Journal articles on the topic 'Menopause – Physiological aspects'

In the debates about the association between mental illness and the menopause, the psychiatric approach contradicts assertions by the gynaecological and psychoanalytic literature that the menopause has a negative effect on mental health. General population studies show that, if at all, psychiatric morbidity is more common in women in the five years before menopause. Sociocultural and family factors are more important in the aetiology of mental illness in menopausal women than physiological changes. Anxiety and depression in such women do not respond to oestrogen therapy, although some cases respond to antidepressants.

The antioxidants glutathione, selenium and vitamins C and E meet the criteria for nutraceuticals and their in vivo concentrations can undoubtedly influence and improve many disease processes. In an attempt to quantify and correlate their individual roles as nutritional supplements with their therapeutic potential to improve symptoms and lifestyle during the menopause, we conducted a literature search covering the 15 years up to 2001. Few publications were found dealing specifically with menopausal women. Approximately 90% reported research with vitamins and/or selenium and only one paper investigated a possible correlation between glutathione and breast cancer. This relatively low level of research interest in nutritional or antioxidant aspects of the menopause may just reflect a preoccupation with the more general chronic diseases of an ageing population, without necessarily acknowledging the important physiological changes that occur in women. The little encouraging data in the literature should stimulate more research into the prognostic value, mechanisms and efficacy of nutraceutical supplementation that specifically relate to menopausal women.

The health problem of women towards elderly is menopause syndrome starting from 40 to 45 years old and it needs attention. It is estimated that one-third of a woman's life span will be in age with a hypoestrogen condition. Women will experience various kinds of disorders both physically and psychologically which negatively impact both in the short and long term. Factors that can influence complaints during menopause are physiological factors due to decreased ovarian activity, socio-cultural and psychological factors that underlie women's personality. This study used a cross sectional approach which aims to learn more about the relationship between anxiety levels with menopausal women's complaints. The research was carried out in the working area of the Tanah Sareal Community Health Center, Central Bogor District, starting from Oktober until November 2020 with a questioner via E-form conducted to 107 respondents. Results: The age of the respondents was dominated by 50-55 years with an elementary and high school education background. In general, respondents are married and some have normal nutritional status and tend to be obese, most of them do not smoke. Bivariate analysis showed that there was a significant relationship between anxiety and menopause complaints. Multivariate analysis confounder test with regression, the variable anxiety was the most closely related to menopausal complaints with p = 0.023 and an OR value of 5.7. It is recommended that Tanah Sereal Puskesmas carry out health promotion to change women's views about menopause as a physiological thing and pay more attention to psychological aspects in providing health services. The results of this study can be taken into consideration in developing a nursing intervention model in the form of more comprehensive health promotion in preventing and overcoming menopausal complaints by involving family members.

How menopause affects women with learning disabilities is a neglected area of research. Women with learning disabilities experience the same physiological effects of the menopause as others, including hot flushes and night sweats, but difficulties in understanding and communication mean that additional supports are often required. They are less likely to report the psychological difficulties or symptoms associated with menopause than women in the general population. Menopause is usually earlier in women with learning disability and earlier still for those with Down's syndrome. Debate about hormone replacement therapy often ignores the needs of women with learning disabilities who, as a result, are very often excluded from the decision-making process. Physical problems among women with learning disabilities and other aspects of ageing warrant particular focus.

Background: Menopause is one of the most significant events in a woman's life and brings in a number of physiological changes that affect the life of a woman permanently and can be influenced by various socio-demographic factors and coping activities. The objectives of the study were to determine the commonly reported menopausal symptoms among middle age women and to correlate identified menopausal problems with coping strategies found in participants.Methods: By using modified MRS questionnaire, 150 menopausal women aged 40-60 years were interview to document of 12 symptoms (divided into somatic, psychological and urogenital domain) commonly associated with menopause.Results: The mean age of menopause was 49.8 years (±4.9) (range 43 - 57 years). The most prevalent symptoms reported were joint and muscular discomfort (70.6%); physical and mental exhaustion (61.3%); and sleeping problems (59.3%). Followed by symptoms of anxiety (48.6%); irritability (45.3%) hot flushes and sweating (38.6; dryness of vagina (37.9%); depressive mood (38.0%). Other complaints noted were incontinence/Frequency of urine (27.3 and heart discomfort (23.3%). Perimenopausal women (47.2%) experienced higher prevalence of somatic and psychological symptoms compared to premenopausal (n=15.6) and postmenopausal (37.2%) women. However urogenital symptoms found more in postmenopausal group of women. There is a strong significant association between the menopausal symptoms and coping strategies adopted by the menopausal women.Conclusions: Symptoms have variable onset in relation to menopause. Some women experience symptoms earlier during perimenopause while some experience them at a later time. The application of various coping methods, including the establishment of social support networks, is warranted to enhance postmenopausal women’s behaviors in different aspects.

