Search Results (24)

Purpose: Previous data showed an increased risk of developing urinary incontinence in breast cancer patients. However, there is a lack of studies including both pre and postmenopausal women. The aim of this study was to analyze the incidence of subsequent urinary incontinence in breast cancer patients and variables associated with an increased urinary incontinence. Methods: This study utilized IQVIA Disease Analyzer database to examine the five-year cumulative incidence of urinary incontinence among 68,066 women diagnosed with breast cancer in gynecological practices in Germany between January 2005 and December 2021 by using Kaplan–Meier curves, stratified by age group. Multivariable Cox regression models were conducted to assess the association between age, co-diagnoses, and endocrine therapy (tamoxifen, aromatase inhibitors) and incident urinary incontinence. Results: Within five years of the start of follow-up, 5.8% of women were diagnosed with urinary incontinence. Age (HR = 1.36; 95% CI = 1.21–1.54 for age 51–60; HR = 2.06; 95% CI = 1.84–2.31 for age group 61–70 and HR = 2.71; 95% CI = 2.42–3.04 for age group >70 as compared to age group ≤50), depression (HR = 1.41; 95% CI: 1.25–1.59) and menopausal and other perimenopausal disorders (HR = 1.21; 95% CI: 1.10–1.27) were associated with an increased urinary incontinence risk. The association was negative and statistically significant for aromatase inhibitor therapy (HR = 0.71; 95% CI: 0.66–0.78) as compared to women without endocrine therapy, whereas tamoxifen therapy was not associated with decreased or increased urinary incontinence risk. Conclusions: In conclusion, this study reports an 5.8% incidence of urinary incontinence within five years after breast cancer diagnosis. Age-related differences and co-diagnoses should be taken into account. Full article

Background/Objectives: To identify clinical, biochemical, and psychological factors associated with metabolic syndrome (MS) in climacteric women and to determine independent predictors of MS across menopausal stages. Methods: A cross-sectional study was conducted in 225 women (perimenopausal, n = 75; early postmenopausal, n = 75; late postmenopausal, n = 75). Anthropometry, clinical history, and fasting laboratory tests were obtained. Psychological measures included perceived stress (Perceived Stress Scale, PSS), anxiety symptoms (Short Health Anxiety Inventory, SHAI-18), and depressive symptoms (Hamilton–Bech–Rafaelsen Scale). Results: Perimenopausal women had higher BMI than both postmenopausal groups (33 ± 5 vs. 30 ± 5 and 29 ± 4 kg/m²; F = 13.39, p < 0.001). Waist/hip ratio showed a modest group effect (F = 6.34, p = 0.002), being higher in perimenopause versus late postmenopause (p = 0.001). Significant group differences were observed in lipid and glucose profiles across menopausal stages. Total cholesterol (F = 4.86, p = 0.009), HDL cholesterol (F = 7.12, p = 0.001), and non-HDL cholesterol (F = 8.13, p < 0.001) differed significantly, as confirmed by post hoc Tukey HSD tests, with higher total and non-HDL cholesterol levels in early and late postmenopausal women compared with the perimenopausal group, and higher HDL cholesterol levels in early postmenopausal women compared with the perimenopausal group. Fasting glucose showed a significant difference (H = 9.89, p = 0.007, Kruskal–Wallis test), with higher median levels in perimenopausal (127 mg/dL) than in early postmenopausal women (97 mg/dL, p = 0.003, Mann–Whitney U). Perceived stress was highest in early postmenopause (61.3%) compared with late postmenopause (48.0%) and perimenopause (34.7%), χ² = 10.68, p = 0.0048, while anxiety and depression did not differ. Logistic regression analyses identified perceived stress and depressive symptoms as significant predictors of metabolic syndrome under different diagnostic definitions. Higher perceived stress was inversely associated in the psychological model (aOR = 0.62; 95% CI 0.43–0.88; p = 0.008) but positively related in the clinical model including fasting glucose and blood pressure (aOR = 1.54; 95% CI 1.07–2.22; p = 0.021). In the combined model, both fasting glucose and perceived stress remained independent predictors (p < 0.05), under-scoring the contribution of psychological factors to metabolic risk. Conclusions: Among climacteric women, perceived stress and cardiometabolic factors (systemic arterial hypertension, Type 2 DM, and elevated fasting glucose) are independent predictors of metabolic syndrome. Early identification and integrated management of stress and metabolic risks may help reduce the burden of metabolic syndrome across menopausal stages. Full article

