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The rising costs of health care in the United States continue to stimulate interest in alternative health care options among Americans. Western medicine is also beginning to pay more attention to these alternative practices and their utility for successful treatment of illness. Alternative health care practices have always been used by Hispanics whose mortality and morbidity profiles have stimulated interest from researchers. Though Hispanics occupy some of the lowest socioeconomic positions in the United States, they have higher life expectancy rates and comparable rates of morbidity for many health conditions relative to other racial/ethnic groups. This has been referred to as the "Hispanic health advantage" and the "Hispanic health paradox" [Turra CM, Elo IT. The impact of salmon bias on hispanic mortality advantage: new evidence from social security data. Popul Res Policy Rev. 2008;27:515. Franzini L, Fernandez-Esquer ME. Socioeconomic, cultural, and personal influences on health outcomes in low income Mexican-origin individuals in Texas. Soc Sci Med. 2004;59(8):1629-1646. George M. The Mexican-American health paradox: the collective influence of sociocultural factors on Hispanic health outcomes., Discussions: 2013;9(2):2-3. Gallo LC, Penedo FJ, Espinosa de los Monteros K, Argueles W. Resiliency in the face of disadvantage: do hispanic cultural characteristics protect health outcomes. J Pers. 2009;77(6):1707-1746. Turra CM, Goldman N. Socioeconomic differences in mortality among U.S. adults: insights into the Hispanic paradox. J Gerontol. 2007;62(3):184-192]. Even when controlling for socioeconomic status and education, life expectancy for Hispanics is greater than that of whites (CDIC, 2015). Debate about the causes of this paradox continues and some data indicates that the paradox is specific to older Hispanics (i.e., middle and older ages). Among Hispanic ethnic groups, this "paradox" has been most salient for Mexican Americans, therefore, this chapter focuses on Mexican Americans and the intersections of traditional health care practices among Mexican Americans (curandismo) with the practice of Western medicine to explore how they combine and conflict to impact aging Hispanics in three health areas: diabetes, menopause, and dementia., (Copyright © 2017. Published by Elsevier Inc.)

Abstract The vaginal microbiome of trans men and menopausal women is suspected to be similar due to a lack of estrogen leading to the absence of lactobacilli. However, data are scarce. We performed an analysis of the vaginal microbiome of trans men (n = 25) in comparison to that of menopausal (n = 25) and premenopausal women (n = 25). The vaginal microbiome of trans men and menopausal women showed a higher alpha diversity than that of premenopausal women. Various beta diversity indices (e.g., Bray‒Curtis (Un-)Weigthed Unifrac), showed significant differences in community composition between trans men and premenopausal (p

Abstract The proportion of women experiencing premature menopause is on the rise in India, particularly in the age groups of 30–39 years. Consequently, there is a need to understand the factors influencing the prevalence of premature menopausal status among women. Our study uses the data from 180,743 women gathered during the latest Indian version of the Demography Health Survey (National Family Health Survey-5). Our results suggest that close to 5% of women in rural areas and 3% of women in urban areas experience premature menopause, and this figure varies across Indian States. The regression results show that surgical menopause, lower levels of education, poorer wealth index, rural residence, female sterilization, and insurance coverage are key drivers of premature menopause. One of the striking factors is that the prevalence of premature menopause among those with the lowest levels of education (6.85%) is around seven times higher than those with the highest level of education (0.94%). We conducted a decomposition analysis to delve into the factors contributing to this inequality. The results show that undergoing a hysterectomy (surgical menopause) account for 73% of the gap in premature menopausal rates between women with the lowest and highest levels of education. This indicates that women with poor education are more likely to undergo hysterectomy at a younger age. This finding warrants further exploration as we would expect that women from lower socio-economic background would have limited access to surgical care, however, our results suggest otherwise. This perhaps indicates a lack of awareness, lack of alternative treatment options, and over-reliance on surgical care while neglecting conservative management. Our results have implications for addressing the diverse needs of the increasing number of women in their post-menopause phase and for focusing on conservative treatment options for these women.

Introduction: Physical exercises, in conjunction with Tribulus supplementation, can serve as an alternative to prevent complications associated with menopause. This study investigated the impact of combined exercises and Tribulus supplementation on the sex hormones estrogen, testosterone, and the testosterone-to-cortisol ratio in overweight postmenopausal women.Methods: In this study, 60 inactive postmenopausal women were selected based on voluntary entry criteria and were randomly divided into four groups of 15 individuals: combined exercise, supplement, combined exercise with supplement, and control. The combined training consisted of 10 weeks of aerobic and resistance training. The participants took a Tribulus supplement in the form of 500 mg capsules twice a day for ten weeks. The estradiol, cortisol, testosterone, and testosterone-to-cortisol ratios were measured before and after the training protocol. Data analysis was performed using SPSS version 25 software and repeated measures analysis of variance test.Results: The results showed a significant decrease in cortisol levels in the three experimental groups (P=0.001). There was also a significant increase in the total testosterone-to-cortisol ratio among the three experimental groups and the control group (P=0.001). This significant increase was also observed between the exercise and supplement group (P=0.001) and between the supplement group and the combined exercise + supplement group (P=0.001). No significant difference was observed in follicle-stimulating hormone, estradiol, and dehydroepiandrosterone (P>0.05).Conclusion: According to the results of this study, it is possible to use combined exercises with Tribulus supplement as an effective intervention to improve sex hormones in overweight postmenopausal women.

Abstract Background Menopause, 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. Methods This 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

Background Previous studies have found associations between monocyte count, high-density lipoprotein cholesterol (HDL-C), and thyroid-stimulating hormone (TSH) with acute coronary syndrome (ACS). However, research on the correlation between the monocyte count to high-density lipoprotein cholesterol ratio (MHR) and the onset of ACS is limited. The association between MHR, TSH, and the onset of ACS in postmenopausal women remains unclear. Objective To explore the predictive value of MHR and TSH for the onset of ACS in postmenopausal women and to investigate the correlation between these indicators and the degree of coronary artery stenosis in patients. Methods A total of 325 postmenopausal women hospitalized in the Department of Cardiology at Northern Jiangsu People's Hospital, from 2020 to 2021 and who underwent coronary angiography were selected as the study subjects. Patient general information was collected through the electronic medical record system. Venous blood was collected upon admission to measure monocyte count, total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C), and TSH. Left ventricular ejection fraction (LVEF) was measured using the biplane Simpson method, and coronary artery lesions were observed through coronary angiography. The Gensini scoring system was used to uniformly measure the extent of coronary artery lesions. Patients meeting the diagnostic criteria for ACS were classified as the ACS group (n=184), and non-ACS patients as the control group (n=141). The ACS group was further divided into subgroups based on the tertiles of the Gensini score: ≤36.5 as the low-risk subgroup (n=59), 36.6-66.5 as the moderate-risk subgroup (n=64), and >66.5 as the high-risk subgroup (n=61). Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of ACS. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of TSH, MHR, and combined detection for ACS and to calculate the area under the curve (AUC). Spearman's rank correlation analysis was used to explore the correlation between TSH, MHR, and combined detection indicators with the Gensini score. Results The baseline data of patients in the ACS and control groups showed that BMI, smoking rate, hypertension, diabetes, LDL-C, monocytes, TSH, and MHR in the ACS group were higher than in the control group, while LVEF and HDL-C were lower (P

Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder affecting women across various life stages, presenting a wide array of symptoms that differ markedly during adolescence, reproductive age, and menopause. In adolescence, the overlap of PCOS symptoms with normal pubertal changes complicates diagnosis, with common presentations including menstrual irregularities, acne, and hirsutism. During the reproductive years, PCOS is often associated with infertility, menstrual dysfunction, and metabolic complications such as insulin resistance and type 2 diabetes. In menopausal women, reproductive symptoms diminish, but the risk of cardiovascular disease, persistent hyperandrogenism, and metabolic syndrome becomes more pronounced. This review aims to define the distinct clinical presentations of PCOS across these life stages, highlighting the diagnostic and management challenges inherent to its heterogeneous nature. By understanding the age-specific manifestations and complications of PCOS, healthcare providers can develop more effective, individualized therapeutic strategies, ultimately improving patient outcomes and quality of life.

Abstract Studies on the beneficial role of dietary antioxidants in preventing or managing hypertension in postmenopausal women are infrequent. The present cross-sectional study aimed to assess the association between dietary antioxidants and hypertension among menopausal women in Rafsanjan, a city located in the southeast of Iran. This study was based on data from the Rafsanjan Cohort Study (RCS), as part of the Prospective Epidemiological Research Studies in IrAN (PERSIAN). Among 2359 postmenopausal women, finally, 1936 women were included in this study. Participants were grouped as having normal blood pressure (BP), elevated BP, stage 1 hypertension, or stage 2 hypertension as defined by the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) BP guideline. A food frequency questionnaire (FFQ), was utilized to ascertain the levels of various nutrients and dietary antioxidants in the diet. The association between dietary intakes of antioxidants and blood pressure groups was evaluated by crude and adjusted models in the multinominal logistics regression analysis. Normal BP, elevated BP, stage 1 hypertension, and stage 2 hypertension were observed in 35.69%, 3.62%, 10.59%, and 50.10% of postmenopausal women respectively. In the adjusted model, in subjects with higher consumption of β-carotene, the odds ratios of elevated BP in the 3rd quartile was about 2 times (OR: 2.04 (1.06–3.93) higher than 1st quartile. Also, in subjects with medium quality of DAQS, the odds ratios of elevated BP and stage 1 blood pressure were about 2 times (OR: 2.09 (1.05–4.17) and 1.69 times (OR: 1.69 (1.09–2.63) higher than subjects with low quality respectively. Furthermore, we did not find any statistically significant association between increased intake of dietary antioxidants and decreased odds of hypertension. After controlling the effects of confounding variables, increased dietary intake of selenium, carotenoids, vitamin A, vitamin C, and vitamin E did not decrease the odds of hypertension in postmenopausal women. Accordingly, it is suggested that this association be further investigated in the follow-up phase of this prospective study.

Abstract Woodsmoke (WS) exposure is associated with significant health-related sequelae. Different populations can potentially exhibit varying susceptibility, based on endocrine phenotypes, to WS and investigating neurological impacts following inhaled WS is a growing area of research. In this study, a whole-body inhalation chamber was used to expose both male and female C57BL/6 mice (n = 8 per group) to either control filtered air (FA) or acute WS (0.861 ± 0.210 mg/m3) for 4 h/d for 2 days. Neuroinflammatory and lipid-based biological markers were then assessed. In a second set of studies, female mice were divided into two groups: one group was ovariectomized (OVX) to simulate an ovarian hormone-deficient state (surgical menopause), and the other underwent Sham surgery as controls, to mechanistically assess the impact of ovarian hormone presence on neuroinflammation following FA and acute WS exposure to simulate an acute wildfire episode. There was a statistically significant impact of sex (P ≤ 0.05) and statistically significant interactions between sex and treatment in IL-1β, CXCL-1, TGF-β, and IL-6 brain relative gene expression. Hippocampal and cortex genes also exhibited significant changes in acute WS-exposed Sham and OVX mice, particularly in TGF-β (hippocampus) and CCL-2 and CXCL-1 (cortex). Cortex GFAP optical density (OD) showed a notable elevation in male mice exposed to acute WS, compared to the control FA. Sham and OVX females demonstrated differential GFAP expression, depending on brain region. Overall, targeted lipidomics in phosphatidylcholine (PC) and phosphatidylethanolamine (PE) serum and brain lipids demonstrated more significant changes between control FA and acute WS exposure in female mice, compared to males. In summary, male and female mice show distinct neuroinflammatory markers in response to acute WS exposure. Furthermore, ovarian hormone deficiency may impact the neuroinflammatory response following an acute WS event.

Introduction: Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal women. In the early menopausal years, endometrial hyperplasia, polyps and submucosal fibroids are common etiologies of post menopausal bleeding. The most common cause of postmenopausal bleeding is endometrial atrophy, comprises of 60-80%, while endometrial hyperplasia and endometrial cancer contribute to only 11% of Post menopausal bleeding. The aim of study is to analyses histomorphological pattern of endometrium in patients presenting with post-menopausal bleeding in Jharkhand. Materials and Methods: 103 postmenopausal women presenting to tertiary center of Jharkhand in 2020-22 with bleeding were subjected to endometrial curettage for histopathology. Analysis is based on morphological criteria to assess endometrium. Endometrial histology is of four categories: Proliferative, Secretory, premalignant and carcinoma. Results: The highest incidence of postmenopausal bleeding was noticed in age group of < 60 years and incidence of malignancy was higher after 57 years of age. The majority of patients had parity between 1 and 3 (78.6%). Malignant & premalignant lesions comprises about 22.3% among that 77.7% were due to benign causes. Among the benign causes of postmenopausal bleeding, proliferative endometrium was the commonest finding. Types of hyperplasia encountered were simple hyperplasia without atypia (6.8%), Complex hyperplasia without atypia (3.9%),Complex hyperplasia with atypia (4.8%) and Simple hyperplasia with atypia (4.8%). 21.4% of cases of postmenopausal bleeding were associated with atrophic endometrium. Secretory endometrium seen in 17.5% of women. Endometrial carcinoma accounted for 12.6% of cases of postmenopausal bleeding. Out of these 69.2% were of endometroid type of endometrial carcinoma, 15.3% were of papillary serous carcinoma and 15.3% had clear cell carcinoma. The mean age of patients with endometrium carcinoma was 62.3 years. All cases of endometrial carcinoma were associated with 1 or more risk factor like diabetes/hypertension/Nulligravida. Conclusion: Proliferative Endometrium was a major cause of postmenopausal bleeding. Among the malignant causes, endometrial adenocarcinoma of endometroid type was most frequent with a lower mean age at presentation than other high grade cancers like papillary serous carcinoma & clear cell carcinoma.

