Search Results (1,697)

Background/Objectives: While the prevalence of depression increases during the peri- and post-menopausal periods, the potential of diet as both a modifiable risk factor and complementary treatment option has received limited research attention in this population. To address this gap, we conducted a scoping review aiming to map and synthesize the existing literature on diet and depression in peri- and post-menopause. Methods: Studies were identified through Medline, EMBASE, PsycINFO, CENTRAL, Web of Science, and Scopus. After deduplication in Covidence, two reviewers independently screened titles, abstracts, and full texts using predefined eligibility criteria. Data were extracted using standardized forms and presented in tables and figures. Methodological quality was assessed using the Cochrane RoB-2 for intervention studies and NHLBI tools for observational studies. Results: Thirty-eight studies met the inclusion criteria, including 29 observational and 9 interventional studies. Dietary patterns showed the most consistent associations with depressive symptoms, whereas findings for foods, nutrients, and other food components were inconsistent. Most observational studies had a moderate to high risk of bias, while over half of experimental studies were rated as low risk. Conclusions: Although limited by volume and poor methodological quality, existing evidence suggests that healthy diets may be protective against depressive symptoms in peri- and post-menopausal women, while unhealthy diets may increase risk. High-quality cohort studies and clinical trials are needed to guide future research and inform professionals working at the intersection of nutrition, psychiatry, and women’s health. Protocol registration: osf.io/b89r6. Full article

Postmenopausal osteoporosis (PMOP) has become an important public health issue. The diagnosis of PMOP relies on clinical symptoms and radiology. However, most patients with PMOP do not exhibit obvious symptoms in the early stages of this disease. This study aimed to explore the feasibility of surface-enhanced Raman scattering (SERS) technology in the auxiliary screening of PMOP. PMOP rats were induced by ovariectomy (OVX) surgery, with a Sham group and an icariin (ICA) treatment group serving as controls. A monolayer film of Au nanoparticles (NPs) was prepared using the Marangoni effect in an oil/water/oil three-phase system, and was used to detect serum SERS signals in the Sham, OVX, and ICA treatment groups. Then, the spectral diagnostic model for PMOP screening was established utilizing partial least squares (PLS) and support vector machine (SVM) algorithms. Histopathology confirmed the establishment of the PMOP rat model. The assignment of Raman peaks and the analysis of spectral differences revealed the biochemical changes associated with PMOP, including the upregulation of tyrosine levels and the downregulation of arginine, tryptophan, lipids, and collagen. When employing the PLS-SVM algorithm to simultaneously classify and discriminate three groups of samples, the diagnostic sensitivity for PMOP is 93.33%, the specificity is 96.67%, and the accuracy of three-class classification is 91.11%. This study demonstrated the potential of SERS for the auxiliary screening of PMOP. Full article

Although the relationship between risk factors and disease patterns still remains poorly understood, arterial hypertension in climacteric women is a substantial risk factor for multimorbidity. This cross-sectional study analyzed data from 1003 women aged ≥40 years attending Brazilian Basic Health Units to assess multimorbidity (≥2 chronic conditions) and its patterns (cardiometabolic, musculoskeletal, and neuropsychological). An adjusted logistic regression revealed that postmenopausal status (OR: 2.17; 95% CI: 1.05–4.48) and an age of ≥70 years (OR: 2.85; 95% CI: 1.16–6.99) were key risk factors for multimorbidity. Notably, 86% of hypertensive women had multimorbidity, most frequently dyslipidemia (50%), type 2 diabetes (37%), and thyroid disorders (18%). The cardiometabolic pattern (86% prevalence) was strongly associated with hypertension, especially among women aged ≥50 years (OR: 2.10; 95% CI: 1.10–3.98) and those with obesity grade I+ (OR: 2.30; 95% CI: 1.36–3.89). Musculoskeletal disorders were associated with postmenopausal status (OR: 2.41; 95% CI: 1.05–5.51) and obesity (OR: 1.92; 95% CI: 1.08–3.43), while neuropsychological diseases showed no significant associations. These findings highlight that hypertensive climacteric women—especially postmenopausal, older, or those with obesity—face elevated risks of cardiometabolic and musculoskeletal multimorbidity, underscoring the need for targeted preventive strategies in this population. Full article

