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

Objective: To develop and evaluate the acceptability and effectiveness of an extended reality (XR) avatar-based menopause education simulation module for the clinical training of OB/GYN residents.

Methods: This menopause education pilot recruited 57 OB/GYN residents from nine institutions via listservs and snowball sampling. Participants completed a menopause-focused XR avatar simulation module developed using Kern's curriculum design framework and guided by APGO/CREOG objectives and national guidelines. Learners completed an 11-item preintervention and postintervention assessment measuring usability and satisfaction (Kirkpatrick Level 1: reaction outcomes) and knowledge and self-reported confidence (Level 2: learning outcomes). Descriptive statistics summarized additional outcomes, and paired t tests were used to evaluate changes in knowledge. We also conducted a brief descriptive review of voluntary free-text comments.

Results: From preintervention to postintervention, mean knowledge scores improved from 79.8% to 82.8% (P=0.028). Participants reported improved preparedness and confidence across multiple domains: 59% improvement in overall readiness to manage menopause, 50% in comfort managing hormone therapy, and 39% in managing nonhormone therapy. No learners reported feeling "not at all prepared" postintervention. Most rated the module as effective (63%) and more engaging than lectures (60%); 96% would recommend it. Narrative feedback endorsed the module as valuable while suggesting improvements in interactivity, content depth, and avatar responsiveness.

Conclusions: The XR simulation module demonstrated acceptability and effectiveness in enhancing clinical menopause training. Results support its potential as a scalable educational tool to address gaps in clinical menopause education.

Objective: Menopause is accompanied by decreased circulating estrogen for all people; however, only some develop genitourinary syndrome of menopause, the cause of which is unknown. In this pilot study, we measured vaginal blood vessel and nerve fiber density, as well as vaginal fluid immune markers to identify a potential cause of vaginal symptoms.

Methods: This is a secondary analysis of samples from a randomized trial of vaginal estradiol or moisturizer versus placebo for moderate-severe postmenopausal vaginal discomfort. Fourteen participants were selected from the placebo tablet/vaginal moisturizer or dual placebo arms of the original study: eight with a ≥2-point reduction in most bothersome symptom severity (responders) and six with a <2-point reduction in symptom severity (nonresponders). At 0, 4, and 12 weeks, we characterized vaginal protein gene product 9.5-positive nerve fiber and CD31+ vessel length and density from vaginal wall biopsies (immunofluorescent staining) and vaginal fluid immune markers (MesoScale Discovery). We compared responders versus nonresponders at baseline and across visits using linear mixed models to evaluate associations between symptoms, nerve/vessel length and density, and immune markers.

Results: There were no significant differences in baseline characteristics between responders and nonresponders. Mean CD31+ vessel length at 12 weeks was higher in responders than nonresponders (P = 0.034), while all other measurements were similar between the two groups. No clear patterns were observed across proinflammatory or chemoattractant cytokine concentrations with biopsy measures.

Conclusions: Vaginal blood supply and extent of vascularization may contribute to vaginal discomfort symptoms in postmenopausal people; however, the results of this small study need to be confirmed with a larger sample size.

Objectives: While there has been increasing interest in older adults' sexuality, the literature to date has largely ignored sex toy use. This study investigated sex toy use in partnered sex and masturbation among older adult women.

Methods: A survey was fielded in October 2023 among a national demographically representative sample (N = 3,001). Participants had to be at least 60 years old, identify as a woman, and be living in the United States.

Results: Most of the survey participants were 60-69 years old (67.1%). Participants reported much greater use of sex toys during masturbation than during sex with a partner. Of the women who reported masturbating at least once in the last year, 46.4% used toys almost always or always during masturbation, compared with 5.1% who used sex toys almost always or always during partnered sex. Those who reported almost always or always using sex toys during masturbation were significantly more likely to report always or almost always having an orgasm compared with the lower frequency sex toy users. Of those who had partnered sex, 38.7% reported using sex toys during partnered sex at least rarely. Those who reported almost always or always using sex toys during partnered sex were more likely to report always or almost always having an orgasm compared with the lower frequency sex toy users.

Conclusions: Given the prevalence of masturbation and sex toy use as well as their relationships to orgasm, older women could benefit from information from health care professionals on these topics.

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.