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Hot Flashes/Hot Flushes/Menopausal Symptoms
Published in Charles Theisler, Adjuvant Medical Care, 2023
Hot flashes are intense waves of heat felt over the face, neck, and chest. Hot flashes and sweating, especially night sweats, are the most common symptoms of menopause and perimenopause. Mood and sleep disturbances are also frequent complaints. Menopause marks the end of the menstrual cycles and is diagnosed after a woman has gone 12 months without a menstrual period. Some hot flashes pass in a few seconds, while others may last for more than 10 minutes. Overall, episodes of hot flashes can last several months or years. African American and Hispanic women tend to experience hot flashes for more years than white and Asian women. Researchers do not know the exact causes of hot flashes.
Lifestyle Medicine in Menopause and Bone Health
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Menopause, or the “climacteric” (meaning a critical period or event), is the end of the monthly menstrual cycle.1 Menopause can mean significant changes for women mentally, emotionally, and physically, but healthy lifestyle behaviors can help. Diet, physical activity, and other lifestyle behaviors can improve menopausal symptoms and prevent or reverse potential pathologic outcomes. However, relevant patient education and counseling requires special provider knowledge and attention.
Endocrine Therapies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
It works by binding reversibly to the aromatase enzyme through competitive inhibition, thus inhibiting the conversion of androgens to estrogens in peripheral tissues (i.e., extra-gonadal tissues). For this reason, it is not recommended for use in premenopausal women as their ovaries will continue to produce estrogen. If menopausal status is unknown, a laboratory test is recommended. Studies have shown that anastrozole achieves >96.7% inhibition of aromatase at a dosage of 1 mg/day, and 98.1% inhibition at 10 mg/day. The 1 mg/day dose provides a decrease in aromatase activity sufficient for at least an 85% decrease in estradiol levels in postmenopausal women, with levels of corticosteroids and other adrenal steroids unaffected.
Assessment of knowledge, understanding and awareness of Chinese women clinical staff towards menopause hormone therapy: a survey study
Published in Journal of Obstetrics and Gynaecology, 2023
Ye Zhu, Xin Yang, Yanjie Wang, Xiaodong Zhu
Chinese clinical staff showed non-compliance to MHT as they thought that menopause is a natural process of ageing, and intervention is not required. Previous studies have demonstrated that Chinese immigrant women interpreted menopause as a natural ageing process (Liu and Eden 2007). A total of 209 (32.4%) participants were reluctant to the use of MHT as they were worried about weight gain and medication dependence, which is also a common concern among the general population. A retrospective analysis revealed that there is no evidence that oestrogen or a combination of oestrogen and progestogen increases body weight and body mass index. Approximately 60% of women in menopause will gain weight, due to decreased oestrogen levels, increased food intake and reduced physical activity (Kongnyuy et al.1999).
Optimizing sleep across the menopausal transition
Published in Climacteric, 2023
Menopause is an important transition point from a reproductive to a non-reproductive stage of life encompassed within the normal aging process for women. Menopause occurs at a median age of 51.4 years [1], but can range between 40 and 58 years of age. The transition to menopause and postmenopause can be associated with the emergence of several symptoms, including sleep disturbances, which have a major impact on long-term health, healthcare utilization, quality of life and work productivity. Sleep disturbance can arise due to multiple factors, including underlying physical and mental health conditions, medications, personal life stressors, socioeconomic factors, as well as factors specifically related to menopause (e.g. vasomotor symptoms). For some women, sleep disturbances that are already present before menopause can become exacerbated during this time. Surgical menopause can be associated with more severe sleep disturbances than natural menopause, as reviewed elsewhere [2]. Here, this review provides an overview of sleep disturbance in the natural menopausal transition, focusing on its association with vasomotor symptoms and the underlying changes in female reproductive hormones. The review also highlights current treatment options. Sleep disturbance significantly affects functioning and health in the context of menopause, and there is a need for further research of the underlying mechanisms to advance effective preventative and treatment strategies that ensure optimal health and well-being of midlife women.
Impact of estetrol (E4) on hemostasis, metabolism and bone turnover in postmenopausal women
Published in Climacteric, 2023
J. Douxfils, U. Gaspard, M. Taziaux, M. Jost, C. Bouvy, R. A. Lobo, W. H. Utian, J.-M. Foidart
As women age after menopause, risks increase for osteoporosis, cardiovascular disease and cognitive decline. Hormone therapy (HT), used to relieve the spectrum of menopausal symptoms that include both vasomotor and genitourinary symptoms, can also reduce bone loss, bone fractures, new onset diabetes mellitus, coronary heart disease and all-cause mortality [1]. Nevertheless, the risk of developing venous thromboembolism (VTE) is still a matter of concern for women around the age of the menopause and starting oral HT [2]. The risk of VTE is increased especially with preparations containing oral conjugated equine estrogen (CEE) [3], is less pronounced with oral estradiol (E2) and is lowest with transdermal E2 preparations [3,4]. Combinations containing CEE or E2 and medroxyprogesterone acetate or norethisterone have been linked to an even greater increased risk of VTE [3]. The VTE risk has been explained, at least in part, by the hemostatic imbalance induced by HT [5–7]. HT can also impact metabolic markers including total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDLc), triglycerides and glucose levels [8–11].