Pub Date : 2025-12-01Epub Date: 2025-11-02DOI: 10.1016/j.maturitas.2025.108773
Caroline F. Pukall , Melody Garas , Natalie O. Rosen , Sophie Bergeron , Michele Chittenden
Vulvodynia, defined as idiopathic chronic vulvar pain, is a prevalent and distressing condition that entails significant impacts on many aspects of psychosocial wellbeing. Given the location of the pain in vulvodynia and the unique sexual challenges faced by individuals with this condition, the purpose of the present paper was to narratively review the literature on sexual wellbeing in vulvodynia. In the face of evolving definitions of sexual wellbeing, we examined the following aspects: sexual function, pain during sexual activity, sexual satisfaction, sexual pleasure, and genital self-image. Secondary aims were to examine the frequency with which these aspects are studied, to report on premenopausal or postmenopausal status of the samples, and to describe the subtypes of vulvodynia featured in the literature. A search for articles in Medline, PsycINFO, and Web of Science examining these aspects in the last 10 years yielded 54 studies for inclusion and extraction. Results indicated that sexual function, pain during sexual activity, and sexual satisfaction are the most common aspects of sexual wellbeing studied in the vulvodynia literature. Sexual pleasure and genital self-image, however, are not frequently assessed in vulvodynia studies. In addition, the vulvodynia literature focused predominantly on premenopausal samples with provoked pain. Numerous psychosocial factors were found to be associated with sexual wellbeing outcomes, including intrapersonal and interpersonal aspects. These factors should be considered as intervention targets in the management of vulvodynia, given the widespread effects of this condition.
外阴痛被定义为特发性慢性外阴疼痛，是一种普遍和令人痛苦的疾病，对心理社会健康的许多方面产生重大影响。鉴于外阴痛疼痛的位置和独特的性挑战所面临的个人与这种情况下，本论文的目的是叙述性回顾外阴痛的性福利的文献。面对不断变化的性幸福定义，我们研究了以下几个方面：性功能、性活动中的疼痛、性满足、性愉悦和生殖器自我形象。次要目的是检查这些方面的研究频率，报告绝经前或绝经后的样本状态，并描述文献中外阴痛的亚型。在Medline、PsycINFO和Web of Science上搜索过去10年里关于这些方面的文章，得出了54项研究。结果表明，性功能、性活动中的疼痛和性满意度是外阴痛文献中研究的性健康最常见的方面。然而，在外阴痛的研究中，性快感和生殖器自我形象并不经常被评估。此外，外阴痛的文献主要集中在绝经前的样本与诱发性疼痛。许多社会心理因素被发现与性健康结果有关，包括个人和人际方面。鉴于外阴痛的广泛影响，这些因素应被视为外阴痛治疗的干预目标。
{"title":"Sexual wellbeing in vulvodynia: A narrative review","authors":"Caroline F. Pukall , Melody Garas , Natalie O. Rosen , Sophie Bergeron , Michele Chittenden","doi":"10.1016/j.maturitas.2025.108773","DOIUrl":"10.1016/j.maturitas.2025.108773","url":null,"abstract":"<div><div>Vulvodynia, defined as idiopathic chronic vulvar pain, is a prevalent and distressing condition that entails significant impacts on many aspects of psychosocial wellbeing. Given the location of the pain in vulvodynia and the unique sexual challenges faced by individuals with this condition, the purpose of the present paper was to narratively review the literature on sexual wellbeing in vulvodynia. In the face of evolving definitions of sexual wellbeing, we examined the following aspects: sexual function, pain during sexual activity, sexual satisfaction, sexual pleasure, and genital self-image. Secondary aims were to examine the frequency with which these aspects are studied, to report on premenopausal or postmenopausal status of the samples, and to describe the subtypes of vulvodynia featured in the literature. A search for articles in Medline, PsycINFO, and Web of Science examining these aspects in the last 10 years yielded 54 studies for inclusion and extraction. Results indicated that sexual function, pain during sexual activity, and sexual satisfaction are the most common aspects of sexual wellbeing studied in the vulvodynia literature. Sexual pleasure and genital self-image, however, are not frequently assessed in vulvodynia studies. In addition, the vulvodynia literature focused predominantly on premenopausal samples with provoked pain. Numerous psychosocial factors were found to be associated with sexual wellbeing outcomes, including intrapersonal and interpersonal aspects. These factors should be considered as intervention targets in the management of vulvodynia, given the widespread effects of this condition.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108773"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145467671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-11DOI: 10.1016/j.maturitas.2025.108778
Michael Babin , Ehud Grinstein , Masha Ben-Zvi , Irit Segman , Jonathan Harmatz , Ohad Gluck , Ron Sagiv , Shimon Ginath
Objectives
Stress urinary incontinence (SUI) affects 10–20 % of the female population. The primary surgical treatment for women with SUI is mid-urethral sling surgery (MUS). No clear guidelines exist for second-line management in patients with recurrences. This study compared quality of life and the occurrence of urinary symptoms after a secondary retropubic tension-free vaginal tape (TVT) intervention in patients with failure of primary transobturator tape (TOT) surgery with those who had experienced successful primary TOT surgery.
