Menopause (New York, N.Y.)[JOURNAL]
Sun
200 papers
Reconsidering menopausal hormone therapy in women over 65: aligning practice with evolving evidence.
Sugianto SRS, Hickey M
Menopause · 2026 Jun · PMID 42118558 · Publisher ↗
Abstract loading — click title to view on PubMed.
Femoral bone mineral density and mortality risk in postmenopausal women: a National Health and Nutrition Examination Survey cohort study.
Zhang Z, Gu P, Jia Y … +9 more , Jia Z, Hao T, Han S, Wen Y, Yang C, Ye S, Yang W, Zhong J, Chen Q
Menopause · 2026 May · PMID 42118555 · Publisher ↗
OBJECTIVE: Osteoporosis is highly prevalent among postmenopausal women. While previous studies have primarily focused on the relationship between bone mineral density (BMD) and fracture risk, the prognostic value of BMD...
OBJECTIVE: Osteoporosis is highly prevalent among postmenopausal women. While previous studies have primarily focused on the relationship between bone mineral density (BMD) and fracture risk, the prognostic value of BMD with regard to mortality remains unclear. METHODS: A total of 2,977 postmenopausal women from the National Health and Nutrition Examination Survey (2005-2018) were included in this study. BMD at four femoral sites was assessed using dual-energy x-ray absorptiometry. The associations between BMD, osteoporotic fractures, and mortality were evaluated using Kaplan-Meier curves, receiver operating characteristic analysis, and multivariate Cox regression. Restricted cubic splines were applied to explore nonlinear relationships, and subgroup analyses were performed to evaluate the robustness of the results. RESULTS: Kaplan-Meier analysis revealed that mortality risk was significantly elevated when femoral BMD reached the osteoporotic threshold or in the presence of osteoporotic fractures (P < 0.001). Receiver operating characteristic curve analysis showed that the area under the curve for BMD at all femoral sites was greater than that for body mass index (area under the curve = 0.591). After full adjustment, osteoporosis was associated with a 47% increased risk of mortality (hazard ratio = 1.47, 95% CI: 1.16-1.86). Site-specific BMD was inversely correlated with mortality risk (all P <0.001). The restricted cubic splines plots demonstrated a stronger inverse association between increased BMD and mortality risk within specific ranges: 0.46-0.71 g/cm² for total femur BMD and 0.33-0.54 g/cm² for trochanter BMD. CONCLUSIONS: Femoral BMD and osteoporosis are independent predictors of all-cause mortality in postmenopausal women. The inverse relationship between BMD and mortality risk is more pronounced within specific BMD ranges, which may provide valuable insights for mortality risk stratification and clinical decision-making in this population.
Mapping Menopause: a rapid review exploring complex menopause care.
Hira J, Ollivier R, Johnston C … +3 more , Prestley N, Yakubu T, Brotto LA
Menopause · 2026 May · PMID 42118554 · Publisher ↗
IMPORTANCE: With the growing and aging global population, the number of women reaching menopause annually is increasingly significant. Patients continue to face gaps in menopause care and barriers to accessing adequate t...
IMPORTANCE: With the growing and aging global population, the number of women reaching menopause annually is increasingly significant. Patients continue to face gaps in menopause care and barriers to accessing adequate treatment, often due to provider knowledge gaps. These inconsistencies in care are compounded in those with complex menopause. OBJECTIVE: The primary objective of this review was to explore the available literature on complex menopause care delivery in tertiary care settings to inform recommendations for enhanced health care delivery. EVIDENCE REVIEW: The review protocol was registered on Open Science Framework (10.17605/OSF.IO/YKEHV) and employed a rapid review methodology. An extensive search across 4 electronic databases (MEDLINE, Embase, PsycINFO, and Web of Science), along with a grey literature search, was conducted. Data from eligible papers published after 2010 were extracted and screened in Covidence. Quality assessment was completed using Critical Appraisal Skills Program checklists. FINDINGS: Thirteen papers were included in the review, with 10 being high quality and 3 being moderate. Key themes identified in the papers included the use of interdisciplinary care teams, unique needs for unique populations (eg, premature ovarian insufficiency, human immunodeficiency virus, gynecologic or breast cancer), and psychosocial concerns in these populations. There continue to exist gaps in care delivery for the populations identified in this review. CONCLUSIONS AND RELEVANCE: Tertiary care clinics should incorporate a wider array of specialists in complex menopause care, including nonphysician practitioners, to allow for holistic care and to improve health care delivery.
Estradiol loss, the "estrobolome," and midlife symptoms: what the gut microbiome adds to menopause care.
