 15.63 (3.01) mm of Hg in Group B. The mean IOP in left eye (LE) was 12.27(3.78) mm of Hg and 15.47(2.84) mm of Hg in Group A and Group B, respectively. The mean IOP of both eyes was 12.03±3.48 mmHg in Group A and 15.55±2.82 mmHg in Group B. The mean difference of IOP in RE, LE and both were statistically significant between the two groups. The mean RNFL in RE was 103.97±7.42 μm in Group A and 98.90±}6.21 μm in Group B. The mean RNFL in LE was 101.87±6.69 μm and 97.97±6.65 μm in Group A and Group B, respectively. The mean RNFL of both eyes was 102.92±7.77 μm in Group A and 98.45±7.86 μm in Group B. The mean RNFL was statistically significant between the two groups. Post-menopausal women are at an increased risk of developing elevated IOP and thin RNFL than premenopausal women. BSMMU J 2022; 15(2): 61-64

Assessment of clinical and psychological parameters in pre- and post-menopausal women

Background: Literature evidence on periodontal disease-associated microorganism in pre-and postmenopausal women suggest a complicated relationship between steroid hormones, periodontal tissues, and microorganism. Aim: The objective of the study was to assess and contrast the periodontal health condition and quality of life (QoL) of pre-and postmenopausal women. Materials and Methods: 100 patients were divided into four groups, i.e., healthy pre-menopausal, periodontitis pre-menopausal, healthy post-menopausal, and periodontitis post-menopausal. Periodontal parameters such as Gingival Index (GI), Plaque Index (PI), Probing Pocket Depth, Clinical attachment levels, Simplified Oral hygiene index, and a Utian QoL questionnaire were filled by the patients. The differences between three groups were analyzed using a one-way ANOVA test at baseline and 3 months, followed by a post hoc Tukey test. Results: The PI, GI, and Simplified Oral Hygiene Index levels were significantly different between healthy premenopausal and postmenopausal subjects. QoL scores were compared between the healthy premenopausal and healthy postmenopausal subjects, among which no statistically significant difference was found with P = 0.705 when compared between the positive questions score and P = 0.730 when compared between the negative questions score of the two groups. Conclusion: This study shows that there is no relation between menopause and QoL in women with periodontitis before and after menopause.

Interactions between heavy metals and sleep duration among pre-and postmenopausal women: A current approach to molecular mechanisms involved

The effects of heavy metals (cadmium, lead, and mercury) and their mixtures on sleep duration in pre-and postmenopausal women, particularly the molecular mechanisms, remain unknown. Here, we assessed the interaction between heavy metals and sleep duration among pre-and postmenopausal women (n = 1134). Furthermore, molecular mechanisms related to sleep disorders induced by studied heavy metals were further analyzed to support the previous findings. We found that serum lead levels were positively related to weekend and weekday sleep duration in premenopausal women. There were interactions between serum lead and mercury and menopausal status for sleep duration. Serum lead and mercury levels were shown to be inversely related to sleep duration in postmenopausal women. Despite the lack of statistically significant associations between mixed heavy metals and sleep duration, there were increasing trends in premenopausal women's sleeping patterns and decreasing trends in postmenopausal women's sleeping patterns. In silico analysis, IL1B, hsa-21-5p, hsa-887-3p, hsa-877-3p, and NR4A1 were identified as the most relevant genes, miRNAs, and transcription factors linked with sleep disorders induced by combined heavy metals (cadmium, lead, and mercury). Furthermore, “type 1 melanocortin receptor binding,” “endocrine hormone secretion,” “interleukin-1 receptor antagonist activity,” “altered melanocortin system,” and “sleep wake disorders” were identified as the predominant molecular mechanisms involved in the pathophysiology of sleep disorders induced by the studied heavy metals. Cut off point values and miRNA sponge templates for heavy metal exposure levels relevant to sleep disorders in pre- and postmenopausal women were reported. Future research is needed to verify our findings and provide insight into the molecular processes of long-term mixed heavy metal exposure in various populations, such as children and the elderly.

