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

{"title":"Age-specific reference values for lumbar spine trabecular bone score (TBS) in Brazilian adult women.","authors":"Caroline de Freitas Gomes, Rosa M R Pereira, Jackeline Couto Alvarenga, Liliam Takayama, Valéria de Falco Caparbo, Diogo Souza Domiciano","doi":"10.1097/GME.0000000000002847","DOIUrl":"https://doi.org/10.1097/GME.0000000000002847","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate age-related changes in lumbar spine trabecular bone microarchitecture using the trabecular bone score (TBS) and to establish age-specific reference values for healthy Brazilian women.</p><p><strong>Methods: </strong>In this cross-sectional study, we evaluated 527 healthy adult women aged 20-82 years recruited as a convenience sample from hospital employees and their relatives. Lumbar spine TBS and bone mineral density (BMD) were obtained from a Hologic Discovery A DXA system using TBS iNsight software (v3.0.3). Primary analyses were restricted to BMI 15-37 kg/m2 and excluded current menopausal hormone therapy users, with sensitivity analyses including these participants. Women were stratified by age decade; menopause-centered analyses were additionally performed using years since menopause, and nonlinearity was explored using restricted cubic splines.</p><p><strong>Results: </strong>In the primary analytical sample (n=477), TBS was independently associated with age after adjustment for height and weight (β=-0.004 per year, P<0.001). Among postmenopausal women, years since menopause was independently associated with lower TBS (β=-0.002 per year, P=0.010). Menopausal status and the age-by-menopausal status interaction were not independently associated with TBS. TBS declined earlier across age decades than BMD T-scores, and sensitivity analyses including hormone therapy users yielded similar results. Using the reference distribution from premenopausal women aged 20-39 years, TBS cutoffs were 1.365 for normal microarchitecture and 1.248 for degraded microarchitecture, with intermediate values indicating partially degraded microarchitecture. A substantial proportion of women with normal BMD showed impaired trabecular microarchitecture by TBS, ranging from 34.8% to 41.6% across skeletal sites.</p><p><strong>Conclusions: </strong>This study provides the first age-specific normative TBS reference data for Brazilian women. The findings indicate that trabecular microarchitecture deteriorates earlier and more rapidly with aging than bone mass loss captured by BMD, supporting the use of TBS as a complementary tool for evaluating skeletal health and fracture risk.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795069","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":"Real-world safety signals of fezolinetant in women with menopausal vasomotor symptoms: a pharmacovigilance analysis of the WHO VigiAccess database.","authors":"Yan Li, Lu Zhai, Limantian Wang, Shudan Deng, Bomeng Zhao, Huiyan Niu, Lu Zhang, Xiaoling Gao","doi":"10.1097/GME.0000000000002887","DOIUrl":"https://doi.org/10.1097/GME.0000000000002887","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize the real-world safety profile of fezolinetant, a neurokinin-3 receptor antagonist approved for the treatment of menopausal vasomotor symptoms, using adverse event reports from the WHO VigiAccess database.</p><p><strong>Methods: </strong>Adverse event reports were retrieved from VigiAccess. Disproportionality analyses using reporting odds ratio, proportional reporting ratio, information component, and empirical Bayes geometric mean were applied to identify safety signals. A signal was defined as meeting all four criteria (reporting odds ratio [ROR] lower 95% CI > 1, proportional reporting ratio ≥ 2 with χ² ≥ 4, IC025 > 0, EBGM05 > 2).</p><p><strong>Results: </strong>A total of 1,091 individual case safety reports comprising 2,143 adverse events were identified, with most reports in women (96.7%) aged 45-64 years (42.16%) and a marked increase in 2024 (n=1,037). Forty-two preferred terms were identified and consistently detected across all methods. The strongest signals included menopausal symptoms (ROR=139.86, 95% CI=75.09-260.53) and facial discomfort (ROR=104.90, 95% CI=33.77-325.87). Liver-related abnormalities showed consistent signals, including increased alanine aminotransferase (ROR=20.60), aspartate aminotransferase (ROR=22.95), and bilirubin (ROR=12.52), suggesting a clustered hepatic signal. Neurological and psychiatric events included insomnia, headache, dizziness, migraine, brain fog, and sleep disorder, whereas gastrointestinal symptoms such as diarrhea and abdominal pain were also observed. Vasomotor symptom-related terms likely reflected the underlying disease rather than treatment effects.</p><p><strong>Conclusions: </strong>This exploratory analysis found that fezolinetant's real-world safety profile was broadly consistent with phase 3 trials, with efficacy in reducing menopausal vasomotor symptoms. Disproportionality signals mainly involved liver and neurological events. These findings do not reflect absolute risk or incidence and should be considered hypothesis-generating. In view of its established benefit, they support a balanced benefit-risk assessment for clinical use.