Stages Of Reproductive Aging Workshop Research Articles

Perimenopause: A critical window to intervene to reduce the risk of cognitive impairment in females

AbstractBackgroundTwo‐thirds of all persons with late‐onset Alzheimer’s disease (AD) are female. The transition to menopause, or perimenopause, negatively impacts the female brain and is proposed to contribute to a female’s greater lifetime risk for dementia. Declining 17‐β estradiol levels during perimenopause is associated with markers of AD pathology, such as reduced cerebral glucose metabolism. Preliminary evidence suggests APOE4‐positive perimenopausal females have greater amyloid In cognitively normal individuals, the T1‐weighted and T2‐weighted (T1w/T2w) ratio from magnetic resonance imaging can be used as a non‐invasive proxy measure of amyloid‐β deposition. Specifically, higher T1w/T2w ratios are associated with higher amyloid‐β accumulation in cognitively normal individuals. Thus, to better understand the impact of perimenopause on the female brain and cognitive health, we compared the T1w/T2w ratio, hippocampal volume, and cognitive performance in perimenopausal females vs. aged‐matched males.MethodsData was acquired from the Human Connectome Project. We included 44 perimenopausal females, defined by the Stages of Reproductive Aging Workshop + 10 Staging System, and 44 age‐matched males. Executive function was measured by the Flanker Task in the NIH Toolbox Cognition Battery and data were available for all 88 individuals. Hippocampal volume data were available for 23/44 perimenopausal females and 27/44 age‐matched males. T1w/T2w neuroimaging data were available for 19/44 perimenopausal females and 27/44 age‐matched males. Between‐group differences in these measures of interest were determined by analysis of covariance (ANCOVA). For the Flanker Task ANCOVA model, the Montreal Cognitive Assessment score and free estrogen levels were included as covariates. For hippocampal volume model, intracranial volume was included as a covariate. For the T1w/T2w ratio model, the Pittsburgh Sleep Quality Inventory score was included as a covariate.ResultsPerimenopausal females performed significantly worse vs. their male counterparts on the Flanker Test (mean difference: ‐28.194; p = .000). Compared with age‐matched males, perimenopausal females had a significantly smaller hippocampal volume (mean difference: ‐544.829; p = .033) and higher T1w/T2w (mean difference: 0.290; p = .042).ConclusionOur results support the hypothesis that the menopause transition is a critical window to intervene to reduce the risk of cognitive impairment in females.

Effect of fsh on lipid profile in postmenopausal women

The World Health Organization (WHO) and Stages of Reproductive Aging Workshop (STRAW) define menopause as a permanent endpoint of the menstrual cycle for one year that occurs naturally or by induction of surgical procedure, chemotherapy or radiation .The etiology of menopause is classified into physiological and non-physiological. Pathophysiology of menopause includes the decline of ovary function in menopause, response to a loss of ovarian feedback mechanism, and the decline of the hypothalamus and pituitary function. Endocrine changes in menopause lead to alteration of gonadotropin secretion cycle patterns, changes in steroid and peptide hormones through monophasic patterns to increase gonadotropin, and decreased estrogen .Aim: This study aims to investigate the effect of FSH on lipid profile in postmenopausal women. Study design: A cross-section observational study. Method: The study is a cross-sectional study done on 90 women. These women aged more than 50 years had cessation of menstrual cycle for over a year. The blood samples were taken from 90 postmenopausal women, and interviews were conducted using a questionnaire. FSH measure, by ElectroChemiLuminescence (ECL) technology for immunoassay analysis done by Cobas e411 device. Lipid profile measure, by manual techniques done by use of spectrophotometer device. Result: We observed increase in Follicle-stimulating hormone (FSH) during postmenopause has a positive significant correlation with body mass index (BMI) (r 0.350, p 0.001), total cholesterol (TC) (r 0.397, p 0.001) and Low-density lipoprotein (LDL) ( r 0.421, p 0.001) FSH also correlated positively but insignificant correlation with triglyceride (TG) (r 0.175, p 0.098) and very low-density lipoproteins (VLDL) ( r 0.055, p 0.604). FHS has a negative significant correlation with Estradiol ( r -0.509, p 0.001) and Vit.D( r-0.220, p 0.037) as well as FSH correlated negative but insignificant with age ( r -0.142, p 0.183) and High-density lipoprotein (HDL) (r -0.048, p 0.656). Conclusion: The current study showed a significant positive correlation of FSH with TC and LDL, an insignificant positive correlation with TG, and an insignificant negative correlation with HDL. Keywords: Postmenopause, FSH, Lituenizing Hormone, HDL

