Exosomas como tratamiento alternativo del síndrome genitourinario de la menopausia / Exosomes as an alternative treatment for genitourinary syndrome of menopause

Objetivo: Evaluar el efecto de los exosomas como tratamiento alternativo en la restauración del síndrome genitourinario de la menopausia en pacientes que acuden a una consulta ginecológica, en Valencia, Estado Carabobo, en el período junio - agosto de 2023. Métodos: Estudio prospectivo, descriptivo, exploratorio, incluyó tres casos de mujeres con diagnóstico de síndrome genitourinario de la menopausia. Se evaluó la respuesta en cuanto a los síntomas, examen clínico según el índice de salud vaginal, la satisfacción con el tratamiento y la tolerabilidad. Se aplicó el tratamiento con exosomas: 2 cc con técnica de punto a punto en todas las paredes vaginales y 1 cc en el vestíbulo, en 3 sesiones, con intervalo de 15 días. Resultados: La edad de las pacientes estuvo entre 53 y 56 años, con un promedio de tiempo de menopausia de 6,6 años. Previo al tratamiento, había un nivel alto de irritación vaginal (100 %), dolor en el introito (100 %), sequedad vaginal, dispareunia, hipersensibilidad y las no relaciones sexuales (66,67 %). Postratamiento predominó la ausencia de los síntomas: sequedad vaginal, dispareunia, hipersensibilidad y dolor en introito (100 %); irritación vaginal y no relaciones sexuales (66,67 %) (p = 0,0001). La mediana del índice de salud vaginal previa fue 13 (10 ­ 13) y posterior fue 18 (17 ­ 20) (p = 0,0476). La satisfacción y tolerabilidad fue de 66,67 %. Una paciente refirió dolor leve. Conclusión: La terapia con exosomas es eficaz para reducir los síntomas y signos del síndrome genitourinario de la menopausia, y bien tolerado(AU)

Objective: To evaluate the effect of exosomes as an alternative treatment in the restoration of genitourinary syndrome of menopause in patients attending a gynecological consultation in Valencia, Carabobo State, in the period June - August 2023. Methods: A prospective, descriptive, exploratory study included three cases of women diagnosed with genitourinary syndrome of menopause. Response was assessed in terms of symptoms, clinical examination according to vaginal health index, satisfaction with treatment and tolerability. Treatment with exosomes was applied: 2 cc with point-to-point technique on all vaginal walls and 1 cc in the vestibule, in 3 sessions, with an interval of 15 days. Results: The age of the patients was between 53 and 56 years, with a mean menopause time of 6.6 years. Prior to treatment, there was a high level of vaginal irritation (100%), pain in the introitus (100%), vaginal dryness, dyspareunia, hypersensitivity and non-sexual intercourse (66.67%). Post-treatment, the absence of symptoms predominated: vaginal dryness, dyspareunia, hypersensitivity and pain in the introitus (100%); vaginal irritation and no sexual intercourse (66.67%) (p = 0.0001). The median index of previous vaginal health was 13 (10 ­ 13) and subsequent was 18 (17 ­ 20) (p = 0.0476). Satisfaction and tolerability was 66.67%. One patient reported mild pain. Conclusion: Exosome therapy is effective in reducing the symptoms and signs of genitourinary syndrome of menopause, and well tolerated(AU)

Función sexual y síndrome climatérico en mujeres de 45 a 64 años / Sexual function and climacteric syndrome in women from 45 to 64 years old

Objetivo: Analizar la función sexual y el síndrome climatérico en mujeres de 45 a 64 años residentes de la Región de Ñuble. Métodos: Se realizó un muestreo no probabilístico a conveniencia con 251 mujeres. Se utilizaron dos instrumentos, Menopause Rating Scale y Female Sexual Function Index. El análisis estadístico incluyó pruebas descriptivas, ANOVA y correlación de Pearson. Resultados: El grupo etario más frecuente fue de 45 a 49 años. En síntomas climatéricos, se destacan molestias moderadas en lo somático. La función sexual evaluada por la escala Female Sexual Function Index, muestra variabilidad. La correlación entre Menopause Rating Scale y Female Sexual Function Index indica que un mayor puntaje en el primero se relaciona con menor función sexual. Conclusiones: Existe una prevalencia significativa de síntomas climatéricos en mujeres, con molestias moderadas en lo somático y leves en lo psicológico y urogenital. Variabilidad en la función sexual; puntajes más altos en dolor y más bajos en lubricación y orgasmo. Existe una correlación inversa entre las escalas Menopause Rating Scale y el Female Sexual Function Index(AU)

