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

{"title":"Use of progestin-containing intrauterine systems in hormone therapy regimens: what are the data?","authors":"Amy J Voedisch","doi":"10.1097/GME.0000000000002672","DOIUrl":"https://doi.org/10.1097/GME.0000000000002672","url":null,"abstract":"<p><p>The levonorgestrel intrauterine system (IUS) is frequently used in perimenopause for contraception and bleeding control and in both perimenopause and menopause for endometrial protection while using estrogen therapy to control bothersome menopause symptoms. The use of an IUS for endometrial protection as part of hormone therapy is off label in the United States but is approved for use in more than 100 countries for up to 5 years. Some IUSs have been approved for contraceptive use for 8 years, and questions remain whether they provide adequate endometrial protection when combined with estrogen therapy beyond 5 years of use.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075573","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 effect of menopause on choroidal thickness and vascularity index.","authors":"Zeynep Özer Özcan, Hüseyin Çağlayan Özcan","doi":"10.1097/GME.0000000000002638","DOIUrl":"https://doi.org/10.1097/GME.0000000000002638","url":null,"abstract":"<p><strong>Objective: </strong>Our study aimed to compare premenopausal and postmenopausal women in terms of choroidal thickness and choroidal vascularity index.</p><p><strong>Methods: </strong>This cross-sectional study included 96 eyes of 96 participants, comprising 48 premenopausal and 48 postmenopausal women. Enhanced depth image optical coherence tomography (EDI-OCT) was used to visualize the choroid. Choroidal thickness measurements were performed at three points, including the subfoveal region (subfoveal choroidal thickness [SFCT]), 1500 μm nasal to the fovea (nasal choroidal thickness [NCT]), and 1500 μm temporal to the fovea (temporal choroidal thickness [TCT]) from EDI-OCT images. The choroidal vascularity index (CVI), total choroidal area (TCA), luminal area (LA), and stromal area (SA) were measured in the subfoveal 3000 μm area by the binarization technique via ImageJ software. Measurements of premenopausal and postmenopausal women were compared after adjusting for age.</p><p><strong>Results: </strong>The comparison of axial length, spherical equivalent, and body mass index values revealed no significant differences (P>0.05 for all). SCFT, NCT, TCT, LA, and TCA values were statistically significantly lower after adjusting for age in the postmenopausal group compared with the premenopausal group (P=0.002, 0.020, 0.004, 0.020, 0.043) respectively. There was no statistically significant difference in SA and CVI values (P>0.05 for all).</p><p><strong>Conclusion: </strong>The decreased choroidal thickness in postmenopausal women likely resulted from the reduction in the vascular component of the choroid, while the stromal component remained unchanged. Further prospective long-term studies are needed to evaluate women before and during menopause to investigate the relationship between choroidal vascular structure and the risk of ischemic vascular diseases.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030088","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":"Trends in obesity among premenopausal and postmenopausal women in the United States between 1999 and 2018: results from the National Health and Nutrition Examination Survey.","authors":"Claire E Cook, Chris Kim, Mahrukh Abid, Alexandra Wasser, Hailey R Banack","doi":"10.1097/GME.0000000000002630","DOIUrl":"https://doi.org/10.1097/GME.0000000000002630","url":null,"abstract":"<p><strong>Objective: </strong>The objective of the present work is to: (1) describe the trends in obesity among premenopausal and postmenopausal women in the United States between 1999 and 2018, and (2) describe the effect of aging on body mass index in women, using novel BMI-for-age percentile curves.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) collected between 1999 and 2018, including self-identified female participants older than 20 years, was used. Menopause status was self-reported, and body mass index (BMI, kg/m2) was calculated based on measured height and weight. Mean BMI across year is described according to menopause status and race/ethnicity. BMI-for-age percentiles and curves were created to describe adult BMI in the context of age.</p><p><strong>Results: </strong>Mean BMI among premenopausal women increased from 27.7 (7.1) kg/m2 in 1999 to 30.2 (8.8) kg/m2 in 2018. In postmenopausal women, mean BMI increased from 28.7 (6.2) kg/m2 in 1999 to 29.7 (7.1) kg/m2 in 2018. Among premenopausal women, BMI values in the 50th percentile range from 25.0 kg/m2 at age 20 to 28.6 kg/m2 at age 60. Among postmenopausal women, BMI values in the 50th percentile range from 27.1 kg/m2 at age 41 to 28.3 kg/m2 at age 60, and 26.5 kg/m2 at age 80.</p><p><strong>Conclusions: </strong>The present findings describe an increase in BMI by both calendar year and chronological age during the years before menopause leading to higher BMI levels among postmenopausal women. These findings highlight the premenopausal period and the menopause transition as an important opportunity for obesity screening, identification, and prevention.