Health care for women in menopause

Clinical lecture is intended for general practitioners – family doctors who provide medical assistance to women with menopausal disorders and are based on the Unified clinical protocol of primary, secondary (specialized), tertiary (highly specialized) heath care “Menopausal disorders and other disorders in the perimenopause” approved by the order of the Ministry of Health of Ukraine dated June 17, 2022 No. 1039.Clinical lecture provides methods and algorithms for diagnosis and treatment of associated with menopause disorders, which will allow forming a comprehensive management strategy of women during menopause by a family doctor in Ukraine and will contribute to improving their health and quality of life.Today, there are no reliable signs that predict the severity and duration of menopausal disorders, so women should focus on a healthy lifestyle as a way to prevent severe menopausal disorders.To clarify the stages of reproductive aging, it is advisable to use the Stages of Reproductive Aging Workshop (STRAW+10). All women over 40 who come for a visit should be asked 6 questions to identify menopausal syndrome. The international Menopause Rating Scale is used to determine the severity of menopause symptoms. Women with symptoms of menopause should be referred to an obstetrician-gynecologist. Treatment of patients with menopausal disorders is carried out by a general practitioner –a family doctor and is carried out using non-medicinal methods and pharmacotherapy. The family doctor can prescribe non-hormonal drugs. Hormonal treatment of menopause symptoms is prescribed by an obstetrician-gynecologist. Treatment of accompanying pathology is prescribed by relevant specialists in accordance with current standards of medical care. Patients with perimenopausal and menopausal disorders need to be monitored by a general practitioner – a family doctor, who maintains the medical documentation and helps the patient comply with the recommendations of specialists.

Assessment of Climacteric Symptoms and Its Impact on Daily Lives of Employed and Unemployed Perimenopausal Women in Selected Rural Villages in South India

Perimenopause is a transitional state which occurs in women in their mid-life. These women may experience climacteric symptoms that affect their day-to-day life. The aim of the study was to assess and compare climacteric symptoms and their impact on daily lives among employed and unemployed perimenopausal women. A cross-sectional survey was done on 160 rural south Indian women aged 40 to 55 years who were identified as symptomatic of perimenopause as per the Stages of Reproductive Aging Workshop 10+ (STRAW) staging criteria. The study participants were grouped as employed and unemployed. Climacteric symptoms were assessed using Greene Climacteric Scale and climacteric symptoms’ impact on daily lives was measured using a structured self-administered questionnaire. Both descriptive and inferential statistics were used to compare the variables between the two groups. The total Greene Climacteric score for unemployed perimenopausal women were found to be significantly higher than the employed group of perimenopausal women (14.5 ± 7.23 versus 12.52 ± 4.9, p < 0.05). The majority (58.8%) of the employed group had minimum impact whereas; the majority (51.2%) of the unemployed group had an average impact score. There was a strong positive correlation between climacteric symptoms and their impact on the daily lives of perimenopausal women. Employment status is a significant factor in causing variation in the climacteric symptoms. Unemployed perimenopausal women suffered more climacteric symptoms than their employed counterparts.

Symptom experience during the late reproductive stage versus the menopausal transition in the Spanish-language Women Living Better survey.

The aim of this study was to characterize and compare the symptoms women self-report during the late reproductive stage and the menopausal transition. This cross-sectional analysis used data from the Spanish-language Women Living Better survey. Women aged 35 to 55 years completed an 82-item online survey to assess menstrual cycle patterns, changes, and 61 symptoms sometimes associated with menopause. Women's menstrual patterns were classified as late reproductive stage or menopausal transition using the Stages of Reproductive Aging Workshop. Demographic and health-related data were collected, including age, country of residence, race/ethnicity, education, parity, smoking, and alcohol use. Descriptive statistics characterized reported symptoms, and logistic regression models examined associations between reproductive stage and symptoms. Of 853 respondents, 358 women were included in the sample analyzed. Participants were on average 40 ± 4.1 years old, 46% reported difficulty paying for basics, 34% lived in Spain, and 20% lived in Mexico. A similar proportion of women in the late reproductive stage and menopausal transition reported 8 of 18 symptom groups. Women in the late reproductive stage had a lower age-adjusted odds of musculoskeletal pain (odds ratio, 0.35; 95% CI, 0.19-0.66) and lower odds of decreased interest in sex (odds ratio, 0.49; 95% CI, 0.25-0.92). Both groups of women reported a similar interference with personal relationships. Late-reproductive-stage women experience multiple symptoms often associated with menopause. A better understanding of symptoms experienced among Spanish-speaking women may lead to more personalized health care and facilitate anticipatory guidance about menopause. Future cross-cultural studies focusing on symptoms during the late reproductive stage are necessary.

