{"title":"Perimenopause and metabolic vulnerability: hormones, body composition and lifestyle changes.","authors":"Vanessa Alves Lobato, Tatiana Palotta Minari, Luciana Pellegrini Pisani","doi":"10.1080/13697137.2026.2713394","DOIUrl":"https://doi.org/10.1080/13697137.2026.2713394","url":null,"abstract":"<p><p>Perimenopause is a transitional phase characterized by substantial hormonal fluctuations, particularly declining estradiol levels, accompanied by age-related metabolic changes. Increasing evidence suggests that this period constitutes a critical window of metabolic vulnerability, marked by adverse alterations in body composition, energy metabolism and cardiometabolic health. Notably, these changes may develop even without significant increases in body weight, potentially delaying their recognition in clinical settings. A narrative review was conducted using the PubMed/MEDLINE, Scopus, Web of Science and SciELO databases. Studies involving perimenopausal women, plus relevant animal models, were included. Search terms covered estrogen deficiency, body composition, metabolism, insulin resistance, inflammation, physical activity and nutrition. Fifty-six studies published between 2000 and 2026 were analyzed. Evidence shows that perimenopause is characterized by increased visceral fat, loss of lean mass, reduced fat oxidation and impaired metabolic flexibility, even without major weight changes. Declining estrogen drives adipose redistribution, muscle dysfunction, hepatic insulin resistance and chronic low-grade inflammation. These changes heighten risk for metabolic syndrome, type 2 diabetes and cardiovascular events. Lifestyle interventions, particularly resistance training and Mediterranean diet adherence, demonstrate strong potential to preserve muscle, improve insulin sensitivity and reduce inflammation. In conclusion, perimenopause should be recognized as a pivotal stage for early detection and prevention of metabolic dysfunction. Lifestyle-based interventions during this phase may reduce long-term cardiometabolic risk and improve women's health.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-16"},"PeriodicalIF":3.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808230","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 : 2026-08-24DOI: 10.1080/13697137.2026.2713393
Mathilde Elisabeth Steen Valland, Sine Jacobsen, Caspar Bundgaard-Nielsen, Pinar Bor
{"title":"Vaginal and urinary microbiomes in postmenopausal women and breast cancer survivors and their associations with genitourinary syndrome of menopause: a scoping review.","authors":"Mathilde Elisabeth Steen Valland, Sine Jacobsen, Caspar Bundgaard-Nielsen, Pinar Bor","doi":"10.1080/13697137.2026.2713393","DOIUrl":"https://doi.org/10.1080/13697137.2026.2713393","url":null,"abstract":"<p><p>Genitourinary syndrome of menopause (GSM) is common among postmenopausal women and breast cancer survivors, particularly those receiving antiestrogen therapy. However, the role of the urinary and vaginal microbiomes in GSM remains underexplored. This study aimed to evaluate urinary and vaginal microbiome differences and their association with GSM in postmenopausal women and breast cancer survivors. A scoping review (PubMed, Embase; May 2025) identified 877 studies addressing the vaginal or urinary microbiome in postmenopausal women and 242 studies in breast cancer survivors. After screening and eligibility assessment, 18 studies involving postmenopausal women and three studies involving breast cancer survivors were included. Across 21 included studies (<i>n</i> = 30-1320 participants), <i>Lactobacillus</i> depletion and anaerobic overgrowth (e.g. <i>Gardnerella</i>, <i>Prevotella</i>, <i>Sneathia</i>) were associated with GSM. Postmenopausal women with low-<i>Lactobacillus</i> community state types (CSTs) had up to 25.9-fold higher odds of GSM. In breast cancer survivors, <i>Lactobacillus</i> was nearly absent (5% of samples), with increased <i>Gardnerella</i> and <i>Sneathia</i> in symptomatic women. Associations between <i>Lactobacillus</i> relative abundance and symptom severity were inconsistent. In conclusion, GSM appears to be associated with microbial dysbiosis characterized by anaerobic overgrowth, rather than <i>Lactobacillus</i> depletion alone. Estrogen suppression in breast cancer survivors may exacerbate dysbiosis and symptoms, highlighting the need for microbiome-targeted treatments.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-9"},"PeriodicalIF":3.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808275","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 : 2026-08-24DOI: 10.1080/13697137.2026.2715963
A J Vincent, L Yeganeh, A Fenton, H Hamoda, N Panay
{"title":"Women's and health professionals' needs and preferences informing the updated IMS recommendations.","authors":"A J Vincent, L Yeganeh, A Fenton, H Hamoda, N Panay","doi":"10.1080/13697137.2026.2715963","DOIUrl":"https://doi.org/10.1080/13697137.2026.2715963","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify and compare the priorities for content and accompanying resources of midlife women (MW) and health professionals (HPs) to inform the updated International Menopause Society (IMS) recommendations.</p><p><strong>Method: </strong>Two online multi-language surveys with a range of response options were disseminated internationally to MW aged 45-65 years and HPs, respectively. Data analysis used descriptive statistics, chi-square and Leximancer thematic analysis of free text responses.</p><p><strong>Results: </strong>Approximately 50% of respondents were European and 50% from the rest of the world. Among MW (<i>n</i> = 756), 44.8% were postmenopausal, 85% reported menopausal symptoms and 82% had consulted a HP regarding menopause. Among HPs (<i>n</i> = 500), most were gynecologists (49.2%), and 286/499 were aware of and 246/279 used the 2016 IMS recommendations. Although >70% respondents perceived that most 2016 topics be retained, similarities and differences between the priorities of HPs and MW were identified. HPs prioritized premature ovarian insufficiency, breast cancer and non-pharmacological/lifestyle interventions; MW emphasized midlife body changes, skin, heart/brain health, quality of life, novel therapies and media/pharma influences. There were significant differences in the accompanying resources preferred by MW and HPs.</p><p><strong>Conclusion: </strong>This study highlights the different priorities and resource needs of MW and HPs. These findings informed the updated IMS recommendations to better address stakeholder needs.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-6"},"PeriodicalIF":3.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808284","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 : 2026-08-18DOI: 10.1080/13697137.2026.2709302
Rossella E Nappi, Malgorzata Binkowska, Herman Depypere, Claudia Mehenditu, Petra Stute, Renata Zablotna-Pociupany, John C Stevenson
{"title":"Literature review of estradiol/dydrogesterone in perimenopausal and postmenopausal women.","authors":"Rossella E Nappi, Malgorzata Binkowska, Herman Depypere, Claudia Mehenditu, Petra Stute, Renata Zablotna-Pociupany, John C Stevenson","doi":"10.1080/13697137.2026.2709302","DOIUrl":"https://doi.org/10.1080/13697137.2026.2709302","url":null,"abstract":"<p><p>Menopausal hormone therapy (MHT) with 17β-estradiol/dydrogesterone (E/D) or Femoston<sup>®</sup> at a range of doses has been shown to provide effective relief from climacteric symptoms and prevention of osteoporosis in postmenopausal women. However, less is known about personalizing MHT for women who require lower doses, or those with obesity or overweight. A literature search was conducted using PubMed to evaluate the safety and efficacy of E/D in perimenopausal and postmenopausal women, with a focus on women with high body mass index (BMI). The results confirmed that ultra-low and standard doses of E/D provide effective relief from symptoms of estrogen depletion, high rates of amenorrhea and fracture risk reduction, without any new safety concerns. In women with high BMI, E/D was shown to provide effective symptom relief, with no significant differences in adverse event frequency according to BMI subgroups. Safety data suggested that dydrogesterone may confer advantages in terms of venous thromboembolism and breast cancer risk as compared with other progestogens. The findings of this literature review shed light on options for optimizing MHT treatment and doses for perimenopausal and postmenopausal women. Further research is warranted to confirm findings in women with high BMI.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-11"},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788914","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 : 2026-08-11DOI: 10.1080/13697137.2026.2707847
Dypti Lulla, Seng Bin Ang, Shirley L L Kwok, Jean-Jasmin M L Lee, Rukshini Puvanendran
{"title":"Cross-sectional survey of perimenopausal women for menopause symptoms and attitudes in Singapore.","authors":"Dypti Lulla, Seng Bin Ang, Shirley L L Kwok, Jean-Jasmin M L Lee, Rukshini Puvanendran","doi":"10.1080/13697137.2026.2707847","DOIUrl":"https://doi.org/10.1080/13697137.2026.2707847","url":null,"abstract":"<p><strong>Objective: </strong>Menopause symptoms and experiences vary considerably between women and can be influenced by multiple biopsychosocial and cultural factors, age and ethnicity. This study investigated the symptoms and attitudes of perimenopausal women in Singapore.</p><p><strong>Method: </strong>Women aged 40-60 years attending women's health talks and forums in Singapore completed an anonymized, voluntary online questionnaire in English. The study collected demographic information, and assessed menopause status and attitudes toward menopause and hormone therapy. Participants reporting menopause symptoms completed the Menopause Rating Scale (MRS) questionnaire.