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795160","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":"Association of moderate-to-vigorous physical activity with sleep quality and flow-mediated dilation in postmenopausal women: a cross-sectional study.","authors":"Baoyi Ouyang, Zilin Fan, Hui Tang, Wenyi Xia, Hui He","doi":"10.1097/GME.0000000000002878","DOIUrl":"https://doi.org/10.1097/GME.0000000000002878","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To examine the cross-sectional associations of moderate-to-vigorous physical activity with sleep quality and brachial artery flow-mediated dilation in postmenopausal women, and to explore whether sleep quality modified the association between physical activity and endothelial function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study included 619 community-dwelling postmenopausal women. Physical activity was assessed using the self-reported International Physical Activity Questionnaire-Short Form, sleep quality was assessed using the Pittsburgh Sleep Quality Index, and endothelial function was assessed by brachial artery flow-mediated dilation. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index score &gt;7. Missing covariate data were handled using multiple imputation. Multivariable logistic regression was used to examine the association between meeting the moderate-to-vigorous physical activity guideline and poor sleep quality. Targeted maximum likelihood estimation was used as a supplementary adjusted analysis. The association between physical activity and flow-mediated dilation was examined using the Wilcoxon rank-sum test and quantile regression. Linear regression models with an interaction term between physical activity guideline status and poor sleep quality were used to explore potential effect modification by sleep quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the main adjustment model for poor sleep quality, which included demographic, socioeconomic, and lifestyle-related factors, meeting the physical activity guideline was associated with lower odds of poor sleep quality (odds ratio [OR]=0.69, 95% CI: 0.47-1.00, P=0.048). The supplementary targeted maximum likelihood estimation analysis showed a similar but slightly attenuated estimate (OR=0.69, 95% CI: 0.48-1.01, P=0.06). Median flow-mediated dilation was 6.90% in the guideline-unmet group and 7.05% in the guideline-met group, with a statistically significant between-group difference after combining results across imputed data sets (P=0.004). In the main flow-mediated dilation-related model, which additionally included blood pressure, blood glucose, and blood lipids, meeting the physical activity guideline was associated with higher flow-mediated dilation at the median quantile (adjusted difference=0.31 percentage points, 95% CI: 0.002-0.61, P=0.048) and upper quantile (adjusted difference=0.39 percentage points, 95% CI: 0.07-0.71, P=0.02). The interaction between physical activity guideline status and poor sleep quality was negative in the main flow-mediated dilation-related model (interaction coefficient=-0.82, 95% CI: -1.58 to -0.06, P=0.03). This indicates that the positive association between meeting the physical activity guideline and flow-mediated dilation was weaker among women with poor sleep quality. However, this interaction finding was not consistently replicated in quantile regression sensitivity analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795075","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":"Hot flashes and night sweats in relation to trouble sleeping and daytime sleepiness.","authors":"Lynnette Leidy Sievert, Sofiya Shreyer, Mohamud A Verjee, Linda M Gerber","doi":"10.1097/GME.0000000000002886","DOIUrl":"https://doi.org/10.1097/GME.0000000000002886","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to determine whether self-reported night sweats (NS) and hot flashes (HF) were differentially associated with sleep problems, assessed by \"trouble sleeping\" on a symptom checklist and the Sleep Habits Questionnaire (SHQ), or with the degree of daytime fatigue, assessed by \"lack of energy\" on a symptom checklist and the Epworth Sleepiness Scale (ESS).</p><p><strong>Methods: </strong>Data were drawn from a study of midlife women aged 40-60 in Doha, Qatar (N=841). Participants were categorized as having (1) neither HF nor NS, (2) only HF, (3) only NS, or (4) both HF and NS. Bivariate analyses using χ2 and ANOVA were conducted, followed by logistic and linear regression analyses.