Study of Metabolic Syndrome in Pre and Post Menopausal Women

Objective: The goal of this study was to determine the occurrence of metabolic disorder (MS) and its various components among pre-and postmenopausal women and their associated relationship between menopausal status and MS. Materials and methods: The present study was conducted at the Biochemistry department in association with Obstetrics and Gynecology Department, Santosh Medical College and Hospital, Ghaziabad. The necessary approval was obtained from the institutional ethical committee to conduct the study and informed written consent was also obtained from the study subjects. The cross-sectional case-control study included premenopausal females aged between 20-40 years as the control group (n=41) postmenopausal females aged between 50-60 years as the case group (n=41). Results: In the study group (post-menopause women), the mean value of BMI is 26.35±2.302 (kg/m2). In comparison with the control group (pre-menopause women), the mean value of BMI is 24.05±1.851 (kg/m2). There was a statically significant increase in the levels of BMI in the study group in comparison with the control group. There was a statically significant increase in the levels of SBP and DBP in the study group compared with the control group. In the study group, the mean value of FBS is 127.12±48.186 (mg/dl). In comparison with the control group (pre-menopause women), the mean value of FBS is 96.12±25.567 (mg/dl). There was a statically significant increase in the levels of FBS in the study group compared with the control group. Conclusion: It has been concluded that MS was significantly more prevalent among postmenopausal women than premenopausal women. This indicates that they are at risk of developing hypertension, cardiovascular disease, and type 2 diabetes mellitus. Therefore, health care workers should closely monitor for the two conditions as metabolic syndrome is an underlying condition for other non-communicable diseases and also be advised to adopt healthy lifestyles to minimize the incidence of these conditions.

Expanding the Clinical Use of CDK4/6 Inhibitors in the Treatment of Hormone Receptor-Positive, HER2-Negative Breast Cancer from Metastatic Setting to Adjuvant Setting.

More than two-thirds of patients with breast cancer present with hormone receptor (HR)-positive, human epidermal growth factor receptor-2 (HER2)-negative disease at their initial diagnosis. HR-positive breast cancer’s growth depends on Cyclin D1, a direct transcriptional target of estrogen receptors (ER). The recent introduction of cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors (palbociclib, ribociclib, and abemaciclib) has revolutionized the treatment of metastatic HR-positive, HER2-negative breast cancer in both endocrine-sensitive and endocrine-resistant settings and in both pre-and post-menopausal women. Multiple large randomized clinical trials had demonstrated improvement in progression-free survival (PFS) and, more recently, in overall survival (OS). Adjuvant endocrine therapy (ET) significantly reduces the risk of recurrence and death among patients with HR-positive early-stage breast cancer (EBC). However, up to 20% of these patients will experience local, regional or distal recurrences in the first ten years. Such resistance to ET motivated researchers to try CDK4/6 inhibitors in EBC, both in adjuvant and neoadjuvant settings. While many clinical trials are still ongoing, at least one study and two meta-analyses had shown beneficial results, based on which the US Food and Drug Administration had recently approved the use of one of these agents, abemaciclib, in combination with ET for the adjuvant therapy of patients with high-risk EBC. In this paper, we review the recently published and ongoing landmark clinical trials attempting to expand the use of CDK4/6 inhibitors, in combination with ET, in the adjuvant setting of EBC.

Qualidade de vida sexual para pacientes com câncer de mama em hormonioterapia

OBJECTIVES: To evaluate how hormonal therapy can impact breast cancer patients sexual quality of life and compare two widely used therapeutic agents: anastrozole and tamoxifen. Studies so far have evaluated the side effects of such therapy on patients general quality of life, but literature remains scarce regarding the impact it has on sexual aspects. We believe there is a demand for a detailed view of these aspects since most patients undergo these treatments for at least five years. MATERIAL AND METHODS: Transverse observational study evaluated in 2019, 41 women with a history of breast cancer, all of them undergoing hormonal therapy. Group presented a mean age of 55.4 years (35 to 77 years); those in menopause with a mean time of menopause of 10.92 years (2 to 28 years). Thirty-eight women lived maritally and/or were sexually active. The mean duration of treatment was 36.84 months. We analyzed data in pre-and postmenopausal women, evaluating the results of questionnaires with general parameters (age, treatment time, general quality of life, adaptation to therapy) as well as specific instruments for evaluation of sexual dysfunction (FSDS-R) and quality of life with specific aspects for breast cancer (FACT-B). The results were placed in 2x2 contingency tables comparing the group receiving tamoxifen versus anastrozole. RESULTS AND CONCLUSION: Tamoxifen compared to anastrozole is a drug with apparent less impact on most common sexual dysfunctions (orgasm, dyspareunia, and feeling good quality of sex life), following those already published in international literature. We found no impact on physical, socio-familiar, and emotional well-being. Finally, we conclude that the results of this study significantly contribute to the choice of adequate therapeutic agent and highlight the need to bring this topic during routine consults and to the decision with the patient for the best suited treatment option.

