Changes in carotid artery intima-media thickness 3 years after cessation of menopausal hormone therapy: follow-up from the Kronos Early Estrogen Prevention Study
Conclusions: Cessation of MHT at the lower doses and formulations used in KEEPS did not appear to alter the trajectory of CIMT over a 3-year follow-up period. CIMT, however, increased in all groups over the entire 7-year timeframe as expected with age and timing of menopause possibly key contributors. (Source: Menopause)
Source: Menopause - December 28, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Physical activity and weight gain after smoking cessation in postmenopausal women
Conclusions: Our data demonstrate that even a modest increase in PA (equivalent to current recommendations) can attenuate weight gain after quitting smoking among postmenopausal women, especially in combination with improved diet. (Source: Menopause)
Source: Menopause - December 28, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Apolipoprotein E4 genotype in combination with poor metabolic profile is associated with reduced cognitive performance in healthy postmenopausal women: implications for late onset Alzheimer's disease
Conclusions: In a general population of postmenopausal women, association between poor metabolic profile with reduction in cognitive performance is more apparent in women who carry an ApoE4 allele. These data indicate a window of opportunity for interventions to reverse the trajectory of the preclinical phase of Alzheimer's disease. (Source: Menopause)
Source: Menopause - December 28, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Hormone therapy and carotid intima-media thickness: the thick and thin of it
No abstract available (Source: Menopause)
Source: Menopause - December 28, 2018 Category: OBGYN Tags: Editorials Source Type: research

Preventing postsmoking cessation weight gain: exercise helps, even if previously inactive
No abstract available (Source: Menopause)
Source: Menopause - December 28, 2018 Category: OBGYN Tags: Editorials Source Type: research

Toward a personalized lifestyle intervention approach to prevent Alzheimer's disease
No abstract available (Source: Menopause)
Source: Menopause - December 28, 2018 Category: OBGYN Tags: Editorials Source Type: research

29th Annual Meeting of The North American Menopause Society October 3-6, 2018, San Diego, CA
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Abstracts Source Type: research

Subject Index
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Index Source Type: research

Author Index
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Index Source Type: research

Abstract Author Index
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Abstracts Source Type: research

Acknowledgment of Reviewers
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Acknowledgment of Reviewers Source Type: research

Appropriate evaluation of postmenopausal bleeding
In clinical practice, although only 3% to 7% of women with postmenopausal bleeding (PMB) will ultimately be found to have cancer, it is the clinician's responsibility to ensure that endometrial cancer is not present. The diagnostic evaluation of PMB has evolved greatly. This Practice Pearl addresses the appropriate evaluation of women with PMB. (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Anxiety, depressive symptoms, and cardiac autonomic function in perimenopausal and postmenopausal women with hot flashes: a brief report
Objective: The aim of the study was to examine whether anxiety and depressive symptoms are associated with an adverse cardiac autonomic profile among midlife women with hot flashes. Methods: Anxiety and depressive symptoms were evaluated by validated self-administered questionnaires among peri- and postmenopausal women in a randomized trial of slow-paced respiration for hot flashes. Pre-ejection period (PEP), a marker of sympathetic activation, and respiratory sinus arrhythmia (RSA), a marker of parasympathetic activation, were measured at baseline and 12 weeks using impedance cardiography and electocardiography. Mult...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Brief Report Source Type: research

The naturally derived small compound Osthole inhibits osteoclastogenesis to prevent ovariectomy-induced bone loss in mice
This study was to determine the bone protective effects and underlying mechanisms of Osthole (OT) in ovariectomized (OVX) mice. We found that the inhibitory effects of OT on receptor activator of nuclear factor kappa-B ligand (RANKL)-activated osteoclastogenesis are responsible for its bone protective effects in OVX mice. Methods: Eight-week-old mice were ovariectomized and OT (10 mg/kg/d) was intraperitoneally administrated to OVX mice 7 days after the surgery and were sacrificed at the end of the 3 months. Osteoclasts were generated from primary bone marrow macrophages (BMMs) to investigate the inhibitory effects of...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Ovariectomy and obesity have equal impact in causing mitochondrial dysfunction and impaired skeletal muscle contraction in rats
Objective: Previous studies have demonstrated that either an obese-insulin resistance condition or a condition involving loss of estrogen impaired skeletal muscle function as indicated by a decrease in muscle contraction. The differing effects of combined estrogen deficiency over obese-insulin resistance on skeletal muscle function have, however, not yet been determined. Our hypothesis was that estrogen deficiency aggravates skeletal muscle dysfunction in obese-insulin resistant rats, via increased muscle oxidative stress and mitochondrial dysfunction. Methods: Twenty-four female Wistar rats were divided into 2 groups...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Effect of combined circuit exercise on arterial stiffness in hypertensive postmenopausal women: a local public health center-based pilot study
This study examined the effect of combined circuit exercise on arterial stiffness in hypertensive postmenopausal women. Furthermore, it ascertained whether performing this exercise program is feasible in local public health centers with better accessibility than research and commercial facilities. Methods: Among 24 hypertensive postmenopausal women, 16 finished this study in either the control (n = 8) or exercise (n = 8) group. Except for one participant who withdrew from the study due to the difficulty of the exercise program, seven participants withdrew due to reasons unrelated to the study. Circuit-type exerc...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Physical performance in relation to menopause status and physical activity
Objective: The aim of this study was to examine differences in physical performance (muscle power, muscle strength, aerobic capacity, and walking speed) across menopausal stages and potential of leisure physical activity (PA) to modify the impact of menopause on physical performance. Methods: In this cross-sectional study, women aged 47 to 55 were randomly selected from the Finnish National Registry and categorized as premenopausal (n = 233), perimenopausal (n = 381), or postmenopausal (n = 299) based on serum concentrations of follicle-stimulating hormone and bleeding diary. Physical performance was measu...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function
Objective: Cognitive outcomes in trials of postmenopausal hormone treatment have been inconsistent. Differing outcomes may be attributed to hormone formulation, treatment duration and timing, and differential cognitive domain effects. We previously demonstrated treatment benefits on visual cognitive function. In the present study, we describe the effects of hormone treatment on verbal outcomes in the same women, seeking to understand the effects of prior versus current hormone treatment on verbal function. Methods: This is a cross-sectional evaluation of 57 women (38 hormone users [25 prior long-term users and 13 curr...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Original Articles Source Type: research

The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women
Conclusions: Vaginal symptoms impact the well-being, functioning, and QoL of postmenopausal women, especially sexual function, self-perception, and body image. This impact is significantly higher in women with GSM. Identifying and treating patients affected by vaginal symptoms and GSM may be beneficial for improving their QoL. (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Original Articles Source Type: research

Advances in osteoporosis from 1970 to 2018
In 1970, there were no drugs under study for osteoporosis. Estrogen was used, but little was known about the correct dose for preventing bone loss. At that time, fractures were not even recognized as a disease, but regarded as part of normal aging. From 1970 to this year (2018), there have been extensive advances in the osteoporosis field ranging from fracture epidemiology to the remarkable invention of bone density measurements. There have been major advances in therapeutic options available for patients for prevention and treatment of osteoporosis. In parallel, the advances in the laboratory helped elucidate the process ...
Source: Menopause - November 29, 2018 Category: OBGYN Tags: 2018 NAMS/Pfizer – Wulf H. Utian Endowed Lecture Source Type: research

High and dry: recognizing the impact of genitourinary syndrome of menopause
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Editorials Source Type: research

A long and winding road: reflections on the evolution of menopause medicine over a professional lifetime
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Editorial Source Type: research

James H. Liu, MD, NCMP 2018-2019 NAMS President
No abstract available (Source: Menopause)
Source: Menopause - November 29, 2018 Category: OBGYN Tags: Editorials Source Type: research

Menopause Board Members: Past and Present
No abstract available (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Board Members Past and Present Source Type: research

A Selection of Notable Papers from the Past 25 Years
No abstract available (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Other Notable Papers Source Type: research

The 2017 hormone therapy position statement of The North American Menopause Society
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Physiologically assessed hot flashes and endothelial function among midlife women
Objective: Hot flashes are experienced by most midlife women. Emerging data indicate that they may be associated with endothelial dysfunction. No studies have tested whether hot flashes are associated with endothelial function using physiologic measures of hot flashes. We tested whether physiologically assessed hot flashes were associated with poorer endothelial function. We also considered whether age modified associations. Methods: Two hundred seventy-two nonsmoking women reporting either daily hot flashes or no hot flashes, aged 40 to 60 years, and free of clinical cardiovascular disease, underwent ambulatory physi...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause
Objective: The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepiandrosterone (DHEA, Prasterone) on moderate to severe dyspareunia or pain at sexual activity, the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause (GSM). Methods: In a prospective, randomized, double-blind, and placebo-controlled phase III clinical trial, the effect of daily intravaginal 0.50% DHEA (6.5 mg) (Prasterone, EndoCeutics) was examined on four coprimary objectives, namely percentage of parabasal cells, percentage or superficial cells, vaginal pH, and mod...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 years
This study aims to determine the prevalence and severity of menopausal symptoms in older postmenopausal women and, hence, the need for treatment options for women of this age. Methods: This is a cross-sectional questionnaire-based study conducted between October 2013 and March 2014 among 2,020 women aged 40 to 65 years and living independently across Australia. The main outcome measures were the prevalence of moderate to severe vasomotor symptoms (VMS), as measured by the Menopause-Specific Quality of Life Questionnaire, and the current use of prescription therapy for menopausal symptoms. Results: The prevalence of m...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy
Conclusions: A distinct bacterial community state (CST IV-A) with a low relative abundance of Lactobacillus is associated with VVA. Future studies recruiting a larger number of women are needed to replicate the findings. This study provides an impetus for future longitudinal studies designed to manage, modulate, and restore vaginal microbiota homeostasis, which would provide stronger evidence for a causal relationship with VVA and ultimately improve the treatment and prevention of atrophic vaginitis in menopause. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Estrogen alone and joint symptoms in the Women's Health Initiative randomized trial
Conclusions: The current findings suggest that estrogen-alone use in postmenopausal women results in a modest but sustained reduction in the frequency of joint pain. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Evolution of postmenopausal hormone therapy between 2002 and 2009
Conclusions: Since the publication of the Women's Health Initiative results, there has been a sustained decrease in hormone therapy claims. The proportional use of low-dose oral and transdermal formulations has increased, but as of 2009, claims for these formulations accounted for approximately one in four total hormone therapy claims. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Does the route of administration for estrogen hormone therapy impact the risk of venous thromboembolism? Estradiol transdermal system versus oral estrogen-only hormone therapy
Conclusions: This large population-based study suggests that participants receiving an estradiol transdermal system have a significantly lower incidence of venous thromboembolism than do participants receiving oral estrogen-only hormone therapy. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

History of hot flashes and aortic calcification among postmenopausal women
Objective: Menopausal hot flashes are considered largely a quality-of-life issue. However, emerging research also links hot flashes to cardiovascular risk. In some investigations, this risk is particularly apparent among women using hormone therapy. The aim of this study was to determine whether a longer history of reported hot flashes over the study period was associated with greater aortic and coronary artery calcification. Interactions with hormone therapy use were examined in an exploratory fashion. Methods: Participants included 302 women participating in the Healthy Women Study, a longitudinal study of cardiovas...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Hot flushes, coronary heart disease, and hormone therapy in postmenopausal women
Conclusions: Among older postmenopausal women with CHD, EPT may increase risk of CHD events substantially in the first year of treatment among women with clinically significant hot flushes but not among those without hot flushes. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Long-term risk of depressive and anxiety symptoms after early bilateral oophorectomy
Conclusions: Bilateral oophorectomy performed before the onset of menopause is associated with an increased long-term risk of depressive and anxiety symptoms. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Estrogen effects on arteries vary with stage of reproductive life and extent of subclinical atherosclerosis progression
The past several years have been marked by confusion and controversy concerning whether estrogens are cardioprotective. The issue is of utmost public health importance because coronary heart disease (CHD) remains the leading cause of death among postmenopausal women. Fortunately, a unifying hypothesis has emerged that reproductive stage is a major determinant of the effect of estrogens on atherosclerosis progression, complications, and plaque vulnerability. Premenopausal Years: Premenopausal atherosclerosis progression seems to be an important determinant of postmenopausal atherosclerosis and thus the risk for CHD. Clea...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Increased longevity in older users of postmenopausal estrogen therapy: the Leisure World Cohort Study
Objective: To examine the effect of postmenopausal estrogen therapy (ET), including duration and recency of use, on all-cause mortality in older women. Design: As part of a prospective cohort study of residents of a California retirement community begun in the early 1980s, Leisure World Cohort women (median age, 73 y) completed a postal health survey including details on ET use and were followed up for 22 years (1981-2003). Age- and multivariate-adjusted risk ratios (RR) and 95% CIs were calculated using proportional hazard regression. Results: Of the 8,801 women, 6,626 died during follow-up (median age, 88 y). ET ...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Correlates of sexual function among multi-ethnic middle-aged women: results from the Study of Women's Health Across the Nation (SWAN)
Objective: To examine sexual function in a cohort of Baby Boomer women of diverse racial/ethnic backgrounds; to compare differences between pre-and early perimenopausal women; and to identify sociodemographic, health-related, and psychosocial (including psychological, behavioral, and relationship) factors related to sexual function. Design: Six domains of sexual function were studied in 3,167 women in the baseline cohort of the Study of Women's Health Across the Nation (SWAN). Participants were 42 to 52 years old, pre-or early perimenopausal, and not using hormones. The study sample included non-Hispanic white, Africa...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Predictors of decreased libido in women during the late reproductive years
Conclusions: Decreased libido in the late reproductive years is associated with a pronounced fluctuation in total testosterone over time. Other independent risk factors for decreased libido include vaginal dryness, depression, and living with children. Sexual dysfunction is a complex disorder, related to physiological and psychosocial factors, requiring further investigation. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Caloric restriction reduces age at menopause: the effect of the 1944-1945 Dutch famine
Conclusions: Our findings suggest that caloric restriction decreases age at natural menopause. Early childhood seems to be a particularly sensitive age period for this effect. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

The Utian Quality of Life (UQOL) Scale: development and validation of an instrument to quantify quality of life through and beyond menopause
Conclusion: We are reporting on the process of validating an instrument for quantifying sense of well-being in a perimenopausal population. Substantial reliability and validity estimates for the scale and its subscales support the UQOL as a valuable new tool for use in clinical research and practice. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Comparison of the antioxidant effects of equine estrogens, red wine components, vitamin E, and probucol on low-density lipoprotein oxidation in postmenopausal women
Objective: Oxidized low-density lipoprotein (LDL) seems to play an important role in the etiology of atherosclerosis. To further study this, we performed two studies: (1) we determined the ability of 10 estrogen components of the drug, conjugated equine estrogen (CEE), trans-resveratrol (t-resveratrol) and quercetin (red wine components), trolox (vitamin E analog), and probucol (a serum cholesterol-lowering drug) to delay or prevent the oxidation of plasma LDL isolated from untreated postmenopausal women, and (2) we assessed the effect of long-term (>1 year) estrogen replacement therapy and hormone replacement therapy...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

17β-estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis
Objectives: The efficacy and safety of 25-μg 17β-estradiol vaginal tablets (Vagifem) were assessed and compared with 1.25-mg conjugated equine estrogen vaginal cream (Premarin Vaginal Cream) for the relief of menopausal-derived atrophic vaginitis, resulting from estrogen deficiency. Design: In a multicenter, open-label, randomized, parallel-group study, 159 menopausal women were treated for 24 weeks with either vaginal tablets or vaginal cream. Efficacy was evaluated by relief of vaginal symptoms and concentrations of serum estradiol and follicle-stimulating hormone. Safety was monitored by the incidence of ad...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Aromatase and estrogen receptor immunoreactivity in the coronary arteries of monkeys and human subjects
Conclusion: The present results provide the first evidence for the local formation of estrogen in the coronary arteries. In addition to complementing the evidence of a cardioprotective effect of estrogen on the coronary circulation, our results highlight the potential importance of local regulation of estrogen formation and the role of available precursor androgens in maintaining the cardiovascular system. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Breast cancer risk among women under 55 years of age by joint effects of usage of oral contraceptives and hormone replacement therapy
Conclusions: Although our results must be cautiously interpreted given small numbers within subgroups, they raise concern and emphasize the need for further evaluation on breast cancer risk of the increasingly common exposure to both oral contraceptives and hormone replacement therapy. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Long-term postmenopausal estrogen therapy may be associated with increased risk of breast cancer: a cohort study
Reports of a role of postmenopausal estrogen replacement therapy in the development of breast cancer have been inconsistent. Although many epidemiologic studies have failed to show an association between short-term use of estrogen and breast cancer, there are indications that long-term use may present an increased risk. We undertook a long-term, retrospective cohort study of the incidence of breast cancer in women who had taken long-term estrogen (average 17.2 years), compared to women who had not taken estrogen. Subjects were 454 women born between 1900 and 1915, who were members of a large health maintenance organization...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Continuation of postmenopausal hormone replacement therapy: comparison of cyclic versus continuous combined schedules
Discontinuation of hormone replacement therapy (HRT) is much more common than what is reported in randomized, double-blind clinical trials. Our purpose in this retrospective study, using a prescription database, was to compare the continuation rate among women who took cyclic combination therapy adding progesterone to estrogen (CYC-PERT) or continuous combined estrogen progestin therapy (CC-PERT). The study subjects were 1,532 women, ≥45 years old, who initially filled index prescriptions for 0.625 mg conjugated estrogens. They were divided into two groups (CYC-PERT = 644, CC-PERT = 888) on the basis of copres...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

Progestin enhances vasoconstrictor responses in postmenopausal women receiving estrogen replacement therapy
Clinical and experimental evidence suggests that the cardioprotective effect of estrogen replacement is due to effects both on scrum lipids and on blood vessels. Current practice includes the use of a progestin in combination with estrogen if the patient still has her uterus: however, little is known about the effects of combination therapy on vascular reactivity. We therefore studied the effects of estrogen alone and with added progestin on forearm vascular resistance at rest, during reactive hyperemia, and after cold pressor stimulation using plethysmography in six healthy, postmenopausal women. Measurements were made be...
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research

NAMS-gallup survey on women's knowledge, information sources, and attitudes to menopause and hormone replacement therapy
The North American Menopause Society (NAMS) sponsored a Gallup Organization survey of 833 women aged 45-60 to determine attitudes and experience with menopause and various forms of hormone replacement therapy (HRT). The results of this survey are presented herein. (Source: Menopause)
Source: Menopause - October 25, 2018 Category: OBGYN Tags: Commemorative Papers Source Type: research