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Llaneza-Suarez C, Garcia-Portilla P, Rodriguez-Vijande B, Carriles J, Sánchez-Prieto M, Coronado Martín PJ, Llaneza Coto ÁP, Sánchez-Borrego R. Rural residence and health-related quality of life in a sample of Spain perimenopausal women. Gynecol Endocrinol 2024; 40:2336335. [PMID: 38629396 DOI: 10.1080/09513590.2024.2336335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The prevalence and severity of perimenopausal symptoms are typically associated with multiple factors, including demographic characteristics. The sociodemographic characteristics of women living in rural areas differ from those residing in urban areas, and it has been suggested that these differences could potentially influence the prevalence of symptoms experienced during perimenopause. OBJECTIVES To evaluate if perimenopausal women living in Spanish rural areas have a higher prevalence of perimenopausal symptoms and assess their influence on health-related quality of life. METHODS A cross-sectional study was conducted in a sample of 270 perimenopausal women residing in rural and urban areas. The participants completed the Cervantes Scale Short Version and Beck Depression Inventory 2. RESULTS Perimenopausal women in rural areas reported a higher incidence of perimenopausal symptoms and a lower perception of health-related quality of life compared to those in urban areas, as evidenced by higher scores on the total Cervantes Scale Short Version scale (33.2 (±16.2) vs. 26.4 (±18.1), p = .001). No differences in the Beck Depression Inventory 2 score were detected. CONCLUSIONS Perimenopausal women residing in rural areas of Spain reported a higher prevalence of perimenopausal symptoms and experienced a poorer Health-Related Quality of Life compared to those living in urban areas of Spain.
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Casey M, Dabkowski E, de Gracia MRL, Moore KA, Kennedy GA, Porter JE, Nasstasia Y, Alvarenga ME. Socioecological factors influencing physical activity engagement for women across the menopausal transition: a systematic review. Menopause 2024; 31:433-446. [PMID: 38595173 DOI: 10.1097/gme.0000000000002337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
IMPORTANCE Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity. OBJECTIVE This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach. EVIDENCE REVIEW The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers. FINDINGS Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities. CONCLUSIONS AND RELEVANCE Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.
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Affiliation(s)
- Meghan Casey
- From the Institute of Health and Wellbeing, Federation University Australia, Ballarat, Victoria, Australia
| | - Elissa Dabkowski
- Collaborative Evaluation & Research Centre, Federation University Australia, Gippsland, Victoria, Australia
| | - Ma Regina L de Gracia
- Institute of Health and Wellbeing, Federation University Australia, Gippsland, Victoria, Australia
| | - Kathleen A Moore
- Institute of Health and Wellbeing, Federation University Australia, Gippsland, Victoria, Australia
| | | | - Joanne E Porter
- Director of the Collaborative Evaluation & Research Centre, Federation University Australia, Gippsland, Victoria, Australia
| | - Yasmina Nasstasia
- Institute of Health and Wellbeing, Federation University Australia, Mount Helen, Victoria, Australia
| | - Marlies E Alvarenga
- Institute of Health and Wellbeing, Federation University Australia, Berwick, Victoria, Australia
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Terzic S, Bapayeva G, Kadroldinova N, Sarria-Santamera A, Gusmanov A, Semenova Y, Aimagambetova G, Laganà AS, Chiantera V, Ukybassova T, Kongrtay K, Abdukassimova M, Babazhanova A, Togyzbayeva K, Terzic M. Menopausal Status Impact on the Quality of Life in Kazakhstani Healthcare Workers: A Cross-sectional Study. J Gen Intern Med 2024; 39:969-977. [PMID: 38315409 DOI: 10.1007/s11606-024-08650-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Menopausal quality of life (MenQoL) is a common concern that primary healthcare workers often encounter. Menopause has a significant impact on women's health, but studies examining its effect on the MenQoL of menopausal healthcare employees have produced conflicting results. OBJECTIVE The aim of this study was to compare the quality of life related to menopausal status (pre-, peri-, or postmenopausal) in healthcare workers from various clinical settings in Kazakhstan. DESIGN This was a cross-sectional study. PARTICIPANTS In total, 222 menopausal healthcare workers (physicians, nurses/midwives, administrative staff, and cleaners) were enrolled from hospitals affiliated with the University Medical Center (UMC) in Kazakhstan. MAIN MEASURES The outcome variable was assessed using the Menopausal Quality of Life Questionnaire (MENQOL), which evaluates MenQoL across four domains of menopausal symptoms: physical, psychological, vasomotor, and sexual. KEY RESULTS The most frequently reported menopausal symptoms were physical ones, such as feeling tired or worn out (70.7%), followed by feeling a lack of energy (65.3%) and dry skin (64.1%). The postmenopause group had the highest mean MenQoL score in the vasomotor domain (mean 3.46 ± 1.84). There was a borderline statistical significance when comparing postmenopause and perimenopause groups in the physical domain. The pairwise comparison of mean sexual scores revealed that postmenopause women had the highest average score (3.3 ± 2.36) compared to both premenopause (mean 2.3 ± 1.82) and perimenopause (mean 2.22 ± 1.58) groups (p < 0.05). CONCLUSIONS Menopausal status has influence on the MenQoL of healthcare workers. The study findings could have important implications for policymakers as they provide insight into the factors influencing the quality of life of menopausal healthcare employees. Creating a more menopause-friendly work environment may not only enhance the well-being of healthcare personnel but also improve their overall job satisfaction and performance.
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Affiliation(s)
- Sanja Terzic
- Department of Medicine, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
| | - Gauri Bapayeva
- Clinical Academic Department of Women's Health, CF "University Medical Center", Turan Ave. 32, Astana, 010000, Kazakhstan
| | - Nazira Kadroldinova
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
| | - Antonio Sarria-Santamera
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kabanbay Batyr Avenue, 53, Astana, Kazakhstan
| | - Arnur Gusmanov
- Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Kabanbay Batyr Avenue, 53, Astana, Kazakhstan
| | - Yuliya Semenova
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan.