Background: Menopause is defined as” the time when there has been no menstrual periods for 12 consecutive months and no other biological or physiological cause can be identified.” Objectives: 1) To describe the socio-demographic characteristics of post menopausal women in study area. 2) To explore out the various factors related to the age at menopause. 3) To assess the health seeking behaviour of study population. Materials and Methods- This study was a cross sectional community based observational study which was carried out among Postmenopausal women in 8 selected villages of Chhatrapur block of Ganjam district, Odisha for a period from October 2016 to September 2018 with a sample size of 247. Results- In the present study, 39.3% of the study population attained menopause at the age 46-50 years and 11.7% at the age 51-55years. Factors like socioeconomic status, age at menarche ,parity ,marital status , addiction status, family history of early menopause ,BMI and contraception user were found to have statistical significant association with the age at menopause. On logistic regression by adjusting all the variables it was found that age of study population [AOR=3.030 (1.639-5.602), educational qualification[AOR=11.798 (4.002-34.777)], and occupation [AOR= 3.913 (1.296-11.82)] were found to be significantly associated with the health seeking behaviour. Conclusion-In the present study the mean age at menopause was 46.98±4.080 years. Majority of postmenopausal women perceived that menopause occurred due to normal process of ageing. But less than half of the respondents sought treatment because of lack of knowledge about the symptoms and availability of treatment modalities. Awareness and knowledge about all the aspects of menopause should be provided to them through the health workers and women organisation. Keywords: Behaviour, Health seeking, Menopause, Postmenopausal women.

Menopause is the challenging period of a woman’s life marking the end of reproductive phases, normally occurring at mid forty between 45-55 years of age. Approximately 43 million of postmenopausal women is in India now. There is Drop in the level of estrogen and progesterone hormone that produce short-term and long-term effects. Main objectives were to assess the interventional measures in order to bring awareness and improvement in the nutritional status of menopausal women. A total of 100 post-menopausal women subjects were selected using purposive random sampling technique. Experiment was conducted in three phases. With help of Questionnaire collected Data were analyzed by using SPSS 16 software. Majority of Selected samples were from 46 - 50 year of age group, in which 26 % had the habit of consuming milk daily while 51% once a week.63% had the habit of exercise, 61.20 %, 26.86 % and 11.94 were following Walking, yoga and exercise percent respectively. 62 % of women had aching joint and muscle pain as a psychological symptom and vaginal dryness, skin wrinkling and skin itching. 28 % of menopausal women had problem of weight gain, bone disease. 67 percent, among all of the menopausal women had put an effort to lose weight. The prevalence of physiological symptoms and psychological symptoms were reported in more percentage. After imparting nutrition education using developed material like booklet, diet-charts, significant improvement and awareness regarding various aspects of menopause were noticed among menopausal women.

The objective of this study was to evaluate the impact of female urinary incontinence (UI) on quality of life. The method of research is based on a literature search on PubMed, Cochrane library and relevant articles from 1977 to 2012. Forty-eight works were found. Literature showed that UI affects a large percentage of the aged out patients. Women experience UI because of many reasons such as childbirth, menopause and previous gynaecologic surgery. Incontinence is to be treated as it impacts physiological and psychological aspects of patient’s life. Treatments include medical, physical (rehabilitation) and surgical approaches. Measures for assessment are made up by specific and non-specific questionnaires. Evaluation of female incontinence must take into account patients with and without medical treatment. Every sort of therapy has to consider the psychological impact too. In current literature depression, anxiety, shame and decreed selfefficacy resulted as the most important factors involving women with UI.