Age-related differences in functional network segregation in the context of sex and reproductive stage.

Age is accompanied by differences in the organization of functional brain networks, which impact behavior in adulthood. Functional networks become less segregated and more integrated with age. However, sex differences in network segregation declines with age are not well-understood. Further, network segregation in the context of female reproductive stage is relatively understudied, though unmasking such relationships would be informative for elucidating biological mechanisms that contribute to sex-specific differences in aging. In the current work, we used data from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) repository to evaluate differences in resting-state network segregation as a product of sex and reproductive stage. Reproductive stage was categorized using the Stages of Reproductive Aging Workshop (STRAW+10) criteria. Replicating prior work, we investigated the following functional networks: auditory, cerebellar-basal ganglia, cingulo-opercular task control, default mode, dorsal attention, fronto-parietal task control, salience, sensory somatomotor mouth, sensory somatomotor hand, ventral attention, and visual. First, our results mirror findings from previous work indicating that network segregation is lower with increasing age. Second, when analyzing associations between network segregation and age within each sex separately, we find qualitative differences between females and males. Finally, we report significant effects of reproductive stage on network segregation, though these findings are likely driven by age. Broadly, our results suggest that impacts of sex may be important to evaluate when investigating network segregation differences across adulthood, though further work is needed to determine the unique role of menopause and sex hormones on the organization of functional brain networks within aging females.

Menstrual cycle phase, menopausal transition stage, self-reports of premenstrual syndrome and symptom severity: observations from the Seattle Midlife Women's Health Study.

The aim of this study was to determine the effects of menstrual cycle phases (postmenses and premenses), self-report of premenstrual syndrome (PMS), late reproductive stages (LRS1 and LRS2), and early menopausal transition (EMT) stage (Stages of Reproductive Aging Workshop [STRAW]) on severity of five symptom groups. A subset of Seattle Midlife Women's Health Study participants (n = 290) in either LRS1 or LRS2 or EMT (STRAW+10 criteria) provided daily symptom data for at least one full menstrual cycle during the first year of the study and reported current PMS. Symptom severity was rated (1-4, least to most severe) in the daily diary for five symptom groups (dysphoric mood, neuromuscular, somatic, vasomotor, and insomnia) identified earlier with the same sample ( Maturitas 1996;25:1-10). A three-way analysis of variance was used to test for within- and between-participants effects on symptom severity. Stage had no effect on severity for any of the five symptom groups. Dysphoric mood and neuromuscular and somatic symptom severity (but not vasomotor or insomnia severity) differed significantly across menstrual cycle phases, increasing from postmenses to premenses. Current PMS and premenses cycle phase had significant interactive effects on dysphoric mood and neuromuscular symptoms, but there were no significant interaction effects on somatic, vasomotor, or insomnia symptom severity. Dysphoric mood, neuromuscular, and somatic symptoms exhibit cyclicity and are influenced by current PMS. Late reproductive stages and EMT stage do not have significant effects on the five symptom groups. Vasomotor or insomnia symptoms do not exhibit significant cyclicity from postmenses to premenses and are not affected by current PMS. Future studies of symptom cyclicity and reproductive aging including daily symptom data across an entire menstrual cycle in samples including women in late menopausal transition stage are essential to capture the effects of both cyclicity and self-reported PMS to capture symptom severity reports at their peak.

Nutritional Risk Factors Associated with Vasomotor Symptoms in Women Aged 40-65 Years.

