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

{"title":"Women's experience of premature ovarian insufficiency (POI) diagnosis: update on actual practices and women's follow-up (EMPOIHER Study).","authors":"Maëva Aubin, Anna Gosset, Virginie Grouthier, Anais Lecomte, Emmanuelle Begon, Jennifer Carrière, Lucie Chansel-Debordeaux, Chloé Depuydt, Sandrine Frantz, Gabrielle Laloux, Marie Lambert, Claude Hocké, Florence Trémollieres, Valérie Bernard","doi":"10.1097/GME.0000000000002623","DOIUrl":"https://doi.org/10.1097/GME.0000000000002623","url":null,"abstract":"<p><strong>Objective: </strong>Although premature ovarian insufficiency (POI) diagnosis can be devastating, few studies focused on women's experiences of the disclosure. The objective of EMPOIHER study was to evaluate women's satisfaction with POI disclosure and the association with subsequent adherence to the treatment plan and medical follow-up.</p><p><strong>Methods: </strong>We studied a cohort of 101 women diagnosed with spontaneous POI who attended two French University Hospitals between 2017 and 2024. Standardized interviews collected gynaecologic history, experience of POI diagnosis, etiological and comorbidities assessment, POI follow-up and menopause hormone therapy (MHT) use. Women's satisfaction with POI disclosure was evaluated using a five-item scale assessing the health care provider's emotional responsiveness, clarity of communication, amount of information provided, opportunity for questions and relevance of discussed topics to the women's concerns.</p><p><strong>Results: </strong>Sixty-four percent of participants declared they were globally satisfied or very satisfied with the way they were informed of their POI diagnosis. However, 70% sought more information using the internet or asked for the opinion of another practitioner. Surprisingly, psychological support was offered to only 19.8% of women. Solely 63.4% of participants benefited from MHT at inclusion. No association was found between women's satisfaction regarding POI disclosure and their adherence to follow-up and MHT.</p><p><strong>Conclusions: </strong>While participants expressed general satisfaction with the communication of their POI diagnosis, there is room for improvement in clinicians' communication skills regarding providing information and empathy. Furthermore, women should be offered psychological support following POI diagnosis. Our findings emphasise the need for guidelines concerning the POI disclosure process. In this study, no association was found between women's satisfaction with POI announcement and their adherence to MHT and gynecologic follow-up.</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":"144960338","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":"Stroke risk in women with or without hysterectomy and/or bilateral oophorectomy: evidence from the NHANES 1999-2018 and meta-analysis.","authors":"Chuan Shao, Chao Xu, Dewei Zou, Gang Zhang, Haotian Jiang, Cheng Zeng, Tao Tang, Hui Tang, Nan Wu","doi":"10.1097/GME.0000000000002616","DOIUrl":"https://doi.org/10.1097/GME.0000000000002616","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the relationship between hysterectomy and/or bilateral oophorectomy and the risk of stroke-a topic of ongoing debate in current research.</p><p><strong>Methods: </strong>We utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018 to estimate both crude and multivariable-adjusted hazard ratios (HRs) and 95% CIs, applying survey-weighted Cox proportional hazards regression model. The modeling incorporated sampling weights and design variables to address NHANES's multistage probability sampling framework. In addition, a meta-analysis was conducted, incorporating findings from NHANES with those from other cohort studies identified through database search.</p><p><strong>Results: </strong>This unweighted NHANES cohort included 21,240 women with 8.3 median follow-up years, documenting 193 stroke-related deaths. Compared with no hysterectomy, hysterectomy was not significantly associated with stroke mortality (HR: 1.28, 95% CI: 0.89-1.85). However, a meta-analysis of 2,065,490 participants from NHANES and 15 other studies demonstrated hysterectomy was linked to a 9% higher stroke risk (HR: 1.09, 95% CI: 1.04-1.15) compared with no hysterectomy. Similar finding was identified for bilateral oophorectomy (HR: 1.13, 95% CI: 1.09-1.17) compared with no bilateral oophorectomy. Subgroup analyses stratified by surgical indication, ovarian conservation status, and reference population consistently demonstrated elevated risks.