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Ovarian cysts are common among post-menopausal women. Although ovarian cancer is a significant cause of mortality in menopausal women, large population-based studies demonstrate that the majority of adnexal masses are benign. In most cases, a pelvic mass or ovarian cyst is an incidental finding, generally corresponding to a benign cyst and easily diagnosed by conventional ultrasound. However, an ovarian tumour may be malignant and should be treated as early as possible. Several diagnostic modalities exist including ultrasound, blood tumour markers, advanced imaging modalities such as magnetic resonance imaging, and computerized tomography to diagnose and characterize the ovarian masses. Complex ovarian masses with malignant characteristics are then discussed in gynaecology oncology multidisciplinary team meetings to decide on treatment modality and hospital - whether a cancer unit or centre would provide the agreed treatment. Adnexal masses with benign morphological and functional properties may be periodically monitored as an alternative to surgery since malignant transformation is rare. [ABSTRACT FROM AUTHOR]

Aging and menopause are associated with morphological and functional changes which may lead to loss of muscle mass and therefore quality of life. Resistance training (RT) is an effective training mode to increase muscle mass. We reviewed the existing literature to identify studies implementing RT protocols and evaluating muscle hypertrophy exclusively in healthy, postmenopausal and elderly women. Participants' age range was comprised between 50 and 80 years. The primary outcome observed was muscle hypertrophy. Fat mass was also evaluated, if available. PubMed and Web of Science were the screened database, and original articles written in English and published from 2000 up to 2020 were included. 26 articles were considered eligible and included. Quality assessment revealed a "moderate quality" of the included studies, however the majority of studies was able to reach level 4 of evidence and on overall grade of recommendation C. In total, data from 745 female participants subjected to different forms of resistance training were considered. Heterogeneity across studies was present regarding study design, intervention length (mean 16 weeks), training frequency (3 d/w), no. of exercises (n = 7.4) and participants' age (65.8 ± 4.9 years). Small-to-moderate significant increases (k = 43; SMD = 0.44; 95% CI 0.28; 0.60; p < 0.0001) of lean body mass were observed in post-menopausal and elderly women, regardless of age, intervention period, weekly training frequency and no. of exercises. No effects were noted for fat mass (k = 17; SMD = 0.27; 95% CI − 0.02; 0.55; p = 0.07). Studies need to concentrate on providing information regarding training parameters to more effectively counteract the effects of aging and menopause on skeletal muscle mass. [ABSTRACT FROM AUTHOR]

Background: Amongst the cardiovascular risk (CVR) factors, hypertension (HT) and obesity appear to be prominent in post-menopausal women. The underlying mechanisms of HT development in menopause are not fully understood. Aim: To determine the association between HT, obesity and dietary intakes in post-menopausal women from rural Zambia. Setting: This study was conducted in Twatasha Compound of Kitwe and Ndeke Community of Ndola. Methods: Blood pressure (BP), weight, height and dietary intakes (24-h recall) were measured in 153 women (> 50 years) from households. The South African Hypertension Society (SAHS), the World Health Organization (WHO) and estimated average requirements (EARs) guidelines were followed for HT, obesity and dietary intake definitions, respectively. Statistical Package for the Social Sciences (SPSS) version 26 was used for descriptive and inferential statistical analyses. Results: Prevalence of HT was 70%, whilst 37.25% and 28.10% of the participants were overweight and obese, respectively. The median interquartile range (IQR) dietary intakes showed inadequate intakes for most nutrients, except for carbohydrates (170 g [133; 225]). The total fat intake represented 14% of total energy intake. All median fatty acid intakes and sodium intakes (409 mg [169; 662]) were below the recommended levels. Only body mass index (BMI) correlated with HT (r = 0.268; p = 0.001). Conclusions: Despite low dietary intakes, an alarming prevalence of HT and obesity was found in our population. Hormonal changes, a high energy-dense diet and poor treatment adherence, may be possible underlying factors. We recommend measures to better manage HT as a CVR factor. Contribution: This article supplements evidence on the prevalence of obesity-related hypertension in post-menopausal women and the link to dietary intake. [ABSTRACT FROM AUTHOR]

