Menopause (New York, N.Y.)[JOURNAL]
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200 papers
Psychological treatments for sexual concerns in perimenopausal and postmenopausal women: a systematic review and meta-analysis.
Green SM, Furtado M, Peak J … +1 more , Babiy Z
Menopause · 2026 May · PMID 41401244 · Publisher ↗
IMPORTANCE: Sexual concerns are commonly reported by perimenopausal and postmenopausal women. Nonpharmacological treatments, including psychological-based treatments, may serve as an alternative and/or complementary opti...
IMPORTANCE: Sexual concerns are commonly reported by perimenopausal and postmenopausal women. Nonpharmacological treatments, including psychological-based treatments, may serve as an alternative and/or complementary option for those who cannot, or choose not, to take medication or who continue to experience symptoms despite their use. OBJECTIVE: This systematic review and meta-analysis examined psychological interventions that directly targeted and/or assessed sexual functioning in perimenopausal and postmenopausal women using standardized measures. EVIDENCE REVIEW: Web of Science, MEDLINE, and PubMed were searched for studies that evaluated the effects of psychological interventions for sexual concerns during perimenopause and postmenopause. Risk of bias assessments were done using the Cochrane Risk-of-Bias Tool and the Newcastle-Ottawa Scale. Data were pooled in a primary meta-analysis using the Female Sexual Function Index (FSFI), as well as subgroup analyses based on psychological intervention type, with effects reported separately for each subgroup. FINDINGS: Sixteen articles (n=1,445) met the eligibility criteria and were included in the systematic review and meta-analysis. Overall, nine randomized controlled trials (n=738) containing FSFI data were pooled in a meta-analysis showing psychological interventions were associated with significant improvements in sexual concerns (standardized mean difference [SMD]=1.37, 95% CI=1.17-1.58, P <0.00001; n=475). Subgroup analysis based on type of psychological intervention revealed that cognitive-behavioral therapy (SMD =-0.00, 95% CI=-0.26 to 0.25; n=233; I2 =0%) and mindfulness-based interventions (SMD =0.02, 95% CI=-0.40 to 0.45; n=86; I2 =0%) had no to small effect on the sexual function in perimenopausal and postmenopausal women, while education programs (SMD=2.53, 95% CI=-2.19 to 2.86; P <0.00001; n=268; I2 =94%) and counseling (SMD=2.43, 95% CI=1.92-2.94; P <0.00001; n=106; I2 =0%) had a large effect. Only one motivational interviewing study (effect size of 0.72) was included, but it revealed a large effect on sexual functioning. Overall risk of bias ranged from low to some concerns, with one study scoring high. CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis suggests that psychological interventions are an effective nonpharmacological treatment option for addressing sexual concerns in perimenopausal and postmenopausal women. Although cognitive-behavioral therapy and mindfulness-based approaches showed small to no effects on sexual concerns, these findings should be interpreted with caution, as the included studies did not directly target sexual concerns but instead assessed them as secondary outcomes. Psychological interventions should be considered when discussing treatment options for sexual concerns in perimenopausal and postmenopausal women.
The long and winding road to menopause: a true milestone or an illusion for women with endometriosis?
Marrocco F, Alberico D, Pifarotti P … +4 more , Nasini A, Buffa MA, Cipriani S, Barbara G
Menopause · 2026 May · PMID 41401228 · Publisher ↗
OBJECTIVE: The primary objective of this study was to determine whether women with and without a history of endometriosis experience menopause differently, in terms of their satisfaction with quality of life. METHODS: Th...
OBJECTIVE: The primary objective of this study was to determine whether women with and without a history of endometriosis experience menopause differently, in terms of their satisfaction with quality of life. METHODS: This study was conducted at Fondazione IRCCS Ca' Granda Policlinico Hospital, Milan, from October 2022 to April 2024. The total sample included 394 postmenopausal women aged 48-55 years: 197 with a clinical history of endometriosis (group 1) and 197 without (group 2). All participants were required to complete a series of validated questionnaires assessing quality of life (Short-Form Health Survey 12, SF-12), sexual function (Female Sexual Function Index [FSFI]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), climacteric symptoms (Menopause-Specific Quality of Life Questionnaire [MENQOL]), and satisfaction with their clinical condition using a 5-point Likert scale. RESULTS: The SF-12 scores were significantly higher in group 2 than in group 1 (physical score: P =0.01; mental score: P <0.001). Group 1 reported lower satisfaction levels than group 2; however, this difference was not statistically significant (OR = 0.78, 95% CI: 0.5-1.2, P =0.26). The FSFI, HADS, and MENQOL scores were not significantly different between the two groups (FSFI score, P = 0.20; HADS anxiety score, P =0.11; HADS depression score, P =0.48; MENQOL score, P = 0.91). CONCLUSION: Postmenopausal women with a history of endometriosis appear to have a similar quality of life compared with those without such a history. While the overall quality of life scores were higher in women without endometriosis, both groups reported comparable climacteric symptoms, sexual functioning, and anxiety and depression levels.
Menopausal hot flashes, night sweats, and insomnia disappeared with lamotrigine: a case report.
