Natural vs. surgical postmenopause and psychological symptoms confound the effect of menopause on executive functioning domains of cognitive experience.

OBJECTIVE: The menopause transition is associated with difficulties in executive function. However, it is unclear whether these difficulties persist past perimenopause. This study investigated whether potential confounders, including natural vs. surgical postmenopause and menopause-related psychological symptoms, influence whether executive dysfunction persists into postmenopause. STUDY DESIGN: A cross-sectional sample of women aged 35-65 years (N = 1971) in one of four groups, premenopause, perimenopause, natural postmenopause, and surgical postmenopause, were surveyed. Participants self-reported executive functioning with the Brown Attention Deficit Disorder Scale (BADDS), anxiety symptom severity with the Generalized Anxiety Disorder Questionnaire (GAD-7), and depression symptom severity with the Center for Epidemiologic Studies Depression Scale (CESD). MAIN OUTCOME MEASURES: We analyzed the association between group and BADDS scores using linear regression models - first, by controlling for age, education, and self-reported attention deficit hyperactivity disorder (ADHD) diagnosis (Model #1) and, second, by further controlling for current difficulty sleeping, anxiety, and depression (Model #2). RESULTS: In both models, BADDS scores were significantly elevated (indicating more difficulties in executive function) among women in the perimenopausal and surgical postmenopausal groups compared with those in the premenopausal group. Likewise, the perimenopausal and surgical postmenopausal groups had the highest proportions of participants who reported difficulty sleeping and clinical levels of anxiety and depression. BADDS scores were significantly higher in natural postmenopausal vs. premenopausal women without controlling for difficulty sleeping, anxiety, and depression (Model #1), but not when adjusting for these variables (Model #2). CONCLUSIONS: The type of menopause and psychological symptoms are important confounders of the relationship between the menopause transition and executive dysfunction, and help explain whether executive dysfunction persists or recovers in postmenopause.

Symptom monitoring improves physical and emotional outcomes during menopause: a randomized controlled trial.

ABSTRACT: Objectives: A recent systematic review suggested that symptom monitoring can result in reductions in menopausal symptoms and improvements in health-related behaviors. To date, no studies have experimentally investigated whether symptom monitoring could be a beneficial intervention during the menopause transition.Methods: One hundred perimenopausal and postmenopausal women (mean age, 46 y; SD, 8 y) were randomized into either a monitoring-intervention or control group. A mixed between/within design was used, with group membership (ie, monitoring-intervention or control) as the between-subjects component and time (ie, baseline and 2-wk follow-up) as the within-subjects component. Dependent variables included symptom reductions and emotional reactions as measured via the Daily Record Keeping form. Secondary outcomes included help-seeking, communication, medical decision making, health awareness, self-efficacy, and health anxiety.Results: A linear mixed-effects model demonstrated that the monitoring-intervention group reported a 42% reduction in physical symptoms at follow-up versus a 12% reduction in the control group: ρ = 0.009, ß = 6.3, 95% CI (1.5-11). Negative emotions also significantly reduced in the monitoring-intervention group but did not alter in the control group: ρ < 0.001, ß = 3.4, and 95% CI (1.6-5.2). These effects remained significant after controlling for potential moderator variables such as trait neuroticism and coping preferences and potential confounders such as medical and demographic characteristics. Variances in other health outcomes were nonsignificant.Conclusions: Findings demonstrated that symptom monitoring reduced symptoms and negative emotions within a perimenopausal and postmenopausal sample, and these outcomes endured after controlling for key moderators and covariates. However, symptom monitoring was not related to improvements in health-related behavioral outcomes, which contrasts with previous findings. These findings show that symptom monitoring may be useful within healthcare settings by providing perimenopausal and postmenopausal women with a simple and accessible means of symptom alleviation while they await treatment or medical consultation.

[Cognitive and psychoemotional changes in menopausal transition: The possibility of medical correction].