Reliability of the Polish Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) and Assessment of Sexual Function before and after Pelvic Organ Prolapse Reconstructive Surgery-A Prospective Study.

It is estimated that 31–44% of all patients with symptomatic POP and/or UI suffer from sexual dysfunction. We aimed to validate the PISQ-12 in pre-and postmenopausal women and to assess the sexual function before and after POP reconstructive surgery. One hundred and forty sexually active patients were hospitalized due to symptomatic POP and 50 healthy controls were enrolled into the study. The patients were asked to complete PISQ-12, the FSFI and Beck’s depression scale questionnaires twice. The Cronbach’s alpha (α) was used to estimate the internal consistency. The scores were compared using the Intraclass Correlation Coefficient (ICC). Improvement in the QoSL (quality of sexual life) was observed in each age group of women. Pre-menopausal patients’ QoSL was much better, both before and after surgery (29.62 and 34.64 points, respectively). The correlation between questionnaires before surgery was 0.63, and after was −0.76. The α value for the PISQ-12 was 0.83 before the procedure and 0.80 afterwards. In all the groups, the test–retest reliability was good—ICC = 0.72. Vaginal reconstructive surgeries improve the QoSL. The only demographic factor influencing the QoSL was the menopausal status. The Polish version of the PISQ-12 is a reliable and responsive instrument for assessing the sexual function in patients with diagnosed POP and/or UI.

Increased frequency of Th17 cells and IL-17 levels are associated with low bone mineral density in postmenopausal women

Osteoporosis is one of the chronic and often neglected bone diseases in aging postmenopausal women that affect the quality of life. Studies on ovariectomized mice models indicated the reciprocal role of Th17 cells and Treg cells in the aetiology of osteoporosis. While Th17 cells promote osteoclastogenesis, Treg cells exhibit anti-osteoclastogenic activity. This exploratory study aimed to determine the difference in the frequency of these T-cell subtypes in pre-and postmenopausal women and to examine their association with BMD. In our study, the frequency of Treg cells, analyzed by flow cytometry, did not differ between pre-and postmenopausal women. However, plasma levels of IL-10 along with IL-10+CD4+T cells were higher in post- compared to premenopausal women. The frequency of Th17 cells was higher in postmenopausal women irrespective of their BMD, however, only postmenopausal women with low BMD had elevated IL-17 levels and their T-scores were associated with Th17 frequency. Collectively, the results suggest that estrogen insufficiency in postmenopausal women may lead to increased Th17 cell frequency and elevated IL-17 levels which are associated with low BMD. This study highlights, Th17 cells and IL-17 as key players in the pathogenesis of osteoporosis and they can be the potential targets for immunotherapy in the treatment of osteoporosis.

STUDY OF CALCIUM, PHOSPHORUS AND ACID PHOSPHATASE IN PRE-AND POST-MENOPAUSAL WOMEN

Introduction: More than 75 million individuals overall experience the ill effects of osteoporosis of which 80 % for example 44 million are postmenopausal ladies. Osteoporosis is second just to cardiovascular disease as a main medicinal services issue, as per the World Health Organization. Around the world, the lifetime hazard for ladies to have an osteoporotic break is 30 – 40%. Menopauseis one of the most significant physiological occasions; it is identified with the suspension of ovarian capacity and the finish of conceptive cycle. The occurrence of osteoporosis in postmenopausal ladies keeps on expanding with continuously maturing populaces. Pre-menopause refers to a ladies' regenerative or rich life, from the main menstrual period to the last. Post-menopause is characterized as the time after menopause, in any event one year without a period. Osteoporosisis a dynamic infection which prompts the exhaustion in the bone structure with loss of bone mineral thickness (BMD) expanding the hazard factor of breaks throughout the years. High danger of creating osteoporosis is described by low BMD and shows a disintegration of the smaller scale engineering with the BMD is the consequence of a harmony between bone resorption because of osteoclasts and bone arrangement because of osteoblasts, during an on-going renovating process.&#x0D; Aim: Study of Calcium, Phosphorus, Acid Phosphatase and BMD T score in Pre-and Post-Menopausal Women.&#x0D; Material and Methods: The present study includes total 100 subjects that include&#x0D; 50 pre-menopausal women (age 35 to 45 years) and 50 post -menopause women (age 46 to 60 years). Blood samples were collected from the subjects were obtained for Calcium, Phosphorus and Acid Phosphatase from Medicine /Orthopaedics/ Obstetrics and Gynaecology Wards.&#x0D; Conclusion: Menopause is one of the most significant physiological occasions: it is identified with the end of ovarian capacity and the finish of conceptive cycle. The rate of osteoporosis in postmenopausal ladies keeps on expanding with continuously maturing populaces. Pre-menopause alludes to a lady's regenerative or prolific life, from the principal menstrual period to the last. Post-menopause is the time after menopause, in any event one year without a period. Beginning stage of menopause builds hazard for some postmenopausal wellbeing inconveniences, for example, osteoporosis, ischemic ailment, and ovarian malignancy, though later menopause is a hazard factor for endometrial and bosom disease.&#x0D; Abbreviation: Menopause, Osteoporosis, BMD T score, Calcium, Phosphorus, Acid phosphatase.

