Menopause Int. 2012 Feb 2;
Alidoosti K, Abbaszadeh A, Hosseininasab A

Menopause is defined as amenorrhea for one year. Signs and symptoms are categorized as physical and psychological changes, including depression, hot flushes and ageing. Woman's responses to menopause are governed by lifestyle factors. The purpose of this study was to determine how Iranian women experience menopause and hormone therapy. A qualitative inquiry was conducted through semistructured, in-depth interviews to explore study questions in 11 menopausal women. Participants had positive and negative menopause experiences. Negative menopause experiences are due to severity of symptoms. Menopause can be facilitated by increasing women's knowledge about this phase and ways to cope with it.

J Autoimmun. 2012 Jan 31;
Konttinen YT, Fuellen G, Bing Y, Porola P, Stegaev V, Trokovic N, Falk SS, Liu Y, Szodoray P, Takakubo Y

The purpose of the review is to consider pathomechanisms of Sjögren's syndrome (SS), which could explain the female dominance (9:1), the most common age of onset (40-50 years) and targeting of the exocrine glands. Estrogens seem to specifically protect secretory glandular acinar cells against apoptosis whereas lack of estrogens during menopause and climacterium specifically leads to increased apoptosis of the exocrine secretory cells. Male gonads produce testosterone and convert it in exocrine glands to dihydrotesterosterone (DHT), which is anti-apoptotic and protects against acinar cell apoptosis. Estrogen-deficient women need to produce dehydroepiandrosterone (DHEA) in the adrenal glands and convert it to DHT in exocrine glands in a complex and branching reaction network in which individual enzymatic reactions are catalyzed in forward and backward directions by a myriad of different isoforms of steroidogenic enzymes. Tailoring DHT in peripheral tissues is much more complex and vulnerable in women than in men. In SS the intracrine steroidogenic enzyme machinery is deranged. These endo-/intracrine changes impair acinar remodeling due to impaired integrin α1β1 and integrin α2β1 expression so that the intercalated duct progenitor cells are unable to migrate to the acinar space, to differentiate to secretory acinar cells upon contact with laminin-111 and laminin-211 specifically found in the acinar basement membrane. The disarranged endo-/intracrine estrogen/androgen balance induces acinar cells to release microparticles and apoptotic bodies and to undergo apoptotis and/or anoikis. Membrane particles contain potential autoantigens recognized by T- (TCRs) and B-cell receptors (BCRs) and danger-associated molecular patterns (DAMPs) recognized by Toll-like receptors (TLRs). In membrane particles (or carrier-complexes) antigen/adjuvant complexes could stimulate professional antigen capturing, processing and presenting cells, which can initiate auto-inflammatory and autoimmune cascades, break the self-tolerance and finally lead to SS.

Maturitas. 2012 Jan 31;
Michalakis K, Coppack SW

There are several causes of primary ovarian insufficiency (POI) but all result in a premature cessation of female reproductive potential, mimicking the normal menopause. In normal menopause, there is increased cardiovascular risk associated with changes in body composition (specifically increasing adiposity). We sought to review the literature on POI in relation to changes in adiposity and related cardiometabolic risk factors. We conclude that POI patients are usually less obese than reference groups.

