CLIMACTERIC

Hyaluronic acid and erbium laser for the treatment of genitourinary syndrome of menopause
Fidecicchi T and Gambacciani M
This study aimed to evaluate the effect of the vaginal erbium laser (VEL) in association with vaginal hyaluronic acid (HA) in postmenopausal women suffering from genitourinary syndrome of menopause (GSM).
Systemic hormone therapy after breast and gynecological cancers: an Italian expert group consensus opinion
Cagnacci A, Villa P, Grassi GP, Biglia N, Gambacciani M, Di Carlo C, Nocera F, Caruso S, Becorpi A, Lello S, Paoletti AM and
The specific Italian Group of Study of the Menopause formulated a consensus opinion on the use of estrogen therapy (ET) or combined estro-progestin hormone therapy (HT) after breast and gynecological cancers. This consensus is based on the risk of recurrence of the specific cancer during ET/HT, the presence of steroid receptors in cancer cells, the use of adjuvant hormone therapies and data on the use of ET/HT after cancer. The following positions were reached. ET/HT can be used after vulvar cancers and melanoma, but with great caution after the rare adenocarcinomas. ET/HT can be used after cervical cancer, but ET should be used with caution after adenocarcinomas. ET/HT can be used after International Federation of Obstetrics and Gynecology (FIGO) stage I-II estrogen-dependent endometrial cancers, except in Black women, and can probably be used after estrogen-independent endometrial cancers. ET/HT cannot be administered or should be used with great caution after most uterine sarcomas. ET/HT can probably be used after ovarian neoplasms except for granulosa cell tumors, and with great caution after low-grade serous ovarian carcinoma and serous borderline ovarian tumors. ET/HT can be used with great caution in women after estrogen receptor (ER)/progesterone receptor (PR)-positive breast cancer and is probably allowed after ER/PR-negative breast cancer.
Perimenopausal combined hormonal contraception: focus on sexual function
Yoldemir T
Age alone should not be an absolute contraindication for any contraceptive methods. However, medical eligibility criteria for combined hormonal contraception (CHC) use must be taken into consideration when choosing an appropriate contraceptive method. Women should be counseled on the benefits and risks of CHC while in their 40s. If there are no contraindications, women may use CHC for contraception up until the age of 50 years. Loss of libido is a common symptom during the late 40s. While women associate this with hormone levels, libido is multifactorial and is influenced by family and work stress, tiredness, self-image, medications and the physical changes in their partner. During this stage, women might experience urogenital issues such as vaginal dryness, dyspareunia and bladder problems, which can further affect the woman's sexual function. Before attributing the cause of sexual dysfunction to CHC use, a complete gynecologic examination and a full biopsychosocial assessment of the woman and her partner should be conducted to define other potential causes. When CHC-related female sexual dysfunction is suspected, using an oral CHC with a higher estrogen dose, a vaginal contraceptive ring or a transdermal contraceptive patch, or switching to a progesterone-only pill or non-hormonal method, might be suggested.
Factors influencing among middle-aged Korean women
Gu H and Hong E
This study aimed to examine factors associated with (a feeling of loneliness and solitude) - including aging anxiety, menopausal symptoms, social support and self-efficacy - in middle-aged women to provide fundamental data for future research endeavors.
Hyperandrogenism after menopause: diagnostic evaluation
Fux-Otta C, Torre D, Chedraui P, Melgarejo B, Ramos N, Carlo MD, Benzi M, Banús V, Estario ME, Leiderman S, Gecchelin R, Bartolacci I, Tarletta M, Ziperovich C, Lella SD, Aramayo C, Martín L, Pereyra C, Real C, Dogliani P, Ñañez M, López M, Iraci G, Fernández G and
Excessive androgen levels in women after menopause often result from an imbalance in ovarian steroid secretion: a rapid decline in estrogen secretion associated with a slow decrease in androgen secretion, compounded by a physiological decrease in sex hormone-binding globulin. Hyperandrogenism is associated with a higher risk of cardiovascular events and gynecological neoplasms, also impacting the emotional well-being of affected women. Therefore, the aim of these guidelines is to guide the clinical physician in the appropriate clinical and biochemical evaluation of hyperandrogenism after menopause, thus optimizing therapeutic outcomes. The most frequent consultation in this stage of life is facial hirsutism associated with hair loss. If the onset of signs is abrupt, severe, associated with virilization and accompanied by serum testosterone levels in the male range, it is necessary to rule out a tumoral origin. A thorough medical history guides the diagnosis. Determination of total testosterone using reliable methods and imaging studies are valid tools to assist when doubts arise in the differential diagnosis.
