Menopause: The Journal of The North American Menopause Society最新文献

{"title":"Evaluation of the association between thyroid-stimulating hormone with handgrip strength and dynapenia in euthyroid postmenopausal women.","authors":"Pascual García-Alfaro, Faustino R Pérez-López, María Angela Sulé, Ignacio Rodríguez","doi":"10.1097/GME.0000000000002499","DOIUrl":"10.1097/GME.0000000000002499","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between serum thyroid-stimulating hormone (TSH) levels with handgrip strength (HGS) and dynapenia in euthyroid postmenopausal women.</p><p><strong>Methods: </strong>This was an exploratory cross-sectional study among 385 participants from the Department of Obstetrics, Gynecology, and Reproduction of the Dexeus Women's University Hospital, Barcelona, Spain. Age, age at menopause, adiposity, alcohol consumption, body mass index (BMI), and smoking status were recorded. TSH was determined by electrochemiluminescence immunoassay. HGS was measured using a digital dynamometer, and physical activity was assessed by the International Physical Activity Questionnaire. Dynapenia was considered when HGS was <20 kg. A directed acyclic graph was designed to identify confounding variables. Multivariable linear and logistic regression models were adjusted by age, age at menopause, adiposity, BMI, glomerular filtration rate, glycated hemoglobin, physical activity, and smoking status.</p><p><strong>Results: </strong>Multivariable linear regression model showed that age ( β = -0.22; 95% CI, -0.28 to -0.16), adiposity ( β = -0.15; 95% CI, -0.22 to -0.07), BMI ( β = 0.15; 95% CI, 0.04-0.25), glomerular filtration rate ( β = -0.04; 95% CI, -0.07 to -0.01), and physical activity ( β = 0.79; 95% CI, 0.07-1.5) were significantly associated with HGS. Instead, serum TSH levels were not significantly associated ( β = 0.21; 95% CI, -0.10 to 0.51). Multivariable logistic regression model showed that dynapenia was associated with age (OR, 1.20; 95% CI, 1.12-1.31) and glomerular filtration rate (OR, 1.03; 95% CI, 1.00-1.05). No significant association between TSH and dynapenia was observed (OR, 0.98; 95% CI, 0.78-1.23).</p><p><strong>Conclusions: </strong>In this study of postmenopausal women, normal TSH levels were not associated with low HGS or dynapenia.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"331-336"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life across menopausal stages among middle-aged Korean women.","authors":"Hye Rin Choi, Yoosoo Chang, Danbee Kang, Jiseon Lee, Yoonyoung Jang, Hoon Kim, Seungho Ryu, Hyun-Young Park, Juhee Cho","doi":"10.1097/GME.0000000000002501","DOIUrl":"10.1097/GME.0000000000002501","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the health-related quality of life (HRQoL) during menopause transition (MT) among middle-aged Korean women.</p><p><strong>Methods: </strong>This cross-sectional study comprised 2,290 middle-aged women who completed web-based questionnaires between 2020 and 2022. Based on self-reported menstrual cycle patterns, menopause status was classified as premenopausal, early or late transition, or postmenopausal. HRQoL was assessed using the Patient-Reported Outcomes Measurement Information system, with all 29 items scored using a T-score metric. Multiple linear regression analyses were performed to investigate whether HRQoL varied based on MT stages. Antimüllerian hormone levels were used as an objective measure instead of self-reported menstrual status in the sensitivity analysis. Logistic regression models were used to estimate the prevalence ratios for moderate or severe HRQoL symptoms across menopausal stages.</p><p><strong>Results: </strong>The mean T-scores for anxiety, depression, and pain interference and intensity were significantly higher with advancing menopausal stage. Anxiety, depression, sleep disturbances, pain interference, and intensity were significantly and linearly positively correlated with MT stages after adjusting for potential confounders. Physical function significantly worsened in the late transition stage compared with premenopausal status ( β = -1.51 [95% CI, -2.72 to -0.31] in late MT and β = -1.92 [95% CI, -3.46 to -0.37] in postmenopause, P for trend = 0.007). However, no significant trends were observed in the sensitivity analysis using antimüllerian hormone levels. Women with moderate or severe symptoms in all domains except physical function had significantly higher prevalence ratios according to MT.