Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 258
Filtrar
1.
Maturitas ; 144: 4-10, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33358207

RESUMO

OBJECTIVE: To assess the impact of confinement due to the coronavirus (Covid-19) pandemic on health-related quality of life (HRQoL) and resilience in peri- and postmenopausal women. MATERIAL AND METHODS: We used an online questionnaire which was sent between April 30th and May 13th, 2020 to women aged 40-70 years who were peri- or postmenopausal according to STRAW criteria. We used the 16-item Cervantes short-form scale (Cervantes-SF) to measure HRQoL, and the 14-item Wagnild and Young Resilience Scale (RS-14) to measure resilience. High scores on the Cervantes-SF indicate low HRQoL and high scores on the RS-14 indicate high levels of resilience. Covid-19 status, sociodemographic descriptors, and lifestyle variables were also evaluated. RESULTS: We included 2430 peri- and postmenopausal women with valid questionnaires. All items of the Cervantes-SF were completed in 2151 cases, whilst the RS-14 was completed in 2413 cases. There was a negative correlation between scores on the Cervantes-SF and RS-14 scales (Rho -0.350; p < 0.0001). Multiple linear regression analysis revealed a statistically significant association between Cervantes-SF scores and living with others (ß-coefficient -10.2; p < 0.001), use of antidepressants (ß 9.3; p < 0.001), physical activity (ß -8.6; p < 0.001) and sexual activity (ß -2.7; p < 0.001). Resilience was associated with the use of antidepressants (ß -5.9; p < 0.001), physical activity (ß 3.2; p < 0.001) and sexual activity (ß 1.7; p = 0.005). According to the multivariate analysis, there were no associations between either Covid-19 or menopausal status and HRQoL or resilience scores. CONCLUSIONS: During the period of mandatory Covid-19 confinement, peri- and postmenopausal women who engaged in physical and sexual activity had higher HRQoL and higher levels of resilience, whilst women who were using antidepressants had lower HRQoL and lower levels of resilience. HRQoL was greater in women who lived with others.


Assuntos
Perimenopausa/psicologia , Pós-Menopausa/psicologia , Qualidade de Vida/psicologia , Quarentena/psicologia , Resiliência Psicológica , Adulto , Idoso , Estudos Transversais , Exercício Físico/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários
2.
Artigo em Inglês | MEDLINE | ID: mdl-32560531

RESUMO

Menopause is a natural period resulting from the decrease in hormonal activity of the ovaries. Growing hormonal deficiencies and changes in the body influence a variety of functions in women, leading to depression and decreased quality of life. The relationship between body composition, the severity of depressive and climacteric symptoms and the quality of life of women with type 2 diabetes and healthy women in the perimenopausal period was studied. Statistically significant differences were observed between the study and control groups regarding all body composition parameters except for protein and the content of torso soft tissues (p < 0.05). In both the study and control groups, resulting symptoms were significantly correlated with numerous body composition parameters (e.g., body mass, fat tissue mass, minerals, abdominal circumference), while symptoms of depression were significantly correlated with similar parameters only in the control group. A statistically relevant relationship was observed between the study and control groups with respect to quality of life in certain domains. The quality of life of women suffering from type 2 diabetes was worse compared with healthy women. Analysis of body composition showed significant differences between healthy women and those with type 2 diabetes. Healthy women showed a tendency to establish a link between body composition and depressiveness.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/psicologia , Perimenopausa/fisiologia , Perimenopausa/psicologia , Qualidade de Vida , Composição Corporal/fisiologia , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Psicologia
3.
Internist (Berl) ; 61(6): 558-564, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32333087

RESUMO

Peri- and postmenopausal disorders can have a significant impact on quality of life. Hormone replacement therapy (HRT) might be necessary in order to decrease women's symptoms. The German S3 guideline "Peri- and Postmenopause-Diagnostics and Therapy" (2020) provides recommendations that include the most recent evidence as well as the Women's Health Initiative (WHI) study results from 2002 and 2004. These results led to reduced prescription patterns due to a high risk of cardiovascular diseases as well as an increased risk for breast cancer if HRT had been administered. Both ongoing analyses of subgroups and other studies extenuated the WHI data, since the increased risks were neither generalizable to the typical postmenopausal patient (regarding age and risk profile) nor to the medication being used today. This article summarizes all aspects of HRT in peri- and postmenopausal women (indications, contraindications, practical approaches, risks, prevention) and provides recommendations with respect to the most recent S3 guideline.