Vasomotor symptoms (VMS) are the most common symptoms among menopausal women; these include hot flashes and night sweats, and palpitations often occur along with hot flashes. Some studies in Mexico reported that around 50% of women presented with VMS mainly in the menopausal transition. It has been proven that VMS are not only triggered by an estrogen deficiency, but also by nutritional risk factors. Evidence of an association between nutritional risk factors and VMS is limited in Mexican women. The aim of this study is to identify nutritional risk factors associated with VMS in women aged 40–65 years. This is a comparative cross-sectional study, undertaken in a retrospective way. A sample group (n = 406 women) was divided into four stages according to STRAW+10 (Stages of Reproductive Aging Workshop): late reproductive, menopausal transition, early postmenopause, and late postmenopause. Hot flashes were present mainly in the early postmenopause stage (38.1%, p ≤ 0.001). Two or more VMS were reported in 23.2% of women in the menopausal transition stage and 29.3% in the early postmenopause stage (p < 0.001). The presence of VMS was associated with different nutritional risk factors (weight, fasting glucose levels, cardiorespiratory fitness, and tobacco use) in women living in the northeast of Mexico.

Menopausal symptoms in women aged 40-65 years in Indonesia

This study aims to determine the prevalence of menopausal symptoms and the factors that influence it in women aged 40-65 years in Denpasar, Indonesia. The research design used is a cross-sectional study conducted on 318 women aged 40-65 years who live in the area of community health centre in Denpasar City, Indonesia. The Stages of Reproductive Aging Workshop (STRAW+10) was used to classify pre, peri and post menopause. The instrument used is a self-designed instrument to determine the respondent's characteristics such as age, number of children, age at menarche, occupation, marital status, education, exercise habits, coffee drinking habits and history of hypertension and diabetes mellitus. know menopausal symptoms. Logistic regression was used to determine risk factors for severe menopausal symptoms. The most common symptoms felt by the respondents in this study were joint and muscle discomfort (52.8%) and sleep problems (51.8%). Only 32.1% of women experienced hot flushes and night sweats symptoms of moderate and severe severity. Age at menarche, history of chronic diseases such as hypertension and diabetes mellitus are risk factors for severe menopausal symptoms. Most women when entering menopause complain of more than one menopause symptom, both somatic, psychological and urogenital symptoms.

Does temporomandibular disorder correlate with menopausal symptoms?

To assess the correlation between menopausal symptoms and pain caused by temporomandibular disorder (TMD) and the impact of sociodemographic factors on the association. In this cross-sectional study, a total of 74 women with TMD symptoms were enrolled and divided into three groups according to the Stages of Reproductive Aging Workshop + 10 (STRAW + 10) criteria: G1 (n = 25, late menopausal transition), G2 (n = 30, early postmenopause), and G3 (n = 19, late postmenopause). Sociodemographic data were collected, along with data on menopausal symptoms (Blatt-Kupperman menopausal index) and TMD-induced pain (craniomandibular index). Statistical analysis was performed using a chi-squared test and linear correlation tests (Spearman and Pearson). Analysis of the three groups showed that TMD-induced pain was more intense in G1 than in G3 (P = 0.0426, r = 0.2364, r2 = 0.05589), and menopausal symptoms correlated with the intensity of TMD-induced pain (P = 0.0004, r = 0.4020). This correlation was more significant during the late menopausal transition (G1: P = 0.0267, r = 0.4427, r2 = 0.1960). In G2, women with fewer than 4 years of schooling had a higher total Blatt- Kupperman menopausal index score (17.0 ± 85.0) and craniomandibular index (0.29 ± 0.23) than women with more than 4 years of schooling (P = 0.02 for both indices). Our results suggest that TMD-induced pain and menopausal symptoms are correlated, and more strongly so in the late menopausal transition. Additionally, sociodemographic factors, such as schooling, have a major influence on symptoms in early postmenopause. Performing the TMD evaluation during the climacteric period may be important.

The Prevalence of Thyroid Dysfunction in Korean Women Undergoing Routine Health Screening: A Cross-Sectional Study.

