Climacteric最新文献

{"title":"Is the patients' fear of cancer the main barrier to prescribing menopausal hormone therapy?","authors":"Isabella Melo Pompei, Sabrina Lara Abonizio Magdalena, Vivien Suemi Arimura, Rogério Bonassi Machado, César Eduardo Fernandes, Rossella Elena Nappi, Luciano Melo Pompei","doi":"10.1080/13697137.2025.2560327","DOIUrl":"https://doi.org/10.1080/13697137.2025.2560327","url":null,"abstract":"<p><strong>Objective: </strong>Menopausal hormone therapy (MHT) is the most effective treatment for relieving menopausal symptoms. However, many women avoid this therapy due to fear, and in Brazil numerous cities lack access to this treatment in the public health system. This study aimed to investigate prescribing habits regarding MHT among gynecologist-obstetricians in the Brazilian public versus private health systems, and to identify the main barriers to its use.</p><p><strong>Method: </strong>This descriptive cross-sectional study utilized a quantitative approach. Gynecologist-obstetricians from across Brazil were invited to complete a structured electronic questionnaire assessing their prescribing practices in both the public and private health sectors.</p><p><strong>Result: </strong>A total of 433 valid responses were analyzed. Among them, 51.5% of participants reported providing care to climacteric patients in the public health system, with 46.2% working in both sectors. Among physicians practicing in both settings, 76.5% reported prescribing MHT more frequently in the private sector. The main barriers to MHT prescription in the public system were treatment cost (68.2%) and lack of availability of free medication (61.4%), while in the private system the predominant barriers were fear of therapy-related risks (93.6%), especially cancer. Only 27.8% reported free access to MHT in their cities.</p><p><strong>Conclusion: </strong>The findings indicate that MHT prescribing practices in Brazil are still significantly influenced by structural barriers in the public sector and by negative perceptions in the private sector. Interventions aimed at expanding access and educating both physicians and patients are essential to ensure safe and equitable use of MHT.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-4"},"PeriodicalIF":3.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148180","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":"The role of lifestyle medicine in menopausal health: a review of non-pharmacologic interventions.","authors":"Chika V Anekwe, Antonio Cano, Jennifer Mulligan, Seng Bin Ang, Corinne N Johnson, Nick Panay, Zoe Schaedel, Eftitan Y Akam, Florence Porterfield, Emily Wang, Rossella E Nappi","doi":"10.1080/13697137.2025.2548806","DOIUrl":"https://doi.org/10.1080/13697137.2025.2548806","url":null,"abstract":"<p><strong>Objective: </strong>Menopause, typically occurring between ages 45 and 55 years, is a natural life stage marked by hormonal changes that can affect the symptom burden, quality of life and chronic disease risk. While not a disease, the transition often requires individualized, holistic care. Lifestyle medicine - encompassing healthy eating, physical activity, mental well-being, avoidance of risky substances, restorative sleep and healthy relationships - offers a promising non-pharmacological strategy to optimize health during this period.</p><p><strong>Method: </strong>A systematic literature search was conducted in PubMed, Embase, Scopus and Web of Science (January 2000-December 2024) using the following keywords and combinations: 'menopause', 'lifestyle medicine', 'healthy eating', 'physical activity', 'mental wellbeing', 'avoidance of risky substances', 'restorative sleep', 'healthy relationships', 'weight management', 'chronic disease prevention', 'health equity and access' and 'general health frameworks'. Peer-reviewed human studies in perimenopausal, menopausal or postmenopausal women evaluating one or more lifestyle medicine pillars were included. Data were extracted on study design, population, interventions, outcomes and main findings.</p><p><strong>Results: </strong>Lifestyle medicine interventions were associated with reductions in vasomotor symptoms, improved sleep quality, enhanced mental well-being, healthier weight regulation, and reduced cardiometabolic and osteoporosis risk. Multidisciplinary, person-centered approaches improved adherence and patient-reported outcomes. Strategies were cost-effective, adaptable and beneficial for long-term disease prevention across diverse populations.</p><p><strong>Conclusion: </strong>Lifestyle medicine offers a foundational, evidence-based framework for equitable menopause care. Integrating these strategies into clinical guidelines and public health policy can improve quality of care, empower women to manage their health and reduce disparities in access. Collaborative action among healthcare providers, policymakers and communities is essential to maximize impact.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-19"},"PeriodicalIF":3.