Maturitas[JOURNAL]
Sun
200 papers
Intrinsic capacity and the trajectory of ischemic heart disease and its complications: the mediating role of insulin resistance indices.
Wang N, Yang Y, Jia X … +7 more , Yang C, Wang Y, Fan J, Zhao C, Niu Y, Fan Z, Shi X
Maturitas · 2026 Jul · PMID 42401064 · Publisher ↗
OBJECTIVE: This study investigated the associations of intrinsic capacity, a multidomain measure of functional health, with the incidence and progression of ischemic heart disease, and the mediation of such associations...
OBJECTIVE: This study investigated the associations of intrinsic capacity, a multidomain measure of functional health, with the incidence and progression of ischemic heart disease, and the mediation of such associations by indices related to insulin resistance (IR). METHODS: We included 386,462 adults from the UK Biobank who were free of ischemic heart disease and its associated complications, including heart failure and arrhythmia, at baseline. Associations were estimated using Cox models, and multistate models for transitions. Mediation by IR-related indices was quantified in a counterfactual framework. RESULTS: Over a median 13.68 years of follow-up, 29,994 ischemic heart disease events occurred. Hazard ratios (95% confidence intervals) for ischemic heart disease were 1.15 (1.11-1.18), 1.38 (1.33-1.43), 1.68 (1.61-1.75), and 2.24 (2.12-2.37) for intrinsic capacity scores of 1, 2, 3, and ≥4 versus 0. Estimates from the multistate model for the transition from baseline to ischemic heart disease were consistent with the Cox results. Hazard ratios (95% confidence intervals) for transition from ischemic heart disease to death were 1.32 (1.14-1.53) for intrinsic capacity score 3 and 1.46 (1.21-1.74) for intrinsic capacity score ≥ 4, and 1.30 (1.09-1.56) from complications to death for intrinsic capacity score ≥ 4. IR-related indices accounted for 6.77-22.40% of the association between intrinsic capacity and ischemic heart disease, 5.38-24.24% for complications, and 2.22-10.04% for death. CONCLUSIONS: Lower intrinsic capacity was associated with higher risks of ischemic heart disease and its progression, partly through IR-related pathways, supporting metabolic dysfunction as a modifiable target for early risk stratification.
Mobility limitation trajectories and longitudinal changes in delayed recall in midlife and later life: A multicohort study.
Xie J, Wang B
Maturitas · 2026 Jul · PMID 42401063 · Publisher ↗
OBJECTIVES: Mobility limitation has been linked to cognitive decline, but evidence largely relies on single-time-point assessments. Whether longitudinal mobility patterns are associated with memory change remains unclear...
OBJECTIVES: Mobility limitation has been linked to cognitive decline, but evidence largely relies on single-time-point assessments. Whether longitudinal mobility patterns are associated with memory change remains unclear. STUDY DESIGN: This multicohort longitudinal study included 25,990 adults aged 45 years or more from the China Health and Retirement Longitudinal Study, the U.S. Health and Retirement Study, and the English Longitudinal Study of Ageing. Mobility limitation trajectories were identified in the China Health and Retirement Longitudinal Study using group-based trajectory modeling and applied to the other two cohorts to assess cross-cohort transportability. MAIN OUTCOME MEASURES: Delayed recall was measured using a common 10-word recall task scored on a 0-10 scale. Linear mixed-effects models examined concurrent associations between trajectory membership and change in delayed recall, adjusted for sociodemographic, lifestyle, and health-related factors. RESULTS: Three trajectories were identified: stable-low limitation, progressive deterioration, and persistent-high limitation. In fully adjusted complete-case models, the persistent-high limitation group showed a faster decline in delayed recall than the stable-low limitation group in the China Health and Retirement Longitudinal Study (β = -0.115; 95% confidence interval -0.152 to -0.079), the Health and Retirement Study (β = -0.026; 95% confidence interval -0.034 to -0.017), and the English Longitudinal Study of Ageing (β = -0.045; 95% confidence interval -0.058 to -0.031). Subgroup analyses suggested effect modification by age, education, and heart disease. CONCLUSIONS: Longitudinal mobility limitation patterns were associated with change in delayed recall across three aging cohorts. Repeated mobility assessment may help characterize the co-evolution of physical and cognitive functioning in midlife and later life.
Digital twins in menopause: a roadmap for integrating endocrine dynamics, multisystem physiology, and precision medicine.
