Maturitas最新文献

{"title":"Sarcopenia predicts mortality in older adults with cardiovascular disease: concordant findings from SDOC and EWGSOP II criteria despite limited role of low lean mass","authors":"Alberto Frisoli Junior ,&nbsp;Amanda Rocha Diniz ,&nbsp;Gustavo Duque ,&nbsp;Giovanna Menin ,&nbsp;Monica Maria Cartocci ,&nbsp;Izo Helber ,&nbsp;Antonio Carlos de Camargo Carvalho","doi":"10.1016/j.maturitas.2025.108618","DOIUrl":"10.1016/j.maturitas.2025.108618","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is a recognized risk factor for mortality in older adults, but inconsistencies in diagnostic criteria and classification methods have led to variability in assessing this risk. The role of low lean mass alone in predicting mortality remains unclear.</div></div><div><h3>Objective</h3><div>This study evaluates the predictive value of sarcopenia diagnoses using different methods and assesses the impact of low lean mass on mortality in outpatient older adults.</div></div><div><h3>Subjects and methods</h3><div>A longitudinal cohort analysis of 439 subjects was conducted, using diagnostic criteria from the Sarcopenia Definition and Outcomes Consortium (SDOC), which do not include low lean mass, and those from the European Working Group on Sarcopenia in Older People (EWGSOP II), which do. Mortality was assessed over an 18-month follow-up.</div></div><div><h3>Results</h3><div>The mean age was 78 years (<strong>±</strong>7.33). Sarcopenia was present in 46.5 % of patients based on the SDOC criteria, while EWGSOP II phenotypes identified probable sarcopenia in 26.2 %, confirmed sarcopenia in 3.2 %, and severe sarcopenia in 13 %. The mortality rate was 7.3 %, with 78.1 % of deceased patients meeting SDOC sarcopenia criteria and 71.8 % classified under EWGSOP II phenotypes. Adjusted hazard ratios for mortality showed significant associations for SDOC sarcopenia (HR = 5.444; 1.943–14.060; <em>p</em> = 0.001), probable sarcopenia (HR = 5.461; 1.848–16.131, <em>p</em> = 0.002), confirmed sarcopenia (HR = 2.789; 0.318–24.412; <em>p</em> = 0.354) and severe sarcopenia (HR = 5.170; 0.318–24.412, <em>p</em> = 0.028).</div></div><div><h3>Conclusion</h3><div>In older adults with cardiovascular disease, sarcopenia is a strong predictor of mortality, regardless of the diagnostic criteria used. However, low lean mass, whether considered in isolation or as part of sarcopenia, does not contribute to mortality risk.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108618"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144223627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep disorders and sexual function in women","authors":"Monica Levy Andersen,&nbsp;Sergio Tufik","doi":"10.1016/j.maturitas.2025.108625","DOIUrl":"10.1016/j.maturitas.2025.108625","url":null,"abstract":"<div><div>Sleep disorders are prevalent among women and can have significant implications for overall health, including sexual function. Emerging evidence suggests that disruptions to sleep, whether due to insomnia, obstructive sleep apnea, or circadian rhythm disorders, may adversely affect sexual desire, arousal, and satisfaction. This review provides a comprehensive overview of the literature, and examines the relationship between sleep disorders and sexual function in women. It explores the pathophysiological mechanisms, psychosocial factors, and hormonal influences that may mediate this relationship. The role of comorbid conditions, such as depression and anxiety, is discussed in light of their potential to exacerbate both sleep and sexual dysfunction. Although our understanding of these relationships is advancing, further research is necessary to uncover causal pathways and to inform the design of optimized treatment strategies. Contemporary research underscores the urgent need for a multidisciplinary approach to addressing the interplay between sleep disturbances and sexual dysfunction. Longitudinal studies involving diverse populations will be essential for tailoring effective treatments.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108625"},"PeriodicalIF":3.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related increase and sex difference in the prevalence of handgrip strength asymmetry among Chinese middle-aged and older adults","authors":"Yu Luo,&nbsp;Xiaoyi Ma,&nbsp;Kemin Yan,&nbsp;Ling Zhang,&nbsp;Wen He","doi":"10.1016/j.maturitas.2025.108622","DOIUrl":"10.1016/j.maturitas.2025.108622","url":null,"abstract":"<div><h3>Introduction</h3><div>In addition to weakness, asymmetry is increasingly recognized as an abnormal condition of handgrip strength (HGS), one which is associated with various adverse health outcomes in older adults. However, the influence of age and sex on the prevalence of HGS asymmetry remains unclear.