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Background: Type-2 diabetes mellitus (T2DM) is considered one of the chronic diseases that can have a relationship with age of menopause onset. Several studies have revealed that early menopause or late menopause can have a correlation with type-2 diabetes. This systematic review and meta-analysis aimed to investigate the association between the age of menopause onset and type-2 diabetes. Methods and materials: PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and Cochrane were searched for studies that have evaluated the relationship between T2DM and age of menopause onset. We pooled the effect sizes of the included studies using both adjusted odds ratios (OR) and hazard ratios (HR) of interest outcomes with their 95% confidence interval (CI). Results: Nineteen papers were included in this study, 8 studies were cohorts, and 11 were cross sectional. Studies revealed a statistically significant association between early menopause age and increased odds of T2DM (OR = 1.24, 95% CI: 1.09–1.40; I2 = 67%; p = 0.001). Late menopause age was also associated with an increased odds of T2DM (OR = 1.14, 95% CI: 1.03–1.26; I2 = 56%; p = 0.01) compared to the reference group with normal menopausal age. As our secondary outcome, the hazard of developing T2DM in individuals with early or late menopausal age was assessed. Pooled analysis demonstrated a significantly higher hazard of T2DM among women with early menopause age (HR = 1.31, 95% CI: 1.05–1.64; I2 = 72%; p = 0.02). Late menopause age did not show a significant association (HR = 0.96, 95% CI: 0.84–1.10; I2 = 68%; p = 0.56). Conclusion: Early and late menopause can both increase the risk of T2DM. Future research is needed to warrant the certainty of our findings. [ABSTRACT FROM AUTHOR]

Abstract Background Type-2 diabetes mellitus (T2DM) is considered one of the chronic diseases that can have a relationship with age of menopause onset. Several studies have revealed that early menopause or late menopause can have a correlation with type-2 diabetes. This systematic review and meta-analysis aimed to investigate the association between the age of menopause onset and type-2 diabetes. Methods and materials PubMed, Web of Science, Scopus, Science Direct, Google Scholar, and Cochrane were searched for studies that have evaluated the relationship between T2DM and age of menopause onset. We pooled the effect sizes of the included studies using both adjusted odds ratios (OR) and hazard ratios (HR) of interest outcomes with their 95% confidence interval (CI). Results Nineteen papers were included in this study, 8 studies were cohorts, and 11 were cross sectional. Studies revealed a statistically significant association between early menopause age and increased odds of T2DM (OR = 1.24, 95% CI: 1.09–1.40; I2 = 67%; p = 0.001). Late menopause age was also associated with an increased odds of T2DM (OR = 1.14, 95% CI: 1.03–1.26; I2 = 56%; p = 0.01) compared to the reference group with normal menopausal age. As our secondary outcome, the hazard of developing T2DM in individuals with early or late menopausal age was assessed. Pooled analysis demonstrated a significantly higher hazard of T2DM among women with early menopause age (HR = 1.31, 95% CI: 1.05–1.64; I2 = 72%; p = 0.02). Late menopause age did not show a significant association (HR = 0.96, 95% CI: 0.84–1.10; I2 = 68%; p = 0.56). Conclusion Early and late menopause can both increase the risk of T2DM. Future research is needed to warrant the certainty of our findings.

Key content: Urethral caruncle is a common post‐menopausal finding.This common benign lesion can be mistaken as a malignancy.Management should be based on the patient's symptoms.Vaginal estrogen should be considered as first‐line management before surgical excision. Learning objectives: To evaluate the symptomatic presentation of urethral caruncle.To establish the differential diagnosis of a mass in the urethra.To review the management options of urethral caruncle including medical and surgical excision.To highlight primary care management of urethral caruncle. Ethical issues: Owing to poor recognition of urethral caruncle, many patients are put through the emotional distress of referral to cancer pathways.Surgery should be considered first line for large urethral caruncle or in symptomatic patients. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Polypoid endometriosis is a rare manifestation of endometriosis, which may mimic pelvic cancer. This subtype commonly encountered in post‐menopausal women may be wrongly mistaken for a neoplasm on clinical, radiological, perioperative or pathologic assessments leading to inadequate treatment. [ABSTRACT FROM AUTHOR]

Introduction: Post-menopausal women living with Human Immunodeficiency Virus (WLHIV) face an increased risk of bone fractures due to the relationship between HIV-related factors and menopause. This narrative review aims to summarise the current knowledge about fracture risk among post-menopausal WLHIV in particular looking at hormonal changes, combined antiretroviral therapy (cART), lifestyle factors, and psychosocial implications. We also profiled a summary of the significant, recent studies of post-menopausal WLHIV residing in low-income countries (LIC). Methods: A thorough search of the literature was performed across PubMed, Medline, Scopus, and Google Scholar, focussing on studies published between 2000 and 2024. Inclusion criteria entailed original research, reviews, and meta-analyses addressing bone mineral density (BMD), fracture incidence, and related risk factors in post-menopausal WLHIV. Results: The review identified 223 relevant studies. Post-menopausal WLHIV exhibit significantly lower BMD and higher fracture rates compared to both HIV-negative post-menopausal women and pre-menopausal WLHIV. cART, particularly tenofovir disoproxil fumarate (TDF), contributes to reduced BMD. Menopausal status exacerbates this risk through decreased oestrogen levels, leading to increased bone resorption. Moreover, lifestyle choices such as smoking, alcohol consumption, and low physical activity are more prevalent in PWHIV, which further elevates fracture risk. Different psychosocial factors may make WLWHIV more vulnerable at this stage of their life, such as depression, isolation, stigma, and housing and nutritional issues. Women living in LICs face a variety of challenges in accessing HIV care. There are gaps in research related to the prevalence of osteoporosis and bone loss in post-menopausal WLHIV in LICs. Conclusion: Post-menopausal women living with HIV face a significantly higher risk of bone loss and fractures due to the combined effects of HIV and menopause. Antiretroviral therapy (particularly TDF), lifestyle factors, and psychosocial challenges exacerbate this risk. There is a need for careful selection of cART, hormone replacement therapy (HRT), and emerging treatments such as Abaloparatide. A holistic approach including lifestyle changes and psychosocial support is crucial to reduce fracture risk in WLHIV, especially in low-income countries. [ABSTRACT FROM AUTHOR]