Objective: To analyze sexual function and climacteric syndrome in women aged 45 to 64 years residing in the Ñuble Region. Methods: A non-probabilistic convenience sampling was carried out with 251 women. Two instruments were used, Menopause Rating Scale and Female Sexual Function Index. Statistical analysis included descriptive tests, ANOVA and Pearson correlation. Results: The most common age group was 45 to 49 years. In climacteric symptoms, moderate somatic discomfort stands out. Sexual function, assessed by the Female Sexual Function Index scale, shows variability. The correlation between Menopause Rating Scale and Female Sexual Function Index indicates that a higher Menopause Rating Scale score is related to lower sexual function. Conclusions: There is a significant prevalence of climacteric symptoms in women, with moderate somatic discomfort and mild psychological and urogenital discomfort. Variability in sexual function; higher scores on pain and lower on lubrication and orgasm. There is an inverse correlation between the Menopause Rating Scale and Female Sexual Function Index scales(AU)

Physical performance, fear of fall and urinary incontinence among premenopausal, perimenopausal and postmenopausal women

Background: The menopausal transition, which occurs when a woman transitions from reproductive to post-reproductive life, is an important turning point in the female life cycle. The prevalence of menopausal symptoms has been shown to vary widely across various Asian research. It's critical to comprehend the connection between menopausal women's health and well-being and physical performance, fear of falling, and urine incontinence in order to design effective therapies.Methods: The study was approved for conduct by the ethical committee. 195 women in the 45� age range participated in this 1.5-year observational analytical study, which was conducted in a community setting.Results: Statistical package for the social sciences (SPSS) version 20.0 was used to analyze the data, and a significance level of less than 0.05 was regarded as statistically significant.Conclusions: Transition through menopause is associated with lowered physical performance, high concern fear of fall in postmenopausal compared to premenopausal and perimenopausal while urinary incontinence varies across different stages of menopause.

Menopausal problems and related health promotion behaviours among post-menopausal women

Background: Menopause is a natural biological process that ends a woman's reproductive years. The typical age range is 45 to 55 years old, with an average age of approximately 51. In addition to symptoms including mood swings, hot flashes, nocturnal sweats, dry vagina, and disrupted sleep, women can face a variety of issues, including irregular menstrual periods. The purpose of the study was to identify the menopause-related health promotion behaviours among post-menopausal women.Methods: Descriptive survey design was used for this study. One-stage cluster probability sampling was used for the selection of 108 post-menopausal women. After getting consent from the participants data was collected through an interview schedule and a health promotion behaviour assessment tool. The Institutional Ethics Committee granted ethical clearance before the study began. Before data was collected, each participant gave their written informed consent.Results: Out of 108 participants, 51.8% of them followed good dietary habits, 26.8% engaged in exercises daily and those who practiced stress reduction measures like yoga, and meditation were 23.1%.Conclusions: The study results show that menopausal women are unaware of the health promotion behaviours that should be adopted in managing menopausal problems. This provides evidence for giving importance to menopausal problems and related health promotion behaviours.

A study of knowledge, attitude and perception of perimenopausal changes in women aged 40-45 years in Gurugram district of Haryana, India

Background: Menopause, defined as cessation of menstruation for at least one year duration, due to exhaustion of the ovarian functions. 'Perimenopause' or 'climacteric' is the period of transition in which the woman's body makes the changes for menopause.Methods: A cross- sectional study by recruiting 100 female participants between 40-45 years.Results: 56% women have not heard about the term menopause or perimenopause. 50% thought that stoppage of menstrual cycle was a natural phenomenon and 70% had no idea about the risk factors of perimenopause or menopause. 68% females did not know about hormone replacement therapy.Conclusions: More spread of awareness and health education is needed regarding the same so as to clarify the doubts and bust the many myths existing so as to help women have a smooth transition to menopause and have a healthy and productive post-menopausal life.

