Climacteric最新文献

{"title":"Hyperandrogenism after menopause: diagnostic evaluation.","authors":"Carolina Fux-Otta, Diana Torre, Peter Chedraui, Belén Melgarejo, Noelia Ramos, Mariana Di Carlo, Mariana Benzi, Victoria Banús, María Eugenia Estario, Susana Leiderman, Romina Gecchelin, Inés Bartolacci, Milena Tarletta, Cintya Ziperovich, Silvina Di Lella, Candelaria Aramayo, Lucila Martín, Celina Pereyra, Constanza Real, Patricia Dogliani, Mónica Ñañez, Mónica López, Gabriel Iraci, Gladys Fernández","doi":"10.1080/13697137.2024.2423874","DOIUrl":"10.1080/13697137.2024.2423874","url":null,"abstract":"<p><p>Excessive androgen levels in women after menopause often result from an imbalance in ovarian steroid secretion: a rapid decline in estrogen secretion associated with a slow decrease in androgen secretion, compounded by a physiological decrease in sex hormone-binding globulin. Hyperandrogenism is associated with a higher risk of cardiovascular events and gynecological neoplasms, also impacting the emotional well-being of affected women. Therefore, the aim of these guidelines is to guide the clinical physician in the appropriate clinical and biochemical evaluation of hyperandrogenism after menopause, thus optimizing therapeutic outcomes. The most frequent consultation in this stage of life is facial hirsutism associated with hair loss. If the onset of signs is abrupt, severe, associated with virilization and accompanied by serum testosterone levels in the male range, it is necessary to rule out a tumoral origin. A thorough medical history guides the diagnosis. Determination of total testosterone using reliable methods and imaging studies are valid tools to assist when doubts arise in the differential diagnosis.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"61-68"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615994","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":"Effects of a therapeutic lifestyle modification intervention on health-related quality of life and sexual functioning and cardiometabolic health in perimenopausal Chinese women: a randomized controlled trial.","authors":"Yuru Wang, Xiaoling Miao, Pramon Viwattanakulvanid","doi":"10.1080/13697137.2024.2435879","DOIUrl":"10.1080/13697137.2024.2435879","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effects of a therapeutic lifestyle modification (TLM) intervention on health-related quality of life, sexual functioning and cardiometabolic health in perimenopausal Chinese women.</p><p><strong>Method: </strong>The study was a randomized controlled trial (registration number: ChiCTR2300070648). Ninety-four perimenopausal women aged between 40 and 55 years were randomly assigned in a 1:1 ratio to receive the TLM intervention or usual care for 12 weeks. Menopause-specific Quality of Life (MENQOL), Female Sexual Function Index (FSFI), pelvic floor muscle strength (PFMS) and composite cardiometabolic indicators were evaluated at baseline and post intervention.</p><p><strong>Results: </strong>After 12 weeks, linear mixed-effects models showed that the TLM intervention led to a statistically significant improvement in MENQOL (-0.60, 95% confidence interval [CI] - 0.80 to -0.41), FSFI (3.82, 95% CI 2.03 to 5.61), resting heart rate (-5.44, 95% CI -10.40 to -0.48), waist circumference(-3.14, 95% CI -4.15 to -2.13) and body fat percentage (-4.25, 95% CI -6.92 to -1.58) compared to the control group. There were also statistically significant differences between the intervention (TLM) group and the control group in the proportions of PFMS (<i>p</i> = 0.006).</p><p><strong>Conclusion: </strong>The TLM intervention effectively improved menopause-specific quality of life in midlife women, supported by enhancements in female sexual functioning and cardiometabolic health status.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"28-39"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821982","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":"Systemic hormone therapy after breast and gynecological cancers: an Italian expert group consensus opinion.","authors":"Angelo Cagnacci, Paola Villa, Giuseppina Paola Grassi, Nicoletta Biglia, Marco Gambacciani, Costantino Di Carlo, Francesca Nocera, Salvatore Caruso, Angelamaria Becorpi, Stefano Lello, Anna Maria Paoletti","doi":"10.1080/13697137.2024.2418503","DOIUrl":"10.1080/13697137.2024.2418503","url":null,"abstract":"<p><p>The specific Italian Group of Study of the Menopause formulated a consensus opinion on the use of estrogen therapy (ET) or combined estro-progestin hormone therapy (HT) after breast and gynecological cancers. This consensus is based on the risk of recurrence of the specific cancer during ET/HT, the presence of steroid receptors in cancer cells, the use of adjuvant hormone therapies and data on the use of ET/HT after cancer. The