Climacteric[JOURNAL]
Sun
200 papers
The impact of ovarian aging on muscle strength and life quality in various reproductive aging stages.
Luo A, Li H, Lv X … +4 more , Zheng P, Lin K, Liang A, Yang S
Climacteric · 2025 Aug · PMID 40110806 · Publisher ↗
OBJECTIVE: Ovarian aging significantly impacts women's overall aging, affecting various systems including the musculoskeletal system. This study investigates the correlation between ovarian function and handgrip strength...
OBJECTIVE: Ovarian aging significantly impacts women's overall aging, affecting various systems including the musculoskeletal system. This study investigates the correlation between ovarian function and handgrip strength (HGS) across reproductive aging stages and their relation to health-related quality of life (HRQoL). METHOD: A cross-sectional study was conducted with female participants spanning all stages of ovarian function. HGS was measured using a dynamometer, and ovarian function was assessed via hormone levels (estradiol [E2], follicle stimulating hormone [FSH], luteinizing hormone [LH], prolactin [PRL], progesterone [P4] and testosterone). HRQoL was evaluated using the Sarcopenia-specific Quality of Life questionnaire (SarQoL). Data analysis involved analysis of variance and Pearson's correlations, adjusted for confounding factors. RESULTS: The prevalence of possible sarcopenia increased from 3.8% in premenopausal women to 10.3% in postmenopausal women. After adjusting for covariates (age, SarQoL, FSH, LH, FSH/LH ratio, PRL, E2, P4 and testosterone), the negative correlation between HGS and the Kupperman Menopausal Index (KMI) was no longer significant. However, the positive correlation between HGS and the SarQoL remained significant in both the overall population and the postmenopausal group. The negative correlation between HGS and FSH was no longer significant after controlling for age, KMI, LH and E2; however, it persisted after controlling for the SarQoL, FSH/LH ratio, PRL, P4 and testosterone. CONCLUSION: HGS is positively correlated with the SarQoL and negatively correlated with age in the overall population. No significant association was found between HGS and testosterone, E2, LH or FSH/LH ratio. Further research is needed to clarify the relationship between HGS and the KMI or FSH.
Effects of aerobic and resistance training on bone, muscle hypertrophy and inflammation in OVX mice.
Ribeiro LB, Machado PG, Reis-Canaan JC … +5 more , Oliveira Júnior IM, Bertolini NO, Macari S, Coimbra CC, Pereira LJ
Climacteric · 2025 Oct · PMID 40099811 · Publisher ↗
OBJECTIVE: Bone loss is common with aging, particularly due to reduced sex hormones, as seen in menopause. While physical training is a known non-pharmacological therapy for osteopenia and sarcopenia, few studies compare...
OBJECTIVE: Bone loss is common with aging, particularly due to reduced sex hormones, as seen in menopause. While physical training is a known non-pharmacological therapy for osteopenia and sarcopenia, few studies compare resistance and aerobic protocols, especially with systemic inflammatory markers. This study evaluated the effects of aerobic and resistance training on physical performance, femoral trabecular bone quality (micro-computed tomography), serum inflammatory markers (IL-1β, IL-6, TNF-α, IL-10) and gastrocnemius muscle area in ovariectomized (OVX) female mice. METHOD: Sixty-four c57bl/6 mice were divided into OVX and SHAM groups and subjected to sedentary, resistance (climbing) or aerobic (treadmill) protocols for 8 weeks. RESULTS: Training reduced body mass ( < 0.001) in trained animals compared to sedentary. Bone quality was higher in trained groups versus sedentary. OVX increased TNF-α, but training did not alter it. IL-1β levels were higher in climbing than treadmill groups, and IL-6 increased with OVX and aerobic training ( < 0.001). IL-10 was elevated in the SHAM and climbing groups ( < 0.01). Gastrocnemius muscle area increased in both trained groups ( < 0.001) with no differences between modalities. CONCLUSION: Aerobic and resistance training improved bone quality and muscle area in OVX mice, with climbing training uniquely linked to increased IL-10 levels.
NK3 receptor antagonist alters the centrally controlled perception of menopausal flushing - a pilot study.
