Climacteric最新文献

{"title":"Association of hormone therapy with cardiovascular events in females using statins for prevention.","authors":"Alexandra Lukey, Gavin Stuart, Paramdeep Kaur, Gillian E Hanley","doi":"10.1080/13697137.2025.2524171","DOIUrl":"https://doi.org/10.1080/13697137.2025.2524171","url":null,"abstract":"<p><strong>Objective: </strong>The association of hormone therapy (HT) combined with statin use for primary prevention of cardiovascular disease remains uncertain. This study aimed to assess the effect of HT, initiated before the age of 60 years, on all-cause mortality and cardiovascular events in females using statins for primary prevention.</p><p><strong>Method: </strong>This population-based, retrospective cohort study included all females aged 40-60 years in British Columbia, Canada, who used statins for primary prevention. The exposure was defined as systemic HT, including estrogen alone or combined with a progestogen, excluding local preparations of estrogen. The study used Cox proportional hazards models from the study start date to the outcome.</p><p><strong>Results: </strong>After exact matching on age using up to a 1-to-4 match, 685 (20%) of the 3,425 statin users initiated HT within the first year of follow-up. HT use was not significantly associated with all-cause mortality after adjusting for confounders (adjusted hazard ratio [aHR], 1.17; 95% confidence interval [CI], 0.87-1.58). Similarly, for the secondary outcome of composite cardiovascular events, HT use did not significantly increase risk (aHR, 0.95; 95% CI, 0.75-1.20).</p><p><strong>Conclusion: </strong>This study found that HT, when initiated before age 60 years, was not associated with an increased risk of all-cause mortality or cardiovascular events in females using statins for primary prevention.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641939","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":"Comparison of bone mineral density and influencing factors in iatrogenic and idiopathic POI.","authors":"Zecheng Wang, Xiangyan Ruan, Lingling Jiang, Mingzhen Zhang, Yu Yang, Anming Liu, Jing Li, Muqing Gu, Yanqiu Li, Jiaojiao Cheng, Fengyu Jin, Juan Du, Alfred O Mueck","doi":"10.1080/13697137.2025.2524170","DOIUrl":"https://doi.org/10.1080/13697137.2025.2524170","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the characteristics of bone mineral density (BMD) in patients with premature ovarian insufficiency (POI), compare BMD between iatrogenic POI and idiopathic POI patients, and investigate the factors affecting BMD in POI patients.</p><p><strong>Method: </strong>This cross-sectional study recruited a total of 88 iatrogenic POI patients, 45 idiopathic POI patients and 45 normal reproductive-age women, all of whom met the study criteria and were treated at the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from 1 January 2023 to 30 June 2024. Medical history was collected for all patients, and follicle stimulating hormone (FSH), estradiol (E2), total testosterone (TT), free testosterone (FT), biologically active testosterone (BioT), dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) were measured. Height and weight were measured, and the body mass index (BMI) was calculated. BMD of the lumbar spine and left femur was measured in POI patients. Multiple linear regression analyses were performed to determine the correlation between characteristics and BMD.</p><p><strong>Results: </strong>The incidence of osteoporosis was significantly higher in iatrogenic POI patients than in idiopathic POI patients (40.9% vs. 20.0%, <i>p</i> < 0.05). The femoral shaft BMD, greater trochanter BMD <i>t</i>-score, total femoral BMD and total femoral BMD <i>t</i>-score were significantly lower in iatrogenic POI patients compared to idiopathic POI patients (all <i>p</i> < 0.05). Multiple linear regression analysis revealed that delay in diagnosis negatively affected the lumbar BMD <i>t</i>-score (<i>p</i> < 0.05) and the BMI and DHEAS positively affected the total femur BMD <i>t</i>-score in iatrogenic POI patients (<i>p</i> < 0.05). No significant correlations were found in idiopathic POI patients.