Abstract Background The role of metabolism in the variation of age at menarche (AAM) and age at natural menopause (ANM) in the female population is not entirely known. We aimed to investigate the causal role of circulating metabolites in AAM and ANM using Mendelian randomization (MR). Methods We combined MR with genetic colocalization to investigate potential causal associations between 658 metabolites and AAM and between 684 metabolites and ANM. We extracted genetic instruments for our exposures from four genome-wide association studies (GWAS) on circulating metabolites and queried the effects of these variants on the outcomes in two large GWAS from the ReproGen consortium. Additionally, we assessed the mediating role of the body mass index (BMI) in these associations, identified metabolic pathways implicated in AAM and ANM, and sought validation for selected metabolites in the Avon Longitudinal Study of Parents and Children (ALSPAC). Results Our analysis identified 10 candidate metabolites for AAM, but none of them colocalized with AAM. For ANM, 76 metabolites were prioritized (FDR-adjusted MR P-value ≤ 0.05), with 17 colocalizing, primarily in the glycerophosphocholines class, including the omega-3 fatty acid and phosphatidylcholine (PC) categories. Pathway analyses and validation in ALSPAC mothers also highlighted the role of omega and polyunsaturated fatty acids levels in delaying age at menopause. Conclusions Our study suggests that metabolites from the glycerophosphocholine and fatty acid families play a causal role in the timing of both menarche and menopause. This underscores the significance of specific metabolic pathways in the biology of female reproductive longevity.

Menopause is an inevitable phase in every woman’s life. Women may suffer from unpleasant symptoms during perimenopause. Understanding the health needs of the community during this period will help in developing menopause management programs that can improve quality of life. Aim: To study the symptoms of menopause and perception of women in relation to menopause in order to understand their needs. Settings and Design: A cross-sectional, multi-centric study was undertaken at three institutions (called DH, SJ, and SK) at two cities in India. The study population comprised women between the ages of 40 and 60. Institutional Ethics Committee approval and consent of participants were ensured. Material and Methods: Two instruments, a pilot-tested, peer-reviewed, validated, structured questionnaire and the Menopause Rating Scale (MRS) were utilized for the study. The minimum sample size was calculated to be 385 per site. Statistical analysis was conducted using the IBM Statistical Package for Social Sciences. Results: A total of 1297 forms were analyzed. MRS scores showed psychological symptoms to be most prevalent. Joint and muscular pains were the most common somatic symptoms. Hot flashes and urogenital symptoms were experienced by a lower number. Our MRS scores were significantly higher than those seen in other regions. Urban women, site SJ, those with irregular menstrual cycles, and lower incomes scored higher than their counterparts. Awareness about menopause was patchy, especially regarding medication or support services available. Conclusions: The high MRS scores emphasize the need to institute awareness programs, providing information on choices available for care (hormone replacement therapy, medications, or counseling) and information on where to access services. Primary care physicians can play a vital role in fulfilling this need by ensuring timely knowledge to the community, providing correct diagnosis and treatment. This will help improve the quality of life and sense of well-being of this community.

Arterial stiffness (AS) has been shown, for the general population, as an independent risk factor for cardiovascular events and mortality. In postmenopausal women, the association of AS with age, cardiovascular disease, and metabolic syndrome (MetS) is not yet well established. Analyse the influence of MetS, age, body mass index (BMI), and menopausal characteristics on the variation of AS in early (EP) and late (LP) postmenopause. The sample consisted of 121 women (58.10±6.46 years old), 57% with LP. Waist circumference (WC) was measured at a level midway between the bottom of the rib cage and the superior margin of the iliac crest, and BMI (obesity: BMI≥25.5 kg/m2) was calculated using the standard equation. MetS was defined as the coexistence of at least 3 of the following 5 risk factors: WC≥80 cm, triglycerides≥150 mg/dL or treatment for dyslipidaemia, high-density lipoprotein

Abstract Background and Aims Targeted research on physiological and psychological changes during menopause is crucial. Most studies have prioritized the investigation of psychological disorders during menopause, with a limited comparison of mental health among women in the various stages surrounding menopause. This study aims to explore the difference in depression and anxiety prevalence between women in premenopausal and menopause. Methods This cross‐sectional study was conducted on 242 female participants referred to Imam Hossein (AS) Educational and Therapeutic Hospital affiliated with Shahid Beheshti University of Medical Sciences. These 242 individuals were selected through accessible sampling. 122 individuals were placed in the menopausal group and 120 individuals in the premenopausal group. First, the medical history of all participants was taken, and then the Beck questionnaire was administered to examine the levels of depression and anxiety. The association between the occurrence and severity of depression and anxiety in menopausal and premenopausal groups was statistically analyzed. Results In this study, the age range of the participants was 45−70, the overall prevalence of depression was estimated to be 33.5% and the overall prevalence of anxiety was estimated to be 54.2%. The prevalence of depression was 30.2% and 36.6% in the menopausal and premenopausal groups, respectively. The prevalence of anxiety was estimated to be 52.5% and 55.7% in the menopausal and premenopausal groups, respectively. No significant difference was observed between the two groups in terms of the occurrence and severity of depression and anxiety. Conclusion our study found a higher incidence of depression during premenopause compared to menopause, possibly due to greater hormonal fluctuations. Despite this, there wasn't a significant confirmation of this hypothesis compared to other groups. Nonetheless, there's a higher prevalence of depression and anxiety among premenopausal women, emphasizing the need for screening and intervention, such as hormone therapy, to prevent severe outcomes.

