Search Results (1,588)

: Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of heart failure cases and is primarily characterized by impaired diastolic function, leading to increased ventricular filling pressures and symptoms like dyspnea and reduced exercise tolerance. Significant gender-specific differences are observed, with women, particularly post-menopausal, experiencing higher prevalence and distinct clinical profiles compared to men. Diastolic dysfunction in HFpEF involves altered cellular mechanisms such as reduced SERCA2a expression, impacting calcium handling and myocardial relaxation. Diagnostic strategies mainly employ echocardiography, including Doppler imaging, tissue Doppler imaging, and strain imaging, to assess ventricular relaxation and stiffness. However, early identification remains challenging, necessitating advanced tools like cardiac magnetic resonance and exercise stress testing for accurate diagnosis, especially in women who often present with subtle symptoms. Treatment options for HFpEF have traditionally been limited, but recent trials, notably EMPEROR-PRESERVED and DELIVER, demonstrated significant cardiovascular benefits using sodium–glucose cotransporter-2 (SGLT2) inhibitors. Additionally, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown promising results, particularly in obese patients. Despite these advances, gender differences in therapeutic response necessitate further research for personalized management strategies. Understanding sex-specific pathophysiological mechanisms and optimizing diagnostic criteria remain essential to improving prognosis and quality of life in HFpEF patients. Full article

Objective: Sexual dysfunction (SD) is a prevalent but frequently overlooked condition that adversely affects women’s quality of life and psychological well-being. This study aimed to examine the relationship between SD and depression, anxiety, and stress levels during premenopausal, pregnancy, and postmenopausal. Methods: This prospective, cross-sectional study included 300 women aged 18–70 who presented with SD symptoms to a tertiary care gynecology outpatient clinic. Participants were categorized into premenopausal, pregnant, and postmenopausal groups. Sexual function was assessed using the Female Sexual Function Index (FSFI), and psychological status was evaluated with the Depression Anxiety and Stress Scale (DASS-21). Univariate and multivariate logistic regression analyses were conducted to identify risk factors associated with SD. Results: The results showed that SD prevalence varied across life stages, with the highest rate (96%) observed in postmenopausal women. Significant decreases were found in all FSFI subscales, particularly lubrication and orgasm, during the postmenopausal period (p < 0.001). Although DASS-21 total scores did not differ significantly between groups (p = 0.227), severe stress was more prevalent in premenopausal women (p = 0.018). Univariate logistic regression revealed that older age, higher parity, and menopause increased SD risk (p < 0.001), while employment (p = 0.006), higher education (p = 0.012), and pregnancy (p < 0.001) were protective factors. Multivariate analysis identified parity as the only independent variable significantly increasing SD risk (p = 0.011). Weak but significant negative correlations were found between FSFI total score and DASS-21 total (r = −0.137, p = 0.018), anxiety (r = −0.135, p = 0.019), and depression (r = −0.176, p = 0.002) scores. Conclusion: These findings highlight the importance of individualized assessment and treatment approaches for women’s sexual health across different life stages, considering the influence of various biological, psychological, and social factors. Full article

Sex-related differences are found not only in the reproductive system but also across various biological systems, such as the cardiovascular system. Compared with premenopausal women, cardiovascular disease (CVD) tends to occur more frequently in adult men and postmenopausal women (Post-MW). Also, during the reproductive years, sex hormones synthesized and released into the blood stream affect vascular function in a sex-dependent fashion. Estrogen (E2) interacts with estrogen receptors (ERs) in endothelial cells, vascular smooth muscle, and the extracellular matrix, causing both genomic and non-genomic effects, including vasodilation, decreased blood pressure, and cardiovascular protection. These observations have suggested beneficial effects of female sex hormones on cardiovascular function. In addition, the clear advantages of E2 supplementation in alleviating vasomotor symptoms during menopause have led to clinical investigations of the effects of menopausal hormone therapy (MHT) in CVD. However, the findings from these clinical trials have been variable and often contradictory. The lack of benefits of MHT in CVD has been related to the MHT preparation (type, dose, and route), vascular ERs (number, variants, distribution, and sensitivity), menopausal stage (MHT timing, initiation, and duration), hormonal environment (progesterone, testosterone (T), gonadotropins, and sex hormone binding globulin), and preexisting cardiovascular health and other disorders. The vascular effects of sex hormones have also prompted further examination of the use of anabolic drugs among athletes and the long-term effects of E2 and T supplements on cardiovascular health in cis- and transgender individuals seeking gender-affirming therapy. Further analysis of the effects of sex hormones and their receptors on vascular function should enhance our understanding of the sex differences and menopause-related changes in vascular signaling and provide better guidance for the management of CVD in a gender-specific fashion and in Post-MW. Full article

