Menopausal Symptoms Research Articles

Effectiveness of Combination of Tibolone and Lactobacilli Plus Lactoferrin in Postmenopausal Women with Vulvar Vestibular Pain: A Preliminary Report.

Postmenopausal dyspareunia and vulvar pain are common complaints, affecting about 60% of women within a few years after hormone levels begin to decline (such as estrogen and androgen). Atrophic changes mainly located in the vulvar vestibule and vulnerability to vulvovaginal infections in postmenopause could be predisposing factors to the development of vulvar burning/pain and introital dyspareunia (vestibulodynia secondary to atrophy). Tibolone is the most effective and safe alternative for treating menopausal symptoms. The role of Lactobacilli and lactoferrin shows its effectiveness in the treatment of vaginal microbiota dysbiosis. The aim of the present study was to assess the efficacy of the combination of tibolone and an oral-specific Lactobacilli mixture in combination with bovine lactoferrin as synergistic therapy for the treatment of vestibulodynia related to atrophy. In this study, we included 35 postmenopausal women with at least 1 year of amenorrhea, affected by vulvar burning/pain and introital dyspareunia. All participants received treatment with open-label, oral Tibolone 2.5 mg and Lactobacilli mixture (5 × 109 CFU per capsule) in combination with bovine lactoferrin (Respecta®). Each product was taken once daily for 90 days. After 90 d of therapy with TIB+ Respecta®, in 30 women that completed the treatment, there was a statistically significant decrease from the baseline in the mean of the Visual Analog Scale for vulvar burning/pain and a reduction in scores in the pain evaluation test. This study provides evidence that the combination of TIB+ Respecta® was effective in reducing symptoms related to vestibular pain and hypersensitivity in a postmenopausal setting.

Use of an estradiol transdermal spray in women with menopausal symptoms: a non-interventional study

Objective This study aimed to investigate the effectiveness, tolerability and application of estradiol metered-dose transdermal spray (EMDTS) in postmenopausal women during real-world use. Methods This was a prospective, non-interventional, multicenter, observational phase IV cohort study. The Menopause Rating Scale II (MRS II) was used to assess symptoms and clinical response. Safety was assessed by the occurrence of adverse events and adverse drug reactions (ADRs). Results A total of 451 postmenopausal women were enrolled at 52 gynecological practices across Germany; 383 patients were evaluated for effectiveness and 430 patients for safety. Mean age was 54.3 ± 7.4 years. In total, 228 patients (59.5%) received EMDTS monotherapy and 155 patients (40.5%) received EMDTS plus progestogens. Significant improvements (p < 0.0001) from baseline in symptom severity were recorded for all 11 items of the MRS II at 3, 6 and 12 months of treatment. At 12 months, 81.4% of patients reported improvement in hot flushes/sweating. At final visit, 73% of patients and 77% of physicians were ‘satisfied/very pleased’ with EMDTS. Most common ADRs were headache (n = 6), nausea (n = 4), dizziness (n = 4) and pruritus (n = 3). Conclusions EMDTS is an effective, well tolerated and easily applied hormone replacement therapy for women experiencing postmenopausal symptoms.

Adherence to a Mediterranean-style diet and severity of menopausal symptoms in perimenopausal and menopausal women from Australia: a cross-sectional analysis

PurposeTo explore the independent associations between adherence to a Mediterranean-style diet and severity of menopausal symptoms in perimenopausal and menopausal women living in Australia.MethodsDietary adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS), the Menopause Rating Scale (MRS) was used to assess the severity of menopausal symptoms, and the 36-item short form survey instrument (SF-36) was used to assess health-related quality of life (HRQoL).ResultsA total of n = 207 participants (50.7 ± 4.3 years; BMI: 28.0 ± 7.4 kg/m2) were included in the final analyses. Participants reported low-moderate adherence to a Mediterranean-style diet (5.2 ± 1.8; range: 1–11). Adherence was not associated with severity of menopausal symptoms. However, low consumption of sugar-sweetened beverages was inversely associated with joint and muscle complaints, independent of all covariates (β = -0.149; CI: -0.118, -0.022; P = 0.042). Adherence to a Mediterranean-style diet was positively associated with the physical function subscale of HRQoL (β = 0.173, CI: 0.001, 0.029; P = 0.031) and a low intake of red and processed meat was positively associated with the general health subscale (β = 0.296, CI: 0.005, 0.014; P = < 0.001).ConclusionDiet quality may be related to severity of menopausal symptoms and HRQoL in perimenopausal and menopausal women. However, exploration of these findings using longitudinal analyses and robust clinical trials are needed to better elucidate these findings.