Pitkänen EK, Jukkola AI, Koponen HJ
Menopause · 2026 May · PMID 41401224 · Publisher ↗
OBJECTIVE: Approximately 75% of women aged between 45 and 55 years suffer from symptoms of menopause. Hormone therapies used in breast cancer treatment can induce the same symptoms. Current medications for menopausal sym...
OBJECTIVE: Approximately 75% of women aged between 45 and 55 years suffer from symptoms of menopause. Hormone therapies used in breast cancer treatment can induce the same symptoms. Current medications for menopausal symptoms are not suitable for everyone. Here, we describe a case of a woman whose menopausal vasomotor symptoms decreased after starting lamotrigine. METHODS: We report a case of a woman whose menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medication. We did not find any reports of lamotrigine in regards to menopausal symptoms. RESULTS: A 53-year-old woman with menopausal symptoms and migraine had tried different medications for migraine. She could not use estradiol 1 mg p.o. regularly, because it worsened her headache. Then, lamotrigine was started for the migraine as a preventive medication. Lamotrigine's official indication is epilepsy and bipolar disorder. It is also used off-label, for example, for migraine. In a few days the nighttime hot flashes, night sweats and sleeping problems disappeared. Then she developed a rash. Because the rash induced by lamotrigine can be severe, the medication had to be stopped. In 2 weeks, the menopausal symptoms returned. CONCLUSIONS: Menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medicine in this case. The precise action mechanism(s) of lamotrigine is unknown. Lamotrigine has interactions with estrogen and progesterone medicines. So, this effect we describe might not have been just a coincidence. Lamotrigine could be worth further research in regards to menopausal symptoms.
Pharmacokinetic analysis of 25 mg estradiol subcutaneous bioabsorbable implant in postmenopausal women (CLARA STUDY).
Malavasi A, Ribeiro CM, Agati LB … +16 more , Berta F, Barradas CA, Oliveira S, Tukiyama CA, Maciel BA, Emanuel AC, Socca EA, Komar D, Vilaronga GN, Prazeres GM, Dias-Jr E, Bolin AP, Fernandes JC, Xavier GM, Pinna G, Ramacciotti E
Menopause · 2026 Apr · PMID 41401223 · Full text
OBJECTIVE: To investigate the pharmacokinetic profile of estradiol delivery after the subcutaneous insertion of a 25 mg estradiol bioabsorbable implant in hysterectomized women presenting with menopause-associated sympto...
OBJECTIVE: To investigate the pharmacokinetic profile of estradiol delivery after the subcutaneous insertion of a 25 mg estradiol bioabsorbable implant in hysterectomized women presenting with menopause-associated symptoms. METHODS: This was a prospective, open-label, single-arm study conducted at a single center between December 2023 and October 2024. Twenty hysterectomized participants received a 25 mg subcutaneous estradiol implant and were followed at weeks 4, 12, and 24 for clinical assessments, symptom evaluation, and safety monitoring. Hormone levels were measured using liquid chromatography-tandem mass spectrometry and electrochemiluminescence immunoassay. Adverse events were recorded, and menopause symptoms were assessed using the Menopause Rating Scale (MRS). RESULTS: Serum estradiol levels increased after treatment, rising from 31.6±7.0 pg/mL preinsertion to 105.2±10.7 pg/mL (mean±SD) at week 1, remaining stable (~80 pg/mL) through Week 20 and above pre-insertion levels until week 24. Estrone had a similar profile. Follicle-stimulating hormone and luteinizing hormone levels decreased throughout the treatment. Sex hormone-binding globulin, total and free testosterone, and prolactin showed minimal variation throughout the study. Subcutaneous estradiol delivery resulted in a sustained pharmacokinetic profile characterized by a Tmax of 75.6 hours and a 6439 hours notably extended half-life (T1/2). Vasomotor and psychological symptoms decreased significantly after 4 weeks of treatment, and the reduction in Menopause Rating Scale score was observed until Week 24. No serious adverse event was reported. CONCLUSION: The 25 mg estradiol implant provided sustained serum concentration of estradiol over a 24-week period of treatment, effective symptom relief, and an acceptable safety profile in hysterectomized women, thereby offering a novel therapeutic option for hormone therapy.
Association between body fat and the prevalence of sarcopenia in older women with obesity: a pilot cross-sectional study.
Abud GF, Ortiz GU, Venturini ACR … +7 more , Travieso SG, Fogagnolo C, Viliod MCL, Esteves GP, Silva BM, da Silva ASR, de Freitas EC
Menopause · 2026 Jun · PMID 41401218 · Publisher ↗
OBJECTIVE: This pilot cross-sectional study aimed to determine the prevalence of sarcopenia among older women with obesity and to compare anthropometric parameters, body composition, and physical function between older w...
