One-pot co-crystallized hexanal-loaded ZIF-8/quaternized chitosan film for temperature-responsive ethylene inhibition and climacteric fruit preservation.

Controlling ethylene production and microbial infection are key factors to prolong the shelf life of climacteric fruit. Herein, a nanocomposite film, hexanal-loaded ZIF-8/CS (HZCF) with "nano-barrier" structure, was developed by a one-pot co-crystallized of ZIF-8 in situ growth on quaternized chitosan (CS) and encapsulation of hexanal into ZIF-8 via microporous adsorption. The resultant film realized the temperature responsive release of hexanal via the steric hindrance and hierarchical pore structure as "nano-barrier", which can inhibit ethylene production in climacteric fruit on demand. Based on this, the maximum ethylene inhibition rate of HZCF was up to 52.6 %. Meanwhile, the film exhibits excellent antibacterial, mechanical, UV resistance and water retention properties, by virtue of the functional synergy between ZIF-8 and CS. Contributed to the multifunctional features, HZCF prolonged the shelf life of banana and mango for at least 16 days, which is 8 days longer than that of control fruit. More strikingly, HZCF is washable and biodegradable, which is expected to replace non-degradable plastic film. Thus, this study provides a convenient novel approach to simplify the encapsulation of active molecule on metal-organic frameworks (MOFs), develops a packaging material for high-efficient freshness preservation, and helps to alleviate the survival crisis caused by food waste.

Relationship Between Menopausal Symptoms, Cancer Screening Behaviors, and Religion Attitudes of Women in the Climacteric Period: A Cross-Sectional Study.

BACKGROUND: Although it is known that religion is used to cope with health problems, there is a lack of information about the effect of religion on menopausal symptoms and cancer screening attitudes of climacteric women. AIM: This study was conducted to determine the relationship between the religious attitudes of women in the climacteric period and their attitudes toward menopausal symptoms and cancer screening. MATERIALS AND METHODS: This was a cross-sectional study of 381 women in the climacteric period in the Central Anatolia region of Türkiye. Data collection form, the Menopause Rating Scale (MRS), OK-Religious Attitude Scale (ORAS), and attitude for cancer screening (short form) (ASCS) were used to collect data. Correlation analysis assessed the relationship between MRS, ORAS, and ASCS. RESULTS: There was a low positive correlation between women's ORAS mean score (35.19 ± 4.80) and MRS mean score (12.68 ± 7.24) (r = 0.284, P < 0.001). There was no statistically significant relationship between the mean ORAS scores of the women and the mean ASCS scores (64.59 ± 10.47) (r = 0.089, P > 0.05). CONCLUSION: Women who experienced more severe menopausal symptoms had stronger religious attitudes. Women's religious attitudes did not affect their attitudes toward cancer screening. It is therefore recommended that health professionals organize counseling and training activities to protect and improve the health of menopausal women and increase their participation in screening and treatment programs.

Climacteric status at age 46 is associated with poorer work ability, lower 2-year participation in working life, and a higher 7-year disability retirement rate: a Northern Finland Birth Cohort 1966 study.

OBJECTIVE: To study the association between an advanced climacteric status at 46 years of age and current perceived work ability, the consequent 2-year accumulation of disability and unemployment days, and the 7-year incidence of disability pensions. METHODS: Study participants (n = 2,661) were recruited from the Northern Finland Birth Cohort 1966 study's 46-year follow-up in 2012. The participants' perceived work ability was investigated using the Work Ability Score (0-7 = poor vs 8-10 = good), along with potential covariates. Data concerning their consequent disability days, unemployment days, and disability pensions were collected from national registers. The association between their climacteric status at age 46 years, work ability, and working life participation was assessed using regression models. RESULTS: The climacteric women were more often smokers and more often had a lower level of education. The odds ratio for poor perceived work ability was 1.41 (95% CI, 1.06-1.87), and the incidence rate ratios for disability and unemployment days during the 2-year follow-up were 1.09 (95% CI, 1.07-1.11) and 1.16 (95% CI, 1.14-1.18), respectively, for the climacteric women compared with the preclimacteric women in models adjusted for smoking and education. The 7-year hazard ratio for disability pensions was 1.72 (95% CI, 1.02-2.91) for the climacteric women. CONCLUSIONS: An earlier menopausal transition is associated with poorer perceived work ability, and it predicts lower recorded work participation and a higher disability pension rate in subsequent years.

Characterization and Potential Action Mode Divergences of Homologous ACO1 Genes during the Organ Development and Ripening Process between Non-Climacteric Grape and Climacteric Peach.

Ethylene is one crucial phytohormone modulating plants' organ development and ripening process, especially in fruits, but its action modes and discrepancies in non-climacteric grape and climacteric peach in these processes remain elusive. This work is focused on the action mode divergences of ethylene during the modulation of the organ development and ripening process in climacteric/non-climacteric plants. We characterized the key enzyme genes in the ethylene synthesis pathway, VvACO1 and PpACO1, and uncovered that their sequence structures are highly conserved, although their promoters exhibit important divergences in the numbers and types of the cis-elements responsive to hormones, implying various responses to hormone signals. Subsequently, we found the two have similar expression modes in vegetative organ development but inverse patterns in reproductive ones, especially in fruits. Then, VvACO1 and PpACO1 were further validated in promoting fruit ripening functions through their transient over-expression/RNAi-expression in tomatoes, of which the former possesses a weaker role than the latter in the fruit ripening process. Our findings illuminated the divergence in the action patterns and function traits of the key VvACO1/PpACO1 genes in the tissue development of climacteric/non-climacteric plants, and they have implications for further gaining insight into the interaction mechanism of ethylene signaling during the modulation of the organ development and ripening process in climacteric/non-climacteric plants.

Effect of tibolone vs hormone replacement therapy on climacteric symptoms and psychological distress.

