Thyroid profile in perimenopausal women: A study to rule out hypothyroidism in the subclinical stage and its relationship to cholesterol levels

Background: One of the most frequent problems affecting perimenopausal women is thyroid dysfunction, symptoms of which might be so subtle that they go unrecognized for a long time. In older women, subclinical hypothyroidism (SCH) is frequent. A significant percentage of individuals are at risk of developing primary hypothyroidism as a result of their SCH. Aim and Objectives: The goal of this study is to know the incidence of thyroid dysfunction and its clinical manifestations, to determine thyroid profile the incidence of SCH, and its relation with the cholesterol levels in perimenopausal women in patients who visit gynecology outpatient department. Materials and Methods: The present study is a descriptive cross-sectional research undertaken in the department of the research comprised 100 women between the ages of 40 and 55 Patients were assessed using a complete history, clinical examination, and laboratory tests such as ELISA was used to test thyroid function in the serum of all patients diagnosed with SCH and also assessed serum cholesterol in patients with SCH. Results: There were 100 patients in the present study and all were women were between the ages of 40 and 55. Menorrhagia was the most common menstrual disorder seen in the study group, with 56% of patients experiencing it. 32% of patients developed oligomenorrhea, which is one of the most common perimenopausal symptoms. Menstrual irregularities (88%) and weight increase were common symptoms in thyroid insufficiency individuals. (65%), irritation and mood changes (74%) Anxiety and sadness (61%) are the most common symptoms, followed by loss of employment. Sexual libido (5%) Subjects with normal free t3 and t4 but increased serum thyroid-stimulating hormone were classified as SCH. 20 of the patients had SCH, 4 had overt hypothyroidism, and the other 76 were euthyroid. Seventy-five percent of the patients with SCH had hypercholesterolemia when they were diagnosed. Conclusion: We propose that perimenopausal women with or without symptoms be routinely screened based on the findings of this study. Early diagnosis and treatment of these issues will aid in lowering morbidity and preventing subsequent consequences.

Osteoporosis and risk factors in perimenopausal women / 上海预防医学

ObjectiveTo screen the risk factors of osteoporosis in perimenopausal women， and to provide direction for timely prevention and treatment. MethodsUsing multilevel stratified random sampling method， the perimenopausal women were investigated by questionnaire survey， and the determination of bone mineral density （BMD） and the levels of several important hormones. ResultsA total of 720 valid questionnaires were received. Among 720 perimenopausal women， 173 had osteoporosis and 547 had no osteoporosis. Univariate analysis of the influencing factors of osteoporosis showed that the levels of parathyroid hormone （PTH）， Estradiol （E2）， body mass index （BMI）， age， time of last period and age of menopause were significantly different among perimenopausal women in the prevalence of osteoporosis（χ2=4.23， 4.86， 16.06， 21.04， 10.52， 13.02； P<0.05）.Logistic regression analysis showed that the increase of PTH （OR=2.70， P<0.05）and menopause （OR=1.76， P<0.05） were the risk factors of osteoporosis . Higher BMI（OR=0.65， P<0.05）， higher personal monthly income（OR=0.72， P<0.05）， longer sunshine time（OR=0.69， P<0.05）， were the protective factors against osteoporosis. ConclusionThe increase of PTH levels and menopause are the risk factors for osteoporosis in women. Perimenopausal women should be monitored for bone mineral density and appropriate intervention. Necessary treatment measures should be taken for the patients with osteopenia and osteoporosis.

Evaluation of endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal women with abnormal uterine bleeding at tertiary rural centre

Background: Abnormal uterine bleeding is one of the commonest clinical presentation ac-counts for 33% gynaecological consultations and this proportion rises to 70% in perimenopausal and postmenopausal age group in any gynaecology clinic. The most probable etiology of abnormal uterine bleeding relates to the patients reproductive age. Various diagnostic techniques have been evolved over the periods to determine the etiology of abnormal uterine bleeding in perimenopausal women, but their accuracy has not been compared properly. The aim of study is to evaluate the endometrium by transvaginal ultrasonography and hysteroscopy and its correlation with histopathology in perimenopausal patients with abnormal uterine bleeding.Methods: Total 96 patients in perimenopausal age group, admitted with chief complaints of ab-normal uterine bleeding were included. All patients underwent transvaginal ultrasonography and hysteroscopy, followed by hysteroscopy guided biopsy and histopathological examination. Accuracy, sensitivity, specificity, positive predictive value and negative predictive value were calculated for both methods and compared, considering histopathological diagnosis as gold standard.Results: Mean age of patients was 44.05±3.29. Hysteroscopy has high accuracy, sensitivity, specificity, positive predictive value and negative predictive value than Transvaginal sonography for diagnosis of all endometrial and intrauterine pathologies.Conclusions: Hysteroscopy results are more consistent with the results of histopathology. Hysteroscopy and hysteroscopy guided biopsy has been proven as gold standard for endometrial evaluation of patients with abnormal uterine bleeding. TVS can be used as most cost effective first step investigation in cases of perimenopausal bleeding.