Sassarini J, Skorupskaite K, McLean J … +2 more , Lumsden MA, Anderson RA
Climacteric · 2025 Aug · PMID 40085748 · Publisher ↗
OBJECTIVE: Kisspeptin/neurokinin/dynorphin (KNDy) signaling links reproductive and thermoregulatory systems, and improvements in menopausal flushing are reported with neurokinin 3 receptor (NK3R) antagonists. A rise in b...
OBJECTIVE: Kisspeptin/neurokinin/dynorphin (KNDy) signaling links reproductive and thermoregulatory systems, and improvements in menopausal flushing are reported with neurokinin 3 receptor (NK3R) antagonists. A rise in brainstem activity preceding a flush has been proposed as its functional origin, with subsequent activity in the insula and prefrontal cortices reflecting individual perception. Using functional magnetic resonance imaging (fMRI), this study investigated the central effect of the NK3R antagonist MLE4901 during a flush, particularly functional connectivity changes in the salience network. METHOD: Five postmenopausal women with flushes completed a 1-week flush diary prior to baseline fMRI, during which hot flushes were triggered by heating. Diaries were continued during 7 days of treatment with the NK3R antagonist MLE4901, with repeat fMRI on day 7. Sternal monitors recorded objective flushing before each fMRI. Connectivity changes in the salience network post flush were assessed. RESULTS: Treatment with MLE4901 reduced the subjective flush frequency (from median 6.9 to 1.1 per day; = 0.02) without changes in objective flushes. Treatment decreased right anterior insula connectivity, which correlated significantly with decreased subjective flushing. CONCLUSION: This pilot study demonstrates decreased connectivity in the salience network during NK3R antagonist treatment. This may indicate areas of interest for further targeted fMRI studies and mechanistic investigation of this novel treatment for flushing.
From waste to wellness - what women want: insights into patient perspectives on topical vaginal estrogen applicators and environmental considerations.
Da Silva AS, O'Kane M, Davis C … +3 more , Rantell A, Araklitis G, Robinson D
Climacteric · 2025 Oct · PMID 40085745 · Publisher ↗
OBJECTIVE: Environmental consciousness and the role of plastic waste are increasing. Topical vaginal estrogen prescription can be prescribed with one reusable plastic applicator or multiple single-use plastic applicators...
OBJECTIVE: Environmental consciousness and the role of plastic waste are increasing. Topical vaginal estrogen prescription can be prescribed with one reusable plastic applicator or multiple single-use plastic applicators. User preference about the role of plastic in personal healthcare is not fully understood. This study aimed to explore patients' perspectives on the applicator and environmental considerations. METHOD: A mixed-methods questionnaire was employed to assess users' experience with topical vaginal estrogen applicators and their views on the environment. RESULTS: Ninety-two respondents had previously used estriol 0.1% cream and 77 had used estradiol 10 μg vaginal inserts. The mean age of participants was 67.3 years. The mean duration of use was 36.5 months, and the discontinuation rate was 26.1% and 29.9% for estriol 0.1% cream and estradiol 10 μg vaginal insert users, respectively. Satisfaction with applicators and ease of use were similar in both groups. There was a higher report of the product being 'messy' (38.0% vs. 18.2%; = 0.026) and 'not hygienic' (48.9% vs. 18.2%; < 0.001) by estriol 0.1% cream users compared to estradiol 10 μg vaginal insert users. Women aged <65 years demonstrated a greater concern about plastic use and the impact on the environment compared to women aged over 65 years (81.0% vs. 56.9%; = 0.002). The younger cohort showed a preference for reusable applicators (66.2%) compared to single-use applicators (33.8%) ( 0.005). There was no statistically significant difference in preference for women aged over 65 years. CONCLUSION: This study demonstrates that younger postmenopausal women showed greater concern for plastic waste and its impact on the environment, with a preference for reusable products. Manufacturers of health products and prescribers should be aware of this growing trend. With similar overall satisfaction and side-effect profiles, users should be made aware of the different types of applicators available to help support an informed decision.
Associations between blood sex hormones, cognitive decline and incident dementia in community-dwelling older Australian women: a prospective cohort study.