The effect of oral capsules containing Ocimum basilicum leaf extract on menopausal symptoms in women: a triple-blind randomized clinical trial

BackgroundMenopause, characterized by various physical and mental changes, is primarily caused by hormonal fluctuations, resulting in numerous complications. Recently, herbal treatments have gained significant attention for their minimal side effects compared to chemical drugs. This study aimed to investigate the effects of oral capsules containing Ocimum basilicum leaf extract (OBLE) on menopausal symptoms.MethodsThis placebo-controlled clinical trial study was conducted in 2020. The research focused on 60 menopausal women referred to Mashhad health centers. Eligible participants were administered either an OBLE 500 mg capsule or a placebo daily for 1 month. Menopause symptoms were evaluated using the Menopause Rating Scale (MRS) before, two weeks, and one month after the intervention. Data were analyzed using SPSS21, independent t, Mann–Whitney, and Friedman tests. A significance level of p < 0.05 was considered significant.ResultsThe independent t-test indicated that the mean (SD) scores of menopausal symptoms in both the OBLE and placebo groups were initially similar before the intervention (P = 0.141). Two weeks after the intervention, the menopausal symptom scores were 9.5 ± 3.5 and 11.2 ± 5.6 in the OBLE and placebo groups, respectively (P = 0.163, df = 58, t = 1.4). After one month, the menopausal symptom scores were 6.9 ± 0.3 in the OBLE group and 11.26 ± 0.6 in the placebo group (P = 0.001, df = 58, t = 3.4). This indicates a significant difference between the two groups one month after the intervention, compared to before and two weeks after the intervention. Additionally, there was a significant difference in the scores of the physical and somato-vegetative dimension between the intervention and placebo groups two weeks and one month after the intervention (P < 0.05).ConclusionThe study results suggested that taking OBLE capsules led to a decrease in the scores of menopausal symptoms. This indicates that OBLE can be considered as a safe and cost-effective medicinal plant for alleviating menopausal symptoms among women.

Menopause symptom prevalence in three post–COVID-19 syndrome clinics in England: A cross-sectional analysis

ObjectivesThere is an overlap between symptoms of perimenopause/menopause and post-COVID syndrome and there is a concern that some female patients referred to post-COVID syndrome clinics may have undiagnosed perimenopause/menopause. However, the prevalence of such symptoms in this population is unknown. MethodsCross-sectional analysis of 122 women's health questionnaires as part of a service improvement project in three National Health Service post-COVID syndrome clinics in England. The primary outcomes were prevalence of menopause symptoms and association between the total menopause symptom questionnaire (MSQ) score and the key predictors. ResultsAge group 40-54 years showed the highest prevalence of most individual symptoms and the highest mean total MSQ score (36.4; confidence interval [CI] 32.3-40.6), correlating clinically with the onset of perimenopause/menopause. Regression modeling shows a significant positive parabolic relationship between age and total MSQ score. Age group 40-54 years is associated with a 6.60-point higher (CI 1.31-11.9) total MSQ score than the age group 55-79 years; an increase of one index of multiple deprivation quintile is associated with a 2.85-point lower (CI −1.24 to −4.45) total MSQ score; presence of a gynecologic diagnosis is associated with a 6.31-point higher (CI 1.32-11.3) total MSQ score. A total of 51% of patients who menstruate reported menstrual disturbance with COVID-19 infection and 21% with COVID-19 vaccination. ConclusionsSymptoms possibly attributable to perimenopause and menopause were highly prevalent among female patients attending post-COVID syndrome clinics in Greater Manchester, England. Our findings provide key prevalence estimates and significant predictors of MSQ scores that are vital for future research, clinical practice, and policy.