Vallée A, Ayoubi JM
Maturitas · 2026 Jul · PMID 42398472 · Publisher ↗
The menopausal transition represents one of the most complex and heterogeneous periods of women's midlife health, marked by non-linear hormonal fluctuations and interconnected changes across cardiovascular, skeletal, met...
The menopausal transition represents one of the most complex and heterogeneous periods of women's midlife health, marked by non-linear hormonal fluctuations and interconnected changes across cardiovascular, skeletal, metabolic, neurocognitive, and thermoregulatory systems. Despite decades of research, current approaches remain limited by sparse longitudinal measurements, fragmented organ-specific studies, and population-based models that overlook the substantial diversity of menopausal trajectories. Digital twin technologies, computational replicas of individual patients that integrate real-time data with mechanistic and AI-driven modelling, offer a novel framework to address these limitations. This review explores whether digital twins could redefine the scientific understanding and clinical management of menopause. We synthesise advances across multiple domains relevant to digital twin development, including bone remodelling models, cardiovascular simulations, neuroendocrine network modelling, vasomotor physiology, multi-omic profiling, and the growing ecosystem of wearable sensors and digital health data. Collectively, these fields provide the conceptual foundations for constructing dynamic, personalised models capable of simulating hormonal decline, predicting multisystem health trajectories, and evaluating potential therapeutic strategies in silico. We highlight the major scientific and technical challenges that currently limit progress, including incomplete endocrine modelling, the scarcity of high-frequency multimodal datasets, and the intrinsic difficulty of validating counterfactual predictions. Ethical and regulatory considerations, such as data governance, algorithmic fairness, transparency, and clinical integration, also require dedicated attention to ensure safe and equitable implementation. Digital twins hold significant promise for ushering in a new era of mechanistically informed, personalised menopause research and care.
Testosterone therapy in women: Keeping pace with the evidence.
Shihab S, Kling JM
Maturitas · 2026 Jun · PMID 42392885 · Publisher ↗
Abstract loading — click title to view on PubMed.
Diagnosis and management of androgen excess presenting after menopause.
Ortiz-Flores AE, Luque-Ramírez M, Escobar-Morreale HF
Maturitas · 2026 Jul · PMID 42391935 · Publisher ↗
Postmenopausal hyperandrogenism is a rare yet clinically relevant condition. It can result from a wide variety of sources and etiologies, from benign functional disorders to life-threatening androgen-secreting tumors. Po...
Postmenopausal hyperandrogenism is a rare yet clinically relevant condition. It can result from a wide variety of sources and etiologies, from benign functional disorders to life-threatening androgen-secreting tumors. Polycystic ovary syndrome is the most frequent cause of hyperandrogenism in postmenopausal patients. Ovarian or adrenal tumors are rare but must be promptly recognized because any delay in diagnosis is associated with a significant risk of mortality. Sudden onset and rapid progression of symptoms or virilizing features are clinical red flags that must lead to the use of imaging to rule out malignancy. Hormonal assessment using accurate assays, in combination with targeted imaging, dynamic testing in selected cases, and a structured diagnostic algorithm will help to establish the etiology of androgen excess in less severe cases. Surgery is the cornerstone of treatment in most cases of severe hyperandrogenism. Gonadotropin-releasing hormone analogs or low-dose glucocorticoids may be helpful for the control of symptoms in gonadal or adrenal functional hyperandrogenism, respectively. Antiandrogens are also helpful in patients with mild functional hyperandrogenism who are concerned about dermocosmetic symptoms. In cases of endocrinopathies or iatrogenic causes, treatment of the underlying cause and avoidance of the drug responsible are needed. This review summarizes the varied etiology of postmenopausal androgen excess, and emphasizes the importance of an accurate diagnostic workup and tailored management.
Domain-specific severity of menopausal symptoms and emotional eating in midlife women.
Yilmaz BN, Yurtsever C, Aykanat Yurtsever B
Maturitas · 2026 Jul · PMID 42391934 · Publisher ↗
OBJECTIVE: To examine the association between the domain-specific severity of menopausal symptoms and emotional eating behavior in women undergoing late menopausal transition and postmenopause, and to identify sociodemog...