Palacios S, Martin J, Hernandez I … +1 more , Orozco R
Menopause · 2026 May · PMID 42118552 · Publisher ↗
IMPORTANCE AND OBJECTIVE: Menopause is characterized by sustained estradiol decline affecting vasomotor, metabolic, skeletal, and neurobehavioral systems. Emerging evidence suggests that the gut microbiome may interact w...
IMPORTANCE AND OBJECTIVE: Menopause is characterized by sustained estradiol decline affecting vasomotor, metabolic, skeletal, and neurobehavioral systems. Emerging evidence suggests that the gut microbiome may interact with endocrine pathways during this life stage. METHODS: Narrative review of literature examining relationships between menopause, estradiol signaling, gut microbiome composition, and symptom domains. Artificial intelligence (AI) disclosure: artificial intelligence tools were used for language editing and to assist in the preliminary creation of a conceptual illustration. All scientific content, literature interpretation, and final manuscript preparation were performed and reviewed by the authors. The authors take full responsibility for the accuracy, integrity, and originality of the work. DISCUSSION AND CONCLUSION: Current evidence indicates menopause is associated with shifts in gut microbial diversity and metabolic function. However, most human evidence remains observational and associative, and causal mechanisms remain to be established.
When biology meets burnout: retaining midcareer women in academic medicine.
Pikula A, Bui E
Menopause · 2026 May · PMID 42118550 · Publisher ↗
Academic medicine faces a workforce challenge. Experienced women physicians leave or disengage at disproportionate rates during their most productive years. We propose that the menopause transition, typically occurring b...
Academic medicine faces a workforce challenge. Experienced women physicians leave or disengage at disproportionate rates during their most productive years. We propose that the menopause transition, typically occurring between ages 40 and 55, converges with established sex inequities to create a predictable yet largely ignored driver of academic medicine attrition. Based on available data from meta-analyses, randomized trials, and longitudinal studies, we argue that menopause functions not merely as a symptom cluster to endure but as a catalyst for chronic disease that compounds workplace demands. Menopausal symptoms cost an estimated $1.8 billion annually in lost work time in the United States alone, with additional billions in medical expenses. Organizational interventions outperform individual-focused approaches in reducing burnout, with effect sizes nearly three times larger. Workplace-based cognitive behavioral therapy and coaching programs for women faculty have shown substantial benefits in randomized trials and cohort studies. We recommend universal design policies, coaching programs, structured mentorship, and systematic outcome tracking. With physician shortages projected to exceed 50,000 by 2033, supporting midcareer women through these natural biological transitions is both an ethical imperative and an institutional necessity.
Cognitive, physical, and dual-task performances distinguish fallers from non-fallers in postmenopausal women: determination of cutoff scores.
Gümüş Kayran Ö, Demirdel S, Türker D
Menopause · 2026 May · PMID 42118545 · Publisher ↗
OBJECTIVES: The aim of this study was to compare cognitive, physical, and dual-task performances in postmenopausal women with and without a history of falls, and to determine cutoff scores for dual-task tests. METHODS: T...
OBJECTIVES: The aim of this study was to compare cognitive, physical, and dual-task performances in postmenopausal women with and without a history of falls, and to determine cutoff scores for dual-task tests. METHODS: This cross-sectional study included 100 postmenopausal women, classified as fallers (n=50) or non-fallers (n=50) based on falls in the previous year. Cognitive performance was assessed using the Montreal Cognitive Assessment. Physical performance was evaluated using the Four Square Step Test, One-Leg Stand Test, Timed Up and Go Test (TUG), 3-Metre Backward Walk Test (3MBWT), and 30-second Chair Stand Test (30s-CST). The TUG, 3MBWT, and 30s-CST were additionally performed under dual-task conditions, and dual-task cost (DTC) was calculated. Receiver operating characteristic curve analysis was used to assess discriminative ability, and multivariable logistic regression evaluated incremental predictive value beyond established risk factors. RESULTS: Postmenopausal women without a history of falls had better cognitive, physical, and dual-task performance (P<0.05). Fallers had greater dual-task cost values (P<0.05). The discriminative abilities of the 3MBWT (AUC=0.742, 95% CI: 0.644-0.840, cutoff= 6.96) and 30s-CST (AUC=0.715, 95% CI: 0.615-0.815, cutoff=8.5) under dual-task conditions and the DTC of 3MBWT (AUC=0.789, 95% CI: 0.701-0.877, cutoff=-52.43) were acceptable (P<0.001). After adjustment for age, body mass index, and chronic disease, dual-task 3MBWT and 30s-CST performance and DTC of 3MBWT were significantly associated with fall risk and provided meaningful incremental improvement in model discrimination (P<0.05). CONCLUSIONS: Postmenopausal women with a history of falls exhibited poorer cognitive, physical, and dual-task performance. Dual-task assessments, particularly the 3MBWT and 30s-CST, provide clinically relevant discrimination of fall risk beyond traditional factors.