</p><p><strong>Conclusions: </strong>Overall HRQoL was lower with advancing menopausal stages. All symptoms should be monitored to control early transition symptoms. Thus, women undergoing MT should consistently assess and manage not only menopausal symptoms but also the overall quality of their health to prevent both menopause-specific and nonspecific conditions and their consequences.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"337-345"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of gestation length and offspring birthweight for gestational age with menopausal symptoms and age of natural menopause at midlife among women enrolled in a prebirth longitudinal cohort.","authors":"Nathan J Cohen, Sheryl L Rifas-Shiman, Diana C Soria-Contreras, Wei Perng, Marie-France Hivert, Emily Oken, Jorge E Chavarro, Lidia Minguez-Alarcon","doi":"10.1097/GME.0000000000002495","DOIUrl":"10.1097/GME.0000000000002495","url":null,"abstract":"<p><strong>Objective: </strong>Reproductive history may help identify women at higher risk for experiencing menopausal symptoms. We hypothesized that gestation length and offspring birthweight for gestational age z-scores would be associated with menopausal symptoms and age at natural menopause in midlife among women in a longitudinal prebirth cohort.</p><p><strong>Methods: </strong>Among 691 women enrolled in pregnancy and followed to midlife, we examined associations of gestation length and offspring birthweight for gestational age z-score at the index pregnancy with total menopausal symptoms assessed with the 11-item Menopause Rating Scale (MRS) using linear regression models, with individual menopausal symptoms using binomial regression models with a log link function, and with age at natural menopause using Cox proportional hazards models. We adjusted all models for age at enrollment, education, parity, annual household income, and prepregnancy body mass index.</p><p><strong>Results: </strong>Mean (SD) MRS total score was 7.9 (5.8) points at age 52.1 (3.8) years, and mean (SD) age at natural menopause was 50.8 (3.7) years. We observed null associations of gestation length (β = -0.07 points per week, 95% confidence interval [CI] = -0.32 to 0.18) and birthweight for gestational age z-score (β = 0.16 points per z-score, 95% CI = -0.31 to 0.63) with the MRS total score in adjusted models. We also observed null associations of gestation length (adjusted hazards ratio = 0.99 per week, 95% CI = 0.94-1.06) and birthweight for gestational age z-score (adjusted hazards ratio = 1.06 per z-score, 95% CI = 0.94-1.19) with age of onset of natural menopause.</p><p><strong>Conclusions: </strong>Birth outcomes were not associated with total menopause symptom scores or age at natural menopause.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"323-330"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the clinical, psychological, and social relevance of menopause for trans and gender diverse people: a qualitative study.","authors":"Michelle Qian Lin Xin, Riki Lane","doi":"10.1097/GME.0000000000002498","DOIUrl":"10.1097/GME.0000000000002498","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to explore the meanings and experiences of menopause for trans and gender diverse (TGD) people and how menopause affects clinical practice.</p><p><strong>Methods: </strong>For this qualitative study in 2021-2022, a scoping literature review informed interview schedule development. Following email invitations, online semi-structured interviews were conducted in March-April 2021 in Australia with three prominent TGD community leaders (trans male, trans female, nonbinary person) and three experienced medical practitioners (general practitioner, endocrinologist, psychiatrist), which were audio-recorded and transcribed. Inductive, iterative thematic analysis of transcripts was conducted. A further literature search was completed in 2024.</p><p><strong>Results: </strong>Themes identified included the following: (1) no consensus on the definition of menopause for TGD individuals; (2) diverse menopause experiences existing in the TGD community; (3) large variations present regarding perimenopausal hormone therapy for older TGD patients: maintain dose, taper to low dose, or cease hormones; and (4) minimal support for TGD people to discuss menopause and concerns around aging. Saturation was not reached with the sample size.