Hewings-Martin Y, Karam J, Cunningham AC
… +5 more, Hedges MS, Castaneda R, Zhaunova L, Faubion SS, Shufelt CL
Climacteric
· 2026 Jun · PMID 42372113
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OBJECTIVE: Perimenopause is the time leading up to and including the first 12 months after the final menstrual period. This study examined how social determinants of health (SDOH) including race/ethnicity, income, educat...OBJECTIVE: Perimenopause is the time leading up to and including the first 12 months after the final menstrual period. This study examined how social determinants of health (SDOH) including race/ethnicity, income, education and healthcare access influence perimenopause symptom burden. METHOD: A cross-sectional survey was distributed to English, Spanish, Portuguese and French-speaking Flo app users aged 35 years and above. Participants completed the validated Menopause Rating Scale (MRS) and provided data on key SDOH. Associations between SDOH and total MRS and domain scores (psychological, somatic, urogenital) were evaluated using multivariable linear regression. RESULTS: A total of 12,382 women completed the survey. All examined SDOH were significantly associated with total and domain MRS scores ( < 0.001). Healthcare access had the strongest association, followed by income sufficiency and education level. Asian, Black and Hispanic/Latino race/ethnicities were significantly associated with MRS scores ( < 0.001) compared with White race/ethnicity. In a subset of 2618 women who reported being in perimenopause, SDOH remained significantly associated with MRS scores, with income sufficiency showing the strongest association ( < 0.001). CONCLUSIONS: SDOH, particularly healthcare access and income, are strongly associated with perimenopause symptom burden. Addressing health inequities is essential to improve perimenopause care and reduce symptom burden.
Vacca L, Pierro M, Foresta A
… +4 more, Caramazza D, Lombisani A, Ercoli A, Campagna G
Climacteric
· 2026 Jun · PMID 42338418
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Pelvic organ prolapse affects millions of postmenopausal women worldwide, frequently requiring surgical intervention when conservative treatments fail. This systematic review and meta-analysis evaluated the effectiveness...Pelvic organ prolapse affects millions of postmenopausal women worldwide, frequently requiring surgical intervention when conservative treatments fail. This systematic review and meta-analysis evaluated the effectiveness and safety of perioperative vaginal estrogen therapy in postmenopausal women undergoing prolapse surgery. Nine randomized controlled trials including 764 women (383 estrogen, 381 controls) were analyzed through December 2024. Meta-analyses demonstrated significant tissue quality improvement (standardized mean difference 0.73, 95% confidence interval [CI] 0.16-1.30, = 0.012) with substantial heterogeneity ( = 86.7%). However, urinary tract infection effects were inconclusive and contradictory (risk ratio [RR] 0.75, 95% CI 0.27-2.04, = 0.570, = 67.2%), with one study showing harm and two studies showing benefit. Composite surgical success showed no difference (RR 0.94, 95% CI 0.83-1.06, = 0.297), with trends toward lower success in estrogen groups. Patient satisfaction was universally high (>95%) regardless of treatment. Vaginal atrophy symptoms improved significantly with estrogen. Safety profiles were excellent. Current evidence supports perioperative vaginal estrogen for tissue quality optimization and atrophy symptom management, but not for preventing complications or enhancing surgical success.
Climacteric
· 2026 Jun · PMID 42329785
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Menopause is a natural life stage with substantial impacts on women's quality of life and long-term health. Education on menopause for healthcare professionals (HCPs) remains limited and inconsistently embedded across he...Menopause is a natural life stage with substantial impacts on women's quality of life and long-term health. Education on menopause for healthcare professionals (HCPs) remains limited and inconsistently embedded across health disciplines. This scoping review mapped current evidence on menopause education, including available programs, delivery approaches and extent of curricular integration. Following the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a search of six databases and gray literature (last searched May 2025) identified original research evaluating menopause-specific education for undergraduate and postgraduate HCPs. Data were synthesized using deductive and inductive analyses. Of 5034 records identified, 14 studies met the inclusion criteria: nine evaluated educational interventions and five examined curricular provision. Most studies originated from the USA and focused on medical residents. Education formats varied widely, including structured curricula, case-based learning, online modules, telemedicine encounters and peer-supported platforms. Core content commonly addressed menopause physiology, symptom management and hormone therapy, while long-term health implications and equity-focused content were infrequently included. Interventions consistently improved knowledge, confidence and preparedness for menopause care. Despite widespread recognition of its importance, menopause education remains inadequately integrated across healthcare training. Standardized, multidisciplinary and equity-focused menopause education frameworks are urgently required to strengthen clinical competence and improve care for midlife women.
