Maturitas最新文献

{"title":"Women's expectations for system support for a healthy menopausal transition: A pilot study","authors":"Marzena Nieroda ,&nbsp;Dania Posso ,&nbsp;Abdul Seckam","doi":"10.1016/j.maturitas.2024.108133","DOIUrl":"10.1016/j.maturitas.2024.108133","url":null,"abstract":"<div><h3>Background</h3><div>This pilot study contributes to the knowledge on healthy menopause by adopting a person-centric, lifelong approach to support a healthy menopausal transition. It focuses on women's expectations of system support for this transition.</div></div><div><h3>Method</h3><div>Twenty-two online in-depth interviews were conducted with women of various ages, experiences, and backgrounds in the United Kingdom, ensuring representation across the menopausal transition journey – before, during and after menopause. The interviews explored perceptions and expectations of healthy menopause and the required support. User journey and systems frameworks guided data collection and analysis. The pilot aimed to verify the feasibility of the developed study approach and protocol.</div></div><div><h3>Results</h3><div>A healthy menopausal transition is seen as preserving essential capacities to maintain normal daily activities despite bodily changes, a crucial aspect of ageing. Participants outlined a journey of awareness, contemplation of lifestyle adjustments, experimentation with new behaviours, and habit formation. These findings underscore the importance of fostering awareness and support for menopausal transition early in life. Participants also stressed the impact of the broader environment across the ageing journey, including education, research, health services, workplace dynamics, built environment, food industry, technology and innovation, media, advertising, and social networks.</div></div><div><h3>Conclusions</h3><div>This work highlights person-centric perceptions of healthy menopause, complementing existing biology-centred perspectives. By introducing a co-creation approach at the system level, it offers opportunities to define holistic support for the menopausal transition. The findings informed a knowledge exchange and ideation workshop with forty relevant system stakeholders to advance solution co-creation.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108133"},"PeriodicalIF":3.9,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between the incidence of Fuchs' endothelial corneal dystrophy and menopausal hormone therapy use and exposure to endogenous estrogen","authors":"Amy E. Millen ,&nbsp;Jing Nie ,&nbsp;Yihua Yue ,&nbsp;Chris A. Andrews ,&nbsp;Jean Wactawski-Wende ,&nbsp;Robert B. Wallace ,&nbsp;Aladdin H. Shadyab ,&nbsp;Sangita P. Patel","doi":"10.1016/j.maturitas.2024.108132","DOIUrl":"10.1016/j.maturitas.2024.108132","url":null,"abstract":"<div><h3>Objectives</h3><div>End-stage Fuchs' endothelial corneal dystrophy is a leading cause of corneal blindness, with a higher prevalence in females than in males. Few modifiable risk factors have been identified. We examined associations between menopausal hormone therapy use (never/past/current), duration of hormone therapy use, estimated lifetime exposure to endogenous estrogen, and serum estradiol with incident Fuchs' endothelial corneal dystrophy in a cohort of postmenopausal women.</div></div><div><h3>Study design</h3><div>This was a prospective analysis in the Women's Health Initiative Observational Study.</div></div><div><h3>Main outcome measures</h3><div>Incident cases of Fuchs' endothelial corneal dystrophy were identified from the Women's Health Initiative Observational Study baseline (1993–1998) through 2019 using Medicare claims data.</div></div><div><h3>Results</h3><div>In 22,980 women, 1382 incident cases of Fuchs' endothelial corneal dystrophy (annualized incidence rate and 95 % confidence interval = 5.0 [4.8–5.3] cases per 1000 person-years) were identified. The adjusted hazard ratios and 95 % confidence intervals for Fuchs' endothelial corneal dystrophy were 1.02 (0.88–1.18) and 0.89 (0.79–0.997) for past and current hormone therapy use (vs. never use) at baseline, respectively. Adjusted hazard ratios (95 % confidence interval) were 0.90 (0.79–1.03) and 0.95 (0.84–1.08), p-trend = 0.36, for ≤10 and &gt; 10 years, respectively, of hormone therapy use compared with no use; and the adjusted hazard ratio (95 % confidence interval) was 1.01 (0.88–1.15), p-trend = 0.87, for 46.7–59.0 versus 13.8–41.0 years of estimated lifetime exposure to endogenous estrogen. No statistically significant associations were observed with serum estradiol concentrations in a subset of participants.</div></div><div><h3>Conclusions</h3><div>In this cohort of postmenopausal women, current hormone therapy use (vs. never use) showed evidence of protection against the development of Fuchs' endothelial corneal dystrophy; however, duration of hormone therapy use, estimated lifetime exposure to endogenous estrogen, or serum estradiol concentrations were not significantly associated with a decreased risk of Fuchs' endothelial corneal dystrophy.