Wafa A Aldhaleei, Ekta Kapoor, Chrisandra Shufelt, Michael B Wallace, Juliana M Kling, Kristin Cole, Stacey J Winham, Mary S Hedges, Stephanie S Faubion
{"title":"The association between metabolic dysfunction-associated steatotic liver disease diagnosis and vasomotor symptoms in midlife women.","authors":"Wafa A Aldhaleei, Ekta Kapoor, Chrisandra Shufelt, Michael B Wallace, Juliana M Kling, Kristin Cole, Stacey J Winham, Mary S Hedges, Stephanie S Faubion","doi":"10.1097/GME.0000000000002460","DOIUrl":"10.1097/GME.0000000000002460","url":null,"abstract":"<p><strong>Objective: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) and vasomotor symptoms (VMS) are associated with increased cardiovascular disease risk. Although visceral adiposity has been linked to MASLD and VMS independently, this study aimed to evaluate associations between the two in midlife women.</p><p><strong>Methods: </strong>A cross-sectional study of women aged 45-60 years receiving primary care at one of four sites was conducted from March 1 through June 30, 2021. MASLD diagnosis was obtained utilizing the International Classification of Diseases , Ninth Revision and Tenth Revision codes. VMS burden was evaluated with the Menopause Rating Scale and categorized as severe/very severe versus none/mild/moderate. Logistic regression models were used to assess the association between VMS and diagnosed MASLD both univariately and after individually adjusting for several risk factors.</p><p><strong>Results: </strong>A total of 4,599 women were included in the final analysis, 304 (7%) of whom had an MASLD diagnosis. On univariate analysis, women with an MASLD diagnosis were more likely to have severe/very severe VMS (odds ratio [OR], 1.50; 95% CI, 1.08-2.08; P = 0.015). However, the association between MASLD diagnosis and severe/very severe VMS was no longer statistically significant after individually adjusting for body mass index (adjusted OR, 1.36; 95% CI, 0.97-1.92) and hypertension (adjusted OR, 1.38; 95% CI, 0.99-1.93).</p><p><strong>Conclusions: </strong>The relationship between MASLD and VMS appears to be best explained by other variables including BMI and hypertension. Although they do not appear to be directly linked, given the prevalence of bothersome VMS in midlife women, addressing VMS may enable greater adherence to lifestyle modifications as part of MASLD management.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"121-127"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846975","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":"Letters to the Editor.","authors":"Alberto Donzelli","doi":"10.1097/GME.0000000000002487","DOIUrl":"10.1097/GME.0000000000002487","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"184"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882506","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":"Considering off-label dosing with estrogen as a component of personalized menopausal hormone therapy.","authors":"James K Pru","doi":"10.1097/GME.0000000000002513","DOIUrl":"10.1097/GME.0000000000002513","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 2","pages":"101-102"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033443","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":"Letters to the Editor.","authors":"Shagun Kapoor, Priyanka Sah, Nilanchali Singh","doi":"10.1097/GME.0000000000002489","DOIUrl":"10.1097/GME.0000000000002489","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"184-185"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801497","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}
Sarah Glynne, Daniel Reisel, Aini Kamal, Amy Neville, Lynsey McColl, Rebecca Lewis, Louise Newson
{"title":"The range and variation in serum estradiol concentration in perimenopausal and postmenopausal women treated with transdermal estradiol in a real-world setting: a cross-sectional study.","authors":"Sarah Glynne, Daniel Reisel, Aini Kamal, Amy Neville, Lynsey McColl, Rebecca Lewis, Louise Newson","doi":"10.1097/GME.0000000000002459","DOIUrl":"10.1097/GME.0000000000002459","url":null,"abstract":"<p><strong>Objectives: </strong>The aims of the study are to explore the range and variation in serum estradiol concentration, and to estimate the prevalence of \"poor absorption\" (women using licensed estradiol doses with subtherapeutic levels), in perimenopausal and postmenopausal women using transdermal estradiol in the real world.</p><p><strong>Methods: </strong>This is a cross-sectional analysis in a specialist menopause clinic in the UK.