Climacteric最新文献

{"title":"Effects of testosterone on exercise capacity in postmenopausal women with stage B heart failure.","authors":"Julia Grant, Sarah E Alexander, Thomas H Marwick, Rakibul M Islam, Erin J Howden, Susan R Davis","doi":"10.1080/13697137.2026.2735781","DOIUrl":"https://doi.org/10.1080/13697137.2026.2735781","url":null,"abstract":"<p><strong>Objective: </strong>Asymptomatic individuals with stage B heart failure (HF) often have reduced exercise capacity. As exogenous testosterone may have favorable skeletal muscle and vasculature effects, this study investigated whether transdermal testosterone improves exercise capacity in women with stage B HF.</p><p><strong>Method: </strong>In this single-center, double-blind, randomized, placebo-controlled crossover trial involving women aged ≥55 years with stage B HF (defined as cardiac remodeling and/or diastolic dysfunction) and reduced exercise capacity (<100% age-predicted peak oxygen uptake V˙O_2peak]), participants were randomly allocated to transdermal testosterone 5 mg/day or identical placebo for 4 months with cross-over after a 4-week washout. The primary outcome was change in V˙O_2peak. Secondary outcomes included changes to cardiac structure and function assessed by echocardiography and cardiac magnetic resonance imaging, and subjective quality of life.</p><p><strong>Results: </strong>Thirty-eight participants (median age 72 years, range 60-80 years; median body mass index 33.2 kg/m² [P25-P75 28.7-35.9 kg/m²]) completed the study. Testosterone treatment increased circulating serum testosterone concentrations and was well tolerated, with no adverse treatment-related events. Testosterone treatment had no significant effect on V˙O_2peak (<i>β</i> = -0.05, 95% confidence interval = -0.74, 0.65, <i>p</i> = 0.897), cardiac structure or indices of cardiac function, or quality of life.</p><p><strong>Conclusion: </strong>Transdermal testosterone treatment did not improve exercise capacity in postmenopausal women with stage B HF.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":3.9,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191697","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":"Reclaiming agency: how women build mood, confidence and social connections during perimenopause.","authors":"Sharmila Kumar, Siham Bardouh, Rutvi Vyas, Sawsan Dergham, Ann Dadich","doi":"10.1080/13697137.2026.2736441","DOIUrl":"https://doi.org/10.1080/13697137.2026.2736441","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to understand women's lived experiences of perimenopause, with reference to brain fog, mood, confidence and social connectedness, and identify opportunities to promote well-being.</p><p><strong>Method: </strong>A qualitative, exploratory study was conducted using semi-structured interviews with 30 midlife women in Australia from culturally diverse backgrounds. Interviews were audio-recorded, transcribed verbatim and analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants described perimenopause as a recurring disruption-stabilization cycle rather than a linear decline. Destabilization was often triggered by sleep loss, cumulative life load and symptom variability, shaping appraisals of mood and confidence. Brain fog was experienced as cognitive disruption accompanied by fatigue and self-doubt, commonly worsened by stress, poor sleep and diet. Participants actively engineered stability using individualized, multi-component strategies, including pacing and withdrawal, sleep optimization, physical activity and well-being practices, organizational and compensatory tools, acceptance and reframing, dietary adjustments, leisure and cognitive stimulation, and social support. Social connectedness was recalibrated, with shifts in engagement, mixed experiences of support versus misunderstanding and a strong preference for validating spaces and relationships.</p><p><strong>Conclusion: </strong>Perimenopause was experienced as dynamic yet manageable through structured self-management and supportive contexts. Findings support holistic, multimodal care that integrates symptom management with sleep, behavioral, cognitive and social interventions.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":3.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165495","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":"Non-linear association between body roundness index and menopausal symptoms in perimenopausal and postmenopausal women.","authors":"Xiao Lyu, Guozhen Chen, Jianhong Xia","doi":"10.1080/13697137.2026.2728616","DOIUrl":"https://doi.org/10.1080/13697137.2026.2728616","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the association between body roundness index (BRI) and menopausal symptoms in Chinese perimenopausal and postmenopausal women.</p><p><strong>Method: </strong>The cross-sectional study enrolled 1795 perimenopausal and postmenopausal women aged 40-69 years who attended the Menopause Clinic at Guangdong Women and Children Hospital. Menopausal symptom severity was assessed using the validated Chinese-modified Kupperman Menopause Index (KMI). Multivariable logistic regression and restricted cubic splines were used to estimate odds ratios (ORs) and identify potential thresholds.