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"191 ","pages":"Article 108132"},"PeriodicalIF":3.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morning tiredness and insomnia symptoms are associated with increased blood pressure in midlife women","authors":"Ville Rimpilä ,&nbsp;Katja Valli ,&nbsp;Tero Vahlberg ,&nbsp;Tarja Saaresranta","doi":"10.1016/j.maturitas.2024.108131","DOIUrl":"10.1016/j.maturitas.2024.108131","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to investigate how blood pressure, sleep architecture, sleep-disordered breathing, body habitus, and levels of serum follicle-stimulating hormone are associated with symptoms of insomnia and sleep quality during menopausal transition.</div></div><div><h3>Methods</h3><div>64 healthy premenopausal women (aged 45–47 years) were recruited to the study. Data were collected at baseline and at 10-year follow-up during sleep laboratory and laboratory visits. A sleep questionnaire was used to evaluate sleep quality and insomnia symptoms. Data were analysed using multiple linear and logistic regression with a backward method.</div></div><div><h3>Results</h3><div>During the menopausal transition, a change in insomnia symptoms was associated with a change in morning systolic blood pressure (β = 0.114 (CI95% 0.023–0.205), p = 0.016). At follow-up, at the age of 56, a higher percentage of REM sleep was associated with a lower odds of restless sleep (OR = 0.842 (95 % CI 0.742–0.954), p = 0.007), while both higher systolic and diastolic evening blood pressure was associated with an increased odds of morning tiredness.</div><div>OR = 1.047 (95 % CI 1.003–1.092), p = 0.034 and OR = 1.126 (95 % CI 1.018–1.245), p = 0.007, respectively.</div></div><div><h3>Conclusions</h3><div>In healthy midlife women, a change blood pressure is related to the development of insomnia symptoms during menopausal transition. In postmenopausal women, a high evening blood pressure may be associated with morning tiredness and a reduced amount of REM sleep may be perceived as restless sleep.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108131"},"PeriodicalIF":3.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of menopausal symptoms on future health and longevity: A systematic scoping review of longitudinal evidence","authors":"Robin Andrews ,&nbsp;Arron Lacey ,&nbsp;Kate Bache ,&nbsp;Emma J. Kidd","doi":"10.1016/j.maturitas.2024.108130","DOIUrl":"10.1016/j.maturitas.2024.108130","url":null,"abstract":"<div><div>Women live longer than men but spend more years in poor health. Menopausal symptoms are not generally associated with adverse health outcomes. However, increasingly, evidence suggests they can significantly impact future health and longevity. Understanding the long-term effects of menopausal symptoms will enable clinicians to identify risk factors and intervene with modifications to support healthy aging.</div><div>This review examined the scope of research investigating the association between menopausal symptoms and future health outcomes. We searched for longitudinal cohort studies. Date and geographical restrictions were not applied. Articles were screened and data extracted using standardised methods.</div><div>Included studies examined the role of menopausal symptoms on future health developments using a sample who had experienced menopause and were deemed healthy at baseline, with clear reporting of their menopausal status at symptom assessment.</div><div>We identified 53 eligible studies with data from over 450,000 women enrolled in 28 longitudinal cohorts.</div><div>Cardiovascular disease, psychiatric disorders, diabetes, and reduced bone mineral density were positively associated with menopausal symptoms. Breast cancer was associated with an asymptomatic menopause. Psychological menopausal symptoms and cognitive decline improved after menopause, except among women from low socioeconomic backgrounds.</div><div>These findings demonstrate that menopausal symptoms are important indicators for future health risks. Future work should investigate the impact of underexplored menopausal symptoms on future health, such as sleeping problems and urogenital issues, and evaluate whether treating menopausal symptoms could lead to improvements in future health outcomes. Should future research continue to support these findings, clinical guidelines should be updated to support clinical decision-making in menopause care.