</div></div><div><h3>Methods</h3><div>The study population included adults aged 45 to 85 years from two waves of the China Health and Retirement Longitudinal Study (CHARLS), categorized by 5-year age groups. HGS ratio was calculated by dividing the maximal HGS (stronger HGS) by the highest HGS value obtained from the opposite hand (weaker HGS). HGS asymmetry was defined as an HGS ratio &gt; 1.1, 1.2 or 1.3. Univariate and multivariate analyses were used to explore the associations of age and sex with HGS asymmetry.</div></div><div><h3>Results</h3><div>The prevalence of HGS asymmetry among Chinese middle-aged and older people, defined by an HGS ratio &gt; 1.1, 1.2, and 1.3, was 42.7 %, 15.6 %, and 6.4 %, respectively. Regardless of the diagnostic threshold, the prevalence of HGS asymmetry increased with age (all, p value for trend &lt;0.0001), starting primarily from 60 to 64 years. The risk of HGS asymmetry was significantly higher in women than in men, though this sex difference diminished after age 70. The age-related increase and sex difference in the risk of HGS asymmetry remained significant even after adjusting for multiple covariates.</div></div><div><h3>Conclusion</h3><div>The prevalence of HGS asymmetry increases with age and is higher in women. HGS asymmetry may serve as an additional marker of muscle function decline and should be routinely evaluated in assessing sarcopenia and frailty, particularly among women and the oldest-old.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108622"},"PeriodicalIF":3.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144189736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group-based pelvic floor telerehabilitation for urinary incontinence in older women: A six-month follow-up pilot study","authors":"Mélanie Le Berre ,&nbsp;Johanne Filiatrault ,&nbsp;Barbara Reichetzer ,&nbsp;Dahlia Kairy ,&nbsp;Caroline Lachance ,&nbsp;Chantale Dumoulin","doi":"10.1016/j.maturitas.2025.108621","DOIUrl":"10.1016/j.maturitas.2025.108621","url":null,"abstract":"<div><h3>Background</h3><div>Urinary incontinence is prevalent among older women. This pilot study evaluated the effects of an online group-based pelvic floor muscle training program in older women with urinary incontinence at a six-month follow-up.</div></div><div><h3>Methods</h3><div>Women aged 65 and over, with stress or mixed urinary incontinence, were recruited. Eligibility was established through in-person evaluations, during which pelvic floor physiotherapists taught and verified correct pelvic floor muscles contraction using digital palpation. The 12-week online pelvic floor muscle training program comprised weekly one-hour training sessions, followed by an unsupervised maintenance exercise regimen. Data were collected before the program (PRE), immediately after (POST), during an interim phone call three months after the end of the program (3MO) and at a follow-up six months after the end of the program (6MO). Participants reported symptoms of urinary incontinence using a 7-day bladder diary and standardized questionnaires at PRE, POST and 6MO. Adherence to maintenance exercises was recorded at 3MO and 6MO. At 6MO, participants provided feedback on their perceived improvement and overall satisfaction.</div></div><div><h3>Results</h3><div>Women experienced a median leakage reduction of 73 % (range 38–88 %) from PRE to 6MO. Improvements were maintained from POST to 6MO for leakage episodes, symptoms of urinary incontinence, quality of life, and urinary incontinence self-efficacy. Adherence to maintenance exercises was substantial at 3MO and 6MO. Participants expressed high satisfaction with symptom improvement and the program overall at 6MO.</div></div><div><h3>Conclusions</h3><div>A 12-week online group-based pelvic floor muscle training including an in-person pelvic floor muscle evaluation and an unsupervised maintenance exercise regimen demonstrated sustained clinical benefits. Further validation through a randomized controlled trial is needed to confirm these findings.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108621"},"PeriodicalIF":3.