</p><p><strong>Results: </strong>Women with both HF and NS scored significantly higher on the SHQ than those with neither HF nor NS (16.3 vs. 12.6, P<0.001). In contrast, mean ESS did not differ by HF/NS category. Among women with only NS, the odds of reporting trouble sleeping were almost twice as high (adjusted odds ratio [OR]: 1.78, 95% CI: 1.11-2.84), and the odds of reporting lack of energy were more than two times higher (adjusted OR: 2.63, 95% CI: 1.48-4.68), compared with women reporting neither HF nor NS, after controlling for menopausal status, age, depressed mood, aches/stiffness in joints, education, and nationality. Women reporting only HF did not differ significantly from those reporting neither HF nor NS in relation to lack of energy or trouble sleeping.</p><p><strong>Conclusions: </strong>These findings suggest that NS are more disruptive to women's sleep and daytime fatigue than are HF.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795063","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":"Combined social determinants of health, mortality, and adverse health outcomes in early natural menopause.","authors":"Wen Yang, Yutong Zhang, Feifei Fu, Yunxia Cao, Zhaolian Wei, Dongdong Tang","doi":"10.1097/GME.0000000000002866","DOIUrl":"https://doi.org/10.1097/GME.0000000000002866","url":null,"abstract":"<p><strong>Objective: </strong>Early natural menopause (ENM) is associated with a higher long-term health burden, yet whether social determinants of health (SDH) modulate this risk is understudied. This study aimed to estimate the association of combined SDH with mortality and adverse health outcomes among women with ENM.</p><p><strong>Methods: </strong>We analyzed data from 19,912 women with ENM in the UK Biobank. Based on 14-item combined SDH scores, participants were categorized into tertiles representing favorable, medium, and unfavorable SDH groups. Multivariable Cox proportional hazards models were used to evaluate the associations of combined SDH with mortality, as well as incident cardiovascular disease (CVD), cancer, and dementia. In addition, we externally validated the mortality findings in the US National Health and Nutrition Examination Survey.</p><p><strong>Results: </strong>In the UK Biobank cohort, higher combined SDH scores showed a progressive association with all-cause mortality and the incidence of CVD and dementia (all P for trend <0.001). Compared with the favorable SDH group, the unfavorable SDH group was linked to higher risks of all-cause mortality (hazard ratio [HR] = 1.75; 95% CI: 1.51-2.03), CVD (HR = 1.48; 95% CI: 1.29-1.70), and dementia (HR = 1.83; 95% CI: 1.30-2.57). Consistently, these all-cause mortality associations were further validated in the US National Health and Nutrition Examination Survey cohort. Notably, among all SDH variables, unemployment exhibited the strongest associations with both all-cause mortality and incident dementia.</p><p><strong>Conclusion: </strong>Cumulative social disadvantage significantly amplifies the risks of mortality and multimorbidity in women with ENM. These findings warrant the integration of multidimensional SDH assessments into clinical management to tailor preventive strategies and mitigate disease burden in this vulnerable population.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of the effects of high-intensity, impact, and strength training on bone mineral density in premenopausal and postmenopausal women.","authors":"Elizabeth Jones, Paul Starrs, Ben Hunter","doi":"10.1097/GME.0000000000002839","DOIUrl":"https://doi.org/10.1097/GME.0000000000002839","url":null,"abstract":"<p><strong>Importance: </strong>Menopausal estrogen decline is the leading cause of osteoporosis, leaving bones vulnerable to fractures. Of the interventions available for preserving bone density, exercise is potentially the most accessible. However, the ideal type, intensity, and age of initiation of exercise interventions remain under debate.</p><p><strong>Objective: </strong>This systematic review and meta-analysis set out to summarize recent evidence on the effects of high-intensity, impact, and strength training on bone mineral density in postmenopausal women, and to compare this evidence to equivalent data in premenopausal women.</p><p><strong>Evidence review: </strong>PubMed and the Cochrane Central Register of Controlled Trials were searched on July 17, 2025, for randomized controlled trials published on or after March 1, 2018. Search terms were structured around menopause-related, exercise-related, and bone-related terms. Studies were eligible if they included either premenopausal or postmenopausal women, at least one intervention arm completing either high-intensity, impact or strength training, a control arm, and bone mineral density as an outcome. Following identification of eligible studies, participant and study characteristics were tabulated, and studies were assessed for quality using the Physiotherapy Evidence Database scale and risk of bias using the RoB 2 tool. Outcomes data were extracted, and a meta-analysis was performed.</p><p><strong>Findings: </strong>Eight randomized controlled trials incorporating 379 participants met the inclusion criteria; six (n=267) in postmenopausal and two (n=112) in premenopausal women. Meta-analysis of pooled intervention types revealed small but significant effects of high-intensity, impact, and strength training at the femoral neck (0.47, t[3]=5.22, P=0.014; n=141) and lumbar spine (0.36, t[4]=4.36, P=0.012; n=182) in postmenopausal but not premenopausal women.