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Background Women at middle age are puzzled by a series of menopausal disturbances, can be distressing and considerably affect the personal, social and work lives. We aim to estimate the global prevalence of nineteen menopausal symptoms among middle-aged women by performing a systematic review and meta-analysis. Methods Comprehensive search was performed in multiple databases from January, 2000 to March, 2023 for relevant studies. Random-effect model with double-arcsine transformation was used for data analysis. Results A total of 321 studies comprised of 482,067 middle-aged women were included for further analysis. We found varied prevalence of menopausal symptoms, with the highest prevalence of joint and muscular discomfort (65.43%, 95% CI 62.51–68.29) and lowest of formication (20.5%, 95% CI 13.44–28.60). Notably, South America shared dramatically high prevalence in a sort of menopausal symptoms including depression and urogenital symptoms. Besides, countries with high incomes (49.72%) had a significantly lower prevalence of hot flashes than those with low (65.93%), lower-middle (54.17%), and upper-middle (54.72%, p  < 0.01), while personal factors, such as menopausal stage, had an influence on most menopausal symptoms, particularly in vaginal dryness. Prevalence of vagina dryness in postmenopausal women (44.81%) was 2-fold higher than in premenopausal women (21.16%, p  < 0.01). Furthermore, a remarkable distinction was observed between body mass index (BMI) and prevalence of sleep problems, depression, anxiety and urinary problems. Conclusion The prevalence of menopausal symptoms affected by both social and personal factors which calls for attention from general public.

In a remote village in Costa Rica, Clara, a withdrawn 40-year-old woman, experiences a sexual and mystical awakening as she begins a journey to free herself from the repressive religious and social conventions which have dominated her life.

Introduction Female sexual dysfunction is very common, but its determinants remain under‐investigated. Vasculogenic impairments are suggested to be related to female sexual dysfunction, but previous literature regarding the association is scarce. This study aims to study the association between arterial health and female sexual function in women in their 60s. Material and methods The sample for this cross‐sectional study comprised 117 women (aged 60–64 years) who participated in the Finnish Retirement and Aging study. Arterial health was measured according to the participants' pulse wave velocity, ankle–brachial index, blood pressure, and pulse pressure. Sexual function was measured using the Female Sexual Function Index, which resulted in a total score and six sub‐scores. Associations were examined using multivariable regression analyses, which were adjusted for age, relationship happiness, systemic menopausal hormone therapy and/or local estrogen, smoking, alcohol risk use, body mass index, and depressive symptoms. Results Higher diastolic blood pressure was associated with a higher total Female Sexual Function Index score (β = 0.24, 95% confidence interval [CI] 0.07–0.41) and with higher desire (β = 0.02, 95% CI 0.01–0.04), arousal (β = 0.04, 95% CI 0.01–0.08), lubrication (β = 0.04, 95% CI 0.002–0.08), satisfaction (β = 0.03, 95% CI 0.003–0.05), and pain (β = 0.06, 95% CI 0.02–0.10) sub‐scores. Also, higher ankle–brachial index was associated with higher satisfaction sub‐score (β = 2.10, 95% CI 0.44–3.73) and lower pulse pressure was associated with higher orgasm sub‐score (β = 0.03, 95% CI 0.0002–0.06). Other associations between ankle–brachial index and Female Sexual Function Index scores were statistically insignificant, but considering the magnitude the findings may imply clinical significance. Systolic blood pressure and pulse wave velocity were not associated with sexual function. Conclusions This study suggested a plausible association between higher diastolic blood pressure and female sexual function, but considering clinical significance our findings suggest an association between higher ankle–brachial index and good sexual function in women in their 60s. Despite the high prevalence of female sexual dysfunction, its relationship with arterial health is poorly understood. Our population‐based study suggested a plausible association between higher diastolic blood pressure and higher ankle–brachial index and good female sexual function in women in their 60s.

How did menopause change from being a natural (and often welcome) end to a woman's childbearing years to a deficiency disease in need of medical and pharmacological intervention? As she traces the medicalization of menopause over the last 100 years, historian Judith Houck challenges some widely held assumptions. Physicians hardly foisted hormones on reluctant female patients; rather, physicians themselves were often reluctant to claim menopause as a medical problem and resisted the widespread use of hormone therapy for what was, after all, a normal transition in a woman's lifespan. Houck argues that the medical and popular understandings of menopause at any given time depended on both pharmacological options and cultural ideas and anxieties of the moment. As women delayed marriage and motherhood and entered the workforce in greater numbers, the medical understanding, cultural meaning, and experience of menopause changed. By examining the history of menopause over the course of the twentieth century, Houck shows how the experience and representation of menopause has been profoundly influenced by biomedical developments and by changing roles for women and the changing definition of womanhood.