Background: Menopause is the cessation of menstruation for a year due to reduced ovarian follicular activity. This results in decreased estrogen secretion and affects haemoglobin and prolactin levels. Haemoglobin levels increase due to decreased estrogen-induced erythropoiesis inhibition. Prolactin levels decrease due to estrogen inhibition of hypothalamic Prolactin Inhibitory Factor (PIF). Estrogen deficiency after menopause causes osteoporosis, increased cholesterol levels, and risk of coronary artery disease. The impact of estrogen deficiency on haemoglobin and prolactin levels is not well studied, but it may affect these hormones in postmenopausal women. Materials and Methods: The study was conducted on women in Guwahati, aged between 35-44 and 45-75 years, who provided informed consent. Those with tuberculosis, malignancy, diabetes, anaemia, thyroid disorders, renal diseases, rheumatoid arthritis, or on hormone replacement therapy were excluded. Blood samples were collected after fasting for 12 hours and stored for estrogen and prolactin estimation using the Enzyme Linked Fluorescent Assay (ELFA) technique. Haemoglobin was estimated using a digital photo colorimeter. Data analysis was done using Microsoft Excel, with mean, standard deviation, ANOVA, and Pearson's correlation coefficient. Results: The study aimed to compare the levels of serum estrogen (17β-estradiol), serum prolactin, and haemoglobin in premenopausal and postmenopausal women in Guwahati. The study population consisted of 100 women, with 50% in the premenopausal group (35-44 years) and 50% in the postmenopausal group (45-75 years). The study found that premenopausal women had higher levels of serum estrogen and serum prolactin, while postmenopausal women had lower levels of both. Haemoglobin levels were higher in postmenopausal women compared to premenopausal women. The study also found a positive correlation between serum estrogen and serum prolactin in both premenopausal and postmenopausal women, but a negative correlation between serum estrogen and haemoglobin in premenopausal women. Discussion: Postmenopausal women experience decreased serum estradiol, leading to symptoms like hot flashes and increased risks of heart disease, osteoporosis, and fractures. Elevated haemoglobin levels post-menopause suggest a link between estrogen and erythropoiesis. Lower estrogen levels are associated with decreased prolactin, impacting health and necessitating hormone replacement therapy monitoring. Conclusion: This study compares estrogen, prolactin, and haemoglobin levels in premenopausal and postmenopausal Guwahati women, revealing significant changes with menopause. Higher estrogen correlates with lower haemoglobin and higher prolactin, while hormone replacement therapy may correct postmenopausal deficiencies. Follow-up studies are warranted. [ABSTRACT FROM AUTHOR]

This case report follows a 66-year-old female who originally presented with malignant melanoma in the left knee and recurrence in the left inguinal region. This prompted a whole body FDG PET/CT scan which showed incidental focal hypermetabolism in the uterus. The diagnosis of endometrial cancer was confirmed at biopsy, and the patient was treated with total abdominal hysterectomy. Melanoma patients are at increased risk of second primary malignancy, and endometrial cancer is a common second primary often diagnosed in cancer survivors. Incidental endometrial focal hypermetabolism should be investigated further for a synchronous malignancy, especially in a post-menopausal woman.

Background: The post-menopausal state, as a feminine physiological aging event, may have effects on the homeostatic mechanisms of some biominerals, which can be inimical to bone health and may result to osteoporosis. There seems to be paucity of data on this important public health challenge among South-Eastern Nigeria Women. Objectives: The present study evaluated the levels of the biominerals calcium (Ca), magnesium (Mg), zinc (Zn) and selenium (Se) and their association with osteoporosis, among post-menopausal women in Nnewi, South-East, Nigeria. Methods: Thirty (30) post-menopausal women aged 49-60years, 30 peri-menopausal women aged 44-48 years, and 25 pre-menopausal subjects, aged 20-34 years, which served as controls, were recruited from patients attending the out-patient and obstetrics and gynaecology clinics of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi and apparently healthy subjects within NAUTH suburb, between June and September, 2023. Serum samples collected from the participants were analyzed for Mg, Zn, and Se, using fast-sequential atomic absorption spectrometry (AA 220/FS) while Ca, and inorganic phosphate were measured by photometric methods. Results: Results showed that serum Mg was significantly lower in post-menopausal subjects compared with their corresponding pre-menopausal counterparts (0.73+ 0.26) (P = 0.020). On the other hand, serum Se and Zn levels were significantly higher in post-menopausal subjects (168.70 + 58.98) and (19.66 + 5.67) compared with their corresponding control values (118.16 + 14.00 and 14.72 + 2.83) (P = 0.000, Cl = 95%). Additionally, a higher serum Ca level was observed in the post- menopausal subjects compared with their pre-menopausal counterparts (2.38+0.14 and (2.36+0.17). However, this difference was not significant (P > 0.05). Conclusion: The study opines that post-menopausal hypomagnesemia can occur and may be linked to osteoporosis. The present study also demonstrates that Zn and Se, which are metallo-enzymes of the antioxidants -superoxide dismutase and glutathione peroxidase, may be elevated in the post-menopausal state. Therefore, a routine monitoring of these important biominerals in the post-menopausal population and larger population-based prospective studies involving nutritional interventions are recommended.

Osteoporosis is widely distributed condition characterized by bone weakness making it more fragile and easier to be fractured. Various elements enter in bone structure making it rigid to tolerate body weight and any accident. Many factors had a role in its progression, like age, gender, taking medications and genetic variations in enzymes responsible for vitamin D metabolism. The aim of our study is to evaluate role of polymorphism of metabolic enzyme CYP24A1 on responding to vitamin D in postmenopausal osteoporotic women. Method: 40 postmenopausal women were followed up for two months and took 50000IU/week of vitamin D during study period, and 30 postmenopausal women without osteoporosis as a control group. Blood sample were taken pre- and post-treatment to determine responder to vitamin D therapy. Results: regarding vitamin D level, there is a significant difference between responder and non-responder at pre-treatment level. GG genotype of rs2762934 was presented in higher percent in patients group (non-response one), and AA genotype of rs4809957 was the predominant one with a negative correlation to the responsiveness to vitamin D therapy. Conclusions: The homozygote wild GG genotype of rs2762934 predict vitamin D non-responsiveness in sample of osteoporotic postmenopausal women. The AA genotype of the same SNP substantially increases the responsiveness. While AA of rs4809957 associate with non-responsiveness. This study will implicate in correct choosing the desired dose of vitamin D for desired osteoporotic women to get better response and avoid any harmful effect of vitamin D overdose. [ J Adv Biotechnol Exp Ther 2024; 7(1.000): 65-73]

This case report highlights the importance of recognizing Hyperostosis Frontalis Interna (HFI) in patients with a diverse clinical presentation, particularly in post-menopausal individuals with relevant risk factors. It emphasizes the need for maintaining a high index of suspicion in neurological settings. Timely identification and treatment of HFI can significantly improve patient outcomes and alleviate debilitating symptoms and comorbidities. HFI, often an under-diagnosed condition and an incidental radiological finding, calls for ongoing research and vigilance in clinical practice.

Abstract Background In Pakistan, the death rate for post-menopausal women with breast cancer is significant due to late detection and delayed referral to proper facilities. There are a few reports on Pakistan’s epidemiology and breast cancer risk factors. There are modifiable and non-modifiable risk factors associated with the development of breast carcinoma; of which body mass index (BMI), central obesity, and lipid profile are considered as major risk markers. Methods This was a cross-sectional analytical study. A total of 384 women constituted the present study sample. Purposive sampling was used to collect 192 confirmed new breast cancer cases throughout the study. By using basic random sampling, an equal number of controls were chosen. Studied parameters included age, fasting blood sugar, cholesterol, triglyceride, serum high-density lipoprotein, cholesterol, serum low-density lipoprotein cholesterol, weight, height, BMI, waist circumference, and waist-to-hip ratio. The inclusion criteria of this study were post-menopausal women (45–65 years) in Pakistan. The confirmation of breast carcinoma was done through histopathology. Breast cancer occurrence was taken as a dependent variable, whereas BMI, central obesity, and lipid profile were taken as independent variables. Results Studied risk factors (cholesterol, BMI, and central obesity) significantly correlated with breast cancer. Cholesterol has a significantly high positive correlation (0.646) with breast cancer. BMI has a positive significant correlation (0.491) with breast cancer, and central obesity has a low but positive significant correlation (0.266) with breast cancer. Moreover, the binary logistic regression model also showed a significant association between biochemical factors and breast cancer occurrence. Regression analysis depicted a linear relationship between a dependent variable (breast cancer occurrence) and independent variables (central obesity, cholesterol, BMI). Conclusion Postmenopausal overweight (central obesity), increased BMI and high cholesterol levels are major risk factors for breast cancer. Moreover, high total cholesterol proved to be the most significant risk marker for the occurrence of breast cancer in post-menopausal women of Pakistan.