Background: Women are more likely to experience thyroid diseases than men. However, thyroid dysfunction risk in women undergoing the menopausal transition remains largely unknown. We explored the prevalence of thyroid dysfunction across menopausal stages. Methods: We conducted a cross-sectional study of 53,230 women aged 40 years or older who underwent health screening between 2014 and 2018. Menopausal stages were categorized into 4 based on the Stages of Reproductive Aging Workshop +10 criteria. A multinomial logistic regression model was used to estimate the prevalence ratios (PRs) with confidence intervals [CIs] for thyroid dysfunction in menopausal stages compared with that in premenopause. Results: The prevalence of overt hypothyroidism was significantly increased during late transition and postmenopause; it remained significant after further adjustments for potential confounders (age, center, year of examination, age at menarche, parity, education level, smoking status, alcohol consumption, physical activity, and body mass index) with corresponding multivariable-adjusted PRs [CI] of 1.61 [1.12-2.30] and 1.66 [1.16-2.37] in the late transition and postmenopausal stages, respectively. A significant increase in the prevalence of subclinical hypothyroidism was also observed in the late transition and postmenopausal stage with multivariable-adjusted PRs [CI] of 1.22 [1.06-1.40] and 1.24 [1.07-1.44], respectively. In contrast, subclinical and overt hyperthyroidism were not significantly associated with menopausal stages. Conclusions: In this study of pre- and perimenopausal Korean women, the prevalence of overt and subclinical hypothyroidism was significantly elevated in the late menopausal transition. Future prospective studies are warranted to investigate the clinical and prognostic significance of thyroid dysfunction in women during menopausal transition.

Plasma Ab42/40 levels differ by postmenopausal stage

AbstractBackgroundAlthough all women who live into late life experience reproductive aging (menopause), there is little understanding about how reproductive aging, as distinct from chronologic aging, influences the development of AD. Studies indicate that some AD biomarkers differ between peri‐ and postmenopausal women, but no studies to date have examined AD biomarkers across (sub)stages of the postmenopause. Here we compared plasma Ab42/40 levels in Early versus Late Postmenopausal women. We hypothesized that plasma levels of Ab42/40 would be lower in the Late versus Early Postmenopause group.MethodParticipants included women from the Human Connectome Aging Project who had plasma Ab42/40 and were either in the Early Postmenopause (i.e., Stages +1a, +1b or +1c; &gt;0 and &lt;6 years after the final menstrual period; FMP) or Late Postmenopause (Stage +2; &gt; 6 years after the FMP) according to the Stages of Reproductive Aging Workshop +10 criteria. Plasma Aβ42/40 was measured using an immunoprecipitation and liquid chromatography‐mass spectrometry assay. A univariate analysis of variance was conducted to compare plasma Ab42/40 in Early versus Late Postmenopause groups controlling for age, education, MOCA score, and ApoE carrier status.ResultThe sample included 42 women (mean age=66.2 years; mean MoCA=25.88; 73.8% white). Plasma Ab42/40 were significantly higher in the Early (n=10; mean age=55.77) versus Late Postmenopause (n=32; mean age=69.44) groups with mean values of 0.11 (SE=.002) and 0.103 (SE=.001), respectively, F(1,28)=7.23, p=.01. We restricted a second analysis to women age 60 years and under to optimally control for age differences between the groups (n=18, mean age=56.56 years; mean MOCA=26.04; mean education=17.17 years; 56% white, Early n=10). Again, plasma Ab42/40 were significantly higher in the Early (n=10; mean age=55.77) versus Late Postmenopause (n=32; mean age=57.56) groups with mean values of 0.11 (SE=.002) and 0.105 (SE=.003), respectively, F(1,13)=6.52, p =.025.ConclusionAdvanced reproductive stage, independent of chronologic age, may be associated with a lower plasma Ab42/40, a pattern shown to be predictive of the development of AD. These findings add to a body of AD biomarker studies showing differences between perimenopausal and postmenopausal women, and suggest that AD biomarkers also differ within distinct stages of the postmenopause.

Perimenopause and the Use of Fertility Tracking: 3 Case Studies.

Perimenopause is a time in a woman's life where fertility may vary depending upon her age and her reproductive stage and has been defined as the transition period prior to menopause that is characterized by irregular menses, hormonal changes, vasomotor symptoms, and declining fertility (Casper, 2020). Fertility tracking during this time in a woman's reproductive stage has not been widely studied. Employing the use of Luteinizing Hormone Urine Assay sticks, an electronic hormonal monitor device or mucus, we propose a set of guidelines to determine the potentially fertile times of a woman's cycle based on staging according to the Stages of Reproductive Aging Workshop (STRAW) criteria and illustrate their application with three case reports.

Cognitive Behavioral Therapy for Sexual Concerns During Perimenopause: A Four Session Study Protocol.