Sleep disturbances in midlife women: prevalence, correlates, and treatments.
Jakubowski K
Menopause · 2026 May · PMID 42118543 · Publisher ↗
Sleep disturbances, including fragmented and poor-quality sleep and clinical insomnia, are common in midlife women and may be attributed in part to the menopause transition. Sleep disturbances often co-occur with depress...
Sleep disturbances, including fragmented and poor-quality sleep and clinical insomnia, are common in midlife women and may be attributed in part to the menopause transition. Sleep disturbances often co-occur with depressive and anxiety symptoms, vasomotor symptoms, substance use, trauma history, and relationship stressors during midlife. Chronic sleep disturbance is related to poorer health and productivity. Numerous pharmacologic and nonpharmacologic treatments exist for sleep disturbance, including evidence-based cognitive-behavioral sleep interventions. Clinicians should query midlife women about their sleep and provide support, resources, and connection to sleep specialists or sleep interventions to improve women's long-term health and well-being.
Association between risk-reducing salpingooophorectomy and bone health in women with hereditary breast and ovarian cancer syndrome.
De Vincentis S, Brigante G, Cuoghi Costantini R … +15 more , Piombino C, Lippi Bruni R, Venturelli M, Barbieri E, Zattarin E, Tenedini E, Grippa M, Sighinolfi G, Caggia F, Fabbri PV, La Marca A, Cortesi L, Dominici M, Grandi G, Toss A
Menopause · 2026 May · PMID 42118531 · Publisher ↗
OBJECTIVE: To explore any association between risk-reducing bilateral salpingooophorectomy (RRSO) and bone mineral density (BMD) and fracture risk among women with a germline likely pathogenic or pathogenic variant in ge...
OBJECTIVE: To explore any association between risk-reducing bilateral salpingooophorectomy (RRSO) and bone mineral density (BMD) and fracture risk among women with a germline likely pathogenic or pathogenic variant in genes causing hereditary breast and ovarian cancer. METHODS: Longitudinal prospective observational study. Clinical, biochemical, and BMD assessments were performed at study entry (V0) and after 18 months (V1). Four groups were compared: RRSO (RRSO in premenopause without hormone therapy [HT]), RRSO+HT (RRSO followed by HT), MEN (natural menopause with/without RRSO), and FERT (regular menstrual cycles not undergoing RRSO). RESULTS: One hundred four women were enrolled (52 BRCA1 germline likely pathogenic or pathogenic variant, 49 BRCA2, 3 other genes): 30 RRSO, 10 RRSO+HT, 29 MEN, 35 FERT. The V0 evaluation was performed at 2.85 ± 2.03 years from RRSO. At V0, no difference in lumbar spine (LS) and femoral neck BMD was detected comparing RRSO to RRSO+HT, MEN, and FERT. At V1 RRSO was associated with higher femoral neck BMD than MEN (P = 0.016), together with worse LS BMD than FERT (P = 0.045). The temporal decline of LS BMD in RRSO was more pronounced than MEN (P = 0.019). Calculated risk of fracture (Fracture Risk Assessment Tool [FRAX]) at V0 was lower in RRSO than MEN (P < 0.001), similar to RRSO+HT and FERT; at V1, FRAX was higher in RRSO than FERT (P = 0.014). CONCLUSIONS: RRSO was associated with greater and prolonged bone health decline in women ovariectomized at premenopausal age, not receiving HT. This high-risk population deserves long-term BMD monitoring, and HT mitigating effect might be considered.
Biological markers of aging across the menopause transition: current evidence.
Castaneda R, Uddenberg ER, Hurtado Andrade MD … +7 more , Meek JL, Frankhouser KN, Faubion SS, Chini EN, LeBrasseur NK, Brar PK, Shufelt CL
Menopause · 2026 May · PMID 42084956 · Publisher ↗
IMPORTANCE AND OBJECTIVE: Aging is a complex biological process uniquely shaped in women by hormonal transitions, particularly across the menopause transition. While chronological age alone fails to capture individual he...