Background and Aim: The number of qualitative studies on the phenomenon of menopause has made it possible to create a new interpretation of understanding the psychosocial experiences of the women during menopause by synthesizing these studies. The purpose of this study was to deeply identify and comprehensively understand the consequences and psychosocial problems of menopause in women. Material and Method: In this study, systematic review and synthesis, Iranian articles in Farsi or English, and original studies with qualitative research method, were included. The articles whose full texts were not available and which had been presented in the conferences, as well as the articles which were published as a letter to the editor and had insufficient data, were excluded from the systematic review. Using the CASP checklist, the selected articles were critically evaluated, and finally 11 articles were included in the systematic review. Data were analyzed using MAXQDA 20 software. Results: Two main themes of satisfaction and positive change in life and dissatisfaction and degradation of women's role were extracted. The theme of feeling of satisfaction and positive change in life included sub-classes of feeling satisfied, accepting menopause, and adopting a new way of life. The theme of feelings of dissatisfaction and degradation of the female role included the subcategories of attitudes and negative feelings towards menopause, dysfunction and female existence. Conclusion: In general, women's psychosocial experience of menopause, due to its complexity and all-round effects on women's health, is placed in a range between satisfaction and acceptance of changes to dissatisfaction and negative attitude towards the phenomenon of menopause. A comprehensive insight into women's experiences and feelings during this period can help policy making and planning interventions to improve women's health during menopause.

Abstract In this study, we examined the difference in the vaginal microbiota of women infected with human papillomavirus (HPV), according to menopausal status. A total of 75 cervicovaginal swab samples from 38 pre- and 37 postmenopausal women with HPV infection were obtained from the Korean HPV cohort. Vaginal microbiota analysis, including microbial diversity and specific bacterial abundances, was performed using 16S rRNA gene sequencing. The mean age of the pre- and postmenopausal women were 29.5 and 55.8 years, respectively (p

Approximately one billion women globally have undergone menopause, occurring at an age of around 51 years and typically between ages 45 and 54. As life expectancy increases, women are projected to spend at least one-third of their lives in postmenopause, emphasising the growing importance of menopause as a critical public health issue. In this context, this paper aims to offer updated insights into the increasing societal and political interest in menopause. It underscores the impact of support mechanisms encompassing familial, workplace, medical, technological, and government support on women’s attitudes and experiences around menopause. Furthermore, the study aims to identify key gaps in research, practice, or legislation concerning support systems for menopausal women and provide recommendations for enhancing familial, workplace, medical, technological, and government support.

In modern medicine, the relevance of the problem associated with the aging of the female body is undeniable. Due to the decrease in the intensity of secretion of sex steroids, the addition of metabolic syndrome is accompanied by processes which can worsen women quality of life. Under conditions of hypoestrogenemia, their physical condition suffers, which directly depends on the structure of the connective tissue that forms the basis of the skin, blood vessels, kidneys, bones, joints and ligaments. This literature review presents current data on reversible and irreversible clinical manifestations of climacteric syndrome. Reversible processes are based on changes that can be corrected: vasomotor, psycho-emotional, urogenital, sexual and musculoskeletal. Late manifestations of menopause on the part of metabolic disorders in the connective tissue determine the greatest severity of the course, and therefore represent a serious public health and health problem. The literature review shows in detail the features of the immune regulation of collagen metabolism, the characteristics of changes in bone modeling markers under conditions of estrogen deficiency. Clinically proven efficacy of phytoestrogens in menopausal disorders and metabolic disorders in women. This review shows the mechanism for reducing vasomotor symptoms, slowing down the process of bone tissue destruction in patients under the influence of this group of drugs. In addition, phytoestrogens provide the correction of lipid metabolism, thereby depressing atherogenesis and promoting prevention of cardiovascular complications. It is necessary to develop a strategy to normalize the vital functions of perimenopausal patients with symptoms of menopause with the introduction into clinical practice of measures to maintain the quality of life of women.

Abstract Background It has been repeatedly shown that men infected by SARS-CoV-2 face a twofold higher likelihood of dying, being hospitalized or admitted to the intensive care unit compared to women, despite taking into account relevant confounders. It has been hypothesized that these discrepancies are related to sex steroid hormone differences with estrogens being negatively correlated with disease severity. The objective of this study was therefore to evaluate COVID-19-related mortality and morbidity among peri- and postmenopausal women in relation to estrogen-containing menopause hormonal treatments (MHT). Methods This is a national register-based matched cohort study performed in Sweden between January 1 to December 31, 2020. Study participants comprised women over the age of 53 years residing in Sweden. Exposure was defined as prescriptions of local estrogens, systemic estrogens with and without progestogens, progestogens alone, or tibolone. MHT users were then compared with a matched cohort of non-users. The primary outcome consisted of COVID-19 mortality, whereas the secondary outcomes included inpatient hospitalizations/outpatient visits and confirmed SARS-CoV-2 infection. Multivariable adjusted Cox regression-derived hazard ratios (HRs) were calculated. Results Use of systemic estrogens alone is associated with increased COVID-19 mortality among older women (aHR 4.73, 1.22 to 18.32), but the association is no longer significant when discontinuation of estrogen use is accounted for. An increased risk for COVID-19 infection is further observed for women using combined systemic estrogens and progestogens (aHR 1.06, 1.00 to 1.13) or tibolone (aHR 1.21, 1.01 to 1.45). Use of local estrogens is associated with an increased risk for COVID-19-related death (aHR 2.02,1.45 to 2.81) as well as for all secondary outcomes. Conclusions Systemic or local use of estrogens does not decrease COVID-19 morbidity and mortality to premenopausal background levels. Excess risk for COVID-19 morbidity and mortality was noted among older women and those discontinuing systemic estrogens. Higher risk for death was also noted among women using local estrogens, for which non-causal mechanisms such as confounding by comorbidity or frailty seem to be the most plausible underlying explanations. Trial registration details Not applicable.

Background: Urinary incontinence (UI) is an unintentional or involuntary loss of urine. Stress and urge incontinence are the most common types. Many women feel embarrassed to seek medical care, and it affects their quality of life to a greater extent and is usually a neglected problem among rural communities. Objective: The objective of the study was to estimate the prevalence and to determine the factors associated with UI among peri- and postmenopausal women. Methodology: A community-based cross-sectional study was done among 200 peri- and postmenopausal women of age ≥40 years. The sample size was calculated using a prevalence of 25% from previous studies with a 95% confidence interval and absolute precision of 6%. A simple random sampling technique was employed. A semi-structured questionnaire consisting of the Questionnaire for Urinary Incontinence Diagnosis scale was used for data collection. Data analysis was performed in SPSS version 20.0. P ≤ 0.05 was considered statistically significant. Results: The prevalence of UI was 24% (48 out of 200 women), of which stress incontinence was seen in 15% and urge incontinence in 17% of women. Mixed incontinence was seen in 8% of women. Factors such as increasing age, attainment of menopause, chronic constipation, diabetes, and recurrent UTIs were significantly associated with UI. Conclusion: Two out of every ten peri- and postmenopausal women were found to have UI. Identification of women at risk, educating them regarding preventive measures, following a healthy diet, and encouraging them to seek medical care can greatly reduce their chance of developing UI and aid in improving their quality of life.