The increasing of older age group in the population determines studying of age related diseases and emergence of new investigations in this area. In Female body, entering the menopausal transition is the start of «aging¼ of reproductive function and linked with decreasing of sex hormons levels. A direct connection between changes of estrogen, progesterone, androgen ratios and cognitive function of women was revealed. The anatomical localization of sex hormone receptors, the mechanisms of interaction of hormones with these receptors determine the ways of implementing biological effects of steroids on the CNS. Modern theories of «healthy nerve cells¼ and «eu-estrogenemia¼ explains the role of additional criteria, such as the absence of neurological diseases history and the duration of hypoestrogenia, to the outcome of menopausal hormone therapy. Additional factors that can affect to MHT action include: the composition of hormone therapy, administration methods, regimens (cyclic, continuous), duration of treatment, history of endocrine diseases, diabetes mellitus, gynecological history (parity, menarche age, COC use), heredity. The sections present the effect of menopausal transition on the development of depression, mood changes, sleep disturbances and mental disabilities. The explanation of negative effects of menopausal hormone therapy to cognitive health is also described by modern point of view. The ambivalent opinions of researchers, the potential of new reading of the results of earlier studies, confirms the necessity of continuing study of this topic.

Climacteric symptoms, age, and sense of coherence are associated with sexual function scores in women after menopause.

BACKGROUND: Postmenopausal sexual function presupposes the integration of hormonal, neural, and vascular interactions and is subject to optimal crosstalk among psychological, interpersonal, cultural, and environmental factors. Sense of coherence (SOC) reflects a person's ability to cope with stressors and may influence the occurrence of menopausal symptoms and sexual dysfunction. AIM: To investigate the association of severity of climacteric symptoms, cardiometabolic risk factors, and SOC with sexual function in postmenopausal women. METHODS: Overall 281 sexually active postmenopausal women without significant psychopathology or cardiovascular disease attending the Menopause Unit of Aretaieion Hospital were evaluated by the Female Sexual Function Index (FSFI), Greene Climacteric Scale, Beck Depression Scale, and Sense of Coherence Scale. Hormonal and biochemical parameters and cardiometabolic risk factors were evaluated. FSFI scores <26.5 were considered pathologic. OUTCOMES: Total and subdomain scores of sexual response were determined. RESULTS: Pathologic FSFI scores were found in 79.7% of the sample. Linear models of multivariable regression analysis showed that FSFI scores were associated with (1) Beck scores (b = -0.200; 95% CI, -0.472 to -0.073, P = .001), vasomotor symptom severity (b = -0.324; 95% CI, -0.985 to 0.051; P < .001), and age and (2) SOC (b = 0.150, 95% CI, 0.036-0.331; P = .008), vasomotor symptom severity (b = -0.361; 95% CI, -0.743 to 0.245; P < .001), and age. Both models were adjusted for menopausal age, diabetes mellitus, hypertension, type of menopause, and menopausal hormone therapy intake. SOC was associated with Beck depression scores (ß = -0.487, P < .001; Greene Climacteric Scale total scores, ß = -0.199, P < .001). FSFI score <26.5 vs >26.5 was associated with SOC (odds ratio, 0.982; 95% CI, 0.563 to 1.947; P = .006) and moderate to severe vasomotor symptom severity (odds ratio, 2.476; 95% CI, 1.478 to 3.120; P = .009) independent of age, diabetes mellitus, hypertension, menopausal hormone therapy intake, type of menopause, or Beck depression classification. CLINICAL IMPLICATIONS: The results indicate the importance of psychometric assessment of postmenopausal women when presenting with scores of low sexual function. The severity of vasomotor symptoms should also be addressed in any case. STRENGTHS AND LIMITATIONS: This is the first study investigating the relationship between SOC and sexuality in menopause in a carefully selected homogenous population. Limitations included the cross-sectional design and the fact that sexual distress was not assessed. CONCLUSIONS: Pathologic FSFI scores were highly prevalent in this sample of postmenopausal women. FSFI is associated positively with age and severity of vasomotor symptoms and negatively with SOC.

Quality of life in menopausal women in the workplace - a systematic review.

Menopausal women are a large and economically relevant group in the workforce. Yet their quality of life (QoL) and needs in the workplace have been neglected. Thus, the aim of this systematic review was to provide an overview of QoL of menopausal women in the workplace. Systematic literature searches were executed, yielding 1211 references. After abstract screening, 156 articles remained for full-text screening. Finally, 12 articles fulfilled the inclusion criteria and were included in this review. Age, educational level, type of work, working environment (e.g. crowding, confined spaces, noise, workstation design), permanent place of residency, mental factors (e.g. stress level, workload, work pattern), comorbidities, menopausal symptoms, time since menopause and physical activity have repeatedly been shown to affect QoL in the workplace in menopausal women. Low-threshold access to medical and psychological support as well as individual adaptation of the workplace environment are, among others, retrieved recommendations for employers from these findings. Further raising of awareness of special needs of menopausal working women as well as further systematic research programs are needed.

