Climacteric最新文献

Objective: The aim of this study was to investigate the efficacy of cranial electrotherapy stimulation (CES) on cognition among perimenopausal women.

Methods: The pretest-post-test randomized controlled trial was conducted between April 2024 and January 2025. Forty-six perimenopausal women, aged 40-55 years, were randomized into two groups: active CES (n = 23) or sham CES (n = 23). Participants were blinded to the study. Both groups received 30-min sessions, 4 days a week for 4 weeks. The participants were assessed at baseline and at the end of 4 weeks of intervention using the Montreal Cognitive Assessment (MoCA) scale.

Results: Demographic and baseline characteristics depicted a normal distribution for both groups, except for MoCA (p < 0.05). Within-group analyses of both groups demonstrated significant differences for MoCA (active CES, p = 0.001; sham CES, p = 0.002) with large effect size ≥ 0.5. Between-group analyses of MoCA showed no significant difference with p = 0.212 and small effect size ≤ 0.3. The time and group interaction effect showed significant improvement with p = 0.001.

Conclusions: CES has the potential to enhance cognitive function in perimenopausal women. Additionally, no adverse events related to the study were reported.

Objective: This study aimed to investigate the association between depression and female sexual function among postmenopausal women.

Study design: The study group was composed of 232 sexually active postmenopausal women. Serum testosterone, androstenedione, dehydroepiandrosterone sulfate, fasting glucose, insulin, sex hormone-binding globulin, total cholesterol, high-density lipoprotein, low-density lipoprotein and triglyceride levels were analyzed. Quantification of pelvic organ prolapse was performed for each patient. The Female Sexual Function Index (FSFI) questionnaire and the Beck Depression Inventory (BDI) were distributed and compared between postmenopausal and premenopausal women.

Results: The mean BDI score was 17.5 ± 9.8. Sexual dysfunction determined by the mean FSFI score was 64.2%. In total, 70.5% of the postmenopausal women with sexual dysfunction had moderate to severe depression. There was a low negative correlation between age and duration after menopause and mean FSFI scores (r = -0.334 and r = -386, respectively). There was a negligible positive correlation between age and duration after menopause and mean BDI scores (r = 0.281 and r = 0.276, respectively). The satisfaction domain of the FSFI was significantly decreased with postmenopausal depression.

Conclusion: Postmenopausal women with sexual dysfunction had higher depression scores. Age and time after menopause were weakly associated with both FSFI and BDI scores in postmenopausal women.

Objective: Testosterone may have a role in brain health. Whether older women who exhibit a decline in blood testosterone are at an increased risk of cognitive decline is uncertain.

Method: A subset of Australian female participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial had testosterone concentrations measured by liquid chromatography-tandem mass spectrometry and underwent a comprehensive cognitive test battery at baseline and study year 3. Cognitive decline was defined as a lower test score at year 3 compared with baseline. The mean change (baseline to year 3) of testosterone concentration was examined by paired-sample t-test. Stable or increased (reference) versus a decline in testosterone concentration was used to investigate the association with cognitive decline using logistic regression.

Results: A total of 395 women (median [interquartile range] age 78.1 [73.7-82.3] years) provided data for analysis. In total, 154 women (39%) had a decline in blood testosterone which was not associated with a decline in any cognitive measure (Modified Mini-Mental State Examination: odds ratio [OR] = 0.96, 95% confidence interval [CI] 0.63 to 1.49, p = 0.86; Hopkins Verbal Learning Test - Revised: Immediate Recall, OR = 0.71, 95% CI 0.44 to 1.13, p = 0.151 and Delayed Recall, OR = 1.42, 95% CI 0.89 to 2.26, p = 0.14; Controlled Oral Word Association Test: OR = 0.79, 95% CI 0.49 to 1.25, p = 0.31; and Symbol Digit Modalities Test: OR = 0.83, 95% CI 0.53 to 1.29, p = 0.40). Limiting the analysis to 237 women aged 70-79 years (74.5 [interquartile range 72.2-77.1] years), no association was observed between a decline in blood testosterone and any cognitive outcome.

Conclusion: : A decline in blood testosterone concentrations over 3 years was not associated with a decline in cognitive function in community-dwelling Australian women aged 70 years and older.

Objective: This study aimed to systematically evaluate and quantify the impact of menopausal status on intraocular pressure (IOP) and central corneal thickness (CCT) in women, through a comparative meta-analysis.