BACKGROUND: The objective was to elucidate the effect of tibolone vs hormone replacement therapy (HRT) on climacteric symptoms and psychological distress. METHODS: All consecutive women with climacteric symptoms were allocated to receive tibolone (2.5 mg) or estradiol valerate (1 mg) plus medroxyprogesterone acetate (2.5 mg). RESULTS: The improvement in "feeling dizzy or faint" after tibolone treatment was more prominent than that after HRT (-0.7 ± 0.8 vs -0.0 ± 0.9, p = 0.004). In addition, other climacteric symptoms, including anxiety, depression, somatic symptoms, and vasomotor symptoms, and sexual function improved after tibolone and HRT, but there were no between-group differences. Psychological distress assessment demonstrated that somatic complaints, obsessive-compulsive symptoms, depressive symptoms, hostility, additional symptoms, and the General Symptom Index improved after tibolone treatment and HRT, but there were no between-group differences. Personality traits assessment revealed that neuroticism improved after tibolone treatment. CONCLUSION: Tibolone seems more beneficial than HRT in treating symptoms of dizziness and faintness. Both tibolone and HRT could improve psychological distress.

Nutrição no climatério: quais os benefícios? Revisão integrativa / Nutrition in Menopause: What are the Benefits? An Integrative Review / Nutrición en el Climaterio: ¿Cuáles son los Beneficios? Una Revisión Integradora

Introdução:A menopausa é uma fase transitória entre o período reprodutivo para o período não fértil na vida da mulher, sendo dividido em três períodos: pré-menopausa, perimenopausa e pós-menopausa, podendo durar de 12 meses a 03 anos. Anutrição e a alimentação possuem um importante papel durante esse período, visando evitar ou minimizar problemas como: osteoporose, constipação, desidratação, hipertensão, ansiedade, diminuição da libido, depressão, alterações no sono, dores nas articulações e ganho de peso. Objetivo:Descrever os possíveis benefícios relacionados à nutrição durante o climatérioMetodologia:Revisão da literatura que utilizou as bases de dados Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed) e Scientific Electronic Library Online (Scielo), por meio dos Descritores em Ciência da Saúde (DeCS) "Diet", "Climacteric" combinados com o operador booleano AND. Nossa pesquisa considerou estudos originais publicados nos últimos cinco anos, tanto de acesso livre quanto restrito, sem restrição de idioma. Excluímos revisões, duplicatas e artigos não relacionados ao tema. Encontramos um total de 122 artigos com os descritores utilizados e selecionamos 19 para a amostra desta revisão. Resultados:Observou-se uma perda de peso significativa entreas mulheres no climatério, assim como ondas de calor em decorrência dos sintomas da menopausa. A compulsão alimentar dos grupos randomizados mostrou-se baixa bem como a pressão arterial. Pode-se constatar, ainda, que o IMC dessas mulheres apresentou declínio e os sintomas relacionados à depressão igualmente registraram uma redução. Conclusões:A intervenção nutricional no climatério resultou em benefícios significativos, incluindo perda de peso, redução dos sintomas da menopausa, melhora da saúde cardiovascular, diminuição do IMC e alívio dos sintomas relacionados à depressão. Esses resultados destacam a importância da nutrição como uma abordagem eficaz para melhorar a qualidade de vida das mulheres nessa fase de transição (AU).

Introduction:Menopause is a transitional phase between the reproductive and the non-fertile periods of women, divided into pre-menopause, perimenopause and post-menopause, lasting from 12 months to 3 years. Nutritionand diet play a relevant role, aiming to avoid or minimize problems such as osteoporosis, constipation, dehydration, hypertension, anxiety, decreased libido, depression, changes in the sleep cycle, joint pain, and weight gain. Objective:Describing the possible benefits related to nutrition during menopause. Methodology:AThis paper presents a literature review that used the Virtual Health Library (VHL), National Library of Medicine (PubMed) and Scientific Electronic Library Online (Scielo) databases, through the Health Science Descriptors (DeCS) "Diet", "Climacteric" combined with the Boolean operator AND. The research considered original studies published in the last five years, both of open and restricted access, without restrictions for languages. Reviews, duplicates and articles unrelated to the topic were excluded. A total of 122 articles were found using these descriptors, and 19 were selected for the sample of this review. Results:Significant weight loss was observed among climacteric women, as well as hot flashes due to menopausal vasomotor symptoms. Binge eating in the randomized groups was low, as was blood pressure. It was also observed that the BMI of these women showed a decline and symptoms related to depression were also reduced. Conclusions:A nutritional intervention during menopause resulted in significant benefits, including weight loss, reduced symptoms, improved cardiovascular health, decreased BMI, and relief of symptoms related to depression. The importance of nutrition is highlighted as an effective approach to improve the quality of life of women in this transition phase (AU).

Introducción: La menopausia es una fase transitoria entre el período reproductivo y el período no fértil en la vida de la mujer, siendo dividido en tres fases: premenopausia, perimenopausia y posmenopausia, pudiendo durar de 12 meses a 03 años. La nutrición y la alimentación tienen un importante papel durante este período, buscando evitar o minimizar problemas como: osteoporosis, estreñimiento, deshidratación, hipertensión, ansiedad, disminución de la libido, depresión, cambios en el sueño, dolor en las articulaciones y aumento de peso. Objetivo: Describir los posibles beneficios relacionados con la nutrición durante el climaterioMetodología: Revisión de la literatura que utilizó las bases de datos Biblioteca Virtual en Salud (BVS), National Library of Medicine (PubMed) y Scientific Electronic Library Online (Scielo), por medio de los descriptores en Ciencia de la Salud (DeCS) "Diet", "Climacteric" combinados con el operador booleano AND. Nuestra investigación consideró estudios originales publicados en los últimos cinco años, tanto de acceso libre como restringido, sin limitación de idiomas. Excluimos revisiones, duplicados y artículos no relacionados con el tema. Encontramos un total de 122 artículos con los descriptores utilizados y seleccionamos 19 para la muestra de esta revisión. Resultados: Se observó una pérdida de peso significativa entre las mujeres en el climaterio, al igual que una reducción de loscalores súbitos como consecuencia de los síntomas de la menopausia. La compulsión alimentaria de los grupos aleatorizados demostró ser baja, así como la presión arterial. Se puede constatar, además, que el IMC de esas mujeres presentó una disminución y los síntomas relacionados a la depresión igualmente registraron una reducción. Conclusiones: La intervención nutricional en el climaterio ocasionó beneficios significativos, incluyendo pérdida de peso, reducción de los síntomas de la menopausia, mejora de la salud cardiovascular, disminución del IMC y alivio de los síntomas relacionados con la depresión. Estos resultados resaltan la importancia de la nutrición como un enfoque efectivo para mejorar la calidad de vida de las mujeres en esta fase de transición (AU).

Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis / Incidência e resultados associados ao estado da menopausa em pacientes com COVID-19: Uma revisão sistemática e metanálise

Abstract Objective Menopause causes several changes in the body that may affect the response to COVID-19. We aimed to investigate the possible association between menopausal status and incidence and outcomes in COVID-19 patients. Methods Combinations of keywordsCOVID-19, menopause, and estrogen were used to search the PubMed, Embase, Web-of-Science, and Scopus databases for articles reporting the incidence and outcomes of COVID-19 (discharge, length-of-admission, intensive care, or mortality) in premenopausal women, available through December 29, 2022. Data from studies comparing the incidence of COVID-19 infection with the age-matched male population were pooled and meta-analyzed using a random-effects model. Results Overall, 1,564 studies were retrieved, of which 12 were finally included in the systematic review to compare disease outcomes, and 6 were meta-analyzed for the incidence of COVID-19 in premenopausal and postmenopausal women. All studies reported better COVID-19-associated outcomes in premenopausal women compared with postmenopausal women. After adjusting for confounding factors, three studies found better outcomes in postmenopausal women, and two found no association between menopausal status and COVID-19 outcomes. Our meta-analysis found a higher incidence of COVID-19 infection among premenopausal women than postmenopausal women, when compared with age-matched men (odds ratio = 1.270; 95% confidence interval: 1.086-1.486; p= 0.003). Conclusion The incidence of COVID-19 was significantly higher in premenopausal women than in postmenopausal women when compared with age-matched men. Although premenopausal women may have more favorable COVID-19-associated outcomes, the presumed preventive effect of estrogens on the incidence and related outcomes of COVID-19 in premenopausal women cannot be proven at present. Further longitudinal studies comparing pre- and post-menopausal women are required to provide further insight into this matter.

Resumo Objetivo A menopausa causa diversas alterações no corpo que podem afetar a resposta ao COVID-19. Nosso objetivo foi investigar a possível associação entre o status da menopausa e a incidência e os resultados em pacientes com COVID-19. Métodos Combinações de palavras-chave COVID-19, menopausa e estrogênio foram usadas para pesquisar os bancos de dados PubMed, Embase, Web-of-Science e Scopus para artigos relatando a incidência e os resultados do COVID-19 (alta, tempo de internação, tratamento intensivo cuidados ou mortalidade) em mulheres na pré-menopausa, disponível até 29 de dezembro de 2022. Dados de estudos comparando a incidência de infecção por COVID-19 com a população masculina da mesma idade foram agrupados e meta-analisados usando um modelo de efeitos aleatórios. Resultados No geral, 1.564 estudos foram recuperados, dos quais 12 foram finalmente incluídos na revisão sistemática para comparar os resultados da doença e 6 foram meta-analisados para a incidência de COVID-19 em mulheres na pré e pós-menopausa. Todos os estudos relataram melhores resultados associados ao COVID-19 em mulheres na pré-menopausa em comparação com mulheres na pós-menopausa. Após o ajuste para fatores de confusão, três estudos encontraram melhores resultados em mulheres na pós-menopausa e dois não encontraram associação entre o status da menopausa e os resultados do COVID-19. Nossa meta-análise encontrou uma maior incidência de infecção por COVID-19 entre mulheres na pré-menopausa do que mulheres na pós-menopausa, quando comparadas com homens da mesma idade (odds ratio = 1,270; intervalo de confiança de 95%: 1,086-1,486; p = 0,003). Conclusão A incidência de COVID-19 foi significativamente maior em mulheres na pré-menopausa do que em mulheres na pós-menopausa quando comparadas com homens da mesma idade. Embora as mulheres na pré-menopausa possam ter resultados mais favoráveis associados ao COVID-19, o efeito preventivo presumido dos estrogênios na incidência e nos resultados relacionados ao COVID-19 em mulheres na pré-menopausa não pode ser comprovado no momento. Mas estudos longitudinais comparando mulheres pré e pós-menopausa são necessários para fornecer mais informações sobre este assunto.

Effects of Unripe Black Raspberry Extract Supplementation on Male Climacteric Syndrome and Voiding Dysfunction: A Pilot, Randomized, Double-Blind, Placebo-Controlled Trial.

Male climacteric syndrome (MCS) is a medical condition that can affect middle-aged men whose testosterone levels begin to decline considerably. These symptoms may include fatigue, decreased libido, mood swings, and disturbed sleep. MCS can be managed with lifestyle modifications and testosterone replacement. However, testosterone therapy may cause number of side effects, including an increased risk of cardiovascular issues. This study aims to evaluate the efficacy and safety of unripe black raspberry extract (BRE) against MCS and voiding dysfunction in men with andropause symptoms. A total of 30 subjects were enrolled and randomly assigned to the BRE group (n = 15) or the placebo group (n = 15). Participants were supplemented with 4800 mg BRE or placebo twice daily for 12 weeks. The impact of BRE was assessed using the Aging Male's Symptoms (AMS scale), International Prostate Symptom Score (IPSS) and the IPSS quality of life index (IPSS-QoL). Additionally, male sex hormones, lipid profiles, and anthropometric indices were assessed 6 and 12 weeks after treatment. The AMS scores did not differ significantly between the two groups. In the BRE group, the total IPSS and IPSS-QoL scores decreased significantly after 12 weeks compared to baseline (p < 0.05), but there was no significant difference compared to the placebo group. However, a significant difference was observed in the IPSS voiding symptoms sub-score compared to the placebo group. Furthermore, LDL-C and TC levels were also significantly lower in the BRE group than in the placebo group (p < 0.05). Collectively, the study provides strong evidence supporting the safety of BRE as a functional food and its supplementation potentially enhances lipid metabolism and alleviates MCS and dysuria symptoms, limiting the development of BPH.