Vaginal microbiome of women with premature ovarian insufficiency: a descriptive cross-sectional study
Giraldo HP, Giraldo PC, Mira TA, Pravatta Rezende G, Yela DA, do Amaral RLG and Benetti-Pinto CL
This study aimed to describe the vaginal microbiome of women with premature ovarian insufficiency (POI) receiving systemic hormone therapy (HT).
Physician-patient alignment on menopause-associated symptom burden: real-world evidence from the USA and Europe
Kingsberg S, Nappi RE, Scott M, Schoof N, Moeller C, Lee L, Janssenswillen C, Caetano C and Banks V
This study aimed to evaluate physician-patient alignment on menopausal symptom burden and impact for women experiencing natural vasomotor symptoms (nVMS) or VMS induced by endocrine therapy for breast cancer (iVMS).
Heartwired for change: advancing women's cardiovascular health
Yang A
Low-dose and ultra-low-dose estradiol and dydrogesterone in postmenopause: an analysis by body mass index
Ren M, Yu Q, Custodio MG, Simoncini T, Nappi RE, Tatarchuk T, Kahler E, Piha T and Stevenson JC
Oral, low-dose and ultra-low-dose continuous combined 17β-estradiol (E) plus dydrogesterone (D) reduce vasomotor symptoms (VMS) in postmenopausal women.
Menopausal age does not affect ventricular structure and function: a Mendelian randomization study
Zeng Y, Cao S and Yuan Y
Observational studies have suggested an association between age at natural menopause (ANM) and ventricular structure and function. Nevertheless, the causal relationship remains unclear. This study aimed to evaluate the causal effects of ANM on ventricular structure and function by Mendelian randomization (MR) analysis.
The musculoskeletal syndrome of menopause
Wright VJ, Schwartzman JD, Itinoche R and Wittstein J
Fifty-one percent of humans are born with ovaries. As the ovarian production of estrogen diminishes in midlife and ultimately stops, it is estimated that more than 47 million women worldwide enter the menopause transition annually. More than 70% will experience musculoskeletal symptoms and 25% will be disabled by them through the transition from perimenopause to postmenopause. This often-unrecognized collective of musculoskeletal symptoms, largely influenced by estrogen flux, includes arthralgia, loss of muscle mass, loss of bone density and progression of osteoarthritis, among others. In isolation, it can be difficult for clinicians and patients to adequately appreciate the substantial role of decreasing estrogen, anticipate the onset of related symptoms and actively treat to mitigate future detrimental processes. Thus, in this review we introduce a new term, the musculoskeletal syndrome of menopause, to describe the collective musculoskeletal signs and symptoms associated with the loss of estrogen. Given the significant effects of these processes on quality of life and the associated personal and financial costs, it is important for clinicians and the women they care for to be aware of this terminology and the constellation of musculoskeletal processes for which proper risk assessment and prophylactic management are of consequence.
COVID-19 vaccination and postmenopausal bleeding: a retrospective cohort study
Pastor-Goutherot L, Miralpeix E, Fabregó B, Serrano L, Vizoso A, Solé-Sedeño JM and Mancebo G
COVID-19 vaccination has been related to menstrual irregularities; however, the effect on postmenopausal women is unknown. The aim of this study was to analyze the prevalence of postmenopausal bleeding (PMB) after COVID-19 vaccination.
