Estradiol and progesterone bioavailability for moderate to severe vasomotor symptom treatment and endometrial protection with the continuous-combined regimen of TX-001HR (oral estradiol and progesterone capsules)
Conclusions: P4 levels observed with TX-001HR were similar in the phase 1 and 3 studies, and were associated with no endometrial hyperplasia with either E2 daily dose over 1 year in the REPLENISH phase 3 study, which showed significant improvements in menopausal vasomotor symptoms. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Topical estrogen prescribing patterns for urogenital atrophy among women with breast cancer: results of a national provider survey
Conclusions: This study highlights heterogeneity in practice patterns both within and across specialties. The clinical variation seen in this study suggests providers may benefit from increased knowledge regarding vaginal estrogen. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Menopause symptoms and chronic pain in a national sample of midlife women veterans
Objective: Women are more likely than men to suffer chronic pain, with the highest rates seen in midlife. The symptoms that characterize menopause broadly affect health and well-being, but their contribution to chronic pain risk during this period is poorly understood. To address this gap in knowledge, we examined relationships between indicators of menopause symptoms and chronic pain among midlife women veterans, a population with prevalent chronic pain diagnoses and elevated risk for bothersome menopause symptoms. Methods: This is a cross-sectional analysis of national Veterans Health Administration medical and phar...
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Perceived social support and the risk of cardiovascular disease and all-cause mortality in the Women's Health Initiative Observational Study
Conclusions: After controlling for potential confounding variables, higher perceived social support is not associated with incident CHD or CVD. However, among women free of CVD at baseline, perceived social support is associated with a slightly lower risk of all-cause mortality. (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

GSM management: need for interprofessional collaborative practice
No abstract available (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

Chronic pain and menopausal symptoms
No abstract available (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

Don’t give up on social support: a topic of inquiry important for a healthy society
No abstract available (Source: Menopause)
Source: Menopause - July 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

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

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

Therapeutic effects of whole-body vibration on fracture healing in ovariectomized rats: a systematic review and meta-analysis
Conclusions: This study suggested that WBV could accelerate callus formation in the early phase of bone healing, promote callus mineralization and maturity in the later phase, and restore mechanical properties of bones. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Age at menarche and risk of all-cause and cardiovascular mortality: a systematic review and dose–response meta-analysis
Conclusions: Age at menarche is inversely associated with all-cause and IHD mortality. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Vaginal ring pessary use for pelvic organ prolapse: continuation rates and predictors of continued use
Conclusion: A ring with support pessary can be used successfully to alleviate symptoms of advanced stage prolapse for 3 years or longer. In addition, proper self-management was found to be a strong predictor for prolonged pessary use. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Genitourinary syndrome of menopause symptom severity and impact outcome measures: are they reliable and correlated?
This study aimed to assess the test-retest reliability of the MBSA and the ASQ and their convergent validity. Method: One evaluator administered the outcomes twice 2 weeks apart to postmenopausal women with GSM and urinary incontinence. MBSA reliability was assessed with the graphical analysis of paired differences, Kappa coefficients and intraclass correlation coefficient (ICC), and the ASQ reliability, with paired t test and ICC. The convergent validity of both outcomes was investigated through their association with the Pearson correlation coefficient. Results: Thirty-one women participated in the study. For the M...
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