Fibroma bilateral de ovario en mujer posmenopáusica. Reporte de un caso y revisión de la literatura / Bilateral ovarian fibroma in postmenopausal woman. Case report and literature review

Los fibromas ováricos son tumores benignos poco frecuentes, generalmente unilaterales, que se presentan principalmente en mujeres perimenopáusicas y posmenopáusicas. Los síntomas pueden variar y en algunos casos están asociados a ascitis y derrame pleural, conocido como síndrome de Meigs. Se presenta un caso de una paciente de 55 años de edad con antecedentes de hipertensión arterial y asma bronquial, quién acude a ginecólogo por dolor en fosa ilíaca derecha de tres meses de evolución. Se realizan diferentes estudios incluyendo ecografía y tomografía abdomino-pélvica, los cuales revelan una tumoración sólida bilateral de ovarios. Se realiza histerectomía abdominal total más salpingo-oforectomía bilateral y a pesar de sus características, el estudio histopatológico hace el diagnóstico de fibroma bilateral. La presentación clínica de los fibromas de ovario es inespecífica, por lo que suelen confundirse con patología maligna del ovario u otras patologías benignas de útero u ovario, constituyendo un reto para el diagnóstico preoperatorio(AU)

Ovarian fibromas are rare tumors that mainly occur in perimenopausal and postmenopausal women. Symptoms can vary, and in some cases, they may be associated with ascites and pleural effusion, known as Meigs Syndrome. The article presents the case of a 55-year-old patient with a history of hypertension and bronchial asthma, who visit a gynecologist due to pain in the right iliac fossa of three months duration. Various studies were performed, including ultrasound and abdominal and pelvic CT, which reveal the presence of solid bilateral ovarian tumors. The patient undergoes a total hysterectomy and bilateral salpingo-oophorectomy and despite it's characteristics, the histopathological study makes the diagnosis of bilateral ovarian fibroma with no signs of malignancy. The clinical presentation of ovarian fibromas is nonspecific, often leading to confusion with malignant ovarian pathology or other benign uterine or ovarian conditions, representing a challenge for preoperative diagnosis(AU)

Cobertura de MRS e indicación de terapia hormonal en Pedro Aguirre Cerda, septiembre de 2019 / MRS coverage and hormone replacement therapy indication at Pedro Aguirre Cerda, September 2019

Introducción: El envejecimiento de la población en todo el mundo es un fenómeno progresivo y Chile no se queda atrás frente a esto. Actualmente existe un subprograma de climaterio mujeres entre los 45 a 64 años, que presenta diversas acciones y propósitos. Objetivo: Describir la cobertura de la aplicación de la Menopause Rating Scale (MRS) e indicación de terapia de reemplazo hormonal en mujeres inscritas en los CESFAM de la comuna de Pedro Aguirre Cerda. Método: Descriptivo transversal. Resultados: La cobertura de aplicación de MRS en mujeres entre 45-64 años fue de un 62,6%. Un 34,3% de mujeres presentaron un puntaje MRS alterado, indicándose terapia hormonal en un 37,8% de los casos, en las indicaciones un 21,8% eran usuarias candidatas acorde a criterios médicos y un 78,2% no lo eran. Conclusiones: Se debe aumentar la cobertura de MRS y recursos para exámenes de laboratorio, de imágenes y capacitaciones, esto para mejorar la entrega de las prestaciones en el subprograma climaterio.

Introduction: The aging of the population worldwide is a progressive phenomenon and Chile is not lagging behind in this. Currently, there is a climacteric subprogram for women between 45 and 64 years of age, which has various actions and purposes. Objective: To describe the coverage of the application of the Menopause Rating Scale (MRS) and indication of hormone replacement therapy in women enrolled in the CESFAM of the commune of Pedro Aguirre Cerda. Method: Cross-sectional descriptive study. Results: The coverage of the MRS application in women between 45-64 years old was 62.6%. A 34.3% of women presented an altered MRS score, indicating hormone therapy in 37.8% of the cases, 21.8% of the indications were candidates according to medical criteria and 78.2% were not. Conclusions: There is a lack of labs and images tests in the climacteric controls, resulting in a mayor number of women no candidates to the hormonal therapy according to medical criteria.