</p><p><strong>Results: </strong>Serum samples were obtained from 1,508 perimenopausal and postmenopausal women. A total of 61.87% were using licensed doses. The median estradiol concentration was 355.26 pmol/L (interquartile range 198.44-646.15 pmol/L). A reference interval for the whole cohort was defined as 54.62-2,050.55 pmol/L. There was substantial interindividual variation across the dose range. Variance was greater in younger women ( P = 0.002) and gel users ( P = 0.002). There was a trend toward greater variance in women using higher doses, but the association failed to reach statistical significance ( P = 0.074). One in four women (24.84%) using the highest licensed dose had subtherapeutic levels (<200 pmol/L). Older women (≥50 y) and patch users were more likely to have low levels (odds ratio 1.77, 95% confidence interval 1.22-2.62, P = 0.003; and odds ratio 1.51, 95% confidence interval 1.18-1.95, P = 0.001, respectively).</p><p><strong>Conclusions: </strong>The reference interval for perimenopausal and postmenopausal women using on-label and off-label doses of transdermal estradiol in the real world is wide, and there is considerable interindividual variation. The number of estradiol users with low estradiol levels (<200 pmol/L) is higher than previously recognized. Measurement of serum estradiol can be helpful to identify women who may benefit from an off-label dose. Dose customization is key to ensure that all women can reap the benefits of HT.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"103-111"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846977","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}
Erfan Ayubi, Sara Abdoli, Maryam Mehrpooya, Zahra Karami, Ensiyeh Jenabi, Ali Ghaleiha, Farzaneh Soltani, Amir Mohammad Salehi
{"title":"The effect of probiotic administration on the severity of menopausal symptoms and mental health of postmenopausal women: a triple-blind randomized controlled trial in the West of Iran.","authors":"Erfan Ayubi, Sara Abdoli, Maryam Mehrpooya, Zahra Karami, Ensiyeh Jenabi, Ali Ghaleiha, Farzaneh Soltani, Amir Mohammad Salehi","doi":"10.1097/GME.0000000000002462","DOIUrl":"10.1097/GME.0000000000002462","url":null,"abstract":"<p><strong>Objective: </strong>Menopausal symptoms are a reproductive health issue for women. Some studies have suggested that the use of probiotics may alleviate the severity of menopausal symptoms and mental health status. This study aimed to evaluate the effect of probiotic administration on the severity of menopausal symptoms and improve mental health in postmenopausal women in Hamadan, Western Iran.</p><p><strong>Methods: </strong>A triple-blind randomized controlled trial was conducted from February 20, 2023, to August 23, 2023, at the Comprehensive Health Service Centers in Hamadan City, Western Iran. Participants were randomized to intervention and control groups. The participants in the intervention group were administered probiotic supplements in 200 mg daily capsules for 6 weeks, and those in the control group received 200 mg daily capsules containing starch powder for 6 weeks. The primary outcomes were measured using the Menopausal Rating Scale and Depression Anxiety and Stress Scale questionnaires at baseline, week 3, and week 6.</p><p><strong>Results: </strong>A total of 84 women took part in the study, with 42 individuals assigned to each of the intervention and control groups, respectively. The findings indicated no significant differences in baseline characteristics between the study groups ( P > 0.05). The results indicated that the study outcomes changed differently over time between the two groups. The participants in the intervention group exhibited greater improvements in depressive symptoms, anxiety, and stress symptoms, as well as in physical, psychological, and urogenital symptoms at both week 3 and week 6, compared with the control group ( P < 0.05).</p><p><strong>Conclusions: </strong>This study provides evidence regarding potential treatment effects of probiotics consumption in alleviating physical and mental symptoms related to menopause. Further multicenter and large-scale clinical trials with longer follow-up are recommended.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"166-173"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951222","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}
Miranda L Janvrin, Amanda Banaag, Jill Brown, Katerina Shvartsman, Tracey P Koehlmoos
{"title":"Menopausal hormone therapy use among active duty service women.","authors":"Miranda L Janvrin, Amanda Banaag, Jill Brown, Katerina Shvartsman, Tracey P Koehlmoos","doi":"10.1097/GME.0000000000002469","DOIUrl":"10.1097/GME.0000000000002469","url":null,"abstract":"<p><strong>Objective: </strong>Menopausal hormone therapy (HT) has been shown to be effective in alleviating symptoms of menopause. While previous literature has described the frequency of HT use for the relief of menopausal symptoms in both the general and veteran female populations, there is currently no literature describing this frequency within the female active duty population. This study aims to address this gap in knowledge by conducting a retrospective cross-sectional study of HT receipt in active duty service women (ADSW) ages 45 to 64 during fiscal years (FYs) 2018 to 2022.