Methods
We conducted a retrospective cross-sectional study to compare efficacy and quality of life in patients who underwent the primary TOT procedure versus those who had a secondary TVT intervention after a failed TOT surgery. The Urinary Distress Inventory 6 (UDI-6) (questions 15–20 in the PFDI-20) was used to assess urinary symptoms.
Results
Sixty-seven patients were enrolled in the study. Forty-five patients underwent successful primary TOT surgery (defined as no bothersome SUI symptoms post-surgery), while twenty-two underwent secondary TVT surgery for recurrent symptoms. Basic demographic characteristics were comparable in both groups. The median follow-up was 32 months for the successful primary TOT group and 25.5 months for the secondary TVT group (p = 0.33). There were no significant differences in UDI-6 scores (24.3 ± 25.3 for the successful primary TOT group versus 29.5 ± 27.2 for the secondary TVT group, p = 0.44). Rates of stress urinary incontinence, urgency urinary incontinence, and voiding dysfunction were also comparable between the groups. There were no surgical complications in the secondary TVT group.
Conclusion
Quality of life, as assessed by the UDI-6 inventory, and rates of urinary symptoms were similar in the secondary TVT and successful primary TOT groups. The secondary TVT procedure may present a favorable surgical option for treating recurrent SUI after failed primary TOT.
{"title":"Long-term subjective assessment of tension-free vaginal tape for recurrent stress urinary incontinence: A comparison with primary trans-obturator tape","authors":"Michael Babin , Ehud Grinstein , Masha Ben-Zvi , Irit Segman , Jonathan Harmatz , Ohad Gluck , Ron Sagiv , Shimon Ginath","doi":"10.1016/j.maturitas.2025.108778","DOIUrl":"10.1016/j.maturitas.2025.108778","url":null,"abstract":"<div><h3>Objectives</h3><div>Stress urinary incontinence (SUI) affects 10–20 % of the female population. The primary surgical treatment for women with SUI is mid-urethral sling surgery (MUS). No clear guidelines exist for second-line management in patients with recurrences. This study compared quality of life and the occurrence of urinary symptoms after a secondary retropubic tension-free vaginal tape (TVT) intervention in patients with failure of primary transobturator tape (TOT) surgery with those who had experienced successful primary TOT surgery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cross-sectional study to compare efficacy and quality of life in patients who underwent the primary TOT procedure versus those who had a secondary TVT intervention after a failed TOT surgery. The Urinary Distress Inventory 6 (UDI-6) (questions 15–20 in the PFDI-20) was used to assess urinary symptoms.</div></div><div><h3>Results</h3><div>Sixty-seven patients were enrolled in the study. Forty-five patients underwent successful primary TOT surgery (defined as no bothersome SUI symptoms post-surgery), while twenty-two underwent secondary TVT surgery for recurrent symptoms. Basic demographic characteristics were comparable in both groups. The median follow-up was 32 months for the successful primary TOT group and 25.5 months for the secondary TVT group (<em>p</em> = 0.33). There were no significant differences in UDI-6 scores (24.3 ± 25.3 for the successful primary TOT group versus 29.5 ± 27.2 for the secondary TVT group, <em>p</em> = 0.44). Rates of stress urinary incontinence, urgency urinary incontinence, and voiding dysfunction were also comparable between the groups. There were no surgical complications in the secondary TVT group.</div></div><div><h3>Conclusion</h3><div>Quality of life, as assessed by the UDI-6 inventory, and rates of urinary symptoms were similar in the secondary TVT and successful primary TOT groups. The secondary TVT procedure may present a favorable surgical option for treating recurrent SUI after failed primary TOT.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108778"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-13DOI: 10.1016/j.maturitas.2025.108751
Amber Sacre , Conor Wall , Alan Godfrey , Victoria Hetherington , Andrew Byrne , Robert Barber
Introduction
Digital technologies are increasingly used in the delivery of health and social care, and by the public, to foster a decentralised approach to healthcare provision and encourage self-management. If new technologies and related innovations are to support people with dementia, it is important to understand the views and needs of people with dementia alongside those of their carers, but this is an under-researched area. This study focuses on how smartphones are used by people with dementia and their carers.
Objectives
To undertake a national survey of people with dementia and their carers to explore their experiences and opinions relating to the use of smartphones by people with dementia.
Study design
We conducted a cross-sectional survey (12 questions) with participants recruited via two UK-based dementia research registries. Descriptive and inferential statistics assessed smartphone ownership, usage patterns, and challenges.
