Symptomatic changes in postmenopause with different methods of hormonal therapy

Objective: The diversity of opinions on the adverse effects of medications used to treat postmenopausal symptoms has prompted the use of various routes and mechanisms of action that need to be explored because bioavailability of the medications can vary. In order to select the appropriate route of administration for hormonal therapy (HT), it is necessary to determine baseline therapeutic efficacy. Design: We designed a prospective, randomized study consisting of four groups of postmenopausal wo-men: group 1 received oral conjugated estrogens, group 2 received a synthethic steroid, group 3 received estradiol nasally in spray form, and group 4 used transdermal estradiol in the form of patches. Criteria used to evaluate effectiveness was the Greene scale, which evaluate six components. These criteria were applied to each patient before hormonal intervention and then each month for 6 months. Luteinizing hormone (LH), follicle stimulating horone (FSH) and estradiol concentration were determined by chemiluminescence. Student’s t-test was used for intra-group comparisons before and after treatment. Results: There was a significant decrease in the vasomotor and sexual component (p < 0.05) with the use of four HT types. For depression, a difference was observed with synthetic steroids and oral estrogens. Upon analyzing the somatic component there was a decrease in symptoms with nasal and transdermal routes. Psychological changes were observed with the use of oral synthethic steroids and transdermal patches. Anxiety component demonstrated differences with nasal spray and oral estrogens, although all HT forms in this component showed a pattern of irregular changes. Conclusions: Changes in the response could be due each route of administration and medication used. Absorption variability may exist, which has repercussions in the control of symptoms and should be taken into consideration when selecting the appropriate route of administration for patients beginning HT.

Calcium-fortified fresh milk ameliorates postmenopausal osteoporosis via regulation of bone metabolism and gut microbiota in ovariectomized rats

The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.

Menopausal Symptoms and Sleep Quality During Menopausal Transition and Postmenopause

Background： Menopausal symptoms and sleep difficulty were physiological processes that were affected by genetic and other factors. This study was to investigate the prevalence of menopausal symptoms and sleep quality in menopausal transition （MT） and postmenopause （PM） women in Taiyuan, Shanxi. Methods： A community-based survey of women＇s menopausal symptoms and sleep quality was conducted between July 2012 and May 2013 at six municipal districts of Taiyuan, Shanxi. A sample of 2429 women aged 40-59 years was divided into four groups： early MT, late MT, early PM, and late PM. Sleep quality in the past 2 weeks before the interview was recorded. The data were analyzed using SPSS 16.0. Results： The prevalence of menopausal symptoms was 49.8%. Mild, moderate, and severe symptoms were observed in 28.9%, 18.5%, and 2.5% of participants, respectively. The highest prevalence of menopausal symptoms occurred in the early postmenopausal stage; the subsequences were the late postmenopausal stage and the early MT stage. Interestingly, among the 13 items of modified Kupperman index, the five most common symptoms were fatigue, arthralgia and myalgia, decreased libido, insomnia, and nervousness. Meanwhile, 55% perimenopausal women had poor sleep. Conclusions： Menopausal symptoms are common but mild among women in Taiyuan, Shanxi during MT and PM. In these stages, the prevalence of poor sleep is high.

Pleomorphic rhabdomyosarcoma of the vagina: A case report

BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.

Adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

Study on the Correlation between Adiponectin and Bone Mineral Density in Postmenopausal Women from Guangxi Zhuang Autonomous Region

Objectives: To explore the relationship between adiponectin (APN) and bone mineral density in this Zhuang ethnic group, thus providing a basis underpinning the prevention and treatment of osteoporosis (OP). Methods: Zhuang women over 50 years old in Guangxi Zhuang Autonomous Region were included in the study. The broadband ultrasound attenuation (BUA) was adopted as the reference to calculate the T value. Quantitative ultrasonic bone density was measured on the right. Body composition measuring instrument was used to measure weight, fat, and muscle mass. Plasma APN level was detected by ELISA and blood lipids were detected by enzymatic method. Results: Plasma APN level was found with significant differences in the normal bone mineral density group, bone mineral density reduction group, and osteoporosis group (P β = −0.176, P = 0.001) when the partial correlation coefficient of APN is −0.210. Elevated APN was an independent risk factor for bone mineral density reduction (OR = 1.191, 95%CI: 1.004 - 1.407, P = 0.04) and OP (OR = 1.1337, 95%CI: 1.137 - 1.572, P Conclusion: Increased APN in postmenopausal women of Zhuang is an independent risk factor for OP. The application of APN in the OP screening and prevention of middle-aged and ageing Zhuang women still needs further research.