A study on the symptoms, sleep quality and cognitive function of the women during menopause

Background: Menopause is the time that marks the end of your menstrual cycle. It is a natural biological process. But the physical symptoms, such as hot flashes, and emotional symptoms of menopause may disrupt your sleep, lower your energy or affect emotional health. The primary objective of the study was to evaluate the pattern of symptoms among women during menopause. The secondary objective was to assess the sleep quality and cognitive function of the women during menopause and to create awareness and educate rural women regarding menopause. Methods: A cross-sectional observational study was carried out in and around B. G. Nagar, Nagamangala, Mandya for 6 months. Results: A total of 504 women were enrolled in the study. Out of 504, 224 (44.4%) participants come under perimenopause, 117 (23.31%) participants come under perimenopause and 163 (33.34%) participants comes under post menopause. After filling out the questionnaire it was observed that there was a decline in cognitive function of postmenopausal women along with poor sleep quality. When the age group of the participants was compared with the different symptoms of menopause a significant relation was found between the age category of the participants and the somatic symptoms. A significant relation was found between the sexual activity and with the somatic symptoms (p=0.00**), psychological symptoms (p=0.00**) and urogenital symptoms (p=0.00**) of the participants. Conclusions: As women passes from premenopausal to perimenopause to post menopause menopausal symptoms were increased. The menopausal transition and postmenopausal years are associated with significant symptoms.

Tumor de células de la granulosa tipo juvenil tras la menopausia / Juvenile granulosa cell tumor in menopausal woman

Los tumores de células de la granulosa son tumoraciones ováricas infrecuentes. Hay dos tipos histológicos: adulto y juvenil. Los tumores de células de la granulosa juvenil representan el 5 %, y solamente un 3 % ocurre en mayores de 30 años. Ante la sospecha, el diagnóstico definitivo intraoperatorio es complejo dada su rareza y su fácil confusión con otras neoplasias ováricas. El patrón quístico con células de la granulosa inmaduras, con frecuentes mitosis, la ausencia de cuerpos de Call-Exner y el estudio inmunoquístico lo confirman. Su baja prevalencia dificulta su diagnóstico. El estadio de la enfermedad es el factor pronóstico más importante, y resulta imprescindible una completa resección. El papel de la terapia complementaria no está bien establecido, además los estudios disponibles solamente incluyen un número mínimo de casos, que no diferencian mujeres adultas. El adecuado seguimiento para la detección precoz de una posible recidiva tardía supone un reto clínico(AU)

Granulosa cell tumors are rare ovarian tumors. There are two histological types: adult and juvenile. Juvenile granulosa cell tumors account for 5%, with only 3% occurring in people over 30 years of age. Given the suspicion, the definitive intraoperative diagnosis is complex given its rarity and its easy confusion with other ovarian neoplasms. The cystic pattern with immature granulosa cells, with frequent mitosis, the absence of Call-Exner bodies and the immunocystic study confirm this. Its low prevalence makes it difficult to diagnose. The stage of the disease is the most important prognostic factor, and complete resection is essential. The role of complementary therapy is not well established, and the available studies include only a minimal number of cases, which do not differentiate between adult women. Adequate follow-up for the early detection of a possible late recurrence is a clinical challenge(AU)

Studies on Serum T3, T4, TSH, Progesterone and Oestrogen in Cardiovascular Disease Patients

