The role of androgens in the treatment of genitourinary syndrome of menopause (GSM): International Society for the Study of Women's Sexual Health (ISSWSH) expert consensus panel review
Conclusions: Vaginal dehydroepiandrosterone, hypothesized to enhance local production of both androgen and estrogen, is effective for the management of dyspareunia in menopause. Vaginal testosterone offers potential as a treatment for genitourinary syndrome of menopause, but more studies are needed. (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Review Article Source Type: research

Vaginal estrogen and mammogram results: case series and review of literature on treatment of genitourinary syndrome of menopause (GSM) in breast cancer survivors
Conclusions: Low-dose vaginal estrogen use for 1 or more years in a small cohort of women with GSM did not appear to be associated with any changes in breast density or Bi-RADS breast cancer risk scores in the majority of study participants, including three breast cancer survivors. Larger long-term controlled clinical trials should be conducted to examine the effects of low-dose vaginal estrogen on mammographic density in women with and without a personal history of breast cancer. Furthermore, relative efficacy and risk of vaginal estrogen compared with other forms of treatment for GSM should also be studied in long-term...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Brief Report Source Type: research

Contraception for midlife women: a review
Family planning represents a key component of reproductive health care. Accordingly, the provision of contraception must span the reproductive age spectrum, including perimenopause. The risk of pregnancy is decreased, but not trivial, among women over 40 years of age. Evidence-based guidelines for contraceptive use can assist clinicians in counseling their patients in this population. Intrauterine contraception is one of the most effective methods and is safe to use in midlife women with few exceptions. Progestin-only contraception is another safe option for most midlife women because it is not associated with an increased...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Clinical Corner: Invited Review Source Type: research

25-Hydroxyvitamin D (25(OH)D) and biomarkers of ovarian reserve
Objective: The aim of the study was to examine the associations between 25-hydroxyvitamin D (25(OH)D) and biomarkers of ovarian reserve in a large community-based sample of women. Methods: In 2010 to 2016, women aged 30 to 44 years without any known fertility problems were recruited from the Chapel Hill, NC area for a prospective time-to-pregnancy cohort study. At enrollment 561 women provided a blood sample that was used to measure 25(OH)D, anti-Müllerian hormone (AMH), follicle-stimulating hormone, and inhibin-B. Unadjusted associations were estimated with Spearman correlation coefficients. Multivariable linear...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Factors associated with knowledge about menopause and hormone therapy in middle-aged Brazilian women: a population-based household survey
Objectives: The aim of the study was to evaluate knowledge about menopause and hormone therapy (HT) among middle-aged Brazilian women and identify the factors associated with the level of knowledge. Methods: A cross-sectional study was conducted with 749 women aged 45 to 60 years, residing in the Metropolitan Region of Campinas, Brazil. The dependent variable was knowledge about menopause and HT evaluated using a numerical score based on the answers given to three questions that had several response options. The independent variables were sociodemographic characteristics, personal habits, and health conditions. Statis...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Perspectives and decision-making about menopausal therapies in women who had bilateral oophorectomy
Conclusions: We identified several modifiable deterrents to decision-making in early surgical menopause which can help inform the development of a patient decision aid for this context. (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Efficacy of misoprostol before diagnostic hysteroscopy in postmenopausal women: a randomized clinical trial
Objective: To evaluate pain and determine the efficacy of misoprostol, compared with placebo, for postmenopausal women before diagnostic hysteroscopy. Methods: This randomized, double-blind, placebo-controlled clinical trial included 158 postmenopausal women who received either 200 μg of misoprostol or placebo through the vaginal route before diagnostic hysteroscopy (79 women/group). The primary outcome was pain assessment (presence and intensity) during the four steps of hysteroscopy: cervical grasping with a Pozzi tenaculum forceps immediately before hysteroscopy, during hysteroscopy, during performance of th...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Balance ability and posture in postmenopausal women with chronic pelvic pain
This study includes a sample of 48 women with CPP recruited from the Gynecology Service of Virgen de las Nieves and San Cecilio Hospitals in Granada (Spain) and 48 healthy control women matched with respect to age and anthropometric characteristics. Outcome variables collected included: balance ability (Mini-Balance Evaluation Systems Test and Timed Up an Go Test) and posture (photogrammetry and Spinal Mouse). Results: Significant differences were found in all Mini Best Test subscales: total (P  (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Effects of dietary and exercise intervention on weight loss and body composition in obese postmenopausal women: a systematic review and meta-analysis
This study examined the effects of dietary and exercise interventions on weight loss and body composition in overweight/obese peri- and postmenopausal women. Methods: Medline, Central, Embase, and Google Scholar databases were searched for relevant trials conducted until December 31, 2016. Randomized controlled trials (RCTs) and prospective studies of overweight/obese peri- or postmenopausal women that examined the effects of dietary or exercise interventions, alone or combined, on weight loss were included. The primary outcome was percentage reduction in body weight. Results: From 292 studies initially identified, 1...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Effects of abaloparatide on bone mineral density and risk of fracture in postmenopausal women aged 80 years or older with osteoporosis
This study describes the effects of abaloparatide in the subgroup of women aged 80 or more years in ACTIVE. Methods: Post hoc analyses of BMD and fracture incidence in this subgroup of women who received abaloparatide or placebo in the 18-month, phase 3, double-blind, randomized controlled ACTIVE trial. Results: The mean ages of the women ≥80 years were 81.9 and 81.7 years in the placebo (n = 43) and abaloparatide (n = 51) groups, respectively. The increases in BMD from baseline to 18 months with abaloparatide treatment were 3.9% at the total hip (P  (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Vaginal pH: a simple assessment highly correlated with vaginal morphology and symptoms in postmenopausal women
Conclusions: Vaginal pH consistently correlated with parabasal and superficial cells and the visual vaginal epithelial changes and symptoms of dryness and dyspareunia, and is thus a simple outpatient procedure that reflects the hormonal milieu and its effects on the vaginal epithelium. (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Effects of oral conjugated equine estrogens with or without medroxyprogesterone acetate on incident hypertension in the Women's Health Initiative hormone therapy trials
Conclusions: CEE (0.625 mg/d) administered orally, with or without MPA, is associated with an increased risk of hypertension in older postmenopausal women. Whether lower doses, different estrogen formulations, or transdermal route of administration offer lower risks warrant further study. (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

In people living with HIV (PLWH), menopause (natural or surgical) contributes to the greater symptom burden in women: results from an online US survey
Conclusions: Two of the most common symptoms in people living with HIV—fatigue and muscle aches/joint pains—invoke additional burden in women. Independent of aging, symptom burden may be exacerbated after menopause, supporting a shifting paradigm for HIV care management. (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Patterns of menopausal hormone therapy use and hyperkyphosis in older women
Conclusions: Women reporting continuous or remote past HT use had less pronounced kyphosis than never-users by their mid-eighties, suggesting a possible role for HT in the prevention of age-related hyperkyphosis. (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

The effects of stair climbing on arterial stiffness, blood pressure, and leg strength in postmenopausal women with stage 2 hypertension
We examined the effects of a stair climbing (SC) regimen on arterial stiffness (pulse wave velocity [PWV]), BP, and leg strength in postmenopausal women with stage 2 hypertension. Methods: Using a parallel experimental design, participants were randomly assigned to either SC (n = 21) or nonexercising control group (n = 20) for 12 weeks. Participants in the SC group trained 4 d/wk, climbing 192 steps 2 to 5 times/d. Participants’ brachial-to-ankle PWV (baPWV), BP, and leg strength were measured at baseline and after 12 weeks of their assigned intervention. Results: There was a significant group by ti...
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Symptoms of menopause or symptoms of HIV? Untangling the knot
No abstract available (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Editorials Source Type: research

Hormone therapy for the treatment of postmenopausal osteoporosis: will it soon become a lost art in medicine?
No abstract available (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Editorials Source Type: research

Stair climbing exercise as a novel health intervention for menopause: cardiovascular and skeletal muscle implications
No abstract available (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Editorials Source Type: research

Quality of life, menopause, and hormone therapy: an update and recommendations for future research
No abstract available (Source: Menopause)
Source: Menopause - June 23, 2018 Category: OBGYN Tags: Editorials Source Type: research

In Reply
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Letters to the Editor Source Type: research

To the Editor
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Letters to the Editor Source Type: research

A systematic review of intravaginal testosterone for the treatment of vulvovaginal atrophy
Conclusion: Adequately powered double-blind, placebo-controlled clinical trials of intravaginal testosterone therapy are needed to establish both efficacy and safety. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Review Article Source Type: research

What's in a name: are menopausal “hot flashes” a symptom of menopause or a manifestation of neurovascular dysregulation?
Hot flashes have typically been classified as “symptoms of menopause” that should be tolerated or treated until they resolve. However, mounting evidence points to hot flashes as a manifestation of one or several underlying pathophysiological processes. Associations exist between the presence, timing of onset, severity, and duration of hot flashes, and the risk of several neurological (affecting sleep, mood, and cognition) and cardiovascular conditions. In addition, four consistent patterns of vasomotor disturbances have been identified across different countries, making it unlikely that these patterns are solel...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Personal Perspective Source Type: research

Dietary strategies for weight loss in midlife women
As women go through menopause, their risk of gaining weight increases. Clinicians will generally recommend dietary change as the first step toward losing weight, but which diets work best? This Practice Pearl reviews whether certain dietary therapies are more effective than others in facilitating weight loss in postmenopausal women. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Association between polycystic ovary syndrome and hot flash presentation during the midlife period
Conclusions: A history of PCOS was not associated with increased hot flash symptoms during the midlife period. Additional research should continue to investigate the health and quality of life associated with a history of PCOS in the aging population. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Prevalence of hormone therapy, factors associated with its use, and knowledge about menopause: a population-based household survey
Conclusions: The prevalence of HT use was 19.5%. Menopause status, information source, surgical menopause, work interruption due to hot flashes, and knowledge about menopause were associated with HT use. Education promoted by healthcare systems can increase HT use in women who have indications for treatment. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Association between insulin resistance and the magnetic resonance spectroscopy-determined marrow fat fraction in nondiabetic postmenopausal women
Objective: The clinical consequences of insulin resistance and hyperinsulinemia on marrow lipid remain elusive. We aimed to explore the effects of anthropometric and biochemical measures, that is, estimates of insulin resistance, on marrow lipid accumulation in nondiabetic postmenopausal women using magnetic resonance (MR) spectroscopy. Methods: The study participants were 91 nondiabetic postmenopausal women. Marrow fat fraction (FF) at the L3 vertebral body by single-voxel MR spectroscopy and bone mineral density (BMD) by dual-energy x-ray absorptiometry were measured. Their glucose and lipid metabolism were determin...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Comparisons of low-intensity versus moderate-intensity combined aerobic and resistance training on body composition, muscle strength, and functional performance in older women
This study aimed to examine the effects of exercise order of combined aerobic and low- or moderate-intensity resistance training into the same session on body composition, functional performance, and muscle strength in healthy older women. Furthermore, this study compared the effects of different (low- vs moderate-) intensity combined training. Methods: A total of 60 healthy older women (age 61—81 y) were randomly assigned to five groups that performed aerobic exercise before low-intensity resistance training (AR-L, n = 12) or after resistance training (RA-L, n = 12), performed aerobic exercise before mode...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Long-term follow-up of bulking agents for stress urinary incontinence in older patients
Conclusions: Bulking agent implantation is an effective treatment for people with intrinsic sphincter deficiency (type III SUI) and it is a valid alternative to more invasive surgeries in older patients. Moreover, it shows an overall success rate (43%) that remains high even after many years. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Fractional microablative CO2 laser in breast cancer survivors affected by iatrogenic vulvovaginal atrophy after failure of nonestrogenic local treatments: a retrospective study
Objective: Vulvovaginal atrophy (VVA) is a condition frequently observed in menopause. Its symptoms can significantly affect the quality of life of patients. Since VVA is related to estrogen deficiency, chemotherapy and hormone therapy for breast cancer (BC) might cause VVA by inducing menopause. Given the lack of effective treatment for VVA in BC survivors, we retrospectively evaluated the efficacy and tolerability of fractional microablative CO2 laser therapy in these patients. Methods: We treated 82 BC survivors with three cycles of CO2 laser after failure of topical nonestrogenic therapy. The severity of symptoms ...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Association between HIV status and psychological symptoms in perimenopausal women
Conclusions: Perimenopausal HIV-infected women experienced a disproportionately high level of affective symptom burden over a 12-month observation period. Given the potential for these factors to influence adherence to HIV clinical care and quality of life, careful assessment and referral for treatment of these symptoms is essential. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Hormonal, metabolic, and endometrial safety of testosterone vaginal cream versus estrogens for the treatment of vulvovaginal atrophy in postmenopausal women: a randomized, placebo-controlled study
Conclusions: Twelve weeks of treatment with topical testosterone or estrogen in postmenopausal women with symptoms of vaginal atrophy demonstrated laboratory and endometrial safety when compared with placebo. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