A situation analysis on postmenopausal women's self-care needs and priorities in Tehran: a population-based study.

BACKGROUND: Women need special care during and after menopause. Due to the emphasis of the World Health Organization on promoting self-care in postmenopausal women, this study aims to analyze the situation and prioritize the self-care needs of postmenopausal women in the Tehran-Iran. METHODS: This was a descriptive-analytical study on 486 postmenopausal women aged 46-85 years living in Tehran in 2021. The Subjects were recruited using a multi-stage sampling method. Data were collected using a socio-demographic and a valid and reliable questionnaire to assess postmenopausal women's self-care status with four domains including physical health, psychosocial health, reproductive-sexual health, and screening tests. The data were analyzed by SPSS-24. RESULTS: The mean age of the participants was 62.58 ± 7.75 years. The mean score of self-care was 44.63 ± 21.64% in the postmenopausal women. The lowest score and highest scores were related to psychosocial health (25.12 ± 28.21%) and periodic tests (50.62 ± 24.40%) respectively. There were significant positive correlations between self-care with women's education level (r = 0.277; p < 0.001), husband's education level (r = 0.258; p < 0.001), as well as monthly income (r = 0.153; p = 0.001). There was a negative correlation between self-care with the number of children (r = - 0.215; p < 0.001). The level of self-care was higher in employed women (p = 0.001) and also, in women whose husbands were employed (p = 0.012). Multiple linear regression test showed the level of education of the husband (B = 2.72, p = 0.038) and the family size (B = -1.54, p = 0.023) are predictors of the self-care of postmenopausal women. CONCLUSION: The findings showed more than 55% of challenges in the self-care behaviors of postmenopausal women in Tehran. The most and least challenging self-care behaviors were related to psychosocial health and performing periodic tests. The priorities were in psychosocial health and reproductive-sexual health dimensions. Self-care promotion is necessary, especially in postmenopausal women, who need special care due to various physical, psychological, and social changes.

Health-related quality of life among menopausal women: A cross-sectional study from Pokhara, Nepal.

INTRODUCTION: Menopause is the permanent cessation of menstruation. Quality of life is a broad concept affected by an individual's physical health, psychological state, level of independence, societal relationship, and environmental features. During the menopausal period, women can experience various symptoms affecting their quality of life. This study assesses the factors associated with health-related quality of life among menopausal women. MATERIALS AND METHODS: A community-based cross-sectional study was carried out among 249 menopausal women to assess their health-related quality of life, associated factors, and self-reported health problems. A pre-tested structured interview schedule was used to conduct face-to-face interviews to obtain the information per the study's objective. The Menopausal Rating Scale (MRS) was used to assess the health-related quality of life. Data was entered in Epi-data, and analysis was done using the Statistical Package for Social Sciences (SPSS). Univariate, bivariate, and multivariate analyses were carried out to obtain results per our objectives. RESULTS: The study found that 51.4% of menopausal women had poor quality of life. The mean and standard deviation of the total MRS score was found to be 9.5±5.3. Ultimately, the factors such as educational attainment {Adjusted Odds Ratio (AOR) = 5.779, 95% Confidence Interval (CI): 2.029-16.459}, medication/treatment of the health problems (AOR = 4.828, 95% CI: 1.662-14.023), alcohol intake status (AOR = 8.006, 95% CI: 2.016-31.785) and physical activity (AOR = 5.746, 95% CI: 1.144-28.872) were significant determinants of quality of life among menopausal women. CONCLUSION: There is a need to pay proper attention to factors affecting the quality of life to improve the status of menopausal women.

Menopause hormone therapy and complementary alternative medicine, quality of life, and racial/ethnic differences: the Study of Women's Health Across the Nation (SWAN).

