Climacteric最新文献

{"title":"The effect of auricular acupressure on quality of life in postmenopausal women: a randomized sham-controlled clinical trial.","authors":"Zainab Alimoradi, Zohreh Hosseini Marznaki, Amirnavid Moeini","doi":"10.1080/13697137.2026.2645641","DOIUrl":"https://doi.org/10.1080/13697137.2026.2645641","url":null,"abstract":"<p><strong>Objective: </strong>With the decline in the average age of menopause, increased life expectancy and rising longevity among women, a significant number face menopausal challenges including physical and psychological symptoms that adversely affect their quality of life (QoL). Given the growing preference for complementary therapies over menopausal hormone therapy (MHT) and promising evidence on auricular acupressure, this study aimed to investigate its effect on QoL in postmenopausal women.</p><p><strong>Method: </strong>The randomized sham-controlled clinical trial enrolled 120 eligible postmenopausal women visiting comprehensive health centers in Qazvin, Iran, between February and August 2024. Participants were randomized into intervention (<i>n</i> = 60) or sham (<i>n</i> = 60) groups using the balanced blocks randomization method. The intervention group received auricular acupressure using Vaccaria seed-embedded tapes on specific points (Chinese/European uterine, ovary, Shenmen, brain, gonadotropin and sympathetic points) over 10 sessions (4-day intervals). Participants were instructed to apply moderate pressure to each point for 20 s, three times daily. The sham group followed an identical protocol but used non-seeded tapes. Data were collected using demographic/fertility questionnaires and the Menopause-Specific Quality of Life Questionnaire (MENQOL), assessing vasomotor, physical, psychosocial and sexual domains (lower scores indicate improved QoL). QoL was evaluated at baseline, 1 month post intervention and 2 months post intervention. Data were analyzed using repeated-measures analysis of variance-analysis of covariance (SPSS version 27, <i>α</i> = 0.05).</p><p><strong>Results: </strong>Baseline QoL scores did not differ significantly between groups. Post intervention, the intervention group showed statistically significant reductions in total QoL scores and all subscales at 1-month and 2-month follow-ups (<i>p</i> < 0.05). Mean differences for intervention versus sham groups in the first and second follow-ups were -28.50, -48.87 for total QoL; -2.36, -5.92 for vasomotor subscale; -2.55, -9.75 for psychosocial subscale; -10.89, -28.41 for physical subscale; and -1.62, -4.78 for sexual subscale. Based on <i>η</i><sup>2</sup>-values, auricular acupressure explained 63.4% of total QoL variance, and 61.6% (vasomotor), 39.9% (psychosocial), 66.2% (physical), and 42.4% (sexual) for the subscales.</p><p><strong>Conclusion: </strong>Auricular acupressure significantly improved overall QoL and all specific domains (physical, psychosocial, vasomotor, sexual) in postmenopausal women. Healthcare providers may consider this non-pharmacological therapy particularly for MHT-ineligible patients to alleviate menopausal symptoms and enhance QoL. Some limitations such as potential social desirability bias from self-reported measures, the lack of objective biomarkers due to budget limits and unevaluated confounding factors related to living conditi","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-14"},"PeriodicalIF":3.2,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"l-Proline as a safer strategy to preserve ovarian function for patients facing gonadotoxic therapies.","authors":"Juan Du, Xiangyan Ruan, Muqing Gu, Jiaojiao Cheng","doi":"10.1080/13697137.2026.2657843","DOIUrl":"https://doi.org/10.1080/13697137.2026.2657843","url":null,"abstract":"<p><strong>Objective: </strong>To develop a safer strategy for preserving ovarian function in patients facing gonadotoxic therapies, this study evaluated the natural osmolytes l-proline and betaine as dimethyl sulfoxide (DMSO)-free alternatives for human ovarian tissue cryopreservation (OTC).</p><p><strong>Method: </strong>The study first characterized the physicochemical properties of the cryoprotectants (CPAs). Ovarian cortical tissues from 10 patients were then processed into biopsies, which were randomized and cryopreserved using slow freezing with 1.5 M l-proline, betaine or DMSO (control). After thawing and a 4-day <i>in vitro</i> culture, assessment included estradiol secretion, glucose uptake, follicular viability (Calcein-AM), apoptosis (TUNEL), and markers of angiogenesis (CD31) and proliferation (Ki-67).</p><p><strong>Results: </strong>l-Proline demonstrated cryoprotective efficacy comparable to DMSO in key follicular metrics: estradiol secretion and follicular viability were not significantly different between the l-proline and DMSO groups, and both were superior to betaine. Apoptosis was equally low in the l-proline and DMSO groups, and considerably lower than in the betaine group. In contrast, DMSO showed higher glucose uptake and expression of CD31 and Ki-67.