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

{"title":"Heightened menopausal symptoms mediate the associations between stress and depressive symptoms among midlife women.","authors":"Nicole E Logan, Janis Gaudreau, Bridget Owens, Brietta M Oaks, Christie L Ward-Ritacco, Natalie J Sabik","doi":"10.1097/GME.0000000000002596","DOIUrl":"https://doi.org/10.1097/GME.0000000000002596","url":null,"abstract":"<p><strong>Objectives: </strong>Investigate associations between stress, cortisol, menopause symptoms, and depression in a sample of midlife women. Because stress has been associated with greater menopause symptoms, we examined this as a mediator for the association between stress and depressive symptoms.</p><p><strong>Methods: </strong>Data from a cross-sectional study of 118 women (40-64 y old) were analyzed. Participants completed in-person visits and self-reported questionnaires, including the Menopause-Specific Quality of Life questionnaire, the Perceived Stress Scale, and the Center for Epidemiological Studies Depression Scale. Saliva samples were collected at 4 intervals upon waking (wake, 30 min, 45 min, and 60 min after waking), and one sample before bed, as a measure of cortisol. Both the diurnal cortisol slope and the cortisol area under the curve with respect to ground (AUCg) were used to characterize cortisol secretion and exposure. A multivariate analysis of variance determined differences in menopause symptoms and depression outcomes. Mediation models examined the indirect effects of menopause symptoms on associations between perceived stress and depressive symptoms.</p><p><strong>Results: </strong>Women with moderate stress had significantly lower cortisol awakening responses (P = 0.047), poorer psychosocial (P < 0.001), physical (P < 0.001), and sexual (P<0.001) menopause symptoms, and depression symptoms (P < 0.001) compared to women with low stress. Mediation analyses (95% CI) between stress and depression demonstrated significant positive indirect effects of psychological (B = 0.247; 0.117, 0.355), physical (B = 0.120; 0.049, 0.210), and sexual menopause symptoms (B = 0.042; 0.006, 0.106).</p><p><strong>Conclusions: </strong>Cross-sectional data revealed that greater stress was associated with poorer outcomes of menopause symptoms, depressive symptoms, and a lower cortisol awakening response. The association between stress and depression was mediated by the psychosocial, physical, and sexual menopause symptoms, and future longitudinal studies should seek to confirm these findings.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642925","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":"Depressive symptoms in women with premature ovarian insufficiency (POI): a cross-sectional observational study.","authors":"Charissa van Zwol-Janssens, Yvonne V Louwers, Joop S E Laven, Jits Schipper, Geranne Jiskoot","doi":"10.1097/GME.0000000000002614","DOIUrl":"https://doi.org/10.1097/GME.0000000000002614","url":null,"abstract":"<p><strong>Objective: </strong>To explore associations between clinical and patient-reported variables and depressive symptoms in women with premature ovarian insufficiency (POI).</p><p><strong>Methods: </strong>An exploratory cross-sectional observational study was conducted using data from the center of expertise for women with POI, Erasmus MC, the Netherlands. To identify variables associated with depressive symptoms, as assessed by patient and clinician-reported outcome measures, we used logistic regression models.</p><p><strong>Results: </strong>Between April 2020 and December 2023, 345 women with POI were included. In this cohort, the prevalence of depressive symptoms was 29.9%. No significant difference was found in depressive symptoms between women using estrogen plus progestogen therapy (EPT) (41.7%) and those not using EPT (42.6%, P=0.89). Younger age at diagnosis (P=0.01), POI due to a genetic cause (P=0.04), severe menopausal symptoms (P<0.001), and lack of emotional support (P<0.001) were independently associated with depressive symptoms. The use of EPT or levels of estradiol were not associated with depressive symptoms.</p><p><strong>Conclusions: </strong>The high prevalence of depressive symptoms among women with POI underscores a need for targeted mental health support. Our findings highlight that younger age at diagnosis, severe menopausal symptoms, and fertility-related grief are associated with depression in this population. Given that estradiol levels did not correlate with depressive symptoms, this suggests that psychosocial factors are crucial. Psychological interventions should focus on these factors to address the unique needs of this population.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642922","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":"Prospective associations of American Heart Association Life's Essential 8 with subclinical measures of vascular health, cardiovascular disease events, and all-cause mortality in women traversing menopause: The Study of Women's Health Across the Nation study.","authors":"Ziyuan Wang, Emma Barinas-Mitchell, Maria M Brooks, Carol A Derby, Jared W Magnani, Rebecca C Thurston, Kelly R Ylitalo, Marnie Bertolet, Samar R El Khoudary","doi":"10.1097/GME.0000000000002549","DOIUrl":"https://doi.org/10.1097/GME.0000000000002549","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to characterize cardiovascular health status as measured by Life's Essential 8 (LE8) in midlife women and to test the associations between baseline and change since baseline in LE8 with subclinical measures of vascular health, cardiovascular disease (CVD) events, and all-cause mortality.