Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature ...Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature range—and women’s menopausal experiences. This study aims to interpret how these environmental factors influence the age of onset, severity of symptoms such as hot flushes and night sweats, and other long-term effects of menopause. Understanding these relationships addresses a significant gap in current knowledge and could guide future public health strategies. Methods: Through a comprehensive analysis of three cross-continental studies involving 1500 postmenopausal women from Spain, South American countries (Ecuador, Panama, Chile), various climates in Türkiye (Black Sea, Mediterranean, Continental), and the United Arab Emirates (UAE), this review evaluates diverse environmental impacts. Studies were selected based on their methodological rigor, geographical diversity, and focus on the unique and personal experiences of menopause. Data was collected via questionnaires and routine medical checkups, analyzing demographic, lifestyle, mood, symptom severity, and onset age variables. Results: Preliminary analysis indicates that 52.5% of participants from Spanish-speaking countries and the UAE reported vasomotor symptoms, with those in higher temperatures and lower altitudes experiencing exacerbated symptoms. Notably, Mediterranean climates were associated with an earlier menopause onset. Seasonal changes had minimal impact across all regions, suggesting lifestyle and other environmental factors play a more significant role. Conclusions: The findings highlight a clear link between climate-related geographical factors and the menopausal experience. Women in warmer, lower-altitude regions suffer more severe symptoms, while those in Mediterranean climates face earlier onset. The absence of significant seasonal variations across the studies underscores the predominance of lifestyle and environmental factors over purely climatic conditions. These insights pave the way for targeted interventions and support the need for further public health research into the complex interactions between climate change and menopause.展开更多
Objective:To observe the effect of acupuncture therapy on depression at perimenopause.Methods:Sixty patients who had depression at perimenopause were divided into a treatment group and a control group,thirty patients ...Objective:To observe the effect of acupuncture therapy on depression at perimenopause.Methods:Sixty patients who had depression at perimenopause were divided into a treatment group and a control group,thirty patients in each group.Patients in the treatment group were treated with Bo’s abdominal acupuncture,while patients in the control group were treated with Prozac.Hamilton depression scale(HAMD)and Beck depression inventory(BDI)were observed before and after treatment to evaluate the clinical effect.Results:Depression levels decreased after treatments in both groups(P<0.05).There were no statistical differences between the two groups in the total effective rate and BDI.Conclusion:Abdominal acupuncture has similar effect in treating depression at perimenopause with Prozac..展开更多
BACKGROUND Perimenopausal is the period when women's ovarian function begins to decline before and after menopause.During this period,women experience a series of mental state changes,such as decreased hormone lev...BACKGROUND Perimenopausal is the period when women's ovarian function begins to decline before and after menopause.During this period,women experience a series of mental state changes,such as decreased hormone levels,decreased libido,and even female sexual dysfunction(FSD)in severe cases,which reduces their quality of life.Factors affecting the occurrence of FSD include physiological and nonphysiological factors,among which physiological factors are uncontrollable.Therefore,it is particularly important to ascertain the related non-physiological factors that affect the occurrence of FSD for improving the quality of sexual life of perimenopausal women.AIM To investigate the mediating effect of depressive mood and body image on menopausal symptoms and sexual function in perimenopausal women.METHODS A total of 186 perimenopausal women were enrolled between January 2019 and January 2021 and divided into the FSD(134 cases)and control(52 cases)groups based on the presence and absence of FSD.Clinical data were compared between the two groups.FSD-related factors were analyzed using logistic regression analysis.Hamilton Depression Scale(HAMD),Body Image Scale(BIS),and Menopause Rating Scale(MRS)scores were compared among women with different FSD scores.The correlation of the MRS score with the BIS and HAMD scores and the mediating effect of the BIS and HAMD scores on the MRS score and female sexual function index(FSFI)were analyzed.RESULTS The HAMD and BIS scores were higher in the FSD group than in the control group,and the difference in monthly income between the two groups was statistically significant(all P<0.05).Monthly income of<2000 yuan[odds ratio(OR)=26.586,P=0.000],BIS score(OR=1.590,P=0.000),and HAMD score(OR=1.884,P=0.000)were independent risk factors for FSD.MRS scores were positively correlated with BIS and HAMD scores(r=0.358 and 0.244,P=0.000 and 0.001,respectively)and negatively correlated with FSFI scores(r=-0.433,P=0.000).Body image and depressive mood had partial mediating effects,accounting for 39.90%of the total effect.CONCLUSION Depression and body image play mediating roles between menopausal symptoms and sexual function in perimenopausal women.展开更多
Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Feder...Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Federation of Trade Unions Workers'Medical Clinics,Hong Kong Baptist University Chinese Medicine Clinic cum Training and Research Centre(Hong Kong,China).One hundred Chinese women,aged 45-55 years,will be recruited.The participants will be randomized into 2 groups.The intervention group will be administered medication,based on pattern differentiation,by qualified traditional Chinese medicine(TCM)practitioners.After each evaluation,TCM practitioners will evaluate and revise the prescription,based on the participants'patterns.The control group will be given the standard formula,i.e.,the Erxian decoction,which contains 6 herbs.The treatment period and the follow-up period will be 8 weeks each.The primary assessment outcome measure will be the Kupperman Index,and the secondary outcome measure will be the Menopause-specific Quality of Life Questionnaire score.Conclusion:Pattern-differentiated treatment is the basic principle of TCM to understand and treat diseases.The study will show the pattern-differentiated treatment is effectiveness than the fixed prescription.展开更多