OBJECTIVE: To examine the association between the domain-specific severity of menopausal symptoms and emotional eating behavior in women undergoing late menopausal transition and postmenopause, and to identify sociodemographic and clinical factors contributing to this relationship. METHODS: This single-center, cross-sectional study was conducted in a tertiary family medicine outpatient clinic in Turkey. The sample comprised 211 women in the late menopausal transition or postmenopausal stage, classified according to the Stages of Reproductive Aging Workshop +10 criteria. Emotional eating was assessed using the Turkish Emotional Eating Scale, and menopausal symptoms were evaluated with the Menopause Rating Scale, which has somatic, psychological, and urogenital subscales. Multivariable linear regression and structural equation modeling were performed to evaluate associations between menopausal symptom domains, emotional eating, and selected sociodemographic and clinical variables. RESULTS: In multivariable regression analysis, scores on the psychological (B = 1.32 [0.49-2.15], p = 0.002) and urogenital (B = 2.46 [1.36-3.57], p < 0.001) subscales of the Menopause Rating Scale were independently and positively associated with total score on the Turkish Emotional Eating Scale, while scores on the somatic subscale demonstrated a weak inverse association (B = -0.88 [-1.80-0.03], p = 0.058). Higher body mass index, being employed, and being in the late menopausal transition were associated with higher scores for emotional eating, whereas being married and having a high school education were associated with lower scores. Structural equation modeling results were consistent with the regression findings and demonstrated good overall model fit. CONCLUSIONS: A differentiated pattern of associations was observed between psychological and urogenital menopausal symptoms and emotional eating compared with somatic symptoms. These findings highlight the importance of a multidimensional assessment of menopausal symptoms, specifically emotional eating, in middle-aged women.
Energy-based therapies for vulvar lichen sclerosus: A systematic review of randomized controlled trials.
Aksahin E, Theis S, Gedik KZ … +1 more , Erel CT
Maturitas · 2026 Jun · PMID 42391933 · Publisher ↗
BACKGROUND: Vulvar lichen sclerosus (VLS) is a chronic, relapsing dermatosis that significantly impairs quality of life. While topical corticosteroids remain the first-line therapy, recurrence and steroid-related side-ef...
BACKGROUND: Vulvar lichen sclerosus (VLS) is a chronic, relapsing dermatosis that significantly impairs quality of life. While topical corticosteroids remain the first-line therapy, recurrence and steroid-related side-effects have prompted interest in alternative options. This systematic review evaluates the efficacy and safety of laser therapies compared with other treatments for VLS. METHODS: A systematic search was performed in MEDLINE (via PubMed), Scopus, Web of Science, CINAHL, and the Cochrane Central Register of Controlled Trials (CENTRAL). Searches used Medical Subject Headings (MeSH) and free-text terms. Randomized controlled trials (RCTs) meeting predefined criteria were included. Two independent reviewers assessed study eligibility and methodological quality using the JBI critical appraisal checklist for RCTs; discrepancies were resolved by a third reviewer. RESULTS: Seven RCTs involving 337 women were included. The majority of studies evaluated fractional CO₂ laser therapy, while others investigated Nd:YAG-based or combination laser modalities. Comparators included sham or low-dose laser, topical corticosteroids, and other active treatments. Five of the seven RCTs found improvements in patient-reported symptoms following laser therapy; however, findings were heterogeneous and not consistently superior to comparator groups. The only sham-controlled trial did not demonstrate superiority of fractional CO₂ laser over sham treatment, suggesting a substantial placebo contribution. Patient satisfaction and adherence were generally higher with laser therapy, and no serious adverse events were reported. CONCLUSIONS: Laser therapies appear promising for VLS management, with favorable safety and patient-reported outcomes. Nevertheless, current evidence is limited by small cohorts and methodological heterogeneity. Larger randomized, sham-controlled trials are required to validate efficacy and long-term safety.
Change of sexual activity and its relation to the quality of life in older people: Cognition of Older People, Education, Recreational Activities, NutritIon, Comorbidities, fUnctional Capacity Studies (COPERNICUS).
Kujawska A, Kujawski S, Hajek A … +5 more , Del Sequeros Pedroso-Chaparro M, Husejko J, Hajec W, Zalewski P, Kędziora-Kornatowska K
Maturitas · 2026 Jun · PMID 42391932 · Publisher ↗
OBJECTIVES: Longitudinal changes in sexual activity and their impact on quality of life in older adults have not been thoroughly examined. The current study examined the change in sexual activity over two years and its r...