The impact of physical activity and exercise interventions on symptoms for women experiencing menopause: overview of reviews

BackgroundWomen experiencing problematic menopausal symptoms report lower health-related quality of life and greater healthcare use than women without symptoms. Not all women want to or are able to take hormone replacement therapy. Strengthening the evidence for menopause symptom-management options, including physical activity, improves agency for women.AimThis overview assesses effectiveness of physical activity and exercise interventions targeting women experiencing menopause symptoms.MethodsMedline, Embase, CINAHL, Scopus, The Cochrane Database of Systematic Reviews and Social Science Citation Index were searched (June 2023) for systematic reviews of physical activity and exercise interventions targeting women experiencing menopause. Reviews were assessed using AMSTAR-2 and a best-evidence approach to synthesis without meta-analysis (SWIM) was adopted. The protocol was registered on PROSPERO (CRD42022298908).ResultsSeventeen reviews included 80 unique relevant primary studies with 8983 participants. There is evidence showing improvement of physical, urogenital, and total symptoms following yoga interventions. Evidence for vasomotor and psychological symptoms was inconclusive. Findings for aerobic exercise were inconclusive although there were some examples of beneficial effects on total and vasomotor symptoms. Evidence was very limited for other types of physical activity and impact on physical, sexual and urogenital symptoms.ConclusionThere is some evidence that yoga, and to lesser extent, aerobic exercise may be beneficial for some menopause symptoms, but there is insufficient evidence to recommend a particular form of exercise. Current reviews categorise women on menopause status; broadening this to include ethnicity, income status, employment and other factors will allow better understanding of context for successful interventions.

The Effect of Thyroid Status on the Features of the Course of Perimenopause

Introduction. According to statistics, the average life expectancy of the female population is steadily increasing and more than ⅓ of a woman’s life is in the period of periand postmenopause. Many women approach the period of perimenopause with existing diseases of the endocrine system, most often associated with the thyroid gland. Such a high prevalence of this pathology occurs due to natural iodine deficiency in almost the entire territory of the Russia. Therefore, the relationship between the symptoms of menopause and endocrine diseases is very relevant.The purpose of the work is to analyze the data presented in the modern literature on the influence of thyroid status on the features of the course of perimenopause.Materials and methods. This review is based on data from domestic and foreign studies obtained as a result of a selective search in the electronic databases PubMed and eLibrary from 2016 to 2023.Results and discussion. The period of perimenopause is accompanied by an increase in the incidence of thyroid diseases. The analysis of the literature data showed the influence of thyroid status on the features of the course of perimenopause and the conditions accompanying it (impaired cognitive functions, changes in bone metabolism, the frequency of abnormal uterine bleeding, the risk of cardiovascular diseases).Conclusion. Given the relationship of thyroid status with the peculiarities of the course of perimenopause, it is necessary to consider the possibility of complex therapy of thyroid diseases and correction of symptoms of menopausal syndrome.

Menopausal stages and overactive bladder symptoms in middle-aged women: A cross-sectional study.

To examine the prevalence of overactive bladder (OAB) according to menopausal stages in middle-aged women. Cross-sectional study. Total Healthcare Center in South Korea. Middle-aged Korean women (n=3469, mean age, 49.5 ± 2.9 years). Menopausal stages were defined according to the Stages of Reproductive Aging Workshop +10 criteria, and menopausal symptoms were assessed using the Korean version of Menopause-Specific Quality of Life (MENQOL). Logistic regression models were used to estimate prevalence ratios with 95% confidence intervals for OAB according to menopausal stage and to assess the associations with menopausal symptoms. OAB symptoms were evaluated using the Overactive Bladder Symptom Score (OABSS). The prevalence of OAB increased with menopausal stage; however, the multivariable-adjusted prevalence ratios for women in menopausal transition and postmenopausal stage were insignificant (ptrend = 0.160) compared to those for premenopausal women. Among individual OAB symptoms, the multivariable-adjusted prevalence ratios for nocturia increased with menopausal stage in a dose-response manner (ptrend = 0.005 for 1 time/day; ptrend < 0.001 for ≥2 times/day). The association between menopausal stages and nocturia occurring ≥2 times/day was evident in women without OAB and with relatively high MENQOL scores, vasomotor symptoms and difficulty sleeping. The prevalence of OAB, particularly nocturia, increased with menopausal stage, and the association was obvious in women with other menopausal symptoms. This finding underscores the importance of addressing nocturia as a potential menopausal symptom in middle-aged women. Further studies are required to understand the mechanisms linking OAB with menopausal symptoms in middle-aged women.