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108130"},"PeriodicalIF":3.9,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause: A randomized double-blind placebo-controlled trial","authors":"Nuno Muiños Fernández ,&nbsp;Juan Ignacio Martínez Salamanca ,&nbsp;José Ignacio Pardo González de Quevedo ,&nbsp;M. Pilar Diz Morales ,&nbsp;Lourdes Palomo Alameda ,&nbsp;Susana Duce Tello ,&nbsp;Milagros González Béjar ,&nbsp;Alejandra Rabanal Carrera ,&nbsp;Javier Rosado Martín ,&nbsp;Laura Noguera Vera ,&nbsp;Ana Doyle Sanchez ,&nbsp;Amelia Rodríguez Mariblanca ,&nbsp;Eva García Aguilar","doi":"10.1016/j.maturitas.2024.108128","DOIUrl":"10.1016/j.maturitas.2024.108128","url":null,"abstract":"<div><h3>Objectives</h3><div>This study evaluated the efficacy of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause.</div></div><div><h3>Study design</h3><div>Randomized, double-blind, placebo-controlled, multicenter clinical trial conducted across 28 Spanish sites involving specialists in gynecology, urology, and primary care. A total of 108 postmenopausal women were randomly assigned in a 1:1 ratio to receive 1 g of vaginal gel with 50 micrograms of estriol or an identical moisturizing vaginal gel without estriol.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was the number of episodes of urinary tract infection by the end of the 24-week treatment. Secondary measures encompassed percentage of patients without recurrence, time to first recurrence, use of antibiotic treatment, vaginal pH, safety, and tolerability, among others.</div></div><div><h3>Results</h3><div>The incidence rate of urinary tract infections (new cases per 100 women-year) was 26 % lower in the group that received estriol vs. the group that received placebo (32.34 vs. 43.76 (RR = 0.74) <em>p</em> &lt; 0.001). The frequency of urinary tract infections fell during treatment in all patients in the estriol group. Favorable pH changes from baseline were observed in the estriol arm at all follow-up visits.</div></div><div><h3>Conclusions</h3><div>Ultra-low-dose 0.005 % estriol vaginal gel is safe and effective in preventing recurrent urinary tract infections in postmenopausal women with genitourinary syndrome of menopause, reducing the incidence and potentially decreasing the susceptibility to urogenital infections by improving vaginal pH.</div><div>Study registration N°: 2018-001481-42. Date of registration: 09-04-2018.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108128"},"PeriodicalIF":3.9,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis investigating differences in chronic inflammation and adiposity before and after menopause","authors":"Laura E. Pernoud ,&nbsp;Paul A. Gardiner ,&nbsp;Sean D. Fraser ,&nbsp;Kirsten Dillon-Rossiter ,&nbsp;Melinda M. Dean ,&nbsp;Mia A. Schaumberg","doi":"10.1016/j.maturitas.2024.108119","DOIUrl":"10.1016/j.maturitas.2024.108119","url":null,"abstract":"<div><h3>Background</h3><div>Menopause represents a pivotal physiological transition characterized by hormonal fluctuations and an augmented susceptibility to chronic diseases. The relationship between menopause and heightened disease risk may be attributed in part to alterations in low-grade chronic inflammation and adiposity.</div></div><div><h3>Methods</h3><div>Three databases were searched for studies assessing differences in inflammation and body adiposity between pre- and postmenopausal women. Meta-analysis examined the association between menopausal status and key inflammatory biomarkers, including leptin, adiponectin, interleukin-6, tumour necrosis factor-α and c-reactive protein, and indices of body adiposity (fat mass, waist circumference, waist-to-hip-ratio and body mass index). The National Institute of Health Quality Assessment Tool for Observational and Cross-sectional studies was used to evaluate quality of studies, and GRADE-assessed evidence certainty.</div></div><div><h3>Results</h3><div>Levels of adiponectin and leptin were higher in postmenopausal women than in premenopausal women [(1.30 μg/ml, 95 % CI; 0.56 to 2.03 μg/ml, <em>p</em> = 0.001), (0.88 ng/ml; 95 % CI: 0.22 to 1.52; <em>p</em> = 0.008)]. A trend towards significance was observed for tumour necrosis factor-α (0.59 pg/ml, 95 % CI; −0.07 to 1.26 pg/ml, <em>p</em> = 0.080), with no significant differences in interleukin-6 and c-reactive protein [(0.83 pg/ml, 95 % CI; −0.24 to 1.91 pg/ml, <em>p</em> = 0.128), (0.06 mg/ml, 95 % CI; −0.17 to 0.29, <em>p</em> = 0.606)]. Postmenopausal women had greater waist circumference, waist-to-hip-ratio and body mass index than premenopausal women [(0.74 cm; 95 % CI: 1.02 to 0.47; <em>p</em> ≤0.001), (0.78; 95 % CI: 1.47 to −0.09; <em>p</em> = 0.027), (0.31 kg/m²; 95 % CI: 0.50 to 0.12; <em>p</em> = 0.001)].