</p><p><strong>Conclusion: </strong>The incidence of osteopenia and osteoporosis in POI patients is high, especially in iatrogenic POI patients, who experience more severe bone loss and a higher incidence of osteoporosis. BMI and a delay in diagnosis significantly affected BMD in iatrogenic POI patients. This, to our knowledge, is the first study showing that DHEAS positively affects BMD in iatrogenic POI patients, which, however, needs further studies for confirmation.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599580","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":"Dietary Inflammatory Index: is it really associated with postmenopausal symptoms?","authors":"Hatice Merve Bayram, Murat Gürbüz","doi":"10.1080/13697137.2025.2524174","DOIUrl":"https://doi.org/10.1080/13697137.2025.2524174","url":null,"abstract":"<p><strong>Objective: </strong>Diet significantly modulates immunological responses and can impact climacteric symptoms. This study evaluated the association between Dietary Inflammatory Index (DII) scores and climacteric symptoms in postmenopausal women.</p><p><strong>Method: </strong>The study was conducted with postmenopausal women between May and July 2024. A face-to-face questionnaire including demographic characteristics, the Menopause Rating Scale (MRS) and the Kupperman Menopausal Index (KMI) was administered. The DII score was computed based on dietary data. Anthropometric measurements were based on participants' self-reports. The data were analyzed using SPSS 24.0.</p><p><strong>Result: </strong>s: In total, 193 postmenopausal women were recruited. Participants in T3, who had the highest DII scores and thus followed the most pro-inflammatory diets, had higher MRS and KMI scores, with significant differences between the groups (<i>p</i> < 0.001 and <i>p</i> = 0.033, respectively). T3 had higher intakes of energy and total fat (<i>p</i> = 0.018 and <i>p</i> = 0.030, respectively) but lower intakes of n-3 fatty acids (<i>p</i> = 0.038). Multivariate linear regression analysis revealed that moderate to high DII scores correlated with elevated MRS scores (odds ratio 1.100, <i>p</i> < 0.001 and 1.106, <i>p</i> < 0.001, respectively). After adjusting for age, marital status, education, employment, physical activity, year of menopause, supplement use and socioeconomic status, the results remained consistent.</p><p><strong>Conclusion: </strong>A pro-inflammatory diet might be associated with higher symptoms. Further studies are needed to confirm these findings.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-8"},"PeriodicalIF":2.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599581","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":"Sleep quality in perimenopausal and postmenopausal women: which exercise therapy is the most effective? A systematic review and network meta-analysis of 31 RCTs.","authors":"Kaili Zhou, Yi Ren, Liuhong Zang, Zhidong Zhou","doi":"10.1080/13697137.2025.2509866","DOIUrl":"https://doi.org/10.1080/13697137.2025.2509866","url":null,"abstract":"<p><p>The effectiveness of various exercise types in improving sleep quality in menopausal women remains controversial. This network meta-analysis was designed to evaluate and rank the efficacy of five exercise modalities on sleep quality in peri-postmenopausal women. Five English databases and three Chinese databases were searched for randomized controlled trials (RCTs) published from inception to July 2024. Pairwise meta-analysis and frequentist network meta-analyses were performed based on the random effects model. The analysis revealed that younger menopausal women (age ≤55 years) (standardized mean difference [SMD] = -2.00; 95% confidence interval [CI] [-2.70, -1.31]), those with sleep disorders (SMD = -2.29; 95% CI [-2.79, -1.78]) and those from Asia (SMD = -2.50, 95% CI [-3.62, -1.38]) were able to derive greater health benefits. Flexibility exercise (low certainty) and aerobic exercise (low certainty), combined exercise (moderate certainty) and mind-body exercise (moderate certainty) significantly improved sleep quality. Combined exercise showed the highest efficacy (surface under the cumulative ranking curve [SUCRA] = 93.5%), followed by flexibility exercise (SUCRA = 76%), and these exercises also showed a positive effect on women's quality of life (SMD = 0.49; 95% CI [0.13, 0.84]; <i>p</i> = 0.007). Future research should develop more acceptable exercise intervention models and use combined and flexibility exercises to explore the optimal parameters of exercise for menopausal women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-13"},"PeriodicalIF":2.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504995","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":"Comparison of predicted aerobic capacity to measured aerobic capacity in menopausal women: an analysis of three methods.","authors":"Catherine A Rattley, Malika Felton, Paul Ansdell, Susan Dewhurst, Rebecca A Neal","doi":"10.1080/13697137.2025.2517127","DOIUrl":"https://doi.org/10.1080/13697137.2025.2517127","url":null,"abstract":"<p><p>Maintaining fitness throughout menopause is crucial for sustaining functional capacity and supporting healthy aging. Declines in physical activity and changes in physiology threaten cardiovascular health in menopause. Aerobic capacity is an indicator of current health status that can be measured directly, by maximal rate of oxygen uptake (V̇O_{2 max}), or using submaximal predictive methods that require fewer resources. This study aimed to establish the validity of these predictive methods for midlife women. Forty-four women (age 52 ± 4 years) completed three predictive cycle ergometer protocols (YMCA, Astrand-rhyming and Ekblom-Bak) and an incremental cycle ergometer V̇O_{2 max} test. Predicted V̇O_{2 max} scores were compared for agreement with directly measured V̇O_{2 max}. All methods evidenced moderate correlations with V̇O_{2 max}. The mean V̇O_{2 max} value derived from the YMCA (35.6 ± 9.7 ml·kg-¹·min-¹) and Astrand-Rhyming (35.5 ± 8.8 ml·kg-¹·min-¹) tests was no different to measured V̇O_{2 max} (34.5 ± 7.2 ml·kg-¹·min-¹), but the Ekblom-Bak test (37.5 ± 7.2 ml·kg-¹·min-¹, <i>p</i> < 0.01) overpredicted V̇O_{2 max}. All methods showed wide limits of agreement, suggesting variability in the accuracy of predictions. When measuring aerobic capacity or prescribing exercise using these predictive methods, the results should be interpreted with caution. Where possible, direct measurement of aerobic capacity should be utilized for prescription of exercise intensity in menopausal women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-6"},"PeriodicalIF":2.9,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504994","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":"Vulvovaginal estrogen therapy for urinary symptoms in postmenopausal women: a review and meta-analysis.","authors":"Irene Porcari, Stefano Uccella, Chiara Casprini, Mariachiara Bosco, Pier Carlo Zorzato, Simone Garzon","doi":"10.1080/13697137.2025.2517138","DOIUrl":"https://doi.org/10.1080/13697137.2025.2517138","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to summarize available evidence on the efficacy of vulvovaginal topical estrogen therapy on lower urinary tract symptoms (LUTS) of genitourinary syndrome of menopause.</p><p><strong>Method: </strong>Multiple databases were systematically searched from inception to October 2024 to identify all studies providing pretreatment and post-treatment data for menopausal women with LUTS who received vulvovaginal estrogen therapy. A random effect meta-analysis was conducted (PROSPERO registration number: CRD42024517516).</p><p><strong>Results: </strong>Seventeen studies were included for a total of 2111 patients. The pooled odds ratio for the occurrence of considered outcomes after versus before treatment was 0.14 (95% confidence interval [CI] 0.05-0.36; <i>I</i>² = 73%) for recurrent urinary tract infections, 0.12 (95% CI 0.05-0.29; <i>I</i>² = 62%) for stress urinary incontinence, 0.22 (95% CI 0.16-0.32; <i>I</i>² = 0%) for urge incontinence, 0.11 (95% CI 0.06-0.18; <i>I</i>² = 23%) for urgency, 0.22 (95% CI 0.16-0.23; <i>I</i>² = 0%) for frequency and 0.24 (95% CI 0.17-0.34; <i>I</i>² = 0%) for nocturia. The pooled mean difference for vaginal pH was -1.29 (95% CI -1.66 to -0.91; <i>I</i>² = 96%).