OBJECTIVES: Longitudinal changes in sexual activity and their impact on quality of life in older adults have not been thoroughly examined. The current study examined the change in sexual activity over two years and its relation to quality of life in older people in Poland. STUDY DESIGN: This was a two-year longitudinal observational study. Changes in quality of life were evaluated using analysis of covariance models, adjusting for baseline scores, demographic factors, changes in marital status, self-rated health, and level of depression. MAIN OUTCOME MEASURES: Change in quality of life was assessed using the World Health Organization Quality of Life scale. RESULTS: The sample included 199 participants (80% female, mean age 69.73 ± 6 years). No statistically significant changes in overall quality-of-life scores were noticed over two years (p = 0.3). After adjusting for baseline scores and covariates using analysis of covariance, cessation of sexual activity was significantly associated with lower follow-up scores in the Social Relationships (p = 0.006) and Environmental (p = 0.007) domains of the Quality of Life scale. Nested models excluding potential mediating variables (health and depression changes) confirmed the robustness of these associations. CONCLUSIONS: Older adults who cease sexual activity experience significant temporal declines in specific quality-of-life domains, notably social relationships and environmental well-being.
MSH4 and MSH5 variants in premature ovarian insufficiency: A literature review and case study.
Fergus-Mackie J, Kline BL, Robevska G … +10 more , van den Bergen J, Bell K, Dulon J, Lokchine A, Touraine P, Jaillard S, Crismani W, Ayers K, Sinclair A, Tucker EJ
Maturitas · 2026 Jun · PMID 42386447 · Publisher ↗
Premature ovarian insufficiency (POI) affects up to 4% of women under 40 years, with genetic factors implicated in a substantial proportion of cases. MSH4 and MSH5 encode components of the MutSγ complex, which stabilises...
Premature ovarian insufficiency (POI) affects up to 4% of women under 40 years, with genetic factors implicated in a substantial proportion of cases. MSH4 and MSH5 encode components of the MutSγ complex, which stabilises Holliday junctions during meiotic recombination. This review examines the evidence for MSH4 and MSH5 involvement in POI. Biallelic MSH4 variants are well-established causes of POI and non-obstructive azoospermia (NOA), with MSH4 recognised as a high-evidence gene on clinical panels. MSH5 variants have similarly been reported in POI and NOA, though many lack functional validation. Affected individuals predominantly present with secondary amenorrhoea, with emerging evidence for milder phenotypes, including diminished ovarian reserve (DOR). Pathogenic variants are typically loss-of-function and/or disrupt conserved functional domains essential for meiotic recombination, in particular the C-terminal ATPase domain found in both MSH4 and MSH5. We also describe two homozygous MSH5 variants not previously reported in POI, identified in our patient cohort. Given the frequent later onset of POI associated with MSH4/MSH5 variants, there are significant implications for cascade screening, enabling predictive genetic testing in at-risk family members.
Advancing paternal age: Effects on sperm quality and offspring health.
Cannarella R, Guadagnino L, Crafa A … +2 more , La Vignera S, Calogero AE
Maturitas · 2026 Jul · PMID 42385478 · Publisher ↗
BACKGROUND: Over recent decades, socioeconomic and cultural changes have led to a progressive increase in paternal age at conception, prompting growing concern regarding its potential effects on male reproductive functio...
BACKGROUND: Over recent decades, socioeconomic and cultural changes have led to a progressive increase in paternal age at conception, prompting growing concern regarding its potential effects on male reproductive function, pregnancy outcomes, and offspring health. In contrast to the extensive literature on female reproductive aging, the biological and clinical consequences of paternal aging have received less attention. OBJECTIVE: This narrative review summarizes and critically discusses current evidence on the impact of advanced paternal age on conventional and biofunctional sperm parameters, sperm epigenetic modifications, reproductive outcomes, and offspring health. METHODS: A comprehensive literature review was conducted, encompassing clinical, epidemiological, and experimental studies investigating the association between paternal age and semen quality, sperm DNA integrity and epigenetic alterations, pregnancy outcomes in natural and assisted reproduction settings, and long-term neurodevelopmental and metabolic consequences in the offspring. RESULTS: Advanced paternal age is associated with progressive alterations in semen volume, sperm motility, morphology, vitality, and biofunctional parameters, including increased sperm DNA fragmentation, chromatin instability, and structural chromosomal abnormalities. Growing evidence further indicates that advanced paternal age is linked to age-related epigenetic sperm remodeling, involving alterations in DNA methylation patterns and non-coding RNA expression, particularly in genes implicated in neurodevelopment and metabolic regulation. Clinically, advanced paternal age has been associated with reduced pregnancy and implantation rates, an increased risk of miscarriage, and abnormal embryo development, especially in the context of assisted reproductive technologies. Moreover, epidemiological and experimental data suggest that paternal aging contributes to a higher risk of neuropsychiatric and metabolic disorders in the offspring. CONCLUSIONS: Paternal aging represents a relevant and multifaceted determinant of reproductive outcomes and offspring health. Integrating paternal age and male-specific factors into infertility assessment and counseling may improve clinical decision-making and support preventive strategies aimed at optimizing reproductive success and long-term health consequences.