Dietary Intake, Menopausal Symptoms, and Body Composition Associated with Possible Sarcopenia Among Vietnamese Middle-Aged Women: A Cross-Sectional Study.

Background: This study aims to investigate the prevalence of possible sarcopenia and its associated factors among middle-aged Vietnamese women. Methods: A cross-sectional study was conducted on 205 women aged 40-55 years who were admitted to the Can Tho Obstetrics and Gynecology Hospital between February and December 2023. The presence of possible sarcopenia was determined according to the AWGS 2019 criteria. Associated factors were dietary intake (total energy, protein, lipid, and carbohydrate intake), the severity of menopausal symptoms by using the Kupperman index, and body composition by using the bioelectrical impedance analysis device, Inbody S10. Logistic regressions were built to analyze the association between possible sarcopenia and its associated factors. Results: The prevalence of possible sarcopenia was 29.8%, with a mean age of 47.2. Possible sarcopenia was detected in 23% of the participants based on the criterion of low handgrip strength, whereas 83.6% of the participants when considered low performance in the chair stand test. Adjusted logistic regression analysis showed that living in a rural area (adjusted odds ratio [AOR]: 2.16, 95% confidence interval [95% CI]: 1.22-4.72), energy intake <25 kcal/body weight, (AOR: 1.94, 95% CI: 1.75-5.06), protein intake <0.91 g/body weight (AOR: 2.42, 95% CI: 1.51-5.76), skipping breakfast (AOR: 2.03, 95% CI: 0.91-4.54), mild menopausal symptoms (AOR: 2.68, 95% CI: 1.61-5.36), and obesity (AOR: 1.59, 95%CI: 1.29-3.67) were significantly associated with higher risk of possible sarcopenia. Conversely, higher muscle mass and higher upper limb mass were associated with a decreased risk of possible sarcopenia (total muscle mass AOR: 0.20, 95% CI: 0.07-0.59). Conclusions: These findings would provide a basis for enhancing management and prevention strategies to reduce the risk of sarcopenia in Vietnam. In particular, attention to nutrient intake and the management of menopausal symptoms may reduce the risk of sarcopenia.

Effects of Resistance Training, Estrogen Therapy, and Calcium Chitosan Supplement Containing Vitamin D on Bone Turnover in Ovariectomized Rats: An Experimental-Comparative Study

Background: Hormone therapy is a highly effective method for treating menopausal disorders. However, its side effects may include an increased risk of cancer, heart disease, and pulmonary embolism. Previous research has demonstrated that both exercise and nutrition separately have positive effects on menopausal symptoms. Therefore, we suggest that combining exercise and nutrition interventions may provide a synergistic effect, yielding results at least similar to those of estrogen (Est) therapy. Objectives: This study aims to compare the independent and combined effects of resistance training (RT), Est therapy, and vitamin D calcium chitosan (Vit D + Ca++ + Chit) supplementation on markers of bone turnover in ovariectomized (OVX) rats. Methods: Forty-two female Wistar rats were randomly divided into seven groups (n = 6 per group): (1) healthy-control (He-Co), (2) OVX-Vit D + Ca++ + Chit + RT, (3) OVX-saline (Sal) + Est + RT, (4) Sal + RT, (5) OVX-Vit D + Ca++ +Chit, (6) OVX-Sal + Est, and (7) OVX-Control (OVX-Co). Bone samples were extracted 48 hours after the final session. Two-way ANOVAs were used to determine differences in intervention effects between groups. The alpha level was set to 0.05. Results: Ovariectomy (OVX) decreased bone tissue expression of alkaline phosphatase (ALP) and osterix (OSX) while increasing peroxisome proliferator-activated receptor gamma (PPAR-γ) gene expression. Ovariectomy also decreased the number of osteocytes and osteoblasts while increasing the number of osteoclasts. Resistance training (RT) and Vit D + Ca++ + Chit intake increased bone tissue expression of ALP, OSX, and PPAR-γ gene expression. Additionally, RT and Vit D + Ca++ + Chit supplementation increased the number of osteocytes and osteoblasts and decreased the number of osteoclasts. Conclusions: The combined interventions had synergistic effects compared to each intervention separately on ALP, osteocyte, osteoblast, and osteoclast observations. Therefore, combining RT with Vit D + Ca++ + Chit could be a non-pharmacological approach to address bone turnover alterations caused by OVX.

