Maturitas[JOURNAL]
Sun
200 papers
Estetrol (E4) for the treatment of moderate to severe vasomotor symptoms in postmenopausal women - Efficacy and safety results from the phase 3 E4COMFORT I multicenter, placebo-controlled study.
Simoncini T, Bouchard C, Cloes M … +6 more , Taziaux M, Palacios S, de Medeiros SF, Vrabii V, Archer DF, Panay N
Maturitas · 2026 Jun · PMID 42068869 · Publisher ↗
OBJECTIVE: To evaluate the efficacy and safety of estetrol in reducing moderate to severe vasomotor symptoms in postmenopausal women. METHODS: Multicenter, randomized, parallel group (1:1:1), placebo-controlled, double-b...
OBJECTIVE: To evaluate the efficacy and safety of estetrol in reducing moderate to severe vasomotor symptoms in postmenopausal women. METHODS: Multicenter, randomized, parallel group (1:1:1), placebo-controlled, double-blind, phase 3 study in hysterectomized and non-hysterectomized participants aged 40-65 years. A total of 640 participants with seven or more moderate to severe hot flashes daily or 50 weekly received estetrol 15 mg, estetrol 20 mg, or placebo for 12 weeks. Co-primary endpoints were the change in frequency and severity of moderate to severe vasomotor symptoms from baseline to weeks 4 and 12. Comparisons versus placebo were made using a mixed-effects model for repeated measures. The safety of estetrol alone was evaluated in relation to treatment-emergent adverse events. RESULTS: Estetrol 15 mg and 20 mg produced significant reductions in the weekly frequency of moderate to severe vasomotor symptoms at week 4 (least square means: -9.63, P = 0.038; and - 14.94, P < 0.001) and at week 12 (-16.41, P < 0.001; and - 22.49, P < 0.001), relative to placebo. Vasomotor symptom severity was significantly reduced with both estetrol doses at week 4 (-0.27, P = 0.011; and - 0.29, P = 0.005) and at week 12 (-0.54 and - 0.66 [both P < 0.0001]), compared with placebo. Drug-related treatment-emergent adverse events occurred in 51.6%, 57.3%, and 20.6% of participants in the estetrol 15 mg, 20 mg, and placebo groups, respectively, with discontinuations due to treatment-emergent adverse events in 6.6%, 7.5%, and 2.3%, respectively. CONCLUSIONS: Estetrol reduced the frequency and severity of moderate to severe vasomotor symptoms and was well tolerated, with low discontinuation rates, supporting its use in symptomatic postmenopausal women. CLINICAL TRIAL REGISTRATION: NCT04209543.
Prevalence of vasomotor symptoms and the associated risk factors: the "Mi Menopausia" app study.
Coronado PJ, Mendoza N, González SP … +6 more , Sánchez-Méndez S, Presa J, Jurado AR, de la Viuda E, Quereda F, Fasero M
Maturitas · 2026 Jun · PMID 42066667 · Publisher ↗
OBJECTIVE: To assess the prevalence of vasomotor symptoms (VMS) and their associated sociodemographic, lifestyle, and medical risk factors, as well as their impact on health-related quality of life (HRQOL) in peri- and p...
OBJECTIVE: To assess the prevalence of vasomotor symptoms (VMS) and their associated sociodemographic, lifestyle, and medical risk factors, as well as their impact on health-related quality of life (HRQOL) in peri- and postmenopausal Spanish women using the Mi Menopausia app. STUDY DESIGN: Cross-sectional convenience sample of 13,956 women registered with the Mi Menopausia app (June 2021-November 2025). A total of 11,378 women were included in the final analysis after exclusions for incorrect or incomplete data, or cancer history. MAIN OUTCOME MEASURES: Moderate to severe VMS (MS-VMS), defined as ≥7 hot flashes/day with sweating or intensity ≥3/5. RESULTS: Of the total of 11,378 women in the final sample, 48.4% were peri- and 51.6% postmenopausal. The prevalence of VMS was 77.4% and MS-VMS 63.9%. MS-VMS were independently associated with obesity (odds ratio [OR] 1.27; 95% confidence interval [CI] 1.12-1.45), smoking (OR 1.26; 95%CI 1.12-1.42), alcohol intake (OR 1.20; 95%CI 1.06-1.34), and a history of bilateral oophorectomy (OR 1.38; 95%CI 1.03-1.84). University education (OR 0.71; 95%CI 0.65-0.77), being employed (OR 0.85; 95%CI 0.76-0.96) and having sexual intercourse (OR 0.87; 95%CI 0.78-0.97) were independently associated with lower odds of MS-VMS. The menopausal symptoms linked to MS-VMS were irritability (OR 1.65; 95%CI 1.12-2.41), insomnia (OR 2.23; 95%CI 1.52-3.27), feeling older (OR 1.93; 95%CI 1.32-2.83) and vaginal dryness (OR 10.66; 95%CI 2.71-41.87). Bone fractures (OR 1.16; 95%CI 1.02-1.33), depression/anxiety (OR 1.37; 95%CI 1.24-1.50), cardiopathy (OR 1.51; 95%CI 1.12-2.02) and pneumopathy (OR 2.30; 95%CI 1.28-4.13) were more common in women with MS-VMS. Women with MS-VMS had lower HRQOL as measured by the Cervantes SF scale. Only 17% of women with VMS were treated; 9.2% used hormone therapy. CONCLUSION: VMS, especially MS-VMS, were associated with reduced HRQOL and with multiple risk factors, supporting the clinical need for targeted interventions in menopausal women.
Effect of testosterone replacement therapy on fracture risk in hypogonadal men: A systematic review and meta-analysis of randomized controlled trials.
Anagnostis P, Divaris E, Zidrou M … +2 more , Kassi E, Tournis S
Maturitas · 2026 Jun · PMID 42066666 · Publisher ↗
OBJECTIVE: Testosterone replacement therapy is the treatment of choice in men with hypogonadism. Although its beneficial effect on bone mineral density is well established, the evidence regarding its impact on fracture r...
OBJECTIVE: Testosterone replacement therapy is the treatment of choice in men with hypogonadism. Although its beneficial effect on bone mineral density is well established, the evidence regarding its impact on fracture risk remains inconclusive. The purpose of this study was to systematically review and meta-analyze the highest-quality available evidence regarding the effect of TRT on fracture risk in hypogonadal men. STUDY DESIGN: A systematic literature search was conducted in PubMed, Scopus and Cochrane databases from inception through 30 September 2025. Only randomized controlled trials were eligible for inclusion. Outcomes were summarized as relative risk (RR), with a 95% confidence interval (CI). The I index was used in order to quantify heterogeneity. RESULTS: The initial search yielded 1145 results after removal of duplicates; seven papers underwent full-text assessment. Finally, two studies were included in the qualitative and quantitative analysis (n = 2711). TRT was associated with increased risk of clinical fractures compared with placebo (RR 1.55, 95% CI 1.21-1.97, p < 0.0001, I 0%). However, no difference between groups was observed when the analysis was restricted to major osteoporotic fractures (hip, spine, wrist, and arm) (RR 0.62, 95% CI 0.12-3.35, p = 0.58, I 63%). This was also the case for vertebral (RR 0.87, 95% CI 0.29-2.58, p = 0.80, I 9%) and hip fractures (RR 1.02, 95% CI 0.33-3.09, p = 0.98, I 0%), when analyzed separately. CONCLUSION: TRT is associated with an increased incidence of predominantly non-major fractures, while the risk of major osteoporotic fractures, including hip and vertebral fractures, was not increased.
Cardiovascular risk among middle-aged and older adults without standard modifiable risk factors ('SMuRF-less' adults) but persistently depressed: Evidence from two prospective cohorts.
Ma C, Zhao DF, Huo RR … +1 more , Liu YH
Maturitas · 2026 Jun · PMID 42066665 · Publisher ↗
OBJECTIVE: While depressive symptoms are a known risk factor for cardiovascular disease (CVD), their influence over time in individuals without standard modifiable risk factors ('SMuRF-less' adults) is unclear. This stud...
OBJECTIVE: While depressive symptoms are a known risk factor for cardiovascular disease (CVD), their influence over time in individuals without standard modifiable risk factors ('SMuRF-less' adults) is unclear. This study examined the association between depressive symptoms and incident CVD in SMuRF-less middle-aged and older adults. METHODS: This prospective cohort study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS; n = 2095) and the English Longitudinal Study of Ageing (ELSA; n = 798). Depressive symptoms were assessed at baseline and at a roughly 2-year follow-up using the CES-D scale. Participants were categorized into four patterns: 'Never', 'Onset', 'Remission', and 'Persistence'. The primary outcome was the first occurrence of self-reported, physician-diagnosed CVD (heart disease or stroke). Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI). RESULTS: Over follow-up, compared with the Never group, participants with Onset (CHARLS: HR 1.55, 95% CI 1.16-2.08; ELSA: HR 1.28, 95% CI 1.01-1.62) and Persistence (CHARLS: HR 2.11, 95% CI 1.68-2.65; ELSA: HR 1.77, 95% CI 1.12-2.79) depressive symptoms had a significantly higher risk of incident CVD. The Remission group did not show a significantly elevated risk (CHARLS: HR 1.15, 95% CI 0.87-1.52; ELSA: HR 1.14, 95% CI 0.71-1.82). A dose-response relationship was observed, with higher cumulative depressive symptom scores associated with linearly increasing CVD risk. CONCLUSIONS: Among SMuRF-less middle-aged and older adults, the onset and persistence of depressive symptoms were associated with an increased risk of incident CVD.
Hysterectomy trends in Israel between 2005 and 2021 - A nationwide cohort.
Ginath S, Mor L, Grinstein E … +5 more , Ben-Zvi M, Haklai Z, Meron J, Ganer Herman H, Sagiv R
Maturitas · 2026 Jun · PMID 42066664 · Publisher ↗
OBJECTIVE: Hysterectomy remains a common gynecologic procedure worldwide, but its frequency and surgical approach vary substantially across countries and over time. We evaluated nationwide trends in hysterectomy rates, s...
OBJECTIVE: Hysterectomy remains a common gynecologic procedure worldwide, but its frequency and surgical approach vary substantially across countries and over time. We evaluated nationwide trends in hysterectomy rates, surgical approaches, and indications in Israel between 2005 and 2021. STUDY DESIGN: This retrospective, population-based cohort study included all hysterectomies performed in women aged ≥15 years in Israel between 2005 and 2021. Data were extracted from the Israeli Ministry of Health database and analyzed by surgical route, indication, and patient age. National population data were used to calculate annual hysterectomy rates, and temporal trends were assessed using linear regression. RESULTS: A total of 88,728 hysterectomies were performed (mean 5219 ± 277 per year, 1.8 per 1000 women annually), corresponding to a lifetime risk of 15.6%. The overall annual hysterectomy rate declined significantly (R = 0.801, p < 0.001), primarily due to a decrease in abdominal hysterectomies (R = 0.962, p < 0.001). Laparoscopic hysterectomies increased markedly (R = 0.929, p < 0.001), while the use of vaginal procedures remained stable. The highest incidence was among women aged 45-54 years (4.2 per 1000), followed by those aged 65-74 years (3.6 per 1000). Laparoscopic and abdominal procedures predominated in younger women, whereas vaginal hysterectomy was most common in older age groups. Leading indications were uterine leiomyoma (29.6%), malignancy (27.7%), and pelvic organ prolapse (26.4%). CONCLUSION: Between 2005 and 2021, hysterectomy rates in Israel declined steadily with a shift from abdominal to minimally invasive approaches, reflecting global trends within a universal healthcare system providing equitable access to gynecologic care.
Association of small dense low-density lipoprotein cholesterol with longitudinal trajectories of cardio-kidney-metabolic comorbidity: A prospective cohort study based on multi-state Markov models.
Wang R, Zhao J, Tang Y … +4 more , Zhang Q, Xie D, Dong W, Li X
Maturitas · 2026 Jun · PMID 42066663 · Publisher ↗
OBJECTIVE: To assess the associations of small dense low-density lipoprotein cholesterol (sdLDL-C) with longitudinal trajectories of cardiovascular-kidney-metabolic multimorbidity (CKMM) in middle-aged and older adults....
OBJECTIVE: To assess the associations of small dense low-density lipoprotein cholesterol (sdLDL-C) with longitudinal trajectories of cardiovascular-kidney-metabolic multimorbidity (CKMM) in middle-aged and older adults. METHODS: This prospective cohort study utilized data from the China Health and Retirement Longitudinal Study. Univariate and multivariable Cox proportional hazard models were used to assess the associations of LDL-C and sdLDL-C with two outcomes: onset of cardiovascular, kidney, and metabolic disease (FCKMD) and CKMM. Multi-state Markov models were used to assess the roles of LDL-C and sdLDL-C in the progression of CKMM (from no CKMD to one, two, three and four CKMDs). Stratified analyses further explored the associations based on different LDL-C levels. A sensitivity analysis was conducted to evaluate the robustness of the relationships. RESULTS: Among 6110 participants followed for a mean of 8.12 years, 2070 (32.88%) developed at least one FCKMD. Of these cases, 349 (16.86%) progressed to CKMM. The transition rate from baseline to FCKMD was 1.72 times that from FCKMD to CKMM. Elevated sdLDL-C levels were linked to an increased risk of FCKMD and CKMM, whereas high LDL-C levels were associated only with higher odds of CKMM. sdLDL-C was associated with the onset of FCKMDs (from baseline to FCKMD, except for chronic kidney disease), and with the transition to heart disease-CKMM. sdLDL-C levels were related to the progression from baseline to FCKMD, regardless of LDL-C levels. Sensitivity analyses confirmed these findings. CONCLUSION: sdLDL-C may serve as an important lipid-related risk marker in the progression trajectories of CKMM and may provide additional value for early risk stratification and precise prevention beyond traditional LDL-C-based assessment.
Trends in the incidence of endometrial intraepithelial neoplasia and endometrial cancer by type, age, and socioeconomic status in Denmark 2005-2022.
Rose J, Baandrup L, Hertzum-Larsen R … +3 more , Aarestrup J, Baker JL, Kjær SK
Maturitas · 2026 Jun · PMID 42061092 · Publisher ↗
OBJECTIVE: To investigate temporal incidence trends in endometrial intraepithelial neoplasia and endometrial cancer by histological type, age at diagnosis, and socioeconomic status in Denmark over the period 2005-2022. M...
OBJECTIVE: To investigate temporal incidence trends in endometrial intraepithelial neoplasia and endometrial cancer by histological type, age at diagnosis, and socioeconomic status in Denmark over the period 2005-2022. MAIN OUTCOME MEASURES: We identified all cases of endometrial intraepithelial neoplasia and endometrial cancer in 2005-2022, and obtained individual-level information on education, income and hysterectomies for the total Danish female population from nationwide registries. Hysterectomy-corrected age-standardized incidence rates were calculated for endometrial intraepithelial neoplasia and endometrial cancer, overall and stratified by type, age, and socioeconomic status. To summarize incidence trends over time, the annual percentage change was calculated. RESULTS: During the study period, 2560 females were diagnosed with endometrial intraepithelial neoplasia and 12,845 with endometrial cancer. The incidence of endometrial intraepithelial neoplasia was stable (range: 3.1-4.3 per 100,000 female-years) independent of age, and was most common among postmenopausal women. The overall incidence of endometrial cancer was also stable, at approximately 15 per 100,000 female-years. Among postmenopausal women, the incidence of endometrioid tumors decreased, whereas non-endometrioid tumors increased; in 2021-2022, non-endometrioid cancers accounted for 20.6% of all cases. Among females with higher socioeconomic status, the incidence of endometrioid endometrial cancer decreased. In contrast, the incidence of endometrial intraepithelial neoplasia and non-endometrioid endometrial cancer increased among females with lower socioeconomic status. CONCLUSION: The incidence of endometrial intraepithelial neoplasia and endometrial cancer overall remained stable. The incidence of endometrial cancer varied by both subtype and age. Our results suggest increasing rates of endometrial intraepithelial neoplasia and non-endometrioid tumors among females with lower socioeconomic status and a decreasing trend of endometrioid cases among the highest socioeconomic groups.
Menopausal experiences and couple interactions among Chinese women and their partners: A qualitative study.
Chen JH, Tsai YF
Maturitas · 2026 Jun · PMID 42061091 · Publisher ↗
OBJECTIVES: This study explored menopausal experiences and couple interactions among Chinese women and their male partners within a cultural context. STUDY DESIGN: A qualitative phenomenological approach was adopted. In...
OBJECTIVES: This study explored menopausal experiences and couple interactions among Chinese women and their male partners within a cultural context. STUDY DESIGN: A qualitative phenomenological approach was adopted. In total, 20 menopausal women (i.e. undergoing menopausal transition or within 12 months after their final menstrual period) and 4 male partners, including 2 matched couples, underwent semi-structured interviews. Data were collected between March 2024 and May 2025 and analyzed via Braun and Clarke's six-phase inductive thematic analysis. RESULTS: The analysis indicated that women had multifaceted menopausal experiences, including physical symptoms, emotional fluctuations, and effects on daily functioning. Their male partners primarily provided practical support but exhibited limited emotional responsiveness. An exploratory dyadic analysis of two couples revealed three patterns of couple interaction: synchronized adaptation, support discrepancy, and cognitive-emotional asynchrony. CONCLUSIONS: Menopause was experienced not only as an individual transition but also as a relational process. Moreover, differences in partner responses and couple interactions emphasized the complexity of menopausal adaptation within intimate relationships. The exploratory dyadic findings indicate the potential value of considering partners in menopause-related care and underscore the need to conduct further research involving larger and more diverse dyadic samples.
Consultation rates, comorbidities, and prescriptions for menopausal disorders among Japanese working women: a descriptive study using a nationwide administrative insurance claims database.
Shimizu K, Nagashima K, Iwakura M … +8 more , Nakao M, Tanihara S, Okawara M, Fujino Y, Jung S, Kimura T, Terauchi M, Nomura K
Maturitas · 2026 Jun · PMID 42061090 · Publisher ↗
OBJECTIVE: This study estimated annual consultation rates for menopausal complaints among insured women in Japan and examined trends in comorbidities and medication use. METHODS: This descriptive study analyzed administr...
OBJECTIVE: This study estimated annual consultation rates for menopausal complaints among insured women in Japan and examined trends in comorbidities and medication use. METHODS: This descriptive study analyzed administrative claims data for women insured by the Japan Health Insurance Association, Japan's largest health insurer. Between the fiscal years 2016 and 2022, 5,833,765 insured women aged 45-57 years were identified. Menopausal disorders and comorbidities were defined using the 10th revision of the International Classification of Diseases, and women with at least one diagnostic code for menopausal disorders during each fiscal year were identified. RESULTS: The annual consultation rate per 100,000 person-years increased from 6848 in 2016 to 9532 in 2022, and was consistently higher among women aged 50-57 years than those aged 45-49 years. Among those diagnosed, 58% had at least one comorbidity. Sleep disorders were the most common (approximately 26%), consistent across age groups, followed by hypertension (approximately 21%), more frequent in the older group. Among patients with menopausal disorders, 75% received at least one prescription. Kampo medications, which are traditional Japanese herbal formulations, were most used (40%), especially by the younger group. Hormone therapy was second (30%), prescribed more frequently in the older group. For hormone therapy, conjugated estrogens and estradiol were most prescribed, and their usage remained stable. Conversely, prescriptions for progestins and combined estrogen-progestin therapies increased annually. CONCLUSION: Consultation rates for menopausal disorders among Japanese working women increased over time, with frequent comorbidities and distinctive Kampo use.
Corrigendum to "Anticholinergic burden is associated with recurrent and injurious falls in older individuals" [Maturitas 84 (2016) 32-37].
Zia A, Kamaruzzaman S, Myint PK … +1 more , Tan MP
Maturitas · 2026 Jun · PMID 42054812 · Publisher ↗
Abstract loading — click title to view on PubMed.
Association between body mass index and incident shoulder adhesive capsulitis in Germany: A retrospective cohort study of 522,830 adults.
Kostev K, Gyasi RM, Yon DK … +2 more , Konrad M, Jacob L
Maturitas · 2026 Jun · PMID 42048914 · Publisher ↗
OBJECTIVES: Little data exists on the effects of body mass index on the incidence of shoulder adhesive capsulitis. This study investigated the association between body mass index and incident adhesive capsulitis in Germa...
OBJECTIVES: Little data exists on the effects of body mass index on the incidence of shoulder adhesive capsulitis. This study investigated the association between body mass index and incident adhesive capsulitis in Germany. STUDY DESIGN: Retrospective analysis of data from 522,830 adults in 677 general practices in Germany over the period 2005-2023. MAIN OUTCOME MEASURES: The index date corresponded to the first documentation of body mass index. The diagnosis of shoulder adhesive capsulitis was assessed in the 10 years following the index date using the International Classification of Diseases, 10th revision. Participants were aged ≥18 years at the index date, had an observation period of at least 12 months prior to the index date, and had no history of adhesive capsulitis prior to or at the index date. Associations were studied using Kaplan-Meier curves and Cox regression analyses. RESULTS: The mean (standard deviation) age of the population was 53.5 (17.3) years, while the proportion of women was 53.1%. The 10-year cumulative incidence of adhesive capsulitis was 0.63%, 0.65%, 1.05%, and 1.25% in people with underweight, normal weight, overweight, and obesity, respectively (p <0.001). These associations were corroborated in the adjusted Cox regression analyses focusing on categorical body mass index (normal weight reference; underweight hazard ratio 0.92 [95% confidence interval 0.68-1.26]; overweight hazard ratio 1.52 [1.39-1.67]; obesity hazard ratio 1.77 [1.61-1.95]) and continuous body mass index (1.03 [1.02-1.04]). CONCLUSIONS: Overweight and obesity were associated with an increased risk of adhesive capsulitis. More data are needed on the mediating factors involved in the relationship between body mass index and adhesive capsulitis.
Association between sleep quality and the occurrence of lower urinary tract symptoms among female nurses: Mediating roles of anxiety and depression.
Wang S, Li L, Ye Q … +2 more , Wu C, Wang K
Maturitas · 2026 Jun · PMID 42048913 · Publisher ↗
OBJECTIVES: Lower urinary tract symptoms (LUTS) are common among female nurses. However, the occupational contributors and underlying mechanisms remain insufficiently understood. This study examined whether sleep quality...
OBJECTIVES: Lower urinary tract symptoms (LUTS) are common among female nurses. However, the occupational contributors and underlying mechanisms remain insufficiently understood. This study examined whether sleep quality predicts the occurrence of LUTS among female nurses and whether anxiety and depression mediate this relationship. METHODS: This study utilized baseline and first-wave follow-up data from the Nurse Urinary Related Health Study. A total of 3565 female nurses without LUTS at baseline were followed up for a median of 2.81 years. LUTS were assessed via the Chinese version of the International Consultation on Incontinence Questionnaire - Female Lower Urinary Tract Symptoms. Sleep quality, anxiety, and depression were measured with the Chinese versions of the Pittsburgh Sleep Quality Index, Generalized Anxiety Disorder 2-item, and Patient Health Questionnaire-2, respectively. Logistic regression, multinomial logistic regression, and mediation modeling were used to conduct statistical inference. RESULTS: During the follow-up period, 1222 female nurses (34.3%) developed LUTS. Poor sleep quality was significantly associated with an increased risk of incident LUTS, with an odds ratio (OR) of 1.41 and 95% confidence interval (CI) of 1.16-1.71. Mediation analysis showed that changes in both anxiety and depression contributed to this association. The product distribution estimates for new-onset and persistent anxiety were 0.587 (95% CI 0.356-0.854) and 1.258 (95% CI 0.409-2.209), respectively, and for new-onset and persistent depression they were 0.604 (95% CI 0.349-0.895) and 0.761 (95% CI 0.029-1.569), respectively. CONCLUSIONS: Poor sleep quality can contribute to LUTS both directly and indirectly, by triggering or sustaining anxiety and depression. Creating a sleep-supportive work environment and integrating education on sleep health and emotional strategies into routine professional training could be effective measures against LUTS for female nurses.
Violence against women and its influence on menopausal symptoms and timing: A narrative review.
Mendoza N, Mendoza-Huertas L, Lopez-Salas E
Maturitas · 2026 Jun · PMID 42048912 · Publisher ↗
BACKGROUND: Violence against women is a major public health issue and human rights concern whose effects extend into women's midlife. Accumulating research links lifetime exposure to violence with dysregulation of stress...
BACKGROUND: Violence against women is a major public health issue and human rights concern whose effects extend into women's midlife. Accumulating research links lifetime exposure to violence with dysregulation of stress and neuroendocrine systems, potentially shaping the menopausal experience. OBJECTIVE: This narrative review synthesizes evidence on the relationship between exposure to violence and menopausal health, with emphasis on symptom burden, quality of life, long-term health sequelae, and potential shifts in the timing of menopause. RESULTS: Violence is consistently associated with more frequent and severe menopausal symptoms-vasomotor, psychological (including anxiety, depression, and insomnia), and sexual/urogenital-along with poorer postmenopausal quality of life across study designs. The proposed mechanisms involve hypothalamic-pituitary-adrenal axis dysregulation, altered autonomic and serotonergic signalling, epigenetic changes, and potentially lower estrogen levels. Psychiatric comorbidities may amplify symptom perception. Other factors (e.g., demographic, lifestyle, psychosocial, and sociocultural factors) likely exert an influence but this remains underexplored. Emerging data suggest earlier menopause among women exposed to violence. CONCLUSIONS: Lifetime exposure to violence is associated with a higher menopausal symptom load, diminished quality of life, and significant long-term health risks. These findings support trauma-informed, comprehensive care in midlife and highlight the need for longitudinal studies with standardized exposure/outcome measures and mechanistic biomarkers to clarify causality and guide interventions.
Association between phenotypic age acceleration and all-cause and cardiovascular mortality risk among individuals with cardiovascular-kidney-metabolic syndrome stages 0-3: a cohort study.
Mai W, Zhong G, He Z … +3 more , Liu T, Mao L, Yang J
Maturitas · 2026 Jun · PMID 42019431 · Publisher ↗
BACKGROUND: Phenotypic age acceleration (PhenoAge acceleration) is closely associated with adverse events, but its association with mortality risk in individuals with cardiovascular-kidney-metabolic (CKM) syndrome stages...
BACKGROUND: Phenotypic age acceleration (PhenoAge acceleration) is closely associated with adverse events, but its association with mortality risk in individuals with cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 remains unclear. METHODS: A total of 8404 participants with CKM syndrome stages 0-3 from the National Health and Nutrition Examination Survey were included. PhenoAge acceleration was calculated as the residual difference between PhenoAge (assessed by inflammatory markers, immune function, metabolic indicators, and liver function) and chronological age. Cox proportional hazards regression models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of mortality. RESULTS: Over a median follow-up of 5.83 years, 713 all-cause deaths occurred, including 203 deaths related to cardiovascular disease (CVD). After adjusting for multiple potential confounders, participants in the Q2, Q3, and Q4 of PhenoAge acceleration exhibited progressively higher risks of all-cause mortality compared with those in the Q1 group, with HRs (95% CI) of 0.90 (0.70-1.15), 1.60 (1.29-2.00), and 2.81 (2.22-3.56), respectively. A similar trend was observed for CVD mortality. Notably, each 1-year increase in PhenoAge acceleration was significantly associated with elevated risks of both all-cause and CVD mortality (P < 0.001). Compared with the non-accelerated aging group, the accelerated aging group had an HR (95% CI) of 2.15 (1.81-2.56) for all-cause mortality and 1.96 (1.30-2.97) for CVD mortality. Restricted cubic spline analysis revealed a linear, positive association between PhenoAge acceleration and mortality risk. CONCLUSION: PhenoAge acceleration is significantly associated with increased risks of all-cause and CVD mortality among individuals with CKM syndrome stages 0-3.
Longitudinal muscle strength trajectories, incident depressive symptoms, and life satisfaction in Chinese middle-aged and older adults.
Cheng Z, Fu F, Lin H … +2 more , Han Z, Xu T
Maturitas · 2026 Jun · PMID 42019430 · Publisher ↗
BACKGROUND: Depression and life satisfaction are critical dimensions of mental health in aging populations. Although grip strength has an established association with depression, the role of its long-term trajectories on...
BACKGROUND: Depression and life satisfaction are critical dimensions of mental health in aging populations. Although grip strength has an established association with depression, the role of its long-term trajectories on depression and their relationship with life satisfaction remain inadequately studied. METHODS: We utilized data from 3158 middle-aged and older adults in the China Health and Retirement Longitudinal Study. Group-based trajectory modeling was used to identify grip strength trajectories from 2011 to 2015. Secondary exposure was the magnitude of grip strength decline from 2011 to 2015. Multivariable-adjusted modified Poisson and logistic regression models were employed to assess associations between these trajectories and incident depressive symptoms or life satisfaction in 2018 and 2020. RESULTS: Three distinct declining grip strength trajectories were identified (high-baseline declining, medium-baseline declining, low-baseline declining). Among the participants, 859 (27.2%) developed depressive symptoms by 2018. Compared with the high-baseline declining group, the medium-baseline declining group had an approximately 26% (IRR 1.26, 95% CI 1.03-1.56) higher risk of depressive symptoms, and the low-baseline declining group had an approximately 70% (IRR 1.70, 95% CI 1.32-2.19) higher risk. Sex-specific dominant hand grip strength thresholds for risk stratification of depressive symptoms in middle-aged adults were identified (males, mild increase below 43.0 kg and significant increase below 33.0 kg; females, mild increase below 29.2 kg and significant increase below 21.9 kg). No such clear threshold was observed for older adults. After full adjustment for confounders, no independent association was observed between life satisfaction and any grip strength indicator, whether baseline level, trajectory, or rate of decline. CONCLUSIONS: Longitudinal grip strength trajectories significantly improve risk prediction of depressive symptoms compared with single-time-point measures and provide practical thresholds for risk stratification in middle-aged adults in clinical and community settings. Preserving muscle strength may represent a promising intervention strategy for depression prevention in middle-aged and older adults.
Associations of mortality with leisure-time physical activity and sitting time in postmenopausal women: Insights from NHANES.
Yang M, Huang H, Fang S … +6 more , Chen Q, Zhang Y, Hou Y, Huang H, Liu N, Du H
Maturitas · 2026 Jun · PMID 42019429 · Publisher ↗
OBJECTIVE: Postmenopausal women are vulnerable to insufficient physical activity and prolonged sitting. While both behaviors have been individually associated with mortality, their joint effects remain unclear. METHODS:...
OBJECTIVE: Postmenopausal women are vulnerable to insufficient physical activity and prolonged sitting. While both behaviors have been individually associated with mortality, their joint effects remain unclear. METHODS: We analyzed 5355 postmenopausal women (median age 63 years [interquartile range 56-71]) from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Leisure-time physical activity was categorized as insufficient (<600 metabolic equivalent of task minutes per week) or sufficient (≥600 metabolic equivalent of task minutes per week). Sitting time was classified as <6 h/day, 6-8 h/day, or ≥ 8 h/day. Survey-weighted Cox proportional hazards models examined the independent and joint associations of physical activity and sitting time with all-cause, cardiovascular disease, cancer and other-cause mortality. RESULTS: During a median follow-up of 78 months, 673 (13.8%) deaths occurred, including 201 from cardiovascular disease, 162 from cancer, and 310 from other causes. Both sufficient leisure-time physical activity and shorter sitting time were independently associated with lower risks of all-cause, cardiovascular disease, and other-cause mortality, but not cancer mortality. In joint analyses, participants with sufficient physical activity and < 6 h/day sitting had the lowest all-cause (adjusted hazard ratio 0.25, 95% confidence interval 0.16-0.39), cardiovascular disease (adjusted hazard ratio 0.15, 95% confidence interval 0.08-0.30) and other-cause (adjusted hazard ratio 0.17, 95% confidence interval 0.08-0.37) mortality, compared with those with insufficient physical activity and ≥ 8 h/day sitting. CONCLUSION: In this prospective cohort study of US postmenopausal women, the combination of sufficient physical activity and lower sitting time was associated with lower risks of all-cause and cardiovascular disease mortality.
Associations among social isolation, living alone, and cardiovascular mortality: The Otassha study.
Imamura K, Kawai H, Ejiri M … +5 more , Sasai H, Ihara K, Hirano H, Fujiwara Y, Obuchi S
Maturitas · 2026 Jun · PMID 42013551 · Publisher ↗
OBJECTIVES: Living alone is potentially associated with cardiovascular mortality; however, the effects of social interactions have not been fully considered. This study examined whether social isolation and living alone...
OBJECTIVES: Living alone is potentially associated with cardiovascular mortality; however, the effects of social interactions have not been fully considered. This study examined whether social isolation and living alone were independently associated with cardiovascular mortality and whether living alone modified the association between social isolation and cardiovascular mortality in community-dwelling older adults. STUDY DESIGN: Community-dwelling older adults residing in Itabashi Ward, Tokyo, who participated in the postal survey, were enrolled. Social isolation was defined based on the frequency of interaction with others. MAIN OUTCOME MEASURES: The main outcome was cardiovascular mortality, obtained from the Itabashi Ward office database. Cox proportional hazards models were used to examine the association between social isolation and living alone, independently of cardiovascular mortality, and to test whether living alone modified the association between social isolation and cardiovascular mortality. RESULTS: In total, 4144 older adults (mean age 72 years; 46% men) were included in the analyses. During follow-up (median 96 months), 95 cardiovascular deaths occurred. Social isolation was independently associated with cardiovascular mortality (hazard ratio 2.20; 95% confidence interval 1.43-3.39), although living alone was not (hazard ratio 0.88; 95% confidence interval 0.52-1.49). Living alone did not significantly modify the association between social isolation and cardiovascular mortality (p for interaction = 0.06). CONCLUSIONS: Social isolation was associated with cardiovascular mortality in older adults, independent of living arrangements. These results highlight the importance of considering social interactions in addition to living arrangements when stratifying cardiovascular risks for older adults.
Evaluation of a midlife services program assessing chief complaints, referral patterns, and therapies provided.
Leibou HZA, Burgess A, Thornton J … +2 more , Ochalski M, Martín M
Maturitas · 2026 Jun · PMID 42013550 · Publisher ↗
OBJECTIVE: The objective of this study is to describe the characteristics of patients referred to the Midlife Services program in south central Pennsylvania, the menopause-associated symptoms prompting referral, and the...
OBJECTIVE: The objective of this study is to describe the characteristics of patients referred to the Midlife Services program in south central Pennsylvania, the menopause-associated symptoms prompting referral, and the therapies prescribed as part of their care. METHODS: Epic Slicer Dicer was used to create a report of all female patients between the ages 45-60 referred to Midlife Services between Jan 1, 2024, and December 31, 2024. Patient charts were reviewed for reason for referral, menopausal symptoms addressed, number of Midlife visits, and treatments initiated. Chi-square analysis was used to examine categorical variables, and independent sample t-tests were conducted to compare continuous variables. RESULTS: In 2024, there were 203 referrals to Midlife Services. Most referrals came from healthcare professionals working in family medicine (n = 90; 44.3%) and obstetrics and gynecology (n = 73; 36%). Of those who attended a Midlife visit, 60% (n = 58) were prescribed estrogen plus progestogen therapy by a Midlife clinician. CONCLUSIONS: There is a growing population of women seeking care for conditions associated with menopause, and a persistent gap in quality care provided to patients with menopausal concerns. Midlife Services began operating in 2018. Similar programs have been created around the United States yet there is a paucity of studies describing the population of women accessing these services, the symptoms that drive them to seek care, and the treatments they are prescribed. The healthcare professionals most frequently making referrals to Midlife were working in family medicine and obstetrics and gynecology, demonstrating the benefit of this service. The majority of patients referred to Midlife were started on hormone therapy, demonstrating that a need was being addressed by Midlife.
Mental health, health-related quality of life, and material and social deprivation: A hierarchical analysis of their relationships and determinants in people attending a Greek public hospital.
Palermos D, Briasoulis A, Ntanasis-Stathopoulos I … +7 more , Titsi K, Tsakliadou C, Charalampopoulou A, Athanasiadou E, Pavi E, Psaltopoulou T, Sergentanis TN
Maturitas · 2026 Jun · PMID 41996744 · Publisher ↗
OBJECTIVE: To assess material and social deprivation, mental health, and health-related quality of life (HRQoL) and their determinants among patients and accompanying persons attending a public hospital cardiology clinic...
OBJECTIVE: To assess material and social deprivation, mental health, and health-related quality of life (HRQoL) and their determinants among patients and accompanying persons attending a public hospital cardiology clinic in Athens, Greece. STUDY DESIGN: Cross-sectional study, conducted in 2024. Patients and accompanying persons aged over 30 years were included. MAIN OUTCOME MEASURES: Material and social deprivation were measured using the European Union Material and Social Deprivation Index. Participants self-reported sociodemographic and lifestyle characteristics, medical history, HRQoL, and mental health indicators. Analyses were guided by a hierarchical framework using univariate and multivariate logistic regression. RESULTS: Among 456 participants (59% female; 25% aged ≥65 years; 40% with ≤12 years of education), 46.3% experienced deprivation, including 28.5% with severe deprivation, almost double the national estimates for 2024. Lower educational attainment, older age, and unemployment were significant determinants of deprivation. Smoking, sleep duration, and presence of physical health conditions were independently associated with deprivation. Deprived individuals reported substantially worse HRQoL, higher depressive symptoms and clinically significant anxiety, and lower life satisfaction. CONCLUSIONS: Material and social deprivation was highly prevalent and closely linked to adverse sociodemographic and lifestyle characteristics, physical morbidity, and impaired mental health and HRQoL. Routine assessment of deprivation in clinical care and targeted support programs for vulnerable populations are warranted.
Effects of exercise on body composition, physical function, and metabolic health in older adults with sarcopenic obesity: A systematic review and meta-analysis.
Gong L, Chen C, Jia Y … +3 more , Zheng Z, Dong X, Hou X
Maturitas · 2026 Jun · PMID 41980429 · Publisher ↗
Exercise interventions benefit body composition, physical function, and metabolic health in older adults with sarcopenic obesity (SO), but the comparative effects of different types of exercise remain unclear. This study...
Exercise interventions benefit body composition, physical function, and metabolic health in older adults with sarcopenic obesity (SO), but the comparative effects of different types of exercise remain unclear. This study conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate overall and type-specific effects. Six databases were systematically searched up to December 2025. Twenty RCTs with a total of 917 participants (mean age 64.1-81.4 years) were included. Overall, exercise significantly reduced body mass index (BMI; MD = -0.51; 95%CI: -0.76 to -0.25), body fat mass (BFM; MD = -1.74; 95%CI: -2.67 to -0.81), body fat percentage (PBF; MD = -2.64; 95%CI: -3.27 to -2.00), and low-density lipoprotein cholesterol (LDL-C; MD = -7.17; 95%CI: -13.62 to -0.71), and increased appendicular skeletal muscle (ASM; MD = 0.34; 95%CI: 0.13 to 0.55), skeletal muscle index (SMI; MD = 0.21; 95%CI: 0.10 to 0.32), handgrip strength (HG; SMD = 0.97; 95%CI: 0.47 to 1.47), gait speed (GS; MD = 0.14; 95%CI: 0.07 to 0.21), knee extension strength (KES; SMD = 0.36; 95%CI: 0.06 to 0.65), and insulin-like growth factor 1 (IGF-1; SMD = 0.65; 95%CI: 0.30 to 1.00). Subgroup analyses demonstrated that resistance training (RT) significantly reduced PBF, and significantly increased ASM, SMI, HG, KES, and IGF-1. Combined training (CT) significantly reduced BMI and PBF, and improved SMI, HG, GS, and IGF-1. Our systematic review and meta-analysis of studies of older adults with SO indicates that the beneficial effect of exercise is not supported by high-quality evidence. Moderate-certainty evidence does suggest statistically significant benefits for body composition and physical function, while low-certainty evidence suggests trivial effects for metabolic health. Future high-quality RCTs addressing methodological issues are needed to improve the certainty of the evidence and to further investigate the optimal type of exercise for this population.
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