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

{"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}

{"title":"Virtual reality for menopause symptom management: opportunities, challenges, and next steps.","authors":"Nancy Safwan, Karisma K Suchak, Omer Liran, Sheryl A Kingsberg, Brennan M R Spiegel, Chrisandra L Shufelt, Stephanie S Faubion","doi":"10.1097/GME.0000000000002529","DOIUrl":"https://doi.org/10.1097/GME.0000000000002529","url":null,"abstract":"<p><strong>Importance and objective: </strong>Menopause is the natural cessation of ovarian function, typically occurring at a mean age of 52 years in the United States. Vasomotor symptoms (VMS; hot flashes and night sweats) affect over 75% of midlife women and typically last 7 to 9 years, with only 54% seeking medical attention. Although hormone therapy is the most effective treatment for VMS, <4% of women currently use it, primarily due to safety concerns. There is evidence that cognitive behavioral therapy (CBT) is an effective management strategy for VMS. Virtual reality (VR) has shown promise in delivering an immersive form of CBT for various medical conditions, including acute and chronic pain, sleep, and mood disorders, potentially overcoming barriers such as access and cost while improving quality of life. This narrative review aims to summarize the existing literature on VR for managing menopause symptoms.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted through PubMed and Medline databases. The search focused on keyword combinations related to VR, artificial intelligence, and menopause symptoms.</p><p><strong>Discussion and conclusion: </strong>The search yielded one study specifically targeting symptoms related to menopause. A pilot study (n = 42) evaluating an immersive VR and artificial intelligence intervention based on CBT and mindfulness techniques for managing hot flashes in women with breast or ovarian cancer demonstrated a significant reduction in frequency of hot flashes (P < 0.01) and improvements in sleep quality, mood, anxiety, stress, and overall quality of life. However, these women experienced hot flashes that might have been associated with their cancer diagnosis or treatment rather than relating specifically to menopause, potentially limiting the generalizability of the findings to women with menopause symptoms. Although VR has shown effectiveness in delivering CBT for other conditions, there remains a significant gap in research on its specific use for menopause-related symptoms.</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":"143604888","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 heterogeneity in the associations between menopausal status and depression: a cross-sectional study with a unique analytical approach.","authors":"Rakibul M Islam, Juwel Rana, Susan R Davis","doi":"10.1097/GME.0000000000002519","DOIUrl":"https://doi.org/10.1097/GME.0000000000002519","url":null,"abstract":"<p><strong>Objectives: </strong>The extent to which menopause status contributes to depressive symptoms remains controversial. This study aimed to examine associations between menopausal status and depressive symptoms and the heterogeneity in these associations.</p><p><strong>Methods: </strong>We conducted three consecutive national surveys of community-dwelling Australian women aged 18-79 years between October 2013 and July 2017. Depressive symptoms were measured by Beck Depression Inventory II (BDI-II) score (range 0-63). Symptoms were classified into a binary outcome of minimal to mild (BDI-II score <20) and moderate to severe (MS) (BDI-II score ≥20). The average effect (average treatment effect [ATE]) and conditional average effect of the menopausal status on depressive symptoms were investigated by causal forest method.</p><p><strong>Results: </strong>The prevalence of MS depressive symptoms in 10,351 participants was 23.7% (95% CI: 22.9-24.5). Compared with premenopause, the BDI-II score was higher for the menopause transition (ATE = 2.43 units, 95% CI: 1.20-3.65) and postmenopause (ATE = 3.03 units, 95% CI: 1.25-4.81). Compared with premenopause, the menopause transition was associated with an average increase in the prevalence of MS depressive symptoms by 6 percentage points (ATE = 0.06, 95% CI: 0.01-0.12). There were no differences in depressive symptoms between the menopause transition and postmenopause.In menopause transition, the BDI-II score was -1.22 units lower and the prevalence of MS depressive symptoms was 5 percentage points lower among employed women compared with unemployed women. In postmenopause, the BDI-II score was 1.75 units higher for unpartnered women compared with partnered women.</p><p><strong>Conclusions: </strong>The menopause transition and postmenopause are associated with a higher BDI-II score and an increased prevalence of MS depressive symptoms compared with premenopause. These associations are favorably modified by paid employment in the menopause transition and unfavorably by being unpartnered postmenopause.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557241","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":"Unpacking eating disorder risk and resilience during menopause: a biopsychosocial perspective.","authors":"Leslie D Frazier, Maria Bazo Perez","doi":"10.1097/GME.0000000000002511","DOIUrl":"https://doi.org/10.1097/GME.0000000000002511","url":null,"abstract":"<p><strong>Objective: </strong>Midlife may represent a developmentally vulnerable period for eating disorders (ED) due to the biopsychosocial factors associated with menopause that influence risk and resilience.</p><p><strong>Methods: </strong>In this cross-sectional study, we utilized CloudResearch, a leading research participant sourcing platform to recruit, prescreen, and generate a diverse and nationally representative sample of women between the ages of 40 and 65 (n = 467), who voluntarily completed a fully online survey administered through Qualtrics, a web-based survey platform. We examined two conceptually driven, multifactorial models to determine the differential influences of biologic (ie, age, menopause stage, menopause symptoms), psychological (ie, body image, self-perceptions of aging and menopause) and social (ie, social support and strain) on healthy eating and eating pathology, and specific ED behaviors (ie, caloric restriction, binging, purging).