Espírito Santo J, Moita J, Esteves JE
… +1 more, Nunes A
Climacteric
· 2026 Jun · PMID 42305054
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OBJECTIVE: This study aimed to examine Portuguese osteopaths' perceptions, confidence and approaches to managing musculoskeletal conditions in menopausal women. METHOD: A nationwide cross-sectional online survey was cond...OBJECTIVE: This study aimed to examine Portuguese osteopaths' perceptions, confidence and approaches to managing musculoskeletal conditions in menopausal women. METHOD: A nationwide cross-sectional online survey was conducted among osteopaths registered with the Portuguese Central Administration of the Health System. A 36-item questionnaire, adapted from validated osteopathic instruments, assessed demographics, attitudes, clinical confidence, therapeutic strategies and barriers to menopause-related musculoskeletal management. The primary outcome measures were osteopaths' attitudes, confidence and therapeutic strategies regarding the relevance of menopause to musculoskeletal health. RESULTS: Data from 258 osteopaths were analyzed. Most respondents recognized menopause as relevant to musculoskeletal health (95%) and reported frequent clinical contact with menopausal women (58%). Mobilization, fascial and soft-tissue techniques were commonly used, whereas high-velocity low-amplitude thrusts were less frequent. Confidence in treatment and patient education was moderate to high, although 36% felt under-informed about menopause and musculoskeletal interactions. Lack of clinical guidelines (59%) and limited research availability (75%) were the main barriers. Most participants (81%) reported a need for advanced training in menopause management. Female osteopaths scored significantly higher than males in perceptions of menopause and musculoskeletal conditions ( = 0.015), clinical experience and therapeutic approaches ( = 0.001), and competences in osteopathic practice ( = 0.001). CONCLUSION: Portuguese osteopaths, particularly women, appear aware of and engaged in managing menopause-related musculoskeletal conditions, adapting manual therapy and educational approaches to patients' needs. However, limited knowledge and the absence of structured clinical guidance may hinder consistent, evidence-informed care. Targeted education and clinical protocols may strengthen osteopathic support for women's musculoskeletal health during midlife.
Climacteric
· 2026 Jun · PMID 42273725
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Migraine is a highly prevalent primary headache disorder that disproportionately affects women owing to the effects of sex hormones, particularly estrogen. Hyperestrogenism during early perimenopause, coupled with anovul...Migraine is a highly prevalent primary headache disorder that disproportionately affects women owing to the effects of sex hormones, particularly estrogen. Hyperestrogenism during early perimenopause, coupled with anovulatory cycles, is associated with an increased frequency and severity of migraine attacks and an increased prevalence of perimenstrual migraine. The natural decline in estrogen levels after menopause is generally associated with migraine improvement; however, this is variable and often complicated by chronic migraine, vasomotor symptoms, cardiovascular risk and use of menopause hormone therapy (MHT). Although there is a trend toward increasing the use of MHT during perimenopause, there are no research trials regarding migraine in this population, although it appears to have a negative clinical effect. This could be explained by the addition of MHT to the already high and fluctuating endogenous estrogen levels. More appropriate during perimenopause is hormone cycle control. This can be achieved using continuous combined hormonal contraception for women with migraine without aura, whereas progestogen-only regimens, with the option of additional transdermal estrogen, can be used in women with migraine with and without aura. For women choosing to use MHT postmenopause, continuous transdermal regimens are better tolerated than cyclical preparations.