Clinical Observation on the Treatment of Pre and Postmenopausal Syndromes by Modified Wumei Decoction

Objective:To compare the efficacy of Wumei Decoction in pre and postmenopausal patients and its effect on follicle-stimulating hormone(FSH)and estradiol(E2).Methods:Sixty-four patients who attended the Department of Traditional Chinese Medicine I in Cangzhou City Central Hospital from January 2020 to January 2022 were selected and randomly divided into treatment group and control group,32 cases in each group.The treatment group took modified Wumei Decoction orally,1 dose of water boiled 2 times a day,divided into 2 warm doses;the control group took Livial orally,2.5 mg/times,1 time/day,and the observation cycles were all for 3 months.Kupperman score,FSH,E2,clinical symptoms and clinical efficacy were compared between the two groups before and after treatment.Results:The Kupperman score of the two groups decreased after treatment,and the difference was statistically significant;the total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant;there was no statistical significance in the comparison of FSH before and after the treatment of the two groups,but the FSH values of the two groups were significantly lower than those before,and the difference was statistically significant;there was no statistically significant difference in the comparison of E2 of the two groups before treatment,and the E2 values of the two groups were higher than those of the control group after the treatment.After the treatment,E2 of the two groups of patients was significantly higher than before,and the difference was statistically significant.After treatment,E2 of the treatment group was higher than that of the control group,and the comparison between the groups was statistically significant.Conclusion:There was no significant difference between modified Wumei Decoction and Livial in lowering follicle-stimulating hormone levels;modified Wumei Decoction was superior in raising oestradiol;and modified Wumei Decoction was relatively effective in improving clinical symptoms.

Primary ovarian choriocarcinoma occurring in a postmenopausal woman:A case report

BACKGROUND Nongestational ovarian choriocarcinoma(NGOC)is a rare but aggressive neoplasm with limited sensitivity to chemotherapy and a very poor prognosis.Few cases of NGOC have been reported,and there is limited information regarding its clinical features,treatment protocols,or prognosis.CASE SUMMARY A postmenopausal woman in her 5th decade of life visited our clinic because of abnormal vaginal bleeding and an abdominal mass.Although she had been menopausal for more than eight years and her last abortion occurred nine years ago,she had an increased level of serumβ-human chorionic gonadotropin(β-hCG).Thus,an ovarian neoplasm of trophoblastic origin was suspected,and exploratory laparotomy was performed.Based on the patient’s clinical history and the histopathological examination and immunohistochemistry results obtained postoperatively,we concluded that she most likely had primary NGOC.Cytoreductive surgery was performed in combination with adjuvant chemotherapy comprising bleomycin,etoposide,and cisplatin.Serumβ-hCG levels decreased to normal after two cycles,and there was no evidence of recurrence after four cycles of chemotherapy.CONCLUSION Even in postmenopausal women,ovarian choriocarcinoma should be considered in the initial differential diagnosis for an adnexal mass.

Erxian decoction potentially prevents postmenopausal osteoporosis by modulating miR-335: a study based on bioinformatics analysis and preliminary clinical case validation