</p><p><strong>Conclusions and relevance: </strong>High-intensity, impact, and strength training (pooled analysis) appeared to be effective at increasing bone mineral density in postmenopausal women, though the small effect sizes and methodological limitations identified should be considered. Further studies are required to determine whether more robust protocols would have generated stronger effects in premenopausal women, or whether there are different osteogenic responses to exercise in the two populations.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707007","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":"Inflammatory and immune biomarkers over midlife and future cognition in women: the SWAN HDL Ancillary Study.","authors":"Meiyuzhen Qi, Carol A Derby, Daniel Rader, Imke Janssen, Emma Barinas-Mitchell, Maria M Brooks, Chung-Chou H Chang, Arun S Karlamangla, Dan McConnell, Sybil Crawford, Samar R El Khoudary","doi":"10.1097/GME.0000000000002874","DOIUrl":"https://doi.org/10.1097/GME.0000000000002874","url":null,"abstract":"<p><strong>Objective: </strong>Limited research has assessed prospective associations of systemic inflammatory (GlycA) and immune (complement factor 3 [C3] and 4 [C4]) biomarkers with future cognition in midlife women, who potentially experience worsening inflammation around the menopause transition. We aim to assess the associations of midlife serum GlycA, C3, and C4 with future cognitive performance in women.</p><p><strong>Methods: </strong>Serum GlycA, C3, and C4 were repeatedly measured over 6.1 ± 3.9 years in 503 midlife women (1,234 observations) from the Study of Women's Health Across the Nation high-density lipoprotein ancillary study. Longitudinal measures of working memory, processing speed, and episodic memory, immediate and delayed recall, were administered 1.46 ± 0.95 years later. We applied joint models to examine the associations of baseline biomarkers and their changes since baseline with subsequent cognition.</p><p><strong>Results: </strong>Higher levels of serum GlycA and complement factor 4 at baseline (50.17 ± 2.65 y) were significantly associated with worse working memory and better immediate recall, respectively, over the next decade. Higher baseline complement factor 4 and increases in C3 and C4 since baseline tended to associate with better future immediate and/or delayed recall.</p><p><strong>Conclusions: </strong>Higher baseline GlycA, rather than its changes since baseline, was associated with lower future working memory, whereas higher baseline complement factor 4 and increases in C3 and C4 since baseline appeared cognitively protective. Targeting inflammation amelioration and immunity improvement over the menopause transition may provide an open avenue to preserve future cognitive health.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669960","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":"Association between type 2 diabetes mellitus and menopausal symptoms among Korean midlife women.","authors":"You Lee Yang, YeonKyung Kim, YoungJoo Shin","doi":"10.1097/GME.0000000000002883","DOIUrl":"https://doi.org/10.1097/GME.0000000000002883","url":null,"abstract":"<p><strong>Objective: </strong>Menopausal symptoms are challenging conditions with a significant impact on women's health, especially in managing type 2 diabetes mellitus (T2DM). However, few studies have explored the link between T2DM and menopausal symptoms in South Korea. Therefore, this study aims to examine the association between T2DM and the number and severity of menopausal symptoms among Korean midlife women.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted involving 296 women aged 40-64 in South Korea. Based on their fasting blood glucose and HbA1c levels, participants were classified into the diabetic group and the nondiabetic group. The Midlife Women's Symptom Index (MSI) was used to measure menopausal symptoms, and various background and health-related characteristics were also assessed. Data analyses were conducted using independent t tests, Mann-Whitney U tests, and hierarchical multiple regression analyses.</p><p><strong>Results: </strong>Women in the diabetic group showed a significantly greater number and higher severity of menopausal symptoms compared with those in the nondiabetic group. Subgroup analyses revealed significant differences in both the number and severity of menopausal symptoms, particularly among postmenopausal stage, with no differences observed in the premenopausal and perimenopausal stages. Furthermore, T2DM was significantly associated with both the number and the severity of menopausal symptoms after controlling for confounding variables.