Maturitas[JOURNAL]
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200 papers
Evaluation of breast risk at menopause: what impact on the use of menopausal hormone therapy?
Rodrigues MAH, Gompel A
Maturitas · 2026 May · PMID 42202686 · Publisher ↗
A key concern with menopausal hormone therapy is the potential duration-dependent increase in breast cancer risk. Despite using progestogens (micronized progesterone and dydrogesterone), associated with the lowest risk,...
A key concern with menopausal hormone therapy is the potential duration-dependent increase in breast cancer risk. Despite using progestogens (micronized progesterone and dydrogesterone), associated with the lowest risk, a slight increase in risk is still observed over 6 years of treatment. This increase in breast cancer concerns estradiol receptor-positive breast cancers and is consistent with a promoter effect on preexisting lesions. It is thus recommended to select patients according to their level of breast cancer risk before indicating menopause hormone therapy or preferring nonhormonal alternatives. A very high risk is being a carrier of a pathogenic variant or having a strong history of breast cancer in the family that occurs at a young age. Women biopsied with atypical hyperplasia, having benefited from thoracic radiotherapy at a young age, or with high breast density, are also at high risk of breast cancer. Lower-risk factors include reproductive and lifestyle factors. Some scores can, albeit imperfectly, help evaluate a woman's risk category and the probability of carrying a pathogenic variant. The IBIS score, Gail score, and CANrisk are the most commonly used tools for risk stratification. Various scientific societies have based their recommendations on the limitations of menopausal hormone therapy, depending on risk category. Discussions with the patient and lifestyle improvements can help modulate and tailor these recommendations.
Associations of accelerated phenotypic aging, genetic risk and lifestyle with incident asthma, subsequent cardiovascular disease and death: A prospective study using multi-state model.
Liu F, Pan L, Wu H … +1 more , Yu Y
Maturitas · 2026 Jul · PMID 42184546 · Publisher ↗
OBJECTIVES: To investigate the associations of phenotypic age acceleration (PhenoAgeAccel) with the risk of dynamic progression of asthma, and whether genetic risk and lifestyle influence these associations. STUDY DESIGN...
OBJECTIVES: To investigate the associations of phenotypic age acceleration (PhenoAgeAccel) with the risk of dynamic progression of asthma, and whether genetic risk and lifestyle influence these associations. STUDY DESIGN: This prospective cohort study included 320,337 adults without asthma and cardiovascular disease (CVD) from the UK Biobank. PhenoAgeAccel was calculated from chronological age and nine clinical biomarkers, and categorized into two groups: biologically younger (negative value) and biologically older (positive value). MAIN OUTCOME MEASURES: The primary outcomes were incident asthma, CVD, and all-cause mortality. A multi-state model was used to estimate the hazard ratios (HRs) of these associations. RESULTS: During a median 13.69-year follow-up, 9073 participants developed asthma, of whom 2061 subsequently developed CVD, and 23,401 died. Compared with biologically younger participants, biologically older participants had significantly higher risks for all transitions: from healthy to asthma (HR 1.29, 95% CI 1.23-1.34) and death (1.59, 1.54-1.63), from asthma to post-asthma CVD (1.28, 1.17-1.40) and death (1.37, 1.09-1.71), and from post-asthma CVD to death (1.44, 1.17-1.76). Biologically older participants with high genetic risk had higher risks of asthma (2.71, 2.46-2.98) and post-asthma CVD (1.91, 1.57-2.33) than biologically younger participants with low genetic risk. Compared with biologically younger participants with favorable lifestyles, biologically older participants with unfavorable lifestyles had higher risks of all transitions, with HRs ranging from 1.56 (1.21-2.02) to 3.43 (3.18-3.69). CONCLUSIONS: PhenoAgeAccel was significantly associated with increased risks of all disease-state transitions. It could be combined with genetic risk to identify participants at high risk for asthma and its adverse progression, potentially guiding targeted preventive interventions.
Heterogeneity and clinician typologies in menopause management: Insights from a European survey and latent class analysis.
Pakpahan C, Castelo-Branco C, Menopause free-hormone management group of the European Society of Gynecology (ESG)
Maturitas · 2026 Jul · PMID 42177904 · Publisher ↗
OBJECTIVES: To investigate clinical practice characteristics, perceived barriers, and prescribing typologies in the management of menopause among clinicians, with a particular focus on menopausal hormone therapy (MHT). S...
