Maturitas[JOURNAL]
Sun
200 papers
The relationship between a frailty index and fall risk in middle-aged and older adults: Findings from three prospective cohort studies - CHARLS, ELSA and HRS.
Geng T, Zhao S, Xi W … +4 more , Peng H, Sheng C, Sun Z, Guo C
Maturitas · 2026 May · PMID 41861454 · Publisher ↗
BACKGROUND: Global population aging has made frailty a critical public health concern. While a frailty index (FI) is able to quantify frailty effectively, its association with fall risk needs further validation across di...
BACKGROUND: Global population aging has made frailty a critical public health concern. While a frailty index (FI) is able to quantify frailty effectively, its association with fall risk needs further validation across diverse populations and cultural contexts. METHODS: This study analyzed data from 24,526 participants aged ≥45 years from national cohorts in the China Health and Retirement Longitudinal Study, the English Longitudinal Study of Aging, and the US Health and Retirement Study. The association between a health deficit-based frailty index and self-reported falls over two years was assessed using a model with multivariable adjustment logistic regression, restricted cubic splines, and stratified analyses. RESULTS: The mean baseline score on the frailty index was 0.1 in China Health and Retirement Longitudinal Study, 0.2 in English Longitudinal Study of Aging, and 0.4 in Health and Retirement Study. A significant positive association was observed between frailty score and fall risk after multivariable adjustment (P < 0.001), with adjusted odds ratios of 1.45, 1.51, and 1.86 per unit increase in score, respectively. A nonlinear dose-response relationship (P < 0.001) and significant sex interaction (P < 0.001) were identified, with a stronger association in men. CONCLUSION: The frailty index is a significant predictor of fall risk in middle-age and older adults, with variations across countries and sexes, supporting its utility as a practical screening tool for targeted interventions to promote healthy aging.
Considerations in Breast cancer screening, density and supplemental imaging in average-risk women.
Harper L, Sparling K, Anderson S … +7 more , Simmons CL, Fraker J, Patel BK, Sanders J, Leming M, Zhu A, Sharpe R
Maturitas · 2026 May · PMID 41856016 · Publisher ↗
Breast cancer remains a prevalent health concern, affecting approximately one in eight women during their lifetime. While screening mammography has significantly reduced mortality through early detection, its sensitivity...
Breast cancer remains a prevalent health concern, affecting approximately one in eight women during their lifetime. While screening mammography has significantly reduced mortality through early detection, its sensitivity is compromised in women with dense breast tissue-a factor that not only increases cancer risk but also obscures malignancies on imaging. Digital breast tomosynthesis has enhanced screening capabilities over traditional 2D mammography, yet limitations persist for dense breasts. In response, recent US federal legislation mandates that mammography lay summaries inform patients about the implications of breast density, including reduced detection rates and elevated risk. Additionally, insurance coverage for supplemental imaging is expanding across the United States. Supplemental screening modalities such as magnetic resonance imaging, whole-breast ultrasound, contrast-enhanced mammography, and molecular breast imaging offer improved detection in dense tissue, but guidance for average-risk women remains unclear. This lack of consensus can lead to confusion among patients and providers. This article aims to equip clinicians with a comprehensive understanding of breast density's impact on screening efficacy, the available supplemental imaging options, and current societal recommendations. By clarifying these considerations, clinicians can better navigate shared decision-making with average-risk patients regarding breast cancer screening.
Associations of reproductive history with serum and intratumoral sex steroid hormone levels among postmenopausal women with breast cancer: Analysis of paired serum and tumor tissue samples.
Minami Y, Tada H, Kawai M … +4 more , Kanemura S, Onuki K, Ishida T, Kakugawa Y
Maturitas · 2026 May · PMID 41856015 · Publisher ↗
BACKGROUND: Intratumoral estrogens may contribute to the growth of breast cancer. Risk factors for breast cancer, including reproductive factors, may influence intratumoral hormone levels. METHODS: This cross-sectional s...
BACKGROUND: Intratumoral estrogens may contribute to the growth of breast cancer. Risk factors for breast cancer, including reproductive factors, may influence intratumoral hormone levels. METHODS: This cross-sectional study of 146 postmenopausal women with breast cancer investigated associations of reproductive factors, including parity and breastfeeding history, with serum and intratumoral (tissue) hormone levels, as well as aromatase activity, by hormone receptor subtype classified as estrogen receptor-positive or estrogen receptor-negative and progesterone receptor-negative, using analysis of covariance. Hormone levels and aromatase activity in paired serum and tumor tissue samples were measured using liquid chromatography-tandem mass spectrometry and the tritiated water-release assay. Epidemiological data were collected through a self-administered questionnaire. FINDINGS: Among women with estrogen receptor-positive cancer, parity history (nulliparous vs. parous) was not significantly associated with serum or tissue hormone levels. No linear association was observed between parity number (nulliparous, 1, 2, ≥3) and tissue estradiol levels (age- and stage-adjusted means: 109.2, 76.7, 85.9, and 113.2 pg/g, respectively; p = 0.58). Tissue estradiol levels were significantly higher among parous women with breastfeeding history (age- and stage-adjusted mean: 103.2 pg/g) than among those without (64.5 pg/g, p = 0.01). In estrogen receptor-negative and progesterone receptor-negative cancers, no associations were observed between these reproductive factors and hormone levels or aromatase activity. CONCLUSIONS: Reproductive history, particularly breastfeeding, may be associated with intratumoral estradiol levels in postmenopausal women with estrogen receptor-positive breast cancer. These findings suggest the importance of considering reproductive factors when investigating biological mechanisms underlying breast cancer progression and prognosis.
Influence of age and diet on the expression of microRNAs in coronary heart disease: Findings from the CORDIOPREV study.
Sánchez-Giraldo M, Díaz-Cáceres A, Ojeda-Rodríguez A … +10 more , López-Moreno A, Alcalá-Díaz JF, Romero-Cabrera JL, Torres-Peña JD, Porras-Pérez E, Narváez ER, Delgado-Lista J, Pérez-Martínez P, López-Miranda J, Rangel-Zúñiga OA
Maturitas · 2026 May · PMID 41849882 · Publisher ↗
OBJECTIVES: Mortality from age-related diseases has risen in the last decade. MicroRNAs are key regulators of gene expression linked to these diseases, and their expression can be modulated by diet. This study examined h...
OBJECTIVES: Mortality from age-related diseases has risen in the last decade. MicroRNAs are key regulators of gene expression linked to these diseases, and their expression can be modulated by diet. This study examined how age and diet influence the expression of microRNAs associated with cardiovascular disease in patients with coronary heart disease. METHODS: From the CORDIOPREV cohort (n = 1002), 120 participants under 56 years and 120 over 66 years were selected through propensity score matching. To assess dietary effects, 60 individuals per age group followed either a low-fat or a Mediterranean diet. Expression of 28 microRNAs in peripheral blood mononuclear cells was analyzed by RT-PCR at baseline and after 5 years. RESULTS: Younger participants (those aged under 56 years at baseline) showed increased expression of miR-1, miR-150, and miR-145 over time, while no significant changes were observed in older subjects (those over 66 years). Among younger individuals on the Mediterranean diet, miR-1 and miR-145 levels significantly increased after 5 years. Pathway analysis indicated that these microRNAs target genes (CCL2, ED1, SMAD3, PLCE1) related to inflammation, cell adhesion, and coagulation. CONCLUSION: The Mediterranean diet may positively modulate the expression of microRNAs associated with cardiovascular disease, with this effect being particularly influenced by age in patients with coronary heart disease.
Association between exogenous hormone use and dementia: A prospective cohort study and synthetic analysis.
Liu J, Cao F, Li Z … +6 more , Zeng H, Zhou M, He Q, Jiang W, Li Y, Yan J
Maturitas · 2026 May · PMID 41844465 · Publisher ↗
OBJECTIVES: To investigate the controversial association between exogenous hormone use (EHU) and dementia, with a focus on subtype-specific risks. STUDY DESIGN: This prospective cohort study followed 273,069 women in the...
OBJECTIVES: To investigate the controversial association between exogenous hormone use (EHU) and dementia, with a focus on subtype-specific risks. STUDY DESIGN: This prospective cohort study followed 273,069 women in the UK Biobank over 3,802,608 person-years, identifying 4,710 dementia cases. MAIN OUTCOME MEASURES: Cox models assessed use of oral contraceptive (OC) and hormone replacement therapy (HRT) in relation to all-cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) across treatment durations. Subgroup analyses were stratified by age, ethnicity, APOE status, education, income, and reproductive factors. A systematic review was conducted to synthesize existing evidence. RESULTS: In the cohort study, OC use was associated with reduced risks of all-cause dementia (HR 0.90, 95%CI 0.84-0.95), AD (HR 0.87, 95%CI 0.79-0.95), and VaD (HR 0.81, 95%CI 0.70-0.93), particularly after 4-14 years of use. HRT showed no significant association with increased dementia risk. Synthesized results largely corroborated these findings: OC use was associated with reduced risks of dementia (HR 0.90, 95%CI 0.89-0.92); and although four European studies reported a moderately increased AD risk after post-menopausal HRT use, neither cohort-based studies (HR 0.98, 95%CI 0.90-1.06) nor traditional case-control studies (OR 1.00, 95%CI 0.90-1.11) found an association between HRT and dementia. CONCLUSIONS: Our combined evidence does not support an increased risk of dementia associated with OC use; similarly, no clear association was observed between HRT and increased dementia risk. Clinical decisions on EHU should be individualized, balancing overall benefits against potential risks.
Healthy lifestyles and survival beyond age 100: Evidence from a national cohort of Chinese centenarians.
Wang X, Qin A
Maturitas · 2026 May · PMID 41825263 · Publisher ↗
OBJECTIVES: Healthy lifestyles are well-established determinants of longevity, yet it remains unclear whether they continue to shape survival in extreme old age. This study examined the association between healthy lifest...
OBJECTIVES: Healthy lifestyles are well-established determinants of longevity, yet it remains unclear whether they continue to shape survival in extreme old age. This study examined the association between healthy lifestyles and survival beyond age 100, and quantified absolute survival gains. STUDY DESIGN: Population-based longitudinal cohort study. METHODS: We analyzed 4536 centenarians from the Chinese Longitudinal Healthy Longevity Survey. A composite healthy lifestyle score (range 0-10) was constructed using dietary diversity, exercise status, sleep quality, smoking status, and drinking status. Weibull accelerated failure time models and restricted mean survival time analyses were used to estimate associations with post-centenarian survival, adjusting for sociodemographic characteristics and major chronic conditions. RESULTS: The sample comprised 4536 centenarians (mean age 102.8 years, SD 2.6); 80.9% were women, 63.9% lived in rural areas, and the mean follow-up was 28.7 months (SD 22.9), during which period 88.9% of the participants died. Participants were classified as having unfavorable (17.9%, n = 813), intermediate (70.5%, n = 3200), or favorable (11.5%, n = 523) lifestyles. Each 1-point increase in the lifestyle score was associated with a 6.9% longer survival time (TR = 1.069, 95% CI 1.049-1.089). Compared with centenarians with unfavorable lifestyles, those with intermediate and favorable lifestyles lived an additional 3.79 months (95% CI 1.57-6.19) and 11.04 months (95% CI 7.10-15.43), respectively. Results were robust across sensitivity analyses. CONCLUSIONS: Even at extreme old age, healthier lifestyles are associated with meaningful survival gains. Further studies are needed to confirm which lifestyle components contribute most to these benefits and to inform healthy ageing strategies.
Association between early menopause and late-life anxiety symptoms among community-dwelling hypertensive women.
Zhao W, Wang R, Zeng N … +5 more , Yan S, Wang Y, Li X, Jiao X, Zeng H
Maturitas · 2026 Apr · PMID 41819944 · Publisher ↗
BACKGROUND: Early menopause has long-term influence on women's health. This study investigated the relationship between early menopause and late-life anxiety symptoms in community-dwelling hypertensive women. METHODS: Th...
BACKGROUND: Early menopause has long-term influence on women's health. This study investigated the relationship between early menopause and late-life anxiety symptoms in community-dwelling hypertensive women. METHODS: This cross-sectional study included community-dwelling older hypertensive women. The on-site investigation was conducted in 2023 in Pingdingshan City in central China, and participants were included using cluster random sampling. The primary variables were early menopause (at the age of 40-44 years) and anxiety symptoms (as rated on the 7-item Generalized Anxiety Disorder scale). Covariates included general information, women's health, health status, and lifestyle. Univariable analysis and multivariable hierarchical logistic regression were used to investigate the factors associated with anxiety symptoms. Propensity score matching (PSM) was performed to investigate the association between early menopause and anxiety symptoms. RESULTS: A total of 4933 participants were included. The prevalence of anxiety symptoms was 21.20% (95% CI 20.06%, 22.34%) and that of early menopause 11.88% (95% CI 10.98%, 12.78%). Anxiety symptoms were significantly associated with early menopause after multivariable adjustment (aOR = 2.041, 95%CI 1.627, 2.559; prevalence ratio = 1.57). The following variables were identified as factors associated with anxiety symptoms (P < 0.05) and included in the PSM covariate set: age, cardiovascular diseases, neurological diseases, depressive symptoms, difficulty grooming or dressing, pain or discomfort, score on the Pittsburgh Sleep Quality Index, frequency of outdoor activities, and frequency of reading. After PSM, 586 pairs of patients showed no covariate differences. There was a 10.75% difference in anxiety symptoms between participants with early and normal menopause [(31.23%, 183/586) vs. (20.48%, 120/586), P < 0.001, risk ratio = 1.53]. CONCLUSIONS: Early menopause is significantly associated with late-life anxiety symptoms in hypertensive women in Central China.
Hearing loss and aging-related health outcomes-A natural population cohort study.
Pang W, Qiu K, Wu X … +12 more , Luo Y, Song Y, Rao Y, Mao M, Li J, Cheng D, Lai X, Jin R, Zhou Y, Dong B, Ren J, Zhao Y
Maturitas · 2026 May · PMID 41819712 · Publisher ↗
OBJECTIVES: To investigate the associations between hearing loss and five aging-related health outcomes-cognitive function, activities of daily living, instrumental activities of daily living, nutritional status, and sar...
OBJECTIVES: To investigate the associations between hearing loss and five aging-related health outcomes-cognitive function, activities of daily living, instrumental activities of daily living, nutritional status, and sarcopenia-among Chinese adults. METHODS: This cohort study used data from the West China Health and Aging Trends Study. Hearing loss was measured by pure tone audiometry, and health outcomes were evaluated using standardized instruments: the Montreal Cognitive Assessment, activities of daily living and instrumental activities of daily living scales, the Mini Nutritional Assessment Short-Form, and a simple five-item scale for sarcopenia (the SARC-F). Associations were examined using both univariable and multivariable logistic regression, with subgroup analyses by age, sex, and level of education. RESULTS: A total of 545 eligible participants (mean age 64.6 years; 374 women [68.6%]) were included. Multivariable analysis showed significant associations between hearing loss and cognitive function (OR 1.7; 95% CI 1.11-2.61), activities of daily living (OR 3.74; 95% CI 1.09-12.82) and instrumental activities of daily living (OR 5.28; 95% CI 1.2-23.35). In adjusted models, moderate or higher-level hearing loss was associated with sarcopenia (OR 3.1; 95% CI 1.32-7.27), difficulties with instrumental activities of daily living (OR 22.62; 95% CI 4.47-114.43), impairments in activities of daily living (OR 6.14; 95% CI 1.55-24.33), poor nutrition (OR 2.8; 95% CI 1.15-6.82) and cognitive decline (OR 2.12; 95% CI 1.13-3.98). CONCLUSION: These findings suggest that both the presence and severity of hearing loss, particularly sensorineural hearing loss, are important factors influencing multi-dimensional aging-related health outcomes. This highlights the importance of regular hearing assessments and timely interventions to support health in older adults.
Impact of concomitant hysterectomy on quality of life in BRCA carriers undergoing risk-reducing salpingo-oophorectomy.
Nahshon C, Assaf W, Fahoum L … +3 more , Regev-Sadeh S, Schmidt M, Segev Y
Maturitas · 2026 May · PMID 41819711 · Publisher ↗
OBJECTIVE: To evaluate the association between concomitant hysterectomy at the time of risk-reducing salpingo-oophorectomy and patient-reported outcomes, including decision regret, health-related quality of life, and sex...
OBJECTIVE: To evaluate the association between concomitant hysterectomy at the time of risk-reducing salpingo-oophorectomy and patient-reported outcomes, including decision regret, health-related quality of life, and sexual function. STUDY DESIGN: National cross-sectional study using an anonymous, questionnaire-based survey. Carriers of the BRCA1/2 pathogenic variant who had previously undergone risk-reducing salpingo-oophorectomy with or without concomitant hysterectomy were eligible. MAIN OUTCOME MEASURES: Validated instruments were used, including the Decision Regret Scale, the EuroQol-5 Dimension questionnaire, and the Female Sexual Function Index. Participants were stratified according to hysterectomy status and postoperative use of hormone replacement therapy. Outcomes were compared using one-way analysis of variance and chi-square tests. RESULTS: A total of 178 women were included, of whom 46 had undergone risk-reducing salpingo-oophorectomy with concomitant hysterectomy and 132 had undergone risk-reducing salpingo-oophorectomy alone. Decision regret was low overall and did not differ by hysterectomy status or use of hormone replacement therapy. Health-related quality of life was largely preserved across groups, with lower scores on the EuroQol questionnaire and higher pain/discomfort reported primarily among women not receiving hormone replacement therapy. Sexual function scores were significantly higher among women receiving hormone replacement therapy across multiple domains of the Female Sexual Function Index. The most favorable outcomes in terms of quality of life and sexual function were observed among women who underwent hysterectomy and received postoperative hormone replacement therapy. CONCLUSION: Among BRCA1/2 mutation carriers who had undergone risk-reducing salpingo-oophorectomy, concomitant hysterectomy was not associated with increased decision regret or impaired patient-reported outcomes. Differences in quality of life and sexual function appear to be primarily related to the postoperative use of hormone replacement therapy rather than by hysterectomy itself, supporting an individualized, patient-centered approach to surgical decision-making and suggesting a key role for postoperative hormonal management.
Joint and independent associations of muscle and bone health with biological age acceleration in Chinese adults: Findings from the China National Health Survey.
Wang Q, Hu Y, He H … +9 more , Chen X, Tu J, Ran Z, Xu D, Chen Z, Wang Z, Zhang M, Liu G, Shan G
Maturitas · 2026 May · PMID 41795347 · Publisher ↗
BACKGROUND: Population aging has intensified interest in identifying physiological determinants of biological age beyond chronological age. Muscle loss and bone deterioration are key features of age-related decline, yet...
BACKGROUND: Population aging has intensified interest in identifying physiological determinants of biological age beyond chronological age. Muscle loss and bone deterioration are key features of age-related decline, yet their individual, joint, and sex-specific contributions to biological age acceleration remain insufficiently characterized in Asian populations. METHODS: A total of 29,437 adults aged 20-80 years from the China National Health Survey conducted in 2023-2024 were included. Appendicular skeletal muscle mass was assessed by bioelectrical impedance analysis, handgrip strength by dynamometer, and bone mineral density by quantitative ultrasound. Biological age acceleration was estimated using the Klemera-Doubal method based on sex-specific biomarker panels. Logistic regression models evaluated associations of low muscle mass, low muscle strength, and sarcopenia with elevated biological age acceleration. Additive and multiplicative interactions between muscle indicators and bone mineral density were examined. Population-attributable fractions were calculated to quantify the contributions of muscle- and bone-related deficits. RESULTS: Lower muscle mass and lower muscle strength were strongly and inversely associated with biological age acceleration in both sexes (all P < 0.0001). Individuals with low muscle mass, low muscle strength, or sarcopenia had approximately 30% to 80% higher odds of accelerated aging. Bone mineral density showed modest and sex-dependent associations, with a weak inverse relationship observed in men but no clear association in women. Joint effects of low bone mineral density and muscle deficits were observed in men and in postmenopausal women with osteoporosis defined as a T-score below -2.5. Population-attributable fraction analysis indicated that muscle-related deficits contributed substantially more to the risk of accelerated aging than low bone mineral density. CONCLUSIONS: Muscle-related indicators are strongly associated with biological age acceleration, whereas the influence of bone mineral density is weaker. Clear combined effects were observed in men and in postmenopausal women with osteoporosis. Muscle-related deficits accounted for a substantially greater proportion of the risk of accelerated aging than low bone mineral density in both sexes.
Adherence to and tolerance of low-dose tamoxifen versus standard-dose tamoxifen in women at increased risk of breast cancer.
Pogorelova MO, Buzzard JA, Fischer KM … +2 more , Salonen BR, Klassen CL
Maturitas · 2026 May · PMID 41795346 · Publisher ↗
OBJECTIVE: Tamoxifen 20 mg daily for 5 years decreases breast cancer (BC) risk by 49% in women with a family history of the disease and by up to 85% in women with a personal history of high-risk lesions. The TAM-01 study...
OBJECTIVE: Tamoxifen 20 mg daily for 5 years decreases breast cancer (BC) risk by 49% in women with a family history of the disease and by up to 85% in women with a personal history of high-risk lesions. The TAM-01 study demonstrated that patients with ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH) or atypical lobular hyperplasia (ALH) had a 50% reduction in cancer events with 5 mg daily for 3 years. We aimed to determine whether the use of low-dose tamoxifen (LDT) leads to better adherence and tolerance than standard-dose tamoxifen (SDT). STUDY DESIGN: A retrospective chart review of women with DCIS, LCIS, ADH/ALH, increased risk due to family history of breast cancer, or high-risk gene mutation was performed. Patients were grouped as SDT or LDT. Patients who declined medications were the control. RESULTS: Among 256 patients, 46% (N = 117) initiated LDT, 21% (N = 55) SDT and 33% (N = 84) declined tamoxifen. 59% of patients on LDT completed 3 years of therapy compared with 47.3% of SDT patients. Five women (2.0%) developed recurrent cancer, and 4 women (1.6%) developed a new malignancy. Vasomotor symptoms were the most commonly reported adverse events, affecting over 40% of patients in both tamoxifen groups. CONCLUSION: LDT was well tolerated, with a trend toward increased likelihood of completion of therapy. Patients with more than one indication for tamoxifen were more likely to complete therapy. Side-effects were similar in the two treatment groups, although severity was not able to be assessed due to the retrospective study design.
Pregnancy-related factors and risk of breast cancer in daughters: A systematic review and meta-analysis.
Olmedo-Requena R, Inés-Puebla I, Lozano-Lorca M … +5 more , Ávila-Cabreja JA, González-Palacios Torres C, Castillo-Hermoso MÁ, Jiménez-Moleón JJ, Barrios-Rodríguez R
Maturitas · 2026 May · PMID 41791896 · Publisher ↗
BACKGROUND AND AIM: Pregnancy-related exposures have been proposed as potential risk factors for breast cancer later in life, but findings remain inconclusive. This study aimed to update evidence on the associations betw...
BACKGROUND AND AIM: Pregnancy-related exposures have been proposed as potential risk factors for breast cancer later in life, but findings remain inconclusive. This study aimed to update evidence on the associations between the exposure to pregnancy-related factors occurring up to birth-maternal and paternal age, gestational age at birth, twin status, and maternal preeclampsia-and breast cancer risk in daughters. MATERIAL AND METHODS: A systematic review and meta-analysis were conducted. Searches were performed in MEDLINE (via PubMed), Web of Science, and Scopus. We included observational analytical studies assessing associations between parental age, gestational age, twin status, and maternal preeclampsia and breast cancer risk in daughters, reporting effect measures with 95% confidence intervals (CI) or sufficient data for calculation. Study quality was assessed using the Newcastle-Ottawa Scale. A dose-response meta-analysis evaluated the effects of maternal and paternal age, while random-effects models assessed the effects of gestational age, twin status, and maternal preeclampsia. Heterogeneity was assessed using the I statistic and publication bias through funnel plots and Egger's tests. RESULTS: Fifty-two studies met the inclusion criteria; 57.7% were high quality. Breast cancer risk increased with maternal age up to 30 years (I = 10.7%, P = .26). A possible association for paternal age (I = 33.8%, P = .08) disappeared in subgroup analysis (I = 1.0%). No associations were found for gestational age (pooled OR [pOR] 0.96, 95% CI 0.84 to 1.10), twin status (pOR 1.19, 95% CI 0.97 to 1.46), or maternal preeclampsia (pOR 1.08, 95% CI 0.71 to 1.64). CONCLUSIONS: Increased maternal age may influence breast cancer risk in daughters. No associations were found for paternal age, gestational age, or twin status; conclusions for maternal preeclampsia remain uncertain due to heterogeneity.
Fibromyalgia and menopause: Friends with benefits?
Gkouvi A, Kontouli KM, Pardali EC … +5 more , Patrikiou E, Lambrinoudaki I, Goulis DG, Bogdanos DP, Grammatikopoulou MG
Maturitas · 2026 May · PMID 41785644 · Publisher ↗
OBJECTIVE: Fibromyalgia and menopause often share common symptomatology, including musculoskeletal pain, fatigue, brain fog and sleep disturbances. The menopausal transition can represent a critical time at which fibromy...
OBJECTIVE: Fibromyalgia and menopause often share common symptomatology, including musculoskeletal pain, fatigue, brain fog and sleep disturbances. The menopausal transition can represent a critical time at which fibromyalgia symptoms often worsen. This study examined the relationship between fibromyalgia and menopause using validated instruments. METHODS: The Revised Fibromyalgia Impact Questionnaire (FIQR) was administered to 169 patients with fibromyalgia, and sociodemographic data and data on medication use were collected. Menopausal status was recorded, and the Greene Climacteric Scale (GCS) was administered. Linear regression analyses were performed to identify the predictors of more severe fibromyalgia impact and worse climacteric symptoms. RESULTS: Participants' mean age was 49.3 ± 9.6 years. Treatments for fibromyalgia included antidepressants (42.0% daily use), paracetamol, nonsteroidal anti-inflammatory drugs, and dietary supplements. Among the peri-/post-menopausal women, 6.25% were on hormone replacement therapy (HRT). The FIQR score was a significant predictor of the severity of menopausal symptoms (β = 0.38, 95% CI 0.26-0.51, p < 0.001), indicating that individuals with worse fibromyalgia tended to experience aggravated menopause symptomatology. Additionally, higher body mass index (BMI) was significantly associated with greater GCS scores (β = 0.84, 95% CI 0.35-1.33, p = 0.001) and more severe fibromyalgia impact (β = 1.1, 95% CI 0.61-1.57, p < 0.001, R = 0.11). Fibromyalgia preceded menopause in 51.0% of the sample and occurred concurrently in 21.9% of the sample. CONCLUSIONS: The findings suggest that fibromyalgia and menopausal symptoms overlap, worsening the symptom burden for patients in menopause. Higher FIQR scores were observed among patients with a greater BMI, indicating a greater overall disease impact and poorer quality of life.
Breast cancer risk in peri- and postmenopausal women with a history of hormonal contraceptive use: A narrative review.
Ferguson D, Fraker J, Sahni S … +2 more , Vegunta S, David PS
Maturitas · 2026 May · PMID 41785643 · Publisher ↗
Breast cancer is the most common cancer among women worldwide, and its incidence is projected to increase substantially by 2050. As hormonal exposure is a key modifiable risk factor, understanding the impact of exogenous...
Breast cancer is the most common cancer among women worldwide, and its incidence is projected to increase substantially by 2050. As hormonal exposure is a key modifiable risk factor, understanding the impact of exogenous hormones-including hormonal contraception-is essential. Although hormonal contraceptives are primarily used during the reproductive years, they are increasingly prescribed to perimenopausal women for both contraception and symptom management. We conducted a structured literature review using Ovid MEDLINE, identifying studies on hormonal contraception and breast cancer risk, including cohort studies, case-control studies, meta-analyses, case series, and systemic and narrative reviews. Evidence indicates that current or recent use of hormonal contraception is associated with a modest, time-limited increase in breast cancer risk (relative risk 1.1-1.6), which generally returns to baseline within a decade of discontinuation. Relative risk appears similar across combined and progestin-only formulations, with longer duration of use conferring a slightly higher risk. Women with BRCA1/BRCA2 mutations require individualized counseling for informed decision-making, with benefits weighed against the minimal potential impact on breast cancer risk. Hormonal contraceptive use does not appear to significantly increase risk in those with a family history of breast cancer. In conclusion, current evidence supports a small, reversible increase in breast cancer risk with hormonal contraception. Clinicians should employ shared decision-making to contextualize this transient risk within the broader benefits of hormonal contraceptive use and women's overall goals for their reproductive health.
Assessment of medication-related risks for mortality prediction in Alzheimer's disease.
Decaix T, Dumurgier J, Bouaziz-Amar E … +7 more , Cognat E, Götze K, Mouton-Liger F, Hugon J, Vrillon A, Paquet C, Lilamand M
Maturitas · 2026 May · PMID 41762939 · Publisher ↗
BACKGROUND: In Alzheimer's disease, exposure to medications with anticholinergic or cognitive adverse effects may contribute to excess mortality, but direct comparisons between measures of this drug-related risk remain s...
BACKGROUND: In Alzheimer's disease, exposure to medications with anticholinergic or cognitive adverse effects may contribute to excess mortality, but direct comparisons between measures of this drug-related risk remain scarce. METHODS: We retrospectively included from a memory clinic 440 patients aged ≥65 years with Alzheimer's disease confirmed by cerebrospinal fluid biomarkers (A + T+). Medication exposure was characterized in relation to polypharmacy and potentially inappropriate medications related to cognition (PIMCog, according to the Beers criteria), both treated as binary variables, and participants' anticholinergic burden (none, low-moderate or high) as rated by three scales (the ACB, ADS, and ARS). Mortality was ascertained until December 2024. Models were adjusted for demographic, clinical, and biomarker variables. RESULTS: The mean age was 74.1 ± 5.8 years, and 58.2% were women. Polypharmacy was present in 42.5% and PIMCog in 32.3%. High anticholinergic burden was found in 21.0% of patients using ACB, 8.6% using ADS, and 6.8% using ARS. During a mean follow-up of 7.3 years, 225 patients (51.1%) died. In adjusted models, mortality was associated with the number of drugs [hazard ratio (HR) 1.06, 95% confidence interval (CI) 1.01-1.11], continuous PIMCog (HR 1.21, 95% CI 1.02-1.45), high ACB (HR 1.45, 95% CI 1.01-2.11), and high ADS (HR 2.00, 95% CI 1.23-3.26), but not ARS. Antidepressants were the most frequent drugs recorded on each scale, representing 38.9% (ACB), 41.2% (ADS), and 56.1% (ARS), as well as PIMCog (33.8%). Substantial overlap was observed, with 98 patients identified by all four scales. CONCLUSION: ACB and ADS scores and PIMCog were more strongly associated with mortality than polypharmacy. These findings highlight the combined effect of clinical factors and support systematic medication review targeting anticholinergic drugs in cognitively vulnerable patients.
Menopausal hormone therapy and breast cancer: Balancing risks and benefits.
Bollam R, Karam J, Shufelt C … +1 more , Faubion SS
Maturitas · 2026 May · PMID 41740564 · Publisher ↗
Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms and plays an important role in the prevention of bone loss and fractures. When initiated earlier in menopause, hormone therapy may ha...
Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms and plays an important role in the prevention of bone loss and fractures. When initiated earlier in menopause, hormone therapy may have some favorable cardiovascular effects, though it is not recommended for cardiovascular disease prevention. Although these benefits are established, perceptions of safety have long been shaped by concerns about breast cancer risk. Evidence accumulated over the past two decades has helped to refine our understanding of the risk of breast cancer associated with hormone therapy, showing that risk varies by hormone therapy formulation, duration of use, and patient-specific factors. For example, combined estrogen-progestogen therapy has been associated with a higher risk of developing breast cancer while estrogen-alone therapy has been linked to reductions in both breast cancer incidence and mortality. The choice of progestogen also matters, with observational evidence indicating that micronized progesterone may have a more favorable breast cancer risk profile than some synthetic progestins. Beyond regimen and duration of use, outcomes are further influenced by timing of initiation and route of administration, underscoring the importance of tailoring therapy to the individual. This narrative review synthesizes current evidence on the benefits and risks of hormone therapy with a focus on breast cancer and risk modifiers to guide evidence-based clinical decision-making in menopause management. It also highlights important research gaps.
Quantifying the impact of modifiable risk factors on frailty: A population-attributable fraction analysis in older adults.
Wu CS, Chuang SY, Chuang SC … +7 more , Wu IC, Chen CC, Wu MS, Cheng CW, Tseng WT, Hsiung CA, Hsu CC
Maturitas · 2026 Apr · PMID 41740232 · Publisher ↗
BACKGROUND: Many risk factors for frailty have been reported, but their relative population-level contributions are not well quantified. This study quantified the population-level impact of modifiable risk factors on inc...
BACKGROUND: Many risk factors for frailty have been reported, but their relative population-level contributions are not well quantified. This study quantified the population-level impact of modifiable risk factors on incident frailty among older adults using population-attributable fractions. METHODS: We analyzed data from the Healthy Aging Longitudinal Study in Taiwan, a nationwide cohort of community-dwelling adults aged 55 years and over. Frailty was defined using the Fried frailty phenotype, and participants with baseline frailty were excluded. Educational attainment was treated as a life-course socioeconomic indicator, whereas lifestyle behaviors, sleep disturbance, and clinical factors were measured at baseline and reflected current or later-life status. Associations with incident frailty were examined using Cox proportional hazards models with age as the time scale, adjusting for sex. Population-attributable fractions were calculated for statistically significant risk factors in the multivariable model. RESULTS: The analytical sample comprised 5334 participants (mean age approximately 69 years; 47% men), among whom 509 incident cases of frailty occurred during follow-up. Lower educational attainment was the strongest contributor to frailty, accounting for 19.9% of cases. Other significant contributors included lack of regular exercise (14.2%), current smoking (9.8%), diabetes mellitus (8.0%), falls (7.0%), cognitive impairment (5.6%), arthritis (4.9%), and stroke (3.6%). Together, these factors accounted for about 51.6% of the frailty burden. CONCLUSIONS: Incident frailty reflects both life-course socioeconomic disadvantage and modifiable current health and behavioral factors. Multidomain prevention strategies targeting social, lifestyle, and clinical risks may help reduce frailty at the population level.
A cross-sectional cohort study of menopause-related symptoms in British Columbia.
Brotto LA, Dobrer S, Adshade M … +10 more , Booth A, Dewar K, Gustafson K, Hsieh CL, Prestley N, Parrilla JS, Smith L, Weir S, Yong PJ, Ogilvie G
Maturitas · 2026 Apr · PMID 41734616 · Publisher ↗
Menopause is a universal experience for women, yet research on its symptoms and associated health-seeking behaviors remains limited. This study documented menopause-related symptoms and severity, and their impacts on the...
Menopause is a universal experience for women, yet research on its symptoms and associated health-seeking behaviors remains limited. This study documented menopause-related symptoms and severity, and their impacts on the mental health and quality of life among midlife women in British Columbia. Of a total of 1850 participants (mean age = 49.43 ± 5.59 years) who completed an online survey, 56.95% experienced symptoms above a "clinically acceptable" threshold, psychosocial symptoms being the most prevalent, with 37.66% of participants scoring above the threshold for depression and 24.38% doing so for anxiety, while 30.85% reported reduced quality of life. Higher levels of education and income were associated with fewer menopause symptoms, lower anxiety and depression scores, and improved quality of life. Geographic locality also influenced outcomes, with women in larger urban areas reporting fewer menopause symptoms and lower mental health burdens than those in smaller communities. The findings of this first-of-its-kind Canadian study highlight the significant burden of menopause symptoms, and underscore the role of social determinants of health, including education, income, and geographic locality, in shaping menopause experiences. These insights emphasize the need for targeted interventions to improve menopause care and support mental health outcomes in midlife Canadian women.
Development of cardiovascular risk factors in women with a BRCA1/2 pathogenic variant within five years after tubo-ovarian cancer risk reduction in the TUBA study.