Climacteric
· 2026 Jun · PMID 42261852
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OBJECTIVE: This study aimed to develop and evaluate a culturally adapted, group-based eight-session cognitive behavioral therapy (CBT) program for perimenopausal/postmenopausal Korean women to reduce vasomotor symptoms (...OBJECTIVE: This study aimed to develop and evaluate a culturally adapted, group-based eight-session cognitive behavioral therapy (CBT) program for perimenopausal/postmenopausal Korean women to reduce vasomotor symptoms (VMS) and improve psychological well-being and quality of life. METHOD: In a non-blinded, parallel-group randomized controlled trial, 50 postmenopausal women were randomly assigned to a group-based CBT intervention group or a wait-list control group. Assessments were conducted at baseline, post intervention and at 4-week follow-up. Primary outcomes were VMS frequency and distress assessed using the Hot Flush Rating Scale (HFRS) and daily interference measured by the Hot Flash Related Daily Interference Scale (HFRDIS). Secondary outcomes included menopause-specific quality of life assessed using the Menopause-Specific Quality of Life Questionnaire (MENQOL), anxiety and depressive symptoms measured by the Hospital Anxiety and Depression Scale, and sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI). RESULTS: Compared with the control group, the CBT group showed significant improvements in VMS frequency, distress and daily interference. Quality of life improved across all MENQOL domains. Anxiety decreased significantly with sustained effects at follow-up. Depressive symptoms did not change significantly, and sleep improvements were not sustained. CONCLUSIONS: Group-based CBT effectively reduced VMS and improved quality of life and anxiety, supporting its use as a safe non-hormonal intervention for perimenopausal/postmenopausal Korean women.
Mejia-Gomez J, Tigert M, Jacobson M
… +14 more, Shprits E, Shea AK, Philippopoulos E, Kotsopoulos J, Bridger A, Sanchez Diaz N, Puveendrakumaran P, Shaltout N, Benipal H, Sosea C, Leslie B, Garzon A, Wolfman W, Zigras T
Climacteric
· 2026 Jun · PMID 42258345
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OBJECTIVE: Borderline ovarian tumors (BOTs) are heterogeneous primary epithelial lesions defined by atypical epithelial proliferation without stromal invasion, accounting for approximately 15% of primary ovarian neoplasm...OBJECTIVE: Borderline ovarian tumors (BOTs) are heterogeneous primary epithelial lesions defined by atypical epithelial proliferation without stromal invasion, accounting for approximately 15% of primary ovarian neoplasms. Menopausal hormone therapy (MHT) treats vasomotor and genitourinary symptoms in postmenopausal women, yet its relationship with ovarian neoplasia, especially BOTs, remains uncertain. This systematic review evaluates the association between MHT and BOT outcomes. METHOD: Five databases were searched from inception to August 2025. Included studies were assessed for type of MHT, duration, and recurrences where reported. Risk of bias was assessed with the Newcastle-Ottawa Scale and certainty of evidence with GRADE. RESULTS: A search identified 469 studies; eleven met the inclusion criteria (four cohort, seven case-control). Six reported a statistically significant association between MHT and increased odds of BOTs; five did not. Combined estrogen-progestin therapy showed a stronger, more consistent positive association (odds ratio 1.426, 95% confidence interval 1.083-1.877), whereas estrogen-only therapy showed a nonsignificant association. Post-diagnosis evidence is extremely limited: no study addressed BOT recurrence, and only one observational study evaluated BOT survival, finding no adverse association. CONCLUSION: Evidence on the MHT-BOT association is heterogeneous and inconsistent. Although a statistical association was observed between combined MHT and increased odds of BOTs, postsurgical safety data are limited and overall certainty of evidence is very low; findings warrant considerable caution. Current literature is insufficient to confirm or exclude an association between MHT and BOT recurrence or survival. Indications for MHT after BOT surgery require individualized, multidisciplinary discussion involving oncology and menopause specialists, balancing quality-of-life benefits against unquantified theoretical risks.