</div></div><div><h3>Conclusions</h3><div>Postmenopausal women had higher adipokine levels and greater adiposity. However, given the low certainty of the available evidence, future prospective cohort studies assessing inflammatory changes over the menopausal transition are warranted to inform future clinical decisions. Protocol registered on the Open Science Framework (OSF-ID: <span><span>10.17605/OSF.IO/DY8T6</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108119"},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322098","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 endometriosis","authors":"Chiara Cassani ,&nbsp;Sara Tedeschi ,&nbsp;Laura Cucinella ,&nbsp;Vittoria Morteo ,&nbsp;Cristina Angela Camnasio ,&nbsp;Lara Tiranini ,&nbsp;Ellis Martini ,&nbsp;Rossella E. Nappi","doi":"10.1016/j.maturitas.2024.108129","DOIUrl":"10.1016/j.maturitas.2024.108129","url":null,"abstract":"<div><div>The shift in paradigm from the belief that endometriosis exclusively affects women of reproductive age has brought attention to its manifestation in postmenopausal patients. Despite this emerging awareness, there remains a dearth of information in the literature regarding postmenopausal endometriosis, with uncertainties surrounding its prevalence, clinical significance, optimal management strategies, and prognosis. Clinical manifestations of endometriosis in menopausal patients lack specificity, with pain onset possible at any stage of life. The primary approach for symptomatic postmenopausal endometriosis continues to be surgical excision, serving both diagnostic and therapeutic purposes while mitigating the risk of coexisting malignancies. Managing the disease in postmenopausal women presents challenges due to possible contraindications for menopausal hormone therapy and the elevated risk of recurrence and malignant transformation. However, conclusive data regarding the appropriateness of menopausal hormone therapy in women with endometriosis or a history of the disease are lacking. Current recommendations lean towards prioritizing combined menopausal hormone therapy formulations or tibolone over estrogen-only therapies due to their potentially higher malignancy risk. The possible increased risk of osteoporosis and cardiovascular disease in postmenopausal women with endometriosis is likely linked to a history of surgical menopause at an earlier age, but more research is warranted. This narrative review summarizes the available literature and provides insights into the intricate connection between endometriosis and menopause, shedding light on pathogenesis, symptoms, oncologic risk, diagnosis, and treatment.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108129"},"PeriodicalIF":3.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142359053","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":"Protective and harmful social and psychological factors associated with mood and anxiety disorders in perimenopausal women: A narrative review","authors":"Kayla McElhany ,&nbsp;Seema Aggarwal ,&nbsp;Geri Wood ,&nbsp;Jennifer Beauchamp","doi":"10.1016/j.maturitas.2024.108118","DOIUrl":"10.1016/j.maturitas.2024.108118","url":null,"abstract":"<div><div>Perimenopause is often called a window of vulnerability for the development or exacerbation of mood and anxiety disorders. Evidence points to social and psychological factors contributing to the onset of mood and anxiety disorders or the symptoms of depression and anxiety during perimenopause. Therefore, the purpose of this narrative review was to synthesize the findings of studies examining associations between social and psychological factors and the development of mood and anxiety disorders and the symptoms of depression and anxiety during perimenopause. PsychINFO, Ovid MEDLINE, and CINAHL were searched for studies (published between January 2014 and November 2023) assessing the social and psychological factors associated with perimenopausal mood and anxiety disorders and the symptoms of depression and anxiety. These factors were categorized as either protective or harmful. Study quality was assessed using STROBE guidelines. The search yielded 17 studies. Social support was identified as a social factor protective against perimenopausal depression and anxiety. Resiliency characteristics were reported to be protective psychological factors associated with fewer depressive symptoms. Mental health history, family history of major depressive disorder, trait anxiety and neuroticism, stressful life events, adverse childhood events, and chronic stress were categorized as harmful psychological factors associated with depression during perimenopause. Limited research has been conducted to understand factors associated with perimenopausal anxiety. The identification of these social and psychological factors associated with mood and anxiety disorders during perimenopause will help lead to earlier detection of women at risk and the development of multifaceted interventions.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108118"},"PeriodicalIF":3.