The menopause transition is usually a gradual process occurring over many years, caused by the cessation of ovarian reproductive function, resulting in the end of menstrual bleeding. In the peri-menopause, ovarian function and therefore the production of the hormones oestrogen, progesterone and testosterone can fluctuate greatly, leading to a wide variety of symptoms, affecting multiple organ systems. Menopause and the management of its associated symptoms can be very challenging for patients and clinicians alike and can negatively impact quality of life. The management options include lifestyle adjustment, talking therapies, dietary supplements as well as prescribed medications, including hormone replacement therapy. The UK's average life expectancy for women is approximately 81 years. Therefore, women will now live up to a third of their life being either peri- or postmenopausal. Thus, understanding and treating, where possible, the symptoms of menopause is essential to reduce the burden associated with this physiological state. [ABSTRACT FROM AUTHOR]

• Exercise has multiple health benefits in post-menopausal osteoporotic women. • Recommendations regarding the benefits of specific exercise types are vague. • Improving BMD is essential to prevent osteoporotic vertebral fractures. Osteoporosis is the most prevalent bone disease worldwide and predisposes affected individuals to fragility fractures. Exercise has been shown to have multiple health benefits in post-menopausal osteoporotic women, but often recommendations regarding the benefits of specific exercise types are vague. Improving bone mineral density (BMD) is an essential component in any program to prevent osteoporotic vertebral fractures. The objective of this report is to briefly review the current understanding on the impact of exercise on BMD in postmenopausal women as it pertains to fragility fractures. Broad categories of exercises include aerobic, resistance, stretching, and balance. Tai Chi, Yoga, and Pilates are a heterogeneous group of specific exercise modalities that can span multiple categories. Current literature suggests that only resistance type exercises have a convincing impact on BMD. Core-strengthening exercises and attention to posture/balance can help mitigate falls. A number of barriers affect patient compliance and accessibility to exercise. In summary, exercise should be included in any multi-modality osteoporosis treatment plan with the goal of sustained exercise throughout life. If possible, osteoporotic women should be on a resistance-based regimen incorporating weight-bearing exercises, and also target posture and balance. Healthcare providers and educators should have resources readily available for patients. [ABSTRACT FROM AUTHOR]

Genital myiasis in females is a parasitic infection of the vulval region with the larva of various files species. Only a few cases of urogenital myiasis have been reported in the literature. We present a case of 55 years postmenopausal, farmer female otherwise healthy presenting to the outpatient department with complaints of maggots and severe itching in the vulval region. Examination revealed erythema in the labia major and groin without lymphadenopathy. In the vaginal examination; inflammation and a large number of maggots were observed in the urethral meatus, labia minora, and vaginal canal, progressing to the cervix. With this, she was diagnosed to be a case of urogenital myiasis. She was managed with the extraction of maggots using turpentine oil, along with broad-spectrum antibiotics and Foleys catheterization for a week. Later during follow up, she was asymptomatic and examination revealed no maggots, and the lesions were healed. Extraction of maggots along with symptomatic management is the mainstay of treatment of myiasis. A significant number of the adult population in the rural areas of developing countries are illiterate and are not familiarized with education regarding genital hygiene. So, along with physicians, policy makers should also be involved in public awareness for genital hygiene. Despite being rare, urogenital myiasis is preventable and treatable condition. Efforts at increasing genital hygiene awareness in a low resource country are utmost for its prevention. • Urogenital myiasis is rare case with maggot infestation of the vulval region. • Manual extraction of maggots using turpentine oil, along with symptomatic treatment is the mainstay of treatment. • Public health awareness regarding maintenance of genital hygiene among the women of rural areas must be encouraged. [ABSTRACT FROM AUTHOR]

