ClimactericPub Date : 2026-08-01Epub Date: 2026-08-18DOI: 10.1080/13697137.2026.2691828
Chiara Benedetto, Suvarna S Khadilkar, Rossella E Nappi, Andrea R Genazzani, Federica Frezet, Laura Cucinella, Hema Divakar, Panagiotis Anagnostis, Nick Panay
{"title":"Hormone therapy (HT) in women with premature ovarian insufficiency or early menopause: Time to think of a new paradigm for healthy aging. A joint FIGO and IMS position paper.","authors":"Chiara Benedetto, Suvarna S Khadilkar, Rossella E Nappi, Andrea R Genazzani, Federica Frezet, Laura Cucinella, Hema Divakar, Panagiotis Anagnostis, Nick Panay","doi":"10.1080/13697137.2026.2691828","DOIUrl":"10.1080/13697137.2026.2691828","url":null,"abstract":"<p><p>Premature ovarian insufficiency (POI) and early menopause (EM) affect millions of women worldwide. Compared with normal menopause, they confer a longer duration of estrogen deficiency and are associated not only with a shorter lifespan, but with a reduced healthspan, owing to an increased risk of cardiovascular, skeletal, cognitive and psychological morbidity, and sexual health concerns. Therefore, interventions in POI/EM represent some of the most actionable opportunities to reduce long-term disability and promote healthy longevity. However, current approaches to hormone therapy (HT) in POI/EM remain fragmented, delayed, and overly influenced by paradigms derived from older postmenopausal populations. We propose a shift toward a life-course model of care. POI and EM should no longer be managed as variants of menopause at normal age but recognized as chronic endocrine conditions and sentinel events for accelerated aging in women. HT should be reframed as a hormonal replacement aimed at preventing long-term disability. Timely initiation, adequate dosing, and long-term continuation of HT should be considered foundational to POI/EM care, alongside integrated preventive strategies. FIGO and IMS, therefore, call for a globally coordinated effort to strengthen awareness, professional education, and research on POI/EM, and to ensure equitable access to multidisciplinary care, with the goal of improving women's health and supporting the long-term sustainability of healthcare systems.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":"29 4","pages":"487-506"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788845","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-03-19DOI: 10.1080/13697137.2026.2631502
Päivi Polo-Kantola, Mia Lindeberg, Angelica Lindén Hirschberg
{"title":"Transdermal estradiol spray in Nordic menopausal women: real-world patient outcomes.","authors":"Päivi Polo-Kantola, Mia Lindeberg, Angelica Lindén Hirschberg","doi":"10.1080/13697137.2026.2631502","DOIUrl":"10.1080/13697137.2026.2631502","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the impact of transdermal estrogen therapy on health-related quality of life (HRQoL) and treatment tolerability in postmenopausal women in a real-world setting.</p><p><strong>Method: </strong>A prospective, non-interventional study was conducted in Sweden and Finland. Participants used a spray delivering 1.53 mg of estradiol (E<sub>2</sub>) per 90 µl dose. HRQoL (measured using the Menopause Rating Scale [MRS]), dosing patterns and treatment satisfaction were assessed through web-based questionnaires at baseline, week 6 and week 12. Mixed-model repeated-measures analysis was performed.</p><p><strong>Results: </strong>Of 249 participants (mean age 52.1 years), 165 (66.3%) completed the 12-week follow-up. Most women (67.2%) used one or two sprays daily. The mean MRS total score was 17.8 at baseline, and decreased by 8.6 points at week 6 (<i>p</i> = 0.012) and 9.9 points by week 12 (<i>p</i> < 0.0001). Improvements were seen across all MRS domain scores (somatovegetative, psychological and urogenital), including hot flashes, sleep issues, depressive moods and sexual problems. Most participants reported satisfaction (78.8%), ease of use (95.2%) and willingness to recommend the spray to a friend (84.2%). No related adverse reactions were reported.</p><p><strong>Conclusion: </strong>The E<sub>2</sub> spray improved HRQoL and was well tolerated. Flexible dosing, ease of use and real-world effectiveness support that the spray is a practical, user-friendly treatment for menopausal symptoms.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"551-557"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484862","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-06-09DOI: 10.1080/13697137.2026.2661353
Dayi Jung, Jung Yoon Park, Kyong-Mee Chung, Mee-Ran Kim