Assuntos
Terapia de Reposição de Estrogênios/efeitos adversos , Estrogênios/efeitos adversos , Terapia de Reposição Hormonal , Perimenopausa/efeitos dos fármacos , Pós-Menopausa/efeitos dos fármacos , Pós-Menopausa/psicologia , Progesterona/efeitos adversos , Idoso , Terapia de Reposição de Estrogênios/métodos , Estrogênios/uso terapêutico , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Perimenopausa/psicologia , Pós-Menopausa/fisiologia , Progesterona/uso terapêutico , Qualidade de Vida , Saúde da Mulher
4.
J Acupunct Meridian Stud ; 13(3): 94-103, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32278077

RESUMO

BACKGROUND AND OBJECTIVE: Perimenopausal depression is caused by the impaired function of the ovarium before menopause and with a series of symptoms. Electroacupuncture (EA) therapy has been demonstrated to improve clinically depression. However, the mechanism underlying its therapeutic activity remains unknown. This study aimed to investigat the effects of EA treatment on the hippocampal neural proliferation through Wnt signaling pathway. METHODS: Chronic unpredictable mild stress (CUMS) combined with bilateral ovariectomy (OVX) were used to establish a rat model of perimenopausal depression. The open field test (OFT) and sucrose preference test (SPT) were used to assess depression-like behaviors in rats. ELISAs were used to measure estrogen (E2), luteinizing hormone (LH) and gonadotropin-releasing hormone (GnRH) levels in the serum. RT-PCR and Western blot assay were utilized for measuring the mRNA expressions and protein expressions of GSK-3ß/ß-catenin. RESULTS: Four-week EA treatment at three points including "Shenshu" (BL23), "Baihui" (GV20) and "Sanyinjiao" (SP6) simultaneously ameliorated depression-like behaviors in rats with CUMS and OVX, whereas rescued the decreased serum level of E2 and prevented the increased serum levels of GnRH and LH. EA treatment ameliorated CUMS and OVX-induced alterations of glycogen synthase kinase-3ß (GSK-3ß) and ß-catenin mRNA levels, ß-catenin and phosphorylated ß-catenin (p-ß-catenin) protein levels. CONCLUSIONS: The results showed that EA treatment promoted hippocampal neural proliferation in perimenopausal depression rats via activating the Wnt/ß-catenin signaling pathway, indicating that EA may represent an efficacious therapy for perimenopausal depression.


Assuntos
Depressão/terapia , Hipocampo/metabolismo , Neurônios/citologia , Perimenopausa/psicologia , Via de Sinalização Wnt , beta Catenina/metabolismo , Animais , Proliferação de Células , Depressão/etiologia , Depressão/genética , Depressão/metabolismo , Modelos Animais de Doenças , Eletroacupuntura , Feminino , Glicogênio Sintase Quinase 3 beta/genética , Glicogênio Sintase Quinase 3 beta/metabolismo , Hipocampo/fisiopatologia , Humanos , Masculino , Neurônios/metabolismo , Perimenopausa/metabolismo , Ratos , Ratos Sprague-Dawley , beta Catenina/genética
5.
Medicine (Baltimore) ; 99(10): e19366, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150082