</p><p><strong>Conclusion: </strong>l-Proline is an effective natural alternative to DMSO for OTC, achieving equivalent preservation of the follicular reserve and function with a favorable biosafety profile. These findings highlight its significant translational potential for enhancing the safety profile of clinical fertility preservation.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do menopausal symptoms signal early biological aging? Mitochondrial, endocrine and clinical insights.","authors":"Juan E Blümel, Peter Chedraui, María S Vallejo","doi":"10.1080/13697137.2026.2663898","DOIUrl":"https://doi.org/10.1080/13697137.2026.2663898","url":null,"abstract":"<p><p>The menopausal transition represents a pivotal period in female aging, marked by profound endocrine, metabolic and cellular shifts. Increasing evidence indicates that menopausal symptoms - vasomotor instability, sleep disturbances, fatigue and cognitive complaints - are more than consequences of estrogen withdrawal, and may serve as a potential clinical indicator of biological aging. Experimental and clinical data suggest that declining estrogen signaling contributes to mitochondrial dysfunction, inflammation and telomere attrition, processes that are closely linked to cellular senescence and tissue deterioration. In addition to estrogen decline, the menopausal transition involves broader endocrine changes. Rising follicle stimulating hormone (FSH) levels, alteration in androgen balance and cortisol dysregulation of the hypothalamic-pituitary-adrenal axis may influence metabolic regulation, musculoskeletal health, stress physiology and body composition. Through these mechanisms, menopausal hormonal changes may contribute to increased cardiometabolic, musculoskeletal and neurocognitive vulnerability in midlife women. Clinical observations increasingly show that severe menopausal symptoms are associated with adverse cardiometabolic profiles, vascular dysfunction and markers of accelerated biological aging. Sleep disturbances and fatigue may further exacerbate metabolic dysregulation and systemic vulnerability, while cognitive complaints may reflect neuroinflammatory and vascular processes associated with aging. By restoring estrogen signaling, menopausal hormone therapy alleviates menopausal symptoms and may influence biological pathways involved in aging. Whether these effects translate into a modification of the aging trajectory remains unclear.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-6"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photobiomodulation therapy in the treatment of genitourinary syndrome in postmenopausal women - a placebo-controlled double-blind clinical trial.","authors":"Silvia Regina Dos Santos Pereira, Raymond Lanzafame, Raquel Agnelli Mesquita-Ferrari, Luciana Toledo Costa Salviatto, Erika da Silva Melo, Cícero Dayves da Silva Bezerra, Paulo Sérgio Bossini, Luciana Almeida-Lopes, Vanessa Dalapria, Alessandro M Deana","doi":"10.1080/13697137.2026.2658817","DOIUrl":"https://doi.org/10.1080/13697137.2026.2658817","url":null,"abstract":"<p><p>Postmenopausal genitourinary syndrome of menopause (GSM) includes a range of genital, urinary and sexual symptoms caused by estrogen deficiency. As women spend about one-third of their lives postmenopause, effective, non-invasive treatments are needed. This study evaluated the clinical effects of photobiomodulation (PBM) therapy in postmenopausal women with urinary incontinence. A randomized, double-blind, placebo-controlled clinical trial was conducted with women over 50 years of age presenting one or more GSM symptoms. Participants were assigned to receive either PBM or placebo. The PBM group underwent four weekly sessions of 808 nm laser applied to eight vaginal points (4J per point, 40s each). The placebo group followed the same protocol with the device turned off. Results showed a significant reduction in urinary loss in the PBM group, with improved scores on the International Consultation on Incontinence Questionnaire - Short Form. While pelvic pressure and sexual function did not differ significantly, improvements in vaginal dryness and burning were reported. PBM appears to be a promising, non-invasive option for reducing urinary incontinence and enhancing aspects of vaginal health in postmenopausal women. Further studies are needed to confirm long-term effects and optimize treatment protocols.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-11"},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endometriosis beyond menopause: a call for greater clinical awareness.","authors":"Shant Apelian, Peter Chedraui, Hugh S Taylor","doi":"10.1080/13697137.2026.2658790","DOIUrl":"https://doi.org/10.1080/13697137.2026.2658790","url":null,"abstract":"","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-3"},"PeriodicalIF":3.