</p><p><strong>Conclusions: </strong>There is a paucity of relevant research and no consensus on definitions, management, or impacts of menopause for TGD people. Therefore, current management approaches should be individually tailored and guided by clinical expertise. To formulate practical and realistic recommendations for clinical practice, future research could include the following: (1) a broader literature review into varied gender-affirming hormone treatment (GAHT) regimens among aging TGD people; (2) utilizing the Delphi technique to achieve expert consensus regarding GAHT in older TGD individuals; and (3) a prospective study design of TGD participants on different GAHT regimens over time.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"288-294"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of genital self-perception in the relationship between attitudes toward menopause and sexual quality of life in postmenopausal women: a pilot study.","authors":"Ruveyde Aydin, Tuğba Ulaş","doi":"10.1097/GME.0000000000002502","DOIUrl":"10.1097/GME.0000000000002502","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the mediating role of genital self-image in the relationship between postmenopausal women's attitudes toward menopause and their sexual quality of life.</p><p><strong>Method: </strong>This study is descriptive. The sample consisted of 351 postmenopausal women who met the research criteria. The data were collected online between May and December 2023 using a descriptive information form, the Attitude Towards Menopause Questionnaire, the Female Genital Self-Image Scale, and the Sexual Quality of Life Questionnaire Scale. Data were collected using descriptive statistics, Pearson correlation analysis, and structural equation modeling.</p><p><strong>Results: </strong>The mean total scale scores of the women were 34.41 ± 9.22 for Attitude Towards Menopause Questionnaire, 16.24 ± 3.40 for Female Genital Self-Image Scale, and 44.46 ± 22.16 for Sexual Quality of Life Questionnaire Scale. Analysis revealed moderate positive relationships: between attitude toward menopause and sexual quality of life ( r = 0.451, P < 0.001); between attitude toward menopause and genital self-image ( r = 0.520, P < 0.001); and between the genital self-image and sexual quality of life ( r = 0.361, P < 0.001). When genital self-image was added as a mediator, there was a direct positive relationship between attitude toward menopause and genital self-image ( β = 0.192, P < 0.001) and between genital self-image and sexual quality of life ( β = 1.126, P < 0.05). The indirect relationship of attitude toward menopause on sexual quality of life through genital self-image was positive and significant ( β = 0.216; P < 0.05; 95% CI, 0.063-0.353). With the inclusion of genital self-image as a mediator, the combined effect of attitude toward menopause and genital self-image explained 22.5% of the variance in sexual quality of life ( R2 = 0.225). In comparison, attitude toward menopause explained 27% of the variance in genital self-image ( R2 = 0.270).</p><p><strong>Conclusion: </strong>There is an inverse relationship between postmenopausal women's negative attitudes toward menopause and their genital self-image and quality of sexual life.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"315-322"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace physical activity, sitting time, and menopause symptoms.","authors":"Sophie E Carter, Alexander J Beaumont, Amy K Campbell","doi":"10.1097/GME.0000000000002497","DOIUrl":"10.1097/GME.0000000000002497","url":null,"abstract":"<p><strong>Objective: </strong>Increasing numbers of women are in employment during the menopause; however, menopause symptoms can negatively impact capacity to work. Aspects of the work environment, such as the amount of time spent in physical activity (PA) and sitting, may influence symptoms, yet this is unexplored. This study aimed to explore relationships between workplace PA and sitting, and menopause symptom severity.</p><p><strong>Methods: </strong>Using a cross-sectional study design, 264 perimenopausal or postmenopausal women were recruited to complete an online questionnaire assessing their self-reported workplace PA and sitting time, and their menopause symptom severity (menopause quality of life, hot flash interference, symptom severity). Multiple linear regression analyses examined the associations between menopause symptom severity and the time spent in PA (standing, walking, and physically demanding tasks) and sitting during work hours. Binomial logistical regression was used to assess if menopause symptom severity predicts whether women meet workplace activity guidelines.</p><p><strong>Results: </strong>No significant associations were observed between the time spent in PA or sitting while at work and menopause symptom severity ( P > 0.05). Menopause symptom severity did not significantly predict whether women met workplace activity guidelines ( P > 0.05).