Results
There were 719 respondents (276 people with dementia, 443 carers). Amongst smartphone owners (47.7 %), only 39.4 % used these devices for dementia management: 89 people with dementia and 19 carers (reporting for people with dementia), mainly for memory support. Overall, 52.8 % used smartphones for safety and independence, primarily specifically for communication (128 people with dementia, 44 carers). Key barriers included setup difficulty (people with dementia) and complexity concerns (non-owners), with moderate concerns over fraud and theft.
Conclusion
Smartphones are underused in dementia care. Improving usability, nuanced smartphone functionality (and app co-design), and enhancing accessibility are essential to reducing digital exclusion and improving care engagement.
{"title":"Smartphone use by people with dementia: An exploratory survey","authors":"Amber Sacre , Conor Wall , Alan Godfrey , Victoria Hetherington , Andrew Byrne , Robert Barber","doi":"10.1016/j.maturitas.2025.108751","DOIUrl":"10.1016/j.maturitas.2025.108751","url":null,"abstract":"<div><h3>Introduction</h3><div>Digital technologies are increasingly used in the delivery of health and social care, and by the public, to foster a decentralised approach to healthcare provision and encourage self-management. If new technologies and related innovations are to support people with dementia, it is important to understand the views and needs of people with dementia alongside those of their carers, but this is an under-researched area. This study focuses on how smartphones are used by people with dementia and their carers.</div></div><div><h3>Objectives</h3><div>To undertake a national survey of people with dementia and their carers to explore their experiences and opinions relating to the use of smartphones by people with dementia.</div></div><div><h3>Study design</h3><div>We conducted a cross-sectional survey (12 questions) with participants recruited via two UK-based dementia research registries. Descriptive and inferential statistics assessed smartphone ownership, usage patterns, and challenges.</div></div><div><h3>Results</h3><div>There were 719 respondents (276 people with dementia, 443 carers). Amongst smartphone owners (47.7 %), only 39.4 % used these devices for dementia management: 89 people with dementia and 19 carers (reporting for people with dementia), mainly for memory support. Overall, 52.8 % used smartphones for safety and independence, primarily specifically for communication (128 people with dementia, 44 carers). Key barriers included setup difficulty (people with dementia) and complexity concerns (non-owners), with moderate concerns over fraud and theft.</div></div><div><h3>Conclusion</h3><div>Smartphones are underused in dementia care. Improving usability, nuanced smartphone functionality (and app co-design), and enhancing accessibility are essential to reducing digital exclusion and improving care engagement.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"203 ","pages":"Article 108751"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-17DOI: 10.1016/j.maturitas.2025.108732
Xiaojun Meng , Bolin Yang , Jibiao Chen , Chenlu He , Hanlu Yin , Jing Gu , Zhuping Xu , Yayong Ji
Background
Although intrinsic capacity (IC) has been evaluated among community-dwelling older people, IC among older people living with HIV (PLHIV) remains underexplored. This study investigated IC impairment and associated factors in older PLHIV in mainland China.
Methods
This cross-sectional study, conducted in China, enrolled older PLHIV aged ≥50 years. IC was assessed using detailed scales covering the domains of locomotion, vitality, cognition, psychology, and sensory capacity. Logistic regression analyses were used to explore the determinants of IC impairment in this population.
Results
Among 830 participants, 26.4 % (219/830) had impairment in at least one domain. A higher risk of IC impairment was associated with age ≥ 70 years (OR 2.44, 95 % CI 1.56–3.81), living with family members (OR 1.83, 95 % CI 1.24–2.69), being overweight or obese (OR 1.45, 95 % CI 1.03–2.04), impaired family function (OR 2.46, 95 % CI 1.65–3.66), and a high level of loneliness (OR 1.52, 95 % CI 1.04–2.24). In contrast, participants who were less likely to have IC impairment included those with an average monthly income ≥5000 RMB (OR 0.52, 95 % CI 0.32–0.86), those who exercised more than twice per week (OR 0.59, 95 % CI 0.42–0.82), and those with a baseline CD4+ T cell count ≥200 cells/μL (OR 0.70, 95 % CI 0.50–0.98).
Conclusion
It is evident that some PLHIV are experiencing impairments across various domains. Formulating policies to support early preventive interventions and to provide timely medical intervention when needed is essential for promoting healthy ageing among older PLHIV.
背景：虽然已经对社区居住老年人的内在能力（IC）进行了评估，但对感染艾滋病毒（PLHIV）的老年人的内在能力（IC）的研究仍然不足。本研究调查了中国大陆老年PLHIV患者的IC损伤及其相关因素。方法：这项横断面研究在中国进行，纳入年龄≥50岁的老年PLHIV。IC的评估采用详细的量表，涵盖运动、活力、认知、心理和感觉能力等领域。Logistic回归分析用于探索该人群中IC损伤的决定因素。结果：在830名参与者中，26.4%（219/830）至少在一个领域有损伤。较高的IC损伤风险与年龄≥70岁（OR 2.44, 95% CI 1.56-3.81）、与家庭成员一起生活（OR 1.83, 95% CI 1.24-2.69）、超重或肥胖（OR 1.45, 95% CI 1.03-2.04）、家庭功能受损（OR 2.46, 95% CI 1.65-3.66）和高度孤独（OR 1.52, 95% CI 1.04-2.24）相关。相比之下，不太可能发生IC损伤的参与者包括平均月收入≥5000元（OR 0.52, 95% CI 0.32-0.86），每周锻炼两次以上（OR 0.59, 95% CI 0.42-0.82）和基线CD4+ T细胞计数≥200细胞/μL （OR 0.70, 95% CI 0.50-0.98）的参与者。结论：很明显，一些PLHIV在各个领域都经历了损伤。制定政策，支持早期预防干预，并在需要时提供及时的医疗干预，对于促进艾滋病毒携带者老年人健康老龄化至关重要。
{"title":"Evaluation of intrinsic capacity impairment and associated factors in older people living with HIV in China","authors":"Xiaojun Meng , Bolin Yang , Jibiao Chen , Chenlu He , Hanlu Yin , Jing Gu , Zhuping Xu , Yayong Ji","doi":"10.1016/j.maturitas.2025.108732","DOIUrl":"10.1016/j.maturitas.2025.108732","url":null,"abstract":"<div><h3>Background</h3><div>Although intrinsic capacity (IC) has been evaluated among community-dwelling older people, IC among older people living with HIV (PLHIV) remains underexplored. This study investigated IC impairment and associated factors in older PLHIV in mainland China.</div></div><div><h3>Methods</h3><div>This cross-sectional study, conducted in China, enrolled older PLHIV aged ≥50 years. IC was assessed using detailed scales covering the domains of locomotion, vitality, cognition, psychology, and sensory capacity. Logistic regression analyses were used to explore the determinants of IC impairment in this population.</div></div><div><h3>Results</h3><div>Among 830 participants, 26.4 % (219/830) had impairment in at least one domain. A higher risk of IC impairment was associated with age ≥ 70 years (OR 2.44, 95 % CI 1.56–3.81), living with family members (OR 1.83, 95 % CI 1.24–2.69), being overweight or obese (OR 1.45, 95 % CI 1.03–2.04), impaired family function (OR 2.46, 95 % CI 1.65–3.66), and a high level of loneliness (OR 1.52, 95 % CI 1.04–2.24). In contrast, participants who were less likely to have IC impairment included those with an average monthly income ≥5000 RMB (OR 0.52, 95 % CI 0.32–0.86), those who exercised more than twice per week (OR 0.59, 95 % CI 0.42–0.82), and those with a baseline CD4<sup>+</sup> T cell count ≥200 cells/μL (OR 0.70, 95 % CI 0.50–0.98).</div></div><div><h3>Conclusion</h3><div>It is evident that some PLHIV are experiencing impairments across various domains. Formulating policies to support early preventive interventions and to provide timely medical intervention when needed is essential for promoting healthy ageing among older PLHIV.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108732"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endometrial cancer is the most common gynecological malignancy in developed countries, mainly affecting older women and raising concerns about potential under-treatment. This study aimed to describe treatment patterns and assess net survival in older women with early-stage endometrial cancer.
Study design
This French retrospective observational study used a gynecological cancer registry. Patients diagnosed with FIGO I-II endometrial cancer from 1998 to 2018 were included and stratified by age (a younger group, under 70 years, and an older group, aged 70 years or more). A multiple penalized splines model was used.
Results
A total of 828 patients were included: 448 women aged under 70 and 380 aged 70 or more. Older patients belonged to higher-risk groups as defined by ESGO-ESTRO-ESP 2021 criteria (p < 0.001) and had a lower rate of low-grade endometrioid carcinoma (75.1 % vs. 85.7 %, p = 0.003). Treatment patterns did not differ by age; surgery plus adjuvant therapy remained the main treatment (69.7 % vs. 70.8 % in the older and younger groups, respectively, p = 0.87). 5-year net survival was 95.0 % (95 % CI: 92.6–97.6) for younger and 84.3 % (95 % CI: 78.8–90.3) for older women. The univariate hazard ratio for death in older vs. younger women was 2.38 (95 % CI: 1.19–4.74; p = 0.02). Multivariate analysis attenuated age's effect: hazard ratio 1.38 (95 % CI: 0.97–3.31; p = 0.06). Charlson Comorbidity Index and non-low-grade endometrioid histology predicted poorer survival. Diagnosis period was not associated with survival.
Conclusion
No significant difference in treatment was found according to age. Although age was associated with 5-year net survival in univariate analysis, this association was no longer observed after adjusting for diagnosis period, comorbidities, and histology.
{"title":"Are older women with early-stage endometrial cancer undertreated and more likely to die from their cancer?","authors":"Jeremy Barben , Ariane Mamguem Kamga , Adrien Guilloteau , Valerie Quipourt , Leila Bengrine-Lefevre , Tienhan Sandrine Dabakuyo-Yonli","doi":"10.1016/j.maturitas.2025.108741","DOIUrl":"10.1016/j.maturitas.2025.108741","url":null,"abstract":"<div><div>Endometrial cancer is the most common gynecological malignancy in developed countries, mainly affecting older women and raising concerns about potential under-treatment. This study aimed to describe treatment patterns and assess net survival in older women with early-stage endometrial cancer.</div></div><div><h3>Study design</h3><div>This French retrospective observational study used a gynecological cancer registry. Patients diagnosed with FIGO I-II endometrial cancer from 1998 to 2018 were included and stratified by age (a younger group, under 70 years, and an older group, aged 70 years or more). A multiple penalized splines model was used.</div></div><div><h3>Results</h3><div>A total of 828 patients were included: 448 women aged under 70 and 380 aged 70 or more. Older patients belonged to higher-risk groups as defined by ESGO-ESTRO-ESP 2021 criteria (<em>p</em> < 0.001) and had a lower rate of low-grade endometrioid carcinoma (75.1 % vs. 85.7 %, <em>p</em> = 0.003). Treatment patterns did not differ by age; surgery plus adjuvant therapy remained the main treatment (69.7 % vs. 70.8 % in the older and younger groups, respectively, <em>p</em> = 0.87). 5-year net survival was 95.0 % (95 % CI: 92.6–97.6) for younger and 84.3 % (95 % CI: 78.8–90.3) for older women. The univariate hazard ratio for death in older vs. younger women was 2.38 (95 % CI: 1.19–4.74; <em>p</em> = 0.02). Multivariate analysis attenuated age's effect: hazard ratio 1.38 (95 % CI: 0.97–3.31; <em>p</em> = 0.06). Charlson Comorbidity Index and non-low-grade endometrioid histology predicted poorer survival. Diagnosis period was not associated with survival.</div></div><div><h3>Conclusion</h3><div>No significant difference in treatment was found according to age. Although age was associated with 5-year net survival in univariate analysis, this association was no longer observed after adjusting for diagnosis period, comorbidities, and histology.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108741"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-10-09DOI: 10.1016/j.maturitas.2025.108748
Jerry S. Lanchbury , Holly J. Pederson
In a previous commentary, “An apparent quandary: adoption of polygenics and gene panels for personalized breast cancer risk stratification,” we highlighted the exceptional progress that had been made uncovering the polygenic risk component underpinning breast cancer susceptibility and drew attention to the critical challenges inherent in translating these advancements into measurable improvements in clinical care. Among the barriers to adoption discussed were the inherent biases in polygenic risk scores (PRS) developed in populations of largely European descent, the unpreparedness of professional societies for adoption, and the lack of education of current healthcare professionals and the cadres of those emerging from training. In this update, we focus on the substantial research advances that have been made and the cultural and practical transitions that have begun to position the field for delivering personalized preventive breast cancer services to all women. It is our perception that the discussion has moved from questions of establishing scientific validity to a focus on the development and application of practical operational solutions to better stratify risk. Additional issues raised are concerns over misuse, the composition of the single nucleotide polymorphism (SNPs) panels used and adjustment for non-European populations. High-risk breast clinics will benefit dramatically from models that incorporate genome-wide susceptibility genetics. Improved risk estimation may aid in patients' decisions about preventive medication and in clinical decisions concerning the need for and frequency of MRI screening, and, in exceptional cases, may even help patients at hereditary risk with surgical decision-making.
{"title":"Polygenic risk scores for breast cancer: Progress, challenges, and clinical integration","authors":"Jerry S. Lanchbury , Holly J. Pederson","doi":"10.1016/j.maturitas.2025.108748","DOIUrl":"10.1016/j.maturitas.2025.108748","url":null,"abstract":"<div><div>In a previous commentary, “An apparent quandary: adoption of polygenics and gene panels for personalized breast cancer risk stratification,” we highlighted the exceptional progress that had been made uncovering the polygenic risk component underpinning breast cancer susceptibility and drew attention to the critical challenges inherent in translating these advancements into measurable improvements in clinical care. Among the barriers to adoption discussed were the inherent biases in polygenic risk scores (PRS) developed in populations of largely European descent, the unpreparedness of professional societies for adoption, and the lack of education of current healthcare professionals and the cadres of those emerging from training. In this update, we focus on the substantial research advances that have been made and the cultural and practical transitions that have begun to position the field for delivering personalized preventive breast cancer services to all women. It is our perception that the discussion has moved from questions of establishing scientific validity to a focus on the development and application of practical operational solutions to better stratify risk. Additional issues raised are concerns over misuse, the composition of the single nucleotide polymorphism (SNPs) panels used and adjustment for non-European populations. High-risk breast clinics will benefit dramatically from models that incorporate genome-wide susceptibility genetics. Improved risk estimation may aid in patients' decisions about preventive medication and in clinical decisions concerning the need for and frequency of MRI screening, and, in exceptional cases, may even help patients at hereditary risk with surgical decision-making.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108748"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-08DOI: 10.1016/j.maturitas.2025.108717
Xiang Qi
{"title":"Concerns regarding prevalence estimates reported in the paper “Motoric cognitive risk syndrome and epigenetic aging”","authors":"Xiang Qi","doi":"10.1016/j.maturitas.2025.108717","DOIUrl":"10.1016/j.maturitas.2025.108717","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108717"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-08-30DOI: 10.1016/j.maturitas.2025.108714
Vesa Putkinen , Elina Lewandowski , Severi Santavirta , Lauri Nummenmaa
Objectives
Faces and bodies serve as important cues of physical attractiveness and reproductive fitness. Previous studies indicate that there are sex-related differences in the visual processing of erotic stimuli. We investigated gaze patterns and sex differences during sexual perception.
Study design
We measured the eye movements of 43 male and 67 female subjects while viewing sexual scenes (intercourse; Experiment 1) and static erotic stimuli (nude and clothed men and women; Experiment 2) in a cross-sectional study.
Main outcome measures
For each region of interest (ROI; face, chest, genitals, back) we computed mean pupil size, gaze duration, first fixation latency and first fixation duration. Intersubject correlation of eye movements (eISC) was computed to assess similarity of gaze patterns across viewers.
Results
Dwell times were the longest for faces and faces were the most likely to be looked at first. In Experiment 1, males looked more at female chest, buttocks, and genital areas while female participants looked more at male faces. In Experiment 2, faces received more fixations for clothed stimuli, whereas chest and genital areas received more fixations for nude stimuli.
Conclusions
Sex differences during sexual perception are larger for static versus dynamic stimuli. Faces are prioritized over sexual signals, and visibility of sexual cues increases saliency of the sexually relevant body regions. The preference for faces even when viewing sexual intercourse may reflect both the importance of facial characteristics in mate selection as well as the role of facial expressions in evaluating partner satisfaction while having sex.
{"title":"Sex differences in gaze patterns while viewing dynamic and static sexual scenes","authors":"Vesa Putkinen , Elina Lewandowski , Severi Santavirta , Lauri Nummenmaa","doi":"10.1016/j.maturitas.2025.108714","DOIUrl":"10.1016/j.maturitas.2025.108714","url":null,"abstract":"<div><h3>Objectives</h3><div>Faces and bodies serve as important cues of physical attractiveness and reproductive fitness. Previous studies indicate that there are sex-related differences in the visual processing of erotic stimuli. We investigated gaze patterns and sex differences during sexual perception.</div></div><div><h3>Study design</h3><div>We measured the eye movements of 43 male and 67 female subjects while viewing sexual scenes (intercourse; Experiment 1) and static erotic stimuli (nude and clothed men and women; Experiment 2) in a cross-sectional study.</div></div><div><h3>Main outcome measures</h3><div>For each region of interest (ROI; face, chest, genitals, back) we computed mean pupil size, gaze duration, first fixation latency and first fixation duration. Intersubject correlation of eye movements (eISC) was computed to assess similarity of gaze patterns across viewers.</div></div><div><h3>Results</h3><div>Dwell times were the longest for faces and faces were the most likely to be looked at first. In Experiment 1, males looked more at female chest, buttocks, and genital areas while female participants looked more at male faces. In Experiment 2, faces received more fixations for clothed stimuli, whereas chest and genital areas received more fixations for nude stimuli.</div></div><div><h3>Conclusions</h3><div>Sex differences during sexual perception are larger for static versus dynamic stimuli. Faces are prioritized over sexual signals, and visibility of sexual cues increases saliency of the sexually relevant body regions. The preference for faces even when viewing sexual intercourse may reflect both the importance of facial characteristics in mate selection as well as the role of facial expressions in evaluating partner satisfaction while having sex.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108714"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-10-04DOI: 10.1016/j.maturitas.2025.108745
Shin Who Park , Woo Chul Son , Miji Kim , Chang Won Won , Won Kim
Introduction
Previous studies have examined the relationship between endogenous testosterone and cognitive function, but findings have been inconsistent. Additionally, the sex-specific effects of free testosterone (FT) on various cognitive domains in adults who are older, especially within Asian populations, remain under investigation.
Methods
This cross-sectional study involved 2710 Korean adults aged 70–84 participating in the Korean Frailty and Aging Cohort Study. Serum FT levels were measured and categorized into quartiles. Cognitive function was evaluated using the Mini-Mental State Examination – Korean version (MMSE-KC), the Korean version of the CERAD battery, Trail Making Test-A (TMT), Digit Span (DS), Word List Memory test, and the Frontal Assessment Battery (FAB). Multivariable logistic and quantile regression analyses were adjusted for age, education, lifestyle factors, depressive disorder, and physical performance.
Results
In women, lower FT levels were independently linked with impairments in the MMSE-KC, TMT, FAB, and Word List Memory test. Compared with higher FT quartiles, the lowest quartile had significantly increased odds ratios of 1.36, 1.34, 1.39, and 1.52 for these tests, respectively. Pairwise comparisons between quartiles showed that women in the lowest FT quartile performed significantly worse on the MMSE-KC and Word List Memory test than those in the highest quartile. In men, however, no significant associations were identified.
Conclusions
This population-based cross-sectional study of older Korean adults found that lower serum FT levels were independently associated with cognitive impairments across multiple domains in women but not men. These findings highlight FT's potential role in cognitive impairment, particularly among women.
以前的研究已经研究了内源性睾酮和认知功能之间的关系，但结果并不一致。此外，游离睾酮（FT）对老年人各种认知领域的性别特异性影响，特别是在亚洲人群中，仍在研究中。方法本横断面研究涉及2710名年龄在70-84岁的韩国成年人，他们参加了韩国虚弱和老龄化队列研究。测定血清FT水平并将其分为四分位数。认知功能评估采用简易精神状态测试-韩文版（MMSE-KC）、韩文版CERAD测试、轨迹测试- a （TMT）、数字广度测试（DS）、单词列表记忆测试和正面评估测试（FAB）。对年龄、教育程度、生活方式因素、抑郁障碍和身体表现进行多变量logistic和分位数回归分析。结果在女性中，较低的FT水平与MMSE-KC、TMT、FAB和单词表记忆测试的损伤独立相关。与高FT四分位数相比，最低四分位数的比值比显著增加，分别为1.36、1.34、1.39和1.52。四分位数之间的两两比较表明，FT最低四分位数的女性在MMSE-KC和单词列表记忆测试中的表现明显低于最高四分位数的女性。然而，在男性中，没有发现明显的关联。结论：这项针对韩国老年人的基于人群的横断面研究发现，较低的血清FT水平与女性多个领域的认知障碍独立相关，而与男性无关。这些发现突出了FT在认知障碍中的潜在作用，尤其是在女性中。
{"title":"Free testosterone and cognitive function: Sex-specific links in adults in the nationwide Korean frailty and aging cohort","authors":"Shin Who Park , Woo Chul Son , Miji Kim , Chang Won Won , Won Kim","doi":"10.1016/j.maturitas.2025.108745","DOIUrl":"10.1016/j.maturitas.2025.108745","url":null,"abstract":"<div><h3>Introduction</h3><div>Previous studies have examined the relationship between endogenous testosterone and cognitive function, but findings have been inconsistent. Additionally, the sex-specific effects of free testosterone (FT) on various cognitive domains in adults who are older, especially within Asian populations, remain under investigation.</div></div><div><h3>Methods</h3><div>This cross-sectional study involved 2710 Korean adults aged 70–84 participating in the Korean Frailty and Aging Cohort Study. Serum FT levels were measured and categorized into quartiles. Cognitive function was evaluated using the Mini-Mental State Examination – Korean version (MMSE-KC), the Korean version of the CERAD battery, Trail Making Test-A (TMT), Digit Span (DS), Word List Memory test, and the Frontal Assessment Battery (FAB). Multivariable logistic and quantile regression analyses were adjusted for age, education, lifestyle factors, depressive disorder, and physical performance.</div></div><div><h3>Results</h3><div>In women, lower FT levels were independently linked with impairments in the MMSE-KC, TMT, FAB, and Word List Memory test. Compared with higher FT quartiles, the lowest quartile had significantly increased odds ratios of 1.36, 1.34, 1.39, and 1.52 for these tests, respectively. Pairwise comparisons between quartiles showed that women in the lowest FT quartile performed significantly worse on the MMSE-KC and Word List Memory test than those in the highest quartile. In men, however, no significant associations were identified.</div></div><div><h3>Conclusions</h3><div>This population-based cross-sectional study of older Korean adults found that lower serum FT levels were independently associated with cognitive impairments across multiple domains in women but not men. These findings highlight FT's potential role in cognitive impairment, particularly among women.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108745"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-09-02DOI: 10.1016/j.maturitas.2025.108715
C. Tamer Erel , Meletios P. Nigledis , Ipek Betul Ozcivit Erkan , Dimitrios G. Goulis , Peter Chedraui , Andrea Giannini , Ludwig Kiesel , Nancy Phillips , Tommaso Simoncini , Eleni Armeni , Judith Boban , Iuliana Ceausu , Timothy Hillard , Irene Lambrinoudaki , Antonina Smetnik , Marina Sprem Goldstajn , Petra Stute , Dorenda van Dijken , Margaret Rees
Introduction
Endometriosis is a common gynecological condition, and problems may persist or develop after the menopause. Endometriosis or its treatment in premenopausal women may lead to premature or early menopause. Thus, it is imperative that healthcare providers are appropriately trained in management of endometriosis at the menopause and beyond.
Aim
To provide an evidence-based clinical guide for the assessment and management of menopausal health in women with a history of endometriosis.
Materials and methods
Review of the literature and consensus of expert opinion.
Summary recommendations
Surgery is the preferred option for managing symptomatic endometriosis after the menopause, as it should reduce pain, ensure an accurate diagnosis, and decrease risk of malignancy. Women with endometriosis may experience a spontaneous early menopause or surgically induced menopause. Endometriosis is also associated with an increased risk of cardiovascular disease, ovarian, breast, and thyroid cancers, as well as osteoporosis. Menopausal hormone therapy (MHT) is indicated for managing vasomotor and genitourinary symptoms and maintaining bone health. Continuous combined MHT may be safer than other forms in both hysterectomized and non-hysterectomized women with endometriosis as the risk of recurrence and malignant transformation of residual endometriosis may be reduced. Estrogen-only MHT should be avoided, even for women who have had a hysterectomy. For women not using MHT, alternative pharmacological treatments, such as neurokinin-3 receptor antagonists, should be considered for managing vasomotor symptoms. Additionally, antiresorptive and anabolic therapies, along with calcium and vitamin D supplementation, should be provided as indicated to ensure skeletal protection. If endometriosis recurs during MHT use and the patient is symptomatic, several management strategies may be employed: altering the regimen, discontinuation, and use of non-hormonal strategies. Herbal preparations should be avoided as their efficacy is uncertain and some may contain estrogenic compounds.
{"title":"Endometriosis and menopausal health: An EMAS clinical guide","authors":"C. Tamer Erel , Meletios P. Nigledis , Ipek Betul Ozcivit Erkan , Dimitrios G. Goulis , Peter Chedraui , Andrea Giannini , Ludwig Kiesel , Nancy Phillips , Tommaso Simoncini , Eleni Armeni , Judith Boban , Iuliana Ceausu , Timothy Hillard , Irene Lambrinoudaki , Antonina Smetnik , Marina Sprem Goldstajn , Petra Stute , Dorenda van Dijken , Margaret Rees","doi":"10.1016/j.maturitas.2025.108715","DOIUrl":"10.1016/j.maturitas.2025.108715","url":null,"abstract":"<div><h3>Introduction</h3><div>Endometriosis is a common gynecological condition, and problems may persist or develop after the menopause. Endometriosis or its treatment in premenopausal women may lead to premature or early menopause. Thus, it is imperative that healthcare providers are appropriately trained in management of endometriosis at the menopause and beyond.</div></div><div><h3>Aim</h3><div>To provide an evidence-based clinical guide for the assessment and management of menopausal health in women with a history of endometriosis.</div></div><div><h3>Materials and methods</h3><div>Review of the literature and consensus of expert opinion.</div></div><div><h3>Summary recommendations</h3><div>Surgery is the preferred option for managing symptomatic endometriosis after the menopause, as it should reduce pain, ensure an accurate diagnosis, and decrease risk of malignancy. Women with endometriosis may experience a spontaneous early menopause or surgically induced menopause. Endometriosis is also associated with an increased risk of cardiovascular disease, ovarian, breast, and thyroid cancers, as well as osteoporosis. Menopausal hormone therapy (MHT) is indicated for managing vasomotor and genitourinary symptoms and maintaining bone health. Continuous combined MHT may be safer than other forms in both hysterectomized and non-hysterectomized women with endometriosis as the risk of recurrence and malignant transformation of residual endometriosis may be reduced. Estrogen-only MHT should be avoided, even for women who have had a hysterectomy. For women not using MHT, alternative pharmacological treatments, such as neurokinin-3 receptor antagonists, should be considered for managing vasomotor symptoms. Additionally, antiresorptive and anabolic therapies, along with calcium and vitamin D supplementation, should be provided as indicated to ensure skeletal protection. If endometriosis recurs during MHT use and the patient is symptomatic, several management strategies may be employed: altering the regimen, discontinuation, and use of non-hormonal strategies. Herbal preparations should be avoided as their efficacy is uncertain and some may contain estrogenic compounds.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"202 ","pages":"Article 108715"},"PeriodicalIF":3.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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