BACKGROUND: Menopausal disorders include obscure symptomatology that greatly reduce work productivity among female workers. Quantifying the impact of menopause-related symptoms on work productivity is very difficult because no such guidelines exist to date. We aimed to develop a scale of overall health status for working women in the perimenopausal period. METHODS: In September, 2021, we conducted an Internet web survey which included 3,645 female workers aged 45-56 years in perimenopausal period. We asked the participants to answer 76 items relevant to menopausal symptomatology, that were created for this study and performed exploratory and confirmatory factor analyses for the scale development. Cronbach's alpha, receiver operating characteristic analysis, and logistic regression analysis were used to verify the developed scale. RESULTS: Approximately 85% participants did not have menstruation or disrupted cycles. Explanatory factor analysis using the maximum likelihood method and Promax rotation identified 21 items with a four-factor structure: psychological symptoms (8 items, α = 0.96); physiological symptoms (6 items, alpha = 0.87); sleep difficulty (4 items, alpha = 0.92); human relationship (3 items, alpha = 0.92). Confirmatory factor analyses found excellent model fit for the four-factor model (RMSR = 0.079; TLI = 0.929; CFI = 0.938). Criterion and concurrent validity were confirmed with high correlation coefficients between each of the four factors, previously validated menopausal symptom questionnaire, and Copenhagen Burnout Inventory scales, respectively (all ps < 0.0001). The developed scale was able to predict absenteeism with 78% sensitivity, 58% specificity, and an AUC of 0.727 (95%CI: 0.696-0.757). Higher scores of each factor as well as total score of the scale were more likely to be associated with work absence experience due to menopause-related symptoms even after adjusting for Copenhagen Burnout Inventory subscales (all ps < 0.0001). CONCLUSION We found that the developed scale has high validity and reliability and could be a significant indicator of absenteeism for working women in perimenopausal period.
Humans ; Female ; Perimenopause ; Reproducibility of Results ; Menopause/psychology* ; Workplace ; Surveys and Questionnaires ; Psychometrics

PURPOSE: The purpose of this study was to investigate the influences of health perception, body image and sexual function on depression according to the menopausal stage in Korean middle aged women. METHODS: Subjects were 182 perimenopausal and postmenopausal women who had not received hormonal replacement therapy. A five-item General HealthShort Form (SF-36) Health Survey Questionnaire (Ware and Sherbourne, 1992) was used to measure health perception. Body image was measured Semantic Differential scale, CES-D was used to measure the level of depression, and sexual function was measured by FSFI. RESULTS: The subjects rated their health as 'moderate', their body image as 'moderate, and level of depression as 'high'. However, there were no significant differences in health perception, body image, and depression between perimenopasual and postmenopausal women. Postmenopausal women experienced lower levels of sexual function than perimenopausal women in sexual arousal, lubrication, orgasm, satisfaction, and pain. In stepwise regression analysis, 21.7% of variance in depression was shown to be perceived health and body image in postmenopausal women. However, in perimenopausal women, perceived health and sexual function explained 34.5% of variance in depression. CONCLUSION: These findings indicate that nurses must consider the menopasusal stage when counseling their patients.
*Body Image ; Depression/epidemiology/*psychology ; Female ; Health Status ; Humans ; Middle Aged ; Perimenopause/*psychology ; Postmenopause/*psychology ; Questionnaires ; *Self Concept ; Sexual Behavior/*psychology ; Women's Health

The important role that gonadal hormones play in women's life is also manifested in regulation of mood and behavior. Estrogen, in particular, has mostly positive effects on women's mood, while some periods of hormonal change like the postpartum, perimenstrual period and the perimenopause are associated with increased risk of depression. The propensity of women to develop depression seems to be due to a combined effect of genetics, gonadal hormones, and psychosocial factors. The sex difference of neuroanatomical response to mood, and changes in modulation of monoamine neurotransmitters by gonadal hormones, also seemed to be a risk factor to increase the vulnerability to depression in women.
Depression* ; Depression, Postpartum ; Estrogens ; Female ; Genetics ; Gonadal Hormones ; Humans ; Limbic System ; Neurobiology* ; Neurotransmitter Agents ; Perimenopause ; Postpartum Period ; Psychology ; Risk Factors ; Serotonin ; Sex Characteristics

Perimenopausal syndrome refers to a series of physical and mental symptoms ,caused by the fluctuation of the sex hormones in the menopause, which is one of the common diseases in gynecology. With the acceleration of the aging population ir the world, it has caused the world's attention. Modern medicine has developed rapidly in the field of basic theory and clinical research, but there are still some problems in the treatment. Clinical treatment is mainly in hormone replacement therapy, but there are some potential risks, adverse reactions and many contraindications, thereby reducing patients' compliance and tolerance. Traditional Chinese medicine under the guidance of the concept of wholism cure perimenopausal syndrome based on syndrome differentiation, which has unique advantages, such as a variety of ways, less side effect, curative effect, which was patients more and more welcome. It is very important for the study to explore the perimenopausal syndrome.
Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Hormone Replacement Therapy ; adverse effects ; methods ; Hormones ; administration & dosage ; adverse effects ; Humans ; Perimenopause ; drug effects ; physiology ; psychology

OBJECTIVETo observe the efficacy of catgut implantation at back-shu points in treatment of mild perimenopausal depression of kidney, deficiency and liver stagnation syndrome and analyze its essential function on target symptoms.

