Pain Severity in Relation to the Final Menstrual Period in a Prospective Multiethnic Observational Cohort: Results From the Study of Women's Health Across the Nation

The development of pain is common in midlife, resulting in increased health care utilization and costs. The aim of this study was to determine the longitudinal trajectory of overall bodily pain among women during the transition between the reproductive years and menopause. We conducted analyses on a community-based, longitudinal cohort of women enrolled in the Study of Women's Health Across the Nation. One thousand four hundred ninety-five women met inclusion criteria, including: 1) defined date of the final menstrual period (FMP), and 2) complete data on Short Form-36 bodily pain. The primary exposure was time to/from the FMP. The primary outcome was the rate of change in Short Form-36 bodily pain, measured on a scale of 0 to 100 with 100 being the most severe pain. We performed within-person trajectory analyses using piecewise regression following nonparametric modeling of functional forms. Mean bodily pain score at the time of the FMP was 29. Mean bodily pain increased at a rate of .26 per year during the transmenopause (the interval spanning 4.5 years before the FMP through .5 years after the FMP), and decreased at a rate of .23 per year after that. Depression and sleep problems were associated with greater increases in pain during the late reproductive years, whereas abdominal cramps at baseline predicted greater decreases in pain during the late reproductive years.

The management of perimenopausal abnormal uterine bleeding

Abnormal uterine bleeding in the perimenopause is a common gynaecological disorder and may affect 20–50 % of all women. It may be the first sign of premalignant or malignant disease. All women require assessment by means of pelvic ultrasound and an endometrial biopsy to exclude sinister pathology, identify other causes, and plan appropriate treatment. Pharmacological treatment includes antifibrinolytics, non-steroidal anti-inflammatories, combined hormonal contraception, cyclical progestogens and the levonorgestrel intrauterine system (LNG – IUS). Second line treatments may include endometrial ablation, uterine artery embolization, myomectomy or hysterectomy depending on the nature of the pathology. Minimal access techniques though the hysteroscopic, laparoscopic/robotic or vaginal route are increasingly used as the preferred surgical options. Novel treatments, either pharmacological or in the outpatient setting are likely to have a significant contribution in the future.     

葛根素注射液对去卵巢大鼠雌激素样作用的研究

目的：观察葛根素注射液对去卵巢大鼠血清雌二醇（E2）水平的影响。方法：大鼠50只,分为葛根素高剂量组、葛根素低剂量组、倍美力组、模型组、假手术组,每组10只。除假手术组外,均摘除大鼠卵巢造成去势模型。造模后第7天,检测大鼠血清E2水平,确定造模成功后,相应予葛根素注射液、倍关力水溶液、生理盐水灌胃。各组用药后30天测血E2含量。结果：用药30天后,模型组大鼠血清E2水平明显低于其它四组,差异有显著性意义（P〈0．01）。结论：葛根素注射液可以提高去卵巢大鼠血清E2水平,具有雌激素样作用。     

围绝经期及绝经期妇女体重指数与血压血脂水平的相关性分析

目的 探讨围绝经期、绝经期妇女体重指数与血压、血脂水平之间的关系。方法 100例围绝经期、绝经期妇女，在妇科体检时常规测量身高、体重、血压等数据，计算其体重指数．并同时采血测定其血清生化指标。按照世界卫生组织关于肥胖的诊断，以体重指数(BMI)为标准分为体重过低、体重正常、体重超重和肥胖四组。应用SPSS软件对四组妇女的血压、血脂水平进行方差分析，比较其差异。结果 体重超重组和肥胖组妇女的血压水平、血脂水平均高于体重正常组或体重过低组。结论 体重指数与围绝经期、绝经期妇女血压、血脂水平有密切关系。     

ESR1基因与5-HTT基因多态性的交互作用对女性围绝经期抑郁障碍的影响

目的 通过多因子降维法(MDR)模型探讨雌激素α受体(ESRl)基因与5-羟色胺转运体(5-HTT)基因多态位点的交互作用对围绝经期首发抑郁障碍的影响.方法 采用病例-对照研究,通过对在妇科门诊就诊的围绝经期汉族女性人群进行抑郁障碍筛查及诊断,最终共纳入围绝经期抑郁障碍患者63例(病例组),围绝经期健康女性131例(对照组).采用聚合酶链反应-限制性片段长度多态性( PCR-RFLP)法对5-HTT基因启动子区域多态(5-HTTLPR)位点、第2内含子上可变数目串联重复序列多态位点(Stin2)及ESR1基因第1内含子上限制性内切酶PvuⅡ(rs11155815)和Xba Ⅰ (rs11155816)多态位点进行基因分型.应用MDR软件对两基因交互作用与围绝经期首发抑郁障碍的关联进行分析.结果 病例组与对照组5-HTTLPR位点各基因型分布频率差异具有统计学意义(P=0.032),患病与L/L基因型呈正相关(OR=3.52,95％CI为1.36～9.09);而两组间Stin2位点、PvuⅡ位点及XbaⅠ位点各基因型分布频率比较,差异无统计学意义(P＞0.05).基因交互作用分析结果显示,5.HTT基因及ESR1基因上的4个多态位点的交互作用与抑郁障碍存在关联(P＜0.05),其中最优模型为5-HTTLPR与Xba Ⅰ多态位点交互作用与疾病的关联模型(x2 =9.24,p =0.010).结论 5-HTT基因与ESR1基因多态交互作用可能增加女性围绝经期抑郁障碍患病的风险.     