AbstractEarly menopause (EM) and premature ovarian insufficiency (POI) affect an estimated 10% of women and can precipitate a wide range of physiological and personal impacts. Receiving a diagnosis of EM/POI and navigating treatment can be complex experiences for women; however, qualitative research exploring these aspects of the condition is limited. Our study aimed to increase understanding of women's lived experiences of EM/POI encompassing its medical, social, and emotional dimensions. We conducted narrative interviews with 30 women aged 28 to 51 years with spontaneous and iatrogenic EM/POI and menopausal symptoms resulting from ovarian suppression therapy, and analyzed transcripts thematically. This article examines the prominent and under-researched themes of women's experiences of navigating “diagnosis” and treatment. Diagnosis emerged as a complex and changeable process wherein women had to negotiate a diagnosis of spontaneous EM/POI and grasp the meaning and probability of iatrogenic EM/POI. Navigating treatment entailed further complexity as women grappled with the risks and efficacy of hormonal and non-hormonal medications. The findings underline the intricacies of EM/POI as a biomedical phenomenon and highlight the need for health practitioners to recognize and respond to the challenges women face in coming to terms with the condition and managing its embodied effects.

Women’s health is an imminent concern worldwide, but it remains an ignored segment of research in most developing countries, and is yet to take the center stage in even developed nations. Some exclusive female health concerns revolve around both pathological and physiological aspects. These gender-specific maladies include breast, cervical, and ovarian cancers, and physiological concerns such as menopause and osteoporosis, which are often coexistent. Recently, women’s health issues, including postmenopausal syndrome, have attracted the attention of researchers and practitioners alike, opening newer pharmaceutical research and clinical avenues. Although not counted as a disease, postmenopausal syndrome (PMS) is a female health phenomenon underpinned by hormonal depletion. Enhanced life expectancy in women has added to their suffering, and pharmacological interventions are needed. Amongst the available treatment modalities, the use of numerous botanicals has emerged as an efficient health management tool for women. Cimicifuga racemosa (CR or Black Cohosh) is a plant/herb which has been traditionally exploited and extensively used by women. This review is an attempt to compile and provide a summary of the importance of CR in complementary and alternative therapies for the improvement of various disorders related to women, such as menopausal syndrome, mammary cancer, and osteoporosis. It aims to systematically highlight the bioactive constituents, pharmacology, pharmacokinetics, therapeutic potentials, quality control processes, chromatographic techniques, and possible mechanisms of action of clinically effective phytomedicine for women’s health. Various clinical trials and patents relating to CR and women’s health have been collated. Furthermore, the plant and its related products have been considered from a regulatory perspective to reveal its commercial feasibility. The present review summarizes the existing data on CR focusing on women’s health, which can help to introduce this traditional phytomedicine to the world and provide some reference for future drug development.

AbstractSeventy-five glorious years have passed since estradiol was discovered by Edward Doisy. From discovery in the ovaries to delineation of diverse physiological effects, research on estrogens has covered a lot of ground. Estrogen receptors that mediate estrogenic effects, have been detected not only in reproductive organs, but also in other body organs. Estrogen receptors function either as conventional transcription factors or as rapid signal transducers. These different modes of action are opted by estrogens to elicit an array of reproductive and non-reproductive functions. It is well established that estrogens promote cell proliferation in various tissues and hence are also linked to carcinogenesis. Anti-estrogens are being used as adjunct therapies for cancers since several years. On the other hand, estrogen-based strategies are used to alleviate adverse effects of menopause. Apart from estrogens synthesized in various organs, exposure to environmental estrogens can also impact physiology. Thus, too much or too less of estrogens can tip the balance and lead to unfavorable consequences. Multiple estrogen receptors with their tissue- or cell type-specific expression eliciting dose-dependent effects make it perplexing to ‘unify’ estrogenic actions in diverse tissues/organs. This warrants more research on estrogen-mediated effects and their regulation in somatic and reproductive tissues. This review presents physiological and pathological aspects of estrogens thus highlighting the good, bad, and ugly facets of estrogens.

Female Sexual Disorders (FSD) include a complex, multidimensional, individual experience that can change as an individual age, suggesting that these problems are caused by multiple factors including psychosocial factors, personal relationships, pathologic changes caused by diseases, and pharmacologic influences. Menopause is an important time for middle aged women and postmenopausal physiological changes could have a significant role in the development of FSD. Few is still known about their correct definition and treatment. Their incidence, prevalence and risk factors are difficult to define because of a high level of overlap in the experience of problems with desire, arousal, and orgasm. Little evidences are known about the best therapeutic approach, and both non-pharmacological and pharmacological treatment options have been described. Among these, phosphodiesterase type 5 inhibitors could be an effective option for many subtypes of female sexual disorders, with an improvement in different aspects of sexual function, such as desire, arousal, orgasm and sexual satisfaction. In this paper authors reviewed what is already known about the use of these vasoactive agents, particularly tadalafil, as a treatment option for female sexual disturbances.