METHODSForty-five cases were randomized into a catgut implantation group (23 cases) and atid acupuncture group (22 cases). In the catgut implantation group, catguts were implanted at Shenshu (BL 23), Ganshu (BL 18), Xinshu (BL 15), Pishu (BL 20), etc., once every week. In the acupuncture group, the conventional acupuncture was applied to the same acupoints as the catgut implantation group, once every two days. The: treatment of 4 weeks made one session, and continuous 2 sessions were required. The efficacy was evaluated in, 2 sessions. The follow-up started in the 12th week. Before treatment, after treatment and in the follow-up period, Kupperman score and the total score in Hamilton depression scale (HAMD), as well as the factor score were observed in the patients separately.

RESULTSKupperman score, the total HAMD score and the scores in the items of anxiety/somatization, retardation, sleep disorder and cognitive disorder after treatment were all reduced significantly as compared with those before treatment in the two groups (P<0.01, P<0.05). In the follow-up period, the difference in Kupperman was not significant in comparison with that after treatment in the catgut implantation: group (P>0.05). The total HAMD score and sleep disorder were reduced significantly as compared with those after treatment in the catgut implantation group (both P<0.01); in the acupuncture group, Kupperman score, the total HAMD score and sleep disorder were all increased as compared with those after treatment (all P<0.05). In; the catgut implantation group, the total HAMD score was lower than that in the acupuncture group (P<0. 05), and the scores in the items of retardation and sleep disorder were reduced significantly as compared with those in the acupuncture group (both P<0.01).

CONCLUSIONThe catgut implantation at back-shu points alleviates perimenopasual sympton is in patients of mild perimenopausal depression of kidney deficiency and liver stagnation syndrome. This therapy effectively relieves depressive disorders by regulating the target symptoms such as anxiety/ somatization, retardation, sleep disorder and cognitive' disorder. The long-term efficacy of this therapy is better than the conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Catgut ; Depressive Disorder ; physiopathology ; therapy ; Female ; Humans ; Kidney ; physiopathology ; Liver ; physiopathology ; Middle Aged ; Perimenopause ; psychology ; Treatment Outcome

BACKGROUND: Osteoprotegerin(OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of the NF-kappaB ligand(RANKL), and has also been shown to be an important inhibitor of osteoclastogenesis in animal models. However, the relationship between OPG gene polymorphism and female bone stati in human populations is unclear. In this study, the relationship between OPG gene polymorphisms and bone mineral metabolism in healthy Korean women was investigated. METHODS: We observed 251 healthy women(mean age, 51.3+/-6.9 yr). The serum OPG concentrations were determined using ELISA, and the biochemical markers of bone turnover and FSH measured using standard methods. The bone mineral densities at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. The A163G, G209A, T245G and T950C polymorphisms of the OPG gene were analyzed by allelic discrimination using the 5 nuclease polymerase chain reaction assay. RESULTS: The lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group(A163G, 0.98+/-0.14g/cm2[GG+GA] vs. 1.05+/- 0.15g/cm2[AA], P =0.070; T245G, 0.97+/-0.13g/cm2[GG+GT] vs. 1.04+/-0.15g/cm2[TT], P=0.056). In the linkage of polymorphisms A163G and T245G, the lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group([AATT] vs. [AGTG+AGGG+GGTG+GGGG]: 1.04+/-0.15 vs. 0.97+/- 0.13; P=0.072). However, there were no differences in the serum OPG levels and bone turnover markers among the different genotypes. CONCLUSION: The A163G and T245G polymorphisms of the OPG gene were observed to be marginally associated with the lumbar spine BMD in healthy premenopausal Korean women, but further studies will be needed to clarify this relationship
Absorptiometry, Photon ; Alleles ; Biomarkers ; Bone Density ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Genotype ; Humans ; Metabolism* ; Models, Animal ; NF-kappa B ; Osteoprotegerin* ; Perimenopause* ; Polymerase Chain Reaction ; Spine

