Menopausal symptoms may affect every aspect of women\'s lives. There are no studies that examine the rate of menopausal women who seek acupuncture for their complaints, particularly muscle stiffness and aches, headaches, fatigue, and depression, which are indications for acupuncture, in Japan. The aim of this preliminary study was to explore the rate of Japanese women in menopause who sought acupuncture for the treatment of their general complaints, and to what extent acupuncture reduced their menopausal symptoms. 29 Japanese women, ages 40 to 59, received three individualized acupuncture treatments at 7 acupuncture clinics in Tokyo and surrounding suburbs. Menopausal symptoms were assessed by the Simple Menopause Index (SMI) which consisted of 10 symptoms from three categories: vasomotor, psychoneurological and musculoskeletal symptoms to determine if women were in menopause. Fifteen of 29 Japanese women had an SMI score greater than or equal to 26, suggesting that they were in menopause. Menopausal symptoms were reduced with individualized acupuncture treatments, exclusively due to improvement of musculoskeletal symptoms. Vasomotor and psychoneurological symptoms were not improved. These results suggest Japanese women in menopause seeking acupuncture may benefit from musculoskeletal symptom relief such as fatigue, chronic neck pain, and low back pain. Considering these results, acupuncturists may advise them to be evaluated by and inform gynecologists of their intention to use acupuncture to treat menopausal symptoms. Future studies focused on improvement of musculoskeletal symptoms and possibly vasomotor and psychoneurological symptoms with larger sample sizes are necessary.

UNASSIGNED: Estrogen deficiency is associated with unfavorable changes in body composition and metabolic health. While physical activity ameliorates several of the negative effects, loss of ovarian function is associated with decreased physical activity levels. It has been proposed that the changes in brain neurochemical levels and /or impaired skeletal muscle function may underlie this phenomenon.
UNASSIGNED: We studied the effect of estrogen deficiency induced via ovariectomy (OVX) in female Wistar rats (n = 64). Rats underwent either sham or OVX surgery and were allocated thereafter into four groups matched for body mass and maximal running capacity: sham/control, sham/max, OVX/control, and OVX/max, of which the max groups had maximal running test before euthanasia to induce acute response to exercise. Metabolism, spontaneous activity, and maximal running capacity were measured before (PRE) and after (POST) the surgeries. Three months following the surgery, rats were euthanized, and blood and tissue samples harvested. Proteins were analyzed from gastrocnemius muscle and retroperitoneal adipose tissue via Western blot. Brain neurochemical markers were measured from nucleus accumbens (NA) and hippocampus (HC) using ultra-high performance liquid chromatography.
UNASSIGNED: OVX had lower basal energy expenditure and higher body mass and retroperitoneal adipose tissue mass compared with sham group (p ≤ 0.005). OVX reduced maximal running capacity by 17% (p = 0.005) with no changes in muscle mass or phosphorylated form of regulatory light chain (pRLC) in gastrocnemius muscle. OVX was associated with lower serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) level in the NA compared with sham (p = 0.007). In response to acute exercise, OVX was associated with low serotonin level in the HC and high level in the NA (p ≤ 0.024).
UNASSIGNED: Our results highlight that OVX reduces maximal running capacity and affects the response of brain neurochemical levels to acute exercise in a brain region-specific manner. These results may offer mechanistic insight into why OVX reduces willingness to exercise.

There is an interest in menopause that demands answers and solutions. Menopause affects each women differently and hence it is unique and needs to be talked about. This focus has led to improvement in women\'s health bringing about better outcome in physical and mental health. Increase in life expectancy has led to menopausal health care, an important issue. Menopause is not disease but causes symptoms that can differ individually. Occasionally, surgery, radiation, and medications can cause menopause. Menopause hormone therapy (MHT), nonhormonal therapy, and lifestyle modifications under supervision can improve menopausal outcome. It also gives window of opportunity to evaluate and reduce risk of cardiovascular, bone, and urogenital health. Menopausal women should be provided with all options that are suitable and feasible for improvement in their life.