The Role of Endometrial Thicknesses as Risk Factor in Endometrial Pathologies

Aim: This study aimed to investigate the role of endometrial thickness in endometrial pathologies and compare transvaginal ultrasonography (TvUSG) and histopathological results in pre-and post-menopausal women with abnormal uterine bleeding. Methods: We retrospectively reviewed the records of 1882 women with abnormal uterine bleeding between 2018 and 2020. After exclusions, the final study population consisted of 1088 women. The primary variable was the endometrial thickness. Secondary variables examined were final diagnosis, age, gravidity, parity, and menopausal status. Results: Results for 653 women (60.0%) with normal endometrium, 26 women (2.4%) with endometrial carcinoma, and 409 women (37.6%) with other endometrial pathology were analyzed. The mean endometrial thickness of the women with normal endometrium was 11.38±5.80 mm (range: 3-45 mm), while the mean endometrial thickness of the women with other endometrial pathology and endometrial carcinoma were 12.27±5.15 mm (range: 3-33 mm), and 17.24±7.19 mm (range: 5-33 mm), respectively. A statistically significant difference was detected between the groups concerning endometrial thickness (F=15.464, p

Differential metabolomics networks analysis of menopausal status.

Menopause is an endocrine-related transition that induces a number of physiological and potentially pathological changes in middle-aged and elderly women. The intention of this research was to investigate the influence of menopause on the intricate relationships between major biochemical metabolites. The study involved metabolic profiling of 186 metabolic markers measured in blood plasma collected from 120 healthy female participants. We developed a method of network analysis using differential correlation that enabled us to detect and characterize differences in metabolites and changes in inter-relationships in pre- and post-menopausal women. A topological analysis was performed on the differential network that uncovered metabolite differences in pre-and post-menopausal women. In this analysis, our method identified two key metabolites, sphingomyelins and phosphatidylcholines, which may be useful in directing further studies into menopause-specific differences in the metabolome, and how these differences may underlie the body's response to stress and disease following the transition from pre- to post-menopausal status for women.

A data-driven, meaningful, easy to interpret, standardised accelerometer outcome variable for global surveillance

ObjectivesOur aim is to demonstrate how a data-driven accelerometer metric, the acceleration above which a person’s most active minutes are accumulated, can (a) quantify the prevalence of meeting current physical activity guidelines for global surveillance and (b) moving forward, could inform accelerometer-driven physical activity guidelines. Unlike cut-point methods, the metric is population-independent (e.g. age) and potentially comparable across datasets. DesignCross-sectional, secondary data analysis. MethodsAnalyses were carried out on five datasets using wrist-worn accelerometers: children (N=145), adolescent girls (N=1669), office workers (N=114), pre- (N=1218) and post- (N=1316) menopausal women, and adults with type 2 diabetes (N=475). Open-source software (GGIR) was used to generate the magnitude of acceleration above which a person’s most active 60, 30 and 2min are accumulated: M60ACC; M30ACC and M2ACC, respectively. ResultsThe proportion of participants with M60ACC (children) and M30ACC (adults) values higher than accelerations representative of brisk walking (i.e., moderate-to-vigorous physical activity) ranged from 17 to 68% in children and 15 to 81% in adults, tending to decline with age. The proportion of pre-and post-menopausal women with M2ACC values meeting thresholds for bone health ranged from 6 to 13%. ConclusionsThese metrics can be used for global surveillance of physical activity, including assessing prevalence of meeting current physical activity guidelines. As accelerometer and corresponding health data accumulate it will be possible to interpret the metrics relative to age- and sex- specific norms and derive evidence-based physical activity guidelines directly from accelerometer data for use in future global surveillance. This is where the potential advantages of these metrics lie.