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

{"title":"Low creatinine to cystatin C ratio is associated with lower muscle volumes and poorer gait speeds in the longitudinal Integrated Women's Health Program cohort.","authors":"Darren Yuen Zhang Tan, Beverly Wen Xin Wong, Liang Shen, Ling-Jun Li, Eu-Leong Yong","doi":"10.1097/GME.0000000000002524","DOIUrl":"https://doi.org/10.1097/GME.0000000000002524","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the longitudinal associations between creatinine-cystatin C ratios (CCR) with muscle volume and function during the menopausal transition. We investigated the longitudinal relationship of baseline CCR, with muscle volumes measured by magnetic resonance imaging (MRI), and objectively measured muscle strength and physical performance after 6.6-year follow-up.</p><p><strong>Methods: </strong>Participants from the Integrated Women's Health Programme (IWHP) cohort (n = 891, baseline mean age 56.2 ± 6.0) who attended both baseline and follow-up visits underwent objectively measured muscle strength and physical performance assessments and MRI. Creatinine to cystatin C ratio was calculated as (creatinine [mg/dL] / cystatin C [mg/L]) and low CCR were those in the lowest tertile (CCR < 8.16). Multivariable regression analyses were used to determine the associations of baseline CCR with muscle volumes and function 6.6 years later.</p><p><strong>Results: </strong>Baseline low CCR was associated with lower MRI-measured muscle volumes and poorer physical function 6.6 years later. Compared to high CCR group, mean fat-free thigh muscle volume of the low CCR group was 0.350 L lower (95% CI, 0.183-0.518) after adjustment for covariates. Similarly, the low CCR group was associated with 0.029 m/s slower (95% CI, 0.006-0.053) slower mean usual gait and 0.049 m/s slower (95% CI, 0.020-0.078) mean narrow gait speeds. CCR was not associated with handgrip strength and repeated chair stands and one-leg stand tests.</p><p><strong>Conclusion: </strong>Low CCR at baseline was associated with lower fat-free muscle volumes and poorer gait speeds 6.6 years later. The potential of CCR as a predictive biomarker for adverse events related to sarcopenia in midlife women merits further investigation.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657691","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":"Abnormal uterine bleeding is associated with fatigue during the menopause transition.","authors":"Siobán D Harlow, Ellen B Gold, Michelle M Hood, Alain A Mukwege, John F Randolph, Gail A Greendale","doi":"10.1097/GME.0000000000002525","DOIUrl":"https://doi.org/10.1097/GME.0000000000002525","url":null,"abstract":"<p><strong>Objective: </strong>During the menopause transition (MT), abnormal uterine bleeding, characterized by prolonged (PMB) or heavy (HMB) menstrual bleeding, occurs often. We assessed whether PMB or HMB was associated with fatigue.</p><p><strong>Methods: </strong>We used longitudinal daily menstrual calendar data from 2,329 participants in the Study of Women's Health Across the Nation to identify episodes of HMB and PMB. At seven annual follow-up visits, four symptoms of fatigue were queried (worn out, feeling tired, full of pep, having energy). General linear mixed models with random intercepts for each woman assessed the association between each fatigue variable and PMB or HMB recorded during the 6 months prior to each annual follow-up visit. Models were adjusted for race and ethnicity, age, body mass index, hormone therapy use, depressive and anxiety symptoms, perceived stress, sleep problems, cigarette use, and discrimination.</p><p><strong>Results: </strong>After adjustment, reporting three or more episodes of HMB in the prior 6 months was positively associated with feeling tired (odds ratio [OR] = 1.62, 95% CI = 1.11 to 2.38) and being worn out (OR = 1.44, 95% CI = 0.98 to 2.13), whereas three or more episodes of PMB in the prior 6-month window was negatively associated with being full of pep (OR = 0.68, 95% CI = 0.49 to 0.95).</p><p><strong>Conclusions: </strong>HMB and PMB during the MT were associated with increased odds of experiencing three symptoms of fatigue. Greater clinical attention to bleeding changes and associated symptoms, including fatigue and lack of energy, is warranted, as is education of women about potential health consequences of excessive menstrual bleeding during the MT.