</p><p><strong>Methods: </strong>We used the Military Health System (MHS) Data Repository (MDR) to conduct a retrospective study of ADSW ages 45 to 64 in the US Army, Air Force, Navy, and Marine Corps during FY 2018 to 2022. Study analyses included descriptive statistics on participant demographics and HT type. Logistic regressions were performed to assess for significant associations between participant demographics and receipt of HT.</p><p><strong>Results: </strong>We identified a total of 13,629 women aged 45 to 64 on active duty service in the US Army, Air Force, Navy, and Marine Corps during FY 2018 to 2022, of whom 1,290 (9.5%) received HT. Significantly lower odds for receipt of HT was observed among ADSW ages 45 to 49, 60 to 64, of Asian/Pacific Islander race, and all ranks below Senior Officer. No significant associations were observed by Service branch.</p><p><strong>Conclusions: </strong>The prevalence of HT use among ADSW ages 45 to 65 is lower than HT use among the US veteran population age 45 and older but higher than among the US general population age 45 and older.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"128-133"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882522","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}
Nicholas L Zerzan, Nancy Greer, Kristen E Ullman, Catherine Sowerby, Susan Diem, Kristine Ensrud, Mary L Forte, Maylen C Anthony, Adrienne Landsteiner, Mary Butler, Timothy J Wilt, Elisheva R Danan
{"title":"Energy-based interventions for genitourinary syndrome of menopause: a systematic review of randomized controlled trials and prospective observational studies.","authors":"Nicholas L Zerzan, Nancy Greer, Kristen E Ullman, Catherine Sowerby, Susan Diem, Kristine Ensrud, Mary L Forte, Maylen C Anthony, Adrienne Landsteiner, Mary Butler, Timothy J Wilt, Elisheva R Danan","doi":"10.1097/GME.0000000000002465","DOIUrl":"10.1097/GME.0000000000002465","url":null,"abstract":"<p><strong>Importance: </strong>Hormone treatments for genitourinary syndrome of menopause (GSM) symptoms have limitations. There is interest in nonhormone therapies, including energy-based interventions. Benefits and harms of energy-based interventions are not currently well known.</p><p><strong>Objective: </strong>The aim of this study was to assess the benefits and harms of energy-based therapies (eg, CO 2 laser, Er:YAG laser, and radiofrequency) for GSM. Outcomes of interest are the eight \"Core Outcomes in Menopause\" and include the following: dyspareunia, vulvovaginal dryness, vulvovaginal discomfort/irritation, dysuria, change in most bothersome symptom, quality of life, treatment satisfaction, and treatment adverse effects.</p><p><strong>Evidence review: </strong>Eligible studies included English language randomized controlled trials (RCT) or prospective observational studies of energy-based treatments with ≥8 weeks follow-up in postmenopausal women with ≥1 GSM symptom and studies of any design reporting adverse effects ≥12 months postintervention. Ovid/MEDLINE, Embase, and CINAHL were searched from inception to December 11, 2023 using vocabulary and natural language terms, along with free-text words. Two authors extracted data and assessed the quality of included studies.</p><p><strong>Findings: </strong>We identified 32 unique studies (16 RCT; 1 quasi-RCT; 15 nonrandomized). Ten RCT and the quasi-RCT were rated low to moderate risk of bias (RoB) and underwent data extraction. Included studies evaluated CO 2 laser (k = 7), Er:YAG laser (k = 3), or radiofrequency and CO 2 laser (k = 1). CO 2 laser compared with sham (k = 4) may result in little to no difference in dysuria, dyspareunia, or quality of life (low certainty of evidence [COE]). CO 2 laser compared with vaginal conjugated estrogens cream (k = 2) may result in little to no difference in dyspareunia, dryness, discomfort/irritation, dysuria, or quality of life (low COE). Treatment effects on all other outcomes and effects of Er:YAG laser or radiofrequency on any outcome are very uncertain (very low COE). Studies noted few adverse events and no serious adverse events.</p><p><strong>Conclusions and relevance: </strong>CO 2 laser resulted in little to no difference in outcomes compared with sham or vaginal estrogen; the evidence is very uncertain on the effect of energy-based interventions versus all other comparators for all other outcomes. Adverse event reporting was limited. There is a need for further evidence assessing energy-based interventions.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"176-183"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950891","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}
Ieva Brimienė, Monika Šiaudinytė, Erik Ilkevič, Eglė Mazgelytė, Dovilė Karčiauskaitė, Jurgita Songailienė, Andrius Kaminskas, Tomas Petrėnas, Algirdas Utkus, Aurelijus Burokas, Ramunė Grikšienė
