Advances in the Pathogenesis of Perimenopausal Syndrome

Perimenopause syndrome refers to the syndrome of the disorders of multiple systems of women around menopause caused by the reduction in secreted estrogen and is also known as menopause syndrome.Its pathogenesis involves increasing age,the abatement of ovarian function,and psychological change caused by the increasing life pressure.The above factors lead to physical and mental changes in postmenopausal women.This paper summarizes the pathogenesis of perimenopause from the perspective of gene studies and existing experimental studies and provide some ideas for clinical treatment and research.

The Role of Cosmetic Gynecology Treatments in Women in Perimenopausal Period

The conditions in which we live nowadays contribute to exposure of our bodies to harmful factors such as UV radiation, pollution, smoking, poor eating habits, low physical activity, stress, which thereafter lead to the acceleration of skin aging process. In women, the process is additionally dependent on the menopause, as a result of the disappearance of hormones, the process is faster. Physiological changes that occur in women’s body during perimenopausal and menopausal period affect their sexual function: pain during an intercourse, decreased libido, lack of agitation. Deficiency of hormones, besides skin changes, leads to vaginal dryness, accompanied by inflammation, often correlated with discharge and burning. As a result of the loss of hyaluronic acid labia become slack and less moisturized. In addition, there has been observed: a gradual loss of pigment and hair, involution of the clitoris, and involution and sticking of labia minora, lipoatrophy of labia majora with subsequent reduction in their volume and thinning the lining around the vaginal opening. This article presents processes of skin aging. It describes mechanisms of intrinsic and extrinsic aging. It also presents the mechanisms of accelerated aging in women in perimenopausal period—accelerated skin aging dependent on hormonal factors associated with the loss of ovarian function. The research presents how the hormonal loss influences woman’s body, her genitals—its functionality and aesthetic look. It also shows how using filler treatments in gynecology can restore the aesthetic appearance of female genital and improve their functionality.

Chief Physician Defen Wang’s Clinical Experience in Dialectical Treatment with Mediation Method of Perimenopausal Sweating

The objective of this paper is to outline Chief Physician Defen Wang’s clinical experience in perimenopausal sweating syndrome differentiation and treatment,to inherit Mr.Gao’s academic concept of mediation technique,and to integrate multiple prescriptions under Mr.Gao’s thinking.The deficiency is based on the deficiency of liver and kidney Yin,the weakness of spleen and stomach,and the standard is the imbalance of Ying and Wei,the imbalance of Qi,blood and body fluid,and the main method of treatment is nourishing liver and kidney,soothing liver and invigorating spleen,regulating Ying and Wei,as well as tonifying Qi and absorbing fluid.

Analysis on the outcomes in randomized controlled trials of perimenopausal syndrome treated with acupuncture and moxibustion

Objective:To search systematically the application situation of the outcomes in the randomized controlled trials(RCTs) of perimenopausal syndrome treated with acupuncture and moxibustion so as to provide the foundation for the core outcome sets in treatment of periomenopausal syndrome with acupuncture and moxibustion.Methods:The articles of RTCs on perimenopausal syndrome treated with acupuncture and moxibustion were searched in China National knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),VIP Chinese Journal Service Platform(VIP),Pubmed,Excerpt medica database(Embase)and Cochrane central register of controlled trials(CENTRAL) databases from January 1,2010 to December31,2020.Two reviewers screened the articles,extracted data and analyzed the application of outcomes in the eligible trials independently.Results:A total of 9391 articles were retrieved initially and 79 articles of them were eligible,including 43 articles in English and 36 articles in Chinese.115 outcomes were involved totally and collected according to 7 outcome domains,of which,the effective rate was the outcome with the highest use frequency.35 articles reported adverse events and 17 articles reported the effect in followup.Conclusion:At present,the outcomes of RCTs on perimenopausal syndrome in treatment with acupuncture and moxibustion are big in divergence,absent in normalization and lack of indicators for long-term prognosis and economics outcomes,as well as have the issues on the incomplete reports on the differentiation between the primary and the secondary outcomes,safety indicators and followup outcomes.It needs to construct the core outcome sets in line with the characteristics of acupuncture-moxibustion discipline so as to improve the quality of clinical trials of acupuncture and moxibustion.

针刺对围绝经期失眠患者内分泌轴的影响:病例系列研究

ObjectiveTo explore the clinical efficacy of acupuncture in perimenopausal insomnia and its impact on the hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-ovarian (HPO) axis.MethodsAcupuncture was performed on 42 patients with perimenopausal insomnia in the prone position. Acupoints included Băihuì (百会BL20), Sìshéncōng (四神聪EX-HN1), Fēngfŭ (风府GV16), Ānmián (安眠EX-HN18), Shéndào (神道GV11), Gānshū(肝俞BL18), Píshū (脾俞BL20), Shènshū (肾俞BL23), Shénmén (神门HT7) and Sānyīnjiāo (三阴交SP6). Acupuncture was performed once every 2 days, three times weekly, and the needles were retained for 30 min each time. The duration of treatment was 4 weeks. The Pittsburgh Sleep Quality Index (PSQI) score and HPA- and HPO-related hormones were evaluated before and after treatment.ResultsThe PSQI score was lower after treatment than before treatment. The score of each item (subjective sleep quality, sleep latency, sleep maintenance, habitual sleep efficiency, sleep disturbance, sleep medication, and daytime dysfunction) was also lower after treatment than before treatment. The levels of HPA-related hormones (cortisol, adrenocorticotrophin, and corticotropin-releasing hormone) and HPO-related hormones (follicle-stimulating hormone and luteinizing hormone) all decreased after treatment. In contrast, the level of estrogen (E2) increased. The differences before and after treatment for all the indicators were statistically significant (all P < 0.05).ConclusionAcupuncture can alleviate clinical symptoms and improve hormone levels in patients with perimenopausal insomnia. Acupuncture is safe and should be considered in clinical practice.