Background Menopause will cause series of pathophysiologic changes and long-term complications (coronary heart disease, cerebrovascular disease, osteoporosis, etc.), among which coronary heart disease is a major health threat. Objective To investigate the effects of menopausal status and aging on common risk factors for coronary heart disease (CHD) in middle-aged women, such as increased carotid intima-media thickness (CIMT), hypertension, dyslipidemia, diabetes, and obesity. Methods A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selected, with 89 excluded according to relevant criteria, and 467 women were finally included as study subjects. The included subjects were divided into the pre-menopausal group (n=176) and postmenopausal group (n=291) according to whether they were postmenopausal during a 3-year follow-up period. Changes in BMI, waist circumference, blood glucose, blood pressure, blood lipids and other indicators were monitored, inter- and intra-group comparisons were performed before and after the follow-up period. Multivariate Logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women. Results The average age of 467 subjects was (47.6±2.3) years old. Compared with baseline, waist circumference, uric acid (UA), total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) levels increased, fasting blood glucose (FBG) level decreased after 3 years (P

Background: Vulvovaginal atrophy (VVA) is a common condition and a silent epidemic affectingmany postmenopausal women who suffer from it in silence. This study aimed to evaluate the effect ofCitrus aurantium vaginal cream on vaginal atrophy in postmenopausal women.Methods: This single-group pretest-posttest quasi-experimental study was conducted on 30postmenopausal women who were referred to the Gynecology Clinic of Imam Khomeini Hospital in thecity of Noor, Iran, from June to November 2020. Citrus aurantium vaginal cream was administered towomen diagnosed with vaginal atrophy (based on subjective symptoms of atrophy, descriptive evaluationof the vagina, vaginal pH measurement, and degree of vaginal maturation determined by vaginal smear)every night in the first two weeks and every other night for the second two weeks. Data were collectedusing the scale of subjective symptoms of vaginal atrophy; descriptive evaluation checklist of vaginalmucosa; laboratory results registration form (vaginal maturation index, vaginal maturation value, andvaginal pH) before the intervention and two and four weeks after the intervention. Data were analyzedusing SPSS software (version 24) through the analysis of variance with repeated measurements, andLSD post-hoc test. A P value less than 0.05 (P

Objective: This study investigated the impact of menopause on stone composition in women with urolithiasis. Study design: A cross-sectional study was conducted from March 2013 to March 2018. Women with urolithiasis patients were divided into two groups according to their menopause status. Main outcome measures: The clinical demographic characteristics, stone removal, stone composition, and urine chemistry were investigated. Univariate and multivariate survival analyses were performed to identify risk factors for the risk of uric acid stones. Results: Our study enrolled 1221 female patients with stone diseases, 783 (64.1 %) of whom were postmenopausal (66 patients surgically menopause and 717 patients naturally menopause). Postmenopausal women had higher rates of diabetes and hyperuricemia, a higher serum uric acid level, a higher urinary specific gravity, and a lower estimated glomerular filtration rate. Stone analysis revealed calcium oxalate stones in 66.2 % of the patients, apatite stones in 19.4 %, calcium oxalate and calcium phosphate stones in 7.7 %, uric acid stones in 4.4 %, struvite stones in 2.0 %, and brushite stones in 0.2 %. Postmenopausal women had a higher rate of uric acid stones. Multivariate analysis confirmed that postmenopausal status and hyperuricemia were independent risk factors of uric acid stones. Postmenopausal women required more invasive procedures to remove the stones, and they had lower self-voiding rates. Conclusions: Postmenopausal women had higher rates of stone episodes, specifically related to uric acid stones. Given the prevalence and impact of chronic kidney diseases, factors that impede optimal renal function management in women must be identified to provide tailored treatment recommendations.

Sex differences are consistently identified in determining the prevalence, manifestation, and response to therapies in several systemic disorders, including those affecting the cardiovascular (CV), skeletal muscle, and nervous system. Interestingly, such differences are often more noticeable as we age. For example, premenopausal women experience a lower risk of CV disease than men of the same age. While at an advanced age, with menopause, the risk of cardiovascular diseases and adverse outcomes increases exponentially in women, exceeding that of men. However, this effect appears to be reversed in diseases such as pulmonary hypertension, where women are up to seven times more likely than men to develop an idiopathic form of the disease with symptoms developing ten years earlier than their male counterparts. Explaining this is a complex question. However, several factors and mechanisms have been identified in recent decades, including a role for sex hormones, particularly estrogens and their related receptors. Furthermore, an emerging role in these sex differences has also been suggested for β-adrenergic receptors (βARs), which are essential regulators of mammalian physiology. It has in fact been shown that βARs interact with estrogen receptors (ER), providing further demonstration of their involvement in determining sexual differences.Based on these premises, this review article focused on the β3AR subtype, which shows important activities in adipose tissue but with new and interesting roles in regulating the function of cardiomyocytes and vascular cells. In detail, we examined how β3AR and ER signaling are intertwined and whether there would be sex- and age-dependent specific effects of these receptor systems.

Abstract Background Menopausal symptoms are very diverse in terms of prevalence and severity, and this difference is due to various factors such as psychological factors, sociocultural status, lifestyle, geographical location, and other factors. This study aimed to assess the prevalence of menopausal symptoms and evaluate the predictive factors related to the prevalence and severity of menopausal symptoms. Materials and Methods This was a cross‐sectional analytical study that was performed on 214 women aged 35–65 years old who were referred to Alzahra Educational, Research and Treatment Center in Rasht, Iran. The data collection tool was a valid and reliable questionnaire, using the list of menopausal symptoms and a checklist of subjects’ general characteristics. Results 16.8% of postmenopausal women in our study had at least one menopausal symptom. Using multiple linear regression, race (p = 0.02), history of chronic diseases (p = 0.04), place of residence (p = 0.02), and marital satisfaction (p = 0.02) were associated with menopausal symptoms. Nineteen percent of the covariates related to the logistics function were explained by the predictor variables in the model. Conclusion Evaluation of menopausal symptoms showed that the severity of menopausal symptoms was related to factors such as body mass index (BMI), ethnicity, place of residence, marital satisfaction, and history of chronic diseases, and need to address BMI, psychological issues, and chronic illness.