Barreras y facilitadores de los médicos de atención primaria para abordar las consultas vinculadas a la sexualidad de pacientes durante el climaterio / Barriers and facilitators of primary care physicians to address consultations related to the sexuality of patients during the climacteric

Introducción. Pese a la alta prevalencia de disfunciones sexuales femeninas durante el climaterio y a que existen intervenciones para mejorarlas, este problema no suele ser consultado por las pacientes ni explorado por los profesionales de la salud. Si bien suponemos que existen condicionamientos culturales que actuarían como barreras para su abordaje, no conocíamos las percepciones, incomodidades y experiencias de los profesionales que atienden en el ámbito de la atención primaria a pacientes que transitan su climaterio. Objetivos. Comprender desde la perspectiva de los médicos de atención primaria los factores que contribuyen a la invisibilidad de la problemática de las disfunciones sexuales femeninas durante el climaterio en mujeres de clase media atendidas en el Área Metropolitana de Buenos Aires. Diseño. Estudio exploratorio transversal con enfoque cualitativo realizado en el Hospital Italiano de Buenos Aires durante2020 y 2021. Resultados. A partir del análisis de diez entrevistas semiestructuradas a médicos de atención primaria (de familia, clínicos y ginecólogos) identificamos seis ejes temáticos: 1) un modelo institucional en el que el tiempo limitado para la consulta y forma de pago capitada incentivaría a que las las disfunciones sexuales femeninas permanezcan invisibilizadas; 2) la longitudinalidad de la relación médico-paciente contribuiría como un facilitador del abordaje de problemáticas vinculadas con la esfera sexual; 3) la discordancia de género entre los profesionales y las pacientes operaría como un obstáculo para abordar aspectos de la sexualidad durante el climaterio; 4) la biografía y la formación de los profesionales de la salud influiría sobre sus habilidades para abordar la problemática de la sexualidad de sus pacientes; 5) el examen ginecológico y/o la detección de síntomas de depresión contribuyen a abrir la puerta para indagar sobre la disfunción sexual femenina; y 6) el prejuicio de que el fin de la etapa reproductiva implicaría el fin de la actividad sexual. Conclusiones. Si bien no existen recomendaciones formales para la pesquisa sistemática de disfunciones sexuales femeninas, su elevada prevalencia, su fácil diagnóstico y la existencia de herramientas terapéuticas para aliviarlas, ameritan que estén más disponibles entre nuestras hipótesis diagnósticas. (AU)

Background. Despite the high prevalence of female sexual dysfunctions during the climacteric and the existence of interventions to improve them, this problem is not usually consulted by patients or explored by health professionals. Although weassume that there are cultural conditioning factors that would act as barriers to its approach, we were unaware of the perceptions, discomforts, and experiences of the professionals who care for patients who are going through their climactericin the field of primary care. Objectives. To understand, from the perspective of primary care physicians, the factors that contribute to the invisibility of the female sexual dysfunctions problem during the climacteric in middle-class women treated in the Buenos Aires Metropolitan Area. Design. Cross-sectional exploratory study with a qualitative approach carried out at Hospital Italiano de Buenos Aires during 2020 and 2021. Results. From the analysis of ten semi-structured interviews with primary care physicians (family, clinicians and gynecologists) we identified six thematic axes: 1) an institutional model in which the limited time for consultation and capitated form of payment would encourage female sexual dysfunctions to remain invisible; 2) the longitudinality of the doctor-patient relationship would contribute as a facilitator in addressing problems related to the sexual sphere; 3) the gender discrepancy between professionals and patients would operate as an obstacle to address aspects of sexuality during the climacteric; 4) the biography and training of health professionals would influence their abilities to address the problems of their patients'sexuality; 5) gynecological examination and/or the detection of symptoms of depression contribute to opening the door toinquire about FSD; 6) the prejudice that the end of the reproductive stage would imply the end of sexual activity. Conclusions. Although there are no formal recommendations for the systematic screening of female sexual dysfunctions, its high prevalence, its easy diagnosis and the existence of therapeutic tools to alleviate them, deserve that they be more available among our diagnostic hypotheses. (AU)

Avaliação comportamental do processamento auditivo central em mulheres no climatério / Behavioral evaluation of central auditory processing in climacteric women

RESUMO Objetivo Comparar as habilidades auditivas centrais de mulheres no climatério, com e sem terapia de reposição hormonal. Métodos Estudo observacional, realizado com mulheres no climatério, divididas em dois grupos, segundo o uso ou não de terapia hormonal. Foram realizados os testes de Localização Sonora em cinco direções; Memória Sequencial para Sons Verbais e Não Verbais; Padrão de Duração; Random Gap Detection Test (RGDT); Masking Level Difference (MLD); Dicótico de Dígitos; Fala Com Ruído Branco, e aplicado o Questionário Avaliação Informal de Fadiga. Resultados Houve diferença tendenciosa de melhor desempenho médio no grupo com terapia hormonal, em comparação ao grupo sem terapia para o teste de Memória para Sons Não Verbais. Nos testes de Localização Sonora, Memória para Sons Verbais, RGDT e MLD, o grupo com terapia hormonal apresentou resultados quantitativamente melhores. O grupo com terapia hormonal demonstrou maior porcentagem de mulheres com alto nível de fadiga. Conclusão Mulheres no climatério, com e sem terapia hormonal, apresentam transtorno de processamento auditivo central envolvendo as habilidades auditivas de localização sonora, ordenação temporal simples e complexa, figura-fundo, resolução temporal e interação binaural. No entanto, as mulheres do grupo com terapia hormonal apresentam melhor desempenho em ordenação temporal simples.