Background/Objectives: While the prevalence of depression increases during the peri- and post-menopausal periods, the potential of diet as both a modifiable risk factor and complementary treatment option has received limited research attention in this population. To address this gap, we conducted a scoping review aiming to map and synthesize the existing literature on diet and depression in peri- and post-menopause. Methods: Studies were identified through Medline, EMBASE, PsycINFO, CENTRAL, Web of Science, and Scopus. After deduplication in Covidence, two reviewers independently screened titles, abstracts, and full texts using predefined eligibility criteria. Data were extracted using standardized forms and presented in tables and figures. Methodological quality was assessed using the Cochrane RoB-2 for intervention studies and NHLBI tools for observational studies. Results: Thirty-eight studies met the inclusion criteria, including 29 observational and 9 interventional studies. Dietary patterns showed the most consistent associations with depressive symptoms, whereas findings for foods, nutrients, and other food components were inconsistent. Most observational studies had a moderate to high risk of bias, while over half of experimental studies were rated as low risk. Conclusions: Although limited by volume and poor methodological quality, existing evidence suggests that healthy diets may be protective against depressive symptoms in peri- and post-menopausal women, while unhealthy diets may increase risk. High-quality cohort studies and clinical trials are needed to guide future research and inform professionals working at the intersection of nutrition, psychiatry, and women’s health. Protocol registration: osf.io/b89r6. Full article

Menopause is associated with significant hormonal and reproductive changes in women. Evidence documents interindividual differences in the signs and symptoms associated with menopause, including cognitive decline. Hypothesized reasons for the cognitive decline include changes in hormone levels, especially estrogen, but study findings have been inconsistent. Hormone replacement therapies (HRTs) are often recommended to alleviate menopause-related symptoms in both peri- and postmenopausal women. However, the North American Menopause Society does not recommend the use of HRT for the management of cognitive complaints in perimenopausal women due to lack of evidence. Additionally, there are many women for which the use of HRT is contraindicated. As such, it would be helpful to have an alternative method for alleviating symptoms, including declines in cognition, during the menopause transition. Iron supplementation may be a promising candidate as it has been associated with improved cognitive performance in premenopausal women with iron deficiency and iron deficiency anemia. Because many women will experience heavy blood losses during perimenopause, they are at risk of becoming iron deficient and/or anemic. The use of iron supplementation in women with iron deficiency may serve to not only improve iron status but also to alleviate many of the signs and symptoms associated with perimenopause (lethargy, depressed affect, etc.), including cognitive decline. However, evidence to inform treatment protocols is lacking. Well-designed studies of iron supplementation in perimenopausal women are needed in order to understand the potential of such supplementation to alleviate the cognitive decline associated with perimenopause. Full article