Abstract Background and Aims Declines in estradiol levels after menopause have been reported to be associated with several health outcomes. This study aimed to determine the effect of age at natural menopause (ANM) on some of the most common chronic diseases. Methods This historical cohort study was performed on 2636 postmenopausal women aged 40–70 years participating in phase one of the PERSIAN cohort study in Kharameh, Iran, during 2015–2017. The effect of early (53 years) on chronic diseases such as hypertension, diabetes, ischemic heart diseases, stroke, thyroid diseases, and depression was assessed using classic logistic regression for diseases with an incidence rate of more than 10% and Firth's logistic regression for diseases with an incidence of less than this amount. Results The mean age of women was 53.48 ± 8.59. Respectively, early and intermediate menopause was associated with ischemic heart disease (odds ratio [OR = 1.61, 95% confidence interval [CI]: 1.08–2.42; p = 0.020), (OR = 1.57, 95% CI: 1.13–2.21; p = 0.008) and thyroid diseases (OR = 3.10, 95% CI: 1.64–6.24; p

Abstract Background and Aims Menopause is one of the most significant stages in women's life. It is accompanied by many complications and a serious challenge. This study aimed to assess the menopause experiences of Iranian women and compatibility strategies. Methods We searched PubMed, Web of Science (ISI), Scopus, Ovid, and the Iranian Clinical Trial Registry and Magiran, SID, from January 1990 to January 2021. Results Psychological effects, sexual disorders, physical problems, bone pain, insomnia, fatigue, and hot flashes are all menopause experiences. Cultural factors, lifestyle, social factors, education level, employment and economic status, marital status, and the number of pregnancies and births can influence this experience. It is important that menopausal women are aware how menopausal compatibility and prepare for this period. Many factors have affected menopausal adopting strategies. Negative emotions, negative attitudes, worry, and anxiety, and their psychological effects exacerbate the annoying experiences of menopause and decelerate menopausal adoption. Conclusions Social support and educational intervention were the practical menopausal adopting strategies. It will guarantee the health of menopausal women in the last third of their lives.

Women in menopause have more mood swings than before menopause. Several studies attempt to clarify the role of menopause in the development of depression, anxiety, and stress in midlife. However, there is controversy about the relationship of body composition with psychological distress in postmenopausal women. This study investigated the relationship between fat mass (FM) and visceral fat level (FVL) with anxiety, depression and stress in women with menopause for at least 1 year. The study included 50 women (57,49±5.62 years), 46% for more than 6 years in estrogen depletion. Women who documented the use of antidepressants or anxiolytics were excluded from the analysis. The short-form version of the Depression Anxiety and Stress Scale (DASS-21) was administered, and body composition (FM, VFL, SMM - skeletal muscle mass) was assessed with the bioimpedance InBody 120. High levels of total and central adiposity were considered for %FM≥35% (Lohman & Going, 1998) and VFL>9 (Biospace, 2021). Spearman's correlation coefficient was used to analyse the association of variables. Comparisons between groups were conducted using non-parametric tests, based on the normality test results, and a statistical significance was set at p< 0.05. The largest part of the sample documented a natural menopause (86%) and the absence of hormone therapy. The mean DASS-21 scale was 10.56 (±8.83), with higher levels for stress (4.72±3.77) and depression (3.56±3.81). All women exhibited normal muscle condition (SMM≥16 kg), but most of them had obesity (68%), especially central obesity (76%). A significant association (p=0.04) was identified between %FM and the DASS-21 scale (r=0.20, p=0.04). Obese women had lower stress (p=0.04) but a higher value on the DASS-21 scale (p=0.04). In parallel, the presence of greater levels of central adiposity determined higher values of these two measures of psychological distress (p=0.01). The results suggest that postmenopausal women with higher levels of fat mass or central adiposity tend to have a higher DASS-21 scale score. Central obesity produces in women symptoms such as difficulty in relaxing, irritability, and nervous excitement.

Women are more likely to experience depressive symptoms and poor quality of life during postmenopause. Physical activity is an effective strategy to improve the mental health of women in this climacteric phase. This study aimed to investigate the variation of depressive symptomatology and mood states in postmenopausal women as a function of moderate-vigorous physical activity (MVPA) levels. The search was conducted on the project Meno(s)Pause+Movement and involved 62 women (age range 48-71 years), most of them with natural menopause (87.1%) and without hormone therapy (85.5%). The Depression Anxiety and Stress Scale (DASS-21) was applied, and the Life Orientation Test-Revised (LOT-R) was used to measure dispositional optimism. Body composition was assessed by bioimpedance, and triaxial accelerometers wGT3X-BT were used to measure MVPA. The cut-off points for the non-dominant pulse proposed by Kamada et al. (2016) were considered, and physical activity was classified according to WHO (2020) guidelines. One-way ANOVA was used to compare the means of the variables in the three MVPA groups (300 minutes/week), being considered a 5% degree of statistical significance. Women who documented using antidepressants or anxiolytics were excluded from the analysis. The research was approved by the Ethics Committee of the University of Trás-os-Montes and Alto Douro (ref. Doc77-CE-UTAD-2022). The mean age, LOT-R, and DASS-21 scores were 53.69 years, 16.52 (±3.0) points, and 11.02 (±9.22) points, respectively. Most of the sample exhibited obesity but a normal muscle condition (skeletal muscle mass ≥16 kg). The average MVPA was 299.05 min/week, with 41.9% of the women showing very recommended levels. No differences were identified in the mean values of the LOT-R, the DASS-21 scale and its dimensions (anxiety, depression and stress) between the 3 AFMV groups. The results suggest that physical activity levels do not influence variation in optimism and depression symptomatology in postmenopausal women.

Menopause is associated with decreased physical activity and sleep disturbances. Short sleep duration and poor sleep quality have been associated with an increased risk of falls, obesity, and type 2 diabetes. It´s important to understand how physical activity influences sleep health in postmenopausal women. The purpose of this study was to analyse the variation of sleep duration and quality as a function of moderate-vigorous physical activity (not recommended, MVPA300 min/week). The sample included 40 postmenopausal women (57.28±5.68 years) enrolled in the Meno(s)Pause+Movement, 85% documenting the use of hormone therapy. Sleep (TST, total sleep time; SOL, sleep onset latency; SE, sleep efficiency; SFI, sleep fragmentation index) and physical activity were estimated using ActiGraph GT3X+ activity monitors. Physical activity was classified according to WHO (2020) guidelines and body composition was measured using bioimpedance (InBody 120). One-way ANOVA was used to compare the means of the variables in the MVPA groups being considered a 5% degree of statistical significance. Women taking medication that influenced sleep were eliminated from the analysis. The research was approved by the Ethics Committee of the UTAD (ref. Doc77-CE-UTAD-2022). Most of the sample showed fat mass ≥35% (65%) and visceral fat >9 points (72.5%). The average MVPA was 299,05 min/week, with 30 women showing levels of at least 150 min/week. All participants presented SFI>5 number of events (25,66±6,38 number of events) and SOL£30 minutes (2.83±1.29 min). The average TST was 7.38 (±0.50) min/day, with 75% showing recommended values. The MVPA groups did not produce a differentiated effect (p>0.05) on the parameters related to the duration and quality of sleep. There is no relationship between MVPA and sleep duration and quality in postmenopausal women. A replication study in a larger sample is suggested.