OBJECTIVE: This pilot cross-sectional study aimed to determine the prevalence of sarcopenia among older women with obesity and to compare anthropometric parameters, body composition, and physical function between older women with nonsarcopenic obesity and those with sarcopenic obesity. In addition, sarcopenia-associated factors were explored. METHODS: In total, 141 older women with obesity (mean age 64.84 y) participated. Obesity was defined by a body mass index ≥30 kg/m², and sarcopenia was determined using handgrip strength (<0.56 kgf/BMI) and low appendicular lean mass (<0.512 kg/BMI). Independent t tests were used to compare differences between groups, and multivariate logistic regression analyses to assess sarcopenia-associated factors. RESULTS: Sarcopenic obesity was observed in 28% of the participants with obesity. Women with sarcopenic obesity were shorter, but had a higher body mass index, waist circumference, and body fat percentage (total, android, and gynoid). These women also presented lower appendicular lean soft tissue and handgrip strength values. Logistic regression analysis showed that body fat percentage was associated with sarcopenia (5-unit increase in body fat: odds ratio: 4.25, 95% CI: 2.26-8.76, P <0.001). CONCLUSION: In this pilot sample of older women with obesity, 28% exhibited sarcopenic obesity. Elevated body fat appeared to be associated with sarcopenia, highlighting a potential relationship that warrants further investigation in longitudinal studies.
Content validity, face validity and acceptability of three hot flash diaries for vasomotor symptoms: a cognitive interview study.
Rutherford C, Hickey M, Ju A … +3 more , D'Abrew N, Acret L, Lensen S
Menopause · 2026 May · PMID 41401214 · Publisher ↗
OBJECTIVE: Around 70% of women experience vasomotor symptoms (VMS) over the menopause transition. These are a leading patient priority for treatment. To robustly evaluate treatment effectiveness, validated tools are need...
OBJECTIVE: Around 70% of women experience vasomotor symptoms (VMS) over the menopause transition. These are a leading patient priority for treatment. To robustly evaluate treatment effectiveness, validated tools are needed. VMS diaries are widely used in clinical trials, but their content validity and acceptability for symptomatic women is not established. The objective of this study is to evaluate acceptability, content validity and face validity of available hot flash diaries. METHODS: We conducted semi-structured interviews to explore acceptability, content, interpretation and experience of completion of three widely used hot flash diaries: Sloan, Guttuso, Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) with English speaking symptomatic peri/postmenopausal women in Australia, recruited through social media (Facebook groups), a registry of previous trial participants, and through Menopause clinics. Content analysis was used to analyze findings. RESULTS: Of 33 women who completed screening questions, 25 provided contact details and consented to being interviewed. Women were aged 40-69 years, most reported menopause between 50 and 59 years, and 18 experienced moderate-severe VMS. Participants considered daily reporting of VMS acceptable, preferred diaries reporting VMS in real-time or twice daily (rather than once daily) and found descriptions for severity categories helpful in assigning severity of their VMS. CONCLUSION: Two diaries (Guttuso and MsFLASH) were found to be acceptable and valid measures of VMS severity and frequency. However, adding descriptions for severity categories to the MsFLASH diary and distinguishing between day and night-time VMS in the Guttuso diary were recommended improvements. Real-time data collection may be preferable.
The relationship between hot flash beliefs and insomnia symptoms in menopausal women.
Caizaguano D, Law C, Gunthert K … +1 more , Behar E
Menopause · 2026 May · PMID 41401213 · Publisher ↗
OBJECTIVE: Hot flashes are a hallmark symptom of menopause and are often implicated in sleep disturbance. Although hot flash severity has been linked to insomnia, the cognitive model of hot flashes suggests that negative...
OBJECTIVE: Hot flashes are a hallmark symptom of menopause and are often implicated in sleep disturbance. Although hot flash severity has been linked to insomnia, the cognitive model of hot flashes suggests that negative beliefs about hot flashes may also influence symptom perception and distress. However, the relationship between hot flash beliefs and insomnia remains understudied. We examined whether hot flash beliefs are uniquely associated with insomnia symptom severity. METHODS: This study is a cross-sectional design utilizing secondary data from participants recruited for a longitudinal study. A total of 102 perimenopausal and postmenopausal women were included in this study. Participants completed measures assessing hot flash severity, hot flash beliefs, and insomnia symptom severity. Hierarchical linear regression was used to examine whether hot flash beliefs were associated with insomnia symptoms above and beyond hot flash severity. RESULTS: Hot flash beliefs were positively associated with insomnia symptom severity (β=0.12, P< 0.05), accounting for 24% of the variance. When hot flash severity was added to the model, both hot flash severity (β=0.80, P< 0.05) and hot flash beliefs (β=0.10, P< 0.05) were significantly positively associated with insomnia symptoms. Together, hot flash severity and hot flash beliefs explained 27% of the variance in insomnia symptom severity. CONCLUSION: Cognitive appraisals of hot flashes are associated with greater insomnia symptom severity in perimenopausal and postmenopausal women. It is possible that negative beliefs about hot flashes may heighten arousal and interfere with sleep, independent of hot flash severity. These findings have implications for cognitive-behavioral interventions targeting insomnia and vasomotor symptoms in this population.
Efficacy and safety of Actaea racemosa for relieving climacteric complaints.
Curtis S, Moore A, Breakspear I
Menopause · 2026 May · PMID 41401209 · Publisher ↗
IMPORTANCE: Black cohosh (BC) is a herbal medicine being prescribed for the management of climacteric complaints. This is the first review to assess the quality of evidence for BC as measured by adherence to Consolidated...
IMPORTANCE: Black cohosh (BC) is a herbal medicine being prescribed for the management of climacteric complaints. This is the first review to assess the quality of evidence for BC as measured by adherence to Consolidated Standards of Reporting Trials (CONSORT) extensions for herbal interventions and harms. OBJECTIVE: Herbal medicines such as Actaea racemosa ( A. racemosa ; synonym Cimicifuga racemosa , BC) are commonly being used by women seeking relief from menopausal (climacteric) complaints. Our objective is to evaluate the quality of reporting of clinical trials investigating A. racemosa for climacteric complaints, by grading their adherence to both the CONSORT extensions for herbal interventions, and for reporting adverse events (harms). EVIDENCE REVIEW: A systematic search of the databases: AMED, CINAHL, EBSCO, Academic Search Ultimate, Google Scholar, PubMed and Science Direct, was conducted in April 2023 and another search done March 2024. The search phrase employed included relevant herbal or herbal product keywords ["black cohosh," "actaea racemosa," "cimicifuga racemosa," "BNO 1055," "remifemin," "Ze 450"] combined using the Boolean operator term AND with keywords regarding climacteric complaints ["menopausal symptoms," "menopause," "climacteric complaints"]. Additional citation searching was conducted to identify any other published studies. Articles were included if they were clinical trials of oral use of A. racemosa in humans. Quality assessment of included articles was undertaken to review adherence to the CONSORT Statement Extensions for reporting on herbal interventions, and harms (adverse events). FINDINGS: Fourteen records were included in the final analysis. Adherence to the herbal extension for the CONSORT ranged between 39% and 87%, with four of them receiving an adherence rating of 50% or less. Adherence to the Harms Extension for the CONSORT ranged between 6% and 90%, with three of the articles receiving an adherence rating of 50% or less. CONCLUSIONS AND RELEVANCE: This is the first time a systematic review of the quality of clinical trial reports of BC, using the CONSORT herbal extension and harms checklists, has been conducted. The wide range of ratings found in our quality assessment suggests the need for further high-quality investigation of this widely used herbal preparation.
Hot flashes linked to linguistic markers of cognitive impairment: observational study of social media posts.
Shaklai S, Serebro M, Greenman Y … +1 more , Yom-Tov E
Menopause · 2026 Apr · PMID 41401206 · Publisher ↗
OBJECTIVES: This study analyzes social media data from Reddit, using artificial intelligence and natural language processing, to explore cognitive changes in the menopause transition and their associations with hot flash...
OBJECTIVES: This study analyzes social media data from Reddit, using artificial intelligence and natural language processing, to explore cognitive changes in the menopause transition and their associations with hot flashes and hormone therapy (HT). METHODS: Posts from 2,387 women in the menopause subreddit and 3,710 matched controls (~340,000 posts) on Reddit were analyzed. A subset of 338 posts was manually labeled for age, hot flashes, cognitive complaints, mood disturbances, and sleep issues. A machine learning model (area under the receiver operating curve [AUC]: 0.67-0.92) applied these labels to the remaining posts. A cognitive scale, developed by correlating cognitive complaints with known linguistic markers of cognitive function, such as text length and lexical diversity, was employed. RESULTS: Hot flashes were reported by 41% of participants and were strongly associated with increased mood disturbances (6-fold), cognitive complaints (10-fold), and sleep difficulties (20-fold). Cognitive complaints correlated positively with length of text (AUC: 0.755) and negatively with unique word usage (AUC: 0.754). Women with hot flashes using HT initially exhibited lower cognitive scores, which improved with treatment over time but remained below those of asymptomatic untreated women. CONCLUSIONS: Hot flashes are associated with subjective cognitive impairment and with text markers of cognitive performance during the menopause transition. This study highlights social media's potential as a valuable research tool for assessing cognitive changes in menopause.
Short-term vocal outcomes of semioccluded vocal tract exercises in postmenopausal teachers.
Aji AM, Joseph BE
Menopause · 2026 May · PMID 41364588 · Publisher ↗
OBJECTIVES: To estimate the short-term vocal outcomes of semioccluded vocal tract exercise in postmenopausal teachers. METHODS: Twenty-three postmenopausal teachers meeting the inclusion and exclusion criteria were recru...
OBJECTIVES: To estimate the short-term vocal outcomes of semioccluded vocal tract exercise in postmenopausal teachers. METHODS: Twenty-three postmenopausal teachers meeting the inclusion and exclusion criteria were recruited for the study, out of which three were lost to follow-up. The participants underwent baseline voice assessment using acoustic measures, aerodynamic measures, and perceptual measures. The participants completed eight face-to-face semioccluded vocal tract exercise sessions during the first month, comprising humming, lip and tongue trills, and straw phonation with and without water resistance. Daily home practice was also carried out over 3 months. Follow-up assessments were conducted at the end of 1 month and 3 months from the baseline assessment to estimate the changes in parameters over the intervention duration of 3 months. RESULTS: Postintervention assessment indicated improvement in all the parameters with statistically significant changes in jitter, shimmer, mean pitch, mean intensity, and harmonics-to-noise ratio ( P <0.05), all showing strong effect sizes. There was also a notable improvement in the Acoustic Voice Quality Index ( P =0.050) and maximum phonation duration ( P =0.053). Cepstral peak prominence and s/z ratio showed no significant changes. Grade in GRBAS (grade, roughness, breathiness, asthenia, strain) rating showed a significant difference ( P =0.039). Further, the Voice-Related Quality of Life scores improved significantly from pretherapy to post-therapy. CONCLUSION: The findings suggest that semioccluded vocal tract exercise, supported by structured sessions and consistent home practice, is effective in improving vocal outcomes in postmenopausal teachers. It serves as an effective therapeutic approach for addressing postmenopausal vocal changes in teachers who are not under hormone therapy.