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female sexual dysfunction as an adverse effect of drugs: a narrative review","authors":"Mikael O.W. Piha ,&nbsp;Katja Kero ,&nbsp;Aleksi Tornio","doi":"10.1016/j.maturitas.2025.108623","DOIUrl":"10.1016/j.maturitas.2025.108623","url":null,"abstract":"<div><div>Sexual adverse effects of drugs are common and can compromise adherence to pharmacotherapy. Drugs can disrupt any or all phases of the sexual response cycle, potentially causing significant distress, which can amount to clinically relevant sexual dysfunction. Psychotropic and neurotropic agents are the best-characterised culprits in drug-related sexual dysfunction in females, although sexual dysfunction has been defined in various ways in the relevant literature. Specifically, serotonergic antidepressants, prolactin-increasing antipsychotics, long-term opioid therapy, and enzyme-inducing antiepileptics are associated with decreased desire, arousal dysfunction, orgasmic dysfunction, and more. In addition, progestin-containing contraceptives, antioestrogenic drugs, and beta blockers appear to increase the risk of sexual dysfunction. Possible mechanisms by which drugs interfere with sexual functions include alterations in neurotransmitter systems, increases in prolactin levels, increased sedation, and inhibition of the hypothalamic-pituitary-ovarian axis. Many medical conditions themselves can also cause sexual symptoms, and these are difficult to distinguish from pharmacological sexual adverse effects. However, different drugs for the same diseases can have substantially different sexual safety profiles, which often allows the clinician to choose a less-offending alternative. In some cases, drugs can exert even long-term adverse effects on sexual function. Therefore, sexual adverse effects must be taken into consideration when weighing the benefits and risks of different treatment modalities.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108623"},"PeriodicalIF":3.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravaginal prasterone for urinary urgency in postmenopausal women without urodynamic detrusor overactivity","authors":"Stefano Pautasso ,&nbsp;Matteo Mancarella ,&nbsp;Lorenzo Novara ,&nbsp;Silvia Carignano ,&nbsp;Francesca Chiadò Piat ,&nbsp;Francesco Testa ,&nbsp;Francesca Luppi ,&nbsp;Valentina Elisabetta Bounous ,&nbsp;Annamaria Ferrero ,&nbsp;Luca Giuseppe Sgro","doi":"10.1016/j.maturitas.2025.108620","DOIUrl":"10.1016/j.maturitas.2025.108620","url":null,"abstract":"<div><h3>Objectives</h3><div>Symptoms of an overactive bladder are frequently reported in women with genitourinary syndrome of menopause. Despite a frequent association with detrusor overactivity, urodynamic assessment does not always reveal this condition, which suggests a leading role for increased bladder mucosal sensitivity due to hormone deprivation in producing urinary symptoms. The present study assessed the effects of intravaginal prasterone on urgency symptoms in those patients receiving treatment for concurrent vulvovaginal atrophy.</div></div><div><h3>Study design</h3><div>This was an observational cohort study on 21 women with genitourinary syndrome of menopause, including urgency symptoms, without detrusor overactivity on urodynamic assessment. Patients received intravaginal prasterone 6.5 mg daily and were reassessed at 12 weeks.</div></div><div><h3>Main outcome measures</h3><div>Urinary symptoms and their impact on the quality of life were evaluated through the Urogenital Distress Inventory (UDI-6) and Overactive Bladder short-form (OAB-Q SF) questionnaires; secondary outcomes included urinary frequency and prevalence of urgency or incontinence as recorded in a voiding diary, and scores on a visual analogue scale (VAS) for vaginal discomfort.</div></div><div><h3>Results</h3><div>A significant improvement in urinary symptoms was observed in the scores on both the UDI-6 (57.1 +/− 20.7 vs 30.2 +/− 22.7, <em>p</em> &lt; 0.001) and the OAB-Q SF (61.3 +/− 19.7 vs 35.7 +/− 22, p &lt; 0.001); a significant improvement was also reported in terms of better quality of life, diminished VAS scores, and a reduction in incontinence and daily and nocturnal frequency.</div></div><div><h3>Conclusions</h3><div>Women complaining of urgency related to genitourinary syndrome of menopause with no urodynamic evidence of detrusor overactivity may benefit from treatment with intravaginal prasterone.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108620"},"PeriodicalIF":3.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144177502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopause and arterial stiffness index: insights from the women's UK Biobank cohort","authors":"Alexandre Vallée","doi":"10.1016/j.maturitas.2025.108608","DOIUrl":"10.1016/j.maturitas.2025.108608","url":null,"abstract":"<div><h3>Background</h3><div>Menopause is a significant physiological transition characterized by hormonal changes that can influence cardiovascular health. One key concern is increased arterial stiffness, a predictor of cardiovascular disease and adverse cardiovascular events. However, the independent association between menopause and arterial stiffness, beyond traditional cardiovascular risk factors, remains unclear. This study investigates the relationship between menopause and arterial stiffness index in the women's UK Biobank cohort.