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

Objective: This study examined the relationship between menopause symptoms and gastrointestinal symptoms.

Methods: The descriptive and cross-sectional study was conducted with 212 women aged 45-55 who actively use the internet and social media (WhatsApp, Instagram, Facebook, etc.). The Personal Information Form, Menopause Rating Scale, and Gastrointestinal Symptom Rating Scale were used to collect research data. Descriptive statistics, Pearson correlation analysis, and multiple regression analysis were used to analyze the research data.

Results: A statistically significant and positive relationship was found between gastrointestinal and menopause symptoms (r=0.599, P=0.001). It was found that for each point increase in the menopause symptom scale, the score in the gastrointestinal symptoms scale was 1.02 points higher on average (B=1.02, P<0.001).

Conclusions: The study found a relationship between menopause symptoms and gastrointestinal symptoms. This shows that gastrointestinal symptoms should be considered in the health assessment of women in menopause.

Objectives: To investigate the association between relative handgrip strength (RHGS) and metabolic syndrome (MetS) in Korean postmenopausal women, and whether this association differs by time since menopause.

Methods: We conducted a cross-sectional analysis of 4,098 naturally postmenopausal women aged 45-65 years from the Korea National Health and Nutrition Examination Survey (2014-2019). RHGS was calculated as the dominant handgrip strength divided by body mass index and categorized into quartiles. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria with an Asian-specific waist circumference cutoff (≥85 cm). Survey-weighted logistic regression was used to estimate adjusted odds ratios (ORs) for MetS and its components across RHGS quartiles. Subgroup analyses were stratified by time since menopause (≤10 vs. >10 y).

Results: Lower RHGS was significantly associated with higher odds of MetS. Compared with Q1 (reference), adjusted ORs for MetS were 0.49 (95% CI: 0.40-0.60) in Q2, 0.28 (0.22-0.34) in Q3, and 0.17 (0.13-0.21) in Q4 (P for trend <0.001). Similar inverse gradients were observed for all MetS components. The association was stronger in women >10 years postmenopause, with OR for Q4 versus Q1 at 0.04 (0.02-0.08) compared with 0.07 (0.05-0.10) in those ≤10 years.

Conclusion: Lower RHGS is independently and dose-dependently associated with increased odds of MetS, particularly among women beyond 10 years postmenopause. RHGS may serve as a simple, low-cost tool for identifying women at elevated cardiometabolic risk in later life.

Objective: Midlife women are subject to stress and burnout, which are associated with decreases in physical function and activity. However, the associations between stress, burnout, and factors including health-related quality of life, physical function, and physical activity have not been assessed concurrently. These studies assess these associations to address critical questions about how stress and burnout independently are associated with key outcomes that impact midlife women's experiences of aging.

Methods: Two studies assessed stress, burnout, quality of life, physical function, and activity in two samples of midlife women (ages 40-65). The first study is from an online data collection assessing health-related quality of life. The second study assessed self-report data on health-related quality of life as well as objective functional assessments and actigraph data to assess physical activity.

Results: Study 1 indicated that self-reported stress and burnout accounted for significant variance in physical and mental quality of life (β range from 0.14 to 0.63 for P<0.05 associations). Study 2 indicated that burnout, but not stress, was negatively associated with steps per day (β=-0.38, P=0.008) and moderate to vigorous physical activity per day (β=-0.31, P=0.030). Post hoc analyses revealed an indirect effect of burnout on physical function outcomes via average steps per day (effects ranged from -0.13 to 0.15).

Conclusion: Psychological and functional aspects of quality of life are associated with increased stress and burnout. Results indicated that higher burnout has a direct association with decreased physical activity levels and an indirect effect on physical function. Distinguishing between stress and burnout and understanding the pattern of association with key indicators of physical function activity, as well as health-related quality of life, provides information that can help prevent functional decline.

Objective: To investigate the impact of estrogen deficiency on metabolic dysfunction-associated steatotic liver disease progression and evaluate the therapeutic potential of tirzepatide (Tzp), a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonist, in a murine model of postmenopausal metabolic dysfunction.

Methods: Female C57BL/6J mice were divided into obese-diabetic (Od) and ovariectomized Od groups, along with lean controls (control, CO). After 12 weeks of dietary intervention, mice received daily Tzp (10 nmol/kg) or vehicle for four weeks. Comprehensive assessments included plasma biochemistry, liver histopathology, AMP-activated protein kinase (AMPK)/mechanistic target of rapamycin (mTOR) complex 1 signaling analysis, and hepatic gene expressions.

Results: Od mice developed severe liver pathology, showing 2-3 fold increases in fat accumulation markers, extensive steatosis with hepatocyte ballooning, and 3-4 fold elevated inflammatory markers. Ovariectomy aggravated these effects, increasing fibrosis markers by 2.4-fold and apoptosis signals. Tzp reduced fat deposition by 50%-70%, inflammation by 60%-70%, and fibrosis by 55%. Molecular analyses revealed Tzp restored metabolic balance by: (1) normalizing key energy-sensing pathways (1.5-2 fold AMPK activation; 50% mTOR reduction), (2) reducing fat synthesis signals by 50%-60%, and (3) enhancing fat breakdown pathways (2-2.5 fold increase). Antioxidant defenses were fully restored to normal levels. Principal component analysis demonstrated metabolic improvement, with treated animals showing gene expression patterns closer to healthy controls.

Conclusion: Estrogen deficiency synergizes with metabolic dysfunction to aggravate metabolic dysfunction-associated steatotic liver disease progression through AMPK/mTOR pathway dysregulation. Tzp demonstrates comprehensive hepatoprotective effects, ameliorating steatosis, inflammation, and fibrosis while restoring metabolic homeostasis in this model of postmenopausal liver disease.

Objective: A notable research gap persists regarding the association between sleep-related disorders and hypertension risk in postmenopausal women in the United States, which this study aimed to address .

Methods: Data from 3,560 naturally postmenopausal women were analyzed using 6 cycles of the National Health and Nutrition Examination Survey from 2007 to 2018. Logistic regression models were employed to assess the relationships between sleep duration, trouble sleeping, and obstructive sleep apnea (OSA) symptoms with hypertension. Restricted cubic splines were used to identify nonlinear associations between sleep duration and hypertension. Finally, stratified analyses were taken to explore the associations between sleep-related disorders and hypertension across various subgroups based on health-related factors.

Results: Trouble sleeping and OSA were associated with an increased odds of hypertension in postmenopausal women (trouble sleeping: odds ratio = 1.61, 95% CI, 1.28-2.02; OSA: odds ratio = 1.63, 95% CI, 1.13-2.37). In addition, a U-shaped relationship between sleep duration and hypertension was identified (P for overall = 0.0007, P for nonlinear = 0.0002), indicating that both insufficient and excessive sleep increased the odds of hypertension. Subgroup analysis revealed that body mass index moderated these associations (trouble sleeping: P for interaction = 0.038; OSA: P for interaction = 0.044), with stronger effects observed in obese women.

Conclusion: Sleep-related disorders are significantly associated with hypertension in postmenopausal women in the United States. Our findings emphasized the importance of sleep health and weight management in the management of hypertension in this population.

Importance and objective: Obsessive-compulsive disorder (OCD) is a psychiatric condition marked by intrusive thoughts and compulsive behaviors. Female-born individuals are more likely to develop OCD; reproductive events such as menarche and the peripartum are also associated with increased symptom severity. This scoping review identified existing literature on the impact of menopause on OCD onset and symptoms.

Methods: We conducted a scoping review following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews reporting guidelines. Four electronic databases (MEDLINE, Embase, PsycInfo, and CINAHL) were searched from inception to April 15, 2025, for original research studies examining the association between menopause and new onset or changes in preexisting obsessive-compulsive symptoms. We described study characteristics, main findings, and gaps in the existing literature.