| | - Gulzhanat Aimagambetova
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
| | - Antonio Simone Laganà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133, Palermo, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90133, Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute - IRCCS - Fondazione "G. Pascale", 80131, Naples, Italy
| | - Talshyn Ukybassova
- Clinical Academic Department of Women's Health, CF "University Medical Center", Turan Ave. 32, Astana, 010000, Kazakhstan
| | - Kuralay Kongrtay
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
| | - Meruyert Abdukassimova
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
| | - Aruzhan Babazhanova
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
| | - Karlygash Togyzbayeva
- Clinical Academic Department of Women's Health, CF "University Medical Center", Turan Ave. 32, Astana, 010000, Kazakhstan
| | - Milan Terzic
- Clinical Academic Department of Women's Health, CF "University Medical Center", Turan Ave. 32, Astana, 010000, Kazakhstan
- Department of Surgery, School of Medicine, Nazarbayev University, Kerey-Zhanybek Khans Street 5/1, Astana, 010000, Kazakhstan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA
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Di Giuseppe J, Delli Carpini G, Giannella L, Terenzi T, Fichera M, Ragno F, Campanati A, Boero V, Caia C, Pesce E, Vercellini P, Gardella B, Dominoni M, Spinillo A, Sopracordevole F, Clemente N, Del Fabro A, Rossi R, Corazza M, Borghi A, Martinello R, Greco P, Rizzo G, Criscuolo AA, Mappa I, Matteini E, Botti E, Campione E, Bianchi L, Ciavattini A. A Longitudinal Multiinstitutional Study of Vulvar Lichen Sclerosus: From Childhood to Perimenopause. J Low Genit Tract Dis 2024:00128360-990000000-00110. [PMID: 38661348 DOI: 10.1097/lgt.0000000000000816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The main outcome of this study was the evaluation of clinical characteristics, comorbidities, and therapeutic approaches in patients with vulvar lichen sclerosus (VLS) aged from childhood to perimenopause. Secondly, it was intended to compare these characteristics according to the menarchal status. METHODS Patients less than 45 years of age with a diagnosis of VLS from January 2002 to June 2022 in 10 referral centers were included in this retrospective longitudinal study. The univariate analysis compared the dependent variables according to menarchal status. RESULTS One hundred eighty-six patients met the inclusion criteria. At diagnosis, between 25% and 40% of premenarchal patients reported signs related to subepithelial hemorrhage. A significantly greater presence of bleeding (p < .005), easy bruising (p = .028), fissures (p = .008), petechiae/splinter hemorrhages (p < .001), and bleeding/blistering or open sores (p = .011) was observed in premenarchal patients with respect to the postmenarchal group. The perineum (p = .013) and the perianal region (p < .001) were significantly more involved in the premenarchal group. Topical calcineurin inhibitors were more used in the premenarchal population (p = .004), whereas vitamin E oil and moisturizers were more used in the postmenarchal population (p = .047). CONCLUSIONS Vulvar lichen sclerosus is a chronic condition that can cause vulvar changes that result in severe morbidity and affects sexual function and quality of life, even before menopause. Vulvar lichen sclerosus continues to be misdiagnosed in this population. This may lead to an average delay from symptom onset to diagnosis. Evaluating clinical manifestations of VLS in premenarchal and postmenarchal age allowed us to find different clinical characteristics between the 2 periods suggestive of the diagnosis.
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Affiliation(s)
- Jacopo Di Giuseppe
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Giovanni Delli Carpini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Luca Giannella
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Tomas Terenzi
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Mariasole Fichera
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Federica Ragno
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Anna Campanati
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Veronica Boero
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlotta Caia
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Pesce
- Gynaecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Vercellini
- Academic Center for Research on Adenomyosis and Endometriosis, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Arsenio Spinillo
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Francesco Sopracordevole
- Gynecological Oncology Unit, IRCCS CRO - Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Nicolò Clemente
- Gynecological Oncology Unit, IRCCS CRO - Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Anna Del Fabro
- Gynecological Oncology Unit, IRCCS CRO - Centro di Riferimento Oncologico - National Cancer Institute, Aviano, Italy
| | - Riccardo Rossi
- Preventive Gynecological Oncology Section, European Medical Center, Florence, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Ruby Martinello
- Obstetrics and Gynaecology Clinic, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pantaleo Greco
- Obstetrics and Gynaecology Clinic, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giuseppe Rizzo
- Department of Obstetrics and Gynecology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome Italy
| | - Anna Angela Criscuolo
- Department of Obstetrics and Gynecology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome Italy
| | - Ilenia Mappa
- Department of Obstetrics and Gynecology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome Italy
| | - Enrico Matteini
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Elisabetta Botti
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Elena Campione
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Luca Bianchi
- U.O.C. Dermatology, Policlinico Tor Vergata, Università Roma Tor Vergata, Rome, Italy
| | - Andrea Ciavattini
- Obstetrics and Gynecologic Section, Department of Odontostomatologic and Specialized Clinical Sciences, Università Politecnica delle Marche, Ancona, Italy
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Memi E, Pavli P, Papagianni M, Vrachnis N, Mastorakos G. Diagnostic and therapeutic use of oral micronized progesterone in endocrinology. Rev Endocr Metab Disord 2024:10.1007/s11154-024-09882-0. [PMID: 38652231 DOI: 10.1007/s11154-024-09882-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
Progesterone is a natural steroid hormone, while progestins are synthetic molecules. In the female reproductive system, progesterone contributes to the control of luteinizing hormone and follicle-stimulating hormone secretion and their pulsatility, via its receptors on the kisspeptin, neurokinin B, and dynorphin neurons in the hypothalamus. Progesterone together with estradiol controls the cyclic changes of proliferation and decidualization of the endometrium; exerts anti-mitogenic actions on endometrial epithelial cells; regulates normal menstrual bleeding; contributes to fertilization and pregnancy maintenance; participates in the onset of labor. In addition, it exerts numerous effects on other endocrine systems. Micronized progesterone (MP) is natural progesterone with increased bioavailability, due to its pharmacotechnical micronized structure, which makes it an attractive diagnostic and therapeutic tool. This critical literature review aims to summarize and put forward the potential diagnostic and therapeutic uses of MP in the field of endocrinology. During reproductive life, MP is used for diagnostic purposes in the evaluation of primary or secondary amenorrhea as a challenge test. Moreover, it can be prescribed to women presenting with amenorrhea or oligomenorrhea for induction of withdrawal bleeding, in order to time blood-sampling for diagnostic purposes in early follicular phase. Therapeutically, MP, alone or combined with estrogens, is a useful tool in various endocrine disorders including primary amenorrhea, abnormal uterine bleeding due to disordered ovulation, luteal phase deficiency, premenstrual syndrome, polycystic ovary syndrome, secondary amenorrhea [functional hypothalamic amenorrhea, premature ovarian insufficiency], perimenopause and menopause. When administrated per os, acting as a neurosteroid directly or through its metabolites, it exerts beneficial effects on brain function such as alleviation of symptoms of anxiety and depression, asw well as of sleep problems, while it improves working memory in peri- and menopausal women. Micronized progesterone preserves full potential of progesterone activity, without presenting many of the side-effects of progestins. Although it has been associated with more frequent drowsiness and dizziness, it can be well tolerated with nocturnal administration. Because of its better safety profile, especially with regard to metabolic ailments, breast cancer risk and veno-thromboembolism risk, MP is the preferred option for individuals with an increased risk of cardiovascular and metabolic diseases and of all-cause mortality.