ABSTRACT Purpose To compare the central auditory abilities of climacteric women, with and without hormone replacement therapy. Methods Observational study, performed with climacteric women with and without hormone replacement therapy. Sound localization tests were performed in five directions; Sequential Verbal Memory Test; Sequential Memory Test for Nonverbal Sounds; Duration Pattern Test; Random Gap Detection Test); Masking Level Difference; Dichotic Digit Test and Speech With White Noise Test and the questionnaire "Informal Fatigue Assessment" was applied. Results The differences pointed out revealed the biased difference that occurs due to higher average performance in the group with TH compared to the group without TH for TMSnV. In the TLS, TMSN, RGDT and MLD tests, the group with HT presented quantitatively better results. Conclusion Climacteric women, with and without hormone therapy, have central auditory processing disorder involving the auditory skills of sound localization, simple and complex temporal ordering, background figure, temporal resolution and binaural interaction. However, women in the hormone therapy group performed better in simple temporal ordering.

Sexual dysfunction in the climacteric period and associated factors / Disfunção sexual no climatério e fatores associados

Abstract Objectives: to evaluate associated factors with sexual dysfunction among middle-aged women. Methods: cross-sectional and analytical study was carried out with climacteric women attended at a Family Health Strategy Unit in the city of Montes Claros, MG. Brazil. The eligible women answered a question form containing sociodemographic, behavioral, anthropometric, gynecological factors and sexuality. The Body Mass Index and waist circumference were used to assess nutritional status and metabolic risk. To evaluate quality of life and sexual performance the Menopause Rating Scale and the Sexual Quotient - Female Version were used, respectively. Bivariate analysis and hierarchical multiple regression were used to identify associated factors with sexual dysfunction in the climacteric period. Results: among 195 women, 29.6% had sexual dysfunction. The prevalence of unsatisfactory sexual performance was higher among women who reported moderate to severe climacteric symptoms (OR=2.47) and lower schooling level was also associated (OR=1.95). However, age at menarche below 12 years (OR=0.43) and non-white (OR=0.36) seem to have a protective effect for good sexual performance. Conclusion: the prevalence of sexual dysfunction was high and the level of schooling and climacteric symptomatology were associated factors with this outcome.

Resumo Objetivos: avaliar os fatores associados à disfunção sexual entre as mulheres de meia-idade. Métodos: estudo de corte transversal e analítico realizado com mulheres climatéricas atendidas em uma Unidade de Estratégia de Saúde da Família no município de Montes Claros-MG, Brasil. As mulheres elegíveis responderam a um formulário contendo questões sociodemográficas, comportamentais, antropométricas, fatores ginecológicos e sexualidade. Utilizou-se o Índice e Massa Corporal e a circunferência da cintura para avaliar o estado nutricional e risco metabólico. Para avaliar a qualidade de vida e o desempenho sexual foram utilizados a Menopause Rating Scale e o Quociente Sexual -Versão Feminina, respectivamente. Empregou-se análise bivariada e regressão múltipla hierarquizada para identificar fatores associados à disfunção sexual no climatério. Resultados: dentre 195 mulheres, 29,6% apresentaram disfunção sexual. A prevalência de desempenho sexual insatisfatório foi maior entre as mulheres que declararam sintomas climatéricos moderados a graves (OR = 2,47) e o menor grau de escolaridade (OR = 1,95). No entanto, a idade da menarca abaixo de 12 anos (OR = 0,43) e a cor de pele não branca (OR = 0,36) parecem ter efeito protetor para o bom desempenho sexual. Conclusão: a prevalência de disfunção sexual foi elevada e o nível de escolaridade e a sintomatologia climatérica foram fatores associados a esse resultado.

Uso de fitoterápicos na saúde da mulher / Use of herbal medicines in women's health / Uso de hierbas medicinales en la salud de la mujer

Objetivo: elencar os benefícios do uso de fitoterápicos na saúde da mulher com base na literatura. Método: revisão integrativa literatura. Pergunta norteadora: Quais os principais fitoterápicos utilizados na saúde da mulher e seus benefícios conforme a literatura? O acesso e seleção dos artigos ocorreu entre os meses de janeiro a fevereiro de 2023. Para a busca dos artigos foram utilizadas informações encontradas nas bases de dados: MedLine, SciELO, BDENF e LILACS, Foram incluídos os artigos completos publicados na íntegra, nos idiomas português e inglês, dentro do período de 10 anos (2012 a 2022), sendo excluídos artigos que não respondiam à pergunta norteadora. Resultados: foram encontrado 6 artigos que apresentaram como as plantas medicinais mais conhecidas ligadas ao tratamento dos sistemas endócrino e reprodutivo feminino no climatério, sendo elas: Glycine max, Angelica sinensis, Vitex agnus castus, Uncaria tomentosa, Lepidium meyenii, Panax ginseng. Conclusão: os fitoestrógenos apresentados no estudo demonstram eficácia para combater os sintomas climatéricos, sendo mais comum as isoflavonas, porém outras plantas também têm benefícios importantes para manter a saúde da mulher no que se refere ao trato genital

Objecive: list the benefits of the use of herbal medicines in women's health based on the literature. Method: integrative literature review. Guide question: What are the main herbal medicines used in women's health and their benefits according to the literature? The access and selection of articles occurred between January and February 2023. For the search of the articles, information found in the databases: MedLine, SciELO, BDENF and LILACS were included, the complete articles published in full, in Portuguese and English, within the period of 10 years (2012 to 2022), being excluded articles that did not answer the guide question. Results: six articles were found that presented the best known medicinal plants linked to the treatment of the endocrine and reproductive systems in the climacteric, which were: Glycine max, Angelica sinensis, Vitex agnus castus, Uncaria tomentosa, Lepidium meyenii, Panax ginseng. Conclusion: the phytoestrogens presented in the study demonstrate efficacy to combat climacteric symptoms, being more common isoflavones, but other plants also have important benefits to maintain women's health with regard to the genital tract.

Objetivo: enumere los beneficios del uso de hierbas medicinales en la salud de la mujer según la literatura. Metodo: Revisión integradora de la literatura. Pregunta guía: ¿Cuáles son las principales hierbas medicinales utilizadas en la salud de la mujer y sus beneficios según la literatura? El acceso y la selección de artículos ocurrieron entre enero y febrero de 2023. Para la búsqueda de los artículos, se incluyeron informaciones encontradas en las bases de datos: MedLine, SciELO, BDENF y LILACS, siendo excluidos los artículos completos publicados en su totalidad, en portugués e inglés, dentro del período de 10 años (2012 a 2022), quedando excluidos los artículos que no respondieron a la pregunta de la guía. Resultados: se encontraron seis artículos que presentaron las plantas medicinales más conocidas vinculadas al tratamiento de los sistemas endocrino y reproductivo en el climaterio, que fueron: Glycine max, Angelica sinensis, Vitex agnus castus, Uncaria tomentosa, Lepidium meyenii, Panax ginseng. Conclusión: Los fitoestrógenos presentados en el estudio demuestran eficacia para combatir los síntomas climatéricos, siendo más comunes las isoflavonas, pero otras plantas también tienen importantes beneficios para mantener la salud de la mujer con respecto al tracto genital.

Prevalência e severidade de sintomas em mulheres na menopausa: um estudo descritivo / Prevalence and severity of symptoms in women in the menopause: a cross-sectional study

Introdução: Muitas mulheres sofrem com sintomas associados à menopausa, que podem apresentar diferentes graus de intensidade e afetar sua qualidade de vida. Objetivo: Identificar a prevalência e severidade dos principais sintomas nas diferentes fases do climatério. Métodos: Foram selecionadas mulheres com idades entre 40 e 65 anos, que responderam a um questionário on-line com dados sociodemográficos, de saúde, alimentação e características menstruais e de menopausa. Para avaliar os sintomas da menopausa e sua intensidade, foi aplicado o questionário internacional validado Menopause Rating Scale (MRS). Resultados: Foram incluídas 283 mulheres (36,8% na pré-menopausa, 24% na perimenopausa e 39,2% na pós-menopausa). Excesso de peso foi mais prevalente na perimenopausa do que na pré-menopausa (P=0,012). Sintomas como diminuição da libido, secura vaginal, incontinência urinária, dores musculares e articulares, alterações lipídicas e ondas de calor, calorões, foram mais prevalentes em valores absolutos nas mulheres pós-menopausa. As mulheres no período de perimenopausa apresentaram maior prevalência, em valores absolutos, de estresse, irritabilidade, dor de cabeça, problemas na pele, falta de concentração/memória, distúrbios do sono e fadiga. De acordo com o MRS, não houve diferença no domínio psicossocial (P=0,265) e os sintomas somato-vegetativos e urogenitais são mais intensos nas mulheres na perimenopausa e pós-menopausa, quando comparadas com as mulheres na pré-menopausa (P<0,001). O escore global do questionário também demonstra essa intensidade menor no grupo pré-menopausa (P=0,001). Conclusões: Este estudo demonstrou uma prevalência e severidade maior de sintomas em mulheres na perimenopausa e pós-menopausa, o que pode prejudicar a qualidade de vida dessas mulheres nessa fase da vida

Introduction: Many women experience symptoms associated with menopause that present with different degrees of intensity and affect their quality of life. Objective: To identify the prevalence and severity of the main symptoms during different climacteric phases. Methods: Women aged 40­65 years answered an online questionnaire on sociodemographic data, health, diet, menstrual, and menopausal characteristics. The internationally validated Menopause Rating Scale (MRS) questionnaire was used to assess menopausal symptoms and their intensities. Results: 283 women were included (36.8% pre-menopausal, 24% peri-menopausal, and 39.2% post-menopausal). Excess weight was more prevalent in the peri-menopausal group than in the pre-menopausal group (P=0.012). Symptoms such as decreased libido, vaginal dryness, urinary incontinence, muscle and joint pain, lipid alterations, and hot flashes were more prevalent in the absolute values of post-menopausal women. Women in the peri-menopausal period had a higher prevalence, in absolute values, of stress, irritability, headache, skin problems, lack of concentration/memory, sleep disorders, and fatigue. According to the MRS, there was no difference in the psychosocial domain (P=0.265) but somato-vegetative and urogenital symptoms are more intense in peri-menopausal and post-menopausal women when compared to pre-menopausal women (P<0.001). The global score on the questionnaire also demonstrated a lower intensity in the pre-menopausal group's symptoms (P=0.001). Conclusions: This study demonstrated a higher prevalence and severity of symptoms in peri-menopausal and post-menopausal women, which may impair the quality of life of these women at this stage of life.

Sentimentos vivenciados pela mulher acerca da sexualidade no período do climatério / Feelings experienced by women about sexuality in the climacteric period / Sentimientos experimentados por las mujeres sobre la sexualidad en el período climatérico

Objetivo: descrever os sentimentos vivenciados pela mulher acerca da sexualidade no período do climatério. Método: O percurso metodologia deu-se por abordagem qualitativa e método de história oral conforme pressupostos de Halbwachs. Resultados: Foram entrevistadas 6 mulheres com idade acima de 45 anos e que receberam nomes fictícios de flores como forma de manter o anonimato das mesmas. Resultados: Os relatos deram origem a 3 categorias e 4 subcategorias conforme a seguir: Mudanças fisiológicas, Mudanças na sexualidade, Desejo sexual, Desempenho sexual, Prazer sexual, Vivência da sexualidade e Necessidade da sexualidade. Conclusão: As dificuldades em lidar com os sintomas do climatério sinaliza a necessidade de criar políticas públicas de saúde, onde profissionais da saúde possam disponibilizar conhecimento em forma de vivencias, materiais e divulgação do que pode ser feito para acompanhar mulheres nesse período. Os profissionais da saúde precisam estar mais atentos para atuar junto às mulheres em crise e desenvolver ações que visem à apropriação do conhecimento e do bem-estar, bem como o desenvolvimento pessoal, para que possam usar mecanismos de enfrentamento eficazes a fim de superar as modificações e os conflitos causados pelo climatério.

Objective: to describe the feelings experienced by women about sexuality in the climacteric period. Method: The methodological course took place through a qualitative approach and oral history method according to Halbwachs assumptions. Results: Six women over 45 years of age were interviewed who received fictitious names of flowers as a way of maintaining their anonymity. Discussion: The reports originated 3 categories and 4 subcategories as follows: Physiological changes, Changes in sexuality, Sexual desire, Sexual performance, Sexual pleasure, Experience of sexuality and Need for sexuality. Conclusion: Difficulties in dealing with climacteric symptoms indicate the need to create public health policies, where health professionals can provide knowledge in the form of experiences, materials and dissemination of what can be done to accompany women in this period. Health professionals need to be more attentive to work with women in crisis and develop actions aimed at appropriating knowledge and well-being, as well as personal development, so that they can use effective coping mechanisms in order to overcome the changes and the conflicts caused by the climacteric.

Objetivo: describir los sentimientos experimentados por las mujeres acerca de la sexualidad en el período climatérico. Método: El curso metodológico se llevó a cabo a través de un enfoque cualitativo y método de historia oral según los presupuestos de Halbwachs. Resultados: Se entrevistaron seis mujeres mayores de 45 años que recibieron nombres ficticios de flores como forma de mantener su anonimato. Resultados: Los relatos originaron 3 categorías y 4 subcategorías así: Alteraciones fisiológicas, Alteraciones en la sexualidad, Deseo sexual, Desempeño sexual, Placer sexual, Experiencia de la sexualidad y Necesidad de la sexualidad. Conclusión: Las dificultades en el enfrentamiento de los síntomas del climaterio indican la necesidad de crear políticas públicas de salud, donde los profesionales de la salud puedan aportar conocimientos en forma de experiencias, materiales y difusión de lo que se puede hacer para acompañar a las mujeres en este período. Los profesionales de la salud necesitan estar más atentos para trabajar con mujeres en crisis y desarrollar acciones encaminadas a la apropiación del conocimiento y del bienestar, así como del desarrollo personal, de manera que puedan utilizar mecanismos de afrontamiento efectivos para superar los cambios y los conflictos provocados por el climaterio.

Depression, anxiety, suicidal ideation and female climacteric: a narrative review

Climacteric is the period in a woman's life cycle that involves perimenopause, menopause and postmenopause. It represents the end of the reproductive period and the beginning of female aging in the biological sense. Over the past 10 years, an emphasis has been placed on the study of mental health in the female climacteric. Studies about the prevalence of depression, anxiety, suicidal ideation and association with different factors have shown important results on the relevance of these disorders during female climacteric. Considering the importance of these findings in the field of public health and epidemiology, we conducted a narrative review aiming to discuss the current knowledge about the prevalence of depression, anxiety and suicidal ideation in the female climacteric, analyzing methods and results in different studies, selected from a literature review between 2009 and 2019, in the PubMed, Lilacs, Embase, Web of Science and Google Scholar databases. Our results showed that the methodology, cultural and sociodemographic differences, as well as a variety of biopsychosocial factors studied, generate some uncertainties about the exact relationship between depression, anxiety, suicidal ideation and female climacteric. We conclude that more research, greater methodological rigor, more accurate results and a biopsychosocial view are needed and urgent for effective interventions, cost reduction in mental health care, as well as prevention and control of depression, anxiety and suicide in climacteric.

Climacteric status is associated with sexual dysfunction at the age of 46 years: a population-based study.

OBJECTIVE: Increasing age and menopausal transition increase the risk of sexual dysfunction. Sexual dysfunction is common in women experiencing menopause before the age of 40 years, whereas evidence on sexual function in women experiencing menopause in their mid-40s is scarce. We aimed to investigate sexual function in 46-year-old women in relation to their menopausal status. METHODS: This study cross-sectionally evaluated sexual function of women in a prospective population-based Northern Finland Birth Cohort 1966 (NFBC1966). A 46-year follow-up study of NFBC1966 included a broad questionnaire evaluating health, lifestyle, and life situation, as well as menstrual history and sexual function, and blood sampling analysis including follicle stimulating hormone and free androgen index (FAI). The participants were divided into two groups by their menopause status, defined by follicle-stimulating hormone and menstrual history. We performed logistic regression models in which parameters of sexual function were dependent factors and climacteric status, self-reported health, FAI, relationship status, smoking, and education level were independent variables. RESULTS: The study population included 2,661 women. In regression models, more advanced climacteric status was associated with higher frequency and difficulty level of low sexual desire and vaginal dryness (odds ratios with 95% confidence intervals: 2.80 [2.12-3.71], 3.22 [2.43-4.27], 3.83 [2.82-5.20], 3.75 [2.75-5.12], respectively), lower frequency of sexual thoughts (1.34 [1.02-1.75]), and higher frequency of problems with intercourse (2.35 [1.51-3.66]). Lower FAI and poorer health were associated with impaired sexual function. CONCLUSIONS: The current study suggests that women experiencing menopausal transition in their mid-40s are at risk of impaired sexual function.

Increased ACS Enzyme Dosage Causes Initiation of Climacteric Ethylene Production in Tomato.

Fruits of wild tomato species show different ethylene-dependent ripening characteristics, such as variations in fruit color and whether they exhibit a climacteric or nonclimacteric ripening transition. 1-Aminocyclopropane-1-carboxylic acid (ACC) synthase (ACS) and ACC oxidase (ACO) are key enzymes in the ethylene biosynthetic pathway encoded by multigene families. Gene duplication is a primary driver of plant diversification and angiosperm evolution. Here, interspecific variations in the molecular regulation of ethylene biosynthesis and perception during fruit ripening in domesticated and wild tomatoes were investigated. Results showed that the activated ACS genes were increased in number in red-ripe tomato fruits than in green-ripe tomato fruits; therefore, elevated dosage of ACS enzyme promoted ripening ethylene production. Results showed that the expression of three ACS isogenes ACS1A, ACS2, and ACS4, which are involved in autocatalytic ethylene production, was higher in red-ripe tomato fruits than in green-ripe tomato fruits. Elevated ACS enzyme dosage promoted ethylene production, which corresponded to the climacteric response of red-ripe tomato fruits. The data suggest that autoinhibitory ethylene production is common to all tomato species, while autocatalytic ethylene production is specific to red-ripe species. The essential regulators Non-ripening (NOR) and Ripening-Inhibitor (RIN) have experienced gene activation and overlapped with increasing ACS enzyme dosage. These complex levels of transcript regulation link higher ethylene production with spatiotemporal modulation of gene expression in red-ripe tomato species. Taken together, this study shows that bursts in ethylene production that accompany fruit color changes in red-ripe tomatoes are likely to be an evolutionary adaptation for seed dispersal.