Background: Menopause is defined by The WHO as 'the permanent cessation of menstruation as a result of the loss of ovarian activity'. A woman today will live approximately one third of her life after menopause. Menopause develops due to low estrogen production by disturbed hormonal cycle of ovulation. Menopause is a natural process in the ageing of a women & it denotes the end of the reproductive capacity which manifests as cessation of cyclic ovarian function and cyclic Menstruation. Objectives-The present study was undertaken on patients attending the OPD of Dr D Y Patil Medical College Hospital Pimpri, Pune to evaluate lipid profile status in post-menopausal women and compare with premenopausal women. Materials & Methods 50 post-menopausal women and 50 pre-menopausal women in the reproductive age group were selected in the study. We measured serum lipid profile [total cholesterol (TC), triglyceride (TG), HDLCholesterol, LDL-Cholesterol, and VLDL-Cholesterol.] in both pre and post-menopausal women. The comparison of lipid profile was done using correlation test and P value less than 0.05 was considered significant. Lipid profile determinations were done by enzymatic method. Software Used: MS Excel (Microsoft 365), RStudio (Version: 2023.08.0-daily+170) and IBM SPSS Statistics 27. Results: This study showed mean of serum total cholesterol in post menopausal group was185.28 mg/dl and 158.28 mg/dl in pre menopausal group. The mean of serum Triglycerides was145.59 mg/dl in post menopausal group as compared to116.34mg/dl in pre menopausal group. Mean of serum VLDL was 29.12mg/dl in post menopausal grp as compared to23.24 mg/dl in pre menopausal group. Mean of serum LDLwas116.96 mg/dl in post menopausal grp as compared to 98.86 mg/dl in pre menopausal females. Lipid profile determinations were done by Enzymatic methods on Alinity C - fully Automated Analyzer. Conclusion: Dyslipidemia is an important risk factor for arteriosclerotic cardiovascular disease (ASCVD). Due to decreased estrogen in post-Menopausal women and increased levels of cholesterol and LDL levels, chances of cardiovascular diseases are increased. It is necessary to educate Women about Menopause and Lipid Profile should be done to assess the risk of cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of urinary tract infection in postmenopausal women with type 2 diabetes mellitus using sodium-glucose co-transporter 2 inhibitors. Material And Methods: This descriptive cross-sectional study was performed on 101 postmenopausal patients with type 2 diabetes mellitus using sodium-glucose co-transporter 2 inhibitors. Samples of blood and urine were sent to the hospital laboratory for analysis. Data was analyzed using SPSS version 20. The Chi-square test was performed after stratification. RESULTS: The mean and standard deviation for age was 60.9±4.4. 24.8% of post-menopausal women with type 2 diabetes mellitus using sodium-glucose co-transporter 2 inhibitors were having urinary tract infections. The majority of these patients were illiterate or had primary education and the duration of diabetes was more than 10 years. Conclusion: Urinary tract infection is a common problem in postmenopausal women with type 2 diabetes mellitus using sodium-glucose co-transporter 2 inhibitors. Patients with poorly controlled diabetes and increased duration of menopause have an increased risk of urinary tract infection. [ABSTRACT FROM AUTHOR]

Purpose: Oral adjuvant endocrine therapy (AET) is an effective treatment for hormone receptor positive breast cancer to decrease recurrence and mortality, but adherence is poor. This study explored post-menopausal women’s experiences with AET, with a particular focus on adherence to AET as well as distress and symptoms experienced prior to and during AET treatment. Methods: Participants were recruited from a hospital registry, stratified by adherence to/discontinuation of AET. Telephone interviews followed a semi-structured interview guide and were recorded and transcribed verbatim. Transcripts were systematically coded using team-based coding, with analysis of themes using a grounded theory approach. Results: Thirty-three participants were interviewed; ages ranged from 57 to 86 years. Participants included 10 discontinued patients and 23 patients who completed their AET course or were adherent to AET at the time of interviewing. Both adherent and discontinued patients reported symptoms throughout their AET treatment course, and both attributed symptoms to factors other than AET (e.g., older age and pre-existing comorbidities). However, discontinued patients were more likely to attribute symptoms to AET and to describe difficulty managing their symptoms, with some directly citing symptoms as the reason for discontinuing AET therapy. Conversely, adherent patients were more likely to describe the necessity of taking AET, despite symptoms. Conclusions: AET adherence was associated with beliefs about AET, symptom attribution, and symptom management. Routine symptom monitoring during AET and addressing both symptoms and patients’ understanding of their symptoms may promote adherence to AET. [ABSTRACT FROM AUTHOR]

Background: In Pakistan, the death rate for post-menopausal women with breast cancer is significant due to late detection and delayed referral to proper facilities. There are a few reports on Pakistan's epidemiology and breast cancer risk factors. There are modifiable and non-modifiable risk factors associated with the development of breast carcinoma; of which body mass index (BMI), central obesity, and lipid profile are considered as major risk markers. Methods: This was a cross-sectional analytical study. A total of 384 women constituted the present study sample. Purposive sampling was used to collect 192 confirmed new breast cancer cases throughout the study. By using basic random sampling, an equal number of controls were chosen. Studied parameters included age, fasting blood sugar, cholesterol, triglyceride, serum high-density lipoprotein, cholesterol, serum low-density lipoprotein cholesterol, weight, height, BMI, waist circumference, and waist-to-hip ratio. The inclusion criteria of this study were post-menopausal women (45–65 years) in Pakistan. The confirmation of breast carcinoma was done through histopathology. Breast cancer occurrence was taken as a dependent variable, whereas BMI, central obesity, and lipid profile were taken as independent variables. Results: Studied risk factors (cholesterol, BMI, and central obesity) significantly correlated with breast cancer. Cholesterol has a significantly high positive correlation (0.646) with breast cancer. BMI has a positive significant correlation (0.491) with breast cancer, and central obesity has a low but positive significant correlation (0.266) with breast cancer. Moreover, the binary logistic regression model also showed a significant association between biochemical factors and breast cancer occurrence. Regression analysis depicted a linear relationship between a dependent variable (breast cancer occurrence) and independent variables (central obesity, cholesterol, BMI). Conclusion: Postmenopausal overweight (central obesity), increased BMI and high cholesterol levels are major risk factors for breast cancer. Moreover, high total cholesterol proved to be the most significant risk marker for the occurrence of breast cancer in post-menopausal women of Pakistan. [ABSTRACT FROM AUTHOR]