Anxiety, aging, and reproductive aging: observations from the Seattle Midlife Women's Health Study.
Woods NF, Pike KC, Mitchell ES
Menopause · 2026 Apr · PMID 41364554 · Publisher ↗
OBJECTIVE: Attention to women's perimenopausal experiences of anxiety has been limited. The purpose of these analyses was to examine the influence of chronological aging and reproductive aging stages on midlife women's r...
OBJECTIVE: Attention to women's perimenopausal experiences of anxiety has been limited. The purpose of these analyses was to examine the influence of chronological aging and reproductive aging stages on midlife women's reports of anxiety. METHODS: Participants aged 35-55 years from the Seattle Midlife Women's Health Study population-based study (N = 508 at baseline) completed an annual health questionnaire and menstrual calendars. In addition, they completed the Symptom Checklist-90 Revised Scales, including anxiety, phobic anxiety, and interpersonal sensitivity, on up to four occasions during the course of the study. Reproductive aging stages were assessed using menstrual calendars and questionnaire data applying Mitchell's (2000) criteria for stages of reproductive aging: late reproductive stages (late reproductive stage 1 [LRS1] and late reproductive stage 2), early menopausal transition stage, late menopausal transition (LMT) stage, and postmenopause (PM). Multilevel modeling using mixed models analysis of linear models (SPSS 28) was employed to examine the effects of age and reproductive aging stages on repeated measures of anxiety, phobic anxiety, and interpersonal sensitivity. RESULTS: Age was significantly and negatively related to each of the measures: anxiety (beta = -0.015), phobic anxiety (beta = -0.008), and interpersonal sensitivity (beta = -0.016), each decreased significantly with age ( P < 0.001). When accounting for age effects, anxiety scale scores increased as women progressed through reproductive aging stages from LRS1 to the LMT, then decreased from late stage to PM, but changes were not significant. When accounting for age effects, phobic anxiety increased significantly from LRS1 to PM stages (LRS1 vs PM betas -0.139, -0.057, -0.052, -0.010 for LRS1 to LMT, P = 0.018). Interpersonal sensitivity increased from LRS1 to LMT, but changes were not significant. CONCLUSION: Aging was significantly and negatively related to anxiety, phobic anxiety, and interpersonal sensitivity, suggesting emotion regulation effects during midlife. When chronological aging was taken into account, reproductive aging was associated significantly with increasing levels of phobic anxiety from the late reproductive stages to PM. Anxiety and interpersonal sensitivity both increased with progression from LRS1 through LMT before decreasing PM, but the changes were not significant.
Transitions in metabolic syndrome clustering patterns before and after menopause: a latent transition analysis in Korean women.
Choi YJ, Kim GS
Menopause · 2026 Apr · PMID 41364541 · Publisher ↗
OBJECTIVE: To identify metabolic syndrome (MetS) clustering patterns, examine transitions between classes from perimenopausal to postmenopausal stages, and identify factors associated with these transitions. METHODS: Thi...
OBJECTIVE: To identify metabolic syndrome (MetS) clustering patterns, examine transitions between classes from perimenopausal to postmenopausal stages, and identify factors associated with these transitions. METHODS: This secondary analysis used data from 1,104 women in the Korean Genome Epidemiology Study, a population-based longitudinal cohort. Latent class analysis was conducted for perimenopausal and postmenopausal stages, and latent transition analysis class changes. Age at menopause, white blood cell count, and homeostasis model assessment of insulin resistance (HOMA-IR) were examined as predictors. RESULTS: Four classes were identified in the perimenopausal stage: metabolic-diabetic, metabolic-hypertensive, low high-density lipoprotein cholesterol (HDL-c), and non-MetS. Five classes were identified in the postmenopausal stage: treated-hypertensive, metabolic-hypertensive, high-risk, low HDL-c, and non-MetS. Approximately 40% of women changed their classes during the menopause transition. The metabolic-diabetic group showed a markedly higher likelihood of progression to the high-risk group (88.3%). In the metabolic-hypertensive group at the perimenopausal stage, higher HOMA-IR was associated with increased transitions to low the HDL-c (odds ratio [OR]: 51.37, 95% CI: 15.27-172.78) and high-risk (OR: 78.10, 95% CI: 19.16-318.30) classes. Later menopause reduced the likelihood of remaining in (OR: 0.10, 95% CI: 0.02-0.50) or progressing to high-risk (OR: 0.05, 95% CI: 0.01-0.43) in the metabolic-hypertensive group but increased the probability of transitioning to treated-hypertensive in women in the non-MetS group (OR: 1.48, 95% CI: 1.13-1.94). CONCLUSIONS: Metabolic risk profiles shift substantially during menopause. Targeted interventions, especially for high-risk groups before menopause, and the inclusion of simple insulin resistance markers such as HOMA-IR in screening may improve prevention and management.
The relationship between anxiety, depression, and menopausal symptoms in postmenopausal women.
Töre FK, Nacar G, Ağrali C
Menopause · 2026 May · PMID 41364387 · Publisher ↗
OBJECTIVES: This study examined the relationship of anxiety and depression with menopausal symptoms in postmenopausal women. METHODS: This descriptive, cross-sectional study was conducted with 236 postmenopausal women ag...
OBJECTIVES: This study examined the relationship of anxiety and depression with menopausal symptoms in postmenopausal women. METHODS: This descriptive, cross-sectional study was conducted with 236 postmenopausal women aged 45-65 years. Data were collected using the Personal Information Form, the Beck Anxiety Inventory, the Beck Depression Inventory, and the Menopause Symptom Assessment Scale. Descriptive statistics, Pearson correlation analysis, and multivariable-adjusted linear analysis were employed for the statistical evaluation of the data. The models were adjusted for the following covariates: age, educational status, income status, marital status, number of living children, presence of chronic disease, body mass index, duration of menopause, and perception of the menopausal period. RESULTS: A statistically significant positive correlation was found between anxiety and menopausal symptoms ( r =0.623, P <0.001). Multivariable-adjusted linear regression analysis indicated that a one-unit increase in anxiety was associated with a 0.424-unit increase in menopausal symptom scores ( B =0.424, P <0.001). Similarly, a statistically significant positive correlation was observed between depression and menopausal symptoms ( r =0.442, P <0.001). A one-unit increase in depression was associated with a 0.416-unit increase in menopausal symptom scores ( B =0.416, P <0.001). CONCLUSIONS: In conclusion, a significant relationship was found between anxiety and depression and menopausal symptoms. This finding highlights the importance of not overlooking psychological factors such as anxiety and depression when evaluating menopausal symptoms in postmenopausal women.
Evaluation of the accuracy and readability of large language model responses on menopause and hormone therapy.
Karam J, Shufelt C, Safwan N … +3 more , Kapoor E, Christmas MM, Faubion SS
Menopause · 2026 May · PMID 41329562 · Publisher ↗
OBJECTIVE: Generative artificial intelligence is rapidly evolving and is now being explored in health care to support patient and clinician education. This study evaluated the accuracy, completeness, and readability of f...
OBJECTIVE: Generative artificial intelligence is rapidly evolving and is now being explored in health care to support patient and clinician education. This study evaluated the accuracy, completeness, and readability of four large language models (LLMs): ChatGPT 3.5, Gemini, ChatGPT 4.0, and OpenEvidence in answering questions about menopause and hormone therapy. METHODS: A total of 35 questions (20 patient-level, 15 clinician-level) were entered into each LLM. OpenEvidence was only used for clinician-level questions. Four blinded expert reviewers rated responses as accurate and complete, accurate but incomplete, or inaccurate. Readability of patient-level responses was assessed using the Flesch Reading Ease Score (FRES) and word count. Analysis used ANOVA for readability, odds ratios for accuracy comparisons. RESULTS: For patient-level questions, ChatGPT 3.5 achieved the highest accuracy (70%), followed by ChatGPT 4.0 (60%) and Gemini (30%); Gemini had significantly lower odds of accuracy compared with ChatGPT 3.5 (OR=0.18, 95% CI=0.05-0.71; P =0.014). FRES scores differed significantly ( P <0.001): Gemini scored 38.9±7.3 ("difficult"), ChatGPT 3.5 scored 31.0±11.2, and ChatGPT 4.0 scored 26.5±8.6 (both "very difficult"). For clinician-level questions, ChatGPT 4.0 achieved the highest accuracy (67%), followed by ChatGPT 3.5 and OpenEvidence (60% each) and Gemini (47%); no significant differences were observed among models (all P >0.05). CONCLUSION: LLMs demonstrated limited accuracy and frequent incorrect or incomplete responses to menopause-related queries, highlighting the need to improve model performance to ensure accurate and reliable information for both patients and clinicians.
A pilot study of vaginal nerve fiber and blood vessel density in postmenopausal women with genitourinary syndrome of menopause.
Dotson EH, Elmariah SB, Bergerat AM … +5 more , James K, Luo T, Reed SD, Guthrie KA, Mitchell CM
Menopause · 2026 Apr · PMID 41288462 · Publisher ↗
OBJECTIVE: Menopause is accompanied by decreased circulating estrogen for all people; however, only some develop genitourinary syndrome of menopause, the cause of which is unknown. In this pilot study, we measured vagina...
OBJECTIVE: Menopause is accompanied by decreased circulating estrogen for all people; however, only some develop genitourinary syndrome of menopause, the cause of which is unknown. In this pilot study, we measured vaginal blood vessel and nerve fiber density, as well as vaginal fluid immune markers to identify a potential cause of vaginal symptoms. METHODS: This is a secondary analysis of samples from a randomized trial of vaginal estradiol or moisturizer versus placebo for moderate-severe postmenopausal vaginal discomfort. Fourteen participants were selected from the placebo tablet/vaginal moisturizer or dual placebo arms of the original study: eight with a ≥2-point reduction in most bothersome symptom severity (responders) and six with a <2-point reduction in symptom severity (nonresponders). At 0, 4, and 12 weeks, we characterized vaginal protein gene product 9.5-positive nerve fiber and CD31+ vessel length and density from vaginal wall biopsies (immunofluorescent staining) and vaginal fluid immune markers (MesoScale Discovery). We compared responders versus nonresponders at baseline and across visits using linear mixed models to evaluate associations between symptoms, nerve/vessel length and density, and immune markers. RESULTS: There were no significant differences in baseline characteristics between responders and nonresponders. Mean CD31+ vessel length at 12 weeks was higher in responders than nonresponders ( P = 0.034), while all other measurements were similar between the two groups. No clear patterns were observed across proinflammatory or chemoattractant cytokine concentrations with biopsy measures. CONCLUSIONS: Vaginal blood supply and extent of vascularization may contribute to vaginal discomfort symptoms in postmenopausal people; however, the results of this small study need to be confirmed with a larger sample size.
Virtual patients, real learning: extended reality simulation for clinical menopause education.
Liss J, Conageski C, Steinauer J … +2 more , Carlson C, Chesnokova A
Menopause · 2026 Apr · PMID 41288461 · Full text
OBJECTIVE: To develop and evaluate the acceptability and effectiveness of an extended reality (XR) avatar-based menopause education simulation module for the clinical training of OB/GYN residents. METHODS: This menopause...
OBJECTIVE: To develop and evaluate the acceptability and effectiveness of an extended reality (XR) avatar-based menopause education simulation module for the clinical training of OB/GYN residents. METHODS: This menopause education pilot recruited 57 OB/GYN residents from nine institutions via listservs and snowball sampling. Participants completed a menopause-focused XR avatar simulation module developed using Kern's curriculum design framework and guided by APGO/CREOG objectives and national guidelines. Learners completed an 11-item preintervention and postintervention assessment measuring usability and satisfaction (Kirkpatrick Level 1: reaction outcomes) and knowledge and self-reported confidence (Level 2: learning outcomes). Descriptive statistics summarized additional outcomes, and paired t tests were used to evaluate changes in knowledge. We also conducted a brief descriptive review of voluntary free-text comments. RESULTS: From preintervention to postintervention, mean knowledge scores improved from 79.8% to 82.8% ( P =0.028). Participants reported improved preparedness and confidence across multiple domains: 59% improvement in overall readiness to manage menopause, 50% in comfort managing hormone therapy, and 39% in managing nonhormone therapy. No learners reported feeling "not at all prepared" postintervention. Most rated the module as effective (63%) and more engaging than lectures (60%); 96% would recommend it. Narrative feedback endorsed the module as valuable while suggesting improvements in interactivity, content depth, and avatar responsiveness. CONCLUSIONS: The XR simulation module demonstrated acceptability and effectiveness in enhancing clinical menopause training. Results support its potential as a scalable educational tool to address gaps in clinical menopause education.
Musculoskeletal disorders following hysterectomy with ovarian conservation: a population-based cohort study.
Neblett MF, Smith CY, Ainsworth AJ … +4 more , Rocca WA, Laughlin-Tommaso SK, Stewart EA, Khan Z
Menopause · 2026 Apr · PMID 41288454 · Publisher ↗
OBJECTIVES: To determine the risk of developing de novo carpal tunnel syndrome (CTS), arthritis, or rheumatoid arthritis in women who underwent hysterectomy with bilateral ovarian conservation (H-OC) before reaching spon...
OBJECTIVES: To determine the risk of developing de novo carpal tunnel syndrome (CTS), arthritis, or rheumatoid arthritis in women who underwent hysterectomy with bilateral ovarian conservation (H-OC) before reaching spontaneous menopause. METHODS: We identified 1,573 women undergoing H-OC for a benign indication at age 18 to 44 years between 1980 and 2002 in Olmsted County, Minnesota. Each woman was age-matched (±1 y) to a referent woman who had not undergone hysterectomy or oophorectomy before the matching date (index date). Diagnostic codes for CTS and arthritis were extracted from the Rochester Epidemiology Project medical records-linkage system through 2019. Hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models and the two cohorts were balanced for 19 chronic conditions and for several potential confounders present at index date. RESULTS: Over a median 25.8-year follow-up, women undergoing H-OC had an increased risk of developing CTS (HR: 1.33; 95% CI: 1.13-1.56) compared with referent women. The risk was similar in strata by age at H-OC and was higher for women with endometriosis and menstrual disorders indications. Women undergoing H-OC also had an increased risk of developing arthritis (HR: 1.34; 95% CI: 1.23-1.47). The risk was similar in strata by age at H-OC and by indication. Rheumatoid arthritis considered separately was also associated with H-OC (HR: 1.55; 95% CI: 1.05-2.30). CONCLUSIONS: H-OC was associated with an increased risk of de novo CTS, arthritis (all types), and rheumatoid arthritis. Further studies are needed to confirm these associations and to explore potential biological mechanisms.
Nocturnal change in body temperature, sleep quality in middle-aged women.