</p><p><strong>Results: </strong>Overall, 78.8% of participants reported menopausal symptoms, most of which were mild to moderate. Higher BRI was independently associated with higher odds of menopausal symptoms after adjustment for covariates in a multivariable logistic regression model (OR: 1.20, 95% confidence interval [CI]: 1.05-1.38, <i>p</i> = 0.009). Restricted cubic spline analysis revealed a non-linear relationship between BRI and menopausal symptoms (<i>p</i>-value for non-linearity = 0.014), with a data-derived inflection point at 2.571. Among women with BRI exceeding 2.571, the odds of menopausal symptoms increased progressively with rising BRI (OR: 1.34, 95% CI: 1.11-1.62, <i>p</i> = 0.002). Subgroup analyses showed consistent associations across strata (all <i>p</i>-values for interaction > 0.05).</p><p><strong>Conclusion: </strong>The BRI may serve as a useful anthropometric marker for identifying midlife women with greater symptom burden, although causal inference requires prospective validation.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135164","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":"Menopause and lung health: a narrative review of physiological changes, disease risks and clinical management.","authors":"Fatih Aktoz, C Tamer Erel, Ipek Betul Ozcivit Erkan","doi":"10.1080/13697137.2026.2735783","DOIUrl":"https://doi.org/10.1080/13697137.2026.2735783","url":null,"abstract":"<p><p>Menopause represents a critical transition that affects multiple organ systems, including the lungs. Declining levels of estrogen, progesterone and androgens alter airway function, inflammatory balance and tissue structure, contributing to changes in pulmonary physiology. Although these mechanisms provide a biological basis for potential associations with asthma, chronic obstructive pulmonary disease and lung cancer, the existing evidence remains inconclusive. Similarly, the effects of menopausal hormone therapy (MHT) on pulmonary outcomes are not clearly defined. This narrative review summarizes the physiological effects of sex hormones on lung function, describes menopause-related structural and inflammatory changes, and discusses the implications of MHT and androgen therapy for respiratory health in women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":3.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135248","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":"GLP-1 receptor agonists in perimenopause and early postmenopause: clinical role, cardiometabolic benefits and knowledge gaps.","authors":"Ipek Betul Ozcivit Erkan, Levent M Senturk, C Tamer Erel, Hasan Hakan Seyisoglu, Sezai Sahmay, Fatih Durmusoglu","doi":"10.1080/13697137.2026.2735765","DOIUrl":"https://doi.org/10.1080/13697137.2026.2735765","url":null,"abstract":"<p><p>Perimenopause and early postmenopause represent a critical metabolic transition with adverse changes in body composition, insulin sensitivity, lipid metabolism and cardiometabolic health, contributing to increased rates of obesity, type 2 diabetes and cardiovascular disease. As the prevalence of obesity continues to rise among midlife women, effective therapeutic strategies are increasingly needed. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as highly effective treatments for obesity and type 2 diabetes through their effects on appetite regulation, weight reduction, glucose homeostasis and metabolic health. Beyond their established role, GLP-1 RAs have demonstrated favorable effects on visceral adiposity, glycemic control, lipid profiles, hepatic steatosis and cardiovascular outcomes. Preliminary experimental evidence also suggests possible complementary effects when combined with menopausal hormone therapy (MHT). However, menopause-specific evidence remains limited. This review summarizes the current evidence regarding the efficacy, safety and clinical application of GLP-1 RAs in perimenopausal and early postmenopausal women. Particular attention is given to their effects on cardiometabolic health, cardiovascular risk, bone and muscle health, cancer risk, cognition and potential interactions with MHT. Although GLP-1 RAs represent a promising therapeutic option for obesity and metabolic dysfunction during menopause, important knowledge gaps remain regarding their long-term safety, effects on menopause-related outcomes and optimal integration into comprehensive menopausal care. The efficacy, safety and potential interactions of GLP-1 RAs when used in combination with MHT remain to be determined.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-11"},"PeriodicalIF":3.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135227","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 of statin use with severe urogenital symptoms and lower sexual function in postmenopausal women: a cross-sectional study.","authors":"Carlos Salinas, María S Vallejo, Juan E Blümel, Peter Chedraui, Sócrates Aedo, Alejandra Elizalde-Cremonte, Álvaro Monterrosa-Castro, Andrés Calle, Carlos Escalante-Gómez, Claudia Rey, Doris Rodríguez-Vidal, Eliana Ojeda, Gustavo Gómez-Tabares, Konstantinos Tserotas, Marcio A H Rodrigues, María T Espinoza, Maribel Dextre, Mónica Ñañez","doi":"10.1080/13697137.2026.2735782","DOIUrl":"https://doi.org/10.1080/13697137.2026.2735782","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the association between statin use, urogenital symptoms and sexual function in postmenopausal women.</p><p><strong>Method: </strong>This cross-sectional study included 1184 postmenopausal women from nine Latin American countries. Participants were classified according to statin use. Urogenital symptoms were assessed using the urogenital domain of the Menopause Rating Scale (MRS) and sexual function was evaluated with the Female Sexual Function Index-6 (FSFI-6). Multivariate logistic regression analyses were performed to identify factors independently associated with severe urogenital symptoms and lower sexual function.