OBJECTIVE: We hypothesized that, among midlife women with vasomotor and/or genitourinary symptoms of menopause, (1) hormone therapy (HT) compared with complementary alternative medicine (CAM) will be associated with higher quality of life (QoL), and (2) race/ethnicity would modify associations of HT and CAM with QoL. METHODS: Cross-sectional and longitudinal analyses of QoL in the Study of Women's Health Across the Nation participants using HT, CAM, or both. Women ( n = 2,514) completed a CAM use questionnaire and QoL assessments at baseline and every 1 to 2 years from 2002 to 2013. Associations between QoL and treatment, adjusted for covariates, and race/ethnicity-by-treatment interactions were analyzed using linear and mixed effects regression models. RESULTS: During 7.8 (SD, 2.9) years of follow-up, 732 women (29%) reported HT of 2.4 (SD, 1.7) years, and 798 women (32%) reported CAM use of 2.1 (SD, 1.4) years. Overall, neither HT nor CAM was associated with QoL. However, the treatment-by-race/ethnicity interaction was significant for self-reported QoL ( P = 0.034 at baseline, P = 0.044 longitudinal). Among White women, self-reported QoL was higher in HT-only users than in those who used neither ( P = 0.030; d = 0.11; 95% confidence interval, 0.01-0.21). In contrast, Black women using HT only had lower self-reported QoL compared with Black women using neither ( P = 0.027; d = -0.21; 95% confidence interval, -0.40 to -0.02). CONCLUSION: Comparisons between treatment type within each racial/ethnic group yielded significant differences in self-reported QoL. Clinicians should be aware of racial/ethnic differences in treatment preferences when counseling patients on treatment options for menopausal symptoms to provide optimal care. VIDEO SUMMARY: http://links.lww.com/MENO/B33 .

Hot Flashes in Adolescence and Young Adult Females: a Link to Vitamin D and Calcium.

Background: Menopause is a stage in life when a woman stops having menstruation and the ovaries produce less estrogen. Hot flashes (HFs) are the classical symptoms for menopausal transition and cessation of menses. Increased anxiety had been reported as a significant risk factor of HFs. Vitamin D deficiency and low daily dietary calcium intake may be associated with the occurrence of hot flashes (HFs) in adolescents and young females that are not related to hormonal changes of menopausal transition. Objective: The aim of this study is to validate this hypothesis. Methods: A case-control study was conducted. Thirty-eight females (38) with HFs aged 18-40 years, and 38 age-matched healthy controls with no HFs were involved. Participants answered questions about HFs symptoms. Psychological symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Serum vitamin D, Follicle Stimulating Hormone, Estradiol, and Prolactin were measured. Results: Vitamin D deficiency, psychological symptoms, and Musculoskeletal pain (MSP) were more prevalent in cases versus controls. About 73.68% of females had HFs on a daily basis, 73.7% of them reported that their HFs associated with excessive sweating. Spearman correlation revealed that number of daily HFs were correlated positively and significantly with anxiety scores (r2= -0.278, p=0.045), and average MSP pain (r2=-0.536, p=<0.001). Binary logistic regression showed that, Anxiety score and vitamin D status, (OR=1.33(1.104-1.7), p=0.02, and OR=0.89(0.79-0.99, p=0.03) respectively were the predictors for HFs. Conclusion: This study showed that adolescents and young females may experience HFs that are not related to hormonal changes of menopausal transition. The predictors for HFs were vitamin D deficiency and anxiety.

Effects of Psychological Well-Being and Depression on Menopausal Symptoms in Middle-Aged South Korean Women and the Necessity of Exercise.

The purpose of this study was to provide basic data on the health by examining the effects of psychological well-being and depression on menopausal symptoms and the necessity of exercise in middle-aged women. This study is a cross-sectional study using a structured questionnaire. The respondent's consent was obtained prior to data collection, and the investigation period runs from November 1, 2021 to November 30, 2021. The final analysis included 150 as respondents to the study. The tool developed by Yang was used for psychological well-being, the Korean integrated CES-D tool was used for depression, and the Menopause Symptom Index was used for menopausal symptoms. The differences and levels of psychological well-being, depression, and menopausal symptoms according to demographic and sociological characteristics were analyzed using descriptive statistics, t-test, and ANOVA. The correlation between psychological well-being, depression, and menopausal symptoms was analyzed by Pearson's correlation, and the effect on menopausal symptoms was analyzed by multiple regression. Because of this study, significant results were found in marital status, religion, economic level, regular exercise, hobbies, personality, and subjective health in the difference in psychological well-being according to general characteristics. In depression, significant results were found in marital status, education level, monthly income, living status, regular exercise, hobbies, stress, personality, and subjective health status. Moreover, age, frequent exercise, hobby, and subjective health all had a significant impact on menopausal symptoms. According to the findings of the regression analysis, the factors influencing menopausal symptoms were, in that order, depression and psychological well-being. Among the factors that showed significant results for menopausal symptoms, exercise is recommended as a factor that can alleviate menopausal symptoms due to individual lifestyle changes, so it is expected to contribute to reducing menopausal symptoms and improving quality of life.