Mejia-Gomez JC, Shprits E, Sosea C
… +13 more, Leslie B, Mathur S, Farooqi S, Chaudhry A, Bacal V, Essalah A, Shaltout N, Shea A, Sermer C, Hojabri S, Wolfman W, Stancati N, Jacobson M
Climacteric
· 2026 Jun · PMID 42257592
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OBJECTIVE: This systematic review investigated the impact of conjugated estrogens/bazedoxifene (CE/BZA) for treating perimenopausal and menopausal symptoms in patients with a history of endometriosis. METHOD: The review...OBJECTIVE: This systematic review investigated the impact of conjugated estrogens/bazedoxifene (CE/BZA) for treating perimenopausal and menopausal symptoms in patients with a history of endometriosis. METHOD: The review followed PRISMA guidelines and was prospectively registered with PROSPERO (CRD42024617174). Without randomized controlled trials (RCTs), the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and Case Series assessed methodology and risk of bias. An information specialist completed the search in June 2025 using Ovid MEDLINE, PubMed, Ovid EMBASE, and Web of Science, combining controlled vocabularies and keywords for dysmenorrhea, dyspareunia, endometriosis, perimenopausal, postmenopausal, menopause hormone therapy, Duavive, and CE/BZA. Eligible studies included RCTs, cohort studies, case reports, and case-control studies evaluating CE/BZA for vasomotor symptoms in premenopausal and menopausal endometriosis patients. RESULTS: Of 1540 retrieved studies, two coauthors (J.C.M.-G., E.S.) independently screened titles and abstracts, selecting 20 for full-text review. Only two publications met inclusion criteria, one case report and one case series, representing nine patients (four detailed, five additional). No RCTs, cohort, or case-control studies directly addressed CE/BZA in endometriosis. Preliminary narrative evidence suggests pain and vasomotor symptom relief, though findings carry high risk of bias. CONCLUSION: Because bazedoxifene antagonizes estrogen receptors and endometriosis is estrogen-dependent, CE/BZA may alter systemic inflammation or endothelial function. Although preclinical models show reduced lesion size, human evidence remains extremely limited and biased, insufficient to assess lesion recurrence or vascular safety. CE/BZA is currently indicated only for postmenopausal vasomotor symptoms; preliminary anecdotal evidence suggests symptom improvement, but large-scale comparative trials are urgently needed to establish safety and efficacy in endometriosis.
Wang Y, Miao X, Withers M
… +2 more, Wong MCS, Viwattanakulvanid P
Climacteric
· 2026 Jun · PMID 42253047
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OBJECTIVE: The relationship between early menopause and the risk of cardiovascular disease (CVD) is understudied in Asian women. This study aimed to investigate this association and its potential causality among East Asi...OBJECTIVE: The relationship between early menopause and the risk of cardiovascular disease (CVD) is understudied in Asian women. This study aimed to investigate this association and its potential causality among East Asian women. METHOD: A seven-year observational study involving 1929 postmenopausal women from the China Health and Retirement Longitudinal Study was combined with two-sample Mendelian randomization (MR) analyses utilizing genetic data from the China Kadoorie Biobank and Biobank Japan. Time-varying Cox proportional hazards models were employed for observational analysis. For MR analyses, the inverse variance-weighted method was used as the primary approach to investigate potential causality between genetically proxied age at natural menopause and CVD. RESULTS: In the multivariable-adjusted Cox regression model, early menopause was significantly associated with an increased CVD risk (hazard ratio 1.43, 95% confidence interval 1.05-1.97). However, MR analyses did not yield significant associations. Additionally, a dose-response relationship was observed between menopausal age and incident CVD risk (-value for non-linearity = 0.022). CONCLUSIONS: Early menopause was associated with a higher risk of incident CVD in the observational study, while MR findings suggested this association may not be causal. This study unravels the importance of early menopause in CVD risk assessment and informs CVD primary prevention for Asian women.