Primordial follicles are long-lived structures assembled early in life. The mechanisms that control the balance between the conservation and the activation of primordial follicles are critically important for fertility and dictate the onset of menopause. The forkhead transcription factor Foxo3 serves an essential role in these processes by suppressing the growth of primordial follicles, thereby preserving them until later in life. While other factors regulating primordial follicle growth have been described, most serve multiple functions at several stages of female germ cell or follicle development, and corresponding mouse mutants exhibit pleiotropic phenotypes with disruption of multiple stages of follicle assembly, development, or survival. To investigate the possibility that Foxo3 also functions in other aspects of ovarian development beyond its known role in primordial follicle activation (PFA), we performed detailed analyses of mouse ovaries including electron microscopy to study primordial follicle structure, assembly, and early growth. These analyses revealed that the timing of primordial follicle assembly, early oocyte survival, and the expression of early germ line markers were unaffected in early Foxo3 ovaries. Taken together, these studies demonstrate that the phenotype associated with Foxo3 deficiency is remarkably specific for PFA and further support the placement of Foxo3 in a unique phenotypic class among mammalian female sterile mutants. Lastly, we discuss the implications of the specificity of this mutant phenotype with regard to the hypothesis that oocyte regeneration may occur in adults and serves as a means to replenish oocytes lost via natural physiological processes.

At menopause, a woman's body undergoes radical hormonal changes, which predisposes to damage of the oral cavity. The onset of menopause is a series of morpho functional physiological adaptive changes with systemic and oral action in women. Oral health is closely related to dental hygiene, a major concern in menopause. The addressability of women to dental services tends to increase due to perimenopausal changes that occur in the gums and teeth and the oral microbiome. These changes have a hormonal substrate that significantly influences the evolution of oral health. The purpose of this review is to understand the occurrence and evolution of oro-dental complications in menopause and the systematization of therapeutic regimens. The PubMed and Web Of Science databases searched identified approximately 21 eligible articles. Periodontal damage is the most common, followed by dryness and burning sensation in the mouth. The role of hormone replacement therapy is controversial in terms of prophylaxis or the obvious therapeutic aspect of menopausal women with oral symptoms. The lack of extensive research, at least for the time being, does not establish clear therapeutic protocols to resolve these dental conditions.

<p>Menopause ranked among reproductive health is one of the issues that requires special consideration because of the position of women. In terms of the elimination of inequalities in gender-related health, it is important to investigate this issue in a holistic approach. Today with the increasing length of life, the time that spent in menopause period is increasing too. Accepted physiological event menopause leads to changes in physiological, mental, social and sexual ways. Changes in the levels of reproductive hormones lead to menstrual cycle disruption, vasomotor symptoms, sleep disorders and mood changes. As menopause period develops with pathological events which threaten life, impair quality of life and affect marriage relationship, it is an important period needs to be addressed by health professionals. In this context, identifying mental problems gone through in menopause period is important in terms of holistic approach. Women in menopause periods should be addressed in the biopsychosocial and cultural integrity and health professionals should determine women who are at risk of mental problems at an early stage and should provide support in a mental aspect.</p><p> </p><p><strong>Özet</strong></p><p>Üreme sağlığı içinde yer alan menopoz, kadınların konumlarından dolayı özel yaklaşım gerektiren konulardan biridir. Cinsiyete bağlı sağlıkta eşitsizlik durumunun ortadan kaldırması açısından bütüncül yaklaşım içerisinde bu konunun araştırılmış olması önemlidir. Günümüzde yaşam süresinin uzaması ile birlikte menopoz döneminde geçirilen süre de artmaktadır. Fizyolojik bir olay olarak kabul edilen menopoz kadında fizyolojik, mental, sosyal ve cinsel yönden birçok değişimler yaşanmasına neden olmaktadır. Üreme hormonlarının düzeylerindeki değişiklikler sonucu adet döngüsünde bozulma, vazomotor belirtiler, uyku bozuklukları, duygu durum değişiklikleri görülebilmektedir. Menopoz dönemi yaşamı tehdit edici, yaşam kalitesini bozucu ve evlilik ilişkisini etkileyen patolojik olaylarla birlikte seyrettiği için sağlık profesyonelleri tarafından ele alınması gereken önemli bir dönemdir. Bu bağlamda menopoz döneminde yaşanan ruhsal sorunların belirlenmesi bütüncül yaklaşım açısından önem taşımaktadır. Menopoz döneminde olan kadınlar biyopsikososyal ve kültürel bütünlük içinde ele alınmalı, sağlık profesyonelleri, ruhsal sorunlar yönünden risk altında olan kadınları erken dönemde belirlemeli, ruhsal yönden destek almalarını sağlamalıdır.</p>