OBJECTIVES: To investigate clinical practice characteristics, perceived barriers, and prescribing typologies in the management of menopause among clinicians, with a particular focus on menopausal hormone therapy (MHT). STUDY DESIGN: A survey-based observational study was conducted using a 26-item questionnaire assessing physician demographics, clinical practice settings, and prescribing patterns for menopausal patients. MAIN OUTCOME MEASURES: Primary outcomes included the extent of MHT prescribing (categorized into ordinal groups), reasons for non-prescription, and types of therapies used in clinical practice. Secondary outcomes included clinician typologies identified through latent class analysis. RESULTS: A total of 361 physicians participated in the study. MHT prescribing patterns varied substantially across respondents. In multivariable ordinal regression (Model 1), clinicians practicing in purely private healthcare systems were less likely to report higher MHT use than those in national health systems. In Model 2, perceived barriers such as fear of cancer were associated with lower MHT prescribing in univariable analysis, although these associations were attenuated after adjustment. Latent class analysis identified three distinct clinician typologies: (1) proactive/guideline-aligned prescribers, (2) pragmatic clinicians with balanced use of hormonal and non-hormonal therapies, and (3) conservative or risk-averse clinicians with limited MHT use. CONCLUSIONS: MHT prescribing in menopause management is shaped more by structural and system-level factors than by individual clinician characteristics alone. While concerns such as cancer risk remain relevant, they do not independently explain prescribing behavior when considered alongside other factors. Distinct clinician typologies highlight substantial heterogeneity in practice, underscoring the need for targeted strategies to improve guideline-concordant menopause care.
The midlife health penalty: A systematic review and meta-analysis of loneliness and health-related quality of life in adults aged 40-65.
Ugwu LE, White JA, Hlungwani TM
Maturitas · 2026 Jul · PMID 42176606 · Publisher ↗
Loneliness is a recognised determinant of morbidity and mortality in older populations, but its association with health-related quality of life during middle adulthood remains less clearly defined. This systematic review...
Loneliness is a recognised determinant of morbidity and mortality in older populations, but its association with health-related quality of life during middle adulthood remains less clearly defined. This systematic review and meta-analysis quantified the association between loneliness and mental and physical health-related quality of life among community-dwelling adults aged 40-65 years and examined whether associations varied by study design and demographic characteristics. Observational cross-sectional and longitudinal studies were identified through electronic searches of EBSCOhost, ScienceDirect, Scopus, and Web of Science, supplemented by citation chaining. Seventeen independent studies were included. Random-effects models showed that loneliness was associated with poorer mental health-related quality of life (pooled correlation 0.42; 95% confidence interval 0.35 to 0.49) and poorer physical health-related quality of life (pooled correlation 0.19; 95% confidence interval 0.12 to 0.26). Heterogeneity was substantial in both domains, indicating that pooled estimates should be interpreted as average associations across diverse populations, measures, and outcomes. Study design moderated mental health findings, with longitudinal studies showing stronger associations than cross-sectional studies. Gender composition and the prevalence of marriage or partnership also explained some of the between-study variation. Evidence for small-study effects was mixed. Findings suggest that loneliness in midlife is meaningfully associated with poorer mental and physical health-related quality of life, although stronger longitudinal and cross-cultural evidence is needed. Midlife loneliness assessment may be considered as part of a broader psychosocial risk evaluation.
Common dermatologic conundrums in breast health: Distinguishing benign from serious conditions.
Srinivasan N, Vidimos AT
Maturitas · 2026 Jul · PMID 42173002 · Publisher ↗
Dermatological conditions of the breast encompass a wide range of inflammatory, infectious, and neoplastic disorders. Cutaneous findings in the breast present unique diagnostic challenges for clinicians, particularly in...
Dermatological conditions of the breast encompass a wide range of inflammatory, infectious, and neoplastic disorders. Cutaneous findings in the breast present unique diagnostic challenges for clinicians, particularly in distinguishing between benign and serious or malignant conditions. This review highlights common diagnostic dilemmas faced by healthcare providers, specifically addressing inflammatory and infectious conditions mimicking serious diseases like inflammatory breast cancer, radiation dermatoses, eczematous nipple-areolar complex dermatoses, and pigmented and neoplastic lesions. This review emphasizes clinical features to distinguish benign from malignant conditions and outlines appropriate referral and biopsy strategies when diagnosis is uncertain. Recognizing distinctive dermatological patterns in breast tissue can improve diagnostic accuracy, facilitate appropriate specialist referral, and optimize patient outcomes, particularly during midlife transitions when dermatological and breast health concerns frequently intersect.
Frailty and risk of incident psoriasis: Prospective UK Biobank evidence with inflammatory, genetic, and proteomic analyses.
Deng P, Cao Z, Yan S … +1 more , Lu J
Maturitas · 2026 Jul · PMID 42173001 · Publisher ↗
OBJECTIVES: Frailty is associated with numerous chronic conditions, but its relationship with psoriasis remains poorly understood. This study investigated whether baseline frailty predisposes individuals to incident psor...
OBJECTIVES: Frailty is associated with numerous chronic conditions, but its relationship with psoriasis remains poorly understood. This study investigated whether baseline frailty predisposes individuals to incident psoriasis. Secondary analyses evaluated inflammatory markers, shared genetic architecture, and circulating proteins as supporting evidence to contextualize this association. STUDY DESIGN: Baseline frailty was assessed using both the physical frailty phenotype and a multidimensional frailty index, classifying participants as non-frail, pre-frail, or frail. Cox proportional hazards models with stratified analyses were used to quantify associations with psoriasis onset. Multi-marker Analysis of Genomic Annotation was applied to identify genes common to both frailty and psoriasis. To examine causality, we employed two-sample and generalized summary-data-based Mendelian randomization. Additionally, circulating inflammatory markers and plasma proteomic data were analyzed as secondary exploratory analyses to identify candidate biological correlates rather than to establish definitive mechanisms. RESULTS: Compared with non-frail individuals, both pre-frail and frail participants had a higher risk of developing psoriasis. Specifically, pre-frail individuals had hazard ratios of 1.22 (95% confidence intervals 1.13-1.32) for physical frailty and 1.40 (95% confidence intervals 1.30-1.52) for the frailty index. Frail participants had hazard ratios of 1.42 (95% confidence intervals 1.18-1.73) and 1.87 (95% confidence intervals 1.62-2.15), respectively, with stronger associations observed in those with higher polygenic risk scores (P for interaction <0.05). Gene analysis identified 81 genes shared between frailty and psoriasis, providing supporting evidence of overlapping genetic architecture. Circulating inflammatory markers, such as neutrophil count and C-reactive protein, were found to partially mediate the frailty-psoriasis relationship, with mediating effects ranging from 0.89% to 18.21%. Proteomic analyses identified PCSK9 as a potential candidate protein associated with psoriasis risk in frail individuals. CONCLUSIONS: Overall, frailty was associated with an increased long-term risk of psoriasis, particularly in participants with higher genetic susceptibility. Inflammatory cell measures and circulating proteins, including PCSK9, should be interpreted as potential candidate markers requiring further validation in pre-frail and frail populations.
Fractional CO₂ laser monotherapy versus combination therapy with vaginal oestrogen for genitourinary syndrome of menopause: A prospective observational cohort study conducted over two years.
Da Silva AS, Taylor AA
Maturitas · 2026 Jul · PMID 42167065 · Publisher ↗
OBJECTIVE: To prospectively evaluate symptom outcomes following micro-ablative fractional carbon dioxide laser therapy for genitourinary syndrome of menopause, and to explore whether concomitant use of topical vaginal oe...
OBJECTIVE: To prospectively evaluate symptom outcomes following micro-ablative fractional carbon dioxide laser therapy for genitourinary syndrome of menopause, and to explore whether concomitant use of topical vaginal oestrogen is associated with additional improvement. DESIGN: Postmenopausal women presenting with symptoms consistent with genitourinary syndrome of menopause were enrolled in a prospective observational cohort study undertaken in routine clinical practice over a two-year period. Participants received fractional carbon dioxide laser therapy either alone or alongside topical vaginal oestrogen. Symptom severity was recorded at baseline and reassessed four weeks after completion of the treatment course using a ten-point visual analogue scale across six symptom domains. RESULTS: Seventy-two participants were included (mean age 61 years). Significant improvements were observed across all symptom domains following laser therapy. Painful sexual intercourse demonstrated the greatest reduction, with scores improving from 5.67 to 2.33 (p < 0.001). Vaginal dryness, burning, itching, pain, and dysuria also improved significantly (p < 0.001). Participants using concomitant topical vaginal oestrogen showed slightly greater improvements in dryness and dyspareunia, although these differences were not statistically significant. CONCLUSION: Fractional carbon dioxide laser therapy was associated with significant symptom improvement at short-term follow-up after treatment completion in this clinical cohort. No statistically significant additional benefit was observed with concomitant topical vaginal oestrogen, although confounding by indication cannot be excluded and the study had limited power. Larger randomised sham-controlled trials with longer follow-up are required to determine comparative efficacy and durability of response.
Healthy living concepts and definitions: A systematic review with concept analysis proposing a four-dimensional model.
Trujillo-Cáceres SJ, Roa-Díaz ZM, Figueroa CP … +9 more , Hernández Vargas JA, Rojas LZ, Aceros Lora AM, Raeisi-Dehkordi H, Beigrezaei S, Artola Arita V, Verschuren WMM, Menassa M, Franco OH
Maturitas · 2026 Jul · PMID 42167064 · Publisher ↗
INTRODUCTION: Despite numerous definitions and theoretical models, healthy living remains conceptually fragmented, lacking a unified framework capturing its dynamic, multilevel, and life-course nature. We systematically...