Stauntonia hexaphylla (Thunb.) Decne (SH), a medicinal plant from the Lardizabalaceae family, holds traditional importance in East Asia for treating rheumatism. Steam treatment is commonly applied to enhance its medicinal properties, but the chemical and biological changes resulting from this process remain unexplored. This study compared steamed and untreated SH fruit (SHF) extracts, analyzing their chemical composition, antioxidant activity, and effects on bone health using in vitro models. Steamed SHF extracts exhibited increased levels of 5-hydroxymethylfurfural (5-HMF), total flavonoids, phenolics, and enhanced antioxidant activity. Bone health assessment using osteoclasts differentiated from RAW 264.7 cells and osteoblasts from MC3T3-E1 cells revealed that steamed extracts promoted alkaline phosphatase activity, calcium nodule formation, and collagen synthesis in osteoblasts while inhibiting tartrate-resistant acid phosphatase (TRAP) activity in osteoclasts. Additionally, steamed SHF extracts effectively modulated gene expression related to osteoclastogenesis and osteoblastogenesis by downregulating TRAP, NFTAc1, RANK, MMP9, c-Fos, and TRAF6 while upregulating ALP, Runx2, BGLAP, Col1a1, and OPG. The component 5-HMF played a pivotal role in promoting alkaline phosphatase and inhibiting TRAP activities. These findings suggest that steamed SHF may offer a promising therapeutic approach for postmenopausal osteoporosis. Full article

Background: Premenopausal women typically exhibit superior glucose metabolism compared to males, but this metabolic advantage is lost after menopause. The primary cause is the sharp decline in estrogen levels post-menopause. Genistein, a natural compound predominantly derived from leguminous plants, possesses structural similarity to estrogen. This enables specific binding to estrogen receptors, allowing genistein to exert estrogen-mimicking effects under conditions of estrogen deficiency. The aim of this study was to investigate the effects and potential mechanisms of genistein on glucose metabolism in the liver and skeletal muscle of ovariectomized (OVX) mice fed a high-fat diet (HFD). Methods: Animal experiments were performed using 8-week-old mice that were OVX to construct a model of estrogen deficiency and impaired their glucose metabolism by a continuous HFD. Genistein was administered by gavage (50 mg/kg-day) for 10 weeks and 17β-estradiol was administered subcutaneously (50 μg/kg) every 4 days for 10 weeks as a positive control. Results: Genistein significantly improved glucose metabolism (including fasting glucose, postprandial glucose, serum glucose levels, and HOMA-IR index) but did not affect serum estrogen levels and uterine weights in OVX mice. Genistein promoted increased expression and translocation of glucose transporter 4 (GLUT4) in the gastrocnemius muscle, enhanced phosphorylation of the PI3K/AKT pathway, and upregulated expression of the G protein-coupled estrogen receptor (GPER). Concurrently, it stimulates hepatic glycogen accumulation and upregulates GLUT2 expression in the liver. Conclusions: GEN improves glucose metabolism in ovariectomized mice, and this improvement is primarily attributed to increased expression and membrane translocation of GLUT4 in the gastrocnemius muscle mediated by the GPER-PI3K/AKT pathway. Full article