IMPORTANCE AND OBJECTIVE: Aging is a complex biological process uniquely shaped in women by hormonal transitions, particularly across the menopause transition. While chronological age alone fails to capture individual health variability, emerging molecular biomarkers offer tools to quantify biological aging and understand mechanisms underlying age-related decline. This review synthesizes the current landscape of aging biomarkers, including senescence-associated secretory phenotype factors, epigenetic clocks, clonal hematopoiesis of indeterminate potential, and telomere length, with a particular emphasis on their relevance to menopause. METHODS: This narrative review synthesizes human studies, translational research, and foundational basic science identified through PubMed searches through June 2025, examining aging biomarkers in general populations, among women in the menopause transition, and in relation to vasomotor symptoms and hormone therapy. DISCUSSION AND CONCLUSION: Evidence demonstrates that changes in biological aging biomarkers are observed across multiple molecular systems during midlife, including the menopause transition, reflecting broader age-related biological remodeling. Postmenopausal status, particularly following early or surgical menopause, has been associated with biological aging phenotypes, including elevated senescence-associated secretory phenotype factors, epigenetic age acceleration, clonal hematopoiesis, and shorter leukocyte telomere length, likely reflecting a combination of chronological aging, hormonal changes, and individual biological vulnerability. While severe vasomotor symptoms have been linked to higher epigenetic age, hormone therapy may favorably influence certain senescence markers and biological age discrepancy. Despite these advances, significant limitations constrain clinical translation, as current biomarkers capture overlapping biological processes and lack validated thresholds to define biological aging, especially in women. Future research requires large, longitudinal studies across diverse populations to establish clinically meaningful thresholds and sex-specific calibration. Advancing precision health strategies for women requires a better understanding of how reproductive and hormonal factors modify biomarker trajectories to improve risk prediction and to facilitate the development of targeted interventions for age-related diseases.
Menopause symptoms and treatment in sexual minority women.
Kling JM, Abraham AE, Nalla A … +6 more , Sobel T, Vencill JA, Cole K, Winham S, Kapoor E, Faubion SS
Menopause · 2026 May · PMID 42084955 · Publisher ↗
OBJECTIVES: Sexual minority women (SMW) have worse mental and physical health outcomes compared with heterosexual women. Limited research has explored menopause in SMW. This study compared menopause symptoms in cisgender...
OBJECTIVES: Sexual minority women (SMW) have worse mental and physical health outcomes compared with heterosexual women. Limited research has explored menopause in SMW. This study compared menopause symptoms in cisgender SMW and heterosexual women. METHODS: This cross-sectional analysis examined questionnaires from women 40-65 years, seen at women's health clinics in Arizona, Florida, and Minnesota between December 2016 and February 2023. Menopause symptoms were evaluated using the Menopause Rating Scale (MRS). An MRS score ≥ 12 indicates moderate or greater symptoms. Multivariable logistic regression was used to compare scores between cisgender SMW and heterosexual women, adjusting for factors that may impact menopause symptoms. RESULTS: Data from 2,273 women were included, with 69 SMW. The mean age was 53.2 (SD: 6.1), body mass index 25.7 kg/m2, and a majority were White (91.9%). The median MRS score among all participants was 15 (interquartile range=10, 20); 67.3% reported MRS scores ≥ 12. The likelihood of being on hormone therapy or selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors was comparable between groups. In both univariate (OR: 0.85, 95% CI: 0.52-1.40) and multivariable (OR: 0.83, 95% CI: 0.47-1.48) analyses, no significant associations between sexual orientation and MRS ≥ 12 were found. CONCLUSIONS: Menopause symptoms and likelihood of treatment were similar for cisgender SMW and heterosexual women presenting to tertiary care centers. Limited diversity in the cohort and the small number of SMW reduce the generalizability of the results. The lack of adverse social determinants of health may have contributed to the findings, but additional research in larger cohorts is needed.
Silent suffering: an exploration of menopausal attitudes and experiences among slum dwellers.
Ahmed S, Kushwaha N
Menopause · 2026 May · PMID 42084944 · Publisher ↗
OBJECTIVES: This study aimed to evaluate the knowledge, attitudes, and lived experiences during the peri and postmenopausal phases among women slum dwellers in Kanpur, Uttar Pradesh, India. METHODS: This qualitative stud...
OBJECTIVES: This study aimed to evaluate the knowledge, attitudes, and lived experiences during the peri and postmenopausal phases among women slum dwellers in Kanpur, Uttar Pradesh, India. METHODS: This qualitative study comprised 35 women slum dwellers aged between 40 and 64 years who had experienced menopause in the previous 5 years. Data were collected using semi-structured interviews and analyzed using reflexive thematic analysis after an iterative approach to understand the knowledge, attitudes, and lived experiences of women. The identified themes were further compared and discussed with the help of available literature to draw significant conclusions. RESULTS: This study unveiled the misery of women slum dwellers during the perimenopausal and postmenopausal stages in terms of sociocultural constraints, accessibility of services, information, and health-seeking behaviors. Attitudinal variations were also observed; the majority of women enjoyed this phase and viewed it as a sign of freedom from pain and mental liberation. In contrast, women also felt upset by viewing it as an end to their femininity and womanhood. Medical implications are generally ignored by these women despite experiencing a range of physical, emotional, and psychological changes. Those seeking medical support are vulnerable in terms of receiving the right information and guidance, making them further stigmatized for adopting traditional unsafe practices. Government policies also neglect women's health during menopause. All these factors lead to the creation of a vicious circle during menopause. CONCLUSIONS: Breaking the culture of silence surrounding menopause empowers women to make their own decisions. If they are treated inappropriately, it may lead to severe health consequences. The findings underscore the critical need to design culturally appropriate, gender-sensitive, and community-oriented health education programs, along with improved access to menopausal health services, especially for women belonging to marginalized groups. A focused intervention with an integrated approach is substantially needed to improve menopausal health, along with providing the right information and encouraging healthy behavioral practices.
Health perceptions, aging, and reproductive aging: observations from the Seattle Midlife Women's Health Study.
Woods NF, Mitchell ES
Menopause · 2026 May · PMID 42084943 · Publisher ↗
OBJECTIVE: Despite increased attention to symptoms experienced by women during the menopausal transition and early postmenopause and risk for disease development, for example, cardiovascular disease and dementia, few inv...
OBJECTIVE: Despite increased attention to symptoms experienced by women during the menopausal transition and early postmenopause and risk for disease development, for example, cardiovascular disease and dementia, few investigators have examined women's self-ratings of their health during this part of the lifespan. Despite recent surges in interest in the menopausal transition, understanding how women experience their health during this period remains limited. Our aim was to identify the relationship of chronological aging and reproductive aging to midlife women's health perceptions using the multidimensional Health Perceptions Questionnaire (HPQ) administered on multiple occasions in the Seattle Midlife Women's Health Study (SMWHS). METHODS: Participants from the population-based longitudinal SMWHS completed annual health questionnaires and menstrual calendars between 1990 and 2005 (N=261, 957 observations). Women's ages ranged from a mean of 41.6 (SD=4.3) to 53.1 (SD=3.1) years at baseline. Participants rated their health using the HPQ on 6 occasions: baseline (1990-1992), 12 and 24 months later, and in 1995, 2001, and 2005. Mean scale scores were calculated for current health, past health, health outlook, health concern/worry, and resistance to illness (possible range was 1-5). Reproductive aging stages were assessed using menstrual calendar and questionnaire data, applying Mitchell's (2000) criteria for reproductive aging and Staging Reproductive Aging (STRAW) criteria (2001, 2010). Multilevel modeling using mixed models analysis of linear models (SPSS 28) was employed to examine relationships of age and reproductive aging stages to repeated measures of health perceptions, including current health, past health, health outlook, health concern/worry, and resistance to illness. RESULTS: Means for each of the health perceptions scales were above 3.0, the midpoint of the scales, indicating more positive than negative ratings of health. Aging was not significantly related to women's ratings of current health, past health, health outlook, health concern/worry, or resistance to illness. Reproductive aging was significantly related only to current health: women's ratings were significantly higher during the late reproductive stages (LRS1 mean=3.72, SD=0.10, and LRS2, mean=3.60, SD=0.05, P=0.013 and 0.035, respectively) and the early menopausal transition stage (mean=3.64, SD=0.05, P=0.006) than the late transition stage (mean=3.44, SD=0.09) or early postmenopause (mean=3.35, SD=0.10). CONCLUSIONS: SMWHS participants eligible for this study perceived their health as positive, regardless of age. Reproductive aging was influential only with respect to current health ratings: women rated their health significantly better during the late reproductive stages and early menopausal transition stages of reproductive aging than during the late menopausal transition stage and early postmenopause, stages when SMWHS participants reported the most severe symptoms related to menopause in our prior studies.
Regional disparities and metabolic determinants of type 2 diabetes in women aged 55 and older.
Zhang K, Kan C, Xu W … +6 more , Han F, Hou N, Zheng T, Li X, Sun X, Xue Y
Menopause · 2026 May · PMID 42084938 · Publisher ↗
OBJECTIVE: To assess long-term trends, regional disparities, determinants, and quality of care for type 2 diabetes mellitus (T2DM) among women aged 55 years or above worldwide. METHODS: Using Global Burden of Disease 202...