</p><p><strong>Conclusions: </strong>In a cohort of perimenopausal and postmenopausal women, self-reported time spent in PA and sitting while at work is not associated with menopause symptom severity. Further research is needed using device-based methods to assess PA and sitting time, to explore in more detail the influence of the time spent in these behaviors while at work on menopause symptoms.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"306-314"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal changes in circulating cyclic guanosine monophosphate in women over the menopause transition compared to men: the Coronary Artery Risk Development in Young Adults (CARDIA) study.","authors":"Giuliana N Lee, Wendy Ying, Bharath Ambale-Venkatesh, Chike C Nwabuo, Henrique Doria de Vasconcellos, Erin D Michos, Pamela Ouyang, Chiadi Ndumele, Pamela J Schreiner, Jared P Reis, Donald M Lloyd-Jones, Cora E Lewis, Stephen Sidney, Colin O Wu, Ron Hoogeveen, Joao A C Lima, Wendy S Post, Dhananjay Vaidya","doi":"10.1097/GME.0000000000002526","DOIUrl":"https://doi.org/10.1097/GME.0000000000002526","url":null,"abstract":"<p><strong>Objective: </strong>The menopause transition is a period of accelerated cardiovascular disease (CVD) development in women, and sex differences in CVD incidence are reduced after menopause. Higher plasma cyclic guanosine monophosphate (cGMP) levels are also associated with greater CVD risk. Thus, we examined the changes in cGMP levels associated with the menopause transition.</p><p><strong>Methods: </strong>We measured plasma cGMP levels in 511 women and 283 men in the Coronary Artery Risk Development in Young Adults (CARDIA) study.</p><p><strong>Results: </strong>Over a 20-year follow-up period, women who completed the menopause transition had smaller reductions in cGMP relative to women who remained premenopausal (P < 0.05) but had similar changes compared to men (P = 0.3) after adjusting for demographic variables.</p><p><strong>Conclusions: </strong>Plasma cGMP changes through the menopause transition may reflect the underlying mechanisms associated with greater cardiovascular disease risk.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low creatinine to cystatin C ratio is associated with lower muscle volumes and poorer gait speeds in the longitudinal Integrated Women's Health Program cohort.","authors":"Darren Yuen Zhang Tan, Beverly Wen Xin Wong, Liang Shen, Ling-Jun Li, Eu-Leong Yong","doi":"10.1097/GME.0000000000002524","DOIUrl":"https://doi.org/10.1097/GME.0000000000002524","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the longitudinal associations between creatinine-cystatin C ratios (CCR) with muscle volume and function during the menopausal transition. We investigated the longitudinal relationship of baseline CCR, with muscle volumes measured by magnetic resonance imaging (MRI), and objectively measured muscle strength and physical performance after 6.6-year follow-up.</p><p><strong>Methods: </strong>Participants from the Integrated Women's Health Programme (IWHP) cohort (n = 891, baseline mean age 56.2 ± 6.0) who attended both baseline and follow-up visits underwent objectively measured muscle strength and physical performance assessments and MRI. Creatinine to cystatin C ratio was calculated as (creatinine [mg/dL] / cystatin C [mg/L]) and low CCR were those in the lowest tertile (CCR < 8.16). Multivariable regression analyses were used to determine the associations of baseline CCR with muscle volumes and function 6.6 years later.</p><p><strong>Results: </strong>Baseline low CCR was associated with lower MRI-measured muscle volumes and poorer physical function 6.6 years later. Compared to high CCR group, mean fat-free thigh muscle volume of the low CCR group was 0.350 L lower (95% CI, 0.183-0.518) after adjustment for covariates. Similarly, the low CCR group was associated with 0.029 m/s slower (95% CI, 0.006-0.053) slower mean usual gait and 0.049 m/s slower (95% CI, 0.020-0.078) mean narrow gait speeds. CCR was not associated with handgrip strength and repeated chair stands and one-leg stand tests.</p><p><strong>Conclusion: </strong>Low CCR at baseline was associated with lower fat-free muscle volumes and poorer gait speeds 6.6 years later. The potential of CCR as a predictive biomarker for adverse events related to sarcopenia in midlife women merits further investigation.