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030045","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":"Inflammation and insulin resistance partially mediate the relationship between age at menopause and depression in postmenopausal women: a cross-sectional study of NHANES 2005-2018.","authors":"Paula Amado Riveros, Efrain Riveros Perez","doi":"10.1097/GME.0000000000002661","DOIUrl":"https://doi.org/10.1097/GME.0000000000002661","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate depression in postmenopausal women and to explore the relationship between age at menopause, hormone therapy, and depression, while also identifying potential mediators that may explain these associations.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from National Health and Nutrition Examination Survey (NHANES) (2005-2020) for women older than 60 years who completed the Patient Health Questionnaire 9 (PHQ-9) depression questionnaire (n=7,027). Exposures included age at menopause and self-reported hormone therapy; the outcome was depression severity (PHQ-9 ≥10). Covariates included sociodemographics, body mass index, medical conditions, and biomarkers (C-reactive protein, homeostatic model assessment of insulin resistance). Survey-weighted logistic regression, Bayesian modeling, and causal mediation analysis were used. Missing data were handled with multiple imputation and inverse probability weighting. Analyses were conducted with R software, with P<0.05 considered significant.</p><p><strong>Results: </strong>In this NHANES sample of postmenopausal women older than 60 years, earlier age at menopause was associated with depression (P<0.0001). Hormone therapy did not show a significant association with depression (OR=0.58, 95% CI: 0.23-1.4), while higher education levels were protective (college degree: OR=0.89, 95% CI: 0.85-0.92, P<0.001). C-reactive protein and homeostatic model assessment of insulin resistance partially accounts for the statistical association between menopause and depression (P<0.0001).</p><p><strong>Conclusion: </strong>Age at menopause is inversely associated with depression in women older than 60 years. This relationship is statistically accounted for by the role of inflammation and insulin resistance. Self-reported hormone therapy is not associated with depression in postmenopausal women.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030021","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 relationship between vaginal aging and sexual quality of life in postmenopausal women.","authors":"Fatma Keskin Töre, Gülçin Nacar, Cansu Ağrali","doi":"10.1097/GME.0000000000002639","DOIUrl":"https://doi.org/10.1097/GME.0000000000002639","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the relationship between vaginal aging and sexual quality of life in postmenopausal women.</p><p><strong>Methods: </strong>A descriptive, cross-sectional study was conducted with 210 postmenopausal women aged 45 to 59 years. Data were collected using a Personal Information Form, the Daily Effects of Vaginal Aging Scale, and the Sexual Quality of Life Scale. Descriptive statistics, Pearson correlation analysis, and multiple regression analysis were used to analyze the data.</p><p><strong>Results: </strong>A statistically significant negative correlation was found between vaginal aging and sexual quality of life ( r =-0.533, P <0.001). A one-unit increase in vaginal aging was associated with a 0.506-unit decrease in sexual quality of life score (B=-0.506, P <0.001).</p><p><strong>Conclusions: </strong>Vaginal aging was significantly associated with lower sexual quality of life in postmenopausal women. These findings suggest that addressing vaginal aging may contribute to enhancing sexual well-being in this population.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030006","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":"Estrogen therapy in patients with gynecologic cancer: a survey of gynecologists and oncologists in the United States.","authors":"Jamie L McDowell, Myla Strawderman, Sarah J Betstadt, Richard G Moore","doi":"10.1097/GME.0000000000002643","DOIUrl":"https://doi.org/10.1097/GME.0000000000002643","url":null,"abstract":"<p><strong>Objective: </strong>Endometrial cancer (EC) and epithelial ovarian cancer (EOC) affect women of all ages, and the incidence of endometrial cancer in premenopausal women is rising. Menopause can be detrimental to longevity and quality of life, but evidence suggests estrogen therapy (ET) is safe in these patients. The purpose of this study was to evaluate the practice patterns of gynecologists and gynecologic oncologists (GYO) in the United States in regards to prescription of ET to gynecologic cancer patients. It was hypothesized that ET is underused in this population.</p><p><strong>Methods: </strong>In 2024, a web-based survey was administered through email or postcard mailer to members of the Society of Gynecologic Oncology and the American College of Obstetricians and Gynecologists. Participants were asked demographic questions and whether they provide ET for patients with a history of EC, EOC, and cervical cancer.