Determining the Prevalence and Severity of Menopausal Symptoms in Post-Menopausal Women of Eluru, Andhra Pradesh, India, using the Menopause Rating Scale (MRS)

Background: This study aimed to assess the prevalence and severity of menopausal symptoms among women in Eluru, Andhra Pradesh, India, to better comprehend the specific challenges faced by rural women during this transitional phase. Methods: Post-menopausal women who visited the Rural Health and Training Center in Eluru between September-November 2021 and had one year of amenorrhea were included. A face-to-face interview administered a questionnaire to collect socio-demographic details and the Menopause Rating Scale (MRS) which contained 11 questions using a 4-point Likert scale. Microsoft Excel and SPSS-20, with one-way ANOVA test were used for data and statistical analysis. Results: A total of 100 respondents were included, aged between 45-60 years. Majority of the respondents (37%) were aged 45-50 years and were unskilled workers (53%) with a monthly income falling under the upper middle-class category (53%). Additionally, 61% belonged to nuclear families. Using the MRS, joint and muscle pains were the most prevalent symptoms (82%), followed by sleep problems (64%) and anxiety (57%). Heat discomfort was reported least frequently (25%). Age groups and symptom severity were found to be significantly associated, indicating that women between 45-50 years were more likely to experience mild-severe symptoms. Conclusion: This study identified a notable prevalence of menopausal symptoms among women in Eluru; however, limitations included the limited sample size and geographic scope. Retrospective data collection might have introduced recall bias. The study highlights the need for increased awareness and education on menopause. Community-based programs and health centers should be established to address these needs.

Women's perceptions and experiences with cannabis use in menopause: a qualitative study.

Since the legalization of recreational cannabis in 2018, the use of cannabis for medical reasons has increased in Canada. The aim of this study was to explore the experiences and perceptions of midlife women using cannabis for medical purposes coinciding with menopause symptom management. Semistructured, one-on-one interviews were conducted using a qualitative description method. This was the second phase of a mixed methods study, where interviewees were purposefully selected from a sample of women (ages 35 and over, located in Alberta) surveyed during the first phase of the study. Interviews were by phone or virtual meeting, audio-recorded, and transcribed verbatim. Qualitative content analysis was applied to analyze the data collected. Twelve interviews were conducted between December 2020 and April 2021. Menopause was perceived as a complex experience for women. Cannabis was described as a therapeutic agent, providing symptom relief through the menopause transition. Women reported similarities in their menopause and cannabis use experiences in the lack of information available, limited role of healthcare providers, feelings of stigmatization, and emphasis on self-education. Women self-managed their cannabis use, learning from their own experiences or the anecdotal sharing of others', accessed cannabis from a variety of medical and nonmedical sources, and relied on experimentation, and a range of supports were described. Midlife women pursued the use of cannabis medically to manage symptoms that overlap with menopause. Understanding how and why midlife women use cannabis medically can provide insight for future research and the development of educational resources to support women in menopause.

Silkworm (Bombyx mori L.) Has Beneficial Effects on Menopausal Symptoms by Enhancing Estrogen Receptor Signaling in Ovariectomized Mice.