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310991","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":"Ultra-low dose estradiol and dydrogesterone for the treatment of menopausal symptoms in a pooled, multi-ethnic population","authors":"John C. Stevenson ,&nbsp;Mulan Ren ,&nbsp;Elke Kahler ,&nbsp;Marcelo Graziano Custodio ,&nbsp;Rossella Elena Nappi ,&nbsp;Tetiana Tatarchuk ,&nbsp;Tommaso Simoncini ,&nbsp;Viktoriya Karpova ,&nbsp;Qi Yu","doi":"10.1016/j.maturitas.2024.108117","DOIUrl":"10.1016/j.maturitas.2024.108117","url":null,"abstract":"<div><h3>Objectives</h3><div>Evidence suggests ethnicity-specific differences in postmenopausal symptoms, highlighting the need for therapies that are efficacious across different ethnicities. We evaluated the efficacy of an ultra-low dose combination of 0.5 mg estradiol and 0.25 mg dydrogesterone (E 0.5 mg/D 2.5 mg) in alleviating vasomotor symptoms across a multi-ethnic population.</div></div><div><h3>Study design</h3><div>Data from two controlled trials were pooled to form a dataset of 583 postmenopausal women from across Europe and China. Participants were randomized to receive treatment with E 0.5 mg/D 2.5 mg or placebo for 12 weeks.</div></div><div><h3>Main outcome measures</h3><div>The main efficacy variable was absolute change in the number of hot flushes from baseline to end of treatment. Health-related quality of life and safety were also assessed.</div></div><div><h3>Results</h3><div>Change in the number of hot flushes per day was greater with E 0.5 mg/D 2.5 mg <em>versus</em> placebo (mean difference − 1.5, 95 % confidence interval − 2.1, −1.0; <em>p</em> &lt; 0.001). Participants treated with E 0.5 mg/D 2.5 mg reported improvement in health-related quality of life (including psychological symptoms, vaginal dryness), and high amenorrhea rates. Combined E 0.5 mg/D 2.5 mg was well tolerated: there were no differences between groups in the percentage of participants with at least one serious adverse event or treatment-emergent serious adverse events. Analysis of change in body weight indicated no differences between groups.</div></div><div><h3>Conclusions</h3><div>This pooled analysis demonstrates the consistent efficacy of E 0.5 mg/D 2.5 mg in the treatment of menopause-related symptoms across a multi-ethnic population of postmenopausal women.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"190 ","pages":"Article 108117"},"PeriodicalIF":3.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0378512224002123/pdfft?md5=bb23181ffbbca67c7fb3a3dc900e4a8a&pid=1-s2.0-S0378512224002123-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in the predictors of skeletal muscle microvascular reactivity in older individuals","authors":"Thiago Silveira Alvares ,&nbsp;Felipe Mattioni Maturana ,&nbsp;Rogerio Nogueira Soares","doi":"10.1016/j.maturitas.2024.108115","DOIUrl":"10.1016/j.maturitas.2024.108115","url":null,"abstract":"<div><p>Aging is associated with an increased risk of cardiovascular disease and vascular dysfunction. Reduced nitric oxide bioavailability is considered one of the key mechanisms underlying vascular dysfunction in large arteries of older adults. However, the relationship between cardiovascular disease risk factors, nitric oxide bioavailability, and skeletal muscle microvascular reactivity, an early hallmark in cardiovascular disease progression, is unclear in older individuals. Also uncertain is whether this relationship is influenced by sex. Therefore, this study assessed the association between cardiovascular disease risk factors, circulating markers of nitric oxide availability (plasma nitrate and nitrite), and skeletal muscle microvascular reactivity in older individuals. First, we confirmed in a cohort of young and older individuals that aging is associated with skeletal muscle microvascular dysfunction. Next, we observed that skeletal muscle microvascular reactivity (<em>P</em> = 0.653; η² = 0.016) and circulating nitric oxide metabolites (Nitrate: <em>P</em> = 0.641, η² = 0.011; Nitrite: <em>P</em> = 0.560, η² = 0.017; NOx: <em>P</em> = 0.639, η² = 0.011) did not differ between older males and females. Finally, using multivariate regression models, we found that: (i) the number of cardiovascular risk factors was negatively associated with skeletal muscle microvascular reactivity in older males and females (B = −0.132, <em>P</em> = 0.044); (ii) the relationship between plasma nitrite and skeletal muscle microvascular reactivity was influenced by sex (F = 6.837, <em>P</em> = 0.016); and (iii) skeletal muscle microvascular reactivity in older females displayed a strong positive association with plasma nitrite (R² = 0.720, <em>P</em> &lt; 0.001). While the impact of cardiovascular disease risk factors on skeletal muscle microvascular reactivity was not influenced by sex, sex-related discrepancies were found in the relationship between nitric oxide bioavailability and skeletal muscle microvascular reactivity in older individuals.</p></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"189 ","pages":"Article 108115"},"PeriodicalIF":3.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229171","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}