INTRODUCTION: Despite numerous definitions and theoretical models, healthy living remains conceptually fragmented, lacking a unified framework capturing its dynamic, multilevel, and life-course nature. We systematically identify and conceptually analyse definitions and theoretical models of healthy living (1) to characterise heterogeneity in definitions, dimensions, antecedents, and consequences, (2) to develop a typology, and (3) to propose a unifying conceptual model. METHODS: We conducted a systematic review with an embedded concept analysis. Embase, Medline, Cochrane Central, Web of Science, CINAHL, LILACS, and Google Scholar were searched from inception to May 18, 2025, without restrictions, following PRISMA 2020 guidelines. Eligible studies included conceptual analyses or theoretical models explicitly defining healthy living; empirical studies without conceptual grounding were excluded. Systematic review methods governed study identification, selection, and data extraction. Following this mapping stage, the Walker and Avant framework was applied to synthesise attributes, antecedents, and consequences, integrated with iterative thematic analysis. RESULTS: Of 10,067 records screened, 36 studies (1991-2025; 18 countries) were included. Definitions and theoretical justifications were highly heterogeneous. Nine conceptual dimensions and six categories of antecedents emerged, with most models emphasising physical, behavioural, and cognitive dimensions and individual-level determinants, while interactions across dimensions were rarely specified. Five major model types and ten subtypes emerged. We define healthy living as a dynamic, multidimensional life-course process integrating behavioural-physical, cognitive-psychological, social-relational, and contextual-structural dimensions. CONCLUSION: This study addresses longstanding conceptual fragmentation and proposes a four-dimensional model of healthy living, providing a foundation for theory, measurement, intervention design, and policy.
The impact of poor sleep on women's midlife transition: A qualitative study using interpretative phenomenological analysis.
Perafan MM, Simpson EEA
Maturitas · 2026 Jul · PMID 42155378 · Publisher ↗
BACKGROUND: Sleep disturbance is a common and distressing symptom of the menopausal transition, and the lived experiences of women with regard to its cognitive, emotional, personal, and professional impacts need further...
BACKGROUND: Sleep disturbance is a common and distressing symptom of the menopausal transition, and the lived experiences of women with regard to its cognitive, emotional, personal, and professional impacts need further exploration. This study examined midlife women's experiences of poor sleep and its impact on daily functioning, family life, and work. METHODS: A qualitative study was undertaken with six cisgender women aged 45-55 years who self-reported poor sleep linked to menopause. Semi-structured online interviews were transcribed verbatim and analysed following guidelines for interpretative phenological analysis. RESULTS: Five themes were identified: the physical, cognitive, and emotional consequences of sleep loss; efforts to regain control through routines and trial-and-error coping; the influence of poor sleep on family relationships and identity; workplace strain and reduced capacity; and, rooted in strength, the unseen battle of women's persistence, resilience, and hope. Women described poor sleep as profoundly affecting daily life, reducing cognition, energy, and confidence, and contributing to irritability. These difficulties stretched relationships and undermined work performance. Although participants showed resilience, they often relied on trial-and-error strategies due to inconsistent professional guidance. CONCLUSION: Fragmented healthcare support and limited workplace understanding of sleep disturbance during menopause highlight the need for routine clinical screening, clearer care pathways, and supportive occupational environments. Further research requires more diverse groups of women, exploring structural barriers such as difficulty accessing specialist menopause care, delays in appointments, prescription costs, and workplace stigma to support more equitable and accessible interventions for women experiencing menopause-related sleep disruption.
The effect of childhood body weight status on cardiovascular disease risk in adulthood: A narrative review.
Siolos P, Mastoropoulou A, Anagnostis P
Maturitas · 2026 Jul · PMID 42155377 · Publisher ↗
The prevalence of obesity among children and adolescents is rising alarmingly worldwide; however, its long-term effect on adult cardiovascular health is still underestimated. A considerable body of evidence suggests a de...
The prevalence of obesity among children and adolescents is rising alarmingly worldwide; however, its long-term effect on adult cardiovascular health is still underestimated. A considerable body of evidence suggests a detrimental effect of childhood obesity on the risk of cardiovascular disease (CVD) in adulthood. This is mostly indicated by an increased prevalence of arterial hypertension and type 2 diabetes mellitus. Longitudinal cohort studies have shown that persistent obesity from childhood to adulthood markedly amplifies these risks, whereas normalization of body mass index (BMI) during puberty can mitigate these adverse outcomes. Childhood obesity is also linked to subclinical atherosclerosis, as indicated by increased carotid intima-media thickness, and to increased left ventricular mass; however, its independent effect on overt CVD - that is, coronary heart disease (CHD), stroke, heart failure - remains less clear and is often confounded by adult BMI. In any case, it is evident that sustained high BMI from childhood to adulthood increases CVD morbidity and mortality. On the other hand, childhood underweight and undernutrition may have the same adverse long-term impact on CVD risk factors in adulthood as seen with childhood obesity. Moreover, early-life undernutrition combined with adult obesity further elevates these risks, especially for CHD. Taken together, these findings highlight the critical role of weight status during early development and necessitate early intervention strategies from childhood in order to reduce long-term CVD risk.
