Association of menopause age and N-terminal pro brain natriuretic peptide
Imo EbongKarol E. WatsonDavid C. GoffDavid A. BluemkePreethi SrikanthanTamara B. HorwichAlain G. Bertoni
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Abstract:
Menopause age can affect the risk of developing cardiovascular disease (CVD). The purpose of this study was to investigate the associations of early menopause (menopause occurring before age 45 y) and menopause age with N-terminal pro brain natriuretic peptide (NT-proBNP), a potential risk marker of CVD and heart failure.Our cross-sectional study included 2,275 postmenopausal women, aged 45 to 85 years and without clinical CVD (2000-2002), from the Multi-Ethnic Study of Atherosclerosis. Participants were classified as having or not having early menopause. NT-proBNP was log-transformed. Multivariable linear regression was used for analysis.Five hundred sixty-one women had early menopause. The median (25th-75th percentiles) NT-proBNP value was 79.0 (41.1-151.6) pg/mL for all participants, 83.4 (41.4-164.9) pg/mL for women with early menopause, and 78.0 (40.8-148.3) pg/mL for women without early menopause. The mean (SD) age was 65 (10.1) and 65 (8.9) years for women with and without early menopause, respectively. No significant interactions between menopause age and ethnicity were observed. In multivariable analysis, early menopause was associated with a 10.7% increase in NT-proBNP levels, whereas each 1-year increase in menopause age was associated with a 0.7% decrease in NT-proBNP levels.Early menopause is associated with greater NT-proBNP levels, whereas each 1-year increase in menopause age is associated with lower NT-proBNP levels, in postmenopausal women.Keywords:
Surgical Menopause
Many postmenopausal women experience hot flashes, night sweats, decreased sexual desire and vaginal dryness. In this study, we aimed to compare the menopause symptom levels of surgical menopause patients and natural menopause patients by using a Menopause Rating Scale (MRS) and investigate whether there is a relationship between lipid levels and menopausal symptoms in surgical menopause patients.This cross-sectional study was conducted on postmenopausal women who applied to the gynecology outpatient clinic. A total of 187 patients were analyzed. Of these,112 were the surgical menopause group and the remaining 75 were the natural menopause group. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides were measured by using an enzymatic color test. In order to evaluate the postmenopausal symptoms of postmenopausal women included in the study, the MRS questionnaire adapted to the Turkish population was used.Considering the results of the MRS of the two groups, the results of surgical menopause patients were found to be statistically significantly higher. The results were statistically significantly higher in both the total score and in the two subgroups(somatic and psychological subgroups)in the surgical menopause group. When the MRS results(subgroups and total score)of women in the surgical menopause group were classified as mild and severe, no statistically significant relationship was found between symptom severity and blood lipid levels.In the surgically induced menopause group, it was shown by this study that menopausal symptoms were more severe than the natural menopause group. Unlike natural menopausal patients, no relationship was found between lipid levels and severity of menopausal symptoms in surgical menopausal patients.
Surgical Menopause
Outpatient clinic
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In this study, comparing four different parameters in women with surgical menopause because of ovariectomy in reproductive age and in women with natural menopause, the effect of withdrawal of ovarian hormones on both groups was investigated. The patient groups in this study were constituted of 100 women in reproductive age who had undergone total abdominal hysterectomy + bilateral salpingo-oophorectomy and 50 women with natural menopause referred to out-patient's clinic within the same period. The findings for four different parameters were recorded one day before the surgery and at 3rd month post-operatively in surgical menopause group and at the day of referral to outpatient clinic in natural menopause group. The parameters planned to be recorded were blood lipid profile, thrombotic system, arterial elasticity and psychosexual variations. Post-operative high-density lipoprotein level in surgical menopause group was found lower than that of natural menopause group (47.08 vs 52.44 mg/dL, P < 0.05). Post-operative very low density lipoprotein level in surgical menopause group was increased more than that in natural menopause group (27.74 vs 23.58 mg/dL, P < 0.05). An increase was observed in post-operative carotid artery Pulsality Index and Resistive Index levels of surgical menopause group compared with natural menopause group (1.44 vs 1.33, P < 0.001 and 0.73 vs 0.68, P < 0.001 respectively). In surgical menopause group, the differences between pre- and post-operative values of bleeding time (1.15 vs 1.24, P < 0.0001), clotting time (5.9 vs 6.08, P < 0.0001) and fibrinogen level (422 vs 395, P < 0.0001) were found statistically significant. While bleeding time and clotting time were increased post-operatively, fibrinogen level was decreased. A significant increase was observed in post-operative mean Kupperman Index levels of surgical menopause group compared with that of natural menopause group (23.89 vs 9.94, P < 0.001). It was concluded that the ovaries should be considered as important organs impacting women's quality of life with their hormones produced also in the period of menopause; that disadvantages of oophorectomy during hysterectomy should be considered and that an attempt to conserve ovaries during surgery except pre-cancerous events would benefit women.
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Surgical menopause (iatrogenic menopause) happens when both ovaries are removed before the natural "switching off" of ovarian function; it can cause premature ovarian insufficiency where the menopause occurs in women before the age of 40. Surgical menopause is associated with a sudden reduction of ovarian sex steroid production rather than a gradual one as is the case in natural menopause. In women who have undergone bilateral salpingo-oophorectomy (BSO) before the natural age of menopause, strong consideration should be given to giving hormone replacement therapy (HRT) till the natural age of menopause at least. Sexual function and sexual desire are altered post-BSO, especially in younger women hence part of HRT prescription must include consideration of androgen too.