OBJECTIVE: To assess long-term trends, regional disparities, determinants, and quality of care for type 2 diabetes mellitus (T2DM) among women aged 55 years or above worldwide. METHODS: Using Global Burden of Disease 2023 data, we quantified incidence, mortality, and disability-adjusted life years (DALYs) attributable to T2DM among women aged 55 years or above from 1990 to 2023. Temporal trends were evaluated using joinpoint regression. Regional determinants were identified through explainable machine learning models (XGBoost with Shapley Additive Explanations). A Quality-of-Care Index, derived from mortality, disability, and prevalence indicators, was constructed to evaluate health care performance. RESULTS: In 2023, South Asia recorded the largest absolute burden of T2DM among women aged 55 years or above, with 749,064 cases (95% uncertainty intervals [UI] 592,209-892,315), 274,542 deaths (171,620-381,640), and 8.11 million DALYs (5.82-10.43 million), followed by East Asia and high-income North America. From 1990 to 2023, Eastern Europe exhibited the steepest long-term increases in age-standardized incidence, mortality, and DALYs rates, with an average annual percent change of 2.49% for incidence and 3.97% for mortality. Mortality and DALYs burdens peaked among women aged 65-69 years. Across regions, high fasting plasma glucose, high body mass index, and low physical activity were the leading contributors to disease burden. Distinct regional risk patterns were observed, including air pollution in Asia, unhealthy dietary patterns in high-income North America, sedentary behavior in Oceania, and alcohol use in South Asia. Lower Quality-of-Care Index scores were strongly associated with higher mortality and DALYs rates, highlighting substantial inequities in diabetes care. CONCLUSIONS: The escalating burden of T2DM among women aged 55 years or older reflects interactions between biological aging and metabolic, behavioral, and environmental risks. Age-targeted prevention, improved care quality, and mitigation of modifiable exposures are critical to reduce diabetes-related disability globally.
Cognitive behavioral therapy for menopausal insomnia in perimenopausal and postmenopausal women with insomnia and nocturnal hot flashes: a randomized-controlled pilot trial.
Arentson-Lantz EJ, Muench A, Kokonda M … +5 more , Meers JM, Swartz M, Manber R, Thurston RC, Nowakowski S
Menopause · 2026 May · PMID 42084929 · Publisher ↗
OBJECTIVES: The objective of this randomized-controlled pilot trial was to develop and test a cognitive behavioral therapy intervention for both insomnia and vasomotor symptoms (VMS) in perimenopausal and postmenopausal...
OBJECTIVES: The objective of this randomized-controlled pilot trial was to develop and test a cognitive behavioral therapy intervention for both insomnia and vasomotor symptoms (VMS) in perimenopausal and postmenopausal women with insomnia disorder experiencing nocturnal vasomotor symptoms. METHODS: Forty-three participants (mean age = 53.6 y) self-described as perimenopausal or postmenopausal who reported at minimum ≥ 1 nocturnal hot flash/night and met diagnostic criteria for insomnia disorder were randomized to cognitive behavioral therapy for menopausal insomnia (CBT-MI) or menopause education control (MEC). The CBT-I intervention was adapted for the study population by incorporating elements of CBT for menopausal symptoms. Primary outcomes measured at baseline, post-treatment measures, 1-month follow-up, and 3-month follow-up included: Insomnia Severity Index (ISI), Sleep Self-Efficacy Scale (SES), and Hot Flash Daily Interference Scale (HFDIS). RESULTS: CBT-MI compared with MEC significantly reduced ISI (CBT-MI vs. MEC: -10.2±1.15 vs. -6.2±0.99; P=0.007), HFDIS (CBT-MI vs. MEC: -1.3±0.29 vs. -0.5±0.17; P=0.01), and increased SES (10.2±1.46 vs. 5.9±1.24, P=0.03) post-treatment and 1-month after the end of treatment (ISI: CBT-MI vs. MEC, -10.9±1.19 vs. -6.5±0.98; P=0.003, HFRDIS: CBT-MI vs. MEC, -1.1±0.28 vs. -0.4±0.18, P=0.047, SES: CBT-MI vs. MEC, 11.9±2.06 vs. 5.6±1.25; P=0.003). Analysis of the ISI factors showed that CBT-MI significantly decreased night-time sleep symptoms and patient perception of insomnia at post-treatment and 1-month follow-up compared with MEC. Night-time sleep symptoms remained improved at 3-month follow-up compared with MEC. CONCLUSIONS: In this pilot study, a CBT intervention targeting both insomnia and VMS showed promising improvements in sleep and hot flash interference in midlife women.
Report of the FDA's expert panel on hormone therapy.
Pinkerton JV, Simon JA, Hodis HN … +3 more , Minkin MJ, Manson JE, Levy B
Menopause · 2026 May · PMID 42084927 · Publisher ↗
The FDA convened an expert panel on July 17, 2025, to review evidence on the benefits and risks of menopausal hormone therapy. Members of The Menopause Society who served on the expert panel summarize the meeting, includ...
The FDA convened an expert panel on July 17, 2025, to review evidence on the benefits and risks of menopausal hormone therapy. Members of The Menopause Society who served on the expert panel summarize the meeting, including panelists' presentations and future directions. The FDA selected a multidisciplinary group of researchers and clinicians based on their expertise, clinical and academic credibility, leadership, and advocacy in caring for menopausal women's health. The panel emphasized the differences between systemic and local vaginal estrogen and the adverse effects of class labeling and the boxed warning, especially for local vaginal estrogen. The panel discussed differences in risk profiles between estrogen alone and estrogen combined with different types of progestogens, and the importance of formulation, route of administration, dosing, and timing of initiation. Following this discussion, a 60-day public commentary period, and an independent review of the literature, on November 10, 2025, the FDA recommended removing boxed warnings from estrogen therapies, with specific, nuanced considerations.
Menopausal symptom network differences between women with and without waist-to-height ratio-defined abdominal obesity.
Wang D, Wang F, Zheng J … +3 more , Chen X, Lei Y, Su J
Menopause · 2026 May · PMID 42084915 · Publisher ↗
OBJECTIVES: To compare the structure of menopausal symptom networks between women with and without abdominal obesity (AO), defined as waist-to-height ratio (WHtR). METHODS: This cross-sectional analysis included 1,150 wo...
OBJECTIVES: To compare the structure of menopausal symptom networks between women with and without abdominal obesity (AO), defined as waist-to-height ratio (WHtR). METHODS: This cross-sectional analysis included 1,150 women from visit 6 of the study of Women's Health Across the Nation (SWAN). AO was defined as a WHtR of ≥ 0.5. We adjusted for demographic and clinical differences by regressing each symptom score on covariates, and subsequently using the residualized symptom scores for network estimation. We used centrality indices and community structure analysis to characterize the networks, and applied the Network Comparison Test (NCT) to evaluate differences in network structure and global strength. RESULTS: Women with AO reported higher prevalence and greater severity of several symptoms. Network density was marginally higher in the AO group (0.59; 46 of 78 edges) than in the non-AO group (0.55; 43 of 78 edges). The NCT revealed significant differences in network structure, whereas global strength remained comparable. Core symptoms differed by AO status: in the AO network, forgetfulness, irritability, and night sweats exhibited the highest centrality, whereas in the non-AO network, night sweats, palpitations, and depression demonstrated the highest centrality. In addition, symptom clusters also differed between the groups. CONCLUSIONS: Women with AO exhibit both a higher prevalence and greater severity of symptoms, as well as a distinct symptom network structure. These findings highlight distinct symptom network profiles in women with AO, which may reflect different patterns of symptom interaction or underlying biological processes that warrant further investigation. Assessment of AO using WHtR may help stratify women who are likely to benefit from targeted, network-based interventions over isolated symptom management.
Cardiometabolic changes in the menopause transition.
Shufelt C
Menopause · 2026 May · PMID 42029050 · Full text
Abstract loading — click title to view on PubMed.
Mixed methods research to support the development of an evidence-based intervention for cognitive symptoms in menopause transition.
Proctor D, Hunter MS, He L … +1 more , Spector A
Menopause · 2026 Apr · PMID 42012840 · Publisher ↗
OBJECTIVES: To explore cognitive difficulties experienced during the menopause transition, and preferences for a future psychosocial intervention to support these symptoms. METHODS: Mixed-methods study involving an onlin...
OBJECTIVES: To explore cognitive difficulties experienced during the menopause transition, and preferences for a future psychosocial intervention to support these symptoms. METHODS: Mixed-methods study involving an online survey and focus groups with questions around participants' experiences of cognitive difficulties, support, and intervention development. Study posters were promoted through menopause support organizations and the University College London Menopause Mind Lab. Participants were perimenopausal and postmenopausal women, aged 40-60, with self-reported cognitive difficulties. RESULTS: Two hundred sixteen peri and postmenopausal women (average age: 51.8 y) participated in the online survey, and 16 in focus groups. Survey data suggested that 93% of participants rated their cognitive difficulties as bothering them mildly to severely, and many felt they needed additional support. Of the participants, 95% expressed an interest in attending a new intervention, with a mix of opinions regarding the practical aspects. There was a preference for the content to include psychoeducation and teaching of strategies, as well as peer and emotional support. For the focus groups, thematic analysis generated ten main themes across two sections. For the experience of menopause, these included: support, menopause awareness, emotional impact, impact on functioning, and menopause symptoms. For the intervention development, these included: impact, content, barriers, cultural considerations, and group characteristics and format. CONCLUSIONS: Study findings demonstrate the need for a psychosocial intervention for cognitive difficulties experienced during menopause. Data from this study will inform the development of an intervention, and further research should focus on testing its feasibility and effectiveness within this population.