Background:miRNAs are closely related to bone metabolism.Studies have shown that Erxian decoction can improve bone metabolism,possibly achieving this regulatory effect through miRNA targets.Netinfer was used to predict the miRNA targets of Erxian decoction for the treatment of postmenopausal osteoporosis,and the results were validated by clinical trials.Methods:In this study,we identified possible targets of Erxian decoction in osteoporosis by means of network pharmacological analysis and bioinformatic prediction.Fifteen cases of postmenopausal osteoporosis with kidney Yin and Yang deficiency(In traditional Chinese medicine,kidney Yin nourishes and moistens the tissues of the internal organs of the body,while kidney Yang promotes and warms the tissues of the internal organs of the body.)were treated with Erxian decoction for four weeks,and serum bone metabolism indices(P1NP,osteocalcin,andβ-CTX)and miRNA-335-5p expression were measured before and after treatment.Results:The constructed miRNA postmenopausal osteoporosis related gene network of the effective compound of the Erxian decoction has 296 points and 981 edges.The 39 postmenopausal osteoporosis related genes regulated by miRNA-335-5p were enriched in ossification,while the signaling pathways were enriched in rheumatoid arthritis,the Toll signaling pathway,the HIF-1 signaling pathway,and the MAPK signaling pathway.After taking Erxian decoction,the expression of the serum bone formation index(P1NP,osteocalcin)and miRNA-335-5p gene expression levels increased significantly.The alterations in P1NP and osteocalcin were correlated with the changes in miRNA-335-5p.Conclusion:Circulating miRNA-335-5p may serve as an important target of Erxian decoction in the treatment of postmenopausal women.The effect of Erxian decoction on bone formation is significant,but the underlying mechanism requires further investigation.

Observation on Therapeutic Effect of Erxian Decoction on Relieving Low Back Pain after PVP of PMOP-derived Vertebral Fracture

[Objectives]To explore the clinical effect of Erxian decoction on relieving low back pain after percutaneous vertebroplasty(PVP)of vertebral compression fracture caused by postmenopausal osteoporosis(PMOP).[Methods]Ninety patients who were treated in Suzhou TCM Hospital from September 2021 to January 2023 were randomly divided into three groups:traditional Chinese medicine group(n=30),western medicine group(n=30)and blank group(n=30).The patients in all the three groups were treated with basic anti-osteoporosis drugs.The patients in the traditional Chinese medicine group were treated with Erxian decoction after PVP,and those in the western medicine group were treated with celecoxib to relieve pain after operation.The visual analogue(VAS)score,Oswestry dysfunction index(ODI)score,TCM syndrome score and serum indexes such as interleukin-6(IL-6)and estrogen E2 were recorded before treatment and 2 weeks,1 month and 3 months after treatment.[Results](i)In terms of pain relief,the VAS score of the western medicine group was lower than that of the traditional Chinese medicine group after 2 weeks of treatment,but there was no significant difference in VAS score between the two groups after 1 month and 3 months,and the pain improvement of the two groups was better than that of the blank group.(ii)After 3 months of treatment,the ODI score in the traditional Chinese medicine group was lower than that in the western medicine group,and the improvement of TCM syndrome in the traditional Chinese medicine group was better than that in the other two groups 1 and 3 months after treatment(P<0.05).(iii)The level of IL-6 in the western medicine group was lower than that in the other groups after 2 weeks,and there was no significant difference between the two groups after 3 months of treatment.After 3 months of treatment,the level of E2 in the traditional Chinese medicine group was higher than that before treatment and higher than that in the western medicine group and the blank group,but there was no significant difference between the two groups(P>0.05).[Conclusions]Both Erxian decoction and non-steroidal anti-inflammatory drugs can relieve residual low back pain after PVP,and their long-term effects are similar,but Erxian decoction has more advantages in alleviating pain,muscle and joint pain and sensory abnormalities in postmenopausal women.Moreover,it is safe and reliable,and is worthy of clinical application.

Postmenopausal Osteoporosis and Osteopenia Management with a Combination of Once-Monthly Oral Ibandronate and Cholecalciferol—A Systematic Review

Postmenopausal osteoporosis and osteopenia are chronic and uncurable conditions that invariably lead to an increased risk of vertebral, hip, and femoral neck fracture if left untreated. Clinical guidelines establish, in general, pharmacological combinations allied to lifestyle changes as the mainstay of their management, and also increasing bone marrow density, lowering fracture risk, and improving quality of life are their main therapeutic goals. The objective of this systematic review was to analyze the available data in the scientific medical literature regarding the role of the ibandronate and cholecalciferol combination in postmenopausal osteoporosis and osteopenia management. Based on our results, we concluded that the above combination is safe and feasible for the clinical control of both conditions.