Ultra-low-dose estradiol and dydrogesterone for treatment of vasomotor symptoms in Europe and China
Yu Q, Stevenson JC, Tatarchuk T, Nappi RE, Graziano Custodio M, Kahler E, Simoncini T, Yang J and Ren M
Among postmenopausal women, oral, ultra-low-dose continuous combined estradiol (E0.5 mg) plus dydrogesterone (D2.5 mg) reduces vasomotor symptoms (VMS).
Statement of Retraction: Role of topical oxytocin in improving vaginal atrophy in postmenopausal women: a randomized, controlled trial
Menopause and MHT in 2024: addressing the key controversies - an International Menopause Society White Paper
Panay N, Ang SB, Cheshire R, Goldstein SR, Maki P, Nappi RE and
The vision of the International Menopause Society (IMS) is that all women across the world will have easy and equitable access to evidence-based knowledge and health care, empowering them to make fully informed midlife health choices. The aim of this White Paper is to provide a well-balanced educational narrative of the menopause and menopause hormone therapy (MHT) from IMS experts, leading into World Menopause Day 2024. This is achieved by exploring the anthropology and history of menopause, the principles and controversies of prescribing MHT, and by placing this into regulatory and menopause society contexts. The White Paper also lays the groundwork for the forthcoming updated IMS recommendations on menopause and will act as a blueprint for the future ethical management of menopause from practical and aspirational perspectives. An important section of the paper is 'The 5Ws of prescribing MHT': WHO is MHT for; WHAT types and doses of MHT; WHEN should MHT be started and stopped; WHY is MHT important; WHERE can MHT be accessed? A key points summary of this information is provided for healthcare professionals and the public. The summary provides 'easy to access' advice regarding several recent controversial MHT prescribing issues in the healthcare and media spotlights.
Maintaining the menopause momentum
Hillard T
Cut-off point development for the Everyday Memory Questionnaire - Revised in perimenopausal women
Zhu C, Thomas EHX, Li Q, Arunogiri S and Gurvich C
Subjective cognitive complaints have been reported in women during perimenopause and the Everyday Memory Questionnaire - Revised (EMQ-R) has been recently evaluated as a standardized instrument to measure subjective cognitive changes. The purpose of this study was to identify potential cut-off points for the EMQ-R retrieval subscale and attentional subscale, and to assess the validity of these cut-off points in detecting objective cognitive changes associated with reported subjective cognitive complaints.
Isoflavones obtained from red clover improve both dyslipidemia and menopausal symptoms in menopausal women: a prospective randomized placebo-controlled trial
Yigit E and Unsal S
This study aimed to investigate the effects of red clover isoflavones on menopausal symptoms and the lipid profile in menopausal females.
Willingness to use clinical scales for menopause management among general practitioners
Farah D, Ceccaldi PF, Farah L, Ayoubi JM and Vallée A
The use of digital healthcare technologies to enhance healthcare delivery has seen significant growth. However, a notable a notable research gap exists in the application of clinical scales for menopause management by general practitioners (GPs). This study aims to investigate willingness of GPs to use specific menopausal scale tools in the care of females for menopause management.
Effect of hormone therapy on personality traits: preliminary evidence in older men and women
Schroeder RA, Mordecai KL, Resnick SM, Terracciano A, Dobs A, Durso SC, Costa PT and Maki PM
Findings concerning the effects of hormone therapy (HT) on cognition and dementia are mixed, with some trials suggesting increased harm at older ages. Personality, like cognition, changes with dementia, but no clinical trials to date have examined the effects of HT on personality traits. This study aimed to determine the effects of HT on personality traits in older men and women.
Rapid and random-start endometrial preparation before outpatient hysteroscopic polypectomy in patients of perimenopausal age
Etrusco A, D'Amato A, Agrifoglio V, Chiantera V, Russo G, D'Augè TG, Monti M, Riemma G, Laganà AS and Giannini A
This study aimed to assess the efficacy of randomly started oral dienogest/ethinylestradiol (DNG/EE) for swift endometrial preparation prior to outpatient hysteroscopic polypectomy in perimenopausal women.