Aging is associated with physiological changes that increase the risk of falls, impacting functional independence and quality of life. Multicomponent exercise training has emerged as an effective strategy for mitigating these risks by enhancing strength, balance, flexibility, and aerobic capacity. This study aimed to evaluate the effects of a 30-week multicomponent training program on functional fitness and fall prevention in older women. A parallel, single-blind randomized controlled trial was conducted with 40 participants (aged ≥ 65 years), divided into an exercise group and a control group. The intervention combined strength, balance, coordination, and aerobic training, following international exercise guidelines for older adults. Functional fitness was assessed using validated tests, including the Timed Up and Go (TUG) test, lower limb strength, flexibility, and aerobic endurance measures. Results demonstrated significant improvements in the intervention group, particularly in TUG performance (p < 0.001), lower limb strength (p < 0.001), and flexibility (p < 0.05), indicating enhanced mobility and reduced fall risk. These findings reinforce the importance of structured, multicomponent training programs for aging populations, particularly women, who experience greater musculoskeletal decline due to menopause-related hormonal changes. Future research should explore long-term retention of benefits and optimize intervention strategies. This study highlights the critical role of tailored exercise programs in promoting active aging, improving functional capacity, and reducing healthcare burdens associated with fall-related injuries. Full article

Menopause is associated with significant hormonal and reproductive changes in women. Evidence documents interindividual differences in the signs and symptoms associated with menopause, including cognitive decline. Hypothesized reasons for the cognitive decline include changes in hormone levels, especially estrogen, but study findings have been inconsistent. Hormone replacement therapies (HRTs) are often recommended to alleviate menopause-related symptoms in both peri- and postmenopausal women. However, the North American Menopause Society does not recommend the use of HRT for the management of cognitive complaints in perimenopausal women due to lack of evidence. Additionally, there are many women for which the use of HRT is contraindicated. As such, it would be helpful to have an alternative method for alleviating symptoms, including declines in cognition, during the menopause transition. Iron supplementation may be a promising candidate as it has been associated with improved cognitive performance in premenopausal women with iron deficiency and iron deficiency anemia. Because many women will experience heavy blood losses during perimenopause, they are at risk of becoming iron deficient and/or anemic. The use of iron supplementation in women with iron deficiency may serve to not only improve iron status but also to alleviate many of the signs and symptoms associated with perimenopause (lethargy, depressed affect, etc.), including cognitive decline. However, evidence to inform treatment protocols is lacking. Well-designed studies of iron supplementation in perimenopausal women are needed in order to understand the potential of such supplementation to alleviate the cognitive decline associated with perimenopause. Full article

Background and objective: Menopause is a significant physiological milestone in a woman’s life, coinciding with increased cardiovascular disease (CVD) risk due to various health-related changes. This narrative review focuses on cardiovascular health-related alterations during menopause and their implications on vascular function. Methods: An electronic database search was performed, drawing from sources such as PubMed and Google Scholar. Publications were included if they addressed CVD risk in peri- and postmenopausal women, and examined the impact of hormonal changes, traditional risk factors (e.g., hypertension, hyperlipidemia, diabetes), or lifestyle factors (e.g., diet, physical activity) on CVD. Results: Estrogen deficiency is pivotal, leading to adverse effects such as endothelial dysfunction, increased arterial stiffness, and lipid profile deterioration. Characteristics of menopause, including the age at onset, type or stage of menopause, and severity of symptoms, further modulate CVD risk. Additionally, the impact of traditional risk factors is amplified during this period. Strategies for the prevention of CVD in menopausal women are critically assessed, with a focus on lifestyle modifications, dietary interventions, and physical activity. Conclusions: This narrative review describes the potential benefits and risks of hormone therapy, alongside lipid-lowering therapies. Emphasis is placed on individualized risk assessment and management, highlighting the need for regular cardiovascular screenings and proactive management of risk factors. Full article

Background/Objectives: Genitourinary syndrome of menopause (GSM) encompasses a variety of symptoms associated with estrogen deficiency, affecting the genitourinary tract. Effective management often requires a multifaceted approach. Although radiofrequency (RF) treatment has been explored as a non-hormonal intervention for GSM, evidence remains limited and inconclusive. Oral collagen peptides have demonstrated systemic tissue benefits in dermatological studies, but with effects that are not yet well understood in the context of GSM. This pilot study investigated whether combining RF with an oral supplementation containing specific bioactive collagen peptides and ultra-low-molecular-weight hyaluronic acid would provide superior symptom relief compared to RF alone in women with GSM. Methods: Twenty menopausal women were randomized into two groups: Group 1 (n = 10) received vulvovaginal RF treatment every two weeks for two months; Group 2 (n = 10) received the same RF treatment alongside daily oral supplementation for four months. Subjective symptoms, objective signs, and vaginal pH were assessed at baseline (T0), post-RF treatment (T1), and three months post-RF treatment (T2), employing a two-way repeated-measures ANOVA to assess differences between groups over time. Results: Both groups showed substantial improvements in all the clinical parameters evaluated at T1 and T2 compared to T0. However, the magnitude of such improvements was higher among patients from Group 2, who achieved better outcomes at T2 compared to patients from Group 1, with differences being statistically significant regarding subjective symptoms (p < 0.001), objective signs (p < 0.001), and vaginal pH (p = 0.015), thus demonstrating the sustained benefits of the combination therapy over RF treatment alone during the follow-up time. Conclusions: Combined treatment with vulvovaginal RF and food supplements improved the signs and symptoms of GSM, and compared to RF treatment alone, it enhanced and maintained the benefits in a three-month follow-up period. Full article

Aging involves immune system deterioration (immunosenescence) and increased oxidative stress, both associated with morbidity and mortality. Menopause accelerates aging, highlighting the need for strategies to mitigate its effects in postmenopausal women. This study assessed the impact of daily oral supplementation for one month with 39 bioactive compounds (UNAMINA)—including amino acids, vitamins, and antioxidants—on immune function, redox parameters, stress-related hormones, and biological age in healthy postmenopausal women. Peripheral blood samples were collected before and after supplementation to analyze lymphocyte and neutrophil functions (adherence, chemotaxis, natural killer cell antitumor capacity, and lymphoproliferative response to mitogens), oxidative stress markers (antioxidant defenses such as glutathione peroxidase (GPx) and reductase activities, reduced glutathione (GSH) concentrations, as well as oxidants such as oxidized glutathione (GSSG), and lipid peroxidative damage) in blood cells, and stress-related hormones (dehydroepiandrosterone (DHEA) and cortisol) in plasma. Supplementation improved all immune cell functions and decreased oxidative stress (increasing antioxidants defenses such as GPx activity and GSH concentration and decreasing GSSG amount) and cortisol concentrations, whereas those of DHEA increased. The biological age also decreased. The results suggest that these bioactive compounds may be a beneficial strategy for promoting healthier aging in postmenopausal women by enhancing immune function, reducing biological age, improving redox balance, and regulating stress hormones. Full article

Lipedema is a chronic disease of the subcutaneous adipose tissue that mostly affects women. The etiopathogenesis of the disease is still poorly understood. Lipedema typically develops after major hormonal changes, such as puberty, pregnancy, and menopause. Alongside genetic susceptibility, the pathophysiological mechanism involving hormonal changes is mostly linked to aberrantly expressed estrogen receptors in adipose tissue. Lipedema has no known cure, and current therapies aim primarily to reduce symptoms, avoid complications, and slow the disease progression. Achieving or maintaining a healthy body composition, preserving or regaining mobility and functionality, preventing the progression of disease, and reducing pain and other symptoms are all possible outcomes of proper nutrition and weight management. Since nutrition may provide a long-term solution to control almost constant inflammation, it should be a major part of lipedema treatment. Despite the lack of a specific, scientifically supported diet for lipedema patients, several dietary approaches have been suggested. In this comprehensive narrative review, supported by published revisions and peer-reviewed studies following scrutiny of digital medical databases, the current state of knowledge and theories regarding the hormonal etiopathogenesis of lipedema are presented, as well as the role of nutritional intervention in reducing its symptoms and progression. Full article

Background/Objective: Palm tocotrienol has bone-protective properties in animal models, yet its underlying mechanism remains unclear. Given osteocytes’ role in bone homeostasis, this research aimed to investigate the effects of palm tocotrienol on the quantity of osteocytes and the expression of osteocyte-specific markers in ovariectomized rats. Methods: Adult female rats (Sprague Dawley; three-month-old; n = 6/group) were randomly divided into baseline, sham control, ovariectomized control, unemulsified palm tocotrienol (UPT), emulsified palm tocotrienol (EPT), and positive control. The baseline group was euthanized without intervention, whereas the sham group underwent a laparotomy procedure in which the ovaries were not excised. The other groups underwent bilateral removal of the ovaries and subsequently received UPT (100 mg/kg/day, 50% vitamin E), EPT (100 mg/kg/day, 25% vitamin E), or a combination of glucosamine sulfate (250 mg/kg/day) and calcium carbonate (1% in drinking water). Control groups were induced with similar gavage stress with olive oil. After 10 weeks, all rats were sacrificed for bone and serum analysis. Results: UPT and EPT significantly increased trabecular osteocyte and total lacunae numbers (p < 0.05 versus ovariectomized control). Both treatments significantly reduced mRNA expression levels of dentin matrix protein-1 (p < 0.05 versus ovariectomized control), whereas sclerostin mRNA expression was unchanged (p > 0.05 versus ovariectomized control). However, neither UPT nor EPT improved circulating or skeletal redox status (p > 0.05 versus ovariectomized control). Conclusions: Palm tocotrienol may support bone health by preserving the quantity of trabecular osteocytes and modulating osteocyte-mediated bone remodeling. Further research is required to elucidate its precise mechanisms. Full article

Sleep deprivation is a prevalent issue that disrupts the circadian rhythm of estrogen, particularly estradiol, thereby significantly affecting women’s skin health and appearance. These disruptions can impair skin barrier functionality and decrease dermal collagen synthesis. In this study, our results demonstrate that topical taurine supplementation promotes the expression of tight junction (TJ)-related proteins and enhances collagen production, effectively restoring skin homeostasis in sleep-deprived female mice. Mechanistically, taurine upregulates the expression of TMEM38B, a gene encoding the TRIC-B trimeric cation channel, resulting in increased intracellular calcium ion levels. This, in turn, promotes the upregulation of TJ-related proteins, such as ZO-1, occludin, and claudin-11 in epidermal cells, while also enhancing the expression of type III collagen in fibroblasts, thus restoring skin homeostasis. These findings suggest that taurine may serve as an alternative to estradiol, effectively improving skin homeostasis disrupted by sleep deprivation while mitigating the potential risks associated with exogenous estrogen supplementation. Collectively, these results provide preliminary insights into the protective mechanisms of taurine against sleep deprivation-induced skin impairments and establish a foundation for its potential application in treating skin conditions related to estrogen imbalances, such as skin aging in menopausal women. Full article

Background: About 14,000 women develop cervical cancer each year in the United States. Human Papillomavirus (HPV) vaccination is an effective primary prevention measure for HPV infections and cervical cancer among adolescents and young adults. For middle-aged and older women, they rely on secondary prevention (i.e., cancer screening) for early detection of cervical cancer. The average age at which women receive a cervical cancer diagnosis is around 50, when most women are in the middle of perimenopause. In this study, we use data from a longitudinal survey to examine whether going through menopause is associated with cervical cancer screening behavior four or eight years later. Methods: Data were taken from 2012, 2016, and 2020 waves of the Health and Retirement Study (HRS), a longitudinal survey of middle-aged and older adults in America. Using the 2012 and 2016 waves as baselines, two four-year (n = 1011 and n = 1263) and one eight-year (n = 823) longitudinal analyses were conducted. The lost follow-ups and those who have had a hysterectomy were excluded. Hierarchical logistic regression models were used to compare women who had gone through menopause to those who were premenopausal or perimenopausal at each of the baselines in terms of their likelihood of having a pap smear test four or eight years later. Results: Results show that the women who had gone through menopause were less likely to have a pap smear test four or eight years later when compared to those who were still premenopausal or perimenopausal at baseline. Women who had gone through menopause at the baseline of 2016 were less likely to have a pap smear test by 2020 (Odds Ratio = 0.76, p < 0.05). A similar association was found among women who had gone through menopause at the baseline of 2012 after controlling for their previous pap smear behavior and other covariates. Conclusions: The American Cancer Society and other professional organizations recommend that women have cervical cancer screenings regularly until age 65. Our findings suggest that women seem less likely to have a pap smear test after menopause. More research is needed to have a comprehensive understanding of cervical screening behavior in this age group of women. Full article