Abnormal uterine bleeding in women of peri-menopausal age: a retrospective study

Background: Abnormal uterine bleeding (AUB) is a phenomenon which refers to menstrual bleeding of abnormal frequency, duration or quantity. It is a common gynaecological complaint caused by wide variety of organic or non-organic causes. The objective of the study was to determine the incidence of abnormal uterine bleeding with respect to aetiopathology, demographic variables, treatment options and other medical disorders.Methods: A retrospective study of randomly selected 200 cases of abnormal uterine bleeding between 40–55 years of age during January 2018 to January 2019, in the Dept. of Obstetrics and Gynaecology, in a tertiary care hospital. Demographic details of each patient were recorded and analysed. Patients were evaluated with menstrual history, physical examination, laboratory tests and histological examinations. Patients were followed up from 3 to 8 months.Results: Most common age group presenting with AUB was 40–45 years (65.55%) and mostly (68.33%) belonged to low socioeconomic status. Most of the women were multiparous and menorrhagia was most common presentation. In 60% cases, cause was non-organic (dysfunctional uterine bleeding) and among organic causes fibroid (21%) uterus was most common. Maximum number of patients (75%) was treated surgically and 20% got medical treatment.Conclusions: Abnormal uterine bleeding (AUB) is a common gynaecological manifestation allied with considerable morbidity and significantly affects the patient's family, personal and social life. Perimenopausal women’s health and quality of life can be maintained and improved through preventive care, life style modification, early diagnosis of risk factor and appropriate treatment.

Effect of mindfulness meditation training on anxiety, depression and sleep quality in perimenopausal women / 南方医科大学学报

OBJECTIVE@#To explore the effect of mindfulness meditation training for improving anxiety, depression and sleep disorders in perimenopausal women.@*METHODS@#Intervention by menopause meditation training was delivered in 121 perimenopausal women with anxiety, depression or sleep disorders in Baiyun District, Guangzhou. Before and after the intervention, the Self-rating Anxiety Scale, Self-rating Depression Scale and Pittsburg Sleep Quality Index were used for assessment of changes in the conditions of the women.@*RESULTS@#After menopausal meditation training, the perimenopausal women showed significant improvement in the mean scores of Self-rating Anxiety Scale (48.26 ± 6.47; =3.865, < 0.01), Selfrating Depression Scale (50.27 ± 6.54; =4.541, < 0.01) and Pittsburgh Sleep Questionnaire (10.64 ± 4.38; =5.596, < 0.01). The symptom remission rates differed significantly among the women with different self-practice frequencies ( < 0.01). The remission rates of anxiety, depression and sleep disorder increased significantly with the frequency of self-exercise ( < 0.01).@*CONCLUSIONS@#Mindfulness meditation training can effectively alleviate the symptoms of anxiety and depression and improve the quality of sleep in perimenopausal women, and the frequency of the exercise is positively correlated with the improvements. Mindfulness meditation training can be an effective intervention for improving the mental health of perimenopausal women.

Influencing factors of dry eye disease in perimenopausal women / 国际眼科杂志(Guoji Yanke Zazhi)

@#Perimenopausal women have a very high risk suffering from dry eye. Local disorder such as inflammation or estrogen deficiency were usually attributed as the main mechanism in recent researches. However, the author believes that comparing with other types of dre eye, there are some others risk factors should be noticed. This article reviewed recent literatures on causes of dry eye in perimenopausal women, including lacrimal gland and conjunctiva dysfunction, hormones deficiency, psychological disorder, systemic diseases, as well as living conditions and personal habits.

Therapeutic evaluation of hormone replacement therapy with combination of Fosamax and alone use of Fosamax in osteoporosis and steopenia of perimenopausal women / 中国综合临床