</p><p><strong>Methods: </strong>Baseline and follow-up LE8 metrics (diet, physical activity, nicotine exposure, sleep, body mass index, lipids, glucose, and blood pressure) were calculated as total and component scores. Changes in LE8 were calculated as differences between follow-up and baseline scores. Subclinical measures of vascular health included carotid intima-media thickness, pulse wave velocity, and carotid plaque presence. CVD events (n = 213) included myocardial infarction, stroke, heart failure, and revascularization. Deaths (n = 161) were recorded from death certificates/family reports. Linear, logistic, and Cox proportional hazards regression models were used.</p><p><strong>Results: </strong>Among 2,924 midlife women (mean age: 46 ± 3 y), 21% consistently showed ideal total LE8 scores (≥80) across visits. Higher baseline and greater increases in total LE8 scores were associated with more favorable measures of all outcomes. Among the components, more favorable baseline/greater increases in glucose, blood pressure, and nicotine exposure scores were generally associated with lower risks for all outcomes. Sleep quality was associated with events; with more favorable baseline and/or greater increases in sleep score associated with lower risks of CVD events and/or mortality.</p><p><strong>Conclusions: </strong>The prevalence of ideal total LE8 scores remained below 25% among midlife women. Glucose, blood pressure, and nicotine exposure are critical components of associated risks with lower LE8 scores. Midlife sleep quality may uniquely contribute to future event risk.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591624","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":"Assessing cardiovascular health across the menopause transition.","authors":"Matthew Nudy, Cynthia H Chuang","doi":"10.1097/GME.0000000000002626","DOIUrl":"https://doi.org/10.1097/GME.0000000000002626","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591607","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":"Masturbation frequency and experiences among US women aged 40-65 years: comparisons across different stages of the menopause transition.","authors":"Cynthia A Graham, Louise Ferrall, Justin J Lehmiller","doi":"10.1097/GME.0000000000002597","DOIUrl":"https://doi.org/10.1097/GME.0000000000002597","url":null,"abstract":"<p><strong>Objective: </strong>The aims of the study were to assess the reported frequency of, and reasons for, masturbation and experiences of orgasm and sex toy use during masturbation and to compare these experiences across women at different stages of the menopause transition.</p><p><strong>Methods: </strong>A nationally representative US sample of 1,500 women aged 40-65 (M age: 52.5 y) completed an online survey asking about their experiences during masturbation. Data were analyzed using descriptive statistics, χ2 tests, and ANOVAs.</p><p><strong>Results: </strong>Over half (55.8%) of the sample described themselves as postmenopausal, 22.7% as perimenopausal, and 21.5% as premenopausal. There were significant differences in the frequency of masturbation, with postmenopausal women reporting a lower frequency compared with the other 2 groups (P < 0.014). Postmenopausal women also rated the importance of masturbation in their lives as lower compared with perimenopausal and premenopausal women (P < 0.001). There were no group differences in the frequency of orgasm during masturbation, with women reporting orgasm an average of 81% of the times that they masturbated. Overall, more women reported that the quality of their orgasms had gotten better than worse over the last 10 years, and most noticed no change. More women reported that orgasm had become more difficult to attain, but about half had noticed no change. There were no significant group differences in the percentage of times that sex toys were used during masturbation (44.4% for the total sample).</p><p><strong>Conclusions: </strong>Sexual pleasure and orgasm remain important for many older women and menopause is not always associated with adverse changes in sexuality, including the ability to orgasm during masturbation.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591623","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":"Using Playmobil as a creative research tool to explore women's experiences of menopause in the workplace.","authors":"Alison Owen, Jennifer Taylor, Amy Burton","doi":"10.1097/GME.0000000000002599","DOIUrl":"https://doi.org/10.1097/GME.0000000000002599","url":null,"abstract":"<p><strong>Objective: </strong>The present work was designed to explore women's experiences of going through the menopause while working, using Playmobil as a tool for eliciting discussion. A growing body of evidence shows the value of using playful approaches in research; however, very little research has explored the use of Playmobil as a research method.</p><p><strong>Methods: </strong>Research was carried out with 12 co-researchers (aged 31-60) working at a UK university, who were perimenopausal and postmenopausal women. Women attended a workshop and were encouraged to discuss and reflect on their experience of menopause in the workplace using playmobil to facilitate group discussion. The session was audio-recorded.