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Affiliation(s)
- Eleni Memi
- Unit of Endocrinology, Diabetes mellitus, and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Vas. Sophias Av. 76, 11528, Athens, Greece
| | - Polina Pavli
- Unit of Endocrinology, Diabetes mellitus, and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Vas. Sophias Av. 76, 11528, Athens, Greece
| | - Maria Papagianni
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42100, Trikala, Greece
- Endocrine Unit, 3rd Department of Pediatrics, Hippokration Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54642, Thessaloniki, Greece
| | - Nikolaos Vrachnis
- Third Department of Obstetrics and Gynecology, Attikon General Hospital, School of Medicine, National and Kapodistrian University of Athens, Rimini Str. 1, 12462, Chaidari, Athens, Greece
- St George's NHS Foundation Trust Teaching Hospitals, St George's University of London, London, UK
| | - George Mastorakos
- Unit of Endocrinology, Diabetes mellitus, and Metabolism, Aretaieion Hospital, School of Medicine, National and Kapodistrian University of Athens, Vas. Sophias Av. 76, 11528, Athens, Greece.
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Wang Y, Miao X, Viwattanakulvanid P. Effects of a therapeutic lifestyle modification intervention on cardiometabolic health, sexual functioning and health-related quality of life in perimenopausal Chinese women: protocol for a randomised controlled trial. BMJ Open 2024; 14:e082944. [PMID: 38626978 PMCID: PMC11029459 DOI: 10.1136/bmjopen-2023-082944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/04/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION Perimenopause is a critical transitional period in reproductive ageing. A set of physiological and psychological changes can affect perimenopausal women's quality of life and further threaten their older adult health conditions. In China, less than one-third of midlife women with menopausal symptoms have actively sought professional healthcare. Regarding the public health significance of comprehensive menopause management, the current study aims to investigate the effects of a therapeutic lifestyle modification (TLM) intervention on cardiometabolic health, sexual functioning and health-related quality of life among perimenopausal Chinese women. METHOD AND ANALYSIS A randomised controlled trial with two parallel arms will be conducted at the gynaecology outpatient department of Yunnan Provincial Hospital of Traditional Chinese Medicine in China. 94 eligible perimenopausal women aged between 40 and 55 years will be recruited for the study. The TLM intervention consists of four elements: menopause-related health education, dietary guidance, pelvic floor muscle training and Bafa Wubu Tai Chi exercise. Participants will be randomly assigned (1:1) to receive either the 12-week TLM intervention or routine care via stratified blocked randomisation. The primary outcome is quality of life; secondary outcomes of interest include sexual functioning and cardiometabolic health. The outcome measures will be assessed at baseline and post-intervention. To explore the effects of the intervention, linear mixed models will be applied to test the changes between the two groups over time in each outcome based on an intention-to-treat analysis. ETHICS AND DISSEMINATION The Research Ethics Review Committee of Chulalongkorn University (COA No 178/66) and the Medical Ethics Committee of Yunnan Provincial Hospital of Traditional Chinese Medicine (IRB-AF-027-2022/02-02) approved the study protocol. Written informed consent will be obtained from all participants. Results will be published in peer-reviewed journals and disseminated through conferences. TRIAL REGISTRATION NUMBER ChiCTR2300070648.
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Affiliation(s)
- Yuru Wang
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Xiaoling Miao
- Yunnan University of Chinese Medicine, Kunming, People's Republic of China
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de Almeida PP, de Oliveira RG, de Almeida LIM, de Oliveira LC. Effects of Pilates exercises on health-related quality of life in postmenopausal women: a systematic review and meta-analysis. Qual Life Res 2024:10.1007/s11136-024-03651-x. [PMID: 38602630 DOI: 10.1007/s11136-024-03651-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE To verify the effects of Pilates exercises on health-related quality of life (HRQoL) in postmenopausal women. METHODS A systematic search was conducted in the following databases: PubMed, Embase, CENTRAL, CINAHL, Web of Science, LILACS, SportDiscus, Scielo, and PEDro. Randomized clinical trials (RCTs) that intervened with Pilates and had HRQoL as an outcome were eligible. The methodological quality of each RCT was assessed using the PEDro scale and the certainty of the evidence using the GRADE system. Meta-analyses were conducted by standardized mean difference (SMD). RESULTS Initially, 760 records were located. After screening, 11 RCTs were included in the systematic review. Five studies presented low risk of bias (PEDro score ≥ 6). Evidence of very low to moderate certainty demonstrated significant effects in favor of Pilates exercises vs control groups for five of the nine HRQoL domains analyzed: bodily pain (SMD = 0.96), physical functioning (SMD = 0.85), social functioning (SMD = 0.45), role physical (SMD = 0.79), and role emotional (SMD = 0.61). Subgroup analyzes demonstrated that Pilates had a positive impact on more domains whens administered for ≥ 48 sessions (eight domains) vs < 48 sessions (three domains); and when administered on equipment (seven domains) vs mat (three domains). CONCLUSION Pilates exercises, in general, allowed significant effects to improve HRQoL in postmenopausal women, especially when performed on equipment and when administered for at least 48 sessions. However, no analysis showed high certainty of evidence, and more RCTs of high methodological quality are needed to confirm these findings.
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Affiliation(s)
- Priscila Peruzzolo de Almeida
- Health Sciences Center, Universidade Estadual do Norte do Paraná, Alameda Padre Magno, no 841, Nova Alcântara, CEP: 86.400-000, Jacarezinho, Paraná, Brazil
| | - Raphael Gonçalves de Oliveira
- Health Sciences Center, Universidade Estadual do Norte do Paraná, Alameda Padre Magno, no 841, Nova Alcântara, CEP: 86.400-000, Jacarezinho, Paraná, Brazil
- Health Sciences Research Center, Universidade Norte do Paraná, Londrina, Paraná, Brazil
| | - Laura Isabel Martins de Almeida
- Health Sciences Center, Universidade Estadual do Norte do Paraná, Alameda Padre Magno, no 841, Nova Alcântara, CEP: 86.400-000, Jacarezinho, Paraná, Brazil
| | - Laís Campos de Oliveira
- Health Sciences Center, Universidade Estadual do Norte do Paraná, Alameda Padre Magno, no 841, Nova Alcântara, CEP: 86.400-000, Jacarezinho, Paraná, Brazil.