Background: During the menopausal transition, women often experience physical (e.g., vasomotor symptoms) and emotional (e.g., anxiety and depression) difficulties that significantly impact functioning and overall quality of life. Although sexual concerns (e.g., decreased sexual desire, orgasm), are reported by up to 87% of peri- and post-menopausal women, and are associated with adverse impact on functioning and distress, treatment options that directly target this area are limited, and most often involve medication (e.g., hormone replacement). Effectiveness of these treatments is often defined as improvements in physical symptoms, however, associated psychological and emotional symptoms rarely, if at all, improve. Cognitive behavioral therapy (CBT) has been proposed as a low-risk treatment for menopausal symptoms with studies showing improvement in frequently reported symptoms (e.g., vasomotor symptoms, depression, anxiety, sleep). Sexual concerns, however, have either not been directly targeted at all in current CBT protocols, or the very few protocols that include sexual concerns, demonstrated modest gains in sexual desire.Methods: This protocol paper outlines the development, design, and implementation of a newly developed CBT for sexual concerns trial during perimenopause (CBT-SC-Peri). Although sexual concerns are prevalent during both the peri- and post-menopausal periods, we will be evaluating the effectiveness of a CBT-SC protocol specifically for perimenopausal women as a means of early intervention. The clinical sample will comprise 82 women aged 40–60 years currently in perimenopause, as per the Stages of Reproductive Aging Workshop (STRAW) definition, and medication stable (if applicable). To ensure participants are experiencing clinically significant sexual concerns, a baseline cut-off score of 26 or lower on the Female Sexual Functioning Index will be utilized. Exclusion criteria include participants with psychotic disorders, or current substance and/or alcohol dependence, or severely depressed/suicidal. The CBT-SC-Peri is a weekly, four session treatment, lasting up to 90 min per session and includes psychoeducation and cognitive and behavioral strategies designed to challenge unhelpful beliefs and promote healthy sexual behaviors. As this is an individual CBT protocol, content will be tailored to address the specific problems relevant for each participant. Eligible women will be placed directly into treatment or on a 4-week waitlist and reassessed prior to starting treatment. The primary outcome (sexual satisfaction), as well as secondary outcomes (desire, arousal, relationship satisfaction, body image, vasomotor symptoms, depression, and anxiety) are assessed at baseline, post-waitlist (for those on waitlist), and post-treatment.Discussion: To our knowledge, this will be the first study to investigate the efficacy of a CBT protocol (CBT-SC-Peri) specifically aimed at improving sexual concerns experienced during perimenopause. If effective, this form of treatment may not only be preferred by some, but necessary for others as consumer demand increases for non-pharmacological treatments for perimenopausal symptoms. Further, this protocol can be integrated into perimenopausal care and will be made available by dissemination to healthcare practitioners.Clinical Trial Registration: Trial # NCT04922385 and Accessible at: https://clinicaltrials.gov/ct2/show/NCT04922385?term=NCT04922385anddraw=2andrank=1.

Beyond premature ovarian Insufficiency: staging reproductive aging in adolescent and young adult cancer survivors.

This cross-sectional study applied a commonly used system to classify reproductive aging (Stages of Reproductive Aging Workshop +10 or ‘STRAW +10’) to 338 adolescents and young adult (AYA) cancer survivors (1). The study aimed to evaluate if STRAW +10 correctly identifies premature ovarian failure in this population and to assess the relationship between cancer treatment and reproductive aging stage.

Female Intrasexual Competition and Its Link to Menopausal Stage, Sex Hormone Levels, and Personality Characteristics.

