Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study
Conclusions:The risks of cardiovascular disease and cancer were not elevated among postmenopausal women using vaginal estrogens, providing reassurance about the safety of treatment. Objective: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. Methods: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observat...
Source: Menopause - January 1, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Urinary incontinence: finding a voice to talk about “it”
No abstract available (Source: Menopause)
Source: Menopause - January 1, 2018 Category: OBGYN Tags: Editorials Source Type: research

Seeing the light: the need for randomized trials of vaginal laser in postmenopausal women
No abstract available (Source: Menopause)
Source: Menopause - January 1, 2018 Category: OBGYN Tags: Editorials Source Type: research

More evidence why the product labeling for low-dose vaginal estrogen should be changed?
No abstract available (Source: Menopause)
Source: Menopause - January 1, 2018 Category: OBGYN Tags: Editorials Source Type: research

Menopause 25th anniversary: past success and future direction
No abstract available (Source: Menopause)
Source: Menopause - January 1, 2018 Category: OBGYN Tags: Editorials Source Type: research

The bidirectional relationship between vasomotor symptoms and depression across the menopausal transition: a systematic review of longitudinal studies
Conclusions:There is a bidirectional association between VMS and depressive symptoms. The menopausal transition appears to increase the risk of recurrent episodes of depression that might not be explained only by VMS. Further investigation is needed to explain the differential effect of night sweats and hot flashes on depression. Objective: To explore the nature of the bidirectional relationship between vasomotor symptoms (VMS) and depression, and to determine whether hot flashes and night sweats differentially affect the association between VMS and depression through their effect on sleep disruption. Methods: Multi...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Review Article Source Type: research

Restoring vaginal function in postmenopausal women with genitourinary syndrome of menopause
Menopause practitioners are often asked to help postmenopausal women restore vaginal health and function. A common scenario is the postmenopausal woman who has been without a sexual partner for many years and is now about to resume or has already unsuccessfully attempted penetrative sexual activity. This Practice Pearl addresses the pathophysiology and effect of atrophic genital changes and offers advice on how vaginal health and comfortable sexual activity can be restored. (Source: Menopause)
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Patient characteristics, menopause symptoms, and care provided at an interdisciplinary menopause clinic: retrospective chart review
Conclusions:Our study addresses a gap in published information on patient characteristics and treatment in menopause-specific interdisciplinary clinics. The chart review highlights the variety of symptom experience and complexity of care faced in a menopause clinic. Rigorous prospective studies including standardized data collection and follow-up are needed to help guide clinicians in managing complex menopause patients. Objective: The goal of this study was to describe the characteristics, menopause symptoms, and treatment progressions in women cared for at an interdisciplinary menopause clinic. Methods: We conduct...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Brief Report Source Type: research

Perimenopausal arthralgia in the shoulder
AbstractObjective:To evaluate perimenopausal arthralgia in the shoulder and treatment thereof.Methods:Participants with perimenopausal (n = 197) or premenopausal (n = 113) shoulder arthralgia were included in the study. The prevalences of synovitis, adhesive capsulitis, rotator cuff disorder, arthritis, and other pathologies in the two groups were compared. Participants diagnosed with synovitis were treated with oral prednisolone for 9 to 12 weeks.Results:The most common diagnosis in the perimenopausal and premenopausal groups was adhesive capsulitis (35.4% and 31.8%, respectively), but the difference in prevalence...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Body composition, cardiometabolic risk factors, physical activity, and inflammatory markers in premenopausal women after a 10-year follow-up: a MONET study
This study investigated body composition, cardiometabolic risk factors, PAEE, and inflammatory markers in premenopausal women after a 10-year follow-up.Methods:In all, 102 premenopausal women participated in the 5-year observational longitudinal Montreal Ottawa New Emerging Team (MONET) study. This present substudy included 48 participants (age: 60.0 ± 1.7 years; body mass index: 23.2 ± 2.2 kg/m2) 6.0 ± 0.3 years after completion of the initial MONET study. Measures included body composition, waist circumference (WC), fasting glucose and insulin levels, insulin sensitivity (QUICKI model),...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Impact of age at first childbirth on primary open-angle glaucoma
Conclusions:First childbirth at the age of 27 years or above decreases the risk of POAG in postmenopausal women. Decreased parity, caused by late first childbirth, attenuated the magnitude of the total effects of age at first childbirth on POAG. Objective: No studies have addressed the relationship between the timing of first childbirth and primary open-angle glaucoma (POAG). The aim of the study was to identify the relationship between age at first childbirth and POAG and to examine the contribution of parity to the age at first childbirth–POAG relationship in postmenopausal women. Methods: The study populati...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Serum uric acid levels and hormone therapy type: a retrospective cohort study of postmenopausal women
AbstractObjective:Serum uric acid levels increase in postmenopausal women, but decrease when hormone therapy (HT) is administered. No study has, however, evaluated the effects of different types of HT on serum uric acid levels. We therefore examined whether estrogen therapy (ET), estrogen plus progestogen therapy (EPT), and tibolone use affected serum uric acid levels in this population.Methods:We performed a retrospective cohort study of postmenopausal women. From 2005 to 2015, postmenopausal women who had undergone blood uric acid-level testing at least twice were enrolled. Participants were grouped according to HT regim...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Is the age at menopause a cause of sexual dysfunction? A Brazilian population-based study
AbstractObjectives:The aim of the study was to evaluate the association between age at menopause and sexual dysfunction and the components of sexual function in postmenopausal women.Methods:In this cross-sectional population-based study, data of 540 women aged 45 to 60 years regarding the age they were when they achieved menopause and its association with sexual dysfunction (evaluated using the Short Personal Experiences Questionnaire) were obtained through interviews. We assessed the data for associations between age at menopause and sexual dysfunction and demographic, behavioral, and clinical characteristics.Results:Age ...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Sleep quality and its association with postural stability and fear of falling among Spanish postmenopausal women
AbstractObjective:To analyze the association of sleep quality with postural balance, as measured with objective stabilometric parameters, and fear of falling (FoF), among Spanish postmenopausal women.Methods:In all, 250 women (60 ± 8 years) took part in this cross-sectional study. Sociodemographic and anthropometric data were collected, as well as information concerning history of falls and FoF. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale, and the Pittsburgh Sleep Quality Index was used to analyze sleep quality. Measurements of sway area (S), velocity (V), and mediolatera...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