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Oppermann K, Spritzer PM. Prevalence and risk factors associated with diabetes mellitus among middle-aged women in southern Brazil: a population-based study. Menopause 2024; 31:225-230. [PMID: 38385732 DOI: 10.1097/gme.0000000000002320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVES To investigate prevalence and clinical factors associated with diabetes among middle-aged women. METHODS In this cross-sectional population-based study, clinical and laboratory examinations were collected from 298 women. Participants wore a digital pedometer for 7 days to assess habitual physical activity. Abdominal computed tomography scans were performed to measure total fat area and visceral fat area. RESULTS Mean age was 57.1 years (SD, 5.4 y); 78.7% of women were postmenopausal. The prevalence of diabetes was 17.1%. Women with diabetes were older (P = 0.02); worked fewer hours per week in the past month (P = 0.04); had an earlier age at menarche (P = 0.03); were more frequently inactive (P = 0.01); had higher body mass index (P = 0.01), higher waist circumference (P < 0.01), higher visceral (P < 0.01), and higher total fat (P < 0.01) but not subcutaneous fat (P = 0.14); and had higher systolic blood pressure (BP) (P < 0.01). There was a prevalence of 19.5% of current smoking, 32.5% of alcohol use, and 16.1% of current hormone therapy use, prevalence similar among the groups of women. There was a higher prevalence of metabolic syndrome (P < 0.01) and statin use (P < 0.01) in women with diabetes. A higher prevalence ratio of diabetes was associated with physical inactivity (prevalence ratio, 2.137; 95% CI, 1.056-4.325; P < 0.03). The odds of having diabetes increased by 12% for each year of earlier menarche and by 1.4% for each millimeter of mercury increase in systolic BP. CONCLUSION The prevalence of diabetes was 17.1%. Age, physical inactivity, early age at menarche, and systolic BP were independently associated with higher prevalence of diabetes in this unselected population of middle-aged women.
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Affiliation(s)
- Karen Oppermann
- From the Medicine School, Universidade de Passo Fundo, Passo Fundo, Brazil
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Fisher T, Powell E, Yuwono NL, Ford CE, Warton K. Circulating cell-free DNA is elevated in postmenopausal compared with pre- and perimenopausal women. Menopause 2024; 31:171-175. [PMID: 38385729 DOI: 10.1097/gme.0000000000002313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
OBJECTIVE With the rising use of circulating cell-free DNA (cirDNA) liquid biopsies for disease screening, it is important to understand biological differences that may impact the accuracy of cirDNA-based clinical tests. Although a number of biological factors have been researched, the relationship between menopause and cirDNA has not been thoroughly investigated. We aimed to compare plasma cirDNA concentration and DNA fragment integrity in healthy women pre- and postmenopause. METHODS Blood was collected from healthy female volunteers 40 years and older. cirDNA was extracted from plasma (n = 52) and quantified by quantitative polymerase chain reaction (n = 47; 26 premenopause, mean age-46 y; 21 postmenopause, mean age-59 y). cirDNA concentration was quantitated using an ALU repetitive sequence with a 115-base-pair (bp) product (ALU-115), and long cirDNA fragments were quantitated using an ALU repetitive sequence with a 247-bp product (ALU-247). cirDNA integrity was expressed as a ratio of ALU-247 over ALU-115. Mann-Whitney U test was used to compare pre- and postmenopause qPCR results, and a two-tailed, unpaired t test was undertaken to compare the integrity ratio between the two groups. RESULTS Postmenopause plasma samples were found to have a significantly higher cirDNA concentration (P < 0.0001, premenopause: mean, 3.10 ± 1.84 ng/mL; median, 2.90 ng/mL; postmenopause: mean, 5.28 ± 2.76 ng/mL; median, 4.56 ng/mL) and significantly higher concentration of long-stranded cirDNA fragments (P = 0.0033, premenopause: mean, 1.06 ± 0.48 ng/mL; median, 0.96 ng/mL; postmenopause: mean, 1.69 ± 0.89 ng/mL; median, 1.48 ng/mL). There was no significant difference in the integrity ratio between the groups (P = 0.1788). CONCLUSIONS Plasma cirDNA concentrations are higher in postmenopausal women. This has important implications in cirDNA liquid biopsy development and screening, especially for diseases such as cancer where the majority of cases are diagnosed postmenopause.
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Affiliation(s)
- Teagan Fisher
- From the Gynaecological Cancer Research Group, Adult Cancer Program, School of Clinical Medicine University of New South Wales, Sydney, Australia
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10
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Wasley D, Gailey S. Menopause and the role of physical activity - The views and knowledge of women aged 40-65. Post Reprod Health 2024:20533691241235273. [PMID: 38393976 DOI: 10.1177/20533691241235273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
Menopause marks the end of female reproductive capacity. It is defined as the point after cessation of the menstrual cycle for 12 months (Nursat et al., 2008). Awareness about menopause has increased over the last decade, yet studies have shown that women still lack knowledge regarding the subject. Likewise, awareness of women between the age of 40-65 on the potential role of physical activity prior to and during menopause in women is unclear. Women (n = 162) aged 40-65 years completed a survey rating their knowledge, answered fact-based questions and reported their experiences of menopause. Their levels of, and beliefs on, the role physical activity on symptoms and menopause associated disease risk were also collected. Women reported their confidence in their current knowledge level at 67% reflecting 37% higher rating than an estimate of their knowledge 10 years ago. Their factual knowledge score was 56%. Knowledge was primarily gained through friends and family and almost half (46%) had not spoken to a healthcare professional. Frustration was expressed with lack of knowledge and support of healthcare and others. Women using HRT (44%) had mixed attitudes towards its role. A high proportion were active and felt that physical activity can help manage symptoms and impact long-term health consequences of menopause. Menopause education strategies for women, healthcare professionals and others need to be improved. Lack of education may be causing women to struggle and feel negatively towards this life stage. Physical activity was viewed positively for the symptoms and a treatment during menopause and long-term health.
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Affiliation(s)
- David Wasley
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Samantha Gailey
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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11
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Ambikairajah A, Khondoker M, Morris E, de Lange AG, Saleh RNM, Minihane AM, Hornberger M. Investigating the synergistic effects of hormone replacement therapy, apolipoprotein E and age on brain health in the UK Biobank. Hum Brain Mapp 2024; 45:e26612. [PMID: 38339898 PMCID: PMC10836173 DOI: 10.1002/hbm.26612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024] Open
Abstract
Global prevalence of Alzheimer's Disease has a strong sex bias, with women representing approximately two-thirds of the patients. Yet, the role of sex-specific risk factors during midlife, including hormone replacement therapy (HRT) and their interaction with other major risk factors for Alzheimer's Disease, such as apolipoprotein E (APOE)-e4 genotype and age, on brain health remains unclear. We investigated the relationship between HRT (i.e., use, age of initiation and duration of use) and brain health (i.e., cognition and regional brain volumes). We then consider the multiplicative effects of HRT and APOE status (i.e., e2/e2, e2/e3, e3/e3, e3/e4 and e4/e4) via a two-way interaction and subsequently age of participants via a three-way interaction. Women from the UK Biobank with no self-reported neurological conditions were included (N = 207,595 women, mean age = 56.25 years, standard deviation = 8.01 years). Generalised linear regression models were computed to quantify the cross-sectional association between HRT and brain health, while controlling for APOE status, age, time since attending centre for completing brain health measure, surgical menopause status, smoking history, body mass index, education, physical activity, alcohol use, ethnicity, socioeconomic status, vascular/heart problems and diabetes diagnosed by doctor. Analyses of structural brain regions further controlled for scanner site. All brain volumes were normalised for head size. Two-way interactions between HRT and APOE status were modelled, in addition to three-way interactions including age. Results showed that women with the e4/e4 genotype who have used HRT had 1.82% lower hippocampal, 2.4% lower parahippocampal and 1.24% lower thalamus volumes than those with the e3/e3 genotype who had never used HRT. However, this interaction was not detected for measures of cognition. No clinically meaningful three-way interaction between APOE, HRT and age was detected when interpreted relative to the scales of the cognitive measures used and normative models of ageing for brain volumes in this sample. Differences in hippocampal volume between women with the e4/e4 genotype who have used HRT and those with the e3/e3 genotype who had never used HRT are equivalent to approximately 1-2 years of hippocampal atrophy observed in typical health ageing trajectories in midlife (i.e., 0.98%-1.41% per year). Effect sizes were consistent within APOE e4/e4 group post hoc sensitivity analyses, suggesting observed effects were not solely driven by APOE status and may, in part, be attributed to HRT use. Although, the design of this study means we cannot exclude the possibility that women who have used HRT may have a predisposition for poorer brain health.