</p><p><strong>Results: </strong>A total of 147 perimenopausal women reported at least one moderate to very severe symptom of menopause. The most common menopause symptoms reported were joint and muscular discomfort (44.2%), followed by sleep problems (43.5%) and physical and mental exhaustion (39.5%). Common terms for attitudes toward menopause included natural (51.3%), old age (45.0%), and threatening, dreading, causing symptoms and health problems (40.0%).</p><p><strong>Conclusion: </strong>This study sheds light on common symptoms of perimenopausal women and their attitudes toward menopause and hormone therapy.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-7"},"PeriodicalIF":3.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705554","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":"Reproductive, lifestyle, socioeconomic and anthropometric correlates of early menopause.","authors":"Keiko Yamanouchi, Tsuyoshi Ohta, Tsuneo Konta, Risako Yamaguchi, Midori Saito, Fumihiro Nakamura, Shouta Horikawa, Kazuyoshi Sakai, Norikazu Watanabe, Manabu Seino, Satoru Nagase","doi":"10.1080/13697137.2026.2707856","DOIUrl":"https://doi.org/10.1080/13697137.2026.2707856","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify lifestyle, reproductive and socioeconomic correlates of early menopause (age <45 years) in a cross-sectional analysis of a population-based cohort of Japanese women.</p><p><strong>Method: </strong>The study analyzed data from 6313 naturally menopausal women in the Yamagata Cohort Study (2009-2015). Women were classified as having early menopause (age <45 years; <i>n</i> = 239) or menopause at age 45-54 years (<i>n</i> = 6074). Data included age at menarche, menstrual pattern at age 20 years, educational attainment, marital status, parity, breastfeeding, smoking and body mass index (BMI). Multivariable logistic regression estimated odds ratios (ORs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Lower educational attainment (OR 1.84, 95% CI 1.32-2.57) and never-married status (OR 2.52, 95% CI 1.24-5.11) were associated with early menopause. Low BMI was associated with early menopause in univariate analysis but not after multivariable adjustment. An interaction was observed between menstrual pattern at age 20 years and BMI: among women with menstrual irregularity, obesity (BMI ≥25 kg/m<sup>2</sup>) was associated with higher odds of early menopause (OR 3.49, 95% CI 1.91-6.37).</p><p><strong>Conclusion: </strong>In this cross-sectional analysis of a population-based cohort of Japanese women, lower educational attainment and never-married status were associated with early menopause. Women with menstrual irregularity and obesity may be at increased risk of early menopause.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-6"},"PeriodicalIF":3.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148705656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Menopausal hormone use after hysterectomy in endometriosis: a Finnish register-based study.","authors":"Milla Sipilä, Liisu Saavalainen, Juuso Saavalainen, Oskari Heikinheimo","doi":"10.1080/13697137.2026.2639979","DOIUrl":"10.1080/13697137.2026.2639979","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the frequency and type of menopausal hormone therapy (MHT) use after hysterectomy among women with surgically diagnosed endometriosis.</p><p><strong>Method: </strong>A retrospective register-based cohort study identified women with a first surgical diagnosis of endometriosis and a reference cohort using Finnish national registries. This study included women aged ≤45 years with hysterectomy and bilateral oophorectomy, and women >45 years with hysterectomy performed between 1996 and 2018. Women with a history of thrombosis, breast cancer or gynecological cancer were excluded. MHT use was identified from national reimbursement registry until the end of 2019.</p><p><strong>Results: </strong>Altogether 11,365 women were included: 1748 women aged ≤45 years and 9617 aged >45 years. Among women with endometriosis, 94.3% (aged ≤45 years) and 73.1% (aged >45 years) used MHT postoperatively, compared with 81.8% and 51.5% in the reference cohort (<i>p</i> < 0.001). Estrogen-only therapy was the most commonly used MHT, but the use of combined estrogen-progestin therapy increased significantly (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>MHT use was very common in women with endometriosis. The shift toward combined therapy reflects evolving international guidance. The high rate of MHT use underscores the need for studies assessing its long-term outcomes in women with endometriosis.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"571-577"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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}