Impacts of menopause hormone therapy on mood disorders among postmenopausal women.

OBJECTIVE: This study aimed to explore the modulatory effects of menopause hormone therapy (MHT) on mood disorders among postmenopausal women. METHODS: A cross-sectional study was conducted to recruit postmenopausal women, including patients (arranged MHT for over 3 years as the medication group) and non-MHT controls. All participants were asked to respond to the Center for Epidemiological Studies Depression Scale (CES-D) and Generalized Anxiety Disorder Screener (GAD-7) questionnaires to assess their depression and anxiety status. RESULTS: A total of 230 cases from the two groups were determined based on propensity score matching analysis by matching the menopausal age and menopausal durations. We found that MHT served as a favorable modulator in the depression status of postmenopausal women. Among the four factors of the CES-D questionnaire, our data indicated that the differences between the two groups fell primarily into two aspects: depressive emotion, and somatic symptoms or retarded activities. MHT was mainly involved in improving the depression of overweight women. However, no substantial effects of MHT were observed on the regulation of anxiety. CONCLUSION: Postmenopausal women, especially the overweight population, who have experienced MHT exhibited an improved depressive status but not their anxiety condition.

A review of African American women's experiences in menopause.

IMPORTANCE AND OBJECTIVE: Little is known and reported about the experiences of African American women as they transition to and experience menopause. Accepted norms are based on the experience of a predominantly White population. The aim of this study is to review available data about the distinct experiences of African American women during the menopause transition and menopause. METHODS: A literature search was developed and executed by the review team in collaboration with a health sciences librarian. The search combined controlled vocabulary and title/abstract terms related to the health status disparities of African Americans in the menopause transition and menopause. The following databases were searched from inception through April 28, 2022: PubMed, Scopus (Elsevier), and Web of Science Core Collection (Clarivate). DISCUSSION AND CONCLUSION: African American women experience distinct differences in physical, psychological, social, and quality of life measures during menopause. Increasing awareness about the unique menopause experiences of African American women is critically important to improve the health of this underserved population.

Longitudinal associations of psychosocial stressors with menopausal symptoms and well-being among women in midlife.

OBJECTIVE: We examined longitudinal associations of psychosocial stressors with menopausal symptoms and well-being of women in midlife in a longitudinal cohort. METHODS: This study is based on 682 women from Project Viva, a prospective cohort enrolled in 1999 to 2002 during pregnancy (median age = 33.3 y) and followed for almost two decades. In pregnancy, women self-reported psychosocial stressors (history of physical and sexual abuse and financial instability, from childhood to the current pregnancy). In 2017 to 2021 (median age, 51.6 y), they reported their menopausal symptoms (0-44 point scale) and well-being (general health [good/fair/poor vs excellent/very good], generalized anxiety symptoms, and depressive symptoms [both-more than minimal levels vs none/minimal]). We performed multivariable and logistic regression models to examine associations of psychosocial stressors with outcomes, adjusting for covariates. RESULTS: History of physical abuse (reported by 37.3%) was associated with worse menopausal symptoms in the somatovegetative (odds ratio [OR], 0.46 points; 95% confidence interval [CI], 0.04-0.87 points) and psychological (OR, 0.52 points; 95% CI, 0.07-0.97 points) domains and with worse general health (OR, 1.73; 95% CI, 1.17-2.55) and greater depressive symptoms (OR, 1.74; 95% CI, 1.05-2.87). History of sexual abuse (7.7%) was associated with worse menopausal symptoms (OR, 2.81 points; 95% CI, 1.05-4.56) and worse general health (OR, 2.04; 95% CI, 1.04-4.03) but not with depressive symptoms. History of financial instability (10.8%) was associated with worse menopausal symptoms (1.92 points; 0.49 to 3.34), worse general health (OR, 2.16; 95% CI, 1.24-3.75), and greater depressive symptoms (OR, 2.68; 95% CI, 1.44-4.98). We observed no association between psychosocial stressors and generalized anxiety symptoms assessed at midlife. CONCLUSIONS: Psychosocial stressors were associated with worse menopausal symptoms and well-being decades after initial report.