Existing hormone replacement therapy for menopause has drawbacks, necessitating new treatment agents. Silkworms have demonstrated estrogenic properties, offering promising alternatives. We assessed the therapeutic effects of freeze-dried silkworm powder (SWP) on menopausal symptoms using an ovariectomized (OVX) mouse model. The experimental design comprised a sham surgery group (Sham), an OVX control group, a low-dose SWP group post-OVX (80 mg/kg, OVX-SWP-L), a high-dose SWP group post-OVX (160 mg/kg, OVX-SWP-H), and an estradiol treatment group post-OVX (OVX-E2). Treatments were administered orally thrice weekly over eight weeks; body weight was monitored weekly. The SWP-treated groups (SWP-L and SWP-H) exhibited less weight gain and increased uterine thickness than the OVX control. Molecular analyses demonstrated that SWP significantly enhanced the phosphorylation of estrogen receptor alpha (ERα), ERK, and AKT. Furthermore, biochemical assays revealed reduced serum neutral lipids across all SWP treatment groups. Notably, HDL-cholesterol levels were significantly increased in the SWP-L group compared to the OVX group. Serum estradiol concentrations were elevated in all the SWP groups, with significant increases in the high-dose group. These findings indicate that SWP may promote the activation of estrogen receptor signaling and improve symptoms associated with estrogen deficiency during menopause.

Melatonin Ameliorates Depressive-Like Behaviors in Ovariectomized Mice by Improving Tryptophan Metabolism via Inhibition of Gut Microbe Alistipes Inops.

Melatonin (N-acetyl-5-methoxytryptamine) is reported to improve mood disorders in perimenopausal women and gut microbiome composition is altered during menopausal period. The possible role of microbiome in the treatment effect of melatonin on menopausal depression remains unknown. Here, it is shown that melatonin treatment reverses the gut microbiota dysbiosis and depressive-like behaviors in ovariectomy (OVX) operated mice. This effect of melatonin is prevented by antibiotic cocktails (ABX) treatment. Transferring microbiota harvested from adolescent female mice to OVX-operated mice is sufficient to ameliorate depressive-like behaviors. Conversely, microbiota transplantation from OVX-operated mice or melatonin-treated OVX-operated mice to naïve recipient mice exhibits similar phenotypes to donors. The colonization of Alistipes Inops, which is abundant in OVX-operated mice, confers the recipient with depressive-like behaviors. Further investigation indicates that the expansion of Alistipes Inops induced by OVX leads to the degradation of intestinal tryptophan, which destroys systemic tryptophan availability. Melatonin supplementation restores systemic tryptophan metabolic disorders by suppressing the growth of Alistipes Inops, which ameliorates depressive-like behaviors. These results highlight the previously unrecognized role of Alistipes Inops in the modulation of OVX-induced behavioral disorders and suggest that the application of melatonin to inhibit Alistipes Inops may serve as a potential strategy for preventing menopausal depressive symptoms.

Prevalence of Menopausal Symptoms and Their Health Seeking Behavior in Postmenopausal Women in a Tertiary Care Hospital

Prevalence of Menopausal Symptoms and Their Health Seeking Behavior in Postmenopausal Women in a Tertiary Care Hospital

Peroxiredoxin 4 deficiency induces accelerated ovarian aging through destroyed proteostasis in granulosa cells

Ovarian aging, a complex and challenging concern within the realm of reproductive medicine, is associated with reduced fertility, menopausal symptoms and long-term health risks. Our previous investigation revealed a correlation between Peroxiredoxin 4 (PRDX4) and human ovarian aging. The purpose of this research was to substantiate the protective role of PRDX4 against ovarian aging and elucidate the underlying molecular mechanism in mice. In this study, a Prdx4−/− mouse model was established and it was observed that the deficiency of PRDX4 led to only an accelerated decline of ovarian function in comparison to wild-type (WT) mice. The impaired ovarian function observed in this study can be attributed to an imbalance in protein homeostasis, an exacerbation of endoplasmic reticulum stress (ER stress), and ultimately an increase in apoptosis of granulosa cells. Furthermore, our research reveals a noteworthy decline in the expression of Follicle-stimulating hormone receptor (FSHR) in aging Prdx4−/− mice, especially the functional trimer, due to impaired disulfide bond formation. Contrarily, the overexpression of PRDX4 facilitated the maintenance of protein homeostasis, mitigated ER stress, and consequently elevated E2 levels in a simulated KGN cell aging model. Additionally, the overexpression of PRDX4 restored the expression of the correct spatial conformation of FSHR, the functional trimer. In summary, our research reveals the significant contribution of PRDX4 in delaying ovarian aging, presenting a novel and promising therapeutic target for ovarian aging from the perspective of endoplasmic reticulum protein homeostasis.

