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Primary ovarian insufficiency (POI) is defined as the presence of amenorrhea for ≥ 4 months accompanied by evidence of two serum follicle-stimulating hormone levels in the menopausal range in women aged less then 40 years. Anti-Müllerian hormone (AMH) has been recognized as the most reliable marker of ovarian reserve status, and its serum level is very low or undetectable in women with POI. Here we report two cases of patients who were diagnosed with POI despite high serum AMH levels and preservation of ovarian follicles, as revealed by ultrasound. In addition, we have presented a review of the current literature regarding this condition.

Hot flashes and night sweats are the most common and annoying consequences of menopause. The present study aimed to investigate the effect of a combined herbal capsule (black cohosh, soy, potato, chaste tree, and burdock) on hot flashes and night sweats in postmenopausal women.

The present study was a randomized clinical trial conducted on postmenopausal women who were referred to Hamadan health centers in 2018-2019. The patients were distributed randomly in two groups of 85 individuals using the permuted block technique. The intervention group received the Menohelp capsule 550 mg twice daily for eight weeks and those in the control group received placebo. Data was obtained using a demographic questionnaire and a night sweat checklist one week before and eight weeks after the intervention. Data analysis was done using Stata 13.

Data analysis revealed that means of hot flashes duration, frequency and intensity did not significantly decrease in the postintervention phase as compared to the pre-intervention phase in both the groups (

> 0.05). Comparative analyses of frequency and intensity of night sweats in the two groups revealed that both variables decreased after intervention with the Menohelp capsule (

< 0.05).

This study revealed that combined herbal medicine (Menohelp) was effective in reducing the frequency and intensity of night sweats. Therefore, it can be used to reduce night sweats in postmenopausal women.

This study revealed that combined herbal medicine (Menohelp) was effective in reducing the frequency and intensity of night sweats. Therefore, it can be used to reduce night sweats in postmenopausal women.

We evaluated the efficacy of gold thread implantation (GTI) in the vulva and vagina to improve female sexual dysfunction (FSD) and vaginal laxity.

A retrospective chart review was conducted on 46 women who underwent GTI between 2017 and 2018 at our institution. Physicians interviewed patients using questionnaires at baseline and 1-3 months post-treatment. The questionnaires consisted of eight questions vaginal laxity, vaginal dryness, pain during intercourse, sexual satisfaction during intercourse, sexual arousal confidence, sexual satisfaction of partner, frequency, and maintaining lubrication.

Overall, participants experienced significant improvement after GTI treatment (

< 0.0001). The median score of vaginal laxity was 3 (slightly loose) at baseline and 5 (slightly tight) at post-treatment. Vaginal dryness also improved from 4 (moderate) at baseline to 2 (little) at post-treatment. The degree of pain during intercourse decreased from 3 to 1. The sexual satisfaction score was 3 (moderately dissatisfied) at baseline and 4 (about equally satisfied and dissatisfied) at post-treatment. Sexual confidence of arousal increased from a score of 3 (low confidence) at baseline to 4 (moderate confidence) at post-treatment. They perceived greater partner sexual satisfaction, moving from a score of 2 to 4. Participants reported lubrication was more frequent during sexual activity, which was maintained until completion of sexual activity. Both scores regarding lubrication increased from 3.5 at baseline to 5 at post-treatment.

GTI may be an option for FSD and vaginal laxity.

GTI may be an option for FSD and vaginal laxity.

Previous researches have investigated depression in postmenopausal women (PMW) with osteoporosis and fractures, but little is known regarding Moroccan PMW without fractures. We investigated depression prevalence and severity in Moroccan PMW with osteoporosis without fractures and its relationship with quality of life (QoL) and physical and psychological state.

This cross-sectional study enrolled 100 PMW with osteoporosis without fractures. Depressive symptoms, QoL, self-esteem, and fatigue were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Arabic version of ECOS-16 questionnaire, Rosenberg self-esteem scale, and Arabic version of the Multidimensional Assessment of Fatigue scale, respectively. A questionnaire including sociodemographic factors, bone density features, pain intensity, and sleep disturbance was completed.

Overall, 58% patients suffered from depression and 55% from pain (63.8% depressed women vs. 42.9% nondepressed patients;

= 0.03). Bone mineral density, lumbar spine T-scornd lower self-esteem.

This study primarily aimed to determine the effect of group education on sexual dysfunction in postmenopausal women referred to health centers in Hamadan, Iran.