</p><p><strong>Results: </strong>A total of 293 participants answered questions about at least one type of cancer. When asked if willing to provide ET, 63.82% (187/293) selected \"yes\" for EC, 65.19% (176/270) for EOC, and 96.8% (274/283) for cervical cancer. Due to lack of heterogeneity, cervical cancer was omitted from analysis. Gynecologic oncology providers were more likely than OBGYNs to prescribe ET for EC (P = 0.0006) and EOC patients (P = 0.0009). Those in practice for 10 or more years (P = 0.022), or who identified as male (P = 0.019), were more likely to prescribe ET to EC patients. Of those who do not prescribe ET, the most common reasons were belief that hormones are contraindicated, better options exist, and risk outweighs benefits. These options were selected more frequently by OBGYNs than GYOs.</p><p><strong>Conclusion: </strong>Many gynecologists, and some gynecologic oncologists, are uncomfortable prescribing hormone therapy to patients with a history of endometrial or epithelial ovarian cancer, despite evidence suggesting its safety. This indicates a need for clinician education to ensure patients are counseled appropriately about options for treating menopausal symptoms.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030023","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":"Menopause and the voice: a narrative review of physiological changes, hormone therapy effects, and treatment options.","authors":"Yael E Bensoussan, Emily G Evangelista, Rebecca J Doctor, Begum A Mathyk, Kate L Bevec, Jamie A Toghranegar, Rupal Patel","doi":"10.1097/GME.0000000000002636","DOIUrl":"https://doi.org/10.1097/GME.0000000000002636","url":null,"abstract":"<p><strong>Importance and objective: </strong>Voice changes during menopause affect patients' communication and quality of life. This narrative review aims to provide a comprehensive exploration of voice changes during menopause. It presents objective and subjective/symptomatic changes as well as treatment options for this population. Lastly, it identifies areas of research and future directions needed to serve this population through collaboration between voice experts and gynecologists.</p><p><strong>Methods: </strong>To inform this narrative review, a literature review was conducted using the PubMed database, encompassing publications from January 2005 to January 2025. The review synthesized research on hormonal influences, acoustic analyses, laryngeal imaging, and patient-reported outcomes, with a focus on understanding the physiological mechanisms underlying menopausal voice alterations.</p><p><strong>Results: </strong>The review reveals a complex narrative of vocal transformation during menopause. Hormonal decline-characterized by reduced estrogen and progesterone levels-precipitates significant laryngeal changes. Up to 46% of menopausal women experience perceptible vocal modifications, including decreased fundamental frequency (by 0.94 semitones), increased vocal instability, and reduced phonation capabilities. Particularly vulnerable are professional voice users, who face unique challenges in maintaining vocal performance. Hormone therapy demonstrates potential protective effects, though findings remain inconsistent.</p><p><strong>Discussion and conclusion: </strong>Menopause-related voice disorders represent a nuanced and underexplored medical phenomenon. This review underscores the critical need for interdisciplinary research that integrates gynecology, otolaryngology, endocrinology, and speech pathology. Future investigations could focus on developing AI-driven voice biomarkers, conducting longitudinal studies, and creating targeted interventions that recognize the voice and respiratory transitions women experience during menopause.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030075","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":"Impact of sleep disturbances on health-related quality of life in postmenopausal women: a systematic review.","authors":"Claudio N Soares, Malek Bajbouj, Nils Schoof, Amit Kishore, Cecilia Caetano","doi":"10.1097/GME.0000000000002633","DOIUrl":"https://doi.org/10.1097/GME.0000000000002633","url":null,"abstract":"<p><strong>Importance: </strong>Sleep disturbances are common during and after the menopause transition, with potential effects on morbidity and quality of life; however, they may be underdiagnosed and undertreated.</p><p><strong>Objective: </strong>We carried out a systematic literature review to investigate the prevalence and impact of sleep disturbances associated with menopause on women's health-related quality of life across the stages of menopause.</p><p><strong>Evidence review: </strong>Searches were conducted in PubMed and Excerpta Medica Database to identify articles published between 2013 and 2023 containing evidence for the impact of sleep quality on health-related quality of life and the epidemiology of sleep disturbances in women in menopause.</p><p><strong>Findings: </strong>In total, 29 publications focusing on epidemiological outcomes of sleep disturbances and 28 studies focusing on the impact of sleep quality on health-related quality of life were identified. Overall, these studies confirmed the high prevalence of sleep disturbances in postmenopausal women. Risk factors for sleep disturbances included menopausal status, depression, vasomotor symptoms, high glycemic index diets, and age. Notably, sleep disturbances were identified even in the absence of vasomotor symptoms. Sleep disturbances were significantly associated with impaired menopause-specific and general health-related quality of life, including depression, anxiety, and musculoskeletal pain. Sleep disturbances were also associated with reduced work productivity and the ability to perform daily activities.