Due to the total aging of the population, within the framework of the concept of “active longevity”, age-related aspects of women’s health have been paid close attention in the last decade. The physiological features of the menopausal period of life are due to the consequences of estrogen deficiency, while the protective effect of menopausal hormone therapy (MHT) in relation to diseases associated with age and aging leaves no doubt. At the same time, in the context of the ongoing COVID-19 pandemic, there are many open questions related to the appointment of MHT, both in terms of possible additional mechanisms for protecting the vascular wall, and in terms of risks, including against the background of changes in the state of immunity and the coagulation system. New realities require the development and justification of often fundamentally different approaches to the management of patients in gynecological practice, both in connection with coronavirus infection and in the postcovid period. That is why the organization of gynecological care during a pandemic requires a personalized approach to the management of patients with hormone-dependent diseases and the risk of unplanned pregnancy, as well as the development of clear algorithms that can be relied on in the daily work of both a practitioner and health care organizers.

Endometriosis, a gynecologic pathology, is defined by the presence of a tissue similar to uterine endometrium, which is located in places other than physiologically appropriate. These endometrial heterotopic islets contain glands and stroma and are functionally capable of responding to exogenous, endogenous, or local hormonal stimuli. Endometriosis affects 8%–10% of women of reproductive age; in 30% of the women, the condition is associated with primary or secondary infertility. In several instances, endometriosis persists as a minimal or mild disease, or it can resolve on its own. Other cases of endometriosis show severe symptomatology that ends when menopause occurs. Endometriosis can, however, reactivate in several postmenopausal women when iatrogenic or endogenous hormones are present. Endometriosis is occasionally accompanied by malignant ovarian tumors, especially endometrioid and clear cell carcinomas. Its pathogenesis is widely debated, and its variable morphology appears to represent a continuum of individual presentations and progressions. Endometriosis has no pathognomonic signs or symptoms; it is therefore difficult to diagnose. Because of its enigmatic etiopathogenesis, there is currently no satisfactory therapy for all patients with endometriosis. Treatments include medications, surgery, or combined therapies; currently, the only procedures that seem to cure endometriosis are hysterectomy and bilateral salpingo-oophorectomy. In this paper, we review the most controversial and enigmatic aspects of this disease.

Background: Awareness about menstruation and menstrual hygiene is an important aspect of health education for adolescent girls and pre-menopausal women. Taboos and socio-cultural restrictions still overcome the scientific facts and hygienic health practices among females of different communities. The present study was designed to assess the knowledge, awareness, beliefs, restrictions and practices regarding menstruation among the undergraduate and postgraduate females of Amritsar city of Punjab.Methods: This observational cross-sectional study was conducted among two hundred female students pursuing different degree courses in the university. A pre-designed questionnaire contains thirty five questions related to socio-demographic profile, knowledge and practices and different socio-cultural and environmental factors which affects menstrual hygiene.Results: The study results elicited that majority of the participants know that menstruation was a physiological process and poor menstrual hygiene leads to urinary and reproductive tract infections. As most of the participants were from middle class families residing in the urban areas of the city, they faced fewer restrictions and can access and afford sanitary napkins easily.Conclusions: This study shows a significant association between the age and knowledge of the participants regarding menstrual hygiene practices. The education status of the parents plays an important role in the good menstrual hygiene practices of the participants.

Introduction. Research in recent years has shown that sexual dysfunction is now common in post-menopausal women and that it has a significant impact on their quality of life.Aim: to identify the major causes of sexual dysfunction in postmenopausal women and their treatment options, by analysing different literature sources.Materials and methods. During the study of this problem, 25 sources of literature, both Russian and foreign, dating from 2007 to 2020 were analysed.Results and discussion. The main etiological aspects of sexual dysfunction in postmenopausal women, such as disorders of sexual desire, sexual pain disorders, orgasmic disorders are considered in this article. The role of physiological processes occurring in a woman’s organism during this age period in the formation of sexual dysfunction is presented, namely, the influence of insufficiency of sex hormones (In particular, estrogens) and genitourinary syndrome on disorders of the sexual sphere.The main methods of treatment are described, including hormone replacement therapy, the use of non-invasive laser technology, and surgical correction of the dysfunction and atrophy of the pelvic floor muscles. Particular attention is paid to the use of the synthetic steroid tibolone and flibanserin, a drug used to treat hypoactive sexual desire disorder, and the data concerning their high efficacy are presented.Conclusions. The predominant manifestation of sexual dysfunction are disorders of sexual desire and sexual pain disorders. Thus it is important to pay attention to this problem and to treat sexual dysfunction by treating its causes.Conclusion. The treatment of sexual dysfunction must address the causes. In many cases, psychotherapy is necessary. MHT has a positive effect on the sexual function of patients. Testosterone therapy is justified in this case, but is rarely used, as it has a number of side effects and contraindications. Synthetic steroids (Tibolone) have shown good results in the treatment of sexual dysfunction.