Wood SC, van Doorn JL, Bookheimer SY
… +4 more, Nichols TE, Ances BM, Welsh RC, Maki PM
Climacteric
· 2026 Jun · PMID 42246482
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OBJECTIVE: The Stages of Reproductive Aging Workshop +10 (STRAW +10) criteria are the gold standard criteria for categorizing menopause stage, with stage typically categorized using three menopause stages. Although STRAW...OBJECTIVE: The Stages of Reproductive Aging Workshop +10 (STRAW +10) criteria are the gold standard criteria for categorizing menopause stage, with stage typically categorized using three menopause stages. Although STRAW +10 criteria include additional substages, few studies have examined menopause symptoms by these substages. To better characterize menopause stage effects on sleep, this study examined sleep quality across three stages and six substages of menopause. To differentiate menopause effects from aging effects, the study further examined associations between age and sleep quality. METHOD: Participants included 239 women aged 40-60 years from the Human Connectome Project in Aging (HCP-A) and the Aging Adult Brain Connectome (AABC). Sleep was measured using the Pittsburgh Sleep Quality Index and menopause was staged according to STRAW +10 criteria using three stages and six substages. All analyses were conducted using mixed-effects models. RESULTS: Independent of age, sleep quality declined linearly across six substages of menopause, but not three stages of menopause. Age was unrelated to sleep quality after adjustment for menopause stage. CONCLUSION: Midlife represents a window of vulnerability to incrementally worse sleep associated with reproductive, but not chronological, aging. Findings highlight the benefit of using STRAW +10 substaging in menopause research.
Climacteric
· 2026 Jun · PMID 42234514
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Menopause is accompanied by loss of ovarian estrogen and progesterone production and by age-related changes in circulating androgens, with implications for respiratory physiology and chronic pulmonary disease. Sex steroi...Menopause is accompanied by loss of ovarian estrogen and progesterone production and by age-related changes in circulating androgens, with implications for respiratory physiology and chronic pulmonary disease. Sex steroids influence lung development, immune responses, airway tone, vascular remodeling and pathways involved in lung carcinogenesis. Epidemiological evidence linking menopausal hormone therapy (MHT) to asthma is heterogeneous; some cohorts show increased incident asthma or exacerbations, particularly with estrogen therapy and in specific subgroups, whereas others suggest preserved lung function or reduced late-onset asthma. Data on chronic obstructive pulmonary disease remain limited and inconsistent. In pulmonary hypertension, evidence is conflicting, and clinical decisions must weigh thrombotic risk, strongly influenced by the route of estrogen administration. Studies on obstructive sleep apnea and sleep-disordered breathing suggest possible modest benefits of MHT in selected populations but are methodologically heterogeneous. For lung cancer, large cohorts, meta-analyses and randomized trials essentially show no clear increase in incidence with MHT and suggest potential survival advantages in some subgroups. Overall, MHT use in women with or at risk for pulmonary disease should be individualized, integrating symptom burden, cardiometabolic and respiratory risk, disease phenotype and formulation/route.
Prats Rodríguez P, García Lumbreras S, García-Alfaro P
… +5 more, Bergamaschi L, García Martinez S, Baulies Caballero S, Rombaut Segarra S, Cabrera Diaz S
Climacteric
· 2026 Jun · PMID 42231870
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OBJECTIVE: This study aimed to describe associations between pregnancy, postpartum status and emotional health in women aged ≥45 years undergoing the menopausal transition. METHOD: The prospective observational study inc...OBJECTIVE: This study aimed to describe associations between pregnancy, postpartum status and emotional health in women aged ≥45 years undergoing the menopausal transition. METHOD: The prospective observational study included 71 women aged ≥45 years: 36 postpartum participants and 35 age-matched controls who had not given birth in the preceding 2 years. Participants completed the Cervantes Short-Form Scale (quality of life), Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire-9 (PHQ-9) at baseline, 12 months and 24 months. RESULTS: Participants had a mean age of 47.3 ± 2.0 years; most were employed, in stable relationships and university educated. Nearly all postpartum participants (97.2%) conceived via assisted reproductive technologies. No baseline differences were found between groups. At 12 and 24 months, postpartum women had higher BDI-II scores than controls ( = 0.010 and = 0.015, respectively). In multivariable analysis adjusting for baseline scores, age and parity, this association remained significant ( < 0.001). No significant associations were observed for PHQ-9 or Cervantes scores after adjustment. CONCLUSIONS: Among midlife women, postpartum status was associated with higher depressive symptom scores on the BDI-II but not on other measures. These findings are preliminary and should be interpreted as hypothesis-generating. Larger studies are needed to confirm these associations and identify potential contributing factors.