</p><p><strong>Conclusions: </strong>Vulvovaginal topical estrogen therapy appears to improve all analyzed LUTS in menopausal women. Available evidence supports current guidelines recommending vulvovaginal topical estrogen therapy for the management of these symptoms in menopausal women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494961","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 effects of repeat fractional CO₂ laser for postmenopausal vaginal symptoms following unblinding from a double-blind RCT.","authors":"Fiona G Li, Blake L Knapman, Erin Nesbitt-Hawes, Rebecca Deans, Jason Abbott","doi":"10.1080/13697137.2025.2517131","DOIUrl":"https://doi.org/10.1080/13697137.2025.2517131","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the effects of blinding on patient-reported outcomes.</p><p><strong>Method: </strong>Findings from this prospective open-label extension study were compared to a previous double-blind sham-controlled randomized trial. Women with any postmenopausal vaginal symptom previously receiving either active or sham vaginal fractional CO₂ laser were recruited from the index randomized controlled trial (RCT), and underwent an active laser protocol. Symptom severity was assessed by co-primary outcomes of a visual analog scale (VAS) for overall and most bothersome symptom and the Vulvovaginal Symptom Questionnaire (VSQ) to 12 months.</p><p><strong>Results: </strong>Of the 25 participants, there was a significant improvement in the co-primary outcomes at 6 months from baseline (mean difference: overall vaginal symptoms VAS, 22.0 [95% confidence interval (CI) -32.2, -11.8]; most bothersome symptom VAS, -22.1 [95% CI -36.7, -7.5]; VSQ, -2.2 [95% CI -3.8, -0.6]). At 12 months, there was significant improvement in most bothersome symptom VAS (-17.8 [95% CI -35.3, -0.3]) and VSQ (-2.3 [95% CI -3.9, -0.8]) scores. There was no significant difference in the post-treatment improvement of the co-primary outcomes at 6 and 12 months following open-label laser treatment, when compared to index RCT outcomes following active laser and sham laser treatment, respectively.</p><p><strong>Conclusion: </strong>Blinding in randomized trials is essential for correctly interpreting clinical outcomes using lasers for genitourinary symptoms of menopause.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494960","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 live birth on the age at natural menopause and predicting the age at natural menopause.","authors":"Burcu Ozbakir, Gemma Ford, Jessica Harris","doi":"10.1080/13697137.2025.2517140","DOIUrl":"https://doi.org/10.1080/13697137.2025.2517140","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether live birth affects the age at menopause (AAM), explore the relationship between different characteristics and AAM, and develop a model to project the AAM in middle-aged women.</p><p><strong>Method: </strong>A cross-sectional study was conducted with 630 postmenopausal women in Cyprus between January 2022 and June 2022. Postmenopausal women between ages 40 and 90 years completed a 90-question questionnaire that assessed reproductive, socio-demographic, familial, lifestyle and newborn/childhood parameters. Linear regression analysis was used to determine the associations related to AAM, which was questioned in the questionnaire. Multiple linear regression analysis was applied to determine the effect of potential associations on AAM.</p><p><strong>Results: </strong>The mean AAM was 48.7 years. In univariate analysis, the strongest associations observed were the positive correlation between AAM and the number of grown-up children and live births. Other reproduction-related parameters were mildly correlated with AAM. In the multivariable analysis, the effect of reproduction became less critical, including live birth. The strongest associations with AAM were the years of marriage before the AAM, relationship quality with the partner, the participant's mother's AAM and the average AAM of any sisters. A formula including parameters strongly associated with AAM contributed to a 26.7% variation in AAM between women (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>As the AAM can be determined to an extent, we can separate early and late AAM groups and prepare for the high-risk conditions related to later or earlier AAM to increase longevity.