Background/Objectives: Dance intervention, as a non-pharmacological therapy, has shown promising potential in alleviating menopausal symptoms among perimenopausal, menopausal, and postmenopausal women. However, a systematic evaluation of its overall effectiveness based on existing trials remains unavailable. This study aims to investigate the effectiveness of dance intervention on health-related outcomes in perimenopausal, menopausal, and postmenopausal women through a systematic review and meta-analysis. Methods: This study systematically searched the relevant databases on 18 October 2024. The risk of bias was assessed using the Cochrane RoB 2 and ROBINS-I tools. Meta-analysis was performed using Review Manager version 5.4. software. For results unsuitable for meta-analysis, narrative synthesis was conducted. The study was registered in PROSPERO (number: CRD42024613134). Results: Meta-analysis demonstrated significant positive effects of dance intervention on psychological symptoms, including depression (I² = 87%, p < 0.001), anxiety (I² = 90%, p = 0.01), vitality (I² = 0%, p = 0.03), interpersonal relationships (I² = 0%, p < 0.001), and somatization (I² = 85%, p = 0.01), in menopausal women, but no significant impact was observed on psychotic symptoms (I² = 89%, p = 0.33). However, the high heterogeneity suggests the presence of potential confounding factors among studies. Sensitivity analysis indicated that the flexibility of the intervention protocol and intra-group differences among participants may have been the main sources of heterogeneity. Further subgroup analysis revealed that interventions conducted less than three times per week had significant effects on depressive symptoms (SMD = −1.93), while a total intervention duration of ≤1800 min significantly improved anxiety symptoms (SMD = −2.15). Conclusions: Dance interventions have significant positive effects on health-related outcomes in perimenopausal, menopausal, and postmenopausal women, except for psychotic symptoms, offering a promising intervention option for clinical practice. Full article

Studying the emotional disorders of perimenopausal women and their influencing factors from a psychological perspective is essential for developing targeted psychological interventions and support strategies. Such efforts can help middle-aged and elderly women better cope with the challenges of perimenopause and improve their overall quality of life. This study aimed to explore the chain mediating effect of self-esteem and psychological resilience on the relationship between illness perception and emotional disorders in perimenopausal women in Macau. A total of 617 postmenopausal women completed the Brief Illness Perception Questionnaire, Psychological Resilience Scale, Self-Esteem Scale, and Hospital Anxiety and Depression Scale. Results revealed a significant positive correlation between illness perception and emotional disorders. Illness perception was found to have a significant direct effect on emotional disorders and an indirect effect through the mediating roles of self-esteem and psychological resilience, both independently and sequentially. These findings indicate that illness perception directly influences emotional disorders in postmenopausal women in Macau and indirectly impacts them through self-esteem and psychological resilience, offering valuable insights for psychological intervention strategies. Full article

The pharmacological effects of pomegranates have been described considering metabolic aspects such as hypoglycemic and hypolipidemic activities. The pomegranate extract has activity on the central nervous system (CNS) as a natural antidepressant and anxiolytic. The chemical composition of pomegranates is complex since the bioactive compounds are multiple secondary metabolites that have been identified in the extracts derived from the peel, seed, flowers, leaves, or in their combination; so, it has not been easy to identify an individual compound as responsible for its observed pharmacological properties. From this point of view, the present review analyzes the effects of crude extracts or fractions of pomegranates and their possible mechanisms of action concerning antidepressant- and anxiolytic-like effects in animal models. Serotonin receptors, estrogen receptors, the peroxisome proliferator-activated receptor gamma (PPARγ), or monoamine oxidase enzymes, as well as potent antioxidant and neuroplasticity properties, have been described as possible mediators involved in the antidepressant- and anxiolytic-like behaviors after pomegranate treatment. The pharmacological effects observed on the CNS in experimental models associated with a specific stress level suggest that pomegranates could simultaneously modulate the stress response by activating several targets. For the present review, scientific evidence was gathered to integrate it and suggest a possible pathway for mediators to be involved in the mechanisms of action of the pomegranate’s antidepressant- and anxiolytic-like effects. Furthermore, the potential benefits are discussed on comorbid conditions with anxiety and depression, such as perimenopause transition and pain. Full article