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039051","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":"Lifestyle medicine: a must-have in the menopause toolkit.","authors":"Rossella E Nappi","doi":"10.1080/13697137.2025.2549207","DOIUrl":"https://doi.org/10.1080/13697137.2025.2549207","url":null,"abstract":"","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-3"},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029030","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":"The value of over-the-counter products/services in the management of mild-to-moderate menopausal symptoms.","authors":"Petra Stute, Heather Currie, Santiago Palacios","doi":"10.1080/13697137.2025.2548802","DOIUrl":"https://doi.org/10.1080/13697137.2025.2548802","url":null,"abstract":"<p><p>For women with mild-to-moderate menopausal symptoms, lifestyle changes and over-the-counter products and services can be beneficial for symptom management, especially for those who are contraindicated or averse to using menopausal hormone therapy (MHT). Lifestyle changes, such as increased exercise and improvements in diet, enhance overall health and are suggested by some low-level evidence - largely from observational studies - to alleviate menopausal symptoms. Over-the-counter dietary and herbal supplements are a popular alternative to MHT. While evidence is mainly low-level, some of these products have shown efficacy and tolerability in menopausal symptom management through meta-analyses, systematic reviews and randomized controlled trials (RCTs). However, mixed evidence and inconsistencies in product dosage, components and quality remain an issue. In addition, caution is advised for women on other medications or with conditions such as breast cancer that could interact with or be impacted by these products. There is high-level evidence from RCTs supporting the efficacy of behavioral therapies, in particular cognitive behavioral therapy, in menopausal symptom management, and clinicians should consider their implementation. Education on menopause and its management is essential. The authors recommend a three-step approach for treating women with self-reported mild-to-moderate menopausal symptoms who prefer to avoid prescription medications even after being informed about their benefit-risk profiles: 1) lifestyle changes; 2) non-prescription options and over-the-counter products; and 3) prescription therapies, if still necessary and with patient agreement. This approach broadens access to menopausal symptom management, providing relief to a wide range of women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-10"},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029066","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":"The association between day-to-day impact of vaginal aging and female sexual function.","authors":"Saniye Koseoglu, Tevfik Yoldemir","doi":"10.1080/13697137.2025.2548799","DOIUrl":"https://doi.org/10.1080/13697137.2025.2548799","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between the day-to-day impact of vaginal aging and female sexual function among postmenopausal Turkish women.</p><p><strong>Method: </strong>The McCoy Female Sexuality Questionnaire (MFSQ) and the Day-to-Day Impact of Vaginal Aging (DIVA) questionnaire were distributed to 195 postmenopausal women. The most bothersome vulvovaginal symptoms were recorded. The scores for each of the MFSQ and DIVA domains were compared between women with moderate to severe symptoms and those with no or mild symptoms.</p><p><strong>Results: </strong>The mean scores for the MFSQ sexual interest and MFSQ partner satisfaction domains, the total MFSQ, and the total DIVA decreased as women got older. Women with moderate to severe pain with penetration had a lower score for the MFSQ sexual interest domain, and a higher score for the DIVA self-concept and body image domain. Women with moderate to severe dryness had a higher score for the MFSQ sexual interest domain, and a lower score for the DIVA self-concept and body image domain.</p><p><strong>Conclusion: </strong>The mean scores of each of the MFSQ and DIVA domains were not influenced by vulvovaginal symptoms such as itching, pain, and irritation. The mean scores of the MFSQ sexual interest and DIVA self-concept and body image domains differed with the severity of dryness and pain with penetration.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029053","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":"'Menopausando': a digital health education platform for women in the transition to menopause and postmenopause.","authors":"Maély de Oliveira Ignácio, Mariana Gomes Martins, Caio Fábio Schlechta Portella, Aline Evangelista Santiago, Juliana Zangirolami-Raimundo, Edmund Chada Baracat, José Maria Soares, Isabel Cristina Esposito Sorpreso","doi":"10.1080/13697137.2025.2548798","DOIUrl":"https://doi.org/10.1080/13697137.2025.2548798","url":null,"abstract":"<p><strong>Objective: </strong>Social media is an increasingly relevant tool for health education, enabling information exchange, promoting autonomy and supporting informed decision-making. This study introduces Menopausando, a predominantly Portuguese-language digital platform designed to support women during menopausal transition and postmenopause.