</p><p><strong>Conclusions: </strong>In summary, the data from NHANES and other studies indicate women with hysterectomy and/or bilateral oophorectomy may be associated with an increased stroke risk. Additional prospective studies are needed to confirm the association between hysterectomy and/or bilateral oophorectomy and stroke risk.</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":"144960317","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":"Considerations for hormone therapy use in survivors of breast cancer.","authors":"Holly J Pederson","doi":"10.1097/GME.0000000000002629","DOIUrl":"https://doi.org/10.1097/GME.0000000000002629","url":null,"abstract":"<p><p>The use of hormone therapy in survivors of breast cancer is complex and contentious. Historically, guidelines have strongly advised against using hormone therapy. Its safety likely depends on many factors. However, long-term oncologic data are lacking, leaving women with unresolved quality-of-life and health concerns and practitioners uncertain about their recommendations. In the short term, there will not be definitive data, and decisions must be made based on the existing imperfect evidence.</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":"144959573","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":"Gonadotropin trajectories among postmenopausal women not using hormone therapy.","authors":"Sarah M Lima, Yihua Yue, Jennifer W Bea, Kathleen M Hovey, Jean Wactawski-Wende, JoAnn E Manson, Denise J Roe, Janet L Funk, Andrew Odegaard, Shelby G Ziller, Matthew Allison, Robert Wallace, Su Yon Jung, Jane A Cauley, Heather M Ochs Balcom","doi":"10.1097/GME.0000000000002631","DOIUrl":"https://doi.org/10.1097/GME.0000000000002631","url":null,"abstract":"<p><strong>Objective: </strong>While evidence suggests that gonadotropins may play an important role in aging-related changes in body composition and health outcomes, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) patterns have not been well characterized in older women. We characterized patterns of FSH and LH change over time after menopause.</p><p><strong>Methods: </strong>In a sample of 291 postmenopausal women from the Women's Health Initiative OsteoPerio study who were not using hormone therapy, we estimated FSH and LH trajectories over a 20-year period using group-based trajectory modeling. Descriptive statistics identified differences according to hormone trajectory group.</p><p><strong>Results: </strong>We estimated 3 FSH trajectories. The low FSH trajectory (36.1% of sample) showed had stable FSH, the moderate FSH trajectory (52.9%) showed FSH increased 30 years after menopause, and the high FSH trajectory (11.0%) showed FSH initially declined then increased 20 years after menopause. The moderate and high FSH trajectory groups were more likely to be never smokers, had lower measures of adiposity, and more severe hot flashes. We estimated 3 LH trajectories. The low LH trajectory (29.6%) showed LH declined over time, the moderate LH trajectory (56.0%) initially declined then increased 30 years after menopause, and the high LH trajectory (14.4%) initially decline then steeply increase 30 years after menopause. The moderate and high LH trajectory groups had lower measures of adiposity at baseline.</p><p><strong>Conclusion: </strong>There is variability in gonadotropin levels during the postmenopausal period in women not using hormone therapy. Research is needed to study whether postmenopausal gonadotropin patterns are associated with aging-related outcomes.</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":"144959571","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":"Trajectories and risk factors of depressive symptomatology following hysterectomy.","authors":"Andrew S Bossick, Wan-Ting K Su, Joelle Abood, Victoria Arruga Novoa Y Novoa, Petra Chamseddine, Annmarie Vilkins, Ganesa R Wegienka","doi":"10.1097/GME.0000000000002606","DOIUrl":"https://doi.org/10.1097/GME.0000000000002606","url":null,"abstract":"<p><strong>Objectives: </strong>Hysterectomy is the second most common gynecological surgery performed on reproductive aged women in the United States. It is not known if some groups of women are more susceptible to depression after hysterectomy.</p><p><strong>Methods: </strong>Participants were scheduled for hysterectomy for benign causes and not undergoing a concomitant urogynecological procedure. Patient Health Questionnaire-9 (PHQ-9) was collected 2 weeks before, and 1, 4, and 6 weeks, and 3, 6, and 12 months post-hysterectomy to understand depressive symptoms associated with surgery. PHQ-9 patterns were identified with latent class analyses. Multivariable multinomial logistic regression was used to estimate relative risk ratios (RRR) and 95% CIs of associations between baseline sociodemographic, clinical, and operative-related characteristics and PHQ-9 class.