Body Composition, Gynecologic-Obstetric Variables, and Prolactin Levels in Patients with Breast Cancer

Objective: The aim of this study was to determine body composition, gynecological, and obstetric data, sex hormones, and prolactin serum levels in pre- (PREW) and postmenopausal women (PMW) with breast cancer (BC) and compare them with a control group (CG) of healthy women. Methodology: BC patients without treatment or use of hormone replacement therapy, or hormonal birth control, and without data of metastasis were included. CG was matched for age, BMI, and menstrual cycle status. FSH, LH, E2, progesterone, testosterone, and prolactin (PRL) were measured using radioimmunoassay kits. Comparisons between BC and CG were made with “t” tests, and with the Mann-Whitney U-test;χ2 test was used to compare the qualitative variables between the groups. Results: Seventy-two patients with BC, and 74 CG women were evaluated. Both groups presented overweight data, BMI (kg/mt2) = 27.21 ± 5.51 vs. 28.40 ± 4.66, p = ns, for BC patients and CG, respectively. In PREW, the age at menarche was later in BC patients compared to the CG (13.3 ± 1.36 years vs. 12.41 ± 1.27 years, p = 0.005). The PMW with BC presented a higher age at menarche and menopause compared to the women of the CG (13.51 ± 1.48 vs. 12.91 ± 1.41, p = 0.09, and 49.03 ± 2.86 vs. 45.5 ± 8.78, p = 0.03, respectively). PRL levels were significantly higher in PMW with BC, in comparison with the CG;median and minimum and maximum values (min-max) were: 14.7 ng/mL (3.6 - 52.7) vs. 5.9 ng/mL (1.9 - 33.3), p = 0.005). A higher percentage of PMW with BC (26.0% vs. 7.1%, χ2 = 5.57, p = 0.01) presented hyperprolactinemia (PRL serum levels > 20 ng/mL), compared to the GC. Conclusions: The higher levels of PRL in PMW with BC compared with CG, suggest a proliferative effect of this hormone in the affected breast tissue. This study demonstrates the need to use biological markers such as PRL to determine the risk of BC in PMW.

Effect of aerobic exercise on insulin resistance and centra1 adiposity disappeared after the discontinuation of intervention in overweight women

目的:本研究旨在分析有氧运动干预停止后,运动对超重/肥胖女性腹部脂肪含量和胰岛素抵抗(HOMA-IR)的作用是否消失。方法:研究对象来自2项相似的独立有氧运动干预研究。研究Ⅰ中,15名绝经后并患有糖尿病的超重,肥胖女性(BMI=24-33 kg/m^2,年龄52-65岁)完成为期8个月的有氧运动干预,并在干预停止后2年随访。研究Ⅱ中,12名绝经前的超重/肥胖妇女(BMI=25-35 kg/m^2,年龄30-50岁)接受为期6周的有氧运动干预,并在干预停止后4年随访。运动方案中,运动强度为60%-75%最大摄氧量、每次30-60 min,每周3-5次运动。通过双能X线(DXA Prodigy;研究1)或生物电阻抗(Inbody 720;研究Ⅱ)测定脂肪含量。用化学荧光免疫法测定血浆葡萄糖和胰岛素水平,算出胰岛素抵抗水平(HOMA-IR)。结果:8个月和6周中等强度有氧运动干预均能有效降低HOMA-IR(-18.9%,p=0.012;-26.7%,p=0.046),8个月的有氧运动干预使上腹部脂肪含量降低(-6.2%,p=0.021),但这些作用在干预停止后的随访中均消失。结论:有氧运动干预能有效降低超重/肥胖女性的腹部脂肪含量和胰岛素抵抗水平。但无论短期还是长期有氧运动,在干预停止后其产生的益处都消退。因此,为获得长期益处,有必要维持长期有氧运动。

Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium

BACKGROUND Postmenopausal bleeding and an endometrial thickness≥5 mm on sonograms of menopausal women can indicate the presence of endometrial lesions.Diagnostic hysteroscopy is a powerful method for endometrial diseases.AIM To investigate the pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or asymptomatic thickened endometrium diagnosed by hysteroscopy.METHODS A total of 187 postmenopausal women with bleeding or asymptomatic thickened endometrium underwent diagnostic hysteroscopy.The women were subsequently divided into three groups:Postmenopausal bleeding(PMB)group(n=84),asymptomatic group(n=94),and additional group(n=9).Women in the additional group manifested abdominal pain and leukorrhagia.RESULTS Among the 187 patients examined,84(44.9%)were diagnosed with PMB and 94(50.3%)with asymptomatic thickened endometrium.Endometrial polyp was the most common endometrial abnormality,which was detected in 51.2%,76.6%and 77.8%of the PMB,asymptomatic,and additional groups,respectively.In the PMB group,7(8.3%)women had hyperplasia with atypia and 14(16.7%)had endometrial adenocarcinoma.Fewer malignant lesions were detected in the asymptomatic group.Endometrial hyperplasia without atypia was found in 8.3%of the PMB group and 7.4%of the asymptomatic group.CONCLUSION Endometrial polyp was the most common pathology in the PMB group.Diagnostic hysteroscopy is recommended for women with PMB and asymptomatic thickened endometrium.

POSTMENOPAUSAL PALPABLE OVARY SYMDROME:A RETROSPECTIVE SURVEY

Objective: A retrospective study of the postmenopausal palpable ovary (PMPO) on their incidence, characteristics of masses and treatment selected were carried out. Methods: 97 postmenopausal women over age 50 with ovarian masses diagnosed by the manual pelvic palpation were analyzed. The age, size and characteristics of tumor, symptoms, as well as pathological findings and treatment were discussed. Results: 86.6% of cases had tumor masses, and 13.4% were physiological in nature. 23.7% of the masses were malignant. 72 patients (74.2%) visited doctors because of existing symptoms. Among them 82.5% cases had the masses discovered by manual pelvic examination, and 91.3% found by abdominal ultrasound screening. Transvaginal sonography can diagnose all the palpable masses. Conclusion: All PMPO patients should be operated as soon as diagnosis is established.

Impact of physical activity on health-related quality of life in osteoporotic and osteopenic postmenopausal women:A systematic review

Objective:This meta-analysis included papers which evaluated the effects of physical activity on the health-related quality of life(HRQoL)of osteoporotic and osteopenic postmenopausal women.Methods:Four English databases were searched for relevant randomized clinical trials(RTCs)published from 1970 to June,2014.Eligible RCTs which used the Quality of Life Questionnaire of the European Foundation for Osteoporosis(QUALEFFO)as their outcome measure were selected for inclusion.Results:Five RCTs were included in the final meta-analysis.The results showed that physical activity produced favorable effects in the HRQoL domains of physical function(p=0.001)and pain(p=0.01),but not in other domains.Compared with a single exercise,combined exercise produced more favorable effects on both physical function(p=0.0004)and pain(p=0.02).Short-term physical activity produced significant favorable results in all general health domains of HRQoL(p=0.01),whereas middle-term physical activity produced significant improvements only in the physical function(p<0.01)domains of HRQoL.Long-term physical activity produced significant improvement only in the pain domains of HRQoL(p<0.01),and only in the physical activity group when compared with a control group.Conclusion:Only weak evidence supports the notion that physical activity effectively improves the health-related quality of life of osteoporotic and osteopenic postmenopausal women.Compared with a single exercise,combined exercise produced favorable effects on both physical function and pain.However,different lengths of exercise produced improvements in different domains.

A New Supplement for the Treatment of Metabolic Syndrome in Postmenopausal Women

Background: Metabolic Syndrome (MS) is considered a cluster of metabolic abnormalities whose pathogenesis is principally attributable to insulin resistance. Lack of estrogens occurs in postmenopausal women and worsening insulin resistance and lipid profile, predispose to MS. The aim of the study was to show whether a new supplement containing cinnamon, corosolic acid and glycyrrhizic acid may counteract MS manifestations. Methods: A total of 60 postmenopausal women were enrolled in a randomized, controlled trial;the active treatment group was taking the new supplement for 3 months and was on a hypocaloric diet, control group was only on diet. At the beginning and after 3 months, metabolic variables were evaluated. Results: After 3 months, a significant difference in the treated group was observed for glucose, HOMA, total cholesterol and HDL-cholesterol;whereas, in the control group, a significant difference was shown only for glucose. After 3 months, a significant difference between groups was highlighted only for HDL-cholesterol. Conclusion: This study has shown the naturally occurring components of this new supplement may improve insulin resistance and lipid profile in a small sample of postmenopausal women.