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between menopausal status and physical function: a systematic review and meta-analysis.","authors":"Pedro R S Macêdo, Sabrina G G F Macêdo, Ananília Regina Silva Cavalcante, Maithê Avelino Salustiano, Mateus D A Lima, Javier Jerez-Roig, Saionara M A Câmara","doi":"10.1080/13697137.2026.2651720","DOIUrl":"https://doi.org/10.1080/13697137.2026.2651720","url":null,"abstract":"<p><p>The aim of this systematic review with meta-analysis was to analyze the association between menopausal status and physical function. This review of observational studies followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement and was registered in PROSPERO. Searches were performed in the PubMed, Cochrane Library, SciELO, LILACS and Web of Science databases. RevMan 5 was used for meta-analysis. Twenty-six studies were included, and 80.8% showed significant associations between menopausal status and physical function. Compared to postmenopausal women, premenopausal (mean difference [MD] = 2.72, <i>p</i> < 0.001) and perimenopausal (MD = 1.68, <i>p</i> < 0.001) women had stronger handgrip strength in meta-analysis of unadjusted results. Associations remained significant when considering studies with results adjusted for covariates. Results were similar when considering different socioeconomic contexts. Premenopausal women also had stronger pinch and knee extension strength, better performance in the single-leg balance tests with eyes closed and open, and better self-reported physical function and functional limitation due to physical problems than postmenopausal women in meta-analysis with unadjusted results. Meta-analyses of adjusted results were conducted for self-reported measures, but differences lost significance. The menopausal transition seems to be a critical period during which physical function tends to decline, underscoring the importance of implementing healthcare strategies for women during this phase.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-13"},"PeriodicalIF":3.2,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal hormone use after hysterectomy in endometriosis: a Finnish register-based study.","authors":"Milla Sipilä, Liisu Saavalainen, Juuso Saavalainen, Oskari Heikinheimo","doi":"10.1080/13697137.2026.2639979","DOIUrl":"https://doi.org/10.1080/13697137.2026.2639979","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the frequency and type of menopausal hormone therapy (MHT) use after hysterectomy among women with surgically diagnosed endometriosis.</p><p><strong>Method: </strong>A retrospective register-based cohort study identified women with a first surgical diagnosis of endometriosis and a reference cohort using Finnish national registries. This study included women aged ≤45 years with hysterectomy and bilateral oophorectomy, and women >45 years with hysterectomy performed between 1996 and 2018. Women with a history of thrombosis, breast cancer or gynecological cancer were excluded. MHT use was identified from national reimbursement registry until the end of 2019.</p><p><strong>Results: </strong>Altogether 11,365 women were included: 1748 women aged ≤45 years and 9617 aged >45 years. Among women with endometriosis, 94.3% (aged ≤45 years) and 73.1% (aged >45 years) used MHT postoperatively, compared with 81.8% and 51.5% in the reference cohort (<i>p</i> < 0.001). Estrogen-only therapy was the most commonly used MHT, but the use of combined estrogen-progestin therapy increased significantly (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>MHT use was very common in women with endometriosis. The shift toward combined therapy reflects evolving international guidance. The high rate of MHT use underscores the need for studies assessing its long-term outcomes in women with endometriosis.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of energy expenditure and substrate oxidation during menopause.","authors":"Camille Marcantei, Lore Metz, Emma O'Donnell, Laurie Isacco","doi":"10.1080/13697137.2025.2610485","DOIUrl":"10.1080/13697137.2025.2610485","url":null,"abstract":"<p><p>The menopausal transition is characterized by numerous physiological changes associated with the hormonal modifications that occur during this period, such as increased body weight and visceral body fat, reduced energy expenditure and fat oxidation rates, and increased risk of cardiometabolic disorders. While the influence of ovarian hormones on the regulation of energy balance has been widely investigated, the effects of the menopausal transition, also called perimenopause, on the different compartments of energy expenditure (i.e. resting, sleeping, thermic effect of food and physical activity energy expenditure) are less described. Furthermore, substrate metabolism adaptations to the menopausal transition are also poorly described despite their significant influence on health. To address this knowledge gap, this narrative review considers the energetic adaptations of the resting and non-resting components during the menopausal transition, as well as central and peripheral estrogen-associated cellular mechanisms that may play a role. Although research on energetic adaptations during the menopausal transition remains limited, current evidence indicates declines in resting and sleeping energy expenditure and fat oxidation, as well as physical activity energy expenditure and peak fat oxidation. These alterations appear to result from central and peripheral adaptations triggered by the menopausal decline in estrogen and the concomitant rise in follicle stimulating hormone (FSH).