</p><p><strong>Results: </strong>Three latent classes (C) were identified from their PHQ-9 score patterns among 455 participants: high and increasing (C1, 15.6%), high and decreasing (C2, 27.7%), and persistently low PHQ-9 trajectory (C3, 56.7%). Insurance type, financial toxicity, pain level, and surgical decision satisfaction before surgery were statistically significantly associated with class membership. At surgery, C1 members were more likely to have public insurance (RRR=2.04, CI: 1.02-4.08), worse finances (0.92, 0.89-0.96), and higher pain (1.22, 1.10-1.35) than members of C3. C2 members were more likely to have worse finances (0.94, 0.91-0.96) than C3 members. C1 members tended to have higher pain (1.14, 1.02-1.26) than C2 members.</p><p><strong>Conclusions: </strong>Depression symptomology after hysterectomy may be associated with presurgical insurance type, financial toxicity, current pain level, and satisfaction. More research is needed to investigate whether these factors can be incorporated into preoperative counseling and screening tools to guide shared decision-making regarding depression and surgery.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835564","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":"Understanding the sexual concerns of older women presenting for care to women's health clinics: a cross-sectional study.","authors":"Jana Karam, Chrisandra Shufelt, Sheryl Kingsberg, Kristin Cole, Stacey Winham, Ekta Kapoor, Juliana M Kling, Stephanie S Faubion","doi":"10.1097/GME.0000000000002617","DOIUrl":"https://doi.org/10.1097/GME.0000000000002617","url":null,"abstract":"<p><strong>Objective: </strong>To compare the prevalence of female sexual dysfunction (FSD) and distress between sexually active midlife women (50-64 y) and older women (65+ y) presenting for care at women's health clinics at a tertiary care center.</p><p><strong>Methods: </strong>This cross-sectional study included women aged 50 and above who received care at Mayo Clinic women's health clinics in Rochester, MN; Scottsdale, AZ; and Jacksonville, FL, between May 1, 2015, and August 31, 2022. Sexual function and distress were compared between midlife and older women using the Female Sexual Function Index (FSFI), Female Sexual Distress Scale-Revised (FSDS-R), and self-reported sexual health concerns.</p><p><strong>Results: </strong>Among 3,465 sexually active women, older women were less likely to report loss of sexual desire (33.4% vs. 47.6%; P<0.001) and reduced genital sensation (13.0% vs. 16.9%; P=0.024) compared with midlife women. There were no significant differences for vaginal dryness, painful intercourse, or arousal/orgasm difficulties. FSFI scores were higher in older women for desire (3.0 vs. 2.4; P<0.001) and lubrication (3.9 vs. 3.6; P<0.001). While total FSFI scores were similar between older and midlife women (21.2 vs. 22.2; P=0.11), sexually related distress was lower in older women compared with midlife women (13.0 vs. 15.0; P=0.015). The prevalence of FSD (defined as FSFI score ≤26.55 and FSDS-R score ≥11) was similar between groups (51.8% vs. 56.2%; P=0.056).</p><p><strong>Conclusions: </strong>Older women experienced FSD at similar rates as midlife women but reported less sexual distress, potentially reflecting lower expectations regarding sexual function. Addressing sexual health concerns in older women may enhance quality of life.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835565","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 workplace: can Playmobil be used to encourage open discussion between women and their employers?","authors":"Sarah Glynne","doi":"10.1097/GME.0000000000002658","DOIUrl":"https://doi.org/10.1097/GME.0000000000002658","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789474","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":"Menopausal experience and sexuality: women's perceptions.","authors":"Sophie Renou, Christèle Assegond, Henri Marret, David Pragout","doi":"10.1097/GME.0000000000002624","DOIUrl":"10.1097/GME.0000000000002624","url":null,"abstract":"<p><strong>Objective: </strong>Menopause can result in significant transformations in a woman's life and sexuality. A limited number of studies have investigated women's perceptions at the time of menopause and their potential impact on their sexuality. The aim of this study is to explore women's perceptions of menopause and their impact on their sexuality from a multidimensional perspective, using a qualitative approach.