History of vasomotor symptoms, extent of coronary artery disease, and clinical outcomes after acute coronary syndrome in postmenopausal women
Objective: Vasomotor symptoms (VMS) during menopausal transition have been linked to a higher burden of cardiovascular risk factors, subclinical vascular disease, and subsequent vascular events. We aim to investigate the association of VMS with the extent of coronary disease and their prognostic role after an acute coronary syndrome. Methods: The Ladies Acute Coronary Syndrome study enrolled consecutive women with an acute coronary syndrome undergoing coronary angiography. A menopause questionnaire was administered during admission. Angiographic data underwent corelab analysis. Six out of 10 enrolling centers particip...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Hormone therapy and urine protein excretion: a multiracial cohort study, systematic review, and meta-analysis
Objective: Experimental models suggest estrogen has a renoprotective effect, but human studies show variable results. Our objective was to study the association of hormone therapy (HT) and albuminuria in postmenopausal women and to synthesize the results with outcomes from prior studies. Methods: We analyzed data from postmenopausal women who participated in the second study visit (2000-2004) of the Genetic Epidemiology Network of Arteriopathy (GENOA) study. The exposure was self-reported HT use and the outcome was albuminuria (urine albumin-to-creatinine ratio>25 mg/g creatinine). We also conducted a systematic ...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Constipation and diarrhea during the menopause transition and early postmenopause: observations from the Seattle Midlife Women's Health Study
Objective: To assess the relationship of constipation and diarrhea severity during the menopause transition (MT) with age, MT stage, reproductive biomarkers, stress-related biomarkers, and stress-related perceptions. Methods: From 1990 to 1992, women aged 35 to 55 years were recruited from the greater Seattle area; 291 of them consented to ongoing (1990-2013) annual data collection by daily menstrual calendar, health diary, and annual health questionnaire. A subset (n = 131) provided a first morning voided urine specimen (1997-2013). These were assayed for levels of E1G, follicle-stimulating hormone, testosterone,...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Trends in oral and vaginally administered estrogen use among US women 50 years of age or older with commercial health insurance
Conclusions: Analyses of US prescription claims data between 2006 and 2015 for women 50 years of age or older showed declining use of oral estrogen generally and vaginally administered estrogen products specifically in age groups less than 65 years of age. (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Original Articles Source Type: research

NAMS CME activity self-assessment examination
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: CME Exam Source Type: research

Management of genitourinary syndrome of menopause in women with or at high risk for breast cancer: consensus recommendations from The North American Menopause Society and The International Society for the Study of Women's Sexual Health
The objective of The North American Menopause Society (NAMS) and The International Society for the Study of Women's Sexual Health (ISSWSH) Expert Consensus Panel was to create a point of care algorithm for treating genitourinary syndrome of menopause (GSM) in women with or at high risk for breast cancer. The consensus recommendations will assist healthcare providers in managing GSM with a goal of improving the care and quality of life for these women. The Expert Consensus Panel is comprised of a diverse group of 16 multidisciplinary experts well respected in their fields. The panelists individually conducted an evidence-ba...
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Consensus Recommendations Source Type: research

The North American Menopause Society (NAMS) Continuing Medical Education Activity
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: CME Activity Source Type: research

Postmenopausal hormone therapy and the kidney: a new target for an old treatment?
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Editorials Source Type: research