健身运动处方改善围绝经期妇女心肺功能、肌肉力量与腰背部疼痛的效果评价

目的：观察健身运动处方改善围绝经期妇女心肺机能、肌肉力量与腰背疼痛的效果,为围绝经妇女科学健身提供依据。方法：以围绝经期妇女（40～60岁）为研究对象,遵循个人意愿,将受试者分为运动组和对照组。运动组按照健身运动处方进行有指导的运动,对照组未进行有规律的运动。分别在0、3和6个月测量心肺机能、肌肉力量及腰背部疼痛等指标...     

社会因素和性激素与围绝经期抑郁症的相关研究

目的：探讨社会因素以及性激素水平与围绝经期抑郁症高发的关系。方法采用汉密尔顿抑郁量表（ HAMD-17）及国际疾病分类（ ICD-10）中“抑郁发作”的诊断标准筛查入选研究对象。收集79名围绝经期抑郁症和58名围绝经期非抑郁症研究对象的一般资料和外周血标本。采用电化学发光法检测血清中的雌二醇（ E2）、睾酮（ T）、孕酮（ P）、黄体生成素（ LH）和卵泡刺激素（ FSH）水平。结果围绝经期抑郁症组睡眠障碍和慢性病发生率高于非抑郁症组（χ2＝4．700,P＝0．030;χ2＝4．866,P＝0．027）。围绝经期抑郁症组E2、T、P水平均低于非抑郁症组（ z＝-3．175,P＝0．001;z＝-3．726,P＜0．000;z＝-2．868,P＝0．004）。 HAMD评分与E2、T、P均存在负相关关系（ r＝-0．284,P＝0．001;r＝-0．389,P＝0．000;r＝-0．352,P＝0．000）。Logistic回归分析显示E2、T、P水平高是抑郁症发生的保护因素[OR（95％CI）分别为：3．851（1．347～11．785）,P＝0．014;4．580（1．298～14．132）,P＝0．012;1．864（0．984～3．942）,P＝0．049）]。结论睡眠障碍、慢性病、E2、T、P水平与围绝经期抑郁症的发生相关,E2、T、P水平高是围绝经期抑郁症发生的保护因素。     

围绝经期女性骨质疏松症的膳食营养策略

妇女进入围绝经期以后,由于卵巢功能减退,雌激素波动性下降,会减少对钙的吸收,同时破骨过程增加,新生骨骼无法及时形成,骨骼密度降低,容易引起骨质疏松症。骨质疏松症重在预防,膳食营养与骨质疏松症关系密切,其是预防骨质疏松症的重要措施之一。该文分析不同营养物质在预防骨质疏松症中的作用,阐述科学合理饮食和运动,预防围绝经期女性骨质疏松症。     

Can acupuncture improve sleep quality and anxiety among women during perimenopause?: A protocol for systematic review and meta-analysis

Background:The decrease in estrogen levels during the perimenopausal period can cause women to have various symptoms such as insomnia, emotional anxiety, and even depression. Therefore, whether the green therapy of acupuncture can improve the sleep quality and anxiety of perimenopausal women has attracted more and more attention. The purpose of this systematic evaluation was to assess the efficacy of acupuncture on insomnia and anxiety in perimenopausal women.Methods:We will search for clinical observational pilot studies or cohort studies of acupuncture for insomnia, anxiety, or depression included in PubMed, Cochrane Library, Embase, Web of science, China Knowledge Network (CNKI), Wanfang, VIP and China Biomedical Database (CBM), etc. The search period will be from the establishment of the database until November 2021. Two researchers will independently perform literature screening, data extraction, and quality assessment. Finally, data analysis will be performed using Revman and Stata software.Results:The purpose of this study was to evaluate the effectiveness and safety of acupuncture therapy for the treatment of insomnia, anxiety, and depression in perimenopausal women.Conclusion:This study will provide new evidence on the effectiveness and safety of acupuncture for the treatment of insomnia, anxiety, and depression in perimenopausal women, and provide additional options for clinicians and patients to improve insomnia and anxiety.Registration Number:INPLASY2021120012