RESUMO

BACKGROUND: Perimenopause is a period that every woman must go through, most people are more or less affected by perimenopausal symptoms, it to affect women's health, work, life, and economy. As acupuncture treatment is more and more increasing in perimenopausal symptoms, there have also been many clinical trials about it. But the results of the trials are inconsistent. Therefore, we will conduct a systematic review and meta-analysis of the safety and efficacy of perimenopausal symptoms treated with acupuncture. METHODS: The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. RCT study on different acupuncture interventions for perimenopausal symptoms will be searched in 8 databases (PubMed, EMBASE, the Cochrane Library, the web of science, CBM, CNKI, WAN FANG, and VIP). Besides, the search will also be performed on the clinical trial research platform if necessary. The primary outcome that will be extracted: the Flushes per 24 hours, the Frequency of hot flashes, the severity of hot flashes, the menopause-related symptom score, the treatment efficacy, the adverse event. Endnote software X8 will be used for study selection, STATA 13.0 and Review Manager software 5.3 will be used for analysis and synthesis. These studies selection, data extraction, and risk of bias assessment will be conducted by 2 independent reviewers. RESULTS: This study will provide the results: 1. the primary and secondary outcome indicators of different acupuncture intervention measures (traditional hand acupuncture, moxibustion, ear acupuncture, laser, acupressure points) for perimenopausal symptoms. 2. The effects of different control groups (medicine control, routine care, waiting, and sham acupuncture control) on the analysis results will be reported, especially the effects of different sham acupuncture control (invasive/noninvasive) on the analysis results. CONCLUSION: This systematic review and meta-analysis study hopes to provide useful evidence for better use of different types of acupuncture in treat perimenopausal symptoms and better design of control groups in related clinical trials. In addition, the research conclusion will be published in peer journals.OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/VZCKU Ethics and dissemination This conclusion of the study will be published in peer journals. The ethical approval is not required because there is no direct involvement of human.


Assuntos
Terapia por Acupuntura/normas , Perimenopausa/psicologia , Terapia por Acupuntura/métodos , Idoso , Protocolos Clínicos , Grupos Controle , Feminino , Humanos , Metanálise como Assunto , Pessoa de Meia-Idade , Revisões Sistemáticas como Assunto , Resultado do Tratamento
7.
Arch Womens Ment Health ; 23(1): 1-10, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30758732

RESUMO

Depression in women is more common during perimenopause (the transition to menopause) than at other times in the life cycle. Symptoms of depression may be different in perimenopausal women compared to younger or older women, and are often dismissed as part of normal menopause. This is an expert narrative review. There are several evidence-based screening modalities which can be integrated into routine women's health visits, and can facilitate distinguishing between depression and normal perimenopausal symptoms. There is emerging evidence regarding the effect of hormonal changes on the development of perimenopausal depression and its optimal treatment, though critical research gaps remain. Obstetrician-gynecologists and other primary care providers play a vital role in the detection and management of depression in women. Providers caring for women during perimenopause have a unique opportunity to diagnose depression in their patients and identify appropriate treatment options.


Assuntos
Depressão/diagnóstico , Perimenopausa/psicologia , Papel do Médico , Feminino , Ginecologia , Humanos , Narração , Obstetrícia
8.
Maturitas ; 131: 91-101, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31740049

RESUMO

INTRODUCTION: Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70 % greater in women. The perimenopause is considered to be a time of increased risk for the development of depressive symptoms and major depressive episodes. AIM: The aim of this position statement is to provide a comprehensive model of care for the management of depressive symptoms in perimenopausal and early menopausal women, including diagnosis, treatment and follow-up. The model integrates the care provided by all those involved in the management of mild or moderate depression in midlife women. MATERIALS AND METHODS: Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS: Awareness of depressive symptoms, early detection, standardized diagnostic procedures, personalized treatment and a suitable follow-up schedule need to be integrated into healthcare systems worldwide. Recommended treatment comprises antidepressants, psychosocial therapies and lifestyle changes. Alternative and complementary therapies, although widely used, may help with depression, but a stronger evidence base is needed. Although not approved for this indication, menopausal hormone therapy may improve depressive symptoms in peri- but not in postmenopausal women, especially in those with vasomotor symptoms.


Assuntos
Depressão/terapia , Transtorno Depressivo Maior/terapia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Adulto , Idoso , Antidepressivos/uso terapêutico , Terapias Complementares , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Europa (Continente) , Feminino , Hormônios/uso terapêutico , Humanos , Estilo de Vida , Menopausa/psicologia , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Sociedades Médicas , Resultado do Tratamento
9.
J Ethnopharmacol ; 248: 112318, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-31629860