Gootzen TA, van Gelder MMHJ, Hermens RPMG … +23 more , van Bommel MHD, Apperloo MJA, Arts-de Jong M, Zanten MMAB, Coppus SFPJ, Custers J, van Doorn HC, Gaarenstroom KN, Harmsen MG, Knippenberg M, van Lonkhuijzen LRCW, Piek JMJ, Simons M, Slangen BFM, Tros R, Vos MC, Yigit R, Zweemer RP, Hoogerbrugge N, Kets CM, Maas AHEM, Steenbeek MP, de Hullu JA
Maturitas · 2026 Apr · PMID 41730824 · Publisher ↗
OBJECTIVES: The effects of risk-reducing salpingo-oophorectomy on the development of cardiovascular risk factors in women with BRCA1/2 pathogenic variants are unknown. We compared the development of cardiovascular risk f...
OBJECTIVES: The effects of risk-reducing salpingo-oophorectomy on the development of cardiovascular risk factors in women with BRCA1/2 pathogenic variants are unknown. We compared the development of cardiovascular risk factors 5 years post-surgery between participants who had risk-reducing salpingo-oophorectomy with and without hormonal replacement therapy and participants who had risk-reducing salpingectomy. STUDY DESIGN: Eligible participants with a BRCA1/2 pathogenic variant from the TUBA study were longitudinally followed and categorized into three groups: (1) salpingectomy without subsequent oophorectomy within 5 years, (2) salpingo-oophorectomy with hormonal replacement therapy (use ≥3 years), (3) salpingo-oophorectomy without hormonal replacement therapy (use <3 years). MAIN OUTCOME MEASURES: Development of cardiovascular risk factors between baseline and 5 years after salpingo-oophorectomy or salpingectomy. RESULTS: Of the 400 participants, 258 (64.5%) had salpingectomy, 93 (23.3%) had salpingo-oophorectomy and used hormonal replacement therapy ≥3 years, and 49 (12.2%) used it for <3 years. At 5-year follow-up, the cardiovascular risk factor hypercholesterolemia (increased LDLc) was observed more often after salpingo-oophorectomy with (18.8%, p ≤0.001) and without (17.1%, p = 0.03) hormonal replacement therapy compared with the salpingectomy group (5.7%). Larger proportions of participants after salpingo-oophorectomy with (47.1%) and without (50.0%) hormonal replacement therapy experienced an increase in the number of risk factors present compared with participants after salpingectomy (24.5%; p = 0.009, p = 0.02, respectively). CONCLUSIONS: Overall, only a small proportion of the study population developed cardiovascular risk factors within five years after salpingo-oophorectomy. However, participants developed the risk factor hypercholesterolemia more after salpingo-oophorectomy (irrespective of use of hormonal replacement therapy) compared with after salpingectomy. TRIAL REGISTRATION: NCT02321228.
Long-term outcomes of surgical menopause after risk-reducing salpingo-oophorectomy: results of the HARMOny study.
Beekman MJ, Terra L, Bleiker EMA … +21 more , Heemskerk-Gerritsen BAM, van Doorn HC, de Hullu JA, van Dorst EBL, Mom CH, van Beurden M, Slangen BFM, Mourits MJE, Roeters van Lennep JE, Gaarenstroom KN, van Engelen K, van der Kolk LE, Collée JM, Wevers MR, Ausems MGEM, Berger LPV, Gomez Garcia EB, van Asperen CJ, Maas AHEM, van Leeuwen FE, Hooning MJ
Maturitas · 2026 Apr · PMID 41724092 · Publisher ↗
BACKGROUND: Premenopausal risk-reducing salpingo-oophorectomy (RRSO), often performed for women at high familial risk of ovarian cancer, induces immediate menopause. Evidence about its long-term effects is scarce. METHOD...
BACKGROUND: Premenopausal risk-reducing salpingo-oophorectomy (RRSO), often performed for women at high familial risk of ovarian cancer, induces immediate menopause. Evidence about its long-term effects is scarce. METHODS: We conducted a cross-sectional study (n = 740) nested in a nationwide cohort of women at high familial risk of ovarian cancer. Participants completed a cognition test and a questionnaire on lifestyle, sexual functioning, urinary incontinence and health-related quality of life (HRQOL, SF-36). Cardiovascular disease (CVD) risk and bone mineral density (BMD) were assessed during a clinical visit. In women aged 60-70 years at study visit (n = 330), we compared potential long-term health effects of RRSO between women who underwent the procedure before menopause (i.e. when aged ≤45years) and those who had the procedure after menopause (when aged ≥54years). RESULTS: Participants' median age was 64.3 years, and the median time since premenopausal RRSO was 21 years. A comprehensive overview of our (partially published) results showed that a premenopausal RRSO compared with a postmenopausal RRSO was not associated with long-term coronary artery calcification, objective cognitive functioning, urinary incontinence or impaired health-related quality of life. However, women in the premenopausal RRSO group had lower bone mineral density and reported more vaginal dryness and sexual discomfort compared with the postmenopausal RRSO group. CONCLUSION: Premenopausal RRSO does not appear to be associated with long-term cardiovascular disease risk, cognition or health-related quality of life. However, it negatively influences bone mineral density and vaginal dryness. CLINICAL TRIAL REGISTRATION: Pre-registered clinical trial number: NCT03835793.
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