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

Objective: The aim of the study was to analyze the effects of 16 weeks of Jazz Dance training compared to a control group in postmenopausal women, postintervention, and at the 6- and 12-month follow-ups, on cardiorespiratory fitness, body composition, muscle strength, and sleep quality.

Methods: Two-arm randomized clinical trial with a total of 47 women (jazz dance intervention group [JDIG] [n = 23] and control group (CG) [n = 24]) with a mean age of 53.41 ± 2.8 y. Data collection was carried out at four times, baseline, postintervention, and 6- and 12-month follow-ups using the 6-minute walk test (cardiorespiratory fitness); bioimpedance (body composition); isokinetic dynamometry (muscle strength); and the Pittsburgh Sleep Quality Index (sleep quality).

Results: In the intention-to-treat analysis, the results showed positive differences for the JDIG in cardiorespiratory fitness at all time points (P = 0.034) and in the group x time interaction (P = <0.001). Lower limb muscle strength showed differences from baseline to postintervention and from baseline to the 12-month follow-up for the concentric force ratio (P = 0.021; P = 0.009). However, for peak extension and flexion, the results were not positive for the JDIG. There was a short-term improvement in sleep duration for the JDIG (P = 0.001) and significant intergroup differences in subjective sleep quality, where the JDIG showed better results compared to the CG (P = 0.041).

Conclusions: Jazz Dance is effective for improving cardiorespiratory fitness (in the short, medium, and long term) and sleep quality (in the short and medium term); however, it does not seem to have presented sufficient intensity and duration for facilitating changes in body composition or increasing lower limb muscle strength in postmenopausal women.

Objective: Midlife women experience menopause- and aging-related health changes that may impact sexual functioning. Research has historically relied on heteronormative constructs of sexuality, and little is known about the experiences of sexual minority women (SMW) during menopause. We therefore examined whether indices of sexual function differed between SMW and heterosexual midlife women Veterans.

Methods: Data were drawn from a cross-sectional survey designed to examine midlife women Veterans' experiences of menopause and aging. Participants self-reported sexual orientation, sociodemographic characteristics, vaginal symptoms, past-month engagement in sexual activity, and pain with sexual activity with structured-item responses. Sexual function was assessed with validated questionnaires. Logistic and linear regression models examined group differences adjusted for age, education, race, menopause status, and body mass index.

Results: In this sample (n = 232, mean age = 56.0, SD = 5.14), 25% self-identified as SMW. Relative to heterosexual women, SMW were more likely to endorse recent sexual activity (odds ratio [OR], 2.20; 95% confidence interval [CI], 11.13-4.30), less likely to report pain during sex (OR, 0.07; 95% CI, 0.16-0.32), less likely to report past-month vaginal symptoms (OR, 0.33; 95% CI, 0.17-0.66), and endorsed lower impact of vaginal symptoms on sexual function (β = -0.24; 95% CI, -0.97 to -0.26). Both groups reported high levels of distress related to sexual dysfunction (sample mean = 19.9, SD = 8.0).

Conclusions: Midlife SMW Veterans reported better sexual functioning and less impact of vaginal symptoms compared with heterosexual peers. Despite this, both groups reported high levels of distress related to sexual function.

Objective: The aim of this study was to compare menopause experience in rural, suburban, and urban-residing women.

Methods: A 2019 online survey of US females queried respondents on menopause symptoms, resources, and treatments. Those ≥45 years of age and in late menopause transition or postmenopause were included in the analysis. Late menopause transition and postmenopause subgroups were stratified by rural, suburban, and urban residence, and age-weighted proportions for menopause symptoms and treatments were calculated and compared using chi-square tests.

Results: A total of 1,531 respondents, 45% (n = 686) late menopause transition, mean age of 50.7 (SD 3.9) and 55% (n = 845) postmenopause, and mean age of 65.1 (SD 8.5) were included. More prevalent symptoms in late menopause transition rural residents were as follows: muscle aches and pains (urban: 49%, suburban: 49%, rural: 65%, P = 0.003), and panic attacks (urban: 18%, suburban: 24%, rural: 30%, P = 0.04). More prevalent symptoms in postmenopause rural residents were as follows: mood swings (urban: 18%, suburban: 14%, rural: 23%, P = 0.02), urinary incontinence (urban: 19%, suburban: 14%, rural: 23%, P = 0.02), and vaginal dryness (urban: 22%, suburban: 29%, rural: 37%, P = 0.004). Vasomotor symptom prevalence was high (71% late menopause transition, 20% postmeopause), but current menopause hormone therapy use was low (11% late menopause transition, 11% postmenopause) and did not differ by residence, despite differences in menopausal resources used.

