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

{"title":"Patient experience of menopause care after breast cancer in the UK: a cross-sectional study.","authors":"Sarah Glynne, Daniel Reisel, Aini Kamal, Louise Newson","doi":"10.1097/GME.0000000000002504","DOIUrl":"10.1097/GME.0000000000002504","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore women's experience of menopause care after breast cancer in the UK.</p><p><strong>Methods: </strong>An online survey incorporating the validated Shared Decision Making SDM-Q-9 questionnaire was disseminated via social media to breast cancer survivors in the UK.</p><p><strong>Results: </strong>A total of 1,195 women completed the survey. The menopause symptom burden was high (99.7%). Fear of recurrence was the dominant concern for 55.6% of women, but 44.4% were more concerned about quality of life and future risk of long-term conditions associated with estrogen deficiency. Women further from diagnosis were less concerned about recurrence (fear of recurrence was the dominant concern for 58.6% of women within 2 y of diagnosis vs. 43.1% of women more than 15 y from diagnosis, P  = 0.001). Of all women, 68.3% were offered treatment (nonhormone treatment, 58.5%; vaginal hormones, 35.5%; menopause hormone therapy, 13.1%; testosterone, 10.1%). Menopause specialists were more likely to prescribe MHT versus nonmenopause specialists (68.2% vs. 31.8%, P  < 0.0001); GP menopause specialists were more likely to prescribe testosterone versus gynecologist menopause specialists (60.8% vs. 39.2%, P  < 0.0001). Of all women, 49.6% who were not offered menopause hormone therapy were willing to consider it, and 83.7% wanted more information about menopause hormone therapy. Information provision and time allocated to menopause-related discussion were poor (<10 min for 73.52% of women). Involvement in menopause-related treatment decisions was low (SDM-Q-9 median score, 11.1/100; IQR, 0.0-28.9). Women who consulted a menopause specialist (30.2%) were significantly more able to discuss their concerns ( P  < 0.001), were given significantly more time (>10 min for 75.6%, P  < 0.001), and felt significantly more involved in menopause-related treatment decisions ( P  < 0.001). Overall, 96% of women wanted more support for menopausal symptoms.</p><p><strong>Conclusions: </strong>Many women in the study cohort had unmet menopause-related health needs after breast cancer, and the quality of menopause care received was poor. Most women felt uninvolved in menopause-related treatment decisions. Women experienced higher quality menopause care if they had access to a menopause specialist.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"396-408"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12024849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399538","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":"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":"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 31 phosphorus magnetic resonance spectroscopy ( 31 P-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":"433-442"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","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":"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":"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":"420-427"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","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":"Prevalence and impact of vasomotor symptoms due to menopause among women in Brazil, Canada, Mexico, and Nordic Europe: a cross-sectional survey: Erratum.","authors":"Lora Todorova, Rogerio Bonassi, Francisco Javier Guerrero Carreño, Angelica L Hirschberg, Nese Yuksel, Carol Rea, Ludmila Scrine, Janet S Kim","doi":"10.1097/GME.0000000000002550","DOIUrl":"https://doi.org/10.1097/GME.0000000000002550","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 5","pages":"481"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018213","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 genitourinary syndrome of menopause.","authors":"Amanda L Clark","doi":"10.1097/GME.0000000000002515","DOIUrl":"https://doi.org/10.1097/GME.0000000000002515","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 5","pages":"469-471"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028867","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":"Urodynamic evaluation of prasterone vaginal treatment of mild to moderate urge incontinence in women with vulvovaginal atrophy: multicenter prospective study.","authors":"Claudia Collà Ruvolo, Manuela Ursino, Carmen Formisano, Alberto Pozzuoli, Roberta Venturella, Nicola Longo, Costantino Di Carlo","doi":"10.1097/GME.0000000000002508","DOIUrl":"10.1097/GME.0000000000002508","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the effects of intravaginal prasterone treatment on urge urinary symptoms in women affected by genitourinary syndrome of menopause.</p><p><strong>Methods: </strong>The study was conducted on postmenopausal women with vulvovaginal atrophy and symptoms of increased urinary frequency and urgency with an Overactive Bladder Screener score of >8. Participants underwent urodynamic examination and completed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) questionnaire before and after 3 months of treatment. Wilcoxon signed rank test for the paired sample was used to compare continuous non parametric variables.</p><p><strong>Results: </strong>Twenty women were prospectively enrolled (January 2022 to January 2024). The median age and menopausal age were 59 years (interquartile range, 56.0-66.5 y) and 50 years (interquartile range, 49.0-52.5 y), respectively. According to the ICIQ-SF, the mean scores before and after treatment were 9.6 (SD, 5.1) and 2.63 (SD, 2.24), respectively ( P  > 0.001). According to the urodynamic examination, the median volume infused increased from 70 to 123 mL ( P  = 0.001) for the first stimulus, from 115 to 202 mL ( P  = 0.001) for the normal stimulus, from 199 to 290 mL ( P  = 0.001) for the urge stimulus, and from 251 to 343 mL ( P  = 0.001) for the maximal bladder filling capacity. At the end of the study, the 42.1% of women reported very much and much better improvement according to the Patient Global Impression of Improvement score.</p><p><strong>Conclusions: </strong>After 3 months of prasterone treatment, women reported a statistically significant objective increase in bladder compliance through a later voiding stimulus and a subjective reduction in urge incontinence episodes through the validated ICIQ-SF questionnaire.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"428-432"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399562","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":"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":"443-452"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","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":"Bone-building osteoporosis therapies and the menopause practitioner.","authors":"Michael R McClung","doi":"10.1097/GME.0000000000002559","DOIUrl":"https://doi.org/10.1097/GME.0000000000002559","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 5","pages":"381-384"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032225","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":"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":"475-480"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}