Method: A systematic search was conducted across PubMed, Scopus, Web of Science and the Cochrane Library up to 15 April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies included original research comparing IOP and/or CCT between premenopausal and postmenopausal women. Meta-analysis was conducted using a random-effects model, and heterogeneity was assessed via I², τ² and H² statistics.

Results: Ten studies were analyzed in this meta-analysis, including data from premenopausal and postmenopausal women (totaling 999 eyes). The pooled results indicated that postmenopausal women had significantly higher IOP and reduced CCT compared to premenopausal women. Despite high heterogeneity (I² = 97.17% for CCT, I² = 84.20% for IOP), the direction of effect was consistent across most studies. The hormonal decline associated with menopause, particularly reduced estrogen levels, appears to affect corneal structure.

Conclusion: Menopause is associated with elevated IOP and decreased CCT, likely due to hormonal alterations, notably estrogen deficiency. Menopausal status may be a relevant factor in ocular assessments and could have implications for risk assessment in conditions such as glaucoma.

Objective: Sarcopenia is a multifactorial skeletal muscle disease commonly observed in the geriatric population. It is influenced by hormonal changes that occur during the postmenopausal period. This study aims to evaluate the sarcopenia status of postmenopausal women.

Method: The study included 300 postmenopausal women. Sarcopenia was defined according to the updated European Working Group on Sarcopenia in Older People (EWGSOP-2) definition.

Results: Of the evaluated patients, 44.7% (n = 134) and 15.4% (n = 46) were sarcopenic and sarcopenic obese, respectively. Older age, the number of chronic diseases, medications used and the status of polypharmacy were significantly higher in the sarcopenic group (all p < 0.050). Non-obese patients with sarcopenia showed greater dependence in activities of daily living (ADLs) (p = 0.002) and instrumental ADLs (IADLs) (p = 0.001). In ADLs (p = 0.001) and IADLs (p = 0.001), non-sarcopenic obese patients showed greater independence. Postmenopausal sarcopenia was related to older age (hazard ratio [HR]: 1.07, 95% confidence interval (CI): [1.04-1.10]; p < 0.001), the presence of osteoporosis (HR: 1.86, 95% CI: [1.05-3.30]; p = 0.034) and the existence of vasomotor symptoms (HR: 2.30, 95% CI: [1.31-4.04]; p = 0.004).

Conclusion: This study highlights the importance of sarcopenia awareness among specialists providing healthcare services to postmenopausal patients. The study underscores the significance of initiating preventive and treatment strategies for at-risk patients before they reach old age.

Objective: This cross-sectional, observational study, conducted in nine Latin American countries, aimed to examine the association between hot flashes and insomnia, and whether the severity of vasomotor symptoms (VMS) correlates with sleep disturbances.

Method: The study collected sociodemographic and clinical data, and evaluated the presence of sleep disorders using Jenkin's Sleep Scale (JSS-4) and menopausal symptoms using the Menopause Rating Scale (MRS) questionnaire.

Results: The study included 1185 postmenopausal women with average age 56.9 ± 5.7 years, body mass index (BMI) of 26.5 ± 5.2 kg/m² and 8.6 ± 6.4 years since menopause. Overall, 20.6% reported sleep disturbances. Compared to those without sleep problems, affected women had longer postmenopausal duration (12 ± 9.0 vs. 10.8 ± 7.8, p < 0.03), had higher BMI (27.9 ± 5.6 vs. 26.1 ± 5.0, p < 0.001), were more often smokers and homemakers, and had more comorbidities. They were also less likely to have a partner or have used menopausal hormone therapy. Sleep disturbances increased proportionally with VMS severity (p < 0.01). In multivariate analysis, sleep disorders were associated with VMS (odds ratio [OR] 4.47), psychotropic use (OR 1.84), obesity (OR 1.45) and comorbidities (OR 1.45).

Conclusion: Women with VMS were more likely to experience sleep disorders and this effect was proportional to the magnitude of the hot flashes. The study also presents several factors associated with sleep disorders in postmenopausal women that should be considered to help prevent these disturbances.

Objective: This study aimed to document the prevalence of sexual difficulties, sexually-related personal distress, sexual dysfunction and associated factors among refugee women in Australia.

Method: The cross-sectional study included refugee women aged 18-63 years. Sexual difficulties were defined as selecting 'always' or 'very often' on the Profile of Female Sexual Function, while distress was a score of at least 11 on the Female Sexual Distress Scale - Revised. Female sexual dysfunction (FSD) combined these scores. Participants also completed the Woman Abuse Screening Tool and the Bristol Female Lower Urinary Tract Symptoms questionnaire.