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605589","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":"Evaluation of postmenopausal bleeding.","authors":"Steven Goldstein","doi":"10.1097/GME.0000000000002522","DOIUrl":"https://doi.org/10.1097/GME.0000000000002522","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 3","pages":"275-277"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of urinary tract infections in women with vulvovaginal atrophy and the impact of vaginal prasterone on the rate of urinary tract infections.","authors":"Rachel Rubin, May Sanaee, Alyssa Yee, Erick Moyneur, Katherine Dea, Alain Y Dury","doi":"10.1097/GME.0000000000002485","DOIUrl":"10.1097/GME.0000000000002485","url":null,"abstract":"<p><strong>Objective: </strong>The aims of this study were to assess the prevalence of urinary tract infections (UTI) in women newly diagnosed with vulvovaginal atrophy (VVA) versus women without VVA and to evaluate the potential of vaginal prasterone to be used in postmenopausal VVA women with UTI as prophylaxis to reduce the future UTI risk. As a first subgroup analysis, women using aromatase inhibitors, medications that stop the production of estrogen were analyzed. As a second subgroup analysis, we looked at women with diabetes to investigate whether the same prophylaxis approach should be considered.</p><p><strong>Methods: </strong>This observational retrospective inception cohort study was conducted using the Integrated Dataverse open-source claims database with data from February 2015 through January 2020.</p><p><strong>Results: </strong>A total of 22,245 women treated with prasterone for a minimum of 12 weeks were matched to women without any prescribed VVA-related treatment. Overall, women treated with prasterone have a significantly lower UTI prevalence compared to those untreated (6.58% vs 12.3%; P < 0.0001). The highest difference in UTI prevalence among the prasterone treated and untreated women was observed in those aged 65-74 (7.15% vs 16.2%; P < 0.0001). Among aromatase inhibitor users and women with diabetes, those treated with prasterone have a significantly lower UTI prevalence (4.90% vs 9.79%; P < 0.01 and 14.59% vs 20.48%; P < 0.0001, respectively).</p><p><strong>Conclusions: </strong>This study suggests that intravaginal prasterone may be a good candidate for prophylaxis in postmenopausal women with UTI to reduce future UTI risk, including for women taking aromatase inhibitors and women with diabetes. This study is based on real-world evidence and warrants further investigation in a clinical setting.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"217-227"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142951026","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 randomized controlled trial to evaluate a novel dual laser therapy for vulvar lichen sclerosus: exploratory study assessing the impact of menopausal status.","authors":"Irena Zivanovic, Marianne Gamper, Debra Fesslmeier, Helena Bischofberger, Volker Viereck","doi":"10.1097/GME.0000000000002478","DOIUrl":"10.1097/GME.0000000000002478","url":null,"abstract":"<p><strong>Objective: </strong>A randomized controlled trial showed that Neodymium:YAG/Erbium:YAG laser therapy was safe and significantly improved clinical outcomes and subjective symptoms of vulvar lichen sclerosus (LS). Most improvements were similar to those after the recommended first-line therapy with topical steroid. In this exploratory study, we wanted to analyze the impact of menopausal status on perception and treatment outcome.</p><p><strong>Methods: </strong>Sixty-six women with clinical lichen sclerosus were assigned to the laser or the steroid arm (2:1). Participants of the laser arm received four laser treatments with a follow-up of 6 months after treatment initiation. Clinical objective (LS score) and subjective outcomes (vulvovaginal symptoms questionnaire [VSQ], symptom visual analogue scale [VAS] score, patient satisfaction) were evaluated.</p><p><strong>Results: </strong>Nineteen of the 66 study participants were premenopausal, 47 postmenopausal. At baseline, premenopausal women were significantly younger (39.4 vs 67.4 yr, P < 0.001), only a few applied local estrogen (16% vs 74%, P < 0.001), and their VSQ score was higher (9.58 vs 7.32, P = 0.015) indicating more severe vulvovaginal symptoms. Laser therapy objectively led to similar clinical improvements for pre- and postmenopausal women (-2.62 vs -2.23, P = 0.437), but subjectively to a significantly higher improvement of the VSQ score in postmenopausal women (-4.13 vs -1.08, P = 0.005). Postmenopausal women were more satisfied with laser therapy than premenopausal women (71% vs 46%, P = 0.002).