Beneficial effect of tibolone on mood, cognition, well-being, and sexuality in menopausal women

Tibolone is a synthetic molecule used extensively for the management of menopausal symptoms, with the proposed additional advantage of enhanced mood and libido. Tibolone, after oral administration, is rapidly converted into 3 major metabolites: 3α-hydroxytibolone and 3β-hydroxytibolone, which have estrogenic effects, and the Δ4-isomer, which has progestogenic and androgenic effects. The tissue-selective effects of tibolone are the result of metabolism, of enzyme regulation, and of receptor activation which vary in different tissues. Tibolone seems to be effective on estrogen-withdrawal symptoms such as hot flushes, sweating, insomnia, headache, and vaginal dryness, with results generally comparable to the effects exerted by estrogen-based treatments, and the additional property of a progestogenic activity on the endometrium. As well as relieving vasomotor symptoms, tibolone has positive effects on sexual well-being and mood, and improves dyspareunia and libido. These effects may depend on both estrogenic and androgenic actions exerted at the genital level and in the central nervous system, and on a reduction of sex-hormone-binding globulin and an increase of free testosterone, without affecting Δ-5 androgens levels. Based on the evidence available, tibolone is a valuable treatment option to relieve menopausal complaints, especially in women suffering persistent fatigue, blunted motivation, and loss of sexual desire despite an adequate estrogen replacement

Gli immigrati nella Strategia aree interne

La presenza di stranieri nei comuni classificati interne è rilevante e ne condiziona la tenuta demografica. Ma come questa realtà rientra nelle strategie di area in corso di definizione? Con azioni di formazione al lavoro, percorsi di Intercultura e strategie educative.The presence of foreigners in municipalities in 'internal area' is relevant and affects the demography of these areas. How could such reality feed into in the definition of local development strategies? With initiatives that enhance professional training, intercultural courses and educational strategies

Paroxetine increases brain-derived neurotrophic factor in postmenopausal women

9nononeOBJECTIVE: Menopause is marked by a decline in ovarian function resulting in one or more climacteric symptoms. In the last few years, attention has been focused on the use of selective serotonin reuptake inhibitors (SSRIs) in the treatment of vasomotor symptoms associated with the menopausal transition. Thanks to the recent findings on the interaction between the serotoninergic system and neurotrophins, it has been suggested that brain-derived neurotrophic factor (BDNF) could contribute to the activity of SSRIs. Moreover, because endogenous gonadal hormones modulate both BDNF expression and serotonin biosynthesis and bioavailability and regulate brain functions like affective and cognitive functions, we proposed to evaluate the effects of a treatment with paroxetine, an SSRI, in a group of postmenopausal women and to clarify the possible relationship between paroxetine, plasma BDNF levels, and climacteric symptoms. METHODS: A total of 119 postmenopausal women (age, 46-60 y; menopause age, 1-20 y) were included; 89 took paroxetine 10 mg/day for 6 months and 30 took estrogen + progestogen therapy (EPT) for 6 months. Blood samples were taken before the beginning of the therapy and at 3 and 6 months. The Green Climacteric Scale questionnaire was used to follow up women's clinical conditions. RESULTS: Plasma BDNF levels significantly increased after 3 and 6 months of therapy (P < 0.001), although a negative correlation between plasma BDNF level and both age and menopause age persisted throughout the treatment. Moreover, a significant reduction in the Greene Climacteric Scale score was observed. In the EPT group, the plasma BDNF level significantly increased after 6 months of therapy. The plasma BDNF levels after 6 months of paroxetine were significantly lower than those after 6 months of EPT. CONCLUSIONS: The present data suggest that a low dose of paroxetine is effective in enhancing plasma BDNF levels, and this increase might have a role in improving climacteric symptoms, highlighting the possible role of BDNF in endocrinological and cognitive functions.noneCUBEDDU, A.; GIANNINI, A.; BUCCI, F.; MERLINI, S.; CASAROSA, E.; PLUCHINO, N.; LUISI, S.; LUISI, M.; GENAZZANI, A.R.Cubeddu, A.; Giannini, A.; Bucci, F.; Merlini, S.; Casarosa, E.; Pluchino, N.; Luisi, S.; Luisi, M.; Genazzani, A. R

