Weight loss outcomes in premenopausal versus postmenopausal women during behavioral weight loss interventions: a systematic review and meta-analysis
This study compared changes in weight, fat mass, and lean mass in premenopausal versus postmenopausal women in dietary weight loss trials. Evidence review: We reviewed publications from January 2000 to June 2020 evaluating a weight loss intervention with a dietary component, with or without exercise, and reporting weight loss of premenopausal and postmenopausal women. Where available, data on mean change from baseline for weight, fat mass, and lean mass of premenopausal and postmenopausal groups were entered into Review Manger for meta-analyses. Differences between menopausal groups were compared in subgroups of stu...
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Review Articles Source Type: research

The impact of frailty in older women undergoing pelvic floor reconstructive surgery
Conclusion: Understanding the concept of frailty and how it may affect surgical decisions and outcomes is essential. The timed up and go test, life space assessment and Mini-Cog assessment at a minimum should be considered preoperatively in patients over the age of 65 years old planning pelvic floor or elective surgery. Video Summary:http://links.lww.com/MENO/A676. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Review Articles Source Type: research

Menopause, the gut microbiome, and weight gain: correlation or causation?
The gut microbiome is a key regulator of metabolism and influences the metabolism of estrogens, however, the microbiome's role in the changes in body composition and metabolic risk factors experienced by menopausal women remains largely unexplored. Menopause has been shown to alter the gut microbiome, and rodent studies suggest that microbiome changes postovariectomy are associated with increased adiposity, decreased metabolic rate, and insulin resistance, changes attenuated by estrogen administration. Given these data, a deeper understanding of the gut microbiome's relationship to menopause-induced changes in body composi...
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Personal Perspective Source Type: research

What providers need to know about progestogens in hormone therapy
Progestogens such as micronized progesterone and the synthetic progestins are defined by their ability to transform the estrogen-primed proliferative endometrium into secretory endometrium. More than 200 progestogens have been synthesized, but only a few are used clinically in hormone therapy. Clinicians caring for menopausal women should be familiar with the clinical properties and characteristics of the three most-used progestogens for hormone therapy: micronized progesterone, medroxyprogesterone acetate, and norethindrone acetate. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Comparative validity and reliability of the WeChat-based electronic and paper-and-pencil versions of the PISQ-12 for collecting participant-reported data in Chinese
The objective of this study is to assess the consistency between the WeChat-based Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire short form (PISQ-12) in Chinese and the paper version and to determine the test–retest reliability of the WeChat questionnaire. Methods: A total of 120 women aged between 24 and 69 years were recruited from the outpatient clinic at Peking Union Medical College Hospital and randomly assigned to two groups. All participants completed the WeChat and paper questionnaires twice. Group A completed the paper questionnaire before the WeChat version; Group B completed the WeC...
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Effects of high protein, low-glycemic index diet on lean body mass, strength, and physical performance in late postmenopausal women: a randomized controlled trial
Conclusions: Protein intake exceeding the RDA did not increase LBM, strength, and physical performance in a sample of late postmenopausal woman consuming a low-glycemic index diet for 6 months. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Bone mineral density in women with deep infiltrating endometriosis who have undergone early bilateral oophorectomy
Conclusion: Higher lumbar spine and femoral neck BMDs are associated with an increase in the likelihood of pelvic DIE in women who underwent early BO. This might be expected to the extent that endometriosis is itself associated with enhanced estrogen status, although further studies are needed to confirm such a hypothesis. These findings suggest that BMD measurement could contribute to the hormonal management of surgical menopause in women with DIE. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Refinement of the German Day-to-Day Impact of Vaginal Aging questionnaire in perimenopausal and postmenopausal women using item response theory and classical test theory
Conclusions: We created a validated refined version of the DIVA, having now three response categories instead of five. With 17 items (short-version) or rather 21 items (long-version for women with recent sexual activity), the refined DIVA is more feasible and showed several excellent measurement properties. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