Salivary gland dysfunction is a common but underexplored complication of menopause that contributes to oral dryness, dysphagia, and increased risk of infection. Although ferroptosis, a form of regulated necrotic cell death driven by iron-dependent lipid peroxidation, has recently been implicated in postmenopausal tissue degeneration, its regulatory mechanisms in salivary glands remain unclear. In this study, we investigated the roles of mitochondrial dysfunction and mitophagy in driving ferroptosis-induced salivary gland injury in an ovariectomized (OVX) rat model of estrogen deficiency. OVX rats exhibited elevated markers of oxidative stress, lipid accumulation, and iron overload, and suppression of GPX4 activity in the salivary glands, consistent with ferroptotic activation. These changes were accompanied by impaired mitochondrial dynamics (MFN1 and OPA1), decreased expression of mitochondrial antioxidant regulators (PGC-1α, SOD, and catalase), and upregulation of mitophagy-related genes (PINK1, ULK1, Rab9, and LC3B), as well as LAMP, a lysosomal marker involved in autophagosome–lysosome fusion, while ferritinophagy (NCOA4) remained unchanged. Early administration of ferrostatin-1 effectively suppressed these pathological changes, preserving both glandular structure and function, as evidenced by the restored AQP5 and AMY2A expression. Collectively, our findings reveal that ferroptosis in estrogen-deficient salivary glands is regulated by mitochondrial instability and aberrant mitophagy, and ferrostatin-1 mitigates this cascade through multi-level mitochondrial protection. These results highlight ferrostatin-1 as a promising preventive agent against menopause-associated salivary gland dysfunction, with broader implications for organ-specific ferroptosis modulation. Full article

Uterine adenosarcoma with sarcomatous overgrowth (ASSO) is an exceptionally rare and aggressive subtype of uterine sarcomas, characterized by high mitotic activity, deep myometrial invasion, and an elevated risk of recurrence and metastasis. We report the case of a 79-year-old institutionalized woman with a history of hypertension, type 2 diabetes, chronic hepatitis B, and mild Alzheimer’s disease. During routine hepatic ultrasound surveillance, an incidental 26 mm endometrial lesion was detected. Initial diagnostic hysteroscopy revealed a benign endometrial polyp. However, due to the patient’s institutionalization and absence of gynecologic symptoms, no specialized follow-up was conducted. Four years later, she presented with profuse postmenopausal bleeding. Imaging revealed a markedly enlarged uterus with a 12–13 cm heterogeneous endometrial mass containing cystic and hemorrhagic areas, demonstrating diffusion restriction and significant contrast enhancement on MRI, with no radiologically suspicious lymphadenopathy. Hysteroscopy demonstrated a giant polyp with a broad implantation base; histology suggested sarcomatous transformation. Definitive diagnosis after total hysterectomy with bilateral salpingo-oophorectomy confirmed high-grade ASSO with homologous sarcomatoid overgrowth, consistent with endometrial stromal sarcoma. This case illustrates the progressive malignant transformation of an initially benign-appearing lesion in a patient with significant comorbidities and limited follow-up. It underscores the importance of clinical vigilance, regular monitoring, and interdisciplinary coordination in the evaluation of uterine enlargement in asymptomatic postmenopausal women. Full article

Background: Vulvar leiomyosarcoma (VLMS) is a rare and aggressive soft tissue malignancy arising from smooth muscle cells, comprising less than 3% of vulvar cancers. Its clinical resemblance to benign vulvar lesions often leads to delayed diagnosis. Despite surgical resection and adjuvant therapy, VLMS is associated with high recurrence rates and a poor prognosis, and due to its rarity, there is no standardized management or surveillance protocol. Case Report: We present a case of high-grade VLMS in a postmenopausal woman, initially diagnosed in 2020 and managed with surgical excision and adjuvant radiotherapy. The primary tumor was a 10 cm solid, lobulated mass involving the mons pubis, with histology confirming high-grade leiomyosarcoma based on marked cellular atypia, high mitotic activity, and smooth muscle differentiation. Immunohistochemistry was positive for SMA, vimentin, and CD34, and negative for S100 and MyoD1. Five years later, the patient developed a local recurrence with an enlarged inguinal lymph node. She underwent complete tumor resection and bilateral inguinal lymphadenectomy. Histology of the recurrent lesion mirrored the initial findings, with no lymph node metastases. This case highlights the aggressive nature and potential for late recurrence in vulvar leiomyosarcoma, underscoring the importance of long-term surveillance. Conclusions: High-grade VLMS is a rare malignancy with a high recurrence risk. This case highlights the importance of early diagnosis, radical surgical treatment, and long-term surveillance. Although recurrence occurred five years after the initial treatment, timely surgical intervention led to a favorable postoperative course. Multidisciplinary management and individualized follow-up strategies remain key to improving outcomes in these rare gynecologic sarcomas. Full article

Menopause is a natural and inevitable part of life for women, leading to many physical and psychological changes accompanied by declining estrogen levels. This systematic review aimed to evaluate the effect of curcumin, due to its antioxidant and anti-inflammatory properties, on postmenopausal outcomes in women. This comprehensive analysis of RCTs (randomized controlled trials) published in the last decade was selected through a search of PubMed, Wiley, Scopus, and Web of Science (PROSPERO Identifier: CRD42024549735). Study selection and data extraction were performed using exclusion and inclusion criteria according to the PICOS framework (P: Population, I: Intervention, C: Comparison, O: Outcomes, S: Study designs). Of the twelve studies that met the criteria, 11 had a low-risk bias, but reports were conflicting on serum estradiol levels, bone density markers, and vasomotor symptoms; no significant effects on physical, psychological, or sexual functions were observed. For cardiometabolic biomarkers, short-term curcumin intake showed no significant effects, while long-term interventions using bioavailable forms of curcumin showed improvements in serum fasting glucose, fasting insulin, HOMA-IR (Homeostatic Model Assessment of Insulin Resistance), and lipid parameters. There are a limited number of studies examining the effect of curcumin intake on menopause-related outcomes. While overdose has been observed in some studies attempting to restore estradiol levels, no significant effects have been observed. However, curcumin intake impacts postmenopausal symptoms (e.g., improving symptoms of osteoporosis) through its antioxidant and anti-inflammatory effects. Different forms and doses, combinations, and durations of interventions may influence outcomes. Better-designed studies are needed to understand the potential effects of curcumin intake during menopause. Full article

Background/Objectives: Cancer ranks as the second most prevalent cause of death worldwide, according to the World Health Organization. Approximately one in six global deaths is attributed to cancer. Among females, breast cancer stands out as the most frequent type of tumor. Raloxifene (RLX), recognized as a selective estrogen receptor modulator, has been employed as a therapeutic option in treating breast cancer among postmenopausal women. The objective of this study was to investigate the anticancer potential of raloxifene-loaded hexosomes, nanoliposomes, and nanoniosomes to identify the most effective formulation. Methods: The particle size, zeta potential, entrapment efficiency, and structural elucidation of the various nanovesicle formulations was validated; Results: Each nanocarrier exhibited a negative surface charge, nanometric size, and a reasonable encapsulation efficiency. Cytotoxicity of the different raloxifene-loaded nanovesicles on MCF-7 breast cancer cell lines and MCF10 non tumorigenic cells revealed the substantial cytotoxic activity of the hexosomal nanocarrier compared to the other nanovesicles, exhibiting the lowest IC50 = 45.3 ± 1.10 µM. Conclusions: The RLX-loaded hexosomal formulation showed superior cytotoxic activity, indicating its potential as a highly effective therapeutic agent. To fully understand its capabilities and mechanisms, further in vitro characterization studies are necessary. Full article

Background/Objectives: The decrease in estrogen levels during menopause is associated with an increase in visceral fat accumulation, which can contribute to the development of metabolic syndrome (MetS). While some studies have suggested a link between the Mediterranean diet (MedDiet) and the reduced incidence of MetS and its components in the general population, these findings have not been confirmed among postmenopausal women. Therefore, this study investigated the association between the adherence to the MedDiet and the odds of having MetS, and established the food groups responsible for this effect in postmenopausal women. Methods: This cross-sectional study involved 312 postmenopausal women who underwent anthropometric measurements and blood parameter assessment. Adherence to the MedDiet was assessed using the Alternate Mediterranean Diet score (the aMED score), and MetS was defined based on the updated 2022 criteria. Results: After adjusting for potential confounders, adherence to the MedDiet was inversely associated with central obesity and hypertension. For each one-point increase in the aMED score (indicating a better adherence to the MedDet), the odds of central obesity and hypertension were significantly reduced by 33% (OR = 0.669, 95% CI: 0.518; 0.866, p = 0.002) and by 18% (OR = 0.817, 95% CI: 0.689; 0.969, p = 0.020), respectively. A greater consumption of nuts and fish was associated with lower odds of central obesity (OR = 0.972, 95% CI: 0.950; 0.995; p = 0.016) and (OR = 0.989, 95%CI: 0.979; 1.000; p = 0.043), respectively, whereas high processed red meat consumption was associated with hypertension (OR = 1.004, 95% CI: 1.000; 1.008, p = 0.048). Conclusions: A greater adherence to the MedDiet was associated with lower odds of central obesity and hypertension among postmenopausal women; however, it did not translate to a reduced likelihood of having MetS. A higher consumption of nuts and fish was associated with lower odds of central obesity, whereas a higher consumption of red, processed meats was associated with higher odds of hypertension. Longitudinal studies are needed to determine the causality of these relationships. Full article

Type 2 Diabetes (T2D) is a prevalent metabolic disease with a strong association with cardiovascular complications. This study evaluated glycemic control and lipid profiles (total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides) in patients with T2D, based on glycated hemoglobin and fasting glucose levels, through a cross-sectional analysis of 4814 individuals (mean age: 66.2 ± 16.07 years with normal distribution; 51.5% male) from the Hospital Universitario Lucus Augusti in Northwest Spain. The aim was to assess the metabolic differences and potential influences of age, sex, and geographic setting. We observed that patients with T2D had lower low-density lipoprotein cholesterol, but higher triglycerides and high-density lipoprotein cholesterol levels compared to patients without T2D. A positive correlation was found between age and fasting glucose levels (r = 0.182; p < 0.05), with the highest glucose concentrations occurring in postmenopausal women. No significant differences were observed between rural and urban participants. These findings support the integration of targeted nutritional strategies and education programs in the clinical management of T2D, particularly in older adults. Full article

Introduction: The decline of serum estrogen in postmenopausal women leads to several changes in the vulvovaginal and vesicourethral areas, resulting in the genitourinary syndrome of menopause (GSM), characterized by bothersome symptoms such as vaginal atrophy, lack of lubrication, dyspareunia, urgency, dysuria, and recurrent urinary tract infections. Nevertheless, this condition could also be experienced by younger women affected by hormone-dependent tumors. Although topical estrogens are considered “the gold standard”, hormonal treatments cannot be indicated in cancer survivors. As a result, energy-based devices using radiofrequency and laser technologies have emerged as alternative options. This prospective study aimed to evaluate the benefits of non-invasive monopolar radiofrequency (RF) in women affected by GSM who have contraindications to, did not respond to, or declined local estrogen therapy. Methods: The patients underwent five weekly sessions of second-generation monopolar RF. At baseline and at the fifth session, two validated questionnaires were administered to the patients: the Visual Analogue Scale (VAS) and the Female Sexual Function Index (FSFI-19). On the other hand, the vaginal mucosa status was evaluated by clinicians through the Vaginal Health Index (VHI). At the end of the cycle, the Patient Global Impression of Improvement (PGI-I) questionnaire was collected. Results: Based on 44 patients who completed five sessions of radiofrequency, a significant improvement was observed in sexual function according to the FSFI scale (22.9 vs. 38.6; p < 0.001) and in VVA atrophy symptoms, as documented by the VAS score (223 vs. 125; p < 0.001). The mean VHI score increased by 3 points (p < 0.001). Moreover, according to PGI-I, 96% of patients reported a perceived improvement (PGI-I score ≤ 3). Conclusions: Radiofrequency could provide an innovative and safe therapeutic approach for patients suffering from GSM and VVA, especially when hormonal strategies are unsuitable. Full article

In the Japanese Multi-Centered Environmental Toxicant Study (JMETS) conducted in five areas across Japan, we demonstrated that bone mineral density (BMD) in female farmers without renal tubular dysfunction was not adversely affected by exposure to low to moderate levels of cadmium (Cd). We then expanded JMETS to the most Cd-polluted area in northern Japan, Akita prefecture, with area A as the control and areas B and C as Cd-polluted areas (Cd exposure levels: B < C), which also covered more female farmers with a wider age range (20–82 years) and Cd exposure sufficient to induce renal tubular dysfunction. We selected 1267 eligible subjects in the three areas and classified them by age and menstrual status. The distribution of blood and urinary Cd levels over the areas was A < B < C (blood Cd: 2.10, 3.78, and 3.39 µg/L, and urinary Cd: 3.02, 4.29, and 6.15 µg/g cr., respectively; p < 0.05), with the steepest age-dependent increase in area C, particularly in older postmenopausal subjects with a urinary Cd level around the threshold for renal tubular dysfunction. Urinary α1-microglobulin (α1MG) and ß2-microglobulin (ß2MG) levels in the three areas also showed age-dependent increases, with higher levels being observed in areas B and C than in area A. Furthermore, ß2MG levels in older postmenopausal subjects were significantly higher in area C than in area A (273 and 157 μg/g cr., respectively, p < 0.05). Age-dependent decreases in BMD were noted in all areas, with rapid reductions from peri- to postmenopausal subjects; however, marked differences in each age class were not observed among the three areas. In multiple regression models of BMD in all subjects using age, body weight, grip, urinary creatinine, urinary α1MG or ß2MG, and blood or urinary Cd as independent variables, urinary α1MG and ß2MG levels correlated with BMD, whereas blood and urinary Cd levels did not. Moreover, age and body weight correlated more strongly with BMD than blood and urinary Cd levels. Therefore, Cd, not only at a low level but also at a level that was sufficient to deteriorate renal tubular function, did not affect bones. These results provide further support for Cd exposure itself not directly affecting bones. Full article

Background: The human body’s exposure to high levels of endogenous estrogens and their metabolites, such as estradiol, estriol, 2-hydroxyestradiol, and 4-hydroxyestradiol, is implicated in the development and complications of breast cancers (BCs). Besides endogenous estrogen production, the human body is also exposed to environmental sources of estrogen and estrogen-like compounds, which include pharmaceutical estrogens, xenoestrogens, and phytoestrogens. Females consume pharmaceutical estrogens as a constituent of postmenopausal hormone replacement therapy (HRT) and oral contraceptive pills, either alone or in combination with progestins. Additionally, humans, including females, are exposed to estrogen-resembling non-native compounds called xenoestrogens, prevailing in pesticides, plastics, and personal care items via inhalation, dermal contact, and oral consumption. Several phytoestrogens, such as isoflavones and lignans, are consumed by humans as food ingredients. Methods and Results: Emerging cellular and molecular experimental evidence indicates that when binding to estrogen receptors (ERs), various pharmaceutical estrogens, including equine/synthetic forms, progestin combinations, and xenoestrogens, promote BC development and complications by triggering survival, proliferation, angiogenesis, and invasion of these cells. Conversely, other experimental observations reveal the protective and beneficial effects of phytoestrogens like genistein from soy products on BC development and complications. Conclusions: This comprehensive review article describes the implications of exposure to exogenous estrogens, such as pharmaceutical estrogens, xenoestrogens, and phytoestrogens, as risk factors in the prevention or development of BC and its complications. Full article