This randomized controlled clinical trial conducted on 90 postmenopausal women from October 2018 to March 2019. Postmenopausal women who met the inclusion criteria and received approval of a psychiatrist were randomly divided into intervention and control groups (n = 45 in each group). They completed the demographic questionnaire and the Female Sexual Function Index questionnaire. Thereafter, four sessions of group training were conducted for women in the intervention group; these women were followed up for 1 month after the last training session. Data were analyzed using the SPSS ver. 16 software, and descriptive statistics and ANCOVA/ANOVA test were used for data analysis.

We found that the two groups were homogenous in most of the demographic variables and the data were normal. The total mean score of sexual function and standard deviation after the intervention was 23.70 ± 3.67 in the intervention group and 19.94 ± 3.64 in the control group, indicating that these scores were significantly higher in the intervention group than in the control group (

< 0.001).

Based on the results, group training is recommended to reduce sexual dysfunction in postmenopausal women at health centers.

Based on the results, group training is recommended to reduce sexual dysfunction in postmenopausal women at health centers.Vaginal atrophy is one of the most common menopausal complications and is often overlooked. There are various pharmacological and non-pharmacological treatment approaches to reduce vaginal atrophy; however, no comprehensive study on a convenient, affordable, inexpensive, and noninvasive treatment with fewer complications has been conducted so far. Thus, the current study aimed to provide a systematic review of pharmacological treatment for vaginal atrophy in postmenopausal women in Iran. In this systematic review, all Iranian articles published in Persian or English during 2009 to 2019 were collected and analyzed by searching the Scopus, PubMed, Web of Science, Magiran, Iranian Registry of Clinical Trials (IRCT), and Cochrane Library databases. The inclusion criteria were clinical trials for vaginal atrophy and menopause. Based on the selection criteria, articles with a Jadad scale score of 3 and above were included in the study and qualitatively analyzed. Overall, 15 clinical trials met the inclusion criteria. In total, 12 articles examined the efficacy of pharmacological treatments (including three herbal medicines, three vitamins and dietary supplements, and two chemical drugs) in treating vaginal atrophy in postmenopausal women. Various types of medication have been used to improve vaginal atrophy, and effective treatments include licorice, chamomile, royal jelly, vitamin E, vitamin D, hyaluronic acid, and Vagifem; however, the results of studies on fennel have been inconsistent. However, considering the small number of studies reviewed, further studies with a stronger methodology are needed to confirm the efficacy of these medications.Although estrogen-progestin therapy has traditionally been standard care for postmenopausal women with an intact uterus experiencing bothersome menopausal symptoms, concerns about side effects related to menopausal hormone therapy (MHT) have led to a dramatic decrease in MHT use over recent decades. As many MHT side effects are now believed to be associated with the progestin component of MHT, efforts have been made to develop a progestin-free alternative to conventional MHT. Recently, a tissue-selective estrogen complex (TSEC), a combination of conjugated estrogen and bazedoxifene, was developed as a progestin-free MHT and is now approved and used worldwide for the relief of vasomotor symptoms and the prevention of bone loss in postmenopausal women. Replacement of synthetic progestin with bazedoxifene could allow more favorable safety profiles, such as those for pain or tenderness, mammographic density, and cancer incidence, for the breast. This review examined the effects of the TSEC on breasts and demonstrated evidence from preclinical and clinical studies supporting TSEC use in clinical practice.

Response to the coronavirus disease 2019 (COVID-19) pandemic has resulted in shelter-in-place orders and major changes to individuals' daily lives. The impact of such stressors on disease activity in individuals with axial spondyloarthritis (axSpA) is unclear. The aim of this study is to examine whether stress, anxiety, and depression are associated with patient-reported disease activity, after accounting for important factors.

We administered a survey to an axSpA cohort from a single center with well-defined demographic and disease characteristics. We included questions about job status changes, exercise, medication use, disease activity (by the Bath Ankylosing Spondylitis Disease Activity Index [BASDAI]), and psychological factors (stress, depressive symptoms, and anxiety). Separate multivariable linear models examined the associations between perceived stress, anxiety, and depression with the BASDAI.

After adjustment for potential confounders, those with higher levels of stress had a statistically significant 0.54-point higher BASDAI, on average, compared with those with lower levels of stress (95% confidence interval [CI] 0.11, 0.97). Those with higher levels of anxiety also had a statistically significant higher BASDAI, on average, compared with those with lower levels of anxiety (β 0.95, 95% CI 0.18, 0.99). The association between depression and BASDAI was not statistically significant. We did not find differences in these associations among subgroups of age, job status, or county of residence.

Individuals with axSpA with higher levels of stress and anxiety had significantly higher disease activity levels, although with a difference below clinical importance. Further planned studies will evaluate the trajectory of disease activity.

Individuals with axSpA with higher levels of stress and anxiety had significantly higher disease activity levels, although with a difference below clinical importance. Further planned studies will evaluate the trajectory of disease activity.

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