Sultana F, Davis SR, Wolfe RS … +2 more , McNeil JJ, Islam RM
Climacteric · 2025 Aug · PMID 40085743 · Full text
OBJECTIVE: Whether blood sex hormone concentrations predict cognitive decline and incident dementia in older women is uncertain. The Sex Hormones in Older Women (SHOW) study is a prospective cohort study of Australian wo...
OBJECTIVE: Whether blood sex hormone concentrations predict cognitive decline and incident dementia in older women is uncertain. The Sex Hormones in Older Women (SHOW) study is a prospective cohort study of Australian women, aged at least 70 years, without cognitive impairment. METHODS: Sex hormones were measured by liquid chromatography-tandem mass spectrometry, and comprehensive cognitive testing was performed at baseline and 3 years later. RESULTS: Of the 6358 participants who had sex hormones measured, 4444 women (median age at baseline 74 years [Q1-Q3 71.7-77.5]) provided data for cognitive analyses. The findings were limited to a decline in executive function and verbal fluency was positively associated with the highest quartiles of estrone (odds ratio [OR] = 1.21, 95% confidence interval [CI] 1.01-1.45, = 0.04) and dehydro-epiandrosterone (DHEA) (OR = 1.21, 95% CI 1.01-1.45, = 0.04), compared with the lowest quartiles. Estrone and DHEA were not associated with any other cognitive decline. Testosterone was not associated with cognitive decline. In an exploratory analysis, cognitive decline was not different in women who had estradiol below the limit of detection (66% of women) compared with women with measurable estradiol. Over a median 4.1 years of follow-up (22,518 person-years), 121 (2.2%) developed dementia; an incident rate of 5.3 per 1000 person-years. There were no associations between any hormone and incident dementia. CONCLUSIONS: The finding of a greater likelihood of a decline in executive function and verbal fluency in community-dwelling older women with the highest blood concentrations of DHEA and its metabolite estrone need reaffirmation and their clinical significance should be further investigated. These findings do not support use of estrogen or DHEA therapy to prevent cognitive decline in older women.
Unraveling sleep quality in menopausal women: objective assessments and self-reported experiences - a mini-review.
Wang L, Xiao Y, Luo M … +1 more , Huang R
Climacteric · 2025 Apr · PMID 40066925 · Publisher ↗
Sleep is a cornerstone of health, playing an integral role in both physiological and psychological functions. However, it is vulnerable to a variety of factors including menopause. According to available research, the on...
Sleep is a cornerstone of health, playing an integral role in both physiological and psychological functions. However, it is vulnerable to a variety of factors including menopause. According to available research, the onset of the menopause transition may not necessarily worsen sleep architecture and could even enhance it, leading to conflict between assessment of subjective and objective sleep complaints. This discrepancy highlights the complex relationship between subjective and objective sleep quality. Understanding this relationship remains challenging due to the limited number of longitudinal studies and small sample sizes. This review explores findings from both subjective and objective sleep assessments in menopausal women and examines the impact of menopausal hormone therapy on sleep quality.
Second pregnancy in China 5 years after ovarian tissue transplantation to prevent iatrogenic POI.
Ruan X, Du J, Jin F … +8 more , Gu M, Cheng J, Li Y, Dai Y, Korell M, Montag M, Liebenthron J, Mueck AO
Climacteric · 2025 Apr · PMID 40063149 · Publisher ↗
OBJECTIVE: This article reports the second live birth in China after frozen-thawed ovarian tissue transplantation to prevent iatrogenic premature ovarian insufficiency (POI). METHOD: A patient with aplastic anemia receiv...
OBJECTIVE: This article reports the second live birth in China after frozen-thawed ovarian tissue transplantation to prevent iatrogenic premature ovarian insufficiency (POI). METHOD: A patient with aplastic anemia received ovarian tissue cryopreservation before hematopoietic stem cell transplantation, and four ovarian cortex strips were thawed and transplanted into her peritoneal pocket 18 months later. RESULTS: Pregnancy occurred spontaneously 5 years after grafting, and a healthy girl was born at 39 weeks of gestation. Until now, the child has developed normally without any major diseases. CONCLUSION: Ovarian tissue cryopreservation and transplantation (OTCT) can be assessed as a successful method especially to prevent iatrogenic POI. In our cryobank for OTCT, which is the first official one in China, intensive research to improve this method has been performed, and we propose after our success for the second pregnancy in China to include this method in the official guidelines for prevention and treatment of (especially iatrogenic) POI.