Introduction: Post-menopausal women living with Human Immunodeficiency Virus (WLHIV) face an increased risk of bone fractures due to the relationship between HIV-related factors and menopause. This narrative review aims to summarise the current knowledge about fracture risk among post-menopausal WLHIV in particular looking at hormonal changes, combined antiretroviral therapy (cART), lifestyle factors, and psychosocial implications. We also profiled a summary of the significant, recent studies of post-menopausal WLHIV residing in low-income countries (LIC). Methods: A thorough search of the literature was performed across PubMed, Medline, Scopus, and Google Scholar, focussing on studies published between 2000 and 2024. Inclusion criteria entailed original research, reviews, and meta-analyses addressing bone mineral density (BMD), fracture incidence, and related risk factors in post-menopausal WLHIV. Results: The review identified 223 relevant studies. Post-menopausal WLHIV exhibit significantly lower BMD and higher fracture rates compared to both HIV-negative post-menopausal women and pre-menopausal WLHIV. cART, particularly tenofovir disoproxil fumarate (TDF), contributes to reduced BMD. Menopausal status exacerbates this risk through decreased oestrogen levels, leading to increased bone resorption. Moreover, lifestyle choices such as smoking, alcohol consumption, and low physical activity are more prevalent in PWHIV, which further elevates fracture risk. Different psychosocial factors may make WLWHIV more vulnerable at this stage of their life, such as depression, isolation, stigma, and housing and nutritional issues. Women living in LICs face a variety of challenges in accessing HIV care. There are gaps in research related to the prevalence of osteoporosis and bone loss in post-menopausal WLHIV in LICs. Conclusion: Post-menopausal women living with HIV face a significantly higher risk of bone loss and fractures due to the combined effects of HIV and menopause. Antiretroviral therapy (particularly TDF), lifestyle factors, and psychosocial challenges exacerbate this risk. There is a need for careful selection of cART, hormone replacement therapy (HRT), and emerging treatments such as Abaloparatide. A holistic approach including lifestyle changes and psychosocial support is crucial to reduce fracture risk in WLHIV, especially in low-income countries.

We report a case of a 55-year-old postmenopausal woman who presented with symptoms of fatigue, male pattern hair loss, and hirsutism over 3 years. Investigations showed elevated total testosterone levels of 5.0 nmol/L (1.44 ng/mL; range, 0.3-3.1 nmol/L) using Beckman-Unicel-DXI-800 immunoassay. Testosterone levels were repeated by liquid chromatography-tandem mass spectrometry and were found to be elevated at 7.3 nmol/L (2.10 ng/mL). Estradiol was detectable and free androgen index was elevated. Dehydroepiandrosterone sulfate levels and androstenedione were within normal range, suggesting a nonadrenal source. Computed tomography scan of the abdomen showed no evidence of adrenal or adnexal tumor. GnRH analog stimulation test led to reduction of gonadotrophins and normalization of testosterone within 4 weeks. She had a biopsy of a cranial hair follicle, which showed androgenic alopecia. These investigations confirmed an ovarian source of androgens. Subsequently, she underwent bilateral salpingo-oophorectomy. Histological study of gonadal tissue confirmed the diagnosis of ovarian hyperthecosis. Four weeks after oophorectomy, her testosterone levels normalized and clinical symptoms improved. Ovarian hyperthecosis is a rare cause of hyperandrogenism in postmenopausal women and can pose a diagnostic and therapeutic challenge. Careful history and physical examination along with critical analysis of biochemistry and imaging studies is crucial for correct diagnosis. [ABSTRACT FROM AUTHOR]

Background: The transition of females to the postmenopausal state is vulnerable to developing obesity deciding the future development of cardiovascular disease and type II diabetes mellitus in these subjects. Insulin deficiency and resistance affect the lipid metabolism in diabetics. Aim: To assess the correlation of Estradiol and lipid profile to the body mass index in the postmenopausal females having type II diabetes mellitus by evaluating Estradiol and lipid profile based on the BMI. Methods: In 240 postmenopausal females having type 2 diabetes mellitus, venous blood was analyzed for Estradiol, fasting glucose, LDL-C, HDL-C, triglycerides, and total cholesterol. For each subject, weight and height were recorded. BMI was divided into 3 categories as obese (<30), overweight (25-25kg/m²), and normal (<18.5-24.9 kg/m²) categories. Results: Spearman's correlation was used for assessing the correlation of lipid parameters to Estradiol, it was seen that the significant results were seen with BMI with p=0.02. Estradiol levels were highest in the obese subjects followed by overweight and normal weighted subjects with respective mean values of 1.3, 1.18, and 0.3nmol/l respectively (p=0.04). HDL was higher in normal-weight subjects (42.6±6.37) and reduced significantly to 37.3±4.7 and 31±2.7mg/dl in overweight and obese subjects with p=0.03. Triglyceride levels were significantly higher in overweight subjects followed by obese and normal-weight subjects (p=0.04). Conclusion: The study concludes that postmenopausal obese females having type II diabetes mellitus have high Estradiol concentration and high atherogenic risk profile in them. [ABSTRACT FROM AUTHOR]

Although the incidence of invasive breast cancer (BC) among women in Asian is generally lower than that in Western countries, the incidence of BC has been on the rise in the past three decades in Asian countries. This hospital-based case-control study aimed to explore the relationship between dietary and metabolic factors and BC risk in pre- and post-menopausal women. We enrolled 285 patients with newly diagnosed BC at the National Taiwan University Hospital and 297 controls from the local community and hospital staff. Before receiving anticancer therapy, all patients with BC and control participants completed a 57-question semi-quantitative Food Frequency Questionnaire. For pre-menopausal women, plant-based factor scores rich in seeds and nuts, soy, fruits, and seaweeds correlated significantly with reduced BC risks, whereas menarche occurring at <12 years of age, reduced physical activity, and high-density lipoprotein <40 mg/dL were associated with increased BC risks. For post-menopausal women, plant-based dietary factor scores were also associated with reduced risks, whereas increased body mass index and energy intake levels correlated with increased BC risks. Diets rich in plant-based dietary patterns are protective against BC risk, regardless of menopausal status. Habitual physical activity is protective against BC risk among pre-menopausal Taiwanese women. Maintaining optimal weight and caloric intake is beneficial for reducing post-menopausal BC risk. [ABSTRACT FROM AUTHOR]

Background: Bleeding Per vagina following established menopause is called post menopausal bleeding. The significance of postmenopausal bleeding, whatever slight it may be, should not be underestimated. As many as one-third of the cases are due to malignancy. The same importance is also given to those eases where normal menstruation continues even beyond the age or 55 years. In recent years, health aspects of postmenopausal women have gained immense importance as it owes significance importance in gaining life expectancy in these women. Aim and Objectives : The aim of this study was to determine the sensitivity and specificity of transvaginal sonography in detection of endometrial carcinoma. Material and Methods: This study hospital based prospective observational study, has been carried out from May 2020 to April 2021 in the department of Obstetrics and Gynaecology of BMC & H. A total of 96 postmenopausal women who attended outpatient department at the Obstetrics and Gynaecology department of BMCH with the complaint of vaginal bleeding will be included after application of exclusion criteria. Template was generated in MS excel sheet and analysis was done on SPSS. Results: In the present study 1 (53.1%) patients were 51-60 years of age, Mean age (mean ± SD) of patients was 53.6771±6.3965. In our study, 89 (92.7%) patients had endometrial halo. We have found that 49% postmenopausal women have atrophic and senile cystic atmhy, 6.3% patients have carcinoma endometrium. mean years of menopause (mean ± SD) of patients was 7.1406 ± 5.4967. Mean endometrial thickness (mean ±SD) of Patients was 6.7604± 4.3067. In the present study, there is more chance of carcinoma in women with >50 years of age. There is more chance (19.4%) of carcinoma in women having BMI >25. There is 50% chance of endometrial carcinoma in women with other CA and 75% chance of endometrial carcinoma in women with HT N & DM. Conclusion: Transvaginal sonography is safe, simple, non invasive and cost effective in the diagnosis of endometrial carcinoma. [ABSTRACT FROM AUTHOR]