Surgical Menopause
Oophorectomy
Premature Menopause
Premature ovarian insufficiency
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The objective: to determine the efficacy of medicine «Menopace» in treatment of women with natural and surgical menopause. Patients and methods. 20 women (I group) with a natural menopause were examined (basic subgroup consisted of 10 patients who used Menopace for 3 months; control subgroup consisted of 10 patients). 20 women (II group) with surgical menopause were examined (basic subgroup consisted of 10 patients who received Menopace for 3 months; control subgroup consisted of 10 patients). Results. The average score of neurovegetative and emotional manifestations of climacteric syndrome during the observation period decreased in women with natural and surgical menopause who used Menopace, compared with subgroups of patients who had not used the medicine. Conclusions. 1. The use of the medicine Menopace in women with natural menopause after 3 months showed the disappearance of clinical symptoms of climacteric syndrome in 70% of the cases, and significant improvement in general condition in 30% of cases. 2. During surgical menopause after 1 month of treatment with Menopace manifestations of sweating were observed 4.5 times less often than in control group, tides were observed 7 times less often than in control group. Neurovegetative and psychoemotional symptoms of menopause were absent in 80% of women after 3 months of treatment and in 20% of cases significant improvement was shown. 3. The obtained results give grounds to recommend wide use of Menopace in practical work for the treatment of menopausal syndrome during natural and surgical menopause. Key words: menopause, therapy, Menopace.
Surgical Menopause
Climacteric
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Surgical Menopause
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Hormone replacement therapy in surgical menopause is a prophylactic measure that is used for preventing the short and long term effects of the lack of ovarian hormones.This is a retrospective study conducted between 2004 and 2006 at the Iasi "Elena-Doamna" Hospital of Obstetrics and Gynecology on two series of patients: 46 patients with surgical menopause who received treatment with transdermal estradiol (Climara), and 20 surgical menopause patients not receiving this treatment who served as controls.A decreases in the average levels of total cholesterol, triglycerides and LDL cholesterol and an increase in the HDL cholesterol level were identified in the series receiving Climara compared to the controls. The climacteric symptoms improved in the patients receiving treatment.Transdermal therapy with estradiol (Climara) is an effective method of treatment in surgically induced menopause.
Surgical Menopause
Climacteric
Hormone Therapy
Hormonal replacement therapy
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This study aimed to compare metabolic syndrome and its components in naturally and surgically menopausal women.This is a longitudinal study, with incident case and control groups, conducted on 446 women participants of the Tehran Lipid and Glucose Study, who experienced surgical or natural menopause over a 10-year period. In both groups, data collection was conducted using questionnaires including information on demographic, reproductive and metabolic characteristics at baseline and again after 3 years. Physical examinations and the biochemical profiles were also assessed.During the follow-up, metabolic syndrome was observed in 28.7% and 32.5% of the naturally menopause and surgically menopausal women, respectively. Mean fasting blood sugar and 2-h plasma glucose were significantly higher in the surgically menopause group, compared to the naturally menopause one, whereas mean systolic blood pressure was significantly higher in naturally menopausal women as compared to surgically menopause ones, after further adjustment for premenopausal status.Although no difference in the prevalence of metabolic syndrome in naturally menopausal women and in surgically menopausal women was found, the components of metabolic syndrome were more prevalent among those with surgical menopause.
Surgical Menopause
Longitudinal Study
Fasting glucose
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It is well established that accelerated bone loss occurs in association with estrogen deprivation as seen following the natural menopause and in premenopausal women undergoing surgical oophorectomy (i.e., surgical menopause). We have measured serum levels of bone biochemical markers after both natural menopause and surgical menopause. Circulating levels of insulin-like growth factor-I (IGF-I), which is considered to be the local regulator of osteoblast activity and one of its binding protein, insulin-like growth factor binding protein-4 (IGFBP-4) which binds to IGF-I and suppress its biological activity, were also measured. Bone mineral density measured by dual energy X-ray absorptiometry was decreased more rapidly after surgical menopause. A concomitantly higher rate of bone turnover as assessed by bone biochemical markers was observed after surgical menopause, and thus the levels of procollagen type I C-peptide, pyridinoline and deoxypyridinoline were increased. The serum levels of IGF-I were significantly reduced after natural menopause compared with that after surgical menopause. The levels of IGF-I were correlated with bone mineral density after natural menopause (r = 0.62, p < 0.001), but no significant correlation was observed between these two variables after surgical menopause. The binding activity of IGFBP-4 was significantly greater after surgical menopause than after natural menopause. A stronger inverse correlation existed between the binding activity of IGFBP-4 and bone mineral density after surgical menopause (r = -0.90, p < 0.001) compared to that after natural menopause (r = -0.29, p < 0.05). The simplest explanation is that whereas the loss of bone depends upon the decreased level of IGF-I after natural menopause, after surgical menopause it depends upon the increased level of IGFBP-4.
Surgical Menopause
Pyridinoline
Bone remodeling
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Oophorectomy
Surgical Menopause
Medical record
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Acute onset of surgical menopause rarely complicates a woman's psychological state. Although most women with acute surgical menopause have associated menopausal symptoms, few psychological consequences have been reported. This article presents the case report of a woman who developed immediate postoperative symptoms of severe anxiety that significantly impacted her quality of life. Physiological and psychological changes associated with surgical menopause and hormone replacement therapy are also discussed.
Surgical Menopause
Surgical procedures
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