following positions were reached. ET/HT can be used after vulvar cancers and melanoma, but with great caution after the rare adenocarcinomas. ET/HT can be used after cervical cancer, but ET should be used with caution after adenocarcinomas. ET/HT can be used after International Federation of Obstetrics and Gynecology (FIGO) stage I-II estrogen-dependent endometrial cancers, except in Black women, and can probably be used after estrogen-independent endometrial cancers. ET/HT cannot be administered or should be used with great caution after most uterine sarcomas. ET/HT can probably be used after ovarian neoplasms except for granulosa cell tumors, and with great caution after low-grade serous ovarian carcinoma and serous borderline ovarian tumors. ET/HT can be used with great caution in women after estrogen receptor (ER)/progesterone receptor (PR)-positive breast cancer and is probably allowed after ER/PR-negative breast cancer.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"4-14"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582142","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":"Low-dose and ultra-low-dose estradiol and dydrogesterone in postmenopause: an analysis by body mass index.","authors":"Mulan Ren, Qi Yu, Marcelo Graziano Custodio, Tommaso Simoncini, Rossella E Nappi, Tetiana Tatarchuk, Elke Kahler, Tony Piha, John C Stevenson","doi":"10.1080/13697137.2024.2418497","DOIUrl":"10.1080/13697137.2024.2418497","url":null,"abstract":"<p><strong>Objective: </strong>Oral, low-dose and ultra-low-dose continuous combined 17β-estradiol (E) plus dydrogesterone (D) reduce vasomotor symptoms (VMS) in postmenopausal women.</p><p><strong>Methods: </strong>Two phase 3, double-blind studies were included. In the European study, postmenopausal women were randomized 2:1:2 to receive E0.5 mg/D2.5 mg (ultra-low dose), E1 mg/D5 mg (low dose) or placebo for 13 weeks. In the Chinese study, women were randomized 1:1 to receive E0.5 mg/D2.5 mg or placebo for 12 weeks. Post-hoc endpoints assessed in body mass index (BMI) subgroups (<25 kg/m²; ≥25 kg/m²) included number of hot flushes and moderate-to-severe hot flushes per day, and the proportion of women with amenorrhea.</p><p><strong>Results: </strong>A total of 640 women were included. At the end of treatment, the mean (95% confidence interval) numbers of daily hot flushes were significantly lower (<i>p</i> ≤ 0.05) for all treatment groups versus placebo, with E0.5 mg/D2.5 mg (BMI < 25 kg/m²: 2.5 [1.9, 3.1]; BMI ≥ 25 kg/m²: 3.2 [2.5, 3.8]) and E1 mg/D5 mg versus placebo (BMI < 25 kg/m²: 2.7 [1.2, 4.2]; BMI ≥ 25 kg/m²: 2.3 [1.1, 3.5]) than with placebo (BMI < 25 kg/m²: 4.4 [3.8, 50]; BMI ≥ 25 kg/m²: 4.2 [3.6, 4.9]). A similar pattern was seen for moderate-to-severe hot flushes. The amenorrhea rate was high (79-98%) across both studies and BMI subgroups.</p><p><strong>Conclusion: </strong>Oral, ultra-low-dose continuous combined E0.5 mg/D2.5 mg and low-dose continuous combined E1 mg/D5 mg alleviated postmenopausal VMS compared with placebo, irrespective of BMI.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"21-27"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544081","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":"Investigating the triglyceride-glucose index in postmenopausal osteoporosis.","authors":"Busra Korpe, Caner Kose, Sumeyye Mermi, Samet Kutluay Ergorun, Huseyin Levent Keskin","doi":"10.1080/13697137.2024.2429430","DOIUrl":"10.1080/13697137.2024.2429430","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study aims to assess the association of the triglyceride-glucose index (TyG index) with postmenopausal osteoporosis and investigate longitudinal changes in TyG index levels in relation to osteoporosis risk.</p><p><strong>Methods: </strong>Out of 704 women, after excluding those with osteopenia, a total of 517 patients who met the inclusion criteria were included. Participants were categorized based on <i>T</i>-scores derived from lumbar spine dual-energy X-ray absorptiometry scans. Demographic data, biochemical parameters and TyG index levels were analyzed. Logistic regression, correlation analysis and receiver operating characteristic (ROC) curve analysis were employed for statistical evaluation.</p><p><strong>Results: </strong>The osteoporosis group (<i>n</i> = 254) exhibited significantly higher TyG index and triglyceride levels compared to controls (<i>n</i> = 263). Longitudinal analysis revealed significant increases in TyG index levels among women developing osteoporosis over time. ROC analysis demonstrated the TyG index's accuracy for osteoporosis (first TyG area under the curve [AUC]: 0.767, second TyG AUC: 0.818, <i>p</i> < 0.001). Regression analyses identified the TyG index as a significant factor associated with osteoporosis (odds ratio: 39.468, 95% confidence interval: 12.884-120.903, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The TyG index emerges as a valuable indicator for postmenopausal osteoporosis. These results emphasize the need for integrating metabolic health indicators into osteoporosis management strategies, warranting further research into targeted interventions.