Aim: This research was done to ascertain if thyroid hormones and female sex hormones (progesterone and estrogen) play a role or are a risk factor in the development of cardiovascular diseases. Study Design: This is an observational study, specifically a case-control study. Place and Duration of Study: This study was conducted at Enugu State University Teaching Hospital for six months. Methodology: Blood samples were collected from 20 persons with cardiovascular disease. The sera from the study subjects were estimated for T3, T4, and TSH using the ELISA technique. The same parameters were estimated in 20 healthy individuals, and the results from both groups were analysed using SPSS version 21. Results: There were no significant differences in serum T3, T4 and TSH, Progesterone and Estradiol (p=0.236, p=0.834, p=0.412, p=0.995 and p=0.512, respectively) in cardiovascular disease patients compared with controls. There were no significant differences in serum T3, Progesterone, Estradiol and TSH (p=0.443, p=0.291, p=0.612 and p=0.550, respectively) in male cardiovascular disease patients compared to female cardiovascular disease patients. There was a significantly higher level of T4 (p=0.042) in male cardiovascular disease patients compared to female cardiovascular disease patients. A significant negative correlation of serum TSH with T4 (r=-0.759, p=0.000) in cardiovascular disease patients. There was no significant correlation of serum TSH with T3 (r=-0.131, p=0.560) in cardiovascular disease patients. There was a significant positive correlation of Serum Progesterone with Estradiol (r=0.815, p=0.000) in cardiovascular disease patients. Conclusion: T4, T3, and TSH serum levels may not be associated with the development of cardiovascular diseases in this environment. Also, serum progesterone may have a linear association with estradiol in cardiovascular disease patients.

Association of periodontal health with physical and emotional well-being among pre and postmenopausal women in Bangalore: a cross sectional study

Background: Menopausal transition is frequently accompanied by physical, emotional as well as periodontal health changes in pre and postmenopausal women due to the decline in circulating blood oestrogen levels. Aim was to investigate the association of periodontal health with physical and emotional well-being among pre and postmenopausal women aged 35-65 years. Methods: A cross sectional study was conducted among 150 pre and 150 postmenopausal women in Bangalore urban district Women Health Questionnaire was used to assess physical and emotional well-being. WHO Oral Health Assessment form for adults 2013 along with plaque and gingival indexes were used to assess the periodontal health status. Descriptive, bivariate, multiple linear regression analysis were carried out. A p<0.05 was considered statistically significant. Results: The mean age among pre and postmenopausal women were 40.09�24 years and 55.42�7 (p<0.001). The mean scores of depression/anxiety mood; somatic symptoms; memory/concentration; vasomotor symptoms; sleep problem was significantly higher in postmenopausal compared to premenopausal group (p<0.001). The mean number of teeth with gingival bleeding (12.93�0 and 6.94�68); deep periodontal pocket (2.05�61 and 0.44�97) were higher in postmenopausal group in comparison to the other group respectively (p<0.001). Depression was significantly associated with periodontal health of women in both the groups. Conclusions: Women after menopause experienced more physical and emotional changes. Periodontal health status was found to be poor among postmenopausal women compared to premenopausal women.

Changes of the vaginal environment in genitourinary syndrome of menopause and progress on the use of mesenchymal stem cells as an intervention / 中华老年医学杂志

Due to decreased estrogen levels in patients with genitourinary syndrome of menopause(GSM), changes occur in the vaginal environment, including changes in vaginal tissue structure, the vaginal microbiota and vaginal mucosal immunity, resulting in a series of symptoms and signs.To develop effective treatment methods for GSM, it is necessary to fully understand potential molecular mechanisms underlying these changes.Mesenchymal stem cells(MSCs)can promote the regeneration of aging tissues, secrete growth factors, and have excellent immune regulation and anti-inflammatory capabilities.They are a powerful treatment option for reproductive aging.Therefore, it is essential to understand changes of the vaginal environment in GSM patients and progress on the use of MSCs as an intervention, in order to gain insight into research on the treatment of GSM.

