Menopausal symptoms in women with premature ovarian insufficiency: prevalence, severity, and associated factors

Analyses of Menopause and Its Related Symptoms on Sleep Quality Using a Novel Wearable Sheet-Type Frontal Electroencephalography Sensor, Haru-1

Objectives

Menopause affects sleep quality and contributes to depressive symptoms, but its precise impact on sleep remains unclear. To address this gap, we conducted detailed measurements of brain activity during sleep in pre- and postmenopausal women using a novel wearable sheet-type frontal electroencephalography (EEG) patch, Haru-1 (PGV Inc., Tokyo, Japan).

Methods

Hospitalized patients aged 30-50 years who had undergone bilateral salpingo-oophorectomy, as well as volunteer participants aged 40-60 years who underwent EEG monitoring at home, were enrolled in the study. EEG recordings were obtained during sleep. Participants were assessed for menopausal symptoms using the Simple Menopausal Index (SMI) and for depressive symptoms using the Quick Inventory of Depressive Symptomatology Japanese version (QIDS-J). Sleep parameters were calculated to investigate the relationships between menopause, menopausal symptoms, depressive symptoms, and sleep characteristics.

Results

A total of 174 participants were recruited, and data from 126 participants were included in the final analysis. Among 126 analyzed participants (mean age: 46.3 ± 7.3 years; 36 premenopausal, 90 postmenopausal), postmenopausal women had lower sleep efficiency (78% vs. 88%; p = 0.0065) and longer sleep onset latency (20 minutes vs. 8 minutes; p = 0.0203). The presence of menopausal symptoms (SMI ≥51) correlated with shorter deep sleep (9 minutes vs. 26 minutes; p = 0.0367), and depressive symptoms (QIDS-J ≥6) were associated with prolonged wake after sleep onset (56 minutes vs. 36 minutes; p = 0.0242).

Conclusions

Menopause was associated with reduced sleep efficiency and increased sleep onset latency. Detailed EEG analyses may contribute to a better understanding of the pathogenesis of menopausal symptoms and their impact on sleep.

Prevalence and Severity of Menopausal Symptoms in Women of Different Ages - China, 2023-2024

What is already known about this topic?

During menopause, women frequently experience a spectrum of physical, mental, and psychological symptoms due to declining ovarian function and fluctuating estrogen levels. There has been a notable absence of systematic, large-scale cross-sectional studies examining menopausal symptoms among Chinese women in recent years.

What is added by this report?

This study examines menopausal symptoms in Chinese women aged 40-60 years, documenting an overall prevalence of 46.3%. The three most commonly reported symptoms are insomnia (50.0%), fatigue (48.2%), and nervousness (46.9%). The prevalence of menopausal symptoms begins to increase in women over age 44, reaching its peak at age 52. Statistically significant differences in symptom severity exist between premenopausal and postmenopausal women within the 45-49 and 50-54 year age groups.

What are the implications for public health practice?

This study represents the first comprehensive large-scale investigation of menopausal symptoms in Chinese women. The findings demonstrate that symptom prevalence varies with age, providing an evidence base for developing targeted health management strategies and interventions specific to different age groups, ultimately enhancing the physical and mental well-being of women experiencing menopause.

Connecting the dots: the role of fatigue in female infertility

Fatigue, an increasingly acknowledged symptom in various chronic diseases, has garnered heightened attention, during the medical era of bio-psycho-social model. Its persistence not only significantly compromises an individual's quality of life but also correlates with chronic organ damage. Surprisingly, the intricate relationship between fatigue and female reproductive health, specifically infertility, remains largely unexplored. Our exploration into the existing body of evidence establishes a compelling link between fatigue with uterine and ovarian diseases, as well as conditions associated with infertility, such as rheumatism. This observation suggests a potentially pivotal role of fatigue in influencing overall female fertility. Furthermore, we propose a hypothetical mechanism elucidating the impact of fatigue on infertility from multiple perspectives, postulating that neuroendocrine, neurotransmitter, inflammatory immune, and mitochondrial dysfunction resulting from fatigue and its co-factors may further contribute to endocrine disorders, menstrual irregularities, and sexual dysfunction, ultimately leading to infertility. In addition to providing this comprehensive theoretical framework, we summarize anti-fatigue strategies and accentuate current knowledge gaps. By doing so, our aim is to offer novel insights, stimulate further research, and advance our understanding of the crucial interplay between fatigue and female reproductive health.

Hydroxychloroquine protects against autoimmune premature ovarian insufficiency by modulating the Treg/Th17 cell ratio in BALB/c mice

AIMS

The role of hydroxychloroquine (HCQ) in premature ovarian insufficiency (POI) remains unclear. The purpose of this study was to evaluate the effect of HCQ on ovarian function in mice with POI and to clarify its potential mechanisms.

METHODS

POI was induced in mice by injection with zona pellucida 3 peptide (pZP3), and HCQ was administered intragastrically. Stages of the estrous cycle were determined using vaginal cytology. The ovarian structure was observed under a microscope after hematoxylin-eosin staining. The levels of serum hormones and anti-ZP antibody (aZPAb) were measured using enzyme-linked immunosorbent assay (ELISA). The expression levels of CD4, CD45, and ZP2, ZP3 were determined using immunofluorescence and immunohistochemistry, respectively. The T regulatory (Treg)/ T helper 17 (Th17) cell ratio was analyzed using flow cytometry analysis. Western blotting was performed to assess the expression levels of proteins, transcription factors and cytokines.

RESULTS

Administration of HCQ to mice with POI greatly restored their estrus cycle. In the treatment group compared to the POI group, estradiol (E₂ ) levels were higher, and follicle stimulating hormone (FSH) levels were lower. In addition, following pZP3, HCQ treatment increased ZP2 and ZP3 expression. Additionally, by inhibiting the activation of the TLR7 signaling pathway, HCQ attenuated the infiltration of inflammatory cells and prevented the activated naive CD4⁺ T cells from developing into Th17 cells.

CONCLUSION

Our findings showed that HCQ effectively restored ovarian function by altering the Treg/Th17 cell ratio in mice with POI, indicating that HCQ maybe a promising therapeutic method for patients with POI.

The Effects of Environmental Contaminant Exposure on Reproductive Aging and the Menopause Transition

PURPOSE OF REVIEW

Menopause marks the end of a woman's reproductive lifetime. On average, natural menopause occurs at 51 years of age. However, some women report an earlier age of menopause than the national average. This can be problematic for women who delay starting a family. Moreover, early onset of menopause is associated with increased risk of cardiovascular disease, depression, osteoporosis, and premature death. This review investigates associations between exposure to endocrine-disrupting chemicals (EDCs) and earlier onset of menopause.

RECENT FINDINGS

Recent data suggest exposure to certain EDCs may accelerate reproductive aging and contribute to earlier onset of menopause. Human and rodent-based studies identify positive associations between exposure to certain EDCs/environmental contaminants and reproductive aging, earlier onset of menopause, and occurrence of vasomotor symptoms. These findings increase our understanding of the detrimental effects of EDCs on female reproduction and will help lead to the development of strategies for the treatment/prevention of EDC-induced reproductive aging.