A mechanistic digital twin of ovarian aging integrating follicular dynamics, mitochondrial decline, and lifestyle perturbations.
Vallée A, Feki A, Poulain M … +1 more , Ayoubi JM
Maturitas · 2026 Jul · PMID 42150275 · Publisher ↗
BACKGROUND: Ovarian aging determines reproductive lifespan, yet the mechanisms driving inter-individual variability remain incompletely understood. We developed a mechanistic digital twin to investigate how follicular dy...
BACKGROUND: Ovarian aging determines reproductive lifespan, yet the mechanisms driving inter-individual variability remain incompletely understood. We developed a mechanistic digital twin to investigate how follicular dynamics, mitochondrial energetics, and lifestyle-related oxidative stress jointly shape hormonal trajectories and menopause timing. METHODS: A system of stochastic differential equations modeled primordial follicle depletion, granulosa cell growth, AMH secretion, mitochondrial decline, and the accumulation of reactive oxygen species (ROS). Smoking, obesity, and circadian disruption modulated oxidative and inflammatory pathways. We simulated 1000 digital twins from ages 18-25 until menopause (AMH <0.1 ng/mL). Monthly outputs included AMH, gonadotropins, estradiol, progesterone, mitochondrial function, ROS, and lifestyle exposures. Parameter uncertainty and key drivers were assessed using posterior sampling and Sobol sensitivity indices. RESULTS: Simulations reproduced hallmark features of ovarian aging, including exponential AMH decline with realistic values (6.4 ng/mL at 25 years, 1.5 at 35, 0.7 at 40), widening inter-individual divergence after age 40, loss of endocrine cyclicity, and a right-skewed menopause age distribution (median ≈47 years). Mitochondrial function declined progressively while ROS accumulated, forming a tightly coupled aging axis. Lifestyle perturbations produced differentiated effects consistent with epidemiological evidence. Smoking exerted the strongest impact, advancing AMH depletion by approximately 1.5-2 years. Obesity induced chronic low-grade inflammation with modest mitochondrial impairment. Circadian disruption destabilized steroid hormone rhythms and advanced AMH decline by approximately 1 year. CONCLUSION: This mechanistic digital twin captures realistic endocrine aging patterns and quantifies how modifiable lifestyle factors accelerate ovarian aging through mitochondrial and oxidative pathways, enabling an individualized prediction of reproductive aging.
Can isometric exercise training improve arterial stiffness and endothelial function in middle-aged and older adults? A systematic review and meta-analysis of randomized controlled trials.
Li Z, Tan S, Luo P
Maturitas · 2026 Jul · PMID 42114354 · Publisher ↗
OBJECTIVE: To evaluate the effects of isometric exercise training (IET) on arterial stiffness (AS) and endothelial function (EF) in middle-aged and older adults through a systematic review and meta-analysis. METHODS: We...
OBJECTIVE: To evaluate the effects of isometric exercise training (IET) on arterial stiffness (AS) and endothelial function (EF) in middle-aged and older adults through a systematic review and meta-analysis. METHODS: We systematically searched PubMed, Cochrane Library, Embase, and Web of Science databases (up to January 1, 2026) for randomized controlled trials (RCTs) investigating the effects of IET on pulse wave velocity (PWV), augmentation index (AIx), or flow-mediated dilation (FMD) in adults aged 45 years or more. Effect sizes were pooled using random- or fixed-effects models to calculate weighted mean differences (WMD) with 95% confidence intervals (CI). RESULTS: Ten RCTs with a total of 375 participants were included. Meta-analysis revealed that IET significantly reduced central PWV (WMD -1.06 m/s, 95% CI -1.58 to -0.54, P < 0.01) and AIx (WMD -4.85%, 95% CI -9.43 to -0.26, P = 0.03), and significantly improved FMD (WMD 2.87%, 95% CI 1.79 to 3.95, P < 0.01). However, no significant effect was observed on peripheral PWV (WMD 0.08 m/s, 95% CI -0.07 to 0.23, P = 0.45). CONCLUSION: IET effectively improves central AS and EF in middle-aged and older adults. This study provides a novel intervention strategy and evidence-based support for optimizing cardiovascular health management in this population, particularly for those intolerant of traditional exercise modalities.