Changes of fasting plasma glucose level before and after menopause: Research based on Kailuan health checkup cohort / 中华内分泌代谢杂志

Objective:To analyze the changes of fasting plasma glucose(FPG)level before and after menopause.Methods:Kailuan health checkup cohort was used to extract data of women aged≥18 years who participated in the first physical examination of Kailuan physical examination cohort and had menopausal age at the end of the seventh physical examination. A total of 3 749 women with 22 057 physical examination records were included in the analysis. Natural logarithmic transformation was applied to FPG, and a segmented linear mixed-effects model was used to analyze the changes in ln-transformed FPG before and after menopause. Additionally, an interaction analysis was performed to assess the multiplicative effect of baseline age and baseline body mass index(BMI)on ln-transformed FPG concerning pre- and post-menopausal periods.Results:The average age of the first physical examination for women in this study was (45.63±4.52)years, the median menopausal age was 51(50~53)years, and the median number of physical examinations was 6(5~7)times. The results of the piecewise linear mixed effect model showed that lnFPG increased from 1 year before menopause, with an average annual increase of 0.021 mmol/L, and continued to increase from menopause to 5 years after menopause, with an average annual increase of 0.007 mmol/L. LnFPG tended to be stable after 5 years of menopause. Baseline age could affect the changes of lnFPG before and after menopause, and there was a negative multiplicative interaction between baseline age ≥45 years and the time period from 6 years to 1 year before menopause( P=0.032). Women with baseline age ≥45 years had a higher average annual increase in lnFPG from 1 year before menopause to 5 years after menopause than women with baseline age <45 years( P<0.05). On lnFPG, there was a positive multiplicative interaction between baseline BMI and time segments around menopause. Compared to women with BMI <24.0 kg/m 2, obese women displayed more annual increase in lnFPG from 6 years to 1 year before menopause as well as from menopause to 5 years after menopause( P<0.05). Conclusions:Menopause has an adverse impact on FPG, with the most significant changes occurring within the period of one year before menopause and up to five years after menopause. Age and BMI significantly influence the changes in FPG before and after menopause.

Mechanism by which strength training improves bone injury in ovariectomized rats / 中国组织工程研究

BACKGROUND:Postmenopausal osteoporosis significantly increases the risk of fracture,which seriously affects the quality of life of patients.Exercise therapy is an important non-drug means and prevention and treatment strategy for patients with osteoporosis,in which strength training is the best mode,but its specific biological mechanism has not been determined. OBJECTIVE:To investigate the effects of strength training on bone morphology,materials and biomechanics in ovariectomized rats and to explore the mechanism of extracellular matrix remodeling. METHODS:Forty-eight female Sprague-Dawley rats were divided into sham operation group,sham operation exercise group,ovariectomized group and ovariectomized exercise group according to the random number table method.The menopausal animal model was established by bilateral ovariectomy in the ovariectomized group and ovariectomized exercise group,while sham operation was performed in the sham operation group and sham operation exercise group.Four weeks after operation,the sham operation exercise group and the ovariectomized exercise group underwent 12-week tail weight-bearing ladder training,and the sham operation group and the ovariectomized group were raised quietly in the cage.The bilateral femur and tibia were separated after training.The right tibia was used for dual-energy X-ray densitometry and biomechanical,biophysical and biochemical analyses,the left tibia was detected using micro-computed tomography for bone microstructural examination,the right femur was subjected to hematoxylin-eosin staining for histological observation,and the left femur was used for western blot and gelatin zymography detection of protein expression and enzyme activity of extracellular matrix metabolism-related factors,respectively. RESULTS AND CONCLUSION:Compared with the sham operation group,the maximal load and stiffness decreased(P＜0.05),bone density,bone mineral density,bone inorganic matter content,bone calcium content decreased(P＜0.05),bone water content increased(P＜0.05),trabecular bone volume fraction,trabecular connectivity density,and trabecular number decreased(P＜0.05),trabecular separation,structural model index increased(P＜0.05),bone adipocyte number and cross-sectional area increased(P＜0.05),matrix metalloproteinase-2 activity decreased(P＜0.05),and protein expression of tissue inhibitor of metalloproteinase-1 and osteoprotegerin increased(P＜0.05)in the ovariectomized group.Compared with the ovariectomized group,the maximal load,stiffness,fracture load and resilience increased(P＜0.05),bone mineral density,bone mineral content,bone mineral density,bone inorganic matter content,and bone calcium content increased(P＜0.05),bone water content decreased(P＜0.05),trabecular separation and bone marrow area decreased(P＜0.05),trabecular bone thickness,cortical bone volume fraction,cortical bone area fraction,cortical bone thickness,and cortical bone porosity increased(P＜0.05),bone adipocyte number and cross-sectional area reduced(P＜0.05),matrix metalloproteinase-2 activity increased(P＜0.05),and protein expression of tissue inhibitor of metalloproteinase-1,Runt-related transcription factor 2 and osteoprotegerin decreased(P＜0.05)in the ovariectomized exercise group.To conclude,strength training can protect against bone injury caused by estrogen deficiency,which is characterized by improvement of bone biomechanical properties,bone tissue composition and bone microstructure,and its mechanism is related to the regulation of extracellular matrix remodeling.