Perimenopausal depression (PMD) is a psychological disorder that occurs in women during perimenopause. In addition to the common clinical symptoms of depression, it often manifests as a perimenopausal complication, and its notable cause is the decline in estrogen levels. Despite numerous studies and trials confirming the benefits of estrogen replacement therapy (ERT) for PMD, ERT remains unapproved for treating PMD. Therefore, we conducted a literature search using selected keywords in PubMed and Google Scholar to write a review discussing the feasibility of using ERT for PMD. This review examines the potential of ERT for PMD in terms of its underlying mechanisms, efficacy, safety, and time window. These four aspects suggest that ERT is a viable option for PMD treatment. However, the risk of thrombosis and stroke with ERT is a matter of contention among medical experts, with a paucity of clinical data. Consequently, further clinical trial data are required to ascertain the safety of ERT. Full article

Perimenopausal depression, occurring shortly before or after menopause, is characterized by symptoms such as emotional depression, anxiety, and stress, often accompanied by endocrine dysfunction, particularly hypogonadism and senescence. Current treatments for perimenopausal depression primarily provide symptomatic relief but often come with undesirable side effects. The development of agents targeting the specific pathologies of perimenopausal depression has been relatively slow. The erratic fluctuations in estrogen and progesterone levels during the perimenopausal stage expose women to the risk of developing perimenopausal-associated depression. These hormonal changes trigger the production of proinflammatory mediators and induce oxidative stress, leading to progressive neuronal damage. This review serves as a comprehensive overview of the underlying mechanisms contributing to perimenopausal depression. It aims to shed light on the complex relationship between perimenopausal hormones, neurotransmitters, brain-derived neurotrophic factors, chronic inflammation, oxidative stress, and perimenopausal depression. By summarizing the intricate interplay between hormonal fluctuations, neurotransmitter activity, brain-derived neurotrophic factors, chronic inflammation, oxidative stress, and perimenopausal depression, this review aims to stimulate further research in this field. The hope is that an increased understanding of these mechanisms will pave the way for the development of more effective therapeutic targets, ultimately reducing the risk of depression during the menopausal stage for the betterment of psychological wellbeing. Full article

(1) Background: Women in their middle years undergoing perimenopause encounter a range of physical and psychological alterations attributed to hormonal changes. The prominent symptoms among menopausal women are depressive symptoms and sleep-related problems. The aim of this study was to conduct a meta-analysis examining the effects of Cognitive Behavioral Therapy (CBT) on women going through menopause, specifically focusing on depressive symptoms and sleep problems. We analyzed studies conducted both within the country and across international settings over the last decade. (2) Methods: A search of the literature was conducted—a targeted search, exclusively considering randomized controlled trials (RCTs) that were published within the timeframe spanning from 15 June 2013 to 15 June 2023. (3) Findings: Upon reviewing nine studies that satisfied our inclusion criteria and involved a total of 923 participants, it was noted that four of these studies incorporated diverse cognitive-behavioral strategies. Among the nine studies, a total of four were included in the meta-analysis: two measured depressive symptoms, and two measured sleep quality. The combined effect size for depressive symptoms was found to be 3.55 (95% confidence interval: −5.48, −1.61; p < 0.05), and for sleep quality, it was 0.78 (95% confidence interval: −1.32, −0.25; p = 0.004). (4) Conclusions: Our review emphasizes the necessity for conducting larger-scale studies focused on the application of CBT for women experiencing menopausal symptoms. Additionally, it is recommended to approach the interpretation of these results with caution due to discrepancies in methodology and the overall quality of the studies. Further clinical trials are necessary to establish the ideal number of CBT sessions needed for the effective treatment of depression in menopausal women. Future studies should cover a wider range of geographical locations, including more countries, and focus on various outcomes such as depressive symptoms and sleep quality. Full article

The aim of the proposed scoping review is to describe and summarize studies assessing the associations between diet-related variables and depression in peri- and post-menopausal women. Studies examining the associations between diet-related variables and mental health indicators in women undergoing menopausal transition or in the post-menopausal period will be systematically retrieved via Medline, EMBASE, PsycINFO, Web of Science, and Scopus databases. All articles identified through the database searches will be imported into Covidence. Following the removal of duplicates, two authors will independently perform title and abstract screening, as well as full-text assessment against eligibility criteria. Data will be extracted using tables developed for observational and experimental studies. The methodological quality of randomized trials, cohort and cross-sectional studies, and case–control studies, will be assessed using the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case–Control studies, respectively. Data extraction tables will be used to produce two tables summarizing the main characteristics and findings of the studies included in the review. In the proposed review, we will systematically identify and summarize the currently available evidence on the association between diet-related variables and depression in peri- and post-menopausal women. To our knowledge, this is the first review focusing on this subgroup of the population. Protocol registration: osf.io/b89r6. Full article

Premenstrual dysphoric disorder is a female affective disorder that is defined by mood symptoms. The condition is linked to unstable progesterone concentrations. Progestin supplementation is given in cases of threatened or recurrent miscarriage and for luteal phase support. Progesterone is essential for implantation, immune tolerance, and modulation of uterine contractility. For a long time, the administration of progestins was associated with an unfavorable impact on mood, leading to negative affect, and, therefore, was contraindicated in existing mood disorders. Establishing the role of the natural progesterone derivative allopregnanolone in advances in the treatment of postpartum depression has shed new light on the general pathophysiology of mood disorders. Allopregnanolone directly interacts with gamma-aminobutyric acid type A (GABA-A) receptors even at nanomolar concentrations and induces significant anti-depressant, anti-stress, sedative, and anxiolytic effects. Postpartum depression is caused by a rapid drop in hormones and can be instantly reversed by the administration of allopregnanolone. Premenstrual dysphoric disorder can also be considered to result from insufficient neuroactive steroid action due to low progesterone derivative concentration, unstable hormone levels, or decreased receptor sensitivity. The decrease in progesterone levels in perimenopause is also associated with affective symptoms and an exacerbation of some psychosomatic syndromes. Bioidentical progesterone supplementation encounters several obstacles, including limited absorption, first-pass effect, and rapid metabolism. Hence, non-bioidentical progestins with better bioavailability were widely applied. The paradoxical, unfavorable effect of progestins on mood can be explained by the fact that progestins suppress ovulation and disturb the endocrine function of the ovary in the luteal phase. Moreover, their distinct chemical structure prevents their metabolism to neuroactive, mood-improving derivatives. A new understanding of progesterone-related mood disorders can translate the study results from case series and observational studies to cohort studies, clinical trials, and novel, effective treatment protocols being developed. Full article

Menopause is an under-reported and under-researched life stage for women living with type 1 diabetes (T1D) despite its lasting approximately 20 years. Menopause is associated with metabolic dysfunction leading to weight gain, impaired insulin sensitivity, hypertension, and hypercholesterolemia, each of which diminishes longevity for women living with diabetes. Its symptoms, affecting cognition, sleep patterns, mood, cardiac and vascular health, and physical health, are known to impact glucose variability dynamics. Associated vasomotor symptoms of hot-flushes/night-sweats, mood swings, anxiety, depression, and sexual dysfunction make it difficult to differentiate between symptoms of menopause and hypoglycemia. While it is recognized that transitioning through menopause increases the potential for developing diabetes, there are no recommendations on managing glucose variability or insulin resistance for women with pre-existing diabetes. Increasingly, women using wearable glucose sensor technologies, insulin pumps, and artificial pancreas systems have self-identified increased glucose variability in the data sets provided by wearable digital health technologies. These datasets, collected in real-time from women outside of traditional research settings, would have been unimaginable 20 years ago. Women highlighting the knowledge deficit are driven to learn and share more about menopause. Their quest for clinician support about the impact of hormone replacement therapies (HRT) on glycemic variability, and the associated risk of developing additional comorbidities, further illustrates the importance of this subject. This work uses datasets from wearable sensors, contributed by women with T1D to inform an understanding of their collective perimenopause and menopause journeys. Glucose readings across a period of weeks, leading up to and immediately following the initiation of prescribed medications, have been analyzed to investigate the physiological effects of HRT on the endocrine system of this sample of menopausal T1D women. Self-management and peer support is bridging the research void, which is why there should be more research into this topic. Full article