High-sensitivity cardiac troponin T and the risk of heart failure in postmenopausal women of the ARIC Study
Conclusions: Irrespective of early menopause status, hs-cTnT elevation is associated with greater HF incidence but this association is partially explained by HF risk factors. Even in the absence of hs-cTnT elevation, early menopause is significantly associated with HF incidence after accounting for HF risk factors. Video Summary:http://links.lww.com/MENO/A693. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Sexual behaviors and function during menopausal transition—does menopausal hormonal therapy play a role?
Objectives: The menopausal transition is a biological adaptation to the variety of life changes (body, comorbidities, relationship), but that biology is not an “end all” in the context of sexual function and overall sexual health. The aim of this study is to evaluate determinants altering the risk of female sexual dysfunction (FSD) and other sexual problems and to establish whether menopausal hormonal therapy (MHT) decreases that risk and modifies sexual behaviors. Methods: A cross-sectional observational study was conducted in 210 women between the ages of 45 and 55. Two groups were identified: MHT ...
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Satisfaction with prophylactic risk-reducing salpingo-oophorectomy in BRCA mutation carriers is very high and little dependent on the participants’ characteristics at surgery: a prospective study
Conclusions: Findings from this prospective study suggest that satisfaction with RRSO is very high and little dependent on the participants’ characteristics at surgery. Women at high risk for ovarian cancer are very satisfied with their choice of risk-reduction strategy. Video Summary:http://links.lww.com/MENO/A712. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Impact of prior preterm or term small for gestational age birth on maternal blood pressure during the menopause transition in the Study of Women's Health Across the Nation
Conclusions: Women with a history preterm and term SGA delivery have higher BP than women with all term AGA births during the menopause transition, but rate of change in BP does not differ in these groups relative to final menstrual period. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Biopsychosocial predictors of depressive symptoms in the perimenopause—findings from the Swiss Perimenopause Study
Objective: The perimenopause is associated with increased hormone fluctuations and an elevated risk of depression. A number of predictors of depressive symptoms in the menopausal transition have previously been suggested. The purpose of this study was to investigate a set of biopsychosocial predictors of depressive symptoms in perimenopausal women. Methods: This cross-sectional study, investigating 114 perimenopausal women (according to the STRAW criteria) aged 40-56 years, was conducted within the scope of the Swiss Perimenopause Study. Multiple regression analyses were performed to identify the most accurate m...
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

High-density lipoprotein cholesterol and arterial calcification in midlife women: the contribution of estradiol and C-reactive protein
Conclusions: The protective cardiovascular association of higher HDL-C levels on AC was modified by estradiol but not CRP concentrations. The pathways through which estradiol might influence this association should be further investigated. Video Summary:http://links.lww.com/MENO/A689. (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Estradiol fluctuations and depressive history as risk factors for menopausal depression
No abstract available (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Editorials Source Type: research

HDL-c and arterial calcification in midlife women: does an HDL paradox exist?
No abstract available (Source: Menopause)
Source: Menopause - March 1, 2021 Category: OBGYN Tags: Editorials Source Type: research

Erratum
No abstract available (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Errata Source Type: research

In Reply:
No abstract available (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Letters to the Editor Source Type: research

To the Editor:
No abstract available (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Letters to the Editor Source Type: research

Efficacy of progestin-only treatment for the management of menopausal symptoms: a systematic review
Conclusions and relevance: A beneficial effect was reported in some trials with the transdermal route at longer duration and with oral treatment at higher doses for VMS for progesterone-only therapy. This report may help to inform future studies of progestin-only therapy for the treatment of menopausal symptoms. Video Summary:http://links.lww.com/MENO/A671. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Review Articles Source Type: research

Serotonergic antidepressants for sleep disturbances in perimenopausal and postmenopausal women: a systematic review and meta-analysis
Conclusions and Relevance: Our results showed that serotonergic antidepressants were effective against sleep disturbances in perimenopausal and postmenopausal women. The efficacy remained significant for women without major depressive disorder. The dropout rates were also comparable between serotonergic antidepressants and placebo groups. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Review Articles Source Type: research

The ewe as an animal model of vaginal atrophy and vaginal Er:YAG laser application
Conclusions: In reproductive sheep, ovariectomy induces vaginal atrophy evidenced in different outcome measurements. Vaginal Er:YAG laser induced visual impact, a short-term increase in epithelial thickness yet no long-term changes compared to sham therapy in menopausal controls. Video Summary:http://links.lww.com/MENO/A672. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Menopause symptoms delineated by HIV clinical characteristics in African American women with HIV
Objective: To obtain data on prevalence and severity of climacteric symptoms in women with HIV (WWH) during the menopausal transition and early menopause and to evaluate for any differences in symptoms by CD4 count and viral load. Methods: We conducted an in-person survey of female patients attending the Johns Hopkins HIV clinic, ages 40 to 50 years with at least one menstrual period within 6 months before the survey. Interviews utilized the Greene Climacteric scale, a validated menopause questionnaire. We also queried patients, (1) if they were informing their primary care physician of menopause symptoms and (2...
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Prevalence of symptoms and associated factors across menopause status in Taiwanese women
Conclusions: Compared with premenopausal and perimenopausal women, postmenopausal women experience the most severe symptoms. Therefore, establishing a menopause consultation hotline answered by medical personnel and implementing support for postmenopausal women to obtain strategies to alleviate symptoms are required and necessary. Video Summary:http://links.lww.com/MENO/A651. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Relationship between number of menopausal symptoms and work performance in Japanese working women
Objective: The presence of various menopausal symptoms could decrease work performance because symptom management strategies differ, and it is difficult to control all symptoms at work. The aim of this study was to examine the relationship between the number of menopausal symptoms experienced and work performance in working women. Methods: An online cross-sectional study was conducted with 599 working Japanese women aged 45 to 65 years. To represent work performance, absolute presenteeism was measured using the Japanese version of the World Health Organization and Work Performance Questionnaire short form, and m...
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Age, menstruation history, and the brain
Conclusions: Menopause may contribute to brain volume beyond typical aging effects. Furthermore, early age of menarche, delayed age of menopause and increasing duration of reproductive stage were negatively associated with brain volume. Further research is required to determine whether the negative association between age of menopause and HV is potentially an indicator of future vulnerability for dementia. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Developing and evaluating a patient decision aid for hormone therapy to manage symptoms of surgical menopause: the story behind the “SheEmpowers” patient decision aid
Conclusion: Through our adopted, systematic approach the SheEmpowers PDA was developed to help women overcome deterrents to decision-making related to lack of knowledge, decision-making skills, and involvement in therapy decisions. The decisional effectiveness of the tool is to be assessed in future studies. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Inverse association between dietary fiber intake and depression in premenopausal women: a nationwide population-based survey
This study aimed to investigate the relationship between dietary fiber intake and depression in women by menopause status using data from a nationwide population-based survey conducted in Korea. Methods: We utilized the Korea National Health and Nutritional Examination Survey data for 2014, 2016, and 2018 with a complex sampling design. Dietary fiber intake was calculated according to the 24-hour recall method, and we used Patient Health Questionnaire-9 scores to assess depression. A t test based on the general linear model was used to compare mean dietary fiber intake according to the presence of depression by meno...
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Physical activity and menopausal symptoms in women who have received menopause-inducing cancer treatments: results from the Women's Wellness After Cancer Program
Conclusion: This exploratory study established a stepwise association between moderate and vigorous PA and a lower total menopausal symptom score. The intervention did not appear to increase self-reported PA in women treated for early stage breast, reproductive, and blood cancers. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Vaginal energy-based devices: characterization of adverse events based on the last decade of MAUDE safety reports
Conclusions: MAUDE-reported data suggests that the majority of patient complaints after vaginal energy-based device treatment include vaginal pain, bladder pain, and urinary symptoms. This study suggests that the majority of complaints are not severe, and some may be related to progression of the disease. The few severe adverse events reported in the MAUDE database may have contributed to the FDA warning regarding energy-based devices. Recall bias after the FDA warning, as well as the potential for litigation, may have prompted an increase in adverse event reporting after July 30, 2018. Video Summary:http://links.lw...
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Identifying women who share patterns of reproductive hormones, vasomotor symptoms, and sleep maintenance problems across the menopause transition: group-based multi-trajectory modeling in the Study of Women's Health Across the Nation
Conclusions: Women can be classified based on shared levels and patterns of FSH, sleep maintenance problems, and frequent VMS across the menopause transition. Either VMS or sleep maintenance problems can be dominant in the face of high FSH. Experiencing one menopause-related symptom or hormone profile does not automatically imply that another is also being experienced. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Age-associated trends of vulvar cancer in the US
Conclusion: The incidence of vulvar cancer increases with age, with the median age of diagnosis 67 years, with HPV (+) tumors occurring into 70's and 80's. Though medical societies do not routinely recommend an external genital examination in women 65 years and above, we show this is a missed opportunity to improve cancer outcomes in some older females. Video Summary:http://links.lww.com/MENO/A678. (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Does age at the start of treatment for vaginal atrophy predict response to vaginal estrogen therapy? Post hoc analysis of data from a randomized clinical trial involving 205 women treated with 10 μg estradiol vaginal tablets
This study evaluated whether age at the start of treatment influences response. Methods: This post hoc analysis used data from a double-blind, randomized, placebo-controlled trial (NCT00108849), which treated 205 postmenopausal women aged ≥45 years with 10 μg vaginal ET for 52 weeks. Women aged  (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Delay in diagnosis and increasing incidence of vulvar cancer: a root cause analysis
No abstract available (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Editorials Source Type: research

