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: 2026-03-10DOI: 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: 2026-03-16DOI: 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}
ClimactericPub Date : 2026-08-01Epub Date: 2026-06-24DOI: 10.1080/13697137.2026.2671751
Lorenzo Vacca, Michele Pierro, Aniello Foresta, Daniela Caramazza, Andrea Lombisani, Alfredo Ercoli, Giuseppe Campagna
{"title":"From tissue to outcome - how perioperative vaginal estrogen transforms prolapse surgery results: a systematic review and meta-analysis of clinical evidence and outcomes.","authors":"Lorenzo Vacca, Michele Pierro, Aniello Foresta, Daniela Caramazza, Andrea Lombisani, Alfredo Ercoli, Giuseppe Campagna","doi":"10.1080/13697137.2026.2671751","DOIUrl":"10.1080/13697137.2026.2671751","url":null,"abstract":"<p><p>Pelvic organ prolapse affects millions of postmenopausal women worldwide, frequently requiring surgical intervention when conservative treatments fail. This systematic review and meta-analysis evaluated the effectiveness and safety of perioperative vaginal estrogen therapy in postmenopausal women undergoing prolapse surgery. Nine randomized controlled trials including 764 women (383 estrogen, 381 controls) were analyzed through December 2024. Meta-analyses demonstrated significant tissue quality improvement (standardized mean difference 0.73, 95% confidence interval [CI] 0.16-1.30, <i>p</i> = 0.012) with substantial heterogeneity (<i>I</i><sup>2</sup> = 86.7%). However, urinary tract infection effects were inconclusive and contradictory (risk ratio [RR] 0.75, 95% CI 0.27-2.04, <i>p</i> = 0.570, <i>I</i><sup>2</sup> = 67.2%), with one study showing harm and two studies showing benefit. Composite surgical success showed no difference (RR 0.94, 95% CI 0.83-1.06, <i>p</i> = 0.297), with trends toward lower success in estrogen groups. Patient satisfaction was universally high (>95%) regardless of treatment. Vaginal atrophy symptoms improved significantly with estrogen. Safety profiles were excellent. Current evidence supports perioperative vaginal estrogen for tissue quality optimization and atrophy symptom management, but not for preventing complications or enhancing surgical success.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"516-526"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307284","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: 2026-04-30DOI: 10.1080/13697137.2026.2658817
Silvia Regina Dos Santos Pereira, Raymond Lanzafame, Raquel Agnelli Mesquita-Ferrari, Luciana Toledo Costa Salviatto, Erika da Silva Melo, Cícero Dayves da Silva Bezerra, Paulo Sérgio Bossini, Luciana Almeida-Lopes, Vanessa Dalapria, Alessandro M Deana
{"title":"Photobiomodulation therapy in the treatment of genitourinary syndrome in postmenopausal women - a placebo-controlled double-blind clinical trial.","authors":"Silvia Regina Dos Santos Pereira, Raymond Lanzafame, Raquel Agnelli Mesquita-Ferrari, Luciana Toledo Costa Salviatto, Erika da Silva Melo, Cícero Dayves da Silva Bezerra, Paulo Sérgio Bossini, Luciana Almeida-Lopes, Vanessa Dalapria, Alessandro M Deana","doi":"10.1080/13697137.2026.2658817","DOIUrl":"10.1080/13697137.2026.2658817","url":null,"abstract":"<p><p>Postmenopausal genitourinary syndrome of menopause (GSM) includes a range of genital, urinary and sexual symptoms caused by estrogen deficiency. As women spend about one-third of their lives postmenopause, effective, non-invasive treatments are needed. This study evaluated the clinical effects of photobiomodulation (PBM) therapy in postmenopausal women with urinary incontinence. A randomized, double-blind, placebo-controlled clinical trial was conducted with women over 50 years of age presenting one or more GSM symptoms. Participants were assigned to receive either PBM or placebo. The PBM group underwent four weekly sessions of 808 nm laser applied to eight vaginal points (4J per point, 40s each). The placebo group followed the same protocol with the device turned off. Results showed a significant reduction in urinary loss in the PBM group, with improved scores on the International Consultation on Incontinence Questionnaire - Short Form. While pelvic pressure and sexual function did not differ significantly, improvements in vaginal dryness and burning were reported. PBM appears to be a promising, non-invasive option for reducing urinary incontinence and enhancing aspects of vaginal health in postmenopausal women. Further studies are needed to confirm long-term effects and optimize treatment protocols.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"620-630"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764128","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: 2026-05-05DOI: 10.1080/13697137.2026.2657843
Juan Du, Xiangyan Ruan, Muqing Gu, Jiaojiao Cheng
{"title":"l-Proline as a safer strategy to preserve ovarian function for patients facing gonadotoxic therapies.","authors":"Juan Du, Xiangyan Ruan, Muqing Gu, Jiaojiao Cheng","doi":"10.1080/13697137.2026.2657843","DOIUrl":"10.1080/13697137.2026.2657843","url":null,"abstract":"<p><strong>Objective: </strong>To develop a safer strategy for preserving ovarian function in patients facing gonadotoxic therapies, this study evaluated the natural osmolytes l-proline and betaine as dimethyl sulfoxide (DMSO)-free alternatives for human ovarian tissue cryopreservation (OTC).</p><p><strong>Method: </strong>The study first characterized the physicochemical properties of the cryoprotectants (CPAs). Ovarian cortical tissues from 10 patients were then processed into biopsies, which were randomized and cryopreserved using slow freezing with 1.5 M l-proline, betaine or DMSO (control). After thawing and a 4-day <i>in vitro</i> culture, assessment included estradiol secretion, glucose uptake, follicular viability (Calcein-AM), apoptosis (TUNEL), and markers of angiogenesis (CD31) and proliferation (Ki-67).</p><p><strong>Results: </strong>l-Proline demonstrated cryoprotective efficacy comparable to DMSO in key follicular metrics: estradiol secretion and follicular viability were not significantly different between the l-proline and DMSO groups, and both were superior to betaine. Apoptosis was equally low in the l-proline and DMSO groups, and considerably lower than in the betaine group. In contrast, DMSO showed higher glucose uptake and expression of CD31 and Ki-67.</p><p><strong>Conclusion: </strong>l-Proline is an effective natural alternative to DMSO for OTC, achieving equivalent preservation of the follicular reserve and function with a favorable biosafety profile. These findings highlight its significant translational potential for enhancing the safety profile of clinical fertility preservation.</p>","PeriodicalId":10213,"journal":{"name":"Climacteric","volume":" ","pages":"600-607"},"PeriodicalIF":3.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834395","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}