Abstract The relationship between menopause and the development of metabolic diseases is well established. In postmenopause women, there is an expansion of visceral white adipose tissue (WATv), which highly contributes to the rise of circulating lipids. Meanwhile, muscle glucose uptake decreases and hepatic glucose production increases. Consequently, in the pancreas, lipotoxicity and glycotoxicity lead to deficient insulin production. These factors initiate an energy imbalance and enhance the probability of developing cardiovascular and metabolic diseases. Although the activation of estradiol receptors (ER) has been shown to be beneficial for the WAT stock pattern, leading to the insulin-sensitive phenotype, authors have described the risk of these receptors’ activation, contributing to neoplasia development. The selective activation of beta-type ER (ERβ) seems to be a promising strategy in the treatment of energy imbalance, acting on several tissues of metabolic importance and allowing an intervention with less risk for the development of estrogen-dependent neoplasia. However, the literature on the risks and benefits of selective ERβ activation still needs to increase. In this review, several aspects related to ERβ were considered, such as its physiological role in tissues of energy importance, beneficial effects, and risks of its stimulation during menopause. PubMed, SciELO, Cochrane, and Medline/Bireme databases were used in this study.

Metabolic and reproductive disorders are pervasive all over the world. There are common causes between them as obesity, the surplus of nutrients, and reduced energy expenditure. Depending on the amount and location of body fat, obesity has severe repercussions for the reproductive system. Obesity is linked to menstruation abnormalities, infertility, miscarriage, poor pregnancy outcomes, reduced fetal well-being, and diabetes mellitus. Their consequences have an impact on a huge portion of the reproductive population. Individuals and society bear a huge social, medical, and economic burden due to reproductive and metabolic disorders. Diabetes causes multiple ranges of reproductive health disorders, like delayed puberty and menarche, menstrual cycle abnormalities, subfertility, poor pregnancy outcomes, and perhaps early menopause. Reproductive disorders are conditions that disturb the reproductive system, such as infections of the reproductive tract, congenital anomalies, reproductive system malignancies, and sexual dysfunction. Obesity, hyperlipidemia, insulin resistance, hepatic steatosis, and hypertension are examples of metabolic disorders, which are diseases characterized by metabolic malfunction and abnormal energy homeostasis. Each disease has its specific physiological and clinical signs; they share some pathological aspects as over nutrition, which is commonly exacerbated by a modern, sedentary lifestyle, causes intracellular stress and inflammation due to metabolic disruption. Because of chemical therapies' adverse effects, natural products are becoming more popular as alternative options to chemical therapies. Nano sizing can improve the solubility, bioavailability, and effectiveness of any product. In this review, we discuss the relationship in some types of metabolic and reproductive disorders of both males and females by summarizing in vivo and in vitro studies and focusing on nano-natural products or their involvement in treatment. Suggesting further studies explaining the potential impact of some nano elements and molecular, metabolic parameters and their role in reproduction. Supplementing the female or male reproductive system would be highly advisable and valuable.

Menopause involves both physiological and psychological manifestations that result from hormonal changes Basically health is understood as the perfect equilibrium of body, mind, intellect and soul. The person who enjoys lightness of body, slowness of breathing, calmness of mind, control over emotions, action in relaxation and blissful awareness is said to be healthy. Women’s health is bound up with social, cultural and economic factor that influence all aspect of their lives and consequences are born by women themselves. Yoga is a physical and mental practice that involves the body, mind and spirit. The practice, which originated in India, is designed to enhance awareness, create a mind-body-spirit balance, cleanse, heal and strengthen the body, liberate the true self and, as practiced today, improve fitness. Keywords: Menopausal problem Management Yoga Therapy