In-utero cigarette smoke exposure and the risk of earlier menopause
Conclusions:In-utero smoke exposure was not associated with earlier menopause, but the effect of in-utero smoke exposure was modified by the smoking habits of the participants themselves increasing the risk for smokers who were in-utero exposed. Objective: Cigarette smoking is a risk factor for earlier menopause. Animal studies show that in-utero smoke exposure is toxic to developing ovaries. Our aim was to evaluate whether in-utero smoke exposed women reach menopause earlier compared with nonexposed women. Methods: This is a cohort study within the Avon Longitudinal Study of Parents and Children. Participants inclu...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Hormone therapy use in the Canadian Longitudinal Study on Aging: a cross-sectional analysis
Conclusions:These findings provide a recent national picture of HT use in Canada that may be used to inform opportunities for improved physician–patient communication regarding menopause management. Objective: The aim of the study was to assess the prevalence and factors associated with hormone therapy (HT) use among Canadian women. Methods: Baseline data from the Tracking cohort of the Canadian Longitudinal Study on Aging (CLSA) was used for this analysis. The main outcome was HT use among women aged 45-85 years, defined as current, past, and never users. Multinomial logistic regression models were used to ex...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Cardiovascular fat in women at midlife: effects of race, overall adiposity, and central adiposity. The SWAN Cardiovascular Fat Study
AbstractObjectives:Cardiovascular fat (CF) is associated with greater coronary heart disease (CHD) risk. Postmenopausal women have greater CF volumes than premenopausal women, and the association between specific CF depot volumes and CHD risk is more pronounced after menopause. Race, central adiposity, and visceral adiposity are important factors that could impact CF volumes. Whether racial differences in CF volumes and in their associations with central (visceral fat [VAT]) and general adiposity (body mass index [BMI]) exist in midlife women have not been addressed before.Methods:In all, 524 participants from the Study of...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Factors associated with reasons incontinent midlife women report for not seeking urinary incontinence treatment over 9 years across the menopausal transition
Conclusions:Over half of women who did not seek treatment for their UI reported reasons that could be addressed by public health and clinical efforts to make UI a discussion point during midlife well-women visits. Objective: We explored factors associated with reasons that women with urinary incontinence (UI) reported for not seeking treatment for their UI from a healthcare professional and whether reasons differed by race/ethnicity, socioeconomic status, or education. Methods: We analyzed questionnaire data collected from 1995 to 2005 in the Study of Women's Health Across the Nation. In visits 7 to 9, we elicited r...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Randomized, double-blind, placebo-controlled clinical trial for evaluating the efficacy of fractional CO2 laser compared with topical estriol in the treatment of vaginal atrophy in postmenopausal women
AbstractObjective:The aim of the study was to evaluate efficacy of fractional CO2 vaginal laser treatment (Laser, L) and compare it to local estrogen therapy (Estriol, E) and the combination of both treatments (Laser + Estriol, LE) in the treatment of vulvovaginal atrophy (VVA).Methods:A total of 45 postmenopausal women meeting inclusion criteria were randomized in L, E, or LE groups. Assessments at baseline, 8 and 20 weeks, were conducted using Vaginal Health Index (VHI), Visual Analog Scale for VVA symptoms (dyspareunia, dryness, and burning), Female Sexual Function Index, and maturation value (MV) of Meisels.Results:For...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Breast cancer, endometrial cancer, and cardiovascular events in participants who used vaginal estrogen in the Women's Health Initiative Observational Study
Conclusions:The risks of cardiovascular disease and cancer were not elevated among postmenopausal women using vaginal estrogens, providing reassurance about the safety of treatment. Objective: To determine the association between use of vaginal estrogen and risk of a global index event (GIE), defined as time to first occurrence of coronary heart disease (CHD), invasive breast cancer, stroke, pulmonary embolism, hip fracture, colorectal cancer, endometrial cancer, or death from any cause. Methods: For this prospective observational cohort study, we used data from participants of the Women's Health Initiative Observat...
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Urinary incontinence: finding a voice to talk about “it”
No abstract available (Source: Menopause)
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Editorials Source Type: research

