Menopause : the journal of the North American Menopause Society
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Although urinary incontinence becomes more prevalent as women age, little is known about the outcomes of urinary incontinence in midlife women. Our aim was to determine the effects of urinary incontinence (stress and urge) on mood (depressed mood, anxiety), perceptions of self (self-esteem, mastery, perceived health), attitudes toward midlife (attitudes toward aging, attitudes toward menopause), and consequences for daily living (interference with relationships, interference with work, sexual desire, physical activity, awakening at night, social support, stress), taking into account the effects of aging ⋯ Urinary incontinence during the menopausal transition and early postmenopause seems to affect perceptions of self--but not mood, attitudes toward midlife, or consequences for daily living--in this midlife population. Appropriate therapies for urinary incontinence during midlife may promote higher levels of self-esteem and a greater sense of mastery by older women.
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To update and expand the previous position statement of The North American Menopause Society (NAMS) on the management of symptomatic vulvovaginal atrophy (VVA) in postmenopausal women. ⋯ Clinicians can improve the sexual health and QOL of postmenopausal women by educating women about, diagnosing, and appropriately managing symptomatic VVA. Choice of therapy depends on the severity of symptoms, the effectiveness and safety of therapy for the individual patient, and patient preference. Estrogen therapy is the most effective treatment for moderate to severe symptoms, although a direct comparison of estrogen and ospemifene is not available. Nonhormonal therapies available without a prescription provide sufficient relief for most women with mild symptoms. When low-dose estrogen is administered locally, a progestogen is not indicated for women without a uterus and generally is not indicated for women with an intact uterus. However, endometrial safety has not been studied in clinical trials beyond 1 year. There are insufficient data to confirm the safety of local estrogen in women with breast cancer; management of VVA should take the woman's needs and the recommendation of her oncologist into consideration. Research on the vaginal microbiome may lead to other therapies in the future.
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Bladder trabeculation (BT) is a secondary result of bladder outlet obstruction (BOO), which may result from severe pelvic organ prolapse (POP) and cause lower urinary tract symptoms (LUTS). This study was conducted to investigate the relationship among clinical manifestations, urodynamic findings, and BT in women with severe POP. ⋯ More than half of the women with severe POP have BT, which, when compared with women without BT, indicates higher incidences of LUTS, detrusor overactivity, and urinary retention. An objective evaluation of BT should become a prerequisite examination for women with severe POP who would undergo prolapse surgical operation.
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Comparative Study
Walking training affects dehydroepiandrosterone sulfate and inflammation independent of changes in spontaneous physical activity.
We hypothesized that physical exercise in postmenopausal women could interfere with the molecular interrelationship of the immune-endocrine system and be effective even in women in whom training determined a reduction of spontaneous physical activity (SPA). For this reason, we investigated the effects of an aerobic program on plasma dehydroepiandrosterone sulfate (DHEA-S) and cytokine levels in relationship to SPA modification. ⋯ In postmenopausal women, walking training, rather than SPA, influences DHEA-S and cytokine concentrations and their correlations, thus interfering with adrenal steroids and the inflammatory markers network. Physical exercise acts in parallel on menopausal neuroendocrine alterations and on the systemic inflammatory profile independent of SPA changes.
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The aim of this study was to assess the risk of metabolic syndrome (MetS) in postmenopausal breast cancer survivors as compared with postmenopausal women without breast cancer. ⋯ Postmenopausal breast cancer survivors present a higher risk of developing MetS as compared with women without breast cancer.