Menopause: The Journal of The North American Menopause Society最新文献

Objective: Approximately 75% of women aged between 45 and 55 years suffer from symptoms of menopause. Hormone therapies used in breast cancer treatment can induce the same symptoms. Current medications for menopausal symptoms are not suitable for everyone. Here, we describe a case of a woman whose menopausal vasomotor symptoms decreased after starting lamotrigine.

Methods: We report a case of a woman whose menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medication. We did not find any reports of lamotrigine in regards to menopausal symptoms.

Results: A 53-year-old woman with menopausal symptoms and migraine had tried different medications for migraine. She could not use estradiol 1 mg p.o. regularly, because it worsened her headache. Then, lamotrigine was started for the migraine as a preventive medication. Lamotrigine's official indication is epilepsy and bipolar disorder. It is also used off-label, for example, for migraine. In a few days the nighttime hot flashes, night sweats and sleeping problems disappeared. Then she developed a rash. Because the rash induced by lamotrigine can be severe, the medication had to be stopped. In 2 weeks, the menopausal symptoms returned.

Conclusions: Menopausal vasomotor symptoms disappeared with lamotrigine and returned after stopping the medicine in this case. The precise action mechanism(s) of lamotrigine is unknown. Lamotrigine has interactions with estrogen and progesterone medicines. So, this effect we describe might not have been just a coincidence. Lamotrigine could be worth further research in regards to menopausal symptoms.

Objective: The primary objective of this study was to determine whether women with and without a history of endometriosis experience menopause differently, in terms of their satisfaction with quality of life.

Methods: This study was conducted at Fondazione IRCCS Ca' Granda Policlinico Hospital, Milan, from October 2022 to April 2024. The total sample included 394 postmenopausal women aged 48-55 years: 197 with a clinical history of endometriosis (group 1) and 197 without (group 2). All participants were required to complete a series of validated questionnaires assessing quality of life (Short-Form Health Survey 12, SF-12), sexual function (Female Sexual Function Index [FSFI]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), climacteric symptoms (Menopause-Specific Quality of Life Questionnaire [MENQOL]), and satisfaction with their clinical condition using a 5-point Likert scale.

Results: The SF-12 scores were significantly higher in group 2 than in group 1 (physical score: P=0.01; mental score: P<0.001). Group 1 reported lower satisfaction levels than group 2; however, this difference was not statistically significant (OR = 0.78, 95% CI: 0.5-1.2, P=0.26). The FSFI, HADS, and MENQOL scores were not significantly different between the two groups (FSFI score, P = 0.20; HADS anxiety score, P=0.11; HADS depression score, P=0.48; MENQOL score, P = 0.91).

Conclusion: Postmenopausal women with a history of endometriosis appear to have a similar quality of life compared with those without such a history. While the overall quality of life scores were higher in women without endometriosis, both groups reported comparable climacteric symptoms, sexual functioning, and anxiety and depression levels.

Objectives: This study explores how women in a UK workplace discuss their menopause experiences and respond to their organization's menopause policy. It aims to understand the value, limitations, and implications of workplace menopause policies from the perspectives of women undergoing this life transition.

Methods: Data were drawn from a workshop involving 11 participants who were perimenopausal and postmenopausal women. Participants shared personal experiences and collectively reviewed their employer's menopause policy. Reflexive thematic analysis was employed to identify key themes reflecting participants' emotional, cognitive, and practical responses to menopause at work and to organizational support.

Results: Three main themes were developed from the data: (1) "I thought I was going mad": the emotional and cognitive toll of going through the menopause at work; (2) "It reads like it's been written for HR, not for us": the gap between policy and reality; and (3) "Not the policy, not HR, just knowing you're not alone": support beyond policy. Participants expressed that menopause at work is not only a biological process but also a deeply social and professional experience. While menopause policy was welcomed, participants felt it often lacked grounding in employees' real needs and contexts.

Conclusions: Workplace menopause policies must move beyond symbolic gestures to offer meaningful, flexible support that respects women's dignity and professional contributions during menopause. Genuine inclusion requires policies shaped by women's lived experiences and organizational practices that facilitate recognition and practical support, fostering a truly inclusive work environment during this significant life stage.

Importance: Sexual concerns are commonly reported by perimenopausal and postmenopausal women. Nonpharmacological treatments, including psychological-based treatments, may serve as an alternative and/or complementary option for those who cannot, or choose not, to take medication or who continue to experience symptoms despite their use.

Objective: This systematic review and meta-analysis examined psychological interventions that directly targeted and/or assessed sexual functioning in perimenopausal and postmenopausal women using standardized measures.

Evidence review: Web of Science, MEDLINE, and PubMed were searched for studies that evaluated the effects of psychological interventions for sexual concerns during perimenopause and postmenopause. Risk of bias assessments were done using the Cochrane Risk-of-Bias Tool and the Newcastle-Ottawa Scale. Data were pooled in a primary meta-analysis using the Female Sexual Function Index (FSFI), as well as subgroup analyses based on psychological intervention type, with effects reported separately for each subgroup.