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 52,891 women from the UK Biobank with measurements of arterial stiffness index. Arterial stiffness index was assessed using a non-invasive photoplethysmographic method. Multiple linear and logistic regression models were used to examine the association between menopause status and arterial stiffness index (continuous and cutoff&gt;10 m/s), adjusting for age, body mass index, antihypertensive medication use, income, education, dyslipidemia, alcohol consumption, chronic kidney disease, smoking, diabetes, heart rate, mean blood pressure, hormone therapy, and previous cardiovascular disease.</div></div><div><h3>Results</h3><div>Postmenopausal women had significantly higher values of arterial stiffness index (9.10 ± 4.61 m/s) than premenopausal women (7.76 ± 2.72 m/s, p &lt; 0.001). Menopause was independently associated with increased arterial stiffness index (B = 0.22, 95 % CI [0.16–0.28], p &lt; 0.001) and a higher odds ratio for arterial stiffness index &gt;10 m/s (OR = 1.41, 95 % CI [1.31–1.51], p &lt; 0.001), after adjusting for confounders.</div></div><div><h3>Conclusion</h3><div>Menopause is significantly associated with increased arterial stiffness, independent of traditional cardiovascular risk factors. These findings highlight menopause as a critical period for cardiovascular health assessment and prevention strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"198 ","pages":"Article 108608"},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond estrogen: Mitochondrial dysfunction and sleep disruption in menopausal hair loss","authors":"Yu-Hsiang Lin ,&nbsp;Jau-Yuan Chen ,&nbsp;Chun-Te Wu","doi":"10.1016/j.maturitas.2025.108619","DOIUrl":"10.1016/j.maturitas.2025.108619","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108619"},"PeriodicalIF":3.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Lin et al., “Beyond estrogen: Mitochondrial dysfunction and sleep disruption in menopausal hair loss”","authors":"Paradi Mirmirani ,&nbsp;Aditya K. Gupta ,&nbsp;Vasiliki Economopoulos","doi":"10.1016/j.maturitas.2025.108617","DOIUrl":"10.1016/j.maturitas.2025.108617","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108617"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144166820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Persistent gaps in menopause care: current recommendations of the POESIT group","authors":"Costantino Di Carlo ,&nbsp;Angelo Cagnacci ,&nbsp;Marco Gambacciani ,&nbsp;Santiago Palacios ,&nbsp;Cláudio Rebelo ,&nbsp;Pluvio Coronado ,&nbsp;Jesús Presa ,&nbsp;Sonia Sánchez ,&nbsp;Ana Fatela ,&nbsp;Mónica Gomes Ferreira ,&nbsp;Rossella E. Nappi","doi":"10.1016/j.maturitas.2025.108607","DOIUrl":"10.1016/j.maturitas.2025.108607","url":null,"abstract":"<div><div>In recent years, menopause awareness has been increasing in several European countries; however, gaps in menopause knowledge, attitudes and practices persist. This review provides an overview of the women's current menopausal experience in Italy, Spain and Portugal, and gives POESIT (Portugal + Spain + Italy) group recommendations to address persistent barriers in menopause care. The perception, occurrence and impact of menopause symptoms vary among countries, with genitourinary syndrome of menopause and vasomotor symptoms being the most frequent overall. Sexuality seems to be particularly affected by menopause, mostly due to genitourinary syndrome of menopause. Nonetheless, women's knowledge about the diverse range of menopause symptoms and their therapies is still poor. The importance of menopause hormone therapy for quality of life and prevention of chronic conditions, such as osteoporosis, is underestimated and its use remains generally low, likely due to women's view of menopause as a natural condition not requiring treatment, and common misconceptions and fears about side-effects (mostly cancer). The lack of knowledge and training about menopause symptoms and treatment indications among healthcare professionals represents another important barrier to providing suitable personalized care to women. The POESIT group highlights the need to raise public knowledge about menopause and its symptoms to improve care for women during and after menopausal transition. Policymakers and scientific societies should be actively involved to address treatment barriers. The POESIT group advocates the improvement of education among healthcare professionals to foster a personalized approach to menopause care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"199 ","pages":"Article 108607"},"PeriodicalIF":3.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}