</p><p><strong>Conclusion: </strong>T2DM was significantly associated with the number and severity of menopausal symptoms among Korean midlife women. Postmenopausal women with T2DM also reported a greater menopausal symptom burden than those without T2DM. Tailored interventions may help managing symptom burden and improve overall quality of life in this population.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669835","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":"Efficacy of a probiotic formula in the management of menopausal symptoms and quality of life: a randomized controlled trial.","authors":"María Rodríguez-Palmero, Claudia Prat, Xavier Molina, Francesc Miras, Pol Huedo, Marta Perez, Jordi Espadaler-Mazo, Santiago Palacios, Silvia P González","doi":"10.1097/GME.0000000000002871","DOIUrl":"https://doi.org/10.1097/GME.0000000000002871","url":null,"abstract":"<p><strong>Objectives: </strong>Estrogen decline during menopause transition is associated with physical and psychological symptoms that impair overall well-being. In a previous randomized trial, a probiotic formula comprising Levilactobacillus brevis KABP052, Lactiplantibacillus plantarum KABP051, and Pediococcus acidilactici KABP021 was found to be associated with a slower decline in estrogen levels. Therefore, we hypothesized that the intake of 1×109 colony-forming units/day of this formula could improve menopausal symptoms and quality of life.</p><p><strong>Methods: </strong>We conducted a decentralized, randomized, double-blind, placebo-controlled trial using a real-world approach. Women between 45 and 60 years old who were in perimenopause or postmenopause and had Cervantes Quality of Life score ≥ 38 were enrolled and allocated 2:1 to the probiotic (n=160) or placebo group (n=85) for a 3-month period. Menopausal symptoms and quality of life were evaluated by using the Menopause Rating Scale II, Cervantes and Utian Quality of Life questionnaires.</p><p><strong>Results: </strong>In the full analysis set, Menopause Rating Scale II total score decreased significantly in the probiotic group compared to placebo across the study (global mean difference between groups: -1.00 [0.47], P=0.033), with an improvement in the somato-vegetative domain (-0.54 [0.20], P=0.007). Per-protocol analysis also revealed differences in the psychological domain between groups, favoring the probiotic (-0.51 [0.25], P=0.040). Cervantes scale showed no significant differences between groups, but the change in Utian Quality of Life score was significantly higher in the probiotic group (2.21 [1.07], P=0.040).</p><p><strong>Conclusion: </strong>In this real-world study, the probiotic formula was associated with improvements in menopause-associated symptoms and quality of life, whereas the global Cervantes score appeared to be similar between groups. Future investigations are required to confirm this clinical effect and the underlying mechanisms of action. ClinicalTrials.gov identifier: NCT06604234.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669895","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":"Premature menopause and hypertension as combined risk factors for cardiovascular events in women: a nationwide cohort analysis.","authors":"Kang-Un Choi, Bo Eun Park, Mayank Dalakoti, Kyungdo Han, Jiyong Choi, Jang-Won Son, Hyungseop Kim","doi":"10.1097/GME.0000000000002867","DOIUrl":"https://doi.org/10.1097/GME.0000000000002867","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the independent and combined effects of premature menopause (PM, before age 40) and hypertension on the risk of cardiovascular disease (CVD) events in postmenopausal women using a nationwide Korean cohort.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the Korean National Health Insurance Service, including 1,168,791 postmenopausal women (aged ≥40 y) without prior myocardial infarction or stroke, followed from 2009 to 2022 (mean follow-up, 11.5 y). PM was self-reported; hypertension was defined as blood pressure ≥140/90 mmHg or antihypertensive medication use. The primary endpoint was incident myocardial infarction, stroke, or CVD mortality, identified using ICD-10 codes. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% CIs.</p><p><strong>Results: </strong>The prevalence of PM was 1.7%, whereas that of hypertension was 43.2%. During follow-up, 117,499 CVD events occurred (9.1 per 1,000 person-years). Compared with women with neither risk factor (6.0 per 1,000 person-years), adjusted HRs were 1.42 (95% CI: 1.40-1.44) for hypertension alone, 1.18 (95% CI: 1.12-1.24) for PM alone, and 1.64 (95% CI: 1.56-1.71; 18.4 per 1,000 person-years) for both. Risks were consistent for myocardial infarction (HR: 1.54), stroke (HR: 1.64), and CVD mortality (HR: 1.85), and across all clinical subgroups.</p><p><strong>Conclusions: </strong>Coexisting PM and hypertension confer a markedly elevated risk of CVD beyond either factor alone. Menopausal age and hypertension should be integrated into CVD risk stratification and primary prevention strategies for postmenopausal women.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669983","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}