</p><p><strong>Method: </strong>This cross-sectional study has been carried out in the Gynecology Discipline, São Paulo University, Brazil, since 2019. In the pre-implementation phase of the digital platform, interviews were conducted with 287 Internet users about their experiences and preferences to be disclosed on the digital platform. The chi-square test or Fisher's exact test and analysis of variance with Stata 16 SE were utilized.</p><p><strong>Results: </strong>Interviewees were 83.3% white with mean age 54.3 (1.82) years, and 78.8% were interested in a menopause digital platform. The platform reached 21,617 website users, 3048 Instagram users, 133 Facebook users and 1126 Spotify users. Facebook users were older, men age 51.3 (9.3) years, than Spotify users, mean age 45.6 (12.2) years (<i>p</i> < 0.001). Female gender was present in all social networks (<i>p</i> < 0.001). The largest number of Brazilian users was on the website, with 21,000 (97.1%) (<i>p</i> < 0.001) (all groups), and other countries' websites and Instagram (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Menopausando effectively supports women during menopausal transition and postmenopause via multiple digital channels. The results expose digital access tendencies and inequalities.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145022980","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":"Androgen therapy in midlife and older women: a position statement of the Latin American Association of Gynecological Endocrinology (ALEG).","authors":"Susana Pilnik, Alejandra Belardo, Lucas Bandeira Marchesan, Adriana Camero-Lascano, Margot Acuña-San Martín, Alejandra Elizalde-Cremonte, Eliana Ojeda, Alejandro Manzur, Peter Chedraui","doi":"10.1080/13697137.2025.2548805","DOIUrl":"https://doi.org/10.1080/13697137.2025.2548805","url":null,"abstract":"<p><strong>Objective: </strong>Androgens have been prescribed to alleviate symptoms in midlife women, but evidence regarding benefits and risks remains limited, with no clearly established indications for Testosterone therapy. In many Latin American countries, Testosterone is prescribed without specific guidelines, making it difficult to identify patients who might benefit. This position statement aims to summarize evidence and provide a Latin American perspective on androgen therapy in midlife and older women.</p><p><strong>Method: </strong>Data were collected from Cochrane reviews, placebo-controlled studies, meta-analyses, international guidelines, consensus statements, and government regulations published between 2000 and the present. Analyses focused on efficacy, safety, and clinical recommendations for androgen therapy in midlife and older women.</p><p><strong>Results: </strong>Testosterone therapy for postmenopausal women should be limited to those with hypoactive sexual desire disorder (HSDD) confirmed through a formal biopsychosocial evaluation (Grade A: High). Routine serum measurements of Testosterone or other androgens are not recommended for diagnosis (Grade A: High), but baseline levels should be checked before therapy to exclude elevated concentrations (Grade C: Low). Treatment monitoring should occur within 3-6 weeks, maintaining Testosterone within the premenopausal physiological range (Grade C: Low). Transdermal formulations are preferred. Subcutaneous pellets and compounded \"bioidentical\" Testosterone are not recommended due to risks of supraphysiological dosing and insufficient evidence (Grade C: Low). Oral dehydroepiandrosterone (DHEA) is not advised systemically (Grade A: High). Vaginal DHEA is approved only for genitourinary syndrome of menopause.</p><p><strong>Conclusion: </strong>Women should receive counseling aligned with current clinical guidelines. Prior to initiating Testosterone therapy, patients must be informed that its use is off-label. Evidence to date does not support systemic DHEA as an effective treatment for sexual symptoms.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":3.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014032","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":"Effect of cranial electro-stimulation on cognition in perimenopausal women: randomized control study.","authors":"Naveeta Thakur, Nidhi Sharma, Simranjeet Kaur, Parveen Kumar, Preeti Kapri, Priyanka Negi","doi":"10.1080/13697137.2025.2530444","DOIUrl":"https://doi.org/10.1080/13697137.2025.2530444","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the efficacy of cranial electrotherapy stimulation (CES) on cognition among perimenopausal women.</p><p><strong>Methods: </strong>The pretest-post-test randomized controlled trial was conducted between April 2024 and January 2025. Forty-six perimenopausal women, aged 40-55 years, were randomized into two groups: active CES (<i>n</i> = 23) or sham CES (<i>n</i> = 23). Participants were blinded to the study. Both groups received 30-min sessions, 4 days a week for 4 weeks. The participants were assessed at baseline and at the end of 4 weeks of intervention using the Montreal Cognitive Assessment (MoCA) scale.