Menopausal transition and bowel disturbances: a step in the right direction
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Editorials Source Type: research

Women's Health Initiative and rate of hormone use: a study that impacted a whole generation
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Editorials Source Type: research

The role of nursing with the journal Menopause and NAMS over the last 25 years: contributions and collaboration
No abstract available (Source: Menopause)
Source: Menopause - May 24, 2018 Category: OBGYN Tags: Editorials Source Type: research

The cross-sectional association between chemerin and bone health in peri/pre and postmenopausal women: results from the EPIC-Potsdam study
Conclusion: The present study provides evidence for an inverse association between chemerin and BUA in peri/premenopausal women. Therefore, the study suggests that high chemerin concentrations may minimize peak bone mass and thereby may promote age-related bone loss. Further studies are needed to investigate the role of chemerin in bone homeostasis in peri/premenopausal and postmenopausal women. (Source: Menopause)
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Brief Report Source Type: research

Vulvar and vaginal fractional CO2 laser treatments for genitourinary syndrome of menopause
Many healthcare providers are offering women treatment with the fractionated CO2 laser for a myriad of gynecologic issues, including genitourinary syndrome of menopause (GSM). Because existing data are limited, providing guidance is challenging. This Practice Pearl addresses what we know and don’t know about the use of the fractionated CO2 laser for the treatment of GSM. (Source: Menopause)
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

GP registrar consultations addressing menopause-related symptoms: a cross-sectional analysis
Conclusions: Registrars seek more assistance and further knowledge about menopause compared with other problems. Thus, they may find the area particularly challenging and could benefit from further education regarding managing menopause. Our findings may help inform the design of measures aimed at improving the delivery of menopause training for general practice registrars. (Source: Menopause)
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Left ventricular remodeling and arterial afterload in older women with uncontrolled and controlled hypertension
Conclusion: Regardless of current blood pressure control, hypertensive older women exhibited increased cardiac mass and arterial stiffness compared with normotensives. Future large-scale longitudinal studies are warranted to directly investigate the mechanisms for the high cardiovascular mortality among older hypertensive women with well-controlled blood pressure. (Source: Menopause)
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Association of age at menarche with obesity and hypertension among southwestern Chinese women: a new finding
Objectives: The purpose of this study was to assess the association of the age at menarche with obesity and hypertension among southwestern Chinese women. Methods: Participants in a cross-sectional study were required to recall and complete a standard self-reporting questionnaire, including age at menarche and lifestyle habits. Cardiovascular risk factors were obtained from the questionnaire or a physical examination. The main outcomes were obesity and hypertension. The association was examined by binary logistic regression and birth cohort. Odds ratios for adiposity and hypertension were computed across menarcheal ag...
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Association between the age-related decline in renal function and lumbar spine bone mineral density in healthy Chinese postmenopausal women
Objectives: The relationship between the decline of renal function and bone mineral density (BMD) in healthy populations is not well-researched. The aim of this study was to investigate the association between the age-related decline in renal function and lumbar spine BMD (LBMD) in a community-based cross-sectional study of 390 healthy postmenopausal women (mean age 62.97 ± 8.79 years) from Shenyang, China. Methods: Dual-energy x-ray absorptiometry was used to measure LBMD. Estimated glomerular filtration rate (eGFR) was calculated using a modified Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)...
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Severe menopausal symptoms associated with reduced adherence to antiretroviral therapy among perimenopausal and menopausal women living with HIV in Metro Vancouver
This study longitudinally investigated the correlates of antiretroviral therapy (ART) adherence among perimenopausal and menopausal WLWH from Metro Vancouver. Methods: Analyses drew on longitudinal data (2014-2017) from Sexual health and HIV/AIDS: Women's Longitudinal Needs Assessment, an ongoing community-based cohort of WLWH, aged 14+, from Metro Vancouver, Canada. At baseline and biannually, participants completed an interviewer-administered questionnaire. Bivariate and multivariable logistic regression with generalized estimating equations were used to identify the correlates of self-reported (Source: Menopause)
Source: Menopause - April 14, 2018 Category: OBGYN Tags: Original Articles Source Type: research