BACKGROUND: Women at middle age are puzzled by a series of menopausal disturbances, can be distressing and considerably affect the personal, social and work lives. We aim to estimate the global prevalence of nineteen menopausal symptoms among middle-aged women by performing a systematic review and meta-analysis.
METHODS: Comprehensive search was performed in multiple databases from January, 2000 to March, 2023 for relevant studies. Random-effect model with double-arcsine transformation was used for data analysis.
RESULTS: A total of 321 studies comprised of 482,067 middle-aged women were included for further analysis. We found varied prevalence of menopausal symptoms, with the highest prevalence of joint and muscular discomfort (65.43%, 95% CI 62.51-68.29) and lowest of formication (20.5%, 95% CI 13.44-28.60). Notably, South America shared dramatically high prevalence in a sort of menopausal symptoms including depression and urogenital symptoms. Besides, countries with high incomes (49.72%) had a significantly lower prevalence of hot flashes than those with low (65.93%), lower-middle (54.17%), and upper-middle (54.72%, p < 0.01), while personal factors, such as menopausal stage, had an influence on most menopausal symptoms, particularly in vaginal dryness. Prevalence of vagina dryness in postmenopausal women (44.81%) was 2-fold higher than in premenopausal women (21.16%, p < 0.01). Furthermore, a remarkable distinction was observed between body mass index (BMI) and prevalence of sleep problems, depression, anxiety and urinary problems.
CONCLUSIONS: The prevalence of menopausal symptoms affected by both social and personal factors which calls for attention from general public.

UNASSIGNED: Postmenopausal bleeding (PMB) refers to any uterine bleeding in a menopausal women. In the early menopausal years, endometrial hyperplasia, polyps and submucosal fibroids are common etiologies of post menopausal bleeding. The most common cause of postmenopausal bleeding is endometrial atrophy, comprises of 60-80%, while endometrial hyperplasia and endometrial cancer contribute to only 11% of Post menopausal bleeding. The aim of study is to analyses histomorphological pattern of endometrium in patients presenting with post-menopausal bleeding in Jharkhand.
UNASSIGNED: 103 postmenopausal women presenting to tertiary center of Jharkhand in 2020-22 with bleeding were subjected to endometrial curettage for histopathology. Analysis is based on morphological criteria to assess endometrium. Endometrial histology is of four categories: Proliferative, Secretory, premalignant and carcinoma.
UNASSIGNED: The highest incidence of postmenopausal bleeding was noticed in age group of < 60 years and incidence of malignancy was higher after 57 years of age. The majority of patients had parity between 1 and 3 (78.6%). Malignant & premalignant lesions comprises about 22.3% among that 77.7% were due to benign causes. Among the benign causes of postmenopausal bleeding, proliferative endometrium was the commonest finding. Types of hyperplasia encountered were simple hyperplasia without atypia (6.8%), Complex hyperplasia without atypia (3.9%),Complex hyperplasia with atypia (4.8%) and Simple hyperplasia with atypia (4.8%). 21.4% of cases of postmenopausal bleeding were associated with atrophic endometrium. Secretory endometrium seen in 17.5% of women. Endometrial carcinoma accounted for 12.6% of cases of postmenopausal bleeding. Out of these 69.2% were of endometroid type of endometrial carcinoma, 15.3% were of papillary serous carcinoma and 15.3% had clear cell carcinoma. The mean age of patients with endometrium carcinoma was 62.3 years. All cases of endometrial carcinoma were associated with 1 or more risk factor like diabetes/hypertension/Nulligravida.
UNASSIGNED: Proliferative Endometrium was a major cause of postmenopausal bleeding. Among the malignant causes, endometrial adenocarcinoma of endometroid type was most frequent with a lower mean age at presentation than other high grade cancers like papillary serous carcinoma & clear cell carcinoma.

