GnRH-a-Induced Perimenopausal Rat Modeling and Black Cohosh Preparations’ Effect on Rat’s Reproductive Endocrine

BackgroundEndometriosis (EMS) is an estrogen-dependent disease, which easily recurs after operation. Gonadotropin-releasing hormone agonist (GnRH-a), an estrogen-inhibiting drug, can effectively inhibit the secretion of gonadotropin by pituitary gland, so as to significantly decrease the ovarian hormone level and facilitate the atrophy of ectopic endometrium, playing a positive role in preventing postoperative recurrence. The application of GnRH-a can lead to the secondary low estrogen symptoms, namely the perimenopausal symptoms, and is a main reason for patients to give up further treatment. The add-back therapy based on sex hormones can well address the perimenopausal symptoms, but long-term use of hormones may cause the recurrence of EMS, as well as liver function damage, venous embolism, breast cancer and other risks, which has long been a heated topic in the industry. Therefore, it is necessary to find effective and safe anti-additive drugs soon. Studies at home and abroad show that, as a plant extract, isopropanolic extract of cimicifuga racemosa (ICR) can well relieve the perimenopausal symptoms caused by natural menopause. Some studies have preliminarily confirmed that black cohosh preparations can antagonize perimenopausal symptoms of EMS patients treated with GnRH-a after operation.ObjectiveTo establish a rat model of perimenopausal symptoms induced by GnRH-a injection, for the purposes of laying a foundation for further research and preliminarily exploring the effect of black cohosh preparations on reproductive endocrine of the rat model.MethodThe rat model of perimenopausal symptoms was established by GnRH-a injection, and normal saline (NS injection) was used as the control. The rats were randomly divided into four groups according to different modeling methods and drug intervention schemes. GnRH-a injection + normal saline intervention group (GnRH-a + NS), normal saline injection control + normal saline intervention group (NS + NS), GnRH-a injection + estradiol intervention group (GnRH-a + E2), and GnRH-a injection + black cohosh preparations intervention group (GnRH-a + ICR). After modelling was assessed to be successful with the vaginal smear method, the corresponding drugs were given for intervention for 28d. In the process of rat modeling and drug intervention, the skin temperature and anus temperature of the rat tails were measured every other day, the body weights of the rats were measured every other day, and the dosage was adjusted according to the body weight. After the intervention was over, the serum sex hormone level, the uterine weight, the uterine index, and the endometrial histomorphology changes, as well as the ovarian weight, the ovarian index, and the morphological changes of ovarian tissues of each group were measured.Results(1) The vaginal cell smears of the control group (NS + NS) showed estrous cycle changes, while other model rats had no estrous cycle of vaginal cells. (2) The body weight gains of the GnRH-a + NS, GnRH-a + E2 and GnRH-a + ICR groups were significantly higher than that of the NS + NS control group. The intervention with E2 and ICR could delay the weight gain trend of rats induced by GnRH-A. (3) After GnRH-a injection, the temperature of the tail and anus of rats showed an overall upward trend, and the intervention with E2 and ICR could effectively improve such temperature change. (4) The E2, FSH, and LH levels in the GnRH-a + NS, GnRH-a + E2, and GnRH-a + ICR groups were significantly lower than those in the NS + NS group (P < 0.01). The E2 level was significantly higher and the LH level was significantly lower in the GnRH-a + E2 group than those in the GnRH-a + NS and GnRH-a + ICR groups (P < 0.05). Compared with those of the GnRH-a + NS and GnRH-a + ICR groups, the FSH level of the GnRH-a + E2 group showed a slight downward trend, but the difference was not statistically significant (P > 0.05). There was no significant difference in the levels of sex hormones between the GnRH-a + NS group and GnRH-a + ICR group (P > 0.05). (5) Compared with those of the NS + NS group, the uterine weight and uterine index of the GnRH-a + NS, GnRH-a + E2 and GnRH-a + ICR groups significantly decreased (P < 0.01). In a comparison between the groups, the uterine weight and uterine index in the GnRH-a + NS and GnRH-a + ICR groups were significantly lower than those in the GnRH-a + E2 group (P < 0.01). There was a statistical difference in the uterine weight and uterine index between the GnRH-a + NS group and GnRH-a + ICR group (P > 0.05). (6) Compared with those of the NS + NS group, the ovarian weight and ovarian index of the GnRH-a + NS, GnRH-a + E2 and GnRH-a + ICR groups significantly decreased (P < 0.01). There was no statistical difference in the ovarian weight and ovarian index among the GnRH-a + E2, GnRH-a + NS and GnRH-a + ICR groups (P > 0.05). (7) Compared with those in the NS + NS group, the number of primordial follicles increased significantly, while the number of growing follicles and mature follicles decreased significantly in the GnRH-a + NS, GnRH-a + E2, and GnRH-a + ICR groups (P < 0.01), but there was a statistical difference in the total number of follicles among the four groups (P > 0.05).ConclusionsThe GnRH-a injection could achieve the desired effect. The animal model successfully achieved a significant decrease in the E2, FSH, and LH levels in rats, and could cause the rats to have rising body surface temperature similar to hot flashes in the perimenopausal period. The intervention with E2 and ICR could effectively relieve such “perimenopausal symptoms”, and ICR had no obvious effect on the serum sex hormone level in rats.