Associations of food insecurity with all-cause and cardiovascular mortality in postmenopausal women.
Wei J, Liu Y, Xu Y
Maturitas · 2026 Jun · PMID 42105714 · Publisher ↗
BACKGROUND: Food insecurity is an important public health issue, with recognized cardiometabolic consequences, yet its long-term mortality impact in postmenopausal women is not well understood. This study investigated th...
BACKGROUND: Food insecurity is an important public health issue, with recognized cardiometabolic consequences, yet its long-term mortality impact in postmenopausal women is not well understood. This study investigated the associations between food insecurity and all-cause and cardiovascular mortality in postmenopausal Non-Hispanic White and Non-Hispanic Black women. METHODS: We analyzed data from the National Health and Nutrition Examination Survey 2005-2016, linked to National Death Index records. The final cohort included 4113 postmenopausal women aged 45-75 years with complete data regarding food insecurity and mortality. All-cause mortality was the primary outcome; cardiovascular mortality was secondary. Survey-weighted Cox models estimated hazard ratios, supplemented by multivariable and propensity-score sensitivity analyses. Mediation analysis evaluated indirect effects of red cell distribution width and the systemic inflammation response index. RESULTS: Food insecurity was associated with higher all-cause mortality (adjusted hazard ratio 1.30, 95% confidence interval 1.02-1.66). Among the four levels of food insecurity severity, very low food security showed the strongest associations, with increased risks of all-cause mortality (hazard ratio 1.54, 95% confidence interval 1.11-2.14) and cardiovascular mortality (hazard ratio 1.97, 95% confidence interval 1.10-3.52). Propensity-score analyses supported the overall direction of these findings. Mediation analyses suggested that red cell distribution width and systemic inflammation response index accounted for approximately 8-9% of the observed association between food insecurity and all-cause mortality. CONCLUSION: Food insecurity may be associated with increased all-cause mortality among postmenopausal women. Red cell distribution width and systemic inflammation response index accounted for a modest proportion of the observed association with all-cause mortality.
Psychosocial impacts of spontaneous and medically induced premature ovarian insufficiency and early menopause: A systematic review and thematic synthesis of qualitative studies.
Minchin E, Laidsaar-Powell R, Kirsten L … +4 more , Atwell J, Dewar E, Gilchrist J, Juraskova I
Maturitas · 2026 Jun · PMID 42102512 · Publisher ↗
In addition to physical symptoms, Premature Ovarian Insufficiency and Early Menopause may contribute to a range of psychosocial concerns, including when they are induced by surgical or chemical treatments for cancer and...
In addition to physical symptoms, Premature Ovarian Insufficiency and Early Menopause may contribute to a range of psychosocial concerns, including when they are induced by surgical or chemical treatments for cancer and other health conditions. However, their psychosocial impacts have not been specifically or comprehensively examined, and comparison of experiences between spontaneous and induced Premature Ovarian Insufficiency/Early Menopause is lacking. This systematic review synthesised the findings from qualitative research exploring psychosocial difficulties associated with early experiences of menopause. Similarities and differences between spontaneous and induced Premature Ovarian Insufficiency/Early Menopause are considered, the latter especially amongst cancer survivors. Five databases and reference lists were searched, and 22 articles were reviewed. Thematic synthesis identified (i) 'Intra-personal impacts' and (ii) 'Inter-personal impacts' as central themes pertaining to the psychosocial experience of Premature Ovarian Insufficiency/Early Menopause, along with (iii) 'Contextual factors' that shaped how these impacts were experienced. Overall, Premature Ovarian Insufficiency/Early Menopause was associated with complex and evolving psychosocial challenges affecting emotional wellbeing, sense of self, bodily perception and inter-personal relationships. For those with induced Premature Ovarian Insufficiency/Early Menopause, particularly following cancer, such impacts were experienced as interwoven with, and compounding, the broader illness and survivorship experience. Psychosocial experiences were shaped by various personal, socio-cultural and systemic factors, including stigma and the availability and quality of support. These findings highlight the need for future targeted research to ensure the psychosocial needs of individuals with Premature Ovarian Insufficiency/Early Menopause, including in the oncology context, are appropriately addressed.
The effect of hormone therapy on vaginal microbiota in women with genitourinary syndrome of menopause: A double-blind, randomized, placebo-controlled trial.
Panyakhamlerd K, Rungruxsirivorn T, Panichaya P … +7 more , Nimitpanya P, Payungporn S, Ariyasriwatana C, Suwan A, Visedthorn S, Ruengket P, Tanprasertkul C
Maturitas · 2026 Jun · PMID 42097107 · Publisher ↗
This double-blind, randomized, placebo-controlled trial investigated the effects of oral combined menopausal hormone therapy (MHT) on vaginal microbiota and clinical outcomes in postmenopausal women with genitourinary sy...