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Affiliation(s)
- Ananthan Ambikairajah
- Discipline of Psychology, Faculty of HealthUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
- Centre for Ageing Research and Translation, Faculty of HealthUniversity of CanberraCanberraAustralian Capital TerritoryAustralia
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | | | | | - Ann‐Marie G. de Lange
- Department of Clinical NeurosciencesLausanne University Hospital (CHUV) and University of LausanneLausanneSwitzerland
- Department of PsychologyUniversity of OsloOsloNorway
- Department of PsychiatryUniversity of OxfordOxfordUK
| | - Rasha N. M. Saleh
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
- Department of Clinical and Chemical Pathology, Faculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Anne Marie Minihane
- Norwich Medical SchoolUniversity of East AngliaNorwichUK
- Norwich Institute of Healthy AgeingNorwichUK
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12
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Graham EE, Michala L, Hachfeld A, Moseholm E. Collection of menopause data in studies of women living with HIV: A systematic literature review. HIV Med 2024; 25:174-187. [PMID: 37776176 DOI: 10.1111/hiv.13552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES An increasing number of women living with HIV are transitioning through midlife and menopause. Women living with HIV may experience earlier menopause and a higher symptom burden than women without HIV, but more evidence is needed. Data collection on menopause in women living with HIV is scarce and often not standardized. We sought to assess how menopause data are collected in cohorts and studies of women living with HIV. METHODS This was a literature review conducted within the PubMed database. We included original studies and cohorts assessing menopause and/or menopausal symptoms in women living with HIV. Study characteristics and menopause data collection, including the definition of menopause, symptom assessment tools, and measurement of biomedical parameters, were noted and summarized systematically in data tables. RESULTS We included 40 articles describing 37 separate studies published between 2000 and 2023; 27 of these were conducted in high-income countries, the majority in the USA (n = 16). Ten studies were from low- and middle-income countries; four of these were conducted in Brazil. In 20 studies, menopause was defined according to the World Health Organization's definition of over 12 months of amenorrhea. Twelve studies used the Menopause Rating Scale to characterize menopausal symptoms, five studies used other specified symptom assessment tools, and 12 studies used a study-specific tool. CONCLUSIONS Menopause data collection in women living with HIV is heterogeneous. We propose that standardized tools should be used to enable comparisons between studies and countries, thereby improving the quality of research and clinical treatment. Further research into the validity of menopausal symptom scoring tools is warranted.
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Affiliation(s)
- Emma Eileen Graham
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
| | - Lina Michala
- 1st Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Hachfeld
- Department of Infectious Diseases, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Ellen Moseholm
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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13
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Genazzani AR, Divakar H, Khadilkar SS, Monteleone P, Evangelisti B, Galal AF, Priego PIR, Simoncini T, Giannini A, Goba G, Benedetto C. Counseling in menopausal women: How to address the benefits and risks of menopause hormone therapy. A FIGO position paper. Int J Gynaecol Obstet 2024; 164:516-530. [PMID: 38178609 DOI: 10.1002/ijgo.15278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri- and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid-life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri- and postmenopause, worldwide.
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Affiliation(s)
- Andrea R Genazzani
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, The University of Pisa, Pisa, Italy
| | - Hema Divakar
- Obstetrics and Gynaecology, Divakars Speciality Hospital, Bengaluru, India
- FIGO Committee on Well Woman Health Care, London, UK
| | - Suvarna S Khadilkar
- FIGO Committee on Well Woman Health Care, London, UK
- Department of Obstetrics and Gynecology, Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Patrizia Monteleone
- Division of Obstetrics and Gynecology, Azienda USL Toscana Nord Ovest, Pisa, Italy
| | | | - Ahmed F Galal
- FIGO Committee on Well Woman Health Care, London, UK
- Department of Obstetrics and Gynecology, Elshatby Maternity University Hospital, Alexandria, Egypt
| | - Paola I R Priego
- FIGO Committee on Well Woman Health Care, London, UK
- Hospital Ángeles del Pedregal, Mexico City, Mexico
| | - Tommaso Simoncini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, The University of Pisa, Pisa, Italy
| | - Andrea Giannini
- Division of Obstetrics and Gynecology, Department of Clinical and Experimental Medicine, The University of Pisa, Pisa, Italy
| | - Gelila Goba
- FIGO Committee on Well Woman Health Care, London, UK
- Department of Obstetrics and Gynecology, University of Illinois, Chicago, Illinois, USA
| | - Chiara Benedetto
- FIGO Committee on Well Woman Health Care, London, UK
- Department of Obstetrics and Gynecology, Sant'Anna University Hospital, Torino, Italy
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14
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Farjam M, Kheirandish M, Ghanbarnejad A, Nikpoor AR, Nejatizadeh A, Aghamolaei T, Shahmoradi M, Alizade H, Homayounfar R, Zarei H, Ghavidel S, Jamshidi V, Eftekhar E. Reference Interval for Non-HDL-Cholesterol, Remnant Cholesterol and Other Lipid Parameters in the Southern Iranian Population; Findings From Bandare Kong and Fasa Cohort Studies. ARCHIVES OF IRANIAN MEDICINE 2024; 27:15-22. [PMID: 38431956 PMCID: PMC10915932 DOI: 10.34172/aim.2024.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 09/19/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Growing evidence shows the undisputable role of non-HDL-C and remnant cholesterol (remnant-C) in cardiovascular disease (CVD) risk assessment and treatment. However, the reference interval (RI) for these lipid parameters is not readily available. The aim of the present investigation was to determine the age and sex-specific RIs for non-HDL-C and remnant-C as well as other lipid parameters among a healthy population in southern Iran. We also report the RI of lipid parameters in rural and urban residents, smokers and post-menopausal women. METHODS Among 14063 participants of Bandare Kong and Fasa cohort studies, 792 healthy subjects (205 men and 578 women) aged 35-70 years were selected. Fasting blood samples were used for determination of total cholesterol (TC), triglycerides (TG) and HDL-C using colorimetric methods. Non-HDL-C and remnant-C were calculated using the valid formula. The 2.5th and 97.5th percentiles were calculated and considered as RI. RESULTS In the total population (n=792, age 35-70), RIs for non-HDL-C and remnant-C was 74.0-206.8 and 8.0-52.7 mg/dL, respectively. Age (35-44 and≥45 years) and gender-specific RIs for serum non-HDL-C and remnant-C were determined. Remnant-C and non-HDL-C level were different between sex and age categories. The mean value of all lipid parameters except HDL-C was higher in men, urban residents, subject with age≥45 years and smokers. CONCLUSION This is the first study in which the RIs for non-HDL-C and remnant-C in southern Iran are reported. This may help physicians to conveniently use these lipid parameters for patient care and better cardiovascular risk assessment.