Paroxetine increases brain-derived neurotrophic factor in postmenopausal women

Objective: Menopause is marked by a decline in ovarian function resulting in one or more climacteric symptoms. In the last few years, attention has been focused on the use of selective serotonin reuptake inhibitors (SSRIs) in the treatment of vasomotor symptoms associated with the menopausal transition. Thanks to the recent findings on the interaction between the serotoninergic system and neurotrophins, it has been suggested that brain-derived neurotrophic factor (BDNF) could contribute to the activity of SSRIs. Moreover, because endogenous gonadal hormones modulate both BDNF expression and serotonin biosynthesis and bioavailability and regulate brain functions like affective and cognitive functions, we proposed to evaluate the effects of a treatment with paroxetine, an SSRI, in a group of postmenopausal women and to clarify the possible relationship between paroxetine, plasma BDNF levels, and climacteric symptoms. Methods: A total of 119 postmenopausal women (age, 46-60 y; menopause age, 1-20 y) were included; 89 took paroxetine 10 mg/day for 6 months and 30 took estrogen + progestogen therapy (EPT) for 6 months. Blood samples were taken before the beginning of the therapy and at 3 and 6 months. The Green Climacteric Scale questionnaire was used to follow up women's clinical conditions. Results: Plasma BDNF levels significantly increased after 3 and 6 months of therapy (P < 0.001), although a negative correlation between plasma BDNF level and both age and menopause age persisted throughout the treatment. Moreover, a significant reduction in the Greene Climacteric Scale score was observed. In the EPT group, the plasma BDNF level significantly increased after 6 months of therapy. The plasma BDNF levels after 6 months of paroxetine were significantly lower than those after 6 months of EPT. Conclusions: The present data suggest that a low dose of paroxetine is effective in enhancing plasma BDNF levels, and this increase might have a role in improving climacteric symptoms, highlighting the possible role of BDNF in endocrinological and cognitive functions. Copyright © 2010 The North American Menopause Society

Reply to ‘Comment on “Petrographic features influencing basic geotechnical parameters of carbonate soft rocks from Apulia (southern Italy)” [Eng. Geol. 233: 76–97]’

Aiming to investigate the implications of the rock-fabric on some basic geotechnical parameters, the paper by Festa, Fiore, Luisi, Miccoli, and Spalluto (2018) mostly focused on the compositional, textural, and diagenetic aspects of the carbonate soft rocks from Apulia (southern Italy). So, further geotechnical considerations are always welcome for a more comprehensive discussion about the soft rocks' mechanical behavior of concern. With this perspective, the comment by G.F. Andriani (Andriani, 2021) to the paper by Festa et al. (2018) includes some geotechnical considerations and new data (albeit from a couple of samples) for the general discussion on the mechanical behavior of soft rocks from Apulia, although representing neither comments nor criticisms. In this comment, for some criticisms, the reply can be easily found in Festa et al. (2018); for other criticisms, they give us a chance to clarify some topics that were not discussed in depth before. According to the comment by Andriani (2021), the main criticisms that need replies include (i) improbable degree of saturation exceeding 100%, (ii) unlikely closed porosity, (iii) weakness of the dataset and scarcity of data, and (iv) insignificance of the uniaxial compressive strength vs. both imbibition and permeability coefficients. Therefore, the replies to these criticisms are assessed in the following sections: 2. the comment regarding degree of saturation; 3. the comment regarding porosity; 4. the comment regarding dataset; and 5. the comment regarding uniaxial compressive strength (UCS) vs. Imbibition and Permeability Coefficients. Finally, the replies to Andriani (2021) criticism regarding the lack of accurate comparative analysis have been disputed in 3 The comment regarding porosity, 4 The comment regarding dataset