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Xiaochaihutang (XCHT) is a traditional Chinese medicine prescription for thousand years in China. Our previous researches show that XCHT has antidepressant-like effects in several depression models, but effect and mechanism of XCHT in perimenopausal depression are still vague. AIM OF THE STUDY: To reveal the antidepressant-like effect and mechanism of XCHT in perimenopausal mice. MATERIALS AND METHODS: Perimenopausal depression model is executed by ovariectomy combined with chronic unpredictable mild stress (OVX-CUMS). Tail suspension test (TST), forced swim test (FST), elevated plus-maze (EPM), novelty suppressed feeding (NSF) and locomotor activity are used to assess antidepressant-like effects of XCHT. The Level of estradiol (E2), follicle-stimulating hormone (FSH), gonadotrophin releasing hormone (GnRH), corticosterone (CORT), adrenocorticotrophic hormone (ACTH) and corticotropin releasing hormone (CRH) are evaluated by ELISA. Antidepressant mechanisms of XCHT in OVX-CUMS mice are analyzed by 5-hydroxytryptamine (5-HT), tryptophan hydroxylase 2 (TPH2) and estrogen receptor α and ß (ERα/ß). RESULTS: The results show that OVX-CUMS significantly increases the immobility time in TST and FST, increases latency to feed, decreases food consumption in NSF and both the time spend and number of entries in open arms in EPM. While, oral administration of XCHT can significantly normalize above depression-like behaviors in OVX-CUMS mice. Moreover, XCHT also remarkably normalized levels of 5-HT, 5-HIAA, E2, GnRH, CORT, ACTH and CRH in OVX-CUMS mice. Finally, the expression of ERß and TPH2 are decreased by OVX-CUMS in prefrontal cortex and hypothalamus, and XCHT can restore these decrease. CONCLUSION: Current findings suggest XCHT can alleviate perimenopausal depression-like behaviors, restore 5-HT and hormones in OVX-CUMS mice, which may be related to normalizing the functions of HPA/HPO axis and enhancing expression of ERß and TPH2 in prefrontal cortex and hypothalamus.


Assuntos
Antidepressivos/farmacologia , Comportamento Animal/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Depressão/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Perimenopausa/efeitos dos fármacos , Animais , Encéfalo/metabolismo , Encéfalo/fisiopatologia , Depressão/etiologia , Depressão/metabolismo , Depressão/psicologia , Modelos Animais de Doenças , Receptor beta de Estrogênio/metabolismo , Comportamento Alimentar/efeitos dos fármacos , Hormônios/metabolismo , Locomoção/efeitos dos fármacos , Aprendizagem em Labirinto/efeitos dos fármacos , Camundongos , Ovariectomia , Perimenopausa/metabolismo , Perimenopausa/psicologia , Serotonina/metabolismo , Estresse Psicológico/complicações , Triptofano Hidroxilase/metabolismo
10.
J Clin Endocrinol Metab ; 105(3)2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31693131

RESUMO

CONTEXT: Women are at increased risk for depressive symptoms during the menopause transition. Changes in estradiol secretion and presence of vasomotor symptoms (VMS) contribute to perimenopausal depressive symptoms, but links with progesterone have not been investigated. OBJECTIVE: To determine whether estradiol variability, ovulatory levels of progesterone, and VMS burden are independently associated with perimenopausal depressive symptomatology. DESIGN AND INTERVENTION: Depressive symptoms, serum levels of estradiol and progesterone, and VMS frequency were assessed weekly in an 8-week observational study. Association of mood with estradiol variability, ovulatory levels of progesterone, and VMS frequency were estimated using generalized estimating equation models. SETTING: Academic medical center. PATIENTS: Fifty unmedicated perimenopausal women with mild-to-moderate depressive symptoms (mean Montgomery-Åsberg Depression Rating Scale [MADRS] score 15.5 ± 5.3). MAIN OUTCOME MEASURE: Depressive symptoms (MADRS score). RESULTS: During the study, 90.0% of participants had varying estradiol levels, 51.1% had ovulatory progesterone levels, and 90% had VMS. Greater estradiol variability and absence of progesterone levels consistent with ovulation, but not VMS frequency, are associated with higher levels of depressive symptoms (ß = 0.11 [95% confidence interval (95% CI), 0.04 to 0.18; P = 0.001]; ß = -2.62 [95% CI, -4.52 to -0.71; P = 0.007], respectively), after accounting for higher body mass index, lifetime history of depression, and stressful life events. CONCLUSIONS: Increasing dysregulation of ovarian hormones, but not VMS, associates with more depressive symptom burden during perimenopause. These results suggest that perimenopausal mood instability is driven by the underlying hormonal dysregulation of the menopause transition involving changes in both estradiol and progesterone.