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Affiliation(s)
- Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Masoumeh Kheirandish
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Ghanbarnejad
- Social Determinants in Health Promotion Research Center, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Amin Reza Nikpoor
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Abdolazim Nejatizadeh
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teymour Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehdi Shahmoradi
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hesam Alizade
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Reza Homayounfar
- National Nutrition and Food Technology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Zarei
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Sahar Ghavidel
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Vahide Jamshidi
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ebrahim Eftekhar
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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15
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Dias Damasceno CM, de Sá Pereira Guimarães FJ, Costa KB, Morais Godoy Figueiredo AC, de Araújo RC, da Cunha Costa M. Variations in Postmenopausal Body Composition: A Cross-Sectional Comparison between Physical Activity Practitioners and Sedentary Individuals. J Funct Morphol Kinesiol 2023; 9:12. [PMID: 38249089 PMCID: PMC10801510 DOI: 10.3390/jfmk9010012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/18/2023] [Accepted: 12/26/2023] [Indexed: 01/23/2024] Open
Abstract
Physical activity is broadly recognized for promoting weight reduction and bestowing numerous health benefits. Nonetheless, robust evidence concerning the impact of physical activity on postmenopausal women, undergoing physiological shifts, remains scant. This study aimed to elucidate the relationship between physical activity and body composition among postmenopausal women. Employing a cross-sectional and retrospective design, 702 women were examined. Data on physical activity and body composition were amassed through anthropometric assessments and Dual-Energy X-ray Absorptiometry (DEXA). A significant proportion of women exhibited anthropometric alterations indicative of overweight/obesity, alongside elevated values in Waist Circumference (WC), Waist-to-Hip Ratio, Waist-to-Height, and bone mass, signifying a heightened risk for disease onset. While a majority engaged in some form of physical activity, this did not yield notable reductions in the assessed metrics. Noteworthy changes were only discerned in BMI and bone mass among pre-menopausal women; whereas among postmenopausal women, in addition to disparities in bone mass, those inactive were 1.18 times more prone to a very high disease risk, as gauged by WC.
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Affiliation(s)
- Camila Mahara Dias Damasceno
- Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, BR 203, Km 2 s/n–Vila Eduardo, Petrolina CEP 56328-900, PE, Brazil; (F.J.d.S.P.G.); (R.C.d.A.); (M.d.C.C.)
| | - Fernando José de Sá Pereira Guimarães
- Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, BR 203, Km 2 s/n–Vila Eduardo, Petrolina CEP 56328-900, PE, Brazil; (F.J.d.S.P.G.); (R.C.d.A.); (M.d.C.C.)
| | - Keyla Brandão Costa
- Higher School of Physical Education, University of Pernambuco, Arnóbio Marques Street, 310, Santo Amaro, Recife CEP 50100-130, PE, Brazil;
| | - Ana Claudia Morais Godoy Figueiredo
- Master’s Program in Health Sciences at the Foundation for Teaching and Research in Health Sciences (FEPECS), North Hospital Medical Sector—Asa Norte, Brasília CEP 70710-907, DF, Brazil;
| | - Rodrigo Cappato de Araújo
- Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, BR 203, Km 2 s/n–Vila Eduardo, Petrolina CEP 56328-900, PE, Brazil; (F.J.d.S.P.G.); (R.C.d.A.); (M.d.C.C.)
| | - Manoel da Cunha Costa
- Graduate Program in Rehabilitation and Functional Performance, University of Pernambuco, BR 203, Km 2 s/n–Vila Eduardo, Petrolina CEP 56328-900, PE, Brazil; (F.J.d.S.P.G.); (R.C.d.A.); (M.d.C.C.)
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16
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Motlani V, Motlani G, Pamnani S, Sahu A, Acharya N. Endocrine Changes in Postmenopausal Women: A Comprehensive View. Cureus 2023; 15:e51287. [PMID: 38288203 PMCID: PMC10823308 DOI: 10.7759/cureus.51287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
Menopause, when menstrual cycles stop, is brought on by a decline in the level of the hormones progesterone and oestrogen synthesised by the ovaries. Menopause is an unavoidable stage of a female's lifecycle, but because experiences differ for every woman, several women require health care aid to manage their health problems. The physiological variations that take place at various periods of the reproducing age, along with the kind and timing of menopause, are components that are frequently associated with a greater threat of cardiometabolic illness. The most researched associations between menopause and cardiometabolic health are reduced levels of ovarian estrogen synthesis and excessive amounts of androgen during the onset of menopause. Although testosterone and oestrogens have differing effects on adipocyte physiology, it is debatable how important oestrogens are for the emergence of metabolic disorders following menopause. The control of adipocyte differentiation by the brain as well as potential roles of oestrogen and endocrine disruptors chemicals are reviewed in this systematic review of the subject. In general, women had a greater frequency of metabolic syndrome compared to men. Female metabolism was significantly impacted by overt hyperthyroidism and subclinical hypothyroidism. Osteoporosis is another medical condition that menopausal women may experience. Estrogen deprivation is the main contributor to osteoporosis in menopausal women. The regular cycle of bone turnover is disrupted by the decrease in estrogen secretion, which boosts osteoclastic resorption activity while decreasing osteoblastic activity. The entire article assesses and provides information on all the changes in a woman's life after menopause.