</p><p><strong>Methods: </strong>We conducted 13 semistructured individual interviews with postmenopausal women aged 49 to 63 years. The interviews were recorded, transcribed, and coded by 2 investigators. These codes were then classified into themes and subthemes.</p><p><strong>Results: </strong>With regard to menopause, the participants first emphasized the physical and psychological symptoms (hot flashes, genitourinary disorders, weight gain, depression, mood swings) that they experienced during this time, which were sometimes incapacitating. They also reported a complex psychosocial context at the onset of menopause. Most of them went through this experience alone. The combination of these various factors resulted in a highly variable menopausal experience. Their sexuality was primarily influenced by the severity of the genitourinary disorders and the quality of the relationship with their partner, and sexual desire levels varied as a result.</p><p><strong>Conclusions: </strong>The overall experience of menopause widely varies from one woman to another, mainly depending on the intensity of the physical and psychological symptoms, as well as on their life context. Sexuality and sexual desire may change quantitatively and qualitatively. Some women are at greater risk for a negative menopause experience and require special attention from health care professionals.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789473","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":"Beyond moods and cycles: a closer look at anger and anxiety throughout midlife reproductive stages.","authors":"Claudio N Soares","doi":"10.1097/GME.0000000000002634","DOIUrl":"https://doi.org/10.1097/GME.0000000000002634","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789472","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":"Unraveling the association between obesity and climacteric symptoms: a generalized structural equation modeling approach.","authors":"Sócrates Aedo, Juan Enrique Blümel, María Soledad Vallejo, Claudia Rey, Marcio Alexandre Rodrigues, Doris Rodríguez-Vidal, Carlos Salinas, Konstantinos Tserotas, Andrés Calle, Maribel Dextre, Alejandra Elizalde, Carlos Escalante, María Teresa Espinoza, Gustavo Gómez-Tabares, Álvaro Monterrosa-Castro, Eliana Ojeda, Mónica Ñañez","doi":"10.1097/GME.0000000000002620","DOIUrl":"https://doi.org/10.1097/GME.0000000000002620","url":null,"abstract":"<p><strong>Objective: </strong>To assess the direct and indirect associations between obesity and the severity of menopausal symptoms in postmenopausal women, considering related conditions such as chronic diseases and physical activity.</p><p><strong>Methods: </strong>This observational subanalysis utilized data from the REDLINC XII multinational study, which included 722 postmenopausal women aged 70 or younger from 9 Latin American countries. Menopausal symptoms were measured using the Menopause Rating Scale (MRS). Clinical, behavioral, and sociodemographic data were obtained through physician-administered surveys. Generalized Structural Equation Modeling was employed to examine the direct and indirect relationships between obesity, chronic cardiovascular and respiratory diseases, chronic hypertension, diabetes mellitus, and physical activity, and MRS scores. Odds ratios (ORs) were calculated to enhance interpretability.</p><p><strong>Results: </strong>A total of 722 participants were included. Obesity was directly associated with higher MRS scores (OR = 1.75). In addition, obesity exhibited indirect associations with MRS scores, with an odds ratio of 19.07, through chronic arterial hypertension, diabetes mellitus, physical inactivity, and chronic cardiovascular or respiratory diseases. The total association between obesity and MRS scores was reflected in an OR of 33.45. Furthermore, physical inactivity and the use of antidepressants were associated with greater symptom severity, whereas higher educational attainment, regular physical activity, and menopausal hormone therapy were associated with lower MRS scores.</p><p><strong>Conclusions: </strong>Obesity is strongly associated with more severe menopausal symptoms, both directly and through related chronic conditions and behavioral factors. Longitudinal studies are needed to establish temporal and causal inferences.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789546","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}