Background: Type 2 diabetes is a metabolic disease associated with a partial or absolute deficiency of insulin, hyperlipidemia, and impaired metabolism of carbohydrates, fats, and proteins. The present study aimed to compare the effects of different types of exercises on lipid profiles in menopausal women with type 2 diabetes. Methods: Fifty-six sedentary obese menopausal women with type 2 diabetes were randomly divided into 4 groups: aerobic exercise, resistance exercise, combined exercise, and a control group. Each group, except the control group, participated in their respective exercises for 8 weeks. Blood samples were collected from the subjects before and 48 hours after the training period. Data were analyzed using the analysis of variance (ANOVA) and paired sample t tests, with a significance level set at P≤0.05. All calculations were performed using SPSS v. 20. Results: Triglyceride levels significantly decreased in the aerobic exercise (P = 0.017) and combined exercise (P = 0.0001) groups. Low-density lipoprotein levels significantly decreased in aerobic exercise (P = 0.034), resistance exercise (P = 0.003), and combined exercise groups (P = 0.009). Cholesterol levels significantly decreased in the aerobic exercise (P = 0.0001), resistance exercise (P = 0.030), and combined exercise (P = 0.01) groups. Additionally, high-density lipoprotein levels significantly increased in the aerobic exercise (P = 0.041) and combined exercise (P = 0.002) groups. Conclusion: It appears that combined exercises, rather than resistance or endurance exercises alone, are a more appropriate intervention for improving lipid profiles in menopausal women with type 2 diabetes.

Introduction Menopause is a challenging stage of a woman’s life, with increased occurrences of musculoskeletal issues and obesity that need to be tackled early and effectively. Less is known about the effect of HIIT & hatha yoga on musculoskeletal parameters in post-menopausal females. Both exercise approaches differ and are comparable in many ways. Thus, the objective of the study is to determine and compare the effects of 12 weeks of HIIT and yoga training protocols in postmenopausal females with central adiposity, sarcopenia, dynapenia, and knee alignment. The present research article presents a study protocol comparing yoga and HIIT protocols prescribed for postmenopausal females. Methods This is an open-label, randomised, parallel-armed, assessor-blinded clinical trial that will be conducted on 160 postmenopausal females between 46 and 70 years randomly assigned to either the HIIT or yoga group. The intervention will be in the form of group therapy for 5 sessions per week for 12 weeks. The outcomes include sarcopenia by lean muscle mass using a bioelectric impedance analyser, a radiological measure of the Hip-Knee-Ankle angle, and the perceived stress scale and 36-item short form questionnaires assessed twice (pre & post). The outcomes, including gait speed, hand grip strength, waist circumference, and body mass index, will be assessed at pre, post-4th week, post-8th week, and post-12th week. Discussion The study outcomes will provide confirmatory evidence on the effects of Hatha yoga and HIIT exercise training protocols in managing menopausal weight gain, musculoskeletal issues (sarcopenia and knee malalignment), physical and functional capacity, as well as mental health in postmenopausal females. Conclusions

Abstract Background Adipose insulin resistance (Adipo-IR) is associated with multiple metabolic diseases, including non-alcoholic fatty liver disease (NAFLD). The study aimed to evaluate sex differences in the association between Adipo-IR and NAFLD, and further investigated other potential modifiers. Methods This cross-sectional study enrolled adults without diabetes who underwent physical examinations in Beijing Chao-Yang Hospital. We calculated the Adipo-IR index as the product of the fasting insulin and free fatty acid concentration. We categorized Adipo-IR into four groups according to quartiles, using the first interquartile range (Q1) as the reference. Logistic regression was used stratified by the modifiers after adjustment for potential confounders. Results There were 5586 participants in the study, 49.8% (n = 2781) of whom were women and 30.4% (n = 1698) with NAFLD. There was a graded positive association between Adipo-IR and NAFLD, with sex (P = 0.01) and hyperlipidemia (P = 0.02) modifying this association. In the hyperlipidemic women, for one unit increase in log-Adipo-IR, the odds of having NAFLD increased by 385% after adjustment for potential confounders (OR = 4.85, 95%CI 3.54–6.73, P

Background: As implant treatment cases increase, many cases of failure/side effects also occur. Generally, dental clinics determine the density of the jawbone using cone beam CT (CBCT). Considering the known potential role of this tool for bone assessment in primary osteoporosis, this study evaluated patients with secondary endocrine causes of low bone mass. Methods: The study included 83 patients with endocrine causes of osteoporosis who were evaluated by dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and mental foramen (MF) region CBCT. The following CBCT indices were measured: anterior (A)—thickness of inferior mandibular cortex 10 mm anterior from MF; molar (M)—thickness of inferior mandibular cortex 10 mm posterior from MF; posterior (P)—thickness of inferior mandibular cortex 25 mm posterior from MF; symphysis (S)—thickness of inferior mandibular cortex equidistant from the centers of right and left MF. Results: The highest correlation coefficient in the secondary causes group was between the A index and the lumbar BMD (r = 0.375, p = 0.001) and the P index and the femoral neck BMD (r = 0.38, p = 0.001). Hypercortisolism seems to be the most predictable cause of secondary osteoporosis using the A, M, and P indices. The A, M, and P indices showed predictive values of the bone micro-architecture that was evaluated using TBS score, and were statistically significant. The symphysis index does not significantly predict osteoporosis or impaired bone micro-architecture. Conclusions: These findings support the potential usefulness of A, M, and P CBCT-derived radiomorphometric mandibular indices in secondary osteoporosis, underlining the well-known effects of these pathologies on bone micro-architecture rather than bone quantity.

Objectives: This study aimed to determine the relationship between the fear of COVID-19 and menopausal symptoms in women during the menopausal period. Methods: This study is a descriptive cross-sectional study. This study was completed with a total of 161 women who met the inclusion criteria. Data were collected face-to-face using the Personnel Information Form, Menopause Symptom Assessment Scale, and Coronavirus 19 Phobia Scale. Results: There is a slightly positive relationship between the social subscale of the COVID-19 fear scale and the somatic subscale of the menopause symptoms scale. There is a slightly positive relationship between the economic subscale of the COVID-19 scale and the psychological subscale of the menopausal symptoms scale. There is a slightly positive correlation between the total score of the total COVID-19 phobia scale and the somatic and psychological subscales of the menopause symptoms assessment scale. However, there is no significant relationship between the total score of the COVID-19 phobia scale and the total score and urological subscale of the menopause symptoms assessment scale. Conclusions: It has been determined that fear of COVID-19 is slightly positively associated with somatic and psychological complaints in menopausal women.