{"title":"Redefining menopausal care: a randomized trial of group CBT for vasomotor symptoms in Korean women.","authors":"Dayi Jung, Jung Yoon Park, Kyong-Mee Chung, Mee-Ran Kim","doi":"10.1080/13697137.2026.2661353","DOIUrl":"10.1080/13697137.2026.2661353","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop and evaluate a culturally adapted, group-based eight-session cognitive behavioral therapy (CBT) program for perimenopausal/postmenopausal Korean women to reduce vasomotor symptoms (VMS) and improve psychological well-being and quality of life.</p><p><strong>Method: </strong>In a non-blinded, parallel-group randomized controlled trial, 50 postmenopausal women were randomly assigned to a group-based CBT intervention group or a wait-list control group. Assessments were conducted at baseline, post intervention and at 4-week follow-up. Primary outcomes were VMS frequency and distress assessed using the Hot Flush Rating Scale (HFRS) and daily interference measured by the Hot Flash Related Daily Interference Scale (HFRDIS). Secondary outcomes included menopause-specific quality of life assessed using the Menopause-Specific Quality of Life Questionnaire (MENQOL), anxiety and depressive symptoms measured by the Hospital Anxiety and Depression Scale, and sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI).</p><p><strong>Results: </strong>Compared with the control group, the CBT group showed significant improvements in VMS frequency, distress and daily interference. Quality of life improved across all MENQOL domains. Anxiety decreased significantly with sustained effects at follow-up. Depressive symptoms did not change significantly, and sleep improvements were not sustained.</p><p><strong>Conclusions: </strong>Group-based CBT effectively reduced VMS and improved quality of life and anxiety, supporting its use as a safe non-hormonal intervention for perimenopausal/postmenopausal Korean women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"631-641"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204374","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-03-10DOI: 10.1080/13697137.2026.2631512
Jeong-Hwa Seon, Ki-Ho Chung
{"title":"Oxidative balance score and periodontitis in postmenopausal women: a nationwide study.","authors":"Jeong-Hwa Seon, Ki-Ho Chung","doi":"10.1080/13697137.2026.2631512","DOIUrl":"10.1080/13697137.2026.2631512","url":null,"abstract":"<p><strong>Objective: </strong>Menopause is a time of declining reproductive function in women, and hormonal changes can affect oral health and chronic diseases such as periodontitis. The oxidative balance score (OBS) indicates oxidative balance using diet and lifestyle habits. This is the first study to investigate the relationship between the OBS and periodontitis in postmenopausal women.</p><p><strong>Method: </strong>The study included 16,489 participants from the Korea National Health and Nutrition Examination Survey (KNHANES). Modified Poisson regression was used to examine the effect of the OBS on periodontitis in postmenopausal women, adjusting for confounders.</p><p><strong>Results: </strong>The OBS was 17.66 ± 0.13 in the presence of periodontitis and 18.42 ± 0.10 in the absence of periodontitis. In the fully adjusted model, higher OBS quartiles were associated with a lower prevalence of periodontitis (Q2, prevalence ratio [PR] = 0.899; Q3, PR = 0.941; Q4, PR = 0.800). When divided into components, lifestyle OBS showed a significant inverse association with periodontitis (PR = 0.786, 95% confidence interval [CI]: 0.638-0.970), whereas dietary OBS did not (PR = 0.952, 95% CI: 0.804-1.127).</p><p><strong>Conclusion: </strong>In postmenopausal women, an increase in the OBS due to a healthy diet and lifestyle is associated with periodontal health. A low OBS may be considered a potential risk indicator for periodontitis.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"578-585"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431022","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 menopausal symptoms in women with and without type 2 diabetes mellitus: a cross-sectional study.","authors":"Orawin Vallibhakara, Nichar Sawatdichai, Sakda Arj-Ong Vallibhakara, Chutintorn Sriphrapradang, Makaramas Anantaburana","doi":"10.1080/13697137.2026.2631503","DOIUrl":"10.1080/13697137.2026.2631503","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the prevalence and severity of menopausal symptoms in women with and without type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Ramathibodi Hospital, Bangkok, Thailand, between April 2023 and April 2024. A total of 599 women aged 40-70 years were enrolled and categorized by T2DM status. Menopausal symptoms were assessed using the Menopause Rating Scale (MRS), sleep quality by the Pittsburgh Sleep Quality Index (PSQI) and genitourinary symptoms using a genitourinary syndrome of menopause (GSM) questionnaire.