Assuntos
Depressão/etiologia , Estradiol/sangue , Perimenopausa/sangue , Perimenopausa/psicologia , Progesterona/sangue , Adulto , Afeto , Depressão/epidemiologia , Feminino , Fogachos , Humanos , Pessoa de Meia-Idade , Ovulação/sangue , Sistema Vasomotor
11.
Maturitas ; 131: 48-56, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31787147

RESUMO

The menopausal transition is a critical phase for psychological disorders such as depression and anxiety, with prevalence rates of depression ranging up to 20% during the menopause. Nevertheless, the majority of women cope adequately with this reproductive transition phase and thus appear to be resilient. We assert that a variety of psychological factors influence the menopausal transition and result in an individual state on a continuum from successful adjustment to maladjustment. The purpose of this review is to offer a conceptual framework of resilience factors during the menopausal transition and to reveal which dimensions of resilience have already been verified for a healthy menopausal transition. We searched the databases PubMed and PsycINFO for studies investigating resilience factors during the menopausal transition which influence psychological and physical adjustment or maladjustment. A total of 23 articles were included. Altogether, we identified 15 different resilience factors, assessed with 23 different questionnaires. These factors can be grouped into six categories: core resilience, spirituality, control, optimism, emotion and self-related resilience. They are associated with a better adjustment to menopausal symptoms, milder physical symptoms, a better quality of and satisfaction with life, better well-being, less perceived stress and fewer depressive symptoms compared with women with lower levels of the respective resilience factors. Our conceptual framework includes resilience factors which have already been verified by empirical data. Further research is needed to determine whether these resilience factors can be assigned to a common factor and to incorporate biological resilience markers.


Assuntos
Depressão/epidemiologia , Menopausa/psicologia , Perimenopausa/psicologia , Resiliência Psicológica , Adaptação Psicológica , Adulto , Ansiedade/epidemiologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
12.
Ann Agric Environ Med ; 26(4): 600-605, 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31885234

RESUMO

OBJECTIVE: The aim of the study was evaluation of the relationship between severity of symptoms of climacteric syndrome, depressive disorders and sleep problems, and the self-rated work ability of peri-menopausal and post-menopausal women in non-manual employment. MATERIAL AND METHODS: The study included 287 women aged 45-60 years, employed in various institutions as non-manual workers. Work Ability Index, Greene Climacteric Scale, Beck Depression Inventory, and Athens Insomnia Scale were used. RESULTS: The examined peri-menopausal and post-menopausal women in non-manual employment obtained good work ability on the Work Ability Index. The severity of menopausal syndrome, according to the Greene Climacteric Scale, was moderate, placing the examined women between results for the general population of women and the pattern for menopausal women. Depressive disorders ranked between low mood and moderate depression. No depression was observed in 59% of the women, whereas moderate depression was observed in 39%, and severe depression in only 2%. Sleep disorders were on the border of normal range. As many as 46% of the women had no sleep problems, which was on the border of normal range in 36%. Only 19% of the examined women suffered from insomnia. Work ability correlated negatively with depression and insomnia severity, as well as with psychological and vasomotor symptoms of climacteric syndrome, but not to its somatic symptoms. CONCLUSIONS: Preventing the occurrence and treatment of menopausal symptoms, sleep and mood disorders may contribute to maintaining the work ability of women in peri- and post-menopausal age.