Associations between menopausal symptoms and cardiovascular disease in middle-aged Chinese women

Objective This study aimed to examine the association between severity of menopausal symptoms and cardiovascular disease (CVD) risk among middle-aged Chinese women. Methods A cross-sectional study recruited 9679 women aged 40–70 years from three socioeconomic regions of China in 2018. Menopausal symptoms were assessed by the modified Kupperman Menopausal Index (KMI). The severity of individual symptoms was classified as none (0 points), mild (1 points) and moderate-to-severe symptoms (2–3 points), and overall menopausal symptoms were classified as none (<15 points), mild (15–24 points) or moderate-to-severe (≥25 points) according to the sum score of the KMI. Logistic regression models were used to examine associations of the severity of menopausal symptoms with CVD risk. Results A total of 5.6% of participants reported being diagnosed with CVD. Overall menopausal symptoms were more common in women aged 60–70 years than in women aged 40–59 years. After multiple adjustment, mild (odds ratio [OR] = 2.07, 95% confidence interval [CI]: 1.64–2.61) and moderate-to-severe (OR = 2.64, 95% CI: 1.92–3.63) overall menopausal symptoms were associated with increased risk of CVD compared with no symptoms. Significant positive associations between the severity of individual menopausal symptoms and CVD risk were observed for all 13 items. Conclusion The severity of menopausal symptoms was positively associated with CVD risk in middle-aged Chinese women.

A review on association between menopausal symptoms and cardiovascular risk factors

Menopausal transition and post-menopausal periods can have short-term and long- term effects on mid-life health of women. The short-term effects include the possibility of experiencing of menopausal symptoms, while the long-term effects include cardiovascular diseases (CVD) risk. The occurrence of menopausal symptoms varies widely within and between populations. Studies indicate that the frequency and severity of menopausal symptoms are linked to CVD risk factors, but the existing literature is divergent and somewhat limited. Thus, women belonging to different populations are likely to be at a different risk of CVD, but the exact physiological mechanism behind this relationship remains unclear. The present narrative review aimed to synthesize the available evidence of menopausal symptoms in association with various conventional CVD risk factors such as blood pressure, total cholesterol and blood glucose levels and obesity, as well as to determine the potential link between these two processes. We undertook a rigorous data base search to identify, examine, and critically assess the existing literature on the associations between menopausal symptoms and CVD risk factors. We applied inclusion and exclusion criteria to filter the retrieved articles and classified the literature into eight major categories. The risk of CVD is higher among women who experience vasomotor, psychological, and urogenital symptoms compared to those who do not experience these symptoms. Our review indicates that menopausal symptoms can be used as markers in assessing CVD risk factors during midlife. Thus there is a need for larger-scale research to support these findings and identify the potential mediators that are controlling this association.

Symptom network and quality of life of breast cancer patients receiving multimodal cancer treatment: Cross-sectional study