The effect of music on menopausal symptoms, sleep quality,and depression: a randomized controlled trial

SUMMARY OBJECTIVE: This study aimed to determine the effect of music on menopausal symptoms, sleep quality, and depression levels in menopausal women. METHODS: This randomized controlled study was carried out between August and December 2022. The study sample consisted of 61 menopausal women (intervention: 30 and control: 31). The intervention group listened to music twice a day for 5 weeks, with a total of 70 sessions. The control group received only routine care. Menopause symptoms, depression levels, and sleep quality were evaluated at the beginning and the end of the study using the Menopausal Symptoms Rating Scale, Beck Depression Inventory, and Pittsburg Sleep Quality Index. RESULTS: The post-test Menopausal Symptoms Rating Scale, Beck Depression Inventory, and Pittsburg Sleep Quality Index scores of the menopausal women were found to be lower in the intervention group than in the control group (p=0.011, p=0.001, and p=0.006, respectively). When the pre-test and post-test mean scores were compared, the mean menopausal symptoms and depression levels decreased, and sleep quality increased significantly in the intervention group. No significant difference was observed in the control group. CONCLUSION: This study shows that music may have an effect on reducing the level of menopausal symptoms and depression levels and also increasing the sleep quality of menopausal women.

Laser therapy for genitourinary syndrome of menopause: systematic review and meta-analysis of randomized controlled trial

Abstract Objective: This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM). Data sources: Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction. Studies selection: RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy. Data collection: Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author. Data synthesis: Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=−0.85; 95% CI=−1.59 to −0.10), dryness (MD=−0.62; 95% CI=−1.12 to −0.12) and burning (MD= −0.64; 95% CI=−1.28 to −0.01) decreased. No serious adverse effects were reported. Conclusion: CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.

Terapia hormonal en la menopausia vía transdérmica: un asunto de eficacia y seguridad

Los síntomas vasomotores (SVM) asociados a la menopausia suelen disminuir la calidad de vida de las mujeres, al generar un elocuente malestar. La terapia hormonal de la menopausia (THM) es el estándar en el tratamiento de los síntomas de la menopausia, siendo el único tratamiento que ha demostrado ser eficaz para los SVM. Objetivo: describir la eficacia y seguridad de la terapia hormonal de la menopausia vía transdérmica (THM TD) para aliviar los síntomas de la menopausia. Métodos: se hizo una revisión sistemática de la literatura en diferentes bases de datos electrónicas (CINAHL Plus, EMBASE, Scopus, Lilacs, Medline, Pubmed, entre otras), a través de términos de búsqueda estandarizados. Los desenlaces evaluados incluyeron los estudios donde se publicó cualquier tratamiento o intervención con la THM TD en mujeres tratadas por síntomas de la menopausia, porcentajes de alivio de los síntomas climatéricos y proporción de eventos adversos asociados. Resultados: se incluyeron 45 publicaciones, y convienen en aconsejar el tratamiento con la THM TD, en vista de un alivio de los síntomas climatéricos cerca del 90%, asimismo de ser más segura y potencialmente más eficaz que la terapia oral; con resultados normales en la evaluación mamográfica, y sin eventos adversos relacionados después de 5 años de seguimiento. Conclusiones: la terapia hormonal en la menopausia vía transdérmica es segura y eficaz para aliviar los síntomas de la menopausia. Al evitarse el metabolismo hepático, alcanza mejores beneficios clínicos, a la vez que minimiza la exposición de eventos adversos. Las publicaciones revisadas demuestran que la vía transdérmica es la mejor forma de tratar los síntomas de la menopausia.

