Salpingectomy to reduce risk of ovarian cancer in women at average risk
Ovarian cancer is a common gynecologic malignancy with a poor prognosis and a lack of screening for women at average risk. Focus has therefore shifted toward strategies for risk-reducing surgery to prevent the development of ovarian cancer. This Practice Pearl describes the evidence supporting opportunistic salpingectomy at the time of hysterectomy or tubal sterilization as a strategy to reduce the risk of ovarian cancer, the risks and benefits associated with the procedure, and the methods used. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

The effect of vaginal erbium laser treatment on sexual function and vaginal health in women with a history of breast cancer and symptoms of the genitourinary syndrome of menopause: a prospective study
Objectives: To assess the effects of vaginal erbium laser treatment on the vaginal health and sexual function of postmenopausal women with a history of breast cancer. Methods: An open, prospective, therapeutic intervention study was conducted with 24 postmenopausal women with a history of breast cancer and vaginal dryness, and/or dyspareunia, who had not used vaginal hormone therapy for at least 6 months. The women were treated using a 2,940-nm Erbium: YAG laser (Etherea-MX, Athena, São Carlos, São Paulo, Brazil), with 90o and 360o scanning scopes, between August, 2017 and October, 2017 in a private clin...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Objective measures of physical performance associated with depression and/or anxiety in midlife Singaporean women
Conclusions: Weak upper and lower body physical performances were associated with depressive and anxiety symptoms in midlife Singaporean women. Future trials are required to determine whether strengthening exercises that improve physical performance could help reduce depressive and anxiety symptoms in midlife women. Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A419. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Prevalence of sarcopenia and associated factors in climacteric women of the Colombian Caribbean
Objective: The aim of the study was to determine the prevalence of sarcopenia and associated factors in climacteric middle-aged women. Methods: This was a cross-sectional study carried out in Colombian Caribbean women (40-59 y, n = 403), who were surveyed with a form that included sociodemographic information and two validated tools (the Menopause Rating Scale and the SF-36 Health questionnaire). Calf circumference, handgrip, and gait speed were measured. Low muscle mass (calf circumference (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Change over time in patient-reported symptoms and quality of life in Edmonton interdisciplinary menopause clinics: preliminary cohort study of clinic patients and waitlist patients
Conclusion: Women attending specialized menopause clinics experienced improvement in symptoms and QOL, whereas women on the waitlists did not experience these changes. Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A418. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

High risk for cardiovascular disease in postmenopausal breast cancer survivors
Objective: Breast cancer patients have a higher mortality risk of cardiovascular disease (CVD) than women from the general population. CVD risk may increase significantly in postmenopausal women with early-stage breast cancer. The aim of this study was to evaluate risk factors for CVD in postmenopausal breast cancer survivors. Methods: In this cross-sectional study, 96 postmenopausal breast cancer survivors were compared with 192 postmenopausal women. The main group included women with amenorrhea>12 months, aged ≥45 years, with breast cancer, and without established CVD. The control group fulfilled the same crit...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Is core temperature the trigger of a menopausal hot flush?
Objective: Menopausal hot flushes negatively impact quality of life and may be a biomarker of cardiovascular and metabolic disease risk; therefore understanding the physiology of hot flushes is important. Current thinking is that a small elevation (∼0.03-0.05oC) in core temperature surpasses a sweating threshold (that is reduced in the menopause), sweating is activated, and a hot flush ensues. Nevertheless, more recent studies examining thermoregulatory control question whether core temperature per se can explain the trigger for a hot flush. The primary aim of this study was to assess the contribution of increases in...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Multiple pregnancies and the risk of diabetes mellitus in postmenopausal women
Objective: We aimed to investigate whether the number of pregnancies during childbearing age was associated with diabetes in postmenopausal women with no history of gestational diabetes. Methods: Our data source was the continuous National Health and Nutrition Examination Survey 1999 to 2014. We selected 9,138 postmenopausal women over 40 years old who did not have a history of gestational diabetes during pregnancy. Logistic regression analyses were applied for the association of the number of pregnancies with diabetes. Results: We found women with ≥4 pregnancies had significantly greater fasting plasma glucose ...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Menopausal hot flashing and endothelial function in two vascular beds: findings from a cross-sectional study of postmenopausal women
Conclusions: Our data support the association of hot flashing with greater insulin resistance and lower macrovascular response. The paradoxical enhanced microvascular response in hot flashers could be the result of the net effect of thermoregulatory and nonnitric oxide-related pathways rather than of endothelial integrity. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Effects of ospemifene on genitourinary health assessed by prospective vulvar-vestibular photography and vaginal/vulvar health indices
Objective: To prospectively evaluate the effects of ospemifene on the vulva and vagina in postmenopausal women using vulvar-vestibular photography and direct visual assessments. Methods: Postmenopausal women (aged 40-80 years) with moderate to severe vaginal dryness as their most bothersome symptom (MBS) were randomized to daily ospemifene 60 mg or placebo in this 12-week, multicenter, double-blind, phase 3 study. Vulvar-vestibular photographic images were captured at baseline and week 12 and were independently assessed with the Vulvar Imaging Assessment Scale (VIAS). Changes from baseline in Vaginal and Vulvar Heal...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Public survey reactions to an arts-based educational menopausal hot flash exhibit
Conclusions: The exhibit concept art was appealing and was reported to have a positive impact on the public. Study findings provide support for building the exhibit full-scale as a traveling educational resource that might change public discourse around menopausal hot flashes. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Focus group reactions to an arts-based educational exhibit on menopausal hot flashes
Conclusions: The concept art is an appropriate tool for improving knowledge and communication about hot flashes. Displaying the concept art and/or future full-scale exhibit in healthcare settings or public venues may facilitate learning and communication among three groups—menopausal women, healthcare providers, and others. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Cognitive behavior therapy for menopausal symptoms (CBT-Meno): a randomized controlled trial
Objective: To evaluate the effectiveness of cognitive behavioral therapy for menopausal symptoms (CBT-Meno) compared with a waitlist condition (no active intervention). A randomized controlled trial was conducted with 71 perimenopausal or postmenopausal women who were seeking treatment for menopausal symptoms. Methods: Blind assessments were conducted at baseline, 12 weeks postbaseline, and 3 months post-treatment. An intention-to-treat analysis was conducted. CBT-Meno sessions included psychoeducation, and cognitive and behavioral strategies for vasomotor and depressive symptoms, anxiety, sleep difficulties, and sexu...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Determination of estradiol and progesterone content in capsules and creams from compounding pharmacies
Conclusion: The variations in estradiol and progesterone levels observed in compounded hormone therapy formulations justify concerns regarding risks as a result of variability, which have been outlined by The North American Menopause Society, the American College of Obstetricians and Gynecologists, and the US Food and Drug Administration (FDA) in their statements regarding compounded hormone use. These data support the need for an US FDA-approved bioidentical hormone therapy. Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A425. (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Age at natural menopause and physical functioning in postmenopausal women: the Canadian Longitudinal Study on Aging
Conclusion: Our study suggests that premature menopause ( (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Original Articles Source Type: research

NAMS 2018 Utian Translational Science Symposium, October 2018, San Diego, California New therapies for leiomyomas: when surgery may not be the best option
The North American Menopause Society (NAMS) held the 2018 Utian Translational Science Symposium on October 2, 2018, in San Diego, California, to discuss new therapeutic approaches to uterine leiomyomas when surgery is not the optimal choice. Uterine leiomyomas arise from a single clonal cell and are the most common gynecologic disorder affecting reproductive and perimenopausal women worldwide. The prevalence of this disorder is approximately 40% to 70% in white women and 60% to 80% in black women. Recent research suggests that both estrogen and progesterone modulate the growth of leiomyomas, with progesterone being a majo...
Source: Menopause - August 28, 2019 Category: OBGYN Tags: NAMS Translational Science Symposium Report Source Type: research

Persistent concerns over the use of compounded hormone therapies
No abstract available (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Editorials Source Type: research

Physical function and age at natural menopause: two take-home messages
No abstract available (Source: Menopause)
Source: Menopause - August 28, 2019 Category: OBGYN Tags: Editorials Source Type: research

To the Editor
No abstract available (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Letters to the Editor Source Type: research

Comparative efficacy and safety of pharmacological interventions for osteoporosis in postmenopausal women: a network meta-analysis (Chongqing, China)
Conclusions: Abaloparatide and teriparatide are most efficacious in preventing new vertebral and nonvertebral fractures in postmenopausal women with osteoporosis, whereas zoledronic acid and romosozumab are in preventing clinical fractures. Meanwhile, there is no statistical difference between abaloparatide, teriparatide or romosozumab, and placebo in terms of safety. Furthermore, in terms of adverse events, zoledronic acid is statistically worse than placebo, and two of the best interventions are denosumab and romosozumab, of which denosumab also reduces the risk of different kinds of fractures. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Review Articles Source Type: research

An individualized approach to the management of vaginal atrophy in Latin America
Conclusions: It is critical that women are empowered to understand vaginal atrophy. Educating women and healthcare providers to engage in open dialogue will facilitate appreciation of the benefits and means of maintaining urogenital health, helping to improve outcomes in middle age and beyond. Women should receive this education before menopause. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Review Articles Source Type: research

Reversible alopecia associated with high blood mercury levels and early menopause: a report of two cases
Conclusions: Women of reproductive age frequently seek treatment for what is thought to be hormone-related hair loss especially at menopause. Two women demonstrated a strong temporal correlation to high Hg levels associated with early menopause, which was reversible. The development of alopecia in the setting of mild Hg intoxication has not been reported in the medical literature despite its appearance in the popular press. Measurement of Hg levels should be considered in women with alopecia and its relationship to early menopause is unclear but bears further research. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Case Report Source Type: research

Cost-effectiveness of antiosteoporosis strategies for postmenopausal women with osteoporosis in China
Conclusion: From the perspective of the Chinese medical system, zoledronate is more cost-effective than the calcium/vitamin D strategy, alendronate, raloxifene, and teriparatide for the treatment of osteoporosis in elderly postmenopausal women. Not factoring the parameters of adherence and persistence in, and consequent variability in treatment effectiveness relative risks, seems like a major limitation, but it can be speculated that it would not change the conclusion that zoledronate is the most economical strategy. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Effects of 8 weeks of moderate-intensity resistance training on muscle changes in postmenopausal women with different angiotensin-converting enzyme insertion/deletion polymorphisms of interest
Conclusions: This study improves our understanding of the association between the ACE I/D polymorphism and muscular responses to moderate intensity resistance training among postmenopausal women and revealed that the DD genotype has predominant adaptations in grip strength, rectus femoris size, and knee extensor strength. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Hormone therapy is not associated with the risk of sudden sensorineural hearing loss in postmenopausal women: a 10-year nationwide population-based study
Conclusions: Our results showed that HT was not associated with the risk of SSNHL in postmenopausal women over a 10-year follow-up study. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Life-long endogenous estrogen exposure is associated with prevalence of allergic rhinitis in postmenopausal women
Conclusions: Longer duration of reproductive period was associated with higher prevalence of AR and aeroallergen sensitization in the postmenopausal period. Moreover, cockroach allergen sensitization was associated with a longer postmenopausal period. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Safety and feasibility of estrogen receptor-β targeted phytoSERM formulation for menopausal symptoms: phase 1b/2a randomized clinical trial
Conclusions: The phytoSERM formulation was well tolerated at 50 and 100 mg daily doses. Based on safety outcomes, vaginal bleeding at the 100 mg dose, and vasomotor symptoms and cognitive outcomes at 12 weeks, a daily dose of 50 mg was considered preferable for a phase 2 efficacy trial. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

The effect of a randomized 12-week soy drink intervention on everyday mood in postmenopausal women
Conclusions: Soy isoflavones had no effect on mood at any of the doses tested. Future research should focus on the menopause transition from peri to postmenopause as there may be a window of vulnerability, with fluctuating hormones and increased symptoms which may affect mood. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Tamoxifen use as a malignancy risk factor in postmenopausal women with endometrial polyps
Objective: We analyzed tamoxifen use as a malignancy risk factor in women with endometrial polyps. Methods: This retrospective study included 675 women who underwent hysteroscopic polypectomy in 2010 to 2015 at the University of Campinas. Women were divided into tamoxifen use (n = 169) and no tamoxifen use (n = 506) groups. The primary outcome was endometrial cancer prevalence. Dependent variables included age, parity, years since menopause, presence of abnormal uterine bleeding, endometrial pattern on hysteroscopy, and endometrial thickness. Results: There were seven cases of endometrial cancer in the tamo...
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Accuracy of the Menopause Rating Scale and the Menopause Quality of Life Questionnaire to discriminate menopausal women with anxiety and depression
Conclusions: The MRS and MENQOL display moderate accuracy in discriminating menopausal women with symptoms of anxiety and depression. The intensity of the symptoms appears to be related to the probability of detecting a probable or definitive disorder. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Confirmatory factor analysis of the Insomnia Severity Index (ISI) and invariance across race: a pooled analysis of MsFLASH data
Conclusions: The ISI in midlife women with hot flashes is composed of two factors that capture dimensions of the insomnia severity and daytime impact. The instrument is a psychometrically sound scale appropriate for use in research and clinical practice to capture the severity and daytime impact of insomnia symptoms in diverse samples of midlife women with hot flashes. An abbreviated screening of two items could be considered to determine if further evaluation is needed of sleep complaints. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Women's Health Initiative clinical trials: potential interactive effect of calcium and vitamin D supplementation with hormonal therapy on cardiovascular disease
Conclusions: CaD did not consistently modify the effect of CEE therapy or CEE + MPA therapy on CVD events. However, the increased risk of stroke due to CEE therapy appears to be mitigated by CaD supplementation. In contrast, CaD supplementation did not influence the risk of stroke due to CEE + MPA. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Fractional CO2 laser versus promestriene and lubricant in genitourinary syndrome of menopause: a randomized clinical trial
Objective: The aim of this study was to compare the effects of fractional CO2 laser therapy, promestriene, and vaginal lubricants on genitourinary syndrome treatment and sexual function in postmenopausal women. Methods: We performed a randomized clinical trial including 72 postmenopausal women over the age of 50 years. The women were randomized into three intervention groups to receive one of the following treatments: three sessions of intravaginal fractional CO2 laser therapy; 10 mg of intravaginal promestriene cream 3 times a week; and vaginal lubricant application alone. Vaginal maturation, Vaginal Health Index (...
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Partner status moderates the relationships between sexual problems and self-efficacy for managing sexual problems and psychosocial quality-of-life for postmenopausal breast cancer survivors taking adjuvant endocrine therapy
Objective: Past studies indicate that>90% of breast cancer survivors taking adjuvant endocrine therapy (AET) experience menopausal symptoms including sexual problems (eg, vaginal dryness, dyspareunia); however, research examining the impact of these problems on quality-of-life is limited. This cross-sectional study examined (1) the impact of sexual problems and self-efficacy for coping with sexual problems (sexual self-efficacy) on quality-of-life (ie, psychosocial quality-of-life and sexual satisfaction), and (2) partner status as a moderator of these relationships. Methods: Postmenopausal breast cancer survivors ...
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Sexual frequency and pain in a randomized clinical trial of vaginal estradiol tablets, moisturizer, and placebo in postmenopausal women
Conclusions: Compared to placebo, neither low-dose vaginal estradiol nor vaginal moisturizer treatment over 12 weeks resulted in significantly greater increases in the proportions of women reporting sexual activity or improvement in pain scores with sexual activity. Trial registration: Clinical trials.gov: NCT02516202. (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Vaginal laser treatment—first, do no harm
No abstract available (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

Understanding the unmet sexual health needs of women with breast cancer
No abstract available (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

Sexual pain in the menopausal patient: individualizing treatment still best
No abstract available (Source: Menopause)
Source: Menopause - August 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

Endometrial safety of low-dose vaginal estrogens in menopausal women: a systematic evidence review
Conclusion: This systematic review supports the use of low-dose vaginal estrogens for treating vulvar and vaginal atrophy in menopausal women without a concomitant progestogen. This review does not support increased endometrial hyperplasia or cancer risk with low-dose, unopposed vaginal estrogens; however, longer-term, real-world data are needed. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Review Article Source Type: research

Clinical care of women with intermediate breast cancer risk
No abstract available (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Conservative management for postmenopausal women with tubo-ovarian abscess
Conclusion: In postmenopausal women with TOA, the prevalence of concurrent pelvic malignancy was 2.6%, which is higher than in the general population, but lower than that reported in the literature; 44% were conservatively managed without any apparent cases of misdiagnoses of cancer. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Hydrogen gas protects against ovariectomy-induced osteoporosis by inhibiting NF-κB activation
This study aimed to investigate the effects of H2 on inhibiting osteoclastogenesis and bone loss in ovariectomized mice. Methods: Osteoclast differentiation from Raw264.7 cells was induced with receptor activator NF-κB ligand (RANKL) with or without 60% H2. The number and resorption activity of osteocalsts were assessed by tartrate-resistant acid phosphatase staining and pit formation assay, respectively. The expression of osteoclast markers and NF-κB phosphorylation were detected by western blot. NF-κB nuclear translocation was assessed by immunofluorescence. NF-κB transcriptional activity was a...
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Higher serum levels of vitamin D are associated with lower blood glucose levels
The objective of the present study was to evaluate the possible association between 25(OH)D sufficiency and glycemia. Methods: This was a cross-sectional study involving 680 women, 35 to 74 years of age, selected through systematic sampling. From each participant, fasting blood samples were collected for the determination of 25(OH)D and glucose levels. Results: The mean fasting blood glucose level was 105 mg/dL (range 26-401 mg/dL). Fasting serum levels of 25(OH)D were (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

The effects of genetic variants related to insulin metabolism pathways and the interactions with lifestyles on colorectal cancer risk
Conclusions: Our findings provide insight into gene–lifestyle interactions and will enable researchers to focus on individuals with risk genotypes to promote intervention strategies. Our study suggests the careful use of data on potential genetic targets in clinical trials for cancer prevention to reduce the risk for CRC in postmenopausal women. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Are obesity indices derived by dual-energy x-ray absorptiometry capable of identifying postmenopausal females with high risk for coronary heart disease?
Objective: The aim of the study was to evaluate the predictive ability of obesity indices derived by dual-energy x-ray absorptiometry (DXA) regarding coronary heart disease (CHD). Methods: DXA total body scans were performed on 71 consecutive postmenopausal women who were referred for myocardial perfusion imaging (MPI). Twenty-four women with CHD diagnosed by MPI were considered as cases, whereas the remaining 47 women with normal MPI results were considered as controls. Biochemical markers, body mass index (BMI) and waist circumference (WC) were also recorded for all women and correlated to DXA adiposity indices. Rec...
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Relationships between menopausal symptoms, sense of coherence, coping strategies, and quality of life
Conclusions: The results provide new insights into the importance of considering SOC and coping strategies and their interactions with menopausal symptoms and quality of life in the situation of menopausal transition. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Pregnancy history and cognitive aging among older women: the Rancho Bernardo Study
Conclusions: Our results show no clinically meaningful long-term influence of pregnancy history on age-related change in cognitive function. These reassuring findings suggest childbearing decisions and timing will not affect cognitive function in older age. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Utilization pattern of hormone therapy in UK general practice between 1996 and 2015: a descriptive study
Conclusion: Our study suggests that the HT guideline changes implemented in UK clinical practice resulted in safer HT use, particularly in women with pre-existing CVD or breast cancer. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Cardiovascular reactivity and psychological hyperarousal in hot flash-associated insomnia disorder
Conclusions: Though hot flash-associated insomnia is characterized by psychological hyperarousal before sleep and during the daytime, it does not relate to cardiovascular responsiveness to acute stressors. Our findings do not support the hypothesis that altered cardiovascular control is a potential mechanism by which hot flash-associated insomnia confers higher cardiovascular disease risk. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research