Conclusions: Rural women may experience greater burden of psychological and somatic menopause symptoms but not vasomotor symptoms. Overall low rates of menopause hormone therapy use suggest a need for education regarding hormone therapy, tailored to residential groups who rely on different resources on healthy aging.

Objective: To assess the association of systolic and diastolic blood pressure (SBP and DBP) in recently menopausal women with white matter hyperintensity (WMH) volume later in life and determine whether short-term menopausal hormone therapy (mHT) modifies these associations.

Methods: Kronos Early Estrogen Prevention Study (KEEPS) was a multicenter, randomized, double-blinded, placebo-controlled 4-year mHT trial (oral conjugated equine estrogens or transdermal 17β-estradiol). KEEPS continuation was an observational follow-up of the participants 10 years after the end of mHT. The associations between KEEPS baseline blood pressure (BP) with KEEPS continuation WMH volume were examined adjusting for covariates in model 1 (age, total intracranial volume, study site, mHT type) and model 2 (additionally conventional CVD risk factors). Interaction terms (BP × mHT type) were added into the linear regression models.

Results: The mean ± SD ages of participants were 53 (±2) years at KEEPS baseline and 67 (±2) years at KEEPS continuation. Elevated BP at KEEPS baseline was associated with greater WMH volume measured 14 years later (model 1: SBP: β = 0.01 [95% CI, 0.001-0.01] and DBP: β = 0.01 [95% CI, 0.003-0.03]) and after additionally adjusting for CVD risk factors (model 2). We did not find any evidence that mHT versus placebo modified these associations. Topographically, higher BP was associated with greater periventricular WMH in the frontal and parietal lobes.

Conclusion: Our findings suggest the importance of maintaining normal BP in recently postmenopausal women with low CVD risk, irrespective of short-term mHT usage, to potentially reduce the risk of WMH later in life.

Objective: The aim of this study was to modify the Chinese version of the Menopause Symptom Assessment Scale (MSAS) and evaluate its validity and reliability.

Methods: An expert panel from the gynecology and nursing domain determined items that should remain or be revised, and 30 participants were selected for the pilot study. A total of 255 women who met the criteria for inclusion were enrolled in the investigation. SPSS 25.0 and AMOS 25.0 were used to analyze data. The internal and external reliability of the scale was evaluated using Cronbach's α coefficient, split-half reliability, and test-retest reliability, respectively. Expert review, exploratory factor analysis, and confirmatory factor analysis were used to evaluate the scale's validity, which encompasses both its content validity and structural validity.

Results: The Chinese version of the MSAS contains 43 items with 5 dimensions, including sexual function, psychological status, interpersonal anxiety, autonomic balance, and other subjective symptoms. The correlation coefficient (r value) between individual items and the total scale ranged from 0.49 to 0.67 (P < 0.05); the Item-Content Validity Index range from 0.80 to 1.00, and Scale-Content Validity Index was 0.91; the Cronbach's α coefficient was 0.85, and the test-retest reliability was 0.93; exploratory factor analysis revealed a cumulative variance contribution of 76.98%; the fitting index of the scale structure model was good.

Conclusions: The updated Chinese version of the MSAS presented good reliability and validity and could be applied in assessing menopausal symptoms in Chinese women.

Objective: Reproductive history may help identify women at higher risk for experiencing menopausal symptoms. We hypothesized that gestation length and offspring birthweight for gestational age z-scores would be associated with menopausal symptoms and age at natural menopause in midlife among women in a longitudinal prebirth cohort.

Methods: Among 691 women enrolled in pregnancy and followed to midlife, we examined associations of gestation length and offspring birthweight for gestational age z-score at the index pregnancy with total menopausal symptoms assessed with the 11-item Menopause Rating Scale (MRS) using linear regression models, with individual menopausal symptoms using binomial regression models with a log link function, and with age at natural menopause using Cox proportional hazards models. We adjusted all models for age at enrollment, education, parity, annual household income, and prepregnancy body mass index.

Results: Mean (SD) MRS total score was 7.9 (5.8) points at age 52.1 (3.8) years, and mean (SD) age at natural menopause was 50.8 (3.7) years. We observed null associations of gestation length (β = -0.07 points per week, 95% confidence interval [CI] = -0.32 to 0.18) and birthweight for gestational age z-score (β = 0.16 points per z-score, 95% CI = -0.31 to 0.63) with the MRS total score in adjusted models. We also observed null associations of gestation length (adjusted hazards ratio = 0.99 per week, 95% CI = 0.94-1.06) and birthweight for gestational age z-score (adjusted hazards ratio = 1.06 per z-score, 95% CI = 0.94-1.19) with age of onset of natural menopause.

Conclusions: Birth outcomes were not associated with total menopause symptom scores or age at natural menopause.