Background: Female intrasexual competition (ISC) represents a unique form of social interaction. It describes behaviors primarily applied to enhance a woman's ability to outcompete other women. Previous research suggests that female ISC is influenced by personality characteristics and sex hormones. Although these factors most likely interact to predict female ISC, no previous study has investigated those factors in parallel in order to link theories from social psychology and biology. Women at the end of the reproductive lifespan represent the ideal study population, as they allow for a controlled hormonal environment.Materials and Methods: Healthy pre- (N = 53) and postmenopausal (N = 56) women were classified according to the Stages of Reproductive Aging Workshop (STRAW+10) criteria. In the follicular phase (for premenopausal women) or on a random day (for postmenopausal women), questionnaires were administered to assess the general tendency to compete intrasexually and the tendency to compete on appearance, attention/interpersonal success, and competence. Additionally, personality characteristics (neuroticism, extraversion, openness, agreeableness, conscientiousness, and self-esteem) were assessed. On the same day, each subject provided an 8 a.m. saliva sample for estradiol, testosterone, progesterone, and dehydroepiandrosterone sulfate. T-tests tested for between-group differences and separate multiple linear regression models tested for an effect of continuous hormone levels and personality characteristics on ISC. Further models were run, testing for an interaction with menopausal stage.Results: No group differences in ISC were evident (all p > 0.05). In premenopausal women, estradiol levels positively predicted the competition for attention (β = 2.103, p = 0.022). In postmenopausal women, self-esteem predicted the tendency to compete overall (β = −0.208, p < 0.001), on appearance (β = −0.061, p = 0.01), on competence (β = −0.087, p < 0.001), and on attention/interpersonal success (β = −0.060, p = 0.01).Discussion: These results, though cross-sectional, suggest that women continue to compete intrasexually in postmenopause, giving rise to new questions about the function of female ISC. If confirmed, the findings will indicate that hormones guide competitiveness in fertile women, whereas self-esteem accounts for individual differences in competitiveness post-reproduction. Particularly the function of postmenopausal ISC warrants further investigation.

Impact of age and menopausal stage on serum anti-Müllerian hormone levels in middle-aged women

Objective This study aimed to evaluate the association between age, menopausal stage and serum anti-Müllerian hormone (AMH) levels in middle-aged women. Methods In this cross-sectional study, the serum AMH levels of 288 healthy women aged 40–55 years (divided into age groups: 40–44, 45–49 and 50–55 years) were evaluated. Stages of Reproductive Aging Workshop + 10 criteria were used to categorize these women into menopausal stages: late reproductive, menopausal transition and early postmenopausal stages. The impact of age, menopausal stage and hormone replacement therapy on serum AMH levels was analyzed using multi-factor analysis of variance. Effects of body mass index, smoking status and oral contraceptive use were simultaneously considered. Results The median AMH level was 0.140 ng/ml. Log-AMH levels varied according to age group (variance = 20.113, F = 88.538, p < 0.001) and menopausal stage (variance = 5.543, F = 24.501, p < 0.001). An exponential model defined as AMH = 227,421.757 × e(−0.301 × age) was fit to describe the decline in AMH level with age. The 5th–95th percentiles of the AMH levels ranged from less than 0.020 to 3.150, less than 0.020 to 1.944 and less than 0.020 to 0.030 ng/ml in the aforementioned menopausal stages, respectively. Conclusion Age and menopausal stage were associated with AMH levels; age had a greater impact on AMH than menopausal stage in middle-aged women.

Symptom experience during the late reproductive stage and the menopausal transition: observations from the Women Living Better survey.

Objective:The aim of this study was to examine the occurrence of a variety of symptoms, their frequency, bother, burden, and interference in the lives of women in the late reproductive stage (LRS) and compare their experiences to that of women in the menopausal transition (MT) stage.Methods:Women ages 35 to 55 years responded to an 82-question online survey offered by Women Living Better. Participants reported current menstrual patterns, recent changes and symptom frequency, bother, and interference. Women's cycles were classified as LRS or MT using Stages of Reproductive Aging Workshop +10 criteria.Results:Of 2,406 respondents, 946 met criteria for LRS and 583 for MT. Participants included 30% from outside the United States, 31% from diverse racial/ethnic groups, and 18% reported having difficulty paying for basics. A similar proportion of women in the LRS and MT+ groups reported each of the symptoms: there was a less than 10% difference for 54 of the 61 symptoms. Of mean bother ratings for all symptoms, only hot flashes differed significantly between the LRS and MT groups. LRS women experienced similar levels of symptom-related interference with personal relationships and daily living to those in the MT stage but did not anticipate these symptoms occurring until they were 50 years old.Conclusions:Women in the LRS experience symptoms strikingly similar to those often associated with the MT. Women do not expect these changes until the age of 50 years or later and are surprised by such symptoms before cycle irregularity. Research about the epidemiology and management of LRS symptoms, anticipatory guidance for women, and education for clinicians who care for them warrant increased attention.

Stages of menopause and abnormal lung function: a cross-sectional study of middle-aged women.