Introduction: Menopause is a physiological period in a woman’s life, but it is often accompanied by symptoms that affect mental well-being and general health, including a tendency for depression. Aim of the study: To evaluate the predisposition to the symptoms of depression in women from Poland, Belarus, Belgium, and Greece. Material and methods: the method of diagnostic survey was used, and the research tools were: The Menopause Rating Scale, the Kupperman Index, Beck Depression Inventory, and a self-made survey questionnaire. Results: Hormone replacement therapy (HRT) was used by 15.8% of Polish, 19% of Belgian, 14.3% of Belarusian, and 15.2% of Greek women patients. The mean value of the Kupperman Index (range 0–63) in Poland was 14.8 ± 8.6, in Belgium—15.5 ± 6.6, Belarus—14.0 ± 9.4, and Greece—10.8 ± 6.5, while the total measure of Menopause Rating Scale (MRS) (range 0–44) was 12.2 ± 7.6 in Poland, 13.8 ± 6.5 in Belgium, 10.8 ± 8.0 in Belarus and 12.9 ± 7.4 in Greece. The severity of mental distress followed a similar pattern across all countries (slightly stronger than mild). The results for somatic complaints were similar, whereas the level of sexual issues varied, with the highest in Belgium and the lowest in Belarus. The mildest symptoms of menopause were experienced by Belarusian women and the most severe by Belgian women. The severity of depression, according to the Beck Depression Inventory (range 0–63), was as follows: Poland 10.5 ± 7.9; Belgium—11.1 ± 5.7; Belarus—13.7 ± 5.7; Greece—11.8 ± 6.6. Conclusions: The differences between the development of perimenopausal-related symptoms across countries were statistically significant. The incidence and severity of depression showed statistically significant differences between the countries studied—the highest was in Belarus and the lowest in Poland. Depression levels were not differentiated by subjects’ age or the use of hormone therapy but by subjects’ education. In Poland and Belarus, increased menopausal pain measured by the Kupperman Index altered levels of depression; in Belgium, there were no such correlations, and in Greece, the correlation was statistically significant, but its strength was negligible. A clearer correlation of the effects of development in menopausal symptoms on the level of depression was shown when measured with the MRS scale—in Greece and Belgium, the correlation was relatively weak, but in Poland and Belarus, it was relatively high. Full article

Aims: Previous research has shown the efficacy of culturally adapted Cognitive Behavioral Therapy (CA-CBT) in reducing depression, yet its effect on increasing sexual satisfaction is not well documented. In this study, an embedded randomized controlled trial design was used to examine the effect of group and individual CA-CBT on depression and sexual satisfaction among perimenopausal women. Method: A total of 64 depressed Iranian perimenopausal women were randomly assigned to two formats of treatments; sixteen sessions of group CA-CBT and eight sessions of individual CA-CBT, as well as a waitlist control group. Depression and sexual satisfaction were measured using BDI-II and ENRICH, respectively, at T1 (pre-treatment), T2 (post-treatment) and T3 (follow-up). Results: Repeated measures ANOVA indicated that the women who underwent both group and individual CA-CBT had effectively reduced depression and increased sexual satisfaction between pre-treatment and post-treatment, and it was sustained after six months of follow-ups with large effect sizes of significant differences (p < 0.001), but the control group did not. Conclusion: The results showed promising evidence for the efficacy of both treatment groups of CA-CBT for depression and sexual satisfaction among perimenopausal women. The population mental health burden among perimenopausal women may likely be reduced by propagating this effective treatment. Full article