UNASSIGNED: Breast cancer (BC) is considered a risk factor for sexual dysfunction, which may be associated with the diagnosis itself or with oncological treatments. However, sexual dysfunction often remains underdiagnosed and unaddressed among BC survivors.
UNASSIGNED: The study sought to evaluate the sexual function of postmenopausal BC survivors compared with postmenopausal women without BC.
UNASSIGNED: This case-control study included 178 postmenopausal BC survivors (stages I-III), 45 to 70 years of age, with amenorrhea for ≥12 months and sexually active. They were compared with 178 women without BC, matched (±2 years) for age and time since menopause in a 1:1 ratio. Sexual function was evaluated using the Female Sexual Function Index (FSFI), which consists of 6 domains (desire, arousal, lubrication, orgasm, satisfaction, and pain), with a total score ≤26.5 indicating risk of sexual dysfunction. Statistical analysis included Student\'s t test, chi-square test, and logistic regression (odds ratio [OR]).
UNASSIGNED: Evaluation of sexual function in postmenopausal women treated for BC.
UNASSIGNED: Postmenopausal BC survivors showed poorer sexual function in the desire domain (P = .002). No significant differences were observed between groups in the other FSFI domains and total score (P > .05). Postmenopausal BC survivors had a higher prevalence of risk of sexual dysfunction (64.6% with a total score ≤26.5) compared with the control group (51.6%) (P = .010). Adjusted risk analysis for age and time since menopause revealed a higher risk of sexual dysfunction in BC survivors compared with women without cancer (OR, 1.98; 95% confidence interval, 1.29-2.96; P = .007). Among BC survivors, the use of hormone therapy was associated with a higher risk of sexual dysfunction (OR, 3.46; 95% confidence interval, 1.59-7.51; P = .002).
UNASSIGNED: Postmenopausal BC survivors should be regularly assessed before and throughout treatment to enable the early detection and diagnosis of sexual dysfunction.
UNASSIGNED: The main strength is that this study might contribute to a better understanding of sexual function in postmenopausal BC survivors compared with women without BC. The main limitation is that while the FSFI is a valid and reliable tool for the evaluation of female sexual function, it does not allow a comprehensive diagnosis of sexual dysfunction, as it is not applicable to partners.
UNASSIGNED: Compared with postmenopausal women without BC, postmenopausal BC survivors face a higher risk of sexual dysfunction, especially when treated with adjuvant hormone therapy.

UNASSIGNED: Healthcare professionals and educators closely monitor the occurrence of climacteric symptoms in women\'s primes. Knowledge and perception of menopause play a crucial role in improving quality of life. This study aimed to assess the knowledge and perceptions of menopause among Saudi women and identify its predictors. This study is the first of its kind in the southern region of Saudi Arabia.
UNASSIGNED: Conducted in accordance with the STROBE guidelines, this cross-sectional study was carried out in the Jazan region from May 2022 to January 2023 and involved 480 Saudi women who provided consent. Data were collected through interviews using a validated questionnaire and random sampling. The questionnaire consisted of four parts: informed consent, demographics, 21 knowledge questions, and ten menopause perception questions. The validity of the content and the internal consistency were evaluated before data collection. Primary healthcare centers were randomly selected from four governorates with a proportional sample size to the population. Descriptive analysis, Pearson correlation, and multivariate logistic regression analyses were performed using IBM-SPSS.
UNASSIGNED: Among the participants, 64 % were under 40 years old, 80 % had experienced menarche between the ages of 10 and 15, 48 % were employed, approximately half held a bachelor\'s degree, and they had a good family income. The mean knowledge score of the participants was 48.87 ± 11.72, with a minimum score of 27 and a maximum score of 78. In terms of knowledge categories, 56.3 % of the participants (N = 270) were classified as having low knowledge, while 43.8 % (N = 210) were classified as having high knowledge. Most of the participants had positive perceptions and agreed that menopause is a natural event in women\'s lives. There was a significant positive correlation between knowledge and perception (R = 0.219, P < 0.01). Variable findings were observed regarding the role of explanatory variables in women\'s knowledge of menopause between univariate and multivariate models. The results of the multivariate model showed that age (46-50 years, OR = 0.42), having children (OR = 1.09), residence (OR = 0.45-5.73) and family income categories (medium: OR = 3.98, good: OR = 3.78, and excellent: OR = 1.95) had a significant impact on knowledge, highlighting the correlation between demographic factors and knowledge.
UNASSIGNED: Based on the study findings, we recommend implementing workplace and community-based activities to increase women\'s awareness of menopause and incorporating it as an integral part of counseling sessions for women in this age group. Therefore, the results of the study will be shared with the relevant authorities responsible for women\'s health, enabling them to effectively support and educate women.