Estriol suppositories enhance colposcopy sufficiency and diagnostic accuracy in postmenopausal women: a comparative study.
Li F, Zhang Y, Yuan X … +3 more , Han T, Wang L, Xia X
Menopause · 2026 Apr · PMID 42012838 · Publisher ↗
OBJECTIVES: Postmenopausal estrogen deficiency leads to atrophy of the urogenital tract and atrophic vaginitis, which can impact the results of colposcopy. This study evaluated the benefits of estriol suppositories on co...
OBJECTIVES: Postmenopausal estrogen deficiency leads to atrophy of the urogenital tract and atrophic vaginitis, which can impact the results of colposcopy. This study evaluated the benefits of estriol suppositories on colposcopy sufficiency, diagnostic accuracy, and patient comfort in postmenopausal women. METHODS: A prospective intervention group of 95 postmenopausal women was enrolled. All participants received 0.5 mg estriol suppositories for 20 days before colposcopy. This prospective intervention group was compared with a historical control group of 101 women who had received other medications. Outcomes, including colposcopy sufficiency, visibility of the squamocolumnar junction (SCJ) and transformation zone (TZ), diagnostic agreement rate between colposcopy diagnosis and histopathology, and pain degrees, were assessed. The diagnostic agreement rate between colposcopic diagnosis and pathological diagnosis was analyzed using Kappa analysis. RESULTS: Within the prospective intervention group, colposcopy sufficiency was significantly improved after pretreatment (χ 2 =85.011, P <0.001). However, no significant change was found in visibility of the SCJ (2.11% vs. 4.21%, P =0.683) and TZ types (χ 2 =0.167, P =0.683). The weighted kappa was 0.584 ( P <0.001), indicating a moderate degree of consistency. Pain degrees were significantly reduced after pretreatment ( P <0.001). 10.53% of participants experienced adverse events. After propensity score matching (n=58 per group), the prospective intervention group demonstrated a significantly higher sufficiency compared with the historical control group (94.83% vs. 67.24%, χ 2 =14.360, P <0.001). There were no statistically significant differences in SCJ visibility or TZ type between the two groups (both P >0.05). The weighted kappa between the two groups was 0.001 ( P =0.011), indicating an extremely low degree of consistency. CONCLUSIONS: Pretreatment with estriol suppositories significantly improves colposcopy sufficiency, enhances diagnostic agreement rate with histopathology, and alleviates procedure-related pain in postmenopausal women, while maintaining an acceptable safety profile.
Age-specific and menopause-specific associations between BMI change and the risk of cervical and ovarian cancers: a population-based cohort study.
Nam SY, Jo J
Menopause · 2026 Apr · PMID 42012837 · Publisher ↗
OBJECTIVES: The association between longitudinal body mass index (BMI) change and the risk of cervical and ovarian cancers remains uncertain. We assessed those associations, evaluating modification by age and menopausal...
OBJECTIVES: The association between longitudinal body mass index (BMI) change and the risk of cervical and ovarian cancers remains uncertain. We assessed those associations, evaluating modification by age and menopausal status. METHODS: We conducted a population-based cohort study of 1.464 million women who completed national health examinations in 2009 and 2013 and were followed through 2017. BMI was categorized using the Asia-Pacific criteria, and 2009-2013 BMI changes were classified into 25 groups. RESULTS: During 12,661,743 person-years, 975 cervical and 1,570 ovarian cancers occurred. Excessive BMI gain from normal to obesity I was associated with increased cervical cancer risk (adjusted hazard ratio [aHR], 3.41; 95% CI: 1.73-6.72), particularly among postmenopausal women. BMI gain from underweight to normal was linked to elevated ovarian cancer risk. BMI change showed heterogeneous associations with ovarian cancer risk, with associations differing by age group. Persistent overweight (aHR: 0.79; 95% CI: 0.65-0.95) and obesity I (aHR: 0.68; 95% CI: 0.57-0.81) was associated with reduced ovarian cancer risk in women below 60 years, whereas BMI gain from normal to obesity I (aHR: 3.23; 95% CI: 1.30-8.04), persistent overweight (aHR: 1.60; 95% CI: 1.14-2.30) and obesity I (aHR: 1.45; 95% CI: 1.05-2.00) were associated with increased risk in those ≥60 years. CONCLUSIONS: BMI change was associated with cervical and ovarian cancer risk, with direction and magnitude varying by age.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe