In Reply
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Letters to the Editor Source Type: research

To the Editor
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Letters to the Editor Source Type: research

In Reply
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Letters to the Editor Source Type: research

To the Editor
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Letters to the Editor Source Type: research

Perspectives on counseling patients about menopausal hormone therapy: strategies in a complex data environment
Conclusions: Necessary components for achieving high-quality, shared decisions about HT involve a combination of medical evidence, communication skills, and recognition of patient goals and concerns. Use of such strategies can enhance women's satisfaction with care. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Review Article Source Type: research

Hormone therapy in menopausal women with fibroids: is it safe?
Menopause is an important transition in the life of women. It has been estimated that by the year 2030, worldwide 1.2 billion women will be menopausal. The most bothersome symptoms of menopause are believed to be due to declines in estrogen levels in postmenopausal women. Thus, hormone therapy is an effective treatment option for menopausal women, although prolonged use of hormone therapy is associated with a slightly increased risk of breast cancer, thromboembolism, and stroke. A literature search for studies evaluating the effects of hormone therapy in menopausal women with asymptomatic fibroids demonstrated variable eff...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Personal Perspective Source Type: research

Evaluation and management of migraine in midlife women
Migraine is highly prevalent in women and, in addition to the pain component, can be associated with significant disability and loss of productivity. Migraine is often connected to fluctuations in hormones (primarily estrogen), commonly arising in puberty, worsening in perimenopause, and quiescing in late menopause. This Practice Pearl discusses the various types of migraine with respect to hormone fluctuations and details acute as well as preventive treatment. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

A randomized, double-blind, placebo-controlled trial of Chinese herbal medicine capsules for the treatment of premature ovarian insufficiency
This study was conducted to evaluate the treatment effectiveness of Chinese herbal medicine capsules containing the Yangyin Shugan formula (YYSG) in premature ovarian insufficiency (POI). Methods: One-hundred forty-six women with POI participated in this stratified, randomized, double-blind, placebo-controlled clinical trial. Participants in two groups (n = 73 in each)—the YYSG group and control group—underwent treatment for 12 weeks. Outcome measures included the Chinese version Menopause-Specific Quality of Life questionnaire (CMS), serum levels of basal follicle-stimulating hormone (bFSH), basal estra...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Older women do not have seasonal variations of vitamin D levels: a study from a southern country
Objective: The aim was to study whether the seasonal variation of vitamin D [25(OH)-D or calcidiol] is similar or different in younger and older women living in a southern country. Methods: Measurement of serum 25(OH)-D concentration in 739 Chilean women aged 20 to 87 years, residents of Santiago (latitude: 33.4° South) who, during a routine gynaecological checkup, agreed to be evaluated. Results: The mean serum concentration of 25(OH)-D for the group was 24.1 ± 10.5 ng/mL. In women 20 to 39 years, the mean was significantly different from the mean of the ≥60 years old group (25.8 ± 1...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Association between waist-to-height ratio and anxiety in middle-aged women: a secondary analysis of a cross-sectional multicenter Latin American study
Conclusions: In this series, WHtR was associated with anxiety in middle-aged women. It is advisable to further study this anthropometric measure in order for it to be incorporated in the routine clinical practice and evaluation of middle-aged women. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Isolated vitamin D supplementation improves the immune-inflammatory biomarkers in younger postmenopausal women: a randomized, double-blind, placebo-controlled trial
Objective: The aim of this study was to evaluate the effect of vitamin D (VitD) supplementation on immune-inflammatory biomarkers in younger postmenopausal women. Methods: In this double-blind, placebo-controlled trial, 160 postmenopausal women aged 50 to 65 years with amenorrhea ≥12 months were randomized into two groups: VitD group, oral supplementation with 1000 IU VitD3/day (n = 80) or placebo group (n = 80). The intervention time was 9 months, and the women were assessed at baseline and endpoint. Serum levels of interleukins (ILs)-1β, IL-5, IL-6, IL-10, IL-12ρ70, IL-17α, tumor necrosis...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Climacteric-related symptoms in menopause transition and beyond: a prospective 19-year follow-up study on previously hysterectomized women
Conclusions: The only symptom with notable decrease was vasomotor symptoms. The etiology of other symptoms, commonly connected to menopause transition, is probably multifactorial and not substantially dependent on the climacteric. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Risk factors for 5-year prospective height loss among postmenopausal women
Conclusions: This set of available variables may be useful in predicting the 5-year risk of height loss of 1 inch or more in postmenopausal women. These findings may help to target older women at risk of height loss who may benefit most from prevention strategies for fracture and mortality. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

SLCO1B1 genetic variation and hormone therapy in menopausal women
Conclusions: Individual variation in sulfated estrogens is explained, in part, by genetic variation in SLCO1B1. Bioavailability of sulfated estrogens may contribute to relief of night sweats. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Menopausal hormone therapy and mild cognitive impairment: a randomized, placebo-controlled trial
Conclusions: Long-term MHT using percutaneous E2 gel and oral MP4 might attenuate cognitive decline in postmenopausal women with MCI. (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Neurokinin 3 receptor antagonism rapidly improves vasomotor symptoms with sustained duration of action
Objective: Seventy percent of postmenopausal women experience vasomotor symptoms, which can be highly disruptive and persist for years. Hormone therapy and other treatments have variable efficacy and/or side effects. Neurokinin B signaling increases in response to estrogen deficiency and has been implicated in hot flash (HF) etiology. We recently reported that a neurokinin 3 receptor (NK3R) antagonist reduces HF in postmenopausal women after 4 weeks of treatment. In this article we report novel data from that study, which shows the detailed time course of this effect. Methods: Randomized, double-blind, placebo-control...
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Neurokinin 3 receptor antagonists for treatment of vasomotor symptoms: a new panacea or just a flash in the pan?
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Editorials Source Type: research

Not time to abandon use of local vaginal hormone therapies
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Editorials Source Type: research

Menopause versus chronologic aging: their roles in women's health
No abstract available (Source: Menopause)
Source: Menopause - July 26, 2018 Category: OBGYN Tags: Editorials Source Type: research

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