Vasomotor symptoms (VMS) associated with menopause usually reduce the quality of life of women, generating eloquent discomfort. Menopausal hormone therapy (MHT) is the standard in the treatment of menopausal symptoms, being the only treatment that has been shown to be effective for VMS. Objective: to describe the efficacy and safety of transdermal menopausal hormone therapy (THM TD) to relieve menopausal symptoms. Methods: a systematic review of the literature was carried out in different electronic databases (CINAHL Plus, EMBASE, Scopus, Lilacs, Medline, Pubmed, among others), through standardized search terms. The outcomes evaluated included studies where any treatment or intervention with TD MHT was published in women treated for menopausal symptoms, percentages of relief of climacteric symptoms and proportion of associated adverse events. Results: 45 publications were included, and they agree in advising treatment with MHT TD, in view of a relief of climacteric symptoms close to 90%, as well as being safer and potentially more effective than oral therapy; with normal results in mammographic evaluation, and without related adverse events after 5 years of follow-up. Conclusions: transdermal hormonal therapy in menopause is safe and effective in relieving menopause symptoms. By avoiding hepatic metabolism, it achieves better clinical benefits, while minimizing the exposure to adverse events. The reviewed publications demonstrate that the transdermal route is the best way to treat menopause symptoms.

Can cognitive behavioral therapy improve vasomotor symptoms and recurrent depression in postmenopausal women?

SUMMARY OBJECTIVE: The aim of this study was to evaluate the effectiveness of cognitive behavioral therapy in the treatment of vasomotor, sexual dysfunction, and recurrent depression in postmenopausal women. METHODS: This prospective, open study evaluated 112 postmenopausal women with vasomotor symptoms. Sexual dysfunction has cultural, social, biological, and emotional issues and divided into two groups: G1, without depression (n=65) and G2, with recurrent depression (n=47). The subjects underwent 12 sessions of in-person cognitive behavioral therapy and 12 sessions of home-based activity over a period of 6 months. They were evaluated at 3 months following the completion of therapy. Depression, memory, and attention-related functions, as well as climactic symptoms, were assessed using a questionnaire. RESULTS: In the depression questionnaire, the G1 group had a lower initial score than the G2 group (p<0.01). Following 6 months of therapy, both groups had similar improved scores. In the depression questionnaire, the women in group G1 had higher baseline values. In the assessment of vasomotor symptoms, the values in both groups were similar and showed an improvement in vasomotor symptoms after 24 weeks of treatment, but these effects disappeared after the follow-up of 48 weeks in the G2 group. Both groups improved the sexual dysfunction after 24 weeks. CONCLUSION: Cognitive behavioral therapy may be effective in reducing vasomotor symptoms and ameliorate the sexual dysfunction and recurrent depression in postmenopausal women after 24 weeks of treatment.

Validation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women

Abstract Objective This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause. Methods In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment. Results The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach's alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001). Conclusion This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.

Effect of Dioscorea villosa extract and the phytoestrogen diosgenin on ovariectomized mice with zymosan-induced arthritis

Abstract Humans are exposed to natural compounds such as phytoestrogens primarily through diet and supplements. These compounds promote health by alleviating the symptoms and illnesses associated with menopause and arthritis. Diosgenin (DSG) occurs naturally in plants such as Dioscorea villosa (DV) and binds to estrogen receptors, so it may have similar effects to this hormone, including against arthritis. Thus, we investigated the effect of chronic treatment with dry extract of DV and its phytoestrogen DSG on ovariectomized mice with arthritis. We found that dry extract of Dioscorea villosa (DV) contains the phytoestrogen diosgenin (DSG) in its composition. Furthermore, arthritic mice treated with DV and DSG showed reduced neutrophil accumulation in the articular cartilage. Also, the dry extract of DV administered orally (v.o) did not alter the leukocyte count in the joints or promote changes in the reproductive tract. However, DSG altered these parameters, with possible beneficial effects by reducing symptoms related to reproductive aging. Thus, oral treatment with dry extract of DV and subcutaneous (s.c) treatment with DSG showed promise by acting against inflammation caused by arthritis and reducing symptoms in the reproductive tract due to menopause.