</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"140-150"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twenty-year cardiovascular disease incidence in menopausal women: insights from the ATTICA study.","authors":"Christina Chrysohoou, Panagiotis Iliakis, Anna Pitsillidi, Eleni Manta, Fotios Barkas, Evangelos Liberopoulos, Petros P Sfikakis, Christos Pitsavos, Costas Tsioufis, Demosthenes Panagiotakos","doi":"10.1080/13697137.2025.2567691","DOIUrl":"10.1080/13697137.2025.2567691","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the 20-year incidence of cardiovascular disease (CVD) in menopausal women, exploring the interplay of traditional and menopause-specific risk factors.</p><p><strong>Method: </strong>The ATTICA study is a prospective cohort survey established in 2001-2002, with three consecutive follow-ups performed in 2006, 2012 and 2022. A total of 1001 women with complete data for CVD evaluation comprised the sample of the current study. For the purposes of this analysis, women were classified according to their menopausal status (at menopause, 276 out of 1001 women [27.6%]).</p><p><strong>Results: </strong>The 20-year cumulative CVD incidence was 321 cases among 1001 women (32%); 274 out of the 337 (81.3%) who were at menopause developed CVD, whereas 47 out of 664 at premenopause developed CVD (7.1%). Age-adjusted analysis revealed that postmenopausal women had 2.25 times (95% confidence interval: 1.20, 4.24) higher risk of CVD, compared to women not at menopause. The fully adjusted model revealed that history of diabetes and hypercholesterolemia were significant predictors for the 20-year-CVD events. Moreover, high-sensitivity C-reactive protein was a significant predictor for CVD events only in women aged above 52 years at menopause.</p><p><strong>Conclusion: </strong>Postmenopausal women had an age-adjusted 2.25 times higher 20-year risk of CVD, as compared to women who were not at menopause. Prevailed hypercholesterolemia and diabetes were the most important determinants for long-term CVD events, whereas chronic systemic inflammation had significant predictive value only in women aged above 52 years at menopause.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"231-238"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation-based model of menopause: hormonal changes and cardiovascular risk in a digital twin view.","authors":"Alexandre Vallée","doi":"10.1080/13697137.2025.2567693","DOIUrl":"10.1080/13697137.2025.2567693","url":null,"abstract":"<p><strong>Objective: </strong>Menopause is associated with profound hormonal changes, including declines in estradiol and progesterone and increases in follicle stimulating hormone (FSH) and luteinizing hormone (LH), which contribute to elevated cardiovascular disease (CVD) risk. Digital twin frameworks offer a novel approach to simulate these complex dynamics.</p><p><strong>Method: </strong>This study developed a semi-mechanistic digital twin model of menopause using 1000 simulated women (50% age ≥55 years, 50% age <55 years) followed over 90 days. Hormonal dynamics were modeled as cyclical in non-menopausal women and stable in postmenopausal women. Cardiovascular risk was assessed with linear mixed-effects models and generalized estimating equations, adjusting for age, body mass index and smoking.</p><p><strong>Results: </strong>The model reproduced expected patterns, with estradiol and progesterone peaks at ovulation and luteal phases in non-menopausal women, and stable, low levels in postmenopausal women, alongside elevated gonadotropins. After adjustment, menopause remained significantly associated with hormonal changes and CVD risk (<i>p</i> < 0.001). CVD-related differences were more pronounced in non-menopausal women, where estradiol peaks and luteal progesterone amplitudes were attenuated.</p><p><strong>Conclusion: </strong>This proof of concept highlights the potential of digital twin models to capture menopause-related hormonal dynamics and their cardiovascular implications. Future work should integrate real-world data, perimenopausal variability and ethical governance to enhance clinical translation.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"239-247"},"PeriodicalIF":3.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}