Objective To explore the efficacy and safety of hormone replacement therapy with combination of Fosamax and simple use of Fosamax in osteoporosis and steopenia of perimenopausal women.Methods One hundred and thirteen perimenopausal women with osteoporosis accepted treatment in Outpatient Clinic of Panyu Convalescent Hospital of Guangzhou from December 2010 to June 2014 were chosen and divided into the control group (n=55) and the observation group (n=58) according to therapeutic method.The control group was treated with Fosamax alone while the observation group was treated with HRT basing on the simple use of Fosamax.The therapeutic effect,lumbar and hip bone mineral density(BMD) level,tibial ultrasound velocity (SOS) and T values of tibia,gonadal hormone concentrations,endometrial thickness and adverse reaction of the two groups before and after the therapy were compared.Results (1) The total effective rate of the observation group after the treatment was 93.10％,significantly higher than tbat of the control group (78.18％,x2=3.829,P=0.034).(2) Before and after treatment in two groups,there were statistically significant differences in terms of lumbar spine BMD,hip BMD,SOS of tibia,blood follicle stimulating prime (FSH) and estradiol(E2) (P＜0.05),and there were statistically significant differences between the two groups after the treatment in terms of lumbar spine BMD,hip B MD,SOS of tibia,FSH and E2 (t =3.389,5.012,3.997,5.829,3.902;P=0.035,0.028,0.033,0.024,0.038).(3) There was statistically significant differences in term of the incidence of adverse reactions between the observation group and the control group (6.90％ vs.16.36％;x2=8.273,P=0.012).Conclusion Compared with alone use of Fosamax,the therapeutic effect of hormone replacement therapy with combination of Fosamax and in osteoporosis and steopenia of perimenopausal women is more significant with low occurrence rate of adverse reaction.It is worth popularization.

Impacto de los factores de riesgo en osteoporosis sobre la densidad mineral ósea en mujeres perimenopáusicas de la Ciudad de Querétaro, México / Impact of risk factors for osteoporosis on bone mineral density in perimenopausal women of the City of Querétaro, México.

Es indispensable evaluar los factores de riesgo en osteoporosis, principalmente los modificables, como: los estilos de vida, para prevenirla, ya que es un grave problema de salud pública. Se estudiaron 805 mujeres (35-55 años) de la ciudad de Querétaro, México. Se obtuvieron datos personales, historia familiar, hábitos como: fumar, actividad física, consumo de alcohol y de cafeína (refresco de cola y café). Las participantes completaron el cuestionario de riesgo de osteoporosis (19 factores, con uno, existe riesgo) (International Osteoporosis Foundation). Se evaluó: Índice de Masa Corporal (IMC), riesgo cardiovascular y complexión corporal (Talla/Circunferencia de muñeca). Se realizó una densitometría ósea (DXA) en dos regiones diagnósticas: columna lumbar y cadera total y las participantes se clasificaron en: densidad mineral ósea (DMO) normal, DMO baja y osteoporosis. La prevalencia de osteoporosis fue de 7% y de DMO baja fue de 34%, predominantemente en región lumbar y en aquellas con menopausia. La edad fue mayor en mujeres osteoporóticas (51 años) y el 85% menopáusicas, con valores menores de: peso, talla, IMC, circunferencia de cintura y cadera, que las normales. Los factores de riesgo modificables que aumentaron el riesgo fueron: bajo peso, fumar y consumo de refresco de cola con 6,5, 1,2 y 1,4 (razón de momios) respectivamente (p<0,05). Factores no modificables significativos: menopausia (quirúrgica), historia de fractura y riesgo de osteoporosis. Se concluye que dentro de los factores de riesgo modificables para la prevención de osteoporosis de mayor impacto en esta muestra son: bajo peso, cigarrillo y el refresco de cola.

It is essential to evaluate osteoporosis risk factors, mainly the modifiable, like the lifestyle, in Mexican women in order to prevent it, since it is a serious public health problem.We studied 805 women (35-55 years old) in the City of Queretaro, México. We obtained: personal data, family history, habits, such as smoking, alcohol, caffeine (coffee and soft drink of cola) and physical activity. Participants complete the questionnaire on 19 risk factors for osteoporosis (International Osteoporosis Foundation) one of them with risk. We evaluated: body mass index (BMI), cardiovascular risk and corporal complexion. Bone densitometry was performed in two diagnostic regions: lumbar spine and total hip and participants were classified as normal bone mass density (BMD), low BMD and osteoporosis. The prevalence of osteoporosis was 7% and of low BMD was 34%, predominantly in the lumbar region and in those with menopause. In osteoporotic women, the age was higher (51 years) and 85% menopausal women, also lower values of weight, height, BMI, waist circumference and hip than women with normal bone mass density. The significantly modifiable risk factors were: low weight, smoking and consumption of soft drink of cola with 6,5, 1,2 and 1,4 (odds ratio), respectively (p <0,05). The significantly non-modifiable risk factors were: menopause (surgical), history of fracture and risk. It is concluded that within the modifiable risk factors for the prevention of osteoporosis, those with the greatest impact were low weight, cigarette and soft drink of cola.

Prevalence of knee osteoarthritis amongst perimenopausal women in urban resettlement colony in South Delhi.