Findings: Sixteen articles (n=1,445) met the eligibility criteria and were included in the systematic review and meta-analysis. Overall, nine randomized controlled trials (n=738) containing FSFI data were pooled in a meta-analysis showing psychological interventions were associated with significant improvements in sexual concerns (standardized mean difference [SMD]=1.37, 95% CI=1.17-1.58, P<0.00001; n=475). Subgroup analysis based on type of psychological intervention revealed that cognitive-behavioral therapy (SMD =-0.00, 95% CI=-0.26 to 0.25; n=233; I2=0%) and mindfulness-based interventions (SMD =0.02, 95% CI=-0.40 to 0.45; n=86; I2=0%) had no to small effect on the sexual function in perimenopausal and postmenopausal women, while education programs (SMD=2.53, 95% CI=-2.19 to 2.86; P<0.00001; n=268; I2=94%) and counseling (SMD=2.43, 95% CI=1.92-2.94; P<0.00001; n=106; I2=0%) had a large effect. Only one motivational interviewing study (effect size of 0.72) was included, but it revealed a large effect on sexual functioning. Overall risk of bias ranged from low to some concerns, with one study scoring high.

Conclusions and relevance: This systematic review and meta-analysis suggests that psychological interventions are an effective nonpharmacological treatment option for addressing sexual concerns in perimenopausal and postmenopausal women. Although cognitive-behavioral therapy and mindfulness-based approaches showed small to no effects on sexual concerns, these findings should be interpreted with caution, as the included studies did not directly target sexual concerns but instead assessed them as secondary outcomes. Psychological interventions should be considered when discussing treatment options for sexual concerns in perimenopausal and postmenopausal women.

Objective: Around 70% of women experience vasomotor symptoms (VMS) over the menopause transition. These are a leading patient priority for treatment. To robustly evaluate treatment effectiveness, validated tools are needed. VMS diaries are widely used in clinical trials, but their content validity and acceptability for symptomatic women is not established. The objective of this study is to evaluate acceptability, content validity and face validity of available hot flash diaries.

Methods: We conducted semi-structured interviews to explore acceptability, content, interpretation and experience of completion of three widely used hot flash diaries: Sloan, Guttuso, Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) with English speaking symptomatic peri/postmenopausal women in Australia, recruited through social media (Facebook groups), a registry of previous trial participants, and through Menopause clinics. Content analysis was used to analyze findings.

Results: Of 33 women who completed screening questions, 25 provided contact details and consented to being interviewed. Women were aged 40-69 years, most reported menopause between 50 and 59 years, and 18 experienced moderate-severe VMS. Participants considered daily reporting of VMS acceptable, preferred diaries reporting VMS in real-time or twice daily (rather than once daily) and found descriptions for severity categories helpful in assigning severity of their VMS.

Conclusion: Two diaries (Guttuso and MsFLASH) were found to be acceptable and valid measures of VMS severity and frequency. However, adding descriptions for severity categories to the MsFLASH diary and distinguishing between day and night-time VMS in the Guttuso diary were recommended improvements. Real-time data collection may be preferable.

Importance: Currently, many postmenopausal women experience symptoms related to the cessation of hormone production, and hormone therapy is the most commonly used treatment to alleviate these symptoms. However, it is contraindicated in several situations, which highlights the importance of alternative therapies such as royal jelly (RJ), particularly given the limited number of studies demonstrating its effectiveness.

Objective: To evaluate the effects of RJ supplementation on postmenopausal symptoms in women.

Evidence review: We developed a search strategy using "royal jelly" and "menopause" with their synonyms. Terms were combined using Boolean operators (OR for synonyms, AND between concepts). We searched MEDLINE (PubMed), LILACS (BVS), Embase (Elsevier), and Cochrane Library through May 2025. Studies were included if they evaluated interventions for postmenopausal symptoms, with outcomes including genitourinary symptoms and quality of life measures.

Findings: A total of 281 studies were identified; 262 were excluded. Of the remaining 19, 14 were selected for full-text reading, and 6 studies involving 471 postmenopausal women were included in the final analysis. The studies were published between 2011 and 2021. RJ supplementation significantly improved postmenopausal symptoms compared with placebo (standardized mean difference=0.73; 95% confidence interval=0.50-0.96; P <0.00001; I2=0%, two studies, 312 participants, moderate-quality evidence).

Conclusions and relevance: RJ supplementation may offer a promising nonhormone option for managing menopausal symptoms and supporting bone and genitourinary health, especially for women who cannot or prefer not to use hormone therapy.

Objective: Hot flashes are a hallmark symptom of menopause and are often implicated in sleep disturbance. Although hot flash severity has been linked to insomnia, the cognitive model of hot flashes suggests that negative beliefs about hot flashes may also influence symptom perception and distress. However, the relationship between hot flash beliefs and insomnia remains understudied. We examined whether hot flash beliefs are uniquely associated with insomnia symptom severity.

Methods: This study is a cross-sectional design utilizing secondary data from participants recruited for a longitudinal study. A total of 102 perimenopausal and postmenopausal women were included in this study. Participants completed measures assessing hot flash severity, hot flash beliefs, and insomnia symptom severity. Hierarchical linear regression was used to examine whether hot flash beliefs were associated with insomnia symptoms above and beyond hot flash severity.

Results: Hot flash beliefs were positively associated with insomnia symptom severity (β=0.12, P<0.05), accounting for 24% of the variance. When hot flash severity was added to the model, both hot flash severity (β=0.80, P<0.05) and hot flash beliefs (β=0.10, P<0.05) were significantly positively associated with insomnia symptoms. Together, hot flash severity and hot flash beliefs explained 27% of the variance in insomnia symptom severity.

Conclusion: Cognitive appraisals of hot flashes are associated with greater insomnia symptom severity in perimenopausal and postmenopausal women. It is possible that negative beliefs about hot flashes may heighten arousal and interfere with sleep, independent of hot flash severity. These findings have implications for cognitive-behavioral interventions targeting insomnia and vasomotor symptoms in this population.

Objective: This pilot cross-sectional study aimed to determine the prevalence of sarcopenia among older women with obesity and to compare anthropometric parameters, body composition, and physical function between older women with nonsarcopenic obesity and those with sarcopenic obesity. In addition, sarcopenia-associated factors were explored.

Methods: In total, 141 older women with obesity (mean age 64.84 y) participated. Obesity was defined by a body mass index ≥30 kg/m², and sarcopenia was determined using handgrip strength (<0.56 kgf/BMI) and low appendicular lean mass (<0.512 kg/BMI). Independent t tests were used to compare differences between groups, and multivariate logistic regression analyses to assess sarcopenia-associated factors.

Results: Sarcopenic obesity was observed in 28% of the participants with obesity. Women with sarcopenic obesity were shorter, but had a higher body mass index, waist circumference, and body fat percentage (total, android, and gynoid). These women also presented lower appendicular lean soft tissue and handgrip strength values. Logistic regression analysis showed that body fat percentage was associated with sarcopenia (5-unit increase in body fat: odds ratio: 4.25, 95% CI: 2.26-8.76, P<0.001).

Conclusion: In this pilot sample of older women with obesity, 28% exhibited sarcopenic obesity. Elevated body fat appeared to be associated with sarcopenia, highlighting a potential relationship that warrants further investigation in longitudinal studies.

Objectives: This study analyzes social media data from Reddit, using artificial intelligence and natural language processing, to explore cognitive changes in the menopause transition and their associations with hot flashes and hormone therapy (HT).

Methods: Posts from 2,387 women in the menopause subreddit and 3,710 matched controls (~340,000 posts) on Reddit were analyzed. A subset of 338 posts was manually labeled for age, hot flashes, cognitive complaints, mood disturbances, and sleep issues. A machine learning model (area under the receiver operating curve [AUC]: 0.67-0.92) applied these labels to the remaining posts. A cognitive scale, developed by correlating cognitive complaints with known linguistic markers of cognitive function, such as text length and lexical diversity, was employed.

Results: Hot flashes were reported by 41% of participants and were strongly associated with increased mood disturbances (6-fold), cognitive complaints (10-fold), and sleep difficulties (20-fold). Cognitive complaints correlated positively with length of text (AUC: 0.755) and negatively with unique word usage (AUC: 0.754). Women with hot flashes using HT initially exhibited lower cognitive scores, which improved with treatment over time but remained below those of asymptomatic untreated women.

Conclusions: Hot flashes are associated with subjective cognitive impairment and with text markers of cognitive performance during the menopause transition. This study highlights social media's potential as a valuable research tool for assessing cognitive changes in menopause.

Objectives: Understanding the association between hot flashes and sleep disturbance is complicated, given that various dimensions of hot flashes (ie, occurrence, frequency, severity, timing) may have different associations with sleep. We evaluated the associations between various dimensions of momentary hot flashes and sleep disturbance (ie, sleep onset latency, sleep quality). We examined whether daytime, evening, and nocturnal hot flash frequency and/or severity predicted sleep disturbance.

Methods: Participants (N=99) completed self-report measures of hot flashes and sleep for seven consecutive days. Participants retrospectively reported the number and severity of daytime (reported each morning and afternoon), evening (reported each evening), and nocturnal (reported each morning) hot flashes they had, and completed a sleep diary each morning. We conducted a series of linear mixed-effects models regressing both sleep outcomes onto daytime/evening hot flash frequency/severity, and regressing sleep quality onto nocturnal hot flash frequency/severity.

Results: Results indicated that within-person evening hot flash severity was associated with sleep onset latency (Est=5.60, SE=2.48, 95% CI [0.75-10.46], P<0.05), and that within-person nocturnal hot flash frequency was associated with sleep quality (Est=-0.46, SE=0.06, 95% CI [-0.58 to -0.34], P<0.001).

Conclusions: We found that more severe evening hot flashes predicted longer sleep onset latency that night, and that more frequent nocturnal hot flashes were associated with worse sleep quality that night. This may suggest that targeting hot flashes that occur at night-both in the evening before bed and nocturnally during sleep-may be useful in improving sleep in perimenopausal and early postmenopausal women.