PurposeBreast cancer patients experience symptoms and side effects from multimodal treatments, which often include menopausal symptoms resulting from cytotoxic chemotherapy or estrogen suppression therapy. This study aimed to explore the symptom network and clusters and its relationship to quality of life (QoL) in breast cancer patients who receive multimodal cancer treatment and experience treatment-related menopausal symptoms. MethodsA correlational study was conducted. Breast cancer patients receiving multimodal cancer treatment and experiencing treatment-related menopausal symptoms were included while they were receiving radiation therapy (N = 250). Symptoms, functions and QoL were assessed using the EORTC QLQ-C30 and BR45. Network analysis, principal component analysis, exploratory factor analysis, and multiple linear regression analysis were conducted. ResultsFatigue was the most central symptom in the symptom-only network as well as in the network consisting of symptoms and QoL. Fatigue, systemic therapy side effects, appetite loss, and cognitive symptoms demonstrated significant associations with QoL. The cancer and treatment related symptom cluster consisted of fatigue, cognitive symptoms, emotional symptoms and systemic therapy side effects. Breast cancer therapy-specific symptoms, such as arm symptoms, skin mucosis symptoms, and breast symptoms, formed a cluster with pain. ConclusionFatigue was the most central symptom in breast cancer patients receiving multimodal cancer treatment and experiencing menopausal symptoms. Evaluation of fatigue and providing interventions to manage fatigue would contribute to improvement of QoL of breast cancer patients receiving multimodal cancer treatments. Future network analysis and symptom cluster studies should specify the population of interest and the treatment phase using comprehensive symptom evaluation tools.

P-600 Development of human ovarian spheroids as an innovating 3D model to study female hormone-related disorders

Abstract Study question Can spheroids of theca and granulosa cells serve as a new model to explore the cellular and molecular mechanisms involved in female hormone-related disorders? Summary answer Layered theca-granulosa cell spheroids can be successfully assembled with preserved cellular viability, β-estradiol production, and significant upregulation of extracellular matrix (ECM) components. What is known already Spheroid models can revolutionize reproductive biology research, faithfully replicating the ovarian microenvironment for insights into hormonal regulation, cell-cell interactions, and pathologies like polycystic ovarian syndrome (PCOS) and premature ovarian insufficiency (POI). These models can replicate the spatial configuration of the theca cells (TCs) and granulosa cells (GCs), which are the primary components of the follicle’s somatic compartment. Studies using rodent spheroids demonstrate improved estradiol and progesterone secretion, suggesting potential applicability. Though challenging to obtain, recent studies have successfully derived TCs through the differentiation of stromal cells (SCs), introducing new possibilities for spheroid reproductive research in the context of human models. Study design, size, duration The study included GCs from around 15 IVF patients and SCs from postmortem ovaries of 3 postmenopausal women were used to be differentiated into TCs. Participants/materials, setting, methods TCs and GCs were used to construct three spheroid types: layered theca-collagen-granulosa (TCG), layered theca-granulosa (TG), and non-layered. In TCG, GCs formed granulosa-spheroids, which were coated with collagen-I and combined with TCs. TG-spheroids were produced similarly without the collagen layer. Non-layered spheroids were assembled using isolated GCs and TCs. All embedded in PEGylated fibrin hydrogel. Media estradiol synthesis was measured via enzyme-linked immune assay (ELISA), and immunofluorescence was employed to characterize cellular functionality and ECM. Main results and the role of chance In GCs, positive expressions for AMHR, CYP19A1, and FHSR were observed, while following differentiation, TCs exhibited positivity for CYP17A1, LHR and CD13. A notable distinction emerged when comparing TCs within the spheroids to those in 2D cultures, as the former demonstrated an improvement in longevity. Layered TG-spheroids exhibited significant increases in collagen-IV, EMILIN-1, and collagen type I compared to G-spheroids. Interestingly, TCG-spheroids exhibited a distinct decrease in collagen type IV. Across all spheroid types, collagen type VI and laminin were notably absent from their ECM. Moreover, all spheroids had a significant increase in β-estradiol production. Non-layered spheroids showed a significant viability decrease inside the PEGylated fibrin over 30 days, in contrast to the sustained viability observed in the layered TG- and TCG-spheroids. Limitations, reasons for caution Utilizing primary cells, particularly specific patient-derived cells, poses a limitation due to their short availability, which could impact the study’s size. Wider implications of the findings Theca-granulosa spheroids deepen our understanding of reproductive health, offering insights into conditions such as POI and menopausal symptoms. By investigating the nuanced endocrine interplay, this 3D model paves the way for new toxicity studies, provides insights into PCOS, and hints at potential applications in hormone replacement therapy (HRT). Trial registration number Not applicable