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"81-86"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784320","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":"Not just sex: other roles for testosterone in women.","authors":"Susan R Davis","doi":"10.1080/13697137.2024.2445301","DOIUrl":"10.1080/13697137.2024.2445301","url":null,"abstract":"<p><p>Testosterone is unquestionably a normal female hormone that exerts important physiological effects in multiple tissues. Clinical trials have consistently demonstrated benefits of testosterone therapy on several domains of sexual function for postmenopausal women with low sexual desire causing substantial personal concern. Whether other benefits can be attributed to testosterone therapy for postmenopausal women remains uncertain. This article summarizes the available data for the use of testosterone therapy beyond the treatment of low sexual desire with distress. The article is not a systematic review of the entire published literature in the field. Rather, it includes recent systematic reviews and meta-analyses the author highlighted in their plenary lecture at the 2024 World Congress on the Menopause. The aim was to provide an overview of the published data for clinicians and researchers in this field.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"1-4"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000946","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":"Evidence-based guideline: premature ovarian insufficiency^†^‡.","authors":"Nick Panay, Richard A Anderson, Amy Bennie, Marcelle Cedars, Melanie Davies, Carolyn Ee, Claus H Gravholt, Sophia Kalantaridou, Amanda Kallen, Kimberly Q Kim, Micheline Misrahi, Aya Mousa, Rossella E Nappi, Walter A Rocca, Xiangyan Ruan, Helena Teede, Nathalie Vermeulen, Elinor Vogt, Amanda J Vincent","doi":"10.1080/13697137.2024.2423213","DOIUrl":"10.1080/13697137.2024.2423213","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study question: &lt;/strong&gt;How should premature/primary ovarian insufficiency (POI) be diagnosed and managed, based on the best available evidence from published literature?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary answer: &lt;/strong&gt;The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;What is known already: &lt;/strong&gt;POI presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life, on fertility and on bone, cardiovascular and cognitive health. Although hormone therapy (HT) can mitigate some of these effects, many questions still remain regarding the optimal management of POI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, size, duration: &lt;/strong&gt;The guideline was developed according to the structured methodology for development of European Society of Human Reproduction and Embryology (ESHRE) guidelines. Key questions were determined by a group of experts and informed by a scoping survey of women and healthcare professionals. Literature searches and assessment were then performed. Papers published up to 30 January 2024 and written in English were included in the guideline. An integrity review was conducted for the randomized controlled trials on POI included in the guideline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants/materials, setting, methods: &lt;/strong&gt;Based on the collected evidence, recommendations were formulated and discussed within the guideline development group until consensus was reached. Women with lived experience of POI informed the recommendations in general, and particularly those on provision of care. A stakeholder review was organized after finalization of the draft. The final version was approved by the guideline development group and the ESHRE Executive Committee.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main results and the role of chance: &lt;/strong&gt;New data indicate a higher prevalence of POI, 3.5%, than was previously thought. This guideline aims to help healthcare professionals apply best practice care for women with POI. The recent update of the POI guideline covers 40 clinical questions on diagnosis of the condition, the different sequelae, including bone, cardiovascular, neurological and sexual function, fertility and general well-being, and treatment options, including HT. The list of clinical questions was expanded from the previous iteration of the guideline (2015) based on the scoping survey and appreciation of emerging knowledge of POI. Questions were added on the role of anti-Müllerian hormone (AMH) in the