A community-based cross-sectional study was carried out in an urban resettlement colony in South Delhi to study the prevalence of knee osteoarthritis in women aged ≥40 years and treatment seeking behavior of women suffering from osteoarthritis. Osteoarthritis was diagnosed by using clinical criteria given by American College of Rheumatology for diagnosis of Idiopathic Osteoarthritis of knee joints. A total 260 women were interviewed out of which 123 (47.3%) women were found to be suffering from knee osteoarthritis. Prevalence of osteoarthritis found to be increased with age. Less than half of those with osteoarthritis underwent treatment. With this high prevalence of osteoarthritis, there is need to spread awareness about the disease, its prevention, and rehabilitation in the community

Genotypes of vitamin D and estrogen receptors in pre and perimenopausal women from Córdoba, Argentina

El propósito del estudio fue determinar la frecuencia de los genotipos de los receptores de vitamina D y de estrógeno y su relación con la densidad mineral ósea en mujeres sanas pre y perimenopáusicas de la ciudad de Córdoba y alrededores. Los genotipos se determinaron con la técnica de reacción en cadena de la polimerasa y análisis de los polimorfismos de longitud de fragmentos de restricción. Se usaron como restrictasas Bsm I y Fok I para el gen del receptor de vitamina D y Pvu II y Xba I para el gen del receptor de estrógeno. Se reclutaron y agruparon por edad doscientos diez mujeres pre y peri-menopáusicas. Sus niveles séricos de Ca y de hormona paratiroidea fueron similares, pero los de fósforo y b-Cross Laps disminuyeron con la edad. La densidad mineral ósea de cuello femoral disminuyó después de los 30 años. Las frecuencias genotípicas de ambos receptores fueron similares a aquéllas de otras mujeres caucásicas. No hubo asociación entre los genotipos de los receptores y la densidad mineral ósea. Los análisis de interacción entre ambos genes no evidenciaron influencia sobre la densidad mineral ósea, utilizándose edad, talla e índice de masa corporal como covariables. Los estilos de vida y hábitos de fumar y beber alcohol tampoco afectaron la densidad mineral ósea. En conclusión, estos datos no sostienen la hipótesis de que los genotipos de los receptores de vitamina D y de estrógeno influencian la densidad mineral ósea de columna lumbar y cuello femoral en mujeres sanas pre y perimenopáusicas de esta región de Argentina.

The aim of this study was to determine the frequency of vitamin D receptor and estrogen receptor genotypes and their relationship with the lumbar spine or femoral neck bone mineral density in healthy pre and perimenopausal women from Córdoba (Argentina) and adjacent areas. Genotypes were assessed by restriction fragment length polymorphism-polymerase chain reaction technique. Bsm I and Fok I for vitamin D receptor gene and XbaI and PvuII for estrogen receptor gene were used as restrictases. Two hundred and ten healthy pre and perimenopausal women were recruited and analyzed by age. Calcemia and serum parathyroid hormone did not change, but serum P and b-CrossLaps decreased with age. Femoral neck bone mineral density decreased significantly after 30 years old. Vitamin D receptor and estrogen receptor genotype frequencies were similar to those from other Caucasian women. No association between vitamin D receptor and estrogen receptor genotypes with the lumbar spine or femoral neck bone mineral density has been detected. Analysis of interaction between vitamin D receptor and estrogen receptor genes using covariates such as age, height and body mass index did not show any influence of the combination of those genotypes on bone mineral density. Lifestyle, smoking and alcohol intake had no effect on lumbar spine and femoral neck bone mineral density. To conclude, these data do not support the hypothesis that vitamin D receptor and estrogen receptor genotypes influence on lumbar spine and femoral neck bone mineral density in healthy pre and perimenopausal women from this area of Argentina.

Effect of Ca Supplementation on Serum Ca Level and Psychological Conditions in Perimenopausal Women / 대한지역사회영양학회지

This study was conducted to investigate the relationship of serum calcium and magnesium level to depression and anxiety symptoms in 66 perimenopausal women. Daily nutrient intakes and dietary sources of calcium were analyzed by convenient method. General status was conducted by a questionnaire whereas the questionnaire of CED-S(the Center for Epidemiological studies-Depression Scale) was used for depression and Spielburger's STAI-S(state-Trait Anxiety Inventory-State) was used for anxiety. Fasting blood samples were collected, and serum calcium and magnesium concentrations were measured before and after calcium supplementation. The age distribution of the subjects was 49-55 years. Results indicated that serum calcium concentrations were significantly(P<0.05) increased to normal ranges after calcium supplementation. Depression and anxiety scores of the subjects with calcium supplementation were significantly(p<0.05) lower than those before calcium supplementation. There were significantly(P<0.05) decreased between serum magnesium concentration and depression and anxiety scores, but calcium concentration was not significantly decreased. These results suggest that psychological conditions of perimenopausal women are possibly effected by serum calcium and magnesium levels. More studies are needed to measure the long-term effects of calcium supplementation on psychological conditions in perimenopausal women.