Tomiishi C, Okamoto S, Lin CA … +2 more , Sakamoto J, Goto K
Menopause · 2026 Apr · PMID 41288448 · Publisher ↗
OBJECTIVE: The present study compared changes in body temperature during sleep, sleep quality (eg, subjective and objective sleep parameters) between middle-aged women and young women. METHODS: Nineteen middle-aged women...
OBJECTIVE: The present study compared changes in body temperature during sleep, sleep quality (eg, subjective and objective sleep parameters) between middle-aged women and young women. METHODS: Nineteen middle-aged women and 14 young women with normal menstrual cycles were recruited. Over 7 consecutive days, skin temperature and sleep parameters (subjectively and objectively analyzed using the Pittsburgh Sleep Quality Index [PSQI] and actigraphy, respectively) were assessed. For the PSQI, higher score means decreased quality of sleep. RESULTS: The skin temperature during sleep was significantly higher in middle-aged women (35.0 ± 0.4℃) than young women (34.6 ± 0.5℃, P < 0.05). In young women, skin temperature increased immediately after bedtime and then gradually decreased, whereas skin temperature did not decrease in middle-aged women ( P < 0.05 between groups). In addition, skin temperature remained significantly higher in middle-aged women than young women during the 30%-80% phase for the entire night ( P < 0.05). Middle-aged women had a significantly higher PSQI score (5.4 ± 0.4) than young women (3.9 ± 0.4, P < 0.05), indicating that sleep quality was impaired in middle-aged women. However, no significant difference was found in objective sleep parameters between middle-aged women and young women. CONCLUSION: Middle-aged women had significantly higher body temperatures during sleep than younger women. A sustained higher body temperature during sleep may be associated with decreased sleep quality, as evaluated by the PSQI.
Sex toy use among a demographically representative sample of women 60 and older in the United States.
Hille JJ, Graham CA, Sanders SA
Menopause · 2026 Apr · PMID 41288446 · Publisher ↗
OBJECTIVES: While there has been increasing interest in older adults' sexuality, the literature to date has largely ignored sex toy use. This study investigated sex toy use in partnered sex and masturbation among older a...
OBJECTIVES: While there has been increasing interest in older adults' sexuality, the literature to date has largely ignored sex toy use. This study investigated sex toy use in partnered sex and masturbation among older adult women. METHODS: A survey was fielded in October 2023 among a national demographically representative sample (N = 3,001). Participants had to be at least 60 years old, identify as a woman, and be living in the United States. RESULTS: Most of the survey participants were 60-69 years old (67.1%). Participants reported much greater use of sex toys during masturbation than during sex with a partner. Of the women who reported masturbating at least once in the last year, 46.4% used toys almost always or always during masturbation, compared with 5.1% who used sex toys almost always or always during partnered sex. Those who reported almost always or always using sex toys during masturbation were significantly more likely to report always or almost always having an orgasm compared with the lower frequency sex toy users. Of those who had partnered sex, 38.7% reported using sex toys during partnered sex at least rarely. Those who reported almost always or always using sex toys during partnered sex were more likely to report always or almost always having an orgasm compared with the lower frequency sex toy users. CONCLUSIONS: Given the prevalence of masturbation and sex toy use as well as their relationships to orgasm, older women could benefit from information from health care professionals on these topics.
Association between relative handgrip strength and metabolic syndrome in Korean postmenopausal women by time since menopause.
Baek JK, Chung YS, Kim HR … +3 more , Kim HY, Yun BH, Seo SK
Menopause · 2026 Mar · PMID 41252275 · Publisher ↗
OBJECTIVES: To investigate the association between relative handgrip strength (RHGS) and metabolic syndrome (MetS) in Korean postmenopausal women, and whether this association differs by time since menopause. METHODS: We...
OBJECTIVES: To investigate the association between relative handgrip strength (RHGS) and metabolic syndrome (MetS) in Korean postmenopausal women, and whether this association differs by time since menopause. METHODS: We conducted a cross-sectional analysis of 4,098 naturally postmenopausal women aged 45-65 years from the Korea National Health and Nutrition Examination Survey (2014-2019). RHGS was calculated as the dominant handgrip strength divided by body mass index and categorized into quartiles. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria with an Asian-specific waist circumference cutoff (≥85 cm). Survey-weighted logistic regression was used to estimate adjusted odds ratios (ORs) for MetS and its components across RHGS quartiles. Subgroup analyses were stratified by time since menopause (≤10 vs. >10 y). RESULTS: Lower RHGS was significantly associated with higher odds of MetS. Compared with Q1 (reference), adjusted ORs for MetS were 0.49 (95% CI: 0.40-0.60) in Q2, 0.28 (0.22-0.34) in Q3, and 0.17 (0.13-0.21) in Q4 ( P for trend <0.001). Similar inverse gradients were observed for all MetS components. The association was stronger in women >10 years postmenopause, with OR for Q4 versus Q1 at 0.04 (0.02-0.08) compared with 0.07 (0.05-0.10) in those ≤10 years. CONCLUSION: Lower RHGS is independently and dose-dependently associated with increased odds of MetS, particularly among women beyond 10 years postmenopause. RHGS may serve as a simple, low-cost tool for identifying women at elevated cardiometabolic risk in later life.
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