The effects of swimming training on arterial function, muscular strength, and cardiorespiratory capacity in postmenopausal women with stage 2 hypertension
We examined the effects of a swimming (SWM) regimen on arterial stiffness (pulse wave velocity [PWV]), blood pressure (BP), wave reflection (augmentation index [AIx]), muscle strength, and aerobic capacity in sedentary, postmenopausal women with stage 2 hypertension. Methods: One hundred participants (∼74 years of age) were recruited from multiple general practice centers. Using a parallel experimental design, participants were randomly assigned to either SWM (n = 52) or nonexercising control group (n = 48) for 20 weeks. Participants in the SWM group trained 3 to 4 days/week. Participants’ carotid to...
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Can the use of probiotics in association with isoflavone improve the symptoms of genitourinary syndrome of menopause? Results from a randomized controlled trial
Conclusions: Probiotics improved the metabolism of isoflavones after 16 weeks of treatment. However, the increase in the contents of isoflavones and their metabolites failed to yield an estrogenic effect on the urogenital tract and relieve the vulvovaginal symptoms. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Relationship between vasomotor symptom improvements and quality of life and sleep outcomes in menopausal women treated with oral, combined 17β-estradiol/progesterone
Objective: To characterize the impact of TX-001HR on the relationship between vasomotor symptom (VMS) improvement and quality of life and sleep. Methods: REPLENISH (NCT01942668) was a phase 3, randomized, double-blind, placebo-controlled, multicenter trial, which evaluated four daily doses of 17β-estradiol and progesterone (E2/P4) combined in a single, oral, softgel capsule in postmenopausal women (40-65 years) with a uterus and moderate to severe VMS (≥7/day or ≥50/week). In post hoc analyses, growth models were used to examine relationships between linear changes in VMS frequency and severity over 12 week...
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Personality traits and diabetes incidence among postmenopausal women
Conclusions: Low optimism and high NEE and hostility were associated with increased risk of incident diabetes among postmenopausal women independent of major health behaviors and depressive symptoms. In addition to efforts to promote healthy behaviors, women's personality traits should be considered to guide clinical or programmatic intervention strategies in diabetes prevention. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Improvement in sleep outcomes with a 17β-estradiol–progesterone oral capsule (TX-001HR) for postmenopausal women
Conclusion: TX-001HR significantly improved MOS-Sleep parameters from baseline to week 12, which was sustained for up to 12 months, and was associated with a very low incidence of somnolence. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Efficacy and safety of ospemifene in postmenopausal women with moderate-to-severe vaginal dryness: a phase 3, randomized, double-blind, placebo-controlled, multicenter trial
Objective: To evaluate the safety and efficacy of ospemifene for the treatment of moderate to severe vaginal dryness in postmenopausal women with vulvovaginal atrophy (VVA). Methods: This 12-week, multicenter, double-blind phase 3 study randomized postmenopausal women (aged 40-80 years) with VVA and moderate to severe vaginal dryness as their most bothersome symptom to daily oral ospemifene 60 mg or placebo. Coprimary efficacy endpoints included changes from baseline to week 12 in percentages of vaginal parabasal and superficial cells, vaginal pH, and vaginal dryness severity with ospemifene versus placebo; other se...
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Vaginal estrogen use and chronic disease risk in the Nurses’ Health Study
Conclusions: Vaginal estrogen use was not associated with a higher risk of cardiovascular disease or cancer. Our findings lend support to the safety of vaginal estrogen use, a highly effective treatment for genitourinary syndrome of menopause. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Knee osteoarthritis and menopausal hormone therapy in postmenopausal women: a nationwide cross-sectional study
Conclusions: The prevalence of knee OA was lower in participants with MHT than in those without MHT. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Menopausal hormone therapy trends before versus after 2002: impact of the Women's Health Initiative Study Results
Objective: To better understand how to educate patients and providers about study findings relevant to treatment guidelines, we assessed pre- versus post-Women's Health Initiative (WHI) differences in menopausal hormone therapy (MHT) initiation and continuation and their correlates, and in women's reasons for initiation and discontinuation. Methods: We analyzed survey data from up to 14 approximately annual visits over 17 years (1996-2013) from 3,018 participants in the Study of Women's Health Across the Nation, a prospective cohort study. We used logistic regression to compare pre- versus post-WHI associations of cov...
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Persistent vasomotor symptoms and breast cancer in the Women's Health Initiative
Conclusion: Women with persistent VMS are more likely to be diagnosed with breast cancer than women who never experienced VMS, but not more likely to die from breast cancer. (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Does menopausal hormonal therapy have a role in treatment of knee osteoarthritis?
No abstract available (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

A call to increase the use of hormone therapy to prevent disease in symptomatic postmenopausal women
No abstract available (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

Vasomotor symptoms and breast cancer: WHI continues to surprise us
No abstract available (Source: Menopause)
Source: Menopause - June 1, 2019 Category: OBGYN Tags: Editorials Source Type: research

The experiences and needs of Asian women experiencing menopausal symptoms: a meta-synthesis
Conclusions: Although cultural influences serve as a protective factor against menopausal symptoms, the traditional and conservative nature of the Asian society poses as a help-seeking barrier. Therefore, to ensure the healthy well-being of postmenopausal women, the implementation of culturally appropriate mitigation and management strategies is necessary. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Review Article Source Type: research

Adnexal tumors in menopausal women: surgery or surveillance?
Asymptomatic ovarian tumors in menopausal women do not always require surgical removal. Experts recommend an initial evaluation with transvaginal ultrasound to help characterize the tumor's malignant risk. Low-risk tumors can be monitored with ultrasound, whereas high-risk tumors should be referred to a gynecologic oncologist. Indeterminate tumors require secondary testing with the strategies outlined in this Practice Pearl. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

The relationship between serum fibroblast growth factor 23, Klotho, and lumbar spine bone mineral density in northern Chinese postmenopausal women
Conclusions: Klotho was positively correlated with LBMD, and there was a linear relationship between Klotho serum protein levels and LBMD; however, the levels of serum Klotho were not independently associated with reduced LBMD in northern Chinese postmenopausal women. Moreover, serum FGF23 levels were not significantly related to LBMD in this sample population. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Follicle-stimulating hormone is associated with lipids in postmenopausal women
Conclusions: These data suggest that higher FSH in postmenopausal women is related to higher levels of both TC and LDL-C. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Follicle-stimulating hormone, but not cardiorespiratory fitness, is associated with flow-mediated dilation with advancing menopausal stage
Conclusions: These data suggest that endothelial function is lower with progressive menopausal stage in women with high cardiorespiratory fitness; that FMD is lower in women with higher cardiorespiratory fitness; and that FSH, but not estradiol, is associated with FMD. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

