Sleep disorders (SD) are a common complaint in women going through menopause transition. It is well known that there is a close relationship between SD and one of the main menopausal symptoms: vasomotor symptoms (VMS). To acknowledge this association is essential when investigating menopausal transition and SD. The Study of Women's Health across the Nation (SWAN), shows that the prevalence of sleep disturbance increases with age. The prevalence in perimenopausal and postmenopausal women varies from 39% to 47% and 35% to 60% respectively. Although both menopausal transition and aging increase sleep disturbances, etiology in menopausal women is probably multifactorial. A decline in the levels of reproductive hormones and melatonin, and the complex interaction among these hormones can significantly contribute to sleep problems, poor concentration, fatigue and decreased quality of life. On the one hand menopause nearly adversely affects all components of metabolic syndrome (MS) and on the other hand the cumulative long-term effects of deprived sleep have been associated with many cardio metabolic consequences including hypertension, obesity, and impaired glucose metabolism. Management strategies should be taken into account to help women ameliorate their night sleep, in order to prevent future complications and to improve their quality of life (QoL).

Osteoporosis is a disease related to bone metabolism disorder. It is characterized by low bone mass and deterioration of the micro architecture, whose consequence is greater bone fragility and an increased risk of fractures. The purpose of this review is to summarize literature review regarding dietary calcium and vitamin d intake and exercise interventions for the treatment of osteoporosis in isolation. Recommendations as adequate amounts of total calcium, vitamin D and protein intake, regular exercise to improve strength and balance to reduce the risk of falls and consequent fractures, are known to be effective strategies for the prevention of osteoporosis, but also an important complement in the treatment.

High oncological risk patients: what do we have for sure?A germline mutation in BRCA1 or BRCA2 results in a significantly elevated lifetime risk of developing breast cancer (BC) and ovarian cancer (OC). Indeed, more than 90% of hereditary cases of BC and OC are thought to be a result of a mutation in BRCA1/2. 1 In patients with BRCA1 mutations, cumulative risk of BC and OC by age 80 is about 72% and 44% respectively; for BRCA2 mutations, that risk is about 69% and 17% respectively. 2 Therefore, the NCCN Guidelines Panel recommends RRSO for women with a known BRCA1/2 mutation, between the ages of 35 and 40 with a BRCA1 mutation and between 40 and 45 years of age in women with a BRCA2 mutation, since ovarian cancer onset tends to be later in this group 3 RRSO is associated with an OC risk-reduction of approximately 80% and it also seems to reduce BC risk by approximately 50%. All-cause mortality was lower for BRCA carriers who undergo RRSO (HR 0.40, 95% CI 0.26-0.61), as well as breast cancer specific (HR 0.44, 95% CI 0.26-0.76), and ovarian cancer specific mortality (HR 0.21, 95% CI 0.06-0.80). 4 The largest reduction in mortality after RRSO was due to a decrease in ovarian cancer specific mortality, which was the predominant reason for improved all-cause mortality in these women. 2 The role of bilateral risk-reducing mastectomy is still controversial.