Seeing the light: the need for randomized trials of vaginal laser in postmenopausal women
No abstract available (Source: Menopause)
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Editorials Source Type: research

More evidence why the product labeling for low-dose vaginal estrogen should be changed?
No abstract available (Source: Menopause)
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Editorials Source Type: research

Menopause 25th anniversary: past success and future direction
No abstract available (Source: Menopause)
Source: Menopause - December 22, 2017 Category: OBGYN Tags: Editorials Source Type: research

Author Index
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Index Source Type: research

Subject Index
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Index Source Type: research

Abstract Author Index
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Abstracts Source Type: research

28th Annual Meeting of The North American Menopause Society October 11-14, 2017, Philadelphia, PA
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Abstracts Source Type: research

Acknowledgment of Reviewers
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Acknowledgment of Reviewers Source Type: research

Erratum
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Erratum Source Type: research

Effect of programmed exercise on insulin sensitivity in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials
Conclusion: Exercising for 3 to 4 months significantly lowered insulin levels and HOMA-IR values, BMI waist circumference, and percentage body fat mass; exercising for 6 to 12 months lowered waist circumference in postmenopausal women. (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Review Article Source Type: research

Caring for the lesbian patient at midlife and beyond
Abstract: Clinicians who have an understanding of lesbian women and their unique stressors, who provide a welcoming and inclusive environment, and who provide cross-cultural care are well positioned to reduce healthcare stigma and improve clinical outcomes. This Practice Pearl addresses these issues, focusing on the lesbian patient at midlife and beyond. (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Factors associated with different symptom domains among postmenopausal Saudi women in Riyadh, Saudi Arabia
Conclusions: Establishing educational and counseling programs for postmenopausal women, their spouses, and other family members could improve social support and hence quality of life of postmenopausal women. Effective preventive strategies to deal with modifiable risk factors, such as obesity and work stress, should also be implemented. (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Vasomotor hot flashes and cardiac repolarization: a randomized placebo-controlled trial of postmenopausal hormone therapy
Conclusions: Hot flashes predict beneficial shortening in cardiac repolarization during OE, but not if MPA is combined with OE. These data may provide one explanation for MPA-related cardiac hazards in epidemiological studies. (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Hot flush frequency and severity at baseline as predictors of time to transient and stable treatment success: pooled analysis of two CE/BZA studies
Objective: To evaluate the impact of baseline hot flush frequency and severity on time to symptom improvement during treatment with conjugated estrogens/bazedoxifene (CE/BZA). Methods: Data were pooled through week 12 from two randomized placebo-controlled trials (SMART-1 and SMART-2) of nonhysterectomized postmenopausal women with hot flushes treated with CE 0.45 mg/BZA 20 mg or CE 0.625 mg/BZA 20 mg. Time to transient and stable improvement (≥ 50% reduction in hot flush frequency/severity) was estimated using nonparametric models. Results: Transient improvement in hot flush frequency occurred earlier in wo...
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Time to first occurrence of breast pain and vaginal bleeding in phase 3 trials of CE/BZA
Objective: In studies of the menopausal therapy, conjugated estrogens/bazedoxifene, breast pain and vaginal bleeding rates were comparable to placebo and lower than conjugated estrogens/medroxyprogesterone acetate (MPA). This post hoc analysis determined median time to occurrence of these events. Methods: Participants in phase 3 conjugated estrogens/bazedoxifene trials recorded breast pain and vaginal bleeding in daily diaries. Median time to first incident was determined in women taking conjugated estrogens 0.45 mg/bazedoxifene 20 mg, conjugated estrogens 0.625 mg/bazedoxifene 20 mg, placebo, and conjugated estro...
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Vasomotor symptoms are associated with depressive symptoms in community-dwelling older women
Objective: To assess the prevalence of, and factors associated with, moderate-to-severe depressive symptoms in community-dwelling older Australian women. Methods: A questionnaire-based, cross-sectional study was conducted amongst community-dwelling older women. Participants were recruited between April and August 2014 from a national database based on the electoral roll. Depressive symptoms were assessed by the Beck Depression Inventory-II (BDI-II) tool. Vasomotor symptoms (VMS), vulvovaginal atrophy (VVA), and pelvic floor symptoms were assessed using validated questionnaires. Women were provided a comprehensive list of ...
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Missing documentation in breast cancer survivors: genitourinary syndrome of menopause
Conclusion: Breast cancer survivors often experience GSM due to lack of estrogen. The worrisome lack of documentation of assessment or treatment for GSM in a large breast cancer survivorship practice reveals missed opportunities to improve quality of life. Dissemination of recent progress in the development of GSM assessment tools, patient handouts, and new treatments to providers who care for breast cancer survivors is needed to improve this process. (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