The evolution of modern human reproductive scheduling is an aspect of our life history that remains vastly uncomprehended. The present work aims to address this gap by validating a non-destructive cutting-edge methodology to infer adult life-history events on modern teeth with known life history and then applying it to fossil specimens. We use phase-contrast synchrotron X-ray microtomography to visualize the dental cementum of 21 specimens: nine contemporary humans; 10 Neanderthals from Krapina (Croatia, 130–120 kyr); one Neolithic Homo sapiens from Ajmana (Serbia); and one Mesolithic H. sapiens from Vlasac (Serbia). We were able to correctly detect and time (root mean square error = 2.1 years; R 2 = 0.98) all reproductive (menarche, parturition, menopause) and other physiologically impactful events in the modern sample. Nonetheless, we could not distinguish between the causes of the events detected. For the fossil specimens, we estimated age at death and age at occurrence of biologically significant events. Finally, we performed an exploratory analysis regarding possible sexual dimorphism in dental cementum microstructure, which allowed us to correctly infer the sex of the Neolithic specimen, for which the true value was known via DNA analysis.

BACKGROUND AND OBJECTIVE: Breasts are an important aspect of a woman's femininity and all aberrations in their functional and cosmetic attributes are essential for scientic evaluation as breast cancer has become the most common cancer among women worldwide. Its risk increases with age and menopausal status. Serum parameters like Ferritin and TIBC concentration is altered in sera of these patients. Iron homeostasis is inuenced by estrogen and overload impacts cellular proliferation and physiological dysfunction in electron and oxygen transport, energy production and DNA synthesis. A vicious cycle between breast cancer, iron homeostasis deregulation, menopausal status and serum parameters derangement enables us to prognosticate such patients. METHOD: Histopathologically conrmed, 50 newly diagnosed cases were analyzed with age matched 50 clinically healthy controls with no family history. Level of serum ferritin was estimated by Sandwich Elisa using Ferritin SAElisa kit and serum TIBC level measured with CL-1000i Chemiluminescence immunoassay analyzer. RESULT: Serum ferritin level in breast cancer cases (300.73±25.33ng/ml) was statistically higher than in controls (85.22±41.80ng/ml). In breast cancer, ferritin level was higher in postmenopausal (300.73±25.33ng/ml) compared to premenopausal (228.059±11.24ng/ml) patients and even in their healthy counterparts.Serum TIBC level in breast cancer (772.99±127.93) was higher than in controls (329.41± 69.40).In postmenopausal breast cancer female TIBC level was higher (815.39±104.32) compared to premenopausal females (652.31±110.86) and similarly it was higher in postmenopausal healthy controls than in premenopausal controls and signicant statistically. CONCLUSION: Serum ferritin and TIBC parameters can be used as prognostic markers for breast cancer and their levels are elevated in postmenopausal females of both breast cancer patients and healthy cases.