Depressive symptoms and suicidality by menopausal stages among middle-aged Korean women.

AIMS: There has been increasing evidence of hormonal changes during reproductive events that lead to mood changes. However, studies on the severity of psychological problems according to the menopausal stage are limited. Thus, this study aimed to investigate the association between menopausal stages, depression and suicidality. METHODS: A total of 45 177 women who underwent regular health check-ups between 2015 and 2018 at Kangbuk Samsung Hospital were included. Participants were stratified into four groups (pre-menopause, early transition, late transition and post-menopause) based on the Stages of Reproductive Aging Workshop Criteria. The Center for Epidemiological Studies-Depression scale (CESD) was used to evaluate depressive symptoms, and the degree of depressive symptoms was classified as moderate (CESD score 16-24) or severe (CESD score ⩾ 25). To measure suicide risk, we administered questionnaires related to suicidal ideation. RESULTS: Overall, the prevalence of CESD scores of 16-24 and ⩾ 25 was 7.6 and 2.8%, respectively. Menopausal stages were positively associated with depressive symptoms in a dose-dependent manner. Multivariable-adjusted prevalence ratios (PRs, 95% confidence intervals) for CESD scores of 16-24 comparing the stages of the early menopausal transition (MT), late MT and post-menopause to pre-menopause was 1.28 (1.16-1.42), 1.21 (1.05-1.38) and 1.58 (1.36-1.84), respectively. The multivariable-adjusted PRs for CESD scores ⩾ 25 comparing the stages of the early MT, late MT and post-menopause to pre-menopause were 1.31 (1.11-1.55), 1.39 (1.12-1.72), 1.86 (1.47-2.37), respectively. In addition, the multivariable-adjusted PRs for suicidal ideation comparing the early MT, late MT and post-menopause stages to the pre-menopause stage were 1.24 (1.12-1.38), 1.07 (0.93-1.24) and 1.46 (1.25-1.70) (p for trend <0.001), respectively. CONCLUSIONS: These findings indicate that the prevalence of depressive symptoms and suicidal ideation increases with advancing menopausal stage, even pre-menopause.

Menopause Rating Scale (MRS) in the Malay language-translation and validation in a multiethnic population of Selangor, Malaysia.

BACKGROUND: The Menopause Rating Scale (MRS) is an internationally used tool to measure menopause-related symptoms and to date it is unavailable in the Malay language. We aimed to translate and validate the Malay language version of the MRS. METHODS: Translation of the English version of MRS into Malay was done by a bilingual expert and back translated. Translated version of MRS was reviewed by a panel to determine the face validity. A sample of 321 women aged 40-60 years residing in Klang, Selangor, Malaysia was selected by stratified random sampling method in a house-to-house survey. The Malay language version of MRS was self-administered. Reliability analyses, including test-retest reliability (on 30 women after a two-week interval) were conducted. To ascertain the construct validity, 11 items were analyzed confirmatory factor analysis was conducted to evaluate the structural model fit of the Malay language version of MRS. RESULTS: A total of 294 (91.6%) completed the survey and their mean age was 50.9 years (SD = 6.3). An overall Cronbach's alpha for MRS was 0.904. Cronbach's alpha for psychosomatic, urogenital, and somatovegetative subscales were 0.889, 0.846, and 0.776 respectively. The corrected item correlations were approximately 0.6 and inter-item correlations were between 0.3 and 0.9. On exploratory structural equation modelling, the chi-square test of goodness of fit yielded a significant value; χ2 = 78.4, df = 25, p < 0.001, (reported if N > 200). Additionally, the value of Tucker-Lewis Index (TLI) = 0.954showed a good fit to the model. CONCLUSION: The translated English version of the Menopause Rating Scale into the Malay language showed excellent reliability, test-retest reliability, and construct validity. The instrument can be used to assess menopause-related symptoms among Malaysian women.

Health Problems experienced by Peri-menopausal Women and their Perception towards Menopause.