Assuntos
Climatério/fisiologia , Depressão/fisiopatologia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Climatério/psicologia , Depressão/economia , Depressão/psicologia , Emprego , Feminino , Humanos , Pessoa de Meia-Idade , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Distúrbios do Início e da Manutenção do Sono/economia , Distúrbios do Início e da Manutenção do Sono/psicologia , Avaliação da Capacidade de Trabalho
13.
Curr Psychiatry Rep ; 21(12): 130, 2019 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-31768664

RESUMO

PURPOSE OF REVIEW: We review recent data on bipolar disorder in menopausal-aged women, particularly in women undergoing the menopausal transition (MT). We discuss evidence on the severity of symptoms in bipolar women during the MT. Moreover, we address two factors in bipolar disorder and menopausal research: standardized menopausal staging and women's conceptualization of their menopausal and bipolar symptoms. RECENT FINDINGS: While there are few studies within the last 5 years on bipolar women undergoing the MT, new evidence suggest that mood symptoms in women worsen with progression through the MT. Consistent use of the standardized menopausal staging system can facilitate understanding of the timing of worsening symptoms. Moreover, whether women conceptualize their symptoms as arising from their MT or bipolar disorder can influence whether they seek hormonal therapy or psychiatric treatment, respectively. The MT is a potential time for mood instability in vulnerable women, which can manifest as first-onset development of bipolar disorder or increased symptom severity in women with pre-existing bipolar disorder. Adoption of a standardized menopausal staging may offer novel frameworks for understanding of the role of the MT in bipolar disorder.


Assuntos
Transtorno Bipolar/psicologia , Perimenopausa/psicologia , Feminino , Humanos , Pessoa de Meia-Idade
14.
Molecules ; 24(20)2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31618892

RESUMO

Icariin is a prenylated flavonol glycoside isolated from Epimedium herb, and has been shown to be its main bioactive component. Recently, the antidepressant-like mechanism of icariin has been increasingly evaluated and demonstrated. However, there are few studies that have focused on the involvement of the phosphatidylinositol 3-kinase (PI3K)/serine-threonine protein kinase (AKT) signaling in mediating the perimenopausal depression effects of icariin. Perimenopausal depression is a chronic recurrent disease that leads to an increased risk of suicide, and poses a significant risk to public health. The aim of the present study was to explore the effect of icariin on the expression of the PI3K-AKT pathway related to proteins in a rat model of perimenopausal depression. Eighty percent of the left ovary and the entire right ovary were removed from the model rats. A perimenopausal depression model was created through 18 days of chronic unpredictable stimulation, followed by the gavage administration of target drugs for 30 consecutive days. We found that icariin administered at various doses significantly improved the apparent symptoms in the model rats, increased the organ indices of the uterus, spleen, and thymus, and improved the pathological changes in the ovaries. Moreover, icariin administration elevated the serum levels of female hormone estradiol (E2), testosterone (T), and interleukin (IL)-2, decreased those of follicle stimulating hormone (FSH) and luteotropic hormone (LH), promoted the expression levels of estrogen receptor (ER) and ERα in the hypothalamus, and increased those of serotonin (5-HT), dopamine (DA), and noradrenaline (NA) in the brain homogenate. Furthermore, icariin elevated the expression levels of AKT, phosphorylation-akt (p-AKT), PI3K (110 kDa), PI3K (85 kDa), and B-cell lymphoma 2 (Bcl-2) in the ovaries, and inhibited those of Bax. These results show that icariin administration rebalanced the disordered sex hormones in perimenopausal depression rats, regulated the secretion of neurotransmitters in the brain, boosted immune function, and improved the perimenopausal syndrome. The mechanism of action may be related to the regulation of the expression of PI3K-AKT pathway-related proteins.


Assuntos
Flavonoides/farmacologia , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Animais , Comportamento Animal , Biomarcadores , Depressão/etiologia , Depressão/metabolismo , Depressão/psicologia , Modelos Animais de Doenças , Feminino , Ovário/metabolismo , Perimenopausa/psicologia , Ratos , Receptores Estrogênicos/metabolismo
15.
Menopause ; 26(10): 1193-1203, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31513088