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]

There is a fundamental gap in knowledge in how Parkinson's disease manifests and affects women throughout their hormonal life cycle, resulting in unmet needs and adversely impacting women's quality of life. A set of questionnaires was developed and deployed through Fox Insight (open access) to address these issues by gathering data. This is the data from the first survey. The data from the questions regarding self-image were striking. 61% of women report that their Parkinson's disease negatively impacts their self-image. Here we explore the negative impact of Parkinson's disease on women to begin to fill the gaps in knowledge. [ABSTRACT FROM AUTHOR]

Binge eating disorder (BED), a form of overnutrition, may impact healthy aging for postmenopausal women. In community samples, 12–26% of older women (ages 60+) engage in binge eating. In younger adults, BED is comorbid with physical and psychological morbidities. However, little is known regarding the clinical phenotype, including medical and psychiatric comorbidities, of BED in postmenopausal women. This pilot study sought to identify psychosomatic, cardiometabolic, body composition, and physical function characteristics of postmenopausal, older adult (age ≥60 years) women with BED. Participants (N = 21, ages 60–75) completed a battery of physical assessments and surveys assessing psychosomatic health. Overall, 62% of women reported BE onset during peri- or post-menopause. Rates of comorbid depression, anxiety, sleep problems, and a history of severe menopausal symptoms were high. Cardiometabolic health was poor, and 42.9% met the criteria for metabolic syndrome. Additionally, 71.4% met the BMI criteria for obesity, and 40% of this sample met the criteria for sarcopenic obesity. Almost half of the sample presented with at least one mobility limitation; 85.7% had poor endurance. Evidence suggests that BED is highly comorbid with other chronic health conditions and may complicate treatment of these conditions, warranting further investigation and increased attention from healthcare providers serving postmenopausal women. [ABSTRACT FROM AUTHOR]

IntroductionPsychological features have been bidirectionally associated with osteoporosis, but it is still unclear whether patient’s anxiety fluctuations during the anti-osteoporotic treatment can have an impact on bone mineral density (BMD) variation. The aim of this study was to investigate the interrelations between psychological distress features, such as anxiety, depression, health-related QoL (HRQoL) and bone health in women receiving anti-osteoporotic treatment.Methods192 post-menopausal osteoporotic women were treated with alendronate or risedronate according to the standard procedure. The levels of anxiety, depression, and perceived HRQoL, along with BMD, were assessed at baseline and at a 2-year follow-up.ResultsAt the end of the study, the patients showed a statistically significant increase of both psychic and somatic anxiety (p

Introduction/Purpose: To evaluate the endometrial thickness (ET) as a predictor of endometrial abnormalities in postmenopausal women and whether consideration of baseline risk factors increases diagnostic accuracy. Methods: This is a retrospective observational study of postmenopausal women presenting with bleeding or thickened endometrium (≥4 mm) on ultrasound, between 2003 and 2012. Risk factors for endometrial abnormality were analysed using logistic regression. Of 301 women, 220 were symptomatic and 81 were asymptomatic. The median ET was 6 mm (IQR 4–9) for symptomatic women and 9 mm (IQR 6–12) for asymptomatic women. Results: Abnormal pathology was found in 35 symptomatic (15.9%) and 6 asymptomatic women (7.4%). For each 1 mm increase in ET, the odds of an abnormal diagnosis increased by 16.3% (95% CI 9.6–23.5) for symptomatic and 19.9% (95% CI 3.1–39.3) for asymptomatic women. The Youden's index method identified an ET threshold of ≥7.1mm for symptomatic and ≥14.5mm for asymptomatic women. In symptomatic women the sensitivity was 88.6% (95% CI 72.3–96.3) and specificity 69.2% (95% CI 61.9–75.6), while in asymptomatic women the sensitivity was 50.0% (95% CI 13.9–86.1) and specificity was 89.3% (95% CI 79.5–95.0). The addition of age in the symptomatic women model reduced the sensitivity (82.9% (95% CI 65.7–92.8)) but increased the specificity (72.4% (95% CI 65.3–78.6)). Conclusion: ET is a significant predictor of abnormality. In the absence of risk factors, our study suggests that invasive procedures may be withheld until the ET is ≥7.1 mm with bleeding and ≥14.5 mm in asymptomatic women with no bleeding. [ABSTRACT FROM AUTHOR]

Introduction: Gliomatosis peritonei (GP) is characterized by the presence of benign, mature glial implants in the peritoneum or omentum. Aim: Understanding unusual findings with clear knowledge of pathological comparisons makes diagnosis more reliable and guides future treatment. Case study: This is a case of a 70-years-old lady, post-menopausal, who presented with abdominal mass which progressively increased in size for the past 40 years. She also had constipation requiring laxatives and occasional lower abdominal pain. Her abdomen was clinically distended with a large hard central mass. Results and discussion: Computed tomography of the abdomen showed features of left ovarian teratoma with multiple gliomatosis peritonei. Histopathology of the mass post-surgery revealed a left ovarian mature cystic teratoma and the peritoneal deposits to be heavily calcified and fibrotic mature implants with no evidence of malignancy. Conclusions: Gliomatosis peritonei (GP) is a rare finding associated with ovarian teratoma and rare in postmenopausal women. It is important to appreciate a variety of radiological presentations of this condition to establish an accurate diagnosis. [ABSTRACT FROM AUTHOR]

This study used secondary data from the longitudinal aging study of India with an objective to estimate the prevalence of hypertension among post menopausal women in India and evaluate the associated risk factors. We extracted data from the first wave of the Longitudinal Ageing Study in India (LASI), which is a nationally and state representative of aging and health. In descriptive analysis weighted prevalence & 95% Confidence Interval (CI) of hypertension with all the social determinants & health status variables were calculated in different age groups. We performed unadjusted and adjusted logistic regression analyses to assess the Odds Ratio with 95% CI. Approximately half of the Indian post-menopause women suffered from hypertension 51.68% (95% CI: 50.00% - 53.00%). Self-reported prevalence of hypertension among post-menopause women in India is 32.54% which indicates that 19.14% of the women did not aware that they had hypertension prior to the survey. Urban residents, Muslims & other religions, currently not working, and currently not married women had a higher prevalence of hypertension. Compared with women with normal BMI, those who were overweight or obese were more likely to suffer from hypertension. A large difference in the prevalence of hypertension in diabetic vs non-diabetic women (77.44% Vs 47.78%) and also with increased vs normal waist circumference (61.93% vs 41.87%). We report a significant prevalence of hypertension among pot-menopausal women in India. We found that age, high BMI, abdominal obesity and presence of diabetes were significant risk factors associated with this. [ABSTRACT FROM AUTHOR]