Objective Given the distinct physiological and societal traits between women and men, we propose that there are distinct risk factors for lumbar degenerative disc disease surgeries, including lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS), in middle‐aged and older populations. However, few studies have focused on middle‐aged and older women. This study aims to identify these risk factors specifically in this population. Methods In this case–control study, the study group comprised 1202 women aged ≥ 45 years who underwent operative treatment of lumbar degenerative disc disease (LDH, n = 825; LSS, n = 377), and the control group comprised 1168 women without lumbar disease who visited a health examination clinic during the same period. The study factors included demographics (age, body mass index [BMI], smoking, labor intensity, and genetic history), female‐specific factors (menopausal status, number of deliveries, cesarean section, and simple hysterectomy), surgical history (number of abdominal surgeries, hip joint surgery, knee joint surgery, and thyroidectomy), and systemic diseases (hypercholesterolemia, hypertriglyceridemia, hyper‐low‐density lipoprotein cholesterolemia, hypertension, diabetes, cardiovascular disease, and cerebrovascular disease). Multivariate binary logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) of associated factors. Results The risk factors for surgical treatment of LDH in middle‐aged and older women included BMI (OR = 1.603), labor intensity (OR = 1.189), genetic history (OR = 2.212), number of deliveries (OR = 1.736), simple hysterectomy (OR = 2.511), hypertriglyceridemia (OR = 1.932), and hyper‐low‐density lipoprotein cholesterolemia (OR = 2.662). For surgical treatment of LSS, the risk factors were age (OR = 1.889), BMI (OR = 1.671), genetic history (OR = 2.134), number of deliveries (OR = 2.962), simple hysterectomy (OR = 1.968), knee joint surgery (OR = 2.527), hypertriglyceridemia (OR = 1.476), hyper‐low‐density lipoprotein cholesterolemia (OR = 2.413), and diabetes (OR = 1.643). Cerebrovascular disease was a protective factor against surgery for LDH (OR = 0.267). Conclusions BMI, genetic history, number of deliveries, simple hysterectomy, hypertriglyceridemia, and hyper‐low‐density lipoprotein cholesterolemia were independent risk factors for surgical treatment of both LDH and LSS in middle‐aged and older women. Two disparities were found: labor intensity was a risk factor for LDH patients, and knee joint surgery and diabetes were risk factors for LSS patients. In the four dimensions of demographics, female‐specific factors, surgical history, and systemic diseases, we used multivariate binary logistic regression analysis to explore the risk factors for surgical treatment of lumbar degenerative disc disease in middle‐aged and older women. We found that body mass index, genetic history, number of deliveries, simple hysterectomy, hypertriglyceridemia, and hyper‐low‐density lipoprotein cholesterolemia were common independent risk factors for surgical treatment of lumbar disc herniation (LDH) and lumbar spinal stenosis (LSS)in middle‐aged and older women. Two disparities were found: labor intensity was a risk factor for patients with LDH, and knee joint surgery and diabetes were risk factors for patients with LSS.

The aim of this study was to evaluate the effect of serum selenium on PPAR-γ and the selected proinflammatory cytokines (IL-1β, IL-6, TNF-α) in relation to depressive symptoms and obesity in middle-aged women. The research procedure was as follows: a survey was performed using the authors’ questionnaire and the BDI, anthropometric measurements, and the analysis of blood for the levels of selenium, cytokines, and genetic analysis of the PPAR-γ polymorphism (n = 443). It was found that the BMI increased along with the concentration of IL-6. No moderating effect of selenium was observed, although the cut-off values for “p” were established for IL-β*Se (p = 0.068) and IL-6*Se (p = 0.068), so there was a potential association with these two markers. At high selenium levels, the effect of higher IL-β levels on a decrease in BMI was stronger, as was the effect of an increase in IL-6 levels on an increase in BMI. No effect of selenium on PPAR-γ was found in relation to depressive symptoms and obesity. Higher selenium levels may have a beneficial effect on BMI even at high IL-β concentrations, however, at high IL-6 concentrations, this effect was not observed. Selenium levels had no impact on depressive symptoms.

Impaired left ventricular (LV) relaxation is indicative of grade I diastolic dysfunction, which is mainly assessed by late diastolic transmitral flow velocity (E/A ratio). Although the E/A ratio has important diagnostic and prognostic implications with cardiac outcomes, the causal link between abnormal E/A ratio and left ventricle remodeling (LV remodeling) remains unclear. A longitudinal analysis of 869 eligible women aged ≥45 years, who had received echocardiography scans as well as 5-year follow-up assessments between 2015 and 2020. Women with pre-existing cardiac abnormalities including grade II/III diastolic dysfunction as diagnosed by echocardiography, or structural heart disease were excluded. E/A abnormality was defined as baseline E/A ratio <0.8. The classification of LV remodeling was based on the measurements of left ventricular mass index (LVMI) and relative wall thickness (RWT). Logistic and linear regression models were used. Among the 869 women (60.71±10.01 years), 164 (18.9%) had developed LV remodeling after the 5-year follow-up. The proportion of women with E/A abnormality versus non-abnormality was also significantly different (27.13% vs 16.59%, P=0.007). Multivariable-adjusted regression models showed that E/A abnormality (OR: 4.14, 95%Cl:1.80-9.20, P=0.009) was significantly associated with higher risk of concentric hypertrophy (CH) after follow-up. No such association was found in either concentric remodeling (CR) or eccentric hypertrophy (EH). Higher baseline E/A ratio was correlated with lower ΔRWT during the 5-year follow-up (β=-0.006 m/s, 95% CI: -0.012 to -0.002, P=0.025), which was independent of demographics and biological factors. E/A abnormality is associated with a higher risk of CH. Higher baseline E/A ratio may be associated with decreased relative changes in RWT.

Background Chronic stress and diseases occur more frequently in middle-aged compared to younger women and this is often the result of physical, psychological and socio-economic changes. These health consequences reduce lower body muscle mass and flexibility, leading to generalized impairments in functional movement and balance. Dynamic Neuromuscular Stabilization (DNS) training using the inertial load of water is known for its positive impact on functional strength improvement and muscle stabilization. Objective This study aimed to determine the effect of DNS training using inertial water loads on functional movement and postural sway in middle-aged women. Method A sample of 24 middle-aged women participated in the study and were randomly divided into two groups: the experimental group, n  = 12 (age: 58.33 ± 1.48 yrs, height: 162.16 ± 1.27 cm, weight: 61.77 ± 2.21 kg) and control group, n  = 12 (age: 59.58 ± 1.13 yrs, height: 160.1 ± 1.13 cm, weight: 57.51 ± 1.12 kg). Center of Pressure (COP), moving distance, Root Mean Square (RMS), movement area and Functional Movement Screen (FMS) were conducted and analyzed pre- and post-examination. Participants engaged in the DNS training regimen, which utilized the inertial load of water, for 60 min each session, conducted twice weekly for 12 weeks. Results There were significant differences in the COP distance ( p  < 0.001), RMS ( p  < 0.05), COP area and FMS test ( p  < 0.001) in the pre-post comparison of each group. And significant differences were found in COP distance ( p  < 0.05), RMS ( p  < 0.05), COP area ( p  < 0.05) and FMS test ( p  < 0.05) between groups. The DNS training improved the dynamic stability of single-leg standing, torso stability and functional movement in middle-aged women. Conclusion DNS training programs using the inertial load of water have been shown to be effective in movement improvement and posture retention ability, which is beneficial for functional movement, equilibrium strategy, and dynamic stability of middle-aged women. Furthermore, the DNS training method designed in this study can be useful for trainees who require posture correction in a safe and effective way regardless of their age and gender.

Uncovers the origins of midlife anxiety in Victorian print culture. Aging by the Book offers an innovative look at the ways in which middle age, which for centuries had been considered the prime of life, was transformed during the Victorian era into a period of decline. Single women were nearing middle age at thirty, and mothers in their forties were expected to become sexless; meanwhile, fortyish men anguished over whether their \"time for love had gone by.\" Looking at well-known novels of the period, as well as advertisements, cartoons, and medical and advice manuals, Kay Heath uncovers how this ideology of decline permeated a changing culture. Aging by the Book unmasks and confronts midlife anxiety by examining its origins, demonstrating that our current negative attitude toward midlife springs from Victorian roots, and arguing that only when we understand the culturally constructed nature of age can we expose its ubiquitous and stealthy influence.

Background and aims Physical activity is one of the most important indicators of health in the society and plays an important role in the lives of people, especially women. Nevertheless, one of the major challenges in modern society is the inactivity and lack of optimal physical activity of women, which has caused a rising prevalence in chronic diseases. Models and theories help to better understand these behaviors and better planning for behavior change in target groups. This study was conducted with the aim of investigating the predictors of regular physical activity among middle-aged women based on the trans-theoretical model. Design The present study was conducted cross-sectionally on 250 middle-aged women (age range 45–59) covered by comprehensive health databases. Method Inclusion conditions included willingness to participate, living in the area under study, not having certain diseases and disorders that would cause changes in lifestyle or physical activity. The random sampling method was simple. In this study, questionnaires of transtheoretical model constructs and short international questionnaire of physical activity were used. Data were analyzed using SPSS version 26 and Amos 24 software. Results In path analysis, change methods with path coefficient β  = 0.20 are the strongest predictors of physical activity behavior in middle-aged women, and it clearly shows a significant positive relationship with the amount of physical activity ( P  < 0.05). Also, the stimulus control substructure with a factor loading of β  = 0.17 and a confidence interval (CI) of 95% also has a high predictive power of the tendency to physical activity behavior. Chi-square ratio to degrees of freedom (χ²/DF) < 3 and RMSEA = 0.065 indicate a good fit of the model with the data (GFI = 0.91, CFI = 0.98). Conclusion The path analysis revealed that the proposed model by Prochaska fits well with the research data, indicating that change processes are strong predictors of physical behavior. These findings can serve as a foundation for developing targeted, evidence-based interventions to promote physical activity among middle-aged women.