Prevalence of, and factors associated with, urogenital pelvic floor disorders among women from a refugee-background: A cross-sectional study.
Jahangirifar M, Davis SR, Fooladi E … +1 more , Islam RM
Maturitas · 2026 Jun · PMID 42379080 · Publisher ↗
OBJECTIVES: This study examined the prevalence of and factors associated with urogenital pelvic floor disorders among women from a refugee background in Australia. METHODS: A cross-sectional survey was conducted between...
OBJECTIVES: This study examined the prevalence of and factors associated with urogenital pelvic floor disorders among women from a refugee background in Australia. METHODS: A cross-sectional survey was conducted between February and July 2023 among women aged 18 to 65 years who entered Australia on humanitarian visas. Participants completed questionnaires in English, Arabic, or Persian. Recruitment occurred via community centres in Melbourne, Australia, and social media. Urogenital pelvic floor disorders were defined as any urinary incontinence (stress-only, urge-only, or mixed) or bothersome pelvic organ prolapse symptoms, assessed using the Bristol Female Lower Urinary Tract Symptoms Short Form Questionnaire and the Pelvic Organ Prolapse Distress Inventory-6. Intimate partner abuse was measured using the Woman Abuse Screening Tool. RESULTS: Of 326 participants (median age 40 years), 50.3% (95% confidence interval 44.9 to 55.7%) reported urogenital pelvic floor disorders, including urinary incontinence (44.2%) and bothersome pelvic organ prolapse symptoms (26.5%). Urinary incontinence was associated with bothersome pelvic organ prolapse symptoms (adjusted prevalence ratio 1.7, 95% confidence interval 1.3 to 2.2) and intimate partner abuse (adjusted prevalence ratio 1.5, 95% confidence interval 1.1 to 1.9). Bothersome pelvic organ prolapse symptoms were associated with age (adjusted prevalence ratio 2.8 for 36 to 50 years; adjusted prevalence ratio 2.2 for 51 years or older) and intimate partner abuse (adjusted prevalence ratio 1.8, 95% confidence interval 1.2 to 2.7). Overall, pelvic floor disorders were more likely among women aged 36 to 50 years (adjusted prevalence ratio 1.6), employed women (adjusted prevalence ratio 1.4), and those reporting intimate partner abuse (adjusted prevalence ratio 1.4). CONCLUSION: Urogenital pelvic floor disorders were highly prevalent and associated with age, employment, and intimate partner abuse. These findings underscore the need for culturally responsive care and interventions addressing social determinants among refugee women.
Association of menopausal type and hormone therapy with headache in a large Taiwanese cohort.
Chang SH, Yeh YC, Huang LC … +2 more , Chen SC, Geng JH
Maturitas · 2026 Jun · PMID 42379079 · Publisher ↗
OBJECTIVES: To examine associations of menopausal status, menopause type, and use of hormone replacement therapy with the prevalence of headache. STUDY DESIGN: Cross-sectional, population-based analysis of 14,625 women f...