RESUMO

OBJECTIVE: The aim of the study was to assess the effectiveness of Chinese herbal medicine combined with traditional Chinese medicine (TCM)-based psychotherapy (TBP) on perimenopausal depression (PMD). METHODS: This multicenter, randomized, placebo-controlled clinical trial was conducted in nine hospitals in China between August 2015 and June 2017. The study included 307 women with PMD who were divided randomly into two treatment groups: the Bushen Tiaogan formula (BSTG) plus TBP (n = 156) and placebo plus TBP (n = 151). All participants underwent treatment for 8 weeks and were followed up for 4 weeks. The primary outcome measures included scores of the Greene Climacteric Scale (GCS), Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS). Secondary outcomes included serum levels of sex hormones and lipids, as well as adverse events. RESULTS: The average GCS, SDS, and SAS scores after treatment were significantly lower in the BSTG-plus-TBP group than those in the placebo-plus-TBP group, and the differences were greatest at the end of the 12th week: the average GCS scores were 10.8 in the BSTG-plus-TBP group versus 18.5 in the placebo-plus-TBP group (P < 0.001); the average SDS scores were 30.7 in the BSTG-plus-TBP group versus 45.4 in the placebo-plus-TBP group (P < 0.001); the SAS scores were 28.6 in the BSTG-plus-TBP group versus 42.6 in the placebo-plus-TBP group (P < 0.001). In addition, treatments with BSTG plus TBP significantly reduced the levels of basal follicle-stimulating hormone (P = 0.045) and triglycerides (P = 0.039) and increased the level of high-density lipoprotein cholesterol (P < 0.001) compared to placebo treatments with TBP. No serious adverse events occurred, and the safety indices of complete blood counts, renal function, and liver function were within normal ranges, before and after treatments. CONCLUSIONS: Treatment with BSTG formula plus TBP was more effective than TBP alone for improving PMD symptoms, sexual hormone levels, and blood lipid conditions in women with mild PMD.


Assuntos
Depressão/terapia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa/métodos , Perimenopausa/psicologia , Psicoterapia/métodos , Ansiedade/sangue , Ansiedade/tratamento farmacológico , China , HDL-Colesterol/sangue , Depressão/sangue , Formas de Dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Hormônio Foliculoestimulante Humano/sangue , Seguimentos , Humanos , Pessoa de Meia-Idade , Perimenopausa/sangue , Autorrelato , Resultado do Tratamento , Triglicerídeos/sangue
16.
Menopause ; 26(10): 1146-1153, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31513090

RESUMO

OBJECTIVE: The aim of this study was to explore the association of self-reported physical fitness (PF) and its components with cardiometabolic and mental health in perimenopausal women. METHODS: These cross-sectional analyses included 191 participants (53 ±â€Š4 y old) from the FLAMENCO project. Self-reported PF was assessed with the International Fitness Scale (IFIS). Body mass index (BMI), fat mass (FM), waist circumference (WC), systolic and diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglycerides, C-reactive protein (CRP), and glucose were measured. The Beck's Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Life Orientation Test Revised, and Positive and Negative Affect Schedule were used to assess mental health. RESULTS: After adjusting for potential confounders, greater overall PF was associated with lower BMI, FM, WC (P < 0.001), DBP and CRP, and higher HDL-C (P < 0.05). Cardiorespiratory fitness (CRF), speed-agility, and flexibility were associated with lower BMI, WC, and FM (P < 0.001), and muscle strength (MS) with lower WC and FM (P < 0.05). In addition, CRF, MS, and speed-agility were associated with lower CRP (P < 0.01), and flexibility with enhanced triglycerides and HDL-C (P < 0.05). Overall PF and all its components were associated with lower depression, anxiety, and negative affect (P≤0.01), and greater positive affect (P≤0.05). Overall PF and MS were associated with better sleep quality (P < 0.05), and CRF, MS, and speed-agility with greater optimism (P≤0.05). Finally, overall PF showed evidence of significant association with less pharmaceutical expenditure (B = -7.2, ß=-0.145, P = 0.08). CONCLUSIONS: Self-reported PF was associated with better cardiometabolic and mental health in perimenopausal women. The IFIS might be proposed as an inexpensive, quick, and easy tool in clinical settings.