[Objectives]This study was conducted to explore the intervention mechanism of Danggui Buxue Decoction in perimenopausal syndrome based on network pharmacology and molecular docking.[Methods]The chemical components and...[Objectives]This study was conducted to explore the intervention mechanism of Danggui Buxue Decoction in perimenopausal syndrome based on network pharmacology and molecular docking.[Methods]The chemical components and targets of Danggui Buxue Decoction were acquired through the TCMSP database,and the main targets of perimenopausal syndrome were obtained through the GeneCards database.The component targets and disease targets were intersected,and combining with active components and Chinese herbs in the decoction,a traditional Chinese medicine-component-target network was constructed using Cytoscape 3.7.1 software.The STRING platform was employed for protein-protein interaction analysis.The DAVID analysis platform was used to conduct target GO and KEGG enrichment analysis,so as to predict the action mechanism Danggui Buxue Decoction.Finally,an active component-disease target-signal pathway network diagram was constructed.[Results]Twenty two components in Danggui Buxue Decoction related to perimenopausal syndrome and 120 corresponding targets were obtained,including active components such as 1,7-dihydroxy-3,9-dimquercetin and kaempferol,and key targets such as TNF,ESR1 and PPARG.The results of GO analysis and KEEG analysis indicated that Danggui Buxue Decoction might regulate the transcription of RNA polymerase II promoter,DNA templating,gene expression,signal transduction,hypoxia response and other biological processes by regulating multiple signal pathways such as chemical carcinogenesis-receptor activation,cancer pathways,lipid and atherosclerosis,tryptophan metabolism,malaria,steroid hormone biosynthesis and chemical carcinogenesis-DNA adduct.[Conclusions]Danggui Buxue Decoction intervenes in perimenopausal syndrome through multiple components,targets and pathways,providing a basis for elucidating the intervention mechanism of Danggui Buxue Decoction and expanding its clinical application.展开更多
The prevalence of,and related factors to,stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigat...The prevalence of,and related factors to,stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated.In this study,1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area,and two impoverished,mountainous communities in Hubei province,and followed from April to October 2014.Detailed information about demographic characteristics,menstruation,pregnancy,sexual life and chronic diseases was collected.A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis.Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4,95% CI:1.92-6.04),vaginal delivery (OR=0.623,95% CI:0.45-0.87),low income (OR=0.063,95% CI:0.40-0.92),atrophic vaginitis (OR=1.4,95% CI:1.03-1.80),pelvic organ prolapse (OR=2.81,95% CI:1.36-5.80),chronic pelvic pain (OR=2.17,95% CI:1.90-4.03),constipation (OR=1.44,95% CI:1.07-1.93) and incontinence of feces (OR=3.32,95% CI:2.03-5.43).Moreover,the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1 %) or the ratio of mixed urinary incontinence (17.4%),and SUI had a greater impact on daily life among women with decreased sexual desire.In conclusion,SUI is a common disorder affecting over one third of the women surveyed,and has a severe impact on the daily life of perimenopausal women with declined sexual desire.Age,mode of delivery,and monthly income are major risk factors involved in the development of SUI.展开更多
In order to fully understand the research progress of Chinese and Western medicine in the treatment of perimenopausal abnormal uterine bleeding,this paper reviews all kinds of research by referring to related literatu...In order to fully understand the research progress of Chinese and Western medicine in the treatment of perimenopausal abnormal uterine bleeding,this paper reviews all kinds of research by referring to related literature reports at home and abroad.The results showed that western medicine mainly used hormone drugs,supplemented by surgery,but the clinical adverse reactions were more and the recurrence rate was higher;traditional Chinese medicine often obtained satisfactory results through the treatment of traditional Chinese medicine,syndrome differentiation,stage treatment,acupuncture and other treatment methods,with fewer adverse reactions and low recurrence rate,but the effect of sudden collapse and hemostasis was slower;the combination of Chinese and Western medicine can learn from each other and become The research focus in recent years is worthy of further discussion.展开更多
Women worldwide are dealing with hot flashes (潮热), a perimenopausal feature that is often tiring,embarrassing, and energeticallydraining. Conventionally, Chinese medicine defines hot flashes as Kidney-yin deficiency...Women worldwide are dealing with hot flashes (潮热), a perimenopausal feature that is often tiring,embarrassing, and energeticallydraining. Conventionally, Chinese medicine defines hot flashes as Kidney-yin deficiency and its clinical manifestations include red face,sweating, hot sensations in the palms and soles, mouth and nose dryness, constipation, insomnia, lumbar soreness, knee weakness, redtongue, etc. To obtain a broader perspective and understand the dynamics of hot flashes, we examined the mechanisms behind hot flashesbased on both the knowledge from ancient Chinese medicinal texts, as well as novel research findings of Chinese and Western medicine.This perspective was the foundation for the acupuncture study of our traditional Chinese medicine conducted in 2018-2019 in Shanghai.This study, designed as a pragmatic randomized control trial with two parallel groups, focused on regulating and unblocking conceptionand governor vessels. The results confirmed that our acupuncture method could effectively reduce both the frequency and severity of hotflashes and improve life quality of middle-aged women.展开更多
Time series analysis, based on the idea that female reproductive endocrine physiology can be construed as a nonlinear dynamical system in a chaotic trajectory, is performed to measure the correlation dimension of the ...Time series analysis, based on the idea that female reproductive endocrine physiology can be construed as a nonlinear dynamical system in a chaotic trajectory, is performed to measure the correlation dimension of the menstrual cycle data from subjects in two different age cohorts. The dimension is computed using a method proposed by Judd (Physica D, vol. 56, 1992, pp. 216-228) that does not assume the correlation dimension to be necessarily constant for all appropriate time scales of the system’s strange attractor. Significant time scale differences are found in the behavior of the dimension between the two age cohorts, but at the shortest time scales the correlation dimension converges to the same value, approximately 5.5, in both cases.展开更多