Factors affecting climacteric women with SARS-CoV-2 infection: A multinational Latin America study (REDLINC XI).

OBJECTIVE: To evaluate the association between factors, especially those linked to the climacteric, and a history of COVID-19 infection. METHODS: This was an observational, cross-sectional, and analytical study in which women from ten Latin American countries, aged 40-64, who attended a routine health check-up were invited to participate. A positive history for COVID-19 was based on reverse transcription-polymerase chain reaction reports. We evaluated sociodemographic, clinical, lifestyle, anthropometric variables, and menopausal symptoms using the Menopause Rating Scale (MRS). RESULTS: A total of 1238 women were included for analysis, of whom 304 (24.6 %) had a positive history for COVID-19. The median [interquartile range: IQR] age of participants was 53 [IQR 12] years, duration of formal education was 16 [6] years, body mass index 25.6 [5.1] kg/m2, and total MRS score 10 [13]. In a logistic regression model, factors positively associated with COVID-19 included postmenopausal status and having a family history of dementia (OR: 1.53; 95 % CI: 1.13-2.07, and 2.40; 1.65-3.48, respectively), whereas negatively associated were use of menopausal hormone therapy (current or past), being a housewife, and being nulliparous (OR: 0.47; 95 % CI: 0.30-0.73; 0.72; 0.53-0.97 and 0.56; 0.34-0.92, respectively). Smoking, being sexually active, and use of hypnotics were also factors positively associated with COVID-19. CONCLUSION: Postmenopausal status and a family history of dementia were more frequent among women who had had COVID-19, and the infection was less frequent among current or past menopause hormone therapy users and in those with less physical contact.

Validation of the Menopause Transition Scale (MTS).

OBJECTIVE: All women will experience menopause transition, and a majority will experience symptoms that negatively affect their quality of life. Current validated menopause symptom scales are time consuming, phrased in clinical language, and difficult to adopt for digital use. This study seeks to validate a short novel survey which can be reliably completed without coaching and accurately represents the experience of the menopause transition. METHODS: We developed a patient-centric questionnaire (Menopause Transition Scale, MTS) to examine for symptoms of menopause. Survey responders represented a total of 144 women with at least one symptom of menopause. Survey responders included women affected by cancer aged 30 to 65 (n = 72) and women not affected by cancer aged 45 to 60 (n = 72). Cronbach Alpha was used to examine for internal consistency and dimensionality was assessed using exploratory factor analysis. The cross-validation was analyzed against established patient scales using Spearman correlations or Chi-Square analysis, as appropriate. RESULTS: The MTS questions showed internal consistency with a Cronbach Alpha of 0.63. The individual questions loaded into three unique domains. The MTS overall correlated with validated scales for menopause symptoms, the Menopause-Specific Quality of Life Questionnaire (r = -0.86, P < 0.0001) and Greene Climacteric Scale (r = -0.65, P < 0.0001). Libido correlated with scales (P = 0.0150) and subscales (r = -0.70, P < 0.0001) relating low sexual desire. Energy (r = -0.62, P < 0.0001), Mood (r = -0.48, P < 0.0001), and Hot Flashes/Night Sweats (r = -0.77, P < 0.0001) correlated with scales and subscales related to mood, depression, and vasomotor symptoms. The majority of our responders expressed mild vaginal bleeding. The highest frequency of severe symptoms were low libido and poor energy. CONCLUSIONS: The MTS is a short thorough patient-centric survey that is readily amenable to digital adoption to measure symptoms of menopause as women transition in the out-patient setting. Further study is needed for the longitudinal assessment of symptoms through the transition process and the response of women to therapeutic options.Video Summary: http://links.lww.com/MENO/A938.

Determining the psychometric properties of the Greene Climacteric Scale (GCS) in women previously treated for breast cancer: A pooled analysis of data from the Women's Wellness after Cancer Programs.

OBJECTIVES: This paper examines the utility of a common climacteric symptoms scale, the Greene Climacteric Scale (GCS), in two groups of women with a history of breast cancer, those who were at menopause before commencing breast cancer treatment, and those who were not. STUDY DESIGN: This pooled analysis of 297 women previously diagnosed with breast cancer, aged 28-74 years, was undertaken on baseline data from two structured lifestyle interventions: the Women's Wellness After Cancer Program (WWACP) and the Younger Women's Wellness After Cancer Program (YWWACP). Data were split into two data subsets (women who were post-menopausal on commencement of breast cancer treatment and those who were either pre- or peri­menopausal). Multitrait/multi-item analysis was conducted to test scaling assumptions for each group separately. RESULTS: GCS domain scores were positively skewed, with significant floor effects for vasomotor symptoms and ceiling effects for sexual dysfunction. Multitrait analysis showed acceptable convergent validity (77% of items correlated ≥ 0.40 with their hypothesized domains) but weak discriminant validity for anxiety, depression, and somatic symptoms in both groups. The exploratory factor analysis in women who were menopausal at the commencement of breast cancer treatment and those who were not revealed distinct factor structures that accounted for 60.2% and 62.7% of the total variance, respectively. CONCLUSIONS: The original GCS factor structure was not replicated in this sample. Among women previously treated for breast cancer, the presence of multiple concurrent and severe menopausal symptoms with possible treatment-related causes underpins the need for a breast cancer-specific measure to enhance their identification and management. TRIAL IDS, AUSTRALIAN AND NEW ZEALAND CLINICAL TRIALS REGISTRY: WWACP, ACTRN12614000800628; YWWACP, ACTRN12614001087640.