Takamatsu K, Miki T, Miyazaki K
… +3 more, Hashimoto A, Morga A, Wang X
Climacteric
· 2026 May · PMID 42159172
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OBJECTIVE: This study aimed to report results of exploratory patient-reported outcomes (PROs) from the STARLIGHT study. METHOD: Perimenopausal/postmenopausal women aged ≥40 to ≤65 years from 36 centers in Japan seeking t...OBJECTIVE: This study aimed to report results of exploratory patient-reported outcomes (PROs) from the STARLIGHT study. METHOD: Perimenopausal/postmenopausal women aged ≥40 to ≤65 years from 36 centers in Japan seeking treatment/relief for vasomotor symptoms (VMS) associated with menopause were randomized 1:1:1, stratified by menopausal status, to receive fezolinetant 15 or 30 mg or placebo orally once daily for 12 weeks. The Patient-Reported Outcomes Measurement Information System Sleep Disturbance - Short Form 8b (PROMIS SD-SF 8b) total score, Menopause-Specific Quality of Life (MENQOL) total and domain scores, and Patient Global Impression of Change in Vasomotor Symptoms (PGI-C VMS) assessed the effect of fezolinetant on health-related quality of life (HRQoL). RESULTS: In total, 147 participants were randomized (placebo, = 47; fezolinetant 15 mg, = 53; fezolinetant 30 mg, = 47). Improvements from baseline in the PROMIS SD-SF 8b total score and MENQOL total score were observed in the fezolinetant and placebo groups at weeks 4, 8 and 12. A higher proportion of participants in the fezolinetant 15 mg and fezolinetant 30 mg groups versus placebo reported improvement from baseline in the PGI-C VMS at weeks 4, 8 and 12. CONCLUSION: Fezolinetant was associated with improvements in PROs (PROMIS SD-SF-8b, MENQOL and PGI-C VMS); however, these analyses were exploratory and not powered for confirmatory hypothesis testing.
Climacteric
· 2026 May · PMID 42118132
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OBJECTIVE: This study aimed to compare the self-reported sleep problems of middle-aged women who had not menstruated for more than a year (postmenopause), those who have menstruated within the last year (premenopausal/pe...OBJECTIVE: This study aimed to compare the self-reported sleep problems of middle-aged women who had not menstruated for more than a year (postmenopause), those who have menstruated within the last year (premenopausal/perimenopausal) and those who could not have menstruated for medical reasons (e.g. hysterectomy). METHOD: The UK Biobank dataset was utilized to conduct cross-sectional (approximately = 200,000) and longitudinal (approximately = 20,000) analyses, drawing on responses from baseline and follow-up self-reported questionnaires. RESULTS: Cross-sectionally, self-reported sleep duration ( < 0.001) and a composite measure of sleep problems (problematic sleep index) ( < 0.001) showed consistent differences across these 'menopausal' groups. Longitudinally, sleep duration and sleep problems increased with age (both < 0.001), length of time within the study (i.e. aging) ( < 0.001), perceived overall health ( < 0.001) and health change ( < 0.001). Menopause exacerbated these effects; however, the decline in sleep quality was mitigated by hormone replacement therapy ( < 0.05), particularly among women in premenopausal/perimenopausal stage and those in whom menopause was well established ( < 0.05). CONCLUSION: While not supported by objective measures of sleep, health or hormones, these results add substantially to the literature on women's sleep, health and menopause, highlighting the potential benefits of early, tailored interventions and timely hormone replacement therapy use for improving sleep and well-being in midlife.