Objective: To explore the effect of tibolone as well as Estradiol and Drospirenone replacement therapy on the neurohumoral indexes and immune function in perimenopausal women. Methods: A total of 180 perimenopausal wo...Objective: To explore the effect of tibolone as well as Estradiol and Drospirenone replacement therapy on the neurohumoral indexes and immune function in perimenopausal women. Methods: A total of 180 perimenopausal women who were treated in our hospital between December 2014 and December 2016 were collected and divided into the tibolone group (n=90) as well as Estradiol and Drospirenone group (n=90) by random number table, they received tibolone as well as Estradiol and Drospirenone replacement therapy respectively, and both therapies lasted for 6 months. The differences in serum levels of neurohumoral indexes and immune function indexes were compared between the two groups. Results:Before treatment, differences in serum levels of neurohumoral indexes and immune function indexes were not statistically significant between the two groups. After 6 months of treatment, serum E2, IL-4 and IL-13 levels of both groups of patients were significantly higher than those before treatment while P, T, FSH, LH, PRL, IFN-γ and IL-2 levels were significantly lower than those before treatment, and serum E2, IL-4 and IL-13 levels of observation group were significantly higher than those of control group while P, T, FSH, LH, PRL, IFN-γ and IL-2 levels were significantly lower than those of control group. Conclusion: Both tibolone and Estradiol and Drospirenone can be used in the treatment of women with perimenopausal syndrome, but tibolone is more effective in optimizing hormone levels and equalizing immune function.展开更多
Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Me...Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syn- drome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95%: 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche 11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause;however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%;CI95%: 81.7 to 87.8), waist circumference (66.4%;CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%;CI95%: 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.展开更多
Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese...Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese Biomedical Literature Database, Wan Fang Database, and VIP Database up to December 2018. Hand search for further references was conducted. Study selection, data extraction, quality assessment, and data analyses were performed as request of the Cochrane standards. Results: Nine publications in total were suitable for inclusion. There was evidence that modified XYS was tested to be more effective in improving overall symptoms compared with HRT (odds ratio 3.50, 95% CI 2.56 to 4.78). Whereas HRT was more sensitive and direct in decreasing FSH (WMD 6.69, 95% CI 5.60 to 9.52) and LH (WMD 7.00, 95% CI, 5.75 to 8.25) in comparison with XYS group. It was also strongly supported that XYS had less adverse effect than HRT (odds ratio 0.07, 95% CI 0.05 to 0.10). Conclusion: Modified XYS might be more effective and safer in treatment of perimenopausal syndrome. However, due to poor methodological quality in the majority of included studies, the potential benefit and safety about XYS need to be confirmed in rigorously designed, multi-centre, and large-scale trials.展开更多
Objective: To evaluate the sleep quality and its related factors among perimenopausal women. Methods: A self-designed questionnaire was administered to 506 perimenopausal women. The questionnaire included the influe...Objective: To evaluate the sleep quality and its related factors among perimenopausal women. Methods: A self-designed questionnaire was administered to 506 perimenopausal women. The questionnaire included the influencing factors on the sleep quality, the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scales (SDS), the Zung Self-Rating Anxiety (SAS) and the Modified Kupperman Index (KI). Data were analyzed by SPSSll.5. Results: The mean PSQI was 5.97±4.30. Twenty-four percent of perimenopausal women reported poor sleep. Age and perimenopausal symptoms were significantly correlated with sleep quality. The sleep quality of the 45~49 age group was the poorest and the 40~44 age group was the best. The women who had higher Kupperman index were more likely to be poor sleepers. There was no significant correlation between occupation and sleep quality. Night sweat, depression, anxiety, hot flash, stressful life event, and regular exercise were significantly and independently related with sleep quality. Among them, regular exercise was a protective factor of sleep quality. Conclusion: High incidence of poor sleep quality exists among perimenopausal women. Some effective interventions Should be taken to improve the sleep quality of perimenopausal women.展开更多
Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and ...Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and Gynecology </span><span style="font-family:Verdana;">at University Hospitals and included 176 patients with perimenopausal bleeding </span><span style="font-family:Verdana;">who attended a patient clinic during the period from January 2017 to May 2019. All patients were subjected to transvaginal ultrasound, saline sonohysterography and out-patient endometrial sampling using pipelle;all the results were compared to histopathology obtained by hysteroscopic guided biopsy and/or hysterectomy. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">In comparing the validity of TVS and SHG we found highly significant decrease in malignancy assessment in </span><span><span style="font-family:Verdana;">the TVS method compared to hysteroscopic-guided biopsy. According to the validity of pipelle in detection of malignant lesion, it was found to detect 80 cases out of 88 cases of malignancy with sensitivity 90.9%, specificity 100% and 95.45% accuracy with respect to histopathology by hysteroscopy guided biopsy and/or hysterectomy. Combination tests were done between SHG and pipelle and we found that the validity of combination tests in detecting malignancy improves the sensitivity and specificity in detection of malignancy sensitivity = 100% and specificity = 100% and this was found to be as an effective method in detection of malignancy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> When SHG combined to outpatient endometrial sampling “pipelle”, the results were the same as hysteroscopy.展开更多
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 involv...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.展开更多
Objective:To study the effects of the ethnic medicine Polygala fallax Hemsl with Guangxi characteristics on the sex hormones andβ-EP in research objective perimenopausal rat models.Methods:40 female SPF rats were ran...Objective:To study the effects of the ethnic medicine Polygala fallax Hemsl with Guangxi characteristics on the sex hormones andβ-EP in research objective perimenopausal rat models.Methods:40 female SPF rats were randomly divided into 4 groups,including the normal,model,high-dose and lowdose groups.Rats of three groups except for the normal one were treated with perimenopausal modelling through the method of subcutaneous injection of compound 4-VCD for 15 consecutive days.Rats of the normal and model group were normally fed without any treatment.Rats of the high-dose and low-dose groups were administered by high-and low-dose intragastric administration of the extract of Polygala fallax Hemsl.According to the menstrual cycle of the vaginal smear of the rat,each menstrual cycle is a course of treatment and 6 consecutive courses of treatment would be given.The indexes of serum sex hormones(E2,FSH,LH)andβ-EP of rats in each group were observed after treatment.Results:After the treatment of 6 cycles,for the levels ofβ-EP and E2,the model group was lowest(P<0.05),the normal group was highest(P<0.05);and the high-dose group was higher than the low-dose group;For the levels of FSH and LH,the normal group was lowest(P<0.05),the model group was highest(P<0.05),and the high-dose group was lower than the low-dose group.Conclusion:Guangxi characteristic national medicine Polygala fallax Hemsl can effectively improve the levels of serum sex hormones andβ-EP in perimenopausal rat models and relieve the related symptoms with a certain dose-effect relationship.展开更多
[Objectives] To observe the effect of soy isoflavones on the perimenopausal syndrome model of female rats,and to find its mechanism,in order to provide experimental evidence for the clinical treatment of menopausal sy...[Objectives] To observe the effect of soy isoflavones on the perimenopausal syndrome model of female rats,and to find its mechanism,in order to provide experimental evidence for the clinical treatment of menopausal syndrome. [Methods]50 female SD rats were randomly divided into five groups,with 10 rats in each group,respectively,for the normal control group,sham operation group,model group,diethylstilbestrol group,soy isoflavone treated group,except the normal control group and sham operation group,the other groups were ovariectomized rats,the formation model of perimenopausal rats treated with normal saline,diethylstilbestrol,soy isoflavone by gavage,normal control group and sham operation group were given the same dose of normal saline and soy isoflavone by gavage. After 6 weeks of continuous treatment,abdominal aorta was taken blood,the serum was isolated,and radioimmunoassay method to measure E_2( Eestradiol),P( Progesterone),T( Testosterone). And removal of the pituitary gland,uterine and adrenal prepared pathological section,experimental effect was observed by light microscopy,using immunohistochemical method to observe the brain pituitary FSH( Follicle-Stimulating Hormone) and LH( Luteinizing Hormone) levels. [Results] Radiation immune analysis results showed that soy isoflavone could significantly improve serum E_2 level in ovariectomized rats,compared with the model group,the statistical analysis showed significant difference( P < 0. 05),but the serum P and T level had little effect. The pathological results showed that( i) uterus: the uterine wall and endometrial thickness of soy isoflavone group was between that of model group and sham operation group,the surface epithelium was columnar,glands increased;( ii) pituitary gland: soy isoflavone ovariectomized group cells were between model group and normal group;( iii) adrenal gland: soy isoflavone group adrenal tissue did not change significantly. Immunohistochemical results showed that soy isoflavone group pituitary tissues of FSH and LH cells compared with the model group decreased significantly. [Conclusions] The soy isoflavones could make the uterus wall and endometria of perimenopausal syndrome animal model thicken,improve the serum level of E_2 in ovariectomized rats,and decrease the level of FSH and LH,but had little effect on the adrenal tissues,level of T and P.展开更多
文摘Objective: This systematic review investigates the impact of climate change on menopause, focusing on the correlation between geographical location—considering altitude, temperature, humidity, and annual temperature range—and women’s menopausal experiences. This study aims to interpret how these environmental factors influence the age of onset, severity of symptoms such as hot flushes and night sweats, and other long-term effects of menopause. Understanding these relationships addresses a significant gap in current knowledge and could guide future public health strategies. Methods: Through a comprehensive analysis of three cross-continental studies involving 1500 postmenopausal women from Spain, South American countries (Ecuador, Panama, Chile), various climates in Türkiye (Black Sea, Mediterranean, Continental), and the United Arab Emirates (UAE), this review evaluates diverse environmental impacts. Studies were selected based on their methodological rigor, geographical diversity, and focus on the unique and personal experiences of menopause. Data was collected via questionnaires and routine medical checkups, analyzing demographic, lifestyle, mood, symptom severity, and onset age variables. Results: Preliminary analysis indicates that 52.5% of participants from Spanish-speaking countries and the UAE reported vasomotor symptoms, with those in higher temperatures and lower altitudes experiencing exacerbated symptoms. Notably, Mediterranean climates were associated with an earlier menopause onset. Seasonal changes had minimal impact across all regions, suggesting lifestyle and other environmental factors play a more significant role. Conclusions: The findings highlight a clear link between climate-related geographical factors and the menopausal experience. Women in warmer, lower-altitude regions suffer more severe symptoms, while those in Mediterranean climates face earlier onset. The absence of significant seasonal variations across the studies underscores the predominance of lifestyle and environmental factors over purely climatic conditions. These insights pave the way for targeted interventions and support the need for further public health research into the complex interactions between climate change and menopause.
文摘Objective:To observe the effect of acupuncture therapy on depression at perimenopause.Methods:Sixty patients who had depression at perimenopause were divided into a treatment group and a control group,thirty patients in each group.Patients in the treatment group were treated with Bo’s abdominal acupuncture,while patients in the control group were treated with Prozac.Hamilton depression scale(HAMD)and Beck depression inventory(BDI)were observed before and after treatment to evaluate the clinical effect.Results:Depression levels decreased after treatments in both groups(P<0.05).There were no statistical differences between the two groups in the total effective rate and BDI.Conclusion:Abdominal acupuncture has similar effect in treating depression at perimenopause with Prozac..
文摘BACKGROUND Perimenopausal is the period when women's ovarian function begins to decline before and after menopause.During this period,women experience a series of mental state changes,such as decreased hormone levels,decreased libido,and even female sexual dysfunction(FSD)in severe cases,which reduces their quality of life.Factors affecting the occurrence of FSD include physiological and nonphysiological factors,among which physiological factors are uncontrollable.Therefore,it is particularly important to ascertain the related non-physiological factors that affect the occurrence of FSD for improving the quality of sexual life of perimenopausal women.AIM To investigate the mediating effect of depressive mood and body image on menopausal symptoms and sexual function in perimenopausal women.METHODS A total of 186 perimenopausal women were enrolled between January 2019 and January 2021 and divided into the FSD(134 cases)and control(52 cases)groups based on the presence and absence of FSD.Clinical data were compared between the two groups.FSD-related factors were analyzed using logistic regression analysis.Hamilton Depression Scale(HAMD),Body Image Scale(BIS),and Menopause Rating Scale(MRS)scores were compared among women with different FSD scores.The correlation of the MRS score with the BIS and HAMD scores and the mediating effect of the BIS and HAMD scores on the MRS score and female sexual function index(FSFI)were analyzed.RESULTS The HAMD and BIS scores were higher in the FSD group than in the control group,and the difference in monthly income between the two groups was statistically significant(all P<0.05).Monthly income of<2000 yuan[odds ratio(OR)=26.586,P=0.000],BIS score(OR=1.590,P=0.000),and HAMD score(OR=1.884,P=0.000)were independent risk factors for FSD.MRS scores were positively correlated with BIS and HAMD scores(r=0.358 and 0.244,P=0.000 and 0.001,respectively)and negatively correlated with FSFI scores(r=-0.433,P=0.000).Body image and depressive mood had partial mediating effects,accounting for 39.90%of the total effect.CONCLUSION Depression and body image play mediating roles between menopausal symptoms and sexual function in perimenopausal women.
基金funded by Chinese Medicine Research Practical Training Program of Hong Kong Hospital Authority Chinese Medicine Department(Hong Kong,China)。
文摘Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Federation of Trade Unions Workers'Medical Clinics,Hong Kong Baptist University Chinese Medicine Clinic cum Training and Research Centre(Hong Kong,China).One hundred Chinese women,aged 45-55 years,will be recruited.The participants will be randomized into 2 groups.The intervention group will be administered medication,based on pattern differentiation,by qualified traditional Chinese medicine(TCM)practitioners.After each evaluation,TCM practitioners will evaluate and revise the prescription,based on the participants'patterns.The control group will be given the standard formula,i.e.,the Erxian decoction,which contains 6 herbs.The treatment period and the follow-up period will be 8 weeks each.The primary assessment outcome measure will be the Kupperman Index,and the secondary outcome measure will be the Menopause-specific Quality of Life Questionnaire score.Conclusion:Pattern-differentiated treatment is the basic principle of TCM to understand and treat diseases.The study will show the pattern-differentiated treatment is effectiveness than the fixed prescription.
基金Supported by Project of Science and Technology Department of Guizhou Province(ZK[2021]-546)Project of Science and Technology Department of Guizhou Province([2019]1401)+1 种基金Guizhou Administration of Traditional Chinese Medicine(QZYY-2021-03)Guizhou Provincial Health Commission(gzwkj2021-464).