{"title":"Associations of reproductive hormones and stress-related factors with menopausal symptoms.","authors":"Ieva Brimienė, Monika Šiaudinytė, Erik Ilkevič, Eglė Mazgelytė, Dovilė Karčiauskaitė, Jurgita Songailienė, Andrius Kaminskas, Tomas Petrėnas, Algirdas Utkus, Aurelijus Burokas, Ramunė Grikšienė","doi":"10.1097/GME.0000000000002463","DOIUrl":"10.1097/GME.0000000000002463","url":null,"abstract":"<p><strong>Objective: </strong>The main aim was to evaluate the relationships between menopausal symptoms, endogenous hormones, and stress-related factors.</p><p><strong>Methods: </strong>Participants were recruited through online advertisements at Vilnius University and social networks. Sixty-three White Lithuanian women aged 50.2 ± 2.9 years without any known diseases or conditions that could affect menopausal symptoms, hormone levels, or mental health were selected to participate in the cross-sectional study. The Menopause-Specific Quality of Life Questionnaire was used to assess the intensity of menopausal symptoms in four domains (vasomotor, psychosocial, physical, and sexual). The levels of reproductive hormones were measured in blood serum. To evaluate the level of chronic stress, we used the Perceived Stress Scale 10 (PSS-10) and the assessment of hair glucocorticoids (cortisol, cortisone). Multiple linear regression analysis was performed to estimate the associations between menopausal symptoms severity, endogenous hormones, and stress-related factors.</p><p><strong>Results: </strong>Age (the unstandardized β [ B ] = 0.12), follicle-stimulating hormone concentration ( B = 0.9), and PSS-10 score ( B = 0.08) were associated with the total Menopause-Specific Quality of Life Questionnaire score (all P < 0.05). The vasomotor domain was related to age ( B = 0.19), follicle-stimulating hormone ( B = 1.24), and dehydroepiandrosterone sulfate concentration ( B = -2.8) (all P < 0.05). The psychosocial domain was associated with the PSS-10 score ( B = 0.13, P < 0.001). The physical domain was associated with the number of sleep hours ( B = -0.35, P = 0.02). The sexual domain was negatively related to testosterone concentration ( B = -3.5, P = 0.01).</p><p><strong>Conclusions: </strong>The results of the present study show that not only hormonal changes but also other factors, such as age, hours of sleep, and experienced stress, are associated with the intensity of menopausal symptoms.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"151-157"},"PeriodicalIF":2.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846968","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}
Yun Soo Chung, Jin Kyung Baek, Thi Minh Chau Tran, Hae-Rim Kim, Hye In Jung, Jae Kyung Lee, Eun A Choi, Hee Yon Kim, Bo Hyon Yun, Seok Kyo Seo
{"title":"Handgrip strength and diabetes in postmenopausal women: insights from the Korean National Health and Nutrition Examination Survey 2014-2019.","authors":"Yun Soo Chung, Jin Kyung Baek, Thi Minh Chau Tran, Hae-Rim Kim, Hye In Jung, Jae Kyung Lee, Eun A Choi, Hee Yon Kim, Bo Hyon Yun, Seok Kyo Seo","doi":"10.1097/GME.0000000000002453","DOIUrl":"10.1097/GME.0000000000002453","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between handgrip strength (HGS) and diabetes mellitus (DM) in postmenopausal women in Korea relative to the menopausal duration.</p><p><strong>Methods: </strong>Data from the Korean National Health and Nutrition Examination Survey conducted between 2014 and 2019 were analyzed. A total of 4,098 postmenopausal women aged 45 to 65 years were included in the study. Handgrip strength was measured using a digital hand dynamometer. Participants were categorized into quartiles based on HGS with Q1 representing the weakest strength and Q4 the greatest strength. The association between DM and HGS was assessed using logistic regression analysis while adjusting for relevant covariates.</p><p><strong>Results: </strong>Postmenopausal women aged 45 to 65 years with stronger HGS were less likely to have DM ( P < 0.001). This association persisted even after adjusting for age, body mass index, and comorbidities ( P < 0.001). The inverse relationship between HGS and DM prevalence was more pronounced in women who had been postmenopausal for >10 years than in those who had been postmenopausal for a shorter duration (P-interaction <0.001). In addition, compared to their nondiabetic counterparts, women with DM were less likely to be categorized into the Q4 group ( P < 0.001).</p><p><strong>Conclusions: </strong>The findings suggest that weaker HGS was associated with likelihood of having DM among postmenopausal women in Korea. Owing to the inherent limitation to the cross-sectional study design, further research is warranted to elucidate the underlying mechanisms of the association between DM and HGS in postmenopausal women.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"31-37"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770506","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}