UNASSIGNED: Recent evidence has shown that reproductive factors are associated with an increased risk of heart failure with preserved ejection fraction in women. However, the pathogenic pathways underlying this relationship are unclear. Subclinical myocardial fibrosis has been found to be a common pathway in a large proportion of patients with heart failure with preserved ejection fraction.
UNASSIGNED: This study examined the relationship between vital reproductive factors (parity, pregnancy, age at menopause, and use of hormone replacement therapy [HRT]) with interstitial myocardial fibrosis (IMF) and myocardial scar measured by cardiac magnetic resonance imaging (CMR) T1 mapping and late gadolinium enhancement, respectively.
UNASSIGNED: There were 596 female participants (mean age 67 ± 8 years) enrolled in MESA (Multi-Ethnic Study of Atherosclerosis) who had complete parity data and underwent CMR. Parity was categorized as 0 live births, 1 to 2, 3 to 4, and ≥5 live births. Multivariable regression models were constructed to assess the associations of parity status, history of null gravidity, age at menopause and HRT with CMR obtained measures of IMF (extracellular volume [ECV], native-T1 time) and myocardial scar.
UNASSIGNED: Women with a history of nulliparity had greater ECV% (β = 0.95 ± 0.28, P = 0.001) and native-T1 ms (β = 10.6 ± 4.9, P = 0.03) than those who had 1 to 2 live births. These associations were independent of age, traditional cardiovascular risk factors, and interim cardiovascular events. Similar associations were found for women with a history of null gravidity compared to those with a history of pregnancy (ECV% [β = 0.7 ± 0.3, P = 0.02] and native-T1 ms [β = 10.6 ± 5.2, P = 0.04]). There was no association between age at menopause and HRT with markers of IMF. There were no associations between parity status, null gravidity, and age of menopause with the presence of myocardial scar; however, those who used HRT were independently associated with a lesser risk of myocardial scar (OR: 0.20; 95% CI: 0.05-0.82).
UNASSIGNED: In a multiethnic cohort, women with a history of nulliparity or null gravidity had greater IMF defined by CMR, while those who used HRT were less likely to have myocardial scar.

Menopausal women experience changes in ovarian activity and fluctuating hormone levels. The aim of this study was to detect ongoing sleep and nutritional problems in postmenopausal women. This study was conducted with 62 postmenopausal women who had been diagnosed with major depressive disorder, were aged 42-64, were not dieting for at least 1 month, and had been using antidepressants for at least 6 months. The Pittsburgh Sleep Quality Index and Depression Anxiety Stress Scale-42 were used. Anthropometric measurements were taken and body composition analysis was performed. The prevalence of obesity and overweight were 12.9% and 71%, respectively. Hot flashes, night sweats, and mood swing were more common in those who had been through menopause for <5 years. Also, the PSQI, Depression, and Stress scores of those women were higher. Women who had been menopausal for ≥5 years had a higher BMI, waist/hip ratio, and fat mass and better sleep quality and lower daytime dysfunction according to the PSQI. Energy and fat intake were higher, while protein, vitamin C, and calcium intakes were lower in women who had been menopausal for ≥5 years. It is crucial for healthcare professionals to review approaches for early and late menopausal periods and to individualize treatment options, especially in patients whose symptoms persist.

Introduction: The ongoing concern of the medical profession regarding chronic medication is related to increasing patient adherence and compliance to treatment and reducing medication side effects. In this respect, drugs represented by fixed-dose combinations of active substances within the same tablet have emerged. Such a principle can be extrapolated by following the potential beneficial effects that a chronic medication can have on chronic pathologies affecting different systems. Materials and Methods: The study included 48 female Albino Wistar rats, aged 16-18 months, which were divided into two groups: ovariectomized and non-ovariectomized rats. One batch of 12 non-ovariectomized rats received no treatment, becoming a control batch (NOVX-M). The ovariectomized (OVX) group was divided into 3 batches of 12 rats each: no treatment, control (OVX-M), fenofibrate-treated (OVX-F) and statin-treated (OVX-S) rats. At 12 weeks after ovariectomy, a femoral fracture occurred in the right hind limb of all animals included in the experiment To reveal the changes, at intervals of 2, 4, 6 and 8 weeks post-fracture, the proximal part of the femur was evaluated by NMR diffusiometry, which allows random motion of proton molecules expressed by self-diffusion coefficients, D, thus allowing analysis of the size and complexity of microscopic order cavities within biological structures, such as pores inside bones. Results: The effects of hypolipidemic medication in the absence of estrogen were evidenced, proving the beneficial effect that fenofibrate can have in preserving healthy tissue exposed to osteoporotic risk during the menopausal period. The effects of lipid-lowering medication are also influenced by the duration of administration. Conclusions: Osteoporosis and heart disease are two chronic pathologies that affect mainly female population in the second half of life, and proving the dual therapeutic potential of lipid-lowering medication may also have positive effects by increasing adherence and compliance to treatment.