文摘[Objectives]This study was conducted to explore the intervention mechanism of Danggui Buxue Decoction in perimenopausal syndrome based on network pharmacology and molecular docking.[Methods]The chemical components and targets of Danggui Buxue Decoction were acquired through the TCMSP database,and the main targets of perimenopausal syndrome were obtained through the GeneCards database.The component targets and disease targets were intersected,and combining with active components and Chinese herbs in the decoction,a traditional Chinese medicine-component-target network was constructed using Cytoscape 3.7.1 software.The STRING platform was employed for protein-protein interaction analysis.The DAVID analysis platform was used to conduct target GO and KEGG enrichment analysis,so as to predict the action mechanism Danggui Buxue Decoction.Finally,an active component-disease target-signal pathway network diagram was constructed.[Results]Twenty two components in Danggui Buxue Decoction related to perimenopausal syndrome and 120 corresponding targets were obtained,including active components such as 1,7-dihydroxy-3,9-dimquercetin and kaempferol,and key targets such as TNF,ESR1 and PPARG.The results of GO analysis and KEEG analysis indicated that Danggui Buxue Decoction might regulate the transcription of RNA polymerase II promoter,DNA templating,gene expression,signal transduction,hypoxia response and other biological processes by regulating multiple signal pathways such as chemical carcinogenesis-receptor activation,cancer pathways,lipid and atherosclerosis,tryptophan metabolism,malaria,steroid hormone biosynthesis and chemical carcinogenesis-DNA adduct.[Conclusions]Danggui Buxue Decoction intervenes in perimenopausal syndrome through multiple components,targets and pathways,providing a basis for elucidating the intervention mechanism of Danggui Buxue Decoction and expanding its clinical application.
文摘The prevalence of,and related factors to,stress urinary incontinence (SUI) among perimenopausal Chinese women and its impact on daily life among those women with sexual desire problem in Hubei province were investigated.In this study,1519 perimenopausal women aged 40 to 65 years were selected from three urban communities in the Wuhan area,and two impoverished,mountainous communities in Hubei province,and followed from April to October 2014.Detailed information about demographic characteristics,menstruation,pregnancy,sexual life and chronic diseases was collected.A cross-sectional survey was carried out following information collection by Chi-square test and multiple logistic regression analysis.Univariate and multivariate logistic regression analysis demonstrated that the potential factors associated with developing SUI were old age (OR=3.4,95% CI:1.92-6.04),vaginal delivery (OR=0.623,95% CI:0.45-0.87),low income (OR=0.063,95% CI:0.40-0.92),atrophic vaginitis (OR=1.4,95% CI:1.03-1.80),pelvic organ prolapse (OR=2.81,95% CI:1.36-5.80),chronic pelvic pain (OR=2.17,95% CI:1.90-4.03),constipation (OR=1.44,95% CI:1.07-1.93) and incontinence of feces (OR=3.32,95% CI:2.03-5.43).Moreover,the ratio of SUI (33.2%) was higher than the ratio of urgency urinary incontinence (24.1 %) or the ratio of mixed urinary incontinence (17.4%),and SUI had a greater impact on daily life among women with decreased sexual desire.In conclusion,SUI is a common disorder affecting over one third of the women surveyed,and has a severe impact on the daily life of perimenopausal women with declined sexual desire.Age,mode of delivery,and monthly income are major risk factors involved in the development of SUI.
基金Key research and development plan of Shandong Province(No.2019GSF108208).
文摘In order to fully understand the research progress of Chinese and Western medicine in the treatment of perimenopausal abnormal uterine bleeding,this paper reviews all kinds of research by referring to related literature reports at home and abroad.The results showed that western medicine mainly used hormone drugs,supplemented by surgery,but the clinical adverse reactions were more and the recurrence rate was higher;traditional Chinese medicine often obtained satisfactory results through the treatment of traditional Chinese medicine,syndrome differentiation,stage treatment,acupuncture and other treatment methods,with fewer adverse reactions and low recurrence rate,but the effect of sudden collapse and hemostasis was slower;the combination of Chinese and Western medicine can learn from each other and become The research focus in recent years is worthy of further discussion.
文摘Women worldwide are dealing with hot flashes (潮热), a perimenopausal feature that is often tiring,embarrassing, and energeticallydraining. Conventionally, Chinese medicine defines hot flashes as Kidney-yin deficiency and its clinical manifestations include red face,sweating, hot sensations in the palms and soles, mouth and nose dryness, constipation, insomnia, lumbar soreness, knee weakness, redtongue, etc. To obtain a broader perspective and understand the dynamics of hot flashes, we examined the mechanisms behind hot flashesbased on both the knowledge from ancient Chinese medicinal texts, as well as novel research findings of Chinese and Western medicine.This perspective was the foundation for the acupuncture study of our traditional Chinese medicine conducted in 2018-2019 in Shanghai.This study, designed as a pragmatic randomized control trial with two parallel groups, focused on regulating and unblocking conceptionand governor vessels. The results confirmed that our acupuncture method could effectively reduce both the frequency and severity of hotflashes and improve life quality of middle-aged women.
文摘Time series analysis, based on the idea that female reproductive endocrine physiology can be construed as a nonlinear dynamical system in a chaotic trajectory, is performed to measure the correlation dimension of the menstrual cycle data from subjects in two different age cohorts. The dimension is computed using a method proposed by Judd (Physica D, vol. 56, 1992, pp. 216-228) that does not assume the correlation dimension to be necessarily constant for all appropriate time scales of the system’s strange attractor. Significant time scale differences are found in the behavior of the dimension between the two age cohorts, but at the shortest time scales the correlation dimension converges to the same value, approximately 5.5, in both cases.