Background: Osteoporosis, characterized by reduced bone mass and increased fracture risk, presents a significant public health challenge. Dual-energy X-ray Absorptiometry (DEXA) scans offer a reliable means of assessing bone mineral density (BMD) and detecting osteoporosis. The aim of this study is to assess awareness, attitude, and practice of women in the Jazan region toward DEXA scan. Methods: Data were collected through a self-administered online questionnaire. Statistical analysis was conducted using SPSS version 29.0. The total knowledge scores of participants were calculated to assess potential associations with sociodemographic data. A p-value of less than 0.05 was considered statistically significant. Results: Among 400 women, 230 (57.5%) had low knowledge scores primarily due to poor knowledge of the DEXA scan procedure. Merely 39 women had undergone a DEXA scan mainly due to medical prescription (n = 22, 56.4%). Total knowledge scores were significantly higher among women with high monthly incomes (p = 0.019) and those working in medical-related jobs (p = 0.017). Conclusions: This study underscores the need for targeted interventions to improve awareness of DEXA scans among women in Jazan City. Additionally, the findings suggest that socioeconomic factors may influence awareness levels, emphasizing the importance of tailored educational strategies to reach diverse demographics.

Background/Objectives: Temporomandibular dysfunction syndrome consists of several disorders of the masticatory system, namely those of the muscles, the joint itself, as well as the dental and periodontal system. This syndrome is often characterized by pain and an inability to perform functions within the dental–maxillary apparatus, which creates a certain degree of disability in patients. Women are more susceptible to this syndrome than men and hormonal factors, particularly estrogen, are central to its etiology and physiopathology. Methods: A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Embase, and Web of Science databases regarding articles published from January 2008 to December 2023. Two authors conducted searches in the mentioned databases based on a pre-established search strategy using agreed-upon keywords. Additionally, each review author performed the selection process of eligible studies based on established inclusion criteria. The Newcastle–Ottawa scale and Risk of Bias tool 2 were used to assess each article for its methodological quality. Results: Of the 1030 records found in the four bibliographic databases, 22 studies were included in this review. Polymorphism in the alpha estrogen receptor appears to be significantly more prevalent in women with temporomandibular dysfunction, suggesting a genetic predisposition. There is a significant role of estrogen in the physiopathology of TMD-related pain. Women with polycystic ovary syndrome (PCOS) have a significantly higher incidence of TMD, accompanied by elevated inflammatory factors and decreased progesterone levels. In premenopausal women, there is scientific relevance to the association between beta-estradiol levels and TMD development and progression. The effects of estrogen hormones on temporomandibular dysfunction remain highly debated and challenging. Conclusions: These findings emphasize the importance of considering hormonal factors, genetic predisposition, and reproductive life stages in understanding and managing temporomandibular dysfunction. Further research is needed to elucidate the specific mechanisms underlying these associations.

Genitourinary syndrome of menopause (GSM) encompasses a range of distressing symptoms in the vulvovaginal and/or bladder–urethral regions related to menopause changes, negatively influencing woman’s quality of life and sexual activity. Fractional micro-ablative CO2 laser therapy has shown the potential to reinstate the vaginal epithelium to a condition akin to the premenopausal state, thereby ameliorating the subjective symptoms associated with GSM. We conducted a prospective, pilot study in 73 sexually active postmenopausal women treated with CO2 laser for their GSM symptoms, while assessing Vaginal Health Index Score (VHIS) and sexual function through the Female Sexual Function Index (FSFI) Questionnaire. The laser treatment resulted in a decrease in VHIS and patient-reported vulvovaginal atrophy (VVA) symptoms, with a significantly lower prevalence of vaginal itching, dryness, and burning (p < 0.001), as well as dyspareunia (p = 0.002). The occurrence of urinary incontinence, urgency, and vaginal heaviness significantly reduced, with an improvement in the staging of cystocele, either to Stage 1 or complete resolution (p < 0.001). FSFI total and domain scores were significantly higher after the treatment, indicating better sexual function, with a post-treatment score median of 25 (p < 0.001). Therefore, using a three-cycle fractional CO2 laser was an effective choice for reducing urogenital discomfort related to GSM in postmenopausal women.

The presentation of sleep disorders varies widely among women and men, and sleep disorders among women are frequently subject to under- and delayed diagnosis. Insomnia is a complex sleep disorder with a multifactorial etiology, and women face many sex-specific sleep health challenges that may contribute to and influence the presence of insomnia symptoms across their lifespan. These include sex differences in neurobiology, hormonal variation during menstruation, pregnancy and menopause, increased prevalence of mood disorders, increased vulnerability to adverse socioeconomic factors, and gender discrimination, among other psychosocial stressors, particularly among women of racial-ethnic minority. As the medical community continues to recognize the significance of sleep as a vital pillar of overall wellbeing, the integration of sex-specific considerations in research, diagnosis, and treatment strategies is essential to optimizing sleep health for women.

Menopause-related insomnia is a common symptom of perimenopausal women, which is clinically common but easy to be neglected. Menopause-related insomnia will affect the health of perimenopausal women and even in the old age. There is still a lack of consensus and guidelines on the clinical management of menopause-related insomnia in China. In order to standardize the management of menopause-related insomnia and improve the management of menopause-related sleep health, experts were organized to develop this consensus. The management of menopause-related insomnia mainly includes the establishment of a multidisciplinary expert team, pharmacological and nonpharmacological management, which is expected to play a guiding role in the clinical practice.

Abstract Background Menopause is a natural period in women’s life and can be affected by several factors. The aim of this study was to identify the associated factors for age of natural menopause and among women with early and premature menopause based on a cohort study in Iran. Methods This population-based study was conducted on 894 post menopause women between 35 and 70 years old who participated in the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort Study, a part of Prospective Epidemiological Research Studies in Iran (PERSIAN) from March 2016 to February 2019. All women completed a standard self-reported questionnaire. Data were analyzed using chi-square test, independent t test, and ANOVA as well as a multivariable linear regression model. Results The mean age at natural menopause was 48.31 ± 6.34 years. After adjusting other variables, gravida, history of cardiac disease, socioeconomic status and residence status were predictive of age at menopause (P