Lifelong estradiol exposure and risk of depressive symptoms during the transition to menopause and postmenopause
Conclusions: Patterns of reproductive lifetime exposure to estrogen are associated with risk of high depressive symptoms during the MT and initial postmenopausal years; longer exposure to estrogen seemed protective. (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Original Articles Source Type: research

The history and basic science development of soy isoflavones
Abstract: This review summarizes the 2016 NAMS/Pfizer—Wulf H. Utian Endowed Lecture that focused on the history and basic science of soy isoflavones. Described is a personal perspective of the background and history that led to the current interest in soy and isoflavones with a specific focus on the role that soy isoflavones play in the health of postmenopausal women. This overview covers the metabolism and physiological behavior of isoflavones, their biological properties that are of potential relevance to aging, issues related to the safety of soy isoflavones, and the role of the important intestinally derived meta...
Source: Menopause - December 1, 2017 Category: OBGYN Tags: 2016 NAMS/Pfizer - Wulf H. Utian Endowed Lecture Source Type: research

Shining the light on genitourinary syndrome of menopause in survivors of breast cancer
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Editorials Source Type: research

Perimenopausal depression and early menopause: cause or consequence?
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Editorials Source Type: research

Vaginal estrogen in the treatment of genitourinary syndrome of menopause and risk of endometrial cancer: an assessment of recent studies provides reassurance
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Editorials Source Type: research

Sheryl A Kingsberg, PhD 2017-2018 NAMS President
No abstract available (Source: Menopause)
Source: Menopause - December 1, 2017 Category: OBGYN Tags: Editorials Source Type: research

In Reply
No abstract available (Source: Menopause)
Source: Menopause - October 28, 2017 Category: OBGYN Tags: Letters to the Editor Source Type: research

To the Editor
No abstract available (Source: Menopause)
Source: Menopause - October 28, 2017 Category: OBGYN Tags: Letters to the Editor Source Type: research

Vasomotor symptoms in women in Asia appear comparable with women in Western countries: a systematic review
Conclusions: The reported prevalences of VMS in Asia, particularly in South Asian and Middle Eastern countries, are consistent across studies that used random sampling and validated questionnaires, and are comparable with those in Western countries. Data from nationally representative studies that employ validated instruments are still needed in several Asian countries to ascertain the true prevalence of VMS. (Source: Menopause)
Source: Menopause - October 28, 2017 Category: OBGYN Tags: Review Article Source Type: research

The role of hormone therapy in the management of severe postpartum depression in patients with Turner syndrome
Conclusion: This case highlights the complex interplay between ovarian steroids, depletion of their levels, and psychiatric sequelae. The postpartum period represents a particularly vulnerable time for patients with premature ovarian insufficiency, which requires very close monitoring and early replacement of depleted hormone levels. (Source: Menopause)
Source: Menopause - October 28, 2017 Category: OBGYN Tags: Case Reports Source Type: research

Two cases of epithelioid trophoblastic tumors in postmenopausal women
Conclusions: Epithelioid trophoblastic tumors may occur a long time after a prior gestational event and should even be excluded in postmenopausal women with uterine masses. Immunohistochemical staining is helpful to make the differential diagnosis with other gestational trophoblastic neoplasms. (Source: Menopause)
Source: Menopause - October 28, 2017 Category: OBGYN Tags: Case Reports Source Type: research

Navigating the cervical cancer screening guidelines for women aged older than 65 years
Abstract: One of the most notable changes stemming from consensus guidance in 2012 is cessation of cervical cancer screening in low-risk women aged older than 65 years. Despite evidence provided for this recommendation, implementation in clinical practice can be challenging, with resistance from patients and providers. This NAMS Practice Pearl reviews data supporting this recommendation and provides clinicians with confidence as we counsel our patients. (Source: Menopause)
Source: Menopause - October 28, 2017 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research