</p><p><strong>Conclusion: </strong>Compared to premenopausal women, postmenopausal women experienced a lower subjective burden of the disease and a better subjective improvement after laser therapy. Perceptions and expectations are age-dependent and should be considered when treating women with lichen sclerosus.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 3","pages":"228-233"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502292","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":"Fragmented QRS complexes in electrocardiogram and their relationship with somatic symptoms in postmenopausal women.","authors":"Busra Korpe, Caner Kose, Nazlı Turan Serifler, Vakkas Korkmaz, Huseyin Levent Keskin","doi":"10.1097/GME.0000000000002491","DOIUrl":"10.1097/GME.0000000000002491","url":null,"abstract":"<p><strong>Objective: </strong>Menopause significantly impacts cardiovascular health, yet the relationship between myocardial abnormalities and noncardiac symptoms in postmenopausal women remains underexplored. This study aims to investigate the association between fragmented QRS waves (fQRS) positivity on electrocardiograms (ECG) and somatic symptoms in postmenopausal women.</p><p><strong>Methods: </strong>We included 623 postmenopausal women attending a menopause clinic for routine annual gynecological examinations. Women were categorized into fQRS-positive (n = 248) and fQRS-negative (n = 375) groups based on ECG results analyzed by a blinded cardiologist. The Menopause Rating Scale (MRS) was used to assess menopausal symptoms across three subscales: somatic, psychological, and urogenital. Data on demographics, physical activity, and medical history were also collected. Statistical analyses included comparisons of MRS scores, and a binary logistic regression analysis was used to identify the relationship between fQRS positivity and somatic symptoms. Adjusted models were created for potential confounders.</p><p><strong>Results: </strong>Women with fQRS positivity reported significantly higher somatic symptoms and total MRS scores compared to those without fQRS positivity. Specifically, higher scores were observed in the fQRS-positive group for the somatic subscale and total MRS score. Binary logistic regression analysis revealed that fQRS positivity was significantly associated with somatic symptoms after adjusting for all confounders (odds ratio, 10.76; 95% CI, 7.21-16.07; P < 0.001).</p><p><strong>Conclusions: </strong>Postmenopausal women with fQRS positivity on ECG exhibit a higher severity of somatic symptoms compared to those without fQRS positivity. These findings suggest a potential link between somatic symptoms and myocardial conduction abnormalities indicated by fQRS positivity. Further research is needed to clarify the underlying mechanisms of this association.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"240-246"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950927","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":"Diverse experiences of menopause.","authors":"Yamnia I Cortés","doi":"10.1097/GME.0000000000002510","DOIUrl":"10.1097/GME.0000000000002510","url":null,"abstract":"<p><p>Although the biologic underpinnings of menopause remain consistent across populations, the experience of this phase can vary. This Practice Pearl summarizes key sociocultural, behavioral, environmental, and healthcare-system factors that contribute to the menopause journey. In addition to obtaining an accurate health history, screening for social determinants of health can enhance individualized menopause care with the potential to significantly improve overall health outcomes.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":"32 3","pages":"278-280"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502295","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 role of short luteal phases on cycle regularity during the perimenopausal transition.","authors":"Caroline Visby Madsen, Gianluca Adornetto, Kirstine Kirkegaard","doi":"10.1097/GME.0000000000002477","DOIUrl":"10.1097/GME.0000000000002477","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to explore the correlation between short luteal phases and cycle irregularity in perimenopausal women.</p><p><strong>Methods: </strong>In this feasibility pilot study, daily salivary-progesterone measurements from presumed perimenopausal women have been analyzed using the inne minilab-an at-home system for ovulation and cycle tracking. Data were collected between 2020 to August 2022 from 29 women from Germany and Austria from users over the age of 42 years. Mean age was 44.5 years. The women were divided into two groups based on the presence of short luteal phases. Wilcoxon rank sum test was used to compare the two groups with regard to perimenopausal characteristics: cycle length variability, occurrence, and frequency of short cycles, long cycles, and anovulatory cycles.