OBJECTIVES: To examine associations of menopausal status, menopause type, and use of hormone replacement therapy with the prevalence of headache. STUDY DESIGN: Cross-sectional, population-based analysis of 14,625 women from the Taiwan Biobank (2012-2018). Menopausal status, menopause type (natural versus surgical), use of hormone replacement therapy, and headache were self-reported. Multivariable logistic regression models were constructed to estimate associations, adjusting for demographic characteristics, reproductive history, lifestyle factors, comorbidities, and relevant clinical variables. MAIN OUTCOME MEASURES: Self-reported physician-diagnosed headache, overall and stratified by menopausal status (premenopausal versus postmenopausal), menopause type (natural versus surgical), and use of hormone replacement therapy. Associations were quantified using adjusted odds ratios with 95% confidence intervals derived from multivariable logistic regression models. RESULTS: The prevalence of headache was lower among postmenopausal than premenopausal women (22% versus 38%; adjusted odds ratio [OR] 0.82; 95% confidence interval [CI] 0.69-0.96). Natural menopause was independently associated with a significantly lower prevalence of headache (adjusted OR 0.83; 95% CI 0.67-0.98). Surgical menopause demonstrated a similarly significant inverse association (adjusted OR 0.79; 95% CI 0.63-0.98), with a point estimate numerically lower than that of natural menopause. Among postmenopausal women, use of hormone replacement therapy was consistently linked to increased headache: adjusted OR 1.40 (95% CI 1.15-1.71) for natural menopause and adjusted OR 1.95 (95% CI 1.33-2.88) for surgical menopause. CONCLUSIONS: Both natural menopause and surgical menopause were associated with a lower prevalence of headache, whereas use of hormone replacement therapy was associated with a higher prevalence among postmenopausal women. However, the cross-sectional design precludes strong conclusions regarding causal relationships, and these findings should be interpreted with caution.
Depressive symptoms and risk of incident hip fracture in older adults: A harmonized multinational cohort study.
Tu MQ, Yi TP, Tu JY
Maturitas · 2026 Jun · PMID 42364505 · Publisher ↗
BACKGROUND: Hip fracture is a major cause of disability and mortality in older adults. Prior studies examining depression and hip fracture have reported inconsistent findings. We investigated the association between depr...
BACKGROUND: Hip fracture is a major cause of disability and mortality in older adults. Prior studies examining depression and hip fracture have reported inconsistent findings. We investigated the association between depressive symptoms and incident hip fracture among adults aged 60 years or more across multiple countries. METHODS: We conducted a harmonized longitudinal analysis of five population-based cohorts: CHARLS, ELSA, HRS, SHARE, and KLoSA. We fitted cohort-specific Cox proportional hazards models and pooled fully adjusted estimates using fixed- and random-effects meta-analysis. We additionally applied a longitudinal modified treatment policy with a sequential doubly robust estimator and SuperLearner to estimate counterfactual risks under emulated baseline depressive-symptom scenarios. RESULTS: The analytic sample included 46,177 participants (CHARLS 2550; ELSA 4073; HRS 8650; SHARE 25,515; KLoSA 5389), with 1887 incident hip fractures during follow-up. In fully adjusted models, depressive symptoms were associated with higher hip fracture risk in CHARLS (HR 1.78; 95% CI 1.20-2.64), ELSA (HR 1.81; 95% CI 1.22-2.68), HRS (HR 1.62; 95% CI 1.29-2.04), and SHARE (HR 1.33; 95% CI 1.17-1.51), whereas estimates in KLoSA were attenuated (HR 1.12; 95% CI 0.84-1.48). Pooled estimates were HR 1.36 (95% CI 1.23-1.50) under the fixed-effects model and HR 1.41 (95% CI 1.19-1.63) under the random-effects model. LMTP analyses yielded consistently higher odds of subsequent hip fracture under the "all depressive symptoms" scenario in four cohorts, whereas KLoSA showed a nonsignificant increase in hip fracture odds. CONCLUSIONS: Depressive symptoms were associated with a higher subsequent risk of hip fracture in four of five cohorts of older people, with modest pooled effects. Findings in KLoSA were heterogeneous and statistically uncertain despite directionally positive estimates, underscoring the need to clarify cohort- and context-specific sources of variability.
Depressive symptom trajectories around incident hip fracture in older adults: an event-centered matched analysis from the Health and Retirement Study.
Hu H, Shou K
Maturitas · 2026 Jun · PMID 42361712 · Publisher ↗
OBJECTIVE: To examine depressive symptom trajectories around incident hip fracture and determine whether excess burden reflects pre-fracture worsening, peri-fracture change, or post-fracture trajectory differences. METHO...