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurophysiological correlates of subjective cognitive decline in perimenopausal and postmenopausal midlife women at risk for Alzheimer's disease.","authors":"Lisa Mosconi, Schantel Williams, Caroline Carlton, Caroline Andy, Francesca Fauci, Camila Zarate, Camila Boneu, Trisha Ajila, Matilde Nerattini, Steven Jett, Michael Battista, Silky Pahlajani, Matthew E Fink, Roberta Diaz Brinton, Jonathan P Dyke","doi":"10.1097/GME.0000000000002512","DOIUrl":"https://doi.org/10.1097/GME.0000000000002512","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate neurophysiological correlates of subjective cognitive decline (SCD) among midlife women at risk for Alzheimer's disease (AD).</p><p><strong>Methods: </strong>We examined 156 cognitively normal perimenopausal and postmenopausal women aged 40 to 65 years, with an AD family history and/or apolipoprotein E epsilon 4 genotype, who were not on menopause hormone therapy. Participants underwent neuropsychological testing, health and menopausal symptom questionnaires, and brain volumetric magnetic resonance imaging, arterial spin labeling-magnetic resonance (MR) measuring cerebral blood flow, and 31phosphorus magnetic resonance spectroscopy (31P-MRS) measuring mitochondria high-energy phosphates (adenosine triphosphate [ATP], phosphocreatine [PCr], inorganic phosphate [Pi]). We used multivariable regressions to compare outcomes between participants with and without SCD and to identify the main correlates of SCD status.</p><p><strong>Results: </strong>The SCD group (n = 53) exhibited worse verbal memory and executive function test performance (multivariable adjusted P = 0.029) compared to controls (n = 103). On brain imaging, the SCD group showed higher PCr/ATP in precuneus, posterior cingulate, and parietal regions compared to controls (multivariable adjusted P < 0.05) and no overall differences in Pi/ATP, PCr/Pi, volume, or cerebral blood flow measures. Results were controlled for age, race, smoking status, hysterectomy status, presence of vasomotor symptoms, menopause symptom severity score, past menopause hormone therapy usage, history of depression, AD family history, and apolipoprotein E epsilon 4 status. The factors more strongly associated with SCD status were inferior parietal PCr/ATP, menopause symptom severity, and presence of vasomotor symptoms.</p><p><strong>Conclusions: </strong>Among perimenopausal and postmenopausal midlife women, SCD was associated with altered brain mitochondria bioenergetics in some brain regions similarly affected by AD, warranting further investigation.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abnormal uterine bleeding is associated with fatigue during the menopause transition.","authors":"Siobán D Harlow, Ellen B Gold, Michelle M Hood, Alain A Mukwege, John F Randolph, Gail A Greendale","doi":"10.1097/GME.0000000000002525","DOIUrl":"https://doi.org/10.1097/GME.0000000000002525","url":null,"abstract":"<p><strong>Objective: </strong>During the menopause transition (MT), abnormal uterine bleeding, characterized by prolonged (PMB) or heavy (HMB) menstrual bleeding, occurs often. We assessed whether PMB or HMB was associated with fatigue.</p><p><strong>Methods: </strong>We used longitudinal daily menstrual calendar data from 2,329 participants in the Study of Women's Health Across the Nation to identify episodes of HMB and PMB. At seven annual follow-up visits, four symptoms of fatigue were queried (worn out, feeling tired, full of pep, having energy). General linear mixed models with random intercepts for each woman assessed the association between each fatigue variable and PMB or HMB recorded during the 6 months prior to each annual follow-up visit. Models were adjusted for race and ethnicity, age, body mass index, hormone therapy use, depressive and anxiety symptoms, perceived stress, sleep problems, cigarette use, and discrimination.</p><p><strong>Results: </strong>After adjustment, reporting three or more episodes of HMB in the prior 6 months was positively associated with feeling tired (odds ratio [OR] = 1.62, 95% CI = 1.11 to 2.38) and being worn out (OR = 1.44, 95% CI = 0.98 to 2.13), whereas three or more episodes of PMB in the prior 6-month window was negatively associated with being full of pep (OR = 0.68, 95% CI = 0.49 to 0.95).</p><p><strong>Conclusions: </strong>HMB and PMB during the MT were associated with increased odds of experiencing three symptoms of fatigue. Greater clinical attention to bleeding changes and associated symptoms, including fatigue and lack of energy, is warranted, as is education of women about potential health consequences of excessive menstrual bleeding during the MT.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}