Climacteric
· 2026 May · PMID 42112893
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OBJECTIVE: Research on allostatic load (AL) and depression has been increasing, but has lacked attention on perimenopausal women. This study aimed to explore the dual trajectories of AL and depression in perimenopausal w...OBJECTIVE: Research on allostatic load (AL) and depression has been increasing, but has lacked attention on perimenopausal women. This study aimed to explore the dual trajectories of AL and depression in perimenopausal women and identify their common influencing factors. METHOD: Data from seven follow-up sites of the Study of Women's Health Across the Nation (SWAN) were used, and 1185 perimenopausal women aged 42-52 years were eventually included. Trajectories of AL and depression were identified by fitting different group-based trajectory models. A dual trajectory model was used to estimate the probability of the correlation between different level trajectory groups of AL and depression, and multivariate logistic regression was used to estimate the degree of association of demographic characteristics of perimenopausal women with AL and depression. RESULTS: In a dual trajectory model of AL and depression, AL and depression showed an interactive association, with high AL trajectories increasing the likelihood of high depression trajectories (14.65%) and high depression trajectories increasing the likelihood of high AL trajectories (41.2%). After considering demographic characteristics, age, race, income level, social support, hot flashes and night sweats were found to be common influences on AL and depression. CONCLUSION: Interventions should be tailored according to the different trajectory groups of AL and depression, with a focus on high-vulnerability subgroups (high AL without depression, low AL with high depression, high AL with high depression). AL monitoring should also be integrated into perimenopausal depression management. In addition, care should be taken to address the common risk factors behind these trajectories and develop interventions based on relevant determinants.
Climacteric
· 2026 May · PMID 42095404
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Publisher ↗
OBJECTIVE: With the decline in the average age of menopause, increased life expectancy and rising longevity among women, a significant number face menopausal challenges including physical and psychological symptoms that...OBJECTIVE: With the decline in the average age of menopause, increased life expectancy and rising longevity among women, a significant number face menopausal challenges including physical and psychological symptoms that adversely affect their quality of life (QoL). Given the growing preference for complementary therapies over menopausal hormone therapy (MHT) and promising evidence on auricular acupressure, this study aimed to investigate its effect on QoL in postmenopausal women. METHOD: The randomized sham-controlled clinical trial enrolled 120 eligible postmenopausal women visiting comprehensive health centers in Qazvin, Iran, between February and August 2024. Participants were randomized into intervention ( = 60) or sham ( = 60) groups using the balanced blocks randomization method. The intervention group received auricular acupressure using Vaccaria seed-embedded tapes on specific points (Chinese/European uterine, ovary, Shenmen, brain, gonadotropin and sympathetic points) over 10 sessions (4-day intervals). Participants were instructed to apply moderate pressure to each point for 20 s, three times daily. The sham group followed an identical protocol but used non-seeded tapes. Data were collected using demographic/fertility questionnaires and the Menopause-Specific Quality of Life Questionnaire (MENQOL), assessing vasomotor, physical, psychosocial and sexual domains (lower scores indicate improved QoL). QoL was evaluated at baseline, 1 month post intervention and 2 months post intervention. Data were analyzed using repeated-measures analysis of variance-analysis of covariance (SPSS version 27, = 0.05). RESULTS: Baseline QoL scores did not differ significantly between groups. Post intervention, the intervention group showed statistically significant reductions in total QoL scores and all subscales at 1-month and 2-month follow-ups ( < 0.05). Mean differences for intervention versus sham groups in the first and second follow-ups were -28.50, -48.87 for total QoL; -2.36, -5.92 for vasomotor subscale; -2.55, -9.75 for psychosocial subscale; -10.89, -28.41 for physical subscale; and -1.62, -4.78 for sexual subscale. Based on -values, auricular acupressure explained 63.4% of total QoL variance, and 61.6% (vasomotor), 39.9% (psychosocial), 66.2% (physical), and 42.4% (sexual) for the subscales. CONCLUSION: Auricular acupressure significantly improved overall QoL and all specific domains (physical, psychosocial, vasomotor, sexual) in postmenopausal women. Healthcare providers may consider this non-pharmacological therapy particularly for MHT-ineligible patients to alleviate menopausal symptoms and enhance QoL. Some limitations such as potential social desirability bias from self-reported measures, the lack of objective biomarkers due to budget limits and unevaluated confounding factors related to living conditions highlight the need for future research with multimodal assessments.