OBJECTIVE: To examine depressive symptom trajectories around incident hip fracture and determine whether excess burden reflects pre-fracture worsening, peri-fracture change, or post-fracture trajectory differences. METHODS: We used waves 3-13 (1996-2016) of the Health and Retirement Study. Eligible participants were aged 65 years or more, free of baseline hip fracture, and had repeated depressive symptom assessments. Incident hip fracture was defined as the first positive report after a prior negative report. Depressive symptoms were measured using the 8-item Center for Epidemiologic Studies Depression Scale. Cases were matched to controls using coarsened exact matching. Piecewise linear mixed-effects models estimated group differences in pre-event slope, interval-level change around the fracture-reporting interval, and post-event slope. RESULTS: The matched sample included 5098 participants (mean age 75.0 years; 60.3% recorded as female), including 552 incident hip fracture cases and 4546 controls. The main fracture-related difference was an excess increase in depressive symptoms around the fracture-reporting interval (coefficient = 0.249, 95% confidence interval 0.076 to 0.423). This increase was not preceded by a differential pre-event slope (coefficient = 0.001, 95% confidence interval - 0.015 to 0.017), and was followed by a flatter post-event slope (coefficient = -0.041, 95% confidence interval - 0.080 to -0.002). CONCLUSION: Incident hip fracture was associated mainly with an acute worsening in depressive symptoms around the fracture-reporting interval rather than excess pre-fracture deterioration or sustained divergence over longer follow-up. The peri-fracture period may be an important window for psychological assessment and support.
Gut, vaginal, and urinary microbiome alterations in women with genitourinary syndrome of menopause: A systematic review.
Tsuboi I, Inoue S, Hirayama T … +4 more , Mitsui Y, Watanabe M, Hirakawa H, Sadahira T
Maturitas · 2026 Jun · PMID 42341424 · Publisher ↗
BACKGROUND AND OBJECTIVE: Genitourinary syndrome of menopause (GSM) is a chronic condition caused by estrogen deficiency, encompassing vaginal dryness, dyspareunia, and urinary symptoms. Alterations in the vaginal, urina...
BACKGROUND AND OBJECTIVE: Genitourinary syndrome of menopause (GSM) is a chronic condition caused by estrogen deficiency, encompassing vaginal dryness, dyspareunia, and urinary symptoms. Alterations in the vaginal, urinary, and gut microbiome may contribute to GSM pathophysiology. We synthesize the evidence on microbiome composition and diversity across these compartments in postmenopausal women with GSM. METHODS: PubMed, Scopus, and Embase were searched from inception to April 2026 for studies assessing the microbiome in postmenopausal women with GSM using 16S rRNA gene sequencing, metagenomics, or culture-based methods. RESULTS: Twenty-three studies (5027 participants) were included: 15 examined the vaginal microbiome, seven the urinary microbiome, and one the gut microbiome. Postmenopausal women consistently showed reduced Lactobacillus abundance and increased microbial diversity. Estrogen therapy partially restored Lactobacillus dominance but did not uniformly improve symptoms. In the SWAN cohort (n = 1320), sexual pain was the only GSM symptom independently associated with a specific community state type (CST IV-C1; OR 2.26, 95% CI 1.20-4.23). Specific species showed associations with distinct symptom domains: Prevotella with urinary symptoms, Finegoldia magna with recurrent urinary tract infection, and Streptococcus with sexual pain. Parallel Lactobacillus depletion and pathobiont enrichment across all three compartments pointed toward a vaginal-bladder-gut axis, potentially linked through estrobolome disruption and bacterial translocation. CONCLUSION: The postmenopausal genitourinary microbiome is characterized by Lactobacillus depletion and increased diversity, but microbiome restoration alone does not predict symptom resolution. The shared microbial alterations across compartments suggest a vaginal-bladder-gut axis that may collectively drive GSM, but this requires multi-compartment longitudinal validation. PROSPERO registration: CRD420261335478.
Repurposing metformin: is it the new holy grail for longevity?
Grammatikopoulou MG, Lambrinoudaki I
Maturitas · 2026 Jun · PMID 42321033 · Publisher ↗
Abstract loading — click title to view on PubMed.
Patterns of brain activation and hippocampal functional connectivity associated with verbal memory in midlife postmenopausal women.
Wugalter KA, Thurston RC, Wu M … +3 more , Schroeder RA, Aizenstein HJ, Maki PM
Maturitas · 2026 Jun · PMID 42320222 · Publisher ↗
OBJECTIVE: A range of factors may impact cognitive and brain health in postmenopausal women, yet the underlying neural circuitry supporting memory abilities in this population remains unclear. This study characterized no...