Analysis of multimorbidity patterns in perimenopausal women based on medical examination data.
Luo W, Mao J, Su S … +5 more , Jia M, Xian S, An J, Qi X, Mu L
Climacteric · 2025 Aug · PMID 40053459 · Publisher ↗
OBJECTIVE: The concurrent presence of multiple chronic diseases, termed multimorbidity, is increasingly prevalent among patients with chronic illnesses. This phenomenon is particularly pronounced in middle-aged women, ye...
OBJECTIVE: The concurrent presence of multiple chronic diseases, termed multimorbidity, is increasingly prevalent among patients with chronic illnesses. This phenomenon is particularly pronounced in middle-aged women, yet has not received adequate attention. The objective of this study was to investigate the pattern of multimorbidity and its changes over time in perimenopausal women. METHODS: A longitudinal study was conducted on the coexistence of chronic diseases in 3990 middle-aged women aged 40-65 years. The primary analytical tools were association rule mining and cross-lagged panel modeling, applied to the comprehensive medical examination data of the cohort. RESULT: At the first medical examination, 77.72% of participants were diagnosed with two or more chronic diseases, a figure that rose to 86.98% by the last examination. The most frequently observed multimorbidity combination pair under strong association rules is obesity and dyslipidemia. Additionally, the findings indicated that central obesity significantly influences lipid composition. CONCLUSION: This study highlights the elevated prevalence of multimorbidity in perimenopausal women and the added complexity of endocrine-related disorders at this life stage. There is an urgent need to develop personalized health management strategies for this demographic and to monitor and intervene in their health status in order to achieve healthy aging for perimenopausal women.
Preparing for the future: artificial intelligence in menopausal health care.
Ang SB, Hillard T
Climacteric · 2025 Apr · PMID 40053329 · Publisher ↗
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Skin temperature and nitric oxide in premenopausal and postmenopausal women with fibromyalgia.
Rus A, Coca-Guzmán B, Casas-Barragán A … +3 more , Molina F, Correa-Rodríguez M, Aguilar-Ferrándiz ME
Climacteric · 2025 Apr · PMID 40009069 · Publisher ↗
OBJECTIVE: This study aimed to investigate skin temperature, indicative of peripheral vascular blood flow, core body temperature and nitric oxide (NO) levels in premenopausal and postmenopausal women with fibromyalgia (F...
OBJECTIVE: This study aimed to investigate skin temperature, indicative of peripheral vascular blood flow, core body temperature and nitric oxide (NO) levels in premenopausal and postmenopausal women with fibromyalgia (FM) and controls. METHOD: A case-control study was carried out in 32 healthy premenopausal and 52 healthy postmenopausal women and in 17 premenopausal and 53 postmenopausal women with FM. Hand skin temperature was measured using infrared thermography, tympanic and axillary temperature with an infrared thermometer, and serum NO levels using an ozone chemiluminescence-based method. RESULTS: Tympanic temperature was higher in postmenopausal women with FM than in postmenopausal controls. Significant differences were found in all of the temperatures recorded in both hands between healthy premenopausal women and premenopausal women with FM and between postmenopausal controls and postmenopausal women with FM. No differences were found in hand temperature, axillary or tympanic temperature, or NO levels between healthy premenopausal and postmenopausal women or between premenopausal and postmenopausal women with FM. CONCLUSION: The association between menopause and FM could be responsible for the higher tympanic temperature observed in women with FM. FM, but not menopause, may increase hand skin temperature, which could be indicative of excessive peripheral vasodilation. Menopause may not alter body temperature or NO levels in either patients with FM or healthy women.
Laser for genitourinary syndrome of menopause: what we know and what we need to know.
Li FG, Abbott J
Climacteric · 2025 Aug · PMID 39968760 · Publisher ↗
Energy-based treatments, including the fractional CO laser, have been widely used for treatment of genitourinary symptoms associated with menopause. With the availability of data from seven double-blind sham-controlled r...