</p><p><strong>Results: </strong>Three themes were developed using Reflexive Thematic Analysis regarding menopause experiences in the workplace: (1) menopause symptoms fundamentally changing experiences of work, (2) symptoms leading to doubts about the ability to work effectively, and (3) ideas for moving forward and improving experiences of menopause in the workplace.</p><p><strong>Conclusions: </strong>Playmobil was a useful method for stimulating discussion. Physical and psychological symptoms of the menopause can have a substantial impact on a person's working life. Workplace settings need to ensure sufficient support is available for employees who are experiencing menopause.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591626","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":"Transdermal versus oral hormone therapy in premature ovarian insufficiency.","authors":"Klara Beitl, Katalin Widmann, Rodrig Marculescu, Robert Krysiak, Johannes Ott","doi":"10.1097/GME.0000000000002588","DOIUrl":"https://doi.org/10.1097/GME.0000000000002588","url":null,"abstract":"<p><strong>Objectives: </strong>Hormone therapy is recommended in women with premature ovarian insufficiency to mitigate long-term risks associated with estrogen deficiency, such as loss of bone mineral density. However, data on the optimal route of administration are scarce. This study aimed to compare the effect of transdermal and oral hormone therapies on the T-scores of the femur and the hip in women with premature ovarian insufficiency.</p><p><strong>Methods: </strong>This retrospective, single-center cohort study included 55 women with spontaneous premature ovarian insufficiency who were regularly monitored at the Clinical Division of Gynecological Endocrinology and Reproductive Medicine of the Medical University of Vienna. For hormone therapy, participants received either oral or transdermal estrogen therapy. The main outcome parameters were the T-scores of the femur and hip assessed by dual-energy x-ray absorptiometry scans.</p><p><strong>Results: </strong>Among the 55 women included [median age: 34 y, interquartile range (IQR): 27-36], 65.5% showed reduced bone mineral density in the dual-energy x-ray absorptiometry scan results (osteopenia: n= 27, 49.1%; osteoporosis: n= 9, 16.4%). Participants were treated with transdermal and oral estradiol in 27 (49.1%) and 28 cases (50.9%), respectively. There were no significant differences in the T-scores of the femur and the hip, neither at baseline (P=0.586, P=0.400) nor at follow-up assessment (P=0.618, P=0.471) between the two treatment groups.</p><p><strong>Conclusions: </strong>Both oral and transdermal hormone therapies effectively help maintain bone mineral density in women with premature ovarian insufficiency, indicating that either option is a suitable treatment choice for this population.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591625","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":"\"I did not recognize myself\": a mixed methods study to better understand the experiences of menopause in a US workplace.","authors":"Sharon Mallen, Jennifer Coppola, Nicole Shaffer, Mary Jane Minkin, Alexis Ward, Sally Snow","doi":"10.1097/GME.0000000000002575","DOIUrl":"https://doi.org/10.1097/GME.0000000000002575","url":null,"abstract":"<p><strong>Objective: </strong>This mixed-methods study aimed to describe the prevalence and impact of menopausal symptoms on midlife women in a US workplace.</p><p><strong>Methods: </strong>An online survey was disseminated to all US-based employees of a US-headquartered pharmaceutical company. Eligible respondents were aged 40-65 years and self-identified as having (or expecting to have) personal experience of menopause. Descriptive statistics were generated. Survey respondents were sampled for in-depth interviews, on which thematic analysis was performed.</p><p><strong>Results: </strong>Eligible survey responses were received from 1,642 employees, of which 18 participated in in-depth interviews. The mean respondent age was 51 years, and a range of job roles were represented. The majority of respondents (83%) reported that they had current or prior experience of menopause. Menopause symptoms most commonly impacting workplace performance included changes to sleep patterns, changes to memory, hot flashes and anxiety, although interviews highlighted a diversity of symptom presentations. Menopause symptoms were reported to affect stress levels, confidence in abilities, patience with others, and ability to concentrate at work; 7% of menopausal respondents took time off work due to menopause symptoms. Although half of the respondents disclosed that they would feel extremely or somewhat comfortable discussing menopause with colleagues, only 9% of those with current symptoms reported that they had received support with their menopause symptoms at work.</p><p><strong>Conclusions: </strong>This study found that menopause impacts women's perceptions of their own performance at work, and that many are unsure how to approach conversations about menopause in the workplace. A substantial gap in knowledge about menopause was identified, highlighting the need for further education and support.