</p><p><strong>Results: </strong>Demographic and baseline characteristics depicted a normal distribution for both groups, except for MoCA (<i>p</i> < 0.05). Within-group analyses of both groups demonstrated significant differences for MoCA (active CES, <i>p</i> = 0.001; sham CES, <i>p</i> = 0.002) with large effect size ≥ 0.5. Between-group analyses of MoCA showed no significant difference with <i>p</i> = 0.212 and small effect size ≤ 0.3. The time and group interaction effect showed significant improvement with <i>p</i> = 0.001.</p><p><strong>Conclusions: </strong>CES has the potential to enhance cognitive function in perimenopausal women. Additionally, no adverse events related to the study were reported.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-6"},"PeriodicalIF":3.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854750","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":"The association between depression and female sexual function in postmenopausal women.","authors":"Tevfik Yoldemir, Narmin Garibova","doi":"10.1080/13697137.2025.2539850","DOIUrl":"https://doi.org/10.1080/13697137.2025.2539850","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between depression and female sexual function among postmenopausal women.</p><p><strong>Study design: </strong>The study group was composed of 232 sexually active postmenopausal women. Serum testosterone, androstenedione, dehydroepiandrosterone sulfate, fasting glucose, insulin, sex hormone-binding globulin, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride levels were analyzed. Quantification of pelvic organ prolapse was performed for each patient. The Female Sexual Function Index (FSFI) questionnaire and the Beck Depression Inventory (BDI) were distributed and compared between postmenopausal and premenopausal women.</p><p><strong>Results: </strong>The mean BDI score was 17.5 ± 9.8. Sexual dysfunction determined by the mean FSFI score was 64.2%. In total, 70.5% of the postmenopausal women with sexual dysfunction had moderate to severe depression. There was a low negative correlation between age and duration after menopause and mean FSFI scores (<i>r</i> = -0.334 and <i>r</i> = -386, respectively). There was a negligible positive correlation between age and duration after menopause and mean BDI scores (<i>r</i> = 0.281 and <i>r</i> = 0.276, respectively). The satisfaction domain of the FSFI was significantly decreased with postmenopausal depression.</p><p><strong>Conclusion: </strong>Postmenopausal women with sexual dysfunction had higher depression scores. Age and time after menopause were weakly associated with both FSFI and BDI scores in postmenopausal women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854777","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":"Associations between declining testosterone concentrations and cognitive performance in community-dwelling older Australian women: a prospective cohort study.","authors":"Farhana Sultana, Rakibul M Islam, Susan R Davis","doi":"10.1080/13697137.2025.2539854","DOIUrl":"https://doi.org/10.1080/13697137.2025.2539854","url":null,"abstract":"<p><strong>Objective: </strong>Testosterone may have a role in brain health. Whether older women who exhibit a decline in blood testosterone are at an increased risk of cognitive decline is uncertain.</p><p><strong>Method: </strong>A subset of Australian female participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial had testosterone concentrations measured by liquid chromatography-tandem mass spectrometry and underwent a comprehensive cognitive test battery at baseline and study year 3. Cognitive decline was defined as a lower test score at year 3 compared with baseline. The mean change (baseline to year 3) of testosterone concentration was examined by paired-sample <i>t</i>-test. Stable or increased (reference) versus a decline in testosterone concentration was used to investigate the association with cognitive decline using logistic regression.</p><p><strong>Results: </strong>A total of 395 women (median [interquartile range] age 78.1 [73.7-82.3] years) provided data for analysis. In total, 154 women (39%) had a decline in blood testosterone which was not associated with a decline in any cognitive measure (Modified Mini-Mental State Examination: odds ratio [OR] = 0.96, 95% confidence interval [CI] 0.63 to 1.49, <i>p</i> = 0.86; Hopkins Verbal Learning Test - Revised: Immediate Recall, OR = 0.71, 95% CI 0.44 to 1.13, <i>p</i> = 0.151 and Delayed Recall, OR = 1.42, 95% CI 0.89 to 2.26, <i>p</i> = 0.14; Controlled Oral Word Association Test: OR = 0.79, 95% CI 0.49 to 1.25, <i>p</i> = 0.31; and Symbol Digit Modalities Test: OR = 0.83, 95% CI 0.53 to 1.29, <i>p</i> = 0.40). Limiting the analysis to 237 women aged 70-79 years (74.5 [interquartile range 72.2-77.1] years), no association was observed between a decline in blood testosterone and any cognitive outcome.</p><p><strong>Conclusion: </strong>: A decline in blood testosterone concentrations over 3 years was not associated with a decline in cognitive function in community-dwelling Australian women aged 70 years and older.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":3.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854749","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}