Moderate Consumption of Beer (with and without Ethanol) and Menopausal Symptoms: Results from a Parallel Clinical Trial in Postmenopausal Women

The menopausal transition can be a challenging period for women’s health and a trigger of uncomfortable symptoms. Beer is the main food source of isoxanthohumol, a precursor of 8-prenylnaringenin, the strongest phytoestrogen identified to date. As phytoestrogens are reported to reduce perimenopausal symptoms, we evaluated if a daily moderate consumption of beer with (AB) and without alcohol (NAB) could improve menopausal symptoms and modify cardiovascular risk factors. A total of 37 postmenopausal women were enrolled in a parallel controlled intervention trial and assigned to three study groups: 16 were administered AB (330 mL/day), 7 NAB (660 mL/day), and 14 were in the control group. After a 6-month follow-up of the 34 participants who finished the trial, both interventions (AB and NAB) significantly reduced the severity of the menopause-related symptoms (p-value AB vs. Control: 0.009; p-value NAB vs. Control: 0.033). Moreover, AB had a beneficial net effect on psychological menopausal discomforts compared to the control group. As the sex hormone profile did not differ significantly between the study groups, the effects of both types of beers (AB and NAB) are attributed to the non-alcoholic fraction of beer. Furthermore, moderate NAB consumption improved the lipid profile and decreased blood pressure in postmenopausal women.

Relationship of frequency and severity of perimenopausal symptoms on the quality of sexual life of postmenopausal women living in urban and rural areas

Background: The changes that occur in a woman’s body during the perimenopausal period may influence feelings of attractiveness and perception of status in an intimate relationship, which may play a role in overall sexual satisfaction. Aim of the study: The present study aimed to analyze the influence of selected perimenopausal symptoms on the perception of satisfaction with sexual life in urban and rural women. Material and methods: This study included 224 women from urban areas and 106 women from rural areas who were using general practice services. Inclusion criteria were women who had not menstruated for 2–5 years. The measures used were the Menopause Rating Scale (MRS) and the Sexual Quality of Life-Female questionnaire (SQoL-F). Spearman’s rank correlation coefficient was used to assess the relationship between the severity of perimenopausal symptoms and satisfaction with sexual life. Results: A greater proportion of urban women reported symptoms in the perimenopausal period than rural women. Statistically significant correlations were observed for irritability (P = 0.03) and sexual problems (P = 0.01). However, rural women reported a greater degree of symptom severity. There was a statistically significant difference in severity of somatic and psychological symptoms between urban and rural women. In urban women, the average score for general satisfaction with their sexual life was 62 ± 19.96, whereas the average score for rural women was slightly less, 59 ± 23.56. A statistically significant inverse relationship was observed between the severity of perimenopausal symptoms and quality of sexual life, with values of Spearman’s rank correlation coefficients ranging from −0.490 to −0.064. Conclusions: Urban or rural residence had a slight influence on the frequency and severity of perimenopausal symptoms, and severity of symptoms had a significant influence on women’s satisfaction with their sexual life.

The Reproductive Health Priorities, Concerns, and Needs of Women in Midlife: A Feminist Poststructuralist Qualitative Analysis

Reproductive health research rarely involves the inclusion of women over 40, creating a large knowledge gap regarding women in midlife. Women continue to have reproductive health needs, concerns, and priorities up to the point of menopause that should be examined to improve reproductive health outcomes and provide individualized care. In-depth, individual, semi-structured interviews were conducted with 20 women between the ages of 40 and 55 who had not reached menopause and did not have a permanent method of sterilization. Using the feminist poststructuralist tenets, three major themes were identified: (a) knowledge acquisition during the perimenopause, (b) subjectivity regarding family planning, and (c) the agency of aging. Participants spoke to a need for reproductive health that listens to their lived experience, addresses menopause clinically and positively, and encourages autonomously driven health priorities. Further research on effective nonhormonal contraception, education on perimenopausal symptoms, and healthy aging is necessary.

A Study on the Perimenopausal Symptoms and Its Relevant Factors

Objective: To explore the relevant factors of perimenopausal symptoms. Method: Community female subjects conforming to perimenopausal criteria were recruited through advertising. Modified Kupperman Index(KI) was used for evaluation of perimenopausal symptoms, Zung Self-Rating Depression Scale (SDS)for depressive symptoms and Zung Self-Rating Anxiety Scale (SAS)for anxiety symptoms. Eysenck Personality Questionnaire(EPQ) is used to evaluate the individual mental characteristics of subjects,including Extraversion(E), Neuroticism (N),Psychoticism(P),and Lie(L). Metacognition Questionnaire-30 (MCQ-30) is used to evaluate the metacognitive levels of subjects in the 5 important factors, including cognitive confidence(F1), positive beliefs about worry(F2), cognitive self-consciousness(f3), negative beliefs about uncontrollability of thoughts and danger(F4), and beliefs about the need to control thoughts (F5). Meanwhile, the levels of plasma gonadal hormones such as diol, testosterone and progesterone, are monitored. Pairwise correlation and linear regression are used to analyze the relevance between perimenopausal symptoms and the aforementioned factors. Results: Among 66 perimenopausal female subjects, 40 (60.4%) showed perimenopausal symptoms, with the most frequent being fatigue, joint and muscle pain , headache, dizziness, hypersensitivity and agitation. N score(β’=0.419，P<0.001), SDS anxiety factor (β’=0.363，P<0.001)and BMI （β’=0.244，P=0.001） are significantly correlated with KI total score. Age（β’=0.482，P<0.001）, SDS anxiety factor（β’=0.276，P=0.006）, SDS core depressive factor（β’=0.287，P=0.010）and SDS anxiety factor（β’=0.287，P=0.010）are significantly correlated with psychological symptoms. SAS standard score (β’=0.277，P=0.029) and SDS (β’=0.254，P=0.045) are significantly correlated with somatic symptoms. Conclusion: Emotional symptoms such as depression and anxiety are apparent. Perimenopausal females with Neuroticism personality, of elder age and higher BMI suffer from perimenopausal symptoms more severely.