Assuntos
Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Aptidão Cardiorrespiratória/fisiologia , Aptidão Cardiorrespiratória/psicologia , Saúde Mental , Perimenopausa/sangue , Perimenopausa/psicologia , Ansiedade , Proteína C-Reativa/análise , HDL-Colesterol/sangue , Estudos Transversais , Depressão , Feminino , Frequência Cardíaca/fisiologia , Humanos , Pessoa de Meia-Idade , Força Muscular/fisiologia , Autorrelato , Triglicerídeos/sangue , Circunferência da Cintura
17.
Expert Opin Pharmacother ; 20(15): 1837-1845, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31355688

RESUMO

Introduction: Although postnatal depression is now well recognized, there is also a risk of depressive symptoms during perimenopause. The mechanisms underlying perimenopausal depression are still poorly understood; however, there are available treatment options. Areas covered: This review describes: the current pharmacotherapeutic approaches for perimenopausal depression, their strengths and weakness, and provides recommendations on how current treatment can be improved in the future. An electronic search identified specific guidelines for the treatment of perimenopausal depression released in 2018, as well as recent clinical studies on the subject. Expert opinion: The 2018 guidelines recommend selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) as front-line medications for perimenopausal depression, but SSRIs and SNRIs are not always effective. The efficacy of estrogen in perimenopausal depression is well documented, but estrogen is not FDA-approved to treat mood disturbances in perimenopausal women. Clinical practice guidelines currently recommend to restrict hormone therapy to the symptomatic treatment of menopause (not for the prevention of chronic diseases). Research with new estrogenic compounds is under way to improve their benefit/risk ratio in perimenopausal depression.


Assuntos
Depressão/tratamento farmacológico , Perimenopausa/psicologia , Inibidores de Captação de Serotonina/uso terapêutico , Depressão/patologia , Feminino , Humanos , Inibidores de Captação de Serotonina/farmacologia
19.
Maturitas ; 123: 78-81, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31027682

RESUMO

Insomnia is a common and recurring condition during the menopausal transition that negatively affects both quality of life and health. Peri-menopausal insomnia has a multifactorial etiology; previous depression, hormonal changes and age/hormone-related irregularity in circadian rhythms can contribute to menopausal insomnia. Age-related poor health, pain and stress may favor the development of insomnia, while vasomotor symptoms, in particular hot flashes, may contribute to chronic forms of insomnia by activating a vicious cycle. Insomnia increases two- to threefold the risk of developing depressive symptoms during the peri-menopause. In fact, the menopausal transition is a window of vulnerability for the development of depressive symptoms, in which the risk of a major depressive disorder is 2-4 times greater than in the premenopausal period. Depression naturally has a negative impact on daily functioning, quality of life and health. Since the relationship between insomnia and depressive symptoms has been shown to be bidirectional, the aim of this review is to provide a brief overview of their association in the context of the menopausal transition. By exploring the potential pathways of their bidirectional relationship, this overview should be useful for preventive and therapeutic purposes. By treating insomnia we may be able to interrupt the self-reinforcing feedback loop with depressive symptoms, and thereby improve affective symptoms and women's wellbeing in this period of their life.


Assuntos
Depressão/psicologia , Retroalimentação , Perimenopausa/psicologia , Reforço Psicológico , Distúrbios do Início e da Manutenção do Sono/psicologia , Feminino , Nível de Saúde , Fogachos/psicologia , Humanos , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono/terapia
20.
Rev Med Inst Mex Seguro Soc ; 56(6): 533-536, 2019 Mar 15.
Artigo em Espanhol | MEDLINE | ID: mdl-30889341

RESUMO

Background: It is known that hormonal changes influences mood, so the woman shows notorious hormonal changes in stages of her life. Objective: To determine the difference in the frequency of depression in premenopausal and postmenopausal women. Methods: We studied 371 premenopausal and postmenopausal women who didn't receive hormonal treatment and in which Hamilton depression scale was applied. Descriptive statistics, central tendency and dispersion measures were used. The comparison between the groups was with Student t test, and Chi squared test. Pearson's correlation analysis was done between age, body mass index and Hamilton scale score. In the postmenopausal women, the time since menopause was also correlated with Hamilton scale score. Results: Premenopausal women were predominantly healthy (46.6%). In perimenopausal women predominated minor depression (21.4%) and in postmenopausal women, major depression (59.3%). Conclusion: Postmenopausal women more frequently had a higher score than those premenopausal.


Assuntos
Depressão/epidemiologia , Perimenopausa/psicologia , Pós-Menopausa/psicologia , Pré-Menopausa/psicologia , Índice de Massa Corporal , Distribuição de Qui-Quadrado , Intervalos de Confiança , Depressão/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA