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

Objective: This mixed-methods study aimed to describe the prevalence and impact of menopausal symptoms on midlife women in a US workplace.

Methods: An online survey was disseminated to all US-based employees of a US-headquartered pharmaceutical company. Eligible respondents were aged 40-65 years and self-identified as having (or expecting to have) personal experience of menopause. Descriptive statistics were generated. Survey respondents were sampled for in-depth interviews, on which thematic analysis was performed.

Results: Eligible survey responses were received from 1,642 employees, of which 18 participated in in-depth interviews. The mean respondent age was 51 years, and a range of job roles were represented. The majority of respondents (83%) reported that they had current or prior experience of menopause. Menopause symptoms most commonly impacting workplace performance included changes to sleep patterns, changes to memory, hot flashes and anxiety, although interviews highlighted a diversity of symptom presentations. Menopause symptoms were reported to affect stress levels, confidence in abilities, patience with others, and ability to concentrate at work; 7% of menopausal respondents took time off work due to menopause symptoms. Although half of the respondents disclosed that they would feel extremely or somewhat comfortable discussing menopause with colleagues, only 9% of those with current symptoms reported that they had received support with their menopause symptoms at work.

Conclusions: This study found that menopause impacts women's perceptions of their own performance at work, and that many are unsure how to approach conversations about menopause in the workplace. A substantial gap in knowledge about menopause was identified, highlighting the need for further education and support.

Objectives: Although investigators have devoted significant effort to understanding women's experiences of depressed mood and clinical depression during the menopausal transition and early postmenopause, they have focused less on women's perimenopausal experiences of emotional arousal, including anger. The purpose of these analyses was to examine the influence of aging and reproductive aging stages on women's reports of anger.

Methods: Participants aged 35-55 years from the Seattle Midlife Women's Health Study population-based cohort (N=501 at baseline) completed an annual health report. Participants completed the State-Trait Anger Inventory (STAXI) (State Anger, Trait Anger, Anger Temperament, Anger Reaction, Anger-in, and Anger Control subscales) and the SCL90 Hostility scale on up to five occasions during the course of the study. Reproductive aging stages were assessed using menstrual calendars and questionnaire data. Menstrual calendars were used to identify menopausal transition stages using the Mitchell (2000) criteria for stages of reproductive aging: late reproductive stages (LRS1 and LRS2), early menopausal transition stage (EMT), late menopausal transition stage (LMT), and postmenopause (PM). Multilevel modeling with Mixed Models Analysis of Linear Models (SPSS 28) was used to examine the effects of age and reproductive aging stages on the repeated measures of anger and hostility using the STAXI Scales and SCL-90 Hostility Subscale.

Results: Age was significantly related to most anger measures, with State and Trait Anger and Anger Control increasing with age. Anger Temperament, Anger Reaction, Anger Expressed Aggressively, and Hostility each decreased significantly with age. Only Anger Suppressed was not related to age. When accounting for age effects, Reproductive Aging Stages significantly affected State and Trait Anger and Anger Temperament: each decreased after the late reproductive stages with women's progression through further reproductive aging stages.

Conclusions: Aging was significantly related to anger, with anger expression indicators decreasing with age, suggesting emotion regulation may occur during midlife. When aging was taken into account, reproductive aging was associated with decreasing levels of State and Trait Anger and Anger Temperament Scale scores. Both chronological aging and reproductive aging had important effects on dimensions of anger, warranting further attention during midlife and the menopausal transition and early postmenopause.

Objectives: Investigate associations between stress, cortisol, menopause symptoms, and depression in a sample of midlife women. Because stress has been associated with greater menopause symptoms, we examined this as a mediator for the association between stress and depressive symptoms.

Methods: Data from a cross-sectional study of 118 women (40-64 y old) were analyzed. Participants completed in-person visits and self-reported questionnaires, including the Menopause-Specific Quality of Life questionnaire, the Perceived Stress Scale, and the Center for Epidemiological Studies Depression Scale. Saliva samples were collected at 4 intervals upon waking (wake, 30 min, 45 min, and 60 min after waking), and one sample before bed, as a measure of cortisol. Both the diurnal cortisol slope and the cortisol area under the curve with respect to ground (AUCg) were used to characterize cortisol secretion and exposure. A multivariate analysis of variance determined differences in menopause symptoms and depression outcomes. Mediation models examined the indirect effects of menopause symptoms on associations between perceived stress and depressive symptoms.

Results: Women with moderate stress had significantly lower cortisol awakening responses ( P = 0.047), poorer psychosocial ( P < 0.001), physical ( P < 0.001), and sexual ( P <0.001) menopause symptoms, and depression symptoms ( P < 0.001) compared to women with low stress. Mediation analyses (95% CI) between stress and depression demonstrated significant positive indirect effects of psychological (B = 0.247; 0.117, 0.355), physical (B = 0.120; 0.049, 0.210), and sexual menopause symptoms (B = 0.042; 0.006, 0.106).

Conclusions: Cross-sectional data revealed that greater stress was associated with poorer outcomes of menopause symptoms, depressive symptoms, and a lower cortisol awakening response. The association between stress and depression was mediated by the psychosocial, physical, and sexual menopause symptoms, and future longitudinal studies should seek to confirm these findings.

Objective: To discuss the potential for adverse consequences that could arise from the quest to prolong the functional life span of the human ovary.

Methods: A series of arguments are presented that: (a) question the dogma that monthly ovulatory menstrual cycles are critical for women's health; (b) review adverse consequences of decades of menstrual cyclicity; (c) review the evidence for a longevity benefit of ovarian steroid hormone treatment after the age at natural menopause has been achieved; and (d) utilize a mathematical model of ovarian follicle loss over time to raise the possibility that current strategies directed at delaying menopause might well backfire and in fact cause a woman to have a prolonged menopause transition.

Results: Regular, monthly menstrual cycles have not been the reality for women for most of history. Rather, when not pregnant, lactational amenorrhea and nutritionally based hypothalamic amenorrhea were the norm for reproductive-aged women. Moreover, monthly menstrual cycles cause substantial morbidity for women during their reproductive years. Providing steroid hormones after menopause has failed to demonstrate an increase in the female life span. Restoring ovarian follicles either surgically or medically has a high probability of causing women to spend more years of life in the menopause transition.

Conclusions: Strategies to prevent or delay menopause would benefit from careful consideration of unintended consequences as they are implemented. Directing treatment trials to those with the greatest chance for benefit should be undertaken before adopting this type of treatment for a broader population.

Objective: Low hand grip strength, with or without reduced physical performance, has been defined previously as possible sarcopenia. Identifying credential parameters of sarcopenia is crucial given its high prevalence among postmenopausal women. Since hand grip strength is a key parameter in diagnosis of sarcopenia and parity affects estrogen exposure, this study aims to examine the association between parity and hand grip strength (HGS).

Methods: Data from the Korean National Health and Nutrition Examination Survey (KNHANES), from 2014 to 2019, were analyzed and included 4,102 postmenopausal women aged 45-65 years. Participants were categorized into two groups: hand grip strength <18 kg and hand grip strength ≥18 kg. Parity was determined through the collection of standardized questionnaires regarding information on the total number of pregnancies carried to a viable gestational age and subsequently, categorized into four groups: parity 0, parity 1, parity 2, and parity greater than three. The association between parity and hand grip strength was assessed utilizing logistic regression analysis.

Results: Among participants, 17.8% had HGS <18 kg, indicating possible sarcopenia. Mean HGS was 20.33 kg for nulliparous women, 21.65 kg for primiparous women, and 21.76 kg for those whose parity was  two, and 21.88 kg for those whose parity was three or more ( P <0.01). Compared with nulliparity, the odds of low HGS decreased by 49% in multiparity after adjusting for height, weight, age, menopause age, high alcohol intake, dyslipidemia, and diabetes mellitus (OR: 0.51, P <0.01).

Conclusions: The results of this study found that higher parity is significantly associated with increased hand grip strength, which may reduce the likelihood of possible sarcopenia.

Objective: The aims of the study were to assess the reported frequency of, and reasons for, masturbation and experiences of orgasm and sex toy use during masturbation and to compare these experiences across women at different stages of the menopause transition.

Methods: A nationally representative US sample of 1,500 women aged 40-65 (M age: 52.5 y) completed an online survey asking about their experiences during masturbation. Data were analyzed using descriptive statistics, χ 2 tests, and ANOVAs.

Results: Over half (55.8%) of the sample described themselves as postmenopausal, 22.7% as perimenopausal, and 21.5% as premenopausal. There were significant differences in the frequency of masturbation, with postmenopausal women reporting a lower frequency compared with the other 2 groups ( P < 0.014). Postmenopausal women also rated the importance of masturbation in their lives as lower compared with perimenopausal and premenopausal women ( P < 0.001). There were no group differences in the frequency of orgasm during masturbation, with women reporting orgasm an average of 81% of the times that they masturbated. Overall, more women reported that the quality of their orgasms had gotten better than worse over the last 10 years, and most noticed no change. More women reported that orgasm had become more difficult to attain, but about half had noticed no change. There were no significant group differences in the percentage of times that sex toys were used during masturbation (44.4% for the total sample).

Conclusions: Sexual pleasure and orgasm remain important for many older women and menopause is not always associated with adverse changes in sexuality, including the ability to orgasm during masturbation.