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144494981","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":"Practices and challenges in the management of the menopause in the Asia-Pacific Menopause Federation.","authors":"Seng Bin Ang, Felicia Clara Jun Hui Tan, Stella Rizalina Sasha Sugianto, Sonia Davison, Qi Yu, Masakazu Terauchi, Mee-Ran Kim, Jignesh Shah, S K Zinnat Ara Nasreen, Choon Moy Ho, Enkhee Sodnomdorj, M Fidel Ganis Siregar, Rubina Hussain, Ma Corazon Zaida N Gamilla, Yang Chua, Yung-Chieh Tsai, Unnop Jaisamrarn","doi":"10.1080/13697137.2025.2514030","DOIUrl":"10.1080/13697137.2025.2514030","url":null,"abstract":"<p><strong>Objectives: </strong>The experiences and needs of women undergoing the menopausal transition vary widely amongst countries in the Asia-Pacific. Thus, practices and challenges amongst clinicians treating perimenopausal and menopausal women in the Asia-Pacific also vary. This study aims to characterize the diverse practices and challenges in managing the menopause across the Asia-Pacific.</p><p><strong>Methods: </strong>Clinicians in the member organizations of the Asia-Pacific Menopause Federation were invited to participate in a questionnaire seeking information on their usual practices and the challenges faced in managing the menopause.</p><p><strong>Results: </strong>A total of 39 clinicians from 14 countries in the Asia-Pacific Menopause Federation responded to the questionnaire. While there were similar practices in assessment, clinicians' preferences in prescribing menopausal hormonal therapy varied widely. Challenges they faced included cultural and literacy barriers amongst their patients, a lack of support for menopause care in their healthcare systems and limited availability of novel therapies.</p><p><strong>Conclusion: </strong>Practices in managing the menopause vary across the Asia-Pacific. Further research and governmental support are needed to establish consensus on managing the menopause and supporting midlife women's health issues in the Asia-Pacific.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":2.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144474110","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":"Adjuvant treatment with tamoxifen for estrogen receptor-positive breast cancer and gynecological risks in premenopausal and perimenopausal women - a systematic review.","authors":"Julie Isabelle Plougmann Gislinge, Kresten Rubeck Petersen, Signe Borgquist, Pernille Ravn","doi":"10.1080/13697137.2025.2509839","DOIUrl":"10.1080/13697137.2025.2509839","url":null,"abstract":"<p><strong>Objective: </strong>Tamoxifen (TMX) is known to increase the risk of endometrial cancer (EC) in postmenopausal women, but data on the effects in premenopausal and perimenopausal women remain inconsistent and not well illuminated. This study aimed to evaluate whether TMX increases the risks of gynecological symptoms and EC in premenopausal and perimenopausal women receiving adjuvant therapy for estrogen receptor-positive breast cancer.</p><p><strong>Methods: </strong>Systematic searches in PubMed, Cochrane and Web Of Science yielded 319 relevant articles, of which 38 were analyzed after excluding duplicates and non-qualifying studies. The Oxford Criteria were used to ensure consistent evaluation before final inclusion. No meta-analysis was conducted due to study heterogeneity.</p><p><strong>Results: </strong>Ten studies (two meta-analyses, one systematic review, four retrospective cohort studies, one retrospective comparative study, one prospective cohort study and one case-control study) were included. TMX was associated with an increased risk of EC in premenopausal and perimenopausal women (mean relative risk 2.25; standard deviation 0.9) compared to no treatment or treatment with raloxifene or aromatase inhibitors. Risk appeared in some studies to increase with treatment duration and persisted for ≥5 years post treatment. TMX also significantly increased the risk of gynecological symptoms, benign and premalignant endometrial pathology, intrauterine procedures and hysterectomy (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>TMX seems to increase EC risk and significantly increase the risk of gynecological symptoms in premenopausal and perimenopausal women, with risk persisting years following treatment cessation. Healthcare professionals should counsel these women on potential risks and emphasize prompt evaluation of gynecological symptoms.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332536","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}