This double-blind, randomized, placebo-controlled trial investigated the effects of oral combined menopausal hormone therapy (MHT) on vaginal microbiota and clinical outcomes in postmenopausal women with genitourinary syndrome of menopause (GSM). Thirty-four healthy postmenopausal women aged 40-60 years with moderate to severe GSM were randomized to receive either oral estradiol 1 mg/dydrogesterone 5 mg (Femoston conti®) or placebo daily for 12 weeks. Vaginal microbiota was assessed at baseline and week 12 using 16S rDNA gene sequencing. Clinical outcomes, including the most bothersome symptom (MBS), vaginal atrophy score (VAS), vaginal pH, vaginal health index (VHI) and vaginal maturation value (VMV), were evaluated at baseline, week 6, and week 12. The MHT group demonstrated significant more improvement in all clinical measures compared with placebo: MBS (p = 0.008), VAS (p < 0.001), vaginal pH (p = 0.001), VHI (p < 0.001) and VMV (p < 0.001). However, no significant differences were observed in microbial composition or diversity between groups after treatment. These findings suggest that while systemic hormone therapy provides meaningful symptom relief and improves vaginal tissue health, these clinical benefits can occur without concurrent, statistically significant changes in the vaginal microbiota. This supports the clinical value of early systemic MHT in managing GSM, even in the absence of microbiome restoration.
Comparative efficacy of various exercise modalities on blood pressure in patients with metabolic syndrome: A systematic review and dose-response network meta-analysis of randomized controlled trials.
Zhang Y, Li D, Tan Z … +1 more , Chen X
Maturitas · 2026 Jun · PMID 42097106 · Publisher ↗
This study investigated the dose-response relationships between different exercise modalities and blood pressure in individuals with metabolic syndrome. The review was conducted in accordance with PRISMA-NMA guidelines....
This study investigated the dose-response relationships between different exercise modalities and blood pressure in individuals with metabolic syndrome. The review was conducted in accordance with PRISMA-NMA guidelines. Electronic databases, including PubMed, Web of Science, Embase, and the Cochrane Central Register of Controlled Trials, were systematically searched for randomized controlled trials. Bayesian network and dose-response meta-analyses were performed. A total of 28 studies were included, with a total of 2084 participants, of whom 49.5% were women, with a mean age of 55 (standard deviation = 7.03) years and a mean body mass index of 31.68 (standard deviation = 3.62) kg/m. Aerobic exercise, combined aerobic and resistance training, mind-body exercise, and high-intensity interval training were significantly associated with reductions in systolic blood pressure. High-intensity interval training at 690 metabolic equivalent minutes per week was the most effective modality and dose (-5.07 mmHg, 95% CrI -9.20, -0.92). For diastolic blood pressure, both aerobic exercise and high-intensity interval training were significantly associated with reductions, with high-intensity interval training at 830 metabolic equivalent minutes per week showing the greatest effect (-4.42 mmHg, 95% CrI -8.4, -0.33). Subgroup analyses suggested greater effects among participants with hypertension and in interventions lasting ≥16 weeks. This dose-response network meta-analysis identified nine exercise prescriptions for effective blood pressure management in metabolic syndrome. Further studies are needed to validate the recommended dose ranges. PROSPERO REGISTRATION NUMBER: CRD420261288594.
Non-exercise estimated cardiorespiratory fitness and incident diabetes in middle-aged and older adults: a cross-cultural comparative cohort study using data from CHARLS and ELSA.
Chen Z, Zhao F, Li S
Maturitas · 2026 Jun · PMID 42090941 · Publisher ↗
BACKGROUND: The cross-cultural association between non-exercise estimated cardiorespiratory fitness (eCRF) and incident diabetes remains unclear. We investigated this association and its modifiers in Chinese and British...
BACKGROUND: The cross-cultural association between non-exercise estimated cardiorespiratory fitness (eCRF) and incident diabetes remains unclear. We investigated this association and its modifiers in Chinese and British middle-aged and older adults. METHODS: This prospective analysis examined 8399 diabetes-free participants, including 3742 adults aged ≥45 years from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2018) and 4657 adults aged ≥50 years from the English Longitudinal Study of Ageing (ELSA, 2012-2019). eCRF was calculated via a validated non-exercise algorithm. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident diabetes, with adjustment for sociodemographic, lifestyle and clinical confounders. RESULTS: Over approximately seven years of follow-up, 478 and 248 cases of incident diabetes occurred in CHARLS and ELSA, respectively. Higher eCRF was linked to lower diabetes risk in both cohorts (P-trend <0.001), with a clear dose-response relationship. Per 1-MET eCRF increment, the adjusted diabetes risk reduced by 32% (HR 0.68, 95% CI 0.58-0.79) in CHARLS and 36% (HR 0.64, 95% CI 0.53-0.78) in ELSA. Subgroup heterogeneity was observed: in CHARLS, associations were stronger in men, those aged <60, and non-obese individuals; in ELSA, effects were consistent by sex/age but significant only in obese individuals and drinkers. CONCLUSIONS: Higher eCRF is independently associated with lower diabetes risk in both populations. The significant cross-population differences in effect modifiers identified in this study suggest that global strategies to improve cardiorespiratory fitness for diabetes prevention should be tailored to population-specific characteristics for maximum impact.
Effectiveness of non-pharmacological interventions for insomnia related to natural menopause: A meta-analysis of randomized controlled trials.
Luo R, Zhu J, Yang J
Maturitas · 2026 Jun · PMID 42090940 · Publisher ↗
Insomnia is common in the general population and is more prevalent in menopausal women. This meta-analysis synthesized and assessed the effect of non-pharmacological interventions for insomnia related to natural menopaus...
Insomnia is common in the general population and is more prevalent in menopausal women. This meta-analysis synthesized and assessed the effect of non-pharmacological interventions for insomnia related to natural menopause. Comprehensive searches for randomized controlled trials were conducted across multiple databases from inception to February 2025, including PubMed, Web of Science, Embase, and the Cochrane Library. Sleep quality was evaluated with the Pittsburgh Sleep Quality Index, and insomnia was evaluated with the Insomnia Severity Index. The risk of bias was evaluated with the revised Cochrane RoB 2 tool, and random effects models were used for meta-analyses. Twenty-two studies with a total of 1648 participants were analyzed. Non-pharmacological interventions significantly reduced PSQI and ISI scores. In a subgroup analysis, cognitive behavioral therapy, exercise, acupuncture, acupressure, and integrated interventions all improved low sleep quality in women after natural menopausal (cognitive behavioral therapy: MD -3.38, 95% CI -4.15 to -2.62, P < 0.01, heterogeneity I = 0%, P = 0.67; exercise: MD -1.17, 95% CI -1.88 to -0.47, P < 0.01; heterogeneity I = 24%, P = 0.27; acupuncture: MD -6.25, 95% CI -7.64 to -4.87, P < 0.01, heterogeneity I = 22%, P = 0.26; self-administered acupressure: MD -2.26, 95% CI -3.10 to -1.43, P < 0.01, heterogeneity I = 0%, P = 0.38; nurse-administered acupressure: MD -7.61, 95% CI -8.30 to -6.93, P < 0.01, heterogeneity I = 0%, P = 0.74; integrated interventions MD -2.89, 95% CI -3.67 to -2.12, P < 0.01, heterogeneity I = 33%, P = 0.19). The sensitivity analysis indicated that these findings are robust. They suggest that non-pharmacological interventions are preferred options for managing insomnia related to natural menopause and may be beneficial for patients who refuse to use hypnotic medications or hormone therapy, or who have contraindications. PROSPERO REGISTRATION OF REVIEW PROTOCOL: CRD420250652866.
Aging, neurodegenerative diseases and geriatrics.
Zhu S, Gharti S, Chhetri JK … +1 more , Chan P
Maturitas · 2026 Jul · PMID 42069449 · Publisher ↗
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How do female healthcare staff experience the menopause transition in the workplace? A critical meta-synthesis.
Hughes T, Robertson N
Maturitas · 2026 Jun · PMID 42068870 · Publisher ↗
OBJECTIVE: To provide a conceptual overview of how female healthcare staff experience menopause transition in the workplace via a critical interpretive meta-synthesis. METHOD: Search strategy - Seven electronic databases...
OBJECTIVE: To provide a conceptual overview of how female healthcare staff experience menopause transition in the workplace via a critical interpretive meta-synthesis. METHOD: Search strategy - Seven electronic databases were searched systematically using keywords and subject headings within the core review concepts of menopause, healthcare staff and workplace. Inclusion criteria - Primary, qualitative research published in English reporting on healthcare staff experiences of the menopause transition. Data extraction and synthesis - Data were extracted from seven eligible papers with constructs extracted and synthesised via reciprocal translational analysis. RESULTS: Three interrelated themes were identified: Distress in the workplace; Fear of judgement; and Pressure to perform. CONCLUSIONS: Menopause significantly affects female healthcare workers' wellbeing and performance, and appears to be worsened by stigma, lack of support and gender dynamics. Systemic changes, including more organisational awareness, appear warranted to enhance and sustain female employees at work.
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