BACKGROUND: Osteoprotegerin(OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of the NF-kappaB ligand(RANKL), and has also been shown to be an important inhibitor of osteoclastogenesis in animal models. However, the relationship between OPG gene polymorphism and female bone stati in human populations is unclear. In this study, the relationship between OPG gene polymorphisms and bone mineral metabolism in healthy Korean women was investigated. METHODS: We observed 251 healthy women(mean age, 51.3+/-6.9 yr). The serum OPG concentrations were determined using ELISA, and the biochemical markers of bone turnover and FSH measured using standard methods. The bone mineral densities at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. The A163G, G209A, T245G and T950C polymorphisms of the OPG gene were analyzed by allelic discrimination using the 5 nuclease polymerase chain reaction assay. RESULTS: The lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group(A163G, 0.98+/-0.14g/cm2[GG+GA] vs. 1.05+/- 0.15g/cm2[AA], P =0.070; T245G, 0.97+/-0.13g/cm2[GG+GT] vs. 1.04+/-0.15g/cm2[TT], P=0.056). In the linkage of polymorphisms A163G and T245G, the lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group([AATT] vs. [AGTG+AGGG+GGTG+GGGG]: 1.04+/-0.15 vs. 0.97+/- 0.13; P=0.072). However, there were no differences in the serum OPG levels and bone turnover markers among the different genotypes. CONCLUSION: The A163G and T245G polymorphisms of the OPG gene were observed to be marginally associated with the lumbar spine BMD in healthy premenopausal Korean women, but further studies will be needed to clarify this relationship
Absorptiometry, Photon ; Alleles ; Biomarkers ; Bone Density ; Discrimination (Psychology) ; Enzyme-Linked Immunosorbent Assay ; Female ; Femur Neck ; Genotype ; Humans ; Metabolism* ; Models, Animal ; NF-kappa B ; Osteoprotegerin* ; Perimenopause* ; Polymerase Chain Reaction ; Spine

OBJECTIVETo observe the effect of Chinese medicine therapy combined with psychological intervention (combined therapy) on the clinical symptoms and levels of blood lipids and sex hormones of patients of peri-menopausal syndrome complicated with hyperlipidemia.

METHODSWith the use of a randomizing digital table method, 185 patients that fit the registration standard were randomly assigned to three groups. The 59 cases in Group A were treated with two Chinese patents, Kunbao Pill and Modified Xiaoyao Pill; the 63 in Group B received psychological intervention alone; and the 63 in Group C were treated with both (the combined therapy), with the treatment course for all six months. The items of observation included: (1) scoring by SCL-90 on eight factors and seven symptoms; (2) scoring on Chinese medicine symptoms by Kupermann scale, including anxiety and bad temper, scorching sense action with sweating, dizziness, tinnitus, soreness and weakness of the loin and knees, palpitation, insomnia, lassitude, weakness, and hyposexuality; (3) blood contents of total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apoprotein AI (ApoAI) and B (ApoB); (4) levels of sex hormones, including estradiol (E(2)), progesterone (P), pituitary prolactin (PRL), follicular stimulating hormone (FSH), and), luteinzing hormone (LH) in some randomly selected patients; (5) adverse reaction; and (6) one-year follow-up study on long-term effect.

RESULTSA total of 21 patients (6, 8, and 7 cases in Groups A, B, and C, respectively) dropped out; the drop-out rate was insignificant among groups. (1) The markedly effective rates in Group A, B, and C were 26.42% (14/53), 18.18% (10/55), and 53.57% (30/56), respectively, and the total effective rates in them were 64.15% (34/53), 50.91% (28/55), and 87.50% (49/56), respectively, suggesting the therapeutic efficacy in Group C was significantly better than that in Groups A and B (P<0.01). (2) SCL-90 scoring showed that the total scores decreased significantly after treatment in Group C (P<0.01), but remained unchanged in Groups A and B (P>0.05). (3) Scoring on Chinese medicine symptoms showed the same results as shown by SCL-90 scoring in terms of total scores and individual symptoms, except that menstrual disorder and amenorrhea were unchanged in all three groups (P>0.05). (4) Levels of HDL-C, ApoAI, and E(2) increased and those of TG, TC, LDL-C, ApoB, FSH, and LH decreased after treatment in Group C, reaching near normal levels; similar trends of blood lipids were shown in Group A, but the level of sex hormones was unchanged. In Group B all the above-mentioned indices were unchanged (P>0.05). (5) A one-year follow-up study showed the markedly effective rate and the total effective rate in Group C were higher than those in the other two groups respectively (P<0.01). (6) No adverse reaction was found.

CONCLUSIONChinese medicine therapy combined with psychological intervention could not only improve the nervous symptoms, but also regulate the blood levels of lipids and sex hormones in patients of peri-menopausal syndrome complicated with hyperlipidemia.

Adult ; Anxiety ; complications ; drug therapy ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Hot Flashes ; complications ; drug therapy ; Humans ; Hyperlipidemias ; complications ; therapy ; Medicine, Chinese Traditional ; Middle Aged ; Mood Disorders ; complications ; drug therapy ; Perimenopause ; drug effects ; psychology ; Psychotherapy ; methods ; Research Design ; Syndrome ; Treatment Outcome