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Affiliation(s)
- Vidhi Motlani
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Gunjan Motlani
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Soumya Pamnani
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Akshat Sahu
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Neema Acharya
- Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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Singh S, Baranwal K, Rana I, Khan IA, Bajpai S. Sociodemographic Determinants of Urogenital Morbidities Among Menopausal Women in Rural Areas of Eastern Uttar Pradesh. Cureus 2023; 15:e46677. [PMID: 37942388 PMCID: PMC10629220 DOI: 10.7759/cureus.46677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2023] [Indexed: 11/10/2023] Open
Abstract
Background After their mid-forties, almost all women, irrespective of their cultural background and health conditions, begin to experience physical, psychological, and emotional disturbances because of the progressive decline in hormone levels that occur as a reproductive-aged woman transitions from regular cyclic menses to her final menstrual period, ovarian senescence, and beyond. These morbidities hamper day-to-day life and lead to poor quality of life. Timely attention and management of these morbidities help women maintain a healthy and active life. This study aims to evaluate sociodemographic determinants of urogenital morbidities among rural menopausal women. Materials and methods We conducted the present cross-sectional study among a menopausal transition group and a postmenopausal group of women age 40 to 55 residing in the Chargawan block of the district of Gorakhpur from August 1, 2021, to July 31, 2022. After estimating the sample size based on the 2011 census of India, we selected 385 eligible participants. Results We studied a total of 385 women over a period of one year, out of which 171 (46%) were in the menopausal transition and 214 (54%) were postmenopausal. For urinary incontinence and burning micturition, when we compared both groups in relation to age, we found no significant association (p > .05). The symptom of urinary incontinence was significantly associated with the socioeconomic status of participants in both the menopausal transition and postmenopausal groups (p < .05). Conclusions Postmenopausal women harbor a considerable number of urogenital morbidities. Sociocultural, demographic, and behavioral factors influence these morbidities. These associations might serve as indicators of women at risk of experiencing more severe urogenital morbidities.
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Affiliation(s)
- Shalini Singh
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Kavita Baranwal
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Indu Rana
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Imran Ahmed Khan
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
| | - Somesh Bajpai
- Community Medicine, Baba Raghav Das Medical College, Gorakhpur, IND
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18
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Abstract
Most women worldwide experience menopausal symptoms during the menopause transition or postmenopause. Vasomotor symptoms are most pronounced during the first four to seven years but can persist for more than a decade, and genitourinary symptoms tend to be progressive. Although the hallmark symptoms are hot flashes, night sweats, disrupted sleep, and genitourinary discomfort, other common symptoms and conditions are mood fluctuations, cognitive changes, low sexual desire, bone loss, increase in abdominal fat, and adverse changes in metabolic health. These symptoms and signs can occur in any combination or sequence, and the link to menopause may even be elusive. Estrogen based hormonal therapies are the most effective treatments for many of the symptoms and, in the absence of contraindications to treatment, have a generally favorable benefit:risk ratio for women below age 60 and within 10 years of the onset of menopause. Non-hormonal treatment options are also available. Although a symptom driven treatment approach with individualized decision making can improve health and quality of life for midlife women, menopausal symptoms remain substantially undertreated by healthcare providers.
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Affiliation(s)
- Erin R Duralde
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Talia H Sobel
- Division of Women's Health Internal Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - JoAnn E Manson
- Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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19
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Bajerska J, Skoczek-Rubińska A, Małczak L, Vucic V, Arsic A, Kojadinovic M, Ristic-Medic D. Plasma fatty acid composition and some markers of dietary habits are associated with cardiovascular disease risk determined by an atherogenic plasma index in postmenopausal women. Nutr Res 2023; 115:47-60. [PMID: 37300953 DOI: 10.1016/j.nutres.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023]
Abstract
It is hypothesized that plasma proportion of selected fatty acids (FAs) and dietary habits are linked with the risk of cardiovascular disease (CVD) in postmenopausal women. Therefore, this study was designed to determine the association of plasma FA composition and markers of dietary habits with an atherogenic index of plasma (AIP), a predictor of CVD risk in postmenopausal women. In total, 87 postmenopausal women with an average age of 57 ± 7 years were recruited and their dietary intake, anthropometric and biochemical parameters, and FA status in total plasma lipid proportions were determined, showing that 65.5% of the participants had a high risk of CVD according to their AIP value. After adjusting for some confounders (age, body mass index, and physical activity level), the risk of CVD was only positively associated with the frequency of consumption of animal fat spreads (butter and lard) of terrestrial origin. Regarding the FA profile, CVD risk was positively associated with the percentages of vaccenic acid, dihomo-γ-linolenic acid, and monounsaturated fatty acids (MUFA; mainly n-7) in total FA, as well as the MUFA/SFA ratio in total plasma and stearoyl-CoA desaturase-16 activity (16:1/16:0 ratio). In contrast, the risk of CVD was negatively associated with percentages of α-linolenic acid, total polyunsaturated fatty acids (PUFA), and PUFA/MUFA ratio in total plasma lipid, and the estimated activity of Δ5-desaturase (20:4/20:3 n-6 ratio). These results support the current recommendations to decrease the frequency of animal fat spread intake because it is associated with a reduced CVD risk based on AIP in postmenopausal women. In accordance with these plasma percentages of ALA, vaccenic acid, dihomo-γ-linolenic acid, PUFA, PUFA/MUFA ratio, and 16:1/16:0 ratio may be important parameters in CVD risk assessment.
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Affiliation(s)
- Joanna Bajerska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland.
| | - Aleksandra Skoczek-Rubińska
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Lidia Małczak
- Department of Human Nutrition and Dietetics, Poznań University of Life Sciences, Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Vesna Vucic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of the Republic of Serbia, University of Belgrade, Belgrade PO BOX 102, Serbia
| | - Aleksandra Arsic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of the Republic of Serbia, University of Belgrade, Belgrade PO BOX 102, Serbia
| | - Milica Kojadinovic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of the Republic of Serbia, University of Belgrade, Belgrade PO BOX 102, Serbia
| | - Danijela Ristic-Medic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of the Republic of Serbia, University of Belgrade, Belgrade PO BOX 102, Serbia
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20
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Allen A, Tully-Wilson C. Early Adaptive Schemas and Sexual Wellbeing in Women: Exploring Differences in Menopausal Status. INTERNATIONAL JOURNAL OF APPLIED POSITIVE PSYCHOLOGY 2023:1-29. [PMID: 37361625 PMCID: PMC10185943 DOI: 10.1007/s41042-023-00100-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
There is limited research concerning the relationship between early adaptive schema, from Young's Schema Theory, and women's sexual wellbeing. Schema Theory posits that early adaptive schema start forming in early childhood from core emotional needs being met, and positively influence individuals' concept of self, relationships with others, and their behaviours. Building on this theory, the current study explored the relationship of early adaptive schema and adult women's sexual wellbeing at pre-, peri-, and post-menopause. Four hundred and sixty-seven women, mostly partnered and heterosexual, from over ten countries, participated in an online survey measuring relationships between early adaptive schema and sexual wellbeing, measured by sexual functioning and sexual satisfaction. The strength of association of early adaptive schema and sexual well-being were evaluated in addition to known predictors. The results showed higher early adaptive schema were associated with higher sexual wellbeing, measured by sexual satisfaction and sexual functioning,with medium-to-large effect sizes, at pre and peri-menopause, and produced a non-significant result for post-menopause. The association of early adaptive schema continued after known factors were accounted for. The results support the use of early adaptive schema to promote sexual wellbeing for women at pre- and peri-menopause.