Discussions and conclusion: Eight studies met criteria for inclusion in this review. All studies used quantitative methods, were cross-sectional, and relied on self-reported retrospective assessment of changes or onset of obsessive-compulsive symptoms in relation to the onset of menopause. Of 373 participants reporting on OCD onset, 17 (4.6%) reported that the initial appearance of their OCD symptoms had coincided with the onset of menopause. Of 265 participants reporting on symptom changes, 72 (27.2%) reported an exacerbation of their symptoms with the onset of menopause, while 30/265 (11.3%) reported an improvement in symptoms. Cross-sectional research suggests that OCD symptoms may change in severity or start with menopause in a subset of individuals. Longitudinal studies prospectively tracking OCD symptoms in the premenopause, perimenopause, and postmenopause phases are needed to confirm these findings. In the meantime, increased symptom monitoring of midlife female-born individuals with OCD is warranted.

Objectives: The present research sought to explore the potential role of masturbation in the relief of symptoms associated with menopause.

Methods: A demographically representative US sample of 1,178 women ages 40-65 completed an online survey about their current symptom management strategies (including masturbation) and their efficacy. Data were analyzed quantitatively using t tests and χ2, and qualitatively with thematic analysis.

Results: Nearly one in five perimenopausal and postmenopausal women had noticed that self-pleasure provided symptom relief. Relative to other symptom management strategies, masturbation was rated among the highest in providing symptom relief, especially with respect to psychological symptoms (ie, mood changes) and sleep disturbances. Nearly half of perimenopausal and postmenopausal women indicated that they would be open to trying masturbation as a symptom relief approach if their doctor recommended it.

Conclusions: Masturbation may play a valuable role in managing menopause symptoms, and it is important that physicians discuss the potential benefits of self-pleasure with their patients.

Objectives: To quantify the burden of sleep disturbances on health-related quality of life (HRQoL) and mental well-being in perimenopausal and postmenopausal women with/without co-occurring vasomotor symptoms (VMS).

Methods: Perimenopausal and postmenopausal women aged 40 to 65 years who participated in the National Health and Wellness 2019/2021 (US; N=27,621) and 2017/2020 cross-sectional surveys (France, Germany, Italy, Spain, UK; N=20,220) were included. Patient-reported outcomes were HRQoL (Short-Form Health Survey physical and mental component summary scores, EuroQol Visual Analogue Scale, EQ-5D-5L), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7 assessment). Associations between self-reported sleep disturbances and/or VMS and study outcomes were evaluated using generalized multivariable linear regression.

Results: Among perimenopausal women, sleep disturbances were reported by 61.7% (US) and 60.6% (Europe) with VMS, and 38.0% (US) and 40.8% (Europe) without VMS. Among postmenopausal women, sleep disturbances were reported by 66.7% (US) and 63.4% (Europe) with VMS, and 44.5% (US) and 40.9% (Europe) without VMS. Compared with women with neither symptom, perimenopausal and postmenopausal women with sleep disturbances had worse HRQoL (P<0.001) and higher (worse) depression and anxiety scores (P<0.05 perimenopausal, P<0.001 postmenopausal) irrespective of VMS. In addition, among postmenopausal women, those with sleep disturbances alone had worse HRQoL and higher (worse) depression and anxiety scores than those with VMS alone (P<0.001).

Conclusions: Sleep disturbance was common among perimenopausal and postmenopausal women irrespective of VMS, and independently associated with negative effects on HRQoL, depression, and anxiety. Effective treatments for sleep disturbances and VMS in menopausal women are needed to mitigate the associated burden and improve well-being.

Objectives: Subjective cognitive symptoms, also referred to as "brain fog," are commonly reported by women in perimenopause. The factors that contribute to "brain fog" are not clear. The aim of the current study was to explore whether demographic factors (age, educational level, parity, and marital status), lifestyle factors (mindfulness, alcohol consumption, caffeine intake, attitude towards menopause, and hormonal therapy use), psychological and menopausal symptoms (anxiety, depression, stress, sleep, physical, vasomotor, sexual, and psychosocial), are linked to menopausal brain fog.

Methods: A total of 208 perimenopausal women were included in the analysis, who were aged 41-60 years and completed an online survey that included assessment of demographic and lifestyle factors as well as menopause symptoms alongside the Everyday Memory Questionnaire-Revised (measuring subjective deficits in retrieval and attention). For initial exploration, univariable logistic regression was conducted for each of the factors described above in relation to the subjective cognitive outcomes. A random forest analysis was subsequently performed to assist in selecting variables based on their importance. Selected variables (all 8 psychological and menopausal symptom variables, mindfulness, age, alcohol consumption, educational level, and parity) were included in a multivariable logistic regression to estimate the adjusted effects of the selected variables on the outcome.

Results: In the multivariable models, higher mindfulness was significantly associated with reduced odds of reporting both memory retrieval (odds ratio [OR] = 0.51; 95% CI = 0.34-0.77; P = 0.002) and attentional difficulties (OR = 0.37; 95% CI = 0.24-0.57; P < 0.001). Higher Menopause-specific Quality Of Life-Psychosocial scores were linked to increased odds of attentional complaints (OR = 2.35; 95% CI = 1.31-4.34; P = 0.005), and showed a marginal association with retrieval difficulties (OR = 1.64; 95% CI = 0.94-2.89; P = 0.086). Menopause-specific Quality of Life-Sexual also showed a marginal association with retrieval complaints (OR = 1.36; 95% CI = 0.95-1.97; P = 0.097). No other demographic, lifestyle, or menopause-related variables were significantly associated with cognitive outcomes after adjustment.

Conclusions: Current findings highlight the relevance of mindfulness and certain menopausal symptoms in subjective cognitive complaints, warranting further investigation to clarify their causal roles and potential as intervention targets.

Objective: Fatigue and sexual function are reproductive health issues for women. The aim of the present study is to determine the effect of probiotic supplementation on fatigue severity, sexual function (primary outcome), and quality of life (secondary outcome) among postmenopausal women.

Methods: A parallel, double-blind randomized controlled trial was conducted over 3 months, from September 5, 2024, to December 5, 2024, at Comprehensive Health Service Centers in Hamadan City, Western Iran. The women in the intervention group were administered probiotic supplements in 200 mg daily capsules for 6 weeks. The control group received identically shaped and colored 200 mg capsules filled with starch powder, also taken once daily for 6 weeks. The primary outcomes were measured using the Fatigue Severity Scale (FSS), Female Sexual Function Index (FSFI), and Menopause-Specific Quality of Life Questionnaire (MENQOL) questionnaires at baseline, week 3, and week 6.

Results: In the study, 80 postmenopausal women were randomly assigned to 2 groups: one receiving probiotic capsules (n=40) and the other receiving a placebo (n=40). The results reported no significant differences in baseline characteristics between the 2 groups (P>0.05). The findings showed that the study outcomes changed differently over time between the probiotic and placebo groups. Women in the probiotic group demonstrated a statistically significant reduction in fatigue severity at both 3 and 6 weeks compared with the placebo group (P=0.006 and 0.001, respectively). The mean FSFI scores and their dimensions in the probiotic group at 3 and 6 weeks following the initiation of the intervention were significantly higher than those in the placebo group, with statistically significant differences observed across all domains, except the pain domain at week 3 (P<0.05). Results showed at 3 and 6 weeks following the initiation of the intervention, the probiotic group experienced a reduction in symptoms across the vasomotor (P=0.03 and 0.004, respectively), psychosocial (P=0.01 and 0.004, respectively), physical (P=0.07 and 0.002, respectively), and sexual domains (P=0.02 and 0.005, respectively), as well as in the total MENQOL score (P=0.003 and <0.001, respectively), when compared with the placebo group.

Conclusion: This study provides evidence supporting the potential therapeutic effects of probiotic consumption in alleviating fatigue severity and improving sexual function in postmenopausal women. In addition, quality of life during menopause was found to improve. Further multicenter, large-scale clinical trials with extended follow-up periods are recommended to confirm these findings.