</p><p><strong>Results: </strong>Among the 599 participants, 81 women (13.5%) had T2DM. Compared with non-diabetic women, those with T2DM had significantly higher odds of sexual problems (odds ratio [OR] 3.17, <i>p</i> < 0.001), vaginal dryness (OR 1.82, <i>p</i> = 0.04) and sleep disturbances (OR 2.04, <i>p</i> = 0.009). T2DM was also associated with greater genitourinary symptom severity (MRS domain, <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>Women with T2DM reported more frequent and severe menopausal symptoms, especially in the genitourinary and sleep domains. These findings support the need for integrated, symptom-specific evaluation in menopausal care for women with T2DM.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"558-563"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430939","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-05-12DOI: 10.1080/13697137.2026.2627567
John A Groeger, Piril Hepsomali
{"title":"Sleep problems persist in middle-aged women and influence changes in health but are moderated by menopause and its treatment.","authors":"John A Groeger, Piril Hepsomali","doi":"10.1080/13697137.2026.2627567","DOIUrl":"10.1080/13697137.2026.2627567","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the self-reported sleep problems of middle-aged women who had not menstruated for more than a year (postmenopause), those who have menstruated within the last year (premenopausal/perimenopausal) and those who could not have menstruated for medical reasons (e.g. hysterectomy).</p><p><strong>Method: </strong>The UK Biobank dataset was utilized to conduct cross-sectional (approximately <i>N</i> = 200,000) and longitudinal (approximately <i>N</i> = 20,000) analyses, drawing on responses from baseline and follow-up self-reported questionnaires.</p><p><strong>Results: </strong>Cross-sectionally, self-reported sleep duration (<i>p</i> < 0.001) and a composite measure of sleep problems (problematic sleep index) (<i>p</i> < 0.001) showed consistent differences across these 'menopausal' groups. Longitudinally, sleep duration and sleep problems increased with age (both <i>p</i> < 0.001), length of time within the study (i.e. aging) (<i>p</i> < 0.001), perceived overall health (<i>p</i> < 0.001) and health change (<i>p</i> < 0.001). Menopause exacerbated these effects; however, the decline in sleep quality was mitigated by hormone replacement therapy (<i>p</i> < 0.05), particularly among women in premenopausal/perimenopausal stage and those in whom menopause was well established (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>While not supported by objective measures of sleep, health or hormones, these results add substantially to the literature on women's sleep, health and menopause, highlighting the potential benefits of early, tailored interventions and timely hormone replacement therapy use for improving sleep and well-being in midlife.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"533-543"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873707","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-07-15DOI: 10.1080/13697137.2026.2689718
Belma Gözde Özdemir, Çetin Çelik
{"title":"Menopause and epigenetic changes: a review.","authors":"Belma Gözde Özdemir, Çetin Çelik","doi":"10.1080/13697137.2026.2689718","DOIUrl":"10.1080/13697137.2026.2689718","url":null,"abstract":"<p><p>Menopause is the biological process that occurs with the end of the menstrual cycle, not only involving hormonal changes but also leading to significant epigenetic transformations at the genomic level. Alterations in estrogen, progesterone and androgen levels positively or negatively influence epigenetic mechanisms such as DNA methylation, histone modifications, genome methylation and microRNA expression. These changes can alter the aging process by altering cell gene expression, and immunosenescence can increase susceptibility to osteoporosis, cardiovascular disease and some cancers. Furthermore, altering epigenetic mechanisms through environmental factors (such as nutrition, exercise and stress management) and lifestyle offers promising strategies for maintaining health during menopause and reducing the risk of chronic disease. Menopause-associated epigenetic alterations are not only linked to accelerated biological aging but also play a critical role in the pathogenesis of major chronic diseases, including cardiovascular disease, osteoporosis and hormone-related cancers. These epigenetic changes, particularly DNA methylation patterns and microRNA profiles, have emerged as promising biomarkers for early detection and risk stratification, as well as potential targets for personalized therapeutic interventions. This review aims to review the literature on epigenetic changes associated with menopause.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"527-532"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444758","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-06-08DOI: 10.1080/13697137.2026.2675562