BACKGROUND: Perimenopause is a period of physiologic changes in the women's lives when they approach reproductive senescence along with temporal changes in health and quality of life. During this period, many women present with problems of hot flushes; altered mood and sleep; and vaginal and sexual changes. The objective of this study was to identify the health problems experienced and perception towards menopause among perimenopausal women of Kathmandu. METHODS: This descriptive cross-sectional study was carried out among purposively selected 180 women from two wards of Nagarjun Municipality, Kathmandu, who were aged 45 to 55 years. By using a semi-structured interview schedule, face to face interview was taken at the respondents' residence. The collected data were analyzed using descriptive and inferential statistical techniques. RESULTS: The mean age of the respondents was 48.98±3.908 years and their mean body mass index was 27.42±3.645 kg/ m2. About 35.0 % of the respondents had experienced cessation of menstruation and their mean age at menopause was 47.84±4.41years. The common physical problems reported by them were joint and muscle pain (17.2%), hot flushes (14.4%) and night sweats (13.3%). Vaginal itching (16.7%), loss of libido (10.6%) and dry vagina (5%) were commonly reported sexual problems. Anxiety (16.7%), poor memory (8.9%), and irritability (7.2%) were the psychological problems reported by them. Most (77.8%) of them had a positive perception and the rest (22.2%) had a negative perception towards menopause. Their perception status was significantly associated with their age and family type. CONCLUSIONS: Perimenopausal women experience several physical, sexual and psychological problems during the menopause transition.

Citalopram improves vasomotor syndrome and urogenital syndrome of menopause in Mexican women: a randomized clinical trial.

PURPOSE: This study aimed to determine the efficacy of non-hormonal therapy with citalopram vs fluoxetine for treating vasomotor syndrome (VMS) and urogenital syndrome of menopause (GSM) in Mexican women. METHODS: A parallel prospective randomized clinical trial was conducted in 91 postmenopausal women with a total score on the Menopause Rating Scale (MRS) ≥ 17 and with the clinical diagnosis of VSM and GSM. Patients were randomly assigned to receive citalopram (n = 49) or fluoxetine (n = 42). Follow-up was carried out at 3 and 6 months. RESULTS: The citalopram group experienced a significant improvement compared to the fluoxetine group in the MRS total score (p < 0.01), as well as in the psychological (p < 0.001) and somatic (p < 0.0001) domains at 3 and 6 months of follow-up. After 6 months of follow-up, the group that received citalopram decreased the relative risk (RR) to present VMS symptoms (RR = 0.30, CI 0.19-0.5, p = 0.0001), depressed mood (RR = 0.31, CI 0.15-0.6, p = 0.0002), irritability (RR = 0.40, CI 0.22-0.73, p = 0.002), anxiety (RR = 0.30, CI 0.13-0.69, p = 0.003), physical and mental exhaustion (RR = 0.35, CI 0.18-0.67, p = 0.001), sexual problems (RR = 0.18, CI 0.06-0.48, p = 0.0001), vaginal dryness (RR = 0.34, CI 0.14-0.80, p = 0.01), and urinary problems (RR = 0.36, CI 0.14-0.92, p = 0.043). CONCLUSION: We conclude that citalopram tends to improve VSM and GSM symptoms in postmenopausal Mexican women. Thus, we recommend the daily use of citalopram 20 mg. However, further studies will be required to support the results of the present work. These should include a larger number of patients and a placebo group. CLINICAL TRIAL REGISTRATION: This clinical trial was retrospectively registered by the United States National Library of Medicine in the www. CLINICALTRIALS: gov database on 04/20/2022. The given test Registration Number is NCT05346445.

[Temporal trend and contributing factors of depressive symptoms in Chinese menopausal women: analysis based on CHARLS panel data].

OBJECTIVE: To understand the temporal trend of and the factors affecting depressive symptoms in Chinese menopausal women to provide evidence for the development of prevention and treatment strategies. METHODS: CHARLS data were used to select menopausal women aged 45-60 years. Complete values of the key variables were screened and missing values were removed to obtain the cross-sectional data of the years 2011 (n=4318), 2013 (n=4200), 2015 (n=3930), and 2018 (n= 4147). The panel data were matched by the cross-sectional data, and a total of 5040 cases with complete record of the follow-up data were obtained for the 4 years to constitute a balanced short panel dataset with n=1260 and T=4. The prevalence and temporal trend of depressive symptoms in the menopausal women were analyzed based on the panel data. The random-effects Logit model with a panel dichotomous choice model was used to explore the factors affecting depressive symptoms in the menopausal women. RESULTS: The prevalence of depressive symptoms in the menopausal women calculated based on the panel data was 35.9%, 33.1%, 36.7% and 43.7% in the 4 years, respectively, showing no statistically significant changes in the temporal trend (APC=3.25%, P=0.183). The results of the random-effects Logit model analysis showed that living in the urban area (OR=0.570, 95%CI: 0.457-0.710), a high education level (OR=0.759, 95%CI: 0.655-0.879), and having a spouse (OR=0.363, 95% CI: 0.236-0.558) were associated with a decreased incidence of depressive symptoms, while poor self-reported health (OR= 2.704, 95% CI: 2.152-3.396), disability (OR=1.457, 95%CI: 1.087-1.954), chronic disease (OR=1.407, 95% CI: 1.179-1.680), falls in the last two years (OR=2.028, 95% CI: 1.613-2.550), abnormal sleep duration (OR=2.249, 95% CI: 1.896-2.664), and dissatisfaction with life (OR=4.803, 95% CI: 3.757-6.140) were associated with an increased incidence of depressive symptoms. CONCLUSION: The prevalence of depressive symptoms is relatively high in menopausal women in China. Measures should be taken to ensure that the menopausal women living in rural areas, with low education level, without spouse, with a poor self-reported health status, disability, chronic diseases, falls in recent two years, abnormal sleep time and dissatisfaction with life have access to psychological health care services and interventions.

Risk of high depressive symptoms after the final menstrual period: the Study of Women's Health Across the Nation (SWAN).

OBJECTIVE: To examine depressive symptoms during postmenopause and the contribution of depressive symptom trajectories before the final menstrual period (FMP) and psychosocial/health factors to postmenopause depressive symptoms. METHODS: Longitudinal analysis of depressive symptoms (Center for Epidemiologic Studies-Depression scale) collected every 1 to 2 years from 1996 to 2017 from 1,551 midlife women in the Study of Women's Health Across the Nation for a median follow-up of 19.0 years. Latent class growth analysis identified depression trajectories from baseline to FMP. Multivariable random effects (woman as random effect) linear or logistic regression models were conducted. RESULTS: Women had higher odds of reporting high depressive symptom score (≥16) during postmenopause than when they were premenopausal (OR = 1.49, 95% CI, 1.09-2.04), but not when perimenopausal. Three pre-FMP trajectories were identified: Group 1 (47.7%), consistently low scores, Group 2 (39.9%), moderate scores below the high depressive symptom threshold, and Group 3 (12.4%), consistently high scores. Both the moderate (OR = 2.62, 95% CI, 1.89-3.66) and high score (OR = 6.88, 95% CI, 4.72-10.02) groups, compared with the consistently low group, had significantly higher postmenopausal depressive symptom scores. Other pre-FMP variables associated with high postmenopausal depressive symptoms were: higher odds of childhood trauma/maltreatment, poor role physical, high anxiety symptoms, sleep problems, high vasomotor symptoms, and lower odds for chronological aging and lower social support. CONCLUSIONS: Compared with premenopause, postmenopause remains a period of increased risk for higher depressive symptoms, especially for women with pre-FMP depressive symptoms. Pre-FMP depressive symptom trajectories are highly predictive of postmenopause depressive symptoms independent of health and psychosocial factors.

[The significance of menopause for Chilean women attending primary health care centers]. / El significado de la menopausia para un grupo de mujeres chilenas atendidas en el sistema público de salud.

BACKGROUND: Menopause connects a biological event with social representations related to aging Aim: To assess the meaning of menopause in a group of Chilean women attending primary health care. MATERIAL AND METHODS: Secondary analysis of a descriptive qualitative study of in-depth interviews to explore the meaning of menopause in fifteen women aged 55 to 71 years who experienced menopause between 2 and 29 years before. Data were collected using the method proposed by the Grounded Theory. Guba's criteria of scientific rigor were used. RESULTS: Relational analysis shows that menopause divides the life cycle of women into two stages related with the possibility of having children, which is heavily influenced by the cultural significance of menopause. CONCLUSIONS: Women perceive that menopause is a natural stage and that it is the end of a period focused on tasks related to reproduction and motherhood. However, that "normality" includes a suffering process, loaded with negative cultural beliefs about menopause passed down for generations.