The effect of a midwife-based counseling education program on sexual function in postmenopausal women: a randomized controlled clinical trial
Objective: The present study was conducted to investigate the effect of a midwife-based counseling education program on sexual function in postmenopausal women. Methods: A randomized clinical trial was conducted on 52 eligible postmenopausal women. Participants’ sexual function was assessed using the Female Sexual Function Index (FSFI). The women were randomly allocated into two groups: (1) the intervention group, in which the participants received a midwife-based counseling education program in 4 sessions held at 10-day intervals, with each session lasting for 70 minutes; (2) the control group, in which the par...
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Evaluation of clinical meaningfulness of estrogen plus progesterone oral capsule (TX-001HR) on moderate to severe vasomotor symptoms
Objective: The aim of this study was to determine the clinical meaningfulness of TX-001HR in reducing moderate to severe vasomotor symptoms (VMS) in menopausal women with a uterus. Methods: In the REPLENISH study (NCT01942668), women with moderate to severe hot flushes (≥7/d or ≥50/wk) were enrolled in a VMS substudy and randomized to four doses of daily TX-001HR (17β-estradiol/progesterone) or placebo. Participants assessed improvement of their VMS by the Clinical Global Impression and the Menopause-Specific Quality of Life (MENQOL) questionnaire, which were used to define clinical responders, clinically i...
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Oral 17β-estradiol/progesterone (TX-001HR) and quality of life in postmenopausal women with vasomotor symptoms
Objective: The aim of the study was to describe the effects of TX-001HR (17β-estradiol [E2] and natural progesterone [P4] in a single oral capsule) on menopause-specific quality of life in women with moderate to severe vasomotor symptoms (VMS). Methods: The REPLENISH study (NCT01942668) was a phase 3, randomized, double-blind, placebo-controlled, multicenter trial which evaluated four E2/P4 doses in postmenopausal women with VMS and a uterus. Women with moderate to severe hot flushes (≥7/d or ≥50/wk) were included in a VMS substudy. Participants self-administered the Menopause-Specific Quality of Life (MENQ...
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Secular trends and associated factors of age at natural menopause in Taiwanese women
Conclusions: The results suggest that women in the younger cohorts, with higher educational levels, and who are parous and married may have later ANM. The trend effect of secular time and educational levels on ANM may reflect the influences of socioeconomic/nutritional status in their childhood or throughout their lifetime. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Factors related to age at menopause among Korean women: the Korean Longitudinal Survey of Women and Families
Conclusions: Various factors influenced menopause, including sociodemographic, health status, and health behaviors. Specific tailored interventions for the management of depressive symptoms and smoking cessation could be developed to target modifying variables for Korean women, in preparation for menopause. Also, the role of perceived body weight on menopause could be further explored to identify sociocultural factors for age at menopause. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

The burden of vulvovaginal atrophy on women's daily living: implications on quality of life from a face-to-face real-life survey
Conclusions: Severe VVA symptoms showed a direct association with worse quality of life in postmenopausal women. This important effect on the quality of life of many women should be recognized as equivalent to those from other conditions and pathologies of which there is greater awareness. (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Self-awareness and the evaluation of hot flash severity: observations from the Seattle Midlife Women's Health Study
Objective: The purpose of this study was to test the association of two dimensions of self-awareness with hot flash (HF) severity. Methods: A subset of women from the Seattle Midlife Women's Health Study (N = 232) provided data for these analyses. Structural equation modeling was used to evaluate two dimensions of self-awareness (Internal States Awareness [ISA] and Self-Reflectiveness [SR]), and secondary factors of perceived stress, anxiety, and attitudes toward menopause as continuous with earlier life, health perceptions, and menopausal stage with respect to HF severity. The measurement and structural models we...
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Gastric responses to acute psychological stress in climacteric women: a pilot study
Objective: Women exhibit reduced ovarian sex hormones during the menopausal period that result in well-known physical and psychological symptoms. However, symptoms related to gastric motility (GM) have not been thoroughly investigated. We hypothesized that stress response gastric motility (SRGM) is lower in postmenopausal (PM) and perimenopausal (PERIM) women than in premenopausal (PREM) women. Estrogenic decline leads to neuroendocrine changes in different areas of the brain. These changes can result in hypothalamic vasomotor symptoms, disorders in eating behaviours, and altered blood pressure, in addition to psychologi...
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Early life exposure to famine and reproductive aging among Chinese women
Objective: To assess the effect of early life exposure to famine, as endured during 1959 to 1961 in China, on reproductive aging in adult women. Methods: Between 2011 and 2012, 2,868 women born around the Chinese famine period (1956-1964) were enrolled in this study from three communities in China. Age at natural menopause was obtained retrospectively from a structured questionnaire. The associations of early life famine exposure with reproductive aging during adulthood were estimated, with adjustment of socioeconomic status, lifestyle factors, and body mass index. Results: Women exposed to prenatal famine had a hi...
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Original Articles Source Type: research

Hot flashes: treating the mind, body and soul
No abstract available (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Editorials Source Type: research

Menopause and the gastrointestinal system: our gut feelings
No abstract available (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Editorials Source Type: research

Importance of prenatal and early-life nutrition in early menopause and subsequent health
No abstract available (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: Editorials Source Type: research

Fernand Labrie, OC, OQ, MD, PhD, FRCPC, FRSC, CAHS (June 28, 1937–January 16, 2019)
No abstract available (Source: Menopause)
Source: Menopause - April 27, 2019 Category: OBGYN Tags: In Memoriam Source Type: research

A systematic review of the efficacy and safety of vaginal estrogen products for the treatment of genitourinary syndrome of menopause
Conclusion: Estrogen products were found to be clinically effective for the treatment of GSM with doses as low as 4 μg. Vaginal estrogen products seem to be safe with few adverse effects, although there is a lack of long-term controlled clinical trial safety data. This review supports the use of commercially available vaginal estrogen therapies as an effective and safe first-line therapy for the treatment of moderate-to-severe GSM. (Source: Menopause)
Source: Menopause - March 29, 2019 Category: OBGYN Tags: Review Article Source Type: research

Hypertension in menopausal women: the effect and role of estrogen
States of estrogen imbalance or deprivation are associated with higher risks of hypertension and cardiovascular disease in women; however, the effects of estrogen on hypertension are multifactorial, complex, and not completely understood. Although controversial, hormone therapy may improve cardiovascular outcomes when initiated by recently menopausal women. Improved screening for hypertension, especially in specific groups of younger women at higher risk, is recommended. Further study is needed to determine whether sex-specific differences exist in therapeutic response to pharmacologic management of hypertension. (Source: Menopause)
Source: Menopause - March 29, 2019 Category: OBGYN Tags: Clinical Corner: NAMS Practice Pearl Source Type: research

Rethinking the techno vagina: a case series of patient complications following vaginal laser treatment for atrophy
Conclusions: Laser therapy for the vagina shows excellent promise for the treatment of GSM in some women; however, complications such as fibrosis, scarring, agglutination, and penetration injury have been documented. Food and Drug Administration–approved products for GSM should be considered frontline treatments until long-term, prospective, randomized, sham-controlled trials are conducted that confirm efficacy and safety for device treatments. (Source: Menopause)
Source: Menopause - March 29, 2019 Category: OBGYN Tags: Case Report Source Type: research

Long-term weight loss maintenance, sex steroid hormones, and sex hormone-binding globulin
Objective: We tested the effects of weight loss on serum estradiol, estrone, testosterone, and sex hormone-binding globulin (SHBG) in overweight/obese women 18 months after completing a year-long, 4-arm, randomized-controlled dietary weight loss and/or exercise trial. Methods: From 2005 to 2008, 439 overweight/obese, postmenopausal women (BMI>25 kg/m2), 50 to 75 years, were randomized to a year-long intervention: diet (reduced calorie, 10% weight loss, N = 118), exercise (225 min/wk moderate-to-vigorous activity, N = 117), combined diet + exercise (N = 117), or control (N = 87). At 12 months, 399 wo...
Source: Menopause - March 29, 2019 Category: OBGYN Tags: Brief Report Source Type: research

The association of miR-25T>C, miR-32C>A, miR-125C>T, and miR-222G>T polymorphisms with a risk of primary ovarian insufficiency in Korean women
Objective: The purpose of this study was to investigate the association of microRNA polymorphisms (miR-25T>C, miR-32C>A, miR-125C>T, and miR-222G>T) with primary ovarian insufficiency (POI) in Korean women. Methods: We conducted a case-control study of Korean women: 142 participants with POI and 266 controls with at least 1 live birth and no history of pregnancy loss. Results: The haplotype-based multifactor dimensionality reduction analysis revealed that the T-C-T-G (miR-25/-32/-125/-222), T-A-C-G (miR-25/-32/-125/-222), C-T-G (miR-32/-125/-222), A-C-G (miR-32/-125/-222), T-G (miR-122/-222), C-T (miR-3...
Source: Menopause - March 29, 2019 Category: OBGYN Tags: Original Articles Source Type: research