Whether hormonal changes during menopausal transition postmenopause stages influence pulmonary function is not clearly understood. We evaluated the association between each stage of menopause and the prevalence of abnormal lung function in healthy middle-aged women. We hypothesized that the prevalence of abnormal lung function would increase from the late menopausal transition stage during menopausal transition postmenopause stages. The study population included women 40 to 65 years of age who underwent comprehensive health screening examination at the Kangbuk Samsung Hospital Total Healthcare Centers from January 2015 to December 2017. Stages of menopause (premenopausal, early menopausal transition, late menopausal transition, and postmenopausal) were defined using the 2011 Stages of Reproductive Aging Workshop (STRAW + 10) criteria. Abnormal lung function was defined based on spirometry as forced expiratory volume in 1 second/forced vital capacity less than70% or forced vital capacity less than 80% predicted. Prevalence ratios (PRs) for abnormal lung function by stages of menopause were estimated from logistic regression models adjusted for age, anthropometric measurements, lifestyle factors, medical history, lipid and inflammatory biomarkers, and reproductive factors. Among 43,822 participants, there were 4,615 participants (10.5%) with restrictive ventilatory disorder and 653 participants (1.5%) with obstructive ventilatory disorder. The fully adjusted PRs (95% confidence interval) for abnormal ventilatory disorder comparing early menopausal transition, late menopausal transition, and postmenopausal stage to premenopausal stage were 1.01 (0.94-1.08), 1.13 (1.03-1.22), and 1.10 (0.98-1.22), respectively. The fully adjusted PRs for restrictive ventilatory disorder comparing early menopausal transition, late menopausal transition, and postmenopausal stages to premenopausal stage were 1.02 (0.94-1.11), 1.18 (1.06-1.30), and 1.15 (1.00-1.31), respectively. There was, however, no clear association between stages of menopause and obstructive ventilatory disorder. In this large study of middle-aged women, the fully adjusted prevalence of abnormal lung function, particularly that of restrictive ventilatory disorder, was higher in women in late menopausal transition and menopausal stages compared to women in premenopausal stage.

A STUDY ON STATUS OF URINARY HYDROXYPROLINE IN POST MENOPAUSAL WOMEN

Introduction: WHO and the Stages of Reproductive Aging Workshop have defined menopausal transition as the time of an increase in follicle-stimulating hormone and either increased variability in menstrual cycle length, two skipped menstrual cycles with 60 days or more of amenorrhea, or both. It concludes with the final menstrual period. Post-menopause begins at that time, although it is not recognized until after 12 months of amenorrhea. During menopause, women face various physiological, psychological, and biochemical changes. Laboratory medicine has given a new background to overcome the clinicianÂÂs diagnostic dilemma. Hydroxyproline is mainly found in collagen and accounts for 13% of total amino acid content and derived from proline by post-translational hydroxylation. Hydroxyproline is derived from another amino acid such as proline. Direct urinary assay of hydroxyproline to measure bone resorption have clinical applications as part of screening programs to assess the risk of osteoporotic fractures. Method: A total of seventy patients with regular medical follow-up records, The Patients were pre and post-menopausal women (35 each) recruited for this study. Patient details like body mass index, education, smoking, alcohol intake, dietary habits, and family history were considered before selecting the patients. Analytical Methods: Urinary Hydroxyproline and Urinary creatinine was estimated by Modified Neumann et al and Spectrophotometric JaffeÂÂs reaction respectively. Result: The study population consisted of 70 participants of premenopausal (n=35) and postmenopausal women (n=35), mean age of 38.11 ± 4.3 and 54.40 ± 4.6 respectively. The bone mineralization marker urinary total hydroxyproline was quantified in pre and post-menopausal women, which is 80.3 ± 75mg/L and 136 ± 103mg/L respectively. The urinary creatinine level in pre and post-menopausal women was 53.7 ± 14.2mg/dL and 37.0 ± 27.3 respectively. The hydroxyproline: creatinine ratio (HCR) was 41% to 69% against the normal reference interval in pre and post-menopausal women. Conclusion: The obtained normative data for the premenopausal woman population would be a new reference range in Indian sub-population or otherwise general population normative reference range commonly being used as a reference interval in all kind of pathophysiological disorders. Hence, the derived parameter confirmed that HCR is the most prognostic significant diagnostic marker in pre and post-menopausal patients.