Background: The causes of postmenopausal vaginal bleeding included endometrial atrophy, hyperplasia, polyps, submucosal myoma, and cancer. Every woman with postmenopausal bleeding (PMB) needs a meticulous clinical investigation since it has a 10 to 15 % of endometrial cancer. Objective: The aim of this work was to achieve an accurate evaluation of the uterine cavity in obese females with postmenopausal bleeding. Patient and Methods: A case-control study that was carried out over 6 months from March 2022 to August 2022 on 68 cases at Gynecology Outpatients in Obstetrics and Gynecology Department, Zagazig University Maternity Hospital where office hysteroscopy is performed. All patients were divided into two groups: Group A included 34 obese patients with post-menopausal uterine bleeding, while group B included 34 non-obese patients with post-menopausal uterine bleeding. All patients were subjected to full history taking, routine clinical examination, laboratory investigations and hysteroscopic evaluation. Results: There was no significant difference between the studied groups concerning the endometrial thickness, time, and amount of bleeding or histological sample distribution. They also revealed that endometrial polyps were significantly associated with non-obese group, but endometrial polyps + fibroids and proliferative endometrial hyperplasia were significantly associated with obese group. Conclusions: Obesity is a risk factor for the development of abnormal uterine bleeding in postmenopausal women considering its association with several uterine and endometrial pathologies causing postmenopausal bleeding. [ABSTRACT FROM AUTHOR]

we aim to synthesize available evidence on the effectiveness of hormonal plus targeted therapies for post-menopausal women with hormone receptor-positive and HER2-negative advanced breast cancer.We searched the following databases: Medline, PubMed, Cochrane Library, CINAHL, Web of Science, Scopus, and African Journal. Only studies that investigated the effectiveness of hormonal therapy combined with targeted therapy for HR+/HER2- advanced breast cancer treatment were included. The outcomes were progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). A random-effect meta-analysis model was employed. Statistical analysis was performed using Comprehensive Meta-analysis version 3.24 studies were included in the meta-analysis with an overall sample size of 7635. Median PFS, OS and ORR were found to be significantly increased in the combination group compared to hormonal monotherapy [SMD = 6.072 (95% CI = 3.785–8.360), p < 0.001], [SMD = 1.614 (95% CI = 0.139–3.089), p = 0.032] and [OR = 1.584 (CI 1.134–2.213), p = 0.007] respectively. Subgroup analysis showed a significant difference in PFS and ORR between patients who received “hormonal therapy + CDK4/6 inhibitors” vs hormonal therapy only [SMD = 6.015 (CI 3.069–8.960), p < 0.001], (OR = 1.828 (CI 1.030–3.243), p = 0.039] respectively.Compared with hormonal monotherapy, targeted plus hormonal therapy significantly improves PFS, OS and ORR in postmenopausal women with HR+/HER2- advanced breast cancer. [ABSTRACT FROM AUTHOR]

Background: Loss of bone mineral density is one of the most important complications of menopause. The results of studies about the relation between body fat and bone mineral density are controversial. The aim of this study is to determine the association between fat mass and bone mineral density on non-obese post-menopausal elderly women. Methods: This cross-sectional study is a part of the second phase of the AmirKola Health and Ageing Project (AHAP) that has been done on 356 elderly women with BMI of 18.5-30. Bone mineral density (BMD) and total body fat were measured using the Hologic Horizon-WI densitometer. Statistical tests were ANOVA and Pearson’s correlation coefficient and P value less than 0.05 was considered significant. Results: The mean age of participants was 70.22±7.34 and the mean age of menopause was 47.68±5.05. Women with highest fat mass, had a greater spine, femur and whole body BMD (p

Introduction: Osteoporosis according to postmenopausal women is a major health problem increasing yearly. Thus, there is a growing need to assess the success of dental implants among these patients. Aim: Evaluation of dental implants success between 6 and 12 months follow-up on postmenopausal women with osteoporosis by means of clinical and radiographic assessment. Materials and Methods: A total of 30 female patients aged between 46 and 65 years were diagnosed with osteoporosis and treated with Vitamin D3 and Calcium (Vit D3 and Ca). The sample was divided into two groups: Group 1- 15 female patients diagnosed with osteoporosis (bone density of D2) and treated with (Vit D3 and Ca) and group 2- 15 female patients diagnosed with osteoporosis (bone density of D3) and treated with (Vit D3 and Ca). A total of 60 dental implants were placed in the mandibular posterior area. Implant loading was done after 6 months. Follow up intervals were 6 to 12 months after loading. Results: According to the study, compromised survival was in two implants in the osteoporosis group with a bone type of D2 with a rate of 3.3%, and compromised survival in the osteoporosis group with bone type of D3 was 11 implants with a rate of 18.3%. The success was in 52 implants, with a rate of 86.7%. Conclusion: Placing dental implants in postmenopausal female patients with osteoporosis and treating with (Vit D3 and Ca) is a safe treatment option for missing teeth, despite the bone density type. More researches about implant with osteoporosis patients are recommended.

Background and aim: Breast cancer is the most prevalent type of cancer diagnosed in women. Multiple risk factors are responsible for this disease which can be preventable if picked earlier. The current research study aimed to evaluate potential risk factors that are associated with the breast cancer. Material and Methods: This research was a retrospective, observational study conducted in the Department of Surgery, Hamdard University Hospital, Karachi from June 2018 to June 2021. All patients coming under the inclusion criteria were registered after taking informed consent. Descriptive statistics were calculated with frequency and percentages assessed for each variable. Results: Post-menopausal status was found in 58.1% of patients, with 47.3% with a history of breast abscess drainage and 9.1% with a gynecological history of polycystic ovary disease. 25% of patients had a past medical history of hypertension. 33.8% of patients had tobacco addiction whereas their partners were more addicted to smoke (64.9%) but were also tobacco addicts (40.5%) when compared. 25.7% of individuals had a family history of breast cancer. Conclusion: The current study's outcomes revealed that various factors are involved in influencing the incidence of breast cancer, among these the important ones that are seen in this research are post-menopausal status, polycystic ovarian disease, and benign breast disease, as well as many other factors such as tobacco addiction, hypertension, and family history. [ABSTRACT FROM AUTHOR]

Purpose: Short and long sleep duration and poor sleep quality are risk factors for weight gain and cancer mortality. The purpose of this study is to investigate the relationship between sleep and weight change among postmenopausal breast cancer survivors. Methods: Women participating in the Women's Health Initiative who were diagnosed with incident breast cancer between year one and year three were included. Self-reported sleep duration was categorized as ≤ 5 h (short), 6 h, 7–8 h (optimal), and ≥ 9 h (long). Self-reported sleep quality was categorized as poor, average, and above average. Post-diagnosis weight change was the difference of weight closest to, but preceding diagnosis, and year 3 weight. We used linear regression to evaluate sleep duration and sleep quality associations with post-diagnosis weight change adjusted for potential confounders. Results: Among 1156 participants, 63% were weight stable after diagnosis; average weight gain post cancer diagnosis was 3.2 kg. Six percent of women reported sleeping ≤ 5 h, 26% reported 6 h, 64% reported 7–8 h, and 4% reported ≥ 9 h. There were no differences in adjusted estimates of weight change among participants with short duration (0.37 kg; 95% CI − 0.88, 1.63), or long duration (− 0.56 kg; 95% CI − 2.03, 0.90) compared to optimal duration, nor was there a difference among poor quality (− 0.51 kg; 95% CI − 1.42, 0.41) compared to above average quality. Conclusion: Among postmenopausal breast cancer survivors, sleep duration and quality were not associated with weight change after breast cancer diagnosis. Future studies should consider capturing change in adiposity and to expand beyond self-reported sleep. [ABSTRACT FROM AUTHOR]