</p><p><strong>Results: </strong>Two multivariate linear regression models were tested. We found that ED risk is elevated by higher body dissatisfaction and reduced by being in perimenopause or postmenopause as compared to premenopause. Resilience (ie, intuitive eating) was elevated by positive perceptions of aging and diminished by higher levels of body dissatisfaction, greater bothersomeness of menopause symptoms, and social support. Binging and purging were elevated by greater bothersomeness of menopause symptoms and greater body dissatisfaction. Dietary restraint was reduced by social relationship strains.</p><p><strong>Conclusions: </strong>This study replicates previous research on the important role of menopause symptoms and body image for ED risk. This study is the first to examine factors related to resilient outcomes and specifically the role of self-perceptions of menopause, aging, and social support as mechanisms to affect adjustment to menopause and promote healthy aging.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557249","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":"A randomized controlled trial to evaluate a novel dual laser therapy for vulvar lichen sclerosus: exploratory study assessing the impact of menopausal status.","authors":"Irena Zivanovic, Marianne Gamper, Debra Fesslmeier, Helena Bischofberger, Volker Viereck","doi":"10.1097/GME.0000000000002478","DOIUrl":"https://doi.org/10.1097/GME.0000000000002478","url":null,"abstract":"<p><strong>Objective: </strong>A randomized controlled trial showed that Neodymium:YAG/Erbium:YAG laser therapy was safe and significantly improved clinical outcomes and subjective symptoms of vulvar lichen sclerosus (LS). Most improvements were similar to those after the recommended first-line therapy with topical steroid. In this exploratory study, we wanted to analyze the impact of menopausal status on perception and treatment outcome.</p><p><strong>Methods: </strong>Sixty-six women with clinical lichen sclerosus were assigned to the laser or the steroid arm (2:1). Participants of the laser arm received four laser treatments with a follow-up of 6 months after treatment initiation. Clinical objective (LS score) and subjective outcomes (vulvovaginal symptoms questionnaire [VSQ], symptom visual analogue scale [VAS] score, patient satisfaction) were evaluated.</p><p><strong>Results: </strong>Nineteen of the 66 study participants were premenopausal, 47 postmenopausal. At baseline, premenopausal women were significantly younger (39.4 vs 67.4 yr, P < 0.001), only a few applied local estrogen (16% vs 74%, P < 0.001), and their VSQ score was higher (9.58 vs 7.32, P = 0.015) indicating more severe vulvovaginal symptoms. Laser therapy objectively led to similar clinical improvements for pre- and postmenopausal women (-2.62 vs -2.23, P = 0.437), but subjectively to a significantly higher improvement of the VSQ score in postmenopausal women (-4.13 vs -1.08, P = 0.005). Postmenopausal women were more satisfied with laser therapy than premenopausal women (71% vs 46%, P = 0.002).</p><p><strong>Conclusion: </strong>Compared to premenopausal women, postmenopausal women experienced a lower subjective burden of the disease and a better subjective improvement after laser therapy. Perceptions and expectations are age-dependent and should be considered when treating women with lichen sclerosus.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 3","pages":"228-233"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502292","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":"Evaluation of postmenopausal bleeding.","authors":"Steven Goldstein","doi":"10.1097/GME.0000000000002522","DOIUrl":"https://doi.org/10.1097/GME.0000000000002522","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 3","pages":"275-277"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502297","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":"Prevalence of urinary tract infections in women with vulvovaginal atrophy and the impact of vaginal prasterone on the rate of urinary tract infections.","authors":"Rachel Rubin, May Sanaee, Alyssa Yee, Erick Moyneur, Katherine Dea, Alain Y Dury","doi":"10.1097/GME.0000000000002485","DOIUrl":"10.1097/GME.0000000000002485","url":null,"abstract":"<p><strong>Objective: </strong>The aims of this study were to assess the prevalence of urinary tract infections (UTI) in women newly diagnosed with vulvovaginal atrophy (VVA) versus women without VVA and to evaluate the potential of vaginal prasterone to be used in postmenopausal VVA women with UTI as prophylaxis to reduce the future UTI risk. As a first subgroup analysis, women using aromatase inhibitors, medications that stop the production of estrogen were analyzed. As a second subgroup analysis, we looked at women with diabetes to investigate whether the same prophylaxis approach should be considered.</p><p><strong>Methods: </strong>This observational retrospective inception cohort study was conducted using the Integrated Dataverse open-source claims database with data from February 2015 through January 2020.</p><p><strong>Results: </strong>A total of 22,245 women treated with prasterone for a minimum of 12 weeks were matched to women without any prescribed VVA-related treatment. Overall, women treated with prasterone have a significantly lower UTI prevalence compared to those untreated (6.58% vs 12.3%; P < 0.0001). The highest difference in UTI prevalence among the prasterone treated and untreated women was observed in those aged 65-74 (7.15% vs 16.2%; P < 0.0001). Among aromatase inhibitor users and women with diabetes, those treated with prasterone have a significantly lower UTI prevalence (4.90% vs 9.79%; P < 0.01 and 14.59% vs 20.48%; P < 0.0001, respectively).