diagnosis of POI, fertility preservation, muscle health and specific considerations for HT in iatrogenic POI. Additionally, the topic on complementary treatments was extended with specific focus on non-hormonal treatments and lifestyle management options. Significant changes from the previous 2015 guideline include the recommendations that only one elevated follicle stimulating hormone","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"510-520"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794310","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":"Physician-patient alignment on menopause-associated symptom burden: real-world evidence from the USA and Europe.","authors":"Sheryl Kingsberg, Rossella E Nappi, Megan Scott, Nils Schoof, Carsten Moeller, Lauren Lee, Cecile Janssenswillen, Cecilia Caetano, Victoria Banks","doi":"10.1080/13697137.2024.2401366","DOIUrl":"10.1080/13697137.2024.2401366","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate physician-patient alignment on menopausal symptom burden and impact for women experiencing natural vasomotor symptoms (nVMS) or VMS induced by endocrine therapy for breast cancer (iVMS).</p><p><strong>Methods: </strong>For this real-world, cross-sectional survey, physicians from the USA and five European countries provided data for consulting patients experiencing nVMS/iVMS; patients optionally self-reported their experiences. Alignment between physician and patient responses was assessed using weighted Cohen's <i>κ</i> analysis.</p><p><strong>Results: </strong>Physicians and patients completed 1029 pairs of surveys (846 nVMS; 183 iVMS). In 28.1% of cases for nVMS and 29.6% for iVMS, patients reported more severe vasomotor symptoms (VMS) than physicians; alignment of responses was slight (nVMS, <i>κ</i> = 0.1364, <i>p</i> ≤ 0.0001; iVMS, <i>κ</i> = 0.1014, <i>p</i> = 0.039). For the non-VMS symptoms surveyed, 18.5-34.9% of patients with nVMS and iVMS reported symptoms without a corresponding physician report; sleep disturbances, cognitive difficulties and mood changes were among the symptoms most under-reported by physicians. Alignment regarding the impact of nVMS and iVMS on sleep, mood and overall quality of life was moderate.</p><p><strong>Conclusions: </strong>Only slight to moderate physician-patient alignment was found across all areas surveyed. These findings suggest that physicians often underestimate the severity of VMS and the presence of other menopausal symptoms, highlighting a need to improve physician-patient communication.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"534-541"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459425","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":"Is it possible that menopause is associated with telomere length? Findings of an integrative review.","authors":"M M S Bem, C M S Paraizo-Horvath, P S Freitas, T R P Brito","doi":"10.1080/13697137.2024.2376193","DOIUrl":"10.1080/13697137.2024.2376193","url":null,"abstract":"<p><strong>Objective: </strong>Knowing the important repercussions of menopause for women's health and that female longevity can be better understood through studies based on aging biomarkers, studies on the relationship between menopause and telomere shortening may help to better understand this stage of life. This study aimed to analyze what research has been produced regarding the relationship between menopause and telomere length.</p><p><strong>Methods: </strong>This integrative literature review included searches in PubMed, CINAHL, LILACS, Web of Science and Scopus databases. Four studies were selected for the final sample.</p><p><strong>Results: </strong>The findings of these studies indicate that older age for menopause and longer reproductive life (difference between age at menopause and menarche) are associated with longer telomeres, that is, with longevity.</p><p><strong>Conclusion: </strong>The relationship between menopause and telomere length is uncertain. The small number of studies included in this review, and the fact that the results indicate that the relationship between menopause and telomere length may be dependent on the stage of the menopause and race/ethnicity, suggest that additional research focusing on these variables should be carried out.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"521-525"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632821","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":"Heartwired for change: advancing women's cardiovascular health.","authors":"Alina Yang","doi":"10.1080/13697137.2024.2413499","DOIUrl":"10.1080/13697137.2024.2413499","url":null,"abstract":"","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"568-569"},"PeriodicalIF":2.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459424","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}