</p><p><strong>Results: </strong>Of the participants, 307 (25.9%) were statin users. According to the MRS, statin users reported significantly higher frequencies of vaginal dryness, urinary complaints and sexual problems as well as a greater prevalence of severe urogenital symptoms than non-users (24.4% vs. 12.3%; <i>p</i> < 0.001). They also showed poorer performance across all FSFI-6 domains and a higher prevalence of lower sexual function (78.5% vs. 64.4%; <i>p</i> < 0.001). After adjustment for confounders, statin use remained independently associated with severe urogenital symptoms (odds ratio [OR] 1.74, 95% confidence interval [CI] 1.22-2.50) and lower sexual function (OR 1.46, 95% CI 1.07-1.99).</p><p><strong>Conclusions: </strong>Statin use was independently associated with severe urogenital symptoms and lower sexual function in postmenopausal women. Longitudinal studies are needed to clarify causality.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":3.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126726","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":"Leveraging STRAW +10 criteria to evaluate menopause stage effects on sleep quality.","authors":"Shelby C Wood, Jacob L van Doorn, Susan Y Bookheimer, Thomas E Nichols, Beau M Ances, Robert C Welsh, Pauline M Maki","doi":"10.1080/13697137.2026.2675563","DOIUrl":"10.1080/13697137.2026.2675563","url":null,"abstract":"<p><strong>Objective: </strong>The Stages of Reproductive Aging Workshop +10 (STRAW +10) criteria are the gold standard criteria for categorizing menopause stage, with stage typically categorized using three menopause stages. Although STRAW +10 criteria include additional substages, few studies have examined menopause symptoms by these substages. To better characterize menopause stage effects on sleep, this study examined sleep quality across three stages and six substages of menopause. To differentiate menopause effects from aging effects, the study further examined associations between age and sleep quality.</p><p><strong>Method: </strong>Participants included 239 women aged 40-60 years from the Human Connectome Project in Aging (HCP-A) and the Aging Adult Brain Connectome (AABC). Sleep was measured using the Pittsburgh Sleep Quality Index and menopause was staged according to STRAW +10 criteria using three stages and six substages. All analyses were conducted using mixed-effects models.</p><p><strong>Results: </strong>Independent of age, sleep quality declined linearly across six substages of menopause, but not three stages of menopause. Age was unrelated to sleep quality after adjustment for menopause stage.</p><p><strong>Conclusion: </strong>Midlife represents a window of vulnerability to incrementally worse sleep associated with reproductive, but not chronological, aging. Findings highlight the benefit of using STRAW +10 substaging in menopause research.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"831-836"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162002","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":"Impact of social determinants of health on perimenopause symptom burden: insights from the Flo app.","authors":"Yella Hewings-Martin, Jana Karam, Adam C Cunningham, Mary S Hedges, Regina Castaneda, Liudmila Zhaunova, Stephanie S Faubion, Chrisandra L Shufelt","doi":"10.1080/13697137.2026.2682228","DOIUrl":"10.1080/13697137.2026.2682228","url":null,"abstract":"<p><strong>Objective: </strong>Perimenopause is the time leading up to and including the first 12 months after the final menstrual period. This study examined how social determinants of health (SDOH) including race/ethnicity, income, education and healthcare access influence perimenopause symptom burden.</p><p><strong>Method: </strong>A cross-sectional survey was distributed to English, Spanish, Portuguese and French-speaking Flo app users aged 35 years and above. Participants completed the validated Menopause Rating Scale (MRS) and provided data on key SDOH. Associations between SDOH and total MRS and domain scores (psychological, somatic, urogenital) were evaluated using multivariable linear regression.</p><p><strong>Results: </strong>A total of 12,382 women completed the survey. All examined SDOH were significantly associated with total and domain MRS scores (<i>p</i> < 0.001). Healthcare access had the strongest association, followed by income sufficiency and education level. Asian, Black and Hispanic/Latino race/ethnicities were significantly associated with MRS scores (<i>p</i> < 0.001) compared with White race/ethnicity. In a subset of 2618 women who reported being in perimenopause, SDOH remained significantly associated with MRS scores, with income sufficiency showing the strongest association (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>SDOH, particularly healthcare access and income, are strongly associated with perimenopause symptom burden. Addressing health inequities is essential to improve perimenopause care and reduce symptom burden.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"795-802"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350902","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":"Assessing the burden of menopausal symptoms and their influence on women's quality of life.","authors":"Sk Zinnat Ara Nasreen, Shahin Rahman Chowdhury, Safinaz Shahreen, Saleheen Huq, Sabereen Huq, Thrina Islam","doi":"10.1080/13697137.2026.2691921","DOIUrl":"10.1080/13697137.2026.2691921","url":null,"abstract":"<p><strong>Objective: </strong>Menopause can affect women's quality of life through vasomotor, psychological and urogenital symptoms. This study assessed the prevalence and correlates of impaired quality of life across menopausal stages in Bangladeshi women.