</p><p><strong>Conclusions: </strong>This study suggests that intravaginal prasterone may be a good candidate for prophylaxis in postmenopausal women with UTI to reduce future UTI risk, including for women taking aromatase inhibitors and women with diabetes. This study is based on real-world evidence and warrants further investigation in a clinical setting.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"217-227"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951026","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":"Fragmented QRS complexes in electrocardiogram and their relationship with somatic symptoms in postmenopausal women.","authors":"Busra Korpe, Caner Kose, Nazlı Turan Serifler, Vakkas Korkmaz, Huseyin Levent Keskin","doi":"10.1097/GME.0000000000002491","DOIUrl":"10.1097/GME.0000000000002491","url":null,"abstract":"<p><strong>Objective: </strong>Menopause significantly impacts cardiovascular health, yet the relationship between myocardial abnormalities and noncardiac symptoms in postmenopausal women remains underexplored. This study aims to investigate the association between fragmented QRS waves (fQRS) positivity on electrocardiograms (ECG) and somatic symptoms in postmenopausal women.</p><p><strong>Methods: </strong>We included 623 postmenopausal women attending a menopause clinic for routine annual gynecological examinations. Women were categorized into fQRS-positive (n = 248) and fQRS-negative (n = 375) groups based on ECG results analyzed by a blinded cardiologist. The Menopause Rating Scale (MRS) was used to assess menopausal symptoms across three subscales: somatic, psychological, and urogenital. Data on demographics, physical activity, and medical history were also collected. Statistical analyses included comparisons of MRS scores, and a binary logistic regression analysis was used to identify the relationship between fQRS positivity and somatic symptoms. Adjusted models were created for potential confounders.</p><p><strong>Results: </strong>Women with fQRS positivity reported significantly higher somatic symptoms and total MRS scores compared to those without fQRS positivity. Specifically, higher scores were observed in the fQRS-positive group for the somatic subscale and total MRS score. Binary logistic regression analysis revealed that fQRS positivity was significantly associated with somatic symptoms after adjusting for all confounders (odds ratio, 10.76; 95% CI, 7.21-16.07; P < 0.001).</p><p><strong>Conclusions: </strong>Postmenopausal women with fQRS positivity on ECG exhibit a higher severity of somatic symptoms compared to those without fQRS positivity. These findings suggest a potential link between somatic symptoms and myocardial conduction abnormalities indicated by fQRS positivity. Further research is needed to clarify the underlying mechanisms of this association.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"240-246"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950927","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":"Diverse experiences of menopause.","authors":"Yamnia I Cortés","doi":"10.1097/GME.0000000000002510","DOIUrl":"https://doi.org/10.1097/GME.0000000000002510","url":null,"abstract":"<p><p>Although the biologic underpinnings of menopause remain consistent across populations, the experience of this phase can vary. This Practice Pearl summarizes key sociocultural, behavioral, environmental, and healthcare-system factors that contribute to the menopause journey. In addition to obtaining an accurate health history, screening for social determinants of health can enhance individualized menopause care with the potential to significantly improve overall health outcomes.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 3","pages":"278-280"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502295","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 role of short luteal phases on cycle regularity during the perimenopausal transition.","authors":"Caroline Visby Madsen, Gianluca Adornetto, Kirstine Kirkegaard","doi":"10.1097/GME.0000000000002477","DOIUrl":"10.1097/GME.0000000000002477","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to explore the correlation between short luteal phases and cycle irregularity in perimenopausal women.</p><p><strong>Methods: </strong>In this feasibility pilot study, daily salivary-progesterone measurements from presumed perimenopausal women have been analyzed using the inne minilab-an at-home system for ovulation and cycle tracking. Data were collected between 2020 to August 2022 from 29 women from Germany and Austria from users over the age of 42 years. Mean age was 44.5 years. The women were divided into two groups based on the presence of short luteal phases. Wilcoxon rank sum test was used to compare the two groups with regard to perimenopausal characteristics: cycle length variability, occurrence, and frequency of short cycles, long cycles, and anovulatory cycles.</p><p><strong>Results: </strong>A significant correlation ( P value =0.02) was found between short luteal phases and short cycle length under 23 days, with a median of two short cycles in the short luteal phase positive group compared to a median of 0 short cycles in the negative group. However, this correlation did not persist when adjusting for number of observations per participant. No difference was found when comparing other cycle characteristics.</p><p><strong>Conclusions: </strong>These findings could suggest that it may not be feasible to utilize the occurrence of short luteal phases in the context of expressing the likelihood of cycle irregularity, length, or anovulation. However, because of the small sample size in this study, the null findings could be due to lack of power. Larger studies would be needed to determine how short luteal phases may be correlated to cycle regularity.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"258-265"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882524","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}