Genitourinary syndrome of menopause and age: a new algorithm for hormonal treatment?
No abstract available (Source: Menopause)
Source: Menopause - February 1, 2021 Category: OBGYN Tags: Editorials Source Type: research

The effect of pathophysiological changes in the vaginal milieu on the signs and symptoms of genitourinary syndrome of menopause (GSM)
Discussions and conclusion: The vaginal milieu plays important roles in producing bothersome symptoms in the host. In women with GSM, low hormone states can result in pathophysiological changes in the vaginal milieu, including the vaginal microbiome and the mucosal immunity. Hormone-associated disruption of the balance of the indigenous microbiota and the dysregulation of these immune responses are the pathophysiological basis of GSM symptoms. However, whether the microbiome and mucosal immunity are markers of vulvovaginal disorder or agents actively promoting a healthy vagina are still not fully understood. It is an i...
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Review Articles Source Type: research

Migraine and menopause - a narrative review
Discussion and conclusion: Many women are informed that their migraines will disappear postmenopause; there are some data to support this, but a specific time frame has not been evidenced. Stroke risk in women with migraine with aura is small in absolute terms, but important at the population level, because migraine is so prevalent. The risk becomes clinically important in the context of additional stroke risk factors, which increase with aging such as hypertension. Estrogen in combined hormonal contraception increases the risk of an ischemic stroke, however, the lower amount of estrogen in HT may not contribute to a m...
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Review Articles Source Type: research

Fibromyalgia screening in patients with unexplained chronic fatigue
Women often complain of symptoms of fatigue and generalized aches and pains around menopause. Even though fibromyalgia is more prevalent in midlife women, not all women presenting with aches and pain and disrupted sleep meet diagnostic criteria for fibromyalgia. This Practice Pearl addresses the distinction between chronic fatigue syndrome and fibromyalgia and the management of fibromyalgia in perimenopausal and postmenopausal women. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Behavioral and psychological health inequities in income disparate perimenopausal women: a brief report
Objective: To assess differences in behavioral and psychological health characteristics in perimenopausal women delineated by income disparity. Methods: A hypothesis generating secondary data analysis was conducted in 33 women, using public health insurance enrollment as a proxy for income. Sociodemographic characteristics were assessed. Study outcomes included behavioral health characteristics: current cigarette smoking, substance abuse history, current exercise, obesity (BMI ≥30); psychological health characteristics, and sleep: depressed mood (Center for Epidemiologic Studies Depression Scale [CES-D]), anx...
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Brief Report Source Type: research