Yuru Wang, Xiaoling Miao, Mellissa Withers, Martin Chi Sang Wong, Pramon Viwattanakulvanid
{"title":"Early menopause and cardiovascular disease risk: triangulating the evidence with a combined analysis.","authors":"Yuru Wang, Xiaoling Miao, Mellissa Withers, Martin Chi Sang Wong, Pramon Viwattanakulvanid","doi":"10.1080/13697137.2026.2675562","DOIUrl":"10.1080/13697137.2026.2675562","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between early menopause and the risk of cardiovascular disease (CVD) is understudied in Asian women. This study aimed to investigate this association and its potential causality among East Asian women.</p><p><strong>Method: </strong>A seven-year observational study involving 1929 postmenopausal women from the China Health and Retirement Longitudinal Study was combined with two-sample Mendelian randomization (MR) analyses utilizing genetic data from the China Kadoorie Biobank and Biobank Japan. Time-varying Cox proportional hazards models were employed for observational analysis. For MR analyses, the inverse variance-weighted method was used as the primary approach to investigate potential causality between genetically proxied age at natural menopause and CVD.</p><p><strong>Results: </strong>In the multivariable-adjusted Cox regression model, early menopause was significantly associated with an increased CVD risk (hazard ratio 1.43, 95% confidence interval 1.05-1.97). However, MR analyses did not yield significant associations. Additionally, a dose-response relationship was observed between menopausal age and incident CVD risk (<i>p</i>-value for non-linearity = 0.022).</p><p><strong>Conclusions: </strong>Early menopause was associated with a higher risk of incident CVD in the observational study, while MR findings suggested this association may not be causal. This study unravels the importance of early menopause in CVD risk assessment and informs CVD primary prevention for Asian women.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"608-619"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197541","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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-03-16DOI: 10.1080/13697137.2026.2631509
Sara L Stockman, Caroline M Ayinon, Baraa Nawash, Nikita Desai, Lauren B Siegel, Soukaina Eljamri, Pouneh K Fazeli
{"title":"Age and diagnostic assessment of natural menopause in low-weight women.","authors":"Sara L Stockman, Caroline M Ayinon, Baraa Nawash, Nikita Desai, Lauren B Siegel, Soukaina Eljamri, Pouneh K Fazeli","doi":"10.1080/13697137.2026.2631509","DOIUrl":"10.1080/13697137.2026.2631509","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine the age of natural menopause in low-weight women and assess how often laboratory evaluation confirms menopausal status.</p><p><strong>Method: </strong>A retrospective study was conducted of 3000 women aged >50 years with a history of body mass index (BMI) <18.5 kg/m<sup>2</sup> seen at a large academic health system between 2004 and 2020. Women with indeterminate menopausal age, BMI ≥18.5 kg/m<sup>2</sup> at menopause or known causes of early menopause were excluded. Clinical data including menopausal age, BMI, reproductive history and laboratory tests were extracted. Associations between BMI and menopausal age were analyzed using unadjusted and multivariable analyses controlling for tobacco use and age at menarche.</p><p><strong>Results: </strong>Among 239 women included, menopausal age correlated with BMI (<i>ρ</i> = 0.13, <i>p</i> = 0.04) and remained significant in multivariate regression (<i>p</i> = 0.02). Median menopausal age was 51 years for BMI 18.0 to <18.5 kg/m<sup>2</sup>, 50 years for BMI 17.0 to <18.0 kg/m<sup>2</sup>, 50 years for BMI 16.0 to <17.0 kg/m<sup>2</sup> and 48 years for BMI <16.0 kg/m<sup>2</sup>. Only 30 women (12.6%) had postmenopausal follicle stimulating hormone (FSH) measured; 30% were below the diagnostic threshold for menopause (<25 mIU/ml).</p><p><strong>Conclusion: </strong>Low BMI is associated with earlier menopause. The substantial proportion of low-weight women classified as menopausal who had non-diagnostic FSH levels highlights the complexity of determining menopausal status and the potential for misclassification in this population.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"564-570"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467201","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}