Energy-based treatments, including the fractional CO laser, have been widely used for treatment of genitourinary symptoms associated with menopause. With the availability of data from seven double-blind sham-controlled randomized trials, the evidence does not support the fractional CO laser as an efficacious treatment for genitourinary syndrome of menopause (GSM). A 2024 meta-analysis of these trials demonstrated that the symptom with greatest absolute improvement was dyspareunia at 16.3%, although not statistically significant. This improvement is far less than previously anticipated based on prospective data that suggested promising improvements of more than 90% satisfaction following laser treatment. Other data, including those from unblinded studies which are subject to a placebo effect, and outcomes that are not participant-reported including the appearance of the vagina on examination and histology, are not reliable in determining efficacy of laser treatment for GSM. While there may be a clinical effect of laser over sham treatments for GSM, the effect is unlikely to be clinically meaningful. Until we define and demonstrate a minimal clinically important difference in a robust and appropriately powered study, the laser should not be used in a clinical context for GSM.
Flaxseed and mulberry extract improve trabecular bone quality in estrogen-deficient rats.
Jacques LS, Pereira JPC, Santos BM … +2 more , Barrioni BR, Del Bianco Borges B
Climacteric · 2025 Apr · PMID 39937165 · Publisher ↗
Many hormones, including estrogens, modulate bone metabolism, which plays a crucial role in maintaining bone health. Estrogen depletion, as occurs in menopause, leads to increased bone resorption and decreased formation,...
Many hormones, including estrogens, modulate bone metabolism, which plays a crucial role in maintaining bone health. Estrogen depletion, as occurs in menopause, leads to increased bone resorption and decreased formation, resulting in osteopenia/osteoporosis. This study investigates the effects of flaxseed () and mulberry ( L.) extracts, known for their phenolic compounds and antioxidant properties, against estrogen deficiency-induced bone loss in female Wistar rats. These extracts were administered to ovariectomized rats for 60 days. High-performance liquid chromatography analysis revealed the presence of some phenolic compounds in the extracts, including trigonelline, gallic acid, theobromine, chlorogenic acid, syringic acid and -coumaric acid. The extracts improved bone microstructure with higher trabecular bone, bone mineral density, calcium, phosphorus and magnesium levels, and lower porosity and intertrabecular space in bone tissue. Furthermore, plasma alkaline phosphatase activity was elevated in extract-treated animals, indicating enhanced bone tissue formation. Although serum carboxy-terminal fragment levels showed no significant change, the data suggest that flaxseed and mulberry extracts may protect against trabecular bone loss and support bone formation in estrogen-deficient conditions. These results suggest that supplementing these natural extracts holds promise in preventing or alleviating the signs and symptoms associated with estrogenic deficiency.
State of the art in menopause: current best practice approaches from the IMS World Congress 2024, Melbourne.
Simon JA, Davis SR, Lindén Hirschberg A … +5 more , Kiesel L, Pompei LM, Reginster JY, Simoncini T, Hillard T
Climacteric · 2025 Apr · PMID 39928407 · Publisher ↗
The 19th World Congress on Menopause, hosted by the International Menopause Society in 2024, convened global experts to discuss the latest advances in menopause management. This review highlights key focus areas presente...
The 19th World Congress on Menopause, hosted by the International Menopause Society in 2024, convened global experts to discuss the latest advances in menopause management. This review highlights key focus areas presented at the congress, offering insights into best practices for clinical application. Cardiovascular health remains a priority, with emphasis on recognizing sex-specific risk factors and exploring emerging therapies. Osteoporosis management underscores the role of menopausal hormone therapy (MHT) as foundational, complemented by anti-resorptive and bone-forming agents in high-risk populations and those not candidates for MHT. Addressing genitourinary symptoms and sexual health, vaginal estrogen therapy is confirmed as a safe and effective option with vaginal dehydroepiandrosterone (DHEA) and oral ospemifene as suitable alternatives, while testosterone therapy offers benefits for hypoactive sexual desire disorder in postmenopausal women. Sleep disturbances, depression and workplace challenges linked to menopause were explored, with tailored interventions such as MHT and cognitive behavioral therapy specifically for sleep recommended. Cancer risk management stressed the need for a multidisciplinary approach to risk reduction beginning with lifestyle modification, and with non-hormonal therapies prioritized for symptomatic treatment of menopausal symptoms in those with hormone-sensitive cancers. Lastly, perimenopause management highlighted comprehensive approaches integrating symptom relief and contraceptive needs.
Influence of estradiol deficiency on the mineralocorticoid receptor response in postmenopausal women: a cross-sectional study.
Martínez-García A, Pérez JA, Tapia-Castillo A … +5 more , Hernández MP, Solórzano M, Carrión P, Fardella CE, Carvajal CA
Climacteric · 2025 Apr · PMID 39928302 · Publisher ↗
OBJECTIVE: Premenopausal women (PreM) have a cardioprotective advantage over postmenopausal women (PostM) due to estrogen. The interaction of estrogen with the mineralocorticoid receptor (MR) pathway remains unexplored....
OBJECTIVE: Premenopausal women (PreM) have a cardioprotective advantage over postmenopausal women (PostM) due to estrogen. The interaction of estrogen with the mineralocorticoid receptor (MR) pathway remains unexplored. This study aimed to identify changes in aldosterone, renin and sexual steroid levels and MR surrogate biomarkers in PostM that may explain changes in blood pressure and renal damage. METHODS: A cross-sectional study was carried out with 47 normotensive and hypertensive Chilean women distributed between PreM and PostM. Clinical, anthropometric and biochemical parameters, including aldosterone, plasma renin activity (PRA) and surrogate markers of MR activity, were assessed. RESULTS: PostM had greater systolic blood pressure (SBP) ( < 0.001) than PreM. A negative correlation was observed between estradiol and fractional excretion of potassium (FEK) ( = -0.29; = 0.023), adjusted for age and SBP. Compared with hypertensive PreM, hypertensive PostM (PostM-HT) showed reduced PRA ( = 0.045) and greater FEK ( = 0.04). Normotensive PostM (Post-NT) exhibited greater SBP ( = 0.03), neutrophil gelatinase-associated lipocalin (NGAL) levels ( = 0.04) and FEK ( = 0.03) than normotensive PreM. CONCLUSION: Our results suggest enhanced MR sensitivity not only in PostM-HT, as evidenced by lower PRA and elevated FEK, but also in PostM-NT, who exhibited greater FEK and NGAL levels, surrogate markers of MR activation. These results support a novel role of MR activation and cardiovascular risk in PostM women.
Medical management of obesity: unlocking the potential.
Xiang AS, Sumithran P
Climacteric · 2025 Aug · PMID 39918221 · Publisher ↗
After a long and challenging history, there have finally been major breakthroughs in the development of effective obesity medications. Agents that act at receptors of one or more gut hormones are achieving unprecedented...
After a long and challenging history, there have finally been major breakthroughs in the development of effective obesity medications. Agents that act at receptors of one or more gut hormones are achieving unprecedented weight reductions and improvements in cardiovascular risk factors, comparable to some bariatric surgical procedures. Importantly, there is evidence of beneficial effects on a growing range of conditions, including type 2 diabetes, fatty liver, chronic kidney disease, obstructive sleep apnea and cardiovascular disease. Barriers to access need to be overcome to allow the standard of care for obesity to match that of other chronic diseases.
Knowledge and attitudes of premenopausal women in southern China toward menopause and menopausal hormone therapy.
Zhang Y, Chen X, Lin Y … +2 more , Liu X, Xiong X
Climacteric · 2025 Apr · PMID 39918216 · Publisher ↗
OBJECTIVE: Menopause is a significant and natural phase in a woman's life, representing a transition that requires early understanding to manage its effects and promote overall well-being. This study aimed to evaluate th...
OBJECTIVE: Menopause is a significant and natural phase in a woman's life, representing a transition that requires early understanding to manage its effects and promote overall well-being. This study aimed to evaluate the awareness, understanding and perceptions of menopause and menopausal hormone therapy (MHT) among premenopausal women in southern China. METHODS: A cross-sectional design was employed to enroll women aged 18-40 years ( = 1631) from August 2022 to January 2023 at a public hospital in Fujian, China. A structured questionnaire, developed from existing research and the Climacteric Scale, was used to assess women's menopausal symptoms and MHT knowledge. Face-to-face interviews were conducted to identify factors correlated with menopausal knowledge levels. RESULTS: More than 50% of women demonstrated a comprehensive understanding of menopause. Education level was a significant predictor of menopause knowledge ( < 0.001), with women holding higher education (college degree or above) demonstrating greater knowledge than those with lower education (high school or below). High awareness of common menopausal symptoms, including irritability, sleep disturbances, fatigue, difficulty concentrating and hot flashes, was observed. Although most participants lacked detailed knowledge of MHT, they agreed on the importance of managing menopausal symptoms and recognized the usefulness of MHT for symptom management. CONCLUSIONS: Premenopausal women in southern China possess a basic understanding of menopause but lack sufficient knowledge about MHT. This highlights the need for educational initiatives and targeted counseling to increase awareness of menopause and MHT, especially regarding its implications and treatment options.
Treating VVA improves symptom severity and patient-reported outcomes: 6-month PEONY results.
Nappi RE, Meriggiola MC, Albani F … +8 more , Bonaccorsi G, Carpini GD, Gambera A, Marsini S, Nicolucci A, Rossi MC, Trionfera V, Villa P
Climacteric · 2025 Apr · PMID 39918178 · Publisher ↗
OBJECTIVE: The real-world PatiEnt satisfactiON studY (PEONY) involves postmenopausal women already treated or starting local estrogen therapy (LET) or ospemifene. The aim of the present analysis was to assess treatment s...
OBJECTIVE: The real-world PatiEnt satisfactiON studY (PEONY) involves postmenopausal women already treated or starting local estrogen therapy (LET) or ospemifene. The aim of the present analysis was to assess treatment satisfaction and persistence, effectiveness and patient-reported outcomes (PROs) in sexual function and quality of life after 6 months of therapy with LET or ospemifene to treat vulvovaginal atrophy (VVA). METHODS: PEONY is an ongoing prospective, observational study conducted in 17 gynecology centers. Participants complete questionnaires at baseline (T0) and after 3 months (T3) and 6 months (T6). The main outcome measures were treatment satisfaction, severity of symptoms, Day-to-Day Impact of Vaginal Aging (DIVA), Female Sexual Function Index (FSFI), Female Sexual Distress Scale - Revised (FSDS-R) and SF-12 Health Survey. RESULTS: Overall, 385 women were included, of whom 145 started (87.6%) or continued (12.4%) ospemifene and 240 started (66.7%) or continued (33.3%) LET at T0. The likelihood of moderate/severe VVA symptoms decreased by 70-90% and the mean treatment satisfaction score increased overall from 7.3 (95% confidence interval [CI]: 7.0; 7.5) at T3 to 7.7 (95% CI: 7.4; 7.9) at T6 ( = 0.003). DIVA and FSDS-R scores significantly improved in both groups. CONCLUSIONS: PEONY underlines the importance of proactively treating VVA with LET or ospemifene to alleviate the burden associated with the disease.
Vaginal oxygen plus hyaluronic acid on lower urinary tract symptoms in breast cancer survivors.
Asinaro G, Massarotti C, Musante V … +6 more , Fiamberti M, Marchese B, Lambertini M, Del Mastro L, Londero AP, Cagnacci A
Climacteric · 2025 Apr · PMID 39903582 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the effect of vaginal oxygen and hyaluronic acid on lower urinary tract symptoms (LUTS) in breast cancer survivors. METHOD: A prospective trial was conducted at a university hospit...