Objective: Overweight and obesity [body mass index (BMI) ≥ 25 kg/m2] are associated with poorer prognosis among women with breast cancer, and weight gain is common during treatment. Symptoms of depression and anxiety are also highly prevalent in women with breast cancer and may be exacerbated by post-diagnosis weight gain. Altered brain function may underlie psychological distress. Thus, this secondary analysis examined the relationship between BMI, psychological health, and resting state functional connectivity (rsFC) among women with breast cancer. Methods: The sample included 34 post-menopausal women newly diagnosed with Stage 0-IIa breast cancer (M age = 63.59 ± 5.73) who were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. At baseline prior to randomization, whole-brain analyses were conducted to evaluate the relationship between BMI and seed-to-voxel rsFC of the hippocampus and amygdala. Connectivity values from significant clusters were then extracted and examined as predictors of self-reported depression and anxiety. Results: Mean BMI was in the obese range (M = 31.83 ± 6.62). For both seeds examined, higher BMI was associated with lower rsFC with regions of prefrontal cortex (PFC), including ventrolateral PFC (vlPFC), dorsolateral PFC, and superior frontal gyrus (z range = 2.85–4.26). Hippocampal connectivity with the vlPFC was negatively correlated with self-reported anxiety (β = 0.47, p < 0.01). Conclusion: Higher BMI was associated with lower hippocampal and amygdala connectivity to regions of PFC implicated in cognitive control and emotion regulation. BMI-related differences in hippocampal and amygdala connectivity following a recent breast cancer diagnosis may relate to future worsening of psychological functioning during treatment and remission. Additional longitudinal research exploring this hypothesis is warranted. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the blood supply contribution of older donors in five Asia Pacific regions. Background: Older people are often the largest blood user group. Thus, as the population ages blood supply needs increase. Minimum and maximum donation age criteria potentially constrain the size of the donor pool. Materials and methods: Haemoglobin values and demographic frequency analytics (sex, age and blood type) were analysed on blood donors aged 60 years or more, from Hong Kong, Indonesia, Japan, Singapore and South Korea over 12 months. Results: Data on 434357 donations was analysed. ABO Rh(D) frequencies of older donors matched that of national frequencies. Older donors were a disproportionately smaller proportion of the total donor pool for each country. Indonesia was the only region with no maximum age limit. Median haemoglobin for older males ranged from 14.2 to 14.8 g/dl and for females 13.1 to 13.9 g/dl. The frequency of female donors was between 15% and 33% of older donors. Older donors had higher donation frequency and lower deferral rates. Conclusion: Older donors are loyal and regular donors but under‐represented in all regions studied. They could help meet future blood supply needs, especially post‐menopausal female donors. Studies including ferritin levels are needed to determine if upper age limits can be safely modified. [ABSTRACT FROM AUTHOR]

Objectives: The impact of depression on post-menopausal women is an important public health issue but remains largely unknown. The purpose of this study was to identify the prevalence of post-menopausal depression in Greece and outline the profile of the women it affects.Study Design: A sample of post-menopausal women completed an anonymous, self-administered, web-based survey which included the Beck Depression Inventory-ΙΙ (BDI-II) and questions regarding socio-demographic data.Main Outcome Measures: The dependent variable of interest was a BDI-II score ≥ 20 (the cut-off for moderate depression according to the BDI).Results: Overall, 502 post-menopausal women participated in the study. The median BDI-II score was 13 (range 0-50); 136 (27.1%) of the women scored ≥ 20 and were considered screen-positive for depression. According to the multivariate logistic regression model, age< 55 years (OR: 1.621; 95% CI: 1.036-2.535), not working (OR: 1.580; 95% CI: 1.013-2.465), smoking (OR: 1.656; 95% CI: 1.081-2.536) and history of depression (OR: 1.650; 95% CI: 1.045-2.604) were independently associated with post-menopausal depression. Subgroup analyses revealed that current smokers (OR: 2.514; 95% CI: 1.485-4.256) had higher odds of moderate depression, while obesity (OR: 2.455; 95% CI: 1.206-4.996), absence of healthcare insurance (OR: 4.413; 95% CI: 1.970-9.887) and a history of depression (OR: 2.253; 95% CI: 1.212-4.190) were identified as independent risk factors for severe post-menopausal depression.Conclusions: More than one out of four post-menopausal women were screen-positive for symptoms indicative of depression, while a personal history of depression, age < 55 years, smoking and current working status were independent predictors of its emergence. [ABSTRACT FROM AUTHOR]

Osteoporosis and fragility fractures result in significant morbidity and mortality and contribute to substantial healthcare costs. Despite being a treatable disease, osteoporosis remains both underdiagnosed and undertreated in the US general population, with significant disparities in care between non-White and White women. These disparities are evident from screening to post-fracture treatment. Non-White women are less likely to be screened for osteoporosis, to be prescribed pharmacotherapy, or to receive treatment post-fracture; furthermore, the mortality rate after fracture is higher in non-White women. Given existing diagnostic and treatment disparities, additional studies and interventions are needed to optimize the bone health of Asian, Black, Hispanic, and Native American women, and to reduce morbidity and mortality from osteoporosis and fragility fractures. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension (PH) is a multifactorial condition that encompasses a group of diseases characterized by a progressive increase in pulmonary vascular resistance and pulmonary arterial pressure, ultimately leading to right heart failure and death. The primary goals of PH treatment are to lower pulmonary arterial pressure, alleviate symptoms such as shortness of breath and chest pain, address modifiable risk factors, and manage the underlying cause, often a common advanced disease like chronic obstructive lung disease or left heart disease. While sex is an unchangeable risk factor for PH development, the presence or absence of estrogens has a significant influence on its progression. Hormone replacement therapy (HRT) is the recommended form of estrogen therapy for postmenopausal women, but only in carefully selected cases. However, a paradox arises, as some research suggests HRT benefits women, while other studies highlight its risks. This review provides a comprehensive analysis of the literature on the role of HRT in PH., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Gill et al.)