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540768","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 impact of 3,3'-diindolylmethane on estradiol and estrogen metabolism in postmenopausal women using a transdermal estradiol patch.","authors":"Mark S Newman, Jaclyn Smeaton","doi":"10.1097/GME.0000000000002542","DOIUrl":"10.1097/GME.0000000000002542","url":null,"abstract":"<p><strong>Objectives: </strong>3,3'-diindolylmethane (DIM) is a supplement, investigational drug, and the primary in vivo product of indole-3-carbinol. DIM is sometimes recommended to postmenopausal women by functional or integrative medicine providers. Some of these women may be concurrently receiving menopausal hormone therapy (MHT), and since DIM's mechanism of action involves the alteration of estrogen metabolism, it is possible that a drug-supplement interaction exists. The objective of this study was to examine the effect of DIM on the estrogen profiles of postmenopausal women receiving MHT in the form of a transdermal estradiol (E2) patch.</p><p><strong>Methods: </strong>This was a retrospective, observational cohort study for which data were collected from a database containing laboratory results for patients processed between January 1, 2016 and December 9, 2019. Laboratory measurements included urinary E2 and 9 other estrogen metabolites. From this database, we identified 1,458 results that were from postmenopausal women using a transdermal E2 patch. Of these 1,458 women, 108 indicated they were concurrently taking a DIM supplement. Wilcoxon rank sum tests were used to assess differences between groups. Multivariable linear regression models were created to confirm the effect of DIM on individual estrogen metabolites.</p><p><strong>Results: </strong>When compared with postmenopausal women using a transdermal E2 patch alone, postmenopausal women using a patch and concurrently taking DIM had statistically significant alterations in their urinary estrogen profiles ( P < 0.001 for all metabolites with differences). Multivariable linear regression models indicated that DIM had a significant effect on 6 of the 10 estrogen metabolites measured, including estrone, estriol, 2-OHE1, 2-OHE2, 4-OHE2, and 16-OHE1, as well as the 2-OHE1/16-OHE1 ratio.</p><p><strong>Conclusions: </strong>Postmenopausal women who are prescribed transdermal E2 patch therapy who choose to concurrently use a DIM supplement may have unexpected changes in their urinary estrogen profiles. Further research is needed to assess whether these changes are clinically significant, as there is a possibility that they may decrease the overall estrogenic impact of MHT on key clinical endpoints such as symptom improvement and bone mineral density. The presence and magnitude of these changes suggest that providers treating postmenopausal women with MHT should ask their patients if they are taking a DIM supplement and, if so, consider the potential implications of drug-supplement interactions for MHT dose management and effectiveness.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"630-639"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical performance of different cervical cancer screening strategies in premenopausal and postmenopausal women.","authors":"Qiang Zhou, Tingyuan Li, Lingling Zhu, Yining Chang, Jingjing Yang, Wen Chen, Ying Yang, Yong He, Chanjuan He, Jingchang Du, Xiaoli Peng, Yuqian Zhao","doi":"10.1097/GME.0000000000002546","DOIUrl":"10.1097/GME.0000000000002546","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the clinical performance of high-risk human papillomavirus (HR-HPV) testing, liquid-based cytology (LBC), and HR-HPV and LBC co-testing for detecting cervical intraepithelial neoplasia (CIN) in premenopausal and postmenopausal women.</p><p><strong>Methods: </strong>A total of 6,085 premenopausal and 4,766 postmenopausal women were recruited for cervical cancer screening using LBC and HR-HPV testing. Following screening, colposcopy and biopsy for pathology were performed according to established protocols. We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for detecting CIN2/3 or worse (CIN2/3+).</p><p><strong>Results: </strong>The sensitivity of LBC for detecting CIN2+ was 73.4% (95% CI=60.7%-83.3%) in premenopausal women and 58.8% (95% CI=44.2%-72.1%) in postmenopausal women. In contrast, significantly higher sensitivities were observed for HR-HPV testing and HR-HPV and LBC co-testing, both of which showed sensitivities of 96.9% (95% CI=88.2%-99.5%) in premenopausal women and 98.0% (95% CI=88.2%-99.9%) in postmenopausal women. While HR-HPV and LBC co-testing demonstrated superior specificity compared with HR-HPV testing alone [95.8% (95% CI=95.2%-96.3%) vs. 86.3% (95% CI=85.4%-87.1%) in premenopausal women; 93.7% (95% CI=92.9%-94.3%) vs. 80.6% (95% CI=79.5%-81.7%) in postmenopausal women], it also exhibited the highest PPV for CIN2+ prediction [19.6% (95% CI=15.4%-24.4%) in premenopausal women; 14.5% (95% CI=10.9%-18.6%) in postmenopausal women] compared with LBC or HR-HPV testing alone.</p><p><strong>Conclusions: </strong>HR-HPV and LBC co-testing demonstrates comparable high clinical accuracy for detecting CIN2+ in both premenopausal and postmenopausal women, with a preference for its use in postmenopausal screening.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"640-647"},"PeriodicalIF":2.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}