</p><p><strong>Results: </strong>A significant correlation ( P value =0.02) was found between short luteal phases and short cycle length under 23 days, with a median of two short cycles in the short luteal phase positive group compared to a median of 0 short cycles in the negative group. However, this correlation did not persist when adjusting for number of observations per participant. No difference was found when comparing other cycle characteristics.</p><p><strong>Conclusions: </strong>These findings could suggest that it may not be feasible to utilize the occurrence of short luteal phases in the context of expressing the likelihood of cycle irregularity, length, or anovulation. However, because of the small sample size in this study, the null findings could be due to lack of power. Larger studies would be needed to determine how short luteal phases may be correlated to cycle regularity.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"258-265"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882524","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":"Underdiagnosed but overtreated? Finding the role of modern therapies in the management of overactive bladder.","authors":"Bence Kozma, Peter Takacs","doi":"10.1097/GME.0000000000002521","DOIUrl":"10.1097/GME.0000000000002521","url":null,"abstract":"","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"187-188"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189342","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":"Pre-pandemic leukocyte count is associated with severity of post-acute sequelae of SARS-CoV-2 infection among older women in the Women's Health Initiative.","authors":"Ted K S Ng, Hind A Beydoun, Diane Von Ah, Aladdin H Shadyab, Shu Cheng Wong, Matthew Freiberg, Farha Ikramuddin, Patricia K Nguyen, Philippe Jean-Luc Gradidge, Lihong Qi, Zhao Chen, Keenan A Pituch, Suzi Hong, JoAnn E Manson","doi":"10.1097/GME.0000000000002490","DOIUrl":"10.1097/GME.0000000000002490","url":null,"abstract":"<p><strong>Objective: </strong>Although dysregulated inflammation has been postulated as a biological mechanism associated with post-acute sequelae of severe acute respiratory coronavirus 2 (SARS-CoV-2) infection (PASC) and shown to be a correlate and an outcome of PASC, it is unclear whether inflammatory markers can prospectively predict PASC risk. We examined the association of leukocyte count and high-sensitivity C-reactive protein (hsCRP) concentrations, measured ~25 years prior to the coronavirus disease 2019 (COVID-19) pandemic, with PASC, PASC severity, and PASC-associated cognitive outcomes at follow-up among postmenopausal women.</p><p><strong>Methods: </strong>Using biomarker data from blood specimens collected during pre-pandemic enrollment (1993-1998) and data on 1,237 Women's Health Initiative participants who completed a COVID-19 survey between June 2021 and February 2022, we constructed multivariable regression models that controlled for pertinent characteristics. PASC status was defined according to established World Health Organization criteria.</p><p><strong>Results: </strong>Controlling for baseline characteristics, log e -transformed leukocyte count (β = 0.27; 95% confidence interval, 0.07-0.47, P = 0.009) and leukocyte count ≥5.5 × 1,000 cells/µL (β = 0.13; 95% confidence interval, 0.02-0.23; P = 0.02) were positively associated with PASC severity, defined as the sum of PASC symptoms, but not associated with overall PASC occurrence or PASC-related cognitive outcomes. Concentration of hsCRP, available on only ~27% of participants, was not associated with any of the PASC outcomes, controlling for the same covariates.</p><p><strong>Conclusions: </strong>Leukocyte count, a widely available clinical marker of systemic inflammation, is an independent predictor of PASC severity in postmenopausal women. Heightened inflammation preceding SARS-CoV-2 infection may contribute to PASC development. Limited statistical power to assess hsCRP role warrants further study.</p>","PeriodicalId":18435,"journal":{"name":"Menopause: The Journal of The North American Menopause Society","volume":" ","pages":"197-206"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059181","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}