In the adult central nervous system (CNS), myelin regeneration primarily occurs through the differentiation of oligodendrocyte progenitor cells into mature oligodendrocytes. In men, declining testosterone levels accelerate the progression of multiple sclerosis (MS), while in women, menopause worsens MS-related disability. We previously demonstrated that functional testes and testosterone are required for the spontaneous remyelination of a focal lysolecithin (LPC)-induced demyelinating lesion in the spinal cords of male mice. Testosterone-dependent myelin repair was dependent on the induction of the chemokine receptor CXCR4 in astrocytes that repopulated the lesion and on cooperation between androgen-receptor signaling and CXCR4 signaling. In the present study, we investigated whether ovaries and estradiol have a comparable key role in female mice. Ovariectomy prevents, the appearance of astrocytes, while treatment with estradiol enhances astrocyte numbers and promotes remyelination by oligodendrocytes within the LPC-demyelinated lesion. Unlike testosterone, estradiol did not induce CXCR4 expression, and its effects remained unaffected by the CXCR4 inhibitor AMD3100. As was seen with testosterone treatment, the presence of astrocytes and myelinating oligodendrocytes within the LPC lesion of estradiol-treated females prevented the incursion of Schwann cells. These findings highlight estradiol’s crucial role in CNS remyelination in females, providing a strong rationale for estrogen-replacement therapy in estrogen-deficient and menopausal women with MS. Full article

Background: Postmenopausal women face increased risk of developing metabolic syndrome (MetS) and cardiovascular disease (CVD) due to hormone changes during menopause. Life’s Essential 8 (LE8), a relatively new cardiovascular health assessment index by the American Heart Association, may impact MetS diagnostics and potential treatment strategies. This study investigated the association between LE8 and MetS among postmenopausal women. Methods: National Health and Nutrition Examination Survey (NHANES) data were extracted (2011–2020). LE8 comprised eight health behaviours and factors (score of 0–100) classified into low (0–49), moderate (50–79), and high (80–100) cardiovascular health status. MetS was defined as metabolic dysfunctions comprising insulin resistance, central obesity, dyslipidaemia, impaired glucose metabolism, and hypertension. Complex survey-adjusted regression models were used. Effect modification by race and female hormone use were investigated. Results: 5402 postmenopausal women were included (mean age: 63.0 y), and 3152 (58.3%) met MetS criteria. LE8 scores for those with and without MetS were 58 ± 13.8 and 70 ± 14.1 (p < 0.001), respectively (mean ± SD). Higher LE8 scores were associated with lower odds of having MetS (Odds ratio (OR) for a 10-score increase: 0.53, 95% CI: [0.48, 0.57], p < 0.001). Nicotine exposure score was inversely associated with the likelihood of having MetS (0.52 [0.34, 0.80], p = 0.022). The association between LE8 status and odds of MetS differed by race (p-interaction = 0.01); ‘moderate’ or ‘high’ cardiovascular health status lowered odds of MetS in all races except other/multi-racial. Conclusions: The inverse relationship between LE8 scores and MetS suggests that integrating LE8 components into management strategies may help prevent CVD in postmenopausal women. Full article

Menopause is the natural period of aging in women induced by ovary deterioration, resulting in estrogen deficiency. We evaluated the antioxidative and anti-inflammatory properties of Cnidium officinale, Pueraria lobata Ohwi, and Leonurus japonicus (CPL) extracts on vascular endothelial dysfunction. After treatment, CPL extracts decreased serum lipid profiles, serum vasoactive substances, tail temperatures, and cardiovascular risk indices. In ovariectomized rats, vasodilation significantly increased, with an increase in endothelial nitric oxide synthase (eNOS) in the CPL200 and CPL500 groups compared with the OVX group (p < 0.05). The extracts also significantly reduced vascular cell adhesion protein 1 (VCAM-1) in the CPL50, CPL100, and CPL200 groups compared with the OVX group (p < 0.05, p < 0.01, and p < 0.001, respectively). Intercellular adhesion molecule 1 (ICAM-1) was also reduced in the CPL100 and CPL200 groups compared with the OVX group (p < 0.001 and p < 0.0001, respectively); this was achieved through the downregulation of the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and inducible nitric oxide (iNOS), which resulted in the synthesis of nuclear factor erythroid 2-related factor 2 (NRF2) and eNOS in HUVECs. Our results show that CPL extracts could provide cardioprotective effects against vascular endothelium dysfunction by decreasing inflammation and upregulating vasodilation, ascertained by evaluating the antioxidant systems of ovariectomized rats. Further studies are needed to explore the long-term cardioprotective effects. Full article