</p><p><strong>Conclusions and relevance: </strong>Healthy sleep is important at all life stages, including during menopause. Our review indicates that sleep disturbances are highly prevalent during postmenopausal years, even among women without vasomotor symptoms, and can severely impact women's well-being and quality of life. This study highlights the importance of promoting increased awareness and developing tailored treatment strategies for sleep disturbances in midlife and beyond.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030079","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":"Treatment patterns in women with breast cancer and endocrine therapy-related menopausal symptoms: a cohort study from the United States, United Kingdom, and Germany.","authors":"Mariam Saadedine, Victoria Banks, Carina Dinkel-Keuthage, Cecile Janssenswillen, Martin Lavallee, Carsten Moeller, Nils Schoof, David Vizcaya, Maja Francuski, Asieh Golozar, Thomas Römer, Ali Kubba","doi":"10.1097/GME.0000000000002611","DOIUrl":"https://doi.org/10.1097/GME.0000000000002611","url":null,"abstract":"<p><strong>Objective: </strong>To describe treatment patterns for menopausal symptoms in women taking endocrine therapy for breast cancer treatment/prevention from the United States (US), United Kingdom (UK), and Germany.</p><p><strong>Methods: </strong>We undertook a retrospective cohort study using data from the US Market Scan Commercial Claims and Encounters Data database, and electronic health records from the UK's Clinical Practice Research Database Aurum and the German Disease Analyzer. Women aged 18-65 years with a first prescription/dispensation for endocrine therapy for breast cancer treatment or prevention (index date) from 2010 to 2022 were followed up, and the following treatment classes were evaluated: antidepressants, benzodiazepines, anticonvulsants, antihypertensives, and hormone therapy.</p><p><strong>Results: </strong>Treatments were recorded in 32.7% (39,137/119,717) US women, 20.4% (8,350/40,956) UK women, and 8.3% (1,031/12,388) German women. Among these, ~80% in the US and UK, and all in Germany, received one treatment class; switches occurred in 20.5% (US) and 16.5% (UK). The most frequent initial treatment classes were antidepressants (31.7% US, 45.3% UK, 38.1% Germany); the second most frequent were benzodiazepines (30.3% US), anticonvulsants (24.3% UK), and hormone therapy (27.2% Germany). Among antidepressants, the most common were venlafaxine (US and Germany), and amitriptyline, sertraline, and citalopram (UK). Six-month continuation rates for antidepressants were 42% (US), 12% (UK), and 7% (Germany); continuation rates for other treatments were even lower.</p><p><strong>Conclusions: </strong>Continuation rates with available treatments for menopausal symptoms in women receiving endocrine therapy for breast cancer treatment/prevention are very low. This indicates a clear unmet need for safe, effective, and well-tolerated treatments in this patient population.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960391","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":"Indication for diagnostic oophorectomy without radiographic evidence: two cases of postmenopausal androgen-secreting ovarian hyperplasia.","authors":"Rhianna Bhatia, Shelley Saber, Lavanya Gunnam, Thad R Denehy, Nana Tchabo, Sonoo Advani","doi":"10.1097/GME.0000000000002605","DOIUrl":"https://doi.org/10.1097/GME.0000000000002605","url":null,"abstract":"<p><strong>Objectives: </strong>Hyperandrogenism, while one of the most common endocrine disorders in women, is relatively uncommon in the postmenopausal population. When present, it may be indicative of an underlying rare androgen-secreting ovarian tumor. Here, we report 2 cases: a 63-year-old woman with 2 years of male-pattern baldness and hirsutism and a 71-year-old female with 2 years of progression to complete scalp alopecia, hirsutism, and libido changes.</p><p><strong>Methods: </strong>Upon endocrine evaluation, testosterone concentrations were markedly elevated for both patients. In the first case, there was no radiologic evidence of ovarian mass on ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI). In the second case, transvaginal ultrasound (TVUS) detected an ovarian lesion, which guided further radiologic workup; however, positron emission tomography (PET) and MRI were unremarkable.</p><p><strong>Results: </strong>In case 1, surgical pathology upon total hysterectomy with bilateral salpingo-oophorectomy revealed bilateral Leydig cell hyperplasia. For case 2, surgical intervention revealed a right ovarian steroid cell tumor with contralateral stromal and hilus cell hyperplasia.</p><p><strong>Conclusion: </strong>In both patients, testosterone levels normalized immediately following total hysterectomy with bilateral salpingo-oophorectomy. In conjunction, these 2 cases highlight the importance of having a high clinical suspicion for steroid cell tumors or hyperplasia in postmenopausal women presenting with features of hyperandrogenism and elevated testosterone levels despite unrevealing radiographic findings.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960330","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}