OBJECTIVE: This study aimed to evaluate the effect of vaginal oxygen and hyaluronic acid on lower urinary tract symptoms (LUTS) in breast cancer survivors. METHOD: A prospective trial was conducted at a university hospital's Menopause Outpatient Clinic. Breast cancer patients experiencing LUTS received intravaginal natural oxygen for 15 min, coupled with a 2% hyaluronic acid solution during the last 5 min. This treatment was performed five times at 15-day intervals. Assessments were repeated at each application and 60 days after the last application. Scores on the Urogenital Distress Inventory-6 (UDI-6) short form and its single items assessing different LUTS aspects were determined. RESULTS: Treatment in 85 breast cancer patients decreased the UDI-6 total score (from 24.8 ± 19.9 to 17.5 ± 16.2; < 0.001) and subscales evaluating irritative ( = 0.001), stress ( = 0.006) and obstructive discomfort ( = 0.001) symptoms. In multivariate analysis, aromatase inhibitors were independently associated with a greater improvement of LUTS (coefficient of regression [CR] - 8.05, 95% confidence interval [CI] -13.41, -2.64; = 0.004)). The use of a gonadotrophin-releasing hormone (GnRH) analog was associated with a greater improvement of irritative symptoms (CR -2.42, 95% CI -4.75, -0.08; = 0.042), while tamoxifen reduced the improvement of stress symptoms (CR 2.49, 95% CI 0.10, 4.90; = 0.041). CONCLUSION: Short-term treatment with vaginal oxygen and hyaluronic acid appeared to improve LUTS of breast cancer patients.
Relationship between insulin resistance surrogates and bone mineral density in postmenopausal women.
Li M, Gao L, Liu Y … +4 more , Zheng Y, Chen L, Wang Y, Zhang W
Climacteric · 2025 Apr · PMID 39903513 · Publisher ↗
OBJECTIVE: This study aimed to investigate the association between four insulin resistance (IR) surrogates and bone mineral density (BMD) and whether IR surrogates could be risk factors for osteoporosis (OP) in Chinese n...
OBJECTIVE: This study aimed to investigate the association between four insulin resistance (IR) surrogates and bone mineral density (BMD) and whether IR surrogates could be risk factors for osteoporosis (OP) in Chinese non-diabetic postmenopausal individuals. METHODS: Four non-insulin-based surrogates including triglyceride glucose (TyG), triglyceride glucose with body mass index (TyG-BMI), triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) and the metabolic score for insulin resistance (METS-IR) index were calculated. All individuals underwent dual-energy X-ray absorptiometry for measurement of BMD. Pearson correlation analysis was employed to evaluate the correlations between IR indices and BMD. Subsequently, logistic regression analysis was performed to investigate the relationship between these indices and OP while the receiver-operating characteristic curve was used to assess the predictive values for OP. RESULTS: Both TyG-BMI and the METS-IR index were significantly positively associated with BMD. As TyG-BMI and the METS-IR index increased, the prevalence of OP decreased. After adjusting confounding factors, the fourth quartile of TyG-BMI and the METS-IR index showed significantly decreased odds ratio of 0.304 and 0.352, respectively, for OP with respect to its first quartile value. The area under the curve of TyG-BMI and the METS-IR index was 0.616 and 0.605, respectively. CONCLUSIONS: IR surrogates TyG-BMI and the METS-IR index were positively associated with BMD and may be protective factors for OP in Chinese non-diabetic postmenopausal women.
Understanding the menopause journey.
Santoro N
Climacteric · 2025 Aug · PMID 39903209 · Full text
The menopause experience is unique to people with ovaries who attain an age at which functioning follicles are depleted. Unlike male reproductive aging, menopause is accompanied by a definable reproductive milestone in t...
The menopause experience is unique to people with ovaries who attain an age at which functioning follicles are depleted. Unlike male reproductive aging, menopause is accompanied by a definable reproductive milestone in that menstrual periods cease and the failure of follicle growth results in a large drop in circulating estrogen and no further ovarian production of progesterone. While the focus on menopause has largely been centered on this absence of hormone production, the most dynamic changes in symptoms and health markers begin before the final menstrual period, and merit attention. Vasomotor symptoms, the most common symptom of menopause and the primary symptom that drives women to seek treatment, peak in frequency and prevalence in the late menopause transition, when women are still having menstrual periods. Body composition and adverse lipoprotein and lipid changes also worsen most acutely in the late transition, and then assume a slower, age-related trajectory of change. Multiple processes that worsen across the transition restabilize after it is over. The notion that the menopause transition is an adaptive process for women has scientific merit and suggests that facilitating this adaptation and recognizing its implications may represent the next phase of progress in the field.
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