Effect of Menopausal Hormone Therapy on the Vaginal Microbiota and Genitourinary Syndrome of Menopause in Chinese Menopausal Women.

Genitourinary syndrome of menopause (GSM) is a chronic and progressive condition with a series of vulvovaginal, sexual, and lower urinary tract discomforts, mainly due to hypoestrogenism. Menopausal hormone therapy (MHT) has generally been considered as the most effective treatment for GSM. In addition, vaginal microbiota is of particular significance to gynecological and reproductive illnesses and potentially has some intimate connections with GSM. Consequently, we sought to evaluate how MHT impacts the composition and structure of vaginal microbiota while alleviating GSM in Chinese menopausal women aged 45-65 years, which has not been investigated previously. 16S rRNA gene sequencing was performed to analyze microbial diversity and composition using vaginal swabs obtained from 100 menopausal women, classified as MHT women who have been taking tibolone regularly (n = 50) and non-treated women who never received any treatment (n = 50). Vaginal Health Index Score (VHIS) and GSM symptoms inquiry were also performed. We found that the vaginal microbial diversity decreased and that the abundance of Lactobacillus increased to be the dominant proportion significantly in the MHT group, in considerable contrast to vaginal microbiota of the non-treated group, which significantly comprised several anaerobic bacteria, namely, Gardnerella, Prevotella, Escherichia-Shigella, Streptococcus, Atopobium, Aerococcus, Anaerotruncus, and Anaerococcus. In this study, women without any MHT had significantly more severe GSM symptoms than those receiving tibolone, especially with regard to vulvovaginal dryness and burning, as well as decreased libido (P < 0.01). However, there was no significant difference in the severity of urological symptoms between the groups (P > 0.05). Furthermore, Lactobacillus was demonstrated to be associated with VHIS positively (r = 0.626, P < 0.001) and with GSM negatively (r = -0.347, P < 0.001). We also identified Chlamydia (r = 0.277, P < 0.01) and Streptococcus (r = 0.270, P < 0.01) as having a prominent association with more serious GSM symptoms. Our study provided an elucidation that MHT could notably alleviate GSM and conspicuously reshape the composition of the vaginal microbiota, which is of extreme importance to clinical practice for the management of GSM.

Association of snoring and body composition in (peri-post) menopausal women.

BACKGROUND: Little attention has been paid to whether snoring frequency is associated with body composition in menopausal women, particularly in China. This study objected to investigate the association between self-reported snoring and body composition in (peri-post) menopausal Chinese women as well as metabolic indicators. METHODS: This cross-sectional study enrolled 715 participants aged 40-67 years from the Menopause Clinic in the Shanghai Sixth People's Hospital. Participants were categorized into four subgroups stratified by self-reported snoring frequency: never, rarely (< 1 night per week), occasionally (1-2 nights per week), regularly (≥3 nights per week), while body composition was measured using bioelectrical impedance analysis (BIA). Besides, blood sample were collected to test the glycolipid indicators. RESULTS: In our sample of investigation, regular snoring (≥3 nights per week) was found to be an independent risk factor for higher fat mass (total, upper limbs, trunk), with the highest risk of 2.4 times for fat mass of trunk after adjusting for metabolic confounders(p = 0.003). Meanwhile, regular snoring was independently associated with higher fat mass (total and each segment) only in menopausal transition (p = 0.023). CONCLUSIONS: We suggested that self-reported regular snoring may be taken as a simple alternative to predict higher fat mass (≥17.11 kg, upper quartile) in menopausal women. Similarly, body composition should be attached to the great importance to those who in menopausal transition in order to help to prevent obstructive sleep apnea (OSA).

Prediction of risk of depressive symptoms in menopausal women based on hot flash and sweating symptoms: a multicentre study.

OBJECTIVE: The present study aimed to develop a symptom-based (namely, hot flashes and sweating) scoring system for predicting the risk of depressive symptoms in menopausal women via a multicentre cross-sectional survey. METHODS: The data examined in the present study were obtained from 1,004 women aged 40-60 years who underwent physical examination at A Hospital. The basic information was obtained using a questionnaire-based survey. A self-rating depression scale was used to obtain the depressive symptom scores, while the Kupperman Menopausal Index was used to obtain the scores for the frequency of hot flashes and sweating. A logistic regression model was also established. The resulting ß coefficient was employed to calculate and predict the risk of depressive symptoms in these women and a risk scoring system was established. The scoring system was validated using samples from 2 other centers (validation sample 1: B Hospital, 440 women; validation sample 2: C Hospital, 247 women). RESULTS: The scoring system developed to predict the risk of depressive symptoms in menopausal women was based on hot flash and sweating symptoms and associated with menopausal status, hot flash scores, education level (high school education and below) and being diabetic. The scoring system yielded a total score of 0-54 points. For women in the study sample, the area under the curve (AUC) of depressive symptom risk score was 0.750 (95% CI, 0.708-0.793). Validation sample 1 had an AUC of 0.731 (95% CI, 0.667-0.794), while validation sample 2 had an AUC of 0.744 (95% CI, 0.669-0.820). The optimal cut-off score to assess depressive symptoms in women participating in the present study was 31 points. The sensitivity and specificity for predicting depressive symptoms in the study sample were 0.667 and 0.701, respectively. In contrast, the sensitivity was 0.840 in validation sample 1 and 0.879 in validation sample 2. CONCLUSION: The hot flash and sweating symptom-based scoring system developed to predict the risk of depressive symptoms in menopausal women relies on non-laboratory survey data. The system is simple, practical, and convenient to use. For Chinese huge population of menopausal women, the scoring system should be considered a reliable screening tool for depressive symptoms.