Med Arh. 2011; 65(6): 330-3
Lucic N, Milicevic S

The goal of the study is to demonstrate the activity of superoxide dismutase mitochondria (MnSOD-e) in normal and pathologic endometrium and correlation of hormonal status of these cases with the MnSOD-e activity.We analyzed 70 female patients, of which 30 of them had bleeding from the uterus (Group A) and 40 women had bleeding from the uterus, as well as a confirmed histopathological diagnosis of endometrial hyperplasia or endometrium carcinoma (Group B). In the follow-up we analyzed: age (respondents divided into five categories), parity (without pregnancy and multiple pregnancies), ultrasound (to determine whether there are pathological changes in the small pelvis), hormonal status of women (we took the blood of subjects to determine follicle stimulating hormone-FSH, luteinizing hormone-LH, progesterone-Pr, estradiol-Es), histopathological analysis (the material was collected by exploratory curettage of normal and pathologically altered endometrium), determining the activity of antioxidant enzymes in the blood and endometrium (we determined the activity of MnSOD-e, whose activity was determined in normal and pathological endometrium).Within age groups dominated patients from 41-50 years, as well as multiple pregnancies. In the experimental group the mean results had lower values of the MnSOD enzyme in blood (0.93) and endometrium (1.94) as compared to the control group in blood (1.27), and endometrium (2.79). The MnSOD-e levels in the follicular phase was approximately at the same level in the experimental and control group, while the values in the luteal phase and stage of menopause was greater in control compared to the experimental group. MnSOD-e levels in endometrium in the follicular phase and stage of menopause were lower in experimental than in the control group, whereas in the luteal phase in the experimental group the value was higher than in the control group.On the basis of the results, which show a decrease in MnSOD activity both in the blood and endometrium of patients with hyperplasia and endometrium carcinoma we can see the importance of detecting activity of these enzymes in the diagnosis of the mentioned histological lesions, and therefore also possibilities of their application in clinical practice.

Calcif Tissue Int. 2012 Feb 2;
Lee K

The effects of total fat mass (FM) and total lean mass (LM) on total bone mineral density (BMD) were examined using the Fourth Korea National Health and Nutrition Examination Survey, 2009. FM, LM, and BMD were measured by DXA in a population-based sample of 6,762 Koreans, aged 19-93 (1,613 men <50 years, 1,400 men ≥50 years, 2,120 premenopausal women, and 1,629 postmenopausal women). After adjusting for confounders (age, height, education, economic status, physical activity, smoking, alcohol use, serum vitamin D, medical history [diabetes, dyslipidemia, rheumatoid arthritis, and osteoporosis], family history of osteoporosis, multivitamin use, dietary intake [energy, calcium, and sodium], age at menarche, age at menopause, and hormone replacement therapy) and FM, higher LM was associated with a lower odds ratio for being in the group-specific lowest quintile of BMD (low BMD) in all groups. The odds for low BMD increased with higher FM in multivariate-adjusted analyses in men <50 years, but this was not significant in other groups. Total BMD decreased with a decrease in the LM quintile across all FM subgroups in men of all ages, in the lower two subgroups of FM quintile in premenopausal women, and in the middle subgroup of FM quintile in postmenopausal women. In conclusion, higher LM was associated with a lower risk of low BMD in both genders, while higher FM was associated with a higher risk of low BMD for men <50 years but not for women and men ≥50 years. The combined effects of LM and FM on BMD were gender- and menopause status-specific.

Hypertens Res. 2012 Feb 2;
Akishita M, Yu J

The incidence of cardiovascular disease (CVD) is lower in younger women than in men of the same age, but it increases after menopause, implicating the atheroprotective action of endogenous estrogen. Although observational studies have suggested the efficacy of estrogen therapy in postmenopausal women, placebo-controlled, randomized trials, such as the Women's Health Initiative, have not confirmed effects of estrogen therapy on CVD. Conversely, basic, experimental research has progressed and provided mechanistic insight into estrogen's action on blood vessels. By contrast, the vascular effects of androgens remain poorly understood and have been controversial for a long time. In recent years, an increasing body of evidence has suggested that androgens may exert protective effects against the development of atherosclerosis, at least in elderly men. Epidemiological studies have shown that the incidence of and mortality due to CVD were increased in elderly men with low testosterone levels, although the efficacy of androgen therapy remains unknown. Furthermore, recent experimental studies have demonstrated the direct action of androgens on the vasculature. In this review, we illustrate the effects of sex steroids on the cardiovascular system, focusing on the action of testosterone on the blood vessels.Hypertension Research advance online publication, 2 February 2012; doi:10.1038/hr.2012.4.