Acupuncture ameliorated vasomotor symptoms during menopausal transition: single-blind, placebo-controlled, randomized trial to test treatment efficacy
Conclusions: Acupuncture treatment may mitigate hot flashes and other climacteric symptoms during the menopausal transition. Video Summary:http://links.lww.com/MENO/A641. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Onset of the climacteric phase by the mid-forties associated with impaired insulin sensitivity: a birth cohort study
Objective: To investigate whether the early-onset menopausal transition is associated with deteriorated glucose tolerance in women in their mid-forties. Methods: A cross-sectional analysis of a cohort study including 2,632 women of the Northern Finland Birth Cohort 1966. The participants were divided into two groups by their menstrual history and follicle-stimulating hormone values at age 46: climacteric and preclimacteric women. Glucose and insulin parameters, as well as mathematical indices derived from them to evaluate insulin sensitivity, were compared between the groups. The results were adjusted for measur...
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Assessment of menopausal symptoms and quality of life in women with premature ovarian failure after hematopoietic stem-cell transplantation for hematologic diseases
Conclusions: Compared with naturally menopausal women with the same number of years since menopause, the MRS and KI scores of women with premature ovarian failure who underwent HSCT showed milder symptoms. The MRS may be a better alternative to reflect the severity of menopausal symptoms. Age was a risk factor for menopausal symptoms. Oncofertility counseling should be initiated as early as possible before the start of treatment. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Relationship between the use of Chinese herbal medicines and Sjögren syndrome risk among women with menopause: a retrospective cohort study
Conclusions: A statistically significant association was found between CHMs use and lower risk of SS onset in menopausal women, suggesting that CHMs could be considered to integrate it into conventional therapy to reduce subsequent SS risk for menopausal women. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Comparison of performance and health indicators between perimenopausal and postmenopausal obese women: the effect of high-intensity interval training (HIIT)
This study examined the effects of 6 weeks of high-intensity interval training (HIIT) on performance and health indicators in obese perimenopausal (PERIM) women and similarly aged and older postmenopausal women (POSTM1 and POSTM2, respectively). Methods: Sixteen PERIM women (average age 49.6 y), 21 POSTM1 women (average age 50.6 y), and 19 POSTM2 women (average age 69.6 y) completed a 6-week HIIT intervention. Anthropometric parameters, mechanical efficiency (ME in %), lipid oxidation (LO in %), and low and high spectral frequencies (LF[ms2] and HF[ms2]) were computed pre- and postintervention. Results: PERIM...
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Long-term resveratrol supplementation improves pain perception, menopausal symptoms, and overall well-being in postmenopausal women: findings from a 24-month randomized, controlled, crossover trial
Objective: Following concerns about hormone therapy, postmenopausal women need alternative options to manage menopause-related symptoms and improve their well-being. A 14-week pilot study has shown that supplementation with resveratrol, a phytoestrogen with circulatory benefits, can improve aspects of well-being including chronic pain, which is a common complaint in postmenopausal women. We aimed to confirm these benefits in a larger, long-term study. Methods: The Resveratrol for Healthy Ageing in Women study, a 24-month randomized, double-blind, placebo-controlled, two-period crossover intervention trial of res...
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Effects of combined 17β-estradiol and progesterone on weight and blood pressure in postmenopausal women of the REPLENISH trial
Conclusions: Twelve-month use of E2/P4 had no clinically meaningful impact on weight or BP in postmenopausal women of the REPLENISH study. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Hypertensive disorders of pregnancy and menopausal symptoms: a cross-sectional study from the data registry on experiences of aging, menopause, and sexuality
Conclusions: In this large cross-sectional study, a history of hypertensive disorders of pregnancy was associated with more bothersome menopausal symptoms. Additional study is needed to determine the strength of this association, underlying mechanisms of the association, and clinical implications for cardiovascular risk prediction in women. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research

Age at menarche and cardiovascular health: results from the NHANES 1999-2016
Conclusions: Our findings suggested that early menarche is associated with worse CVH, especially among young women. Further efforts are warranted to confirm these findings. Video Summary:http://links.lww.com/MENO/A643. (Source: Menopause)
Source: Menopause - January 1, 2021 Category: OBGYN Tags: Original Studies Source Type: research