OBJECTIVE: A range of factors may impact cognitive and brain health in postmenopausal women, yet the underlying neural circuitry supporting memory abilities in this population remains unclear. This study characterized normative patterns of brain activation and hippocampal functional connectivity associated with verbal memory performance in cognitively normal, midlife postmenopausal women. METHODS: In the MsBrain I cohort (N = 171, mean age = 59.3 years, mean education = 15.7 years, 87.7% white), participants completed neuropsychological (California Verbal Learning Test) and neuroimaging assessments, including a functional magnetic resonance imaging task of verbal encoding and recognition. We evaluated the associations of verbal memory measures with regional activation and hippocampal functional connectivity during verbal encoding. RESULTS: During verbal encoding, greater activation of bilateral prefrontal and medial temporal regions, as well as the precuneus, cuneus, caudate, and cerebellar regions, was associated with better performance on the California Verbal Learning Test. Functional connectivity from both hippocampi to primarily right prefrontal regions during verbal encoding was also associated with better California Verbal Learning Test performance. In-scanner experimental recognition accuracy was more strongly associated with activation of parietal and occipital regions, and with functional connectivity between the right hippocampus and bilateral parietal and temporal regions. CONCLUSIONS: Our findings characterize the normative patterns associated with verbal memory abilities in midlife postmenopausal women. The patterns identified here may act as a foundation for better interpreting the effects of risk and resiliency factors on cognition at midlife, and for informing future interventions aimed at sustaining women's memory function.
On methodological fit and interpretive boundaries in qualitative synthesis within the recent article: How do female healthcare staff experience the menopause transition in the workplace? A critical meta-synthesis.
Wilson R, Cronin C, Donevant S … +3 more , Hughes KA, Kaunonen M, Marcussen J
Maturitas · 2026 Jun · PMID 42320221 · Publisher ↗
Abstract loading — click title to view on PubMed.
Authors' reply to Rhonda Wilson et al.
Hughes T, Robertson N
Maturitas · 2026 Jun · PMID 42315395 · Publisher ↗
Abstract loading — click title to view on PubMed.
The genitourinary syndrome of menopause is associated with significant impact on work ability among Chinese-speaking sex workers: a cross-sectional survey.
Jones E, Wong A, Ma M … +4 more , Xu L, Jordan K, Foster R, Broady TR
Maturitas · 2026 Jun · PMID 42314595 · Publisher ↗
OBJECTIVES: Midlife women in the sex industry may be uniquely impacted by the genitourinary syndrome of menopause (GSM) because of the nature of their work. However, there is little research in the area. This study inves...
OBJECTIVES: Midlife women in the sex industry may be uniquely impacted by the genitourinary syndrome of menopause (GSM) because of the nature of their work. However, there is little research in the area. This study investigates the prevalence and severity of GSM in a cohort of Chinese-speaking sex workers (SWs) and determines associations between symptom severity and impact on work and life. STUDY DESIGN: This cross-sectional study was conducted at the Sydney Sexual Health Centre (SSHC) in New South Wales, Australia. Chinese-speaking female SWs aged ≥45 years were invited to participate on attendance at SSHC clinics. Participants completed an anonymous online survey translated into Simplified Chinese. MAIN OUTCOME MEASURES: Measures included an abbreviated Personal Wellbeing Index; a modified Greene Climacteric Scale; and Domains A and B of the Genitourinary Syndrome of Menopause Symptoms and Vaginal Treatment Acceptability Questionnaire. RESULTS: The prevalence of GSM among peri- and post-menopausal participants was 83·1% (n = 49/59). Over half of those with GSM reported moderate to severe symptoms (n = 29/49; 59·2%). Loss of libido (n = 42/53; 79·3%), loss of lubrication (n = 43/55; 78·2%), and vaginal dryness (n = 44/57; 77·2%) were most prevalent. Higher severity of GSM was significantly associated with lower job satisfaction (24·1% vs 63·3%; p = 0·002) and reduced ability to work (92·9% vs 64·3%; p = 0·009). CONCLUSION: GSM is highly prevalent among Chinese-speaking female SWs attending SSHC. Reducing symptom severity may significantly improve the personal and professional lives of menopausal SWs. SW-specific services should be designed - in collaboration with peer-led organisations - to provide culturally competent and accessible GSM-related care.
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