Arch Med Sci. 2011 Jun; 7(3): 486-92
Yazici S, Korkmaz U, Erkan M, Korkmaz N, Erdem Baki A, Alçelik A, Onder E, Ataoğlu S

In the present study, we investigated the effects of breast-feeding time on bone mineral density (BMD) later in life.The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 years, who were screened for osteoporosis by dual energy X-ray absorptiometry (DXA).They were classified into 4 groups with respect to the duration of their breast-feeding as never (group 1), 1-24 months (group 2), 25-60 months (group 3), or > 60 months (group 4). Bone mineral density results for the femur neck and lumbar spine were classified into 3 groups according to WHO criteria as normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD), and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were considered as having low bone mass (LBM).We found a correlation between duration of lactation and femur BMD or spine BMD in the study population (r = 0.116, p < 0.005; r = -0.151, p = 0.001, respectively). Significant differences were found between femur BMD and spine BMD of groups in one-way ANOVA analysis (p = 0.025, p = 0.005, respectively). Additionally, when compared with the other three groups, group 4 was older and had longer duration of menopause (p < 0.01). In logistic regression analysis, age and body mass index were found as independent risk factors of LBM [odds ratio: 1.084 (95% CI 1.031-1.141); odds ratio: 0.896 (95% CI 0.859-0.935)], while duration of lactation was not found as an independent predictor of LBM.In this study, we have found that changes of bone metabolism during lactation had no effect on postmenopausal BMD measured by DXA. Consequently, it can be suggested that long breast-feeding duration is not a risk factor for low bone mass later in life.

World J Gastroenterol. 2012 Jan 21; 18(3): 237-43
Hamaguchi M, Kojima T, Ohbora A, Takeda N, Fukui M, Kato T

To clarify the relationship between age, menopause, and nonalcoholic fatty liver disease (NAFLD) in women.We conducted a follow-up study on nonalcoholic fatty liver disease by using abdominal ultrasonography, and investigated the relationship of age and menopause with the development of NAFLD in women. We followed 1829 women and 2572 men (response rate, 86%) selected in 2001 to represent the non-institutionalized adult population of Gifu, Japan. Data collected included self-reported medical history, lifestyle factors, and menopausal status. The postmenopausal state was defined as beginning 1 year after the cessation of menses. We diagnosed NAFLD with the aid of abdominal ultrasonography by using diagnostic criteria described previously.The prevalence of NAFLD in women increases with age, but does not alter with age in men. Furthermore, the prevalence of NAFLD in premenopausal women (6%) was lower than that in men (24%) and in postmenopausal women (15%). The associations of the postmenopausal state and hormone replacement therapy with NAFLD were statistically significant in a univariate logistic regression model. At the follow-up examination, 67 women (5%) were newly diagnosed with NAFLD. The incidence of NAFLD was 3.5% (28/802) in premenopausal women, 7.5% (4/53) in menopausal women, 6.1% (24/392) in postmenopausal women, and 5.3% (11/206) in women receiving hormone replacement therapy. The weight gain in premenopausal women was equal to that in postmenopausal women. Metabolic syndrome and weight gain were independent risk factors for NAFLD in pre- and postmenopausal women, but age was an independent risk factor in premenopausal women only.Aging is a risk factor for NAFLD in premenopausal women, independent of weight gain or influence of metabolic syndrome.

Asian Pac J Cancer Prev. 2011; 12(8): 1953-6
Yu H, Liu G, Zhao P, Zhu L

Aim: Since any relationship between hormonal and reproductive factors and risk of esophageal cancer is unclear, we investigated this question in Shandong province of China. Methods: A hospital-based 1:1 matched case-control study was conducted from January 2008 to November 2010, with face to face interviews conducted for 132 cases and 132 controls. All cases recruited in this study were confirmed by endoscopy and histological examination. Controls were first-visit outpatients who visited the same hosptial during the same period and were confirmed to have no malignancy. Conditional logistic regression analysis was employed to calculate risk of potential factors. Results: Esophageal cancer positive women had a higher prevalence of reflux, smoking status, lower BMI and less education than health controls (p<0.05). Women whose age of periods ended above 50 years and breastfed for more than 12 months had lower risk of esophageal cancer, with ORs (95% CI) of 0.42 (0.20-0.89) and 0.46 (0.21-0.98). Sensitivity analysis for the histological types of esophageal cancer showed no great difference between adenocarcinoma and squamous cell carcinoma. Conclusion: In summary, our findings suggest an inverse association between later age of menopause and duration of breastfeeding and risk of esophageal cancer. However, many reproductive and sex hormonal factors did not seem to be associated with esophageal cancer, supporting the need to further evaluate reproductive factors in prospective studies.