The purpose of the current investigation was to determine the impact of eight weeks of progressive resistance exercise on strength and morphology of previously sedentary, healthy, post-menopausal women. Six women were recruited from the Grahamstown community in the Eastern Cape, South Africa. Recruits were required to attend five sessions per week (Monday to Friday) of 30 minute duration each. Eight 'compound' resistance exercises (each completed as three sets of 10 repetitions) comprised the exercise programme. Anthropometric (body mass and stature), morphological (body mass index (BMI), lean mass, and fat mass content), and strength (upper and lower body) measures were taken at baseline and at weeks 4 and 8. There were no significant changes (p>.05) in body mass, BMI, fat mass or lean mass. An insignificant trend toward increasing upper body strength was noted. Lower extremity strength increased significantly by 42.52%. In conclusion, this resistance training intervention did not significantly alter body composition but did positively impact leg strength. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: A cross-sectional study was conducted to determine bone health status and nutrient intakes among post-menopausal women residing in low cost houses in Cheras, Kuala Lumpur. Methods: A total of 125 subjects aged 60 ± 4 years who had attained menopause at age 50 ± 5 years participated in this study. Subjects' weight and height were measured and calculated for body mass index (BMI). They were also assessed for bone health status using the Quantitative Ultrasound (QUS). Nutrient intake was assessed using a dietary history Questionnaire. Fasting serum lipid and blood pressure measurements were also taken. Results: The majority of the subjects were overweight and obese (80%) based on BMI status. Calcaneal measurements using the QUS indicated that while 57% or the subjects had normal bone mineral density, 37% were osteopenic and 6% osteoporotic. Calcium intake of the subjects was 505 ± 263mg /day, which is only 50% of the Malaysian Recommended Nutrient Intake for calcium (1000 mg/d). About 74% of the subjects were hypercholesterolemic and 58% were hypertriglyceridemic. Two-thirds reported that they were taking medication for hypertension, diabetes mellitus and heart disease. Conclusion: The results showed low health and nutritional status among post-menopausal women living in low-cost flats in Kuala Lumpur. They have low bone mass which may be due to their predominantly non-milk based diets which places them at high risk of hip fractures. Apart from milk, other food sources of calcium, including soya bean products such as 'tempeh' and healthy ways of cooking should be recommended to older people. [ABSTRACT FROM AUTHOR]

Background: Amongst the most important issues in women's health are the risks and benefits of estrogen replacement therapy. However, continual uncertainty and lack of consensus of standard estrogen replacement therapy has driven many women to seek alternative sources of estrogen, including herbal remedies. To date, there has been no clinical study to look at the effects of Labisia pumila var. alata (Kacip Fatimah) on post- menopausal women. In view of the initial evidence from animal studies that the plant contains phytoestrogens and exert androgenic and estrogenic activities, it is postulated that Labisia pumila may be beneficial to these women. BioLabisia™ is a water extract of Labisia pumila var. alata, produced using a patented technology developed by a group of Malaysian scientists. The objectives of this study were to determine the effects of varying doses of BioLabisia™ a standardized sprayed-dried water extract of Labisia pumila var. alata on the safety profiles such as haematological indices, liver and renal function and the cardiovascular effects from body mass index, waist hip ratio, the effects on blood pressure, chest x-ray and ECG changes. Methodology: This is a randomized, double-blind, placebo-controlled study comparing the effects of BioLabisia™, at 140, 280 or 560 mg/day, given for 6 months, in a group of post-menopausal, but otherwise healthy, Malay women aged 48-55 years old. Ethical approval from participating hospitals were obtained prior to the study. 70 eligible participants were divided into four groups. Group 1 received 140 mg/day BioLabisia™, Group 2 received 280 mg/day BioLabisia™, Group 3 received 560 mg/day BioLabisia™ and group 4 received placebo (maltodextrine). Pre study screening and assessment was done and if the subject was eligible, informed consent was taken and baseline investigations including hematological, liver and renal function tests, chest x-ray and electrocardiography (ECG) were performed. Those respondents with normal baseline investigations were invited to participate in this study. The study duration was six months and all participants were required to come to the clinic for clinical examination two monthly. During each visit the participants were asked regarding any side effects of medication. The participants were also required to come for a supply of medication each month and the investigator team had to ensure that all participants complied with the medication and scheduled visits. On visit 4, all blood investigations, blood pressure, chest x-ray and ECG were repeated again. Results: There was no significant difference seen in demographic profile between the four groups of post-menopausal women. No significant changes were seen in the measurement of body mass index and the waist hip ratio at the end of study period. In terms of haematological indices, liver and renal function, no significant changes were seen in each of the four groups. Other investigations such as blood pressure, chest x-ray and ECG were all normal. Conclusion: In summary, based on the clinical and laboratory evidence, daily intake of BioLabisia™ up to 560 mg/day for 6 months, was found to be safe and has not been shown to cause any adverse effect to the body. [ABSTRACT FROM AUTHOR]

The article provides information on a study that examined the effect of poly-ϒ-glutamic acid (PGA) on calcium absorption in humans. It hypothesized that the mode of action of PGA is increased calcium solubility in the gut lumen thereby increasing paracellular calcium absorption in the lower intestine. It concludes that postmenopausal women given a single dose of PGA demonstrated an increase in intestinal calcium absorption.

Summary: Little is known about patients’ experience of, and knowledge about adjuvant endocrine therapy. A European survey was carried out to explore this knowledge gap. The 547 post-menopausal women with early breast cancer, from 9 European countries, completed a questionnaire about their experience and knowledge of their therapy. Forty one percent of women surveyed were not at all involved in the decision to start adjuvant endocrine therapy and only 10% were fully involved. Only 57% received information about possible side effects, 26% about the risk of their cancer returning and 15% about the possible long term effects of treatment. Older women, less educated women or those without Internet access were less likely to receive information or be involved in decision making. Women''s right to information and involvement in decision making are not respected. Greater efforts are required to ensure that all patients understand how different therapies work so that they can make informed decisions. [Copyright &y& Elsevier]

Summary: Approximately 45% of all women will suffer at least one osteoporotic fracture during their lifetime. Until recently, 20–50% of post-menopausal women were taking hormone replacement therapy, their main motivation often being the prevention of osteoporosis, and while the Women''s Health Initiative recently documented an efficacy of hormone replacement therapy against fractures, it also documented an unfavourable ratio between beneficial and adverse effects. Thus, many women face the choice of continuing, terminating or changing therapy. Fortunately, several other options for pharmacological intervention have been demonstrated to decrease the risk of fractures in randomised studies. Anticatabolic drugs include calcium, vitamin D, oestrogen, raloxifen and bisphosphonates (e.g. etidronate, alendronate, risedronate, ibandronate and pamidronate). Anabolic drugs include parathyroid hormone. Finally, strontium ranelate has both anticatabolic and anabolic effects. In addition, evidence suggests that individualised advice on lifestyle modification, for example increased physical exercise, cessation of smoking, fall prevention and the use of hip protectors, should be offered to most patients. [Copyright &y& Elsevier]

• Adoption of adjuvant bisphosphonates for early breast cancer into standard clinical practice. • UK and Australian experience of adjuvant bisphosphonates in early breast cancer. • Pathway taken for adjuvant bisphosphonates implementation in the UK. • Steps to increase update of adjuvant bisphosphonates in early breast cancer. • Improve the care of women with early breast cancer. International guidelines recommend adjuvant bisphosphonates (BPs) for post-menopausal women with early breast cancer to reduce recurrence and mortality. However, globally, wide variation exists in their adoption. In the UK, adjuvant BPs were a recommendation in the breast cancer Clinical Reference Group service specification and were included as a priority for implementation by the national oncologists group UK Breast Cancer Group in November 2015, promoting national uptake, guidance and funding arrangements. In 2018, adjuvant BPs were recommended by the UKs National Institute for Health and Care Excellence. In Australia, adjuvant BPs are still 'off-label' and do not receive national reimbursement or endorsement. To date there has been no research into the prescribing habits of these agents in Australia. With the aim to gather data on adjuvant BPs prescribing practices, online surveys were developed and disseminated to breast oncologists in both countries between December 2018 and June 2019. Almost all of the UK oncologists prescribed adjuvant BPs, demonstrating that education, endorsement from professional bodies, presence of national guidelines and funding decisions have been critical to implementation. In contrast, only 48% of the Australian responders prescribed adjuvant BPs, while 83% reported that they would prescribe them if funding was available. Lack of local protocol guidance was also seen as a major barrier. This study was intended to assess the pathway taken for adjuvant BP implementation in the UK and how it might inform changes in Australian practice and also guide other countries with similar issues with the ultimate aim of improving the care of women with early breast cancer globally. [ABSTRACT FROM AUTHOR]