Results: Among 299 participants (median age 41 years), sexual difficulties, sexually-related personal distress and FSD were present in 39.3%, 33.2% and 7.0%, respectively. Perimenopausal/postmenopausal status (adjusted odds ratio [aOR] = 2.8, 95% confidence interval [CI]: 1.4-5.6, p = 0.003) and sexual activity (aOR = 0.2, 95% CI: 0.1-0.4, p < 0.001) predicted sexual difficulties. Intimate partner abuse (aOR = 5.9, 95% CI: 2.4-14.5, p < 0.001) and urinary incontinence (aOR = 4.5, 95% CI: 1.5-13.0, p = 0.006) were associated with sexually-related personal distress.

Conclusion: Perimenopausal/postmenopausal status and sexual inactivity were associated with sexual difficulties, while intimate partner abuse and urinary incontinence were associated with sexually-related distress, highlighting the importance of proactive screening for psychosocial and physical health issues in sexual health assessments among refugee women.

Sexual health and sexual well-being are important components of the overall quality of life at midlife, a turning point carrying several biopsychosocial changes. As people age, they are likely to observe a significant increase in sexual difficulties in both sexes affecting every domain of sexual response, and a decline in the frequency of engaging in sexual activity. Women may report hypoactive sexual desire disorder (HSDD) and genitourinary syndrome of menopause (GSM), two very common biologically driven midlife conditions that are often comorbid and may also be influenced by a multitude of individual and contextual risk factors. An appropriate and timely diagnosis is important to avoid chronification of sexual dysfunction that may become refractory to treatment. The therapeutic algorithm comprises a multidisciplinary approach, including pharmacologic and non-pharmacologic management. Individualized treatment is the key to providing integrated care with positive attitudes for the aging couples in order to expand the 'sexspan' of both partners. This article reports our point of view on the topic of midlife sexuality in the context of a stable relationship, as presented at the 19th World Congress on Menopause in Melbourne (Australia) on 22 October 2024.

Objective: Ovarian aging significantly impacts women's overall aging, affecting various systems including the musculoskeletal system. This study investigates the correlation between ovarian function and handgrip strength (HGS) across reproductive aging stages and their relation to health-related quality of life (HRQoL).

Method: A cross-sectional study was conducted with female participants spanning all stages of ovarian function. HGS was measured using a dynamometer, and ovarian function was assessed via hormone levels (estradiol [E2], follicle stimulating hormone [FSH], luteinizing hormone [LH], prolactin [PRL], progesterone [P4] and testosterone). HRQoL was evaluated using the Sarcopenia-specific Quality of Life questionnaire (SarQoL). Data analysis involved analysis of variance and Pearson's correlations, adjusted for confounding factors.

Results: The prevalence of possible sarcopenia increased from 3.8% in premenopausal women to 10.3% in postmenopausal women. After adjusting for covariates (age, SarQoL, FSH, LH, FSH/LH ratio, PRL, E2, P4 and testosterone), the negative correlation between HGS and the Kupperman Menopausal Index (KMI) was no longer significant. However, the positive correlation between HGS and the SarQoL remained significant in both the overall population and the postmenopausal group. The negative correlation between HGS and FSH was no longer significant after controlling for age, KMI, LH and E2; however, it persisted after controlling for the SarQoL, FSH/LH ratio, PRL, P4 and testosterone.

Conclusion: HGS is positively correlated with the SarQoL and negatively correlated with age in the overall population. No significant association was found between HGS and testosterone, E2, LH or FSH/LH ratio. Further research is needed to clarify the relationship between HGS and the KMI or FSH.

Testosterone is unquestionably a normal female hormone that exerts important physiological effects in multiple tissues. Clinical trials have consistently demonstrated benefits of testosterone therapy on several domains of sexual function for postmenopausal women with low sexual desire causing substantial personal concern. Whether other benefits can be attributed to testosterone therapy for postmenopausal women remains uncertain. This article summarizes the available data for the use of testosterone therapy beyond the treatment of low sexual desire with distress. The article is not a systematic review of the entire published literature in the field. Rather, it includes recent systematic reviews and meta-analyses the author highlighted in their plenary lecture at the 2024 World Congress on the Menopause. The aim was to provide an overview of the published data for clinicians and researchers in this field.