</p><p><strong>Method: </strong>This cross-sectional study included 3000 women aged 45-55 years attending outpatient gynecology clinics in Dhaka between December 2022 and June 2024. Menopausal stage was classified using Stages of Reproductive Aging Workshop +10 (STRAW +10) criteria. Symptoms and quality of life were assessed using the Menopause Rating Scale (MRS), with impaired quality of life defined as MRS >16. Multivariable logistic regression identified factors associated with impaired quality of life.</p><p><strong>Results: </strong>Overall, 825 women (27.5%) had impaired quality of life. Symptom severity increased across menopausal stages, and hot flush prevalence rose from 22.1% in premenopause to 47.8% in late postmenopause. Hot flushes showed the strongest association with impaired quality of life (adjusted odds ratio [aOR] 10.28, 95% confidence interval [CI]: 8.84-11.95). Psychotropic medication use (odds ratio [OR] 2.00) and vaginal dryness (OR 1.28) were also associated with impairment, whereas sexual activity (OR 0.75), hormone therapy use (OR 0.70) and good self-rated health (OR 0.58) were associated with lower odds. Early postmenopause had the highest risk (aOR 2.14, 95% CI: 1.71-2.69).</p><p><strong>Conclusion: </strong>Early postmenopause is a vulnerable period for impaired quality of life among Bangladeshi women. Vasomotor and urogenital symptoms were important correlates of poorer well-being, supporting routine symptom assessment and culturally appropriate menopausal care.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"769-775"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444817","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":"Identification and importance analysis of osteoporosis risk factors in perimenopausal women based on the Transformer-LSTM hybrid model and SMOTE.","authors":"Hong-Xia Hu, Wei Wang, Hua-Mao Liang","doi":"10.1080/13697137.2026.2671750","DOIUrl":"10.1080/13697137.2026.2671750","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to identify the core risk factors for osteoporosis in perimenopausal women and propose an analytical framework based on the Transformer-LSTM hybrid model and SMOTE algorithm.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Cohort data on perimenopausal osteoporosis from the Department of Gynecology, Peking University Third Hospital were preprocessed, including cleaning invalid samples, converting feature types and imputing missing values. The SMOTE algorithm was then used to generate synthetic samples to balance the class distribution. Subsequently, a hybrid model integrating Transformer and long short-term memory (LSTM) was constructed: Transformer was employed to capture long-range correlations between features, while LSTM extracted sequence dependencies, thereby improving classification performance. Random errors were controlled through 20 independent experiments. Feature importance was calculated using the permutation method, and multi-dimensional visualization analyses were conducted using lollipop charts, horizontal bar charts, cumulative contribution curves and radar charts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results showed that total type 1 collagen N-terminal propeptide (TP1NP) is the most critical physiological indicator affecting abnormal bone mineral density. Factors such as 'educational level', 'body weight (kg)' and 'whether menopause occurred before the age of 45' also exerted significant influences. Notably, the top 25 core features could explain 80% of the associated risk. The proposed Transformer-LSTM hybrid model achieved an overall classification accuracy of 89.52 ± 1.48%, a macro F1-score of 0.867 ± 0.018 and a macro area under the curve (AUC) of 0.923 ± 0.012 - representing improvements of 3.76% in accuracy, 2.5% in F1-score and 3.6% in AUC compared with the single Transformer model, and of 7.38% in accuracy, 6.4% in F1-score and 7.8% in AUC compared with the single LSTM model. For the minority osteoporosis class, the model's recall rate reached 0.879 ± 0.025, which was 11.4% higher than that of the random forest model and 19.0% higher than that of the logistic regression model.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study provides a scientific basis and quantitative reference for the early identification, prevention, clinical assessment and health management of osteoporosis. The significant performance improvements of the proposed model (3.76-19.0% across key metrics) validate its superiority in capturing complex feature correlations and identifying minority class samples, addressing the core challenges of imbalanced clinical data and limited feature mining capability of traditional models. The identification of core risk factors and their quantitative importance not only enhances the interpretability of machine learning-based osteoporosis risk assessment but also enables targeted screening and personalized intervention for perimenopausal women, which is of great significance for improving t","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"727-746"},"PeriodicalIF":3.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599533","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}