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Affiliation(s)
- Andrew Allen
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556 Australia
| | - Colleen Tully-Wilson
- School of Health, University of the Sunshine Coast, 90 Sippy Downs Drive, Sippy Downs, Queensland 4556 Australia
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21
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Bień A, Korżyńska-Piętas M, Zarajczyk M, Wysokiński M, Niewiadomska I, Jurek K, Rzońca E. Factors Determining the Quality of Life of Polish Women during Menopause Based on the Menopause-Specific Quality of Life Questionnaire. Healthcare (Basel) 2023; 11:healthcare11081173. [PMID: 37108007 PMCID: PMC10138136 DOI: 10.3390/healthcare11081173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/06/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The aim of the study was to present the process of cultural adaptation to Polish conditions and the validation of a scale assessing the quality of life of Polish women during the menopause and to identify the factors determining this quality of life. METHODS The research tools were the menopause-specific quality of life (MENQOL) questionnaire and a standardized interview questionnaire comprising questions on the participants' characteristics. The study involved 516 women using health care services who had symptoms caused by the menopause. RESULTS The value of the Cronbach's alpha coefficient was 0.923. The discriminative power coefficients of all the questionnaire items were higher than 0.3. The study confirmed the validity and internal consistency of the Polish version of the MENQOL questionnaire for measuring the quality of life of postmenopausal women, suggesting that the tool can be used for screening menopausal symptoms in women. There was a relationship between general quality of life and age (p = 0.002), marital status (p < 0.001), education (p = 0.021), the impact of professional work (p < 0.001), the impact of physical activity (p < 0.001) and the impact of social life (p < 0.001). CONCLUSION In the group of women who took part in the study, the authors observed a lower quality of life during menopause reported by older women who were married/in a stable relationship, with no formal education (no formal education) and who, according to their subjective assessment, negatively evaluated the impact of the accompanying menopause-related symptoms on their work, physical activity and social life.
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Affiliation(s)
- Agnieszka Bień
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Magdalena Korżyńska-Piętas
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Marta Zarajczyk
- Chair of Obstetrics Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Mariusz Wysokiński
- Chair of Nursing Development, Faculty of Health Sciences, Medical University of Lublin, 20-081 Lublin, Poland
| | - Iwona Niewiadomska
- Department of Social Psychoprevention, John Paul II Catholic University of Lublin, 20-950 Lublin, Poland
| | - Krzysztof Jurek
- Institute of Sociological Sciences, John Paul II Catholic University of Lublin, 20-950 Lublin, Poland
| | - Ewa Rzońca
- Department of Obstetrics and Gynecology Didactics, Faculty of Health Sciences, Medical University of Warsaw, 00-575 Warsaw, Poland
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22
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Chen PC, Li PC, Ding DC. Possible Association of Hysterectomy Accompanied with Opportunistic Salpingectomy with Early Menopause: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11871. [PMID: 36231169 PMCID: PMC9565814 DOI: 10.3390/ijerph191911871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/16/2023]
Abstract
Opportunistic salpingectomies (OSs) are concurrently performed with hysterectomies to prevent epithelial ovarian cancer. This study aimed to investigate the correlation between OS and early menopause in females who have undergone hysterectomies. This was a retrospective cohort study involving 79 females who had undergone a hysterectomy, with or without an OS, between January 2007 and December 2015. Their ages at surgery, at menopause, and the lengths of time from surgery to menopause were compared. An OS had been performed in 54 and not performed in 25 of the enrolled patients, comprising the OS and non-OS groups. Body mass index was significantly higher in the OS group (OS: 25.27 ± 4.17 vs. non-OS: 22.97 ± 3.27, p = 0.01). Additionally, menopausal sleep problems were more prevalent in the OS group than in the non-OS group (41% vs. 12%, p = 0.01). Notably, the time from surgery to menopause was significantly shorter in the OS group than in the non-OS group (OS: 1.84 ± 1.85 vs. non-OS: 2.93 ± 2.43, p = 0.031). After adjusting the covariates, the OS group was associated with a significantly shorter period between surgery and menopause (p = 0.029). In conclusion, these results showed that a hysterectomy plus an OS might cause earlier menopause than a hysterectomy only. An OS should be preoperatively discussed with patients regarding the possibility of early menopause. The findings of this study require further large-scale investigations to reinforce the results.
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Affiliation(s)
- Pei-Chen Chen
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 97004, Taiwan
| | - Pei-Chen Li
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 97004, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 97004, Taiwan
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
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23
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Chapman-Lopez T, Wilburn D, Fletcher E, Adair K, Ismaeel A, Heileson J, Gallucci A, Funderburk L, Koutakis P, Forsse JS. The influence of resistance training on adipokines in post-menopausal women: A brief review. SPORTS MEDICINE AND HEALTH SCIENCE 2022; 4:219-224. [PMID: 36600971 PMCID: PMC9806702 DOI: 10.1016/j.smhs.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/23/2022] [Accepted: 09/14/2022] [Indexed: 01/07/2023] Open
Abstract
The onset of menopause elicits changes in body composition that negatively influence adipokine levels. Consequently, various health risk factors (e.g., cardiovascular disease, osteoporosis, physical inactivity, obesity, arterial hypertension, hypercholesterolemia, sarcopenia) are influenced by adipokines due to changes in body composition after menopause. Thus, improvements in body composition are considered the primary influencer of adipokines. Though several therapeutic interventions (e.g., medication, diet, meditation, exercise) are employed to target changes in body composition, resistance training appears to be more effective in positively improving body composition through changes in lean-muscle mass/fat-mass ratio. However, due to the lack of research, very little is known about adipokines' anti/inflammatory response in postmenopausal women after completing resistance training. Most resistance training studies in postmenopausal women have focused on leptin, adiponectin, and resistin, with limited research assessing other adipokines that are important in metabolic regulation and inflammatory processes. Additionally, the consistency of resistance training protocols as an intervention is not standardized or fully recognized. Therefore, the focus of this review is to establish a more comprehensive understanding of the benefits of resistance training on influencing adipokine levels based on changes to total body composition in postmenopausal women.
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Affiliation(s)
- Tomas Chapman-Lopez
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Dylan Wilburn
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
- Clinical Muscle Biology Lab, Biology Department, Baylor University, Waco, TX, 76798, USA
| | - Emma Fletcher
- Clinical Muscle Biology Lab, Biology Department, Baylor University, Waco, TX, 76798, USA
| | - Kathleen Adair
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Ahmed Ismaeel
- Department of Physiology, University of Kentucky, 780 Rose St., MS508, Lexington, KY, 40536, USA
| | - Jeffery Heileson
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | - Andrew Gallucci
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
| | | | - Panagiotis Koutakis
- Clinical Muscle Biology Lab, Biology Department, Baylor University, Waco, TX, 76798, USA
| | - Jeffrey S. Forsse
- Department of Health Human Performance and Recreation, Baylor University, Waco, TX, 76706, USA
- Corresponding author. College of Health & Human Sciences, Baylor University, One Bear Place #97313, 76798-7313, Waco, TX, USA.
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