文摘Objective: To explore the effect of tibolone as well as Estradiol and Drospirenone replacement therapy on the neurohumoral indexes and immune function in perimenopausal women. Methods: A total of 180 perimenopausal women who were treated in our hospital between December 2014 and December 2016 were collected and divided into the tibolone group (n=90) as well as Estradiol and Drospirenone group (n=90) by random number table, they received tibolone as well as Estradiol and Drospirenone replacement therapy respectively, and both therapies lasted for 6 months. The differences in serum levels of neurohumoral indexes and immune function indexes were compared between the two groups. Results:Before treatment, differences in serum levels of neurohumoral indexes and immune function indexes were not statistically significant between the two groups. After 6 months of treatment, serum E2, IL-4 and IL-13 levels of both groups of patients were significantly higher than those before treatment while P, T, FSH, LH, PRL, IFN-γ and IL-2 levels were significantly lower than those before treatment, and serum E2, IL-4 and IL-13 levels of observation group were significantly higher than those of control group while P, T, FSH, LH, PRL, IFN-γ and IL-2 levels were significantly lower than those of control group. Conclusion: Both tibolone and Estradiol and Drospirenone can be used in the treatment of women with perimenopausal syndrome, but tibolone is more effective in optimizing hormone levels and equalizing immune function.
文摘Background: This study aims to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syn- drome according to sample characteristics. Methods: A cross-sectional study was conducted with 551 women treated at a clinic in southern Brazil. MetS and its components were defined according to NCEP-ATP III and menopausal status as pre, peri, and post-menopause. Prevalences of menopausal status and of MetS and its components were calculated. Estimates of prevalence ratios crude and adjusted with confidence intervals of 95% were calculated by Poisson Regression with robust variance. Demographic, socioeconomic, behavioral, and reproductive characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of MetS determination. Results: The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95%: 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche 11 years old, with three or more pregnancies and in the post-menopausal period. In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause;however, the confidence intervals include the unit. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%;CI95%: 81.7 to 87.8), waist circumference (66.4%;CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%;CI95%: 47.5 to 55.9). There was a linear increase on mean blood glucose through menopausal status. Conclusions: Our study indicates variation on the distribution of MetS and each component according to menopausal status and other women characteristics. Future studies on MetS should also have foresight to use this type of approach to improve understanding and targeting of actions and programs focusing on women in this period of life.
文摘Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese Biomedical Literature Database, Wan Fang Database, and VIP Database up to December 2018. Hand search for further references was conducted. Study selection, data extraction, quality assessment, and data analyses were performed as request of the Cochrane standards. Results: Nine publications in total were suitable for inclusion. There was evidence that modified XYS was tested to be more effective in improving overall symptoms compared with HRT (odds ratio 3.50, 95% CI 2.56 to 4.78). Whereas HRT was more sensitive and direct in decreasing FSH (WMD 6.69, 95% CI 5.60 to 9.52) and LH (WMD 7.00, 95% CI, 5.75 to 8.25) in comparison with XYS group. It was also strongly supported that XYS had less adverse effect than HRT (odds ratio 0.07, 95% CI 0.05 to 0.10). Conclusion: Modified XYS might be more effective and safer in treatment of perimenopausal syndrome. However, due to poor methodological quality in the majority of included studies, the potential benefit and safety about XYS need to be confirmed in rigorously designed, multi-centre, and large-scale trials.
文摘Objective: To evaluate the sleep quality and its related factors among perimenopausal women. Methods: A self-designed questionnaire was administered to 506 perimenopausal women. The questionnaire included the influencing factors on the sleep quality, the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scales (SDS), the Zung Self-Rating Anxiety (SAS) and the Modified Kupperman Index (KI). Data were analyzed by SPSSll.5. Results: The mean PSQI was 5.97±4.30. Twenty-four percent of perimenopausal women reported poor sleep. Age and perimenopausal symptoms were significantly correlated with sleep quality. The sleep quality of the 45~49 age group was the poorest and the 40~44 age group was the best. The women who had higher Kupperman index were more likely to be poor sleepers. There was no significant correlation between occupation and sleep quality. Night sweat, depression, anxiety, hot flash, stressful life event, and regular exercise were significantly and independently related with sleep quality. Among them, regular exercise was a protective factor of sleep quality. Conclusion: High incidence of poor sleep quality exists among perimenopausal women. Some effective interventions Should be taken to improve the sleep quality of perimenopausal women.
文摘Postmenopausal bleeding is a very common and alarming symptom accounting for 5 percent of all gynecological outpatients’ clinic attendances. This cross-section study was conducted in the Department of Obstetrics and Gynecology </span><span style="font-family:Verdana;">at University Hospitals and included 176 patients with perimenopausal bleeding </span><span style="font-family:Verdana;">who attended a patient clinic during the period from January 2017 to May 2019. All patients were subjected to transvaginal ultrasound, saline sonohysterography and out-patient endometrial sampling using pipelle;all the results were compared to histopathology obtained by hysteroscopic guided biopsy and/or hysterectomy. </span><b><span style="font-family:Verdana;">Result: </span></b><span style="font-family:Verdana;">In comparing the validity of TVS and SHG we found highly significant decrease in malignancy assessment in </span><span><span style="font-family:Verdana;">the TVS method compared to hysteroscopic-guided biopsy. According to the validity of pipelle in detection of malignant lesion, it was found to detect 80 cases out of 88 cases of malignancy with sensitivity 90.9%, specificity 100% and 95.45% accuracy with respect to histopathology by hysteroscopy guided biopsy and/or hysterectomy. Combination tests were done between SHG and pipelle and we found that the validity of combination tests in detecting malignancy improves the sensitivity and specificity in detection of malignancy sensitivity = 100% and specificity = 100% and this was found to be as an effective method in detection of malignancy. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> When SHG combined to outpatient endometrial sampling “pipelle”, the results were the same as hysteroscopy.