Changing pattern of thyroid and adrenal function in postmenopausal women after hormone replacement therapy

Objective:To investigate the changing pattern of thyroid and adrenal function in postmenopa-usal women;and the relationship between hormone replacement therapy(HRT)and thyroid andadrenal function.Methods:The levels of tT_3,tT_4,fT_3,fT4,TSH and cortisol were measured in 60 postmeno-pausal women(30 cases in HRT group;30 cases in control group)before and 12 months afterHRT.Results:The serum levels of tT_3,tT_4,fT_3,fT_4,TSH and cortisol had no significant differ-ence before and 12 months after HRT in postmenopausal women.The values of them were all innormal ranges.Conclusion:Changing pattern of thyroid and adrenal function was not as significant as that ofgonads in postmenopausal women and the impact of HRT on it was not so significantly evident.

Does Surgery Benefit Postmenopausal Overweight Women with Pelvic Floor Dysfunction?

Introduction: Pelvic floor muscle function of 30 overweight postmenopausal women prior to and after colporrhahpy was monitored in this study. Material and Methods: Patients diagnosed with cystokele or combined cystorectokele was involved. 1 mg oral estriol and local estriol cream were administered for 30 days preoperatively. Pelvic floor muscle function was monitored by surface electromyography 1 month before (1st) 1 day prior to surgery (2nd), and six weeks after the surgery (3rd measurement). Body composition parameters (intra- and extracellular water and body fat) were also measured. Results: The ability to relax significantly improved (p = 0.03) in the preoperative period (between 1st and 2nd occasions). Six weeks after surgery a non-significant (p = 0.054) decrease in average muscle activity was detected when compared with values obtained before the surgery. Muscle-activity declined significantly from the first to the last measurements (p = 0.005). Conclusion: Our results confirm that postmenopausal obese women who undergo anterior or posterior colporrhaphy need a follow-up concerning pelvic floor muscle function and suggest that physiotherapy started the earliest possible may aid in preserving postoperative functionality on the long run.

Insulin-Like Growth Factor-1 and Osteocalcin Are Correlated with Markers of Osteoporosis in Postmenopausal Women with Type-2 Diabetes

Objective: The study was conducted to evaluate the relation between insulin-like growth factor-1 and osteocalcin and markers of bone modulation (osteoprotegerin;OPG, receptor activator nuclear kappa B;RANK and RANK ligand;RANKL) in postmenopausal Type 2 diabetic women with and without osteoporosis. Methods: The study was conducted on 90 female divided into three groups (30 each). Group I included healthy postmenopausal women as a control, Group II included diabetic postmenopausal women without osteoporosis Group III included diabetic postmenopausal women with osteoporosis. Fasting blood samples were obtained for the determination of blood glucose, HbA1c, total and ionized calcium, OPG, RANK and RANKL. Also the levels of IGF-1 and osteocalcin were assessed. Results: In postmenopausal Type 2 diabetic women, the osteoporosis resulted in derangement in OPG/sRANKL system. The serum level of OPG was elevated while sRANKL declines in osteoporotic postmenopausal Type 2 diabetic women. IGF-1 level decreased in diabetic postmenopausal women but those women with osteoporosis showed a great decline by about 60%. IGF-1 level in osteoporotic diabetic postmenopausal women was correlated with BMD and most bone turnover markers (OPG, sRANKL, OPG/sRANKL). Osteocalcin declined significantly only in those women with osteoporosis not without osteoporosis. Conclusions: The circulating levels of OPG and sRANKL were not useful markers for bone status in postmenopausal women while the circulating levels of IGF-1 and osteocalcin might give useful information about bone status in postmenopausal diabetic women.