Arch Med Sci. 2011 Oct; 7(5): 776-80
Ertek S, Francesco Cicero A, Erdoğan G

Recent evidence suggests an interaction between bone metabolism and blood pressure (BP) regulation. The aim of our study was to evaluate endocrinological and metabolic factors related to pulse pressure (PP) in normotensive, normolipidaemic, non-smoker subjects.We consecutively enrolled 156 adults (37 males, 119 females) in summer 2009. The BP and body mass index (BMI) were recorded, and serum samples were taken for 25-hydroxy vitamin D (25-OHD), insulin-like growth factor-1 (IGF-1), growth hormone (GH), parathormone (PTH), calcium, albumin, phosphorus, glucose, triglyceride and cholesterol levels.In the postmenopausal group, PP was significantly associated with age and BMI, while in premenopausal patients it was inversely related to ionized calcium. In men, a reverse relationship was present between GH and IGF-1 levels and PP.The PP was predicted by different parameters in different genders and these predictors change even in the same gender before and after menopause. Well-known predictors of PP such as age and BMI were more pronounced in postmenopausal women, but none of the groups showed a relationship between PP and 25-OHD or PTH.

Arch Med Sci. 2011 Apr; 7(2): 264-70
Yazici S, Yazici M, Korkmaz U, Engin Erkan M, Erdem Baki A, Erden I, Ozhan H, Ataoğlu S

We investigated the association between bone mineral density (BMD) detected by dual-energy X-ray absorptiometric (DXA) method and blood pressure (BP) in a large sample of postmenopausal women.The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 ±8.8 years, who were screened for osteopenia or osteoporosis by DXA. Patients with hypertension (HT, n= 306) were compared with normotensive (NT, n = 290) individuals. Bone mineral density results for the femur neck and spine were classified into 3 groups according to World Health Organization criteria: normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD) and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were grouped as having low bone mass (LBM).There were no significant differences in femur T score, femur BMD, femur Z score, spinal T score, spinal BMD and spinal Z score between hypertensive and normotensive groups. The group of patients with low bone mass calculated from femur T scores had higher age, systolic BP, duration of hypertension and duration of menopause, but lower BMI. Similarly, patients with low spine BMD had higher age and duration of menopause, but lower BMI. Linear regression analysis showed a significant correlation between systolic BP and femur BMD and T score values. Furthermore, logistic regression analysis revealed that hypertension is an independent predictor of spinal osteopenia and osteoporosis.The presence of hypertension is an independent predictor of spinal low bone density in Turkish women after menopause.

Obstet Gynecol Int. 2012; 2012: 525896
Revelli A, Molinari E, Salvagno F, Delle Piane L, Dolfin E, Ochetti S

Thanks to the progress in oncostatic treatments, young women affected by cancer have a fairly good chance of surviving the disease and leading a normal post-cancer life. Quite often, however, polychemiotherapy and/or radiotherapy can induce ovarian damage and significantly reduce the content of follicles and oocytes inside the ovary, thus predisposing the patient to menstrual disorders, infertility, and precocious menopause. Several techniques have been proposed to preserve fertility in these patients; among them oocyte collection and cryopreservation prior to the oncostatic treatment has been widely applied in the last decade. The proper indications, the permitting conditions, the available hormonal stimulation protocols, as well as the effectiveness and limits of this option will be discussed herein, with a comprehensive and up-to-date review of the two techniques commonly used to cryostore oocytes, the slow-freezing technique and the vitrification technique.