基金National Natural Science Foundation of China(No.81660830)Open Project for Guangxi Key Laboratory of Chinese Medicine Foundation Research of Guangxi(No.15-140-32-06)+3 种基金Open Project for Guangxi First-class Discipline Construction of Guangxi University of Chinese Medicine(No.2019XK038)Project for Improving Basic Capabilities of Middle-aged and Young Teachers in Guangxi Institutions of Higher Learning(No.KY2016YB835,No.KY2016YB833)Funded by Development Program of High-level Talent Team under Qihuang Project of Guangxi University of Chinese Medicine(No.2018005)Guangxi first-class discipline construction project(No.Gui Jiao Ke Yan[2018]12)。
文摘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.
基金Project for Improving Basic Capabilities of Middle-aged and Young Teachers in Guangxi Institutions of Higher Learning(No.KY2016YB835)National Natural Science Foundation of China(No.81660830)+3 种基金Open Project for Guangxi Key Laboratory of Chinese Medicine Foundation Research of Guangxi(No.15-140-32-06)Open Project for Guangxi First-class Discipline Construction of Guangxi University of Chinese Medicine(No.2019XK038)Funded by Development Program of High-level Talent Team under Qihuang Project of Guangxi University of Chinese Medicine(No.2018005)Traditional Chinese Medicine-Guangxi first-class discipline construction project(No.Gui Jiao Ke Yan[2018]12).
文摘Objective:To study the effects of the ethnic medicine Polygala fallax Hemsl with Guangxi characteristics on the sex hormones andβ-EP in research objective perimenopausal rat models.Methods:40 female SPF rats were randomly divided into 4 groups,including the normal,model,high-dose and lowdose groups.Rats of three groups except for the normal one were treated with perimenopausal modelling through the method of subcutaneous injection of compound 4-VCD for 15 consecutive days.Rats of the normal and model group were normally fed without any treatment.Rats of the high-dose and low-dose groups were administered by high-and low-dose intragastric administration of the extract of Polygala fallax Hemsl.According to the menstrual cycle of the vaginal smear of the rat,each menstrual cycle is a course of treatment and 6 consecutive courses of treatment would be given.The indexes of serum sex hormones(E2,FSH,LH)andβ-EP of rats in each group were observed after treatment.Results:After the treatment of 6 cycles,for the levels ofβ-EP and E2,the model group was lowest(P<0.05),the normal group was highest(P<0.05);and the high-dose group was higher than the low-dose group;For the levels of FSH and LH,the normal group was lowest(P<0.05),the model group was highest(P<0.05),and the high-dose group was lower than the low-dose group.Conclusion:Guangxi characteristic national medicine Polygala fallax Hemsl can effectively improve the levels of serum sex hormones andβ-EP in perimenopausal rat models and relieve the related symptoms with a certain dose-effect relationship.
基金Supported by Guangxi Graduate Education Innovation Program Foundation(YJSJG201601)Natural Science Research Project of Guangxi University of Chinese Medicine(P2005006)
文摘[Objectives] To observe the effect of soy isoflavones on the perimenopausal syndrome model of female rats,and to find its mechanism,in order to provide experimental evidence for the clinical treatment of menopausal syndrome. [Methods]50 female SD rats were randomly divided into five groups,with 10 rats in each group,respectively,for the normal control group,sham operation group,model group,diethylstilbestrol group,soy isoflavone treated group,except the normal control group and sham operation group,the other groups were ovariectomized rats,the formation model of perimenopausal rats treated with normal saline,diethylstilbestrol,soy isoflavone by gavage,normal control group and sham operation group were given the same dose of normal saline and soy isoflavone by gavage. After 6 weeks of continuous treatment,abdominal aorta was taken blood,the serum was isolated,and radioimmunoassay method to measure E_2( Eestradiol),P( Progesterone),T( Testosterone). And removal of the pituitary gland,uterine and adrenal prepared pathological section,experimental effect was observed by light microscopy,using immunohistochemical method to observe the brain pituitary FSH( Follicle-Stimulating Hormone) and LH( Luteinizing Hormone) levels. [Results] Radiation immune analysis results showed that soy isoflavone could significantly improve serum E_2 level in ovariectomized rats,compared with the model group,the statistical analysis showed significant difference( P < 0. 05),but the serum P and T level had little effect. The pathological results showed that( i) uterus: the uterine wall and endometrial thickness of soy isoflavone group was between that of model group and sham operation group,the surface epithelium was columnar,glands increased;( ii) pituitary gland: soy isoflavone ovariectomized group cells were between model group and normal group;( iii) adrenal gland: soy isoflavone group adrenal tissue did not change significantly. Immunohistochemical results showed that soy isoflavone group pituitary tissues of FSH and LH cells compared with the model group decreased significantly. [Conclusions] The soy isoflavones could make the uterus wall and endometria of perimenopausal syndrome animal model thicken,improve the serum level of E_2 in ovariectomized rats,and decrease the level of FSH and LH,but had little effect on the adrenal tissues,level of T and P.