Abstract STUDY QUESTION Can additional genetic variants for circulating anti-Müllerian hormone (AMH) levels be identified through a genome-wide association study (GWAS) meta-analysis including a large sample of premenopausal women? SUMMARY ANSWER We identified four loci associated with AMH levels at P &lt; 5 × 10−8: the previously reported MCM8 locus and three novel signals in or near AMH, TEX41 and CDCA7. WHAT IS KNOWN ALREADY AMH is expressed by antral stage ovarian follicles in women, and variation in age-specific circulating AMH levels has been associated with disease outcomes. However, the physiological mechanisms underlying these AMH-disease associations are largely unknown. STUDY DESIGN, SIZE, DURATION We performed a GWAS meta-analysis in which we combined summary statistics of a previous AMH GWAS with GWAS data from 3705 additional women from three different cohorts. PARTICIPANTS/MATERIALS, SETTING, METHODS In total, we included data from 7049 premenopausal female participants of European ancestry. The median age of study participants ranged from 15.3 to 48 years across cohorts. Circulating AMH levels were measured in either serum or plasma samples using different ELISA assays. Study-specific analyses were adjusted for age at blood collection and population stratification, and summary statistics were meta-analysed using a standard error-weighted approach. Subsequently, we functionally annotated GWAS variants that reached genome-wide significance (P &lt; 5 × 10−8). We also performed a gene-based GWAS, pathway analysis and linkage disequilibrium score regression and Mendelian randomization (MR) analyses. MAIN RESULTS AND THE ROLE OF CHANCE We identified four loci associated with AMH levels at P &lt; 5 × 10−8: the previously reported MCM8 locus and three novel signals in or near AMH, TEX41 and CDCA7. The strongest signal was a missense variant in the AMH gene (rs10417628). Most prioritized genes at the other three identified loci were involved in cell cycle regulation. Genetic correlation analyses indicated a strong positive correlation among single nucleotide polymorphisms for AMH levels and for age at menopause (rg = 0.82, FDR = 0.003). Exploratory two-sample MR analyses did not support causal effects of AMH on breast cancer or polycystic ovary syndrome risk, but should be interpreted with caution as they may be underpowered and the validity of genetic instruments could not be extensively explored. LARGE SCALE DATA The full AMH GWAS summary statistics will made available after publication through the GWAS catalog (https://www.ebi.ac.uk/gwas/). LIMITATIONS, REASONS FOR CAUTION Whilst this study doubled the sample size of the most recent GWAS, the statistical power is still relatively low. As a result, we may still lack power to identify more genetic variants for AMH and to determine causal effects of AMH on, for example, breast cancer. Also, follow-up studies are needed to investigate whether the signal for the AMH gene is caused by reduced AMH detection by certain assays instead of actual lower circulating AMH levels. WIDER IMPLICATIONS OF THE FINDINGS Genes mapped to the MCM8, TEX41 and CDCA7 loci are involved in the cell cycle and processes such as DNA replication and apoptosis. The mechanism underlying their associations with AMH may affect the size of the ovarian follicle pool. Altogether, our results provide more insight into the biology of AMH and, accordingly, the biological processes involved in ovarian ageing. STUDY FUNDING/COMPETING INTEREST(S) Nurses’ Health Study and Nurses’ Health Study II were supported by research grants from the National Institutes of Health (CA172726, CA186107, CA50385, CA87969, CA49449, CA67262, CA178949). The UK Medical Research Council and Wellcome (217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the listed authors, who will serve as guarantors for the contents of this article. A comprehensive list of grants funding is available on the ALSPAC website (http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). Funding for the collection of genotype and phenotype data used here was provided by the British Heart Foundation (SP/07/008/24066), Wellcome (WT092830M and WT08806) and UK Medical Research Council (G1001357). M.C.B., A.L.G.S. and D.A.L. work in a unit that is funded by the University of Bristol and UK Medical Research Council (MC_UU_00011/6). M.C.B.’s contribution to this work was funded by a UK Medical Research Council Skills Development Fellowship (MR/P014054/1) and D.A.L. is a National Institute of Health Research Senior Investigator (NF-0616-10102). A.L.G.S. was supported by the study of Dynamic longitudinal exposome trajectories in cardiovascular and metabolic non-communicable diseases (H2020-SC1-2019-Single-Stage-RTD, project ID 874739). The Doetinchem Cohort Study was financially supported by the Ministry of Health, Welfare and Sports of the Netherlands. The funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. Ansh Labs performed the AMH measurements for the Doetinchem Cohort Study free of charge. Ansh Labs was not involved in the data analysis, interpretation or reporting, nor was it financially involved in any aspect of the study. R.M.G.V. was funded by the Honours Track of MSc Epidemiology, University Medical Center Utrecht with a grant from the Netherlands Organization for Scientific Research (NWO) (022.005.021). The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). The SWAN Genomic Analyses and SWAN Legacy have grant support from the NIA (U01AG017719). The Generations Study was funded by Breast Cancer Now and the Institute of Cancer Research (ICR). The ICR acknowledges NHS funding to the NIHR Biomedical Research Centre. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent official views of the funders. The Sister Study was funded by the Intramural Research Program of the National Institutes of Health (NIH), National Institute of Environmental Health Sciences (Z01-ES044005 to D.P.S.); the AMH assays were supported by the Avon Foundation (02-2012-065 to H.B. Nichols and D.P.S.). The breast cancer genome-wide association analyses were supported by the Government of Canada through Genome Canada and the Canadian Institutes of Health Research, the ‘Ministère de l’Économie, de la Science et de l’Innovation du Québec’ through Genome Québec and grant PSR-SIIRI-701, The National Institutes of Health (U19 CA148065, X01HG007492), Cancer Research UK (C1287/A10118, C1287/A16563, C1287/A10710) and The European Union (HEALTH-F2-2009-223175 and H2020 633784 and 634935). All studies and funders are listed in Michailidou et al. (Nature, 2017). F.J.M.B. has received fees and grant support from Merck Serono and Ferring BV. D.A.L. has received financial support from several national and international government and charitable funders as well as from Medtronic Ltd and Roche Diagnostics for research that is unrelated to this study. N.S. is scientific consultant for Ansh Laboratories. The other authors declare no competing interests.