Socio-demographic factors and household food insecurity are considered to influence the nutritional status of older women. The rapidly growing elderly population in Africa is a concern particularly in sustaining their health and nutritional status. In spite of this, there is a scarcity of information in older Zambian women and this study aimed to assess the socio-demographic factors, nutritional status and household food insecurity status of older women in rural Zambian communities. This cross-sectional study was conducted in Twatasha compound of Kitwe and Ndeke community of Ndola. The socio-demographic characteristics, anthropometric measurements, dietary intakes and household food security were evaluated in a convenience sample of 153 older women (≥ 50 years) through the Household Food Insecurity Access Scale (HFIAS). IBM SPSS version 26 was used for descriptive (frequencies, means and standard deviations, and medians with interquartile frequencies) and inferential (bivariate and Spearman correlations) statistical analyses. The socio-demographic characteristics showed that almost all (98.7%) of the participants had other members of the family residing with them. Most participants (57%) had attained primary school education, 19% had secondary education and 5% had college education. Almost half (49%) of the participants did not report their employment status and 36% reported to be unemployed. Over-nutrition was most prevalent (37.3% overweight and 39.8% obese) while 20.9 % and 2.0% of the respondents were normal weight and underweight respectively. The median (25th percentile; 75th percentile) 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. The majority (86.0%) of the participants were identified as severely food insecure while only 6.0% were food secure. The majority of the participants (80-90%) used at least seven out of the nine behavioural responses to food insecurity. The findings show resource-poor and severely food insecure communities. We recommended urgent interventions to improve access to healthy foods (such as home gardening projects) and promote healthy dietary habits (including nutrition education). [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]

Purpose: Menopause is associated with an increased risk of estrogen receptor-positive (ER +) breast cancer. To characterize the metabolic shifts associated with reduced estrogen bioavailability on breast tissue, metabolomics was performed from ovary-intact and ovariectomized (OVX) female non-human primates (NHP). The effects of exogenous estrogen administration or estrogen receptor blockade (tamoxifen treatment) on menopause-induced metabolic changes were also investigated. Methods: Bilateral ovariectomies were performed on female cynomolgus macaques (Macaca fascicularis) to model menopause. OVX NHP were then divided into untreated (n = 13), conjugated equine estrogen (CEE)-treated (n= 13), or tamoxifen-treated (n = 13) subgroups and followed for 3 years. Aged-matched ovary-intact female NHP (n = 12) were used as a premenopausal comparison group. Metabolomics was performed on snap-frozen breast tissue. Results: Changes in several different metabolic biochemicals were noted, particularly in glucose and fatty acid metabolism. Specifically, glycolytic, Krebs cycle, acylcarnitines, and phospholipid metabolites were elevated in breast tissue from ovary-intact NHP and OVX + CEE in relation to the OVX and OVX + tamoxifen group. In contrast, treatment with CEE and tamoxifen decreased several cholesterol metabolites, compared to the ovary-intact and OVX NHP. These changes were accompanied by elevated bile acid metabolites in the ovary-intact group. Conclusion: Alterations in estrogen bioavailability are associated with changes in the mammary tissue metabolome, particularly in glucose and fatty acid metabolism. Changes in these pathways may represent a bioenergetic shift in gland metabolism at menopause that may affect breast cancer risk. [ABSTRACT FROM AUTHOR]

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.

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.

Objectives: Psychological symptoms of menopause may impose a negative effect on the quality of life of menopausal women. Thus, the management of these symptoms can improve the quality of life and psychological health of such woman. The present study aimed to determine the effect of evening primrose on psychological symptoms in menopausal women. Methods: In this triple-blind randomized clinical trial, the effect of the evening primrose oil on postmenopausal psychological symptoms was investigated. The subjects were 100 menopausal women, referred to a healthcare center in Dastena city (Chaharmahal and Bakhtiari Province, Iran), who were randomly assigned to two groups. The intervention group used two 1 g pearls of evening primrose oil daily. The study instruments included a sub-scale of Menopause Rating Scale (MRS). Menopause data were analyzed using an independent t -test and Friedman test by the SPSS software. P values < 0.05 were considered statistically significant. Results: The two groups were balanced in demographic characteristics and psychological disorder severity before the intervention. The median (interquartile range) MRS score in the intervention group before the intervention and 2 and 4 weeks after the intervention were 11 (10-12), 6 (5-7), and 3 (2-4), respectively, and in the placebo, they were 11 (9-11), 10 (9-11), and 11 (10-12). A significant reduction was observed in the intervention group compared with the placebo group 2 and 4 weeks post-intervention. Conclusions: The use of evening primrose oil can decrease postmenopausal psychological symptoms. [ABSTRACT FROM AUTHOR]

This article outlines why dental health is important for patients with chronic kidney disease [ABSTRACT FROM AUTHOR]

Abstract Background A complete infectious focus survey relies on a thorough physical examination as well as a pelvic examination. Tubo-ovarian abscess, though less likely to occur in senior women, may become a life-threatening disease requiring emergent surgery. Hence, clinical awareness and aggressive management are warranted to avoid delayed diagnosis and subsequent complications. Case presentation We report a post-menopausal woman presented with sepsis of unknown origin, which turned out to be a huge tubo-ovarian abscess. Although tubo-ovarian abscess mostly occurs in women of fertile age, it is likely that the immune status of our post-menopausal patient was compromised because of old age and uremia. Moreover, due to underlying dementia, she could not express her discomfort in the early stage. Her sepsis resolved after a unilateral salpingo-oophorectomy surgery and antibiotic treatment. It is crucial to exclude pelvic inflammatory disease (PID) if no specific source of infection can be identified. Conclusions Rupture of the tubo-ovarian abscess is a condition of high mortality rate. Although tubo-ovarian abscess is more likely to develop in patients aged 15–25 years old, the tubo-ovarian abscess should be listed as a differential diagnosis in all post-menopausal women, especially those who are immunocompromised or with a palpable pelvic mass, to enable timely management and better prognosis.

Abstract Background This study aimed to evaluate the management of asymptomatic intrauterine lesions detected by ultrasonography. Methods Patients who underwent diagnostic hysteroscopy for asymptomatic lesions, including pre- and post-menopausal endometrial polyps, post-menopausal endometrial thickening (ET ≥5 mm) and reduplicative endometrial heterogeneity detected by transvaginal ultrasonography (TVUS), were recruited for this study. Results In the 792 recruited patients, the symptom-free focal masses within the uterine cavity detected by TVUS included 558 patients with pre- or post-menopausal endometrial polyps and 234 patients with postmenopausal endometrial thickening. No pre-menopausal patient presented with carcinoma. The polyp diameter (PD) was not identified as an independent risk factor for malignancy in this study. A significant difference (P = 0.036,

Objective: To evaluate the prevalence of vitamin D deficiency in postmenopausal women in light of restrictions imposed by the Covid-19 pandemic. Methods: This was a single-center cross-sectional study with total of 167 women patients (post-menopausal :133, pre-menopausal: 24) who were divided into two groups according to age. Result: There were significant negative links between serum T4 hormone levels and each of serum calcium values (r=-0.049, p <0.001) in post-menopausal. Serum T4 hormone levels are negatively correlated to TSH hormone levels (r=-0.032, p < 0.001) but T3 hormone levels shows significantly negative correlation (r=-0.277p<0.001). The correlation between serum T4 hormone levels vs Glucose in patients was significantly negative (r= -0.017, p <0.001),The results show that significant decrease(p<0.01) in serum levels T4, T3 hormone, vit. D in post-menopausal women compared as compared to pre-menopausal, correlation of vitamin D with serum calcium (0.23 and T4, hormone (0.137) was significantly positive, and high fasting glucose in post-menopausal as compared to pre-menopausal . Conclusion: Baseline serum vitamin D levels are inversely related with thyroid hormone in post-menopausal women. [ABSTRACT FROM AUTHOR]